RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. NAME OF THE MR. SHAHOOD KOTTARATHEL CANDIDATE AND FIRST YEAR M.Sc. NURSING ADDRESS DAYANANDA SAGAR COLLEGE OF NURSING, KUMARASWAMY LAYOUT,BANGALORE-78
2. NAME OF THE DAYANANDA SAGAR COLLEGE OF INSTITUTION NURSING
3. COURSE OF STUDY DEGREE OF MASTER OF SCIENCE IN NURSING MENTAL HEALTH NURSING
4. DATE OF ADMISSION TO COURSE 14.06.2010
5. TITLE OF THE TOPIC A STUDY TO ASSESS THE LEVEL OF STRESS AND COPING AMONG HOMLESS CHILDREN IN SELECTED SOCIAL WELFARE ORGANIZATIONS IN BANGALORE
1 6. BRIEF RESSUME OF THE INTENTED WORK
INTRODUCTION
While we try to teach our children all about life,
Our children teach us what life is all about.
~Angela Schwindt
Today’s children are the future generation of the nation. Their health, wellbeing and fulfillment of basic needs are the major goals to be achieved for the progress of the country. Rapid urbanization and economic instabilities, familial distortions and various other factors making the children to be homeless and running away from their vicinity.
Due to this, there is a greater increase in population of homeless children and teenagers.
Population explosion is also one of the major factors resulting in destitutions and children living on streets. Here they need to be assessed for disturbed emotional status because of various factors like unavailability of medical services, lack of awareness regarding available resources and lack of caretakers. Mostly the homeless children suffer from stress disorders and coping disabilities.
Homeless children have invariably been exploited and marginalized; used as cheap and expendable labor, for sex and for criminal acts. Most are male, their peer relationships, group life and survival strategies are much the same all over the world, although they are usually younger in developing than in developed countries. More recent economic situations (recession), political changes, increasing family disintegration and natural disasters have led to larger numbers of children heading from rural areas and smaller towns to larger cities and their streets. Some come from families which can no
2 longer support them due to poverty and overcrowding, some come to the shelter after being orphaned due to parental death or family disintegration and some are members of whole families who live on the temporary shelters while some are born to the older homeless children.1
Homeless children constitute a marginalized group in most societies. They don’t have what society considers appropriate relationship with major institutions of childhood such as family, education, and health. The continuous exposure to harsh environments and the nature of their lifestyles threatens their mental, physical, social and spiritual wellbeing. Homeless live in transitory life styles and are vulnerable to inadequate nutrition, physical injuries, substance abuse and health problems including sexual and reproductive problems.2
Homeless children may become involved in scavenging, begging, hawking, prostitution or theft to aid their basic survival. Popular images of homeless children portray them as vulnerable to abuse, at risk of poor health, exploited by adults and also very often as criminals or victims. Homeless children throughout the world are exposed to economic, health and social problems: poverty, lack of medical care and risk of substance abuse. They are exposed to physical or sexual abuse, prostitution.3
A study was conducted by a to assess the behavioural problems of homeless children which describes that homeless children are vulnerable to various conduct disorders, tick disorders and emotional disorders. It has been found that homeless children are considered to be negligent and destitute in most of the less developed countries. The study reports that homeless children are showing profound stress and
3 lacking in coping abilities. The study concluded that it is very important to identify the psychological wellbeing, emotional status of homeless children in order to make their behavior and future in a better way.4
Homeless children are confronted with stressful and traumatic events that they often are too young to understand, and this leads to severe emotional distress. More than half of homeless children surveyed said that they worried about their physical safety, especially with regard to violence, guns, and being injured in a fire. Homeless children also experience stress through constant change and these stressful changes accumulate as these children grow older .These children’s stress coping mechanisms are also very poor.
Homeless children are seven times more likely than other children to be placed in foster care. Twenty two percent of homeless children experience foster care or living with relatives, compared with three percent of housed children. As a result of these stressful events, homeless children between the ages of six and 17 have very high rates of mental disorders compared to their peers. One-third of homeless children have at least one major mental disorder and almost half have problems with anxiety, depression, or withdrawal, compared to other school age children. Thirty-six percent demonstrate delinquent or aggressive behavior, compared with 17 percent of other school age children. The stress of homelessness in children can lead to insecure attachments to others, poor self-esteem, and dysfunctional personality development. These conditions manifest themselves in the behavior of homeless children. Often, boys exhibit aggression, while girls exhibit depression and passive or withdrawn behavior. Despite significantly more incidents of mental illness, less than one-third of these children actually receive professional help.5
4 6.1 NEED FOR THE STUDY
Homeless children are introduced to the harsh realities of the world too early. On one side, stressful family environment and on other side ,insecure and risky life.
Homeless children are exposed various types of life situations which cause distress in them. In the harsh atmosphere of their life they will not get the opportunity to learn social skills like coping with emotion ,coping with stress and life events and so on. The children ran away from families as a solution to problems faced at home are not able to acquire life any attempt at improving quality of their life and they will come to unhealthy practices of various natures.
The exact number of homeless children is impossible to quantify, but the figure almost certainly runs into 150 million across the world. UNICEF estimated that there are about 11 million homeless children present in India approximately . It is also estimated that 1 to 1.25 million homeless children are there each in Mumbai, Kolkata, Delhi, and
45000 in Bangalore 6. Another official figure available in 1999,report of DWCD, ministry of HRD, government of India stated more than 11 million homeless children are there in India, of which 4,20,000 – lived in six metropolitan cities of country.7
A group of Indian researchers conducted a study to assess the psychological problems amongst the homeless boys and to determine possible risk factors. It is estimated that there are one lakh homeless children in Delhi. Very little is known about them, their needs or their experiences. The result of the study was 20.7% of children were found to have high hopelessness and 8% of children had depression. 2% of children revealed that they had attempted suicide at various situations of life. Among children with high hopelessness, 3.2% had ever attempted suicide. 8.3% of the depressed children
5 gave history of suicidal attempts. 38% of children gave history of physical abuse, 14.6% of sexual abuse and a large number reported substance abuse. 69.33% were found to have behavioral problems, 81% of children had antisocial behavior, 7.8% were neurotic and
10.5% remained undifferentiated and concluded that homeless children suffer from a wide array of mental health problems like stress disorders, coping disabilities and so on and there is a need for a broad based psychosocial intervention program and education of stress reduction techniques. 8
A study was conducted to examine the stressors and coping behaviors of school- aged homeless children staying in shelters. A secondary analysis of interview data from
30 children, between the ages of 8 to 12 years, was used to delineate the stressors and coping behaviors. Study reported that homeless, family, self, peer group, school, and violent behavior were the stressor categories derived from content analysis. The children expressed more stresses in the homeless, family, and self categories than in the other 3 categories. The coping behaviors from the content analysis were categorized by using
Ryan-Wenger's (1992) coping taxonomy. The majority of the children's coping responses were in the social support, cognitive avoidance, and behavioral distraction categories.
The study concluded that nurses should assess each child's stressors and coping behaviors when providing care to homeless children, and assist the child in alleviating some stressors by strengthening one's coping. 9
A cross-sectional study was done to explore the differences in the impact of self- reported coping style, self-esteem and perceived support on the psychological adjustment of homeless and housed female youth and the data were obtained from 72 homeless female youth accessing an emergency shelter in a large Canadian urban centre and a
6 comparison group of 102 housed females from local high schools who had never resided in a shelter .The result of the study explained that homeless youth reported lower self- worth, lack of problem focused coping, increased suicidal behaviour, increased stress related problems, less perceived parental support and higher levels of depressive symptoms and both internalizing and externalizing behaviour problems than housed youth. Hierarchical regression analyses indicated that disengagement coping was a significant predictor of depressive symptoms and both internalizing and externalizing behaviour problems in homeless and housed youth. 10
Current study evaluates that how stress, coping strategies, and social support were associated with depressive symptoms, poor physical health, and substance use in homeless youth. Data were obtained from a stratified random sample of 432 homeless youth. Stressful life events were associated positively with symptoms of depression, poor physical health, and substance use. Use of emotion-focused coping strategies increased the risk of symptoms of depression, poor health, and substance-use disorders, whereas use of problem-focused coping strategies decreased the risk of alcohol use disorder and poor health. Social support decreased the risk of symptoms of depression and poor health but was not related to the risk of substance use. Results indicate that effective coping skills and social support may counteract the negative effects of stressful life events on physical and psychological health in homeless youth. 11
As per studies homeless youth are at alarmingly high risk for a myriad of physical and psychological problems as a result of both the circumstances that preceded their homelessness. Sexually transmitted infections (STIs), trauma, tuberculosis, uncontrolled asthma, and dermatologic infestations are a few of the health problems with which these
7 youth commonly present .These somatic problems are compounded by high rates of drug and alcohol abuse as well as depression and suicide. Despite the obvious need for medical services, homeless youth often do not receive appropriate medical care due to numerous individual and systems barriers impeding health care access by this population.
In addition to the barriers experienced by the adult homeless population, homeless adolescents confront further hurdles stemming from their age and developmental stage.
Some of these impediments include a lack of knowledge of clinic sites, fear of not being taken seriously, concerns about confidentiality, and fears of police or social services involvement. Improved access to appropriate health care is necessary if we are to better support and care for this population of young people. The homeless children should be cared with highest priority to reduce incidents of stress disorders and stress coping problems. To effectively manage and treat homeless youth, individual providers must be aware of the diagnoses associated with homelessness, as well as the community resources available to these youth. Finally, providers need to be the voices advocating for improved services for this disadvantaged and silent population. 12
From these findings, it is very clear about the different kinds of daily life situations which lead homeless children to be stressed, and lack of positive coping mechanism to tackle such stressfull situations. such a situation will lead to stress related psychological problems and other psychiatric disorders in homeless children. So researcher felt the necessity to do such a study in Bangalore, where number of homeless children raises day by day.
8 6.2 REVIEW OF LITERATURE
For the present study, the researcher made an extensive review of literature to collect information related to research topic, the researcher has made use of various journals ,research reports ,un published thesis ,texts ,medline research and internet to avail the information pertaining to level of stress and coping among homeless children.
The review of literature for the present study is organized as following:
6.2.1 Studies related to problems faced by homeless children.
6.2.2 Studies related to stress and their affects among homeless children.
6.2.3 Studies related to level of coping among homeless children.
6.2.1 Studies related to problems faced by homeless children
A prospective study was conducted on the neglected health care needs of homeless children and sample was consist of 539 homeless youth . The study reports that homeless children are often the victims of physical and sexual abuse and family chaos.
They have a multitude of health problems such as malnutrition, respiratory infections, sexually transmitted diseases, including human immunodeficiency virus, mental illness, and substance abuse. Health care, if available, is generally fragmented and often not relevant to their needs. Their high-risk existence leads to individual morbidity and has a negative effect on the health of the community. Homeless children were found to have a greater number of problems--both physical and psychological--than the general children.
High-risk behaviors, such as drug abuse and failure to use condoms during sex, make this
9 population especially vulnerable to sexually transmitted diseases, including human immunodeficiency virus. The potential impact on public health is enormous. Adequate access to health services needs to be addressed legislatively .13
A comparative study was conducted to find out the differences between runaways and non-runaways in a mental health clinic and to study differences between runaways in a mental health clinic and legal / shelter system. The researchers passed through the Psychiatric clinical records of runaways and non-runaways 21 cases in each group were studied in various factors. Runaway cases who were in child and adolescent shelters were interviewed by the researchers. The result of the study was : Neglect, sexual abuse, rejection, poverty and truancy were more common in the runaway group. The runaway group had more conduct disorder and substance abuse. Physical abuse, authoritarian and being in custody were more common in runaways in shelters. The research came into a conclusion that Various factors correlate with running away and these children have profound stress and coping disabilities. Some of these factors lie beneath long before runaway has taken place and understanding and managing them help in preventing and prompt treatment. 14
A study was conducted to compare between Latin American and Ethiopian homeless children in terms of victimization, gender, age, reasons for homelessness, family relations and structure, delinquency, drug use, groups and the outcomes of homelessness. In particular, the victimization of homeless children in Ethiopia is examined. The study reported Widespread abuse of homeless children. More than half of the homeless boys questioned reported being "regularly" physically attacked. Homeless
10 life is also highly victimogenic for girls. Sexual offences, in particular, were widespread.
Forty four percent had been raped and a further 26% had been sexually attacked. The study concluded that Similarities between Latin American homeless children and their
Ethiopian counterparts regarding gender, background and life experiences are noted.
Comparisons concerning the victimization of homeless children were not possible, as this is an issue that is relatively unexamined in the Latin American context. 15
A study was conducted to explore homeless youths' histories of exposure to violence, perpetration of violence, and fear of violent victimization, and to examine the extent to which these constructs are associated with demographic variables. A Sample of
432 youth who were homeless were sampled from both service and street sites. The study results explains that respondents reported a high rate of exposure to violence.
Female respondents reported levels of exposure to violence that were as high as those reported by males. Females were more likely to report having been sexually assaulted and fearing victimization, and tended to be less likely to report perpetrating violence.
With a few exceptions, ethnic identity was not a significant predictor of exposure to violence or fear of victimization. Age tended to be inversely associated with risk of exposure to violence. Length of time homeless was not associated with fear of victimization. The study concludes that homeless youth are at high risk for exposure to a variety of forms violence as both witnesses and victims. 16
A study was conducted on homeless youth in psychiatric setting with specific treatment. It was found that homeless youth in treatment had a larger number of social and drug abuse problems than did homeless youth. They were more likely to be unemployed, stressed, and to have behavioral problems, legal problems. They had more
11 depression and lower self-esteem, and use more alcohol and drugs. Discharged homeless and non- homeless youth had similar lengths of stay and drop-out rates in one residential program and similar, although limited, amounts of treatment in outpatient programs. 17
6.2.2 Studies related to stress among homeless children
A study was conducted to review the prevalence literature on psychological distress and psychiatric disorders among homeless youth in Australia, and to compare these rates with Australian youth as a whole. The study result shows that homeless youth have usually scored significantly higher on standardized measures of psychological distress than all domiciled control groups. Youth homelessness studies have also reported very high rates of suicidal behavior. Furthermore, rates of various psychiatric disorders are usually at least twice as high among homeless youth than among youth from community surveys. The study concluded that homeless youth in Australia have extremely high rates of psychological distress and psychiatric disorders. As homeless youth are at risk of developing psychiatric disorders and possibly self-injurious behavior the longer they are homeless, early intervention in relevant health facilities is required.18
A study was conducted to compare the stressors and coping behaviors of homeless, previously homeless, and never homeless poor school-aged children. The data was collected by interview from 132 children . Forty-four (68%) of the homeless children identified at least one stressor related to being homeless. Homeless children experienced more stress in stressors related to the family, self, peers, health, school, and environment.
Significantly more previously homeless and never homeless children identified more social support coping behaviors compared to the homeless children. 19
12 The present study explored stress and depression levels in Canadian homeless youth, as well as the methods they used to cope. Twenty-seven homeless youth and 27 peers who have home responded to a questionnaire investigating history of running away, depression level, coping strategies, family history, and stress. Analyses revealed that these youth have higher levels of stress and depression than non homeless children .
Stress and depression were positively correlated for the homeless youth. There were also differences in coping strategies: homeless youth were more likely to engage in acts of self-harm and to use drugs and alcohol, while non-runaways more frequently resorted to productive problem solving and disclosure/discussion with someone they trust. 20
A study was conducted to examine victimization and stress symptoms among urban homeless adolescents and to test whether emotional numbing and avoidance represent distinct posttraumatic stress disorder (PTSD) symptom clusters and the result of the study was Eighty-three percent of homeless youths were physically and/or sexually victimized after leaving home. Approximately 18% of these youths met research criteria for PTSD. The study concluded that Sexual and physical victimization are serious threats for homeless adolescents, and it leads to high stress in children and those who are victimized are at risk for PTSD. 21
A research study was conducted to assess the level of exposure of psychosocial stressors in homeless children. Study reported high Level of exposure to severe psycho
-social stressors among homeless children in emergency family shelters in an urban locale. The relationship between such exposure and child mental health problems was then investigated, along with the effects of adult family social support. The study
13 revealed that homeless children have high level of stress and stress related psychological problems. 22
A study was conducted to examine the psychological adjustment of 159 homeless children in comparison with a sample of 62 low-income children living at home. In each group, ages ranged from 8 to 17 years. As expected, homeless children were found to have greater recent stress exposure than housed poor children, as well as more disrupted schooling and friendships. Child behavior problems were above normative levels for homeless children, particularly for antisocial behavior. Across the samples, however, behavior problems as well as stress related problems were more related to parental distress, cumulative risk status, and recent adversity than to housing status or income. 23
6.2.3 Studies related to coping among homeless children
A study was conducted to assess impact of coping strategies used by homeless youth upon suicidal ideation, suicide attempts, and feeling trapped/helpless. Coping strategies examined in the analysis included problem-focused and avoidant coping, along with several coping strategies identified in previous exploratory qualitative studies.
Greater risk was associated with avoidant coping, social withdrawal, use of drugs and alcohol as coping, with "belief in a better future" linked to lowered risk levels. Gender interactions emerged with respect to avoidant coping and social withdrawal, both of which served as greater contributors to risk levels among females. Several approaches to coping including problem-focused strategies and strategies identified by youths in previous qualitative works emerged as not serving to ameliorate suicidality.24
14 A study was conducted to investigate the support mechanisms existing among the homeless children in coping with homeless life in Nigeria; and examine the ways of coping strategies homeless children employs that can be incorporated into policy directions in an effort to build a sustainable and workable solution to their problems.
Quantitative technique was used to collect the primary data from the homeless children.
The study reports that homeless children are employing unhealthy coping strategies to cope with the daily stressfull situation. There were varieties of strategies that homeless children employ to cope with difficult life situations. In the total sample, 32.4% engaged in hawking, while 16.4% begged for alms, 19.5% engaged in trading, while 16.5% expressed that they cope through prayers, in order to survive. Some others engaged in forming gangs as a network to assist one another, theft and robbery activities and drug pushing. Many homeless children smoke Indian hemp and take hard drugs to cope with difficult life situations. 25
A study was conducted to evaluate the association among suicide behaviors, high- risk behaviors, coping style, and psychological adjustment in homeless and non-homeless adolescents and data were obtained from 100 homeless adolescents accessing an emergency shelter and comparison group comprised of 70 youth accessing local community drop-in centers that lived with their parents and had never stayed in a shelter .The study results reports that , relative to non-homeless youth, homeless youth presented with a higher prevalence of suicidal ideation, past suicide attempts, depressive symptomatology and decreased level of coping. Disengagement coping was a predictor of suicidal ideation, past attempts, depressive symptoms and both internalizing and externalizing behavior problems in homeless youth. The study concluded that relative to
15 non-homeless youth, findings indicate that homeless youth reported greater use of a
disengaging coping style and are at greater risk for high-risk behaviors, past suicide
attempts, and clinically elevated levels of depressive symptoms and behavior problems.26
STATEMENT OF THE PROBLEM
“A study to assess the level of stress and coping among homeless children in selected social welfare organizations in Bangalore.”
6.3 OBJECTIVES OF THE STUDY
6.3.1 To assess the level of stress among homeless children.
6.3.2 To assess the level of coping among homeless children.
6.3.3 To identify the association between level of stress, level of coping with
selected demographic variables.
6.4 RESEARCH HYPOTHESIS
H1 = There will be significant correlation between stress and coping among homeless
children.
H2 =There will be significant association between selected demographic variables with
the stress and coping among homeless children.
6.5 RESEARCH VARIABLES
DEPENDENT VARIABLE :level of stress and coping.
16 6.6 OPERATIONAL DEFENITIONS
6.6.1 HOMELESS CHILDREN : It refers to children who do not have their own
home and who are living in selected social welfare organizations, with the age
group 8 -15 years.
6.6.2 STRESS : Individual’s reaction to physical, psychosocial and emotional
threats elicited by stress tool.
6.6.3 COPING : Individual’s cognitive and behavioral effort made to master,
tolerate and reduce demand that exceeds person’s resources assessed through
coping tool.
6.6.4 SOCIAL WELFARE ORGANISATION : It is the selected organization
which is providing support, shelter and care for homeless children.
6.7 ASSUMPTIONS
6.7.1 Homeless children may show interest to participate in the study and provide
necessary information.
6.8 DEELIMITATION
6.8.1 Study is delimited to homeless children in selected social welfare organizations
in Bangalore.
17 7 MATERIALS AND METHODS
7.1 SOURCES OF DATA
Data will be collected from homeless children in selected social welfare
organizations in Bangalore.
7.2 METHOD OF DATA COLLECTION
The data for this study will be collected using stress and coping interview
schedule.
7.2.1 RESEARCH DESIGN: Descriptive design
7.2.2 RESEARCH APPROACH: Descriptive approach will be adopted.
7.2.3 RESEARCH SETTINGS : Study will be conducted in selected social
welfare organizations in Bangalore.
7.2.4 POPULATION : population of the present study comprises of all homeless
children in social welfare organizations in Bangalore.
7.2.5 SAMPLE : It is a subset of population selected for the study which comprises of
homeless children In selected social welfare organizations in Bangalore.
7.2.6 SAMLE SIZE : sample size of the present study consist of 50 homeless
children in selected social welfare organizations in Bangalore.
18 7.2.7 SAMLING TECHNIQUE : Purposive sampling technique will be adopted.
7.2.8 SAMPLING CRITERIA :
Inclusion criteria :
1. Homeless children between 8-15 years.
2. Homeless children who are available at the time of study.
Exclusion criteria
1. Homeless children who are not interested to take part in research.
2. Homeless children who are suffering from mental retardation or any chronic
diseases.
7.2.9 TOOLS FOR DATA COLLECTION
Data will be collected by using standardized stress and coping scale by conducting
structured interview schedule
7.2.10 DATA ANALYSIS METHOD :Data analysis will be through descriptive and
inferential statistics
DESCRIPTIVE STATISTICS : Percentage ,mean, median and standard deviation
will be used to explain demographic variables
19 INFERENTIAL STATISTICS : chi- square test will be used to study the
association between level of stress, coping, with selected demographic variables
7.3 DOES THE STUDY REQUIRE ANY INTERVENTIONS TO BE CONDUCTED
ON PATIENTS OR OTHER HUMANS OR ANIMALS?
Yes, homeless children are involved
7.4 HAS THE ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR
INSTITUTION?
- Permission will be obtained from the institutional ethical research committee of
dayananda sagar college of nursing ,Bangalore.
- Permission will be obtained from authorities of selected social welfare
organizations ,Bangalore.
- Informed consent will be obtained from children who are willing to participate in the
study.
20 8. LIST OF REFERENCES
1. http ://www.nimhans.kar.nic.in/deaddiction /lit/Drug%20Abuse%20_Street
%20Children_ Bangalore.pdf
2. Simms MD. Medical care of children who are homeless in foster care. Journal of
current opinion in pediatrics. 1998;10:486-90
3. Andal J Daniodaran. The working child and the street child: effect on future child
development. Summer bulletin of the newyork academy of medicine.
2002;11(3):74-78
4. Goodman L. Homelessness as psychological trauma. Journal of American
psychology. 1999;46(2):219-25
5. Zimma BT. Emotional and behavioural problems and severe academic delays
among sheltered homeless children. American journal of public health.1994;feb
84(2):260-64
6. http://www.slumdogs.org
21 7. Rana A. Street children:a challenge to social work profession. First edition. Tata
institute of social sciences publications, Bombay. 14-15
8. Khurana S, Sharma N. Mental health status of runaway adolescents.
Indian Journal of pediatrics. 2004 May;71(5):405-9
9. Huang CY, Menke EM. School-aged homeless sheltered children's stressors and
coping behaviors . Journal of Pediatric Nursing. 2001 Apr;16(2):102-9
10. Votta E, Farrell S. Predictors of psychological adjustment among homeless and
housed female youth. Journal of adolescent research. 1998 april vol. 13( 2)
134-57
11. Jennifer B. Unger, Michele D. Kipke ,Thomas R. Simon. Stress, Coping, and
Social Support among Homeless Youth. Journal of Canadian academy of child
and adolescence psychiatry. 2009 May;18(2):126-32
12. Feldmann J, Middleman AB. Homeless adolescents: common clinical concerns
Journal of Pediatric Infectious Disease. 2003 Jan;14(1):6-11
13. Sherman DJ. The neglected health care needs of street youth. Public health
report. 2004 Jul-Aug; 107(4):433-40
14. Techakasem P, Kolkijkovin V. Runaway youths and correlating factors, study in
Thailand. Journal of medical association. 2006 Feb;89(2):212-6
15. Lalor KJ. Street children: a comparative perspective. Child abuse and neglect.
1999 Aug;23(8):759-70
22 16. Kipke MD, Simon TR, Montgomery SB. Homeless youth and their exposure to
and involvement in violence while living on the streets .Journal of adolescence.
1997 may; 20(5):360-7
17. Smart RG, Ogborne AC. Street youth in substance abuse treatment: characteristics
and treatment compliance. Journal of adolescence. 1994;29(115):733-45
18. Kamieniecki GW. Prevalence of psychological distress and psychiatric disorders
among homeless youth in Australia: a comparative review. Australian journal of
psychiatry. 2001 June;35(3):352-8
19. Menke EM. Comparison of the stressors and coping behaviors of homeless,
previously homeless, and never homeless poor children. Issues in mental health
nursing. 2000 Oct-Nov;21(7):691-10
20. Ayerst SL. Depression and stress in street youth. Journal of adolescence. 1999;
34(135): 567-75
21. Stewart AJ, Steiman M . Victimization and posttraumatic stress disorder among
homeless adolescents. Jouranal of American academy of child and adolescent
psychiatry. 2004 Mar;43(3): 325-31
22. Zima BT, Bussing R. Psychosocial stressors among sheltered homeless children:
relationship to behavior problems and depressive symptoms. American journal of
orthopsychiatry. 1999 Jan; 69(1):127-33
23. Masten AS, Miliotis D, Graham-Bermann SA . Children in homeless families:
risks to mental health and development. Journal of consultant clinical psychology.
1993 Apr;61(2):335-43
23 24. Kidd SA, Carroll MR. Coping and suicidality among homeless youth. Journal of
adolescence . 2007 Apr;30(2):283-96
25. Oyeniyi, Aransiola J, Melvin. Coping strategies of street children in Nigeria.
Journal of social and psychological sciences. 2009 Jul; 35(3):120-23
26. Votta E, Manion I . Suicide, high-risk behaviors, and coping style in homeless
adolescent males’ adjustment . Journal of adolescenct health. 2004
Mar;34(3):237-43
9. SIGNATURE OF THE STUDENT:
10. REMARKS OF THE GUIDE: The research topic is relevant as the study
helps to identify the level of stress and coping among
homeless children in selected social welfare
organizations
11. NAME AND DESIGNATION OF THE GUIDE:
11.1 GUIDE NAME AND ADDRESS: Mr. MG. Vishwas.
ASST.PROFESSOR and HOD
Department of Psychiatric Nursing
Dayananda Sagar College of Nursing
Kumaraswamy layout
24 Bangalore -560078
11.2 SIGNATURE OF THE GUIDE:
11.3 HEAD OF THE DEPARTMENT
NAME AND ADDRESS: Mr. MG. Vishwas
Asst. Professor and HOD
Department of Psychiatric Nursing
Dayananda Sagar College of Nursing
Kumaraswamy layout
Bangalore -560078
11.4 SIGNATURE OF HOD:
12. REMARKS OF THE PRINCIPAL: The study is feasible to be conducted in
selected social welfare organizations
13. SIGNATURE OF THE PRINCIPAL:
25 26