BFUNJ, Volume 11, Number 2, December 2016
23
RESEARCH ARTICLE EFFECTIVENESS OF DEEP BREATHING EXERCISES AND PROGRESSIVE MUSCLE RELAXATION TECHNIQUE ON STRESS AMONG AMPUTATED PATIENTS
'Kaur Manpreet 2KumarAnii 3Maheshwari Sushil Kumar
ABSTRACT INTRODUCTION: Amputation is the loss of a body pari, usually a finger, toe, arm or leg. People who have limb loss are at higher risk of depression or stress. Relaxation techniques are a great way to help with stress management such as deep breathing exercises and progressive muscle relaxation technique (PMRT). AIM: To assess the effectiveness of deep breathing exercises and progressive technique on stress among amputated patients in selected hospitals of Punjab.
muscle relaxation
MATERIAL & METHODS: A quasi experimental (two group pre test post test) research design was chosen for the study. Convenient sampling with random allocation technique was -used to select 60 amputated patients having stress. The subjects in experimental group (n=30) were provided deep breathing exercises and PMRT and conventional treatment and in control group (n=30) only conventional therapy was provided. Modified Perceived Stress Scale (PSS) and Socio demographic data sheet was used to collect the data. Deep breathing exercises and PMRT was provided twice a day for ten minutes for two weeks.
'Ex M.Sc. Nursing Student UCON, BFUHS, Faridkot 'Lecturer, UCON, BFUHS, Faridkot 'Assoclate Professor, UCON, BFUHS, Faridkot
RESULTS: There was significant difference in stress score after two weeks of deep breathing exercises and PMRT in experimental group (p value 0.026) as compared to control group. Stress had significant relationship with age, marital status, educational status, cause of amputation, site of amputation. CONCLUSION: The study concluded that deep breathing exercises and PMRT was effective in reducing stress among amputated patients after two weeks (twice for ten minutes) of intervention in experimental group. Stress was more often in above or equal to 56 years of age group, widow/widower, illiterate and amputation due to crush injury, having Above Knee Amputation (AKA). KEYWORDS: Stress, amputated patients, technique, perceived stress scale.
deep breathing
INTRODUCTION & BACKGROUND STUDY
exercises, progressive
OF THE
Amputation involves removal of body part, usually an extremity, often made necessary by progressive peripheral vascular disease (often a sequel of diabetes mellitus), fulminating gas gangrene, trauma, crushing injuries, burns, frostbite, electrical burns), congenital deformities, chronic osteomyelitis or malignant turner'. An amputation is a last resort when other treatments have failed. It have a considerable psychological impact like experience negative thoughts and emotions after an amputation. This is especially true in people who had an emergency amputation, as they did not have time to mentally prepare themselves forthe effects of surqery", Limb
loss
is one
of the
most
physically
and
psychologically devastating events that can happen to a person. The loss of a limb can have a considerable psychological impact. People who have had an amputation due to trauma also have an increased risk of developing post-traumatic stress disorder (PTSD).3 Literature reports that during the early posttraumatic
muscle relaxation
Address for Correspondence
MR. ANIL KUMAR Lecturer, University College of Nursing, BFUHS, Faridkot M. No. 9780008707 Email:
[email protected]
period, approximate 36-40% of the patients consulted the psychiatry clinic out of which 22% of these patients needed psychiatric supportive treatment for acute stress disorder after limb amputation. After the 6 month, 77 .2% had chronic and delayed post-traumatic stress disorder and needed psychiatric supportive treatment', Various therapies are available and tested for their efficacy to reduce stress associate with amputation. Tragea et al (2014) reported that relaxation breathing and progressive muscle relaxation twice a day for six weeks demonstrated significant benefits in the reduction of perceived stress. Rosaura PA et al (2015) concluded that breathing and biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms". Relaxation techniques are a great way to help with stress management. Relaxation is a process that decreases the effects of stress on your mind and body. Relaxation techniques can help you cope with everyday stress and with stress related to various health problems, such as cancer and pain?
BFUNJ, Volume 11, Number 2, December 2016 One method of progressive muscle relaxation is to start by tensing and relaxing the muscles in toes and progressjvely working way up to neck and head. It can also be started with head and neck and work down to toes. Tense the muscles for at least five seconds and then relax for 30 seconds, and repeat." Deep breathing is another the best ways to lower stress in the body." Breathing techniques helps to feel connected to the body-it brings your awareness away from the worries in the head and quiets the mind." Breathing methods are useful to settle the body and mind and induce a heightened sense of awareness." Present study aimed to assess the effectiveness of deep breathing exercises and progressive muscle relaxation technique on stress among amputated patients in selected hospitals of Punjab.
MATERIAL & METHODS Research Approach & Design: A quasi-experimental study with quantitative approach was done to assess the effectiveness of deep breathing exercises and progressive muscle relaxation technique on stress among amputated patients. Research setting: The present study was conducted at orthopaedic wards of GGS Medical College and Hospital Faridkot, Civil hospitals of Bathinda, Sri Muktsar Sahib and Ferozepur. Sample & Sampling technique: The sample for the study was 60 amputated patients and convenient sampling technique with random assignment was used to select the sample. The patients who had impaired cognitive abilities, patients who were already receiving counselling sessions to reduce stress were excluded from the study. Data Collection tools: After the selection of study subjects, identification profile of the patients was filled in the record Performa. Two tools were used to collect data from the subjects. I
Tool 1: Socio -Demographic profile of the patient which was prepared by the investigator under the guidance of guide and co- guide. It includes 14 variables such as
24 age, gender, religion, marital status, religion, residence, educational status, occupation, cause of amputation, site of amputation, type of anaesthesia, any previous history of amputation, presence of any other disease, and any history of addiction. Tool 2: Modified perceived stress scale which consist of 10 items. Each item is rated on a 5-point scale ranging from never (0) to almost always (4). Try out of the tools and intervention was done to ensure the reliability and understanding of the tool. Pilot study was conducted in orthopaedic ward of Guru Gobind Singh Medical Hospital, Faridkot to find feasibility of the study and was found to be feasible. Data Collection Procedure: As per the plan, stress level was assessed. After assessing the stress, intervention of deep breathing and PMRT was given twice (morning and evening) daily for ten minutes till two weeks to the experimental group. Post assessment of the stress was done after two week of intervention. Ethical Consideration: Ethical committee of University College of Nursing, BFUHS (Baba Farid University of Health Sciences) has approved the study plan. Permission was taken from the GGS Medical College and Hospital Faridkot, Civil hospitals of Bathinda, Sri Muktsar Sahib and Ferozpur. Written informed consent was taken from each study subject after informing them about study and its objectives. Freedom was provided to the participants for quitting in between of the study. Confidentiality and privacy of the study subjects was maintained throughout the study. Data Analysis: Statistical analysis was done by using SPSS (20) software. The descriptive statistics (percentage, mean, standard deviation) and in inferential statistics (independent t test, chi square, ANOVA test) was used for statistical analysis. The t-test and AN OVA were used to assess the effectiveness of provided deep breathing exercises redusing the stress. The p value considered statistically significant.
and PMRT to at
