dissertation presentation viva during final year M.Sc. Nursing.

1. SDM INSTITUTE OF NURSING SCIENCES
SATTUR; DHARWAD -580009
DESSERTATION PRESENTATION
Under the guidance of,
Mr. Ananda Kudari.
Associate Professor & HOD
Dept. of Medical and Surgical
Nursing
Mr. Nagesh V.A.
Asst. Professor & HOD
Dept. of Mental Health Nursing
SDMIONS
By
Mr. Chetan. R. S
2nd Year MSc[N].
Department Of Medical
Surgical Nursing
SDMIONS.

2. Outline:
• Problem statement
• Introduction
• Need for the study
• Objectives
• Hypothesis
• Assumptions
• Review of literature
• Methodology
• Analysis &Interpretation of data
• Discussion
• Summary
• Conclusion

3. STATEMENT OF THE PROBLEM
“A STUDY TO EVALUATE THE
EFFECTIVENESS OF ART THERAPY ON
SYMPOMTOMS OF BURNOUT SYNDROME
AMONG STAFF NURSES AT SELECTED ICU’S
AT SDM HOSPITAL DHARWAD”

4. INTRODUCTION
• Burnout is a state of chronic stress that leads to
physical and emotional, exhaustion, cynicism,
detachment, feelings of ineffectiveness and lack of
accomplishment.
• Burnout is unfortunately one of the challenges that
many nurses in different parts of the world are facing.
Number of nurses leaving the profession due to
occupational stress and inability to provide good
quality care.

5. NEED FOR THE STUDY
• Many researchers have indicated that burnout syndrome is quite common
among doctors and nurses. the prevalence of burnout syndrome among
nurses differs from unit to unit of their work Burnout syndrome is common
among certain professions which require high commitment, motivation and
require high standards of behavior idealistic dedication to their jobs, like
social workers and health care workers.
• Art therapy is a creative method of a therapeutic technique originated in the
fields of art and mind therapy which focuses on individual treatment goals
with the aim of development, stabilization, or acceptance on emotional,
cognitive, social, or physical level in the patient.

6. OBJECTIVES OF THE STUDY
 Objectives of the study are to,
• assess the symptoms of burnout syndrome among staff
nurses.
• evaluate the effectiveness of art therapy on symptoms of
burn out syndrome.
• find out the association between pre-test symptoms of
burnout syndrome score among staff nurses and selected
socio demographic variables.

7. OPERATIONAL DEFINITIONS
• EVALUATE: in the study evaluate refers to the
process of identifying the changes in symptoms of
burnout syndrome after an art therapy among staff
nurses.
• EFFECTIVENESS: in this study effectiveness refers
to positive changes as evidenced by reduction in the
symptoms of burn out syndrome of nurses after
implementation of an art activity.
• ART THERAPY OR ACTIVITIES : in this study
art therapy refers to activities to assist the staff
nurses working in ICUs, tertiary level hospital with
drawing, painting, crafting, and paper cutting in their
free time, either in the hospital or may be at home for
reduction of symptoms of burnout syndrome.

8. • SYMPTOMES OF BURNOUT SYNDROME:
refers to physical symptoms like- tired, sick,
headache, emotional symptoms like-sense of failure,
self-doubt, feeling alone and behavioural symptoms
like- withdrawal from responsibility, isolation from
others which will be measured by Modified Maslach
burnout inventory scale on staff nurses .

9. • STAFF NURSES: refers to the registered
nurses who are presently working in ICUs of
tertiary level teaching hospital.
• SELECTED ICU’S: the intensive care unit is
a designated area of a hospital facility that is
dedicated to the care of patients who are
seriously ill.

10. HYPOTHESES
• Hypotheses is tested at 0.05 level of significance
• H1: The mean post test score of staff nurses on
burn out symptoms is significantly lower than the
pre-test score.
• H2- There is a significant association between
pre-test symptoms of burnout of staff nurses and
selected socio demographic variable.

11. ASSUMPTIONS:
• Researcher was assumed that
• Nurses working in ICUs may experience symptoms
of burnout syndrome.
• Quality of patient care will be affected due to
symptoms of burn out syndrome.
• Art therapy will helps the staff nurses to reduce
symptoms of burnout syndrome.

12. CONCEPTUAL FRAMEWORK
• THE ROY’S ADAPTATION MODEL IS USED
FOR THE STUDY

13. REVIEW OF LITRATURE
 Review of literatures related to,
• incidence and prevalence of burnout syndrome
among health care workers
• incidence and prevalence of burnout syndrome
among staff nurses
• uses of art therapy on patient
• uses of art therapy on staff nurses

14. RESEARCH METHODOLOGY
• Research Approach : quantitative evaluative
approach
• Research Design : Pre –experimental with
single group pre-test and post-test research design
• Variables under the study:
 Independent variables: Art Therapy
 Dependent variables: symptoms of burnout
syndrome of staff nurses.
• Research Setting : Selected ICUs of SDM
Hospital Dharwad.

15. • Population : staff nurses who are working in ICUs
of SDM Hospital Dharwad.
• Sample selection size : 40
• Target population: staff nurses who are working in ICUs
at SDM Hospital Dharwad.
• Sample: staff nurses who are presently working in ICUs
of SDM Hospital Dharwad.
• Sampling techniques :non –probability convenience
sampling technique

16. • Inclusion criteria:
 In this present study inclusion criteria are the
staff nurses, who are,
• working in ICUs of SDM Hospital Dharwad.
• willing to participate in the study.
• interested in art therapy.
• available and present at the time of data collection.
 Exclusion criteria:
In this present study exclusion criteria are the
staff nurses who
• does not have time to participate in the study.

17. • Tool description :In this study a Modified Maslach
burnout inventory Scale (MMBI) was used to assess
the level of burnout symptoms on staff nurses
working in the ICU’s.
• There are four alternative response columns; for
each question like
• never [0].
• A few times per month[1],
• A few times per week[2],
• Every day[3].
• Among 21-items all 21were positively word enhance
scored as;0,1,2,and3respectively.

18. CONTENT VALIDITY
• Content was given to five experts from the
Medical Surgical Nursing Department;
• One is from psychiatrist and statistician.
• The final tool was prepared as per the suggestions
& advices given by the experts.
• There was 100% agreement by all experts on all
the items.

19. RELIABILITY OF THE TOOL
• The reliability of the tool was established by using test –
retest method. (Karl Pearson co- efficient of correlation
method)
• The reliability coefficient “r” value of modified Maslach
burnout inventory scale regarding assessment of symptoms
of burnout syndrome with interventions of ART Therapy
was 0.896 and developed tool found to be reliable.

20. PILOT STUDY
• The Pilot study was conducted in SDMCMS & Hospital Dharwad.
The period of data collection was 6 days between 20th December
2018 to 26th December 2018 .Formal permission was obtained from
the authorities and purpose of the study was explained to the
subjects and confidentiality was assured.
• STEPS FOLLOWED IN DATA COLLECTION PROCESS:
• Subject are collected according to the selection criteria and assured
the confidentiality of the sample
• Written consent was obtained from subjects to participate in the
study
• Samples are selected by non-probability convenient sampling
technique

21. • On the first day, pre-test was done for the group
with Maslach burnout inventory Scale
• On the same day Art therapy was administered to
the group and same procedure has fallowed every
alternative days till 6 days with the same scale.
• The data collection procedure carried out by the
researcher.

22. • DATA COLLECTION METHOD:
The study was conducted in SDMCMS &
Hospital Dharwad.
• The period of data collection fifteen days between
5th March 2019 to 19th March 2019 and prior to
data collection permission was obtained from the
concerned authorities.

23. PLAN FOR DATAANALYSIS:
• Collated data was organized as fallow.
• Organized data in master sheet.
• Computed frequency and percentage to be used for
analysis of baseline data.
• Mean and standard deviation for the obtained score
were calculated.
• Paired “t” test was used to evaluate the effective role of
Art therapy on symptoms of burnout syndrome among
ICU’S staff nurses.
• Yeats correction for chi-square (X2) test was used to
find out the association between level of symptoms of
burnout syndrome score and Selected demographic
variables.

24. RESULT AND ANALYSIS
• SECTION I: frequency and percentage distribution
of subjects according to the demographic variables.
N=40
SL.N
o Demographic
Variables
Frequency Percentag
e
01
Age in years
a. 20-30
b. 31-40
c. 41-50
d. Above 50
24
15
1
00
60
37.5
2.5
00
02
Gender
a. Male
b. Female
10
30
25
75

25. 4 Marital status
a. Married
b. Unmarried
c. Widow
d. Widower
e. Separated
17
23
00
00
00
42.5
57.5
00
00
00
5 Type of family
a. Nuclear
b. joint
c. Extended
d. Others
33
7
00
00
82.5
17.5
00
00
6
Highest educational
level in nursing
a. GNM( N)
b. Basic
B.Sc. ( N)
c. Post Basic
B.Sc. (N)
d. M.Sc. (N)
36
3
1
00
90
7.5
2.5
00

26. 7 Critical care nursing
experience (in year)
a. < 1
b. 1-2
c. 3-4
d. 5-6
e. Above 6
3
13
10
9
5
7.5
32.5
25
22.5
12.5
8 Present working
area of the nurse
a. SICU
b. MICU
c. RICU
d. NSICU
7
13
9
11
17.5
32.5
22.5
27.5
9 Present shift of
working
a. 8am to 2pm
(Morning shift)
b. 2pm to
8pm(Afternoon
shift)
c. 8pm to 8am (Night
Shift)
d. 8am to 5 pm
(Substitute shift)
15
11
11
3
37.5
27.5
27.5
7.5

27. Figure: 04. Bar diagram shows that percentage distribution
of subjects according to their age (in years)
N=40
20-30
31-40
41-50
ABOVE-50
60%
37.50%
2.50%
0%

28. Figure: 05. Pie diagram depicts that percentage distribution
of subjects according to their Gender
N=40
GENDER

29. Figure: 06. Bar diagram shows that percentage
distribution of subjects according to their Religion.
N=40
87.50%
12.50%
0% 0%

30. Figure: 07. Clustered cone diagram shows that
percentage distribution of subjects according to their
marital status
N=40
MARRIED UNMARRIED WIDOW WIDOWER SEPARATED
42.50%
57.50%
0% 0% 0%

31. Figure: 08. Clustered pyramid depicts that percentage
distribution of subjects according to their type of family
N=40
NUCLEAR JOINT EXTENDED OTHERS
82.50%
17.50%
0% 0%
TYPE OF FAMILY

32. Figure: 09. Cylindrical diagram shows that distribution of
subjects according to their highest educational level in
nursing
N=40
GNM(N) BASIC B.Sc (N) POST BASIC
B.Sc(N)
M.Sc (N)
90%
7.50%
2.50%
0%
HIGHEST EDUCATIONAL LEVEL IN NURSING

33. Figure: 10. Pie diagram shows that percentage distribution of subjects
according to critical care nursing experience (in years)
N=40
LESS THEN 1
7.5%
1-2 YEARS
32.5%
3-4 YEARS
25%
5-6 YEARS
22.5%
ABOVE-6
12.5%
CRTICAL CARE NURSING EXPERIENCE (IN YEARS)

34. Figure: 11. Cylindrical diagram depicts that percentage
distribution of subjects according to their present working
area of the nurse
N=40
SICU MICU RICU NSICU
17.50%
32.50%
22.50%
27.50%
PRESENT WORKING AREA OF THE NURSE

35. Figure: 12. Pie diagram shows that percentage distribution of
subjects according to their present shift working
N=40
8am -2pm
38%
2pm-8pm
27%
8pm-8am
27%
8am-5pm
8%
PRESENT SHIFT OF WORKING

36. SECTION II: Pre-test level of symptoms of burnout syndrome
score of staff nurses.
Table -2
• Frequency and percentage distribution of subjects by pre-test levels of
Symptoms of burnout syndrome
N=40
Level of symptoms of burnout
syndrome
Frequency Percentage
No Burnout 00 00.00
Low level of burnout 00 00.00
Moderate level of burnout 01 2.5
High level of burnout 39 97.5
TOTAL
40 100

37. Figure13. Cylindrical diagram shows that Pre-test level of symptoms of
burnout syndrome scores of staff nurses
N=40
No burnout Low level of burnout Modrate level of
burnout
High level of burnout
0% 0%
2.50%
97.50%

38. Section III
Post-test level of symptoms of burnout syndrome score of nurses
Table -3
Frequency and percentage distribution of subjects by post-test levels of Symptoms
of burnout syndrome
N=40
Level of symptoms of burnout syndrome Frequency Percentage
No Burnout 00 00.00
Low level of burnout 00 00.00
Moderate level of burnout 40 100
High level of burnout 00 00.00
TOTAL 40 100

39. Figure14. Cylindrical diagram shows that Post-test level of
symptoms of burnout syndrome scores of staff nurses
N=40
No burnout Low level of burnout Modrate level of burnout High level of burnout
0% 0%
100%
0%
POST- TEST LEVEL OF SYMPTOMS OF BURNOUT SYNDROME SCORE OF STAFF NURSES

40. Section IV
Comparison of mean pre-test and post test level of symptoms of burnout syndrome score
Table- 04
Comparison of mean pre-test and post test level of symptoms of burnout syndrome score
[n=40]
Level of symptoms of
burnout syndrome
Mean Standard
deviation
Degree of
freedom
‘P’ valve Calculated ‘t’
value
Table value
Pre-test 54.55 4.67 39
0.0002 4.06 2.97
Post-test 34.12 1.88 39

41. Figure: 15.Pie diagram shows that Comparison of mean pre-test and post-
test level of symptoms of burnout syndrome score.
N=40
Pre-test
62%
Post-test
38%
COMPARISON OF PRE AND POST-TEST LEVEL OF SYMPTOMS OF BURNOUT SYNDROME SCORE OF STAFF
NURSES

42. • Section V: Association between pre test symptoms of
burnout syndrome of staff nurses and selected socio-
demographical data
Table -05
• Association between pre-test symptoms of burnout
syndrome score and selected Socio-Demographic
variables.

43. • Table No05: Revealed that the analysis and interpretation of
data using descriptive and inferential statistics and chi-squared
were calculated to find out the association between the
demographic variables and level of symptoms of burnout
syndrome. There was a non-significant association among the
variables like age, gender, religion, and marital status and type
of family, Critical care nursing experience. There is significant
association between the Highest educational level in nursing,
Present working area of nurses, Present shift of working

44.  Major findings of the study:
• Findings related to the personal demographic
variables
• Assess the symptoms of burnout syndrome among
staff nurses.
• Evaluate the effectiveness of art therapy on symptoms
of burn out syndrome.
• Find out the association between pre-test symptoms
of burnout syndrome score among staff nurses and
selected socio demographic variables.

45. CONCLUSION
• Based on the findings of the study the following conclusions are drown,
• The results of the study indicated that in pre-test
39 (97.5%) of the subject had moderate level of
symptoms of burnout and 1(2.5%) had high level
of symptoms of burnout. In pre-test the mean
symptoms of burnout syndrome score was ±54.55
and SD was± 4.67 whereas the mean post-test
score was ±34.12 and SD was ±1.88. The
calculated ‘t’ value was ±4.06 which was higher
than the table value i.e. 2.97 which was
significant at p ≤ 0.05 (0.0002 ≤ 0.05) level.
Hence the research hypothesis was accepted.

46. SUMMARY
• The aim of the present study is to evaluate the effectiveness of art therapy on
symptoms of burnout syndrome among staff nurses at selected ICUs at SDM SDM
Hospital Dharwad.
• The objectives of the study was fulfilled
• The hypothesis were achieved
• The tool used for the study was Modified Maslach burnout inventory Scale for
Assessment of level of symptoms of burnout syndrome. The tool was validated by
07 experts and their suggestions were incorporated.
• The quantitative evaluative approach with pre experimental one group pre and post-
test research design was utilized to achieve overall comprehensive purpose with a
sample size of 40 by using non-probability convenience sampling technique.

47. IMPLICATION OF THE STUDY
Nursing Practice
• The findings of this study helps to plan, organize,
develop and utilize various types of ART therapy
techniques like paintaning ,crafting ,paper cutting
drawing in nursing service setting, which helps in
diverting mind of the staff nurses and can helps in
comprehensive nursing care to the patient.
• Skillful and artistic nurses can teach the patients
and relatives about the uses and advantages of an
ART therapy in patient care.

48. Nursing Administration
• Nurse Administrator can organize and conduct
seminar, workshop, guest lecturer to make a staff
nurses aware about ART therapy and its uses.
• It also helps the nurse administrator to plan for
manpower, money, materials, methods and time to
conduct successful education programme regarding
art therapy

49. Nursing Education
• The nurse educator can utilize the findings of the study
in developing the material related to ART therapy to
health care workers, nurses to teach patients, family and
student Nurse.
• Nurse Educator can organize educational programme
regarding ART therapy to promote the positive working
capacity and promote comprehensive care outcome of
the patient in the Hospital and in the educational set up
• Continue Nurse Education for the staff nurses must
include the techniques and uses of ART therapy in order
to update their knowledge regarding reduction of
symptoms of burnout syndrome.

50. Nursing Research
• The nurse researcher can include evidence based
practice in nursing field.
• Nurse Researcher can utilize the methodology in
further research.
• This study as valuable reference material for future
investigators
• Research should focus on improving level of
knowledge regarding ART therapy and prevention of
burnout syndrome among staff nurses.

51. Recommendations:
• The similar study can be conducted in larger
sample
• A study can be undertaken by utilizing other
domains like practice and comparative study.
• A similar study can be conducted in
different settings to find out the significant
difference.
• The same can be conducted with an experimental
research approach having a control group.
• The similar study can be conducted by using
different type of ART therapy.

52. REFERENCES
• Books - 02
• Journals and inter- net - 68
• Total reference - 80

53. •THANK YOU