INTRODUCTION

I’ had give all wealth that years have piled,

The slow result of life’s decay,

To be once more a little child,

According to ‘the united nations convention on the rights of the child’. A child is
defined as “a human being below the age of 18 years unless under the law, applicable
to the child, majority is attained earlier.”

Children are divieded in various age group. The period from birth till 1 year is termed
as ‘infancy’ till the age of 6 months the child is completely dependent on the mother for
nutrition in the form of breast milk, from 6monts onwards the child is weaned and
introduced to food starting from liquid food, simultaneously the infant’s teeth develops
and he tries to put everything in the mouth. The period of weaning and teething poses
the infant at the risk of diarrhea. The period from 1year to 3 year the child is called a
toddler. The toddler tries to explore the world around him and eats whatever seems
good to him. The practice of pica is seen in the children as they play outdoors in the
mood. And lastly the duration from 3 years to 6 years the child is termed as a
preschooler.

Statistically, india has crossed the 1 billion population mark, and is home to 19% of the
word’s population. Every year, 26 million children are born in india. India also has the
highest number of child births for any country and accounts for 23% of the word’s
under 5 deaths worldwide, india contributes 2.4 million, which is the highest for any
country. The overall infant mortality rate is 57 rural 62 and urban 42. Though the
economic power of india has improved dramatically, the health, particularly of
children, is yet to meet expectations. The reason is obvious the country’s expenditure
on health and education if 5% of its total expenditure. The under 5 mortality rate in
india is 74% while that of USA,UK, germany and sweden is 8%,6%,5% and 3%
respectively most children in india under the age of 5 years die of one or more of the
five common disease such as diarrhea, respiratory infection, malaria, measles, and
malnutrion , now HIV/AIDS also contributes significantly to child death. About 54% of
children who die suffer from some degree of malnutrition.

The government of india in collaboratio with world health organization ,united nation
international children’s emergency fund the world bank and various non-government
organizations has been striving to reduce the under -5 morbidity and mortality rates and
to promote healthful living for the children of india. Since india is the most populated
country the challenges faced by india in reduction of child mortality and morbidity is
related to the infection disease. Surprisingly , many of these infection can be prevented
by simple measure like, environment hygiene, provision of safe drinking water,
improving health facility, encouraging immunization, improving nutrition of children
and foremost importance lies in educating mothers regarding these illnesses and its
prevention.

On the other hand, many problems in children are caused by infections diseases and
malnutrion and though the above mentioned statistics seem dismal comperd to those of
the developed nation the scenario is changing the severity of malnutrition is apparently
descreasing many infectious disease such as small pox no longer exist. Poliomyelitis is
on the verge of eradication and only fever cases of tetanus and diphtheria are being
encoutered.

A mother in the family occupies pivotal role. If she is educated and is having
significant health awareness, she will take the responsibility of increasing the total
family health awareness which facilitates high standards of living. Healthy practices
adopted by the mothers can raise the healthful living condition, there by lessens the
morbidity and mortality of under-five children. Mother’s knowledge and children’s
health are correlated factors. If the mothers are having knowledge, they can save their
children even in critical situation. The awareness of mothers about health, diseases and
preventive services is a barometer by which we can measure the progress of family,
community and country. The various researchers quoted the same. Hence the
investigator felt the need to assess the knowledge and attitude of mothers of under five
children regarding prevention of common childhood illness. Assessment of the
knowledge and attitude of the mother will help to identify the need for health education
in the society and family and also to find out the areas of health awareness to be
provided.

This achievement is result of the efforts of indian government and the other
organization who contributed in promotion of child health and survival by introducing
a series of programmers and provides various facilities for the beneficiaries under each
programme, initiating with the expanded programme on immunization in 1978,
universal immunization programme in 1985, child survival and safe
motherhood(CSSM) 1992, reproductive and child health(RCH) programme in 1997,
(this programme was later combined with family planning and adolescent helth
components). At present, child health strategy is a part of the national reproductive and
child helth(RCH) programme which was initiated in april 2005. Integrated management
of childhood illness strategy developed by WHO nad UNICEF,is a curative, preventive
and promotive strategy aimed at reducing under 5 child deaths and improving
nutrition . in india , it is expanded to include the first week of life and therefore, named
integrated management of neonatal and childhood illness it deals with normal newborns
newborn sickness, diarrhea, acute respiratory infection , fever, malnutrition, anemia,
vitamin A deficiency, feeding and immunization. This programme clasifies the age
group of under 5 into two viz. birth-2 months and 2 months to 5years and illness such
as diarrhea, fever annd cough which are the primary cause of child mortality and
morbidity as discussed above.
To mentain concerning the illnesses, first of all diarrhea, the disease is described as
passage of loose stool more than 3 times a day. Diarrhea is usually a symptoms of
gestrointestinal infection, which can be caused by a variety of bacterial, viral and
parasitic organisms. Infection is spread through contaminated food or drinking – water
or form person to person as a result of poor hygiene. One of the most common
complication of diarrhea is dehydration prompt treatment needs to be initiated at home
to prevent the child from prograssing to severe dehydration leading to shock and death.

Secondly fever, it described as the rise in body temprature(37.5 deg. Measured orally)
fever is commonly caused due to bacterial, viral or parasitic infection to name a few
diarrhea and upper respiratory tract infections are some of those the measures to reduce
fever and replacing the body fluids lost due to increased temprature should begin at
home. If it is not taken care properly the illness may take an ugly turn placing the child
at the risk of dehydration and febrile seizure. Dehydration if untreated may lead to
shock causing death and likewise febrile seizure may be a reason for delayed milestone
or the child may develop epilepsy for his/her whole life and on other hand febrile
seizure may also prove fatal for some. Similarly, cough is usually caused by an upper
respiratory tract infection. It is a defined as a fourceful and sometimes violent
expiratory effort proceeded by a preliminary inspiration. Untretad respiratory infection
is child may lead to pneumonia which contributes to 19% of child death in india
(WHO, 2009) these illness are preventable and educating mothers regarding their
causes, symptoms andhome management will help in upgrading their causes, symptoms
and home management will help in upgrading the health of majority of children.

Education aids learning is a unique process in itself. It helps to upgrade once

knowledge on the subject to be taught. A learner cannot learns as long as he is
understands the topic. To clarify the issue one has to provide the learner proper means
of education. Education can be provided by coupling it with a range of audio-visual
aids. And audio-visual aids are classified into projected and non projected forms. The
non projected methods prove convenient for providing education in the community.
Some examples of non-projected methods are charts, posters, cards, projectors,
pamphlets, models, photographs, booklets etc. among the entire visual aids information
booklet is a kind of visual aids, which can be printed and distributed among the people
to allow them to read at their own convenience and comprehend. Likewise the
advantages of information booklet for the mothers participating in the present study
will be that they can learn at to their own convenience. It wont necessitate the presence
of a teacher to teach, the language used will be a simple layman language and it will not
require gathering people in groups to deliver health education. The picture will help in
understanding the concept in a better way, and last but not the least mothers can refer to
booklet whenever required hence, it will help in re- enforcing the knowledge. But to
prove its effectiveness will entirely on the pre-test and post-test knowledge score.

Therefore, the type of visual aid that will be used in the study is the information
booklet. The information booklet will be thin booklet with paper cover.it will be based
on the home management of common illness in children aged between 2months to5
years and the illnesses included will be diarrhea, fever, cough. The booklet will
undergo validity from the experts and reliability will be done on 10 mothers followed
by pilot study again including another 10 mothers then the main study will be
counducted on 100 mothers. The samples will be chosen on the basis of inclusion
criteria.

Other than ORT, essential elements in the management of childhood diarrhoea include
increased & continued feeding of energy dense food in addition to breastfeeding, zinc
therapy and the use of appropriate antimicrobials for the severe cases of diarrhea.2
Timely and appropriate management at household and in health services remains an
important intervention for reducing mortality due to childhood diarrhoea. 6 However,
application of the guidelines recommended for diarrhoea management in communities
remain suboptimal in large segments of vulnerable population such as those residing in
urban slums across the developing world.7 According to a national level survey NFHS
III (National Family Health Survey), only 43% children suffering from diarrhoea in
India receive any kind of ORT or increased fluids. Even more worrisome is the fact that
this proportion seems to have stagnated or declined in most states in the last decade.19
A joint WHO/ UNICEF statement in 1981, while recognizing centrality of mothers in
the management of diarrhoea, stressed the need ‘to understand their present attitudes,
perceptions and practices regarding diarrhoea’.9 In this context, the objective of this
study was to determine the knowledge, attitude and practice of mothers regarding
diarrhoeal illness, its prevention and management in their children belonging to five
years of age and below.
BACKGROUND OF THE STUDY:-
Chindren are susceptible to quite a number of infections as their immunity is not well
developed and statistics according to WHO projects that infction is one of the major
causes of morbidity and mortality among children. Out of many infectious diseases, the
infection of the gastrointestinal system diarrhea alone claims 1.9 million lives in under
5 years of age itself every year making it the second most common cause of child
deaths worldwide. The incedence of acute respiratory tract infection in children aged
less than 5 yeaes is estimated to be 0.29 and 0.05 episodes per child year in developing
and industrialized countries, which translates into 5 million new episodes each year,
respectively.

Diwan P.(2010), reports india losses one child below five year of age in every
20second and about 5000 children die every day. NGO world vision says that in india
child mortality rate can be avoidable because 20% of the deaths occur due to infections,
which are treatable like diarrhea, above 2.1 million children die every year out of which
1.9 millio deaths can be preventable. Studies have revealed that infection can be
treatable which will help to bring down the child death rate by 90% vaccination has a
key role in cutting unnecessary deaths. Vaccines like influenza, hepetitis B, rotavirus,
and smallpox vaccines are among that are at present and accessible but not included in
the schedule

Throughout history, disease have been brought under control by a range of measures
like better sanitation, uncondaminated potable water, uncrowded housing and an
adequate diet, exposure to pathogens are less frequent and less intense, and hence
people are better able to fight off severe infection rather than falling prey to it. But in
the slum areas the situation remains un changed the houses are crowded, there are
presences of open dreains, visiting public toilets or open air defecaion is a common
practice this usually leads to contamination of drinking water. Spreading awareness
regarding personal and environmental hygine, using clean drinking water(by boilling
and filtering) can help to maintain health of the children.

William roe polk (1985) states that more than half of the worlds population lives in
less-developed areas that are characterized by a lack of potable water, inadequate
means for disposal of human fecal waste, and intense crowding in rudimentary housing.
Under such condition of poverty, underdevelopment and lack of education, the
pathogenic bacteria, viruses, and protozoa capable of causing diarrhea disease in
humans are readily transmitted to young childrean. Indeed under such condition, the
hands that touch infants drink are heavily contaminated with fecal material, and
therefore with diarrhea-causing pathogens. As a consequence, in the first 2 years of life,
young children in the less developed countries bear an enormous burden of the
diarrheal disease.

Though abundant development has taken place in the fiels of science and research,
superstition or blind beliefs still persists in the society. This causes impact on the lives
of the people affecting the health of children prominently.

Nielson M. and et at (2001) conducted a study on “childhood diarrhea and hygiene

mothers perception and practices in punjab,pakistan. They carried out this study to
know the cause of diarrhea, the researchers found out that according to mothers the
causes of diarrhea were consumption of too much food, consumption of contaminated
food, humoral theory of hot and cold due to envy the malice. This calls for an attention
towords spreading awerness among people regarding the actual causes of illness and to
renounce or minimize superstitious beliefs related to child care as superstitious baliefs
cause more harm than benefits.

Mrs. Gupta R and mr.gupta R K. (2001) conducted a study on “traditional beliefs and
practices among graduate mothers regarding various pediatric ailments” the various
ailments considered were diarrhea, fever, skin disorders, jaundice, seizures etc. the
researchers found out various beliefs the mothers had regarding causation of these
ailments. The cause of illnesses stated by the mothers were teething, indigation of milk,
hot and cold diet, evil eye, maternal diet, “ curse of goddess” etc. the home
management done were restriction of feeds/diet/fruits, application of [scared thread
worn around neck, waist or arm to ward of evil spirit], application of black mark on
body/burning of chillies, use of janam ghuti, applicationof ash/soil from scared packs
carrying of iron items especially small knife, long iron nail along with them. Jhar-
phoonch were the main traditional practices applied by this mothers. These mothers
were influenced mainly by elders, associates, quacks, teleseries, magazines and
newspapers.

All the efforts taken to improve standard of living will be successful only when the
community is made aware. Awearness can be spread through a lot of medium such as
role play, television, radio,newspapers, magazines, and so on. Traditionally in india
messages were communicated to the people through propaganda, street palces, puppet
shows and dramas. These practices are still prevelent and it provides education
collaborated with entertainment but people tend to easy forget the things they learnt and
continue their earlier practices.

Educating the right person and through the use of effective medium is the need of the
hour. Mother is an important person in a child’s life because she is the primary care
taker of the child and remains with the child both during wellness and illness hense,
making mothers aware about the illnesses, the causes, its sign and symptoms, home
management and complication may prove benificial. And the medium of education
should be such that it would help inspreding awareness, it should be handy, if should re
enforce knowledge so that children are taken care in a healthy manner. Though, no such
perfect medium for educationis yet developed. The researcher wants to test a particular
visual aid to prove its effectiveness in enhancing the knowledge of the people. This will
in turn help in formulating the effective aid of eeducating the community on large
scale.

NEED OF THE STUDY:-

‘There is no cause which merits a higher priority than the protection and development
Of children, on whom the survival, stability and advancement of all nations and indeed
human civilization depends.’
-The plan of action of world summit for children (1990)

Children constitute the foundation of the nation. Healthy children grow to become
healthy adults with optimal physical strength and emotional poise to become useful
member of our society and contribute effectively in the nation building process. In
india health of under -5 children is not satisfactory, acute respiratory infection,
diarrhea, measles, malnutrition and HIV/AIDS are the major causes of morbidity and
mortality. Of the estimated 26 million babies born each year alone 5 million do not
survive their first birthday, another 4.5 million do not live to see their fifth birthday.

As it is truly said a little learning Global estimation of number of deaths due to

diarrhea among under fives have shown a steady decline from 4.4 million in 1980, 3.3
million 1990, 2.5 million in the year 2000, 1.7 million cases in 2005 and 1.9 million in
the year 2007. National Institute of Cholera and Enteric Diseases (2006) reported that
diarrhoeal diseases rank second amongst all infectious disease as a killer in children
below five year of age world wide.
 Globally 1.3 billion episodes occur annually with an average of 2-3 episodes per
children per year. World Health Organization initiated diarrhoeal diseases control
programme in 1980, approximately 4.6 million children is used to die each year of the
dehydration caused by diarrhoea. The mortality due to diarrhoea have been reduced to
1.7 million during the year 2004.

World Health Organization (Global Burden of Disease – Update 2008) stated major
causes of death in neonates and children under five diarrhoeal, fever & cough disease.
In India like developing countries annual episodes of diarrhea in children under five
year old, 3.2 episodes per child and 2 billion episodes globally.

Annual mortality from diarrhea, fever & cough in children under five years in
developing countries was 1.8 million deaths and it was decreased from 4.5 million
deaths in last 20 years. Banerjee (2006) stated diarrheal disease is major killer disease
in under five children in India and this is an important public health problem. It causes
heavy economic burden on health services. One third of pediatric admission are due to
diarrhea disease and 17% of deaths due to its complications.
In India acute gastro enteritis is one of the second leading causes of death for all age
groups and for children, respectively. About 10% of all deaths of children occurs due to
acute gastro enteritis and its mortality fell sharply, after oral rehydration therapy was
introduced, and ecological analysis showed that oral rehydration therapy use rates were
correlated with infant gastro enteritis mortality.

Rice ( 2005 ) stressed that nurses assess the severity of dehydration as well as
prescribe and supervise oral rehydration therapy to treat children with diarrhoea. She
also stressed the need for further nursing research especially related to home made oral
rehydration solution.

Janchez.R ( 2005 ) stated that promotion and reinforcement of the breast feeding
practice is an effective way for the nutritional recovery of infants with persistent
diarrhea.

Bhave.H (2004) explained that diarrhoea is a biggest single killer disease of children
below five years of age due to dehydration. In the modern world, it is one of the major
causes of nutritional loss and poor growth. Oral rehydration therapy is an appropriate
intervention for dehydrated children.

Acta Paediatrics ( 2003 ) stated that zinc supplementation is effective in reducing

diarrhoeal morbidity when given either daily or in a weekly schedule, 50% reduction in
diarrhoeal morbidity in children.

Most of the mothers do not have adequate and practice towards management of
diarrhoea. Though many teaching programme were conducted by the government
related to diarrhoea but mothers still have lack of knowledge in home management,
hence it is essential to assess the knowledge on management of diarrhea. So the
investigator feels the necessity for a study in this aspect.

As compared to its population the land available for the people to dwell is very less,
this causes over crowding places the population at risk for many communicable
disease, unemployment low standard of living, lack of health facility scarcity of food
and drinking water andso on. Unhyginic practices are commonly seen in overcrowded
places and slums.due to poverty majority of the masses cannot afford good shelter,
healthy food, clean clothing, and even basic education

Due to lack of health awareness people follow practices which are unhealthful, for
these resons children become major sufferers, owing to their poor immunity as
compared to an adult, a child develops infection at a faster rate and may succumb to it.
This contributes to a high morbidity and mortality rates. Therefore it is the
responsibility of the health personal to educate the community regarding prevention of
common preventable disease which will turn help in averting the the spread of infection
and avoid further complication. Here, directly or indirectly children will be the major
benefectors. To improve the health status of indian children the government of india is
working hand in hand with various indian and foreign organizations. The world bank is
sponsoring many programmes in india this has helped in lowering the child mortality
and morbidity.

Women in india gain knowledge regarding health practices from their mother, grand
mother , mother in low and elders of the society, these practices do not always have a
scientific base and many women are either illiterate or attain only primary education.
So there remains a little scope for the women to gain correct knowledge regarding
healthy practices. As a result children are malnourished and many do not survive.
Gender disparity is another problem which poses problem for the helathy up bringing
of the girl child, therefore majority of the women in the society are undernourished and
babies born to them are usually small for gestational age or underweight. It is difficult
for an undernourished child to sustain life and infection makes it more complicated.

This follow-up observational study examined gender disparities in seeking health care
and in home management of diarrhea, acute respiratory infection and fever among the
530 children aged less than 5 years. The researchers found out that at times at the
household level, girls were less likely to get home fluids and oral rehydration solutions
during diarrhea. Expenditure per treated episode differed significantly. Results of
logistic regression analysis showed that chances of spending money were 4.2 times
higher for boys. The boys were 4.9 times more likely to be taken early for medical care
and 2.6 times more likely to be seen by qualified allopathic doctors compared to girls.
Persistence of gender disparities calls for effective interventions for correction the
major maternal factors responsible for under five mortality are illiterate mothers,
marrige and child birth before the age of nineteen years, short birth intervels, home
deliveries by local dais and untrained relatives. The child factors associated with five
mortality are neonatal period, lack of immunization, communicable disease, presence
of sibling death, lack of medical aid at the time of death, inadequate breast feeding
from third day onwards, first order, pre maturity anf low birth weight. These maternal
and child factors need to be addressed through education to change the value system,
which is practiced wrongly.

As a discussed earlier there are countless audio-visual aids through which

education/information can be provided to the community. Out of all these aids the
researchers chose to develop an information booklet as a type of visual aid for
educating mothers. In the year 2006, vittappa C. conducted “ A study to assess the
effectiveness of information booklet on vaccine preventable disease among the mothers
of under five children in begur primary health center, bengalore south karnataka, the
researchers concluded that information booklet on vaccine preventable disease was
effective in improving knowledge of mothers of under five children. To conclude, the
researchers thought of developing an information booklet on home management of
common illneses in children 2 months to 5 years and to test its effectiveness on the
knowledge gain by the mothers. The booklet will contain information in written as well
as in pictorial form. The researcher assumes that information booklet can be the
convenient method of education as it is handy and mother can read as and when she get
time, and she can even refer the information booklet when ever necessary.

PROBLEM STATEMENT:-

“ A STUDY TO ASSESS THE EFFECTIVENESS OF INFORMATION BOOKLET

ON KNOWELDGE OF THE MOTHERS REGARDING HOME MANAGEMENT OF
SELECTED COMMON ILLNESSES IN CHILDREN (2 MONTHS TO 5YEARS)
RESIDING IN SELECTED URBAN SLUMS OF VISNAGAR CITY”.

OBJECTIVE OF THE STUDY:-

 To assess the knowlegde of the mothers of children aged between 2 months to 5

years, before giving the information booklet regarding home management of
selected common illnesses in children (diarrhea, fever and cough).
 To assess the knowlegde of the mother of children aged between 2 months to
five years, after giving the information booklet regarding home management of
selected common illnesses in children (diarrhea, feverand cough)
 To compare pre test and post test knowledge scores of mothers regarding
management of selected common illnesses in children (diarrhea, feverand
cough)
 To co-relate selected demographic variables withmothers post test knoelegde
score regarding home management of selected common illnesses in children
(diarrhea, fever, and cough)
OPERATIONAL DEFINATIONS:-

1. ASSESS:-
Assess, is defined as estimation of value of a thing .
In this study “assess” is defined as “ estimation of effectiveness of information
booklet on home management of selected common illnesses in children.
(diarrhea, fever, and cough)

2. EFFECTIVENESS:-
Effectiveness is defined as checking for the desired effect, intended result or an
outcome.
In this study “effectiveness” is defined as an outcome of the information
booklet on home management of selected common illnesses (diarrhea, fever,
and cough) in children on the knowledge of the mother.

3. INFORMATION BOOKLET:-
Information booklet means a small thin information book with paper cover
In the study – information booklet refers to a small thin information booklet
which contains information in english and marathi language regarding home
management of selected common illnesses in children (diarrhea, fever, and
cough) on the following aspect.

1. Meaning of diarrhea, fever, and cough

2. Causes of diarrhea, fever, and cough
3. Sign & symptoms of diarrhea, fever, and cough
4. Home management of diarrhea, fever, and cough
5. Prevention of diarrhea, fever, and cough
6. Follow up of diarrhea, fever, and cough

4. KNOWLEDGE:-
Knowledge means the fact or information and skills acquired through
experience or education.
In this study knowledge means information and facts acquired by mothers about
common illnesses in children (diarrhea, fever, and cough) which are assesed by
using semi structured questionnaire.

5. MANAGEMENT:-
Management is the defined as the technique of treating a disease.
In this study management is the technique of managing selected common
illnesses in children (diarrhea, fever, and cough) at home level.
 6. ILLNESS:-
Illness is defined as a disease caused by pathogenic microorganisms.
In this study as sickness, disease or an ailment.

7. CHILDREN:-
Children are “young human being the age of full physical development
In this study Children refers to a young human being between 2 months to 5
years of age.

8. MOTHER:-
Mother is a female parent.
In this study Mothers are considered as the female parnt of children aged
between 2 month tto 5year.

9. URBAN SLUM:-
Urban slum is an overcrowded and squalid backstreet, district, etc. usually in a
city.
In this study urban slum is an overcrowded and squalid area of visnagar city.

10. SELECTED COMMON ILLNESSES IN CHILDREN:-

The selected common illnesses of childhood are diarrhea, fever and cough.

1. DIARRHEA:-
Diarrhea is defined as the passage of liquid or watery stool more than
three times a day.
In this study Diarrhea is defined as the passage of liquid or watery stool
more than three times a day

2. FEVER:-
Fever is an abnormal elevation of temprature . the normal temprature
taken orally ranges from about 97.6 deg C to 99.6 deg C.
In this study Fever is an defined as abnormal rise in temperature above
97.4 deg C.

3. COUGH:-
A fourcefull and sometimes violent expiratory effort preceded by a
preliminary inspiration.
In this study Cough is defined as a moist cough accompanied by
production of mucus or exudates.

SCOPE OF THE STUDY:-

 “ A study to assess the effectiveness of information booklet on knowledge of the
mothers regarding home management of selected common illnesses in children (2
months to 5 years) residing in selected urban slums of visnagar city.
If the researcher is able to prove that the study is effective. At that juncture, this
research can be applied in the following fields.

1. Nursing education – in nursing education the information booklet can be used to

teach the students concerning how to prepare a booklet and it usefulness in
educating the community.
2. Nursing administration – the nurse administrator can use this material to enhance
the knowledge of the student and the staff nurse regarding home management of
common illnesses in children.
3. Child health nursing- nurses working in pediatric ward can use booklet as a source
of information to educate the mothers and to spread awareness among them. It will
be handy teaching material for the busy nurse in the clinical area.
4. Community health nursing- distributing booklet in the community will help the
mothers help the mothers and significant others to gain knowledge readily and as
the book is handy people can refer them when ever needed. Thus it will help in
reinforcing the knowledge of the community.

ASSUMPTION:-

1. Mother of the children residing in selected areas of urban slums of visnagar

city. Has some knowledge regarding home management of selected
common illnsses (diarrhea, fever, cough) selected common illnesses in
children(2 months to 5 years).

2. Information booklet regarding home management of selected illnesses in

children would be the easiest way to improve the knowledge of the mothers.

HYPOTHESIS:-

1. Null Hypothesis - Ho- There will be no significant effect of information

booklet on knowledge of the mothers regarding home management of
selected common illnesses in children.

2. Research Hypothesis - H1- There will be significant effect of information

booklet on knowledge of the mothers regarding home management of
selected common illness in children.
 LIMITATION:-

1. Mothers of children aged 2 months to 5 years of selected urban slums will

be included in the study.
2. The study will be conducted in urban area and will not include rural area.
3. The study will include mothers only and not the father and significant
others, since mother is more close to the child during illness to care for the
child. The father may be dificult to contact during the study because of job.
4. The practices will not be observed.

ETHICAL ASPECT:-

1. The study proposal has been sanctioned by the ethical committee of the
college.
2. Informed consent was taken from the participants.
3. Information of the study was given in detail to the participants.
4. Permission was ontained from the concerned authority of the urban slums.

CONCEPTUAL FRAMEWORK:-

A conceptual frame work can be defined as concepts and assumptions that integrate
in to a meaningful configuration.

Conceptual frame work is a global idea in relation to a specific discipline conceptual

models can be made by concept, which describes the mental images of phenomeno and
integrate them in to meaningful configuration. The conceptual framework gives an idea to
the researchers main view and core them of research that is, it is a visual diagram by
which the researcher explains that specific area of interest.

According to abdellah (1986), a conceptual framework is a theoratical approach to the

study of problems that are scientifically based and emphasize selection, arrengements and
classification of concepts.

Roy’s adaptation model was introduced in the year 1964. According to this theory a
person is an adaptive system which consist of input of stimuli, adaptation level and out-put
as behavioral responses that serve as feedback and control processes known as coping
mechanism. The meta peradigm of this model is as follows.

The study is based on modified penders Health promotion model (1984). The study seeks
to increase on individual level of well being. The model focus on aspects to individual
cognitive perceptional factors, modifying factors and participation on health promoting
behaviours. The model also identified factors that influence health promotion activities. In
this modified model the community nurse interacts to assess the level of knowledge on
management of selected common illness (diarrhoea, fever, cough) among the mothers of
under five children. Diarrhea is one of the communicable childhood diseases caused by
various organisms which include viruses, bacteria, and parasites.

The transmission of diarrhea, fever & cough is through consumption of contaminated

food and water by the host. It can be food-borne or water-borne. “In children the
symptoms of diarrhea are as a result of relationship between the infectious agents (viruses,
bacteria and parasites), the host immune system and the supporting environmental factors
and management imposed on the host” (Harding, 2005). 6 In this study the host is the
under-five child, the agent is the mother as the caretaker of the underfive child, and the
environment is the household physical conditions which include toilet facility, residence,
and source of drinking water.

Based on Pender’s Health Promotion Model the conceptual framework planned. The
conceptual frame work components are individual characteristics, behavior specific to
affect and cognition and health promoting behviour.The individual characteristics refers
the sample characteristics and existing knowledge. The behavior specific to affect and
cognition refers to the structured teaching program. The health promoting behavior refers
the outcome of the intervention that positive out come to change the behavior.

Person - according to roy’s adaptation theory a person or individual is an adaptive system,

who functions as a while through the inter depandence of sub-parts, the individual
behaviour is based on sub-parts of system such as input, control processes,effectors,out-
put and feedback.

Environment – according to this theory, environment is defined as ‘all conditions

circumstances and influences that surround and effect the development and behaviour of
person’s or group’. Thus all stimuli, whether internal or external are part of the person’s
environment.

Health – according to this model health is defined as ‘a state and process of being and
becoming an integrated and whole person’. Health in a state reflects the adaptation process
and is demonstrated by adaptation in each of the integrated adaptive modes, physiologic,
self-concept, role function and interdependence the integration of wholeness.

Nursing – according to this model goal of nursing is defined as the promotion od adaptive
responses in relation to the four adaptive modes. The person’s adaptation level determines
whether a positive response to the internal or external stimuli.

Input – input is the stimuli from the external environment and internal self. The stimuli
are of three types. Adaptation level is determined by the composition of these stimuli. The
stimuli are described as follows:
 a. Focal stimuli: These are the stimuli most immediately confronting the person.
When the researcher approaches the mother to participate in the study the mother
may or may not feel the need to participate in the study.

b. Contextual stimuli: They are all those other stimuli of person’s internal and
external world that can be identified as having positive or negative influence on the
situation.

In this study, contextual stimuli is the need of the mother to gain knowledge
regarding the home management of common illness in children which will help the
mother to take good care of her child during her child’s illnesses.

c. Residual stimuli: They make up the charecteristic of the person that is present and
relevent to the situation.

d. Control process: These coping mechanism are controlled by regular and sub
systems. These coping mechanisms are infuenced by the perception of stimuli.

Physiologic mode: In this study the physiological need of the mother will include her own
health. Mothers need to be educated about the importance of their own health because if
mother is sick then she will not be able to take appropriate care of her child. It is rightly
said healthy mother healthy child.

Self concept mode: According to roy’s adaptation model the spiritual aspects of the
human system and the need to know who one is, so that one can exist with a state of unity,
meaning, and purpusefullness of 2 modes. In this study the self concept of the mother
which will include her own beliefs, culture and traditional practices, as well as health
practices as well as health practices that she follows may influence child care.

Out –put: The out put is in the form of adaptive response or ineffective response.

a. Adaptive response: According to roy’s adaptation model adaptive response helps

tp promote the integrity of the human system. Adaptive resonse of the mothers can
be judges through the post test knowledge score this will show a positive out-come
indicating that the mothers has gained this wil show a positive out come indicative
that mothers gained knowledge from the information booklet.

b. Ineffective response: A poor post test knowledge score will reflect that there is an
inadequate gain in knowledge by the mother. Many factors many contribute
towards ineffective response such as lack of time to read the book.
 INPUT CONTROL PROCESS EFFECTORS OUTPUT

STIMULI
approches mother to participate in
the study by explaning her The
researcher about the significance
of the study. Mother may feel the
need to participate in the study in
order to gain the information
booklet regarding home
management of common illness in
children to acquire knowledge.
ADAPTION
Mother participate in the study.
ADAPTIVE PROCESS
COGNATOR Mothers will gain adequate
knowledge regarding home
Mother may gain management of common illness
adequate knowledge PHYSIOLOGICAL in children after administration
through the NEEDS of information booklet.
information booklet Mother has to stay
to care for the child physically and mentally
when she or he healthy.
suffers from
diarrhea, cough and SELF CONCEPT
fever
Mother’s beliefs cultural
and traditional practices
will influence the INEFFECTIVE
utilization of information RESPONSE
booklet on her knowledge
regarding child care There will not be adequate
gain in knowledge by the
mothers regarding home
management of common
illnesses in children.

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