1. RESEARCH PROPOSAL
PRESENTATION
NAME OF GUIDE- Mrs.JYOTHI DIVAKARAN
Asst.PROFESSOR
Govt.COLLEGE OF NURSING
NAME OF RESEARCHER- AISWARYA S KUMAR
1ST YEAR Msc.NURSING
Govt.COLLEGE OF NURSING

2. TITLE
Effect of Jacobsons progressive muscle
relaxation technique on anxiety among
primigravida

3. BACKGROUND OF THE STUDY
Women encounter physical, emotional, and
psychological changes during pregnancy. The
literature indicates that some women find these
changes to be stressful. They may respond to
this stress by feeling anxious. The frequency
and intensity of the anxiety reaction depends
on how women perceive these stressors and on
their ability to cope with the anxiety

4. Antenatal anxiety has received increased
attention with regards to both its impact on
infant outcomes and as a risk factor for
postnatal depression

5. Preterm labour and low birthweight for
gestational age are the outcomes linked most
consistently with antenatal stress or anxiety in
humans .

6. • The studies of the effects of antenatal stress
and anxiety in humans have concentrated on
obstetric outcome. A study found that women
who experienced severe life events in the first
trimester of pregnancy had a 50% increase in
the rate of congenital abnormalities in
cranial—neural crestderived organs (e.g. cleft
palate). Even greater risk was associated with
the most severe and rare stress, the unexpected
death of a child1.

7. • Another study says that preterm labour and
low birthweight for gestational age are the
outcomes linked most consistently with
antenatal stress or anxiety in humans2. In one
study of 8719 women, it was reported a
significant association between selfreported
general distress at 30 weeks and an increased
risk of preterm delivery, defined as <37
weeks3.

8. • Another study have shown that individuals
who experienced severe stressful events during
pregnancy showed a 50% increase in marked
premature delivery (babies born at <34 weeks).

9. • In a cohort study conducted by Avon
Longitudinal Study of Parents and Children
(ALSPAC)it was found that there was a strong
link between maternal anxiety in the third
trimester and behavioural/emotional problems
in the resulting children at 4 years.It was found
that self-reported antenatal anxiety at 32
weeks' gestation predicted severe
behavioural/emotional problems in both boys
and girls4.

10. NEED AND SIGNIFICANCE OF
THE STUDY
• Depressive and anxiety disorders are the most
common psychiatric illnesses during
pregnancy and the postpartum period.
According to international data the prevalence
of antenatal depression is between 7% and
17% and approximately 10% of pregnant
women suffer from some kind of anxiety
disorder5.

11. • More women with lower anxiety levels and a
more positive state of mind had normal deliveries.
Anxiety was related to lower birth weight and to
difficult delivery. A positive state of mind and
emotional stability were associated with having a
normal delivery. Therefore, moderate levels of
anxiety were associated with complications
during delivery and poorer foetal outcomes,
whereas a positive state of mind was associated
with better childbirth experiences

12. • Relaxation exercises have become a standard
intervention for individuals with anxiety
disorders. Relaxed muscles bring on a more
serene state with less physical and
psychological tension, according to the
University of Missouri report. In 2010 study
reported by the National Institutes of Health
shows that progressive muscle relaxation can
significantly alleviate stress among pregnant
women6.

13. • Progressive muscle relaxation techniques
have been utilized to effectively control stress,
fear, anxiety, insomnia and chronic pain. This
procedure can also be effectively applied to
natural childbirth. Through conditioned
practice this can be quickly learnt to
recognize -and differentiate- a tensed muscle
from a completely relaxed muscle.

14. • With this simple awareness, physical muscular
relaxation can be induced at the first signs of
tension caused by anxiety. Physical relaxation
enables mental peace-in any situation, even
natural childbirth7.

15. PURPOSE OF STUDY
The purpose of the study is to assess the level of
anxiety among primigravida, evaluate the
effect of Jacobsons progressive muscle
relaxation technique on anxiety among
primigravida, find out the association
between anxiety among primigravida and
selected sociodemographic variables.

16. STATEMENT OF THE PROBLEM
A study to assess the effect of Jacobsons
progressive muscle relaxation technique on
anxiety among primigravida admitted in
TDMCH, Alappuzha.

17. OBJECTIVES
To assess the level of anxiety among primigravida.
Evaluate the effect of Jacobsons progressive
muscle relaxation technique on anxiety among
primigravida.
Find out the association between anxiety among
primigravida and selected sociodemographic
variables.

18. OPERATIONAL DEFINITIONS
Effect
Effect refers to the change in the level of anxiety of
primigravida brought about by progressive muscle
relaxation as measured by the anxiety assessment
tool.

19. Jacobsons progressive muscle
relaxation technique
In this study Progressive muscle relaxation (or PMR)
refers to a technique for reducing anxiety related to
pregnancy in primigravidas by alternately tensing and
relaxing the muscles.

20. Anxiety
A feeling of worry, nervousness, or unease,
typically about pregnancy and its outcome,and
which is measured using spielberger anxiety
inventory.
Primigravida
A woman who is pregnant for the first time.

21. Socio personal variables
Refers to the data regarding the age, socio
economic status,occupation, educational status,
gestational age etc.
Low risk
Primi gravid women between 18-35yrs, without
any diseases complicating pregnancy

22. CONCEPTUAL FRAMEWORK
Roys adaptation model

23. ASSUMPTIONS
The study assumes that
All primigravida experience some level of anxiety.
Primigravida are willing to learn progressive
muscle relaxation exercise.
PMR exercise has no known harmful effect on
pregnancy.

24. HYPOTHESIS
H1 There is significant difference between the
level of anxiety of primigravida in the
experimental and control group before and
after intervention.
H2 There is significant association between the
socio personal variables and levelof anxiety
among primigravida.

25. RESEARCH APPROACH
Experimental approach is adopted

26. RESEARCH DESIGN
Quazi experimental with non equivalent control
group design

27. STUDY PERIOD
2MONTH

28. TOOL
Spielberger anxiety inventory

29. SETTING OF THE STUDY
The Antenatal ward (Ward 2) of MCH
Alappuzha was selected for the study.

30. POPULATION
The population for the study is low risk
primigravida of ward 2 admitted at MCH,
Alappuzha

31. SAMPLE AND SAMPLING
TECHNIQUES
The sample size is 60 primigravida, 30 each in
experimental and control group. The criteria
for selection of subjects are the following

32. INCLUSION CRITERIA
primigravida
Admitted in the MCH Alappuzha.
Primi gravid women in third trimester after 36 weeks of
gestation.
With low risk pregnancy.
Willing to participate in the study.
Able to read and write Malayalam.

33. EXCLUSION CRITERIA
primigravida
With impairment in vision and hearing.
With psychiatric illness.
With disease complicating pregnancy.

34. THE SAMPLING TECHNIQUE
non probability convenient sampling.

35. PLAN FOR DATAANALYSIS
Data was analysed using descriptive and
inferential statistics.

36. PILOT STUDY
Pilot study undertaking 6 primigravida admitted
in antenatal ward TDMCH Alappuzha.

37. REFERENCES
• 1,Carmen Hernandez Martinez,Victoria Arija
Val,Michelle Murphy,Pere Cavalle Busquets,;Relation
Between Positive And Negative Maternal Emotional
States And Obstetrical Outcome;Journal-Women And
Health,Vol51,No.2,Pp124-135,2011
• 2,Vivette Glover,Thomas G O Connor,Effects Of
Antenatal Stress And Anxiety,Abstracts From
Workshop Presentation In Manchester 15 Oct 2008
• 3,Vivette Glover,Thomas G O Connor,Effects Of
Antenatal Stress And Anxiety,Abstracts From
Workshop Presentation In Manchester 15 Oct 2008

38. • 4,niloufer S Ali,iqbal S Azam,badar S Ali,ghurnata Tabbusum,sana S
Moin,frequency And Associated FACTORS For Anxiety And Depression
In Pregnant Women;a Hospital Based Cross Sectional
Study,january22,2002.
• 5, P H C Rondó, R F Ferreira, F Nogueira, M C N Ribeiro, H Lobert, R
Artes Maternal Psychological Stress And Distress As Predictors Of Low
Birth Weight, Prematurity And Intrauterine Growth Retardation(Citations:
81)
• Journal: European Journal Of Clinical Nutrition - Eur J Clin Nutr , Vol. 57,
No. 2, Pp. 266-272, 2003
• 6, Alder J, Urech C, Fink N, Bitzer J, Hoesli Iresponse To Induced
Relaxation During Pregnancy: Comparison Of Women With High Versus
Low Levels Of Anxiety. Source:ob/Gyn, University Hospital Basel, Basel,
Switzerland. Jalder@uhbs.Ch 2011 Mar;18(1):13-21.

39. • 7, Farideh Bastani, Msc, ,Author VitaeAlireza
Hidarnia, PhdAuthor Vitae, Anoshirvan
Kazemnejad, PhdAuthor Vitae, Maryam Vafaei,
PhdAuthor Vitae, Maryam Kashanian, MD A
Randomized Controlled Trial Of The Effects Of
Applied Relaxation Training On Reducing
Anxiety And Perceived Stress In Pregnant
Women. Journal Of Midwifery & Women's
Healthvolume 50, Issue 4, July–August 2005,
Pages E36–E4
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