Introduction
Heart attack is formally referred to as acute myocardial infarction. A heart attack is a potentially fatal disease that develops when the blood supply to the heart muscle is suddenly interrupted, resulting in tissue injury.1 A obstruction in one or more of the coronary vessels frequently causes this. Plaque, a material primarily composed of fat, cholesterol, and cellular waste products, can accumulate and cause an obstruction. Numerous alterations in a person's physical, psychological, and social parameters will result from myocardial infraction. Sweating, nausea, puking, and fainting can accompany chest discomfort, but they can also happen without any pain at all. The most typical signs of myocardial infarction in women are tiredness, weakness, and loss of breath. Breathlessness is a frequent sign, and in some cases the only symptom, of cardiac damage that restricts the left ventricle's ability to pump blood. Breathlessness can be caused by either low blood oxygen levels or pulmonary edema.2 Other signs and symptoms include fatigue, dizziness, palpitations, irregular heartbeat or blood pressure, loss of awareness, and abrupt demises.
Need of the Study
Additionally, patients in the therapy group's written assessments of the Progressive muscle relaxation method showed a high level of emotional happiness with it as a way to lessen stress in their lives.3
Using a randomized distribution technique, samples were divided into two group controls. Patients who have had a myocardial infarction administer the gradual muscular relaxation method twice daily for three days. As a consequence, patients with myocardial infarction who use the progressive muscle relaxation method experience substantially lower respiratory rates and minor changes to the other vital signs.4
The data were split into two groups: intervention and control. From the perspectives of age, sex, and level of worry, both are comparable. Patients with myocardial infraction are administered the progressive muscular relaxation method over the course of three days. As a consequence, patients with myocardial infraction who were admitted in the CCU experienced significantly less worry and systolic and diastolic blood pressure.5
The researcher believed that in order to avoid further complications that are brought on by variables affecting anxiety, myocardial infarction patients should keep their bodily parameters and conquer their anxiety.6 These people can learn relaxation methods in addition to taking medication to more effectively lower their high levels of worry. The researcher discovered that progressive muscle relaxation method is more successful at decreasing worry than other techniques. 7 This inspired the researcher to perform this study in an effort to lower tension levels among myocardial infarction patients and stop further complications. 8
Objectives
To assess the level of physical parameters of patients with myocardial infarction.
To assess the level of anxiety of patients with myocardial infarction
To assess the effect of progressive muscle relaxation techniques on physical parameters and anxiety among patients with myocardial infarctions.
To find the correlation between physical parameters and anxiety among patients with Myocardial infarction
To find out the association between pre test score of patients of myocardial infarction with selected socio demographic variables.
Setting of the study
The current research was carried out at two institutions, K. Gurunath Cardiovascular Hospital and B.M. Shah Multi Specialty Hospital in Supela Bhilai. K Gurunath cardiac hospital has 10 beds, while B M Shah multispecialty hospital has 55 spaces for patients with a variety of specialties.
Sample
The sample of the present study is 46 myocardial infarction patients at selected hospitals of Durg (C.G).
Sampling technique
Among myocardial infarction cases, a representative group was chosen using non-probability-convenient selection.
Result
Table 1
Percentage distribution of subjects according to age (N=46)
Table 2
Percentage distribution of subjects according to gender (N=46)
|
S. No. |
Gender |
Experimental group |
Control group |
||
|
Frequency (f) |
Percentage (%) |
Frequency (f) |
Percentage (%) |
||
|
1. |
Male |
9 |
39.2 |
12 |
52.1 |
|
2. |
Female |
14 |
60.8 |
11 |
47.9 |
|
|
Total |
23 |
100 |
23 |
100 |
Table 3
Percentage distribution of subjects according to education (N=46)
Table 4
Percentage distribution of subjects according to religion (N=46)
Table 5
Percentage distribution of subjects according to type of food (N=46)
|
S. No. |
Type of food |
Experimental group |
Control group |
||
|
Frequency (f) |
Percentage (%) |
Frequency (f) |
Percentage (%) |
||
|
1. |
Vegetarian |
11 |
47.8 |
15 |
65.2 |
|
2. |
Mixed diet |
12 |
52.2 |
8 |
34.8 |
|
|
Total |
23 |
100 |
23 |
100 |
Table 6
Percentage distribution of subjects according to type of family (N=46)
Table 7
Percentage distribution of subjects according to occupation (Male) (N=46)
Table 8
Percentage distribution of subjects according to occupation (Female) (N=46)
Table 9
Percentage distribution of subjects according to Habitat (N=46)
|
S. No. |
Habitat |
Experimental group |
Control group |
||
|
Frequency (f) |
Percentage (%) |
Frequency (f) |
Percentage (%) |
||
|
1. |
Urban |
14 |
60.8 |
16 |
69.5 |
|
2. |
Rural |
9 |
39.1 |
7 |
30.4 |
|
|
Total |
23 |
100 |
23 |
100 |
Table 10
Percentage distribution of subjects according to family monthly income (N=46)
Table 11
Percentage distribution of subjects according to personal habits (N=46)
Table 12
Percentage distribution of subjects according to recreational activity (N=46)
Table 13
Percentage distribution of subjects according to source of Information (N=46)
Table 14
Percentage distribution of subjects according to availability of Government Health Services (N=46)
Assessment on level of physical parameters among patients with myocardial infarction
This section deals with the level of physical parameters includes Blood pressure, Pulse, Respiration and Spo2 among patients with myocardial infarction. The level of physical parameters was categorized as mild, moderate and severe. In terms of systolic blood pressure, mild hypertension is 120-139mm of Hg, moderate is 140-159mm of Hg and severe is ≥160mm of Hg. In terms of diastolic blood pressure, mild hypertension is 80-90mm of Hg, moderate is 90-99mm of Hg and severe is ≥100mm of Hg, where as in pulse rate the normal pulse rate is 72-80, mild pulse rate is 80-90b/min, moderate pulse rate is 90-100b/min and severe pulse rate is >100b/min, for respiration the normal rate is 16-24/min, mild is 24-30b/min, moderate respiration is 30-50b/min, and severe respiration is more than ≥50b/min. Collected data were organized, analyzed and presented using descriptive statistics.
Table 15
Over all analysis of pretest and posttest value of physical parameters of patients with myocardial infarction (N=46)
Table 16
Over all analysis of assessment of anxiety among patients with myocardial infarction (N=46)
Over all analysis of pretest and post test anxiety score of experimental and control group among myocardial infarction patients
The shows that in experimental group, in pre-test, 12(52.1%) are having severe anxiety, 11(47.8%) are having moderate anxiety, Whereas in post test 17(73.9%) patients are having mild anxiety, 6(26%) were having no anxiety level where as in control group pre-test, 14(60.8%) are having severe anxiety, 9(39.1%) are having moderate anxiety, Whereas in post test 10(43.4%) patients are having severe and moderate anxiety, and 3(13%) were having mild anxiety level.
Table 17
Comparison of physical parameters among patients with myocardial infarction in experimental group (N=46)
Table 18
Comparison of anxiety score among patients with myocardial infarction in experimental group
|
Anxiety |
Mean |
SD |
df |
Paired t test |
P value |
Table value |
Inferences |
|
|
|
|
|
|
|
|
|
|
Before intervention |
50 |
7.0 |
22 |
3.4 |
0.001 |
2.07 |
Significance |
|
After intervention |
44.5 |
6.6 |
Paired ‘t’ test was used to assess the level of anxiety among patients with myocardial infarction before and after the intervention. It was identified that, the mean level of anxiety before and after progressive muscle relaxation among the experimental group was 50and 44.5 respectively. Standard deviation was 7.0, 6.6 and the calculated ‘t’ value was 3.4. While comparing with table value, it showed that the calculated ‘t’ value was greater than the table value at 0.001 level of significance. Thus the research hypothesis, ‘There will be a significant difference in the level of anxiety among patient with myocardial inafraction in experimental group before and after progressive muscle relaxation technique was accepted.
Figure 1
Comparison of anxiety score among patients with myocardial infarction in experimental group
Figure 2
Comparison of level of anxiety among patients with myocardial infarction between experimental and control group in post test
Table 19
Comparison of level of physical parameters among patients with myocardial infarction between experimental and control group in post test (n=46)
Table 20
Comparison of level of anxiety among patients with myocardial infarction between experimental and control group in post test (n=46)
|
Anxiety |
Group |
Mean |
SD |
Mean difference |
't' value |
|
Anxiety |
Experimental Group |
20.9 |
4.5 |
-23.6 |
4.2*** |
|
Control Group |
44.5 |
6.6 |
Table 21
Correlation between physical parameters and anxiety among patients with myocardial infarction in experimental group N= 46
Unpaired 't' test was used to compare the level of physical parameters after the intervention among the experimental and control group. It was identified that the mean level of blood pressure among patient with myocardial infarction in experimental and control group was 5.7and 4.5 respectively with a mean difference of 1.2. Likewise the standard deviation of the experimental and control group was 4.9 and 3.3 respectively. The calculated ‘t’ value was 6.4 which was greater than the table value at 0.001 level of significance. The mean level of physical parameter of pulse rate among the experimental and control group was 11.5 and 3.5respectively with a mean difference of 8. Standard deviation was 3.3, 2.5 and the calculated ‘t’ value was 7.0. While comparing with table value, it showed that the calculated ‘t’ value was greater than the table value at 0.001 level of significance. The mean level of physical parameter of respiratory rate among the experimental and control group was 5.9 and 3.5respectively with a mean difference of 2.4. Standard deviation was 3.3, 2.6 and the calculated ‘t’ value was 7.0. While comparing with table value, it showed that the calculated ‘t’ value was greater than the table value at 0.001 level of significance. The mean level of physical parameter of SPO2 among the experimental and control group was 7.6 and 7.3 respectively with a mean difference of 0.3. Standard deviation was 2.7, 2.6 and the calculated ‘t’ value was 14.6. While comparing with table value, it showed that the calculated ‘t’ value was greater than the table value at 0.001 level of significance. Hence, the research hypothesis ‘There will be a significant difference in the level of physical parameters among patient with myocardial infarction in experimental and control group’ was accepted.
Unpaired 't' test was used to compare the level of anxiety after the intervention among the experimental and control group. It was identified that the mean level of anxiety among patient with myocardial infarction in experimental and control group was 20.9 and 4.5 respectively with a mean difference of -23.6. Likewise the standard deviation of the experimental and control group was 4.5 and 6.6 respectively. The calculated ‘t’ value was 4.2 which was greater than the table value at 0.001 level of significance. Hence, the research hypothesis ‘There will be a significant difference in the level of anxiety among patient with myocardial infarction in experimental and control group’ was accepted.
Table 22
Chi square analysis to find out the association between pre-test level of anxiety with their selected socio-demographic variables (N= 46)
Table 23
CHI square analysis to find out the association between pre-test score of physical parameters with their selected socio-demographic variables (N= 46)
Conclusion
Hence it is concluded that type of family, occupation (male), occupation (female), personal habits, recreational activity were associated with pre test level of physical paramaters were as age, gender, education, religion, type of food, family income, source of information and availability of government health services, were not associated with pre test level of physical paramaters.
