A STUDY TO ASSESS THE EFFECTIVENESS OF EDUCATIONAL INTERVENTION

ON KNOWLEDGE AND PRACTIC REGARDING FEBRILE SEIZURE AMONG

MOTHERS OF UNDER FIVE CHILDREN ATTENDING SELECTED PHC GONDA, UP

by

Twinkle Patel
Synopsis Submitted for
Registration of subjects for Dissertation
to
Dr. Atal Bihari Vajpayee Medical University UP

M.Sc. Nursing I Year

In
Child Health (Peadiatric) Nursing
Under the guidance of
Prof. Leelavathy
Child Health (Peadiatric) Nursing
SCPM College of Nursing and Paramedical Sciences
Lucknow Road, Haripur, Gonda, U.P.-271003
2023
 PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1
NAME OF TWINKLE PATEL
CANDIDATE AND
TENUWA, MAJHAUWAMEER, BASTI.
ADDRESS

2
NAME OF SCPM COLLEGE OF NURSING AND
INSTITUTE PARAMEDICAL SCIENCES
HARIPUR, LUCKNOW ROAD, GONDA
UTTAR PRADESH.
3
COURSE OF STUDY MSC NURSING
AND SUBJECT CHILD HEALTH NURSING

4 DATE OF
ADMISSION
5
TITILE OF THE ‘EFFECTIVENESS OF EDUCATIONAL
STUDY INTERVENTION ON KNOWLEDGE AND
PRACTICE REGARDING FEBRILE SEIZURE
AMONG MOTHER OF UNDER FIVE CHILDREN
ATTENDING SELECTED PHC AT GONDA ,UP.’’

.
 6. BRIEF RESUME OF THE INTENDED WORK-

6.1 - Introduction

Adolescents - young people between the age of 12 and 19 years are often thought of as healthy group. It

is the transition stage between childhood and adolescent. The impact of modernization and

technological ascertainment reflects in daily life. The unhealthy eating habits and lack of exercise leads

to many disease in adolescents as polycystic ovarian syndrome.1 Polycystic ovarian syndrome is a

common health problem which increases in adolescent girls and young women during the reproductive

years. The term polycystic means many cysts and polycystic ovarian syndrome gets its name because of

clusters of small, pearls size cysts in ovaries. The cysts are fluid filled bubbles that contain eggs that have

not get been released because of hormonal imbalance.3 By accruing knowledge regarding PCOD, its

causes, preventive measures and management in adolescent girls will be able to improve their life style

pattern.

6.2 – Need for the study

According to 2011 report there are 600 million adolescent girls that stand at the crossroad between

child hood and adult world. As India is having the largest population of adolescent around 243 million

lives in India. Among these population 18% of adolescent girls lives in Karnataka2 . PCOD is a common

problem among teen girls and young girls. Infactamong100% of girls 10% of girls have polycystic ovarian

syndrome. The common features of normal puberty in adolescent are menstrual irregularity and insulin

resistance2 . PCOD is sometimes inheritable as it is influenced by genes. It is more likely to develop. If

there is a family history of diabetes. It is also seen if mother or close relatives are having PCOD.4 The

investigation felt that as the adolescent have poor knowledge and negative life style attitude towards

PCOD. A STP will be helpful for them to acquire knowledge regarding PCOD, its causes, management and
also help them to change the lifestyle. The exact prevalence of PCOD is not known as the syndrome not

defined precisely. The estimated prevalence in women of reproductive age is 5-10%. Globally,

prevalence estimates of PCOD are highly variable ranging from 22 % to as high as 26%. Prevalence

among general female population in India will raise up to 10% mainly among 15-18 years3 .

6.3 Review of literature

Febrile seizures are the most common form of the childhood seizures, affecting 2-5% of all

children and usually appearing between 3 months to 5 years of age. The condition is perhaps one

of the most prevalent causes of admittance to pediatric emergency wards worldwide. The risk of

epilepsy following febrile seizure is 1-6%. The association, however small, between febrile

seizure and epilepsy may demonstrate a genetic link between febrile seizure and epilepsy rather

than a cause and effect relationship. The effectiveness of prophylactic treatment with

medications remains controversial. There is no evidence of the effectiveness of antipyretics in

preventing future febrile seizure. There is a reason to believe that children who have experienced

a simple febrile seizures are over investigated and over treated. This review aims to provide

physicians with adequate knowledge to make rational assessment of children with febrile seizure.

The study to analyze current parental perception of febrile seizures in order to improve the

quality of management, care and explanations provided to families at pediatrics emergency unit.

The meaning attributed by parents to the word “seizure” and “epilepsy” usually referred to an

exact clinical description of the phenomena, but many admitted being unfamiliar with the term or

at least its origin. Understanding and integrating these parental interpretations seems essential to

improving care for families who first experiences this symptoms.

Febrile seizure are common in first 5 years of life and many factors increase seizures risk have

been identified. Initial evaluation should determine whether features of a complex seizures are

present and identified the sources of fever. Routine blood tests , neuro imagine and

electroencephalography are not recommended and lumber puncture is no longer recommended in

patient with uncomplicated febrile seizure. The risk is increased in patient younger than 18

months and those with a lower fever, short duration of fever before seizure onset or family

history of febrile seizure. Continuous or intermittent antiepileptic or antipyretic medication is

not recommended for the prevention of recurrent febrile seizure.

To provide an update on the current understanding, evaluation and management of febrile seizure

.Febrile seizure, with a peak incidence between 12 to 18 month of age , likely result from a

vulnerability of the developing central nervous system to the effect of fever , in combination with

an underlying genetic predisposition and environmental factors . The majority of febrile seizure

occur within 24 hours of the onset of fever. Febrile seizure can be simple or complex. Clinical

judgement based on variables presentation must direct the diagnostic studies which are usually

not necessary in the majority of cases. A lumbar puncture should be considered in children

younger than 12 months of age or with suspected meningitis.

6.4 – Statement of the problem

Effectiveness of educational intervention on knowledge and practice regarding febrile seizure

among mother of children attending selected primary health center at Gonda, UP.

6.5 – Objectives
1. To assess the knowledge regarding polycystic ovarian syndrome among adolescent girls before and

after structured teaching programme.

2. To assess the effectiveness of structured teaching programme on knowledge regarding polycystic

ovarian syndrome among adolescent girls. 3. To find out the association between pre-test knowledge of

adolescent girls regarding polycystic ovarian syndrome with selected demographic variable

6.6 – Research Hypothesis

H1- There will be a significant difference between pretest and post test knowledge score on

febrile seizures.

H2- The mean post test practice score will be significantly higher than mean pretest practice

score.

H3- There will be a significant association between pretest scores of knowledge and selected

demographic variables.

6.7 – Assumption

This study assumes that, knowledge is the basis of practice

 Parents of children may have inadequate knowledge regarding febrile seizure.

 Educational intervention is interactive and effective way to gain knowledge regarding febrile

seizure and related health problems.

6.8 – Operational definition

 Effectiveness – It refers to extend of which the learning package on febrile gives the

desired effect in improving knowledge of mothers attending in primary health

center ,Gonda.

 Educational intervention – It is a teaching module developed by the researchers to

import knowledge on febrile seizure. In this study it is referred as organized content with

relevant audio visual aids to provide information on febrile seizure among mothers of

under five children.

 Knowledge – It refers to the response received from the mother regarding febrile seizures

in their children as measured by a structured knowledge questionnaires.

 Practice -: It refers to the activities reported by mothers in relation to prevention,

compliance with therapeutic regimen, and management of child with febrile seizure as

measured by checklist.

 Mother – It refers a mother of under five children attending primary health center,

Gonda.

 Febrile seizure – A febrile seizure is a convulsion in a child caused by a 100.4°F in body

temperature often from an infection.

 PHC – It is the most basic package of essential health services and products needed to

prevent disease, promote health and manage illness.

6.9 – Criteria for sample selection

 Inclusion criteria

Mothers of under five children who are

-Attending primary health center.

 - Able to communicate freely in Hindi.

- Present at the time of data collection.

- Willing to participate in this study.

 Exclusion criteria –

- Mother of critically ill children.

- Mothers who are belongs to medical / nursing profession.

6.10 – Delimitation

The study is limited to

 Mothers of children attending primary health center, Gonda.

 Sample size is 40.

 Data collection period is limited to 4 weeks.

 Education intervention will be evaluated by self administered questionnaire.

7- Material and methods

7.1 – Sources of data -

 Books

 Journals

 Websites

7.2 – Method of collection of data

7.2.1 – Research design – Research design is a blue print of our research study.
 The research design used for the study was pre- experimental one group pretest and post test

design.

7.2.2 – Research setting – The study conduct at primary health center, Gonda. This study is

conduct among 40 mothers under five children attending primary health center, Gonda.

7.2.3 – Population - The population for the present study is mothers of under five children

attending primary health center, Gonda.

7.2.4 – Sample – Sample is a selected proportion of the defined population.

In this study the sample is mother of under five children attending primary health center, Gonda.

7.2.5 – Sample technique –

The sampling technique is process of selecting a portion of the population to represent the

entire population.

Convenient sampling technique is used in this study. In this method of researcher select those

unit of population in the sampling which appear convenient to her or to management of the

organization where she is conducting research.

7.2.6 – Sample size-

Sample size is the number of items to the selected form the universe to constitute a sample.

The sample size is 40 mothers of under five children attending primary health center, Gonda is

consider as the sample for the present study.

7.3 – Tools of data collection –

The research tools consist of-

  Demographic variables it included age of the mothers, education, occupation, religion,

type of family, family monthly income, history of maternal seizure, febrile seizure attack

is a life threatening event, age of child, child has previous history of febrile seizure,

reason of visit to primary health center, have thermometer at home.

 Self administered questionnaire to assess the knowledge of mother regarding febrile

seizure, strurctured questionnaire regarding febrile seizure.

7.4 - Research Tools -

Section -A Demographic Data of Mother

Instruction- (Read following question carefully and place a tick mark in the

appropriate space provided at each time)

1. Age of mother

a)20-30

b)31-40

c)41- 50

2.Education of mother

a) Primary b) Secondary

c) Graduate d) Illiterate

3. Occupation

a) Government job b) Private job

c) House wife d) coolie

4. Religion
 a) Hindu b) Christian

c) Muslims d) others

5. Types of family

a) Nuclear family

b) Joint family

6. Family monthly income

a) less than Rs. 10000/month

b) Rs. 10000- 15000

c) Rs. 16000- 20000

d) Rs. 20000 and above

7. History of maternal seizure?

a) yes

b) No

8. Previous history of febrile seizure in their family?

a) yes

b) No

9. Do you think febrile seizure attack is a life threatening event?

a) yes
 b) No

10. Age of child

a) At birth to 1 year

b) 1 year to 3 year

c) 3 year to 5 year

11. Does the child has previous history of febrile seizure?

a) yes

b) No

12. Reason of visit to primary health center?

a) Immunization

b) Febrile seizure

c) Other

13. Do you have thermometer at home?

a) yes

b) No

Section – B Self – administered questionnaires

Instructions (Read the following question and tick any one option)

1. What is meant by febrile?

a) Seizure b) cyanosis
 b) Fever

2. What is a febrile seizure?

a) It is a communicable disease

b) A seizure occuring in young children with a fever

c) It is a mental illness

3. What is the cause of febrile seizure?

a) Viral and bacterial infection

b) Indigestion

c) Diarrhea

4. What age group of children is more prone for febrile seizure

a) 5 -10 years

b) Above 10 years

c) 3 month to 5 years

5. What are the type of febrile seizure?

a) Primary or secondary

b) Simple and complex

c) High or low grade

6. What is the warning sign of febrile seizure attack?

a) Headache

b) Visual disturbance

c) Fever above 100.4 degree F

7. What are the changes in the eyes during febrile seizure?

a) Up rolling of eyes
 b) Sunken eyes

c) Closed eyes

8.What would be the conscious level during febrile seizures?

a) Alert and conscious

b) Semi conscious

c) Loss of conscious

9. What are the changes in the skin during febrile seizure?

a) Rashes

b) Bluish discolorations of skin

c) Erythema

10. What are the changes in extremities during febrile seizure?

a) Jerking movement

b) Deviation of angle hands and legs

c) Shivering

11. What is immediate observation made during febrile seizure?

a) Colour of child

b) Body temperature

c) watch for nearby sharp object

12. What are the changes in the excretory system during febrile seizure?
 a) Involuntary pass urine

b) Urinary incontinence

c) Anuria

13. What are the changes occur in the breathing pattern during febrile seizure?

a) Increase breathing

b) No breathing

c) Irregular breathing

14. What is the most common complication when the febrile seizure lasts for more than minute?

a) status epileptics

b) Brain damage

c) Cerebro vascular accident

15. What is the consequency of recurrent febrile seizure?

a) Brain damage

b) Meningitis

c) Mental retardation

16. How to position a child after an episode of febrile seizure?

a) Supine

b) Prone
 c) Side lying, turn child head to side and face downward

17. What is the diagnostic test available to rule out febrile seizure?

a) Electro cardio gram

b) Electro encepahlo gram

c) Echo cardio gram

18. What is the complication of recurrent episode of febrile seizure?

a) Dysarhtria

b) Delayed vocabulary development

c) Dyslalia

19. When should the parent call for emergency help?

a) Seizure more than 30 min, trouble breathing chocking

b) Temperature above 100.4°F

c) The child going pale colour

7.4 – Data collection method-

Convenient sampling method was used to select the sample for main study. The data

collection was done for a period of four weeks. The demographic profile is collect from

the mothers. In pre – test, a self administered questionnaire will administered to each

sample and duration of 30 minutes is given.

 Educational intervention is given for about 45 min. The post – test will conduct after one

week to assess the effectiveness of teaching in improving the knowledge regarding febrile

seizure by using the same questionnaires.

8 – Research variables

 Dependent variable – knowledge of mothers regarding febrile seizure occuring among

children.

 Independent variable – Educational intervention on prevention and care of children

with febrile seizure.

9 – Plan for data analysis –

 Demographic variables analyze by using frequency and percentage distribution.

 Knowledge score analyze by using frequency, percentage, mean and standard deviation.

 Effectiveness will be checked by using T –test and association will be analyzed by x 2 test

10 – Pilot study – The pilot study will be conduct to test the feasibility and reliability of the

tool. Pilot study is conduct among five mother of under five children who is selected from

PHC. The knowledge regarding prevention and care of children with febrile seizure assess

with the prepared questionnaire.

The sample selected for the pilot study is not consider as sample for main study. Based on

pilot study finding the main study will proceed.

11 – Ethical considerations- Research is conduct after approval from the higher authorities in

primary health center, Gonda. Details of the study is inform to the authority of the center and

consent is obtain from the sample and assurance given to maintain the confidentiality of the

collected data.
12 – References

Books

 Paruldutta (2010) “Pediatric Nursing “,2nd edition, Jaypee brothers medical publisher.

 Suraj Gupta (2005) “Textbook of pediatric”, 7th edition, Jaypee brothers.

 B.T. Basavanthappa (2007) “Nursing research”, 7 th edition, Lippincott Williams and

Wilkins publisher.

 Suresh k Sharma “Nursing research”, 3rd edition.

 Nelson “textbook of pediatrics”, 20th edition.

Website –

 http://www.pubmed.com

 http://www.hindawt.com

 http://www.indianpediatrics.com

 http://www.pediatricneurosciences.com

13 Signature of the candidate :

14 Remarks of the guide :

15.1 Name and designation of the Guide :

15.2 Signature :
15.3 Co-guide [if any] :

15.4 Signature :

15.5 Head of the department :

15.6 Signature :

16.1 Remarks of the principal :

16.2 Signature :