http://doi.org/10.33698/NRF0156 – Ruchika Rani , Ashok Kumar, Poonam Sharma
Abstract : In the modern scenario, human life has become very fast, hectic and demanding. Mental stress is the penalty the man is paying today for becoming civilized. Academic stress pervades the life of students, and tends to impact adversely their mental and physical health, and their ability to perform school work effectively. A pre experimental study was conducted with the objectives to assess and compare the stress level of B.Sc nursing first year students before and after the administration of Yoga Nidra to them. Sample size of 50 was selected by using total enumeration sampling technique and data was collected by using modified stress assessment scale. The stress level is categorized into 5 categories of severe (57-80), high (47-56), moderate (37-46), low (27-36) and very low (0-26). The findings of the study reveals that mean stress score after Yoga Nidra (17.8) was lesser than the mean stress score before Yoga Nidra (28.82). This indicates decrease in stress scores of B.Sc nursing first year students. There was no significant association of stress level and selected personal variables of age, gender, and type of family, order of birth, religion, family income and place of living.
Keywords
Yoga Nidra, Stress, B.Sc Nursing First Year students.
Correspondance at
Ashok Kumar
Assistant Professor, College of Nursing AIIMS, Jodhpur.
Introduction
The phenomenon of stress has largely been associated with affluence and western lifestyle. Psychiatric disorders are the most prevalent problems of modern living, and drugs used for the management of these disorders are selling in billions of dollars around every year around the world. It is estimated that about 50 million people have either moderate or severe forms of psychiatric disorders in India. The findings of the Surveysconducted by Mental Health Organization (2000) revealed that 1 in 4 people experience some kind of mental health problem in the course of a year. Stress is a big problem in our society1. According to Psychologists, 75 percent of bodily disease is said to be stress related.
Extreme stress conditions are detrimental to human health but in moderation, stress is normal and, even in many cases, proves useful.Ratana Saipanish (2003) reported that source of stress which the most undergraduate students experience is receiving a lower grade than they expected (grade pressure). Too much stress can interfere student’s preparation, concentration, and performance but positive stress can be helpful to students by motivating them to peak performance2. Hens Selye (1956, 1976) termed the body’s response to stressors as the General Adaptation Syndrome. Stress has a number of immediate effects. Chronic stress may even cause severe illness and even death3.Kaplan & Sadock, (2000) reported that Learning and memory can be affected by stress4. Felsten & Wilcox (1992) reported in his study that academic stress pervades the life of students, and tends to impact adversely their mental and physical health, and their ability to perform schoolwork effectively5.
Lizy T.V (2001) conducted a study to identify and analyze the stress reactions and coping strategies of 2nd year GNM students in response to the clinical stress in selected Schools of nursing in Andhra Pradesh. Findings indicated that majority of GNM 2nd year students(71.11%) had moderate degree of stress. A significant positive correlation was shown between clinical stress and stress reactions6.
There are various non-pharmacological therapies to prevent and treat the psychosomatic disorders related to stress. Yogic relaxation therapy has been effectively prescribed in conjunction with other medical and yogic procedures in the management of severe psychosomatic diseases.
Swami Satyananda Saraswati (1976) explains Yoga Nidra is a state of mind between wakefulness and dream. When someone practices Yoga Nidra, it opens the deeper phases of the mind.Yoga Nidra appears to work by changing the neuro hormonal reactivity to stress creating somatic conditions essentially opposite to those prompted by sympathetic over activity. During Yoga Nidra the organs system of the body attain deep, physiological rest and the body’s powerful, inherent, regenerative mechanism are set in motion7.
In the wakeful state of awareness, the conscious mind is actively engaged with external environment through the sensory channels of experience. During this period, fast rhythm beta waves (frequency 13- 20 c.p.s) predominate. During the dreaming state, subconscious mind becomes predominate. In this state, the suppressed desires, fears, inhibitions and deep seated impressions samskaras are actively expressed. This is characterized by theta waves (frequency 4- 7c.p.s). In the deep sleep state i.e. the unconscious mind, all mental activity and fluctuations disappears, and body and mind are paralyzed. In this state, slow delta wave rhythm (frequency 0-4 c.p.s) predominates. Between the states of waking and dreaming, a distinct and important band of awareness and experience lies, it lasts for more than 3 to 5 minutes and characterized by alpha waves (frequency 7- 12 c.p.s), Psychologists called this state as hypnogogic state.
A study was conducted on college going students of Dev Sanskriti Vishwavidyalaya to find out the impact on stress and anxiety through Yoga Nidra. Practice time was 30 minutes with duration of 6 months. 80 students were taken for observing the effect as well as 30 in control group. The result showed a significant change in the practice group as Yoga Nidra positively decreased the stress level of the male and female subjects. (Kumar and Bhanu 2003)8.
The goal of Yoga Nidra is to produce a response which counters the stress response. A number of studies have been found that Yoga Nidra is useful in reducing the stress and anxiety in students. Many studies have been conducted in India and abroad to see the effect of Yoga Nidra on stress level of school and college going students. The researcher’s personal experience also shows that students need to learn practice of Yoga Nidra in order to improve physiological and psychological wellbeing. Since nursing students are busy in clinical area and theoretical part also throughout the day which make them stressful, so researcher felt the need to conduct study to assess the effect of Yoga Nidra on stress level of nursing students.
Objectives of the Study
To assess the impact of Yoga Nidra on the stress level of B.Sc Nursing first year students.
Hypothesis of the study
H1The level of stress before Yoga Nidra of B.Sc nursing first year students will be significantly higher than the level of stress after Yoga Nidra at 0.05 level of significance.
Materials and Methods
The present study was conducted in M. College of Nursing, Mullana, Ambala.The research approach adopted for study was experimental in nature. The research design was pre experimental i.e. one group Pre-test Post-test design. The independent variable of the study was administration of Yoga Nidra and dependent variable was the level of stress among BSc Nursing 1st year students of M. M. College of Nursing, Mullana, Ambala. Total enumeration sampling technique was used for the purpose of sampling.
In this study, Modified stress assessment scale which was originally prepared by M. Singh, Senior Psychologist in Dev Sanskriti Vishwavidyalaya, Haridwar, was used. Permission had been taken from the author for the necessary modification in the personal variables of the tool. The tool consisted of forty statements on a three point scale of Always, Sometime and Never scored as 3, 2 and 1 respectively. The maximum and minimum scores of modified stress assessment tool were 80 and 0 respectively.
Table 1 : Level of stress on the basis of stress scores
| Stress Level | Stress Scores |
| Severe | >57 |
| High | 47-56 |
| Moderate | 37-46 |
| Low | 27-36 |
| Very low | <26 |
The technique adopted to collect the data was Self reporting technique.The content validity of tools was established by nine experts, including seven nursing experts in the field of psychiatric nursing, medical surgical nursing, child health nursing, and community health nursing, and one psychologist and one expert in the field of human consciousness and yogic sciences.
Researcher had undergone training and attended camps organized by a Saint Anandmurti Gurumaa, where Yoga Nidra was learnt under her supervision. Researcher had practiced Yoga Nidra for period of more than 1 year. Yoga Nidra is a relaxational technique which is performed in the posture of shavasana, with the eyes closed. It consists of 8 stages i.e. Preparation, Sankalpa, Rotation of consciousness, Breath awareness, Opposite feelings and sensations, Visualization, Sankalpa and Ending the practice.The content of audiotape was validated from a yoga teacher, Kamakhya Kumar, chief coordinator of Yoga Arogya Polyclinic, School of Yoga and health, Dev Sanskriti Vishwavidyalaya, Haridwar as audio CD contained all the essential eight stages of Yoga Nidra and certified that researcher will be able to conduct sessions of Yoga Nidra.
The pilot study was conducted in the month of November in the Mohan Dai Oswal College of Nursing, Ludhiana. The Yoga Nidra was administered with audio tape and speakers. Researcher found feasible to conduct the study through pilot study. Students preferred tool in Hindi language. The reliability of modified stress assessment tool was established by test retest method and Karl Pearson coefficient of correlation method was used and reliability coefficient was found to be 0.91. The tool was hence, found to be reliable and feasible.
For data collection self-introduction and establishment of rapport with the subjects was done. Students were explained about the purpose of the study and the process of Yoga Nidra. The subjects were assured about the confidentiality of their responses. The classes for Yoga Nidra for the final study were arranged at 4:00pm regularly for 20 days excluding Sundays.Fifty students were selected by using Total enumeration sampling technique. On day 1, stress scores were obtained before Yoga Nidraby giving modified stress assessment tool to assess the stress level of students and then they were exposed to the Yoga Nidra for 20 days consecutively except Sundays. The duration of each session of Yoga Nidra was 48 minutes.
The Yoga Nidra was administered by using recorded instructional audio tape. The students were allowed to lie down in shavasanas posture on the mats spread over the floor. The students were asked to close
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their eyes and have complete relaxed posture. Once the relaxed posture was attained, students were told not to make any physical movement. Then recorded audio CD was played. The voice was made audible to all the students with the provision of speakers. The students were told to follow the instructions given by instructor during all the stages of Yoga Nidra.
Stress scores were obtained on day 20th after the administration of Yoga Nidra to evaluate the effectiveness of Yoga Nidra using the same tool as used before Yoga Nidra. Data collected was analysed by using SPSS – 16 version.
Results
Findings regarding demographic variables in Table 2 revealed that 80% nursing students were in the age group of 17-19 years. Most of the students(84%) were female. Majority of them (74%)were from nuclear family. Two third of the students (62%)were first born child in their family and belongs to Hindu religion (64%). Forty four percent of students in the family income of Rs. 10,001/- to 15,000/- per month and equal number had Rs.15,000/- per month . There were equal number of students in rural area and urban area i.e.50%. (Table 2)
Table 2: Socio Demographic Variables of Nursing Students. N = 50
Table 3 and figure 2 reveals that before the administration of Yoga Nidra 23(46%) nursing students were in very low stress level followed by 17 (34%) students were in the category of low stress level and 8(16%) students in moderate stress level and 1(2%) in high and 1(2%) in severe stress level.
Whereas after the administration of Yoga Nidra 41(82%) students were in very low stress level followed by 4(8%) in low stress level, followed by 2(4%) in moderate stress level. There was no effect of Yoga Nidra on students having stress in the category of high stress level and severe stress level.
Table 3: Comparison of stress level of nursing Students N=50
| Categories of stress | Before Yoga Nidra | After Yoga Nidra |
| n % | n % | |
| Severe (³ 57) | 01 02 | 01 02 |
| High (47-56) | 01 02 | 02 04 |
| Moderate (37-46) | 08 16 | 02 04 |
| Low (27-36) | 17 34 | 04 08 |
| Very Low (£26) | 23 46 | 41 82 |
Maximum score : 80, Minimum score : 0
Figure 1: Impact of Yoga Nidra at Stress Level of nursing Students
Table 4 & figure 2 depicts that, the mean stress score of nursing students before Yoga Nidra was 28.82 and the mean stress score after Yoga Nidra was 17.80 with the mean difference of 11.02 and standard error mean difference of 2.10. After Yoga Nidra, the standard deviation was high, because period of 20 days of Yoga Nidra proved effective for category of moderate, low and very low stress level than high and severe stress level. The computed ‘t’ value (‘t’=5.24) was statistically significant at 0.05 level of significance. Thus it is established that the difference obtained in the mean stress scores before and after Yoga Nidrawas true difference and not by chance. Hence, the research hypothesis H1 has been accepted.This indicates that the administration of Yoga Nidra was an effective technique to reduce the stress level of nursing students.
Table 4: Mean Stress Score of Nursing Students Before and After Yoga Nidra.
| Group | Mean ± SD sEmd | ‘t’ |
| Before Yoga | 28.82 ± 10.33 | |
| Nidra | 2.10 | 5.24* |
| After Yoga | 17.80 ± 12.62 | |
| Nidra | ||
| Maximum score: | 80 | |
| Minimum score: | 0 df (49), p<0.05 |
*significant at 0.05 level
This indicates that the administration of Yoga Nidra was an effective technique to reduce the stress level of nursing students.
Figure 2: Mean Stress Score of Nursing Students Before and After Yoga Nidra.
Stress scores of students before Yoga Nidra and after Yoga Nidra were significantly not associated with age, gender, type of family, order of birth, religion, family monthly income and place of living.
Discussion
The stress is often the cause of diseases or aggravates the diseases. (Science Reporter, 2000). The school and college going students experience stress as stated by Muhamad et al, 2001.The present study findings revealed that the sixteen percent of students were in category of moderate stress level followed by 2% students in high and 2% students in severe stress level.
The present study findings suggest that the effect of Yoga Nidra on stress level of nursing students is positive revealing evidence for the effect of Yoga Nidra in reducing stress level of students. The mean stress score after Yoga Nidra (17.8) of nursing students was significant lesser than the mean stress score before Yoga Nidra (28.82) as per t test (p<.05). The students also reported that this Yoga Nidrawas useful, that they felt relaxed, peaceful, and calm. Similarly Kumar Kamakhya (2004) conducted a study on the post graduate students by considering the variable of age, gender, type of family. The mean stress scores after Yoga Nidra were significantly lower than the stress scores before Yoga Nidra of post graduate students, as findings similar to present study.
The practices of Yoga Nidra helps in building up the coping abilities and prevent the person from becoming a victim of distress as stated by Flak, 1978; Gupta R.K, 2007 which report that a minimum of 15 sessions of these techniques for 20 to 30 minutes each is extremely effective in reduction of stress as reported by the present study9,10.
On the basis of findings of the present study, it can be concluded that the administration of Yoga Nidra was significantly effective in decreasing the stress level of nursing students and the reduction was independent of age, gender, type of family, order of birth, religion, family income and place of living.
The findings of the present study revealed that nursing students are under stress because of academic and clinical assignments thus Yoga Nidra is useful in reducing stress and anxiety in students.This research also puts forward idea of holistic nursing practice.Nurses play a vital role in stress management by interacting with patients as a total person. To meet patient’s physical, psychological and spiritual needs, a nurse should mentally relaxed and calm. Thus, a training programme for nurses can be useful in orienting the nurses regarding such techniques to enhance their physical, psychological and spiritual health.There should be provision for such classes where Yoga Nidra is used to augment the capacities of receptivity and attention and awaken the joy of learning in students.The nursing research in the field of stress and its treatment with Yoga Nidra would help the nurses to know if these modalities help the students Based on the findings, the study recommends the practice of Yoga Nidra to reduce the physical and psychosomatic disorders due to stress and also to enhance the student’s well being and their academic performance.
It is recommended that the study can be replicated on a large sample of students from different colleges to make broader generalizations and the yoga Nidra should be
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