Research Paper
Medical Science
E-ISSN No : 2454-9916 | Volume : 5 | Issue : 3 | March 2019
EFFECTIVENESS OF RECREATIONAL THERAPY ON LEVEL ANXIETY AMONG PRE-OPERATIVE PATIENT AT NLC GH NEYVELI 1
2
Arivuselvi K. M.Sc (N), | Suganthra Devi S. M.Sc (N)., Ph.D 1 2
Assistant Professor, Department of Mental Health Nursing Community, O. P. R. Memorial College of Paramedical Science, Vadalur. Principal & HOD, Department of Community, O. P. R. Memorial College of Paramedical Science, Vadalur.
ABSTRACT Anxiety is a normal, emotional, reasonable, expected response to real or potential danger. However if the symptoms of anxiety are prolonged, irrational, disproportionate and or severe occur in the absence of stressful events or stimuli or interfere with everyday activities, then these are called anxiety disorder. Anxiety is one of the most common psychological disorders among pre-operative patient. Recreational therapy is one of the best therapies to accomplish pre-operative wellness among patient. Recreation is a form of activity therapy used in most psychiatric settings. It is a planned therapeutic activity that enables people with limitations to engage in recreational experience. Hospitalization and surgery are critical negative life events that lead to the experience of considerable anxiety in patient may perceive the day of surgery as the biggest and the most threatening day in their lives. Objectives: 1.To assess the level of anxiety among pre-operative patients. 2. To assess the effectiveness of recreational therapy. 3.To associate the level of anxiety among pre-operative patient with the selected demographic variables Methodology: Experimental research design pre test & post test was used to collect data among 50 samples by using convenient sampling technique after obtaining informed consent. Structured questionnaire to assess the pre-test level of anxiety among pre-operative patient and post test was conducted by using same tool. Conclusion: A pretest and post test was conducted to assess the level of anxiety using a structured questionnaire and anxiety screening questionnaire The study subject 66% (33) of pre-operative patients was having a mild anxiety level on recreational therapy. And 34% (17) of pre-operative patients were having a moderate anxiety level on recreational therapy. KEYWORDS: anxiety recreational therapy. present at any given time whereas trait anxiety is more individualized and refled ones personality consistencies.
INTRODUCTION: “Anxiety happens when you Think you have to figure out
Hospitalization and surgery are critical negative life events that lead to the experience of considerable anxiety in patient may perceive the day of surgery as the biggest and the most threatening day in their lives.
Everything all at once Breath you strong You got this take it day by day” ~ Karen salmansohn The Anxiety is a negative emotional state characterized by nervousness, worry and apprehension. Hospitalization and surgery are critical negative life events that lead to the experience of considerable anxiety in patient may perceive the day of surgery as the biggest and the most threatening day in their lives. The recreational therapy includes role play drama, craft, games, music to reduce the level of anxiety among pre-operative patients. Recreational therapy can provide a release from stress and tension for individual of all ages. Therapy is essential for the sick patient as for the health one, the sick patient need therapy to feel lonely hours and for expressing feeling and aggression through it to reduce trauma case by hospitalization. Recreational therapy is defined as a treatment service designed the restore, remediate and rehabilitate a person's level of functioning and independence in life activities, to promote health and wellness as well as reduce or eliminate the activity limitations and restrictions to participations in life situations cost by an illness or disabling condition. Pre – operative care given before surgery when physical and psychological preparations are made for the operation, according to the individual needs of the patient the pre – operative period runs from the time the patient is admitted to the hospital or surgery center to the time that surgery behinds pre – operative anxiety was found to be associated to with multiple psychological and physiological adverse effects. NEED FOR THE STUDY: Anxiety is a negative emotional state characterized by nervousness, worry and apprehension. It is associated with autonomous aroused or activation of the body to understand the performance of the anxiety it is better to understand such categories of anxiety which include cognitive anxiety and somatic anxiety. Cognitive anxiety is directly related to though process and somatic anxiety is physical components these two encompasses the mental and physical sides of anxiety, in addition to cognitive and somatic anxiety. It is important to understand the meaning between state and trait anxiety. State anxiety fluctuates and is continuously changing throughout experience and
OPERATIONAL DEFINITION: Assess: refers to identify the level of anxiety among pre-operative patients using a recreational therapy. Effectiveness: refers to the recreational therapy which has achieved the desired result in term of reducing anxiety among pre-operative patients. Recreational therapy: refers to therapy which entertains the pre-operative patients in order to reduce anxiety. Anxiety: it is an unpleasant emotional experience that involve feeling of tension apprehension, nervousness and high autonomic activity. OBJECTIVES: 1. To assess the level of anxiety among pre-operative patients. 2.
To assess the effectiveness of recreational therapy.
3.
To associate the level of anxiety among pre-operative patient with the selected demographic variables.
HYPOTHESIS: Ÿ H1: There will be significant difference in the level of anxiety among pre – operative patients. Ÿ
H2: There will be significant between the levels of anxiety among pre – operative. patient with selected demographic variables
METHODOLOGY : Experimental design was adopted for this study Population: The population for the present study comprised of Pre – Operative Patients at selected hospital. Sample 50 Pre – Operative Patients at selected hospital was drawn using Convenient sampling technique Description of tool: Tool consist of two section, Ÿ
Section A : To assess the demographic variables
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42
Research Paper
E-ISSN No : 2454-9916 | Volume : 5 | Issue : 3 | March 2019
Section B: To assess the anxiety screening questionnaire.
Ÿ
S. Demographic No variables
RESULT AND DISCUSSION:
9
Mild f
%
Moderate Severe f
%
f
%
χ2
p-value
Sleeping pattern: Disturbed Normal
24 48 9 18
15 2
30 4
-
-
1.57 (df=1)
0.210 NS
10 Source of information: Mass media Friends peer/group Family members Health professional
12 24 11 22 9 18 1 2
3 7 5 2
6 14 10 4
-
-
2.94 (df=3)
2.94 (df=3)
*-P<0.05, significant and **-P<0.01 &***-P<0.001, highly significant Table 2 shows the association between the demographic variables and post test level of anxiety. The chi- square value obtained for demographic variables like age, gender, educational status, marital status, occupation, and religion, type of surgery, period of stay, sleeping pattern, and source of information was also statically highly significant. Figure 1 The above figure shows that in the pre-test out of 50 samples 2% had mild anxiety, 26% had a moderate anxiety and 72% had severe anxiety level. In the post test out of 50 samples 66% had mild anxiety, 34% had a moderate anxiety and none of them had a severe anxiety. Table 1: Paired “t”-test was found to evaluate the effectiveness of recreational therapy on level of anxiety among pre-operative patient at NLC GH Neyveli. Overall
16
2.47 7.62 2.50
8.38
31.11
Ahiya, N. (2004). A short text book of Psychiatry. 5th ed, Medical publisher (P) Ltd.Pp:34-38.
P-value
2.
Ahuja. R. (2009) “Research Methods” first edition published by Prem Raw at publication, Jawahar Nagar Jaipur Pp -120.
P<0.001***
3.
American Psychiatric Association. (2004). Diagnostic & Statistical manual of mental disorders. 4 th ed, Washington: American Psychiatric Association.Pp-79-86.
4.
Basvanthappa B.T (2004) “Nursing Research” first edition, Jaypee publication, Calcutta Pp93- 139.
5.
Bhatia, L.T.(2004). Essential of psychiatry. 4th ed, New Delhi: CBS publishers and Distributors. Pp: 8.1-8.5.
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Maguire P, Faulkner A, regnard C-Managing the anxious patient with advancing disease a flow diagram palliate Med.
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Moffic HS, Paykel ES-depression in medical- in- patients. Br.J.psychiatry, 1975; 126; 346-353.
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Maranets I, Kain ZN-Preoperative anxiety and intra operative anesthetic requirements Anesth Analog, 1999; 89; 1346-1351.
9.
Clarke DM, Minas IH, Stuart GW- the Prevalence of Psychiatric Morbidity in general hospital in patients. AustN2J Psychiatry, 1991; 25:322-329.
*-P<0.05, significant and **-P<0.01 & ***-P<0.001, highly significant Table-1 shows the Mean level of anxiety in the pre-test and post test. The mean score were found as 16 and 7.62 for the pre-test and post test. Thus, the difference in the level of anxiety was confirmed by the paired “t” value 31.11 which was significant at P<0.001. it indicates that the recreational therapy was found to effective in reducing the level of anxiety. Table 2: Association between level of anxiety in Post test and selected demographic data. S. Demographic No variables 1
2
3
Mild f
%
Moderate Severe f
%
f
%
χ2
p-value
Age (in years): 20-30 years 30-40 years Above 40 years
5 10 8 16 20 40
4 2 11
8 4 22
-
-
1.34 (df=2)
0.511 NS
Gender: Male Female
20 40 13 26
10 7
20 14
-
-
0.01 (df=1)
0.903 NS
Educational status: No formal education Primary school High school Graduate
13 26 9 18 7 14 4 8
6 5 4 2
12 10 8 4
-
-
0.09 (df=6)
0.992 NS
30 60 3 6
15 2
30 4
-
-
0.089 P=0.765 (df=1) NS
4
Marital status: Married Unmarried
5
Occupation: Employed Unemployed
19 38 14 28
11 6
22 12
-
-
0.237 (df=1)
0.626 NS
Religion: Hindu Christian Muslim Others
24 48 7 14 2 4 0 0
14 2 1 0
28 4 2 0
-
-
0.69 (df=2)
0.707 NS
Type of surgery: Minor surgery Major surgery
33 66 0 0
17 0
34 0
-
-
0
1 NS
Period of stay: Day care <1 week >1 week
0 0 33 66 0 0
0 17 0
0 34 0
-
-
0
1 NS
6
7
8
43
REFERENCES: 1.
Pre test Post test Mean ‘t'-value Mean SD Mean SD difference
Level of anxiety
CONCLUSION: The following conclusion was drawn from the findings of the study. A total of 50 samples were selected for the study by using convenient sampling method. Written consent from all the samples was obtained. A pretest and post test was conducted to assess the level of anxiety using a structured questionnaire and anxiety screening questionnaire. The study subject 66% (33) of pre-operative patients was having a mild anxiety level on recreational therapy. And 34% (17) of preoperative patients were having a moderate anxiety level on recreational therapy.
10. Muszbek, k, Szekely.a, Balogh EMet al- Validation anxiety and depression scale. Qual life Res, 2006; 15; 761-766.
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