RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

PRELIMINARY SYNOPSIS ON THE M.Sc.(N) DISSERTATION

A COMPARATIVE STUDY TO ASSESS THE QUALITY OF LIFE

OF SENIOR CITIZENS IN SELECTED RURAL AND URBAN

FAMILIES IN MANGALORE.

Submitted by:

Ms. DIVYA ROSE

1st year M.Sc. Nursing student,

Srinivas Institute of Nursing

Sciences, Farangipete Post,

Arkula, Valachil Padavu,

Mangalore – 574143.

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

1. NAME OF THE CANDIDATE

AND ADDRESS

(IN BLOCK LETTERS)

MS. DIVYA ROSE

1st YEAR M. Sc. (NURSING)

COMMUNITY HEALTH NURSING

SRINIVAS INSTITUTE OF NURSING

SCIENCES

VALACHIL, MANGALORE - 574143

2. NAME OF THE INSTITUTION

SRINIVAS INSTITUTE OF NURSING

SCIENCES,

VALACHIL, PADAVU, ARKULA,

FARANGIPETE POST,

MANGALORE – 574143.

3. COURSE OF STUDY

SUBJECT

M. Sc. NURSING

COMMUNITY HEALTH NURSING

4. DATE OF ADMISSION 16/06/20095. TITLE OF THE TOPIC.

A COMPARATIVE STUDY TO ASSESS THE QUALITY OF

LIFE OF SENIOR CITIZENS IN SELECTED RURAL AND

URBAN FAMILIES IN MANGALORE.

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6. BRIEF RESUME OF THE INTENDED WORK

Introduction

“Age appears to be best in four things old wood best to burn, old

wine to drink, old friends to trust and old authors to read”

[Alonso of Aragon] 1

Neeraja K.P. [2006] 2 states that old age is natural, normal, universal

and inevitable biological phenomenon. It is a development phase in the life

process which begins at conception and continues until death. Old age is the last

stage in the life journey and closing period in the life span of a man with

decreased capacity for adaptation. We cannot heal old age, we have to protect

them and help them to extend their life span.

The aged are known as ‘elderly’ or ‘old people’. Sixty years and above

age group of people will be called as ‘Geriatric age group’. Old age makes

definite changes in the body quite as natural as the reverse processes which

occur during the period of growth on the other side of the hill of life.

Old age is depicted positively in terms of maturity, wisdom,

compassion and the potential for spiritual growth as well as self acceptance.

The old person is a source of wisdom based on the rich experience longevity

has made possible. The elders in the intergeneration lineage played the role of a

historian providing information about the cultural and familial past, a role

model, which the youngsters could follow, a mentor who can guide the young

with their valuable experience and of nurturant, who cared for the kin in crisis.

They enjoyed unparallel sense of honour, legitimate authority within the family

and in the community. Division of labour was observed within the family and

the aged had an important role to play, which made their life more meaningful.

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Anupam Hazra [2009]3 states that the increase in the number of

elderly women is much more than in case of men. The percentage of elderly

persons working is declining, particularly in the case of women. Nearly two-

thirds of elderly women will be widows, while only 22% of elderly men will be

widowers. A large proportion of the elderly population will continue to live in

poverty or at the subsistence level, and will also remain illiterate.

According to Nikita Ivanovich Panis,4 “in youth the days are short

and the years are long, in old age the years are short and the days are long.”

According to Neeraja K.P.

2 “active ageing highlights the importance

of health and ongoing participation for the individual for the maintenance of a

sense of purpose, quality of life and wellbeing throughout the life. It is a

continuation of vital living, self-esteem, positive thinking that are essential

components. Active ageing implies attainment of economic security, sense of

purpose and integration into the family, participation in decision making, access

to health care and its meaning and purpose in life.”

Lillypet Shantham5 reminds that good health is the pre-requisite for

good quality of life. “According life to years” was recent slogan of the world

day of the aged initiated by the WHO, active ageing was proposed for the

international years of the aged. “Active in society and family” is present, where

the image of the aged persons as dependent, as a heavy and annoying burden

must be changed and made the aged as independent.

Neeraja K.P. [2006]2 says, “the cycle of life goes on, as the wheels

turn, we have to remember that, it is not only the duty of the young to look after

the elders, but it is also a pleasure to care for those who cared for us, unless we

take care of the aged today we will also be neglected tomorrow. Let the old be

allowed to have their whims and fancies.”

6.1 Need for the Study

“Talleyrand says,6 “Everybody wants to live long, but nobody wants to

be old.”

R. Sreevani [2002]7 depicts that older adults are the most rapidly

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growing segment of the population. In India, life expectancy at birth has

increased by about 20 years in the past 5 decades. The average life span today is

66 years. Every month the world’s older population increases by 1.2 million.

Currently 580 million people in the world are aged sixty years and above, out of

which 355 million are in developing countries and it will rise to 1000 million by

2020.From India, it has been reported that at present there are 77 million elderly

people and the number is expected to be 177 million in the next two and half

decades. In Karnataka, out of a population of 5.5 crores, 8 percent are elderly

citizens.

Anupam Hazra [2009]3 reports that recent statistics related to elderly

people in India, it is observed that as many as 75% of elderly persons were

living in rural areas. About 48.2% of elderly persons were women, out of whom

55% were widows. A total of 73% of elderly persons were illiterate and

dependent on physical labour. One third was reported to be living below the

poverty line i.e. 66% of older persons were in a vulnerable situation without

adequate food, clothing or shelter. About 90% of the elderly were from the

unorganized sector i.e. they have no regular source of income.

According to Anupam Hazra3, historically, the joint family system has

been considered as a characteristic of Indian life. In earlier period, the eldest

male member controlled all economic and social affairs and the eldest female

member managed household matters. Migration, urbanization and

westernization have severely affected the value system of family in Indian

society. Mostly, elderly parents are taken care of by their adult sons and their

families. In most of these families, the primary caregiver is daughter – in-law.

Women, the traditional care givers in the family, are unable to extend the

elderly care due to increased educational and vocational opportunities and need

to work and earn outside.

Neeraja K.P. [2006]2 points out that the huzzles of modern life,

dissolution of joint family, shrinking family size, changing role of family roles,

busy life have neglected the care of the aged. The new culture of sending the

senior citizens to old age homes has doubled. The life of aged without love and

affection of their near and dear have relegated them to a passive life.

Kavitha A.K.[2007]8 had done a comparative study on quality of life

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among senior citizen living in home for the aged and family set up in Erode

district, Tamil Nadu.The sample size was 100 i.e. 50 from each group and it

consisted of both males and females. The tool was a 5-point scale, includes

selected variables and different areas of quality of life .Structured interview

schedule was used to collect data. Findings show that there is moderate quality

of life among those who are in home for the aged. Also it is more than the

quality of life of senior citizens in the family set up. She also recommends that a

comparative study can be done on quality of life of senior citizens in urban and

rural population.

Watanabe Toshiyuki [1999]9 had investigated the quality of life of

elderly i.e. more than 65 years of age, medical patients staying at home and that

of their care givers and their family environments. The controls were healthy

elderly individuals, other members and their families. Finding shows that no

correlation was seen between quality of life of other members and family

environment in the control group.

Neeraja K.P.2 emphasizes that the field of nursing, that specializes in

the care of the elderly. The geriatric nurse or Nurse Gerontologist can be either

specialist or a generalist offering comprehensive nursing care to the older

persons by adopting nursing process in combination with a specialized

knowledge of ageing. Geriatric nursing care can be provided either at hospitals

or in the community settings. Nursing persons are a major force working in the

health care delivery system. They have the responsibility of taking care of

elders in the families and homes for the aged.

During the community postings in urban and rural areas of Mangalore,

the investigator noticed some differences in the lifestyles and in the quality of

life of elders in urban and rural areas, and thus she feels to do a study on this

aspect.

6.2 Review of Literature

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According to Basavanthappa10, “review of literature is a key step in

research process. It refers to an extensive, exhaustive and systematic

examination of publications relevant to the research project.”

1. Studies Related to Physical Problems of Senior Citizens

Yogeendra Prabhu [2007]11 has done a comparative study on

“perceived health problems and subjective well being status of the elderly

people living with their families and old age homes” at Mangalore. Purposive

sampling technique was used to select 60 subjects i.e. 30 living with their

families and 30 living in old age homes. Result shows health problems of the

elderly, living with their families were lower than that of the elderly, living in

old age homes. Also the subjective well being status of the elderly living with

their families were lower than those living in old age homes.

Marja et al [2007]12 has done a cross sectional study on “care related

quality of life in old age”. This study presents a multi dimensional model of

care related quality of life and based on analyses of cross-sectional data sets,

examines the distinction between dimensions of quality of life by age and

gender, with a special focus on older home care clients. Correlation analysis and

stepwise linear regression were applied to analyze variation in quality of life by

age group and the association between quality of life and perceived quality of

home care. The result suggests that individual quality of life and the priorities of

(physical, psychical, social and environmental) dimensions in the assessment of

quality of life by older persons vary considerable and exhibit distinct profiles in

different stages of ageing.

2. Studies Related to Psychological Problems of Senior Citizens

Nisha Naik [2003]13 has done a comparative study to assess the

emotional well-being of senior citizens staying in old age home versus senior

citizens staying with family. The sample of the study consisted of 120 male and

female senior citizens out of which 60 from old age home and 60 residing in

family. Findings show that there is significant difference in wellbeing of senior

citizen staying with family and senior citizens staying in old age home.

Also there is no association of emotional well being with any demographic

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variables like age, sex, marital status, educational status, types of family, size of

family, source of income, type of housing etc.

Guha et al [2000]14 has done a comparative study on psychiatric

morbidity among the inmates of old age home and community in Mumbai.

A sample of 30 inmates of 3 residential old age home and 30 controls from the

community were assessed using standardized psychometric instruments.

The prevalence rate of psychiatric morbidity in the study group was 26.7% and

the control group was 10%. The problems are higher in old age homes than in

the people in the community. Low income was also a possible predisposing

factors in increasing the morbidity trend in the group. Dementia (6.7%), a major

depressive disorder (13.4%) and OCD (3.3%) were found in old age homes.

The study reveals depression was the commonest psychiatric morbidity.

Shah et al [2000]15 has done a descriptive study on the prevalence of

psychiatric disorders in 78 elderly people in a rehabilitation unit. The tool was

Evans liver pool depression rating scale, 28 (35.9%) were found to be depressed

and 15 had anxiety and 33 (42%) had no evidence of impairment. The study

suggested that all the patients undergoing rehabilitation should be routinely

screened for depression as it is common and treatment will improve the

outcome.

3. Studies Related to Social Problems of Senior Citizens

Sarvimaki and stenbock [2000]16 has done a cross sectional study on

the quality of life of the aged in Finland. The subjects were chosen in home for

the aged, because people in home for the aged usually have more health

problems. The structured interview was done by standardized tool. The study

reveals the majority were women 67% of men and only 13% of women were

married 80% were satisfied with their health 82% were independent and 3%

totally dependent, 55% meet their children once in a week, 35% with the grand

children and 35% with neighbors. The study suggests nurses to give care and

help other healthy professional to maintain and to improve quality of life.

Yadidya M.S. [2003]17 has done a comparative study on “quality of

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life among senior citizen living in selected homes for the aged and family set

up” in Bangalore city. Total samples were 100 i.e. 50 from each, have selected

and matched for sex i.e. 25 males and 25 females in each group. The modified

WHO standardized tool was used by the determined and reliability was

determined by the pilot study. Finding shows that the quality of life of senior

citizens living in selected homes for the aged is less than the family set up.

6.3 Statement of the Problem A COMPARATIVE STUDY TO ASSESS THE QUALITY OF LIFE OF

SENIOR CITIZENS IN SELECTED RURAL AND URBAN FAMILIES IN MANGALORE.

6.4 Objectives of the Study The objectives of the study are to,

1. describe the quality of life among senior citizens in different rural and

urban families.

2. compare the quality of life among senior citizens in different rural and

urban families.

3. compare the quality of life with the selected demographic variables

such as income, type of family and marital status.

6.5 Operational Definitions

Quality of Life

Quality of life refers to the level of satisfaction in life experienced by

the senior citizens in physical, psychological and social level of independence.

Senior Citizen

A person with the age of 65 -85 years

6.6 Assumptions1. The quality of life of senior citizens in rural families is

more than that of urban families.

2. The quality of life will vary according to the selected demographic variables such as income, type of family and marital status.

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7.

6.7 DelimitationsThe study will be delimited to,

1. Persons above 65-85 years.

2. Senior citizens living in urban and rural families.

6.8 Hypothesis

Research Hypothesis

H1: There will be significant relationship between quality of life and

income.

H2: There will be significant relationship between quality of life and type

of family.

H3: There will be significant relationship between quality of life and

marital status.

Statistical Hypothesis

H01: There will be no significant relationship between quality of life and

income.

H02: There will be no significant relationship between quality of life and

type of family.

H03: There will be no significant relationship between quality of life and

marital status.

Materials and Methods7.1 Source of Data

The data will be collected from the senior citizens living in urban and

rural families in Mangalore.

7.1.1 Research Design

In view of the nature of the problem and to accomplish the objectives of

the study, a descriptive comparative design is used. Here the researcher

describes two or more groups of participants.

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SCHEMATIC OUTLINE OF RESEARCH DESIGN

STUDY SETTING Selected families in Urban area at

Mangalore

STUDY SETTING Selected families in rural area at

Mangalore

SAMPLINGSimple random sampling

SAMPLINGSimple random sampling

SAMPLE50 subjects from the selected urban

families

SAMPLE50 subjects from the selected

rural families

DESIGNDescriptive comparative Design

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INSTRUMENTModified WHO Quality of

life scale

INSTRUMENTModified WHO Quality of

life scale

VARIABLES

DEPENDENTQuality of life

INDEPENDENT Demographic variables such as

income, type of family and martial status

ANALYSIS

Frequency and percentage mean score, standard Mann -Whitney distribution of deviation, mean u- test /Unpaired Demographic variables percentage are used ‘t’ test

Summary, findings and conclusion

7.1.2 Setting

The study will be undertaken in selected urban families [Jeppu urban

PHC] and rural families [Pudu rural PHC] in Mangalore.

7.1.3 Population

In the present study, the population consists of senior citizens living in

selected urban and rural families at Mangalore.

7.2 Method of Data CollectionInterview schedule.

7.2.1 Sampling Technique

Simple random sampling technique is used.

7.2.2 Sample Size

The sample size of the study will be 100 senior citizens i.e.50 from

urban families and 50 from rural families.

7.2.3 Inclusion Criteria for Sampling

The senior citizens, who are

> At the age of 65 -85 years.

> Willing to participate

> Those who are able to answer.

7.2.4 Exclusion Criteria for Sampling

> Mentally sick people > Persons below 65 years of age > Persons more than 85 years

7.2.5 Instrument Used

The modified WHO quality of life rating scale consists of 2 sections.

Section A: Demographic variables

Section B: Dependent variable – quality of life.

It contains the following areas,

- Physical Problems - Psychological Problems - Social Problems

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7.2.6 Data Collection Method

Data will be collected after getting permission from the concerned PHC.

Investigator will introduce herself to the participants. The objectives of the

study will be explained to the participants and get the oral and written consent

from them. The researcher collects the data from 50 senior citizens living in

urban families and 50 from rural families.

7.2.7 Data Analysis Plan

The collected data will be analyzed using both descriptive and

inferential statistics. Mean Standard deviation and mean percentage will be used

to describe the variables. Statistical significance will be analyzed using Mann-

Whitney U test / unpaired ‘t’ test. Data will be presented in tables, graphs and

diagrams.

7.3 Does the study require any investigation or intervention to be

conducted on Patients or other humans or animals, if so please describe

briefly.

There is no need of any investigations or interventions on human beings

or animals. Only interview to be done.

7.4 Has ethical clearance been obtained from your institution in case of

7.3?

Yes, consent letter from the concerned authority to be taken.

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8. REFERENCE

1. Alonso of Aragon. Familiar quotations [online] 1919 [cited 1996 June 19];

Availablefrom:URL: http://www.luminarium.org/sevenlit/bacon/quotes.php

2. Neeraja KP. Textbook Of Growth and Development For Nursing Students.

1st Edition. New Delhi: Jaypee Brothers Medical Publishers; 2006.

3. Hazra Anupam. Status Of Elderly In India. Social Welfare October 2009;

5-13.

4. Nikita IP. Quotes and quotations [online] 2009 Famous quotes and

authors.com:Availablefrom:URL:http://www.famousquotesand

authors.com/authors/Nikita_ivanovich_panin_quotes.htm/

5. Lillypet Shantham. A Study to asses the needs of the elderly as perceived by

them and their significant family members in selected urban community.

Nightingale’s Nursing Times October 2006; 24-27.

6. Talleyrand CM. Famous quotes [online] 2008 July 6 Open source software

EducationalSociety.Availablefrom:URL:http://www.softpanorama.org/skep

tics/quotes/talleyrand_quotes.shtm/

7. Sreevani R. When Old Age Becomes Disease .Nightingale’s Nursing Times

September 2006; 9-10.

8. Kavitha AK. A comparative study on quality of life among senior citizens

living in Home for the aged and family set up in Erode District 2007.

9. Toshiyuki W. Quality of life of elderly patients staying at home and that of

their caregivers and their family environments. Clinical Psychiatry

Journal1999.PageNo:1079-1086.JapanAvailablefrom:

URL:http://sciencelinks.jp/j-east/article.php

10. Basavanthappa BT. Nursing Research. 2nd edition. NewDelhi: Jaypee

Brothers Medical Publishers; 2007

11. Prabhu Yogeendra. a comparative study of perceived health problems and

subjective well being status of the elderly people living with their families

and old age homes at Mangalore. Unpublished M. Sc [ N] Thesis: Rajiv

Gandhi University Of Health Science, 2007.

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12. Marja, Vaarama, Pieper, Richard, Sixsmith, Andrew. Care related quality of

lifeinoldage.PublicHealth[online]2008.Availablefrom:URL:http://www.spi

nger.com/public+health/book/detailspage=toc

13. Naik NA. Comparative study to assess emotional well-being of senior

citizens staying in old age home versus senior citizens staying with family.

Nightingale’s Nursing Times January 2007; 37-38.

14. Guha P, Ghoshal M, Das R. Psychiatric morbidity among the inmates of old

age home and community. The German Journal of Psychiatry, 2005

October vol:8 ,Page:94-97. Availablefrom:URL:http://www.gjpsy.uni-

goettingen.de/gjp-article-guha.pdf.

15. Shah A, Bhat R, Mackenzie S, Koen C. Descriptive study on prevalence of

psychiatric disorders in elderly people in a rehabilitation unit. International

Psychogeriatrics2008.Availablefrom

:URL:http://journals.cambridge.org/action/displayabstract.

16. Sarvimaki A, Stenbock HB. Quality of life in old age described as a sense

of wellbeing-meaning and value. Journal of immigration and minority

health.2008. Available from:

URL:http://www.springerlink.com/content/n742374695214013/

17. Yadidya M.S. A comparative study on quality of life among senior citizens

living in selected homes for the aged and families in Bangalore city.

Unpublished M. Sc[N] Thesis: Rajiv Gandhi University Of Health Science,

2003.

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