MSC Thesis 1
MSC Thesis 1
MSC Thesis 1
By
JOJI MATHEW
Prof. T. BHEEMAPPA
Department of Psychiatric Nursing
November 2007
i
Rajiv Gandhi University of Health Science, Karnataka
bonafide and genuine research work carried by me under the guidance of Prof.
Bangalore.
Place : Bangalore
(JOJI MATHEW)
ii
CERTIFICATE BY THE GUIDE
bonafide research work done by Mr. JOJI MATHEW, in partial fulfilment of the
Place : Bangalore
Prof. T. BHEEMAPPA
Department of Psychiatric Nursing,
Sarvodaya College of Nursing
Bangalore – 560 079
iii
ENDORSEMENT BY THE HOD, PRINCIPAL / HEAD OF THE
INSTITUTION
bonafide research work done by Mr. JOJI MATHEW, under the guidance of Prof.
Bangalore.
Date: Date:
Place: Place:
iv
COPY RIGHT
I, hereby declare that the Rajiv Gandhi University of Health Sciences, Bangalore,
Karnataka, shall have the right to preserve, use and disseminate this dissertation in print
Place : Bangalore
(JOJI MATHEW)
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ACKNOWLEDGEMENT
I raise my heart in gratitude to God Almighty who has been my shepherd and
guiding force behind all my efforts. His Omni presence has been my anchor through the
hard times.
The investigator owes a deep sense of gratitude and appreciation to all those who
Group of Institutions, Bangalore for his encouragement and support and rendering me
HOD of Psychiatric Nursing for his keen interest, guidance, valuable suggestion,
study as a guide.
Rani, HOD of Research Methodology and Child Health Nursing for her constructive
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My special thanks to Assistant Professor Anitha Kumari, Department of
Psychiatric Nursing for her guidance, valuable suggestion and moral support from the
Professor Hemalatha Ravi former faculty of Sarvodaya College of Nursing for their
K. Lalitha, Dr. Nagarajaiah, Dr. Ramachandra and Dr. Reddemma for their whole
statistics, G.K.V.K. Bangalore for his guidance in statistical analysis and presentation of
data.
Sarvodaya college of Nursing for their suitable suggestion, genuine interest and timely
Its my privilege to convey my sincere thanks to the experts who have validated
the research tool and have guided me with their valuable suggestions and corrections.
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I thank all the participants who had extended their kind co – operation and
My special thanks to V.S. Communications for their timely help in bringing out
Mrs. Aleyamma Mathew and my brother Mr. Jubin Thomas Mathew for their
out my study.
prayers, help, support and encouragement have always been a source of encouragement
throughout my study.
Thanks to all.
Joji Mathew
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LIST OF ABBREVATIONS USED
1. AD : Alzheimer’s Disease
9. SD : Standard Deviation
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TABLE OF CONTENTS
1. INTRODUCTION 1-14
2. OBJECTIVES 15
4. METHODOLOGY 31-41
5. RESULTS 42-58
6. DISCUSSIONS 59-64
7. CONCLUSION 65-67
8. SUMMARY 68-71
9. BIBLIOGRAPHY 72-77
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LIST OF TABLES
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LIST OF FIGURES
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ABSTRACT
information booklet” was undertaken by Mr. Joji Mathew in partial fulfillment of the
requirement for the degree of Master of Science in Nursing, under Rajiv Gandhi
Alzheimer’s disease is the fourth leading cause of death in adults. It robs the quality of
not only the elderly, but also the family members who are forced to devote their lives
selected community.
2. To find out the association between the level of knowledge and selected
demographic variables.
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Assumption
disease.
Method
The research design adopted for the study was descriptive design. A formal
written permission was obtained from the medical officer of the urban family welfare
select 100 adults from Jayachamarajendranagar, Bangalore in the age group between 21
In view of nature of the problem and to accomplish the objectives of the study a
structured interview schedule was prepared and thirty questions were formulated to
assess the knowledge of adults regarding Alzheimer’s disease. Reliability and validity of
the tool was ensured in consultation with guide and experts in the related field. The data
Results
Out of 100 adults 16 percent had adequate knowledge 37 percent had moderate
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overall mean value of the adults knowledge regarding Alzheimer’s disease was 53.9
knowledge and educational status, marital status and family size. Age, gender,
Alzheimer’s disease.
In view of the nature of the present study and to accomplish the objectives of the
The study revealed with the assumption of the study that the knowledge of adults
Key Words
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1. INTRODUCTION
“You have to begin to lose your memory if only in bits and pieces to realize
that memory is what makes our lives. Life without memory is our coherence, our
- Luis Buneul
Increase in life expectancy during the twenty first century have produced an aged
changes that takes place over time and results in progressive loss of functional capacity.
The aged have to cope up with many physical and mental health problems with
Alzheimer’s disease is known to men since 100 years only, Alzheimer’s day is
celebrated throughout the world on 21st September every year. The theme of world
word de – “apart, away” and “mens” – mind. Dementia is a progressive brain dysfunction
which result in a restriction of daily activities and in most cases leads in the long term to
1
Dementing illness are the most commonest disorders among elderly and thought
to be the fourth leading cause of death among adults in many developed nations
following heart disease, cancer and stroke. Dementia robs the quality of not only the
elderly, but also the family members who are forced to devote their lives caring for their
Dementia is the most feared and devasting disorder of late life. Current estimates
reveals that there are about 18 million cases of dementia in the world and by 2025, there
will be about 34 million suffering from dementia. The overall prevalence of dementia
ranges from 5 percent to 7 percent. Alzheimer’s disease is the most common dementing
Alzheimer’s disease attacks the parts of the brain that control thought, memory
and language. The onset of the disease is gradual and the person’s decline is usually
slow.5
1906 on the occasion of 37th meeting of South West Psychiatrists in Tubingen, Dr. Alois
Alzheimer’s described, the case of a 51 years old women Auguste D, who suffered from
disorientation and often aggressive behavior, died after four years of the disease in a state
of severest dementia with his description he gave an account of the disease which is still
valid today.6
2
Alzheimer’s disease is defined as progressive, irreversible, degenerative
Alzheimer’s disease affect all groups in the society and is not linked with social
class, gender, ethnic group or geographical location and although Alzheimer’s disease is
more common among elderly persons, younger persons can also be affected.
disease are dementia in Alzheimer’s disease with early onset, dementia in Alzheimer’s
disease with late onset, dementia in Alzheimer’s disease atypical or mixed type, dementia
deterioration together with, declining activities of daily living and by neuro psychiatric
neurofibrillary tangles and senile or neuritic plaques. This neuronal damage occurs
primarily in the cerebral cortex and results in decreased brain size. Similar changes are
found to a lesser extent in normal brain tissue of older adults. Cells principally affected
by this disease are the ones that use the neurotransmitter acetylcholine. Biochemically,
3
The ultimate cause of Alzheimer’s is unknown. In Alzheimer’s disease there are
mainly three stages of disease, they are early stage, middle stage and late stage. In the
early stage the patients have a tendency to become less energetic or spontaneous though
changes in their behaviour often go un-noticed even by the patient’s immediate family.
The early stage of Alzheimer’s disease is often overlooked and incorrectly labelled as
As the disease stage progresses to the middle stage, patients might still be able to
perform tasks independently, but may need assistance with more complicated activities.
In the late stage patient will not be able to perform even the simple tasks
independently and will require constant supervision. They may eventually to lose the
ability to swallow food and fluid and this can ultimately lead to death.
medications offer relatively small symptomatic benefit for some patient but do not show
disease progression. It helps a little for the memory. Right now, Alzheimer’s disease is
diagnosed by a battery of mental and other tests and even the diagnosis rests on the
The sun will continue to show its rays on the world. The waves of the vast ocean
will continue their rush to reach the shore and the wind will continue to blow the leaves
of the tree.
But let us all accept the patient with Alzheimer’s and give them a better
tomorrow.
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Need for the Study
Morituri Salutamus
According to Dr. Harlem “Tomorrow’s elderly people are today’s adult and
yesterday’s children”. Adulthood is a unique phase of human development. Adults are the
Life expectancy has gone up from 20 years at the beginning of the 20th century to
62 years today. India has a large segment of older people in the population. This segment
is growing fast with the rapid increase of the grey population in India.12
Indian aged population is currently the second largest in the world. By 2020, of
the countries with the largest elderly population in the world, five will be in developing
world, China 230 million, India 142 million, Indonesia 29 million, Brazil 27 million,
Pakistan 18 million.
department of economic and social affairs by 2050, the number of Indians aged above 80
will increase more than 6 times from the current number of 78 lakhs to nearly 5.14 crores.
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Alzheimer’s and other forms of dementia are becoming more prevalent among the
2047.
Very little is known about the prevalence of dementia outside the more developed
countries. The idea that illness like Alzheimer’s a disease of a rich developed nation is a
myth. Alzheimer’s disease can occur to any adult at any age. Women are three times
citizens suffers from Alzheimer’s. In Kolkata there are about 46,000 patients with
Alzheimer’s. In Delhi it accounts for about 50,000 Alzheimer’s patient and in Bangalore
there are 30,000 elderly patients suffering from Alzheimer’s disease. Today in India
32,00,000 people are affected by dementia. The figure is expected to double every 20
years.13
An estimated 4.5 million Americans are afflicted with Alzheimer’s disease and
other 20 million family must care for them. There are currently 800,000 people living
with dementia in United Kingdom today, a number expected to double within twenty
years. The number of people with dementia in the Asia Pacific region will rise from about
Alzheimer’s is a major public health challenge since the median age of the
disease, awareness is key. As baby boomers age, it is expected that the number of people
6
Alzheimer’s disease in the media, to Indian context a Malayalam movie
Thanmathra, 2005 directed by Blessy portrays the effect of Alzheimer’s disease which
Iris is a 2001 film that tells story of Irish novelist Iris Murdoch and her
relationship with John Bayley. The film contrasts the start of their relationship and their
disease like former U.S. President Ronald Reagan, Harold Wilson, Iris Murdoch, Eddie
Alzheimer’s disease patient care is the road ahead is long and hard. Care giving in
such cases is intensive and prolonged. Hence, caregivers play a very crucial role.
Caregivers need to be educated about the nature of the disease and its progression,
they must be counseled to handle negative emotions and feelings. Caregivers must be
Caregivers need to be alert to alert to signs and symptoms of stress and burn out.
Often carers neglect themselves teaching them to listen to their own bodies, respond to
their own needs and maintain a regular regime of self care is essential.
disease among 150 community dwelling persons aged over 45, who did not have a closed
relative diagnosed with Alzheimer’s disease, participated in the study, result found that
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about Alzheimer’s symptoms overall, was fair, only a slight percentage reported memory
problems to be symptoms of the disease. The study concluded the efforts to increase
developing Alzheimer’s disease in a sample of healthy adults. Survey method was used.
127 young adult and 118 older adults participated. Younger adults obtained a score of 54
percent, while older adults obtained 58 percent on knowledge test. Knowledge and fear
scores were not significantly correlated with having a family member or knowing
four ethnic groups of older adults. Participants were ninety six Anglo, 37 Latino, 30
Asian and 30 African American older adults completed a short survey about Alzheimer’s
disease. The result suggest that certain minority groups do not have sufficient information
about Alzheimer’s disease, and this may explain the lack of Alzheimer’s disease service
use by minorities.18
The investigator during his clinical posting and his interactions with the adults in
the community has observed that adults have the lacunae in their knowledge bank on
Alzheimer’s disease. The investigator also observed various myths and misconceptions
about Alzheimer’s disease. There were no studies conducted in Bangalore to assess the
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Nurses are a vital sources in educating the public on various health related issues.
Alzheimer’s disease. Furthermore, the study of this kind will serve as guidelines for
future nurses to provide comprehensive care for Alzheimer’s disease and remember those
Keeping above facts in view the researcher is keen to assess the knowledge of
adults regarding Alzheimer’s disease so that the knowledge gaps can be filled up by
educating the public and increasing the awareness about Alzheimer’s and to accept an
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Statement of the problem
Objectives
selected community.
2. To find out the association between the level of knowledge and selected
demographic variables.
Operational Definitions
knowledge questionnaire.
selected community.
10