Rajiv Gandhi University of Health Sciences, Karnataka,
Bangalore
ANNEXURE 1
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1 / Name of Candidate and Address / Miss. SHARY JOSE1 YEAR M.Sc NURSING
SRI H.D.DEVEGOWDA CO-OPERATIVE COLLEGE OF NURSING, MANICHANAHALLY GATE, BELUR ROAD, HASSAN, KARNATAKA.
2 / Name of the Institution / SRI H.D.DEVEGOWDA CO-OPERATIVE COLLEGE OF NURSING, MANICHANAHALLY GATE, BELUR ROAD, HASSAN, KARNATAKA.
3 / Course of study and Subject / M.Sc. NURSING ,
MEDIAL SURGICAL NURSING
4 / Date Of Admission To The Course / 01-06-2012
5 / Title Of The Topic :
“ A STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE OF CARE GIVERS ON CARE OF ELDERLY IN SELECTED HOSPITALS AT HASSAN , WITH A VIEW TO PREPARE AN INFORMATIONAL BOOKLET “
6.
8 / Introduction :
“ In old age our bodies are worn-out instruments ,on which the soul tries in vain to play the melodies of youth .But because the instruments has lost its strings , or is out of tune , it does not follow that the musician has lost his skill”
Henry wadsworth Longfellow
Old age is also called as senescence,in human beings , the final stage of the normal human life span . the old has a dual definition . it is the stage in processes of an individual,and it is an age group or last generation comprising a segment of the oldest members of a population .the social aspect of old age are influenced by the relationship of the physiological effect of aging and the collective experience and shared values of that generation to the particular organization of the society in which it exists1
Both physiological and psychological effects of aging differ widely among individuals. However, physicaly chronic ailments, especially aches and pains, in psychologicaly that may be loneliness in the family and society are more prevalent than acute ailments, requiring older people to spend more time and money on medical problems than younger people. The rising cost of medical care has caused a growing concern among older people and societies, in general resulting in constant reevaluation , reform of institutions and programs designed to aid the elderly with these expenses and also should provide respect and concern in society and family1
6.1Need for the study:
World Elders Day was observed recently and according to the report released on October 1 by UNFPA and HelpAge International on Ageing in the 21 st Century, by 2050 in India women over 60 years would exceed the number of elderly men by 18.4 million. “The population of the elderly is increasing at 3.9 per cent as compared to 1.9 per cent of the total population. As per HelpAge's India study on Elder abuse, 31 per cent of the elderly interviewed reported facing abuse. The report has recommended the inclusion of the ageing and needs of the elderly in all national development policies,” a statement issued by HelpAge stated. the quality of life2.
Now a days,Abuse of the elderly in the family is increasing and it takes several forms and ranges from psychological torture to physical torture including insults, humilitations, and partial or total denial of food, clothing, shelter and medical help and emotional support. It was found that there is a pattern in the abuse of the elderly. Abuse is more in the case of those who are dependent on the kin's for support, have nothing or very little to contribute to the family either physically or materially, who are chronically ill and / or in constant need of care and who are widows. However, poverty, by no means, is the only cause of abuse though it is a major one. Old people are abused in affluent families as well. Abuse is also more from grand children and in laws than from own children. The major remedy in all cases is to make the old less dependent on the family, empower them through monetary or material grants, provide facilities for medical help3.
India has the second largest aged population in the world .There currently are an estimated 100 million elderly in india by 2050 it is said to reach 326 million(projections made by UN in their 1996 version). In that total elderly sleep on an empty stomach every night,75% of persons of age 60 and above are reside in rural areas. 1 out of 8 elderly feel no one cares they exist,30 millions are lonely and below 33%are below poverty line and majority of them are illiterate4.
· We note that the education on these aspects is absent even for the present youths. School syllabour should take care of this and public health authorities should carry the message of healthy aging. The school should especially drive into the minds of its pupils the basic principles of nutrition and health care. The present old people also need education on health and nutrition. The camp approach is quite appropriate for this. Either the community or government and voluntary agencies could organize these camps. They should be supplemented/reinforced by audio-visual publicity programmes. The Holy Quran proclaimed various principles in support of the elderly. In many verses there are explicit commandment to show respect tot he elderly, treat them kindly and give them noble status in both family and community levels. These principles have had a far reaching impact on traditional values and practices. For instance, these commandments5.
Review of literature and clinical experience made the investigator to realize that ,the population of elderly is increasing even with the abuse of them in the family and society. With proper knowledge of care regarding elderly and importance of grand parents in our family can reduce the assultation of elders.this motivated the investigator to under take astudy on knowledge and attitude regarding the care of elderly.
6.2 Review of literature :
A descriptive study was conducted to assess st the health and social problems of the elderly and their attitude towards life, carried out in the Field practice area of the Department of Community Medicine in South India. A total of 213 elderly patients (60 years old and above) who attended the outreach clinics were interviewed using a pre-tested schedule. Findings were described in terms of proportions and percentages to study the socio-economic status of the samples and its correlation to social problems. Around 73% of the patients belonged to the age group of 60-69 years old, Nearly half of the respondents were illiterate. Around 48% felt they were not happy in life. A majority of them had health problems such as hypertension followed by arthritis, diabetes, asthma, cataract, and anemia. About 68% of the patients said that the attitude of people towards the elderly was that of neglect6.
. A study was conducted in rural and urban slum areas of Wardha district to assess the difference in quality of life between Rural and Urban slum elderly population.samples are collected from this district about Four hundred individuals aged 60 years and above selected each from rural and urban area, Data was collected using WHOQOL BREF scale( Field trial WHO 1996) 44 percent were males and 56 percent females as compared to 41 percent males and 59 percent females in urban slums. The proportion of rural elderly in the age group 60-69 years was 45.5percent and urban slum elderly in the age of 70-79 was 42.2 percent group 60-69 years was 45.5percent in urban. The difference in physical and psychological domain scores amongst rural population with respect to age was statistically significant No significant difference was found for urba slum population7.
A study was conducted in Sudergarh District Odisia regarding the role of family in health and halth care utilization among elderly .samples are collected from 100 people aged 60yrs and above were interviewed. Majority of the respondent in joint family system were satisfied with their family structure and 65.4% elderly commented that modernization has destroyed the family structure and family value. A decline in the proportion of JFS was seen in the subsequent generation and majority of the elderly perceived that family system has a significant impact on health8.
A study was conducted in chittoor and cuddapha district, regarding Pshysocial contribution to self esteem among older widows. A sample of 320 widows in the 60 to 80 yrs range were drawn by using purposive sampling from rural and urban localities. And it is found that, Many view old age as a dreaded period. Older people differ in many ways not only in the nature of problems but also in the type of adjustment they make. Many older persons suffer in silence with personal, emotional and social problems. But their perception about themselves always differs and that is a crucial factor for good psychological health9.
A study was conducted in the urban areas of Tripati and the rural villages in chittoor district, regarding Councelling needs of elderly, samples are collected from 120 people in the age group of 60-69 and above 70 were interviewed and it is found that the health problems among various subgroups. The responses given to the statements regarding health were analyzed. The statements included problems regarding, visual, auditory, body pains, digestion, sleep disturbances and frequent illnesses10 .
6.3 Problem Statement :
“ A STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE OF CARE GIVERS ON CARE OF ELDERLY IN SELECTED HOSPITALS AT HASSAN , WITH A VIEW TO PREPARE AN INFORMATIONAL BOOKLET “
6.4 Objectives of the study :
1. To assess knowledge level of care givers regarding the care of elderly as measured by structured knowledge questionnaire .
2.To assess the level of attitude of care givers on care of elderly as measured by an attitude scale.
3.To find out association between mean knowledge and attitude score with selected demographic variables(age, occupation, income of the family,type of family, education)
4. To find out the releationship between mean knowledge score and mean attitude score of caregivers regarding care of elderly.
6.5 Operational definitions :
1.Assess:
In this study, it re refers to the evaluvation of knowledge and attitude of caregivers on the care of elderly
2. Knowledge:
In this study ,it refers to the correct response of care givers regarding elderly care as measurd by structured knowledge questionnaire.
3.Attitude:
In this study, it refers to the view or opinion of care givers regarding care of elderly as measured and scored by an attitude scale.
4.Care givers:
In this study , it refers to the person who between the age group of 20 to60yrs provides direct care to the elderly person.
.
5.Care :
In this study ,it refers the fulfillment of the special needs and requirements of elderly patients given by the care giver.
6.Elderly:
In this study, it refers to the a person over 65 years old who have functional impairments.
7.Informational booklet:
In this study, it refers to a written matterial which provides information regarding knowledge and attitude towards care of elderly.
6.6 Variables under study :
1.Dependent variable:
In this study it is Knowledge and attitude regarding care of elderly.
2.Extraneous Variable:
In this study, it includes age, occupation, income of the family,type of family, education
6.7 Assumptions :
1. Caregivers will have some knowledge and attitude regarding the care of elderly.
2. Information booklet is an accepted strategy for improving the knowledge and attitude .
3. As knowledge increases more favourable attitudes develops.
6.8 Delimitations :
The study is delimited to :
1. Caregivers those who are caring the elderly patients.
2. A period of 4-6 weeks.
6.9 Hypotheses (Projected outcome) :
All hypotheses are tested 0.05 level of significance.
H1:. There will be significant relationship between the mean knowledge score and mean attitude score of caregivers regarding care of elderly .
H2: There will be significant association between the mean knowledge score and selected demographic variables.
H3 : There will be a significant association between the mean attitude score and selected demographic variables.
Materials and Methods :
7.1 Source of Data :
The data will be collected from caregivers of elderly patients those who are admitted in the selected Hospitals at Hassan and,those who are present at the time of data collection .
7.1.1 Research Design :
Descriptive survey design will be used for the study.
7.1.2 Setting :
The study will be conducted in SSM (150 bedded) hospital Hassan ,sanjeevini co-operative hospital (250 bedded) Hassan and Mangala(250 bedded) hospital Hassan.
7.1.3 Population :
Population for this study will consist of caregivers of elderly patients those who are admitted in selected hospitals at hassan.
7.2 METHOD OF DATA COLLECTON :
7.2.1 Sampling Procedure :
The required amount of samples will be selected from selected hospitals at hassan ,using purposive sampling technique .
7.2.2 Sample Size :
The sample size for the study comprises of 50 caregivers of elderly patients those who are admitted in selected hospitals at Hassan,Karnataka.
7.2.3 Inclusion criteria for sampling :
1. Caregivers of elderly patients, those who are admitted in selected hospitals at Hassan.
2 .Caregivers of elderly patients those who were present at the time of data collection
3 .Caregivers of elderly patients who are willing to participate in the study
7.2.4 Exclusion criteria for sampling :
1. Caregivers of elderly patients,those who are not admitted in selected hospitals at Hassan.
2. Caregivers of elderly patients those who are absent at the time of data collection.
3. Caregivers of elderly patients who are not willing to participate in the study
7.2.5 Instruments Intend To Be Used :
Section 1 - Demographic proforma
Section 2 - Structured knowledge questionnaire to assess the
knowledge regarding care of elderly
Section 3 - Structured attitude scale to asses the attitude regarding care of elderly
7.2.6 Data Collection Method :
The investigator will obtain formal permission from concerned authorities. The purpose of the study will be explained to the caregivers informed written consent will be obtained from them and it should be kept confidential. A structured knowledge questionnaire and attitude scale will be administered to assess the knowledge and attitude regarding the care of elderly this will be followed by giving an informational booklet.
7.2.7 plan for Data Analysis :
Data analysis will be done by using descriptive and inferential statistics. Finding will be presented in the form of table and Figures .Demographic data will be presented in frequency, percentage, mean and standard deviation. Chi- squiretest will be use to find out the mean association between mean knowledge score and mean attitude score with demographic variables.Inferential statistics such as Karl-pearson co- relation co-efficient ‘r’ test will be used to find out the relationship between mean knowledge score and mean attitude score.
7.3 Does the study require any investigation or intervention to be conducted on patients?
No. The study does not involves any investigation or intervention however an informational booklet will be given to the sample to imrove the knowledge.
7.4 Has ethical clearance been obtained from institution in case of 7.3?
Yes, ethical clearance will be obtained from the ethical committee of the Hospital prior to the conduction of the study. Administrative permission will be obtained from the concerned authorities. Written consent will be obtained from the study sample and confidentiality will be maintained.
LIST OF REFERENCE (VANCOVER STYLE)
1.Old age.(online) available from:http//www.wikipedia.org/wiki/old- age
2.Statistics.elderlywomen(online)availablefrom:http//www.governance.comviews/think-tanks/more-elderly-women-men-india-2050-unfpa
2.A lena, k ahok,m padma, v kamath and v kamath.Health and social problems
of the elderly : Cross sectional study in Udupi taluk Karnataka.indian journal
of community medicine.
3.Attitude towards oldage(online) available from :http://www.krepublishers.com/02-Journals/S-HCS/HCS-03-0-000-09-Web/HCS-03-1-000-09-Abst-PDF/HCS-03-1-001-09-122-Sijuwade-P-O/HCS-03-1-001-09-122-Sijuwade-P-O-Tt. Pdf.
4.Ageing scenario (online) available from http://www.helpageindia.org/about-us/79.html.
5. .Attitude towards oldage(online) available from :http://www.krepublishers.com/02-Journals/S-HCS/HCS-03-0-000-09-Web/HCS-03-1-000-09-Abst-PDF/HCS-03-1-001-09-122-Sijuwade-P-O/HCS-03-1-001-09-122-Sijuwade-P-O-Tt. Pdf.
6.Health and social problems of elderly(online) available fromhttp://www.ijcm.org.in/article.asp?issn=09700218;year=2009;volume=34;issue=2;spage=131;epage=134;aulast=Lena.
7. Assessment of quality of life among rural and urban elderly population of wardha district.department of community medicine , Jawaharlal Nehru medical college wardha maharashtra.(online) available from: http://www.krepublishers.com/02-Journals/S-HCS/HCS-03-0-000-09-Web/HCS-03-1-000-09-Abst-PDF/HCS-03-1-001-09-122-Sijuwade
8. The role of family in health and health care utilization among elderly (online) avilable from: http://ethesis.nitrkl.ac.in/3646/1/project.pdf.
9.Psychosocial contribution to self estee among older adults(online) avilable from :http//: scholar.google.co.in/scholar?q=psychosocial+contribution+to+self+esteem+among+older+widows+cuddapah+and+chittoor&btnG=&hl=en&as_sdt=0%2C5&as_vis=1
10. Regarding the councelling needs of elderly (online) avilable from: http//: scholar.google.co.in/scholar?hl=en&as_sdt=0,5&as_vis=1&q=counselling+needs+of+elderly+study+conducted+in+chittoor+district.