Knowledge, Attitude and Practice regarding Management of Fever among Children
Imrongnungla Jamir1, Kalivi Zhimo2, Kedokhono Kotsu3, Kenei-Ii Pienyu4, Bendangmenla Ao5*
1-4BSc. Nursing IV, College of Nursing, Christian Institute of Health Sciences and Research, Dimapur Nagaland.
5Associate Professor, Pediatric Nursing, College of Nursing, Christian Institude of Health Sciences and Research, Dimapur, Nagaland.
*Corresponding Author Email: amenlapongen@gmail.com
ABSTRACT:
Fever is a very common symptom among infants and children seeking medical care. Most children undergo evaluation for a febrile illness, and nearly one-third of pediatric outpatient visits are for fever. A cross sectional research study was adopted to assess the knowledge, attitude and Practice of mothers regarding management of fever for children 0-14 years of age, in a secondary hospital, Christian Institute of health sciences and research, (CIHSR) in North East India. A total of 60 subjects participated, using total enumerative sampling technique. The tool used for the study was a self-structured validated questionnaire. Data was analyzed and interpreted using descriptive statistical method. The mothers had positive attitude towards management of fever with 78.40% but their knowledge level were very poor (20%) and practice level was 22% respectively. This emphasizes the need to impart information about management of fever. Conclusion: The study concludes that most of the caregivers had poor knowledge and practice related to childhood fever. It is pertinent to impart information and give education especially to the immediate caregivers to prevent further complication and reduce morbidity and mortality. Health care personnel has an immense task to impart knowledge to the public so as to imbibe positive attitude and practice regarding management of fever.
KEYWORDS: Knowledge, attitude, practice, Fever management.
INTRODUCTION:
Majority of the children has one or more episodes of fever annually. Parents’ major unrealistic concerns for childhood fever, “Fever Phobia” (Poirier, Collins, and McGuire, 2010), have been documented that parents have false beliefs and limited knowledge regarding fever, its management, and its role in illness. Parents are usually anxious about maintaining a normal temperature, which leads many parents to administer medications to their children even if there is minimal or no fever. (Bilenko N, Tessler H, Okbe R, Press J, Gorodischer R (2006).
Awal Khan, Hedayatullah Khan, Afsha Badshah Said, et.al. (2015) in their study reported on Knowledge, Attitude and Practice of Parents regarding Fever in Children home showed that more than 93% were wrong about normal body temperature, 90% parents detected fever through tactile method, 57% parents don’t know about appropriate body part for placing thermometer and 40% visit chemist for fever treatment.
Many parents follow different home practices which seems to be harmful at times, in a study done by RC Parmar, DR Sahu et, al, (2001) Practice of parents on children with febrile convulsion showed that 127 (90.7%) did not carry out any intervention, prior to getting the child to the hospital. Others took measures like shaking the child, firm application of broken onion at the nostrils with forceful closure of mouth and tepid sponging. Only 10 parents (7.1%) were aware of risk of aspiration and vomiting. Ravi Prakash Agrawal, Santokh Singh Bhatia, et.al. (2013) in their study revealed that many parents (69.51%) managed the fever initially at home and only (17.07%) correctly managed fever by taking their children to hospital or to a qualified practitioner, rest of the parents primarily rely on local medical store or unqualified practitioner.
The researchers came across many children with fever. Of which many reach hospitals late or had very less awareness about the danger signs of fever. Approximately from January-October 2016, over 116 patients were admitted with fever. It was learned that some parents prepare local herbs for fever; some give over the counter drug, some visit the doctor and some parents’ practices sponge or tepid bath. And thereby, the researchers felt the need to conduct the study to assess the knowledge, attitude and practice of parents regarding fever management.
OBJECTIVES:
· To assess the level of knowledge of mothers regarding management of fever.
· To assess the attitude of mothers towards management of fever.
· To assess the practice of mothers about management of fever
METHODS AND MATERIALS:
A cross sectional descriptive research study design was used. The setting of the study was conducted in a secondary hospital of Christian Institute of health Sciences and research (CIHSR) North East India, Nagaland. The population were mothers of children between 0- 14 years of age. Total enumerative sampling technique was used with a Sample size was 60. The tool used for the study was a self-structured validated questionnaire. The instruments consisted of two parts; Part I included the demographic data, part II consisted of knowledge attitude and practice questionnaire. All ethical approval was obtained from the Nursing research committee and permission obtained from the concerned department. Informed written consent was taken from the subjects. Data was collected using self-administered questionnaire. Data was analyzed and interpreted using Descriptive statistical method. Health belief model was used as a basis for the study.
RESULT:
TABLE.1 Demographic data for all the mothers
|
Sl. No |
Demographic variables |
Frequency(f) n=60 |
Percentage (%) |
|
1 Age Group |
|||
|
|
a.18-29 |
23 |
38.4% |
|
|
b. 30-39 |
34 |
56.6% |
|
|
c. 40-49 |
3 |
5% |
|
|
d. Above 50 years |
0 |
0 |
|
2 Educational Level |
|||
|
|
a. Illiterate |
0 |
0 |
|
|
b. Below class 12 |
47 |
78.3% |
|
|
c. Graduate |
11 |
18.3% |
|
|
d. Post graduate |
2 |
3.4% |
|
3 Occupation |
|||
|
|
a. Farmer |
2 |
3.5% |
|
|
b. Employed |
20 |
33% |
|
|
c. Unemployed |
38 |
63.5% |
|
4 Community |
|||
|
|
a. Rural |
25 |
41.6% |
|
|
b. Urban |
35 |
58.4% |
Figure 1: Knowledge of mothers regarding fever
Figure 2: Distribution of mother’ s practice about management of fever
Figure 3. Distribution of mother’s attitude towards management of fever.
Table 1: Majority of the mother’s Educational level were below Class 12 (78.3%)
Figure 1: Shows that out of 60 participants 20% (12) had adequate knowledge, 17% (10) had moderate knowledge and 63% (38) inadequate.
Figure 2: 16(27%) has adequate practice, 13(22%) has moderate practice, 31(52%) has inadequate practice
Fig 3. Out of 60 samples, 47(78.4%) had positive attitude and 13(21.6%) had neutral attitude towards child’s management of fever.
DISCUSSION:
This chapter deals with the discussion of study with appropriate literature reviews, statistical analysis and the findings based on the objectives. The main aim of the study was to assess the knowledge, attitude and practice of mothers’ regarding fever management for children visiting the Hospital. A total of 60 samples were taken for the study using total enumerative sampling technique. Based on the educational status, majority of the sample 47(78.3%) were below class 12, and 11(18.3%) were graduate.
Our First objective was to assess the level of knowledge of mothers regarding management of fever. From the study we found that 38(63.3%) have inadequate knowledge, and only 12(20%) have adequate knowledge. Only 20(33.33%) of the mothers could define fever correctly. In a study reported by Liqa Athamneh, et.al (2014) 10% of parents believed that 38°C (100.4°F) or 39°C (102.2°F) are the normal body temperatures of a child. In our study, only 28(46%) of mothers were of the opinion that complications of fever may cause loss of consciousness, brain damage and death. In reference to our study, as reported by M.R kain, M. Safi, et.al (2014) revealed that 96.8% of parents considered that fever was a very serious condition, which could lead to side-effects such as brain damage (28.9%), seizures, paralysis, breathing difficulty and coma.
The second objective was to assess the attitude of mothers towards management of fever, majority of them 47(78.4%) had positive attitude, 26(43.3%) strongly agreed that further help should be sought from doctors when the fever last more than 3-5 days. Liqa Athamneh, et.al (2014) in their study reported that they use pharmacological and other physical methods to reduce a temperature of 38 degree C and they would wait until the child’s temperature reached 39°C before show to the doctor .Interestingly in our study we noted that 7(11.6%) strongly agreed and 17(28.3%) agreed to the statement that many childhood fever are caused by evil spirit. Similarly, in a study by Srividhya., S and Subramanian., N (2019) the Parengi Porja tribal mothers in India perceived that different agents are causing illnesses, which are always linked to supernatural and natural agents like the evil eye, evil spirits etc.
The third objective from our study was to assess the practice of the mothers regarding fever management. Out of 60 samples, 16(27%) has adequate practice, 31(52%) has inadequate practice regarding management of fever at home. It was observed that only 12(20%) use thermometer and 32(54.3%) use hands to check their child’s temperature. A corresponding study reported by Balafama A. Alex- Hart, Angela I. Frank-Briggs (2011) stated that (76.2%) mothers measured their children's body temperature by touching their forehead, while 21 (13.9%) used thermometer and the commonest action (70.9%) taken during fever was to administer Paracetamol. Remarkably, 56(93.3%) mothers opined administering Paracetamol to child during fever and 40(66.6%) use small specific measuring cup to measure anti-fever drugs. Comparatively, Liqa Athamneh, et.al (2014) 38% of parents use the regular teaspoon or tablespoon or measuring spoon or syringes of other drugs.
IMPLICATION:
The investigators have drawn the following implications from the study which is a vital concern to the field of nursing education, nursing research, nursing practice/service and nursing administration
Nursing Administration/ Practice:
The findings will help the professional to assess, plan, implement and evaluate appropriate evidence base on care of child regarding management of fever from mothers.
· Nurses have the responsibility to impart health education to the mothers, who will gain knowledge, have positive attitude and good practice regarding management of fever.
Nursing Education:
· Nursing curriculum should also encourage provisions to update skills of nurses and enable the nurses to practice competently.
· This study has enabled to develop a pamphlet brochure to provide health education on management of fever to the public especially in pediatric ward, POPD, NICU and labor ward.
Nursing Research:
· Nurse researcher can inform clinical nurse to improve the areas where the research findings revealed weakness
· A similar study can be conducted to a larger sample for a better generalization.
· The study can help the researcher (nurse) to develop insight in teaching module and materials for mother’s education.
CONCLUSION:
From the study we concluded that most of the mothers had inadequate knowledge and practice about fever management, however most mother had a positive attitude. Many of the mothers were not aware of the complications of fever. Many were not aware about the importance of fluid intake during fever, and many has wrong conception about childhood fever. Thus, Findings from this study underscore the need to develop and evaluate programs that educate parents and provide them skill-based training regarding fever management in children.
REFERENCES:
1. Alex-Hart, B. A., and Frank-Briggs, A. I. (2011). Mothers' Perception of Fever Management in Children. Nigerian Health Journal, 11(2), 69-72. Retrieved from www.ajol.info/index.php/nhj/article/download/90516/79935
2. Awal k, Hedayatullah K, Afsha, B.S., Aurang Z., and Fakhrul., I. (2015), Knowledge Attitudes and practice of parents regarding, Fever in children and its management at home. International journal of endorsing health science research. 2015 oct; Vol (3), Issue 3. Retrieved from https://1library.net/document/y95gd7jz-knowledge-attitudes-practice-parents-regarding-fever-children-management.html#fulltext-content.
3. Bilenko N, Tessler H, Okbe R, Press J, Gorodischer R(2006). Determinants of antipyretic misuse in children up to 5 years of age: a cross-sectional study. Journal of clinical therapeutics. 2006 May;28(5):783-93; retrieved from https://pubmed.ncbi.nlm.nih.gov/16861100/
4. Liqa Athamneh , Marwa El-Mughrabi, Mohmmad Athamneh, E James Essien, Susan Abughosh (2014) Parents' Knowledge, Attitudes and Beliefs of Childhood Fever Management in Jordan: a CrossSectional Study. Journal of applied research on children. Vol 5. (1) 2014. Retrieved from file:///E:/stds%20research/RESEARCH%20%20childhood%20fever-2017%20imrong/Knowledge%20Attitudes%20and%20Beliefs%20of%20Childhood%20Fever%20Management.pdf
5. Maha Mohammed Omer Elbushra (2004), Causes of fever in children under 5 years and knowledge, attitude and practices of mothers and health team towards the management of acutely febrile children. Retrieved from; http://ils.uofk.edu/cgi-bin/koha/opac-detail.pl?biblionumber=25806andquery_desc=an%3A22313#
6. M.R kain, M. Safi, et.al (2014), Knowledge and management of fever among Moroccan parents. Eastern Mediterranean health Journal, (2014) 2014 Jun 18; 20(6):397-402. Retrieved from; https://pubmed.ncbi.nlm.nih.gov/24960517/
7. Parmar, R. C., Sahu, D. R., and Bavdekar, S. B. (2001). Knowledge, attitude and practices of parents of children with febrile convulsion. Journal of postgraduate medicine, 47(1), 19. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11590285
8. Poirier, Collins, and McGuire, (2010). Fever phobia: a survey of caregivers of children seen in a pediatric emergency department. Journal of clinical pediatrics, 2010 Jun; 49(6):530-4. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20488812/
9. Ravi Prakash Agrawal, Santokh Singh Bhatia, et.al.(2013). Perception of fever and management practices by parents of pediatric patients. International Journal of research in medical science. Vol 1, No 4 (2013). Retrieved from https://www.msjonline.org/index.php/ijrms/article/view/2634
10. Srividhya Samakya V.1 T. Subramanyam Naidu (2019). An Anthropological Analysis of Evil Eye, Evil Spirits, and Ancestral Spirits Afflictions: Parengi Porja Tribal Women Views About Illness Etiologies and Its Treatment Practices. The Oriental Anthropologist 19(2) 273–283, 2019. https://journals.sagepub.com/doi/abs/10.1177/0972558X19862394?journalCode=oana
Received on 28.10.2020 Modified on 15.11.2020
Accepted on 13.12.2020 ©A&V Publications All right reserved
Asian J. Nursing Education and Research. 2021; 11(1):41-44.
DOI: 10.5958/2349-2996.2021.00010.0