DISSERTATION VIVA-VOCE

Guided By,
Prof. Mrs.Rani . P , M.Sc(N),

Presented by

Principal,

Reg No: 13325004

Sruthi College of Nursing, Guntur.

Ms. B. Sirisha,

Co-Guided By,

II-Year, M.Sc(N),

Mr. Selvaraj, M.Sc(N),

Sruthi College of Nursing,

Reader,

Guntur.

Sruthi College of Nursing, Guntur.

Anxiety does
not empty
tomorrow of
its sorrows,
but only
empties
today of its
strength.
Charles
Spurgeon

INTRODUCTION
Everyone experience anxiety about the future is part of
being human and helps us plan ahead and make better
decisions. Some anxiety is normal and even productive.
However, when anxiety becomes disruptive and disabling to
a persons life, it is considered an unhealthy psychiatric
disorder.
National Health Interview Survey shows that 39% of people
over 65 years of age suffer from some limitation of activity
due to chronic conditions and 11% are unable to carryout
major activities because of their anxiety towards illness and
also they suffer from some kind of anxiety disorders.

NEED FOR THE STUDY

Many researchers have stated that Anxiety is
uncontrollable and ambiguity is more stressful for a
geriatric, which can be predicted, modified or
terminated. Nurses being the central figure in a
geriatric care can help to identify the level of anxiety
and provide opportunity for these people to cope with
the stressful situation.
The researcher personally felt from the experience that old
age people that need to be relieved from the anxiety by
using progressive muscle relaxation technique which is
effective in reducing anxiety by alternately tensing and
relaxing the muscles. So the researcher is interested to
conduct this study which may mutually benefit the old age
people and also the society.

STATEMENT OF THE PROBLEM

A study to evaluate the effectiveness of

progressive muscle relaxation technique on
anxiety among old age people in selected
community areas, Ponnur.

OBJECTIVES
To assess the level of anxiety among experimental and
control group before giving progressive muscle relaxation
exercise.
To assess the level of anxiety among experimental and
control group after giving progressive muscle relaxation
exercise.
To compare the pre test and post test level of anxiety in
experimental and control group
To evaluate the effectiveness of progressive muscle
relaxation exercise in experimental group.
To find out the association between anxiety and selected
demographic variables among experimental and control
group.

OPERATIONAL
DEFINITIONS
OPERATIONAL DEFINITIONS
Anxiety
It refers to mental or emotional tension associated
with feelings of uncertainty and helplessness.
Effectiveness
In this study it refers to the extent to which
progressive muscle relaxation exercise reduces the
anxiety among old age people.
Evaluate
It refers to assess or determine the effectiveness of
progressive muscle relaxation exercise.

OPERATIONAL
DEFINITIONS
OPERATIONAL DEFINITIONS
Progressive muscle relaxation
It refers to a technique for reducing anxiety by
alternately tensing and relaxing the muscles.
Old age people
Old age people refers to individuals whose age is 60
years and above of both sex.

HYPOTHESIS
H1: There will be a statistically significant
difference in anxiety level after giving progressive
muscle relaxation exercise among experimental
group.
H2: There will be a statistically significant association
between anxiety with selected demographic variables
among experimental and control group.

ASSUMPTIONS
Old age people will have certain level of anxiety
Progressive muscle relaxation technique will help to reduce
the level of anxiety

DELIMITATIONS
Study is delimited to:
Old age people who are available at data collection only.
Old age people who are willing to participate in the study only.
Old age people who can understand Telugu and English only.
Sample size of 60 Old age people with 60 years and above only.
6 weeks of data collection procedure.

CONCEPTUAL FRAMEWORK

REVIEW OF LITERATURE
The review of literature is systematic and
critical review of the most important published
and unpublished data based on the material found
in print and non print forms. The related
literature for the present study has been discussed
under following sections
Section A: Literature related to anxiety disorders
among elderly.
Section B: Literature related to efficacy of progressive
muscle relaxation technique.

METHODOLOGY
Research Approach:
Research Design:
group design.

A quantitative research approach

Quasi experimental Non equivalent control

GROUP

PRETEST

INTERVENTION

POSTTEST

Experimental
Group

01

02

Control Group

01

--

02

Key:
O1: Pretest level of anxiety among samples.
X: Progressive muscle relaxation technique teaching and
demonstration.
O2: Post test level of anxiety among samples.

METHODOLOGY
Setting: Community Health Centre, located at Ponnur. Ponnur is an
urban slum area which is located 6 kilometres away from Guntur with
the population of 3000.
Population:
The population in the present study includes old age people above 60
years in Ponnur.
Sample:
Samples of the study are aged 60 and above 60 years who are available
during the data collection in Ponnur.
Sample Size & Sampling Technique:
The sample size of the study is 60 old age people (experimental
group=30, control group=30)
from
selected community areas,
Ponnur by using non probability purposive sampling technique

METHODOLOGY
Criteria for Sample Selection:
Inclusion criteria
Old age people who are available at the time of data collection.
Old age people who are willing to participate in the study.
Old age people who can understand Telugu and English
Old age people with 60 years and above of both sex.

Exclusion criteria
The old age people who are unable to hear.
The old age people who are not willing to participate in the study.

The old age people who are practicing other relaxation technique.

The old age people who have muscular disorders.

METHODOLOGY
VARIABLES:
Dependant variable

: Level of anxiety.

Independent variable

: Progressive muscle relaxation

technique.
Extraneous variables

: Age, gender, income, religion,

marital status, type of family, dietary pattern

DESCRIPTION OF THE TOOL

Part I:It consists of Socio demographic Variables such as age,
gender, income, religion, marital status, type of family, dietary
pattern
Part II: Hamilton Anxiety Rating Scale.
It is used to assess the level of anxiety among old age
people from selected community areas, Ponnur.
Scoring key: Each item is scored independently based on a five-point,
ratio scale. Sum the scores from all 14 parameters
0

Not Present

Mild

Moderate

3
4

Score

Level of Anxiety

14-17

Mild Anxiety

18-24

Moderate Anxiety

25-30

Severe Anxiety

Severe
Very Severe

 PART III: PROGRESSIVE MUSCLE RELAXATION TECHNIQUE

It consists of 10 steps.

RELIABILITY
The reliability of the present study tool was
established by split half method by using the
spear brown prophecy formula = 2r/1+r and the
r value was obtained and reliability was
calculated.
The reliability of the tool was found to be
r= 0.9, 1 which indicates the tool was reliable.
The samples used for testing reliability were not
included in the main study.

PILOT STUDY
After getting permission from the medical officer to conduct study in
Ponnur and consent from participants, the pilot study was conducted
among 6 old age people. The subjects were selected by using
purposive sampling technique. 3 subjects were assigned to
experimental group and 3 subjects to control group. Pre test was done
by administering Hamilton anxiety rating scale for both in
experimental and control group. The intervention Progressive muscle
relaxation technique was given for 1 week from 5/1/15 to 10/1/15 in
the experimental group, without intervention in control group. Post
test was conducted on 7th day to assess the effectiveness of
progressive muscle relaxation technique on anxiety. After conducting
the pilot study, the study was found to be feasible. Tool was found to
be reliable.

DATA
COLLECTION PROCEDURE
DATA
COLLECTION
PROCEDURE
Data collection for the study was done in Selected community areas, Ponnur.
Researcher got permission from the concerned authority.
Population were identified (60 & above 60 old age people) by non probability
convenient sampling technique.
On day-1(03/02/15), Pre-test level of anxiety among samples were assessed.
On day-1(03/02/15), Progressive muscle relaxation technique teaching &
demonstration was given (7 days (03/02/15 to 09/02/15)3follow up was done).
On day-28(02/03/15), Post test level of anxiety was assessed

DATA ANALYSIS AND INTERPRETATION

The data has been analyzed and presented under the following
heading:
Section I: Frequency and percentage distribution of selected
demographic variables.
Section II: Mean and Standard deviation to determine the
effectiveness of progressive muscle relaxation technique on
reducing the level of anxiety among old age people in experimental
and control group.
Section III: Relationship between pre and post test effectiveness of
progressive muscle relaxation technique on reducing the level of
anxiety among old age people in experimental and control group.
Section IV: Association between the pre and post test effectiveness
of progressive muscle relaxation technique on reducing the level of
anxiety among old age people in experimental and control group
with selected demographic variables.

Section I: Demographic Characteristics

AGE
70
60

60
53.3

50
40
30

33.4

30

20

PERCENTAGE
10
0

10

13.3

60-65 years
66-70 years
71-75 years

GENDER
80
70
60
50
40

MALE
FEMALE

30

PERCENTAGE

20
10
0
23.2 76.7

26.773.3

INCOME
45 43.4
40

33.3

35
30

26.7

25

PERCENTAGE

20
20
15
10

2020

16.6
13.3

6.7

5
0

EXPERIMENTAL0GROUP

< Rs 5000
Rs 5001-7000
Rs 7001-9000
Rs 9001-11000
> 11000

RELIGION
100

93.4

90 83.3
80
70

HINDU
CHRISTIAN
MUSLIM
OTHERS

60

PERCENTAGE

50
40
30
20

13.4

10

3.3

3.3
3.3

EXPERIMENTAL
0
0GROUP

MARITAL STATUS
90
90

80
80
70
60
50

PERCENTAGE

40
30
20

10
6.7
10 6.7
3.33.3
0

EXPERIMENTAL0GROUP

MARRIED
UNMARRIED
WIDOW/WIDOWER
DIVORCED

TYPE OF FAMILY
80

73.3

70

70
60
50

PERCENTAGE

NUCLEAR
JOINT
EX TENDED

40
30

23.4

20
10
0

3.3

EXPERIMENTAL GROUP
30 0

DIETARY PATTERN
70
60
60
50
40
40

33.3
VEGETARIAN

30

NON VEGETARIAN
PERCENTAGE

20
10
0
66.7

Section II: Effectiveness of progressive muscle

relaxation technique on anxiety among old people in
experimental group
N= 30
S.No

Level of anxiety

Experimental group
Pre test

Post test

(%)

(%)

Mild

13.3

20

66.7

Moderate

26

86.7

10

33.3

Severe

Total

30

100

30

100

LEVEL OF ANXIETY- EXPERIMENTAL GROUP

90

80

66.7

70

60
PRE TEST

50

POST TEST

PERCENTAGE
40

30

20
13.3
10

MILD

MODERATE
86.7
33.3

0SEVERE0

Section II: Effectiveness of progressive muscle

relaxation technique on anxiety among old people in
Control group
N= 30
S.No

Level of anxiety

Control group
Pre test

Post test

(%)

(%)

Mild

16.6

10

Moderate

25

83.4

27

90

Severe

Total

30

100

30

100

LEVEL LOF ANXIETY CONTROL GROUP

90

80

70

60
2ND DAY

50

3RD DAY

PERCENTAGE
40

30

20

16.6
10

10

MILD

MODERATE
83.4
90

0SEVERE0

Section III: Comparison of pre-test and post-test level of

anxiety of old age people in experimental and control
group
N= 60
S.No

Group

Pre test
Mean

Post test

Standard

Mean

deviation
1

Experimental

20.13

3.63

Standard

Paired t
test

deviation
12.13

6.04

Group

C = 7.27
t = 1.69
s*

Control Group

19.3

3.8

20.16

3.34

C = 1.4
t = 1.69
NS

MEAN & STANDARD DEVIATION OF PRETEST & POSTTEST LEVEL OF ANXIETY OF OLD AGE PEOPLE IN EXPERIMENTAL & CONTROL GROUP
25

20.13
20

20.16

19.3

15
12.13
10
6.04
3.8

3.63

EXPERIMENTAL
GROUP
3.34
CONTROL GROUP

MEA
N

PRE TEST

POST TEST

STANDAR
PRE TEST
D
DEVIATIO
N

POST TEST

Section IV: Association between the effectiveness of

progressive muscle relaxation technique on anxiety
among old age people with their selected demographic
variables
Control Group:
There is significant association between age and marital
status
There is no significant association between gender,
income, religion, type of family, dietary pattern.

Experimental group:
There is no significant association between age, gender,
religion type o family, dietary pattern, income and
marital status.

DISCUSSION
It has been discussed based on the tabulation of
the data which is based on objectives of the
study.

Demographic Characteristics
1. Age, in experimental group 18 (60%) and in control group 16
(53.3%)were between 60 65 years.
2. Gender, in experimental group 23(76.7%) and in control group
22 (73.3%) were female.
3. Income, in experimental group 13 (43.4%) earn <Rs.5000 and
in control group 10 (33.3%) earn Rs. 9001- 11,000
4. Religion, in experimental group 25(83.3%) and in control group,
28 (93.4%) are Hindus.
5. Marital status, in experimental group 24 (80%) and in control
group 27 (90%) are married.
6. Type of family, in experimental group 22(73.3%) and in control
group 21 (70%) live in Nuclear family.
7. Dietary pattern, in experimental group 18 (60%) and in control
group 20(66.7%) were non vegetarians

Effectiveness of progressive muscle relaxation technique on

reducing the level of anxiety among old age people in
experimental and control group.
In experimental group
Pre-test
4 (13.3%) had mild level of anxiety
26 (86.7%) had moderate level of anxiety

Post test
20 (66.7%) have mild level of anxiety
10 (30%) have moderate level of anxiety.

In control group
Pre-test
5(16.6%) had mild level of anxiety
25 (83.4%) had moderate level of anxiety

Post test
3 (10%) have mild level of anxiety
27 (90%) have moderate level of anxiety.

Comparison of pre-test and post-test level of anxiety of old

age people in experimental and control group
In Experimental Group,
Pre test mean is 20.13 and standard deviation is 3.63
Post test mean is 12.13 and standard deviation is 6.04.
Calculated value of paired t test is 7.27 and the tabulate value is 1.69.
The calculated value is greater than tabulated value. hence the research
hypothesis is accepted.
In Control group,
Pre test mean is 19.3 and standard deviation is 3.8
Post test mean is 20.16 and standard deviation is 3.34
Calculated value of paired t test is 1.4 and the table value is 1.69.
The calculated value is less than the table value. Hence the null hypothesis
is accepted.
While comparing the data, the research hypothesis is accepted. So the
progressive muscle relaxation technique is effective in reducing the
anxiety levels in old age people.

Association between the effectiveness of progressive muscle

relaxation technique on anxiety among old age people with their
selected demographic variables

Control Group:
There is significant association between age and marital
status
There is no significant association between gender,
income, religion, type of family, dietary pattern.

Experimental group:
There is no significant association between age, gender,
religion type o family, dietary pattern, income and
marital status.

IMPLICATIONS
Nursing practice:
Progressive muscle relaxation technique is effective in
controlling the progression of anxiety disorder.
The progressive muscle relaxation technique quality of
care and the old age people life.
The study helps nurses to take care of old age people with
Anxiety
The interventions are cost effective.
Nursing education:
In education it helps the students to gain more insight
causes of anxiety, stress & other emotional problems of old
age people, how to reduces & come out from stress &
anxiety.

 Nursing administration:
The community health centre Medical Officer can plan
continuing nursing education programs to nurses and
include such topics to enhance knowledge of nurses.
Community Health Nurses should motivate the people to
involve in practicing the interventions.
Take necessary actions for publishing the articles related to
progressive muscle relaxation technique on anxiety to
reduce the anxiety level of old age people.
Nursing research
The study will be valuable reference and pathway for
future researcher
The findings can be generalized with the public in general
and health professional to understand more about the
importance regarding progressive muscle relaxation
technique on anxiety.

LIMITATIONS

The study was limited only to 60 & above 60 years old

age people.
Only to sample size of 60 old age people.
The study was limited only to selected areas at Ponnur.
RECOMMENDATIONS
On the basis of findings of the study the following
recommendations have been made: A similar study can be replicated on large sample, in different
settings with in different population as long term study.
The study can be conducted for old age people who are 60 or
above 60 years in old age home and hospital set up.

CONCLUSION

The purpose of the study was to assess the effectiveness

of progressive muscle relaxation technique on anxiety, in
terms of practice among old age people in a selected
community areas at Guntur. The pretest was conducted
and the score was inadequate. So it highlights the need
for education and the researcher has conducted
progressive muscle relaxation technique teaching &
demonstration programme. After progressive muscle
relaxation technique of teaching & demonstration the
mean post-test showed adequate practice that proved the
effectiveness of progressive muscle relaxation technique.