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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Effectiveness of Educational Programme on Knowledge regarding Abuse and Age-related Changes among Elderly Population
Correspondence Address :
Dr. Embhah Dkhar,
Padmashree Institute of Nursing, Sulikere Post, Kommaghatta, Kengeri-560060, Bengaluru, Karnataka, India.
E-mail: embhah3@gmail.com
Introduction: Age-related changes are a universal and regular process of ageing. Normal ageing produces changes in structures and functions of organs, and abuses is widespread among the elderly population and is a highly complicated problem.
Aim: Effectiveness of educational programme on knowledge regarding abuse and age-related changes among elderly population.
Materials and Methods: A Quasi-experimental research study was conducted in India from 1st December 2019 to 30th December 2019 through a community-based survey in Padmashree Institute of Nursing in Kommaghatta Rural community, Bengaluru, India. This survey was conducted among 60 elderly people using a systematic random sampling technique. An educational programme was conducted as an intervention to impart knowledge to the elderly. Questionnaires were used to assess the knowledge of abuse and age-related changes. Data was analysed by Statistical Package For Social Science (SPSS) version 20.0.
Results: The study findings showed that in the pretest level of knowledge, none of the subjects had adequate knowledge, whereas, post-test in the educational programme, the majority had moderately adequate knowledge (76.7%). The pretest mean score was 49.7% which showed adequate improvement in the post-test score level of 70.6%, which was statistically significant (p<0.001).
Conclusion: The study finds evidence that nurses working in the community setting needs to use educational programmes to improve knowledge regarding abuse and age-related changes among the elderly, which helps in preventing elderly abuses.
Ageing, Elderly abuses, Structured questionnaire
Ageing is an inevitable developmental phenomenon bringing along several physical, psychological, hormonal and social changes (1). Elderly is the term used for the age above 60 years. According to the data of the present century, about 280 million world’s population belongs to the age group of 60 years and above. In developing countries, the percentage of elderly was less previously as compared to the current situation, as per the recent survey the population of elderly has been increasing (2).
Elder individuals have physiological changes that occur in all organs (3). These physiological changes (musculoskeletal changes, cardiovascular changes, respiratory changes, digestive system, urinary system, vision, hearing, integumentary and central nervous system) are expected as part of ageing and may begin in early adulthood (4). These changes leads to major public health issue which may cause a burden to the family and country. These changes in body composition increase the older adult’s risk of developing a wide range of chronic disorders (5),(6),(7),(8).
Elderly abuse is inappropriate behaviour or harm to the elderly or older people (9). Abuse can happen anywhere, like within families, hospitals, healthcare centres, and old age homes (10). In India, abuse against the elderly is a fundamental challenge. It can be done by their children, daughter-in-law, son-in-law and/or caregiver. Common abuses to elders are physical, psychological, emotional, financial, abandonment, neglect, etc (11).
Globally, the prevalence of elder abuse is projected to increase in many countries as the ageing population has rapidly increased whose needs may not be fully met due to resource constraints. The number of victims may rapidly increase if the proportion of elderly abuse remains unchanged. A significantly less population is aware of elderly abuse, especially in developing countries like India (12).
According to Help Age India organisation conducted survey to identify crimes against the elderly in 2014, the survey report showed that half of the elderly experienced abuse. Family members cause 77% of elderly abuse, 32.5% are abused by their relatives, 21% by friends and 20% by neighbours (13).
According to recent data in Karnataka State, the population of the elderly is estimated to be about eight lakhs, and Bangalore has the highest percentage of elderly abuse and shame in the community. The overall report of India shows that Bangalore tops in elderly population facing abuse in different forms. The survey conducted among the elderly shows overall abuse to be 16%, verbal abuse of 12.5%, financial abuse of 8.5%, and physical abuse of 1.5%. The elderly also experienced multiple of abuse (14),(15).
A recent study shows that about 15.7% of the elderly found some form of abuse (16). In India, elderly abuse most commonly occurs in the female gender (17). Many national and international agencies recommend an age-friendly environment for the elderly (18),(19). Child abuse is common and recognised as compared to elder abuse in India context. Abuse in the elder population was not noticed, neglected and only few research studies were conducted in India compared to western countries cited above. This present study research investigator wants to emphasise the elder population’s knowledge on self identification of abuse and age-related changes. Imparting knowledge on abuse make elder population recognise and aware of it.
Quantitative research was conducted to assess the effectiveness of the educational programme on knowledge regarding abuse and age-related changes among the elderly. The research design used in the study was a quasi-experimental - one-group pretest and post-test design. Pretest was conducted on same day intervention administered and post-test was performed after one week the total duration of data collection four weeks.
The study was approved by the research ethical committee Padmashree Institute of Nursing and formal permission was obtained from the concerned authority of Sulikere PHC with the registration number 05_N293_94681 30/03/2019 and informed consent was obtained from the samples. The study was conducted in Kommaghatta village, Bengaluru, Karnataka, India from 1st December 2019 to 30th December 2019.
The research investigator performed an extensive community-based survey to identify the elder subjects above 60 years. Total 120 elderly and care giver were identified, and out of them, 60 subjects were selected for the study using systematic random sampling (Table/Fig 1).
Sample size calculation: The first subject was selected using a random sampling technique followed by an interval of two subjects. The following formula was used for sampling technique:
K=N/n,
Where N= Total population
n=sample size
k=120/60=2,
So, samples were allocated six groups, and each group had 10 elderly subjects
Educational Programme
The study was conducted for the duration of four weeks. The researcher obtained permission from the concerned authority of the rural community (Primary Health Center (PHC) - Sulikere in Bengaluru) and the informed consent from the sample. The eligible samples were selected based on systematic sampling technique; pretest was conducted by using structured knowledge questionnaires.
Followed by the pre-test an educational programme covered abuse and age-related changes among the elder population. This programme involved audio-visual aids such as flashcards and charts on knowledge regarding age-related changes and elder abuse among the elder population. The duration of the programme was 30 minutes for each group which consisted of 10 members. At the end of the session, information booklets were distributed to the participants.
Post-test was performed after one week duration by using the same knowledge tool. After completion of the study remaining 60 all the eligible subjects who have not been selected through sampling technique samples received similar intervention.
Measurement of Outcomes
The tool consist of 28 questionnaire items with four domains such as general information regarding age-related changes (two items), knowledge regarding age-related structural changes (eight items), knowledge regarding age-related physiological changes (nine items), and knowledge regarding elderly abuse (nine items). Section A included a demographic questionnaire to obtain information regarding age, gender, religion, educational status and previous occupation. Section B included a structured knowledge questionnaire to assess the knowledge regarding age-related changes and elderly abuse [Annexure]. Interpreting the score (<50%=inadequate knowledge, 50-75%=moderately adequate knowledge, and >75%= adequate knowledge) (20). A high score 50% and above indicates higher knowledge, and a low score below 50% indicates lower level of knowledge.
The tool reliability was obtained by using split half method score was 0.87. The tool was reliable to conduct the study.
Statistical Analysis
SPSS version 20.0 was used to analyse the data. Paired t-test was used to analyse the mean difference in the knowledge score between pretest post-test and p<0.05 levels were found to be highly significant.
Total 60 subjects were enrolled and majority of them were in the age group of 61-70 years (51, 85%). There were more females (37, 61.7%) then males. The demographic characteristics showed that out of 60, 45 (75%) of the participants were having primary education and 20 (33.3%) elderly were private employees. Other characteristics has been given in (Table/Fig 2).
The (acquired result of the) pretest level of knowledge was inadequate as it shows less than 50% of frequency level i.e. 24 (40.0%) (Table/Fig 3). Only around 60% i.e. 36 of elderly are aware about the abuses and age-related changes in moderately adequate level. The study shows that none of the subjects have adequate level of knowledge that is above 75% of knowledge level among the elderly. On the contrary, the results of the post-test showed a great variation that is around 46 (76.7%) had adequate level of knowledge, 14 (23.3%) have a moderate level of knowledge, and none of the subjects have an inadequate level of knowledge. This shows that after the administration of educational programmes, the majority of elderly have received an understanding about the need of the knowledge regarding abuse and age-related changes and among elderly in a moderate level of knowledge as compared with the pretest results.
The baseline mean score was 13.93 and in the post-test mean score is 19.77. The difference in mean score is 5.84 which indicates that there was an improvement in the level of knowledge after administration of education programmes among the study population (Table/Fig 4). Educational programmes have a positive impact on increasing the knowledge level, which influences the improvement of Quality of Life (QoL) among the elder population.
The overall mean difference was 5.84, standard deviation was 2.29, the mean difference percentage was 20.9%, and paired t-test value was 19.70. These scores show a highly significant difference at p<0.001 level. In addition, there was statistical significance in all aspects of knowledge at p<0.001 level (Table/Fig 5). The highest mean percentage was identified in the aspects of knowledge regarding elderly abuse and the lowest percentage in general information. This trend shows that most subjects were unaware of elderly abuse, and after educational programmes, the subjects gained a high knowledge about elderly abuse. The interventions improved the level of knowledge among the elderly, resulting in decreased abuse in the elderly and increased QoL.
The study was undertaken to identify the impact of educational programmes on rural community elderly on abuse and age-related changes. According to recent data, the prevalence of elderly abuse in India has increased in recent decade (21). Study results revealed that the educational programme had improved the knowledge regarding abuse and age-related changes, there was significant improvement in the mean score from 49.7 to 70.6 after administration of intervention (mean difference 20.9). The educational programme was statistically significant in the post-test level of knowledge at p<0.001 level.
The findings of similar randomised controlled trials, conducted the combinations of interventions included education and case scenarios study results showed improvement of participants’ level of the knowledge as compared to the baseline knowledge level (22). A study performed among students’ reaction to the material presented in the context of their previous knowledge of elder abuse and study results showed that the level of knowledge increased from 28.5% to 53.5% (23). Another study done by West A et al., showed the significant difference between mean scores of pre and post-tests (22.77 to 25.35) in knowledge of elder abuse in medical students’ (24).
The systematic review conducted on efficacy of community based elder abuse interventions on level of knowledge study was performed by multidisciplinary interventions and psychological interventions, results of study showed that there was rise in the level of knowledge as compared to baseline and study identified that there was scarcity of studies on abuse among older population (25). The above result suggests a need to enhance knowledge by using new strategies regarding age-related abuse and age-related changes. The elderly who had received an educational programme had a better understanding of abuse.
Most elderly and family members may not be aware of elderly abuse and age-related changes. Hence, providing an educational programme about abuse and age-related changes can contribute to better compassion on knowledge in families and the communities. Furthermore, emphasising the knowledge of elderly abuse among the public helps make a better place for the elderly. Educational programmes can be conducted in the hospital and other healthcare settings by involving the family members to enhance their knowledge and improve the quality of life of the elderly.
Technology-based awareness programmes can be conducted by involving the student nurses in public and voluntary agencies. A previous study conducted on nurses’ ability to recognise elder abuse induced by family members showed significantly increased scores from 255.96±26.55 and 224.85±35.11 after the intervention (26). The findings of present study are the basis for professional nurses and students to conduct further research studies. In addition, nursing researchers should conduct interactive sessions with people above 60 years on psychological problems and how to overcome them.
Limitation(s)
The project has some limitations. The level of knowledge can differ based on their educational background. The study involved specifically to elderly population. The study cannot be generalised, hence the study involves only one group of people and no randomisation.
The proposed educational programme effectively improved the knowledge regarding abuse and age-related changes among the elderly. However, there is a need to conduct an awareness programme or educational programme in the hospital setting, home care, old age home and community or healthcare settings to improve and enhance the knowledge of the elderly and the healthcare providers. This change can positively impact the health and safety of the elderly.
Authors pay sincere thanks to Padmashree Institute of Nursing, the medical surgical department and Head, and the study participants.
DOI: 10.7860/JCDR/2022/56410.16968
Date of Submission: Mar 16, 2022
Date of Peer Review: Jun 08, 2022
Date of Acceptance: Aug 02, 2022
Date of Publishing: Sep 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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