A STUDY TO ASSESS THE EFFECTIVENESS OF HYDROTHERAPY ON OBESITY AMONG OBESE WOMEN BETWEEN THE AGE GROUP OF 30 TO 60 YEARS IN SELECTED

VILLAGES. BACK GROUND OF THE STUDY This has been a century of great changes. In the 21st century, changes were noted not only in the science and technology but also in the lifestyle of its inhabitants.Changes in the lifestyle made life easier and marked the beginning of certain chronic ailments such as osteoarthritis, cardiovascular disorder, hypertension and obesity. Excessive deposition of fat in the body, which is usually referred as overweight or obesity in literature, is dangerous. Every individual needs a certain amount of body fat for stored energy, heat insulation, shock absorption and/ or other functions. Srinivas states that Obesity is a multi-factorial disorder, which is often associated with many other significant diseases such as diabetes, hypertension and other cardiovascular diseases, osteoarthritis and certain cancers. The management of obesity will therefore require a comprehensive range of strategies focussing on those with existing weight problems and also on those at high risk of developing obesity. Hence, prevention of obesity during childhood should be considered a priority, as there is a risk of persistence to adulthood. (Nutrition Journal 2004) The World Health Organization WHO, (2005) defines "obesity" as a BMI equal to or more than 30. These cut-off points provide a benchmark for individual assessment, but there is evidence that risk of chronic disease in populations increases progressively from a BMI of 21. According to the world health organization (WHO), nearly 20% to40% of adult population and 10% to 20% of the children are affected by obesity.

NEED FOR THE STUDY Obesity is the one of the leading preventable health problem worldwide. It affecting the productivity of the human. People who are overweight or obese have a greater chance of developing high blood pressure, high cholesterol, or other lipid disorders, type II diabetes mellitus, heart disease, stroke and certain cancers. Statistical data shows that 80% of type II diabetes mellitus related to obesity, 70% of the cardio vascular disease related to obesity, 42% breast and colon cancers diagnosed among obese individual, 30% gall bladder surgery related to obesity, 26% obese people having high blood pressure. Cathy (February
01, 2005)

states that Hydrotherapy is the use of water to

revitalize, maintain, and restore health. Hydrotherapy treatments include saunas, steam baths, foot baths, sitz baths, and the application of cold and hot water compresses.

Father Sebastian Kneipp, a 19th century Bavarian monk, is said to be the father of hydrotherapy. There is a physiological basis to hydrotherapy. Cold is stimulating, and it causes superficial blood vessels to constrict, shunting the blood to internal organs. Hot water is relaxing, causes blood vessels to dilate, and removes wastes from body tissues. Alternating hot can cold water also improves elimination, decreases inflammation, and stimulates circulation.

STATEMENT OF THE RPOBLEM A study to assess the effectiveness of hydrotherapy on obesity among obese women between the age group of 30 to 50 years in selected villages kaniyakumari district.

OBJECTIVES 1) To assess the effectiveness of hydrotherapy on obesity between experimental and control group 2) To assess the effectiveness of hydrotherapy on obesity among obese women in Experimental group. 3) To associate the post test obesity with socio demographic variables among Experimental group. 4) To associate the post test obesity with socio demographic variables among Control group. HYPOTHESIS H1 There will be a significant reduction in the post test level of obesity between experimental and control group. H2 There will be a significant difference in obesity before and after hydrotherapy among obese women in experimental group. H3 There will be a significant relationship between post test obesity and socio demographic variables among experimental group. H4 There will be a significant relationship between post test obesity and socio demographic variables among control group OPERATIONAL DEFINITION 1. Effectiveness The outcome of hydrotherapy on obesity among obese women has achieved the desired effect on body weight as weight reduction. 2. Hydrotherapy Intake of 4 liters of water measured by liter cane to reduce the obesity among obese women for a period of 1 month (30 days).

3. Obesity Body weight more than 30% of BMI. 4. Obese women Women who have weight more than 30% of BMI. ASSUMPTION 1. Increased intake of water to 4 liters may reduce body weight among obese women. 2. Hydrotherapy on obesity may accept by the people in the selected villages. 3. Weight reduction may be measurable by weighing machine. DELIMITATION Study is delimited to obese women residing at selected villages at Coimbatore. Samples selected by non-random method. Obesity is measured only by calculating BMI CONCEPTUAL FRAME WORK The present study is aimed to helping the obese women to prevent the complication of the obesity by reducing the weight and maintaining the normal body weight. The conceptual framework of this study is based on Modified Wiedenbachs Helping Art of Clinical Nursing Theory. This theory views nursing as an art based on goal-directed care. According to this theory nursing practice consists of identifying a patients need for help, ministering the needed help and validating that the need for help was met. IDENTIFYING THE NEED FOR HELP It involves, determining the patients need for help based on the existence of a need. Whether the patient realizes the need and what prevents the patient from meeting the need.

RESEARCH METHODOLOGY Research methodology is a way to systematically solve the research problem. It is a science of studying how research is done scientifically. Methodology is a significant part of the research under which the researcher is able to project a blue print of the research undertaken. This includes research design, variables, setting, population, and sample size, sampling technique, development of tool, data collection procedure and ethical consideration. The problem stated in this study was A study to assess the effectiveness of hydrotherapy on obesity among obese women in experimental and control group.

RESEARCH APPROACH The research approach used for this study was a evaluative approach, without random selection of sample by manipulating the variables to assess the effectiveness of hydrotherapy on obesity. RESEARCH DESIGN The term research design refers to the plan of a scientific investigation. Research design helps the researcher in the selection of the subject. Identification of variables, then manipulation, control, observations to be made and types of statistical analysis to interpret the data. VARIABLES Three categories of variables discussed in the present study were: Independent Variable : Hydrotherapy i.e., increasing the intake of water into 4 liters.

Dependent Variable : Obesity i.e.,body weight of the obese women that is measured by reliable weighing machine. Socio demographic Variable : Age Education, income, type of work, dietary pattern, religion, marital status, type of family hereditary, menstrual history, under any treatment, and related to reproduction. Setting of the study Population Sample size The sample size is determined based on the type of precision required, level of significance, type of variables, type of study, availability of sample and feasibility of conducting the study. The sample size for the present study is decided to be 60 obese women 30 in experimental and 30 in the control group. Sampling technique The purpose of using a sampling technique is to increase representatives and to decreases bias of sampling error. In this study purposive sampling technique is used to select subjects as they fulfilled the inclusion criteria. Criteria for selection of sample In sampling criteria the researcher specifies the characteristics of the population under the study by detailing the inclusion and exclusion criteria. Inclusion criteria are characteristics that each sample elements must possess to be included in the sample. Exclusion criteria are characteristics that conformed or contaminate the results of the study, therefore such participates are excluded from the study.

Inclusion Criteria The women who were having weight more than 30% of their BMI between the age group of 30 to 50 years. The women who were willing to participate in the study. 24 Exclusion Criteria Obese women who had any medical complication. Obese women who underwent any surgery. Obese women who had mental illness at the time of data collection Description of the tool

Data collection The samples will be divided into 2 group i.e. experimental and control group. Hydrotherapy (Drinking water 4 liters/ day) is explained to the experimental group and they are motivated to follow the instruction for 4 weeks. During that period samples has to be followed by the investigator daily. After 4 weeks weight has to be checked for both experimental and control group using same weighing scale and findings has to be recorded. Plan for pilot study;

Ethical consideration The study objective, intervention and data collection procedures will be approved by the research and ethical committee of the institution. Informed consent will be obtained from the individual obese woman in oral form. The obese women will have the freedom to leave the study at their own will without assigning any reason. The benefits of hydrotherapy, ill effects of obesity, were explained to the obese women involved in the study. Plan for data analysis Plan for report writing Work plan Budget Bibliography 1. Anne MC Murray (1994). Community health nursing. 2nd edition, London: Churchill Livingstone. 2. F.P. Anitha (2002). Text book of dietetics and nutrition. 4th edition, Newyork: publication Oxford University. 3. Brunner and suddarths (2004). Text book of medical surgical nursing. 10th edition, Pheladelphia: Lippincott publication. 4. BT. Basavanthappa (2007). Nursing research. 2nd edition, Delhi: Jaypee brothers medical publishers. 5. BT. Basavanthappa (2008). Text book of community health nursing. 2nd edition, Delhi : Jaypee brothers medical publication. 6. Davidson and Passmore (1986). Text book of human nutrition and dietetics.

8th edition. Pheladelphia: Churchill publication, Livingstone. 7. Denese F.Pout et.al (2004). Text book of nursing research. 7th edtion, Pheladelphia: Lippincott company. 8. Dr.C. Gopalan (1996). Nutrition research in south east Asia. 1st edition, Delhi: A.I.T.B.S. publishers and distributors. 9. J.S. Gavrow (1994). Human nutrition and dietetics. 9th edition, Edenburgh: Churchill Livingstone. 10. T.K. Inderani (2005). Nursing manual of nutrition and therapeutic diet. 1st edition. Delhi: Jaypee brothers medical publication.