|Year : 2019 | Volume
| Issue : 3 | Page : 188-192
A Comparative study of half-orphan and double-orphan adolescents to explore the psychological well-being in orphanage of district Srinagar, Kashmir
Tabasum Dilawar Malla1, Ifshana Iliyas Rather1, Nusrat Yousuf2
1 Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
2 Department of Anesthesia, Sher I Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
|Date of Submission||14-Nov-2018|
|Date of Decision||19-Feb-2019|
|Date of Acceptance||26-Apr-2019|
|Date of Web Publication||30-Sep-2019|
Tabasum Dilawar Malla
Kathi-Maidan, Alamgari-Bazar, Srinagar, Jammu and Kashmir
Source of Support: None, Conflict of Interest: None
Introduction: The impact of orphanhood on the mental health of adolescents is an inevitable phenomenon. This impact is raised when an adolescent loses both of his/her parents. Hence, the present study was aimed to compare the level of psychological well-being (PWB) and its dimensions (autonomy, environmental mastery, positive relations with others, purpose in life, personal growth, and self-acceptance) between half-orphans and double-orphans. Materials and Methods: The present study was conducted from June 2015 to June 2016 in selected orphanages of district Srinagar, Kashmir. The sample size consists of 115 adolescent orphans, and among those, 70 (61%) were half-orphans and 45 (39%) were double-orphans. Level of PWB was assessed using standardized scale – Ryff's PWB scale. t-test was used to compare the PWB and its dimensions between half-orphans and double-orphans. Results: Using t-test, it was found that there is significant difference between half-orphans and double-orphans only in case of positive relations with others (t = 2.034,P < 0.05) and self-acceptance (t = 2.325,P < 0.05) dimensions of PWB, while there is insignificant difference of autonomy (t = 0.126), environmental mastery (t = 1.013), personal growth (t = 0.377), purpose in life (t = 0.355) dimensions of PWB, and overall PWB (t = 1.788). Conclusion: Mean difference was found between half-orphans and double-orphans in every dimension while there was statistically significant difference between the two groups in only two dimensions (positive relationship with others and self-acceptance dimension of PWB) where half-orphans dominate. It is therefore recommended that the orphanages may have to consider the possibility of recruiting qualified counselors, psychiatric nurses, or child psychologists.
Keywords: Double-orphan, half-orphan, orphanage, psychological well-being
|How to cite this article:|
Malla TD, Rather II, Yousuf N. A Comparative study of half-orphan and double-orphan adolescents to explore the psychological well-being in orphanage of district Srinagar, Kashmir. Indian J Soc Psychiatry 2019;35:188-92
|How to cite this URL:|
Malla TD, Rather II, Yousuf N. A Comparative study of half-orphan and double-orphan adolescents to explore the psychological well-being in orphanage of district Srinagar, Kashmir. Indian J Soc Psychiatry [serial online] 2019 [cited 2019 Oct 13];35:188-92. Available from: http://www.indjsp.org/text.asp?2019/35/3/188/268347
| Introduction|| |
Globally, an orphan is defined by international organizations based on age and parental status. The UNICEF, UNAIDS, and USAID joint report on orphan estimates and program strategies, children on the brink, defines an orphan as a child aged 0–17 years whose mother (maternal orphans) or father (paternal orphans) or both (double orphans) are dead.
The UNICEF and global partners define an orphan as a child who has lost one or both parents. By this definition, there were over 132 million orphans in Sub-Saharan Africa, Asia, Latin America, and the Caribbean in 2005. Of the more than 132 million children classified as orphans, only 13 million have lost both parents. The UNICEF and numerous international organizations adopted the broader definition of an orphan in the mid-1990s as the AIDS pandemic began leading to the death of millions of parents worldwide, leaving an ever-increasing number of children growing up without one or more parents. Hence, the terminology of a “single-orphan and half-orphan” – the loss of one parent – and a “double-orphan” – the loss of both parents – was born to convey this growing crisis.
A new study by an international charity for orphaned and abandoned children found that India is home to 20 million orphans, a figure projected to increase by 2021.
Orphans frequently lack sufficient food, shelter, schooling, and medical care and are at risk of abuse and economic exploitation (Afework T, 2013). Most research work on orphan concentrates on basic need. There is little available research, but increasing concern, regarding the psychological well-being (PWB) of orphans in Kashmir.
An estimate by a UK based charity “Save the Children;” Kashmir valley has 215,000 orphans out of which >37% have lost one or both parents to the prevailing conflict. More than 15% of these children live in orphanages. A report available on the website of Save the Children organization reveals that 37% of the orphans lost one or both parents due to the conflicts while 55% were orphaned due to the natural death of parents and remaining 8% due to other reasons.
Consequences/effects of orphanhood
- Loss of affection and nurturing
- Inadequate hygiene
- Loss of guidance and discipline
- Risk of prostitution and other risky behavior
- Loss of regular primary health care
- Increased economic distress
- Child labor
- School dropout 
- Inhibited physical development 
- Increased susceptibility to psychological risks and emotional problems 
- Inhibited social development and connectivity.
The literature on PWB has progressed rapidly since the emergence of the field over five decades ago. PWB refers to how people evaluate their lives. As summarized by Huppert (2009, P. 137) “PWB is about lives going well. It is the combination of feeling good and functioning effectively.” By definition, therefore, people with high PWB report feeling happy, capable, well supported, satisfied with life, and so on.
Carol Ryff has worked on the study of PWB. When she thought of well-being, she thought about it more in terms of optimal psychological functioning rather than happiness. She has identified six broad facets associated with optimal psychological functioning as follows:
- Autonomy: This means being self-determining, independent, and regulating behavior internally; resisting social pressures to think and act in certain ways; evaluating oneself by personal standards 
- Environmental mastery: This means feeling competent and able to manage a complex environment; choosing or creating personally suitable contexts 
- Sense of personal growth: This means having feelings of continued development and being open to new experiences 
- Positive relations with others: This means having warm, satisfying, trusting relationships. It also means being concerned about other welfare and being capable of strong empathy, affection, and intimacy; understanding give-and-take of human relationships 
- Purpose in life: This means having goals and a sense of direction in life. It means feeling that both the present and past experiences are meaningful; holding beliefs that give a purpose to life 
- Self-acceptance: This means having a positive attitude toward yourself; acknowledging and accepting multiple aspects of self; feeling positive about one's past life.
In 1988, a study of preschool children admitted to New Orleans Hospitals as psychiatric patients over 34 months found that nearly 80% came from fatherless homes, according to Photius.com. One more study done by Jyotika and Tankha  found that male students of science faculty were significantly higher on four factors of PWB namely environmental mastery, positive relations with others, purpose in life, and self-acceptance than the commerce students. There was no significant difference found on other two factors of PWB using Ryff's PWB scale. Female gender, suspected HIV infection, experiences of potentially traumatic events, including the loss of both parents, urban residence, eating fewer than three meals per day, and low caregiver involvement have been found to be associated with poorer child health outcomes as per Thielman et al.
As per the study conducted by Zhou in 2012, the mean of the “child bereavement” scores of double orphans was found significantly higher than that of paternal orphans.
There is little available research, but increasing concern, regarding the PWB of orphans in Kashmir.
Unfortunately, in Kashmir, mental health is a neglected area as it is in most of India. The need for psychological health and psychiatry is yet to be recognized, and consequently, a very small percentage of the orphans have received any sort of counseling and treatment.
Based on the above descriptions, the researcher felt the need to address the special needs of this vulnerable group. Hence, the present study was undertaken to find out the extent of well-being of the orphans.
| Materials and Methods|| |
The present study was carried out at Madre-E-Meharban Institute of Nursing Sciences and Research, SKIMS, Soura, conducted from June 2015 to June 2016 in selected orphanages of district Srinagar, Kashmir. This research was initiated following approval by the Institutional Ethical Committee and Board of Research Studies of Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar. Permission was taken from the Chairman of Raahat Manzil, Jammu and Kashmir Yateem Trust, and Al-Noor Yateem Trust, and consent was taken from adolescent orphans before data collection. Setting was selected for the study on the basis of feasibility of conducting the study and availability of the required sample. These areas were selected based on the fact that there is large number of orphan children in these areas.
The study is descriptive in its nature since it attempts to assess the level of PWB in orphans, which involves comparative survey since it compares the status of PWB of half-orphans and double-orphans.
In the present study, the population consists of all the adolescent orphans falling in the age range of 12–18 years and residing in orphanage of Srinagar district during the period of data collection.
The sample size consists of 115 adolescent orphans from the selected orphanages of Srinagar district.
Stratified proportionate simple random sampling technique is used. The population of selected orphanages was divided into five strata (7th, 8th, 9th, 10th, and 11th class). The students were selected from each of these strata by simple random sampling with the lottery method.
All the cases were assessed for sociodemographic variables such as gender, habitat, educational qualification, type of orphan, and time spent in orphanage. To assess the PWB of the respondents, the researcher employed the Ryff's PWB scale  – a self-report inventory, in English and Urdu language.
The scale consists of a series of statements reflecting the six areas of PWB: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Subscale consists of 9, 9, 6, 9, 6, and 7 items, respectively. Respondents rate statements on a scale of 1–6, with 1 indicating strong disagreement and 6 indicating strong agreement.
Individual indicated their response on 6-point liker-type scale, which higher scores on each scale indicating greater wellbeing on each dimension. The number of responses made by the subject on each question depends on whether the question is positive or negative. If it is a positive question, responses are rated from 1 to 6, where a score of 6 indicates strong agreement. If it is a negative question scoring done is in reverse order which is from 6 to 1, where 6 indicated strong disagreement. For each category, a high score indicates that a respondent has a mastery of that area in his/her life. Conversely, a low score shows that the respondent struggles to feel comfortable with that particular concept.
Data were organized in Microsoft Excel Sheet and was analyzed using SPSS version 20.0 and SYSTAT-13. Frequency and percentage distribution were used to describe the demographic variables. Quartile deviation was used to assess the level of PWB and its dimensions in adolescent orphans. Chi-square test was used to analyze the association of PWB and its dimensions with selected demographic variables. t-test was used to compare the PWB and its dimensions between half-orphans and double-orphans.
| Observations|| |
[Table 1] represents the distribution of study subjects according to their sociodemographic variables. The data obtained are described in terms of gender, habitat, educational status, type of orphan, and time spent in orphanage.
|Table 1: Frequency and percentage distribution of subjects according to demographic variables|
Click here to view
[Table 2] represents that “t” value of 2.034 (P < 0.05) and higher mean on positive relations with others suggests better PWB of half-orphan than double-orphan adolescents. As regards self-acceptance, “t” value 2.325 (P < 0.05) and higher mean score of half-orphan adolescents indicates greater PWB than double-orphan adolescents. The mean scores on other four variables namely autonomy, environmental mastery, personal growth, and purpose in life as well as overall PWB of half-orphans indicate better PWB than double-orphan adolescents although the difference was statistically insignificant.
|Table 2: Independent sample t-test for assessing the level of psychological well-being according to dimensions between half-orphans and double-orphans|
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Independent-sample t-test for assessing the level of PWB according to the dimensions between half-orphans and double-orphans.
| Discussion|| |
In Kashmir, there is growing concern about the consequences of the epidemic for orphaned children and adolescents. According to a 2014 study conducted by Save the Children, a London-based charity organization, the estimated population of orphans in Jammu and Kashmir due to conflict and natural death of parents is around 215,000, 15% of whom live in orphanage homes across the territory.
In a humanistic expansion formula, society is the preponderant parameter that germinates human values, beliefs, and their acceptance. The stakeholders of humankind are the pillars upon which society thrive its existence and children are the base in this construction. Further, in an attempt to reduce a just and equitable future, one has to start with its base. That, in fact, reflects the role of children in the futurity of society, state, and its development. Children are like dividends that are returns to its stakeholders in the future. It is an investment in building the edifice of humanity. If not properly invested and taken care, they, perhaps, will give bad results and losses.,
Our study results reveal that two-third of the adolescents were half-orphans, nearly four-fifth of them were males, almost three-fourth of the adolescent orphans were from rural area, about one-third of them were belonging to the 8th-standard. Furthermore, the maximum of respondents had spent more than 6 months in orphanage.
In our study, it was found that there is significant difference between half-orphans and double-orphans only in case of positive relations with others (t = 2.034, P < 0.05) and self-acceptance (t = 2.325, P < 0.05) dimension of PWB, while as there is insignificant difference of autonomy (t = 0.126), environmental mastery (t = 1.013), personal growth (t = 0.377), purpose in life (t = 0.355) dimension of PWB, and overall PWB (t = 1.788). The results are consistent with the studies carried out at Kashmir by Khan and Jahan  on 80 adolescents where nonorphans scored higher on PWB than orphan adolescents. Certain dimensions of PWB namely personal growth, positive relations, purpose in life, and self-acceptance also differ significantly in orphans and nonorphans. The study was also in conformity with the findings of a study conducted by Tsige  where the results revealed that institutional orphan children are relatively not psychologically well compared to the noninstitutional children.
The sample size is limited to 115 adolescent orphans of selected orphanage in Srinagar which limits the generalization of research findings. The sample size difference between comparable group is wide (half-orphans: double-orphans = 70:45).
| Conclusion|| |
In view of difference between the comparable groups, the orphans need to be treated and taken care of accordingly. Qualified counselors and trained psychiatric nurses need to be posted in the orphanages for the overall well-being of orphans.
We would like to thank Dr. Shabir Ahmad Dar, Senior Resident, for his continuous support and valuable suggestions.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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