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Self Esteem And Substance Abuse - Free Essay Example

Sample details Pages: 21 Words: 6178 Downloads: 8 Date added: 2017/06/26 Category Health Essay Type Essay any type Did you like this example? CHAPTER I INTRODUCTION Self esteem is all about how much we feel valued, loved, accepted and thought well of by others and how much we value, love and accept ourselves. People with healthy self-esteem are able to feel good about them, appreciate their own worth and take pride in their abilities, skills and accomplishments. People with low self- esteem may feel as if no one will like them or accept them or that they canà ¢Ã¢â€š ¬Ã¢â€ž ¢t do well in anything People with high self esteem tend to be ambitious in what they want to experience in Life, they have a drive to express them and to communicate openly and honestly about their needs and desires. Don’t waste time! Our writers will create an original "Self Esteem And Substance Abuse" essay for you Create order People with low self esteem rarely live their life to the full, they distance themselves from others, denied their love and support, and uncomfortable with success, some of them even take alcohol and drugs. We all experience problems with self esteem at certain times in our lives-especially during our teens figuring out, where we fit in the world. The level of self esteem determines how we operate in life à ¢Ã¢â€š ¬Ã¢â‚¬Å"how we interact with others such as spouse, children, friends, and strangers .It determines our achievements, and our satisfaction and happiness. Self esteem has long been believed to play an important role in the use of alcohol; People with alcohol problems often have low self esteem. They judge themselves negatively-not just for their addiction, but also for other parts of their behavior or their personality. Most of the individuals who are addicted to drugs and alcohol are not happy with their lives and live a life of despair and hopelessness, the major symptom is poor self esteem. Poor self esteem is at the heart of an individualà ¢Ã¢â€š ¬Ã¢â€ž ¢s addiction and dependency and there is an inverse relationship between alcohol dependency and self esteem, that if a personà ¢Ã¢â€š ¬Ã¢â€ž ¢s self esteem improves the individualà ¢Ã¢â€š ¬Ã¢â€ž ¢s addictive behavior. 1.1. Need For The Study: Low self esteem is one of the causative factor that vast majority of alcohol addicts share in common, low self esteem is challenging in four areas. First they feel that they lack personal power, secondly many with low self esteem feel lacking the affection and attention of others, thirdly low self esteem results when people feel that they lack virtue, often feel unloved, unappreciated and lastly those possessing low self esteem hold themselves as incompetent in one or more areas. Several researchers have argued that self esteem poses high risk for alcohol abuse in some populations, including adolescents, college students, and females (Donnelly, 2000). Another area of life that Alcoholics with low Self-Esteem often struggle with their occupation. Perhaps they may lack education, information, skill sets, or the belief in their ability to obtain a worthwhile job and so they self-sabotage and then get to the right about the fact that no one wants to hire them. Seeking continuous education is hopeless to those who have such low self-esteem since they see themselves as incapable of excelling in the process of studying, taking exams, and achieving success in all the systems. Low self- esteem can also manifest as a result of oneà ¢Ã¢â€š ¬Ã¢â€ž ¢s inability to generate wealth, they see themselves struggling to survive in a world marked by competition, often struggle with their occupation. Those with low self esteem often resort to addictive behaviors in an effort to numb out the pain and escape to a world that allows them a temporary release from their sufferings and problems 1.2. Statement of the Problem: Promotion of self esteem activities among alcoholic dependants 1.3. Objectives: 1.3.1 Assessment the self esteem level among alcoholics 1.3.2 Association of self esteem and Alcoholism 1.3.2 Assessment of the effectiveness of self esteem activities in promotion of self esteem among alcoholics. 1.4. Assumptions: 1.4.1. Self esteem level may be low among alcoholic dependants. 1.4.2. Practice of self esteem activities may improve the self esteem level among alcoholic dependants 1.5. Operational Definitions: 1.5.1. PROMOTION- refers to the improvement in level of self esteem among Alcoholic dependants. 1.5.2. SELF ESTEEM- perceived self concept of an alcoholic individual 1.5.3. ALCOHOLICS- a person craves alcohol, is unable to limit his or her drinking. 1.6. Promotion of Self-Esteem Activities Among Alcoholics Dependants: Conceptualization is the process of specifying what we mean when we use particular terms (Giemman) The conceptual framework is derived from Penderà ¢Ã¢â€š ¬Ã¢â€ž ¢s health promotion Model. In this study Individual characteristics and experience by physical, social psychological and occupational problems may change the level of self-esteem of the Alcoholic patients. Self-Esteem activities are promoted based on the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s problems may bring change in the level of self-esteem. It includes perceived benefit of Self-Esteem activities like Individual and Group activities. PENDERà ¢Ã¢â€š ¬Ã¢â€ž ¢S HEALTH PROMOTION MODEL CHAPTER 2 REVIEW OF LITERATURE 1. Studies related to low self esteem and alcoholism 2. Studies related to self esteem activities and alcoholism 1. Studies related to low self esteem and alcoholism: A study conducted on self esteem and Alcohol use on 61 Alcoholic dependants who were admitted in a rural Midwestern medical centre. An individualà ¢Ã¢â€š ¬Ã¢â€ž ¢s reactions to his or her social environment are mediated by a sense of self esteem, low levels of self esteem are develop during Socialization. Results suggest that specific form of social support is important to recovering alcoholic dependants (Steffennhagen and Burns, 2006). A Pearson correlation was calculated examining the relationship between the amounts of alcohol consumed in the past 30 days and self esteem. A low to moderate correlation was found (r (23) =.250, p.05). (Jeremy W.Lawing, 2006). A Study conducted on drinking problems and self-Esteem of college students,148 lower division college students were given the following paper and pencil tests: The Michigan Alcoholism Screening Test, and the à ¢Ã¢â€š ¬Ã…“Personal Selfà ¢Ã¢â€š ¬? section of The Rosenberg Self-Esteem Scale. College Students are havin g low self Esteem (F = 4.23, p = .04). Tabulation of the incidence of heavy drinking (31%).Result shows an drinking behavior of college students are having low self esteem(()swego,2005). A study was conducted on the effects of self esteem on substance abuse among homeless men. This experimental study involving 305 samples of homeless men was assigned randomly to the treatment group and Control group. Control group was referred to community based services, experimental subjects were exposed to individual therapy, group interventions, life skills and relapse prevention training residing in a 24 Hour shelter for three months. Results indicated that self-esteem was increased in experimental group than in control group (Brandon, 2004). A descriptive study was conducted on self-esteem and alcohol dependants. Study comprises of two groups such as alcoholic dependants as one group and non-alcoholics in another group. Study shown that alcoholic dependants have lowered self esteem compa red to non alcoholics self esteem (Donnelly, 2003) A study was conducted to compare the level of self esteem among 30 alcoholics and 30 non alcoholic persons. They are assessed for self esteem using self esteem scale. The results showed that alcoholics had low self esteem when compared to non alcoholics(P001).Alcoholic dependants were perceived as less loving and less dominant as compared to non alcoholics, they also perceived alcoholics to be aggressive and sadistic(Neeliyara,2003). A study conducted to identify the relationship between alcohol consumption and self esteem. Study comprises of 26 Samples (Employees of local retail store), their self esteem was assessed by using Rosenbergà ¢Ã¢â€š ¬Ã¢â€ž ¢s self esteem scale. Results showed that alcohol consumption is strongly related to self esteem (T.F.Heatherson,2000). A Study conducted on how self esteem influences alcohol consumption Study comprises of 61 samples. Over the course of two weekends self esteem was measured using Rosenbergà ¢Ã¢â€š ¬Ã¢â€ž ¢s self esteem scale. Study showed the results that self esteem is negatively correlated with alcohol consumption. In a study on adolescents drinking behavior, adolescents with high self esteem reported consuming less alcohol than adolescents with low self esteem. (Gerrerd, Russell, 2000 A cross-sectional survey design investigated the relationship of substance use and self esteem. Self -esteem was assessed using Hare Self-esteem Scale. Four hundred and eleven samples were completed the survey. Results revealed that there is a direct relationship between alcohol use and self-esteem (F=12.8,df=2,343,p,.00001).Regardless recent alcohol abusers had the lowest self-esteem scores and never users had the highest scores(F.X.Gibbons,2000). A study says that low self-esteem is the universal common denominator among all people suffering from addictions. Low self-esteem is the true disease and it is the underlying origin of all problematic behaviors that p lagues the world (Candito, 1996). A prospective study of self-esteem and Alcohol Use Disorders in Early Adulthood. The relation among Self-esteem and Alcohol use disorder diagnoses was examined in a sample of 240 men evaluated at four annual assessments over the college years. The results support clinical observations that low self esteem plays a particularly important it eological role in alcohol problems in men (Fromme.K, 1989). A number of studies have indicated that adolescents who refrain from drinking alcohol have higher self-esteem than do adolescents who drink. The questionnaire used in this study included the Adolescent Alcohol Involvement Scale which has fourteen questions about alcohol use, the Rosenberg (1965) Self-esteem Scale, (Mendel son, Mock, Erbaugh, 1984). 2. Studies related to self esteem activities and alcoholism A Study conducted on how group activity has an impact on self esteem among alcoholics. Study comprises 40 samples, 20 patients undergone group activities for 12 weeks in an inpatient setting and 20 patients as control groups. Patients in the intervention group showed significant enhancement in self esteem, social skills and self confidence where as there is no changes observed in control group (John Wiley, 2009) A Study was conducted how utilization of self esteem programs (Holistic Addiction Treatment Programme) plays an important role in Relapse prevention. Study comprises of 145 samples. Results show that 70 to 90 percentages, self esteem programs are effective in Relapse prevention and over all well-being to the treatment of recovering alcoholics (Harry Henshaw, 2007). A Study conducted on self esteem activities among Alcoholic patients. Study comprises of 43 samples, volunteers in the group undergone self esteem activities along with drug treatment, the other group only underwent drug treatment. Pretest-posttest comparison on a variety of physiological parameters indicated that significant improvements had occurred in psychological wellbeing including self esteem, self awareness, lifestyle adaptation and relapse prevention skills. Results suggest that promotion of self esteem activities improves self esteem among alcoholic dependants (Michael Peterson, Bryan johnstone, 2003) A study conducted on self-esteem and alcoholism among high school students total sample was 140(55males and 85 females) high school students. The questionnaire used in this study included the Adolescent Alcohol Involvement Scale (Moberg, 1983) which has fourteen questions about alcohol use, the Rosenberg (1965) Self-esteem Scale, and the Beck Depression Inventory (Beck, Ward, Mendel son, Mock, Erbaugh, 1961). Study has showed that indicated that adolescents who refrain from drinking alcohol have higher self-esteem than do adolescents who drink (Butler, 1980; Young, Werch, Brakeman 1989) CHAPTER 3 MATERIALS AND METHODS Designing a research involves the development of plan or strategy that will guide the collection and analysis of data. The present study is designed to promote the Self-esteem among Alcoholic Patients. The methodology of the study constitutes research design, setting, population and sampling criteria for the selection of samples and tool for data collection. 3.1. One Group Pre Test Post Test Design: 3.2. Setting: This study was conducted in Kasthuriba Gandhi De-Addiction Centre, Coimbatore. The De-Addiction centre consists of 25 bedded 3.3. Population: The overall population for the study was alcoholic patients who were admitted in the Kasthuriba Gandhi DE-Addiction Centre from 28.06.2010 to 25.07.2010. 3.4 Sample size And Sampling Technique: Purposive sampling Technique was used to select samples who were admitted in the Kasthuriba Gandhi De-Addiction Centre during the period of study.30 patients were selected as samples during the study. 3.5. Criteria for Selection of the Sample: Inclusion Criteria: Patients who were admitted in Kasthuriba Gandhi De-Addiction Centre Alcoholic patients with Low self esteem Exclusion Criteria: Patients who are not willing to participate in the study. Alcoholic dependants associated with Psychotic symptoms. 3.5. Instruments and Tool for Data Collection: The tool was prepared based on review of literature and guidance of experts from the field of Psychiatry. Section I: This section includes demographic variables like age, education, family Income, occupation, marital status, marital disharmony, Type of Family Duration of Alcohol intake Consumption of alcohol, physical and psychological problems. Section II: This section consists of modified Rutgersà ¢Ã¢â€š ¬Ã¢â€ž ¢s Alcohol Problem Index scale. It is a useful tool to assess the problem index among alcoholic patients. It consists of 15 questions. Section III: This section has an index to measure personà ¢Ã¢â€š ¬Ã¢â€ž ¢s self-esteem. It consists of 20 statements to assess the level of self-esteem of alcoholic dependants. Score Interpretation: Self à ¢Ã¢â€š ¬Ã¢â‚¬Å"Esteem Assessment Scale consists of 20 s tatements of assessment of patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s level of self esteem. The total score is 60, patient who scores the item à ¢Ã¢â€š ¬Ã‹Å"3à ¢Ã¢â€š ¬Ã¢â€ž ¢ and more than 46 is having low self-esteem. Section IV: This section consists of intervention for Low self à ¢Ã¢â€š ¬Ã¢â‚¬Å"Esteem such as Individual activities and Group activities. Individual Activities: Promoting individually performing activities. The patients are encouraged to do individual activities such as Art writing and Reading Newspapers. Group Activities: Group activities is two or more individuals unite together to promote an same activity. Patients are encouraged to do psychodrama (Group was given a theme, group members act out based on the theme) and Outdoor games (Tenniequots) 3.6. Variables of the study: Independent variable: Self-esteem activities. Dependant variable: Alcoholic dependants. 3.7. Techniques for Data Analysis and Interpretation: The tables were formulated for base line information such as age, education, occupation, type of family, marital disharmony, income per month, amount of alcohol intake, duration of alcohol intake, physical and psychological symptoms. Pairedà ¢Ã¢â€š ¬Ã¢â€ž ¢ test was used to analyze the significant difference in the level of self-esteem before and after promoting self esteem activities. 3.7.1. Pairedà ¢Ã¢â€š ¬Ã¢â€ž ¢tà ¢Ã¢â€š ¬Ã¢â€ž ¢test: The test was used to point out the effect of promotion of self esteem activities among alcoholic patients. t=d SD/ n SD= (d-d) Here d=Mean difference between pretest and posttest score. SD=Standard Deviation of the Pre test and post test Sore n=Number of Samples. Pilot study report Pilot study was conducted for a period of 2 weeks, from 28th May 2010 to 11th May 2010, to test the practicability of the tool and feasibility of conducting the main study. Study was conducted in Psychiatric ward of P S G Hospital. For pilot study 5 samples were selected. Data were collected by interview method. Through the pilot study it was proved that self esteem activities in promotion of self esteem. The researcher would like to continue the study to promote self esteem among alcoholic dependants. Changes brought after pilot study During the pilot study, self esteem level was assessed and found to be low among alcoholic dependants. CHAPTER 4 DATA ANALYSIS AND INTERPRETATION The process of evaluating data using analytical and logical reasoning to examine each component of the data provided. This form of analysis is just one of the many steps that must be completed when conducting a research experiment. Data from various sources gathered, reviewed, and then analyzed to form some sort of finding or conclusion. There are a variety of specific data analysis method, some of which include data mining, text analytics, business intelligence, and data visualizations. 4.1. General Profile of alcoholic Dependants 1. Age Among thirty alcoholic dependants, six patients were at the age of 21-30 years, fifteen patients were at the age of 31-40years, seven patients were at the age between 41-50 years and two patients were between 51-60years. 2. Education Most of the alcoholic dependants were completed their secondary education, seven patients had completed primary education, six patients completed higher secondary education and seven had graduate degree. 3. Occupation: A. Type of Work It was found that ten were doing business, five were farmers, four were engineers, two were bus drivers and there was one from each category like tailor, rashion shop, goldsmith, shopkeeper, hotel supervisor, massion, mandapam decorator, Carpentor, cable TV Manager. B. Hours of Work Hours of work for alcoholic dependants were varying from6-15 hrs. Most of them nineteen were working between 11-15 hrs and eleven patients were working 6-10 hours per day. C. Income per Month Income of alcoholic dependants varied depends upon their occupation, fifteen were earning between Rs.6000-10000 per month, eight patients were earning between Rs.11000-15000 per month, four were earning between Rs.1000-5000 per month, three patients were earning between Rs 16000-20000 per month. D. Conflict in Work Area Majority of alcoholic dependants, twenty expressed no conflict in work area and ten had conflict in their work area. 4. Family history A. Marital status Twenty four patients were married, six patients were unmarried. B. Marital disharmony: Thirty alcoholic dependants came out with the problem of and only eleven patients had no such problems. C. Relationship with spouse: Among the alcoholic dependants, twelve patients were maintaining good relationship with their spouse and twelve patients were not maintaining good relationship with spouse. D. Relationship with children: Twenty two were maintaining good relationship with their children and two patients were not maintaining good relationship with children. E. Type of Family: Among twenty four alcoholic dependants, six patients were from joint family and eighteen from nuclear family. F. Family History of Alcoholism: There is no family history of alcohol intake among twenty five alcoholic dependants and only five patients were having the family history of alcoholism. 5. Social History: A. Social Support: Among thirty alcoholic dependants, one had Peer group support, three had support from friends, and twenty six had family support. 6. Alcoholic History: A. Duration of Alcohol Intake In years: Duration of 11-15-years of alcohol intake was found among fifteen alcoholic dependants, 6-10years among ten alcoholic dependants, 1-5years among three alcoholic dependants and 16-20 years among two alcoholic dependants. B. Consumption of Alcohol started by: Most of the patients twenty five were started consuming alcohol through friends, three started by their relatives and two started by their family members. C. Quantity of Alcohol when started (Bear in ml): Majority of the alcoholic dependants, twenty three started with 100-300ml of bear while seven alcoholic dependants were stated with 700-900ml of bear. D. Quantity of Alcohol at present (Hot): At present eleven alcoholic dependants was consuming 700-900ml of hot which is more than nineteen alcoholic dependants consuming 400-600ml. E. Time of drinking Alcohol: Among thirty alcoholic dependants, twelve patients were taking alcohol in the evening, four were taking alcohol in the morning and evening, fourteen were taking alcohol throughout the day. F. Money spent on Alcohol Consumption: Among thirty alcoholic dependants, most of them twenty two spent Rs 4000-6000per month for alcohol consumption seven spent Rs7000-9000 per month and one spent Rs 1000-3000 per month. G. Motivation for treatment of Alcoholism: Maximum number of patients thirteen were motivated by self, seven were motivated by already treated patients in de-addiction centre, five were motivated by family members and five were motivated by Relatives. H. Reason for Alcoholism: Seventeen patients were started on alcoholism due to psychological factors such as wifeà ¢Ã¢â€š ¬Ã¢â€ž ¢s death, job stress etc, thirteen patients were started due to peer group pressure and none had the reason of physical and psychiatric illness. TABLE 4 1 DEMOGRAPHIC DATA OF ALCOHOLIC PATIENTS 1 AGE IN YEARS 21-30 6 31-40 15 41-50 7 51-65 2 2 EDUCATION Primary 7 Secondary 10 Higher secondary 6 Graduate 7 3 OCCUPATION A.TYPE OF WORK Business 10 Farmer 5 Tailor 1 Accountant in Rashionshop 1 Goldsmith 1 Hotel Supervisor 1 Driver 2 Construction Worker 1 Engineers 4 Mandapam Decorator 1 Carpenter 1 Cable T.V. Manager 1 B.HOURS OF WORK 6 10 11 11 15 19 C.INCOME PER MONTH 1000-5000 4 6000-10,000 15 11,000-15,000 8 16,000-20,000 3 D.CONFLICT IN WORK AREA Present 10 Absent 20 4 FAMILY HISTORY A.MARITAL HISTORY Married 24 Single 6 B.MARITAL DISHARMONY Present 13 Absent 11 C.RELATIONSHIP WITH SPOUSE Maintains good relationship 12 Not maintains good relationship 12 D.RELATIONSHIP WITH CHILDREN Maintains good relationship 22 Not maintains good relationship 2 E.TYPE OF FAMILY Joint family 6 Nuclear family 18 F.FAMILY HISTORY OF ALCOHOLISM Present 5 Absent 25 SOCIAL HISTORY A.SOCIAL SUPPORT Neighbors 0 Peer group 1 Friends 3 Family 26 5 ALCOHOLIC HISTORY A.DURATION OF ALCOHOL INTAKE IN YEARS 1 5 3 6 10 10 11 15 15 16-20 2 B.CONSUMPTION OF ALCOHOL STARTED BY Friends 25 Family members 2 Relatives 3 Self 0 C.QUANTITY OF ALCOHOL WHEN STARTED (BEAR) ML 100-300 23 400-600 7 700-900 0 D.QUQNTITY OF ALCOHOL CONSUMPTION AT PRESENT(HOT)ML 100-300 0 400-600 19 700-900 11 E.TIME OF DRINKING ALCOHOL Morning 0 Evening 12 Both 4 Throughout the Day 14 F.MONEY SPENT ON ALCOHOLISM 1000-3000 1 4000-6000 22 7000-9000 7 G.MOTIVATION FOR TREATMENT OF ALCOHOLISM Family members 5 Relatives 5 Self 13 Treated patients 0 H.REASON FOR ALCOHOLISM Physical Illness 0 Psychiatric Illness 0 Psychological Illness 17 Peer group Influence 13 4.2. Assessment of Problem Index among Alcoholic Dependants: Among thirty alcoholic dependants, Majority of alcoholic dependants are not able to work, inability to carryout responsibilities, had fight with relatives, neglected by relatives, advised by relatives and friends, to stop alcohol, noticed a change in personality, most of them felt guilty,neede more alcohol to get the same effect previous one, and felt physically and psychologically dependant on Alcoholism. TABLE 2 ASSESSMENT OF PROBLEM INDEX n=30 S.No PROBLEM STATEMENTS 1 2 3 4 1 Not Able To Work 10 15 5 0 2 Neglected Responsibilities 10 15 5 0 3 Had Fight With Others 20 5 5 0 4 Neglected By Relatives 10 14 6 0 5 Advised By friends, neighbours, relatives to stop alcohol 0 20 10 0 6 Kept Promised To Stop Drinking 10 12 8 0 7 Noticed A Change In Personality 12 16 2 0 8 Felt Guilty 0 23 7 0 9 Forgetting Places 16 14 0 0 10 Fainted Suddenly 26 4 0 0 11 Gone Suddenly 26 3 1 0 12 Needed More Alcohol To Get The same Effect As Of previous One 0 20 6 4 13 Tried To Control Drinking 16 8 6 0 14 Stopped Drinking Because Of Withdrawal Symptoms 20 10 0 0 15 Felt physical or Psychologically dependant On Alcohol 0 16 10 4 Score Interpretation: 1.None of the Time, 2.1-2 Time, 3.3-4 Times, 4.More than five t imes 4.3. Assessment of Level of Self-Esteem among alcoholic Dependants: Fifty one patients were got admitted in kasthuriba Gandhi de-Addiction Centre, Coimbatore in the month of July. Among them thirty alcoholic dependants were selected for the study based on the exclusion criteria. Level of self-esteem was assessed for each patient by using self-esteem assessment tool. All thirty alcoholic dependants were having low self-esteem that they become anger when criticized, afraid to try new things, showing difficulty in performing social activities and social interaction. All the alcoholic Dependants were scored the level of self-esteem score between50-60. 4.4. Promotion of Self-Esteem Activities: Self-Esteem activities are promoted by scheduling as individual and group activities. Individual activities are promoted in the morning and group activities are promoted in the evening to boost up self-esteem among Alcoholic dependants. TABLE 3 Self-Esteem Activities Protocol S. No Time Activities 1 Morning Individual Activities 8.30-9.30am A. Self Reporting 11.00-12.00Noon B. Art Writing 2 Afternoon Group Activities 1.30-3.00Pm A. Psychodrama 3.30-5.00Pm B. Tenniquoite TABLE 4 ASSESSMENT OF SELF-ESTEEM BEFORE PROMOTING SELF-ESTEEM ACTIVITIES n=30 S. No Level of Self-Esteem No. of. Patients Pre test 1. Self- Esteem Score (46) 30 SCORE INTERPRETATION: Problems with low self-esteem are indicated by a total score higher than 46 TABLE 5 ASSESSMENT OF SELF-ESTEEM AFTER PROMOTING SELF-ESTEEM ACTIVITIES n=30 S. No Level of self-Esteem No. of. Patients Pretest Post test 1. Self-Esteem Score(46) 30 0 TABLE 6 COMPARISON OF SELF-ESTEEM BEFORE AND AFTER PROMOTING SELF-ESTEEM ACTIVITIES n=30 S. No Level of Self-Esteem Pre test Post test 1 Self-Esteem Score(46) 30 30 2. Self-Esteem Score(46) 0 30 INTERPRETATION: Thirty alcoholic Dependants were scored 46 before promoting Self-Esteem activities. But after promoting Self-Esteem Activities they have scored 46 TABLE 7 Difference in pretest and Posttest Self-Esteem Score of Alcoholic Dependants S. No Pretest Score Posttest Score Difference 1 56 33 23 2 54 36 22 3 56 32 24 4 56 32 24 5 55 30 25 6 54 33 21 7 52 34 22 8 52 33 21 9 55 33 22 10 55 32 23 11 54 31 23 12 54 30 24 13 56 33 23 14 54 31 23 15 55 32 23 16 56 33 23 17 56 33 23 18 54 33 21 19 56 34 22 20 54 32 23 21 56 33 21 22 54 33 23 23 55 33 21 24 56 34 22 25 53 32 21 26 56 33 21 27 54 30 23 28 56 36 20 29 55 33 22 30 53 34 19 TABLE 8 COMPARISON OF SELF-ESTEEM BEFORE AND AFTER PROMOTING SELF-ESTEEM ACTIVITIES n=30 S. No Level of Self-Esteem Pre test Post test 1 Self-Esteem Score(46) 30 0 2. Self-Esteem Score(46) 0 30 INTERPRETATION: Thirty alcoholic dependants were scored 46 before promoting self-esteem activities. But after promoting self-esteem activities they have scored 46 4.5. COMPARISON OF PRETEST AND POSTTEST LEVEL OF SELF-ESTEEM AMONG ALCOHOLIC DEPENDANTS In order to find out the significant difference between pretest and posttest scores of level of self-esteem, pairedà ¢Ã¢â€š ¬Ã‹Å"tà ¢Ã¢â€š ¬Ã¢â€ž ¢ test was compared to test the significance, the hypothesis was stated. Hypothesis: There is a significant difference in level of self-esteem before and after promoting self-esteem activities. t = d/SD/n SD = (d-d)/n-1 (d-d) = 65.25 SD= (65.25)/30-1 SD= 65, 25/29 SD= 2.25 SD=1.5 t=d/SD/n =21.5/1.5/30 =21.5/1.5/5.4 =21.5/0.27 t=79.62 df=n-1 =30-1 =29 As the calculated value is 79.62, which is greater than table value (3.66)at the degree of freedom of 29.It is significant at the level of 0.001,and hypothesis is accepted. Hence there is significant improvement between mean pretest and posttest score of self-esteem. 4.6. Influence of demographic variables on Alcoholic dependants with low self-esteem: 4.6.1Influence of age on pretest score of alcoholic dependants with low sel-esteem: Karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: Age positively influence low self-esteem among alcoholic dependants. There is a relationship between age and level of self-esteem. r= XY/(x-x)(y-y) =3068/1715(49) =3068/84035 =0.0365 =0.191 The calculated value is 0.191 that there is a positive correlation between age and level of self-esteem. Hypothesis is accepted hypothesis. 4.6.2Influence of hours of work on pretest score of alcoholic dependants with low self-esteem: Karl Pearson co-efficient of correlation between hours of work and pretest self-esteem score of alcoholic dependants. Hypothesis: Hours of work positively influence low self-esteem among alcoholic dependants. There is a relationship between hours of work and level of self-esteem r= XY/(x-x) (y-y) =157.92/81.76 (49) =157.92/4006.2 8 =0.03941 =0.198 The calculated value is 0.198 that there is a positive correlation between hours of work and level of self-esteem..Hypothesis is accepted hypothesis. 4.6.3 Influence of duration of alcohol intake on pretest score of alcoholic dependants with low sel-esteem: Karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: Duration of alcohol intake positively influence low self-esteem among alcoholic dependants. There is a relationship between duration of alcohol intake and level of self-esteem. r= XY/(x-x)(y-y) =572/405(49) =572/19845 =0.028 =0.169 The calculated value is 0.169 that there is a positive correlation between duration of alcohol intake and level of self-esteem. Hypothesis is accepted hypothesis. 4.6.4 Influence of quantity of alcohol intake on pretest score of alcoholic dependants with low self-esteem: Karl Pearson co-efficient of correlation between quantity of alcohol intake and pretest self-esteem score of alcoholic dependants. Hypothesis: quantity of alcohol intake positively influence low self-esteem among alcoholic dependants. There is a relationship between quantity of alcohol intake and level of self-esteem. r= XY/(x-x)(y-y) =565908/547890(49) =565908/268466 =2.1 =1.4 The calculated value is 0.14 that there is a positive correlation between quantity of alcohol intake and level of self-esteem. .hypothesis is accepted hypothesis. 4.6.5Influence of age on pretest score of alcoholic dependants with low sel-esteem: karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: Age of Alcoholic dependants positively influence low self-esteem among alcoholic dependants. There is a relationship between r= XY/(x-x)(y-y) = 4289/1891.2(70.8) = 4289/132370 = 0.032 = 0.18 The calculated value is 0.18 that there is a positive correlation between age and level of self-esteem. .hypothesis is accepted hypothesis. 4.6.6Influence of hours of work on posttest score of alcoholic dependants with low sel-esteem: karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: hours of work positively influence low self-esteem among alcoholic dependants. There is a relationship between hors of work and level of self-esteem. r= XY/(x-x)(y-y) =320/1715(70.8) =320/121422 =0.0026 =0.05 The calculated value is 0.05 that there is a positive correlation between hours of work and level of self-esteem. .hypothesis is accepted hypothesis. 4.6.7 Influence duration of alcohol intake on posttest score of alcoholic dependants with low sel-esteem: karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: Duration of alcohol intake positively influence low self-esteem among alcoholic dependants. There is a relationship between hors of work and level of self-esteem. r= XY/(x-x)(y-y) =1175.5/405(70.8) =1175.5/28674 =0.04 =0.20 The calculated value is 0.20 that there is a positive correlation between duration of alcohol intake and level of self-esteem. .hypothesis is accepted hypothesis. 4.6.9 Influence of quantity of alcohol intake on posttest score of alcoholic dependants with low sel-esteem:karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: hours of work positively influence low self-esteem among alcoholic dependants. There is a relationship between hors of work and level of self-esteem. r= à ¢Ã‹â€ Ã¢â‚¬Ëœ XY/(x-x)(y-y) =9597444/547890(70.8) =9597444/38790612 =0.02 =0.157 The calculated value is 0.157 that there is a positive correlation between quantity of alcohol intake and level of self-esteem. .hypothesis is accepted hypothesis. CHAPTER V RESULTS AND DISCUSSION Introduction: The main aim of the study was to assess the level of self-esteem among alcoholic dependants and to promote self esteem activities. The study was conducted in Kasthuriba Gandhi De-Addiction centre at Coimbatore. A total of thirty patients were selected for the study .each patients baseline information was collected to understand the background of the patient and also some of the factors such as age, occupation, income which are expected to have an impact on alcoholism. 5.1 General Profile of the Alcoholic Dependants: The young age of alcoholic dependant who started intake of alcohol at the age of 21years was six and in the age of 65years are two. Many research studies says that, alcohol abuse and alcohol Dependence are not only adult problems they also affect a significant number of adolescents and young adults between the ages of 12-20,eventhough drinking under the age of 21 is illegal(Joseph.A,2008). Study shows seven alcoholic dependants were having only primary level of education others were completed their secondary, higher secondary and graduates. An individual receives less than or up to 12 years of education can the causative effect of Alcoholism. This finding implies that improving educational levels has the potential to counteract the risk factors and help to prevent alcoholism said Wan. Most of the alcoholic dependants were heavy workers such as drivers, civil engineers; farmerà ¢Ã¢â€š ¬Ã¢â€ž ¢s etc. Some study shows occupation has higher alcoholism rates, High risk occupation s attract problem drinkers or create them through job pressures. One hundred and fifty male manual recruits to Scottish breweries and distilleries were interviewed and compared with similar men in lower risk jobs. The alcohol producers reported poorer employment records and were significantly heavier drinkers than the controls. The alcohol producers were also more likely than the controls to have drunk more since recruitment. These results suggest that the drink trade attracts a disproportionate number of people likely to develop alcohol-related problems and indicates that drinking habits may be strongly influenced by work environment. In this study some alcoholic dependants started taking alcohol by learning from peergroups, work environment. The culture of the workplace may either accept and encourage drinking or discourage and inhibit drinking. A workplaces tolerance of drinking is partly influenced by the gender mix of its workers. Studies of male-dominated occupations have d escribed heavy drinking cultures in which workers use drinking to build solidarity and show conformity to the group (4, 5). Some male-dominated occupations therefore tend to have high rates of heavy drinking and alcohol-related problems (6, 7 In my study four Alcoholic dependants are having monthly Income Rs.1000-4000,Most of the alcoholic dependants are having the monthly income of more than 6000-20000.The more income people have higher social status or class, more likely theirhigh socio-economic status induces to drink alcoholic beverages. Marital disharmony also one of the risk factor for consuming alcohol, here in general practice alcoholism should be considered, when the doctor detects marital disharmony, repeated sickness absenteeism, repeated aggressive behavior, patients presenting with anxiety and depression, and those who smell of drink.( B. D. Hoer and R. H. Wilkins). Psychological factor plays a major role in consumption of alcohol, most of the alcoholic dependa nts in this consumes alcohol due to psychological factors. some research studies says that people turn to alcohol during periods of stress, frustration e.g. as a result of failure in an exam, loss of dear one, marital breakup, loss of personal property, etc as a way of trying to overcome the stress or depression. 5.2. Assessment of Problem Index Among alcoholic Dependants: Among thirty alcoholic dependants, majority of alcoholic dependants are not able to work, had inability to carryout responsibilities, had fight with relatives, were neglected by relatives,were advised by relatives and friends to stop alcohol, noticed a change in personality, most of them felt guilty, neede more alcohol to get the same effect as previous one, and felt physically and psychologically dependant on Alcoholism. 5.3. Assessment of level of self-esteem among Alcoholic dependants: Data on level of self-esteem pointed out that most of the alcoholic dependants are having low self-esteem. Their level of self-esteem was assessed by using self-esteem scale .Most of them scored the item very often(3) that inability to accept criticism, poor social interaction, afraid to try new things, difficulty to look people in the eye, uncomfortable in the presence of strangers, Feeling embarrassment when others are praising etc. There is a significant amount of research on the relationship between self-esteem and focusing on how self-esteem influences who is likely to consume alcohol. Research shows that low self-esteem is negatively correlated with alcohol consumption. In a study on adolescent drinking behavior, adolescents with high self-esteem reported consuming less alcohol than adolescents with low self-esteem and reported smaller increases in alcohol consumption over time (Gerald, Gibbons, Bergen, 2000). In addition in a study on college students. Students with lo w self-esteem became more intoxicated than students with high self-esteem (Glindemann, Geller, and Fortney, 1999).Although research shows a relationship alcohol and self-esteem. TABLE 5.1 5.4. Promotion of Self-esteem Activities among Alcoholic Dependants: S. No Time Activities 1 Individual Activities 8.30-9.30am A. Self Reporting 11.00-12.00Noon B. Art Writing 2 Group Activities 1.30-3.00Pm A. Caroms 3.30-5.00Pm B. Volley Ball 5.5. Comparison of Level of Self-Esteem Before And After Promoting Self-Esteem Activities: It was found in the assessment that the level of self-esteem was improved after promotion of self-esteem activities. Alcoholic dependants who scored the item very often (3) in the pretest were scored sometimes (2) or occasionally (1) after promotion of self-esteem activities. Patients were actively participated in self-esteem activities, before promoting self-esteem activities alcoholic dependants had the problems like becoming angry for criticism, poor interaction, inability to try new things, having difficulty looking people in the eye, difficulty making small talk, etc.But after promoting self-esteem activities alcoholic dependants showed an improvement in accepting criticism, trying new things, facing other peopleà ¢Ã¢â€š ¬Ã¢â€ž ¢s in the eye, good social interaction. CHAPTER VI SUMMARY AND CONCLUSION The present study was conducted in selected De-Addiction Centre, Coimbatore from 28.6.10-25.7.10.Alcoholic dependants were selected by sample free technique. The level of self-esteem was assessed by using self-esteem scale. alcoholalcohol induced psychiatric illness and dependants with high self-esteem were excluded. After initial assessment of self-esteem, self-esteem activities were promoted which include Individual and Group activities. Reassessment was done after a gap of fourteen days using the same scale to identify the enhancement in promotion of self-esteem of alcoholic dependants. The data collected during assessment and was revealed that the level of self-esteem had significantly improved after promotion of self-esteem activities. The demographic variables like age, hours of work, quantity of alcohol intake, and duration of intake of alcohol were analyzed by using Karl Pearsonà ¢Ã¢â€š ¬Ã¢â€ž ¢s co-efficient of co-relation to identify the influence of these variable s on the level of self-esteem and alcoholic dependants. The results indicated that there is a positive relationship between age hours, quantity, duration of alcohol intake and pretest self-esteem score of alcoholic dependants. The results also indicated for posttest. The significance of level of self-esteem on pretest and posttest level of alcoholic dependants were calculated using pairedà ¢Ã¢â€š ¬Ã¢â€ž ¢tà ¢Ã¢â€š ¬Ã¢â€ž ¢test.The results showed that after promoting self-esteem activities the alcoholic dependants had a significant improvement in level of self-esteem. 6.1. Major Findings of The Study: Majority of alcoholic dependants were in the age group of 20-65years. In pre assessment of level of self-esteem all 30 alcoholic dependants had low self-esteem. In post assessment of level of self-esteem, all 30 alcoholic dependants had improved their self-esteem. The mean pretest score .there is a increase in posttest mean score. The paired à ¢Ã¢â€š ¬Ã‹Å"tà ¢Ã¢â€š ¬Ã¢â€ž ¢test value of self-esteem is 9à ¢Ã¢â€š ¬Ã¢â€ž ¢tà ¢Ã¢â€š ¬Ã¢â€ž ¢= ) is greater than the table value at the degree of freedom 29 is significant at the level of 0.001. 6.2 Limitation of The Study: This study was limited only to alcoholic dependants This study was aimed only to promote self-esteem of alcoholic dependants The study was limited only to the De-addiction centre. 6.3 Suggestions For Further Study Similar study can be conducted for other psychoactive substance use disorders patients A similar study can be conducted with family members. A similar study can be conducted for alcoholic dependants on any psychiatric set up. A study can be conducted among friends of alcoholic dependants who regularly visit wine shops/bars/Arrack shops. A study can be conducted on childrenà ¢Ã¢â€š ¬Ã¢â€ž ¢s of alcoholics to identify the level of self-esteem. 6.4 Recommendations: A follow up study on promotion of self-esteem among alcoholic dependants after six months to one year can be carried out to explore in to the retaining impact of self-esteem. Mass media, Posters can be used to create awareness on alcohol treatment to public; this will be helpful in removing misconceptions regarding alcoholic patients. A similar study can be conducted to assess the self-esteem of the childrenà ¢Ã¢â€š ¬Ã¢â€ž ¢s of alcoholics and to promote self-esteem activities earlier. 6.5. Conclusion: The study highlights the practice of self-esteem activities are useful tools for Alcoholic dependants who are having low self-esteem. Thre is no medical treatment to treat low self-esteem, only we can promote self-esteem by involving them in self-esteem activities .Alcoholic dependants with low self-esteem need positive reinforcement to enhance self-esteem. Individual activities makes the individuals to complete the task by alone and improves the individual capablity. Group activities makes the group to work together to achieve the task and also it improves social interaction. The study review showed that promotion of self-esteem activities among alcoholic dependants was the most effective method for enhancement of self-esteem. The result can potentially be employed as non-pharmacologic adjuvant therapy in the management of alcoholic dependants with low self-esteem.

Self Esteem And Substance Abuse - Free Essay Example

Sample details Pages: 21 Words: 6178 Downloads: 8 Date added: 2017/06/26 Category Health Essay Type Essay any type Did you like this example? CHAPTER I INTRODUCTION Self esteem is all about how much we feel valued, loved, accepted and thought well of by others and how much we value, love and accept ourselves. People with healthy self-esteem are able to feel good about them, appreciate their own worth and take pride in their abilities, skills and accomplishments. People with low self- esteem may feel as if no one will like them or accept them or that they canà ¢Ã¢â€š ¬Ã¢â€ž ¢t do well in anything People with high self esteem tend to be ambitious in what they want to experience in Life, they have a drive to express them and to communicate openly and honestly about their needs and desires. Don’t waste time! Our writers will create an original "Self Esteem And Substance Abuse" essay for you Create order People with low self esteem rarely live their life to the full, they distance themselves from others, denied their love and support, and uncomfortable with success, some of them even take alcohol and drugs. We all experience problems with self esteem at certain times in our lives-especially during our teens figuring out, where we fit in the world. The level of self esteem determines how we operate in life à ¢Ã¢â€š ¬Ã¢â‚¬Å"how we interact with others such as spouse, children, friends, and strangers .It determines our achievements, and our satisfaction and happiness. Self esteem has long been believed to play an important role in the use of alcohol; People with alcohol problems often have low self esteem. They judge themselves negatively-not just for their addiction, but also for other parts of their behavior or their personality. Most of the individuals who are addicted to drugs and alcohol are not happy with their lives and live a life of despair and hopelessness, the major symptom is poor self esteem. Poor self esteem is at the heart of an individualà ¢Ã¢â€š ¬Ã¢â€ž ¢s addiction and dependency and there is an inverse relationship between alcohol dependency and self esteem, that if a personà ¢Ã¢â€š ¬Ã¢â€ž ¢s self esteem improves the individualà ¢Ã¢â€š ¬Ã¢â€ž ¢s addictive behavior. 1.1. Need For The Study: Low self esteem is one of the causative factor that vast majority of alcohol addicts share in common, low self esteem is challenging in four areas. First they feel that they lack personal power, secondly many with low self esteem feel lacking the affection and attention of others, thirdly low self esteem results when people feel that they lack virtue, often feel unloved, unappreciated and lastly those possessing low self esteem hold themselves as incompetent in one or more areas. Several researchers have argued that self esteem poses high risk for alcohol abuse in some populations, including adolescents, college students, and females (Donnelly, 2000). Another area of life that Alcoholics with low Self-Esteem often struggle with their occupation. Perhaps they may lack education, information, skill sets, or the belief in their ability to obtain a worthwhile job and so they self-sabotage and then get to the right about the fact that no one wants to hire them. Seeking continuous education is hopeless to those who have such low self-esteem since they see themselves as incapable of excelling in the process of studying, taking exams, and achieving success in all the systems. Low self- esteem can also manifest as a result of oneà ¢Ã¢â€š ¬Ã¢â€ž ¢s inability to generate wealth, they see themselves struggling to survive in a world marked by competition, often struggle with their occupation. Those with low self esteem often resort to addictive behaviors in an effort to numb out the pain and escape to a world that allows them a temporary release from their sufferings and problems 1.2. Statement of the Problem: Promotion of self esteem activities among alcoholic dependants 1.3. Objectives: 1.3.1 Assessment the self esteem level among alcoholics 1.3.2 Association of self esteem and Alcoholism 1.3.2 Assessment of the effectiveness of self esteem activities in promotion of self esteem among alcoholics. 1.4. Assumptions: 1.4.1. Self esteem level may be low among alcoholic dependants. 1.4.2. Practice of self esteem activities may improve the self esteem level among alcoholic dependants 1.5. Operational Definitions: 1.5.1. PROMOTION- refers to the improvement in level of self esteem among Alcoholic dependants. 1.5.2. SELF ESTEEM- perceived self concept of an alcoholic individual 1.5.3. ALCOHOLICS- a person craves alcohol, is unable to limit his or her drinking. 1.6. Promotion of Self-Esteem Activities Among Alcoholics Dependants: Conceptualization is the process of specifying what we mean when we use particular terms (Giemman) The conceptual framework is derived from Penderà ¢Ã¢â€š ¬Ã¢â€ž ¢s health promotion Model. In this study Individual characteristics and experience by physical, social psychological and occupational problems may change the level of self-esteem of the Alcoholic patients. Self-Esteem activities are promoted based on the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s problems may bring change in the level of self-esteem. It includes perceived benefit of Self-Esteem activities like Individual and Group activities. PENDERà ¢Ã¢â€š ¬Ã¢â€ž ¢S HEALTH PROMOTION MODEL CHAPTER 2 REVIEW OF LITERATURE 1. Studies related to low self esteem and alcoholism 2. Studies related to self esteem activities and alcoholism 1. Studies related to low self esteem and alcoholism: A study conducted on self esteem and Alcohol use on 61 Alcoholic dependants who were admitted in a rural Midwestern medical centre. An individualà ¢Ã¢â€š ¬Ã¢â€ž ¢s reactions to his or her social environment are mediated by a sense of self esteem, low levels of self esteem are develop during Socialization. Results suggest that specific form of social support is important to recovering alcoholic dependants (Steffennhagen and Burns, 2006). A Pearson correlation was calculated examining the relationship between the amounts of alcohol consumed in the past 30 days and self esteem. A low to moderate correlation was found (r (23) =.250, p.05). (Jeremy W.Lawing, 2006). A Study conducted on drinking problems and self-Esteem of college students,148 lower division college students were given the following paper and pencil tests: The Michigan Alcoholism Screening Test, and the à ¢Ã¢â€š ¬Ã…“Personal Selfà ¢Ã¢â€š ¬? section of The Rosenberg Self-Esteem Scale. College Students are havin g low self Esteem (F = 4.23, p = .04). Tabulation of the incidence of heavy drinking (31%).Result shows an drinking behavior of college students are having low self esteem(()swego,2005). A study was conducted on the effects of self esteem on substance abuse among homeless men. This experimental study involving 305 samples of homeless men was assigned randomly to the treatment group and Control group. Control group was referred to community based services, experimental subjects were exposed to individual therapy, group interventions, life skills and relapse prevention training residing in a 24 Hour shelter for three months. Results indicated that self-esteem was increased in experimental group than in control group (Brandon, 2004). A descriptive study was conducted on self-esteem and alcohol dependants. Study comprises of two groups such as alcoholic dependants as one group and non-alcoholics in another group. Study shown that alcoholic dependants have lowered self esteem compa red to non alcoholics self esteem (Donnelly, 2003) A study was conducted to compare the level of self esteem among 30 alcoholics and 30 non alcoholic persons. They are assessed for self esteem using self esteem scale. The results showed that alcoholics had low self esteem when compared to non alcoholics(P001).Alcoholic dependants were perceived as less loving and less dominant as compared to non alcoholics, they also perceived alcoholics to be aggressive and sadistic(Neeliyara,2003). A study conducted to identify the relationship between alcohol consumption and self esteem. Study comprises of 26 Samples (Employees of local retail store), their self esteem was assessed by using Rosenbergà ¢Ã¢â€š ¬Ã¢â€ž ¢s self esteem scale. Results showed that alcohol consumption is strongly related to self esteem (T.F.Heatherson,2000). A Study conducted on how self esteem influences alcohol consumption Study comprises of 61 samples. Over the course of two weekends self esteem was measured using Rosenbergà ¢Ã¢â€š ¬Ã¢â€ž ¢s self esteem scale. Study showed the results that self esteem is negatively correlated with alcohol consumption. In a study on adolescents drinking behavior, adolescents with high self esteem reported consuming less alcohol than adolescents with low self esteem. (Gerrerd, Russell, 2000 A cross-sectional survey design investigated the relationship of substance use and self esteem. Self -esteem was assessed using Hare Self-esteem Scale. Four hundred and eleven samples were completed the survey. Results revealed that there is a direct relationship between alcohol use and self-esteem (F=12.8,df=2,343,p,.00001).Regardless recent alcohol abusers had the lowest self-esteem scores and never users had the highest scores(F.X.Gibbons,2000). A study says that low self-esteem is the universal common denominator among all people suffering from addictions. Low self-esteem is the true disease and it is the underlying origin of all problematic behaviors that p lagues the world (Candito, 1996). A prospective study of self-esteem and Alcohol Use Disorders in Early Adulthood. The relation among Self-esteem and Alcohol use disorder diagnoses was examined in a sample of 240 men evaluated at four annual assessments over the college years. The results support clinical observations that low self esteem plays a particularly important it eological role in alcohol problems in men (Fromme.K, 1989). A number of studies have indicated that adolescents who refrain from drinking alcohol have higher self-esteem than do adolescents who drink. The questionnaire used in this study included the Adolescent Alcohol Involvement Scale which has fourteen questions about alcohol use, the Rosenberg (1965) Self-esteem Scale, (Mendel son, Mock, Erbaugh, 1984). 2. Studies related to self esteem activities and alcoholism A Study conducted on how group activity has an impact on self esteem among alcoholics. Study comprises 40 samples, 20 patients undergone group activities for 12 weeks in an inpatient setting and 20 patients as control groups. Patients in the intervention group showed significant enhancement in self esteem, social skills and self confidence where as there is no changes observed in control group (John Wiley, 2009) A Study was conducted how utilization of self esteem programs (Holistic Addiction Treatment Programme) plays an important role in Relapse prevention. Study comprises of 145 samples. Results show that 70 to 90 percentages, self esteem programs are effective in Relapse prevention and over all well-being to the treatment of recovering alcoholics (Harry Henshaw, 2007). A Study conducted on self esteem activities among Alcoholic patients. Study comprises of 43 samples, volunteers in the group undergone self esteem activities along with drug treatment, the other group only underwent drug treatment. Pretest-posttest comparison on a variety of physiological parameters indicated that significant improvements had occurred in psychological wellbeing including self esteem, self awareness, lifestyle adaptation and relapse prevention skills. Results suggest that promotion of self esteem activities improves self esteem among alcoholic dependants (Michael Peterson, Bryan johnstone, 2003) A study conducted on self-esteem and alcoholism among high school students total sample was 140(55males and 85 females) high school students. The questionnaire used in this study included the Adolescent Alcohol Involvement Scale (Moberg, 1983) which has fourteen questions about alcohol use, the Rosenberg (1965) Self-esteem Scale, and the Beck Depression Inventory (Beck, Ward, Mendel son, Mock, Erbaugh, 1961). Study has showed that indicated that adolescents who refrain from drinking alcohol have higher self-esteem than do adolescents who drink (Butler, 1980; Young, Werch, Brakeman 1989) CHAPTER 3 MATERIALS AND METHODS Designing a research involves the development of plan or strategy that will guide the collection and analysis of data. The present study is designed to promote the Self-esteem among Alcoholic Patients. The methodology of the study constitutes research design, setting, population and sampling criteria for the selection of samples and tool for data collection. 3.1. One Group Pre Test Post Test Design: 3.2. Setting: This study was conducted in Kasthuriba Gandhi De-Addiction Centre, Coimbatore. The De-Addiction centre consists of 25 bedded 3.3. Population: The overall population for the study was alcoholic patients who were admitted in the Kasthuriba Gandhi DE-Addiction Centre from 28.06.2010 to 25.07.2010. 3.4 Sample size And Sampling Technique: Purposive sampling Technique was used to select samples who were admitted in the Kasthuriba Gandhi De-Addiction Centre during the period of study.30 patients were selected as samples during the study. 3.5. Criteria for Selection of the Sample: Inclusion Criteria: Patients who were admitted in Kasthuriba Gandhi De-Addiction Centre Alcoholic patients with Low self esteem Exclusion Criteria: Patients who are not willing to participate in the study. Alcoholic dependants associated with Psychotic symptoms. 3.5. Instruments and Tool for Data Collection: The tool was prepared based on review of literature and guidance of experts from the field of Psychiatry. Section I: This section includes demographic variables like age, education, family Income, occupation, marital status, marital disharmony, Type of Family Duration of Alcohol intake Consumption of alcohol, physical and psychological problems. Section II: This section consists of modified Rutgersà ¢Ã¢â€š ¬Ã¢â€ž ¢s Alcohol Problem Index scale. It is a useful tool to assess the problem index among alcoholic patients. It consists of 15 questions. Section III: This section has an index to measure personà ¢Ã¢â€š ¬Ã¢â€ž ¢s self-esteem. It consists of 20 statements to assess the level of self-esteem of alcoholic dependants. Score Interpretation: Self à ¢Ã¢â€š ¬Ã¢â‚¬Å"Esteem Assessment Scale consists of 20 s tatements of assessment of patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s level of self esteem. The total score is 60, patient who scores the item à ¢Ã¢â€š ¬Ã‹Å"3à ¢Ã¢â€š ¬Ã¢â€ž ¢ and more than 46 is having low self-esteem. Section IV: This section consists of intervention for Low self à ¢Ã¢â€š ¬Ã¢â‚¬Å"Esteem such as Individual activities and Group activities. Individual Activities: Promoting individually performing activities. The patients are encouraged to do individual activities such as Art writing and Reading Newspapers. Group Activities: Group activities is two or more individuals unite together to promote an same activity. Patients are encouraged to do psychodrama (Group was given a theme, group members act out based on the theme) and Outdoor games (Tenniequots) 3.6. Variables of the study: Independent variable: Self-esteem activities. Dependant variable: Alcoholic dependants. 3.7. Techniques for Data Analysis and Interpretation: The tables were formulated for base line information such as age, education, occupation, type of family, marital disharmony, income per month, amount of alcohol intake, duration of alcohol intake, physical and psychological symptoms. Pairedà ¢Ã¢â€š ¬Ã¢â€ž ¢ test was used to analyze the significant difference in the level of self-esteem before and after promoting self esteem activities. 3.7.1. Pairedà ¢Ã¢â€š ¬Ã¢â€ž ¢tà ¢Ã¢â€š ¬Ã¢â€ž ¢test: The test was used to point out the effect of promotion of self esteem activities among alcoholic patients. t=d SD/ n SD= (d-d) Here d=Mean difference between pretest and posttest score. SD=Standard Deviation of the Pre test and post test Sore n=Number of Samples. Pilot study report Pilot study was conducted for a period of 2 weeks, from 28th May 2010 to 11th May 2010, to test the practicability of the tool and feasibility of conducting the main study. Study was conducted in Psychiatric ward of P S G Hospital. For pilot study 5 samples were selected. Data were collected by interview method. Through the pilot study it was proved that self esteem activities in promotion of self esteem. The researcher would like to continue the study to promote self esteem among alcoholic dependants. Changes brought after pilot study During the pilot study, self esteem level was assessed and found to be low among alcoholic dependants. CHAPTER 4 DATA ANALYSIS AND INTERPRETATION The process of evaluating data using analytical and logical reasoning to examine each component of the data provided. This form of analysis is just one of the many steps that must be completed when conducting a research experiment. Data from various sources gathered, reviewed, and then analyzed to form some sort of finding or conclusion. There are a variety of specific data analysis method, some of which include data mining, text analytics, business intelligence, and data visualizations. 4.1. General Profile of alcoholic Dependants 1. Age Among thirty alcoholic dependants, six patients were at the age of 21-30 years, fifteen patients were at the age of 31-40years, seven patients were at the age between 41-50 years and two patients were between 51-60years. 2. Education Most of the alcoholic dependants were completed their secondary education, seven patients had completed primary education, six patients completed higher secondary education and seven had graduate degree. 3. Occupation: A. Type of Work It was found that ten were doing business, five were farmers, four were engineers, two were bus drivers and there was one from each category like tailor, rashion shop, goldsmith, shopkeeper, hotel supervisor, massion, mandapam decorator, Carpentor, cable TV Manager. B. Hours of Work Hours of work for alcoholic dependants were varying from6-15 hrs. Most of them nineteen were working between 11-15 hrs and eleven patients were working 6-10 hours per day. C. Income per Month Income of alcoholic dependants varied depends upon their occupation, fifteen were earning between Rs.6000-10000 per month, eight patients were earning between Rs.11000-15000 per month, four were earning between Rs.1000-5000 per month, three patients were earning between Rs 16000-20000 per month. D. Conflict in Work Area Majority of alcoholic dependants, twenty expressed no conflict in work area and ten had conflict in their work area. 4. Family history A. Marital status Twenty four patients were married, six patients were unmarried. B. Marital disharmony: Thirty alcoholic dependants came out with the problem of and only eleven patients had no such problems. C. Relationship with spouse: Among the alcoholic dependants, twelve patients were maintaining good relationship with their spouse and twelve patients were not maintaining good relationship with spouse. D. Relationship with children: Twenty two were maintaining good relationship with their children and two patients were not maintaining good relationship with children. E. Type of Family: Among twenty four alcoholic dependants, six patients were from joint family and eighteen from nuclear family. F. Family History of Alcoholism: There is no family history of alcohol intake among twenty five alcoholic dependants and only five patients were having the family history of alcoholism. 5. Social History: A. Social Support: Among thirty alcoholic dependants, one had Peer group support, three had support from friends, and twenty six had family support. 6. Alcoholic History: A. Duration of Alcohol Intake In years: Duration of 11-15-years of alcohol intake was found among fifteen alcoholic dependants, 6-10years among ten alcoholic dependants, 1-5years among three alcoholic dependants and 16-20 years among two alcoholic dependants. B. Consumption of Alcohol started by: Most of the patients twenty five were started consuming alcohol through friends, three started by their relatives and two started by their family members. C. Quantity of Alcohol when started (Bear in ml): Majority of the alcoholic dependants, twenty three started with 100-300ml of bear while seven alcoholic dependants were stated with 700-900ml of bear. D. Quantity of Alcohol at present (Hot): At present eleven alcoholic dependants was consuming 700-900ml of hot which is more than nineteen alcoholic dependants consuming 400-600ml. E. Time of drinking Alcohol: Among thirty alcoholic dependants, twelve patients were taking alcohol in the evening, four were taking alcohol in the morning and evening, fourteen were taking alcohol throughout the day. F. Money spent on Alcohol Consumption: Among thirty alcoholic dependants, most of them twenty two spent Rs 4000-6000per month for alcohol consumption seven spent Rs7000-9000 per month and one spent Rs 1000-3000 per month. G. Motivation for treatment of Alcoholism: Maximum number of patients thirteen were motivated by self, seven were motivated by already treated patients in de-addiction centre, five were motivated by family members and five were motivated by Relatives. H. Reason for Alcoholism: Seventeen patients were started on alcoholism due to psychological factors such as wifeà ¢Ã¢â€š ¬Ã¢â€ž ¢s death, job stress etc, thirteen patients were started due to peer group pressure and none had the reason of physical and psychiatric illness. TABLE 4 1 DEMOGRAPHIC DATA OF ALCOHOLIC PATIENTS 1 AGE IN YEARS 21-30 6 31-40 15 41-50 7 51-65 2 2 EDUCATION Primary 7 Secondary 10 Higher secondary 6 Graduate 7 3 OCCUPATION A.TYPE OF WORK Business 10 Farmer 5 Tailor 1 Accountant in Rashionshop 1 Goldsmith 1 Hotel Supervisor 1 Driver 2 Construction Worker 1 Engineers 4 Mandapam Decorator 1 Carpenter 1 Cable T.V. Manager 1 B.HOURS OF WORK 6 10 11 11 15 19 C.INCOME PER MONTH 1000-5000 4 6000-10,000 15 11,000-15,000 8 16,000-20,000 3 D.CONFLICT IN WORK AREA Present 10 Absent 20 4 FAMILY HISTORY A.MARITAL HISTORY Married 24 Single 6 B.MARITAL DISHARMONY Present 13 Absent 11 C.RELATIONSHIP WITH SPOUSE Maintains good relationship 12 Not maintains good relationship 12 D.RELATIONSHIP WITH CHILDREN Maintains good relationship 22 Not maintains good relationship 2 E.TYPE OF FAMILY Joint family 6 Nuclear family 18 F.FAMILY HISTORY OF ALCOHOLISM Present 5 Absent 25 SOCIAL HISTORY A.SOCIAL SUPPORT Neighbors 0 Peer group 1 Friends 3 Family 26 5 ALCOHOLIC HISTORY A.DURATION OF ALCOHOL INTAKE IN YEARS 1 5 3 6 10 10 11 15 15 16-20 2 B.CONSUMPTION OF ALCOHOL STARTED BY Friends 25 Family members 2 Relatives 3 Self 0 C.QUANTITY OF ALCOHOL WHEN STARTED (BEAR) ML 100-300 23 400-600 7 700-900 0 D.QUQNTITY OF ALCOHOL CONSUMPTION AT PRESENT(HOT)ML 100-300 0 400-600 19 700-900 11 E.TIME OF DRINKING ALCOHOL Morning 0 Evening 12 Both 4 Throughout the Day 14 F.MONEY SPENT ON ALCOHOLISM 1000-3000 1 4000-6000 22 7000-9000 7 G.MOTIVATION FOR TREATMENT OF ALCOHOLISM Family members 5 Relatives 5 Self 13 Treated patients 0 H.REASON FOR ALCOHOLISM Physical Illness 0 Psychiatric Illness 0 Psychological Illness 17 Peer group Influence 13 4.2. Assessment of Problem Index among Alcoholic Dependants: Among thirty alcoholic dependants, Majority of alcoholic dependants are not able to work, inability to carryout responsibilities, had fight with relatives, neglected by relatives, advised by relatives and friends, to stop alcohol, noticed a change in personality, most of them felt guilty,neede more alcohol to get the same effect previous one, and felt physically and psychologically dependant on Alcoholism. TABLE 2 ASSESSMENT OF PROBLEM INDEX n=30 S.No PROBLEM STATEMENTS 1 2 3 4 1 Not Able To Work 10 15 5 0 2 Neglected Responsibilities 10 15 5 0 3 Had Fight With Others 20 5 5 0 4 Neglected By Relatives 10 14 6 0 5 Advised By friends, neighbours, relatives to stop alcohol 0 20 10 0 6 Kept Promised To Stop Drinking 10 12 8 0 7 Noticed A Change In Personality 12 16 2 0 8 Felt Guilty 0 23 7 0 9 Forgetting Places 16 14 0 0 10 Fainted Suddenly 26 4 0 0 11 Gone Suddenly 26 3 1 0 12 Needed More Alcohol To Get The same Effect As Of previous One 0 20 6 4 13 Tried To Control Drinking 16 8 6 0 14 Stopped Drinking Because Of Withdrawal Symptoms 20 10 0 0 15 Felt physical or Psychologically dependant On Alcohol 0 16 10 4 Score Interpretation: 1.None of the Time, 2.1-2 Time, 3.3-4 Times, 4.More than five t imes 4.3. Assessment of Level of Self-Esteem among alcoholic Dependants: Fifty one patients were got admitted in kasthuriba Gandhi de-Addiction Centre, Coimbatore in the month of July. Among them thirty alcoholic dependants were selected for the study based on the exclusion criteria. Level of self-esteem was assessed for each patient by using self-esteem assessment tool. All thirty alcoholic dependants were having low self-esteem that they become anger when criticized, afraid to try new things, showing difficulty in performing social activities and social interaction. All the alcoholic Dependants were scored the level of self-esteem score between50-60. 4.4. Promotion of Self-Esteem Activities: Self-Esteem activities are promoted by scheduling as individual and group activities. Individual activities are promoted in the morning and group activities are promoted in the evening to boost up self-esteem among Alcoholic dependants. TABLE 3 Self-Esteem Activities Protocol S. No Time Activities 1 Morning Individual Activities 8.30-9.30am A. Self Reporting 11.00-12.00Noon B. Art Writing 2 Afternoon Group Activities 1.30-3.00Pm A. Psychodrama 3.30-5.00Pm B. Tenniquoite TABLE 4 ASSESSMENT OF SELF-ESTEEM BEFORE PROMOTING SELF-ESTEEM ACTIVITIES n=30 S. No Level of Self-Esteem No. of. Patients Pre test 1. Self- Esteem Score (46) 30 SCORE INTERPRETATION: Problems with low self-esteem are indicated by a total score higher than 46 TABLE 5 ASSESSMENT OF SELF-ESTEEM AFTER PROMOTING SELF-ESTEEM ACTIVITIES n=30 S. No Level of self-Esteem No. of. Patients Pretest Post test 1. Self-Esteem Score(46) 30 0 TABLE 6 COMPARISON OF SELF-ESTEEM BEFORE AND AFTER PROMOTING SELF-ESTEEM ACTIVITIES n=30 S. No Level of Self-Esteem Pre test Post test 1 Self-Esteem Score(46) 30 30 2. Self-Esteem Score(46) 0 30 INTERPRETATION: Thirty alcoholic Dependants were scored 46 before promoting Self-Esteem activities. But after promoting Self-Esteem Activities they have scored 46 TABLE 7 Difference in pretest and Posttest Self-Esteem Score of Alcoholic Dependants S. No Pretest Score Posttest Score Difference 1 56 33 23 2 54 36 22 3 56 32 24 4 56 32 24 5 55 30 25 6 54 33 21 7 52 34 22 8 52 33 21 9 55 33 22 10 55 32 23 11 54 31 23 12 54 30 24 13 56 33 23 14 54 31 23 15 55 32 23 16 56 33 23 17 56 33 23 18 54 33 21 19 56 34 22 20 54 32 23 21 56 33 21 22 54 33 23 23 55 33 21 24 56 34 22 25 53 32 21 26 56 33 21 27 54 30 23 28 56 36 20 29 55 33 22 30 53 34 19 TABLE 8 COMPARISON OF SELF-ESTEEM BEFORE AND AFTER PROMOTING SELF-ESTEEM ACTIVITIES n=30 S. No Level of Self-Esteem Pre test Post test 1 Self-Esteem Score(46) 30 0 2. Self-Esteem Score(46) 0 30 INTERPRETATION: Thirty alcoholic dependants were scored 46 before promoting self-esteem activities. But after promoting self-esteem activities they have scored 46 4.5. COMPARISON OF PRETEST AND POSTTEST LEVEL OF SELF-ESTEEM AMONG ALCOHOLIC DEPENDANTS In order to find out the significant difference between pretest and posttest scores of level of self-esteem, pairedà ¢Ã¢â€š ¬Ã‹Å"tà ¢Ã¢â€š ¬Ã¢â€ž ¢ test was compared to test the significance, the hypothesis was stated. Hypothesis: There is a significant difference in level of self-esteem before and after promoting self-esteem activities. t = d/SD/n SD = (d-d)/n-1 (d-d) = 65.25 SD= (65.25)/30-1 SD= 65, 25/29 SD= 2.25 SD=1.5 t=d/SD/n =21.5/1.5/30 =21.5/1.5/5.4 =21.5/0.27 t=79.62 df=n-1 =30-1 =29 As the calculated value is 79.62, which is greater than table value (3.66)at the degree of freedom of 29.It is significant at the level of 0.001,and hypothesis is accepted. Hence there is significant improvement between mean pretest and posttest score of self-esteem. 4.6. Influence of demographic variables on Alcoholic dependants with low self-esteem: 4.6.1Influence of age on pretest score of alcoholic dependants with low sel-esteem: Karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: Age positively influence low self-esteem among alcoholic dependants. There is a relationship between age and level of self-esteem. r= XY/(x-x)(y-y) =3068/1715(49) =3068/84035 =0.0365 =0.191 The calculated value is 0.191 that there is a positive correlation between age and level of self-esteem. Hypothesis is accepted hypothesis. 4.6.2Influence of hours of work on pretest score of alcoholic dependants with low self-esteem: Karl Pearson co-efficient of correlation between hours of work and pretest self-esteem score of alcoholic dependants. Hypothesis: Hours of work positively influence low self-esteem among alcoholic dependants. There is a relationship between hours of work and level of self-esteem r= XY/(x-x) (y-y) =157.92/81.76 (49) =157.92/4006.2 8 =0.03941 =0.198 The calculated value is 0.198 that there is a positive correlation between hours of work and level of self-esteem..Hypothesis is accepted hypothesis. 4.6.3 Influence of duration of alcohol intake on pretest score of alcoholic dependants with low sel-esteem: Karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: Duration of alcohol intake positively influence low self-esteem among alcoholic dependants. There is a relationship between duration of alcohol intake and level of self-esteem. r= XY/(x-x)(y-y) =572/405(49) =572/19845 =0.028 =0.169 The calculated value is 0.169 that there is a positive correlation between duration of alcohol intake and level of self-esteem. Hypothesis is accepted hypothesis. 4.6.4 Influence of quantity of alcohol intake on pretest score of alcoholic dependants with low self-esteem: Karl Pearson co-efficient of correlation between quantity of alcohol intake and pretest self-esteem score of alcoholic dependants. Hypothesis: quantity of alcohol intake positively influence low self-esteem among alcoholic dependants. There is a relationship between quantity of alcohol intake and level of self-esteem. r= XY/(x-x)(y-y) =565908/547890(49) =565908/268466 =2.1 =1.4 The calculated value is 0.14 that there is a positive correlation between quantity of alcohol intake and level of self-esteem. .hypothesis is accepted hypothesis. 4.6.5Influence of age on pretest score of alcoholic dependants with low sel-esteem: karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: Age of Alcoholic dependants positively influence low self-esteem among alcoholic dependants. There is a relationship between r= XY/(x-x)(y-y) = 4289/1891.2(70.8) = 4289/132370 = 0.032 = 0.18 The calculated value is 0.18 that there is a positive correlation between age and level of self-esteem. .hypothesis is accepted hypothesis. 4.6.6Influence of hours of work on posttest score of alcoholic dependants with low sel-esteem: karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: hours of work positively influence low self-esteem among alcoholic dependants. There is a relationship between hors of work and level of self-esteem. r= XY/(x-x)(y-y) =320/1715(70.8) =320/121422 =0.0026 =0.05 The calculated value is 0.05 that there is a positive correlation between hours of work and level of self-esteem. .hypothesis is accepted hypothesis. 4.6.7 Influence duration of alcohol intake on posttest score of alcoholic dependants with low sel-esteem: karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: Duration of alcohol intake positively influence low self-esteem among alcoholic dependants. There is a relationship between hors of work and level of self-esteem. r= XY/(x-x)(y-y) =1175.5/405(70.8) =1175.5/28674 =0.04 =0.20 The calculated value is 0.20 that there is a positive correlation between duration of alcohol intake and level of self-esteem. .hypothesis is accepted hypothesis. 4.6.9 Influence of quantity of alcohol intake on posttest score of alcoholic dependants with low sel-esteem:karl Pearson co-efficient of correlation between age and pretest self-esteem score of alcoholic dependants. Hypothesis: hours of work positively influence low self-esteem among alcoholic dependants. There is a relationship between hors of work and level of self-esteem. r= à ¢Ã‹â€ Ã¢â‚¬Ëœ XY/(x-x)(y-y) =9597444/547890(70.8) =9597444/38790612 =0.02 =0.157 The calculated value is 0.157 that there is a positive correlation between quantity of alcohol intake and level of self-esteem. .hypothesis is accepted hypothesis. CHAPTER V RESULTS AND DISCUSSION Introduction: The main aim of the study was to assess the level of self-esteem among alcoholic dependants and to promote self esteem activities. The study was conducted in Kasthuriba Gandhi De-Addiction centre at Coimbatore. A total of thirty patients were selected for the study .each patients baseline information was collected to understand the background of the patient and also some of the factors such as age, occupation, income which are expected to have an impact on alcoholism. 5.1 General Profile of the Alcoholic Dependants: The young age of alcoholic dependant who started intake of alcohol at the age of 21years was six and in the age of 65years are two. Many research studies says that, alcohol abuse and alcohol Dependence are not only adult problems they also affect a significant number of adolescents and young adults between the ages of 12-20,eventhough drinking under the age of 21 is illegal(Joseph.A,2008). Study shows seven alcoholic dependants were having only primary level of education others were completed their secondary, higher secondary and graduates. An individual receives less than or up to 12 years of education can the causative effect of Alcoholism. This finding implies that improving educational levels has the potential to counteract the risk factors and help to prevent alcoholism said Wan. Most of the alcoholic dependants were heavy workers such as drivers, civil engineers; farmerà ¢Ã¢â€š ¬Ã¢â€ž ¢s etc. Some study shows occupation has higher alcoholism rates, High risk occupation s attract problem drinkers or create them through job pressures. One hundred and fifty male manual recruits to Scottish breweries and distilleries were interviewed and compared with similar men in lower risk jobs. The alcohol producers reported poorer employment records and were significantly heavier drinkers than the controls. The alcohol producers were also more likely than the controls to have drunk more since recruitment. These results suggest that the drink trade attracts a disproportionate number of people likely to develop alcohol-related problems and indicates that drinking habits may be strongly influenced by work environment. In this study some alcoholic dependants started taking alcohol by learning from peergroups, work environment. The culture of the workplace may either accept and encourage drinking or discourage and inhibit drinking. A workplaces tolerance of drinking is partly influenced by the gender mix of its workers. Studies of male-dominated occupations have d escribed heavy drinking cultures in which workers use drinking to build solidarity and show conformity to the group (4, 5). Some male-dominated occupations therefore tend to have high rates of heavy drinking and alcohol-related problems (6, 7 In my study four Alcoholic dependants are having monthly Income Rs.1000-4000,Most of the alcoholic dependants are having the monthly income of more than 6000-20000.The more income people have higher social status or class, more likely theirhigh socio-economic status induces to drink alcoholic beverages. Marital disharmony also one of the risk factor for consuming alcohol, here in general practice alcoholism should be considered, when the doctor detects marital disharmony, repeated sickness absenteeism, repeated aggressive behavior, patients presenting with anxiety and depression, and those who smell of drink.( B. D. Hoer and R. H. Wilkins). Psychological factor plays a major role in consumption of alcohol, most of the alcoholic dependa nts in this consumes alcohol due to psychological factors. some research studies says that people turn to alcohol during periods of stress, frustration e.g. as a result of failure in an exam, loss of dear one, marital breakup, loss of personal property, etc as a way of trying to overcome the stress or depression. 5.2. Assessment of Problem Index Among alcoholic Dependants: Among thirty alcoholic dependants, majority of alcoholic dependants are not able to work, had inability to carryout responsibilities, had fight with relatives, were neglected by relatives,were advised by relatives and friends to stop alcohol, noticed a change in personality, most of them felt guilty, neede more alcohol to get the same effect as previous one, and felt physically and psychologically dependant on Alcoholism. 5.3. Assessment of level of self-esteem among Alcoholic dependants: Data on level of self-esteem pointed out that most of the alcoholic dependants are having low self-esteem. Their level of self-esteem was assessed by using self-esteem scale .Most of them scored the item very often(3) that inability to accept criticism, poor social interaction, afraid to try new things, difficulty to look people in the eye, uncomfortable in the presence of strangers, Feeling embarrassment when others are praising etc. There is a significant amount of research on the relationship between self-esteem and focusing on how self-esteem influences who is likely to consume alcohol. Research shows that low self-esteem is negatively correlated with alcohol consumption. In a study on adolescent drinking behavior, adolescents with high self-esteem reported consuming less alcohol than adolescents with low self-esteem and reported smaller increases in alcohol consumption over time (Gerald, Gibbons, Bergen, 2000). In addition in a study on college students. Students with lo w self-esteem became more intoxicated than students with high self-esteem (Glindemann, Geller, and Fortney, 1999).Although research shows a relationship alcohol and self-esteem. TABLE 5.1 5.4. Promotion of Self-esteem Activities among Alcoholic Dependants: S. No Time Activities 1 Individual Activities 8.30-9.30am A. Self Reporting 11.00-12.00Noon B. Art Writing 2 Group Activities 1.30-3.00Pm A. Caroms 3.30-5.00Pm B. Volley Ball 5.5. Comparison of Level of Self-Esteem Before And After Promoting Self-Esteem Activities: It was found in the assessment that the level of self-esteem was improved after promotion of self-esteem activities. Alcoholic dependants who scored the item very often (3) in the pretest were scored sometimes (2) or occasionally (1) after promotion of self-esteem activities. Patients were actively participated in self-esteem activities, before promoting self-esteem activities alcoholic dependants had the problems like becoming angry for criticism, poor interaction, inability to try new things, having difficulty looking people in the eye, difficulty making small talk, etc.But after promoting self-esteem activities alcoholic dependants showed an improvement in accepting criticism, trying new things, facing other peopleà ¢Ã¢â€š ¬Ã¢â€ž ¢s in the eye, good social interaction. CHAPTER VI SUMMARY AND CONCLUSION The present study was conducted in selected De-Addiction Centre, Coimbatore from 28.6.10-25.7.10.Alcoholic dependants were selected by sample free technique. The level of self-esteem was assessed by using self-esteem scale. alcoholalcohol induced psychiatric illness and dependants with high self-esteem were excluded. After initial assessment of self-esteem, self-esteem activities were promoted which include Individual and Group activities. Reassessment was done after a gap of fourteen days using the same scale to identify the enhancement in promotion of self-esteem of alcoholic dependants. The data collected during assessment and was revealed that the level of self-esteem had significantly improved after promotion of self-esteem activities. The demographic variables like age, hours of work, quantity of alcohol intake, and duration of intake of alcohol were analyzed by using Karl Pearsonà ¢Ã¢â€š ¬Ã¢â€ž ¢s co-efficient of co-relation to identify the influence of these variable s on the level of self-esteem and alcoholic dependants. The results indicated that there is a positive relationship between age hours, quantity, duration of alcohol intake and pretest self-esteem score of alcoholic dependants. The results also indicated for posttest. The significance of level of self-esteem on pretest and posttest level of alcoholic dependants were calculated using pairedà ¢Ã¢â€š ¬Ã¢â€ž ¢tà ¢Ã¢â€š ¬Ã¢â€ž ¢test.The results showed that after promoting self-esteem activities the alcoholic dependants had a significant improvement in level of self-esteem. 6.1. Major Findings of The Study: Majority of alcoholic dependants were in the age group of 20-65years. In pre assessment of level of self-esteem all 30 alcoholic dependants had low self-esteem. In post assessment of level of self-esteem, all 30 alcoholic dependants had improved their self-esteem. The mean pretest score .there is a increase in posttest mean score. The paired à ¢Ã¢â€š ¬Ã‹Å"tà ¢Ã¢â€š ¬Ã¢â€ž ¢test value of self-esteem is 9à ¢Ã¢â€š ¬Ã¢â€ž ¢tà ¢Ã¢â€š ¬Ã¢â€ž ¢= ) is greater than the table value at the degree of freedom 29 is significant at the level of 0.001. 6.2 Limitation of The Study: This study was limited only to alcoholic dependants This study was aimed only to promote self-esteem of alcoholic dependants The study was limited only to the De-addiction centre. 6.3 Suggestions For Further Study Similar study can be conducted for other psychoactive substance use disorders patients A similar study can be conducted with family members. A similar study can be conducted for alcoholic dependants on any psychiatric set up. A study can be conducted among friends of alcoholic dependants who regularly visit wine shops/bars/Arrack shops. A study can be conducted on childrenà ¢Ã¢â€š ¬Ã¢â€ž ¢s of alcoholics to identify the level of self-esteem. 6.4 Recommendations: A follow up study on promotion of self-esteem among alcoholic dependants after six months to one year can be carried out to explore in to the retaining impact of self-esteem. Mass media, Posters can be used to create awareness on alcohol treatment to public; this will be helpful in removing misconceptions regarding alcoholic patients. A similar study can be conducted to assess the self-esteem of the childrenà ¢Ã¢â€š ¬Ã¢â€ž ¢s of alcoholics and to promote self-esteem activities earlier. 6.5. Conclusion: The study highlights the practice of self-esteem activities are useful tools for Alcoholic dependants who are having low self-esteem. Thre is no medical treatment to treat low self-esteem, only we can promote self-esteem by involving them in self-esteem activities .Alcoholic dependants with low self-esteem need positive reinforcement to enhance self-esteem. Individual activities makes the individuals to complete the task by alone and improves the individual capablity. Group activities makes the group to work together to achieve the task and also it improves social interaction. The study review showed that promotion of self-esteem activities among alcoholic dependants was the most effective method for enhancement of self-esteem. The result can potentially be employed as non-pharmacologic adjuvant therapy in the management of alcoholic dependants with low self-esteem.

Wednesday, May 6, 2020

Personal Narrative An Amazing Toy Car - 944 Words

With every phone call after that day, I wished it was Vineet. On one such routine day, I ran towards the phone and to my satisfaction he was Vineet who said, â€Å"Thank you. That is an amazing car I ever had.† I was so happy that day since my efforts paid off, but there remained a feeling of guilt. Few weeks back, my friends decided to give a gift to Vineet since he was recovering from nephrotic syndrome and asked me for a contribution. I said, â€Å"I would rather buy skates for myself†. Later that week, we visited him and he was looking helpless and weak on his bed. But, on seeing us he was so surprised and delighted when he received the gift. He thanked everyone and said, â€Å"Thank you! That is an amazing toy-car†. I said with a feeling of guilt, â€Å"Sorry but I’ve made no contribution for your gift†. Intending to do something special for him and the fact that my friend’s family was moving to another city, I put my efforts in making a battery operated toy-car by myself. By the time toy-car was ready, my friend had left for the city. I had an easy option to ask my father to buy something for Vineet but instead I chose a harder way, because it was my mistake and only I could have fixed it. I then sent the toy-car via courier. Later he called me up and said those above words. But the guilt in me ever remained that I did not see him smile. The love for Internal Medicine comes from the lesson learnt in childhood that once the right time is gone it doesn’t come back. Out of all theShow MoreRelatedProduct Placement10682 Words   |  43 Pagescinemas earliest history. Before films were even narrative forms in the sense that they are recognised today, industrial concerns funded the making of what film scholar Tom Gunning has described as cinematic attractions[9] these were short films of no longer than one or two minutes. In the first decade or so of film history (1895-1907) audiences did not go to see films as narrative art forms but as fairground attractions interesting for the amazing visual effects they appeared to be. This formatRead MoreProduct Placement10670 Words   |  43 Pagescinemas earliest history. Before films were even narrative forms in the sense that they are recognised today, industrial concerns funded the making of what film scholar Tom Gunning has described as cinematic attractions[9] these wer e short films of no longer than one or two minutes. In the first decade or so of film history (1895-1907) audiences did not go to see films as narrative art forms but as fairground attractions interesting for the amazing visual effects they appeared to be. This formatRead More Robert Altmans Film Adaptation of Raymond Carvers Short Cuts4363 Words   |  18 Pagesbetween their actions and the ramifications of those actions. 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Tuesday, May 5, 2020

Compare and contrast the methods used by Robert Browning to portray the two speakers in ‘My Last Duchess’ and ‘Porphyria’s Lover’ free essay sample

Compare and contrast the methods used by Robert Browning to portray the two speakers in ‘My Last Duchess’ and ‘Porphyria’s Lover’ ‘My Last Duchess’ and ‘Porphyria’s Lover’ are both poems about men who appear to have a compulsive need for control over the women in their lives. However, the speakers appear to be quite different as we see that the protagonist in ‘My Last Duchess’ is a Duke with a high self-esteem and confidence, whereas the protagonist in ‘Porphyria’s Lover’ emerges as a depressed man with no apparent intuitions or social life. Browning uses different structural techniques in both poems to portray each character; there are contrasting rhyme schemes and meters to capture their complex mentality. The language and literary devices used to portray the speakers also differs with pathetic fallacy in ‘porphyria’s Lover’ and symbolism in ‘My Last Duchess’. The presentation of both these speakers in the form of a dramatic monologue enables Browning to aptly portray them, revealing as much regarding their personal life as possible. In ‘My Last Duchess’, the Duke is addressing an ambassador, whereas in ‘Porphyria’s Lover’, we are presented with the speaker’s thoughts. The fact that he isn’t addressing anybody in particular is already discomforting, warning the reader of his insanity. Browning uses rhyme and meter to present certain aspects of these two very different speakers. Rhyming couplets are used in ‘My Last Duchess’; ‘wall†¦call’ and ‘hands†¦stands’. This is initially unapparent due to the use of enjambment. This could imply that he’s unknowingly in control of everything, or that he’s attempting to come across as modest. The well organized rhyming scheme and iambic pentameter are there to show the Duke’s power he is exerting upon everyone, despite the fact that he denies having the skill of speech, ’which I have not’, giving the reader the impression that he is gloating, whereas the more unusual rhyming scheme in ‘Porphyria’s Lover’ jars on the reader’s senses and reflects on the protagonist’s mind and confusion. Social status also plays a large part in their personalities, as it makes the Duke feel more distinguished and self-righteous, and it makes Porphyria’s Lover feel like he is not important, as she is of a higher status than he is, which makes him seek her attention by trying to make her feel bad for him, as seen when he ignores her. The peculiar ABABB rhyming scheme in ‘Porphyria’s Lover’ unsettles the reader, who is not expecting the extra rhyme. Furthermore, the unbalanced rhyme scheme reflects on the speaker’s unbalanced mental state. The speaker in ‘My Last Duchess’, is less emotionally engaged as there is no empathy displayed. The Duke is jealous over the fact that she ‘thanked men’, as if she thought their gifts were better than his ‘nine-hundreds-years-old-name’. We can see that the protagonist has a dominant personality as he gives ‘commands’. Moreover, the iambic pentameter is used, which is similar to everyday speech as well as making him appear controlled, together with sounding cold and monotonous. On the other hand, in ‘Porphyria’s Lover’, the setting of the poem seems warmer and more welcoming as Porphyria arrives. Sexual tension is present, unlike in ‘My Last Duchess’, where everything is cold and distant. Nevertheless, the protagonist’s morbidity is portrayed later on through his quiet and ominous nature as he finds ‘a thing to do’, a subtle way of hinting at the fact that he is going to murder her, as well as threatening thoughts as he is in her arms, ‘that moment she was mine’. It is written in the iambic tetrameter, although the meter falls on the line ‘I listened with heart fit to break’, the first time that the speaker refers to himself, and also suggesting that his heart is breaking. We see that the vocabulary used is predominantly simple and monosyllabic due to his thoughts being focused on the events that have just occurred. We can also infer that due to his lack of complex vocabulary, he is of a lower social status. The word ‘stooping’ was chosen in particular by Browning to highlight that she is ‘stooping’ down to his level in society. We also saw this in ‘My Last Duchess’ when the Duke wouldn’t ‘stoop’ to endure his Duchess thanking men. Porphyria’s ‘pride and vainer ties’, and the Duchess’s lack of love for the Duke ensure that so long as they are living, they will not succumb to the power of the men. Ensuing the murders, the Duke and the speaker in ‘Porphyria’s Lover’ finally have total control over them. Porphyria’s lover trifles with the corpse as he ‘oped her lids’ and ‘propped her head up’, conveying the speaker as mentally deranged, even necrophyllic with their ‘kiss’. In addition to feeling content about being in control, he doesn’t feel guilty as God hasn’t objected to his crime: ‘And all night long we have not stirr’d, /And yet God has not said a word! ’ Much like the speaker in ‘Porphyria’s Lover’, subsequent to the murder of Duchess, we see he has finally been able to attain total control over her, in the form of a painting veiled by a ‘curtain’ which only he may draw. It becomes evident that the Duke is notably jealous of his wife interacting with other men; he expresses that it should be solely his ‘presence’ that ‘called’ her ‘smiles’ upon her face, which he depicts as a ‘spot of joy’. The juxtaposition of the two words, ‘spot of joy’, conveys the phrase as a stain, a symbol of her tainted nature. The repetition of this throughout ensures that the reader is aware, and the Duke is making sure the ambassador knows that this is part of what made her ‘smiles stop’. What further infuriated him was that ‘she liked whate’er? She looked on’, as opposed to focusing all her attention and gratitude on him. Porphyria is a woman with responsibilities elsewhere and the fact that she may be having an affair with the speaker is symbolised when she lets her ‘hair fall’, which is also a synecdoche for her entire being. This is because the word ‘fallen’ had negative connotations in Victorian times, as it was used when referring to women involved in sexual relationships before marriage. The metaphor of her eyes without a ‘stain’, can be interpreted in one of two ways. First, it could imply that by dying, the ‘stain’ of Porphyrias sin is gone. Alternatively, it could mean that theres no ‘stain’ of his sin visible in her eyes. After Porphyria’s death, we see the speaker feeling no remorse, as ‘God’ doesn’t speak a ‘word’. The motive for murder in both cases is due to a ‘stain’ or a ‘spot’, imperfections which the men must remove. Browning uses different ideas and linguistic techniques to portray the speakers. Symbolism is used in ‘My Last Duchess’ to communicate the Duke’s attitudes and feelings towards his wife; he feels as though he is ‘Neptune†¦ taming a seahorse’, which leads us to think that that is how he feels about his wife; a beautiful, fragile animal over which he should have complete control. He is overly proud of his accomplishment, yet the image of a god taming a sea-horse seems inhumane and strange to the reader as he is praising himself so highly, and degrading his previous wife by comparing her to an animal. Objectification of women is highlighted again through the ‘Duchess painted on the wall’ with a ‘curtain’ that can only be ‘drawn’ by the Duke, giving himself full control over her. His conceited nature is emphasized as ‘Fra Pandolf’s hands’ paint the picture rather than Fra Pandolf, portraying him as nothing but an object to complete his intentions. We see the extent of the Duke’s jealousy, as he feels aggravated by his wife blushing due to Fra Pandolf’s comments, which is unnecessary as he is a monk, which procures good behaviour. Both of these symbols are highly derogatory towards women, his Duchess in particular; in one of her representations, she is depicted as a helpless, lesser animal, and the other is her ‘painted on the wall’. We see how imperative the theme of authority and power over women is in this poem, as these two symbols open and close it. In ‘Porphyria’s Lover’, Browning uses pathetic fallacy to portray the speaker. The speaker’s state of mind is effectively conveyed as the ‘sullen wind’ awoke and ‘tore the elm-tops down’. When Porphyria arrived however, she ‘shut’ out the ‘storm’, implying she had expelled his mental torment. Porphyria and her lover’s relationship is an abnormal one, and the way in which Browning portrays the speaker as being emotionally void concerns the reader and makes him quite a disturbing character. In spite of this, Porphyria is the only comfort or felicity in his life, lighting his ‘cheerless grate’ up. To conclude, Robert Browning uses many different methods, both similar and different to portray the speakers in ‘My Last Duchess’ and ‘Porphyria’s Lover’. He has written two monologues portraying seemingly distinct speakers, with one recognizable characteristic in common, being that they both crave and lust for power and possession. Through the use of imagery, style, and pathetic fallacy, the characters are brought to life, allowing us to experience their complexities and insecurities, as well as establishing that despite their differences in terms of personalities and social status, they are both morally twisted and self-interested, as seen with their satisfaction after the murders.

Wednesday, April 15, 2020

Effects of Pollution in China Essay Example

Effects of Pollution in China Paper In the last two decades, the air pollution in China has increased substantially. The lack of good air quality is especially prominent in the more urban, industrialized areas of China. Environment Minister Chou Shenanigan warned, If China meant to quadruple the size of its economy over 20 years without more damage, it would have to become more efficient in resource use. Thinness, there would be a painful price to pay (BBC News). The topic of air pollution is not a new concern to the world; however, the effects of air pollution, especially to the hundred of thousands of people directly or indirectly harmed by the side effects of bad air, should be of grave concern. According to the Ministry of Health, air pollution has made cancer the leading cost of death in China. Air pollution not only affects the people, but also the quality of fresh water, produce, and other natural resources. These kinds of environmental outcomes may seem erratic in other countries but unfortunately, it has become the norm in China. We will write a custom essay sample on Effects of Pollution in China specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Effects of Pollution in China specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Effects of Pollution in China specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In fact, air pollution in China since the sasss has gotten so bad that many of the industrialized areas in Beijing and Shanghai rarely see the sun but rather clouds of smoke and fog. China, with its infamous reputation of becoming a global economic powerhouse, is ironically becoming its own downfall. In the midst of their tremendous economic and industrial growth, the energy outputs to support this growth are reaching an all-time high which means there is more residue of coal and fuel burning released in the atmosphere. In order to understand the extent of pollution in China, one must understand the environmental, social, and political aspects of it. Currently, China is the leading nation in terms of population. Even though China has approximately 1. 3 billion people living in its territory, the ungenerous effects that pollution has taken upon the population is still of high concern although many people and government officials choose to not talk about it in order to not cause more burden on the already stressed country. According to the Worlds Resource Institute, respiratory disease is the number one cause of death in China (Worlds Resources Institute). In some regions, especially the major industrial zones in Huber Province, rates of chronic lung disease are at least five times higher than the rest of the country. Even the women who do not smoke cigarettes and are living around those areas have the highest rates of lung cancer globally that pertains to the population of women who do not smoke (Worlds Resources Institute). It is estimated that annual premature deaths attributable to outdoor air pollution were likely to reach 380,000 in 2010 and 550,000 in 2020 (BBC News). With these potential outcomes that are doubling every decade, China will face even more problems if these environmental issues are not dealt with now. In addition to air population, there is also the concern Of water pollution which coincides with the big cycle of environmental distress. In addition, many people who live near concentrated areas of pollution do not know how to protect themselves well because they are unaware of the long term effects of inhaling the air and drinking the water. Nearly half of Chinas population consumes drinking water contaminated with animal and human waste and acidic rain and erosion. While there has been an overall decline in mortality from infectious diseases, diarrhea diseases and viral hepatitis, both associated with fecal pollution of water, are the leading infectious diseases in China (Worlds Resources Institute). Because f contaminated, polluted water, China has the highest liver and stomach cancer deaths in the world. While the government is preoccupied with wanting to censor all this preventable chaos, many more people are becoming ill and dying from the lack of clean resources. Water pollution has become an intricate part of the problem as well. Many of the main rivers flowing through China have been the target for dumpiest for years. Because of its mass and distance, many people do not think ;ice when they dump their small amount of trash or waste inside the water; however, if twenty housing other people are having the same exact justification, then it now becomes an environmental safety hazard as well as a social problem. As a result, it is estimated that three-quarters of the rivers running through Chinese cities are so polluted that they cannot be used for drinking or fishing. Even the infamous Yellow River is suffering from man-made environmental problems. Once the countrys second biggest source of fresh water, the river is now so polluted that almost 70% is hazardous to drink; moreover, because the river has been the target for over-exploitation for many years, the water ends to dry up before it reaches the sea for almost a third of the year. According to the World Health Organization, reports estimate that diseases triggered by indoor and outdoor air pollution kill 656,000 Chinese citizens each year and polluted drinking water kills another 95,600 (Plant). The majority of the air pollution in China is generated by the burning of coal and fuel oil in order to generate electric power. They do not have that much hydrophone, power that comes from the energy of massive moving water, to help with demand and supply and, therefore, rely on the burning of coal. Coal s a natural resource that is abundant in amount but requires a lot of manpower and miners to obtain it every year. Because of its population and carrying capacity, China burns more coal to produce electricity than the U. S. , Europe and Japan combined. Air pollution and acid rain, which comes from the coal residue evaporating in the form of smoke into the atmosphere, is killing people. In addition to chemical and industrial factories producing all this dirtiness into the air, vehicles of transportation also add to this pollution epidemic. In the 1 sass, the number of vehicles on roads increased very vapidly, especially in medium-sized and large cities. In Beijing, the number of vehicles increased by a factor of 4, from 0. 5 million in 1990 to 2 million in 2002. In addition, the emission factor, the amount of pollution emitted by one car, in China is much higher than in developed countries because China has much lower emissions standards for automobiles (The Chinese Academy). Thus, the drastic rise in the number of vehicles and rapid development of industries in cities has led to worsening air quality, particularly higher concentrations of nitrogen oxides. The burning of poor quality fuel only adds o urban air pollution. Considering the amounts of traffic that the more urban, centralized cities deal with on a constant basis, the amount of fuel being burned into the atmosphere is reaching tremendous heights. Over the years, the government had implemented their own ways of dealing with the pollution problem as well as progressing social development. Embarrassed by the repercussions of industrialization and arbitration, Chinas environmental agency insisted that the health statistics be removed from the published version of media reports because the government did not wish to cause social instability. According to Spiegel Online International, in 2007 the Chinese government put pressure On the World Bank to take potentially damaging statistics out of a report on pollution in China (Spiegel Online International). Reportedly, the World Bank reluctantly agreed to the demand of the Chinese government and this report about pollution was never published. Many people did not believe the Chinese government undergone such secretive endeavors to protect them but rather it was just the Communists instinctive response to every case of bad news to cover it as much as possible. The Chinese government often has had a hard time irritating pressing issues at hand and, therefore, chooses to suppress it until the issue starts developing more and then reaches the attention of foreign countries. This kind of pattern has affected the Chinese government for many years now because of its lack of aggression towards personal, current issues. In terms of the environmental issues, Chinas model of pollution compared to that of the United States and Europe is worse because the density of its population is greater and people do not know how to protect themselves properly from the essential tools of life, water and air. Because of Chinas reputation as being one of the leading nations in fast economic growth, the government places economic growth before any other problem the nation might have. Some may say, the country is addicted to fast growth and instances of progression. Having a strong, solid economy would place China on the map as a great superpower and can very well earn them the respect and recognition from every other nation. If China starts to slow down their industrial development and economic growth at all, the effects would be social instability, the potential to lose foreign business and trading ratters, and takes away Chinas hard-earned reputation. Slowing down production to solve such insignificant problems may be a stretch for the Chinese government; however, the threat of pollution is very much real and staggering which in the long run, would affect the economy in a negative way. With the amount of health-related issues due to the environment, health care costs have climbed sharply. The lack of clean water has affected the farming and crop industry tremendously. The amounts of high energy- dependent industries create greater need for imported coal and fuel; therefore, the environmental problems gradually get harder and more expensive to address the longer they remain unresolved. According to National Geographic, the rate in which this pollution is harming women and children would have a great effect on the next generation of Chinas leaders, especially with the many recorded incidents of birth defects and brain damage that pregnant women are inhaling everyday of their lives. The pollution in China is not just a current problem but an issue that can surely affect the future of China extensively. In recent years, the Chinese government have been striving to address these environmental issues and making reforms to reverse Some of the effects. The government has set goals in order to reduce the emission of fuel and to conserve energy by reducing the level of energy that industries use as well as slowing down the demand for coals. Taking ideas from the United States, China has set to develop alternative methods of energy such as solar power. Yet most of the governments targets for energy efficiency, as well as improving air and water quality, have not been reached. Although there are many targets and goals set forth by the government to fix this pollution problem, no real concrete actions has taken effect. Chinas lack of monumental changes towards conservation and energy-efficient ways has resulted in no real progression. China refused to invest a lot of money and tax reforms to reach their supposed targeted goals. Even many bureaucratic leaders and city officials often do not invest their money and efforts into closing down factories and industries because that would hurt their local economies. In a way, the government reflects a dog-eat-dog world where everyone chooses to look out for themselves in order to prosper the most. In attempts to stick to their original goals, China began to explore the idea of the Green G. D. P in the mid sasss. The Green G. D. P was an effort to create an environmental yardstick for evaluating the performance of every official in China It recalculated gross domestic product, or G. D. P. , to reflect the cost of pollution (BBC News). In other words, this was a way to calculate the financial loss that pollution has had on the economy and for the government to adjust their expenditures in such a way to reflect a better G. D. P. However, the calculations for some provinces in China reach staggering amounts that was unrealistic for the Chinese government to adjust because if they did, their Roth rate for certain areas would be zero which means the overall economy would decline. Because of the failing numbers of the Green G. D. P for Chinas economy, the government pulled out of the project in 2007. The failed success of Green GAP for the Chinese government pushed the progression of environmental friendliness preservation back because of the financial and economic issues that arose from partaking in the Green G. D. P (New York Times). One such issue that China struggles with is realizing that any attempt or unrealistic goal set forth to fix the environment problem will always be met with many obstacles and resistance. Such unfortunate issues are part of the reason why China is reluctant in fixing their environmental problems and plays a role in the still on-going pollution issue today. In 201 1 , Toyota Motor announced that they will be making low-emission cars in China. Because China has the biggest market for cars, Toyota Motor wanted to get into that market in an environmentally friendly way. Along with having the biggest market for cars, China also has the biggest market for pollution. China was keen on welcoming the foreign aid of car expenditures to their market because Of its emphasis on producing low-emission Cars in the entry. As China attempts to work towards its pollution problems after many failed efforts, the people foresee this as a positive business venture on both the Japanese and Chinese because it benefits both sides. Japan would create a bigger market for themselves in East Asia and China will be on the road of becoming more green and energy-efficient, a problem that they have been facing for decades. All and all, it is safe to say that China as well as every other country around the world recognizes that the amount of pollution has increased tremendously. China has played a huge part in the matter because of its sieve industrialization and arbitration that attributes to their fast economic growth. Although there are many Chinese officials and leaders out there who fail to see the correlation between air pollution and long-term health and social effects, the growth of air pollution is not going away. Although there are very few studies attributing the socio-economic class, population size, and demographics to the growth of air pollution, the presence of air pollution affects everybody. There is, indeed, a major correlation between air pollution and increased mortality; therefore, China trivet to undergo many environmental-friendly programs. In short, there is sufficient evidence that exposure to outdoor air pollution is a health hazard in China. The importance oftenest increased health risks is greater than in developed countries because air pollution in China is at much higher levels and because the Chinese population accounts for more than one-fourth of the worlds total population. Future research will need to clarify the lifetime course of air pollution effects, examine the relevance of long-term exposures, understand alternative methods, and finding correlations between air elution and health hazards for the Chinese population.