RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
1. NAME OF THE CANDIDATE : Ms. RUPINDER KAUR BRAR
AND ADDRESS I YEAR M.SC NURSING
NO-9, SAPTHAGIRI
MANSION BHANU NURSING
HOME ROAD,BOMMANAHALLI
BANGALORE-560 068.
2. NAME OF THE INSTITUTION : CHINAI COLLEGE OF
NURSING,
BOMMANAHALLI,
BANGALORE-68.
3. COURSE OF STUDY AND : MASTER DEGREE OF
SUBJECT NURSING
PSYCHIATRIC NURSING
4. DATE OF ADMISSION TO : 15.06.2009
COURSE
5. TITLE OF THE TOPIC : “A STUDY TO ASSESS THE
EFFECTIVENESS OF
STRUCTURED TEACHING
PROGRAMME ON PREVENTION
OF SUBSTANCE ABUSE AMONG
YOUNG ADULTS STUDYING IN
SELECTED COLLEGES AT
BANGALORE”.
6. BRIEF RESUME OF THE INTENDED WORK:
INTRODUCTION:
Good health is a prerequisite of developmental process and human productivity. Health is essential for the economical and social development of the country. Health is a state of complete physical, mental, social and spiritual well being and not merely an absence of disease or infirmities. It is also a state of well being of individual and community. Now a day there is an increasing trend for the abuse of psychoactive substances in the developing countries like India, which has a great impact on social, cultural, economical and also health status of individual & community. Substance abuse especially amongst youth has been a matter of concern throughout the world. Adolescence is the critical period when the first initiation of substance use takes place. Among the youth the students are more vulnerable due to increased academic pressure, peer group influence and increased popularity & availability of substances like alcohol, tobacco etc. The technical persons or the students of professional institutions also are not away from such hazardous behavior.
Substance abuse has a major impact on individuals, their families, and their communities. The effects of substance abuse are cumulative, contributing to costly social, physical, mental, and public health problems. These problems include teenage pregnancy, HIV/AIDS, other sexually transmitted diseases (STDs), domestic violence, child abuse, motor vehicle crashes, physical fights, crime, homicide, and suicide. Advances in preventing substance abuse and the provision of treatment to substance users have contributed to improved lives for many Americans. Although disparities in access to substance abuse treatment remain, some progress in reducing them has been accomplished. With regard to disparities in attitudes toward drug and alcohol use, data demonstrate that the highest rates of disapproval exist among youth in select racial and ethnic populations. Addiction is a state of physical or psychological dependence on a substance. Physical addiction includes the development of tolerance (needing more and more of the drug to achieve the same effect) and withdrawal symptoms that appear when the user stops taking the drug, and disappear when more of the drug is taken.
Many different types of drugs can be abused: not only illegal drugs such as heroin, cannabis, cocaine or ecstasy, but also prescription drugs such as tranquillizers, analgesics (painkillers), and sleeping pills. Even medicines that can be bought off the supermarket shelf can be abused (such as cough mixtures or herbal remedies) and the abuse of alcohol is a major area of concern.
Studies from different parts of the world have shown that college students have a higher prevalence of alcohol drinking and alcohol-use disorders, than non-college youth. This could be attributed to the well established developmental phase college students go through, in which they are away from home, family and longstanding friendships. Throughout their college years, students pass through a phase of vulnerability (intellectually, emotionally and socially), in a new environment characterized by considerable peer influence, and often aggressive promotion of alcoholic beverages. In addition to the college setting being a unique environment to which a large proportion of young people are exposed en masse, nearly all of the world's future leaders, policy-makers, and healthcare providers will have passed through the college system as young people.
Substance abuse is a major health problem among public. According to the recent statistics in India 5-10% of the people are using abuses. Among them 75% of the young youths are using alcohol, nearly 35% of the young adults are having the habit of smoking, 35% of the people are having the habit of alcoholism.
6.1 NEED FOR THE STUDY
The period of young adulthood is not an easy stage of life. Many physical and emotional changes take place during young adulthood period. The period of young adulthood is a critical one and that has many health-related beliefs, attitudes and behaviors are adopted and consolidated. During this stage of life, young people have increased freedom to access to health compromising substances and experiences – such as alcohol, tobacco, other drugs and sexual risk taking as well as opportunities for health enhancing experiences like regularly scheduled exercise and healthful diets. [Jerome. E. Kotecki, 2003]
Health demands of young adulthood cannot be ignored since they form an important part of the human resource of our country. Habits and behaviors (Food habits, substance abuse, conflict and emotional management, sexual expression) picked up during adolescence have life-long impact. [Dutta, 2007]
Bennett and Woolf (1991) defines substance abuse as psychoactive drugs, of any class or type, used alone or in combination, that poses significant hazards to health. Substance abuse is the use of any substance that threatens a person’s health or impairs his or her social or economic functioning.
Substance abuse usually begins in adolescence. Few people begin misuse of tobacco after 18 years of age. Half of regular smokers who start in adolescence and smoke all their lives will eventually be killed by tobacco. Alcohol is the commonest factor in substance related deaths among the young adults. [Anupam Sachdeva, 2007].
Young people are often at the leading edge of social change, and this is particularly true in the case of substance abuse. The surge in illicit drug usage during the last decade has been primarily a youth phenomenon, with onset of use most likely occurring during adolescent period. [Marlow, 2006]
Elizabeth Hurlock (2006) states that it is impossible to predict when substance abuse will begin. But it is considered that the average age group is young adults between 18-25 years. Common physical manifestations of young adults in substance abuse include alterations in vital signs, weight loss, chronic fatigue, chronic cough, respiratory congestion, red eyes, and general apathy and malaise. The mental status examination may reveal alterations in level of consciousness, impaired attention and concentration, impaired thought processes, delusions and hallucinations. Low self esteem, feelings of guilt, or worthlessness and suicide, homicidal thoughts are also common. [Jane Ball, 2004]
Common substances that cause addiction and dependence are as follows. Certain stimulants, depressants, opioids, cannabis, hallucinogens and inhalants, steroids, sedatives – hypnotics, are usually causes severe conditions of addiction.
One in five deaths in the United States is attributed to cigarettes. It is estimated that 4, 34,000 deaths per year among young adults in developed countries is due to smoking. Current smoking rate is 31.7% among young adults in developed countries. [Stanhope 2003]. Studies indicate that substance abuse increased from 6.3% of the populations studied in 2000 to 7.1% in 2001. This represents about 15.9 million American aged 12 years and older being identified as “current users”. In 2001, the rate among Americans was 7.4%, white individuals, 7.2%, and Hispanics 6.4%. The highest rates of illicit drugs use were among Native Americans/ American Indians and Alaskan Natives at 9.9%. The lowest rate of substance use was among Asian Americans at 2.8% [Ignatavicins 2006].
There fore the investigator planned to conduct the study among young adults in selected colleges because of the high prevalence of the problem among young adults. The investigator planned to give health education regarding the prevention of substance abuse.
6.2 REVIEW OF LITERATURE
A review of literature is an essential activity of scientific research project which provides a basis of future investigation, justifies the need for replication, throw light on the feasibility of the study indicate the constraints of data collection and helps for relate findings from one study to another with a view to establish a comprehensive body of scientific knowledge in a professional discipline, from which valid and pertinent theories may be developed.
A longitudinal study conducted by young R. Sweeting [2008], on alcohol use and antisocial behaviour in young people among 2586 samples. The exploration of the causal effects of alcohol use or misuse and antisocial behaviour among young males, using a structural equation models of longer and shorter-term relationships and joint-effects models in respect of alcohol-related trouble at age of above 15. The results shows there is support the susceptibility hypothesis, particularly in the longer-term models. There is no support for ‘pure’ disinhibition, antisocial behavior causing alcohol (mis) use the reverse also applies.
Kishore et al., [2006] conducted a cross sectional study regarding substance use among intercollege students in India. 1094 students were included of which the prevalence of substance abuse for ever users was 58.7%, regular use of substance abuse was found to be 31.3%.
Berger, Martin et al., [2005] conducted a study on perceived academic performance and alcohol, tobacco and marijuana use in Australia. The sample size was 1579. The result shows persistent or increasing perception of academic ‘failure’, compared to improving or stable perception of average performance.
Dipika Sur, SP Mulchopadhyay [2002-2005] conducted a descriptive study on smoking habits among slum dwellers and the impact on health and economics among approximately 3000 families in the slum are area of Howrah Municipal Corporation (HMC) adjacent to the city of Kolkata in India. The results indicate of 1729 smokers identified in the study population 58% smoked beedi followed by cigarette 41%. The average smoking years ranged from 12-23 years for all types of tobacco smokers but the average consumption per day was higher for bidi smokers 13/day against 8/day for cigarette smokers. The average cost per day was higher for cigarette smokers Rs 10 against Rs 3 for bidi smoker. Total numbers of smokers among sampled young adults were 18.34%.
A study conducted by Sid fiddler [1998] on Alcohol and drug abuse and its relationship to Indian suicide rate among young adults aged 15to29years in Saskatchewan Indian Federated College. The results shown that 31.6% of the total registered Indian population, had 32.6% of the off reserve population of their particular age group. The pattern of drinking in the adolescent sample parallels those of the adult groups (82.1%) at a reduced frequency. In comparing populations suicide rates and substance abuse appear from 15 – 24 age grouping was 11.5 times higher than the Canadian non Indian counter parts.
Patel et al., [1998] conducted a study immediately after 45 minute drug awareness programme knowledge about tobacco and alcohol was assessed in 964 students studying in certain colleges of Baroda. It was assessed by using a 20 item questionnaire administered in a classroom. A majority of the students had adequate knowledge. Incorrect responses were commonly regarding the following items: alcohol dependence is a disease, alcohol ensures good sleep and quitting smoking is an impossible task. Substance use was reported by 38 out of 964 students and it was limited to smoking, smokeless tobacco and alcohol and cannabis.
STATEMENT OF THE PROBLEM:
“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON PREVENTION OF SUBSTANCE ABUSE AMONG YOUNG ADULTS STUDYING IN SELECTED COLLEGES AT BANGALORE”.
6.3 OBJECTIVES OF THE STUDY:
6.3.1. To assess the knowledge of young adults regarding prevention of substance abuse.
6.3.2. To evaluate the effectiveness of structured teaching programme on prevention of substance abuse among young adults.
6.3.3. To determine the association between pretest and post test knowledge regarding substance abuse among young adults with selected socio demographic data such as age, religion, education, occupation of the father, monthly family income, type of family, location of family and sources of information regarding substance abuse.
6.4 HYPOTHESES OF THE STUDY:
H1: The mean post-test knowledge scores of young adults regarding prevention of substance abuse will be significantly higher than the mean pretest knowledge score.
H2: There will be a significant association between pre-test and post test knowledge and selected demographic variables such as age, religion, education, occupation of the father, monthly family income, type of family, location of family and sources of information regarding prevention of substance abuse.
6.5. VARIABLES:
Research variables are the concepts at various levels of abstraction that are entered manipulated and collected in the study.
INDEPENDENT VARIABLE:
Structured teaching programme on prevention of substance abuse among young adults in selected colleges at Bangalore.
DEPENDENT VARIABLE:
Knowledge regarding prevention of substance abuse among young adults.
EXTRENEOUS VARIABLE:
Age, religion, education, occupation of the father, monthly family income, type of family, location of family and sources of information regarding prevention of substance abuse.
6.6. OPERATIONAL DEFINITIONS:
Ø EFFECTIVENESS:
It refers to the significant gain in knowledge regarding prevention of
substance abuse as measured by the instrument and shown by post test
knowledge scores.
Ø STRUCTURED TEACHING PROGRAMME:
It refers to the systematically developed instructional and teaching aids designed for young adults regarding prevention of substance abuse.
Ø PREVENTION:
It means the intervention prior to the onset of disease preventing the possibility of occurrence of disease.
Ø YOUNG ADULTS:
It refers to the period of age between 18 to 25 years of age.
Ø SUBSTANCE ABUSE:
It refers to the misuse of substances like alcohol, nicotine and other
drugs.
6.7. ASSUMPTION:
Knowledge regarding substance abuse will create an awareness for young adults not to indulge in substance abuse.
Group teaching will provide opportunity for active learning among participants.
6.8 . DELIMITATION:
1. The study is de-limited to young adults of age18 to 25 years.
2. The study is de-limited to young adults in selected colleges.
3. The data collection period is de-limited to 6 weeks.
7. MATERIALS & METHOD:
7.1SOURCE OF DATA:
Data will be collected from young adults in selected colleges at Bangalore.