PROBLEM of STATEMENT: a Study to Evaluate the Effectiveness of Raj Yoga on Promotion Of

RAJIVGANDHIUNIVERSITY OF HEALH SCIENCES, BANGALORE.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

BY,

Ms R.SHEELA PRIYA

I st YEAR M.SC NURSING

PSYCHIATRIC NURSING

2009-2011 BATCH

SNEHA COLLEGE OF NURSING,

BANGALORE-43

INTRODUCTION

Ageing is a natural process. In the words of Seneca: old age is an incurable disease, but more recently, old age should be regarded as a normal, inevitable biological phenomenon. The study of the physical and psychological changes which are incident to old age is called gerontology. The care of the gerontology is social gerontology or geriatrics. There is a ample scope for research into the degenerative and other disease of old age; their treatment in hospital and general practice; and finally into preventive geriatrics and the epidemiology of conditions affecting the aged. Our knowledge about the aging process is incomplete. The changes takes place during old age are senile cataract, glaucoma, nerve deafness, osteoporosis affecting mobility, failure of special senses and changes in mental outlook1.

Psychiatric care of elderly people can be more interesting thanthat of younger patients. Successful treatment of elderly patientsrequires a demanding mélange of psychological, medical,social, political, and managerial skills—an epitome ofmodern medicine. About 450 million people alive today suffer from mental problems according to estimates given in WHO’sWorld Health Report 2001. One person in every four will be affected by a mental disorder at some stage of his or her life.2

6.1 NEED FOR THE STUDY:

Ageing merely stands for growing old but noone knows when old age begins. The biological age of a person is not identical with the chronological age. Years wrinkle the skin, but worry, doubt, fear, anxiety and self distrust wrinkle the soul.In this age of modern science and and technology we are losing our axis of balance and harmony at all levels i.e. physical,mental,emotional especially for the old age who are institutionised.With the passage of time certain changes takes place in old age. The important one the old age people facing in their life is the psychological problem in addition to physical problems. The main psychological problems are mentalchanges, emotionaldisturbances, irritability, social maladjustment depression and even suicidal thoughts .so we need some measures.3

The YOGA, the science of spirituality has been recognized as a science of health and healing for managing various psycho-physiological problems of man. It provides a systemic approach to understand the root causes of our psycho-physiological problems such asfickleness of mind, hatred, greed, anger, depression, tremor,breathing disturbances etc are well documented and provides healing and purifying techniques for such conditions in old age .It provides a permanent solution and the deep underlying roots of the inner disturbances of man are managed using YOGA techniques.4

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The first report of the inquiry, Promoting Mental Health and Well-Being in Later Life, focused on older people and the ways in which mental health in older age can be sustained or improved. This second report focuses on those older people who do experience mental health problems and on the adequacy of the support and services that are available to them5.

The prevalence of old age mental health problems among people over 65 is 15% in the general community.25% is general practice patients, and >30% in residential home.6

Raja Yoga is known as the highest of all teachings because the aim of Raja Yoga is perfection to regain the divinity once again. Raja yoga works on soul. This Yoga (union) is the method by which there is a transformation in the very personality, the very nature, of the soul itself, that is, within the Sanskaas past thousands of years are all shed, and the original divinity sparkles once more.7

6.2 REVIEW OF LITERATURE:

The review of literature attempts to cover the broad areas required for the study is:-

1. Review of literature on the effectiveness of raja yoga meditation

2. Review of literature on the mental health problems of old age

3. Review of literature on the effect of raja yoga on mental health promotion among old age.

A study was conducted to know the clinical of transformative practices for integrating body- mind –sprit. this includes meditation prayer and yoga the purpose is to know the long term spiritual transformation with the mental and physical aspects of life currently there are number of study that attest to the mental health enhancing and surfing reducing benefits from transformative practices like yoga prayer, yoga etc., trails of transformative practices are needed to help all levels of the health care systems focus their attention on the manifestations and effect of the care delivered 8

The study investigated that the effectiveness of meditation therapy in treating old age mental disorders. Study authors and experts from religious/spiritual organizations were contacted. Types of studies: Randomized controlled trials. Types of participants: patients with a diagnosis of old age anxiety disorders, with or without another co morbid psychiatric condition The small numbers of studies included in this review do not permit any conclusions to be drawn on the effectiveness of meditation therapy for old age anxiety disorders. Transcendental meditation is comparable with other kinds of relaxation therapies in reducing anxiety, and Kundalini Yoga did not show significant effectiveness in treating obsessive-compulsive disorders compared with Relaxation/Meditation9

A Study was conducted to explore the short term impact of a comprehensive, but relief lifestyle intervention based on yoga, on subjective well being levels in normal and diseased subjects. The inventory consists of questions related to one’s feelings and interpersonal relationship. there was significant improvement in subjective well being scores of 77 subjects within the period of 10 days as compared to controls. These observations suggest application of yoga leads to remarkable improvement in the subjective well being scores on the subjects10

The study was conducted to know the short term impact of a lifestyle intervention based on yoga on anxiety levels in normal and diseased subjects. The interventions consist of asana, pranayama relaxation technique, and meditation stress management. The observations suggest that a short educational Programme for lifestyle modification and stress management leads to remarkable reduction in the anxiety scores within a period of 10 days.11

A studyconducted to determine the effect of yoga on fatigue, mood and quality of life among the age group 65-85 years. The intervention produced improvements in quality of life measures related to sense of well being and physical measures compared to exercise groups12.

A Study was conducted to evaluate the effectiveness of different meditation practices on physiological and neuropsychological outcomes. Included studies were comparative on any meditation practice had more than 10 adult participants. The physiological effects of meditation practices have been elevated in 312 poor quality studies. The conclusion on effects of meditation practices in health care cannot be drawn based on the available evidenced13.

STATEMENT OF THE PROBLEM:

A STUDY TO EVALUVATE THE EFFECTIVENESS OF RAJA YOGA MEDITATION ON THE PROMOTION OF MENTAL HEALTH AMONG OLD AGE PEOPLE AT SELECTED OLD AGE HOME.

6.3 OBJECTIVES:

• To assess the association between post test and demographic variables such as age, sex, education, loss of spouse, any loss,religion,illness,type of family.
• To assess mental wellbeing of old age people at selected old age home before raja yoga meditation.
• To evaluate the effectiveness of yoga on the promotion of mental health among old age people at selected old age home.
• To assess the relationship between the pretest and post test among old age people at selected old age home.

6.4 HYPOTHESIS:

Ho-There will not be a significant difference between the pretest and post test on mental wellbeing.

H1-There will be a significant association between the post test and selected demographic variables such as age, sex, education, loss of spouse, any loss, religion, illness, type of family.

H2-There will be significant relationship between the pretest and post test on mental wellbeing.

6.5 OPERATIONAL DEFINITION:

Effectiveness:

In this study it refers to the systematic determination of merit, worth, and significance of yoga using criteria against a set of standards.

Raja Yoga:

In this study it refers to the Science of Physical and Mental Control Often called the "royal road" it offers a comprehensive method for controlling the waves of thought by turning our mental and physical energy into spiritualenergy.

Promotion:

In this study it refers to promotion in the minds of the old age and helps to stimulate the development of mental health.

Mental health:

In this study it refers tothe psychological state of old age who is functioning at a optimum level of emotional and behavioral adjustment.

Old age:

In this study it refers to the person staying in old age home above 60 years of age.

Old age home:

In this study it refers to the place where the old age people sheltered for a long period.

Inclusion criteria:

• The old age people who are willing to participate.
• The old age people above the age group of 60 years.
• The old age people who are indicated to do raja yoga meditation.
• The old age people who can read and understand either kannada or English

Exclusion criteria:

• The old age people who are not willing to participate.
• The old age people who are contraindicated to do raja yoga meditation.
• The old age people who are having physical disabilities like hearing loss ,loss of vision etc., and mental disabilities like loss of memory or any cognitive problems.

7.METERIALS AND METHODS:

7.1Source of data:

Old age people above 60 years of age at selected old age home at Bangalore.

7.2 .Method of data collection:

Research design:

One group .pre test- post test design

Setting: selected old age home atBangalore.

Sample size: 40 samples.

Sampling technique:

Convenient sampling.

Tools for data collection:

a)Socio demographic data sheet

b)Observation check list.

c)self administered questioner(yes/no)

Duration of study:

4-6 weeks

Method of data analysis and interpretation:

The researcher will use appropriate statistical technique for data analysis and present in the form of table, graphs and diagrams.

• Pilot study:

10% of the population planned for the study during the year of 2010.the sample will be excluded from the main study.

• Main study: Data will be collected by the interview method using the above tools.
• Statistical analysis: In order to analyze the data descriptive statistical method.Appopriate parametric and non-parametric tests will be used.

Ethical issues: All the subjects will be explained about the purpose, the objectives and the procedure of the study

Research variables:

Dependent: Promotion of mental health

Independent:Raja yoga meditation.

Projected out come:

• It helps to evaluate the effectiveness of raja yoga meditation on the promotion of mental health among old people in selected old age home at Bangalore.

7.3 Does the study require any investigation or intervention to be conducted on patients or other human or animal?

No

7.4 Has the clearance been obtained from institution?

Yes

8. REFERENCE:

1)Inkers, D. J, Gussekloo, J., Stek, M. L, Westendorp, R. G J, van der Mast, R. C (2004). Temporal relation between depression and cognitive impairment in old age: prospective population based study. BMJ 329: 881

2) Biderman, A, Cwikel, J, Fried, A V, Galinsky, D (2002). Depression and falls among community dwelling elderly people: a search for common risk factors. J. Epidemiol. Community Health 56: 631-636

3)Darkins, A. (2001). Program Management of Telemental Health Care Services. J Geriatric Psychiatry Neurol 14: 80-87 Abas, M, Crawford, M J, Colgate, R. (1999). A national target for reducing suicide. BMJ 318: 191a-191

4) Porter, R. J, O'Brien, J. T (1998). SSRIs may well be best treatment for elderly depressed subjects. BMJ 316: 631-631

5)Yoga in stroke rehabilitation: a systematic review and results of a pilot study.Lynton H, Kligler B, Shiflett S.Top Stroke Rehabil. 2007 Jul-Aug; 14(4):1-8.

6)A review of mind/body therapies in the treatment of musculoskeletal disorders with implications for the elderly.Luskin FM, Newell KA, Griffith M, Holmes M, Telles S, DiNucci E, Marvasti FF, Hill M, Pelletier KR, Haskell WL.Altern Their Health Med. 2000 Mar;6(2):46-56

7)Psychosocial correlates and outcomes of yoga or walking among older adults.Kraemer JM, Marquez DX.J Psychos. 2009 Jul;143(4):390-404.PMID: 19606645

8)Effect of Raja yoga meditation on the lipid profile of post-menopausal women.Vyas R, Raval KV, Dikshit N.Indian J Physiol Pharmacol. 2008 Oct-Dec;52(4):420-4

9)Body awareness, eating attitudes, and spiritual beliefs of women practicing yoga.Dittmann KA, Freedman MR.Eat Discord. 2009 Jul-Sep;17(4):273-92.

10))Effect of yoga based lifestyle intervention on subjective well-being.Sharma R, Gupta N, Bijlani RL.Indian J Physiol Pharmacol. 2008 Apr-Jun;52(2):123-31.

11)Yoga techniques as a means of core stability training.Omkar SN, Vishwas S, Tech B.J Bodyw Mov Other. 2009 Jan; 13(1):98-103. Epub 2008 Feb1.

12)Sharma R et al effect of yoga based lifestyle intervention on well-being. Indian j physiol pharmacol 2008 apr –Jun 52(2)2:123-31.

13)Luskin F, transformative practices for integrating mind-body-spirit,standard center for research in disease,standard university school of medicine,redwood city,J Altern complement Med 2004

14)Ospina MB,Bond K, karkhanch M,et al,Meditation practices for health ;state of research,Evid Rep Technol Assess, 2007 June.(155);1-263

15)Shang C,Emerging paradigms in mind-body medicine Altern complement Med 2001 Feb;7(1);83-91

16)Sharma R et al, Effect of yoga based life style on subjective wellbeing,Indian J Physiol Pharmacol. 2008 Apr-June;52(2):123-31

17.Gupta N, Effect of yoga based life style intervention on state and trait anxiety. Indian J Physiol Pharmacol,2006 Jan-Mar;50(1):41-7

18)Grananth J et al ,Stress management:a randomized study of coginitive behavioural therapy and yoga.Cogn Behav Ther.2006 ;35(1);3-10

19)Oken BS et al, Randomised, controlled, six month trial of yoga ; effect on coginition and quqlity of life;Altern Ther Health Med.2006 Jan –feb;12(1)

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