To,

The Registrar
KUHS, Thrissur

Sub- Submission of the Title of the Synopsis of Dissertation

Respected Sir/Madam
I,RAJI R(name as in the admission register ) registered for M.Sc. NURSING, MEDICAL
SURGICAL NURSING (course & subject) in the year 2017-2019 (year) batch under the
guidance of MRS. RINCY RACHEL MATHEW, ASST.PROFESSOR, MEDICAL
SURGICAL NURSING, ST. GREGORIOS COLLEGE OF NURSING, PARUMALA (Name
of the Guide with Post, Dept & College).
I am due to appear forMSc. NURSING, MEDICAL SURGICAL NURSING (course with
subject) in 2018 SEPTEMBER (Year and Month). I am submitting the Title of the Synopsis of
Dissertation as mentioned below & as suggested by my aforesaid Guide.

Title of Synopsis of Dissertation :

Effect of topical application of licorice oil for joint pain among the inmates of old age homes
in Kollam district.
Certificate :
Certified that the Institutional ethics committee met on 23.06.2018, approved the proposal of
the dissertation as per letter no …SGCON/EC/2018/03 Dated…23 .06.2018

Kindly accept and register my Title of Synopsis of Dissertation

…………………………………………………………………
(Candidate name and signature)
…………………………………………..
………………………………………………………..
(Guide name and Signature) (HOD Name and Signature with Seal)

………………………………………………..
(Signature & Seal of the Principal)
PROFORMA FOR SUBMISSION OF MSC NURSING DISSERTATION
PROPOSALSYNOPSIS

Name & Address of student Raji R

1st year M.Sc. Nursing
St. Gregorios College Of Nursing, Parumala
P.O, Pathanamthitta (Dist.)
Email ID of the Student rajibasil2017@gmail.com
Name & Address of recognized St. Gregorios College Of Nursing, Parumala
Institution P.O, Pathanamthitta (Dist.) pin- 689626
Title of the Dissertation Effect of topical application of licorice oil for
joint pain among the inmates of old age homes
in Kollam district.
Name of the Guide Mrs. Rincy Rachel Mathew
Address, Phone number and Email ID Asst. Professor
of the Guide St. Gregorios College Of Nursing, Parumala
P.O, Pathanamthitta (Dist.)
9539796075, ril.rin@gmail.com
Educational qualification of the guide M.Sc Nursing, Medical Surgical Nursing
Experience of teacher in guiding 6 years
postgraduate student (in years)
Experience of teacher in guiding Nil
M.Phil/Ph.D students if any (in years)
Synopsis of the study attached Yes

Date :
Signature of the guide :
Enclosures :

 Bio data of the guide

 Synopsis of the student
Name of the college St. Gregorios College Of Nursing, Parumala
P.O
Pathanamthitta (Dist.) pin- 689626
Department Medical Surgical Nursing

Name of the Guide and College Name Mrs. Rincy Rachel Mathew, St. Gregorios
College Of Nursing
Contact Mobile No. of the Guide 9539796075, ril.rin@gmail.com
Name of the PG course with subject MSc Nursing, Medical Surgical Nursing

PROPOSAL OUTLINE

TITLE OF THE STUDY:

Effect of topical application of licorice oil for joint pain and its influence on activities of daily
living among the inmates of selected old age homes at Kollam district.

INTRODUCTION
The art of life is the art of avoiding pain.
- William Hazlin
Life expectancy has increased significantly in the last few decades. For this good news, If people
live long enough, they are more likely to develop multiple long-term conditions, a degree of
disability, dementia or the risk of chronic and life-limiting pain from a variety of causes.As the
number of individuals older than 65 years continues to rise, fragility and chronic diseases
associated with pain will likely to increase. Joint pain is a common musculoskeletal disease
affecting 80% of people at some point in their lives. The three most common sites of pain in
elderly are the back, leg/knee or hip and other joints.
The elderly are often either untreated or undertreated for pain.Good pain management is essential
to support and maintain independent living. People rely on certain drugs for pain relief, which has
side effects if used continuously. As people get older; body cannot respond to medications due to
the reduced metabolism.Many older adults have turned to complementary and alternative medicine
(CAM) therapies for treating their conditions. It is generally more natural and safer than
conventional medicine and also provides a greater relief of symptoms.
The most commonly preferred natural remedy for joint pain includes the use of essential oils,
applying heat or warmth and dietary modifications. Moreover, many herbal medicines are
practiced in modern medicine. One such herbal medicine which is effective in reducing joint pain
includesGlycyrrhiza Glabra Linn (Family fabacea) commonly known as licorice, sweet wood,
mulethi and yastimadhu. It is an easily and cheaply available herb found in Asia with less side
effects. Clinical and experimental studies suggest that it has several other useful pharmacological
properties such as analgesic, anti-inflammatory, antimicrobial, antispasmodic, immunomodulatory
and wound healing properties.

NEED AND SIGNIFICANCE OF THE STUDY

Non–steroidal anti-inflammatory drugs (NSAIDS) are the most common form of analgesics in the
world. Even though, NSAIDS show efficiency in reducing pain and inflammation, they have
unwanted side effects. Specifically in the elderly, NSAIDS have become a leading cause of
hospitalization and may increase the risk of death from ulceration more than 4 fold. Apart from
this, there is an increased risk of reinfarction, renal dysfunction, atrial fibrillation, stroke and
cardiovascular disease.
Therefore, it is necessary to identify a natural remedy for suppressing joint pain with less or little
side effects. The application of complementary and alternative therapies has been rapidly
increasing in the conventional practice of medicine as it is a branch of health care system. Licorice
is said to be one of the most extensively researched complementary medicine and it has a lengthy
list of versatile uses.
A double blind study was conducted to assess the healing effect of licorice on helicobacter pylori
infected peptic ulcers among 40 patients in the Gastroenterohepatology Research Centre of Shiraz
University of Medical Sciences in Iran, 2013. Group A received bismuth sub nitrate and group B
received licorice. The study results revealed that 70% of reduction in pain was observed in group
B and 80% of reduction for group A. Even though there is 10% variation when compared to group
A and group B, bismuth sub nitrate has certain side effects while licorice have little side effects.
A review article published in Ayur Times states that licorice has antispasmodic and muscle
relaxant characteristics. It reduces muscle cramps and tenderness in patients with fibromyalgia. It
is also indicated for arthritis, bursitis and gout.
From the light of above mentioned facts, the natural intervention such as licorice is one of the most
suitable remedy for relieving pain. Natural therapeutic agents have little side effects when
compared to NSAIDS. Moreover the researchers own experience and observation of reduction in
pain in the joints after the topical application of licorice oil has inspired to conduct a study to
assess the effectiveness of licorice oil for joint pain among the inmates of old age home.
PURPOSE:
To assess the effect of licorice oil on joint pain among the inmates of an old age home in order to
relieve the joint pain by using a natural remedy with less side effect.
STATEMENT OF THE PROBLEM
A study to assess the effectiveness of topical application of licorice oil for joint pain and its
influence on activities of daily living among the inmates of selected old age homes in Kollam
district.
OBJECTIVES
1. To assess the level of joint pain among the experimental and control group.
2. To assess the activities of daily living related to joint pain among the experimental and
control group.
3. To assess the effect of licorice oil on joint pain among the experimental group.
4. To compare the level of joint pain among the experimental and control group after the
intervention.
5. To compare the activities of daily living related to joint pain among the experimental
and control group
 OPERATIONAL DEFINITIONS
EFFECTIVENESS: It refers to the reduction of pain after 1 hour of licorice oil application in
terms of change in numeric pain rating scale and improvement in the activities of daily living as
assessed by the modified womac knee osteoarthritis index.
LICORICE OIL:It refers to the oil prepared by adding 200gms of crushed licorice root to 1 litre of
coconut oil which is boiled until it becomes light brown in color.
TOPICAL APPLICATION OF LICORICE OIL:It refers to applying 5ml of licorice oil topically
with finger pads over the painful knee joint once in a day which should be kept for the duration of
one hour.
JOINT PAIN:It refers to the level of pain in the knee joint between the score of 4 to 10 as reported
by the samples on a numeric pain rating scale.
CONCEPTUAL FRAMEWORK
Conceptual framework adopted for the present study is based on Katharine Kolcaba Theory
HYPOTHESIS
H1: The level of pain score after the topical application of licorice oil among the experimental
group will be significantly lower than that of control group.
H2: The activities of daily living related to joint pain after the topical application of licorice oil
among the experimental group will be significantly improved than that of control group.

RESEARCH METHODOLOGY
 Research Approach: quantitative approach
 Research design: quasi experimental research design
 Setting of the study: The study will be conducted in Jubilee Mandiram and
Snehasadanam in Kollam district.
 Population:Inmates of old age homes with joint pain.
 Target population:Inmates of old age homes with joint pain in Kollam district.
 Accessible population:Inmates of the selected old age homes with joint pain in Kollam
district.
 Sample:Inmates of the selected old age homes with joint pain in Kollam district who meets
the inclusion and exclusion criteria.
 Sample size:The sample size will be 60
 Sampling technique:Purposive sampling technique will be used for this study.
SAMPLING CRITERIA:
 Inclusion criteria:All inmates of the selected old age homes with moderate to severe knee
pain.
 Exclusion criteria:
 Those who are not willing to participate.
 Those individuals who are not able to verbalize their pain score: unconscious,
altered sensorium, differently abled.
 Those with swelling, open wounds and fractures.
VARIABLES:
 Dependent variable: joint pain
 Independent variable: licorice oil
DEVELOPMENT AND DESCRIPTION OF TOOL
Section A: Questionnaire on sociodemographic data
Section B:Tool to assess the level of joint pain by numeric pain rating scale
Section C:Questionnaire on activities of daily living related to joint pain
PILOT STUDY:Plan to conduct pilot study in 6 inmates of an old age home in Kollam district.
PLAN FOR DATA ANALYSIS
Data collected on the basis of Pain Scale Scores will be recorded and analyzed through the
following Statistical techniques:
Descriptive Statistics
 Mean and Standard Deviation used to assess the level of Joint Pain among the inmates.
Inferential Statistics
 Statistical paired t Test - is used to compare pre & post joint pain scores for statistical
analysis.
PLAN FOR DATA COLLECTION
 Permission will be taken from the authorities of selected old age homes.
 Informed consent will be taken from the participants
 Level of pain will be assessed before the intervention for both experimental and control
group.
  Activities of daily living related to joint pain will be assessed before the intervention for
both experimental and control group.
 5ml of licorice oil will be applied once in a day on the painful knee joint for the
experimental group.
 Placebo will be applied to the control group. (Placebowill beprepared by adding 1gm of tea
leaves to 1litre of coconut oil.)
 Level of pain will be assessed 1hr after the intervention for both experimental and control
group for 4 days.
 Activities of daily living related to joint pain will be assessed after 4 days of intervention
for both experimental and control group.
WORKPLAN:Appendix A
BUDGET:The budget for the overall study will be met by the investigator.
ETHICAL CONSIDERATION:Ethical clearance was obtained from the institutional ethical
committee.
REFERENCES
1. Dr. Aza Abdulla, Professor Nicola Adams. Guidance on the management of pain in older
people. Age and ageing: 2013(42);1-57
2. Damayanti Datta. Pain epidemic. India Today: October 2015
3. Stephen J Gibson, David Lussier. Prevalence and relevance of pain in older persons. Pain
medicine: 2012(13); 23-26
4. A review on Glycyrrhiza Glabra and its pharmacological activities. International journal of
pharmaceuticals and drug analysis: 2016(4)
5. Anyssa Garza. The increasing effects on health care. The aging population:2016
6. Supakanya wongrakpanich, Amarapon wongrakpanich. A comprehensive review of non-
steroidal anti-inflammatory drug use in elderly. Aging and disease:2018(1);143-150
7. Dr.Jagdev singh. 26 amazing benefits and uses of mulethi. Evidence based information on
mulethi:2015
WORK PLAN

APPENDIX A

JA FEB MAR APRI MA JUN JUL AU SEP OC NO DE JA FE MA APRI MA JUN

N L Y E Y G T T V C N B R L Y E
Review of
literature
Problem
Selection
Problem ....
Presentation
.
Proposal
presentation
Ethical
clearance
Synopsis
submission
Tool
preparation
Tool
validation
Pilot
Study
Data
collection
Data
analysis
Data
interpretatio
n
Chapter
presentation
Final
submission
Appendix B
Informed Consent

I--------------- (participant’s name) is ready to take part in the research study conducted by
Mrs. Raji R, 2nd year M.Sc. Nursing student of St. Gregorios College of Nursing, Parumala on the
topic “to assess the effectiveness of topical application of licorice oil for joint pain among the
inmates of selected old age homes in Kollam district”.
As part of the research, I am aware that a series of questions are asked through a
questionnaire and numeric pain rating scale, which I should answer depending on best choice
provided. I can quit from the study any time and it will not affect me in any personal affairs.
It is also assured that all the details collected for the study will be confidential and will be
used only for this study purpose.
In the context of any doubts related to the study, the person whom to contact and
responsible will beRaji R, the researcher of the study.

Date: Signature of the sample

Place: Signature of the researcher

 APPENDIX C
TOOL TO ASSESS THE EFFECT OF LICORICE OIL FOR JOINT PAIN
INSTRUCTIONS
Read the following questions carefully and put tick mark on the correct responses.
SECTION A
QUESTIONAIRRE ON SOCIODEMOGRAPHIC DATA
Sample number: …………. Date: …………..
1. Gender
a. Male b. Female c. Transgender
2. Age in years
a. 60-65 b.66-70 c.71-75 d.≥75
3. A. Do you have any history of chronic diseases?
a. Yes b.No
B. If yes, specify …………
4. How long have you been suffering from joint pain……………
5. How long does the pain persists ……………..
6. What does your pain feel like?
a. Burning b. Stabbing c. Gnawing d. shooting e. Lancinating
7. A. Are you on any oral medications for pain?
a. Yes b. No
B. If yes, specify…………
8. A. Do you take any oral medications whenever you feel pain?
a. Yes b. No
B. If yes, specify………………………..
9. A. Do you apply anything topically for pain?
a. Yes b. No
B. If yes, specify………………………..
10. A. Does the pain distressing your activities of daily living?
a. Yes b. No
B. If yes, specify………………
SECTION B
TOOL TO ASSESS THE LEVEL OF JOINT PAIN
Numerical Pain Rating Scale

It consists of reading from 1- 10. Based on the scores the intensity of pain is calculated.
RATER DESCRIPTION
0 No pain
1 -3 Mild pain
4–6 Moderate pain
7 – 10 Severe pain
SECTION C

QUESTIONNAIRE ON ACTIVITIES OF DAILY LIVING RELATED TO JOINT PAIN

MODIFIED WOMAC KNEE OSTEOARTHRITIS INDEX
The following questions concern your physical function. By this we mean your ability to move
around and to look after yourself. For each of the following activities, please indicate the degree of
difficulty you have experienced in your knees. What degree of difficulty do you have with:

SI:NO QUESTIONS NONE MILD MODERATE SEVERE EXTREME

(0) (1) (2) (3) (4)
A. B. Going down
stairs
C. D. Going up stairs
E. F. Rising from
sitting.
G. H. Standing
I. J. Bending to floor
K. L. Rising from bed
M. N. Lying in bed
O. P. Getting on/off
toile
Q. R. Lifting heavy
items
S. T. Tidying a room,
dusting, cooking
U. V. Travelling
independently on
public
transportation

SCORE BOARD

DESCRIPTION SCORE
None 0
Mild difficulty 1-11
Moderate difficulty 12-22
Severe difficulty 23-33
Extreme difficulty 33-44
TOTAL SCORE =44