Date of Award

Winter 8-1-2018

Document Type

Thesis

Degree Name

M.Sc. Nursing

Department

Department of Psychiatric (Mental Health) Nursing

First Advisor

Mrs. Jeyalakshmi. K

Second Advisor

Ms. Rochelle Jane D'sa

Abstract

ABSTRACT A research study to effectiveness of Motivational Enhancement Therapy on relapse prevention among adults with Alcohol Dependence Syndrome in selected hospitals of Udupi District, Karnataka was carried out at Manipal Academy of Higher Education (MAHE), Manipal. The objectives of the study were to assess the level of motivation among adults with Alcohol Dependence Syndrome in selected hospitals of Udupi District, to find the effectiveness of Motivational Enhancement Therapy on relapse prevention among adults with Alcohol Dependence Syndrome in selected hospitals of Udupi District in terms of increase in motivation scores measured by using URICA scale and decrease in warning signs of relapse measured by using Likert scale for assessing warning signs of relapse and to find the association between the level of motivation with selected demographic variables. The conceptual framework for the study was based on ‘System Model’ by WHO – SEARO technical publications. The conceptual framework shows input, process, output and feedback. The research hypothesis was there will be a significant increase in the score of motivation among adults with Alcohol Dependence Syndrome. There will be a significant decrease in the score of warning signs of relapse among adults with Alcohol Dependence Syndrome and there will be association between levels of motivation with selected demographic variables among the adults with Alcohol Dependence Syndrome in selected hospital of Udupi District. Abstract Manipal college of Nursing Manipal v The tools used for the study were Demographic Proforma, University Rhode Island Change Assessment Scale (URICA) which is designed to assess the readiness for change and Likert scale for assessing warning signs of relapse. The content validity of the tools established through the suggestions of experts. Pretesting of the tools was done by administering to five participants from Kasturba hospital, Manipal and reliability was done among twenty participants from District Hospital, Udupi. All the tools were found reliable. Pilot study revealed the feasibility of the study and the administrative permission for conducting the study was taken from the Dean, Manipal College of Nursing, Manipal. Research proposal with validated tools were submitted to the Institutional Ethics Committee (IEC) and the clearance was obtained. The main study was conducted during the month of January 2018 to March 2018 at the A.V Baliga Memorial Hospital, Doddanagudde. The gathered data was coded and summarized in a master data sheet and analysed using SPSS 16.0 Version based on the research objectives. Frequency and percentage of the demographic variables were calculated. Paired t test was computed to find the effectiveness of Motivational Enhancement Therapy on increasing the level of motivation and decreasing the warning signs of relapse. Among 30 participants, most (76.7%) of the participants belongs to the age group of 36 - 45 years and majority (80%) belongs to hindu religion. All (100%) were males. Forty percent had an education up to higher secondary. Most of them (56.7%) were private employees and maximum were married (73.3%). Most (36.7%) of them had a monthly income between 10,001 to 25,000 rupees. Most (30%) of them had Abstract Manipal college of Nursing Manipal vi comorbidity as hypertension. Most (86.6%) of them were using alcohol for 5 to 15 years and majority (76.7%) were hospitalized for one to four times. There were two dropouts in the study due to the discontinuation of treatment and seeking health facilities near to home place. In pre-test, among the 28 participants, majorities (60.7%) of them were in precontemplation stage and 39.3% were in contemplation stage whereas none of them were in action and maintenance stage. However post-test level of motivation score significantly increased in action stage (85.7%) and 14.3% were in contemplation stage and none were in pre-contemplation stage and maintenance stage. Out of 28 participants in pre-test, majority (53.6%) of them were in low risk of relapse and 42.9% were in moderate risk of relapse. Whereas, 3.6% of them were in high risk of relapse. In the post-test (100%) were in low risk of relapse. The Paired t test computed at .05 level of significance, revealed that Motivational Enhancement Therapy was effective in terms of increasing the level of motivation ( t = ˗2.270, p = .031) and decreasing the warning signs of relapse (t =5.842, p = .000). The Fisher’s exact test value shows that there was significant association between the level of motivation and duration alcohol use (p = .041 at .05 level of significance). Whereas there was no significant association between the level of motivation and other selected demographic variables. Abstract Manipal college of Nursing Manipal vii The study findings concluded that regular Motivational Enhancement Therapy along with standard pharmacological management will help to increase the level of motivation and to decrease the warning signs of the relapse among the adults with Alcohol Dependence Syndrome in de- addiction setting.

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