RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA, BANGALORE ANNEXURE II PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1.

Name of the candidate and address (in block letters)

PRIYANKA. A FIRST YEAR MSc NURSING NETHAJI INSTITUTE OF SCIENCES,MANNAGUDDA MANGALORE NETHAJI INSTITUTE SCIENCES MANNAGUDDA MANGALORE OF

NURSING

2.

Name of the Institution

NURSING

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Course of Study and Subject

M. Sc. NURSING PSYCHIATRIC NURSING 13.10.2010

4. 5.

Date of Admission to the Course Title of the study

A STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE TOWARDS MENTAL ILLNESS AMONG KORAGA TRIBE OF SELECTED COMMUNITIES IN MANGALORE

Brief resume of the intended work

Although the benefits of public knowledge of physical diseases were widely accepted, knowledge about mental illness and effective treatment are vague. Attitude which hinders recognition and appropriate help seeking behavior is often prevalent. Much of the mental health information is misleading. Most of the literature suggests that lay people have a poor understanding mental illness. They are unable to correctly identify mental disorder, do not understand the underlying causative factors, are fearful of those who are perceived as mentally ill. They have incorrect beliefs about the effectiveness of treatment, and are often reluctant to seek help for mental disorders and are not sure to help others. The ability to recognize mental illness is thought to be important because, the inability to recognize a disorder in oneself or others could result in delays seeking appropriate treatment.5

Attitudes towards mental illness often involve negative stereotypes and prejudice or stigma. Stigma and discrimination are often associated with fear of unpredictability although the risk of violence from mental illness is generally no longer high than other person. Research indicates that fear perception of dangerousness related to mental illness have increased past few decades.7

Mental disorder has to be found common, over a third of people in most countries reporting sufficient criteria at some point of their life. The social stigma associated with mental disorder is a wide spread problem. Some people believe these with serious mental illness cannot recover, are to blame for problems. It has been observed that the general trend of Studies carried out in India indicated lack of knowledge about mental health and illness and a tendency to maintain social distance from the mentally ill.8

6.1 Need for the study From the time immemorial diseases were an inheritant part of mankind, mental illness also took its place among them. Unlike any other physical illness, mental illness differed in the fact that it had a lot of stigma attached to it even making it more difficult for the person as well as the family members to proceed with the treatment modalities . The purpose of this study is to find ways that correct ignorance and faculty thinking among mentally ill among Koraga tribes, so that people will have les negative attitude towards these individuals. If people are given accurate information about mental illness it can lead to less negative attitudes, which can make it easier for the mentally ill to have a better quality of life. A Descriptive study To Assess The knowledge, attitude and practices of family members of clients with mental illness was done on One adult family member accompanying client with pure psychotic mental disorder attending the OPD of CMC Vellore for the first time. The clients were chosen randomly every day from the OPD Register of new patients. Questionnaire and attitude scale were used for the study. The attitude scores were found to be associated with the education level of the family members. The mean attitude score was statistically higher among those with secondary level of education and above (mean score = 16.6 ,SD = 4.9)in comparison of those with primary education ( mean score = 13.9 SD = 4.5) The family members from urban area scored significantly higher mean score on attitude scale than those in rural area.1 A cross sectional survey was conducted among 2254 Qataris from October 2008 to march 2009 to assess the knowledge and attitude and practice regarding mental illness among Qataris and other Arab expatriates. A questionnaire was designed to assess the knowledge, attitude and practice regarding mental illness. Out of the 2254 subjects surveyed, 49.6% were Qataris and 50.4 %were other Arab expatriates 54.8% were Males and 45.2% were Females. A majority of the respondents thought that substance abuse like alcohol, drugs result in mental illness. Fewer (40.6 %) believed that mentally ill people are 3

mentally retarded.48.3 % believed that it is the result from the punishment of the God. The most common information source was from medias. Recognition of mental disorders in the studied population was poor. The study concluded that knowledge of mental illness among the Arab speaking population is poor.2 A study on police officers' knowledge and attitude towards mental illness were done in southwest Scotland in 2001. Questionnaires were sent to all operational officers in a regional police service regarding their level of knowledge and attitudes towards Mental illness. It was widely accepted by police officers that mental illness occurred commonly, can be effectively treated in the community and that the main risk of harm is to patients themselves. There was a good knowledge of relevant legislation, but most officers felt they did not have sufficient training in mental illness, and were keen for more improved liaison between sector psychiatrists and local police may be of value in the earlier identification and treatment of the mentally ill.10 A cross-cultural approach study was conducted in 2004 on teachers' knowledge, Beliefs and attitudes concerning schizophrenia in Japan and Taiwan. Mental health literacy of the general public is essential for the effective promotion of society's mental health. However, there has been no investigation of the general public's mental health literacy with the Japanese and Taiwanese socio cultural backgrounds. As a common finding with the studies in Western countries, only small percentages of the Japanese and Taiwanese respondents were able to make a correct identification. A further common finding was the emphasis on psychosocial factors as a cause of schizophrenia, as was the rejection of psychotropic medication, although future study is required to determine to what extent the respondents know about therapeutic procedures utilized by psychiatrists. Significantly stronger stigma perception was shown in the Japanese respondents than in the Taiwanese, which may be attributable to the high institutionalization rate in Japan12. A descriptive cross sectional study to assess the knowledge and attitude about mental illness among the Nursing Staffs in Nepal. A sample of 110 respondents ,who were predominantly females and young working in B.P.Koirala Institute Of Health Sciences 4

Nepal. The study revealed some interesting findings that around( 37.5%) people thought that mentally ill people are insane. The majority(65.4 % ) had showed their knowledge about causes of mental illness are genetic or inherited and biochemical disturbances. About three fourth were ready to work together (71.8 %) and chat with them (91.8%) Respondents expressed their faith in Psychiatrists (93.5%) but less in faith healers (3.0%) The vast majority had obtained information about mental illness from seeing mentally ill persons (94%) followed by communication with medical personnel (84.5%). The study revealed that there was over all adequate knowledge by a large positive attitude .17 6.2 Review of literature A literature review should assist the researcher to refine the research topic, and identify gaps to enrich the planned research, by using outcomes from existing Research to further develop the proposed study. Therefore, a literature review should be executed before, after and during the study, to build on existing research, to confirm a scientific process and to weigh against the discussion of the findings of this research. However, in this study, the purpose of the literature review was to give a clear understanding of the nature and meaning often problem that had been identified, to provide sources for selecting or focusing on the topic, in order to reduce the chances of selecting an irrelevant topic, and to save time and avoid Duplication and unnecessary repetition. A descriptive study was conducted in the city of Ludhiana to assess the knowledge and practices of general practitioners regarding psychiatric problems. The sample consisted of 158 non psychiatric medical practitioners. A detailed Questionnaire was administered and is advised to fill it and return by post. A total of the 158 practitioners were surveyed, 133 practitioners answered the Questionnaire. The results showed that 70.68% felt mental diseases as very common.89.4% reported that these are due to a combination of stress, social, cultural, individual, organic and biological factors. In this study it was found that the majority of the non mental health practitioners see patients with mental health problems in their practice. About 79.7% do not know any diagnostic criteria. They are aware of etiology, increasing incidence and treatment available for mental health problems.4 5

A descriptive, cross sectional survey, with a quantitative approach was conducted among 224 community members from 4 divisions of kinondoni community namely Magomeni, Kinondoni, Kibamba and Kawe in Tanzania in the year 2011to determine the knowledge and attitudes of the Kinondoni community members towards mental illness. An adjusted, existing questionnaire, with, self-compiled, closed ended questions, was used to collect data. Reliability was supported by a pilot study to test the questionnaire beforehand. The results were presented in tables of means, in which each variable had its own table of analysis of variance. The results were as follows; knowledge about mental illness was very poor as most of the respondents in Kinondoni community n=182 (61%) responded that mentally ill people cannot perform regular jobs, had no friends, and were dangerous. Respondents n= 239 (79.6%)had negative attitudes towards people with mental illness as they stated that they have no right to find a job, have friends and be integrated into society. The results conclude that the Kinondoni community members have less knowledge and negative attitude towards mental illness.14 A Descriptive study was conducted in 2003 on the new neighbour experience of living next door to people suffering from long-term mental illness. Nineteen neighbours of group homes for people with long-term mental illness, in seven different communities in eastern Norway, have been interviewed. The grounded theory procedures as well as the constant comparative method were employed to analyze the findings. From the data, one main category was identified: the need for information.13 An exploratory research study was conducted by Nagarajaiah, Chinnayya HP, Sujatha, and Shyamala in 2002 to assess the Attitude of high school students towards mental disorder. The sample consists of on fifty high school students aged 13-16 years. Majority of them (68%) feel that mental patient are always dangerous, we should keep Ourselves away from them further majority of them feel that mentally ill person can be managed in PHC and other local hospitals. Majority of them disagree that the treated mental patients can work with responsibity.11

A Quantitative descriptive study was done in Bhutan to assess the Attitude of Nurses towards Mental illness in Bhutan. The sample represents the known population of Nurses from National Referral Hospital Thimphu, Structured questionnaire and Opinion towards mental illness scale were used for assessing data.Responses were analyzed using descriptive statistics including mean, deviation (mean = 134.39, SD = 17.35), and frequency and Spearmans correlation were used. The findings indicated that Nurses surveyed have a positive attitude towards mental illness. Findings from this study shows that the Nurses with Psychiatric experience of 3 to 4 weeks and 4 weeks were found to have more positive attitude towards mental illness.15 A study to evaluate the mental health knowledge of primary care medical officers following short term training in mental health care was conducted by Sriram TG, Chandrasekhar CR, Isaac MK, Srinivasa Murthy R,Shanmugham V in 1990 by using a multiple choice questionnaire. Seventy-eight medical officers who underwent two weeks training in mental health care were assessed using parallel forms of a standardized multiple-choice questionnaire administered before and soon after the training. It was found that young doctors scored significantly higher in the Pre training assessment. The medical officers demonstrated a significant gain in knowledge, although the amount of gain varied. Doctors who had relatively lower Pre training scores showed a higher gain six doctors (8%) showed less than acceptable post training scores. These doctors were older than the rest of the group. The doctors pre training knowledge was best with respect to epilepsy and poorest With respect of manic-depressive psychosis. Items pertaining to epidemiology and Etiology elicited relatively less gain than other clinical dimensions.9 A study was conducted to assess beliefs and attitudes towards mental health among medical professionals in Delhi; a convenient sample of 76 medical professionals from three medical teaching institution of Delhi was collected. A pre tested validated 25 items self reported questioner is used to assess the attitude towards mental illness, knowledge about the cause treatment etc. Only about 60% of the respondents considered mental illness to be a disease.24% believed that people in contact with mentally ill could 7

develop odd behavior,70% claim that they would feel comfortable talking to psychiatric patient ,8% said mental illness is untreatable,8% considered psychiatric treatment is more disabling than other illness.3 A descriptive cross sectional survey type research was done among the outpatient department of Lokopriya Gopinath Bordoloi regional institute of mental health Tenz pur and 5 rural extension clinics of LBRIMH in Bishwanath chariali sootea of somtpur district from June to July 2008.The sample consist of 30 rural and 30 urban family members who were accompanying the severe mentally ill patients. Purposive sampling method was used and the data collection was done by using questionnaire and interview .The scores (R=83.33%, U=93%) agreed that mental illness is like other illness,(R= 83.33%, U=90%) agreed that anybody under severe stress can become mentally ill. No significant difference was found in knowledge towards mental illness among Urban and Rural16. 6.3 Statement of the Problem

A study to assess the Knowledge and Attitude towards Mental Illness among Koraga tribe of selected communities in Mangalore

6.4

Objectives of the study The objectives of the study:

To assess the level of knowledge of Koraga tribe regarding Mental Illness. To assess the attitude of Koraga tribe towards Mental Illness To find out the association of level of knowledge with the selected demographic variables. To find out the association of level of attitude with the selected demographic variables. To find out the association of knowledge and attitude with selected demographic variables

6.5 Operational definition Knowledge: In this study, knowledge means the level of awareness of Koraga tribes about mental illness measured by using Questionnaire Attitude: In this study, attitude means the settled opinion or way of thinking of Koraga tribes towards mental illness measured by modified attitude scale. Mental Illness: According to WHO, Mental illness is defined as clinically significant condition characterized by alteration in thinking, mood and behavior associated with personal distress and confusion Koraga tribes: In this study, Koraga tribe of Mangalore, the original inhabitants of undivided Dakshina Kannada district one of the back ward community in Mangalore.

6.6

Assumptions The study assumes that: The Koraga tribes May vary in attitude towards mental illness. May have less knowledge about mental illness

6.7

Delimitations The study is delimited to:

The members of Koraga tribe of selected communities in Mangalore. The Koraga tribe people who are available at the time of data collection.

6.8

Hypotheses 9

All hypotheses will be tested at 0.05 level of significance H1: There will be significant association between the knowledge score and the selected demographic variables. H2: There will be significant association between the attitude score and the selected demographic variables. H3: There will be significant relationship between the knowledge and attitude scores

7. Material and methods 7.1 Source of data Data will be collected from the members of Koraga tribe in selected communities in Mangalore. . 7.1.1 Research approach Survey approach is used for the study. 7.1.2 Research design

Descriptive research design is adopted for the study 7.1.3 Setting The study will be conducted among the Koraga tribe in Mangalore 7.1 .4 Population The population comprises of members of Koraga tribe 7.1.5 Variable The variable is research variable, in this study the variable refers to knowledge and attitude towards mental illness

7.2

Methods of data collection

7.2.1 Tool:

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Interview schedule as the tool for data collection. A Structured Questionnaire to assess the knowledge Attitude scale to study the attitude.

7.2.2 Sampling Procedure: The sampling procedure will be purposive sampling. 7.2.3 Sample size:

Sample will be 60 selected tribe members. 7.2.4 Inclusion criteria The members of Koraga tribe who is willing to participate for the study. The members who will be present at the time of data collection.

7.2.5. Exclusion criteria 7.2.6 The members other than Koraga tribes from the selected community The tribal members who are absent at the time of data collection. Instrument to be used 7.2.7 Demographic Performa Structured Questionnaire Attitude scale

Data collection method The Researcher will obtain prior permission from the respective authorities.

1. 2.

Demographic Performa will be used to collect the data. Structured Questionnaires will be used to assess the level of knowledge among the tribal members

3.

Attitude scale will be used to assess the attitude of tribal members

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7.2.8 Plan for data analysis Descriptive and inferential statistics will be used to analyze the data. Demographic Performa will be analyzed using frequency, mean and standard deviation. Chi-square test will be used to find the association between the level of knowledge and attitude with selected demographic variables. P value < 0.05 is considered as significant. Analyzed data will be presented in the form of tables, graphs and figures. 7.3 Does the study require any investigations or interventions to be conducted on patients, or animals? If so please describe briefly Yes, assessment of knowledge and attitude towards mental illness among Koraga tribe will be done. 7.4 Has ethical clearance been obtained from your institution in case of 7.3? Ethical clearance has been obtained

List Of References.

1. Vimala Rajan D, Anantha kumari, Siva, Rajeshwari,Bragunza, Deepa A Study to 12

assess the knowledge, attitude and practices of family members of clients with mental illness, Nursing Journal Of India, October 2003
2. Abdul Bari Bener, Tuna Burgut.F Mental illness knowledge and practice among Arab

population in Qatar Journal Of Primary care and Community Health July 2010 ,vol1 111 -118 3. Jugal Kishore, Mukherjee Radhika, Parashar Mamta, Jiloha.R.C, Ingle.G.K Beliefs and attitude towards Mental Health among Medical Professionals in Delhi Indian Journal Of Community medicine, 2007,32(3) ,198-200
4. Chaudhary R.K, B.P. Mishra, Knowledge and practices of General Practitioners

regarding Psychiatric problems ,Industrial Psychiatry Journal , 2009 Jan June 18 1,22-26
5. Knowledge and attitude towards Mental illness ,URL:

http://www.bjp.rcpsych.org 6. The stigma of Mental illness , URL: http://www.scribd.com

7. Judith Rabkin Public Attitude towards Mental Illness a literature review Schizophrenia Journal, 1974(10) 8. Bourget Mental Health Literacy a review of literature,Management Consulting For The Canadian Alliance On Mental Illness And Mental Health, November 2004
9. Sriram TG, Chandrashekar CR, Isaac MK, Srinivasa Murthy R, Shanmugham V. Training primary care medical officers in mental health care: an evaluation using a multiple-choice questionnaire. Acta Psychiatrica Scandinavica 1990; 81(5): 414-7. 10. Carey S, Police officers' knowledge of, and attitudes towards, mental illness in

southwest Scotland. Scott Med J. 2001 Apr; 46(2): 41-2.

11. Nagarajaiah, Chinnayya HP, Sujatha, Shyamala. A study on attitude of high school

students towards mental disorders. Indian Journal of Psychiatry 2002; 48(9): 261-74.

12. Kurumatani T, Ukawa K, Kawaguchi Y, Miyata S, Suzuki M, Ide H, Seki W,

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Chikamor E, Hwu HG, Liao SC, Edwards GD, Shinfuku N, Uemoto M,et al Teachers' knowledge, beliefs and attitudes concerning schizophrenia- a crosscultural approach in Japan and Taiwan. Soc Psychiatry Psychiatr Epidemiol 2004 May; 39(5): 402-9.
13. Granerud A, Severinsson E. The new neighbour: experience of living next door to

people suffering from long-term mental illness. Int J Ment Health Nurs. 2003 Mar; 12(1): 3-10. 14. John Jeoffrey Combo , Knowledge and Attitude of the Kinondoni Community to mental illness, Thesis presented at Stellenbosch University, Tanzania, March 2011 15. Richen Pelzang, Attitude Of Nurses towards mental illness in Bhutan,Journal Of Bhutan Studies,2, 60-78 16. Kunjalata Gogoi, Arunjyoti Barnah, Puspita Chakraborti ,Sailendra, Kr Deuri, Mental illness: knowledge of family members in rural and urban areas in Assam, The Nursing Journal of India, January 2011,1 17. Shyangwa.P.M, Singh.S, Khandelwal.S.K, Knowledge and Attitude about mental illness among Nursing Staffs in Nepal Journal Of Nepal Medical Association, 2003, 42, 27-31

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Signature Of The Candidate

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Remarks Of The Guide

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Name And Designation 11.1 Guide

11.2 Signature 11.3 Co-Guide 11.4 Signature 11.5 Head Of The Department

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11.6 Signature 12.1 Remarks Of The Principal 12.2 Signature

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