A Study to Assess the Effectiveness of Tai-chi Exercise on Level of Stress regarding the Impact of Covid-19 among Caregivers of In-patients of selected Wards at Jubilee Mission College and research Institute, Thrissur

 

Megha K.U.1, Merin Siby Karimattam1, Neethu M.S., Praveena P.1, Resna Rajan1,

Riyamol Jacob1, Rosemi T.J.1, Sandra M.J.1, Smiji Raju1, Chinju Raj2 , Dhanya3,

Angela Gnanadurai4

1IIIrd Year BSC(N) Students, Jubilee Mission College of Nursing, Thrissur.

2Asst. Professor, Jubilee Mission College of Nursing, Thrissur.

3Professor, Jubilee Mission College of Nursing, Thrissur.

4Principal, Jubilee Mission College of Nursing, Thrissur.

*Corresponding Author E-mail: meghau2000@gmail.com

 

ABSTRACT:

Stress describes a person's physical or emotional response to the demands or pressures of daily life. Common causes of stress include work, money, relationships and illness. Significant events like the Covid-19 pandemic can also increase stress and anxiety. Corona virus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Corona viruses are a large family of viruses that are known to cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). Tai Chi is a Chinese martial art and it consists of smooth continuous movements like Chinese dance along with mental concentration and deep breathing. Tai Chi will help to reduce the stress of daily life due to different reasons. The present study is aimed to assess the effectiveness of Tai Chi exercise on level of stress regarding the Impact of Covid-19 among caregivers of in-patients of selected wards at JMMC &RI, Thrissur. Objectives: To assess the level of stress regarding the impact of Covid-19 before and after Tai Chi exercise among caregivers of in-patients, to associate the pretest level of stress with selected socio-demographic and clinical data variables. Methodology: Quantitative research study was conducted to identify the effectiveness of Tai Chi exercise on level of stress regarding the impact of Covid-19 among caregivers of in-patients of selected wards at JMMC & RI, Thrissur. One group pretest post test research design was selected for the study. There were 40 samples selected by convenience sampling technique. The subject was recruited for the study based on the predetermined inclusion and exclusion criteria. Informed consent was taken from the samples and the objectives and purpose of the study were explained. The data collected have 2 sections, in which section A includes socio-demographic & clinical data such as Age, Gender, Place, Educational status, Occupation, Marital Status, Socioeconomic status, History of any illness. Section B was perceived stress scale is a standardized scale which consists of 10 questions for measuring the perception of stress. Individual scoring on PSS can range from 0- 40 with higher scores indicating higher perceived stress. The score 26-40 is considered as High perceived stress, 14-26 belongs to Moderate stress and 0-13 belongs to low stress.
Result and interpretation: Result shows majority of the subjects about 14(35%) belongs to the age group of 35-45 years, 25(62.5%) were females, 30(75%) from rural area, 14 (35%) have secondary education, 17(42.5%) were unemployed, 30(75%) were married and 18(45%) were having income between 11000-15000. About 5 (12.5%) has history of Covid-19 infection. By using perceived stress scale to assess the level of stress regarding the impact of Covid-19, we found that in pretest majority of the caregivers have about 34 (85%) had moderate stress 6(15%) had high stress. In post test 39(99%) had low stress and 1(1%) had moderate stress. There was no association between pretest level of stress with selected socio-demographic and clinical data variables.

 

KEYWORDS: Tai-chi, Impact of Covid-19, Level of stress, Caregivers of in-patients.

 

 


INTRODUCTION:

Corona virus disease 2019 (COVID-19) is an infectious disease caused by a newly discovered corona virus, named severe acute respiratory syndrome corona virus-2 (SARSCoV-2). Corona viruses are a large family of viruses that are common in people and many different species of animals, such as camels, cattle, cats, and bats1. Sometimes, animal corona viruses can infect human and then spread among them, as with Middle East respiratory syndrome corona virus (MERS-CoV), severe acute respiratory syndrome corona virus(SARS-CoV), and now SARS-CoV-2. The COVID- 19 pandemic is a worldwide public health emergency which has been affecting people both physically and psychologically1. Hence, many people have been experiencing stress, anxiety, depression, low sleep quality, mood alterations, and high levels of post-traumatic stress disorder1.

 

Stress has been defined as a process in which environmental demands exceed the adaptive capacity of an organism, resulting in psychological and biological changes that may place people at risk for disease1. Stress during an infectious disease outbreak can include fear and worry about one’s health, worsening of chronic health problems, and increased use of substances2. Most people infected with the virus causing COVID-19 will experience mild to moderate respiratory illness and recover without requiring special treatment3. However, older people and those with underlying medical problems, such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer, are more likely to develop severe illness, which may lead to death3. People at higher risk for severe illness are at increased risk of stress due to COVID-19 outbreaks.3 Chronic exposure to stressful conditions is associated with a failure to comply with medical regimens, resulting in disease exacerbation and leading to co-morbid serious health problems such as hypertension, heart attack and stroke, diabetes mellitus, and obesity3. Patients with chronic disease face lifestyle disruptions due to the COVID-19 outbreaks, to their physical activity, sleep, stress, and mental health, which need to be better addressed4. The mental health and psycho social consequences of the COVID-19 pandemic may be more severe among people with chronic illness.4

 

Corona virus disease 2019 (COVID-19) is an infectious disease caused by a newly discovered corona virus, named severe acute respiratory syndrome corona virus-2 (SARSCoV-2). Corona viruses are a large family of viruses that are common in people and many different species of animals, such as camels, cattle, cats, and bats1. Sometimes, animal corona viruses can infect human and then spread among them, as with Middle East respiratory syndrome corona virus (MERS-CoV), severe acute respiratory syndrome corona virus(SARS-CoV), and now SARS-CoV-2.The COVID- 19 pandemic is a worldwide public health emergency which has been affecting people both physically and psychologically1. Hence, many people have been experiencing stress, anxiety, depression, low sleep quality, mood alterations, and high levels of post-traumatic stress disorder1.

 

Stress has been defined as a process in which environmental demands exceed the adaptive capacity of an organism, resulting in psychological and biological changes that may place people at risk for disease1. Stress during an infectious disease outbreak can include fear and worry about one’s health, worsening of chronic health problems, and increased use of substances2. Most people infected with the virus causing COVID-19 will experience mild to moderate respiratory illness and recover without requiring special treatment3. However, older people and those with underlying medical problems, such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer, are more likely to develop severe illness, which may lead to death3. People at higher risk for severe illness are at increased risk of stress due to COVID-19 outbreaks.3 Chronic exposure to stressful conditions is associated with a failure to comply with medical regimens, resulting in disease exacerbation and leading to co-morbid serious health problems such as hypertension, heart attack and stroke, diabetes mellitus, and obesity3. Patients with chronic disease face lifestyle disruptions due to the COVID-19 outbreaks, to their physical activity, sleep, stress, and mental health, which need to be better addressed4. The mental health and psycho social consequences of the COVID-19 pandemic may be more severe among people with chronic illness.4 Studies in Greece and Northeast Ethiopia showed high prevalence of distress during COVID-19 outbreaks among patients with chronic disease, and moderate perceived stress was reported from the USA among patients with chronic disease and disability4. Their existing chronic conditions may place them at greater risk for developing more severe complications from COVID-19, which can increase perceived stress, and ultimately exacerbate problems with health and well- being among individuals with chronic conditions and disabilities4. Moreover, disruptions to ongoing health-care services for chronic disease patients will further worsen their health and perceived stress as a result of the shifting of health services to urgent COVID-19 patients4.

 

Tai Chi is an ancient Chinese martial art whose movements are based on the harmony between mind, body, and outside forces. It includes rhythmic and relaxing movements emphasizing trunk rotation, weight change, and coordination. Tai Chi has three key components, including mediation, movement, and breathing. The set of relaxing, rhythmic, and fluid movements brings about a state of mental health and calm by fostering the body and mind as a coherent unit as well as evacuating the mind from thoughts that cause tension.

 

MATERIAL AND METHODS:

Research Approach: A quantitative research approach is adopted for the study.

Target Population: Care givers of in-patients.

Accessible population: Caregivers of in-patients admitted in selected wards of JMMC&RI, Thrissur

Sampling Technique: Convenience sampling.

Data collection procedure: Standardized questionnaires

Tool for data collection: Perceived Stress Scale (PSS)

Criteria measures: level of stress

Data analysis: Descriptive statistics and inferential statistics

Research Setting: The study was conducted on selected wards at JMMC & RI Thrissur. (Selected Wards: male medical, female surgery, male surgery, psychiatry)

 

RESULTS:

1. Socio-demographic and clinical data variables among caregivers of in- patients:

In the present study 4(10%) are below 25 years old, 12 (30%) are 25-34 years old, 14(35%) are 35-45 years old and 10(25%) are above 45 year old, 15(37.5%) are male and 25(62.5%) are females, 10(25%) from urban and 30 (75%) from rural, 40( 35% ) have secondary education, 11(27.5%) have higher secondary education, 10 (25%) have primary education, 5(12.5%) are professional and there is no one with no formal education, 17(42.5%) are unemployed, 8 (20%) are private employee, 7(17.5% )are daily wagers, 7(17.5%) are self-employee and 1 person (2.5%) is government employee, 30(75%) are married, 5(12.5%) are separated, 3(7.5%) are Unmarried, 1 person (2.5%) is divorced and 1 person (2.5%) is widow/widower, 18(45%) are having income between 11, 000-15, 000, 12(30%) are having income below 10, 000 5(12.5%) are having income of 16, 000-20, 000, 5 (12.5%) are having income between 21, 000-25, 000 and there is no person with income above 25,000 and 24 (60%) have other illness, 6(15%) have lifestyle diseases, 5 people (12.5%) have Covid-19, 4(10%) have genetic diseases and 1 person (2.5%) has mental illness.

 

1.    Level of stress regarding the impact of Covid-19 before and after Tai-Chi exercise:

In this study the pretest level of stress regarding impact of Covid-19 before Tai Chi Exercise shows zero percentage subjects had low stress, 85% subjects had moderate stress and 15% subjects had high stress.The post-test level of stress regarding impact of Covid-19 after Tai Chi Exercise shows 99% subjects had low stress, 1% subjects had moderate stress and zero percentage subjects had high stress.

 

Fig: 1 Level of stress regarding the impact of Covid-19 before and after Tai-Chi exercise  n=40

 

Percentage distribution of level of stress regarding the impact of Covid-19 before and after Tai-Chi exercise.

 

Inference: This shows that in pretest level of stress shows 0% subjects had low stress, 85% subjects had moderate stress and 15% subjects had high stress. In post-test level of stress shows 99% subjects had low stress, 1% subjects had moderate stress and 0% subjects had high stress.

 

2.Effect of Tai-Chi exercise on level of stress regarding the impact of Covid-19 among caregivers of in-patients:

In this study before the intervention, about 34(85%) had moderate stress, 6(15%) had high stress and zero (0%) had low stress. After intervention, about 39(99%) had low stress, 1(1%) had moderate stress and zero (0%) had high stress.

 

There is a significant difference between pre-test and post test the level of stress regarding the impact of Covid 19 among caregivers of in-patients of selected wards at JMMC and RI, Thrissur. The difference of standard deviation after pre-test and post test is 3.997. Hence the Formulated hypothesis H1: There will be significant difference in the level of stress regarding Impact of Covid-19 before and after the Tai Chi exercise among caregivers of in-patients was accepted.

Table no 1: Frequency and percentage distribution of sample according to over all pretest and Post test level of stress regarding the impact of Covid-19 beforeTai-Chi exercise   (n=40)

Sl. No

Low stress

Moderate

Stress

High stress

 

 

F

%    F

%

F

%

1

Pre-test       0

0      34

85

6

15

2

Post-test    39

99   1

1

0

0

 

Inference: Table 1 shows that in pretest level of stress regarding impact of Covid-19 before Tai-Chi exercise shows zero percentage subjects had low stress, 85% subjects had moderate stress and 15% subjects had high stress. In post-test level of stress regarding impact of Covid-19 after Tai Chi exercise shows 99% subjects had low stress, 1% subjects had moderate stress and zero percentage subjects had high stress. So there is decrease in level of stress regarding impact of Covid-19 among the caregivers of inpatients after Tai-Chi exercise.

 

2.    Association of pretest level of stress with selected socio-demographic and clinical data variables of caregivers of in-patients regarding the impact of Covid-19:

There was no significant association (P<0.05) between the level of stress regarding. The be significant association between the level of stress regarding impact of Covid-19 among the caregivers of in-patients with the selected socio-demographic and Clinical data variables was rejected.

 

Table No 2: Distribution of Chi – square, degree of freedom, p- value of pretest level of stress with selected Socio-demographic and clinical data variables of caregivers of inpatients regarding the impact of Covid-19 (n=40)

Sl No

Socio-demographic variables

Chi-square

Df

P-value

1

Age

1.061

1

0.212

2

Gender

1.307

1

0.254

3

Place

0.261

1

0.526

4

Educational status

1.601

1

0.212

5

Occupation

0.162

1

0.511

6

Marital status

0.261

1

0.526

7

Income-per month

1.008

1

0.423

8

History Of illness

0.112

1

0.1577

Significant P value < 0.05 level

 

Inference: This shows that there was no significant association between the level of stress regarding the impact of Covid-19 among the caregivers of in-patients with the selected socio-demographic and clinical data variables.

 

DISCUSSION:

To assess the level of stress regarding the impact of Covid-19 before and after Tai-chi exercise among caregivers of in-patients:

The findings of the present study shows that 34(85%) had moderate stress, 6(15%) had high stress and zero(0%) has low stress in pre-test whereas in post-test 39 (99%) had low stress, 1(1%) had moderate stress and zero (0%) had high stress. Similar study finding was seen in a study conducted by Mr. Arunkumar G, Sri Gokulam college of nursing, Salem to assess the effectiveness of Tai -Chi exercises on stress among college students at selected colleges, Salem (April 2015). The study findings revealed that out of 60 samples, 30. (100%) of samples had moderate stress in experimental and control group. During post test, in experimental group 10(33.33 %) and 20 (66.67%) of the college students had mild and moderate stress.5

 

Effect of Tai-Chi exercise on level of stress regarding the impact of Covid-19 among caregivers of in-patients:

In the study before the intervention, about 34(85%) had moderate stress, 6(15%) had high stress and zero (0%) had low stress. After intervention, about 39(99%) had low stress, 1(1%) had moderate stress and zero (0%) had high stress. There is a significant difference (p= 0.001) between pretest and post test the level of stress regarding the impact of Covid-19 among caregivers of in-patients of selected wards at JMMC & RI, Thrissur.The difference of standard deviation after pretest and post test is 3.997. Hence the formulated hypothesis H1: There will be significant difference ( p= 0.001) in the level of stress regarding impact of Covid-19 before and after the Tai-Chi exercise among caregivers of in-patients was accepted.

 

To associate the pretest level of stress with selected socio-demographic and clinical data variables:

The findings of the present study shows that there was no significant association ( P<0.05 ) between the level of stress regarding the impact of Covid–19 among the caregivers of in- patients with the selected socio–demographic and clinical data variables. Thus the formulated hypothesis (H2) There will be significant association between the level of stress regarding impact of Covid-19 among the caregivers of in-patients with the selected socio- demographic and clinical data variables was rejected.

 

CONCLUSION:

This study had assessed the effectiveness of Tai Chi exercise on level of stress regarding the impact of Covid-19 among the caregivers of in-patients of selected ward at JMMC & RI. A quantitative research approach and one group pretest post test research design were used in this study. A total of 40 samples were selected by using convenience sampling technique. The level of stress was assessed by using standardized PSS Tool before and after the intervention given to the patient. The individual scoring on PSS can range from 0 - 40. The Score 26 - 40 is considered as high perceived stress, 14-26 belongs to moderate stress and 0 - 13 belongs to low stress. It was found that before the intervention, about 34 samples (85%) had moderate stress, 6 sample (15%) had high stress and zero sample has low stress. After intervention, about 39 samples (99%) had low stress. 1 sample (1%) had moderate stress and zero sample has high stress. There is a significant difference between pretest and post test the level of stress regarding the impact of Covid -19 among caregivers of inpatients of selected wards at JMMC and RI, Thrissur. And the findings showed that there was no significant association ( P< 0.05 ) between the level of stress regarding the impact of Covid -19 among the caregivers of in-patients with the selected socio-demographic and clinical data variables.

 

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Received on 29.11.2022        Modified on 23.05.2023

Accepted on 25.10.2023       ©A&V Publications All right reserved

A and V Pub J. of Nursing and Medical Res. 2023; 2(4):98-102.

DOI: 10.52711/jnmr.2023.25