RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BENGALURU, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

1. NAME OF THE CANDIDATE AND ADDRESS

MS. THOUDAM ROJINA DEVI1ST YEAR M. Sc. NURSINGTHE OXFORD COLLEGE OF NURSING,NO 6/9 & 6/11 1ST CROSSBEGUR ROAD, HONGASANDRABENGALURU – 560068

2. NAME OF THE INSTITUTION

THE OXFORD COLLEGE OF NURSING,NO 6/9 & 6/11 1ST CROSSBEGUR ROAD, HONGASANDRABENGALURU – 560068

3. COURSE OF STUDY AND SUBJECT

MASTER OF SCIENCE IN NURSING,COMMUNITY HEALTH NURSING

4. DATE OF ADMISSION TO THE COURSE

18/06/2009

5. TITLE OF THE TOPIC A STUDY TO EVALUATE THE EFFECTIVENESS OF NURSING INTERVENTIONS IN IMPROVING SELF-CARE CAPABILITY AMONG ELDERLY IN SELECTED URBAN AREAS, BENGALURU

6. BRIEF RESUME OF THE INTENDED WORK:

INTRODUCTION

“I enjoy talking with very old men, for they have gone before us,

as it were, on a road that we too may have to tread, and it seems to me that we

should find out from them what it is like and whether

it is rough and difficult or broad and easy.”

- Socrates

Ageing is a universal, biological fact and a natural process. It begins from the

day we are born, or perhaps even before. No one factor causes it and of course there is

no cure.1 Today demographic change is a global phenomenon resulting from two almost

universal trends: declining fertility and increasing life expectancy. Most countries in the

world experience declining fertility or have stagnating fertility. In most developed

countries fertility is below replacement level and majority of countries report increase

life expectancy. As a consequence most parts of the world will witness demographic

aging – defined as a rise in median age of populations and a growing share of people

above age 65 – during this 21st century.2

This demographic ageing, has hit Indian shores as well. People are living longer.

Expectation of life at birth for males has shown a steady rise from 42 years in 1951-60 to

58 years in 1986-90, it is projected to be 67 years in 2011-16, an increase of about 9

years in a twenty five year period (1986-90 to 2011-16). In the case of females, the

increase in expectation of life has been higher-about 11 years during the same period,

from 58 years in 1986-90 to 69 year in 2011-16. At age 60 too, the expectation of life

shows a steady rise and is a little higher for women.3

The Indian aged population is currently the second largest in the world. It has been

estimated that from 5.4% in 1951, the proportion of 60+ people grew to6.4% in 1981

and is close to 8.1% in 2001.4

The increasing number of people living longer has led to international interest in

the enhancement of quality of life (QOL) and health-related quality of life (HRQOL) in

older age.5 If ageing is to be a positive experience, longer life must be accompanied by

continuing opportunities for life sustenance, self-esteem and freedom. Life sustenance

means the provision of basic needs during old age; self-esteem demands respect for the

elderly from all institutions of civil society; and freedom is the ability to choose and be

free from servitudes of dependence and ill health.6

6.1 NEED FOR THE STUDY:

The increase in elderly population will lead to more number of people who are

confronted with various problems such as physical and psychological deterioration,

necessitating adjustment in life pattern, losses due to retirement, loneliness caused by

children leaving away from home and by partners and friends dying.7

With the increase in age their body undergoes change. As a general rule, slight, gradual

changes are common, and most of these are not problems to the person who experiences

them. Sudden and dramatic changes might indicate serious health problems.

But if the person is capable of taking self-care he or she will undergo program of

regular, thorough health check-ups and self-examinations which will identify changes

that may be cause for concern.8

Thus prior steps can be taken up and many of the disabling problems of aging

can be managed through improved health care and the use of assistive devices. Simple

but effective changes in the home environment can be made that prevent problems and

enable the older person to maintain independence.9

The elderly people, who accounts for a great portion of the population also

accounts for a relatively high proportion of total health care expenditure.9 But there is

going to be a decline of care givers available as family patterns change due to migration

of young people to other parts of the country or overseas, and the elderly will face

multiple diseases especially non-communicable diseases.7

A legitimate concern that public resource and acute medical care strategies are

inadequate to meet the elderly’s health care requirement makes clear the need for other

approaches, including the integration of social support with health care services and

additional emphasis on self-care and assistance to family care giver.8

Nurse-scholar Dorothea Orem developed a theory of self-care as an art of the

Self-Care Deficit Theory of Nursing, which has formed the basis for research,

educational curricula and the organization of nursing departments in hospitals and

community health settings. Dorothea Orem’s self-care deficit theory focuses on client’s

self-care needs.10

Orem describes:-

Self-care: It is the learned goal oriented activity directed towards the self in the

interest of maintaining life, health development and well-being.

Self-care requisites: These are the actions or measures used to provide self care.

Universal self-care requisites: Requisites those are common to all individuals,

such as maintaining air, water, food intake and elimination; Balancing activity,

rest, solitude and social interaction; and preventing hazards and promoting

normalcy.

Developmental self-care requisites: These are the specialized universal self-care

requisites that result from maturation or new requisites that develop as a result of

a condition or event.

Health deviation requisites: Requisites that result from illness, injury, disease or

its treatment; they include such actions as seeking medical assistance, carrying

out a prescribed treatment and learning to live with the effects of illness or

treatment.

Therapeutic self-care: It refers to those self-care activities required to meet the

self-care requisites.

Self-care deficit: It arises when the self-care agency cannot meet self-care

requisites i.e when a patient cannot administer self-care.11

The goal of Orem’s theory is to help the client perform self-care. Nursing care is

necessary when the client is unable to fulfill biological, psychological, developmental or

social needs. The nurse demands why a client is unable to meet the needs, what needs to

be done to enable the client to meet them and how much self-care the client is able to

perform. The goal of nursing is to increase the client’s ability to perform self-care. This

theory can be applied to assess the self-care capability of a person.10

One such study based on Orem’s self-care deficit theory is “The Structure of

Self-Care in a Group of Elderly People ’’ by Olle Soderhamn. The aim of this study was

to investigate through secondary analysis the structure of self-care in a group of elderly.

Data were originally collected from a total of 125 randomly chosen elderly individuals

(65+ years of age) in Sweden by means of a mailed questionnaire. Confirmatory factor

analysis was used to show that self-care agency was totally and significantly balanced

against therapeutic self-care demand and explained by five conditioning factors. 12

6.2 REVIEW OF LITERATURE:

Review of literature for the study has two important concepts which have

been organized under the following headings:

6.2.1 Studies related to the self-care capability.

6.2.2 Studies related to nursing interventions for elderly.

6.2.1 Studies related to the self-care capability

A study was conducted to assess capability for performing activities of daily

living and values of 30 long-term-care facility residents in the age group of 45 to 96 at

Garlington Community Mental Health Center, Portland, Oregon. The Minimum Data

Set for Nursing Home Resident Assessment and Care Screening was used to compare

staff-report and self-report of residents' capabilities in eight activities of daily living

(ADLs) in one long-term-care facility (LTCF). The relative values residents placed on

independence in each of the eight ADLs were compared with their self-reported

capabilities in those ADLs. The result shows that residents perceived themselves to be

significantly more capable than did staff members for dressing (p < .05), toileting

(p < .01). locomotion (p < .05), and personal hygiene (p < .001). For five of the ADLs,

residents tended to report high capability in the ALDs they valued most.13

A study was conducted to review the literature related to self-care and health

promotion for elders and to develop an understanding of self-care as a health resource.

This researchers selected theoretical and empirical articles published between 1990 and

2006, where self-care was related to elders' health promotion. Data were extracted from

primary sources and included definitions of self-care, critical attributes, antecedents,

goals and outcomes. Data’s were interactively compared and display matrices to

describe self-care as a health resource. Fifty-seven articles addressed health self-care

and were integrated into a framework of self-care as a health resource of elders. Self-

care was identified as a two-dimensional construct including action capabilities and

processes for health in self-care practice. The capabilities consisted of fundamental

capabilities, power capabilities and performance capabilities. The action processes

included a process of life experience, a learning process and an ecological process. So

this review offers insight into self-care as a significant health resource of elders with

different health status. It suggests that an elder's self-care ability is determined by the

interaction of various sub-resources and conditions and emphasizes the constantly

evolving nature of self-care. The framework may be used in clinical practice, policy-

making and research into health care of frail or robust elders.14

A study was conducted to evaluate a decision support system for eliciting

elderly patients preferences for self-care capability and providing this information to

nurses in clinical practice—specifically, its effect on nurses' care priorities and the

patient outcomes of preference achievement and patient satisfaction using three-group

quasi-experimental design with one experimental and two control groups (N = 151). In

the experimental group computer-processed information about individual patient's

preferences was placed in patients' charts to be used for care planning. Findings indicate

that information about patient preferences changed nurses' care priorities to be more

consistent with patient preferences and improved patients' preference achievement and

physical functioning. Further, higher consistency between patient preferences and

nurses' care priorities was associated with higher preference achievement with greater

patient satisfaction. Thus this study demonstrated that decision support for eliciting

patient preferences and including them in nursing care planning is an effective and

feasible strategy for improving nursing care and patient outcomes.15

A cross sectional study was done to assess self-care ability and sense of

coherence in 172 consecutively recruited older nutritional at-risk patients from geriatric

rehabilitation ward in a hospital in western Sweden. One hundred forty-four patients

were included in the study because 16 patients refused to take part and 12 could not

complete the entire data collection procedure. The result shows that patients at medium

or high risk for undernutrition had lower self-care ability (P<0.001) and weaker sense of

coherence (P=0.007) than patients at low risk for undernutrition. Lower self-care ability,

being single and admitted from another hospital ward was found to be predictors for

being at medium or high risk for undernutrition. Patients who perceived good health had

higher self-care ability (P<0.001) and stronger sense of coherence (P<0.001) than

patients who perceived ill health. The study revealed that older patients at low risk for

under nutrition have a greater capability to care for themselves than patients at medium

or high risk for under nutrition. Perceived ill health in older patients is associated with

lower self-care ability and weaker sense of coherence.16

A study to assess effects of education and support on self-care and resource

utilization in 179 patients hospitalized with heart failure. Patients were randomized to

the study intervention or to ‘care as usual’. The supportive educative intervention

consisted of intensive, systematic and planned education by a nurse about the

consequences of heart failure in daily life, using a standard nursing care plan developed

by the researchers for older patients with heart failure. Education and support took place

during the hospital stay and at a home visit within a week of discharge. Data were

collected on self-care abilities, self-care behavior, readmissions, visits to the emergency

heart centre and use of other health care resources. The finding indicated that education

and support from a nurse in a hospital setting and at home significantly increases self-

care behavior in patients with heart failure. Patients from both the intervention and the

control group increased their self-care behavior within 1 month of discharge, but the

increase in the intervention group was significantly more after 1 month. Although self-

care behavior in both groups decreased during the following 8 months, the increase from

baseline remained statistically significant in the intervention group, but not in the control

group.17

6.2.2 Studies related to nursing interventions for elderly

Cancer patients' ability to control symptoms and to maintain reasonable quality

of life is limited due to lack of knowledge, guidance, and instructions from health care

providers, who usually refrain from transferring responsibility for the treatment to the

patient. This study describes a measured effect of a structured nursing intervention in

which nurses were trained to apply the self-care model to 48 ambulatory cancer patients

under chemotherapy or radiotherapy or both. The intervention included 10 structured

home visits to each patient during 3 months, in which the nurse assessed symptoms and

advised, guided, supported, and educated the patient in the relevant areas. The symptoms

were quantitatively assessed using the Symptom Control Assessment (SCA) instrument,

which relates to 16 signs, symptoms, and complaints that encompass both the universal

and the deviation-from-health needs, in addition to anxiety, body image, and sexuality.

The instrument allows either the patient or the nurse to rate the severity of the complaint,

the patient's independence in controlling it, the patient's perception of the familial and

external help extended to him or her, and the knowledge of the symptom and its control

possessed by the patient. The results indicate that the intensity of the complaints

decreased in the experimental group during the 3-month period while they increased in

the matched control group, creating a considerable difference between the two groups on

multivariate analysis of covariance (MANCOVA). On t-tests, significant improvement

was found in 15 out of the 16 symptoms, including pain. The greatest reduction was

found in the "psychosocial symptoms," namely anxiety, sociability, body image, and

sexuality. Similarly, the patients' independence, knowledge, and perception of familial

help increased in the experimental group and declined in the control group. Perhaps the

most meaningful change was a significant increase in the ability of the experimental

patients to assume responsibility for their own treatment as it is reflected by the increase

of the independence ratings for all 16 symptoms. The results suggest that the self-care

approach is effective also in improving the quality of life for unstable cancer patients by

reduction of suffering and increase in controlling capabilities.18

A study was conducted to assess capability to learn in people with intellectual

disability. An intervention program for caregivers was developed to initiate an

examination of their own behavior in daily interaction with intellectually disabled

residents, particularly in terms of a possible support of dependent and ignorance of

independent behavior. 40 intellectually disabled residents and 40 staff members

participated in the study. Videotapes were used to assess behavior of staff members and

residents in daily care and support and a questionnaire was developed for further

assessment of independence and everyday competence in intellectually disabled

residents. Effects of the developed intervention program were tested with a pre-post-

control group-design. Results indicated highly significant increases in residents'

independence and everyday competence. 19

A randomized controlled trial was conducted to assess the effectiveness of

community-based complex interventions in preservation of physical function and

independence in elderly people (mean age at least 65 years) living at home with at least

6 months of follow-up was carried out. Outcomes studied were living at home, death,

nursing-home and hospital admissions, falls, and physical function. A meta-analysis was

done. 89 trials including 97 984 people were identified. Interventions reduced the risk of

not living at home (relative risk [RR] 0·95, 95% CI 0·93–0·97). Interventions reduced

nursing-home admissions (0·87, 0·83–0·90), but not death (1·00, 0·97–1·02). Risk of

hospital admissions (0·94, 0·91–0·97) and falls (0·90, 0·86–0·95) were reduced, and

physical function (standardized mean difference -0·08, -0·11 to -0·06) was better in the

intervention groups than in other groups. Benefit for any specific type or intensity of

intervention was not noted. In populations with increased death rates, interventions were

associated with reduced nursing-home admission. Interpretation Complex interventions

can help elderly people to live safely and independently, and could be tailored to meet

individuals' needs and preferences. 20

The occurrence of diabetes is one out of 5 African American women older than

60 years. These women face distinct challenges in managing diabetes self-care.

Therefore, a tailored self-care intervention for this population was developed and tested.

The effectiveness of a tailored, four-visit, in-home symptom-focused diabetes

intervention with and without booster telephone calls was compared with an attentional

control focused on skills training for weight management and diet. African American

women (n = 180; >55 years old, Type 2 diabetes mellitus >1 year, HbA1c >7%) were

randomly assigned to the intervention or attentional control condition. Half the

intervention participants were assigned to also receive a telephone-delivered booster

intervention. Participants were evaluated at baseline and 3, 6, and 9 months. Baseline

HbA1 was 8.3 in the intervention group (n = 60), 8.29 in the intervention with booster

group (n = 55), and 8.44 in the attentional control condition (n = 59). HbA1c declined

significantly in the whole sample (0.57%) with no differences between study arms.

Participants in the booster arm decreased HbA1c by 0.76%. Symptom distress,

perceived quality of life, impact of diabetes, and self-care activities also improved

significantly for the whole sample with no significant differences between study arms.

Parsimonious interventions of four in-person visits yielded clinically significant

decreases in HbA1c. Although the weight and diet program was intended as an

attentional control, the positive effects suggest it met a need in this population. Because

the contents of both the intervention and the attentional control were effective despite

different approaches, a revised symptom-focused intervention that incorporates weight

and diet skills training may offer even better results.21

STATEMENT OF THE PROBLEM:

A STUDY TO EVALUATE THE EFFECTIVENESS OF NURSING

INTERVENTIONS IN IMPROVING SELF-CARE CAPABILITY AMONG

ELDERLY IN SELECTED URBAN AREAS, BENGALURU

6.3 OBJECTIVES OF THE STUDY:

6.3.1 To assess the self-care capability among elderly.

6.3.2 To develop Nursing intervention for improving self-care capability among

elderly.

6.3.3 To evaluate the effectiveness of nursing intervention in improving self-care

capability among elderly.

6.4 HYPOTHESIS:

H1 There will be significant difference between self-care capability among

elderly before and after applying the nursing interventions as evidence by

improvement in self-care capability.

6.5 RESEARCH VARIABLES

Independent variable: Nursing interventions

Dependent variable: Self-care capability of elderly

6.6 OPERATIONAL DEFINITION:

Effectiveness:

It refers to the extent to which the nursing intervention improves the self-care

capability among elderly as measured by the extent to which evaluation criteria are

met and the level of satisfaction of the elderly with nursing care.

Self care:

It refers to the actions of the elderly person directed to self or environment in order to

regulate their own feeling, health and well-being. In this study it consist of

Universal self-care requisites

Developmental self-care requisites.

Health deviation self- care requisites.

Universal self-care requisites:

It refers to:

Maintenance of air, water, food, elimination, activity and rest.

Solitude and social interaction.

Prevention of hazards and

Promotion of human functioning.

Developmental self-care requisites:

It refers to self-care needs with aging of the elderly persons.

Health deviation self-care requisites:

It refers to self-care deficit arising due to illness, injury or disease or its treatment

in elderly.

Self- care deficit:

It refers to the elderly person’s inability to perform self-care activities due to physiological

changes, functional changes, cognitive changes and psycho-social changes. (occurring due

to ageing)

Self-care capability:

It refers to the elderly person’s physiological, functional, cognitive, psychosocial abilities

to meet:

Universal self-care requisites

Developmental self-care requisites

Health deviation self-care requisites

Nursing interventions:

It refers to the range of nursing action aimed at meeting self-care needs of the elderly. These

actions include:

Guiding and supporting the elderly

Counseling elderly and the family.

Teaching the primary care giver (family) in assisting the elderly

Referral services.

Elderly:

Elderly refers to a person male or female above the age of 60 years living with their family

and having some degree of partial self-care deficit as identified by the screening instrument.

6.7 ASSUMPTIONS:

6.7.1 The elderly persons have some capability for self-care.

6.7.2 The elderly persons and their family will be complying with nursing

interventions.

6.7.3 Implementing nursing interventions will improve the self-care capability of

elderly persons.

6.8 DELIMITATIONS:

The Study is delimited to selected nursing interventions for improving self-care

capability among elderly in selected urban areas, Bengaluru.

7 MATERIALS & METHODS:

7.1 SOURCES OF DATA:

The data will be collected from elderly people in selected urban areas, Bengaluru.

7.2 METHOD OF DATA COLLECTION:

Nursing process steps will be used for data collection. The steps are; Nursing assessment

and analysis, Goals, Nursing Diagnosis, Nursing Planning, Nursing Implementation and

Nursing Evaluation.

Personal interview

Physical examination

Review of health records/ reports

Nursing care plan audit to compare the evaluation criteria to measure self-care capability

for elderly.

7.2.1 RESEARCH APPROACH

Quasi experimental

7.2.2 RESEARCH DESIGN:

One group Pretest- post test design

7.2.3 RESEARCH SETTING:

Study will be conducted in selected urban areas, Bengaluru.

7.2.4 POPULATION:

Elderly people aged above 60 years with self care deficit in selected urban areas,

Bengaluru.

7.2.5 SAMPLE SIZE:

30 elderly people living in selected urban areas, Bengaluru

7.2.6 SAMPLE TECHNIQUE:

Simple random sampling

7.2.7 SAMPLING CRITERIA:

INCLUSION CRITERIA:

Elderly persons who are

- Having partial self-care deficit and require partially compensatory

nursing care and supportive education.

- Able to meet the self-care with guidance and teaching.

EXCLUSION CRITERIA:

Elderly persons who

- Is terminally ill

eg. End stage renal disease, patient with cancer

- Has undergone amputation of either upper or lower limbs within one

year.

- Had undergone acute spinal cord injury.

- Has need for total nursing care. (wholly compensatory nursing system.)

7.2.8 TOOLS FOR DATA COLLECTION:

1. Demographic data sheet.

2. Screening instrument

3. Nursing assessment format using Orem’s self care theory.

4. Patient satisfaction scale with nursing interventions.

5. Evaluation criteria.

7.2.9 DATA ANALYSIS METHOD:

DESCRIPTIVE STATISTICS

Mean, median, percentage, mode and standard deviation

INFERENTIAL STATISTICS

Parametric test – paired ‘t’ test to compare pre and post intervention self-care

capabilities

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTION

TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS? IF

SO PLEASE DESCRIBE BRIEFLY?

No, the elderly persons involved in the study will not receive any painful or invasive

treatment. Informed written consent will be obtained prior to nursing interventions to

improve self-care capability of elderly.

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION

- Ethical Committee Certificate of the Oxford college of Nursing has been enclosed.

- Informed consent will be taken from the elderly persons willing to participate in

the study.

8 LIST OF REFRENCES:

1. Kristen L.M. Gerentological Nursing, Competencies for care. 1st ed. London.

Jones and Bartlett Publishers; 2006.

2. Rainer Munez. Ageing and Demographic changes in European Societies. Main

Trends and Alternative Policy Operation; Social Protection The World Bank;

2007, Mar.

3. National Policy on Older Population, Ministry of Social Justice and empowerment

Government of India, Shastri Bhawan, New Delhi.

4. HL. Dhar. Emerging Geriartric Challenge. Available at neumech@nda.vsnl.net.in

5. Ann Bowling, Ageing well, Quality of life in old age. Berkshire, England: Open

University Press. 2005.

6. Rajagopala Dhar Chakrabarti, The Greying of India, Population ageing in the

context of Asia. New Delhi: Sage Publication India Pvt. Ltd; 2004; 306-345.

7. Dr Srinivasan K, Dr Shankardass M.K, Dr Rannan-Eliya R.P. Active and Healthy

Ageing; Report of a regional consultation, World Health Organization, Regional

Office for South-East Asia;Dec 2007 .

8. Dean K, Hickey T, Holstein BE. Self-care and Health in Old Age. Australia:

Croom Australia Pvt Ltd;1998.

9. Smith.S, Gove J.E. Physical Changes of Ageing;The Department of Family, Youth

and Community Sciences, Florida Cooperative Extension Service, Institute of

Food and Agricultural Sciences, University of Florida. First published: 2005 Aug.

10. Potter P.A, Perry A.G. Fundamentals of Nursing, 7th ed. St. Louis, Missouri.

Elsevier; 2009: 50

11. Ann MT, Marta RA. Nursing theories and their work. 6th ed. Missouri; Mosby

Elsevier; 2006

12. Olle Soderhamn,(2001) The Structure of Self-Care in a Group of Elderly People.

Nursing Science Quarterly, Vol. 14(1). 55-58

13. Atwood SM, Holm MB, James A. Garlington Community Mental Health Center,

Portland, Oregon 97211. Comment in: Am J Occup Ther. Dec 1994

Nov;48(11):1112.

14. Jaarsmaa T, et al. Effects of education and support on self-care and resource

utilization in patients with heart failure, J University of Maastricht, Maastricht,

The Netherlands. Sep 1998.

15. Cornelia M. Ruland, American Medical Informatics Association Decision Support

for Patient Preference-based Care Planning Effects on Nursing Care and Patient

Outcomes. J Am Med Inform Assoc. 1999 Jul–Aug; 6(4): 304–312.

16. Soderhamn U, Bachrach-Lindström M, Ek AC Self-care ability and sense of

coherence in older nutritional at-risk patients. Eur J Clin Nutr. 2007. Jan;62(1):96-

103.

17. Hoy B, Wagner L, Elisabeth O.C. Self-care as a health resource of elders: an

integrative review of the concept; Nordic College of Caring Science2007; Vol 21;

456–466

18. Benor A, Dan E, Vered R.N.D, Tamar R.N.K, Measuring impact of nursing

intervention on cancer patients' ability to control symptoms. Cancer Nursing; 1998

Oct; 21(5) :320-334

19. Kruse A, Ding-Greiner C. Promotion and maintenance of independence in older

people with intellectual disability-results of an intervention study. Z Gerontol

Geriatric 2003 Dec;36(6):463-74.

20. Beswick A.D, Rees K, Dieppe P, Ayis S et al. Complex interventions to improve

physical function and maintain independent living in elderly people. Lancet.

March 2008; 371(9614): 725–735.

21. Anne H S, John C; Jennifer L; April S; Dorothy B. Controlled Trial of Nursing

Interventions to Improve Health Outcomes of Older African American Women

With Type 2 Diabetes. Nursing Research 2009 Oct 21

9 SIGNATURE OF THE

STUDENT

10 REMARKS OF THE

GUIDE

The topic which is selected by the candidate

is relevant and appropriate as it attempts to

evaluate the effectiveness of nursing

interventions in improving self care capability

of elderly.

11 NAME AND DESIGNATION OF THE GUIDE

11.1 GUIDE NAME &

ADDRESS

MRS. SHANI JOHN SAQUEIRA

Professor

Community health Nursing

The Oxford College of Nursing,

No 6/9 & 6/11 1st cross

Begur Road, Hongasandra

Bengaluru – 560 068

11.2 SIGNATURE OF GUIDE

11.3 HEAD OF THE DEPARTMENT

NAME AND ADDRESS MRS. SHANI JOHN SAQUEIRA

Professor

Community Health Nursing

The Oxford College of Nursing,

No 6/9 & 6/11 1st cross

Begur Road, Hongasandra

Bengaluru – 560 068

11.4 SIGNATURE OF HOD

12 REMARKS OF THE

PRINCIPAL

This study is relevant as it attempts to

evaluate the effectiveness of nursing

interventions in improving self care capability

among elderly which will enable the nurses in

improving their skills while providing care to

the elderly.

12.1 SIGNATURE OF

PRINCIPAL

DR. G. KASTHURI,

Principal

The Oxford College of Nursing,

No 6/9 & 6/11 1st cross

Begur Road, Hongasandra

Bengaluru – 560 068

THE OXFORD COLLEGE OF NURSING

NO 6/9 AND 6/11 1ST CROSS, BEGUR ROAD, HONGASANDRA, BENGALURU-560068

ETHICAL COMMITTEE

NAME OF THE CADIDATE : MS. THOUDAM ROJINA DEVI

YEAR : 2009-2011

SUBJECT : COMMUNITY HEALTH NURSING

TITLE OF THE TOPIC : A STUDY TO EVALUATE THE

EFFECTIVENESS OF NURSING

INTERVENTIONS IN IMPROVING SELF-

CARE CAPABILITY AMONG ELDERLIES IN

SELECTED URBAN AREAS, BENGALURU

ETHICAL COMMITTEE MEMBER APPROVAL

DESIGNATION NAME SIGNATURE

1. CHAIRMAN Dr. G. KASTHURI

2. LEGAL ADVISOR MAJOR MUDDEGOWDA

3. SOCIOLOGIST PROF. LEELAVATHI

4. PSYCHOLOGIST MRS. SUJATHA. C

5. STATISTICIAN DR. RANGAPPA

6. FACULTY ADVISOR PROF. G. THILAGAVATHY

SIGNATURES OF THE PRINCIPAL