Rajiv Gandhi University of Health Sciences, Karnataka s29

Rajiv Gandhi University of Health Sciences, KarnatakaBangaloreAnnexure II SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FORDISSERTATION1 Name of the candidate and address MS STELLA MATHEW K 1 YEAR MSc NURSING FATHER MULLER COLLEGE OF NURSING KANKANADY MANGALORE2 Name of the Institution FATHER MULLER COLLEGE OF NURSING3 Course of study and subject MSc NURSING CHILD HEALTH NURSING4 Date of admission to course June 1st 20135. Title of the topicKNOWLEDGE REGARDING FOREIGN BODY ASPIRATION AMONG MOTHER’S OF UNDER-FIVE CHILDREN. 6. BRIEF RESUME OF THE INTENDED WORK6.1 Need for the studyA foreign body is any object originating outside the body. Most references to foreign bodies involve propulsion through natural orifices into hollow organs. Foreign bodies can be inert or irritating. If they irritate they will cause inflammation and scaring. They can bring infection into the body or acquire infectious agents and protect them from the body's immune defenses. They can obstruct passageways either by their size or by the scarring they cause. Some can be toxic1.Both children and adults experience problems caused by foreign objects getting stuck in their bodies. Young children, in particular, are naturally curious and may intentionally put shiny objects, such as coins or button batteries, into their mouths. They also like to stick things in their ears and up their noses. The effect of a foreign body can be very different. For example, a coin causes local pressure on the tissue but generally, is not a medical emergency to remove. A button battery, which can be a very similar size to a coin, generates hydroxide ions at the anode and causes a chemical burn in 2 hours. An ingested button battery that is stuck in the esophagus is a medical emergency1. Aspiration of foreign bodies occurs mostly in infants and toddlers between the ages of 6 months and 3 years because in this age group articles are usually placed in the mouth. The act of reflex coughing may expel some objects, but others may be retained in the respiratory tract, resulting in either immediate or delayed clinical manifestations2. Foreign body aspiration is the fourth leading accidental cause of death under six years of age3. In infants, food items are commonly aspirated where as older children aspirate marbles, coins, small toy parts, screws, peanuts, small bone, seeds etc. Foreign body aspiration is a life-threatening emergency and needs urgent intervention. Foreign body aspiration claims thousands of lives each year, because they rarely reach in time for intervention4. Food items such as nuts, seeds and food particles have been implicated in 70% to 90% of cases involving infants and toddlers. Various types of nuts top the list of aspirated foreign bodies. Peanuts are the most common (36% to 55%). Melon and sun flower seeds are also commonly aspirated. Older children tend to aspirate non food items such as paper clips, coins, balls, marbles and pins. Balloon aspiration is frequently fatal. Balloons can pass through the vocal cords and lodge in the carina. They prevent air passage through the lungs. As a result using balloons should be avoided at home and in day care centers5. FBA is a serious health problem in paediatric patients causing significant morbidity and mortality. The leading cause of death in children less than three year of age is foreign body aspiration (FBA). The medical literature lists inorganic objects such as plastic and metal parts of toys as the most commonly aspirated objects. 96% to 97% of patients with FBA have clinical features of wheezing, coughing and unilateral decreased breath sounds, either alone or in combination. However, all children with the symptomatic triad of cough, respiratory distress and stridor had foreign body aspiration6 . A study was conducted to evaluate the level of awareness of foreign body aspiration and its resultant dangers in the community by the Department of Community Health of Christian Medical College Hospital Ludhiana, Punjab. About 63 primary care givers were interviewed. The results revealed that awareness levels about the condition were very low, 25 % had not heard about the condition, 46% could not recognize if it happened and also 76% did not know about the attendant dangers of condition. The researcher concluded that there is a dire need to spread awareness about both prevention and treatment of this morbid condition7. From the available literature reviewed it is clear that it is essential to give proper education regarding the knowledge for foreign body aspiration. Foreign body aspiration can be a life-threatening emergency. An aspirated solid or semisolid object may lodge in the larynx or trachea. If the object is large enough to cause nearly complete obstruction of the airway, asphyxia may rapidly cause death. Lesser degrees of obstruction or passage of the obstructive object beyond the carina can result in less severe signs and symptoms. Since it is the mother’s who is wholly and solely responsible for safety of their children, they need to have a thorough knowledge regarding foreign body aspiration. So the researcher found it relevant to assess the knowledge regarding foreign body aspiration for mothers of under-five children in a selected rural community at Mangalore. 6.2 Review of literatureA retrospective study was conducted in Ha Emek Medical Center to examine the demographic data of children at high risk foreign body aspiration in order to develop precautionary measures. The study was conducted in children less than 16 years, who underwent bronchoscopy for suspected foreign body aspiration during the period of 1994– 2004. Foreign bodies were found in 73% of cases among 134 children. The incidence of bronchosopies that were positive for foreign bodies was higher in the children less than two years (82.6%) with older children (57.1%). In majority of cases food was aspirated (82%) especially nuts and seeds. It is recommended that well-defined public education programs should achieve prevention8. A retrospective study was conducted to analyze the epidemiological, clinical, radiological and endoscopic characteristics of paediatric foreign body aspiration in Algeria. The children (62.34% males and 37.65% females) were aged 4 months to 18 years with 66% between 1 and 3 years. Choking was related in 65% of cases. The most common radiologic finding was pulmonary air trapping (40.7%). The aspirated bodies were organic in 66.7%, dominated by peanuts, sunflower seeds, beans, metallic or plastic as pen caps and scarf pins. The endoscopic removal by rigid bronchoscopy was successful and complete in 97%. The complications related to the endoscopic procedure were 0.29% with a mortality of 0.26%9. A study was conducted to evaluate the parent’s knowledge regarding FBA .An 8 item questionnaire regarding knowledge of FBA was distributed. From the 1766 questionnaires distributed 1603 were recovered among that 1490 were fully answered by mothers. From this it found that 4.3% did not recognize a small toy as a cause of FBA while 20.2% did not know that peanuts and other nuts can be a cause for the same. More over 41.8% of mothers did not know the symptoms suggesting FBA. Finally they conclude that as a substantial number of mothers lack knowledge regarding FBA it is important to give information to mothers with children younger than 12 months and mothers with a first child 10.A study was conducted to evaluate the level of awareness of foreign body aspiration and its resultant dangers in the community by the Department of Community Health of CMC Hospital Ludhiana, Punjab. About 63 primary care givers were interviewed about their awareness of foreign body aspiration, its attendant dangers, preventive measures taken, and how will they take care of a child in the event of a foreign body aspiration according to an agreed protocol. The results revealed that awareness levels about the condition were very low, 25 % had not heard about the condition, 46% could not recognize if it happened and also 76% did not know about the attendant dangers of condition. The researcher concluded that there is a dire need to spread awareness about both prevention and treatment of this morbid condition7. A descriptive study was conducted to assess the effectiveness of training programme on first aid measures for common childhood accidents such as burns, falls, foreign body aspiration, poisoning and animal bite at Mugalur village, Bangalore. The knowledge of the 140 mothers of children <15 years was assessed using a scoring system. Majority 72% of mothers had children 6-15 years of age and 28% of the mothers had children less than five years of age. Though a large proportion of the 140 mothers included in the study, only 56 mothers attended the training programme on first aid. Their mean pre training score was 2.34±1.98 which increased to 11.64±1.27 immediately following training. The study recommended that caregivers of young children need to be educated on first aid11. 6.3 Statement of the problemA study to assess knowledge regarding foreign body aspiration among mother’s of under-five children in a selected rural community in Mangalore with a view to give health education.6.4 Objectives of the studyThe objectives of the study are ,1. To assess the knowledge level of mothers of under-five children regarding foreign body aspiration.2. To determine the association between knowledge of mother’s of under-five children regarding foreign body aspiration and selected demographic variables.6.5 Operational definitionsKnowledge on Foreign body aspiration: It refers to the correct response obtained from the mothers of under five children to the questionnaire on aspiration of an object or substance found in the part of body to which it does not belong under normal circumstances, such as bolus of food in the trachea or a particle of dust in the eye among under- five children. 6.6 AssumptionsThe study assumes that, Mothers of under-five children may have some knowledge regarding foreign body aspiration. Knowledge of mothers can be assessed through a structured knowledge questionnaire.6.7 DelimitationsThe study is delimited to  Mothers of under-five children Mothers residing in rural areas of Mangalore. 6.8 HypothesisThe hypothesis will be tested at 0.05 level of significance.H1: There will be a significant association between knowledge score of mothers of under- five children on foreign body aspiration and selected demographic variables.7. Materials and methods7.1 Source of dataData will be collected from mothers of under five- children in selected rural area, Mangalore.7.1.1 Research designThe research design selected for this study is descriptive design.7.1.2 SettingThe study will be conducted in selected rural area, Mangalore.7.1.3 PopulationIn the present study population consists of the mothers of under-five children. 7.2 Method of collection of data7.2.1 Sampling procedure In this study purposive sampling technique will be adopted.7.2.2 Sample sizeIn this study, sample size will be 150 mothers of under-five children residing in selected rural area, Mangalore.7.2.3 Inclusion criteriaMothers of under-five children,1. Under five children only.2. Who can understand and speak either Kannada or Malayalam.7.2.4 Exclusion criteriaMothers of under-five children,1. Who have participated in any research studies on foreign body aspiration within the last 6 month.7.2.5. Instrument intended to be usedPart 1: The tool consists of demographic Proforma such as age, education, occupation, family monthly income, number of children.Part 2: Structured knowledge questionnaire on foreign body aspiration.7.2.6 Data collection methodIn order to conduct the study in rural area of Mangalore, written permission will be obtained from the rural PHC. Mothers of under-five children will be selected by purposive sampling technique. The purpose of the study will be explained and permission will be obtained from the subjects with assured confidentiality. Knowledge will be assessed by a structured knowledge questionnaire regarding foreign body aspiration. After which a health education will be given to the mothers of under five children regarding foreign body aspiration.7.2.7. Data Analysis Plan Data will be presented in terms of frequency, percentage & graphical representation. Association between knowledge of mothers of under- five children and selected demographic variables will be done using chi-square test.7.3 Does the study require any investigation or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.Yes, a knowledge assessment on foreign body aspiration among under-five children will be done to mothers of under-fives by administering knowledge questionnaire.7.4 Has ethical clearance been obtained from your institute in case of 7.3?Yes, ethical clearance has been obtained.8. REFERENCES1. URL: http://en.wikipedia.org/wiki/foreign-body. Accessed on 28-10-13. 2. Marlow DR, Redding BA. Textbook of Pediatric Nursing. 6th ed. Philadelphia: W.B.Saunders; 1988. 3. Jayalakshmi LS. Mothers’ awareness about accidents among toddlers. The Nursing Journal of India 2004 Dec 25(12):276-8.4. Khan NU, Nabi IU, Yousaf S. Foreign bodies in larynx and tracheo-bronchial tree. Pak Armed Forces Med J 2000 Jan 50(2):68-70.5. Behrman RE, Kliegman RM, Nelson WE, Vaughan VC. Nelson Textbook of Pediatrics. 14th ed. Philadelphia: WB Saunders Company Publication; 1987. 6. Reilly JS, Cook SP, Stool D, Rider G. Prevention and management of aerodigestive foreign body injuries in childhood. pediatr clin, North Am 1996 Dec 43(6): 1403-11. 7. Singh A, Ghosh D, Samuel C, Bhatti W. Pediatric Foreign Body Aspiration: How much does our community know. Journal of Indian Association of Pediatric Surgeon. 2010 November 15(4): 129-32. 8. Patil Prasad N.A study to assess the effectiveness of planned teaching module regarding foreign body aspiration and its prevention in under-five children. International Journal of Nursing Care.2013 april 1(1): 47-51. 9. BoufersaouiA, Smati L, Benhalla KN, Boukari R, Smail S, Anik K et al . Foreign body aspiration in children: Experience from 2624 patients. Int J Pediatr Otorhinolaryngol. 2013 Oct 77(10):1683-8. 10. Higuchi O, Adachin Y, Adachi YS, Taneichi H, Ichimaru T, Kawasaki K. Mother’s knowledge about foreign body aspiration in young children. Int J Pediatr Otorhinolaryngol. 2013 Jan 77(1): 41-4.11. Sonavane SR. Knowledge, attitude and practice of first aid among women in a rural area [online]. Available from: URL:http://www.novapdf.com9. Signature of the candidate10. Remarks of the guide11. Name and designation of (in block letters)11.1 Guide MS SEEMA CHAVAN ASSISTANT PROFESSOR DEPARTMENT OF CHILD HEALTH NURSING FATHER MULLER COLLEGE OF NURSING KANKANADY MANGALORE.11.2 Signature12 12.1 Head of the department MRS MALARVIZHI M ASSOCIATE PROFESSOR DEPARTMENT OF CHILD HEALTH NURSING FATHER MULLER COLLEGE OF NURSING KANKANADY MANGALORE.12.2 Signature13. 13.1 Remarks of the Chairman /Principal13.2 Signature

Rajiv Gandhi University of Health Sciences, Karnataka s29

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