370 Indian Journal of Public Health Research & Development, May 2020, Vol. 11, No. 05 Effectiveness of Psychoeducation Program on Knowledge among Adults of Selected Area of ,

Rahul Singh Gusain1, Grace M. Singh2, Rajkumari Sylvia3

1M.Sc. Nursing Student, 2Associate Professor, Psychiatry and Mental Health Nursing Department, 3Associate Professor, Child Health Nursing Departement, Himalayan College of Nursing, Swami Rama Himalayan University, Dehradun, Uttarakhand,

Abstract Background: Mental health awareness delivers a wide range of knowledge and encompasses recognition and help-seeking behaviour. Mental health services should be assess at ground level to monitor its delivery. Different mean of communication can use to highlight the mental health issues.

Methodology: Quantitative research approach with quasi pre-post-test control group design was adapted for present study. Total 126 adults were selected through systematic random sampling. The tools administered consisted of baseline data and structured knowledge questionnaire. Descriptive and inferential statistics used for analyses.

Result: This study showed that the psychoeducation program on mental health awareness significantly improved in knowledge score from baseline mean 13.79 ±3.76 to 16.51±2.77; p<0.05 post intervention which was quantified by structured knowledge questionnaire.

Conclusion: The study reported that psychoeducation program was effective in enhancing the awareness among adults.

Keywords: Psychoeducation, mental health, awareness.

Introduction revealed that stigma and discriminating to the mentally ill client is still present in the community.1 In a study The life cycle of the human being is a continuous in Tehran (2011) people reported that people suffering process, which consists of a series of development in from mental illness are discriminated and not accepted the human body. The modifications in the build develop in the community.2 with various stages of the life cycle. The adult is the stage of life at which an individual attains the physical In India, WHO reported that mental health problem and mental maturity. ha as high burden as, 2443 DALYs per 100,000 population. The suicide rate is 21.1 per 100,000 Mental health awareness delivers a wide range of population.3 In Uttarakhand, the incidence rate of knowledge and encompasses recognition and help- postpartum depression was 11% among mothers and the seeking behaviour. A study conducted in Zambia (2010) prevalence rate of depressive disorder was 6% as per 2014 report. These belief and attitudes are a potential barrier to seeking optimal professional help. Corresponding Author: Mrs. Grace Madonna Singh Material and Method Associate Professor, Himalayan College of Nursing The quasi pre-post-test control group method was e-mail: [email protected] implemented with systematic sampling technique in Indian Journal of Public Health Research & Development, May 2020, Vol. 11, No. 05 371 the study. Study was done on all the adults of Bhogpur Findings: In an experimental group out of 63 and Ghamandpur village of block, Dehradun, samples the majority 30.15%of the adults stayed in the Uttrakhand. Total samples was 126, for each group 63 age set of 31-40 years. 58.7% were females, 57.1% were samples were assigned. The data was collected through residing in the joint family. Maximum of the sample knowledge questionnaire to assess the knowledge 33.3 % had secondary education. Family income of of mental health awareness and demographic details majority 69.84 % of the sample was between Rs 5000- was obtained through baseline data. Samples of the 10000. 65.07% were married, 95.2% followed the Hindu experimental group received the psychoeducation religion. Whole sample 100% had reported that they program on the pre-test day. Post-test was taken after don’t have any source of information regarding mental seven days from participants of both groups. The health and also don’t have any past history of mental tools were structured questionnaire of mental health illness. awareness which contains 25 question in which each correct response have given one mark and zero mark for In the control group out of 63 sample, the majority wrong response. Scoring of tool were determined as 0-8 33.33%of the adults fell in the age series of 41-50 average, 9-16 good, 17-24 V. good. years, 69.1% were females, 60.3% were residing in the joint family. Most of the sample 39.7 % had secondary Results education. Family income of majority 63.5% of the samples were between Rs 5000-10000. Most of the In the study it showed that samples have good level samples 65.07% were married, the majority of the of knowledge regarding mental health awareness. The samples 85.7% followed the Hindu religion. 100% mean post test score was higher than pre-test score samples reported that they never suffered with mental of psychoeducation program, which concluded that illness and didn’t have any source of information psychoeducation program was effective. regarding maintenance of mental health.

Table 1: Effectiveness of psychoeducation program among the group

Pre-test Post-test Group Mean difference ‘t’ value p- value Mean ± SD Mean ± SD Experimental n=63 13.79 ±3.76 16.51±2.77 2.714 8.23 0.001* Control n=63 12.44 ±3.90 12.40±3.17 0.048 0.177 0.860 df125, p <0.05 Significant *

Table 1 presented that post-test mean knowledge were compared to each other by applied paired t-test and score of the experimental group increased from baseline got the t value 8.230 and p-value was 0.001, which was 13.79 ±3.76 to 16.51±2.77. The mean difference highly significant level of significance at p<0.05. So, between the two means was 2.714 which had interpreted it could be inferred that psychoeducation program was that post mean knowledge score was increased, which effective to upgrading the awareness of mental health.

Table 2: Pretest score and post-test score comparison between groups

Experiment Control(n=63) Knowledge Score (n=63) ‘t’ value Mean Difference p value Mean ± SD Mean ± SD Pretest 13.77 ± 3.736 12.45 ± 3.937 1.92 1.32 0.06 Post-test 16.48 ± 2.75 12.35 ± 3.18 7.79 4.13 0.001* df125, p <0.05 Significant * 372 Indian Journal of Public Health Research & Development, May 2020, Vol. 11, No. 05 Table 2 illustrate that the post-test mean knowledge value of 0.001, which was highly significant and it was score of the experimental group was 16.48 and control tested statistically at p <0.05 level. Therefore it could be group was 12.35. Difference between the two means concluded that psychoeducation program was effective were 4.13, which were compared to each other by in the experimental group. independent sample ‘t’- test and its value was 7.79 at p

Table 3: The association between pre-test levels of knowledge with the baseline data

S.No. Baseline data Average Good V. Good χ2 df p 21-30 6 22 09 31-40 8 19 12 1. Age (Years) 18.39 6 0.005* 41-50 13 10 5 51-60 15 5 2 Male 6 34 11 2. Gender 0.232 2 0.890 Female 8 53 14 Nuclear 11 44 9 3. Family type 5.656 2 0.102 Joint 3 43 16 No formal education 1 21 5 Primary education 2 20 6 4. Education 7.767 6 0.256 Secondary education 7 26 4 Graduation and above 4 20 10 5000-10000 8 59 18 5. Family income 10001-15000 4 20 2 2.882 4 0.577 15001-20000 2 8 5 Married 6 28 13 6. Marital status 3.468 2 0.177 Unmarried 8 59 12 Private Job 6 29 6 Government Job 1 8 5 7. Occupation 6.912 6 0.329 Own Business 3 10 1 Other Homemaker, Unemployed 4 40 13 Hindu 13 78 22 8. Religion 0.033 2 0.983 Muslim 1 9 3

Table 3 shows illustrated that no significant tested on level of significance at p<0.05. So, It could be association among baseline data and knowledge score inferred that there was an association between age group was found except with age group of adults. It was and knowledge score Indian Journal of Public Health Research & Development, May 2020, Vol. 11, No. 05 373

Figure 1: Effectiveness of psychoeducation program among the group.

Figure 2: Pretest score and posttest score comparison between the groups

Discussion test knowledge score in control group and the post-test mean knowledge score was comparably higher than pre- The study aims to teach the community people test knowledge score in experimental group. Therefore about how to maintain mental health and its benefits it could be inferred that the psychoeducation program which can promote and prevent mental illness. A total increased the knowledge scores of adults. of 63 samples were selected in each group, through the systematic random sampling techniques. The discussion The results of this research study were supported was done according to objectives and with supportive by Chisholm K, Patterson P, Torgerson C, Turner study E, Jenkinson D, Birchwood M. 2016 done a study on contact impact on adolescent mental health knowledge Effectiveness of psychoeducation program: The and mental illness stigma. The purpose was to examine study showed that the post-test knowledge score was whether the contact in intergroup in count to education comparably higher in experimental group than post- 374 Indian Journal of Public Health Research & Development, May 2020, Vol. 11, No. 05 was extra operative than education unaccompanied in Ethical Consideration: Administrative agreement dropping the mental illness stigma in youngsters. The was attained from principal Himalayan College of schools were randomized, the random allocation done Nursing, SRHU. The ethical permission was taken from through concealed method for the samples selection, the ethical committee of SRHU than written consent of total of 769 applicants were included in the study. the participants was taken before doing the collection of Results of the study reported that applicants knowledge data. based stigma in the education unaccompanied condition upgraded significantly which was more than applicants Source of Funding: Self in the contact and condition of education, -0.65, 95% Conflict of Interest: Nil CI (-1.13 to -0.17). p=0.008, d=0.05. The intermediation on education executed in dropping mental illness stigma, References encouraging knowledge of heath and individual who experiences mental health disorders.4 1. Kapungwe A, Cooper S, Mwanza J, Mwape L, Sikwese A, Kakuma R, Lund C, Flisher AJ. Mental Association between baseline data and pretest illness-stigma and discrimination in Zambia. knowledge score: The present study explored statically African Journal of Psychiatry. 2010;13(3). that age group and knowledge score of adults had the 2. Ghanean H, Nojomi M, Jacobsson L (2011) association. Similar studies also were done on age group Internalized Stigma of Mental Illness in Tehran, and knowledge. Iran. Stigma Research and Action 1: 11–17. Yu Y,Liu Z-wei, Hu M, et al (2015) done a study 3. World health organization, Mental health in India on literacy on mental health among adults. A multistage 2019 [internet], 2019. Available from:http://www. cluster sampling method was adopted. Total of 2052 searo.who.int/india/topics/mental_health/about_ subjects was included for the study. The research study mentalhealth/en/ aims to identify knowledge of mental health. The result 4. Chisholm K, Patterson P, Torgerson C, Turner E, explored that younger age and higher education were the Jenkinson D, Birchwood M. Impact of contact on major components of mental health.5 adolescents’ mental health literacy and stigma: the School Space cluster randomised controlled trial. Conclusion BMJ open. 2016 Feb 1;6(2):e009435. The study established on psychoeducation program 5. Yu Y, Liu ZW, Hu M, Liu XG, Liu HM, Yang JP, stated that it was effective and efficient in enhancing the Zhou L, Xiao SY. Assessment of mental health knowledge level of adults. The study also explored that literacy using a multifaceted measure among a there was an association between age and knowledge Chinese rural population. BMJ open. 2015 Oct level of mental health among adults. 1;5(10):e009054.