RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA

BANGALORE.

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION.

DISSERTATION PROPOSAL

" A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING

PROGRAMME ON KNOWLEDGE ABOUT HAZARDS OF SUBSTANCE ABUSE

AMONG ADOLESCENT BOYS IN SELECTED PU COLLEGES,

BELLARY, KARNATAKA. "

SUBMITTED BY,

Mr.RAVINDRA RAJU.C,

1st YEAR M.Sc. NURSING,

INDIAN COLLEGE OF NURSING,

TILAK NAGAR,

CONTONMENT,

BELLARY.

1

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA.

1. NAME OF THE CANDIDATE AND ADDRESS

MR. RAVINDRA RAJU.CINDIAN COLLEGE OF NURSING, BELLARY, KARNATAKA.

2. NAME OF THE INSTITUTION INDIAN COLLEGE OF NURSING, BELLARY.

3. COURSE OF STUDENT AND SUBJECT

FIRST YEAR M.Sc NURSING (PSYCHIATRIC NURSING)

4. DATE OF ADMISSION TO COURSE

15-06-2012

5. TITLE OF THE TOPIC

“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE ABOUT HAZARDS OF SUBSTANCE ABUSE AMONG ADOLESCENT BOYS IN SELECTED PU COLLEGES, BELLARY, KARNATAKA”.

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

2

INTRODUCTION

"An ounce of prevention is worth a pound of cure".

(Nancy M Valentine)

The word 'adolescence' is derived from the Latin adolescere (to grow up). Adolescence is

therefore literally the period of growing up and becoming an adult. In western society the term

is now mainly used to describe the period from about 12 to about 18 or 19 years, or the period

of development from childhood to young adulthood1.

Adolescents are the citizens of tomorrow on whom the future of the nation stands. It is a

challenge to meet their health needs. 18-20% of Indian population constitutes the age group of

between 10-20 years2. Adolescence may be defined as a critical period of human development

manifested at the biological, psychological and social level of integration, of variable onset

and duration, but marking the end of childhood and setting the foundation for maturity3.

Adolescence is marked by physical and social changes. Between 12 and 18 years marked

bodily changes occur, and in all societies, the life that young people lead in this phase is

eventful and changes considerably1.

Biologically its onset is signaled by the acceleration of physiological growth and the

beginning of secondary sexual development; its termination by fusion of epiphyses of the bone

and the completion of sexual maturation. Biological maturation provides increasing muscular

strength and dexterity, which permit adolescent to participate successfully in the activities of

their social group, thus acquiring a psychological sense of adequacy. At the same time,

positive psychological motivation is a prerequisite for task perseverance and the search for a

variety of experiences, which provide the conditions necessary for full muscular development

through exercise3.

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Psychologically it is marked by the acceleration of cognitive growth and personality

formation. The striking attainment during adolescence is the ability to conceptualize at an

abstract level. This is provided by formal schooling and informal social experience. A second

and related psychological theme of adolescence is the search for a sense of identity. No longer

a child not yet an adult, the adolescent is busy engaged in determining who he/she is and what

he/she is to become. In this busy engaged in determining who he/she is and what he/she is to

become. In this effort he/she examines his/her parents from a more critical perspective and

leans more towards the peer groups for his/her sense of belonging. A third key developmental

task consists of the further evolution of sexual identity and gender appropriate behavior, which

are decided by the societal culture3.

Socially, adolescence is a period of intensified preparation for the assumption of an adult role

and is associated with cultural norms. In many cultures the onset of adolescence is clearly

signaled by puberty rites, usually in the form of tests of strength and courage, the completion

of which entitles the individual to be recognized as an young adult3.

Man's eternal thirst for new and more enriching experiences has driven him beyond the routine

and mundane pleasures of everyday life to the search for, and reliance on, substances that even

momentarily afford him relief from monotony and uniqueness of perception. These

experiences are satiating not only in themselves, but also because, for that point in time, they

make the individual stand apart from his fellow beings. Innumerable researchers have been

conducted, and a great deal more has been written about the nature and consequences of these

mind-changing drugs/substances, and yet, they remain an enigma. They have been hailed as of

enormous social, medical and religious value-and also as the most destructive, pathogenic and

misleading discovery of all times4.

The development of interest in this area over the past fifty to sixty years however does not

make substance-taking behavior a new phenomenon. These mind-changing substances have

already accompanied mankind through his social evolution for many millenniums and will, no

doubt, continue to be in many more to come- whatever be our views, decisions or sanctions

regarding them4.

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One of the earliest references to substance that had a potential for abuse was the opiates,

mentioned in Summerian writings around 6000 B.C. Mention of marijuana was made in China

around 2737 B.C. during the reign of Emperor Shen Nung. Homer in the 9 th century B.C.

described the use of "mood-changing drugs." The use of hemp has been described by

Hirodotus among Scythians in the 4th century B.C. The Coca leaf was used during the times of

the In civilization in South America to give a feeling of exhilaration and vigour to the user.

The plant "Echinocactus Williamsil lem" from which peyote was obtained was used by the

Indian tribes of Mexico for producing euphoric ecstacy4. In India, the narcotic and euphoric

properties of the cannabis plant were known to the Aryans. The 'Somaras' or the 'nector of the

Gods' mentioned in the ancient Sanskrit texts were probably fermented liquor. Spellman

(1967) states that 'bhang' appears in the Atharva Veda in the sense of cannabis about 1300

B.C. During the Moghul period and later, opium and cannabis were used habitually on a very

large scale, Besides these, the use of cocaine had been common for the last seventy to

seventy five years as noted by Chopra and Chopra in 1965. Little attention was however paid

to the effect of drugs on habitual users until the end of the 19 th century when the Government

of India appointed two commissions in 1893 and 1895 to study the situation. A second inquiry

was conducted after independence in 1954-55 when the Government appointed a prohibition

inquiry committee. Between the two inquiries, considerable changes had occurred in the drug

habits, the mode of administration and the type of addicts4.

In the United States, writers like Bayard Taylor and Fitzhugh Ludlow began to propagate

accounts of their own ecstatic states and psychedelic experiences due to cannabis use in the

early 1900's. But by far, the most significant contribution to popular knowledge of the non-

opiate psychoactive drugs came in 1954 with the publication of Aldous Huxley's book "The

Doors of Perception" - an account of the way in which mescaline had thrilled and enhanced

the authors perceptions of the world, as well as illuminating his earlier religious and

philosophical beliefs. "The Doors of Perception" turned out to be what is arguably the most

important single event in the unfolding of the psychedelic movement and must rank with the

earlier, though then somewhat obscure chemical advances that had been made by Hofmann

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and Stall in the synthesis of Lysergic Acid Diethylamide4.

In India, the last two decades have been a period of rapid increase in the percentage of drug

and alcohol abusers. Alcohol is getting a social sensation over a wider stratum of society.

There has been a marked increase in the use of heroin (popularly known as smack and brown

sugar) in our country in the last few years.

The affected groups have also changed. Earlier it was usually seen among the elite's,

the upper middle class and the students' community. But today the class, age, and education

are seen to be no bar to drug and alcohol abuse. New risk groups has emerged, which includes

youth both educated and illiterate, employed and unemployed, rural and urban industrial

workers, labour class, and people on tour.

World Health Organization in its technical report describes a 'Dependence- producing drug' as

a drug having the capacity to interact with a living organism to produce a state of psychic or

physical dependence or both. Such drugs may be used medically or non-medically without

necessarily producing such a state. The characteristics of a state of drug dependence, once

developed, will range with the type of drug involved4 .

The existence of such a state is not necessarily harmful in itself. There are however several

types of substance that, because they can produce substantial central nervous system

stimulations or depression, or disturbances in perception, mood, thinking, behavior or motor

functions, are generally recognized as having the capacity, under circumstances of use, to

produce individual and public health and social problems4.

The use of substance never remains an isolated phenomenon and inevitably involves profiting

from their sale and ultimately the development of a black market, with a rise in crime caused

by those addicted, attempting to obtain adequate funds to maintain their habits. At the same

time it leads to the debilitation and non productivity of a large segment of society, to the extent

that, the future efficiency of a nation's population depends to a large extent on the calibre of its

present student population. Studies of substance abuse in India and abroad have tended to

utilize the student community as the target population for their studies on Substance abuse4.

6

NEED FOR STUDY

Addicts are more extroverted, psychotic

Having more criminal propensity

Who appear in their nudity?

Under drug influence

- Dr. K. S. Shetty Adolescence is a period of "Stress and Storm", It is viewed as a time for search,

experimentation and introspection from which evolves a personal identity. When adolescents

emerges from childhood, they begin to think about the world in new ways. Psychologically

adolescence is the age when the individual becomes integrated into the society of adults, the

age when the child no longer feels that he/she is below the level of his/her elders but equal, at

least in rights5.

Adolescence is a transitional period where their status is vague and there is confusion about

the roles they are expected to play. It is a period of search for identity and it is a dreaded age,

and a time of un-realism. The physical change is crucial in the development, especially of

adolescent girls, social grouping, new values in selection of friends, social acceptance etc.

The major changes in morality consist of replacing specific moral concepts with generalised

moral concepts of right and wrong5.

Substance abuse refers to the harmful or hazardous use of psychoactive substance including,

alcohol, cigarette smoking, tobacco chewing. Substance frequently abused by adolescents

include but, are not limited to the following, alcohol, marijuana, hallucinogen, cocaine,

opiates, steroids, inhalants, methamphetamine, tobacco.6 The teenage or young people are

being exposed to alcohol and smoking at an early age. More children are introduced to drugs

during adolescents or in the junior or middle high school years. A study shows that 30% of

eight grades have used alcohol and 66% of 12th grade teens have used alcohol.7

The pre-university students are more involved in substance abuse due to insufficient parental

supervision, pear group influence, influence of mass media, family conflict, psychological

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distress, lack of communication, sever discipline, parental attitude towards adolescents alcohol

and smoking.8A study conducted in U.S showed that one in five teenagers is involved in

alcohol abuse. As per W.H.O estimates about 80% of adult smokers initiate their tobacco use

before the age of 18 years. As per national sample survey of India, 29.3% of rural and 20.2%

of urban male as well as 2.3% of rural and 0.7% of urban females smoke beedies and

cigarettes.9

WHO mental health survey was carried out in 2004-2008 in many countries such as, Middle

East, Africa and China towards a global view of alcohol, tobacco, cannabis and cocaine use.

The data collected from 54,069 participants using 18 surveys from 17 countries through face

to face interview .Findings revealed that half of the people who had ever used alcohol began

using at age of 7, range between 14-21years and tobacco 15-21yrs, 16-22 years for cannabis

and 19-22 years for cocaine. Smoking is responsible for nearly a half million deaths each year

, and Tobacco cause 59 million daily (4.1% ) both these two were leading cause of global

burden of disease.10

A descriptive study was conducted to assess the knowledge related to substance abuse among

adolescents in Bangalore among 100 students between the age group of 16-19yrs by using

random sampling technique. The findings of study revealed that, the mean knowledge score on

substance abuse was found to be 41.28% for boys and 39.46% for girls.11

A descriptive study was conducted to assess the knowledge, attitude and perception of school

going adolescents on substance and drug abuse in Bangladesh among 4035 students between

14-17yrs of age by using random sampling technique. The findings of study revealed that a

fair level of knowledge on tobacco (27%), alcohol (9%) among study participants of both

sexes, including its harmful effects on the body and society.12

All the studies showed that the current consumption of substance abuse among adolescent as

high and have poor knowledge regarding ill effects of substance abuse .Adolescence is a

period of exploration and experimentation, but young people often have lack of knowledge. In

both developed and developing countries adolescents are facing overwhelming problems, due

to substance abuse and their effects which was seen to be more influenced by peer group in

8

schools. School health education programs can reduce health risk behaviors such as tobacco

use, drug and alcohol use, as well as actions of these substance abuse increase mortality and

morbidity rate among the adolescents .So education is the main route and source to increase

the knowledge and to reduce the mortality and morbidity related to the substance abuse.

Teaching will help the PUC students to transform the information to others and promote

positive health behavior among children and adolescents.

Alcohol and illicit drug use among youth age is between 12 and 17years .It is estimated

1.1millon meet the diagnostic criteria for dependence on illicit drugs and 9,15,000 are

dependent on alcohol. More than half (55%) of our nations 12th grade have tried on illicit

drugs and more than One quarter (29%) have tried a drug other than marijuana such as

cocaine, inhalants and heroin. Youth age 16-17years have the second highest rate (16.4%) of

current illicit drug use in the country .The highest rate is from (19.9%)among youth people

age 18-20 years .Although consumption of alcoholic beverages are illegal for people under

21years of age,10.4millon current drinkers are between 12 and 20 years age of this group

nearly half (5.1%)engage in binge drinking and 2.3million people are classified as heavy

drinkers.

The hazards of substance use initiation and progression among adolescents aged 14 to 20

years. The risks for initiating use of any substance accelerated in early adolescence and peaked

at age 18.The risks for progression from use of other illicit drugs (cocaine) increased over the

first 4.5 years after initiating substance use diminished in subsequent years.

Substance abuse is a major public health problem that puts millions of adolescents at increased

risk for alcohol related and drug related traffic accidents, risky sexual practices , poor

academic performance, juvenile delinquency and developmental problems.

So that ill effects of substance can be reduced substance abuse. The above facts motivated the

researcher to conduct the study.

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REVIEW OF LITERARURE

Review of Literature is the major component of the research process.

According to polite literature Review refers to the activities involved in identifying and

searching for information on a topic and development of an understanding of the knowledge.

Review of Literature is defined as a broad comprehensive in-depth, systematic and critical

review of scholarly publications. Unpublished scholars print materials, audio visual materials

and personal communication.(B.T. Basanvathappa.)

Review of Literature involves an extensive, exhaustive and systematic examination of

publications relevant to the research protect .One of the most satisfying aspects of the

literature review is the contribution .It makes to the new knowledge, insight and general

scholarship for the researcher.

An existence review of literature relevant to the research study topic was undertaken to gain

deeper understanding and insight into the problem. Several textbooks, journals, reports,

articles, circulations and website were referred to collect maximum information to lay

foundation to study.

REVIEW OF LITERATURE IS ORGANIZED INTO TWO PARTS.

PART A: General information about substance abuse

PART B: Reviews related to study.

Part B: Further categorized into following.

1) Review of literature related to demographic variables, causes and predisposing

factors of substance abuse.

2) Literature related to Alcohol abuse.

3) Literature related to Tobacco abuse.

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4) Literature related to Cannabis abuse.

5) Literature related to Inhalants abuse.

6) Literature related to Hazards of substance abuse.

7) Literature related to prevention of substance abuse.

General Information About Substance Abuse:

A Epidemiological survey was conducted to estimate the pattern of alcohol and other

substance dependence in rural and slum population in Chandigarh city among 3,000

individuals above 15years of age by using random sampling technique .The finding of the

study revealed that majority of them (85%) reported having health related complications.13

A cross sectional study was conducted to assess the role of knowledge regarding tobacco risk

taking attitude, peers and other influences on tobacco and areca nut use among adolescents

using random sampling technique in New Delhi India among 596 , IX-XI standard students.

The findings of the study revealed that 42% of tobacco users started before the age of

14years .A total 21.3% of students were found to be consuming tobacco in some or the other

way and were at risk of oral health disorders due to areca nuts use.14

A cross sectional study was conducted to assess the prevalence of smoking and tobacco

chewing among adolescents between the age group of 10-19years using the interview method

in Gujarat among 930 adolescents .The main observation of the study was 33.12% of

adolescents were addicted with one or other type of tobacco chewing ,32.26% adolescents

were in the age group of17-19yrs15

An article on drug abuse, state that there were 20,000-45,000 addicts in Manipur with majority

being heroin, intra drug users, with sharing needles, syringes and as a results of which 80% of

the intra drug users become human immune virus infected16.

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LITARATURE RELATED TO DEMOGRAPHIC VARIABLES, CAUSES AND

PREDISPOSING FACTORS OF SUBSTANCE ABUSE.

The longitudinal study was conducted on adolescent substance use. The aim of the study was

influence of representations of attachment, maternal adolescent relationship on adolescent

substance abuse. Sample of the study was 200 adolescents aged 14- 16years, their mothers and

friends were assessed over two years. The study results showed that higher levels of security

in attachment styles had an indirect effect on changes in substance use. These findings

highlight the roles of representations of attachment in the development of adolescent substance

use18.

A study on relation between stress and alcohol consumption conducted in adolescence.

Sample of the study was children at high risk for alcoholism children of alcoholic parents

(N=451) aged 13-17 years. The study results showed that shared risk factors accounted for

53%of the impact of trait family stressors on growth in adolescent drinking19.

A community based cross sectional study at urban conducted during Aprilo4-March-2005 on

Narcotic substance use and the socio demographic characteristics. Sample of the study was

208 males aged between 15-24 years .The study results showed that 59.1% of the Nicotine

substance users were between 21-24 years of age ,78.8%were using ganja ,36.0%were

dependent users,58.7% were single at the time of interview ,39.9% each heroin and

bhang ,37% were abusers 48%were either illiterate or just literate ,64%belonged to middle

socioeconomic status.68% had initiated narcotic substance use out of curiosity20.

A cross sectional study was conducted to explore the association between parental divorce and

adolescent drunkenness in last 4 weeks and the contribution of socio-economic position,

family structure and social support .The data was obtained from 3,694 elementary school

students (mean age 14.3, 49% males and response rate 93%).Respondents completed

questionnaire on how often they had been drunk in the last 4 weeks. The study results showed

that parental divorce was found to have an effort on adolescent drunkenness in last 4 weeks21.

A study on regular use of alcohol tobacco in India and its association with age gender and

poverty was conducted .Sample was 4, 71,143 people over the age of 10 years .The study

12

results showed that respondents belonging to scheduled casts and tribes were more likely to

report regular use of alcohol as well as smoking and chewing tobacco . People from rural areas

had higher rates compared to urban dwellers, as did those with no formal education.

Individuals with income below the poverty line had higher relative’s odds of use of chewing

tobacco and alcohol compared to those above the poverty line .The regular use of tobacco and

alcohol also increased significant with each diminishing income quintile22.

A study on identifying the factors associated with the initiation, continuation and quitting of

the use of tobacco was conducted , the sample size was 90 adolescents .The study showed that

multiple factors associated with the use of tobacco products and facing difficulties to quit

tobacco products.23

A longitudinal study on parental substance use disorder and the risk of adolescent was

conducted. Drug abuse data was obtained from three cohorts of adolescents and their families

over a period of 7 years .The results indicate that parents psychoactive substance use disorder

is positively associated with adolescence drug abuse. Affective disorders among parents are

associated with a higher risk of alcohol, but not drug abuse24.

A study on role of social networks and media respectively in predicting age of smoking

initiation was conducted .Data collected from 10,030 adolescents, the study results showed

that there is significant correlates of age of smoking initiation using bivicariate methods and a

multivate proportion hazards model ,the age of smoking initiation was earlier among

those adolescents who had a favorite tobacco advertisement25.

A study on association between trauma , PTSD and substance use disorders was conducted .

Sample was 10,641 participants the study results showed that among PTSD substance use

disorders alcohol (24%) and opioid use (33.2%) and also experience poor physical and mental

health26.

A study on medication of family alcoholism risk by religious affiliation types was done.

Objectives of the study was religiously affiliation in inversely associated with alcohol

dependence (AD).Sample of the study wast,329 male and female adolescents (Mean age -19.6

13

years ).Parental alcoholism religious affiliation types and their interactions were examined a

predictors are offspring alcohol dependence symptoms .The study results showed that

offspring are current diffentiating religious obligations also exhibited fewer alcoholic

dependence symptoms ,without parental alcohol dependence history27.

LITERATURE RELAATED TO ALCOHOL ABUSE

A study on growth in alcohol use in at risk adolescent’s Boys was conducted .Objective of

the study was alcohol use frequently in sets and shows rapid growth during the adolescents

years .Sample was 200 at risk boys tested separately for the 3 years middle school period and

4 year high school periode. Data was obtained by alcohol use by members of the adolescents

social network is critical to initiation of use and peer use is critical to growth28.

A study on adolescents’ substance use and hospital presentations was done .Aim of the study

was to examine the prevalence of different substances used by adolescents admitted to hospital

emergency departments and compare outcomes for those using “alcohol alone” investigate the

relationship between hazardous alcohol consumption ,patterns and hospital events .The design

used for this study was randomized control trail .Participants were 67 adolescents aged 12-19

years with alcohol intake. The study results showed that alcohol alone (n=67,53%),alcohol

plus (n=31,24%) and other drugs (n=2,22%) 29.

A study on affect of alcohol intake on central nervous system ,among 85 adolescents was

conducted .The study results showed that alcohol is central nervous system

depressant .Moderated doses cause sedation, lack of coordination and poor judgment .The vast

majority of adolescents have used alcohol at least once in 6 years at the age 18 years30.

A study on developmental issues that affect college drinking was conducted.Sample

size was 510 college going students .The study results showed that many physical and

psychological demands at this age can overload coping abilities ,create mismatches between

needs and resources and heighten vulnerability to chance events . Usually they take alcohol to

cope with stress31.

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LITERATURE RELATED TO TOBACCO ABUSE

A 4 years longitudinal study on smoking increases the risk of panic and other

anxiety disorders was conducted .Data was obtained from adolescents and young adults at

community .International diagnostic interview on nicotine dependence panic attacks, panic

disorders ,other anxiety disorders and other mental disorders were assessed. The study results

showed panic attacks and panic disorders were strongly associated with occasional and regular

smoking and nicotine dependence32.

A study on Is cigarette smoking a gateway to alcohol and illicit drug use disorders ? was

conducted among adolescents with and without Attention deficit hyperactivity disorders

(ADHD).sample size 97 ADHD and 203 control youth of both sexes aged at least 12

years .Data was obtained by structured diagnostic interviews association tested by

using Cox proportional hazards regression models .The study results showed that ADHD

youth who smoked (N=76P<05)cigarettes were significantly more likely to subsequently use

alcohol and illicit drug as well as to develop abuse33.

A study on role of particular gene in nicotine dependence was conducted .The

sample of the study was 316 smokers age between 18-50 years .The study results showed that

CHRNA4 gene play a role in nicotine dependence phenotype.34

A study on relationship between tobacco use and other substances was conducted.

Sample of the study was 90 tobacco users . Data was obtained by using questionnaires .The

study results showed that use of tobacco is closely related to the use of opioids and heroin35.

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LITERATURE RELATED TO CANNABIS ABUSE

A study on items response theory analysis of lifetime cannabis use disorder, symptoms

severity in an American Indian community sample was conducted. The aim of the study was

to assess DSM mental disorders ,lifetime cannabis use disorderr and its relationship to first

cannabis use before age 15 years .A sample of 349 participants who had used cannabis used

cannabis at least 21 times in a single year. The study results showed that cannabis use disorder

(CUD) symptoms “activities given up” and “role failure “were most severe

symptoms .Hazardous use was more severe in childhood conduct disorder36.

A 21 years longitudinal study on, “does cannabis use encourage other forms

of illicitdrug use”? was conducted. Aim of the study was to examine the relationship between

cannabis use in adolescence and the onset of other illicit drug use .Sample of the study was

1,265 children .The study results showed that nearly 70%ued cannabis and 26%used other

illicit drugs .Those using cannabis on more than 50 occasions a year had hazards of other

illicit drug use that were 140 times higher than non users37.

A study on “Is cannabis a stepping stone for cocaine” among 213 adolescents aged

18-20 years and 20-25 years was conducted .The study results showed that some evidence of

cannabis being a “stepping stone” for cocaine.38

A study on cannabis abuse related hazards was conducted .Data gathered from 220

cannabis abusers aged 18-25 years .The study results showed that cannabis abusers

demonstrated decreased EEG power and signal to noise ratio ,schizotypal personality

characteristics and early stage sensory processing deficits39.

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LITERATURE RELATED TO INHALANT ABUSE

National institute of drug abuse (2002) conducted a study on inhalant abuse .It is stated that

cannabis is a common substance used among adolescents .It is available in small packets,

which make easy to hide and steal by the users and inexpensive .Most substances are

paints ,glue or correction fluid .Effects of inhalants abuse showed that it may cause damage to

the CNS and liver.

A study on inhalant use ,abuse and dependence among adolescent patients was

conducted. Sample was 847 admissions of patients who had completed structured diagnostic

assessments. The study results showed that adolescents with inhalant abuse or dependence

were significantly more likely to meet lifetime criteria for abuse on alcohol, hallucinogens,

nicotine, cocaine and amphetamines to have had major depression, attempted suicide40.

A study on recanting of life time inhalant use was conducted. Aim of the study was

to establish the prevalence of recanting of life time inhalant use. A sample of 62 students

reported on their life time inhalant use, other druguse and drug related beliefs, attitudes and

behaviors .The study results showed that 49% of students who reported life timeinhalants use,

67% of the reactors or lifetime inhalant users.33% Appear to be use incorrectly .It is

concluded that recanting is asignificant problem, if not handled carefully41.

LITERATURE RELATED TO HAZARDS OF SUBSTANCE ABUSE.

A study on adverse health effects of non medical cannabis use was conducted. A sample

of cannabis abused adolescents observed for a longer period .The study results showed that

there is an association between cannabis use and adverse outcomes. These include a

dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function,

cardiovascular disease and adverse effects of regular use on adolescent psychosocial

development and mental health42.

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A study on association between frequency substance use and quality of life among

adolescents receiving a brief outpatient intervention was conducted. Sample was 106

adolescents aged 13 to 21 years ,who met criteria for substance abuse over a 12 month

period .The study results showed that reduced frequency of use was associated with quality of

life improvement ,frequency of substance use predicted poor quality of life.43

A review on substance abuse and cerebral blood flow was conducted .Objectives was to

review acute and chronic effects of abuse on cerebral blood flow and metabolism. Data was

obtained from human research reports animal studies, book chapters and abstracters. The study

results showed that ethanol in small doses produces cerebral vasodilatation,higher doses

induce cerebral vasoconstriction and higher doses induce cerebral vasoconstriction. Sedative

and anti –anxiety drugs lead to reduction in CBF and cerebral metabolism .Caffeine reduces

vasoconstrictor, cigarette smoking causes vasodilatation, inhalant and solvent vasodilators.

Chronic abuse is accompanied by a decrease CBF .A number of drugs of abuse including

ethanol amphetamine and cocaine phenyl propanolamine combinations increase the risk for

stroke. Ethanol, nicotine inhalants marijuana and solvents decrease cerebral blood flow.44

A study on effects of substance misuse on inpatient admission ,remission and relapse of

positive symptoms in first episode of psychosis was conducted .Sample of 103 individuals

were investigated for 15 months .The study results showed that substance misuse was

independently associated with increased risk of inpatient admission in first episode of

psychosis45.

A study on seropreventive of anti hepatitis C virus among injecting drug users

(IDU)and non injecting drug users was conducted .A sample of 53 injecting drug users and 24

non injecting drug users were screened .The study results showed that 62%of injecting drug

users having hepatitis. The seropositives prevalence of hepatitis C virus is high in IDU and

related to injecting46.

A study on effect of cannabis abuse on brain functions was consucted. Data was

obtained through manual literature and internet search method .The study results showed that

cannabis addiction is destructive and may effect all our lives considered a chronic brain

18

disease ,impairs cognitive functions ,perception ,reaction time ,learning, memory

concentration ,social skills of emotions ,hallucinations and paranoid state with fixed delusions

and even acute psychosis47.

A study on health effects of tobacco use and exposure was conducted .A sample of

502 chronic smokers was screened .The study results showed that 65-85% of global tobacco

consumption can cause respiratory disorders, cardiovascular hazards ,cancers ,exposed

pregnant women subjects herself to risks and fetus.20-80%of passive smoking implicates the

whole population48.

LITERATURE RELATED TO PREVENTION OF SUBSTANCE ABUSE

A study on interventions for reducing adolescents alcohol abuse was conducted. The

objective was to assess the effectiveness of substance abuse interventions for their ability to

reduce adolescent alcohol use. The data was obtained Medline; Wilson social science abstracts

and dissertations .The study results showed that interventions significantly reduce adolescent

alcohol use. Individual interventions had larger effect than family basedinterventions.49

6.3 STATEMENT OF THE PROBLEM

A study to assess the effectiveness of structured teaching programme on knowledge

about hazards of substance abuse among adolescent boys in selected PU colleges, Bellary

Karnataka.

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6.4 OBJECTIVES OF THE STUDY

1. To assess the adolescent boys knowledge on hazards of substance abuse .

2. To develop and administer a structured teaching programme on hazards of

substance abuse .

3. To evaluate the effectiveness of structured teaching programme on knowledge

about hazards of substance abuse.

4. To associate the level of knowledge on hazards of substance abuse among

adolescent boys with their demographic variables.

6.5 DELIMITATION

The study is limited to only adolescent boys

This study is limited to those, who are willing to participate in the study.

This study is limited to those who can understand English only.

6.6 HYPOTHESIS

H1: There will be a significant difference between pre-test and post-test level of knowledge

scores of adolescences boys.

H2: There will be a significant association between the post-test level of knowledge score and

selected demographic variables.

6.7 ASSUMPTION

Adolescent boys may have less knowledge on hazards of substance abuse

Adolescent boys may have a desire to know about hazards of substance abuse.

Structured teaching programme may improve the knowledge of adolescent boys on

hazards of substance abuse .

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Participants are willing to interact with their ideas and doubts regarding hazards of

substance abuse.

Knowledge about hazards of substance abuse among adolescent boys may decrease

the incidence of adolescent boys abuse and implications.

6.8 OPERATIONAL DEFINITIION OF TERMS

1. Assess : It refers to the statistical measurement of knowledge

regarding prevention of substance abuse

2. Effectiveness : In this study it refers to gain in knowledge as

Determine by significant difference in pre and post test

knowledge scores.

3. Structured teaching programme: In this study refers to systematically organized teaching

Strategy on substance abuse provides verbal interaction

with the use of charts.

4. Knowledge : In this study it refers ability to give correct response to

questions regarding substance abuse asked by investigator

as measured by structure knowledge questionnaire .

.

5. Adolescence boys : In this study it refers to the boys who are studying PUC

( Pre University college) And aged 15-18 years.

6. Hazards : In this study it refers to many dangers that include,

Physical Emotional, leagel, financial, relational,

Andmedical consequences due to substance abuse.

7.Substance abuse :In this study it refers to the Problematic use or misuse of

Alcohol Or other substances.

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7. MATERIALS AND METHODS:

7.1 Sources of data:

Adolescence boys who are studying at Nalanda, Chaitanya Colleges, bellary .

7.2. Type of study approach : An evaluative approach.

7.3. Research Design : One group pre test, post test design

7.4. Settings : The study will be conducted in Nalanda, Chaitanya Colleges,

Bellary who are studying PUC.

7.5 Sampling technique : Non probability convenient sampling technique

7.6 Sample Size : The sample size of the study is 60 Adolescents boys.

7.7 Follow up : No follow up.

7.8 Duration of the study : 4-6weeks

7.9.INCLUSION CRITERIA:

Adolescence boys studying at nalanda, chaitanya College, Bangalore.

Adolescence boys who are available during the period of data collection.

Adolescence boys who are able to speak in English.

EXCLUSION CRITERIA

Adolescence boys who are not willing to participate in the study

Adolescence girls studying in selected pu colleges

8. DESCRIPTION OF THE TOOL :-

Independent variable :- Structure teaching program.

Dependent variable :- Knowledge of adolescent among boys regarding hazards of

substance abuse.

Attributes variables :- personal characteristics which include age, religion, place of

residence, types of diet, socio economic status, no. of siblings, habits types of family

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9. DATA COLLECTION PROCEDURE:

After obtaining permission from the concerned authority, the investigator will take

consent from the participants and explain the purpose of the study to the subject and

questionnaires will be administered followed by a teaching programme and post test will be

conducted immediately.

10. DESCRIPTION OF THE TOOL:

Tool will be preparing as per the personal experiences and suggestion from the experts.

Toll consists of

1. Section A : Socio demographic variables consisting of item related age, type of family,

religion, previous exposure

2. Section B : Structured knowledge questionnaire regarding various aspect of drug abuse

problem

11. METHODS OF DATA COLLECTION :

The data obtained will be analyzed in terms of the objectives of the study using

descriptive and inferential statistics. The plan of data analysis is as follows:

Descriptive statistics

Frequency and percentages of knowledge, score will be used to analyze the demographic

data.

Mean, median and standard deviation of pre test and post test knowledge scores, will be

used for assess the level of knowledge.

Inferential statistics:

‘t’ test to assess the effectiveness of structured teaching programme on knowledge

regarding drug abuse problems.

“Chi – square” to determine the association between post test knowledge and selected

demographic variables

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12. Does the study require any investigation or intervention on patients or other

humans/animals? If so please describe briefly?

Yes, structured teaching programme regarding hazards of substance abuse will be done

and knowledge will be assessed.

13. Has ethical clearance been obtained?

Ethical clearance will be obtained from concerned authority and the ethical committee.

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9 NAME OF THE CANDIDATE : MR.RAVINDRA RAJU

10 REMARKS OF GUIDE :

11 NAME AND DESIGNATION :

11.1 GUIDE :

11.2 SIGNATURE :

11.3 CO- GUIDE :

11.4 SIGNATURE :

11.5 HEAD OF THE DEPARTMENT :

11.6 SIGNATURE OF H O D

12 12.1 NAME OF THE PRINCIPAL:

12.2 REMARKS OF THE PRINCIPAL:

12.3 SIGNATURE

29