A Study to assess the effectiveness of Biofeed back assisted progressive muscle relaxation on Anxiety and Depressive symptoms among alcoholics in Krishna Nursing Home, Coimbatore

N. Narmatha

Assistant Professor, Gem Institute of Nursing Education and Research, Coimbatore, Tamil Nadu.

*Corresponding Author Email: narmathavinotha0@gmail.com

ABSTRACT:

The problem of alcohol occurs at different levels of severity, from mild and annoying threatening. Although alcohol dependence is most severe problem, less severe drinking problem can also be dangerous. Alcoholism is a condition that results in the continued consumption of alcoholic beverages, despite health problems and negative social consequences. Alcoholism is also known as alcohol dependence, is a disease that includes alcohol craving, withdrawal symptoms, physical symptoms, and psychological symptoms like anxiety, depression, suicidal tendencies etc., This study was aimed to assess the effectiveness of biofeedback assisted progressive muscle relaxation on reduction of anxiety and depressive symptoms among alcoholics in Krishna Nursing home Coimbatore. This study adopted an evaluative approach, and made use of true experimental randomized pretest and post test control group design. Conceptual framework adopted for this study was the Modified Roy’s adaptation theory (1984). A total of 60 samples out of which 30 samples for experimental group and 30 for control group using simple random sampling (consecutive sampling) who fulfilled the inclusion criteria. Pretest was done for both experimental and control group to assess the Anxiety and depressive symptoms using Beck anxiety scale and Beck depressive Inventory scale respectively. Biofeedback assisted progressive muscle relaxation was administered to the experimental group for 30 minutes once a day for 10 days and routine treatment for control group. Post test was done for experimental and control group using same above mentioned scales. The gathered data were analyzed using descriptive and inferential statistics. The independent t value of anxiety was 9.324 and depressive symptoms value was 8.42which was significant at P<0.05 level respectively. The study findings revealed that biofeedback assisted progressive muscle relaxation were beneficial ad there was a significant reduction in anxiety and depressive symptoms among alcoholics in experimental group.

KEYWORDS: Anxiety, Depressive symptoms, Biofeedback, Progressive muscle relaxation.

INTRODUCTION:

For many people, drinking alcohol is nothing more than a pleasant way to relax. However people with alcohol disorder use drink to excess, endangering both themselves and others. The progressive muscle relaxations have been claimed for a variety of health problems associated with anxiety and depressive symptoms. It has strong efficacy to reduce the anxiety and depressive symptoms. Biofeedback is helping recovering alcohol addicts and gain control their mind and body during treatment.

Globally prevalence of alcohol disorders in adults has been estimated to be 2.8% for men and 0.5% for women respectively in 2013. Alcohol consumption is 7.77% in Canada. In India prevalence of alcoholism is 5-20%. In a rural population of Punjab alcohol was found to be t5he commonest abuse about 82.5%. Tamil Nadu alcoholism prevalence rates about 11% of the respondents consumed alcohol. In urban 85% people are having the habits of alcoholism.

MATERIALS AND METHODS:

Research approach:

Evaluative approach was adopted for this study.

Research deign:

The research design selected is true experimental randomized pre test and post test control group design.

Setting of the study:

The study was conducted in Krishna Nursing Home, Coimbatore.

Population:

The target population selected for this study was alcoholics.

Sample:

Samples were adult male alcoholics admitted in Krishna Nursing Home.

Sample size:

Sample size 60

Sampling technique:

Consecutive simple random sampling technique was used to select the sample for the study.

Instruments and scoring procedure:

The instruments consists of 3 sections.

Part I:

It consists of demographic data such as name, age, sex, religion, education, occupation, marital status, monthly income, duration of alcoholism, number of admission in hospital.

Part II:

Beck anxiety inventory was used to assess the level of anxiety.

Part III:

Beck depression inventory was used to assess the level of depressive symptoms.

Validity:

Validity of the tool was established with 1 psychologist, 1 clinical psychologist 1 psychiatrist and 3 nursing experts.

Reliability:

Reliability of beck’s anxiety inventory and beck’s depressive inventory scale was established by internal consistency method using Karl Pearson’s formula. reliable r=0.98 for beck’s anxiety inventory and r=0.91 for beck’s depressive inventory.

protection of human rights:

The research proposal was approved by the dissertation committee. A written permission was obtained from the head of the institutions, and oral consent was obtained from each participant after explaining the purpose of the study before collecting the data. Confidentiality of the permission was maintained.

Data collection procedure:

Data collection was done for a period of 6 weeks. The demographic variables and pre test was done to assess anxiety and depressive symptoms by using Beck’s anxiety inventory and Beck’s depressive symptoms scale respectively. 30 samples were selected for the experimental group and 30 were control group. On the 1^st day 15 samples were selected for the experimental group and pretest was done using Beck’s anxiety inventory and Beck’s depressive inventory to assess the level of anxiety and depressive symptoms. Biofeedback assisted progressive muscle demonstrated by the researcher. The the samples were administered biofeedback assisted progressive muscle relaxation for 25 to 35 minutes. Post test was conducted on the 10^th day using same scale. The collected data were analyzed using descriptive and inferential statistics.

RESULTS AND DISCUSSION:

Regarding age, in experimental group, majority 13(43.3) belonged to 31-44 years of age, 11(36.7%) belonged to 45-50 years of age, 3(10%) belonged to 26-30 years of age and 3(10%) belonged to 20-25 years of age. In control group, majority 14(46.7%) belonged to 31-44 years of age, 9(30%) belonged to 45-50 years of age, and 7(23.3%) belonged to 25-30 years of age. In sex experimental group majority 30(100%) were males in control group 30(100%). Regarding education, in experimental group, majority had high school education, 8(26.7%) had higher secondary education, 8(26.7%) had degree and 5(16.6%) had primary education. In control group, majority 13(43.3%) had higher education, 9(30%) had high school education, 5(16.7%) had degree and 3(10%) had primary education. Regarding monthly income in experimental group, majority 18(60%) were having an income 10(33.3%) were having an income of 5001-8000, and 2(6.7%) were having an income of 3001-5000. In control group, majority 15(50%) were having an income of above 8001, 13(43.3) were having an income of 5001-8000, and 2(6.7%) were having an income of 3001-5000. Regarding occupation in experimental group, majority 16(53.3%) were business, 7(23.3%) were coolie, 6(20%) were private employee, and 1(3.3%) were government employee. In control group, majority 15(50%) were business, 6(20%) were private employee, 5(16.7%) were coolie and 4(13.3%) were government employee. Regarding marital status, in experimental group, majority 23(73.7%) were married, and 7(23.3%) were unmarried. In control group, majority 26(86.7%) were married and 4(13.3%) were unmarried. Regarding religion in experimental group, majority 28(93.3%) were Hindu and 2(6.2%) were Christian. In control group majority 30(100%) were Hindu. Regarding residence, in experimental group, majority 18(60%) were living in urban and 12(40%) were living in rural. In control group, majority 22(73.3%) were living in urban and 8(26.7%) were living in rural. Regarding duration of alcohol intake, in experimental group, majority 16(53.3%) were having above 5 years of alcohol intake, 6(20%) were having below 1 year of alcohol intake, 4(13.3%) were having 4-5 years of alcohol intake, 2(6.7%) were having 3-4 years of alcohol intake and 2(6.7) were having 2-3 years of alcohol intake. In control group, majority 15(50%) were having 4-5 years of alcohol intake, 7(23.3%) were having above 5 years of alcohol intake, 4(13.3%) were having 2-3 years of alcohol intake, 3(10%) were having 3-4 years of alcohol intake and 1(3.3%) were having below 1 year of alcohol intake. Regarding history of previous admission, in experimental group, majority 22(73.3%) had no previous admission and 8(26.6%) were had previous admission. In control group, majority 21(70%) had no previous admission. Regarding number of biofeedback, in experimental group, majority 23(76.7%) had received no treatment, 4(13.3%) had received above 2 times. 2(6.7%) had received 2 times and 1(3.3%) had received 1 time. In control group majority 23(76.7%) had received no treatment, 5(16.6%) had received 2 times and 2(6.7%) had received 1 time.

Table 1 depicts thst the pretest mean score level of anxiety was 21(SD±8.6) and post test mean score was 9(SD±1.3) respectively. The post test mean score was lower than the pre test mean score. The ‘t’ value was 7.66 which was significant at p<0.05 level, which showed that biofeedback assisted progressive muscle relaxation was effective in reducing anxiety.

Table 2 depicts that the pre test mean score level of depressive symptoms was 18(SD±7.13) and post test mean score was 12(SD±1.8) respectively. The post test mean score was lower than the pre test mean score. The mean difference was 6. The paired ‘t’ value was 7.1 which was significant at p<0.05 level, which showed that biofeedback assisted progressive muscle relaxation was effective in reducing depressive symptoms.

Table 3 depicts that the mean score of post test in level of anxiety in experimental group was 9(SD±1.38) and control group was 12(SD±1.38) respectively. The post test mean score in experimental group was lower than the post test mean score in control group. The mean difference was 3. The independent ‘t’ value was 4.88 which was significant at p<0.05 level, which showed that biofeedback assisted progressive muscle relaxation was effective in reducing anxiety.

Table1: Comparison of mean, standard deviation, mean difference and paired ‘t’ value of pretest and post test level of anxiety among alcoholics in experimental group n =30

Level of anxiety	Mean	Standard deviation	Mean difference	Paired’t’ value	Table value	Inference
Pre test	21	8.6	12	7.66	2.05	singnificant
Post test	9	1.3	12	7.66	2.05	singnificant

df=29 p<0.05

Table 2: Comparison of mean, standard deviation, mean difference and paired ‘t’ value of pretest and post test level of depressive symptoms among alcoholics in experimental group n =30

Level of depressive symptoms	Mean	Standard deviation	Mean difference	Paired ‘t’ value	Table value	Inference
Pre test	18	7.13	6	7.1	2.05	significant
Post test	12	1.8	6	7.1	2.05	significant

df=29 p<0.05

Table 3: Comparison of mean, standard deviation, mean difference and independent ‘t’ value of post test level of anxiety between experimental group and control group among alcoholics. n₁=30n₂=30

Groups	Mean	Standard deviation	Mean difference	Independent ‘t’ value	Table value	Inference
Experimental group	9	1.38	3	4.88	2.02	significant
Control group	12	3.39	3	4.88	2.02	significant

df=58 p<0.05

Table 4 depicts that the mean score of post test in level of depressive symptoms in experimental group was 8(SD±2.08) and control group was 12(SD±2.44) respectively. The post test mean score in experimental group was lower than the post test mean score in control group. The mean difference was 4. The independent ‘t’ value was 5.46 which was significant at p<0.05 level, which showed that biofeedback assisted progressive muscle relaxation was effective in reducing depressive symptoms.

CONCLUSION:

The present study was conducted to assess the effectiveness of biofeedback assisted progressive muscle relaxation on anxiety and depressive symptoms among alcoholics in Krishna nursing home Coimbatore. The study findings revealed that the independent‘t’ value of anxiety was 9.324whichwas significant at p< 0.05. The independent‘t’ value of depressive symptoms was 8.42 which was significant at p<0.05. The results of the study concluded that biofeedback assisted progressive muscle relaxations were highly effective in reducing anxiety and depressive symptoms.

IMPLICATIONS:

The findings of the study have certain implications for nursing service, education, administration and nursing research.

Nursing Service:

· Psychiatric nurses teach to the alcoholics to practice progressive muscle relaxation when admitted the hospital following detoxification.

· Learning material like posters, self instructional module, can be made available in the ward andoutpatient department, rehabilitation centers and de-addiction centers.

· Conduct education program for the teachers and students regarding alcoholic anxiety and depressive symptoms.

Nursing Education:

· Nurse educator can encourage the nursing students to conduct health education program in community area regarding the effects of alcoholism to promote their health status.

· Nurse educator can conduct the workshop on importance of complementary and alternative medicine to the students.

· Nurse educator can recognize and encourage the nursing students to celebrate the international day against drug abuse and illicit trafficking and conduct rally to create awareness among general population in clinical and community settings.

Nursing Administation:

· Nurse administrator can recognize awareness of alcoholic anxiety and depressive symptoms in psychiatric hospitals, rehabilitation center, and de-addiction center.

· Nurse administrators have more responsibility as supervisors in creating awareness among various age groups especially in adolescent by providing Handouts, pamphlets, Booklets regularly in various schools, colleges.

· Nurse administrator can organize the in service education program regarding various cutting edge technological advancements in the treatment of alcoholic anxiety and depressive symptoms to all health care providers which create awareness and helps to provide early care.

· Nurse administrator can conduct mass education program by using variety of audio visual aids like television, computer, which would benefit to the community.

Nurse Research:

· The study findings can be effectively utilized by the emerging nurse researcher to conduct further studies and improving the body of knowledge in nursing.

· Students can do the mini project on other aspects of alcoholism such as relaxation techniques, and preventive measures of alcoholic anxiety and depressive symptoms.

RECOMMENDATIONS:

· A longitudinal study can be conducted to assess the prevalence rate of alcoholic anxiety and depressive symptoms.

· Comparative study can be conducted between the clinical settings and community settings.

· The similar study can be conducted on large samples for generalization of findings.

· The similar study can be conducted as a quasi experimental study.

LIMITATIONS:

· The researchers had difficulty to controlling the alcoholics.

· The researcher had difficulty in gaining cooperation of the family members.

REFERENCES:

1. Davy vancompfort., (2011). Efficacy of biofeedback assisted progressive muscle relaxation. “Sage Journal” Pp: 567-579

2. Elizabeth A Goodwin., (2010). Cognitive behavioral biofeedback assisted progressive muscle relaxation for anxiety. “Clinical Case Studies” Pp: 112-125

3. Ghufari S et al., (2008). Effects of applying biofeedback assisted progressive muscle relaxation for multiple sclerosis. “Iran National Society” Pp: 45-53

4. Pookala Bhat., (2010). Biofeedback assisted progressive muscle relaxation in management of anxiety “Indian Journal of Psychiaty”. Pp 111-114

5. http://www.ncbi.nlm.nih.gov/pubmed/7623470

6. http://www.pubs.niaaa.nih.gov/publications/arh29-2/107-120pdf

7. http://www.ncbi.nlm.nih.gov/pubmed/16420070

8. http://myuminfo.umanitoba.ca/documents/2028/....medicate anxiety

Received on 20.09.2021 Modified on 19.02.2022

Asian J. Nursing Education and Research. 2022; 12(3):345-349.

DOI: 10.52711/2349-2996.2022.00072