T.JOHN COLLEGE OF NURSING GOTTIGERE

BENNARGHATTA ROAD BANGALORE-83

SYNOPSISREGISTRATION OF SUBJECTS FOR DISSERTATION

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,KARNATAKA

PREPARED BYSAIRA ROY,1ST YEAR MSC NURSING,T. JOHN COLLEGE OF NURSING

GUIDED BY MRS JOSEPHINE CYNTHIA P, ASSISTANT PROFESSOR, MENTAL HEALTH NURSING, T. JOHN COLLEGE OF NURSING

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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

1. Name of the candidate and address

(in block letters)

SAIRA ROY

I YEAR MSc NURSING

T.JOHN COLLEGE OF NURSING

GOTTIGERE, BENNARGHATTA

ROAD,

BANGALORE-83

2. Name of the InstitutionT.JOHN COLLEGE OF NURSING

GOTTIGERE ,BENNARGHATTA

ROAD,

BANGALORE-83

3. Course of Study and Subject MSc NURSING

MENTAL HEALTH NURSING

4. Date of Admission to the course 13-06-2011

5. Title of the Topic

“EFFECTIVENESS OF MUSIC THERAPY ON JOB STRESS

AMONG IT PROFESSIONALS RESIDING IN SELECTED

URBAN AREA, BANGALORE”

Brief resume of the intended work

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6.

Introduction

“Music is a friend of labor for it lightens the task by refreshing the

nerves and spirit of the worker.” -William Green 1.

Listening to music does wonder to alleviate stress. Music has always been a

great healer. In the Bible, we learn about how David played the harp to help ease his

severe depression of King Saul. Music is a significant mood-changer and reliever of

stress, working on many levels at once2. Every day, music serves us faithfully,

playing an integral part of our public and private lives. It is vastly used in arenas of

national importance and personal significance. In many normal applications it

supports or transcends spoken word. It therefore cannot be seen as simply a vehicle

for the emotions but also as a complex creation of the intellect3.

Stravinsky wrote: ‘I know that twelve notes on each octave and varieties of

rhythm offer me opportunities that all of human genius will never exhaust.’ He was

making reference to the infinite musical possibilities that the basic ingredients,

rhythm and pitch, coupled with ingenuity and inspiration afford to him or any other

human. Music can now be appreciated as a diverse entity, just as man is a diverse and

complicated being. Music therapists can combine spiritual and emotional aspects

with structure and logic; they can link the artistic to the scientific and the intuitive to

the intellectual4.

Positive manipulation of the inert human responsiveness to musical elements is

the major tool used by therapists. This response amazingly is present despite of

trauma to the organs including brain damage and coma5. Psychologists have given

term ‘baby song’ to the earliest attempts of a baby to ‘talk’ to its mother. So we can

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say that music is the basis of language development. However, this early two-way

communication is more song than speech. This research reaffirms that music links us

to our basic need to communicate6.

A music therapy session may incorporate a number of different elements, such

as making music, writing songs, or passively listening to music. While music

therapists often aim to foster the patient's emotional expression, there can be many

other different goals in a music therapy session. These goals include relief of stress,

improvement of mood, and enhancement of quality of life for people dealing with

illness. Research shows that patients do not need to have any musical ability to

benefit from music therapy7.

Music therapy, with its potential to influence both psychological and

physiological processes, then becomes an important alternative in the practice of

stress management8. Of all the stressors working in an individual’s life, job stress is

one of the leading causes of stress. Workplace has become a source of extreme stress

as a result of technological changes, mass retrenchments, mergers and acquisitions,

information overload, demand for more productivity, fierce competition, and

uncertain future9.

Workplace stress has become one of the major causes of concern. Stress in the

workplace is not good for the organization as it leads to decrease in quality and

productivity. It is also not good for the individual either as it is leads to job

dissatisfaction and low morale9.

Music therapy is utilized in psychiatric facilities, especially for stress related

problems. Music reduces four neuro-endocrine hormones associated with stress

response, and so music is an antidote to stress. Music lowers epinephrine and

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dopamine level in the fight and flight response and is associated with blood pressure8.

Music therapy allows persons with mental health needs to explore personal feelings,

make positive changes in mood and emotional states, have a sense of control over

their lives through successful experiences, practice problem solving and resolve

conflicts leading to stronger family and peer relationships. The future of music

therapy is promising because state of the art music therapy research in physical and

psychiatric rehabilitation, is documenting the effectiveness of music therapy in terms

that are important in the context of a biological medical model10.

6.1 Need for the study

According to National Institute for Occupational Safety and Health, USA

workplace stress can be defined as the harmful physical and emotional responses that

occur when the requirements of the job do not match the capabilities, resources, or

needs of the worker. Stress at the workplace can lead to poor health and even

injury11.

Job Stress Symptoms: Early Warning Signs that coping with workplace stress

is becoming difficult for an employee are - headache, upset stomach, sleep problems,

Irritability and short temper, Difficulty in concentrating, Job dissatisfaction, Low

morale, absenteeism, conflicts, and etc12.

Since stress at the workplace arises due to continuing workplace conditions,

the above health conditions may continue for long periods, and may lead to serious

health problem. Some corporate bosses are of the opinion that some amount of

pressure and job stress on employees is good for increasing productivity. But,

organizations with recent studies have shown that organizations actively taking care

of employees’ health concerns in the form of internal policies are able to increase

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their bottom lines12.

Organizations are waking up to the truth that high levels of job stress in the

organization do not make for good business practice. Increased job stress leads to

increased absenteeism, tardiness and intentions to leave the job, all of which lead to

decreased productivity13.

High work pressure, long hours in front of the computer and a fast-paced

lifestyle, if these factors team up to weaken your physical health, here is one more

strong reason why they are simply unhealthy: mental health professionals are now

convinced that an increasing number of persons working in the IT and IT-enabled

services sector fall prey to depression, because of the high stress they undergo14.

Studies confirm that at least 10 per cent of the population in Bangalore has

gone through some degree of depression. Of these, IT and IT employees form a large

chunk, say doctors. “At least eight years ago, you hardly saw any IT professionals in

Bangalore. But now about 30 to 40 per cent of the patients I see for various

psychiatric problems, including depression, are people from the IT sector,” informs

Murali Raj, Head of the Department of Psychiatry at Manipal Hospital. He says the

patients mostly go through anxiety, stress and depression and in worst cases may be

panicky and become extremely paranoid. The signs that a person is going through

stress and depression becomes apparent through loss of interest in regular activities,

poor sleep and appetite, feeling of worthlessness, negative thoughts about the past

and present and hopelessness about the future and even thoughts of self harm14.

“Depression is usually related to work and stress these people undergo because

of the pressure to perform better, compete with other colleagues and meet tight

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deadlines. Most of their work is target-oriented and if targets are not met, it can lead

to anxiety. Peers are not very supportive as they also competing in the same field.

Moreover, insecurity about the job may lead to feelings of stress and depression,” Dr.

Murali Raj adds. Since IT professionals are more achievement oriented, they do not

have much of a social life and the time spent with family is also less. There is also

lack of recreation and opportunities to relax, and all these may lead to frustration and

eventually depression, he explains. But taking time off from their busy schedule,

taking up recreational activities and better sleep and eating patterns are bound to help

matters14.

Negative effects of stress in the workplace on the health and well-being of

workers have been observed throughout human history. The World Health

Organization has noted that “occupational health and the well-being of working

people are crucial prerequisites for productivity and are of utmost importance for

overall socioeconomic and sustainable development”. In a recent survey by

Northwestern National Life, many employees viewed their jobs as the number one

stressor in their lives. In the United States, nearly 600,000 workers are disabled each

year by stress-related psychological disorders, costing $5.5 billion in annual

payments to individuals and their families15.

Music therapy can be used to improve treatment of job stress, at least in the

short term, say researchers in Finland, Professor Christian Gold, from the University

of Jyvaskyla, said: "Our trial has shown that music therapy, when added to standard

care helps people to improve their levels of job stress16."Dr Mike Crawford, who

specialized in mental health services London, at Imperial College said in a journal

editorial: "The results of my study suggest that music therapy can improve the mood

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and general functioning of people with job stress”17.

Sundar. S and Sairam T.V, researchers from Chennai says “It seems now more

than ever the healing power of music, over body and spirit, is being put to the test.

Many of us have always felt that music could help with healing. Now science is

starting to show that we are right”18.

A study was conducted in Amrita Vishwa Vidyapeetham University, Kochi,

Kerala, in 2010 to identify the advances made in the therapy with music and the

developments made in its applications in the health care, using primarily resources of

published material in the internet. The current study was mainly aimed at

understanding music therapy from the perspective of its applications in the field of

medicine as a novel alternative therapy. Apart from the advantage that it does not

have any side effects, it also have an added advantage that it is a completely patient

friendly therapy, that is the therapy can be conducted in the comfort zone of the

patient. It is the psychological and emotional approach towards treatment that makes

this therapy stands out from the conventional therapies. The main objective of music

therapy is to alter the patient’s psychological condition and increase their receptivity

towards the medication. Recent researchers are pointing out the effectiveness of this

therapy in the treatment of Alzheimer’s, Parkinson’s, dementia, depression and stress

and a lot of positive research conclusions are accumulating, promising the future of

music therapy as a potential therapy19.

Raga Hindol, Bhairavi, Malhar, Sree are no longer just music to the ears, but

also a form of treatment, recovery, prevention and improvement. Scientists have

found that music therapy enhances quality of life among workers suffering from job

stress18.

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From the reviews and researcher’s personal experience, there is a need to

assess the effectiveness of music therapy for job stress among IT professionals.

6.2 Review of literature

A literature review is a body of text that aims to review the critical points of

current knowledge including substantive findings as well as theoretical and

methodological contributions to a particular topic. Literature reviews are secondary

sources, and as such, do not report any new or original experimental work20.

In this study literature can be discussed under the following heading

1. Studies related to job stress

2. Studies related to effectiveness of music therapy.

3. Studies related to effectiveness of music therapy for job stress

STUDIES RELATED TO JOB STRESS

A cross sectional study was conducted to evaluate the work place stress among

the medical university employee in a rural area. Both the General Health

Questionnaire (GHQ)-12 and Holmes–Rahe Scale were used to evaluate 406

participants. On the GHQ scale 239(58.9%) recorded psychiatric morbidity out of

which 201(49.5%) had moderate and 38(9.3%) severe morbidity. Medical university

employees were the highest stressed group (P ≤ 0.04). Prominent work

environmental stressors were poor departmental reorganization, lack of cohesiveness

in department, difficult superiors and juniors (P ≤ 0.001, Pearson correlation).

Stressors associated with work organization and work nature were: non-involvement

in departmental decision making and lack of proper feedback; along with; work load,

lack of clarity in job, and a erratic work schedule (P ≤ 0.001 on Pearson correlation).

Harassment, favouritism, discrimination, and lack of self-expression (P ≤ 0.003)

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were other factors responsible for work dissatisfaction. A high stress level was

detected in the study population21.

A study was conducted to examine the incidence of work stress in reference to

the problems that arise due to the interaction of work Stress with skilled and

unskilled workers. The extent of work stress was examined on its twelve sub-scales.

It was hypothesized that there will be significant difference in skilled and unskilled

workers on all 12 subscales of occupational Stress. The final data was collected on

360 workers which include 180 skilled and 180 unskilled workers. The Occupational

Stress Index (Srivastava, A.K., and Singh, A.P., 1981) was used for data collection.

Correlational analysis was done among all the twelve subscales of occupational stress

on both the dimensions i.e., skilled and unskilled workers. It revealed significant

difference among skilled and unskilled workers22.

A study was conducted to assess the job stress and job satisfaction of

scientists. Totally 160 respondents were selected for the study. Majority of the

scientists (62.50%) had medium level of Job satisfaction, while 20% had high level

of job satisfaction and the rest 17.50 per cent of them had low level of job

satisfaction. More number of researchers (64.59%) and teachers (63.27%) were

noticed in medium level of job satisfaction category, compared to extension workers

(50.00%). Nearly half of the respondents (51.88%) belonged to medium category of

job involvement followed by 28.12 per cent and 13.13 percent belonged to high and

low category of job involvement respectively. Nearly 74 per cent of the respondents

experienced medium level of job stress, while only 18.12 per cent and 8.13 per cent

of them experienced high and low level of job stress, respectively23.

A research paper was conducted to find the organizational role stress among

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women in the Indian information technology sector. Organizational stress originates

in organizational demands that are experienced by the individual. Stress is built up in

the concept of role which is conceived as the position a person occupies in a system.

This paper investigates the intensity of organizational role stress among women

informational technology professionals in the Indian private sector. Organizational

role stress scale is used on a sample of 264 to explore the level of role stress.

Resource inadequacy has emerged as the most potent role stressor, followed by role

overload and personal inadequacy. The research finds differences in the level of

stress between married and unmarried employees on several role stressors. However,

level of education does not emerge as a significant differentiator of stressors24.

STUDIES RELATED EFFECTIVENESS OF MUSIC THERAPY

A controlled trial study was conducted to investigate the effect of music

therapy during acute psychotic episode. Sixty participants were quasi-randomized.

Standardized psychological assessments [Brief Psychiatric Rating Scale (BPRS),

Calgary Interview Guide for Depression, Nurses' Observation Scale for Inpatient

Evaluation (NOSIE-30) and Depression Anxiety Stress Scale (DASS21)] were

conducted before and after the sessions to determine whether there were any

significant changes. Statistically significant changes in BPRS scores were seen 

outcomes. Despite the treatment group, having a 9.3% decrease in their length of stay

in hospital as opposed to the control group, this did not reach statistical significance.

Study concluded that there is an advantage of adding music therapy to

pharmacological treatment25.

A study was conducted to identify the effect of music therapy for persons with

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dementia. Fifty-nine persons with dementia were enrolled in this study. All of them

underwent a multidimensional assessment including Mini Mental State Examination,

Barthel Index and Neuropsychiatry Inventory at enrolment. Subjects were randomly

assigned to experimental (n=30) or control (n=29) group. The music therapy sessions

were evaluated with standardized criteria. The experimental group received 30 music

therapy sessions, whereas the control group received educational support or

entertainment activities. Neuropsychiatry inventory at enrolment total score

significantly decreased in the experimental group (interaction time× group: F3,

165=5.06, P=0.002). The empathetic relationship and the patients' active participation

in the music therapy approach, also improved in the experimental group. The study

shows that music therapy is effective in patients with moderate-severe dementia26.

A study was conducted to test the effect of music on pain, depression and

disability, and comparing the effects of researcher-provided music (standard music)

with subject-preferred music (patterning music). However, the effect of music on

pain, depression, and disability in working age adults with chronic non-malignant

pain has not been investigated. A randomized controlled clinical trial was carried out

with a convenience sample of 60 African American and Caucasian people aged 21-

65 years with chronic non-malignant pain. They were randomly assigned to a

standard music group (n = 22), patterning music group (n = 18) or control group (n =

20). Pain was measured with the McGill Pain Questionnaire short form; depression

was measured with the Centre for Epidemiology Studies Depression scale; disability

was measured with the Pain Disability Index. The music groups had less pain,

depression and disability than the control group27.

A study was conducted to find the effects of Music Therapy Strategy on

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Depressed Older Adults in Stanford University School of Medicine. A music-

facilitated psycho educational strategy was developed as a cost-effective and

accessible intervention for older adults experiencing symptoms of depression,

distress, and anxiety. Thirty older adults who had been diagnosed with major or

minor depressive disorder were randomly assigned to one of three 8-week conditions:

(1) a home-based program where participants learned music listening stress reduction

techniques at weekly home visits by a music therapist; (2) a self-administered

program where participants applied these same techniques with moderate therapist

intervention (a weekly telephone call); or (3) a wait list control. Participants in both

music conditions performed significantly better than the controls on standardized

tests of depression, distress, self-esteem, and mood. These improvements were

clinically significant and maintained over a 9-month follow-up period. The potential

for this type of intervention with homebound elders and others who have limited

access to services is discussed28.

STUDIES RELATED TO EFFECTIVENESS OF MUSIC THERAPY ON

JOB STRESS

An experimental study was conducted to evaluate the effectiveness of music

therapy for job stress among IT employees. Data were collected from six IT

companies in Kolkata. Purposive sampling technique was used to locate IT

professionals of Kolkata after fixing certain parameters in terms of the age range, the

socio-economic background and the educational qualifications. A total of

101respondents, 60 were male and 41 female. The mean age was 29.13 years, with a

mean work experience of 4.29 years. The mean percapita income was Rs. 9331. 00.

Among the respondents 67% were unmarried and 33% married. The scales given to

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assess job stress was PGI–Well–Being Scale and Organizational Role Stress Scale

(ORS- Scale) by Pareek (1983) .The study concluded that there was a reduction in

job stress for 72% of IT employees with regular music therapy29.

A study was conducted to determine the efficacy of music therapy added to

standard care compared with standard care only in the treatment for job stress among

working-age people. Participants (n = 79) with job stress were randomized to receive

individual music therapy plus standard care (20 bi-weekly sessions) or standard care

only, and followed up at baseline, at 3 months (after intervention) and at 6 months.

Participants receiving music therapy plus standard care showed greater improvement

than those receiving standard care only in job stress (mean difference 4.65, 95% CI

0.59 to 8.70), anxiety symptoms (1.82, 95% CI 0.09 to 3.55) and general functioning

(–4.58, 95% CI –8.93 to –0.24) at 3-month follow-up. The response rate was

significantly higher for the music therapy plus standard care group than for the

standard care only group (odds ratio 2.96, 95% CI 1.01 to 9.02). Individual music

therapy combined with standard care is effective for job stress among working-age

people. The results of this study indicate that music therapy with its specific qualities

is a valuable enhancement to established treatment practices30.

A study was conducted to measure the effect of music listening on state

positive affect, work quality and time-on-task of computer information systems

developers. Effects of music on work performance, in this case, software design, may

be explained by increases in state positive affect. Data from 56 (male = 41, female =

15) developers were obtained from four different Canadian software companies. Data

were collected in the participants’ actual work environments over five weeks. Results

indicated that state positive affect and quality-of-work were lowest with no music,

while time-on-task was longest when music was removed. Narrative responses

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revealed the value of music listening for positive mood change and enhanced

perception on design while working. Evidence is provided of the presence of a

learning curve in the use of music for positive mood alteration. Overall, the study

contributes to the development of a model that aspires to elucidate music and

workplace interactions; as well, it has implications for organizational practice31.

A study was conducted to explore the effectiveness of music as a relaxation

technique for job stress among 500 women information technology (IT) professionals

in Chennai, India. The data collected were analyzed using descriptive one-way

analysis of variance and Pearson’s correlation. This study reveals that 84% of the

respondents experience medium level of job stress and also suggest that age and

experience significantly influence the overall stress and depression experienced by

the employees. And also concluded that a reduction in stress with the help of music.

This study shows that there might be a strong relationship between overall stress, and

music as a relaxation technique32.

6.3 Statement of the problem

A quasi experimental study to assess the effectiveness of music therapy on job stress

among IT professionals residing in selected urban area, Bangalore

6.4 Objectives of the study

1) To assess the pre test level of job stress in both experimental and control

group.

2) To evaluate the effectiveness of music therapy by comparing the post test

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level of job stress in both experimental and control group.

3) To associate the post test level of job stress with their selected socio

demographic variable in both experimental and control group.

6.5 Operational definition

1. ASSESS: It refers to an act to measure the job stress among IT professionals,

before and after the intervention by using modified job stress inventory.

2. EFFECTIVENESS: It refers to the desired change brought about by the music

therapy and is statistically measured in terms of reduction in the level of job stress

among IT professionals.

3. MUSIC THERAPY: It refers to a relaxation technique that involves listening to

music, with a view to reduce job stress, compiled on different ragas played according

to clients like.

4. JOB STRESS: It refers to stress in the work place which may affect on

physiological and psychological well being of the IT professionals.

5. IT PROFESSIONALS: They refer to the employees who are skilled in

information technology area.

6.6 Assumption

The study assumes that ,

1) IT professionals will have job stress.

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2) Music therapy is an effective relaxation technique to reduce job stress.

3) Job stress varies from person to person.

4) Interventions prepared by the investigator are adequate to reduce the job

stress.

5) IT professionals themselves use music as a relaxation technique.

6.7 Delimitations

1) The study is limited to the IT professionals residing in selected urban area

in Bangalore.

2) The study is limited to the IT professionals who are willing to participate.

3) Data collection method is limited with the tool which is prepared by the

researcher.

6.8 Hypotheses

H1: There will be significant difference in the post test level of job stress in the

experimental group than in the control group.

H2: There will be significant association between post test job stress score of both

experimental and control group with their selected demographic variables.

6.9 Variables

Independent variable: Music therapy.

Dependent variable: job stress.

Materials and method

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7.1 Source of Data

Source of data will be the IT professionals residing in selected urban area in

Bangalore.

7.1.1 Research design

The research design selected for the study is quasi experimental design with

two group pre test and post test.

Experimental

Group(Group I)

O1 X O2

Control

group(Group II)

O1 - 02

O1= Pre test level of job stress.

O2= Post test level of job stress.

X= Intervention – music therapy.

7.1.2 Setting

The study will be conducted in selected urban area at Bangalore.  

7.1.3 Population

Population of the study consists of all the IT professionals residing in selected urban

area at Bangalore

7.2 Method of data collection

7.2.1 Sampling procedure

The sampling procedure using in this study is non probability convenient

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sampling.

7.2.2 Sample size

In this study the sample size is of 60 IT professionals residing in selected

urban area at Bangalore.

7.2.3 Inclusion criteria for sampling

IT professionals;

1) Those who are residing in selected urban area at Bangalore.

2) Those who are able to read and write English.

7.2.4 Exclusion criteria for sampling

IT professionals ;

1) Those who are not willing to participate in the study.

2) Those who are not available during the time of data collection.

7.2.5 Description on the tool

Structured questionnaire will be used to collect the data. It has two sections.

Section A: Socio demographic variables.

Section B: Modified job stress inventory will be used to assess the job stress

among IT professionals

7.2.6 Data collection method

Samples will be selected according to the selection criteria of the study.

Samples will be assessed for job stress by using modified job stress scale inventory.

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7.2.7 Plan for data analysis

The collected data will be analyzed by using descriptive and inferential statistics. The

descriptive statistics will be planned to explain the frequency, percentage, mean, and

mean percentage and standard deviation of pre test and post test level of job stress.

The inferential statistics will be planned to compare the pre test and post test level of

job stress by using paired‘t’-test. The Chi-square test is planned to associate the post

test level of job stress with socio demographic variables.

Ethical consideration

7.3 Does the study require any investigations or interventions to be

conducted on patients or other humans or animals? If so, please describe

briefly?

Yes, music therapy will be administered to the subjects.

7.4 Has ethical clearance been obtained from your institution in case of 7.3?

Yes

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8. Signature of the candidate

9. Remarks of the guide

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10. Name and designation of (in block letters)

10.1 Guide MRS. JOSEPHINE CYNTHIA,

ASSISTANT PROFESSOR,

T.JOHN COLLEGE OF NURSING.

10.2 Signature

10.3 Co-guide (if any) MRS. R NAGANANDINI,

ASSO. PROFESSOR.

10.4 Signature

11 11.1 Head of the department MRS R.NAGANANDINI

11.2 Signature

12. 12.1 Remarks of the Chairman and Principal

12.2 Signature

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