INTRODUCTION:

“'Normal' is a useful word for medicine and psychology, but otherwise it is too abstract. When we decide what's 'normal' and what's 'not normal', it could be very dangerous."

Alexandre Jollien

Unconditional love is probably the most vital element of his existence to any child. For a child with mental retardation, unconditional love is often lacking. It can be hard to love a child who is often unattractive. To make matters worse, the retarded child brings with him many problems.¹

In the present day society the status of mental deficiency and maladjustment has become an alarming universal problem. Mental Retardation has posed a great problem throughout the world due to its highly complex, social, medical, psychological, legal and educational components, and part from various unanticipated problems. It is considered as one of the most difficult problem to understand, define, educate and manage to everybody's satisfaction at different levels of the human community.²

Lack of information about the medical and social management of the retarded child is shocking. Yet this retarded group makes up approximately 3% of the population of the world.¹5-15% of all 3–15-year-old children in the world are mentally impaired. In fact, 0.4-1.5% (10-30million) is severely mentally retarded and an additional 60-80million children are mildly or moderately mentally retarded. Current socioeconomic and demographic changes and a rise in the number of employed mothers may withhold the necessary stimulation for normal development from infants and young children.³

When individuals were asked for their general opinion concerning mental retardation, they usually rated MR more negative and debilitating than mental illness, a result which may indicate some confusion of facts and a need for additional information. There has been considerable concern with the impact of community attitudes on MR services. It was found that the attitudes of rural teachers affected the integration of mentally retarded students into normal classes. Likewise it was found that subjects who had no prior contact with or knowledge about mentally retarded persons tended to have a more negative attitude towards them. The longer the experience with the mentally retarded, the more positive the attitudes expressed by volunteers working with them.⁴

Physical integration alone is not sufficient to promote positive perceptions among those without disabilities. People with mental retardation must also participate in age–appropriate, socially valid activities to be accepted by those without disabilities.⁵

Perceptions of people with mental retardation held by those without disabilities improved over an 11–year period. However, reports of global improvements may obscure differences in perceptions associated with the context in which those perceptions are measured. With the increased visibility of persons with mental retardation in inclusive settings over the past 20 years, persons without a disability may be inclined to evaluate a person with mental retardation who participates in segregated physical/sport activities negatively compared to a person engaging in integrated activities. Indeed, professionals in the field of mental retardation have criticized segregated recreation/sports such as Special Olympics on numerous grounds, including negative effects on attitudes toward persons with disabilities, the promotion of handicapism, and continuation of self–fulfilling prophecies about deviant characteristics of persons with disabilities.⁶

The learner with special educational needs finds it difficult to comply with the demands and expectations of society, possibly because of his perceived lack of performance or potential. He is often treated with little interest or sympathy, with uneasiness, fear, embarrassment and/or even disgust.⁷

Nurses consider that their training, knowledge and skills are essential for competent mental health nursing practice. Such skills are as important to mental health nursing as the monitoring of vital signs is to medical and surgical nursing.⁸

It is crucial that the nurses need specialized knowledge, attitude and skill in caring these special groups and hence the present study was aimed to assess the knowledge and opinion of nurses in care of mentally handicapped children.⁹

NEED FOR THE STUDY:

“Passion Works is a studio where persons with mental retardation or other disabilities can create beautiful works of art and products and provide those to the community”

- Bob Taft

Since the beginning of the modern era, although people with physical impairments have always been present as “cripples”, they were not segregated from society for special treatments and services which we recognise today At the lower end of the economic ladder “cripples”, low-paid workers, the out-of-work and the mentally ill formed a broad oppressed layer of society in which there was a heavy overlap of roles.

The mentally handicapped child deviates from the majority of children in body, mind or behaviour, to such an extent that he cannot derive sufficient benefit, make progress or develop from the instruction provided in mainstream education. He requires education of a specialized nature to facilitate his adaptation.¹⁰

The most immediate impression of disability is paradoxical. On the one hand there is the appearance that disability implies a personal tragedy, passivity and dependency. On the other hand disability can be seen as a form of group discrimination, involving constant struggles and independent action. The paradox of disability confounds any attempt to discover uniform attitudes towards disabled people. It is also a challenge to helpers to face squarely their role in a conflictual social relationship.¹¹

It is a shocking and alarming fact that approximately 2.5 – 3% of the total populations are mentally retarded which in most cases is a lifelong condition. Mentally retarded which in most cases is a lifelong condition. Mental retarded children at homes are lifelong pain for parents. Proper handling and treatment can make them to live self-sufficiently.¹²

A study was conducted on prevalence and pattern of mental disability using Indian disability evaluation assessment scale in a rural community of Karnataka. The prevalence of mental disability was found to be 2.3%. The prevalence was higher among females (3.1%) than males (1.5%). There is ample scope for community-based rehabilitation of the mentally disabled.¹³

Since the turn of this century the number of workers, professional and lay, in industrial societies who work in the field of disability has increased enormously. Almost every aspect of the life of a person who is disabled has its counterpart in a “profession” or voluntary organisation. Potential and real control over the life of a disabled individual is a modern fact. This has resulted in the attitude that the disabled individual is obviously particularly dependent upon others for help.¹⁴

Many health professionals and nurses, who are involved in the care of disabled children, do not exhibit the essential sensitivity and appropriate attitudes towards them, resulting in a poor quality of nursing care. The growth of professional expertise in the field has also meant that these helpers have had an almost absolute monopoly in defining and articulating the problems of disability to the public at large.¹⁵

Besides education, even medical care of the retardate has not become popular. This might be attributed to the relatively underdeveloped state of pediatrics in this country. On the other hand, people have not demanded facilities for the retardate, which might have prompted more governmental interest in this field. The disinterest in the education and care of the retardate resulted not so much from indifference to the retardate's problems but rather from a preoccupation with problems of national reconstruction soon after independence such as land reforms.¹⁶

Today there is almost no aspect of life for which there is no profession. Hence professional nurses working in psychiatric units need to have a thorough knowledge and a positive attitude in caring these special groups of population. The investigator with his personal experience had a curious thought to assess the knowledge and opinion of the nurses on care of mentally challenged children. Thus, the increasing help will facilitate greater numbers of disabled people functioning independently in the community.¹⁷

STATEMENT OF THE PROBLEM:

A study to assess the knowledge and opinion regarding care of mentally handicapped children among nurses in a selected psychiatric hospital at Bangalore.

OBJECTIVES:

a) To assess the knowledge and opinion of nurses regarding care of mentally handicapped children.

b) To correlate the knowledge and opinion of nurses regarding care of mentally handicapped children.

c) To find out the association between nurses’ knowledge and opinion on care of mentally handicapped children with their selected demographic variables.

HYPOTHESIS:

H₁: There will be significant correlation between knowledge and opinion of nurses on care of mentally handicapped children.

H₂: There will be significant association between the knowledge of nurses on care of mentally handicapped children with their selected demographic variables.

H₃: There will be significant association between the opinion of nurses on care of mentally handicapped children with their selected demographic variables.

OPERATIONAL DEFINITION:

Assess:

It refers to the statistical measurement of knowledge and opinion of nurses on care of mentally handicapped children as determined from the scores based on the structured knowledge questionnaire.

Knowledge:

It refers to the correct responses of nurses on care of mentally handicapped children to the structured knowledge questionnaire.

Opinion:

It refers to expressed feeling of nurses regarding care of mentally handicapped children as measured by opinion scale.

Care of mentally handicapped children:

It refers to those measures taken by the nurses who take care of children below 18 years of age diagnosed to have intelligent score below 70 and admitted in the selected hospital.

Nurses:

It refers to the person working in selected psychiatric hospital, Bangalore after completion of his/her diploma/degree in nursing (GNM, B. Sc, DPN and Post basic) and has registered in State Nursing Council.

METERIALS AND METHODS:

Research Approach:

Exploratory research approach.

Research Design:

Non experimental descriptive design was adopted for this study to assess the knowledge and opinion regarding care of mentally handicapped children among nurses.

Population:

The population for the present study was Nurses working in psychiatric hospitals.

Sampling techniques and Sample size:

The investigator selected 40 nurses through convenience sampling technique.

RESULT:

The major findings of the study was summarized as follows:

· Majority (40%) of nurses were in the age group of 36-45 years, With regard to the gender of nurses, the highest percentages (62.5%) of them were females and lowest percentages (37.5%) of them were males. Considering the religion of nurses, majorities (72.5%) of nurses were Hindus, Regarding the marital status of nurses, Majority (62.5 %) of the nurses were married, With regard to the professional qualification of nurses, higher percentage of nurses (75%) had completed their GNM, On considering the area of work of nurses, higher percentages of nurses (40%) were working in general wards, Regarding the years of experience of nurses, higher percentage (40%) were having 5-10 years of experience, Considering the family history of mental retardation , Highest percentage (92.5%) of nurses has no family history of mental retardation, With regard to the source of information, highest 42.5% of the nurses had had their knowledge from professional conferences, regarding special training/certification done on care of mentally 87.5% of nurses did not have any special training or certification handicapped children and Experience in care of mentally handicapped children.

· Regarding the overall knowledge scores of nurses on care of mentally handicapped children, 17 (42.5 %) got poor knowledge, 18 (45%) got average knowledge, 5 (12.5%) got good knowledge and no one got very poor and excellent knowledge.

· When considering the opinion of nurses on care of mentally handicapped children, 3 (7.5 %) of the nurses have negative opinion, 16 (40%) of the nurses opinion were neutral, 21 (52.5%) had positive opinion and none of them had highly positive or highly negative opinion.

· The highest mean 3.05±0.846 with mean percentage 50.83 was for the area of manifestations, diagnosis and management of MR and lowest mean 3.70±1.181 with mean percentage 41.1 was for the area of prevention and nursing care of mentally handicapped children. Further, the overall mean was 11.38±2.498 with mean percentage 45.52. In the area of opinion of nurses on care of mentally handicapped, the mean was 44.83±10.749 with the mean percentage 59.77.

· The significant association was found between the knowledge scores of nurses and their selected demographic variables such as age, gender, religion, marital status, professional qualification, area of work, years of experience, family history of MR, experience in care of MR children and source of knowledge, special training/ certification area of work, as the obtained χ2 value is lesser than the table value at p < 0.05. However significant association was found between the opinion of nurses and their selected demographic variables such as area of work ( p < 0.05), and highly significant association was found with the variables such as family history of MR, experience in care of MR children and source of knowledge ( p < 0.001). Hence H2 and H3 is accepted.

· Correlation of knowledge with opinion of nurses reveals that the mean knowledge score is 11.38 with SD 2.498 and the mean opinion score is 44.83 with SD 10.749. The coefficient of correlation is 0.313 which shows a positive correlation. Hence H1 is retained.

Figure-1: Correlation of Knowledge and Opinion.

Figure-1 shows the correlation of knowledge with opinion of nurses. It reveals that the mean knowledge score is 11.38 with SD 2.498 and the mean opinion score is 44.83 with SD 10.749. The coefficient of correlation is 0.313 which shows a positive correlation. Hence the research hypothesis H₁is retained.

A) Association between Knowledge of the Nurses and Their Demographic Variables. (Through Chi-Square test).

Table 1: Association between knowledge scores of nurses and their demographic variables. n = 40

Nurses	Df	χ²	Table value	Level of Significance
Age	8	8.974	15.51	Not Significant
Gender	2	1.449	5.99	Not significant
Religion	4	1.887	9.49	Not significant
Marital status	6	5.144	12.59	Not significant
Professional qualification	2	4.929	5.99	Not significant
Area of work	6	6.412	12.59	Not significant
Years of experience	6	8.239	12.59	Not significant
Family history of MR	2	0.949	5.99	Not significant
Special training	2	12.775	5.99	Significant**
Experience in care of MR children	2	0.755	5.99	Not significant
Source of knowledge	6	5.683	12.59	Not significant

*Significant at p < 0.05 level.

The above table shows that there was a significant association between the knowledge scores of nurses and their selected demographic variables such as age, gender, religion, marital status, professional qualification, area of work, years of experience, family history of MR, experience in care of MR children and source of knowledge. Hence H₂ is retained for the above mentioned demographical variables.

B) Association between Opinion of The Nurses and their Demographic Variables. (Through Chi-Square Test).

Table 2: Association between opinion scores of the nurses and their demographic variables. n= 40

Nurses	Df	χ²	Table value	Level of Significance
Age	8	6.076	15.51	Not significant
Gender	2	1.359	5.99	Not significant
Religion	4	3.525	9.49	Not significant
Marital status	6	7.851	12.59	Not significant
Professional qualification	2	1.349	5.99	Not significant
Area of work	6	13.513	12.59	Significant*
Years of experience	6	4.273	12.59	Not significant
Family history of MR	2	16.662	5.99	Highly significant***
Special training	2	1.170	5.99	Not significant
Experience in care of MR children	2	17.537	5.99	Highly significant***
Source of knowledge	6	22.551	12.59	Highly significant***

*Significant at p < 0.05 level.

The above table reveals that there was a significant association found between the opinion of nurses and their selected demographic variables such as area of work, family history of MR, experience in care of MR children and source of knowledge. Hence the H₂is retained.

CONCLUSION:

The study was done to assess the knowledge and opinion regarding care of mentally handicapped children among nurses in a selected psychiatric hospital at Bangalore. The result of study showed that majority of the nurses that is 17(42.5%) got poor knowledge, 21(52.5%) had positive opinion.

RECOMMENDATIONS:

· The study may be undertaken by increasing the sample size to generalize the findings.

· A similar study can be replicated on samples being care givers of mentally handicapped children.

· Comparative study may be conducted by comparing the opinion of various sectors of population on care of mentally handicapped children.

· Experimental study can be conducted to assess the effectiveness of selected strategies in care of mentally handicapped children.

REFERENCES:

1. Anita M Burr. Learning care for mentally retarded children. The American Journal of Nursing. 2016 Jun; 29(2): 155-60.

2. Shambhu Upadhyay, Anju Singh. Psychosocial Problems and Needs of Parents in Caring Mentally Retarded Children: The Impact of Level of Mental Retardation of children. Indian Journal Social Science Researches. 2017; 6(1): 103-112.

3. Shah PM. Prevention of mental handicaps in children in primary health care. Bull World Health Organ. 2015; 69(6):779-89.

4. Victor Finkelstein. Attitudes and disabled people. International exchange of information in rehabilitation. Newyork: Lamport Gilbert Printers Ltd; 1980.

5. A.L. Carsrud, R.D Ahlgren, B. G. Dodd, Evaluating the effects of a community awareness programme on attitudes towards sheltered work and living projects, Applied Research in Mental Retardation 2014; 5: 99 – 105.

6. J. Thomas Kellow, Georgia C. Frey, Dawn Rosser Sandt. Perceptions Of A Person With Mental Retardation As A Function Of Participation In Integrated Versus Segregated Recreation/Sport Activities: An Experimental Analysis.

7. Krajewski, J. J, Hyde, M. S. Comparison of teen attitudes toward individuals with mental retardation between 1987 and 1998: Has inclusion made a difference. Education and Training in Mental Retardation Developmental Disabilities 2015; 35 (3): 284-293.

8. M A J Olivier, E E Williams. Teaching the mentally handicapped child: Challenges teachers are facing. The International Journal of Special Education. 2015; 20(2).

9. Biordi B, Oermann MH. The effect of prior experience in a rehabilitation setting on students' attitudes toward the disabled. Rehabil Nurs. 2013 Mar-Apr; 18(2): 95-8.

10. Jacqueline Fawcett. Contemporary Nursing Knowledge. Second edition. Philadelphia: F.A. Davis Company. 2015.

11. Polit DF, Hungler BP. Nursing Research. Principle and Methods. Philadelphia: JP Lippincot Company; 2017.

12. Elliott H. Sherr and Donna M. Ferriero. Mental Retardation: Encyclopedia of the Neurological Sciences. USA: Elsevier Science; 2013.

13. Ganesh Kumar, Acharya Das. Prevalence and pattern of mental disability using Indian disability evaluation assessment scale in a rural community of Karnataka. 2017; 50: 21 – 23.

14. Hastings R. P, Graham S. Adolescents' perceptions of young people with severe learning difficulties: The effect of integration schemes and frequency of contact. Educational Psychology. 2015; 15(2): 149-159.

15. Yazbeck M, McVilly K, Parmenter T. R. Attitudes toward people with intellectual disabilities. Journal of Disability Policy Studies. 2014; 15: 97-111.

16. Upadhyay. Psychosocial Problems and Needs of Parents in Caring Mentally Retarded Children. Indian Journal Social Science Researches. 2017; 6(1): 103-112.

17. Zubillaga P, Emparanza JI, Guinea B, Mendizábal F, Muriel A, Ruiz M, et al. A cohort study of accidents occurring in mentally handicapped patients living in institutions. Ann Gen Psychiatry. 2015 May 8; 9:22.

Received on 11.02.2025 Revised on 14.04.2025

Accepted on 03.06.2025 Published on 27.10.2025

Available online from November 08, 2025

Int. J. Nursing Education and Research. 2025;13(4):231-236.

DOI: 10.52711/2454-2660.2025.00047

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