1
SYNOPSIS PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
MR. GEORGUKUTTY MATHEW FIRST YEAR M.SC (NURSING) PSYCHIATRY NURSING YEAR 2011-2013
DHANWANTARI COLLEGE OF NURSING NO. 41/3, MAJ CAMPUS, NEAR CHIKKABANAVAR RLY STN, HESARAGHATTA ROAD, CHIKKABANAVAR POST BANGALORE – 560 090 2
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA SYNOPSYS PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. NAME OF THE CANDIDATE AND Mr. GEORGUKUTTY MATHEW ADDRES 1ST YEAR M.Sc (NURSING) DHANWANTARI COLLEGE OF NURSING, NO. 41/3, MAJ CAMPUS, NEAR CHIKKABANAVAR RLY STN, HESARAGHATTA ROAD, CHIKKABANAVAR POST BANGALORE – 560 090
2. NAME OF THE INSTITUTION DHANWANTARI COLLEGE OF NURSING, NO. 41/3, MAJ CAMPUS, NEAR CHIKKABANAVAR RLY STN, HESARAGHATTA ROAD, CHIKKABANAVAR POST BANGALORE – 560 090
3. COURSE OF THE STUDY AND 1ST YEAR M.Sc (NURSING), SUBJECT MENTAL HEALTH NURSING
4. DATE OF ADMISSION TO THE 15-06-2011 COURSE
5. TITLE OF THE STUDY “A STUDY TO ASSESS THE EFFECTIVENESS OF PRANAYAMA ON DEPRESSION AMONG OLD AGE PEOPLE RESIDING IN SELECTED OLD AGE HOMES AT BANGALORE. ” 3
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
“You do not heal old age. You protect it; promote it; you extend it”.
Sir James Sterling Ross
Ageing is a universal phenomenon, which is experienced by every human being across various cultures. The experience of ageing is unique to every individual because of the individual differences in personalities, varying social support networks and differing according to the culture to which one belongs. Also aging involves many major life changes and is a psychological step, or a transition, that alters one’s relation to the world and demands new responses.1
The Indian family has traditionally provided natural social security to the old people. However, in more recent times, the traditional role of the family is being shared by institutions such as old age homes. Many of the elderly parents are compelled to leave their children and stay in old age homes. The old age homes, which were a rarity, have recently spread across the country, a fact that indicates the growing rift between the generations.2
According to the survey conducted by the Madras Institute of Ageing, there were 529 old age homes in India in 1995 (Krishnan Nair, 1995). Help age India has reported that there were 700 old age homes in 1998 (Help age India, 1998). Our discussion is based on data released by the Madras Institute on Ageing. India had only
96 old age homes before 1950; another 94 were added in the next two decades (1951-
70). During the next two decades, there was a rapid expansion in the number of old age homes in the country y. As of 1995, Kerala State led the rest of the country with
102 old age homes, followed by Tamil Nadu (94) and Maharashtra (65). South India 4
(Kerala, Tamil Nadu, Karnataka and Andhra Pradesh) accounts for 275 old age homes forming 52 per cent of the total.3
Elderly depression can be quite common as ageing presents its own set of challenges - many elderly people have to face some very difficult situations where certain health conditions could be taking a toll on the person on the one hand and, on the other, failing health or death of a spouse could contribute heavily to depression in the elderly.4
Sometimes, people who have led a fairly independent life might be required to depend on another because of disabilities and coming to terms with these changes and challenges can be heart wrenching for the elderly. In such cases, it is only natural one begins to feel terribly lonely and in the absence of a support system in terms of spouse, family, and friends, elderly depression sets in during old age.4
While it is common for older people to suffer from elderly depression, very few actually seek professional help on time. In the absence of a spouse and children, who are busy with their own lives, everyone fails to pay attention to the subtle signs and symptoms of depression. The general mindset is to attribute these signs and symptoms of elderly depression as part of growing old.3
So the researcher is interested to use the pranayama on reduction of depression among old age persons because the prevalence rate was more among elderly persons.
Pranayama will have greater impact on the improvement of the emotional status of old age persons and it will change the attitude of elderly persons to accept the old age a global phenomenon.7
6.1 NEED FOR THE STUDY 5
Demographic ageing is a global phenomenon. By 2025, the world's population is expected to include more than 830 million people at an age of 65. With a comparatively young population, India is still poised to become home to the second largest number of older persons in the world. Recent statistics related to elderly people in India,(according to census 2001), showed that as many as 75% of elderly persons were living in rural areas. About 48.2% of elderly persons were women, out of whom
55% were widows. A total of 73% of elderly persons were illiterate and dependent on physical labor. One-third was reported to be living below the poverty line, i.e., 66% of older persons were in a vulnerable situation without adequate food, clothing, or shelter.8
About 90% of the elderly were from the unorganized sector, i.e., they have no regular source of income. The socio-economic problems of the elderly are nowadays aggravated by factors such as the lack of social security and inadequate facilities for health care, rehabilitation etc. Living arrangements of older people are influenced by several factors such as gender, health status, and presence of disability, socio- economic status and societal traditions. To overcome these problems and to ensure a good, healthy and quality life, the elderly members of the society can move a long way with the support of the family members as well as the other society members. 9
However, of all the problems associated with an aging population, health care demands the top priority. Ageing is a time of multiple illness and general disability.
Along with the changes in the biological compositions, life style factors are also important for disorders and diseases in old age. Old age diseases are not always curable, implying a strain on financial as well as physical health infrastructure resources. However, the feeling of well- being can still override actual physical discomforts if the surrounding environment is nurturing.10 6
Although depression in the elderly is a common problem, only a small percentage gets the help they need. There are many reasons depression in older adults is so often overlooked: Some assume seniors have good reason to be down or that depression is just part of aging. Elderly adults are often isolated, with few around to notice their distress. Physicians are more likely to ignore depression in older patients, concentrating instead on physical complaints. Finally, many depressed seniors are reluctant to talk about their feelings or ask for help.7
By providing the findings of the various literatures made on the health status of elderly, it could able to understand the need for the study.
6.2 REVIEW OF LITERATURE
Review of literature is an important step in the development of any research project. It helps the investigator to analyze what is known about the topic and to describe method of inquiry used in earlier world including their success and short comings. It gives a broad understanding of the problem keeping those aspects in mind of the investigator. Probed in to available resource of the document, informations and studies related to pet therapy and its relation on depression among old age.
The review of the literature is an extensive systematic scrutinization of potential sources of previous study and work. This process helps in identification and selection of problem, back ground of the study, formation of the tool, choosing the methodology, formulating hypothesis. (Polit and Hungler 1990).
Review of literature of the present study was arranged under the following headings:
1. Literature related to prevalence and incidence of depression
2. Literature related to management of depression. 7
3. Literature related to effectiveness of pranayama in reducing depression
among old age people.
1. Literature related to prevalence and incidence of depression
A T Beekman, (2000) conducted a study to assess the prevalence of depression in later life. The objective of the study was to assess the prevalence of late-life depression in the community. Systematic review of community-based studies of the prevalence of depression in later life (55+). This study concluded that there is consistent evidence for higher prevalence rates for women and among older people living under adverse socio-economic circumstances.12
Dyer CB, (2000) conducted a study to assess the prevalence and incidence of depression and dementia in neglected patients. The objective of the study was to describe the characteristics of abused or neglected patients and to compare the prevalence of depression and dementia in neglected patients. They selected Baylor
College of Medicine Geriatrics Clinic at the Harris County Hospital District (Houston,
Texas). Standard geriatric assessment tool has used./ this study revealed that there was a statistically significant higher prevalence of depression (62% vs 12%) and dementia
(51% vs 30%) in victims of self-neglect compared to patients referred for other reasons.13
David C. Steffens,(2000) conducted a study to assess the Prevalence of
Depression and Its Treatment in an Elderly Population examined the current and lifetime prevalence of depressive disorders in 4559 nondemented individuals aged 65 to 100 years. This sample represented 90% of the elderly population of Cache County,
Utah. Using a modified version of the Diagnostic Interview Schedule, we ascertained past and present DSM-IV major depression, dysthymia, and subclinical depressive disorders. This study concluded that these estimates for prevalence of major 8 depression are higher than those reported previously in North American studies.
Treatment with antidepressants was more common than reported previously, but was still lacking in most individuals with major depression. The prevalence of subsyndromal depressive symptoms was low, possibly because of unusual characteristics of the population.14
Patricia A. Parmelee, (2002) conducted a study Depression Among
Institutionalized Aged: Assessment and Prevalence Estimation. Aged nursing home and congregate apartment residents were screened for symptoms of depression and cognitive impairment. Of 708 survey respondents, 12.4% met DSM-IIIR criteria (33) for major depression; about half this group also displayed significant cognitive deficits. Another 30.5% of the total sample reported less severe but nonetheless marked depressive symptoms. Such “minor” depressive syndromes were much more common among congregate housing than nursing home residents. Possible major depression was more prevalent among newly admitted residents of both housing components.15
K. Jongenelis, (2004), conducted a study Prevalence and risk indicators of depression in elderly nursing home patients: the AGED study. Prevalence and risk indicators of depression were assessed in 333 nursing home patients living on somatic wards of 14 nursing homes in the North West of the Netherlands. Depressive symptoms were measured by means of the Geriatric Depression Scale (GDS). This study showed that The prevalence of depression in the nursing home population is very high. Whichever way defined, the prevalence rates found were three to four times higher than in the community-dwelling elderly.16
Ryan J. Anderson, (2008), conducted a study The Prevalence of Comorbid
Depression in Adults With Diabetes. The objective of the study was to estimate the 9 odds and prevalence of clinically relevant depression in adults with type 1 or type
2 diabetes. A total of 42 eligible studies were identified; 20 (48%) included a nondiabetic comparison group. In the controlled studies, the odds of depression in the diabetic group were twice that of the nondiabetic comparison group (OR =
2.0, 95% CI 1.8–2.2) and did not differ by sex, type of diabetes, subject source, or assessment method. This study concluded that The prevalence of co morbid depression was significantly higher in diabetic women (28%) than in diabetic men (18%), in uncontrolled (30%) than in controlled studies (21%).17
6.3(A) STATEMENT OF THE PROBLEM
“A study to assess the effectiveness of Pranayama on depression among old age peoples residing in selected old age homes at Bangalore.”
6.3(B) OBJECTIVES OF THE STUDY
To assess the level of depression among old age peoples before pranayama.
To find out the effectiveness of Pranayama by post test scores of depression
among old age peoples
To compare the pre and post test level of depression among old age peoples.
To determine the association between the level of depression and selected
demographic variables of old age people residing in selected old age homes at
Bangalore.
6.3(C )OPERATIONAL DEFINITION
Effectiveness: It refers to the outcome of Pranayama in reducing depression among old age people residing at selected old age homes at Bangalore.
Pranayama: Pranayama is the art of harmonizing breathing. It has the capacity of freeing the mind from stress. 10
Depression: The level of mood such as feeling of loneliness, decrease passion for life, feeling of unworthiness which is measured by using geriatric depression scale.
Old age people: Refers to the individual who are above 60 years of age living in selected old age homes at Bangalore.
Old age homes: It is a place where deserted elder people are looked after with compassion and their basic needs are fulfilled.
6.3(D) RESEARCH HYPOTHESIS
H1. There will be a significant difference in the depression level before and after pranayama among old age people.
H1. There will be significant association between the level of depression among old age persons and selected demographic variables .
6.3(E) ASSUMPTION.
The study is based on the assumption that:
1. Old age peoples residing at old age homes have more chance for experiencing
depression.
2. Successful administration of Pranayama makes positive changes in the level of
depression.
6.3(F) LIMITATION
Old age people those who are residing at selected old age homes at Bangalore.
Old age persons those who are above 60 years.
The data collection period is limited to 6 weeks.
This study is limited to Old age peoples who are willing to participate in the
study.
7. MATERIALS AND METHODS
7.1 Sources of data 11
Data will be collected from old age peoples residing in selected old age homes at Bangalore.
7.2 Methods of data collection
Structured interview schedule will be used to collect the data.
Research design
Quasi Experimental Design[one group pre and post test design].
I. Research approach
Evaluative Approach
II. Research variables
a. Dependent variables
Depression among old age peoples residing in selected old age homes at
Bangalore.
b. Independent variables
Pranayama
c. Extraneous variables
d. Characteristics of old age people such as Age, Sex, Education,
Occupation, Religion, Marital status, Type of family, Duration of visit
by the family members, Hobbies and Reason for staying in the old age
home.
III. Setting
Study is planned to conduct in selected old age homes at Bangalore.
IV. Population
Old age peoples residing in selected old age homes at Bangalore.
V. Sample 12
Old age peoples residing in selected old age homes at Bangalore. The sample size
will be 60.
VI. criteria for sample selection
a) Inclusion criteria
Old age peoples residing in selected old age homes at Bangalore.
Old age peoples who can communicate freely in Kannada or English.
Old age people those who are in the age of 60 and above.
Those who are available at the time of study.
Old age persons those who are having depression.
b) Exclusion criteria
Old age peoples who are restricted to pranayama.
Those who are suffering from any chronic physical and mental illness.
VII. Sampling Technique
Simple random sampling
VIII. Tool for data collection
The data was collected by using Geriatric Depression Scale to assess the level of
depression among old age persons. Tool consists of two parts:
Part I: Demographic variable.
Part II: Geriatric Depression Scale.
IX. Methods of data collection
After obtaining permission from concerned authority an informed consent
from samples, the researcher will collect data from samples before and after
pranayama.
X. Plan for data analysis 13
Descriptive and inferential statistics will be used to analyze the data.
XI. Projected outcomes
After the study, the investigator will able to know the Level of Depression among old age peoples, based on the findings. Pranayama will be administered to old age peoples. It will help them to reduce the level of Depression.
7.3 Does the study requires any investigation or intervention to the patient or other human being or animal?
No
7.4 Has ethical clearance been obtained from the concerned authority to conduct the study?
Not applicable. 14
8. LIST OF REFERENCES
1. Annette G. Luckenotte (1996), “Gerentological Nursing”, Philadelphia,
Mosby year book publications.
2. Barbara Fadem, “High yield psychiatry“, Lippincott willams and willkers,
2nd edition, Pp : 56-60, 2003.
3. Bellack Alan S, “Hand book of behaviour therapy in psychiatric setting”,
Plenum press, New York, London, Pp : 269 – 280, 1993.
4. Bellack, Alan S and Herson Michel, “Dictionary of behavioural technique
and therapy”, Paragons press, New York, 1985.
5. Bhatia M.S, “A Concise text book of psychiatric nursing”, C.B.S publishers
and distributors, Delhi reprint, Pp : 180, 1977.
6. Butler J and Richard, “ Behaviour and Rehabilitation ”, Bristol, John
Wright and Sons Ltd, Pp : 68-90, 1978.
7. Dunton Ruth William, “Occupational therapy principles and practice”,
Licht Sidney, U.S.A, 2nd edition, Pp : 177 – 180, 1957.
8. Fontaine and Fletcher, “Mental Health Nursing“, Addison – Werley,
Longman, 4th edition, Pp : 283-296, 1999.
9. Helen C. Anderson et al. (1971), “Geriatric Nursing”, The C.V Mosby
compony, 5th Edition.
10. Irvin R.E. (1998), “The Older Patients”, New York, Hodder and Stoughtan
publishers, 3rd Edition.
11. Jennie Kay et al. (1989), “Nursing Care for the Aged”, Appleton Lang
publications, USA.
12. A T Beekman, (2000), The British Journal of Psychiatry, Volume :
174: Page No: 307-311, http://bjp.rcpsych.org/content/174/4/307.short 15
13. Dyer CB, (2000), Journal of the American Geriatrics Society, Volume :
48(2):Page No: 205-208,
http://ukpmc.ac.uk/abstract/MED/10682951/reload=0;jsessionid=D1AA94090
D2CD2716981AD92F6D50BEB
14. David C. Steffens,(2000), Archives of General Psychiatry, Volume: 57, Page
No:601-607, http://archpsyc.ama-assn.org/cgi/content/abstract/57/6/601
15. Patricia A. Parmelee, (2002), Journal of Gerontology, Volume: 44, Issue:1,
Page No: 39-41, http://geronj.oxfordjournals.org/content/44/1/M22.short
16. K. Jongenelis, (2004), Journal of Affective Disorders, Volume : 83, Issues :
2-3, Page No: 447-449,
http://www.sciencedirect.com/science/article/pii/S016503270400182X
17. Ryan J. Anderson, (2008), Journal Of Diabetes Care, volume: 24, Page No:
106-107, http://care.diabetesjournals.org/content/24/6/1069.short 16
9. Signature of the candidate :
10. Remarks of the guide :
11. Name and designation of :
11.1 Guide :
11.2 Signature :
11.3 Co-guide :
11.4 Signature :
11.5 Head of the department :
11.6 Signature :
12. Remarks of the Principal :
12.1 Signature :