INTRODUCTION:

Today’s children are tomorrow’s citizens. Childhood is a very special and vulnerable period of life.¹Children are the inheritance from GOD. They are like clay in a potter’s hand. So they should be handled with love and care².Childrenare more curious to learn about their surrounds and have inability to recognize the dangers of their activities.

Children’s exploring nature makes them at high risk of unintentional injury like choking and may lead to the serious danger³. They are in a continuous process of growth and development. Any alteration in its course leads to developmental disorders.⁴

Choking occur when something stuck in the airway, making child unable to breath. If the airway is partially blocked, child can still breathe, cough loudly and body tries to clear the airway by coughing. If child’s airway is completely blocked, child cannot breathe, having difficulty in coughing and airflow into and out of the lungs will be blocked and the brain does not get enough oxygen, choking can become a life-threatening emergency.⁵

Common causes of choking are foods such as hot dogs and grapes, peanuts, other nuts, popcorn, watermelon seeds, dried peas. Nonfood items includes marbles, round toys parts, safety pins, buttons, latex balloons. Choking is a life-threatening condition which requires immediate action.⁴ Rapid and right intervention can limits the incidence of choking.⁵Hands-on skill training program isthe systematically organized program in which the mothers of children are educated, demonstrated and allowing to redemonstrate the first aid for choking. first aid care is initial support provided to child in the medical emergency.⁶ In mild airway obstruction, advice the child to cough because coughing generates high and sustained pressure which may expel the stucked object.⁷ If the child is under 1 year of age and is not able to cough and cry, clear blocked airway quickly by chest thrust and back thrust. If the child is above 1 year of age, clear blocked airway by Heimlich maneuver.⁸Mother is an important care provider and she is more responsible to improve the safety of the children. ¹Parents and caregiver should also be aware of food and other objects that could be choking hazards. All toys should be carefully inspected for danger. As soon as infant crawl or play on floor then floor must be keep clean and take all small article that can be picked and swallowed, like coins, buttons, removable toys and sharp object should be keep away from child reach. Do not give food which may lead to choking such as hard candy, nuts, seeds and raw carrots. Additionally, guardian must know about the first aid for choking by giving back thrust, chest thrusts and Heimlich maneuver⁹. lndia contributes about 1 million under fives death to the global burden, in India it is 53/1000 live births, in Karnataka 45/1000 lives births, a high rate that has not declined much in the recent past.¹⁰Health care is one of the most important of all human endeavors to improve the quality of life. Health must meet the need of the people, as they perceive them¹¹. Children are the most important segments for a nation for the optimal physical, mental, emotional development of its future worthy citizens. i A nation’s health depends on the healthy citizen.¹²

RESEARCH STATEMENT:

A quasi-experimental study to assess the effectiveness of hands-on skill training program on knowledge and skills on first aid for choking among mothers of children in selected community areas of district Mohali, Punjab.

OBJECTIVES:

a) To assess the pre-test level of knowledge score on first aid for choking among mothers of children in both experimental and control group.

b) To assess the skills on first aid for choking among mothers of children in both experimental and control group before hands-on skill training program.

c) To plan and conduct hands-on skill training program on first aid for choking among mothers of children in experimental group.

d) To assess the post-test level of knowledge score on first aid for choking among mothers of children in both experimental group and control group.

e) To assess the skills on first aid for choking among mothers of children in both experimental group and control group after hands-on skill training program.

f) To evaluate the effectiveness of hands-on skill training program on level of knowledge score on first aid for choking among mothers of children.

g) To evaluate the effectiveness of hands-on skill training program on skills on first aid for choking among mothers of children.

h) To find the correlation between level of knowledge score and skills on first aid for choking among mothers of children.

i) To associate the research findings with selected socio-demographic variables.

OPERATIONAL DEFINITIONS:

Effectiveness:

It refers to the extent to which hands-on skill training program has achieved the desired outcome.

Hands-on skill training program:

It refers to the systematically organized program in which the mothers of children are educated, demonstrated and allowing to redemonstrate the first aid for choking.

Knowledge:

It refers to the appropriate response to items included in structured knowledge questionnaire on first aid for choking.

Skills:

It refers to the mother’s ability to redemonstrate back thrust, chest thrusts and Heimlich maneuver which will be assessed by checklist.

First aid for choking:

It refers to back thrust, chest thrusts and Heimlich maneuver.

Mothers:

It refers to mother’s having children less than 5 years of age.

METHODOLOGY:

Research approach:

A quantitative research approach was adopted for the study.

Research Design:

Quasi-experimental research design was considered appropriate for the study.

Setting of The Study:

Study was conducted in Village Ballo Majra, Mohali and Bad Majra Mohali.

Target Population:

Target Population comprised of mothers having children less than 5 year of age of Ballo Majra, Mohali and Bad Majra, Mohali, Punjab.

Samplingtechnique:

Non probability purposive sampling technique was used for the study.

Criteria For Sample Selection:

The inclusion as well as exclusion criteria used for the present study is as follow:

Inclusion criteria:

The study was includes the mothers of children less than 5 year of age in Village Ballo Majra and Bad Majra, district Mohali, Punjab:-

1. who were willing to participate in the study.

2. who were available during data collection period.

3. who were able to read and write Hindi or Punjabi.

Exclusion criteria: The study was exclude the mothers:-

1. who were not willing to participate in the study.

2. who were not able to read and write Hindi or Punjabi.

Development of Tool:

The tool consisted of three sections. Section I consisted of selected socio-demographic variables and section II consisted of Structured knowledge questionnaire and section III consisted of Checklist.

Section I: Socio- demographic variables

This section consists of 8 variables such as age of mother, age of youngest child, gender of youngest child, educational status of mother, working status of mother, monthly family income (in rupees), type of family, history of choking incidence in child.

Section II: Structured knowledge questionnaire

This section consists of 12 items to assess the knowledge of mothers on first aid for choking.

Section III: Checklist

It consists of 14 steps to assess the skills on first aid for choking among mothers of children.

RESULT:

Section I: Frequency and percentage distribution of mothers of children according to their socio demographic variables:

In experimental group, majority of mothers 11(37%) were in age group of 20-25 years, majority of children 17(57%) were in the age group of 2-3 year, 16(53%) were girls, 12(40%) mothers educational status level were up to higher secondary level, 21(70%) were employed, 10(43%) of mothers were having 20,001- 30,000, 18(60%) of mothers were from joint family, 15 (50%) of mothers have encountered choking incidence in their child and majority of mothers 10(33%) were give neck thrusts to their child.

In control group, majority of mothers 12(40%) were in age group of 32-37 years, 11(37%) were in the age group of 2-3 year and 11(37%) were in the age group of 4-5 years, 16(53%) were boys, 16(53%) mothers educational status level were no formal education, 29 (97%) were home maker, 18(60%) of mothers were having <10,000 monthly family income, 16(53%) of mothers were from joint family, 18(60%) of mothers have encountered choking incidence in their child and majority of mothers 10(33%) were give neck thrusts to their child.

Section- II:

Table 2.1:- Frequency and percentage distribution of pre- test level of knowledge score on first aid for choking among experimental and control group. N=60

Level of knowledge	Knowledge score	Pre-test level of knowledge
Level of knowledge	Knowledge score	Experimental group (n_e= 30) f (%)	Control group (n_c= 30) f (%)
Poor	1-4	20 (66.7%)	18(60%)
Average	5-8	10 (33.3%)	12(40%)
Good	9-12	0 (0%)	0(0%)

Table 2.2: Frequency and percentage distribution of skills on first aid for choking among experimental and control group before hands-on skill training program. N=60

Level of skills	Skills score	Before hands-on skill training program on skills
Level of skills	Skills score	Experimental group (n_e= 30) f (%)	Control group (n_c= 30) f (%)
Poor	1-4	12 (40%)	11 (36.7%)
Average	5-8	18 (60%)	18 (60%)
Good	9-14	0 (0%)	1(3.3%)

Table 2.3: Frequency and percentage distribution of post- test level of knowledge score on first aid for choking among experimental and control group. N=60

Level of knowledge	Knowledge score	Post-test level of knowledge
Level of knowledge	Knowledge score	Experimental group (n_e= 30) f (%)	Control group (n_c= 30) f (%)
Poor	1-4	0 (0%)	13 (43.3%)
Average	5-8	3(10%)	16 (53.3%)
Good	9-12	27 (90%)	1 (3.3%)

Table 2.4: Frequency and percentage distribution of skills on first aid for choking among experimental and control group after hands-on skill training program N=60

Level of skills	Skills score	After hands-on skill training program on skills
Level of skills	Skills score	Experimental group (n_e= 30) f (%)	Control group (n_c= 30) f (%)
Poor	1-4	0 (0%)	11(36.7%)
Average	5-8	1 (3.3%)	17 (56.7%)
Good	9-14	29 (96.7%)	2 (6.7%)

Table 2.5:- Comparison of pre-test and post-test level of knowledge score on first aid for choking in experimental and control group

N=60

Level of knowledge	Experimental group n_e= 30		Control group n_c= 30
Level of knowledge	Pre-test f₁(%)	Post-test f₂(%)	Pre-test f₁(%)	Post-test f₂(%)
Poor	20 (66.7%)	0 (0%)	18 (60%)	13 (43.3%)
Average	10 (33.3%)	3 (10%)	12 (40%)	16 (53.3%)
Good	0 (0%)	27 (90%)	0 (0%)	1 (3.3%)

Table 2.6:- Comparison of before and after hands-on skill training program on skills on first aid for choking in experimental and control group N=60

Level of skills	Experimental group n_e= 30		Control group n_c= 30
Level of skills	Before hands-on skill training program f₁(%)	After hands-on skill training program f₂(%)	Before hands-on skill training program f₁(%)	After hands-on skill training program f₂(%)
Poor	12(40%)	0 (0%)	11 (36.7%)	11 (36.7%)
Average	18 (60%)	1 (3.3%)	18 (60%)	17 (56.7%)
Good	0 (0%)	29 (96.7%)	1 (3.3%)	2 (6.7%)

Table 3.3: Effectiveness of hands-on skill training program on level of knowledge score among experimental and control group during pre-test and post-test on first aid for choking N=60

Test	Group	Mean	Median	S.D	Unpaired t test
Pre-test	Experimental group	4.13	4	1.306	0.317 Non significant
Pre-test	Control group	4.23	4	1.135	0.317 Non significant
Post-test	Experimental group	9.90	10	1.125	13.707 Significant
Post-test	Control group	4.83	5	1.683	13.707 Significant

NS: Non-significant *Significant at p<0.05 level

Table 3.4: Effectiveness of hands-on skill training program on skills among experimental and control group during before and after hands-on skill training program on first aid for choking N=60

Test	Group	Mean	Median	S.D	Unpaired t test
Before hands-on skill training program	Experimental group	4.77	5	1.431	0.791 Non significant
Before hands-on skill training program	Control group	5.07	5	1.507	0.791 Non significant
After hands-on skill training program	Experimental group	11.20	11	1.495	13.698 Significant
After hands-on skill training program	Control group	5.37	6	1.790	13.698 Significant

NS: Non-significant *Significant at p<0.05 level

Section- IV

Table 4:- Correlation between pre-test level of knowledge score and skills on first aid for choking N=60

Research variable	Mean	Standard deviation	Karl Pearson correlation	Inference
Knowledge	4.13	1.306	0.073	Not significant
Skills	4.77	1.431	0.073	Not significant

SECTION- V

Table 5.1:- Association of pre-test level of knowledge score on first aid for choking with selected socio-demographic variables

There is significant association of pre-test level of knowledge on first aid for choking with educational status of mother and monthly family income (in rupees). Hence hypothesis (H₆) is accepted for socio-demographic variable such as educational status of mother and monthly family income (in rupees) and rejected for age of mother, age of youngest child, gender of youngest child, working status of mother, type of family, have you ever encountered any choking incidence in your child.

Table 5.2:- Association of skills on first aid for choking with selected socio-demographic variables before hands-on skill training program

There is significant association before hands-on skill training program on skills on first aid for choking with type of family. Hence hypothesis (H₇) is accepted for socio-demographic variable such as type of family and rejected for age of mother, age of youngest child, gender of youngest child, educational status of mother, working status of mother, monthly family income (in rupees), have you ever encountered any choking incidence in your child.

IMPLICATIONS

Nursing practice

-Heimlich maneuver, back thrusts and chest thrusts are the method of first aid for choking which helps mother to provide first aid for their children in choking emergency. These methods are effective to prevent choking incidence.

-Nurses in the hospital setup, they can use the research based evidenced in educating the mothers, parents about the methods of first aid.

Nursing Education:

These methods of first aid for choking were included in the nursing curriculum. Students were educated regarding the methods of first aid for choking, so that students can educate the mothers about these methods and how they can prevent choking incidences in their child in the community setup.

Nursing Administration:

-The administration can draw written policies and protocol in colleges and hospital regarding the method of intervention to provide first aid for choking. So, students can give education and demonstration on first aid for choking to parents in hospital and also in community areas.

-Evidenced based practice for staff nurses and student nurses, hands-on skill training workshop should be provided to expert them with the techniques. So that they can educate and demonstrate mothers, parents regarding the first aid measures.

Nursing Research:

Nurses need to be actively engaged in all phases of research process, to address ongoing nursing practices. The present study information can be used by future researchers. The present study can be the source of review of literature for others who are conducting studies on similar topics.

REFERENCES:

1. 3002109jeethukr.pdf [Internet]. [cited 2020 Jun 4]. Available from: http://repository-tnmgrmu.ac.in/2061/1/3002109jeethukr.pdf

2. AG Harikiran et.al., (2008) Department of Preventive and Community Dentistry, Pp236-242.

3. Abdullah Ferye, G. Engere L. Better “Patient Care Through Nursing Research”, The Mac Million Company, (1965) Pp.:667-668

4. Active Behaviour | Learning and Development | Teach Early Years [Internet]. [cited 2019 May 23]. Available from: https://www.teachearlyyears.com/learning-and-development/view/active-behaviour

5. Prevent Choking in Babies and Young Children: For Child Care Providers [Internet]. HealthLink BC. 2016 [cited 2019 May 22]. Available from: https://www.healthlinkbc.ca/healthlinkbc-files/prevent-choking-baby-child

6. Choking Prevention for Children [Internet]. [cited 2020 Jun 4]. Available from: https://www.health.ny.gov/prevention/injury_prevention/choking_prevention_for_children.htm

7. Al-Johani AA., Sabor S, Aldubai SA. Knowledge and practice of first aid among parents attending Primary Health Care Centers in Madinah City, Saudi Arabia, A Cross Sectional Study. J Fam Med Prim Care. 2018;7(2):380–8.

8. Definition of Hands-on Training | Bizfluent [Internet]. [cited 2019 May 22]. Available from: https://bizfluent.com/about-5076464-definition-handson-training.html

9. Contributor NT. Choking 2: foreign-body airway obstruction in infants and children [Internet]. Nursing Times. 2019 [cited 2020 Jun 20]. Available from: https://www.nursingtimes.net/clinical-archive/critical-care/choking-2-foreign-body-airway-obstruction-in-infants-and-children-02-01-2019/

10. First aid for a baby who is choking [Internet]. BRC Site name. [cited 2020 Jun 4]. Available from: https://www.redcross.org.uk/first-aid/learn-first-aid-for-babies-and-children/choking-baby

11. Choking is a leading cause of injury and death among children [Internet]. ScienceDaily. 2019 [cited 23 May 2019]. Available from: https://www.sciencedaily.com/releases/2010/02/100226212559.

12. Nesrin N. Abu Baker, Huda F. Ghsaraibeh, Haya M. Alzoubi. Mothers knowledge and practices of managing minor illnesses of children underfive years. Journal of research in nursing 2012 Nov; 18(7): [651-666].

13. Htm Bose Nirmal Kumar, Tribal Life in India, National Book Trust, New Delhi, 1977.

14. Centre for Community Child Health 2006, Behavior Problems pp 8, Downloaded from www.raisingchildren.net.au

15. T. Baskar Rao MD, DPH. A text book of community medicine 1st ed. Hyderabad: Paras medical Publishers; 2004.

Received on 12.01.2023 Modified on 29.04.2023

Int. J. Nur. Edu. and Research. 2023; 11(3):259-263.

DOI: 10.52711/2454-2660.2023.00059