RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA, BANGALORE ANNEXURE II PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION 1. Name of the candidate and address RESHMA N. FIRST YEAR M. Sc. NURSING CITY COLLEGE OF NURSING, CITY ENCLAVE, SHAKTHINAGAR, MANGALORE – 575016 2. Name of the Institution CITY COLLEGE OF NURSING, CITY ENCLAVE, SHAKTHINAGAR, MANGALORE – 575016 3. Course of study and subject M. Sc. NURSING CHILD HEALTH NURSING 4. Date of admission to the course 15.06.2012 5. Title of the study A COMPARATIVE STUDY TO ASSESS THE BEHAVIOURAL PROBLEMS BETWEEN SCHOOL CHILDREN OF EMPLOYED AND UNEMPLOYED MOTHERS IN THE SELECTED SCHOOLS OF MANGALORE. 1 6. Brief resume of the intended work Introduction Women play multiple roles in the family that affect the health and wellbeing of all family members. Women play important roles as generators of family income, whether in household farms or businesses or as wage employees. In developing countries especially, such work is likely to be essential to family survival. Behavioural problems in children can be a part of normal development. Such problems are often transient and may not be even noticed and may be exhibited in certain settings and not in others. Some school children exhibit a range of deviant behaviours that may be a burden not only for parents and families, but also for teachers and people in the community. The importance of early detection of emotional and behavioural problems is being recognized worldwide. However, until now there has been little systematic research into childhood psychiatric disorders in the developing countries1. 6.1 Need for the study Behavioural problems are prevalent among 10-20% of the children in the age group of 4-12 years in the world2. The prevalence of externalizing behavioural problems in Western Australia was 13.2%3 whereas a research study conducted in Ludhiana, India, reported 46.5%4 and in Karnataka 49% of the children had behavioural problems out of which 36.5% had significant problems5. National Statistics of Labour force shows that 71-77% of the working mothers have children in the age group of 5-16 years. Among them 60% are full time workers and an estimated 8.1 million young children under the age of 18 live in families with an unemployed parents6. Behavioural problems in childhood may lead to limited functional capabilities in adulthood. Behavioural problems like thumb sucking, nail biting, school phobia, school refusal, social problems, conduct disorders, etc. are more common among school children. The main reasons for behavioural problems are broken homes, rejection, overprotection, parental employment, etc. Industrialisation, urbanisation, and increased economic demand 2 have made the parents work, either single or both. The mother has to fulfil her role both as a home maker and as an employee, making it difficult to fulfil the task of meeting the children’s needs7. A cross-sectional case control study was conducted to determine the prevalence of emotional and behavioural problems among male Saudi school children and identifying their risk factors. One thousand three hundred and thirteen male school children of AlAbanae school were included. Study was conducted in two phases: a cross-sectional approach (screening phase) to assess their emotional and behavioural problems and a case control phase to study risk factors. Among the 1313 participants, 109 (8.3%) were emotionally or behaviourally disturbed students (according to cut-off score for boys estimated at the 90th percentiles). Among the studied socio-demographic variables, educational level (intermediate versus primary), and the mother’s occupation (working versus non-working) were associated with a higher risk of developing emotional and behavioural disturbance. The study concluded that emotional and behavioural problems in children are associated with education and occupation of mothers8. Most of the women had gradually entered the work force than before. Fewer children are raised by stay-at-home mothers and more are spending prolonged hours at childcare facilities. Children of the working mothers are placed in group childcare, which results in receiving less one-to-one attention and instruction. This may have significant cognitive and behaviour effect in childhood. Maternal employment sometimes leads to behavioural problems in children9. A study was conducted to assess the impact of maternal employment on cognitive and behavioural effect on children. The participants from various communities including Avon and Springfield, South Dakota, were selected. A questionnaire was distributed to 32 participants (28 females and 4 males) between the ages of 28 and 59 years. The research result showed that in 34% of cases one parent served as a full-time homemaker, while the other parent worked. Nineteen percent of the participants reported working part-time and enrolling their child in day-care, and 47% of participants reported working full-time and enrolling their child in day-care. Regarding behavioural problems of children, 42% children who have attended out-of-home care reported behaviour problems, whereas none 3 of the parent who stayed at home with their children reported behavioural problems with their children. The study concluded by stating that several cognitive and behavioural differences were noted between children of working and nonworking mothers and also differences were found in school performance, participation in extracurricular activities, and abnormal behavioural issues10. Behavioural problems during school period are the strongest predictors of more serious problems later including delinquency, substance abuse, antisocial behaviour, academic failure, and depression in the adolescent age group. A healthy growth of young children depends so closely on the emotional status of their parent and family caregivers that the emotional and behavioural needs of young children are best met through a holistic approach that focuses on their full environment of relationships. Early prevention strategies and efforts to identify and treat emergent behavioural problems are likely to be more psychologically beneficial and cost effective than trying to treat emotional difficulties after they become more serious at a later age7. So, in terms of time spent with the children, parents play an important role in identifying the behavioural changes in children. From clinical experience, the researcher found that most of the children admitted to the paediatric ward exhibited one or the other emotional or behavioural problems and found that most of the mothers were employed. Hence the investigator was interested to compare the parent-reported behavioural problems among school children of employed and unemployed mothers. This finding may help find the problems of children and take up necessary interventions. 6.2 Review of literature A descriptive study was conducted in Mangalore to assess the emotional problems of children of working mothers. Purposive sampling technique was used to select 150 samples from two schools. Data were collected using behavioural rating scale and emotional rating scale. Majority of the children of working mothers had moderate behavioural problems (82%), 10.66% had mild behavioural problems, and 17.33% had mild emotional problems. Only one child had severe emotional problems. When the 4 various emotional and behavioural problems were analysed, it was found that the mean percentage score of various behavioural problems of children of the working mothers was maximum (52.33%) for the problem of personality disorder whereas it was least (0.33%) for antisocial behaviour. The mean percentage score of emotional problems was maximum (66.5%) for anxiety and least (2.66%) for jealousy. For conduct disorder, adjustmental problems, habit disorder, and educational difficulties, it was 42.4%, 40%, 29.8%, and 49.8%, respectively. For fear, anger and irritability, depression, sleeping disturbances, and feeling of loneliness it was 33%, 39.87%, 60%, 30.5%, and 50%, respectively. The study concluded that mothers’ parenting style had a great impact on children’s emotional, behavioural, and educational problems11. A study was conducted to assess the impact of maternal employment on the selfconcept emotional maturity and achievement motivation of adolescents. A sample of 75 adolescents of employed and unemployed mothers studying in 8th and 9th standards of Hubli, Dhārward cities of North Karnataka was selected for the study. Children’s Selfconcept Scale by Ahluwalia, Emotional Maturity Scale by Singh and Bhargava, and DeoMohan Achievement Motivation Scales were used to collect the data. The data were analysed using ‘t’ test and ANOVA. The variables studied were self-concept (t=4.84, p<.01), emotional maturity (t=-5, p<.01), and achievement motivation (t=-2.8, p<.01), respectively. The study result revealed that there were several behavioural and cognitive differences noted between the children of employed and unemployed mothers12. A comparative study was conducted in Salem, Tamil Nadu to assess the level of behavioural problems among preschool children of age group 2-5 years of employed and unemployed mothers. One hundred samples were selected through non-probability convenience sampling technique – 50 employed mothers and 50 unemployed mothers of preschool children. The result revealed that among the preschool children of employed mothers, 33 (66%) had moderate behavioural problem and 17 (34%) had mild behavioural problems, and none had severe behavioural problems, whereas among the preschool children of unemployed mothers majority (78%) had mild behavioural problems, 11 (22%) had moderate behavioural problems, and none had severe behavioural problems. The estimated value score was t=6.348 at p<.05, which showed there was significant difference between the level behavioural problems among preschool children of employed and unemployed mothers. The study concluded by saying that the behavioural problems 5 in preschool children are higher among employed mothers than in unemployed mothersl3. A study was conducted to compare the emotional intelligence of children of working mothers and nonworking mothers. One hundred (50 each) children were randomly selected from all government high and higher secondary schools of zone Shopian. Emotional intelligence scale by Hyde et al was used for the collection of data and ‘t’ test was used for the analysis of the data. The study result found that children of employed mothers had a mean score than that of unemployed mothers. There was significant difference between emotional intelligence between the children of employed and unemployed mothers (t=3.70). The study concluded that children of working and nonworking mothers are significantly different on composite scores of their emotional intelligence. Children of nonworking mothers are more emotionally intelligent than children of working mothers14. The prevalence of emotional and behavioural problems among 1488 primary school children aged 5 to 11 years was studied in Karachi, Pakistan. Assessment of children’s mental health was done using Strength and Difficulties Questionnaire (SDQ). The result show that 34.4% parents rated children as falling under the “abnormal category” on SDQ, 35.8% were reported by the teacher. The study concluded that there was gender difference in prevalence. Boys had higher estimates of behaviour/externalising problems; whereas emotional problems were more common amongst females. The study concluded by saying that the prevalence of behaviour problems was more in employed parents and also there was gender difference (more common in boys than girls).15 A survey research study was conducted to determine the emotional and behavioural problems in Singaporean children based on parent teacher and child reports. A community sample of 2139 children between the age group of 6-12 years was selected. Child Behaviour Check List (CBCL), Teacher Rating Form (TRF) and child report questionnaires for depression and anxiety were administered. Higher prevalence of emotional and behavioural problems was identified by CBCL (12.5%) than by TRF (2.5%). Correlation between child reported depression and anxiety, and parents’ and teachers’ reports were low to moderate. The study concluded by stating that Singaporean children had high rates of externalizing problems (4.9%) than internalizing problems16. 6 6.3 Statement of the problem A comparative study to assess the behavioural problems between the school children of employed and unemployed mothers in selected schools of Mangalore. 6.4 Objectives of the study 1. To determine the behavioural problems among school children as expressed by employed mothers using a behavioural rating scale. 2. To identify the behavioural problems among school children as expressed by unemployed mothers. 3. To compare the behavioural problems between school children of employed and unemployed mothers. 4. To find the association of scores on behavioural problems among school children of employed mothers with their selected demographic variables. 5. To find the association of behavioural scores among school children of unemployed mothers with their selected demographic variables. 6.5 Operational definitions 1. Behavioural problems: It refers to the problems which include, habit problems, e.g., thumb sucking, nail biting etc; sleeping problems, e.g., nightmares, crying in sleep, waking often etc; anxiety problems, e.g., nervousness, worries about things, self-conscious etc; conduct problems, e.g., jealousy, disobedience, hyperactivity etc, emotional problems, e.g., frustration, lack of concentration, etc; social problems e.g., social phobia, disobedience etc. in school age children, which will be measured using a rating scale as expressed by mothers. 2. School children: In this study it refers to children in the age group of 8-12 years attending the selected school. 7 3. Employed mothers: In this study it refers to the women who work outside the home for more than 6 hours a day in public or private sector and have the school age children studying in the selected schools of Mangalore. 4. Unemployed mothers: : In this study it refers to the women who are homemakers and are not working in private or public sector and have the school age children studying in the selected schools of Mangalore. 6.6 Assumptions Behavioural problems are more common in school children of employed mothers. Behavioural problems in children can be known better when expressed by parents. 6.7 Hypotheses The following hypotheses will be tested at .05 level of significance H1: There is significant difference in the behavioural problems between school children of employed and unemployed mothers. H2: There is significant association of behavioural problem scores of school children of employed mothers with their selected demographic variables. H3: There is significant association of behavioural problem scores of school children of unemployed mothers with their selected demographic variables. 6.8 Delimitations The study is delimited to: 1. Employed mothers who are working in public or private sector for more than 6 hours a day. 2. Unemployed mothers who are home makers. 3. Employed and unemployed mothers who are having school children in the age group of 8-12 years. 8 7. Material and methods 7.1 Source of data The data will be collected from the employed (60) and unemployed (60) mothers of school children of selected Schools of Mangalore. 7.1.1 Research approach Descriptive comparative research approach is appropriate for the present study. 7.1.2 Research design Comparative research design is appropriate for the present study so as to compare the behavioural problems between school children of employed and unemployed mothers in the selected schools of Mangalore. 7.1.3 Setting The study will be conducted in selected schools of Mangalore. 7.1.4 Population The target population of the study is employed (60) and unemployed (60) mothers of school children of the selected schools of Mangalore. 7.1.4 Variables The present study consists of the following variables: Research variable: Behavioural problems of school children. Socio-demographic variables: In this study the socio-demographic variables include, age, sex, education, occupation, monthly income, number of children, age of children, employment status of spouse, number of working hours, and type of work or occupation. 9 7.2 Method of data collection 7.2.1 Sampling procedure Purposive random sampling technique will be used to select the sample based on inclusion and exclusion criteria. 7.2.2 Sample size The sample for the present study would consist of 120 mothers (i.e., 60 employed and 60 unemployed mothers). 7.2.3 Inclusion criteria Employed and unemployed mothers: Having children between the age group of 8-12 years. Of children studying in selected schools of Mangalore. Who are willing to participate in the study. Who can read or write Kannada or English. Employed mothers who are working away from home for at least 6 hours a day. Unemployed mothers who are home makers and not on any public or private work. 7.2.4 Exclusion criteria Employed and unemployed mothers: Who are not staying with their children. Who have children with physical or intellectual disability. 10 7.2.5 Instruments intended to be used Behaviour rating scale. 7.2.6 Data collection method Permission will be obtained from the concerned authority. Admission records maintained in the school will be verified to find the employment status of mothers of children studying in 3rd, 4th, 5th and 6th standards. Based on the inclusion and exclusion criteria the sample (60 employed and 60 unemployed mothers) will be selected using purposive random sampling technique. Informed consent will be obtained from the sample. The prepared tool (behavioural rating scale) will be sent to the parents through the children studying in the selected schools and data on behavioural problems of their children will be obtained (if possible data will be ascertained from the sample during the parent-teacher meeting). 7.2.7 Data analysis pl an The collected data will be analysed using both descriptive and inferential statistics. Descriptive statistics: Frequency and percentage distribution will be used to analyse the demographic data. Mean, median, percentage and standard deviation will be used to assess the behavioural problems of school children of employed and unemployed mothers. Inferential statistics Unpaired ‘t’ test will be used to compare the behavioural problems of children of employed and unemployed mothers. 11 Chi-square test will be used to test the association between behavioural problems of children with selected demographic variables. 7.3 Does the study require any investigation or intervention to be conducted on patients or other humans or animals? No. 7.4 Has ethical clearance been obtained from your institution? Yes, ethical clearance will be obtained from the institutional ethical committee. 12 List of references 1. Betz LC, Hunsberger MM. Family-centred nursing care of children. 2nd ed. Philadelphia: W. B. Saunders Company; 1994 2. Prevalence of behavioural problem worldwide. [online]. Available from: URL:http://ije. oxford journal.org/cg. 3. World Health Organisation. The mental health context. Journal of Psychiatry 2003;3(2):11-3. 4. Gupta I, Verma M, Singh T, Gupta V. Prevalence of behavioural problems in school going children. Ind J Paed 2001;68(4):323-6. 5. Gururaj G, Gurish N. Prevalence of behavioural problems in children of Karnataka. Indian Journal of Pediatrics.2007;74(2):1095-8. 6. Statistics of working mothers. [online]. Available from: URL:http://www.suite 7. Duttta P. Pediatric nursing. New Delhi: Jaypee Brothers Medical Publishers; 2007. 8. Abdel MM, Rehman AA. Emotional and behavioural problems among male Saudi school children and adolescents’ prevalence and risk factors. German Journal of Psychiatry 2004;1:1-9. 9. Han WJ, Waldfogel J, Brooks-Gunn J. The effects of early maternal employment on later cognitive and behavioural outcomes. Journal of Marriage and Family 2001;63(2):336-54. 10. DeJong A. Working mothers: cognitive and behavioural effects on children. Department of Consumer Sciences p. 75-8. 11. Divya P. A descriptive study to assess the behavioural and emotional problems of children (6-12 years) of working mothers in selected school in Mangalore. Unpublished Master of Science in Nursing theses submitted to RGUHS, Bangalore; 2009. 13 12. Hangal S, Aminabhavi VA. Self-concept, emotional maturity and achievement motivation of the adolescent children of employed mothers and homemakers. Journal of the Indian Academy of Applied Psychology 2007 Jan;33(1):103-10. 13. Anitha J, Jayasudha, Kalaisalvi. Behavioural problems among preschool children. Nightingale Nursing Times 2010;6:34-5. 14. Khan MA, Hassan A. Emotional intelligence of children of working and nonworking mothers Researcher 2012;4(4). 15. Syed EU, Hussein SA, Haidry SE. Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan: multi informant survey. Ind J Paediatrics 2009 Jun;76(6):623-7. 16. Woo BS, Dss F, Chan Y. Emotional and behavioural problems among singaporean children. Singapore Med J 2007;48(12):1100. 14 15
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