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International Journal of Excellence Innovation and Development

||Volume 1, Issue 1, Nov. 2018||Page No. 054-059||

Effect of Yoga therapy on Level of Anxiety


among Menopausal Women Residing in
Selected Villages at Namakkal District
T. Jayadeepa1, P.Muthulakshmi2, E.Kayalvizhi3, A.Malarvizhi4
1
Ph.D Scholar, MAHER University, Chennai & Vice Principal, Dhanvantri College of Nursing, Pallakkapalayam,
Namakkal.
2
Principal, PPG College of Nursing, Saravanampatti, Coimbatore, Tamilnadu
3
Associate Professor, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamilnadu
4
Assistant Professor, Vivekanandha College of Arts and Sciences for women, Tiruchengode, Tamilnadu

Abstract––Menopause means the natural and permanent menopause is 51.4, but some reach menopause in their
stopping of the monthly female reproductive cycles, 40s or 60s. Among women aged 40 to 45, an estimated
which is usually a manifest of a permanent absence of 5% have already reached natural menopause (US
monthly periods and menstruation. Likes menarche, Census Bureau, 2000).
menopause is an important development event in a
women’s life having physical, psychological and facial Anxiety and Depression Association of America (2014),
implication for the women. Objectives: To assess the reported that there is a possibility of a person to
effectiveness of Yoga therapy on level of anxiety among experience the symptoms of depression and anxiety will
menopausal women. Materials and Methods: A True be higher. According to National Institute of Mental
experimental research design where pre and post test Health (2015), about 18.1% of adults in the United
with control group was used. Samples: Menopausal States have diagnosed to be with Anxiety Disorder and
women with menopausal symptoms at Namakkal (Dt). the most common symptoms are irritation, fear and
Multistage sampling technique was used to select the dread.
villages and Simple random sampling technique was
used to select the samples. MRS (Menopause Rating Syed Alwi Syed Abdul Rahman (2012) conducted a
Scale) was used to assess the level of anxiety. Results: In study to determine the commonly reported menopausal
experimental group, the pre and post test mean score for symptoms among Sarawakian women (aged 40-65
yoga was 55.63 % and 20.37 % showing the difference years) in Malaysia using a modified Menopause Rating
of 35%. Paired‘t’ test score for anxiety symptoms was Scale (MRS) and the most prevalent symptoms reported
18.43 in experimental group showing the significant were joint and muscular discomfort (80.1%); physical
effectiveness of yoga therapy. Unpaired‘t’ test score was and mental exhaustion (67.1%); and sleeping problems
13.7 for yoga therapy. Conclusion: There was no (52.2%). Other symptoms experienced by the
significant association between post test anxiety menopausal women were hot flushes and sweating
symptoms scores in both groups. It concluded that Yoga (41.6%), irritability (37.9%), dryness of vagina (37.9%),
therapy was effective in reducing the level of anxiety anxiety (36.5%) and depressive mood (32.6%).
among menopausal women. According to the authors’ report, in this study,
Perimenopausal women experienced higher prevalence
Keywords––Yoga therapy, level of anxiety & menopausal of somatic and psychological symptoms when compared
women to premenopausal and postmenopausal women.

INTRODUCTION Nisar N & Ahmed Sohoo N ( 2016) conducted a study


Menopause is a part of every woman’s life. When a to determine the quality of life of menopausal women
woman’s reproductive system slows down and from rural Sindh and the women were selected by
eventually stops, and this stage usually occurs between multistage random sampling method within the age
the age of 40- 60yrs which associated with hormonal, range of 40-70 years. Along with collection of socio-
physical and psychological changes. Menopause can also demographic data, the Menopause Rating Scale (MRS)
occur when ovaries are removed or stopped reproductive and WHO Quality of life Brief (WHO QOL Brief) were
functioning. Menopause occurs as the ovaries stop collected. The mean scores of all menopausal symptoms
producing estrogen, causing the reproductive system to (Somatic, Vasomotor, Psychological and Urogenital /
gradually or abruptly shut down (Jayne Marshall, 2014). sexual problems) were high in the menopausal women
when measured with Menopause Rating Scale (MRS).
An estimated 6,000 US women reach menopause (final There was a significant difference in the mean somatic
menstrual period) every day, that’s over 2 million per scores of women with premenopause, perimenopause
year. In Canada, it is estimated that, by the year 2026 and post menopause stage. The psychological symptoms
almost one quarter of the population will be comprised were more severe for women in perimenopause and post
of women over age 51. The average age of natural menopause status (P=<0.001).

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Effect of yoga therapy on level of anxiety among menopausal women Jayadeepa et al.

Lunny CA, et al. (2014) conducted a study to examine The inclusion criteria for the study were
the use of Complementary and Alternative medicine  Age group between 45- 60 years
(CAM) therapies among a sample of 423 menopausal  Who were in normal physiological process
women in Canada. 91% of women reported trying CAM  With menopausal symptoms.
therapies for their symptoms. The most common  Who scored more than 22 in MRS.
treatments were vitamins (61.5%), relaxation techniques  Who gave consent to participate in this study
(57.0%), yoga/meditation (37.6%), soy products  Who were able to understand and speak Tamil
(37.4%), and prayer (35.7%).
Along with Demographic variables, MRS (Menopause
A randomized controlled study in Germany of women Rating Scale) was used to identify the level of anxiety
presenting with depression and anxiety, and the among menopausal women.
researchers found that regular yoga led to decreased  Pre test was conducted by using MRS (Menopause
symptoms of depression and anxiety. At the end of the Rating Scale) to assess the level of anxiety
three-month trial, women who participated in two yoga  The yoga therapy (Duration of 40 minutes once in a
classes per week for three months had depression scores day for 1 week) was demonstrated to experimental
that improved by 50% and anxiety scores that improved group
by 30% (Harvard Health Publications, 2009).  Posttest was conducted with same pretest tool after
1 week.
Holger Cramer, Romy Lauche), et al. (2012)
conducted a Randomized Controlled Trials study to Validity and Reliability
analyze the effectiveness of yoga for menopausal  The content validity of the demographic variables
symptoms and the results showed that There was and MRS (Menopause Rating Scale) was validated
moderate evidence for short-term effects on in consultation with guide and field of experts. The
psychological symptoms (SMD = −0.37; 95% CI −0.67 tool was modified according to the suggestions and
to −0.07; P = 0.02). This systematic review found recommendations of the experts
moderate evidence for short-term effectiveness of yoga  Split Half method (Cronbach's Alpha) was used to
for psychological symptoms in menopausal women. find out the reliability of the MRS (Menopause
Rating Scale). (r1 = 0.86)
Being it is a common problem, researcher showed much  The stastical analysis was done by Descriptive
interest in treating the menopausal symptoms. Even in Statistics: Frequency & Percentage. Mean and
literature yoga was found to be safe and effective to treat Standard Deviation and Inferential Statistics by
the menopausal symptoms. So, Researcher would like to Mean and Standard Deviation, ‘t’ test and Chi –
undertake this project. square test

Objectives RESULTS
 To assess the level of anxiety among experimental In pre & post test scores on level of anxiety among
and control group of menopausal women before and menopausal women depicts that in experimental group,
after Yoga therapy. in pretest majority 14 (70%) of them had severe
 To assess the effectiveness of Yoga therapy on level symptoms and 6 (30%) of menopausal women had very
of anxiety among experimental and control group of severe symptoms whereas in post test 11 (55%) of them
menopausal women. had moderate symptoms and 9 (45%) of them had mild
 To find out the association between post test score symptoms, whereas in control group, in pretest majority
on level of anxiety among menopausal women in 12 (60%) of them had very severe symptoms and 8
experimental and control group with their (40%) of menopausal women had severe symptoms
demographic variables. whereas in posttest 13 (65%) of them had very severe
symptoms and 7 (35%) of them had severe symptoms. It
MATERIALS AND METHODS seems that the yoga therapy was effective in reducing the
Research Approach and Design level of anxiety among menopausal women in
It is an Evaluative research approach with True experimental group than control group. The result was
experimental research where pre and post test with similar to a study conducted by Prabhnoor Kaur and
control group design. The setting for study was Annai Sandeep Kaur (2014), reported that there was a
Sathya Nagar and Kamarajar, Namakkal (Dt). The significant improvement in all the parameters of
samples for the present study were menopausal women climacterium (Psychological, vasomotor and somatic)
residing in Annai Sathya Nagar and Kamarajar (Dt), who except the sexual component within both the groups and
fulfill the sampling criteria. The sample size was 40 moderate evidence for short-term effects on
menopausal women, out of which 20 were experimental psychological symptoms (16.73±2.243, 6.10±1.373 at a
group and 20 were control group. The Multistage Level of significance P = 0.0000). Conclusion: This
sampling technique was used to select the villages and systematic review found moderate evidence for short
Simple random sampling technique was used to select term effectiveness of yoga for psychological symptoms
the samples. in menopausal women.

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International Journal of Excellence Innovation and Development
||Volume 1, Issue 1, Nov. 2018||Page No. 054-059||

Table 1: Section A- frequency and percentage distribution of samples according to their demographic variables.
Experimental group (N1 =20) Control group (N2 =20)
Demographic Variables
Frequency Percentage Frequency Percentage
Age in Years
a. 45 – 48 6 30 5 25
b. 49 – 52 5 25 7 35
c. 53 – 56 5 25 4 20
d. 57 – 60 4 20 4 20
Socioeconomic status
a. Rs.1000 – Rs. 2000 2 10 5 25
b. Rs.2001 – Rs. 3000 2 10 4 20
c. Rs.3001 – Rs. 4000 7 35 4 20
d. Rs.4001and>above 9 45 6 30
Education
a. No formal education 5 25 5 25
b. Primary education 7 35 8 40
c. Secondary education 7 35 6 30
d. Higher secondary education 1 5 1 5
e. Graduate - - - -
Occupation
a. Housewife 6 30 3 15
b. Sedentary workers 6 30 6 30
c. Moderate workers 5 25 7 35
d. Heavy workers 3 15 4 20
Age at menarche
a. Less than 12 Years 1 5 3 15
b. 13 Years 8 40 10 50
c. 14 Years 8 40 5 25
d. Above 14 years 3 15 2 10
Religion
a. Hindu 14 70 12 60
b. Muslim 4 20 5 25
c. Christians 2 10 3 15
d. Others - - - -
Dietary pattern
a. Vegetarian 5 25 6 30
b. Mixed diets 15 75 14 70
Types of habits
a. Tobacco chewing 4 20 5 25
b. Betal nut chewing 8 40 6 30
c. Smoking - - - -
d. None 8 40 9 45
Period of cessation of menstruation
a. < 5 years 9 45 9 45
b. 6 – 10 years 7 35 8 40
c. 11 – 15 years 4 20 3 15
Type of family
a. Joint family 10 50 11 55
b. Nuclear family 10 50 9 45
c. Extended family - - - -
Source of information
a. Neighbours 8 40 9 45
b. Relations 9 45 7 35
c. Mass media 3 15 3 15
d. Health professionals - - 1 5
Use of home remedies for symptoms
a. Yes 1 5 1 5
b. No 19 95 19 95

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Effect of yoga therapy on level of anxiety among menopausal women Jayadeepa et al.

Table 2: Section B- frequency and percentage distribution of post test scores on level of anxiety among menopausal
women in experimental group and control group after yoga therapy.
Experimental group (N1= 20) Control group (N2= 20)
Level of Pre test score Post test score Pre test score Post test score
Anxiety Frequency Percentage Frequency Percentage Frequency Percentage Frequency Percentage
(N) (%) (N) (%) (N) (%) (N) (%)
No symptoms - - - - - - - -
Mild - - 9 45 - - - -
Moderate - - 11 55 - - - -
Severe 14 70 - - 8 40 7 35
Very severe 6 30 - - 12 60 13 65

70
70
Percentage of menopausal women

Pretest
60 55
Posttest
50 45

40
30
30

20

10
0 0 0 0
0
Mild Moderate Severe very severe

Level of anxiety
Fig. 1: Bar diagram showing the pre and post test scores on level of anxiety among menopausal women in
experimental group.

70 65
60
Percentage of menopausal women

60

50
40
40 35
Pretest
30 Posttest
20

10
0 0 0 0
0
Mild Moderate Severe very severe

Level of anxiety
Fig. 2: Bar diagram showing the pre and post test scores on level of anxiety among menopausal women in control
group.

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International Journal of Excellence Innovation and Development
||Volume 1, Issue 1, Nov. 2018||Page No. 054-059||

Table 3: Section C- pre and post test mean and SD and mean % score on level of anxiety among menopausal women
after yoga therapy.
Difference
S. No Level of anxiety Max. Scores Pretest Posttest in Mean
Mean SD Mean (%) Mean SD Mean (%) (%)
1. Yoga therapy 8 7.31 0.45 55.63 5.39 0.48 20.37 35.26

Table 4: Paired ‘t’ values of level of anxiety among experimental group and control group after yoga therapy.
Paired ‘t’ Value
S.No Level of anxiety
Experimental Group Level of Significant Control Group Level of Significant
1 Anxiety symptoms 18.43 Significant 0.73 Not Significant
df – 19 (n-1) Table Value = 2.093 (P < 0.05 Significant)

Table 5: Unpaired ‘t’ test value of post test scores on level of anxiety among experimental group and control group of
menopausal women after yoga therapy.
S. No Level of Menopausal symptoms Unpaired ‘t’ value Level of significant
1. Level of Anxiety 13.7 P <0.05 Significant
df =38 Table Value=2.021 Significant at P<0.05

Paired ‘t’ test value of level of anxiety was 18.43 in group, the period of cessation of menstruation of
experimental group and 0.73 in control group. It was menopausal women were less than 5 years (40%).
significantly high when compared to table value Most of the menopausal women in both the groups
(2.093) and shows that yoga therapy was effective in were not used any home remedies for menopause
reducing the level of anxiety symptoms among symptoms (95% and 95%) respectively. The study
menopausal women in experimental group than control findings reveals that the post test scores on level of
group. anxiety after Yoga therapy in experimental group
shows that 55% of the menopausal women had
Unpaired ‘t’ test to analyze the effectiveness between moderate symptoms and 45% of menopausal women
post test scores of experimental group and control had mild symptoms and in control group, 65% of the
group on level of anxiety and it shows that moderately menopausal women had very severe symptoms and
significant difference and the score was 13.7. It was 35% of menopausal women had severe symptoms.
high when compared to table value (2.021). It revealed Paired ‘t’ test scores on level of anxiety among
that the yoga therapy was effective in reducing the experimental group of menopausal women after yoga
level of anxiety among menopausal women. therapy shows highly significant difference (18.43, TV
= 2.093). Unpaired ‘t’ test score on level of anxiety
shows that moderately significant difference (13.7,
CONCLUSION TV= 2.021) and it revealed that the yoga therapy was
 Prior to implementation of yoga therapy, effective in reducing the level of anxiety among
menopausal women had severe and very severe menopausal women. There was no significant
anxiety symptoms. The effectiveness was association between post test level of anxiety scores
evaluated by post test scores; the mean score on when compared to demographic variables in both
level of anxiety was reduced from 55.63% (56) to experimental and control group.
20.37% (20) after yoga therapy with the difference
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