A Study To Assess The Effectiveness Of Breathing Exercise .
Original Research ArticleInternational Journal of Science and Healthcare ResearchVol.3; Issue: 3; July-Sept. 2018Website: www.ijshr.comISSN: 2455-7587A Study to Assess the Effectiveness of Breathing Exercise in Lowering HighBlood Pressure among Hypertensive Patients at General Hospital,Alnamas, Kingdom of Saudi ArabiaDr. Eman Elsayed Hussein Mohammad, Dr. X. S. Blessing NimaSajai, Dr. Selvia Arokiya MaryApplied Medical Science College for Females, Alnamas, University of BishaCorresponding Author: Dr. X. S. Blessing NimaSajaiABSTRACTHypertension (HTN or HT), also known as highblood pressure (HBP), is a long-term medicalcondition in which the blood pressure inthe arteries is persistently elevated. High bloodpressure is a major risk factor for coronaryarterydisease, stroke, heartfailure, atrialfibrillation, peripheral vascular disease, visionloss, chronickidneydisease,and dementia. Hypertension has a majoreconomic impact ranging from medical costs tohuman capital loss and decrease inproductivity. The Global Burden of Disease2010(GBD2010)study showstheestimation that hypertension was the leadingrisk factor for death in the Kingdom of SaudiArabia(KSA).Statisticsshowsthathypertension accounted for about 24% of totaldeaths from cardiovascular and circulatorydiseases and 1.87% of total deaths fromhypertensive urogenital, blood, and endocrinediseases. From 1990 to 2010 the burden ofhypertension remained very high in Kingdom ofSaudi Arabia (KSA) Previous studies reportedhigh levels of blood pressure in Kingdom ofSaudi Arabia (KSA). These levels ranged from26.1% among individuals 30–70 years old in1995–2000 to 25.5% among individuals 15–64years old in 2005, A study was done toassess Effectiveness Of Breathing Exercise InLowering High Blood Pressure AmongHypertensive Patients At General Hospital, Alnamas, Kingdom of Saudi Arabia. 80patients were selected by convenient rity with settings were added reason. Thetool used for the study includes demographicdata and vital signs assessment sheet & digitalBP apparatus to assess the blood pressure. Aftercollecting the data, the data analysis was doneaccording to the objectives of the study usingdescriptive statistics and inferential statistics.The study findings reveals that reveals that,Level of significance (P-value 0.001)as suggested by “Paired t test”. The mean pretesttotal levelofhypertension Scorebefore breathing exercise was 40 and mean posttest level of hypertension score was observed tobe 26.66. The reduction in hypertension overbreathing exercise (Mean 13.34,) wassignificant at 5% .So the breathing exercise waseffective on hypertensive patient. The findingsrevealed that there was significant associationbetween hypertension level and age,gender, Education of the participant, Occupationof the participant, Duration since diagnosisof hypertension, Family history of diabetesmellitus. But there is no associationbetween hypertension levelandReligion,Marital status, Family income per –month.Key Words: Assess, effectiveness, breathingexercise, hypertension, cardiovascular diseaseI.INTRODUCTION“Important event you can do byyourself during your life time is breathing inand out so if you do your breathing air inand out regularly as an exercise. you canmaintain your blood circulation and keepyour body in relax state and healthy”Hypertension is one of the leadingcauses of cardiovascular diseases and otherlife style disease. If we want to know indetail, Hypertension (HTN or HT), alsoknown as high blood pressure (HBP), isa long-term medical condition in whichthe bloodpressure inthe arteries ispersistently elevated. High blood pressure isInternational Journal of Science and Healthcare Research (www.ijshr.com)Vol.3; Issue: 3; July-September 2018153
Eman Elsayed Hussein Mohammad et.al. A Study to Assess the Effectiveness of Breathing Exercise in LoweringHigh Blood Pressure among Hypertensive Patients at General Hospital, Alnamas, Kingdom of Saudi Arabiaa major risk factor for coronary arterydisease, stroke, heartfailure,atrialfibrillation, peripheral vascular disease,visionloss, chronickidney disease,and dementia. Hypertension has a majoreconomic impact ranging from medicalcosts to human capital loss and decrease inproductivity. As per global review theprevalence of hypertension is highest inAfrica (46% of adults) while the lowestprevalence is found in the Americas (35%of adults).According to The Global Burden ofDisease 2010 (GBD 2010) study revealedthat the hypertension was the leading riskfactor for death in the Kingdom of SaudiArabia (KSA). Statistics shows thathypertension accounted for about 24% oftotal deaths from cardiovascular andcirculatory diseases and 1.87% of totaldeaths from hypertensive urogenital, blood,and endocrine diseases. From 1990 to 2010the burden of hypertension remained veryhigh in Kingdom of Saudi Arabia(KSA) Previous studies reported high levelsof blood pressure in Kingdom of SaudiArabia (KSA). These levels ranged from26.1% among individuals 30-70 years old in1995-2000 to 25.5% among individuals 1564 years old in 2005.Recent research shows that 3 or 415-minute sessions of slow breathing (lessthan or equal to 10 breaths per minute) canlower both systolic and diastolic bloodpressure, usually within 8 weeks (1) – (19).In one clinical trial, some diabetics were notable to sufficiently lower their respirationrate. However, with a longer training perioda lower rate of respiration might beachieved.Slow breathing has the physiologicaleffect of relaxing the muscles surroundingthe small blood vessels, which allows theblood to flow more easily. Alpha blockersblock receptors in arteries and smoothmuscle. This action relaxes the bloodvessels and leads to an increase in bloodflow and a lower pressure for the control ofhypertension.This section will provide briefdescription on the various significances ofthe study. The proposed study serves thehypertensive patients with information andexperience in doing breathing exerciseswhich helps them to maintain their bloodpressure in normal range. It also help themduringlifethreateningemergencysituations. The proposed study will benefitsand help the future researcher as their guide.The study can also open in development ofthis study. While seeing in our nursingprofession, saving one’s life and preventingthem from getting further complications andmaintain the health of the patients is a greatchallenge. Also nowadays many peoplewere suffering from hypertension and otherlife style diseases, so I selected this study toassess the effectiveness of breathingexercises among hypertensive patients whowere attending in Medical clinic and ward atGeneral Hospital Alnamas.Statement of the ProblemA Study To assess Effectiveness OfBreathing Exercise In Lowering High BloodPressure Among Hypertensive Patients AtGeneral Hospital, Alnamas, Kingdom ofSaudi Arabia.A. Aim/objectives of the studyToassessEffectivenessOfBreathing Exercise In Lowering High BloodPressure Among Hypertensive Patients AtGeneral Hospital, Alnamas, Kingdom ofSaudi ArabiaB. Objectives To assess the pretest blood pressurevalue among hypertensive patientsbeforedemonstratingbreathingexercise. To assess the post-test blood pressurevalue among hypertensive patients afterdemonstrating breathing exercise. To evaluate the effectiveness ofbreathing exercise among hypertensivepatients. To find out the association between thepost-test blood pressure value amongInternational Journal of Science and Healthcare Research (www.ijshr.com)Vol.3; Issue: 3; July-September 2018154
Eman Elsayed Hussein Mohammad et.al. A Study to Assess the Effectiveness of Breathing Exercise in LoweringHigh Blood Pressure among Hypertensive Patients at General Hospital, Alnamas, Kingdom of Saudi Arabiahypertensive patients with their selecteddemographic variables.C. Operational definitionAssess: Assess refers to know somethingaccuratelyHypertension: Blood pressure is the forceexerted by the blood against the walls of theblood vessels. Normal blood pressure of 120mm Hg when the heart beats (systolic) and ablood pressure of 80 mm Hg when the heartrelaxes (diastolic) and when systolic bloodpressure is equal to or above 140 mm Hgand/or a diastolic blood pressure equal to orabove 90 mm Hg the blood pressure isconsidered to be raised or high Or termed ashypertension.D. HypothesisResearch hypotheses:The following research hypotheses wereformulated to achieve the aim of the currentstudy:H1- There will be a statistical significantdifference in blood pressure before and afterbreathing exercise intervention.H2- There will be a significant associationbetween the blood pressure level of studysubjects with their selected demographicvariablesE. AssumptionBreathing exercise might have direct effectin reducing high blood pressureF. DelimitationThe data collection is delimited to 7 weeksThe patients who are willing to participateduring data collectionG. Projected outcomeThe study findings help to assessblood pressure before and after breathingexercise intervention among hypertensivepatients.H. LimitationThe study was conducted amongHypertensive Patients At General Hospital,Alnamas, Kingdom of Saudi Arabia,generalization can be done but with cautionII.METHODOLOGYThis chapter includes researchdesign, the setting of the study, the samplesize, the criteria for sample selection, themethods of sample selection the instrumentsand tools for data collection, the techniqueof data analysis and protection of humansubjects. The present study was designed toassess effectiveness of breathing exercise inlowering high blood pressure amonghypertensive patients at general hospital,Alnamas, Kingdom of Saudi Arabia.A. Research ApproachThe research approach used for this studywas quantitative approach.B. Research DesignThe research design selected for thepresent study was quasi experimental onegroup pre-test post-test design. TheInvestigatorhaddevelopedStressAssessment Rating Scale for evaluation ofpretest and post-test stress score of thesamples. For manipulation of independentvariable Investigator had prepared a plan fordemonstration on the Progressive MusclesRelaxation Technique and observes itseffect on the stress of samples as dependentvariable. The research design adopted forthe study is diagrammed as:ONEGROUPPRE TESTO1INTERVENTIONXHypertensivePatientAssess VitalSignsincludingBloodPressure italSignsincludingBloodPressureKEY -:O1 It is the First Observation meansassessment of pre-test score of bloodpressure level among hypertensive ingeneral hospital at Alnamas.X Treatment to the group is theadministration of the breathing exercise.International Journal of Science and Healthcare Research (www.ijshr.com)Vol.3; Issue: 3; July-September 2018155
Eman Elsayed Hussein Mohammad et.al. A Study to Assess the Effectiveness of Breathing Exercise in LoweringHigh Blood Pressure among Hypertensive Patients at General Hospital, Alnamas, Kingdom of Saudi ArabiaO2 It is the second observation meansassessment of post-test score of bloodpressure level among hypertensive ingeneral hospital at Alnamas.C. Setting of the studyThe study was conducted at generalhospital, Alnamas, Kingdom of SaudiArabia.80 hypertensive patients wereselected as samples for this study. Thissetting was selected because of theavailability of participants and feasibility ofconductingthestudy.Researcher’sconvenience and familiarity with settingswere added reason.D. PopulationThe target population for this studyis hypertensive patients from generalhospital, Alnamas, Kingdom of SaudiArabia.E. SampleSample consisted of 80 hypertensivepatients who attended in medical OPD &ward at general hospital, Alnamas,Kingdom of Saudi Arabia.F. Sampling Technique80 hypertensive patients wereby convenient sampling method.selectedG. Criteria for sample selection1.Inclusion Criteria: The patients who arewilling to participate in the study, agebetween 30-60, patient free from liverdisease, renal disease, cardiac disease,cancer, diabetes etc and patient who ismedically fit to do breathing exercise2. Exclusion Criteria: Unconsciouspatients, smokers and women withcontraceptives, patient who is having therange of normal blood pressure &hypertension stage 2, patients who notinterested to do breathing exerciseH. Research tool and techniqueThe tool used for the research studywas demographic data and vital signsassessment check list to assess the bloodpressureI. Description of the toolThe tool used for the study includes twosection that is section I and section II.Section I: I had items related todemographic data consists of age, sex,education, occupation, marital status, familyincome, Duration since diagnosis ofHypertension and familyhistory ofhypertension.Section II: Vital Signs Assessment Sheetand digital BP apparatusScoring Procedure: The subjects wereclassified into four categories based on theirblood pressure value. The score for theblood pressure level is assessed by digitalBP apparatus. The patients are classifiedaccording to the range as follows.CATEGORYNormalPre HypertensionHypertensionStage 1HypertensionStage 2SYSTOLIC(mmof Hg) 120121-139140-159DIASTOLIC(mm ofHg) 8081-8990-99 160 100J. Data Collection ProcedureBefore conducting the study, formalpermission was obtained. Informed consentwas obtained from the participants. Theperiod of data collection was done for sevenweeks. The researcher introduced self toeach subject and explained the purpose ofthe study and checked vital signs emonstratedbreathingexercise and its three types. Researchersassisted the patients while doing exercise.10 mts after finishing breathing exercise bythe patient, Make the patient in relaxed stateand vital signs was checked again andrecorded.K. Plan for data analysisData analysis was done according tothe objectives of the study using descriptivestatistics and inferential statistics.L. Descriptive StatisticsFrequency percentage mean and standarddeviation were used for the analysis.International Journal of Science and Healthcare Research (www.ijshr.com)Vol.3; Issue: 3; July-September 2018156
Eman Elsayed Hussein Mohammad et.al. A Study to Assess the Effectiveness of Breathing Exercise in LoweringHigh Blood Pressure among Hypertensive Patients at General Hospital, Alnamas, Kingdom of Saudi ArabiaM. Inferential StatisticsPaired “T” test was used for testingeffectiveness of breathing exercise. Chi square was used to determine theassociation between demographic variableswith level of blood pressure.N. Protection of human subjectsAfter the problem statement wasapproved formal permission was obtainedbefore starting the study. The oral & writtenconsent was obtained from each participantsof the study before starting the datacollection. Assurance was given to thesubject that the anonymity of eachindividual would be obtained.RESULTS & DISCUSSIONThis section shows the resultfindings of the study which is based on dataanalysis and interpretation of data collectedfrom the participantsThe data collected during the presentstudy were analysed based on the objectivesformulated for the study. The objectives ofthe study were To assess the pre-test blood pressurevalue among hypertensive patientsbefore demonstrating breathing exercise. To assess the post-test blood pressurevalue among hypertensive patients afterdemonstrating breathing exercise. To evaluate the effectiveness ofbreathing exercise among hypertensivepatients. To find out the association between thepost-test blood pressure value amonghypertensive patients with their selecteddemographic variables.Frequencyandpercentagedistribution of sample characteristics of thestudy.Findings related to frequency anddistribution of blood pressure level of theparticipants.Association between blood pressure leveland demographic variables such as age, yearof study, previous education syllabus, parenteducation, family income, area of residence.B. Frequency and percentage of samplecharacteristics of the studyFrequency and percentage ofhypertension(N 80)Hypertension levelPre HypertensionHypertension-Stage 1distribution of pre-test level ofFrequency6317Percentage78.75%21.25%III.A. Organization of the FindingsIn order to find out the relationshipbetween the variables and also to assess theblood pressure value the data gathered weretabulated, analyzed and interpreted usingboth descriptive and inferential statistics.The data are presented under the followingheadings.Distribution of frequency anddemographicvariablesamonghypertension (N rital statusFamily incomeper –monthDuration sincediagnosisofHypertensionFamily history ofHypertensionpercentage ofpatientswithCategory r level of educationGraduate and aboveUnemployedPrivate SectorGovernment /separatedLess 2001SR-3000SR3001SR-4000SR4001SRand above 3years8.7521.2566.2513.754-6years7-9years 10yearsYes36.2528.7521.2583.75No16.25Frequency and percentage of distribution of post-test level ofhypertension (N 80)Hypertension levelFrequencyPercentageNormal2328.75%Pre Hypertension465.75%Hypertension-Stage 11113.75%International Journal of Science and Healthcare Research (www.ijshr.com)Vol.3; Issue: 3; July-September 2018157
Eman Elsayed Hussein Mohammad et.al. A Study to Assess the Effectiveness of Breathing Exercise in LoweringHigh Blood Pressure among Hypertensive Patients at General Hospital, Alnamas, Kingdom of Saudi ArabiaDetermine the effectiveness of deep breathing exercise on level of blood pressure among patients with hypertension (N 80)PARAMETERSMEAN SCORENSE ( )Paired“t” “p-value”(OnePre- tailed)Mean hypertension Pre-Test Level Of Post-Test Level Of 4801.8068.603 0.001Above table reveals that, Level ofsignificance (P-value 0.001) as suggestedby “Paired t test”. The mean pre-test totallevel of hypertension Score before breathingexercise was 40 and mean post-test level ofhypertension score was observed to be26.66. The reduction in hypertension overbreathing exercise (Mean 13.34) wassignificant at 5%.So the breathing exercisewas effective on hypertensive patientThe findings revealed that there wassignificantassociationbetweenhypertension level and age, gender,Education of the participant, Occupation ofthe participant, Duration since diagnosis ofhypertension, Family history of diabetesmellitus. But there is no association betweenhypertension level and Religion, Maritalstatus, Family income per- month.IV.CONCLUSIONSSlow and Deep breathing can have apowerful influence on our health. when ourbreathing is full and deep, the diaphragmmoves through its entire range downward tomassage liver, stomach and other organsand tissues below it, and upward to massagethe heart. when our breathing is full anddeep, the belly, lower ribcage, and lowerback all expand on inhalation, thus drawingthe diaphragm down deeper into theabdomen, and retract on exhalation,allowing the diaphragm to move fullyupward toward the heart. in deep breathingthe upward and downward movement of thediaphragm, combined with the outward andinward movements of belly ribcage andlower back help to massage and detoxifyour inner organs and promote blood flowand peristalsis, and pump the lymph moreefficiently through our lymphatic system.The lymphatic system which is an importantpart of our immune system has no pumpother than muscular movements, includingthe movements of breathing. Our studyshows breathing exercise is effective inlowering high blood pressure. Based on thestudy, the investigator proposed followingrecommendations: To maintain blood pressure, all can dobreathing exercise Breathing exercise is one
A Study to Assess the Effectiveness of Breathing Exercise in Lowering High Blood Pressure among Hypertensive Patients at General Hospital, Alnamas, Kingdom of Saudi Arabia International Journal of Science and Healthcare Research (www.ijshr.com) 156 Vol.3; Issue: 3; July-September 2018 O2 It is the second observation means assessment of post-test score of blood pressure level among .
May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)
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Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. 3 Crawford M., Marsh D. The driving force : food in human evolution and the future.
