INTRODUCTION:

Every child develops and grows at her/his own pace and in her/his own time through reaching the various developmental milestones.

Children’s growth and development do not occur in a linear fashion, but are influenced by each child’s environment, nutrition and parental care. These factors play a critical role in a child reaching her/his full potential. Recent evidence indicates that good nutrition, particularly in early childhood, is critical to the positive health outcomes of children. In fact, children’s nutritional status can be viewed as a good proxy indicator of a community’s state of health.¹

The nutritional status of a child is usually described in terms of anthropometry, i.e. body measurement, such as weight, in relation to age or height, which is reflective of the degree of underweight or wasting of that child. Food is the prime necessity of life; life cannot be sustained without an adequate nourishment child needs adequate food for growth and development. ²

According to the WHO, breast milk has the complete nutritional requirements that a baby needs for healthy growth and development in the first six months of life. According to the United Nations Child Emergency Fund (UNICEF), children who are breastfed in the first six months of life have a six times greater chance of survival as opposed to non-breastfed children.³

Children are malnourished if their diet does not provide adequate nutrients for growth and maintenance or they are unable to fully utilize the food they eat due to illness (under nutrition). ⁴

NEED FOR STUDY:

In India about 2/3 portion of the under five children of our country is malnourished among them 5-8% is severely malnourished whole rest fall in the group of mild or moderate malnutrition so it can be said that malnutrition one of the most wide spread conditions affecting child health.⁵

In India nearly 75% of the populations reside in the village of the total rural population around 50% is still under the poverty lines. Majority of children in India are not in a position to get adequate nourishment because of very low per capita income of their families. A significant proportion of these children live in economic and social environment which impedes the child’s physical and mental development, this condition include poverty, poor environment sanitation, diseases, infections, inadequate access to primary health care, inappropriate child caring and feeding practices.⁶

STATEMENT OF THE PROBLEM:

“A descriptive study to assess the knowledge and attitude regarding malnutrition among parents of under five children at selected area of Belgaum District”.

OBJECTIVES:

1) To assess the knowledge regarding malnutrition among parents of under five children.

2) To assess the attitude regarding malnutrition among parents of under five children.

3) To correlate the knowledge and attitude regarding malnutrition among parents of under five children.

4) To find out the association between knowledge and attitude regarding malnutrition with selected demographic variables of parents of under five children.

OPERATIONAL DEFINITION:

1) Malnutrition: In this study it refers to the lesser intake of food for children in terms of quality and quantity to maintain optimum health.

2) Mother of Under Five Children: In this study it refers to those who have child of age group (1-5years).

3) Knowledge: In this study it refers to information awareness and correct response of mothers towards malnutrition.

4) Attitude: In this study it refers to opinion feelings or thought exhibited by the mothers under five children.

Assumptions:

The researcher assumes that,

· Parents of under five children will have some knowledge on malnutrition.

· Parents of under five children will have positive attitude towards malnutrition.

· Parents of under five children will have some knowledge regarding the diet of children.

· Parents of children will extend their co-operation in providing factual information regarding their knowledge and attitude on malnutrition.

Limitations:

· Only 50 mothers/fathers of under five children in village of Belgaum District.

· Data collection is limited to 4-5 weeks.

· Data collection is only in the area of Belgaum District.

· Data collection is through interview method.

REVIEW OF LITERATURE:

The Review of Literature arranged in 2 sections,

— Section- A: Studies related to knowledge regarding malnutrition among parents of under five children.

— Section- B: Studies related to attitude regarding malnutrition among parents of under five children.

Research approach

In this study the descriptive survey approach was used and aimed at assessing the knowledge and attitude regarding malnutrition among parents of under five children.

Research design

In view of the nature of the study and to accomplish the objectives of the study, Non experimental design was appropriate to assess the knowledge and attitude regarding malnutrition among parents of under five children.

Setting

Setting is the physical location and condition in which data collection takes place. The study was conducted in Bastwad Village of Belgaum district.

Population

In the present study the population comprised of parents having children below 5 years of age living in the selected village of Belgaum district (Bastwad)

Variables:

· Independent Variables: Informant, Age, Education, Occupation, Religion, Type of family, Number of children, Food pattern of the family, Source of information previous experience and previous exposure to malnutrition.

· Dependent Variables: knowledge and attitude of malnutrition among parents of under five children.

Sample and sample size:

The present study was conducted among 50 parents of under five children.

Sampling technique

The sampling technique used for the present study is convenient sampling technique.

Criteria for Selection of Sample:

Inclusion Criteria:

Mothers/Fathers

· Having under five children (1-5 years)

· Who can understand, read and write Kannada, Hindi, and Marathi.

· Residing in selected urban area.

· Willing to participate in the study.

· Available at the time of data collection.

· Having more than one child.

Exclusion Criteria:

Mothers/fathers

· Having children group more than 5 years.

· Working in Health care sector.

Child

· Suffering with any chronic physical or mental illness

Description of the tool

The tools were designed for collecting relevant information from the parents of under five children regarding their demographic data, knowledge and attitude on malnutrition.

The tools were divided into three parts;

§ Part A: Demographic Data of parents of under five children. It consists of 12 items of demographic variables.

§ Part B: Structured interview schedule seeks information about knowledge on Malnutrition.

§ Part C: Attitude scale to assess the attitude among parents towards malnutrition.

Major finding:

Regarding the informer 28(56%) were mothers and remaining 22(44%) fathers (Fig-1). Age of parents about 5(10%) of samples belongs to 18 years and below, 11 (22%) belongs to 19-22 years, 29(58%) of samples fit in to 23-27 years, 5(10%) were in the age group of 28 years & above (Fig-2). Majority of the parents 50(100%) were residing in rural area (Fig-3). Maximum parents 35(70%), belongs to Jain religion. 10(20%), Hindu religion 4(8%) Muslim religion and remaining were Christian religion 1(2%) (Fig-4). Education status of parents about 7(14%) were Illiterate, 35(70%) Primary, 6(12%) Secondary and Degree and Above 2(4%) (Fig-5). Major type of families was 36(72%) Nuclear, 10(20%) Joint and minimum were Extended 4(8%) (Fig-6).Maximum Occupation of mother was 46(92%) unemployed and remaining Employed 4(8%) (Fig-7). Occupation of Father 1(2%) Unemployed, 7(14%) Government employee, 20(40%) Private employee and Others 22(44%) (Fig-8). Majority of family income were 3000 and below 27(54%) and 6(12%) 12001 and below were minimum (Fig-9).About 38(76%) of the parents were Vegetarian, 5(10%) Non-Vegetarian and 7(14%) remaining were Mixed (Fig-10).. Maximum 33(66%) parent had only one child, 13(26%) parents had two children and 3 children and Above 4(8%) (Fig-11). Maximum parents were getting information from 23(46%) Others and 14(28%) Health care Workers. 5(10%) mass media 5(10%), Family friend 2(4%) Neighbor and very low no 1(2%) (Fig-12).

Fig 1 : Percentage distribution of informant of parents of under five children

Fig.2 Percentage Distribution of age of parents of under five children

Fig.3 Percentage Distribution of Area of Residence of parents of under five children

Fig.4 Percentage Distribution of Religion of parents of under five children

Fig.5 Percentage Distribution of Education status of parents of under five children

Fig.6 Percentage Distribution of Type of Family of parents of under five children

Fig.7 Percentage Distribution of occupation of parents of under five children

Fig.8 Percentage Distribution of Occupation of Fathers of under five children

Fig.9 Percentage Distribution of Family Income of Parents of under five children

Fig.10 Percentage Distribution of Food Pattern of parents of under five children

Fig.11 Percentage Distribution of No. of Children of parents of under five children

Fig.12 Percentage Distribution of Source of Information of parents of under five children

PART-B: Assessment of knowledge among parents of parents of under five children.

Table-1: Distribution of knowledge on malnutrition among parents of under five children. N=50

Level of knowledge	Number	Percentage
Inadequate knowledge	15	30
Moderately Adequate knowledge	29	58
Adequate knowledge	06	12

Table 2 describes that 29 (58%) of parents had Moderately Adequate knowledge, about 15(30%) were having Inadequate knowledge and remaining 6(12%) were having adequate knowledge (fig-13).

Table-2: Mean and Standard Deviation of knowledge on malnutrition among parents of under five children. N=50

Statistics	Knowledge on Malnutrition
Mean	8.64
Standard Deviation	2.57

The above table explains that the knowledge on malnutrition scored mean is 8.64 with a standard deviation of 2.57

Fig.13: Distribution of knowledge on malnutrition among parents

Fig.14: Distribution of attitude on malnutrition among parents

PART-C: Assessment of attitude among parents of parents of under five children

Table-3: Distribution of attitude on malnutrition among parents of under five children. N=50

Level of attitude	Number	Percentage
Negative attitude	00	00
Moderately positive attitude	43	86
Positive attitude	7	14

Table 4 describe that 43 (86%) were having moderately attitude and remaining 7(14%) were having positive attitude on malnutrition (fig-14).

Table-4: Mean and Standard Deviation of attitude on malnutrition N=50

Statistics	Attitude level
Mean	32.84
Standard Deviation	3.38

The above table explains that the attitude on malnutrition scored a mean is 32.84 with a standard deviation of 3.38(fig-16).

PART-D: Correlation between knowledge and attitude regarding malnutrition among parents of under five children. r= 0.097 N=50

The above ‘r’ value shows that there is a positive correlation between Knowledge and attitude on malnutrition among parents of under five children. This implies that parents of under five children had moderately adequate knowledge and moderately positive attitude towards the malnutrition (fig-15).

Fig 15.Corelation between Knowledge and Attitude

Association between knowledge of parents and Demographic Variables

There was no significant association found between the knowledge on malnutrition among parents of under five children and demographic variables such as Informant age, education, occupation, economic status, type of family, religion, area of residence, food pattern, and source of information.

Association between Attitude of parents and Demographic Variables

There was no significant association found between attitude on Malnutrition among parents, demographic variables such as Informant age, education, occupation, economic status, and type of family, religion, area of residence, food pattern, and source of information

DISCUSSION:

This chapter deals with the detailed discussion on the findings of the study interpreted from the analysis.

The findings of the study are discussed in relation to the objectives, need for the study and related literature of the study.

Characteristics of Selected Demographic Variables of the Sample:

· 56% of mothers were given the Information on malnutrition

· 58% of parents were in the age group of 23-27 years

· 100% of parents were from Rural area

· 70% of parents were belongs to Jain religion

· 70% of parents were studied Primary

· 72% of parents were belongs to Nuclear family

· 92% of mothers were Unemployed Mothers

· 40% of fathers were private employed Fathers

· 54% of parents monthly income is Rs. 3000 and below

· 76% of parents dietary pattern is Vegetarians

· 66% of parents had only one children

· 46% of parents were got information from Others and Health Care Workers

Assessment of knowledge among parents of under five children

This finding shows that 29(58%) of parents were having moderately adequate knowledge. The mean value of knowledge on malnutrition was 8.64 with a standard deviation of 2.57.

Assessment of attitude among parents of under five children

The judgment shows that attitude 43(86%) of parents were having moderately positive attitude. The mean value of attitude on malnutrition was 32.84 with a standard deviation of 3.38.

Correlation between knowledge and attitude regarding malnutrition among parents

Result show that there is a strong positive correlation between knowledge and attitude regarding malnutrition among parents of under five children (r=1.132.) this implies if there is increase in knowledge the attitude also increase.

Association between knowledge scores of the parents of under five children with selected demographic variables

There is no significant association between knowledge and demographic variables such as Informer age, education, occupation, economic status, type of family, religion, area of residence, food pattern, and source of information of the parental knowledge on Malnutrition.

Association between attitude scores of the parents of under five children with selected demographic variables

There is no significant association between attitude and demographic variables such as Informer age, education, occupation, economic status, type of family, religion, area of residence, food pattern, and source of information of the parental attitude on Malnutrition.

NURSING IMPLICATIONS:

The findings of the study have implications on nursing education, nursing practice, nursing administration and nursing research.

Implications for Nursing Education

The nursing curriculum should having emphasis on malnutrition and its consequences which help the nurses to interview the target group in the form of health awareness, prevention of malnutrition and health problems due to malnutrition.

Implications for Nursing Practice

Nurses are key persons in the health care team, they play a major role in health promotion and maintenance in the clinical as well as in community setup; it is a practicing profession, hence the researcher generally integrate findings into practice.

Implications for Nursing Administration

The nurse administrators should see that the aspect of health promotion while providing nursing care. Nursing administration should implement the program should organize Continuing Nursing Education (conferences, workshop, seminar and education) on malnutrition and its consequences. The Community Nurse Administrator should educate nurses working under them on various aspects of malnutrition such as health problems due to malnutrition, legal aspects, prevention, treatments and rehabilitation.

Implications for Nursing Research

There is a need for more and in depth nursing research on malnutrition in order to provide evidenced based nursing care. People generally believe the malnutrition is effectively prevented by providing good nutrition. Hence there is a need for comprehensive nursing research on malnutrition which helps in finding effective measures and solutions in the management of malnutrition.

LIMITATIONS:

· Only 50 mothers/fathers of under five children in area of Belgaum District.

· Data collection is limited to 4-5 weeks.

· Data collection is only in the area of Belgaum District.

· Data collection is through interview method.

· A large number of samples could not be taken because of the time constrains.

RECOMMENDATIONS:

The following studies can be undertaken to strengthen the accident & emergency care.

1) The same study can be repeated in different regions of the state or nation so as to compare the results.

2) The same study can be repeated on a large sample so as to generalize the results.

3) Similar kind of study can be conducted among different age group of children.

4) The same study can be conducted as experimental study i.e STP or NEP.

CONCLUSION:

The study was concluded by if there is an increase in knowledge the attitude also increases towards malnutrition among parents of under five children.

REFERENCE:

1. Darshan sohi. A Text book of nutrition (for nursing course). 1^st ed. Jalandhar: PV publications; 2010. p.

2. 1Integrated child Development services. Available from http://www.wcd.gujarat gov.in/introduction.html.

3. Williams. Basic nutrition and diet therapy. 12^th ed. New Delhi: Elsevier publication; 2000. P. 4.

4. The British Dietetic association, food fact sheet. Available at www.bda.uk.com/food fact

5. Principles of parenting: Meeting children’s needs 1995. Available at : http://www. aces.edu/pubs/docs/H/HE-0685/

6. H.Darlene Marin. Extension nutrition specialist northeast research. Availablefrom http://www.nnncc.org/nutrition/nutrition. pres.html. April- 1997.

Received on 09.09.2014 Modified on 25.09.2013

Asian J. Nur. Edu. and Research 5(1): Jan.-March 2015; Page 72-77

DOI: 10.5958/2349-2996.2015.00016.6

A descriptive study on Malnutrition