SYNOPSYS PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
Ms. MENKA RANA
FIRST YEAR M.SC (NURSING)
MENTAL HEALTH NURSING
YEAR 2012-2013
INDIAN ACADEMY COLLEGE OF NURSING
HENNUR CROSS, HENNUR MAIN ROAD
BANGALORE
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
SYNOPSYS PROFORMA FOR REGISTRATION OF SUBJECT
FOR
DISSERTATION
1. / NAME OF THE CANDIDATE AND ADDRES / Ms. MENKA RANA1ST YEAR M.Sc. (NURSING)
INDIAN ACADEMY COLLEGE OF NURSING, (HENNUR CROSS) HENNUR MAIN ROAD BANGLORE.
2. / NAME OF THE INSTITUTION / INDIANACADEMY COLLEGE OF NURSING, HENNUR CROSS) HENNUR MAIN ROAD BANGALORE.
3. / COURSE OF THE STUDY AND SUBJECT / 1ST YEAR M.Sc. (NURSING),
MENTAL HEALTH NURSING
4. / DATE OF ADMISSION TO THE COURSE / 11/06/2012
5. / TITLE OF THE STUDY / “A PRE- EXPERIMENTAL STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAME REGARDING PREVENTION OF SUBSTANCE ABUSE AMONG THE STUDENTS IN SELECTED PRE- UNIVERSITY COLLEGES IN BANGALORE.”
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
“The cause of worldwide consumption of Hashish, Opium, Wine and tobacco lies not in the taste or in any pleasure, recreation or mirth, they afford but simply in man’s need to hide from himself the demands of conscience” Tolstoy
Drug is a substance which may have medicinal ,intoxicating , performance enhancing or other effects when taken or put into a human body .Drug addiction isdefined as a state of periodic or chronic intoxication detrimental to the individual and the society produce by the repeated intake of habit-forming drugs.1
Alcoholism is worldwide social and medical problem over the past 30 to 40 years, alcohol consumption has increased in quantity and frequency .The age at which people start drinking has also declined. The population groups at great risk are that undergoing rapid socio statuses.2
Substance abuse is becoming a social problem, not in India alone, but the entire world. The use of drugs has its own culture and history, which varies from country to country. The problem of substance abuse is growing at an explosive rate. Substance abuse is a social problem, not in India alone, but the entire world. The use of drugs has its own culture and history, which varies from country to country. The problem of substance abuse is growing at an explosive rate and in just little over a decade it has spread its malevolent tentacles to almost every part of the globe surmounting almost all barriers of race, caste, creed, religion, sex educational status, economic strata etc.3
Substance abuse and dependence crosses all lines of race, culture, education socioeconomic status, leaving no group untouched by its devastating effects .Substance abuse usually begins in adolescence, the time for discovery challenge and experimentation. Adolescents are poly substance abuser. They mostly widely use tobacco, alcohol and marijuana, nicotine and alcohol are termed "gateway" drugs because they often "open the gates" to further heavier drug use for teens. To the young persons, choice of drug is often related to "drug fashion."4
During the post decade several risk factors has been identified among adolescents. Substance abuse is considered an important factor in a wide variety of social problem, affecting rates of crime, domestic violence, sexually transmitted diseases (including HIV/AIDS) and Hepatitis B, unemployment, homelessness, teen pregnancy and failure in school.5
The current statistics found that, 29% of college students report that illegal drugs were made available to them on college property. Not only that, 38.4% of college students report that drugs are readily available (as opposed to 22.4% at private colleges). College students in upper grades report greater access to drugs than do teenagers in lower grades. And 62.9% report that street gangs are present to sell the drugs. Here are the rates, reported by teens, as to which drugs they knew how to obtain easily. it is found that students using Marijuana constitutes 85.8%, Amphetamines: 55.4%, Cocaine: 47.8% ,Barbiturates: 46.3%, Crack: 39.2% ,LSD: 33.1% ,Tranquilizers: 30.1%, Heroin: 29.6%, Crystal meth: 26.7%.2% So, even if teens do not use drugs, it is clear that they are readily available, either at college or by some other means. And it is also clear that teen drug use, in the area of hard drugs, teen drug use has been declining. Use of the strong drugs is much less than it was in the 1960s and 1970s. Indeed, only 8.1% of college seniors report that they have ever used cocaine, and only 1.5% report any use of heroin. The use of hallucinogens and most opiates is also lower. It is marijuana that causes the greatest amount of concern regarding teen drug use. 6
Substance abuse among adolescents has become a global challenge and also an important public health concern and for the past two decades there has been a dramatic increase in the demand for interventions to address the substance abuse problem. This demand has led to the development of multiple primary, secondary and tertiary substance abuse prevention programmers. June 26, 1992 was declared by WHO as the International Day against Drug Abuse and Illicit Trafficking. In addition, the years 1991-2000 were designated as the United Nations Decade against abuse.7
BangaloreWith each passing year, Bangaloreans from all walks of life risk turning into addicts with the changing landscape of the society If figures are to be believed, substance abuse is slowly gaining ground in the city., 2,800 patients have walked into NIMHANS (National Institute of Mental Health and Neuron Sciences) seeking help to fight their inner demons, 65 per cent of whom are alcohol abusers, 20 per cent consume opiates and indulge in injections and the remaining 15 per cent use petroleum solvents, thinners and glue. Twenty per cent of addicts consume opiates and
Indulge in injections.8
Global trade and liberalization of socio cultural interaction of the society has made easy access to use and spread of narcotic substance. Substance abuse is a universal phenomenon with, its roots in history and tradition substance. Abuse problem has become a global challenge from a transit country India is fast becoming a major consumer of different kinds of substances.9
6.1 NEED FOR THE STUDY
College students are the most vulnerable group and are at high risk of drug abuse related problems compared to other population. The prevalence rate of drug abuse is highest among young adolescents and young adults, a large majority of whom are students. Substance abuse by students in secondary schools and colleges is a serious problem. As it is gaining gradual popularity among college students, it would be vital to examine their knowledge towards substance abuse. Health education is an important strategy of all the programmers to prevent and control drug abuse and to give the health education the teachers should have knowledge about prevention of substance abuse.10
The WHO Expert Committee on Drug Dependence (2005) endeavored to ascertain factors associated with the prevention of drug dependence and urged that it would be necessary to eliminate the ignorance and misconception about drug effects.11
A study conducted among 15,000 students of Mangalore University colleges threw light on the extent of substance abuse among the student community. The result showed that 7.04% of the male and 0.4% of the female population have accepted to be users of various stimulant substances ranging from Ganja to Heroin. Among these, 6.6% of the male and 0.4% of the female population were found to be drug addicts. This percentage indicates that the number of addicts among the student population in Mangalore is approximately 1050 out of the total population of 15,000 under study. 12
A study was conducted in on college students to examine the prevalence rates and correlates of non-medical use of prescription stimulants. A self-administered mail survey was used. The sample consisted of 10,904 from 4-year colleges in the United States, randomly selected in 2001. The study result showed that the lifetime prevalence of non-medical prescription stimulant use was 6.9%, past year prevalence was 4.1% and past month prevalence was 2.1%, past year rates of non-medical ranged from zero to 25% at individual colleges. Non-medical prescription users were more likely to report use of alcohol, cigarettes, marijuana, ecstasy, and cocaine respectively.13
A study conducted to assess the knowledge about psychoactive substance abuse among college students. The investigator adopted a comparative descriptive research approach. The sample consisted of 50 male and 50 female college students. A self-structured questionnaire was used to collect the data. The findings of the study showed that a significant higher knowledge scores among females than males (t=2.27). The students with higher mass media exposure had higher scores. Age, family income, father’s education and year of study did not have any relationship with knowledge scores.14
A study was conducted to assess the knowledge and attitude of 180 undergraduate students of Kerala on drug dependence using a structured questionnaire. The result of the study showed that students’ (98.33%) knowledge was inadequate in all the areas. The result also showed that there was significant positive relationship between knowledge and year of study, family income and substance abuse.15
A study was conducted on knowledge of students on cannabis and tobacco among 964 school students of Baroda. The tool was a questionnaire containing 20 items. Data were collected immediately after 45 minutes of drug abuse awareness programmer. After seven days data were collected using the same tool. The study revealed that the majority of students had increased knowledge after the awareness programmer. The substance abuse use was reported by 38% out of 964 students.16
A study conducted among undergraduate medical students in two medical colleges of Calcutta. The study indicated that the prevalence of total drug abusers was 76.8% of the respondent student population. The study revealed that the drug abuse rate gradually increased with advancement of each academic year, i.e., from 24% in first year to 74.4% in the final year. It was maximum in the age group of 25-29 years. The prevalence among boys (58.4%) was significantly higher than girls. 25% hostellers were found to be more drug abusers than non-hostellers.17
A study was conducted to assess the awareness among college students to determine relationship of knowledge and selected variables in 100 pre-degree students (first year) from 3 colleges in Kolkata using a structured knowledge questionnaire. The results showed that the college students’ knowledge of drug abuse was inadequate; no significant relationship was found between knowledge, sex and mass media exposure. But there was significant relationship between knowledge and parental education.18
Above studies show that education is one of the main sources for increasing the knowledge and changing the behaviors of college students regarding substance abuse.19
6.2 REVIEW OF LITERATURE
The literature review is an essential component of the research as it aids researcher in formulating the research plan. By definition, the review of literature is broad, comprehensive, in-depth, systematic and critical,audiovisual material and personal communication. The primary purpose of the literature review is to give broad background knowledge or understanding of limitation that is available related to research problem of interest. It is also help the researcher to conduct his or her actual study. The literature review include both research and non research literature.20
For the present study the review of literature is organized under the following headings.
A.Literature related to knowledge of substance abuse among adolescents
B.Literature related to the prevention of substance abuse among adolescents.
C.Literature related to theprevalence of incidence of substance abuse.
D.Literature related to the effectiveness of education program regarding prevention of substance abuse.
- Literature related to knowledge of substance abuse among adolescents
Gincy 2007 conducted a study to assess the knowledge and attitude of 180 undergraduate students of Kerala on drug dependence using a structured knowledge questionnaire17. The results of the study showed that students’ (98.33%) knowledge was inadequate in all the areas. The result also showed that there was significant positive relationship between knowledge, year of study, family income and drug abuse.21
Sean Esteban .et.al (2008) conducted a study, among secondary school students in Rivers State to determine the commonly used substances and the factors that influences their use in their students. The sample consisted of 1049 students of four schools. The tool was a questionnaire containing 117 items of substance use. The study results showed that 87% were using at least one substance, 3% were past users, and 10% had never used any of substances. The substances commonly used are alcohol 65%, Kolanut 63%, cigarette 61%, paracetamol 41.5%, butazolidine 39.3%, pemoline 28% and cannabis 26%, tetracycline 25.7%, ampicillin 24.3% and valium 24%. The mean age of onset was 12-13 years. The study concluded that the use of substances/drugs among our youth is assuming a dangerous dimension and hence calls for immediate measures to improve knowledge on drug abuse and curb this disturbing trend of abuse of substances.22
Vasumath (2009)conducted a study, to assess the awareness among college students and to determine relationship of knowledge and selected variables in 100 pre-degree students (first year) from 3 colleges in Calcutta using a structured knowledge questionnaire. Stratified sampling was used. The study result showed that college students’ knowledge of drug abuse was inadequate. No significant relationship was found between knowledge, sex and mass media.23
Sandeep.et al. (2011), conducted a study, Awareness A study was conducted among students with disability to long term educational, employment and social outcomes in USA to determine the relationship of substance abuse among them. The study results indicate that adolescents with disability who used either cigarettes or marijuana had significantly higher dropouts, lower high school graduation status, and lower college attendance and also were significantly more likely to engage in sexual activity at a younger age. The findings support the need for improved substance use prevention programmer targeting the need of youth with disabilities.24
JRK, Christian [2011] conducted a study among Colombian youth to examine the relationship between earlier marijuana use and later adolescent behavioral problems. A community-based sample of Colombian adolescent was interviewed in 1995-1996 and 1994-1998. The sample consisted of 1151 males and 1075 females. The findings of the study revealed that adolescent marijuana use was associated with increased risk at work or school and violent experience. Peer marijuana use and sibling marijuana problems and adolescent problem behavior in a society in which drug use, crime, violence and low educational attainment are pervasive. So, the study concluded that the early adolescent marijuana use is associated with an increase in problem behavior during later adolescence.25
Henry Wechsler [2012] conducted a study to examine the relationship between early age of onset of cigarette, alcohol, marijuana and cocaine use and engaging in multiple risk behaviors among middle school students in North Carolina. A modified version of the Centre for Disease Control and Prevention of Youth Risk Behaviors Survey was administered to 2227 of six through 8 grade students attending 53 randomly selected middle schools. A health risk behavior scale was constructed for this study. The independent variables included first time use of cigarette, alcohol, marijuana and cocaine at age 11 years or earlier; actual age of onset of each substance, race and ethnicity, family composition, sex, school grade, academic ranking. The results of the study showed that all the independent variables were found to be associated with high risk behaviour scale; having smoked at age 11 years or younger accounted for 21.9% of variation in the health risk behavior scale. Male sex, early marijuana or cocaine use, older age, lower academic rank, white race and single parent family explained an additional 19.1% of variation in the model and same way 52.8% (P<0.001) variation in the health risk behavior scale when age of onset of smoking, male sex, age of onset of alcohol, marijuana, cocaine use and lower academic rating accounted. The study concluded that early age of onset of substance abuse was the strongest correlate of number of health risk behaviors in which young adolescents had engaged.26
Cadiz DM,et.al . 2012, Quasi-experimental evaluation of a substance use awareness educational intervention for nursing students, This article reports on a study that evaluated the effectiveness of an educational intervention, Addressing Nurse Impairment, for addressing nursing students' knowledge acquisition, changes in self-efficacy to intervene, and changes in substance abuse stigma. A gap exists in nursing students' education regarding the risks of addiction within the profession and how to handle a colleague suspected of having a substance use disorder. The seminar was adapted from an existing evidence-based prevention program called Team Awareness, as well as information from focus groups and a pilot test. A quasi-experimental pretest-posttest design was used to evaluate the effect of the seminar. When the control and experimental groups were compared, the results indicated that the seminar significantly affected knowledge and self-efficacy to intervene but did not significantly affect stigma. This research contributes to the body of evidence related to educational interventions for nursing students regarding substance abuse in the nursing profession.27