Children are an embodiment of our dreams and hopes for
the future. They are the most vulnerable group in the
society. UNICEF Statistics (2005) reported that acute
respiratory infections (ARI) is one of the leading causes
of underfive mortality in developing countries, responsible
for 1.9 million deaths annually. Among 42 countries
in the world 90 percent of child mortality burden, 14-24
percent of the under-five mortality burden is due to
pneumonia. Nearly 70 percent of this pneumonia mortality
occurs in Africa and south-east Asia regions. Most of
the children have about 4-6 attacks of ARI each year.
Park (2002) stated that every year ARI in young children
is responsible for an estimated 4 million deaths worldwide.
Bangladesh, India, Indonesia and Nepal together account
for 40 percent of the global ARI mortality. In India,
of the 2.5 million born, 1.5 million do not reach their
1st birthday, and 5 million their fifth birthday. It
means every day nearly 2500 under-five children die
of which 600 die due to acute respiratory infection
WHO Report (2000) stated that children below 5 years
of age suffer about 5 episodes of ARI per child per
year, thus ac
The author is Lecturer, Dr G Sakunthala College
of Nursing, Trichy-5 |
counting for about 238 million attacks. Consequently,
although most of the attacks are self-limiting episodes,
ARI is responsible for about 30-50 percent of visits
to health care facilities and for about 20-40 percent
admissions to hospitals.
Objectives:
The present study sought to : (i) determine the knowledge,
attitude and knowledge on practices of mothers regarding
ARI during pre-test and posttest; (ii) evaluate the
effectiveness of a planned teaching programme (PTP)
among mothers in the experimental group; (iii) determine
the relationship between knowledge, attitude and knowledge
on practices of mothers regarding ARIs during pre-test
and posttest; and (iv) determine the relationship
between knowledge, attitude and knowledge on practice
of mothers regarding ARIs during post test and selected
demographic characteristics (age of the mother, educational
status, type of family, family monthly income, occupation
and sources of information, age of the child, gender
and birth order of the child).
Hypothesis
All the hypotheses were tested at 0.05 level of significance.
1. There will be a significant increase in the level
of knowledge, attitude and knowledge on practice regarding
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ARIs among the mothers who had PTP
2. There will be a significant difference in the post-test
level of knowledge, attitude and knowledge on practice
scores of mothers regarding ARIs between the control
and experimental group.
3. There will be a significant relationship between
knowledge, attitude and knowledge on practice scores
of mothers regarding ARIs during pre-test and post-test.
4. There will be a signification association between
posttest knowledge, attitude and knowledge on practice
of mothers regarding ARIs and selected demographic
variables as age of mother, education, type of family,
occupation, family income, source of information regarding
ARIs, age of child, gender and birth order.
Assumptions
The study assumes that (i) knowledge, attitude and
knowledge on practice of mothers have a strong influence
on adoption of healthy behaviour; (ii) health education
promotes early health seeking behaviour; (iii) group
teaching will provide opportunity for active learning
among the participants; (iv) a nurse has an important
role to play in the health education regarding ARI
among mothers;
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and (v) adequate knowledge of the disease condition
will help in adopting positive attitude towards healthy
practice.
Conceptual Framework : The framework of present study
was based on the modified Rosenstocks Health Belief
Model (1996). According to this model, there are three
factors i.e. individual perception, modifying factors,
and likelihood of taking action which determine the
individual’s decision towards taking preventive action.
Research Approach : The researcher aimed to evaluate
the effectiveness of PTP on ARIs. An evaluative approach
was considered appropriate.
Research Design : The researcher adopted a quasi experimental
design, non-equivalent control group pre-test posttest
design. In this design there are two groups - control
and experimental.
Setting of the Study : Two children speciality hospitals
were selected for the purpose of the study. One hospital
served as the experimental group and the other as the
control group. The study was conducted at the outpatient
departments of the two hospitals.
Population : The population of the study consisted of
mothers of under-five children suffering from ARIs .
Sample : The sample consisted of 60 mothers (30 each
in the experimental and control groups) of under-five
children with ARIs. The mothers who visited the outpatient
department of the two hospitals at Trichy during the
study period and those who fulfilled the inclusion criteria
were selected for the study .
Sampling technique : Nonprobability convenient sampling
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was used for this study . Research tool and technique
: A semi-structured questionnaire consisting of 20
questions to assess the knowledge regarding ARIs covering
the Meaning, Causes, Predisposing factors, Signs and
symptoms, Spread, Prevention, Treatment and Complications,
Threepoint Likerts’ scale with 10 statements to assess
attitude of mothers towards ARIs and knowledge on
practice questionnaire with 12 statements to assess
the knowledge on practices regarding ARIs. The tool
was prepared by the investigator after thorough study
of all the possible literature available, field visit,
interview with the mothers in the paediatric outpatient
departments and consultation with the experts in the
field. Investigators’ experience also contributed
substantially towards preparation of the tool. The
study was carried out by means of an interview schedule.
Planned Teaching Programme: PTP using the Lecturecum-
demonstration and group discussion was given at the
outpatient department only to experimental group.
The content included Meaning, Causes, Predisposing
factors, Signs and symptoms, Spread, Prevention, Treatment
and Complications, after pre-test interview.
Validity and Reliability : The tool was evaluated
by 7 experts in the field. Reliability was assessed
by Cronbach’s method with r=0.9 indicating high reliability.
The pilot study was conducted in a non-study paediatric
outpatient department, the purpose of which was to
assess feasibility of tool, availability of samples
and plan for analysis.
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A total of six mothers were selected. These mothers
were not included in the main study. On the basis
of the results of the pilot study, the questionnaire
and the teaching programme were modified and refined,
validity and reliability of the questionnaire was
also established. Data analysis : Data was analysed
by descriptive statistics (frequency, percentage,
mean and standard deviation) and inferential statistics
(paired ‘t’ test correlation coefficient and chi square);
paired ‘t’ test were used to find out the differences
between pre-test and post-test of the study groups.
Correlation coefficient were used to determine the
association between knowledge, attitude and knowledge
on practice. Chi square values were used to see the
relationship between knowledge, attitude and knowledge
on practice with selected demographic characteristics.
The research proposal was approved by the dissertation
committee prior to the pilot study. Permission was
obtained from the Principal, Head of the Child Health
Nursing Department, the hospital in-charge of both
the experimental and control groups. Informed consent
was obtained from each participant of the study before
starting the data collection. Assurance was given
to the subjects that anonymity of each individual
and confidentiality of the information given by them
would be maintained.
Findings of the Study 1. There was a gross inadequacy
(100%) of knowledge regarding ARIs among mothers in
both the groups. 2. PTP was found to be effec-
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tive in improving the knowledge, attitude and knowledge
on practice of mothers regarding ARIs as shown by
the post-test scores of experimental group (Table
1).
3. There was a significant positive correlation between
knowledge, attitude and knowledge on practice in both
the groups during the pre-test and post-test.
4. Significant relationships were found between knowledge,
attitude and knowledge on practice with certain demographic
variables viz. educational status, type of family
and monthly income.
Recommendations
 Similar studies can be done
(i) on a larger scale, (ii) in urban and rural areas
so as to compare the findings; (iii) with randomisation;
(iv) on prevalence of ARIs in Trichy district; and
(v) on prevention and risk factors
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Nursing education: The findings can
be used as an example by the tutor in the class rooms
for giving importance to health education.
Nursing administration: Nursing administration
could formulate policies that will include all nursing
staff to be actively involved in health education programmes
in their respective hospitals and colleges.
Nursing research: The findings of the
study can be used to further justify the need for education
of the people in the awareness and preventive aspects
of health.
Conclusion
The study showed that the health education imparted
to the mothers had an effect on their knowledge, attitude
and knowledge on practice regarding acute respiratory
infections had a great potential for accelerating the
awareness among the mothers on various |
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Table 1 : Comparison of pre-test and post-test
scores of mothers among control and experimental groups
regarding acute respiratory infections.
|
Groups |
Components |
Pre-test
Mean (M) |
Post-test
Mean (M) |
Mean
Difference (MD) |
SD |
DF |
Paired
‘t’ test |
| Control
(n=30) |
Knowledge |
17.16 |
17.15 |
0.34 |
0.7 |
29 |
3 |
| Attitude |
18.86 |
18.93 |
0.07 |
0.2 |
29 |
1.5 |
| Knowledge
on Practice |
21.83 |
21.93 |
0.1 |
0.2 |
29 |
1.5 |
| Experi
mne=n3ta0l |
Knowledge |
18.2 |
65.56 |
47.36 |
6.76 |
29 |
38.345*** |
| Attitude |
19.06 |
23.7 |
4.84 |
1.4 |
29 |
18.8*** |
| KPrnaocwticleedge
on |
20.73 |
26.66 |
5.93 |
2.47 |
29 |
13.11*** |
***p < 0.05 ‘t’ value is significant at 0.05 level.
Mean post-test scores of the control group means that
there exists a true difference between the groups in
knowledge attitude and knowledge on practice scores.
The effectiveness of PTP on ARIs is evident in the experimental
group. |
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aspects regarding acute respiratory infections.
References
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