A STUDY TO ASSESS THE EFFECTIVENESS OF CALISTHENIC

EXERCISES IN REDUCING STRESS AMONG NURSING STUDENTS

IN SELECTED COLLEGES OF NURSING AT DISTRICT

FATEHGARH SAHIB

MASTERS OF SCIENCE IN NURSING

MENTAL HEALTH (PSYCHIATRIC) NURSING

2023

RIDHIMA SHARMA

SCHOOL OF NURSING
DESH BHAGAT UNIVERSITY
MANDI GOBINDGARH
PUNJAB
147301
 A STUDY TO ASSESS THE EFFECTIVENESS OF CALISTHENIC
EXERCISES IN REDUCING STRESS AMONG NURSING STUDENTS
IN SELECTED COLLEGES OF NURSING AT
DISTRICT FATEHGARH

Dissertation submitted for the partial fulfilment of the requirement of the degree of

MASTERS OF SCIENCE IN NURSING

MENTAL HEALTH (PSYCHIATRIC) NURSING

2023

RIDHIMA SHARMA

Supervisor Co-Supervisor
Prof. Lovesampuranjot Kaur Ms. Sakshi
Mental Health (Psychiatric) Nursing Asst. Professor
School of Nursing School of Nursing
Desh Bhagat University Desh Bhagat University
Mandi Gobindgarh Mandi Gobindgarh

SCHOOL OF NURSING
DESH BHAGAT UNIVERSITY
MANDI GOBINDGARH
PUNJAB
147301
 CERTIFICATE

The work included in dissertation entitled “A Study To Assess The Effectiveness Of

Calisthenic Exercises In Reducing Stress Among Nursing Students In Selected
Colleges Of Nursing At District Fatehgarh Sahib” ’submitted to School of Nursing, Desh
Bhagat University, Mandi Gobindgarh for the degree of Master of Sciences in Nursing in the field of
Mental Health (Psychiatric) Nursing was carried out by Ridhima Sharma, Department of Mental
Health (Psychiatric) Nursing, Faculty of Nursing Desh Bhagat University, Mandi Gobindgarh .This is
the original work of above said person conducted under our guidance and supervision and has not
been submitted in any part/ full for any degree/ diploma of this or any other University/ Institute. This
dissertation is fit to be considered for the award of Degree of Master of Sciences in Nursing, Mental
Health (Psychiatric) Nursing.

Supervisor Co-Supervisor
Prof. Lovesampuranjot Kaur Ms. Sakshi
Mental Health (Psychiatric) Nursing Asst. Professor
School of Nursing School of Nursing
Desh Bhagat University Desh Bhagat University
Mandi Gobindgarh Mandi Gobindgarh

Principal
School of Nursing
Desh Bhagat University
Mandi Gobindgarh
 DECLARATION

I, hereby affirm that the work “A Study To Assess The Effectiveness Of Calisthenic Exercises
In Reducing Stress Among Nursing Students In Selected Colleges Of Nursing At District
Fatehgarh Sahib” presented in this dissertation is exclusively my own and there is no
collaboration. It does not contain any work for which a degree has awarded by any other
university/institution. All the ideas and references have been duly acknowledged.

Dated:

Signature:

Roll No.

Countersigned by

Prof. Lovesampuranjot Kaur

Mental Health (Psychiatric) Nursing
Desh Bhagat University
School of Nursing
Desh Bhagat University
Mandi Gobindgarh
147301
 ACKNOWLEDGEMENT

“Acknowledge all of your small victories, they will eventually add up to something great”

Kara Goucher

This present thesis is the end product of hard work and effort of all those who have helped and
guided to give concrete to my plans and made them presented in the form of this dissertation. If
anyone feels that I have not properly recognized their contribution to my work in this
acknowledgement, please accept my apology.

Firstly, I am grateful to THE ALMIGHTY GOD for giving all the wisdom, knowledge, strength
and guidance to complete the study successfully.

I consider it a privilege to express my gratitude and respect to all those who guided and inspired
me in the completion of this project. I would like to extend my sincere thanks
Dr. Victor Devasirvadam, Director of Desh Bhagat University School of Nursing, Desh Bhagat
University for giving an opportunity as well as her support, valuable suggestions and guidance
to carry out my work.

My sincere thanks and heartfelt gratitude to Prof. Lovesampuranjot Kaur Desh Bhagat
University School of Nursing Desh Bhagat University, my guide and teacher who has supported
me throughout my thesis with her patience and knowledge. I consider it as a great privilege to
have her as my guide. It is indeed a great honour and privilege to be guided by her.

My sincere thanks and appreciation to my co-guide Ms. Sakshi in Desh Bhagat University,
School of Nursing, Desh Bhagat University, Mandi Gobindgarh. I am highly indebted to my Co-
Guide for his suggestions, encouragement and for her input in various aspects of the study.

My sincere thanks to all experts who have contributed their valuable suggestions in validating
the tool. I am also thankful to librarian and statistician who helped me a lot with their
experience in completion of my research project.

Finally, again I thank my God, for letting me through all the difficulties. I have experienced his
guidance day by day. You are the one who let me finish my degree. I will keep on trusting you
for my future. Thank you, Lord.

With lots of thanks

 ABSTRACT

Calisthenic exercises leads to an improvement in overall strength and energy to the

body, in turn promoting overall health. Calisthenics also improves mental health, which
in turn helps in treating depression, stress, anxiety and the like. Title: “A study to
assess the effectiveness of calisthenic exercises in reducing stress among nursing
students in a selected college of nursing at Chennai “Objectives: To assess the level of
stress and find out the effectiveness of calisthenic exercises, associate the post test
stress score with their selected demographic variables among nursing students.
Methods and materials: A pre experimental design was chosen Non probability
convenient sampling technique used to select the sample.60 nursing students were the
sample. Perceived stress scale was used to assess the nursing students stress.

Results: In pretest, the nursing students stress score was 23.12 after the administration
of calisthenic exercise the post test stress score was 14.18 Difference is 8.94.It was
statistically significant at p<0.001 level.

Conclusion: Statistical significance was calculated by using chi square test and one way
Anova-test, student paired t-test. After calisthenic exercise the stress level has reduced
among nursing students. So calisthenic exercise has significant impact in reducing the
stress among nursing students.

Key words: stress, nursing students, calisthenic exercises,

 LIST OF CONTENTS
Chapter
TITLE Page No
No
Introduction 1-3
Need for the study 3-5
Statement of the Problem 5
Objectives of the study 5
I Operational definitions 5-6
Hypothesis 6
Assumptions 6
Delimitations of the study 6-9

Review of Literature 10-20

Reviews of related studies
II
Conceptual framework 20

Research Methodology 21
Research Approach 21
Research Design 21-22
Variables in the study 22
Setting of the study 22
Population 22-23
Sample 23
Sample Size 23
III Sampling Technique 23
Sampling Criteria 23
Development and description of the tool 23
Description of the instrument 24-25
Reliability of the Tool 25
Ethical Consideration 25
Pilot study 26
 Data collection procedure 26-28
Plan for data analysis 28-30

IV Data analysis and interpretation 31-72

V Discussion 73-76
Summary and Conclusion 77-82
Summary
Findings of the study 77-80
Implication 80-81

VI Recommendation 81
Limitation 82
Conclusion 82
Reference 83-89
Appendices
 LIST OF TABLES

Table No TITLE
1. Demographic profile of nursing students
2. Each question wise pretest level of perceived stress
scale score
3. Each question wise pretest percentage of perceived
stress scale score
4. Pretest level of stress among nursing students
5. Each question wise posttest level of perceived stress
scale score
6. Each question wise posttest percentage of perceived
stress scale score
7. Posttest level of stress among nursing students
8. Comparison of Pretest and Posttest Stress Score
9. Comparison of overall stress score before and after
calisthenic exercises
10. Each question wise pretest and posttest percentage of
stress
11. Effectiveness and generalization of calisthenic exercise
12. Association between the post test level of stress score and
selected demographic variables
13. Association between posttest level of stress and
demographic variables
14. Association between stress reduction score and
demographic variables
 LIST OF FIGURES

Figure
No TITLE
1. Conceptual framework model
2. Schematic representation of research design
3. Age distribution of Nursing students
4. Basic education of Nursing students
5. Religion distribution of Nursing students
6. Year of study distribution of Nursing students
7. Occupation of parents of Nursing students
8. Monthly family income of Nursing students
9. Medium of instruction in higher secondary of Nursing students
10. Type of family system of Nursing students
11. Residence of the Nursing students
12. Any problem in the family of nursing students
13. Average study time in a study
14. Leisure activities carried out in a day
15. Pretest level of stress score among nursing students
16. Posttest level of stress score among Nursing students
17. Box plot compares the students pretest and posttest stress score
18. Pretest and posttest level of stress score among nursing students
 LIST OF APPENDICES

APPENDICES TITLE
I Certificate of approval from institutional ethics committee
II Content validity certificates
III Permission letter from concern department
IV Tool for data collection
V Informed consent form
VI English Editing Certificate
VII Training Certificate for calisthenic exercises
VIII Intervention
 LIST OF ABBREVIATIONS

ABBREVIATION EXPLANATION
RGGGH Rajiv Gandhi Government General
Hospital
HOD Head of the Department
SD Standard Deviation
DF Degree of Freedom
WHO World Health Organization
ESV Effect Size Values
PSS Perceived Stress Scale
 CHAPTER I
INTRODUCTION
“Being active can boost your feel good endorphins And distract you from daily worries”

– Mayo clinic staff.

Health is a state of complete physical, mental and social well being and not merely an
absence of any diseases or infirmities-WHO. This implies that disease in humans can occur
due to physical, mental or psychological disturbances. In today’s fast growing society and
increase in demands, stress is thought to play a major role in illness, causation of diseases
and disabilities at all ages1.

Stress has been identified as a 20th century disease and has been viewed as a complex and
dynamic transaction between individuals and their environments2. Stressors can be broadly
defined as situations or events that have the potential to affect health outcomes3. Stress can
be regarded as a psychological threat, in which the individual perceives a situation as a
potential threat4.

Stress refers to a forceful interaction between the individual and the environment. In this
interaction and boundaries related to work may be apparent as threatening to exceed the
person’s resources and skills5.Stress is not equal with nervousness or anxiety but also
provides the originality, abilities and energies; though it can cause tiredness and sickness,
either physical or psychologically. Stress is a psychological factor that influences the
academic performance6. Although every profession is effected by stress but the health
professionals are more at risk to stress especially nursing profession7.

Stress or anxiety is not only a workplace problem but different stressors can also effect the
students, which may be stress related to academic performance, or may be due to
difficulty to adapt the environment of a new organization. The students may face stressors
like social, environmental, academic, emotional, personal, and family. These stressors might
disturb the learning ability and academic performance of the students8.The most often
reported stressors were failure and uncertainty related to performance and expectations for
clinical practice9.

1
Negative insight towards nursing profession, disrespectful attitude towards nurses and
embarrassing behaviour, lack of self- confidence, thinking mistakes, not able to state self
and not able to manage time are combined sources of stress in nursing students also the
theoretical training, as a result of the above mentioned problems, students have indicated to
rapidity conflicts in their individual, household as well as practical lives10. The cause of
stress connected to the student doesn’t want to contribute in the courses, study load, the
anxiety of not being competent to grow up, low levels of course11.

Nursing students experience a high level of stress and anxiety throughout their education. In
fact, nursing students experience more anxiety, especially test anxiety, than students from
any of the healthcare disciplines12. Nursing students face not only academic stress but stress
at work during their training period. One focus of interest in research on stress at work is the
sources of stress, or stressors, which interact and contribute to the onset of stress in
organizational settings (Spielberg & Reheiser) 200513.

People who exercise regularly will tell you they feel better. Some will say it’s because
chemicals called neurotransmitters, which are produced in the brain, are stimulated during
exercise. Since it’s believed that neurotransmitters mediate people’s moods and emotions,
they can make you feel better and less stressed14.

Calisthenics are exercises that rely solely on body weight for resistance that can be
performed anywhere. No gym, no cash, noproblem. Calisthenics are a great way to build
muscle and improve your mood, all without stepping foot in a gym15. Callisthenics are
aerobic and dynamic exercises. They are rhythmic, smooth, enjoyable exercises that are
easy to perform alone or in a group format, and can be modified according to subject’s
fitness levels. A popular calisthenics is the jumping jack; it also works towards heart health
and stress relief16.

Calisthenics derived from the Greek kalos, meaning beauty, and sthenos, meaning strength,
calisthenics don’t necessarily require any exercise equipment. Calisthenics can act as a
self-confidence and self- esteem booster17. Calisthenic exercises are intended to increase
body strength and flexibility with movements using only one’s body weight for resistance.
The benefit both muscular, cardio vascular fitness and also improves psychomotor skill.

2
Calisthenic exercises leads to an improvement in overall strength and energy to the body,
in turn promoting overall health. These exercises have been known to improve mental
health, which in turn helps in treating depression, stress, anxiety and the like. Calisthenic
workout can help burn unwanted fat in the body, thus providing a fit physique18.

Exercises produce neurotransmitters called endorphins in the brain, these are the body’s
own natural tranquilizers, and endorphins can make one feel calm and relaxed during and
for up to three hours after moderate physical activity. Exercise can cause many people who
are physically active to give up unhealthy and stressful habits that interfere with exercises,
smokers may cut down/quit because smoking hinders aerobic performance, and others may
eat more nutritiously to improve performance19.

NEED FOR THE STUDY

The World Health Organization (WHO) has estimated that stress- related disorders will be
one of the leading causes of disability by the year 202020.Nursing schools are now
recognized as a stressful environment that often exerts a negative effect on the academic
performance and psychological well-being of the students21 Studies from the United
Kingdom and India have reported increasing levels of stress among nursing students.22, 23
A study was conducted in Brazil on 1st, 2nd, & 3rd year B.Sc nursing students to assess
depression among students associated with their self esteem. There were 224 subjects
included based on the data obtained. The study adopted a descriptive qualitative approach
using psychometric resources, which includes tests, inventories, questionnaires and
scales. The findings of the study concluded, highlighting 1 case of serious depression, 14
moderate depressions, 28 mild depression and 181 without signs of depression24.

A cross-sectional research was designed and 2013 nursing students in a public higher
education institute were recruited. The Stressors in Nursing Students Scale-Chinese
Version (SINS-CN) was used to measure nursing students stress. Data analysis includes
descriptive analysis and analysis of variance. The overall SINS-CN mean score was 3.33
(SD = 0.49), while the scores for different dimensions were: clinical, 3.44 (SD =
0.54), education, 3.35 (SD = 0.62), finance and time, 3.31 (SD = 0.72),
confidence, 3.21 (SD = 0.60), and personal problems, 3.03 (SD = 0.68). Among 10 most

3
common stressors, four belong to the clinical dimension, four to the education dimension,
one to the confidence dimension, and one to the finance & time dimension. Analysis for
factors associated with stress indicated that no statistical significance was found in most
demographic variables, except year two students stress scores were significantly lower
than those of students in other years (p values were between 0.000 and 0.026)25.

The present descriptive cross-sectional study was conducted at College of Nursing,

Maharishi Markandeshwar University, Mullana (Ambala) in the month of August 2011
using pretested self-administered questionnaire. Out of a total 400 students, 282
completed and returned the questionnaires, giving an overall response rate of 70.5%. One
hundred and fourteen (40.4%) of the respondents were males, while 168 (59.6%) were
females. The mean age of study subjects was 19.12 years, with a standard deviation of 1.5.
The mean perceived stress score of all 282 students was 28.67 (SD = 5.32), with a median
of 26 (IQR = 22-34). Female students significantly had more perceived stress score
(31.33) than male students (26.01). The maximum mean PSS (29.66) was observed in the
2nd year students, and the least mean PSS (26.28) was found in the 3rd year students26.

A descriptive study completed to assess the level of stress among under graduate nursing
students in selected college at Chidambaram, TamilNadu.181 nursing students were
selected, the study results showed that overall stress level among nursing students were
under mild stress (27.6%), moderate stress (69.6%), and high stress (28%) also the level
of stress was significantly P (<0.05) influenced by the choice in selection of course
among nursing students27.

A study was conducted to know the effects of high intensity calisthenic exercises on pain,
disability, psychological strain and serum cortisol concentration in people with chronic
back pain, 20 subjects were randomly allocated into exercise and control group. Subjects
in exercise group received a 12 week exercise program, while control group received 12
weeks of passive modalities. The findings of data analysis identified reduction in pain
(41%, t10=8.51, P<.001), disability (31%, t10=7.32, P<.001) and psychological strain
(35%, t10=7.09, P<.001) in subjects in exercise group and no changes in control group.

4
The study concluded that regular calisthenics would reduce pain, disability and
psychological strain28.

Based on the above reviews it confirmed that the under graduate nursing students are
experienced a stress in their academic year in the same way calisthenic exercises improve
the mood status of the individual. So the investigator felt that to conduct a study to
reducestress among nursing students by calisthenic exercises.

STATEMENT OF THE PROBLEM

“A Study To Assess The Effectiveness Of Calisthenic Exercises In Reducing Stress

Among Nursing Students In Selected Colleges Of Nursing At District Fatehgarh Sahib”
.

OBJECTIVES OF THE STUDY

 To assess the existing level of stress among nursing students before calisthenic
exercises intervention.
 To evaluate the post test level of stress among nursing students after calisthenic
exercises intervention.
 To determine the effectiveness of calisthenic exercises on stress among nursing
students.
 To find out the association between the level of stress in nursing students with
their selected demographic variables.

OPERATIONAL DEFINITIONS 

Assess: It refers to the evaluation of the existing level of stress among nursing
students.

Effectiveness: It refers to the significant reduction in the level of stress after regular
performance of calisthenic exercises among nursing students.

Calisthenic Exercises: It refers to a form of aerobic and dynamic exercises consisting

of a variety of simple, often rhythmical movements were jumping jacks,neck roll, free
hand neck resistance, arm circle, trunk twist, alternating

5
toe touch with bar and standing one leg toe raised applied on selectedgroup of nursing
students for stress management.

Stress: It refers to the score obtained on psychological distress are academic and clinically,
physical distress are head ache, malaise and sleep experienced by the students that
demands exceed their personal and social resources the individual is able to mobilize.

Nursing Students: In this nursing student refers to those who are undergoing four years in
baccalaureate nursing programme as per the Indian Nursing Council regulations in selected
college of nursing.

HYPOTHESIS

H1: There will be significant difference between pretest and posttestscores of students in
reduction of stress through calisthenics exercise.

H2: There will be significant association between the post levels ofstress among nursing
students with their selected demographic variables.

ASSUMPTIONS

 The nursing student may have mild, moderate or high levels ofacademic stress.
 Stress level may vary from individual to individual.
 Calisthenic exercises on stress management will help nursingstudents to cope
better with their day today life stressors.
 The reduction in stress among the nursing students may showeffective practical and
preventive measures.

DELIMITATIONS OF THE STUDY

 The setting of the study (selected college of nursing) is limited tothe study.
 The sample size is limited to 60 subjects.
 The period of data collection is limited to 4 weeks.

6
CONCEPTUAL FRAMEWORK

The conceptual framework selected for the study is based on Kenny's Open
System Model. All the living system is open, in this there is continuous exchange
of matter, energy and information. Open system has changing degree of
interaction with the environment from which the system receives input and gives
back output in the form of matter, energy and information.
The main concept of open system model is input, throughput, output and feedback.
The study is undertaken to determine the effect of calisthenic exercises on stress
among nursing students.
INPUT

Input can be matter, energy and information from the environment. In this
present study the environment refers to college of nursing and refers to the
collection of demographic variables from the samples such as age, religion, basic
educational status, year of study, occupation of parents, monthly income, medium
of the instruction in higher secondary education, percentage of marks obtained in
higher secondary, types of family, residence, any problems in the family, average
study time per day, leisure time activities carried out in a day and pre test level of
stress among nursing students assessed by structured questionnaire of perceived
stress scale.
THROUGHPUT

The matter, energy and information are continuously processed throughput the
system which is also called complex transformation known as throughput process
is used for input. In this present study the throughput refers to calisthenic exercises
on stress reduction among nursing students who are regularly practicing
calisthenics exercises with 30 minutes duration; those are jumping jacks, neck
rolls, free hand neck resistance, arm circles, alternating toe touches with bar, trunk
twists, abductor/adductor leg raise, prone leg extension, standing one legged toe
raise.

7
OUTPUT

After processing the input and throughput, the system returns to the output matter,
energy and information in an altered state. In thepresent study significant changes
happened in the level of stress of the samples.
FEEDBACK

Feedback gives information about environment response to the system. Output is

utilized by the system in adjustment, correction and accommodation to the
interaction with the environment. In the present study, effectiveness of calisthenics
exercise is considered in calculating mean percentage and testing hypothesis. If
moderate level of stress occurs for students during feedback inform the samples
to continue the intervention.

8
 FIGURE: 1 –MODIFIED CONCEPTUAL FRAMEWORK BASED ON J.W.KENNY, S OPEN SYSTEM MODEL

INPUT THROUGH PUT OUTPUT

CALISTHENICS
Demographic EXERCISES 30
characteristics MINUTES PER
 Age Perceived DAY
Significant
 Education status stress scale 1. Jumping jacks
reduction
 Religion 2. Neck rolls Post test
structured of Stress
3. Free-hand neck
 Year of study questionnaire stress score level
resistance
 Occupation
Assess the 4. Arm circles assessed by
 Monthly income
Level of stress 5.Alternating toe
 Medium of structured
Among touches
instruction in +2
nursing 6. Trunk twists perceived
 % of marks students in 7. Abductor /
 Type of family selected stress scale
Adductor leg raise
 Residence College of 8. Prone leg
 Any problem in Nursing
extension.
the family Moderate
9. Standing one-
 Average study stress
legged toe raise
 Leisure activity level

23
FEED BACK

9
 CHAPTER II

REVIEW OF LITERATURE

This chapter explains in detail about the review of literature and conceptual framework used
for the study. Review of literature is an extensive, exhaustive and systematic examination of
publications relevant to research project. One of the most satisfying aspects of the literature
review is the contribution it makes to the new knowledge, insight and general scholarship of
the researchers.

Review of literature serves as the key step in research process. It helps in many ways starting
from selection and formulation of problem, providing conceptual framework for the study,
assess feasibility, providing methodology for comparison and replication, avoiding obstacles
and making generalization.

The review of literature pertaining to the present study is aimed at assessing the
effectiveness of calisthenic exercises in reducing stress among nursing students in a selected
college of nursing at Chennai.
The Review of Literature Consists Of The Following Sections:
 Review of literature related to stress.
 Review of literature related to calisthenic exercises.
 Review of literature related to effectiveness of calisthenicexercises on stress.

REVIEW OF LITERATURE RELATED TO STRESS

Studies indicate that nursing students may be more prone to stress than other students.
Kalavani S, Dr.D. Karaline, Karunagari et al (2018) A Descriptive Cross Sectional study
was carried out in the year 2015 among 181 nursing students in a selected college at
Chidambaram taluk, Tamil Nadu. Data were collected by using demographic profile and
Modified Perceived Stress Scale (PSS) to assess the stress level of the participants.
Descriptive and inferential statistics were used to analyze the data. The findings revealed
that the overall stress level among nursing students, were under mild stress (27.6%),
moderate stress (69.6%) and high stress (2.8%) also the level of stress was significantly

10
(p<0.05) influenced by the choice in selection of course among nursing students. From this
study, the researcher highlights that an effective intervention strategies have to be taught to
the B.Sc. nursing students to relieve stress during their training period to promote stress free
life26.

Seyed fatemi, Naiemeh, Tafreshi (2017) was conducted in 1991 to investigate the
perception level and sources of stress across academic years among B.Sc nursing students,
94 students were recruited for the purpose. The findings of the study revealed that psychiatric
problems were more prevalent in nursing students than the general population. Many items
ranked as stressful among nursing students were also identified in general population. In
addition, the study concluded that nursing students had the feelings of inadequacy,
difficulty in relationship with faculty, were given multiple assignments, have to devote long
hours to study and lacked free time, timely feedback and faculty response to student’s
needs29.

Agarwal B, chowdhry M, Mullerpatan R, (2014) was conducted a study to assess the

short term movement therapy on levels of academic stress in 50 final year female students
of physiotherapy. They were divided in group I group II. The result revealed that the groupI
score was 124.8 and group II score was 124.12 in before administration of movement
therapy. One month later the score of group I 89.60 and group II score 129.40, there after
one month the same test was conducted score of group I 119.04, group II 126.44. The
study result shows that group I statistically significant reduction comparing to group II
maintained a fairly constant score the study concluded with movement therapy helped to
reduce the stress level in students30.

Gibbons C, Dempster M, Montroy M (2014) a study was conducted at Saudi to determine

rates and severity of depression, anxiety and stress among adolescent boys. The study
recruited 1,723 male students out of which 59.4% had at least one of the three disorders,
40.7%had at least two and 22.6% had all the three disorders. Moreover
>1/3rd of the participants (38.2%) had depression, while 48.9% had anxiety and 35.5% had
stress. Further conclusion of the study was made that depression, anxiety and stress were
strongly, positively andsignificantly correlated31.

Omigbodun O. (2014) conducted study in Hong Kong to assess stress and burn out among
11
nursing students. The study recruited 158 students, 37 males and 121 females between the
age of 18-26 which employed a cohort design using self administered questionnaires and
Maslach burn out inventory. The results of the study revealed that students suffered greater
levels of stress, and this was explained by emotion - oriented coping. The study concluded
that undertaking a nursing program leads to increased levels of stress, burn out and
psychological morbidity and is largely related to individual personality and coping traits32.

Brobeck E, Marklund B, Haraldson K, et al (2013) conducted study on specific stressors

in children, for which 23 children age group between 8 – 12 years were recruited for the
study. The findings of the study revealed 6 boys and 7 girls with stress related symptoms,
further comparison was made between the sex, the study concluded that majority of girls
were found to have more stress than boys. In the study more girls (41.2%) than boys
(16.2%) rated their stressor as “it upset mea lot”33.

Jones MC, Johnson DW (2012) Researchers and social commentators have pointed out that
economic factors that the employees are facing in the 21st century have been linked to
increased levels of stress. There has been a great deal of research in to what makes nursing
stressful. Two Canadian studies in 1999 and 2001 showed approximately 37% of Canadian
nurses fell within Karasek’s high stress job category34.

Boyce W.T(2011) conducted study was at U.S.A to found the mean score for current state of
health amongst nurses was not significantly different from any other occupational group, but
nurses had the highest mean number of self reported sickness and absenteeism. The study
concluded that of all occupational groups compared with doctors, nurses have been found to
score high in stress35.

Jones MC, Johnson DW (2011) conducted study was to found that short term sick leaves
were associated with the combination of high demands and low decision latitude(high strain
jobs) and low social support at work. Staff nurses who had high strain jobs felt significantly
less empowered, less committed and less job satisfaction than nurses who reported less job
strain36.

Peggy Blake Gleeson, Elizabeth J Protas (2011) conducted study was to determine the
effects of stress, and reported that stress levels were significantly correlated with illness

12
frequency (P=.001) and severity (P=.0001) and concluded that that stress is particularly
important in illness because it has the potential to impair human functioning. Stressful life
events put people at higher risk for depression, and life stressors play a significant role in
precipitating 1st and 2nd episode of major depression37.

REVIEW OF LITERATURE RELATED TOCALISTHENIC EXERCISES:

Taspinar O, Aydin T, et al (2015) was carried out the study to evaluate the effects
of calisthenic exercises on psychological status in patients with ankylosing
spondylitis and multiple sclerosis.In this study comprised 40 patients diagnosed with
AS randomized into two exercise groups (group 1 = hospital-based, group 2 =
home-based) and 40 patients diagnosed with MS randomized into two exercise
groups (group 1 = hospital-based, group 2 = home-based). The study results
confirmed that the exercise programme was completed by 73
participants (hospital-based = 34, home-based = 39). Mean age was 33.75 ± 5.77
years. After the 8-week exercise programme in the AS group, the home-based
exercise group showed significant improvements in erythrocyte sedimentation rates.
The hospital-based exercise group showed significant improvements in terms of the
Bath AS Metrology Index and Hospital Anxiety and Depression Scale-Anxiety
scores. This study concluded the positive effects of calisthenic exercises on
neurologic and rheumatic chronic inflammatory processes associated with
disability should not be underestimated38.

Chennamma D. Chilamur and N. Chandrappa (2015) investigated physical

education is that phase of education which is concerned, first, with the organization
and leadership of children in big- muscle activities to gain the development and
adjustment inherent in the activities according to social standards and second, with
the control of health or growth, continues naturally, associated with the
leadership ofthe activities so that the educational process may go on without growth
handicaps. Physical education should aim to improve the mass of students and to
give them as much health strength and stamina as possible them to perform the
duties that awards them after they leave the college39.

13
El-Sobkey, Salwa. (2015) conducted study was in Saudi to explore
calisthenic exercises induced changes in myocardial oxygen consumption in
normotensive healthy subjects. The study recruited 11 female college students. They
performed upper and lower extremity one minute calisthenic exercises. This resulted
in increased post-exercise RPP (Rate pressure Product) estimating increase in
MVO2 demand, this increase influenced by the three selected exercise cadences
(P=0.029 for upper extremity and 0.0001 for lower extremity). The study
concluded that more MVO2 is required with lower extremity calisthenics than
upper extremity calisthenics40.

Aldwin C.M, and Revenson T.A (2011) conducted study was to review 101 reports
of exercise training in heart failure patients and selected 9 trials for combined
analysis. It included subjects with left ventricular ejection fractions less than 50%.
They used exercise as the only intervention for at least 12 weeks, and obtained
survival rate up for > 3 months after exercise training. The study concluded that this
information provided on 395 exercise trained and 406 control patients, both
mortality (-35%, 95% CI, -8 to -54) and the combined end patient’s death or hospital
admission (-28%, -95%CI, -7 to -46) were significantly reduced in exercise-trained
subjects41.

Peggy Blake Gleeson, Elizabeth J Protas (2011) conducted study was in Texas to
compare the oxygen consumption (VO2) during calisthenic in middle – aged women
(aged 43- 63 years) with and without coronary artery disease. Indirect caloriemetry
was used to measure VO2 in 15 healthy women and 15 women with CAD, 4
exercises were performed for 3 minutes. Oxygen consumption was lowest for both
the groups during knee extension and trunk flexion. Further the study concluded that
both the groups demonstrated highest levels of VO2 during hip flexion exercise42.

Asent, S.M,Landers, D.M. and Etnier, J.L (2010) conducted study was in
Washington to determine whether regular calisthenic exercise is associated with
decreased risk for dementia and Alzheimer disease. A prospective cohort study
recruited 1740 persons older than 65 years without cognitive impairment who scored

14
above 25th percentile on cognitive ability screening instrument (CASI). During a
mean follow up of 6.2 years (SD, 2.0), 158 participants developed dementia (107
developed Alzheimer disease). The incidence rate of dementia was 13.0/1000 person
–years for participants who exercised 3 or more times per week compared with
19.7/1000 person –years for those who exercised less than 3 times per week. The
study concluded that regular exercise is associated with a delay in onset of dementia
and Alzheimer disease43.

Dr Jaykishan Santhosi (2010) conducted a study was in India (nagpur) to find out
the effects of calisthenics and yoga exercises on selected physical and physiological
variables. The study was conducted on a total of 120 randomly selected male
students between the ages of 18-22 years. They were divided into 4 groups - group1,
group2, group3 and group4 as only calisthenic group, only yogasana group,
combined group and control group respectively. The experimental group were
given exercises for 1hour daily for 6 weeks for a period of 12 weeks. The study
concluded that from the intra group comparison physical and physiological fitness is
improved by the training of all calisthenic exercises selected and from inter group
comparison, combined calisthenic and yoga both are best for improving physical
and physiological fitness44.

Rasen J Bridgewater, M Margie H Sharpe (2010) conducted study was in

Australia to assess the effectiveness of calisthenic exercises in early Parkinson
disease. The effects of 12 weeks of twice weekly exercise were investigated in a
group of 13 persons with Parkinson disease. They were compared with 13 non
exercising parkinsonians. Exercise participation increased cardio pulmonary fitness
and habitual activity level and marginally improved mood. Functional ability
remained stable in exercise group, but decreased in control group. No change was
noted in parkinsonian signs. The study concluded that exercises promote cardio
pulmonary function, activity level, and mental functioning45.

Shih-Chueh Chen, MD, PhD, Kwo-Chang Ueng (2010) validate the effects of a
simplified, gentle form of t'ai chi chuan in patients with type 2 diabetes and obese.
Study subjects were hospital- based patients with type 2 diabetes and who were

15
also obese (ages 40–70, with a body–mass index [BMI] range of 30–35). The
patients were randomly selected and grouped into t'ai chi exercise (TCE) and
conventional exercise (CE) groups. After receiving instruction in t'ai chi, the TCE
group and the CE group practiced three times per week, including one practice
session lasting up to 1 hour, for 12 weeks. After 12 weeks, hemoglobin A1C
values of the TCE group did not decrease (8.9 ± 2.7% : 8.3 ± 2.2%; p = 0.064).
BMI (33.5 ± 4.8 : 31.3 ± 4.2; p = 0.038) and serum lipids, including triglyceride
(214 ± 47 mg/dL : 171 ± 34 mg/dL; p = 0.012) and high density lipoprotein
cholesterol (38 ± 16 mg/dL : 45 ± 18 mg/dL; p = 0.023) had significant
improvements. Serum malondialdehyde tended to decrease from baseline
(2.66 ± 0.78 μmol/L : 2.31 ± 0.55 μmol/L; p = 0.035), and C- reactive protein also
decreased (0.39 ± 0.19 mg/dL : 0.22 ± 0.15 mg/dL; p = 0.014). No improvements
occurred in BMI, lipids, and oxidative stress profiles in the CE group46.

Jenkins,C.D (2009) conducted study was in New orleans to evaluate the impact of
exercise training on mortality of 53 patients with CAD’s with high levels of
psychosocial stress (PSS), and in 469 patients with low levels of psychosocial
stress(LPSS).And compared them with 27 control patients with high PSS , who did
not undergo formal exercise training. The study concluded that mortality was
approximately 4 fold greater in patients with high PSS, than those with LPSS (22%
VS 5%; P_.003) exercise training decreased the prevalence of PSS from 10% -
4% (P_.0001) and similarly improved peak oxygen with high and low PSS47.

REVIEW OF LITERATURE RELATED TO EFFECTIVENESS OF

CALISTHENIC EXERCISES ON STRESS. “Finding way to reduce stress can
not only make one happier and healthier, it can help you live a longer and more
productive life”

Akpan S, John, Edet B, Ella E (2017) conducted a descriptive cross sectional

study to assess stress and coping strategies among graduate nursing students in
Nigeria by using simple random sampling technique and sample size 154.stress level
assessed by structured questionnaire of PSS. The results also revealed that out of the
154 respondents 73% had low level stress and 81% had high level of stress. The
investigator concluded half of respondents suffered from high levelof stress48.
16
Evangelista AL, Evangelista RAGT, et al (2017) completed Effects of High
Intensity Calisthenic Training on Mood and Affective Responses. The purpose of
this study was to analyze affective and humor responses to high-intensity (HIIT)
body work (calisthenic) training. Twenty-six healthy adult men who were
recreationally active underwent an acute single session of HIIT body work
training.Based on 8 sets of 20 sec of all-out supramaximal intensity and 10 sec of
passive recovery period. The exercises used were the burpee, jumping jack,
mountain climber, and squat and thrust. The subjects responded to the Profile of
Mood States (POMS) and a feeling scale before and after the session. mood states
before and after the HIIT whole body protocol. Fatigue (P = 0.03, ES = 0.48) was
higher at the end of the session. The effect size showed a small magnitude of
reduction in anger (ES = 0.27) and depression (ES = 0.24) as well as in tension (ES
= 0.18), confusion (ES = 0.14), and vigor (ES = 0.13)49.

Dake C (2016) conducted in Saudi to explore calisthenicexercises induced changes

in myocardial oxygen consumption in normo tensive healthy subjects. The study
recruited 11 female college students. They performed upper and lower extremity one
minute calisthenic exercises. This resulted in increased post-exercise RPP (Rate
pressure Product) estimating increase in MVO2 demand, this increase influenced by
the three selected exercise cadences (P=0.029 for upper extremity and 0.0001 for
lower extremity). The study concluded that more MVO2 is required with lower
extremity calisthenics than upper extremity calisthenics50.

Valarmathi V, Tamil Selvaarasan and A. Judie (2016) Conducted study was to

determine the effectiveness of aerobic dance movement therapy on academic stress
among adolescents selected school at Kancheepuram district, Tamilnadu. Quasi
experimental non equalent pre-test, post-test control group design was used. There
are 268 students screened by the academic stress scale was developed by
Dr.BalajiRao (2013) out of which 170 adolescents who had slightly stress, and
moderate stress were selected 88 in study group and 82 in control group and the
intervention was given for one month followed by the post test was conducted. The
analysis revealed that comparison of post test of study and control group mean and
SD value of adolescents academic stress was found to be statistically highly
17
significant with t= 6.14 at p<0.0001**51.

C,Jefferson C,Roehrs T, et al (2015) conducted study to review 101 reports of

exercise training in heart failure patients and selected 9 trials for combined analysis.
It included subjects with left ventricular ejection fractions less than 50%. They used
exercise as the only intervention for at least 12 weeks, and obtained survival rate up
for > 3 months after exercise training. The study concluded that this information
provided on 395 exercise trained and 406 control patients, both mortality (-35%,
95% CI, -8 to -54) and the combined end patient’s death or hospital admission (-
28%, -95%CI, -7 to -46) were significantly reduced in exercise-trained subjects52.

Rasen.J Bridgewater,Mmargie H Sharpe (2015) A study was conducted in

Australia in 2010 to assess the effectiveness of calisthenic exercises in early
Parkinson disease. The effect of 12 weeks of twice weekly exercise was investigated
in a group of 13 persons with Parkinson disease. They were compared with 13 non
exercising parkinsonians. Exercise participation increased cardio pulmonary fitness
and habitual activity level and marginally improved mood. Functional ability
remained stable in exercise group, but decreased in control group. No change was
noted in parkinsonian signs. The study concluded that exercises promote cardio
pulmonary function, activity level, and mental functioning53.

Stephan Gielen, Volker Adams, Sven Möbius-Winkler (2013) assesses the effects
of regular physical exercise on local inflammatory parameters in the skeletal
muscle of patients with chronic heart failure. 20 male patients with stable chronic
heart failure (left ventricular ejection fraction 25 ± 2%; age 54 ± 2 years) were
randomized to a training group (n = 10) or a control group (n = 10). At baseline and
after six months, serum samples and vastus lateralis muscle biopsies were obtained.
Serum tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-1-beta levels
were measured by enzyme-linked immunosorbent assay, local cytokine, and iNOS
expression by real-time polymerase chain reaction. Exercise training significantly
reduced the local expression of TNF-alpha, IL-1-beta, IL-6, and iNOS in the
skeletal muscle of chronic heart failure patients. These local anti-inflammatory
effects of exercise may attenuate the catabolic wasting process associated with the

18
progression of chronic heart failure 54.

Armstrong RB (2009) conducted A study was in Greece on patients with low back
pain, 20 subjects were recruited over a period of 8 months. The subjects were
randomly assigned to exercise and control groups. The exercise group followed a 12
week of calisthenic exercise programme, whereas the control group received 12
week of passive modalities without any exercises. The outcome measures of both
the groups are as follows; Effect size values (ESV) for exercise group were 2.34
for pain, 1.68 for disability, 2.01 for psychological strain and 0.06 for cortisol
concentration. ESV for control group was 0.03, 0.03, 0.16 and 0.32 respectively.
The study concluded that calisthenic exercise would decrease pain, disability and
psychological strain55.

Murrow L JL, Lopez AD (2009) conducted study was in 2009 on effects of

calisthenic exercise training on high risk behaviours. In which indices of
hostility, depression and overall psychosocial stress were decreased by 50 – 70%.
Data from a recent randomized trial demonstrated that exercise training can
decrease depressive symptoms as effectively as antidepressants. Stress has been
linked to the onset of Illness and plays an etiological role in the disease process. It
can worsen pain symptom and make the burden of disease harder to bear as well56.

Richard V. Milani, Carl J. Lavie, (2009) examined that Reducing Psychosocial

Stress: A Novel Mechanism of Improving Survival from Exercise Training. We
evaluated the impact of exercise training during cardiac rehabilitation on mortality
in 53 patients with coronary artery disease with high levels of psychosocial
stress and in 469 patients with coronary artery disease with low levels of
psychosocial stress and compared them with 27 control patients with high
psychosocial stress who did not undergo formal cardiac rehabilitation and exercise
training. It reveals that mortality was approximately 4-fold greater in patients with
high psychosocial stress than in those with low psychosocial stress (22% vs 5%; P
= .003). Exercise training decreased the prevalence of psychosocial stress from 10%
to 4% (P < .0001) and similarly improved peak oxygen uptake in patients with high
19
and low psychosocial stress57.

Dimitris chatzitheodorou, Chris kabitsis, Paraskevi Malliou. (2007) conducted

study was to know the effects of high intensity calisthenic exercises on pain,
disability, psychological strain and serum cortisol concentration in people with
chronic back pain, 20 subjects were randomly allocated into exercise and control
group. Subjects in exercise group received a 12 week exercise program, while
control group received 12 weeks of passive modalities. The findings of data analysis
identified reduction in pain (41%, t10=8.51, P<.001), disability (31%, t10=7.32,
P<.001) and psychological strain (35%, t10=7.09, P<.001) in subjects in exercise
group and no changes in control group. The study concluded that regular
calisthenics would reduce pain,disability and psychological strain58.

Eric B. Larson, MD, MPH; Li Wang, MS; James (2006) suggest that people
with high levels of physical activity are less likely to develop dementia. All 1740
participants in this cohort study were 65 years of age or older and were cognitively
intact at baseline. Over 6.2 years, the rate of dementia was 13.0 per 1000 person-
years in those who exercised 3 or more times per week and 19.7 per 1000 person-
years in those who exercised less than 3 times per week. It evidence that regular
exercise is associated with a lower risk for dementia. However, the existing
evidence does not prove that regular exercise is associated with a lower dementia
risk59.

Roehrs T, et al (2005) conducted study in Italy to evaluate the effectiveness of

calisthenic exercises and their correlation between aerobic capacities, pulmonary
functions and cognition. The study devised an aerobic exercise program consisting
of submaximal level of calisthenics for relatively healthy women between 60 – 80
years. The calisthenics were performed for 4 months, 3days/week, 40 -
50minutes/day. Further the results revealed significant improvements in aerobic
capacity, pulmonary and cognitive functions after 4 months. The study concluded
that overall subjects expressed their happiness and well being on every occasion,
during and after exercise program60.

20
 CHAPTER -III
METHODOLOGY

This chapter consists of the research approach, research design, variables in the study,
setting of the study, and the population, sample, sample size, sampling technique, selection
criteria, development and description of tool, content validity, pilot study, reliability, data
collection procedure and plan for data analysis.

RESEARCH APPROACH
The research approach is the most essential part of any research. The entire study is based
on it. The research approach used in the studyis applied form of research to find out a well
programme, treatment, practice or policy as effective as possible. In this study effectiveness
of calisthenic exercise in reducing stress among the nursing students was evaluated.
Therefore a quantitative evaluation approach was essential to test the effectiveness of
interventions.

Data collection period: The study was conducted for four weeks from to 02-01-2023 to
29 -01-2023.

RESEARCH DESIGN:- The investigator has selected the pre-experimental design as

suitable method for study (one group pre-test, post test).There was a manipulation for the
subjects without a control group and randomization.
Table.1 Shows Research design

S. Group Pre- Intervention Post-

No Test Test
1 Stress among the nursing O1 X O2
students in school of Nursing

21
 Key
O1 Pre test to assess the level of stress among the nursing students by
perceived stress scale.
X Calisthenic exercises (30 minutes per day)
O2 Post test to assess the level of stress among the nursing students
by perceived stress scale.

VARIABLES IN THE STUDY

Variables: A variable is a characteristic, which can be taken on different

values. The categories of variables discussed in the presentstudy were

Independent Variable: Calisthenic exercises for management of stress among

nursing students.

Dependent variable: Level of stress among nursing students

Extraneous variables: Demographic variables such as age, religion, education,

socio economic status, personal habits, methods of recreation, rest and
sleep.

SETTING OF THE STUDY

According to Polit and Hunger (1997), setting refers to the physical location and
condition in which data collection takes place in the study. The setting was
selected based on acquaintance of the investigator with the institution, feasibility
of conducting the study, availability of the sample, Permission and proximity of
the setting to investigation
The study was conducted to School of nursing, Desh Bhagat University, Mandi
Gobindgarh.

POPULATION

Target population: was the aggregate of cases about whom the researcher would
like to make generalization. The nursing students residing in nurses home are
target population.
22
Accessible population: is the aggregate of cases that conform to the designed
criteria and which is accessible to the researcher.
School of nursing, Desh Bhagat University, Mandi Gobindgarh were the
accessible population for this study.

SAMPLE:- All the School of nursing were included in the study and those who
fulfilled the sampling criteria.

SAMPLE SIZE:- The sample size was 60.

SAMPLING TECHNIQUE: - Convenient Sampling technique will be used

to select the 60 samples of nursing students at Desh Bhagat University, Mandi
Gobindgarh.

SAMPLING CRITERIA: - The study sample was selected by the

following inclusion and exclusioncriteria.

Inclusion criteria:
 Those who are studying in Baccalaureate nursing programme.
 Those who are available and willing to participate in this study.
Exclusion criteria:
 Those who have already undergone calisthenic exercise
programme.
 Those who are having orthopaedic related problems.
 Those who are having any systemic illness.

DEVELOPMENT AND DESCRIPTION OF THE TOOL

 The tool used for the study was perceived stress scale.
 The technique used for the study was structured questionnaire
method. Tools: The instrument selected in research should be as
far as possible the vehicle that obtains the best data for drawing
conclusions to the study. The study consists of the following
tools:
23
DEVELOPMENT OF TOOL:

Tool was selected after extensive literature review from the various text book, internet
search, guidance and discussion with experts in the field of nursing, psychiatry and statistics.
A structured questionnaire was used to collect data from the female school of Nursing at
Desh Bhagat University, Mandi Gobindgarh

Section A: Consists of demographic variables such as age, sex, education, socio-economic

status, personal habits, and methods of recreation, rest and sleep.
Section B: Students stress assessment by perceived stress scale will be used on
nursing students.

DESCRIPTION OF THE INSTRUMENT

Section-I: There is no score allotted for baseline variables.

Section-II: Perceived stress scale which consists of 10 questions.

The investigator collected the data by questionnaire method. The items were assessed by
the tool scores, the questions in the scale ask about your feelings and thoughts during the
last month. The tool consists of 10 items in each case you will be asked to indicate how
often you felt or thought a certain way. For each question choose from the following
alternatives: 0-never, 1-almost never, 2- sometimes, 3-fairly often, 4-very often.

Determine the PSS score by following these directions:

First, reverse your scores for questions 4, 5, 7, & 8. On these 4 questions, change the
scores like this: 0 = 4, 1 = 3, 2 = 2, 3 = 1, and 4 = 0. Now add up your scores for each
item to get a total. Individual scoreson the PSS can range from 0 to 40.

Minimum score = 0 Maximum score =4 Questions= 10 Totalscore=40

24
 Level of stress Range of score
Low stress 0-13
Moderate stress 14-26
High perceived stress 27-40

RELIABILITY OF THE TOOL

The reliability of an instrument is the degree of consistency with which it

measures the attribute and it is supposed to be measuring over a period of time.
The tool was a standardized one. Reliability of the tool was assessed by using
Test retest method. Stress score reliability correlation coefficient value is
0.82.Hence the tool was reliable and was used in this study.

CONTENT VALIDITY

Data collection tool is an instrument that measures the variables of interest of the study
accurately, precisely and sensitively.
Content validity of the tool was obtained from experts in the field of psychiatric nursing,
psychiatry, psychology and statistical expert. The experts were an associate professor,
psychiatrist and clinical psychologist. The experts were requested to check the relevance,
sequence and adequacy of the content. There was uniform agreement of the tool which is
adopted to conduct the study. Hence, the investigator precedes the same tool.

ETHICAL CONSIDERATION

The study objectives, intervention, data collection procedure approved by the Institutional
Ethics Committee of Desh Bhagat University, Mandi Gobindgarh. The nursing students
were explained about the purpose and need for the study. They were assured that their
details and answers will be used only for the research purpose. Further they were ensured
that their details will be kept confidentially. Thus the investigator followed the
ethical guidelines, which were issued by the institutional ethics committee
after getting a written permission.

25
PILOT STUDY
Pilot study is a trail run for the main study to test the reliability, practicability and
feasibility of the study.

The main objectives of the pilot study are to help the researcher to become
familiar with the use of tool and to find out the difficulties in the main study. The
investigator underwent calisthenic exercises training programme from stipulated
and popular fitness centre by a therapist and obtained a certificate. The pilot study
was conducted after getting ethical clearance and the permission from the S. Lal
Singh Memorial Institute of Nursing. It was conducted for a period of one week.
Sample of 10 nursing students was selected by convenient sampling technique.
Informed consent was obtained from them before collection of the data.

Data were collected from the nursing students by structured questionnaire was
perceived stress scale before the implementation of calisthenic exercise. After
completion of calisthenic exercise sessions, the nursing students were assessed
their stress by using same scale. Pilot study samples are excluded in the main
study.

DATA COLLECTION PROCEDURE

There are 160 nursing students were residing in the age group from 17 to 22 years,
irrespective of caste, creed and religion. Initially the investigator approaches each
nursing students after getting permission from the Desh Bhagat University,
Mandi Gobindgarh.
Investigator selected 72 nursing students initially. In which 3 of them were
dropped due to acute illness like fever and cold, 3 of them were unable to
attend due to their physical inability and 6 were not willing to participate in the
study. The investigator selected 60 nursing students as per the inclusion and
exclusion criteria. The nursing students were introduced with the whole
programme after an introduction and then a written informed consent was
obtained from them for willingness to participate in the study. They were assured
that their responses and details will be kept confidential and will be used only for
the research purpose. Before the tool perceived stress scale was administered some

26
informal discussion were made with participants to establish rapport so that they
would be relaxed.
The total 60 nursing students were divided into two groups. Each group contained
30 nursing students. Every day the 30 participants were gathered around 5.30AM
in the common hall in the Nurses Home. In the first two days pre test
questionnaire was administered to them and they were asked to give appropriate
answers for all statements to find out the level of stress by structured scale before
calisthenics.
Following assessment three weeks of calisthenic exercise was administered after
demonstration. The calisthenic exercise was administered to the group for half an
hour in the morning and evening session. Each participant were assigned and
supervised as well as corrected during the performance of calisthenic exercise for
19 days. Before starting calisthenic exercise attendance was taken by the
researcher. Every day calisthenic exercise started in the morning session from
5.30 A.M 6.00 A.M and evening sessions from 5.30 P.M to 6.00 P.M. The
researcher everyday supervised and encouraged the participants during
calisthenic exercise. On the end of three weeks calisthenic exercise session the
post-test was administered by Perceived stress Scale for assess the level of stress
during the fourth week among the nursing students.
SCHEDULE OF DATA COLLECTION PROCEDURE
Day Description of activity Duration
Consent of all the participants, Pretest level of stress
1 assessment and introduction, need , purpose & 45 mts
importance
2 Exercise 1. Jumping jacks Exercise 2. Neck rolls 30 mts
4 Exercise 3. Free-hand neck resistance Exercise 4. 30 mts
Arm circles
5 Exercise 5. Alternating toe touches, Exercise 6. 30 mts
Trunk twists
6 Exercise 7. Abductor/adductor leg raise, Exercise 8. 30 mts
Prone leg extension
7 Exercise 9. Standing one-legged toe raise 30 mts
8 Post test after 3 weeks of duration 4th week 45 mts

27
Intervention protocol:

Place Desh Bhagat University, School of Nursing

Intervention Calisthenic Exercises

Tool Perceived stress scale

Duration Four weeks

Frequency Twice a day

Time Morning 5.30 AM to 6.00 AM.

Evening 5.30 PM to 6.00 PM.

Administered by The Investigator

Recipient Desh Bhagat University, School of Nursing

Procedure Exercise 1. Jumping jacksExercise 2. Neck rolls

Exercise 3. Free-hand neck resistance
Exercise 4. Arm circles
Exercise 5. Alternating toe touches
Exercise 6. Trunk twists
Exercise 7. Abductor/adductor leg raise
Exercise 8. Prone leg extension
Exercise 9. Standing one-legged toe raise

PLAN FOR DATA ANALYSIS

The data analysis involved the use of statistical procedures to give an organization
and meaning to the data. The collected data was analyzed by means of
descriptive statistics, and inferential statistics. To compute the data, a data sheet
was prepared by the investigator.

DESCRIPTIVE STATISTICS
 Analysis of the baseline data was done by using frequency and percentage.

28
  Stress among nursing students was analyzed by computing frequency,
percentage, mean and Standard deviation.

INFERENTIAL STATISTICS

 Paired “t” test was used to find out the effectiveness of calisthenic
exercises in reducing stress among nursing students.
 Chi-square analysis was used to determine the association between the
level of stress and selected socio demographic variables among nursing
students.

29
 RESEARCH APPROACH
(Quantitative Evaluative Approach )

RESEARCH DESIGN
(Pre experimental one group pretest post test Design)

TARGET POPULATION
(Nursing students , Desh Bhagat University) e

ACCESSIBLE POPULATION
(Nursing students , Desh Bhagat University)

SAMPLE
(60 Nursing students)

SAMPLE SIZE
(60 Nursing students )

SAMPLING TECHNIQUE
(Convenient Sampling technique )

PRE TEST -TOOL- Perceived Stress Scale - (SHELDON COHEN)

INTERVENTION (CALISTHENIC EXERCISES)

POST TEST ( Perceived Stress Scale)

ANALYSIS AND INTERPRETATION

DISSEMINATION OF RESULT

FIGURE: 2 SCHEMATIC REPRESENTATION OF RESEARCH

METHODOLOGY

30
 CHAPTER IV

DATA ANALYSIS AND INTERPRETATION

This chapter deals with the analysis and interpretation of the data obtained from
60 nursing students in school of Nursing, Desh Bhagat University. The collected
data were tabulated and presented according to the objectives under the
following orderly sections.
 Section I
Distribution of nursing students’ data according to the socio demographic
variables
 Section II
Pretest level of stress among nursing students before administration of calisthenic
exercise
 Section III
Posttest level of stress among nursing students after administration of calisthenic
exercise
 Section IV
Assess the effectiveness of calisthenic exercise on stress amongnursing
students
 Section V
Association between the post test level of stress and selecteddemographic
variables among nursing students

31
 SECTION I
Table 4.1: Distribution of nursing students according to the socio
demographic variables

No. of
Demographic information %
students
Age in years 17 -18 years 37 61.7%
19 -20 years 23 38.3%
21 -22 years 0 0.0%
Basic Education +2 54 90.0%
Graduate 6 10.0%
Religion Hindu 54 90.0%
Muslim 3 5.0%
Sikh 3 5.0%
Year of study I Year 30 50.0%
II Year 30 50.0%
Occupation of parents Government 5 8.3%
Private 13 21.7%
Business 2 3.3%
Others 40 66.7%
Family Monthly income Below 10,000 24 40.0%
Rs.10,000- 15,000 22 36.7%
Rs.15,000- 20,000 8 13.3%
>Rs. 20,000 6 10.0%
Medium of the instruction in Tamil 40 66.7%
higher secondary education English 20 33.3%
Percentage of marks obtained 70-80 percent 5 8.3%
in higher secondary 80-90 percent 13 21.7%
Above 90 42 70.0%
Types of family Nuclear 52 86.7%
Joint 6 10.0%

32
 Extended 2 3.3%
Residence Rural 40 66.7%
Urban 14 23.3%
Semi urban 6 10.0%

Any problems in the family Nil 46 76.7%

Financial problem 14 23.3%
Others 0 0.0%
Average study time per day < 1 hours 20 33.4%
1-2 hours 29 48.3%
>2 hours 11 18.3%
Leisure activities carried out Exercise 4 6.7%
in a day Gardening 0 0.0%
Playing 7 11.7%
Watching T.V 37 61.6%
Others 12 20.0%

The above table 4.1 shows the demographic information of nursing students those who are
participated for the following study on “A study to assess the effectiveness of calisthenic
exercises in reducing stress among nursing students in selected colleges of nursing at
district Fatehgarh Sahib”

Among 60 nursing students (61.7%) were 17 – 18 years of age group, (38.3%) were 19-20
years and none of them in the age group of 21 – 22 years.

According to basic education (90%) had +2, (10%) had graduate. In religion (90%) were
Hindu, (5%) were Muslim, and (5%) were Sikh. The year of study (50%) were from I
year, (50%) were from II year.

According to occupation of their parents (21.7%) were private job, (8.3%) were
government job, (3.3%) were business and (66.7%) were other than the private,
government and business.

33
In family monthly income (40%) of students family income was below 10,000, (36.7%) was
Rs. 10,000-15,000, (13.3%) was Rs.15,000- 20,000, (10%) was >Rs. 20,000.

Regarding medium of instruction in higher secondary education (66.7 %) were Tamil,

(33.3%) were English. In percentage of marks obtained in higher secondary (70%) were got
above 90 percentage, (21.7%) were got 80-90 percentage, (8.3%) were got 70-80 percentage.

The type of family was (86.7%) were nuclear family, (10%) were joint family, (3.3%) were
extended family. Regarding residence (66.7%) was from rural, (23.3%) were from urban,
(10%) were from semi urban.

Any problem in the family was (76.7%) didn’t have any problem in their family, (23.3%) had
financial problem.

Among nursing students average study time per day was (48.3%) were studying 1-2 hours,
(33.4%) were studying less than 1 hour, and (18.3%) were studying more than 2 hours.

Regarding leisure activities carried out in a day was (61.6%) were watching T.V, (20%) were
involved other than exercise, gardening, playing, and watching T.V, (6.7%) were exercise,
and none of theminvolved in gardening.

34
 AGE DISTRIBUTION
80%

70%
61.7%
60%
% of students

50%
38.3%
40%

30%

20%

10%
0.0%
0%
17 -18 years 19 -20 years 21 -22 years

Fig 3. Simple cylinder diagram depicts distribution of nursing students according to their age.

Among 60 nursing students (61.7%) were 17 – 18 years of age group, (38.3%) were 19-20 years and none of them in the age group of
21 – 22 years.

35
 BASIC EDUCATION

Graduate
10%

+2
90%

Fig 4 Pie diagram portrays distribution of nursing students according to their basic education.

The above diagram portrays that the majority of the nursing students were (90%) had +2, (10%) had graduate.

36
 RELIGION
100%
90.0%
90%
80%

70%
% of students

60%

50%

40%

30%

20%

10% 5.0% 5.0%

0%
Hindu Muslim Sikh

Fig 5 bar diagram identifies distribution of nursing students according to their religion.

The above diagram identifies that the most of the nursing students (90%) were Hindu, (5%) were Muslim, and (5%) were Christian.

37
 YEAR OF STUDY

II Year I Year
50% 50%

Fig 6 Pie diagram states the distribution of nursing students according to their year of study

The above diagram states the nursing students (50%) were from I year, (50%) were from II year according to their year of study.

38
 OCCUPATION OF PARENTS
100%

90%

80%

70% 66.7%
% of students

60%

50%

40%

30%
21.7%
20%
8.3%
10% 3.3%
0%
Government Private Business Others

Fig 7 Simple bar diagram depicts the distribution of nursing according to their occupation of parents

The above diagram depicts that the majority (21.7%) were private job, (8.3%) were government job, (3.3%) were business and
(66.7%) were other than the private, government and business occupation of their parents.

39
 MONTHLY INCOME

70%

60%

50%
40.00%
% of students

40% 36.70%

30%

20%
13.30%
10.00%
10%

0%
Below 10,000 Rs.10,000- 15,000 Rs.15,000- 20,000 >Rs. 20,000
-10%

Fig 8 Pyramid diagram manifests distribution of nursing students according to their monthly family income

The above diagram manifests that the majority (40%) of students family income was below 10,000, (36.7%) was Rs. 10,000-15,000,
(13.3%) was Rs.15,000-20,000, (10%) was >Rs. 20,000.

40
 PERCENTAGE OF MARKS OBTAINED IN HIGHER SECONDARY

70-80 percent
Above 90 8%
70%
80-90 percent
22%

Fig 9 Pie diagram narrates distribution of nursing students according to their percentage of marks obtained in higher
secondary.

The above diagram narrates that the majority of the nursing students (70%) were got above 90 percentage, (21.7%) were got 80-90
percentage, (8.3%) were got 70-80 percentage of marks obtained in higher secondary.

41
 TYPE OF FAMILY SYSTEM

Joint family
10%
Extended family
3%

Nuclear family
87%

Fig 10 Pie diagram identifies distribution of nursing students according to their type of family system.

The above diagram identifies that the majority of nursing students (86.7%) were nuclear family, (10%) were joint family, (3.3%)
were extended family.

42
 RESIDENCE
80%

70% 66.7%

60%
% of students

50%

40%

30%
23.3%
20%
10.0%
10%

0%
Rural Urban Semi urban

Fig 11 Simple bar diagram explains distribution of nursing students according to their residence.

The above diagram explains that (66.7%) were from rural, (23.3%) were from urban, (10%) were from semi urban.

43
 ANY PROBLEM IN THE FAMILY
100%
90%
80% 76.7%

70%
% of students

60%
50%
40%
30% 23.3%
20%
10%
0.0%
0%
Nil Financial problem Others

Fig 12 simple cylinder diagram depicts distribution of nursing students according to any problem in the family.

The above diagram depicts majority of the students (76.7%) didn’t have any problem in their family, (23.3%) had financial problem.

44
 AVERAGE STUDY TIME IN A DAY
50% 48.3%

45%

40%

35% 33.4%
% of students

30%

25%

20% 18.3%

15%

10%

5%

0%
< 1 hours 1-2 hours >2 hours

Fig 13 Pyramid diagram states the distribution of nursing students according to their average study time in a day.

The above diagram states that (48.3%) were studying 1-2 hours, (33.4%) were studying less than 1 hour, and (18.3%) were studying
more than 2 hours.

45
 LEISURE ACTIVITIES CARRIED OUT IN A DAY
70%
61.6%
60%

50%
% of students

40%

30%
20.0%
20%
11.7%
10% 6.7%

0%
Exercise Playing Watching T.V Others

A fig 14 cylinder diagram narrates distribution of nursing students according to leisure activities carried out in a day.

The above diagram narrates that the majority (61.6%) were watching T.V, (20%) were involved other than exercise, gardening,
playing, and watching T.V, (6.7%) were exercise, and none of them involved in gardening.

46
 SECTION II
Table 2 : pretest level of stress among nursing students before
administering calisthenic exercise

Sr. no Items

Fairly often
Sometimes

Very often
t never
Almos
Never
1 In the last month, how often have you been upset
because of something that happened 6 4 29 18 3
unexpectedly?
2 In the last month, how often have you felt
that you were unable to control the important things 2 12 24 15 7
in your life?
3 In the last month, how often have you felt nervous and
2 5 25 16 12
stressed?
4 In the last month, how often have you felt
confident about your ability to handle your personal 5 9 27 9 10
problems?
5 In the last month, how often have you felt
6 4 19 11 20
that things were going your way?
6 In the last month, how often have you found that you
could not cope with all the things 3 11 29 11 6
that you had to do?
7 In the last month, how often have you been
1 16 22 11 10
able to control irritations in your life?
8 In the last month, how often have you felt
4 2 15 23 16
that you were on top of things?
9 In the last month, how often have you been angered
because of things that happened 2 12 25 16 5
that were outside of your control?
10 In the last month, how often have you felt
difficulties were piling up so high that you could not 1 17 19 11 12
overcome them?

The above table 2 shows the each question wise pretest level of perceived stress scale
score among nursing students in school of Nursing, Desh Bhagat University.

47
 Table 3: Each question wise pre test percentage of perceived stress
scale score

S. no Items

% of mean
Maximum

Mean
score

score

score
SD
1 In the last month, how often have you
2.13
been upset because of something that happened 4 .98
unexpectedly? 53.25%
2 In the last month, how often have you felt that
2.22
you were unable to control the 4 1.01
important things in your life? 55.50%
3 In the last month, how often have you felt 2.52
1.02
nervous and stressed? 4 63.00%
4 In the last month, how often have you felt
2.17
confident about your ability to handle 4 1.14
your personal problems? 54.25%
5 In the last month, how often have you felt 4 2.58
1.29
that things were going your way? 64.50%
6 In the last month, how often have you found
2.10
that you could not cope with all the 4 .99
things that you had to do? 52.50%
7 In the last month, how often have you 4
2.22
been able to control irritations in your life? 1.08
55.50%
8 In the last month, how often have you felt 4 2.75
1.10
that you were on top of things? 68.75%
9 In the last month, how often have you been
angered because of things that happened that 4 2.17
were outside of your .96
control? 54.25%
10 In the last month, how often have you felt
2.27
difficulties were piling up so high that you 4 1.13
could not overcome them? 56.75%
Total 40 23.12
4.64
57.80%
The above table 3 shows the each question wise pre test percentage of perceived stress
scale score among nursing students in school of Nursing, Desh Bhagat University.

48
 Table 4: PRE TEST LEVEL OF STRESS AMONG NURSING
STUDENTS

Level of stress No. of Students %

Low stress 0 0.0%
Moderate stress 42 70.0%
High perceived stress 18 30.0%
Total 60 100%

The above table 4 shows the students pre test level of stress score. In general, none of the
students are having Low level stress score and 70.0% of them having moderate level of
stress score and 30.0% of them are having high perceived level of stress score.

Stress score interpretation

0 – never 1 - almost never 2 – sometimes 3 - fairly often 4 - very oftenMin=0 Max=4 Total

questions=10 Maximum marks= 40

Sr no. Grade Percentage Marks

1. Low stress 1 – 33% 1 – 13

2. Moderate stress 34 – 66% 14 – 26

3. High perceived stress 67 – 100 % 27 – 40

49
 PRETEST LEVEL OF STRESS SCORE
100%
90%
80%
70.0%
70%
% of students

60%
50%
40%
30.0%
30%
20%
10%
0.0%
0%
Low stress Moderate stress high perceived stress

Fig 15 Pretest level of stress score among nursing students

50
 SECTION III
Table 5: Post test level of stress among nursing students after administration
of calisthenic exercise

S.no Items

Fairly often

Very often
Sometimes
Never

Almos

never
t
1 In the last month, how often have you been
upset because of something that happened 13 18 25 3 1
unexpectedly?
2 In the last month, how often have you felt that
you were unable to control the 12 25 20 3 0
important things in your life?
3 In the last month, how often have you felt
9 18 26 6 1
nervous and stressed?
4 In the last month, how often have you felt
confident about your ability to handle your 9 18 29 2 2
personal problems?
5 In the last month, how often have you felt
13 19 20 5 3
that things were going your way?
6 In the last month, how often have you
found that you could not cope with all the 8 16 26 10 0
things that you had to do?
7 In the last month, how often have you been
7 23 24 6 0
able to control irritations in your life?
8 In the last month, how often have you felt
12 27 16 5 0
that you were on top of things?
9 In the last month, how often have you been
angered because of things that happened that 8 23 22 6 1
were outside of your control?
10 In the last month, how often have you felt
difficulties were piling up so high that you 9 28 22 0 1
could not overcome them?

The above table 5 shows the each question wise postt est level of perceived stress scale
score among nursing students in school of Nursing, Desh Bhagat University.

51
 Table 6: Each question wise post test percentage of perceived stress
scale score

S.no Items

% of mean
Maximum

Mean
score

score

score
SD
1 In the last month, how often have you been upset 4
because of something that happened 1.35 .94 33.75
unexpectedly? %
2 In the last month, how often have you felt that
you were unable to control the important things 4 1.23 .83 30.75
in your life? %
3 In the last month, how often have you felt 4 38.25
1.53 .93
nervous and stressed? %
4 In the last month, how often have you felt
confident about your ability to handle your 4 1.50 .91 37.50
personal problems? %
5 In the last month, how often have you felt that 4 1.0 35.75
1.43
things were going your way? 8 %
6 In the last month, how often have you found
that you could not cope with all the things that 4 1.63 .92 40.75
you had to do? %
7 In the last month, how often have you been able 4 37.00
1.48 .83
to control irritations in your life? %
8 In the last month, how often have you felt that 4 30.75
1.23 .87
you were on top of things? %
9 In the last month, how often have you been
angered because of things that happened that 4 1.48 .91 37.00
were outside of your control? %
10 In the last month, how often have you felt
difficulties were piling up so high that you 4 1.27 .78 31.75
could not overcome them? %
Total 40 3.2 35.45
14.18
0 %

The above table 6 shows the each question wise post test percentage of perceived stress
scale score among nursing students in school of Nursing, Desh Bhagat University.

52
 TABLE 7: POST TEST LEVEL OF STRESS

Level of stress No. of Students %

Low stress 29 48.3%

Moderate stress 31 51.7%

High perceived stress 0 0.0%

Total 60 100%

The above table 7 shows the students post-test level of stress score. In general 48.3% of
students are having low level of stress score, 51.7% of them having moderate level of stress
score and none of them are having high perceived level of stress score.

53
 POSTTEST LEVEL OF STRESS SCORE
100%

90%

80%

70%

60%
51.7%
48.3%
50%
% of students

40%

30%

20%

10%
0.0%
0%
Low stress Moderate stress high per ceived stress

Fig 16 Post test level of stress among nursing students

54
 SECTION IV
Table 8: Assess the effectiveness of calisthenic exercises on stress among
nursing students

Perceived Stress Pretest Posttest Mean Student’s

Scale Items Mean SD Mean SD paired
Difference t-test
1 In the last month,
how often have you t=5.34P=0.001
been upset because of ***
2.13 .98 1.35 .94
something that DF= 59 ,
happened Significant
unexpectedly? 0.78
2 In the last month,
how often have you t=5.40 P=0.001
felt that you were ***
2.22 1.01 1.23 .83
unable to control the DF= 59 ,
important things in Significant
your life? 0.99
3 In the last month, t=5.60 P=0.001
how often have you ***
2.52 1.02 1.53 .93
felt nervous and DF= 59 ,
stressed? 0.99 Significant
4 In the last month,
how often have you t=4.15 P=0.001
felt confident about ***
2.17 1.14 1.50 .91
your ability to handle DF= 59 ,
your personal Significant
problems? 0.67
5 In the last month, t=6.00P=0.001
how often have you ***
2.58 1.29 1.43 1.08
felt that things were DF= 59 ,
going your way? 1.15 Significant
6 In the last month,
how often have you t=3.50 P=0.001
found that you could ***
2.10 .99 1.63 .92
not cope with all the DF= 59 ,
things that you had to Significant
do? 0.47

55
 7 In the last month,
t=4.32 P=0.001
how often have you
***
been able to control 2.22 1.08 1.48 .83
DF= 59 ,
irritations in your
Significant
life? 0.74
8 In the last month, t=8.20 P=0.001
how often have you ***
felt that you were on 2.75 1.10 1.23 .87
DF= 59 ,
top of things? 1.52 Significant
9 In the last month,
how often have you
t=4.35 P=0.001
been angered because
***
of things that 2.17 .96 1.48 .91
DF= 59 ,
happened that were
Significant
outside of your
control? 0.69
10 In the last month,
how often have you t=5.30 P=0.001
felt difficulties were ***
2.27 1.13 1.27 .78
piling up so high that DF= 59 ,
you could not Significant
overcome them? 1.00
*** Very high significant at p< 0.001
The above table 8 shows the comparison of pre test and post teststress score
among nursing students.

Considering Stress regarding “In the last month, how often have you been upset
because of something that happened unexpectedly? “, in pretest, students are
having 2.13 score whereas in post-test they are having 1.35 score. Difference is
0.78. This difference is large and it is statistically significant difference.

Considering stress regarding “In the last month, how often have you felt that you
were unable to control the important things in your life?” in pretest students are
having 2.22 score whereas in posttest they are having 1.23 score. Difference is
0.99. This difference is large and itis statistically significant difference.

56
Considering stress regarding, “In the last month, how often have you felt nervous
and stressed?” in pretest students are having 2.52 score whereas in posttest they
are having 1.53score. Difference is 0.99. This difference is large and it is
statistically significant difference.

Considering stress regarding, “In the last month, how often have you felt confident
about your ability to handle your personal problems?”. In pretest students are
having 2.17 score whereas in posttest they are having 1.50 score. Difference is
0.67. This difference is large and it is statistically significant difference.

Considering stress regarding “In the last month, how often have you felt that
things were going your way?” in pretest students are having 2.58 score whereas
in posttest they are having 1.43 score. Difference is 1.15. This difference is
large and it is statistically significant difference.

Considering stress regarding, “In the last month, how often have you found that
you could not cope with all the things that you had to do?, in pretest , students
are having 2.10 score whereas in posttest they are having 1.63 score. Difference is
0.47. This difference is large and itis statistically significant difference.

Considering stress regarding “In the last month, how often have you been able to
control irritations in your life?” in pretest , students are having 2.22 score whereas
in posttest they are having 1.48 score. Difference is 0.74. This difference is large
and it is statistically significant difference.

Considering stress regarding “In the last month, how often have you felt that you
were on top of things?, in pretest , students are having 2.75 score whereas in
posttest they are having 1.23score. Difference is 1.52. This difference is large
and it is statistically significant difference.

Considering stress regarding “In the last month, how often have you been angered
because of things that happened that were outside of your control?, in pretest ,
students are having 2.17 score where as in posttest they are having 1.48 score.
Difference is 0.69. This difference is large and it is statistically significant

57
difference.
Considering stress regarding, “In the last month, how often have you felt
difficulties were piling up so high that you could not overcome them?” in pretest ,
students are having 2.27 score whereas in posttest they are having 1.27 score.
Difference is 1.00. This difference is large and it is statistically significant
difference.

Significance of difference between pretest and posttest score was

calculated using student paired t-test

Table 9: COMPARISON OF OVERALL STRESS SCORE

BEFORE AND AFTER CALISTHENIC EXERCISES

No.Of Pretest Posttest Meandifferen Student’S paired

students Mean±S Mean±S ceMean±SD t-test
D D
Overall 60 23.12 ± 14.18 ± 8.94 ± 3.83 t=17.81 P=0.001***
Stress 4.64 3.20
DF = 59, significant
Score
*** very high significant at P≤0.001

Table 9 shows the comparison of overall stress before and after the administration of;
calisthenic exercises. On an average, students are reduced their stress from 23.12 to 14.18
after the administration of calisthenic exercise. Difference is 8.94, this difference is
statistically significant. Statistical significance was calculated by using student’s paired
‘t’test.

58
Fig 17: Box Plot compares the students pretest and posttest stress
score

59
Table 10: Each question wise pretest and posttest percentage of stress

Sr. Pretest Posttest % of stress

no stress stress reduction
Perceived Stress Scale Items
score

1 In the last month, how often

have you been upset because
of something that happened
unexpectedly? 53.25% 33.75% 19.50%

2 In the last month, how often

have you felt that you were
unable to control the
important things in your life? 55.50% 30.75% 24.75%

3 In the last month, how often

have you felt nervous and
stressed? 63.00% 38.25% 24.75%

4 In the last month, how often

have you felt confident about
your ability to handle your
personal problems? 54.25% 37.50% 16.75%

5 In the last month, how often

have you felt that things were
going your way? 64.50% 35.75% 28.75%

6 In the last month, how often

have you found that you could
not cope with all the things
that you had to do? 52.50% 40.75% 11.75%

7 In the last month, how often

have you been able to control
irritations in your life? 55.50% 37.00% 18.50%

8 In the last month, how often

have you felt that you were on
top of things? 68.75% 30.75% 38.00%

60
9 In the last month, how often
have you been angered
because of things that
happened that were outside of
your control? 54.25% 37.00% 17.25%

10 In the last month, how often

have you felt difficulties were
piling up so high that you
could not overcome them? 56.75% 31.75% 25.00%

Overall 57.80% 35.45% 22.35%

The above table 10 shows each question wise pretest and posttestpercentage
of stress among nursing student.

61
 Table 11: Comparison of pretest and posttest level of stress score
Level of Pretest Posttest Generalized
stress McNemar’s
test
n % n %
Low stress 0 0.0% 29 48.3% 2=43.33
Moderate 42 70.0% 31 51.7% P=0.001***(S)
stress
High 18 30.0% 0 0.0%
perceived
stress
60 100.0% 60 100.0%
Total
***significant at p<0.001 level
Table 11shows the pre-test and post-test level of stress score among nursing
students
Before calisthenic exercise, none of the students are having low level stress score
and 70.0% of them having moderate level of stress score and 30.0%of them are
having high perceived level of stress score.
After calisthenic exercise, 48.3% of students are having low level of stress score,
51.7% of them having moderate level of stress score and none of them are having
high perceived level of stress score.Level of stress reduction score between pretest
and posttest was calculated using Generalised McNemar’s chi square test.

62
 PRETE T AND POSTTEST LEVEL OF STRESS SCORE
S
100%

90%

80%
70.0%
70%
% of students

60%
51.7%
48.3%
50%

40%
30.0%
30%

20%

10%
0.0% 0.0%
0%
Pretest Posttest

Fig 18 Pretest and post test level of stress score among nursing students

63
 Section IV Assess the effectiveness of the calisthenic exercise among
nursing students

Table 12: Effectiveness and generalization of calisthenic exercise

Max Mean Mean Difference Percentage

score score of stress reduction Difference of
score with 95% stress reduction
Confidence score with 95%
interval Confidence
interval

Pretest 40 23.12 8.94(7.93 – 9.93) 22.35 %( 19.83% –

24.83%)
Posttest 40 14.18

Table 12 shows the effectiveness of calisthenic exercises in reducing stress among

nursing students in school of Nursing at Desh Bhagat University.

On an average, in post test after having calisthenic exercises, students are reduced
22.35% stress score than pretest score. Differences and generalization of stress
reduction score between pre test and post test score was calculated using and
mean difference with 95% CI and proportion with 95% CI.

In this study effectiveness of the study is point estimate of 22.35% and

interval estimate is 19.83% to 24.83%. It means in this similar setup of the
study, whom ever conducted, 95 % we can assure, effectiveness of the study
will lies between 19.83 to 24.83% stress score reduction.

64
 SECTION V
Tab 13: Association between the post test level of stress and selected
demographic variables among nursing students.
Demographic variables Pretest level of stress score N Chi
High squar
Low Moderate perceived e test
n % n % n %
Age in years 17 -18 0.0
0 26 70.3% 11 29.7% 37
years % P=0.95
19 -20 0.0 (NS)
0 16 69.6% 7 30.4% 23
years %
21 -22 0.0
0 0 0.0% 0 0.0% 0
years %
Basic +2 0.0
0 39 72.2% 15 27.8% 54
Education % P=0.26
Graduate 0.0 (NS)
0 3 50.0% 3 50.0% 6
%
Religion Hindu 0.0
0 38 70.4% 16 29.6% 54
% P=0.98
Muslim 0.0 (NS)
0 2 66.7% 1 33.3% 3
%
Sikh 0.0
0 2 66.7% 1 33.3% 3
%
Year of study I Year 0.0
0 20 66.7% 10 33.3% 30
% P=0.57
II Year 0.0 (NS)
0 22 73.3% 8 26.7% 30
%
Occupation of Governme 0.0
0 3 60.0% 2 40.0% 5
parents nt % P=0.64
Private 0.0 (NS)
0 8 61.5% 5 38.5% 13
%
Business 0.0 100.0
0 2 0 0.0% 2
% %
Others 0.0
0 29 72.5% 11 27.5% 40
%
Family Below 0.0
0 16 66.7% 8 33.3% 24
Monthly 10,000 % P=0.71
income Rs.10,000- 0.0 (NS)
0 15 68.2% 7 31.8% 22
15,000 %
Rs.15,000- 0.0
0 7 87.5% 1 12.5% 8
20,000 %

65
 >Rs. 20,000 0.0
0 4 66.7% 2 33.3% 6
%
Medium of Hindi 0.0
0 27 67.5% 13 32.5% 40
the % P=0.55
instruction English (NS)
in higher 0.0
secondary 0 15 75.0% 5 25.0% 20
%
education
Percentage 70-80 0.0
0 3 60.0% 2 40.0% 5
of marks percent % P=0.61
obtained in 80-90 0.0 (NS)
higher 0 8 61.5% 5 38.5% 13
percent %
secondary Above 90 0.0
0 31 73.8% 11 26.2% 42
%

Types Nuclear 0.0

0 35 67.3% 17 32.7% 52
of family % P=0.20
Joint 0.0 100.0 (NS)
0 6 0 0.0% 6
% %
Extended 0.0
0 1 50.0% 1 50.0% 2
%
Residence Rural 0.0
0 29 72.5% 11 27.5% 40
% P=0.52
Urban 0.0 (NS)
0 10 71.4% 4 28.6% 14
%
Semi urban 0.0
0 3 50.0% 3 50.0% 6
%
Any Nil 0.0
0 31 67.4% 15 32.6% 46
problems % P=0.42
in the Financial 0.0 (NS)
family 0 11 78.6% 3 21.4% 14
problem %
Others 0.0
0 0 0.0% 0 0.0% 0
%
Average < 1 hours 0.0
0 14 70.0% 6 30.0% 20
study time % P=0.97
per day 1-2 hours 0.0 (NS)
0 20 69.0% 9 31.0% 29
%
>2 hours 0.0
0 8 72.7% 3 27.3% 11
%
Leisure Exercise 0.0
0 2 50.0% 2 50.0% 4
activities % P=0.27
carried out Gardening 0 0.0 0 0.0% 0 0.0% 0 (NS)

66
 in a day %
Playing 0.0
0 5 71.4% 2 28.6% 7
%
Watching 0.0
0 24 64.9% 13 35.1% 37
T.V %
Others 0.0
0 11 91.7% 1 8.3% 12
%

The above table 13 shows the association between pre test level of stress and their
demographic variables of nursing students. None of the demographic variables are
significantly associated with their pre test level of stress score. Statistical
significance was calculated using chi square test.

67
 Table 14: Association between posttest level of stress and their demographic
variables

Posttest level of stress score N Chi square

High test
Low Moderate perceived
Demographic variables n % n % n %
Age in years 17 -18 years 14 37.8% 23 62.2% 0 0.0% 37 2=4.26
P=0.05* (S)
19 -20 years 15 65.2% 8 34.8% 0 0.0% 23

21 -22 years 0 0.0% 0 0.0% 0 0.0% 0

Basic Education +2 26 48.1% 28 51.9% 0 0.0% 54 2=0.01

P=0.93 (NS)
Graduate 3 50.0% 3 50.0% 0 0.0% 6

Religion Hindu 27 50.0% 27 50.0% 0 0.0% 54 2=0.60

P=0.74 (NS)
Muslim 1 33.3% 2 66.7% 0 0.0% 3

Sikh 1 33.3% 2 66.7% 0 0.0% 3

Year of study I Year 11 36.7% 19 63.3% 0 0.0% 30 2=4.73

P=0.09* (S)
II Year 20 66.7% 10 33.3% 0 0.0% 30

Occupation of Government 3 60.0% 2 40.0% 0 0.0% 5 2=1.72

parents P=0.63 (NS)
Private 8 61.5% 5 38.5% 0 0.0% 13

Business 1 50.0% 1 50.0% 0 0.0% 2

Others 17 42.5% 23 57.5% 0 0.0% 40

Family Monthly Below 10,000 9 37.5% 15 62.5% 0 0.0% 24 2=2.16

income P=0.53 (NS)
Rs.10,000-
13 59.1% 9 40.9% 0 0.0% 22
15,000

Rs.15,000-
4 50.0% 4 50.0% 0 0.0% 8
20,000

>Rs. 20,000 3 50.0% 3 50.0% 0 0.0% 6

Medium of the Hindi 15 37.5% 25 62.5% 0 0.0% 40 2=5.63

68
 instruction in English P=0.02* (S)
higher secondary 14 70.0% 6 30.0% 0 0.0% 20
education

Percentage of 70-80 percent 2 40.0% 3 60.0% 0 0.0% 5 2=0.92

marks obtained in P=0.63 (NS)
higher secondary 80-90 percent 5 38.5% 8 61.5% 0 0.0% 13

Above 90 22 52.4% 20 47.6% 0 0.0% 42

Types of family Nuclear 25 48.1% 27 51.9% 0 0.0% 52 2=2.68

P=0.62 (NS)
Joint 4 66.7% 2 33.3% 0 0.0% 6

Extended 0 0.0% 2 100.0% 0 0.0% 2

Residence Rural 24 60.0% 16 40.0% 0 0.0% 40 2=8.68

P=0.01* (S)
Urban 2 14.3% 12 85.7% 0 0.0% 14

Semi urban 3 50.0% 3 50.0% 0 0.0% 6

Any problems in Nil 24 52.2% 22 47.8% 0 0.0% 46 2=1.16

the family P=0.28 (NS)
Financial
5 35.7% 9 64.3% 0 0.0% 14
problem

Others 0 0.0% 0 0.0% 0 0.0% 0

Average study < 1 hours 10 50.0% 10 50.0% 0 0.0% 20 2=0.33

time per day P=0.84 (NS)
1-2 hours 13 44.8% 16 55.2% 0 0.0% 29

>2 hours 6 54.5% 5 45.5% 0 0.0% 11

Leisure activities Exercise 0 0.0% 4 100.0% 0 0.0% 4 2=6.88

carried out in a P=0.08 (NS)
day Gardening 0 0.0% 0 0.0% 0 0.0% 0

Playing 2 28.6% 5 71.4% 0 0.0% 7

Watching T.V 22 59.5% 15 40.5% 0 0.0% 37

Others 5 41.7% 7 58.3% 0 0.0% 12

The above table 14 shows the association between posttest level of stress and their
demographic variables. 19 -20years age group of students, II year students, English medium
students and urban students are reduced more stress score than others. Statistical significance
was calculated using chi square te

69
Table 15: Association between stress reduction score and demographic variables

Stress reduction score N Chi squaretest

Gain
score=Pos
Demographicvariables Pretest Posttest t-Pre
Mean SD Mean SD Mean SD
Age inyears 17 -18 22.9 4.8 14.9 2.9 4.2 37 t=2.03P=0.05*
O
8.02
years 5 5 3 3 9 (S)
19 -20 23.3 4.3 13.2 3.6 10.1 3.1 23
years 9 6 7 4 2 6
21 -22 0.0 0.0 0.0
0.00 0.00 0.00 0
years 0 0 0
Basic Education Plus Two 22.9 4.6 14.1 3.2 3.8 54 t=0.81 P=0.41
8.80
% of students

6 9 7 7 6 (NS)
Graduate 24.5 4.1 14.3 2.7 10.1 4.2
6
0 8 3 3 7 6
Religion Hindu 22.9 4.8 14.0 3.0 3.8 54 F=0.34 P=0.71
8.93
6 0 4 5 6 (NS)
Muslim 24.3 3.2 16.6 6.0 6.6
7.67 3
3 1 7 3 6
Christian 24.6 2.5 14.3 2.8 10.3 1.1
3
7 2 3 9 3 5
Year ofstudy I Year 23.5 4.7 15.5 3.1 4.1 30 t=2.00 P=0.05*
8.05
7 5 2 7 2 (S)
II Year 22.6 4.5 13.7 3.2 3.6 30
8.97
7 5 0 7 1
Occupation of Governme 23.8 5.8 16.0 6.0 3.7 F=0.45 P=0.71
7.80 5
parents nt 0 1 0 0 7 (NS)
Private 23.3 4.4 13.5 2.5 3.5 13
9.85
8 4 4 0 1
Business 23.5 13.5 3.5 10.0 2.8
.71 2
0 0 4 0 3
Others 22.9 4.7 14.2 2.9 4.1 40
8.73
2 8 0 9 0
Family Monthly Below 23.5 4.7 14.1 2.9 4.0 24 F=0.39
9.46
income 10,000 8 5 3 8 6 P=0.75(NS)
Rs.10,000 22.8 4.4 14.0 3.1 3.9 22
8.86
- 15,000 6 9 0 2 1
Rs.15,000 21.2 4.6 13.5 2.2 3.8
7.75 8
- 20,000 5 8 0 0 5

70
 >Rs. 24.6 4.9 16.0 5.2 3.6
8.67 6
20,000 7 7 0 2 7
Medium of the Tamil 23.3 4.8 15.1 2.6 3.8 40 t=1.99
8.15
instruction in 0 2 5 7 4 P=0.05*
higher secondar y English (S)
education
22.7 4.3 12.4 4.1 10.2 3.9 20
5 5 7 1 8 9

Percentage of 70-80 25.2 3.2 14.2 2.9 11.0 1.2 F=1.58

5
marks obtained in percent 0 7 0 5 0 2 P=0.24
higher secondar 80-90 24.1 4.2 14.2 2.3 2.7 13 (NS)
9.92
y percent 5 4 3 5 5
Above 90
22.5 4.8 14.1 3.5 4.2 42
8.38
5 4 7 0 7
Types offamily Nuclear 23.2 4.6 14.2 3.2 4.0 52 F=0.40
9.00
9 3 9 9 1 P=0.67
Joint 20.5 4.1 12.6 2.3 2.9 (NS)
7.83 6
0 4 7 4 3
Extended 26.5 4.9 16.0 1.4 10.5 3.5
2
0 5 0 1 0 4
Residence Rural 22.6 4.9 13.6 2.5 3.9 40 F=3.30
7.21
3 2 5 6 6 P=0.04*
Urban 23.3 3.8 14.6 3.5 10.1 4.1 14 (S)
6 9 4 0 1 0
Semi 25.8 3.7 16.6 5.2 3.4
9.67 6
urban 3 6 7 4 3
Any problemsin Nil 23.2 4.7 14.2 3.4 3.8 46 t=0.06
9.00
the family 2 0 2 6 1 P=0.81(N
Financial 22.7 4.5 14.0 2.2 4.2 14 S)
8.71
problem 9 6 7 0 5
Others 0.0 0.0 0.0
0.00 0.00 0.00 0
0 0 0
Averagestudy < 1 hours 23.4 4.0 13.5 2.5 3.5 20 F=1.36
9.90
time perday 5 6 5 4 8 P=0.26
1-2 hours 22.8 5.2 14.7 3.7 4.3 29 (NS)
8.10
6 8 6 4 0
>2 hours 23.1 4.1 13.8 2.6 2.9 11
9.36
8 2 2 4 4

71
 Leisure Exercise 26.5 3.0 18.0 3.5 6.0 F=0.76
8.50 4
activities 0 0 0 6 3 P=0.52
carried Gardening 0.0 0.0 0.0 (NS)
0.00 0.00 0.00 0
out in a 0 0 0
day Playing 23.8 5.5 15.2 3.0 4.5
8.57 7
6 8 9 9 4
Watching 23.2 4.7 13.7 3.3 3.6 37
9.49
T.V 4 4 6 5 3
Others 21.1 3.6 13.5 1.5 3.6 12
7.58
7 9 8 1 8

The above table 15 shows the association between level of stress reduction score and
their demographic variables.19 -20years students, II year students, English medium
students and urban students are reduced more stress score than others. Statistical
significance was calculated using one way analysis of variance F-test and student
independent t-test.

72
 CHAPTER V
DISCUSSION
This chapter deals with detailed description of the study findings gathered
from the statistical analysis. Stress is one of the major health issues of the
nursing students. It has a significant long-term effect on individual,
family and community. Understanding the effects of stress is the first
important step towards addressing an issue. The data is gathered from the
nursing students who revealed the negative aspects of stress and
importance of calisthenics exercises.
The data was statistically analyzed and the finding was discussed
under the objectives formulated by the researcher.

 Section I:
Deals with the socio demographic variables of nursing students.

 Section II:
Pretest level of stress among nursing students before
administration of calisthenic exercise.

 Section III:
Posttest level of stress among nursing students after
administration of calisthenic exercise

 Section IV:
Assess the effectiveness of calisthenics exercise on stress among
nursing students.

 Section V:
Association between the post test level of stress and selected
demographic variables among nursing students.

The first objective of this study is to assess the existing level of stress
among nursing students before calisthenic exercises intervention.

73
In general, none of the students are having mild level stress score and
70.0% of them having moderate level of stress score and 30.0%of them
are having severe level of stress score.
My study consistent with this study which is conducted by
Seyed fatemi, Naiemeh, Tafreshi (2017) was conducted in 1991 to
investigate the perception level and sources of stress across academic
years among B.Sc nursing students, 94 students were recruited for the
purpose. The findings of the study revealed that psychiatric problems
were more prevalent in nursing students than the general population.
Many items ranked as stressful among nursing students were also
identified in general population. In addition, the study concluded that
nursing students had the feelings 0f inadequacy, difficulty in
relationship with faculty, were given multiple assignments, have to
devote long hours to study and lacked free time, timely feedback and
faculty response to student’s needs1.
The second objective of this study to evaluate the post test level of
stress among nursing students after calisthenic exercises
intervention.
In general, 48.3% of students are having low level of stress score, 51.7%
of them having moderate level of stress score and none of them are
having high perceived level of stress score.
My study consistent with this study which is conducted by
Valarmathi.V, Tamil Selvaarasan. T and Judie.A (2016) Conducted
study was to determine the effectiveness of aerobic dance movement
therapy on academic stress among adolescents selected school at
Kancheepuram district, Tamilnadu. Quasi experimental non equalent pre-
test, post-test control group design was used. There are 268 students
screened by the academic stress scale was developed by Dr.BalajiRao
(2013) out of which 170 adolescents who had slightly stress, and
moderate stress were selected 88 in study group and 82 in control group
and the intervention was given for one month followed by

74
the post test was conducted. The analysis revealed that comparison of
post test of study and control group mean and SD value of adolescents
academic stress was found to be statistically highly significant with t=
6.14 at p<0.0001**
The third objective of this study is to determine the effectiveness of
calisthenic exercises on stress among nursing students.
 On an average, students are reduced their stress from 23.12 to
14.18 after the administration of calisthenic exercise. Difference
is 8.94, this difference is statistically significant. Statistical
significance was calculated by using student’s paired ‘t’test.
 Before calisthenic exercise, none of the students are having low
level stress score and 70.0% of them having moderate level of
stress score and 30.0% of them are having high perceived level of
stress score.
 After calisthenic exercise, 48.3% of students are having low level
of stress score, 51.7% of them having moderate level of stress
score and none of them are having high perceived level of stress
score.
 Level of stress reduction score between pre test and post test was
calculated using Generalised McNemar’schi square test.
 On an average, in post-test after having calisthenic exercises,
students are reduced 22.35% stress score than pre test score.
 Differences and generalization of stress reduction score between
pre-test and post test score was calculated using and mean
difference with 95% CI and proportion with 95% CI.
My study consistent with a study which was conducted by Murrow L JL, Lopez AD
(2009) conducted study was in 2009 on effects of calisthenic exercise training on high risk
behaviours. In which indices of hostility, depression and overall psychosocial stress were
decreased by 50 – 70%. Data from a recent randomized trial demonstrated that exercise
training can decrease depressive symptoms as effectively as antidepressants. Stress has been
linked to the onset of Illness and plays an etiological role in the disease process. It can worsen

75
pain symptom and make the burden of disease harder to bear as well.
The fourth objective of this study is to find out the association
between the level of stress in nursing students with their selected
demographic variables.
 None of the demographic variables are significantly associated
with their pre test level of stress score. Statistical significance
was calculated using chi square test.
 The post test level of stress and their demographic variables of 19
-20years students, II year students, English medium students and
urban students are reduced more stress score than others.
 Statistical significance was calculated using chi square test.
My study consistent with a study which was conducted by
Randal Beaton(2007) determined the relationship between stress level
and academic achievement by survey method results showed that 30% of
the student experienced high stress 20%of student experienced medium
stress and 50% student’s experienced low stress7 . The present study
analysis revealed that effectiveness of aerobic dance movement therapy
on academic stress was found to be statistically significant with t= 6.14
at p<0.0001.
Krishan Lal(2014), reported that academic stress among adolescent in
relation to intelligence and demographic factors. The demographic factors
such as (male and female) and (urban and rural) are not key factor in
academic stress among high school students. However, all students of
high school suffer from equal level of academic stress due to learning
environment American International Journal of Research in Humanities,
Arts and Social Sciences.

76
 CHAPTER-VI
SUMMARY, IMPLICATION, RECOMMENDATION,
LIMITATION AND CONCLUSION

This is the most creative part of this study. This chapter gives a brief
account of the present study including summary, finding and conclusion
draw from the findings, limitations, recommendations and nursing
implications.
SUMMARY
Stress is a state of being under pressure. In modern usage stress refers to
being under a great deal of emotional, mental and social pressure for a
prolonged period of time. Social environment and situation is also
considered stressful if there is lot of obstacles to communication and
mutual tolerance. There is only 24 hours per day so calisthenic exercises
are an efficient way to reduce stress in everyday life. It reprioritizes
the goals and activities of the life which focuses on what is truly
important and lets the trivial ones go. So the researcher conducted a study
to assess the effectiveness of calisthenic exercises in reducing stress
among nursing students in a selected college of nursing at Chennai. The
data was collected for 4 weeks in selected college of nursing, Chennai
from 02.01.2018 to 29.01. 2018. The collected data was analyzed by
using the descriptive statistics (percentage, mean, standard deviation) and
inferential statistics (student paired t test and chi square test). The study
findings were discussed based on the objectives.
MAJOR FINDINGS OF THE STUDY
Findings of socio demographic profile of the nursing students.
Among 60 nursing students (61.7%) were 17 – 18 years of age group,
(38.3%) were 19-20 years and none of them in the age group of 21 – 22
years.

77
 According to basic education (90%) had +2 , (10%) had graduate
. In case of religion (90%) were hindu, (5%) were muslim, and
(5%) were Christian. The year of study (50%) were from I year, (50%)
were from II year.

According to occupation of their parents (21.7%) were private

job, (8.3%) were government job, (3.3%) were business and (66.7%)
were other than the private, government and business.
In family monthly income (40%) of students family income was
below 10,000, (36.7%) was Rs. 10,000-15,000, (13.3%) was Rs.15,000-
20,000, (10%) was >Rs. 20,000.
Regarding medium of instruction in higher secondary education
(66.7 %) were Hindi, (33.3%) were English.
In percentage of marks obtained in higher secondary (70%) were
got above 90 percentage, (21.7%) were got 80-90 percentage, (8.3%)
were got 70-80 percentage.
The type of family was (86.7%) were nuclear family, (10%) were
joint family, (3.3%) were extended family.
Regarding residence (66.7%) was from rural, (23.3%) were from
urban, (10%) were from semi urban.
Any problem in the family was (76.7%) didn’t have any problem
in their family, (23.3%) had financial problem.
Among nursing students average study time per day was (48.3%)
were studying 1-2 hours, (33.4%) were studying less than 1 years,
(18.3%) were studying more than 2 years.
Regarding leisure activities carried out in a day was (61.6%) were
watching T.V, (20%) were involved other than exercise, gardening,
playing, and watching T.V, (6.7%) were exercise, and none of them
involved in gardening.

78
Finding the level of stress among nursing students before calisthenic
exercises.
Before administering the calisthenic exercises, In general, none
of the students are having mild level stress score and 70.0% of them
having moderate level of stress score and 30.0%of them are having
severe level of stress score.
Finding the level of stress among nursing students after calisthenic
exercises.
In the post-test domain wise percentage of stress level in general,
48.3% of students are having mild level of stress score, 51.7% of them
having moderate level of stress score and none of them are having
severe level of stress score.
Finding the effectiveness of calisthenic exercises among nursing
students

 On an average, students are reduced their stress from 23.12 to

14.18 after the administration of calisthenic exercise. Difference
is 8.94, this difference is statistically significant. Statistical
significance was calculated by using student’s paired ‘t’test.
 Before calisthenic exercise, none of the students are having mild
level stress score and 70.0% of them having moderate level of
stress score and 30.0%of them are having severe level of stress
score.
 After calisthenic exercise, 48.3% of students are having mild
level of stress score, 51.7% of them having moderate level of
stress score and none of them are having severe level of stress
score.
 Level of stress reduction score between pre test and post test was
calculated using Generalised McNemar’schisquare test.
 On an average, in post-test after having calisthenic exercises,
students mean stress reduction score was 14.18, it shows there is
a significant difference between the pretest and post test score.

79
  Differences and generalization of stress reduction score between
pre-test and post test score was calculated using and mean
difference with 95% CI and proportion with 95% CI.
Finding of an association of stress with the selected demographic
variables
There is a close association in the level of stress reduction and
their demographic variables of 19 -20years students, II year students,
English medium students and urban students are reduced more stress
score than others. Statistical significance was calculated using chi square
test
IMPLICATION OF THE STUDY
The finding of the study has implications for nursing education,
nursing practice, nursing research and nursing administration.
Nursing Education
 Nursing curriculum focuses to develop skills in identifying the
stress level and its management.
 Conferences, workshops and seminars can be held for nurses to
reduce stress and positive attitude.
 Arrange in-service education to update their knowledge regarding
stress reduction measures.
 Make available literature related to calisthenic exercises.
 Arrange the CAM and AYUSH programme
Nursing Practice
 Psychiatric nurse must have the skills in teaching about stress
reduction measures.
 Self-instructional material regarding reduction of stress can be
distributed to the students
 The nurse must have the skills to avoid manual pressure.
 There is no need for any specific preparation to provide
calisthenic exercises.

80
 Arrange aerobic dance movements weekly once.
Nursing Research
 This study will be a valuable reference material for further
researcher.
 The results of study encourage the management to adopt
calisthenic exercise for relieving stress.
 Adequate allocation of funds, manpower, time, adequate training
should be provided to the nurses for conducting this research.
 Research can be done to find out the effectiveness of calisthenic
exercises which helps to reduce stress among nursing students.
Nursing Administration
 Proposed to health administration to strategically plan and meet
the health needs of risk group.
 The administration both private and Govt sectors should take
initiatives to relieve stress.
 The administration can encourage the nurses for conducting
research aspects for prevention of stress.
 The administration can organize conferences, workshops and
seminars for nurses working in the hospital and other health care
setting.
RECOMMENDATION
 Keeping in view, the finding of the present study can be used as a
guide for future research.
 A similar study can be replicated with on a large sample in
different setting
 A similar study can be conducted to assess the effectiveness of
other complimentary therapies on stress.
 A longitudinal study can be undertaken to find out the long term
effect of calisthenic exercises on stress.

81
 LIMITATION OF THE STUDY
 The study was limited to the nursing students.
 The study was limited to the selected college of nursing at
Chennai.
 The nursing students who were to participate in the study.
 The data collection was restricted only for 4 weeks.
 The stress level was assessed based on the score obtained.
CONCLUSION
Education in evidence based care gives the opportunity to nurses
to improve their ability to use theoretical knowledge in practice. The
study was conducted to find the effectiveness of calisthenic exercises on
stress among nursing students. Calisthenic exercises which stimulate the
brain function through physical activity and reduce the mental stress. So
the investigator concluded that the calisthenic exercises are an
appropriate method to reduce the stress.

82
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 ANNEXURE-1

Letter Requesting Expert Opinion to Establish Content Validity

To

-------------------------------

………………………….

Subject: Request for expert opinion and suggestions to establish

content validity of the research tool.

Respected Madam /Sir,

This is for your kind information that I Ms. Ridhima, M.Sc. Nursing Student Mental Health
(Psychiatric) Nursing, Desh Bhagat University, Mandi Gobindgarh has undertaken a research study on
the topic for " A study to assess the effectiveness of calisthenic exercises in reducing stress
among nursing students in Desh Bhagat University, School of Nursing at District Fatehgarh
Sahib”
Here with, I have enclosed
1) Problem statement and Objectives of the study
2) Demographic Profile
3) Perceived Stress Scale (PSS)
I request you to give valuable suggestions regarding appropriateness of the items in
terms of content, language and accuracy. Kindly oblige me with your opinion and
comments. I humbly request you to kindly return the paper at your earliest
convenience.

Thank You & Regards

Ms. Ridhima
M.Sc. Nursing II year
Mental health (Psychiatric) Nursing
Desh Bhagat University
Mandi Gobindgarh
 CERTIFICATE OF VALIDATION

TO WHOM IT MAY CONCERN

I ------------------------------ designation-------------------- department of ----------------------------

hereby certify that Ms. Ridhima, M.Sc. Nursing student Mental Health (Psychiatric) Nursing,

Desh Bhagat University, Mandi Gobindgarh has undertaken a research study on the topic. for “A

study to assess the effectiveness of calisthenic exercises in reducing stress among nursing

students in Desh Bhagat University, School of Nursing at District Fatehgarh Sahib”

It can be used by the researcher. I have thoroughly studied the tool and validate it.

Signature of Validator:

Name:

Designation:
ANNEXURE-2
ANNEXURE -3
 ANNEXURE -4

Letter seeking informed consent from the participant

I ………………………………………M/O, T/O …………………………………….

Hereby giving the consent to participate in the study entitled is " A study to assess the effectiveness of
calisthenic exercises in reducing stress among nursing students in Desh Bhagat University, School
of Nursing at District Fatehgarh Sahib”." for the benefit of science only. The general purpose has
been explained to me. However, I can opt out of the study at any part of time without asking the reason
and will not be affected by my discussion of not participating in the study. Your confidentiality of data
will be maintained.

Name and signature of Participant

…………………………………..

………………………………….

Name and signature of Investigator

……………………….……….

…………………………………

Name and signature of Guide with Date

…………………………………………

………………………………………….
 INTERVIEW ON A STUDY TO ASSESS THE EFFECTIVENESS OF CALISTHENIC
EXERCISES IN REDUCING STRESS AMONG NURSING STUDENTS IN SCHOOL OF NURSING

(SOCIO DEMOGRAPHIC VARIABLES) - PART-1

Instructions SAMPLE NO:

DATE:
This section deals with back ground issues and the level of stress among nursing
students through the interview schedule will pose questions listed below and
place a tick mark (□) in check box against correct response given by the
respondent.
1) Age in years
a ) 17-18yrs □
b) 19-20yrs □
c) 21-22yrs □
2) Basic Education
a) + 2 □
b) Graduate □
3) Religion
a)Hindu □
b) Muslim □
c) Christian □
d) Others □
4) Year of study
a) I Year □
b) II Year □
5) Occupation of parents
a)Government □
b) Private □
c) Business □
d) Others □
6) Monthly income
a) Below 10,000 □
b) 10,000 - 15,000 □
c) 15,000 - 20,000 □
d) Above 20,000 □
7) Medium of the instruction in higher secondary education
a) Hindi □
b) English □
8) Percentage of marks obtained in higher secondary
a) 70-80 percent
b) 80-90 percent
c) Above 90
9) Types of family
a) Nuclear
b) Joint
c) Extended
10) Residence
a) Rural
b) Urban
c) Semi urban
11) Any problems in the family
a) Nil
b) Financial problem
c) Others (specify) _
12) Average study time per day
a) <1 hours □
b) 1-2 hours □
c) >2 hours □
13) Leisure activities carried out in a day
a) Exercise □
b) Gardening □
c) Playing □
d) Watching T.V □
e) If any other ……………………………… (Specify) □
 Perceived Stress Scale

A more precise measure of personal stress can be determined by using a variety of instruments that
have been designed to help measure individual stress levels. The first of these is called the Perceived
Stress Scale.

The Perceived Stress Scale (PSS) is a classic stress assessment instrument. The tool, while originally
developed in 1983, remains a popular choice for helping us understand how different situations affect
our feelings and our perceived stress. The questions in this scale ask about your feelings and thoughts
during the last month. In each case, you will be asked to indicate how often you felt or thought a certain
way. Although some of the questions are similar, there are differences between them and you should
treat each one as a separate question. The best approach is to answer fairly quickly. That is, don’t try to
count up the number of times you felt a particular way; rather indicate the alternative that seems like
a reasonable estimate.

For each question choose from the following alternatives:

0 - never 1 - almost never 2 - sometimes 3 - fairly often 4 - very often

l. In the last month, how often have you been upset because of something that
happened unexpectedly?

2. In the last month, how often have you felt that you were unable to control the
important things in your life?

3. In the last month, how often have you felt nervous and stressed?

4. In the last month, how often have you felt confident about your ability to handle
your personal problems?

5. In the last month, how often have you felt that things were going your way?

6. In the last month, how often have you found that you could not cope with
all the things that you had to do?

7. In the last month, how often have you been able to control irritations in
your life?

8. In the last month, how often have you felt that you were on top of things?

9. In the last month, how often have you been angered because of things that
happened that were outside of your control?

10. In the last month, how often have you felt difficulties were piling up so high that
you could not overcome them?
Figuring Your PSS Score
You can determine your PSS score by following these directions:

• First, reverse your scores for questions 4, 5, 7, and 8. On these 4 questions, change the scores like
this:
0 = 4, 1 = 3, 2 = 2, 3 = 1, 4 = 0.

• Now add up your scores for each item to get a total. My total score is .

• Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived
stress.
► Scores ranging from 0-13 would be considered low stress.
► Scores ranging from 14-26 would be considered moderate stress.
► Scores ranging from 27-40 would be considered high perceived stress.

The Perceived Stress Scale is interesting and important because your perception of what is happening
in your life is most important. Consider the idea that two individuals could have the exact same events
and experiences in their lives for the past month. Depending on their perception, total score could put
one of those individuals in the low stress category and the total score could put the second person in
the high stress category.

Disclaimer: The scores on the following self-assessment do not reflect any particular diagnosis or course of treatment.
They are meant as a tool to help assess your level of stress. If you have any further concerns about your current well
being, you may contact EAP and talk confidentially to one of our specialists.

EAP
State of New Hampshire
Employee Assistance Program
 CALISTHENIC EXERCISES

INTRODUCTION
Calisthenics exercises consisting of a variety of gross motor movements
running, standing, grasping, pushing, etc. Calisthenic are aerobic and dynamic
exercises performed rhythmically and with minimal equipment. divided into aerobic and
anaerobic exercises They are intended to increase body strength, body fitness, and
flexibility, through movements calisthenics can provide the benefits
of muscular and aerobic conditioning, in addition to improving psychomotor
skills such as balance, agility and coordination. Calisthenics also consider as
"movement through space" which means you can move freely without any restriction
blocking your full strength. Calisthenics also a part in physical education in primary
and secondary schools.
MEANING
The word calisthenics derived from the Greek words kallos which means
perfect or good or beauty (pleasure due to body perfection) and sthenos which means
strength (great mental strength, courage, strength and determination).
HISTORY OF CALISTHENICS
Calisthenics originated in ancient Greece. Art of calisthenics passed from the
Greeks to romans.527 BC shaolin monks are the first group of warriors to use this
exercise to increase mental and physical performance. In nineteenth century Germans
popularized this exercise in gymnastics.
Calisthenics were intended solely for women, quickly became for both sexes.
Health benefits of this exercises recognized beginning of twenty century.
BENEFITS OF CALISTHENIC EXERCISES
PHYSICAL BENEFITS OF CALISTHENIC EXERCISES

 Build muscle and bone strength

 Increase flexibility and burn fat
 Increasing endurance
 Promotes life longer
 Improves the ability of daily activities
  Improves the mental health and mood
 Reducing the risk of type 2 diabetes
 Reduction of cardiovascular disease
 Maintain body weight
 Exercise boosts energy
 Promotes better sleep
 Reduces Fatigue
MENTAL AND EMOTIONAL BENEFITS OF CALISTHENIC EXERCISES
 Increased production of endorphins
 increases resilience to stress
 Sharper the memory and thinking
 Increase the sense of self worth
 Higher the self esteem
 Regulate and promote sleep
 Boost up the immune system and reduce the impact of stress
 Stronger resilience
 Improve concentration, motivation, memory, and mood
 Alleviate the symptoms anxiety and depression
 Increases pain tolerance
COGNITIVE BENEFITS OF CALISTHENIC EXERCISE
 improves executive functions
 Increasing focus and attention
 Promotes cognitive flexibility
 exercise in one path it can increases the willpower
 helps in control your emotions
 makes think faster
 helps in battle the depression
 Improves Academic Performance
ADVANTAGES OF CALISTHENICS EXERCISES
 Calisthenic exercises doesn’t require any special equipment
 Calisthenics exercises it can be performed anywhere and anytime
 It can be performed by everyone regardless of age
 Anyone can perform this form of exercise free of cost

KIND OF CALISTHENIC EXERCISES

1. JUMPING JACKS

2. NECK ROLLS

,
3. FREE HAND NECK RESISTANCE

4. ARM CIRCLES
5. ALTERNATING TOE TOUCHES

6. TRUNK TWISTS
7. ABDUCTOR/ADDUCTOR LEG RAISE
 8. PRONE LEG EXTENSION

9. STANDING ONE LEGGED TOE RAISE

 ANNEXURE-5
LIST OF FORMULAS USED FOR ANALYSIS

1. Mean:

A =arithmetic mean
n = the number of terms (e.g., the number of items or numbers being
averaged)
x1 = the value of each individual item in the list of numbers being
averaged.

2. Median

1(
n+1)th value
2
3. Standard Deviation:

Were,
S= Standard deviation
X=Individual observation
Mean of x
N= Number of items.

4. Chi square test

Where,- O is observed frequency

- E is expected frequency
- Df- degree of freedom

5. Karl Pearson’s correlation