A Study to Assess the Effectiveness Of
RajigandiUniversity of Health sciences
Bangalore, Karnataka
Proforma for Registeration of
Subject for Dissertation
1. / Name of the Candidate and Address / : / S. LEELAVATHIM.Sc. Nursing Student 1stYearIndianCollege of Nursing,
Thilak Nagar, Bellary.
2. / Name of the Institution / : / Indian College of Nursing, Bellary.
3. / Course of study and subject / : / M.Sc. (Nursing 1st Year) Community Health Nursing
4. / Date of submission / : / 15.06.2009
5. / Tittle of the Topic / : / “A study to assess the effectiveness of planned teaching programme knowledge on balanced diet among the mothers of pre-schoolers in selected area at Bellary Karnataka.”
6.
6.1
6.2
6.3
6.5
7.0
7.1
7.2
7.3
7.4 / BRIEF RESUME OF THE INTENDED WORK
Introduction :
A diet which contains all the nutrients, which contains the various groups of food stuffs such as energy yielding food, body building foods required by a child for the proper maintenance of health and optimum growth is termed as balanced diet. So that individuals is assured of obtaining the requirement of all these nutrients.(1)
Balanced diet should meet the requirement of protein, should be met which amounts to 15-20% of daily energy needs, fats 20-30%, carbohydrates rich in natural fiber should constitute the remaining food energy.(2)
It is important that a child’s diet should be both good in quality as well as adequate in quantity. If his diet is deficient in nutrients and energy, it can adversely affect his weight gain and body growth. The child’s diet should supply him with proteins, carbohydrates, fats, vitamins, minerals and other nutrients in adequate quantities. Pre-school children are extremely vulnerable. They succumb readily where the diet is poor in quality and quantity and infections diseases infestations are wide spread.
The rate of grwoth and development of pre-school children depend to a large measure on the adequacy of the diet, consumed by them. Frequent attacks of infectious diseases affect their growth and increase the requirements of various nutrients.
Morality rate in pre-school children is an indicator of the general state of health of population and directly refflects the quality of life and the level of socio - economic development of a country.(3)
The danish fitness and Nutrition council has examined the scientific literature to evaluate the performance and health related aspects of consuming dietary supplements in the physical activity.
Metabolic disorders in young children attending schools, balanced diet in order to optimize the resource, promote optimal growth and development and prevent adult diseases through dietary practices in childhood.
Need for Study
The rapid growth occurs during pre-schoolers which is followed by a long period of gradual growth during childhood. However, due to poor eating habits, children perticularly pre-schoolers are more habits, children perticularly pre-schoolers are more easily prone to deficiencies like protein energy malnutrition, anaemia 60-70% and vitamin-A deficiency.
Malnutrition is a world wide problem the effects of malnutrition are also frequently more serious during the formative years of life. The standard of living of the family is an important factor pree schoolers from well-to-do families have better height and weight. The socio economic factor is connected with the nutrition and living of children.According to the Gomez classification 37.2% the children presented a malnutrition
In a recent study is to identify the association between socio-economic, environmental, feeding and individual factors involved in the acute malnutrition of the migrating pre-schooler. A comparative, transversal observational study was conducted in 511 children between the ages of 1 and from child care centers.
Protein Energy malnutrition in India in pre-school age children is 1-2 percent. The great majority of cases of PEM 80% are the “Intermediate” ones, that is mild and moderate cases which frequently go unrecognized. The problem exists in all the states and that nutritional marasmus is more frequent than Kwashiorkor.(4)
This study focuses on the determinants of liner growth deficit in under five children using multievel modeling. The sample included 3,746 pre-schoolers from 15 Brazilian municipalities, with a three tier analysis. Municipal date were obtained from the 1991 National census household data were collected from 1999 to 2001 using structured questionnaries and measuring children’s weight and height. In this final multievel model maternal schooling at the household level, incomplete immunization prior hisotry of malnutrition were strongly associated with liner growth deficit in pre-schoolers knowledge and education of balanced diet can help to mothers of pre-schoolers to move from malnutrition. One of the main objective of the primary care is to teach mothers of pre-schoolers to take care of and be responsible for their children health. (5)
It has felt that need to provide knowledge regarding balanced diet among mothers of pre-schoolers, its effect on health status and remove the nutritional problems in pre-school.
Review of literature
A review of literature on the research topic makes the researches familiar with the existing studies and provides information which helps to focus on studies and provider information, which helps to focus on a particular problem lay a foundation up on which to bare new knowledge. It creates accurate picture of the information found on the subject
(polit and Hungler 2000).
Reviews related to importance of balanced diet in pre-schoolers.
Awell-balanced diet is one of the most important factors that assure a child’s healthy growth and development.
A Study was conducted on malnutrition among the indigenous early child hood population is still currently a serious public health problem and the question was posed of identifying the prevalence of malnutriation among the pre-schoolers. A rural sample was selected from the Northern, central and Southern regions where 70%, calculated for 3,236 pre-schoolers and 4,899 school age children. By regions, for pre-schoolers, the South showed the highest prevalence of under height (69.8%) and under weight (49.8%) than the North (respectively 36.1% and 22.6%) entailing statistically significant differences. (P-0.0002 and P-0.04) for over weight and obesity, the North showed a 14.2% prevalence, and then South 5.6%.)The nutritional condition of the children studied reveals a geographical polarization, the greatest prevalences related to underheight and underweight children being found in Southern Mexico, due to lifestyles and availability of food differing from one region to the other. (6)
A study was to evaluate the change on the energy and macronutrients intake in obese and Eutrophic pre-schoolers, attending National Board of Day care Centres, in the eastern area of Santiago, as product of an Educational intervention in intake, nutrition and physical activity, sustained in the theory of the social cognitive learning and the model of community organization. The sample comprised of thirty five obese children, plus eighty five eutrophic children (4-5 years old). Energy intake was evaluated, measuring full two days a week plus one weekend day. The intervention produced a reduction in energy, proteins, lipids, and carbohydrates in obese girls energy and carbohydrate in obese boys. This intervention demonstrated to be effective in early modulation of pre-school children dietary intake, one of the important risk factors for obesity and chronic diseases.(7)
Study was conducted focuses on the determinants of linear growth deficit in under five children using multilevel modeling. The sample included, 3,746 pre-schools from 15 Brazilian municipalities (ten from the state of Bahia and five from Sao Paulo) with a three - tier analysis. Municipal data were obtained from the 1991 National census. Individual and house hold date were collected from 1999 to 2001 using stuctured questionaries and measuring children’s weight and height. In the final multilevel model, poor Environmental and Economic conditioning and maternal schooling at the house hold level, and incomplete immunization, prior history of malnutrition, and no report of breast feeding at the individual level were strongly associated with liner growth deficit. (8)
Conducted a study was to investigate the impact of low fat diets in children aged 2 to 5. Eight two children attending a school cafeteria in a cross-sectional study were evaluated. Body weight (W) height (H) and body composition (BC) the anthropometric rawdata were processed as Z-Score of the weight - for - age and of the height for age. This cross-sectional study suggest metabolic disorders in young children attending school. There will alow to design balanced diets in order to optime the resources, promote the optimal growth and development and prevent adult diseases through dietary practices in child hood. (9)
Conducted a study aim to create a greater understanding of the relationship between food insecurity and nutrient intake for three at risk groups preschoolers. Using date from the continuing survey of food intake by individuals. A nationally representative data set, sub-samples were drawn of 1379 pre-schoolers. Dietary nutrient intake was assessed with an in-home interview regarding food consumption over the previous 24 hours. Repondents were then screened in to one of two groups bared on their agreement with the following statements (1) “Enough of the kinds of food we want to eat”, (2) “Enough, but not always what we want to Eat” (3) “Sometimes not enough to Eat”. Households that agreed with either of the last two statements were considered food insufficient leads to malnutrition. (10)
Conducted study of an actual meal and statusd of nutrition of children in the age of from birth till 5 years living in Murmansk, 998 children were surveyed. The basic nutrients misbalance of structure of diets of children are established and their reasons are analyzed. On the basis of the received data the regional recommendations for organization of a healthy meal in children’s pre-school establishments and programme of hygienic training of parents to skills of a balanced diet of children of early and junior age were developed. (11)
Conducted a study to assess the current status of protein energy malnutrition (PEM) in the high and low altitude preschool children aged 12-71 months. A cross-sectional study conducted during the year of 2003 and involved 572 and 469 preschool children of South Western Soudi Arabia born and living permanently at high and low altitude areas. Annual family income per person was negatively and significantly associated with underweight and stunting, but not with wasting. Multivariate analysis showed that after controlling for all sociobiological factors, low altitude remained a strong risk factor. The difference in PEM between high and low altitude preschool children could be related to the milder environmental conditions at high altitude and the higher incidence of tropical infections in lowland children. Future studies are required to verify these speculations, and to establish programs to control and prevent PEM in preschool children at low altitude.(12)
Conducted a comparative study was to examine the influence of infant feeding methods on the body weight of pre-school children. The research was done on the basis of a retrospective analysis of medical documentation of 465 children aged 4-5 years. The body weight at the time of birth (lower than 3500 grams. Higher than 3500 grams.) with in there groups an average body weight, an average increase in body weight and the number of children falling in to categories “below the norm”, “in the norm” and “above the norm” were compared according to body weight percentile grids and the Body Mass Index. In comparison to infants feed artificially, a smaller increase in body weight until the pre-school age. How ever weight deficiency was more frequently observed in this group of children. This research it was concluded that the feed method may have an impact on the body weight of pre-school children. (13)
Conducted a descriptive study to determine whether the increase in the percentage of stunted growth in Bush Negro children. In this villages of Dan and Botopasi, children aged 2-5 years from two schools and their mothers were examined, age of introduction of and composition of complementary feeding and current nutritional status of the mothers and child were determined.Sixteen children and their mothers were included between the ages of 2-5, 6 of the children showed stunted growth but none of the children or their mothers was wasted. Stunted growth in there children is better explained by a shortage of well balanced complementary feeding rather than by a absolute shortage of energy. Education about food recommendations for the child is great importance in the prevention of chronic malnutrition. (14)
Conducted study was to evaluate the energy intake of obese and normal nutritional status pre-schoolers from four to five years old, attending several day care centres / (JUNJI) in the Eastern area of Santiago. The sample of a population of 450 children. The food intake was evaluated twice a week and on one weekened day, food intake was measured by food weighing and at the home. It was measured by food recording. FAO2001energy requirements were used to calculate the energy requirements of the children energy intake was similar in the educational home. Energy intake exceeds their energy requirement. Energy intake at home, is greater and of minor quality, situation that worsens over the weekened in all pre-schoolers, independently of their nutritional conditions (energy adequacy > 114%). (15)
Statement of the Problem :
A study to assess the effectiveness of planned teaching programme knowledge on balanced diet among the mothers of pre-schoolers in selected area, atBellary, Karnataka.
Objectives :
- To assess the existing knowledge of mothers of pre-schoolers regarding balanced diet.
- To assess the effectiveness of planned teaching programme regarding balanced diet.
- To evaluate the pre and post knowledge of the mothers of pre-schoolers with their demographic variables.
- To find the association between the knowledge scores and selected demographic variables.
- Effectiveness :
- Planned teaching programme :
- Mother :
- Pre-schooler:
- Knowledge :
- Balanced diet :
ASSUMPTIONS:
It is assumed that
Mothers of pre-schoolers may have less knowledge regarding balanced died.
Teaching strategy regarding balanced diet among mothers of pre-schoolers may have to improve the knowledge.
DELIMITATIONS:
Study is delimited to mothers of pre-schoolers.
The study is delimited to who all are willing to participate in study and able to respond to investigator tool.
The study is delimited to mothers of preschoolers who are available at the period of study.
Projected outcome :
The present study gives an insight in to the knowledge of mothers of pre-schoolers with regard to balanced diet, its effect on health status and prevention of malnutrition before and after planned teaching programme, so that the future investigation and health care professionals can take effective steps on enhancement of their knowledge regarding balanced diet in mothers of pre-schoolers there by the mortality and morbidity of pre-schoolers due to malnutrition can be reduced.
Materials and Methdos :
Source of Data :
a)Design :
The research design chosen for the studies is “Experimental” one group pre and post test design’.
b)Setting of the study :
The study can be conducted on mothers of schoolers of selected area in Bellary, Karnataka.
c)Population:
The population includes in the present study are the mothers of schoolers of selected area in Bellary.
d)Sample :
The sample consists of 50-60 mother of pre-schoolers of selected area in Bellary.
Variables Under Study:
Independent Variables :-
Planned teaching programme on balanced diet among the mothers of preschoolers.
Dependent Variables :-
Knowledge among mothers of preschoolers regarding balanced diet and prevention of malnutrition.
Selected Variable :
Socio - Demographic variables of mothes of pre-schoolers included in the present study are
Age
Education
Area
Religion
Socio-economic Status.
Age :
Mothers of age between 25 to 35 years.
Education :
Illetrates mothers and litraters.
Area :
Mothers living in both rural and urban area.
Religion :
Mothers of three religions that is Hindu, Muslim, Christian and others.
Socio - Economic Status :
Mothers of all socio - economic status of low midle and high.
e)Sample Techniques :
Simple random sampling techniques by lottery will be used in selecting the sample.
f)Inclusion criteria :
The study includes the mothers who
are having the 25-35 years of age.
are staying in Bellary.
are available at the time of data collection.
are willing to participate in the dstudy.
can understand and speak Kannada, Telugu and Hindi.
g)Exclusion Criteria :
The study includes the mothers who
are not having 25-35 years of age.
are staying other than selected area in Bellary.
are not available at the time of data collection.
can not understand and speak Kannada, Telugu, and Hindi.
Method of Collection of data :
a)Data collection instrument :
Structured questionnaire will be used for data collection.
b)Data collection method :
Data will be collected from the sample based on the knowledge levels of the mothers of pre-schoolers, plannedteaching programme will be implemented then with a gap of seven day again knowledge of mothers of pre-schoolers will assessed to see the effectiveness of planned teaching programme.
The study will be conducted for a period of 4-6 weeks.
does the study require any investigation or intervention to be conducted on patients or other human? If so please describe briefly.
No.
Has Ethical clearance been obtained from your institution ?
Yes.
8. / List of References :
1)Dr. M. Swaminathan hand book of Food and Nutrition, published by the Bangalore printing and publishing Co. Ltd., Fifth Edition, year of publication is 1978. Page No. 162-190.
2)K. Park text book of preventive and social medicine, M/s Banarisdas Bhanot publishers 19th Edition, page No. 505-529.
3)TK Indrani, Nursing manual of Nutrition and therapeutic Diet, Jaypee brothers medical publishers (P) Ltd, 1st Edition year of publication is 2003 page no. 152-155.
4)Salcedo- Rocha AL, Prado – AguilarCA (1991) study related to identity the association between social-economic environmental involved in preschoolers.
5)Oliveria LP, Barreto ML, Arris AM (2007) study related to determinates of liner growth deficit in preschoolers.
6)Chavez Zuniga MC (2003) study related to malnutrition among the indigenous early child hood
7)Vasquez F, Andrade M, Rodriguez Mdel (2004) A study related to evaluate the change on the energy in preschoolers.
8)Oliverira LP, Bareto ML (2007) Study related to focuses on the determinants of linear growth deficit in under five children using multilevel modeling.
9)Rodriguez PN, Zeni, Suarez CE (2002), Study related to investigate the impact of low fat diets in children aged 2 to 5 years.
10)Rose, Donald and Victor Oliveria (1997), Study nutrient Intakes of individuals from food. Insuffiecient house holds in the united states.American journal of public haelth, 87(12),1956-1961.
11)Dmitrievskaisa SV, Istomia Avkorolev AA, Lukicheva LA(2004), Study related to an actual meal and status of nutrition of children in the age of 5 years.
12)AL- Hashem Fahaid H (2008), Study related to assess the current status of protein energy malnutrition low altitude preschool children.
13)Los- rycharska E, Kiejdo P (2005), Study related to comparative study was to examine the influence of infant feeding methods on the body weight of pre-school children.
14)Vander Crabben S.N., Heymans HS, Vankempen AA (2006), Study related to determine increase in the percentage of stunted growth in Bush Negro children.
15)Vasquez F, Salazar G, Rodriguez Model P. Andrade M (2007) Study related to energy intake of obese and normal nutritional status pre-schoolers from five years old.
16)Dr. M. Sawminathan, Advanced text - Book on food and nutrition published by the Bangalore printing 1st volume, year of publication is 1974, page No. 542-575.
17)Onila Salins text book of Nutrition guide Jaypee brothers Medical publishers (P) Ltd., Second edition year of publication is 1999 page No. 34-40.
18)K.V. Rameshwar Sarma, text book of Nutrition. Published by frontline publications, first edition, year of publication is 2009, page No. 25-30, 143-149.
19)Molly Sam, N. Geetha, A text book of nutrition. Jaypee brothers Medical publishers (P) Ltd. First edition, year of publication is 2000, Page No. 70 - 80.
20)Angel Mary gold, text book of food a Nutrition for nurses, frontline publications, 1st Edition, year of publication of 2004 page No. 68-79.
21)Rekha Sharma “ text book of Diet Management” published by Read elsevier India privated limited third edition, year of publication is 1991, page No. 1-12.
22)Rachel Rao Manual of Nutrition and Dietetics, published by Vora Medical Publications, 1st Edition, year of publication is 2004, page No. 93-100.
23)LC gupta. Kusum Gupta, Abhishek gupta text book of food an nutrition, Jaypee brother medical publishers (P) Ltd, New Delhi. 6th Edition year of publication is 1984, page No. 100-110.
24)B. Sreelakshmi, text book of Dietetics, published by AITBS publishers India - 2008 1st Edition year of publication is 2005.
25)Sumati R. Mudambi, shalini M. Rao and M.V. Rajagopal text book of food a science published by new age International (P) Ltd, New Delhi, second Edition, year of publication 2006.
26)Quandt,sara A,and pamela Rao.”Hunger and food security among older adults in a Rural community”.Human organization, Vol.58(1)28-35
Web sites :
www. Gooogle.com
www. Pubmed.com
www. Medline.com
9 / Signature of the student
10 / Remarks of guide / The research topic selected for the study is relevant and forwarded for the needful action.
11 / Name and designation of the guide / Mrs. KAMESHWARI
H.O.D. Department of CommunityHealthNursingIndianCollege Of Nursing,Bellary.
12 / Guide / Mrs. KAMESHWARI
Department of CommunityHealthNursingIndianCollege Of Nursing,
Bellary.
13 / Signature
14 / Co-Guide ( If any ) / Mr. T.V.MATHEW
15 / Signature
16 / Head of the Department / Mrs. KAMESHWARI
HOD. Dept. of CommunityHealthNursingIndianCollege Of Nursing, Bellary.
17 / Signature
18 / Remarks of the chairman & principal / I discussed with the research committee. I felt that research problem is good & feasible
19 / Signature
1