INTRODUCTION:

Aspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign materials that enter the bronchial tree, usually oral or gastric contents (including food, saliva, or nasal secretions)¹. India looks indeed like a leading third world Country; malnourished children breathe polluted air and suffer from lack of nutrition and hygiene. It leads the world with 27% of the global pneumonia cases. Worse, every minute, a child dies of in India, followed by Afghanistan, China, Pakistan and Bangladesh annually, two million². Children under five dies from pneumonia and contributes to almost 20% of childhood mortality cases³. Few studies have been designed that distinguish between aspiration pneumonia and aspiration pneumonitis. Several studies suggest that 5-15% of the 4.5 million cases of community-acquired pneumonia result from aspiration pneumonia, approximately 10% of patients who are hospitalized after drug overdoses will have an aspiration pneumonitis. Every year 0.9 million infants die from aspiration pneumonia. Indeed, it is the leading cause of child death in the world. The millennium development goal target of reducing the infant mortality rate by two-third by 2015 has renewed interest in accurate assessment of the number of children affected and underlying causes. A paper in the world health organization (WHO) bulletin reviews the history and current status of knowledge on pneumonia in infants. The 1993 world development report estimated the proportion of childhood deaths caused by acute respiratory infections at around 30%⁴.In Karnataka, age distribution of prevalence rate of major killer disease like aspiration pneumonia is 5% among infants this suggest that of every thousand children’s born alive 12-20 die from pneumonia before their fifth birthday⁵. Patients who aspirates have 3times higher mortality than patients do not aspirate. The strongest predictors of aspiration pneumonia are unconscious patients, patients with cerebro vascular disease, tracheostomy, chronic obstructive pulmonary disease, bronchitis, bronchial asthma and lung cancer. Weakest predictors of aspiration pneumonia are patients with viral infection, tonsillitis, pharyngitis, and laryngitis^6.

Every year 1.9 million children under five years of age die from bronco pneumonia. Indeed, it is the leading cause of child death in the world. The millennium development goal target of reducing the less than five mortality rate by two-third by 2015 has renewed interest in accurate assessment of the number of children affected and underlying causes. A paper in the world health organization (WHO) bulletin reviews the history and current status of knowledge on pneumonia in children’s among under fives. The 1993 world development report estimated the proportion of childhood deaths caused by acute respiratory infections at around 30%⁷. Hence the investigator personally felt that providing of adequate knowledge regarding aspiration pneumonia to mothers of infants is very essential.

OBJECTIVES OF THE STUDY:

1. To assess the knowledge of mothers of infants on aspiration pneumonia.

2. To associate the knowledge with selected demographic variables

3. To develop an information booklet.

MATERIAL AND METHODS:

Quantitative non experimental approach with descriptive survey design was selected for study. Approval from the Medical Superintendent of the selected hospital was obtained. 60 mothers of infants were selected through non-probability convenient sampling. Before the study, participants were informed verbally about the aim of the study; Any doubts or questions raised by the participant were clarified. It was mentioned that they could withdraw from the study at any time; Then informed consent was obtained. To protect the privacy, confidentiality, and the identity of the participants, the study included the mothers of infant having less than one year child, who are responding and interested to participate, and available at the time of the study. Exclusion criteria were Child above 1 year of age, Infants who are affected with diseases other than aspiration pneumonia.

Data collection tools and technique:

Mother’s knowledge regarding aspiration pneumonia was assessed by using structured questionnaires, the structured self administered questionnaire was constructed in two parts.

Part I: Includes 10 aspects related to the demographic variables of respondents about age, number of child, religion, place of stay, type of family, educational status of mother, occupation of mother, birth order of child, family income, and source of information.

Part II: Consists of 25 questions classified under 5 aspects related to knowledge on Aspiration pneumonia.

· Definition and general concept of aspiration pneumonia

· Causes & incidence for aspiration pneumonia

· Signs & Symptoms of aspiration pneumonia.

· Diagnosis and management of aspiration pneumonia

· Prevention & complication of aspiration pneumonia.

Development of an Information booklet:

The information booklet was developed based on the review of the related research and non research literature, objectives of the study and analysis result of the obtained data.

RESULTS:

Section A: Description of demographic variables of the sample

Table 1 Demographic variable shows that maximum, sample belongs 21-25 (48.3%) years of age group, Hindu religion (58%), urban residents (52%), nuclear family (57%), economic status under Rs-10k-20k (93%), having one child (52%),below graduated education (42%), electronic media as a source of information(37%), house wife occupation (62%), first birth order of baby (57%).

Table 1: Description of sample characteristics (n = 60)

Sl. No	Demographic Variables	Frequency	%
1.	Age in years
	a. 18-20	10	16.7
	b. 21-25	29	48.3
	c. 26-30	19	31.7
	d. Above30	2	3.3
2.	Religion
	a. Christian	10	16.7
	b. Hindu	35	58.3
	c. Muslim	15	25
3.	Residence
	a. Rural	29	48.3
	b. Urban	31	51.7
4.	Family
	a. Joint	26	43.3
	b. Nuclear	34	56.7
5.	Economic status
	a. Rs5000-10000	0	0
	b. Rs10000-20000	56	93.3
	c. Rs20000-30000	2	3.3
	d. AboveRs30000	2	3.3
6.	Education Status of Mother
	a. HS	9	15
	b. PE	25	41.7
	c. PG	09	15
	d. PU	01	1.7
	e. UG	16	26.7
7.	Number of Children
	a. 1	31	51.7
	b. 2	21	35
	c. 3	08	13.3
8.	Source of Information
	a. EM	22	36.7
	b. F&R	18	30
	c. HP	13	21.7
	d. PM	7	11.7
9.	Occupation of Mother
	e. FW	03	5
	f. HW	37	61.7
	g. PE	20	33.3
10.	Birth order of baby
	h. First	34	56.7
	i. Second	20	33.3
	j. Third	06	10

Section B: Distribution of sample according to knowledge levels regarding aspiration pneumonia.

Table 2: shows that 60% had moderate knowledge, 40% had inadequate knowledge and zero percentage of respondents had adequate knowledge.

Knowledge levels	Frequency	Percentage
Inadequate (0-12)	24	40
Moderate (13-20)	36	60
Adequate (21-25)	0	0
Total	60	100

Table 3: The data presented in this table shows that knowledge score was in the range of 9-20. The data also reveals that knowledge score mean 13.24.the median value is 13.

Knowledge score	Range	Mean	Median	SD
Knowledge score	9-20	13.24	13	2.66

Section C: Association between knowledge levels with demographic variables.

Table 4: Shows that there was a significant association knowledge scores (χ2=17.14,P=0.0002) with Religion of the mother, (χ2=48.42, P<0.0001) Educational status of mother, (χ2=19.37,P=0.0007) Sources of information and (χ2=13.98, P=0.0009) Occupation of mother.

Sl No	Variables	X²value	df	Table value	P value	Inference
1	Age in years	6.58	3	7.82	P>0.05	Not significant
2.	Religion	17.14	2	17.14	P=0.0002	Significant
3.	Place of residence	1.88	1	3.84	P>0.05	Not significant
4.	Type of family	0.69	2	5.99	P>0.05	Not significant
5.	Economical status of family	1.44	2	5.99	P>0.05	Not significant
6.	Educational status of mother	48.42	4	23.51	P<0.0001	significant
7.	Number of children in family	2.09	2	5.99	P>0.05	Not significant
8	Sources of information	19.37	4	19.37	P=0.0007	significant
9	Occupation of mother	13.98	2	13.98	P=0.0009	Significant
10	Birth order of baby	5.21	2	5.99	P>0.05	Not significant

DISCUSSION:

Many of the study reported that mothers of infants are having moderate level of knowledge regarding aspiration pneumonia. A study by D. Simyu et al (8) conducted to assess the mothers' knowledge, attitudes and practices regarding aspiration pneumonia in children in Baringo district, Kenya. A total of 309 mothers we interviewed. Their mean age was 31.5 years (range 16-51) and 34% had no formal education. Only 18% of mothers described pneumonia satisfactorily. 60.2% knew that measles is preventable by immunization. 87.1% of the mothers said they would seek health center services for severe ARI. Formal education had a positive influence on the KAP of the mothers: The study reveals that the mothers had good knowledge of mild forms of ARI but not the severe forms like aspiration pneumonia.

S. Uwaezuoke et al (9) conducted a study to determine maternal perception of pneumonia in Enugu, eastern Nigeria. 400 women were interviewed using a pre-tested structured questionnaire. Sixty-one percent of them would recognize pneumonia by difficult breathing, 42% by fast breathing and 26.5% by severe cough. Few of the mothers mentioned signs suggestive of 'chest in drawing' (8.5%) and 'central cyanosis' (1%). The maternal knowledge score on pneumonia signs increased significantly with educational status and social class (p < 0.05).

S. fuchg et al (10) conducted a study among mothers to assess the knowledge and recognition of aspiration pneumonia. The study population consists of 501 mothers. The findings show that about 84% of the mothers said that they knew what aspiration pneumonia is.68.7% said that pneumonia is caused by lack of parenteral care.28.9% believed that virus causes the disease. More than 80% correctly picked rapid breathing and chest retractions from a list of possible signs and symptoms of pneumonia.

CONCLUSION:

The following conclusions are drawn from the study:

1. Majority of the mothers participated in the study have moderate knowledge on aspiration pneumonia and its prevention. The study was based on the Pederson’s health promotion model. It provides a comprehensive frame work for assessment of knowledge of mothers regarding aspiration pneumonia and its prevention and to develop an information booklet.

2. The research approach used is descriptive study and the samples were selected by using non probability convenient sampling technique. Data was collected by means of structured questionnaire and analyzed, interpreted by applying statistical methods.

IMPLICATIONS OF THE STUDY:

The findings of the study have implications for the nursing profession. The implications have been written under the following headings-nursing practice, nursing administration, nursing education, nursing research and general education in schools and colleges.

Nursing Practice:

· It can be included in the health educational programme, which should be carried out in hospitals, anganwadis, and in community.

· Teaching family members to provide children with a secure and healthy home environment to avoid risk of aspiration pneumonia or other respiratory infections.

· Nurses can motivate post natal mothers to have healthy practice in order to prevent pneumonia like infections as they frequently encounter them in clinical settings.

Nursing Education

Nursing curriculum is responsible for preparing future nurses with emphasis on curative, preventive and promotive health practices.

· Nurse educators should give more importance to Aspiration pneumonia and its prevention as they are dealing with postnatal mothers, who are future nurses and need to have adequate knowledge in educating and preventing the community from infectious disease like pneumonia.

· Need to conduct in-service education for nurses and health workers.

· As a nurse educator, there are abundant opportunities for nursing professionals to educate mothers on the importance of prevention of home tragedies among under five children.

· This study adds to the nursing knowledge as it provides information about knowledge and practice of mothers on prevention of aspiration pneumonia.

Nursing Administration

· Community health administration authorities should take initiates nurses or other health personnel for educating mothers on prevention of aspiration pneumonia and also to prevent home tragedies of under five children.

· Nursing administrator in hospitals, in the community and in education can organize and conduct health awareness campaigns by using common and simple methods.

· Nursing administrators can bring awareness among the public in general and specific focus groups regarding nature and prevention of aspiration pneumonia.

· Nursing administrators can organize staff development programmes for nurses to update their knowledge regarding prevention of aspiration pneumonia.

· The nursing administrator can mobilize the available resource personnel towards health education for mothers on prevention of aspiration pneumonia.

Nursing Research

· This study helps nurse researchers to develop appropriate health education tools for educating mothers on prevention of aspiration pneumonia according to their demographic, socio-economic, cultural and political characteristics.

· So far only few studies have been conducted on knowledge and practice of mothers about prevention of aspiration pneumonia. This study revealed that there is a dearth of knowledge among mothers which needs further research to explore it.

RECOMMENDATIONS:

· A similar study may be conducted on a larger sample for a wider generation.

· A study can be done to evaluate the effectiveness of structured teaching programme on prevention of aspiration pneumonia.

REFERENCES:

1. A. Parthasarathy, P.S.N Menon, Piyush Gupta, M.K.C Nayar” Text book of Pediatrics” 4th edition. New Delhi: Jaypee brother’s Publishers;2009; pno 578.

2. S. Balakrishnan. Lipoid Pneumonia in Infants and Children in South India. British Medical Journal. 1973_Nov; vol 4(5888); 329–331.

3. International child disease and developmental research.” Health and Science Bulletin”; 4(2); June 2006.

4. WHO Bulletin” Global estimate of clinical incidence of clinical pneumonia among children under five years of age”;2004.

5. Agnihotrao, V. Ramana kumar, etal.” Respiratory disease burden in rural India”:2005.

6. Noe KH, Tapsell LM, Drazkowski JF,” Epilepsy and Pneumonia “The American Journal on Pediatrics 2010 Nov 29 11;4(11):pg 77-76

7. WHO Bulletin” Global estimate of clinical incidence of clinical pneumonia among children under five years of age”;2004.

8. Simyu D. E, Wafula E.M, Nduati R.W.” Mothers knowledge, attitudes and practices regarding acute respiratory infections in children”. East African medical journal:2003;June;80(6):303-7.

9. Uwaezuoke SN, Emodi IJ, Ibe BC.” Maternal perception of pneumonia in children”. Annals of Tropical Paediatrics:2002 Sep; 22(3):281-5.

10. S. fuchg.” The burden of pneumonia in children in Latin America”. Pediatric respiratory review: vol 6; 2000.

Received on 19.11.2019 Modified on 10.12.2019

Int. J. Nur. Edu. and Research. 2020; 8(1):109-113.

DOI: 10.5958/2454-2660.2020.00023.X