Problem statement:-“TO ASSESS THEEFFECTIVENESS OfSTRUCTURED ACTIVITYPROGRAMME ON THE LEVEL OFSELF CARE ABILITY ONPERSONAL HYGIENE OFPATIENTS DIAGNOSED WITH N. Padmavathi, Dr. k lalitha, Dr. R. parthasarathySCHIZOPHRENIA.”Msc Nursing and clinical instructor Nimhans , banglore Journal of NRSI - april-may(2011), vol. 4, issue 1
IntroductionSchizophrenia:-It is a psychotic condition characterize by disturbances in thinking, emotions and behavior in the presence of clear consciousness, which usually leads to social withdrawal.
AIM:- TO Prepare structured activity programme and evaluate its effectiveness on the level of self care ability on personal hygiene for patients diagnosed with schizophrenia. 01/30/13
OBJECTIVE Toassess the level of self care ability on personal hygiene of patients with schizophrenia. To find out the effectiveness of structured activity programme on the level of self care ability on personal hygiene seen among patients with schizophrenia.
Hypothesis H0:- there will be statistically no significant difference in the level of functional ability between experimental group and control group before and after implementation of structured activity programme.
Research approach:-true experimental approach. Research design:- pre test and post test design with control group. Settings:- In patients female open general ward as well as closed ward at NIMHANS, BANGLORE. POPULATION:-FEMALE PATIENTS WHO WERE DIAGNOSED WITH SCHIZOPHRENIA.
Sample size- 30 PATIENTS 15 Control group & 15 Experimental group Sampling technique:- MULTIPHASE SIMPLE RANDOMv SAMPLING.v PATIENTS WHO MET THE SELECTION CRITERIA COTROL GROUP – PATIENTS FROM CLOSED FEMALE WARD EXPERIMENTAL GROUP- PATIENTS
INCLUSION CRITERIA Patients with schizophrenia All sub types of schizophrenia Only FEMALE Patients admitted first time in NIMHANS. Duration of illness >6 months Age 18-60 yrsEXCLUSION CRITERIA:- Patients with co-morbid condition like alcoholism, MR etc. Patients with acute symptoms. 01/30/13
TOOLS Part-1 socio-demographic data sheet Name, age, religion, habitat, education, occupation, marital status, family status, family income, diagnosis, duration of illness & handicap. Part-2 rating scale for functional assessment 5 point rating scale raging from 0-4. Maximum- 176 & minimum- 0. Higher the score High self care ability. Tools had been pilot tested and found to be feasible, practical, and suitable for study. 01/30/13
Data collection procedure Permission from concerned authorities. Written informed consent from care giver/ staff Incharged. After collection of pre-test data implementation of SAP. 12 session on personal hygiene activities such as brushing, teeth, eating, nail care & hair care. Each activity 3 days. Skill training & lecture method by using video tap & ppt slides. 01/30/13
Data analysis-1. MANN WHITNEY U test- Compare the score b/w the group. Non-parametric test Equivalent of independent sample ‘t’ test.2. WILICOXON SIGNED RANKS TEST Compare the score within the group. Non-parametric test Equivalent of paired ‘t’ test. 01/30/13
Major findings of the study:- Dimension wise comparison of pre test score on self care ability on personal hygiene between the experimental group and the control group at baseline. N=30 Table-1Dimension Experimental Control group Z-value P- group(n=15) (n=15) value MEAN SD MEAN SDBrushing 10.93 4.62 13.13 5.49 -1.125 0.261teeth(D1)Eating (D2) 7.93 4.85 12.20 7.18 -1.66 0.096Nail care(D3) 3.80 3.69 5.47 6.61 -0.336 0.737Hair care(D4) 11.80 6.65 12.73 6.64 -0.021 0.983 01/30/13
Dimension wise comparison of pre test and post test score on self care ability on personal hygiene Within the experimental group . N=30 TABLE- 2Dimension Pre test Post test improve Z-value P- ment value MEAN SD MEAN SDBrushing 10.93 4.62 33.80 4.02 22.9 -3.412 0.001teeth(D1)Eating (D2) 7.93 4.85 31.47 5.22 23.5 -3.410 0.001Nail care(D3) 3.80 3.69 29.80 5.99 26.0 -3.415 0.001Hair care(D4) 11.80 6.65 31.40 5.68 19.6 -3.411 0.001 Improvement in self care ability and statically significant at p=0.001. 01/30/13
Dimension wise comparison of pre test and post test score on self care ability on personal hygiene Within the control group . N=30 TABLE- 3Dimension Pre test Post test improve Z-value P- ment value MEAN SD MEAN SDBrushing 13.13 5.49 22.33 5.37 9.2 -3.413 0.001teeth(D1)Eating (D2) 12.20 7.18 18.40 6.08 6.2 -3.306 0.001Nail care(D3) 5.47 6.61 12.13 6.52 6.7 -3.417 0.001Hair care(D4) 12.73 6.64 20.33 6.32 7.6 -3.424 0.001 Improvement in self care ability compare to pre test and post test. 01/30/13
. Dimension wise comparison of post test score on self care ability on personal hygiene between the experimental group and the control group. N=30 Table-4Dimension Experimental Control group Z- P- group(n=15) (n=15) value value MEAN SD MEAN SDBrushing 33.80 4.02 22.33 5.37 -4.305 <0.001teeth(D1)Eating (D2) 31.47 5.22 18.40 6.08 -4.323 <0.001Nail care(D3) 29.80 5.99 12.13 6.52 -4.339 <0.001Hair care(D4) 31.40 5.68 20.33 6.32 -3.931 <0.001 Highly significantly difference in level of self care ability in post test score b/w expermental group and control group since ‘p’ value was 01/30/13
Major findings:- Even both group had improvement in all four dimensions, but the experiment group had significant improvement than the control group. Dimension wise comparison of post test score b/w experimental & control group showed that SAP Is significantly improved the self care ability of subject in experimental group. So null hypothesis was rejected. 01/30/13
conclusionStudy was carried out to assess the effectiveness of structured activity programme on the level of self care ability on personal hygiene of patients diagnosed with schizophrenia.Finding showed that SAP improved the self care ability on personal hygiene.The intervention package would provide significant implication on field of education, practice & research.
REFERENCESBhugra, D.(2005). The global prevalence of schizophrenia.Plos medicine ,2(5) ,372-373. Plante T G. SOCIAL skills training; a programme to help schizophrenic client cope. Journal of psychosocial nursing and mental health services 1989; 27(3)- 6-10. Robert KH, liberman RP, Alex Kopehwic. Psychosocial skill training for schizophreniac: lesson from the laboratory schizophrenia bulletin . 2000;26(1): 21-46 World health organization. World health report . Mental health : new understanding, new hope. Geneva.2001