RajigandiUniversity of Health sciences

Bangalore, Karnataka

Proforma for Registeration of

Subject for Dissertation

1. / Name of the Candidate and Address / : / P. BHAVANI,
M.Sc. Nursing Student 1stYearIndianCollege of Nursing,
Thilak Nagar, Bellary.
2. / Name of the Institution / : / Indian College of Nursing, Bellary.
3. / Course of study and subject / : / M.Sc. (Nursing 1st Year) Community Health Nursing
4. / Date of submission / : / 16/06/09
5. / Tittle of the Topic / : /

A Study to determine the effectiveness of structured teaching programme oN Quality of life among senior citizens living in family settings, in selected communities at Bellary, Karnataka

6.
6.1
6.2
6.3
6.37
6.4
6.5
6.6
6.7 / BRIEF RESUME OF THE INTENDED WORK
Introduction :
Aging is a part of the body’s growth process. Aging is a physiological process, which begins at conception resulting progressive changes. The common myths of the elderly persons are frail,senile, unhealthy, unhappy, set their ways.
Quality of life is a association between physically healthy, emotionally well being, life satisfaction, social support, recreational activities and family connections. Oldage should be regarded as a normal, inevitable, biological phenomenon. (1)
United Nations has designed 1st October as the “International day of the Elderly”.86.7 million projected population of people 65 and over in the year of 2050.(2)
Government of India had declared the year 2000 as a “National Year of Senior citizens.” Aged 60 and above 7.5% of countries population. It is expected to reach 15% by 2025. Senior citizens aged 60 and above are 33lakhs 98 thousands 909 in Karnataka.
Old people have limited regenerative ablities and are more prone to get diseases, syndroms sickness than adults because of the biological process. .(3)
K. PARK (2008) describes problems due to aging process it includes wrinkles of the skin, senile cataract, glaucoma, bony changes affecting mobility, nerve deafness, failure of special senses and mentalchanges.
Psychological problems are impaired memory, rigidity, dislike of changes, frustation, fear and anxiety.
Emotional disorders are social maladjustment, bitterness, withdrawal, depression, sucicide.Sexual maladjustment like cessation of reproduction by women, diminition of sexual activity, jealousy and irritability.
Socio economic problems are mainly dependency due to lack of job. Problems associated with longterm illness like atherosclerosis, thrombus formation, high blood pressure cancer of cervix, breast and prostate, accidents, rhenmotoid arthritis, Asthama, emphysema, dysuria and diabetes etc., (4)
Current trends in India demographics shows rapid urbanization, changes in lifestyle, migration diminishing joint family system, caregiver’s neglegency directly (or) indirectly and other various, social factors created a boom in emerging of old age homes. (5)
To overcome these problems and to ensure the quality of life among senior citizens by good healthy and quality of life, good family and social support, adequate nutrition, rest, excercises, social security, love and affection and proper health care facilities and policies are required.
Senior citizens play a valuable role in the socialization of young children and it transmitting social and cultural heritage with the help of their vast experience. Their experience and wisdom can be sought by the younger generation for solving problems during crisis situation. (6)
It is every citizen responsibility to add the years to their life by ensuring quality of life among senior citizens.
need for study :
The Ministry of social justice and environment has adopted in January, 2007 a National Policy on old persons. It has become important to emphasize and promote geriatric health concerns in the population policy by sensitizing, training and equipping rural and urban health centers and hospitals for providing geriatric health care.
Demographic aging is a global phenomenon. By 2025, the world population is expected to more than 830 million people at an age of 65. Unitted Nations is expected to more than 86.7 million population of people 60 by the years 2050.
India has the second largest aged population in the world. India’s elderly population increased rapidly.
As per 2001 census 70.6 million or 6.9% of total elderly population. It is projected that the number of older persons will be 94.8 million in 2011 and 143.7 million or 10.7% by 2021.
According to geriatrics association of India stated that by 2009. India has 77 millions elderly people it includes 7.7% of the total population. In Karnataka Senior Citizens aged 60 and above or33lakhs 98 thousands and 909. (7)
It is expected to reach 14% by the year of 2025. And it has been projected that by the year of 2050, the number of olderly people would rise about 324 million. World Health Organization state that the global average age 66 years, it is projected to reach 73 years by the year of 2025.(8)
In India 75% of elderly persons were living in rural areas. About 48.2% were women out of 55% were widows. One third was reported to be living below the poverty line. 66% of older persons were in a vulnerable situation without food, clothing or shelter. 90% of elderly were from unorganized sector, i.e. they have no regular source of income.
The socio-economic problems of the elderly are nowadays aggrivated by factors such as lack of social security, inadequate facilities of nutrition, shelter, health care and rehabilitation.
Finally he concluded that to overcome these problem and to ensure a good healthy and quality of life there is a need to support the senior citizens by family, society as well as proper health care facilities.
World Health Organization (2001) stated that our main efforts should be to improve their over all quality of life and bettering their emotional status, ensuring general health and providing care giving services.(9)
National policy for older persons (NPOP) was announced in 1999 by the ministry of Social Justice and empowerment. The objectives are to encourage individuals to make provisions for their own as well as their spouse’s old age, to encourge families to take care of the older family members, to enable and support voluntary organizations and NGOs to supplement the care provide by the family, to provide care and protection to the vulnerable group, to provide health care facility to elderly and to promote research and training facilities to the caregivers, to create awareness amongest elderly persons to develop themselves in to fully independent citizen. (10)
There is a need to improve the strategies and role of the geriatric in health care system.
At present, most geriatric services are available at tertiary care hospitals. There is a need to enhance geriatric services at primary and secondary level services also.(11)
There is a need to building of the community leaders is essential for the success of community - based geriatric and rehabilitative health services. Community leaders can play an important role in identifying the felt needs of the elders and in resource generation. (12)
Nursing persons are having responsibility of take care of all age groups individuals, family and community so it is important for the nurse to take care senior citizens in community.
During clinical experience, the investigator come across many senior citizens experiencing loneliness, stress, low self esteemdecreased physical and psychological health status and also detoriation in their quality of life.
In view of above investigator want to assess the knowledge of quality of life and want to develop the knowledge regarding quality of life through the Structured Teaching Programme among senior citizens. The main intention of the investigator is to help or make seniorcitizens to lead quality of life with their own dependency.
review of literature :
A review of literature on the research topic makes the researcher familiar with the existing studies and provides information, which helps to focus on studies and provides information, which helps to focus on a particular problem lay a foundation upon which to base new knowledge. It creates accurate picture of the information found on the subject (Polit and Hungler 2000).
A study on “senior citizen’s physical activity and welfare”. The involved 62 senior citizens among the age group of 50-78. The investigator used cross sectional study. Finally investigated reported a positive association between physical activity, social interaction and well-being. The elderly believed in physical activity’s effect on physical-motor aspects of health. The social representation activity by the group being studied was close to the physical activity’s biopsychosocial dimension.(13)
A study on “Low-income senior citizens in the Municipality”. He stated that the female with low education; 24.8% lacked any kind of retirement pension; 43.6% presented a low level of social integration; 46.7% required some form of help for 1 to 3 routine activities; 74.9% presented 1 to 5 chronic non-communicable diseases; and 56.2% scored under 24 on a cognitive test. Some 87.0% had sought health care and 22.4% required some kind of inpatient care. The results that the need for improved professional training, adequacy of health services, and effective public policy to provide qualified health care for the elderly population.(14)
A study on “Preservation of quality of life and its relation to lifestyle” in centenarians Tokya Medical and DentalUniversity, he included 556 male and 1341 female centenarians participated in the present visitation interview survey and were studied using a structured questionnaire. He investigate Quality of life (QOL) and associated factors in centenarians, he concluded that several lifestyle factors in centenarians, he concluded that several lifestyle factors were found to be associated with preservation of quality of life in centenarians; Results facilitate establishing a public health and welfare policy for the most senior citizens.(15)
A study on “elderly citizen’s perception of their health and care provided” he involved that 201 senior citizens, structured tools were used to measure self appraisal of family stress, perceived social support, caregiver satisfaction and psychological health of family members and of themselves. Even though the senior citizens had survived past the estimated life estimated life expectancy, the quality of life has not improved significantly in the post-apartheid period.(16)
A study on “elderly patients requiring help and nursing care”.The involved 1092 frail people (60 years and older), as well as 406 of their primary caregivers. This paper examines the intensity of help provided, size and concluded that the fail person the more likely they are taken care of by a primary caregiver. Assistance for the elderly is mainly provided by family members. Professional providers are part of the support system when the degree of need of care is extremely high or the primary caregiver reported extremely hig levels of burden. We found that lack of information about services only partly explains the low rate of service utilization. Their role as caregiver affects virtually all areas of life. (17)
A study on “Ear diseases and hearing in the elderly population”. The included 332 males, 648 were females, their ages ranged from 60-96 years with an average age of 68.5 years. Stated that hearing impairment is very prevalent and increases with age and screening for hearing loss using an audiometer and/or acoustic impedance is recommended for all senior citizens in their community at least once a year. Early detection of elderly persons who could benefit from a properly fitted hearing aid will certainly improve the quality of life and may prevent psychiatric and functional impairment. (18)
A study on “improving the quality of life and oral conditions of the aged”. The survey was conducted for all senior citizens aged 70, he stated that teeth is very closely related to one’s daily activities. He concluded that preventing tooth loss is vital for maintaining the masticatory function; so to prevent tooth loss, periodontal disease must be averted.(19)
A study on “Caregivers of chronically ill elderly perceived burden”. He involvement 88 caregivers of elderly chronically ill persons was obtained from various sources in community, the amount of burden they experienced was recorded using the Burden Interview he stated that sons, as caregivers, reported significantly less burden than did daughters or other relatives. Community health and home health nurses working with families in a caregiving situation have an opportunity to reduce caregiver burden. This is done by assessment of the care giving environment and implementation of plans for early intervention.(20)
A study on “Psychosocial intervention for family caregivers of people with dementia reduces caregiver’s burden”. He concluded that psychosocial intervention with a clearly defined aim that includes giving information and having a conversaton group have significant, positive effects on burden and satisfaction for caregivers of people with dementia.(21)
A study on “older husbands as caregivers of their wives”.He included 323 older husbands caring for their wives. He concluded that nearly 60% of them spent at least 84 h/week care giving and about 40% regularly peformed personal care. Comparisons between husbands of wives with and without memory problems revealed selected differences on context and relational variables. This study contributes to knowledge on male caregivers and provides directions for nursing practice and research.(22)
A study on “psychologically abusive behavior by those caring for the elderly”.He included 92 caregivers, Burden Scale were used. He concluded that caregiver psychologically abusive behavior and its related risk factors. Analytical resutls provide important information for medical and social interventions and policies for improving the quality of life of elderly people. (23)
A study on “daughters-in-law in korean caregiving families”.He used cross-sectional descriptive cur relational stated daughter-in-laws caregivers were not at greater risk group of negative health outcomes than daughter caregivers. However, daughters-in-law and daughter caregivers in Korea were a vulnerable group regardless of their relationship with the care-recipient. The cultural norms and social expectations regarding family-centered caregiving in Korea may cause negative health.(24)
statement of the problem :
A Study to Determine the Effectiveness of Structured Teaching Programme on quality of life among seniorcitizens living in family settings in selected communities at Bellary, Karnataka.
Objectives of the Study :
6.31To determine the quality of life among senior citizens in selected communities.
6.32 To determine the pretest knowledge of the subjects.
6.33To develop and impart the Structured Teaching Programme regarding quality of life.
6.34 To determine the effectiveness of Structured Teaching Programme on quality of life.
6.35To analyse the posttest knowledge of subjects who have undergone Structured Teaching Programme on quality of life.
6.36To determine the association between the scores and demographic variables of the subjects.
Operational Depinitions :
Quality of life :
Refers to the sense of well being of senior citizens like health status, leisure time activities, life satisfaction, coping style, and feeling of happiness, social support and religion
Senior citizens :
It refers to the chronological age of the individuals who are above 60 years both males and females.
Effectiveness :
It refers to output of Structured Teaching Programme in terms of improvement in knowledge as assessed by structured questionaire.
Structured Teaching Programme on quality of life :
Structured Teaching Programme on quality of life is designed to provide information about quality of life on all aspects. It includes like definition, problems related to physical,psychological, socio economical, problems associated with long term illness and management of the problems.
Knowledge :
It refers to the level of undersdtanding on quality of life as expressed through the response by the interview technique to the investigator.
Family settings :
It is defined as a group of biologically related individuals living together and sharing their decisions among themselves.
Hypothesis :
  1. There is a significant difference in pretest and post test knowledge regarding quality of life.
  2. There is a significant association between selected demographic variables.
Research variables :
a)Dependent Variable : Senior citizens knowledge regarding quality of life.
b)Independent Variable : Strucutred Teahcing Programme on quality of life.
Assumption :It is assumed that
Senior citizens may have good quality of life.
Quality of life among senior citizens can be enhanced by nutrition, exercise, recreational activities, social support and medical facilities.
Delimitations :
The study is delimited to senior citizens who are staying in family settings only.
The study is delimited to who all are willing to participate in study and able to respond to investigator tool.
The study is delimited to senior citizens who are available at the period of study.
Projected outcome :
Structured Teaching Programme will improve the knowledge of Senior citizens regarding quality of life and they will apply this knowledge on practice effectively to lead a qualtiy of life.

7.Materials and Methods :

7.1 / Materials / Interview technique bythe help of Structured questionare.
7.2 / Method / Interview Method
7.21 / source of data / Senior citizens who are staying in family settings at Bellary.
7.22 / Method of data collection : / The investigator conduct the pre-test by interview technique.
After the pretest, the Structured Teaching Programme on quality of life will be conducted by investigator.
Finally she determine the knowledge of a subjects with the help of the interview technique by using structured questionnaire.
Inclusive criteria : / Senior citizens who are present in family settings only.
Who can able to hear and respond only.
Who give consent for the study.
Exclusive Criteria : / Seniorcitizens who are not present in family settings.
Who have not given consent for the study.
Who can’t able to hear and respond.
7.23 / Research
Design : / Quasi experimental research design.
7.24 / Settings : / Study will be conducted in selected communities at Bellary, Karnataka.
7.25 / Sample Technique : / Simple random sample technique.
7.26 / Sample Size : / 60 Senior citizens are selected for this study.
7.27 / Duration of the study : / The duration of the period is limitted for 4-6 weeks.
7.28 / Tool of research: / By the help of the Structured questionare the investigator will follow interview technique to assess the quality of life among senior citizens.
7.29 / Collection of data : / By interview technique
7.2.10 / Method of data analysis and presentation : / The investigator will analyse the data obtained by using descriptive and inferential statistics.
7.3
7.4 / Does the study require any investigation or intervention to be conducted on senior citizens or other humans or animals? If so please describe briefly.
Yes, the study will be conducted on senior citizens in selected communities who are staying in family settings.
Has ethical clearance been obtained from your institutions in case of 7.3 ?
Yes. Informed consent will be obtained from the institution authorities and subjects privacy. Confidentiality and anonymity will be guarded. Scientific objectivity of the study will be maintained with honesty and impartiality.
8. / List of References :
  1. Sharma Dr. O.P. geriatric Care, A Text book of Geriatrics and Gerantology. Viva Books, New Delhi. 2008; 673-677.
  2. Park.K, Park’s Text book of Preventive and Social Medicine. M/s Banarasidas Bhanot Publishers, Jabalpur, 2008, 475-477.
  3. Ingle G.K., Nath A, Geriatric Health in India: Concerns and Solutions, Indian Journal of Community Medicine, Vol. 33, Issue 4, October 2008, 214-218.
  4. Journal of Sociology and Geronotalogy (2009)
  5. Jamuna D, Reddy LK. The impact of age and length of widowhood on the self concept of elderly widows. Indian Journal of Gerontology 1997; 7:91-96.
  6. WHO, Healthy Aging, Practical pointers on Keeping Well, WHO Western Pacific Region. 2005.
  7. Joshi K, Kumar R, Avasthi A. Morbidity profile and its relationship with diability and psychological distress among elderly people in Northern India. International Journal of Epidemiology 2003; 32:978-987.
  8. Guha R. Morbidity Related Epidemiological Determinants in Indian Aged. An Overview, In Ramachandran CR, Shah B, editors. Public Health Implications of Ageing in India. New Delhi: Indian Council of Medical Research; 1994.
  9. Khandelwal SK. Mental health of older people. In : DeyAB, editor, Ageing in India. Situational analysis and planning for the future. New Delhi: Rakmo Press; 2003.
  10. Santana, Maria a study related to senior citizen’s physical activity and welfare (2009).
  11. FelicianoAB a study related to low income senior citizen’s in the municipality(2008).
  12. Ozaki A, a study related to preservation of quality of life and its relation to lifestyle in centenarians Tokya Medical and Dental Univeristy (2008).
  13. Brathwait D,A study related to elderly citizens perception of their health and care (2008).
  14. Pohlmann K, A study related to elderly patients requiring help and nursing care (2008).
  15. Bunnag C, A study related to ear diseases and hearing in elderly population (2008).
  16. Yoshida Y, A study related to improving the quality of life and oral conditions of the aged (2008).
  17. Faison KJ, A study related to caregivers of chronically ill elderly perceived burden (2008).
  18. Signe A, A study related to psychosocial intervention for family caregivers of people with dementia reduces caregiver’s burdern (2008).
  19. Ducharme F, A study related to older husbands as caregivers of their wifes (2007).
  20. Wang J, A study related to psychologically abusive behavior by those caring for the elderly (2007).
  21. Kims JS, A study related to daughter-in-laws in korean (2007).

9 / Signature of the student
10 / Remarks of guide / The research topic selected for the study is relevant and forwarded for the needful action.
11 / Name and designation of the guide / Mrs. KAMESHWARI
H.O.D. Department of CommunityHealthNursingIndianCollege Of Nursing,
Bellary.
12 / Guide / Mrs. KAMESHWARI
Department of Community Health Nursing
Indian College Of Nursing,
Bellary.
13 / Signature
14 / Co-Guide ( If any ) / Mr. T.V.MATHEW
15 / Signature
16 / Head of the Department / Mrs. KAMESHWARI
HOD. Dept. of Community Health Nursing
Indian College Of Nursing, Bellary.
17 / Signature
18 / Remarks of the chairman & principal / I discussed with the research committee. I felt that research problem is good & feasible
19 / Signature

1