A QUASI EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE ABOUT CHILD

ABUSE AMONG PRIMARY AND MIDDLE SCHOOL TEACHERS IN SELECTED

SCHOOLS AT BANGALORE.

M.Sc Nursing Dissertation Protocol submitted to

RajivGandhiUniversity of Health Sciences, Karnataka, Bangalore.

By

Mrs. PANIMALAR .A

M.Sc NURSING 1ST YEAR

2009-2011

Under the Guidance of

HOD, Department of Medical surgical Nursing

KTG College of Nursing

Hegganahalli Cross

Vishwaneedam Post

Magadi Road

Bangalore –91

RajivGandhiUniversity of Health Sciences, Karnataka

Curriculum Development Cell

CONFIRMATION FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

Registration No.

Name of the candidate :Mrs. Panimalar .A

Address:KTG College of Nursing

Heggnahalli Cross

Bangalore 560091

Name of the Institution:KTG College of Nursing

Date of admission to course:15/05/09

Title of the Topic :A Quasi experimental study to assess the effectiveness of structured teaching programme on knowledge about child abuse among primary and middle school teachers in selected schools in Bangalore.

Brief Resume of the work: Attached

Signature of the student:

Guide Name:

Remark of the guide:

Signature of the Guide:

Co-Guide name:

Signature of the Co-guide:

HOD Name:

Signature of the HOD:

Principal Name:Mr. Biju Ramachandran

Principal Mobile No.:

Principal E-mail ID:

Remark of the Principal:

Principal Signature:

RAJIVGHANDIUNIVERSITY OF HEALTH SCIENCE

KARNATAKA, BANGALORE.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / Mrs. PANIMALAR. A
I YEAR M.SC
K. T. G COLLEGE OF NURSING,
HEGNAHALLI CROSS,
BANGALORE-560091
2. / NAME OF THE INSTITUTION / K. T. G COLLEGE OF NURSING,
HEGNAHALLI CROSS,
BANGALORE-560091
3. / COURSE OF THE STUDY AND SUBJECT / I YEAR M.SC NURSING
MEDICAL SURGICAL NURSING
4. / DATE OF ADMISSION TO COURSE / 15/05/2009
5. / TITLE OF THE COURSE / A QUASI EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE ABOUT CHILD ABUSE AMONG PRIMARY AND MIDDLE SCHOOL TEACHERS IN SELECTED SCHOOL AT BANGALORE
6. / BRIEF RESUME OF THE INTENDED WORK
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8 / “Before you beat a child be sure you yourself are not the cause of offence”
Austin O’Malley.
“Nothing can be more dishonest or harmful to our future generations than underplaying an issue such as the abuse of the children”.
Child abuse is a disturbing common problem in the society today. There have been substantial and significant increases in the incidence of child abuse, since the last national incidence. Still saddening news is that, adults, the role models are the one, responsible for committing such acts towards children. On top of that, parents have also been committed of causing harm to their offspring, an offence that barb no excuse.
Child abuse is referred as the cruel treatment of child by an adult this study will be conducted on teachers because of their presence with the children one third of a day in the school and also teacher are good observers of child behavior in the school. In countries like India there is general lack of sensitivity to the issue about child abuses among professionals and the lay public alike. So this is influenced the researcher to conduct a study among teachers about their knowledge on child abuse.
The primary concern of the child abuse management is personal safety and welfare of the child the best way of adapting personal safety is to empower the people with own choice. The personal safety skills involve active reorganization and living of situation. The remedial measures for child a buse include high level of socio legal help and counseling of the child and parents. The children living in the streets can be adopted and provided educational and occupational opportunities. The role of teacher is to identify the possible cases actively and refer them to the health care services appropriately.
The nurses need to have knowledge regarding child abuse in order identify possible cases in the community setup, refer and care them accordingly.
NEED FOR THE STUDY
Abused children are 25 percent more likely to experience teen pregnancy. 14.4 percent of all men and 36.7 percent of all women in prison in the United States were abused as children. Children who have been sexually abused are 2.5 times more likely to develop alcohol abuse and 3.8 times more likely develop drug addictions. Abused teens are 3 times less likely to practices safe sex, putting them at greater risks for STDs. It was identified that one third of abused and neglected children will eventually victimized their own children, and nearly two third of the people in treatment for drug abuse reported being abused as children.
There are nearly 3 million reports of child abuse made annually. There were 906,000 child abuse convictions. The rate of child abuse is estimated to the 3 times greater than is reported. The rate of victimization is 12.3 children per 1,000 children. Children below 3 years are the most likely to experience abuse. They are victimized at a rate of 16.4 per 1,000. 79 percentage of children killed are younger than 4. These statistics are from the Administration for Children and Families of the US Department of Health And Human services. “Child Maltreatment Report”.
Due to child abuse, most of the children used to go in a wrong way. So it affects the health of the new generations. In order to promote the younger generations, this child is insisted me to do research upon this.
More than 2.5 million cases of child abuse and neglect are reported each year. Of these 35 percent involves physical abuse, 50 percent involves sexual abuse and 50 percent involves neglect. Studies show that one in four girls and one in eight boys are sexually abused before they are 18years of age.
Kerala is the state which has the highest incidence in the reported cases of child abuse. From Karnataka the recent arrests and investigations by social group reveal that more than 10,000 pedophiles visit every year.
According to crime in India, the annual publication of the National Crime Record Bureau (NCRB), Union Ministry of Home Affairs, during 2003, 374 children in the age group of 10-18 were kidnapped for illicit intercourse and 57 for being forced in to prostitution. And 2,949 children were raped that year, a figure that registered 21% raise in 2004.
REVIEW OF RELATED LITRATURE
“A review of literature involves identification, location scrutinization and summary of written materials that contains information on research problems.”
According to Polit and Bick, review of literature is a written summary of the existing knowledge on a research problem. An in depth study of any subject involves a systematic review and appraisal of all the relevant scholarly literature and specific topic.
The literature reviewed has been presented under the following categories
6.2.1Literature related to Child Abuse
6.2.2Literature related to impact of Child Abuse
6.2.3Literature related to teacher’s knowledge on Child Abuse
Literature related to Child Abuse
Madu and Peltzer conducted an investigation into the risk factors that could discriminate childhood sexual abuse, (CSA), from non-abuse in the Northern Province, South Africa. Data was gathered from 414 students and they filled a retrospective self rating questionnaire in a class room setting. The results showed an overall CSA prevalence rate of 54.2 percentages. Four factors- ethnicity, mother employed presence of step parent in the family during childhood and violence at home significantly discriminated CSA from non abuse.
Linda M Williams conducted a Longitudinal Research on Partner Violence, Child Physical Abuse, and Child Sexual Abuse. Study participants included father mother and child victims from families of reported incest, child physical abuse, and/or partner violence. The study addressed scientific questions about the long term outcomes of family violence and the differential impact of violence on the family.
Literature related to impact of Child Abuse
Nelson conducted a study on 1159 female and 832 male pairs in a young adult Australian volunteer twin panel. Each subject completed a structured telephone interviews. Results showed that a history of CSA, reported by 16.7 percent of the women and 5.4 percent of the man, was more common among those reporting parental alcohol-related problems and also found that significantly increased risk was observed in the women reporting a history of CSA for subsequent occurrence of major depression, suicide attempts, conduct disorder, alcohol dependent, nicotine dependents, social anxiety etc.
Finkelhor, conducted the first national telephone survey of men and women. Of the 2,626 Americans questioned regarding prior sexual abuse, victimization was reported by 27 percent of the women and 16 percent of the men. One of the major findings was that many of those who were victims never disclosed the experiences to anyone. Of those participants who confirmed sexual abuse, 42 percent of the women and 33 percent of the men acknowledged never having disclosed.
Literature related to teacher’s knowledge on Child Abuse
Brendgen, in her study explained about pupils facing verbal abuse from the teacher are likely to be delinquent. Verbal abuse by a kindergarten teacher triggered by a child’s inattention or disruptive behavior can produce a “Vicious cycle” that boost that risk of delinquency and learning problem later on. The researcher and her colleague followed 399 children for 7 years starting from kindergarten. The researcher found that boys, as well as children who showed anti social behavior and inattention problems in kindergarten, were most frequent target of teacher abuse, they report in the current issue of journal of pediatric.
‘Roa K N, Begam S, Venkataramana V, Gangadharappa N, conducted a study about nutritional neglect and physical abuse in children of alcoholic, which was higher at risk. His study was comparison of nutritional neglect and physical abuse in children of alcoholics, which was higher at risk. His study was comparison of nutritional neglect and physical abuse in children of alcoholics with children of non alcoholics. Outcome of this study shows that 45 percent of the children of alcoholics had physical injuries in contrast to 23.4 percent of children of non alcoholics. Thereby he concluded that alcoholism in parents of malnourished and injured children are frequently ignored in routine clinical evaluation. If the risk children are identified early some of the morbidity can be avoided.
Hawkins R, Mc Callum C, conducted Mandatory Notification Training for suspected child abuse and neglect in South Australian schools. The main aim of the study was to investigate whether Mandatory Notification Training achieve its stated aims. With this study the researchers concluded that the South Australian Educational Department Mandatory Notification Training is successful in achieving its stated aims.
Riggs RS, Evans DW, had prepared an article on child abuse prevention and implementation within the curriculum. They reported that the number of reported cases of child abuse and neglects increasing. Most educators are aware of the problem; however, awareness alone has minimal impact on prevention. Specific planning is needed and this article explores various avenues for including child abuse education as a part of the regular school curriculum. The ultimate goal is to develop educational strategies as one means of preventing abuse when school children grow to adulthood and become parents.
Yanowits KL, Monte E, Tribble JR, conducted a study on teacher’s beliefs about the effects of child abuse. Teacher’s expectations about the effects of physical and emotional abuse on children’s classroom behaviors were examined in this study. They concluded this study that the teacher’s expectation generally mirrored research findings as to the actual effect of child abuse. Suggestions are made to incorporate the results in training program designed to increase teacher’s self-confidence in reporting potential cases of child abuse.
Alnasir F A conducted a study on health attitudes of school teachers towards their pupils. The purpose of this study was to assess schoolteacher’s health attitudes and perceptions. This study has been concluded that there is a need for an in-service education of teachers in order to promote their health attitudes that can reflect on the attitude of their pupils.
Kenny M.C conducted a study with the objectives to determine teacher’s self reported knowledge of the signs and symptoms of child maltreatment, reporting procedures, legal issues surrounding child abuse. The results of this study were that, most teachers reported being unaware of the signs and symptoms of child maltreatment, as well as reporting procedure. The educator and child abuse questionnaire (ECAQ) was found to be a reliable measure with four factors: (1) Awareness of signs and symptoms of child abuse, (2) Knowledge of reporting procedures, (3) Attitude towards discipline, (4) Seriousness of child abuse.
Abrahams N, Casey K, Daro D, in considering the great responsibility placed upon teachers to involve themselves in child abuse prevention, education and deduction. The national committee for prevention of child abuse (NCPCA) conducted a nationwide survey of teachers from 40 schools districts in 29 randomly selected countries. The survey explores teacher’s knowledge, attitudes, and beliefs about child abuse and its prevention. The finding of this study reveals that the teachers responded poorly in reporting child behavior and they are provided with in sufficient knowledge on how to address it.
O’Toole R, Webster SW, O’ Toole AW, Lucal B, was studied to determine the effect of characteristics of the cases, the teacher, and the organizational setting on recognition and reporting of child abuse. The result of this study with analysis of OLS regression showed that cases characteristics alone accounted for 50.3 percent of the variance in recoding and 51.08 percent of the variance in reporting. The findings do not appear to support the problems of “Over reporting”. There is evidence for underreporting”, particularly in less serious cases involving physical and emotional abuse. Teachers are undeterred by the many problems and fears that may accompany a report of child abuse to child protective services. Teachers use discretion in reporting abuse, they recognize.
Shumba A, conducted a study regarding epidemiology and etiology of reported cases of child physical abuse in Zimbabwean primary schools, with the objectives to determine the nature and extend of physical abuse perpetrated on primary school pupils by their teachers, and to determine why some teachers physically abuse their primary school pupils in Zimbabwe. This finding indicates that teachers perpetuate various forms of physical abuse and this form of abuse is now on the increase.
Crenshw WB, Crenshaw LM, Litchtenberg JW, conducted a study on the recognition and reporting of the child abuse among teachers, counselors, principals. The result emerged : (a) Reporting tendency varied by type of abuse described, forming a 3-level hierarchy: (b) reporting tendency and reporting rates were unrelated to the gender of the victim or respondent; (c) responding tendency were unrelated to the type of the profession of the educator though certain type of abuse were suspected and /or reported significantly less often by classroom teachers; (d) for each scenario a linear composite of decisional items discriminated reports from non reporters with 75 percentage to 85 percentage accuracy. Most salient in distinguishing reporters from non reporters were issues involving quality of suspicion and the respondents belief that schools should be a first line defense against abuse and neglect; (e) educators were uniform in their high level awareness of mandatory reporting laws; (f) educator’s preparedness to detect child abuse differed by profession, but most desired additional training.
Statement of the problem
A Quasi-Experimental study to assess the Effectiveness of structured teaching program on knowledge about ‘Child Abuse’ among primary and middle school teachers in selected Schools at Bangalore.
OJECTIVES OF THE STUDY :-
1.To assess the existing knowledge of primary and middle school teachers regarding child abuse.
2.To assess the post test Knowledge of primary and middle school teachers.
3.To compare the pretest and post test knowledge of primary and middle school teachers.
4.To evaluated the effectiveness of structured teaching program among primary and middle school teachers regarding child abuse.
5.To determine the association between knowledge on child abuse among primary and middle school teachers with demographic variables such as: age, sex, education and income.
HYPOTHESIS
H1: These will be a significant difference between pretest and post test knowledge on child abuse among primary and middle school teachers.
H2: There will be a significant improvement in knowledge among primary and middle school teachers on child abuse after STP than before STP.
OPERATIONAL DEFINITIONS:-
Knowledge: It is the level of awareness about the causes, signs, symptoms and behaviors of abused children and early identification and management of child abuse.
Child abuse: Child abuse is defined as an emotional abuse, sexual abuse and neglect. Physical abuse is hurting of body, which includes battery and assault. Emotional abuse includes refusing love and care.
Teacher: Teacher is a person who develops knowledge, intellectual skills, especially children’s.
ASSUMPTION
Teachers who do not have the knowledge and positive attitudes to victims’ cannot identify the possible cases of child abuse.
DELIMITATIONS
1. The study is delimited to the school teachers who are:
(a). Primary and middle school teachers
(b). Available during the period of studies.
2. The duration of study on subjects is limited to 30 days.
MATERIALS AND METHODS
SOURCE OF DATA: The data will be collected from primary and middle school teachers.
METHODS OF COLLECTION OF DATA:
SAMPLING CRITERIA:
Inclusion Criteria: - 1. Teachers of primary and middle schools.
2. Male and female teachers.
3. Teachers, who are willing to participate in the study.
4.Teachers, who are available during the study.
Exclusion Criteria: - 1.Teachers of high and higher secondary schools.
2. Teachers, who are not willing 15 participate in this study.
RESEARCH DESIGN: The research design adopted for the study is “quasi experimental design”.
VARIABLES:
Independent variable: Structured teaching program.
Dependent variable: Knowledge on child abuse.
SETTING OF THE STUDY: The study will be conducted in selected schools at Bangalore.