RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1.

NAME OF THE CANDIDATE AND ADDRESS

Ms.Amita John

1ST YEAR MSc NURSING, ORIENTAL COLLEGE OF NURSING,#43/52,2ND MAIN.WEST OF CHORD ROAD,RAJAJINAGAR,

BANGALORE-10.

2.

NAME OF THE INSTITUTION

Oriental College of Nursing Bangalore- 10.

3.

COURSE OF STUDY AND SUBJECT

1st Year M .Sc. Nursing,

Child Health Nursing

4.

DATE OF ADMISSION OF THE COURSE

10 - 06 -2011

5.

TITLE OF THE TOPIC

“ An experimental study to assess the effectiveness of yoga therapy on reducing level of stress among 10th standard students in selected schools Bangalore”.

6.

BRIEF RESUME OF THE WORK

6.0 INTRODUCTION

6.1 NEED FOR THE STUDY

6.2 REVIEW OF LITERATURE

6.2.1 STATEMENT OF THE STUDY

6.3 OBJECTIVES OF THE STUDY

6.3.1 OPERATIONAL DEFINITIONS

6.3.2 ASSUMPTION

6.3.3 HYPOTHESIS

6.3.4 SAMPLING CRITERIA

Enclosed

Enclosed

Enclosed

Enclosed

Enclosed

Enclosed

Enclosed

Enclosed

Enclosed

7.

MATERIALS AND METHODS

7.1 Sources of data: Data will be collected from 10th standard students in selected schools, Bangalore.

7.2 Method of data collection: structured questionnaire method.

7.3 Does the study require any investigations of interventions to be conducted on the patients or other human being or animals? Yes

7.4 Has ethical clearance been obtained from your institution?

YES. Ethical committee’s report is here with enclosed.

8

LIST OF REFERENCES Enclosed

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1.

NAME OF THE CANDIDATE AND ADDRESS

Ms. Amita John

1ST YEAR MSc NURSING,

ORIENTAL COLLEGE OF NURSING, #43/52,2ND MAIN,WEST OF CHORD ROAD, RAJAJINAGAR,

BANGALORE.

2.

NAME OF THE INSTITUTION

Oriental College of Nursing,

Bangalore- 10.

3.

COURSE OF STUDY AND SUBJECT

1st Year M .Sc. Nursing,

Child Health Nursing

4.

DATE OF ADMISSION OF THE COURSE

10 - 06 -2011

5.

TITLE OF THE STUDY

“ An experimental study to assess the effectiveness of yoga therapy on reducing level of stress among 10th standard students in selected schools ,Bangalore”.

6. BRIEF RESUME OF INTENDED WORK

6.0 INTRODUCTION

“Stress is nothing more than socially acceptable form of mental illness”

Richard Carlson Let’s start with a little theory

A number of studies suggest a close relationship between stress levels and success all the studies basically arrive at the same conclusion:

Stress helps to improve our efficiency, but only up to a certain point. Once this point is reached if stress continues to increase, the quality of our performance begins to decline1.

Stress comes in all forms and is an unavoidable consequence of life. Transient feeling of anxiety and stress is part of life for every individual, in course of normal development transient feeling anxiety is experienced and usually mastered by every child and adolescent. A mild degree of anxiety and stress may be stimulating and motivating and may help to overcome stress1.

Stress is natural part of being human; it’s your body responding to changes in the world around you. It changes how your body works and puts your mind into different moods. When you get a bit stressed about an exam it just means that you really care about the results you will get. That can be a good thing if it pushes you into working extra hard as you try to get a good score. But it can be bad if you get too worried and effects of stress stop doing well2.

Everyone gets stressed out, even children. While we may think of childhood as a care free time with few major responsibilities, the truth is that our preteen and teens have plenty to worry about from everyday challenge like tests and after school activities of life. Stress is the body’s way of preparing to meet tough situation with focus, strength, stamina, and heightened alertness. Our nervous system kick into overdrive triggering the fight or flight response our heart rate increases, we breath faster our blood pressure rises, our metabolism speeds up, our pupils dilate and we start sweating .Most of time though we are not in real physical danger, so our nervous system return to their normal states3.

Students have a lot of stress especially during the exam period. It is more than vital for students to be able to manage stress if they want to succeed in the exams. Exams themselves are a compelling experience that causes stress, because the stakes are high the dreams that students make for their lives, the beginning of a career, the expectation that they have for themselves and parents. The exam stress is usually associated with the fear that students will disappoint their parents with their performance. Stress is dangerous and can have negative effects on our health when we let it get out of control. The pressure is there to perform well and stand first in the class. The entire modern society today runs on the concept of competition. Your kids have to beat other students in their class in order to shine in your eyes. But in every class (say of 50 students) only 1 student will secure first position. So there is very little (2% in 50 student class) chance of every student to come first. This competition makes them go through tremendous pressure and stress throughout the year, but it exponentially heightens up during the examinations4.

Yoga is a science of right living and it works when integrated in our daily life. It works on all aspects of the persons: the physical, mental, emotional, psychic and spiritual. The word yoga means ‘unity’ or ‘oneness’ and is derived from the Sanskrit word ‘yuj’ which means ‘to join’5.

Yoga has a diverse range of things that it can offer. It could be said that a primary goal of yoga is to gain balance and control in one's life. To free one from confusion and distress. To provide a sense of calm that comes from the practice of yogic exercises and the practice of breath control5.

The practice of yoga exercises aims at overcoming the limitations of the body. Other forms of exercises are good but good is not enough, they strain the muscles, joints, the entire skeletal system and cause free radical damage at a cellular level5.

Yoga will teach you that the goal of every individual's life should be to take journey inside one's self. When there is perfect harmony between mind and body, we achieve total balance and control6.

A study done on prevalence of stress in students at some schools in Kerala, evaluating children of all grades from 1st to 12th, in order to cover all age groups from 4-17 years. Subjects were taken from seven identified schools from Trivandrum, Kerala . A total of 667 school children between age of 4 and 17, were screened from seven schools in Trivandrum district. A standardized stress assessment scale was used to collect the data from the sample  using Spearman-Brown Prophecy formula (garret, 1969) .The results indicate that 93 to 100% of the children aged 4 to 17 years showed medium to moderate stress while 1.9% severe stress. This suggests that in every age more than 90% of the school children of the state are facing above normal levels of stress and tension. Also more than 97% of the children above 10 years showed above average stress. More number of children with severe stress was observed at the age of 14 whereas the majority of the children between 13 to15 showed moderate or severe level of stress than any other age groups7.

Similar results were obtained in a study done in Brazil by C. R. Sbaraini and B. Schermann (2007). A total of 883 children studied, 27.2% of children over 10 years and 18.2% of 14 year old children showed a significantly higher prevalence of stress7.

6.1. NEED FOR STUDY:

Stress is something inevitable in a life of an individual from the childhood to end stage of life. While some stress are desirable and motivating us to do well in our exams, being too stressed out only reverse our productivity and interferes with our performance. For some children the word ‘exam’ evokes images of impending doom giving rise to unpleasant sensation and feeling of distress. We fear something that we go through year after year with great predictability right from primary school7.

Strangely the stress levels peaks to a crescendo, just before the dreaded ‘Board exams’ in class 10 and 12. We know that there is a great premium on academic excellence, as it is gateway to the future of bright career prospects. In our country it is even more so, as it is often the only yardstick to measure a student’s caliber, where .01 aggregate marks can matter, fostering unhealthy levels of competition. To many youngsters eyeing seats in professional courses like medicine, engineering or management, it is perceived to be a ‘do or die’ situation. Often even parents get sucked into this vortex of exam stress, further heightening the tensions of their child with undue expectations from them. Meanwhile, the children feel double the pressure so as not to ‘let their parent’s down8.

A study conducted in a private school at Chattisgarh, North India, show the dramatic increase in suicidal tendency of the students and presence of suicidal ideas in school students. The study was done on 2402 students from classes VII to X on socio-demographic scale, 12-item general health questionnaire, Mooney problem checklist, and suicide risk eleven. The results shows 1078 (45.8%) had psychological problems, half (1201 students) perceived problems in their role as students, 930 (45%) reported academic decline, 180 (8.82%) students reported that life was a burden, 122 (6%) reported suicidal ideas and 8 (0.39%) students reported suicidal attempt9.

The term ‘ exam stress’ can be broadly explained as a feeling of anxiety over ones performance in the exams , the results and reaction of parents and friends all weigh upon students to create exam stress. Many students find themselves weighed down by expectation. Comparisons, parental expectations and peer pressure are major for students attempting their board exams. These concerns make students down, leading to severe stress during examination. Exam stress is most apparent in children when they have to prove themselves and display their years work in the pressured situation of a one or two hour exam. Lost appetites, under confidence, nervousness, anxiety and even depression are no strangers to the youngsters who are conditioned to look upon the exams as the be all. Not a year goes by without the media reporting a number of suicides and suicidal attempts by children as young as 14 to 17 due to the fear of the boards, or their poor performance in the same7.

A survey done by Times Of India news paper showed increase in students opting for board exams by 14.98% as compared to 2010, CBSE has registered almost 15% increase in the number of students who are taking examination in 2011. For classes 10th, the number of students has remarkably increased. A total of 10, 61,566 students are part of Class 10 exam in 2011, whereas in 2010, the figure was 9, 02,517. The reason behind the increase is that for the first time this year, the students were given an option of either appearing for the board exam or taking an internal exam conducted by the respective schools under the Continuous and Comprehensive Evaluation scheme10.

Recent news about teenagers apparently committing suicide because they were worried about exams has sent pangs of anxiety among parents across the country. These show the stress the students face during the exam. Similarly, in the past month there have been a number of reports shows that how the pressure of school exams is having a terrible impact on the mental well-being of teenagers, with doctors prescribing anti-depressants such as Prozac and Seroxat to help young people deal with stress. The Government’s drug watchdog, show that in( 1995) 46,000 anti-depressant prescriptions were given to teenagers between 16 and 18 in full-time education. By last year this had risen to 140,000. There has also been a rise of almost 50 percent in the prescription of so-called “happy drugs”as named by teenagers such as Prozac and Seroxat to under 16yrs. This has risen from 76,000 in( 1996) to 110,00011.

The Children’s charity, Child line, in Britain has recently collated figures that reveal a 50 percent increase in calls concerning exam pressure in the past year, up from 600 to 900. Thousands more are asking for a leaflet about beating exam stress or used the charity’s website to help them. The charity say lots of children ring them because they are worried that poor exam results mean they are letting their parents down, or they won’t be able to do what they want in the future. Adrian Brown of Child line said, “Fear of failure and pressure to succeed can be immense. They don’t want to let parents, teachers and themselves down.”13.

The study in general points out that majority of the children studied have pressure of one thing or another that leads to mild or moderate level of stress in them. The study results emphasize the fact contradictory to the common belief that only adults suffer from stress and stress related problems, children from a very young age itself suffer from tension and stress of different types at varying levels mainly due to academics. Awareness raising is needed for parents, teachers and professionals to take joint action to relieve the suffering caused by stress in many of these children7.

  The researcher felt that the students will be under full stress during 10th standard. Yoga therapy will help these students in overcoming the stress and thus helping them to perform well in exams. Hence, the researcher decided to study the effectiveness of yoga therapy in reducing level of stress.

6.2. REVIEW OF LITERATURE:

Review of literature is a systematic identification, location, scrutiny and summary of written materials that contain information on research problems. It is a key step in research progress. It refers to an extensive, exhaustive and systematic examination of publications relevant to research project. It is an essential part of every research which helps in many ways starting from selection and formulation of problem, providing conceptual framework for the study, assess feasibility, providing methodology, for comparison and replication, avoiding obstacles and making generalization. It also helps to support the hypothesis under the study and critically analyze the structure and content of the research project.

A study done in Jalandar, India on effect of yoga on the academic performance as excessive stress hampers students performance. The study was done on 800 adolescent students; 159 high-stress students and 142 low-stress students were selected on the basis of scores obtained through Stress Battery scale. A yoga module consisting of yoga asanas, pranayama, meditation, and a value orientation program was administered on experimental group for 7 weeks. The experimental and control groups were post-tested for their performance on the exams. The results show that the students, who practiced yoga performed better in their academics than who did not practise12.

A study was done on Division of Yoga and Life Science at Bangalore to investigate the effectiveness of two yoga based relaxation techniques namely cyclic meditation and supine rest. The study was done on 208 school students (132 boys, 76 girls) between ages of 13-16 years. After the application of both therapies the total and net scores were significantly increased. Although the magnitude of change was more for cyclic meditation than supine rest but, at the end of study both the therapies cyclic meditation and supine rest were effective on increasing attention and reducing stress in children13.

A study published in the Journal of Alternative and Complementary Medicine found that certain types of yoga session increase GABA levels in brain. Anxiety and stress is associated with low GABA level (Gamma- Amino butyric Acid ) . The results show specific effects of yoga practice on the brain begins and improves the mood and reduces anxiety and stress7.

A study was conducted from the University of Colorado School Of Medicine regarding use of yoga as a complementary therapy for children and adolescent. There is also a progressive trend towards use of yoga as a mind body complementary and alternative medicine intervention to improve specific physical and mental health conditions. A brief overview of yoga therapy is presented along with yoga resource and practical. The majority of available studies with children and adolescent suggest benefit to using yoga as a therapeutic intervention and shows very few adverse effect .Yoga appears to be promising as a complementary therapy for children and adolscents14.

A study to analyze the effect of yoga on children was done at Flushing Hospital in USA. The pilot study compared 4th and 5th standard students at two after school programmes. One programme offered yoga 1 hour per week for 12 weeks (yoga) effects on well being were evaluated by an additional questionnaire completed by the yoga group only. The results showed majority of children participating in yoga reported enhanced well being and fewer negative behaviors in response to stress and had better balance than the comparison group15.

A study to assess the therapeutic effect of yoga for children to improve the quality of life and physical outcomes measure in pediatric population. The study included case control of studies cohort and randomized controlled trials that examined yoga as an exercise intervention for children. The research conclusion evidenced shows physiological benefits of yoga for pediatric population that may benefit children through the rehabilitation process16.

A study was done in Vivekananda Kendra Yoga Research Foundation at Bangalore, India to assess the uninostril breathing facilities the performance of spatial memory scores. According to study the right and left brain functions are affected and thus help in increasing the performance in verbal and spatial memory test. Each group was made to practice specific breathing technique (a) right nostril breathing (b) left nostril (c) alternate nostril breathing (d) breath awareness without manipulation of nostrils these techniques were practiced for 10days. The results showed an average increase in spatial memory scores for the trained groups was 84%17.

A study was integrated yoga practices for 35 minutes daily in the presence of trained yoga teacher for 12 weeks in a school at New Delhi. The samples were divided control group did not undergo any kind of yoga practice or stress management. Physiological parameters like heart rate, respiratory rate, and blood pressure were measured. Global Assessment of Recent Stress Scale and Spielbergers State Anxiety score were assessed at baseline and during the examination.  In the yoga group, no significant difference was observed in physiological parameters during examination stress, whereas in the control group, a significant increase in stress was observed18.

6.2.1. STATEMENT OF THE PROBLEM:

“An experimental study to assess the effectiveness of yoga therapy on reducing level of stress among 10thstandard students in selected schools, Bangalore’’.

6.3 OBJECTIVES OF THE STUDY:

1. To assess the level of stress among 10th standard students before

implementing yoga therapy.

2. To assess the level of stress among 10th standard students after

implementing yoga therapy.

3. To assess the effectiveness of yoga therapy among 10th standard

students.

4. To find out the association between level of stress among 10th

standard students and selected demographic variables.

6.3.1. OPERATIONAL DEFINITIONS:

1. Effectiveness: it refers to the extent to which the yoga therapy will

help the10th standard students in reducing the level of stress.

2. Yoga therapy-simple yoga techniques that can reduce stress

among the students like:

Pranayam- rhythmic breathing practiced to relieve stress.

Sukhasana- is an asana practiced in yoga which helps to

increase concentration level and relieve stress.

Shavasana- is an asana done to relax the mind and body.

3. Stress – is body’s way of responding to any kind of demand like

the stress faced by students regarding studies to score good

marks in their exams.

4. Students- male and female children studying in 10th standard

between the age group of 14-16yrs.

6.3.2ASSUMPTION

1. It is assumed that 10th standard students have stress.

2. It is assumed that yoga therapy will help in reducing level of stress

among 10th standard students.

6.3.3. HYPOTHESES:

H1: there will be significant reduction in level of stress among 10th

standard students after yoga therapy.

H2: there will be significant association between pretest level of stress

among 10th standard students and selected demographic variables .

6.3.4 SAMPLING CRITERIA

1.Inclusion Criteria : 10th standard students

- Who are available for yoga practice

- Who are willing to participate

2. Exclusion Criteria:10th standard students

- Who are under any treatment for respiratory problems

or fractured.

- Who are already attending other yoga classes.

6.3.5. DELIMITATION:

The study is delimited only to 10th standard students.

7. MATERIALS AND METHODS

7.1 SOURCE OF DATA

Data will be collected from 10th standard students in selected schools

Bangalore

7.2 METHODS OF COLLECTING DATA

· Research approach: evaluative approach .

· Research design: true experimental design.

· Setting: selected schools of Bangalore .

· Population: all students who meet the inclusion criteria.

· Sample: 10th standard students in selected schools, in Bangalore.

· Sample size: 60 students (30 experimental group, 30 control group).

· Sampling technique: simple random sampling.

· Method of data collection: structured questionnaire method.

· Tool for data collection: stress scale (modified version of Holmes

· and Rahe stress scale).

Method of data analysis and interpretation:

The researcher will use appropriate statistical

techniques for data analysis present in the form of tables and diagrams. Demographic variables will be analyzed by frequency and percentage distribution. Level of stress will be analyzed with mean percentage and standard deviation. Effectiveness of yoga therapy in reducing level of stress will be analyzed by paired ‘t’ test. Association between level of stress and demographic variable will be analyzed by Chi square test.

Duration of study: 4 weeks.

Variables:

Independent variable: yoga therapy for reducing the level

of stress

Dependent variable: level of stress among 10th standard

students.

Demographic variable:

- Age

- Sex

- Education of parents

- Socio economic status of parents

- Occupation of parents

- Religion

- Type of family

- Birth order

- Area of residence

- Recreational activities

Projected outcome: the study will be successful in reducing the level of stress among10th standard students. Hence, it will help the students in getting good results in their exams.

7.3 Does the study require any investigations or interventions to be conducted on patient or other human being or animals?

Yes

7.4 Has ethical clearance been obtained from your institution?

Yes, ethical committees report is enclosed.

8. LIST OF REFERENCES:

1. Examination stress, Michel Lemieux, 2007 ( updated , cited 12.06.2007

http://www.cegepadistance.ca/en/services/le_stress_et_les_examens.asp

2. Exam stress? Yoga; yagnas to rescue ,DNA daily news analysis 2011

http://www.dnaindia.com/academy/report_exam-stress-yoga-reiki-yajna

to the- rescue-for mumbai-students_1509039

3. Manage exam stress tips for students, 15 Dec 2008

http://www.manageyourlifenow.com

4. Dr. Kewlani Neelam Holistic healer ,Press Release - Stress During

Exams, Stayfit magazine March 2009

http://www.sanskrutiayurveda.com/stress-during-exams

5. Introduction to Yoga, yoga alliance , 2003

http://www.introductiontoyoga.com/

6. Aims Of Yoga, Yoga online, 2011

http://yoga.org.nz/what-is-yoga/yoga_aims.htm 7. Prevalence Of Stress Among School Children In Kerala , Sapana Dinesh

posted on feb 17 , 2010

http://www.articlesbase.com/mentalhealth articles/prevalence-of-

stress-among school-children-in-kerala-1868702.htm

8. De Stress To Tackle Exam Distress, Dr. Sujatha Sharma, Public health

foundation of India http://yoga.org.nz/what-is-yoga/yoga_aims.htm

9. Arun priti , Chavan BS ,Stress and suicidal ideas in adolescent students

In Chandigarh, Indian journal of Medical sciences 2009,

volume.63, issue.7 page

281-287 http://www.indianjmedsci.org/article.asp?issn=001

10. CBSE exam stastics ,incidence rate of students attempting, DNA Daily

13April 2011,

http://www.cbsemath.com/apps/blog/show/prev?from_id=6822062

11. Britain Teenagers Driven To Depression Due To Exam Pressure

Liz smith , 25 June 2004 International committee of 4th

international

http://www.wsws.org/articles/2004/jun2004/dep-j25.shtml

12. Kauts Amit, Sharma Neelam, Effect of yoga on academic

performance in relation to stress, International journal

of yoga 2009 17july , volume 2, issue1, pages 39- 43

http://www.ijoy.org.in/article.asp?issn=0973-

6131;year=2009;volume=2;issue=1;

spage=39;epage=43;aulast=Kauts

13. Pradhan .B , Nagendra.H, Division Of Yoga And Life Science , Swami

Vivekanada Anusthana, Immediate Effect Of Yoga Based

Relaxation Techniques on attention In Children

http://www.ncbi.nlm.nih.gov/pubmed/21170232

14. L C Isley Kaley ,J Peterson , C Fishcer, E Peterson, Yoga as a

Complementary Therapy for children and Adolescent 2010,aug

7,volume 8 page20-32,

http://www.ncbi.nlm.nih.gov/pubmed/20877530

15. DL Beger, EJ Silver, RE Stein ,Effects Of Yoga On Inner-City

Children's Well-Being: a pilot study 2009, sep15 ,volume 5

page no: 36-42

http://www.ncbi.nlm.nih.gov/pubmed/19771929

16. ML Galantino, RGalbavy, LQuinn, Therapeutic effects of yoga for

children review of literature 2008, page no. 66-80 .

http://www.ncbi.nlm.nih.gov/pubmed/11214505

17. KV Naveen, R Nagarthna,HR Nagandran,S Telles, Yoga breathing

through particular nose increases spatial memory ,2007 oct 8

volume 2 page 55-61,

http://www.ncbi.nlm.nih.gov/pubmed/9354111.

18. Gopal aravind , Mondal sunitha, Gandhi asha, Arora sankar,

Bhattacharj jayashree ,Effect of integrated yoga practice on

immune response examination stress, International journal of

yoga , 2011 volume 4, issue1 page

no: 26-32http://www.ijoy.org.in/article

PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

SUBMITTED BY:

Ms. Amita John

1st yr. M. Sc. (Nursing)

Child Health Nursing

2011-2013 Batch.

Oriental college of nursing,

Bangalore -10.

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