ACKNOWLEDGEMENT

First of all we would like to thanks Almighty GOD for his courage and wisdom which he
showered upon us and helped us to complete this research project.

We are thankful to Mrs. Sarita Suryavanshi (community health nursing) principal

of Gyandeep Institute of Nursing Science Jabalpur for providing this opportunity for
conducting this research project and for her valuable guidance and suggestions.

This study has been undertaken and completed with the timely support of Mr. Bimleshvyas

Lecturer M.sc Nursing (Psychiatrics)ans research coordinator , Gyandeep Institute Of

Nursing Science Jabalpur .We express our sincere gratitude to her for the inspiring guidance ,
valuable suggestion and encouragement from the very begging which helped us to complete the
study.

Since thanks to Vice Principal Ms. Anu Fouzdar M.sc Nursing (Community

Health Nursing)for her judgment and enlightening suggestion.

We would like to specially thank our faculty who helped us in this study period.

No research can be completed without unrelenting support of all those good hearted people who
have helped us tirelessly to make this work possible one.

I express our sincere gratitude towards those helping han

Date By:-

Place: Jabalpur MEERA KUMARI

MRS. GUNJA SINGH

MUKTA BECK

KUSUM LAKARA
 TABLE OF CONTENT

S.NO. CHAPTERS PAGE NO.

I. INTRODUCTION 2-11
 Background of the study 2

 Need for research 5

6
 Statement of the Problem
6
 Objectives of the study
7
 Operational Definition
8
 Hypotheses
8
 Conceptual Framework
11
 Limitations and summary

II. REVIEW OF LITERATURE 12-14

*Studies related to child abuse 12

*Studies related to physical abuse 13

13
*Studies related to sexual abuse
14
*Studies to related to prevention of child abuse

III. METHODOLOGY 15-22

 Research Approach 14
 Research Design 14
 Setting of the study 17
 Population 17
  Sampling technique 17
 Sample size 17
 Criteria of selection 18

 Limitations 18

 Method of data collection 18

 Development of the Tool 19

19
 Description of the Tool
19
 Scoring
19
 Pilot study
19
 Validity
20
 Reliability
20
 Data collection
20
 Plan for statistical analysis
21

IV. DATA ANALYSIS & INTERPRETATION 38-45

V. DISCUSSION
46-50

VI. SUMMARY
51-53
 TABLE OF CONTENT

LIST OF TABLE

S. NO. TABLES PAGE NO.

1. Demographic distribution according to frequency and percentage

2. Allotment of score

3. Assessment of score

4. Overall score of knowledge

5. Comparison of pre and post test knowledge

 TABLE OF CONTENT

LIST OF FIGURE

S. NO. FIGURE PAGE NO.

1. Conceptual framework based on Health Belief Model

2. Schematic diagram for the research design of study

3. Percentage distribution of urban mothers by their age

4. Percentage distribution of child by their gender

5. Percentage distribution of urban mothers by their religion

6. Percentage distribution of urban mothers by their types of family

TABLE OF CONTENT
 LIST OF ANNEXURES

S. NO. ANNEXURES PAGE NO.

1. Letter seeking permission to conduct study of Ghamapur in Jabalpur

(M.P.)

2. Questionnaire to assess the knowledge on child abuse

3. Answer key
 ABSTRACT
Anon-experimental study was carried out to assess the level of knowledge of
mother regarding child abuse in selected urban area in Jabalpur (MP)

The objective of the study were :-

1) To assess the knowledge level of the urban mother on child abuse.

2) To find out the association between the knowledge of mother regarding child
abuse and their demographic variable.

Methodology:-

The research design adopted for this study was one group knowledge assesses non
experimental design. 40 urban mothers were selected by conviencesampling
technique. A self-administered questionnaires was used for data collection, which
consist of part 1 and part 2 .

Part1 - consist of socio demographic characteristics of the sample information

related to child abuse.

Part 2 -The knowledge items related to child abuse were included

The pilot study was conducted 18 March 2016 to assess the feasibility and
reliability of the tool.

Data were collected on 18 March 2016 by using self administered questionnaires.

The collected data were analyzed by statistical tests such as percentage
distribution, mean, standard deviation.
 CHAPTER-1
INTRODUCTION

Child abuse is most often to the problem besetting families which can elevate the
risks to children .these problem are complex and inter connected, holistic responses
.child abuse and neglect has begun to demonstrate linkages between maltreatment
and long –term adverse effect and long term physical, and behavioral effects on
children; early victimization portends future difficulty for victim and a higher
properly for problem behavior as juveniles and, later as adults.

CHILD:-

Child is human the stage of birth and puberty .The legal definition of “child
”generally refers to a minor known as a person younger then the age of majority
‘child” may also describe a relationship with a parent or authority figure , or
signify group membership in a clan ,tribe , or religion ;it can also signify being
strongly affected by a specific time ,place or circumstances , as in a child of nature
or a child of the sixties

ABUSE:-

Abuse is the improper usage or treatment for a bad purpose often to unfairly or
improperly gain benefit and to treated with cruelty with cruelty or violence’s
especially and repeatedly ,

PHYSICAL ABUSE

Physical abuse is non-accidental injury ranging ,from minor bruises to server

fracture or death as a result of punching , beating, kicking ,biting ,shaking,
throwing stabbing ,choking [with a hand ,stick , strap or other object ],burning or
otherwise harming a child that is inflicted by a parent caregiver ,or other person
who has responsibility for the child to such injury is considered abuse regardless of
whether the caregiver intended to hurt the child physical discipline such spanking
or padding is not considered abuse as long as it reasonable and causes no bodily
injury to the child .

EMOTIONAL ABUSE

The persistent emotional maltreatment of a child such as to cause severe and

persistent adverse effect on the child’s emotional. It may involve conveying to
children that are worthless or unloved ,inadequate ,or valued only insofar as they
meet the needs of another person .It may include not giving the child opportunities
to express their views ,deliberate silencing them or” making fun” of what they say
or how they communicate .It may feature age or developmentally inappropriate
expectations being imposed on children . These may include interactions that are
beyond the child’s developmental capability, as well as overprotection and
limitation of exploration and learning, or preventing the child participating in
normal social interaction. It may involve serious bullying (including cyber
bullying), causing children frequently to feel frightened or in danger, or the
exploitation or corruption of children. Some level of emotional abuse is involved in
all type of maltreatment of a child, though it may occur alone. This definition
includes witnessing domestic violence.

SEXUAL ABUSE

Forcing or enticing a child or young person to take part in sexual activities, not
necessarily involving a high level of violence, whether or not the child is aware of
what is happening. The activities may involve physical contact, including assault
by penetration (for example, rape or oral sex) or non-penetration acts such as
masturbation, kissing, rubbing, and touching outside of clothing. They may also
include non-contact activities, such as involving children in looking at, or in the
production of, sexual Image, watching sexual activities, encouraging children to
behave in sexually inappropriate ways, or grooming a child in preparation for
abuse ( including via the internet)21. This would include prostitution and sexual
exploitation of a child for commercial or financial gain. The guidance also
recognizes that other children, and women, may perpetrators of child sexual abuse.

NEGLECT

A persistent failure to meet a child’s basic physical and/or developmental needs.

Neglect includes failing to provide for a child’s health, education, emotional
development, nutrition, clothing, shelter, safety and safe living conditions, and
includes exclusion of the child from the home and abandonment. It is different
from poverty, according to the World Health Organization (WHO), because it
happens when there is failure to provide the resources to meet a child’s needs if
those resources exist or should be available. Neglect

Includes:

 A parent or guardians failure to provide adequate food, clothing and shelter

such excluding a child from the home, abandoning them and leaving them
alone.
 Failure to protect a child from physical or emotional harm or danger.
 Failure to ensure the child has access to appropriate medical care and
treatment when needed.

Neglect is defined development so that a parent or guardian developmentally

failing to do or to provide certain thinks will have a detrimental impact on the
development or safety of young child the but not necessarily on an elder child.
BACKGROUND

Child abuse is a state of emotional physical, economic and sexual maltreatment

meted out to a person below the age of eighteen and is a globally prevalent
phenomenon. However, in India as in many other countries there has been no
understanding extent magnitude and trends of the problem . The growing
complexities of life and the dramatic change brought about by socio- economic
transition in India have played a major role in increase the vulnerability of
children to various and newer forms of abuse.

Child abuse has serious physical and psycho-social consequences which

adversely affect the health and overall well being of a child. According to WHO
“child abuse or maltreatment constitutes all forms of physical and/or emotional ill-
treatment, sexual abuse neglect or potential harm to the child’s health, survival
development or dignity in the context of a relationship of responsibility, trust or
power.”

Child abuse is a violation of the basic human right of a child and is on outcome of
a set of interrelated familial, social psychological and economic factor.The
problem of child abuse and human right violation is one of the most critical matters
on the international human right agenda. In the India context, acceptance child
right s as primary inviolable right is fairly recent, as in there universal
understanding of it.
 NEED OF THE STUDY

The issue of child abuse assumes extraordinary significance due to the

rising number of child abuse cases reported and unreported in the country despite
the existence of a plethora of national and international legal as well as policy
commitments and conventions.

The forms and dynamics of child abuse have undergone major changes in
the new millennium, adding multifaceted dimensions, complexities and challenges.

According to World Health Organization (WHO), one in every four girls

and one in every seven boys in the world are sexually abused more than 4,00,000
children in India are reported to be victims of commercial sexual exploitation.
According to the (American) National Committee To Prevent Child Abuse (1997)
state that neglect represented 54% of confirmed cases of child , physical abuse
22% sexual abuse 8% emotional maltreatment 4% and other forms of maltreatment
12%. The united states department of health and human services reports that for
each year between 2000 and 2005 female parents acting alone were most likely to
be perpetrators of child abuse .

American psychiatric association state that approximately 15% to 25% of

women and 5% to 15% of men were sexually abused when they were children.
Most sexual abuse offenders are acquainted with their victims, approximately 30%
are relatives of the child, most often brothers, father, uncles or cousins around 60%
are other acquaintances such as friends of the family ,baby sitters , or neighbors
strangers are the offenders in approximately 10% of child sexual abuse cases most
child sexual abuse is committed by men, studies show that women commit 14% to
40% of offenses reported against girls.

A survey conducted by the National center for the child Abuse and
Neglects (1996) in the united states had recorded 1.9million of child abuse cases “
The most common form of child maltreatment is neglect physical abuse , sexual
abuse and constitute, approximately 25%, 13%and 5% of confirmed maltreatment
cases, respectively.

KEMP.AM, ET.AL. (2006)

A study conducted in delhi on child abuse, showed an increasing incidence of child

sexual abuse form 110 cases in 1990 to 210 cases in 1995. Study finding revealed
that the children in the rural communities are more likely to be abused or neglected
than children in rural.

GRERMMARIE VENKATARAMNI,(2005)

Due to increased prevalence, lack of awareness and lack of research study on

knowledge of child abuse among mother in India so the researcher select this study
to create awareness and preventive aspects of child abuse in India.

In many cases, child abuse leady to serious emotional disturbances during

and serious adulthood .one of the disturbing aspects

If a child fears doing anything new because of the change that it will lead
to a violent attacks or because an abusive parent keep extremely tight control over
children ,the child will lose his or her sense of curiosity and wonder at the world
and will stop trying new thing and exercising his or her mind .

That child will never achieve his or her intellectual potential the study was
undertaken few attempt have been made to asses knowledge of rural mother
regarding child abuse
PROBLEM STATEMENT :-

A study to assess the level of knowledge regarding child abuse on child abuse
among the mother of selected urban area in Jabalpur (MP)

OBJECTIVES OF THE STUDY-:

 To assess the level of knowledge of mother regarding child abuse in

selected urban area in Jabalpur.

HYPOTHESIS

H1 these will be significant of association between the knowledge of mother

regarding child abuse their demographic variables.

DELIMITATI ON

1. Urban study is limited to those who are willing to participate

2. The study will be conducted only to those mother who living in selected
urban area.
3. Those who are available during the study period.
4. The duration of the study is 30 days.

OPRATIONAL DEFINATION

ASSESS – To make a judgment about effectiveness planned health teaching.

KNOWLEDGE - Refers to level of understanding.

CHILD - A young human being below the age of puberty

ABUSE – Any action that intention harm or injuries another persons.

CONCEPTUAL FRAME WORK

HEALTH BELIEF MODEL: - Modified conceptual frame is based on Rosen

stock’s and Booker (1974) and mailman’s (1975) Health belief model. It addresses
the relationship between person’s belief and behavior.

INDIVIDUAL PERCEPTION: -Perceive susceptibility to disease and perceived

seriousness of disease and perception is influence and modified with by
demographic and socio-psychology variable perceived threat of illness and cures of
action.

MODIFYING FACTORS:- Nursing intervention usually focus on factor that can

be identify and commitment to plan of action . The investigator has to evaluate
knowledge. In this study modifying factor refer to knowledge regarding child
abuse.

LIKELIHOOD OF ACTION:- Perceived benefit of preventive action minus

perceived to prevent action. This individual perception and modifying factors
together influence the perceived threat of complications due to. In this study action
refers to giving health education based on the assessment of the level of
knowledge.
 Individual perception
dual perception Modifying factors Likely hood action

CUES TO ACTION
DEMOGROAPHIC
VARIABLE  Exposure to
__________________ mass
Adequate
knowledge  Health
 Age Mother’s education
 Gender knowledge  Sharing
 Family income regarding child personal
 Type of family abuse
Moderate
experience
 Religion knowledge
 Advice from
 Parent
other
education
Inadequate
 Source of
knowledge
information

Figure: - CONCEPTUAL FRAMEWORK BASED ON

“HEALTH BELIEF MODEL”
 CHAPTER- 2
REVIEW OF LITERATURE

Review literature is a critical summary on topic of interest, often prepared to

put a research problem in context. A literature review helps to the foundation
for a study and can also inspire new ideas. The investigator carried out an
extensive review of literature on the research topic in order to collect maximum
relevant information for building the reviewed literature has been divided under
the following heading.

HEADING

*Studies related to child abuse

*Studies related to physical abuse

*Studies related to sexual abuse

*Studies to related to prevention of child abuse.

STUDIES RELATED TO CHILD ABUSE

1) Georgina M.Hosang (21 January 2013) A study was done to examine

whether child abuse or neglect is more strongly associated with adult
cardiovascular disease and whether these association differ by gender. A total
of 116 participants report their experience of childhood maltreatment by using
questionnaire. Cardiovascular disease was assessed using the older adult
resource survey multidimensional functional assessment questionnaire. Result
child abuse but not neglect was significantly associated with adult cardio
vascular disease. The significant relationship between child abuse and
cardiovascular disease was specific to women. Conclusion the result of the
study, indicate that being abused as a child is significantly associated with
cardiovascular disease in adulthood. Particular among women.

Ingrid I.E.Staal 24 January 2013. A Study was done on prevention and early
detection of parenting problems are of great importance. we have developed a
structured interview which uses parents concerns for a joint needs assessment
by parents and a child health care Nurse . Followed by a professional
judgementon the risk level of future parenting and development problems
.Structured problems analysis of raising kids (SPARK) .Previous result haveshown that
the risk assessment of the spark is associated with risk factors for child
maltreatment. This study reports the predictive value of the spark for report on
high impact parenting problem and child abuse and neglect (ARCAN) AND
(YCA) Youth care agency .A structured assessment of the concern and care
needs of toddlers parents by a child health care nurse is a valuable predictor of
reports on child abuse and neglect and serious parenting problems in toddlers
practical implication . Systematically exploringand evaluationparental concerns
with an instrument like the spark can contribute to the early recognition of families
at risk for major child rearing pro

Rayon mills 4 February 2013. A Study was conducted to examine whether notified child
maltreatment is associated with adverse psychological outcomes in children’s and whether
differing pattern of psychological outcomes are seen depending on the type of maltreatment.
The participant were 7,223 mother and child pair enrolled in a population based birth
cohort Study in Brisbane ,Australia. The primary outcomes were the internalizing and
externalizing Scale of the youth self report (YSR) at approximately 14 years of age. Result
the YSR was completed By 5,172 subjects (71.6%) with increased attrition of cases of
notified maltreatment. When evaluated as nonexclusive categories ofmaltreatment , physical
abuse, neglect and emotional abuse were each significantly associated with both

internalizing and externalizing behavior after adjustment. Conclusion : This

study suggest that child neglect and emotional abuse have serious adverse
effect on child mental health and warrant the attention give other forms of child
maltreatment additionally. It confirms that young people who are notified for
more than one type of maltreatment are at particular risk of child mental health
problem.

(2) STUDIES RELATED TO PHYSICAL ABUSE:

Megan R Holmes- 14 January 2013. A study was conducted over 4.5 million
children each year are exposed to intimate partner violence (IPV) further more
IPV rarely occur without Other form of violence and aggression in the home.
IPV is associated withmental health And parenting problems in mothers, and
children experience a wide variety of short-term Social adjustment and
emotional difficulties including behavioral problems. The current Study investigated of
IPV exposure on children’s aggressive, and tested if this relation was mediated by poor
maternal mental health and in turn by maternal warmth and child maltreatment and
moderated by children’s age and genders. Study finding high light the indirect

consequence of piv in the home on children aggressive behavior method

secondary data analysis using structural equation modeling (sem) was
conducted with the survey of child and adolescent wellbeing children were
below the age 3-8(n=1 161) result conclude that ipv was significantly related to
poor maternal mental health, was associated with more child aggressive
behavior lower maternal warmth and more frequent child physical and
psychological abuse. The result also identified maternal mental health as an
important variable in mediating the relationship between IPV exposure and
aggressive behavior on implication is for multi competent family intervention
that could be tailored helping the mother cope with such mental health issue
while also addressing deficit in children social behavior development.
EMINE ONCU / AHMET ON OR KURT 9 JAN 2013. A study
conductedkind of abuse and factors influencing the abuse among children
under 18 year of age who are working full time at workplace and enrolled in
vocational training centre. Questionnaire method wasadministered to595
apprentices who were attending a vocational training center. It was determined
that totally 62.5% of apprentice are subjects to abuse at their workplace hence
finding revealed it is necessary to prevent abuse among working children and
workplace should be constantly inspected. Low family income and extending
working time of apprentice increase the possibility of sexual abuse.

(3) Christina M. Rodriguez 4 January 2013. AStudy was conducted in

corroborating that parents compromised empathy is associated with evaluated
physical child abuse risk. The present study utilized on analog task of parental
empathy towards ones own child and physical child abuse potential and with
their tendency to punish perceived child misbehavior. A sample of 135 mothers
and their 4-9 years old children were recruited with mothers estimating children
emotional reaction using a behavior stimulation of parental empathy. Result
finding suggest that parental demonstration of poorer empathic ability on the analog task
was significantly related to increased physical abuse potential likelihood to punish and
negative child attribution. Conclusion: parental empathy appears to be a relevant target for
prevention and intervention programme . Future research should also consider similar analog
approaches to investigate such construct to betters uncovers the factors that elevate abuse risk

STUDIES RELATED TO SEXUAL ABUSE :

Debra Kaminer– 26January, 2013. A comparative study was done on

contribution of different form of violence exposure to trauma sequelae can
help to prioritize intervention for polyvictimized youth living in context of
limited mental health resource. Xhosa-speaking adolescent (n-230) attending a
high school in low- income urban community in south Africa completed
measure of violence exposure and post traumatic stress symptoms .Result
while witnessing of community violence was by far the most common form of
violence exposure, for the sample as a whole only sexual victimization and
being direct victim of community violence together with contributed
independently to the severity to post traumatic stress symptoms. Conclusion:
The finding provides some preliminary motivations for focusing trauma
intervention initiative in this community on girl. Who have experienced sexual
abuse compounded by victimization in the community and boys who have been
direct victim of either domestic or community violence.

Paul D Alton 11 January 2013. A study was done on growing consensus in

the research and theoretical literature that vulnerability to the perpetration of
child sexual abuse appear to involve the offender early developmental
experience. The study explore the perception of nine clerical child sex offender
in relation to their developmental experience. In the study nine participants
were selected on the basis of being priests or brother who had sexually abused
children. Participants were identify from a larger group of clergy who were
currently attending or had previously attended an institution that provide
therapeutic intervention for sex offender and age between 38 and 75 year.
Conclusion: many of this themes are reflected in this existing literature but
what appear to distinguish the participants in the present study is there
experience of an ideology within clerical training

that prevent remediation and compounded earlier psychosexual difficulties.

Kate walsh 8 January 2013. A study was done on linkage between childhood
sexual abuse (CSA) and later sexual revictimization . 546 female college
student who comleted anonymous survey regarding CSA and adult rape,
perceptions of sexual control, sex related alcohol expectations, and likelihood
of engaging in risk sexual behavior. The result shows that sex related alcohol
expectancies and likelihood of risky sexual behavior only predicted substance-
related rape, not forcible rape, conclusion finding suggested that low perceived
sexual control stemining from CSA is associated with increased sex- related
alcohol expectancies and a higher likelihood of engaging in the context of
alcohol use.

STUDIES RELATED TO EMOTIONAL ABUSE:

Albert Reijntjes 14 January 2013.

A cross sectional studies was done on bullying is increasingly

conceptualization as strategic behavior motivated by a desire to gain social
dominance in the peer group. Method using three wave design, participant
(N=394) were followed from late childhood. Into early adolescence were
participated in this study. Result states more intense bulling is associated with
higher level of social dominance conclusion finding suggest that high bulling
lead to the attainment of high social dominance and do not support the view that
children high in social dominance engage in bulling to maintain their
dominance position

j. TinaSalva 29 January 2013. A study was conducted on knowledge about the

effects of early life adversity kin relationship in later is spares. The purpose of
this study was to examine if childhood abuse adversity negatively influence
emotional closeness with family in mid and later life. Method using
retrospective account of early family abuse and adversity of 1,266 Middle aged
adult 1,219 older adult from a large population based survey. The National
survey of middle development in united states.
Separate multiple regression analyses were conducted for the two cohorts to
examine the effect of childhood emotional and physical abuse. Result suggest
emotional and physical abuse predicted family closeness in middle aged adult .
conclusion only emotional abuse predicted family closeness in older adult
.Moderation model revealed that high level of self acceptance with better
maintenance of emotional closeness among middle aged adult who were
emotionally and physically abused as children.

Ji-Kangchen 17 february 2013. A study was examined how peer social

support mediates the association between school victimization and student
psychological health among junior-high student. In an Asian content (Taiwan).
Method data were obtained from a large- scale

Random sample of 1650 junior high students (grades 7-9) in one diverse
country of Taiwan. The result of structural provided a good fit for the sample as
a whole. Overall finding showed that student psychological health is not
significantly directly associated with victimization support play an important
mediating role between exposure to school violence and student psychological healthby
students with maltreatment by teacher. Conclusion the finding imply the peer social life,

STUDIES RELATED TO PREVENTION OF CHILD ABUSE:

1) Michaelunger 20 December 2012. A study was done to examined the

relationship between resilience risk, and the service use pattern of adolescents
with complex needs who use multiple formal and mandated services such as
child welfare, mental health juvenile justice and special educational support. In
this study youth who were known to be multiple services users who were
between the ages of 13 and 21 are participated.

Participants completed a self. Report questionnaire administered individually

path analysis was used to determine the pattern of service use and services use
satisfaction among participants . The finding shows that there was no
significant relation between service use history and resilience or any of the
three functional outcomes. Service use satisfaction, a measure of an adolescents
perception of the quality of the services received, did however show a string
positive relationship with resilience. Conclusions result show that resilience is
related to services used by youth. Coordinating services may not increase
resilience or be more effective by an adolescent receiving intervention as
personally empowering and sensitive to his or her needs.

2) Michael S. Hurlburt 7january 2013. A study was done on prevention

form of the incredible years (IY) parenting program was offered to parents who
had children enrolled in head start, regardless of whether they reported
having a history of child maltreatment. This study compared whether parenting
practices and child behavioral out comes differed in families who self reported
a history of child maltreatment relative to families who did not. A site
randomized controlled trial of the IY parenting program was conducted in 64
classrooms in seven head start centers in seattle, washing ton, families of 481
children took part in the study. With 335 in the IY condition and 146 in the
control condition. Parenting practices and child behavior were measured by
blinded raters, through in home observation and self report questionnaires prior
to the start of the IY program has positive impacts for parents who self reported
a history of child maltreatment. Practice Agencies serving parents referred for
child maltreatment should carefully examine the characteristics of the parenting
programs they deer use of a parenting program that has a base of empirical support such as
IY and sufficient intensity and duration, is likely to make substantial changes in

parents child-rearing practices.

3) Gillian Morantz / Donald C.cole/ Ajaya/ David Ayuky 3 january 2013.

A study was conducted to determine the prevalence of maltreatment
experienced by institutionalized children prior to their admission to charitable
children institution (orphanages) in western Kenya, and to describe their socio-
demographic characteristics ,reason for admission and the factors associated
with prior experiences of maltreatment method. A systematic file review was
taken in five CCls demography prior care giving setting and maltreatment data
extracted. Forms of maltreatment were recorded according to WHO and
ISPCAN guidelines. Result a total of 462 files were reviewed. The median
(inter quartile range) age of children was 6.8 years at admission,56% were male
and 71% had lost one or both parents. The majority of child and youth resident
had experienced at least one form of maltreatment (66%). Study concluded that
the high prevalence of maltreatment prior to admission particularly among non-
orphans, suggest the need for better child abuse and neglect prevention
programs in communities and psychological support services in in
 CHAPTER 3
METHODOLOGY

Methodology is the most important part of research study, which enables the
researcher to form blueprint of the research undertaken. Research methodology
provides a brief description of the method adopted by the investigator in the
study. Research methodology involves systematic procedure by which the
researcher starts from the time of identification of the problem to its final
conclusion.

The present study aimed to assessing the effectiveness of structured teaching

programme on child abuse among mother of urban area in Jabalpur city (MP).

This chapter deals with different steps which were undertaken by the
investigators for gathering and organization the data . It includes the description
of research approach. limitation, method of data collection, development and
description of the tool validity, development of structured teaching
programmer, on child abuse, pilot study, reliability, data collection and plan for
data analysis.
RESEARCH PROBLEM RESEARCH SETTING POPULATION SAMPLE
A study to assess the DESIGN TECHNIQUE
Selected urban Target population
level of knowledge Descriptive area in jabalpur mother’s who is Random
of mother regarding design having 3-12 year sampling
child abuse in child technique
selected urban area
in jabalpur

METHOD DATA SAMPLE SIZE

Information Analysis
Commu- COLLECTION
providing AndInterp 60 Mother’s who
nication of
by health re-tation By structuring is having 3-12 year
finding
education questionnaire child
schedule

Schematic Representation Of Research Study

SETTING OF THE STUDY

Setting of the study refers to the physical locations and condition in which data
collection has been taken place.

The setting of the present study was selected urban area in Jabalpur city.
Jabalpur situated in the heart of Madhya Pradesh. It has vast area of
10,160,km,sq with population of 2,460714 (2014 Census).

POPULATION

A Population is a group whose member possess specific attributes that a

researcher is interested in studying.

TARGET POPULATION

Mothers of selected urban area in Jabalpur city.

ASSESSIBLE POPULATION

Mothers of selected urban area in Jabalpur city

SAMPLING TECHNIQUE

Sampling technique is a process of selecting a portion to obtain data regarding a

problem.

Convenient technique was considered appropriate to select the study area.

SAMPLE SIZE

40 Women were taken from selected urban area in Jabalpur city.

CRITERIA FOR SELECTION

Inclusion criteria

The women who were-

1. Mother willing to participate.

2. Mother who can understand Hindi and English.

Exclusion criteria

1. Who are not available at the time of data collection?

2. Who are not willing to participate in the study?

LIMITATION

A standardized restriction framed for conducted the study.

The study was limited to-:

1. Who are available during data collection.

2. Who are living in urban area in Jabalpur city.

3. Urban study is limited to those who are willing to participate.

 METHOD OF DATA COLLECTION
Method of data collection includes development of tools, testing of validity, and
reliability and data collection procedure. A questionnaire is a self- report
instrument and contain questions that respondent are asked to answer in writing. A
self- administered questionnaire was selected as a method of data collection for
present study.

DEVELOPMENT OF TOOL

After through search of literature, research guidance suggestions based on pilot

result, the self- administered questionnaire was developed to assess the
effectiveness of structured teaching programmer on child abuse among mother of
urban area in Jabalpur city.

DESCRIPTON OF THE TOOL

The final format of the structured questionnaire was comprised of two parts.

PART-1: The socio demographic data consist of information about the mothers
of urban area:-

1. Age

2. Gender

3. Religion

4. Types of family

PART-2:It consists of 30 items related to child abuse. These were:

1; - Knowledge about child abuse.

2. Physical abuse .

3- Sexual abuse.

4- Emotional abuse.

5- Neglect.

SCORING

Each question had one more possible correct response and each possible correct
response was awardedwith one score point and wrong answer zero

LEVEL PERCENTAGE RANGE

OF KNOWLEGDE
OF SCORE
Low 0-10 0-5
Average 11-20 06-10
Good 21-30 11-25

PILOT STUDY-

Pilot study was conducted on 18th march 2016 to assess the feasibility and
reliability of the tools. Foursubjects were selected from the urban mothers in
Jabalpur city.

CONTIENT VALIDITY-

Validity refers to the degree to which instrument measure what it is supposed to be

measuring.
RELIABILITY OF THE TOOLS – Thereliability of an instrument is the
degreeof consistency which if measure the attribute it is suppose to be measuring.

The reliability of the tools was the established by using data collected from
mother’s who having 3-12 year child in selected urban area in Jabalpuriability was
established by interrelated method . The reliability obtain for tool wasrel r=0.919

PRE TESTING -pre testing is the trial administration of newly developed

instrument to identify flows and assess time requirement. The tool was given to
mother’s who having 3-12 child in selected urban area in Jabalpur, after obtain
permission .The tool was found to be clear and understandable

CHAPTER-4
DATA ANALYSIS AND INTERPRETATION

Data analysis is defined as the process of systematically applying statistical and

logical technique to describe, summarize and compare data.

The chapter deals with analysis and interpretation of the data collection to assess
the level of knowledge among urban mother regarding child abuse

The purpose of analysis is to reduce the data to manageable and interpretable from
so that the research problem can be study and tested.

The analysis and interpretation of data of this study are based on data collection
through multiple questionnaires schedule on demographic variable of mother and
to assess level of knowledge among urban mother the result were computed using
descriptive and inferential statistics based on the objective of the study.
ORGANIZATION AND PRESENTATION OF DATA

The data analyzed were presented under the following handling.

Section 1:- Classification of demographic characteristics of respondent

Section 2:- Findings related to assessment of knowledge among urban

mothers regarding Child abuse.

Section 3:-Finding related to association between demographic variables.

SOCIO-DEMOGRAPHIC VARIABLES

Table-IFrequency and percentage of selected socio-demographic variables.

N=40

S. No. Variables Frequency Percentage

1. Age
a) 22-30 Years 13 32.05%
b) 26-29 Years 14 35.0%
c) 30-33 Years 8 20.0%
d) 34- 40 Years 5 12.5%
2. Religion
a) Hindu 26 65.0%
b) Muslim 8 20.0%
c) Christian 6 15.0%
 3. Monthly income of family
a) Rs.3000/-5000 10 25.0%
b) Rs.5000- Rs.10,000/- 15 37.5%
c) Rs.11,000- Rs.20,000/- 9 22.5%
d) Above Rs.20,000/- 4 10.0%
4. Gender
a) Male 25 62.5%
b) Female 15 37.5%
5. Type of family
a) Joint 10 25.0%
b) Nuclear 30 75.0%

TABLE 1

Reveals that the majority of respondents 23.05%belong to age group of 22-25 yrs
followed by 35.0% noticed in the age group of 26-29 yrs followed by 20% noticed
in the age group of 30-33 yrs the majority of respondents were 62.5%n and 37.5 %
male and female respondent were family income per month 11000-20000 is22.5 %
of respondents were family income per month 5000-10000 is37.5%of respondents
family income pr month were above 20000 is 10.6% of respondents are in nuclear
type of family and 25.0% of respondents were joint family.
 AGE
35.0% 35.00%

32.05% 30.00%

25.00%

percentage
20.0% 20.00%

15.00%
12.5%
10.00%

5.00%

0.00%

22-30 yr 26-29 yr 30-33 yr 34-40 yr

Age group

Figure-1 Bar diagram representing percentage distribution of subjects by their age

 GENDER
Male Female

37.5%

62.5%

Figure 2- Pie diagram representing percentage distribution of subjects by their gender

 RELIGION
65.00%
70.00%

60.00%

50.00%

percetage
40.00%

20% 30.00%

20.00%

10.00%
HINDU
MUSLIM 0.00%
CHRISTIAN

Religious group

Figure 3 - Conical diagram representing percentage distribution of subjects by religious group

TABLE-2
Assessment of knowledge score among mothers regarding child abuse
Classification of respondents on assessment of knowledge

Assessment of Category of scoring Respondent

knowledge
0 0%
Inadequate 0-10

18 30%
Moderate 11-20

Adequate 21-30 22 73.33%

Table 2
Reveals that majority of 22(73.33%) of respondent were adequate level of
knowledge 18(30%)of respondent were moderate level of knowledge of 0(0%) of
despondence were on knowledge
 DISTRIBUTION OF
RESPONDENT ON
ASSESSMENT OF
KNOWLEDGE REGARDING
CHILD ABUSE
70%

30%

22

18
0 %
HINDU
0-10 MUSLIM
10-20 20-30
Inadequate Moderate
CHRISTIAN Adequate

Series 1

Figure 4 – distribution of respondent on assessment of knowledge regarding child abuse

SOURCE OF INFORMATION REGARDING CHILD
ABUSE

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%
(a) Friends (b) T.V (c)Books (d) Personal (e) Any other
experience

Series2 1.66% 73.33% 28.83% 0.00% 0.00%

Serise1 1 22 17 0 0

Figure 5 -Distribution of respondent by source of information

 CHAPTER-5
DISCUSSION

Comprehensive nursing is a systematic process of problem diagnosis, problem

analysis, development of plan of care and continuous assessment of evolving plan
of care. It is an individualized plan based on scientific principle and concept in the
form of understanding on the part of the nurses and the utilization of the
specialized skills and techniques for the care of the client. Nursing education
include the appropriate nursing skills the right positive attitude to the student.
Theoretical and practical knowledge is essentials renderingintelligent and
qualitative nursingcare.

The present study of non experimental in nature and designed a study to assess the
level of knowledge of mother regarding child abuse in selected urban area in
Jabalpur. This study was conducted over a periods of 6weeks. A self-administered
questionnaire was use as a tool which consist of 2 parts

PART-1:Consist of socio-demographic characteristics of the sample and the

general information regarding child abuse

PART 2: To the level of knowledge among urban mothers regarding child abuse.

The majorfinding of the study was discussed under the objective.

DESCRIPTION OF DEMOGRAPHICVARIABLE :

1: Majority of respondent 32,05% were in the age group of 22-30 years.

2: Majority of the respondent 37.5% were female.

3: Majority of respondent 25.5% were 16000-20000 family.

4: Majority of the respondent 75.5% were nuclear family.

5: Majority of respondent 65.5% were Hindu.

7: Majority of the respondent 70% were television

OBJECTIVE: 1

To assess the level of knowledge among urban mothers regarding child abuse

The finding of the present study to assess the level of knowledge among urban
mothers regarding child abuse. The majority of 70% of respondent were adequate
level of knowledge 30% of respondent were moderate level of knowledge (0%) of
respondent were knowledge.

OBJECTIVE 2:

Association between the demographic variable and mother regarding child

abuse.

1: Regarding association between age level of knowledge regarding child abuse

among mother, the statistical, findings depict there exist significant association
between age and the level of knowledge regarding child abuse among urban
mothers.

2: Regarding association between family income and level of knowledge

regarding child abuse among mothers, the statistical finding depict there exist
significant between family income and level of knowledge regarding child abuse
among mothers.

4: Regardingassociation between types of family and level of knowledge

regarding child abuse among mothers, the statistical finding depict there exist
significant association between types of family and level of knowledge regarding
child abuse.
5: Regarding association between religion and level of knowledgeregarding child
abuse among mothers, the statistical finding depict there significant between
religion and level if knowledge regarding child abuse.
 CONCLUSION, IMPLICATION, LIMTATION
CONCLUSION

Child abuse is one of the common problem in children so prevention of child abuse is very
important school authorities and parent can help to prevent child abuse .

Finding of the study show that a study to assess the level of knowledge of mothers regarding
child abuse .children's are effective in terms of identification of risk factors which is responsible
for child abuse the following conclusion.

DISTRIBUTION OF DEMOGRAPHIC VARIABLES OF RESPONSIBLE :-

Majority of respondent % were in the age of % years and % were female % family incom were
% of respondent to degree.

70% of respondent were television findings related to overall and aspect wise.

The finding of the present study reveals that 70% of respondent were adequate level of
knowledge 30%were moderate of knowledge and 0% were no knowledge .

In the present study the respondent age, gender, familyincome , types of family ,religion , parents
education , and source of information found to be significant associated with level of knowledge
regarding child abuse among mothers.

NURSING IMPLICATION :-

The present study enables the mother to identify factors influencing child abuse.

The study also helped the mothers to know more about child abuse and prevention aspect.

The finding of the study has implication for nursing practice , nursing education , nursing
administration and nursing research.

IMPLICATION FOR NURSING PRACTICE :-

Nursing are the key for achieving health and practicing healthy life style . Awareness
programmer cab be arranged in community regarding prevention of child abuse among mothers.
1) Nursing should organized the health education awareness programmer to educate the mothers
in different aspects of prevention child abuse among mothers.

2) It also highlights the needs to develops audio visual tools guideline for imparting knowledge
into the public.

IMPLICATION FOR NURSING RESEARCH :-

1) The study helps the nurse researcher to identify the areas of prevention of child abuse among
mothers to decrease the incidence of child abuse.

2) The study helps the nurse research are suffering from child abuse.

IMPLICATION FOR NURSING ADMINISTRATION :-

The nurse administrator needs to plan organize and conduct health education programmer for
prevention of child abuse among mothers.

LIMITATIONS:-

The limitation of the present study was-

1) Study is limited to mothers who is having 3-12 years child.

2) Mothers of selected urban areas in Jabalpur.

RECOMONDATION:-

Keeping in view the finding of the present study the following recommendation are made since
the study was carried out on a small sample , the results can be used only as a guide for further
studies.

1) A similar study can be replicated by using a large sample.

2) A similar study can be conducted to compare the finding of rural and urban mothers to assess
level of knowledge among mothers regarding child abuse.

3) Study cab is conducted regarding mother awareness of child abuse.

SUMMARY:-

The chapter deals with the conclusion drawn base on analysis and interpretation of data
collection from the respondents of the study .Therefore it is concluded that a study to assess the
level of knowledge of mother regarding child abuse was effective in term of identification which
responsible for level of knowledge of mother regarding child abuse . This chapter also deals with
the implication to the nursing profession, nursing education , nursing administration, nursing
research , limitation and recommendation.
 CHAPTER-6
SUMMARY

SUMMARY OF THE STUDY :-

The primary aim of the study was to assess the level of knowledge of mothers
regarding child abuse.

OBJECTIVES OF THE STUDY :-

1) To assess the level of knowledge among urban mothers regarding child abuse .

2)Association between the demographic variables and mothers regarding child

abuse.

HYPOTHESIS :-

H-Theses will be significant association between the knowledge of mothers

regarding child abuse and their demographic variables.

Review of literature to parent study has been organized as followes-

1) Study related to child abuse.

2) Study related to physical abuse.

3) Study related to sexual abuse .

4) Study related to emotional abuse.

The study design consisted approach with a descriptive survey design.

The study population is related to the urban mothers in Ghamapur in Jabalpur

convenient sampling.
A self administered questionnaires was used for data collection which was
consisting of two parts.

Part1- Consist of socio demographic characteristics of the sample and the general
information related to child abuse.

Part 2- knowledge items related to child abuse and its prevention.

The sample consisted 40 urban mothers .

The data was collected -

The data gathered were analyzed an interpretation according to the objective.

Descriptive statistics were used :-

Mean median with graphical presentation of data.

Inferential statistical was used to test hypothesis at 0.05 levelsignificant. chi -

squire test was applied for finding relationship between factors influencing level of
knowledge demographic variables respectively .

In this study 70% of respondent had adequate level of knowledge 30% had
moderate level of knowledge and 0% of respondents had no knowledge .

In the present study age, gender, types of family , income , religion , parents
education and source of information found to be significant associations with level
of knowledge among urban mothers .Thus the student researcher found a
satisfactory in assessing the level of knowledge of mother regarding child abuse
with the help of questionnaires schedule.
 REFERENCES
1) Dorothy R Marlow , Barbara A, reading text book of pediatrics nursing 6th
edition published by Elsevier , New Delhi page number 905-909,1004-1005.

2)Wong's Essential of pediatrics nursing Donna ,L,WongMarlynHockenberry

Eaton6th editions .published by Harcourt ( India) 27 M block market greater
kailash 2 , New Delhi.page no 784-787.

3) Adele pillitteri , child health nursing care of the child and family .page no 490-
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4) Jane Ball and Ruth Bindler , pediatric nursing caring for children 2nd editions
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5) Behrman ,Kliegman Jenson Nelson text book of pediatrics 17th edition

published by Elservier New Delhi page no 2295-2298.

6) Polit F Denise cherly.Tatano beck BERNADETTE p Hungler , essential of

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7) Besavanthapa BT nursing research 2 nd editions Jaypee Brothers medical

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8) Marelyn J wood janet c Ross Kerr , basic step in planning nursing research 6th
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9) Ross Marie Nieswiadomy , foundations of nursing research 5th edition

published by Dorling Kinders( INDIA) pvt Ltd , New Delhi page no, 138-144,156-
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10)patricia queen samour and kathy king , hand book of pediatrics 7th edition
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11) Ms Bhatia (1996) A comprehensive text book of child and adolescent

psychiatric

1996 page no 17-24.

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surgical patient (1st edition) Marry and Aspen.

14) James R.S Ash Will WJDrosk CS (2000)' Wong's nursing care of infants and
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16) Denise F, polit , cherty Tatano beck (2008) nursing research. generating and
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Web Page-

18) Alna Sir F.A Health attitudes of school teachers (online) 2004;Mar 25 (3) 26-
30 Availables from ,URL http// medline A.B.

19) Arthur Becker - Weidam child abuse and neglect( online) 2000 April 26
available from, URL http//www child abuse and neglectory.
20) Statistic on child and neglect (online) 2005 July 15 Available from URL http/
www child abuse statistic.com.

21) Current issue of child abuse ( online) sep is available from URL http// www
the Hindu. Com/10hd line htm.

22) Jim hopper child abuse statistics research and resources (online) 2006 Dec .Jim
hopper.Com.

23) Lung C. and DuroD. Current Trends in child abuse Reporting and Facilities
(1996) available from URL ; http www child abuse com/ fsghtm.

24) Garbarino and Ense of school violance , Revised 2001 edition

Americanspsychiatric publishing available from ; URL http www .com
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ANSWER KEY

QUESTION NO. ANSWER NO. QUESTION NO. ANSWER NO.

Q1 D Q16 D

Q2 D Q17 A

Q3 D Q18 D

Q4 B Q19 D

Q5 D Q20 A

Q6 D Q21 C

Q7 C Q22 C

Q8 D Q23 C

Q9 C Q24 C

Q10 D Q25 D

Q11 D Q26 D

Q12 B Q27 D

Q13 B Q28 D

Q14 D Q29 D

Q15 D Q30 D

ANSWER KEY
 HEALTH EDUCATION
CHILD ABUSE-

INTRODUCTION

Content- Child abuse or maltreatment is any act or failure to act by a parent or

other caregiver that result in actual or potential harm to a child.

It includes all forms of physical sexual abuse psychological abuse or neglect and
can occure in a child's home or in the organization school or communities the child
intreacts with. In western countries preventing child abuse is considerd a high
priority and details laws and policies exist to address this issue.

Definition- child abuse and child maltreatments as all forms of physical and
emotional and sexual mistreatment or lack of care that causing injury.

Explain the types of child abuse-

There are 4 types of child abuse.

1) physical abuse- Intentional use of physical force against the child that result
in or has a high likelihoods of resulting in harm for the child's servival
development or degnity . This includes hitting biting kicking shaking beating
scalding burning.
2) Sexual abuse- child sexual abuse is a form of child abuse in which an adult
or older adolescents abuse a child for sexual stimulation.

Incidence of sexual abuse- In the united state approximately 15% -25% of women
and 5%-15% of men were sexually abused when they were children.

Approximately 30% are relatives of the child most often brothers father uncle ot
cousins.

Psychological abuse- child psychological abuse to the describing it as

nonaccidental verbal or symbolic acts by a childs parent or caregiver that result or
have reasonable potential to result in significant psychological harm to the child.
3) Emotional abuse- child abuse can causes a range of emotional effects .children
who are constantly ignored shamed terrorized or humiliated suffer atleast as much
if not more than if they are physically assaulted.

Risk factors of child abuse-

- Young children are at risk of physical abuse

- Boys are victims of beating and physical punishments whil girls are at higher risk
of sexual abuse.

- Lack of incom to meet the family.

Explain the causes of child abuse-

1) Lack of support and social isolation.

2) Stress- unemployment financial pressure poverty poor housing stressfull job.

3) Poor control over their impulses.

4) Mental health problem and display antisocial behaviour.

5) Lack of education parents and child.

6) Child of alcohol abuse parents.

Sign &Symptoms of child abuse-

1) sadness or low self esteem.

2) Depressions

3) Emotional difficulties sach as anger anxiety.

4) Difficulties in communicating.

5) Criminal behaviour.

Preventions of child abuse-

1) Teach your child's to use their voice to allow them prevent abuse in their own
life.

2) Never disciplin your child when your anger is out of control.

3) Participate in your childs activities and get to know your child's friends.

4) Be aware of changes in your child's behaviour or attitude and inquiries into it.

5)Teach your child the cortect names of his/ her private part of body.

6) Be alart for any talk that reveals premature sexual understanding.

7) Pay attentions when some one shows greater than normal interest in your child.