INTRODUCTION:

Health and illness underpin our everyday existence. Health allows us to live full lives and to function as social beings. Illness disrupts our lives, sometimes seriously. The Children of today are the resources of the future. Preservation of their lives will always be a priority. Child health includes the care of the children from infancy to adolescence.¹

Healthy children become healthy adults. Improving the health of children is one responsibility among many in the fight against poverty. Nephrotic syndrome is a common type of kidney disease seen in children. It is one of the several manifestations of glomerulornephritis. Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema, although additional clinical features such as hyperlipidemia are also usually present. ²

Today, Nephrotic syndrome is recognised as a common chronic illness in childhood. Although Nephrotic syndrome may be associated with many renal diseases, the most common form in childhood is Primary Nephrotic Syndrome, which develops in the absence of features of nephritis or associated primary external disease.⁶ Supportive treatment of Idiopathic Nephrotic Syndrome consists of fluid and salt restriction, protein intake tailored to the protein losses, prevention of thrombosis and infection, and mainly in steroid resistant cases measures to prevent of premature atherosclerosis and deterioration of kidney function.³

NEED FOR THE STUDY:

Nephrotic syndrome occurs when the kidneys do not work properly and leak large amounts of protein into the urine. It can affect people of any age, but is usually first seen in children aged two to five years of age. It affects more boys than girls. The condition is usually first diagnosed between the ages of two and five years old. Nephrotic syndrome is rare and affects about 1 in 50,000 children a year. It tends to be more common in families with a history of allergies. In the UK, it is more common in Asian families.⁴

A study conducted on 206 Indian children with Nephrotic syndrome showed a primary renal cause in 195 (96%), of which 77% were boys. In 126 children (96 boys, 30 girls) onset of the disorder occurred before the age of 5 years. Renal biopsy showed minimal lesions in 150 patients (77%), in 85 of these biopsy was done 3 months to 16 years after onset of the Nephrotic syndrome.⁵

The descriptive study was conducted to assess mother’s knowledge regarding recurrence of Nephrotic syndrome. The study reveals that the quantity of parental information concerning symptoms of Nephrotic syndrome disease recurrence is insufficient so upgrading parental awareness and knowledge through educational courses and providing comprehensive and necessary information concerning disease, signs and symptoms, and its complications can greatly improve the quality of the care levels.⁶

OBJECTIVES:

1. To assess the level of knowledge regarding Nephrotic syndrome and its home care management among parents of children with Nephrotic syndrome before and after giving the information booklet.

2. To determine the effectiveness of information booklet on level of gain in knowledge regarding Nephrotic syndrome and its home care management among parents of children with Nephrotic syndrome.

3. To find the association of level of knowledge among parents of children with Nephrotic syndrome with their selected personal variables.

HYPOTHESIS:

H₁: the mean post-test knowledge score of the parents of children with nephrotic syndrome would be significantly higher than their mean pre-test knowledge score.

H₂: there would be significant association between the pre-test knowledge scores with selected personal variables of parents of children with nephrotic syndrome.

METHODOLOGY:

Research Design: The research design selected for study was pre-experimental design with one group pre-test post-test design.

Sampling technique: purposive sampling technique

Sample: sample size was 60 parents of children with nephrotic syndrome in selected hospitals of Mysore

VARIABLES

Dependent variable: Parent’s knowledge regarding nephrotic syndrome and its homecare management.

Independent variable: information booklet on nephrotic syndrome and its homecare management.

Demographic variables: age of the parents, age of the child, education of the parents, type of family, income of the family, place of residence, duration of illness, previous exposure to educational programme and source of information.

SETTING

The present study was conducted in 3 selected hospitals of Mysuru.

Names of Selected Hospital Samples

JSS Hospital, Mysuru — 20

K.R. Hospital, Mysuru. — 30

Holdsworth Memorial Hospital, Mysuru — 10

Total — 60

DATA COLLECTION TECHNIQUE:

Section A- It deals with socio demographic characteristics which include age of the parents , age of the child, education of the parents, type of family, income of the family, place of residence, duration of illness, previous exposure to educational programme and source of information.

Section B- It was prepared to assess knowledge regarding nephrotic syndrome and its homecare management among parents of children with nephrotic syndrome.

RESULTS:

Section 1: Selected personal variables of the parents of children with nephrotic syndrome.

TABLE 1: Frequency and percentage distribution of parents of children with nephrotic syndrome in selected personal variable

n = 60

Sl.

Sample characteristics

Frequency(F)

Percentage (%)

Age of the parents in years

Mother

1.1) 18-25 years

1.2) 26-30 years

1.3) 31-35 years

23.33

43.33

33.33

Age of the child in years

2.1) 1-5years

2.2) 6-10years

2.3) 11-15 years

23.33

11.66

Education of the parents

3.1) No formal education

3.2) Primary education

3.3) High school

3.4) PUC

3.5) Graduate/Master degree

36.66

18.33

Type of family

4.1) Nuclear

4.2) Joint

56.66

43.33

Income of the family (Monthly)

5.1) < Rs.5000

5.2) Rs.5001-10000

5.3) Rs.10001-15000

5.4) >Rs.15000

26.66

36.66

11.66

Place of Residence

6.1) Rural

6.2) Urban

58.33

41.66

Duration of illness (In years)

7.1) Since birth

7.2) Past 1-2 years

7.3) Past 3-5 years

7.4) >5 years

8.33

26.66

Previous exposure to educational programme

8.1) Yes

8.2) No

11.66

88.33

Source of information

9.1) Mass media

9.2) Health professionals

9.3) Relatives/ friends/ Family

9.4) No information

6.66

8.33

28.33

56.66

Section 2: Knowledge regarding nephrotic syndrome and its home care management among parents of children with nephrotic syndrome.

Table 2: Knowledge level of parents of children with nephrotic syndrome n = 60

Knowledge	Pre-test		Post-test
Knowledge	Frequency	%	Frequency	%
Inadequate (1-17)	45	75	4	6.6
Moderately adequate (18-26)	13	21.6	30	50
Adequate (27-34)	2	3.3	26	43.3

Table 3: Mean, Median, Range ,Standard deviation of pre test and post test knowledge scores of parents of children with Nephrotic syndrome n = 60

Group

Pre test scores n=60

Mean

Median

Range

Parents of children with Nephrotic syndrome

14.62

7-26

±4.741

Table 3 continued

Group	Post test scores n=60
Group	Mean	Median	Range	SD
Parents of children with Nephrotic syndrome	24.23	24.50	16-32	±4.945

Table 4: Mean, mean difference, SD difference, SEMD, and paired 't’ test of pre test and post test knowledge scores of parents of children with Nephrotic syndrome. n=60

Group	Mean	Mean difference	SD difference	SE MD	‘t’ value
Pre test	14.62
		9.61	±0.2935	0.379	25.381*
Post test	24.23

Section 4: Association between knowledge regarding nephrotic syndrome and its homecare management among parents of children with nephrotic syndrome with their selected personal variables

The selected personal variables such as education of the parents, income of the family (monthly) and place of residence were having significant association with the knowledge scores of parents of children with nephrotic syndrome regarding nephrotic syndrome and its homecare management at 0.05 level.

CONCLUSION:

· The findings of the study revealed that the parents of children with nephrotic syndrome had inadequate knowledge regarding the nephrotic syndrome and its homecare management. Data shows that majority 45 (75%) had inadequate knowledge and 13 (21.6%) had moderate knowledge regarding nephrotic syndrome and its homecare management in the pre-test. It also revealed that the mean post-test knowledge score (24.23) was higher than the mean pre-test knowledge score (14.62).

· The above findings of the study showed that the information booklet is highly effective in improving the knowledge regarding nephrotic syndrome and its homecare management among parents of children with nephrotic syndrome.

· The findings of the study also revealed that the pre test knowledge regarding nephrotic syndrome and its homecare management among parents of children with nephrotic syndrome had significant association with their selected personal variables viz. education of the parents, income of the family(monthly) and place of residence

RECOMMENDATIONS:

The following recommendations were made based on the results of the study.

1. A similar study can be replicated on a larger sample with similar demographical characters.

2. A similar study can be replicated with a control group using a larger population of the community.

3. A comparative study can be conducted on urban and rural parents of children with nephrotic syndrome.

4. A study can be replicated based on true experimental design

5. A study on knowledge, attitude and practices of parents of children with nephrotic syndrome regarding nephrotic syndrome and its home management can be carried out.

6. A follow-up study can be conducted to determine the effectiveness of teaching programme.

REFERENCE:

1. Michael Bury (University of London). Health and Illness. 1st ed. UK. John Wiley and Sons Ltd; 2005

2. Khemchand N Moorani, Mukesh raj. Spectrum of infection in children with newly diagnosed primary Nephrotic syndrome. Pakistan journal of medical research. 2012 Januvary-March;51(1).

3. Allison A Eddy, Jordan M Symons. Seminar on Nephrotic syndrome in childhood. The Lancet 2003; vol 362: 629–39.

4. R N Srivastava, G Mayekar, R Anand, V P Choudhry, O P Ghai, H D Tandon. Nephrotic syndrome in Indian children. Arch Dis Child.1975; 50:626-63

5. Ashrafalsadat Hakim, Simin Madhooshi, Ehsan Valavi. A study about knowledge of parents of children with Nephrotic syndrome toward recurrence of disease. Jundishapur Journal of Chronic Disease Care. 2013;2(4):49-55.

6. J. Lissa et al. A Study to assess the knowledge on Nephrotic Syndrome among mothers of children admitted with Nephrotic Syndrome in Indira Gandhi Institute of Child Health, Bangalore. Asian Journal of Nursing Education and Research (AJNER) Volume 03, Issue 01, January-March 2013.

Received on 26.05.2015 Modified on 14.06.2015

Int. J. Nur. Edu. and Research 3(3):July-Sept., 2015; Page 284-287

DOI: 10.5958/2454-2660.2015.00009.5