INTRODUCTION:

Dementia is defined by a loss of previous levels of cognitive, executive and memory function in a state of full alertness¹. As standards of living improve across the globe, people are living longer, and the world’s population is aging rapidly. Although the proportions of people age 60 or more years are smaller in the “developing” countries than in the “developed” countries, the stress numbers of older adults will by 2020 be much larger in the low and middle income countries of the world than in the attluent countries. Thus, depression and dementia will soon become major public health problems in countries such as India².Prevention of dementia is the attempt to avoid developing dementia. Although no cure for dementia is available, there are many ways to decrease the risk of acquiring dementia in the first place, including both lifestyle changes and medication³. Alzheimer’s disease International stated that now there are an estimated 35.6 million people with dementia world wide. By 2050’it is projected that this figure will have increased to over 115 million. Much of the increase will be in developing countries. Already 58% of people with dementia live in developing countries, but by 2050 this will rise to 71%. The fastest growth in the elderly population is taking place in china, India, and their south Asian and western pacific neighbours⁴. A new case of dementia arises every seven seconds, with the number of people with dementia set to double every 20 years. The report comes nearly 100 years after the first identification of Alzheimer’s disease and estimates that 24.3 million people currently have dementia worldwide. In Scotland 63,000 people have dementia and this is expected to rise to 137,059 by 2040^5. The number of people attached is set to double every 20 years with 42.3 million living with dementia in 2020 and 81.1 million living with dementia by 2040^6. Alzheimer’s disease is mostly seen in older people but very occasionally it develops in middle age, occasionally in the 30’s (about 10% of all Alzheimer’s cases). People over the age of 65 are most frequently affected. The incidence of Alzheimer’s disease increases with age and by the age of 85 years nearly half of all people are affected by the disease⁷.

OBJECTIVES OF THE STUDY:

1. To assess the level of knowledge and regarding Alzheimer’s dementia among adults.

2. To assess the level of attitude regarding Alzheimer dementia among adults.

3. To find the correlation between knowledge and attitude score of adults regarding Alzheimer’s dementia.

4. To find the association between level of knowledge regarding Alzheimer’s dementia among adults with their selected demographic variables.

5. To find the association between level of attitude regarding Alzheimer’s dementia among adults with their selected demographic variables.

HYPOTHESES:

H₁ There will be a significant correlation between knowledge and attitude scores of adults regarding Alzheimer’s dementia.

H₂ There will be a significant association between knowledge scores regarding Alzheimer’s dementia among adults with their selected demographic variables.

H₃ There will be a significant association between attitude scores regarding Alzheimer’s dementia among adults with their selected demographic variables.

MATERIALS AND METHODS:

The research design was non experimental descriptive survey design, to assess the knowledge and attitude of Alzheimer’s dementia among adults. Sample for this study is adults who are in the age group of 30-60 years.

Criteria for sample selection:

a). Inclusion Crieria

· Both male and female.

· Adults who are available during the data collection period.

b). Exclusion Criteria

· Adults who are sick.

· Adults who are having hearing impairments.

Instrument and scoring procedure:

A). Description of The Tool:

The instrument consist of three parts

PART I

It consists of demographic variable such as age, sex, marital status, and religion, Type of the family, education, monthly income, occupation, and health information resources.

PART II

It consists of structured interview schedule includes 25 multiple choice questions on knowledge which includes definition, causes, signs and symptoms, management, prevention and complication regarding Alzheimer’s dementia.

PART III

It consist of five point Likert scale which consist of 15 statements to assess the attitude regarding Alzheimer’s dementia with five responses which includes 11 positive and 4 negative statements.

B). Scoring Procedure:

PART II

The Structured interview schedule consists of 25 multiple choice questions on knowledge which includes definition, causes, signs and symptoms, management, prevention and complication scored such as 3,4,3,6,8and 1 respectively. Each question has got four options. Each right answer was scored 1 and each wrong answer was scored 0. Total score is 25. The scores were interpreted as follows

Table 1:

Level of Knowledge

Score

Percentage %

Inadequate

Moderately adequate

Adequate

0-8

9-16

17-25

0-33

34-66

67-100

PART III

The five point likert scale consists of 15 statements. Each has 5 responses such as strongly agree, agree, uncertain, disagree and strongly disagree.

The scores were measured as follows

Table 2:

Response

Positive scoring

Negative scoring

Strongly agree

Agree

Uncertain

Disagree

Strongly disagree

Table 3:

Level of attitude

Score

Percentage %

Unfavorable

Moderately favorable

Favorable

0-25

26-50

51-75

0-33

34-66

67-100

VALIDITY AND RELIABILITY:

VALIDITY:

The validity of the tool was established in consultation with guide and 4 experts in the field of psychiatric nursing and one expert in psychiatry medicine.

RELIABILITY:

The reliability of the structured interview schedule was established by testing for stability and internal consistency. Stability was assessed by test retest method where Karl Pearson correlation of coefficient formula was used. The value was found to be reliable (r=0.9). Internal consistency was assessed by split half method where spearman’s brown prophecy was used. The value was found to be reliable(R=0.9). Hence the structured interview schedule was found to be reliable.1

ii) 5 point Likert scale:

The reliability of the five-point Likert scale was established by testing for stability and internal consistency. Stability was assessed by test retest method; Karl Pearson formula was used. The value was found to be reliable (r=0.9). The internal consistency was assessed by Cronbach’s alpha method. The value was found to be reliable(r=0.8).

DATA COLLECTION PROCEDURE:

The data was collected for a period of 5 weeks from 100 samples. Before conducting the study written permission was obtained from the leaders of the community. The purpose of the study was explained to the subjects prior to the study and oral consent was obtained. The samples were interviewed by the researcher those who met the inclusion criteria were selected by using non probability systematic sampling technique. The investigator introduced about the study and rapport was established. The structured interview schedule was used to assess knowledge and five point likert scale was used to assess the attitude, regarding Alzheimer’s Dementia by interview for 45 minutes to one hour. The investigator collected the data from 4 to 5 samples per day. From each street 10 to 15 samples were collected. The data was analyzed by using statistical measurements. The date and time of awareness programme was informed by distributing notice to all houses in Nanchiyampalayam. After the data collection, awareness programme on prevention of Alzheimer’s Dementia was conducted for two days from 9.00am to 5.00pm in the community centre using audiovisual aids like posters, models, and charts to explain about what is Alzheimer’s dementia, causes, and stages of Alzheimer’s dementia, management, prevention of Alzheimer’s dementia. On the first day 62 adults were attended the programme and the second day 56 members were attended. Pamphlets were distributed to all who attended the programme.

Protection of human subjects:

The proposed study was conducted after approval of dissertation committee. The written permission was obtained from the leaders of the Nanchiyampalayam community at Dharapuram. Oral consent of samples was obtained before collecting the data. Assurance was given to them that confidentiality of each individual would be maintained.

RESULT:

The distribution of adults according to their demographic variables of age, sex, marital status religion, type of family, education, family monthly income, occupation, health information resources.Distribution of adults according to their age depicts that highest percentage (49%) of adults were in the age group of 30-40 years and (30%) of them were in 41-50 years and least percentage (21%) of them were in 51-60 years of age. Distribution of adults according to their sex depicts majority (71%) were females and least percentage (29%) were Males. Distribution of adults according to their marital status depicts most of adults (94%) were married and (6%) of them were unmarried. Distribution of adults according to their religion depicts Majority (75%) of adults were Hindus, (20%) of adults were Christian and least (5%) of adults were Muslims. Distribution of adults according to their type of family depicts majority (72%) of adults belongs to nuclear family and least percentage (28%) of the adults belongs to joint family. Distribution of adults according to their education depicts (28%) of adults had no formal education, (22%) of the adults studied primary education, (24%) of the adults studied high school education, (12%) of the adults studied higher secondary education and (14%) of the adults were graduates. Distribution of adults according to their family monthly income depicts highest percentage (45%) of them belongs to the income group of Rs1001-3000 whereas (20%) of them were earning Rs 3000-5000. However (19%) belongs to the income group of less than Rs 1000 and 16% of the adults were earning more than Rs 5000 per month. Distribution of adults according to their occupation depicts highest percentage (35%) of them were daily wages whereas (32%) of them were self employee. However (11%) were government employee and (14%) of them were private employee whereas least percentage (8%) of them were unemployed. Distribution of adults according to their health information resources depicts highest percentage (45%) of the adults had health information from television programmes, whereas (24%) had health information from newspaper. However (22%) of the adults had health information from health personnel and least percentage (4%) of them had health resource information from radio and (5%) of them had no health information resources.

b) Table: 4 Area wise analysis of knowledge on Alzheimer’s dementia among adults.

Sl. No

Areas in knowledge questions

Score

Mean

Mean %

Definition

Causes

Sings and symptoms

Management

Prevention

Complications

1.39

1.35

0.65

2.09

4.26

0.29

46.33

33.75

21.66

34.83

53.25

0.8

0.6

1.1

1.9

0.4

Total

10.03

40.12

Correlation of knowledge and attitude scores among adults regarding Alzheimer dementia:

Table: 6 n=100

S. No

Variable

Mean scores

Co Efficient of co – relation

Table Value

Knowledge

10.03

0.55

0.1946

Attitude

48.62

df=98 (p<0.05)

Table-6 showed that there is a positive correlation (r = 0.55) of knowledge and attitude regarding Alzheimer’s dementia among adults.

Chi square value were calculated to find out the association between knowledge among adults with their demographic variables of age, sex, marital status, religion, family type education, family monthly income, occupation health resources.It was found that there was association with knowledge scores and education(X²⁼19.879), type of family(X²⁼5.246), health information resources(X²⁼20.55) of the adults, whereas no association was found between knowledge of adults and selected demographic variables such as age, sex, religion, occupation, family monthly income .

Chi Square values were calculated to find out the association between the attitude of adults with their age, Sex, Marital status, family monthly income, Religion, type of family, occupation, Education, health information resources. It was found that there was association with attitude scores and education(X²⁼14.642) of the adults whereas no association was found between attitude of adults and selected demographic variables such as age, sex, marital status, religion, occupation, type of family, family monthly income, health information resources.

CONCLUSION:

The present study assessed the knowledge and attitude regarding Alzheimer’s Dementia among adults. The results showed that 51% had inadequate knowledge and 47% had moderately adequate knowledge and 2% had adequate knowledge. In attitude 70% had moderately favorable attitude and, 30% had favorable attitude. The mean knowledge and attitude scores are 10.03(SD ±3.4) and 48.62(SD±5.2). The study findings concluded that the awareness programme will play an important role in improving the knowledge and attitude of adults regarding Alzheimer’s dementia.

IMPLICATIONS:

The findings of the study have certain important implications for nursing service, education, administration and nursing research.

Nursing Service:

1. Mental health promotion is a vital function of the nurse and psychiatric nurse can organize for mass education in community regarding Alzheimer’s dementia using different AV aids.

2. Nurse as the change agent, can introduce the various preventive measures to prevent Alzheimer’s dementia.

Nursing Education:

· Imparting the concepts of preventive measures of Alzheimer’s dementia to nursing students.

· Nursing students must be encouraged to utilize knowledge on preventive measures to give health education in the hospitals, and community.

Nursing Administration:

· Nurse administrators can organize in service education programmes in prevention of Alzheimer’s dementia in all health sectors.

· To organize awareness camps on special days.

Nursing Research:

· The study findings can effectively be utilized by the emerging researchers.

· The study findings can be a baseline for further studies to build upon.

RECOMMENDATIONS:

1. Similar study can be replicated on larger samples there by findings can be generalized to a large population settings.

2. Experimental studies can be conducted with intervention to improve their knowledge and attitude.

3. A comparative study can be conducted in urban and rural areas.

LIMITATION:

It was more time consuming to explain about Alzheimer’s dementia among adults because of difference in their understanding.

REFERENCE:

1. Basavanthappa, B. T. (2009). Nursing Research (2^nd ed.). New Delhi: Jaypee brothers. pp 23,46,58.

2. Basavanthappa, B. T. (2007) Psychiatric Mental Health Nursing

3. (1^st ed). New Delhi: Jaypee Publications. pp 579-591.

4. Ganguli, M. (2009). Depression, Cognitive Impairment and Dementia. Indian J Psychiatry,51,29-34

5. Hebert, L.E. et.al. (2003) Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch Neurol 60(8),1119-22.

6. http://www.aan.com -- American Academy of Neurology

7. http://www.medicalert.org -- Medic Alert

8. http://www.clinica ltrials.gov -- Find clinical trials

Received on 22.02.2020 Modified on 13.03.2020

Int. J. of Advances in Nur. Management. 2020; 8(2):149-153.

DOI: 10.5958/2454-2652.2020.00035.9