A
Study to Assess the Effectiveness of Therapeutic Back Massage on Quality of
Sleep among Cardiac Patients in a Selected hospitals at Rajkot
Mr. Chauhan
Denishenkumar Y.1, Mr. Jeenath
Justin Doss K.2
1II year, M.Sc. Nursing, Shree Anand Institute of Nursing, Ghanteshwer
Park, Jamnagar Road, Rajkot - 360006
2HOD, Principal, Shree Anand
Institute of Nursing, Ghanteshwer Park, Jamnagar Road,
Rajkot - 360006
*Corresponding Author’s Email: denishmedicare@gmail.com
ABSTRACT:
The Improvement in quality of
sleep of hospitalized cardiac patients with insomnia has an important role to
play in enabling effectiveness of therapeutic back massage intervention as an
independent nursing intervention. The objective of the study is to evaluate the
effectiveness of therapeutic back massage on quality of sleep among the
hospitalized cardiac patients with insomnia.
The research design adopted
was Quasi Experimental Time Series design. The conceptual frame work for this
study was based on Modified Ludwig Von Bertalanffy’s
General system theory. The study had been conducted in Unicare
hospital, Rajkot.
Non-probability purposive
sampling technique had been adopted to select the desired samples. The sample
size was 40. As an intervention therapeutic back massage was administered for
10-15 minute and the same was repeated for 7 days. The data was collected
through General Sleep Disturbance Scale.
The collected data were analysed by using both descriptive and inferential
statistical methods, ‘F’ test was used to evaluate the effectiveness
therapeutic back massage on quality of sleep among hospitalized cardiac
patients. The obtained ‘F’ value was 45.33*** which is greater than tabulated
‘F’ value 2.7 which was highly significant at 0.001 level. Hence the findings
of the study revealed that therapeutic back massage helps in improving the
quality of sleep among hospitalized cardiac patients. Among all demographic
variables gender, day time sleeping and sleeping pattern was having significant
association with the pre test level of insomnia.
KEYWORDS: Effectiveness, therapeutic back massage,
quality of sleep, cardiac patients, insomnia.
INTRODUCTION:
Sleep and rest
are basic human needs essential to all individual’s physical and psychological
well being. Getting enough quality sleep at the right time can help to protect
our mental health, physical health, quality of life, and safety. The purpose of
sleep is a mystery, however it is necessary for health and a sense of well
being.1 Sleep can be defined as a normal state of altered
consciousness during which the body rests; it is characterized by decreased
responsiveness to the environment, and a person can be aroused from it by external
stimuli. 2
Sleep begins in stage one of the sleep phase known as NREM,
or non-rapid eye movement, sleep. NREM sleep has four stages: light sleep,
deeper sleep, and two stages of deepest sleep.3 The average daily amount of sleep varies
considerably among adults. Most adults in the age group of 20 to 50 have
average 6 to 8 ½ hours of sleep. However 5% to 10% of this age group sleeps
more than 9 hours and 2% to 5% sleep less than 6 hours without difficulty.4
Insomnia is the inability to obtain an adequate amount
or quality of sleep. The difficulty can be in falling asleep, remaining asleep,
or both.4The causes of insomnia are medical conditions, pain,
stress, fear, anxiety, menstruation, mental disorders, shift work, circadian
rhythm disorder, use of psychoactive drugs or stimulants, medications, herbs,
caffeine, nicotine, cocaine etc. and withdrawal from drugs, alcohol, or
sedatives. Out of this, the causes of insomnia among hospitalized cardiac
patients are the cardiac diseases like congestive cardiac failure, myocardial
infarction, coronary artery diseases etc.5
There are several measures like massage therapy, music
therapy, pharmacotherapy, bright light therapy, behaviour therapy and Yoga etc
to treat sleeplessness, of which the therapeutic massage is considered one of
the effective methods used to induce sleep.6 The three main physical
effects of therapeutic massage are release of muscle tension, increased blood
circulation and initiation of relaxation response. The release of muscle
tension will improve balance and co-ordination, resulting in more restful sleep
and lesser the need for pain medication. The increased circulation will improve
nutrition to the tissues and will remove waste products from tissues, reduce
swelling, improve skin tone, and relieve dryness and itching and favours speedy healing etc.7 Now a days
massage therapy is commonly used in clinical practice. The analysis of survey
revealed that promoting relaxation was the main motivation for nurses using
massage therapy.8
NEED FOR THE STUDY:
India is undergoing an epidemiological transition and
is on the threshold of an epidemic of cardiovascular disease. Cardiovascular
diseases (CVDs) accounted for around one‐fourth of all deaths in India in
2008. CVDs are expected to be the fastest growing chronic illnesses between
2005 and 2015, growing at 9.2% annually. A more worrying fact is that the
incidences of CVDs have gone up significantly for people between the ages 25
and 69 to 24.8%, which means losing more productive people to these diseases.
Prevalence of Coronary Heart Diseases (CHDs) is between 7‐13 per cent in
urban and 2‐7 per cent in rural India. A conservative estimate indicates
that there could be 30 million CHD patients in India of which 14 million are in
urban and 16 million in rural areas. If the current trend continues by the year
2020, the burden of atherothrombotic CVD in India
will surpass other regions of the world.9
According to World Health Report 2002, cardiovascular
diseases (CVDs) will be the largest cause of death and disability by 2020 in
India. In 2020 AD, 2.6 million Indians are predicted to die due to coronary
heart disease which constitutes 54.1 % of all CVD deaths. Nearly half of these
deaths are likely to occur in young and middle aged individuals (30-69 years).
Currently Indians experience CVD deaths at least a decade earlier than their
counterparts in countries with established market economies (EME). The Global
Burden of Disease (GBD) study estimates that 52% of CVD deaths occur below the
age of 70 years in India as compared to 23% in EME.9
1.
To
evaluate the effectiveness of therapeutic back massage on quality of sleep
among hospitalized cardiac patients.
2.
To
associate the quality of sleep with the demographic characteristics of the
hospitalized cardiac patients in experimental and control group.
HYPOTHESIS
H1:
Therapeutic back massage will be effective in improving the quality of sleep
among hospitalized cardiac patients.
H2:
There will be a significant association between the quality of sleep with
selected demographic variables in both experimental and control group among
hospitalized cardiac patients.
MATERIAL AND
METHODS:
Research Approach: Quantitative
Approach
Research Design: Quasi
Experimental Time Series Research Design
Target Population: Cardiac clients
Accessible Population: Cardiac clients in selected hospitals
Sampling Technique: Non Probability purposive sampling
Data Collection Procedure: Demographic variables, General Sleep
Disturbance scale
Group: 20 under
Experimental group and 20 under Control group
Pre Assessment of Quality
of sleep in Experimental group and Control group
Therapeutic
Back Massage to only experimental group
Post
Assessment of Quality of sleep in Experimental group and Control group
Data Analysis: Descriptive and
Inferential Statistics
MAJOR FINDINGS:
Major study findings
include:
A. Findings related to demographic
variables of the study.
1. The
majority of 28(70%) sample’s age is between 51-60years and above 60 years.
2. The
majority of 23(57.5%) sample’s are males.
3. The
majority of 31(77.5%) sample’s are having primary and secondary education.
4. The
majority of 29(72.5%) sample’s are married.
5. The
majority of 16(40%) sample’s are not working people.
6. The
majority of 25(62.5%) sample’s are admitted in general ward.
7. The
majority of 34(85%) sample’s are vegetarian.
8. The
majority of 30(75%) sample’s are not using the comfort devices.
9. The
majority of 36(90%) sample’s are staying in the hospital for 1 week.
10.
The majority of 31(77.5%) sample’s are Hindus.
11.
The majority of 30(75%) sample’s are day time sleeper.
12.
The majority of 28(70%) sample’s are light sleeper.
B. Findings related to effectiveness of
therapeutic back massage on quality of sleep among hospitalized cardiac
patients
With
regards to effectiveness of back massage on reducing insomnia and improving
quality of sleep ,the obtained ‘F’ value of
ANOVA test in Experimental group for the level of insomnia was 45.33
that was very highly significant at p<0.001 level and in Control group it is
5.99 which is not highly significant at p<0.001 level.
C. Findings related to association between
demographic variables and pre test level of insomnia.
Among the demographic
variables (age, religion, occupation, educational status, marital status,
duration of hospital stay, ward admitted, dietary pattern, use of comfort
devices) obtained ᵡ² value below the tabulated value at the level of 0.05
significance. The variables (gender, day time sleeper, sleeping pattern) had
obtained ᵡ² value above the tabulated value at the level of 0.05 which
has significant association.
CONCLUSION:
The main conclusion
from this present study is that most of
the cardiac patients who had severe,
moderate level of insomnia in pre test have mild, moderate in post test
Day-1,2,3,4,5,6,7. This shows the imperative need to understand the purpose of
back massage regarding reduction of insomnia levels and improvement in quality
of sleep in cardiac patients with insomnia and it will improve the quality of
life which includes the stability in physiological, psychological, sexual,
vocational and lifestyles aspects.
REFERENCES:
1)
Berger TK, Fundamentals of Nursing Collaboration for
Optimal Health, Appleton large Publications,2nd edition,(1999),
1121-1122.
2)
Potter PA, Fundamentals of Nursing, Mosby
Publication, 6th edition, (2000), 1203 -1204.
3)
Matthew TN, Geraldo LF, Sleep in Heart Failure. Progress in Cardiovascular Diseases, Volume
51, Issue 4, January 2009, Pages 339-349.
4)
Hospital
Statistics for Insomnia. Available at: www. Wrong diagnosis. com/i/ insomnia/causes.htm
5)
Insomnia Overview. Available at:
www. Sleep disorder deal channel. com/ insomnia/index.shtml
6)
Reji Varghese, A Comparative
Study on the Effectiveness of Therapeutic Back Massage and Music Therapy on the
Quality of Sleep among Hospitalized Patients with Inadequate Sleep. Unpublished
M.Sc. nursing dissertation submitted to RGUHS, Bangalore (2005).
7)
Dan Ketchum, Mind
over matter. Journal of Alternative and Complementary Medicine, March 2014,
Available at livestrong.com
8)
Vickers. A, Massage
and Aroma Therapy. A guide for Health Professionals, Vol:
48, (2006), 142-169.
9)
National Cardiovascular Disease Database by WHO,
Available at:www.searo.who.int/india/cardiovascuardisease/ NCDResources.
Received on 26.07.2016 Modified on 10.08.2016
Accepted on 29.08.2016 ©
A&V Publications all right reserved
Int. J. Nur. Edu.
and Research. 2016; 4(4): 487-489.
DOI: 10.5958/2454-2660.2016.00089.2