INTRODUCTION:

The World Health Organization defines mental health as “a state of well being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community (2005).Most people experience feelings of anxiety before an important event such as exam, business presentation or first date. Anxiety disorders, however, are illnesses. That causes people to feel frightened, distressed and uneasy for no apparent reason if Left untreated, these disorders can dramatically reduce productivity and significantly diminish an individual's quality of life.

Anxiety disorders are among the most common mental illnesses in America more than 40 million were affected by this debilitating illness each year. Anxiety is a feeling of nervousness, apprehension, fear, or worry. Some fears and worries are justified, such as worry about a loved one or in an anticipation of taking a quiz, test or other examination.B4 Anxiety interferes with the sufferer's ability to sleep or other day to day function. It is noteworthy that teenagers are particularly susceptible to having irritability as a symptom of a number of emotional problems, including anxiety. Anxiety may occur without a cause, or it may occur based on a real situation but may be out of proportion to what would normally be expected. Severe anxiety can have a serious impact on daily life. Anxiety can be accompanied by a variety of physical symptoms. Most commonly, these symptoms are related to the heart, lungs, nervous, and gastrointestinal systems. You may have upset stomach, diarrhea, trouble breathing, feel as if you may faint or are having a heart attack.

It is common for an anxiety disorder to accompany another anxiety disorder, including such illnesses as substance abuse. Anxiety disorders can also coexist with physical disorders. In such instances, these disorders will also need to be treated, before undergoing any treatment, it is important to have a thorough medical check up to rule out other possible causes. We need strong public acknowledgment that severe anxiety is the basis for many of the most pervasive psychiatric disorders, and we need a public outcry for research into the stressors that underlie anxiety disorders. This is the only pathway to for the better treatments. Though drowning your sorrows in a bottle may temporarily allow you to forget your worries, numerous studies shows that you may be doing more harm than good when turning to alcohol for anxiety relief.B12 According to the National Institute on Alcohol Abuse and Alcoholism drinking alcoholic beverages stimulates production of the same hormones that your body releases when under anxiety. In other words, anxiety is induced rather than reduced.

For a minority of people social drinking can gradually deteriorate into alcohol abuse and eventually into alcohol dependenceB12. The drinking could have started in a lot of different ways, but that’s not what’s important. What is important is that the drinking became a habit and the habit became alcohol dependence or alcoholism. It matters not a hoot whether the alcohol is in the form of beer, wine or hard liquor. Alcoholism, also known as alcohol dependence, is a disease that includes the following four symptoms. Craving – a strong need, or urge, to drink. Loss of control -not being able to stop drinking once drinking has begun. The Physical dependence - Withdrawal symptoms are nausea, sweating, shakiness, and anxiety after stopping drinking, tolerance - The need to drink greater amounts of alcohol to get “high.”There is no “common” look for alcoholics you may be old or young; male or female; single, married, divorced, widowed or living with someone; practice any religion or none; live in the country, city, or suburb; earn a lot or a little; come from any ethnic, cultural, or racial background; have any level of education; and live any type of lifestyle and work.

Alcohol abuse and alcoholism cut across gender, race, and nationality. Nearly14 million peoples in the United States-1 in every 13 adults--abuse alcohol and 19,171 persons died of alcohol-induced causes. Alcohol problems are highest among young adults ages 18-29 and lowest among adults in age 65 and above. It has been proven that people who start drinking at an early age, 14 or younger, have an increased chance to develop alcohol problems at some point in their lives.

India is one of the largest producers of alcohol in the world and there India is one of the largest producers of alcohol in the world and there has been a steady increase in its production over the last 15 years, according to new statistics. India is a dominant producer of alcohol in South-East Asia, with 65 per cent of the total share, and contributes to around 7 per cent of the total alcohol beverage imports into the region. More than two-thirds of the total beverage alcohol consumption in the region is in India, according to figures in the newly-compiled Alcohol Atlas of India .There has been a steady increase in production in the country. Production doubled from 887.2 million liters in 1992-93 to 1,654 million liters in 1999-2000. It was expected to treble to 2,300 million liters by 2007-08. (The Hindu 2008)

According to researcher personal experience most of the people are vulnerable to anxiety. They use proper compensatory mechanism it relived. But lack of adequate compensatory mechanism and divertional therapies leads to addiction takes place; it may be alcoholism and drug abuse. So use proper compensatory mechanism will help to lead a quality life. Pranayama is a One of the simple and convenient method without any side effects to reduce anxiety among alcoholics.

STATEMENT OF THE PROBLEM:

Effectiveness of Pranayama on Anxiety among Alcoholics in a Selected De Addiction Centre at Chennai.

OBJECTIVES OF THE STUDY:

● To evaluate the effectiveness of pranayama on level of anxiety among alcoholics.

● To determine the association between level of anxiety among alcoholics with their selected demographic variables (Age, Religion, education, marital status, type of family, occupation, monthly income, duration of addiction).

HYPOTHESES:

H1: Pranayama is effective in reducing the anxiety among the alcoholics.

H2: There is a statistically significant association between level of anxiety among alcoholics with their selected demographic variables. (age, religion, education, marital status, type of family, occupation, monthly income, duration of addiction).

OPERATIONAL DEFINITIONS:

Effectiveness:

It refers to the outcome of pranayama in terms of reduction in the level of anxiety among alcoholics.

Alcoholics:

A person who consumes excessive alcohol and becomes addict.

Anxiety:

A state of apprehension, tension or uneasiness that stems from the anticipation of danger, which may be internal or external. A person is said to have anxiety when he/she scores between 41-120 in State trait anxiety inventory.

Pranayama:

A type of yogic breathing exercise which consists of four steps:

1. Inspiration, end inspiration

2. Breath holding

3. Expiration, end expiration

4. Breath holding

Time ratio 4: 4: 6: 2 (10 breathe cycle)

20 second rest for each cycle, 15 minutes once in a day.

Assumptions:

● Pranayama has a strong influence on anxiety among alcoholics

● Pranayama is a simple measure to reduce anxiety among alcoholics

● Pranayama improves physical and mental wellbeing of clients with alcoholics.

Delimitations:

The study is delimited to the alcoholics who were admitted in a selected Deaddiction center at Chennai.

Projected outcome

● The study will help the nurses to assess the level of anxiety among alcoholics.

● The study will help the nurses to identify the effectiveness of pranayama on reducing anxiety among alcohol.

● The study findings will help the nurses to practice the pranayama as an intervention for reducing anxiety among alcoholics.

Research literature were reviewed and organized under the following headings.

● Alcoholics with anxiety.

● Effectiveness of Pranayama technique on anxiety.

● Effectiveness of Pranayama on anxiety among alcoholics

Conceptual Framework:

The conceptual framework for the study was developed on the basis of Irwin Rosen stock’s Belief and Personal Health Behavioral model, one of the most influential psychological approaches designed to account for the ways in which healthy people seek to avoid illness.B14 This model postulates that the health seeking behavior is influenced by a person’s perception of a threat posed by health problems and the values associated with actions named at reducing the threat within the framework.

 Human behavior is seen as being dependent upon two primary variables:

 The value placed by a person upon a particular outcome.

 The person’s beliefs that a given action will result in particular outcome.

Accordingly the Health Belief Model suggest that preventive action taken by an individual to avoid disease is due to particular individual perception that he or she is personally susceptible and the occurrence of the disease would have at least some severe personal implication.B9 The assumption in this model is if we take particular actions susceptibility would be reduced or the severity of the disease would be reduced. The model comprises of three components with different variables:

METHODOLOGY:

Research Approach

A Quantitative approach was used for analyzing the effectiveness of pranayama on reducing anxiety among alcoholics.

Research Design

According to Polit and Hungler., (2004) “Quasi-experimental design involves the manipulation of an independent variable that is, institution of an intervention. Quasi-experiment however lacks either the randomization or control group features that characterize true experiments”. Random selection and randomization was not adopted as it was not possible to have the entire listing of anxiety among alcoholic clients, hence this design was chosen.

A quasi experimental pre-test and post-test design with control group was chosen for this study without randomization. Assessment was made before and after the intervention (Pranayama) with State Trait Anxiety Inventory. (STAI)

The diagrammatic representation of research design is given below.

Group	Pre test	Intervention						Post test
		Days
		01	02	03	04	05	06
Experimental group	O₁	X	X	X	X	X	X	O₂
Control group	O₃	*	*	*	*	*	*	O₄

(O₁-O₂) = Effectiveness of Pranayama intervention.

Keys

O₁- pre test assessment of level of anxiety in experimental group

O₂- post test assessment of level of anxiety in control group

O₃- pre test assessment of level of anxiety in control group

O₄- post test assessment of level of anxiety in control group

X - Intervention (Pranayama)

* - Routine nursing care

Variables

Dependent Variable: Level of anxiety

Independent Variable: Pranayama (SKY)

Extraneous Variables: (Age, Religion, education, marital status, type of family, Occupation, monthly income, duration of addiction)

The Schematic Representation of Research Methodology

Description of Tool

The tool for the study has two sections

Section A: Demographic variables

Section B: State – Trait Anxiety Inventory, Spielberger (1979)

Scoring Procedure

A tool had two parts state level and trait level anxiety each part had 20 questions

 Totally 40 questions

 A total raw score = 160

 Mild score = 41-80

 Moderate = 81-120

 Severe = 121-160

Pranayama Intervention Technique

“Pranayama involves the regulation of the exhalation, the inhalation, and the suspension of the breath. The regulation of these 3 processes is achieved by modulating their length and maintaining this modulation for a period of time, as well as directing the mind into the process. These components of breathing must be both long and uniform” (Yoga Sutra). Like the arteries that carry blood throughout our physical body, our energetic (subtle) body has the nadis (meridians) that are like rivers carrying prana throughout the body. By directing the energy flow into our subtle body, pranayama helps to awaken the nadis. This energizes the seven chakras that are the centers of purification, storage and distribution of prana in the physical body.

Data analysis and interpretation

The collected data regarding effectiveness of Pranayama on level of anxiety Among alcoholics were organized, analyzed and interpreted as follows

Section I: Data on Demographic Variables of Alcoholics

Section II: Level of anxiety among Alcoholics

Section III: Effectiveness of Pranayama on level of anxiety among Alcoholics

Section IV: Association between the level of anxiety among Alcoholics with Selected Demographic Variables.

Section I: Data on Demographic Variables of Alcoholics

Table 1: Frequency and Percentage Distribution of Demographic Variables of Alcoholics in Experimental and Control group N=60

S No

Demographic Variables

Experimental Group

Control Group

Total

Age in years

a) Less than 18

b) 19 - 25

c) 26 - 40

d) 41 & above

16.67

33.33

13.33

33.34

11.67

33.33

Religion

a) Hindu

b) Muslim

c)Christian

d)Others

83.33

6.67

16.67

13.33

76.66

11.67

Education

a)Primary

b)Higher Secondary

c)Graduate

23.33

26.67

33.33

16.67

28.33

21.67

Marital Status

a)Married

b)Unmarried

c)Divorce

46.67

36.67

16.66

56.67

3.33

51.67

38.33

Type Of Family

a)Joint Family

b)Nuclear Family

53.33

46.67

53.33

Occupation

a)Self Employee

b)Employed

c)Un employed

66.67

33.33

53.33

46.67

Monthly Income In Rupees

a)Less Than 2000

b)2001 - 3000

c)3001 - 4000

d)4000 And Above

13.33

22.33

6.67

56.67

36.67

53.33

6.67

16.67

21.66

Duration Of Alcoholism

a)Less than one year

b)2 - 3Years

c)4 - 5Years

d)Above 5 Years

16.67

46.66

36.67

43.33

13.33

28.33

28.34

Table 3 Mean, standard deviation, mean deviation, and `t value for experimental and control group

S. No.	Group	Mean Value	Standard Deviation	Mean Difference	t Value
1	Experimental group
	Pre test	94.57	11.84
	Post test	59.8	14.25	34.77	20.27***
2	Control Group
	Pre test	94.23	12.59
	Post test	93.27	13.03	0.86	1.58ns

***Significant at P<0/001 level

Figure 4: Mean level of anxiety for experimental and control group during pretest and post test

Table 4 Frequency, Percentage, and χ² analysis of Level of Anxiety among Alcoholics with their Selected Demographic Variables N=60

S No

Demographic Variables

Mild level

Moderate level

Chi square

χ²

Age in years

a) Less than 18

b) 19 - 25

c) 26 - 40

d) 41 & above

8.33

3.33

6.67

31.67

4.17^NS

df = 3

Religion

a) Hindu

b) Muslim

c)Christian

d)Others

18.33

3.33

58.33

11.67

8.33

1.38^NS

df=2

Education

a)Primary

b)Higher Secondary

c)Graduate

1.67

26.67

16.67

3.84^NS

df =2

Marital Status

a)Married

b)Unmarried

c)Divorce

16.67

46.67

21.67

10.75*

df=3

Type Of Family

a)Joint Family

b)Nuclear Family

3.33

18.33

43.33

6.54*

df=1

Occupation

a)Self Employee

b)Employed

c)Un employed

11.67

43.33

0.57^NS

df=2

Monthly Income In Rupees

a)Less Than 2000

b)2001 - 3000

c)3001 - 4000

d)4000 And Above

1.67

6.67

1.67

11.67

43.33

3.49^NS

df=3

Duration Of Alcoholism

a)Less than one year

b)2 - 3Years

c)4 - 5Years

d)Above 5 Years

3.33

8.33

23.33

21.67

23.33

0.54^NS

df=3

* - Significant at p < 0.05 level; NS- Not significant

Table 3 reveals the mean, standard deviation, mean Among 30 samples in an experimental group the pre test score reveals majority 24(80%) of the samples had moderate level of anxiety, one fifth 6(20%) were under mild level of anxiety, none of them were under normal level of anxiety, the post test assessment score of the samples indicates majority 21(70%) of the samples were under mild level of anxiety and samples with normal level of anxiety were 5(16.67%) and sample with moderate level of anxiety were 4(13.33%).

Table 2.2 depicts frequency and percentage distribution of level of anxiety in control group. Among 30 samples in control group the pre test score reveals majority 23(76.67%) of the samples had moderate level of anxiety, a little above one fifth 7(23.33%) were under mild level of anxiety, the post test assessment score of the samples indicates a little above three fourth 23(76.67%) of the samples were under moderate level of anxiety, 7 (23.33%) were mild level of anxiety and none of them were under normal level of anxiety Section III : Effectiveness of Pranayama on level of anxiety among Alcoholics..

difference, and `t value for experimental and control group, Among 30 samples in an experimental group the mean pre test score 94.57 and standard deviation 11.84 was more than mean post test score 59.8 with standard deviation 14.25. The calculated mean difference is 34.77 and the obtained `t value is 20.27, which is statistically significant at p< 0.001 level hence it was inferred that Pranayama is an effective in reducing level of anxiety among alcoholics. Among 30 samples in control group the mean pre test score 94.23 and standard deviation 12.59 was more than mean post test score 93.27 with standard deviation 13.03. The calculated mean difference is 0.86 and obtained t value was 1.58 which was not statistically significant at p<0.001 level.

Section IV: Association between the levels of anxiety among Alcoholics with Selected Demographic Variables.

DISCUSSION:

The basic aim of the current study is to evaluate the effectiveness of Pranayama on level of anxiety among the alcoholics. The study has been conducted by using Quasi-experimental design at Wisdom hospital de–addiction center at Chennai. The total sample size was 60 among which 30 samples were placed each in control and in experimental group.

The structured self administered STAI scale Spielberger (1979) was administered to assess the level of anxiety among the alcoholics. The responses were analyzed through descriptive statistics (mean, frequency, percentage) and inferential statistics (paired `t` test and Chi-square).

Anxiety is something most people go through almost as a matter of course, on a regular basis. There are degrees of severity, however, and based on this psychiatrists have classified them into three types, namely general anxiety, phobias and panic disorder. Some amount of anxiety we are told is actually a good thing because it acts as an alarm when danger is close.B3 However, if you are always anxious about everything and nothing and anxious about being anxious on top of that, then it is a vicious cycle, which can impair your normal day-to-day, functioning. Whatever the case, be it phobia, panic or general anxiety, there are implications for the person’s social, emotional well being and in some cases even their physical well being.

One of the ways in which anxiety can be managed is through the regular practice of Pranayama. Pranayama is an age-old technique developed by the Yogis of ancient India as the key to inner wellness. Pranayama is the technique of breath manipulation to achieve desired level of physical and emotional wellness.

According to Gautama. (2000) Yoga and meditation are gaining world wide popularity among people. It is not possible for many of us to practice yoga religiously after a hard day’s work. Breathing exercise does not take away our energy. It is a kind of relaxation in which our consciousness is alert in Pranayama. It’s indeed amazing that sitting and breathing evenly can be a means of tapping deeper resources within us. Devoting half an hour a day even for a week reveals the beauty of this practice. It increases the quality of alertness of the mind, which becomes capable of looking fresh and thinking in completely new ways. Breathing is not only the nourishment of our body but it is also the one essential link between the terrestrial and the vast expanse of cosmos.

Molton. I, et. al., (2005) Pranayama on anxiety management technique improves quality of life in alcoholism. The current study evaluated the efficacy of a 6 days, group-based, Pranayama intervention in reducing anxiety Improving Quality Of Life (QOL) among alcoholics. The study reveals that 6 days Pranayama group Intervention was effective in improving the QOL by reducing anxiety among Alcoholics.

The findings of the study were discussed according to the objectives to evaluate the effectiveness of Pranayama on level of anxiety among alcoholics.

Among 30 samples in an experimental group the mean pre test score 94.57 and standard deviation 11.84 was more than mean post test score 59.8 with standard deviation 14.25. The calculated mean difference is 34.77 and the obtained ´t´ value is 20.27, which is statistically significant at p<0.001 levels, hence it is inferred that Pranayama is an effective intervention in reducing anxiety among alcoholics. (Table-3)

Among 30 samples in control group the mean pre test score 94.23 and standard deviation 12.59 was more than mean post test score 93.27 with standard deviation 13.03. The calculated mean difference is 0.86 and obtained ‘t’ value is 1.58 which is not statistically significant at 0.05 level. (Table-3)

In a research conducted by the National Institute of Mental Health and Neuroscience in India on July 2006, states that up to 73 percent of participants with anxiety had a significant reduction while practicing Sudharshan Kriya Yoga (SKY), a Pranayama technique.

Nutrition Group, Agharkar Research Institute, (2006) compared the efficacy of SKY against both guided imagery and the drug diazepam. In this study, consisting of 37 participants and taking place over a period of 7 weeks, researchers found that, although inferior to guided imagery, SKY was shown to be as effective as diazepam in the treatment of anxiety. During the study, participants practiced 30 minute daily sessions and once-weekly 75 minute sessions of SKY. Lastly, although more clinical studies are needed to support the findings, Sudarshan Kriya Yoga has also been shown to be clinically effective in the treatment of anxiety. Studies also suggest that regular practice of SKY lowers levels of epinephrine in the blood, and increases an individual’s overall sense of well-being.

Second objective of the present study is to determine the association between level of anxiety among alcoholics with their selected demographic variables. (Age, Religion, education, marital status, type of family, occupation, monthly income, duration of addiction). The results in the present study shows the presence of statistically significant relationship between alcoholics and marital status (χ2=10.5, P = 0.05), and family (χ2=6.54, P =0.05).

Raj. K (2010) studied the level of anxiety and effect of family on drug addicts in her study she states disorganized family environment is considered as one of the key parameter that makes a normal us individual to get inclined to the world of drug addiction, her study results concluded that the non addicts family environment is for better supportive and organized than addicts at 0.001 level of significance.

Tehran (2006)., in his research suggest that environmental influences are important on the association between sleep problems and anxiety in adults the results shows the strongest correlations with sleep problems (R=.20,.21…respectively)and with anxiety (R = .24,.28 subsequently analysis indicated that family disorganization and mental depression are occupied for approximately 30% of the association between sleep problems and anxiety. (R= .18).

Raskin, H. et. al 2005 conducted a longitudinal study on marriage and mental health of a cohort of young adults in his study reveals that Married people are stress, anxiety and depressed and have fewer alcohol related problems, as compared to unmarried people. The rate of alcohol problems and depression is faster in married people, than in unmarried people. Married men report fewer cases of alcohol related problems. Better mental health fails to show relationship with length of marriage and presence of children. The quality of marriage may be responsible for the relationship between mental health and marriage.

Allan. V (2006) conducted a comparative study on psychological and mental health of young adolescents who have cohabited and the married and the unmarried persons. Results show that there are significant differences in the levels of anxiety of the two groups. However, alcohol problems are found to be prevalent in married and single individuals compared to unmarried male and female cohabitates. When a person living in a joint family, responsibilities and role will be more and family genetics plays a predominant role to increased anxiety level, marital status also plays a vital role to raise a anxiety level because of increases demand in their effort due to role transition.

SUMMARY, CONCLUSION AND RECOMMENDATIONS:

Major study findings include

Among alcoholics with moderate level of anxiety, majority of them were between 26 – 40 years, Hindus, married, 2-3 years duration of addiction. Regarding the level of anxiety in experimental and control group majority of them were reported to have moderate level of anxiety, on day 6th most of them reported to have mild level of anxiety in experimental group and there were no measurable difference in control group.

With regard to effectiveness of Pranayama on level of anxiety among the alcoholics the calculated mean difference is 34.77 and obtained ‘t’ value is 20.27 which it is statistically significant at p<0.001 level, hence it was inferred that Pranayama is an effective in reducing anxiety among alcoholics.

● With regard to the association between the level of anxiety their selected demographic variables such Age, Religion, education, Occupation, Monthly Income, Marital Status, Type of Family, Duration of Addiction there were statistical significant association between level of anxiety and type of family and marital status {( χ²= 6.54,P < 0.005),( χ²2= 10.75, P < 0.005)}.

CONCLUSION:

The main conclusion from the present study is that majority of the alcoholics in an experimental group had moderate and mild level of anxiety during pre-test and at the time of post test they had reduction in level of anxiety from moderate to mild level and mild to normal level. This shows the imperative need to understand the purpose of Pranayama (SKY) technique regarding reduction of anxiety among the alcoholics and it will improve the quality of life.

IMPLICATIONS OF THE STUDY:

According to Tolima, (1995) the section of the research report that focuses on nursing implication usually includes specific suggestions for nursing practice, nursing education, nursing administration and nursing research.

Nursing Practice:

The findings of the study clearly points out that Pranayama (SKY) intervention are effective on reducing level of anxiety among alcoholics.

The reduction of anxiety among alcoholics had an important role to play in enabling effectiveness of Pranayama intervention as an independent nursing intervention. This can be facilitated by motivating the nurses to:

● Develop sensitivity to the effects of Pranayama on reducing level of anxiety among the alcoholics.

● Understand the importance of Pranayama technique intervention as a adjunct to the Pharmacological therapy.

● Encourage peer use of Pranayama intervention as a form of relaxation among the alcoholics with anxiety.

● Encourage the use of Pranayama intervention in reduction of anxiety and to minimize the requirement of non-pharmacological management.

Nursing Education

Health personnel may separate the theory and practice while treating the alcoholics with anxiety and tend to reduce the level anxiety which can be beneficial for the alcoholics. So nursing educators should motivate students to:

● Ensure that nursing students learn to assess anxiety and effectiveness of Pranayama intervention in reduction of anxiety, as an independent nursing intervention.

● Provide adequate clinical exposure to students, where Pranayama is used in reduction of anxiety.

● Arrange for participating capacity building program on Pranayama techniques Ensure the availability of enough literature related to Pranayama techniques in reduction of anxiety in library, for students reference.

Nursing Administration:

● Collaborate with hospital authorities in formulating policies to employ the specially qualified nurses in de – addiction ward and periodically supervise their application of Pranayama intervention.

● Conduct capacity building programme on Pranayama intervention and it’s application in various fields.

● Provide opportunity for nurses to attend training programme on Pranayama techniques while handling the alcoholics with anxiety.

Nursing Research

● Encourage further research studies on the effectiveness of Pranayama intervention in treating other mental illnesses.

● As it is evident from the review of literature more research needs to be conducted on the effectiveness of Pranayama intervention along with other routine procedure, in reduction of anxiety among other population.

● Disseminate the findings through the conferences, seminars publication in Professional, national and international journals and World Wide Web.

RECOMMENDATIONS:

● The study can be replicated with large sample size.

● The study can be conducted on patients with drug abuse

● A study can be conducted to assess the knowledge, attitude and practice of pranayama among nurses posted in de – addiction ward.

● Comparative study can be conducted between Pranayama and other relaxation therapies to reduce level of anxiety among alcoholics

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Received on 01.06.2015 Modified on 11.06.2015

Int. J. Nur. Edu. and Research 3(3):July-Sept., 2015; Page 299-309

DOI: 10.5958/2454-2660.2015.00012.5

S. No.	Level of anxiety	Pretest		Post test
S. No.	Level of anxiety	n	%	n	%
1	Normal`	0	0	5	16.67
2	Mild	6	20	21	70
3	Moderate	24	80	4	13.33