RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA, INDIA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. / NAME OF THE CANDIDATE AND ADDRESS / SMT. UMADEVI. G.FIRST YEAR M.Sc. NURSING,
BAPUJI COLLEGE OF NURSING,DAVANGERE – 4,
KARNATAKA.
2. / NAME OF THE INSTITUTION / BAPUJI COLLEGE OF NURSING,
DAVANGERE - 4.
KARNATAKA.
3. / COURSE OF STUDY AND SUBJECT / FIRST YEAR M.Sc. NURSING,
COMMUNITY HEALTH NURSING.
4. / DATE OF ADMISSION TO COURSE / 17th OCTOBER 2007
5. /
TITLE OF THE TOPIC
/ “A STUDY TO ASSESS THE EFFECTIVENESS OF THE PTP REGARDING HOME MANAGEMENT OF DIARRHOEAL DISEASES AMONG MOTHERS OF UNDER FIVE CHILDREN ATTENDING PHC KONDAJJI DAVANGERE - DISTRICT”.6. /
BRIEF RESUME OF THE INTENDED WORK :
INTRODUCTION :Children constitute the most important and vulnerable segment of our population. They are truly the foundation of the nation. Hence, the focus of every citizen should be to promote their health and safeguard their interest “A healthy child is a sure future” is one of the themes of WHO. Healthy children grow to become healthy adults, who are strong both in body and mind.
Diarrhoea is one of the most common manifestations of illness in infants and children. It is characterized by an increase in fluidity, frequency and volume, as well as a possible change in colour of feces in comparison with the useful stool pattern of the individual. For example the usual stool pattern of the breastfed infant may be several stools a day. Where as that of formula fed infants may be one stool every other day. Diarrhea is symptom of variety of conditions and it constitutes one of the main causes of morbidity and mortality among infants and children through out the world.
Of the estimated total 10.6 million deaths among children younger than five age worldwide, 42 percent occur in the world health organization (WHO) African region. The underfive mortality rate in the African region is seven times higher than that in the European region. In 1980 this difference was equal to 4.3 times.
Well infants and children are less prone to develop dirrhoea than those who are ill. Those are deliberated from other conditions or are malnourished tend to not only develop diarrhea but have serious manifestations of the condition.
Infants develop diarrhea more frequently and have more serious manifestations of the condition than do older children.
Several child health interventions including breast feeding, immunization against diarrheal diseases, oral rehydration therapy and micronutrient supplementation have been shown to both effective and cost in treating and preventing diarrhea.
6.1 Need for the study :
Diarrhoeal diseases constitute one of the major causes of morbidity and mortality, specialy in children below five years of age, they are responsible for about 6.27 lakh deaths each year, outbreaks of diarrhoeal diseases continue to occur in India due to poor environmental condition.
The global burden of disease estimate for the number of deaths in children under five years of age was 12.8 million in 1990. An analysis of 10.5 million deaths in 1999 attributed 1.6 million of them to diarrhea only. Diarrhea thus still accounts for 1.6-2.5 million deaths annually and each child in the developing world experiences an average of three episodes of diarrhea per year.
Diarrhea remains one of the principal water destined for human contact that is exposed to the environment is a potential source of diarrhoeal disease. In developing countries, in particular, surface water is often contaminated with pathogens (including bacteria, viruses, and parasites) due to contact with human and livestock waste. Drinking, handling, cooking and bathing in such water exposes people, especially young children to a wide range of health risks, including diseases. Causes of morbidity and mortality in children.
During clinical experience in hospitals, it was found that mothers of under-five children have inadequate regarding management of diarrhoeal diseases. Though it is a major public health problem. Therefore the investigator personally felt that there is a need to assess mothers knowledge regarding management of diarrhoeal diseases and preparing an information guide short, for them so that the study will help the health professionals to gain insight to educate mothers by which she can provide a helping hand in the management of diarrhoeal diseases, to a great extent.
6.2 REVIEW OF LITERATURE :
Review of literature is a key step in the research process. It involves identification, and scrutiny of written material that contain information on the research problem.
Ghosh S (1997) conducted study on community based behavioural practicesof mothers of families residing the slums in Calcutta and Varanasi and in rural areas in Haryana and Hyderabad. The result of the study found that risk factors attributed to mothers showing significant association with presence of a child with diarrhea in the family included use of pond water for cleaning child feeding containers, indiscriminate disposal of childrens stools, bottle feeding containers and water storage in a wide mouthed container.
K.R. Thankappan (1997) conducted study on the incidence of diarrhea morbidity. It is believed that house hold practices and water quality and diarrhea are interlinked. Hence this study focuses on quality of drinking water and house hold practices to acertain the incidence of diarrhea morbidity, particularly among children under the age of five. The study hypothesis that water quality affects the household practices which in turn determines morbidity outcomes. Two paraayaths are each from Kerala and Tamilnadu, were selected to form the experimental control area of the study. A baseline survey to determine the households in which underfive children are present was conducted followed by a detailed survey of the household.
Clements J,, Elyazeed RA (1999) conducted study on early initiation for breast feeding and the risk of infant diarrhea in rural Egypt. Objective was to evaluate whether initiation of breastfeeding within the first three days of life, when breast milk contains colostrums was associated with a lower rate of diarrhea in rural Egyptian infants during the first 6 months of life infants initially breastfed (n = 198) were monitored prospectively with twice-weekly home visits to ascertain dietary practices and diarrhoeal illness. The results found that infants in whom breastfeeding was initiated early had a 26% lower rate of diarrhea than those initiated late.
Reviews related to management of diarrhoeal diseases :
Graey M (1999) conducted study on nutritional effect and management of diarrhea in infancy in cutin university, Australia. The study results suggested that oral rehydration therapy has been a major advance and has saved many lives from acute diarrhea. ORT provides clear and practical methods for replacement of fluid and electrolyte losses during diarrhea. Early refeeding during diarrhea is another important principal to reduce its duration, severity and its nutritional impacts.
Piechulek H, Aldana JM (1999) data were collected on nutritional aspects of women in general and during special time frames such as pregnancy, lactation and common childhood illness (diarrhea, acute respitaroty infections and measles) from rural areas in Bangladesh. A distinctive gender bias was evident regarding decision making and food allocation within the household. Inadequate feeding practices were observed during diarrhea with 22.2% of the mothers discontinuing breast feeding. Breast feeding and nutritional support were comparatively both during ARI and measles when the children were ill, 97% of the mothers administered a special diet with a variety of food preferences which were perceived to improve the symptoms of the respective illness. Maternal education influenced both the occurrence of diarrhea and the nutritional management of diarrhea and measles significantly therefore community health education should focus on the importance of breast feeding and continued nutritional support during illnesses. In order for this health education to be effective traditional beliefs noted in this study have to be incorporated.
Rajib Dasgupta (2000) conducted study on the determinants at the household level are explored through a dataset based on a primary survey of 300 households in Delhi. The association between household level vulnerability factors and incidence of diarrhea were examined through assessing distribution of incidence over different types of households. For the cross-sectional study, water samples were tested from the main sources assessed, and storage containers in the household. The results found that the household factors for vulnerability to diarrhoeal diseases.
6.3 Objectives of the Study :
1) To determine the knowledge of mothers regarding home management of diarrhea underfive children before interviewing with PTP by pre test.
2) To introduce planned teaching programme.
3) To determine the knowledge of mothers regarding home management of diarrhea. Underfive children after intervening with PTP by post test.
4) To find the association between knowledge and sociodemographic variables.
Hypothesis :
1) The mean post test score will be more comparing to mean pretest score.
2) There will be significant association between knowledge and sociodemographic variables.
7. /
MATERIALS AND METHODS :
7.1 Source of Data :The data will be collected from the mothers of underfive children. The are having diarrhoeal diseases.
7.2 Methods of Collection of the Data :
Based on objectives of the study “structured interview schedule” and structured questionnaires” is developed by the investigator for the present study to collect the data.
Research design :
The research design selected is quasi experimental method (one group pretest post-test design).
Setting of the study : PHC Kondajji Davangere district.
Inclusion criteria :
· Mothers of underfive children who are literate and illiterate
· Age group (20-35 yrs)
· Mothers who are willing to participate
· Mothers who are able to read and understand Kannada and / or English.
Exclusion criteria :
· Mothers who are not willing to participate
· Mothers below 20 yrs and above 35 yrs
· Mothers who are unable to read and understand Kannada and / or English.
Sampling :
Sample Size : 50 mothers
Sampling technique : Purposive sampling technique
Tool of research :
Development and description of the tool. The researcher develops the “structured interview schedule” and structured questioner schedule”.
Methods of data analysis and presentation :
The researcher will use appropriate statistical technique for data analysis and present in the form of tables, graphs and diagrams, statistical method which will be used for descriptive and inferential statistical measures.
Duration of the study: 2 weeksVariables:
Independent Variables: Mothers of under five children. The children who are having diarrhoeal diseases.
Dependent Variables: Structural teaching programme.
Demographic variables : Age, sex, income, occupation, education of the mothers.
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so, please describe briefly :
Yes, Study will be conducted to mothers of underfive children regarding home management of diarrhoeal diseases in Kondajji PHC Davangere. the intervention will be planned teaching programme.
.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes
Written consent and permission to conduct the study will be obtained from the concerned authorities.
8. / LIST OF REFERENCES :
1) Snyder JD, Merson MH. The magnitude of the global problem of acute diarrhoeal disease : a review of active surveillance data. Bulletin of the World Health Organization 1982;60:604-13.
2) Bern C, Martines J, de Zoysa I, Glass RI. The magnitude of the global problem of diarrhoeal disease: a ten-year update. Bulletin of the World Health Organization 1992;70:705-14.
3) World Bank. World Development report 1993: investing in health. New York : Oxford University Press; 1993.
4) Murray CJL, Lopez AD. The global burden of disease : a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge (MA): Harvard School of Public Health on behalf of the World Health Organization and the World Bank; 1996.
5) ‘World Health Organization. The world health report 1999: making a difference. Geneva : World Health Organization; 1999.
6) Briscoe\ J. 1984a Technology and child survival : the example of sanitary engineering. Population and Development Review 1984a;10(suppl):237-53.
7) Chakraborty AK, Das JC. Comparative study of incidence of diarrhea among children in two different environmental situations in Kolkata. Indian Paediatrics 1983;20(12):907-13.
8) Ghosh S, Sengupta PG, Mondal SK, Basu MK, Gupta D, Sircar BK. Risk behavioural practices of rural mothers as determinants of childhood diarrhea. The Journal of Communicable Diseases. The Indian Society for Malaria and Other Communicable Diseases, Delhi. Vol. 29.
9) Glass RI, Sevennerholm AM, Stoll BJ, Khan MR, Hossain KMB, Haq MI et al. Protection against cholera in breast-fed children by antibodies in breast milk. New England Journal of Medicine 1983;308(23):1392-1398.
10) Koo D. et al. Epidemic cholera in Guatemala, 1993 : transmission of a newly introduced epidemic strain by street vendors. Epidemiology and infection. Cambridge University Press 1996;116:121-126.
11) Mehrotra Ritu Priya. The gastroenteritis outbreaks and its control in Sunder Nagri : An assessment at community level. Unpublished report. Centre for social medicine and community health, Jawaharlal University, New Delhi 1988.
12) Park K. Park’s textbook of preventive and social medicine, 16th edition. Banarasidas Bhanot Publishers, Jabalpur 2000.
13) Vathanophas K et al. The study of socio-economic, behavioural and environmental factors related to diarrhoeal diseases in children under five years in congested area of Bangkok Metropolis. Journal of Medical Association of Thailand 1986;69:156-162.
9. / SIGNATURE OF THE CANDIDATE /
10. / REMARKS OF THE GUIDE
11. / NAME & DESIGNATION OF
(IN BLOCK LETTERS)
11.1 GUIDE
11.2 SIGNATURE
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF THE DEPARTMENT
11.6 SIGNATURE
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