INTRODUCTION:

An infant is someone who becomes a child and then an adolescent, passing through his parent’s lives and disappearing into an adult, a full –fledge person, with a life and a future all his own. No one can slow this process at any point in time.¹ The birth of an infant is one of the most awe-inspiring and emotional events that can occur in one’s life time. After nine months of anticipation and preparation, the neonate arrives amid a flurry of excitement. Healthy and sturdy babies are likely to evolve as physically and mentally strong adults with enhanced quality of human resource development.² The health of a growing child is always a matter of great concern to the parents. The physical health of a child is important because it is associated with the mental and social development. Parents are a child’s first teacher and they play an important role in their child’s learning and development. Children who receive responsive and consistent care giving early in life develop secure attachments to their parents/caregiver, which helps with their growth and learning.¹Healthy children are the future of a nation. The development of children has been considered as an integral part of national development. The national policy too recognizes children as the nation’s supreme important asset. l The most basic care, given to the child is monitoring his growth and development. If optimizing chances of a child attaining full potential is the corner stone of childcare then assessment of developmental milestones must be mandatory²The child develops very fast in the infant stage. Growth is an essential feature of life of a child that distinguishes him or her from an adult. In the postnatal life the newborn infant reclines in a helpless manner with disorganized activity. As the age advances he or she acquires better coordination of motor activity and reacts to his/ her environment in a willful manner, until he blends into a fully integrated and autonomous individual.³Growth refers to measure of physical maturation evidenced by multiplication of cells and increase of intracellular substances results in increase in the size of body and its various organs measured in terms of centimeter and kilograms.¹ Mothers are considered as the primary care givers and they can identify various changes occurring in their children including the developmental delays. The life-long learning experience of becoming a mother starts when the mother-to-be is in her progenitor’s womb, continues during childhood with the experience of being raised by her parents, continues with the occurrence of pregnancy and having a baby, and extends even further with the experience of raising a child.⁸It is essential to understand normal development and acceptable variations in normal developmental patterns of the children to recognize possible developmental disabilities. Assessment and monitoring of developmental milestones are essential for early diagnosis of developmental disabilities and it is helpful in taking early intervention programs³

Growth is an essential feature of life of a child that distinguishes him or her from adult. In the postnatal life the newborn infant reclines in a helpless manner with disorganized activity. As the age advances he or she acquires better coordination of motor activity and reacts to his/ her environment in a willful manner, until he blends into a fully integrated and autonomous individualAbout 2.1 million Indian children under 5 years of age die each year. India occupies 49^th position with mortality rate of 76/1000 live birth⁴Assessing child's development is a team effort, family plays an important role. Mother can identify the milestone development of infant by observations. Mothers can tell about the infant's doctor about any worries or concerns she may have. Pediatrician may also use developmental screening. Screening involves a series of questions and observations that gets at your child's ability to perform certain age-appropriate tasks using developmental milestones as a guide can helps to identify infants who may be at risk for developmental delay⁵.

HYPOTHESIS:

H₁:

There will be significant increase in the mothers’ knowledge on the developmental milestones in infants after planned teaching.

H₂:

There will be significant association between pre- test level of knowledge and their age, education, number of children, socio- economic status and employment status.

MATERIALS AND METHODS:

The mothers having infant upto one year children selected for the study. The study has been conducted in the rural places of wardha where there are fewer facilities. First the researcher conducted pre test, planned teaching given with all the contents of definition, and various developmental milestones upto one year and there importance. Then post test had been conducted interventional approach had been utilized.

RESULTS:

Pre and Post Test Level of Knowledge Score

Level of pre test knowledge score n=60

Graph 1: Level of Pre Test Knowledge Score

The above graph shows the frequency and percentage wise distribution of mothers of infants according to level of pre test knowledge regarding developmental milestones. The levels of knowledge were seen into 4 categories, poor, average, good, and excellent. 8.33% of the mothers of infant had poor, 71.67% had average and 20% of them had good level of pre test knowledge score. Mean knowledge score was 6.93±1.83.

Level of post test knowledge score n=60

Graph 2: Level of Post Test Knowledge Score

In the above graph shows the post test knowledge of mothers of infants the levels of knowledge were seen into 4 categories, poor, average, good, and excellent. 26.67% of the mothers of infants had good and 73.33% had excellent level of post test knowledge score. Mean knowledge score was 13.35±1.41.

Effectiveness of Planned Teaching on Knowledge Regarding Developmental Milestones Among Mothers of Infants n=60

Table 1: Effectiveness of Planned Teaching Programe Regarding Developmental Milestone

Knowledge Score

Mean

Mean Percentage

t-value

p-value

Pre Test

6.93

1.83

43.33

16.88

0.0001,

Post Test

13.35

1.41

83.73

*HS- Highly Significant

Table no 1 depicts the overall mean knowledge scores of pre test and post test which reveals that post test mean knowledge score was higher 13.35 with SD of ±1.41 when compared with pre test mean knowledge score value which was 6.93 with SD of ±1.83.

The statistical Student’s paired t test implies that the difference in the pre test and post test knowledge score found to be 16.88 statistically significant at 0.05% level. Hence it is statistically interpreted that planned teaching on knowledge regarding developmental milestones among mothers of infants was effective. Thus H1 is accepted and H0 is rejected.

Graph 3: effectiveness of planned teaching programe regarding developmental milestones

DISCUSSION:

The present study undertaken was to assess the effectiveness of planned teaching on knowledge regarding developmental milestones among the mothers of infants in selected rural area of Wardha district. A detailed review of literature indicated that most of the studies indicating that education had significant effect in improving the knowledge regarding developmental milestones among the mothers of infants. This study was the modest effort to evaluate the knowledge of mothers regarding developmental milestones. Internationally adopted children often arrive from institutional settings where they have experienced medical, nutritional and psychosocial deprivation. This study uses a validated research assessment tool to prospectively assess the impact of base line (immediately post adoption) nutritional status on 58 children as measured by weight-for-age, height-for-age, weight-for-height and head circumference-for-age z scores, as a determinate of cognitive (MDI) and psychomotor development (PDI) scores longitudinally. A statistical model was developed to allow for different ages at time of initial assessment as well as variable intervals between follow up visits. The study results show that both acute and chronic measures of malnutrition significantly affect base line developmental status as well as rate of improvement in both MDI and PDI cores. This study contributes to the body of literature with its prospective nature, unique statistical model for longitudinal evaluation, and use of a validated assessment tool to assess out comes⁶. Breast feeding as been associated with multiple developmental advantages for the infants: however, there have also been numbers of studies that find no significant benefits to child development. Although our effect sizes were small, Brest feeding for 4 months or longer was associated with improved developmental out comes for children aged 1-3 years after adjustments for multiple confounding factors⁷ More than 200 million children’s under 5years of age in developing countries do not reach their developmental potential. Children, especially infants and toddlers constitute the most disadvantaged group as for as psychosocial development is concerned. This is attributable to the greater vulnerability of developing brain in the early formatting years. Besides biological determinants, family environments of young children are major predictors of cognitive and socioemotional abilities. The present study is an attempt to assess the magnitude of global developmental delay among children under 3 years of age and to analyze the impact of important biological ambient environmental factors on their psychosocial development⁸. The study about infant and new born development conducted by National Institute of Child Health about child development, language development on June 2002. 494 children examined cognitive development for baby means the learning process of memory, language, thinking and reasoning. Baby is learning to recognize the sound of mother's voice infant is also learning to focus vision from periphery or the corner of eye to the centre. The way you cuddle, hold, and play with your baby will set the basis for how infant will interact with mother and others. It is easier to improve the development of infant physically, mentally and emotionally by positive, loving parent. So positive parenting is an important factor in development of infant. According to World Health Organization nurses and midwives play a central role in health service delivery - promotion prevention treatment and rehabilitation-in areas of great healthy need, where they may be the only frontline providers of health. The number of resolutions on nursing adopted by WHO. World Health Assembly demonstrate the importance of WHO member states attach to nursing, as means of achieving better population health outcomes.⁹

In a study conducted by Ross S Erin, K et al in 2009 on “Early Growth Faltering in Healthy Term Infant Predicts Longitudinal Growth” aim to determine whether a slowing in early weight-for-age could be used to identify children at increased risk of later growth faltering. The population of this study infants aged birth to 2 years were analyzes for 1978 healthy, term infants born between 1999-2001.The result of this study was the period prevalence of underweight was 24%.By the end of this study, they come to conclude that during early infancy when well- child visits are most frequent can be used to identify children at risk of later poor growth.¹⁰A descriptive cross-sectional study of nursing mothers and their children attending well-baby clinics in Ibadan was designed. Two hundred and forty nursing mothers and their children were recruited from three types of well baby clinics (university teaching hospital, state maternity hospital and primary care health centers) in the Ibadan North local government area of Oyo state, Nigeria. Result of the analyses showed that majority of the mothers 74% were married, 31.3% had completed primary and/or secondary education, 16.7% had no formal education while 51.8% had tertiary education. Timely and complete immunization was practiced by 93.8% for BCG, 80.4% for one dose, 60.4% for two doses and 49.2% for three doses of DPT and oral polio vaccines, 53.8% for measles and 12.1% for hepatitis B. Sixty-three percent of the children were underweight, 68% were stunted and 23% were wasted. This study reaffirms the importance of female education in the practice of CSS and good nutritional outcomes in children. Basic knowledge of child health, nutrition and related issues should continue to be made available to women and be included in the school curricula.¹¹ The physical activity recommendations were produced in part to provide WHO Member states with the evidence base needed to make policies for physical activity programmes to promote good health.

NURSING IMPLICATIONS:

Nursing Administration:

· Findings of the study can be used by the Nursing Administrator in creating policies and plans for providing education to the mothers of infants in rural area This will contribute to the total patient care, allowing for detection of dangerous situations, recognition of changes in clinical condition and hazardous effect and requests for appropriate interventions.

· The study will help the nursing administrator to plan and organize to give continuing education through nurses, or medical students to the parents regarding developmental milestones and its administration.

Nursing Education:

· The nursing students develop an insight about behavioral problems in children according to the age group and implement the knowledge of the same while dealing with clients in various settings.

· The student nurse can use the instrument prepared for this study to acquire information regarding knowledge of developmental milestones in infants.

· Findings will help nursing students to understand about need to be equipped with adequate knowledge.

· Findings will help nursing faculty to give more importance for planning and organizing planned teaching to improve knowledge of clinical practicing skill of student.

· Educators will help students, colleagues and junior staff to be trained in using this knowledge.

Nursing Research:

· The nurse researchers can use the findings of this study as baseline data to conduct further interventional research to identify the level of knowledge and to determine the association of other demographic variable as education, occupation, area of location and type of family etc with the level of knowledge of the mother.

Nursing Practice:

· Findings will help nursing personnel to estimate the knowledge of mothers and their educational status.

· Findings of the study will help nursing personnel to improve the knowledge and to act appropriately while treating the child.

· The study findings will help nursing personnel to understand about necessity of providing education programme for the mothers or parents regarding developmental milestones and any problem present in the children.

Personal Experience:

The entire study gave an enriching experience to the investigator. It helped her to develop her skill in critical thinking and analysis and realize the importance of effective communication with the respondent. The entire study was varied and had rich learning experience, which enabled the investigator to develop her skill in dealing with different personalities. The concept clarity about research as a whole was increased. At every stage the investigator received guidance and support from her guide. This boosted confidence to go ahead and carry out the planned activities. The co-operation from study samples was remarkable. The research was a great learning opportunity for the investigate.

RECOMMENDATIONS:

On the basis of the findings of the study, it is recommended that the following studies can be conducted.

· A study can be undertaken with large sample size to assess the level of knowledge and for generalization of findings.

· An experimental study could be undertaken with control group.

· All the institutions where intimated the findings of the study so as to improve the knowledge and practice of staff nurses or students regarding developmental milestone problems present in children to handle the situation properly.

· A study could be done on fathers to assess the knowledge on developmental milestones.

CONCLUSION:

After the detailed analysis, this study leads to the following conclusion: The mothers of do not have 100% knowledge regarding developmental milestones Demographic variables did not show a major role in influencing knowledge score among the mothers.

Hence based on the above cited findings, it was concluded undoubtedly that the majority of mothers of infants have average knowledge regarding developmental milestones and needs intervention through educational programs or handouts.

REFERENCE:

1. Marlow R Dorothy. Text book of Pediatric Nursing: 5th Edition. Philadelphia: WB Saunders; 1988.Page no.335.

2. Singh and Jacob. Pediatric Nursing: 2nd Edition. Indore: N B brothers Publishers; 2003. Page no. 1-13, 66-92.

3. Neil Salkind. Child Development: 6th Edition. Philadelphia: Rinchart and Winston Inc; 2002. Page No. 204.

4. Early Childhood Learning Division, Department of Education [Internet]. Newfoundland and Labrador;2011.Availablefrom: URL:http://www.ed.gov.nl.ca/edu/earlychildhood/literature_review.pdf

5. http://www.childmind.org/en/milestones-at-5-years

6. Kyla Boysc, February 2010 Child developmental research

7. www.babycenter.com/baby-milestones.

8. Child development : infant social development research study 19th Oct 2008.www.pediatricbehavior.com/childdev/infantsocialdev.

9. Marlow, Detal (1961). Textbook of Pediatric Nursing, New Delhi, W.B. Saunder Company.

10. Research Milestone (Year 2005) second issue of MAAP Journal (2005).

11. International child disease and developmental research. "Health and science Bulletin".4(2); June 2006.

12. Ross S Erin, Krebs F Nancy, Shroyer W Laurie A, Dickinson L. Miriam, Barrett H Paul, Johnson L Susan, Early Growth Faltering in Healthy Term Infant Predicts Longitudinal Growth,2009(85)583-588.

13. Rasaki Ajani Sanusi ,Adunni Olatokunbo Gbadamosi: Research Article: ‘Do Mothers knowledge and practice of ‘ Child Survival strategies’ Affect the Nutritional Status of Children? (Article).

Received on 05.12.2016 Modified on 25.12.2016

Int. J. Nur. Edu. and Research. 2017; 5(2): 160-164.

DOI: 10.5958/2454-2660.2017.00033.3