INTRODUCTION:
ASSUMPTIONS
The mother of under five year children may have poor knowledge regarding PEM its causes and its prevention.
A study approach was adopted in this study using one group pre test post test design. The population of the study consisted of all mother’s of selected area in simrol of Indore. Purposive sampling technique was used to select 30 mothers of under five children.
The study intended to measure the gain in knowledge score of mother’s of under five year children after the administration of structured teaching regarding protein energy malnutrition causes and it’s prevention. The group was assessed before and after introducing the intervention the key variable were knowledge of mother’s of under five year children regarding protein energy malnutrition and structured teaching programme. A structure knowledge questionnaire was developed for data collection.3experts did the validation of the tool. Reliability of each tool was calculated using split half method.
The actual data collection was from15th June to 08th august 2017. Prior to the data collection the study indicate that–The study indicate that mean post test knowledge score 31.7 was higher than mean pre test knowledge score14.6. The analysis and finding of this study showed that educating mother of under five year children helped them to improve their knowledge and practice to prevent PEM.
The findings of the study had implication in community health nursing, nursing practice, nursing education, nursing administration, and nursing research by helping to raise the awareness among mother’s of under five year children ‘health worker in the community to acquire knowledge on protein energy malnutrition. Government of India or M.P providing education to community people & health worker, nursing and medical staffs regarding protein energy malnutrition and its prevention.
Thus this study concluded that structured teaching programme is effective in increasing the knowledge of mother’s of under five year children regarding protein energy malnutrition& its prevention.
BACK GROUND OF THE STUDY:
Children are treasures of our nation. They are to develop into citizen and leaders of tomorrow. Healthy children are the greatest resources and pride of any nation. Investment in the children development is an investment in the future of the nation. Their health and development monitored at every step of their life.
The world health organization (WHO): defines malnutrition as the cellular imbalance between the supply of nutrients and energy and the body’s demand for them to ensure growth, maintenance, and specific function “The term protein energy malnutrition (PEM) applies to a group of related disorders that include Marasmus, kwashiorkor and intermediate states of marasmus,-kwashiorkor.
The term Marasmus is derived from the Greek word “Marasmos” which means withering or wasting. Marasmus involves inadequate intake of protein and calories and is characterized by emaciation. The term kwashiorkor is taken from the Ga language of Ghana and means “The sickness of the weaning. Williams first used the term in 1933, and it refers to an inadequate protein intake with reasonable calorie intake. Edema is characteristic of kwashiorkor but is absent in marasmus.1
Nutritional deficiency disorders are major public health problem in India and other developing countries they affect vast majority numbers if population responsible for approximately 55% of childhood death, in India there are about 60 million malnourished children and every month about 1 lake children die due to effect of malnutrition. Malnutrition is a man made disease of human society. The ecology of malnutrition is complete with numbers of influencing factors like disease condition, Infection, Socioeconomic status, Cultural practices and available health and other services.
NEED FOR STUDY:
The researcher identified that during community posting by physical examination and shakier test many of under 5 year children are found malnourished in village Simrol and also researcher found that lack of knowledge regarding PEM were found on Mother’s of under five year children, simrol, Indore. So researcher has decided for a exploration of knowledge regarding the topic.
There are many nutritional problems which affect vast segments of our under 5 year population; PEM is identified as a major nutritional problem in India. It affects children’s in the first year of life. The PEM current concept of protein energy malnutrition is that it’s clinical forms. The incidence of PEM in India in preschool age children 1-2% the great majority of case of PEM nearly 80%.
The investigator will be planning to develop structural teaching programme to improve the knowledge of the mother’s of under five year regarding malnutrition in simrol, Indore.
STATEMENT OF THE PROBLEM:
A pre experimental study to assess the effectiveness of structured teaching programme through pamphlet on the knowledge among mothers of under five year children regarding PEM and its prevention in a village, simrol, Indore in the year 2017-2018.
OBJECTIVES:
· To assess the pre test knowledge of mothers of under five year children regarding PEM& its prevention.
· To assess the post test knowledge of mothers of under five year children regarding PEM and its prevention.
· To evaluate the effectiveness of structured teaching programme regarding PEM and its prevention for mother of less than 5 year children.
HYPOTHESIS:
H1: There will be significant difference between pre-test and post test knowledge score of mother’s of under five year children after the administration structured teaching programme at the level of p≤ 0.05
CONCEPTUAL FRAMEWORK
conceptual framework serves as a guide to systematically identifying logical, precisely defined relationship among variables.
Based on Modified M. King Goal Attainment model (1981), the investigator developed the conceptual framework of the present study
RESEARCH METHODOLOGY:
The study adopted pre experimental one group pre-test, post-test design. Comprise of 30 mothers under 5 years children’s who are living in Simrol, The sample was select through a convenient sampling technique, i.e. mothers under 5 years children who are willing to participate in study.
In this study a pre experimental one group pre test post test design was used to observe the effectiveness of structured teaching programme on the knowledge of mothers under 5 years children’s as a regard of PEM.
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O1 |
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XO2 |
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Pre-test knowledge |
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Structured teaching programme |
Post-test knowledge |
Figure. One group pre test post test design
DEVELOPMENT AND DESCRIPTION OF THE TOOL:
A structured knowledge questionnaire was used to collect data. Questionnaire is considered to be most efficient and objective method. Questionnaire is a quick and generally inexpensive means of obtaining data from large number of respondents and questionnaire are one of the easiest research instruments to test for reliability.
Tools used in the study were:
Section A:
Socio-Demographic Data: It consisted of 6 items, for obtaining information on selected factors such as-Age (in years) Educational status, occupation, income of family, family size, number of under five year children.
Section B:
Structured interview schedule to assess level of knowledge of mothers of under five year children regarding PEM & its Prevention. Knowledge consisted of20 items. Each item of structure questionnaire had 4 response alternatives and the correct response among them was scored 1. The response were scored and graded as follows:
· Poor (0-5)
· Average (6-10)
· Good (11-15)
· Very good (16-20)
SAMPLE:
A sample is a subject of a population’s selection to participate in a research study (Polit and Hungler, 1999) 4
Sample size comprised of 30 samples of mothers who have children under five year of age in simrol, Indore.
SAMPLING TECHNIQUE:
The sample was select through a convenient sampling technique. Due to limited time and availability of the subjects as per sample inclusion criteria made the investigator to adopt the convenient sampling technique for present study.
DATA COLLECTION METHOD
Permission and need for the study I’ll be explained to the Mothers under five year children. Who will be chosen by purposive or convenient sampling technique
Variables under study:
Abdellah and Levine E. (1980)1,Variables are the conditions or characteristics that the investigator observes, manipulates or control.
Two types of variables were identified in this study:
· Independent variable
· Dependent variable
Independent variable:
Wood and Haber, (2002)5.
It is the variable that has presumed effect on the dependent variable.
Kothari C.R., (2004)2
Independent variable that is not related to the purpose of the study but may affect the dependent variable.
In this study, the independent variable is structural teaching programme regarding PEM.
Dependent variable:
The dependent variable is the response or outcome that the researcher wants to predict or explain. It is the outcome variable which is measured or observed following the intervention of the independent variable.
In this study, the dependent variable is the knowledge of mother regarding PEM under five year children.
RELIABILITY OF THE TOOL:
Reliability of the research instrument is concerned with its consistency and stability. It is the extent to which instrument yields the same result on repeated measure. (Nieswiadomy M. Rose, 2008)3
Reliability is the degree of consistency that the instrument or procedure demonstrates. Pre-testing and reliability of the tool was carried out among 5 subjects. The tool was found to be clear and understandable. The mother under five year children answered the tool in 15-20 minutes.
The reliability of co- efficient for the knowledge test was calculated by using Karl Pearson’s correlation formula. The reliability co-efficient was found to be r=0.84 which proved that the tool was reliable, no modification was made thus tool was found to be valid reliable and feasible for the purpose of study.
PROCEDURE FOR DATA COLLECTION
To conduct the research study in simrol written permission was obtained from the concerned authorities before data collection. Data collection was held in simrol the data collection period extended from 15th June to 08th august 2017.
Sample of 30 mothers were selected using purposive samples technique. The investigator introduced herself and the purpose of the study was explained to the subjects and informed consent was obtained.
Pre-test was given using a structured knowledge questionnaire. The time taken to complete questionnaire was 10-15 minutes. Following the pre-test structural teaching was given and visual aids like charts were used to facilitate understanding. The duration of session was15-20 minutes. After the session the mother asked doubts which were clarified subsequently.
Seventh day after the pre-test post–test was conducted using the same questionnaire to assess the gain in knowledge score. The time taken to complete the questionnaire was 10-15 minutes. The investigator did not find any difficulty in collecting data from the subjects. The respondents were co-operative, excited and interested to learn more regarding PEM& its Prevention under five year children. The data was thus collected and compiled for data analysis.
FINDINGS:
The data were analyzed according to the objective of the study using descriptive and inferential statistics.
SECTION I- SOCIODEMOGRAPHIC DATA:
Most of the mothers of under five year children, 3 (10%) belonged to the age group of less than 20 year, out of 30, 19 (63.3%) were between 21-25 year, out of 30, 4 (13.3%) were between 26-30 year,4 (13.3%) were between 3l-35 year. Out of 30 mothers of under five year children, 11 (36.6%) lad illiterate 13(43.3%) had education up to high school,5 (16.6%) education up to Higher Secondary and l(3.3%) were graduated. Most of mothers under five year children occupation had,6 (20%) labour, 23 (76.6%) house wife, 1 (3.3%) home business. no one had any professional job. Monthly family income, 1 (3.3%) less than Rs.1000, 5 (16.6%) had earning between Rs.1000-3000, 14 (46.6%) had Rs. 4000-5000, and 10 (33.3%) had above Rs.5000. Family had belonged to joint family, 15 (50%) and 15 (50%) nuclear family. Number of under five year children’s in home, 18 (60%) had 1 children, 9 (30%) had 2 children’s, 2 (6.6%) had 3 children’s and 3 (3.3%) had more than 3.
SECTION–II Assessment of pre-test knowledge score of mothers of under five year children regarding PEM and its intervention:
The finding of the study showed that out of 30 sample 12(40%) had average Knowledge score and 18(60%) had poor knowledge score and no one had good and very good knowledge score regarding PEM and its Prevention in the pretest.
SECTION–III Assessment of Post-test knowledge score of mothers of under five year children regarding PEM and its intervention.
In the post test knowledge of mothers of under five year children, 25 (75%) had very good knowledge, 5 (25%) had good knowledge and no one had poor and average knowledge.
SECTION–IV Effectiveness of structured teaching programme on post test knowledge score:
Effectiveness of structured teaching programme on knowledge of mothers of under five year children regarding PEM and its Prevention. The mean post test knowledge score 31.7 was higher than mean pre test knowledge score 14.6. Thus indicating highly significant difference and effectiveness of structured teaching programme in increasing the knowledge of mothers of under five year children regarding PEM and its Prevention. Thus the hypothesis made by the researcher i.e.H1-The mean post test knowledge score of mothers of under five year children is significantly higher than the mean pretest score alter the administration of structured teaching programme at the level of p≤5 0.05 is not rejected.
CONCLUSION:
The main aim of the study was to assess the effectiveness of Structured teaching programme regarding the knowledge of protein energy malnutrition and its prevention, among mothers of under five year children in selected village simrol of Indore. After detailed analysis and experience of the investigator, the finding revealed that following results:
1. The mother’s of under five year children did not have adequate knowledge of PEM & its prevention. They required education and close supervision to enhance their knowledge and the workout to prevent Protein Energy Malnutrition.
2. Mean pre test knowledge score of mothers regarding of Protein Energy Malnutrition & its prevention was 14.6 and mean post test knowledge score 31.7.
3. Structured teaching programme was an effective method for the gain in knowledge of mothers of under five year children which was evident in the post test knowledge scores. Hence on the basis of above cited finding it could be concluded that the written material prepared by the investigator in the form of pamphlet and hydrabadiladdoo helped the mothers to improve their knowledge regarding, PEM & its prevention.
The overall experience of conducting the study was enjoyable and satisfactory. The response of the participants to the study and their quest to gain new knowledge was an encouraging hand for the investigator. The constant help and support of the guide and co-guide provided a positive reinforcement for the successful completion of the study. The study was a new learning experience for the investigator.
WHO–World Health Organization
PEM-Protein Energy Malnutrition
PHC-Primary health center
STP- Structured Teaching Programme
REFERENCES:
1. Abdullah, PG and Levine, G., (l980), Better patient care through nursing research, (6thed), New York; Macmillan. Retrieval on 13 Des.1980.
2. Kothari, C.R.,(2006), Research Methodology; (2nd ed.), New Delhi; New Age lnternational P. (Ltd) Publisher Retrieval on March 2006.
3. Nieswiadomy, M. Rose, (2008), Foundation of Nursing Research; (5th ed.), South Asia; Pearson.Abdullah, PG & Levine, G., (1980), Better patient care through nursing research, (6th ed), New York; Macmillan.
4. Polit, D,F. and Hungler, B.P., (1999), Nursing Research Principles and Methods; Philadephia; Lippincott Co.
5. Wood, G.L &harber, J (2002) Nursing Research Methods, Critical appraisal and utilization. (2nded). Philadelphia: Mosby publocation.
Received on 23.01.2019 Modified on 29.01.2019
Accepted on 04.02.2019 ©A&V Publications All right reserved
Asian J. Nursing Education and Research. 2019; 9(1):113-116.
DOI: 10.5958/2349-2996.2019.00022.3