"Quasi Experimental Study to Assess the Stress Level and Effects of Progressive Muscle Relaxation Exercise on Blood Pressure among Hypertensive Patients Attending Bule Hora Hospital OPD in Bule Hora Town, West Gujji Zone, Southern Ethiopia”

Abstract

Background: Stress is a physiological response to anything that upsets our personal balance. Hypertension is elevation of blood pressure above normal for a period. It is one of the most common health problems in adults and the leading cause of various health issues like cardiovascular disorder and stroke. Progressive muscle relaxation techniques (PMR) significantly reduced patients' perceptions of stress and improved their health. PMR is beneficial for patients with essential hypertension, and nurses can use it to improve their quality of life.

Objective: 1) Assess the level of stress, Blood Pressure and its association with socio-demographic and illness profile variables 2) Assess the effects of progressive muscle relaxation exercise in reducing blood pressure among patients with hypertension.

Materials and Methods: Quasi Experimental design was adopted and simple random sampling techniques were used and about 330 outpatient department (OPD) patients were included with elevated blood pressure. Three sets of standard questionnaires to assess demographic variable, illness profile and stress level. Stress level was assessed by standard scale as perceived Stress scale developed by Cochin in the year 1983 and practiced about Modified Jacobson’s (1963) Muscle Relaxation Exercises. Data Analysis used in the study were descriptive statistics like Frequency and Percentage. Inferential statistics like independent ‘t’ test and paired ‘t’ test, Chi-square test, Mann Whitney Test and ANOVA test was done for comparison of means of the blood pressure among 3 different groups of personal habits.

Results: - Perceived stress scale assessment shows that 246 patients (74.54%) had moderate stress, only 9 (2.72%) had severe stress and 75(22.72%) had mild stress. Illness profile assessment shows that majority 91(55.4 %) had family history of Hypertension in experimental group, regarding illness for more than one year was 100 (60.7%) and regular treatment seeking behavior among 100(60.7%) in experimental group. Significant association was found between age and stress level (2=15.277), between personal habits and Blood Pressure level (_x2=10.891). Effectiveness in reduction of Blood Pressure by Progressive Muscle Relaxation techniques was statistically significant in Systolic Blood Pressure as (148.39 mm of Hg-139.50 mm of Hg) the mean difference reduction was 8.89 mm of Hg. The “t” value is 7.215. Comparison of mean score of blood pressure by ANOVA among three different groups of personal habits reveled that smoking and alcoholics had association in elevation in diastolic Blood Pressure.

Conclusion: - Old Age, Personal habits like smoking and alcohol has strong association with stress and Blood pressure. The study findings suggest that Progressive Muscle Relaxation techniques had significant effect on systolic blood pressure in hypertensive patients. It has also showed the various responses and views of the subjects like feeling of relaxation, peace and calmness as a result of the relaxation exercises. The investigator strongly urges the health care personnel to adopt relaxation exercise as a non-pharmacological method of treating hypertension.