PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

Mr. ARAVIND S INDI

I YEAR M. Sc NURSING

PSYCHIATRIC NURSING

YEAR 2010-2011

TULZA BHAVANI COLLEGE OF NURSING

NO, 899/3, NEAR HAJRAT JUNEEDI DARGA, GYANG BAWADI,

BIJAPUR-586101

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / MR. ARAVIND SHRISHAIL INDI
I YEAR M.Sc. (NURSING),
TULZA BHAVANI COLLEGE OF NURSING, NO, 899/3, NEAR HAJRAT JUNEEDI DARGA, GYANGBAWADI, BIJAPUR-586101
2. / NAME OF THE INSTITUTE / Tulza Bhavani College of Nursing
no, 899/3, near hajrat juneedi darga, gyang bawadi, Bijapur-586101
3. / COURSE OF THE STUDY AND SUBJECT / I Year M.Sc. (Nursing),
Psychiatric Nursing.
4. / DATE OF ADMISSION TO THE COURSE / 10-04-2010
5. / TITLE OF THE STUDY / “A Study to assess knowledge of primary school teachers regarding prevention of common behavioural problems among children at selected schools of Bijapur, with a view to develop information booklet”


6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

It is important to realize that all children go through periods of behavioural and/or emotional difficulty. It is also important to recognize that all children are individuals; therefore there is no universal formula for resolving all emotional or behavioural problems. Within the next little while, hopefully, I can begin to offer some insight to recognizing children with difficulties and offer some suggestions to help you, as Leaders find the right approach to aid them.1

Behaviour refers to the actions of a system or organism, usually in relation to its environment, which includes the other systems or organisms around as well as the physical environment. It is the response of the system or organism to various stimuli or inputs, whether internal or external, conscious or subconscious, overt or covert, and voluntary or involuntary.2

Behavioural problems are defined as the reaction and clinical manifestations which are resulting due to emotional disturbance or environmental maladjustments. Common Behavioural Problems in Children are, Hyperkinetic disorder, conduct disorder, emotional disturbances, tic disorder, autism, attention deficit hyperactivity disorder and learning disabilities.3

Serious behaviour problems can be effectively,A combination of anger management, coping and problem solving skills for children and education and support for parents and carers is likely to be needed. School staff have a significant role in ensuring that management of behaviours at school is consistent and effective. Early treatment is very important as behaviour problems are more difficult to change once they are well established. Early treatment can also help to reduce negative impacts on school learning and on self-esteem.3

Parents and carers are assisted by learning specific behaviour management skills for dealing with difficult behaviours. Meeting in small groups with other parents and carers whose children have similar difficulties helps to ensure that the parenting techniques learned are effective for their children’s needs. Parenting groups should be facilitated by a skilled parenting educator who has training and expertise in helping parents and carers manage behaviour problems.4

6.2 NEED FOR THE STUDY

Every individual has the right that his physical, social and emotional needs should be satisfied in society as well as in class room environment. The desire to be accepted and protected in childhood is natural. He or she needs help for adjustment. This is his/her right that s/he should be provided with an environment in which his/her natural capabilities flourish so that s/he may become useful member of the society.5

Through education individuals' behaviors are shaped. In formal or conventional mode of education, teacher plays a pivotal role in this regard. Moreover, it is again overwhelming at primary and secondary school levels. It is, therefore, necessary that a teacher should know his or her pupils thoroughly as to their abilities, limitations, motives, aspirations, needs and physical development patterns, so that teaching can be made interesting and effective. Teacher should be able to know all such things through the study of educational psychology. Such knowledge can contribute to the promotion of learning process and developing students' personalities positively by understanding about individual behaviour.5

Students with emotional disturbance and behavioral problems exhibit a wide range of characteristics. The intensity of the disorder varies, as does the manner in which a disability or problem presents itself. While some students have mood disorders, such as depression, others may experience intense feelings of anger or frustration. Further, individual students react to feelings of depression, anger or frustration in very different ways. For example, some students internalize these feelings, acting shy and withdrawn; others may externalize their feelings, becoming violent or aggressive toward others.6

In a questionnaire survey of 10,000 primary school children, teachers reported behaviour problems in 38% of 6199 children on whom complete information was made available. Categorization of 3572 behaviour problems according to a modified APA-DSM II classification showed aggressive reactions to be the commonest (22.7%). This was followed by disorders of sleep (17.1%), unsocial aggressive reactions (15.5%), aggressive-regressive reactions (13.5%), regressive reactions (10.7%), school grade problems (8.7%) and others. Significant influence of sex, age and socio-economic class was noted on the overall prevalence, and prevalence of specific behaviour problems. A general lack of awareness among the parents about the childhood behavioural problems was noticeable from the pattern of utilization of the pediatric outpatient services in the study area. There is a need to educate parents on behaviour of children and the significance of behavioural deviations. 7

Risk factors for behaviour problems occur throughout children’s development, and children face new risks as they mature and encounter new challenges. Children’s environments also become more complex as they grow older, making intervention more difficult. Some early risks have been repeatedly tied to many behaviour problems in later childhood. Reducing these risks has the possibility to prevent the development of multiple problems. A few programmes have had remarkable effects in preventing the development of behavioural problem in adolescence. In one project, nurses visited poor unmarried teenage mothers before and after the birth of their children. Their visits focused on improving the mother’s physical and psychological health, educational and family planning, childcare and support from family and friends. The mothers’ own adjustment improved. More importantly, their children showed less delinquency, smoking, drug and alcohol use and sexual activities at age 15, compared to children whose mothers did not receive the programme.8

Many times, behavioural problems are first brought to the attention of parents by teachers or school officials. Children who are easily distracted, unwilling or unable to cooperate with school rules, or are disruptive to classroom activities can make it difficult not only for teachers, but also for other students. Parents of children with behavioural problems can work with teachers, child psychologists, and their child to help formulate a plan to help children get the most benefit from the educational process. 9

6.3 REVIEW OF LITERATURE

The review of literature in a research report is a summary of current knowledge about a particular problem and includes what is known and not known about the problem. The literature is reviewed to summarize knowledge for use in practice or to provide a basis for conducting a study. Review of literature section includes a description of the current knowledge of a particular problem, the gaps in this knowledge base and the contribution of the study to the development of knowledge in this area. Review of literature is a key steps in research process. The typical purpose for analyzing a review existing literature is generate research question to identify what is known and what is not known about the topic. The major goals of review of literature are to develop a strong knowledge base to carry out research and non research scholarly activity.10

§  Review of literlature related to prevention of common behavioural problems in primary school childrens.

Hanisch C, Freund-Braier I, Hautmann C, Jänen N, Plück J, Brix G, Eichelberger I, Döpfner M. (2010 ) conducted a study in Germany to evaluate the effects of PEP on child problem behaviour, parenting practices, parent-child interactions, and parental quality of life. Parents and kindergarten teachers of 155 children were randomly assigned to an intervention group (n = 91) and a nontreated control group (n = 64). They rated children's problem behaviour before and after PEP training; parents also reported on their parenting practices and quality of life. Standardized play situations were video-taped and rated for parent-child interactions, e.g. parental warmth. The results showed mothers of the intervention group described less disruptive child behaviour and better parenting strategies, and showed more parental warmth during a standardized parent-child interaction. Dosage analyses confirmed these results for parents who attended at least five training sessions. Children were also rated to show less behaviour problems by their kindergarten teachers. Conclusion was made that training effects were especially positive for parents who attended at least half of the training sessions.11

Elhamid AA, Howe A, Reading R. (2009 ) conducted a study in Egypt on Prevalence of emotional and behavioural problems among (1186) 6-12year old children in Egypt. Data were collected from teachers and parents using the Strengths and Difficulties Questionnaire with a 98 and 91% response respectively. Prevalence of abnormal symptom scores was reported for both parents and teachers. Prevalence of probable psychiatric diagnoses was measured using the SDQ multi-informant algorithm. These prevalences have then been compared to published UK data. The prevalence of emotional and behavioural symptoms was high as reported by both parents and teachers (Abnormal total difficulties: teachers 34.7%, parents 20.6%. Abnormal prosocial scores: teachers 24.9% , parents 11.8% but prevalence of probable psychiatric diagnoses was much lower (Any psychiatric diagnosis 8.5% ; Emotional disorder 2.0% ; Conduct disorder 6.6% Hyperactivity disorder 0.7% ). Comparison with UK data showed higher rates of symptoms but similar rates of probable disorders. Despite public, professional and political underestimation of child mental health problems in Egypt, rates of symptoms are higher than in developed countries, and rates of disorders are comparable. Findings supported greater investment in community and primary care prevention and treatment initiatives.12

Syed EU, Hussein SA, Haidry SE (2009) conducted a study in Pakistan on Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan. A cross sectional survey of school children of certain towns within Karachi metropolitan area, aged 5 to 11 years during 1(st) half of 2006. SDQ was filled out by parents and school teachers for the same children. Demographic data of parents, teachers and children were also collected using a separate Performa. Assessment of children's mental health was conducted using Strength and Difficulties Questionnaire (SDQ). Parents rated 34.4% of children as falling under the "abnormal category on SDQ, slightly higher estimates 35.8% were reported by the teacher. The findings suggest a striking difference between the informants' ratings as well as gender wise difference in prevalence of common child mental health problems. Conclusion of the study showed prevalence of child mental health problems was higher than reported in studies from other countries. There was also a gender difference in prevalence; boys had higher estimates of behavior/externalizing problems, whereas emotional problems were more common amongst females. 13

Hiscock H, Bayer JK, Price a, Ukoumunne OC, Rogers S, Wake M (2008) conducted a study in Australia on Universal parenting programme to prevent early childhood behavioural problems: cluster randomised trial. Structured three session programme method at age 8-15 months, co-led by well child providers and a parenting expert. The programme covered normal development and behaviour, strategies to increase desired behaviour, and strategies to reduce unwanted behaviour. At 18 months, child behaviour and parenting scores were similar in the two groups. At 24 months, externalizing scores in the intervention and control groups were similar (mean 11.9 (SD 7.2) v 12.9 (7.4)); however, on the parent behavior checklist subscale scores, intervention group parents were less likely to report harsh/abusive parenting (mean 38.9 (SD 7.7) v 40.5 (8.8); adjusted mean difference -1.83, 95% confidence interval -3.12 to -0.55) and unreasonable expectations of child development (40.9 (9.9) v 42.7 (9.6); -2.18, -3.74 to -0.62). Mean scores for nurturing parenting and maternal mental health were similar in the two groups at both times. A universal parenting programme resulted in modest improvement in parenting factors that predict behavioural problems in children but did not reduce externalizing behavioural problems or affect maternal mental health at 2 years. 14

Woo BS, at all (2007) conducted a study in Singapore on Emotional and behavioural problems in Singaporean children based on parent, teacher and child reports. The Child Behaviour Checklist (CBCL), Teacher Rating Form (TRF) and child report questionnaires for depression and anxiety were administered to a community sample of primary school children. 60 Parents of a sub-sample of 203 children underwent a structured clinical interview. The result was that higher prevalence of emotional and behavioural problems was identified by CBCL (12.5 percent) than by TRF (2.5 percent). According to parent reports, higher rates of internalising problems (12.2 percent) compared to externalising problems (4.9 percent), were found. Correlations between child-reported depression and anxiety, and parent and teacher reports were low to moderate, but were better for parent reports than for teacher reports15

Lindsay G, Dockrell JE, Strand S.( 2007 ) conducted a study in UK on Longitudinal patterns of behaviour problems in children with specific speech and language difficulties A sample of children with SSLD were assessed for BESD at ages 8, 10 and 12 years by both teachers and parents. Language abilities were assessed at 8 and 10 years. Results showed: High levels of BESD were found at all three ages but with different patterns of trajectories for parents' and teachers' ratings. Language ability predicted teacher- but not parent-rated BESD.The study confirms the persistence of high levels of BESD over the period 8-12 years and the continuing comorbidity of BESD and language difficulties but also indicates a complex interaction of within-child and contextual factors over time.16

Furniss T, Beyer T, Guggenmos J. (2006) conducted a study in Germany on Prevalence of behavioural and emotional problems among six-years-old preschool children: baseline results of a prospective longitudinal study. The sample consisted of 1887 preschool children who started primary level education within 6 months upon data collection. The data were collected with standardized parent questionnaires. Result was as follows, the 6-month prevalence of behavioural and emotional symptoms was 12.4%. The overall score for internalizing symptoms was significantly higher than the score for externalizing symptoms. The disturbed children had the highest mean scores on the syndrome scale "Anxious or Depressed”. Conclusion came that the level of psychopathology in preschool children was already as high as levels seen elsewhere in school children. The attention of child mental health services need to focus on preschool children as on school children, especially in boys. 17