1Associate Professor and HOD, Dept. of Pediatric Nursing, JSS College of Nursing, Mysuru.
2Tutor, JSS School of Nursing, Mysuru.
*Corresponding Author Email: ambikasath@gmail.com
ABSTRACT:
Background: High grade Fever also increases the risk of febrile convulsions. Mother is first person to understand that the child is ill and who take care of their children constantly. She checks temperature of child as well. If high grade fever is neglected or mismanaged it leads to febrile convulsions in a child. Most childhood seizures are relatively common and represented by febrile episodes associated with childhood convulsions. Methods: The main aim of the study to assess the maternal awareness on prevention and management of febrile Seizures among mothers of Under-Five Children. A descriptive survey approach was adopted for this study. The study was conducted among 60 mothers of under-five children in a selected hospital at Mysuru. Non probability convenience sampling technique was adopted. Personal Proforma was used to assess the selected personal variables and structured knowledge questionnaire was used. The data was tabulated and analyzed in terms of objectives of the study, using descriptive and inferential statistics. Results: The findings of the study revealed that the knowledge of mothers of under-five children regarding prevention and management of febrile seizures was inadequate. The data shows that majority of mothers (41, 68%) had inadequate knowledge, 15 (25%) had moderate knowledge, and 4 (6.66%) had good knowledge. The knowledge score of mothers of under-five children regarding prevention and management of febrile seizures ranges from 0 to 17, with a mean score of 9.37 and standard deviation ±2.39. - The computed Chi-square value to ascertain the association between knowledge with their selected personal variables of mothers of under-five children was found to be significant for age of mother, educational status, previous exposure to educational programs, and sources of information regarding febrile seizures. Discussion and Conclusion: The study concluded that the knowledge of mothers of under-five children regarding prevention and management of febrile seizures was inadequate. There is a need for health education programs to improve knowledge and promote appropriate care. These findings suggest that targeted interventions can be designed to improve knowledge and promote better care for children with febrile seizures.
KEYWORDS: Knowledge, Underfive children, Febrile seizures.
INTRODUCTION:
The age groups of 0-5 years are categorized as under five children. This age group of children is vulnerable to get any kind of infection. Under five years Children are in developing stage and all body systems are immature. And as their play activities, poor feedings, and immaturity of immune system they get frequently infected with different infections like Respiratory Tract Infection, Otitis Media, Diarrhoea, Gastroenteritis etc. Fever is a common presentation of the infections. In some children high grade fever can result convulsion. Fever means that the body is fighting against the infection. “Fever is defined as an elevation of body temperature in response to pathological stimulus”. A clinical policy published by American College of Emergency physicians (ACEP), a child is considered febrile only when his rectal temperature exceeds 380C (100.40F). Fever above 41.50C (106.70C) needs immediate and aggressive antipyretic therapy to control the risk of irreversible organ damage.1
High grade Fever also increases the risk of febrile convulsions. Mother is first person to understand that the child is ill and who take care of their children constantly. She checks temperature of child as well. If high grade fever is neglected or mismanaged it leads to febrile convulsions in a child. Most childhood seizures are relatively common and represented by febrile episodes associated with Childhood convulsions. The National Institutes of Health (NIH) has defined a “febrile convulsion’ (FC) as a seizure episode in infancy or childhood, mostly occurs between 3 months to 5 years of age, associated with fever but without any evidence of intracranial infection, pathological or any traumatic cause”. Many Studies revealed that between 2% and 5% of all children will experience Febrile Convulsions before the age of five years.1
Febrile seizures are the most common form of convulsions occurring in children between the ages of 6 months and 5 years, typically triggered by fever. Although febrile seizures are generally benign, they are alarming to caregivers and can lead to significant parental anxiety, mismanagement, and sometimes unnecessary hospitalization or inappropriate use of medications.2
A febrile seizure can be very frightening for parents. In consequence, parents’ ignorance and poor understanding about how to deal with seizure and their anxiety will lead to mismanagement of febrile seizure. Knowledge on febrile seizure is important for parents, especially knowledge regarding febrile when it will occur, seizure characteristics, how to manage seizure, and how seizure can be prevented. The incidence rates in India are comparable to those in developed world. A survey conducted in Uttarkhand found a prevalence of 2.27 per 1000 population.3
Febrile seizure (FS) is a benign convulsive disorder in under 5-year-old children, but at the same time, it is an alarming event in the lives of both child and parents. Lack of parent's knowledge about the nature of FS and how they should deal with it can lead to poor management. The fever is one of the most common presenting complaints, is being the reason for health visits in about 70% of pediatric age group. Parents frequently perceive fever as a disease rather than a symptom or sign of illness. Studies found that parents are not correctly informed or well educated about the definition, measurement, and diagnosis of fever.4
With the above findings, the researchers felt the need to understand the mother’s knowledge can help to improve early management of children with febrile seizure and it can be prevented and also can be managed at the earliest.
RESEARCH GAP:
In India, studies have shown that febrile seizures affect approximately 2–5% of children under five years of age. In many cases, due to lack of awareness, mothers may panic, delay seeking medical care, or practice harmful traditional methods, which may increase the risk of complications.5
Mothers are primary caregivers and play a crucial role in early detection, initial management, and prevention of recurrence of febrile seizures. Educating them about recognizing symptoms, reducing fever promptly, and seeking timely medical help is essential to reduce morbidity and anxiety.
There is a significant gap in the knowledge of mothers regarding the management of febrile seizures, especially in semi-urban and rural settings. Assessing their current level of awareness can help in designing effective educational programs to prevent complications. Thus, this study aims to assess the knowledge of mothers of under-five children regarding prevention and management of febrile seizures in a selected hospital at Mysuru.
SUPPORTING LITERATURE:
A cross- sectional study in Uttar Pradesh to assess knowledge regarding febrile seizures among 200 mothers. They found that only 34% of mothers had adequate knowledge about managing a seizure at home. Education level was significantly associated with knowledge scores (p<0.01). Aswathi S, et al. (2019) in their study reported that panic and inappropriate management (such as force-feeding or shaking the child) during febrile seizures were common among Indian mothers due to lack of awareness. Rahman S, et al. (2020) conducted a study in Bangladesh and reported that only 40% of mothers knew to place the child on the side during seizures. Nearly 60% believed in home remedies or spiritual interventions. Joshi M & Thomas I. (2018) in a descriptive study in Kerala found that mothers with previous exposure to health education or those with a healthcare background had significantly higher knowledge levels regarding febrile seizure management. WHO (2020) emphasized the importance of caregiver education as a preventive strategy for seizure-related injuries and complications. It is recommended routine parental counseling in pediatric outpatient departments.6
A prospective questionnaire study was done to assess the level of parents' knowledge, attitude, and practices regarding febrile convulsion which was conducted at the Department of Pediatrics, KIMS, Bangalore, over a period of one year, the study enrolled 110 children with febrile convulsion aged 6 months to 5 years. A questionnaire was used to collect data, which was analysed using descriptive statistics. The results revealed that only 41.8% of parents recognized convulsion, and 85% were unaware that convulsion can occur due to fever. The study also found that higher socioeconomic and educational status was associated with better understanding of practices. The study concluded that adequate awareness and education can significantly improve parental first aid practices, highlighting the need for targeted interventions to address knowledge gaps and reduce parental anxiety.7
Mothers are primary caregivers and play a crucial role in early detection, initial management, and prevention of recurrence of febrile seizures. Educating them about recognizing symptoms, reducing fever promptly, and seeking timely medical help is essential to reduce morbidity and anxiety.
OBJECTIVES OF THE STUDY:
This study aims to assess the knowledge of mothers of under-five children regarding prevention and management of febrile seizures in JSS Hospital at Mysuru. By doing so, it seeks to contribute to the growing body of knowledge that can support pediatric healthcare professionals, caregivers, and policymakers in supporting the caregivers in taking care of children with febrile seizures.
OBJECTIVES:
1. To assess the knowledge of mothers of under five children regarding prevention and management of febrile seizures in selected hospital in Mysuru.
2. To find the association between level of knowledge of mothers of under five children regarding febrile seizures and their selected personal variables.
MATERIALS AND METHODS:
Research Approach:
Descriptive Research Approach.
Research Design:
Descriptive Cross-sectional survey design.
Study Setting and Population:
The study was conducted at JSS Hospital, Mysuru, a tertiary care teaching hospital with pediatric inpatient facilities. The study population included mothers of underfive children admitted in pediatric wards for various medical or surgical conditions.
Sample Size:
60 mothers of underfive children.
Sampling Technique:
A purposive sampling technique was used to select participants who met the eligibility criteria. A total of 60 mothers of underfive children were included in the study.
Inclusion Criteria:
· Mothers having children below five years of age
· Mothers who are willing to participate and provide informed consent
· Mothers who can understand Kannada or English
Exclusion Criteria:
· Mothers whose children have known neurological disorders unrelated to febrile seizures
· Mothers who are healthcare professionals
Description of the Tool for Data Collection:
A structured knowledge questionnaire was used to assess knowledge regarding prevention and management of febrile seizures. The tool consisted of:
· Section A: Demographic Profile (age, education, occupation, number of children, history of febrile seizures, etc.)
· Section B: Structured Knowledge Questionnaire on prevention and management of Febrile Seizures
· Nature and cause of febrile seizures
· Signs and symptoms
· First-aid measures
· Prevention and management strategies
(Total of approximately 20 questions; scoring: 1 mark for correct, 0 for incorrect. The total knowledge score ranged from 0-20. Knowledge score were categorized as 16-20 good knowledge, 11-15 average knowledge and 0-10 poor knowledge.)
· The tool was validated by subject experts in the field of pediatrics nursing
· Reliability was established using split-half method (reliability coefficient r ≥ 0.7)
Data Collection Procedure:
· Ethical clearance was obtained from the Institutional Ethical Committee of JSS Academy of Higher Education (JSSAHER)
· Informed consent was taken from each participant
· Confidentiality and anonymity of participant information were maintained throughout the study.
Plan for Data Analysis:
· Descriptive Statistics: Frequency, percentage, mean, standard deviation to assess knowledge level
· Inferential Statistics: Chi-square test to assess the association between demographic variables and knowledge scores
RESULTS:
n=60
|
Sl. No |
Demographic variables |
Frequency(f) |
Percentage (%) |
|
1 |
Age of mothers (in years) <25 25-30 >30 |
12 19 21 |
20 31.7 48.3 |
|
2 |
Religion Christian Hindu Muslim Others |
5 50 4 1 |
8.3 83.3 6.7 1.7 |
|
3 |
Types of family Nuclear family Joint family Extended family |
31 28 1 |
51.7 21.7 1.7 |
|
4 |
Area of Residence Urban Rural |
36 24 |
60 40 |
|
5 |
Educational Status No formal education SSLC PUC Graduate and above |
3 14 18 23 |
5 23.3 30 41.7 |
|
6 |
Occupational Status Housewife Private Government Own business |
38 12 5 5 |
63.3 20 8.3 8.3 |
|
7 |
Monthly family income (in rupees) Less than Rs 20,000 More than Rs 20,000 |
32 28 |
53.3 46.7 |
|
8 |
Number of children One Two Three Four and above |
22 2 36 00 |
36.7 3.3 60 00 |
|
9 |
Previous exposure to any educational programme related to febrile seizure? Yes No |
29 31 |
48.3 51.7 |
|
10 |
Source of information regarding febrile seizure Relatives/ Friends Mass media Health professional |
30 9 21 |
50 15 35 |
SECTION -II
Table 2 Frequency and percentage distribution of level of knowledge of mothers of under five children regarding prevention and management of febrile seizure
|
Level of knowledge |
Frequency |
Percentage |
|
Inadequate knowledge |
41 |
68% |
|
moderate knowledge |
15 |
25% |
|
Adequatet knowledge |
04 |
6.66% |
Table 2 shows that, majority 41(68%) of mothers of under five children had poor knowledge, 15(25%) had average knowledge and 4(6.66%) had good knowledge regarding prevention and management of febrile seizure.
Figure 1: Frequency and percentage distribution of level of knowledge of mothers of under five children regarding prevention and management of febrile seizure
Table 3: Mean median, standard deviation and range for knowledge scores of mothers of under five children regarding febrile seizure N=60
|
Variable |
Mean |
Median |
Range |
Standard deviation |
|
Knowledge Scores |
9.37 |
9 |
17 |
±2.39 |
SECTION –III: Association between knowledge of mother of under five children regarding prevention and management of febrile seizure and their selected personal variables:
The results revealed a statistically significant association between level of knowledge of mothers of under five children and three personal variables such as age of mother, educational status, previous exposure to educational programs, and sources of information regarding febrile seizures as indicated by the Chi-square values of 3.97* and 5.991*, 7.815 and 3.97 respectively (p< 0.05). No significant association was found between other variables such as occupation of mother, area of residence and source of information.
CONCLUSION:
The present study revealed that the overall knowledge of mothers of under-five children regarding the prevention and management of febrile seizures was found to be moderate to inadequate. Febrile seizures, being one of the most common neurological conditions in early childhood, require prompt recognition and appropriate first-aid measures to prevent complications. The findings highlight a significant gap in awareness related to identifying early warning signs, home management techniques during seizures, and the importance of timely medical intervention. Hence this study stressess the urgent need for targeted health education programs and awareness campaigns to empower mothers with the necessary knowledge and skills. Strengthening maternal education through community health workers, primary healthcare centers, and mass media can play a vital role in enhancing the care and safety of children at risk.
CONFLICT OF INTEREST:
Nil.
ACKNIOWLEDGEMENTS:
Sincere gratitude to authority of JSS Hospital, Mysuru for providing permission to conduct the study in pediatric wards also JSSAHER for providing Institutional ethical clearance for this study.
REFERENCES:
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3. Syahida JA, Risan NA, Tarawan VM. Knowledge and attitude on febrile seizure among mothers with under-five children. Althea Medical Journal. 2016; 3(4):649-54.
4. Xixis KL, Samanta D, Keenaghan M, Vernon NT. Febrile Seizure (Nursing). StatPearls Publishing, Treasure Island (FL), 25 Mar 2021.PMID: 33760538
5. Venugopal Raju, Balabaskar Reddy. Prevalence of febrile seizures in children. Med Pulse International Journal of Pediates Fabruary 2020; 13(2): 28-31. http://medpulse.in/Pediatries/indox.plap
6. Abeysekara MS, Weerasekara MP, Wijesena BV, Perera RA, Kuruppu NR, Sriyani KA. Mothers’ knowledge believes and practices regarding febrile convulsions and home management. 2017;
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Received on 07.07.2025 Revised on 24.07.2025 Accepted on 08.08.2025 Published on 13.08.2025 Available online from August 20, 2025 Asian J. Nursing Education and Research. 2025;15(3):160-164. DOI: 10.52711/2349-2996.2025.00033 ©A and V Publications All right reserved
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