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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
Ms. MERCY SAMPOORNA.P
NAME OF THECANDIDATE
1
I YEAR M. Sc NURSING
E.T.C.M COLLEGE OF NURSING
AND ADDRESS
P.O. BOX No. 4, KOLAR – 563 101
KARNATAKA
NAME OF THE
E.T.C.M COLLEGE OF NURSING,
INSTITUTION
P.O. BOX No. 4, KOLAR – 563101
COURSE OF STUDY AND
MASTER OF SCIENCE IN NURSING,
SUBJECT
PSYCHIATRIC NURSING
2
3
DATE OF ADMISSION TO
15-6-2012
4
COURSE
“A
STUDY
PSYCHOSOCIAL
CANCER
5
TO
ASSESS
NEEDS
PATIENTS
IN
OF
THE
ORAL
SELECTED
TITLE OF THE TOPIC
CANCER HOSPITALS AT BANGALORE
IN
A
VIEW
TO
DEVELOP
INFORMATION BOOKLET”.
1
AN
6. BRIEF RESUME OF THE INTENDED WORK
“Health is a large word. It embraces not the body only, but the mind and
spirit as well... and not today's pain or pleasure alone, but the whole being and
outlook of a man”.
- James H. West
According to WHO, health is state of complete physical, mental, social and
spiritual well being, not merely an absence of disease or infirmity1.
The state of positive health implies the notion of ‘perfect functioning’ of the body
and mind. It conceptualizes health biologically, as a state in which every cell and every
organ is functioning at optimum capacity and in a perfect harmony with the rest of the
body; psychologically as a state in which the individual feels a sense of perfect wellbeing
and of mastery over his environment and socially, as a state in which the individuals
capacities for participation in the social system are optimal1.
Cancer is the Latin word for crab because of the crab-like tenacity a malignant
tumor sometimes seems to show in grasping the tissues it invades. The word cancer often
abbreviated as ”Ca” is a term often frightens most people it is otherwise known as
malignant neoplasm. It includes tumor, malignancy, carcinoma etc. Cancer is a collective
term describing a large group of disease characterized by uncontrolled growth and / or
spread of abnormal cells2.
Cancer is a generic term for a large group of diseases that can affect any part of
the body. One defining feature of cancer is the rapid creation of abnormal cells that grow
beyond their usual boundaries, and which can then invade adjoining parts of the body and
2
spread to other, a process referred to as metastasis. Metastasis is the major cause of death
from cancer3.
Cancer is the second largest cause of disease worldwide, representing about 13%
of all deaths (7.6 million deaths) 4. Cancer is the second most common disease in India5.
The data from Hospital Based Cancer Registry [HBCR] of India has shown that
Cancer of Cervix (28%) and Breast (16%) in women are most common and cancer of
Head and Neck region constitute about 30 % of all cancer in males and females6.
Oral cancer is part of a cancer group called head and neck cancers, and is defined
as an uncontrollable growth of cancerous cells that invades the mouth (called oral cavity)
and the part of the throat behind the mouth (called oropharynx)7.
The Commonest cancers among Males and Females seen at Kidwai Memorial
Institute of Oncology [KMIO] 2004-05 are as below6.
MALE
Pharynx
Oral cavity
Leukemia
Esophagus
Lung
Lymphoma
Stomach
Brain & Nervous system
Larynx
Liver
FEMALE
Cervix
Breast
Oral cavity
Esophagus
Ovary
Leukemia
Thyroid
Stomach
Lymphoma
Pharynx
The leading Sites of Cancer in Males are as follows - Pharyngeal cancers
(excluding cancer of nasopharynx) accounts for (14.1%), Oral cavity (11.2%),
Leukaemias (8.4%), Oesophagus (8.3%) and Lung (6.8%). Leading Sites of Cancer in
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Females are Cancer of the cervix uteri accounted for (26.7%), Cancer of the breast
(16.6%), oral cavity (11%), Oesophagus (5.7%) and ovary (5%) 6.
The risk factors for mouth cancer include: Smoking; Chewing tobacco; Heavy
smoking, heavy drinking; Too much sun exposure on the lips; people who consume lots
of red meat, processed meat and fried foods; Gastro esophageal reflux disease; HPV
(human papillomavirus) infection; Prior radiation treatment (radiotherapy) in the head
and/or neck area; Regularly chewing betel nuts; Exposure to certain chemicals especially asbestos, sulphuric acid and formaldehyde; Cancer starts when the structure of
the DNA (deoxyribonucleic acid) alters - a genetic mutation8.
The impact of cancer on patients brought psychosocial problems like difficulties
in the family, smoking, alcohol abuse, work and leisure, social isolation, dependency,
financial crisis. The psychosocial problems are leading for major psychiatric problems in
oncologic clients9.
Each year on 4 February is celebrated as World Cancer Day."Together it is
possible" is the 2012 theme for World Cancer Day10.
World No Tobacco Day (WNTD) is observed around the world every year on
May 31. It is meant to encourage a 24-hour period of abstinence from all forms of
tobacco consumption across the globe11.
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6.1 NEED FOR THE STUDY
"Cancer is not a death sentence, but rather it is a life sentence; it pushes one
to live."
- Marcia Smith
According to the WHO, Oral health is defined as ‘being free of chronic mouth
and facial pain, oral and throat cancer, oral sores, birth defects and other diseases and
disorders that affect the mouth and oral cavity. Having a good oral health enables
individuals to communicate effectively, to enjoy food, to speak well, to enjoy a higher
quality of life, and to have both a higher self-esteem and social confidence. However,
despite considerable improvement in the field of oral health throughout the world, oral
health problems still persist both in developed and developing country12.
Oral cancer is an important public health matter which is responsible for 3% to
10% of cancer mortality worldwide. Oral or oropharyngeal cancer is the eleventh most
common cancer worldwide with over 3, 00,000 new cases13. Oral cancer is the third most
common cancer in India after cervical and breast cancer amongst women14. In India alone
over 1, 00,000 cases are registered every year. In Karnataka 75% of people are using
tobacco or alcohol and 40% of people are in risk15.
A study was conducted in Italy to assess the functional and psychological
evaluation after flap reconstruction plus radiotherapy in oral cancer. 36 of 153
consecutive patients surgically treated for carcinoma of the oral cavity. 50% of the cases
examined, moderate to severe late toxicity was observed, regarding subcutaneous tissues,
salivary function, dysphagia, and taste impairment. Patients with severe dysphagia
showed higher levels of depression and anxiety. Finally they concluded that dysphagia
and taste impairment are associated with quality of life and depression16.
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A study to assess the functional status and coping in patients with oral and
pharyngeal cancer before and after surgery. These psychosocial and physical functioning
as well as the functions of recreation/pastimes, sleep/rest, home management, work, and
eating were rated as being impaired 2-4 months and also 12 months after treatment. This
study reveals that there is a need of individualized rehabilitation for these patients, and
that the Sickness impact profile (SIP), and coping, measured by the Sense of coherence
(SOC) scale may serve as evaluation tools in a rehabilitation programme17.
Oncology patients have various psychological problems such as emotional
liability,
changes
in
future perspectives,
feelings
of solitude, abandonment,
marginalization, stigmatisation, interpersonal problems, and all these problems can occur
during different disease stages and during treatment with variety of psychological
consequences18.
Psychosocial issues facing the head and neck cancer patient are numerous and
include coping with the initial cancer diagnosis, adjustment to living with cancer and the
treatments involved (including difficulties with speech, eating and drinking, and sexual
adjustment), depression and anxiety. The patient must also often confront issues with a
spouse and family, facial disfigurement, rehabilitation, and for the terminal cancer
patient, accepting death. It is recommended that additional psychosocial research and
patient education efforts continue in order to assist head and neck cancer patients19.
Oral cancer is the most common cancer in India and according to Dr Geoff Craig
“People are dying of oral cancer because of ignorance”. So Sangeeta Darvekar Charitable
Trust thought of a mass awareness program about oral cancer, its causes, its treatment
and resultant problems and the way of preventing this cancer20.
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“India has the highest number of oral cancers in the world with 75,000 to 80,000
new cases every year. The government should ban gutka under the Food Safety and
Standard Authority of India rules that came in effect on August 2011,” says Bhavna
Mukhopadhyay, executive director, Voluntary Health Association of India, a non-profit
organization20.
The Mouth Cancer Foundation in June 2004 to be a professional support
organization solely dedicated to helping people with mouth, throat and other head and
neck cancers deal with the crisis of cancer. Through a variety of ways the charity gives
resources, information and contact with people in a similar situation at a difficult time21.
Additionally worrisome, the remarkable advances in biomedical care for cancer
have not been matched by achievements in providing high-quality care for the
psychological and social effects of cancer. Numerous cancer survivors report that cancer
care providers did not understand their psychosocial needs, failed to recognize and
adequately address depression and other symptoms of stress, were unaware of or did not
refer them to available resources, and generally did not consider psychosocial support to
be an integral part of quality cancer care22.
Psychosocial health needs encompass the mental, emotional, social, and spiritual
aspects of health and the actions necessary to attain optimal well-being21. Cancer patients
also experience other physical, informational, and practical needs that may influence
psychosocial health. The supportive care framework is inclusive of the psychosocial as
well as the physical, informational, and practical needs that are important to address in
cancer care23.
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Many studies have suggested that unmet psychosocial needs of oral cancer
patients can affect treatment and put patients at risk of illness later in life. Yet, that
psychosocial need are often not acknowledged or addressed in cancer care. Oral cancer
remains a major health problem in India, and only dedicated, sustained efforts towards
early detection, prevention and helping the oral cancer patients to meet psychosocial
needs will reduce the burden of this disease and also the above need for the study and
reviews of literature clearly suggests that less studies has been conducted on psychosocial
needs of oral cancer patients. So the investigator found it relevant to assess the
psychosocial needs of oral cancer patients in a view to develop an information booklet.
6.2 REVIEW OF LITERATURE
The review of literature is arranged under the following categories:
6.2.1 Review of literature related to incidence and prevalence of oral cancer
6.2.2 Review of literature related to psychosocial needs of patients
6.2.3 Review of literature related to information booklet to patient
6.2.1 Review of literature related to incidence and prevalence of oral cancer
A retrospective study was conducted to determine whether the incidence of oral
cancer is continuing to rise in the United Kingdom. There were 32,852 oral cancer cases
registered and had significant increases in incidence of 18% and 30% were seen in males
and females respectively. The trend was observed in younger (<45 years) and older (45+
years) age groups with 3.5% and 2.4% average annual increases respectively. These
increases were consistent for the majority of regions in the older group. For the younger
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group the increases in incidence were more rapid and differed geographically. Incidence
remains higher in men than women24.
A population-based study was conducted among oral cancer patients in Taiwan
during the period 1979- 2003, the incidence of oral cavity cancers is increasing rapidly in
South-East Asia, which may be attributable to tobacco smoking, alcohol and betel-nut
chewing. 26,166 cases were seen having an initial diagnosis of oral cavity cancers. 3.11
fold increase in risk for second cancer at all sites was observed after oral cavity cancers
compared with the general population (standardized incidence ratio = 3.11, 95%
confidence interval: 2.97-3.25). Of nine sites with excess risks of developing a second
cancer, the frequency was highest in the oral/pharynx (60%), followed by lung (7.2%)
and esophagus (5.5%). Second esophageal and lung cancers had a greater impact on
survival compared with other types of second cancer. Notably, the risk excess was more
prominent for patients with a follow-up interval of <=1 year and a first primary cancer
diagnosed at age of <=40. Finally they concluded that oral cavity cancers are associated
with an increased risk of nine second malignancies, which had a negative impact on
survival25.
A study conducted by Lizzy Sunny et al (2004) on 9670 oral cancer patients in
Mumbai of which 6,577 were men and 3,093 were women was done to provide a
population based incidence trend and cumulative risk of oral cancers. This study found
that 1 out of every 57 men and 1 out of every 95 women will contract oral cancer at some
time in their whole life and 97% of the chances are after they complete the age of 4026.
A case control study of 348 cases of cancers of the oral cavity with equal number
of controls was conducted by A. Nandakumar et al (1990) in Bangalore, India. It showed
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an elevated relative risk (25.3%) of oral cancer due to chewing of pan tobacco, any
smoking (cigarette or bidi or both) had only slightly elevated risk of developing oral
cancer, whereas a history of alcohol drinking or inhalation of snuff did not influence the
risk. A new finding of study was the markedly elevated risk of oral cancer in persons
consuming ragi (Eleusine coracana, family graminae) in comparison to those not
consuming ragi as staple cereal in their diet. There also appeared to be some interaction
between ragi consumption and tobacco chewing with substantially higher relative risks in
those who pursued both habits compared to those who gave a history of either27.
6.2.2 Review of literature related to psychosocial needs
A study was conducted to identify the prevalence of psychosocial need, and the
contributory factors to need, among cancer patients, using a descriptive cross-sectional
questionnaire survey of adult cancer patients. The participants were 1,000 patients from
four hospitals in the north west of England with the following characteristics: tumor type
(breast, colorectal, lymphoma, lung), being 1 month from a 'critical moment' in the cancer
journey (i.e. (i) diagnosis, (ii) end of first treatment, (iii) recurrence, (iv) move from
active treatment to palliative care), and aged over 18 years. The main outcome measure
was a psychosocial needs inventory comprising seven needs categories (48 need items).
A sample of 402 was achieved (40% response rate). Psychosocial needs relating to the
need categories 'health professionals', 'information' and 'support networks' are commonly
expressed and strongly felt by cancer patients. Needs relating to 'identity', 'emotional and
spiritual' issues and 'practical' issues are less commonly expressed but are also strongly
felt. Particular needs are related to tumor type, illness 'critical moment', age, gender,
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health status, socioeconomic and other social factors. This information should increase
awareness among cancer care professionals about a range of psychosocial needs and may
help them target particular patient groups for particular support interventions28.
A study was conducted to evaluate the psychosocial support needs of teenage
young adult cancer patients undergoing radiotherapy in Wales. A focus group interview
was utilized to encourage dialogue and collect rich data. Transcripts were analyzed
through open coding and content analysis. Emergent themes in terms of psychosocial
tensions were identified and categorized as external stressors and intrinsic anxieties. All
participants indicated a desire to maintain their identity as individuals and resume as
normal life as possible throughout the treatment process and beyond. Peer support was
deemed as vital to achieving this goal. Participants demonstrated a distinct sense of unity
and group cohesion throughout the session with suggestions that they considered
themselves to be very different from what they thought of as usual cancer patients. A
range of information was offered prior to radiotherapy however there was variation in the
efficacy of this provision between centers. At variance with literature, issues related to
body image were not overtly demonstrated as significant. Support services provided by
external organizations were not being signposted. Psychosocial support is vital to the
psychological recovery and wellbeing of young adult cancer patients. Findings suggest
that issues related to peer support and age appropriate services and information are not
being addressed within current service provision29.
A study was conducted on routine assessment of psychosocial and supportive care
needs. A total of nine clinical practice guidelines, three systematic reviews, and 14
primary studies were included in the review. Overall, this body of literature suggested
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that routine collection of psychosocial health care data has an influence on
communication with oncologists and other study specific outcomes, but the evidence was
limited by heterogeneity and methodological limitations. Given the limitations in the
current body of evidence, there remains a need for rigorous empirical research regarding
the optimal approach to psychosocial needs assessment, including the specific
characteristics that influence effectiveness on patient outcomes. This guideline fills an
important gap in psychosocial care, regarding the routine assessment of psychosocial
health care needs such as mental, emotional, social, spiritual and other actions to attain
optimum health30.
A study was conducted on psychosocial needs of patients with leprosy in South
Africa. 30 leprosy patients (15 males, 15 females; 41-60 years old) underwent interviews.
Intense grief was the most common general reaction on hearing the diagnosis of leprosy.
All responses experienced anxiety while admitted at a hospital and the majority felt that
lengthy institutionalization had more disadvantages that advantages. 11 subjects first
consulted a traditional healer before visiting a doctor because of belief that a spell had
been cast on them, family influences and traditional beliefs. In general, the subjects were
very satisfied with the treatment that they received from the Leprosy Mission and a West
fort Hospital. Of 23 married subjects, 9 men and 7 women had been deserted by their
marriage partners because of leprosy. It is concluded that the psychosocial need of
leprosy sufferers in South Africa are similar to those of leprosy sufferers in other parts of
the world in the need for self acceptance, social acceptance and acceptance by the
community31.
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6.2.3. Review of literature related to information booklet to patients
An exploratory study investigated factors influencing patient satisfaction with and
utilization of information booklets. The research was conducted in two stages. In stage 1,
five commonly used cancer information booklets were reviewed by 36 Australian
patients who were either receiving chemotherapy or had just completed treatment. Data
were collected on patient satisfaction with, preference for and utilization of information
booklets. A high level of satisfaction was found for all five information booklets,
although a clear preference for one particular booklet emerged. Stage 2 focused on the
side effects of patient information preference style on their satisfaction and recall of
information presented in two booklets in the course of their treatment. No differences
were found between patients who seek information and those who avoid it. The findings
of this study suggest that patients' information needs may be better met if information
booklets are written in plain English, and presented to patients prior to treatment. Future
studies incorporating a larger sample of patients and greater selection and variety of
information booklets are required to further determine if patient characteristics and
features of booklet presentation influence patient satisfaction and preference32.
A study was conducted to evaluate the level of understanding and the impact of
the information booklet "For a better understanding of radiotherapy" for radiotherapy
patients. One hundred booklets with a questionnaire and a postage-paid envelope were
sent to the oncologists of these ten radiotherapy centers. The information given in the
booklet was considered clear for 57.4% of the patients; 74.2% did not require
explanations of the vocabulary, whereas 14.8% wanted explanations and 13.0% did not
state an opinion. In the qualitative analysis, the booklet was found to be well received and
13
understood even if technical explanations were sometimes needed. This booklet was
judged to be useful by the patients and thought to "answer the questions which the patient
may ask". It seems important to define the right moment for its distribution (the first visit,
the first sequence of treatment, for example, would be more appropriate). Lastly, certain
passages, especially in the introduction, could be modified so as to improve the legibility
(in particular for the elderly). In addition, the informative content, largely well
understood, could be extended with a glossary, using simple technical and always clear
explanations33.
A study was conducted to determine the need for information among survivors of
childhood cancer, to assess the acceptability of an information booklet, and to investigate
the effectiveness of the booklet in increasing knowledge and influencing health related
behaviors. The booklet was developed for young people aged 14 years and above by the
United Kingdom Children's Cancer Study Group Late Effects Group. Included is
information about treatment of cancer, general advice about a healthy lifestyle, the
rationale for long term follow up, and information about employment and life insurance
problems. Survivors were interviewed at the follow up clinic, offered the booklet, and
contacted approximately one week later for a telephone interview. The clinic interview
assessed survivor's understanding of their illness and treatment and its impact on their
lives, and their preferences for further information. The telephone interview determined
survivors' general reaction to the booklet, whether it increased knowledge and influenced
health related behaviors. After reading the booklet there was an increased awareness of
the risk from sun bathing (p < 0.05), and greater appreciation of the importance of follow
up (p < 0.05). These results suggest that written information is likely to be an acceptable
14
and effective supplement to discussions with medical professionals and may readily be
incorporated into long term follow up clinics34.
A study was conducted to develop an information based booklet for patients with
hip or knee osteoarthritis, offering information and advice on maintaining activity. Six
information based guidelines and 54 systematic reviews were identified. The focus
groups found the draft booklet to be informative and easy to read. They reported a lack of
clarity about the cause of osteoarthritis and were surprised that the pain could improve.
The value of exercise and weight loss beliefs was accepted and reinforced, but there was
a perceived contradiction about heavy physical work being causative, while moderate
exercise was beneficial. There was a fear of dependency on analgesia and
misinterpretation of the message on hyaluranon injections. The information on joint
replacement empowered patients to discuss referral with their GP. The text was revised to
accommodate these issues. The booklet was readable, credible, and useful to end-users. A
randomized controlled trial is planned, to test whether the booklet influences beliefs
about osteoarthritis and exercise35.
STATEMENT OF THE PROBLEM
“A study to assess the psychosocial needs of oral cancer patients in selected
cancer hospitals at Bangalore in a view to develop an information booklet”.
15
6.3 OBJECTIVES OF THE STUDY
1) To assess the psychosocial needs of oral cancer patients.
2) To find association between the psychosocial needs of oral cancer patients with
their selected demographic variables.
3) To develop an information booklet on psychosocial needs of oral cancer patients.
6.4. OPERATIONAL DEFINITIONS
1) Assess: In this study, it refers to the critical analysis and exploration of
psychosocial needs of oral cancer patients.
2) Psychosocial needs: It refers to those needs arising in the physical, informational,
emotional, psychological, social, spiritual, and practical domains as part of a
patient’s experience of cancer and its treatment.
3) Oral cancer: It refers to malignancies indicative of unchecked cell growth that
are mainly found in and around the oropharynx, gingiva, floor of the oral cavity,
lower lip and base of the tongue.
4) Oral cancer patient: It refers to the oral cancer patients who are diagnosed with
oral cancer and hospitalised.
5) Information booklet: It refers to the concise and comprehensive information
material regarding psychosocial needs of oral cancer patients; which includes
actions necessary to attain optimal well being.
16
6.5 ASSUMPTIONS
 Oral cancer patients are unable to meet their psychosocial needs.
 Information booklet provided by the investigator would update their knowledge
regarding psychosocial needs of oral cancer patients.
6.6 DELIMITATIONS
 Study is delimited to oral cancer patients of selected cancer hospitals at
Bangalore.
7. MATERIALS AND METHODS
7.1 SOURCES
Data will be collected from the oral cancer patients in selected cancer hospitals at
Bangalore.
7.1.1 RESEARCH APPROACH
Exploratory research approach
7.1.2 RESEARCH DESIGN
Non-experimental descriptive research design
7.1.3 VARIABLES UNDER THE STUDY
Research variable:
Information
booklet on psychosocial needs of oral cancer
17
patients
Demographic variable:
Selected demographic variables such as age, gender, religion, type of family,
marital status, educational qualification, occupation, income, number of previous
hospitalization and any previous exposure to health education, mass media, information
booklet etc regarding cancer.
7.1.4 SETTING OF THE STUDY
The study will be conducted in selected cancer hospitals at Bangalore.
7.1.5 POPULATION
The population for the study comprises of oral cancer patients in selected cancer
hospitals.
7.1.6 SAMPLE
The sample will be oral cancer patients aged 18 years and above who are
hospitalized in selected cancer hospitals at Bangalore.
7.1.7 SAMPLE SIZE
The sample size will be 100 oral cancer patients.
7.1.8 SAMPLING TECHNIQUE
Convenient sampling technique will be used.
7.1.9 CRITERIA FOR SELECTION OF THE SAMPLE
 Inclusion criteria

Oral Cancer Patients who are willing to participate.

Oral Cancer Patients available during data collection.
18
 Exclusion criteria

Oral cancer patients who are unable to communicate due to any other reasons
like hearing impairment, oral surgery or chronic illness etc.

Oral cancer patients who are unconscious.
7.2 METHOD OF DATA COLLECTION
A structured interview questionnaire method.
7.2.1 TOOLS FOR DATA COLLECTION
The researcher will collect data through structured interview questionnaire. It
comprises two parts.
Part I: Demographic Variables like age, gender, religion, type of family, marital
status, educational qualification, occupation, income, number of previous hospitalization
and any previous exposure to health education, mass media, information booklet etc
regarding cancer.
Part II: Structured Interview Questionnaires (SIQ) on Psychosocial Needs of
Oral Cancer Patients.
7.2.2 DATA COLLECTION PROCEDURE
 Structured Interview Questionnaire (SIQ) will be used to collect data from oral
cancer patients after obtaining the formal permission.
19
7.2.3 METHOD OF DATA ANALYSIS
Collected data will be analyzed using descriptive and inferential statistics.
Descriptive statistics: The data collected will be organized and summarized by
using descriptive statistics like mean, frequency, percentage distribution and standard
deviation.
Inferential statistics: The association between psychosocial needs of oral cancer
patients with their selected demographic variables will be found using chi-square test.
7.3.
DOES
THE
STUDY
REQUIRE
ANY
INVESTIGATION
OR
INTERVENTIONS TO BE CONDUCTED ON PATIENT OR OTHER HUMANS
OR ANIMALS?
Yes, non - invasive intervention will be done. The psychosocial needs will be
assessed by using a Structured Interview Questionnaires (SIQ) on Psychosocial Needs of
Oral Cancer Patients followed by providing information booklet on Psychosocial Needs
of Oral Cancer Patients.
7.4. HAS ETHICAL CLEARANCE BEEN OBTAINED FROM
YOU’RE INSTITUTION?
a) Yes, Ethical clearance will be obtained from the research committee of E.T.C.M
College of Nursing, Kolar.
b) Permission will be obtained from the concerned authorities of the selected cancer
hospitals of Bangalore.
c) Informed consent will be obtained from the oral cancer patients who are willing to
participate in the study.
20
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http://www.iarc.fr/en/mediacentre/iarcnews/2012/worldcancerday2012.php
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22
Available from: URL: http://www.oralcancerawareness.org/mouth_cancer.html
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health needs. The National Academies Press. 2008: p 23-30.
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Recommendations. Submission to cancer care Ontario, Toronto.1994.
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9.
SIGNATURE OF THE
CANDIDATE
The research topic selected is relevant and
10.
REMARKS OF THE GUIDE
feasible for the study.
MR. PRAVEEN. A. LONI
11.
NAME AND DESIGNATION
Associate Professor & HOD of Mental
11.1. GUIDE
Health Nursing Department,
ETCM College of Nursing, Kolar, 563101
11.2. SIGNATURE OF THE
GUIDE
11.3. CO-GUIDE (if any)
11.4. SIGNATURE OF THE
CO-GUIDE
MR. PRAVEEN. A. LONI
11.5. HEAD OF THE
DEPARTMENT
Associate Professor & HOD of Mental
Health Nursing Department,
ETCM College of Nursing, Kolar, 563101
11.6. SIGNATURE OF THE
HOD
12.1. REMARKS OF THE
12.
PRINCIPAL
This topic was discussed with the members
of the research committee and finalized.
She is permitted to conduct the study.
12.2. SIGNATURE OF THE
PRINCIPAL
25