Management of upper respiratory tract infection among the mothers of under five children in selected area of Bhubaneswar, Odisha..

Dr. Sikandar Kumar

Vice-Principal, L.J.M College of Nursing, Bhubaneswar

*Corresponding Author Email: sikkandar.kumar@gmail.com

ABSTRACT:

The purpose of the study was to assess and improve the knowledge among the mothers of under five children regarding upper respiratory tract infection. 30 samples were selected from the bhubaneswar. The subjects who were between 20-40 yrs having children below age of 5 yrs were selected by purposive sampling. The closed ended questionnaire knowledge regarding URTI were administered. Information related to prevention and management of URTI was given through planned teaching programme. The findings showed that during pretest the knowledge of the subjects regarding URTI was inadequate where as in post test the score the knowledge was adequate. There was no significant difference (p=0.05) between the post test score and their selected demographic variable. Finding reveals that most of the mothers were in the age group of between 30-35 years and most of them have the educational qualification of secondary level. Most of them were Hindu religion and majority of them were housewife. Majority of them were belongs from nuclear family all of them line in rural area and majority of them having the monthly income of 1001-5,000. In pre-test, overall level of knowledge on management of URTI among the mothers were 40%. Where as in post test knowledge score for the mother were 87%. Hence, it depicts that intervention was effective for the gaining of the knowledge regarding management of URTI mong the mother of under five children.

KEY WORDS: Management, respiratory tract infection, mothers, under five children.

INTRODUCTION:

Children are an embodiment of our dreams and hopes of the future. They are wet clay in the potter’s hands, handled with care they become beautiful, else they break and become discarded. They are the most vulnerable group in the society.

Respiratory tract infections are one of the leading causes of morbidity and mortality in children. Respiratory problems are responsible for a large proportion of paediatric admissions are described according to the areas of involvement.

The Upper Respiratory Tract, or Upper airway, consists primarily of the nose, mouth and oral pharynx. Upper respiratory tract infections to children includes common cold, rhinitis, sinusitis, nasopharyngitis, epiglotitis, tracheitis, and laryngotracheitis.

Under 5 children’s are risky population to get Upper respiratory tract infection due to lack of immune power. They need immediate and prompt treatment to prevent Lower respiratory tract infection. The important risk factors associated with respiratory diseases include malnutrition, low birth weight, climatic variation, overcrowding house, poor ventilation and lack of environmental sanitation.

Children constitute foundation of a nation healthy children grow to become healthy adults with optimal physical strength and emotional poise to become useful members of our strength and contribute effectively in the nation building process.

In India Under five children constitute about 13 percentage of the total population. Every year 12 million children in developing countries die before they reach their 5^th birthday. 7 in 10 of these deaths are due to acute respiratory infections. Mortality due to Acute Upper respiratory tract infection is high in developing countries which may reach 1000 or more per 1,00000 live birth. More than 10 million children die each year and in the developing countries 25% of deaths are attributed to Upper respiratory tract infection alone.

Mothers play a key role in the management of child with URTI. Mothers has to understand that the appropriate decision making recognize the mild, moderate and severe respiratory infection and initiate correct domiciliary management for Upper respiratory infection at home as soon as possible to prevent the progression of the infection.

The ignorance and inadequate knowledge are important factors which affects health of child. If upper respiratory infection is not treated in early stage it may leads to certain complications like staphylococcal pericaraditis, empyema, pneumothorax and staphylococcal pneumonia which increases the risk child mortality.

Therefore the investigation need to provide accurate information about prevention and domicilliary management of Upper respiratory infection to the mothers to help them to provide effective home management to children suffering from upper respiratory infection.

NEED FOR THE STUDY:

In India under five children constitute about 13 percentage of the total population of India. Every year some 12 million children in developing countries die before they reach their 5^th birthday. 7 in 10 of these deaths are due to acute respiratory infections. In United States of America(USA), adults have 2 to 4 and children’s have between 6 to 8 of Upper respiratory tract infection. Mortality due to Acute Upper respiratory tract infection is high in developing countries which may reach 1000 or more per100, 000 live births compared to 30-40 per 100,000 live births in Industrialized nation.

The WHO estimates that in 1990 AURI tragically caused 13 million children die each year, 4.3 million children die from AURI. India has 440 million children. About 24 million of them donot live to the age of 5. Acute upper respiratory tract infections are leading cause of mortality (30%) in India.

More than 10 million children die each year and in the developing countries 25% of deaths are attributed to Upper respiratory tract infection alone.

A study conducted among Under 5 children regarding common Upper respiratory tract infection and recorded the findings such as rhinitis 62%, sinus infection 42%, common cold 72% and laryngitis 60%.

A study conducted for the causes of respiratory infection over 200 different viruses have been isolated in children with URTI. The common viruses are rhino virus 85% and other viruses such as corona virus, parainfluenza virus, adeno virus, entero virus 15%.

The ignorance and inadequate knowledge are important factors which affects health of child. If upper respiratory infection is not treated in early stage it may leads to certain complications like staphylococcal pericaraditis, empyema, pneumothorax, and staphylococcal pneumonia which increases the risk child mortality.

STATEMENT OF PROBLEM:

A study to evaluate the effectiveness of Planned Teaching Programme on management of Upper Respiratory Tract Infection among mothers of under5 children in a selected area of Bhubaneswar, Odisha.

OBJECTIVES:

The objectives of the study were to

· Assess the existing level of knowledge of mothers of under 5 children’s on management of URTI.

· Evaluate the effectiveness of Planned Teaching Programme on management of URTI among mothers of under 5 children’s.

· Determine the association between post test level of knowledge score with their selected demographic variables.

· Find out the significant difference between the pre-test and post-test knowledge score of mothers of under 5 children’s.

OPERATIONAL DEFINITIONS:

· EFFECTIVENESS: Refers to determine the extent to which planned teaching programme has achieved the desired effect which will be measured in terms of significant gain in knowledge as determined by difference in post test knowledge score of mothers of under 5 children’s.

· KNOWLEDGE: Refers to the information and understanding of mothers of under 5 children’s about domiciliary management and prevention of URTI.

· PLANNED TEACHING PROGRAMME: Refers to systematically organized teaching programme of one hour duration for group of mothers of under 5 children about domicilliary management and prevention of URTI.

· DOMICILLIARY MANAGEMENT: Activities provided by mothers for treating the children suffering from upper respiratory tract infections which things available of home like honey, ginger, turmeric, tulsi etc.

· UPPER RESPIRATORY TRACT INFECTION: Upper respiratory tract infections are inflammation of upper respiratory tract that is ear, nose, and throat leads to common cold, pharyngitis, and other otitis media.

· MOTHERS OF UNDER FIVE CHILDREN: Refers to community women who were having children’s in the age group of 0-5 years.

METHODOLOGY:

The methodology of research indicates the general pattern of organizing the procedure for gathering valid and reliable data for the purpose of investigation or data collection.

In this study the methodology includes the research approach or design, study setting, sample, sample size, sampling technique, development of tool for data collection procedure plan for data analysis and ethical consideration.

RESEARCH DESIGN:

The research design refers to the researcher overall plan for obtaining answer to the question.A quantitative research approach with pre-experimental research design one group pre-test and post-test design was used to conduct the study.

SCHEMATIC PRESENTATION OF RESEARCH DESIGN

SETTING:

According to Polit and Hungler (1999), ‘’ setting is the physical location and condition in which data collection takes place in a study. The present study was be conducted in a selected area of Chakeisihani.

SAMPLE:

A subset of a population, selected to participate in a study. The sample for the present study comprises mothers of under 5 children who fulfill the inclusion criteria.

SAMPLING TECHNIQUE:

It refers to the process of selecting a portion of population to present the entire population. The non-probability purposive sampling technique was adopted for the present study.

SAMPLE SIZE:

This refers to the number of persons to be selected to constitute the sample. The sample size of this study consists of 30 mothers of under 5 children’s.

SAMPLING CRITERIA:

The following inclusion and exclusion criteria are use in selecting the sample.

INCLUSION CRITERIA:

Mothers of under five children who were

· Willing to participate in the study.

· Available during the time of data collection.

· Able to read, write, and speak Oriya.

EXCLUSION CRITERIA:

The study exclude the mother who were

· Absent during the period of data collection.

· Those found ill during the data collection.

ETHICAL CONSIDERATION:

· Participants are not to be harmed physically, psychologically or emotionally.

· Information regarding participant will be kept confidential

· Participants’ right of autonomy is to be maintained.

TOOL FOR DATA COLLECTION:

· The closed ended questionnaires are used for collection of data.

· The steps selected for preparing the tools are:-

REVIEW OF RELATED LITERATURE:

The Books, Journals, Reports of research studies data basis etc.

DATA DESCRIPTION OF THE TOOLS:

It includes the demographic variables such as age, educational qualification, religion, occupation, types of residence, type of family and socioeconomic data.

PROCEDURE FOR DATA COLLECTION:

· Prior permission was obtained from the concerned authority of the community.

· For this study permission was obtained from the Corporator and ward member of that area.

· Written consent was obtained from the mothers by assuring the confidentiality of the data.

PLANNED FOR DATA ANALYSIS:

The data was analyzed by using descriptive and inferential statistics.

RESEARCH HPOTHESIS:

HYPOTHESIS –1(H₁):

There is no significant difference between the level of pre test and post test knowledge on URTI among the mothers of under 5 children in a selected area of Chakeisihani.

HYPOTHESIS -2(H₂):

There is a significant association between the level of post test knowledge score regarding URTI with their selected demographic variables.

CONCEPTUAL FRAMEWORK:

Concept is defined as a complete formation of an object property or events derived from individual perception and experience (Kozzer 2011).

Conceptualization is a process of forming ideas which are utilized and form conceptual frame work for development of data need to be collects and gives direction to an entire research process (Kozzer 2011).

According to Polite and Hungler, ‘’ Conceptual framework represents a less formal or less well developed attempt at organizing phenomena than theory and deal with abstraction that are assembled by virtue of their reference to a common theme ‘’.

This study is based on Adaptation Theory pioneered by Sister Callista Roy (1968). Roy’s model as an outcome model concerned with maintaining balance and stability and enhancing harmony between individual and environment. System is a set of organized components related to form of a whole. Roy considers the recipient of care to be an open adoptive system.

ADAPTATION:

The adaptive system has inputs of stimuli and adaptation level, output as behavioural responses that serve as feedback and control and process known as coping mechanisms.

The adaptive system has input coming from the external environment as well as from the person. She identifies in its as stimuli and adaptation level.

Stimuli are conceptualized as falling into three classifications focal, contextual and residual stimuli.

(i) FOCAL STIMULI

The internal and external stimulus must immediately confronting the person, the object or event that attracts one’s attention.

(ii) CONTEXTUAL STIMULI

· These are all other stimuli of the person’s internal and external world that can be identified as having a positive or negative influence on the situation.

· The contextual stimuli for the present study are types of residency and type of family.

(iii) RESIDUAL STIMULI

· These are those internal or external factors having an indeterminate effect on the person’s behaviour, that effect has not or cannot be validated.

· The residual stimuli for the present study are age and religion of mothers.

INPUT:

The person receives inputs or stimuli from both the environment and the self. Along with the stimuli, the adaptation level of the person, act as input to that person as an adaptive system.

The focal, contextual and residual stimuli combine and interface to set the adaptation level of the person at a particular point in time. Significant stimuli that comprise the focal, contextual and residual stimuli include the factors such as the degree of change, past experiences, knowledge level, strengths and / or limitations.

The inputs or stimulus for the present study is management of URTI in the form of PTP among the mothers of under 5 children’s. In this the stimuli is given about the meaning, causes, sign and symptoms, diagnostic evaluations and the management of URTI. Which may improve the past experience and level of knowledge of mothers.

OUTPUT AND FEEDBACK:

Outputs of the person as a system are the response of the person. Output is categorized as adoptive response or ineffective responses. The responses of output provide feedback for the stimuli.

In this study, output process consists of level of knowledge of mothers in management of URTI in the form of poor, average, good and excellent.

INSTRUMENT:-

· Closed ended questionnaire was used. The instrument and the teaching module has been validated by various experts and it was found to be valid. The content were translated from English to Odiya. The content validity of this questionnaire was ensured with expert opinion and the reliability was checked by performing a pilot study other than the main setting. The instrument were having two section. Section-I contains all the demographic variables such as age, education, occupation, type of family, residence, monthly income etc. section-ii contains the questionnaire on knowledge regarding URTI like cause, symptoms, management, and prevention. The overall knowledge scores were interpreted as inadequate (50% or less), fair or moderate (51 to 74%) and adequate (75% and above).

DATA COLLECTION PROCEDURE:

Prior permission was obtained from the concerned authority of the community. For this study permission was obtained from the Corporator and ward member of that area. Written consent was obtained from the mothers by assuring the confidentiality of the data. Pretest was conducted. The time taken for collecting the data for each mothers were ranged from 25 to 30 minute. Soon after pretest planned teaching module was given. Teaching programme was given for 45 minutes. After seven days post test was done by using same questionnaire. The data were analyzed by using descriptive and inferential statistics.

RESULT AND DISCUSSION:

Distribution of mothers of under five children’s according to their demographic variables depicates that the mothers of under 5 childrens about 43% were in age group of 30-35 years where as 27% were in age group of 25-30 years, 17% were in the age group of 35-40 years and 13% were in age group of 20-25 years. Almost 50% mothers have the educational qualification of secondary where as 33% had primary , 17% had higher secondary and none of them had

DATA ANALYSIS AND INTERPRETATION

FIGURE-1

FIGURE-2

Table-1

Area	Maximum score	Pre-test			Post-test			Effective-ness
Area	Maximum score	Mean	Mean%	S.D	Mean	Mean%	S.D	Effective-ness
Knowledge on causes, sign and symptoms of URTI.	20	9.9	50%	3.6	16.3	82%	1.7	32%
Knowledge on management and prevention of URTI.	20	6.5	33%	2.3	18.4	92%	1.0	59.5%
Overall	40	16.4	40%	6.5	34.7	87%	2.2	46.7%

Table-2-

Sl. No.	Demographic Variables	Chi-square value	Level of significance
1	Age(in year)	2.05	Not significant
2	Educational Qualification	2.32	Not significant
3	Type of family	0.12	Not significant
4	Monthly incom	3.08	Not significant

(df = 6), (Table value = 12.59), (Level of significance = 0.05, not significant)

IMPLICATION:

The findings of the study will keep the nursing personnel to assess the level of knowledge of mothers of under 5 children’s and help in which they lack knowledge can be conducted for teaching.

The findings will help to be utilize for assessing the level of knowledge and to improve their level of knowledge.

· The community health nurse can use the tool to assess the level of knowledge related to management of URTI among the mothers of under 5 children’s.

· A module can be prepared based on present finds for improving the knowledge of the mothers of under 5 children’s related to the management of URTI.

· The findings of the study can be utilized for conduction of research by using large sample.

RECOMMENDATION:

Based on the findings of the study of the following recommended have been made for further study.

· Similar study can be under taken among large samples so that results can be generalized.

· A study can be done to assess the level of knowledge score related to management of URTI among mothers of under 5 children’s.

SUMMARY:

This chapter deals with discussion summary of the study findings, conclusion, implication of the study in nursing field and recommendation for further study.

REFERENCE:

1. Gupta Piyush (2007), "Essential Paediatric Nursing”, 2^nd edition , CBS Publishers and Distributors Pvt. Ltd, Page No-412-414.

2. Kliegman, Behrman, Jenson, Stanton (2007), “Nelson Text book of Paediatric”, 18^thedition, Elsevier, a division of Reed Elsevier India Private Limited , Page No-1752-1757.

3. Datta Parul (2009), “Paediatric Nursing”, 2^nd edition, Jaypee Brother Medical Publishers (P) Ltd Pages No-274.

4. Gupte Suraj (2004), “The text book of Paediatric”, 10^th edition, Jaypee Brothers Medical Publishers (P) Ltd, Page No-248-249.

5. Hockenberry J. Marilyn, (2006), Wong’s Essentials of Pediatric Nursing. Seventh edition, Mosby Publication, Missouri. Pp: 681-682.

6. Howie S.M.(2003), “Nutrition education for children under 12 years in North Staffordshire,” Hum Nutr Appl Nutr, vol-37A, no.- 54-58.

7. Hurlock E.B., (1999), Child Development, 6^th edition, Mc. Graw Hill, New York. Pp -465.

8. “Integrated Child Development Services and Department of Women and Child Development,” Project Information Dissemination Brochure. (2007) Uttar Pradesh: ICDS/ WCD.

9. Hassan A.E., (2005), “Health Education Program for Mothers of Children Suffering from respiratory infection in United Arab Emirates”, Journal of Egypt Public Health Association, Vol-80, No-5-6, pp-525-45.

Hockenberry J.Marilyn, (2006), Wong’s Essentials of Pediatric Nursing. Seventh edition, Mosby Publication, Missouri. Pp: 681-682.

Received on 04.07.2014 Modified on 05.08.2014

Int. J. Nur. Edu. and Research 2(3): July- Sept. 2014; Page 224-230