Stella Mary, I (2022) An Experimental study to Assess the Effectiveness of Positive Behaviour Therapy Upon Stress, Coping and Blood Pressure among Hypertensive Patients at Selected Community, Chennai. Doctoral thesis, The Tamil Nadu Dr. M.G.R. Medical University, Chennai.
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Abstract
STATEMENT OF THE PROBLEM: “An Experimental Study to Assess the Effectiveness of Positive Behavior Therapy upon Stress, Coping and Blood pressure among Hypertensive patients at selected community, Chennai. OBJECTIVES OF THE STUDY: 1. To assess the stress, coping and blood Pressure in control and experimental group of Hypertensive patients before and after administration of Positive Behavior therapy. 2. To evaluate the effectiveness of Positive Behavior therapy by comparing the stress, coping and blood pressure in Hypertensive patients in control and experimental group of Positive Behavior Therapy. 3. To determine the level of satisfaction among experimental group of Hypertensive patients regarding Positive Behavior therapy. 4. To find out the association between selected demographic variables and the Stress, coping and Blood Pressure in control group and experimental group of Hypertensive patients before and after administration of Positive Behavior therapy. 5. To find out the association between selected clinical variables and the Stress, coping and Blood Pressure in control group and experimental group of Hypertensive patients before and after administration of Positive Behavior therapy. 6. To find out correlation between stress, coping and blood pressure in pre and post test of control and experimental group. Samples were chosen through Purposive sampling technique. Known cases of hypertension was identified through survey registers and screening was done door to door survey in the selected areas and sampling frame was made. Among them 150 were assigned to control group and 150 were assigned to experimental group. Positive behavior therapy was developed by Professor Dr. Hemalatha Natesan (2004). It is a package, combining the eastern techniques of yoga and western techniques of Cognitive Behavior therapy². It helps people develop positive perception and pleasing personality. It also helps to improve mental and physical health. It has four major strategies namely, Relaxation therapy, Counseling, Exercises, Behavioral assignments. Relaxation therapy involves deep breathing practice, relaxation training and autosuggestion. Counseling included stopping stress symptoms, negative thoughts stopping and instilling positive thoughts. Exercises were given for tension releasing, smile therapy and laugh therapy. Behavior assignments were administered to develop routine good health habits to ensure positive thinking and healthy behavior. Positive therapy was given for one hour daily for a period of two weeks. After two weeks entire sample was reassessed using perceived stress scale. After two weeks, Positive Behavior Therapy was administered for 60 minutes for each group of hypertensive patients which includes deep breathing exercise – 5 mins, relaxation exercise and auto suggestion – 25 mins, stopping stress symptoms - 5mins, stopping negative thoughts- 5 mins, instilling positive thoughts- 5 mins, relieving stress symptoms- 5 mins, smile therapy- 5 mins, laughter therapy- 5 mins and all the samples were individually counseled with behavioral assignments. The second post-test was conducted after a month of intervention and third post test was conducted after three months of intervention. The researcher obtained verbal and written consent from the subjects to participate in study. An assurance was given regarding confidentiality before data collection procedure. The data was collected using the predetermined and pretested tools such as demographic variable Performa, Clinical variable Performa, Perceived stress scale, COPE coping questionnaire through self administration method. Blood pressure was measured using Aneroid BP apparatus (BP monitoring sheet). The study participants in the experimental group were administred Positive Behavior Therapy. The experimental group consisted of 150 samples, they are divided into 6 groups of 25 in each group. For each sample the therapy was given for 2 weeks at the rate of 1 hour per sample per day. At the end of 2nd week the first post test, after one month second post test and after three months third post test were conducted. This procedure was followed for other groups periodically in community area, Chennai. The study participants were gathered in common recreation hall in the community area. The control group data were collected first followed by experimental group data was collected. The level of satisfaction regarding Positive Behavior Therapy was assessed using the satisfaction rating scale on Positive Behavior Therapy. MAJOR FINDINGS OF THE STUDY: ➤ The stress between the two groups at each levels namely pre, post 1, 2 and 3. At pre test, the mean stresses of both groups were 40.7±10.4 and 41.0±8.2. The difference was not statistically significant (P>0.05). At post-1, the mean stresses of both groups were 40.5±10.3 and 37.0±7.4. The difference between the means of both groups was statistically significant (P<0.001). At post-2, the mean stresses of both groups were 40.6±10.3 and 33.2±6.7. The difference between the means of both groups was statistically significant (P<0.001). At post-3, the mean stresses of both groups were 40.5±10.3 and 30.3±6.4. The difference between the means of both groups was statistically significant (P<0.001). ➤ The coping between the two groups at each levels namely pre, post 1, 2 and 3. At pre test, the mean coping of both groups were 138.4±9.4 and 138.9±9.4. The difference was not statistically significant (P>0.05). At post-1, the mean copings of both groups were 138.6±9.2 and 146.9±9.2. The difference between the means of both groups was statistically significant (P<0.001). At post-2, the mean copings of both groups were 138.7±9.2 and 153.2±9.2. The difference between the means of both groups was statistically significant (P<0.001). At post-3, the mean coping of both groups were 138.7±9.2 and 159.4±9.0. The difference between the means of both groups was statistically significant (P<0.001). ➤ The SBP between the two groups at each levels namely pre, post 1, 2 and 3. At pre test, the mean SBPs of both groups were 144.0±9.7 and 144.2±8.5. The difference was not statistically significant (P>0.05). At post-1, the mean SBP of both groups were 143.6±9.5 and 141.7±9.3. The difference between the means of both groups was statistically significant (P<0.001). At post-2, the mean SBPs of both groups were 143.4±9.6 and 139.5±9.3. The difference between the means of both groups was statistically significant (P<0.001). At post-3, the mean SBPs of both groups were 143.2±9.7 and 138.8±9.4. The difference between the means of both groups was statistically significant (P<0.001). ➤ The DBP between the two groups at each levels namely pre, post 1, 2 and 3. At pre test, the mean DBPs of both groups were 88.4±5.6 and 88.5±5.3. The difference was not statistically significant (P>0.05). At post-1, the mean DBP of both groups were 88.3±5.7 and 86.4±5.7. The difference between the means of both groups was statistically significant (P<0.001). At post-2, the mean DBPs of both groups were 88.0±5.8 and 84.2±5.2. The difference between the means of both groups was statistically significant (P<0.001). At post-3, the mean DBPs of both groups were 87.8±5.8 and 83.0±5.2. The difference between the means of both groups was statistically significant (P<0.001). ➤ The HR between the two groups at each levels namely pre, post 1, 2 and 3. At pre test, the mean HRs of both groups were 89.9±7.4 and 90.0±7.5. The difference was not statistically significant (P>0.05). At post-1, the mean HR of both groups were 89.7±7.4 and 88.2±7.2. The difference between the means of both groups was statistically significant (P<0.001). At post-2, the mean HRs of both groups were 89.6±7.4 and 89.6±7.3. The difference between the means of both groups was statistically significant (P<0.001). At post-3, the mean DBPs of both groups were 89.6±7.3 and 84.2±6.8. The difference between the means of both groups was statistically significant (P<0.001). ➤ There was significant difference in Stress scores between Pre test (Mean 40.7, SD 10.4) and Post test 1(40.5, 10.3), Post test 1 (40.5, 10.3) and Post test 2 (40.6, 10.3), Post test 2 (40.6, 10.3) and Post test 3 (40.5, 10.3), Pre test (40.7, 10.4) and Post test 3 (40.5, 10.3) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There was significant difference in stress scores between Pre test (41.0, 8.2) and Post test 1 (37.0, 7.4), Post test 1 (37.0, 7.4) and Post test 2 (33.2, 6.6), Post test 2 (33.2, 6.6) and Post test 3 (30.3, 6.4), Pre test (41.0, 8.2) and Post test 3 (30.3, 6.4) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There was significant difference in Coping scores between Pre test (138.4, 9.4) and Post test 1 (38.6, 9.2), Post test 1 (138.6, 9.2) and Post test 2 (138.7, 9.2), Pre test (138.4, 9.4) and Post test 3 (138.7, 9.2). There was no significant difference in Coping scores between Post test 2 (138.7, 9.2) and Post test 3(138.7, 9.2). (P>0.05) ➤ There was significant difference in Coping scores between Pre test (138.9, 9.4) and Post test 1 (146.9, 9.2), Post test 1 (146.9, 9.2) and Post test 2 (153.2, 9.2), Post test 2 (153.2, 9.2) and Post test 3 (159.4, 9.0), Pre test (138.9, 9.4) and Post test 3 (159.4, 9.0) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There was significant difference in Systolic Blood Pressure scores between Pre test (144.0, 9.7) and Post test 1 (143.6, 9.5), Post test 1 (143.6, 9.5) and Post test 2 (143.4, 9.6), Post test 2 (143.4, 9.6) and Post test 3 (143.2, 8.7), Pre test (144.0, 9.7) and Post test 3 (143.2, 8.7) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There was significant difference in Systolic Blood Pressure scores in experimental group between Pre test (144.2, 8.5) and Post test 1 (141.7, 9.3), Post test 1 (141.7, 9.3) and Post test 2 (139.5, 9.3), Post test 2 (139.5, 9.3) and Post test 3 (138.8, 9.4), Pre test (144.2, 8.5) and Post test 3 (138.8, 9.4) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There was significant difference in Diastolic Blood Pressure scores in Controlled group between Pre test (88.4, 5.6) and Post test 1 (88.3, 5.7), Post test 1 (88.3, 5.7) and Post test 2 (88.0, 5.8), Post test 2 (88.0, 5.8) and Post test 3 (87.8, 5.8), Pre test (88.4, 5.6) and Post test 3 (87.8, 5.8) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There was significant difference in Diastolic Blood Pressure scores in experimental group between Pre test (88.5, 5.3) and Post test 1 (86.4, 5.7), Post test 1 (86.4, 5.7) and Post test 2 (84.2, 5.2), Post test 2 (84.2, 5.2) and Post test 3 (83.0, 5.2), Pre test (88.5, 5.3) and Post test 3 (83.0, 5.2) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There was significant difference in Heart Rate in Control group between Pre test (89.9, 7.4) and Post test 1 (89.7, 7.4), Post test 1 (89.7, 7.5) and Post test 2 (89.6, 7.4), Post test 2 (89.6, 7.4) and Post test 3 (89.6, 7.3), Pre test (89.9, 7.4) and Post test 3 (89.6, 7.3) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There was significant difference in Heart Rate in Experimental group between Pre test (90.0, 7.5) and Post test 1 (88.2, 7.2), Post test 1 (88.2, 7.2) and Post test 2 (86.1, 6.9), Post test 2 (86.1, 6.9) and Post test 3 (84.2, 6.8), Pre test (90.0, 7.5) and Post test 3 (84.2, 6.8) which is significant at P<0.001, P<0.05, P<0.05 and P<0.001 respectively. ➤ There is significant difference between Tests in Control and Experimental Group of Patients with Hypertension (within and between groups P<0.001). ➤ There is no association between selected Demographic Variables and Stress among Control and Experimental Group of Patients with Hypertension (P>0.05). Hence the H02 is retained except with regard to religion (P>0.05). ➤ There is no association between Selected Clinical Variables and the Stress among Control and Experimental group of Patients with Hypertension (P>0.05). ➤ There is no association between selected Demographic Variables and Coping among Control and Experimental Group of Patients with Hypertension (P>0.05) except religion and Coping (P<0.05). ➤ There is no association between Selected Clinical Variables and Coping among Control and Experimental group of patients with Hypertension (P>0.05). ➤ There was no statistically significant relationships between the DBP with COPE in respect of control group (P>0.05). The DBP was negatively strongly correlated in respect of experimental group subjects except pre test (P<0.001). The COPE were determined by DBP as 87.0%, 64.8% and 53.7% in post-1,2 and 3 tests respectively. RECOMMENDATIONS: ◉ A similar study can be conducted in different settings ◉ A interventional study can be conducted to improve the knowledge and practice regarding preventive measures of hypertensive clients. ◉ The study can be conducted among different groups like school teachers, corporate sectors and traffic police. ◉ The study can be conducted on the quality of life among the hypertensive clients. ◉ Comparative study can be conducted to evaluate the effectiveness of Positive Therapy with other non pharmacological interventions and alternative therapies. CONCLUSION: Over all study findings indicates that the Positive Behaviour Therapy is effective for Hypertensive patients. Health professionals especially nurses play vital role in helping the Hypertensive patients in managing stress and coping effectively, by which blood pressure can be efficiently maintained.
| Item Type: | Thesis (Doctoral) |
|---|---|
| Additional Information: | 21130/2014 |
| Uncontrolled Keywords: | Effectiveness, Positive Behaviour Therapy, Stress, Coping, Blood Pressure, Hypertensive Patients, Selected Community, Chennai. |
| Subjects: | NURSING > Medical Surgical Nursing |
| Depositing User: | Subramani R |
| Date Deposited: | 25 Dec 2022 15:28 |
| Last Modified: | 28 Dec 2023 02:16 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/21084 |
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