Research Proposal Presentation

Catalyst of Knowledge Tradition
PhD. Islamiyyat
Research Proposal Presentation
By:
SITI AWA ABU BAKAR
13PI01004
Sem 2: Session I/2014/2015
SUPERVISORY COMMITTEE MEMBERS
DR. MARIAM BINTI ABDUL MAJID (HEAD)
[IIUCS: AI (DAKWAH)]
DR. HAJJAH AINI BINTI AHMAD
[OUM: FNHS (NURSING SCIENCE)]
ASSOC. PROF. DR. MOHD. BASRI BIN MD. NOR
[IIUM: KULIYYAH OF MEDICINE (ANESTHESIOLOGY)]
Content Outline:
• Introduction
• Literature review
• Methodology
• Data analysis
• Conclusion
Research Title
Effects of Holy Quran Listening
on
Physiological Stress Response
of
Mechanically Ventilated Muslim Patients
In
Intensive Care Unit
Background of the study
Problem statement
Research Objective
Introduction
Significance and Contribution
Limitation and scope
Theoretical Framework
Background of the study
About 25%
experienced
anxiety & stress
(Davydow, Desai,
Needham,
Bienvenu, 2008;
Davydow, Gifford,
Desai, Bienvenu,
Needham, 2009).
Many factors
contributing to
these
psychological
disturbances
(Hopkins, Key,
Suchyta,
Weaver, Orme,
2010).
Problem Statement
ICU Stressors
Adverse effects
of sedations
Muslim Believes
and Practices
Increase LOS
Nurses cannot
prescribe
medication
Increase
expenses
Research Objective
To examine effects of Holy Quran listening on
physiological stress response of MV Muslim patients
Research Questions
1.
Are there any relationships between demographic data with stress
physiological response of MV Muslim patients of three study groups?
2.
Are there any relationships between clinical characteristics with stress
physiological response of MV Muslim patients of three study groups?
3.
Are there any means difference in physiological response parameters of
MV Muslim from intervention group compare to the other two group of
the study?
4.
Are there any effects of listening to Holy Quran recitations on
physiological stress response parameters of intervention group compare
to the other two group of the study?
Hypotheses (Ha)
• Intervention group will exhibit greater means
difference in physiological stress response
parameters than placebo and control groups.
• Intervention group will exhibit greater effects
on physiological response parameters than
placebo and control groups.
Operational Definition
• Holy Quran Listening
Listen to Al Fatihah & Ya-Seen recitation via headphone.
• Physiological stress response
Heart rate (HR), Systolic BP (sBP), Diastolic BP (dBP), SaO2,
PaO2, Serum Cortisol, Blood Glucose.
• Mechanically ventilated Muslim patients
Muslim patients who are alert and receiving ventilation
through mechanical respirator either via endotracheal
tube, tracheostomy or mask.
Significance of the study
Reduce stress
& anxiety
Atari,Sajedi &
Heydari S.M. (2000).
Grant (2004)
9/26/2014
Promote
weaning
Stanley (2009)
Al Bukhary
Reduce
complication
Dossey(1996)
Promote
Comfort
Kolkaba
(2003)
Limitation & Scope of the Study
• Small population, mechanically ventilated Muslim
patients.
• Listen to readily recorded identified chapters of
Holy Quran via headphone.
• Only to examine the effects of listening of Holy
Quran on physiological stress response
• Limited access of research grant
• Researcher have limited knowledge and skills in
tafsir al Quran and Hadith
Theoretical Framework
Listening to
⁺⁺
Al Fatihah
and Yaseen
(Duraseh &
Mohd Doha,
2007)
MV Muslim patients with
Stress (Chlan 2013)
Intervening
Variables:
 Age
 Gender
 Ventilation
Mode
 Category of
patients
 Medication
 Type of disease
 SIRS
 SAPS
 SOFA
 APACHE II
 RAS
 Procalcitonin
level
 Date of
intubation
Relief
Normal physiological
parameters:
HR, BP, MAP, RR, SaO2,
PaO2, (Yucel 2008)
Stress biomakers
serum cortisol & blood
glucose (Nelson, 2009)
Ease
Transcend
ence
Early extubation
Date of extubatiom
(Chlan 2013)
Shorter length of stay in
ICU:
APACHE II score, Date of
discharge from ICU &
Length of stay
(Chlan 2013)
(Modification of Kolkaba’s Theory of Comfort (2010)
Comfort
Literature Review
Holy Quran
Listening
Islamic
Perspective
Holy Quran
Hadith
Nursing
Perspective
Related
Research
LR: What Holy Quran have said?
Allah is As-Shafi; The Healer:
‫َقا ِتلُو ُه ْم ٌ َُع ِّذ ْب ُه ُم ه‬
‫ٌِن‬
ُ ِ‫َّللاُ ِبؤ َ ٌْدٌِ ُك ْم َوٌ ُْخ ِز ِه ْم َو ٌَنصُرْ ُك ْم َع َلٌ ِْه ْم َو ٌَ ْشف‬
َ ‫ور َق ْو ٍم م ُّْإ ِمن‬
َ ‫ص ُد‬
Allah have said that:
• “Fight them; Allah will punish them by your hands and will disgrace
them and give you victory over them and satisfy the breasts of a
believing people” (Q9:14)
ُ ْ‫َوإِ َذا َم ِرض‬
‫ٌِن‬
ِ ‫ت َفه َُو ٌَ ْشف‬
Allah have said that:
• “And when I am ill, it is He who cures me” (Q26:80)
Allah have said that:
• ‫ور َو ُه ًدى َو َرحْ َم ٌة‬
ُّ ‫ٌَا أَ ٌُّ َها ال هناسُ َق ْد َجا َء ْت ُكم م ْهو ِع َظ ٌة مِّن ره ِّب ُك ْم َو ِش َفا ٌء لِّ َما فًِ ال‬
ِ ‫ص ُد‬
‫ٌن‬
َ ‫لِّ ْلم ُْإ ِم ِن‬
• O mankind, there has come to you instruction from your Lord
and healing for what is in the breasts and guidance and mercy
for the believers (QS10:57)
• ُ‫َّللا َت ْط َمئِنُّ ْالقُلُوب‬
ِ ‫َّللا ۗ أَ ََل ِب ِذ ْك ِر ه‬
ِ ‫ٌن آ َم ُنوا َو َت ْط َمئِنُّ قُلُو ُبهُم ِب ِذ ْك ِر ه‬
َ ‫اله ِذ‬
• Allah SWT said that:
• Those who have believed and whose hearts are assured by
the remembrance of Allah. Unquestionably, by the
remembrance of Allah hearts are assured. (QS13:28)
‫ٌن ۙ َو ََل ٌَزٌ ُد ه‬
‫ٌن إِ هَل َخ َسارً ا‬
َ ‫الظالِ ِم‬
َ ‫آن َما ه َُو ِش َفا ٌء َو َرحْ َم ٌة لِّ ْلم ُْإ ِم ِن‬
ِ ْ‫َو ُن َن ِّز ُل ِم َن ْالقُر‬
ِ
• Allah have said that:
And We send down from the Qur’an that which is a
healing and a mercy to those who believe (QS 17: 82)
..ۚ ‫َّللا‬
ِ ‫ُث هم َتلٌِنُ ُجلُو ُد ُه ْم َوقُلُو ُب ُه ْم إِلَ ٰى ِذ ْك ِر ه‬
• Allah have said that:
…and then their skins and their hearts soften for Allah's
remembrance..(QS 39:23).
• The Quran itself is referred to as a ‘cure’ and ‘mercy’ :
‫ٌِن‬
ُّ ‫ٌَا أَ ٌُّ َها ال هناسُ َق ْد َجا َء ْت ُكم م ْهوعِ َظ ٌة مِّن ره ِّب ُك ْم َوشِ َفا ٌء لِّ َما فًِ ال‬
َ ‫ور َو ُه ًدى َو َرحْ َم ٌة لِّ ْلم ُْإ ِمن‬
ِ ‫ص ُد‬
Allah have said that:
• “O mankind, there has to come to you instruction from your Lord and
healing for what is in the breasts and guidance and mercy for the
believer” (Q10:57)
‫ٌِن ۙ َو ََل ٌَزٌ ُد ه‬
‫ٌِن إِ هَل َخ َسارً ا‬
َ ‫الظالِم‬
َ ‫آن َما ه َُو شِ َفا ٌء َو َرحْ َم ٌة لِّ ْلم ُْإ ِمن‬
ِ ْ‫َو ُن َن ِّز ُل م َِن ْالقُر‬
ِ
Allah have said that:
•
“And we send down of the Qur’an that which is healing and mercy to
the believers; but it does not increase the wrongdoers except in loss"
(Q17:82)
• Effects of reciting and listening to the Quran
‫ٌن إِ َذا ُذ ِك َر ه‬
ْ ٌَ ِ‫ت قُلُو ُب ُه ْم َوإِ َذا ُتل‬
ْ َ‫َّللا ُ َو ِجل‬
‫ت َعلٌَ ِْه ْم آ ٌَا ُت ُه َزادَ ْت ُه ْم إٌِ َما ًنا‬
َ ‫ون اله ِذ‬
َ ‫إِ هن َما ْالم ُْإ ِم ُن‬
‫ون‬
َ ُ‫َو َعلَ ٰى َرب ِِّه ْم ٌَ َت َو هكل‬
• The true believers are those who, when Allah's name is mentioned, their
hearts quake, and when His verses are recited to them their faith grows,
and who put their trust in their Lord (Q8:2)
•
Effects of reciting and listening to the Quran:
‫ص ًّما َوعُمْ ٌَا ًنا‬
ُ ‫ت َرب ِِّه ْم لَ ْم ٌَخِرُّ وا َعلَ ٌْ َها‬
ِ ‫ٌِن إِ َذا ُذ ِّكرُوا ِبآ ٌَا‬
َ ‫َوالهذ‬
Allah have said that:
•
who do not behave like the blind and the deaf, when the Revelations of their Lord are recited
to them for admonition ;(Q25:73).
ٰ ِ ‫ث ِك َتابًا ُّم َت َشابهًا هم َثانًِ َت ْق َشعِرُّ ِم ْن ُه ُجلُو ُد الهذٌِن ٌ ْخ َش ْون ر هب ُهم ُثم َتلٌِنُ ُجلُو ُد ُهم وقُلُو ُب ُهم إلَ ٰى ِذ ْكر ه‬
‫ه‬
‫ك‬
ِ ٌِ‫َّللا ُ َن هز َل أَحْ َس َن ْال َحد‬
َ ِ‫َّللا ۚ َذل‬
َ ْ
َ َ
َ
‫َ َ ْ ه‬
ِ ْ
ِ
ِ
‫َّللا ٌَ ْهدِي ِب ِه َمن ٌَ َشا ُء ۚ َو َمن ٌُضْ ل ِِل ه‬
‫َّللا ُ َف َما لَ ُه مِنْ َها ٍد‬
ِ ‫ُهدَى ه‬
Allah have said that:
•
Allah has revealed the best teaching, a self-consistent Book *43 which repeats its contents in
manifold forms whereat shiver the skins of those that hold their Lord in awe, and then their
skins and their hearts soften for Allah's remembrance. That is Allah's Guidance wherewith He
guides whosoever He pleases. And he whom Allah does not guide to the Right Path has none
to guide him. (Q39:23)
LR: What Holy Quran have said?
• Yucel (2007) : When Muslim perform worship (salat, du’a, holy
Quran recitation, dhikr) it will ease the patient’s (if that is
what is best for him or her):
• the pain.
• worry and fear.
• anxiety
• increases psychological comfort and enhances coping skills.
LR: What Hadith have said?
• Prophet Muhammad Peace Be Upon Him (PBUH) have said that:
‫ما أنزل هللا داء إال أنزل له شفاء‬
“Allah has not sent any disease without sending a cure for it”
(Sahih al Bukhari: no 5354)
• Al Fatihah
• Ash-Shifa – Messenger of Allah (sallallahu „alayhi wa sallam) said:
“The Opening of the Book is a cure to every poison.”
• Ar-Ruqyah – It is also named Ar-Ruqya, the Spiritual Cure due to the
hadith of Abu Sa‟id reported by Bukhari that after he had recited it to
cure a person who had been bitten by a scorpion, the Messenger of
Allah (sallallahu „alayhi wa sallam) asked him, “…And what made you
to know that it was a ruqya.”
LR: What Hadith have said?
• Prophet Muhammad Peace Be Upon Him (PBUH)
have said that:
‫ما أنزل هللا داء إال أنزل له شفاء‬
“Allah has not sent any disease without sending a
cure for it”
(Sahih al Bukhari: no 5354
LR: What Hadith have said?
• Surah Yaseen
• Maqri (Rahmatullah Alaihi) said, “If Surah Yaseen is read by
one who fears the ruler or an enemy, one gets rid of this fear.”
LR: Nursing & Other Related
Research
Rath (2008)
Chlan, et.al.
(2013)

 Pre-test/post-test design
 Intercessory prayer
 42 pre-term neonates

no statistical significance
between the groups for any
outcome measures,
outcomes were noted for
salivary cortisol, behavioral
state and acute
complications for the prayer
group.
Salivary
cortisol
 Behavioral
state
 70 MV patients3 groups
RCT
 Self-initiated music
Urine
cortisol
NIL
No significant reduction in
cortisol level
 Quasi=experimental
 Recitation of Al quran
verses and du’a
 60 adult patients
 Quasi experimental
 Recitation of holy
Quran before cesaerian
section
 80 women

RR, HR,
BP
Self reported
surveys
prayer session reported that
they experienced a greater
degree of spiritual comfort
and strength.
 Urinary free cortisol
Yucel (2008)
AjorPaz &
Ranjbar
(2010)
NA
NA
Related Research
Author
Study Design & aim
Study Sample &
Design
Findings
Woodmanse
e, M.F.
(2000)
quasi-experimental, pretest, post-test
Examine effects of
intercessory prayer on
stress level of individual
prayors
50 prayors; 12
male AND 38
One group
• Prayors not
experienceing
significant stress
Han, L. et.al
(2010)
Randomized placebocontrolled trial to
examine effects of
music on physiological
stress response and
anxiety level of
mechanically ventilated
patients in Chins
137 participants
• Short-term
randomly assigned
therapeutic effects
into 3 groups;
of music listening
music , placebo
result in substantial
and control group.
reduction in
physiological stress
responses arising
from anxiety of
mechanically
ventilated patients
Related Research
Author
Study Design
Study Sample & Design
Fimdimgs
Dijkstra, B.M. Randomized
et.al (2010)
controlled trial to
determine the effects
of music on
physiological response
and sedation scores in
sedated mechanically
ventilated patients.
20 subjects were
randomly assigned to
experimental and
control group. The
exerimental group
listened to music for 30
minutes over 2 days.
• No significant
difference on
physiological
parameters for
both study
groups but the
sedation score
significantly
increase in the
experimental
group
Mir Bagher
AjorPaz, N. &
Ranjbar, N.
(2010)
80 women expecting
LSCS randomly selected
and assigned into
2 groups : control (30
members) and
experimental (50
members)
• Anxiety level
decreased
significantly n
experimental
group after
intervention
Quasi-experimental
study to study the
recitation effects of
Holy Quran recitation
on anxiety of women
before cesarean.
Related Research
Author
Study Design
Study Sample &
Design
Fimdimgs
Azar Avazeh,
et.al (2011)
Quasi-experimental
pretest-posttest to
determine the effect of
reciting the word “Allah”
on the pain and agony of
dressing change in burn
patients
30 hospitalized
• Reciting 100
burn patients who
times word of
recited 100 word of
‘Allah before and
“ Allah” before and
during burn
during the
dressing indicate
procedure.
successful effect
in alleviating
pain and anxiety.
Mottaghi,
M.E.; Esmaili,
R. & Rohani,
Z. (2011)
Quai-experimental to
investigate the effect of
hearing to Holy Quran on
the athlete competitive
anxiety
80 female students • Listening to
who attended sport
Quran verses
events were
significantly
assigned into
reduced anxiety
experimental and
in athlete before
control group.
competition
Related Research
Author
Study Design
Study Sample &
Design
Fimdimgs
Ko, Y. & Lin, P.
(2011)
One group pre-test post-test
quasi-experimental design
to investigate the effect of a
relaxation tape on level of
anxiety in surgical patients.
80 surgical patients
were given
relaxation tape the
day before
scheduled surgery.
• Relaxation tapes
can significantly
reduce the level
of anxiety and
vital signs of
surgical patients.
Nilson, U.
(2008)
RCT
To evaluate the effect of bed
rest with music on relaxation
for patients who have
undergone heart surgery on
postoperative
day one.
Forty patients
undergoing open
CABG and/or aortic
valve replacement
surgery were
randomly
allocated to either
music listening
during bed rest (n =
20) or bed rest only
(n = 20).
• Listening to music
during bed rest
after open-heart
surgery has some
effects on the
relaxation system
as regards
• s-oxytocin and
subjective
relaxations levels.
Related Research
Author
Study Design
Study Sample &
Design
Fimdimgs
Sharifi, A.;
Alipour, A. &
Baharloei, S.
(2012)
Experimental pretestposttest with control group
to compare the effect of
music and holy quran
voices on anxiety of
women before cesarean.
45 women waiting
for cesarean were
assigned randomly
into 3 groups
(music, holy quran
& control)
• Voices of Holy
Quran reduce
anxiety greater
than music
before cesarean.
Zulkarnain,
N.A.; Abdul
Kadir, R.S.S.;
Murat, Z.H. &
Isa, R.M. ( )
Experimental study to
investigate and compare
the effects of listening to
Al-Quran and classical
music on human brain
wave using ECG.
Participants were listened
to Surah Yasin of Al Quran
and Pachelbel’s Canon D
major of classical musics.
28 healthy UiTM
students
• Listening to al
Quran recitation
increases the
alpha band more
than listening to
the classical
music.
Related Research
Author
Study Design
Study Sample &
Design
Fimdimgs
Saadatmand, Randomized placebo-controlled
V. et.al (2013) trial to identify the effect of
nature-based sounds
intervention on agitation,
anxiety level and physiological
stress responses in patients
under mechanical ventilation
support.
60 ICU mechanically
ventilated patients
were randomly
assigned to control
and experimental
groups. 90 mins NBs
were played to
experimental group.
• Experimenta
l group had
significantly
lower sBP,
dBP, anxiety
and
agitation
levels yhan
control
group
Chlan, L.L. et
.al (2013)
65 particiants were
assigned randomly
into experimental,
placebo and control
groups.
• Music not
significantly
reduce
urine
cortisol
level.
Randomized controlled trial to
determine the effects of music
listening on anxiety during
ventilatory support and urine
cortisol is an integrative
measure of stress beside other
demograhic and physiological
parameters.
Methodology
Method & Study Setting
» Experimental Design: Randomized Controlled Trial
» Sampling (n=120) distributed randomly into 3 groups.
Sample calculation is based on Nilson (2008)
» Will be ethically conducted at Intensive Care Unit, Tengku
Ampuan Afzan, Kuantan, Pahang by having registered to
National Medical Research Registration (NMRR).
36
9/26/2014
Sampling Criteria
Inclusion
•
•
•
•
•
•
Exclusion
Muslim
•
Understand Malay and
English language
•
Alert, mentally competence
(RASS=0)
Free from:
Corticosteroids drugs
Inotropic drugs
37
Hearing impairment /
skull injury
Mental health disorder
9/26/2014
Study Procedure
Eligible and enrolled in the study (n=120)
Pretest measures:
SBP, DBP, MAP, HR, RR,SaO2, PaO2, Sr.Cortisol, Blood Glucose
Intervention Group (n=40)
Rest & Listen to Al-Fatihah &
Ya Seen for 30 minutes via
headphone
Placebo Group (n=40)
Rest & Listen to MusiCure
for
30
minutes
via
headphone
Control Group (n=40)
Rest without listening to
Al-Fatihah & Ya-Seen and
MusiCure
30
minutes
session quiet rest without
prayer
Monitor SBP, DSB, MAP, HR and RR, SPO2 at 5
minutes interval throughout the 30 minutes
session
Posttest
(5 minutes after the 30 minutes session)
SBP, DBP, MAP, HR, RR, SaO2, PaO2, Sr. Cortisol, Blood Glucose
Posttest
(5 minutes after the 30 minutes session)
SBP, DBP, MAP, HR, RR, SaO2, PaO2Se. Cortisol, Blood Glucose
38
9/26/2014
Data analysis
• Data will be analyzed by using SPSS software for window; will
use:
• Descriptive statistic
• Parametric or non parametric statistic pending to the
data distribution either normally or not normally
distributed.
• Will use Repeated Measures ANOVA to examine changes
of physiological parameters and anxiety level within and
among group.
21 DECEMBER 2011
39
Findings
• Response rate will be descriptively analyzed.
• The findings will be presented by following topics:
• Demographic and clinical characteristics
• Effect on physiological stress responses
• Changes of physiological stress responses
2 DECEMBER 011
40
Implications
» Nursing practice
» cheap and convenient non-pharmacological
complimentary nursing intervention.
» Nursing research
» More research on spiritual needs for the Muslim patients of
Malaysia
» Nursing education
» prepare nurses for holistic nursing: integrate Islamic
practices in nursing care for Muslim patients in the
curriculum.
» Health organization
» Reduce cost and trusted by public, provide required
material to support patients’ spiritual needs
» International Islamic University College of Selangor
»
Give impact on IIUCS related to health science empirical
research pertaining to Islamic Study.
9/26/2014
41
Conclusion
• This RCT should be able to identify the therapeutic effects of
listening to holy Quran recitation in reducing the
physiological stress response of mechanically ventilated
Muslim patients.
• This study findings should be able to generalized as a
relevance nursing intervention and into nursing body of
knowledge.
• This is a non-pharmacological nursing intervention that can be
used as complementary adjunct in the care of patients those
requiring mechanical ventilator support and critically ill.
References
•
Atari M.A.,Sajedi P.,Heydari S.M. (2000). Evaluation Of Koran Voices Effect On Anxiety And Vital Signs
Of Patients In Preinduction: Stageteb Va Tazkieh; Summer (37);91-94.
•
Davydow, D.S., Desai, S.V., Needham, D.M., & Bienvenu, O.J. (2008) “Psychiatric morbidity in
survivors of the acute respiratory distress syndrome: a systematic review”, Psychosomatic Medicine.
Vol.70 (4): 512-9.
•
Davydow, D.S., Gifford, J.M., Desai, S.V., Needham, D.M., & Bienvenu, O.J. (2008) “Posttraumatic
stress disorder in general intensive care unit survivors: a systematic review”, General Hospital Psychiatry.
Vol.30 (5): 421-34.
•
Davydow DS, Giff ord JM, Desai SV, Bienvenu, OJ, Needham DM (2009) “Depression in general
intensive care unit survivors: a systematic review”, Intensive Care Medicine. Vol.35 (5): 796-809.
•
Hopkins RO, Key CW, Suchyta MR, Weaver LK, Orme JF Jr. (2010) “Risk factors for depression and
anxiety in survivors of acute respiratory distress syndrome”, General Hospital Psychiatry. Vol.32 (2): 14755.
References
Deuraseh, N. & Mohd Tohar, S.N.A. (2007). Healing Through Ruqyah (Incantation) With
Special Focus On The perception of Malay-Muslim society in Kelantan and Terengganu
on Ruqyah as an alternative way of healing in Malaysia. Journal of International Society
for The History of Islamic Medicine. Vol. 6-7 : p. 50-54
Dossey L. (1996). Prayer Is Good Medicine. San FranciscoParahoo, K. (2006). Nursing
Research: Principles, Process & Issues. 2nd ed. Palgrave Macmillan
Fawcett, J., (1995). Analysis and Evaluation of Conceptual Models of Nursing, (3rd ed.)
F.A. Davis, Philadelphia
Holy Quran, Chapter 17:82
.Kolcaba, K. (2010). An introduction to comfort theory. In The
November 10, 2010, from http://www.thecomfortline.com/
comfort line. Retrieved
Tracy, M.F., & Chlan, L. (2011). Nonpharmacological Interventions to Manage Common
Symptoms in Patients Receiving Mechanical Ventilation: Critical Care Nurse. Vol. 31(3):
p.19-29.
Study Gantt Chart
Year
Month
2014
1
2
3
4
5
6
7
2015
8
9
1
1
1
0
1
2
1
2
3
4
5
6
7
2016
8
9
1
1
1
0
1
2
1
2
3
4
5
6
7
8
9
1
1
1
0
1
2
Topic
Proposal
Preparation
& submission
Ethical
application
Data
Collection
Data Analysis
Write up
Presentation
Submission
2 DECEMBER 011
45