PERFORMA FOR REGISTRATION OF SUBJECT FOR

DESSERTATION

SUBMITTED BY:

MARY LALRINPUII

1ST Year M.Sc Nursing

Paediatric Nursing

2012-2014 Batch

Oriental College of Nursing

 RANJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA

SYNOPSIS PERFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION
1 NAME OF THE CANDIDATE AND MARY LALRINPUII
ORIENTAL COLLEGE OF NURSING
ADDRESS
#43/52, 2nd MAIN, INDUSTRIAL TOWN
WEST OF CHORD ROAD
RAJAJINAGAR
BANGALORE-10

2 NAME OF THE INSTITUTE ORIENTAL COLLEGE OF NURSING

#43/52, 2nd MAIN, INDUSTRIAL TOWN
WEST OF CHORD ROAD
RAJAJINAGAR
BANGALORE-10

3 COURSE OF THE STUDY AND M.Sc NURSING 1st YEAR

PAEDIATRIC NURSING
SUBJECT

4 DATE OF ADMISSION 30-06- 2012

5 TITLE OF STUDY

A study to assess the effectiveness of structured teaching program on

knowledge regarding hazards of alcohol consumption among adolescents at

selected PU College in Bangalore.

6. BRIEF RESUME OF INTENDED WORK

6.1 INTRODUCTION

Start children off on the way they should go, and even when they are old they will not
turn from it.
-Proverbs 22:6

The World Health Organization’s European Charter on Alcohol states that “all children and

adolescents have the right to grow up in an environment protected from the negative consequences of

alcohol consumption and, to the extent possible, from the promotion of alcoholic beverages”.1

As per Erikson’s theory adolescents are in identity versus role confusion phase. They are still in

teens and lacks maturity of thoughts and experience. She/he is not aware what is proper and improper

and therefore is in danger of going on the wrong path2. Youngsters like to experiment with a risky life

without knowledge about long-term health dangers and risks3.

Adolescents associated with rapid physical growth, sexual maturation and emotional

development4. Adolescents facing so many problems at their age, mainly morphological problems,

psychological problems, social problems, family problems and educational problems. In addition many

serious diseases in adulthood have their roots in adolescence. Teenagers can be more vulnerable to the

effects of alcohol because they have not built up physical tolerance. They also lack drinking experience

and are less able to judge their own levels of intoxication5. Alcohol marketing communications have a

powerful effect on young people and come in many forms. These include traditional advertisements on
television through ubiquitous ambient advertising to new media such as social network sites and viral

campaigns4.

Wider implementation of policies is needed to save lives and reduce the health impact of

harmful alcohol drinking, says a new report launched today by WHO. Harmful use of alcohol results in

the death of 2.5 million people annually, causes illness and injury to many more, and increasingly

affects younger generations and drinkers in developing countries6. Globally, the world Health

organization has reported alcohol as one of the leading risk factors for morbidity and mortality world-

wide, with approximately 1.8 million deaths annually, and representing a considerable economic

problem for many communities around the world6. A substantial proportion of these deaths are the

results of injuries caused by the hazardous and harmful drinking, such as road traffic injuries and

interpersonal violence7.

There has been extensive research into the factors associated with the use and misuse of alcohol

by young people. These factors include genetic factors8, socio-demographic factors9, family factors10,

peer influence11 and access of alcohol12.

Alcohol problems are associated with life style and socio-economic conditions of people. These

are becoming more – prevalent in adolescents – both boys and girls mainly because of their risk taking

behavior and more over the emotional control of family; the moral control of school and the social
control of community are declining. Information explosion and communication across cultural

boundaries through mass media have lot of influence on behavior pattern of adolescents all over the

world. In India, the prevalence of drug abuse, which is generally low in early adolescence, aged 12 & 13

rises – steeply in the late teenage and is highest during the early 20’s13.

Indian teenagers, mainly in the age group of 15 to 19, are spurring the sales of alcohol in the

country, with girls starting to have their first drink at the age of 15, reveals an Assocham (Associated

Chambers of Commerce and Industry of India) survey that was conducted by Assocham Social

Development Foundation (ASDF).14

6.2 NEED FOR THE STUDY

Adolescent’s health is today threatened by the use of alcohol and other psycho active substances.

It is therefore important to develop upgraded alcohol education related to alcohol use, and its

consequences in school health care. Promotion of national and community based-age appropriate

education programme is needed to ensure alcohol free activities from youth and public15.

The WHO estimates that 320,000 young people between the ages of 15 & 29 die from alcohol

related causes. This represents 9% of all deaths in this age group. The 2011 Global Status Report on

Alcohol & Health states that there has been a marked increase in alcohol consumption amongst young

people in recent years. The 2008 Global report from 73 countries showed a five-year trend in under-age
drinking with 71% of countries reporting an increase15.

There's early experimentation, more binge drinking (bouts of heavy drinking in very short time),

high levels of fiesta drinking and a greater acceptance of social drinking, explains Dr G. Gururaj of

NIMHANS, Bangalore, an epidemiologist who has been charting alcohol's impact through the decade.

A 2009 survey on 2,000 teenagers by apex trade body Assocham shows there has been a 60 per cent rise

in alcohol consumption among the 19-26 age group in the last five years. Over 45 per cent of metro

teenagers drink five to six times a month, while 70 per cent drink on social occasions. In November

2011, yet another Assocham survey found a 100 per cent rise in drinking among the 15-18 age group in

the last 10 years16.

In Karnataka state, one of the highest installed capacities for beverage alcohol production in the

country, per capita availability of beverage alcohol has risen from 2.96 liters to 6.35 liters of absolute

alcohol equivalent per person per year over a ten-year period. At present, the State is third in the country

in terms of ethanol production17. A study carried out by the National Institute of Mental Health and

Neurosciences (NIMHANS), Bangalore revealed that 70% HIV patients were alcoholics and they had

been teenagers18. A monograph on ‘Alcohol related harm: Implications for public health and policy in

India' (2011) by NIMHANS, revealed that over 50 per cent of regular alcohol users fall into the

category of hazardous drinking, and the use of alcohol was increasing disproportionately in younger age

groups.19.
 In India, prevalence rates of use of alcoholic beverages ranges from 23 % to 74 % among males

and 80% among the adolescent group. Statistics from a recent survey by the social development

foundation of the Associated Chambers of Commerce and Industry of India (Assocham) reveals that

nearly 45 percent of 12th graders in metropolitan cities drink excessively at least five to six times a

month20. Globally, according to WHO, the extent of world-wide psychoactive substance abuse is

estimated as 2 billion alcohol users, 1.3 billion smokers, 129 million cannabis users and 185 million

drug users. About 76.3 million are diagnosed with alcohol related disorders and 3.2 % of overall human

deaths are caused by alcohol consumption21.

Adolescence is a very sensitive period because of biological, hormonal and psychological

changes, super added with increased responsibility. Lack of information and ignorance make the

adolescents more vulnerable to alcoholism along with peer pressure and identity problem.

Young adolescents are at risk of alcohol related problems and are noted as special population in

need of services in the report by the institute of medicine. Young adolescents as a group are heaviest

drinkers in America and other Western societies. In India also, the trend is increasing in favor of alcohol

use among student population. Campus atmosphere and peer pressure is forcing and influencing the

adolescent students to indulge in alcoholism mainly due to lack of adequate knowledge about the

consequences of its use or falsely perceived knowledge and attitude towards alcoholism as the students
use alcohol for “company, festivity or curiosity22.

Whatever it is that leads the adolescents to begin drinking, once they start, they face a number

of potential health risks, like brain effects, liver effects, growth and endocrine effects, social effects and

so on. Loss of employment, drunk driving or public disorders, tortuous behavior, marital conflicts,

divorce or domestic violence are some forms of social effects seen among the adolescence lives.23

The investigator from her own experience and discussion with colleagues and experts realized

that alcoholism is a problem among college students. If college students are provided with knowledge

on ill effects of alcohol, this might help the students to change their behavior and influence others.

Therefore structured teaching programme is one of such effective intervention which can be carried out

to bring the awareness among adolescents students in a school set up.

6.3 REVIEW OF LITERATURE

The literature was reviewed and is presented under the following headings:

1. Studies related to prevalence of alcohol consumption among adolescent

2. Studies related to knowledge regarding alcohol and its hazards among adolescents

1. Studies related to prevalence of alcohol consumption among adolescent

A study was conducted among undergraduate medical students in two medical colleges of

Calcutta. The study indicated that the prevalence of total long abusers were 76.8% of the respondents
student population. The long abuse rate-gradually increased with advancement of each academic years

i.e. from 24% in 1st year to 74.4% in the final year, it was maximum in the age group of 25-29 years.

The prevalence among boys (58.4%) was significantly higher than girls. Twenty five percentage of

hostelites were found to be more long users than non-hostelites. In the pattern of long abuse 12.6% of

students used tobacco and 3.6% alcohol. Most common combination was of alcohol and tobacco. Other

drugs constituted 12.7% of students24.

A comparative study was conducted on Alcohol and drug consumption among students in

Pachuca, Hidalgo in Mexico. The study reveals that out of the total sample, 47.9% had tried alcohol and

12.6% had drunk large quantities-5 drinks or more per sitting-during the month previous to the survey.

With respect to drugs, 5.1% had tried illegal or medical drugs without prescription, in particular

inhalants, marihuana and tranquilizers. More boys consumed illegal drugs and more girls medical drugs

without prescription. Boys, who are also older, more frequently consumed alcohol and drugs and were

more often employed during the previous year at part-time jobs. High alcohol level and drug consumers

were characterized by their frequent report of being bored in their free time, drinking with friends and

enrolling in antisocial behaviour25.

An epidemiological study was conducted to assess the prevalence of alcohol consumption

among 2,264 individuals (male, 1,033; female, 1,231) aged 15 years and older in a tea garden

population of Assam. The study revealed that 59.2% (male, 69.3%; female, 54%) population was using
 alcohol , 32.2 % of subjects aged 15-24 was found to be using alcohol. The study concluded by

recommending health education for the public regarding the health hazards of alcoholism 26.

A questionnaire study was carried out to study the prevalence of adolescents problematic

alcohol use and it parental predictors. Questioners were sent to 1132 finish families and 1028 response

were received. According to the responses at 15 years of age 83% of girls and 74% of boys had used

alcohol, 18% of boys and 14% girls had been drink more than once a month. The child’s permanent

separation from at least one biological parent was the strongest socio-demographic predictor of

adolescent drinking. Fathers present heavy drinking and parental early drinking were best predictors of

their children’s problematic alcohol use at the age of 15.27

A study was conducted among high school students from Holon (a city in the center of Israel)

were surveyed about their consumption, knowledge and attitudes towards alcohol use and alcohol

dependence.509 samples were taken in that 259 pupils attended a vocational high school and 253

attended an academic high school. 40% of the pupils attending the academic school reported that they

had drank beer between 1 to 9 times during the last 2 months. In comparison with 72% of the vocational

pupils, 42% of the academic pupils and 47% of the vocational pupils drank other alcoholic beverages

(such as hard liquor, cognac, whisky or vodka) between 1 to 9 times during the last 2 months. Boys

drank alcohol more frequently than girls did. An earlier mean age of beer consumption was found

among pupils in the vocational schools—12.8 years; as opposed to pupils in the academic school—13.4
years .Among the three leading reasons for drinking in the two schools were helping foster a sense of

belonging, wish to feel like an adult and desire to forget daily anxieties and conflicts28.

2. Studies related to knowledge regarding alcohol and its hazards among adolescents

A study was conducted on a total of 545 Spanish university students from the University of

Valladolid, were surveyed in about their alcohol use, knowledge of the effects of alcohol, and attitudes

towards social drinking and towards alcoholism and alcoholics. The knowledge regarding alcohol (mean

scores 7.7 +/- 0.1, ranging 1-15) was associated with academic aspects: it was higher among medicine

and nursing students and increased according to the length of stay at university. The attitudes both

towards social drinking (mean scores 0.6 +/- 0.1, ranging -9 to 9) and towards alcoholism and the

alcoholics (mean scores 3.0 +/- 0.1, ranging -6 to 9), were related to alcohol consumption: those

students self-reported as "heavy" and "moderate" drinkers, and those with alcohol intake over 40 g/day,

had a more favourable attitude. The results suggest a need for education on alcohol30.

A cross sectional survey conducted to identity the alcohol knowledge in early adolescents.

Through convenient sampling 1854 students selected for the study. By an alcohol effects questionnaire,

alcohol expectancy were measured. The results show that the participant with no alcohol drinking

experience had a lower level of alcohol knowledge than these with experience (t = 2.73, P=.007).

Results support that alcohol expectancy is in important like with early drinking experience and alcohol
knowledge. 31

A study was conducted to assess the knowledge and attitude of college students regarding

alcoholism in selected colleges at Udupi district in 2007. It was found that 40% of the students started

consuming alcohol at the age of 18 years. With regard to attitude, forty-five percent had unfavorable

attitude towards alcohol use and thirty percent had average level of knowledge. After an awareness

programme, the knowledge level increased to 56% compared to the 35% at the previous level.32

A study was conducted in Bangalore among pre-university students on knowledge and effect

related to alcoholism. The sample selected for the study includes 50 Pre-University students and simple

random sampling method was used. The data was collected by using structured questionnaire. Each

correct response was given one score and zero for incorrect response. Results The overall mean

knowledge was found to be more (68.8%) about general information on alcohol than the knowledge on

the effects of alcohol (33.2%). The overall mean attitude was 77.7%. The highest attitude response

identified in the aspect of keeping away from alcoholics (92%).A significant association is found

between knowledge and type of family. There exists a significant association between attitude and type

of family, and also between attitude and academic marks. Interpretation and Conclusion Overall

findings showed that, respondents knowledge about effect of alcohol is inadequate (33.2%), although

the respondents overall attitude towards effect of alcohol is found to be favourable (77.7%). So
enhancement in knowledge aspect is required33.

A survey was conducted on 1000 subjects (524 males and 476 females) to know the impact of

alcoholism in increasing the anti social behavior at Kottayam Medical College, Kerala. The result

showed that 50% of males had consumed alcohol while attempting suicide and 50% of women who

attempted suicide were the wives of drunkards. All the subjects were below 35 years of age and 16.8%

were students. Majority of the females (62.8%) and 40.5%of males were diagnosed to have severe

mental stress and mild depression. It was concluded that severe mental stress and alcoholism are the

main causative factors for increased suicidal tendencies.34 Alcohol has strong association with the

scores of health problems including accidents, domestic violence, depression, sexual assault, infection,

and hypertension and of course alcohol dependence. Disease outcomes are among the most important

alcohol related problems. The effect of excessive alcohol consumption on the neurological system is of

particular significance. Over ingestion of alcohol can lead to stupor, coma and death.35

6.4 STATEMENT OF THE PROBLEM

A study to assess the effectiveness of structured teaching program on knowledge regarding

hazards of alcohol consumption among adolescents at selected PU College in Bangalore.

6.5 OBJECTIVES

• to assess the pre-test & post-test knowledge regarding hazards of alcohol consumption among
 adolescents..

• to find out the effectiveness of structured teaching programme on hazards of alcohol consumption

among adolescents.

• to find out the association between pre test knowledge score regarding hazards of alcohol

consumption among adolescents and selected demographic variables.

6.6 HYPOTHESIS

H1 – there will be a significant difference between the mean pre test knowledge scores and the mean

post-test knowledge scores on hazards of alcohol consumption among the adolescents after

Structured Teaching Program than before Structured teaching program.

H2 – there will be a significant association between the level of pretest knowledge score regarding

hazards of alcohol consumption and the demographic variables.

6.7 OPERATIONAL DEFINITIONS

Effectiveness: In this study it refers to the extent to which the structured teaching programme has

achieved the desired outcome as seen from gain in knowledge scores.

Structured teaching programme: In this study it refers to the systematically developed instruction

with teaching aid designed by the investigator for the adolescents to provide information regarding

hazards of alcohol consumption on physical, mental and social well being of an individual using charts
and hand-outs that takes about 45 minutes.

Knowledge: In this study it refers to the correct answers to the questionnaire obtained from the

adolescents on alcohol consumption and its hazards as assessed by structured knowledge questionnaire.

Hazards of alcohol consumption: In this study it refers to the problems due to drinking of

intoxicating liquids like beer, wine, liqueur, etc. that toxicate the body causing certain ill effects which

impairs the normal physical, mental and social functioning of the individual.

Adolescents: In this study it refers to the boys and girls in the age group of 15-18 studying in 11th and

12th grade in a selected higher secondary school at Bangalore.

P.U College: In this study it refers to the college which is having 10+1, 10+2 as regular courses which

is affiliated to the state and national educational board.

6.8 ASSUMPTION

The study assumes that

 alcohol is commonly consumed among adolescents .

 structured teaching programme is an accepted teaching strategy.

 adolescents may have some knowledge regarding alcohol consumption and its hazards
6.9 DELIMITATION

1. The study is limited to 4 weeks

7.0 MATERIALS AND METHODS

7.1 SOURCES OF DATA

Data will be collected from 100 adolescents of age between 15-18 yrs old, who fulfill the
inclusion criteria.

7.2 METHODS OF DATA COLLECTON

7.2.1 RESEARCH DESIGN

Quasi experimental research design (one group pre-test and post-test) will be used.

7.2.2 SETTING OF THE STUDY

The study will be conducted at a selected P.U College in Bangalore.

7.2.3 POPULATION

All the adolescents between the ages of 15-18 years, who are studying in PU-I & PU-II in a P.U

College at Bangalore.

7.2.4 SAMPLING SIZE

 The study will be conducted among 100 adolescents studying in a selected P.U College in
 Bangalore.

7.2.5 SAMPLING TECHNIQUE

Simple random sampling technique will be used.

7.2.6 SAMPLING CRITERIA

Inclusion Criteria

- Students who are willing to participate in the study.

- Students who can read , write and understand English

- Adolescents of age between 15 -18 yrs studying in a selected P.U College

Exclusion Criteria

- Students who have attended seminar or workshop regarding hazards of alcohol consumption

7.2.7 DATA COLLECTION TOOL

The tool for data collection consist of two parts:

Part I: Demographic Proforma

Part II: Structured knowledge questionnaire which consist of the hazards of alcohol consumption on

physical, mental and social well being of an individual

 7.2.8 DATA COLLECTION METHOD

Prior permission will be obtained from the concerned authorities of the selected higher

secondary school. The investigator will introduce herself to the participants. The objectives of the study

will be explained to the adolescent students and their informed consent will be taken. The samples will

be selected by simple random sampling technique. The pretest knowledge on hazards of alcohol

consumption will be measured by administering the structured knowledge questionnaire, followed by

structured teaching programme on the same day, and after seven days post test will be conducted by

using the same questionnaire.

7.2.9 DATA ANALYSIS PLAN

Collected data will be analyzed in terms of descriptive (frequency, mean, median, standard

deviation).

Inferential statistics:1. Paired t test will be used to find out the effectiveness of structured teaching

program.2. Chi- square test will be used to fine out the association between selected demographic

variables and knowledge score.

7.2.10 VARIABLES

Independent Variable: Structured teaching program.

 Dependent Variable: Knowledge regarding alcohol consumption and its hazards.

Demographic Variables: Age, sex, socio-economic status, parents occupation, type of family,

health problems, family problems (divorce, substance abuse by parents), emotional problem.

7.2.11 PROJECTED OUTCOME

The study will help the students to gain knowledge regarding hazards of alcohol consumption.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVIEWS

TO BE CONDUCTED ON PATIENT OR OTHER HUMANS OR ANIMALS?

Yes

7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR

INSTITUTION?

Yes
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