A STUDY TO ASSESS THE KNOWLEDGE OF HIGH

SCHOOL TEACHERS REGARDING SELECTED

BEHAVIOURAL PROBLEMS AMONG ADOLESCENTS
IN A SELECTED HIGH SCHOOL AT SALEM DISTRICT,
TAMILNADU

By
30095614

VIVEKANANDHA COLLEGE OF NURSING

(AFFILIATED TO THE TAMILNADU DR.M.G.R. MEDICAL UNIVERSITY, CHENNAI-32)
ELAYAMPALAYAM, TIRUCHENGODE, PIN -637205
TAMILNADU

APRIL 2011
A STUDY TO ASSESS THE KNOWLEDGE OF HIGH SCHOOL

TEACHERS REGARDING SELECTED BEHAVIOURAL

PROBLEMS AMONG ADOLESCENTS IN A SELECTED HIGH

SCHOOL AT SALEM DISTRICT, TAMILNADU

RESEARCH GUIDE:________________________________________
Prof. Mrs. K.KANAGAVALLI, M.Sc(N)., (Ph.D.,)
PRINCIPAL,
VIVEKANANDHA COLLEGE OF NURSING,
ELAYAMPALAYAM,
T IRUCHENGODE – 637 205.

CLINICAL SPECIALITY GUIDE:____________ ________________

Prof. Mrs. L. PARIMALA DEVI, M.Sc(N).,
DEPARTMENT OF CHILD HEALTH NURSING,
VIVEKANANDHA COLLEGE OF NURSING,
ELAYAMPALAYAM,
T IRUCHENGODE – 637 205.

VIVA VOCE
1. INTERNAL EXAMINER

2. EXTERNAL EXAMINER

Submitted in partial fulfillment of the requirements for the

DEGREE OF MASTER OF SCIENCE (NURSING) The
Tamil Nadu Dr. M.G.R. Medical University, Chennai – 32
APRIL 2011
 VIVEKANANDHA COLLEGE OF NURSING
(Affiliated to the Tamilnadu Dr.M.G.R. Medical University)
Elayampalayam, Tiruchengode – 637 205, Tamilnadu
Phone: 04288 – 234561

CERTIFICATE

This to certify that, this thesis, titled “A STUDY TO ASSESS

THE KNOWLEDGE OF HIGH SCHOOL TEACHERS

REGARDING SELECTED BEHAVIOURAL PROBLEMS

AMONG ADOLESCENTS IN A SELECTED HIGH SCHOOL AT

SALEM DISTRICT, TAMILNADU” submitted by

Ms.UDHAYAKUMARI, M.Sc (Nursing) (2009 – 2011 Batch)

Vivekanandha College of Nursing in partial fulfillment of the

requirement of the Degree of Master of Science (Nursing) from the

Tamilnadu Dr.M.G.R. Medical University is her original work carried out

under our guidance.

This thesis or any part of it has not been previously submitted for

any other Degree or Diploma.

Prof. Mrs. R.KANAGAVALLI, M.Sc (N), (Ph.D.,)

PRINCIPAL

SPONSORED BY
ANGAMMAL EDUCATIONAL TRUST, ELAYAMPALAYAM
 DECLARATION

I hereby declare that this thesis entitled “A STUDY TO ASSESS

THE KNOWLEDGE OF HIGH SCHOOL TEACHERS
REGARDING SELECTED BEHAVIOURAL PROBLEMS
AMONG ADOLESCENTS IN A SELECTED HIGH SCHOOL AT
SALEM DISTRICT, TAMILNADU” is the outcome of the original work
undertaken and carried out by me under the guidance and direct supervision of
Prof. Mrs. R.KANAGAVALLI, M.Sc (N), (Ph.D.,) and Speciality Guide
Prof.Mrs. L. PARIMALA DEVI, M.Sc (N)., Department of Child Health
Nursing, Vivekanandha College of Nursing, (Sponsored by Angammal Educational
Trust), Elayampalayam, Tiruchengode, Namakkal District.
I also declare that the material of this thesis has not formed in any way the
basis for award of any other Degree, Diploma or Associate fellowship previously of
the Tamil Nadu Dr. M.G.R. Medical University.

30095614
Vivekanandha College of Nursing,
Elayampalayam, Tiruchengode.

P lace: Elayampalayam,
Date:
 ACKNOWLEDGEMENT

“Love is a tiny seed God planted in the mind, to blossom

into flowers and make a person kind”.

Success of an individual is only possible when he/she blessings of GOD and

support from others. The success of this study would not possible without God’s
blessings and contributions of the teachers, well wishers and others. It is with
gratitude that I wish to acknowledge all those who have enriched and crystallized
in my study.
First I, wish to acknowledge my heartfelt to Almighty God of all the
wisdom and knowledge for his guidance, direction, strength, shield and support
throughout this endeavor.
I extent heartfelt thanks to Vidhya Rathna, Rashtria Rathna, Hind Rathna
Dr.M.Karunanithi B.Pharm, M.S, Ph.D.,(D.Lit.,) Chairman and secretary of
Vivekanandha Group of Institution to undertake this investigation in
Vivekanandha College of Nursing (Affiliated to the Tamilnadu Dr.M.G.R.Medical
University,Chennai), Elayampalayam, Tiruchengode.
Nursing is a noble profession and the teacher who teach are equally on the
same pedestal. It is initiation and guidance of my teachers and well wishers who
gave the strength in my career at all levels.
My deepest regard and honour to my esteemed research guide
Prof.Mrs.R.Kanagavalli, M.Sc(N), (Ph.D.,),, Principal, Vivekanandha College of
Nursing, who firmly but patiently, intelligently and gradually guided me at every
step of this work. Her kind guidance throughout my study is truly immeasurable
one. Without her guidance it would have been impossible for me to complete this
work.
I sincerely express my heartful thanks to Prof.Mrs.L.Parimaladevi,M.Sc(N),
Department of Child Health Nursing, Vivekanandha College of Nursing, for her
motherly attitude, dexterous and expert guidance, valuable suggestions, affectionate
enduring support, timely motivation and enthusia stic words which kept me working
towards the successful completion of this dissertation.
It pleasure and privilege to express my deep sense of gratitude to
Prof.Mrs.K.Kamala, M.Sc(N), (Ph.D.,), Principal, Rabindranath Tagoore College of
Nursing, for her valuable suggestions, constant guidance and constructive criticism
which contributed towards completion of the study.
It is privilege to express my deep sense of gratitude to my class coordinator
Ms.Jayalakshmi, M.Sc(N), for her valuable suggestion and valuable guidance.
I owe my special thanks to all the P.G.Faculty Members of Vivekanandha
College of Nursing for their valuable suggestions and guidance.
My special thanks to all subject experts who spent their valuable time for
validating my tool.
I express my sincere and special thanks to
Mrs. Arularasi, M.Sc, Lecturer in Biostatistics, Vivekanandha College of Nursing
for her valuable guidance and advice in statistical analysis and presentation of data.
I am thankful to the Librarians of Vivekanandha College of Nursing,
Elayampalayam, for helping me with review and attending library facilities
throughout the study.
My special thanks to the Principal of Velasamy Chettiar Higher Secondary
School and teachers of the school for their co-operation and help during my study.
 I extend my sincere thanks to Participants who cooperated with me to
conduct the study.
I extend my thanks to the Dissertation Committee Members for their healthy
criticism, supportive suggestions which moulded the research.
I extend my sincere thanks to Shri Krishna Computers, Five Roads, Salem
for skillful word processing and graphic presentation.
We are what, we are with the blessing and love of our dear and near one. It
would not have been possible for me to complete this work, without the love and
support of my parents and my brother, who initiated me to take up this noble
profession and also for their strong support, prayers, and encouragement throughout
my career.
I extend my deep sense of gratitude my lovable father Mr.A.Vadivel and my
dearest brother V.Venkateshkumar for his invaluable support, constant
encouragement, timely help, and inspiration throughout the course of this study.
I express my thanks to my Grandmother for her constant support, prayers
and encouragement.
I render my deep sense of gratitude to all My Classmates and Friends for
their constant help throughout the study.
I thank all my well wishers who helped me directly and indirectly.

V.UDHAYAKUMARI
 ABSTRACT

The thesis title “A STUDY TO ASSESS THE KNOWLEDGE

OF HIGH SCHOOL TEACHERS REGARDING SELECTED

BEHAVIOURAL PROBLEMS AMONG ADOLESCENTS IN A

SELECTED HIGH SCHOOL AT SALEM DISTRICT” was

conducted by Ms. V.UDHAYAKUMARI in partial fulfillment of the

requirement for the degree of master of nursing during the year 2009-

2011.

THE OBJECTIVES OF THE STUDY ARE

1. To assess the knowledge of high school teachers regarding selected

behavioural problems of adolescents.

2. To determine the relationship between the knowledge of high school

teachers on selected behavioural problems with selected demographic

variables such as age, sex, educational qualification, teaching

experience.

3. To prepare health education pamphlet regarding selected behavioural

problems among adolescents.

The research approach adopted for the study was descriptive in

nature 40 high school teachers from Velasamy Chettiar Higher Secondary

school were selected for the study.40 teachers were selected for this study

by convenience sampling method.

 A semi-structured questionnaire was developed to collect data from

the sample, it had 2 parts, Part A deals with Socio -demographic variables

of the teachers. Part B contain 3 sections consists of 216 questions to

assess the knowledge of high school teachers regarding causes, signs and

symptoms, management and prevention of behavioural problems of

adolescents.

Collected data was analyzed by using descriptive and inferential

statistics in terms of frequencies percentage, mean, standard deviation

and Chi-square analysis.

SUMMARY OF THE MAJOR FINDINGS

Findings related to sample characteristics

Among 40 samples,26(65%) were below 40 years of age,14(35%)

were above 40 years,18(45%) were males and 22(55%) were

females,19(47.5%) teachers have master degree withB.Ed,17(42.5%) of

them have master degree with M.Ed,4(10%) of them teachers have master

degree with M.Phil,30(75%) had below 15 years of experience,10(25%)

had above 15 years of experience,28(70%) were deals with XI,XII

standard,40(100%) teachers had child psychology in their

curriculum,22(55%) of them have participated in the inservice education

on child psychology.
Findings related to knowledge score of teachers

The overall knowledge score of teachers regarding conduct

disorder, emotional disorder, substance abuse were 34.09%. The mean

score percentage of knowledge of teachers regarding conduct disorder

was about 37.14%. The mean score percentage of knowledge of teachers

regarding emotional disorder about 32.73%.The mean score percentage of

teachers regarding substance abuse was about 33.76%.

Findings regarding the relationship between the selected

demographic variables and knowledge level of teachers

Chi –square analysis was applied to compare the knowledge with

selected social demographic variables. Result shows that age, education,

teaching experience, participation in inservice education programme on

child psychology are significant at 5% (P<0.05) level. Other demographic

variables like sex, deals with which standard of children are not

significant at 5% level.

Based on th ese findings the following recommendations were made

1. A quasi-experimental study can be done to observe the effect of

programmed instruction on knowledge and skill of teachers in

school health programme.

2. A formal continuing education programme must be conducted in

all schools regarding selected behavioural problems among

adolescents, it’s identification and management.

 3. A concentrated effort should be made by community health nurse

to increase awareness among high school teachers and their role in

the total school health services.

4. A comparative study may be conducted between rural and urban

teachers regarding the knowledge on behavioural problems of

adolescents.

5. A similar study may be done on nurses to find out their knowledge

and role perception about behavioural problems of adolescents.

6. A study can be conducted in the community to identify the

prevalence of behavioural problems among adolescents.

7. A similar study can be conducted to assess the knowledge of

parents regarding behavioural problems of adolescents.

8. The study can be replicated using a large sample there by findings

can be generalized to a large population.

9. A study can be carried out to assess the knowledge , attitude of

teachers regarding emotional needs of adolescents.

An information booklet was developed for teachers regarding the

selected behavioural problems among adolescent.

 TABLE OF CONTENTS

CHAPTER PAGE.
CONTENTS
NO NO
I INTRODUCTION 1-27
? Need for the study 16
? Statement of the problem 21
? Objectives of the study 22
? Operational definitions 22
? Assumptions 23
? Limitations 24
? Conceptual framework 24
II REVIEW OF LITERATURE 28-56
III METHODOLOGY 57-68
? Research approach 58
? Research design 59
? Setting of the study 61
? Target population 61
? Sample and sampling technique 62
? Selection criteria 62
? Selection and development of instrument 63
? Content validity 65
? Reliability 65
? Pilot study 66
? Data collection 66
? Plan for data analysis 67
IV DATA ANALYSIS INTERPRETATION AND 69-93
DISCUSSION
V SUMMARY, FINDINGS, CONCLUSIONS, 94-102
IMPLICATIONS AND RECOMMENDATIONS
? Summary 94
? Major findings of the study 95
? Conclusion 97
? Implications 98
? Recommendations 101
REFERENCES 103-111
 LIST OF TABLES

S. NO TITLE PAGE NO

4.1.1 Distribution of high school teachers by their age 71

4.1.2 Distribution of high school teachers by their sex 72

4.1.3 Distribution of high school teachers by their 73

education
4.1.4 Distribution of high school teachers by years of 74
teaching experience
4.1.5 Distribution of high school teachers based on 75
their dealings with which standard of children
4.1.6 Distribution of high school teachers who had 76
child psychology in their curriculum
4.1.7 Distribution of high school teachers who had 77
inservice education on child psychology
4.2.1 Knowledge of high school teachers on selected 78
behavioural problems among adolescents
4.2.2 Distribution of high teachers according to their 80
knowledge regarding conduct disorder
4.2.3 Distribution of high school teachers according to 81
their knowledge regarding emotional disorder
4.2.4 Distribution of high school teachers to according 82
their knowledge regarding substance abuse
4.3.1 Association between the knowledge on 83
behavioural problems with age of high school
teachers.
4.3.2 Association between the knowledge on 84
behavioural problems and sex of high school
teachers
4.3.3 Association between the knowledge on 85
behavioural problems and education of the high
school teachers
4.3.4 Association between the knowledge on 86
behavioural problems and teaching experience of
the high school teachers
4.3.5 Association between the knowledge on 87
behavioural problems and deals with which
standard of children
4.3.6 Association between the knowledge on 88
behavioural problems and high school teachers
who had inservice educational programme.
4.3.7 Cumulative table showing the significance of 89
socio demographic variables over the knowledge
score
 LIST OF FIGURES

S. NO TITLE PAGE NO
1.1 Conceptual frame work 27
3.1 Schematic representation of the research design 60
4.1.1 Distribution of high school teachers by their age 71

4.1.2 Distribution of high school teachers by their sex 72

4.1.3 Distribution of high school teachers by their 73

education
4.1.4 Distribution of high school teachers by years of 74
teaching experience
4.1.5 Distribution of high school teachers based on 75
their dealings with which standard of children
4.1.6 Distribution of high school teachers who had 76
child psychology in their curriculum
4.1.7 Distribution of high school teachers who had 77
inservice education on child psychology
4.2.1 Knowledge of high school teachers on selected 78
behavioural problems among adolescents
4.2.2 Distribution of high teachers according to their 80
knowledge regarding conduct disorder
4.2.3 Distribution of high school teachers to their 81
knowledge regarding emotional disorder
4.2.4 Distribution of high school teachers to their 82
knowledge regarding substance abuse
 LIST OF APPENDICES

S.NO TITLE PAGE NO

A Letter seeking permission to conduct study 112

B Letter granting permission to conduct study 114

C Letter for validation of tool 115

D Letter seeking permission from the participants 117

E Semi-structured questionnaire 118

F Evaluation criteria check list for validation of 133

tool

G Certificate of validation 134

H Health Education pamphlet 135

 CHAPTER I

INTRODUCTION

“Adolescence is a period of life that present

Special challenges of adjustments”.

- Whaley and Wong, 2008

Life cycle of human organism under goes various kinds of

developmental changes. Though every stage of life cycle is considered to

be very important some stages are very vital in nurturing the personality

development of an individual.

Development is a lifelong process. Adolescence is the period that

begins with the onset puberty and end at the age of 19 years.

Adolescence is the period of life between childhood and adulthood.

During this transition period, dramatic physical, cognitive, psychosocial

and psychosexual changes take place that are exciting and at the same

time frightening.

The term “adolescence” is derived from Latin word “Adolescere”

meaning “to change”, “to grow ”, “to mature”. It also means “to emerge”

or “achieve identity” and is the most challenging and critical times of

one’s life. Drastic physical, psychological and social transformation and

maturation characterize adolescence.

 Adolescence is the most important period in one’s life. It is a

period of stress and strain, of day dreams, intense affection and

excitement. The mind is pious and pure, free from all wickedness. It is

full of love and showers its affection on anyone without any pre-thinking.

Adolescent period is defined by the WHO, as age group between

10 and 19 years of age. This can be further divided into early

(10-13years), middle (14-16 years), and late (17-19 years) adolescence.

The age group between 15 and 24 years are termed “youth” and together

the two groups are termed “young people” (10-24 years).

The onset of puberty brings dramatic changes to the body and

mind. (Dhal, 2004)

Large pulses in sex hormones change feelings and interests as well

as the body. Major brain growth, reorganization, and interconnectedness

occur within multiple regions of the brain that will extend into young

adulthood. (Giedd, 2004)

The adolescent tryout many new roles during this time as part of

the important developmental task of identity formation. The peer group is

utmost importance as adolescent experiments with new roles outsides the

confines of the family unit. Adolescence is considered as a “period of

transition from childhood to adulthood.” They are no longer children yet

not adults. Adolescent cravings for strong emotional experiences are

reflected in their enjoyment of loud music, horror movies, and extreme

amusement park rides. Although their cognitive skills are nearly at adult

levels their ability to make good decisions under the influence of strong

emotions is poor. (Dhal, 2004)

World Health organization refers to people aged 10-19 years of

adolescent’s. The total global population of 6.3 billion (630 crores), 1.2

billion (120 crores) are adolescents. In India as per 2002 census there are

225 million adolescents comprising nearly 22% of total population out of

which 12% belong early adolescence (10 -14 years) and 10% to the total

late adolescent age group (15-19 years).

In India, there are more than 230 million adolescents, which is

approximately 23 % of the total population. The sex ratio of females to

males is 927 per 1000 males.

They are not only in large number but also the citizens and workers

of tomorrow. The swiftly changing global conditions are placing a great

strain on the young people modifying their behavior and relationships and

exacerbating their health problems. Healthy and developed adolescents

have a better chance of becoming healthy responsible and productive

adults.

Adolescents are regarded as one of the most valuable assets of any

society. Such an emphasis is obviously based on the potential of the

adolescents to contribute intellectually, politically and economically to

the society.
 Their willingness and readiness to any kind of adjustment and a

sense of well being are crucial factors for their positive contribution to the

society, adolescence period of intense socializing. Adolescence is the

stage that the social relationship attains heightened significance. They

need an opportunity for reflection in order to gain perspective and the

fundamental issues of life as they are related to living with others.

Adolescent period is filled with anxiety, frustration, identity crisis,

looking out for support and a struggle between dependency needs and

independence. The emotional turn oil goes hand in hand with the

physiological changes that occur in the body. This phase in life is a highly

vulnerable period because of simultaneous interaction of the bio-

psychosocial factors. Hence adolescent from a risk group of the

community. Ability to cope with and perform the expected roles in this

age group depend “Homeostasis” in family environment and personality.

Adolescence is characterized by adolescent growth spurt (i.e) an

acceleration of growth in most skeletal dimensions and in many internal

organs, changes in body composition (i.e) in the quantity and dis tribution

of fat and musculature. These changes are associated with the

development of gonads, reproductive organs and secondary sex

characters. (Piyush Gupta, 2007)

 Adolescence is that it is a period between the age of 10 & 25 years

of bio-psychosocial maturation leading to functional independence in

adult life. (Russell Viner, 1998)

National policy of education1986 said that 7.5% of total school

curriculum had been allotted to health education in teacher training

course. They had a lack of co-ordination between state council of

education, research, training and state school health bureau. So the

teachers were not getting adequate training in health aspect.

The 9th conference of central council of health and central family

welfare resolved that the teachers in primary and higher secondary classes

should be trained to observe and screen the students for detect and

deviation from normal physical and mental health to maintain effective

surveillance. The supportive training programme can be planned for the

teachers about prevention and to develop desirable psychosocial well

being with the group and to the society.

The school is psychologically important to adolescents as a focus

of a social life. Teenagers usually distribute themselves into a relatively

predictable social hierarchy. They know to which groups they and others

belong. A sense of school connectedness and optimal social

connectedness and optimal social connectedness is associated with

positive outcomes for school completion, positive mood, and decreased

high risk behaviour in adolescent. (Bond, et.al, 2007)

 School connectedness is correlated with caring teachers and the

absence of prejudice or discrimination from peers. The sense of school

connectedness is less dependent on class size, attendance, academic

preparation and parental involvement. (Males and Lievens, 2003)

If an adolescent does not enter puberty at the same time as his or

her peers considerable inner conflict may occur. Early maturing girls and

boys have higher rates of sexual risk taking behaviours, delinquency and

substance abuse than their on time peers. (Costello , et.al, 2007)

The teachers are the capable person to identify the behavioural

problems of adolescent. The teachers will promote psychosocial

competencies like decision makin g, problem solving, critical and creative

thinking, interpersonal relationship skills, self awareness, empathy and

skills for coping with emotional stress among adolescence. “It is the

personality of the teachers and their attitude towards students more than

teaching that constitute the crux of mental health in

school”. (Bernard,W.H , 1970)

Mental health programmes in schools are effective in identifying

the children with behavioural problems early and target them for

intervention. Teachers have often received some training in mental health

programmes and problems of the children. This makes the teachers to

become potentially well qualified in identification of behavioural

problems among adolescence and planning the remedial mental health

programmes. The mental health programmes helps to improve the coping

skills, decrease the stress and increase the psychosocial well being of the

adolescence.

Findings ways to nurture and augment the mental health of youth is

an important responsibility of teachers who by virtue of their close

contact with adolescence and their capacity to modify behavior are a

powerful group of people.

Jellinek, et.al, (2002) concerns for the adolescent include engaging

in high risk behaviour, such as sex, alcohol and drug use, driving while

intoxicated and using tobacco products in addition to aggressive or hostile

behaviour, depressed mood, and school absenteeism or academic failure.

Rao, A.R, (1995) estimated that in India the age group between 10

and 20 years occupies 1/3 of total population.

Mohan Issac, (1999) also states that there are few epidemiological

studies which quote 15-20% of students are having recognizable mental

disorders in the forms of depression, anxiety, alcoholism and drug abuse.

Children betwee n 11-19 years of age group spend most of their

time I in the school. School is the place where growing children come to

grips with their emotional integration into the larger society. According to

who (1994) schools have an unrestricted opportunity to improve the lives

of young people school are aiming the full support of families and

community are needed to provide comprehensive mental health to the

children schools can act as a safety net to provide the children from

hazards that affect their learning and promote wellbeing of the children.

Gutgesell, (2004 ) failure to set appropriate limits and expectations,

lack of pride in the adolescent’s achievements, negative affect towards

the adolescent, frustration or anger with the normal level of adolescent

mood liability and failure to support the adolescent’s positive engagement

in the community and school signal problem the parent- adolescent

relationship.

Behavioural problems in adolescents includes conduct disorder,

emotional disorders, substance abuse can be caused by genetics, chemical

imbalances, damage to the central nervous system, exposure to

environmental toxins such as high levels of lead, exposure to violence,

stress, divorce of parents, lack of support and conducive environment in

home, community and school. The appearance of adolescents with

behavioural problems are poor concentration, depression, low self

esteem, hostility, inability to make good peer relationship, chronic

anxiety or feeling of difficulty in handling life.

Conduct disorder (CD) is a repetitive and persistent pattern of

behavior in which either the basic rights of others or major age

appropriate societal norms and rules are violated. (APA, 2000)

 Juvenile delinquent involves wrong doing by a child or a young

person who is under age spe cified by the law of the place

concerned.(Sethna, 2008).

Kassinove and Tafrate., (2002) state in contrast to anger aggression

is almost always goal directed and has the aim of harm to a specif ic

person or object. Aggression is one of the negative outcomes that may

emerge from general arousal and danger.

Mood disorders are disturbances in the regulation of mood,

behavior, and affect that go beyond the normal fluctuations that most

people experience. (Lippincott Williams, 2004)

Mood is a pervasive and sustained emotion that may have a major

influence on a person’s perception of the word. It includes depression,

joy, elation, anger and anxiety. Affect is described as the emotional

reaction associated with an experience. (Taber’s 2005)

Mood disorder is a condition where by the prevailing emotional

mood is distorted or inappropriate to the specified circumstances.

Depression is a form of affective manifestation in which the client will

exhibit mood disturbances related to self and his

environment.(K.P.Neeraja, 2008)

Anxiety is an emotional response (apprehension, tension,

uneasiness) to anticipation of danger, the source of which is largely

unknown or unrecognized. Anxiety may be regarded as pathologic when

it interferes with effectiveness in living, achievement of desired goals or

satisfaction or reasonable emotional comfort. (Shahrokn & Hales, 2003)

Anxiety is pervasive feeling of dread, apprehension and impending

disaster. (K.P.Neeraja, 2008)

Anxiety is a response to an undefined or unknown threat which

may be due to unconscious conflict or insecurity. (Bimla Kapoor, 2008)

Suicidal behavior involves thoughts or actions that may lead to self

inflicted death or serious injury. (Hodas, Sergent, 1983)

Suicide is the intentional or purposeful taking of one’s own life. It

is the ultimate act of self destruction. Suicide may be completed,

attempted or suicidal ideation. (Nicki Barbara, 2002)

Substance abuse is described as a maladaptive pattern of substance

use leading to clinically significant impairment or distress. The substance

of abuse may be any chemical substances are alcohol, amphetamines,

barbiturates, caffeine, cannabis, cocaine hallucinogens, inhalants,

nicotine, sedative hyponotics and anxiolytics and opioids. (Mary C.

Townsend, 2006)

In India 5-10 % young people are using substances. Among then

75% of young people are using alcohol and 50% them dependent. Nearly

35% of the young adults are having the habit of smoking. (Dutta, 2007)
 Substance abuse may produce unhealthy lifestyles and behaviours

chronic substance abuses impair social and occupational functioning,

creating personal, professional, financial and legal problems. Substance

abuse in early adolescence leads to emotional and behavioural problems

including depression, problems with family relationship problems with

failure to complete school or studies and develop chronic

problems.(Lippincott Williams & Wilkins, 2004)

Substance abuse is the misuse of an addictive substance that

changes the user’s mental state. The addictive substances commonly

abused are tobacco, alcohol and controlled or illicit drugs. Substance

abuse usually begins in adolescence. Few people begin tobacco misuse

after 18. Half of regular smokers who start in adolescence and smoke all

their lives will eventually be killed b tobacco. Alcoholism is a primary

chronic disease with genetic, psychosocial and environmental factors

influencing its development and manifestations. The disease is often

progressive and fatal. It is characterized by impaired control over

drinking. Preoccupation with d rug alcohol use of alcohol despite adverse

consequences and distortions in thinking most notably denial. (Robert

R.Pinger)

Alcohol is a substance prepared by using chemical substances to

produce some kind of sedative and anesthetic feeling. Sometimes alcohol

is classified as a food because it contains calories without nutritional

value. The sprit content varies for each variety of alcohol beverages.

Alcohol exerts a depressant effect on the CNS, resulting in behavioural

and mood changes. The effects of alc ohol on the CNS are proportional to

the alcoholic concentration in the blood. (Mary C. Townsend, 1998)

Alcoholism is considered as a excessive and compulsive drinking

that produces disturbances in mental or cognitive levels of functioning,

which interferes with social and economic functioning. (K.P.Neeraja,

2008)

Smoking is a very common behavior among young adults. Nicotine

the active ingredient in the tobacco plant is one of the most toxic and

addictive drugs known to man. One in 6 deaths in United States are

associated with cigarette smoking of adolescents and college students.

Drugs used for smoking is not only nicotine nowadays there are other

drugs such as cannabis, heroin, cocaine and even some of the lysergic

acid diethylamide(LSD) drugs also used for smoking. (Marlow, 2005)

Alcohol (ethanol) is a CNS depressant that reduces the activity of

neurons in the brain. In the United States chronic uncontrolled alcohol

intake is the largest substance abuse problem. An alcoholic continues to

use alcohol despit e reduced occupational functioning and negative

psychological, social and health consequences.

 Nicotine’s pharmacokinetic properties enhance its abuse potential.

Cigarette smoking rapidly distributes nicotine to the brain, with drug

levels peaking within 10 second of inhalation. Acute effects dissipate in a

few minutes. So the smoker must continue to dose throughout the day to

maintain pleasurable drug effects and prevent withdrawal. (Lippincott

Williams, 2004)

High school and college students who experiment with alcohol

begin use in a social context and become light or moderate drinkers.

Some alcoholics become problem drinkers. That is the individual begin to

experience social, legal or financial problems because of their alcohol

consumption physical dependence on a alcohol and the loss of control

over one’s drinking are two important characteristics of alcoholism. The

problem of alcohol increases as assault and sexual abuse of women were

associated with alcoholism. (Sandip, 2006)

The hazards of smoking at any age are undisrupted. A preventive

approach to teenage smoking is especially important. There is a high

probability of regular smoking in childhood and adolescence leads to a

increased risk of heart diseases, stroke, emphysema and other conditions.

Approximately 5% of 12 to 17 years old males and 12% of 18-25

years old males reported using tobacco for smoking in United States. 57

million U.S residents are current cigarette smokers and 7.6 million used

as the smokeless tobacco.20% of teenage girls and boy s smoke. The

incidence of smoking is among less educated and those in low

socioeconomic group. (Lippincott Wiliams, 2007)

Nicotine is the most psychoactive component found in smoke from

tobacco product (cigarettes, cigars, pipes). In India half of the 300 million

current smokers die due to tobacco caused diseases. Most of the cigarettes

contain at least 10 mg of nicotine. By inhaling smoke, the average

smokers takes in 1 to 2 mg of nicotine with each cigarette. (Mohar, 2006)

P sychosocial factors which make the person to chew tobacco are

curiosity, social non conformity, poor impulse control, early initiation of

tobacco, low self esteem and concerns regarding personal autonomy.

They develop tobacco chewing habit due to poor social and familiar

support, poor stress management skills, boredom, psychological distress,

low self esteem and relief from fatigue. (Niraj Ahuja, 2004)

Tobacco are leaves of plant that are used in dried form they are

high in nicotine and consequently addictive in nature. Tobacco can be

taken in the forms of chewing, snuff and smoking. Tobacco use is one of

the most important risk factors for oral diseases including periodontal

diseases, oral mucosal lesions, oral ulcers and oral cancers. (Clichy,

2003)

By 2020 predicted that tobacco will become leading cause of death

and disability. World wide more than 10 million people will be killed due

to use of tobacco than deaths from aids, tuberculosis maternal mortality

and motor vehicle accidents. Till the year 2000 tobacco might have killed

more than 60 million people in developed countries which is more than

the number of people who have died in the word war II. (Mukesh Yadav,

2001)

Drug abuse is the use of illicit drug or misuse of legitimate drug

resulting in the physical or psychological harm. It includes smoking ganja

or cocaine or LSD, injecting morphine, drinking alcohol and so forth,

there are sometimes referred to as being high on speed or trip or getting

ticks. Over the counter drugs are those drugs with in the exception of

tobacco and alcohol that can be purchased without a physician

prescription. (Neeraja, 2006)

Most adolescents are able to experiment once or twice with

different drugs such as marijuana, cocaine or alcohol and make the choice

not to continue using these drugs or that they are not appropriate for their

age. (Lippincott)

Adolescent abusing drug has often adopted the use of substances as

a means of coping with feeling of depression, anxiety, restlessness or

chronic feelings of boredom or emptiness.

The percentage of senior high school students who reported

smoking in the past 30 days was approximately 45.2% for boys and

40.5% for girls. (Centers for Disease Control and Prevention, 1999)
 Adolescents at greatest risk 80% to 90% of high school students

who have tried alcohol or the 45% to 55% who have tried marijuana but

rather the estimated 4% who report daily use of alcohol during the past 30

days and the 1% to 2% w ho use hard drugs regularly. (U.S Department of

Health and Human Services, 1999)

Approximately 9.3% to15.8% of boy s from 10 to 18 years old and

from 3.8% to 9.2% of girls are affected conduct disorder. Conduct

disorder was 3 to 4 times higher for boys than girls. (Loeber, et.al, 2000)

NEED FOR THE STUDY

Clay in the hands of a potter is mould into a beautiful form so are

the children who are the responsibilities of the school teacher handled

with love and care they become something beautiful or else they will be

discarded or broken.

Children and adolescents have different problems in the areas of

school, home among peers and teachers and also in general which need to

be studied in depth. (Pandian, D.R, 1991)

School teachers can be sensitized to the need for positive mental

health among adolescents because they cater to a large target population.

This will provides quantum leap in the health promotion and preventive

programmes.
 Also considering the complications the complexities of mental

health problems among adolescents integrated efforts of teacher, parents

and mental health professional are indispensable. But effective handling

of these problems requires additional skill and knowledge on the part of

the teachers. At a national workshop on promotion of mental health held

at Cochin , 1991. It was communicated that one of the components in

achieving mental health is that, “Teacher must have adequate knowledge

skill and attitude to foster better mental health in

children”.(Parthasarathy, R., 1994)

The social and behavior choices of today’s teenagers predict the

health of tomorrow’s adult student spend considerable amount of their

wakeful hours in schools with the teachers whose from time immemorial

has been help up with great regard. This gives the teachers ample

opportunity to recognize adolescents displaying maladaptive behavior.

Also teachers by virtue of their stance can help adolescents tide over this

period of turbulence to attain good and positive mental health.

Master S. Roshan, in the proceedings of the indo-us symposium

conducted in October 1987 at Bangalore, suggested that for a meaningful

mental health programme s, help from schools and college should be

sought.
 American College of Physician’s Association, (1989) stated that

active promotion of adolescent health and well being is required. This

means that adolescence should be viewed as a critical stage of growth and

development and not simply as a period of transition from childhood to

adulthood.

Barg Butter and Franklin, (2004) conducted a study to assess the

attendance problem and its outcome among 80 samples of 13-15 years

old school children at Botswana. It was a survey approach with

descriptive design. Results showed that the school children who failed to

attend more than 40 % of a school term were conduct problem.

Rosario , (1998) conducted a study in Bangalore and found that

11.27% of school going adolescents boys and 1.47% of girls were

psychologically disturbed. The rate of disturbances was highest in the age

group of 13 and 14 years. It has been found that 20-50% of the

adolescents in any set up suffer from different emotional problems that

they are incapacitated both in the academic and extracurricular activities.

The social and behavioural choices today’s teenagers predict the health of

tomorrow’s adults.

The problems among adolescents have detrimental effect on their

mental health and therefore needs special attention from the mental health

professional. But the prevailing conditions can’t afford to avail the above
ideal situation and hence it is necessary to plan alternative strategy to

promote and maintain the psychological and social health of students.

Marmot ML, (1993) reported that regardless of physiological or

emotional readiness the adolescent has expectations. Too often

adolescents tend to develop a substance abuse as a means of coping with

their difficulties to accomplish the developmental tasks.

Jonson S, (1994) reported that smoking is the primary preventable

cause of death and yet 3000 adolescents become smokers each day most

adult smokers begin this bad habit at the age of 18.

Deykin. N, (2001) reported that the transition in the early

adole scent stage (physical, psychological and social) make then to be

confused, lonely and depressed. When depression is prevalent it is a risk

factor substance abuse in an adolescent. It not only affects the individuals

but the entire family and society.

Global Youth Tobacco Survey, (2000-2004) reported nearly 5

million people die due to tobacco use every year. By the year 2020 the

rate is likely to increase to 1o million tobaccos attributable deaths, among

where seven million deaths will occur in the developing countries like

mainly china and India .

India is the second largest producer of tobacco in the world. Every

year 80,000-90,000 Indians die due to tobacco use. Most tobacco users

start using tobacco before the age of 18 years WHO 1988 estimated that
20-30% in the 18-25age group in United States use cocaine and 1981

report stated that 3.1% adolescents used cannabis.

National center for health statistics stated that suicide is the third

leading cause of death for teenagers aged15-19 years between the year

1980 and 1990. Suicide rates increased by 30% but have gradually

decreased in 1985. The rate of suicide in the 15-19 years old population

was 7.9 a decrease of 7% from 1990.

Approximately 4,00,000 people die annually because of tobacco

used and an estimate 60% of the direct health care cost in the united

states go to treat tobacco related illnesses. (Kaplo & Sadock, 2001)

Heroin is considered a highly addictive drug a CNS depressant.

The estimated number of heroin users which remained fixed at roughly

6,00,000 from the 1970s into the 1990s almost quadrupled in the 1990s to

an estimated 2.4million users. (Lamarine, 2004)

In Bhuvaneshwar with a population 2.3 lakhs the number of drug

addicts were estimated as 20 % Kanpur is first emerging city of drug

addiction. The study says out of its total adult male population of

5,90,291 in the age group of 15-60. There could be around 34,768 drug

users 2007.

Adolescence is the period is more vulnerable to them because

many physiological changes take place during that time. Today’s

adolescents are the adults of tomorrow their health and knowledge the

health of the complete generations.

Adolescents are more flexible in their attitude and have no social

status to safeguard. Their health is directly linked to the behavior which is

developed and modified with in the family and the environment.

Many adolescents are affected by mental health problems. Studies

show that around one in five adolescents do pass through a more

prolonged phase of emotional difficulties and one in 10 adolescents suffer

mental illness severe enough to cause problems in their development and

daily life.

The school teachers by joining forces with the mental health

professionals can inflate the balloon of mental health services, essential to

explore teachers knowledge and role perception towards promotion of

mental health in schools, among adolescents.

Apart from this the investigator had come across very limited

studies done to assess the teacher’s knowledge on common behavioural

problems of adolescent. Hence this study is selected.

STATEMENT OF THE PROBLEM

A STUDY TO ASSESS THE KNOWLEDGE OF HIGH SCHOOL

TEACHERS REGARDING SELECTED BEHAVIOURAL PROBLEMS

AMONG ADOLESCENTS IN A SELECTED HIGH SCHOOL AT

SALEM DISTRICT.
OBJECTIVES OF THE STUDY

1. To assess the knowledge of high school teachers regarding selected

behavioural problems among adolescents.

2. To determine the relationship between the knowledge of school

teachers on behavioural problems with selected demographic variables

such as age, sex, educational qualification, teaching experience.

3. To prepare a health pamphlet regarding selected behavioural problems

among adolescents.

OPERATIONAL DEFINITION

Knowledge

Knowledge is referred to the correct responses of school teachers

on self administered knowledge questionnaire regarding selected

behavioural problems as evident from the test score.

High School Teachers

The school teachers include those teachers with professional

qualifications who handle classes X, XI &XII standard in selected school.

Adolescence

Referred to those who were at the age group of 15-19 years.

Behavioural Problems

It affects the child behaviours, feeling, difficult to do well in

school. The selected behavioural problems are conduct, emotional and

substance abuse.
Conduct Disorder

Conduct disorders refers as the child will behave antisocially by

breaking the other’s property, fighting with others, truancy from school

and home, fire setting, aggression toward people and animals.

Emotional Disorder

Emotional disorders refer as the children will feel for something

fear about some objects and anxiety to the unwanted situations.

Substance Abuse

Substance abuse is like misuse of addicting substance like alcohol,

nicotine, tobacco and use of illicit drugs that disturbs the normal physical,

psychological, social and occupational functioning of an individual.

ASSUMPTIONS

1. Teachers will have less knowledge regarding selected behavioural

problems of adolescents.

2. There will be a significant relationship between the knowledge score

and the socio demographic variables such as age, sex, educational

qualifications and teaching experience, participation in inservice

education of teachers.
LIMITATIONS

1. School teachers who are dealing with X, XI &XII standard student

only included in the study.

2. Sample was limited to only 40 teachers in a selected school at Salem

District. So the findings cannot be generalized.

CONCEPTUAL FRAME WORK

A conceptual frame work is the precursor of a theory. It provides

broad perception for nursing practice, research and education. Their

overall purpose is to make scientific findings meaningful and

generalizable.

Conceptual framework is the conceptual understanding of a study.

It refers to the understanding of interest and reflects the assumptions and

philosophical view of investigation. (Denise F.Polit, 2006)

According to Polit and Hungler, a conceptual frame work is

interrelated concepts on abstractions that are assembled together in some

rational scheme by virtue of their relevance to a common theme. It is a

device that helps to stimulate research and the extension of knowledge by

providing with direction and impetus.

The conceptual framework for the study is based on the “Modified

Pender’s health promotion model (1996)”. According to the model,

health promotion is defined as activities directed towards the

development of resources that maintain or enhancing an individuals well

being. The model is divided into three major components like cognitive

perceptual factor, modifying factor, participation in health promotion

behavior.

INDIVIDUAL PERCEPTION

The individual perception , “The primary motivational mechanisms

of health promoting behaviours” are said health exert a direct influence

on health promoting behavior of all the cognitive perceptual factors,

perceived control of health, perceived self effic acy and perceived health

status are among strongest determinants of health promoting

behaviours.(Frank Stromberg, et.al., 1990)

In the present study, the individual perceptions considered are

inadequate knowledge on selected behavioural problems of adolescents

such as conduct disorder, emotional disorder, substance abuse and

perceived benefits such as acquiring adequate knowledge of school

teachers regarding behavioural problems of adolescents.

MODIFYING FACTORS

Modifying factors consist of demographic characteristics,

interpersonal influences, situational and behavioural factors.

Pender’s states that according to the “Health Promotion Model”

modifying factors exert their influence through the cognitive perceptual

mechanisms that directly affect the behavior.

 Modifying factors included in this study are teachers age, sex,

educational qualification, teaching experience, participation in inservice

education on child psychology, interpersonal influences like friends,

colleagues and self learning, situational factor like place of school rural

and urban, behavioural factor like knowledge on health, identification of

behavioural problems among adolescents.

PARTICIPATION IN HEALTH PROMOTION BEHAVIOUR

Cognitive perceptual factors constitute the exclusive sources of all

the connection between the modifying factors and participation in health

promoting behaviours.

CUES TO ACTION

It is the last part of the health promotion model and consist s of

activating cues on triggers that spark of health promotion activity such a

mass media, participation in inservice education, information from health

care personnel, discussion with friends and colleagues about behavioural

problems.
 Cognitive Perceptual Factors Modifying factor Participation in health pro motion
? Demographic characters of teachers behavio ur
Knowledge on selected ? The teacher will gain knowledge on
? Age
behavio ural problems of
? Sex behavioural problems and its
adolescents.
? Educational qualification management .
? Conduct disorder:- Juvenile ? Will be interested in attending in
? Teaching experience
delinquency, aggression. service education on child
? Interpersona l influences like friends,
? Emotional disorder :- Anxiety, psychology.
colleagues and self learning.
depression and suicide. ? Able to identify the student with
? Situational factors:- Place of
? Substance abuse:- Smoking, behavioural problems.
residence like rural and urban.
alcoholism, drug abuse. ? Refer the student to guidance &
? Behavio ural factors:- Knowledge on
? Perceived benefits:- counselling centre.
Acquiring adequate knowledge health, identification of behavioural
of school teachers regarding problems among adolescents.
behavioural problems of
adolescents.

Cues to action
? Mass media.
? Attending in service education on
child psychology.
? Receiving information from health
care personnel on behavioural
problems of adolescents.
? Discussion with friends, neighbours
family members, and colle agues.

FIG – 1.1: ADOPTED FROM MODIFIED PENDER’S HEALTH PROMOTION MODEL (1996)
 CHAPTER-II

REVIEW OF LITERATURE

A good research does not exist in vaccum. Research findings

should be an extension of previous knowledge and theory as well as guide

for research activity. In order for a researcher to build an existing work it

is essential to understand what is already known about a topic. A

thorough review of literature provides a foundation upon which to base

new knowledge.

A literature review involves the systematic identification, location,

scrutiny and summary of written material that contains information on

research problem. (Polit and Hungler, 2006)

Review of literature is a broad systematic and critical collection

and evaluation of important scholarly published literature as well as

unpublished materials. The review serves as an evidence and essential

background for any research. (B.T.Basavanthappa, 2004)

Review of literature is a critical summary of research on a topic of

interest generally prepared to put a research problem in context to

identify gaps and weaknesses in prior studies so as to justify a new

investigation. (Polit and Beck, 2004)

 Review of literature was done from published articles, textbooks

and report, present study the investigator was reviewed and organized the

related literature as the following section:

? Literature related to adolescents and selected behavioural

problems among adolescents.

? Studies related to selected behavioural problems among

adolescents.

LITERATURE RELATED TOADOLESCENTS AND SELECTED

BEHAVIOURAL PROBLEMS AMONG ADOLESCENTS

Adolescence is that it is a period between the ages of 10 and 15

years of bio -psychosocial maturation leading to functional independence

in adult life. (Russell Viner, 1998)

Adolescence is the period of recapitulation of the childhood

oedipal complex. (Freud)

Adolescence is a period of “stress and strain”, “storm and strife”.

They are particularly prone to mental health problems because of the

tension, frustration, confusion and feeling of insecurity. The common

mental ailments are mood disorders like anxiety, depression, suicide,

conduct disorder like violent and aggressive behaviours, these need

timely identification and intervention. (A. Parthasarathy, 2007)

 The struggle between identify and role confusion typified the

adolescent stage of development (Erickson)

Adolescence as the second decade of life from 10 to 20 years of

age but also defines a category of “youth” as being 10 -25 years. In India

there are more than 230 million adolescents which is approximately 23 %

of the total population. Recent research indicate that 27% young people,

17-19 years have mental health problems involving anxiety, substance

abuse disorder 15- 40% of adolescents suffers from anxiety and

depression. (Osqgrave, 2000)

School teachers plays an important role in improving the academic

performance of the child with psychological problems by modifying class

room behavior. Positive reinforcement is a stimulus or event which

increase s the childhood of a response when it terminates or ends

following response. (Prohbjot Malhi, 2002)

Teachers should be familiar with the basic principals governing

mental health and applying them will result not only in great personal and

professional satisfaction but also effective service to the budding human

resources. (Bernard, W.H, 2000)

Behavioural problems in adolescents may be manifested as a

disturbance in feelings eg. depression, anxiety, in behaviour eg. Conduct

disorder/disturbances aggressive behavior in performance. Dysfunctions

may involve any or all these areas. (Richer Dalton, 1997)

 Behavioural problems are common in childhood. It is defined that a

child has behavioural problems if behavior thoughts or feelings differ

quantitatively from the norm and as a result of this difference, the child is

either suffering or development is being significantly impaired. (David,

2000)

Behavioural problems are the reactions and clinical manifestations

which are resulting due to emotional disturbances or environmental

maladjustments. Conduct disorders is defined as repetitive, persistent,

aggressive conduct in which basic rights are violated. (K.P. Neeraja,

2008)

Conduct or antisocial problem is not uncommon in the course of

normal growth and development. Many children violate the rules and test

limits to varying degree in their way to trust in their environment.

(John Comely, 1994)

Conduct disorder as persistent, socially disapproved behavior that

often involves damage to others property and aggression towards oth er

people and is unresponsiveness to normal control or authority. (Robin,

1999)

Conduct disorder is defined as persistent antisocial behavior of

children and adolescents that significantly impairs their ability to function

in the social, academic or occupational area. (IAP, 2007)

 The causes of conduct disorders include genetic factors,

psychosocial factors like abused or neglected children, chaotic situations

eg. angry disruptive , demanding unable to progress, Neuro psychological

deficit and parental factors includes prenatal and perinatal complications,

parental antisocial personality stress, poor parental practices. Family

factors include broken family, large family size with lower socio-

economic status. Social problems like poverty, unemployment, poor

housing, organic factors like brain damage and neuro biological factors

like decreased production of noradrenaline. (K.P.Neeraja)

Juvenile delinquent who breaks th e law is a vagrant, persists in

disobeying orders, whose behaviours endangers his own moral life as

well as the moral life of other. (K.P. Neeraja, 2008)

Juvenile delinquency is a legal term for behavior of children and

adolescents that in adults would be judged criminal under law.

Aggression is one of the negative outcomes that may emerge from

general arousal and anger. (Kassinove and Tafrate, 2002)

Aggression is a behavior intended to threaten or injure the victim’s

security or self esteem. It means “to go against”, “to assault” or “to

attack.” It is a response that aims at inflicting pain or injury on objects or

persons. (Mary .C. Townsend, 2000)

Violent behavior may be assoc iated with hormonal dysfunction

caused cushing’s disease or hyperthyroidism. (Tardiff, 2003)

 Some research indicates that various neurotransmitters (eg.

Epinephrine, norepinephrine, dopamine, acetylcholine & serotonin) may

play a role in the facilitation and inhibition of aggressive impulses.

Most violent youth begin to exhibit their violent behaviours during

early adolescence. More mild forms of aggression such as bullying which

can involve verbal and physical aggression, peak during middle school

years. The peak age of onset for serious violence is 15 to 16 years for

boys and few years earlier for girls. (Nelson, 2006)

Emotional problems include grief, anxieties, anger and stress, rapid

physical, psychological, social and sexual changes during adolescence

may lead to stress. Strong emphasis placed on educational achievement

has put a lot of pressure on adolescents. This could cause headaches,

eyestrain difficulty in concentrating and sleep problems. (A.K.Dutta,

2007)

A change in student mood and behavior is a significant warning of

possible suicide. The students become depressed and withdrawn and

show disinterest in personal hygiene. These signs are followed by loss of

interest in studies often he or she stops attending classes and stay at home

most of the day. Usually the students communicate it to at least one or

other person, usually in the form of a suicide warning. Depression is most

common illness among adolescents which adversely affect mood, every

interest, sleep, appetite and overall functioning. Studies have reported that
up to 80 % adolescents in the United States suffer from depression

emerging early in life often recurs and continues into adulthood. There is

evidence that another study done in Tobago also revealed that among 203

adolescents aged 14 -18 years,10% were having depressive disorder and

4.04% had major depression. (Dr MKC Nair and Ranjankumar Pejarer,

2001)

He revised during their adolescent health care visits that 28% of

adolescents were seriously depressed and 12% reported having attempted

suicide. (Riggs & Cheng’s, 1998)

The signs &symptoms of major depression can be remembered

using the mnemonic. SIGECAPS.

S- Sleep disturbance (usually decreased, can be increased

I - Interests decreased for usual activities

G- Guilt excessive or inappropriate

E- Energy decreased

C- Concentration problems.

A - Appetite change usually decreased can be increased

P- Pleasure decreased

S - Suicidal thoughts or actions

Depressed children and adolescents may not be able to identify

their affective state. Depression can be indicated by “boredom”,

restlessness difficulty in concentrating, decreasing school performance,

preoccupation with somatic complaints (fatigue or vague or localized

pains), running away, fights with peers and other “acting out

behaviours”.(Nelson, 2006)

Treatment of depression includes pharmacological approaches like

antidepressants of various classes, the tricyclic antidepressants or

serotonin reuptake inhibitors and nonpharmacological treatment includes

individual psychotherapy or play therapies. (IAP, 2007)

Anxiety is a serious mood disorders which affects a person’s

ability to function in ever day activities. Anxiety is often a component

found within many other mental disorders as well as the most common

mental disorder that presents with anxiety and depression.

Anxiety is the most common problem that occurs in adolescents. It is

estimated that around 13% of young people had an anxiety in a year.

(Samilama & Vijaya lakshmi, 2006)

Risk factors of anxiety include genetics, temperamental disposition

for behavioural inhibition and social environment or life circumstances eg

parental distress or dysfunction or trauma especially during vulnerable

developmental periods eg. attachment or separation individuation.

Depression is estimated to affect 1% to 3% of school age children

the rate increases upto 17% by late adolescence 20% to 50% of

adolescents report significant, sub-syndromal levels of

depression.(Hankin, 2006)
 Suicide is an act of self destruction. Suicide is one of the

commonest causes of death among young people. Suicide is the sixth

leading cause of death among young people, aged 5-14 years and third

leading cause of death among all those 15-24 years old. An alarming

number of adolescents report thinking about suicide. In a national survey

of high school students in 1995, 24% said that they had thought seriously

about attempting suicide at some point,18 % indicating they had even

made specific plans. A significant organic contribution plays a role in

suicidal behaviour. It has been clearly established that victims of suicide

have diminished CNS serotonin concentration as compared with

nonsuicidal control dying under similar circumstances.(Christopher. H )

Health demands of young adulthood cannot be ignored since they

form an important part of the human resource of our country. Habits and

behaviours (food habits, substance abuse, conflict and emotional

management, sexual expression) picked up during adolescence have

lifelong impact. (Dutta, 2007)

Smoking is the inhalation of noxious fumes or irritating particulate

matter that may cause severe pulmonary damage. Tobacco use often

simply translated as cigarette smoking. Other forms include chewing and

snorting tobacco, with other substances, using nicotine in the cigars are

also called as smoking. (Michael H. Merson , 2001)

 Smoke is a lung irritant a person must learn how to inhale and must

adjust to the body’s natural rejection of this substance. Once inhaled, the

nicotine in tobacco is readily absorbed into the bloodstream and has an

almost immediate effect on the reward systems in the brain. Nicotine

mimics the neuron transmitter, acetyl chlorine receptors. Nicotine affects

the brain in much the same way as cocaine, opiates and amphetamines.

Nicotine not only stimulate s the release of dopamine, it also prolongs the

actions of dopamine by decreasing the metabolizing enzyme, monoamine

oxidize and increases the expression of nitric oxide, which inhibits

dopamine reuptake. So even more dopamine is available in the synapse.

All forms of cigarettes contain at least 10 mg of nicotine. By

inhaling smoke the average smoker takes in 1 to 2 mg of nicotine with

each cigarette. Most smokers among young adult s use tobacco regularly

because they are addicted to nicotine. Although nearly 35 million

smokers make a serious attempt to quit each yotar, less than 7% who try

to quit on their own stay abstinent for more than 1 year. (Lippinccott

Williams, 2000)

Globally, 300 million young people 18-25 years smoke. Half of

these who would smoke all their life are likely to die of tobacco related

diseases. Others will suffer from tobacco related disease and requires

extensiv e healthcare. The age at which smokin g begins is becoming

younger as 10 years old. The general population survey in India, reported

the use of tobacco or alcohol is 0.2 to 0.3% are children less than 15 years

of age 2.5 to 3.4% are in the age group of 18 -25 years. (Dutta , 2007)

Tobacco is dried leaves of the plant nicotiana tobaccum tobaccos

which belongs to family Solana cae and was discovered by Columbus.

Tobacco was originally a native plant of America but is now cultivated as

cash crop throughout the world. The leaves are either smoked as

cigarettes, beedi, pipes, cigars, snuffed or chewed as such in raw state or

mixed with lime (khaini ) or with pan and various proprietary products

like pan masala, guttcha. The women continue chewing tobacco due to

habituation, to get relief from anxiety and appetite. (Mukesh Yadav,

2001)

Tobacco consumer has belief that tobacco consumption helps in

relieving tooth ache and morning motions. Enjoyment 30.3% and

curiosity 26.1% were the two major factors that make the consumption of

tobacco amongst people. (Bartal. M, 2001)

Increasing tobacco consumption in the South East Asia region

particularly among young women. Consumption levels range between

55% and 80% among adult men and between 3% and 71% among adult

women. Millions of children, women and poorer section of our

communities are addicted to tobacco. (Uton Muchtar Rafei, 1999)

The long term use of nicotine not only imposers a financial burden

but also shortens the user’s life. Among the long term effects are the
potential for respiratory diseases chronic bronchitis, emphysema,

infections processes and cancer of the lung, larynx and or mouth , cancer

of the esophagus, throat, kidney, pancreas and bladder and cardio

vascular disease. (Marlow, 2003)

Pharmacologic therapies for cessation of smoking include nicotine

replacement, antagonist therapy, aversive therapy, nicotine mimicking

agents and non nicotine medication. Non pharmacologic therapies include

sensory replacement and acupuncture. To remain abstinent many patients

require counseling, psychotherapy and behavioural therapy. (Lippincott

Williams, 2003)

Avoidance of tobacco use, prop er oral hygiene by use of tooth

paste and brush, intake of sugar free diet and drinking of fluorinated

water are most important aspects to prevent dental carries due tobacco

consumption. Mechanical removal of plaques and debris by proper

brushing of teeth is effective. Dental examination and treatment must be

undertaken promptly and regularly. (Achar’s, 2000)

Alcohol is a substance commonly referred as ethyl alcohol.

Alcohol is also known as ethanol and sometimes abbreviated as “ETOH”.

Alcohol containing beverages include bear, wine and distilled spirits. The

alcohol content of a beverage is expressed as a proof is the concentration

of ethyl alcohol. Alcoholism is the use of alcoholic beverages that causes

any damage to the individual, society or both. (Marlow, 2006)

 A definite cause of alcoholism hasn’t been identified. Most experts

believe genetic biological, psychological and socio cultural influences are

involved. In genetic factors include identical twins have a higher risk than

fraternal twins. Children of alcoholics have a fourfold increased risk of

alcoholism. Other factors like biochemical abnormalities, nutritional

deficiencies, endocrine imbalances, and allergic responses may contribute

to alcoholism. Psychological factors include the urge to drink alcohol to

reduce anxiety or symptom of mental illness, the desire to avoid

responsibility in family social and low self esteem. (Lippincott Williams,

2004)

Alcohol can induce a general, nonselective, reversible depression

of the CNS. About 20 % of a sin gle dose of alcohol is absorbed directly

and immediately into the blood stream through the stomach wall. Unlike

other “ foods” it does not have to be digested. The blood carries it directly

to the brain where the alcohol acts on the brain’s central control areas,

slowing down or depressing brain activity. The 80 % of the alcohol in one

drink is processed only slightly more slowly through the upper intestinal

tract and into the blood stream. Only moments after alcohol is consumed,

it can be found in all tissues, organs and secretions of the body. Rapidity

of absorption is influenced by various factors. At low doses, alcohol

produces relaxation, loss of inhibitions, lack of concentrations,

drowsiness, slurred speech, and sleep chronic abuse results in multi-

system physiological impairments. (Mary. C. Townsend, 2000)

Acute or chronic abuse of alcohol (ethanol) is responsible for many

acts of vio lence, suicide, accidental injury and death. Alcohol drinking is

likely to begin in the middle school years, and increases with age. By 18

years of age 80 % to 90% of adolescents have tried alcohol. Ethanol is a

depressant that reduces inhibitions against aggressive and sexual acting

out. Severe physical and psychological symptoms accompany abrupt

withdrawal, and long term use leads to slow tissue destruction, especially

of the brain and liver cells. The most noticeable effects of alcohol occur

within the central nervous system and include changes in cognitive and

autonomic functions such as judgment, memory, learning ability and

other intellectual capacities. (Marilyn. J. Hockenberry, 2009)

The chronic effects of alcoholism are also highly complicated.

Chronic alcohol abuse may pro duce serious change to the bone marrow,

heart, liver, pancreas, stomach, intestines, reproductive tract and

neurological complications. Neurological complications include

Korsakoff’s syndrome and Wernicke’s encephalopathy. Long term and

excessive alcohol consumption is associated with an increase in the rates

of certain cancers, particularly esophageal and colonic. The social and

psychological effects of chronic alcohol abuse are wide spread and

profound. They include job loss, family disintegration, homelessness,

depression, ill health, violence, accidents and multiple concomitant

psychiatric disorders. (Lawrence. E. Frisch, 2006)

Alcohol intoxication symptoms include disinhibition of sexual or

aggressive impulses, mood liability, impaired judgment and impaired

social or occupational functioning, slurred speech, in co-ordination,

unsteady gait, nystagmus and flushed face. Intoxication usually occurs at

blood alcohol levels between 100 and 200 mg/dl. Death has been reported

at levels ranging from 400- 700 mg/dl. (Mary.C.Townsend, 2006)

A heavy drinker who stops drinking or abruptly reduces his alcohol

intake is likely to go through withdrawal. Symptoms begin shortly after

the drinking stops and last for up to 10 days. In itially the patient

experiences anorexia, nausea, anxiety, fever, insomnia, diaphoresis,

agitation, tremor progressing to severe tremulousness and possibly,

hallucinations and violent behavior. Major motor seizures (sometimes

called “rum fits”) may occur. (Lippincott William, 2004)

Diagnosis of alcoholism includes blood alcohol level of 0.10%

weight/ volume (200mg/dl) indicates alcohol intoxication. Others include

urine toxicology, serum electrolyte, blood urea nitrogen level, serum

glucose level, plasma ammonia level, liver function studies, hematology

studies, echocardiography and electrocardiograph also helps to evaluate

alcoholism. (Lippincott, 2002)

 Substance abuse as a maladaptive pattern of substance use

manifested by recurrent and significant adverse consequences related to

repeated use of the substance. Substance abuse has also been referred to

as any use of substances that poses significant hazards to health. (Mary.

C. Townsend, 2000)

Substance abuse is a global phenomenon that involves adolescents

and adults throughout the world with enormous physiological and

psychological complications. The onset of tobacco, alcohol and other

drug use generally occurs during adolescents. Many teenagers initially

experiment with these substances and later become

dependent.(Parthasarathy, 2007)

Substance abuse usually begins in adolescence. Few people begin

misuse of tobacco after 18 years of age .Half of regular smokers who start

in adolescence and smoke all their lives will eventually be killed by

tobacco. Alcohol is the commonest factor in substance related deaths

among the young adults. (Anupam Sachdeva, 2007)

Young people are often at the leading edge of social change and

this is particularly true in the case of substance abuse. The surge in illicit

drug usage during the last decade has been primarily a youth

phenomenon, with onset of use most likely occurring during adolescent

period. (Marlow, 2006)

 Substances have deleterious effects over the individual. Substance

abuse includes smoking, alcoholism and drug abuse. People will opt

substance abuse for varied reasons like tensions release, salvation of

problems, to fulfill their needs like to overcome anxiety, pressure or

fatigue, experimental use, recreational use or circumstantial phase. As

like smoking, and use of alcohol, drugs also abused by the young

pleasure, peer pressure and for experiment. (Neeraja, 2007)

The treatment measures for drug addiction include building trust,

provide basic living support, prevent or reduce negative behaviours and

in itiate a therapeutic process whenever the person is ready for it.

Detoxification program, counseling and psychotherapy,

pharmacotherapy, self help approach, continuing care and after care and

ancillary health and services.

STUDIES RELATED TO SELECTED BEHAVIOURAL

PROBLEMS

Bhasin. SK, et.al., (2010) conducted a study on depression, anxiety

and stress among adolescent students belonging to affluent families. The

main objectives of the study is depression, anxiety and stress (DAS)

among adolescent school students belonging to affluent families and the

factors associated with high level of (DAS).A to tal of 242 adolescents

th
students belonging to class 9-12 selected for the study. The result

shown that the scores in the three domains were found to be remarkably
correlated. It was seen that depression was significantly more among the

females (mean rank 132.5) than the males (mean rank 113.2), p=0.03.

Depression (p=0.025), anxiety (0.005) and stress (p<0.001) were all

significantly higher among the board classes i.e 10 th &12th as compared to

th
the classes 9th & 11 all the three (DAS) were found to be have an

inverse relationship with the academic performances of the students.

Schneeweiss. S, et.al., (2010) conducted a study to assess the risk

of suicide attempts and suicides after initiation of antidepressant

medication among children and adolescents. New users of antidepressants

who were 10 to 18 years of age with a recorded diagnosis of depression.

The findings of the study was 20,906 children who initiated

antidepressant therapy 16,774 (80%) had no previous antidepressant use.

During the first year of use 266 attempted and 3 completed suicide occur.

Which yielded an event rate of 27.04 suicidal acts per 1000 person years.

Can. G, et.al., (2009) conducted a study to determine the factors

contributing to regular smoking in adolescents in Turkey. The main

objectives of the study to determine the levels of lifetime cigarette use,

daily use, and current use among young people (aged 15 -19 years) and to

examine the risk factors contributing to regula r smoking. A total of 4666

students participated in the study. The data were gathered by using the

questionnaire method. The chi-square test and logistic regression analysis

were used in data analysis. The result shows that male students smoked
3.02 time (95% CI2.20-4.16) more than females. Those whose mothers

were smokers smoked 1.57 times (95% CI1.09-2.28) more than those

whose mothers were not, those whose friends were smokers smoked 2.42

times (95%CI1.73-3.39) more than those friends were not smokers ,poor

achievers in school smoked 2.62 times(95% CI1.97-3.49) more than high

achievers. The risk rising 1 .06 times 95% (11.01 -1.11) with earlier age at

first experimentation.

Johnson. JL, et.al., (2009) conducted a study to associations of

trying to lose weight, weight control behaviours and current cigarette use

among US high school students. The purpose of this study to describe the

association of current cigarette use with specific healthy and unhealthy

weight control practices among 9th-12 th grade stu dents. In this study youth

risk behavior survey data (2005) were analyzed. Behaviours included

current cigarette use trying to lose weight, and current use of 2 healthy

and 3 unhealthy behaviours to lose weight or to keep from gaining

weight, separate logistic regression models calculated adjusted odds ratio

(AORs) for association of current cigarette use with trying to lose weight

(model 1) and the 5 weight control behaviours, controlling for trying to

lose weight (model 2). Result shows that in model 1 compared with

students who were not trying to lose weight, students who were trying to

lose weight had higher odds of current cigarette use (AOR-

1.30,95CI:1.15-1.49) in model 2, the association of current cigarette use

with the 2 healthy weight control behaviours not statistically significant.

Each of the 3 unhealthy weight control practic es was significantly

associated with current cigarette use with AORS for each behavior

approximately 2 times as high among those who engaged in the behavior,

compared with those who did not.

Montoya. R, et.al., (2009) conducted a study to estimate

differences between perceived and reported drug use among university

students in Colombia. The total 427 students aged 18 to 24 years are

participated. The results suggest that students over estimate the use of

tobacco, marijuana and cocaine over the last 12 months. Alcohol use was

perceived accurately. Students who reported using those substances

during that period overestimated their peer’s drug use more than those

who did not use.

Nyamathi. AM, et.al., (2009) conducted a study cross section study

to correlates of heavy smoking among alcohol using methadone

maintenance clients in LOS Angeles area. This study examines predictors

of heavy smoking among 256 male and female methadone maintenance

therapy (MMT) client from five MMT clinics. The findings of this study

was women report lower rates of heavy smoking than men ( 47%Vs54%).

Park. HS, (2009) conducted a quasi-experimental study “to

evaluate the effects of a core competency support program on depression

and suicidal ideation for adolescents”. Participants for the study were
high school students, 27 in the experimental group and 29 in the control

group. Data were analyzed using the SPSS/WIN 14 program with X 12

test, t-test and ANCOVA. The study revealed that the participants in the

core competency support program reported decreased depression scores

and decreased suicidal ideation scores significantly different from those

in the control group. The result of the study was core competency support

program was effective in decreasing depression and suicidal ideation for

adolescents.

Welte J.W, et.al, (2009) conducted a study to assess the association

between problem gambling and conduct disorder among adolescents and

young adults in United States. The purpose of this analysis is to examine

the relationship between current problem gambling and current conduct

disorder. Data were analyzed for a U.S national survey of respondents

aged 14-21 years. The study results shows that a strong co-morbidity

between current problem gambling and current disorder was found.

Further analyses showed that early onset problem gamblers had a higher

risk for conduct disorder than late onset problem gamblers.

Wang. KY, & Yang. CC, ( 2009) conduc ted a study to investigate

the prevalence and predictors of smoking behaviour among military

university students in Taiwan. Author was used cross-sectional design

2,477 students were recruited from 7 universities across Taiwan.

Structured questionnaires were used to collect the data. The findings of

this study was the prevalence of smoking among students in Taiwan has

been recently reported as 5.7% of this number 12.8% started smoking

after enrollment in school and 33.3% became regular smokers.

William Andersen MK, et.al, (2009) conducted a study to examine

the onset of alcohol consumption among children and adolescents at

Danish. A total of 480 randomly chosen children and ado lescents

between 7 and 18 years of age. The study results suggest that age at onset

of alcohol consumption was 13.4 years for boys and 13.9 yearsfor girls

(p=0.020). There was a significant association between age at onset and

smoking of the adolescents (hazard ratio 2.19, 95% confidence interval

CI 1.16-4.12, p=0.015) and maternal smoking during pregnancy hazard

ratio 2.231 95% CI1.31-3.78, p=0.003.

Bor. W, et.al., (2008) conducted a study to identify early risk

factors for adolescents antisocial behavior. The total of 8000 participants.

The findings of the study were based on a series of logistic regression

models significant risk factors for adolescent antisocial behavior included

children’s prior problem behavior (i.e aggression and attention/

restlessness problems at age 5 years) and marital instability which

doubled or tripled the odds of antisocial behavior.

Cao. H, et.al., (2008) conducted a study to examine the prevalence

of emotional problems in Chinese children. The samples of 2,940

children aged 10 to 15 years were used. Child behaviour checklist and a

structured self rating questionnaire were administered. The result

indicated that the 12.5 % of boys and 8.3 % girls have emotional

problems.

Connor. DF, et.al., (2008) conducted a study to examine whether

Quetiapine is superior to placebo in the treatment of adolesce nts with

conduct disorder.9 youths were randomly assigned to receive Quetiapine

& 10 youths were randomly assigned to receive placebo. Patients were

assessed weekly throughout the trial. The study results shows that the

Quetiapine was superior to placebo on all clin ician. Assessed measures

and on the parent assessed quality of life rating scale.

Gibbs. A, et.al., (2008) conducted a study to evaluate the impact of

psychosocial interventions on children with disruptive and emotional

disorders in a health camp. A total of 157 consecutively referred children

with a range of emotional and behavioural problems were rated by

parents and teachers before and after their residential stay, using the

strengths and difficulties questionnaire. The study results sh ows

significant improvements in SDQ related emotional, conduct, hyperactive

and total problems.

Mastsuura, et.al., (2008) conducted a study to identify the children

with conduct or antisocial problems which was investigated by using

Rutter’s questionnaire in Japan, China and Korea. The study sample were

2638 children from Japan 2432 children from China and 1975 children
from Korea. The prevalence rate of antisocial problem among children

were 3.9 -12% in Japan, 8.3% in china & 14.1-19.1% in Korea.

Park. E, (2008) conducted a study to investigate the prevalence and

risk factors of suicide attempt among adolescents in South Korea. The

data of the 2006 youth health risk behavior web based survey collect by

the Korean center for disease control was analyzed using logistic

regression. The result shows that the prevalence of a suicide attempt was

5.2% in South Korea. The risk factors of a suicide attempt were suicidal

ideation (31.83), depression (7.98), drug use (4.67), currently smoking

(3.19), feeling unhappiness (2.77), stress (2.60), currently drinking

alcohol (2.39), sexual activity (2.33), living with neither parent (2.24),

in itial alcohol drinking by age 9(1.80), health status (2.15), skipped

breakfast (1.75), disease(1.65).

Young R. Sweeting, (2008) conducted a longitudin al study on

alcohol use and antisocial behavior in young people among 2586

samples. The exploration of the causal effects of alcohol use or misuse

and antisocial behaviour among young males, using a structural equation

models of longer and shorter term relationships and joint effects models

in respects of alcohol related trouble at age of above 15. The results

shows there is support the susceptibility hypothesis, particularly in the

longer term models. There in no support for pure disinhibition, antisocial

behavior causing alcohol (mis) use reverse also applies.

 Burke, (2007) conducted a study on in attention as a key predictor

of tobacco use in adolescence in Pittsburgh. This study was chort study

conducted among young adulthood. The results are no hyperactivity

impulsivity, significantly predicted adolescent tobacco use and young

adult daily uses the tobacco use and young adult daily uses the tobacco

use and young adult daily uses the tobacco. Peer substance use, parental

substance use and conduct disorder also predicted increases in tobacco

use.

Castilla. R, et.al., (2007) conducted a study to compare gender

symptoms of anxiety of the children who were exposed to the stress of

current civil war Colombia. A total of 399 school children aged 15 were

evaluated. Children and their parents were assessed with the screen for

child anxiety related emotional disorder. The result indicates among 911

children, 93(54.71%) boys & 20(81.7%) girls had anxiety. The result

reveals that the children who were exposed to dangerous and violent

situation in their environment had experienced higher levels of anxiety

symptoms which is particularly true of girls.

Check. K, et.al., (2007) conducted a cross sectional study estimate

the over all prevalence of emotional and behavioural deviance among the

school children in Johor Bhahau. Totally 589 children aged 10 - 12 years

were investigated through parental scales. The result indicates 40%

children from rural area and 30.2% children from urban area have

prevalence of emotional problems.

Maltena. G, et.al., ( 2007) conducted a study to investigate the

behavioural and emotional problems in children with intellectual

disability who are attending special schools in cape town, South Africa.

The samples of 355 children were used. A prevalence of 31% of

psychopathology was found through Rutter’s questionnaire.

Monuteaux, MC., et.al, (2007) conducted a longitudinal study on

predictors, clinical characteristics and outcome of conduct disorder in

girls with attention deficit hyperactivity disorder.5 year prospective

longitudinal study of girls with (n=140) and without (n=122)ADHD aged

6-18years. The result shows that the ADHD was significant risk factors

for lifetime CD throughout childhood and adolescence. Among ADHD

girls, childhood onset (<12 years) CD was predicted by parental

antisocial personality disorder (ASPD), while adolescent onset CD (12

years) was predicted by family conflict.

Sangamesh Nidagundi, (2007) conducted a descriptive study to

assess the knowledge of adolescents aged 16 and 19 years regarding

substance abuse among 100 students in Karnataka. The results of the

study was found that41.28%meanknowledgescoreforboysand39.46%

mean score for girls.

 Thomas. A, (2007) conducted a cohort study to describe the

national trends in lung cancer incidence among young adults and the

relationship to adolescent smoking. The result showed the lung cancer

incidence rate among women aged 40-44 in Norway continued to

increase into the most recent time inter 2005-2006, whereas the rate

among men and age d 40-44 was essentially constant after 2005.

Consequently lung cancer incidence rates converged among male and

female young adults. Lung cancer incidence rates at age 40-44 were

highly correlated with smoking prevalence at age 15 -19 in males (r=0.88)

and females(r = 0.82) within the same birth cohort. The lung cancer

incidence rate in young Norwegian women now equals that of men. The

risk of at age 40-44 was closely associated with teenage smoking,

indicating that duration and age of onset is important.

Everett. SA, et.al., (2006) conducted a study to investigate the

students perception of emotional problem is American public schools.

Totally 726 public school students from 15-18 years were participated.

Each student completed a self administered survey instrument under the

supervision of teacher. The result indicates that 7% of girls and 14 % of

boys had the emotional problems.

Niemela. SM, (2006) conducted a study to assess the association

between drunkenness frequency and adaptive functioning at turkey, a bout

2306 adolescents boys with 18 years old were investigated. Self report
questionnaire were used to study the demographic factors adaptive

functioning, risk behavior, life events and mental health service use. The

result reveals that 85% reported as drunkenness and most of the subjects

were occasionally drunk. Out of 85% of drunkenness 40% reported

drunkenness less than a month and 35% reported drunkenness at a

duration of less than once a week, while 10% reported being frequently

drunk once a week. They concluded that occasional drunkenness is a

normative alcohol use pattern and associates with social competence and

good psychosocial functioning.

Sirvant Ruiz, (2006) conducted a study on factors related to young

people’s attitudes to the consumption of alcohol and other psychoactive

substances among 775 young people. The results obtained confirm the

multicominal nature of these phenomena. The attitudes of young people

towards substance use was found to be more favourable the lower the

perception of risk, the more mistaken their beliefs and more permissive

their disposition to the use of alcohol and other illegal drug. Other

determining factors are their relationship with per groups that use drugs,

antisocial behaviours and attention seeking indications.

SUMMARY

This chapter views about the literature review, literature related to

behavioural problems such as conduct disorders, emotional disorder,

substance abuse and studies related to conduct disorders, emotional

disorder, substance abuse.

 CHAPTER-III

METHODOLOGY

INTRODUCTION

Methodology is a guide by the research to answer questions or test

hypothesis. (Paul T.Lasard, 2004)

Research methodology involves systemic procedure in which the

researcher starts from identification of problems to its final conclusion. It

is a way to solve the research problems systematically. (Polit and

Hungler, 2004)

A systematic method of spinning the problem of a research is

known as research methodology. (Sanjay Narula , 2007)

Research methods may be unde rstood as all those methods and

technique that are used for research conduction. Thus research techniques

and methods signify to the researchers use in performing research

operations. (Nancy Burns, 2004)

Selection of an appropriate design makes the researcher to address

critical issue to ensure that, the data produced by credible and

interpretable within the chosen perspective research design refers to the

researcher’s overall plan for obtaining answers to the research

questioning.
 This chapter deals with the methodological approach and it is a

wave to solve the research problem systematically. It includes,

? Research approach

? Research design

? Study setting

? Target population

? Sample

? Sampling technique

? Sample selection criteria

? Selection and development of instrument

? Content validity and reliability

? Pilot study

? Data collection procedure

? Plan for data analysis.

RESEARCH APPROACH

The research approach tells the researcher from where the data is to

be collected, what to collect and how to collect it and how to analyze

them. It also suggests possible conclusion and helps the researcher

answering specific research questions in the most accurate and efficient

way. (B.T Basavanthappa, 2008)

 The research approach adopted for this study is non-experimental

in nature. Surveys also collect information on people’s knowledge,

opinion, values and attitudes.

This study aims at assessing the knowledge of high school teachers

regarding selected behavioural problems among adolescents.

RESEARCH DESIGN

Research design is a blueprint for conducting a study that

maximizes control over factors that could interfere with the validity of the

findings. (Nancy Burns, 2005)

The term research design refers to the plan of scientific

investigations. Research design designates the logical manner in which

individuals or other units are compared and analyzed; it is the basis for

making interpretations from the data. (Arvindkumar, 2005)

Research design is the overall plan for addressing a research

question including specification for enhancing the study’s integrity.

Research design selected for this study was non-experimental descriptive

research design with the objectives of assessing the knowledge of high

school teachers regarding selected behavioural problems among

adolescents.
 FIG-3.1: SCHEMATIC REPRESENTATION OF RESEARCH DESIGN
ASSESSMENT
To assess the
POPULATION knowledge of high
High school teachers school teachers
working in Velasamy regarding selected
behaviour problems of
Chettiar Higher
adolescents
Secondary School at
Salem District. TOOL
DEMOGRAPHIC
Semi-structured
VARIABLE’S OF questionnaire on
TEACHERS knowledge regarding
? Age SAMPLE Identification of
causes, signs and learning needs
? Sex symptoms,
? Educational The high school
teachers who are management of
qualification selected behaviour
working in Velasamy
? Teaching problems of
experience Chettiar Higher
Secondary School and adolescents Information booklet
? Participation in on selected problems
teaching X, XI & XII
inservice education of adolescents
standard students were
selected for the study
STUDY SETTING

Study setting is the physical location and condition in which data

collection takes place. (Polit and Hungler, 2004)

Selection of the area for the study is one of the essential steps in

the research process. The selection of the school for the present study is

on the basis of

? Availability of subjects

? Feasibility of conducting the study

? Economic of time and money.

The present study was conduc ted in a Velasamy Chettiar Higher

Secondary School at Omalur, Salem District. The study conducted for 40

selected samples of high school teachers. Totally 95 teachers were

working in this school.

POPULATION

Population is defined as the entire aggregation of cases that meet a

designated set of criteria. (Polit and Hungler, 2004)

A population is a well defined set that has certain specific

properties. (B.T.Basavanthappa , 2006)

The target population for the present study was teachers teaching

X, XI &XII standard students in Velasamy Chettiar Higher Secondary

School at Omalur, Salem District.

SAMPLE AND SAMPLING TECHNIQUE

The sample is a subset of a population selected to participate in the

research study. (Nancy Burns, 2004)

The sampling technique is the process of selecting a portion of the

population to represent the entire population. (Polit & Beck, 2005)

The sample of this study is composed of 40 high school teachers of

Velasamy Chettiar Higher Secondary School and teaching X, XI & XII

standard students only.

Convenience sampling technique is used to select the 40 subjects

from the target population. The investigator conducted a survey in the

school to find out the total number of teachers who are teaching X, XI &

XII standard students.

Convenience sampling is a selection of the most readily available

Person’s as participants in a study.

CRITERIA FOR SELECTION OF SAMPLE

Inclusion Criteria :

? Teachers teaching the students from X, XI & XII standard.

? Teachers who gave consent for the study.

Exclusion Criteria:

? Teachers who are not teaching the students from X, XI & XII

standard.

? Teachers who are unwilling to participate in the study.

SELECTION AND DEVELOPMENT OF THE INSTRUMENT

SELECTION OF TOOL

The instrument selected for the study was a vehicle that would

obtain best data to draw conclusions pertinent to the study. (T reece &

Treece, 2004)

Semi structured questionnaire is prepared to assess the knowledge

of high school teachers regarding selected behavioural problems of

adolescents.

Semi structured questionnaire is considered to be the most

appropriate instrument to elicit the responses from the subjects.

DEVELOPMENT OF THE TOOL

Steps in the construction of the tool the following steps were

carried out in preparing the tool such as literature reviewed expert

opinion. This helped in the selection of the content for the development

of the tool.

DESCRIPTION OF THE TOOL

The semi structured questionnaire was organized in two parts; part

A and part B

Part-A

Part A consists of socio -demographic variables of teachers. This

part consist of questions including age, sex, educational qualification,

teaching experience, participation in inservice education programme

on child psychology and teachers understanding about behavioural

problems among adolescents.

Part –B

This part consists of questions related to knowledge of high school

teachers regarding selected behavioural problems of adolescents. Totally

52 questions and these distributed in 3 sections and total score for this

section was 216.

Section-I

It consists of totally 14 items related to knowledge of teachers

about conduct disorders such as juvenile delinquency, aggression. Total

score for this section was 58.

Section –II

It consists of totally 20 items related to knowledge of teachers

regarding emotional disorder such as anxiety, depression, suicide. Total

score for this section was 85.

Section –III

It consists of totally 18 items related to knowledge of teachers

regarding substance abuse such as smoking, alcoholism, drug abuse.

Total score for this section was 73.

Based on the scores the knowledge of teachers was divided into

three categories
 Below average -below 50% score

Average - 50 to70% score

Excellent - above 70% score

CONTENT VALIDITY

Content validity is concerned with the scope or range of items used

to measure the variables. (Rose Marie Nieswaiadomy, 1993)

Validity is the most important simple methodological criteria for

evaluating any measuring instrument. Validity refers to whether a

measurement instrument is accurately measures what it is supposed to

measure.

The experts in the field of pediatric nursing, psychiatric nursing

and medicine examined the relevancy and accuracy of the items. Based

on the expert’s opinion, items regarding the knowledge of teachers

related to conduct disorders were simplified. Finally the tool had 62

questions.

RELIABILITY

Reliability of research instrument is defined as the extent to which

the instrument yields the same results on repeated measures. (Polit &

Hungler, 2004)

The semi-structured questionnaire was tried out with 10 teachers.

The spearman Brown’s split half method was used to estimate the
reliability co-efficient and it found to be r=0.93, which indicates high

reliability.

PILOT STUDY

Pilot study is a small scale version or trial run for the major study.

(Polit & Hungler, 2004)

The function of this pilot study is to obtain information for

improving the project for assessing its feasibility.

After obtaining permission from the principal a pilot study was

conducted in Government Higher Secondary School, Ulagappampalayam

in month of July 2010. 10 teachers were selected for the pilot study and

administered semi-structured questionnaire. The teachers were co-

operated well and answered for all the questions.

DATA COLLECTION PROCEDURE

The data was collected during the month of November 2010 at

Omalur, Salem District.

The investigator personally visited the school and teachers were

selected based on the inclusive criteria. The purpose of questionnaire was

explained to the samples with self-introduction. The questionnaire was

distributed to the teachers in their own classes and they took 25-30

minutes to fill the answers for the questions and they were very

cooperative.
PLAN FOR DATA ANALYSIS

Data obtained were analyzed view of objectives of the study by

using descriptive and inferential statistics. The plan for data analysis was

as follows.

? Data were organized in master sheet.

? The frequencies and percentage of the analysis of socio-

demographic variables like age, sex, educational qualification,

teaching experience, participation in inservice education

programme on child psychology were analyzed and were presented

in tables and diagrams.

? Mean score, standard deviation, range and mean score percentage

for knowledge score on each behavioural problem among

adolescents in different areas such as conduct disorder, emotional

disorder, substance abuse and were analyzed and presented in

tables.

? Inferential statistics especially Chi-square test is used to assess the

relationship between the knowledge of teachers regarding sele cted

behavioural problems of adolescents and demographic variables.

The findings are expressed in tables, figures and graphs.

CONCLUSION

This chapter deals with research approach, research design, study

setting, sample and sampling techniques, development and description of

the tool, content validity and reliability , pilot study, data collection

procedure and plan for data analysis.

 CHAPTER-IV

DATA ANALYSIS, INTERPRETATION AND DISCUSSION

This chapter deals with the analysis and interpretation of the data

collected from forty teachers regarding their knowledge about the

behavioural problems among adolescents. Data analysis is a method for

rendering quantitative meaningful and intelligible information. (Polit and

Hungler, 2006)

The data collected through semi-structured questionnaire were

analyzed by using descriptive and inferential statistics which are

necessary to provide a substantive summary of results in relation to the

objectives.

OBJECTIVES ARE

1. To assess the knowledge of high school teacher regarding selected

behavioural problems among adolescents.

2. To determine the relationship between the knowledge of high school

teachers on behavioural problems with selected demographic variables

such as age, sex, educational qualification, teaching experience.

PRESENTATION OF DATA

The data is analyzed and presented in 3 sections,

Section-I:

Description of socio -demographic variables of high school

teachers in frequencies and percentage analysis.

Section-II:

Descriptive analysis of the kno wledge of teachers regarding

general information, causes, signs and symptoms and

management of conduct disorder, emotional disorder and

substance abuse among adolescents carried out through the

application of mean, standard deviation and mean

percentage.

Section-III:

Association of selected socio-demographic variables with

level of knowledge on behavioural problems among

adolescents analyzed through chi-square test.

 SECTION – I
Table & Figure - 4.1.1: Distribution of high school teachers by their
age
S. No Age No (40) Percentage
% (100)
1 <30 years 12 30
2 31-40 years 14 35
3 41-50 years 8 20
4 >50years 6 15
Total 40 100

60

50

40 35
Percentage (%)

30
30

20

20 15

10

0
< 30 yrs 31-40 yrs 41-50 yrs > 50 yrs

AGE

Among 40 teachers, the maximum numbers of teachers 14(35%)

from 31-40 years and12(30%)were below 30 years and 8(20%) were from

41-50 years and 6(15%) were from above 50 years.

Table & Figure - 4.1.2: Distribution of high school teachers by their
sex
S. Sex No(40) Percentage
No % (100)
1 Male 18 45
2 Female 22 55
Total 40 100

45

55

Male
Female

Out of 40 teachers 18(45%) were male teachers and 22(55 %) were

female teachers.
Table & Figure-4.1.3: Distribution of high school teachers by their
education.
S. No Education No (40) Percentage
% (100)
1 Degree with teacher training 0 0
2 Master degree with B.Ed 19 47.5
3 Master degree with M.Ed 17 42.5
4. Master degree with M.Phil 4 10
Total 40 100

50 47.5

42.5

40
Percentage(%)

30

20

10
10

0
Degree with Master degree Master degree Master Degree
teacher Training with B.Ed., with M.Ed., with M.Phil

EDUCATION

Out of 40 teachers 19(47.5%) of have master degree with B.Ed and

17(42.5%) had master degree with M.Ed and 4(10%) had master degree

with M.Phil.
Table & Figure -4.1.4: Distribution of high school teachers by year of
teaching experience.
S. No Teaching experience No(40) Percentage
% (100)
1 <5 years 14 35
2 6-10 years 10 25
3 11-15 years 6 15
4 16-20 years 4 10
5 >20years 6 15
Total 40 100

60

50

40
35
Percentage (%)

30 25

20 15 15

10
10

0
< 5 years 6-10 years 11-15 years 16-20 years > 20 years

TEACHING EXPERIENCES

Out of 40 teachers 14(35%) had below 5years of experience,

10(25%) had 6-10 years of experience, 6(15%) between 11-15 years of

experience and the rest 4(10%) had 16-20 years of experience, 6(15%)

had above20 years of experience.

Table & Figure -4.1.5: Distribution of high school teachers based on
their dealings with which standard of children.
S. No Standard of children No (40) Percentage
% (100)
1 X standard 12 30
2 XI standard 10 25
3 XII standard 18 45

Total 40 100

60

50
45

40
Percentage(%)

30
30 25

20

10

0
X standard XI standard XII standard

STANDARD OF CHILDREN

Out of 40 teachers 12(30%) of them dealings X standard

children,10(25%) of them dealings XI standard children, 18(45%) of

them dealings XII standard children.

Table & Figure -4.1.6: Distribution of high school teachers who had
child psychology in their curriculum.
S. No Child No (40) Percentage
Psychology % (100)
1 Yes 40 100
2 No 0 0
Total 40 100

100% Yes
No

All 40(100%) teachers have studied child psychology in their

curriculum.
Table & Figure -4.1.7 : Distribution of high school teachers who had
inservice education on child psychology.
Percentage
S. No Inservice education No (40)
% (100)
1 Yes 22 55
2 No 18 45
Total 40 100

45%

55%

Yes
No

More than half 22(55%) teachers had inservice training regarding

child psychology and 18(45%) did not have inservice training regarding

child psychology.
 SECTION-II

Assessing Knowledge on Behavioural Problems.

Table & Figure - 4.2.1: Knowledge of high school teachers on selected

behavioural problems among adolescents.
S. Behavioural Maximum Mean
Range Mean SD
No Problems Score Score
1 Conduct 58 19-37 21.17 2.94 37.14
disorders
2 Emotional
disorders 85 21-48 27.82 5.29 32.73
3 Substance
abuse 73 19-46 24.65 5.2 33.76
Over all Total 216 59-131 73.64 13.43 34.09

60

50

37.14
40
33.76
Percentage (%)

32.73

30

20

10

0
Conduct disorders Emotional disorders Substance abuse

BEHAVIOURAL PROBLEMS
 Table and figure 4.2.1 presents the knowledge score of teachers.

The mean score percentage of knowledge regarding conduct disorder is

37.14 %, emotional disorder is 32.73% and substance abuse is 33.76%.

The overall knowledge on behavioural problem through mean score

percentage is 34.09 %only. This shows knowledge of teachers regarding

behavioural problems among adolescents are below average.

All the selected teachers were studied the subject child psychology

in their curriculum. But the overall knowledge of the teachers on

behavioural problems were below average. Therefore, the investigator felt

that there was no significant correlation between their knowledge level

and their curriculum on child psychology.

Table & Figure-4.2.2: Distribution of teachers according to their
knowledge regarding conduct disorder.
S. No Areas Mean SD Mean score%
1 General information 7.03 3.06 39.05
2 Causes 7.55 3.53 37.75
3 Signs & symptoms 2.8 1.38 35
4 Management 3.8 1.43 34.54

39.05
40 37.75
35 34.54

30
Percentage (%)

20

10

0
General Causes Signs & Management
information Symptoms

KNOWLEDGE REGARDING CONDUCT DISORDER

Table and figure 4.2.2 presents the knowledge score of teachers

regarding conduct disorder in different areas such as general information,

causes, signs and symptoms and management. The mean score

percentage of teacher’s knowledge regarding conduct disorder in the area

of general information 39.05%,causes 37.75%, signs and symptoms

35%,management 34.54%.
Table & Figure-4.2.3: Distribution of teachers according to their
knowledge regarding emotional disorder.
S. Areas Mean SD Mean score%
No
1 General information 7.55 3.54 29.03
2 Causes 8.1 3.58 32.4
3 Signs & symptoms 7.68 2.69 34.90
4 Management 4.5 0.94 27.5

40
34.9
32.4
29.03 27.5
30
Percentage (%)

20

10

0
General Causes Signs & Management
information Symptoms

KNOWLEDGE REGARDING EMOTIONAL DISORDER

Table and figure 4.2.3 shows the knowle dge score of teachers

regarding emotional disorders in different area, such as general

information, causes, signs and symptoms and management. This shows

the mean score percentage of knowledge on emotional disorders in the

area of general information 29.03 , causes32.4% ,Signs and symptoms

34.90%, management 27.5%.

Table & Figure -4.2.4: Distribution of teachers according to their
knowledge regarding substance abuse
S. No Areas Mean SD Mean score%
1 General information 6.17 2.30 38.56
2 Causes 7.45 2.88 41.38
3 Signs & symptoms 5.8 2.69 23.20
4 Management 5.22 2.58 37.28

50

41.38
38.56
40 37.28
Percentage (%)

30
23.2

20

10

0
General Causes Signs & Management
information Symptoms

KNOWLEDGE REGARDING SUBSTANCE ABUSE

Table and figure 4.2.4 represents the knowledge score of teachers

regarding substance abuse in different areas such as general information,

causes, signs and symptoms, management. This shows the mean score of

teachers knowledge on substance abuse in the areas of general

information is 38.56%, causes is 41.38% signs and symptoms is 23.20%

and management is 37.28%.

 SECTION-III
ASSOCIATION OF SELECTED SOCIO DEMOGRAPHIC
VARIABLES WITH LEVEL OF KNOWLEDGE

Table 4.3.1 : Association between the knowledge on behavioural

problems with age of high school teachers.
Knowledge score
S. T. No < Avera ge >Average Chi-
Age
No (40) square
No % No %

1 < 40years 26 17 77.27 9 50

4.01*

2 >40 years 14 5 22.73 9 50

‘*’ - Significant at 5% level; (? 2 = 0.05; df = 1; table value =3.84)

The above table 4.3.1 displays the statistical outcomes of chi-

square analysis. It was worked out the statistical significance of

association between the knowledge on behavioural problems and age of

the high school teachers. The chi-square test shows that there is a

significant association of knowledge and age of the high school teachers.

Table-4.3.2: Association between the knowledge on behavioural
problems and sex of high school teachers.
Knowledge score
S. T. No < Average > Average Chi-
Sex
No (40) square
No % No %

1 Male 18 12 54.55 6 33.33

1.6NS

2 Female 22 10 45.45 12 66.67

‘NS’- Not significant at 5%level; (? 2 = 0.05; df = 1; table value =3.84)

Table 4.3.2 shows the statistical findings of association between

knowledge and sex of the high school teachers. The chi-square analysis

was employed to explicate the relation between these two entities and it

was found to be statistically not significant association between

knowledge and sex of the high school teachers.

Table-4.3.3: Association between the knowledge on behavioural
problems and education of the high school teachers.
Knowledge score
S. T. No < Average >Average Chi-
Education
No (40) square
No % No %

27.78
Master degree 14
1 19 63.64 5
with B.Ed

2 Master degree 17 8 36.36 9 50 8*

with M.Ed

Master degree
3 4 0 0 4
with M.Phil 22.22

2
‘*’- Significant at 5% level; (? – 0.05; df = 2 ; table value - 5.99)

Table 4.3.3 shows the statistical findings of association between

knowledge and educational qualification of high school teachers. The chi-

square analysis was employed to explicate the relation between these two

entities and it was found to be statistically significant at 5% level. It

implies that there is a significant association between knowledge and

educational qualification of the high school teachers.

Table-4.3.4: Association between the knowledge on behavioural
problems and teaching experience of the high school teachers.

Knowledge score
S. Teaching T. No < Average > Average Chi-
No experience (40) square
No % No %

1 < 15 years 30 21 95.45 9 50

10.91*

2 > 15 years 10 1 4.55 9 50

‘*’- Significant at 5% level; (? 20.05; df = 1; table value =3.84)

Table -4.3.4 shows the statistical findings of association between

knowledge and teaching experience of the high school teachers. The chi-

square analysis was employed to explicate the relation between these two

entities and it was found to be statistically significant at 5% level. It

implies that there is a significant association between knowledge and

teaching experience of the high school teachers.

Table-4.3.5: Association between the knowledge on behavioural
problems and deals with which standard of children.

Knowledge score
S. Standard of T. No < Average > Average Chi-
No children (40) square
No % No %

1 Category-1 12 7 31.82 5 27.78

0.06NS

2 Category-2 28 15 68.18 13 72.22

‘NS’ – Not significant at 5% level; (? 2 = 0.05; df = 1; table value =3.84)

Note :
Category 1: Deals with X standard
Category 2: Deals with XI & XII standard

Table -4.3.5 shows the statistical findings of association between

knowledge and deals with which standard of children. The chi-square

analysis was employed to explicate the relation between these two entities

and it was found to be not significant at 5% level. It implies that there is

no significant association between the knowledge and deals with which

standard of children.
Table-4.3.6: Association between the knowledge on behavioural
problems and high school teachers who had inservice educational
programme.
Knowledge score
S. Inservice T. No < Average > Average Chi-
No education (40) square
No % No %

1 Yes 22 6 27.27 16 88.89

15.19*

2 No 18 16 72.73 2 11.11

‘*’- Significant at 5% level; (? 2 = 0.05; df= 1; table value =3.84)

Table 4.3.7 gives the outcome of association between knowledge

and high school teachers who had inservice educational programme. The

chi-square analysis was worked out to bring out the relation between

these two entities and it was found to be statistically significant at 5%

level. It implies that there is a significant association between knowledge

and high school teachers who had inservice educational programme.

Table-4.3.7: Cumulative table showing the significance of social
demographic variables over the knowledge score
S. Socio-demographic Chi-square
P value Results
No variable value
1 Age 4.01 P<0.05 *
2 Sex 1.6 P>0.05 NS
3 Educational qualification 8 P<0.05 *
4 Teaching experience 10.91 P<0.05 *
5 Deals with which standard 0.06 P>0.05 NS
6 Inservice educational 15.19 P<0.05 *
programme

‘*’-Significant (P<0.05); ‘NS’-Not significant (P>0.05)

The cumulative outline of association between knowledge on

behavioural problem and socio-demographic variables of a high school

teachers under the study was given in the above table 4.3.8. Among the

socio-demographic variables for association with level of knowledge, the

four of these factors such as age, educational qualification, and teaching

experience, inservice education was found to be statistically significant,

others were not significant.

DISCUSSION

This study is focused on the knowledge of high school teachers

regarding selected behavioural problems among adolescents in a selected

high school at Salem District.

The discussion is described under the following headings

? Socio -demographic variables of high school teacher.

? Knowledge of high school teachers regarding selected behavioural

problems of adolescents.

? Association of knowledge of high school teachers regarding

behavioural problems with selected socio-demographic variables.

Socio -Demographic Variables of High School Teachers

? Among the study group maximum number 65% (26)of teachers

from the age group of below 40 years, and 35 %(14) of teachers

were in the age group of above 40 years.

? In this study group, 45% (18) of the teachers were males and

55% (22) were females.

? Among the study group, 47.5% (19) of teachers have master degree

with B.Ed and42.5% (17) of them have master degree with M.Ed

and 10% (4) of them have master degree with M.Phil.

? In this study 75% (30) of the teachers have below 15 years of

experience in teaching and 25%(10) of them have above 15years of

experience.
 ? In this study sample 30% (12) were deals with X standard and

70% (28) were deals with XI,XII standard.

? Another finding of the study is that 100% (40) of teachers had

child psycholo gy in their curriculum.

? Among the study sample 55% (22) of teachers were attended

inservice education on child psychology and 45% (18) of teachers

not attended inservice education on child psyc hology.

Knowledge o f High School Teachers with Selected Behavioural

Problems

Knowledge of high school teachers on selected behavioural

problems are divided into three categories.

Below average - below 50%

Average - 50% to 70%

Excellent - above 70%

Overall mean score percentage of knowledge of school teachers

regarding selected behavioural problems such as conduct disorder,

emotional disorder, substance abuse is below average (34.09%) level.

In the area of conduct disorders, the mean score percentage of

causes 37.75% ,general information is 39.05%,signs and symptoms is

35%,management is 34.54%.A study done by Svedam L., (1994) which

also indicate the teachers have fair knowledge (42.6%) about conduct

disorder. So, this study supports the findings of the present study.
 The mean score knowledge of teachers regarding emotional

disorder, general information 29.03%, causes32.4%, signs and symptoms

34.90%, management 27.5 %.

The mean score knowledge of substance abuse, general

information 38.56%,causes 41.38%,signs and symptoms23.20% and

management 37.28 %.

These results indicates that the teachers regarding below average

level of knowledge regarding behavioural problems among adolescen ts in

different areas such as general information, causes, signs and symptoms

and its management. So, they need more education in child psychology

inorder to effectively indentify and manage the students and made

modification of the student’s behavior.

Association of Knowledge with Selected Demographic Variables

The present study reveals knowledge of high school teachers

regarding selected behavioural problems among adolescents is not

influenced by the socio-demographic variables of teachers such as sex,

deals with which standard of children and have no significant association

with knowledge score of teachers. Age, teachers experience, education

and participation in inservice education program me have high significant

relationship with knowledge score that is found through chi-square

analysis. Balasubramaniyam (1988) study also indicated that teachers

experience in teaching have significant relationship with knowledge

score. So, the study supports the findings of the present study.

The study shows that the teachers need more education and

training on adolescent behavioural problem, behavior therapy to improve

their knowledge and help them to modify problematic children’s

behavior. This can be achieved by adding mental health information and

education on psychological aspect of adolescents by the help of health

and educational department.

CONCLUSION

This chapter dealt with analysis and interpretation of the data

collected from 40 teachers on behavioural problems of adolescents at

selected high school Salem District.

 CHAPTER-V

SUMMARY, FINDINGS, CONCLUSION, IMPLICATION AND

RECOMMENDATION

This chapter presents a brief account of the summary, major

findings, conclusion, implications and recommendations of the study.

SUMMARY OF THE STUDY

The primary aim of the study is to assess the knowledge of high

school teachers regarding selected behavioural problems among

adolescents in a selected high school at Salem district.

THE OBJECTIVES OF THE STUDY

1. To assess the knowledge of high school teachers regarding selected

behavioural problems among adolescents.

2. To determine the relationship between the knowledge of high school

teachers on behavioural problems with selected demographic variables

such as age, sex, educational qualification, teaching experience.

3. To prepare a health education pamphlet regarding selected behavioural

problems among adolescents.

Based on the literature reviewed and with the guidance from

various subject experts, the investigator developed the conceptual frame

work, methodology for the study and a data analysis plan , in a most

effective and efficient way. The conceptual frame work adopted for this

study is based on the Pender’s Health promotion model.

 In view of the nature of the problem selected for the study and the

objectives to be accomplished, descriptive survey was considered as

appropriate research approach for this study. The sample of the study

comprised of 40 high school teachers working in Velasamy Chettiar

Higher Secondary School, Omalur. The instrument used for the data

collection was a semi-structured technique. The data was collected in the

month of November 2010.

The knowledge of high school teachers regarding behavioural

problems of adolescents were assessed and compared with selected socio

demographic variables like age, sex, educational qualification, teaching

experience and attendance of inservice education on child psychology by

using descriptive as well as inferential statistics.

MAJOR FINDINGS OF THE STUDY

The major findings of the study are summarized as follows,

Findings related to sample characteristics

? Among 40 samples 26(65%) were below 40 years of age and

14(35%) were above 40 years.

? Among 40 subjects 18(45%) were male 22(55%) were female

teachers.

? 19(47.5%) teachers have master degree with B.Ed and 17(42.5%)

have master degree with M.Ed and 4(10%) of them have master

degree with M.Phil.

 ? Among 40 teachers 12(30%) were deals with X standard and

28(70%) were deals with XI & XII standard.

? Out of 40 samples, 30(75%) teachers have below 15 years of

experience and 10(25%) had above 15years of experience.

? All selected 40(100%) teachers had child psychology in their

curriculum.

? Among 40 teachers, 22(55%) of them have participated in the

inservice education on child psychology and 18(45%) of them not

participated in the inservice education on child psychology.

Findings related to knowledge score of teachers

? The overall knowledge score of teachers regarding conduct

disorder, emotional disorder, substance abuse were 34.09%.

? The mean score percentage of knowledge of teachers regarding

general information-39.05%, causes-37.75%, signs and symptoms-

35, and management-34.54%. The total mean score percentage of

teachers knowledge on conduct disorder is 37.14%.

? The mean score percentage of knowledge of teachers regarding

general information – 29.03%, causes-32.4%, signs and symptoms

-34.90% , and management-27.5%. The mean score perce ntage of

teachers knowledge on emotional disorder is about 32.73%.

 ? The mean score percentage of knowledge of teachers regarding

general information-38.56%, causes-41.38%, signs and symptoms -

23.20, and management- 37.28%.The total mean score percentage

of teacher’s knowledge on substance abuse is about 33.76%.

Findings regarding the relationship between the selected

demographic variables and knowledge level of teachers

The investigator tries to find out the relationship between the

knowledge of teachers with age, sex, educational qualification, deals with

which standard of children, teaching experience and participation of

inservice education on child psychology. The chi-square test was used to

determine the statistical significance of the mean score, it was found that

sex, deals with which standard of children are not significant, but age,

educational qualification, teaching experience, participation of inservice

education on child psychology was significant at 5% (P>0.05) level.

CONCLUSION

Overall knowledge of teachers regarding selected behavioural

problems were below average 34.09%. Since the present study revealed

that the socio-demographic variables such as sex, deals with which

standard of children had no influence, but age, educational qualification,

experience of the teachers and their participation in inservice education

regarding child psychology had influence on the knowledge score of the

high school teachers. So the health education during training on regarding

behavioural problems of adolescents were very much essential for

teachers to promote the adolescents behavior in a good manner. Health

personnels who working in schools should take the responsibility to

improve the knowle dge of teachers in the area of behavioural problems

among adolescents. The world will be brighter with well behaved

adolescents. So the teachers should give more importance to the

behavioural modification of the adolescents.

IMPLICATIONS

The findings of the study has implications in different branches of

nursing profession. i.e nursing service , nursing education, nursing

administration and nursing research. By assessing the knowledge of

teachers regarding behavioural problems, we get a clear picture regarding

different steps to be taken in all these fields to improve the knowledge of

teachers about behaviourl problems of adolescents.

Health Service

Today the nursing practice is concentrating on preventive aspect

than creative aspects, so the community health service has got an

important role to improve the health of mankind. As a pa rt of community

health services, school health service is an important aspect where the

nurse can work for a group of children and adolescents and will be able to

provide adequate service to them. For providing full time service to the

school children, adequate health personnel are not there in our country, so
the nurse should take help from school teachers, who are more respectful

than any other persons in the community. The community health nurse

should educate the teachers regarding selected behavioural problems

adolescents. So the teachers can improve their knowledge regarding

causes, signs and symptoms and management towards behavioural

problems among adolescents.

Participation in the regular school health programme will be

essential for the teachers to improve their understanding about

behavioural problems of adolescents.

Nursing Education

? In-service education, workshop, skill training for identifying

behavioural problems are some of the effective means of increasing

teachers participation in school health service.

? The curriculum of the teacher training course, should have the

content on behavioural problems among adolescents and that

should be implemented and reviewed periodically in order to

develop the necessary knowledge and skills required by the

teachers in the area of behavioural problems of adolescents.

? The information booklet on “Selected behavioral problems among

adolescents”, for self learning of teachers can be provided by the

Department of education. The booklet must have a pictorial

summary on behavioural problems in the areas of causes, signs and

 symptoms and management, so that the information communicated

will be meaningful and useful.

Nursing Administration

Nursing personal should be prepared to take a leadership role in

educating school teachers regarding behavioural problems among

adolescents. They should inculcate their interest in educating these

teachers during their school visits and disseminate information about

behavioural problems. Appointment of school health nurse in all the

schools were helpful to concentrate on the mental health care of

adolescents. Mental health services should include individual counseling,

personal guidance programmes or services, periodical screening of

behavioural problems and relaxation techniques.

Nursing Research

There should be more scope for research in this area to improve

teacher’s knowledge in early identification of behavioural problems

among adolescents. Health education pamphlets can be prepared to

improve teacher’s knowledge regarding behavioural problems. There is a

need for extensive research regarding counseling techniques, parenting

techniques, communication skill in order to improve teacher’s knowledge

and in turn help bringing favorable attitude regarding behavioural

problems of adolescents.
RECOMMENDATIONS BASED ON THE STUDY

10. A quasi-experimental study can be done to observe the effect of

programmed instruction on knowledge and skill of teachers in

school health programme.

11. A formal continuing education programme must be conducted in

all schools regarding selected behavioural problems among

adolescents, it’s identification and management.

12. A concentrated effort should be made by community health nurse

to increase awareness among high school teachers and their role in

the total school health services.

13. A comparative study may be conducted between rural and urban

teachers regarding the knowledge on behavioural problems of

adolescents.

14. A similar study may be done on nurses to find out their knowledge

and role perception about behavioural problems of adolescents.

15. A study can be conducted in the community to identify the

prevalence of behavioural problems among adolescents.

16. A similar study can be conducted to assess the knowledge of

parents regarding behavioural problems of adolescents.

17. The study can be replicated using a large sample there by findings

can be generalized to a large population.

 18. A study can be carried out to assess the knowledge , attitude of

teachers regarding emotional needs of adolescents.

SUMMARY

This chapter has dealt with summary, major findings of the study ,

conclusions, implication, and recommendations.

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 APPENDIX-A
LETTER SEEKING PERMISSION TO CONDUCT THE STUDY

From

MS.V.UDHAYAKUMARI

M.Sc.Nursing second year,

Vivekanandha College of Nursing

Elayampalayam.

To

THE PRINCIPAL,

Velasamy Chettiar Higher Secondary School,

Omalur,

Salem.

Sub: Letter seeking permission to conduct the study.

I Ms.V.UDHAYAKUMARI,M.Sc(N) year student (Child

Health Nursing),Vivekananadha College of Nursing, Elayampalayam

have undertaken a thesis on the topic “A STUDY TO ASSESS THE

KNOWLEDGE OF HIGH SCHOOL TEACHERS REGARDING

SELECTED BEHAVIOURAL PROBLEMS AMONG

ADOLESCENTS IN A SELECTED HIGH SCHOOL AT SALEM

DISTRICT.”
OBJECTIVES

1. To assess the knowledge of high school teachers regarding selected

behavioural problems of adolescents.

2. To determine the relationship between the knowledge of high

school teachers on selected behavioural problems with selected

demographic variables such as age, sex, educational qualification,

teaching experience.

3. To prepare health education pamphlet regarding selected

behavioural problems among adolescents.

I would request you to kindly grant me permission to conduct the

study in your school and also issue necessary to the teachers to extend

their co-operations to undertake my study successfully.

Thanking you,

Yours faithfully,

V.UDHAYAKUMARI

Place : Tiruchengode,

Date :
 APPENDIX –B

LETTER GRANTING PERMISSION TO CONDUCT STUDY

From
THE PRINCIPAL,
Velasamy Chettiar Higher Secondary School,
Omalur,
Salem District.

Subject: Permission to conduct the study in Velasamy

Chettiar Higher Secondary School, Omalur, Salem
District.

With reference to the above letter, it has been informed that,

Ms.V.UDHAYAKUMARI II year M.Sc(N) student, Vivekanandha
College of Nursing, Elayampalayam, granted permission to conduct her
study on “A study to assess the knowledge of high school teachers
regarding selectedbehavioural problems among adolescents in a selected
high school at Salem District.”
In this regard the school teachers have been directed to provide
full help and co-operation in facilitating the study.
With thanks,
Yours sincerely,

The Principal.
Place:
Date :
 APPENDIX-C

LETTER FOR VALIDATION OF THE TOOL

From
Ms.V.UDHAYAKUMARI,
IIYear M.Sc Nursing,
Vivekanandha College of Nursing,
Elayampalayam.

To

Respected Sir/Madam
Sub : Requisition for the content validation of the tool
I Ms.V.UDHAYAKUMARI II year M.Sc Nursing student of
Vivekanandha College of Nursing, Elayampalayam have taken a project
on “A STUDY TO ASSESS THE KNOWLEDGE OF HIGH
SCHOOL TEACHERS REGARDING SELECTED
BEHAVIOURAL PROBLEMS AMONG ADOLESCENTS IN A
SELECTED HIGH SCHOOL AT SALEM DISTRICT.”

OBJECTIVES OF THE STUDY

1. To assess the knowledge of high school teachers regarding selected
behavioural problems among adolescents.
2. To determine the relationship between the knowledge of high
school teachers on selected behavioural problems with selected
demographic variables such as age, sex, educational qualification,
teaching experience.
 3. To prepare health education pamphlets regarding selected
behavioural problems among adolescents.
To achieve the above mentioned objectives, I have prepared a semi-
structured questionnaire which consists of :
PART-A : Socio demographic data of teachers
PART-B :Knowledge related to selected behavioural problems
Section –I : knowledge related to conduct disorders
Section – II : knowledge related to emotional disorders
Section – III : knowledge related to substance abuse

I request you to kindly give your valuable opinion and suggestion.

Kindly sign the enclosed certificate of validation stating that you have
validated the tool.
Thanking you,
Yours faithfully,

V.UDHAYAKUMARI
Enclosures
1. Semi- structured questionnaire
2. Score –key
3. Evaluation Checklist
4. Certificate of validation
 APPENDIX-D

LETTER SEEKING PERMISSION FROM THE PARTICIPANTS

Dear Participants,

I am Ms.V.UDHAYAKUMARI, M.Sc., Nursing student of

Vivekanandha College of Nursing, Elayampalayam is interested to know

more about your knowledge on selected behavioural problems among

adolescents. The information which you are giving will be kept

confidential and will be used only for this study. Please participate in this

program by answering my questions honestly and state your willingness

to participate in this study.

Thanking you,

Name :

Signature :

CONSENT FROM THE PARTICIPANT

I understand the purpose of this study and I am willing to

participate in this study.

Signature
 APPENDIX –E
SEMI STRUCTURED QUESTIONNAIRE
PART-A : SOCIO –DEMOGRAPHIC DATA OF TEACHERS
CODE NO :
1. Age
1.1 < 30 years [ ]
1.2 31-40 years [ ]
1.3 41-50 years [ ]
1.4 > 50 years [ ]
2. Sex
2.1 Male [ ]
2.2 Female [ ]
3. Educational qualification
3.1 Degree with teacher training [ ]
3.2 Master degree with B.ED [ ]
3.3 Master degree with M.ED [ ]
3.4 Any other specify [ ]
4. Year of experience
4.1 1< 5 years [ ]
4.2 6-10 years [ ]
4.3 11-15 years [ ]
4.4 16-20 years [ ]
4.5 > 20 years [ ]
5 .Dealing which standard children?
5. 1 X standard children [ ]
5.2 XI standard children [ ]
5.3 XII standard children [ ]
6. Have you had child psychology in your curriculum?
6.1 Yes [ ]
6.2 No [ ]
7. Have you attended inservice education programme on behavioural
problems of adolescents ?
7.1 Yes [ ]
7.2 No [ ]
If yes how often?------------------------
8. Do you find any child having behavioural problems in your class?
8.1 Yes [ ]
8.2 No [ ]
If yes, state the problem?----------------------
9. Do you think teachers play an important role in identifying the
behavioural problems among adolescents?
9.1 Yes [ ]
9.2 No [ ]
10. Do you think moral education will mould the behaviour of the child?
10.1 yes [ ]
10.2 No [ ]
11. Whether curriculum change is necessary for the teachers to solve the
behavioural problems of children?
11.1 Yes [ ]
11.2 No [ ]
 PART-B
KNOWLEDGE RELATED TO SELECTED BEHAVIOURAL
PROBLEMS
SECTION-I
KNOWLEDGE RELATED TO CONDUCT DISORDERS
1. Which age you call it as adolescents?
1.1 10-13 years [ ]
1.2 14-16 years [ ]
1.3 17-19 years [ ]
2. What are the common behavioural disorders among adolescents?
2.1 Conduct disorder [ ]
2.2 Emotional disorder [ ]
2.3 Substance abuse [ ]
3. What are the common conduct disorder seen in adolescent?
3.1 Juvenile delinquency [ ]
3.2 Aggression [ ]
3.3 Stealing of other’s property [ ]
3.4 Run away from home and school [ ]
4. What are the causative factors for conduct disorder?
4.1 Genetic factors [ ]
4.2 Individual characteristics [ ]
4.3 Community or society influence [ ]
4.4 Family factors [ ]
4.5 Abusive, violence [ ]
4.6 Parental antisocial personality [ ]
5. What are the family factors cause conduct disorder?
5.1 Poor parent-child interpersonal relationship [ ]
5.2 Lack of father [ ]
5.3 Parental rejection [ ]
5.4 Lack of secure feeling [ ]
5.5 Large family size [ ]
5.6 Lack of love and affection [ ]
6. Which sex is mostly affected by conduct disorder?
6.1 Boys [ ]
6.2 Girls [ ]
6.3 Both sexes [ ]
7. What do you mean by delinquency?
7.1 Child who commits an offence [ ]
7.2 Destruction of property [ ]
7.3 Violence [ ]
7.4 Antisocial behaviour like committing
sexual offences. [ ]
8. Which age group children’s are called juvenile?
8.1 10-12 years [ ]
8.2 13-14 years [ ]
8.3 15-16 years [ ]
8.4 13-19 years [ ]
9. What are the causes of juvenile delinquency?
9.1 Poverty [ ]
9.2 Peer influence [ ]
9.3 Broken family [ ]
9.4 Financial problems [ ]
9.5 Lack of love and affection [ ]
9.6 Influence of mass media [ ]
9.7 Drug abuse include alcohol, smoking, drug abuse [ ]
10. What are the preventive measures of juvenile delinquency?
10.1 Training for parents to control the children [ ]
10.2 Healthy parent-child relationship [ ]
10.3 Improve the economic condition of the family [ ]
10.4 Counselling to the children [ ]
11. What do you mean by aggression?
11.1 Aggressiveness to people, animals [ ]
11.2 Destruction of property [ ]
11.3 Hitting, biting, kicking, fighting [ ]
11.4 Frequent conflict with peers [ ]
12. What are the causes of aggressive behaviour among adolescents?
12.1 Harsh discipline [ ]
12.2 Parental rejection [ ]
12.3 Severe punishment [ ]
12.4 Socially isolated children [ ]
13. How to identify the adolescent with aggressive behaviour?
13.1 Fighting with others [ ]
13.2 Use of nicknames [ ]
13.3 Spoiling of things [ ]
13.4 Disobedience [ ]
14. How to manage the adolescent with aggressive behaviour?
14.1 Special attention on child’s activities [ ]
14.2 Provide moral education [ ]
14.3 Make the child to mingle with other children [ ]
14.4 More love and affection [ ]
14.5 Social skill training [ ]
14.6 Positive reinforcement for appropriate behaviours [ ]
14.7 Anger control programme [ ]
 SECTION -II
KNOWLEDGE RELATED TO EMOTIONAL DISORDERS
15. What do you mean by emotional disorders?
15.1 Difficult to adjust with others [ ]
15.2 Lack of interest in doing work [ ]
15.3 Mistrust feeling [ ]
15.4 Felt bad on own self [ ]
16. What are the common emotional disorders seen in adolescents?
16.1 Anxiety [ ]
16.2 Depression [ ]
16.3 Suicide [ ]
17. Which sex is highly affected by emotional disorders?
17.1 Boys [ ]
17.2 Girls [ ]
17.3 Both sexes [ ]
18. What do you mean by anxiety?
18.1 Worrying [ ]
18.2 Stress [ ]
18.3 Fear [ ]
18.4 Deviation from normal feeling [ ]
19. What are the causes of anxiety?
19.1 Stress [ ]
19.2 Worrying about competence [ ]
19.3 Fear of school performance [ ]
19.4 Separation from home [ ]
19.5 Fear of teachers [ ]
20. What are the signs and symptoms of anxiety?
20.1 Fear of speaking in some situation [ ]
20.2 Excessive shy [ ]
20.3 Unpredictable panic attack [ ]
21. What are the physiological symptoms of anxiety?
21.1 Dryness of mouth [ ]
21.2 Cold & clammy hands and feet’s [ ]
21.3 Elevated blood pressure [ ]
21.4 Excessive sweating, shivering [ ]
22. How will you identify the child with anxiety?
22.1 Restlessness [ ]
22.2 Difficulty in concentration [ ]
22.3 Inability to perform the activities [ ]
22.4 Disturbed sleep [ ]
23. How will you manage the child with anxiety?
23.1 Provide emotional support to the child [ ]
23.2 Parental counseling and family therapy [ ]
23.3 Anti-anxiety drugs [ ]
23.4 Helping of the child to adopt coping ability [ ]
24. What do you mean by depression?
24.1 Loneliness [ ]
24.2 Lack of interest [ ]
24.3 Feeling of helplessness [ ]
24.4 Feeling of sad [ ]
24.5 Sense of hopelessness [ ]
24.6 Suicidal ideations [ ]
25. What are the causes of depression?
25.1 Stresses of academic achievements [ ]
25.2 Family history of depression [ ]
25.3 Lack of love and affection [ ]
25.4 Harsh parenting styles [ ]
25.5 Abuse or neglect [ ]
25.6 Physical or emotional trauma [ ]
25.7 Loss of parent and relationship [ ]
26. How to identify the adolescent with depression?
26.1 Lack of interest to do activities [ ]
26.2 Withdrawal from peer group and family [ ]
26.3 Low in academic performance [ ]
26.4 Tendency to be alone [ ]
26.5 Sleeplessness and weight loss [ ]
27. What are the measures to manage the adolescent with depression?
27.1 Relaxation technique [ ]
27.2 Family education [ ]
27.3 Counselling to the student [ ]
27.4 Antidepressant drugs. [ ]
28. What do you mean by suicide?
28.1 Act of self injury [ ]
28.2 One who kill himself [ ]
28.3 Act of self damage [ ]
29. What are the common methods of suicide?
29.1 Hanging [ ]
29.2 Ingestion of drugs [ ]
29.3 Firearms [ ]
29.4 Poisoning. [ ]
30. Which sex has high incidence for suicide?
30.1 Boys [ ]
30.2 Girls [ ]
30.3 Both sexes [ ]
31. What are the causes of suicide?
31.1 Feeling of rejection [ ]
31.2 Loss of one or both parents [ ]
31.3 Lack of success in academic or athletic
performance [ ]
31.4 Loss of friend [ ]
31.5 Depression [ ]
31.6 Financial problems of the family [ ]
31.7 Excessive stressful life events. [ ]
32. What are the risk factors for suicide?
32.1 Feeling of anxiety [ ]
32.2 Unmarried pregnancy [ ]
32.3 Drug abuse [ ]
32.4 Alcohol use [ ]
32.5 Fight with close friend [ ]
32.6 Shameful or humiliating experience [ ]
33. what are the warning signs of suicide?
33.1 Previous suicide attempt [ ]
33.2 Thoughts of wishing to kill self [ ]
33.3 Withdrawal from social activity [ ]
33.4 Poor concentration [ ]
33.5 Preoccupation with themes of death [ ]
33.6 Sudden change in school performance [ ]
34. What are the preventive measures of suicide?
34.1 Protective and safe environment [ ]
34.2 Ensuring adequate family support [ ]
34.3 Guidance and counselling to the individual [ ]
34.4 Family education [ ]

SECTION-III

KNOWLEDGE RELATED TO SUBSTANCE ABUSE

35. What is mean by substance abuse?
35.1 Use of any substance like alcohol,
nicotine frequently & regularly [ ]
35.2 Excessive use of substance [ ]
35.3 Use of alcohol, nicotine and certain drugs
against the medical and social norm [ ]
35.4 Improper use of substance [ ]
36. What are the common substances that can be abused?
36.1 Tobacco [ ]
36.2 Alcohol [ ]
36.3 Drugs (Amphetamines) [ ]
36.4 Narcotics [ ]
37. What is the commonest cause of abuse among adolescents?
37.1 Poverty [ ]
37.2 Availability of substances [ ]
37.3 Peer group pressure [ ]
37.4 Environment where the child lives [ ]
38. What are the signs and sy mptoms of substance abused person?
38.1 Impaired attention & concentration [ ]
38.2 Weight loss [ ]
38.3 Head ache [ ]
38.4 Lack of memory [ ]
38.5 Euphoria [ ]
38.6 Lack of energy and motivation [ ]
39. What is mean by alcoholism?
39.1 Drinking alcohol excessively [ ]
39.2 Drinking alcohol daily or regularly [ ]
39.3 Drinking alcohol frequently [ ]
40. What are the causes of alcoholism?
40.1 Parental alcoholism [ ]
40.2 Peer group influence [ ]
40.3 Stressful life events [ ]
40.4 Easy availability of alcohol [ ]
40.5 Influence of mass media [ ]
41. What are the signs and symptoms of alcoholism?
41.1 Increased pulse, blood pressure, temperature [ ]
41.2 Loss of self control [ ]
41.3 Nausea and vomiting [ ]
41.4 Insomnia [ ]
41.5 Sweating [ ]
42. What are the measures to treat alcoholism?
42.1 Group therapy [ ]
42.2 Behaviour therapy [ ]
42.3 Disulfiram drug therapy [ ]
42.4 Counselling to the individual [ ]
43. Which are the factors contributing to tobacco use among adolescents?
43.1 Peer pressure [ ]
43.2 Imitation of adult behaviour [ ]
43.3 Advertisements [ ]
43.4 Feeling of insecurity [ ]
44. What are the problems that arise due to cigarette smoking?
44.1 Lung cancer [ ]
44.2 Oral cancer [ ]
44.3 Emphysema [ ]
44.4 Laryngeal carcinoma [ ]
44.5 Foul smelling breath [ ]
44.6 Periodontal disease [ ]
45. What is the drug used for smoking?
45.1 Caffeine [ ]
45.2 Nicotine [ ]
45.3 Sedatives [ ]
45.4 Analgesics [ ]
46. What are the management of tobacco smoking?
46.1 Youth to youth programs [ ]
46.2 Individual counselling [ ]
46.3 Health education [ ]
46.4 Aversion therapy [ ]
47. Which are the drugs commonly abused by adolescents?
47.1 Cocaine [ ]
47.2 Opiates [ ]
47.3 Cannabis [ ]
47.4 Sedatives [ ]
48. What are the causes of drug abuse?
48.1 Curiosity [ ]
48.2 Lack of parental control [ ]
48.3 Parental rejection [ ]
48.4 Depression [ ]
48.5 Antisocial behavior [ ]
49. What are the physical changes occur in drug abuse adolescents?
49.1 Unexplained weight loss [ ]
49.2 Slurring speech [ ]
49.3 Redness of the eyes [ ]
49.4 Hoarseness of voice. [ ]
50. What are the academic changes seen in drug abuse adolescents?
50.1 Short term memory [ ]
50.2 Conflict with teachers [ ]
50.3 Falling grades [ ]
50.4 Refuse to go to school [ ]
51. What are the measures available to treat the adolescent with drug
abuse?
51.1 Guidance & counselling to the individual [ ]
51.2 Good communication with family [ ]
51.3 Encourage parental support [ ]
52. What are the suggested measures to avoid behavioural problems
among adolescents?
52.1 Self examination [ ]
52.2 Individual teaching [ ]
52.3 Constant supervision [ ]
 SCORE KEY
Q.NO CORRECT RESPONCE SCORE

1 1.1,1.2,1.3 3
2 2.1,2.2,2.3 3
3 3.1,3.2,3.3,3.4 4
4 4.1,4.2,4.3,4.4,4.5,4.6 6
5 5.1,5.2,5.3,5.4,5.5,5.6 6
6 6.1 1
7 7.1,7.2,7.3,7.4 4
8 8.4 1
9 9.1,9.2,9.3,9.4,9.5,9.6,9.7 7
10 10.1,10.2,10.3,10.4 4
11 11.1,11.2,11.3,11.4 4
12 12.1,12.2,12.3,12.4 4
13 13.1,13.2,13.3,13.4 4
14 13.1,13.2,13.3,13.4,13.5,13.6,13.7 7
15 15.1,15.2,15.3,15.4 4
16 16.1,16.2,16.3 3
17 17.2 1
18 18.1,18.2,18.3,18.4 4
19 19.1,19.2,19.3,19.4,19.5 5
20 20.1,20.2,20.3 3
21 21.1,21.2,21.3,21.4 4
22 22.1,22.2,22.3,22.4 4
23 23.1,23.2,23.3,23.4 4
24 24.1,24.2,24.3,24.4,24.5,24.6 6
25 25.1,25.2,25.3,25.4,25.5,25.6,25.7 7
26 26.1,26.2,26.3,26.4,26.5 5
27 27.1,27.2,27.3,27.4 4
28 28.1,28.1,28.3 3
29 29.1,29.2,29.3,29.4 4
30 30.1 1
31 31.1,31.2,31.3,31.4,31.5,31.6,31.7 7
32 32.1,32.2,32.3,32.4,32.5,32.6 6
33 33.1,33.2,33.3,33.4,33.5,33.6 6
34 34.1,34.2,34.3,34.4 4
35 35.1,35.2,35.3,35.3,35.4 4
36 36.1,36.2,36.3,36.4 4
37 37.1,37.2,37.3,37.4 4
38 38.1,38.2,38.3,38.4,38.5,38.6 6
39 39.1,39.2,39.3 3
40 40.1,40.2,40.3,40.4,40.5 5
41 41.1,41.2,41.3,41.4,41.5 5
42 42.1,42.2,42.3,42.4 4
43 43.1,43.2,43.3,43.4 4
44 44.1,44.2,44.3,44.4,44.5,44.6 6
45 45.2 1
46 46.1,46.2,46.3,46.4 4
47 47.1,47.2,47.3,47.4 4
48 48.1,48.2,49.3,48.4,48.5 5
49 49.1,49.2,49.3,49.4 4
50 50.2,50.2,50.3,50.4 4
51 51.1,51.2,51.3 3
52 52.1,52.2,52.3 3
TOTAL 216
 APPENDIX-F
EVALUTION CRITERIA CHECKLIST FOR VALIDATION OF
THE TOOL
Instruction
The expert is required to go through the tool and the content and
give your opinion in the column given in the criteria table. If the tool is
not meeting the criteria please give your valuable suggestion in the
remarks column.
S.NO CRITERIA YES NO REMARKS

1. Demographic variables
The items on base line data
cover all aspects necessary for
the study.
2. Semi structured
questionnaire on knowledge
on behavioural problems
? Relevant to the topics of
the study
? Content organization
? Language is simple and
easy to understand
? Clarity of items used
? Any other suggestions
 APPENDIX –G
CERTIFICATION OF VALIDATION

This is to certify that

Tool – Semi – Structured Questionnaire
PART-A : Socio demographic data of teachers
PART- B : Knowledge related to selected behavioural problems
Section –I : Knowledge related to conduct disorder
Section – II : knowledge related to emotional disorders
Section – III : Knowledge related to substance abuse.

Prepared by MISS. V.UDHAYAKUMARI, II year M.Sc nursing

student of Vivekanandha College of Nursing to be used in her study title
“ A STUDY TO ASSESS THE KNOWLEDGE OF HIGH SCHOOL
TEACHERS REGARDING SELECTED BEHAVIOURAL
PROBLEMS AMONG ADOLESCENTS IN A SELECTED HIGH
SCHOOL AT SALEM DISTRICT” has been validated by me.

Signature

Name :

Designation :

Date :
 APPENDIX –H
HEALTH EDUCATION PAMPHLET

BEHAVIOURAL PROBLEMS AMONG ADOLESCENTS

ADOLESCENTS
Meaning
The term adolescents is derived from Latin
word “Adolescere” meaning “to change”, “to
grow”, “to mature.”
Adolescent period is defined by the WHO, as age group between
10 and 19 years of age. This can be divided into early (10 -13years),
middle (14-16 year), late (17-19years) adolescents.
“Adolescents is a period of transition from childhood to
adulthood.” During this period, maximum amount of physical,
psychological and behavioural changes takes place.

BEHAVIOURAL PROBLEMS
Meaning
Behavioural problems are thoughts or feeling or behavior
differences the child is either suffering significantly or development in
being significantly impaired.
BEHAVIOURAL PROBLEMS AMONG ADOLESCENTS
INCLUDE
Conduct Disorder
? Juvenile delinquency
? Aggression
Emotional Disorder
? Anxiety
? Depression
? Suicide
Substance Abuse
? Smoking
? Alcoholism
? Drug abuse
CONDUCT DISORDER
Meanin g
Conduct disorder are characterized by a persistent and significant
pattern of conduct in which the basic rights of others are violated or rules
of society are not followed.
JUVENILE DELINQUENCY
Meaning
? A juvenile delinquent is a person between the ages of 15-17, who
indulges in anti-social activity.
? Antisocial activity includes
? Destruction of other’s property
? Stealing
? Run away from the home
? Vandalism
Causes
? Genetic factor
? Family factors like large family size, parental
rejection, lack of father.
? Drug abu se include alcohol, smoking and
drugs
 ? Poor economy
PREVENTIVE MEASURES
? Improvement of life
? Social welfare services
? Juvenile institutions and training schools
? Behavior therapy
AGGRESSION
Meaning
? It is destructive, injurious, hostile and often
caused by frustration
Causes
? Genetic factors
? Feeling of anger
? Frustration
? Biochemical factors like increased level of testosterone
Management
? Provide emotional support to the child
? Parental counseling and family therapy
? Social skill training
? Positive reinforcement fo r appropriate behaviours
? Anger control program
EMOTIONAL DISORDERS OR MOOD DISORDERS
Meaning
? Mood disorder are disturbances in the regulation of mood, behavior
and affect that go beyond the normal fluctuations that most people
experience.
The most common mood disorders includes
? Anxiety
? Depression
? Suicide
ANXIETY
Meaning
? Anxiety is an emotional response
(apprehension, tension, uneasiness) to
anticipation of danger, the source of which
is unknown or unrecongnized.
Causes
? Separation from home
? Difficulty in attending of school
? Fear to go to school
? Stress
? Fear of teachers
Symptoms of Anxiety
? Fear of speaking in the common places
? Refuse to go to school
? Unable answer
? Dryness of mouth
? Cold and clammy hands and feets
? Disturbed sleep.
Management
? Counseling to the individual
? Consultation with teachers and parents
? Helping the child to adopt coping ability
? Anti-anxiety drug
DEPRESSION
Meaning
? It is a syndrome of persistently sad or
irritable mood accompanied by disturbances
in sleep and appetite, lethargy and inability
to experience pleasure.
Causes of Depression
? Family history of depression
? Harsh parenting styles
? Loss of parents and relationship
? Excessive stress
? Lack of love and affection
Symptoms of Depression
? Lack of interest to do activities
? Withdrawal from peer group and family
? Low in academic performance
? Tendency to be alone
Management
? Relaxation technique
? Family education
? Counseling to the student
? Antidepressant drugs.
SUICIDE
Meaning
? Suicide is a purposeful taking of one’s own life or act of
self destruction.
Common Methods of Suicide
? Hanging
? Ingestion of drugs
? Fire arms
? Poisoning

Causes
? History of previous attempts of suicide
? Excessive stressful life events
? Financial problems of the family
? Loss of one or both parents
? Depression
Warning Signs of Suicide
? Preoccupation with themes of death
? Withdrawl from social activity
? Sudden changes in school performance
? Poor concentration
? Thoughts of wishing to kill self.
Preventive Measures of Suicide
? Protective and safe environment
? Ensuring adequate family support
? Guidance and counseling to the individual
? Family education
SUBSTANCE ABUSE
Meaning
? Substance abuse refers to maladaptive pattern of substance use that
impairs the health.
? Substance abuse is the repeated use of alcohol or other
psychoactive drugs that leads to problems.
Common Substance Abuse Among Adolescents Includes
? Smoking
? Alcoholism
? Drug abuse

SMOKING
Meaning
? Nicotine is the alkaloid in tobacco that causes dependence and is
the most rapidly addicting drug.
Causes of Smoking
? Peer pressure
? Imitation of adult behavior.
? Advertisements
? Feeling of insecurity
? Availability of cigarettes
Effects of Smoking
? Lung cancer
? Laryngeal carcinoma
? Foul smelling breath
 ? Periodontal disease
? Oral cancer
? Emphysema.
Management of Smoking
? Youth to youth programmes
? Individual counseling
? Health education
? Aversion therapy
ALCOHOLISM
Meaning
? Alcohol (ethanol) is a CNS depressant that
reduces the activity of neurons in the brain.
Causes
? Parental alcoholism
? Peer group influence
? Stressful life events
? Easy availa bility of alcohol
? Influence of mass media
Symptoms
? Loss of self control
? Nausea and vomiting
? Lack of sleep
? Loss of appetite
? Sweating
? Weakness in feet and legs
? Chills and trembling
Management o f Alcoholism
? Group therapy
? Behavioural therapy
? Family therapy
? Aversive therapy
? Disulfiram therapy
DRUG ABUSE
Meaning
? Drug abuse is taking a drug for other than medical reasons and
increased frequency, dose or manner that damages the physical or
mental functioning.
Causes
? Curiosity
? Lack of parental control
? Parental rejection
? Depression
? Antisocial behavior
? Poor self image.
Symptoms
? Slurring of speech
? Unexplained weight loss
? Redness of the eyes
? Hoarseness of voice
? Short term memory
? Poor judgement
? Falling grades
Management
? Guidance and counseling to the individual.
? Good communication with family
? Encourage parental support
? School based health clinics
? Bring up healthy home environments
CONCLUSION
The health education booklet was prepared in the aspects of
meaning, causes, signs and symptoms and management of behavioural
problems among adolescents. This will help the teachers to identification
and management the normal children with behavioural problems and
modify their behavior in a healthy manner.