Impact of Joss Stick skill training on conation among major depressive disorder (MDD) patients in government head quarters hospital at Erode

Sampoornam. W

Annai JKK Sampoorani Ammal College of Nursing, Komarapalayam, Namakkal – 638183.

*Corresponding Author E-mail: sampoornamwebster@yahoo.in

ABSTRACT:

Context: Psychomotor retardation is a central feature of depression which includes motor and cognitive impairments. Particularly in an inpatient setting, psychomotor retardation may require increased nursing care to ensure adequate food and fluid intake and sufficient personal care. Methods: After obtaining written informed assent, MDD patients who fulfilled the inclusion criteria were recruited and enrolled in this study at government head quarter’s hospital, Erode. The total sample size was 50 MDD patients. Purposive sampling technique was adopted in this study. This study was operated based on basic true experimental research design. All the subjects were interviewed before intervention by assessing the demographic profile. The level of conation was assessed with Whealen and Speaken - modified work skill rating scale. The joss stick skill training was demonstrated through video, for 15 to 20 minutes, once a day for 15 days. Posttest was conducted by using the same assessment techniques in experimental and control arm. Result: The unpaired ‘t’ test value of conation between experimental arm and control arm depicted statistical significance (t=6.98). The joss stick skill training was statistically significant, by improving the conation among MDD patients.

KEYWORDS: Joss stick skill training, Conation, Major Depressive Disorder (MDD).

INTRODUCTION:

Major depressive disorder (MDD), also known simply as depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem and loss of interest or pleasure in normally enjoyable activities.¹

Major depressive disorder (MDD) has been ranked as the third cause of the burden of disease worldwide in 2008 by WHO, which has projected that this disease will rank first by 2030. It is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances or suicidal thoughts.²

Globally, the burden of depression has been rising and major depressive disorder (DD) was the third leading cause of disability in 2015. In 2017, 197·3 million (95% UI 178·4–216·4) people had mental disorders in India, including 45·7 million (42·4–49·8) with depressive disorders and 44·9 million (41·2–48·9) with anxiety disorders. In 2017, depressive disorders contributed the most to the total mental disorders DALYs (33·8%, 29·5–38·5)^3–4.

Alterations of brain structure and function have been associated with psychomotor retardation in major depressive disorder (MDD)⁵. Besides disturbances of mood and affect psychomotor retardation is a key feature of major depressive disorder (MDD). Psychomotor retardation involves speech, facial expression, posture, as well as pace and extent of movements. Psychomotor slowing is of clinical relevance since it may help to distinguish depressive subtypes. Furthermore, psychomotor slowing is associated with response to some antidepressants. Nevertheless, to date the neurobiology of psychomotor retardation in MDD is poorly understood^6–7.

METHODS:

Prior to the collection of data, permission was obtained from the head of the department of government head quarters hospital at Erode.

After obtaining written informed assent, MDD patients who fulfilled the inclusion criteria were recruited and enrolled in this study at government head quarter’s hospital, Erode. The total sample size was 50 MDD patients. Purposive sampling technique was adopted in this study. This study was operated based on basic true experimental research design. Study subjects were allocated randomly to either experimental arm (n=25) or control arm (n=25). All the subjects were interviewed before intervention by assessing the demographic profile like age, gender, marital status, duration of illness and number of relapses. The level of conation was assessed with Whealen and Speaken - modified work skill rating scale.

The joss stick skill training was demonstrated through self dramatized video, shown to the subjects for 15 to 20 minutes, once a day for 15 days. Posttest was conducted by using the same assessment techniques in experimental and control arm. Schizophrenic patients with intellectual insight and true emotional insight (Clinical Rating of Insight-6 point scale) were selected in experimental and control group. Participants were randomly allocated by using random number table either to experimental group or control group.

Schizophrenic patients with intellectual insight and true emotional insight (Clinical Rating of Insight -6 point scale) were selected in experimental and control group. Participants were randomly allocated by using random number table either to experimental group or control group.

RESULTS:

Most of the subjects were in the age group of 45 to 60 years in both the arms. Paramount was female subjects in experimental and control arm. Predominately subjects were unmarried in both the arms. The highest number of subjects had MDD for the duration of 5 years in both the arms. Majority of the MDD patients had 3 to 5 number of relapses during their illness period in both the arms.

The conation mean score was 13 in course of pretest analysis and 17 in posttest analysis among experimental arm. The conation mean score was 12 in course of pretest analysis and 13 in posttest analysis among control arm. The conation of MDD patients improved and augmented in experimental arm compared to control arm.

The paired‘t’ test value of conation scores showed statistical significance in experimental arm (t=7.76). The paired‘t’ test value of conation scores showed statistical non significance in control arm (t=2.10). The unpaired‘t’ test value of conation between experimental arm and control arm depicted statistical significance (t=6.98). The joss stick skill training was statistically significant, thereby improving the conation among MDD patients.

Association was found to be significant between posttest conation scores and the duration of illness (c²=7.25; Significant) in experimental arm. Number of relapses significantly associated with conation (c²=5.16; Significant) in control arm.

DISCUSSION:

The study findings revealed that intervening of joss stick skill training were highly significant in improving and augmenting the level of conation among MDD patients.

A prospective study was conducted to assess the effectiveness of occupational therapy on work skill among depressive patients. Work skill rating scale and Student t test was used for analysis. At the end of the study 23% of the patients were integrated into the open labour market, 25% were working in sheltered employment, 25% remained in work therapy, and 27% were unemployed. Controlled studies with depressive patients show, that work therapy contributes to improved vocational integration, a reduction of rehospitalisation’s and community re-entry.

REFERENCES

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7. Calugi S, Cassano GB, Litta A, Rucci P, Benvenuti A, et al, 2011, Does psychomotor retardation define a clinically relevant phenotype of unipolar depression? J Affect Disord 129: 296–300.

Received on 10.01.2022 Modified on 18.02.2022

Int. J. Nur. Edu. and Research. 2022; 10(2):157-159.

DOI: 10.52711/2454-2660.2022.00037