RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA, BANGALORE ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. Name of the candidate and address (in block letters)

ARUN. K. PAUL
K. PANDYARAJAH BALLAL NURSING INSTITUTE COLLEGE OF NURSING, SOMESHWAR ROAD, ULLAL, MANGALORE 575 020.

2.

Name of the Institution

K. PANDYARAJAH BALLAL NURSING INSTITUTE COLLEGE OF NURSING, ULLAL, MANGALORE

3.

Course of Study and Subject

M. Sc. NURSING MENTAL HEALTH NURSING 10/05/2010

4. 5.

Date of Admission to the Course

Title of the study

A DESCRIPTIVE STUDY TO ASSESS THE SUBJECTIVE WELL BEING AND PERCEIVED SOCIAL SUPPORT AMONG THE LONG TERM CARE PATIENTS IN SELECTED

HOSPITALS AT MANGLORE.

6.

Brief resume of the intended work Introduction Subjective well-being means the global tendency to experience the life in a pleasant way. Otherwise, it is a measure in which how people feel about their lives or aspects of their lives. It refers to a broad category of phenomena that includes people's emotional responses, domain satisfaction, and global judgements of life satisfaction 1. Subjective wellbeing is influenced by some factors such as individual coping abilities, income, level of education and self-rated health especially social support. Social support consists of interpersonal transactions and includes emotional support, instrumental support, and informational support. Social support is one of the most important factors in predicting the physical health and well-being of everyone, ranging from childhood through older adults. A general theory that has been drawn from many researches over the past few decades postulates that social support essentially predicts the outcome of physical and mental health for everyone. Subjective well being is interrelated with social support. Subjective well being is good when there is adequate social support though their physical health is disturbed with various chronic illness and disabilities. In long term illness, individuals suffer with chronic illness and disabilities, and they automatically demand for social support in order to promote their health and wellbeing in long term care2. 6.1 The need for the study

Long-term care for people with chronic illnesses and disabilities presents an urgent challenge around the world, as existing systems of care have come under great strain and are unable to fully meet growing demands. The universal problem of long-term care is intensifying, due to a combination of demographic and epidemiological forces. A recent WHO study estimates that in many developing countries, the need for long-term care will increase by as much as 400% in the coming decades3. Long term care people are mostly elderly than young people. The statistical abstract of United States, Health and nutrition 2005 shows that long term care recipients under age 18 is 3%, age between 1864 is 40% and age more than 65 is 57%4. In India, the people suffer from both communicable as well as non- communicable diseases. Certain chronic diseases which are associated with longterm illness are more frequent among the older people than in the younger people5.

A study was conducted in Maastricht university, Netherlands, to test the relationship between social support, coping, and subjective well-being. Data were collected and analysed from 628 patients with one or more chronic rheumatic disorders affecting the joints and in some patients the condition combined with another rheumatic disease. The study result showed that the decrease in social support may affect the subjective well-being negatively. The study concluded that the social support can improve the subjective well being and coping6. While going through all these above mentioned statistical data available from various sources all over the world, and by referring various literatures on Subjective well-being and social support among long term care patients, as a nurse, the researcher felt that it is relevant to conduct a research on this topic. 6.2 Review of literature

A cross-sectional study was conducted in State University, San Diego, USA, to examine the differences in affective aspects of subjective well-being between people with and without spinal cord injuries and to explore the relationships among perceived health, social support, self-efficacy beliefs, and the affective aspect of subjective well-being in these groups. A total of 119 out-patients with spinal cord injuries and 109 college students without disability participated in the study. The study concluded that people with spinal cord injuries may have lower affective subjective well-being than those without spinal cord injuries, and the perceptions of one's health, social skills, and social support may play important roles in achieving affective subjective well-being in people with spinal cord injuries7. A descriptive study done in Republic of Estonia, on the longitudinal changes in psychological coping strategies, social support, life orientation and health-related quality of life in the late period after traumatic brain injury. Thirty-one patients with traumatic brain injury who were first investigated on average 2.3 years after injury and were prospectively followed on average 5.7 years later. The study results show that persons with traumatic brain injury reported an increase in seeking social or emotional support. The study concluded that, when social support, satisfaction with support and health-related quality of life did not improve, the rehabilitation, social and psychological support were continuously

needed8. A descriptive study was conducted in Aligarh, Uttar Pradesh, to find out the impact of religiosity and ego-strength on subjective well being of bronchial asthma and hypertensive patients. The sample consisted of 170 patients. They were categorized into 2 main groups : group 1 comprised of 70 hypertensive patients and group 2 comprised of 100 bronchial asthma patients. The result of the study shows that religiosity, high level of satisfaction and ego- strength are positively related to subjective well being. The study concluded that there is a positive relationship among subjective well being, ego-strength and religiosity9. A cross sectional study was done in the University of California, Los Angeles, to evaluate the relationship between the Sensory Impairments and Subjective Well-Being among aged African American Persons. The study conducted among 988 elderly African American Persons reported visual and hearing impairment of 36.5% and 26% respectively. The findings suggested that poor vision is independently associated with a lower level of subjective well-being among aged African Americans even after adjusting for sociodemographic characteristics, functional limitations and perceived health status. Poor hearing was also found to be associated with a lower level of subjective well-being. The study concluded that the visual and audiological rehabilitation may improve the subjective well-being for African American elderly people10. A study was conducted in the University of Pittsburgh , USA, on the influence of Social support, personal control, and psychosocial recovery following heart transplantation. The study sample included 28 patients who were surveyed during the hospitalization after transplant surgery and 6 months post transplantation. The study found that psychosocial resources assessed during hospitalization were associated with recovery outcomes at 6 months post transplantation. The study concluded that efforts directed toward enhancing perceptions of personal control, social support, and attachment may promote the psychosocial recovery of patients following heart transplantation11.

A longitudinal correlative study was conducted in Taiwan, to explore the degree, to compare the differences and to detect the relationships of uncertainty, social support and psychological adjustment for older cancer patients who were undergoing surgery. A

pre/post test design was used in the study. Purposive sampling technique was used to recruit 43 patients with aged 65-84, from six surgery wards in a medical centre. The study results show that at the time of surgery, the patients had moderate levels of uncertainty and there was a significant decrease in uncertainty at the second data collection period before hospital discharge. The participants, those obtained social support from family members, physicians, nurses, relatives and other patients had low level of uncertainty and anxiety . Thus, the study found the significant relationships among uncertainty and anxiety . The study concluded that a positive relationship existed between anxiety and social support in older cancer patients who undergone surgery12.

6.3

Statement of the problem

A descriptive study to assess the subjective well being and perceived social support among the long term care patients in selected hospitals at

Mangalore. 6.4 1. 2. Objectives of the study To assess the level of subjective well being among the long term care patients. To assess the level of perceived social support among the long term care patients. 3. To correlate the level of subjective well being and perceived social support among the patients. 4. To associate the level of subjective well being with sociodemographic variables among the patients. 5. To associate the level of perceived social support with sociodemographic variables among the patients. 6.5 Operational definitions

1.
that judgments

Subjective well being In this study, subjective well being refers to a broad category of phenomena includes people's emotional responses, domain satisfaction, and global of life satisfaction.

2.

Perceived social support In this study, social support is the physical and emotional comfort given to the patients by their family, friends, co-workers and others.

3.

Long term care patient In this study, long-term care patient is a person aged above 20 years and hospitalised for more than three weeks with chronic illness or disabilities.

6.6

Assumptions The study assumes that,

1. 2.

disease condition may reduce the subjective well being of the patients. subjective well being and perceived social support are interrelated.

6.7

Delimitations Present study will be delimited to,

selected hospitals at Mangalore. those who are willing to participate in the study.

6.8

Hypotheses The following hypotheses will be tested at 0.05 level of significance :

H1 -

There will be a significant correlation between subjective well being and perceived social support.

H2 -

There will be a significant association between the level of subjective well being with sociodemographic variables.

H3 -

There will be a significant association between the level of perceived social support with sociodemographic variables.

7.

Material and methods 7.1 Source of data Data will be collected from the long term care patients hospitalized in selected hospitals in Mangalore. 7.1.1 Research design The research design adopted for the study will be descriptive correlation design. 7.1.2 Setting The study will be conducted in selected hospitals in Mangalore. 7.1.3 Population Population selected for the study comprised of both male and female long term care patients who are above 20 years of age in selected hospitals in Mangalore.

7.2 7.2.1

Methods of data collection Sampling procedure Sampling procedure will be non probability convenience sampling.

7.2.2

Sample size Sixty long term care patients those who fullfil both inclusion and exclusion criteria.

7.2.3

Inclusion criteria for sampling Long term care patients those who are hospitalized for treatment in selected hospitals.

Both male and female long term care patients those who are willing to participate in the study.

7.2.4 7.2.5 1. 2.

The patients those who are able to read Kannada or English. Long term care patients those who are above 20 years of age. Exclusion criteria for sampling Long term care patients those who are unconscious. Long term care patients with sensory impairment. Long term care patients those who are admitted in ICU. Instruments intended to be used Socio-demographic proforma. Subjective well being Scale by WHO and Multi - dimentional perceived Social Support scale.

7.2.6

Data collection method The researcher will get permission from hospital authorities and the consent will be obtained from subjects to conduct study. A rating scale will be given to participants to assess the perceived social support and subjective well being.

7.2.7

Data analysis plan The collected data will be analyzed using descriptive and inferential statistics. In descriptive statistics; Mean, Standard deviation, Frequency and percentage will be used.

In inferential statistics; Karlpearson correlation coefficient method will be used to find out the relationship between subjective well being and perceived social support.

Chi-square test will be used to find the association between subjective well being, perceived social support and demographic variables.

7.3

Does the study require any investigations or interventions to be conducted on patients, or other animals? If so please describe briefly. No, the study does not require any investigations on patients, or other animals.

7.4

Has ethical clearance been obtained from your institution in case of 7.3? The permission to conduct the study obtained from the ethical committee of K.P.B.N.I.

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8.

References
1.

Description of Subjective well-being. Available from: URL : http://www.intosai4kni.org. October 17, 2010.

2.

Corey M. Clark. Relations Between Social Support and Physical Health. Available from: URL:http://www.personalityresearch.org. October 19, 2010.

3.

World Health Organisation. Ethics and Health. Available from: URL: http://www.who.int. October 21, 2010.

4.

Global statistics of long term care. Available from: URL: http://www.longtermcare.gov. October 22, 2010.

5.

Indian statistics of long term care. Available from: URL: http://www.esocialsciences.com. October 22, 2010.

6.

Savelkoul M, van den Borne HB. Social support, coping and subjective well-being in patients with rheumatic diseases. 2000; Feb 39 (2-3); p: 205-218.

7. 8. 9.

Hampton. Disability Rehabilitation.2008; vol. 30(19); p: 1473-1479. Tomberg T, Toomela A . Brain Injury. 2007; vol. 21(5); p: 479- 488. Shahina Maqbool, Zainab. Journal of the Indian academy of applied psychology. 2003; vol.29; p: 63-67.

10. 11.

Mohsen Bazargan , Richard S. Baker. oxford journals; 2010; vol.33; no.1. Bohachick P, Taylor MV. Clinical Nurse Resident .2002 February ; vol. 11(1); p: 34-51.

12.

Lien CY, Lin HR . Jounal of Clinical Nursing. 2009 August; vol.18(16); p: 2311-2319.

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9.

Signature of the candidate

10.

Remarks of the guide

The study is feasible and practical to conduct in the selected area.

11.

Name and designation of (in block letters) 11.2 Guide MRS KIRUPA P ASSISTANT PROFESSOR K.P.B.N.I, ULLAL MANGALORE

11.2 Signature 11.3 Co-guide (if any) MISS SHANTHIPRIYA MONTEIRO LECTURER, K.P.B.N.I, ULLAL MANGALORE

11.4 Signature 12 12.1 Head of the department MRS KIRUPA P ASSISTANT PROFESSOR K.P.B.N.I, ULLAL MANGALORE

12.2 Signature 13. 13.1 Remarks of the Chairman and Principal

13.2

Signature

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