Effect of Information booklet on knowledge of parents in relation to home care management of children with Leukemia in selected hospitals

 

Ms. Preeti Manoj Bagul

 

ABSTRACT:

Leukemia is a condition where adequate care plays a very important role in managing the symptoms of disease and in prevention of frequent relapses. Prevalence of leukemia is continued to rise over several decades, which increases responsibilities of health care team to provide adequate treatment. The investigator felt the need to educate the caregivers of children with leukemia by developing and giving information booklet which will act as a ready reference whenever needed by them. Therefore the present study was undertaken on the problem started as “Effect of information booklet on knowledge of parents in relation to home care management of children with leukemia in selected hospitals.” Objectives: To assess the knowledge of parents in relation to home care management among parents of children with leukemia before and after giving the information booklet in selected hospitals.To compare the effect of information booklet on knowledge in relation to home care management among parents of children with leukemia before and after administration of information booklet in selected hospitals.To find the association between knowledge of parents in relation to home care management of children with leukemia with selected demographic variables selected hospitals. Methodology: A descriptive, evaluative study was conducted at selected hospitals of Mumbai. The sample consisted of 30 caregivers of children with leukemia from pediatric units of selected hospitals. The technique used for sample selection was non probability convenience sampling. Reliability of the questionnaire was calculated by test retest and chi square method respectively. Pilot study was conducted on 5 samples, which was fulfilled in the inclusion criteria. The main data collection for the study was began from 19th September 2016 to 9^th October 2016 Result: Majority of the sample belonged to the age group of 30-40 years and 40-50 years and had secondary education i.e.66.7%. Majority of them had family income of Rs.10, 001- 15,000/month i.e. 66.7%. Majority of the children belonged to the age group of 5-10 years i.e. 60%. Their duration of illness was 2-5 years and got admitted in the hospital for 4-6 times. Knowledge of the sample in various aspects of care of children with leukemia before and after administration of information booklet was answered. Pretest knowledge regarding knowledge about different aspects of care like blood was 66.7%; importance of blood was 76.7%. Meaning of leukemia was 86.7%, signs and symptoms of leukemia was 94.4%, medical management was 70.5%, side effects of treatment of leukemia was 81.1%, Neutropenia was 36.7%, dietary management of leukemia was 63.3%, and supportive management was 77.3%. In post test knowledge of sample improved in above mentioned area to 95.6%, 91.1%, 96.7%, 98.9%, 79.5%, 87.8%, 75.0%, 93.3% and 86.4%. Corresponding p-value was small (of the order of 0.000), which is small (less than 0.05), null hypothesis is rejected. Information booklet is proved to be significantly effective in improving the knowledge of the parents regarding home care management of leukemia. Hence association between knowledge of sample with selected demographic variable i.e. age, education and income of caregivers is taken into consideration. The analysis and interpretation of association between knowledge of sample with selected demographic variable i.e. age, education and income of caregiver is taken into consideration. Fisher’s exact test is used to calculate p- value. The p- value of demographic variable for age was 0.290, related to education it was 0.135, for socio economic status as per month was 0.057, for child’s age it was 1.000, for duration of illness was 0.625 and related to total number of admission to the hospital was 0.402.

 

 

 

 

BACKGROUND OF THE STUDY:

Cancer is a disease of the cells in which the normal mechanisms of the control of growth and proliferation have been altered. it is invasive, spreading directly to surrounding tissues as well as to the new sites in the body.

 

Cancer accounts for the major cause of death in Indian children, next only to infection and malnutrition. researchers have shown that development of rationale use of combination chemotherapy and improve supportive care, the cure rate of leukemia in children has increased tremendously.

 

Leukemia is the cancer of the bone marrow in which there is uncontrolled proliferation of the leucocytes. Leukemia is a malignant disease of the blood forming organ. Leukemia account for 8% of all human cancers and is the most common malignancy in children and young adults.⁴

 

Chemotherapy remains the main line of treatment in leukemia. chemotherapy is mainly given to destroy the malignant cells of the bone marrow. chemotherapy reaches all parts of the body and not just the cancer cells and so, and affects the normal cells hence, producing side – effects.The investigator while working in pediatric unit came across few leukemic patients who were recurrently getting admitted for complaints of fever, nausea, vomiting, decreased body weight, low appetite etc. as the investigator had a discussion with the caregivers of these children, lack of knowledge regarding how to manage the side-effects of chemotherapy and how to manage the side effect of chemotherapy and how to manage the child at home felt.

 

PROBLEM STATEMENT:

Effect of information booklet on knowledge of parents in relation to home care management of children with leukemia in selected hospitals.

 

OBJECTIVES OF THE STUDY:

1.     To assess the knowledge of parents in relation to home care management among parents of children with leukemia before and after giving the information booklet in selected hospitals.

2.     To compare the effect of information booklet on knowledge in relation to home care management among parents of children with leukemia before and after administration of information booklet in selected hospitals.

3.     To find the association between knowledge of parents in relation to home care management of children with leukemia with selected demographic variable selected hospitals.

 

RESEARCH METHODOLOGY:

a descriptive, evaluative approach was used. One group pre test and post test research design was adopted. A non probability convenience sampling technique was used and 30 sample from selected hospitals were selected. An information booklet was developed. Semi structured questionnaire was used to assess the knowledge of sample. Pre test and post test was done. The content validity of the questionnaire was done by 10 experrts from nursing and medical fields for scrutinizing its adequacy and relevance reliability of questionnaire was done Reliability coefficient was 0.8169 in split half test and 0.85 in test retest. A result showed very high reliability. Pilot study was initiated after the investigator obtained official permission from the concerned administrative authorities of the selected hospital. pilot study was conducted from 12^th September to 16^th September 2016. The data gathering process begin on 19th September to 9^th October 2016. In which contents of the consent form were explained. Pre test was initiated and information booklet was administered. After 5 days post test was done. This process continued till the investigator obtained the required sample size.

 

MAJOR FINDINGS OF THE STUDY:

Demographic data of caregiver were recorded. Majority of the sample belonged to the age group of 30-40 years i.e. 80% and 20% of the sample were from 40-50 years of age group. Majority of the sample were educated till secondary i.e 66.7%, 16.7% were studied till primary and 16.7% were graduate and post graduate. Majority of the sample i.e. 66.7% had family income of 10,001-15,000/ month. 20.0% had income above Rs. 15,000/ month.13.3% population had income Rs 5001-10,000/ month.

 

Demographic data of children were as follows: Majority of the children belonged to the age group of 5-10 years i.e. 60.0% and 40.0% of children were from 10-14 years of age group. Majority of children had history of disease since 2-5 years i.e. 53.3% and 30.0% children reported illness since more than 5 years, duration of illness for 1-2 years were 16.7%. 43.3% of children were admitted 4-6 times in the hospital, 36.7% children reported admission 6-8 times, 16.7% of children were admitted 8-10 times and only 3.3% children were admitted 1-3 times in hospital.

 

Knowledge of the sample in relation to various aspects of care of children with leukemia was assessed before and after administration of information booklet. In pre test knowledge about blood was 66.7%, Importance of blood was 76.7%, related to leukemia was 86.7%, Sign and symptoms of Leukemia was 94.4%, Medical management was 70.5%, Side effects of treatment of Leukemia was 81.1%, related to Neutropenia was 36.7, Dietary management of Leukemia was 63.3%, Supportive management of Leukemia was 77.3%. In the post test there was significant increase in knowledge of the sample in the above-mentioned area of knowledge was revealed such as 95.6%, 91.1%, 96.7%, 98.9%, 79.5%, 87.8%, 75.0%, 93.3%, 86.4% respectively.

 

Overall improvement in knowledge was increased from 76.7% to 100.0%. for post test knowledge scores computed SD (standard Deviation) is 1.6 and calculated ‘t’ value is 8.1. which proved that information booklet was effective in improvement of knowledge of sample.

 

Association of demographic variables with knowledge of sample showed that age and socio-economic status was not associated with gained in knowledge, whereas secondary education group had more improvement than primary education group.

 

CONCLUSION:

During the study, it was observed that all the caregivers of childen with leukemia needed information especially on care of child with neutropenia, dietary management and identifying the side effects of treatment of leukemia. They had also showed interest to know about medical management and supportive treatment. The finding of the study showed that there was a marked improvement in their knowledge after administration of information booklet.

 

REFERENCES:

1.      O.P. Ghai, Essential Pediatric, 6th Edition, CBS publications, 2004.

2.      Dr. S.H. Advani “Pediatric oncology in India”, Indian journal of pediatrics, Volume-54, 1987

3.      Steinherz PG, Redner A, Steinherz L, “development of a new intensive therapy for acute lymphoblastic leukemia in children at increased risk of early relapse by Cancer.”, Pulse, Volume, 11,2009

4.      David H. Ebb, “Diagnosis and treatment of childhood acute Myelogenous Leukemia”, Pediatric oncology, volume-14, August-1997.

5.      B.T. Basavanthappa, Nursing research, Reprient – 1998, Jaypee brothers, Medical publication.

6.      Polit. F.D and et al. National research- principles and methods 6th Edition, Lippincott Publications, 1991.

7.      Jennifer Lanctot, Zhenghong Li, Joseph P. Neglia: A Therapy-related acute myeloid leukemia secondary to inhibitors of topoisomerase II: From the bedside to the target genes URL: https://www.ncbi.nlm.nih.gov/pubmed/1318741

8.      Oxford Advanced Learner’s Dictionary, Vol-2

 

 

Received on 22.03.2019         Modified on 02.07.2019

Accepted on 15.10.2019      ©A&V Publications All right reserved