RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1.

NAME OF THE CANDIDATE AND ADDRESS

MS. SILPA. S. DHARAN GOUTHAM COLLEGE OF NURSING, MANJUNATH NAGAR, WEST OF CHORD ROAD, RAJAJINAGAR, BANGALORE 560010.

2.

NAME OF THE INSTITUTE

GOUTHAM COLLEGE OF NURSING, MANJUNATH NAGAR, WEST OF CHORD ROAD, RAJAJINAGAR, BANGALORE 560010.

3.

COURSE OF STUDY AND SUBJECT

M.SC NURSING 1 YEAR PSYCHIATRIC NURSING

4.

DATE OF ADMISSION TO COURSE

25/09/2010

5.

TITLE OF THE TOPIC

A STUDY TO EVALUATE THE EFFECTIVENESS OF REIKI THERAPY ON REDUCTION OF DEPRESSION AMONG DEPRESSIVE PATIENTS IN SELECTED HOSPITAL AT BANGALORE.

6. 6.1

BRIEF RESUME OF THE INTENDED WORK NEED FOR STUDY Depression is nourished by a lifetime of un grieved and un forgiven hurts. Depression is more than just the blues being down in the dump or experiencing temporary feeling, sadness in the time to time in our lives. It is a serious condition that affects a persons mind and body impacts all aspects of everyday life. The World Health Organization has predicted that Depression is the 4th leading contributor to the global burden of disease in 2000. By the year 2020, Depression projected to reach 2nd place of ranking of DALYS [ Disability adjusted life years] calculated for all ages , both sexes. Depression estimated to affect 340 million people globally.1

World Health Organization, statistics says that Depression is common, affective about 340 million people in world wide. Depression is the number one occupation disease of the 21st century . At its worst, Depression can lead to suicide atargic fatality associated with the loss of about 850000 lives every year. In a year nearly 13 million and 14 million people are experiencing Depressive disorder. 97% people Depression are due to their work, home life and relationships. Depression among the youth has increased from 2% to12% in the last five years. Globally 3 out of every 5 visits to the Doctor are for stress related depression problems. 10% of women experiencing post partum Depression after birth of a child. 16% adult are affecting in an year. 6 million elderly people suffer from Depression in world wide.2

NHANES [National Health And Nutrition Examination Survey ] the prevalence of Major Depressive Disorder [MDD] was significantly greater in White individuals compared with African Americans[10.4%,7.5%].3

National Institute Of Mental Health ( NIMH) explains this from the research studies done Americans approximately 6.5% women are suffering from Depression in every year. Male population 3.3% that will suffer from a Major Depressive Disorder,4% of childrens also suffering from Depression combained totaling of 5.3% Americans are suffering from Depression.4

In United States,8.3% of adolescents suffer from Depression and 7 million women are clinically Depressed and 2.5% of childrens are suffering from Depression in every year.5

In Countries, prevalence rate of Depression lowest rates are reported Asian and Southeast Asian Countries. For eg, Taiwan reports less than 2% and Korea 3% Western Countries typically report higher rates, such as Canada7%, Newzealand11% and France16%.Also, Countries plagued by protracted civil war, such as Bosnia and Northern Ireland, reports higher rates of Depression.6

In India the

studies have been found that over all prevalence of

Depression was 15% higher in females in 16.3% and in males 13.9% . Depressed mood is the most common problem of Depression that is 30.8% tiredness, 30.0% while more severe symptoms such as Suicidal thoughts [12.4%] speech and motor retardation is 12.4% were less common. The prevalence of Depression was higher in low income group [5.9%] Prevalence of Depression is also higher among Divorced 26.5% and Widowed 20% compared to currently married that is 15.4%. 15% Employees in India are under stress.7

In Karnataka Statistics says that the prevalence rate of Depression was 11.2% and the overall prevalence of Depressive Disorders among the elderly of 60 yrs and above was found to 21.7%. The prevalence rate of Depression among males and females were 19.9% and 22.6% respectively.8

In Bangalore the Garden City of India. Where 9.1% peoples are estimated to be suffer from Depression. The study findings shows that 25% men in the Bangalore were Depressed, but only 18% of women were Depressed and in college age population 20.7%. 9 Reiki therapy is refered to as the universal life force. To bring over all healing to the body, mind, and spirit. Reiki therapy can help patients suffering from Depression in several ways. Depression often causes, stress,

fatigue and painful physical symptom that Reiki therapy can help patient learn to relax and find ways to lower stress levels. Relaxation Techniques can bring about a general sense of well being that can ease Depression symptoms.10

A study was conducted to evaluate the efficacy of Reiki therapy in reducing Depression in Depressive patients. The study, reports and claims regarding the use and efficacy of Reiki are enumerated and evaluated with the aim of trying to establish whether Reiki has been used and there for could be used to treat Depression patients. Depression is a most common mental health problem, with higher prevalence rates in women and men. The study concluded that Depression seems to be among the most common conditions for which patients seeks alternatives like Reiki therapy.11

Considering the above facts and review of literature, investigator felt that Reiki therapy will reduce the Depression among Depressive patients .So the researcher has interested to see the effectiveness of Reiki therapy to reduce Depression among Depressive patients.

6.2.

REVIEW OF LITERATURE

Review of literature is key step in research process. The typical purpose of analytical a review existing literature is to generate research question to identify what is known and what is un known about the topic. The major goal of review of literature is to develop a strong knowledge base to carry out research scholarly activity.

The extensive review of literature has been done and organized according to the following three aspects. 1. Studies related to Depression. 2. Studies related to Reiki therapy. 3. Studies related to effectiveness of Reiki therapy in Depressive patients.

1. Studies related to depression: A Study was conducted to determine the prevalence rate of Depression. The Study sampled 8449 people between the age group of 15 and 40 years. The study design controlled for age, gender, educational level and marital status, allowing researchers to pinpoint differences that could be accounted to by race/ ethinicity. Based on their responses to the DSM-IIITR Questionnaire. Depressed subjects were characterized as Major Depressive Disorder[MDD],Chronic Dysphoric Mood [CDM] Dysthmic Disorder [DD]. Though prevalence of MDD significantly greater in White individuals compared with African Americans [10.4%,7.5%] DD[7.5%,5.7%] & CDM [13.5%,7.6%] than White participants .Recurrent Depression was more common in White participants [18.2%]than in African American participants [13.3%]. The study was concluded that the Depression is an major life threatening disease seen in the population.12

A Study was conducted among 627 elderly individuals of 60 years and above in the rural area of Udupi Taluk. The objectives was to determine the prevalence of Depression and to study correlates of Depression Among elderly. In this study, the prevalence of Depression among elderly population was determined to be21.7%. The prevalence in the age group of 80 years and above and those individuals who had a history of death in the family with in the sixth months were found to be 34.4% and 52.4% respectively. The study concluded that these two correlates were indepently associated with Depressive disorders in elderly population.13

2. Studies related to Reiki therapy. A study was conducted to examine the effectiveness of Reiki as a mechanism for reducing stress and achieving relaxation and involved an examination of physiological and biochemical effects patients after receiving 30 minutes of Reiki. Random sampling was used for 23 people in a state of good health. Biological indicators related to the response of stress reduction includes ; anxiety, degree of salivation and cortisol, blood pressure, galvanic response epidermal,(GSR), muscle tension and skin temperature. Data were

collected before during and immediately after the session. Comparing before and after measures, anxiety was significantly reduced, t(22)=2.45 p=0.02 salivary IgA levels rose significantly t(19)=2.33,p=0.03,however,salivary cortisol was not statistically significant .There was a significant drop in systolic blood pressure(SBp) ,f(2,44)=6.60P<0.01.Skin temperature increased and elecro myo graph (EMG) decreased during the treatment, these study suggested that both biochemical and physiological changes in the direction of relaxation.14

A study was conducted to examine the effects of Reiki on fatigue, pain, anxiety and overall quality of life. this study was a counter balanced cross over trial of 2 conditions.(1) in Reiki condition, participants received 5 consecutive daily sessions, followed by a 1 week wash out monitoring period of no treatment, then 2additional Reiki sessions and finally 2 weeks of no treatment, and (2) in the rest condition participants were rested for approximately 1 hour each day for 5 consecutive days, followed by a 1 week wash out monitoring period of no scheduled resting and additional week of no treatment. In both conditions participants completed questionnaires

investigating Cancer- related fatigue(Functional Assessment of Cancer Therapy Fatigue Subscale[FACT-F]) and overall quality of life (Functional Assessment of Cancer Therapy, General version [FACT-G]) before and after all Reiki or resting sessions. They also completed a visual analog scale [Edmonton Symptom Assessment System[ESAS] assessing daily tiredness, pain and anxiety before and after each session of Reiki or rest. 16 patients (13women) participated in the trial.8 were randomized to each order of conditions (Reiki then rest; rest then Reiki ) They were screened for ESAS tiredness item, and those scoring greater than 3 on the 0 to 10 scale were eligible for the study. Fatigue on the FACT-F decreased with the Reiki condition (P=.05) over the course of all 7 treatment. In addition participants in the Reiki condition experienced significant improvement in quality of life(FACT-G) compared to those in the resting condition(p<.05)on daily assessment (ESAS) in the Reiki condition . pre session versus post session 5 scores indicated significant decrease in tiredness(p<.001), pain(p<.005),and

anxiety (p<.01) which were not seen in the resting period. The study suggested that Reiki therapy has an positive effect on Cancer related fatigue, pain, anxiety and overall quality of life.15

3. Studies related to effectiveness of Reiki therapy in Depressive patients. A Study was conducted the effectiveness of Reiki therapy in Depression. The research design used in this study was pretest\ posttest treatment and wait list control design.76 self selected participants from

general population were selected. They were randomly divided in to two groups. one was received Reiki therapy another group was not received. Zung Self Rating Depression scale was used for measuring Depression. 82% of patients were reduced Depression and 18% of patients are still like that. The study concluded that Reiki therapy effective for treating Depression.16

A Study was conducted to evaluate the effect of Reiki in Depression patients. 20 participants were randomly assigned to either an experimental or wait list control group. The pre and post test measures by Beck Depression Inventory Scale. The research design included an experimental component to examine changes in these measures and a descriptive component [semi structured interview] to elicit information about the experience of having Reiki treatment. There was76% reduction occur in experimental group and 24% have no changes. The study concluded that a significant differences were observed between the experimental and measurement.17 control groups on

A Study was conducted for Long term effects of Reiki therapy on Depression.45 participants with symptoms of Depression volunteered for this study. Participants were randomly assigned to one of three groups; Hands on (touch)Reiki, Distance (non touch) Reiki, and Distance Reiki placebo. The study suggested that Reiki therapy have an significant reduction in Depression. participants were not received aware of which group would be receiving placebo Reiki.12 Reiki masters, and three second degree Reiki practioners were chosen to conduct the one to one and one- half hour sessions.

Each participants received one treatment weekly for 6 weeks. Three tests, designed to measure levels of Depression, were administered each participants before and after the series of 6 sessions.1 year later, the participants retook the three tests. After testing was completed, the control placebo group received another 6 weeks of Reiki treatments, this time with actual Reiki, and three test were administered to this group again findings of the study demonstrated that there were no changes in the control\ placebo group until they received 6 session of actual Reiki a year after the first 6 placebo sessions. Both the hands on and the distance Reiki were effective in relieving symptoms of

Depression. The study concluded that Reiki therapy have an long term effects in reduction of Depression.18

6.3

STATEMENT OF THE PROBLEM A study to evaluate the effectiveness of Reiki therapy on reduction of Depression among Depressive patients in selected hospital at Bangalore.

6.4

OBJECTIVES OF THE PROBLEM 1. To assess the existing level of Depression among Depressive patients in selected hospital at Bangalore. 2. To determine the effectiveness of Reiki therapy on reducing Depression among Depressive patients in experimental and control group. 3. To find out the association between interventional scores with selected demographic variables among experimental and control group. 4.

6.5

OPERATIONAL DEFINITIONS Evaluate : It refers to the process of evaluating the subjects and rating it based on its important features. Effectiveness : It refers significant difference between pre and post interventional scores on Depression after administering Reiki therapy. Reiki therapy: It refers to a gentle non invasive methods of hands on healing that provides balance to the physical, emotional, spiritual and mental issues in life. Depression: Refers to an emotional state of mind characterized by feeling of

gloom and inadequacy, leading to withdrawal. It is measured by modified Beck Depression Inventory Scale.

6.6

HYPOTHESIS H1: There will be a significant difference between the pre and post interventional scores regarding the Depression among Depressive patients of experimental group of after administering Reiki therapy. H2: There will be a significant difference between pretest and posttest scores regarding Depression among Depressive patients of control group. H3: There will be a significant difference between pre and post interventional scores in Reiki therapy on reducing Depression among Depressive patients of experimental and control group. H4: There will be a significant association between interventional scores with their selected demographic variables among experimental and control group.

6.7

ASSUMPTIONS 1. It is assumed that Depression patients may have inadequate knowledge regarding Reiki therapy. 2. It is assumed that Depression may reduced after giving Reiki therapy

6.8

DELIMITATIONS 1. The study is delimited to Depression patients only. . 2. The study is delimited to 40 patients only. 3. The study is delimited to only selected hospital at Bangalore.

7.

MATERIALES AND METHODS

7.1

SOURCE OF DATA

The subject who diagnosed as Depressive patients admitted in selected hospital at Bangalore.

7.2

METHODS OF COLLECTION OF DATA

7.2.1

SAMPLING CRITERIA INCLUSION CRITERIA

1. The study includes Depression patients of both gender. 2. The patients who are available during the period of study. 3. The patients who are able to understand Kannada and English.

EXCLUSION CRITERIA

1. The patients who are not willing to participate in this study 2. The geriatric depressive patients.

7.2.2

RESEARCH DESIGN

The research design adopted for the present study is True Experimental Design Pretest and posttest control group design.

7.2.3

VARIABLES UNDER THE STUDY-

1. INDEPENDET VARIABLE Reiki therapy 2. DEPENDENT VARIABLE Reduce the Depression among Depressive patients. 3. DEMOGRAPHIC VARIABLE Age, Gender, Socio economic status, Occupation, education, dietary pattern, alcoholism, smoking, marital status ,Duration of hospital stay, family history of psychiatric diseases

7.2.4

SETTING

Study will be conducted in psychiatric wards of selected hospital at Bangalore.

7.2.5

SAMPLE TECHNIQUE

The technique adopted for the present study is simple random sampling by using lottery method without replacement, 20 experimental group and 20control group.

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7.2.6

SAMPLE SIZE

The sample size consist of 40 depression patients (experimental group 20,control group 20)

7.2.7

TOOLES OF RESEARCH

Section 1: Structured self administered questionnaire will be developed by researcher to assess demographic variables among depressive patients.

Section 2:Modified Beck Depression Inventory Scale is used to assess the Depression. 7.2.8 COLLECTION OF DATA 1.A Prior formal permission will be obtained from Hospital authority. 2.Informed consent will be obtained from subjects after explaining the purpose of the study. 3. Structured self administered questionnaire is used to collect the demographic variables. 4.Modified Beck Depression Inventory Scale used to assess pretest scores among experimental group and control group. 5.Administering Reiki therapy for the experimental group for 30 minutes once per day for one week. No treatment for control group. 6.Post test will be conducted after 7 days with same scale among experimental group and control group. 7.BeckDepression Inventory Scale used to assess pretest scores among experimental and control group . 8.Duration of data collection will be 30 days.

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7.2.8

METHOD AND DATA ANALYSIS AND PRESENTATION

The investigator will obtain data using descriptive and inferential statistics and the plan of data analysis will be as follows. 1.Organize the data in a master sheet and a computer. 2.Frequencies and percentage for the analyses of background data. 3.Assessment of pretest by using data sheet ,mean and standard deviation 4..Effectiveness of interventional program analyzed by t test. 5.Association with demographic variables analyzed by 2 (chi- square)

7.3

DOES

THE

STUDY

ENQUIRE

ANY

INVESTIGATION

OR

INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMAN OR ANIMALS ? IF SO DESCRIBE BRIEFLY. Yes, the study requires Reiki therapy as an invention to reduce Depression among Depressive patients in selected Hospitals at Bangalore.

7.4

HAS THE ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASEOF 7.3? Yes, informed consent will be obtained from the institution authorities and subjects . Privacy ,confidentiality and anonymity will be guarded . Scientific objectivity of the study will be maintained with honesty and impartiality.

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LIST OF REFERENCES:

1. Murray C.J and Lopez A.D, Global burden of disease study, Lancet 2000, Page No.1498-1504. 2. The WHO, World Mental Health Consortium, Prevalence and Severity of depression,2006, Page No.2581-2590. 3. Nguyen T and Flack C, Third National Health and Nutritional Survey, Comparative prevalence of Depression by race / ethnicity, Newyork 2004. 4. Bethesda MD ,Dept of Health and Human Services, National Institute of Mental Health ,U.S 2001. 5. Nierenberg A.A, Fava M, Illness Beliefs and Prevalence of Depressed American Patients , J Nerv Ment Disc 2004, Page No.324-327. 6. Sethi B.B ,and Sharma M, Depressive Disorders in the Developing World, Int J Soc Psychiatry 2002.Page No.217-222. 7. Nandi D.N and Ajmany S, The incidence of Mental Disorders in one year in a rural community in India , Indian J Psychiatry 2006,Page No.79-87. 8. Ramachandhran V. Menon and Sarada M ,Arunagiris Socio cultural factors in Depression,Indian J Psychiatry2002, PageNo.268-273. 9. Berardi D and Leggieri G ,Depression in Primary Care- as National Wide Epidemiological Survey2002, Page No.397-400. 10. Sasikala G, Nightingale Nursing Times, Volume 6,September 2010, Page No. 34-36. 11. Zuleikha Ahmed ,Effectiveness of Reiki on Depression, Alternative Therapies in Health and Medicine, October 2003. 12. Neauh N and Sonawalla S, Screening for Major Depression in Asian Americans , A Comparison of the Beck and Chinese Depression Inventory ,AC-a Psychiar Scand 2002, Page No.252-257. 13. Nandi P.S and Banerjee G, A Study of Psychiatric Morbidity of elderly population of rural community, Indian J Psychiatry 2003,Page No.122129. 14. Wardell D and Engebreston J,Biological Correlates of Reiki Touch

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Healing, J Advanced Nursing2001, Page No.439-445. 15. Alberta and Tsang KL ,Department of Psychology, University of Calgary, Integr Cancer Ther 2007. 16. Vera A. Poter Phd Holos University Graduate Seminary,Reiki Effects on Depression. 17. Richeson NE and Spross Ja, College of Nursing and Health Professionals, University of Southern Maine, Portland, U.S.A 2010. 18. Shore and Adina G ,Alternative Therapies in Health and Medicines 2004, Page No.42-48. 19. Polit D.F.et.al,Nursing research principles and methods,3rd edition,J.B. Lippincott Company,Philadelphia,2003,Page No:30-35. 20. Sundar Rao P.S.et.al.,An Introduction to biostatics,3rd edition,Practice Hall of India Limited,New Delhi,1996, Page No:98-106. 21. http://EZIneArticles.com/?expert=Haroldcortez inJune2008. 22. http://www.happymoods.info\incidence and Depression prevalence. 23. http://www.cureresearch.com/d/depression/ stas-Country.htm. 24. http://www.veraporter.com/research.htm/.

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