DISSERTATION PRESENTATION

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DISSERTATION PRESENTATION PRESENTED
BY P.VIJAYA LAKSHMI M.Sc NURSING 2nd YEAR G.S.L
COLLEGE OF NURSING
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PROBLEM STATEMENT A STUDY TO
ASSESS THE KNOWLEDGE AND ATTITUDE REGARDING
SCHIZOPHRENIA AMONG CAREGIVERS OF SCHIZOPHRENIC
PATIENTS, IN SELECTED PSYCHIATRIC HOSPITAL,
RAJAHMUNDRY.
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INDRODUCTION In the modern concept,
mental health is not merely absence of mental
illness. Some Psychologists have defined mental
health as the ability of the individual to make
personal and social adjustments. These
adjustments relate to once daily life in relation
to others,at home and at work. Health in its
modern concepts has defined by WHO implies
complete physical, mental and social well being
and not merely an absence of disease. Mental
Health contributes to Physical Health and
vice-versa.
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Schizophrenia is found all over the World, the
severity of the symptoms and long lasting,
chronic pattern of schizophrenia often cause a
high degree of disability. Schizophrenia is a
chronic, severe and disabling the brain disease.
Approximately one percent of the population
develops Schizophrenia during their life time.
Although schizophrenia affects men and women with
equal frequency, the disorder often appears
earlier in men, usually in the late teens or
early twenties, than in women, who are generally
affected on the twenties to early thirties.
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Although an exact definition of schizophrenia
still evades medical researchers the evidence
indicates more and more strongly that
schizophrenia is a severe disturbance of the
brains functioning. In the Broken Brain the
Biological revolution in psychiatry, Dr. Nancy
Andreasen states - The current evidence
concerning the causes of schizophrenia is a
mosaic. It is quite clear that multiple factors
are involved. These includes changes are
involved. These includes changes in the chemistry
of the brain, chances in the structure the brain
and genetic factors. Viral infections and head
injuries may also play a role finally,
Schizophrenia is a probably a group of related
diseases, some of which are caused by one factor
and some by another.
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There are billions of nerve cells in the Brain.
Each nerve cell has branches that transmit and
receive messages from other nerve cells. The
branches release chemicals, called
neurotransmitters which carry the messages from
the end of one nerve branch to the cell body of
another. In the brain affected with
schizophrenia, something goes wrong in this
communication system. Many families of people
with schizophrenia have found comparing the brain
to a telephone switch board every helpful in
understanding the disease. Maryellen Walsh states
In most people the brains switching system
works well. Incoming perceptions are sent along
appropriate signal paths, the switching process
goes off without a hitch, and appropriate
feelings, thoughts, and action go back out again
to there world in the brain afflicted with
Schizophrenia.. Perceptions come in but get
routed along the wring path or get jammed or end
up at the wrong destination.
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Schizophrenia may develop so gradually that the
family and even the person with disease may not
realize that any is wrong for a long period of
time. This slow determination is referred to as
gradual-oneself or insidious Schizophrenia. A
gradual build up of symptoms may or may not lead
to an acute or crisis episode of Schizophrenia.
An acute episode is short and intensive and
involves hallucinations, delusions, thought
disorder, and an altered sense of self.
Sometimes Schizophrenia has a rapid or sudden
onset very dramatic changes in behavior occur
over a few weeks or even a few days. Sudden onset
usually leads fairly quickly to an acute episode.
Some people are very few such attacks in a life
time others have more. Some peoples lead
relatively normal lives between episodes. Others
find that they are very listless depressed, and
unable to function well.
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NEED FOR STUDY Every Human being
is born and brought up in family. It is an
architect of an individual to personality. A
family prepares an individual to perform this
multiplicity of roles, which requires stable
states of mind and good family environment. The
mental illness has always be regard in a special
way by people time immemorial. The mentally ill
person behaves abnormally which will not be
understood by others and maybe mistaken for
purposeful acting and thereby forming a negative
attitude towards mentally ill. The role of family
is crucial in maintenance of positive mental
health.
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Schizophrenia and it is important to understand
them to successfully treat the illness. In India,
where about 1.1 billion people reside, the
prevalence of Schizophrenia is about 3/1000
individuals (Gururaj, Girish Isaac, 2005). It
is more common in men, and in terms of age of
onset, men tend to be younger by an average of
about five years than women when they develop
schizophrenia. In terms of symptomaologt, overall
men with schizophrenia tend to have more negative
symptoms, whereas women exhibit more affective
symptoms. There are also differences in terms of
prognosis for example, women with schizophrenia
tend to have better outcomes in terms of clinical
course and occupational and social functioning
compared to men.
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Historically, the proposition that family was the
cause of a childs developing Schizophrenia based
primarily on the concepts, these concepts created
an extremely non therapeutic and destructive
atmosphere between hospitalized patient and their
caregivers and mental health professionals. For
instance, the knowledge of how a family adjusts
to or copes with a member illness may help to
nurse to understanding the needs of family. The
two significant factors influence family openness
around a family member with schizophrenia. First,
there is a stigma attached to mental illness,
especially schizophrenia that often inhibits a
familys willingness to talk about their thoughts
and feelings. Second, as complex biological
factors of the illness interfere with the memory
and language system, which in turn affects the
process of sharing information by the all family
member. Families who are new to the illness to
deal with some of the fear, sorrow and
bewilderment that the contributors themselves had
endured when little information about
schizophrenia was available.
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• REVIEW OF LITERATURE
• Review of literature related to knowledge of
  caregivers of schizophrenia.
• Review of literature related to attitude of
  caregivers of schizophrenia.
• Review of literature related to knowledge and
  attitude on caregivers of schizophrenic
  patients.

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Review of literature related to knowledge of
caregivers of schizophrenic patients.
Angermeyer MC, Mastchinger H et al., (1998)
Conducted study on relatives beliefs about the
causes of schizophrenia . Based on a
representatives survey among the members of
German and Austrian associations of relatives of
mentally ill people, this paper examines the
beliefs commonly held by relatives of persons
suffering from schizophrenia concerning the
causes of this disorder. A Comparison of the
information gathered in the course of this survey
with the results of a representative survey
conducted among the general public in Germany
shows that relatives will usually look to
biological factors when searching for the cause
schizophrenia, while the general public tends to
life psychosocial factors, especially
stress-related factors, in order to explain the
development of the illness, we contribute this
discrepancy to relatives greater exposure to the
knowledge of psychiatric experts as well as their
having to deal with their own feelings of guilt.
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Review of literature related to attitude of
caregivers of schizophrenic patients.
Ponizovsky A et al.,(2003) investigated to
explore the knowledge and attitude of the
principals of schools for adult education towards
mental illness and persons with mental disorders.
the method used was telephone interviewed using a
short questionnaire of 16 items tapping their
knowledge and attitudes. Frequency distributions,
Chi-square and t-tests were used to analyzed the
data. The results suggest a case for action
programs to enhance mental health knowledge and
foster more positive attitudes among school
principals would seem to be needed. this would
better assure the integration of the former
inpatient into the adult education system.
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Review of literature related to knowledge and
attitude on caregivers of schizophrenic
patients. Martens y Addington ,(1994) observed
that family members are significantly stressed as
a result of having one of them with
schizophrenia. Ivarsson, Sidenvall, and Carlsson
agreed that burden on a family caregiver is
complex and includes many areas, such as daily
life, worries, and social pressure. In addition,
empirical evidence confirms that caring for a
patient with schizophrenia generates economic
burden on the family. Gutiérrez-Maldonado and
colleagues carried out a study with a Chilean
sample confirming that, disregarding the level of
development of a country caregivers experience
high levels of burden.
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• OBJECTIVES OF THE STUDY
• The researcher will be conducting the
  study to assess the knowledge and attitude of
  caregivers of schizophrenic clients and the
  following objectives are framed.
• To assess the knowledge and attitude.
• To find a correlation between knowledge and
  attitude.
• To find out association between knowledge and
  attitude with the selected demographic variables.

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OPERATIONAL DEFINITIONS Assess- An
activity to estimate the knowledge and attitude
among caregivers of schizophrenic patients, in
selected Hospitals. Knowledge- Refers
to the correct responses of the caregivers of
schizophrenic patients to the items on cognitive
aspects of schizophrenia measured by structured
knowledge questionnaire and expressed in terms of
knowledge.
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Attitude- Refers to the expression of
feelings and thinking of caregivers of
schizophrenic patients regarding schizophrenia
and is measured by an attitude scale and
expressed in terms of attitude scores. Caregivers
of Schizophrenia- Refers to the
family members and care takers who have
accompanied with client during hospitalization. S
chizophrenic Patients- Refers the
person who has been diagnosed as a schizophrenia
by psychiatrist and getting treatment for the
same.
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