INTRODUCTION:

“We are guilty of many errors and many faults, but our worst time is abandoning our children, neglecting the fountain of life. Many of the things we need can wait, the child cannot. Right now is the time when his/her bones are being formed, his/her blood is being made ……..To him/her we cannot answer “Tomorrow”. His/her name is “Today”.

Gabriela Mistral.¹

Child abuse is like a virus-it attacks the host organism and alters it physically. It self replicates. “Infection” creates a downward spiral through generations, each victim more likely to infect more and more victims. Children who survive abuse to adulthood in turn are more likely to abuse their own children who, if they survive, grow up more likely to abuse their own children.²

Child abuse is not just an individual or familial problem. Children who survive abuse grow up more likely to negatively impact our society in many ways, which may be in form of violence, crime, drugs abuse and disease.²Child abuse is a community problem and unless the community is aware of the issue, the extent of the problem and of their role in stopping and preventing child abuse, more and more children, families and communities will suffer.³

In the year 1999, the WHO consultation on child abuse prevention drafted the following definition, “Child abuse or maltreatment constitutes all forms of physical/emotional ill treatment like sexual abuse, neglect, negligent treatment, commercial exploitation or other exploitation, resulting in actual or potential harm to child’s health, survival development or dignity, in the context of a relationship of responsibility, trust or power”.⁴ Neglect is defined as the failure to meet the basic needs of children including housing, clothing, food and access to medical care.²

The first documented case of child abuse occurred in New York in 1874.⁵The different types of child abuse are: physical abuse, neglect, sexual abuse, emotional abuse, parental substance abuse and abandonment.⁶Poverty and substance abuse are more common cause of child abuse.Neglect is the most common form of child abuse, accounting for more than 78% of all the cases. Children resulting from unintended pregnancies are more likely to be abused or neglected. Parents who physically abuse their spouse are more likely than others to physically abuse their children.²

As teachers it is important to have an understanding of; the history of child abuse, causes of child abuse, ways to prevent child abuse and when to report it and an understanding of the lasting affects that child abuse can have. Teacher’s see their students on a daily basis. Making teacher’s one of a child’s best advocates. This is partially why teachers are mandated reporters. It is our ethical responsibility to keep children safe. How is a child supposed to develop and learn when they are not safe in their homes and communities?¹⁴

NEED FOR THE STUDY:

Children are suffering from a hidden epidemic of child abuse and neglect. Over 3 million reports of child abuse are made every year in the United States. In 2009, approximately 3.3 million child abuse reports and allegations were made involving an estimated 6 million children. According to the WHO, one in every 4 girls and 1 in every 7 boys in the world are sexually abused.¹⁸

A report of child abuse is made every 10 seconds. More than five children die every day as a result of child abuse.Approximately 80% of children that die from abuse are under the age of four. It is estimated that between 50 to 60% of child fatalities due to maltreatment are not recorded as such on death certificates. Child abuse occurs at very low socio economic level, across ethnic and cultural lines, within all religions and at all levels of education. Continuing the horrible cycle of abuse, about 30% of abused and neglected children will later abuse their own children. About 80% of children that were abused as children met criteria for at least one psychological disorder during adulthood. The estimated annual cost of child abuse and neglect in the United states for 2008 is $124 billion. In the USA 14% of all men in prison were abused as children and 36% of all women in prison were abused as children.¹⁸

Children who experience child abuse & neglect are 59% more likely to be arrested as a juvenile, 28% more likely to be arrested as an adult, and 30% more likely to commit violent crime. Abused children are 25% more likely to experience teen pregnancy. Abused teens are less likely to practice safe sex, putting them at greater risk for STDs. One-third to two-thirds of child maltreatment cases involves substance use to some degree. Children whose parent’s abuse alcohol and other drugs are three times more likely to be abused and more than four times more likely to be neglected than children from non-abusing families. As many as two-thirds of the people in treatment for drug abuse reported being abused or neglected as children. ¹⁸

India has the largest number of children (375 million) in the world, nearly 40% of its population.³According to the survey done in 2001 by Child Survival and Child Health, 2.5 million children die in India every year, accounting for one in five deaths in the world, with girls being 50% more likely to die. One out of 16 children die before they attain one year of age, and one out of 11 die before they attain five years of age. India accounts for 35% of the developing world's low birth weight babies and 40% of child malnutrition in developing countries, one of the highest levels in the world.Three out of four children in India are anemic. Every second new born has reduced learning capacity due to iodine deficiency.¹¹

In India more than 2.5 million cases of child abuse is reported every year, out of which, 54% involves physical abuse, more than 53% suffered sexual abuse and 48% emotional abuse at the hands of parents and family members.¹⁹

The state of Andra Pradesh, Assam, Bihar and Delhi reported the highest percentage of sexual abuse in both girls and boys. Delhi, the nation capital, has an abuse rate of over 83%. Severest sexual abuse in age group 11 to 16 years. The highest percentage i.e 89% of the crimes was perpetrated by family members. Boys face more abuse (> 72%) than girls (65%). More than 70% of cases go unreported and unshared even with parents or family. 65% of school going children reported facing corporal punishment i.e. two out of three children were victims of corporal punishment. Every second child reported facing emotional abuse. In 83% of the cases parents were the abusers.³

Samvada’s 1996 study on students in Bangalore states that 47% of the respondents had been sexually abused; 62% of whom had been raped once and 38% of whom had suffered repeated violations.⁸

If every teacher had a better understanding of child abuse and its history, its causes, prevention and reporting and effects of child abuse we would be one step closer to stopping child abuse and its devastating effect on children around the world. With the help of teachers as advocates for abused children we can hopefully decrease these overwhelming statistics.⁶In this study the researcher has planned a structured teaching program so as to increase the knowledge of teachers and to help the abused child as advocates we can hopefully decrease these overwhelming statistics.¹⁵

STATEMENT OF PROBLEM:

A study to evaluate the effectiveness of structured teaching program on knowledge regarding child abuse and its prevention among primary school teachers in selected government primary schools of Belgaum city, Karnataka.

OBJECTIVES:

1. To assess the knowledge regarding child abuse and its prevention among primary school teachers.

2. To evaluate the effectiveness of structured teaching program on knowledge regarding child abuse and its prevention among primary school teachers.

3. To find out the association between the pre test knowledge scores and selected demographic variables.

Hypothesis:

1. H1_:The mean post –test knowledge scores of primary school teachers will be higher than their mean pre-test knowledge scores at 0.05 level of significance.

2. H2: There will be a significant association between pre-test knowledge scores of primary school teachers and selected demo graphic variables at 0.05 level of significance.

OPERATIONAL DEFINITIONS:

1. Evaluate: Refers to statistical analysis of knowledge scores of primary school teachers on child abuse and its prevention as included in structured knowledge questionnaire.

2. Effectiveness of structured teaching program: Significant differences in the pre test and post test knowledge scores of primary school teachers on child abuse and its prevention.

3. Knowledge: Refers to correct response from the primary school teachers about child abuse and its prevention and is expressed in terms of gain in knowledge scores.

4. Child abuse: Refers to physical, sexual, emotional mistreatment, or neglect of a child.

5. Government primary school teachers: Refers to teachers who are teaching in government primary schools in Belgaum.

6. Structured teaching program: Refers to a verbal material used for teaching which will be prepared by researcher and content validated by experts. It is intented to provide knowledge regarding child abuse and its prevention.

Delimitation

This study will be delimited to the teachers teaching in selected Government primary schools of Belgaum city.

RESEARCH METHODOLOGY:

In view of the nature of the problem selected for the present study and the objectives to be accomplished an evaluative approach was considered appropriate for the present study.

Research design:

The research design used for the present study is pre experimental: one group pre –test post-test design.

Research setting:

Setting are the more specific places where data occurs based on the research question and the type of information needed to address it.⁵⁹ The setting planned for this particular study is selected primary schools from Bhadkal Galli, Malli Galli, Vishveshwarya Nagar, Shivabasaveshwar Nagar, Kulkarni Galli, Phoolbhag Galli, Market, Kelkar Bhag of Belgaum city.

Research population:

In this study the population consists of primary school teachers who teach in the primary schools of Belgaum city.

Sample size:

The sample for the present study were primary school teachers. 60 teachers of selected primary schools of Belgaum city were selected.

Sampling technique:

Sampling is the process of selecting a portion of population to represent it. Based on the criteria mentioned, convenient sampling was used to select the sample according to the purpose of the study.

Criteria for selecting the sample:

The sample selection was based on the following inclusion and exclusion criteria.

Inclusion criteria:

1. Primary school teachers of selected primary schools of Belgaum city who are willing to participate in the study.

2. Teachers who are present at the study time.

3. Teachers who can speak and understand Kannada.

Exclusion criteria:

1. Teachers who are on leave.

2. Teachers who refuse to participate in the study.

3. Teachers who attended in programs like Prevention of child abuse.

Development of the tool:

A structured knowledge questionnaire regarding child abuse and its prevention for primary teachers was prepared for the present data.

The steps carried out in preparing the tool:

a. Literature review on child maltreatment, teachers’ knowledge regarding child abuse and its prevention and prevention of child abuse.

b. Discussion with the experts in the field of nursing.

c. Validity of the tool.

Description of the tool:

The tool consists of:

Section I: Socio -demographic data containing 7 items.

Section II: consists of 38 items (multiple choice questions) on child abuse and its prevention.

Description of structured teaching program:

Structure teaching program used in the present study consists of education regarding:

1. Introduction

2. Definition

3. Incidence

4. Effects

5. Etiology

6. Types of child abuse

7. Coping strategies

8. Levels of Prevention

9. Refferal System

10. Successful Approaches needed in the future

11. Summary.

Validity of the tool:

Seven experts in the field of psychiatry nursing have established content validated of the tool, besides this tool was validated by presenting it to the members of research committee of K.L.E.U’s University Institute of Nursing Sciences, Belgaum. The experts were suggested to review and verify the items for adequacy, clarity, appropriateness and meaningfulness.

Minor modifications made on the basis of suggestions and comments given by the experts. There was 100% agreement among the experts regarding the items of the tool and structured teaching program. A CVI of 0.71 was found for the structured knowledge questionnaire. A CVI of 0.85 was found for structured teaching programme.

Reliability:

Instruments reliability is the consistency, with which it measures the target attribute.An instrument is reliable, to the extent that it measures the true score.The tool was tested for reliability on 10 primary school teachers during pilot study by using split half method and Karl Pearson’s coefficient of Correlation formula. Correlation coefficient r =0.76 (approximately 0.8).

The method used for data collection was as follows:

1. The research investigator introduced herself and explained the purpose of the study to the selected primary school teachers.

2. The written consent was obtained by the teachers.

3. The pre test included assessment of subject’s knowledge through structured knowledge questionnaire.

4. Structured teaching program was administered at the end of the pre test.

5. The post test of the study was carried out after 7 days of pre test using the same structured knowledge questionnaire.

6. Data collected was tabulated and then analyzed.

Data analysis plan:

The data obtained were analyzed in terms of the objectives of the study using descriptive and inferential statistics. The plan of the data analysis was developed under the excellent direction of the experts in the field of nursing and statistics. The plan of the data analysis was as follows:

1. Organize the data on master sheet.

2. Compute frequency, percentage, mean, standard deviation and range to describe the data.

3. Classify the knowledge scores as follows:

a. Good- above [mean(X) +standard deviation (SD) =(X+SD)

b. Average- between (X+SD) to (X-SD)

c. Poor- below (X-SD)

4. Use of inferential statistics to draw the conclusions.

RESULTS:

Section I: Findings related to socio demographic variables of primary school teachers.

Table 1: Frequency and percentage distribution of primary school teachers according to socio demographic variable n = 60

SI.

Demographic variables

Frequency

(f)

Percentage (%)

Age

a.21-30 years

b.31-40 years

c.41-50 years

d.51 years and above

Gender

a.Male

b.Female

Religion

a.Hindu

b.Muslim

c.Christain

d.Others

Qualification

a.D.Ed

b.B.Ed

c.MA/M.Ed

d.Other.

Total years of experience

a.0-5 years

b.6-10 years

c.11-15 years

d.16 years and above

Area of residence

a.Urban

b.Rural

Awareness of child abuse

a.Yes

b.No

TABLE 1: The data presented in table 1 indicates that,

1.Maximum of the teachers 19(31%) belonged to the age group of 51 years and above, while 15 (25%) belonged to the age group 31-40 years, and minimum number 13(22%) belonged to the age group 21-30 years and 41-50 years.

2. Majority of the teachers were females 44(73%) and 16(27%) were male teachers.

3. Majority of the teachers 48(80%) were Hindus, 5(9%) belonged to other category, 6(10%) were Muslims, while 1(1%) belonged to Christain religion.

4. Majority of the teachers qualification is D.Ed 44(73%), 8(13%) were B.Ed and minority of teachers 4(7%) did MA/M.Ed and fall under other specific course.

5. Majority of the teachers experience in teaching is 16 years and above 32(53%), 13(22%) fall under 11-15 years, 12(20%) had 0-5 years of experience and minimum of teachers 3(5%) had 6-10 years.

6. Most of the teachers were staying in urban area 51(85%) and minimum of teachers 9(15%) were living in rural area.

7. Majority of the teachers have come across child abuse 44(73%) and minority of teachers16 (27%) reported having no knowledge about child abuse.

SECTION II: Findings related to knowledge of primary school teachers regarding child abuse and its prevention.

Table 2: Mean, Median, Mode, Standard deviation and range of knowledge scores of subjects regarding child abuse and its prevention. n=60

Area of Analysis	Mean	Median	Mode	Standard Deviation	Range
Pre test	19.68	19	17.64	3.92	15
Post test	32.51	33	33.98	0.71	9
Difference	12.83	14	16.34	3.21	6

Table 2: reveals that difference between pre test score and post test score showed that over all difference in between pre test and post test in Mean was 12.83, Median was 14, Mode was 16.34, Standard deviation was 3.21 and Range was 6.

Table 3: Frequency and percentage distribution of knowledge scores of subjects regarding child abuse and its prevention. n=60

Knowledge Scores	Pre test Frequency Percentage		Post test Frequency Percentage
Good(> 24)	08	13.33%	60	100
Average(16-23)	42	70%	-	-
Poor(<15)	10	16.66%	-	-

Table 3: reveals that in pre test majority of subjects 42(70%) had average knowledge, 8 (13.33%) had good knowledge and 10 (16.66%) had poor knowledge.

Table 4: Pretest and posttest knowledge scores of primary school teacher’s initems on child abuse and its prevention. n=60

Sl.

Items

Total score

Mean % of Knowledge scores of Subjects

Pre test (X)

Post test (Y)

Gain in knowledge

Child abuse and its prevention

2280

19.68%

32.51%

12.83%

Table 4: reveals that there was 12.83% gain in knowledge among primary school teachers in the area of child abuse and its prevention. This shows that structured teaching program helps to gain the knowledge of child abuse and its prevention among primary school teachers.

SECTION IV:

TABLE 6: Association between the pre test knowledge scores of primary school teachers and demographic variables. n=60

Sl.No	Demographic data	Good	Average	Poor	Test	P value	Remark
1.	Age
	a. 21-30 years	4	7	1	Fisher	0.557	NS
	b. 31-40 years	2	11	3	Exact
	c. 41-50 years	1	9	2
	d. 51 years and above.	1	15	14
2.	Gender
	a.Male	3	11	2	Fisher	0.700	NS
	b.Female	5	31	8	Exact
3.	Religion
	a.Hindu	8	33	7	Fisher	0.655	NS
	b.Muslim	0	5	1	Exact
	c.Christain	0	1	0
	d.Others	0	3	2
4.	Qualification
	a.D.Ed	6	30	9	Fisher	0.651	NS
	b.B.Ed	2	5	0	Exact
	c.MA/M.Ed	0	3	1
5.	Experience in teaching
	a. 0-5 years	4	7	1	Fisher	0.058	NS
	b. 6-10 years	2	2	1	Exact
	c. 11-15 years	0	10	1
	d. 16 years and above	2	23	7
6.	Residence
	a.Urban	6	35	10	Fisher	0.273	NS
	b.Rural	2	7	0	Exact
7.	Awareness of Child abuse
	a.Yes	7	30	7	Fisher	0.620	NS
	b.No	1	12	3	Exact

If P >0.05 level of significance is significant and if P < 0.05 level of significance is not significant.

Table 6: revealed that there was no association between the pre test knowledge scores of primary school teachers and with demographic variables.

DISCUSSION:

I) Findings related to socio demographic variables of primary school teachers.

Maximum of the teachers 19(31%) belonged to the age group of 51 years and above, while 15 (25%) belonged to the age group 31-40 years, and minimum number 13(22%) belonged to the age group 21-30 years and 41-50 years.

Majority of the teachers were females 44(73%) and 16(27%) were male teachers. These findings were supported by a study conducted by Mathews B, Walsh K, Butler D. The study revealed that most of the teahers were females 83.3% and 16.7% were males.

Majority of the teachers 48(80%) were Hindus, 5(9%) belonged to other category, 6(10%) were Muslims, while 1(1%) belonged to Christian religion. Majority of the teachers qualification is D.Ed 44(73%), 8(13%) were B.Ed and minimum of teachers 4(7%) did MA/M.Ed and fall under other specific course. Majority of the teachers experience in teaching is 16 years and above 32(53%), 13(22%) fall under 11-15 years, 12(20%) had 0-5 years of experience and minimum of teachers 3(5%) had 6-10 years. Most of the teachers were staying in urban area 51(85%) and minimum of teachers 9(15%) were living in rural area. Majority of the teachers have come across child abuse 44(73%) and minimum of teachers16 (27%) reported having no knowledge about child abuse. These findings were supported by a study conducted by Goebbels AF.et.al in Netherlands. The study revealed that 19% of the teachers had no knowledge regarding child abuse and its prevention and 81% teachers had knowledge regarding child abuse and its prevention.

II. Findings related to the pre test knowledge scores of primary school teachers.

The pre test knowledge scores of primary school teachers were 19.68% in the area of child abuse and its prevention. The mean pre test knowledge scores were 19.68, with standard deviation 3.92, median 19, mode 17.64 and range 15. Among the total sample (n=60), majority 42(73%) of teachers had average knowledge, where as 10(16.66%) teachers had poor knowledge and 8(13.33%) had good knowledge.

III. Findings related to the effectiveness of structured teaching program regarding child abuse and its prevention.

While evaluating the effectiveness of structured teaching program on knowledge regarding child abuse and its prevention among primary school teachers, the pre test and the post test data analysis revealed that the mean post test knowledge score 32.51% was higher than the mean pre test knowledge score (19.68%), with the median 33, mode 33.98 and range 9. The study contradict by the study conducted by Klermier C, Webb C, Hazzard A, Pohl J on teachers found that significant increase from pre to post testing about child abuse and its prevention.⁵⁴Calculated paired‘t’ test value on knowledge 6.99 revealed that there was a significant gain in knowledge of primary school teachers regarding child abuse and its prevention after introducing structured teaching program at 0.05 level of significance.

IV. Findings related to association between the pre test knowledge scores of primary school teachers and selected demographic variables.

Fisher Exact test was computed to find out the association of knowledge of primary school teachers with demographic variables. Test results were, Fisher Exact=0.557 for age, for gender the Fisher Exact value was 0.700, for religion of teachers the value was 0.655, for qualification of teachers the value was 0.651, for teaching experience of teachers the value was 0.058, for residence of teachers the value was 0.273 and for the awareness of child abuse among teachers the Fisher Exact value was 0.620. The computed values were not significant at 0.05 level of significance. Hence there was no statistically significant association between knowledge and selected demographic variables. This finding is contrary to the findings of the study conducted by British Columbia’s Family and Child Service Act (1980) where there was no association between pretest knowledge scores and demographic variables.

CONCLUSION:

Based on the analysis of the findings, the following inference was drawn. There was evident increase in the knowledge scores in all the area included in the study after administrating of structured teaching program. Thus it was proved that STP was effective teaching method for creating awareness on importance of knowledge regarding child abuse and its prevention among primary school teachers.

NURSING IMPLICATIONS:

The findings of the study have implications in the area of nursing education, nursing practice, nursing administration and nursing research.

Nursing education

The educational background of a nurse should equip him/her with the knowledge necessary to function as a health educator. Health education is the major key to improve knowledge of primary school teachers.

Health education program such as one in the study can be organized by nurses at different levels like day care centers, high schools, community and parental education. Making use of power point, charts, videos in order to give lecture, discussion at community set up will help to increase the awareness among community pupils. The power point presentation could be utilized by the teachers to provide health education to the children and parents regarding child abuse and its prevention. This help the parents to how to up bring their children and the importance of need for providing the basic needs for social and emotional development of the child. And it helps the children to understand the present situation and perform good in their academic activities.

Nursing practice

Since the present study shown that most of the teachers had an average knowledge regarding child abuse and its prevention, the present study would enable them to enhance their knowledge regarding child abuse and its prevention and motivate them to take care of children which helps in normal growth and development of children as well as how to rescue the children in case of abuse.

Nursing administration

Nurse administrators are the back bone to provide facilities to improve knowledge regarding child abuse and its prevention. There should be provision for nurses to devote time for giving health education and conducting school health programs. Also there is a need to encourage nurses to develop educational material. Necessary administrative support should be provided to conduct health education in any setting.

Nursing research

Based on the findings, nursing professionals and nursing students can conduct further studies on knowledge regarding child abuse and its prevention. So nursing students must be motivated and guided to conduct research studies. Presently study tool, STP and power point presentations will be used by others or modify it for re-use. The present study can be a source of review of literature for others who are planning to conduct studies on the similar topics. The findings of the study can be presented in any conference and make the data available for other nurse researcher. Such studies must be conducted in various other schools because today’s children are tomorrow’s citizen.

REFERENCE:

1. http://pib.nic.in/features/feyr2001/fsep2001/f20092011.html ;( 10/10/4).

2. http://www.findcounseling.com/journal/childabuse/http://en.wikipedia.org/wiki/childabuse.

3. Mrs Bimal Sapna, Mr.Kalia Raman, Mr.Das Karobi. Child Abuse: Issues and Management. Nightingale Nursing Times. 2009; 4. (12): 14. Available from: URL:www.ehsd.org/com/pdfs/Child Abuse.pdf.

4. www.who.int/entity/violence-injury-Prevention/violence/global-campaign/en/chap3.pdf (10/12/04).

5. Chicca E. child abuse and neglect: A status Report. Journal of Pediatric Nursing. 1998 April; 13(2):128-130.

6. http://hamiltonk 270.hubpages.com/hub/child-Abuse-History-Causes-Prevention-Reporting-and-Effects.

7. http://wcd.nic.in/childabuse.pdf. Study on Child Abuse: India 2007.

8. www.genocidewatch.org/images/India_12_07_03child_sex_abuse_and_sexual exploitation_continues_unabated_Report.pdf

9. Renz BM, Sherman R. Child abuse by scalding from university school of Medicine, Atlanta.1992 (1992 Oct); 10: 574-80.

10. In India 2007, en.wikipedia.org/wiki/child_sexual_abuse.

11. http://www.childhelp.org/pages/statistics/types of child abuse(National).

12. en.wikipedia.org/wiki/Summary of “study on child abuse: India 2007”.

13. Bethea L. Primary prevention of child abuse.1999 (1999 march); 59(3): 245-59.

14. http://hamiltonk 270.hubpages.com/hub/child-Abuse-History-Causes-Prevention-Reporting-and-Effects.

15. Mrs. Nanthini Subbiah, Prof. Kokila vani N. Child Abuse and Neglect. Nightingale Nursing Times. 2007(2007 Jan30); 2 (10): 21.Available from: URL: http.www.child-abuse-effects.com/child.abusestatistic.

16. www.who.int/entity/violence-injury-Prevention/violence/global-campaign/en/chap3.pdf (10/12/04).

17. Chalk, Gibbons, Scarupa. Child abuse importance?.CannadaAnswersChildabuseimportance.http://www.preventchildabuse.org/aboutU, http://www.childwelfare.gov/can/impact/c….

18. http://www.wikipedia.org/wiki/child abuse.

19. Mrs.Kavimani.M. Child Abuse. Nightingale Nursing Times. 2007 (2007 Jan 30) ; 2(10): 27 – 30.

20. www.Zentactics.com/childabuse statistics.html.

21. National Incidence Study.www.Zenatics.com/childabusestatistics.html.

22. Howard KS, Brooks Gunn J. The role of Home visiting program in preventing child abuse and neglect. 2009; 19, (2):119-46.

23. Polit DF, Beck CT. Nursing research Principles and methods.7^th edition Philadelphia Lippincott Wilkins; 2004: 243.

24. Kozier B, Erb G, Berman A, Burke K. Fundamental of Nursing. Concepts, Process and Practice. 7^th edition. Delhi: Saurabh Printers Pvt Ltd; 2005.

25. Nair MK, Rajmohanan K, Nair SM, Ghosh CS, Leena ML. Child Disciplining practices in Kerala. Indian Paediatrics. 2009(2009 Jan); 46: page no8385. Available from: India.nairMKc@rediffmail.com

26. Brendgen M, Wanner B, Vitaro F. Verbal abuse by the teachers and child adjustment from Kindergarten through grade 6. Indian Pediatrics. 2006(2006 May); 117, (5):1585-98.Available from:www.ncbi.nlm.nih.gov/pubmed/16651312.

27. Tiwari PA, Gulati N, Sethi GR, Mehra M. Why do some boys run away from home? Indian Journal Pediatrics. 2002(2002 May); 69(5): 397-99. Availablefrom:sheelopoonam@yahoo.com.

28. Metha MN. Physical abuse of abandoned children in India. 1982;6(2): 171-75.

29. Retsela T. Kebed D. Physical punishment of elementary school children in urban and rural communities in Ethiopia. 1997(1997 Jan); 35(1): 23-33.

30. Mathews R, Reisc C, Iacopino V. Child labor. A matter of health and human rights. 2003(2003 April); 25 (6): 435-47.

31. Pagare D, Meena GS, Jiloha RC, Singh MM. Sexual abuse of street children brought to an observation Home. 2005(2005 Feb); 42( 2): 134-39.

32. Hunter WM, Jain D, Sadowski LS, Sanhueza AI. Risk factors for severe child discipline practices in rural India. 2000(Sept 2000); 25( 6): 435-47.

33. Goebbels AF, Nicholson JM, Walsh K, De Vries H. Teachers' reporting of suspected child abuse and neglect: behaviour and determinants. 2008 Dec; 23(6):941-51.Available from www.ncbi.nlm.nih.gov/pubmed/8800523.

34. Saptaro J, Mullen PE, Burgess PM, Weels DL, Moss SA. Impact of child sexual abuse on mental health. The British Journal of Psychiatry. 2004(2004 May); 32(2):184.

35. Poore G. Incestuous sexual abuse. Shakti Productions. 2000; 30(2):120-27.

36. A:/special story.htm (20/10/05).

37. Poore G. Incestuous sexual abuse. Shakti Productions. 2000; 30(2):122-24

38. Nhunder TJ, Shumba A.The nature and frequency of reported cases of teacher perpetrated child sexual abuse in rural primary Schools in Zimbabwe. Child Abuse and Neglect. 2001(2001 Nov); 25(11): 1517-34. Availablefrom:www.ncbi.nlm.nih.gov/pubmed/110766014.

39. Mehta MN, Prabhu SV, Mistry HN. Child Labor in Bombay. Child Abuse and Neglect. 1985; 9(1): 107-11.Available from: www.ncbi.nlm.nih.gov/pubmed/4038895

40. Kartikeyan SK, Chaturvedi RM, Bhalerao VR. Role of the family in drug abuse. 1992(1992 Jan); 38(1): 5-7.

41. Kushwaha KP, Singh YD, Rathi AK, Singh KP, Rastogi CK. Prevalence and abuse of psychoactive substances in children and aldoscents.1992(1992 March); 59(2): 261-80.

42. Segal UA. Child abuse by the middle class?. A study of professionals in India. 1995(1995 Feb); 19(2): 217-31.

43. Martin SL, Moracco KE, Garro J, Tsui AO, Campbell JC. Domestic violence across generations: findings from Northern India. 2002(2002 jan); 31 : 560-72.

44. Day NL, Richardson GA, Goldschmidth L, Cornelius MD. Effects of prenatal exposure on preschooler’s behavior. 2000(2000 Jan); 21( 3): 180-88.

45. Koschel MJ. “It is child abuse?” AJN. 2003(2003 April); 103( 4): 45-47

46. www.who.int/entity/violence-injury-Prevention/violence/globalcampaign/en/chap3.pdf (10/12/04).

47. Allen B. An analysis of the impact of diverse forms of childhood psychological maltreatment and emotional adjustment in early adulthood. 2008(2008 Aug); 13(3): 307-12.

48. Kenny MC. Teachers attitude towards and knowledge of child maltreatment. Child Abuse and Neglect. 2004(2004 Dec); 28(12): 1131-19. Available from:www.ncbi.nlm.nih.gov/pubmed/15607772

49. Abrahams N, Casey K, Daro K. Teachers’ knowledge, attitudes and beliefs about child abuse and its prevention. 1992; volume no 16, issue no 2: page no 229-38.

50. Kenny MC. Child Abuse reporting: teachers’ perceived deterrents. Child Abuse and Neglect. 2001(2001 Jan); 25(1): 81-92.

51. Feng JY, Herang TY, Wang CJ. Kindergarten teachers’ experience with reporting child abuse in Taiwan. 2010(2010 Feb); 34(2): 124-8.

52. Goebbles AF, Nicholson JM, Walsh K, Devries H. Teachers’ reporting of suscepted child abuse and neglect: behavior and determinants. 2008(2008 Dec); 23(6): 941-51.

53. Abrahamas N, Casey K, Daro K.Teachers’ knowledge, attitudes and beliefs about child abuse and its prevention.1992; 16(2): 229-38.

54. Klermier C, Webb C, Hazzard A, Pohl J. Child sexual abuse prevention: evaluation of a teacher training model.1998; 12(4): 551-61.

55. Mc Granth P, Cappilli M, Wiseman D, Khalil N, Allan B. Teachers’ awareness program on child abuse: a randomized controlled trial.1987; 11 (1): 125-32.

56. MacIntyee D, Carr A. Evaluation of the effectiveness of the Stay safe primary prevention program for child sexual abuse.1999 (1999 Dec); 23 (12): 1307-25.

57. Peleg-Oren N. Drug- not here! Model of group intervention as preventive therapeutic tool for children of drug addicts.2002; 32(3): 245-59.

58. McLaughlin RJ, McClanahan KK, Holcomb JD, Gibbins AD, Smith QW, Vlasak JW, Kingery PM. Reducing substance abuse risk factors among children through a teacher as facilitator program.1993;23(2):137-50.

59. Polit DF, Hungler BP. Nursing Research Principles and Methods. 6^th edition.Philadelphia: Linpincott; 1999: P. 111.

60. Polit DF, Beck CT. Nursing research: Principles and methods. 7^th ed. Philadelphia: Lippincott Williams and Wilkins; 2004.p.15, 28, 29, 88, 115, 162, 196, 226, 289, 290, 328, 452, 710.

61. eprints.qut.edu.au/33010/1/ARC_DP0664847_Final_Report.pdf.

62. .www.csse-scee.ca/CJE/Articles/Full Text/CJE19-1-03Beck.pdf.

Received on 08.08.2014 Modified on 10.09.2014

Asian J. Nur. Edu. and Research 5(1): Jan.-March 2015; Page 26-34

DOI: 10.5958/2349-2996.2015.00007.5

A Study to Assess the Effectiveness of Structured Teaching Program on Knowledge Regarding Child Abuse and its Prevention among Primary School Teachers in selected Government Primary Schools of Belgaum City, Karnataka