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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
Ms. SUNITHA ANN KURUVILLA
1
NAME OF THE
I YEAR M. Sc NURSING
CANDIDATE
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
PO BOX NO 4, KOLAR - 563101
COURSE OF STUDY
MASTER OF SCIENCE IN NURSING
AND SUBJECT
MEDICAL SURGICAL NURSING
2
3
DATE OF ADMISSION
1-7-2011
4
TO COURSE
“EFFECTIVENESS OF VIDEO ASSISTED
TEACHING MODULE ON KNOWLEDGE
TITLE OF THE
OF OLDER ADULTS REGARDING
5
TOPIC
PREVENTION OF SELECTED
GASTROINTESTINAL DISORDERS OF
GERIATRICS”
1
6. BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY
I truly believe that age … if you are healthy… age is just a number
- Hugh Hefner
Health is a central issue associated with increase in longevity and population
ageing. The maintenance of health status and functioning with age is a critical factor
impacting upon many other aspects of the lives of older persons, their families and
communities.1
Old age is the evening of life. It is an integral part of human life. It is
unavoidable, undesirable and problem ridden phase of life. Ageing is a time of
numerous illnesses and common disability. Old people have limited regenerative
capabilities and are more prone to disease, syndromes, and sickness than other age
groups.2
It is estimated that presently in 2011, there are around 600 million persons
aged 60 years and over all over the world. This figure may double by 2025 and will
reach virtually two billion by 2050. Out of these, a vast majority of the older persons
will be in the developing world. According to an estimate of the United Nations
Organization (UNO), presently one out of every 10 persons is 60 years or older.3
According to Indian Scenario of Geriatric population in India in 2011, Seven
per cent of the 1.1 billion Indian population are over the age of 60. According to an
estimate, by 2021, India’s elderly population will cross 137 million. Currently, India
has the second largest aged population in the world.3
As age progresses, the health problems faced by the adults are neurological
disorders, Sensory disorders, Cardiovascular disorders, Endocrine Disorders,
Respiratory disorders, Genito-urinary disorders, Gastro-intestinal Disorders and
2
Musculoskeletal disorders. The most common health problems seen in all the elderly
people are Gastro-intestinal Disorders.
Ageing is accompanied by several changes in the gastro-intestinal (GI) system
and older adults frequently present with GI problems. According to John Hopkins
Medicine, almost 40 percent of all older adults experience digestive symptoms.4
Depending on their age and any illness in the elderly; they have a slower
gastrointestinal motility.5
Physician visits for constipation are more frequent by individuals 65 years of
age or older. Elderly people report problems with constipation five times more
frequently than younger people. They are more likely to suffer from constipation due
to changes in diet, medication, decreased mobility and intestinal motility. The
incidence of constipation is over 10% worldwide and over 15% in India. Around 2%
of the population suffers recurrent and constant constipation and is more common in
women than in men. In the elderly, up to 50% self-report constipation and up to 74%
use laxatives daily. It occurs due to poor diet and liquid intake, Immobility and lack of
exercise, stress, ignoring the urge to defecate, medications and may be secondary to
another disease.6
Another gastrointestinal problem in the older adults is dyspepsia (indigestion).
An abnormality in digesting food or lack of proper digestion is termed as dyspepsia.
Globally, the prevalence of uninvestigated dyspepsia varies between 7% - 45%, while
the prevalence of functional dyspepsia has been noted to vary between 11% - 29.2%.
In India, dyspepsia was more prevalent in adults above 40 years of age. Among the
Asian countries, India stood second highest with an incidence of 30.4% having
dyspepsia among the population.7
Gastroesophageal reflux disease (GERD) is a chronic condition caused by the
reflux of acidic gastric contents into the esophagus and this problem is highly
3
prevalent and is considered common in the elderly and may present with various
symptoms, such as heartburn, regurgitation, dysphagia, or chest pain. 8 Studies show
that 15% of older individuals have heartburn and regurgitation at least once a week
and 7% have symptoms daily.9 Another common disorder seen in the elderly is peptic
ulcer disease. It is a focal area of the stomach or duodenum that has been destroyed by
digestive juices and stomach acid.10
There are many ways to prevent these disorders through proper nutrition,
physical activity and with regular exercise, etc.
The challenges in treating this population include communication, education,
and breaking through barriers. The objective of geriatric care is to meet long term care
needs, improve the quality of life, and to maintain their independence for as long as
possible. Media plays an active role in creating awareness among people. The module
of video assisted teaching is an audio visual aid and it is used as an instructional
device in which the message can be heard as well as seen. The images initiates,
stimulates and reinforce learning. It provides significant gains in informational
learning, retention, recall, thinking, reasoning and activity interest, which enhances
personal growth and development. Most of the geriatric people are ignorant and it is
necessary to educate. Education of patient is the key to success, and skilled nurses in
the health care delivery system are the important member in enhancing the knowledge
of the public.
Based on the above mentioned information and the personal observations by
the investigator, she feels the need to educate older adults regarding prevention of
selected gastrointestinal disorders of geriatrics using a video assisted teaching
module.
4
6.2 REVIEW OF LITERATURE
The review of literature is arranged under the following categories:
6.2.1 Review of literature related to geriatric people.
6.2.2 Review of literature related to gastrointestinal disorders in geriatric people.
6.2.3 Review of literature related to effectiveness of video assist teaching module.
LITERATURE RELATED TO GERIATRIC PEOPLE
As we enter the 21st century, population aging has emerged as a major
demographic trend worldwide. Throughout the world today, there are more people
aged 65 and older than the entire populations of Russia, Japan, France, Germany and
Australia -combined. By 2030, 55 countries are expected to see their 65 and older
populations at least 20 percent of their total. By 2040, the global population is
projected to number 1.3 billion older people—accounting for 14 percent of the total.
By 2050, the U.N. estimates that the proportion of the world's population age 65 and
over will more than double, from 7.6% today to 16.2%. China and India have the
largest older populations. By 2050, China will see its number of elders grow 30%
from 109 million to 350 million and India, from 62 million to 240 million.11
According to the United Nations Department of Economic and Social Affairs,
one out of every ten people on the planet is now 60 years of age or older and they
predicted that, by the year 2050 one out of five people will be aged 60 years and by
2150, one out of every three people will be aged 60 years or older. Additionally, the
oldest old are the most rapidly expanding segment of the elderly population.
Currently, the oldest old make up 11 percent of the 60+ age group will grow to 19
percent by 2050. With the number of elderly people on earth at any one time rising
5
rapidly, there is an increased urgency to address the rights and roles of elderly persons
in our world.11
Population aging is a worldwide phenomenon, and India is no exception.
Indian population has approximately tripled during the last 50 years, but the number
of elderly Indians has increased more than fourfold. The 2001 census has shown that
the elderly population (60+) of India accounted for 77 million and census 2011
projections indicate that the elderly population has crossed the 100 million mark. It
took more than 100 years for the aged population to double in most of the countries in
the world, but in India it has doubled in just 20 years. The life expectancy has also
gone up to over 70 years today. With fast changing socio-economic scenario,
industrialization, rapid urbanization, higher aspirations among the youth and the
increasing participation of women in the workforce, roots of traditional joint family
system has been eroding very fast. In urban areas of the country traditional joint
family system has become thing of past. In such changing situations, majority of older
persons, who have passed most part of their life with their joint or extended families
are on the verge of isolation or marginalization in old age.12
A study conducted on identifying unmet needs in older patients at Australia.
The study raveled that out of 546 participants 50 percent of women, 25 percent of
men lived alone, over percent participants reported one or more health problems. The
researcher found that health assessment was effective in identifying significant
physical and psychological problems in older adults. Thus the researcher felt that
identifying unmet physical and psychological needs to improve quality of life in older
adults.13
6
LITERATURE RELATED TO GASTROINTESTINAL DISORDERS AMONG
GERIATRICS
Senior health is the most important requirement when it comes to needs of the
elderly. With advancing age, the body tends to slow down and becomes less efficient.
Elderly people are prone to a few age related health issues. This is a normal aspect of
life and one cannot help it. However, through proper care and nursing facilities, one
can definitely help in keeping most of these health issues in check and preventing
them from causing any serious harm. Regular medical checkup is necessary. They can
help in anticipating potential future health-related issues. At the same time, they may
help in identifying serious health problems at an early enough stage during which
treatment is possible.14
As people age, their digestive system gradually starts weakening. Aged and
elderly people especially, face this problem wherein they start finding certain foods
indigestible or difficult to digest. What one must realize is that their diet can no longer
be the same as it was twenty years ago. Their diet should now be modified
accordingly such that it remains a nutritious, balanced diet and yet, contains
foodstuffs that their system is able to accept, without causing them any discomfort or
problems. Often, the diets of elderly people need to be altered depending on their
medicinal prescriptions.15
A study was conducted to assess the prevalence of chronic constipation (CC)
in adult population in Moscow. Data was collected from 1189 randomly selected
subjects older than 18 years. A specially designed Questionnaire, which included
questions for constipation, dietary habits, physical activity, and obstetric history was
used. 34.3% subjects said that they had constipation and 16.5% had chronic
constipation. Females had significantly (p < 0.001) higher rate of symptoms of
constipation. Prevalence of CC has a tendency to increase with age reaching
7
maximum 32.8% in subjects older 65 years. It was concluded that Chronic
Constipation is a common condition especially in the elderly, associated with female
gender, dietary habits, and physical activity.16
A Cohort study was conducted to identify dietary and physiological
characteristics of older individuals with chronic constipation, compared with a control
group of individuals without constipation in University hospital and affiliated clinics,
Pennsylvania. The sample was 18 subjects with constipation and 18 control subjects
who were ambulatory, community-dwelling outpatients over the age of 60 years.
Measures included a 1-week food diary, diet questionnaire, bowel diary, the Hopkins
Symptom Checklist (SCL-90R), colonic transit study, and medical history, including
queries about activity, medications, medical illnesses, and bowel symptoms. Subjects
with constipation reported consuming fewer meals per day compared with control
subjects (P < 0.01) and a tendency to consume fewer calories (P = 0.07). There were
no differences between groups on fiber or fluid intake or any of the other dietary
parameters. However, slow colonic transit was significantly related to low caloric
intake (P < 0.0001), higher percent of protein in the diet (P < 0.05), low fluid intake
(P < 0.05). The data suggested that constipation in the older population is related to
caloric intake rather than fiber consumption or other dietary qualities.17
A study was conducted to evaluate the prevalence of upper gastrointestinal
symptoms in elderly outpatients in Italy. The study involved 3238 outpatients aged 60
years and above. Information on social, behavioral and demographic characteristics,
function in the activities of daily living (ADL), co-morbidities and drug use were
collected by a structured interview. Data was collected by a upper gastro-intestinal
symptom questionnaire for the elderly, a validated diagnostic tool which includes the
following five symptom clusters: abdominal pain syndrome, reflux syndrome,
indigestion syndrome, bleeding and non-specific symptoms. Presence and severity of
8
gastrointestinal symptoms were analyzed through a logistic regression model. 3100
subjects were included in the final analysis. The overall prevalence of upper
gastrointestinal symptoms was 43%. The prevalence of Abdominal pain syndrome
was 13.9%, reflux syndrome was 21.9%, indigestion syndrome was 30.2%, bleeding
was 1.2%, and other non-specific symptoms were 4.5%. Upper gastrointestinal
symptoms were more frequently reported by females (P < 0.0001), with high number
of co-morbidities (P < 0.0001), who were taking higher number of drugs (P < 0.0001).
Logistic regression analysis demonstrated that female sex, disability in the ADL,
smoking habit, and body mass index, as well as the presence of upper and lower
gastroenterological diseases, psychiatric and respiratory diseases were significantly
associated with the presence of upper gastrointestinal symptoms. Among all the
symptoms evaluated, there was highest prevalence of indigestion syndrome in the
elderly people.18
A survey was conducted to estimate the prevalence and characteristics of
symptomatic gastroesophageal reflux disease in the elderly in City of Turku, Finland.
Stratified random sampling was used. A questionnaire was sent to 559 subjects over
65 years of age. The questionnaire inquired about the following symptoms: heartburn,
regurgitation, chest pain, dysphagia, dyspepsia, respiratory symptoms, vomiting, and
belching. The response rate was 92%. Twenty-nine incompletely filled forms were
rejected. Thus, the questionnaires from 487 subjects, representing 87% of the original
number, constitute the basis for the study. The age related prevalence of daily
symptoms suggestive of gastroesophageal reflux disease was 8% in men and 15% in
women (P < 0.05). Fifty-four percent of men and 66% of women reported that they
had symptoms at least once a month (P < 0.05). It was found that gastroesophageal
reflux disease are common in elderly subjects. Women suffer from these symptoms
9
more frequently than men. Typical reflux symptoms are often associated with atypical
complaints, such as abdominal symptoms, chest pain, or respiratory symptoms.19
A cross sectional study was conducted in an intensive field practice area of
Comprehensive Rural Health Services Project Ballabgarh in district Faridabad,
Haryana. The study aimed to find out the prevalence of self-reported health problems
and health seeking behaviour among rural elderly population. Out of the 1117 aged
(60 yrs. of age) a total of 987 (88.4%) could be interviewed. Among these 490
(49.6%) were males and 497 (50.4%) were females. The sample was selected using
stratified random cluster sampling. The duration of recall was one month for acute
problems and one year for chronic problems. Majority of the aged were illiterate
(81.6%), living in joint families (82.9%), belonging to lower socio-economic status
(48.8%), living with spouse and children (56.0%), presently head of the house-hold
(40.1%), not working (64.5%) and fully dependent (71.1%). In response to an open
ended question about any health problem experienced in last one month, 86.1%
females and 78.2% males reported having had at least one problem and this difference
was statistically significant (p<0.001). Overall, 21.6% men and 17.1% women
reported occurrence of single health problem in last one month but 57% men and 69%
of women reported at least 2 or more health problems. Frequency of self-reported
gastrointestinal health problems in a month among males and females were as
follows: Constipation in males was 4.1% and in females was 2.8%, Indigestion/Gas in
males was 3.9% and females was 8.5%, Loss of appetite in males was 3.5% and in
females was 3.4%, Abdominal Pain in males was 3.3% and in females was 5%,
Vomiting/Nausea in males was 1.2% and in females was 3.2%, Loose stools in males
was 6.7% and in females was 7.2%, Weakness in males was 6.5% and in females was
9.4%.20
10
A study was conducted to assess the knowledge, general attitudes towards
nutrition, dietary restriction attitudes, and dietary restriction behavior in the elderly in
Taiwan. The nutrition knowledge, attitudes and behavior scales were developed by
the researchers. A multi-staged, stratified random sampling method was used. The
interview was completed by 1937 elderly persons aged above 65 years. The Pearson
product-moment correlation coefficient was used to study the relationships between
nutrition knowledge, attitudes, and behavior. The results indicated that the elderly had
poor nutrition knowledge in all three aspects, especially about the relationship
between nutrition and disease. An average of 49.4% answered correctly. Elderly
people expressed favorable attitudes toward healthy foods. From the percentages of
positive responses to dietary restriction behaviours, it was found that a moderate to
high number of elderly people abided by their traditional dietary restrictions.21
LITERATURE RELATED TO EFFECTIVENESS OF VIDEO ASSISTED
TEACHING MODULE
A study was conducted on effectiveness of DVD computer based teaching on
the use of inhaler and ability to correctly demonstrate inhaler technique. Total of 34
adults with pulmonary disease and experience using inhalers were randomized into
the control or intervention groups. The intervention group viewed the tutorial, after
which they demonstrated their inhaler technique and completed an Inhaler Technique
Knowledge Test. The intervention group demonstrated significantly better inhaler
technique, with a mean Observed Inhaler Technique Score of 88.3 ± 12.3 compared
with 67.4 ± 19.2 for the control group (p = 0.001). The intervention group also scored
significantly higher on the Inhaler Technique Knowledge Test, with a score of 80.9 ±
17.0 versus 67.4 ± 11.8 for the control group (p = 0.01). Overall, the program was
acceptable to patients.22
11
An evaluative study was done to assess the effectiveness of video assisted
teaching programme regarding self care management among patients with COPD in
terms of knowledge and practice in 2010. The research design adopted was one group
pretest, post test, pre experimental design was used for the study which was
conducted at IRT Perundurai Medical College Hospital. The total sample of the study
was 50 patients with COPD. The Samples were selected by purposive sampling
method. Structured interview schedule was used to assess the knowledge through pre
test. Following this, video assisted teaching was administered for 40 minutes. Post test
was done on 7th day. The data collected was analyzed and interpreted using
descriptive and inferential statistics. Prior to implementation of Video assisted
teaching programme 66% had inadequate knowledge and 15% had moderately
adequate knowledge whereas after implementation of video assisted teaching
programme 82% had adequate knowledge and 16% had moderately adequate
knowledge. Finding showed that the video assisted teaching programme was effective
in increasing the knowledge and practice among patients with COPD regarding self
care management.23
A study was conducted to examine the efficacy of DVD technology compared
to print-based material in COPD self-management education of 40 rural patients in
rural health using random assignment of samples to two groups. Pretest - Posttest
design with a control group. A MANCOVA testing planned Multivariate contrasts
determined patients receiving a DVD reported statistically significant higher levels of
lung-specific physical functioning as compared to patients receiving a Pamphlet.
Additionally, DVD patients Reported clinically significant improvements on two
dimensions of lung-Specific quality of life.24
12
STATEMENT OF THE PROBLEM
To assess the effectiveness of Video Assisted Teaching Module (VATM) on
knowledge of older adults regarding Prevention of selected Gastrointestinal
Disorders of Geriatrics in a selected old age home at Bangalore.
6.3 OBJECTIVES OF THE STUDY
1.
To assess the existing level of Knowledge regarding Prevention of selected
Gastrointestinal Disorders of Geriatrics among older adults on the basis of pretest score.
2.
To develop a Video Assisted Teaching Module regarding Prevention of
selected Gastrointestinal Disorders of Geriatrics.
3.
To administer the Video Assisted Teaching Module regarding Prevention of
selected Gastrointestinal Disorders of Geriatrics.
4.
To evaluate the effectiveness of Video Assisted Teaching Module (VATM) on
knowledge regarding Prevention of selected Gastrointestinal Disorders of
Geriatrics among older adults by comparing pre and post test knowledge
score.
5.
To determine the association between post test knowledge level of older adults
regarding Prevention of selected Gastrointestinal Disorders of Geriatrics with
their selected demographic variables.
6.4 OPERATIONAL DEFINITIONS
1. EFFECTIVENESS: In this study it measures the improvement score in post
test when compared with the pre test score after exposing to video assisted
teaching module.
13
2. VIDEO ASSISTED TEACHING MODULE (VATM): In this study Video
Assisted Teaching Module refers to information in compact disc comprising
systematic instructions on prevention of selected Gastrointestinal Disorders of
Geriatrics like Gastroesophageal reflux disease, Constipation, Dyspepsia and
Peptic ulcer with verbal interactions.
3. KNOWLEDGE: In this study it refers to the written responses received from
the older adults to the knowledge items listed in the structured questionnaire.
4. OLDER ADULTS: It refers to the patients aged 60 years and above who
reside in a selected old age home.
5. PREVENTION: It refers to avoidance of occurrence of selected
gastrointestinal disorders in the geriatrics.
6. GASTROINTESTINAL DISORDER: In this study it refers to health
problems related to digestive system of the geriatric people such as
Gastroesophageal reflux disease, constipation, dyspepsia and peptic ulcer.
7. GERIATRICS: It refers to the elderly population of age 60 years and above.
8. OLD AGE HOME: It refers to the institution which provides long care
facilities with physical, social, psychological and economic support for the
aged people.
6.5 ASSUMPTIONS

The older adults will have some knowledge about prevention of
gastrointestinal disorders of geriatrics.

Teaching through Video Assisted Module will enhance the knowledge of older
adults.
14

The written responses to the questionnaires would accurately reflect the actual
knowledge
of
the
older
adults
regarding
prevention
of
selected
gastrointestinal disorders of geriatrics.
6.6 NULL HYPOTHESIS
H01: There will be no significant statistical association between post test knowledge
scores of older adults regarding prevention of selected gastrointestinal disorders
of geriatrics with their demographic variables.
H02: There will be no difference between the knowledge of older adults regarding
prevention of selected gastrointestinal disorders of geriatrics prior to and after
the video assisted teaching module.
7. MATERIALS AND METHODS
7.1 SOURCES OF DATA
Data will be collected from the older adults in a selected old age home at
Bangalore.
7.1.1 RESEARCH APPROACH
Evaluative research approach
7.1.2 RESEARCH DESIGN
Pre experimental research with one group pre and post test design.
7.1.3 VARIABLES UNDER THE STUDY
Independent variable:
Video Assisted Teaching Module on Prevention of selected Gastrointestinal
Disorders of Geriatrics.
15
Dependent variable:
Knowledge of older adults regarding Prevention of selected gastrointestinal
disorders of Geriatrics.
Extraneous variables:
Selected demographic variables such as age, gender, educational qualification,
occupation before retirement and source of information, type of food, number of
meals per day, years of stay in old age home, habits, sleep pattern, source of
information on GI problems.
7.1.4 SETTING OF THE STUDY
The study will be conducted in a selected old age home at Bangalore.
7.1.5 POPULATION
The population for the study comprises of older adults who are residing in the
old age homes.
7.1.6 SAMPLE
The sample will be older adults aged 60 years and above and who are residing
in a selected old age homes at Bangalore.
7.1.7 SAMPLE SIZE
The sample size will be 40 older adults
7.1.8 SAMPLING TECHNIQUE
Simple random sampling technique will be used.
16
7.1.9 CRITERIA FOR SELECTION OF THE SAMPLE
i.
Inclusion criteria

Both male and female older adults.

Older adults who are in the age group of 60 years and above.

Older adults who are willing to participate in the study.

Older adults who are able to read and understand English and Kannada.
ii.
Exclusion criteria

Older adult who are sick and confined to bed.

Older adults who are not able to follow the instructions.
7.2 METHOD OF DATA COLLECTION:
A structured questionnaire
7.2.1 TOOLS FOR DATA COLLECTION
The researcher will collect data through structured questionnaire. It comprises
of two parts.
Part I : Demographic Variables like age, gender, educational qualification, type of
food, number of meals per day, years of stay in old age home, habits, sleep pattern,
occupation if any before retirement and source of information on GI problems.
Part II : Structured knowledge Questionnaire on prevention of selected
gastrointestinal disorders of geriatrics like GERD, Constipation, dyspepsia and peptic
ulcer.
7.2.2 DATA COLLECTION PROCEDURE
 Structured questionnaires will be used to collect data.
 The data will be collected in the following stages:
17
 Formal permission will be obtained from the authorities of the old age
homes.
 Formal permission will be obtained from study participants after
explaining the objectives of study.
 The study participant will be selected by using simple random sampling
technique who fulfills the inclusion criteria.
 Pre test data will be collected by the researcher herself using structured
questionnaire and then administer Video Assist Teaching Module to all the
subjects.
 Post test will be conducted on 8th day after the teaching programme using
the same structured knowledge questionnaire.
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 and percentage distribution and standard deviation.
Inferential statistics
Significance of difference between pre test and post test knowledge scores of
older
adults regarding prevention of selected gastrointestinal disorders of geriatrics
will be found using paired “t” test.
The association between knowledge of older adults with their demographic
variables will be found using chi-square test.
18
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 pre test knowledge of older
adults will be assessed by using a structured knowledge questionnaire followed by
video assist teaching module on prevention of selected gastrointestinal disorders of
geriatrics will be conducted and on 8th day post test will be done using the same
questionnaire.
7.4. HAS ETHICAL CLEARANCE BEEN OBTAINED FROM
YOUR INSTITUTION?
a. Permission will be obtained from the research committee.
b. Permission will be obtained from the authorities of the selected old age homes.
c. Informed consent will be obtained from the subjects enrolled before the study.
19
8. LIST OF REFERENCES
1. Koonin EB. Altschul SF. Bork P. The Mark Manual of Geriatrics. 2nd edition,
Functional Motifs. 1996.
2. Anonymous. Old Age. http://en.wikipedia.org/wiki/Old_age. 2011
3. International Day of Older Persons. 2011. October 1.
http://www.gits4u.com/renew/snrctz8.htm
4. David Fisher. Digestive disorders in adults. 2010. June 17.
http://www.livestrong.com/article/152144/
5. Penny Tenzer. Persistent Pain and the Older Patient. 2008. April 4.
http://www.medscape.org/viewarticle/571472
6. Smeltzer C.Suzanne. Bare G. Brenda. Brunner and Suddarths text book of
medical
and
surgical
nursing.
10th
edition.
Lippincott
publication.
Philadelphia. 2004
7. Sanjiv M. Khean L. Epidemiology of functional dyspepsia: a global
perspective.. 2006. May 7; available from:URL:
http://www.wjgnet.com/1007-9327/12/2661.asp
8. Judith AR. et al. Age Differences in the Epidemiology and Treatment of
GERD-Related Symptoms. 2003. May. available from:URL:
www.ispor.org/research_source/free/PGS13.pdf
9. Kasper DL. et al. Harrison’s Principles of Internal Medicine; Vol 2, 16th
edition, New York: McGraw-Hill. 2004
10. Anonymous. Gastrointestinal specialists. Ulcer disease. Available from : URL:
https://www.gis.md/fact-ulcer.html
11. James J. The Demographics of ageing. Available from : URL:
http://transgenerational.org/aging/demographics.htm. 2010.
20
12. Agewell Foundation. Study on human rights of older persons in India.
http://social.un.org/ageing-working-group.pdf. 2011. April 20.
13. Wade MJ, Pine D. Weinstock RS. A Comparison of Healthy related Quality
on elderly. 2003. p. 32; 613-618.
14. Anonymous. Health Care Requirements.
http://www.buzzle.com/articles/needs-of-the-elderly.html. 2011
15. Anonymous. Dietary Requirements. http://www.buzzle.com/articles/needs-ofthe-elderly.html. 2011
16. Lazebnik LB. et al. Prevalence and risk factors of constipation in the adult
population of Moscow. Available from URL:
http://www.ncbi.nlm.nih.gov/pubmed/21695954. 2011
17. Towers AL. et al. Constipation in the elderly: influence of dietary,
psychological,
and
physiological
factors.
Available
from
URL:
http://www.ncbi.nlm.nih.gov/pubmed. 1994
18. Pilotto A. et al. Association of upper gastrointestinal symptoms with
functional and clinical charateristics in elderly. Available from URL:
http://www.ncbi.nlm.nih.gov/pubmed/21799648. 2011
19. Raiha IJ. Prevalence and characteristics of symptomatic gastroesophageal
reflux disease in the elderly. Available from URL:
http://www.ncbi.nlm.nih.gov/pubmed
20. Anil G. et al. Indian Journal of Physical Medicine and Rehabilitation.
Prevalence and determinants of disability in the rural elderly population in
Northern India. 16(2). 2005. October:39 – 44
21. Wei Lin. Ya Wen Lee. Nutrition knowledge, attitudes, and dietary restriction
behavior of the Taiwanese elderly. Available from URL:
http://apjcn.nhri.org.tw/
21
22. Navarre et al. conducted a study on effectiveness of DVD computer based
teaching on the use of inhaler. 2007
23. Angelin S. Efectiveness of Video Assisted Teaching Programme regarding
self care management among patients with COPD. 2010
24. Stellfson C. et al. The efficacy of DVD technology versus print-based material
in COPD self-management. 2009
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9.
SIGNATURE OF THE
CANDIDATE
The research topic selected is relevant
10.
11.
and feasible for the study.
REMARKS OF THE GUIDE
MRS. BEENA MARREL. M
NAME AND DESIGNATION
PRINCIPAL
11.1. GUIDE
ETCM College of Nursing, Kolar
11.2. SIGNATURE OF THE
GUIDE
11.3. CO-GUIDE (if any)
11.4. SIGNATURE OF THE
CO-GUIDE
MRS. BEENA MARREL. M
ASSISTANT PROFESSOR
HOD OF MEDICAL SURGICAL
11.5. HEAD OF THE
NURSING
DEPARTMENT
ETCM College of Nursing, Kolar
11.6. SIGNATURE OF THE HOD
12.
This topic was discussed with the
12.1. REMARKS OF THE
members of the research committee and
PRINCIPAL
finalized. She is permitted to conduct
the study.
12.2. SIGNATURE
23