Download The study includes drug abuse patients

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1)
NAME OF THE
CANDIDATE AND
ADDRESS
:
Mr. ANAND L. R.
1ST YEAR M.Sc NURSING.
PRAGATHI COLLEGE OF NURSING
#33 BYRATHI EXTN, NEAR EBENEZER HOSPITAL,
HENNUR BAGALUR MAIN ROAD, KOTHANUR
POST, BANGALORE:560077
2)
NAME OF THE
INSTITUTION
:
PRAGATHI COLLEGE OF NURSING
#33 BYRATHI EXTN, NEAR EBENEZER HOSPITAL,
HENNUR BAGALUR MAIN ROAD, KOTHANUR
POST, BANGALORE:560077
3)
COURSE OF STUDY
AND SUBJECT
:
DEGREE OF MASTERS IN NURSING
PSYCHIATRIC NURSING
4)
DATE OF
ADMISSION TO THE
COURSE
5)
TITLE OF THE
STUDY
:
:
14/07/2011
EFFECTIVENESS OF SELF INSTRUCTIONAL
MODULE ON OCCUPATIONAL REHABILITATION
AMONG DRUG ABUSE PATIENTS AT SELECTED
REHABILITATION CENTER BANGALORE.
1
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
Since the beginning of human history and before, people have found ways to alter their
bodies and their consciousness by taking substances such as herbs, alcohol, and drugs. Out of
this practice has sprung many important contributions to science and culture, prominent among
them being the development of modern medicine and the medical profession and the making of
fine wines and liquors. Some religions have found uses for mind-altering drugs as a way to aid
communion with the divine principle.
Addiction usually does not happen overnight. Rather, people who become addicted to
drugs (such as alcohol, cocaine, heroin, marijuana, etc.) are gradually introduced and
desensitized to them over a period of time. They may initially enjoy the use of drugs in a
recreational sort of way. For instance, someone might get into the habit of having a beer or some
wine after work as a way of releasing the days stresses. Someone else may use marijuana on an
occasional basis as a way to share special time with friends or as an aid to appreciating food,
music, or sex. Another person may start using cocaine as a way of staying up late at night to
study for exams.1
The 1996 National Household Survey on Drug Abuse estimated the number of users of
illicit drugs in the United States to be about 13 million. In addition, the survey estimated that
10% of Americans abuse or are dependent on alcohol, and 25% of Americans smoke cigarettes.2
WHO reported that psychoactive substance use poses a significant threat to the health,
social and economic fabric of families, communities and nations. The extent of worldwide
2
Psychoactive substance use is estimated at 2 billion alcohol users, 1.3 billion smokers and 185
million drug users.
WHO seeks to promote the concept of Health for All through its strategy of reducing the
incidence and prevalence of psychoactive substance use and to provide the best available
evidence on management of substance related problems.
The achievement of this goal is
designed to lead to reductions in the demand for psychoactive substances and to reduce the
health and social problems associated with such use.3
According to the National Household Survey on Drug Abuse, in 1999 an estimated 14.8
million Americans were current illicit drug users, meaning they had used some illicit drug during
the month prior to the survey. This represents 6.7 percent of the population 12 years and older.
This number is down more than 50% from the peak year of 1979 when 25 million people (14.1%
of the population) were using illegal drugs.4
Addiction has been defined as an illness characterized by “compulsion, loss of control,
and continued patterns of abuse despite perceived negative consequences: obsession with a
dysfunctional habit”.
Drug abuse is a chronic or habitual use of any chemical substance which alters states of
body or mind. Drug addiction is due to biological factors, psychological factors, and social
factors. Substance abuse disorders are more common in Depression, Anxiety disorders, and
Personality disorders.5
Drugs can act directly on one or more electro chemical neurotransmitters that convey
information and regulate mood. Prolonged or chronic use can reset the body’s internal bio 3
chemical response system in a new homeostatic but distinctly abnormal pattern. Affects many
critical body systems such as cardio vascular damage, coma, seizures, respiratory collapse,
hepatic failure, renal failure, hemorrhagic disorders, transient psychosis and nutritional
deficiencies.
The management for drug abuse includes Supportive and Symptomatic treatment. The
psychiatric symptoms may require proper Psychotropic medications and sometimes
hospitalization. Various types of programs offer help in drug rehabilitation, including: residential
treatment (in-patient), out-patient, local support groups, extended care centers, and recovery or
sober houses. Newer rehabilitation centers offer age and gender specific programs.
Rehabilitation is a set of services offered to individuals with mental or physical
disabilities. These services are designed to enable participants to attain skills , resources ,
Attitudes, and expectations needed to compete in the interview process, get a job, and keep a job.
Services offered may also help an individual retrain for employment after an injury or mental
disorder has disrupted previous employment.
Occupational rehabilitation helps people who have been injured or have suffered an
illness to get back, both physically and mentally, in working shape. There are many
rehabilitation clinics that address different needs, but all are designed to increase the patient’s
maximum independent functions. Many employers pay for their employees to use these
programs in order to maintain performance, as well as keep up with safety standards.
An occupational rehabilitation therapist develops a plan of action for the injured worker
by assessing his or her needs, and evaluating what the areas in which he or she requires help.
4
other specialists can also be enlisted to aid in such a program, including nutritionists,
physiotherapists, and psychologists. Sometimes a rehabilitation team must consider whether the
worker will return to his or her job or, if that is not a possibility, the team may help a patient
regain function in order to seek a new job.6
Occupational therapy practitioners intervene in a wide variety of settings with people who
abuse substances. Recognition of the effect that the substance abuse has had on the occupational
functioning of the individual and the family is a unique dimension that the occupational therapist
brings to the interdisciplinary approach. By facilitating the skills, daily routines, and occupational
roles that the individual values and helping integrate them into the individual's view of self, the
occupational therapist can enhance the life-style and support the abstinence of the newly
recovering substance abuser. Occupational rehabilitation plays a major role in treating substance
abuse.
6.1. NEED FOR THE STUDY
Substance abuse occurs when a person is engaged in a pattern of using alcohol or other
mood-altering substance like alcohol, marijuana, cocaine, street drugs, designer drugs, pain
medications, and other pharmaceuticals.”
Among these, alcohol is the most commonly abused substance. “When someone is
abusing, there are negative consequences or there’s a huge potential for them,” Stoffel says. “For
example, there’s a potential for organ damage that may or may not yet have occurred.”
Psychoactive drug abuse commonly results from a combination of low self-esteem, peer
pressure, inadequate coping skills, and curiosity. Most people who are predisposed to drug abuse
5
have few mental or emotional resources against stress, an overdependence on others, and a low
tolerance for frustration. Taking the drug gives them pleasure by relieving tension, abolishing
loneliness, allowing them to achieve a temporarily peaceful or euphoric state, or simply relieving
boredom.
Drug abuse has led to a detrimental impact on the society. It has led to increase in the
crime rate. Addicts resort to crime to pay for their drugs. Drugs remove inhibition and impair
judgment egging one on to commit offences. Incidence of eve- teasing, group clashes, assault
and impulsive murders increase with drug abuse apart from affecting the financial stability,
addiction increases conflicts and causes untold emotional pain for every member of the family.
Professional Guide of psychiatry reported that 19.5 million people over the age of 12
years were using illegal drugs in worldwide. Among them 19,000 deaths occurring due to the
drug addiction.
The United States has the highest substance abuse rate of any industrialized nation.
Government statistics show that 36% of the United States population has tried marijuana,
cocaine, or other illicit drugs. By comparison, 71% of the population has smoked cigarettes and
82% has tried alcoholic beverages.7
In 1999, more than 4 million of the drugs using population were hardcore users: 3.3
million chronic cocaine users and 977,000 chronic heroin users, according to Office of National
Drug Control Policy estimates. While casual use of illicit drugs and cocaine in particular, has
fallen dramatically since the early 1980s, the number of hard-core users of cocaine and heroin
has remained virtually unchanged.4
According to a 2004 national survey on drug use and health done by the Office of
National Drug Control Policy, 19.1 million Americans (7.9 percent) who were 12 years or older
6
used drugs illicitly. In addition, 121 million Americans (50.3 percent) who were 12 years or
older were current drinkers of alcohol, with 55 million (22.8 percent) admitting to binge drinking
(defined by drinking five or more drinks at one sitting on at least one occasion in the last 30
days).
Heavy drinkers (defined by binge drinking at least five days in the prior month)
accounted for 16.7 million Americans (6.9 percent). Of those 12 to 20 years old, 10.8 million
(28.7 percent) drank alcohol in the 30 days prior to the survey, with 7.4 million (19.6 percent)
binge drinking and 2.4 million (6.3 percent) drinking heavily. Pregnant women aged 15 to 44
reported past-month alcohol use at a rate of 11.2 percent and binge drinking at a rate of 4.5
percent in the month prior to the survey. (Sept. 8, 2005)
The 2004 survey reported that 22.5 million Americans (9.4 percent) who were 12 years
and older met criteria for substance abuse or dependence. However, only 3.8 million of these
people (1.6 percent of Americans) had been treated for drug or alcohol problems in the previous
year. This left a staggering number of individuals in need of, but not receiving, treatment for
their substance abuse problems.
Regular drug and alcohol abusers are more likely to be involved in accidental injuries,
motor vehicle accidents and incidents of violent and aggressive behavior. In fact, approximately
20 percent of emergency room admissions, as well as 20 percent of all general hospital
admissions, are alcohol-related. (Professional Practice Council of American Academy of
Physician Assistants, 1996)
Most illicit drug users begin to use and abuse drugs when they are young. Men (8.5%)
have a higher rate of illicit drug use than women (4.5%). The highest rates of drug abuse were
found among young people ages 16-17 yrs (19.2%) compared with ages 18-20 yrs (17.3%). Only
7
about 1 % of people age 50 yrs and older reported using illicit drugs.8
A community based cross-sectional study was conducted during April 2004-March 2005
in an urban resettlement colony in East Delhi to study the narcotic substance use and the sociodemographic characteristics of users. 208 male narcotic substance users aged 15-24 years were
studied. 59.1% of the narcotic substance users were between 21-24 years of age. 78.8% were
using ganja and 39.9% each heroin & bhang. 37% were abusers; 36% were dependent users.
58.7% were single at the time of interview. 48% were either illiterate or just literate; 64%
belonged to middle socio-economic status. 68% had initiated narcotic substance use out of
curiosity.9
Drug-statistics Bangalore2007 Survey reported that approximately 1 in 5 people aged
between 16 and 59 said that they had taken at least one of the drugs. People aged 18 to 21 were
most likely to admit to having taken drugs, with almost half (46%) claiming to have taken
them.10
Rehabilitation is a treatment designed to facilitate the process of recovery from drug
abuse as early as possible. Rehabilitation includes physical therapy which uses exercises and
physical activities to help condition muscles and restore strength and movement, Occupational
Therapy uses activities of daily living and exercise to promote the highest level of independent
functioning.11
Occupational therapy as a profession concerned with promoting health and wellbeing
through occupation. The primary goal of occupational therapy is to enable people to participate
in the activities of everyday life. Occupational therapists achieve this outcome by enabling
people to do things that will enhance their ability to participate or by modifying the environment,
8
or the activity to better support participation.
Occupational Therapy enables people to achieve
health, wellbeing and life satisfaction through participation in occupation.
Occupational Therapy has been described as an active method of treatment with a
profound psychological justification in case of substance abuse. Occupational Therapy is the
application of goal-oriented, purposeful activity in the assessment and treatment of individuals
with substance abuse.
The constant stress in the day-to-day life leads many people are changing to drug
addiction. Drug abuse patients often experience multiple problems such as health and mental
health illnesses and the breakdown of family relationship and unemployment or low income
leading to psycho social problems. Occupational rehabilitation is the only way to give exercise to
both mind and body. Nurse as a role of a teacher imparts knowledge of practical working and
social and coping skills to the drug abuse patients. To fulfill these purposes this study becomes a
need.12
6.2 REVIEW OF LITERATURE
This related literature of the present study has been collected and organized under the following
sections.
Section I: literature related to drug abuse
A report states that approximately 23% of Australians use illicit drug in which Marijuana
was the most common drug used. Amphetamines had been recently used by approximately 4%
of those aged 14 years and over and 2% had used ecstasy/designer drugs; approximately 1% had
9
used heroin, cocaine, or injected an illegal drug during the previous 12 months. Rates of
marijuana use, as for most illicit drugs, increased over the past decade, although rates for other
drugs were much lower than for marijuana.13
A study investigated the reasons for initiating drug use in drug-dependent adolescents and
youths in five regions in Yunnan. The data were collected from a stratified random sample of
467 registered drug addicts under 25 years of age. Pearson chi-square tests were used to analyze
the association of reasons for drug use with socio demographic factors, knowledge of drug
related harm, and access to illicit drugs. The results shows that Curiosity was the most
commonly reported reason for initiating drug use and the majority of the respondents reported
having little or no knowledge of drug-related harm. The majority of the drug abusers initiated
drug use at the age of 13-14 years or younger. There is a potential for sustained educational
programs to reduce the high prevalence of adolescent drug use.14
A study was conducted to examine the prevalence of risky drinking and the association
between risky drinking behaviors and risk groups of substance abuse among college freshmen.
Bivariate analyses were performed to evaluate the association between risky drinking behaviors
and risk groups of substance abuse. The results of our study indicated that 87.0% of the
participants reported lifetime alcohol use, and 69.4% reported the consumption of alcohol during
the past 30 days. Of the former group, 21.4% had engaged in binge drinking, 8.6% had
experienced alcohol-related harassment, 9.5% had experienced alcohol-induced blackouts, and
82.0% had experienced drinking alcohol with peers without adults. Substance abuse prevention
programs for college students should address the health effects of risky drinking behaviors and
train students how to avoid submission to peer pressure.15
10
A study was conducted to assess consumption of alcohol, cigarettes and illegal substance
among physicians and medical students in two German states using self-administered
questionnaire. The majority of respondents consumed alcohol at least once per week. A
significantly higher percentage of men (p < 0.05) reported hazardous or harmful drinking
compared to women. The majority of physicians (85.7%) and medical students (78.5%) were
non-smokers. Use of illegal substances was considerably lower in physicians (5.1%) than
medical students (33.0%). Male students indicated a significantly (p < 0.001) higher level of
illegal drug-use compared to female students.16
A longitudinal quasi-experimental panel study was conducted in order to design and
implement a skill-based intervention to prevent and reduce substance use among urban
adolescents who attended 2 randomly selected high-schools in Tehran, Iran. One-year post
intervention data show that substance abuse, knowledge, attitudes, peer resistance skills, level of
self-control, self-efficacy, and perceived susceptibility among intervention group were
significantly improved, whereas level of self-control and attitudes against substance abuse
among the control group deteriorated. To efficiently prevent substance abuse among youth
primary preventive interventions should be implemented before onset of substance abuse to
improve resistance skills and provide adolescents with information and skills needed to develop
anti-drug norms.17
Section II: Literature related to occupational rehabilitation
A retrospective study was conducted to assess the quality of occupational rehabilitation
for patients with drug abuse by means of an audit of 100 files of patients with abuse disorders
who visited their occupational physicians. Quality of rehabilitation was assessed by means of 10
11
performance indicators, derived from the guidelines for the treatment of employees with mental
health disorders Four of 10 performance rates were below 50%: continuity of care (34%),
interventions aimed at providers of care in the curative sector (39%), assessment of impediments
in the return to work process (41%), and assessment of symptoms (45%). The highest
performance rate concerned assessment of work related causes (94%). Overall optimal care was
found in 10% of the cases this study shows that the rehabilitation process of employees with
abused disorders leaves significant room for improvement, especially with regard to continuity
of care. Quality of care was partly related to a better outcome. More rigorous study designs are
needed to corroborate this finding.18
This study was conducted to investigate the role of occupational therapists working with
patients with drug abuse during the rehabilitation process. Occupational therapists(N-172)
working in rehabilitation centers were surveyed with regard to their involvement with substance
abuse, particularly drug abuse, knowledge of policies, training in the administration of therapy
procedures, and perceived levels of competency. Most respondents reported an awareness of
policies regarding occupational rehabilitation in their centers. Respondents' main role with this
population included activities in positioning, environmental modification, and staff instruction.
The study concluded that the major role of occupational therapists working in centers involved
providing direct intervention with the patient and not conducting or instructing others in
occupational rehabilitation. Therapists also served as a resource on health-related issues for
rehabilitation center personnel19.
An explorative study was conducted to describe and enhance the understanding of how
persons with drug abuse experience the influence of the social environment on their engagement
12
in occupations. Nine persons were interviewed and the data obtained were analyzed using a
comparative method. The findings may contribute to a deeper understanding of how other
persons can facilitate and restrict meaningful occupational experiences. This provides knowledge
that can be used by occupational therapists when empowering their clients and those close to
them to reflect on their actions and the consequences of these actions to enhance occupational
engagement.20
A study was conducted to describe the needs for occupational therapy among people of
working age with drug abuse condition, and to describe treatment interventions based on these
assessments. The results generated categories of needs that have implications for interventions:
1) need for patient education, 2) needs due to limitations in activity performance, 3) needs due to
patient's discouragement, 4) need as a result of patient's dependency and 5) needs related to
work. The suggested interventions focused on increased knowledge of how to handle daily
occupations, mainly categorized as education and behavioral interventions.21
Section III: Literature related to knowledge on occupational rehabilitation
A study was conducted to assess the quality of rehabilitation of drug abuse patients by
occupational physicians and to relate the quality of the process of occupational rehabilitation to
the outcome of return to work. One hundred occupational physicians of a cohort of drug abusers
were interviewed about return to work management. Concluded that Quality of occupational
rehabilitation of drug abusers can be improved substantially, especially with regard to
communication between physicians and continuity of care. There is a need for the development
of more effective rehabilitation procedures which should be evaluated in a randomized controlled
trial.22
13
The study was conducted to examine the impressions of physical and occupational
therapists on therapeutic engagement among their patients. Engagement in this context was
defined as a patient's deliberate effort to work toward recovery by participating fully in their
rehabilitation therapies. Using a survey approach, physical and occupational therapists (N=199)
from across the United States were asked about issues they have encountered in their daily
practice that have acted as either barriers or facilitators of patient engagement. Results show that
drug abuse was rated as the most frequently encountered barriers impacting patient engagement.
Making therapy tasks meaningful and explicitly related to personal goals of the patient was the
most commonly reported practice for enhancing therapeutic engagement. Study concluded that
the knowledge of therapists gained from day-to-day experience with patients in rehabilitation can
be of use to other rehabilitation professionals in treating patients who are difficult to engage in
the rehabilitation process.23
A cross-sectional, descriptive self-report survey concluded that National and state
organizations need to develop policies that focus on prevention, treatment, and rehabilitation of
alcohol and other drug-using healthcare professionals. The results of this study may help to
delineate the characteristics of health professionals abusing drugs, leading to the development of
more effective policies designed to protect the public, and move toward more tailored and
effective intervention strategies for health professionals.24
A study was conducted to describe the role and activities of Drug Rehabilitation Centers
in reducing the drug-abuse problem in Dharan. It also offers suggestions for increasing the
effectiveness of prevention programs. This study concluded that there should be a strong
coordination and network with each other to increase the effectiveness of the treatment program
for drug abuse. The treatment centers should be increased in number as well as in quality.25
14
Section IV: literature related to self-instructional module.
A study was conducted to evaluate the effectiveness of student centered module of
learning reported that 100% of students found the module, as a positive learning experience as it
improved the knowledge, understanding and skill in the selected learning area. 26
A study was conducted to evaluate the effects of self-instruction on learning, satisfaction
with the teaching approach, and health status of persons with rheumatoid arthritis (RA) by
control-group pre-test-posttest design, among thirty subjects receiving care at a rheumatology
clinic who met the study criteria; they were randomly assigned to two groups, self-instruction
and control. One-way analysis of covariance on posttest Rheumatoid Arthritis Knowledge
Inventory (RAKI) scores, with the pre-test as covariate, was used to examine the difference in
learning between the self-instruction and control groups. There was significant difference
between the groups (P=0.01). Participants who completed the self-instructional program had
improved scores on the posttest as compared to the control. 27
A study was conducted on the “Effectiveness of need based self-instructional module on
knowledge regarding the management of dysmenorrhea among adolescent girls in an urban
school, north Bangalore”. The results of this study revealed that the mean pre-test knowledge
score of 55% at 0.05 level of significance. The study results suggested that the self instructional
module was effective in increasing the knowledge level of adolescent girls. 28
A study was conducted on the effectiveness of self instructional module on home care for
rehabilitation of hospitalized patients with coronary artery disease revealed that the mean
posttest knowledge scores 48.5, was significantly higher than the mean pretest knowledge
scores 25.5 at 0.05 levels of significance. The study results suggested that the self instructional
module was effective in increasing the knowledge level of patients. 29
15
STATEMENT OF THE PROBLEM
A study to assess the effectiveness of self-instructional module on occupational
rehabilitation among drug abuse patients at selected rehabilitation center, Bangalore.
6.3 OBJECTIVES
6.3.1 To assess the knowledge of patients with drug abuse regarding occupational rehabilitation
in terms of pretest knowledge scores.
6.3.2 To assess the effectiveness of self-instructional module by comparing pre and posttest
knowledge scores of patients.
6.3.3 To determine the association between posttest knowledge scores of drug abuse patients and
their demographic variables.
6.4 HYPOTHESES
H1: There is no significant difference in pretest and posttest knowledge scores of drug abuse
patients on occupational rehabilitation.
H2: There is no significant association between posttest knowledge scores of drug abuse
Patients and their demographic variables.
6.5 ASSUMPTIONS
6.5.1 Self-instructional module may enhance the knowledge on occupational rehabilitation
among drug abuse patients.
6.6 OPERATIONAL DEFINITIONS
 Effectiveness: Refers to the extent to which the self instructional module has attained the
desired gain in knowledge score as measured by knowledge questionnaire.
16
 Self-Instruction Module: It refers to systematic organized self-learning /directed material
on occupational rehabilitation which was given to drug abuse patients.
 Drug abuse patients: Refers to Males who are diagnosed as drug addicts between 21-60
years of age admitted in the selected rehabilitation center, Bangalore.
 Occupational Rehabilitation: Occupational Rehabilitation refers to any meaningful,
goal directed activities (self-care skills, education, work, or social interaction) which is
given to change the behavior of the drug abuse patients.
 Rehabilitation Centre: Refers to an area where physical and occupational rehabilitation
services are provided for drug abuse patients.
7.0 MATERIAL AND METHODS
7.1 SOURCES OF DATA
Drug abuse patients who are admitted in selected rehabilitation center, Bangalore.
7.2.1 RESEARCH APPROACH
In the present study an evaluative approach will be used to assess the effectiveness of selfinstructional module on occupational rehabilitation among drug abuse patients.
7.2.2 RESEARCH DESIGN
In this study one group pretest - posttest (pre-experimental design) has been adopted to
carry out the present study.
7.2.3 SETTING OF THE STUDY
Study will be conducted at selected rehabilitation center, Bangalore.
17
7.2.4 RESEARCH VARIABLES
Independent variable: In this study it refers to self-instructional module on occupational
rehabilitation.
Dependent variable: In the present study it refers to the knowledge level of the drug
abuse patients on occupational rehabilitation.
7.2.5 POPULATION
In this study, drug abuse patients were the population for the study.
7.2.6 SAMPLE SIZE
In this study the sample comprised of 60 drug abuse patients admitted in a selected
rehabilitation center, Bangalore.
7.2.7 SAMPLING TECHNIQUE
In the present study the convenient sampling technique was used to select the samples.
7.2.8 SAMPLE CRITERIA
INCLUSIVE CRITERIA
The study includes drug abuse patients
 between 20-60 years of age
 who gave consent to participate in the study
 Who can understand Kannada.
 Who are available at the time of data collection.
18
EXCLUSIVE CRITERIA
The study excludes drug abuse patients
 Drug abuse patients with medical complications.
 Drug abuse patients who were under primary treatment.
7.2.9 DATA COLLECTION TOOL
The data will be collected by using structured questionnaire schedule which consist of two
parts.
Part 1- It includes the demographic variables such as age, educational status, monthly
income, type of family, family history of drug abuse, duration of use and source of
information.
Part 2-It includes knowledge items on occupational rehabilitation
7.2.10 DURATION OF THE STUDY
As per university guidelines that is 4 to 6 weeks.
7.2.11 DATA ANALYSIS METHOD
The collected data will be analyzed through descriptive inferential statistics.
Descriptive statistics- It includes mean, frequency, percentage, range, standard deviation
to describe demographic variables and knowledge aspects.
Inferential statistics- It includes parametric paired t’ test and non-parametric chi-square
test to assess the effectiveness of self-instructional module and study the association
between the Knowledge scores with selected demographic variables.
19
7.3 DOES THE STUDY REQUIRE ANY INTERVENTION TO BE CONDUCTED
IN A PATIENTS OR OTHER HUMANS OR ANIMALS?
YES
7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR
INSTITUTION?
YES, Ethical clearance certificate enclosed.
20
8. LIST OF REFERENCES
1.
Mark Dombeck, Alcohol Substance Abuse ( Interent ) 2009; Available from http://
www.mhcinc.org.
2.
Kevin P Daly: John Richards, Substance Abuse 2008; Available from http://
www.emedicene health .com / substance abuse.
3.
World Health Organization. Regional health forum. Vol 10 (23); 2005.
4.
Susan Everingram, C. Rydell Cocaine Consumption in the U.S. Estimating part Trends
and Future Senarios. Socio – Economic Planning sciences Vol – 29 (4) December 2000.
5.
Dr.K.Lalitha, Mental health and Psychiatric Nursing, 2007, 11 edition, VMG book
house, 35-48.
6.
S. Zaimov, wisegeek Article of occupational Rehabilitation 2003 – 2005 (24) 2008 2010.
7.
Professional Guide to disease, 2005, 8th edition.
8.
James C. Anthony, vocational rehabilitation outcomes of veterans with substance use
disorders in a partial hospitalization program psychiatric serve 51, 2000, 1570-1572.
9.
Heather R. Huhman, the peer supported community program, published by Substance
abuse and mental health services administration, 2008.
10. Drug-Statistics Bangalore, 2007.
11. Jain.V, Socio demographic profile of 15-24 years old male narcotic substance users in a
resettlement colony of Delhi, 2009.
12. Megge Miller, Illicit drug use regarding amphetamines, 2000.
13. Siddiqui HY, National survey on extent patterns and trends of drug abuse in India
monitoring system, 2004, 3-9.
21
14. Weich L, Occurance of comorbid substance use disorders among acute psychiatric
inpatients at Stikland hospital in the Western Cape, South Africa, 2009, 213-217.
15. Sennekamp W, Basler B, [Problematic consumption of addictive drugs in psychiatric
rehabilitation, 2004.
16. Ovandir Alves et al, Yon amine Drug abuse among workers in Tehran, Iran, 2004,
2004.
17. Indian express, 2000.
18. Chung JC, Active learning of geriatric rehabilitation: deliberations of an undergraduate
occupational therapy programme, 2001, 250-256.
19. Chan SC, drug abuse and engagement in occupation, 2004 , 408-15.
20. Schkrohowsky JG, Kalesan B, Alberg AJ, Tobacco awareness in three U.S. medical
schools, 2007, 101-6.
21. Lequerica AH, Donnell CS, Tate DG, Patient engagement in rehabilitation therapy:
physical and occupational therapist impressions, 2009, 753-60.
22. Sullivan, Michael, Psychologically Based Occupational Rehabilitation: The drug abuse
Prevention Program, 2003, 97-104
23. Bimla kapoor, text book of Psychiatric Nursing, I edition, New Delhi, Kumar
publications.2005.
24. Sreevani, Text books of Mental health Nursing, Jaypee publications, 2005, II edition.
269-275.
25. Verbeek J, Spelten E, Kammeijer M, Sprangers M, Return to work of cancer survivors:
a prospective cohort study into the quality of rehabilitation by occupational physicians,
2003 , 3527.
22
26. Souza D, Juliana L. Evaluation of SIM for senior secondary school students. The
Nursing Journal of India2004 August; 9 (8): 75-87.
27. Brock C. A study to identify the effectiveness of learning activity package for trhe
adults with rheumatoid arthritis, Journal of Advanced Nursing 2003 June; 28 (8): 265275
28. Yumnum Sundari Devi. Effectiveness of need based SIM on knowledge regarding the
management of dysmenorrhoea among adolescent girls in an urban school, North
Bangalore. Unpublished M.Sc Nursing Thesis, RGUHS Bangalore 2002.
29. Lindsay C, Jenrich J.A, Bierndt M, programmed instruction booklet cardiac
rehabilitation teaching, Heart Lung, 1999 November; 20 (6): 698-531.
23
SIGNATURE OF THE STUDENT
:
REMARKS OF THE GUIDE
: The research topic selected for the
candidate is suitable as there is a need for
improving the knowledge of patients with
drug abuse regarding occupational
rehabilitation.
NAME AND DESIGNATION OF THE GUIDE
GUIDE NAME AND ADDRESS
: Ms. Manjula Rathna
Asst. Professor
Psychiatric Nursing
Pragathi College of Nursing
# 33, Byrathi Extn, Near Ebenezer
Hosital, Kothanur Post, Hennur
Bagalur Main Road, Bangalore-560077
SIGNATURE OF THE GUIDE
:
HEAD OF THE DEPARTMENT
:
Ms. Manjula Rathna
Asst. Professor
SIGNATURE OF HOD
:
24
REMARKS OF THE PRINCIPAL
: The research topic selected for the
candidate is appropriate. There is a need
for improving the knowledge of patients
with drug abuse regarding occupational
rehabilitation.
SIGNATURE OF THE PRINCIPAL
:
25