Download a study to assess the knowledge and practices of self medication

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BENGALURU, KARNATAKA
PERFORMA FOR REGISTRATION OF SUBJECTFOR
DISSERTATION
1.
NAME OF THE
CANDIDATE AND
ADDRESS
Ms. DIMPLE. C. GABRIEL
1ST YEAR MSc. NUSRSING
THE OXFORD COLLEGE OF NURSING,
NO.6/9 & 6/11,1ST CROSS,
BEGUR ROAD, HONGASANDRA,
BENGALURU– 560068
2.
NAME OF THE
INSTITUTION
3.
COURSE OF STUDY
AND SUBJECT
THE OXFORD COLLEGE OF NURSING,
NO.6/9 & 6/11,1ST CROSS,
BEGUR ROAD, HONGASANDRA,
BENGALURU– 560068
MASTER OF SCIENCE IN NURSING
CHILD HEALTH NURSING
4.
DATE OF ADMISSION 11/06/2012
TO THE COURSE
5.
TITLE OF THE
TOPIC
A STUDY TO ASSESS THE
KNOWLEDGE AND PRACTICES OF
SELF MEDICATION AMONG
ADOLESCENTS IN SELECTED
COLLEGES, BENGALURU WITH A
VIEW TO DEVELOP AN
INFORMATIONAL BOOKLET.
1
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
“Let food be thy medicine and not medicine be thy food”
-Hippocrates
Medications are one of the main options in the cure, treatment, and prevention of numerous
medical conditions.Infact, medications are the primary treatment client associate with
restoration of health.1
Self medication can be defined as obtaining and consuming drugs without advice of a
physician either for diagnosis, prescription or surveillance of treatment. There is a lot of
public and professional concern about the irrational use of drugs. Knowledge of their side
effects leads to serious long term deleterious complications. Self medication is the treatment
of common health problems with medicines especially designed and labeled for use without
professional supervision and approved as safe and effective for such use. These medications
do not require a prescription for purchase and are thus called non-prescription medicines.2
According to WHO self-medication is defined as the selection and use of medicines by
individual to treat self recognized illness or symptoms. Self medication is one element of self
care3.self medication can take place through the consumption of industrialized or manipulated
medicines or the use of home remedies (teas, herbs etc)and include various type of activitiesacquiring medicines without a prescription, resubmitting old prescriptions to purchase
medicines, sharing medicines with relatives or member of one social circle, using left over
medicines stored at home or failing to comply with professional prescription either by
2
prolonging it or interrupting it too early or decreasing or increasing the originally prescribed
dosage4
The consumption of medications can be considered an indirect indicator of the quality of
health care services. Children and adolescents are strongly susceptible to the irrational use of
drugs with and without medical control. Economic, political and cultural factors have
contributed to the growth and spread of self-medication worldwide. These factors are related
with aspects such as the great availability of products in the current days; the state of health
that a pharmaceutical agent may represent; irresponsible publicity; pressure to convert
prescription-only drugs into over-the-counter drugs; quality of health care; difficult access to
health care services in poor countries.5
There are many public and professional concerns about irrational use of drugs. The
prevalence rate is high all over the world up to 68% in European countries, 57% in USA,
92% in adolescence of Kuwait. The prevalence rate of self medication and self care are 31%
in India, 59% in Nepal and 51% in Pakistan6. A study was conducted to assess the prevalence
of self-medication in Brazilian children. The finding showed self medication ranging from
7.1 to 53.2%for different age groups.5
A study was conducted to describe and examine the pattern of medication use among
adolescence in Kuwait. The result showed that prevalence of self medication among high
school students was 92% and concluded that self medication tend to increase with age and
differed between male and female students. Few students consulted pharmacist for
information on drugs.7
A news paper report regarding the self medication practices pointed that a 19-year-old girl
consumed pills 4 times without consulting a gynecologist. She experienced abdominal
3
cramps, skin allergies and vomiting sensation and was hospitalized. Adolescents prefer to use
the morning after pill without consulting a medical practitioner. 8
Self medication is dangerous and it has wide range of ill effects. The ill effects include
bleeding in the stomach, acidity, nausea, vomiting, diarrhea, constipation, dizziness, rashes,
and headaches, dryness in the mouth, stomach pain, and blurred vision, ringing in the ear,
restlessness, confusion, reduced concentration, and allergic reaction like swelling of lips,
face, and tongue. It may also increase blood pressure which counteract the effect of some
blood pressure medicines, cardiacfailure.5
4
6.1 NEED FOR THE STUDY
Self- medication is a problem that exists world-wide. The practice of taking
medications to treat without consulting a doctor is hazardous to man and an apparent public
health problem. In developing country like India the system of self-medication is flourishing
due to various factors like socioeconomic factors, lifestyle, previous experience of treating a
similar illness, ready access to drugs and the increased potential to manage mild illness
through self-care. Self-medication is a problem that has the potential to harm society at a
large as well as individual patient. Self-medication provides a lower cost alternative for
people who cannot afford the cost of clinical services which all contribute to the spread of
self-medication.9
Self-medication begins in early adolescence, often during the middle school years. By the
age of 16, nearly all adolescents have taken medicine independently. There is considerable
variation, however, in the age at which independent self-care is achieved, as well as in the
accuracy of medication and dosage selection.10
Stoelben and colleagues evaluated the medication knowledge of a group of 53 adolescents
in Dresden, Germany. Fifty-six percent of the students had taken at least one medication
during the previous 2 weeks, with the most common agents being analgesics and antipyretics.
Girls reported taking significantly more medications than boys. Despite the relative frequency
of medication use; these students had little understanding of common medication
information. On a test of medication knowledge, the mean score was only 5.74 ± 1.89 out of
a possible 13. Forty-seven percent were able to select the correct definition for an antibiotic,
but only 6% could define analgesic. Sixty-two percent of the students said they read the
package insert for prescription drug information, with physicians listed as the second most
commonly used information source. On the assessments of drug knowledge, girls performed
5
significantly better than boys (p<0.05). Parental education had no influence on medication
knowledge. In spite of their relatively low scores on the medication knowledge test, 55% of
the students rated their knowledge as satisfactory, 19% as good, and 11% as sufficient. One
student labeled his knowledge as very good and one as bad. The results suggest that while
self-medication is common among adolescents, they may have significant knowledge deficits
which may predispose them to medication misuse and/or adverse effects.10
A survey was conducted among 86 adolescents between 10 and 14 years of age about their
medication use. Eighty-eight percent of the subjects reported having access to medicine in
their household. Despite their access, 64% reported that they had asked a parent or guardian
for the last dose of medicine that they took, while 36% took medicine independently. When
asked to choose an appropriate medication for common illnesses, 62% of the students were
able to correctly identify antipyretics for a headache. Analgesics were appropriately identified
by 87% of the subjects, but only 15% were able to select appropriate therapy for menstrual
pain. The selection of cough and cold products was made appropriately by 50-60% of the
students.10
The frequency of self-medication was assessed in an international cross-sectional survey of
123,227 students in 2003. In this study health behavior in school-aged children database was
utilized to identify medication use characteristics in three age groups: 11, 13, and 15 years. In
all 28 countries included in the database, analgesic use was higher in girls than boys. Use of
analgesics for headaches increased by age, but medications for inability to sleep or
nervousness declined. Use of medications for stomachache increased by age in girls, but
decreased in boys. Data from the United States revealed analgesic use for headache in 48.9%
of boys and 65.9% of girls, with medication for stomachache used in 20.5% of boys and
34.6% of girls, while medications for sleeplessness or nervousness were used in 10% or less.7
6
The use of medications for dysmenorrheal by adolescent girls has been studied by several
investigators. A survey was conducted among 76 healthy adolescent girls with moderate to
severe dysmenorrheal. The patients were interviewed upon enrollment into a clinical study of
oral contraceptives for the treatment of dysmenorrheal. Symptoms were reported as moderate
in 42% of the young women and severe in 58%. Seventy-three patients (93%) reported taking
at least one medication for menstrual pain. The majority (91%) used OTC medications, but
21% reported obtaining additional prescription medications, including acetaminophen and
codeine, ibuprofen and hydrocodone, and rofecoxib. A third of the patients used at least two
types of medication, and 15% used three types. Approximately 70% took doses which were
less than 50% of the recommended maximum daily dose. Fewer than 10% of the patients
took the full daily dose.10
In a study of 650 adolescents with recurrent migraines or tension headaches, 22% were
determined by investigators to be overmedicating with OTC analgesics (taking more than
three doses per week for more than 6 weeks). Approximately 14% of the patients, all between
6 and 18 years of age, were self-medicating without telling their parents. The authors of the
study reported that 85% of the adolescents were considered high-achievers. They suggested
that these patients may be using OTC medications in place of exercising, eating better, or
using other non-pharmacologic means of minimizing stress.10
A study was conducted on ‘self-medication and non-doctor prescription practices in
Bokhara valley, western Nepal’. Questionnaire method was used to collect data from 142
respondents. Paracetamol, analgesics and antacids were the drugs most commonly prescribed
drugs. A significantly higher proportion of young (<40 years) male respondents had used
self-medication than other group. Average number of drugs used per person was 1.23 and
stoppage of drug in between was due to economic restraints. Among the respondents 25%
were students who practiced self-medication which was significant.11
7
A cross-sectional study was conducted on ‘assessment of self-medication practices among
medical, pharmacy, and health science students in Gondar University, Ethiopia. The study
aimed at assessing the magnitude and factors of self-medication. A questionnaire was used
for the study. Out of 414 students, 213 reported at least one episode of an illness, and 82 of
them practiced self-medication. Most drugs for self-medication were obtained from the
pharmacy or drug shops; and the most commonly used drugs were paracetamol and nonsteroidal anti-inflammatory drugs. Common reported illnesses were fever and headache
(24.8%) followed by cough and common cold (23.9%). Prior experience and the nonseriousness of the illness were the top two reported factors for self-medication. Study
concluded that, self-medication was practiced with a range of drugs from the conventional
analgesics to antibiotics.12
These above studies shows the fact that even the younger generations are at the risk of the
problems from self- medication which emphasizes the need for creating awareness. Though
rise in self- medication practice is more in adult group it is found to be still more in student
population where unsafe use of antibiotics, analgesics, antacid and vitamin supplement are
common5.
In view of the above facts and interest in the topic, the researcher felt a great need to
assess the knowledge and practices of self-medication among adolescents and to educate
them by providing an information booklet.
8
6.2 REVIEW OF LITERATURE
One of the most important early steps in a research project is the conducting of the
literature review. A literature review is an account of what has been published on a topic by
accredited scholars and researchers. In writing the literature review, the purpose is to convey
to the reader what knowledge and ideas have been established on a topic, and what their
strengths and weakness are. A literature review discusses published information in a
particular subject area and sometimes information in a particular subject area within a certain
time period5
This chapter deals with the literature which is reviewed and relevant to
the present study and organized under the following headings.
6.2.1 Studies related to prevalence of self medication
6.2.2Studies related to knowledge and practices of self medication
6.2.1Studies related to prevalence of self medication
Across sectional survey was conducted on 200 participants randomly selected from the
coastal regions of south India. Each participant underwent a face to face interview with the
help of a structured questionnaire the result reported self medication use by 71% of the
subjects, which ranged from a frequency of at least one time to a maximum of 5 times and
above. Lack of time (41.5%), minor illness (10.5%) and quick relief (10%) were cited as the
most common reason for self medication use. The majority of the participants (93.5%) were
not aware about the side effects of sm. Findings revealed females and people living in urban
areas are more likely to use self-medication than males and people in rural areas.13
9
A descriptive study was conducted about self-medication among children and adolescents
in Germany to investigate the prevalence and correlates of self-medication .17 450 children
aged 0–17 years participated in the 2003-2006 German health interview and examination
survey for children and adolescents. The result was 25.2% of participants reported selfmedication. Self-medication accounted for 38.5% of total medicine use and included all
medication classes. These clustered among drugs acting on the respiratory system (32.1%),
alimentary tract and metabolism (21.6%), skin (14.2%) and nervous system (11.3%), as well
as homoeopathic preparations (8.6%). Vitamin preparations were most frequently used with a
weighted user prevalence of 4.7% followed by cough and cold medicines 4.4% and
analgesics 3.7%. Overall use of aspirin among children <12 years old was 0.3%, particularly
among children <6 years old. Use of self-medication was closely related to older adolescent
ages of between 14 and 17 years, children with a poor health status, with no immigration
background, from families with a higher household income and with mothers with a higher
educational level .the conclusion was self-medication use is highly prevalent in Germany,
particularly among children and adolescents from families with a higher socioeconomic
status.14
A study was conducted to evaluate the self-medication of self-prescribed antibiotics among
government doctors in the Hassan district, Karnataka. A close and open-ended questionnaire
was used to collect data from a sample of 160 government doctors, randomly chosen from
Hassan district. Data was collected using a self assessing questionnaire. Out of 160 doctors
only 97.5% filled and returned the questionnaires. The result showed that the most frequently
used antibiotic for self-medication, was penicillin (68%).Other antibiotics included
amoxicillin (40%), flouroquinolones 13.3%, macrolides 8%, co-amoxiclav, cephalosporins,
tetracyclines, sulphonamides, tinidazole and metronidazole.15
10
A web-based survey was conducted on secondary public school students in the Detroit
metropolitan area, USA to assess the prevalence of medical and non-medical use of four
categories of prescription drugs (opioid, stimulant, sleeping, and sedative/anxiety
medication).a secondary objective was to examine the association between the use of four
categories of prescription medications and illicit drug use and probable drug abuse. The result
showed that the sample consisted of 54% female, 52% white, and 45% African American,
and 3% from other racial categories. Forty-eight percent of the sample reported no lifetime
use of four categories of prescription drugs (non-users), 31.5% reported medically prescribed
use
only (medical
users),
17.5%
reported
both
medical
and
nonmedical
use
(medical/nonmedical users) and 3.3% reported nonmedical use only (nonmedical users).
Multivariate analysis indicated that medical and nonmedical users were significantly more
likely than non-users to report illicit drug use and probable drug abuse.16
A descriptive study was conducted to determine the prevalence of self-medication in
children and adolescents in the municipalities of Limeira and Piracicaba, state of São Paulo,
and to correlate results with socio demographic indicators and with the use of health care
services. The study comprised of 772 inhabitants from 85 urban census sectors selected
through cluster sampling. Subjects were divided into two study groups according to their
pattern of drug use: self-medication (lay advice) and medical prescription. The findings
showed the prevalence of self-medication was 56.6%. Mothers (51%) and drugstore
employees (20.1%) were most frequently responsible for self-medication. The main groups of
self-prescribed drugs were: analgesic/antipyretic and non-hormonal anti-inflammatory drugs.
Subjects in the age group of 7-18 years and public health care users showed increased risk for
self-medication.17
11
A descriptive research study was conducted in Basrah, Southern Iraq to estimate the
prevalence of self-medication with antimicrobial drugs and to record the stored medicine at
home. A questionnaire method used to collect data from the sample of 300 households. It was
found that majority of households (94%) stored drugs at home. Only 31% of the total drugs
were for current use, while 45% were leftovers and 23% of the drugs were kept for future
use. A large proportion of the stored drugs (66%) were obtained from private pharmacies.
Only 42% of all the drugs were stored appropriately. A majority of the families (78%)
admitted to practicing self-medication. The most common reasons for self-medication with
antimicrobial drugs were associated with influenza, upper respiratory tract infections,
diarrhea and tonsillitis.18
A cross-sectional study was conducted to assess the prevalence of antibiotic misuse
among boarding secondary school students in Dares Salaam, Tanzania. A randomized sample
of students was recruited from at least 3 secondary schools from each of the three
municipalities. Questionnaire with both closed-and open-ended questions was used for data
collection in which socio-demographic characteristics, knowledge of antibiotics, sources of
prescription, procurement of antibiotics, infections for which antibiotics were used, and
antibiotic therapy compliance were assessed. The result was a total of 424 randomly selected
students with a mean age of 20 years were interviewed, of those 150 were females and 274
were males. Prevalence of antibiotic usage among the students was high (69%). Of 293
students who had used antibiotics, 73% of them had procured the drugs on prescription. The
conclusion was that the study revealed inadequate knowledge on antibiotics among the
respondents and that pharmacy played a major role on easy availability of antibiotics as overthe-counter drugs attributing to high rate of irrational use of antibiotics.19
6.2.2 Studies related to knowledge and practices on self medication
12
A descriptive study was conducted to evaluate the knowledge, attitude and practice of selfmedication among first-year medical students ofArabianGulf University, Manama, and
kingdom of Bahrain. A revalidated questionnaire, containing open-ended and close-ended
questions, was administered to the subjects. The study reported that, out of 134 respondents,
43 were male’s and91were females. The respondents’ knowledge about appropriate selfmedication was poor, but knowledge of the benefits and risks of self-medication was
adequate. The respondents found self-medication to be time-saving, economical, convenient
and providing quick relief in common illnesses. Important disadvantages of self-medication
mentioned were the risk of making a wrong diagnosis, inappropriate drug use and adverse
effects. The majority (76.9%) of the respondents had a positive attitude favoring selfmedication.20
A cross-sectional study was conducted on ‘assessment of self-medication practices among
medical, pharmacy, and health science students in Gondar University, Ethiopia’. This was
conducted on 414 students taken as a sample from 2485 students in which 213 students had at
least one episode of illness. The pre-tested, semi-structured questionnaire was prepared. In
the result (76.9%) of the respondents had a positive attitude favoring self-medication. The
study result showed that fever and headache was the most frequently reported causes of
morbidity; respiratory and gastrointestinal tract diseases were the second and third most
common causes of morbidity. Among the reasons given for self-medication, 29 respondents
felt that they had previous experience of treating a similar illness. Twenty-five respondents
felt that the illness was mild and did not require the service of a physician. Eight respondents
reported that cost-effectiveness was their major reason to practice self-medication, and
13stated emergency use.21
13
A study was conducted to examine adolescent non-medical use of prescription medications
and its relationship to other problem behaviors. The study result suggested that approximately
10.9% of the sample engaged in non medical use of prescription medications and 36.8% had
a legal prescription for a controlled medication. Sensation-seekers were more likely to engage
in most problem behaviors when compared with all other groups and impulsivity and
depression was variable among groups. The conclusion suggested that there were different
subtypes of non-medical users of prescription medications.22
A descriptive
research study was conducted
on ‘evaluation of the practice of self-
medication among college students, in west Uttar Pradesh’ to describe and examine the
branded medicines used by college students, awareness, trust in medicine system, reasons
behind self-medication, drug information resources, danger findings and knowledge of drug
profile. Samples of 253 young students belonging to different regions of west utter Pradesh
were randomly selected. Major reasons which was found as the reason of self- medication at
student level were time saving, did not need advice from prescriber for minor illness,
economic, fear from crowd at clinic. Most of the respondent had positive attitude in selfmedication in minor illness and the majority of professional students had a poor knowledge
about appropriate self-medication while the knowledge of the benefits and risks was not
adequate.23
A cross-sectional study was conducted to evaluate the knowledge and behavior towards
antibiotic self-medication among medical and non-medical university students in Iran. Study
sample included 200 randomly chosen students from a medical and a non-medical university
in Ahwan. Data was collected using self-administered questionnaires with open-ended and
close-ended items. A total of 195 university students participated in the study. Among
participants, 50.3% were females and 49.7% were males. But there were no significant
variation between male and female students in self- medication pattern. About 42.2% of
14
medical students and 48% of non-medical students of study population had used antibiotics
without a prescription or medical advice. Among penicillin’s, amoxicillin was the most
frequently used in self-medication for non-medicals students. The factors responsible for selfmedication include their academic medical knowledge (50%) among the medical group and
previous experience with prescribed medication (32.6%) in the non-medical group.24
A cross-sectional study was conducted to assess the extent of self-medication practice
among random sample of an-najah national university students, Palestine. It included
1581students of different academic levels enrolled at different faculties. A pre-validated
questionnaire with several open-ended and closed-ended questions was administered to the
students. The result was sixty three percent of respondents were females enrolled at nonmedical schools. The mean age of respondents was 19.9 years. Ninety-eight percent of
respondents reported practicing self-medication. Analgesics, decongestants, herbal remedies,
and antibiotics were the most common classes reported in self-medication.25
A narrative study was conducted a study to review the literature relating to self-medication
practice with nonprescription medication among university students in university Sains
Malaysia library. The result was that eleven studies were identified. In general, the review
showed that self-medication practice with nonprescription medication was highly prevalent
among university students. The common medications were analgesic, antipyretic products,
cough and cold remedies, anti allergy and vitamins or minerals. The sources of the medicines
were pharmacy, home medicine cabinet, supermarket/shop and other person such as family,
friend, neighbors and classmates. The sources of drug information were family member,
previous experience, pharmacy salesman, doctor or nurse, advertisement and others. The
review also showed that the self-medication practice could have many problems.26
15
A randomized, cross-sectional, study was conducted in Qom state, Iran to assess the self
medication practices among university students. The target population of this study was 564
students out of 10,000 students attending four medical and non-medical science universities.
The result was 76.6% of the students had used analgesics in self-medication in the previous 3
months. The frequency of analgesic use in the study period was once in 19.2% of the
participants, twice in 22.2%, three times in 16.3% and more than three times in 35.5% of the
participants, although 6.8% of them were not sure when they were used. Of all the
respondents, 49.8% reported headache as the problem. This was the most common problem,
after which came dysmenorrheal, headache and stomach ache. Bone and joint pains were
other problems that led to the use of analgesics. The most commonly used source of
information for self-medication with analgesics was advice from friends and family (54.7%),
previously prescribed medications (30.1%), their medical knowledge (13.3%) and
recommendation of a pharmacist (1.9%).27
A descriptive study was conducted to assess the self-medication practices and the factors
influencing self medication practices among the people living in Ghulam Mohammad Abad,
Faisalabad. By simple random technique a sample of 369 people were selected. A pre-tested
questionnaire was filled by interviewing each individual. The result was prevalence of self
medication found in study group was 61.20%. An increase pattern of self medication
practices were found in the younger age group (15-35 years) which were 64.8 %. Self
medication practice was found more in male (64.5%) as compared to female (58.5%). The
unmarried persons as compared to married were involved 8% more in self-medication.
Similarly 11% increase pattern of self medication was observed amongst the respondents
belonging to nuclear family (66.9%) as compared to extended type of family status (55.9%).
There were 13.60% more practices of self medication in urban population (64.2%) as
compared to rural (50.6%) and self medication was observed in illiterate (50.4%) and in
16
metric level education (62.3%) and person’s having education above metric (74.4%). The
prevalence of self medication was more among skilled labor (75.9%) as compared to (54.9%)
in unskilled labor.28
A cross-sectional study was conducted in southwest Nigeria on self-medication with
antibiotics for the treatment of menstrual symptoms. It was administered to female
undergraduate and graduate students (n = 706). The universities were selected by
convenience and the study samples within each university were randomly selected cluster
samples. The survey was self-administered and included questions pertaining to menstrual
symptoms, analgesic and antibiotic use patterns, and demographics. Data were analyzed
using descriptive statistics and logistic regression. The result was that, the response rate was
95.4%. Eighty-six percent of participants experienced menstrual symptoms, and 39%
reported using analgesics to treat them. Overall, 24% of participants reported self-medicated
use of antibiotics to treat the following menstrual symptoms: cramps, bloating, heavy
bleeding, headaches, pimples/acne, and moodiness, tender breasts, backache, joint and
muscle pain. The conclusion was that, approximately 1 out of 4 university women surveyed
in southwest Nigeria self-medicate with antibiotics to treat menstrual symptoms. 29
A study was conducted to determine the proportion of general out patients who practiced
self medication, the drugs employed and the reasons for resorting to self medication, in
Nigeria. Two hundred consenting respondents were selected by simple random sampling and
interviewed with the aid of semi structured questionnaire by the authors with three assistants.
The result was majority of the respondents (85%) admitted to self medication while the
remaining proportion (15%) did not practice it. The study concluded that majority of the
respondents practiced self medication using an array of drugs like analgesics, anti-malaria
17
and antibiotics used either singly or in combination. The main reasons identified for self
medication were minor ailments and financial constraint.30
18
STATEMENT OF THE PROBLEM
A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICES OF SELF
MEDICATION AMONG ADOLESCENTS IN SELECTED COLLEGES, BENGALURU.
WITH A VIEW TO DEVELOP AN INFORMATIONAL BOOKLET.
6.3 OBJECTIVES OF THE STUDY
6.3.1
To assess the level of knowledge of adolescents regarding self-medication.
6.3.2 To assess the practices regarding self medication among adolescents.
6.3.3 To find out the correlation between knowledge and practices regarding selfmedication among adolescents.
6.3.4 To find out the association between the knowledge scores with selected demographic
variables.
6.3.5 To find out the association between the practice scores with selected demographic
variables.
6.4 HYPOTHESES OF STUDY
This study attempts to examine the following hypotheses.
6.4.1 RESEARCH HYPOTHESIS
H1: There will be significant correlation between knowledge and practice scores of
adolescents regarding self-medication.
H2: There will be significant association between knowledge scores with selected
demographic variables.
H3: There will be significant association between practice scores with selected demographic
variables.
19
6.5 RESEARCH VARIABLES
Demographic variables: age, gender, education, parent’s education, occupation and
exposure to mass media.
Dependent variable: knowledge and practice of adolescents regarding self-medication.
6.6 OPERATIONAL DEFINITIONS
1. ASSESSMENT: refers to the process used to identify the level of knowledge and practices
of adolescents towards self medication.
2. KNOWLEDGE: In this study it refers to the correct responses of adolescents to the items
regarding self-medication as elicited by structured questionnaire.
3. PRACTICE: refers to the self-reported usage of medication carried out by adolescents as
elicited by check list.
4. SELF-MEDICATION: in this study, self-medication refers to obtaining and consuming
drugs without the advice of a physician either for diagnosis, prescription or treatment.
5. ADOLESCENTS: refer to individuals whose age is in between 16-18 years and studying
in selected colleges, Bengaluru.
6. INFORMATION BOOKLET: refers to systematically prepared information material
regarding meaning, factors, and types of drugs used and ill effects of self medication.
6.7 ASSUMPTION
1. Adolescents may have some knowledge regarding self-medication usage.
2. Adolescents may have more interest to know about ill effects of self-medication.
20
3. The knowledge and practice of adolescents will vary with the selected demographic
variables.
6.8 DELIMITATION
The study is delimited to:
1. Adolescents at selected colleges in Bengaluru.
2. Four weeks period of data collection
7.0 MATERIALS AND METHODS
7.1 TYPE OF STUDY/RESEARCH APPROCH
Exploratory research approach
7.2 RESEARCH DESIGN
Descriptive survey design
7.3 RESEARCH SETTING
The study will be conducted in selected colleges, Bengaluru
7.4POPULATION
Population in the study includes adolescents studying in selected colleges, Bengaluru.
7.5 SAMPLE AND SAMPLE SIZE
100 adolescent students
7.6 SAMPLING TECHNIQUE
Simple Random Sampling Technique will be adopted for this study.
21
7.7 SELECTION CRITERIA
Inclusion criteria
-Students in the age group of 16-18 years, studying in selected colleges, Bengaluru.
- Students who are willing to participate in this study
Exclusion criteria
Students, who are not available during study period.
7.8 DURATION OF STUDY:
One month of data collection.
7.9 DATA COLLECTION METHOD:
7.9.1 TOOL FOR DATA COLLECTION
1. Structured questionnaire will be used to collect data. It consists of two parts.
Part 1: socio-demographic profile- age, gender, education, religion and exposure to .mass
media, parent’s education and occupation.
Part 11: multiple choice questions regarding self-medication of drugs.
2. Check list will be used for assessing the practice of self-medication among
adolescents.
7.9.2 DATA COLLECTION PROCEDURE:
Permission will be obtained from the head of institution. Written consent will be taken from
the participants after explaining the purpose of the study. Data collection technique will be
22
through structured questionnaire and checklist. There after an information booklet will be
given to the participants.
7.10 DATA ANALYSIS METHOD:
The data obtained will be tabulated and analyzed in terms of the objectives of the study by
using descriptive and inferential statistics. The plan of data analysis is as follows:
Descriptive statistics:
A. Frequency and percentage distribution will be used to analyze the socio-demographic
variables and knowledge and practices of adolescent students in self medication.
B. Mean: mean percentage and standard deviation will be used to assess the knowledge and
practices in self-medication usage.
Inferential statistics:
Chi-square test will be used to find out the association between the knowledge scores and
practice scores and the selected demographic variables.
Karl Pearson’s coefficient of correlation will be used to find out the relation between
knowledge scores and practice scores.
8. DOES THE STUDY REQUIRE ANY INVESTIGATION OR
INTERVENTION ON PATIENT OR HUMAN/ANIMAL?
If so, describe briefly yes, the study will be conducted on pre degree students, in selected
colleges, Bengaluru.
23
9. HAS ETHICAL CLEARANCE BEING OBTAINED FROM YOUR
INSTITUTION?
1. Permission will be obtained from the research committee, the oxford college of
nursing, Bengaluru.
2. Informed consent will be obtained from the head of the selected colleges.
3. The informed consent will be obtained from the samples for their willingness to
participate in the study.
24
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http//ncbi.nlm.nih.gov/pmc/articles/PMC 2082655/
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20(6):1661-9. Available from: http//www.scielo.br/scielo.php?script=sci-s0102
5. Francis S V T, Pereira, Selm. Medication in children and adolescents.journal de pediatria.
2007; 8(3):133-136. Available from: http//www.scielo.br-pid=s002175572007000600010
6. Rajput MS, Mathur V.Pharmacoepidemological study of self-medication in Indore
city.Indian journal of pharmacy practice. 2010; 3(1):25-30. Available from:
http//ijopp.org/pdf/ijopp-vol-3-1-jan-mar2010.pdf
7. Abahussain.E, Matowe LK, Nicholls PJ. Self-reported medication use among adolescents
in Kuwait. Med Princ Pract. 2005 May-Jun; 14(3):161-164. Available from:
http//www.ncbi.nlm.nih.gov/pubmed/15863989
8. Express news service. Ill effects of self-medication. 2012 sept 22. Available from:
http//newindianexpress.com/cities/Bangalore/article/237936.ece
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9. Phalke VD, Phalke DB, Durgawate PM.Self-medication practice in rural Maharashtra.
IJCM.2006; 31(1):34-35. Available from: http//www.ijcm.org.in/article.asp.issn=0970-0218
10. Marcia L.Buck. Self-medication by adolescents. Pediatric Pharm. 2007; 13(5):1-4.
Available from: http//www.medscap.com/viewarticle/557968
11. PR Shankar, P Partha, N Shenoy. Self-medication and non-doctor prescription practices
in Pokhara valley, Western Nepal: a questionnaire based study.BMC Fam Pract. 2002 sept
17; 3:17. Available from: http//www.ncbi.nlm.nih.gov/pmc/articles/PMC 130019/
12. Abay SM, Amelo W, Assessment of self-medication practices among medical, pharmacy
and health science students in Gondar University, Ethiopia. J Young Pharm.2010 Jul;
2(3):306-310. doi:10.4103/0975-1483.66798.
Available from: http//www.ncbi.nlm.nih.gov/pubmed/21042491.
13. Balmurugan E, Ganesh K.Prevalence and patterns of self-medication use in coastal
regions of South India. BJMP. 2011; 4(3):428. Available from:
http//www.bjmp.org.content/prevelance-and-pattern-self medication-use-coastal –regionssouth-India
14. DuY, Knopf H. Self-medication among children and adolescents in Germany: results of
the National Health Survey for children and adolescents. BJMP. 2009; 68(4):599608.Available from: http//www.ncbi.nlm.nih.gov/pubmed/19843063
15. Nalini GK. Self-medication among Allopathic Medical doctors in Karnataka,
India.BJMP. 2010; 3(2):325. Available from: http//www.bjmp.org/files/2010-3-2-325 pdf
16. Mc Cabe SE, Boyd CJ, Yang A. Medical and non-medical use of prescription drugs
among secondary school students. J Adolescent Health.2007 Jan; 40(1):76-83. Available
from: http//www.ncbi.nlm.nih.gov/pubmed/17185209.
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17. Pereira FS, Bucaretchi F, Stephan C.Self-medication in children and adolescents.J Pediatr
(Rio J). 2007; 83(5):453-458.Available from: http//www.ncbi.nlm.nih.gov/pubmed/17940684
18. Jassim AM. In home drugs storage and self-medication with antimicrobial drugs in
Basrah, Iraq. OM J.2010; 25:79-87. Available from: http//www.omjournal.org/original
articles/full text/201004/inhomedrug storageandself medication.html
19. Maambete KD.Irrational antibiotic usage in boarding secondary school settings in Dares
Salaam. East Afr J Public Health. 2009; 6(2):202-204. Available from:
http//www.ncbi.nlm.nih.gov/pubmed/20000030
20. James H, Handu SS, Al Khaja KA, OtoomS, Sequeira RP. Evaluation of the knowledge,
attitude and practice of self medication among first year medical students. Med Princ Pract.
2006; 15(4):270-275. Available from: http//www.ncbi.nlm.nih.gov/pubmed/16763393.
21. Abay SM, Amelo W. Assessment of self-medication practices among medical, pharmacy
and health science students in Gondar University Ethiopia. J Young Pharm. 2010; 2(3):306310. Available from: http//www.ncbi.nlm.nih.gov/pubmed/21042491
22. Boyd CJ.Adolescents’ non-medical use of prescription medication and other problem
behavior. J Adolescent Health.2009 Dec; 45(6):543-550.
Doi: 10.1016/j.jadohealth.2009.03.023.Available from:
http//www.europepmc.org/articles/PMC2784421
23. Gosh S, Gupta A, Chaudhary R .Evaluation of the practice of self medication among
college students in West Uttar Pradesh. International journal of pharma professionals’
research.2010; 1(1):1-10 Available from: http//www.researchgate.net/publication/228815689
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24.S Sarahroude.A, Arc, A.F.Sawalha, Ashtarinezhad. Antibioticself-medication among
South and Iranian University students. International Journal of pharmacology.2010; 6(1):48552. Available from: http//www.scialert.net/abstract/doi-ijp.2010-48-52
25. Sawalha AF. Assessment of self-medication practice among university students in
Palestine; Therapeutic and toxicity implication. The Islamic university journal. 2007;
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26. Almasdy D, Sharrif A.Self-medication practice with non-prescription medication among
university students; a review of literature. Archives of pharmacy practices.2011; 2(3): 95100. Available from: http//www.archivepp.com/resources/files/110201115933118.pdf
27. Sarahroodi S, Jamshid AM, Sawalha AF, Mikaili P. Pattern of self-medication with
analgesics among Iranian university student’sin central Iran. J Family and community med.
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28. Baig S.Self-medication practices. The professional medical journal; 19(4):16. Available
from: http//www.theprofessional./com/article/2012/vol-19-no-4/016 prof-1951, pdf
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11. SIGNATURE OF THE
STUDENT :
12. REMARKS OF THE
The topic which is selected found to be appropriate and
GUIDE:
relevant to assess the knowledge and practice of self
medication among adolescents.
13. NAME AND
DESIGNATION OF GUIDE :
Mrs. B.B.BHAVANI
PROFESSOR OF PEDIATRIC
NURSING
13.1 GUIDE’S NAME AND
Mrs. B.B.BHAVANI
ADDRESS :
Professor
Department of Pediatric Nursing
The Oxford College of Nursing.
No.6/9& 6/11, 1st cross
Begur Road. Hongasandra
Bengaluru.
13.2 SIGNATURE OF THE
GUIDE :
29
13.3 HEAD OF THE
PROF. B. B. BHAVANI
DEPARTMENT
Professor
NAME AND ADDRESS :
Department of Pediatric Nursing.
The Oxford College Of Nursing
No. 6/9 & 6/11, 1st cross,
Begur Road, Hongasandra, Bengaluru- 56006
13.4 SIGNATURE OF HOD:
14. REMARKS OF
The research topic selected is relevant as it attempts to
PRINCIPAL :
empower the knowledge and practice of adolescents
regarding self medication.
14.1 SIGNATURE OF
PRINCIPAL :
PROF. G. THILAGAVATHY
The Principal
The Oxford College of Nursing
No.6/9 & /11, 1st Cross,
Begur, Road, Hongasandra,
Bengaluru- 560068
30
THE OXFORD COLLEGE OF NURSING
No.6/9 &6/11, 1st cross, Begur Road, Hongasandra,
Bengaluru -560068
ETHICAL COMMITTEE
NAME OF THE STUDENT
:
MS. DIMPLE. C. GABRIEL
YEAR
:
1ST YEAR M.Sc. NURSING (2012-2013)
SUBJECT
:
CHID HEALTH NURSING
TITLE OF TOPIC
:
A STUDY TO ASSESS THE KNOWLEDGE
AND PRACTICES OF SELF MEDICATION AMONG ADOLESCENTS IN SELECTED
COLLEGES, BENGALURU.
ETHICAL COMMITTEE MEMBER APPROVAL
DESIGNATION
NAME
1. CHAIRMAN
: PROF.G.THILAGAVATHY
2. LEGAL ADVISOR
: MAJOR MUDDE GOWDA
3. SOCIOLOGIST
: PROF. LEELAVATHI
4. PSYCHOLOGIST
: MRS.MAMATHA
5. STATISTICIAN
: MR.ARUN KUMAR
SIGNATURE
6. FACULTY ADVISOR: PROF.B.B .BHAVANI
SIGNATURE OF THE PRINCIPAL
31