RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,

KARNATAKA, INDIA.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. NAME OF THE CANDIDATE Mr. PARAMESH G.M.

AND ADDRESS FIRST YEAR M.Sc. NURSING,
BAPUJI COLLEGE OF NURSING,
DAVANGERE – 4,
KARNATAKA.

2. NAME OF THE INSTITUTION BAPUJI COLLEGE OF NURSING,

DAVANGERE - 4.

3. COURSE OF STUDY AND FIRST YEAR M.Sc. NURSING,

SUBJECT PSYCHIATRIC NURSING.

4. DATE OF ADMISSION TO 30.06.2008

COURSE

5. TITLE OF THE TOPIC “KNOWLEDGE AND ATTITUDE

TOWARDS MENTAL ILLNESS
AMONG CARE GIVERS OF
MENTALLY ILL PATIENTS AT
SELECTED HOSPITALS
DAVANGERE”
6. BRIEF RESUME OF THE INTENDED WORK :
INTRODUCTION :
Mental illness is mal adjustment in living. It produces a disharmony in the
persons ability to meet human needs comfortably or effectively and function
within a culture. A mentally ill person loses his ability to respond according to the
expectations he has for himself and the demands that society has for him. 1
Mental and behavioural disorders are understood as clinically significant
conditions characterized by alteration in thinking, mood (emotions) or behaviour
associated with personal distress and / or impaired functioning (WHO, 2001).1
The knowledge and attitudes of a community towards mental illness and
mentally ill carry implications for the epidemiological studies of mental disorder
as these may influence the willingness of the subjects to declare symptoms in the
course of surveys of psychiatric disorder, declaration will also depend on the
prevailing concepts of mental disorder in the society.2
In India the social stigma attached to mental illness vary according to the
culture. A great deal of misconception, superstition and ignorance exists in respect
of mental disease, much stigma is often attached, mental illness are viewed as
visitation of evil spirits, of a goddess of a curse.2
The stigma associated with mental illness and mental hospitals and the
rejection of the mentally ill by their relatives and society at large, there is a
necessity for mental health education programme at mass level.2
Improvements in the education of the family members and public about
mental illness and provision of the opportunity for personal contact with mentally
ill people are considered to be important measures promoting the acceptance of
the mentally ill by the family members and the public.6
This initiated the researcher to conduct study on knowledge and attitude
towards mental illness among the care givers of the mentally ill patients at
selected hospitals Davangere.
6.1 Need for the study :
Health is today an issue of major concern for all left movements within the
health sector, mental health has finally been recognized to be as serious a problem
of development as other diseases.3
“The 1993 world development report estimates that mental health problems
the world over produce 8.1% of the global burden of disease (GBD) Measured in
Disability Adjusted life years (DALYs), a toll greater than that exacted by
tuberculosis, cancer, or heart disease.3
The burden from neuropsychiatric disorders ranges from 34% in sub
Saharan Africa to a high of 8% in China and the latin American and Carabian
region. Of the other disorders considered, depressive disorders self inflicated
injuries, Alzheimer’s diseases and other dementias and alcohol dependence cause
the largest burden followed by epilepsy., psychoses, drug dependence and post-
traumatic stress disorders.3
In India according another estimate, nearly 3 crores of individuals were
likely to suffer from mental illness and 1.75 lakhs of new cases were added every
year. Mental retardation was estimated to be at 0.5% to 1% of all children, while
alcohol and drug dependence rates showed a disturbing trend, there was also
significant degree of mortality (92000 annually) from suicide.3
When our attitudes towards understanding and accepting mental illness are
examined over centuries, we find that they have not progressed dramatically. 2
An individuals values and personal beliefs affect his attitude about mental
illness, people with mental disorders and treatment of mental illness. The need
continues for public education to modify or alter misconceptions about mental
illness and person with mental disorder.2
During the clinical posting investigator observed that most of the care
givers of mentally ill patients are lacking their knowledge about mental illness
and also have an negative attitude towards mentally ill patients. This stimulated
the researcher to asses the knowledge and attitude towards mental illness among
the care givers of mentally ill patients at selected hospitals Davangere.
6.2 Review Of Literature :
The purpose of review of literature is to obtain comprehensive knowledge
base and indepth of information from previous studies.

A study was conducted on “attitude towards people with mental illness,

among nursing staff in psychiatric and somatic care and sample consisted of 120
registered or assistant nurses. The results showed that nursing staff in somatic
care, to a higher degree than nursing staff in mental health, reported more
negative attitudes with regard to people with schizophrenia as being more
dangerous and unpredictable. The conclusion of this study was nursing staff are in
several respects comparable with public opinions about mental illness and
mentally ill persons.4

A study was conducted on Beliefs about mental health problems and help
seeking behaviour among young adults. A cross sectional population survey was
done to 2.258 participants, beliefs about cause, consequences, time line and
controllability of self perceived mental health problems were assessed and this
study was concluded that young adults knowledge of mental health problems,
help seeking behaviour may be encouraged by proper education.5

A study was conducted on knowledge and attitude towards people with

mental illness among doctors. 312 medical doctors were selected from eight
health institutions, completed various questionnaires on knowledge and attitude
towards people with mental illness, and this study was concluded that culturally
enshrined beliefs about mental illness were prevalent among doctors. A review of
medical curriculum is needed and the present antistigma campaigns should start
from the doctors.6
 A study was conducted on knowledge and attitude towards mental illness.
This study aims to determine knowledge and attitude of a representative
community samples, multistage clustered sample of 2040 individuals participated
and results showed that poor knowledge of causation was common, negative
views of mental illness were widespread with as many as 96.5% (SD = 0.5)
believing that people with mental illness are dangerous because of their violet
behaviour, most would not tolerate even basic social contact with a mentally ill
person 82.7% (SE = 1.3).7

A study was conducted on the influence of education of nursing students on

the formation of attitudes towards psychiatric illness. Attitude towards mental
illness were examined in 137 undergraduate students in the technological
educational institute, before and after completion of 105 hours course of
psychiatric nursing, after psychiatric training students expressed less authoritarian
views and their opinion toward social integration of mentally ill persons was
found to be more positive and this study concluded that theoretical training and
clinical psychiatric clearkship improve attitudes towards mental illness. 8

A study reported on public attitudes towards people with mental illness.

This study aims to investigate the attitudes of the urban population in Germany
towards people mental illness and a total 7,246 German speaking persons aged 16
and over were interviewed in six German cities by telephone using standardized
questionnaire and study concluded that improvements in the education of the
public about mental illness and provision of the opportunity for personal contact
with mentally ill people are considered to be important measures for promoting
the acceptance of the mentally ill by the public.9
 A study was conducted on perception of stigma among family members of
individuals with schizophrenia and major affective disorder. This study aimed to
estimate the extent and socio demographic distribution of stigma as perceived by
relatives of mentally ill individuals and a total of 178 relatives were interviewed
using the family interview schedule, results showed that about 75% of the
respondents had experienced some sort of stigma due to presence of mental
illness in the family, 42% were worried about being treated differently and 37%
wanted to conceal the fact that a relatives was ill.10

A study was conducted to determine the attitudes knowledge and help

seeking practices for an emotional disorders among 67 community leaders
consisting of nurses, teachers and police officers and 135 community members.
The result showed that the community leaders did some what worse in
recognizing mental illness than did community members and also concluded that
education about mental health problems is needed to community leaders.11

A study was conducted on attitudes among college students towards mental

illness. A total of 101 undergraduate students enrolled. The opinions about mental
illness scale was administered to all participants. This study examines the
difference between senior occupational therapy psychiatry majors as compared to
senior accounting majors in their attitude towards mentally ill. No significant
differences were found for gender and attitudes toward mental illness.12

6.3 Statement of problem :

A study to asses the knowledge and attitude towards mental illness among
care givers of mentally ill patients at selected hospitals Davangere
6.4 Objectives of the Study :
1. To asses the knowledge regarding mental illness among care givers of
mentally ill patients by structured questionnaire.
2. To assess the attitude towards mental illness among care givers of mentally
ill patients by OMI scale.
3. To compare the knowledge with demographic variables.

6.5 Hypothesis
H1 : There will be positive significant association between knowledge and attitude
towards mental illness among care givers of mentally ill patients.

6.6 : Operational definitions :

1) Assess : In this study it refers to organized systematic and continuous
process of collecting data from care givers of mentally ill patients.
2) Knowledge : In this study it refers to correct response of care givers to
structured qestionnarire dealing with mental illness from their knowledge
score.
3) Attitude : In this study it refers to opinion of care givers to OMI scale
dealing with mental illness from their attitude score.
4) Mental illness : In this study it refers to maladjustment in living. It
produces a disharmony in the persons ability to meet human needs
comfortably or effectively and function within a culture.
5) Care givers : In this study it refers to family members who regularly cares
for a mentally ill patients.
6) Mentally ill patients : In this study it refers to those who are having
mental illness, attending the out patient department with their family
members.
6.7 : Assumption :
1) Care gives may deficit of knowledge regarding mental illness.
2) Care givers may have negative attitude towards mental illness.
6.8 : Delimitations :
This study is limited to caregivers of mentally ill patients who are attending
the psychiatric OPD.
7. MATERIALS AND METHODS :
7.1 Source of Data :
Care givers of mentally ill patients attending psychiatric OPD at Bapuji
hospital and CG hospital, Davangere.

7.1.1 Population :
In this study population consists of care givers of mentally ill patients who
are attending the psychiatric OPD at Bapuji Hospital and CG hospital,
Davangere.

7.1.2. Inclusion and exclusion criteria :

Inclusion criteria :
 Care givers of mentally ill
patients
 Who can understand Kannada or
English language
 Who are willing to participate in
the study

Exclusion criteria :
 Care givers of medical illness,
who comes with reference to psychiatric OPD.
 Who are not willing to
participate.

7.2 Methods of Collection of the Data :

Research design : Descriptive study
Setting of the study : Out patient department of Bapuji Hospital, and
C.G Hospital Davangere.
Sampling Technique : The researcher will use purposive sampling technique
Sample Size : The sample size will be 60 care givers of mentally ill patients
Tool : The researcher will develop structured questionnaire into
Step I : Sociodemographic proforma.
Step II :
 To structured questionnaire to
assess the knowledge regarding mental illness.
Step III :
 Opinion about Mental Illness
(OMI) scale to assess the attitude regarding mental illness.

Collection of data :
The researcher will collect the data from care givers by using structured
questionnaire to assess the knowledge and OMI scale to assess attitude regarding
mental illness. Informed consent from care givers of mentally ill patients will be
obtained and prior permission from concerned authority.

Method of data analysis and interpretation :

The researcher will use descriptive statistical techniques such as mean,
standard deviation, standard proportions, chi-square test etc, for data analysis and
present it in the form of tables, diagrams and graphs.

7.3 Does the study require any investigations or interventions to be

conducted on patients or other humans or animals? If so, please describe
briefly :
Yes
The study will be conducted on care givers of mentally ill patients regarding
knowledge and attitude towards mental illness.

7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes
Informed consent will be obtained from institution authorities and subjects
privacy, confidentially and anonymity will be guarded. Scientific objectivity of
the study will be maintained with honesty and impartiality.
8. LIST OF REFERENCES :
1) R. Sreevani. A guide to mental health and psychiatric nursing. Second edition
(2007), 2-3.

2) Dr. (Mrs). K. Lalitha. Mental health and psychiatric nursing. First edition
(1995), 31-40.

3) World federation of teachers union. Teachers of the world 2007 July-

Sept;8(1).

4) Bjorkman T, Angleman TRN, Jonsson MRN. Attitudes towards people with

mental illness : a cross-sectional study among nursing staff in psychiatric and
somatic care. Scandinavian Journal of Caring Sciences 2008;22(2):170-177.

5) Vanheusden K, van der Ende J, Mulder CL, van Lenthe FJ, Verhulst FC,
Mackenbach JP. Beliefs about mental health problems and help-seeking
behavior in Dutch young adults. Soc Psychiatry Psychiatr Epidemiol 2008
Aug 21.

6) Adewuya AO, Oguntade AA. Doctors’ attitude towards people with mental
illness in western Nigeria. Soc Psychiatry Psychiatr Epidemiol 2007
Nov;42(11):931-6.

7) Gureje O, Lasebikan VO, Ephraim-Oluwanuga O. Community study of

knowledge of and attitude to mental illness in Nigeria. Br J Psychiatr
2005;186:436-441.

8) Evagelou H, Adali E, Koukia F, Katostaras M, Priami G, Toulia. The

influence of education of nursing students on the formation of attitudes
toward psychiatric illness. ICUS NURS WEB J 2005;23:1-8.

9) Gaebel W, Baumann A, Witte AM, Zaeske H. Public attitudes towards people

with mental illness in six German cities. European Achieves of Psychiatry
and Clinical Neuroscience 2002;252(6):278-287.
10)Shibre T, Negash A, Kullgren G, Kebede D, Alem A, Fekadu A, et al.
Perception of stigma among family members of individuals with
schizophrenia and major affective disorders in rural Ethiopia. Social
Psychiatry and Psychiatric Epidemiology 2001;36(6):299-303.

11)Kohn R, Sharma D, Camilleri CP, Levav I. Attitudes towards mental illness in

the commonwealth of Dominica. Rev Panam Salud Publica 2000
Mar;7(3):148-54.

12)Cuomo D, Ronacher A. Attitudes among college students towards mental

illness. Inter disciplinary research conference 1998.
9. SIGNATURE OF THE CANDIDATE

10. REMARKS OF THE GUIDE

11. NAME & DESIGNATION OF

(IN BLOCK LETTERS)
11.1 GUIDE

11.2 SIGNATURE

11.3 CO-GUIDE (IF ANY)

11.4 SIGNATURE

11.5 HEAD OF THE DEPARTMENT

11.6 SIGNATURE

12. 12.1 REMARKS OF PRINCIPAL

12. 2 SIGNATURE

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

 BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF

SUBJECT FOR DISSERTATION

“A STUDY TO ASSESS KNOWLEDGE AND ATTITUDE

TOWARDS MENTAL ILLNESS AMONG CARE GIVERS OF
MENTALLY ILL PATIENTS AT SELECTED HOSPITALS
DAVANGERE”.

Mr. PARAMESH G.M.

FIRST YEAR M.Sc. NURSING,
PSYCHIATRIC NURSING

BAPUJI COLLEGE OF NURSING

DAVANGERE – 577 004.