Effectiveness of structured teaching programme on knowledge regarding acute respiratory tract infections among mothers of under five children in selected rural area

INTRODUCTION

Children under the age of 5 years are grouped with the mothers considering as vulnerable and risk group comprising about 32 percent of total population in India. It includes all infections of less than 30 days duration, except the infection of the ear lasting less than 14 days. The incidence of ARI is highest in young children, especially below 5 years of age and decreases with the increasing age.¹ In India, ARTI is one of the major causes of childhood death. It is also one of the main reasons that children are delivered to the hospitals and health facilities. In India, year 2001 were outpatients attendance attributed to acute respiratory tract infections was so high as 20 to 40 %in all the clients and 12 to 35% of in clients.

Children all over the world suffering from frequent cough and cold, but in developing countries the life threatening due to pneumonia, that are the leading cause of death among under five children.^2,3

It was estimated that 15 million deaths of under-five children were occurring in the world annually, where 14 million occur in developing countries. Among this 14 million deaths, approximately one-quarter to one- third are due to acute respiratory tract infections. In India 7,80,000 deaths among under-five children annually are due to acute respiratory tract infections. By using standard techniques 70 per cent of lives currently being lost due to acute respiratory tract infections could be saved.⁴ Each year young children throughout the world experience four to eight episodes of respiratory tract infections amongst which major episodes are limited to upper respiratory tract infections. Mainly pneumonia is very high in developing countries. Younger children have a higher incidence, but children between the age of 2 and 5 years are mostly affected in the same population. Below the age of 1year, children may have a 1.5 to 2.5 fold higher incidence.⁵

Objective was to study effectiveness of structured teaching programme on knowledge regarding acute respiratory tract infections among mothers of under five children.

METHODS

A quantitative approach was selected for the present study. It was quasi experimental one group pre-test and post-test design among 45 mothers of under five children. The study was conducted at mati (rural area), Lucknow, Uttar Pradesh. The study population includes mothers of under five children who met the designated inclusion criteria. The estimated sample size is 70 (calculated by power analysis). Purposive sampling technique was used in the study.

Formula: n= z²Pq÷d²

Where n is sample size.

Z is confidence interval: 95% (z= 1.96) P is population proportion= 25% D is precision or error (10% i.e.0.01)

Note*: Due to covid-19 pandemic condition sample size will be 45 in the study.

Inclusion criteria

Mothers who are available AND willing to participate in the study, who have under five children and who are residing in selected rural area were included in the study.

Exclusion criteria

Mothers who are critically ill and suffering with mental disorder were excluded in the study.

Part A

Socio-demographic variables

This section consists of 16 items related to socio demographic variables it is used to check the correlation between study and experimental group with selected demographic variables of the mothers of under five children. The demographic profile included such as age of mother, marital status, number of under five children, type of house, educational qualification, occupation, religion, monthly income, source of ventilation, drainage system, source of water, having any pet animal, source of information, previous knowledge regarding prevention of acute respiratory tract infection and health services availed from.

Part B

Self structured questionnaire

This section consists of 20 items related to knowledge regarding acute respiratory tract infections and its prevention mothers of under five children in selected rural area.

Development of intervention

The structured teaching programme was prepared under the following headings Definition, Classification, Common cause, Mode of transmission, signs and symptoms, Management, Prevention and Complications of acute respiratory tract infections.

Data collection

The data was collected through structured knowledge questionnaire among mothers of under five children for duration of 45 days from 01^st March 2021 to 17^th April 2021.

Ethical aspects

The study was carried out after obtaining ethical clearance from Institutional Ethics Committee of King George’s Medical University, Lucknow and other administrative permission was also taken prior to the study. Informed consent was taken by all the potential participants and freedom was given to withdraw from the study at any time. They were assured confidentiality and safety of the data provided by them.

RESULTS

Table 2 depicts that, in pre-test area wise maximum mean percentage (51%) was found in item no. 4 i.e. mode of transmission and mean and SD was (0.51±0.48), where as in post teat maximum mean percentage (80.66%) was found in item no. 7 i.e. prevention the mean and SD was (2.42±0.39).

Effectiveness of structured teaching programme by comparing the pre-test and post-test knowledge scores of subjects.

Level of significance (P <0.05)

The researcher calculated the paired t-test value and compared the calculated t- value (9.81) with the tabulated value (2.26) on 44 degree of freedom. The calculated value lies beyond the tabulated value and this result shows that there was significant change in the knowledge level of adult population in post-test. So, this is evident that the structured teaching programme on knowledge regarding acute respiratory tract infections was found effective in terms of knowledge.

DISCUSSION

In relation of age majority of mothers (40%) are aged between 26 -30 years, (33.33%). In relation of number of under five are majority of (44.44%) of mothers were having i.e. one. In relation of education majority (33.3%) of mothers of under five children were having primary education. In relation of marital status (77.7%) of mothers of under five were married. In relation of monthly income (33.3%) were having Rs 5001-10000.

In the study (80%) of mothers of under five children were Hindu. In relation of occupation (55.5%) of mothers were home maker. In relation of type of house (44.4%) were having pucca house. In relation of pet animal (66.6%) were not having any pet animal, (33.3%) were having pet animal. (22.2%) of pet shelters were having inside the house. In relation of source of ventilation (48.8%) were having door and window. In relation of source of water (55.5%) were having hand pump. In relation of type of drainage (77.7%) were having open drainage system. In relation of illness history (44.4%) under five children were ill 3-5 times in a year. In relation of common causes of illness (33.3%) were cold and cough. In relation of previous information (55.5%) were not heard about ARTI, (44.4 %) were heard ARTI. In relation of source of information (44.4%) of mothers were having information from communication media. In relation of utilization of health services (33.3%) were utilizes private health care services.

Effectiveness of structured teaching programme regarding acute respiratory tract infection among mothers of under five children.

The researcher calculated the paired t-test value for the tabulated and compared the calculated t- value (9.81) with the tabulated value (2.26) on 44 degree of freedom at p <0.05 level of significance. The calculated value lies beyond the tabulated value and this result shows that there was significant change in the knowledge level of mothers of under five children in post-test. So, this is evident that the structured teaching programme on knowledge regarding acute respiratory tract infections was effective in terms of knowledge. The above mentioned findings are supported by following study.

These findings are supported by the similar study conducted by Kavungal T, which was highly improved the calculated paired ‘t’ test value was 19 and the tabulated ‘t’ value was 2.05.⁶ that findings proved that there is a significant improvement in post test score when campared to pre-test score, so the structured teaching programme on acute respiratory tract infections was effective among mothers of under five children.⁶

Limitations

During data collection period, some of the study participants were reluctant to participate in the study due to covid-19 pandemic. The study was limited to the mothers who have under five children only.

CONCLUSION

The result shows that the level of knowledge of subjects regarding acute respiratory tract infections was poor in the pre-test when compared to the post-test. The study finding proved that the structured teaching was effective in improving the knowledge among mothers of under five children regarding acute respiratory tract infections. So it is concluded that there is a need of providing proper information and education regarding acute respiratory tract infections, its sign and symptoms, complications, use of preventive measures and its importance. The health care provider should provide health education to improve the knowledge.

Recommendations

A similar study can be conducted with a larger sample for the purpose of generalization, or to assess the knowledge regarding dengue fever and its preventive measures among different age group of population. The study can be conducted using different research design.7

ACKNOWLEDGEMENTS

The author expresses her profound and long lasting gratitude to the subjects who participated in the study with their cooperation and participation, it would have been impossible to conduct the study. She also extends her deepest gratitude to Miss Aditi Mecarty, Clinical Instructor, KGMU College of Nursing for her judicious advice, motivation and support throughout the research study.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

REFERENCES

1. 1. Parul D. Pediatric Nursing. 3^rd edition. Jaypee Brother’s Medical Publishers (P) Ltd. New Delhi. 2014:9.
2. 2. Park K. Epidemiology of Communicable Diseases. Park′s Textbook of Preventive and Social Medicine. 21^st ed. Jabalpur: M/S Banarsidas Bhanot Publishers. 2011:156.
3. 3. World Health Organization Programme for the Control of Acute Respiratory Infections. Acute respiratory infections in children: case management in small hospitals in developing countries: A manual for doctors and other senior health workers (WHO/ARI/90.5). Geneva: WHO, 1990.
4. 4. National Health Profile (NHP) of India - 2011. Available at http:// cbhidghs. nic.in/ writereaddata/ mainlinkFile/08%20 Health % 20Status %20 %20 Indicators %20%202011.pdf. Accessed on 26 March 2021.
5. 5. Lal S. Epidemiology of Communicable Diseases and Related National Health Programmes. Textbook of Community Medicine. New Delhi: M/s CBS Publishers and Distributons; 2^nd edition. 2011:543.
6. 6. Kavungal T. Assess the knowledge and effectiveness of structured teaching programme regarding the acute respiratory tract infection among mothers of under five children. Int J Advances Nur Management. 2021;9(2):127-30.
7. 7. Kumar SG, Majumdar A, Kumar V, Naik BN, Selvaraj K, Balajee K. Prevalence of acute respiratory infection among under-five children in urban and rural areas of puducherry, India. J Nat Sc Biol Med. 2015;6:3-6.