A Study to Assess the Knowledge on High Risk Factors and Remidies Related to Child Abuse

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A STUDY TO “ASSESS THE KNOWLEDGE AND PRACTICES

AMONG THE REPRODUCTIVE AGE GROUP OF MOTHERS

RELATED TO PREVENTION OF ACCIDENTS IN INFANTS”

IN A SELECTED AREAOF MADHUGIRI. IN A VIEW

TO DEVELOP A SELF INSTRUCTIONAL MODULE

PROFORMA FOR REGISTRATION OF SUBJECTS

FOR DESSERTATION

MRS.HITESH GUPTHA

CHILD HEALTH NURSING

MADHUGIRI SRI RAGHAVENDRA COLLEGE OF NURSING

MADHUGIRI

RAJIVGANDHIUNIVERSITY OF HEALTH SCINCES

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

6.BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION:

“Accidents do not always happen by accident, practicing safety teaches safety”

Injuries are a major causes of death during infancy, especially for children 6 to 12 months old. The top leading causes of injury to infants were falls, ingestion injuries, and burns constant. Vigilance, awareness and supervision are essential as the child gains increased locomotor and manipulative skills that are coupled with an insatiable curiosity about the environment.1

Most accidents can be prevented it is place that sometimes an accident can take place inspite of all precautions taken by us, but this is not usually the case. An accident is often a harmful event that could be avoided by a little careful thought. Most injuries to infants occur in home and are known to have a modifiable component. Addition information on safety behavior, practices, and device over ship could inform prevention programmes aimed at reducing injury.1

Parents education and training programmes can improve maternal psychosocial health, child behavioral problems and parenting practices in reducing child injury3 Education and counseling should be given based on the needs and adult education should be provided on the subject of child development. Injury can occur in numerous ways. Sharp, long pointed articles, fork, can be poked into the eye or ear causing serious damage, even, clothes and hair can present dangers to infants who cannot call attention to the problem.2

Injury do not always indicate neglect. It is a difficult task to watchs children carefully without overprotecting or unnecessarily confining them. Small falls help children learn the dangers of highest, touching a hot object once can emphasize to the child the pain of burn. Parents need to remember that infants and young children cannot anticipate danger or understand where it is or is not present.1 It is always wise to explain why something is dangerous. It must be remembered that the child need to be physically removed from the situation.2

It is not easy to teach safety, supervise closely, and refrain from saying “no” a hundred times a day. Preventing injuries to children is casually the best reason for limit setting and discipline. When child is taught the meaning of “no” they should also be taught what “yes” means. Children should be praised for playing with suitable toys, their effects at behaving or listening should be reinforced, and innovating and creative recreational toys should be provided for them.2Children are imitators, they copy what they see and hear, practicing safety teachers safety, which applies to parents and their children.1

NEED FOR STUDY:

Injuries are a major cause of death during infancy. In the field of home accidents there is still the need for a better surveillance to make the problem and the risk more visible. The prevention in the home needs to be part of the overall injury prevention plans with involvement of multiple sectors. There is a need to demonstrate that there is incidence of the effectiveness that injury in the home are preventable by legislation, home visitation, child proof closures, safer home environment. Drowning is a leading cause of death in children from 1-4 years old in low middle income countries of the region. Road traffic injury are the leading cause in the age group of the 5-14 years old in high income countries. Children from host deprived social classes suffer from 3-4 times higher mortality. The deaths are the tip of the iceberg. Long term physical and psychological disability is a major consequence.2

Following the WHO statistics 2002 the three leading causes of injury deaths were self inflicted injury. to poisoning injuries can be categorized by infants. Unintentional or accidental and intentional unintentional are road traffic injuries ,poisoning ,drowning, falls and burns .Injuries can also be classified by place to activity eg: home or leisure accidents, occupational.4

It is recommended that individuals home visits should be made to determine the risks in the home environment to the educational needs of mothers. The tools used for data collection were 0.6 years old childrens mothers knowledge of safety precautions for the prevention of home accidents seal to “frequency of encountering home accidents form”. The department on environment and health of the German federal ministry of health and social security Dr.Schmitz stressed the objectives. For environment and health which still today are in the foreground of the Ministries activities. Special attention is given to preventive action.4

Germany has excellent series at its disposal in the are of acute care, there is clearly a great dealt left to be done in the are of prevention and especially preventing a children accidents. Injuries constitute a major public health problem world wide. Home are an important setting for non-fatal unintentional injuries. Injury rates were highest among the youngest and falls were the most common injuries among all the study groups. Common accidents among the infants are aspiration of foreign objects, combined with mechanical suffocation, motor vehicle injuries, fall, poisoning, burns, drowning and bodily damage with occurs in numerous ways.5Another commonly unrecognized danger to infants is animal attacks. Parents must be constantly vigilant to protect the child from household pets and from animals.2

Injury prevention requires protection of the child of education of the caregiver. Thus the researches as selected infants in prevention of accidents by educating the mothers and caregivers.

6.2 REVIEW OF LITERATURE.

6.2.1 A study was conducted on accidental injuries among infant and child leading to death, and it could be prevented if the parents took additional safety precautions it can be done by prospective interviews with the parents and well baby clinics. 289 structured interviews were conducted with mothers and the result is 75% mothers sleeping next to infants, 74% had other older children, 74% keeping detergents and medication in a high or locked cabinet. Use of care seat belts was more common in higher income families 24% of the parents allowing their children to play unsupervised in street. These mothers were more likely to be non educated. The infant and child safety practices in Taddah needs further improvements.5

6.2.2. A study was conducted by department of health policy and management which is designed for injury prevention practices among families living in disadvantaged, urban areas. 150 mothers were interviewed about their living government, when they brought their children to a hospital, pediatric primary care clinic. Only 37% knew their hot water temperature was 125o or less 50% families didn’t usestair gates 27% said theydidn’t have smoke detectors mothers uniformly reported very favorable attitudes and strong support from others for in home injury prevention practices the factors associated were family income e, housing quality and environmental barriers to help parents for overcoming specific barriers skill based interventions are needed.6

6.2.3. A study was conducted on accidents among children under 5 years old who presented at the surgery or the accident and emergency department. The details obtained from answers to a questionnaire sent to parents show that 100% of children had 120 accidents. There maximum numbers of accidents occurred in 2nd year of life 85% cases are of direct casualty admission 86% children had only one accident and 4% required hospital admission. The common cause of injury was a fall; and majority of accidents happened at home the accident cases had younger mother and sibling who had accident similar other family had study of safety equipment’s good awareness and knowledge of prevention.7

6.2.4. A study was conducted on safety hazards on household with young children, interviewed 23- mothers concerning safety hazards related to burns poisoning and falls, maternal supervision social support and safety activities. These were supplemented by measures of mother risk perception, stress and coping their child’s previous injury experience and socio-economic status collected by telephone surveys was an important predictor of home hazards child related variables risk perception had little influence on home hazards maternal supervisory style was an important correlate of all types of house hold hazards results suggests that residential injury prevention strategies for young children should stress active.8

6.2.5. A study was focused on unintentional home related injuries are a major cause of morbidity and mortality among children under 5 years injury incidence in homes for these children continues at high levels based on the health belief model the tool is composed of 6 scales that measure injury susceptibility and seriousness benefits, barrier and self efficacy of injury prevention performance criterion related validity was established for all scales except the seriousness scale this instrument is important for nursing investigations on the predictors of injury prevention behavior and for development of nursing interventions to prevent injuries.9

6.2.6. A study was conducted on unintentional injuries in infants less than 1 yr old the methods are demographical social economic data, nature severity of injury and clinical outcome of all infants 405 cases of accidental injury and poisoning in infants is seen 40.5% of injuries occurred when infants were left alone 91% of injuries occurred at home 60.5% occurred inbedrooms falls were the major mechanisms of injury 63% were head injury the mechanisms and patterns of injurychanged with increasing motor ability of infants parents and caregivers should be taught regarding prevention.10

6.2.7. A studywas focused on geographical information system technology which is useful tool for policy makers to identify priority areas for the prevention of injuries in the home environment the risk of hospitalized fall-related injuries for people aged 75 yrs And over and poisoning of children 4 yrs of age or less. This study shows that the use of geographic mapping and special statistics can provide a useful can provide a useful means of estimating home injury risk, eliminating the instability of estimates in the future geographical mapping of injury locations coupled with satellite imagery and provide an additional level of detail for injury surveillance within a defined area.11

6.2.8. A study was conducted on patterns of burns injury in the perambulatory infant and the aim was to explore the patterns of these injuries to identify whether they could be prevented with better parents education. The infants under 6 months of age who sustained born injury requiring admission and out patient treatment in the burns unit the mechanisms of injuries is usually caused by hazards in the home environment these infants a large amount of follow up care better parental education may help to reduce the number of injuries.12

6.2.9. A study was conducted with the mother of 1-3 yrs old children for the purpose of examining the effect of home severity education regarding home accidents. The tools used for data collection were of home safety were “0-6 years old childrn’s mothers knowledge of safety precautions for the prevention of home accident scale” the effect of education was evaluated with pre-test and test utilization a difference was seen in the mother score and in the frequency of children’s accidents before and after education individual home visits should be made to determine the risks in the home environment. Education and counseling should be given.13

6.2.10. A study was focused on infants under 1 yr of age have a significant risk of burn injury during 3yr period there were 104 new burns cases identified which represents 11.8% pediatrics admissions 63.5% treated as important and 36.3% treated as out patients. Scalds were the commonest type of burn and the source was from cups containing hot drinks and the second most common source was contact burns and the source was radiators/hot water pipes the frequency of burns highlights a need for burn prevention special attention is needed to lookat the specific etiology of these burns.14

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6.2.11. A study was fussed on unintentional injuries among infants are 0-12 months. They are treated for unintentional injuries in emergency departments. The leading cause was fall-related injures and males were more likely to be hospitalized than females. Gender differences suggest that parenting practices may play a role, but ecological approaches should be considdred in an effort to understand the connection between injuries and an infant’s developmental stage.15

6.2.12. A study was conducted to assess the incidence of fall injuries among infants. A total of 2672 injured infants, specially trained health visitors performed interviews with the children’s guardians using a questionnaire. The result shows that the incidence of falls increases with increasing infant age. A high percentage of severe injuries was detected, most of them concussions fractures. Approximately 10% infants with all related injuries required hospitalization. Infant walker use was associated with higher are common cause of serious infant injuries and nursing equipment is frequently involved in this.16

STATEMENT OF THE PROBLERM:

A study to “assess the knowledge and practices among the reproductive age group mothers related to prevention of accidents in infants “in a selected area of Madhugiri in a view to develop a self instructional module.

6.3OBJECTIVES

6.3.1To assess the knowledge on prevention of accidents in infants among the reproductive age group mothers.

6.3.2To identify the practice on prevention of accidents in infants among the reproductive age group mothers.

6.3.3To develop a implement self instructional module on prevention of accidents in infants.

6.3.4To associate the knowledge and practice of mothers with selected variables.

6.4VARIABLES UNDER STUDY:

Age of the mother, Educational status, place of domicile, living conditions, socio-economic status, cultural taboos, exposure to mass media

6.5.OPERATIONAL DEFINITIONS:

ASSESSTo evaluate the level of knowledge of reproductive age group of mothers regarding prevention of accidents in infants.

KNOWLEDGEThe level of understanding reproductive age group of mothers regarding prevention of accidents in infants.

PRACTICESIt refers to what the parents follow and implement to avoid accidents to the child.

MOTHERSIn this study mothers refers to that the reproductive age group women.

PREVENTIONIn this study “prevention” refers to that actions taken to decrease the accidents in infants.

ACCIDENTSIt refers to injury accruing an expected or an event that happens by chance.

INFANTSIn this study infants refers to that the age group between 0-1 year.

AREAIn this study Area refers to that a selected place of Madhugiri.

SELFIn this study a self instruction module refers that a scientific

INSTRUCTIONALinformation given to the mothers which is prepared based on

MODULEtheir understanding level.

6.6.ASSUMPTIONS:

6.6.1Reproductive age group of mothers may have deficit knowledge on prevention of accidents in infants.

6.6.2Self instructional module will enhance knowledge of mothers regarding prevention of accidents in infants.

7. MATERIALS AND METHODS:

7.1 Source of Data

• Research approach: Descriptive approach
• Research design: Survey method
• Setting of the study: Community setting Madhugiri
• Population: Reproductive age group of mothers.
• Sample size: 100
• Sampling criteria

*Inclusion criteria

Mothers of under reproductive age group.

Mothers who are living in Madhugiri.

Mothers who can understand Kannada, English and Hindi.

*Exclusion Criteria

Mothers who are not willing to participate in the study

Mothers who cannot understand Kannada, English and Hindi.

7.2 METHOD OF DATA COLLECTION

• Tools of data collection:

PartA: Demographic Performa.

PartB: Structured questionnaire of knowledge of practice of prevention of accidents in infants.

• Data analysis and Interpretation.

Data analysis will be through descriptive and inferential statistics.

• Duration of the Study - 6 weeks.

• Does the study requires investigation or intervention on patients or other persons or animals described briefly.

- No –

• Has ethical clearance has been obtained from your institution.

Yes, ethical clearance will be obtained from

-The research committee of Madhugiri Sri Raghavendra Institute of Nursing ,Madhugiri

-The authorities of selected communities, Madhugiri

-The informed consent from the candidates willing to participate in

-the study.

8. LIST OF REFERENCES:

1.Wongs “Nursing care of infants and children” 8th edition, Mosby publication.

2.Dorothyt R Morlow Text book of “Pediatri Nursing” 6th edition, published by W.B.Saunders Company.

3.

4. of accidents.co.in

5.Jan MM, hasanain Fh, etal., infants and child safety practices of parents 2000.

6.Gielen AC, Wilson ME, etal., in home injury prevention practices for infants and toddlers the role of parental belief barriers and housing quality, 1995.

1. Br.J.Gen Pract. Accidents among children under 5 yrs old, 1993.

1. Kronenfeld JJ, Jackson Kw, etal., safety hazards in ouseholds with young children 1993.

1. Russell KM development of an instrument to assess maternal childhood injury health belifs and social influence, 1991.

1. Snodgrass AM aug A, uninstional inuries in infasts in singapoor 2006.

1. Chongs, Mitchell r. the use of mapping to identify priority areas for the prevention of home injuries 2009.

1. Burlinson infant, 2009.

1. Altundag S, ozturk MC, the effect of home safety education on taking plrecaution MC reducing the frequency of home accidents, 2007.

1. Khambalia A brussoni M etal., risk factors for unintentional injuries due to falls in children aged 0-6 years 2006.

1. Nguyen DQ, DicksonWA, etal., infants under 1yr of age have a significant risk of burn injury 2008.

16.Gilchrist P. Ballesteros Mf, etal., unintentional injuries among infants age 0-12 months 2007.