BACKGROUND:

Mental retardation is not a disease or single entity. It refers to a developmental mental disability and that appears in children by birth or under the age of 18years. In most of the cases, it persists throughout adulthood. It can be defined as a level of intellectual functioning is well below average and results in significant limitations in the person’s daily living skills. It exists when there is significantly sub average general intellectual functioning with concurrent deficits in adaptive behavior.² Failure to achieve developmental milestones is suggestive of mental retardation.

These limitations will cause a child to learn and develop more slowly than a typical child. They are likely to have trouble in the school. They will learn, but it will take them longer. The causes for mental retardation are many may be biological or environmental factors or interaction between two. It includes heredity about 30%, prenatal illness and issues, childhood illness and injuries, and environmental factors. In about 40% of cases, the cause of mental retardation cannot be found.¹

Raising a child who is mentally challenged requires emotional strength and flexibility. The child has special needs in addition to the regular needs of all children, and parents can find themselves overwhelmed by various medical, care giving and educational responsibilities. Whether the special needs of the child are minimal or complex, the parents are inevitably affected. Support from family, friends, the community or paid caregivers is critical to maintaining balance in the home.²

Mental retardation is a challenge not only to any nation, but also to the entire human race. All over the world 83 million people are mentally retarded. Prevalence of mental retardation is believed to be between 1% and 3%, with mild retardation being most prevalent. Prevention is better than cure. Mental retardation can be prevented by immunization against disease such as measles and Hib prevents many of the illnesses that can cause mental retardation. Pregnant women should be educated about the risks of alcohol consumption and need to maintain good nutrition during pregnancy. Children should undergo routine developmental screening as part of their pediatric care. Parenting a child with a disability is above and beyond that of caring of a normal typical child but good parental care also will prevent retardation. Mothers are the first teachers and children spend maximum time at home, so mothers needs to be involved in training of mentally retarded child in learning self care comprising of brushing, bathing, feeding , toileting, dressing and grooming.³

Physical exhaustion can take a toll on the parent of a mentally challenged child. The degree of this is usually relative to the amount of care needed. Feeding, bathing, moving, clothing and diapering a child is some of the physically doing tasks that the parent faced. The child may have more physician and other health-care appointments than a typical child and may need close medical monitoring. He may also need to be watched to avoid inadvertent self-harm such as falling down stairs or walking into the street. These additional responsibilities can take a physical toll on a caretaker, leading to exhaustion. The American Academy of Family Physicians relates that these issues can cause significant caregiver stress. ³

Mental retardation begins in childhood or adolescence before the age of 18. In most cases, it persists throughout adult life. A diagnosis of mentally challenged is made if an individual has an intellectual functioning level well below average, as well as significant Limitations in two or more adaptive skill areas. Mentally challenged children at homes are lifelong stressors for parent. But proper handling and treatment can make them to live self sufficiently. The interactions of parent with children with disabilities can have a profound impact on the development and progress of the child. The exposure of the child to an environment comprised of a variety of stimulation, encouragement, verbalization, provides chances for exploration and gives ample opportunities for manipulating objects. Again, if the experience is rewarding, the child is expected to develop relatively a rich repertoire of information in contrast to a child who has been denied all such stimulations. ⁴

Research has shown that the best place for children with mentally challenged to grow in is their own families and at special schools where they can be nurtured with appropriate stimulation. Therefore services should be organized so that the families are supported, strengthened & empowered to look after their affected member. It should also be recognized that families are not just recipients of services but care-providers as well. In other words, they are partners in care.

OBJECTIVES OF THE STUDY:

1. To assess the knowledge of parent before and after administration of planned teaching programme on care of mentally challenged child while attending parent-teacher meeting in special school of Ahmadabad District.

2. To assess the attitude of parent before and after administration of planned teaching programme on care of mentally challenged child while attending parent-teacher meeting in special school of Ahmadabad District.

3. To find out association between pretest knowledge score towards care of mentally challenged child with selected demographic variable of parent in special school of mentally challenged of Ahmadabad District.

4. To find out association between pretest attitudes towards care of mentally challenged child with selected demographic variable of parent in special school of mentally challenged of Ahmadabad District.

MATERIALS AND METHODS:

A pre experimental one group pretest post test research design was performed. Researcher took 60 parent attending parent-teacher meeting by convenient sampling technique of special schools for mentally challenged of Ahmadabad District. A structured questionnaire for assessing the knowledge and summated Likert’s scale to assess the attitude regarding care of mentally challenged children. A structured questionnaire comprising of 30 questions related to care of mentally challenged was prepared to assess the knowledge of parent attending parent-teacher meeting.⁵

A summated Likert’s scale consisting 20 items was prepared to assess the attitude of parent regarding mentally challenged children. 60 parent who fulfilled the inclusion and exclusion criteria were selected from the special school for mentally challenged, Ahmadabad District conveniently. Every subject had given their socio demographic profile i.e. age, educational qualification, no. of mentally challenged children, no. of normal children, any previous knowledge about care of the mentally challenged children etc.

FINDINGS:

Sample characteristics (frequency and percentage distribution of socio-demographic characteristics of study subjects)

Out of 60 sample 17(28.33%) were of 25-30 years, 21(35.00%) were of 31-35 years, 12(20.00%) were of 36-40 years, 10(16.67%) were of 41-45 years of age. In gender 16(26.67%) were male, 44(73.33%) were female. In religion 30(50.00%) were Hindu, 6(10.00%) were Christian, 24(40.00%) were Muslim. In educational status 16(26.67%) were primary, 10(16.67%) were secondary, 18(30.00%) were higher secondary, 16(26.67%) were graduate and above. In occupation status 11(18.33%) were employed, 37(61.67%) were unemployed and 12(20.00%) were self employed. In monthly income 2(3.33%) were <5000-10,000, 20(33.33%) were 10,001- 15,000, 26(43.33%) were 15,001- 20,000, 12(20.00%) were 20,001- 25,000. In type of family 27(45.00%) were nuclear and 33(55.00%) were joint family. In type of marriage 40(66.67%) were unconsanginous marriage, 20(33.33%) were consanginous marriage. In number of normal children 7(11.67%) were nil, 25(41.67%) were one, 19(31.67%) were two, 9(15.00%) were three and more. In number of mentally challenged children 47(78.33%) were one, 13(21.67%) were two. In how long have you been caring for this/these children 29(48.33%) were 1-4, 17(28.33%) were 5-8 and 14(23.33%) were 9-13. In from where did you get previous knowledge about care of the mentally challenged children 13(21.67%) were mass media, 11(18.33%) were special school, 19(31.67) were health personnel and 17(28.33) were no information.

In age of children 31(51.67%) were 5-7 years, 17(28.33%) were 8-10 and 12(20.00%) were 11-13 years. In gender of children 35(58.33%) were male and 25(41.67%) were female. In intelligent quotient of the child 19(31.67%) were mild 50-70 and 41(68.33%) were moderate 35-49. In any complication during pregnancy of mentally retarded child 16(26.67%) were intra uterine growth retardation, 11(18.33%) were fetal distress, 14(23.33%) were cord entangle and 19(31.67%) were no complication. In level of dependency on parent 35(58.33%) were completely dependent and 25(41.67%) were partially dependent.

Table 1 Area wise mean, mean percentage and percentage gain of pre-test and post test knowledge of the samples. [N =60]

Sr No	Area of Content	Max. Score	Pre-Test Knowledge Score			Post-Test Knowledge Score			Percentage (%) Gain	Mean difference
Sr No	Area of Content	Max. Score	Mean Score	Mean%	SD	Mean Score	Mean%	SD	Percentage (%) Gain	Mean difference
1	General information	6	1.36	22.78	0.97	3.31	55.28	1.17	32.50	1.95
2	Home care	3	1.45	48.33	0.94	2.23	74.45	0.81	26.12	0.78
3	Activities of daily living	7	4.82	68.81	1.11	5.87	83.81	0.83	15.00	1.05
4	Issue with emotional processes	2	1.78	89.17	0.45	1.93	96.67	0.25	7.50	0.15
5	Issues with financial areas	5	3.82	76.33	1.17	4.55	91.00	0.62	14.67	0.73
6	issues with disciplining and behaviour	2	1.00	50.00	0.58	1.50	75.00	0.53	25.00	0.50
7	Prevention of disability	5	2.63	52.67	0.94	3.03	60.67	0.66	8.00	0.40
	TOTAL	30	16.87	56.23	3.42	22.43	74.78	1.92	18.55	5.56

Table 2 Mean, Mean Difference, Standard Deviation (SD) and‘t’ test value of the Pre-test and Post-test Knowledge scores of samples. [N=60]

Knowledge test

Mean

Mean difference

Calculated ‘t’ value

Table ‘t’ value

Pre-test

16.87

5.56

3.42

1.92

17.42

2.00

Post-test

22.43

Table 3 Distribution of favourable and unfavourable Attitude based on pre-test and post-test attitude score of the samples. [N=60]

Level of Attitude	Pre-test		Post-test
Level of Attitude	Frequency	Percentage(%)	Frequency	Percentage(%)
favourable(61 to 100)	12	20%	56	93.33%
unfavourable(20 to 60)	48	80%	04	6.66%
Total	60	100%	60	100%

Table 4 Mean, Mean Difference, Standard Deviation (SD) and ‘t’ value of the Pre- test and Post test Attitude scores of samples. [N=60]

Knowledge test

Mean

Mean difference

Calculated ‘t’ value

Table ‘t’ value

Pre-test

48.12

19.93

8.16

5.7

14.19

2.00

Post-test

68.05

Table 5 Analysis and interpretation of the data related to association of pre-test knowledge and attitude score with selected demographic variables. N=60

S. No.	Socio-demographic variables	Knowledge scores			Attitude scores
S. No.	Socio-demographic variables	Calculated value	Table value	df	Calculated value	Table value	df
1.	Age of parent	10.06	12.59	6	0.07	7.81	3
2.	Religion	14.12	9.49	4	1.44	7.81	3
3.	Educational status	3.77	12.59	6	2.90	7.81	3
4.	Monthly income	9.82	12.59	6	4.35	7.81	3
5.	Occupational status	6.47	9.49	4	1.06	5.99	2
6.	Type of family	8.12	5.99	2	0.13	3.84	1
7.	Type of marriage	3.37	5.99	2	0	3.84	1
8.	Number of normal children	2.83	12.59	6	0.85	7.81	3
9.	Number of mentally challenged children	4.51	12.59	6	0.08	3.84	1
10.	Any previous knowledge about care of mentally challenged children	9.40	12.59	6	0.31	7.81	3

*=p<0.05level

DISCUSSION:

Findings of the study revealed that the knowledge pretest mean score was 16.87, knowledge post test mean score was 22.43. The mean attitude pretest score was 48.12, mean attitude post test score was 68.05. Devavhi (2009) demonstrated that the structured teaching programme was effective in increasing knowledge from 19.68 to 32.57 and attitude 18.35to 22.45 among mothers.

So it was concluded that present status of knowledge and attitude of parent regarding care of mentally challenged children, majority of parent had inadequate knowledge and attitude. The teaching programme was effective in term of knowledge and attitude gain. The difference between pretest and post test knowledge and attitude was found statistically significant.

CONFLICT OF INTEREST:

None

SOURCE OF FUNDING:

Nil

ETHICAL CLEARANCE:

The ethical approval was taken from ethical committee of Gujarat University, JG college of Nursing, Ahmadabad. Permission was taken from the commissioner, Health medical service and medical education and director of special school prior to final data collection. Apart from this, informed consent was taken from each respondent to participate in the study.

REFRENCES:

1. Eisenberg Daniel, Schneider Helen. (2007) Perceptions of Academic Skills of Children Diagnosed With mental retardation. Journal of child psychiatric, May 2007 vol. 10 no. 4 390-397

2. Anita, DR Gaur, AK Vohra and Khurana Hitesh.(2009).Indian Journal of Community Medicine; Vol. 28, No. 3.

3. Anderson Donnah L., Watt Susan E. and Noble William. (2012). Knowledge of mentally challenged child and attitudes toward children with mentally challenged: the role of parent experience. Psychology in the special Schools, Vol. 00(0), 2012

4. Drews C.M. (2010). Effectiveness of planned teaching programme on home based care in selected areas for the parents of mentally retarded children in a special school at Mangalore, American Journal of public health, volume 3.

5. Carola Burns N and Susan, K.G. (2007).Understanding nursing research Building and Evidence Based Practice. 4th edition, New Delhi, Elsevier.

Received on 22.07.2016 Modified on 30.08.2016

Int. J. Nur. Edu. and Research. 2016; 4(4): 481-484.

DOI: 10.5958/2454-2660.2016.00087.9