RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA
SYNOPSIS PROFORMA FOR REGISTRATION OF
SUBJECT FOR DISSERTATION
Ms.V.S.BEENA SREE
1ST YEAR M.sc., NURSING
CHILD HEALTH NURSING
YEAR 2008 – 2009
SRI.H.D.DEVE GOWDA CO-OPERATIVE COLLEGE OF NURSING
HASSAN
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
ANNEXURE – II
PROFORMA FOR REGISTERATION SUBJECTS FOR DISSERTATION
1 / Name of the candidate and address / V.S.BEENA SREEI YEAR, M.Sc. NURSING
SRI.H.D.DEVEGOWDA CO-OPERATIVE COLLEGE OF NURSING, HASSAN, KARNATAKA.
2 / Name of the Institution / SRI.H.D.DEVEGOWDA CO-OPERATIVE COLLEGE OF NURSING, HASSAN, KARNATAKA
3 / Course of Study and Subject / M.Sc. NURSING
CHILD HEALTH NURSING
4 / Date of Admission to the Course / 25-07-2008
5 / Title of the Topic:
ASSESSMENT OF KNOWLEDGE OF MOTHERS WITH SCHOOL AGE CHILDREN REGARDING PREVENTION OF CHILD ABUSE IN A SELECTED COMMUNITY AT HASSAN WITH A VIEW TO PREPARE AN INFORMATION BOOKLET.
6. Brief Resume of the Intended Work
6.1 Need for the Study
“Child abuse casts a shadow the length of a life time”
-Herbert Ward
Child abuse is a significant problem that requires an effective means of prevention. Child abuse encompasses a spectrum of abusive actions or acts of commission and lack of action or acts of omission of children. Child abuse includes physical abuse, emotional abuse, sexual abuse and neglect.1 Child abuse has negative outcome in children and adolescents that can extend into adulthood. Abused children often suffer physical injuries and stress that may disrupt early brain development. Children who are abused or neglected are at higher risk for health problems such as depression, alcoholism, drug abuse, smoking, sexual promiscuity, suicide and certain chronic diseases2.
UN report releases shocking child abuse statistics in Australia during 2006. It is estimated that from the approximate 4 million population under the age of 14years up to 600,000 Australian children have been abused3. A survey conducted by U.S Department of Health and Human services in 2007 reports that an average of 2,450 children are abused per day. 60% of them are neglect, 20% are physical abuse, 10% are sexual abuse and 7% are emotional abuse. An average of nearly 4 children die everyday as a result of child abuse. A report of child abuse is made every 10 seconds4. 1,530 children died in the United States in 2006 from abuse and neglect5. Inflicted traumatic brain injury is the leading cause of death due to child abuse6.
A study was conducted by the Ministry of women and child development, government of India to develop a comprehensive understanding of child abuse. The research was done across 13 states and it involved 2,447 children, 2,324 young adults and 2,449 stakeholders. The major results showed that children in the 5-12 years age group are most at risk of different kinds of abuse and exploitation; two out of three children were physically abused; 53.2% of children reported having faced sexual abuse. Every second a child reported facing emotional abuse. Boys face more physical abuse 72.6% compared to 65% of girls. Fathers and male relatives were the most common perpetrators. Most children did not disclose the matter to anyone. The states of Andra Pradesh, Assam, Bihar and Delhi reported higher rates of abuse of all forms as compared to other states. India is the world’s sixth most dangerous place for children. A few cases of abuse or neglect we see in the news are only a small part of the problem. Many cases are not reported to police or social services7.
A cross – sectional study was conducted by School of psychiatry, University of New South Wales, in Australia to determine whether childhood physical and sexual abuse are associated with poor mental and physical outcomes in older age. The participants were 21,000 older adults (aged > 60 years) currently under the care of general practitioners participating in the depression and early prevention of suicide in general practice study. The results revealed that 1458 (6.7%) participants reported childhood physical abuse. 1429 (6.5%) participants reported childhood sexual abuse. Participants who had experienced either childhood sexual or physical abuse had a greater risk of poor physical health and mental health. Older adults who reported both childhood sexual and physical abuse also had a higher risk of poor physical health and mental health. The researcher concluded that the effects of childhood abuse appear to last a life time 8.
The ultimate goal is to stop child abuse before it starts. Strategies that support parents and teach positive parenting skills are very important. It is the need of time to understand and improve public awareness of child abuse prevention, especially for the parents. Several randomized, controlled trails of home-visiting programs by professionals have demonstrated modest effects in the primary prevention of child abuse and neglect9. Nurse-family partnership remains the most effective and longest enduring intervention for high risk families. Pediatric Nurse plays an important role in the prevention of child maltreatment. Their knowledge of the effectiveness of different programs can help to guide parents towards appropriate services10.
Through the review of literature and personal experience the researcher has realized the increased incidence of child abuse, its serious long term effects in life and deficiency of knowledge among mothers regarding prevention of child abuse. Hence the researcher felt the need to select this study and to assess the knowledge of mothers regarding prevention of child abuse and to provide an information booklet.
6.2 Review of literature:
A study was conducted to examine the associations between reported spanking, spanking frequency, or spanking with an object and the odds of physical abuse in a representative sample of mothers from North and South Carolina. A cross-sectional, anonymous telephone survey of adult mothers with children aged<18 years was done. Survey responses were used to determine the association between corporal punishment and an index of harsh physical punishment consistent with physical abuse. The results revealed that mothers who report that the child was spanked are 2.7 times more likely to report abuse. The researcher concluded that although reported spanking increases the odds of reported physical abuse, the relationship between the reported hitting of a child with an object and reported abuse is much stronger. Reduction in this form of discipline through media, educational, and legislative efforts may reduce child physical abuse11.
A study was conducted to examine the associations between childhood adversity, parental bonding, gender, depressive symptoms, and quality of life in non-treatment-seeking adults from the community. Effects of differential parental rearing were compared in adults who reported a high degree of childhood maltreatment (n=72) and those who reported no significant adverse events in childhood (n=69). Subjects completed retrospective measures of childhood maltreatment and perceived parenting style, as well as measures of current depressive symptoms and quality of life. The results showed that the subjects without childhood maltreatment were younger and endorsed less current depressive symptomatology than did subjects with childhood maltreatment. While the subjects without a history of maltreatment reported more "optimal" bonding experiences with their parents, the maltreatment group members were more likely to characterize their early parental bonding experiences in terms of "affectionless control” or "weak or absent" bonding. The researcher concluded that a relationship exists between early life maltreatment and suboptimal parental bonding. Effects of childhood maltreatment appear to be linked with the occurrence of depressive symptomatology in adulthood, suggesting possible targets for primary or secondary prevention12.
A study was conducted to investigate the associations between individual, family, and extra-familial factors and the likelihood of subsequent childhood and adolescent maltreatment. The authors analyzed 1,411 participants in the Chicago Longitudinal Study whose maltreatment records were verified from administrative data. Findings suggest that maternal age at the child's birth was a robust predictor of maltreatment outcomes. Receipt of public assistance and single-parent family status were significantly associated with select outcomes. Among school-age indicators examined, parent participation in school was negatively associated with most maltreatment outcomes. Participation in the Chicago Child-Parent Center program was negatively associated with maltreatment, although effects varied by type and timing of maltreatment. In separate analyses, several factors were associated with neglect, but only maternal age at the child's birth was associated with physical abuse. Findings suggest that prevention programs may need to target select populations and specific mechanisms associated with different types of maltreatment to maximize effectiveness13.
A study was conducted to investigate parental knowledge of symptoms of child sexual abuse and to determine the factors associated with that knowledge in U.S.A. A total of 150 parents listed symptoms of child sexual abuse in the areas of physical/medical, emotional, sexual behavior, and behavior towards others. Results suggest that, although most parents are familiar with some of the symptoms of child sexual abuse, they are more likely to know emotional or behavioral reactions which could be suggestive of many other life stressors. Parents with higher socioeconomic status listed more symptoms, but race and parenting experience were not significant factors. Results suggest the need to inform parents of more indicative physical or sexual symptoms, and to target parents of lower socio-economic background in awareness efforts14.
A study was conducted to examine the face validity and feasibility of multimedia materials on child sexual abuse prevention campaign. A quantitative survey method assessed participants' comfort level, knowledge gain, and likelihood of behavioral change in response to the media campaign. Furthermore, a focus group method explored participants' attitudes and opinions regarding the campaign and the unique effects of ethnic or cultural norms on participants' acceptance of the media materials. Quantitative data suggest that participants reported increased child sexual abuse knowledge and low levels of discomfort or anxiety related to exposure to the materials. Focus group results suggest that study participants, regardless of ethnic background, agreed that the media campaign can have a positive impact on public knowledge of child sexual abuse15.
A study was conducted to determine the knowledge, attitudes and practice of child sexual abuse prevention education among parents.385 parents of Grade 3 pupils from four schools in the northeast part of China were given self-administered anonymous questionnaires. Among this sample, more than 80% of parents approved of school child sexual abuse prevention education. However, at the same time, 47.3% of parents expressed some concern that this education may induce the children to learn too much about 'sex'. Only 4.2% of parents had provided books or other materials about child sexual abuse prevention for their children. The parents' knowledge on child sexual abuse prevention was inadequate16.
A study was conducted to assess Chinese parent’s knowledge, attitudes and communication practices with their children about child sexual abuse. 652 parents of grade 3 pupils of seven elementary schools in Central China completed an anonymous questionnaire. The results revealed that more than 95% of responded agreed that elementary schools should provide programmes to prevent child sexual abuse and were willing to have their children participate in such programmes. Many parents personally lacked basic knowledge about characteristics of perpetrators and non-physical consequences of child sexual abuse. The researcher concluded that future prevention programmes should include community wide efforts to educate adults to ensure that parental advice is accurate and hopefully effective17.
6.3 Statement of the problem
A study to assess the knowledge of mothers with school-age children regarding prevention of child abuse in a selected community at Hassan with a view to prepare an information booklet
6.4 Objectives of the study
1. To assess the knowledge of mothers regarding prevention of child abuse.
2. To develop an information booklet on prevention of child abuse.
3. To find out the association between the knowledge of mothers regarding prevention of child abuse with the selected socio – demographic variables.
6.5 Operational definitions
1. Assess: It refers to determine the knowledge of mother with school age children regarding prevention of child abuse.
2. Knowledge: It refers to the scores obtained by the mothers with school age children on knowledge assessment towards prevention of child abuse.
3. Mothers: It refers to mothers who have school age children.
4. School-age children: It refers to children in the age group of 6 – 12 years.
5. Prevention: It refers to taking prior action to stop the happening of child abuse.
6. Child abuse: It refers to maltreatment of children which include physical abuse, sexual abuse, emotional abuse and neglect.
7. Information booklet: It refers to a small book containing information regarding prevention of child abuse.
6.6 Assumptions
It is assumed that:-
- School - age children are at risk of child abuse.
- Mothers have some knowledge regarding prevention of child abuse.
6.7 Hypotheses
At 0.05 level of significance.
H1: There will be significant association between the knowledge of mothers
regarding prevention of child abuse with the selected socio- demographic variables.
6.8 Delimitations
The study is delimited to
- Mothers with school-age children in a selected community at Hassan.
7. Material and methods
7.1 Source of data
The data will be collected from mothers with school age children in a selected community at Hassan.
7.1.1 Research design
Descriptive research design will be used for the study.
7.1.2 Setting
The study will be conducted in a selected community at Hassan.
7.1.3 Population
Mothers with children in the age group of 6 – 12 years in a selected community at Hassan
7.2 Method of data collection
7.2.3 Sampling procedure
Purposive sampling will be adopted for the study.
7.2.2 Sample size
In this study sample size will be 90 mothers with children in the age group of 6 -12 years.
7.2.4 Inclusion criteria for sampling
1. Mothers with children in the age group of 6 -12 years.
2. Mothers willing to participate in the study.
3. Mothers who can read kannada.
7.2.5 Exclusion criteria
1. Mothers who are not willing to participate in research study.
2. Mothers who cannot read kannada.
7.2.6 Instruments intended to be used
Structured questionnaire will be used to assess the knowledge of mothers regarding prevention of child abuse.