Rajiv Gandhi University of Health Sciences Bangalore, Karnataka

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RAJIV GANDHI UNIVERSITY OF HEALTH

SCIENCES
BANGALORE, KARNATAKA

“A STUDY TO ASSESS THE EFFECTIVENESS OF


STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE
REGARDING HAZARDS OF SUBSTANCE ABUSE AMONG
STUDENTS IN SELECTED COLLEGES OF BANGALORE.”

PROFORMA FOR REGISTRATION OF SUBJECT FOR


DISSERTATION

Mrs.TIJI.K.R
Ist Year M.Sc NURSING
MEDICAL SURGICAL NURSING
YEAR 2010-12

S.B. COLLEGE OF NURSING


YELAKHANKA NEW TOWN
BANGALORE-560064

1
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,
KARNATAKA

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. Name of the Candidate and Mrs.TIJI.K.R


Address: Ist Year M.Sc NURSING
COLLEGE OF NURSING
SB COLLEGE OF NURSING
BANGALORE -560064

2. Name of the Institution: SB COLLEGE OF NURSING, BANGALORE

3. Course of study and subject: 1st Year M.Sc Nursing, Medical surgical Nursing

4. Date of admission to course: 29-09-2010

5. Title of the study:

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


regarding hazards of substance abuse among students in selected colleges of Bangalore.”

6. Brief resume of the intended work:


6.1 Introduction Enclosed

2
6.2 Need for the study Enclosed
6.3 Review of literature Enclosed
6.4 Objectives of the study Enclosed
6.5 Operational definitions Enclosed
6.6 Hypothesis of the study Enclosed
6.7 Assumptions Enclosed
6.8 Delimitations of the study Enclosed
6.9 Pilot study Enclosed
6.10 Variables Enclosed

7. Materials and methods:

7.1 Source of data – Data will be collected from students

7.1.1 Research design

7.1.2 Research approach

7.1.3 Settings of the study

7.1.4 Population

7.2 methods of data collection:

The data will be collected by the investigator herself using structured closed

ended questionnaire. The teaching programme will be conducted after obtaining

permission from concerned authorities.

7.2.1 Sampling technique

7.2.2 Sample size

7.2.3 Criteria for sample selection

a) Inclusion criteria
3
b) Exclusion criteria

7.2.4 Tools for data collection

7.2.5 Data analysis method

a) descriptive statistics

b) inferential statistics

7.2.6 projected outcome

7.3 Does the study require any intervention or investigation to the patients or other

human being or animals?

No, intervention or investigation will be conducted on the sample. However, group

structured teaching programme will be given to the sample.

7.4 Has ethical clearance obtained from your institution?


Yes, ethical clearance will be obtained from the concerned authorities, prior to the
conduction of the study consent will be obtained from the sample confidentiality will be
assured.
List of references:
8.
Enclosed.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,


KARNATAKA
4
PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. Name of the Candidate and Mrs.TIJI.K.R


Address:. Ist Year M.Sc NURSING
COLLEGE OF NURSING
SB COLLEGE OF NURSING
BANGALORE 560064

2. Name of the Institution: SB COLLEGE OF NURSING, BANGALORE.

3. Course of study and subject: 1st Year M.Sc Nursing, Medical surgical Nursing

4. Date of admission to course: 29-09-2010

5. Title of the study:

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


regarding hazards of substance abuse among students in selected colleges of Bangalore.”

6. BRIEF RESUME OF THE INTENDED WORK:

6.1 INTRODUCTION:

5
“The cause of worldwide consumption of Hashish,

Opium, Wine and tobacco lies not in the taste or in any pleasure,

recreation or mirth, they afford but simply in man’s need to hide from

himself the demands of conscience”

-Tolstoy

Substance abuse is a social problem, not in India alone, but the entire world. The use of

drugs has its own culture and history, which varies from country to country. The problem of

substance abuse is growing at an explosive rate and in just little over a decade it has spread its

malevolent tentacles to almost every part of the globe surmounting almost all barriers of race,

caste, creed, religion, sex educational status, economic strata etc. 1

Substance abuse and dependence crosses all lines of race, culture, education and

socioeconomic status, leaving no group untouched by its devastating effects. A recent survey

estimated that about 16 million citizens of the United States had used an illegal substance in the

month preceding the study. Substance abuse is an enormous public health problem, with far

ranging effects throughout society In addition to the toll substance abuse can take on one’s

physical health, it is considered an important factor in a wide variety of social problem, affecting

rates of crime, domestic violence, sexually transmitted diseases (including HIV/AIDS),

unemployment, homelessness, teen pregnancy and failure in school. 2

The current statistics found that, 29% of college students report that illegal drugs were

made available to them on college property. Not only that, 38.4% of college students report that

drugs are readily available (as opposed to 22.4% at private colleges). College students in upper

grades report greater access to drugs than do teenagers in lower grades. And 62.9% report that

street gangs are present to sell the drugs. Here are the rates, reported by teens, as to which drugs

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they knew how to obtain easily. it is found that students using Marijuana constitutes 85.8% ,

Amphetamines: 55.4%,  Cocaine: 47.8%  ,Barbiturates: 46.3% , Crack: 39.2%  ,LSD: 33.1% 

,Tranquilizers: 30.1% , Heroin: 29.6% , Crystal meth: 26.7% .2% So, even if teens do not use

drugs, it is clear that they are readily available, either at college or by some other means. And it

is also clear that teen drug use, in the area of hard drugs, teen drug use has been declining. Use of

the strong drugs is much less than it was in the 1960s and 1970s. Indeed, only 8.1% of college

seniors report that they have ever used cocaine, and only 1.5% report any use of heroin. The use

of hallucinogens and most opiates is also lower. It is marijuana that causes the greatest amount of

concern regarding teen drug use. 3

Substance abuse among adolescents has become a global challenge and also an important

public health concern and for the past two decades there has been a dramatic increase in the

demand for interventions to address the substance abuse problem. This demand has led to the

development of multiple primary, secondary and tertiary substance abuse prevention

programmers. June 26, 1992 was declared by WHO as the International Day against Drug Abuse

and Illicit Trafficking. In addition, the years 1991-2000 were designated as the United Nations

Decade against abuse.4

Global trade and liberalization of socio cultural interaction of the society has made easy

access to use and spread of narcotic substance. Substance abuse is a universal phenomenon with,

its roots in history and tradition substance. Abuse problem has become a global challenge from a

transit country India is fast becoming a major consumer of different kinds of substances.5

6.1 NEED FOR THE STUDY:

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College students are the most vulnerable group and are at high risk of drug abuse related

problems compared to other population. The prevalence rate of drug abuse is highest among

young adolescents and young adults, a large majority of whom are students . Substance abuse by

students in secondary schools and colleges is a serious problem. As it is gaining gradual

popularity among college students, it would be vital to examine their knowledge towards

substance abuse. Health education is an important strategy of all the programmes to prevent and

control drug abuse.6

The WHO Expert Committee on Drug Dependence (1973) endeavored to ascertain

factors associated with the prevention of drug dependence and urged that it would be necessary

to eliminate the ignorance and misconception about drug effects.7

A study conducted among 15,000 students of Mangalore University colleges threw light

on the extent of substance abuse among the student community. The result showed that 7.04% of

the male and 0.4% of the female population have accepted to be users of various stimulant

substances ranging from Ganja to Heroin. Among these, 6.6% of the male and 0.4% of the

female population were found to be drug addicts. This percentage indicates that the number of

addicts among the student population in Mangalore is approximately 1050 out of the total

population of 15,000 under study. 8

A study was conducted in on college students to examine the prevalence rates and

correlates of non-medical use of prescription stimulants. A self-administered mail survey was

used. The sample consisted of 10,904 from 4-year colleges in the United States, randomly

selected in 2001. The study result showed that the lifetime prevalence of non-medical

prescription stimulant use was 6.9%, past year prevalence was 4.1% and past month prevalence

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was 2.1%, past year rates of non-medical ranged from zero to 25% at individual colleges. Non-

medical prescription users were more likely to report use of alcohol, cigarettes, marijuana,

ecstasy, and cocaine respectively.9

A study conducted to assess the knowledge about psychoactive substance abuse among

college students. The investigator adopted a comparative descriptive research approach. The

sample consisted of 50 male and 50 female college students. A self-structured questionnaire was

used to collect the data. The findings of the study showed that a significant higher knowledge

scores among females than males (t=2.27). The students with higher mass media exposure had

higher scores. Age, family income, father’s education and year of study did not have any

relationship with knowledge scores. 10

A study was conducted to assess the knowledge and attitude of 180 undergraduate

students of Kerala on drug dependence using a structured questionnaire. The result of the study

showed that students’ (98.33%) knowledge was inadequate in all the areas. The result also

showed that there was significant positive relationship between knowledge and year of study,

family income and substance abuse.11

A study was conducted on knowledge of students on cannabis and tobacco among 964

school students of Baroda. The tool was a questionnaire containing 20 items. Data were collected

immediately after 45 minutes of drug abuse awareness programme. After seven days data were

collected using the same tool. The study revealed that the majority of students had increased

knowledge after the awareness programme. The substance abuse use was reported by 38% out of

964 students.12

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A study conducted among undergraduate medical students in two medical colleges of Calcutta.

The study indicated that the prevalence of total drug abusers was 76.8% of the respondent student

population. The study revealed that the drug abuse rate gradually increased with advancement of each

academic year, i.e., from 24% in first year to 74.4% in the final year. It was maximum in the age group of

25-29 years. The prevalence among boys (58.4%) was significantly higher than girls. 25% hostellers were

found to be more drug abusers than non-hostellers.13

A study was conducted to assess the awareness among college students to determine relationship

of knowledge and selected variables in 100 pre-degree students (first year) from 3 colleges in Kolkata

using a structured knowledge questionnaire. The results showed that the college students’ knowledge of

drug abuse was inadequate; no significant relationship was found between knowledge, sex and mass

media exposure. But there was significant relationship between knowledge and parental education. 14

Above studies show that education is one of the main sources for increasing the knowledge and

changing the behaviors of college students regarding substance abuse. 15

6.3. REVIEW OF LITERATURE:

Review of literature involves the systematic identification, location, scrutiny and

summary of the written materials that contain information on research problem. Literature

review refers to the activities involved in identifying and searching for information on a topic

and developing a comprehensive picture of the state of knowledge on that topic. Related

literature, both research and non-research was explored to broaden the understanding and gain an

insight in to the selected problem under study.16

A study was conducted among students in USA to assess the effectiveness of a universal

drug abuse prevention approach for youth at high risk for substance abuse initiation. The

effectiveness of a universal drug abuse preventive intervention was examined among youth from

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29 inner city middle schools participating in a randomized controlled prevention trial. A sub

sample of youth (21% of full sample) was identified as being at high risk for substance use

initiation based on exposure to substance using peers and academic performance in school. The

prevention programme taught drug refusal skills, anti drug norms, personal self-management

skills and general social skills. Findings of the study indicated that youth at high risk who

received the programme (n=426) reported less smoking, drinking, inhalant use and poly drug use

at the one year follow-up assessment compared to youth at high risk in the control condition that

did not receive the intervention (n=332). Results indicated that a universal drug abuse prevention

programme was effective for minority, economically disadvantaged, inner city youth. Findings

suggest that universal prevention programmes can be effective for a range of youth along a

continuum of risk.17

A study was conducted to determine the effectiveness of hygiene promotion programme

in changing behaviors associated with the spread of diarrhea in Burkina Faso. A sample of 3,

09,771 people participated in the study. Structured observation checklist was used to assess the

hygienic behaviors of the participants. The pre and post test after the teaching programme

showed a significant difference. Hand washing with soap after cleaning a child’s bottom

increased from 13% to 31%, mothers who washed their hands with soap after using the latrine

increased from 1% to 17%. This study revealed that hygienic promotion programme could bring

about change in behavior.18

A study was conducted among secondary school students in Rivers State to determine the

commonly used substances and the factors that influences their use in their students. The sample

consisted of 1049 students of four schools. The tool was a questionnaire containing 117 items of

substance use. The study results showed that 87% were using at least one substance, 3% were past users,

11
and 10% had never used any of substances. The substances commonly used are alcohol 65%, Kolanut

63%, cigarette 61%, paracetamol 41.5%, butazolidine 39.3%, pemoline 28% and cannabis 26%,

tetracycline 25.7%, ampicillin 24.3% and valium 24%. The mean age of onset was 12-13 years. The study

concluded that the use of substances/drugs among our youth is assuming a dangerous dimension and

hence calls for immediate measures to improve knowledge on drug abuse and curb this disturbing trend of

abuse of substances.19

A study was conducted to assess the knowledge and attitude of 180 undergraduate students of

Kerala on drug dependence using a structured knowledge questionnaire 17. The results of the study showed

that students’ (98.33%) knowledge was inadequate in all the areas. The result also showed that there was

significant positive relationship between knowledge, year of study, family income and drug abuse. 20

A study was conducted to assess the awareness among college students and to determine

relationship of knowledge and selected variables in 100 pre-degree students (first year) from 3 colleges in

Calcutta using a structured knowledge questionnaire. Stratified sampling was used. The study result

showed that college students’ knowledge of drug abuse was inadequate. No significant relationship was

found between knowledge, sex and mass media. 21

A study was conducted among students with disability to long term educational, employment and

social outcomes in USA to determine the relationship of substance abuse among them. The study results

indicate that adolescents with disability who used either cigarettes or marijuana had significantly higher

dropouts, lower high school graduation status, and lower college attendance and also were significantly

more likely to engage in sexual activity at a younger age. The findings support the need for improved

substance use prevention programme targeting the need of youth with disabilities. 22

A study was conducted among Colombian youth to examine the relationship between earlier

marijuana use and later adolescent behavioral problems. A community-based sample of Colombian

adolescent was interviewed in 1995-1996 and 1994-1998. The sample consisted of 1151 males and 1075

12
females. The findings of the study revealed that adolescent marijuana use was associated with increased

risk at work or school and violent experience. Peer marijuana use and sibling marijuana problems and

adolescent problem behavior in a society in which drug use, crime, violence and low educational

attainment are pervasive. So, the study concluded that the early adolescent marijuana use is associated

with an increase in problem behavior during later adolescence. 23

A study was conducted to examine the relationship between early age of onset of cigarette,

alcohol, marijuana and cocaine use and engaging in multiple risk behaviors among middle school students

in North Carolina. A modified version of the centre for Disease Control and Prevention of Youth Risk

Behaviors Survey was administered to 2227 of six through 8 grade students attending 53 randomly

selected middle schools. A health risk behavior scale was constructed for this study. The independent

variables included first time use of cigarette, alcohol, marijuana and cocaine at age 11 years or earlier;

actual age of onset of each substance, race and ethnicity, family composition, sex, school grade, academic

ranking. The results of the study showed that all the independent variables were found to be associated

with high risk behaviour scale; having smoked at age 11 years or younger accounted for 21.9% of

variation in the health risk behavior scale. Male sex, early marijuana or cocaine use, older age, lower

academic rank, white race and single parent family explained an additional 19.1% of variation in the

model and same way 52.8%

(P<0.001) variation in the health risk behavior scale when age of onset of smoking, male sex, age of onset

of alcohol, marijuana, cocaine use and lower academic rating accounted. The study concluded that early

age of onset of substance abuse was the strongest correlate of number of health risk behaviors in which

young adolescents had engaged.24

The review of literature indicates that college students are the most vulnerable group to

involve in drug abuse practice. This is mostly due to poor knowledge. Studies also showed that

students have poor knowledge on drug abuse and its adverse effects. So, health education

13
program mes are necessary to make them aware about drug abuse and its adverse effects to lead

a better life and to prevent complications.25

6.4 OBJECTIVES OF THE STUDY :

1. To assess the pre-test knowledge regarding hazards of substance abuse among students.

2. To evaluate the effectiveness of structured teaching programme on knowledge regarding

Post-test score with their selected demographic variables.

6.5 OPERATIONAL DEFINITIONS:

1. Assess:

It is a measurement of the knowledge about substance abuse among students as observed

from the scores based on questionnaire.

2. Effectiveness:

It refers to the improvement in the knowledge of the students regarding substance abuse

after undergoing structured teaching programme as evidenced by increase in the post test

mean score.

3. Structured teaching programme:

It refers to the systematically developed instructions and teaching aids designed for

college students to improve knowledge regarding substance abuse.

4. Knowledge:

In this study, it refers to the scores the students are able to obtain in response to the

questions relating to substance abuse.

5. Hazards:

14
In this study, a hazard refers to a situation that poses a level of threat to life, health, property, or

environment.

6. Substance abuse:

Substance abuse is a pattern of drug, alcohol or other substance use that creates much

adverse result from its continual use.

7. College students:

It refers to the male and female students of selected Colleges in Bangalore, enrolled for

degree programme.

6.6 HYPOTHESIS OF THE STUDY:

H1 : There will be significant improvement between pre-test and post- test hazards of

substance abuse knowledge scores.

H2 : There will be significant improvement between pre-test and post-test hazards of

substance abuse knowledge score.

6.7 ASSUMPTIONS:

This study assumes that,

1. College students have some basic knowledge regarding substance abuse.

2. Structured teaching programme will help to improve knowledge of college students

regarding substance abuse.

6.8 DELIMITATIONS OF THE STUDY:

This study is delimited to,

1. The study is limited to the selected college students.

2. Colleges having marketing accounting as a main stream of study.

15
3. Study will be conducted on students who are willing to participate.

6.9 PILOT STUDY:

Pilot study is defined as a small scale version or trail run of the major study. The

study will be conducted with 12 students. The purpose to conduct the pilot study

is to find out the feasibility for conducting the study and design on plan of

statistical analysis.

6.10 VARIABLES:

 Independent variables:

The structured teaching programme (STP) on substance abuse was independent

variable.

 Dependent Variables:

It is the knowledge scores of students regarding substance abuse.

 Extraneous Variables:

Extraneous variables in this study are age of the students, sex, year of the study,

stream of study, place of stay, type of family, living status of parents, part time

job, and monthly pocket money, educational status of parents, monthly family

income and mass media exposure on substance abuse.

7. MATERIALS AND METHODS:

The methods and the necessary materials used for the present study are as follows,

7.1 SOURCE OF DATA:

Data collected from the students of selected colleges of Bangalore.

16
7.1.1 RESEARCH DESIGN:

Pre-experimental i.e. one group pre-test-post-test design was adopted for the study.

7.1.2 RESEARCH APPROACH:

Evaluative research approach

7.1.3 SETTINGS OF THE STUDY:

Study will be conducted in selected colleges, Bangalore.

7.1.4 POPULATION:

Population for the present study constitutes 50 Students of selected colleges, of

Bangalore. Sample includes both male and female.

7.2 METHODS OF DATA COLLECTION (INCLUDING SAMPLING

PROCEDURE):

Data will be collected by the investigator herself using structured closed ended

questionnaire. This teaching programme will be conducted after obtaining permission

from the concerned authorities. Subjects will be collected according to selection criteria

of the study.

7.2.1 SAMPLING TECHNIQUE:

No probability convenient.

7.2.2 SAMPLE SIZE:

The sample consists of 50 college students of males and females who fulfilled the

inclusion criteria will be the sample.

72.3 CRITERIA FOR SAMPLE SELECTION:

The inclusion as well as the exclusion criteria used for the present study is as follows,

a) INCLUSION CRITERIA:

17
The study includes,

1. Both male and female students

2. College students who are studying in first or second year degree.

3. Students who are present at the time of data collection.

4. Students who are willing to participate in this study.

b) EXCLUSION CRITERIA:

College students who are:

1. Not willing to participate in this study.

2. Not present at the time of data collection.

3. Who have attended classes regarding hazards of substance abuse.

7.2.4 TOOL FOR DATA COLLECTION:

Section A:

Obtain information about the selected background factors such as age, sex, year of study,

stream of duty, place of stay, type of family, living status of parents, part time job, and

monthly pocket money, educational status of parents, monthly family income and mass

media exposure.

Section B:

Interview schedule consisting of structured questionnaire to assess the pre-test and post-

test knowledge of students.

Section C:

Structured teaching programme regarding hazards of substance abuse among students.

7.2.5 DATA ANALYSIS METHOD:

The data collected will be analyzed using descriptive and inferential statistics:

18
a) Descriptive Statistics:

Frequency and percentage will be used for analysis of demographic and mean

percentage and standard deviation will be used for assessing the level of knowledge.

b) Inferential Statistics:

Paired‘t’ test will be used to analyze the significant difference between the mean pre-

test and post –test knowledge score.

Chi- Square test will be used to analyze the association between the post- test

knowledge and selected demographic variables.

7.2.6 PROJECTED OUT COME:

The investigation will assess the level of existing knowledge of the college students

regarding substance abuse. Based on the findings, structured teaching programme will be

administered which will be beneficial in improving the level of knowledge of the

students.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR

INTERVENTIONS TO THE PATIENTS OR OTHER HUMAN BEINGS OR

ANIMALS?

No, intervention or investigation will be conducted on the sample. However, group

structured teaching programme will be given to the sample.

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR

INSTITUTION?

Yes, ethical Clearance will be obtained from the concerned authorities prior to the

conduction of the study. Written consent will be obtained from the sample confidentiality

19
will be assured.

8. LIST OF REFERENCES:

Details of the referred books, journals and other sources are as the following,

1 Anis Ahmed, Sen AK. Prevalence of drug abuse among students of Jamia Milia Islamia: A Survey

report. Disability and Impairments 1998; 12 (1): 31-39.

2 World Health Organization. International Substance abuse Day. Nursing Journal of India June

26th1992; LXXXIII (5): 130.

3 Meena, Khanna P, Vohra AK, Rajput R. Prevalence and pattern of alcohol and substance abuse in

urban areas of Rothak city. Indian Journal of Psychiatry 2002; 44(40; 348-352.

4 Sharma RR. Knowledge of psychoactive substance use: disorders among college students. Nursing

Journal of India 2001; 92(2): 29-30.

5 Sabeena J. A study to assess the undergraduate students’ knowledge of and attitude towards drug

abuse in a selected college of kerala [unpublished Master of Science in Nursing]. New Delhi:

Delhi University; 1993.

6 The I.C.D-10. Classification of mental and Behavioural disorders. Geneva: WHO publication; 2002.

7 Michael B, Allen F, Harold AP. The DSM IV - Handbook of differential diagnosis. 1 st ed. New

Delhi: Jaypee Brothers Medical Publishers Pvt. Ltd.

8 WHO - web page www.who.int/homepage. January 15, 2004.

9 World Health Organization. The extent, pattern and trends of drug abuse in India. National Survey

sponsored by Ministry of Social Justice and Empowerment, Government of India and United

Nations Office on Drugs and Crime, Regional Office for South Asia. 2004.

10 WHO – http://www.int/ssubstance_abuse/facts/global_burden/en/ February 25, 2005.

11 www.ncadd.org. National Council of Alcoholism and Drug Dependence.

January 12, 2004.

20
12 WHO – http://www.who.int/substance_abuse/facts/psychoactive/en/ February 25, 2005.

13 Sreevani R. A Guide to Mental health and psychiatric Nursing: Jaypee brothers medical publishers

private LTD; 2004.

14 Franklin CA. Modis Medical Jurisprudence and Toxicology. 21st edition Bombay: N. M. Tripathi

(p) LTD; 1988.4(Section II).

15 Gincy. A study to assess knowledge and attitude of adolescence towards alcoholism in a selected

community in Udupi District. [Masters Degree in Nursing]. University of Manipal; 1999.

16 Sean Esteban McCabe JRK, Christian J, Teter and Henry Wechsker. Non- medical Use of

prescription stimulants among US college students’ prevalence and correlates from a national

survey. Addiction Jan 2005; 100 (1 page 96).

17 Vasumathi. An explorative study to determine the relationship between knowledge and attitude

towards alcoholism among pre university students [unpublished]. Mangalore: Rajiv Gandhi

university of Health Science; 2001.

18 Sandeep.et al. Awareness and use of substance among high school students. Indian Journal of

Psychiatry 1998; 40:85.

19 Narendranath N, Bhattacharya. Prevalence of alcohol abuse in selected Medical Colleges of

Calcutta city. Indian Journal of Psychiatry 1993; 35(2): 12-13.

20 Treece FW, Treece JW. Elements of Research in Nursing. St.Louis: The C. V. Mosby Company;

1982.

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9
Signature of the Candidate:

10 Methodology, need for study


Remarks of the guide:
is appropriate it can be

approved.

11
Name and designation of

11.1 Guide : Mrs.LATHA.M (Asso.Professor)

11.2 Signature :

11.3 Co-guide :
Mrs.LATHA.M ( Asso.Professor,
11.4 Signature :
Dept. of medical surgical nursing)
11.5 Head of the Department :

11.6 Signature :

12 12.1 Remarks of the Chairman &

Principal :

12.2 Signature :

22
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