Proforma for Registration

PROFORMA FOR REGISTRATION

SUBJECTS FOR DISSERTATION

GEETHA K

1ST YEAR M.Sc NURSING

PAEDIATRIC NURSING

2010-2012

SEA COLLEGE OF NURSING

K.R PURAM, BANGALORE-49

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / MRS. GEETHA K.
1 YEAR M.SC. (N) STUDENT
SEA COLLEGE OF NURSING
BANGALORE – 49.
2. / NAME OF THE INSTITUTION / SEA COLLEGE OF NURSING
3. / COURSE OF STUDY AND SUBJECT / M.SC. NURSING
CHILD HEALTH NURSING
4. / DATE OF ADMISSION TO COURSE / 03-05-2010
5. / TITLE OF TOPIC / A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING BABY BOTTLE SYNDROME AMONG MOTHERS OF INFANTS, IN A SELECTED PRIMARY HEALTH CENTRE BANGALORE

6.0. BRIEF RESUME OF THE INTENDED WORK

6.1 NEED FOR THE STUDY

While breastfeeding may not seen the right choice for every parent, it is the best choice for every baby.

.- Amy Spangler

Infant feeding practices refer generally to meet nutritional and immunological needs of the body at different stages of the child growth. Breast milk is a vital for better child survival. However, faulty habits arising from ignorance, superstitious and wrong beliefs in communities. The effect infant feeding practices are largely socio-economic and environmental conditions that hamper their growth and development. It is believed that awareness of the mothers regarding feeding practices affect the nutritional status and health of infant.

Health is not complete without oral health and health for all by the year 2025 can only be achieved through the medium of primary health care approach. The concept of dental health under the theme “Health for all by 2025 A.D” is a significant issue among human beings because 95% of all human beings have one or other dental problem at least once in their life time. Among the major portion comes from the pediatric population, the researcher found that oral debris is very commonly seen in mouth with poor oral hygiene in the age group of 5-8 yrs.1

Baby bottle syndrome is a unique form of rampant decay of the primary teethin which a variety of terms have been used to describe this condition. Baby bottle tooth decay, early childhood caries, nursing bottle syndrome, nursing caries etc. The problem is usually caused byimproper use of the bottle especially with the habit of sleeping with the bottle in the mouth, bovine milk, fruit juices or carbonated beverages. The sugary liquid pools around the front teeth. The bacteria living in every baby’s mouth then turns the sugar to acid which causes decay.2

Despite the decline in the prevalence of dental caries in children in the western countries, caries in preschool children remains a problem in both developed and developing countries. Numerous studies have been conducted to find the prevalence of baby bottle syndrome. InEngland and USA the prevalence is reported to be6.8-12% and 11-53.1% respectively. A comprehensive review of the occurrence of the caries on maxillary anterior teeth in children, including numerous studies from Europe, Africa, Asia the Middle East, and North America found the highest caries prevalence in Africa and south EastAsia. 3

While in India prevalence of 44% has been reported for caries in 8-48 months olds. A study was done in Udupi [Karnataka] has reported that caries prevalence of 19.44%.Untreated baby bottle syndrome can lead to harsh consequences such as abscess, pain, malocclusions and lasting psychosocial impediments.3

A joint working group composed of the Federation Dentaire Internationale, the international association for dental research [IADR] and WHO developed new goals for oral health for the year 2020, which encouraged a broader view of oral health and indicators by including other diseases and conditions as well as dental caries.4

A study was conducted in India in Davangere [Karnataka] among 813 children aged 2-6 yrs to find the prevalence of nursing caries in selected three kindergarten schools from each government, government aided and private governments showed that 19.2% of pre-school children had nursing caries. It was concluded that nursing caries were more in children who were taking a feeding bottle to bed at night and were increasingly seen families of lower socioeconomic groups. 5

A study was conducted in Ludhiana among 609 children of 3-6 yrs age group to determine the prevalence and to examine the relationship between age and caries experience by 105 care givers showed that 52.87% children of 3-4 yrs, 45.1% children of 4-6yrs and 58.55% children of 5-6yrs age group are suffered from caries. It was concluded that this study can be used for screening child populations in need of treatment, helping public workers and planners to develop dental health programs to aid early intervention and prevention.6

One of the most encouraging signs of our times is the awakening of the mother to the needs and rights of the children. Mother plays a key role in the treatment of the child with the any disease. The overall awareness among mothers with regard to their rights, duties and responsibilities would strengthen the health care. In addition maternal education is important for child health as educated mothers can care better for their children and recognize when they need healthcare.7

Structured teaching programme is a systematic way of educating people. Various studies have shown that structured teaching programme has been very effective in preventing and improving the knowledge on various diseases. A structured teaching programme done on school teachers regarding oral hygiene of school children in selected rural primary schools at Mangalore revealed that there was significant increase in the knowledge level after structured teaching programme , which proves that structured teaching programme is an effective method to use in improving the knowledge level of the people.

Based on these information it is important that all children should get best dental care as early as possible to improve their general health status. So the investigator felt it is necessary to do structured teaching programme on mothers regarding early identification of baby bottle syndrome, which will in turn reduce the incidence of dental carries in early age group

6.2 REVIEW OF LITERATURE

Researchers review the literature to generate a picture of what is known about a particular problem. Relevant literature of only those sources that are pertinent or highly important in providing the in depth knowledge needed to study on selected problem was reviewed. The literature review indicated whether adequate knowledge exists to make changes in practice or whether additional research is needed.

1] Literature related to prevalence of baby bottle syndrome

2] Literature related to effects of baby bottle syndrome.

3] Literature related to effectiveness of structured teaching programme .

A cross-sectional descriptive study was conducted to determine the percentage of baby bottle use including late night feeding, behavior contributing to baby bottle addiction and chance of adverse health affects among 1038 caretakers from 13 groups of children age 1month-4 yrs . The results revealed that children aged 1-2 yrs, 2-3 yrs, and 3-4 yrs are found to remain on the bottle feeding constituted 92%, 70% and 42% respectively and remain on the night feeding comprised 70%, 50% and 37% respectively. It was concluded that the children are still using baby bottle and have night feeding far beyond the recommended age including the practices of bottle to sleep, returning to bottle.8

A study was conducted in Jeddah, Saudi Arabia to determine the prevalence of nursing bottle syndrome in pre-school children, aged 3-6 yrs. A total of 633 children, 346 males and 287 females, were examined between January and March 1995. Results showed that prevalence of the syndrome in this populationwas 20%. There was no significant difference between sexes with respect to the prevalence and the severity of the disease. The need for early recognition of children who are at-risk of this disease and prevention is stressed.9

An eight year study was conducted in USAamong 12American Indian and Alaska native communities showed that baby bottle syndrome is a preventable dental disease thataffects more than 50% of the children suggested that one to one counseling and community based education activity reduce the incidence of baby bottle syndrome to 38%.10

A study was conducted among pre-school children of Hubli and Dharwad city to determine the prevalence of dental caries and treatment needs in the age group of 3-5 yrs was estimated among 1500 children. The results showed that the 54.1% subjects were noted with dental caries and suggested to instill positive attitudes among the mothers towards preventing dental caries.11

A study was conducted to assess the effectiveness of structured teaching programme for school teachers regarding oral hygiene of children in selected rural primary schools at Mangalore. The findings of the study have revealed that school teachers had average knowledge regarding oral hygiene [mean %=55.46%]. And the planned teaching programme has improved theknowledge. Hence the researcher concluded that the planned teaching programme is an effective strategy in increasing the knowledge of school teachers.12

Another study was conducted in India to evaluate the effectiveness of structured teaching programme on knowledge of prevention of pneumonia among 60 mothers of under-five children having acute respiratory tract infection admitted at selected hospitals at Bangalore. One group pre-test and post-test design was adopted. The results revealed that mean post test knowledge score 32.22% of the subjects was higher than the mean pre test knowledge score 18.03%, the overall differences in the mean score is 14.18% .it was concluded that the mothers should be encouraged to attend the teaching session/teaching programs during their visit because the mothers will be more receptive to improve their knowledge level.7

STATEMENT OF THE PROBLEM

A study to assess the effectiveness of structure teaching program on knowledge regarding baby bottle syndrome among mothers of infants in a selected P.H.C. Bangalore

6.3 OBJECTIVES

To assess the level of knowledge regarding baby bottle syndrome among mothers of infants.
To evaluate the effectiveness of structure teaching program on knowledge regarding prevention of baby bottle syndrome among mothers of infants.
To find out the association between post knowledge score with selected

Demographic variables.

6.4 HYPOTHESIS

H- There is a relationship between structure teaching program on baby bottle syndrome and knowledge of mothers.

6.5 RESEARCH VARIABLES

1] Independent variable: In this study independent variables refers to the structure teaching program

2] Dependent variable: In this study dependent variables refers to the knowledge on prevention of baby bottle syndrome.

3] Demographic variable: In this study demographic variable refers to age, sex, education, occupation, income, and marital status.

6.6 OPERATIONAL DEFINITION

Assess: It refers to the evaluation of knowledge on prevention of baby bottle syndrome among mothers of infants.

Effectiveness: It refers to the extent to which the structure teaching program achieves desired effect in improving the knowledge of mothers of infants on prevention of baby bottle syndrome.

Structured teaching programme:A systematically developed instructional method for educating mothers on knowledge regarding prevention of baby bottle syndrome.

Knowledge: It refers to the correct responses from the pt on knowledge regarding prevention of baby bottle syndrome.

Baby bottle syndrome:Is the rapid decay of baby teeth in infant or child from frequent exposure, for long periods of time, to liquids containing sugars. The upper front teeth are most commonly affected.

Infants: Infants is the child between age groups of 0-1years.

7.0MATERIALS AND METHODS

7.1 SOURCE OF DATA: The data will be collected from the mothers visiting to selected P.H.C

7.2 METHODS OF DATA COLLECTION

7.2.1 Research design - one group pretest-posttest design.

7.2.2 Population -Mothers of infants attending selected P.H.C

7.2.3 Sample size - 60 samples.

7.2.4 Sampling technique- purposive sampling technique.

7.2.5 CRITERIA FOR SELECTION OF SAMPLE

a] Inclusion criteria:

1. Mothers who have infants with breast feed or bottle feeding.

2. Who can understand English and Kannada.

b]Exclusion criteria:

1. Mothers who are not willing to participate

2. Mothers with sickness

7.2.6 RESEARCH SETTING: At selected urban Primary Health Centre in Bangalore.

7.2.7 TOOLS OF DATA COLLECTION:Structured questionnaire method consisting of two parts

Part A: Items on demographic variables like age, religion, type of family, income, education etc.

Part B: Structured questionnaire on prevention of baby bottle syndrome among mothers of infants

7.2.8DATA COLLECTION PROCEDURE:

A structured questionnaire will be prepared to assess the knowledge among mothers who attend P.H.C . A structured teaching programme will; be prepared regarding various aspects of baby bottle syndrome and its prevention, content of the tool will be ascertained by guide and experts. Reliability of the tool will be ascertained by test and re-test method prior to the study written permission will be obtained from the concerned authority. Mothers will be given teaching on baby bottle syndrome with A.V.A ids after one week post test will be conducted and pre and post test scores will be compared to check the effectiveness of STP.

7.2.9DATA ANALYSIS METHOD:

Data analysis will be done by using descriptive and inferential statistics. The descriptive statistics like mean, standard deviation, frequency distribution and percentage will be used to assess the socio demographic variables. The inferential statistics like paired “t’ test and chi square test will be used to compare the pre and post knowledge score and to find out the knowledge scores with selected socio demographic variables respectively

7.3DOES THE STUDY RECQUIRE ANY INVESTIGATION OR INTERVENTIONS TO BE CONCLUDED ON PATIENTS OR OTHER HUMAN OR ANIMALS.

Yes,only a structured knowledge questionnaire will be used to assess the knowledge of baby bottle syndrome among mothers of infants regarding prevention of baby bottle syndrome, no other invasive physical or laboratory test will be conducted on samples.

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED?

Yes, A written permission from them institutional authority will be obtained. Consent will be obtained from mothers of infants before study. Confidentiality and anonymity of the subject will be maintained.

LIST OF REFERNECES

B.Kanmani, oral debris: A study to determine its effects on oral care. Nursing nightingale times.2010; 6[3]:48-49
Dorean Bradley Sutter. Nursing bottle syndrome-the causes of early childhood tooth decay. The world’s largest source of community created content. Available from URL: cause.html? Cat: 25
Jose.B.King.NM. Early childhood caries lesions in pre-school children in Kerala. Journal of pediatric dentistry. 2003;[25]: 594-600Available from URL: hub.hku.hk/handle/10722/66142
Habib.MBenzian.Charlotte.Nalkstad.Johann.T.B.Arnanrd. The role of the FDI World Dental Federation in global oral health. Bulletin of the world health organization. 2005; 83[9] Available from URL:
Tyasi.R.the prevalence of nursing caries in Davengere preschool children and its relationship with feeding practices and socio-economic status of the family. Journal of Indian soc pedod. Prev. Dent. 2008; 26:153-7 .Available from URL:
Simratvir.M,Moghe.G.AThomas.A.M.Singh.N.Chopra.S. Evaluation of caries experience in 3-6 year old children, and dental attitudes amongst the caregivers in the Ludhiana city. 2009; 27[3]:164-169.Available from : URL :
Metilda.S.Bijapur. Effectiveness of planned teaching programme on prevention of pneumonia among mothers of children having ARI. Nightingale nursing times 2010; 6[7]41-2.
Sawasivorn.S.Wanthanaphuti.P.pue-arun.S.Juansang.S. Situation of baby bottle use: is it suitable to recommend weaning by the age of one year? Journal of medical association.Thailand.2008;91 suppl 3:S128-35. Available from : URL :
Nathaniel.O.Salako.Amal Linjawy.Najlaa Alamoudi. Prevalence of nursing bottle syndrome among preschool children in Jeddah, Saudi Arabia. The Saudi dental journal, 1995; 8[1]. Available from : URL :
Bruerd.B.Jones.C.preventing baby bottle tooth decay: eight year results. public health report. 1996; 111[1]:63-65. Available from URL:
Mahejabeen.R.Sudha.P.Kulkarni.S.S.Anegundi.R.dental caries prevalence among pre-school children of Hubli: Dharwad city: Journal of Indian SOS pedod prev dent. 2006; available from URL:
Praveen.v.Bagali.Helen claret Dsouza.Asha.P.Shetty. Determining school teachers’ level of knowledge about oral hygiene of school children. Nightingale nursing times 2010; 6[2]:4-5

9 / SIGNATURE OF THE CANDIDATE / GEETHA.K
10 / REMARK OF THE GUIDE / Properly educated mother shall take initiative to reduce baby bottle syndrome syndrome incidence
11
11.1
11.2
11.3 / NAME AND DESIGNATION
GUIDE
SIGNATURE
CO- GUIDE / G. PRISCILLA NIRMAL
PROFESSOR AND HOD OF CHILD HEALTH NURSING
G. PRISCILLA NIRMAL
SUBHA ( M S c . N)
11.3
11.4 / H.O.D
SIGNATURE / G. PRISCILLA NIRMAL PROFESSOR AND HOD OF CHILD HEALTH NURSING
G. PRISCILLA NIRMAL
12.1
12.2 / REMARKS OF PRINCIPAL
SIGNATURE / Structured teaching programme shall help us to know to conduct many more awareness programmes among mothers of infants.
G. PRISCILLA NIRMAL