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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1 NAME OF THE
CANDIDATE AND
ADDRESS
Ms. VANDANA SAINI
NO:5, NOOR BUILDING, RMV 2ND STAGE,
BHOOPASANDRA MAIN ROAD,
BANGALORE – 94.
2 NAME OF THE
INSTITUTION
NOOR COLLEGE OF NURSING,
NO.5, BHOOPASANDRA MAIN ROAD,
RMV II STAGE, BANGALORE-94.
3 COURSE OF THE STUDY
AND SUBJECT
M.SC. NURSING, 1ST YEAR,
MENTAL HEALTH NURSING
4 DATE OF ADMISSION 01.10.2011
5 TITLE OF THE TOPIC
“A STUDY TO ASSESS THE
KNOWLEDGE REGARDING CARE OF
DEMENTIA AMONG CARE GIVERS OF
DEMENTIA PATIENTS WHO ATTEND
MIND PSYCHIATRIC HOSPITALS AT
BANGALORE.” WITH A VIEW TO
DEVELOP INFORMATION BOOKLET.
1
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
“You have to begin to lose your memory if only in bits and pieces to realize
that memory is what makes our lives. Life with memory is our coherence, our
reason, our feeling, our action, without it we are nothing.”
- LUIS BUNEUL
Increases in life expectancy during the twenty first century have produced an
aged population of an unprecedented size and longevity. Ageing leads to several
biological changes that take place over time and results in progressive loss of
functional capacity. The aged have to cope up with many physical and mental health
problems with advancing age requiring constant attention. Depressions, Hypertension,
Arthritis, Dementia, and Alzheimer’s are highly prevalent among the aged.1
The theme hopes to not only promote awareness about the disease, but also
help people seek early help so they can manage the disease successfully.1
Alzheimer’s disease is a form of dementia. Dementia is derived from the Latin
word de — “apart, away” and “mens” — mind. Dementia is a progressive brain
dysfunction which result in a restriction of daily activities and in most cases leads in
the long term to need for care. Literal meaning of dementia is Madness and insanity
Dementia (meaning "deprived of mind") is a serious cognitive disorder. It may
be static, the result of a unique global brain injury or progressive, resulting in long-
term decline in cognitive function due to damage or disease in the body beyond what
might be expected from normal aging. Although dementia is far more common in the
geriatric population, it may occur in any stage of adulthood. This age cutoff is
defining, as similar sets of symptoms due to organic brain syndrome or dysfunction,
are given different names in populations younger than adult. Up to the end of the
nineteenth century, dementia was a much broader clinical concept. Dementia is a non-
specific illness syndrome (set of signs and symptoms) in which affected areas of
2
cognition may be memory, attention, language, and problem solving. It is normally
required to be present for at least 6 months to be diagnosed.2
Memory loss is a common symptom of dementia. However, a memory loss
life does not mean you have dementia. People with dementia have serious problems
with two or more brain functions, such as memory and language.3
Dementing illness are the most common disorders among elderly and thought
to be the fourth leading cause of death among adults in many developed nations
following heart disease, cancer and stroke. Dementia robs the quality of life not only
the elderly, but also the family members who are forced to devote their lives caring
for their impaired loved ones.4
Dementia is the most feared and divesting disorder of late life. Current
estimates reveals that there are about 18 million cases of dementia in the world and by
2025, there will be about 34 million suffering from dementia. The overall prevalence
of dementia ranges from 5 percent to 7 percent. Alzheimer’s disease is the most
common dementing disorder accounting for 80 percent of all cases of dementia.5
It is clear that the main risk factor for dementia is age. About 3% of men and
women between the ages of 65 and 74 suffer from dementia, but after age 65, the
percentage of people with dementia approximately doubles with every decade of life.
The proportion of people aged 85 and older with dementia is between 25 and 35%.
However, it is important to understand that dementia is a disease which is seen more
in older people, and is not a normal part of ageing. It is also clear that, as the
population of older people grows throughout the world, the number of people with
dementia will rise. If current population trends continue, the number of people with
dementia could double every 20 years. Currently the causes of dementia are not
known for certain, and there is no known cure.6
Primary causes of dementia include a number of neurological disorders, from
the well-known Alzheimer's disease to less familiar disorders, such as Pick's disease.
Primary causes of dementia usually cause irreversible memory loss and impaired
thought processing. Dementia-like symptoms can develop as a result of an underlying
medical condition such as medication like anti-diarrhea, anti - epileptic medication,
3
antihistamines etc, alcohol, vitamin deficiency, infection like meningitis, encephalitis,
and human immunodeficiency virus etc.7
There is currently no cure for Dementia. Currently available medications offer
relatively small symptomatic benefit for some patient but do not show disease
progression. It helps a little for the memory. Right now, Dementia is diagnosed by
a battery of mental and other tests and even the diagnosis rests on the
judgment of the physician.7
The sun will continue to show its rays on the world. The waves of the vast
ocean will continue their rush to reach the shore and the wind will continue to blow
the leaves of the tree. Let us all accept the patient with Dementia and give them
a better tomorrow.7
6.1 NEED FOR THE STUDY
Life expectancy has gone up from 20 years at beginning of the 20 th century to
62 years today. India has large segment of older people in the population. This
segment is growing fast with rapid increase of the grey population in India. And
dementia is one of great problem facing during the old age period.8
Dementia is one of the world's fastest growing diseases -- won't go away and it
is fast becoming "everyone's problem." A look at the facts and statistics surrounding
dementia clearly show that it is a massive issue.8 Indeed, the numbers and statistics
surrounding dementia are staggering. Worldwide, there are now an estimated 24
million people living with some form of dementia. Without a major medical
breakthrough in the fight against dementia, this number could jump to as many as 84
million who have age-related memory loss by the year 2040 Health analysts estimate
that in just five years the number of Americans with Alzheimer's will jump to 7.7
million and by 2050 the number is projected to more than double to 16 million.9
Annual Incidence of Dementia in Victoria is: 6,175. Incidence Rate of USA is
approximately 1 in 738 or 0.14% or 368,320 people. Incidence extrapolations for
USA for Dementia is 368,320 per year, 30,693 per month, 7,083 per week, 1,009 per
day, 42 per hour, 0 per minute, 0 per second. This extrapolation calculation uses the
4
incidence statistic. 1,461 men died from dementia and related disorders in Australia
2002. 3,024 women died from dementia and related disorders in Australia 2002.10
“Dementia is a terminal illness," says lead author Susan L. Mitchell, M.D.,
M.P.H., a senior scientist at the Institute for Aging Research. "As the end of life
approaches, the pattern in which patients with advanced dementia experience
distressing symptoms is similar to patients dying of more commonly recognized
terminal conditions, such as cancer."11
The study underscores the need to improve the quality of palliative care in
nursing homes to reduce the physical suffering of patients with advanced dementia,
and to improve communication with their family members. "This will help to ensure
that patients and families understand what to expect in advanced dementia, so that
appropriate advance care plans can be made," says Dr. Mitchell.11
A study conducted on carer’s knowledge of dementia and their expressed
concerns. The investigator wished to determine how much carers from different
settings caring for patients with dementia knew about the disorder and elicit their
main concerns about the disease. A survey questionnaire was administered to 136
carers. The carers came from one of three categories one was from carers with no
prior contact with elderly mental health services pre assessment group; second carers
who had been in contact with mental health care professionals post assessment group;
third carers in contact with an dementia Society support group. A questionnaire on
the subject of dementia. Carer’s worries about the disorder also recorded. The study
highlights the need for elderly mental health teams to evaluate their methods of
dissemination of knowledge to carers, develop educational packages for carers and
evaluate their effectiveness.12
A study examines on the multi nodal strategies for caregivers of persons with
dementia. The researcher divided 139 caregivers in 3 groups: 62 in educational
support; 19 -Alzheimer’s Association support group and 58 did not receive any
treatment. Outcome measures coping styles, burden, caregivers concerns and
symptoms profile in caregivers. Results revealed that the distress increased in
educational support group after intervention; high participant satisfaction with groups;
support group, members reported higher distress and life impact and lower anxiety.
Control group had lowest distress and lower care giving satisfaction.13
5
Dementia is one of the most devastating conditions that can affect us. It
progressively destroys the brain cells, affecting every aspect of daily life and can last
for many years. Dementia does not discriminate on the grounds of gender, culture or
intellect. Whilst risk factors increase with age, younger people can also be affected.
Because lack of early diagnosis and support, lack of awareness in general hospital
wards of the special needs of patients with dementia, lack of palliative care – either in
hospital, hospice or own home, lack of awareness of the help that can be given by
friends, neighbors, shops or local services etc.14
Keeping above fact researcher is keen to assess the knowledge of care givers
regarding dementia so that knowledge gap can be filled up by educating the
caregivers and public and increasing awareness about dementia and accept the
individual who is suffering dementia as an important member of society.15
6.2 REVIEW OF LITERATURE
Review of literature is a systematic search of published work to gain
information about a research topic. Conducting review of literature is challenging and
enlightening experience. Through the literature reviews, researcher generates a
picture of what is known about a particular situation and the knowledge gap
that exists between the problem statement and the research subject problems
and lays a foundation for the research plan.16
Review of literature provides basis for future investigation testifies the
replication, throw light on feasibility of the study and constraints of data
collection, relates the findings from the study to another with a hope to establish a
comprehensive body of scientific knowledge in a professional discipline from which
valid and pertinent theories may develop.16
Here the review of literature related to the present study has been divided
under the following areas.
Part A: Literature related to the general aspects of dementia.
Part B: Literature related to knowledge of care givers on dementia.
PART A: LITERATURE RELATED TO THE GENERAL ASPECTS OF
DEMENTIA.
6
A study conducted on the prevalence of common psychiatric disorders in long
term care population. The results shows a total of 74 studies examining the
prevalence of psychiatric disorders and psychological symptoms in LTC populations
were identified including 30 studies on the prevalence of dementia, 9 studies on
behavioral symptoms in dementia, and 26 studies on depression. Dementia had a
median prevalence (58%) in studies while the prevalence of BPSD was 78% among
individuals with dementia. The median prevalence of major depressive disorder was
10% while the median prevalence of depressive symptoms was 29% among LTC
residents. The outcome measures shows Dementia, depression and anxiety disorders
are the most common psychiatric disorders among older adults in LTC.17
A study conducted to ascertain the prevalence of dementia among Kashmiri
Pandit aged 60years and above. Materials and Methods are used for this study is a
cross-sectional survey was conducted among the elderly population of the Kashmiri
living in a migrant camp. A Kashmiri version of the Mini-Mental State Examination
as the test instrument, and a score below 24 was considered indicative of dementia. A
functional ability questionnaire was also administered to the subjects. A neurologist
carried out the examinations. Results show a sample comprising 200 subjects (95
males and 105 females) were evaluated. The prevalence of dementia is 6.5% among
the Kashmiri Pandit population aged 60 years and above, which is higher than that
reported from other parts of India.18
A study conducted to identify the characteristics and causes of dementia prior
to age 45. They identified 235 individuals, ages 17 to 45, who previously had normal
cognitive function and were evaluated for progressive cognitive decline at Mayo
Clinic from 1996 to 2006. In one-third of patients, the dementia was caused by a
neurodegenerative disorder such as front temporal dementia, Huntington's disease or
familial prison disease. In 20 percent of patients, young-onset dementia was caused by
autoimmune or inflammatory conditions such as multiple sclerosis, autoimmune
encephalopathy or neuropsychiatric Lupus. The results show that this is an important
finding, because many of these diseases may have specific treatments.19
A study was conducted to determine the clinical profile of patients attending
a specialist cognitive disorders clinic in West Bengal. A retrospective study was
carried out in the study. Almost one-fourth (94/379, 24.5%) of all the patients with
7
dementia were of young onset. Women constituted about one-third of these cases. The
most common etiologies were Alzheimer disease (33%), front temporal dementia
(27%), and vascular dementia (20%). In contrast to other published studies of
young-onset dementia, front temporal dementia was commoner than vascular
dementia. This could be due to referral bias. A positive family history was found in
close to one-fifth of the patients. Close to 10% of the patients had reversible causes of
dementia.20
A Study conducted on behavioral and psychological symptoms of dementia in
Taiwan. Studies showed that between 30% and 63% of Taiwan's AD patients
experienced delusion. Hallucination occurred less frequently, which ranged from 21%
to 26%. Anxiety occurred in 35-76% of patients and depression 22-50%, sleep
abnormalities 26-61% and 39-46%. The differences in the prevalence of BPSD might
result from the different clinical settings and evaluation instruments. The prevalence
and clinical manifestations of BPSD in Taiwan are similar to Western reports. Based
on differing cultural backgrounds, the interpretation of agitation and apathy might
differ, so, the development of cross-cultural applicable criteria and rating scales for
the assessment and treatment of BPSD are important for future studies.21
A study conducted of around 7,000 people over 65 identified significant
differences in the risk factors for men and women. The main risk for men is a
variation in a gene linked with the most common form of Alzheimer's disease,
according to the French study. The main risk for women was difficulty with routine
daily tasks that would allow them to live without assistance, such as preparing meals,
managing money, food shopping, doing housework and using a telephone. Women
who struggled with such tasks were around 3.5 times more likely to develop
dementia, whereas for men it more than doubled the risk. None of the 6,892 people in
the study had dementia when it began but 2,882 were classed as having mild cognitive
impairment, meaning they were starting to show signs of mental decline and did not
perform highly on memory tests. The study noted that Women are more vulnerable to
getting Alzheimer's disease than men and this study shows how risk factors, such as
stroke and depression, affect men and women differently.22
A study to identify the 15 point index to identify patients at risk of developing
dementia before symptoms develops. A total of 3375 persons were included in the
8
longitudinal study. The participants' average age was 76, and the length of the study
was six years. None of the patients showed signs of dementia at the onset of the study.
The 15-point Index was compiled retrospectively by the researchers, who looked back
over the data to discover signs and symptoms that would help to identify patients at
risk for Alzheimer's. A total of nine items were identified as risks, and each item was
given a point value that brought the highest possible risk to 15. Result shows that the
participants, 480 persons developed Alzheimer's. Of these, 56% scored an 8 or higher
on the 15-point index, 23% had moderate scores, and 4% had low scores. This
indicates that the index could provide a useful assessment tool to medical practitioners
when assessing older patients for Alzheimer's disease risks.23
A study conducted on protocol of a cluster randomized trial on dementia
management in a general practice setting. Methods/Design is used for this study the
IDA project a three armed cluster-randomized trial where dementia patients and their
informal caregivers are recruited by general practitioners. In the control group patients
receive regular treatment, whereas in the two intervention groups general practitioners
participate in a training course in evidence based dementia treatment. The study
recruitment and follow-up took place from July 2005 to January 2009. 303 general
practitioners were randomized of which 129 recruited a total of 390 patients..
Discussion says that from a public health perspective, the IDA trial is expected to lead
to evidence based results on the community effectiveness of non-pharmaceutical
support measures for dementia patients and their caregivers in the primary care
sector.24
A study conducted on Health Professionals perspectives of providing care to
people with dementia in the acute setting. Open-ended interviews were conducted
with 25 medical, nursing, and other health care professionals drawn from 3
metropolitan teaching hospitals in Australia. Results showed acute care hospitals are
not the best place for people with dementia and can negatively influence health
outcomes such as functional independence and quality of life. Participants reported
attempts to provide best practice but experienced major constraints stemming largely
from environmental, socio cultural and economic issues. Recommendations include
the delivery of acute services in tandem with dementia services and a whole
9
organization shift in thinking away from what conveniently suits the institution to
thinking that is person-centered and dementia-friendly.25
10
A study conducted on acute care management of older people with dementia.
A descriptive qualitative Design used for data collection using semi-structured
approach. Method used was audio-taped interviews with a cross section of thirteen
staff that worked in acute medical or surgical wards in Queensland, Australia
Hospital. The result shows sub themes with the overarching theme being paradoxical
care, in that an inconsistent approaches to care emphasized safety at the expense of
well-being and dignity. In conclusion dementia as a risk management strategy does
not encourage an evidence-based approach. Staff education and environmental
resources may improve the current situation so that people with dementia receive care
that takes into account their individual needs and human dignity.26
PART B: LITERATURE RELATED TO KNOWLEDGE AND PRACTICE OF
CARE GIVERS ON DEMENTIA.
A study conducted on mindfulness meditation and education for dementia
caregivers. Design used for this study was a pilot randomized trial. In this study two
comparison groups were there. Caregivers serving as an active control group and a
respite-only group serving as a pragmatic control. This study was conducted at the
Oregon Health & Science University, Portland. The subjects were community-
dwelling caregivers aged 45-85 years of close relatives with dementia. Results shows
there were 31 caregivers randomized and 28 completers. There was a significant
effect on RMBPC by group co varying for baseline RMBPC, with both active
interventions showing improvement compared with the respite-only group. In
conclusions both mindfulness and education interventions decreased the self-rated
caregiver stress compared to the respite-only control.27
11
A study conducted on the isolate needs. Families express both for medical and
psychological care, and for educational and social support in 112 caregivers of
patients affected by moderate to severe dementia. The medical needs caregivers
express are mainly relative to a better knowledge of the disease (78%) and the exact
diagnosis (65%); the education-related needs are mainly relative to the acquisition of
communicational skills (83%) and the optimal handling of cognitive (77%) and
behavioral disorders (81%); the psychological ones mainly concern the area of
assistance induced emotional stress management (37%) and the elaboration of
feelings such as anxiety, rage and guilt (49%). Variance analysis shows a correlation
between emotional caregivers' needs and the subjective and objective burdens they
carry. The results shows caregivers still express low levels of illness-consciousness
and high levels of psychological discomfort.28
A study conducted on knowledge about dementia in the general public of
Japan. A quota sampling method was used to select 2,500 participants, 2,115 of who
were eligible for the analyses. A result shows the average number of correct responses
among females was significantly greater than that among the males. A multiple
comparisons test demonstrated that middle-aged women were more knowledgeable
than younger and older respondents. In conclusions the gaps in knowledge on
dementia among the general public, which may prevent caregivers from planning
upcoming social and financial challenges? Correct information needs to be given by
health professionals and care staff. Educational initiatives planned for the general
public could be useful, and should target those groups, men and non-middle aged
women who have lower knowledge.29
12
A study conducted on empowering older people with early dementia and
family caregivers. A rural town in Japan is selected as setting. This study involved 37
community-dwelling elderly with early or mild dementia and 31 family caregivers.
Three types of data were collected; observational data collected during the activities,
written comments from the caregivers, the record of phone interviews and
counseling’s with caregivers. The PAR lasted for 5 years and evolved over three
cycles: individual, group and community. In the first cycle, the major focus of the
intervention was to regain procedural skills for each PWD through a cooking
programme. In the second cycle, to increase interactions with family members and
with other PsWD, group activities that promoted communication among family
members as well as among PsWD were implemented. In the third cycle, community
participation was planned and implemented through culturally relevant sequential
activities. The results shows the importance of interventions for both community
dwelling elderly with early dementia and their family caregivers.30
A study conducted on factors that influence home return from health care
facilities for the elderly--related to the attitude of family caregivers. Subjects were
elderly who were in long-term care insurance facility in June 2004, and their
caregivers. A face-to-face interview based on a questionnaire was conducted for the
institutionalized elderly and by the mail for the caregivers. The caregivers of 34.6% of
the elderly who hoped to return home intended to accept them home. There were
differences between the plans of the elderly and caregivers. It has been suggested that
more physical activities in the facility, establishment of a care-system for the
demented elderly living in the community and an educational campaign by the long-
term care insurance system are necessary to increase the willingness of caregivers to
accept home return of institutionalized elderly.31
A study conducted on the structure of risk factors and outcomes for family
caregivers: implications for assessment and treatment. A sample of 67 caregivers
caring for a family member in the middle stages of dementia were assessed on 15 risk
factors and six outcome measures. Results shows risk factors were at best only
moderately correlated with one another. Outcome measures showed somewhat higher
correlations with one another, but participants varied in terms of the number and type
of outcomes that were elevated. Implications of study were Caregivers possess unique
combinations of risk factors and outcomes that suggest the need for individualized or
tailored interventions.32
13
A study conducted on Caregiver burden associated with behavioral and
psychological symptoms of dementia in elderly people in the local community Japan.
The subjects were 67 participants with dementia living with their caregivers, 51
Alzheimer's disease, 5 vascular dementia and 11 other. The Neuropsychiatric
Inventory and NPI Caregiver Distress Scale were used to assess subjects' BPSD and
related caregiver distress, respectively. The results shows aberrant motor behavior had
the highest mean NPI score, and depression/dysphoria had the lowest.
Agitation/aggression had the highest mean NPI-D score, and euphoria/elation had the
lowest. Delusion, agitation/aggression, apathy/indifference, irritability/lability and
aberrant motor behavior showed a correlation between the NPI and NPI-D scores. In
conclusion the burden associated with BPSD is different for each symptom and does
not always depend on frequency and severity of BPSD. These findings suggest that
some symptoms, such as agitation/aggression and irritability/lability, may affect the
caregivers significantly, although their frequency and severity are low.33
6.3 STATEMENT OF THE PROBLEM
“A study to assess the knowledge regarding care of dementia among care
givers of dementia patients who attend in Mind psychiatric hospitals at Bangalore.”
with an view to develop information booklet.
6.4 OBJECTIVES OF THE STUDY
To assess the knowledge and practice regarding dementia among care givers
of dementia patients.
To find out the association between knowledge and practice with selected
demographic variables.
To develop information booklet for care giver regarding care of dementia.
6.5 OPERATIONAL DEFINITIONS
Assess:
It refers to the estimation of knowledge level of care givers regarding
dementia.
Knowledge:
It refers to level of understanding regarding dementia
Dementia:
14
It refers to a condition in which there is a gradual loss of brain function; it is a
decline in cognitive/intellectual functioning The main symptoms are usually loss of
memory, confusion, problems with speech and understanding, changes in personality
and behavior and an increased reliance on others for the activities of daily living.
Information Booklet:
It refers to self contained information regarding care of dementia patients for
self learning prepared by investigator.
Care givers:
Refers to persons who are responsible for attending to the needs of old age
people between the age group of 21-50 yrs
6.6 ASSUMPTIONS Care givers may have little knowledge on Dementia
Socio demographic variables influence the knowledge
6.7 DELIMITATIONS OF THE STUDY
Study is limited to care givers of patients with dementia
Study is limited to 6 weeks.
7.0 MATERIAL AND METHODS
7.1 Source of data:
Care givers of patients with dementia who attend in Mind psychiatric hospitals
at Bangalore.
7.2 Research Approach:
Descriptive survey approach will used for the study
7.3 Research design:
The study will be used for this is Descriptive Research Design
7.4 Variables:
15
Age, sex, religion, Type of family, Family history
7.5 Population:
Care givers of patients with dementia attending mind psychiatric hospital at
Bangalore.
7.6 Sample:
Sample for present study consist of 50 caregivers of patients with dementia at
mind psychiatric hospital Bangalore
7.7 Sample Size:
50 caregivers of patients with dementia
7.8 Sample Technique:
Non probability convenient sampling
7.9 Criteria for sample selection
Inclusion Criteria
Care givers who are present at the time of data collection.
Care givers who are willing to participate in study.
Care givers who can understand English / Kannada.
Exclusion Criteria
Those who have other chronic illness.
Those who are not willing to participate
Setting of the study
Study will be conducted in mind psychiatric hospital at Bangalore. The
distance of 10 Kms from Noor College of nursing which is 200 bedded hospitals with
16
all types of facilities with rehabilitation for the psychiatric patients. There are
different specialty doctors who treat dementia patients very effectively.
8.0 DESCRIPTION OF THE TOOL
The tool was organized in to two sections
Section I
Socio-demographic data containing 9 items age, Gender, religion, type of family,
Educational status, Monthly income, Family history of dementia, Sources of
information.
Section II
Knowledge questionnaire regarding care of dementia.
9.0 DATA COLLECTION PROCEDURE Prior to data collection, formal written permission will be obtained from concerned
authority and from participants.
After explaining about the study, structured knowledge questionnaire will be used
assess the level of knowledge and duration of data collection will be up to 6 weeks.
10.0 PLANS FOR DATA ANALYSISData will be analyzed by using descriptive and inferential statistics.
11.0 DESCRIPTIVE STATISTICS Frequency percentage distribution will be analyzed with the demographic data of
caregivers of patients with dementia.
Mean standard deviation will be used for analysis of knowledge of caregivers of
patients with dementia.
12.0 INFERENTIAL STATISTICS Chi- square test will be used to analyze the knowledge of care givers of patients with
dementia with selected demographic variables.
13.0 DOES THE STUDY REQUIRE ANY INVESTIGATION OF
INTERVENTION ON CLIENT OF OTHER HUMANS? IF SO,
PLEASE DESCRIBE BRIEFLY
17
No. investigation or intervention will be conducted on the subjects
14.0 ETIHICAL CONSIDERATION TOWARDS SAMPLE
RELATED TO STUDY Yes, informed consent will be obtained from the concern authorities to
conduct study. Privacy, Confidentiality and anonymity will be maintained will be
maintained throughout the study.
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18
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30. Gail W Stuart. Principles and practice of psychiatric nursing. 9th edition.
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6. Signature of the Candidate
17. Remarks of the guide
18.
18.1 Name and Designation
of the guide (in block
letters)
18.2 Signature
21
18.3 Co –Guide
18.5 Head of Department
18.6 Signature
19. 19.1 Remarks of the
Chairman and Principal
19.2 Signature
22