INTRODUCTION:

Stress is a term heard so often that It’s meaning is frequently distorted and its implications are taken for granted. In today’s world, everybody seems to be talking about stress not only in daily conversation but also through television, radio and newspapers. Stress is an universal feature of life and no one can live without experiencing some degree of stress. Every human being has his own understanding of stress, because all demands of adaptability do evoke the stress phenomenon. Selye (1974) beautifully summarized the nature of stress in the following words: "Everybody knows what stress is and yet nobody knows what it is”.

College is a wonderful opportunity not only to further your education but experiment with life before it gets too serious. Having said that, college life is not without its' stressful situations. Here are a few common causes of stress amongst college students.

Academic stress among college students has been a topic of interest for many years. College students, especially freshmen are particularly prone to stress due to the transitional nature of college life. For example, many college students move away from home for the first time, which can necessitate leaving a previously learned support systems such as parents, siblings and high school friends. Students may need to develop entirely new social contacts and are expected to take responsibility for their own deeds. They may have difficulty in adjusting to more rigorous academic expectations and the need to learn to deal with individuals of differing cultures and beliefs. Thus, stress may result from being separated from home for the first time, the transition from a personal to an impersonal academic environment, and the very structure of the academic experience at the college level. Significant changes in living conditions, the novel demands of the college academic environment, and the large change in social surroundings are just a few of the potential sources of stress for a college student.

People feel that they are relaxing when they collapse in an easy chair with a cup of tea or coffee, a drink or a cigarette and read a newspaper or switch on the television. But this, in fact, is merely sensory diversion. Twentieth century research into sleep has proven that even entering into this traditional haven will rarely banish stress. True relaxation is an experience far beyond all this. For absolute relaxation one must remain aware, this is Satyananda Yoga Nidra, the state of dynamic sleep which was devised by Swami Satyananda Saraswati.

It is to be understood that ordinary sleep is not relaxation, for tensions cannot always be resolved completely in ordinary sleep. Yoga Nidra is qualitatively different relaxation. It is a sleep where all the burdens are thrown off to attain more blissful state of awareness, a relaxation much more intense than ordinary sleep.

In Yoga Nidra, exactly opposite process is used to make the brain centers active by focusing awareness on the parts of the body in a definite sequence. Thus, the person tries to stimulate various parts of the brain by awareness on the corresponding focusing the parts of the body. By awareness is meant 'attitude of witness' towards physical or mental actions of the body.

Yoga Nidra is one such wonderful technique, not only for physical or mental relaxation but also for preparing the mind for spiritual discipline. lt concerns mainly with pratyahara (withdrawing senses from sense objects) and dharana (concentration).

NEED FOR THE STUDY:

About one-fifth of India's population is in the adolescent age group of 10-19 years, it is estimated that there are almost 200 million adolescents in India (age group of 15-24). It is expected that this age group will continue to grow reaching over 214 million by 2020. However, growth for this age group will peak at 223 million in 2015 and will decrease slowly. In the eventuality of increasingly problematic adolescence, the community should step in to help children handle stress better, Sankaranarayanan says if the most important causative factors of suicide sense of abandonment were to be removed then suicide would decline. A relationship of trust established with an adult, a teacher, parents or even counselors, he says, will help the child bounce back from any set back in life. The nursing student, as she steps into the professional environment is exposed to varied learning situations including academic and clinical experiences. They need to adapt quickly to the constantly changing leaning situation in a milieu of almost myriad relationships. To develop into an effectively functioning citizen of our democratic society, she needs to have a well integrated personality.

Nursing students have the same academic stressors as other college students, such as midterm and final examinations, research papers and other assignments, In addition, nursing students experience aclinical component which is highly stressful. Students have a large amount of preparatory work before their clinical assignments. They often must travel long distances to clinical sites and use highly technical equipment. In addition, they must perform procedures that can cause serious harm to their patients, thus enhancing their fear of making mistakes. Studies indicate that nursing students may be more prone to stress than other students. Beck and Srivastava (1991) performed a study to investigate the perception level and sources of stress across academic years in 94 nursing students enrolled in a baccalaureate nursing program in a university. Psychiatric symptoms were more prevalent in these students than in the general population. Many of the items ranked as stressful by the nursing students were also identified by other populations, such as amount of material to learn, examinations and lack of timely feedback from faculty. In addition, the nursing students identified feelings of inadequacy in dealing with acutely i patients and difficulty in relationships with faculty. Nursing students had to devote long hours to study, were given multiple assignments, and lacked free time, timely feedback and faculty response to student needs.

The nursing curriculum introduces the students to varied new situations such as the hospital where there is always sickness, pain and death, the public health field where they would have to counsel and guide individuals and families which require a growth in social understanding and to develop a social responsibility. Many students also find it difficult to adjust to the hostel life because of certain rules and regulation, which they find more or less strict and rigid. All these factors put the student under stress and her success will depend a great deal on her personality make up which will influence her ability to adjust and adapt herself to continually changing situations.

The student nurse is preparing for a career with a variety of experiences where she has to make adjustments to various situations. The acting requirements of the curriculum and the regulation of the institution place stringent demands on the student. Both conformity and discipline are necessary for the efficient operation of a school, college or hospital. The critically ill do not possess any margin for laxity or mistakes on the part of nurses.

Yoga Nidra may have untold benefits that go beyond the therapeutic. It helps harmonizing two hemispheres of the brain and the two aspects of autonomous nervous system viz. sympathetic and parasympathetic. The rotation of body awareness stimulates different parts of the brain that control each and every nerve. When you are aware of each part of your body, you are actually massaging the corresponding part in the brain as well. You establish the connection between the body and the mind. The impressions in the subconscious are brought to surface, experienced and removed. Thus, the fixation of awareness to the body is replaced with the awareness linked to subtle aspects of prana and spiritual dimensions. Everyone can practice, including beginners who are stiff.

The investigator through her observation and interaction with nursing students realized that the learning experiences of the student nurses are stressful, as they have to adjust to new systems of learning for which they were not prepared to play the dual role which is expected of them as a student and as a nurse which is the most difficult area to get adjusted.

This study is expected to throw light on the prevalence of disturbance among the nursing students so that coping strategies like yoga, guidance and counseling be included in the curriculum.

STATEMENT OF THE PROBLEM:

A study to assess the effect of Yoga Nidra on stress among nursing students in selected colleges of Nursing in Hyderabad.

OBJECTIVES:

1. To compare the morning and evening stress before and after Yoga Nidra among nursing students in experimental group.

2. To compare the morning and evening post test stress of nursing students in experimental and control group.

3. To find out the significant difference in the morning and evening stress among nursing students in relation to their background factors (age, birth order, economic status, medium of instruction, academic performance, friends, relationship with teachers, chronic illness, painful event, health practice, parents' availability, parents' conflict, financial support, hostel life, year of course).

HYPOTHESES:

H₁: There will be a significant difference in the morning and evening stress before and after Yoga Nidra among nursing students in experimental group.

H₂: There will be a significant difference in the morning and evening post test stress between nursing students in experimental and control group.

H₃: There will be a significant association between morning and evening stress before and after Yoga Nidra and background factors among nursing students in experimental group.

OPERATIONAL DEFINITIONS:

1. Yoga Nidra:

Yoga Nidra is a systematic method of inducing complete physical, mental and emotional relaxation as stated in the audio tape.

2. Stress:

Stress is defined as a strain, a constraining influence, a physical and emotional or mental pressure or force as measured by the items in the likert scale. Stress was measured in terms of score. For the purpose of the study both morning and evening stress were measured.

3. Effect:

The effect refers to the positive outcome of Yoga Nidra in changes seen in stress. In this study the posttest and pretest stress scores were compared.

4. Nursing Students:

Refers to the students undergoing B.Sc., nursing programme which is a four year degree course in nursing.

ASSUMPTIONS:

1. Yoga therapy has no adverse effects.

2. Students who are taught yoga therapy will have no difficulty in practicing yoga.

DELIMITATIONS:

1. Study is limited to the BSc nursing students.

2. Data were collected by self-administered Likert scale.

3. Students in selected colleges at Hyderabad

REVIEW OF LITERATURE:

Review of literature of the present study is arranged under the following headings:

1. Studies related to stress among nursing students

2. Studies related to relaxation techniques and stress among nursing students.

3. Studies related to Yoga Nidra

I. STUDIES RELATED TO STRESS AMONG THE NURSING STUDENTs:

Burnard. P., et al. (2007) conducted a comparative, longitudinal study of stress in student nurses in five countries, Albania, Brunei, the czech Republic, Malta and Wales to compare and contrast levels and sources of stress amongst an international sample, A descriptive quantitative design was used and the tool was stress in Nurse Education Questionnaire among 1707 nursing students across the five countries. The mean score for the total sample for all the items on the stress scale was 52.3 (SD 17%). ANOA revealed that there were significant differences (P< 0.05) in total stress score by year of study. The findings indicate that student nurses world-wide do share much in common while still retaining individual cultural features relating to stress throughout their course of study Nicholl H., Timmins F. (2005) conducted an explorative study to measure the perceived stressors among 70 nursing students with academic study, Convenient sampling technique was used to recruit students as study subjects. A developed questionnaire from the literature was used. Self-report method was used to collect data. Factors related to writing assignments at degree level, fulfilling, personal needs and academic demands, were perceived as major stressors by these students, Factors of little concern were financial issues and attendance on the programme individual items receiving highest mean scores were trying to balance work commitments and the required study (mean 3.89, SD 1) and the prospect of the final examination (mean 3.86, SD 1)

Maville J. A (2004) conducted an explorative study on phenomenon of stress as perceived by Nurse Practitioner (NP) students enrolled in the Master of Science in nursing program. The study utilized a qualitative approach for data collection and analysis consistent with grounded theory methodology. They recruited 12 students, 4 men and 8 women, during their final year of a university-based NP program Data were collected through individual interviews and a demographic questionnaire. The students reported stress levels ranging from moderate to highest ever in their lives. Although reasons given for becoming an NP included increased autonomy and increased ability, high-level stress as attributed to high demands and to independent teaching learning techniques in the NP courses. Participants also expressed concerns about time management and financial obligations.

Deary l. J., et, al. (2003), conducted a longitudinal cohort study to investigate prospectively the determinants of, and relationships among, stress, burnout and attrition in nursing students. The tool used was a battery of instruments to measure personality, intelligence, psychological morbidity, stress, coping and burnout. Data were gathered on entry, at 12 and 24 months, and at the end of the nursing programme. It was found that students experienced increasing levels of stress and use of negative coping mechanisms as the programme progressed and psychological morbidity increased. Positive aspects of personality were more likely to lead to aspects of burnout, and personality was a more important indicator of attrition than cognitive ability. Stress, burnout and attrition may not be directly linked.

Lo (2002) investigated the perception and sources of stress, coping mechanisms used and self-esteem in nursing students during 3 years of their undergraduate nursing programme. The sample consisted of a cohort t of nursing students going through 3 years of a nursing programme. The questionnaire consisted of demographic data, the General Health Questionnaire (GHQ 12), self-esteem scale and the modified ways of coping scale. Results indicated that students in first year experienced significantly less transient stress as compared with second year students in third year had more positive self-esteem than second year students. There were no significant differences with regard to chronic stress, avoidance and proactive coping, and negative self-esteem Chronic and transient stresses as measured by GHQ were significantly correlated (p 0.01) with proactive coping behavior. The four main stressors in the last three years for this cohort of students in descending order are nursing studies, finance, family and health. They coped by using both problems focused and emotion focused coping skills.

Sheu et al (2002) examined (1) the degree of stress perceived and types of stressful events (2 the physio-psycho-social (P-P-sy status of nursing students during their clinical practice 13) the coping behaviors of these students (4) the effect of different coping behaviors on their physio-psycho-social health. The subjects were 561 nursing students who had completed their initial clinical practice. Results showed that stress for these students came mainly due to lack of professional knowledge and skills as well as caring of patients. The response of stress was social behavioral symptoms, staying optimistichad an effect, which reduced the occurrence of physio-psycho-social symptoms and improved P.P.S symptoms and improved effect, which reduced the occurrence of P P-S status. Finally, problem solving behavior also had negative main effect, which deteriorated P-P.S status.

II. STUDIES RELATED TO RELAXATION TECHNIQUES AND STRESS AMONGNURSING STUDENTS.:

Seyedfatemi, N., et al, 2007 conducted a descriptive cross sectional study to determine sources of stress and coping strategies in nursing students in Iran Faculty of Nursing and Midwifery. The sample size was 366 nursing students. The student stress survey and the adolescent coping orientation for problem experiences inventory (ACOPE) were used for data collection. Interpersonal and environmental sources of stress were reported more frequently than intrapersonal and academic sources. Mean interpersonal (P 0.04) and environmental (P s 0.04) sources of stress were significantly greater in first year than in fourth year student.

Bost N, Wallis M. (2006), conducted a study to investigate the effectiveness of massage therapy in reducing physiological and psychological indicators of stress in nurses employed in an acute care hospital A Randomized controlled trial design was used. Sixty nurses were recruited to the five week study and randomly assigned to two groups. A 15 minute back massage once a week was given to the experimental group, Physiological stress was measured at weeks one, three, and five by urinary cortisol and blood pressure readings. Psychological stress levels were measured at weeks one and five with State Trait Anxiety Inventory (STAI). the final results the two groups did not reach statistical significance. However, STAI scores decreased over the five weeks for those participants who received the five week period. These differences between the groups were statistically significant.

Adachi H. et al, (2005) conducted a study to evaluate the validity of the Stress and Stress-Coping Questionnaire (SSCQ) for female nursing groups. Subjects were 300 female nurses employed at hospitals. Mean age was 32.9 +l 8.9 years and mean number of years of work experience was 11^th, 9^th, 8^thyear. Data for the study were collected via the self-completed SSCQ which all subjects completed. In order to assess the validity of the SSCQ, subjects were asked to complete a 60-question General Health Questionnaire (GHQ) that assessed mental well-being. Based on the results of factor analysis, the original version of the SSCQ, comprising 153 questions in 10 subscales, were revised to the nurse-specific SSCQ -N, comprising 123 questions and 15 subscales. Cronbach's alpha coefficient for subscales varied from 0.70 to 0. 83, showing a significant correlation with the point score of the GHQ, for demonstrating criterion-related validity in the SSCQ. These results verify the usefulness for female nursing groups of the SSCQ for assessing mental well-being and suggesting ways to manage stress in nurses.

Kato T. (2005) conducted a study to investigate the effect of interpersonal stress coping training on reducing stress response of 100 student nurses. They were divided into two groups; the coping training (CT) group and the no training control (NT) group. During a three weeks period, 50 participants in the CT group were required to adopt postponed solution coping and keep daily records of how they coped with interpersonal distress All participants were asked to complete a self-reported questionnaire including measures of distress and coping strategies before and after the training, and also after a 18 weeks follow-up period. The CT group, compared with the NT group, significantly improved their postponed solution coping after the training. The CT group was found to be significantly lower in distress than the NT group both after the training and after the follow-up period.

Wang. H.F., et.al., (2005) conducted a descriptive cross-sectional design, the study examined the perception and sources of entrance exam stress and use of coping behaviors, the effect of difference in entrance exam stress levels on coping behaviors used and measurement of coping function to determine which coping behavior works best for buffering the impact of stress on psychological health during a preparatory stage of a college and university entrance exam among nursing students. By convenient sampling 441 3rd year nursing students were recruited. Three measurements stress perceived scale, coping behaviour inventory and a variance (2 way ANOVA) revealed that problem focused coping had a positive main effect of alleviating psychological distress.

Kanji. N., et al., 2004) conducted a comparative study to determine the effectiveness of autogenic training in reducing anxiety in nursing students. A controlled trial with 93 nursing students aged 19-49 years. The treatment group received eight weekly sessions of autogenic training, the attention control group received 8 weekly sessions of laughter therapy, and the time control group, received no intervention. The tool was the state-trait anxiety inventory the Maslach burnout inventory. There was a statistically significantly greater reduction of state (P 0.001) and trait (P 0.001) anxiety in the autogenic training group than in both other groups immediately after treatment. There was no difference between the groups for Masla Burnout Inventory. The autogenic training group also showed statistically significantly greater reduction immediately after treatment in systolic (P <0.001) and diastolic (P<0.05) blood pressure, and pulse rate (P<0.002), than the other two groups. Autogenic training has at least a short-term effect in alleviating stress in nursing students.

Evans W, Kelly B. (2004), conducted a study to examine the stress experiences and coping abilities of student nurses. A survey design was employed to examine the stress experiences of Diploma student nurses in a large Dublin Teaching Hospital. A questionnaire was utilized which measured and explored five specific constructs pertinent to student nurse stress. These included clinical stress, academic stress, coping, emotions and personal factors which assist student nurses during periods of stress. Findings showed that examinations, the level and intensity of academic workload, the theory-practice gap and poor relationships with clinical staff were the leading stressors identified. Emotional reactions to stress included feeling exhausted and upset under pressure. Students adopted short-term emotion focused coping strategies when attempting to deal with stress. A sense of achievement, and determination, were personal factors, which assisted students to continue in the event of stress being present Content analysis of the open questions shed further lightin relation to the stress phenomenon, particularly in relation to clinical stress.

Sharif F, Armitage P.,(2004), conducted a quasi-experimental pre-post-test, follow-up and control group design study to investigate the effect of psychological educational counseling in reducing anxiety in nursing students. The research study used methodological triangulation, involving the use of structured data collection techniques such as standardized questionnaires and semi structured focus groups. Focus groups were used to provide greater insight regarding the student's opinions. The sample consisted of 100 second and fourth -year baccalaureate nursing students. They were randomly assigned to either an experimental group or a control group. The experimental group received a 12-weeks intervention programme Quantitative analysis of data was undertaken using t test and analysis of variance for repeated measures to test differences between and within groups. The results indicated that from pre- to post-test there was no statistically significant reduction in anxiety between groups, but there was a statistically significant reduction in anxiety after one semester (in the follow up) Student self-esteem was increased significantly from pre- to post-test. This increase was statistically significant and remained the same in follow-up. A statistically significant difference was seen in the student grade point average from pre-test to follow-up in the experimental group but not for the control group. The implementation of an intervention programme reduced their anxiety, increased their self-esteem and improved their grade point average over time.

Beddoe A. E. Murphy S.0. (2004) conducted an exploratory study to assess the effects of an 8-week mindfulness-based stress reduction course on stress and empathy. A convenient sample of 16 students participated in the course, used guided meditation audiotapes at home, and completed journal assignments. Stress and empathy were measured using paired sample t tests. Participation in the intervention significantly reduced students' anxiety (P 05), Favorable trends were observed in a number of stress dimensions including attitude, time pressure, and total stress. Two dimensions of empathy, personal distress and fantasy also demonstrated favorable downward trends. Regular home meditation was correlated with additional benefit Participants reported using meditation in daily life and experiencing greater well-being and improved coping skills as a result of the program Findings suggest that being mindful may also decrease tendencies to take on others' negative emotions. Coping with stress and fostering the affective domain are important facets of nursing education that may be facilitated by mindfulness training.

Ill. STUDY RELATED TO YOGA NIDRA:

Gupta R. K. (2007) conducted a quasi-experimental study to determine the effectiveness of Yoga Nidra on stress level among 60 student nurses in selected Nursing Institutes. Two groups were formed out of which 30 samples were selected for control group and 30 for experimental group. Sampling technique used was simple random technique; Yoga Nidra was given to experimental group and after one week post-test was administered to both the groups. Findings show that mean posttest stress level of the experimental group was lower than the mean pre-test stress level. In control group there is no significant difference in pre-test and post-test stress levels whereas in experimental group there is a significant difference at P<0.05 Findings related to association of stress levels with demographic variables show that age, income, marital status, type of family and present residence show significant relationship with increase in the stress levels at P<0.05.

RESEARCH METHODOLOGY:

RESEARCH DESIGN:

Evaluative research is an applied form of research that involves how well a programme, practice, procedure or policy is working. It involves the collection and analysis of information relating to the functioning of a programme or intervention with the aim of assessing its effectiveness, Polit (1999).

The selection of research approach is a basic procedure for conducting research study. In view of the nature of the problem selected and the objective to be accomplished, evaluative research was considered as an appropriate research approach for the present study. The research approach used in this study was true experimental design to evaluate the stress among student nurses before and after Yoga Nidra. Here the dependent variable was measured at four points of time, twice before and twice after the intervention. The research design selected for the present study was true experimental design, to find the stress among student nurses before and after Yoga Nidra.

O1 - Morning Pre-test stress in experimental group

02 - Evening Pre-test stress in experimental group

O3 - Morning Pre-test stress in control group

O4 - Evening Pre-test stress in control group

O5 - Morning Post-test stress in experimental group

O6 - Evening Post-test stress in experimental group

O7 - Morning Post-test stress in control group

O8 - Evening Pre-test stress in control group

SETTING OF THE STUDY:

It is essential for the researcher to consider the setting in which the experimental treatment is conducted. There may be a significant difference between the treatment setting and the other settings to which the researcher may want to apply the results. The study was conducted in Vijay Marie College of Nursing and JMJ College of nursing, Hyderabad. Both experimental and control groups were randomly assigned in separate colleges to avoid contamination.

VARIABLES:

According to Polit(1999), variables are the conditions or characteristics that the investigator manipulates, controls or observes. The three categories of variables discussed in the present study are:

Independent variable - Yoga Nidra

Dependent variable – Stress

Associate variable - Age, birth order, economic status, medium of instruction, academic performance, friends, relationship with teachers, chronic illness, painful event, health practice, parents' availability, parents' conflict, financial support hostel life, and year of Course.

POPULATION:

Target Population refers to the population that the researcher wishes to make a generalization. In this research the target population was the nursing students. Accessible Population refers to the aggregate of cases which conform to the designed criteria and which is accessible to the researcher as the pool of subjects or objects. In this research the accessible population was the B.Sc. nursing students of Vijay Marie college of Nursing and JMJ College of nursing, Hyderabad.

SAMPLE SIZE:

To fulfill the objective of the study the B.Sc, nursing students of Vijay Marie college of Nursing and JMJ College of nursing, Hyderabad were selected. The sample size for this study was arbitrarily decided to be eighty, 40 experimental groups and 40 control group. Factors like nature of the study, availability of sample, time, money and material were considered while deciding the sample size.

SAMPLING TECHNIQUE:

Stratified random sampling is a probability sampling technique. In this technique the population and the study is divided into homogenous groups or classes called strata and the sample is drawn from each stratum at random proportionately or disproportionately.

In the present study, stratified random sampling technique was used. B.Sc, nursing students were divided into strata of I, II, III and IV year and further sample was drawn from each stratum by proportionate method, at random in Vijay Marie College of Nursing and JMJ College of nursing, Hyderabad.

COLLEGE	I YEAR	II YEAR	III YEAR	IV YEAR
JMJ	10	10	10	10
VIJAY MARIE	10	10	10	10

SAMPLING CRITERIA:

Inclusion criteria Specifies Nursing Students:

1. In B. Scprogramme only

2. In the age group of 17-22 years

3. Who are living in the hostel?

4. Who are exposed to clinical postings at least once.

Exclusion criteria Specifies Nursing Students

1. Who are known to have physical or psychological illness?

2. Who are in their menstrual cycle.

3. Who are already practicing any relaxation techniques?

DESCRIPTION OF THE TOOL:

The tool used for the study was a 4 point Likert scale. It consisted of two sections:

Section I: Background variables:

It consisted of items seeking background information such as age, birth order, economic status, medium of instruction, academic performance, friends, relationship with teachers, chronic illness, painful event health practice, availability of parents, parents conflict, financial support, hostel year of course as listed in the questionnaire.

Section II: Stress scale for student nurses:

The investigator developed a 4 point Likert scale consisting of fifty statements. Out of which, 20 are positive statements and 30 are negative statements. The responses ranged from "often to never as specified in the tool.

SCORING:

Statement	Never	Rarely	Occasionally	Often
Positive	3	2	1	0
Negative	0	1	2	3

The stress of student nurses was measured in terms of stress score. The maximum score was 150. Reverse scoring was done as follows:

VALIDITY OF THE TOOL:

Five experts including three nursing personnel, one psychologist and one sociologist validated the tool. The experts were requested to check the relevance, sequence, adequacy and language of the tool. The tool was modified according to expert’s opinion. Items with 100% agreement were included in the tool. A few items were modified and retained in the tool, thereby content validity was ascertained.

RELIABILITY:

The reliability of the tool was established by test-retest method among 10 nursing students. The tool was administered twice with an interval of one week The correlation co-efficient was calculated using Karl Pearson's method and the "r value was 0.75. The tool was found to be highly reliable.

TRY OUT:

The tool was administered to 10 B.Sc. nursing students in a similar set up. The tool was tested for its clarity. Few words or terminologies were modified for easy comprehension of the subjects.

YOGA NIDRA:

Yoga Nidra is an efficient method of inducing complete physical, mental and emotional relaxation, while maintaining consciousness. Yoga Nidra is a sleep where all the burdens, stress, strain, anxiety are thrown off to attain more blissful state of awareness, a relaxation much more intense than ordinary sleep. In Yoga Nidra the consciousness directs the unconscious to relax it lasts for 25 to 45 min. It is important to remain awake and aware during the practice. The instruction for Yoga Nidra was recorded in an audio cassette by Fr. Pradeep who is a trained instructor in Yoga Nidra.

DATA COLLECTION PROCEDURE:

The study was conducted from 15.10.07 to 31.10.07. Formal permission was sought and obtained from Vijay Marie College of Nursing and JMJ College of Nursing, Hyderabad. A total of 40 BSc nursing students for experimental group and 40 BSc. nursing students for control group were selected by stratified random sampling. Purpose of the study was explained to the students. Informed consent was obtained, confidentiality of information was assured.

Data was collected using a self-administered Likert scale to assess stress. Pretest was conducted twice. First pretest was conducted in the morning and the second pretest was conducted on the following day evening. For the experimental group intervention-Yoga Nidra, using an audio cassette was given for 7 consecutive days. The students were followed up during 7 days for practice of Yoga Nidra. Data from control group was collected simultaneously. Post test was conducted after Yoga Nidra for experimental group after the completion of 7 days and for control group without intervention. The posttest stress scores were taken both in the morning and evening. The tool was checked for its completion after every test.

PLAN FOR DATA ANALYSIS:

The data were edited, coded and entered in excel sheet. The data were analyzed using SPSS version 10. A probability of less than 0.05 was considered statistically significant. The data were analyzed as follows:

1. Data on Background factors of nursing students in experimental and control group were analyzed using frequency and percentage distribution,

2. Stress before and after Yoga Nidra in experimental group was analyzed using paired‘t’ test.

3. Assessing posttest stress in experimental and control groups were analyzed using unpaired t test.

4. Association between stress and background variables in experimental group before and after Yoga Nidra was analyzed using linear regression.

ETHICAL CONSIDERATIONS:

The main study was conducted after obtaining due permission from Vijay Marie College of Nursing and JMJ College of Nursing, Hyderabad. The research problem and objectives were approved by the research committee. The purpose and other details of the study were explained to the study participants and the informed consent was obtained. Assurance was given to the study subjects of their anonymity and the confidentiality of the data collected from them.

DATA ANALYSIS AND INTERPRETATION:

Polit (2000) states that statistical analysis is a method rendering quantitative information and elicits meaningful and intelligible form of research data.

The analysis and interpretation of data of this study was based on data collected by self-administered Likert scale. The results were computed using descriptive and inferential statistics. The data were entered into excel sheet and analyzed using SPss10 version A probability of less than 0.05 was considered to be significant.

The data were analyzed and organized under the following headings,

Section I: Data on background factors of nursing students.

Section II: Data on stress before and after Yoga Nidra among nursing students in experimental group.

Section III: Data on posttest stress among nursing students in experimental and control group.

Section IV: Data on association between stress among nursing students and their background factors.

SECTION Il: DATA ON STRESS BEFORE AND AFTER YOGA NIDRA AMONG NURSING STUDENTS IN EXPERIMENTAL GROUP.

For the purpose of the study, the following null hypothesis was stated.

H 01: There will be no significant difference in the morning and evening stress before and after Yoga Nidra among nursing students in experimental group.

Figure 1, reveals the significant difference in morning and evening stress before and after Yoga Nidra among nursing students in experimental group.

The mean difference between the pretest and posttest morning stress was 17.75. The obtained value 7.486 (P 0.0001) was significant. Therefore null hypothesis (H01) was rejected.

The mean difference between the pretest and posttest evening stress was 9.78. The obtained‘t’ value 4.745 (P=0.0001) was significant. Therefore null hypothesis (H01) was rejected.

It was inferred that the nursing students who practiced Yoga Nidra had significant decrease in post test both in the morning and evening stress. Therefore Yoga Nidra was effective.

FINDINGS:

The major findings of the study were presented based on the objectives of the study.

Objective 1: To compare the morning and evening stress before and after Yoga Nidra among nursing students in experimental group.

Ø Morning post test mean stress score was low 37.35 (SD 1592) among nursing students.

Ø There was a significant difference in the morning stress before and after Yoga Nidra, t- 7.486 (P<0.05) among nursing students.

Ø Evening post test mean stress score was low 41.40 (SD 16.76) among nursing students.

Ø There was a significant difference in stress before and after Yoga Nidra, t = 4.745 (P>0.05) among nursing students.

Objective 2: To compare the morning and evening post test stress of nursing students in experimental and control group.

Ø Morning post test mean stress core in experimental group was lower M = 37.35 (SD 15.92) than the control group M = 58.68 (SD 12.51).

Ø There was a significant difference in morning post test stress between experimental and control group, t = 7.59 (P>0.05).

Ø Evening post test mean stress score in experimental group was lower M = 41.40 (SD 16.76) than the control group M= 61.70 (SD = 1043)

Ø There was a significant difference in the evening post test stress between experimental and control group, t = 7.89 (P>0.05).

Objective 3: To find out the significant difference of stress in relation to their background factors (age, birth order, economic status, medium of instruction, academic performance, friends, relationship with teachers, chronic illness, painful even health practice, availability of parents, parents' conflict, financial support, hostel life, year of course).

Ø Morning stress was significantly (P<0.05) reduced in the post test, independent of background factors (age, birth order, economic status, medium of instruction, academic performance, friends, relationship with teachers, chronic illness, painful event, health practice, availability of parents, parents' conflict, financial support, hostel life, year of course) among nursing students.

Ø Evening stress was significantly (P<0.05) reduced in the post test, independent of all background factors (age, birth order, economic status, academic performance, friends, relationship with teachers, chronic illness, painful event, health practice, availability of parents, parents conflict, financial support, hostel life, year of course) except medium of instruction, which made a significant difference (P<0.05) in evening stress among nursing students.

DISCUSSION:

The results of the study were discussed according to the study findings

Findings 1 related to morning and evening stress before and after Yoga Nora among nursing students in experimental group.

· Morning post test mean stress score was 37.35 (SD = 15.92)

· There was a significant difference in the morning stress before and after Yoga Nidra, t = 7.486 (P<0.05)

· Evening post test mean stress score was low 41.40 (SD 16.76)

· There was a significant difference in stress before and after Yoga Nidra, 4.745 (P<0.05)

The above findings were supported by the studies conducted by Gupta R. K. (2006), and Sharif F., Armitage P., (2004) who reported significant difference in the mean posttest stress level in experimental group after intervention.

Findings 2, related to morning and evening post test stress scores among nursing students in experimental and control group.

· Morning post test mean stress score in experimental group was lower M= 37.35 (SD 15.92) than the control group M= 58.68 (SD 12.51)

· There was a significant difference in morning post test stress between experimental and control group, t = 7.59 (P<0, 05).

· Evening post test mean stress score in experimental group was lower M = 41.40 (SD 16.76) than the control group M= 61.70 (SD 10.43)

· There was a significant difference in the evening post test stress between experimental and control group, t = 7.89 (P<0.05).

The above findings were supported by the studies conducted by Gupta R. K. (2006), Kato T. (2005), and Bost N, Wallis M. (2006), who reported significant difference in the mean posttest stress level between experimental and control group.

Findings 3, on association between the morning stress before and after Yoga Nidra and background factors among nursing students in experimental group.

· Morning stress was significantly (P> 0.05) reduced in the post test, independent of background factors (age, birth order, economic status, medium of instruction, academic performance, friends, relationship with teachers, chronic illness, painful event, health practice, availability of parents, parents' conflict, financial support, hostel life, year of course) among nursing students.

· Evening stress was significantly (P> 0.05) reduced in the post test, independent of background factors (age, birth order, economic status, academic performance, friends, relationship with teachers, chronic illness, painful event, health practice, availability of parents, parents conflict, financial support, hostel life, year of course) except medium of instruction, which made a significant difference (P<0.05) in evening stress among nursing students.

The above findings were not supported by the study conducted by Gupta R.K. (2006) who reported that there was significant association between stress and background factors.

IMPLICATIONS:

The findings of the study have the following implications in nursing.

Nursing Education:

· Nursing students have more of educational stress which need to be addressed through Yoga Nidra.

· Yoga Nidra can be regularly practiced by nursing students to alleviate their stress during their clinical postings.

· Nursing students with reduced stress may contribute favorably in their education and patient care.

· Evening practice of Yoga Nidra by the nursing students may reduce the evening stress among them.

Nursing Research

· The study will be a valuable reference and a pathway for further researchers.

· Stress is a growing factor in the modern world for an increase in disease rate; therefore more research needs to be conducted in the area of coping with stress.

LIMITATIONS:

· Yoga Nidra was practiced over a period of one week which was not sufficient.

· Binding could have avoided investigators bias.

· The tool used in this study was developed for this specific work only, so all the limitations in the use of constructed tool were applicable to this study.

· The effect due to the influence of authority on study subjects could not be controlled.

· Influences of the anxiety among nursing students regarding exam announcement was beyond the control of the investigator.

RECOMMENDATIONS:

· A longitudinal study can be undertaken to see the long term effect of Yoga therapy in reducing stress.

· Studies with different relaxation techniques can be used to assess the most effective one.

CONCLUSION:

The following conclusions were drawn from the findings of the study

· Majority of the nursing students had stress

· Majority of the nursing students had reduction in stress after Yoga Nidra.

Therefore, nursing students need assistance to keep their stress at minimal level in interventions like Yoga Nidra, Nursing educators should provide adequate avenues nursing students reduce the stress level.

REFERENCE:

1. Brunner and Suddarth, (2004), "Text Book of Medical Surgical Nursing", Philadelphia: J. P. LippincottCo.

2. Edward A., et al. (1982), "Stress Mana Comprehensive Guide to Wellness", New York: Ballantine Books.

3. Garfield CA, (1979), "Stress and Survival", London, C. V. Mosby Company.

4. Kaila H.L, et al., (2001), "Stress Management", Bombay Himalaya Publishing House.

5. Karista. A., (1986), "The Text Book of Stress Survival", Bombay: Rajendra Publications

6. Kotharic R., (1997), Research Methodology, Methods and Techniques", WishwaPrakashan, New Delhi, Pp 51.55.

7. Lachman V.D., (1983), "Stress Management Manual for Nurses Urlandognune and Stratton, INC.

8. Lazarus R.S., (1986), “Psychological Stress and the Coping Process” New York, Holt Rine Hart and Winston.

9. Mahajan (1991), "Methods in Biostatistics". New Delhi, Jaypee Brothers Medical Publisher (P) Ltd.

10. Mechanic, D. (1978) "Students under stress A study in the social psychology of Adaptation", Madison.

11. Pestoniee D.M (1992), "Stress and Coping", the Indian Experecine, New Delhi: Sage Publication.

12. Phipps (1996), "Medical Surgical Nursing", Mosby, New York.

13. Polit (999), "Nursing Research principles and Methods", Lippincott, Philadelphia.

14. Potter and Perry (1993), "Fundamentals of Nursing", Bangalore, Mosby publishers.

15. Selye H., (1956) “The Stress of Life", New York, Mc Graw Hill Publications.

16. Talbot and Laura (1995), "Principles and Practice of Nursing Research", Missouri: Mosby Publications, Pp: 78-82.

17. Tanner Odean (1976), "Stress Time Life Book", Alexandria.

Received on 27.03.2017 Modified on 14.04.2017

Asian J. Nur. Edu. and Research.2017; 7(3): 429-440.

DOI: 10.5958/2349-2996.2017.00085.4

Group	Day 1 Morning	Day 2 Evening	Day 3 to Day 9	Day 10 Morning	Day 11 Evening
	Pretest	Pretest	Intervention	Post test	Post test
Experimental Group	O1	02	X	O5	O6
Control Group	O3	O4	-	O7	O8