PSYCHO-SOCIALINTERVENTION PACKAGE ON SOCIAL ANXIETY AMONG NURSING STUDENTS”.

J. Anitha 1 and Dr. R. Rajkumar 2 . 1. Associate Professor, Billroth College of Nursing, Chennai, Tamil Nadu, Chennai. 2. Professor, Dept.of community medicine, MAHER, Enathur, Kancheepuram. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History


Objective:
To determine the effectiveness of psychosocial intervention package on social anxiety among nursing students .Method:Quasi experimental with time series design was adopted. The study was conducted at selected Nursing colleges, chennai. 200 samples using multistage sampling technique, which fulfilled the inclusive criteria, were included in this study. Social interaction scale (SIAS) was used for data collection. Results:The mean difference scores of social anxiety in the study group have reduced when compared with control group. The mean difference of scores between study and control group in post-test -1 and post-test2 shows highly significant with the 'value, t = 5.393 and t=12.754 respectively at p< 0.001. Conclusion:The study concluded that psychosocial intervention package had significant changes in the level of social anxiety among nursing students.

…………………………………………………………………………………………………….... Introduction:-
Nurses are a vital personality in health care setting. Nurses as interdisciplinary team member interacts with patients, families, communities, and the society they practice in. When social anxiety prevails among nurses and if there is no good professional adjustment, the quality of care is been compromised. Social anxiety is the most common anxiety disorder and the third most common psychiatric disorder, after major depressive disorder and alcohol dependence. Lifetime prevalence estimates for social anxiety vary greatly and range from 0.4 to 20.4% in different studies. Only few people with social anxiety seek professional help for its treatment, if it is left untreated, social anxiety is usually chronic, associated with significant functional impairment and high risk of other co morbid psychiatric disorders. Nurses should be able to develop therapeutic interaction with patients. This would be possible only when they are confident, concern for others and free of anxiety. The nurses need to be an excellent communicator in their profession in order to work effectively in their setting. Psychosocial interventions capitalize on psychological or social actions to produce change in psychological, social, biological, and functional outcomes. In the present study the investigator has structured the psychosocial intervention package with the light of literature review, cognitive behaviour therapy and expert guidance. The intervention measures are targeted to reduce social anxiety and satisfactory adjustment for nursing students.

Statement of The Problem:-
A quasi experimental study to evaluate the effectiveness of Psycho-social Intervention package on Social anxiety among the Students in selected Nursing Colleges, Chennai.
Objectives of The Study:-1. To assess the social anxiety among nursing students before and after the psychosocial social interventional package in the study and control group 2. To determine the effectiveness of psychosocial intervention package on social anxiety among nursing students. 3. To associate the mean difference level of social anxiety among nursing students in study group and control group with their selected demographic Null hypothesis:-NH=There is no significant difference in the level of pre-test and post-test level of social anxiety among nursing students in the study and control group Methodology:- Research Design:-Quasi Experimental study Pre-test and Post-test design was adopted for the study.
Variables of the study : Independent variable:-Psycho Social Intervention Package, Dependent variable-Social Anxiety and Demographic variables -Age, Gender, Year of study, Religion, No of siblings, Birth order, Medium of instruction at school, Board of study, habitant, history of mental illness in the family, Educational background (school studied), history of school discontinue, type of family, no of close friends, contended with physical appearance, fathers education, mothers education, fathers occupation, mothers occupation, fathers income, mothers income and nature of stay

Setting, Sample and Sampling technique:-
The study was conducted at various nursing colleges affiliated under Dr.Tamil Nadu MGR Medical University in Chennai. The total number of Nursing Colleges affiliated with the university located in Chennai and around region is 20. After the initial survey, considering the accessibility of setting, it was decided to include 8 nursing colleges in the study. Out of 8 colleges, 5 colleges were randomly allotted to study and 3 colleges were allotted to control group. All the colleges which provide basic B.Sc degree course, Total number of students studying in the above 8 college were 954 out of that 200students were surveyed and selected by group administered questionnaire. The samples that fulfilled the inclusive criteria were included in the study. Multistage sampling Technique was adopted for the study.

Data collection Instruments:-Part-A,Semi Structured questionnaire on Back ground Variables, Part-B, Social Interaction anxiety scale (SIAS)-
The SIAS is a standardized tool developed by R. P. Mattick& J. C. Clarke. It is a twenty-item measure on which the social anxiety respondent's rate their experiences in social situations associated with social Anxiety .Pilot study was conducted among 10 % of the population. The results of the pilot study revealed that the tool was reliable and the study was feasible. The reliability score was r=0.83 for Social interaction anxiety scale

Data Collection Procedure:-Step-I Pre interventional:-
The investigator received the Ethical committee approval from the institutional ethical committee. Formal written permission was obtained from the Principals of selected college of Nursing. The students were explained regarding the purpose and usefulness of the study. The investigator assured about the anonymity and confidentiality after, the brief introduction about the purpose of the study and after obtaining the informed consent, using the instrument SIAS as a screening tool the samples were selected. After screening the students score that fulfilled the inclusive criteria were selected for the study and this score was taken as a pre-test score.

758
Step Step III:-Post Intervention The post-test was carried out by the investigator at 2 and 4th month, with SIAS. At the end of the study the same interventions was carried out for the control group.

Results and Discussion:-
The findings of the present study revealed that in the below figure that shows the frequency and distribution of social anxiety in the study and control group. It showed in the study group there were significant changes in the score of social anxiety but not in the control group. The above figure shows that there is a reduction in the level of social anxiety in the study group where as in control group there is no changes.

759
The below graph 2.1 and 2.2 shows the comparision of social anxiety in the study group and control group. (2.1) Comparison of pre-test and post-tests level of social anxiety among Nursing students in the Study group.
The plot box shows a significant reduction in level of social anxiety in the study group.

Comparison of pre-test and post-tests level of social anxiety among Nursing students in the control group:-
. The above plot box shows no reduction in level of social anxiety in the control group.NH1:There is no significant difference in the level of pre-test and post-test level of social anxiety among nursing students in the study and control group, Hypothesis was rejected.

760
Major findings of the study:-1. The mean difference scores of social anxiety in the study group have reduced when compared with control group. The mean difference of scores between study and control group in post-test -1 and post-test2 shows highly significant with the 'value, t = 5.393 and t=12.754 respectively at p< 0.001. 2. In the study group, it was found there is a significant association with social anxiety and the selected demographic variables -medium of instruction, no of close friends, Nature of stay of the student. In the control group, it was found there is a significant association with social anxiety and selected demographic variables-year of study and type of family.

Conclusion:-
The study concluded that psychosocial intervention package had significant changes in the level of social anxiety among nursing students.