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I thank Lord Almighty for his enriched blessing and abundant grace and mercy which encircled me through every step of my work and in converting this work a reality and without god this would never have been possible. I wish my sincere thanks to our Managing Trustee for all the facilities provided to us in the institution. I thank the Ethical Committee of PSG institute of medical sciences and research for granting permission to conduct the study. With deep sense of gratitude, I express my sincere thanks to our principal Prof. Elizabeth Jean Abraham, PSG College of Nursing. The words of appreciation and encouraging support that principal had showed on me, kindled my spirit and enthusiasm to go ahead and to accomplish this study successfully. I honestly express my wholehearted thanks to my subject guide

Prof.(Mrs).Esther Daisy Joel, M.Sc (N), HOD of Mental Health Nursing Department, PSG College of Nursing. Thank you Madam for your dexterous and expert guidance, valuable suggestion, affectionate enduring support, timely motivation and enthusiastic words which kept my working towards the completion of this successful Dissertation. In the creation and implementation of this project, I owe a profound depth of gratitude to my research guide Dr.(Mrs) M.L. Subhadra Iyengar, Ph.D, Professor, HOD of Research Department, PSG College of Nursing for her valuable suggestions, timely correction and scholarly guidance in each and every step of this study which has made the study possible and purposeful.

I whole heartily thank Prof. (Mrs).Meera Saravanan, MSc(N), Professor of Mental Health Nursing Department, for her constant support and donative approach which guided and encouraged me to proceed with my dissertation. I express my sincere thanks to Dr.Sasidharan pillai, Medical director, District Cancer Centre, Kozhencherry for his valuable suggestions and guidance in translating this study to an illustration. I have an immense pleasure in thanking Dr. Sasidharan pillai, Medical Director of District Cancer centre, for his immense guidance and suggestions for the study. I sincerely express my profound gratitude and warmest thanks to all faculties in Mental Health Nursing Department for their support, encouragement and strong motivation throughout the study period. I am extremely thankful to Mrs. Ellamma, Nurse, District Cancer Centre, and All The Ward Sisters for their timely support in conducting the study. I extend my sincere thanks to All Library Staffs for rendering all the facilities and support during the time of this study. I also deeply appreciate the work of Mr. Maruthu, Tekno Solutions, Computer operator, who helped me to turn the study into a final product. I take this opportunity to express my thanks to My Friends who have been a source of encouragement and support during the course of this work. Last but most important my heartfelt unexplainable thanks to My Mother, who are the source of my strength, inspiration, constant help and encouragement in every walk of my life.

I continue to be indebted to all for their support, guidance and care who directly and indirectly involved in my progress of work and for the successful completion of this thesis.

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