Knowledge regarding Prevention of Home Accidents among mothers of under five children in Pediatric Department, Bangalore.

INTRODUCTION

Child is the most precious possession of mankind most loved and perfect in its innocence Fragile, helpless, completely dependent on its caretakers, Before entring to the world, the fetus is safe in mother’s womb but the moment the infant enters the world in an uncertain place, where environment should be a safe heaven for the child to grow free from any hazards, although the surrounding at times be dangerous. Children are to be cared and protected from environmental hazards.^1,2 In today’s world, both developed as well as the developing countries, danger prevails not only on the roads, but also exists in the home and playgrounds. Accidents are one of the five leading cause of death in developing countries yearly. 10% of children suffer for accident for which it is necessary to contact the health care services.³ In childhood injury mortality at home is greater than other childhood diseases, because Home accidents occur as an unexpected, unplanned event which usually produces death or damage. Common home accidents include burns, falls, drowning, poisoning, suffocation, injury by sharp objects etc.^2,4

According to the World Health Organization every year about, 830,000 children die from home accidents worldwide. This corresponds to 2,000 child deaths in a day. In addition, majority of children (millions) have been referred to hospital due to home accident-related to injuries, eventually resulting in permanent disabilities.⁵ The Center for Disease Control (2011) observed that home accidents make up the third leading cause of emergency department visits in the USA and in the United Kingdom it is noted that 40% of all accidents occur at home whiles 2,700,000 people get treatment relating to home accidents. Similarly, 7,000 deaths are recorded annually due to home accidents.6 In India around one million children die each year of home accidents and injury was one of the third leading causes of death responsible for (11%) of all deaths, after diarrhoea (18%) and pneumonia (17%). The overall under fives mortality rate due to home accidents was estimated at 39.5 per 100 000 per year in India. Drowning (22%), road traffic injuries (12%), burns (11%) and (10%) were the most common types of accidents. The mortality rate was as twice as high in rural areas (32 per 100000) compared to the urban areas (15 per 100 000).⁷

A Cross-sectional study conducted among Nepale mothers of Parsa district. The result showed that 96% cases of Poisoning is the cause of childhood accident unintentionally, followed by 94% foreign body aspiration, 85% flame burn. Unsupervised children are more prone to injury than supervised children. The parent’s level of awareness of cause of childhood accident among children of under-five, (58%) has inadequate level of knowledge, moderately adequate (32%) and adequate (10%)8 .Another study conducted in JIPMER, Pediatric Medical OPD department, Puducherry. The result revealed 63% of mothers had inadequate knowledge, 36% had moderately adequate and 1% mothers had adequate knowledge on prevention and management of accidents.9 A study on mothers knowledge about home accidents and prevention among pre- schoolers in rural area Sharkia . The majority of the mothers (84.7%) reported that the child had suffered an injury at home. Cut/wound represented the highest percentage of home injury (37.3%) followed by fall (29.3%), burn (12%), animal bite (3.3%) then poisoning (1.3%).10 One more study conducted in Aligarh, depicted (53.4%)of injuries were due to fall, sharp injuries (11.6%) and burns were (10.7%). accidents due to electrocution and drowning were(1.0%).¹¹

As observed from the above literature, one of the fundamental rights of every child is to grow in a healthy home. Ordinary household items can be very hazardous to young children at home, so it is utmost important for parents in our communities to educate about prevention of home accidents. Henceforth the researcher decided to investigation the prevalence of home accidents among under five children in Bengaluru.

OBJECTIVES

1) To assess the knowledge regarding prevention of home accidents among mothers of under five children

2) To find out the association between knowledge of mothers regarding prevention of home accidents with their selected socio-demographic variables.

METHODOLOGY

The study was structured within the frame of the Descriptive approach with Non experimental quantitative design. A sample of 60 mothers of underfive children attended pediatric department of the selected hospital, Bengaluru. Samples were selected through non-probability convenience sampling technique who could speak and write kannada or English. Data collection tool consisted of a structured Questionnaire collected with the help of various sources like books, journals, articles, internet and among other publications. The initial draft was sent to 8 experts chosen according to their experience and expertise in the related fields to evaluate the questions in terms of relativity, simplicity and importance. The needed modifications as per their opinions and valuable suggestions, the tool was refined and modified in the final tool.

The tool was divided into 2 parts: Part1: Sociodemographic characteristics of the mother and child. Part 2: Structured Questionnaire to collect Knowledge regarding prevention of home accidents among mothers of under five children consists of 26 MCQs on various aspects such as burns, drowning, fall, electric shock, poisoning includes kerosene/chemicals, foreign bodies in eye/ear/nose, injury. Each correct answer was given one mark and every wrong answers was scored 0, total score was 26. The score was categorized and interpreted as Inadequate Knowledge (0-13), Moderate Knowledge (14-19) and Adequate Knowledge (20-26).

Prior to collection of data formal permission was obtained from the selected hospital, Bangaluru. Nine fourth year B.Sc. (N) students introduced themselves obtained Informed consent from the mothers after assuring confidentiality and anonymity; the data collection took one week with average time taken by each mother to respond was 20- 30 minutes.

DATA ANALYSIS

The data were collected, tabulated, and analyzed using SPSS version 17.0 Descriptive statistics were presented as frequency, percentage. Inferential statistics Chi square test were used to find out the statistically significance at the P value <0.05.

RESULTS 

I.A]Description of Socio-demographic Characteristics of mother

The study result revealed that 41.7% of mothers belong to the age group of 26-30 years, 31-35 years (40.0%), majority (78.3%) of them were Hindus, 98.3% of the mothers were married while 1.7% were widow, More than half (71.7%) of mothers belong to nuclear families, 61.7% of them resides in urban, less than half (41.7%) were graduates, No formal education were 5%. it was noticed that more than half (65%) of mothers were home maker, 48.3% of the family income were < = 25,000.

B] Description of Socio-demographic Characteristics of child

The study analyzed the age of the child (43.3%) belong to the age group 3-4 years, whereas 41.7% belongs to the age group of 1-3years, majority (63.3%) of the child were male, 70% of the children had 1or 2 siblings

Fig 1: Depicts that less than half (40%) of the mothers had their children suffered from home accidents and rest 60% of the mothers reported either did not have any occurrence of home accidents or mothers can’t remember.

Fig 2: Indicates the most prevalent type of home accidents were cuts & wounds 45.83 %, fall 41.66% and Burns 12.50%.

The study also sought to project the frequency of the occurrence of home accidents 45.33% of mothers reported occurrence only once, whereas 33.33% twice and 20.83% more than three.

Fig 3: States the treatment of the child 41.66% of mothers were treated at home whereas, 29.16% at private hospital and 8.33% at PHC.

The study also investigated the sources of information about prevention of home accidents. It was indicated that out of 60 mothers only 20 received information through some mode, rest of them were nil and it is revealed that 30% of them gained information through T.V and newspaper, 25% of them depend on social media to obtain information and10% through friends/relatives.

II. Assess Knowledge regarding prevention of home accidents among mothers of Under-five children (fig 4)

III. Association between Knowledge regarding prevention of home accidents among mothers of under five children with their social demographic variables

Findings of the study results showed there was no significant association between mothers knowledge and the selected variables like age, religion, family type, marital status, residence, education status, occupation and income ( P <0.05).Whereas there is significant association found to exist between gender of the child and knowledge of mothers P <0.05

DISCUSSION

The finding of the present study reveals the age analysis of mothers age group 26-35 years makes up (81.7%) This result approximate with another study conducted in aligarh (India) were majority (91%) of mothers were in the age group of 20- 35 years (11). The current study depicted the religious status of the mother (78.3%) were Hindu’s which was contracted by another studies reported 65.0% were from Muslim families and rest 35.0% were from Hindu families.¹¹ this shows that the data collected from the mother depends on the places where they live. From the study 98.3% of the mothers were married while 1.7% widow, Which was contradicted by study reported 73.3% were married and 26.7% were singles, hence we can deduced from the results the study majorly constitute married couples¹². With regards to the type of family (71.7%) of mothers belong to nuclear families which is further noticed by a study conducted in India reported (55.0%) of mothers belong to joint families.¹¹ This is not surprising since it seems to validate the national statistics of household as stated by the GLSS (2012). The study examined the educational background of the mother noticed that (95%) of the mothers had some level of education, while 5% had no formal education. Similar results were obtained by other researcher stated 90.4% mothers had some sort of education were as 9.6% of them were illiterate¹³ on the other hand this finding disagrees were 23.3% of mothers were highly educated and 31.8% were illiterate.¹⁴ The study explored the occupational status of mother noticed that (65%) were home maker. This result goes in the same direction with the other studies conducted by^14,11,2, reported (60%), (73.1%), and (79.56%) respectively were homemakers. Regarding the income status of the family 48.3% of their income is < = 25,000. Another study indicated (45.31%) had a family income 5000 – 10000 Riyal per month15 which was also contracted by a another study found that 60% had low income.¹²

The findings on the socio demographic profile of the child indicates 56.7% are from the age group of 0-3years. Another study conducted in Chennai indicated (56%) children are < 3 years. which is accurate to the current findings, hence we can conclude that home accidents are more common in the age group <3.16 It is noticed from the results that majority (63.3%) of the mothers had male children while minority had female children (36.7%).This results approximate with other studies conducted in Egypt 63.7% of the mothers had male children and (36.3%) had female children¹⁴. The current study shows (40%) of the mothers had their children suffered from home accidents and rest 60% of the mothers reported NO. This is in disagreement with the findings of .15 about 60% of the child had history of home accidents and 40% said No. Furthermore, the study sought to inquire the most prevalent type of home accidents indicated that cut & wounds 45.83 %, fall 41.66% and Burns 12.50%. This result was similar to that of a study conducted in Egypt, common accidents was cut/wound (48%) followed by fall/fracture (36%) and burn (11.9%) respectively¹⁴. this is an indication that cut/wounds are the most prevalent home accidents among under-five children. the frequency of the occurrence of home accidents the study projected 45.33% of mothers reported occurrence only once, However it was contracted by another study (56.7%) mothers reported home accidents occurred twice¹². With regards to the treatment of the child the study stated 41.66% were treated at home, 29.16% at private hospital, but the study conducted in Tripura reported (33%) were treated at home² . From the study it reveals that 30% of the mothers gained information through T.V and newspaper, 25% of them obtain information through social media and 10% through friends/ relatives, which was contradicted by another study, stated 63.28% gained information through social media, 35.94% through T.V, 25.78% through friends and relatives.¹⁵

The current study represents mothers knowledge were majority 63.3% of mothers had inadequate knowledge, 35% moderate knowledge and 1.7% had adequate knowledge, this result approximate with another two studies found that (35.9%) had Inadequate knowledge, (54.3%) moderate knowledge and (9.8% )adequate knowledge.15 (96.1%) of mother had moderate knowledge, while 3.9% had inadequate level of knowledge.¹¹

The present study showed there was no significant association found to exist between mother’s knowledge and socio demographic variables at the significant level ( P <0.05). Whereas there is significant association found to exist between genders of the child

(x2 =6.12, p <0.04) and mothers knowledge at the level of P <0.05. These findings are not in consistent with the findings of another study done in Chennai concluded that there is an association between the level of knowledge regarding domestic accidents and socio demographic variables of mothers of under five children.¹⁶

NURSING IMPLICATIONS

Nurse educator can periodically organize special training program for the mothers of under five children to improve their knowledge on prevention of home accident by conducting awareness programs, first aid management of home accidents and safety practices. Prepare and distribution of manuals/ pamphlets which contains all the first aid measures to the mothers

RECOMMENDATION

The sample was concentrated in locality where one population group was studied and hence, it could not be generalized. Further research is recommended including different sub group of populations.

CONCLUSION

Child safety is one of the most important social values that demands attention, supervision. Hence these findings call for prompt and target group interventions to overcome knowledge gap. A multi-faceted integrated preventive approach such as safety measures and Health education about the early treatment of home accidents can play important role in the prevention of home accidents among under-five.

ACKNOWLEDGEMENT

We thank all mothers for their participation and cooperation without them this would not have been possible to bring it into reality. Also we extend are thankfulness to the Hospital in Bangalore for given us permission to conduct this study with their support and help.