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					           RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
                     KARNATAKA, BANGALORE

                                    ANNEXURE – II

     PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION


1.   Name of the candidate and address    SUKANYA K. S.
     (in block letters)                   I YEAR M. Sc. NURSING
                                          DR. M. V. SHETTY COLLEGE OF NURSING
                                          VIDYANAGAR
                                          MANGALORE – 575013.


2.   Name of the Institution              DR. M. V. SHETTY COLLEGE OF NURSING
                                          VIDYANAGAR
                                          MANGALORE – 575013.


3.   Course of Study and Subject          M. Sc. NURSING
                                          PAEDIATRIC NURSING


4.   Date of Admission to the Course      22.06.2011


5.   Title of the study

      A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE AND

      ATTITUDE            ON       RISK-TAKING         BEHAVIOURS     AMONG

      ADOLESCENTS IN A SELECTED PRE-UNIVERSITY COLLEGE

      AT      MANGALORE            WITH     A    VIEW    TO    DEVELOP    AND

      DISTRIBUTE HEALTH EDUCATION COMPACT DISC.




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6.   Brief resume of the intended work


     6.1      Need for the study

           “Adolescence is like having only enough light to see the step directly in front of you.”

                                                                                - Sarah Addison Allen

              Adolescence is a developmental period of rapid physical, psychological, sociocultural,
     and cognitive changes characterised by efforts to confront and surmount challenges and to
     establish a sense of identity and autonomy.1 This period of transition starts at the age of 10
     years and ceases by the age of 19 years. Adolescence is also a period of preparation for
     adulthood, a time when childish behaviour and attitudes are replaced by attitudes and
     behaviour of an adult type.2

              An adolescent is at the crossroads of storm and stress that come from physical and
     glandular changes. Thus emotions, hormones, judgment, identity, and the physical body are
     so in flux that parents and even experts struggle to fully understand. Rapid physical changes
     are accompanied by important psychological changes relating particularly to the way the
     adolescent perceives himself or herself.3 Habits, good and bad, are often formed in this age
     range, which impact the health and social wellbeing of adolescents throughout their lives.
     Adolescents’ risky behaviours often result from their inadequate knowledge of and
     experience with such behaviours and their lack of understanding of the risks involved.4

              Currently, the world’s adolescent population is 1.2 billion; 87% of these adolescents
     live in the developing countries. India has the largest national population of adolescents (243
     million)4. Karnataka is the eighth largest state in India in terms of population. According to
     population census, the population of Karnataka was 5.273 crores (52.73 million) and about
     21% of that comprised the adolescent population. The current population of Karnataka is
     6,11,30,704.5

              According to the view of developmental neuroscience, the temporal gap between
     puberty, which impels adolescents toward thrill seeking, and the slow maturation of the
     cognitive-control system, which regulates these impulses, makes adolescence a time of
     heightened vulnerability for risky behaviour.6 Adolescents often engage in risky behaviours




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such as smoking, drinking alcohol, using drugs, and early unprotected sexual activity . Risky
behaviours might pose a threat to adolescents’ future health. The adverse health consequences
of these behaviours have been recognised as important public health issues. When
adolescents take one risk, they also tend to take other risks. The interrelationship or cluster of
health risk behaviours can be labelled as “risk behaviour syndrome.” This occurs in different
combinations in different subpopulations.7

       A comparative cross-sectional study was conducted among the male adolescent
population of an urban village in South Delhi and a rural village in Western Uttar Pradesh to
examine the prevalence of risk behaviour among adolescents. Data collection was done by
interview method. The study sample comprised of 199 urban and 152 rural male adolescents
between 10-19 years of age. The result showed that consuming alcohol, smoking, premarital
sexual intercourse, and consuming cannabis were present in 32%, 25.1%, 12.5% and 11.5%
of the urban village adolescents and in 1.3%, 48.7%, 11.2% and 16.5% of those residing in
the rural village. About 66.8% of urban and 51.3% of rural adolescents indulged in physical
fights. About 12.5% of urban and 6.6% of rural adolescents were in possession of assault
weapons such as iron rods, chains or knives. The researcher concluded that there was a high
prevalence of risk behaviour in both urban and rural adolescents.8

       A cross-sectional study was conducted to examine health risk behaviours of
adolescents between the ages 14 and 19 years living in the Luangnamtha province, Lao PDR,
Vietnam. A simple random technique was used to select the sample. An ordinal logistic
regression model was used for analysis. The study result showed that out of 1360 respondents
about 46.8% (n=637) reported no, 39.3 percent (n=535) reported one risk, 8.1 percent
(n=110) reported two risks, and 5.8 percent reported more than two health risk behaviours.
The researcher concluded that there are sex, age and ethnic differences in the concurrent risk
behaviours. The most common concurrent risk behaviours among boys was alcohol use,
smoking, followed by being sexually active and not using condoms, while in girls common
concurrent risk behaviours are alcohol use, sexually active, and not using condoms. The
influencing factors on multiple high risk-taking behaviours are present in one’s demographic
background, namely, adolescent’s education and peers influence.7




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       As the health risk behaviours pose a threat to adolescent life, it is essential put
interventions to encourage the adolescents to choose friendships, to establish the friendship,
and lead the life with good behaviour. Harmful risk-taking ventures influence the quality of
life of the adolescent adversely, so it is important to prevent adolescents from indulging in
such risk-taking behaviours.

       Thus the findings are more supportive with the clear cut fact that risk-taking
behaviour is prevalent among adolescents in one or the other way. The youth of our country
are the valued possessions of the nation. Without them there can be no future and their needs
are immense and urgent. As nurses we have a major role in identification, control and
prevention of risk-taking behaviours among adolescents. Hence, the investigator felt that
there is a need to assess the knowledge and attitude on the risk-taking behaviours among
adolescents and thus prevent the occurrence of risk-taking behaviours among adolescents
with the help of a health education compact disc.


6.2    Review of literature

       A descriptive study was conducted to examine the risk-taking behaviours among
adolescents in India, Mumbai. Data was collected using National Family Health Survey-2.
Logistic regression analysis was done to examine the covariates of adolescents’ risk-taking
behaviours. The findings show that adolescents who were working, living single, less
educated, and not related with the head of the households were more likely to indulge in risk-
taking behaviours. Based on caste the result showed that 32% adolescent in the scheduled
tribes, 20% of the scheduled castes, 16% of other backward classes, and 15% of ‘other’ castes
have been found to be involved in risk-taking behaviours.4

       A case study analysis was conducted to explore adolescent risk-taking behaviours in
Port Elizabeth School, South Africa. A sample of 100 was selected in the age group of 13-18
years. Data collection was done by social survey with a structured questionnaire. The
sampling technique included both purposive and volunteer sampling method. The result
showed that Male respondents were responsible for higher percentage – 56.9% of risk-taking
incidences – than the female respondents 43%.9




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        A population-based study among adolescents was conducted in Switzerland to
examine the prevalence of body piercing. Data collection was done by survey method with a
sample of 7548 students ages between 16 to 20 years. Survey was done with a classroom
questionnaire. The result showed that 20.2% of the sample had a piercing, and it was
significantly more prevalent among females 33.8% than males 7.4%.10

        A cross-sectional study was conducted in New Delhi to assess the role of knowledge
regarding tobacco, risk-taking attitude, peers, and other influencers on tobacco and areca nut
use, amongst adolescents in two schools. Simple random sampling method was used to select
650 children out of 810 for data collection. Results showed that almost 42% of tobacco users
started before the age of 12 years. A total of 16.28% students smoked cigarettes and
consumed smokeless tobacco. A total of 21.31% students were found to be consuming
tobacco in some form or the other. The study also found out that 9.23% students were either
consuming alcohol.11

        A cross-sectional study conducted in South Delhi on the health risk behaviours related
to road safety among adolescents in the age group of 14-19 years. Five hundred and fifty
adolescent students were selected by cluster sampling. Statistical analysis was done through
proportions, chi-square test, and multivariate regression. The results showed that more than
half (52.4%) reported ‘not always’ wearing a seat belt. About 72.1% of the two-wheeler
riders reported ‘not always,’ and 23.3% reported ‘never’ wearing a helmet. Nearly 20%
students rode with a driver who had alcohol before driving, and 37.3% subjects had driven
with a driver not possessing a driving license. Almost 77.5% (426) of the respondents were
‘at risk’ related to safety on roads .12


6.3     Statement of the problem

        A descriptive study to assess the knowledge and attitude on risk-taking behaviours
among adolescents in a selected pre-university college at Mangalore with a view to develop
and distribute health education compact disc.




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6.4   Objectives of the study

      The objectives of the study are to:

     determine the existing knowledge on risk-taking behaviours among adolescents using
      a structured knowledge questionnaire.

     determine the attitude of on risk-taking behaviours among adolescents using a
      modified Likert scale.

     find the association of knowledge and attitude on risk-taking behaviours among
      adolescents with selected demographic variables.


6.5   Operational definitions

1.    Knowledge: Knowledge is familiarity with someone or something, which can include
      information, facts, descriptions, and skills acquired through experience or education.

             In this study, it refers to the responses and awareness expressed by the
      adolescents to the knowledge items listed in the structured knowledge questionnaire
      on risk-taking behaviours such as reckless driving, substance abuse, physical fights,
      body piercing, and smoking.

2.    Attitude: Attitude is a predisposition or a tendency to respond positively or
      negatively to a certain idea, object, person, or situation.

             In this study, it refers to the opinions of the adolescents on risk-taking
      behaviours such as reckless driving, substance abuse, physical fights, body piercing,
      and smoking.

3.    Risk-taking behaviours: Risk-taking refers to the tendency to engage in behaviours
      that have the potential to be harmful or dangerous, yet at the same time provide the
      opportunity for some kind of outcome that can be perceived as positive.




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             In this study, risk-taking behaviours refers to certain behaviours such as
      reckless driving, substance abuse, physical fights, body piercing, and smoking which
      result in negative consequences in adolescents.

4.    Adolescents: The transitional period between puberty and adulthood in human
      development, extending mainly over the teen years and terminating legally when the
      age of majority is reached; youth.

             In this study, adolescent refers to boys and girls studying in a pre-university
      college with co-education system at Mangalore.

5.    Selected Pre-University College: In this study, it refers to one among the pre-
      university colleges in Mangalore which offers pre-university courses with co-
      education system with English as the medium of instruction under the control of
      Block Education Officer within the city limits.

6.    Health Education Compact Disc: In this study, it refers to the audiovisual aid
      prepared on the aspects of risk-taking behaviours and its consequences on reckless
      driving, substance abuse, physical fights, body piercing, and smoking.


6.6   Assumptions

      The investigator assumes that:

     adolescents may have some knowledge on risk-taking behaviours.

     adolescents possess either positive or negative attitudes on risk-taking behaviour

     health education compact disc will enhance the knowledge on selected risk-taking
      behaviours


6.7   Delimitations of the study

      The study is delimited to:

     adolescents in a selected pre-university college at Mangalore.

     80 adolescents



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           selected aspects of risk-taking behaviours included in the knowledge questionnaire
            and modified Likert scale.


     6.8    Hypotheses

            The hypothesis will be tested at 0.05 level of significance.

     H1:    There will be a significant association between the knowledge on risk-taking
            behaviours among adolescents and selected demographic variables..

     H2:    There will be a significant association between the attitude on risk-taking behaviours
            among adolescents and selected demographic variables.

7.   Material and methods

     7.1    Source of data

            Data will be collected from 80 adolescents studying in pre-university college.


     7.1.1 Research design

            The research design for the study will be descriptive design. Descriptive study design
     is to study the characteristics of a person, situation or groups and/or the frequency with which
     certain phenomena occur.


     7.1.2 Setting

            The study is planned to be conducted in the selected pre-university college at
     Mangalore which provides adolescents with co-education which is 15 kms away from
     college. The medium of instruction is English. The college will be selected for the study on
     basis of availability of the sample and feasibility of the study.


     7.1.3 Population

            In the present study, the population comprises adolescents studying in a selected pre-
     university college at Mangalore who are fulfilling the inclusion criteria.




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7.2     Method of data collection

7.2.1 Sampling procedure

        A type of proportionate stratified random sampling is done. In this sampling, the 1st
year and 2nd year pre-university college students of different batches are distributed into
different strata.


7.2.2 Sample size

        In this study, the sample consists of 80 adolescents studying in the selected pre-
university college, Mangalore.


7.2.3 Inclusion criteria for sampling

       Adolescents available at the time of data collection.

       Adolescents willing to participate.


7.2.4 Exclusion criteria for samplings

       Sample will be selected according to the sampling procedure. The researcher will not
        have any exclusion criteria in selecting the samples.


7.2.5 Instruments intended to be used

1.      A structured knowledge questionnaire will be used to assess the knowledge on risk-
        taking behaviours among adolescents.

2.      A modified Likert scale is used to assess the attitude on risk-taking behaviours among
        adolescents.




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7.2.6 Data collection method

       The researcher will obtain prior permission from the Institution Review Board.

Steps In The Data Collection Methods

Step 1: Selecting a pre-university college based on the geographical proximity, feasibility of
       the study and availability of the sample.

Step 2: Obtaining permission from the Block Education Officer and the Principal of selected
       pre-university college.

Step 3: Researcher introducing herself to the students of pre-university college and
       distributing the knowledge questionnaire and modified Likert scale.

Step 4: A health education compact disc is shown and distributed to the selected sample.


7.2.7 Plan for data analysis

       The data will be organised in a master sheet. The collected data will be analysed using
descriptive and inferential statistics. Description of subjects with respect to demographic
variables will be presented using frequency and percentage. A chi-square test will be used to
find the association between knowledge and attitude on risk-taking behaviours and selected
demographic variables.


7.3    Does the study require any investigations or interventions to be conducted on
       patients, or other animals? If so please describe briefly.

       No. However, a knowledge questionnaire and a modified Likert scale will be
administered to the subjects to collect the data.


7.4.   Has ethical consideration been obtained from the institution in case of the above?

       Yes. Ethical clearance has been obtained from the ethical committee of the college.
Consent from the sample will be taken at the time of data collection.




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8.   References

     1.    Clemente R, Hansen WB, Ponton LE. Issues in clinical child psychology, Handbook
           of adolescent health risk behaviour. New York: Plenum Publishing Corporation; 1996.

     2.    Ollendick TH, Schroeder CS. Encyclopaedia of clinical child health and paediatric
           psychology. New York: Kluwer Academic/Plenum Publishers; 2003.

     3.    American Bar Association. Cruel and unusual punishment: the juvenile death penalty,
           adolescence, brain developmental legal culpability. [online] Available from: URL:
           http://www.americanbar.org/content/dam/aba/publishing/criminal_justice_section_ne
           wsletter/ crimjust_juvjus_Adolescence.authcheckdam.pdf

     4.    Agrawal S. Analysing adolescent risk-taking behaviour in India: findings from a
           largescale. IIPS, Mumbai; 24

     5.    India Guide: Population of India: Karnataka’s Population 2011. [online]. Available
           from: URL:http://www.indiaonlinepages.com/population/karnatakapopulation.html

     6.    Steinberg L. Current direction in psychological science risk-taking in adolescence.
           New Perspectives from Brain and Behavioural Science;16:55.

     7.    Sychareun V, Thomsen S, Faxelid E. Concurrent multiple health risk behaviours
           among adolescents in Luangnamtha province, Lao PDR. BMC Public Health
           2011;11:36.

     8.    Kishore J, Singh A, Grewal I, Singh SR, Roy K. Risk behaviour in an urban and a
           rural male adolescent population. The National Medical Journal of India 1999;12(3).

     9.    Suris J-C, Jeannin A, Chossis I, Michaud PA. Piercing among adolescents: Body art
           as risk marker. The Journal of Family Practice 2007 Feb;56(2):126-30.

     10.   Kotwal A, Thakur R, Seth T. Correlates of tobacco-use pattern amongst adolescents in
           two schools of New Delhi India. Indian J Med Sci 2005;59:243-52.

     11.   Sharma R, Grover VL, Chaturvedi S. Health-risk behaviours related to road safety



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among adolescent students. Indian J Med Sci 2007 Dec; 61(12):656-62.




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9.    Signature of the candidate



10.   Remarks of the guide




11.   Name and designation of (in block letters)

      11.2 Guide                         MRS. DEEPA DANIEAL
                                         (ASSOCIATE PROFESSOR)
                                         H.O.D, PAEDIATRIC NURSING,
                                         DR. M. V. SHETTY COLLEGE OF NURSING,
                                         KAVOOR.VIDYANAGAR
                                         MANGALORE -575 013.

      11.2 Signature

      11.3 Co-guide (if any)



      11.4 Signature

12    12.1 Head of the department        MRS. DEEPA DANIEAL
                                         (ASSOCIATE PROFESSOR)
                                         H.O.D, PAEDIATRIC NURSING,
                                         DR. M. V. SHETTY COLLEGE OF NURSING,
                                         KAVOOR.VIDYANAGAR
                                         MANGALORE -575 013.

      12.2 Signature



13.   13.1   Remarks of the Chairman and Principal




      13.2   Signature




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