Main Article Content


Background: Objective Structured Clinical Examination (OSCE) is an instrument for an evaluation test to asses observable skills. However, this situation of the test can lead to anxiety for students expressed in affective and somatic signs. Progressive muscle relaxation technique is one of non-pharmacology therapies and can be used to decrease the affective and somatic signs in the students.
Objective: This study aims to determine effects of the progressive muscle relaxation technique on affective and somatic signs in nursing students when taking the OSCE.
Methods: This study was a quasi-experimental with a pre-test and post- group design. Fifty eight participants were selected by inclusion criteria and divided into two groups (a treatment group and a control group). The progressive muscle relaxation before the OSCE was conducted for 30 minutes. Zung’s self-rating anxiety (ZSAS) was applied to measure the affective signs. A sphygmomanometer, manual heart rate palpation, and thorax inspection were used to measure the somatic signs. The data were analysed by using a Wilcoxon test.
Results: The Wilcoxon test showed that the effects of progressive muscle relaxation technique on the affective signs indicated p-value of 0.0001 (p<0.005). Then it also affected the somatic signs as occurred in systolic blood pressure with p-value of 0.00, diastolic blood pressure with p-value of 0.004, heart rate with p-value of 0.00, and respiration rate with p-value of 0.00. The affective and somatic signs in the treatment group decreased after the treatment was given. However, they were not found in the control group.
Conclusion: There are effects of progressive muscle relaxation technique on affective and somatic signs in nursing students when taking the OSCE. The affective and somatic signs in the treatment group were lower than in the control group.


Affective sign Progressive Muscle Relaxation Somatic sign

Article Details

How to Cite
Risdiana, N., Sandy, J. L., & Johan, J. (2021). Effects of progressive muscle relaxation technique on affective and somatic signs in nursing students taking objective structured clinical examination. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 12(1), 58–67.


  1. Zayyan M. Objective structured clinical examination: The assessment of choice. Oman Med J. 2011;26(4):219–22.
  2. Wahjudi JW, Findyartini A, Kaligis F. The relationship between empathy and stress: A cross-sectional study among undergraduate medical students. Korean J Med Educ. 2019;31(3):215–26.
  3. Hetaimish B, Frcs C, Elbadawi H. OSCE Assessment for Medical Student Clinical Skills and Performance, Are We Doing It The Right Way? Int J Sci Res. 2015;4(11):963–7.
  4. Kim KJ. Factors associated with medical student test anxiety in objective structured clinical examinations: a preliminary study. Int J Med Educ. 2016;7:424–7.
  5. Zartman RR, McWhorter AG, Seale NS, Boone WJ. Using OSCE-Based Evaluation: Curricular Impact over Time. J Dent Educ. 2002;66(12):1323–30.
  6. Roth WT, Doberanz S, Dietel A, Conrad A, Mueller A, Wollburg, et al. NIH Public Access. J Psychiatr Res. 2008;42(3):205–12.
  7. Starr C, McMillan B. Human Biology. Eleventh E. Boston; 2016.
  8. Tyani ES, Utomo W, Hasneli Y. Efektifitas Relaksasi Otot Progresif Terhadap Tekanan Darah Pada Penderita Hipertensi Esensial. J Online Mhs [Internet]. 2015;2(37):1–31. Available from:
  9. Ramasamy S, Panneerselvam S, Govindharaj P, Kumar A, Nayak R. Progressive muscle relaxation technique on anxiety and depression among persons affected by leprosy. J Exerc Rehabil. 2018;14(3):375–81.
  10. Zung WWK. A Rating Instrument For Anxiety Disorders. Psychosomatics. 1971;12(6):371–9.
  11. Nuss P. Anxiety disorders and GABA neurotransmission: A disturbance of modulation. Neuropsychiatr Dis Treat. 2015;11:165–75.
  12. Zhang X, Ge TT, Yin G, Cui R, Zhao G, Yang W. Stress-induced functional alterations in amygdala: Implications for neuropsychiatric diseases. Front Neurosci. 2018; 12(MAY):1–9.
  13. Prager EM, Bergstrom HC, Wynn GH, Braga MFM. The Basolateral Amygdala GABAergic System in Health and Disease HHS Public Access. J Neurosci Res [Internet]. 2016; 94(6):548–67. Available from:
  14. Goldstein DS. Adrenal responses to stress. Cell Mol Neurobiol. 2010; 30(8):1433–40.
  15. Safi SZ. A fresh look at the potential mechanisms of progressive muscle relaxation therapy on depression in female patients with multiple sclerosis. Iran J Psychiatry Behav Sci. 2015;9(1):1–7.
  16. Gurav R, Nahar S. Effect of Progressive Muscle Relaxation on Anxiety in Geriatric Population. Int J Sci Res [Internet]. 2018;7(May 2019):75–8. Available from:
  17. Astuti A, Anggorowati A, Johan A. Effect of Progressive Muscular Relaxation on Anxiety Levels in Patients With Chronic Kidney Disease Undergoing Hemodialysis in the General Hospital of Tugurejo Semarang, Indonesia. Belitung Nurs J. 2017;3(4):383–9.
  18. Kozako IN ‘Ain MF, Safin SZ, Rahim ARA. The Relationship of Big Five Personality Traits on Counterproductive Work Behaviour among Hotel Employees: An Exploratory Study. Procedia Econ Financ [Internet]. 2013;7(Icebr):181–7. Available from:
  19. Sherwood L. Human Physiology: From Celss to Systems. Eighth Edi. 2013.
  20. Lindquist R, Snyder M, Tracy MF. Complementary and Alternative Therapies in Nursing, 7th edition. Vol. 34, Critical Care Nurse. New York: Springer Publishing Company; 2014. 76–76 p.
  21. Hinkle JL, Cheever KH. Textbook of Medical Surgical Nursing. 13th Editi. China: Wolters Kluwer Health | Lippincott Williams & Wilkins; 2010.