CHAPTER III

METHODOLOGY

Research methodology is a way to solve the research problems

systematically. It involves a carries of procedures in which researcher starts
from initial identification of the problems to its conclusion. The chapter deals
with the description of methodology and different steps, which were
undertaken for gathering and organizing data for the investigator including.
-Research approach -Research design -Study setting and site -Target
population -Sample and sampling technique -Development and description of
tool -Pilot study -Data collection procedure -Plan for data analysis
-Development of self-instructional module

Research approach:
Research approach tells the researcher from whom the data was to be
collected, when the data is to be collected and how to analyze them. It also
suggests possible conclusion and helps researcher in answering specific
research questions in the most accurate and efficient way as possible. The
research approach used for the study is quasi-experimental in nature.
According to Polit and Hungler, the purpose of quasi-experimental study is
to explore aspects of a situation. The researcher planned to describe the
knowledge of school teachers regarding learning disabilities.

STATEMENT OF THE PROBLEM

A study to assess the effectiveness of self-instructional module on occupational

rehabilitation among drug abuse patients at selected rehabilitation center, Bangalore.

6.3 OBJECTIVES
6.3.1 To assess the knowledge of patients with drug abuse regarding occupational rehabilitation

in terms of pretest knowledge scores.

6.3.2 To assess the effectiveness of self-instructional module by comparing pre and posttest

knowledge scores of patients.

6.3.3 To determine the association between posttest knowledge scores of drug abuse patients and

their demographic variables.

6.4 HYPOTHESES

H1: There is no significant difference in pretest and posttest knowledge scores of drug

abuse

patients on occupational rehabilitation.

H2: There is no significant association between posttest knowledge scores of drug abuse

Patients and their demographic variables.

6.5 ASSUMPTIONS

6.5.1 Self-instructional module may enhance the knowledge on occupational rehabilitation

among drug abuse patients.

6.6 OPERATIONAL DEFINITIONS

 Effectiveness: Refers to the extent to which the self instructional module has attained the

desired gain in knowledge score as measured by knowledge questionnaire.

16

 Self-Instruction Module: It refers to systematic organized self-learning /directed material

on occupational rehabilitation which was given to drug abuse patients.

  Drug abuse patients: Refers to Males who are diagnosed as drug addicts between 21-

60 years of age admitted in the selected rehabilitation center, Bangalore.

 Occupational Rehabilitation: Occupational Rehabilitation refers to any meaningful, goal

directed activities (self-care skills, education, work, or social interaction ) which is given

to change the behavior of the drug abuse patients.

 Rehabilitation Centre: Refers to an area where physical and occupational rehabilitation

services are provided for drug abuse patients.

7.0 MATERIAL AND METHODS

7.1 SOURCES OF DATA

Drug abuse patients who are admitted in selected rehabilitation center, Bangalore.

7.2.1 RESEARCH APPROACH

In the present study an evaluative approach will be used to assess the effectiveness of self-

instructional module on occupational rehabilitation among drug abuse patients.

7.2.2 RESEARCH DESIGN

In this study one group pretest - posttest (pre-experimental design) has been adopted to

carry out the present study.

7.2.3 SETTING OF THE STUDY

Study will be conducted at selected rehabilitation center, Bangalore.

17
7.2.4 RESEARCH VARIABLES

Independent variable: In this study it refers to self-instructional module on occupational

rehabilitation.

Dependent variable: In the present study it refers to the knowledge level of the drug

abuse patients on occupational rehabilitation.

7.2.5 POPULATION

In this study, drug abuse patients were the population for the study.

7.2.6 SAMPLE SIZE

In this study the sample comprised of 60 drug abuse patients admitted in a selected

rehabilitation center, Bangalore.

7.2.7 SAMPLING TECHNIQUE

In the present study the convenient sampling technique was used to select the samples.

7.2.8 SAMPLE CRITERIA

INCLUSIVE CRITERIA

The study includes drug abuse patients

 between 20-60 years of age

 who gave consent to participate in the study

 Who can understand Kannada.

 Who are available at the time of data collection.

 18

EXCLUSIVE CRITERIA

The study excludes drug abuse patients

 Drug abuse patients with medical complications.

 Drug abuse patients who were under primary treatment.

7.2.9 DATA COLLECTION TOOL

The data will be collected by using structured questionnaire schedule which consist of two

parts.

Part 1- It includes the demographic variables such as age, educational status, monthly

income, type of family, family history of drug abuse, duration of use and source of

information.

Part 2-It includes knowledge items on occupational rehabilitation

7.2.10 DURATION OF THE STUDY

As per university guidelines that is 4 to 6 weeks.

7.2.11 DATA ANALYSIS METHOD

The collected data will be analyzed through descriptive inferential statistics.

Descriptive statistics- It includes mean, frequency, percentage, range, standard deviation

to describe demographic variables and knowledge aspects.

Inferential statistics- It includes parametric paired t’ test and non-parametric chi-square

test to assess the effectiveness of self-instructional module and study the association

between the Knowledge scores with selected demographic variables.

 19

7.3 DOES THE STUDY REQUIRE ANY INTERVENTION TO BE CONDUCTED

IN A PATIENTS OR OTHER HUMANS OR ANIMALS?

YES

7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR

INSTITUTION?

YES, Ethical clearance certificate enclosed.

 20

8. LIST OF REFERENCES

1. Mark Dombeck, Alcohol Substance Abuse ( Interent ) 2009; Available from http://

www.mhcinc.org.

2. Kevin P Daly: John Richards, Substance Abuse 2008; Available from http://

www.emedicene health .com / substance abuse.

3. World Health Organization. Regional health forum. Vol 10 (23); 2005.

4. Susan Everingram, C. Rydell Cocaine Consumption in the U.S. Estimating part Trends

and Future Senarios. Socio – Economic Planning sciences Vol – 29 (4) December 2000.

5. Dr.K.Lalitha, Mental health and Psychiatric Nursing, 2007, 11 edition, VMG book

house, 35-48.

6. S. Zaimov, wisegeek Article of occupational Rehabilitation 2003 – 2005 (24) 2008

-2010.

7. Professional Guide to disease, 2005, 8th edition.

8. James C. Anthony, vocational rehabilitation outcomes of veterans with substance use

disorders in a partial hospitalization program psychiatric serve 51, 2000, 1570-1572.

9. Heather R. Huhman, the peer supported community program, published by Substance

abuse and mental health services administration, 2008.

10. Drug-Statistics Bangalore, 2007.

11. Jain.V, Socio demographic profile of 15-24 years old male narcotic substance users in a

resettlement colony of Delhi, 2009.

12. Megge Miller, Illicit drug use regarding amphetamines, 2000.

13. Siddiqui HY, National survey on extent patterns and trends of drug abuse in India

monitoring system, 2004, 3-9.

21

14. Weich L, Occurance of comorbid substance use disorders among acute psychiatric

inpatients at Stikland hospital in the Western Cape, South Africa, 2009, 213-217.

15. Sennekamp W, Basler B, [Problematic consumption of addictive drugs in psychiatric

rehabilitation, 2004.

16. Ovandir Alves et al, Yon amine Drug abuse among workers in Tehran, Iran, 2004,

2004.

17. Indian express, 2000.

18. Chung JC, Active learning of geriatric rehabilitation: deliberations of an undergraduate

occupational therapy programme, 2001, 250-256.

19. Chan SC, drug abuse and engagement in occupation, 2004 , 408-15.

20. Schkrohowsky JG, Kalesan B, Alberg AJ, Tobacco awareness in three U.S. medical

schools, 2007, 101-6.

21. Lequerica AH, Donnell CS, Tate DG, Patient engagement in rehabilitation therapy:

physical and occupational therapist impressions, 2009, 753-60.

22. Sullivan, Michael, Psychologically Based Occupational Rehabilitation: The drug abuse

Prevention Program, 2003, 97-104

23. Bimla kapoor, text book of Psychiatric Nursing, I edition, New Delhi, Kumar

publications.2005.
24. Sreevani, Text books of Mental health Nursing, Jaypee publications, 2005, II edition.

269-275.

25. Verbeek J, Spelten E, Kammeijer M, Sprangers M, Return to work of cancer survivors:

a prospective cohort study into the quality of rehabilitation by occupational physicians,

2003 , 3527.

22

26. Souza D, Juliana L. Evaluation of SIM for senior secondary school students. The

Nursing Journal of India2004 August; 9 (8): 75-87.

27. Brock C. A study to identify the effectiveness of learning activity package for trhe

adults with rheumatoid arthritis, Journal of Advanced Nursing 2003 June; 28 (8): 265-

275

28. Yumnum Sundari Devi. Effectiveness of need based SIM on knowledge regarding the

management of dysmenorrhoea among adolescent girls in an urban school, North

Bangalore. Unpublished M.Sc Nursing Thesis, RGUHS Bangalore 2002.

29. Lindsay C, Jenrich J.A, Bierndt M, programmed instruction booklet cardiac

rehabilitation teaching, Heart Lung, 1999 November; 20 (6): 698-531.

6.3 STATEMENT OF THE PROBLEM:

“A study to evaluate the effectiveness of self instructional module regarding knowledge

on opioids and cocaine abuse among teenage students at selected P.U colleges, Bangalore”.

6.4 OBJECTIVES OF THE STUDY:

The objectives of the study are to:

1. assess the level of knowledge in teenagers regarding opioids and cocaine abuse.

2. find out the difference between the mean pre test and post test knowledge regarding

opioid and cocaine abuse.

3. determine the association between the mean pre test knowledge level of teenage students

regarding opioid and cocaine abuse with selected socio demographic variable.

4. determine the association between the mean post test knowledge level of teenage students

regarding opioid and cocaine abuse with selected socio demograpj=hic variable.

6.5 HYPOTHESIS:

H1 : There will be significant difference between the mean pre test and post test knowledge score

of teenage students regarding opioid and cocaine abuse will be significantly higher than the pre

test knowledge scores.

H2 : There will be significant association between the mean pre test knowledge level of teenage

students regarding opioid and cocaine abuse with selected socio demographic variables.

H3 : There will be significant association between the mean post test knowledge level of teenage

students regarding opioid and cocaine abuse with the selected socio demographic variables.
6.6 OPERATIONAL DEFINITION OF TERMS:

In this study it refers to:

Evaluate:

The method of estimating and interpreting the effectiveness of self instructional module on

knowledge of opioids and cocaine abuse.

Effectiveness:

The significant increase in the level of knowledge among teenagers regarding abuse of opioid

sand cocaine as measured as the correct responses to the items given in the tool after the

exposure to a self instructional module. The knowledge score will be interpreted as adequate,

moderately adequate and inadequate level of knowledge.

Self instructional module:

A systematically organized self instructional module by the investigator and validated by

experts, which includes opioids and cocaine definition, causes, ill effect, management and

prevention.
P U college:

It is a place where teenagers learn, a place where undergraduate adolescents go to be educated.

Teenage students:

A teenage students is someone who is between 15 to 19 years old and who goes to college for

education.

Knowledge:

The level of understanding and awareness of teenagers regarding opioid and cocaine abuse

measured by the correct response from the participants to the items given in the questionnaire.

Abuse:

It refers to maladaptive pattern of substance uses.

Socio demographic variables:

Attributes of subjects that are measured through the study such as age, sex, educational

qualification, religion, monthly family income, area of residence, family use of substance, source

of information and habits.

6.7 ASSUMPTIONS:

The study is based on the following assumptions:

1. teenagers may have inadequate knowledge regarding opioid and cocaine.

2. knowledge may influence the awareness of harmful effects of opioids and cocaine

abuse.
 3. knowledge regarding opioids and cocaine abuse varies according to their level end

perception.

6.8 DELIMITATIONS:

The study will be delimited to students:

1. who are between the age group of 15 to 19 years.

2. at selected PU college.

7. MATERIALS AND METHODS:

7.1 SOURCES OF DATA:

Teenage students who are studying at selected PU colleges, Bangalore.

7.2 METHODS OF DATA COLLECTION:

Research method : Experimental study

Research Design : Experimental sampling.

Sampling technique : Simple random sampling

Sample size : 60 teenage students.

Setting of this study : selected P U college, Bangalore.

7.2.1 CRITERIA FOR SELECTION OF SAMPLES:

Inclusion criteria
The study includes teenage students who are:

1. studying in a selected P U college.

2. willing to participate in the study.

3. availability at time of data collection.

Exclusion criteria

The study excludes teenage students who are:

1. not available at the time of data collection.

2. have undergone educational program regarding opioid and cocaine abuse within 6

months.

7.2.2 DATA COLLECTION:

A structured knowledge questionnaire will be prepared to assess the teenage students

regarding opioids and cocaine abuse. A self instructional module will be prepared regarding

opioids and cocaine abuse. Content validity of the tool and self instructional module will be

ascertained in consultation with guide and experts from various fields like Psychiatry Medicine

and Nursing. Reliability of the tool will be established by split half method.

Prior to the study, written permission will be obtained from the concerned authority.

Further consent will be taken from the teenager students regarding their willingness to participate

in the study. The proposed period of data collection will be on August 2013.

7.2.3 DATA ANALYSIS METHOD:

 Data analysis will be done by using descriptive(mean, standard deviation) and inferential

statistics(‘t’ test, chi-square test). Frequency and percentage distribution will be used to analyze

demographic variables. Mean and standard deviation will be used to assess the knowledge of the

teenage students regarding opioid and cocaine abuse. A paired ‘t’ test will be done to compare

the mean pre test and post test knowledge scores of the teenage students. A chi square(χ 2)test will

be done to determine association between the mean pre test knowledge level and the selected

socio demographic variables.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR

INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER

HUMANS OR ANIMALS:

No.

The study requires intervention in the form of a self instructional module. No other

interventions which can cause any physical harm will not be done for the subjects.

7.4 HAS ETHICAL CLEARANCE BE OBTAINED:

Yes.

A. Written permission from the institutional authority will be obtained.

B. Written consent will be obtained from the samples regarding their willingness to

participate in the study.

C. Confidentiality and anonymity of subjects will be maintained.

LIST OF REFERENCE:

1. Leslie L. Iverson, Oxford university press.

2. Drug abuse and dependence, www.health.am/psychiatric/more/opioid abuse and

dependence, December 06,2005.

3. William J Meehan MD, Steven A. Adelman MD, opioid abuse July

31,2009.http//emedicine.medscape.com

4. Singapore psychiatrist nesilienmind.com, Article source

http//www.ezine.articles.com/23135

5. Opioid dependence,www.opioidcocaine.net/narcotics/heroin.

6. Madeira Moddie “dealing with drug abuse”fronyline volume 22, issue 17, August 2005,

13-15.

7. Prathima Moorthy N, Manjunatha, Department of Psychiatry deaddiction center,

NIMHANS.

8. http//ibnlive.com/news/inindiansurveys//html(accessed on 09/09/2011).

9. www.azaindia.com

10. A report of the commission of substance abuse among adults.

11. Asmara Ahmed Malik, Shifa medical institute, department of Psychiatry 2011.

12. Abhay M, Gaidhare, Quazi Syed Zhiruddin, version of record first published, 29 April

2008,page 42-52.

13. Deborah E. Smith, Richard E Schwartz, psychiatric research, diagnostic laboratories of

America, south plans field.

14. Suresh k. Sharma, Nursing Research and statistics, Elsevier publication, page no:40-42.
15. Kuramoto SJ, Chilcoat HD, Ko J, Psychiatric Institute for Research and education.

jkurmoto@psych.org.

16. Soravisut N, Raltanasalee P, Junkey A, Department of forensic medicine, faculty of

medicine, Thailand.

17. Raisch DW, Campbell HM, Garnand DA, university of New Mexico, Albuquerque, USA.

18. Wanjek B, Rosendel J, Gabriel HH(2004).

19. Pletcher MJ, Keryesz SG, Sidney Drug Alcohol Dependence 2005 october 1:80(1):45-51.

20. Richardson LP, Russo JE, Katon W, Department of paediatrics,school of medicine,

University of Washington.

21. Curcio F, Franco T, Topa M, itinery2008@alive.it.emm.rec.medicalscience 2011,

August(15).

22. Maulik Pal, Tripathi, Pandey, Trends towards substance abuse. Opioid dependent subjects,

New Delhi.

23. Neilson DA, Bahl A Varma, Kreek MJ, Laboratory of the biology of addictive diseases,

Drug alcohol and dependence 2012, July 1:124(1-2):113.20.

24. Prathima Moorthy, N, Manjunatha, Department of Psychiatry deaddiction center.

introduction
mostly, people use psychoactive substances because they expect to benefit from their use, whether by
pleasure or by the avoidance of pain, including social uses. But using psychoactive substances also
carries with it the potential for harm, whether in the short run or in the longer term.

The main harmful effects due to substance use can be divided into four categories (see Fig. 2). First
there are the chronic health effects. For alcohol this includes liver cirrhosis and a host of other chronic
illnesses; for tobacco taken in cigarette form, this includes lung cancer, emphysema and other chronic
illnesses. Through the sharing of needles, heroin use by injection is a main vector for transmission of
infectious agents such as HIV (see Box 1) and hepatitis B and C virus in many countries. Second there are
the acute or short-term biological health effects of the substance. Notably, for drugs such as opioids and
alcohol, these include overdose.

Figure 2. Mechanisms relating psychoactive substance use to health and social problems

Also cla ssed in this category are the casualties due to the substance’s effects on physical coordination,
concentration and judgement, in circumstances where these qualities are demanded. Casualties
resulting from driving after drinking alcohol or after other drug use feature prominently in this category,
but other accidents, suicide and (at least for alcohol) assaults are also included. The third and fourth
categories of harmful effects comprise the adverse social consequences of the substance use: acute
social problems, such as a sudden break in a relationship or an arrest, and chronic social problems, such
as defaults in working life or in family roles

What is the health burden attributable to psychoactive drugs?

The source document for this Digest states:

There is now a developing tradition of estimating the contribution of alcohol, tobacco and illicit
substance use to the global burden of disease (GBD). The first significant attempt at this was in the WHO
project on the Global burden of disease and injury (6). Based on a standard of measurement known as
disability-adjusted life years (DALYs), estimates of the burden imposed on society due to premature
death and years lived with disability were assessed. The global burden of disease project showed that
tobacco and alcohol were major causes of mortality and disability in developed countries, with the
impact of tobacco expected to increase in other parts of the world

What main harmful effects are caused by psychoactive drug use?

Mostly, people use psychoactive drugs because they expect some benefit, either getting pleasure or
avoiding pain. However, using these drugs can cause harm in the short and longer term.

The main harmful effects of drug use are as follows:

  Short-term Long-term

Health Deaths and injuries caused by
effects driving after drinking alcohol or after
other drug use,
other accidents, suicide,
assaults (at least for alcohol)
overdose (for drugs such as opioids
and alcohol).
For alcohol this includes liver cirrhosis.
For cigarette smoking this includes lung cancer,
emphysema and other chronic illnesses.
For heroin taken by injection and through the sharing
of needles, this includes the possibility of contracting
HIV or hepatitis B and C.

Social For example a sudden break in a For example neglecting work and family duties.
problems relationship or an arrest.

Table 3 offers ample evidence that the burden of ill-health from use of psychoactive substances, taken
together, is substantial: 8.9% in terms of DALYs. However, GBD findings re-emphasize that the main
global health burden is due to licit rather than illicit substances.

Among the ten leading risk factors in terms of avoidable disease burden, tobacco was fourth and alcohol
fifth for 2000, and remains high on the list in the 2010 and 2020 projections. Tobacco and alcohol
contributed 4.1% and 4.0%, respectively, to the burden of ill health in 2000, while illicit substances
contributed 0.8%. The burdens attributable to tobacco and alcohol are particularly acute among males
in the developed countries (mainly Europe and North America). This is because men in developed
countries have a long history of significant involvement with tobacco and alcohol and because people in
these countries live long enough for substance- related health problems to develop.

What are psychoactive drugs and how much are they used?

Alcohol and cocaine are examples of psychoactive drugs.

Source: WHO
Psychoactive drugs are substances that can alter the consciousness, mood, and thoughts of those who
use them. Examples include tobacco, alcohol, cannabis, amphetamines, ecstasy, cocaine, and heroin.
More...

1.1 Tobacco smoking is spreading rapidly in developing countries and among women. The average
consumption of cigarettes is particularly high in Asia and the Far East, with the Americas and Eastern
Europe following closely behind. More...

1.2 Whereas the consumption of alcohol is decreasing in developed countries, it is increasing in

countries of the former Soviet Union and in developing countries, especially in the Western Pacific
Region. More...

1.3 Worldwide, about 200 million people use some type of illicit drug, most commonly cannabis, but
also others such as amphetamines, opioids, and cocaine. The use of illicit drugs is more frequent among
males an d younger people. The number of people who inject drugs is also increasing, which contributes
to spreading HIV More...