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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,

KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1

NAME OF THE CANDIDATE

Mr. PRUDHVI RAJ P

ADDRESS

GOLDFINCH COLLEGE OF NURSING,


# 150/24, KODIGEHALLI MAIN ROAD,

MARUTHI NAGAR, BANGALORE 92.


GOLDFINCH COLLEGE OF NURSING

NAME OF THE INSTITUTION

MARUTHI NAGAR
3

COURSE OF STUDY &

BANGALORE-560092
M.Sc. NURSING

SUBJECT
DATE OF ADMISSION TO

PSYCHIATRIC NURSING
30-06-2011

COURSE
5. TITLE OF THE TOPIC
A STUDY TO ASSESS THE PSYCHOLOGICAL AND SOCIAL PROBLEMS OF
SIGNIFICANT FAMILY MEMBERS OF MENTALLY ILL PERSON IN A SELECTED
SETTING AT BANAGLORE

6.0 BRIEF RESUME OF THE INTENDED WORK


INTRODUCTION

Smile at each other; make time for each other in your family
-Mother Theresa
A great saying is there If you lose everything in your life its not at all a problem,
if you have a good family. A Family unit is a unit which builds up a persons personality.
How you behave and what you become in life is very much dependent on your family
life. Psychologists believe that a child learns the most from his/ her family life. The way
your family members deal with you has a life long effect on your personality.
The life with your family is very important it plays a major role in your
development into the person you become. Those children who belong to the families
which have a rich education background tend to learn more. Similarly, for example,
children who belong to a family from which a few of the people are in the field of
professional sports, the kinds tend to have interest in sports and they also plan to go into
the same field. Thus it is the effect of your family life which guides you to decide what
profession you want to do as an adult.

Family life is also important in the sense that it gives you your basic strength as a
person. The people who have a smooth and well settled family life are generally less
scare of life. Those who are a part of a broken family are generally less confident. These
people always expect the worst in life. This is a general state of mind resulting in
building up of a negative personality.1

In the same way having a family member with a mental illness can be very
stressful. Whether the ill person is a son, daughter, husband, wife, brother or sister. You
will be affected by their illness too. A person with a psychiatric disorder often needs
2

much love, help and support. At the same time, the problems, fears and behaviour of
your ill relative may strain your patience and your ability to cope.
There are many different kinds of mental illness and each has its own symptoms
during period when your relative is ill, he/ she may be demanding and disruptive, or
extremely withdrawn and inactive. In fact, ill persons behaviour may keep on changing
because the symptoms may fluctuate.
Much of the unusual behaviour associated with some mental illness is beyond the
control of the person with the illness. At times, your ill relative may embarrass you in
front of friends and neighbours. Because it is difficult to talk about your relatives
problems with people outside your immediate family, you may not offer an explanation.
Many families, unfortunately, give up their own social lives when a relative becomes
mentally ill because they are nervous about inviting people into their home.
While it takes courage to tell your friends and family about your relatives illness,
it is not good to isolate yourself. Try to find ways to explain the illness and treatment to
others, and to talk about the discomfort you and other people feel as a result of your
relatives behaviour.2
To be suffering from a psychiatric condition is by many described as a painful and
sometimes traumatic experience. When someone close to you goes through this you not
only be affected because she / he is in pain, your life will be affected in a number of other
ways. IT can affect your financial situation, how and where you live and work. The
emotional effects can be a constant worry which in turn can cause physiological problems
for family members as well. Some of the family members have had to give up their own
recreational pursuits. Some at one or more occasions, leave their job. An even larger

number felt isolated and restrained from seeing other people. Half of the family members
may develop psychological or social problems of their own to the extent that they need
help and support. Symptoms described by family members were sleeping problems,
stomach pain or depression. It is not unusual that family members are carrying around
feeling of guilt and shame because they think they are to blame for the development of
the psychiatric illness or for not knowing how to handle this kind of family crisis. A
consequence of feeling guilty and ashamed is that it might feel difficult talking to others
about what you are going through. A lot of the times it helps to talk to other people who
have similar experiences as you have.
When it comes to children they are often the invisible victims. Having a parent
with al psychiatric illness brings about a lot of difficulties. As a child it is hard to
understand a parent is not feeling well and many blame themselves. This can result in a
low self esteem and a poor self image. The children might also be embarrassed to bring
friend home or might not be allowed to . Many children therefore grow up to feel
different that everybody else around them and end up lonely and isolated from peers of
their own age. Therefore it is very important to look for signs that a child is not feeling
well. The more a child gets the appropriate support the less likely it is that she/ he
develops psychological problems of his / her own.3
Hence, by doing proper assessment of problems faced by family members of mentally
ill in the beginning stage itself we can prevent the further deterioration of the family.
6.1 NEED FOR THE STUDY
A family is the same as it is for you with your own body. You want all the parts of
it to be well. For example, your finger it is not different from you, when it hurts, you

take care of it. Like this, our family takes care of us all. If any one member of the family
is facing a problem, it will affect the whole family. So if a family member is facing a
psychiatric problem, it will have an impact on others.
According to a Swedish study, half of the family members have had to given up
their own recreational pursuits. A fifth had to, at one or more occasions leave their job.
An even larger number stated they have felt isolated and restrained from seeing other
people. Half of the people in this study claimed they develop psychological or social
problems of their own to the extent that they need help and support. Symptoms described
by family members were Sleeping problem, stomach pain or depression.3
A study stated that as much as 50 percent of the mentally ill population also has a
substance abuse problem. The drug most commonly used is alcohol, followed by
marijuana and cocaine. The incidence of abuse is greater among males and those in the
age bracket of 18 to 44.4
It is estimated that approximately 450 million people worldwide have a mental
health problem. W.H.O stated that family members are often the primary caregivers of
people with mental disorders. They provide emotional and physical support, and often
have to bear the financial expenses associated with mental health treatment and care. It is
estimated that one in four families has at least one member currently suffering from a
mental or behavioral disorder.5

A study was aimed at evaluating a caregiver burden questionnaire generated in


collaboration with Israeli family members of mentally ill individuals, and assessed the
burden of Israeli caregivers as well as its relation to their age, gender and kinship

relationship to the mentally ill individual. 53 family members answered the


questionnaire. Factor analysis was performed, as well as calculation of internal
consistency and validity. Hypothesis testing included the Pearson correlation for
association of caregiver age with burden, and the Mann-Whitney test for gender
difference in burden. Association of caregiver burden with Kinship relationship could not
be assessed as nearly all participants (94%) were parents of a mentally ill individual. The
basic psychometric properties of the questionnaire were sound. Mean burden was
moderate. Caregiver age was not associated with burden. Females were significantly
more burdened than males. Further participatory study of caregiver burden is
recommended. Mothers of mentally ill individuals may require particular assistance.6
In the past 50 years, a shift toward community care and the
deinstitutionalization of psychiatric patients has resulted in transferring of responsibility
and day-to-day care to family members.7 In part, this shifting of responsibility has been
caused by a deficit in community support services. The profound psychosocial, physical,
and financial impact on the family of individuals with severe mental illness is comparable
to that of persons with other illnesses such as Alzheimers disease or cancer. Worried,
Tired and Alone, a 2003 report analyzing the issues affecting caregivers of people with
mental illness in Western Australia, found that as a result of long-term care giving, the
majority of caregivers surveyed experienced personal, emotional and physical strain on
their lives and the loss of their personal freedom. Emotional impact such as Guilt, loss,
helplessness, fear, vulnerability, and cumulative feelings of defeat, anxiety, resentment,
and anger are commonly reported by caregivers. Caregivers may feel isolated, restricted
from pursuing their own activities, and may be overwhelmed by a lack of support from

friends, family and treatment providers. Frustration in ensuring medication adherence;


coping with disturbed or awkward interpersonal behavior and fatigue from continuous
supervision of a family member have also been reported to add to caregiver burden. In
addition, caregivers have reported great anxiety due to fear that their relative may attempt
suicide. Worried, Tired and Alone found that many caregivers feel a deep and pervasive
sense of fear and uncertainty as well as powerlessness and helplessness, often
exacerbated by the unpredictable behaviors of the individual with mental illness
experiencing a relapse.8
22
Diagnosis

Epilepsy
Organic brain

Bangalore
No. of cases

Rate/ 1000

278

7.82

0.11

syndrome
Schizophrenia

1.83
65
20

0.56

28

0.79

Depressive Psychosis
Total no. of cases &

395

11.1

Prevalence rate/1000
Population studied

35,548

Mania

Most commonly reported behaviors were the reactions of violence, volatile mood swings,
alienation, abusive language and the capacity of the individual to appear normal one
7

minute and on the edge the next. Financial impact A loved one's mental illness may lead
to a disruption of household and work routines and a loss of productivity for the family
unit. Family members are often put in a position where they are required to pay for
medical treatment for their loved one with a mental illness, as well as bear the brunt of a
potential increase in medical costs for other family members. Physical impact ;Physical
and mental health problems of caregivers increase for those providing the highest levels
of care. Rates of caregiver depression have been estimated to range from 38% to 60%.
Caregivers of family members with a higher number of symptoms and level
of cognitive impairment experience more depression. Similarly, there is a link between
caregiver burden and symptoms of infectious illnesses (primarily upper respiratory
illness) experienced by caregivers. The more severe the loved one's symptoms, the
greater the number of infectious illnesses contracted by the
caregiver.9
Hence in this study the Investigator interested to assess the psychological and
social problems of family members of mentally ill.
6.2 REVIEW OF LITERATURE
A review of the literature refers to an extensive, exhaustive and systematic
examination of publication relevant to the research project. Most often associated with
academic-oriented literature, such as thesis, a literature review usually precedes a
research proposal and result section. The result of a literature review and analysis
according to the style requirements for courses, journals, thesis, dissertation and grant
proposal makes the presentation. A well structured literature review is characterized by a
logical flow of ideas; current and relevant references with consistent appropriate.10

The review of literature is presented under the following aspects.

Section-A: LITERATURE RELATED TO PSYCHOLOGICAL PROBLEMS OF


FAMILY MEMBERS OF MENTALLY ILL
A careful family history may provide not only help in the management of a
patient's disorder but also the clues for screening and identifying other at-risk patients for
whom either prevention or early intervention is appropriate. Obtaining a family
psychiatric history has definite clinical benefit. A child of a schizophrenic mother has an
eightfold increase in the risk for that disorder, as well as an increased risk for suicide. In
the general population, anxiety neurosis has a prevalence of about 5%, which increases to
about 50% in the offspring of persons with the disorder. Of persons with mania or
depression, roughly two-thirds of the offspring between 5 and 15 years will be clinically
depressed.
In these cases, a family history succeeds in identifying unsuspected cases of
illness that need treatment and may suggest to the physician that a shattered family
system exists. Finally, the detection of family roles and functioning will give assistance in
achieving therapeutic goals and compliance. Not only may an individual's health or
illness be a result of what happens in a family, but the family may be predictably altered
by the illness of one of its members. Using family systems theory, some effective
interventions may now be directed at altering the family's impact on illness. The family
strengths and weaknesses, and its ability to withstand major stresses in the future, can be
assessed. A good family history may reveal unexplained symptoms to be the
manifestations of a stress-related or psychosomatic illness.11

A study mentioned that Schizophrenia is a severe mental illness, which is stressful


not only for patients, but also for family members. Numerous studies have demonstrated
that family caregivers of persons with a severe mental illness suffer from significant
stresses, experience moderately high levels of burden, and often receive inadequate
assistance from mental health professionals. Effective family functioning in families
with schizophrenia may be influenced by a variety of psychosocial factors. The purpose
of this article was to present a review of the social science literature related to families
living with schizophrenia that has been published during the last three decades. There is
general agreement in the literature that a multitude of variables affect families with a
severe mental illness, such as schizophrenia. Therefore, this literature review examined
the most frequently investigated variables (coping, psychological distress and caregiver
burden, social support caregiver resiliency and depression, and client behavioral
problems) as they are related to families and schizophrenia.14

A cross sectional study was conducted on care of the mentally ill has moved from
institutions to the community. Care of mentally ill has moved from institutions to the
community. Consequently, the burden of caring for these patients has transferred from
institutional caregivers to families. The level of burden experienced by the family, as
well as the acceptance by the patient of the care that he or she received, have a significant
impact on the patients care. The purpose of this study was to identify factors that affect
the sense of burden felt by family members caring for patients with mental illness at
home in Japan.

10

A research was conducted on abuse of carers by relatives with severe mental


illness. Background relatives often experience considerable problems looking after a
family member with severe mental illness. The problems arising from verbal and
physical abuse are not well researched or acknowledged. The aim is to examine the
frequency with which family carers experienced verbal and physical abuse from relatives
who were being looked after by a community mental health service and to identify the
correlates and consequences of that abuse. One hundred and one clients and their family
carers were interviewed. Supporting a previous study of patients on an acute admission
ward, the experiences of verbal and physical abuse were positively correlated. Higher
rates of abuse were associated with poor relationship between patients and their families
and a history of poly-drug misuse and previous criminal offences on the part of the
patient. Relatives experiencing higher levels of abuse were more likely to have
symptoms of emotional distress and were related as experiencing more burdens.
Verbal and physical abuses are not infrequent problems facing family members caring for
a relative with severe mental illness. Some of the risk factors for such abuse can be
identified.

Care plans for family carers could usefully target risk reduction strategies to

minimize the occurrence of abuse.16


A study was conducted on The needs of mentally ill parents stated that
approximately 10% of women and 6% of men who become parents will experience
mental health problems and a significant proportion of these have a severe psychiatric
illness. Method of this study is a literature review. The results of this study shows that
Mothers with severe mental illness have a wide range of complex health and social care
needs in addition to their parenting needs, which must be addressed by services in

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pregnancy and postpartum to optimize outcomes. There is limited evidence on the needs
of fathers with severe mental illness but they may have a greater number of needs than
women, and a greater need for training in parenting skills than womens suffering from
severe mental illness. Parents with mental illness may experience stigma and
discrimination, and fear accessing services due to fears of losing custody of their child.
Lastly author concluded that although a significant proportion of parents with severe
mental illness do lose custody, many can successfully parent if adequate support is
available and needs are assessed and managed by a multidisciplinary team.17
A study enrolled mentally ill mothers from Mecklenburg-Vorpommern,
Germany, with children between the ages of 0-3 years . Using different self and expert
ratings, psychological symptoms, social support , parental stress, and behavior of the
children were assessed. Teenage mothers and adult mothers were compared using the
mean values of the data. The data of 104 mothers were included, 46.1% of mothers were
younger than 20 years of age when they gave birth. All mothers show a variety of
psychological problems. While adult mothers had significantly more affective and
anxiety disorders, teenage mothers had significantly more eating disorders, and sexual
abuse in their histories. Young mothers reported subjectively significantly less social
support and more parenting stress than older mothers.18
A study was conducted on the experience of mothers getting assistance for their
adult children who are violent and mentally ill. If individuals with mental illness become
violent, mothers are most often victims, yet there is little available research addressing
how, when, and from who mothers seek help for themselves or their children when they
become victims of this form of familial violence. The objectives of this study were to

12

describe how mothers understood violence their adult children with mental illness
exhibited toward them and to articulate the process mothers used to get assistance and
access mental health treatment when this violence occurred. Method adopted for this was:
Grounded theory methods were used to explore and analyze mothers' experiences of
violence perpetrated by their adult children with mental illness. Eight mothers of adult
children who are violent with a diagnosed Diagnostic and Statistical Manual of Mental
Disorders Axis I disorder participated in one to two open-ended interviews. Mothers were
of diverse ethnic backgrounds.
The results obtained for this study were Getting immediate assistance involved a
period of living on high alert, during which mothers waited in frustration for their
children to meet criteria for involuntary hospitalization. This was a chaotic and fearful
period. Fear and uncertainty eventually outweighed mothers' abilities to manage their
children's behavior, at which time they called the police or psychiatric evaluation teams
who served as gatekeepers to mental health treatment. Mothers accepted the
consequences of being responsible for their children's involuntary hospitalization or of
being left home with their children if the gatekeepers did not initiate involuntary
hospitalization. Mothers can identify signs of decomposition in their children who are ill
and recognize their need for hospitalization. They cannot, however, always access mental
health treatment due to their children's refusal or failure to meet legal criteria for
involuntary hospitalization. Mothers' inability to intervene early sometimes results in
their own violent victimization.19

13

About a third of all inpatients in psychiatric hospitals are parents of children aged
below 18 years. The mental illness of a parent and especially the need of inpatient
treatment burdens families. This study was contributed to assess parental stress,
behavioral and emotional problems of the children and the needs of psychiatric inpatients
for support. Barriers and hindrances as well as positive experience with support for their
children were assessed. All psychiatric hospitals in a county with about 1.5 million
inhabitants in South-West Germany participated in this study. From 643 inpatients after
drop-out 83 (54 female, 29 male) patients with non full aged children were questioned
with inventories as the SDQ, the PSS and further assessments. Diagnoses and biographic
data were assessed by the documentation of the German Association of psychiatry and
psychotherapy. Parents reported about an increased level of stress by parenthood (PSS
mean 41.9, SD 9.4). Psychopathology of the children influenced the stress of the mentally
ill parents. 40% of the patients are dissatisfied with the care of their children during their
inpatient treatment, but 51% have strong resentments against the youth welfare custodies
and do not ask for support. Our results prove the high negative attitude of mentally ill
parents against youth welfare service which must be reduced by active information policy
and offers in collaboration with the treating psychiatrist of the parents.20
Section-B: LITERATURE RELATED TO SOCIAL PROBLEMS OF FAMILY
MEMBERS OF MENTALLY ILL
A descriptive study was conducted on chronic mentally ill population is a diverse group
comprising of the patients with different problems of varying degree of disability and
different levels and types of needs. The present study aims at assessing the burden faced
by the families and the needs for rehabilitation among beneficiaries of a rural mental

14

health camp in South India. Using the interview schedule for the assessment of family
burden and rehabilitation needs. 50 Caregivers were interviewed. The results indicated
mild to moderate objective burden experienced by the families. Highest burden was
perceived in the domain disruption of family activities followed by Financial
burden.12
A study was conducted using a cross-sectional method. A Questionnaire was
delivered to 30 patients and 30 family caregivers of patients who left a rural psychiatric
hospital and returned home for care. During follow-up home visits, a nurse enrolled the
patients in the study and delivered the Questionnaire, which was filled out by the patients
and family members. Demographic data on the patients were collected during a 30-40
minute interview with each family.
The results of the study revealed that patients satisfaction with daily life and their
ability to perform tasks had a strong impact on the sense of burden felt by the caregivers.
This is important because patients could often be taught how to perform a task, but their
willingness to perform these tasks was often the problem within the home. This finding
makes sense and is consistent with findings of other studies. These results suggest that
providing support that enhances the quality of life of patients with mental illness may
indirectly help to reduce the sense of burden felt by family members caring for them.15
A study was conducted on family stigma, which is defined as the prejudice and
discrimination experienced by individuals through associations with their relatives,
methods; The author describe the family stigma and present research related to mental
illness stigma experienced by family members. Research indicates this type of stigma
negatively impacts family members and relative with mental illness. Results: The author

15

also present strategies to eliminate stigma and discuss implications for the training goals
of psychiatrists throughout the text. Conclusion: The author end this article with
recommendations for psychiatry training goals.13
This study was conducted on Socio-economic conditions of relapsed patients
admitted in a Nigerian Mental Health Institution. Relapse in psychiatric disorders is
highly distressing, costly and engenders burn-out syndrome among mental-health
workers. Aim is to study the socio-economic factors associated with relapse in individual
admitted with psychiatric disorders and the pattern of socio-economic impact of relapse
in those groups.. A cross-sectional survey of all relapsed patients without cognitive deficit
admitted into the federal Neuro-Psychiatric Hospital, Lagos, Nigeria between June and
October 2007 was conducted using a self-validated Structured Interview Schedule
(Relapse Socio-economic Impact Interview Schedule) and Key Informant Interview
Guide. Secondary data were elicited from the patient folders, case notes, ward admission
registers and nominal rolls. Data were summarised using mean, standard deviation,
frequency and percentiles. Pearson's moment correlation coefficient was used to test the
association among variables. The Mann-Whitney U-test was used to compare the premorbid and the post-morbid states. This study involved 102 respondents. Their mean age
was 36.5 9.8 years, mainly of male gender (72.5%) suffering from schizophrenic
disorder (37.8%). Relapse and re-admission ranged between 2 and 12. Unemployment
rate, marital separation and divorce increased more than 5-fold from pre-morbid to
morbid states. Few (4.9%) could still settle their hospital/drug bills on their own, while
most (95.1%) depended on family, philanthropist and government/waivers to pay for
their bills. Their social relationships were negatively influenced with most of them

16

expressing social isolation and low quality of life. There were significant relationships
(P<0.05) between age, sex, number of relapses, number of admissions, pre-morbid
marital status, morbid state marital status, pre-morbid state occupational status and
morbid state occupational status. There was significant change (P= 0.00) in the quality of
life, societal integration/acceptability, economic status, employment status and marital
status of the respondents between the pre-morbid and post-morbid periods. The illness
significantly affected the emotional status of the participants. Conclusion. Relapse and
readmission in psychiatric patients have a negative impact on socio-economic well-being
of patients, family and the society. Efforts should be taken to provide early
interventions.21

6.3 STATEMENT OF PROBLEM


A descriptive study to the assess the psychological and social problems of
significant family members of mentally ill person in selected setting at Bangalore.
6.4 OBJECTIVES OF THE STUDY

1) To assess the psychological problems of significant family members of mentally


ill person.

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2) To assess the social problems of significant family members of mentally ill


person.
3) To correlate the psychological problems with social problems of significant
family members of mentally ill person.
4) To associate the psychological problems of significant family members with the
selected demographic variables.
5) To associate the sociological problems of significant family members with a
selected demographic variables.
6.5 HYPOTHESES
H1: There will be significant correlation between psychological problems and social
problems of significant family members of mentally ill person.
H2: There will be significant association between psychological problems and social
problems of significant family members with the selected demographic variables.

6.6 OPERATIONAL DEFINTIONS


Assess: It refers to a method of evaluating the psychological and social problems of
significant family members of mentally ill person with the help of rating scale.
Psychological problems: It refers to disequilibrium of higher mental functions of
significant family members due to mentally ill person; usually interfere with the
emotional or physical health, communication among the family members, work
productivity and life adjustment, etc.

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Sociological problems: It refers to the impact of a person with mental illness among the
significant family members such as financial burden on the family, interaction with the
society, relationship within the family, contribution to society and family organization.
Significant family members: Care giver of a mental ill person either blood relationship
(parents, brothers, sisters or children.) or other relationship (spouse or in laws).
Mental illness: Description of the behaviors labeled as symptomatic of mental disorders
like schizophrenia, mania, depression, mental retardation, etc.,
6.7. ASSUMPTIONS
1)

Family members of mentally ill person may have increased psychological and
social problems.

2)

Significant family members may struggle with accepting the realities of mental
illness that is treatable, but not curable.

3)

The impact of mental illness on family may differ depends on the demographic
variables.

6.8. DELIMITATIONS
The study is delimited to
A period of four weeks
Significant family members in selected settings at Bangalore.
6.9 PROJECTED OUTCOME

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This study will reveal the psychological and social problems of significant
family members of mentally ill person in selected setting.

7.0 MATERIALS AND METHODS


7.1 SOURCE OF THE DATA: Data will be collected form significant family members
of mentally ill person in selected settings at Bangalore.
7.1.1 RESEARCH DESIGN AND APPROACH: Non experimental descriptive design
will be adopted for the study to assess the psychological and social problems of

20

significant family members of mentally ill. The research approach adopted for this study
will be quantitative method.
7.1.2 SETTING FOR THE STUDY: The study will be conducted in selected setting at
Bangalore.
7.1.3 POPULATION: The population selected for the study will be significant family
members of mentally ill persons.
7.2 METHODS OF DATA COLLECTION
7.2.1 SAMPLING TECHNIQUE: Convenient sampling technique will be used by the
researcher in the study.
7.2.2 VARIABLES UNDER THE STUDY
Study variables: psychological and social problems of significant family members of
mentally ill person.
Attribute variables: Age, sex, education, residence, family type, etc.
7.2.3 SAMPLE SIZE: 100 significant family members of mentally ill persons.
7.2.4 DURATION OF STUDY: The data will be collected within the period of 4 weeks.

7.2.5 INCLUSIVE CRITERIA:


Significant family members who are
Taking care of mentally ill person
Available at the time of study
Aged between 18 to 60 years

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7.2.6

EXCLUSIVE CRITERIA:

Significant family members who are


Not able to understand English or kannada
Not willing to participate

7.2.7

INSTRUMENT INTENDED TO BE USED

Part-I: Demographic data consists of gender, age, educational status, residence,


etc.,
Part-II: Structured rating scale to assess psychological and social problems of
significant family members of mentally ill person.
7.2.8

METHOD OF DATA COLLECTION


Written permission will be taken from the concerned sectors for
conducting the study. Written consent will be obtained from the study
participants. The investigator will administer the structured rating scale to assess
the psychological and social problems of family members of mentally ill.

7.2.9

LIMITATIONS
The study limited to significant family members of mentally ill who are
giving care to the mentally ill patient and who are willing to participate in the
study.
22

7.2.10 PILOT STUDY PLAN: Only 10% of the total sample size of the main study will
be taken for the pilot study.
7.2.11 METHOD OF DATA ANALYSIS AND INTERPRETATION:
The investigator will analyze the data obtained by using descriptive and
inferential statistics and the plan of data analysis will be as follows:

Organize the data in a master sheet/computer.

Mean, mode and median will be used to analyze the psychological and
social problems of significant family members of mentally ill person.

Correlation co-efficient will be used to analyze the relationship between


psychological and social problems of significant family members of
mentally ill person.

Chi-square will be used to analyze the association of psychological and


social problems with selected demographic variables.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR


INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER
HUMAN OR ANIMALS? IF SO, PLEASE DESCRIBE BRIEFLY:
Yes, the study will be conducted among the significant family members
of mentally ill in selected setting at Karnataka.

7.4 HAS ETHICAL CLEARANCE BEEN ABTAINED FROM YOUR


INSTITUTIONS IN CASE OF 7.3?
Yes, the ethical clearance will be obtained from concern authorities and
consent will be taken from the subject. Privacy, confidentiality and anonymity will
23

be guarded. Scientific objectivity of the study will be maintained with honesty and
impartiality.

7.5.ETHICAL COMMITTEE

24

Title of topic

A study to assess the psychological and


social problems of significant family
members of mentally ill person in a selected
setting at Bangalore.

Name of the candidate

Mr. Prudhvi Raj P

Course and the subject

MSc Nursing in Psychiatric nursing

Name of the guide

Prof. Suresh S

Ethical committee

Approved

8.0 LIST OF REFERENCES


1) The importance of family life. www.grandmas crftguides.com/family_corner.
2) Canadian Mental Health Association. Mental Illness in the Family. May 1-7-2011.
25

Available from : http://www.cmha.ca/bins/content_page.asp?cid=4-37-186.


4)Hanna Molander, Effects of Mental illness on the Family. First version : 22 Jul 2008.
Latest revision: 19 Aug 2008. Available from:
http://web4health.info/en/answers/life-family-mental-illness.htm.
4) Agnes B. Hatfield, Ph.D.Dual Diagnosis and Mental illness (Schizophrenia and Drug
or Alcohol dependence). Copyright 1993 National Alliance for the Mentally ill. Available
from : www.schizophrenia.com/family/dualdiag.html.
5) World Health Organization. Family burden cannot be ignored. Investing in Mental
Health 2003. www.who.int/mental_health/en/investing_in_mnh_final.pdf.
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Signature of the candidate


The impact of mental illness is running in most

10

Remarks of the guide

of the families. This study will enable the


mental health nurse to identify the psychological
and social problems faced by the significant
care giver or family members and help them to
overcome their psychological and social
problems.

Name and designation of


11

11.1 Guide

Prof. Suresh S

11.2 Signature
11.3 Co-Guide( if any)

11.4 Signature
11.5 Head of Department

Prof. Suresh S

11.6 Signature
12

12.1 Remarks of the

This study helps the significant family members

Principal.

to overcome their psycho social problems to a


great extent

12.2 Signature

29

30