PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

MR. MAHESH KUMAR KUMAWAT

M.Sc ( N) 1st Yr
COMMUNITY HEALTH NURSING
YEAR 2007-2009

PADMASHREE COLLEGE OF NURSING

GURUKRUPA LAYOUT, NAGARBHAVI
BANGALORE-560072

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 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

MR. MAHESH KUMAR KUMAWAT.

NAME OF THE I YEAR M.SC NURSING,
CANDIDATE AND PADMASHREE COLLEGE OF NURSING,
1 GURUKRUPA LAYOUT,
ADDRESS
NAGARBHAVI,
BANGALORE-560072.

NAME OF THE Padmashree College Of Nursing,

INSTITUTION Gurukarupa Layout,
2
Nagarbhavi
Bangalore-72

COURSE OF STUDY I year M.Sc (nursing)

3 Community Health Nursing
AND SUBJECT

4 DATE OF ADMISSION 20 / 04 / 2007

TO COURSE

“A Descriptive Study To Assess The

5 TITLE OF THE TOPIC Mother’s Knowledge On Their Practices In
Prevention Of Home Accidents Among
Toddlers In Selected Rural Community At
Bangalore”.

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6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

“Prevention is better than cure”.

Shape of the future of the life: Healthy environments for children.

The children of today are the adults of tomorrow.
They deserve to inherit a safer, fairer and healthier world.
There is no task more important then safeguarding their environment.
Dr. Gro Harlem Brundtland, Director General WHO (2003)

A child after one year of age walk, run, and climb up & down on his or her
own. They are interested in the surrounding to explore things. As they are not
aware of the danger related to their activities. Toddlers are egocentric. Their
activities should be under the supervision. The stairs, gates, window should be
closed or protected. The harmful objects such as medications, kerosene, chemicals,
sharp instruments, hot things, stove, heater etc should be out of their reach. 1

“Home accidents” is meant as accident with takes place in the home or in its
immediate surroundings. Some of the common accidents are drowning, burns,
poisoning, falls, injuries from sharp instruments etc. About 60% of home accidents
are attributed to is carelessness of parents and 20% of accidents due to poor
maintenance in the home environment.2

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 The slogan “safety first” does not mean that safety is the most important
thing in life. Some times we take risks in our life to prevent home accidents. On
the other hand we must stay alive to have a successful and happy life. 3

Home accidents are the largest single cause of mortality and disability in
toddlers. In approximate order of incidence accidents include (i) motor vehicle
accidents (ii) drowning (iii) burns (iv) suffocation (v) falls (vi) poison. When
parents understand their child’s level of growth & development, they can predict the
hazardous situation and judge how much freedom their child can be permitted.4

Accidental burns, falls are very common when mother does the cooking or
boiling or cleaning the floor with an infant crawling or walking around the place.
Most accidents occurs when the family lives just in one room for all purposes. Hot
objects on the floor, tub with full of water may cause injury. Electric heaters, room
heaters within the reach of child may cause electric shock or burn. Sometimes the
toddlers fall into boiling water, oil etc. or catch the hot objects.5

The future development of children depends on their enjoying good health

today. A house is an exciting place for infants and small children who love to
explore but are not aware of the potential dangers. Life cannot be risk free, but
utilizing a household safety list can prevent household accidents. The incidents of
accidental injury are increasing in India especially home accident in children; hence
the knowledge of mothers is essential for undertaking measures to prevent them.
Ingestion of toxic agents is common during early childhood. The highest incidence
occurs among children in the two years old age group. Although in many instances
poisoning does not result in mortality but it may cause significant morbidity e.g.

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 esophageal stricture from lye ingestion. Mouthing activity continues to be
prevalent after one year of age, and exploring objects by tasting. 6

The toddlers who are developing normally are at risk for accidents e.g. falls,
motor vehicle accidents and coming in contact with sharp objects as well as toddlers
who delayed in walking may have poorer balance and coordination, leading to
higher risk for falls. Child- proofing the environment and awareness of outdoors and
playground safety can help prevent accidents.7

Cuts, scratches and scrapes are very common at home. 50% of cuts due to
fall. The children play with knives, scissors and agricultural tools. Drowning is one
of the most common causes of death for under fine children. Every year 2000-4500
casualty visits only because of drowning related accidents due to poor safety
precaution or lack of proper supervision.8

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6.2 NEED FOR THE STUDY

The living condition in the rural areas such as cooking over open fires leads
to burns and scars badly build poor houses and poor maintenance such as their
without railing might cause falls. Accidental drinking of kerosene stored in soft
drink bottle leading to poisoning of children this and all happened in the house for
lack of supervision of the mothers.

The unintentional injuries in the home result from falls, burns, poisoning,
drowning, suffocation & sharp knifes in the kitchen makes the room more
dangerous in the house. High accidents rates among children under two years of age
is burn caused by various items e.g. cooking stove, coppers, boilers, hot foods &
irons etc. This is mainly being attributed to lack of supervision.

Data from the Survey of Income and Program Participation for 1991-1992
(National Center for Health Statistics 1993) indicates that of the estimated 48.9
million people who have disability. The children who are younger than three years
of age the prevalence of disability is 2.2%, 3-5 years of age group of children the
prevalence of disability is 5.2%. The males are more disabled than the females.
About 85% of burn injuries in house due to scalds from hot tap water or liquid
spilled from cooking pots. SCI (Spinal Cord Injury) in the United States nearly 10%
is estimated in children aged 1-15 years annually.

The choking, suffocation and strangulation are important causes of

unintentional injury and death in toddlers. The choking on foods and toys,

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suffocation from plastic bags and strangulation from strings on children’s item are
common cause of mechanical obstruction.9

The unintentional injuries are major causes of emergency department visits,

hospitalization, permanent disability and death among children aged 1-14 years in
South American countries. The majority of unintentional injuries happen in or near
home.10

The Researcher discussed with some of rural mothers and observed that they
have inadequate knowledge than the urban mothers regarding prevention of
domestic accidents e.g. poison, burns, drowning, falls etc. The rural mothers show
the negligence in prevention of domestic accidents. Thus the investigator was
fascinated to assess the mother’s knowledge on practices regarding prevention of
domestic accident among mothers of toddlers.

Researcher felt that it is essential to emphasize safety awareness among

parents’ who have toddlers. Parent educations are the key determinants in domestic
accidents prevention and provision of safe environment is very important.

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6.3 STATEMENT OF PROBLEM

A descriptive study to assess the mother’s knowledge on their practices in

prevention of home accidents among toddlers in selected rural community at
Bangalore

6.4 OBJECTIVES

1. To describe the demographic variable of mothers.

2. To assess the existing knowledge of mothers on their practices in
prevention of home accidents among toddlers.
3. To find out the association between knowledge of mothers and selected
demographic variables on prevention of home accidents.

6.5 OPERATIONAL DEFINITIONS

1. Knowledge:
Knowledge refers to the awareness and understanding of mothers of toddlers
regarding types, causes and prevention of home accidents.

2. Practices:
Practices refers to the activities that women undertake in relation to the prevention
of home accidents as measured by their oral expression.

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3. Mothers of toddlers
Mothers who are having children between one to three years of age, residing in rural
community.

4. Home accidents
Accidents, which take place in the home or in its immediate surroundings e.g.
kitchen, bathroom and garden etc

6.6 ASSUMPTIONS

1. The rural mothers may have inadequate knowledge regarding the types of home
accidents among toddlers at home.
2. The rural mothers may have inadequate knowledge regarding the prevention of
home accidents.
3. The toddlers are more potential for home accidents due to carelessness
of parents.

6.7 NULL HYPOTHESIS

1. Mothers have inadequate knowledge in prevention of home accidents among

toddlers.
2. There is no association between knowledge of mothers and selected demographic
variables.

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6.8. REVIEW OF LITERATURE

A study was conducted on home accidents among 402 children in west

London. This study was based on home interviews of parents. Results revealed that
the domestic accidents such as falls, poisonings, cuts, burns and scalds were due to
lacking parental supervision and poor environment11

A study was conducted on the efforts to prevent childhood injuries the

Hennepin Country Burn Center began a joint venture with a public health agency to
decrease home hazards for children less than six years of age who were treated at
the burn center. Children were referred to a public health nurse for a home safety
assessment. During the initial visit, child hazards were identified and
recommendations were made for reducing injured risk 12

A Study was conducted on safety hazards in households with young children

in California-Los Angeles by interview of 230 mothers of young children about
safety hazards related to burns, poisoning falls & self reported measures of maternal
supervision, social support and safety attitudes. SES (socio economic status) was an
important predictor in home hazards13.

A study was conducted on home related injuries among pre-school children

in the Netherlands. This study contributed the information need to develop a safety
education programmed for all parents. This study suggested how to avoid the risk
situation through parental safety behaviors, especially by providing safe child’s
environment.14

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 A study was conducted by Department Community Medicine and General
Practice, Monash University, Melbourne on domestic childhood accidental injuries
by using a protected questionnaire on 171 children, reveals that children below four
years the accidents occur mainly in the kitchen15.

A study was conducted on home accidents among small children &

preventive potential by collected data from the Norwegian National injury sample
register. Most of frequently reported injuries were falls, medical drugs & hazardous
substances. The survey showed that most of the parents do not take precautions to
reduce risk of injuries. So the parents require to follow the legislation, educational
campaigns, information to parents on home hazards reduction & free supply of
security equipment.16

A study conducted on nonfatal injury in the United States. The study focused
on adolescent mothers to know their beliefs and practices regarding injury
prevention. The result reveals that no mother spontaneously identifies the
importance of injury prevention as a part of mothering. So the potential benefits of
home visits, to stress well baby care and programs to prevent injury among children
with young mother is essential17.

A study was conducted on home accidents by intervening of parents from

Dec. 2000 to Nov.2001 in primary care clinic Southern Israele, reports the total
accidents as 219. Among these the burns was 85 cases (36.1%), falls 67 cases-
(28.5%), contusions 31 cases (13.2%), lacerations 29 cases (12.3%), nail
penetrations 19 cases (8%). The burns rate was highest in below two years children
that were 39/57 (68.4%). So that burn prevention plan is needed. 18

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 A study was conducted on examining parental strategies, their efficacy for
managing child injury risk in Ontario by multi methods strategies. Parents used the
main three types of prevention strategies- environmental (e.g. hazard removal,
safety devices to prevent access), parental (e.g. increased supervision, parent
modification of their own behaviors) and child based (e.g. teaching rules or
prohibitions to promote safety). The study concludes that emphasis made on child
based strategies never decrease the risk of injury to toddlers by the parental but the
environmental strategies protect an decrease the children’s risk of home injury.19

A study was conducted on the epidemiology of home injuries to under five

children in New Zealand. The cases were selected from the New Zealand Health
Information Service Public hospital morbidity and mortality data. The rate of death
due to injury at home between 1989 and 1998 was 13/100000 per year due to
suffocation, drowning, fire etc. so injury prevention strategies should be continued
and strengthened.20

A study was conducted on unintentional home-related injuries in the Islamic

Republic of Iran by obtaining data & information from emergency department visits
and health services between March 1998 and March 1999. The result was 79,723
unintentional home-related injuries reported, in which burns (49%, incidence of
19/10,000 rural & 13/10,000 urban inhabitants). Injury rates were highest among
children aged zero to four years. Most deaths occurred due to home-related
accidents. Home visitation as a tool for face-to-face training with a sharper focus on
burns, falls and drowning prevention can be recommended as a part of primary
health care policy.21

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 A study was done on home injure hazard risk prevention methods for young
children by using modified Delphi technique for children age one to five years in
USA. Result reveals that most of the significant hazards as firearms and pools and
its prevention as smoke alarms and safe water temperature.22

A study was conducted on parental survey of beliefs & practices about

bathing & water safety & their children guidance for drowning prevention in
Boston. Many of under five children’s deaths occur in bathtubs. In this study, they
distributed a written survey about parental beliefs & practices concerning their
children’s bathing and general water safety to a convenience sample of caregivers.
136 caregivers of 209 children (one to five years) participated. 85% of respondents
reported using baby bathtubs, 46% using bath seats, some caregivers reported
leaving a 6-12 months old baby unsupervised in tub alone. So safety anticipatory
guidance is needed for caregivers.23

A retrospective was study conducted on Epidemiology of Pediatric burns in

Indore, India based on 110 pediatrics burns (0-14 Years) seen at the burn unit over a
period of seven years (1993-1999). The Epidemiological data included age, sex, and
seasonal variation, place of burn and Cause and mode of burn. Burns in the infants
and toddlers, early childhood due to scalding was predominant, while in the late
childhood there were many more flame and electric burns. Males were mainly
affected. Most of the burns (53.6%) occurred in winter season between October and
February. 95% of accidents occurred at home.24

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7) MATERIAL AND METHODS

7.1. SOURCE OF DATA

Mothers of toddlers who are residing in selected rural community.

7.2. METHODS OF COLLECTION OF DATA

I. Research design
Non-experimental descriptive approach

II. Research Variables

- Study variables:
Knowledge on their practices of mothers in prevention of home
accidents among toddlers
- Extraneous variables:
Age, education, income, spacing of children, number of children,
occupation, type of house and type of family.

III. Setting
The study will be conducted in selected rural community at
Bangalore

IV. Population
Mothers of toddlers who are living in selected rural community at
Bangalore

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V. Sample Size
Mothers of toddlers who fulfill inclusion criteria, the sample size are
60.

VI. Criteria for Sample Selection

Inclusion Criteria
i) Mothers who are having children between one to three years of age
group.
ii) Mothers who are living in selected rural community.
iii) Mothers who can make communication effectively in local
language.
iv) Mothers who are willing to participate in the study.

Exclusion criteria
i) Mothers who are disabled.
ii) Mothers who are not available at the time of data collection.

VII. Sample Technique

Non-probability, convenient sampling technique

VIII. Tool for Data Collection

The tool consist of the following section
Section A: Demographic Performa of toddler’s mothers consists of
age education, occupation, income, types of family,
types of house and number of children.
Section B: To assess the mother’s knowledge on their practices in
prevention of home accidents with structured interview schedule.

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IX. Methods of Data Collection

After obtaining the permission from concerned authority and informed

consent from samples, the investigator personally will conduct interview to assess
the knowledge on practices with structured interview schedule in prevention of
home accidents among toddlers. Duration of the study 4-6 weeks.

X. Plan for Data Analysis

The data collected will be analyzed by means of descriptive and
inferential statistics.

Descriptive statistics:- Frequency, mean and standard deviation

will be used.

Inferential statistics: - Chi-square test will be used to assess the

association.

XI. Projected out Come

The investigator will be able to assess the existing level of knowledge of
mothers on their practices in prevention of home accidents among toddlers. Based
on the results if mothers’ knowledge is found to be inadequate, the investigator will
develop a health education material on certain guideline regarding prevention of
home accidents among toddlers and distribute to mothers.

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7.3 Does the study require any investigation or interventions to be
conducted on patients or other humans or animals?
No

7.4 Has ethical clearance been obtained from your institutions?

(i) Study does not require any intervention to be conducted on mothers of toddlers.
(ii) Permission will be obtained from institution to conduct study.
(iii) Informed consent will be taken from each subject for participation in the
study.

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8. LIST OF REFERENCES

1. Tambulwadkar RS. Paediatric Nursing. 2nd ed. Mumbai: Ratilal K Vora; 2003; 46.

2. Park. K. Park’s Text Book of Prevention and social medicine. 18th ed. Jabalpur :
M/s Banarsidas Bhanot; 2005 Jan; 325.

3. Kasthuri Sundar Rao . Community Health Nursing. 4th ed. Chennai: BI Publication
Pvt Ltd; 2004; 569.

4. Marlow Dorothy R, Barbara A Redding. Text Book of Pediatric Nursing. 6th ed.
Philadelphia: WB Saunders Company; 2002; 747.

5. Chellappa Jessie M. Paediatric Nursing. 4thed. Bangalore: Gajanana Book

Publishers and distributors; 2002; 38.

6. Donna W, Whalley and Wong’s Essessentials of Paediatric Nursing. 5th ed.

Philadelphia: Mosby Company; 1997; 376-379.

7. Edwards, Hertzberg, Hays, Young blood. Paediatric Rehabilitation Nursing.

Philadelphia: WB Sounders Company; 1999; 9, 494, 509.

8. Galal S. Working with families to reduce the risk of home accidents in children.
Estern Mediterranean Health Journal. 1999 Mar 3; 52(3): 44-48.

9. Tarrago SB.Prevention ofchoking,strangulation and suffocation in

childhood. WMJ.2000 Dec; 99(9): 43-6, 42.

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10. Ribas Rde C Jr, Tymchuk AJ, Ribas AF.Brazilian mothers knowledge
about home dangers and safety precautions: an initial evaluation. Soc
Sci Med. 2006 Oct; 63(7): 1879-88.

11. Alwash R, Mc Carthy M. How do children accidents happen. Health Educ

J. 1987; 46(4): 169-71.

12. Sullivan M, Cole B, Lie L, Twomey J. Reducing child hazards in the

home. J Burn core Rehabil. 1990 Mar-Apr; 11(2): 175 – 9.

13. Glik DC, Greave PE, Kronenfeld JJ, Jackson KL. Safety hazards in
households with young children. J. Pediatr Psychol. 1993 Feb; 18(1):
115-31.

14. Wortel E, de Geus GH. Prevention of home related injuries of preschool children:
safety measure taken by mothers. Health Educ Res. 1993 Jun; 8(2): 217-31.

15. Ariff KM, Schattner P. Domestic accidental injuries to children presenting at a rural
general practice. Med J Malaysia. 1998 Mar; 53(1): 82-86.

16. Myklestad I, Engeland A. Home accidents among small children and

preventive potential. Tidsskr Nor Laegeforen. 2000 Nov 20; 120 (28):
376-9.

17. Bennett Murphy LM. Adolescent mothers beliefs about parenting and
injury prevention. J Pediatr Health care. 2001 Jul-Aug; 15(4): 194-9.

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18. Broides A, Assaf M. Home accidents in Arab Bedouin children in
Southern Israel. J child Health care. 2003 Sep; 7(3): 20-14.

19. Morrongiello BA, Onelejkol, Littlejohn A. Understanding toddlers in

home injuries: Examining parental strategies and their efficacy for
managing child injury risk. J Pediatr Psychol. 2004 sep; 29(6): 433-46.

20. Gulliver P, Dow N, Simpson J. The epidemiology of home injuries to

children under five years in New Zealand. Aust NZJ Public Health. 2005
feb; 29(1): 29-34.

21. Mohammadi R, Ekman R, Svanstrom L, Gooya MM. Unintentional home

related injuries in the Islamic Republic of Iran. Public Health 2005 oct;
119(10): 919-24.

22. Katcher ML, Meister AN, Sorkness CA, Staresinic AG, Pierce SE, Goodman BM,
et al. Use of the modified Delphi technique to identify and rate home injury hazard
risks & prevention methods for young children. Inj Prev. 2006 Jan; 12(3): 189-94.

23. Lee LK, Thompson KM. Parental survey of beliefs and practices about
bathing and water safety and their children guidance for drowning prevention.
Accid Anal Prev. 2007 Jan; 39(1): 58 – 62.

24. Mukerji G, Chamemias, Patidar GP, Guptas. Epdemiology of Paediatric

burns in Indore India. Burns 2001 Feb; 27(1): 33-8.

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9. Signature of Candidate

10. Remarks of the Guide

11. Name and Designation of

11.1 Guide:

11.2 Signature

11.3 Co-Guide (if any)

11.4 Signature

11.5 Head of Department

11.6 Signature

12.1 Remarks of the Chairman & Principal

12.2 Signature

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