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CHAPTER-I INTRODUCTION A man spends the first half of his life learning habits that shortened other half of his life. Health and illness are defined according to the values of a particular society. When a person is able to adjust and adapt to his environment he is said to be healthy. A person with good mental health lives in harmony with the society. A study describes that people are not simply ill or well but their degree of health changes according to their inner or outer of circumstances. Inner circumstances refer to human biology, which includes genetic factors, constitutional factors, sex, colour, physique, health status and physiological factors like puberty and old age. Outer circumstances refer to the environment in which the person lives.1 The attitude of an individual (whether one is laughing or crying, alert or drowsy, happy or sad irritable or tranquil) depends on specific biochemical activity is the nervous system. Some times one attempts to alter that bio chemistry in order to achieve a state of mood or mind which enables him to enjoy peace tranquility though the use of drugs. Although one may attempt to alter biochemistry through meditation, relaxation, exercise, acupuncture and the like, the most common way adopted by some of us is by taking a drug. Whatever means one uses, the end result is still a change in the biochemical activity of the nervous system. In the historical evolution, man has been able to dominate nature by his knowledge, his inventiveness and his technological achievements, thereby achieving greater control over the world and its organization. While technological progress and inventiveness have brought comforts to the individual it has also increased his

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insecurity due to all the new problems he has to face, which inevitably generates anxiety. In the tension filled modern World, no one is entirely freed from anxiety what ever his class, creed or station in life may be. Some of us therefore seek relief from anxiety by using drugs, which reduce his tension and alters his mood. The uses of these drugs have introduced the phenomenon of dependence.

Universally,

irrespective of time, place, or culture, throughout history, man has had the habit of using substances which affect his mind and alter his level of consciousness. The origin of drug use is mentioned in the Rig Veda for ritual use of soma Rash. The opium, derived from poppy, as a sleep inducing drug was mentioned in 300 BC and it is acclaimed that opium use could be traced back to 4000 B.C. in samerid, Australia and India. Asia – Pacific region, produce more than 60% if the World’s opium that is needed for medicinal purpose, illicit opium is produced mostly is the golden triangle and golden crescent regions.

The area covered by golden

triangle are Burma, Laos, and Thailand which covers an area of 75,000 square miles and produces 400-800 tones of opium annually. The golden crescent -an area along the borders of Pakistan, Iran and Afghanistan produces an estimated 600-900 tons of opium annually. All this production finds its way into the illicit drug traffic all over the World for money. The Overall situation of drug abuse in the Asia – Pacific countries in summarized by Abarro (1987:15) Cannabis and opiates continue to dominate the drug abuse scene, and also the most favorite drug abuse occurs in Japan, Philippines, Bangladesh, Australia, Singapore, Malaysia, Thailand, Indonesia and New Zealand. Lately, cocaine is much used in countries like Australia, New Zealand and Philippines. Cocaine abuse

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problems have also been reported in Bangladesh, Japan, Sri lanka and also in India and Pakistan. In Pakistan at least 1.55% of the total population comes under the category of regular drug abusers. The problem of dug abuse has been compounded by the lack of economic growth, increasing social and political instability and cultural confusion. Research findings and other sources suggest that the ‘hippie culture’ of the early 1960’s popularized the use of drugs- as a way of life among the youths and the age between 15-30 years. According to the under -Secretary General of the United Nations, ‘the illicit drug trade is a three hundred billion dollar a year business industry, catering to tens of millions of addicts”. According to a 1986 National Institute on Drug Abuse study of drug related deaths in 27 metropolitan areas across the country of US, 25% of blacks are accounted as victim of drugs leading of ‘AIDS”. The history of the human race has also been history of drug use. There is simple historical evidence for the fact that drug abuse ante dated drug therapy, Just as toxicology pared the way for pharmacology. For centuries, herbs, roots, hark, leaves and plants have been used to relieve pain and to control diseases. The use of drugs in itself does not cause any harm; for drug, properly administered have a curative effect. Unfortunately, certain drugs also produce enticing side effects such as feeling of euphoria -a sense of feeling good, elation, serenity and power. What began as some thing of a recreational activity, evolved in time in to a problem of dependence and abuse (UN, 1989) According to a study describes, “If a man begins with certainties, he shall end is doubts, but it he will content to begin with doubts, he shall end in certainties”.2

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First the ‘what’ question. what is a drug? “What are drug use, abuse, misuse, and overuse?” what is drug dependence and tolerance? The answers to these questions are as follows:Drug: Any substance, which when taken in to a living organism, many modify one or more of its functions. Drug abuse: Persistent or sporadic excessive use, inconsistent with or unrelated to acceptable medical practice. Drug Misuse: Medical or lay use of a drug, for a disease state not considered to be appropriate Drug overuse: Excessive medical of lay use if a drug, in terms of Length of therapy, or severity of disorder, in which there is accepted evidence of therapeutic effect. Drug addiction: A behavioral pattern of compulsive drug use characterized by over whelming involvement with the use of a drug, the securing of its supply and a high tendency to relapse after withdrawal. Drug habituation: The term ‘Drug habituation’ has been used when drugs are used as a habit, and there is no physical dependence, but just psychological craving and dependence when the drug is with held. Drug dependence: According to WHO, ‘A state, psychic and sometimes also physical, which results from the interaction between of living organism and a drug which is characterized by behavioral and other responses, that always include a

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compulsion to take the drug on a continuous or periodic basis, in order to experience its psychic effects and sometimes to avoid discomforts of its absence’.3 Tolerance: Drug tolerance in characterized by diminished response to drugs with continued exposure. There is a need to apply increasing doses of a drug in order to produce the same effect. Commonly used Drugs: (1)Narcotics: Eg: Opium’s, morphine, heroin or brown sugar, pethidine, methadone etc. (2)Stimulants: Eg : Amphitamines, cocaine, crack, caffeine and such like. (3)Hallucinogens: Lysergic Acid Diethyl amide (LSD), Marijuana, ganja, bhang, hashish, charas. (4)Volatile substances: Gasoline, Petrol (5)Others: Poisonous mushrooms nail, polish recover and such like. When compared to American ethnic racial populations. Indian adolescents use drugs more heavily with there consequences

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. Stronger evidence exists for

correlations between early substance abuse, the onset of a pattern of juvenile criminal activity, and adult criminal activity leading to long term incarceration5. Growth and development of an individual occur on the basis of their cultural and hereditary background. In growth and development of human being, as a child he is completely dependent on his family. In the next stage of adolescence, a sense of attachment comes into a predictable shift from family to peer group, where they develop a sense of identity. A study describes has coined the term transescence to 5

describe this age group, emphasizing the importance of change and transition 6. According to a study, the initiation of drug abuse was found to be most common after bearing high school and he found a majority of the students to be experimental abusers.7 NEED FOR STUDY The adolescence is a period of biological growth and maturation, self discovery and social adaptation. Real and imagined weaknesses and deficits of self and environmental provoke an adolescent to redefine himself. Many questions arise; what kind of people and they? What kind if people should they be? Etc., Freud made the link between the biological changes of the puberty and what he considered one of the major development concerns of adolescence; establishment of firm individuality, a sense of self and ego identify. No matter whether one lives in the city or in the middle class suburbs, all young men and women feel pressurized when they face the challenges of every day life, This may either head to immediate adaptation and self control in some, or aggreniveress and other inadequate role performances leading to the use of drugs as an antidote to their mental stress and trauma. There is a need to caution the adults about the attitude determinants leading to drug dependency is adolescent students. Adolescence also grows in a complex urban environment usually fall victims of this drug culture. Also other external factors such as westernization, television and globalization have created such all impact on our culture that our adolescent population easily tends to inherit the negative aspects like drug misuse etc.,

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Secondly the urban environment is risk with social conflicts, income in equities, crime and drug use that the adolescence get influenced by the prevalent practices, a final view is that early adolescence is extremely dynamic, exemplified by escalating transactions with family and peers that often lead to conflicts cause by an expectation of greater freedom, especially when parents are antagonistic to new and often experimental trends, languages, behaviors, clothing, past times or peer associations statistically, only about 1/5th of youth in early adolescence seem to experience acute adjustment problems. Today’s adolescents are the pillars of tomorrow’s society. Accounting to World statistics a very high level of crime in the community is caused by illegal acts committed is the school leading to increase in number of Juvenile delinquent homes. The investigator claims that many professional, non professional adolescence misuse drugs that are meant for the purpose of medical practice. According to a study conducted by nearly 65% of adolescent were addicted to codeine cough syrup in Assam. Many of the students in school and colleges remain unidentified and are the silent victims of this fatal habit. Age specific mortality rate for 2nd decade in 1987 with regard to drug dependence was 84.6/1, 00,000 for late adolescents. Increasingly, the term ‘Risk Taking’ is utilized to describe the emergence of all behaviors which are initiated during adolescent. 8 According to a study , the family dynamics has an impact on adolescence and 46% of adolescent were from nuclear families and the commonest motivation factor leading to drug dependence was peer group pressure 54%.the adolescent, who were protected by parents and strict school administration under teachers scrutiny, when they enter the college get ample independence where there are chances for getting in

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to greater ill effects such as drugs. They are plenty of unidentified adolescence going for drug addiction day by day because of their attitude to take risk probing behavior. 9 The researcher has personally witnessed many adolescent are unaware about the ill effects of drug dependences and face lot of compilation. So this provoked the researcher to do the study.

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CHAPTER-II OBJECTIVES STATEMENT OF THE PROBLEM ‘A study to assess the level of knowledge on ill effects of drug dependence among adolescents in selected school at Bangalore.’ OBJECTIVES 1. To describe the level of knowledge on ill effects of drug dependence. 2. To find out factors leading to drug dependence. 3. To identify the types of drugs available in the market. 4. To assess the level of knowledge on the behavioral changes occurs due to drug dependence. 5. To identify Rehabilitative measures available at the state level and National level. OPREATIONAL DEFINITONS 1.

Knowledge: it is the perceptual ability and the expressed ideas of the adolescent students towards ill effects existing in the society related to drug dependence.

2.

Adolescence: students of 14-21 years studying at Anupama Pre -university College

3.

Drug dependence: it is a psychic and physical state of an individual, which results from the interaction between the body and a drug, which is characterized by behavioral and physical responses, that always include a compulsion to take that particular drug on a continuous or periodic basis, in order to experience its psychic effects and at times to avoid physical discomfort in its absence.

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4.

Ill effects: it is an illness leading to abnormal physical, psychological and social consequences to the individuals and the society. ASSUMPTIONS 1. The adolescents have the knowledge of ill effects of drug dependence. 2. Ill effects of drug dependence can be assessed through structured interview schedule. DELIMITATIONS 1. The study is delimited to PU College. 2. The study is delimited to the age group of adolescent between 14-21 years of both sexes. 3. The study is delimited to students who are willing to participate in the study. CONCEPTUAL FRAMWORK High level knowledge Conceptual framework provides a certain frame for clinical practice, research and education. It gives direction and quittance for structuring research. (kozies 1995) Dunn.H.L. (1961) developed a model, high level wellness one end of vertical health grid representing high level wellness (health), whereas the other end representing low level wellness as it relates to the factors in the family, community, environment and society. The present study aims at assessing the level of ill effects of drug dependence among the adolescent students based on Dann’s model, this study conceptualizes drug knowledge’s of adolescents in a vertical health grid with 2 extremes. One end of the

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health grid representing high level of knowledge (health), whereas the other end representing low level of knowledge (ill effects of drug dependency) Dunn explores the concept of conceptual as it relates to the family, community, environment and society. Mental health is viewed as an expression of adolescent’s harmonies with internal as well as external environment. Internal environment refers to psychological and physical, external environment refers to personal, family, social and cultural factors. These 3 major factors- ‘person related’, ‘family related’ and ‘social-cultural related’, may continuously affect mental health during the adolescent phase of development. Personal factors include age, sex, birth order, personality, physical health and intelligence. Environmental factors refer to the type of family, size of family, home environment, parent-child relationship. Socio-cultural factors refer to socio economic status, religion. Cultural practice parents working status and values of life. All these variables are shown in the conceptual frame work developed for the present study. The above 3 factors influences the life of an adolescent. This influence in observable in the knowledge and attitude of an adolescent which can be measured. Since the purpose of the study is to assess the level of knowledge on problems of drug dependence among adolescent students a questionnaire and a rating scale was developed based on the knowledge. The data collected from the questionnaire should reveal the high level and low level knowledge of the adolescence on drug dependence as per the Dunn’s high level and low level wellness model. 11

The investigation proposes to provide a drug knowledge guide after the study to the low level knowledge adolescent students with a hope that they will be benefited to become high level knowledge group.

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CHAPTER-III REVIEW OF LITERATURE The review of the literature is carried out to examine the ill effects on drug dependence among adolescent. A review of literature is an essential step in the development of research project. if reveals to the investigator, what has been done in the related area, the feasibility of doing the proposed research, the use of methodological tools and it also works as a connective link between the findings of preview research that has been done in the problem area and the result of the proposed study. The review of literature is done under the following, Studies related to ill effects of Drug Dependence among adolescent etc. Section A: 1. on cultural aspects. Section B: 2. Familial aspects and social aspects. Section C: 3. Ill effects related to drugs. Section-A: 1. Cultural aspects: A study conducted and found out that the use of Bhang had been a traditional one, in North India and the result was there was an intake of cannabis before the age of 20 because of curiosity and risk taking behavior among adolescence.10

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A study conducted a cross cultural study regarding drug abuse and personality among college students and inferred that the drug users have been found to have maladjustment basically from any culture and different set of value patterns.11 According to AIIMS study report 1987at Bangalore, a multi centered study of drug abuse among students was conducted and the result showed that opium, heroin and cannabis were used in 1.18, 2.04 and 3.85%respectively and there is an increase only in use of pain killers in twenty told.12 According to SPARC study in India report No 25, majority of the adolescence were either Hindus (77%), Christians (10%) and the rest were from other religion.13 According to a study report,’ selected cities in India, 96.5% of male population were given to drug abuse compare to 2.5% of the female population.’14 According to a study report,’ states that a rural drug abuse pattern is often associated with traditional consumption in India where the heroin abuse is reported to have spread ever to rural areas.15 According to WHO 1994 report, in 12 months a 3million man, women and children have been infected with HIV in Asia.16 According to a study report,’ found out substance use in females of us where the age of menarche was significantly correlated with affiliation with another boy friend and risky sexual behaviour.17 According to a study report,’ stated that the drug use among African American race 259 males and 368 females of adolescence age group who responded to a structured questionnaire, where there the result was that each of the components of

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ethnic identity offset, risks form the ecology, family, personality and peer domains, help in lessening drug use. 18 Section B: 2. Familial aspects and social aspects According to Police Journal, students are shown as the main victims of drug addiction, the study covered a sample group of 85 students, and it was proved that the parental attitude towards children is a major etiological factor for student’s drug dependence.19 According to a study report,’ conducted a study in Jaipur. It revealed that 40% of drug addicts were from nuclear families and 21% were from middle class families and 22.62% that the influence of family members was an important motivational factor for hearing drugs during the period of dedication.20 According to a study report,’ conducted a study in surat city and found that 300 child laborers use cannabis and opium due to micro social and macro social Stressors which initiate and perpetuate their substance use.21

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Section C: 3. Awareness of ill effects related to drug dependence among adolescent students. Varma v.k.et.al studied on drug abuse amongst college students .the results of the descriptive study shows that out of 408 subjects 77(18.87%)admitted to having taken the drugs at sometime or the other as per the epidemiological studies of drug abuse in India ,the number of those who had taken the drug 10 times or more was a follows: Mandrax -4, amphetamines-11,cannabis -2 and it was found that some of the students coming from rural background were susceptible to the influence of urban subculture and this in turn to the use of drugs.22 Sethi..et.al., studied on the pattern of drug abuse among male students among 1513 students drawn from 2 degree colleges in Lucknow city and as per the criterion adopted 11.5% students were categorized as drug abusers and 40.8% used bhang. 23 Mohan D. et al., studied on prevalence of drug abuse in high school population. The result shows the abuse of alcohol and tobacco as the most popular drug of dependence in the school sample. The tool was who questionnaire on a bio data schedule and awareness and prevalence schedule on drug and its problems.24 Dube.K.C studied on the use of dependence producing drugs on arts and science college students. It was found that in Delhi the overall prevalence rate of drug was 10.08%.25 Vinoy K.Vrma and ravinder ang, studied on non medical drug use amongst non-medical drug use amongst non –student youth in India. In a surrey on non medical drug use by 266 students ranging from 10-24 years of age, where he found that cannabis and tobacco were the drugs commonly used by them.26

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Shekhar Saxena studied on rapid increase on heroin dependence in Delhi in the recent year.27 Ponnudurai.R studied on drug abuse among internees with the help of the youth survey questionnaire developed by who 22.67% of them were alcoholics, 9.33% of boys used cannabis which was followed by sedatives and hypnotics and they reported that it was easy to obtain the drugs like marijuana and amphetamines.28 Zulfikar Ali studied on the use of psycho active substance among medical students and concluded that almost 1/3 rd of the medical students reported a life time use of psychoactive substance.29 Pallab.K.Maulik explored the reason for relapse in opium dependent subjects. The assessment was done using a questionnaire designed for the study on adolescence and adults. The result showed that there were symptoms of inability to control urges in 8%, frustration in 6.6%, inllness and pain 75%, sleep disturbance by 34.7%.30 According to a study report,’ 1998 studied on recent patterns of use and associated risk of illicit drug use in adolescence were his conclusion that the drug use among adolescence doubled in 1990’s and is a significant cause of morbidity and mortality.31 According to a study report,’ studied on new patterns of drug use. it was a normal population study where the latent class analysis revealed the use of the following drugs i) cannabis ii) amphetamines iii)heroin. The adolescence associations with party going and getting in to habit of drug dependence were very common.32 According to a study report,’ conducted a study of integrative research review of risk behaviors among adolescence in rural, suburban and urban areas and

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concluded that education alone is not sufficient to prevent drug abuse and that some other objective steps should be taken to stem the root.33 Aytaclar.S.et al., studied on association between hyperactivity and cognitive functioning in childhood and substance use in early adolescence where in a comparative study was made on high risk group having fathers with a lifetime's diagnosis of a psychoactive substance use disorder and normal fathers with no history of misuse of drug. If showed that high risk group had a significantly higher behavioral activity and exhibited poorer performance in studies too.34 Krueger .R.F,studies on personality traits and late adolescence predict mental disorders in early adulthood. A prospective epidemiological study was conducted in university of Wisconsin, USA, which conclude that high negative emotionality at 18 year led to substance dependence and anti –social personality.35 Kaminer .Y. conducted a study on addictive disorders in adolescence and its result was adolescence with behavioral deregulation, poor social skills, a limited social network and substance abuse during late substance dependence in adulthood.36 Woodward.L.S conducted a study on childhood peer relationship problems and psychological adjustment in late adolescence. This paper examined the relationship between teacher reported peer relationship problems at age 9 years and psychosocial adjustment in late adolescence. Result showed that, in the age group of 18 years, children with high rates of early peer relationship problems were at increased risk of externalizing behavior problems such as substance abuse.37 A study conducted on “Parental involvement in adolescents education”, several types of parental involvement were analyzed for gender differences including

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school discussion, parent-school connection, parental expectation, parents attendance at school events and three measures of parental supervision (Check homework, limiting television watching, limiting going out with friends). These results showed that daughters are experiencing more parental involvement with their education that the sons.38 The heaviest drinkers are men in their late teens or early twenties. There has been disturbing evidence of increasing drinking and drunkenness amongst adolescents.

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CHAPTER- IV METHODOLOGY Methodology of research indicates the general pattern for organizing the procedure for gathering valid and reliable data. The problem for this study is to assess the ill effects of drug dependence among the late adolescent students in Anupama PU College. This chapter deals with the research approach, design, setting, Population, sampling technique criteria for the selection of sample, sample size, development and description of the tool, content validity of the tool, Pilot study, Procedure for data collection and plan for data analysis. Research approach and Design: He approach chosen for this study in descriptive. The aim of the descriptive research is to obtain accurate and meaningful description of the phenomena under the study. According to polit and hungler(2005) the descriptive research is not concerned with the relationship among variables. Its purposes are to observe, describe and document aspects of a situation. The main objective of the descriptive research study is to have an accurate portrayal of the characteristics of persons, situations or groups and the frequency with which certain phenomena occur.

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SCHEMATIC REPRESENTATION OF RESEARCH DESIGN

Selected School Anupama PUC

Purpose Assess the Level of knowledge on ill effects ,Factors, Types of drugs and Behavioral changes occurs due to drug dependence

Research Design Non-Experimental Descriptive approach design

Sample 100 Adolescent’s student

Target population Adolescent students of 14-21 years of both sex.

Sampling Technique Simple Random sampling

Development of tool and Data Collection

Step-I *Preparation of Questionnaire *Content Validity *Pilot study

Step-II * Procedure for data collection

Data AnalysisDescriptive: Percentage, Frequency distribution and Inferential: Chi-Square

Findings and conclusion

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Setting: The setting of the study comprises of the Anupama Pre –University College, West of Chrod Road,II stage,Mahalakshmipuram,Bangalore-86. The age group of the students is between 14-21 years age. The setting was selected because of the active co-operation of the students. Population: The study population comprises of the adolescent students aged 14-21 years at Anupama Pre –University College. Criteria for the selections of the sample: The investigator approached the students based on the following selection criteria. •

Adolescent students of 14-21 years of both the sex ,studying in PUC I and IInd year.

•

Students who are willing to participate in the study.

•

Those individuals who could be met at the respective centers at the time of the study.

•

Some of the students coming from rural background were susceptible influence of urban subculture

Sample Size: The sample size consists of 100 adolescent of age group 14-21 years. Sampling technique: The samples were selected by non-Probability convenient sampling technique.

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Development and description of the tool: The tools developed for this study is a structured questionnaire and rating scale based on the review of literature, discussion with experts and investigators personal experience. Description of the tool: The structured questionnaire has two parts. It is developed to determine the knowledge of problems of drug dependence among the adolescent students. Part-I Part-II Part-I 1. Demographic data and family background 2. Social background 3. Ill effects related to drugs 1. Demographic data and family background of adolescent students consists of age, sex, religion, qualification, average school grade occupation and questions regarding family background consists of details such as whether the adolescent in living in a joint or nuclear family, with whom he/she is living, whether both parents are alive, whether they have siblings, qualification of father, location of house, whether they have discussion with parents on career, fathers occupation, whether any one uses drug/alcohol in family etc. 2. Social background includes aspects such as the adolescent student’s participation in social activities, usage of alcoholic beverages, about the peer group, dominance in peer group, whether they are introverts, their source of getting drug,

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whether their friends have encounter with drugs, whether their friends had undergone treatment for drug addiction, drug addiction on a social problem and their participation in anti social activities. 3. Ill effects related to drugs consist of 8 specific closed ended questions on ill effects related to drug dependence. The individual has to either mark yes or No, yes was scored as 1 and No was scored as 2. Part-II It consists of 10 items on knowledge related to ill effects of drug dependences, where the score was given based on three options like Yes/No/Don’t know.Total score 20. Content validity: Validity refers to a complex concept which broadly concerns the soundness of the study’s evidence, that is, whether the findings are cogent and convincing and well ground. The content validity of the prepared tool was obtained from 1 biostatistion, 3experts in mental health nursing and 1 psychiatrist. Reliability of the tool: Reliability of the tool was established by test-retest method. This was done by introducing the tool to same group of sample at different time after reshuffling the questions. The reliability score obtained showed high correlation between the score r =0.78 hence the tool was considered reliable. Pilot study: After a written permission was obtain from the principal of the Anupama Preuniversity College. The data for the pilot study and for the main study was collected.

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Pilot study was conducted with 10 students. Among them, 5 students from boys and 5 students from girls who were selected on the basis of Non- Probability convenient sampling technique. After getting oral consent from the students, the individual and the investigator were seated in a room without disturbance, facing each other. Brief introduction given on the questionnaive were reinforced. The questionnaire was administered on an individual basis. Each session lasted for about 40 minutes. The pilot study was conducted for a period of 3 days. Findings of the pilot study revealed that it was feasible and practical to conduct the study and the criterion adopted was found to be effective. The plan for statistical analysis was also determined; therefore the data collection for the main study was done excluding the samples included in the pilot study. Procedure for data collection: The data collection for the study was done within a period of 5 weeks. After a brief introduction of self and study, after obtaining the oral consent from the subject, the investigator and the student were seated in a quiet room, facing each other. The investigator established rapport with the student and administered the questionnaire after a brief introduction. The instructions given on the questionnaire were reinforced. The instructions were, •

All the responses will be treated confidential.

•

They can give frank and honest answer to the best of their ability.

•

Doubts can be clarified. After the instructions, the questionnaire was given and the subject was asked

to tick the responses. The total time taken for answering the questionnaires by each student was 30-40 mints. Hence the investigator was able to collect the data from 5-7 26

students per day on all days in a week at Anupama Pre- University College, where the investigator got samples on 3 shifts that is from7-9 in the morning, 12-2 in the afternoon, 5-7 in the evening. At the Anupama Pre- University College, the investigator met 7 students each day from Monday to Saturday, during working hours between 9am and 4 pm. The data collection was done for 5 weeks. Pilot Study was conducted during the 1st week and from 2nd week data was gathered for the main study. By the end of the data collection period data had been collected from 100 students. Plan for data analysis: The data obtained was planed to be analysed based on the study using descriptive and inferential statics were used. Descriptive statistics: •

Simple percentage and frequency distribution were used to analyses the demographic data of the students.

•

Mean and standard deviation were used to identify the knowledge and attitude of adolescent students regarding the ill effects related to drug dependence.

•

Distribution of scores was done on the knowledge acquired, which was interoperated as moderate, adequate and inadequate.

Inferential staatistics: Chi-square test (x2) was used to determine the association between the level of knowledge,demographic variables and family back ground.

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Summary This chapter dealt with research approach & desigh,variables,setting and sampling criteria, it includes the preparation & assessment of the tool and demographic variables.this chapter also dealt with the Polit study,data collection procedure and plan for data analysis.

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CHAPTER-V RESULTS This chapter deals with analysis and interpretation of data collected from 100 Adolesent students studying in PUC for assessing the level of knowledge.The data collected from 100 adolesents students studying in PUC was organized, tabulated, analyzed and interpreted by using descriptive and inferential statistic.The analysis and interpretation was based on the data collected through structured interview schedule. Polit (1999) states that statistical analysis is a method of rendering quantitative information and elicits meaningful and intelligible form of research data. Analysis is the process of organizing and synthesizing data so as to answer research questions and test hypotheses. The objectives of the study were: 1. To describe the level of knowledge on ill effects of drug dependence. 2. To find out factors leading to drug dependence. 3. To identify the types of drugs available in the market. 4. To assess the level of knowledge on the behavioral changes occurs due to drug dependence. 5. To identify Rehabilitative measures available at the state level and National level.

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Organization and presentation of the data: The data collected were edited,tabulated,analyzed, interpreted and findings obtained were presented in the form of tables and diagrams represent under folowing sections. Section A: Measurement of level of knowledge of Problems related to drug dependences among the adolescent students. Section B: Measurement of the level of knowledge of Problems related to ill effects drug among the adolescent students. Section C: Association of selected demographic variables (Table-1), Family background (Table-2) and Social background (Table-3) with the Level of knowledge of adolescent on Problems of ill effects Drug.

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Section-A Table-I –(a) Frequency and Percentage distribution of Demographic Variables of adolescent student. n=100 Sl.No Demographic Variables 01 Age of adolescent

02

Frequence (f)

14 -17 years

27

27

18-21 years

73

73

Male

48

48

Female

52

52

100

100

23

23

61-75%

63

63

Above>75% Ordinal Position

14

14

First

30

30

Second

53

53

Third No of Sibling

17

17

Nil

20

20

One

30

30

Two

41

41

Three Religion

09

09

Hindu

39

39

Christian

34

34

Muslim Residence

24

24

Rural

33

33

Urban

45

45

Semi

22

22

Sex

03

Qualification

04

PUC Academic Performance Below <60%

05

06

07

08

Percentage (%)

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Table-I describes the data regarding age ,of which 27(27%) students belongs to the age group 14-17 years and 73 (73%) were of 18-21 years of age group (fig-1). when considering sex,48 (48%) were males and 52(52%) were females (fig-2) on considering the qualification PUC 100(100%) fig-3. With regard to Academic Performance were Below <60% were 23(23%),6175%were 63(63%) Moderate. Above 75% were 14(14%)

of them have scored.

Ordinal Position was First 30(30%), Second 53(53%) and Third 17(17%). No of Sibling were Nil 20 (20%), One 30 (30%), Two 41(41%) and Three 9(9%).Religion were Hindu 39 (39%),Christian 34(34%) and Muslim(24%). In relation to Residence for Adolescent were Rural 33(33%) ,Urban45(45%) and semi urban 22(22%).

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Sex

Male 48% Female 52%

Graph 1:Percentage distribution of Demographic Variables according to sex

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Academic Performance

63%

70

60

Percentage (%)

50

Below < 60% 61-75% Above 75%

40

23%

30

14% 20

10

0

Level of Academic Performance

Graph 2:Percentage distribution of Demographic Variables according to Academic Performance

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Residence

45%

45

Percentage (%)

40

35

22%

33 %

30 25 20

Semi

15 10

Urban

5 Rural

0

Graph 3:Percentage distribution of Demographic Variables according to Residence

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Table-I-(b)- Frequency and Percentage distributions of adolescent students according to family Back Ground n=100 S.No 09

10

11

12

13

14

15

16

Demographic Variables Type of Family Joint Nuclear Extended Family Income Below Rs7000 Rs7000-10000 Above Rs 10,000 Parents Alive Yes No Living with Both Parents Mother/Father Talker Relatives Hostel Speak to Career Frequently Rarely Never Qualification of Talker Undergraduate Postgraduate Professional Occupation of Talker Self employed Managerial Clerical Skilled Unskilled Family use Drug/Alcohol Yes No

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Frequency

Percentage (%)

38 53 09

38 53 09

61 19 20

61 19 20

67 33

67 33

29 23 17 16 15

29 23 17 16 16

46 39 15

46 39 15

21 51 28

21 51 28

40 17 17 19 07

40 17 17 19 07

33 67

33 67

Table-II. Describes the data regarding type of family like Joint 38(38%), Nuclear 53(53%), Extended09 (09%).In relation to

Family Income were Below

Rs7000-61(61%), Moderate Rs7000-10000 -19 (19%) and Above Rs 10000-20(20%). Considering are both your Parents Alive in Yes 67(67%) and No33 (33%).At Present with whom are you living with

Both Parents 29(29%), Mother/Father23

(23%), Talker17 (17%), Relatives 16 (16%) and Hostel 15(15%). How often do you speak to your parents on your career in Frequently 46(46%), Rarely 39(39%) and Never 15(15%).Qualification of Talker like Undergraduate-21(21%), Postgraduate 51(51%) and Professional 28(28%). With regard to financial aspects in Occupation of Talker like self employed 40(40%), Managerial 17(17%), Clerical-17 (17%), Skilled 19(19%) and Unskilled 07(07%). Does anybody in your family use Drug /Alcohol Yes 33(33%) and No67 (67%).

37

Type of Family

Extended 9% Joint 38%

Nuclear 53%

Graph 4:Percentage distribution of Family Back Ground according to Type of Family

38

Family use drug/Alcohol

70

Percentage (%)

60

50

67%

40 30

33%

20 10 0

Yes

No

Graph 5:Percentage distribution of Family Back Ground according to Family use Drug / Alcohol.

39

Table-II. Frequency and Percentage distributions of adolescent students according to Social back ground. n=100

40

Sl.No Social Variables 01 Activities Sports Clubs Societies Cultural 02 Occasion Religious Social Other Never 03 Peer Group Large Yes No 04

05

06

07

08

09

10

11

Dominant Role Yes No Introvert Yes No Sometimes Encounter With Drugs Yes No Some times Use Of Drugs Oral Smoked Shifted Injected Others Not Applicable Sources Of Drug Pharmacy Illicit Not Known Not Applicable Undergone Treatment For De-Addiction Yes No Not Applicable Social Problem Yes No Antisocial Activities 41 Yes No

Frequency(f)

Percentage (%)

33 24 20 23

33 24 20 23

16 21 27 36

16 21 27 36

62 38

62 38

40 60

40 60

26 40 34

26 40 34

19 53 28

19 53 28

24 21 11 5 8 31

24 21 11 5 8 31

30 16 27 27

30 16 27 27

28 42 30

28 42 30

62 38

62 38

20 80

20 80

Table III-Among 100 samples Activities like Sports 33(33%), Clubs 24(24%), Societies 20 (20%) and remaining Cultural 23 (23%). Use alcoholic beverages on any occasion At Religious services 16(16%), on Social occasion 21(21%), other occasion 27(27%) and Never 36(36%).Peer Group Large Yes 62 (62%) and No 38(38%). Have a dominant role in your peer group Yes 40(40%) and No60(60%).An Introvert Yes 26(26%), No40(40%) and Sometimes 34(34%).Your friends having Encounter With Drugs Yes19(19%),No53(53%) and Sometimes 28(28%).Use Of Drugs

Oral 24(24%), Smoked21(21%), Shifted11(11%), Injected 5(5%), Others

8(8%) and Not Applicable 31(31%). Source of getting the drugs Sources Of Drug

Pharmacy30 (30%),

Illicit16(16%),Not Known 27 (27%) and Not Applicable 27(27%).Undergone Treatment For the De-Addiction Yes 28(28%) ,No42 (42%) and Not Applicable 30 (30%).Aware the drug addiction in a Social Problem Yes 62(62%) and No38(38%).

Percentage (%)

Participate in Antisocial Activities Yes 20 (20%) and No 80 (80%).

42

Graph 6:Percentage distribution of Social Back Ground according to activities

43

Graph 7:Percentage distribution of Social Back Ground according to Occasion

44

Peer Group Large

70

60

Percentage (%)

50

40

62% 30

38%

20

10

0 Yes

No

Graph 8:Percentage distribution of Social Back Ground according to Peer Group Large

45

Use of Drugs

35

31%

30

24%

Percentage (%)

25

21%

20

15

11% 8%

10

5%

5

0 Oral

Smoked

Shifted

Injected

Others

Not Applicable

Graph 9:Percentage distribution of Social Back Ground according to use of Drugs.

46

Table III- Frequency and Percentage distributions of adolescent students on knowledge of Problems related to Drug Dependences n=100 S.No 01

02

03

04

05

06

07

08

Ill Effects of Drug Self-Medication Yes No Pain-Killers Yes No Take Sleeping Pills For Sleeplessness Yes No Some Time Drug Addiction Can Decrease Ones Life Span Yes No Sometimes Drug Can Cause Serious Psychological Symptoms Yes No Drug Is a Sedative Yes No Black Coffee & Cold Beverages Helps in Sobering Up Yes No Habit Of Tobacco Chewing Yes No Sometimes

Frequency(f)

Percentage (%)

49 51

49 51

41 59

41 59

27 47 26

27 47 26

46 34 20

46 34 20

58 42

58 42

58 42

58 42

47 53

47 53

25 61 14

25 61 14

Table IV-The data represented illeffects of 100 samples like self Medication Yes 49 (49%) and No51 (51%).use pain killers yes 41 (41%) and No 59 (59%).Take 47

sleeping Pills for sleeplessness like yes 27 (27%),No 47(47%) and some time 26 (26%). Drug Addicition can decrease ones Life span Yes 46 (46%),No 34(34%) and some times 20 (20%).Drug can causes serious Phychological Symptoms Yes 58 (58%) and No 42(42%).Black coffee & Cold Beverages Helps in sobering up Yes 47(47%) and No 53 (53%).Habit of Tobacco chewing yes 25 (25%).No 61(61%) and sometimes 14 (14%).

48

Self-Medication

51

Percentage (%)

50.5 50 51%

49.5 49 48.5

49%

48 Yes

No

Graph 10:Percentage distribution of Knowledge of Problems according to self Medication

49

Section-B Table-4-Description of Level of Knowledge on illefects of Drug Dependences Frequency and percentage distribution of adolescent student and the level of knowledge related to ill effect of drug dependences. n=100 S.No

01

Contents

Level of Knowledge

Inadequate

Moderate

Adequate

<50%

51-75%

>75%

F 56

% 56

F 41

% 41

F 03

% 03

The above Table -4-shows 56(56%) of them have inadequate knowledge , 41(41%) of them have moderate level of knowledge and 03(03%) of them fit in the category of Adequete Knowledge.

50

Level of Knowledge 56% 60

41%

Percentage (%)

50

40

30

3

20

3%

10

0

Inadequate<50%

Moderate51-75%

Adequate>75%

Graph-11-Percentage distribution of adolescent student and the level of knowledge related to ill effect of drug dependences

51

Table 5- Chi square value to assess the association between knowledge scores and demographics variables. n=100 Sl..No Demographics Variables 01 Age of adolescent 14 -17 years 18-21 years 02 Sex Male Female 03 Academic Performance Below <60% 61-75% Above>75% 04 Ordinal Position First Second Third 05 No of Sibling Nil One Two Three 06 Religion Hindu Christian Muslim 07 Residence Rural Urban Semi 08 Type of Family Joint Nuclear Extended 09 Family Income Below Rs7000 Rs7000-10000 Above Rs 10,000 10 Parents Alive

F

%

X2

Table Value

Inference

27 73

27 73

21.16

01

P>0 NS

48 52

48 52

0.160

01

P>0.68 NS

23 63 14

23 63 14

40.82

02

P>0 NS

30 53 17

30 53 17

19.94

02

P>0 NS

20 30 41 09

20 30 41 09

22.48

03

P>0 NS

39 34 24

39 34 24

30.48

03

P>0 NS

33 45 22

33 45 22

7.94

02

P>0.019 NS

38 53 09

38 53 09

30.02

02

P>0 NS

61 19 20

61 19 20

34.46

02

P>0 NS

11.56

01

P>0.001

52

11

12

13

14

15

16

Yes No Living with Both Parents Mother/Father Talker Relatives Hostel Speak to Career Frequently Rarely Never Qualification of Talker Undergraduate Postgraduate Professional Occupation of Talker Self employed Managerial Clerical Skilled Unskilled Family use Drug/Alcohol Yes No Knowledge Inadequate <50% Moderate51-71% Adequate>75%

S:Significant

67 33

67 33

29 23 17 16 15

29 23 17 16 16

46 39 15

46 39 15

21 51 28

21 51 28

40 17 17 19 07

40 17 17 19 07

33 67

33 67

56 41 03

56 41 03

NS : Non Significant

NS

7

04

P>0.136 NS

15.86

02

P>0 NS

14.78

02

P>0.001 NS

29.4

04

P>0 NS

11.56

01

P>0.001 NS

81.74

12

P>0 NS

*P<0.01

It is evident from the table that Chi square value computed for the educational qualification with the level of Knowledge is statiscally significant at P< 0.001 level. The other demographi Variables such as Age of adolescent,sex,Academic Performance,Ordinal Position,No of sibling,Religion,Residence,Type of Family, 53

Family IncomeParent Alive,living withSpeak to career,qualification of Talker, Occupation of Talker,Family use Drug/ Alcohol showed no statistically significant association with the level of knowledge.

CHAPTER-VI DISCUSSION

54

This chapter discusses the findings obtained in the previous chapter on analysis and interpretation of data collected for the study on the level of knowledge on problems related to drug dependences among the adolescent students. For this the level of knowledge calculated knowledge between selected data on personal, family and socio cultural factors with the level of knowledge were done. Relevant studies from the review of literature and the integration of conceptual farm work, based on the modified Dunns High level awareness Model, Developed for the investigator. Characteristics of the demographic variables The characteristics of the demographic variables, described in terms of their frequency and percentage which showed that 27% were in the age group of 14-17 years, 73% were 18-21 years, Females 52% and Males 48%, academic Performance were below <60% marks 23%, 75% and Above 63% and 14%, ordinal Position first 30%, second 53%, and Third 17%.religion in Hindu 39%.Residence were in urban 45%. The first objective was to describe the level of knowledge on ill effects of drug dependences. 56% inadequate level of knowledge and 41% Moderate Level of knowledge. A study revels that the students had easy access to obtain drugs like cannabis, amphetamines but they did not possess adequate knowledge of the ill-effects of drugs39 and the present study also shows statistically that none of 100 students had adequate knowledge on drugs. Association between selected Demographic, familial and social factors with the level of knowledge.Data analysis has shown that through chi-square test there is

55

no significant association between level of knowledge and selected demographic, familial and social factors. The second objective was to find out factors leading to drug dependence Family Background. 53% were from nuclear type of family.46% had discussion with their parents regarding their career.40% were self employed of occupation of Talker. A study in Jaipur revealed 46.1% of drug addicts among the adolescence were from nuclear families.40 The south India Police Journal reveals that ,the major etiological factor for adolescents students going in to drug addiction is due to poor Parental attitude towards their children.41 This correlates with the present study where majority of children come from nuclear family. However 46% of children had very frequent discussions with parents on career issues. However it is necessary to provide counseling on awareness of drug dependences among adolescent students. The third objective was to identify the types of drugs available in the market 49% of them take self Medication and 46% of them teke Medication if they take serious physical symptoms and 58% of them with psychological symptoms. Taking in to account the study conducted on drug awareness and dependences, the results showed that the college students have knowledge and even admitted to have taken drug at sometimes in their life.42

56

The Fourth objective was to assess the level of Knowledge on the behavioral changes occurs due to drug Dependence Taking the female adolescent characteristics, if may be pointed out that in a study

by castilla Nezzich et al in us reveals the use of drugs by females in

significantly correlated with risky sexual behavior at the age of menarche, through there are socio-cultural differences between the adolescence of that study and present study. This should be taken in to account for further in-depth study on drug awareness and risky sex behaviour. 45% had urban location too their college a cultural shock of the urban life may have lead to drug dependences. Taking the level of marks it may be pointed out that , ‘A study on prevalence of drug abuse with the similar educational group of adolescent found that tobacco, cannabis and alcohol were the most abused drug of choice.’43 The fifth objective was to identify rehabilitative measures available at the state level and National Level. 62% had large peer group and 62% accepts that drug dependences are a social problem. In the present study majority of children accepted that drug dependences is a social problem where a study in the surat city has brought out the fact that 300 child laborers use drugs due to macro and micro social stresses.44 According to the present study which revels that 62% had large peer group brought out by a study results who had high rates of early peer relationship were stepping in to problems of drug dependences in late adolescences years.45’

57

CHAPTER-VII CONCLUSION The present study assessed the level of knowledge on ill effects of Drug Dependences among adolescents. The result revealed that majority 56% are inadequate level of knowledge and 41% are Moderate level of knowledge. Demographic variables have influence on the level of knowledge in adolescents. Implications on nursing The investigator has drawn the following implications from the studies which are of vital concern to the field of nursing services, nursing education, nursing administration and nursing research. Mental health nurses practitioners The integration of mental health into primary health care should be reinforced strongly at all levels.

The community mental health nurse practitioners should

attempt at educating the Pre-university students, and the community adolescence regarding drug and its ill effects. Knowledge can be created at the early high school level through school health programmed. This can be followed by guidance and counseling and referral services can be given. Involvement of community leaders by mental health nurse practitioners in mental health. Nursing Education Knowledge and sensitized nurse educationist will be able to identify minor problems of adjustments in adolescence within the context of socio-cultural and religious factors. She can establish a counseling and guidance cell in every intuition.

58

Nursing Administration They should try to be in contact with the school administrators and send the nurses to school health programmers and help in the early identifications of adolescent drug abusers. Nurse administrators should try to influence the Medias impact negatively on drug dependences. Nursing Research This study can be further replicated the findings of the study can be disseminated and implemented based on these findings nursing theories can be evolved, which will strengthen the field of nursing research. Recommendations for further study On the basis of the findings of the study it is recommended that:  A similar study can be conducted in any other setting and in rural community.  A comparative study could be conducted between both the sexes.  A similar study can be conducted in de-addiction group of adolescence who has come for treatment. Limitations 1. The sample size was limited to 100 students. 2. The study was limited to Adolescents students who study for Puc in 14-21 years. 3. The study setting was limited to Adolescents students who are studding in Anupama PUC ,in Bangalore.

59

CHAPTER- VIII SUMMARY This chapter comprises of summary for the present study from ancient period, man has depended on the use of substance/drug for sleep producing effect. In the modern world there is a struggle for existence and the survival of the fittest. Hence to reduce anxiety one seeks refuge in drugs and alcohol to alter the state of mind. Of mans various stages of life, adolescents seem to be the most crucial face in shaping one’s life. They are basically risk takers. Drug depender among adolescence was very common and the majority of them were experimental abusers. The new environment they enter after learning school, the physiological and psychological changes after puberty create a transitory change and put them into all new risk taking activities due to mainly peer group influence. The investigator through her personal and professional experience wanted to study the knowledge of drug dependences in adolescence. They study done was to assess the level of knowledge on problems of drug dependence, among the adolescent students in selected settings of Bangalore. The objectives for this study were, 1. To describe the level of knowledge on ill effects of drug dependence. 2. To find out factors leading to drug dependence. 3. To identify the types of drugs available in the market. 4. To assess the level of knowledge on the behavioral changes occurs due to drug dependence. 5. To identify Rehabilitative measures available at the state level and National level.

60

Assumptions: There is knowledge among the adolescents, group of students regarding problems of drug dependences. The adolescents groups of student are capable of expressing their review with regard to the problems of Drug Dependences. Extensive review of literature and professional experience guided the investigator to design the methodology and develop the tools for data collection the conceptual framework for the study was based on Dunn’s high level wellness model. This was modified into high level knowledge model. Knowledge has been categorized in to high level Knowledge and low level Knowledge. The investigator selected a descriptive surrey approach to assess the level of Knowledge on problems of drug dependence among the adolescent students. The setting of the study comprises of Anupama Pu college. The age groups of the students were between 14-21 years. The sample size consists of 100 adolescents students who fulfilled the selection criteria. The sampling technique used for the study was a structured questionnaire and a 3 point rating scale. The content validity of tools were obtained from experts, test re-test method was used to check the reliability of the tool for the pilot study. The ethical aspects of the research study was maintained throughout the study period by getting formal permission from the authorities and consent from the samples.The practicability and feasibility of the tools checked by the pilot study

61

enabled the investigator to collect data for the main study. The data collected was analysed by using descriptive and the findings of the study revealed that the Overall mean 10.46 indicates the level of knowledge of adolescents’ students on problems of drug dependences is inadequate.

62

CHAPTER-IX BIBLIOGRAPHY 1. Ruth FC, Constance JH. Fundamentals of Nursing. 2rd ed. Philadelphia: Mosby Publications; 1998. p. 1098-100. 2. Annette UR, La RA. Preventing Maladjustment from infancy through Adolecend. New delhi: sage publication; 1987. Vol 2. p.82-7. . 3. Bhatia BD, Craig M. Elements of Psychology and mental hygiene for nurses in india. 1st ed. Calcutta: Orient longman publications; 1965.p. 211-13. 4. Munjal. GC, Jiloba. RC. Drug Abuse in Delhi. Indian Journal of Psychiatry 1994 Mar; 135(3):121-28. 5. Crobsmith, Chhikara S. Ecologiccal Environment and self concept of Adolescents. Journal of Psychoimentry 1997 Jan ; 10(1):13-8. 6. Bahr JS, Beane, Mallghan LS. Family Religiosity and the risk of Adolescent Drug Use. Journal of Marriage and the family 1998 Mar; 60(4): 979-92. 7. Mohan D.Prevalence of Drug abuse in High school Population. Indian Journal of Psychiatry 2000 July; 20(2): 20-24. 8. Niten SW, Das J. Codeine containing cough syrup addiction in Assam and Nagaland. Indian Journal of Psychiatry 1994; 36(3): 129-32. 9. Satija DC,Shivgautam. A Double Blind Comparative study of usefulness of colonidine and symptomatic therapy in opiate detoxification. Indian Journal of Psychiatry 2003; 30(3): 55-6.

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10. Sethi BB. Long Term effect of cannabis. Indian Journal of Psychiatry 2001; 23(8): 224-9. 11. Zulfikar ARV. Psychoactive substances use among Medical Students. Indian Journal of Psychiatry 1989; 40(3): 13-9. 12. Ahamad H. A cross cultural study regarding drug abuse and personility among college student. Indian Express 1998 Feb 12;Sect.B:3(col. 5). 13. SPARC Study Report. 2007; available from: URL: http//www.businessbeacon.com/kommon/bin . 14. Ministery of welfare in india. 1992; available from: URL: http//www.ministry ofwelfareindia.org. 15. International Narcotics Control Board. 1992.; 2006 avaiable from : URL: http//www.incb.org/pdf/e/ar/2006/annual – report 2006. 16. World Health Organzation. 2008; available from: URL: http//www.unodcorg/unodu/en/data-and-analysis/WDR 2008. 17. Castilla M, Crow A. Adolescent development and adjustment. 3rd ed. New York: MC.Graw Hill Publications; 1998. p.15-7. 18. Bravender T, Brook JS, Boyle NM. Predicting substance use in late adolescence: results from the ontario child health study follow-up. American Journal of Psychiatry1992 Jun; 149(6): 761-67. 19. South India Police Journal Report 2000.

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20. David D. Drugs and the whole person. 2nd edition. USA. Library of Congress Publication;1990. 21. Rajkumar B. Subatance. Substances use by child Labourers. Indian Journal of Psychiatry 2003; 35(3): 159-61. 22. Varma VK. Drug Abuse amongst College students. Indian Journal of Psychiatry 2000; 19: 01-10. 23. Sethi BB. Long Term effect of cannabis. Indian Journal of Psychiatry 2001; 23(8): 224-9. 24. Mohan D.Prevalence of Drug abuse in High school Population. Indian Journal of Psychiatry 2000 July; 20(2): 20-24. 25. Dala M, Dubo KC. Prrevalence and pattern of Psychology Disturbance in school going Adolescent Girls. Indian Journal of clinical Psychology 2000; 17(2):83-8. 26. Verma S, Sing MB. Perceived Causes of Behavioural Problems among Indian adolescents. Psychology-Lingua 2000;28(2):310-7. 27. Shekhar S. Rapid Increase of Heroin Dependence in Delhi. Indian Journal of Psychiatry 2000;26(1):41-5. 28. Ponnudurai R,Jagakar J. A Psycho Demographic study of the patients of a deaddiction in Madras. Indian Journal of Psychiatry 1993;35(3):167-68. 29. Ali RV. Psychoactive Substances use among Medical students. Indian Journal of Psychiatry 1999;55(4):22-6.

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30. Pallab KM, Paintal HK. A Conflict Based Study of Attitudes of adolescent, towards their parents-Implications for Parental Counselling. Indian Journal of Clinical Psychology 1996 Mar;23(4):04-11. 31. Bravender T, Brook JS, Boyle NM. Predicting Substance use in late adolescents. Results from the ontario child health study folloe-up. The American Journal of Psychiatry 1992 Jun;149(6):761-67. 32. Purohit N, Pedersen WS. Relationship between perceived parental behaviour and ways of coping among school going adolescents. Indian Journal of clinical Psychological Review 1998;50(4):200-11. 33. Fash PS, Frauenknecht M, Black DR, Conster DC. Adolescent Problem solving, strees, and the stepped approach Model. American Journal of Health Behaviour 1996 April;20(2):30-41. 34. Aytaclar S, Aneja. Parent Child Relationship in Poinion of Adolescent Boys and Girls. Praachi Journal of Psychocultural Dimensions 1996 oct;2(2):02-22. 35. Krueger RF, Kaminer Y, Kaur Tejpreet, Sigh MB. Relationship of Socio personal factors with disciplinary tchniques of Parents. Journal of Psychological review 1999;51(1):24-31. 36. Chauhan SS. Mental Hygiene-A science of Adjustment. 2nd ed. Lucknow: Allied Publishere Lit; 02-20. 37. Woodward LJ, Woolfield NF. Adolescence a time of change, and a time of challenge for carers. Australian Paediatric Nurses 1993;5(2):15-7.

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38. Jennifer C. Adolesscent self reports of social activity, assessment of stability and relations to social adjustment. Journal of Adolescent 1987;10(01):83-93. 39. Hague N. Bupvenorphine abuse. Indian Journal of Psychiatry 1990;32(2):198200. 40. Rakesh L. Bupvenorphine Dependence analysis. Indian Journal of Psychiatry 1991;33(1):62-5. 41. Rajeev G. Drug abuse among non-student youth lobur. Indian Journal of Psychiatry 1987;29(4):359-62. 42. Rajkumar B. Substances use by child labourers. Indian Journal of Psychiatry 1993;35(3):159-61. 43. Report of Advisory Council on the misuse of drugs. Treatment and rehabilitation of drugs: Department of Health and social security. Delhi: Crown Publisher; 1992. p. 01-81. 44. Varma VK. Drug Abuse amongst college students. Indian Journal of Psychiatry 2000;19:11-26. 45. Ponnudurai R. Alcohol and drug abuse among Internees. Indian Journal of Psychiatry 2004;55(3):128-32.

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CHAPTER - X ANNEXURE -1 Letter seeking permission for conducting the study from The Princioal, Anupama Pre-University College Date:……………. To The principal, Anupama Pre-University College, West of chrod Road,IInd stage, Mahalakshmipuram,Bangalore-560086. Respected sir/Madam, Subject: Requesting permission for data collection-reg Mr.Vinoth Kumar. G., M.sc Nursing IInd year student of our college.He is interested to conduct a study on “A study to assess the level of knowledge on ill effects of drug dependence among adolescent in selected schools at Bangalore.”as a partial fullfillment of M.sc Nursing curriculum requirement.I kindly request you to grant him permission to conduct the study. The study will not affect any individual or the institution in any aspect. The study will be conducted in a descriptive Approach.so that he will not hinder the work and he will abide by the rules and regulations of the institution. If you are interested to know the finding of the study , a copy of the same will be given to you after the university Examination. Thanking you Copy to:

Youre Faithfully Mr. Vinothkumar. G. IInd Year Msc.Nursing Student (Principal)

68

ANNEXURE-2 LETTER GRANTING PERMISSION FOR CONDUCTING THE STUDY

69

ANNEXURE-3 Letter seeking Experts opinion for content validity of the tool From, Mr.Vinoth kumar.G M.sc (N) II nd year Padmashree College of Nursing, Bangalore -72. To,

Respected Madam/Sir, Sub: Seeking permission for Validation of the Research tool. I, Mr.Vinoth kumar.G I yr M.Sc Nursing ( Psychiatric Nursing ) student of Padmashree College of Nursing, request your good self; if you would kindly accept to validate my research tool on the topic. “A study to Assess the Level of Knowledge on illeffects of drug dependences among adolesecents in selected school at Bangalore.” I would be obliged if you would kindly affirm your acceptance to endorse your valuable suggestions on this topic. I had attached the details of my study along with the research Thanking You in Anticipation Yours Sincerely,

(Mr.Vinothkumar.G)

70

ANNEXURE-4 Criteria rating scale for validity of tool EVALUATION CRITERIA CHECK LIST Kindly go through the evaluation criteria check list for validation of tool. There are two columns given for your responses and a column for remarks. Kindly place right mark() in the appropriate column and give your remarks.

S.No 1

Content Baseline data:

Yes

 All the characteristics necessary for the 2

study are included Questionnaire:  Covers the adequate content about knowledge

and

illeffects

of

drug

dependences  Questions ate arranged in sequence  Questions are arranged in logical order  Language is simple and easy to follow  All items necessary to objective the objective of the study are included  Any technical terms that can be replace by simple terms

71

No

Remarks

Dear Madam/Sir Kindly go through the content and place right mark () against questionnaire in the following columns ranging from relevant to not relevant. When found to be needs modifications, kindly give your opinion in the remarks given.

S.No

Items

Relevant

Needs

Not

modification

relevant

Part-I A. Demographic data 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

72

Remarks

B.Structured Interview Questionnaire to assess the Social back ground 1 2 3 4 5 6 7 8 9 10 11 C.Structured Interview Questionnaire to assess the ill-effects related to drugs 1 2 3 4 5 6 7 8

73

Part II Description of Level of Knowledge on illefects of Drug Dependences 1 2 3 4 5 6 7 8 9 10

74

ANNEXURE-5 Content Validity Certificate I hereby certify that I have validated the tool of Mr.Vinoth kumar.G , M.Sc nursing student, who is undertaking a study, “ A study to assess the level of knowledge on illeffects of drug dependences among adolescents in selected school at Bangalore.”

Place: Date:

Signature of Expert,

Name and designation of Expert

75

ANNEXURE-6 List of Experts for content validity Prof.Dase Gowda, M.Sc (N), Principal and H.O.D, Government College of Nursing, Bangalore. Prof.J Premakumari, M.Sc(N), H.O.D of dept of Psychiatric Nursing, Oxford Collage of Nursing, Bangalore. Prof.B.H.Rajashekariah, M.Sc(N), Principal, R.V.College of Nursing, Bangalore. Mr.Surendhar, Biostatistition, GKVK , Bangalore. Dr.Satheesh, R.M.O, NIMHANS, Wilson Garden, Bangalore.

76

ANNEXURE-7 Letter to the subjects requesting to participate in the study Dear Respondents! I would like to inform you that I am Mr.Vinoth Kumar.G., PG student of Padmashree of college of Nursing ,Bangalore-72,conducting study on,”A study to assess the level of Knowledge on ill effects of drug dependence among adolescents in selected school at Bangalore.”This study goal is to find out the level of Knowledge and illeffect of drug dependence among adolescents.Here, a set of questions will be asked regarding the Knowledge and ill effects. I assure that here is no any potential risk in this study.The information which collected during this study will be kept confidential Participation of in this study is completely depends on your wish and therre is no compulsion. If you would like to participate kindly give your consent.Even after given consent also, you have right to withdraw from this study. If you want to enquire any further information you can contact to

Mrs.Sharmila. J. M.sc(N), Head of the Department, Padmashree College of Nursing, Nagarbhavi, Bangalore-72.

77

ANNEXURE – 8 Consent Form

Dear respondent, I am a PG Nursing student (psychiatric Nursing) from Padmashree College of Nursing, Bangalore, conducting a study on “ A study to assess the level of knowledge on illeffects of drug dependences among adolescents in selected school at

Bangalore.” You will be asked questions regarding

knowledge and ill effects of drug dependences. The information which collected will be kept confidential and used only for the study purpose. Kindly sign the consent form.

Thanking You

Signature of the Respondent,

Yours faithfully,

(Mr.Vinoth kumar.G)

78

ANNEXURE-9 CERTIFICATE FOR ENGLISH EDITING To Whom It May Concern This is to certify that the tool developed by Mr.G.vinoth kumar, IInd year M.sc Nursing student of Padmashree College of Nursing for his study, A study to assess the level of knowledge on illeffects of drug dependences among adolescents in selected school at Bangalore,” is edited for the English language appropriateness by

79

ANNEXURE-10 Structured interview questionnaire to assess the level of knowledge on illerrects of drug dependence among adolescents Dear Respondents! Please Plack a tick mark in the space provide (√ ) which ever choice you think is right please answer all items. A.Demographic Variables: 1.Age (Years)

[ ]

2.Sex a)Male

[ ]

b)Female

[ ]

3.Qualification a)High secondary

[ ]

b)PUC

[ ]

c)College

[ ]

4.What is your Last Academic Performance(%)?

[ ]

5.Ordinal Position a)First

[ ]

b)Second

[ ]

c)Third [ ]

80

6.No of sibling a)Nil

[ ]

b)One

[ ]

c)Two

[ ]

d)Three

[ ]

7.Religion a)Hindu

[ ]

b)Christian

[ ]

c)Muslim

[ ]

d)Others

[ ]

8.Residence a)Rural [ ] b)Urban

[ ]

c)Semi urban

[ ]

9.Type of Family a) Joint

[ ]

b)Nuclear

[ ]

c)Extended

[ ]

10.Family Income/Month(Rs) [ ]

11.Are both your Parents alive? a)Yes

[ ]

b)No

[ ]

12.At presnt with whom are you living with a)Both your Parents

[ ]

b)With mother/father

[ ]

c) With Talker

[ ]

d)Hostel

[ ]

81

13.How often do you speak to your parents on your career? a)Frequently

[ ]

b)Rarely

[ ]

c)Never

[ ]

14.Qualification of Talker a)Undergraduate

[ ]

b)Post Graduate

[ ]

c)Professional

[ ]

15.Occupation of Talker a)Self-employed

[ ]

b)Managerial

[ ]

c)Clerical

[ ]

d)Skilled

[ ]

e)Unskilled

[ ]

16.Does anybody in your family use Drug/Alcohol? a)Yes(specify the relationship)

[ ]

b)No

[ ]

B.Social Background 01.Do your participate in activities like a)Sports

[ ]

b)Clubs

[ ]

c)Societies

[ ]

d)Cultural

[ ]

02.Do you use lcoholic beverages on any occasion? a)At religious services

[ ]

b)On social occasion

[ ]

c) Other occasion

[ ]

d)Never

[ ]

82

03.Is your peer group large? a)Yes

[ ]

b)No

[ ]

04.Do you have a dominant role in your peer group? a)Yes

[ ]

b)No

[ ]

05.Are you an introvert? a)Yes

[ ]

b)No

[ ]

c)Some times

[ ]

06.Have you comes across your friends having encounter with drugs a)Yes

[ ]

b)No

[ ]

c)Some times

[ ]

07.What drugs they use? a)Oral

[ ]

b)Smoked

[ ]

c)Shifted

[ ]

d)Injected

[ ]

e)Others

[ ]

f)Not Applicable

[ ]

08.What is their source of getting the drugs? a)Pharmacy

[ ]

b)Illicit [ ] c)Not known

[ ]

d)Not applicable

[ ]

09.Have they undergone treatment for de-addiction? a)Yes

[ ]

b)No

[ ]

c)Not applicable

[ ]

10.Are you aware the drug addiction in a social Problem? a)Yes

[ ]

b)No

[ ] 83

11.Do you participate in antisocial activities? a)Yes

[ ]

b)No

[ ]

C.Ill-effects related to drugs: 1.Do you take self –medication? a)Yes

[ ]

b)No

[ ]

2.Do you take frequently pain –killers? a)Yes

[ ]

b)No

[ ]

3.Do you sleeping pills for sleeplessness or during stress? a)Yes

[ ]

b)No

[ ]

c) Sometimes

[ ]

4.Drug addiction can decrease one’s life span? a)Yes

[ ]

b)No

[ ]

c) Sometimes

[ ]

5.Drug can cause serious physical and psychological symptoms a)Yes

[ ]

b)No

[ ]

6.Drug is a sedative a)Yes

[ ]

b)No

[ ]

7.Black coffee and cold beverage helps in obering up? a)Yes

[ ]

b)No

[ ]

8.Do you have habit of Tobacco chewing? a)Yes

[ ]

b)No

[ ]

c) Sometimes

[ ] Part-II 84

Description of Level of Knowledge on illefects of Drug Dependences

S.No

Statements

01 02 03 04

People do not get Physically dependent on Drug Brown sugar increase the carrying for sweets Drug abusers are difficult to work with Youngsters from traditional,religious families never

05 06

become drug abusers Drugs do not attack academic performances People who know about drug can manage to use it in

07

control without getting addicted Telling youngster not to drink or to take drug increase

08 09

their desire to try it One can get addicted to drug used for Medical Purposes Withdrawal Symptoms like tremors and nausea does not

10

appear during withdrawal from drugs Handing drug addicts during withdrawal period in difficult and risky.

85

Yes

No

Don’t known

2

0

1

Scoring key Statement of the prolbem: A study to assess the level of knowledge on illeffects of drug dependence among adolescents in selected school at Bangalore Part-I A.Demographic Variables - Coding key Sl. No. 1.

Demographic Variables 14-17 years 18-21 years

2.

01 02

Sex a)Male

3.

4.

Coding key

Age

01

b)Female Qualification

02

a)High secondary

01

b)PUC

02

c)College

03

What is your Last Academic Performance(%)?

5.

6

< 60%

01

61-75

02

>75

03

Ordinal Position a)First

01

b)Second

02

c)Third

03

No of sibling a)Nil

01

b)One

02

c)Two

03

d)Three

04

86

7.

8.

9

10.

10.

Religion a)Hindu

01

b)Christian

02

c)Muslim

03

d)Others Residence

04

a)Rural

01

b)Urban

02

c)Semi urban

03

Type of Family a) Joint

01

b)Nuclear

02

c)Extended

03

Family Income/Month(Rs) <7000

01

7000-10,000

02

>10,000

03

Are both your Parents alive? 01

a)Yes 11.

b)No Are both your Parents alive? a)Yes

12.

02 01

b)No At presnt with whom are you

02

living with

13.

a)Both your Parents

01

b)With mother/father

02

c) With Talker

03

d)Hostel How often do you speak to your

04

parents on your career? a)Frequently

01

b)Rarely

02

c)Never

03 87

14.

15.

16

Qualification of Talker a)Undergraduate

01

b)Post Graduate

02

c)Professional Occupation of Talker

03

a)Self-employed

01

b)Managerial

02

c)Clerical

03

d)Skilled

04

e)Unskilled Does anybody in your family use

05

Drug/Alcohol? a)Yes(specify the relationship) b)No B.Social Background 1 Do your participate in activities

01 02

like

2

a)Sports

01

b)Clubs

02

c)Societies

03

d)Cultural Do you use lcoholic beverages on

04

any occasion?

3

a)At religious services

01

b)On social occasion

02

c) Other occasion

03

d)Never Is your peer group large?

04

a)Yes 4.

01

b)No Do you have a dominant role in

02

your peer group?

5.

a)Yes

01

b)No Are you an introvert?

02

a)Yes

01 88

b)No 6.

02

c)Some times Have you comes across your

03

friends having encounter with drugs

7.

8.

a)Yes

01

b)No

02

c)Some times What drugs they use?

03

a)Oral

01

b)Smoked

02

c)Shifted

03

d)Injected

04

e)Others

05

f)Not Applicable What is their source of getting the

06

drugs?

9.

a)Pharmacy

01

b)Illicit

02

c)Not known

03

d)Not applicable Have they undergone treatment for

04

de-addiction?

10.

a)Yes

01

b)No

02

c)Not applicable

03

Are you aware the drug addiction in a social Problem? 01

a)Yes 11.

b)No Do you participate in antisocial

02

activities? a)Yes

01

b)No C.Ill-effects related to drugs: 1. Do you take self –medication?

02

89

a)Yes 2.

01

b)No Do you take frequently pain –

02

killers? a)Yes 3.

Do

01

b)No you sleeping

02 pills

for

sleeplessness or during stress?

4.

a)Yes

01

b)No

02

c)Sometimes Drug addiction can decrease one’s

03

life span?

5.

a)Yes

01

b)No

02

c)Sometimes Drug can cause serious physical

03

and psychological symptoms a)Yes 6.

01

b)No Drug is a sedative

02

a)Yes 7.

01

b)No Black coffee and cold beverage

02

helps in obering up? a)Yes 8.

01

b)No Do you have habit of Tobacco

02

chewing? a)Yes

01

b)No

02

c)Sometimes

03

Part-II 90

Description of Level of Knowledge on illefects of Drug Dependences

Items Total No of Iteam = 10

No 0

Yes 2

Total No of Iteam (10 x 2) = 20 Maximum score = 20

91

Don’t Known 1