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DESSERTATION PROTOCAL
1
2
NAME OF THE
CANDIDATE AND
ADDRESS
Ms. JOTHI. M
NAME OF THE
INSTITUITION
HINA COLLEGE OF NURSING
M. Sc NURSING STUDENT
HINA COLLEGE OF NURSING,
YELAHANKA NEW TOWN,
BANGALORE-64
YELAHANKA NEW TOWN,
BANGALORE
3
COURSE OF STUDY
SUBJECT
4
5
DATE OF ADMISSION
TO COURSE
M. Sc NURSING
PSYCHIATRIC NURSING
27/06/2008
TITLE OF THE TOPIC:
Assess the anxiety level and effectiveness of psychotherapy of the
mother of hospitalized neonatal ICU child in selected hospital at Bangalore.
6. BRIEF RESUME OF INTENDED WORK
6.1 NEED FOR THE STUDY
The children who received psychotherapy were compared with controls
or children receiving another form of treatment. Only those studies using Ss
younger than a mean age of 13 yrs at the time of treatment were included.
Exceptions to the age limitation were made only if separate analyses for
younger children were reported or if individual data from older could be
eliminated. Results show that therapy with children was similar in
effectiveness to therapy with adults; treated children achieved outcomes about
two-thirds of a standard deviation better than untreated children. Although
behavioral treatments appeared to be more effective than non behavioral
treatments, this apparent superiority was due largely to the types of outcome
and target problems included in behavioral studies. (Casey et al., 2001)
Anxiety disorders are among the most prevalent psychiatric conditions in
the US and in most other population’s studies. Further, studies have
persistently shown that they produce in order morbidity, use of health are
services, and functional impairment. Recent studies also suggest that chronic
anxiety disorder may increase the rate of cardiovascular related mortality.
reported that modern psychotherapies have often demonstrated a significant
degree of effectiveness, in that they help clients overcome their presenting
symptoms, their degree of 'efficiency' may not measure up to their
'effectiveness.' Efficiency in psychotherapy includes several issues that are
often neglected in research on 'effectiveness.' These criteria include such
ingredients
as
thoroughgoingness,
depth-centeredness,
maintenance
of
pervasiveness,
therapeutic
extensiveness,
progress,
preventive
psychotherapy, minimization of therapeutic harm, and encouragement of
scientific flexibility. It is contended that these aspects of psychotherapy are of
profound importance to therapists and clients and that such aspects should be
consciously included as values in psychotherapy (Ellis & Albert .,1999).
The investigator observed that the mother of hospitalized child will have
a lot of tension and anxious. This may affect their health status of the mother.
In many of the hospital there is no consideration about psychological state of
the mother. So the investigator felt that assess the anxiety level and
effectiveness of psychotherapy is needed.
6.2 REVIEW OF LITERATURE:
Tritt. K, (2004) et al., stated that the influence of co-admission of their
children in the treatment of 29 female patients diagnosed with generalized
anxiety disorder, 15 of whom were admitted with accompanying children and
14 without, were compared (response rate 95.3%). The results indicate that
mothers with generalized anxiety disorder who were accompanied by their
children during in-patient psychotherapeutic treatment achieved treatment
results that were just as good as mothers with the same diagnosis who were
admitted without children.
M. L. Smith et al., (1998) reported that the benefits of psychotherapy in
475 controlled studies, using only studies of patients seeking treatment for
neuroses, true phobias, and emotional-somatic complaints. The results of 81
controlled trials were integrated statistically using the meta-analytic technique.
The condition of the typical patient after treatment was better than that of 77%
of untreated controls measured at the same time, and the rate of relapse in the
1st 2 yrs was small. Behavior and psychodynamic verbal therapies appeared to
be superior to other therapies. The relationship between severity of illness and
choice of therapy is unknown, and could account for some of the differential
effects, but does not vitiate this further evidence of the efficacy of
psychotherapy.
Smith (2004) et al., coated that 375 controlled evaluations of
psychotherapy and counseling were coded and integrated statistically. The
findings provide convincing evidence of the efficacy of psychotherapy. On the
average, the typical therapy client is better off than 75% of untreated
individuals. Few important differences in effectiveness could be established
among many quite different types of psychotherapy. More generally, virtually
no difference in effectiveness was observed between the class of all behavioral
therapies (e.g., systematic desensitization and behavior modification) and the
non behavioral therapies (e.g., Regression, psychodynamic, rational-emotive,
and transactional analysis).
Casey (2001) et al., revealed that children who received psychotherapy
were compared with controls or children receiving another form of treatment.
Results show that therapy with children was similar in effectiveness to therapy
with adults; treated children achieved outcomes about two-thirds of a standard
deviation better than untreated children. Although behavioral treatments
appeared to be more effective than non behavioral treatments.
Manos (1994) et al., stated that
motioned the outcome of
psychoanalytically oriented psychotherapy administered to 15-54 yr olds who
presented with a variety of syndromes, including personality disorders,
anxiety/somatoform disorders, psychotic disorders, psychosexual disorders,
and bulimia. Ss and 16 non treatment controls (aged 16-38 yrs) were evaluated
post intake. MMPI scores, target symptoms, global evaluation, and other
clinical evaluations were used as outcome measures. Findings show that Ss
who underwent therapy improved significantly more than controls on
subjective and objective parameters.
Paplau (1963) identified four levels of anxiety and described their effects
mild anxiety is associated with tension of day to day living. Moderate anxiety,
in which persons focuses only on immediate concerns, involves the narrowing
of the perceptual filed. Severe anxiety is marked by a significant reduction in
the perceptual filed. Panic is associated with awe, dread, and terror and the
person feeling it is unable to do things even with direction.
Melnyk (2007) conducted the study to test COPE program for mothers
of critically ill children: an integrative model of young children's post-hospital
adjustment behaviors. COPE effects on children's post-hospital externalizing
behaviors were indirect, via associations with parental beliefs and maternal
negative mood state. Furthermore, COPE participation was associated with
more maternal support of their children, which was also associated with less
internalizing and externalizing behaviors 3 months post discharge.
Parloff, (1996) et al., stated that the treatment of adults by a range of
individual psychosocial therapies. The contradiction between increased
conceptual and methodological sophistication and increased skepticism
regarding the scientific merit of positive research findings in the field of
psychotherapy is examined. Efficacy research findings are discussed through a
critique of global outcome surveys via meta-analysis and studies of particular
therapies for specific problems/disorders according to Diagnostic and
Statistical Manual of Mental Disorders (DSM-III) and behavioral medicine
categories (e.g., depression, schizophrenia, anxiety, alcoholism). Issues and
trends with regard to therapy manuals, brief therapies, clinical trials, placebos
and specificity of effects, theory development and integration, are also
discussed.
STATEMENT OF THE PROBLEM:
Assess the anxiety level and effectiveness of psychotherapy of the
mother of hospitalized neonatal ICU child in selected hospital at Bangalore.
6.3OBJECTIVES:
 To assess the anxiety level of the mother of hospitalized neonatal
ICU child.
 To evaluate the effectiveness of psychotherapy on mother of
hospitalized neonatal ICU child.
 To determine the association between the anxiety level of the mother
of hospitalized neonatal ICU child with their demographic variables.
6.4. RESEARCH HYPOTHESIS:
The anxiety level of the mother will become low after giving
psychotherapy.
6.5. OPERATIONAL DEFINITIONS OF THE TERMS:
ASSESSMENT:
Refers to the process used to identify evaluate and analyse the anxiety
level and effect of psychotherapy of mothers in relation to the hospitalized
neonatal child.
ANXIETY:
The state of feeling nervous or worried that something bad is going to
happen.
PSYCHOTHERAPY:
Helping person attempts to relieve an individual distress of facilitating
changes in his feelings, attitudes and behaviors by means of verbal and
emotional communications.
NEONATES:
It is said to be baby’s age between 0 - 28 days.
NICU:
An intensive care unit designed with special equipment to care of
premature or seriously ill new born.
6.6ASSUMPTIONS OF THE STUDY:
It is assumed that,
The anxiety level of the mother will be reduced with effect of psychotherapy.
7.0 MATERIALS METHOD:
7.1 SOURCE OF DATA:
Mothers of hospitalized neonatal child are considered as source of data.
7.2 METHOD OF COLLECTION OF DATA:
Purposive sample collection method will used to collect data from
mothers.
7.2.1. RESEARCH DESIGN:
The selection of research design is an important and essential state in
research as it is concerned with the overall framework of conducting the study
by giving a plan, structure and strategy of investigation (Abdelah & Levine,
1965)
The research design selected for present study is pre test and post test
design under quasi experimental design to assess the anxiety level and
effectiveness of psychotherapy on a randomly selected sample of 50 subjects
7.2.2SETTING OF THE STUDY:
The study will be conducted in the hospitals of Bangalore District
(Urban). There are about 20 hospitals in this district and total of 100 mothers of
neonatal. The settings of the study is among the mothers of hospitalized child.
7.2.3POPULATION:
The mothers whose child is admitted in the NICU in the selected
hospitals of Bangalore constituted the population.
7.2.4, SAMPLE SIZE:
There will be about 50 mothers are considered as sample.
7.2.5. SAMPLING PROCEDURE:
Based on availability of the mother on the time of study, the sample was
collected. Purposive sampling procedure will be used in this study.
7.2.6. SAMPLING CRITERIA:
INCLUSION CRITERIA:
Mothers,
 Those children admitted in NICU.
 Who are willing to participate.
 Those who are able to read and write.
EXCLUSION CRITERIA:
Mothers,
 Will not present at the time.
 Not able to read and write.
 Child admitted other than NICU.
7.2.7. DATA COLLECTION TOOL:
A structural scale is used to assess the anxiety level and effectiveness of
psychotherapy.
7.2.8. DATA COLLECTION METHOD:
Formal permission will be obtained from incharge of the hospital. Pre
test will be carried out before giving psychotherapy then after therapy again
anxiety level will be assessed by using rating scale.
7.3. DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR
INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR
OTHER HUMANS AND ANIMALS? IF SO PLEASE DESCRIBE
BRIEFLY.
-No7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR
INSTITUITION IN CASE OF 7.3?
Formal ethical clearance will be obtained from the concerned authority and
consent from hospitalized mother before data collection.
REFERENCES:
 Andrews, Archives of General Psychiatry; 1981 Nov Vol 38 (11) 12031208.
 Ellis, Albert. Psychotherapy Theory, Research and practice; 1980 Win
Vol 17 (4) 414-419
 Fam Process. 2003 Fal; 42 (3) : 391 – 402.
 J. Pediatr Psychol. 2007 May; 32 (4) : 463 – 74.
 Smith, Meta analysis of psychotherapy outcome studies; 1977 Sep Vol
32 (9) 752-760.
 Wien Klin Wochenschr. 2004 Nov 30; 116 (21-22): 750-4
9.
SIGNATURE OF THE CANDIDATE :
(JOTHI. M)
10. REMARKS OF THE GUIDE:
The study is useful to reduce the anxiety level of mothers of hospitalized
NICU children. The need for study explained is appropriate and methodology is
as per the statement of the problem. Hence, can be approved for undertaking
this study.
11.
NAME AND DESIGNATION :
11.1
GUIDE:
Mrs. PARIMALA KRIPANIDHI
ASSOCIATE PROFESSOR AND HOD
Dept. of PSYCHIATRIC NURSING
Hina College of Nursing, Bangalore.
SIGNATURE :
11.3
HEAD OF THE DEPARTMENT :
Mrs. PARIMALA KRIPANIDHI
ASSOCIATE PROFESSOR AND HOD
Dept. of PSYCHIATRIC NURSING
Hina College of Nursing, Bangalore.
11.2
SIGNATURE :
12.1
REMARKS OF THE CHAIRMAN AND PRINCIPAL :
This study is recommended by research committee and it is useful to
assess the level of motivation among drug addiction patients. Hence, can be
approved for the study.
12.2
SIGNATURE :