RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE
SYNOPSIS PROFORMA FOR THE REGISTRATION
OF SUBJECT FOR DISSERTATION
: 1ST YEAR M.SC. NURSING,
GOVERNMENT COLLEGE OF
NURSING, FORT, BENGALURU-02.
2. / NAME OF THE INSTITUTION / : GOVERNMENT COLLEGE OF
NURSING, FORT, BENGALURU-02.
3. / COURSE OF STUDY AND SUBJECT / : 1ST YEAR M.SC. NURSING,
PSYCHIATRIC NURSING.
4. / DATE OF ADMISSION TO COURSE / : 28-07-2011
5. / TITLE OF THE TOPIC. / “EFFECTIVENESS OF SELF INSTRUCTIONAL MODULE ON KNOWLEDGE AND ATTITUDE REGARDING ATTENTION DEFICIT HYPERACTIVITY DISORDER IN CHILDERN AMONG D.ed STUDENTS OF SELECTED COLLEGES, BENGALURU”.
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
“HELPING PARENT’S HELP THEIR KIDS”
Attention Deficit Hyperactivity Disorder is a neurobehavioral condition characterized by Excessive restlessness inattention distraction impulsivity. It is usually first identified when Children’s are school aged, although it also can be diagnosed in people of all age groups. In an average classroom of 30 children, research suggested that at least one will have ADHD.1
High activity levels and short attention spans are a normal part of childhood for many children, But for those with ADHD hyperactivity and in attentiveness are excessive interfere with daily Functioning. Some children with ADHD only have problem with attention, other children only have issues with hyperactivity and impulsivity; some children’s have problem with both. Overtime, children with ADHD tend to shed some of the over activity and impulsivity, but they often continue to have significant problems with inattention, distraction and organization.1
ADHD can interfere with a child’s ability to perform in school and capacity to develop and maintain Social ‘peer’ relationships .ADHD can increase a risk of dropping out of school or having disciplinary problems. ADHD also is associated with an increased risk of having hazardous cigarette smoking and substance abuse. Effective treatments are available to help manage the inattention, hyperactivity and impulsiveness symptoms of ADHD. And can improve a person’s ability to function at home, and at school, and other places.1
ADHD is first described by HEINRICH HOFFIN 1854 biological, biochemical, environmental and psychological factors influence ADHD 2.
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood onset psychiatric disorders that affect 2.0-14.0% of school age children. Attention deficit hyperactive disorder is characterized by an age inappropriate level of inattention with or without motor over activity and impulsivity in social, academic and occupational spheres. Boys are more commonly affected by ADHD than girls and the male: female ratio is approximately 3:1 to 4:1. The onset is usually by three years of age but the diagnosis is not made until the child is elementary school.3
According to the previous studies prevalence rate in preschool children’s is 2.0% and 18.2% recent reports highlight behavioral social, familial and academic difficulties in preschool age children with ADHD as compared to other children. An Indian study found 40.0% of children’s with ADHD to have co morbid disorder. The purpose of this study is to determine the prevalence of ADHD in preschool population and also getting help in the diagnosis by the teacher’s parents and also from educational students.3
6.1. NEED FOR THE STUDY
The prevalence of ADHD among children’s as zoomed in the past few years, a study by associated chambers of commerce and industry of India (ASSOCHAM) has found. From 4% in 2005, the number of children’s-in the age group of 3-17 having ADHD has gone up to 11% in 2011. Genetics, diet, social, Physical and parental behavior environment are the main reasons cited for the sharp rise in ADHD cases. More boys are affected by ADHD than girl. The occurrence among the boy’s increases from 6% to 11%, while among the girls it rose from 2% to 5.5% said the study titled “Raising numbers of ADHD kids in metropolitan cities”.3
The survey was conducted in Delhi-NCR, Mumbai, Ahmadabad, and Kolkata Bangalore, Chennai, Hyderabad Chandigarh Jaipur and Luck now. It covered around 1000 school teachers who said that they have 1-3 children’s who are diagnosed with ADHD in every single class.The symptoms of ADHD include restless feeling, often fidgeting with hands or feet, running, climbing, or leaving a seat, when they are expected to sit quiet or remain silent, blurting out answers before hearing the whole question, and having difficulty waiting in line or for their turn.3
Other symptoms of dysfunction include lack of foresight and poor hindsight, poor organization, sense of time, lack of sense of self-awareness and reading of social clues. Such children get frequently angry; they lie, curse, steal, and blame others. However, these children are very high on energy and good at multi-tasking. The study said that ADHD tends to improve with age but can cause significant interference in a child’s academics and interpersonal relations in the initial years. The child has tendency to lose belongings in school or make multiple careless mistakes.3
The Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common behavior problems in school age with an estimated prevalence between three to seven percent. Although the disorder is in particular a problem at the school setting, only few studies included the professions involved such as class teachers, special education teachers, school psychologists or school medics. Therefore, it was the aim of this study to assess the knowledge and resources of these professions and to analyze their way of communication and cooperation a total of 124 persons were questioned using a 19-item self-developed questionnaire. The Study reveals that the knowledge of the professions concerned seems to be satisfying. However, school psychologists and special education teachers are able to use their resources and their possibilities for cooperation better than school medics or class teachers do. The results also indicate that the major problem is at the interface between the professions.
The Study concluded the development of a network with special focus on ADHD to overcome the barriers is proposed.4
A study conducted on increase in teachers knowledge about ADHD after a week-long training program. A teachers training program for ADHD was designed and a pilot run in 3 school in Karachi, Pakistan. The study reveals that 49 teachers, All of them women, completed the questionnaires before and after the training program, and 35 of them Filled it out at the 6 month interval. Mean scores of these tests were compared using a paired t-test the Authors found the difference of mean score of 1.48+/ -2.59, and this was statistically significant (P<.005). The authors conclude that the workshop improved the knowledge of the school teachers regarding ADHD symptomatology and it remained same significant even after 6 months of training.5
As per the above needs in researcher clinical experience there is a need to improve the knowledge of D.ed students regarding ADHD so that they play a important role in early detection of ADHD that helps in early diagnosis and treatment further helps in making difference in educational and social development of the child.
6.2. REVIEW OF LITERATURE
A descriptive cross sectional study was conducted in randomly selected schools of Gampha district using a Stratified sampling method . The knowledge and attitude of primary school teachers on ADHD teachers were Assessed by self administered questionnaire distributed among all the primary school teachers in the selected schools. Teachers who had training in the child psychology recorded significantly higher knowledge Had favorable knowledge. The study concluded that the knowledge of ADHD and its treatment among primary school teachers need to be improved that will help in educational and social development of child.6
A study was designed to explore prevalence of ADHD in primary schools in Saudi Arabia. The data collected from both teachers and parents for 708 primary school pupils attending grades 1-3 (7-9 years old), using DSM-IV criteria of ADHD. The results showed that the overall rate of ADHD was 2.7%, and in particular, the rate of attention type, 2.0% hyperactivity/ impulsivity type,1.4% and combined type 0.7%. Teachers reported ADHD in a higher frequency than parents. However, applying a combination of reports from teachers and parents, screening of ADHD is likely to be more accurate. The study concluded that The importance of detecting ADHD in pupils at an early age and to develop a specific set of psychological clinical interventions for helping them.7
A study was conducted on role of teacher and parent questionnaire in the assessment of patients social- psychological adaptation. Parents and teachers of 342 school children , aged from 7 to 11 years, were questioned with the STRENTH AND DIFFICULTIES QUESTIONNAIRE (SDQ). Using non-randomized method. The following comparative analysis of SDQ items measured in parents and teachers of children’s with ADHD And age mached controls was carried out. It has been shown that the spectrum of disturbances characteristic of ADHD is not confined only to main symptoms of ADHD.The results of questionnaire of both parent s and teachers indicated the marked intensity of emotional disturbances, behavioural problems and difficulties in interaction with peers as well as the underdevelopment of social trends in behaviour in children with ADHD COMPARED to the controls. The data obtained confirm the necessity of treatment extension beyond the core symptoms with considering more general parameters of the patients quality of life.8
A study was conducted on a survey on prevalence rate among male subjects in elementary school (7-9 years) in Iran. This study listed all the school in Mashhad and chose 12, including 24 classes 714 students by stratified cluster sampling. A total of 72 children’s were selected randomly for pilot study. Their parents and teachers filled the 10-item canners ‘questionnaire for ADHD Separately. Clinical interview was based on DSM-IV criteria Students with total scores higher than the cut -off point 23 were selected for interview The study reveals that a total of 109 students out of 714 school boys had ADHD (15.27%+/-2.64%). The subgroups prevalence Rates were as follows; attention deficit (AD) =4.62%, HYPERACTIVE impulsive (HI)=5.32%, and combined type (CT)=5.32%. The study concluded frequency of ADHD among Iranian school boys is more than that in many countries.9
A study was conducted on estimated prevalence of attention-deficit/hyperactivity disorder in a sample of Panamanian school-aged children. The assessment battery included the conners’ parent and Teacher Rating Scales, the structured developmental History of the Behavioral Assessment System for children (BASC-2), and the Wechsler Intelligence Scale for children (WISC- 111). The prevalence of ADHD (N=229) was 7.4%, with an estimate of 1.8% for the predominantly inattentive subtype, 3.1% for the predominantly hyperactive/impulsive subtype, and 2.6%for the combined subtype. The prevalence rate of ADHD is relatively low in Panama compared to those reported for samples in neighboring countries.10
The knowledge and attitudes of practicing teachers regarding ADHD were compared with those of undergraduate education students. Key elements of studies of American and Canadian teachers by Jerome, Gordon, and Hustler (1994) and Jerome, Washington, Laine, and Segal (1999) were replicated. Information was gathered about participants' demographic background (training in ADHD), attitudes towards ADHD, and knowledge about its diagnosis and treatment. Results confirmed the existence of some knowledge gaps, although both practicing teachers and undergraduate education students possessed sound information about ADHD. Misconceptions about ADHD primarily concerned dietary treatment. Attitudes and knowledge were significantly correlated and most participants regarded ADHD as a valid diagnosis with implications for the school setting, and expressed a desire for comprehensive training.11
A study was conducted on Educators' knowledge and attitudes regarding stimulants in the treatment of attention deficit hyperactivity disorder. A designed questionnaire is used to determine the knowledge and attitudes of educators regarding stimulants. Two hundred ninety-one regular classroom and special education teachers in two Ohio school systems received the questionnaire; the overall response rate was 65%. Our findings suggest that educators generally believe stimulants are useful for students with ADHD and that they frequently recommend them to parents. Physicians requesting input from educators regarding students taking stimulants should be aware of the limitations of educators' knowledge and participate in the development of programs to improve that knowledge.12
A comparative study was conducted on American and Canadian teachers' knowledge and attitudes regarding ADHD. The results indicated that both samples had little in-service training regarding ADHD. Despite this, most teachers regarded ADHD as a valid diagnosis with educational implications and wanted more formal training. While most teachers did well on knowledge-based questions regarding the etiology and educational implications of the condition, many still perceived non-medical therapies such as diets as being effective. The implications of improved in-service training for all professionals involved with children with ADHD are discussed.13
This study was designed to analyze the knowledge, misconceptions, and lacks about Attention Deficit Hyperactivity Disorder (ADHD) in a sample of 193 teachers. Results indicated an average of correct responses of 31.67, 63.88 and 40.46% in general knowledge, symptoms/diagnosis and treatment, respectively. Teachers displayed significantly more knowledge in the Symptoms/Diagnosis scale than in the other scales. Their knowledge correlated positively with: years of experience with hyperactive children, number of hyperactive pupils in their classrooms, and level of perceived self-efficacy.14
A study was conducted on Measuring teacher attitudes and expectations toward students with ADHD. Test of Knowledge About ADHD (KADD) was constructed based on the error-choice method, which is an indirect method of attitude measurement. 103 Elementary school teachers completed the error-choice Instrument. Results indicated adequate to good internal consistency reliability for the KADD for this sample, with a Cronbach's coefficient alpha of 0.82. Additionally, results yielded
initial discriminant evidence to suggest that the KADD has construct validity for
this sample. Implications for the use of this instrument in applied areas are discussed.15
STATEMENT OF THE PROBLEM
EFFECTIVENESS OF SELF INSTRUCTION MODULE ON KNOWLEDGE AND ATTITUDE REGARDING ATTENTION DFICIT HYPERACTIVITY DISORDER IN CHILDREN AMONG D.ed STUDENTS OF SELECTED COLLEGES, BENGALURU.
6.3 OBJECTIVES OF THE STUDY
1) To assess the knowledge and attitude regarding ADHD in children among D.ed students by pre test.