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A study of the effectiveness of a relaxation technique in lessening excessive anxiety of selected psychiatric inpatients Miller, Winifred Margaret

Abstract

Excessive anxiety is a pervasive problem in our society and particularly among patients with psychiatric problems. Are there simple techniques which nurses can teach patients which will assist in ameliorating such anxiety? An experimental study was conducted to investigate the effectiveness of a relaxation technique in relieving excessive anxiety. Thirty-six selected psychiatric inpatients were assigned at random to three groups. Subjects in Group 1 received individual relaxation training by means of a simple relaxation technique involving controlled breathing and muscle relaxation exercises. Group 2 subjects received individual placebo treatments on an equivalent schedule to Group 1. Subjects in Group 3 received the ordinary ward care and no special approach. Level of anxiety was measured by a physiological index (twenty-four hour urinary potassium excretion) and a psychological scale (IPAT Anxiety Scale Questionnaire). Both measures were tested at the beginning and end of the five day experimental period and changes in levels between groups compared statistically. Non-parametric analyses were utilized because of the lack of a normal distribution. The central tendencies of changes in the physiological and psychological indices measured for the three groups were analyzed by means of the Kruskal-Wallis One-Way Analysis of Variance. The null hypothesis was tested and the five percent (p < .05) level of significance was accepted. When the null hypothesis was untenable Mann-Whitney U Tests (one-tailed) were done to determine individual differences between groups. Group 1: "Relaxation" subjects were found to exhibit significantly greater declines in IPAT Anxiety Scale Questionnaire scores as compared with Group 3: "Control". No other statistically significant difference was found between individual groups. Inspection of IPAT scores and urinary potassium values suggests, however, that there is a marked difference in individual response, both physiologically and psychologically to the "Relaxation" and "Placebo" approaches. The lack of consistency between the findings for the urinary potassium excretion measure and Anxiety Scale Questionnaire scores arises, perhaps, from the fact that the Anxiety Scale is an index of multiple factors while urinary potassium excretion is a unitary physiological factor. On the basis of the findings in this study the technique described is deemed to be an effective method for nurses (or others) to employ as a means for relieving excessive anxiety. A number of recommendations for further study were made including the need to test other "high stress" populations, for example, patients in burn units or prior to cardiac surgery, and the need to identify which individual patients are most, likely to respond favourably to the relaxation training. The use of a multifactorial index, such as urinary electrolyte excretion profiles, as a more accurate overall measure of physiological stress is suggested.

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