Download 1 SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR

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SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT
FOR
DISSERTION
Miss. AKHILA SOMAN. N. S
FIRST YEAR M.SC (NURSING)
PSYCHIATRIC NURSING
YEAR 2009-2011
THE KARNATAKA COLLEGE OF NURSING
# 12, KOGILU MAIN ROAD,YELAHANKA
BANGALORE – 56
2
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT
FOR
DISSERTATION
Miss. AKHILA SOMAN N. S
1.
NAME OF THE
AND ADDRES
CANDIDATE
1ST YEAR M.Sc (NURSING)
THE KARNATAKA
NURSING,
COLLEGE
OF
#12
KOGILU
MAIN
ROAD,
YELAHANKA, BANGALORE – 560 064
2.
NAME OF THE INSTITUTION
3.
COURSE OF THE STUDY AND
SUBJECT
4.
5.
DATE OF ADMISSION TO THE
COURSE
TITLE OF THE STUDY
THE KARNATAKA COLLEGE
NURSING, BANGALORE – 560 064
OF
1ST YEAR M.Sc (NURSING),
PSYCHIATRIC NURSING
15/06/2009
“A STUDY TO ASSESS THE
EFFECTIVENESS OF STRUCTURED
TEACHING PROGRAMME ON HOME
CARE PRACTICES AMONG PARENTS
HAVING CHILDREN WITH
RUCURRENCE OF SCHIZOPHRENIA
BETWEEN THE AGE GROUP OF 20-30,
ADMITTED IN FAMILY THERAPY
WARD AT SELECTED PSYCHIATRIC
HOSPITAL, BANGALORE .”
3
6. BRIEF RESUME OF THE INTENDED WORK.
INTRODUCTION.
“Our greatest battles are that with our own minds”
-
Jameson Frank
The world health organization defines health as “A state of complete, physical ,mental
,social, and spiritual well being of an individual and not merely an absence of disease or
infirmity”. It refers that health is an absolute and infinite state, but all individual can not adhere
the same feel of health because of innate differences. According to the above definition, mental
health as an integral part, component of total health experience.3
Mental health is a state of balance between the individual and the surrounding, world and
state of harmony between oneself and others, a co-existence between the realities of the self and
that of other people and that of environment.Ginsburg (1995)defined mental health as the ability
to hold a job, have a family, keep out of the trouble with the law and enjoy the usual
opportunities for pleasure.7
Mental disorders are believed to have been a part of human experience throughout the
history. Attitude towards mentally ill have not always been so enlighting. Mental illness was
viewed as demonic possession, the influence of ancestral spirits, the result of violating a taboo or
neglecting a cultural ritual and spiritual condemnation. So the mentally ill people have been
ridiculed, neglected, banned ,persecuted and deprived of their freedoms.9
4
The publications of Sigmund Freud lead to new concepts in the treatment of the mentally
ill. Begining in 1950’s pharmacotherapy changed picture of mental health care.5 In the world
500 million people are believed to suffer from neurotic, stress related, somatoform disorders.
Unemployment, marital dysharmony, loss of individuals, any major illness, isolation etc lead to
these problems.4
Schizophrenia is a devasting mental illness that impairs mental and social functioning and
often leads to the development of comorbid diseases. These changes distrupt the lives of patients
as well as their families1. According to Brich Wood, etal ,(1989), Schizophrenia affects men and
women equally. It is a debiliting mental illness that affect 1% population in all cultures. 12Being a
disabling, chronic psychiatric disorder that possess numerous challenges in its management and
consequence. It extols a significant lost to the patient in terms of personality suffering, on the
care giver as a result of the shift burden of care from hospital to families and on society at large
in terms of significant direct and indirect costs that include frequent hospitalizations and the need
for long term psychosocial and economic support as well as life time lost productivity.11
Families having Schizophrenia patients experiencing on extensive ‘burden of care’, such
as taking care of daily tasks, maintaining adequate nutrition, looking after the personal hygiene,
correct medications and accurate follow-up1.Although there is ‘burden of care’, family
intervention in Schizophrenia demonstrated the positive impact of various family interventions in
improving family environment and reducing relapse. There are several psychosocial
interventions available including education, support and management to reduce the relapse rate
of Schizophrenia. These psychosocial interventions should be administered with in family
groups, because it improve compliance to medication, and reduce the risk of relapse.8
5
Research efforts have been expanded in last 3 decades, and urgent need exists for
enhancing development and evaluation of effective family intervention strategies, because family
members are the primary care givers, strategies to promote optimal family functioning would
results in better care for the patient, there by enhancing patient outcomes.11
6
6.1 NEED FOR THE STUDY.
“Choose always the way that seems the best, however rough it may be, custom will
soon render it easy and agreeable.”
-‘Pythogoras’
According to national advisory mental health council (2007) approximately 30% of the
2.8 million people with severe mental illness receive active treatment in a given year. 70%-80%
of children needing mental health treatment do not receive appropriate service. The full spectrum
of mental disorders affects 25% of the adult population in a given year. Severe mental disorders,
such as schizophrenia, manic, depressive illness and obscessive compulsive disorder affect 2.8%
of the adult population (approximately 5 million people) and account for 25% of all federal
disability payments.11
Kessler R C, Chin W T, Demler O,Walterse E,(2005), states that an estimated 26.2% of
Americans ages 18 and older about one in four adults suffer from a diagnosable mental disorder
a given year, a label that typically includes schizophrenia, schizoaffective disorder. Roughly 11.1
million Americans of all ages are receiving formal and informal care at any time. This represents
about 4% of the population and is comprised of about 9.5 million receiving care at home or in
the community and another 1.6 million residing in nursing home or in intermediate care
facilities.11
National advisory mental health council states that about 1 in 5 children in the United
states younger than 18 years have a mental health problem severe enough to require treatment.11
Schizophrenia affects 1% of the population in all cultures. Schizophrenia occurs equally in males
7
and females, although typically appears earlier in man with peek ages of onset being 22-28 years
for males and 26-32 years for females . The life time prevalence of schizophrenia is 1-1.5%.12
According to Reshmi Nemade, (2007), 1.2% of Americans (3.2 millions) have
schizophrenia disorder. About 1.5 million people will be diagnosed with schizophrenia this year
around the world. In United states about 100000, people will be diagnosed which translates to
7.2 people per 1000 or about 21000 people in a city of 3 million who are suffering from
schizophrenia.35
National Institute of Mental Health (NIMHANS),(2008),states that the prevalence rate
for schizophrenia is 1.1% of the population over the age of 18, or in other words at any one time
as many as 51 million people worldwide suffer from schizophrenia, they reported that;
4.3-8.7 million people in India
6-12 million people in China,
2.2 million people in USA,
Over 2800000, people in Canada,
Over 250000, in Britten, are suffering from schizophrenia.35
About 1in every 100 people suffers from schizophrenia or 2.5 million Americans,
regardless of race, ethnic group or gender. In 3 out of 4 cases it begins between the ages of 17
and 25 years.95% of people with schizophrenia have it for their life time. The annual cost of
family care giving and well fare related expenditure as a result of schizophrenia is 53 billion in
the United States.11
8
People with schizophrenia occupy 25% of all inpatient beds. An estimated 1/3rd to one
half of the homeless people have schizophrenia in the United states. Schizophrenia is ranked 4th
world wide as terms of burden of illness. Patients with schizophrenia, 25% do not respond
adequately to traditional antipsychotic drugs. 22-25% of patients with schizophrenia attempt
suicide and 10-15% succeeded11.
According to Stephen H, Shultz, Stephen W North and
Clereland G Shields (2008), New York , schizophrenia begin usually in adolescence or early
adulthood less than 20% patients maintain full recovers after 1st episode. Drug treatment and
psychosocial interventions such as family therapy are the main approach and preventing relapse.4
Faith C D, (1993), states that prognosis is good for only 20-30% of sufferers, half of the
patients diagnosed with schizophrenia will experience repeated relapse and hospitalization. The
remaining 20-30%will experience moderate symptoms and a significant degree of disability. It is
estimated that 10-16% of patients with schizophrenic die by suicide3. Pai and Kapoor (1993),
evaluated the impact of home care for schizophrenia patients in terms of outcome. The findings
of the study revealed better clinical outcome, better social functioning and significant reduction
in burden on the family, compared to patients who are hospitalized and followed up on outpatient
basis10.
WHO (2009) started that 90% of people with untreated schizophrenia are in developing
countries like India40.The life expectancy of individual with schizophrenia is shorter than that of
general population for a variety of reasons. Suicide is an important factor, because approximately
10% of individual with schizophrenia commit suicide and between 20% and 40% make at least
one suicide attempt. 4
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6.2 REVIEW OF LITERATURE.
“Literature reviews can serve number of important functions in the research process and
they also play a critical role for nurses seeking to develop and evidence base practice.” 2
Review of literature has been presented under the following headings;
1) Literature related to care givers of schizophrenic patients.
2) Literature related to effect of burden of care givers on quality of care provided
to schizophrenic patients.
3) Literature related to effects of psychoeducation and family interventions on
schizophrenia.
1) Literature related to care givers of schizophrenic patients.
Van Wijnguard. B. etal(2009) conducted a study regarding care giver consequences of
care givers of patients with schizophrenia. Primary care givers of 252, mainly inpatients with
schizophrenia selected. The findings of the study suggested that care givers of schizophrenia
worry more and more about nursing tasks, they report less social support and less coping
abilities. They explain that in schizophrenia mostly mothers are caring ill adult.37
Garbrecht. A, Grund Mann J (2009) conducted a research about relationship quality in
families with schizophrenic adolescent among 43 patients and their care givers using a structured
questionnaire. The findings of the study revealed that there is criticism, emotional over
involvement, expressed emotion and hostile behavior showed by the care givers to the ill
10
member. This study enlights the need for parental counseling because it help care givers to
develop alternative relationships style.27
Sinitz etal (2009) conducted a comparative study regarding routine care given by care
givers of inpatients and outpatients with schizophrenia. 147 care givers of both inpatients and
outpatients are assessed using a questionnaire. The findings of the study suggested that care giver
of outpatients have lower quality of care, high subjective burden and less positive attitude
towards patient. They have feeling of timidity, fear and shame36.
Brelt Borde. N. J. etal (2009) analyzed the emotional over involvement of care givers
towards schizophrenia and patients course of illness. The study conducted using a cross sectional
analysis, in a sample of 37 care givers and their ill relatives. The
findings revealed that
emotional over involvement and burden of care negatively affects the patients outcome. The
study also stated that the lack of social support and stigma experienced by care givers of
schizophrenic patients.14
Honsy and suye(2008), conducted a study which investigated the burden of the primary
family care givers of schizophrenic patients and factors that affect care giver burden. An
interview session has conducted among 126 patients and primary care givers . The findings
concluded that, the physical and mental health condition of the primary care giver of
schizophrenic patients was the most important factor determining the care giver burden level.30
Caquneo Urizar . A. etal(2008), conducted a research to analyze the quality of life and
family functioning in schizophrenia patient care givers. A family function questionnaire was
administerd to a sample of 49 patients and 70 relatives. The findings revealed that caregivers of
11
schizophrenic patient have poor family functioning, social support and very low quality of care
provided to the ill member.25
Karanagn. D.J, White A and Robertson. D(2008) conducted a study, which checked the
relationship between expressed emotion is family and relapse of the schizophrenia. Two groups
of care giversare selected, one with 54 care givers of psychosis patients and second with care
givers of patient having early psychotic episodes.They are assessed using family altitude
scale.The findings confirmed that expressed emotion in care givers are strongly associated with
relapse of schizophrenia.18
Fredl. M, Wancata. J etal (2008) conducted a research which assessed the gender specific
difference between mothers and fathers caring for a schizophrenic patient. They investigated the
time spend with patients as well as other aspects of caring. 101 mothers and 101 fathers of same
patients suffering from schizophrenia included in study. The findings of the study suggested that
about half of mothers spend more time with patients than fathers. Mothers are more involved in
patients care than fathers.17
Lueboontha Vatchai. P and Leubothanetchai. O(2006) conducted a study on quality of
life, correlated health status and social support of schizophrenic patient care givers. 120
schizophrenic care givers were studied,The findings suggested that 70% of the relatives were
with low moderate level of quality of life. Health status and social support of care givers were
positively correlated with quality of life.19
Klinik and Poliklinic for Psychiatric and Psychotherapy (2003) conducted a research
study regarding the attitudes of relatives of schizophrenic patients, especially those dealing with
12
attitude of social distance and restrictions. 161 relative and close reference patients with
schizophrenia were interviewed. The findings, suggested that relatives of schizophrenic patients
displaying greater social distance towards any mental disorders.31
2.Literature related to the effect of burden of care givers on quality of care provided to
schizophrenic patients.
Aggarwal M and Avasthi. A (2009), India, conducted a research on burden of
schizophrenia on care givers. 50 care givers of patients with schizophrenia were assessed, the
findings revealed that the care givres of patients with schizophrenia experience a huge amount of
burden. They have lack of proper socialization. So the care giving to the ill member is low
quality and inadequate 23.
Caqueo-utizara etal (2009) conducted a research regarding burden experienced by care
givers of schizophrenic patients. 258 primary care givers were included. The findings suggested
that the poor quality of care given to the ill member is related to the emotional, economic distress
number of unfulfilled needs and family relationship problems.24
Higarthag F etal (2008), conducted a study of burden of relatives who have a
schizophrenic member in the family. 99 close relatives, 34men and 65 women were assessed
using care burden scale. The findings of the study reveals significant greater family burden and
poor quality of care provider to ill family member.29
Granden . P and Jenaro. C(2008) explored the care giver burden and social functioning in
schizophrenia 101 primary care givers, mostly mothers assessed using a structured questionnaire.
13
The findings suggested higher frequency of relapses, decreased social interaction and very low
quality of care provided to patient.28
Moller – Leim Kubler. AM. etal (2008), conducted a research to identify the best
predictors of the course of burden during two year follow up period. 60 care givers assessed
based on transactional stress model concerning burden well being and quality of care. The
findings of the study suggested that after identification of predictors of burden and proper
intervention care giver life quality improved, the quality of care provider to ill member
increased.20
Garabiaghi A etal(2007) conducted a study to identify the relationship between distress
and quality of care provided to the ill family member among care givers of schizophrenic
patients. 51 care givers over 5 years were assessed; The findings revealed there is a strong
positive relationship between the emotional burden of care givers with the quality of care
provided to the ill member.34
Chadd R. K and Ganguly K. K (2007) conducted a research regarding care givers burden
and care giving strategy of care givers of schizophrenic patients. A comparative study done with
100 care givers of schizophrenic patients and 100 care givesr of bipolar affective disorder. .The
findings of the study revealed, burden remained high in case of schizophrenia and confirmed a
positive correlation between burden and care giving strategy.15
Chien W. T. and Chan . S. W(2007) assessed the level of perceived burden of the families
caring for a relative with schizophrenia and care giving pattern. A total of 203 family care givers
selected and assessed using a social support questionnaire. The findings suggested that family
14
who perceived a higher level of burden were those who lived in family with poor function and
showed neglected care for the ill member. 27
Maganasm and Ramirez Garcia J (2007), conducted a study on relation between care
giver burden and characteristics of care giving pattern. 85 care givers were selected. The findings
concluded that 12 to 18% care givers being at risk of depression. Care giver burden have
significant association between strategies and quality of care.33
Chrzastowski. S(2006) explored the relation between the burden of care in parents of
patients with schizophrenia and family interactions. Three groups of families were selected
having adult schizophrenic patients. They are assessed using a structured questionnaire.The
findings revealed high level of burden among families having schizophrenic adult. Parental
burden correlated with care giving strategies16.
3) Literature related to effects of psychoeducation and family interventions on
schizophrenia;
Worakul. P etal (2007) conducted a study on effect of psychoeducation programme on
knowledge and attitude upon schizophrenia on primary care givers of schizophrenic patients.
After one day psychoeducation programme, which included lecture, group discussion etc, the
participants evaluated for knowledge and attitude, before and after the programme The findings
revealed that there is a significant difference in the knowledge and attitude of care givers before
and after psychoeducation programme. The psychoeducation programme increase knowledge
and shape the attitude of care givers. 22
15
Magliano etal (2006) explored the effectiveness of psychoeducation programme family
intervention for schizophrenia on patients personal and social functioning as well as relatives
burden and perceived support. 71 families were assessed. The findings suggested that psycho
education family intervention have a significant impact on functional outcomes of schizophrenia
when provided to patients and care givers in real world settings.32
Chien N. T and Chan S. N(2004) conducted a research on effectiveness of multiple
family group intervention for families of patient with schizophrenia, in terms of patients
psychosocial functioning, rehospitalization compared with a psychoeducation intervention and
standard care. 96 families who were caring for a relative with schizophrenia provided with
psychoeducation sessions and assessed. The findings of the study reveled that psychoeducation
intervention was associated with greater improvement in patient functioning rehospitalization
and standard care.26
Barhato A. D and , Aranzo. B (2000) conducted a study on family intervention in
schizophrenia. 25 studies were reviewed. The findings concluded that the relapse of
schizophrenia is relatively well associated with the psychoeducational approaches, having a
positive outcome of illness course and relapse13.
Schneider. F etal (1991) explored the effectiveness of psychoeducation group
intervention with family members of psychosis patients in terms of benefits for patients clinical
outcome. The study involved 16 patients and 16 family members. At 9 month follow up the
relapse rate was zero. There was decreased burden experienced by family members, and family
functioning improved.21
16
6.3(A) STATEMENT OF THE PROBLEM.
“A study to assess the effectiveness of structured teaching programme on home care
practice among parents having children with recurrence of schizophrenia between the age group
of 20-30 admitted in family therapy wards at selected psychiatric hospital, Bangalore.”
6.3(B) OBJECTIVES.
 To assess the pre-interventional knowledge of parents regarding home care practices of
schizophrenia.
 To assess the effectiveness of structured teaching program regarding home care practices
of schizophrenia.
 To assess the post-interventional knowledge of parents regarding home care practices of
schizophrenia.
 To associate the knowledge regarding home care practices of schizophrenia with selected
demographic variables.
17
6.3(C) OPERATIONAL DEFINITION.
Assess
It refers to evaluation of desired or intended outcome of the study.
Effectiveness
It refers to the extent to which the structured reaching program has achieved the desired
result that is brought by administration of structured teaching programme.
Structured teaching program
It refers to the systematically developed instruction and teaching aids, designed for giving
instruction and teaching regarding home care practices of schizophrenia.
Parent
It refers to a father or mother having children with reccurence of schizophrenia
Home care practice
It refers to the action of providing care for the children with recurrence of schizophrenia
in the home setting, by the family members.
Child
It refers to son or daughter between the age group of 20-30, with recurrence of
schizophrenia.
18
Recurrence
It refers to the occurrence of schizophrenia often or repeatedly, more than one time.
Schizophrenia
It refers to the psychotic condition charecterised by a disturbance in thinking, emotion,
volitions and faculties in the presence of clear consciousness, which usually leads to social
withdrawal.
Family therapy ward
It refers to a specialized area of psychiatric hospital where the patients along with care
givers are treated and the efforts aimed at helping patient’s family to understand and cope with
patient’s disease and help in patients recovery.
6.3(D) HYPOTHESIS
 There is a significant difference between pretest and post test level of knowledge of
parents after structured teaching program regarding home care practices of schizophrenia.
 There is a significant association between post test level of knowledge of parents with
selected demographic variables.
6.3(E) LIMITATION
 This study is limited to the parents of children with recurrence of schizophrenia.
 This study is limited tom children between the age group of 20-30 having recurrence of
schizophrenia.
19
7. MATERIALS AND METHODS
7.1 Sources of data
The data will be collected from parents having children with recurrence of schizophrenia
between the age group of 20-30, who are admitted in the family therapy ward in selected
psychiatric hospital at Bangalore
7.2 Methods of data collection
I.
Research design
Non -experimental method
II.
Research approach
Descriptive approach
III.
Research variables
a) Independent variable
Structured teaching programme regarding home care practices of schizophrenia
b) Dependent variable
Knowledge of parents regarding home care practices of schizophrenia
20
c) Demographic variable
It includes characteristics of parents such as age, sex, occupation, income and socioeconomic status.
IV.
Setting
The study is planned to conduct in family therapy ward in selected psychiatric hospital at
Bangalore.
V.
Population
The accessible population of the study includes the parents having children between the
age group of 20-30, with recurrence of schizophrenia admitted in family therapy ward at selected
psychiatric hospital, Bangalore
VI . Sample
All parents who full fill the inclusion criteria, that is having children between the age
group of 20-30, with recurrence of schizophrenia and willing to participate in the study are
considered as sample.
The sample size of the pilot study will be 6 and for the main study will be 60.
VI.
Criteria for sample selection
a) Inclusion criteria
 Parents having children between the age group of
schizophrenia.
20-30, with recurrence of
21
 Both father and mother of patient with reccurence of schizophrenia
 Parents who can communicate freely in Kannada or English
b) Exclusion criteria
 parents who are willing to participate in the study
 Children who does not belong to the age group between 20-30.
VII.
Sampling technique
Non probability convenience sampling technique is used for selecting the sample.
VIII. Tool for data collection
Structured questionnaire scheduled consists of following session, which is constructed in
English/Kannada language.
Section A
Demographic proforma includes sample number, age, sex, educational status, occupation,
income/socio-economic status
Section B
Questionnaire on knowledge
This consists of questionnaires to assess the knowledge regarding home care practice of
schizophrenia among parents.
22
VIII.
Methods of data collection
Formal permission will obtain from the managing director of selected hospital, to conduct
the study. Informed consent will be taken from samples and the sample will be selected on the
basis of selection criteria. After that the researcher will collect data from the samples.
Phase 1
Pretest will be conducted to assess the knowledge of parents using a self administered
questionnaire.
Phase 2
A structured teaching progarmme on home care practices of schizophrenia will be given
to the parents. They are encouraged to clarify their doubts
Phase 3
After that post test will be administered to assess the level of knowledge to the same
subjects by using the same questionnaire.
Duration of the study ; 10 days
IX.
Plan for data analysis
Data planned to be analysed by using descriptive and inferential statistics.
a) Descriptive statistics
Used to analyse the frequency percentage, mean, median, standard deviation, used to
assess the knowledge of parents.
23
b) Inferential statistics
Chi-squire test will be used to associate knowledge of parents with selected demographic
variables.
c) Projected outcomes
After the pretest, the investigator administers structured teaching programme to parents
regarding home care practices of schizophrenia. Which will help them to initiate a positive step
in preventing recurrence of schizophrenia using family interventions.
7.3 Does the study requires any investigation or intervention to the patients or other human
being or animals?
No.
7.4 Has ethical clearance been obtained from the concerned authority to coduct the study?
Yes.
After obtaining ethical clearance from the institution, permission obtained from the
concerned authority of selected hospitals and informed consent from subject to conduct the
study.
24
8. LISTS OF REFERENCES
BOOK REFERNCES
1.Ahuja Niraj, (2006), “A SHORT TEXT BOOK OF PSYCHIATRY”,6th edition, Jaypee
Brothers Medical(pvt) Ltd:Newdelhi, page no: 57-73
2.Basavanthappa B T, (2005), “NURSING RESEARCH” ,1st,edition, Jaypee Brothers
Medical(pvt) Ltd:Newdelhi, page no:49-51
3.Benner P Margaret, (1997), “MENTAL HEALTH AND PSYCHIATRIC NURSING’’, 3rd
edition, Spring house corporation, Pennsylvania, page no: 3-6
4.Carpenter W, Buchanan R, (2006), “SCHIZOPHRENIA: INTRODUCTION AND
OVERVIEW: A COMPREHENSIVE TEXT BOOK OF PSYCHIATRY”, Williams and
Wilkins, Phyladehia, page no: 176- BASIC 189
5.Clement I, (2005lp), “COMPONENTS OF PSYCHIATRIC NURSING”,1st edition, A P Jain
$Co : Newdelhi, page no: 3-11, 41-51
6.Nambi S, (2006), “PSYCHIATRY FOR NURSES’’,1st edition, Jaypee Brothers Medical(pvt)
Ltd:Newdelhi, page no:1-13,21-23,78-89.
7.Kapoor Bimla,(2003), “TEXT BOOK OF PSYCHIATRIC NURSING”, volume I, 2nd edition,
Kumar publishing H, Delhi, page no: 1-6.
8. Kapoor Bimla,(2003), “ TEXT BOOK OF PSYCHIATRIC NURSING’’, volume II, 2nd
edition, Kumar publishing H, Delhi, page no:148-156,229-242,436-469.
25
9.Lalitha K,(2003),
“MENTAL HEALTH AND PSYCHIATRIC NURSING”, 1st edition,
Gajanana Pook publishers, and Distributors, Bangalore, page no:1-4,17-21, 31-44
10.Randolph Wang,(1998), “AMERICAN NURSING REVIEW FOR PSYCHIATRY AND
MENTAL HEALTH NURSING CERTIFICATION”,2nd edition, Spring house corporation,
Pennsylvania, page no: 145-152.
11.Stuart. W Gail,(2001),
“PRINCIPLE, PRACTICE OF PSYCHIATRIC NURSING”, 7th
edition, Harcourt India (pvt) Ltd, page no:60-66, 251-263, 402-437, 744-753, 796.
12. Townsend C Mary, (1999), “ESSENTIALS OF PSYCHIATRIC/MENTAL HEALTH
NURSING”,1st edition, F.A Davis Company, Phyladelphia, page no: 4-7, 200-201,324-360.
JOURNAL REFERENCES
13.Barbito A, Aranzo. B,(2000), Family interventions in schizophrenia and related disorders: A
clinical review of clinical trails. Journal Of Acta Psychiatric Scand;1202(2):8-97.
14.Breit Borde N J, Lopez. S R, (2009), Emotional over involvement can be deleterious for care
givers health. Journal Of Social Psychiatry, Psychiatric Epidemiology;44(9):716-723.
15.Chadda R K, Singh T B, Ganguly K K, (2007), A study of relationship between burden and
coping in care givers of patient with schizophrenia and bipolar affective disorder. Journal Of
Acta Psychiatric Scand;42(11):923-930.
16.Charzastowski (2006), Predictors of changes in care giving burden in people with
schizophrenia: A 3year follow up study. Journal Of Acta Psychiatric Scand;437:66-76.
26
17.Freidl M, Wancata J, (2008), Are there gender specific differences between mothers and
fathers caring for a schizophrenic patients. Journal Of Socio Psychiatry Psychiatric
Epidemiology;88(3):513-519.
18.Karanagh D J, White A, (2008), Predictive validity of the family attitude in people with
schizophrenia. Journal Of Psychiatry Research;160(3) 356-363.
19.Lueboonthavatchai P, (2006), Quality of life and correlated halth status and social support
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patient’s
care
givers.
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Of
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20.Moller –leimkunler A M, (2008), Predicting care giver burden in schizophrenic patient: 2 year
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21.Schneider F, Leither.D and Heimann.H,(1991), Psycho educational family group for
psychosis. Journal Of Schweiz Arch Neuro Psychiatric;142(3),
22.Worakul P and Thaicha Chart N et al, (2007), Related effects of psycho educational
programme on knowledge and home care practices of schizophrenia. Journal Of Community
Mental Health;591-607.
WEBSITE REFERENCES
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from India;36(1):71-79,
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27
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with
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9. Signature of the candidate
:
10. Remarks of the guide
:
11. Name and designation of
11.1 Guide
:
11.2 Signature
:
11.3 Co-guide
:
11.4 Signature
:
11.5 Head of the department
:
11.6 Signature
:
12. Remarks of the Principal
:
12.1 Signature
:
31
32