RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

1. NAME OF THE

CANDIDATE

AND ADDRESS

MS. LEISHANGTHEM TAMPHASANA DEVI

THE OXFORD COLLEGE OF NURSING

J.P. NAGAR, 1ST PHASE, BANGALORE – 78

2. NAME OF THE

INSTITUTION

THE OXFORD COLLEGE OF NURSING

J.P. NAGAR, 1ST PHASE, BANGALORE – 78

3. COURSE OF

STUDY

DEGREE OF MASTER OF NURSING,

PSYCHIATRIC NURSING.

4. DATE OF

ADMISSION

17.05.07

5. TITLE OF THE

STUDY

ASSESSMENT OF KNOWLEDGE ABOUT

IMPORTANCE OF SOCIAL SKILLS

TRAINING AMONG PARENTS OF

MENTALLY CHALLENGED IN SELECTED

CENTRES OF BANGALORE.

6. BRIEF RESUME OF THE INTENDED WORK “Normal is a useful word for medicine and psychology but otherwise it

is too abstract. When we decide what is normal and what is not normal it

could be very dangerous” (Alexander Jowen)

INTRODUCTION Although no two children are alike, there are general similarities in the

mental and physical development of all normal children. A child cross certain

milestones and developmental levels at expected age limits for attaining normal

growth and development. When there is delay in attaining milestones and a

child is not attaining the normal development levels then the child is said to

have some disability.1 One of the common abnormalities in children in mental

retardation. Mental retardation is a developmental disability that is marked by

lower-than-normal intelligence and limited daily living skills. Mental

retardation is normally present at birth or develops early in life and can be seen

in children under the age of eighteen.19

A person is regarded as mentally retarded if he or she is unable to dress,

feed, wash or otherwise care for himself or herself, to hold a job or to carry out

most of the other tasks needed to get through an ordinary day.12 Most of the

treatment of mental retardation is to develop their intellectual and functioning

skills to the maximum possible levels. Many retarded now have the opportunity

to attend special preschool program and day school teaching them basic skills

such as bathing and feeding themselves.5 They also provide educational

programs, extracurricular activities and social events developed specially for

retarded children. Social skills’ training is one of them which helps in

socialization and normalization of the child. This training is one type of

behavioral therapy used in persons who have marked deficits or who fail to

employ social skills aptly to achieve their social goals.19

Social skills trainings are taught in a manner to learn through doing. They

repeatedly practice social interaction in a step by step manner. The process of

repetition helps solidify social learning so that they are able to function socially

on their own.13A multidisciplinary approach including nurses, social workers

associations and parents to achieve the goals of this training. There is no doubt

that the best place for mentally challenged children to grow up is their own

family.2

So the parents should be trained as co therapist for social skills training of

such children.

6.1 NEED FOR THE STUDY “Disability is natural. We must stop believing that disabilities keep a

person from doing something.”(Benjamin Snow)

It is estimated that there are between 5-8% children who are

handicapped in some way or the other. Significant among them would be the

blind, orthopedically handicapped, mentally retarded and those with learning

disabilities. The prevalence of mental retardation is estimated to be

approximately 3% of global population (2006).There are 27 schools at

Bangalore where special training is given to them.1

The types of mental retardation are given below.

1. Mild mental retardation

Approximately 95% of the mentally retarded population is in the mildly

retarded category. Their IQ score ranges from 50-70,and they can often acquire

academic skills upto above the sixth grade level.3

2. Moderate mental retardation

About 10 % of the mentally retarded population is considered moderately

retarded. Moderately retarded persons have IQ scores ranging from 35-55.They

can carry out work and self-care tasks with moderate supervision.3

3. Severe mental retardation

About 3-4% of the mentally retarded population is severely retarded.

Severely retarded persons have IQ scores of 20-40.They may master very basic

self care skills and some communication skills. Many severely retarded

individual are able to live in a group home.3

4. Profound mental retardation

Only 1-2 of the mentally retarded population is classified as profoundly

retarded. Profoundly retarded individuals have IQ their scores under 20-

25.They may be able to develop basic self care and communication skills with

appropriate support and training.3

A major crisis is undergone by parents when their child is diagnosed with

mental retardation.8As every human being learns to cope with various situation

from time to time in order to survive, a lot of adjustment and coping is needed

on the part of parents.4

A study by Aharoni H (2000) in mentally retarded reveals that intellectually

challenged person needs specially designed instructional approach and positive

social attitude. They have developmental delays in acquisition of basic motor

skills. A social attitude of equality and acceptance play a major role in

managing such children.15

A study by Levy, Shiff R (1986) examines the functioning of families with a

mentally retarded young child based on the maternal, paternal and child

interactions. 40 families were observed. In families with retarded child there

was less frequent maternal behaviour towards the child, less frequent

communicative behaviour of the retarded child towards the parents. More

frequent spousal interchanges were also noticed with regard to the child. This

study reports that special home based interventions were needed for families

with mental retardation.18

The need for parent’s involvement in care was exposed by Hornby G and

Murray R (1983).In their study programmes were conducted with groups of

parents of school aged mentally challenged children. It involves six to eight

children weekly two hourly sessions. Discussion was led by educational

psychologists using a combination of reflective and behavioural procedures. By

means of post programmed questionnaires and attendance checks it was

evaluated that the programmes were valuable to the parents.17

Parents can’t change the retarded child’s potential; they can’t give him more

ability; they can’t control all of his behaviour. In social learning, however,

where experience, training and attitude are so important, parents can make a

very positive contribution in helping their children how to get along

comfortably with other people within their environment.9

From the above studies and facts it is revealed that parents are the primary

care giver and they must be aware of the new trends in training of mentally

challenged. Hence the researcher felt the need of investigating the knowledge of

parents regarding social skills training of mentally challenged so that their

knowledge can be updated.

6.2 REVIEW OF LITERATURE “A lot of people with a disability say, ‘ This is who I am .I don’t come here

hoping my disability will go away , but because I want to participate”

(Carolyn R Thompson)

Review of literature can be classified under the following headings

Reviews regarding social skills training of mentally challenged

Reviews on knowledge of parents regarding social skills training

Reviews regarding information booklet

1. Social skills training of mentally challenged

An investigation on effectiveness of social skills training among children

with behavioural problems was done by Wong Y, Liu C and Wang YF

(2007).Children (n=101) with behavioural disorders were selected as sample.

Before intervention the score was of no difference. After interventions the score

improved significantly. This study reveals that socials skills training is

acceptable and is helpful in improving psychosocial competence for children.14

A study on prediction of social skills in 6 year old children with or without

developmental delays by Jason KB, Rachel MF, Keith AC, Bruce LB (2007)

reveals that social skills impairment are more easily predicted in children with

developmental delays. It was done on 66 children with retardation and 106

children without retardation. It also suggest that emerging social skills are tied

to children’s early developmental status, regulatory skills and supportive parent

child interaction.6

In a unique experiment, Navjyoti trust for vocational rehabilitation in

Chennai (2001) was able to modify the learning environment to successfully

teach the skills of light engineering assembly for mentally retarded children.

Work of a high quality is accomplished by individuals with retardation and

there is a long list of small and large scale industries that have been successfully

able to utilize these individuals.11

2. Knowledge of parents regarding social skills training

Vimala D, Anantha Kumari Rajan, Rajeswari Siva and Deepa Braganza

(2001) have done a study on the assessment of knowledge and attitude of family

members of clients with mental illness. The study was done on family member

living living and accompanying the clients with mental disorder.70% of the

families interviewed were men. It reveals that educational interventions are

necessary to improve the general knowledge of family members regarding

mental illness. An improvement in the attitude towards mentally ill persons

among the public and the first level health care providers will lead to better

practices, early identification of illness.16

The family of an intellectually disabled child need interactive psycho

education for changing the attitude of parents with such children based on a

study by Russell PS, John J K and Lakshmanan JL (1999).Fifty seven parents

randomized to ten weeks of experimental and control therapy was assessed

using the parental attitude scale. The result was that interactive group psycho

education is effective for changing attitudes of parents with intellectually

disabled child.20

The effectiveness of three parents teaching skills on a series of tasks with

handicapped students was studied Cowart JD, Iwata BA, and Poynter H

(1984).The parents’ behaviour modification skills were assessed via the teacher

and students. Training in behaviour modification skills were introduced in a

multiple baseline design across subjects. The result of the study was that the

training produced noticeable gains in both parent and student performance on

tasks that were different from those use during training.21

3. Information booklet

The Longitudinal Interval Follow-up Evaluation is an integrated system for

assessing the longitudinal course of psychiatric disorders. It consists of a semi

structured interview, an Instruction booklet, a coding sheet, and a set of training

materials. An interviewer uses it to collect detailed psychosocial,

psychopathologic, and treatment information for a six-month follow-up

interval. The weekly psychopathology measures are ordinal symptom-based

scales with categories defined to match the levels of symptoms used in the

Reasearch Diagnostic Criteria. The ratings provide a separate, concurrent record

of the course of each disorder initially diagnosed in patients or developing

during the follow-up. Any DSM-III or Research Diagnostic Criteria disorder

can be rated with the life and any length or number of follow-up intervals can

be accommodated. The psychosocial and treatment information is recorded so

that these data can be linked temporarily to the psychiatric status ratings. This

shows the uses of information books and coding sheets on assessing psychiatric

disorders (2006).22

A study by Ruby Johnson (2004) on psychotropic drugs knowledge on

nurses uses an information booklet to provide additional knowledge to the

nurses. The result was that an information booklet on psychotropic drugs has

made the nurses to learn about psychotropic drugs easily.10

Hudson AM and Matthew JM’s (2001) study on evaluation for children

with intellectual disabilities and challenging behaviors. An intervention system

with booklets, workbook, videotape and instructional manuals was provided.

The intervention system helped parents learn easily about intellectual

disabilities and challenging behavior than those parents who were not provided

with any interventions.23

A study on legal responsibilities towards patients’s care by Prema Paul

(2000) implied that all nurses should be provided with information booklet that

may help them for independent learning to improve their knowledge regarding

legal responsibilities. The information booklet will also serve as a ready

references in case there is any disparity between the nurse, patient and the

management .7

STATEMENT OF THE PROBLEM: A STUDY TO ASSES THE KNOWLEDGE ABOUT IMPORTANCE OF

SOCIAL SKILLS TRAINING AMONG PARENTS OF MENTALLY

CHALLENGED IN SELECTED CENTRES OF BANGALORE.

6.3 OBJECTIVES OF THE STUDY:

6.3.1 To asses the knowledge about importance of Social Skills Training

among parents of mentally challenged.

6.3.2 To find out the association between knowledge about importance of

Social Skills Training and selected demographic variables.

6.3.3 To develop and informational booklet on Social Skills Training of

Mentally Challenged.

6.4. NULL HYPOTHESIS: HO. There is no significant association between knowledge about

importance of Social Skills Training and selected demographic

variables.

VARIABLES:

DEMOGRAPHIC VARIABLES-Age, sex, education, family income support

from other family members

RESEARCH VARIABLES- knowledge about importance of Social Skills

Training among Parents of Mentally challenged children.

6.5 OPERATIONAL DEFINITIONS: 1. Knowledge: Understanding of parents of mentally challenged about

importance of Social Skills Training.

2. Parents: Mother or father of mentally challenged attending parent’s

association for mentally challenged.

3. Social Skills Training: A kind of behaviour therapy used in persons

Who have marked deficit in social skills.

4. Selected centres: Association of parents of mentally challenged at

Bangalore.

5. Mentally challenged: Children within the age group of 5-12

Years, diagnosed as having mental retardation.

6. Information booklet: A material containing facts on Social Skills

Training of Mentally Challenged.

6.6 ASSUMPTIONS: 1. Parents of mentally challenged will be having inadequate knowledge

about Social Skills Training.

2. Parents will give free and frank responses.

6.7 DELIMITATIONS: The study is limited to the parents of mentally challenged attending parents

association for mentally challenged.

7.0 MATERIAL AND METHOD:7.1.0 SOURCES OF DATA:

Data will be collected from parents attending parents association for

mentally challenged.

7.2.0 METHOD OF COLLECTION OF DATA:

Data will be collected from the study sample by using Structured Self

reporting Questionnaire.

7.2.1 RESEARCH APPROACH:

A descriptive survey approach.

7.2.2 RESEARCH DESIGN:

Non experimental descriptive design.

7.2.3 RESEARCH SETTING:

The study will be conducted in selected parent’s association for mentally

challenged at Bangalore.

7.2.4 POPULATION:

Population consists of parents attending parent’s association for mentally

challenged.

7.2.5 SAMPLE SIZE:

60 parents attending parent’s association for mentally challenged at

Bangalore.

7.2.6 SAMPLING TECHNIQUE:

Purposive sampling technique.

7.2.7 SAMPLING CRITERIA:

INCLUSION CRITERIA:

1. Parents who are willing to participate in the study.

2. Parents who can read and write Kannada and English.

EXCLUSION CRITERIA:

1. Parents who are not willing to participate in the study.

2. Parents who cannot read and write Kannada and English.

7.2.8 DATA COLLECTION TOOL:

The researcher herself will construct the following tools to gather data from

the study sample.

A Structured Self reporting Questionnaire, which consists of:

PART: 1.Demographic Proforma

PART: 2 Knowledge Questionnaire on importance of Social Skills Training

of Mentally Challenged.

7.2.9 DATA ANALYSIS METHOD:

The researcher will use appropriate descriptive and inferential statistical

method for analyzing the data.

Descriptive statistics: Mean, Median, Mode and Standard deviation.

Inferential statistics: Chi square (X2) will determine the association between

knowledge and selected demographic variables.

The result will be presented in the form of tables, diagrams and graphs.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION TO

BE CONDUCTED ON PATIENTS OR HUMAN OR

ANIMALS? Yes,

Parents of mentally challenged attending parent’s association for mentally

challenged are involved in this study.

7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM

YOUR INSTITUTION?

Yes,

1. The ethical clearance is obtained from the research committee of The

Oxford College of Nursing.

2. The ethical clearance will be obtained from the selected parent’s

association for mentally challenged at Bangalore.

3. Informed consent will be obtained from the subjects who are willing to

participate in the study.

8. LISTS OF REFERENCES:1. Bhatia M.S.Essentials of Psychiatry.5th Edition.New Delhi(India) Satish

Kumar Jain Publishers;2006.

2. Gelder M, Gath D, Mayon R, Oxford textbook of Psychiatry .2nd Edition.

Walton Street: Oxford; 1989.

3. Sreevani R, Mental Health and Psychiatric Nursing.2nd Edition.New Delhi

(India): Jaypee Brothers Medical Publishers;2007.

4. Stuart GW, Laraia TM. Principles and Practice of Psychiatric Nursing.8 th

Edition.St.Louis (Missouri): Mosby; 2005.

5. Magana S, J Seth, Rubert MP. Hispanic Care Giver of Adults With

Mental Retardation. Importance of Family Functioning. American Journal

on Mental retardation: 2006; 111(4):250-262.

6. Baker K.J, Fenning MR,Crnic AK, Bak LB, Blacher Jan. Prediction of

Social Skills in 6 year old children with and without developmental delays,

contribution of early regulation and maternal scaffolding. American Journal

of Mental Retardation: 2007; 112(5):375-391.

7. Paul Prema Nurses’ knowledge of their responsibilities towards patient

care. The Nursing Journal of India: 2000; 58(9):200-201.

8. Cunic AK, Baker LB. Parenting children with Borderline Intellectual

Functioning: A unique risk population:2007:112(2);107-121.

9. Blodget EH. Mentally Retarded Children What Parents and Others Should

Know.2nd Edition. United States of America. North Central Publishing Co;

1992.

10. Johnson R. A Study to assess the knowledge of nurses regarding

Psychotropic drugs, Unpublished Master of Nursing Dissertation, Rajiv

Gandhi University of Health Sciences.2004.

11. WHO. Mental health and substance abuse. WHO report 2001(Navjyoti

Trust)

12. Proceedings of the 7th International portage conference; 2000; Hiroshima

(parents and self help groups)

13. Social skills training (editorial). Life watch employee assistance program

2000: 103.

14. Y Wang, C Liu, YF Wang. Effectiveness of social skills training among

children with behavioral problem. Beijing Da Xue Xue Bao 2007:39(3):315-

8

15. Aharoni H. Adapted physical activities for the intellectually challenged

adolescent: psychomotor characteristics and implications. International

journal on adolescent medical health. 2005;17(1): 33-47.

16. Vimala, Rajan KA. The knowledge attitude and practices of family

members of clients with mental illness. The Nursing Journal of India. 2003;

444:223-224.

17. Hornby G, Murray R. Group programmes of parents of children with

various handicaps. 1983; 9(4):185-189.

18. Levy, Shiff r. Mother father interaction in families with a mentally

retarded young child. 1986; 91(2):141-9.

19. Bozikas VM “Dycontrol with mental retardation”, The New York Times.

2001. (Col 5).

20. Russell PS, John JK, Lakshmanan J.Family intervention for

intellectually disabled child. Journal of psychiatry. 1999; 174:254-8

21. Cowart JD, Iwata BA, Poynter H. Generalization and maintenance in

training of parents of the mentally retarded. Research on mental retarded.

1984; 5(2): 233- 44.

22. Keller MB, Lavori PW, Freedman B. Longitudinal follow up Evaluation.

General Psychiatry. 1987; 44(6):540-8.

23. Hudson AM, Mathew JM. Evaluation of Intervention system for Parents

of children with Intellectual disabilities. Journal of pediatrics 2005:56:164-7.

9. SIGNATURE OF THE STUDENT:

10. REMARKS OF THE GUIDE: The research topic is relevant as it

helps the parents to attend well to

the needs of their mentally

challenged child.

11.0 NAME AND ADDRESS OF THE GUIDE:

11.1 NAME AND ADDRESS: Mrs. Simi Thomas

Assistant Professor,

Head of the Department,

Psychiatric Nursing,

The Oxford College of Nursing,

1st Phase, J.P. Nagar,

Bangalore – 560 078

11.2 SIGNATURE OF THE GUIDE:

11.3 HEAD OF THE DEPARTMENT:

NAME AND ADDRESS: Mrs. Simi Thomas,

Assistant Professor,

Head of the Department,

Psychiatric Nursing,

The Oxford College of Nursing,

1st Phase, J.P. Nagar,

Bangalore – 560 078

11.4 SIGNATURE OF THE HOD:

12 REMARKS OF THE PRINCIPAL:

The research topic selected is

relevant as the study attempts

to empower the parents mentally

challenged regarding knowledge

of Social Skills Training.

Dr. G Kasthuri

Principal/ Professor

The Oxford College of Nursing

1st Phase, J.P. Nagar,

Bangalore – 560 078

12.1 SIGNATURE OF THE PRINCIPAL: