“A STUDY TO ASSESS THE EFFECTIVENESS OF NEEM TEA ON HIGH BLOOD PRESSURE AMONG
MIDDLE AGED GROUP IN
SELECTED AREA OF
RAICHUR”.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
ANSA.M.PAULOSE
NAVODAYA COLLEGE OF NURSING,RAICHUR
DECEMBER 2011
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
- Name of the candidate : Miss.Ansa.M.Paulose
And Address M.Sc Nursing 1st Year,
Navodaya College of Nursing
Mantralayam Road,
Raichur – 584103.
- Name of the Institution: Navodaya College of Nursing,
Raichur
- Course of study : M.Sc Nursing 1st Year
And subject Medical Surgical Nursing
- Date of admission in to: 04-07-2011
The course
- Title of the Topic:
“A STUDY TO ASSESS THE EFFECTIVENESS OF NEEM TEA
ON HIGH BLOOD PRESSURE AMONG
MIDDLE AGED GROUP IN
SELECTED AREA OF
RAICHUR’’
- BRIEF RESUME OF THE INTENDED WORK
‘’The Thousand Mysteries Around Us Would Not Trouble But Interest Us, If Only We Have Cheerful Healthy Heart.’’
6.1. NEED FOR THE STUDY;-
Hypertension is one of the leading causes of death in the world. It is an important risk factor for cardiovascular diseases. It shows increasing risk of stroke, myocardial infarction, death and all cause mortality associated with bloodpressure.1
Normal blood pressure is 120/80mm of Hg.The first figure is the systolic blood pressure, the pressure there is in the arteries when the heart is contracting. The second or lower figure is the diastolic blood pressure, which is the pressure in arteries between heart beats. High blood pressure is anything above 140/90mm of Hg.2
Hypertension is mainly primary hypertension and secondary hypertension. Hypertension is sometimes called ‘’silent killer ‘because people who have it are often symptoms free. In a national survey conducted from 2003 to 2004.50% people who had pressure exceeding 140/90 mm of Hg were unaware of their elevated blood pressure once identified ,elevated blood pressure should be monitored at regular intervals because hypertension is a lifelong condition.3
The causes of hypertension are different. One cause is age. The systolic blood pressure rises progressively with increasing age. Excessive alcohol intake is strongly associated with hypertension. Smoking greatly increases the risk of cardiovascular disease. It is more common in diabetics. When hypertension and diabetes coexist complications (Eg; target organ diseases)are more severe. History of a close blood relative (Eg; parents, sibling) with hypertension is associated with an increased risk for developing hypertension. Weight gain is associated with increased frequency of hypertension. The risk is greatest with central abdominal obesity. Incidence of hypertension is twice as high in African Americans as in whites.4
Regular physical activity can help control weight and reduce cardiovascular risk .Physical activity may decrease blood pressure. Hypertension is more prevalent in lower socio economic group and among the less educated people exposed to reaped stress may develophypertension may respond difficulty to stress than those who do not develop hypertension.5
About 31 percentages of the adults inthe UnitedStates have hypertension. In the total US population of person with hypertension.90 percentage to 95 percentages have primary hypertension, high blood pressure from an unidentified cause. The remaining 5 percentage to 10 percentage of this group have secondary hypertension6.
In the year 2000 it is estimated that nearly two billion people or 52 percentage of the adult population had hypertension in world wide. It is common in both developed (333million) and undeveloped (639 million) countries. In 1995 it is estimated that 43 million people in the united state had hypertension. In the year 2002 it is estimated that nearly 1.5 million people of adult population had hypertension in India. Dietary and life style changes can improve blood pressure control and decrease the risk of associated heath complications.7
Neem has been useful in controlling blood pressure. Neem leaves are used to cure hypertension and as a result of many research and clinical tests conducted the efficiency of the wonder tree has been provide interacting the disease.AZADIRACHTA INDICA (Neem) is a tree in the mahogany family Meliaceae.It is one of two species in the genus AZADIRACHLA, and is native to India growing in tropical and semi-tropical regions. The scientific classification of Neem is:-
Kingdom:-Plantae
Division:-Magnoliophyla
Order:-Sapindales
Family:-Meliaceae
Genus:-Azadirachta
Species:-Azadirachta Indica8
Neem leaves are said to have antihistamine effect, which may be a reason for the blood vessels to dilate and thus reduce the blood pressure. It has also been scientifically tested as a point use for producing efficient drugs useful in controlling cholesterol level. Blood clot sand heart irregularies.9
The Investigator has observed many middle aged group between 35-55 years who have high blood pressure. Hence the Investigator felt the need to assess the effectiveness of Neem tea in reducing the level of high blood pressure among them.
6.2REVIEW OF LITERATURE
Review of literature familiarizes the Investigator with previous investigation related to one’s field of interest and various method and procedures which can be pursed .It helps the investigator to find the date that could be used for supportive present findings and drawing conclusions.
AnExperimental study was conducted in Maiduguri Nigeria under the leadership ofhealth system of the country on theeffectiveness of Neem leaves among hypertensive patients. By a sample of 10 patients randomly assigned to 10 days on hypertensive patients without medication. They were asked to take Neem leaves (2) in the early morning on empty stomach. The Neem leaves significantly reduced hypertension. The hypertension were reduced by 26.3 percentage10
An Experimentalstudy was conducted in Annamalainagar Tamil Nadu India (Bharathidhasan University) on the effectiveness of Neem leaves among hypertensive patients. It was carried out on 60 middle aged group inclucled both sex. The relevant information was collected by assessing blood pressure levels. Statistical analysis was done using levels, chi – square etc. The results shown that the blood pressure levels were reduced by 36.8 percentage within one month. The study concluded that various factors found associated with hypertension were salt diet, low socio economic data.11
A community based cross-sectional study was conducted to reduce the level of blood pressure among middle aged group with the effectiveness of Neem leaves in urban slum area of Bangalore.This study was conducted under the secondary heath department of Bangalore. It was carried out on 40 samples between the age group of 30 to 40 years. The result shown significant changes after implementation of Neem tea.12
AnExperimental study was conducted by Australian Medigree of health sciences to assess the effectiveness of readymade Neem tea powder in the form of herbal tea among high blood pressure patients in Australia. A sample of 40 subjects were randomly assigned into two groups,(experimental and control group).Theresults reported that experimental group reduced their blood pressure levels by 27.8 percentages The study concluded that Neem tea was effectiveness in reducing the blood pressure levels among experimental group.13
Astudy was conducted in Uttaranchal to reduce the level of blood pressure with the effectiveness of Neem tea powder. This study was carried out on 45 members who were hypertensive with blood pressure above 140/90 mm of Hg.It done on 2003 with the help of educational Committee.This study continued for 2 months.Pre test was done with questionnaire and blood pressures monitored and assessment ofdietary management pattern. The results shown a significant reduction in the levels of blood pressure among the members in experimental groups.14
6.3STATEMENT OF THE PROBLEM
“A study to assess the effectiveness of Neem tea on high blood pressure among middle aged group in selected area of Raichur’’
6.4OBJECTIVES OF THE STUDY
- To assess the levels of blood pressure among the middle aged group.
- To assess the effectiveness of Neem tea on high blood pressure among middle aged group.
- To associate the post intervention levels of blood pressure with the demographic variables of the middle aged group.
6.5OPERATIONAL DEFINITIONS
a)Effectiveness
Determining the extent to which the Neem tea has reduced the blood pressure.
b)Neem Tea
Neem leaves are said to have antihistamine effect, which may be a reason for the blood vessels to dilate and thus reduce the blood pressure. Neem tea is the tea prepared by 2-3 fresh leaves of Neem added in a cup of hot water with added sugar candy if needed.
c) High blood pressure
High blood pressure is a cardiac chronic medical condition. High blood pressure anything above 140/90 mm of hg
c)Middle aged group
It refers to persons between the age group of 35-55years, who are hypertensive.
6.6HYPOTHESIS
On the basis of the objectives, the following hypotheses have been formulated.
H1; There will be a significant difference in the levels of blood pressure among middle aged group before and after the intervention.
H2; There will be a significant association between the post intervention levels of blood pressure and selected socio demographic variables.
7.MATERIALS AND METHODS
7.1. SOURCE OF DATA
Research Design
One group pre test, post test research design will be adapted for the study.
O1XO2
O1: pre test for assessing the levels of blood pressure among middle aged group.
X: Intervention, Neem leaves in the form of Tea
O2: post test for assessing the level of blood pressure among middle aged group.
Setting of the study: Research setting refers to the physical location and condition in which the data collection takes place.
The present study will be conducted in Zaheerabad area of Raichur, where Raichur is one of the backward districts situated in northern part of Karnataka. It has an area of 60 sq. Km and it consists of 5 towns and 300 villages. The total population of Raichur is 2, 32,456 with 35 revenue wards and 8 election wards.
Population
The population for the present study will be comprised of middle aged group within the age group of 35-55 years residing in Zaheerabad area.
Sample and sample size
The sample size is 30 hypertensive patients who are residing in Zaheerabad area.
Sampling technique
Convenient sampling technique will be used to select the area and the purposive sampling technique will be used to select the sample.
Inclusion criteria
The study includes the middle aged groups who are:-
- in between 35-55 years
- residing in Zaheerabad area of Raichur
- available at the time of data collection
- willing to participate in the study
Exclusion criteria
The study excludes the middle aged group who are not;-
- in between35-55 years
- residing in Zaheerabad are of Raichur
- available at the time of data collection
- willing to participate in the study
Selected variables
Dependent variables: Levels of blood pressure of middle aged group.
Independent variables:Neem tea
Extraneous variables
1. Age: It is categorized as
- 35 – 40 years
- 41 – 45years
- 46 – 50 years
- 51 – 55 years
2. Gender: It is categorized as
a. Male
b.Female
3. Religion:It is categorized as
a. Hindu
b.Muslim
c.Christian
4. Education:It is categorized as
a. Illiterate
b.Primary school
c.High school
d.PUC
e.Degree
f. Others
5.Diet:It is categorized as
a. Vegetarian
b.Mixed
6.Occupation:It is categorized as
a. Housewife
b.Agriculture
c.Coolie
d.Business
e.Private employee
f.Govt.employee
g.Others
7. Monthlyincome:It is categorized as
a. Less than 2500/-
b.Rs.2501/- -3500/-
c.Rs.3501/- -4500/-
d. Rs. 4501/- & above.
8.Type of family:It is categorized as
a. Nuclear family
b.Joint family
9.Presence of any hereditary disease in the family
a.Yes
b.No
If yes, specify………..
10. Personal history of any other disorders
a Yes
b.No
If yes, specify………..
11. Any modification of diet after the diagnosis of Hypertension
a. Yes
b.No
If yes, specify………..
7.2METHODS OF DATA COLLECTION
Data collection instrument
Data collection is the gathering of information from sample. The researcher will develop an instrument to collect the data
It consists of two parts namely:-
Part 1:-deals with socio demographic information.
Part 2:-it represents measurement of blood pressure
High blood pressure-Above – 160 /100 mm of Hg
Moderate blood pressure -140/90 – 160/100 mm of Hg
Low blood pressure-Less than 140/90 mm of Hg
Data collection method
After obtaining prior permission from concerned authority and consent from the subjects, 30samples with high blood pressure levels will be select
Data collection will be carried in 3 phases:-
First phase:-
Pre test will be done to assess the levels of blood pressureby sphygmomanometer among middle aged group.
Second phase:-
Neem tea will be given by the Investigator for middle aged group. The Neem leaves in the form of Neem tea will be given in early morning on empty stomach for 15 days by adding candy sugar (if needed) in 50ml of hot water.
Third stage:-
Post test will be done to assess the levelsof blood pressure among middle aged group.
7.3PLAN FOR DATA ANALYSIS
The data obtained from the sample will be organized and summarized with the help ofdescriptive statistics like frequency and percentages, mean and standard deviation. Inferential statistics like paired’ test will be used to evaluate the effectiveness of Neem tea on high blood pressure and chi square test will be used to know the association of post interventions levels of blood pressure with the demographic variables.
7.4PROJECTED OUTCOME
The result of the study through a light on effectiveness of Neem tea on high blood pressure among middle aged group. There by help the future researchers to know about the previous concept and statistics of hypertension and newer methods of interventions in reducing the high blood pressure levels.
7.5DOES THE STUDY REQUIRE ANY INTERVENTION ANY INVESTIGATION OR INTERVENTION?
Yes, the study requires intervention like implementation of Neem tea, where active involvement of middle aged who are having high blood pressure during session is needed.
7.6 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION?
- Permission will be obtained from Institutional Ethical Committee,Navodaya Education Trust, Raichur
- Permission will be obtained from the Research Committee, Navodaya College of Nursing, Raichur.
- Consent will be obtained from all participants.
8. LIST OF REFERENCES
- En.wikipedia org/wike/hypertension. From Wikipedia the free encyclopedia.
- Morris MC, Sacks F, RosherB (1995) Journal of human hypertension (88) S23-S33.
- BrunnerSuddarth’s Text book of Medical –Surgical Nursing, volume1, Tweleth edition 889-900.
- William J, Elliott (October 2003) the economic impact of hypertension. The journal of clinical hypertension 5(4) 3-13.
- Lewis’s Medical-Surgical Nursing, Assessment and Management of clinical problems.769-784.
- En.wikipedia.org/wiki/Azadirachtaindica,Medicine net.com.
- Thoh.M.et al.Azadirachta effects with high blood pressure –included level of high blood pressure. Journal of biological chemistry (2001) 285(8):5888-5895.
- Caldecott.Todd (2006) Ayurveda.The Divine science of life. Elsevier/Mosby contains a detailed study of effectiveness of Azadirachta indicia(Neem :nimbi) on hypertensive patients for health benefits and usage in clinical practice,301-314-Neem.
- Bhowmik,D.et al Herbal remedy of Azadirachtaindica on hypertension and AIDS, journal of chemical and pharmaceutical Research 2010 2(1)62-72.
- Puri H.S effect of Neem leaves on high blood pressure “Journal of pharmaceutical research” ( 2008) S13-S16.
- Conrick (2001)study of Azadirachta indicia on hereditary diseases(2001) 25:6:733-769.
9. Signature of the Candidate:
10. Remarks of the Guide :
11. Name and Designation of the
11.1 Guide : Ms. Annapoorna
Associate Professor & HOD
Medical and surgical
Nursing
Navodaya College of Nursing
Raichur.
11.2 Signature :
11.3 Co-guide (if any) :
11.4 Signature :
11.5 Head of the department : Ms. Annapoorna
Associate Professor & HOD
Medical surgical
Nursing
Navodaya College of Nursing
Raichur
11.6 Signature :
12. Remarks of the Chairman
And Principal :
12.1 Signature :