JNT Pro 1

CHAPTER-I
INTRODUCTION
“The children shows the man as morning shows the day”
Kofi Annan.
Children’s health reflects the national health and wealth .Today children’s are
tomorrow citizens. A well developed child contribution to the national welfare and children
are the priceless resources of the nation. Children are an embodiment of our dreams and hopes
for the future and they are the vulnerable group in society. (Wong’s, 2009).
Pediatric is the branch of medicine that deals with the medical care of infants, children
and adolescents. Treating a child is not like treating a miniature adult. A major difference
between pediatrics and adult medicine is that children are minors and, in most jurisdictions,
cannot make decisions for themselves. (Wong’s, 2005).
Children are an embodiment of our dreams and hopes for the future. Childhood
is more precious period in human life cycles. It requires more care and protection from the
diseases. They are the most vulnerable group in the society. The physical health of a child is
important because it is associated with mental and social development of children. Mothers
are the first care provider of children, is needed to reduce the under five mortality. (Marlow
DR Redding BA, 2005).
In India under-five children constitute about 13 % of the total population of India.
Health of the under-five children in India is not satisfactory. Every year some 12 million
children in developing countries die before they reach their fifth birthday, many during first
1
year of life. Seven in ten of these deaths are due to respiratory infections (mostly Pneumonia),
diarrhea, measles, malaria, malnutrition or a combination of this illness. Acute respiratory
illness ranges from common cold, cough, ear infection and pneumonia. It is most common
cause of morbidity and mortality in children under the age of five years. Hospital based
statistics shows that about 13 % in patient deaths of pediatric ward are due to Pneumonia.
(Gupta Neeru, et.al., 2007).
A report by Director General of Health Services, Government of India,
indicated that acute respiratory infections contributes towards about one third to one fourth of
all under five deaths in India and it stands at 52nd rank in the global scenario of under five
moralities in the world. A child in urban area suffers from 5 to 9 episodes of respiratory
infections annually during the first five years of life, each episode lasting for a mean duration
of 7 to 9 days whereas in the rural areas the annual incidence per child is lower and ranging
from 1 to 3 episodes per year thus accounting for about 238 millions attacks per year. Without
adequate treatment the child may die within 4 to 5 days of onset of illness.(Registrar General
and census commissioner, New Delhi, India, 2001).
A Quasi experimental study was conducted in Trichy on the effectiveness planned
teaching programme on knowledge, attitude and practice of acute respiratory infections
among mothers of under five children. 60 mothers were selected by non probability
convenient sampling technique. The study findings are as follows in case of knowledge the
mean difference was 48.4 and paired ‘t’ test was 38.32 , attitude of the mothers the mean
2
difference was 4.76 and paired ‘t’ test was 11, and knowledge on practice mean difference
was 4.83 and paired ‘t’ test is 10.06 and the P value was found to be P, 0.05 .Hence the study
concluded that planned teaching programme was found to be effective in improving the
knowledge ,attitude and practice of mothers regarding acute respiratory infections.
(M.s.Shereena G Edwin, 2007).
NEED FOR THE STUDY
According to UNICEF survey of 2009 in Andhra Pradesh for two weeks to find prevalence
acute respiratory infections prevalence among mothers of under five and results are 18.8 %
that is 308 children are getting acute respiratory infections and as per demographic data, acute
respiratory infections were more common among boys 18.7 % than girls 16 % . According to
age 6 to 11 months old children 21.4 % than 12 to 23 months old children 17.7 %.
As per WHO estimates in 2007, respiratory infections caused about 987000 deaths in
India, of which 969000 were due to acute lower respiratory infections 10,000 due to acute
upper respiratory infections, and about 9000 due to otitis media. The burden of the disease in
terms of DALYs lost was 25.5 million of these 24.8 million were due to acute lower
respiratory infections, 2.74 lacks due to acute upper respiratory infections and 4.75 lacks due
to otitis media.
According to WHO report in 2011, acute respiratory infections are a major cause of
morbidity and mortality among under five children years worldwide. It causes 150 million
episodes of illness per annum, leading to a heavy burden on the family and the health system.
3
In India, under five children constitute 13 % of the total population and contribute 25 % to the
mortality. Mortality statistics in India have shown that acute respiratory infections including
neonatal pneumonia cause 20 % to 35 % of the mortality among under-5 children.
In India, various community-based studies have reported that the incidence of upper
respiratory tract infection among under five children is 3 to 5 episodes per child per year,
resulting in 41 million episodes of acute respiratory infections episodes per year. The
incidence of lower respiratory tract infection is 0.25 to 0.5 episodes per child per year.
Various studies have shown that among the acute respiratory infections events in children, 87
% to 90 % are due to upper respiratory infections and 10 % to 13 % by acute lower respiratory
tract infections 12 to 14 Further, 96.5 % of mortality due to respiratory events is contributed
by lower respiratory tract infections. Studies have shown that 33 % each of pediatric
outpatients and admissions are due to acute respiratory events.
The child rearing practices play an important role in determining the health of
children. Today teaching about prevention and health promotion are considered essential
components of comprehensive health care. Since “Prevention is better than cure” teaching,
giving information and involving the parents in the caring for the sick child will minimize
complications. Studies show that a planned teaching programme is known to bring about
changes in the existing knowledge. (Park .k, 2007)
A large number of diseases could be prevented with little or no medical interventions.
Mothers play a key role in the management of child with Upper respiratory tract infections.
4
Mothers has to understand that the appropriate decision making, recognize the mild, moderate
and severe respiratory infection and initiate correct domiciliary management for upper
respiratory infection at home as soon as possible to prevent the progression of the infection.
The ignorance and inadequate knowledge are important factors, which affects health of child.
If upper respiratory infection is not treated in early stage it may leads to certain complications
like staphylococcal pericarditis, emphysema, pneumothorax, and staphylococcal pneumonia.
This increases the risk of child mortality.
During my community posting in patrapalli V- kota mandal, chittoor district I saw
number children with severe upper respiratory infections due to mothers inadequate
knowledge, so, I felt the need to Provide accurate information about upper respiratory tract
infection to the mothers to help them to provide effective home management and prevent
complications of upper respiratory infections.
STATEMENT OF THE PROBLEM
A study to assess the effect of planned teaching programme on knowledge, practice and
attitude among mothers of under five children regarding upper respiratory tract infections in
Patrapalli village, V.kota mandal, Chittoor district, Andhrapradesh.
OBJECTIVES OF THE STUDY
1. To determine the knowledge, practice and attitude regarding upper respiratory infections
among mothers of under five children before & after administration of planned teaching
programme in Experimental group.
5
2. To compare the pre and post test mean knowledge, practice & attitude regarding Upper
respiratory tract infections among mothers of under five children in experimental group.
3. To compare the post test knowledge, practice &attitude regarding upper respiratory tract
infections in experimental and in control group.
4. To test the association between the mean difference in post test Scores with selected
demographic variables in experimental group
OPERATIONAL DEFINITIONS
Effect
It refers to the extent of achievement on knowledge, practice and attitude of
mothers of under five children.
Planned Teaching Programme
It refers to impart knowledge regarding acute respiratory tract infections
among mothers under five children.
Knowledge
Knowledge refers to the understanding of mothers regarding upper respiratory tract
infections by asking the correct answer for particular questions.
Practice
It refers to the regular activities done by the mothers of under five mothers
during Upper Respiratory Tract Infections.
6
Attitude
It refers intensity of giving care by the mother to the under five children who
are suffering from upper respiratory tract infections.
Upper Respiratory Tract Infections
It refers to occurrence of infections to upper respiratory tract infections. Mainly
Rhinitis, Pharyngitis, tonsillitis.
Mothers of Under Five Children
It refers to mothers who have children of birth to five years.
HYPOTHESIS
RH1: There will be significant increase in the mean knowledge scores regarding Upper
Respiratory Tract Infections among mothers of under five children in experimental
group.
RH2: There will be significant increase in knowledge regarding Upper Respiratory
Tract Infections among mothers of under five children after administration of
Planned teaching programmes
RH3: There will be a significant difference in knowledge of upper respiratory infections
among mothers between experimental group & control group.
RH4: There will be a significant association between post test knowledge scores &
Demographic variables.
7
ASSUMPTIONS
1. Mothers of under five children may have some knowledge regarding prevention of
Upper Respiratory Tract Infections
2. Administration of planned teaching programme regarding prevention of upper
Respiratory Tract Infections may help the mothers to improve awareness towards
prevention of Upper Respiratory Tract Infections
3. Demographic variables of the mothers may have influence on knowledge
regarding prevention of Upper Respiratory Tract Infection
LIMITATIONS
1. Mothers who have under five children.
2. Planned teaching program.
3. Mothers who can understand Telugu only.
ETHICAL CLEARANCE
Ethical clearance will be obtained from the ethical clearance committee of PESIMSR
Kuppam, A.P through principal college of nursing PES IMSR, Kuppam A.P...
CONCEPTUAL FRAMEWORK
Conceptual frame work means ‘interrelated concepts or obstructions’ that are
assembled together in some rational scheme by virtue of their relevance to a common theme.
8
The conceptual framework for this study was developed by applying Dorothy
Johnson’s open system theory [BT Basavanthappa 2007]. According to the general system
theory “a system consists of set of interacting components”. These are two types of general
system that is
 Closed system and
 Open system
A closed system theory system does not exchange energy, matter or information with
its environment. It receives no input from the environment and gives no output to the
environment. In open system energy, matter or information more into and output of the
systems. All living system, such as plant, animals, people, families and communities are open
system. An open system consists of the
 Input
 Throughput
 Output
According to theorist view the information matter and energy that the system uses
organizes transform the input in a process called as throughout and releases information,
matter and energy output into the environment output into that returns to the system as input is
called as feedback.
In the present study, the investigator considered system Patrapalli, V-kota mandal,
chittoor district. Subsystem as mothers of under five children. The whole PESIMSR is
considered as open system, which possesses input, throughput process, output and feedback.
9
Input
Input is considered as assessment of knowledge, attitude, practice of upper respiratory
infections that is general and specifically about definitions, meaning, causes and risk factors,
signs and symptoms, management.
Throughput
Throughput is the activity phase, here the investigator implemented structure teaching
programme to group of mothers of under five children about the upper respiratory infections
in signs and symptoms and management by using relevant A.V aids via: flash cards, charts,
and video cassette on upper respiratory tract infections.
Output
Output is the post test and it is the outcome of the study. Here the investigator
reassessed the knowledge after 14th day of implementation of structure teaching programme
and it revealed that the sample gained in knowledge through post test scores that is feedback.
10
11
CHAPTER-II
REVIEW OF LITERATURE
“Review of literature does for us what a map does for the traveler.”
The literature is reviewed and organized under following headings.
SECTION: 1 Studies related to incidence of respiratory tract infections.
SECTION: 2 Studies related to knowledge on prevention of upper respiratory
Tract Infection among mothers.
SECTION: 3 Studies related to knowledge, attitude and practice of upper
Respiratory tract infections.
. SECTION: 4 Studies related to effectiveness of planned teaching programmes
related to Upper respiratory infections
Studies related to incidence of respiratory infection.
A descriptive study was conducted to correlate acute respiratory tract infection among
infants in selected area of udpai district. 110 mothers and infants above three months were
selected for study. Structured interview schedule was used for data collection. Majority of
children that is 60.9 % had acute respiratory tract infection 4 to 6 times in past three months.
During one month observation maximum number of children 48.6 % had at least suffered
from acute respiratory tract infection once. The study showed that majority of children
suffered 4 to 6 times with respiratory tract infection in three months of study period. (Pair
Mamatha Shivanada, 2010)
12
A longitudinal a study was conducted in Durgarampur in Singur block of district
Hooghly to determine the acute respiratory tract infections morbidity and epidemiological
factors responsible for such morbidity. 63 children less than 5 years of age were selected by
randomly for study. All children were followed up with periodic home visits at two weeks
interval for 6 months. Frequency of acute respiratory infections episodes was studied and
association with study variables was analyzed. Overall incidence density rate of respiratory
tract infections episodes was 19.57 per 100 persons per month at risk. Incidence was highest
in infants 23.9 per 100 persons per month. Risk ratio analysis showed that low socio-
economic class, low birth weight, under nutrition, inadequate immunization, children not
exclusively breastfed and indoor smoke pollution were significantly associated with
increasing number of acute respiratory tract infections episodes. (Shasikala T et. al., 2008)
A cross sectional study was done assess the prevalence of acute respiratory tract
infections among under five children in urban and rural areas of Gujarat .500 children were
selected for the study. The study states that the prevalence of acute respiratory tract infections
are more in rural area 26.8 % than urban area 17.2 % because of lack of health facilities and
poor awareness about acute respiratory tract infections.(Dr.Bipin prajapathi et. al., (2008)
A Case control study was conducted in New Delhi to determine risk factors associated
with severe lower respiratory tract infections in under five children. 512 children selected for
study. The study states that the main risk factors of lower respiratory tract infections are lack
of breast feeding, mothers with upper respiratory tract infections, siblings with upper
13
respiratory tract infections, severe malnutrition and inappropriate immunizations. This study
shows that upper respiratory infections are one of risk factor for lower respiratory infections.
(Broor et. al., 2007)
A study was conducted in sunderpur, Varanasi to assess the magnitude of the problem
of acute Respiratory Infections among under five children in an urban slum and the clinical
profile of it in order to understand the pattern of disease presentation for identifying methods
of early diagnosis and timely intervention. 150 under five children were selected by stratified
random sampling method and were observed for 52 weeks at weekly interval to record the
illnesses. In total 661 episodes were observed in 5623 child-weeks of observation giving an
episode rate of 6.11 per child per year. Acute Respiratory Tract Infections accounted for 67%
of all morbidities. Mean duration of all the episodes taken together was 8.15 + 5.44 days.
Majority of the episodes (88.96%) were confined to the Upper Respiratory Tract only. Most
commonly occurring clinical features were rhinorrhea, nasal stuffiness and cough. 61.4% of
all the episodes terminated within seven days, and only 26.2% continued for two weeks.
(Sharma AK, Reddy DC, Dwivedi RR, 1999)
A descriptive study was conducted to find the risk factors for acute respiratory
infections in child hood in a populations based sample of the Atlanta metropolitan area.449
mothers who having 575 children less than five years of age were selected by random digit
dialing and questioned about upper respiratory tract infections and ear infections occurring in
their children for two weeks .The final proropotion of children in day care 9 % to 14 % of the
14
total burden of upper respiratory tract infections in this populations was day care related
(Fleming DW et.al., 1987) .
Studies related to knowledge on prevention of upper respiratory infection among
mothers.
A descriptive study was conducted on knowledge and practice regarding Acute Upper
Respiratory Tract Infection in selected rural area in South Bangalore. 60 mothers selected by
simple random sampling technique .The data was collected by Semi structured interview
schedule. Study found that there is significant association between knowledge and practice
with selected demographic variables like education occupation medium of cooking type of.
There is high positive correlation between knowledge and practice. About 48.3 % of mothers
have inadequate knowledge about common cold. Majority 70 % of mothers practice level
regarding management of Acute Upper Respiratory Tract Infection was unsatisfactory, so the
need for improving the level of knowledge and practice was widely recognized. Mass and
individual education in regional languages to enlighten the mothers can be organized at all
levels of health facilities. (Flower Little, 2007)
A descriptive study was conducted in Kumasi, Ghana on maternal knowledge attitude
and practices regarding childhood acute respiratory infections. 143 women were selected by
convenient sampling method and interviewed who had at least one child aged less than five
years. The study showed that 73.4 % of women who had a child or children suffered with
cough, fever within the last 6 months. 73.4 % said that cold as a direct cause of cough. Many
15
women said worm infestation for causing cough and fever 21 %, and constipation for causing
cough 25.9 %. None mentioned pathogens as cause of cough and fever. If there are more
serious symptoms the mothers are more likely to seek treatment of a health care facilities ( e
.g cough only 0.7 %; cough with fever 6.3 % ; cough, fever and anorexia 30 % ; cough, fever
and lethargy 57.3 %). Honey and cough syrup were often used to treat cough and fever but
some herbal and home care therapies had potentially harmful effects for example 25.9 % said
that they used castor oil and enema to prevent acute respiratory infections. The women had an
acceptable knowledge score on severity of symptoms. These findings indicate need for health
education programme on domiciliary management and prevention of upper respiratory
infections for targeting mother of children aged less than five years. (Gupta N, 2007)
A descriptive study was conducted on knowledge and practices regarding pneumonia
among mothers in rural Haryana. 304 mothers were interviewed. About 23 % of mothers
recognized pneumonia by fast breathing and 11.2 % recognized severe pneumonia by chest in
drawing. Only 1.3 % mothers knew infective origin of acute respiratory infections. Although
most of them were convinced about continuation of breast-feeding, 70 % of them were
advising food restriction, use of herbal tea in acute respiratory infections was widely prevalent
and so was the practice of putting warm mustard oil in ear for curing ear pain. Primary health
centre was the most frequent place for treatment of acute respiratory infections. (Saini NK et.
al., 1999)
16
A descriptive study was conducted in rural area of west Bengal on knowledge, attitude
and practice regarding acute respiratory infection. 106 mothers selected by convenient
sampling technique were interviewed to determine how they would recognize pneumonia in
children, what therapies they would practice with mild acute respiratory illness and
pneumonia and the feeding practices they have adopted. Most mothers recognized pneumonia
by observing the quick respiratory ate and difficulty in breathing, with regard to management
of mild acute respiratory infection episodes, more than half of the mothers preferred not to
give any treatment or to use only home remedies. In pneumonia a majority preferred to
consult a qualified doctor. As far as feeding concerned, most of them stated that they would
continue feeding, fluids, and breastfeeds. Only 10 % said they would stop feeding. (Kapoor
SR et. al., 1997)
Studies related to knowledge, attitude and practice of upper respiratory infection.
A descriptive survey study was done to assess the knowledge on management of
children at home with upper respiratory tract infection among mothers attending village clinic
at Chennai. 50 mothers were selected by convenient sampling technique. Data collected using
a self administered questionnaire. The study states that 37.6 % of mothers have inadequate
level of knowledge, 14.3 % have adequate level of knowledge and 48 % of the mothers have
moderate level of knowledge. In the overall level of management, 45.3 % have inadequate
level of management, 15.3 % have adequate level of management and 39.4 % of mothers have
17
moderate level of management. So the study indicates that there is knowledge deficit among
the mothers and is varying with demographic variables. (Samundeswari v, 2010)
A study was conducted on “How do mothers recognize and treat pneumonia at home?”
In rural areas of Mangalore. Two hundred mothers of under-five children having lower
respiratory tract infection were interviewed with the help of pre-tested unstructured
questionnaire to know the danger signs perceived by her in a child suffering from pneumonia
and home remedies used by them before seeking medical help. Retraction and refusal to feed
were the most common symptoms perceived as dangerous. Retraction in 91.1 % and fast
breathing in 8.1 % cases. Honey 25 % and ginger 27 % were the most common home
remedies used for the relief of cough, self advised medications were used by 24 % of mothers
and majority 58.4 % gained this knowledge from mass media. (Sarini NK et. al., 2009)
A quasi experimental study was conducted in Bangalore to assess the effectiveness of
home-based steam inhalation for the under-fives with acute upper respiratory infection. 25
children each in experimental and control group were selected by simple random sampling
.The study shows that home-based steam inhalation was effective in reducing upper
respiratory infection.( Lakshmamma VT, 2009)
A cross sectional study was done to evaluate the health seeking behavior (knowledge
,attitude and practice) of mothers regarding acute respiratory infections among under five
children at Tarpakar Desert,Pakisthan.1000 mothers were selected by convenient sampling
18
technique. The final results shows that 72 % mothers had knowledge about acute respiratory
infections and could recognized it but 28 % had no knowledge about acute respiratory
infections .55 % mothers took acute respiratory infections as a serious disease while 44 % did
not.76 % of mothers said that breast feed should be continued during illness, while 24 % said
routine feeding should not be continued during acute respiratory infections. (Rajesh Kumar,
2008)
A descriptive study was done in Gondar, Ethiopia to evaluate health behavior
(knowledge, attitudes and practices) of rural mothers on acute respiratory infections in
children. 132 mothers with under five children were selected for study .The findings of study
was 77.3 %, mothers recognized that respiratory rate, 76.5 % mothers recognized that high
fever and 62.8 % decreased feeding were important signs of pneumonia. They all knew that
grunting was also new an important sign. Only 35.6 % would take their child with these
symptoms to a nearby health center. Other common treatment was taking child to a traditional
healer 64.4 % and applying butter and herb to the chest via a massage at home 95.5 %. The
traditional practices were predominant interventions proposed by the mothers for mild acute
respiratory infections (e.g. cold, sore throat and ear discharge). Most 58.3 % mothers
proposed to clean the ear and to keep it dry. 85.6 % of mothers would take their child with a
sore throat to a traditional healer for tonsil extraction, a hazardous practice. (Teka T, Dagnew
M, 1995)
19
Studies related to planned teaching programmes related to Upper respiratory infections
A pre experimental study was conducted in Dharwad on the effectiveness of planned
teaching programme on prevention of pneumonia among mothers of children having acute
respiratory infection. 60 mothers of under-five children were selected by simple random
sample technique. Structured questionnaire was used in this study. The pre-test scores shows
that 14 mothers had 23.33 % inadequate level of knowledge and 46 mothers had 76.67 %
moderate level of knowledge and the post-test scores after the planned teaching programme
shows that 59 mothers had 98.33 % adequate knowledge and only 1.67 % with moderate
level of knowledge. This shows that there is significant difference in the pre-test and post-test
level of knowledge and it is significant at p<0.001. This study concludes that planned teaching
programme is effective in enhancing knowledge of mothers regarding pneumonia. (Beejapur
BS, 2010)
A quasi-experimental study was carried out in the pediatric medical wards of Raja
Muthiah Medical College and Hospital at Chidambaram to evaluate the effectiveness of
structured teaching programme on acute respiratory infections among the 50 mothers of under
five with acute respiratory infections was chosen. Structured questionnaire was used to assess
the knowledge, attitude and practice of mothers on acute respiratory infections. The study
findings revealed that after structured teaching programme there was a significant
improvement in the knowledge, attitude and practice of mothers regarding acute respiratory
20
infections. Thus it was found that the simple structured teaching programme to mothers of
acute respiratory infections children was effective. (Sasikala T, and S Jayagowri, 2008)
A study was conducted to assess the effectiveness of training program for reducing
upper respiratory tract infection among toddler in day care center at Canada. A randomized
field trial was conducted in 52 day care centers in Canada .This study result indicate that the
training program for the mothers of toddler play an important role in reducing infection in
children attending day care center.( J.A Taylor ,2008)
A quasi experimental study was conducted on effect of educational programme on
child care knowledge and behavior of mothers of under five children hospitalized with
pneumonia .50 mothers of under five children who selected by purposive sampling technique
.Mothers of experimental group received children routine care and educational programme,
Whereas control group received only routine care. Mother’s knowledge was assessed through
questionnaire and behavioral checklist. The investigator concluded that educational
programme supported that nurses need to involve themselves through helpful method of the
educational programme to teach mothers of under five with respiratory infections. (Pravez
mm et.al. 2005)
21
CHAPTER-III
METHODOLOGY
This chapter includes,research approch, research design , variables, settings of the
study, population, sample design, inclusion, exclusion criteria for sampling data collection
tool, development of tool, content validity, pre testing and establishing reliability of the tool,
description of the tool, preparation of intervention planned teaching programme, pilot study
data collection procedure , plan for data analysis and ethical considerations, problems faced
during data collection. This chapter also deals with description and various steps adopted to
collect and organize data for the study.
RESEARCH APPROACH
Research approach is an umbrella that cover the basic population for the research
study. An evaluate approch was used to evaluate the effectiveness of Planned Teaching
Programme among under five mothers.
RESERCH DESIGN
Researcher selected quasi experimental research design (that is Non equvivalent
control group design). It has experimental group and control group with no randomization,
Quasi experimental research design that is pre test and post test design. This design refers to
the overall plan for obtaining answer to the research question.
22
Quasi experimental research design. (Non equvivalent control group design)
E.GROUP O1 X O2
C.GROUP O1 - 02
E= Experimental group C = Control group
O1 = Pre test O1 = Pre test
X = Planned teaching programme -
O2= Post test O2 = Post test
Variables under the study: Variable which come under my study is as the following,
Two types of variables are there under this study
Dependent variable: knowledge, practice and attitude of the mothers of under five.
Independent variable: Planned teaching programme.
SETTING
Setting is a physical location in which the data collection takes place. The investigator
had selected investigate Patrapalli village, V.kota mandal, chittoor dist. The survey conducted
by the investigator in this area during community health nursing field experience revealed that
most of the children have Upper Respiratory Infections frequently and mothers are lacking
knowledge, practice and attitude regarding prevention of Upper Respiratory Infections and it
is causing lower tract infections and other complications. Therefore, the investigator took up
this area for the study. Based on the investigator’s familiarity with the settings and availability
23
of the subjects the present study was conducted in the selected Patrapalli village, V-Kota
mandal, Chittoor district, Andhrapradesh.
POPULATION
Population consists mothers of under five who are living in Patrapalli village, V.kota
mandal, chittoor district .At present 100 under five mothers are living in patrapalli village.
SAMPLE AND SAMPLING TECHNIQUE
Sampling is the process of selecting a sample from the target population. The sample
selected by using Non probability sampling that is convenience sampling. Sample size is 30 in
experimental and 30 in control group.
Criteria for Sample Collection
Inclusion criteria:
 Mothers who have under five children
 Mothers who are living in Patrapalli village.
 Mothers who knows Telugu
 Mothers who are willing to participate
Exclusion criteria:
 The mothers who refuse to participate in the study
 The mothers who suffers from severe illness and psychiatric problems.
 The mothers who have children above five years
 Mothers who are deaf and dumb.
24
SELECTION AND DEVELOPMENT OF THE TOOL
A structured knowledge, practice questionnaire and Likert three point attitude scale
were developed by the investigator based on literature reviews in order to obtain answers from
mothers of under five mothers at Patrapalli-Kota. The tool used for research study was
structured questionnaire which was prepared by me to assess the knowledge, practice and
attitude of mothers of under five on Upper Respiratory Tract Infections.
The tool was prepared by me after extensive review of literature research and
consultation with experts in the field of pediatrics. There are 45 items in the tool.
Validity
The tool was given for nursing experts in Child Health Nursing and pediatric medicine
department. A few changes done on the basis of experts opinions and 100% agreement was
included in the tool, there by content validity was ascertained.
Reliability: The reliability of the tool was assessed by doing pilot study.
The reliability was established by split half method. The reliability was done by using
Karl-Pearson’s correlation coefficient method. The ‘r’ value was 0.56. Hence the tool was
considered as reliable.
Description of Tool
Part-A
Sought information on demographic data includes Age of the mother, type of the
family, education of the mother, occupation of the mother, income of the family,
25
Immunization of the child, number of living children, previous history of Upper Respiratory
Tract Infections, breast feeding of child.
Part-B
Section I: sought information to assess the knowledge among mothers of under five children
on Upper Respiratory Tract Infections which includes 15 structured questionnaires.15
structured questionnaire related to practice
Section II: Three point Likert Attitude Scale.
Scoring Interpretation
The knowledge, practice and attitude on Upper Respiratory Tract infection were
measured in terms of knowledge and practice scores. Each correct answer was given a score
of one and wrong answer given a score of zero. Total marks of knowledge and practice are 30
and to assess attitude3 point Likert scale was prepared as given the scoring as follows
 Score 3 for agree
 Score 2 for disagree
 Score 1 for strongly disagree
Development of Planned Teaching Programme
A planned teaching programme was developed by me based on the review of literature
and the objectives of knowledge, practice and attitude variables. The first draft of planned
teaching programme was developed and given to experts along with objectives and rating
scales. Based on their suggestions and recommendations the final draft of planned teaching
26
programme was prepared. It was 45 minutes long, lecture cum discussion teaching
programme which uses audio-visual aids and detailed descriptions. The content of the
programme included objectives, instructions, introduction, causes, risk factors, signs and
symptoms, diagnosis and preventive measures and control of Upper Respiratory Tract
Infections, summary and conclusion.
Content Validity
The structured questionnaire and planned teaching progamme were given to 3 nursing
experts and one Pediatrician for adequacy and relevance of tool. Item with 100% agreement
were included in the tool, a few were modified and there by content validity was ascertained.
PILOT STUDY
I have done pilot study for one week from 3-12-12 to 8-12-12 in PES hospital in
pediatric ward at Kuppam formal verbal consent was obtained from the concerned
authorities i.e., medical superintendent ,and HOD of pediatrics, PESIMSR hospital.
Researcher conducted pilot study with 10 mothers 5 in experimental and 5 in control group of
under five mothers who are fulfilling the inclusive criteria were chosen with non probability
convenience sampling method. Then all the selected subjects are assembled in pediatric ward:
then Researcher given self introduction explained the purpose of the study to the subjects and
the subject’s willingness to participate in the study was ascertained. Structured questionnaire
was administered to 10 mothers with the required information on 4-12-12(pretest). And the
planned teaching programme administered on the same day to experimental group on Upper
27
Respiratory Infections. After 5 days i.e. on 9-12-12 post test was conducted by using the same
structured questionnaire. The collected data were analyzed by using descriptive and inferential
statistics. The significance of difference between the pre test and post test was found by paired
“t” test the obtained value 0.00 was found to be highly significant at the level of (P<0.01).
ETHICAL CLEARENCE
The study objectives intervention and data collection procedures were approved by the
research and ethical committee of the institution. The pilot study was conducted by me after
obtaining the approval from medical superintend of PESIMSR. The main study was conducted
after obtaining the approval from medical officer, V-kota, chittoor district, Andhra Pradesh. The
purpose and other details of the study were explained to the study participants. Verbal consent
was obtained from medical offices and participants. Assurance was given to the study. Subject
about the anonymity and the confidentiality of the data collected from them. Thus the ethical
issues were issued in the study.
DATA COLLECTION PROCEDURE
The data collection process was done by me only for 4 weeks for this study i.e. from 17.12.12
to 17.1.13. Time schedule for the data collection from 9:30 AM to 5:00 PM.
Phase I:The subjects were selected by convinence sampling after obtaining their consent and
assuring confidentiality. Pre –test was conducted to experimental and control groups of under
five children mothers who are residing in Patrapalli village, V-kota mandal, chittoor district,
Andhra Pradesh on 20-12-12 by using structure questionnaire to determine the level of expected
28
knowledge ,practice and three point likert attitude scale to assess the attitude regarding
management of upper respiratory problems .
Phase II: Planned teaching programme were administered by me to the experimental group of
under five children mothers who are residing in Patrapalli village, V-kota mandal, chittoor
district, Andhra Pradesh who meet the inclution criteria on 23-12-12 .
Phase III: Post test were conducted on the fifteenth day (that is 7-1-2013) to the experimental
group and control group of under five children mothers who are residing in Patrapalli village, V-
kota mandal, chittoor district, Andhra Pradesh after the planned teaching programme using the
quetionnaire to assess the level of expected knowledge and practices and attitude regarding home
management of upper respiratory problems.
PLAN FOR DATA ANALYSIS
The data was edited, coded and entered in excel sheets by me. The data were analyzed,
using SPSS version 16 and probability of less than 0.05 considered statically significant. The
data were analyzed as follows.
Section-I: Distribution of mothers based on their demographic variables of mothers was
analyzed by using frequency and percentage distribution.
Section-II: comparison of mean knowledge, practice and attitude of mothers of under five in
experimental group regarding Upper Respiratory Tract Infections were analyzed by using
premean, post mean, mean difference and “t” value.
29
Section-III: comparison of post test knowledge, practice and attitude regarding upper
respiratory tract infection in experimental and control group were analysed by using mean,
standard deviation and “t” test.
Section-III: To test the association between the mean differences in post test scores with
selected demographic variables in experimental group were analyzed by using mean, standard
deviation, median, Chi-square.
30
31
CHAPTER-IV
DATA ANALYSIS AND INTERPRETATION
The analysis and interpretation of this study was based on data collected by structured
questionnaire. The results were computed using descriptive and inferential statistics. The data
were entered into excel sheets and analyzed using SPSS 16 version.
A probability of less than 0.05 was considered to significant.
ORGANISATION OF DATA
The collected data were edited, tabulated, analyzed, interpreted and findings obtained were
presented in the form of tables and diagrams represented under the following sections.
Section-I Distribution of mothers based on their demographic variables
Sections-II Pre Test and post test knowledge, practice, and attitude of mothers regarding
upper respiratory infections before and after administration of planned teaching programme in
experimental group.
Section-III comparison of mean knowledge, practice and attitude regarding Upper
Respiratory Infections in experimental group.
Section-IV Comparison the post test knowledge, practice and attitude regarding Upper
Respiratory infections in experimental and in control group.
Section – V Association between the mean difference in pretest and posttest knowledge,
practice and attitude of mothers and selected background factor
32
SECTION-I
DISTRIBUTION OF MOTHERS BASED ON THEIR DEMOGRAPHIC VARIABLES

Table-4.1.1 Frequency and percentage distribution of the mother according to age
S.No Variables Distribution Frequency Percentage
1. Age of the mother a. 15-25 years 30 50%

b. 25-35 years 21 35%
c. 35-45 years 9 15%
d. 45 and above 0 0%
[
Figure-4.1.1: Percentage distribution of Mothers according to age
percentage
50%
50%
40% 35%
15-25 years
30% 25-35 years
15% 35-45 years

20%
45 and above
10%
0%
0%
15-25 years 25-35 years 35-45 years 45 and above
The data presented in the table shows the distribution of samples according to the age.
The maximum number of subjects 50% is from the age group of 15-25 years, 35% are in the
age group of 25-35 years and 15% mothers are from the age group of 35-45 years and none of
them found to be above 45 years of the age.
33
TABLE-4.1.2 Frequency and percentage distribution of mothers according type of the
family
S.No Variables Distribution Frequency percentage
2 Type of family a) Nuclear family 30 50%
b) Conjoint family 30 50%
Figure 4.1.2 Percentage distributions of mothers over type of the family
percentage
nuclear family
50% 50%
conjoint family
The data presented in this table showing that 30 (50%) are comes under nuclear family
and 30 (50%) are from the conjoint family.
34
Table.4.1.3 Frequency and percentage distribution of mothers according to education.
S. No Variables Distribution frequency Percentage
3. Education of the mother a. Profession or honors 1 1.6%

b. Graduate or post 4 6.6%
1. (modified kuppuswamy
graduate
2. classification)
c. Intermediate or post 0 0
high school certificate
d. High school certificate 12 20%

e. Middle school 28 46%
certificate
f. Primary school 6 10%
certificate
g. Illiterate 9 15%
Figure: 4.1.3 Percentage Distributions of Mothers According To Education
Education of the mother

60.00%
professiopn
40.00%
20.00% graduate or post graduate
0.00%
intermediate or post high school
certificate
high school certificate
middle school certificate
The data presented in this table shows the distribution regarding education of the
mother 1 (1.6%) were belongs to profession, 4 (6.6%) mothers were belongs to graduates and
post graduates, 12 (20%) were belongs to high school certificate, 28 (46%) were belongs to
middle school, 6 (10%) were belongs to primary school certificate and 9 (15%) were belongs
to illiterate.
35
Table-4.1.4: Frequency and percentage distribution of mothers according to
Occupation
S.No Variables Distribution frequency Percentage
a. Profession 2 3.3
4. Occupation of the mother
3. (modified kuppuswamy b. semi- profession 0 0
4. classification) c. Clerical, shop
0 0
owner,
farmer 16.6%
10
d. Skilled worker 8 13.3%

e. semi- skilled 15
28%
worker
25 41%
f. Unskilled worker
g. Unemployed
Figure 4.1.4: Percentage distribution of Mothers According To occupation
Occupation of mother
45.00% 41%
40.00% profession
35.00%
30.00% 28%
25.00% semi-profession
20.00% 16.60% 13.30%
15.00% clerical,shop owner,, former
10.00% 3.30%
5.00% 0% 0%
skilled worker
0.00%
semiskilled worker
unskilled worker
unemployment
The data presented in this table regarding occupation of the mother 2 (3.3%) were
comes under profession, 10 (16.6%) were comes under skilled workers, 8 (13.3%) were
comes under semi skilled workers, 15 (28%) were comes under unskilled workers, 25 (41%)
were comes under unemployed.
36
Table 4.1.5 Frequency and percentage distribution of mothers according to income
S.No Variables Distribution frequency Percentage
5 Income of the family a. > 19,575 2 3.3%

(modified kuppuswamy 0 0%
b. 9,788-19,574
classification)
c. 7,323-9,787 2 3.3%
12 20%
d. 4,894-7,322
34 56%
e. 2,936-4,893
f. 980-2,395 10 16.6%
g. <979 0 0%
Figure:4. 1.5 Percentage distributions of Mothers according to income
Income of the family

60.00% 56%
50.00%
>19,575
40.00%
30.00% 9,788-19,574
20.00% 20%
3.30% 16.60% 7,323-9,787
10.00% 0% 3.30%
0.00% 4,894-7,322
0%
2,936-4,893
980-2,395
<979
The above presented data above table about income of the family 2 (3.3%)
were getting >19,575 income per month, 2 (3.3%) were getting income between 9,788-19,574
income per month, 12 (20%) were getting income between 4,894-7,322 income per month, 34
(56%) were getting 2,936-4,893 income per month, 10 (16.6%) were getting 980-2,395 per
month.
37
Table 4.1.6 Frequency and percentage distribution of immunization of the child
6. a. Immunized
[[[
Immunization of the child 57 95%
b.Not immunized 3 5%
Figure 4.1.6 Percentage distribution of immunization of the child
Immunization of the child
100% 95%
90%
80%
70%
60% immunized
50% not immunized
40%
30%
20% 5%
10%
0%
immunized not immunized
The presented data in this table regarding immunization of the child, majority of
children 57 (95%) were immunized and the least 3 (5%) were did not immunized.
38
Table: 4.1.7 Frequency and percentage distribution of children according to number of
living children.
7. Number of living a. One 15 25%
children b. Two 35 58%
c. Three 16.6%
10
d. Above Four 0 0
Figure: 4.1.7 percentage Distributions of Children according to number of living
children
Number of the children

58%
60%
50%
one
40%
25% two
30%
16.60% three
20%
above four
10% 0%
0%
one two three above four
The presented data in the above table regarding number of living 5children, 15 (25%) of one
child in home, 35 (58%) of two children in home, 10 (16.6) of three children in home.
39
Table: 4.1.8 Distributions of children according to Past Upper Respiratory Infections.
8. 5. Past history of upper a) Yes 60 100%

[
6. respiratory infection b) No 0 0%
Table: 4.1.8 Percentage Distributions of children according to Past Upper Respiratory
Infections.
The data presented in this table shows the past history of Upper Respiratory Infections
60 (100%) children suffered with past history of Upper Respiratory Infections.
40
Table: 4. 1.9 Frequency and percentage distribution of children according to breast
feeding
S.No Variable Distribution Frequency Percentage
9. 7. Breast fed the child a) Yes 35 58%

b) No 25 41%
Figure: 4.1.9 Percentage Distributions of Children According To Breast Feeding
breast fed the child
100%
80%
60% 58%
41% yes
40%
no
20%
0%
yes
no
The presented data in this above table it regarding breast fed of the child 35 (58%)
were breast feeded and 25 (41%) were not breast feeded.
41
SECTION-II
PRE TEST AND POST TEST KNOWLEDGE, PRACTICE, AND ATTITUDE OF
MOTHERS REGARDING UPPER RESPIRATORY INFECTIONS BEFORE AND
AFTER ADMINISTRATION OF PLANNED TEACHING PROGRAMME IN
EXPERIMENTAL GROUP.
Figure: 4.2.1 Experimental Pretest Knowledge and practice score percentage
100%
90% 86%
80%
70% 63%
60%
50% knowledge
40% 37% practice
30%
20%
11%
10% 3%
0%
0%
inadequate moderate adequate
Figure 4.2.1 shows that 37% of under five mothers having inadequate knowledge
and 3% mothers having inadequate practice regarding upper respiratory tract infections, 63%
of under five mothers having moderate knowledge and 86% of under five mothers having
moderate practice regarding upper respiratory tract infections, 0% of under five mothers
having adequate knowledge and 11% of under five mothers having adequate practice
regarding upper respiratory tract infection
42
Figure 4.2.2 Experimental Posttest Knowledge and Practice Score Percentage
100%
90% 97% 97%
80%
70%
60%
knowledge
50%
practice
40%
30%
20%
10% 3% 3%
0% 0%
0%
inadequate moderate adequate
Figure 4.2.2 shows 0% under five mothers having inadequate knowledge and
0% under five mothers having inadequate practice, 3% of under five mothers having moderate
knowledge and 3% under five mothers having moderate practice regarding upper respiratory
tract infections. 97% under five mothers having adequate knowledge and 97 % under five
mothers having adequate practice.
43
Figure 4.2.3 Percentage distributions of pretest and posttest attitude scores in
experimental group
96%
100%
90%
80% 74%
70%
60%
50%
pretest
40% 26%
30% posttest
20%
10%
0% 4%
positive
negative
Figure 4.2.3 shows that changed positive attitude in experimental group
regarding Upper Respiratory Tract Infections. In pretest 26% of under five mothers having
positive attitude and 74% of under five mothers having negative attitude and in posttest 96%
of under five mothers having positive attitude and 4% of under five mothers having negative
attitude .
In this study the knowledge, practice and attitude of experimental group increased after
administration of planned teaching programme. So, the planned teaching programme is
effective.
44
SECTION-III
COMPARISON OF MEAN KNOWLEDGE, PRACTICE AND ATTITUDE

REGARDING UPPER RESPIRATORY INFECTIONS IN EXPERIMENTAL GROUP
Table : 4.3.1 Comparison Mean, Mean difference and‘t’ values of pre test and post test
knowledge, practice and attitude scores of mothers regarding upper respiratory
infection
Area of knowledge Pre test Post test mean Mean ‘t’ value
, practice and mean difference
attitude
.000
Area of knowledge 5.900 12.7000 6.8 P<0.05
(S)
.000
Area of practice 8.6667 13.6667 5 P< 0.05
(S)
.000
Area of attitude .27 .97 P<0.05
(5)
Overall 14.8367 27.3367 12.5 .000
Figure 4.3.1 Mean, Mean difference values of pre test and post test knowledge,
Practice and attitude scores of mothers regarding upper respiratory tract infection
Figure 4.3.1 shows that mean difference between the pretest and post test knowledge
scores in knowledge section was 6.8 and‘t’ value .000 (P<0.05) is highly significant, it is
evident that mean of practice 5 and‘t’ value 000 (P<0.05) is highly significant and the mean
difference of attitude section .7 and‘t’ value 000 (P<0.05) is highly significant.
The total mean difference between the pre test and the post test knowledge scores is
12.5 the obtained‘t’ value .000 (P<0.05) is highly significant.
45
SECTION-IV
COMPARISON THE POST TEST KNOWLEDGE, PRACTICE AND ATTITUDE

REGARDING UPPER RESPIRATORY INFECTIONS IN EXPERIMENTAL AND IN
CONTROL GROUP
Table: 4.4.1 comparition of mean, stander deviation and‘t’ values of post test knowledge,
practice and attitude scores of mothers regarding upper respiratory infection in
experimental and control group.
Area of
knowledge Experimental group Control group
, practice Posttest Posttest
and Mean SD Independe Mean SD Independent
attitude nt ‘t’ test ‘t’ test
Knowledge 12.7000 1.51202 . 000 6.9000 3.37313 .760
Practice 13.666 1.60459 . 000 5.5670 2.38313 .338
Attitude .97 .183 .000 .28 .550 .559
Overall 40.036 3.29961 .000 12.747 6.30626 2.417
The table 4.4.1 shows the post test knowledge, practice and attitude regarding upper
respiratory infection among under five mothers in experimental group the mean of posttest
knowledge was 12.70+/- 1.51202, mean of posttest practice was 13.66+/- 1.60 and mean of
posttest attitude was .97+/-.183. The mean of posttest knowledge in control group was
6.9o+/- 3.373, mean of posttest practice was 5.56+/- 2.383 and t mean of posttest attitude was
.28+/- .550 hence there is statical significant difference in posttest scores.
46
SECTION – V
ASSOCIATION BETWEEN THE MEAN DIFFERENCES IN POSTTEST SCORES
WITH SELECTED DEMOGRAPHIC VARIABLE IN EXPERIMENTAL GROUP.
Table: 4. 5.1 Relationship of age with knowledge level of under five mothers.
KNOWLEDGE
Age NO Mean SD Median Median Median Chi-Square
< > Value Result
15-25 Years 12 12.83 1.130 5 14 5
25-35 years 14 12.57 0.80 6 13 6 .564 Not
35-45 years 4 13.66 0.15 6 13 6 significant
Above 45 0 - - - - -
years
Figure 4.5.1: Relationship of Age with Knowledge Level of Under Five Mothers.
This table shows that mean score for age 15-25 years was 12.83 and standard deviation
was 1.130, mean score for age group of 25-35 years was 12.57 and standard deviation was
0.8, mean score for age group of 35-45 years 13.66 and standard deviation was 0.15.Chi-
squire analysis was used to determine the statically significance of association between
knowledge and age group of under five mothers. The Chi-Square value was .564 shows that
there is no significant relationship between age and knowledge.
47
Table: 4.5.2 Relationship of type of family with knowledge level of under five mothers.
Type of No Mean Sd Median Median Median Chi-square

family < > Value Result
Nuclear 14 12.43 1.145 6 13 6 Not

.137
significant
Joint 16 13 22 7 13 7
Figure: 4.5.2 Relationship of Type of Family with Knowledge Level of Under Five
Mothers.
4.5.2 Table shows that mean score for nuclear family was 12.43 and standard
deviation was 1.145 mean score for conjoint family was 13 and standard deviation was 22.
Chi-squire analysis was used to determine the statically significance of association between
knowledge and age group of under five mothers. The Chi-Square value was .137 shows that
there is no significant relationship between type of family and knowledge.
48
Table: 4.5.3 Relationship of education with knowledge level of under five mothers
Educational No Mean Sd Median Median Median chi square
status < > Value Result
Profession 1 7 0 - - -
Graduate 4 13.5 0.40 1 13.5 1
Intermediate - - - - - -
High school 9 12.66 0.73 4 12 4 .981 Not
Middle school 13 12.46 1.08 6 13 6 significant
Primary - - - - - -
school
Illiterate 3 12.66 0.28 1 12 1
Figure: 4.5.3 Relationship of Education with Knowledge Level of Under Five Mothers
4.5.3 Table shows that mean score for profession was 7 and standard deviation was
zero, mean score for graduate was 13.5 and standard deviation was 0.40, mean score for
intermediate was zero and standard deviation was zero, mean score of high school certificate
was 12.66 and standard deviation was 0.73, mean score for middle school was 12.46 and
standard deviation was 1.08, mean and standard deviation for primary school was zero and
mean score of the illiterate was 12.66 and standard deviation was 0.28. Chi-squire analysis
was used to determine the statically significance of association between knowledge and
education of under five mothers. The Chi-Square value was .981 shows that there is no
significant relationship between education and knowledge.
49
Table: 4.5.4 Relationship of occupation with knowledge level of under five mothers
Occupation No Mean SD Median Median Median chi square

< > Value Result
Profession 2 13 0.24 - - -
Semi-profession 0 0 0 - - -
Clerical, farmer 0 0 0 - - -
.093
Skilled worker 4 13.5 0.4 1 13.5 1 Not
Semi-skilled 4 12.75 0.3 1 12.5 1 significant
worker
Unskilled worker 2 12 0.24 - - -
unemployment 18 12.5 1.16 8 12.5 8
Figure:4.5.4 Relationship of occupation with knowledge level of under five mothers
0.24, mean score for semi-profession was zero and standard deviation was zero, mean score
for clerical, farmer was zero and standard deviation was zero, mean score of skilled worker
was 13.5 and standard deviation was 0.4, mean score for semi-skilled worker was 12.75 and
standard deviation was 0.3, mean score for unskilled worker was 12 and standard deviation
0.24, mean score of the unemployment was 12.5 and standard deviation was 1.16. Chi-squire
analysis was used to determine the statically significance of association between knowledge
and occupation of under five mothers. The Chi-Square value was .093 shows that there is no
significant relationship between occupation and knowledge.
50
Table: 4.5.5 Relationship of income with knowledge level of under five mothers
Income No Mean SD Median Median Median chi square

< > Value Result
>19,575 2 12 0.04 - - -
9,788-19,574 0 0 0 - - -
7,323-9,787 2 12.5 0.38 - - -
4,894-7,322 5 13 0.04 2 13 2 .339 Not
2,936-4,893 19 13.27 1.37 9 13 9 significant
980-2,395 2 13.5 0.1 - - -
<979 0 0 0 - - -
Figure: 4. 5.5 Relationship of Income with Knowledge Level of Under Five Mothers
4.5.5 Table shows that mean score for more than 19,575 was 12 and standard
deviation was 0.04, mean score for 9,788-19,574 was zero and standard deviation was zero,
mean score for 7,323-9,787 was 12.5 and standard deviation was 0.38, mean score of 4,894-
7,322 was 13 and standard deviation was 0.04, mean score for 2,936-4,893 was 13.27 and
standard deviation was 1.37 , mean score for 980-2,395 was 13.5 and standard deviation 0.1,
mean score of the <979 was zero and standard deviation was zero. Chi-squire analysis was
used to determine the statically significance of association between knowledge and income of
under five mothers. The Chi-Square value was .339 shows that there is no significant
relationship between income and knowledge.
51
Table: 4.5.6 Relationship of immunization with knowledge level of under five mothers
Immunization No Mean SD Median Median Median Chi-square
< > Value Result
Yes 29 12.65 1.37 14 13 14
.072 significance
No 1 15 0 - - -
Figure: 4. 5.6 Relationship of immunization with knowledge level of under five mothers
4.5.6 Table shows that mean score for immunized child was 12.65 and standard deviation
was 1.37, mean score for not immunized was 15 and standard deviation was 0. Chi-squire
analysis was used to determine the statically significance of association between knowledge and
immunizations of under five mothers. The Chi-Square value was 0.72 shows that there is
significant relationship between immunization and knowledge.
52
Table: 4.5.7 Relationship of number of living children with knowledge level of under five
mothers
Number of No Mean SD Median Median Median Chi-square

living < > Value Result
children
One 9 13 1.15 4 14 4
Two 16 12.82 0.48 7 13 7 .034 significant
Three 5 12 0.2 2 12 2
Four and 0 0 0 - - -
above
Figure: 4.5.7 Relationships of Living Children with Knowledge Level of Under Five
Mothers
4.5.7 table shows that mean score for one child was 13 and standard deviation
was 1.15, mean score for two children was 12.82 and standard deviation was 0.48, mean score
for three 12 and standard deviation was 0.2 and mean score of above four was zero and standard
deviation zero. Chi-squire analysis was used to determine the statically significance of
association between knowledge and number of living children. The Chi-Square value was 0.49
shows that there is significant relationship between number of living children and knowledge.
53
Table: 4.5.8 Relationship of past history of Upper Respiratory Tract Infections with
knowledge level of under five mothers.
Past history No Mean SD Median Median Median Chi-square

of Upper
< > Value Result
Respiratory
Tract
Infections
Yes 30 12.73 1.45 14 13 14 Not
.386
No 0 0 0 - - - significant
Figure: 4.5.8 Relationship of past history of URTI with knowledge level of under five
mothers.
4.5.8 Table shows that mean score for past history of URTI was 12.73 and standard
deviation was 1.45 mean score for no past history of URTI was 0 and standard deviation was
0. Chi-squire analysis was used to determine the statically significance of association between
knowledge and past history of URTI. The Chi-Square value was 0.72 shows that there is no
significant relationship between past history of URTI and knowledge.
54
Table: 4.5.9 Relationship of breast feeding of child with knowledge level of under five
Breast No Mean SD Median Median Median Chi-square
feeding < > Value Result
Yes 18 12.88 0.83 8 13 8 Not
No 12 13.75 1.43 5 12.5 5 .941 significant
mothers.
Figure 4.5.9: Relationship of breast feeding with knowledge level of under five mothers.
4.5.9 Table shows that mean score for breast feeded children was 12.88 and standard
deviation was 0.83 mean score for not breast feeded children was 13.75 and standard deviation
was 1.43. Chi-squire analysis was used to determine the statically significance of association
between knowledge and breast feeding of child. The Chi-Square value was .386 shows that
there is no significant relationship between breast feeding of child and knowledge.
55
Table: 4.5.10 Relationship of age with practice of under five mothers.
PRACTICE
Age No Mean Sd Median Median Median Chi-square
< > Value Result
15-25 Years 13 13.76 1.44 6 15 6
25-35 years 14 13.57 0.05 6 13 6 .564 Not
35-45 years 3 13 0.44 1 13 1 significant
Above 45 0 0 0 - - -
years
Figure: 4.5.10 Relationship of age with practice of fewer than five mothers.
This table shows that mean score for age 15-25 years was 13.76 and standard deviation was
1.44, mean score for age group of 25-35 years was 13.57 and standard deviation was 0.05, mean
score for age group of 35-45 years 13 and standard deviation was 0.44 .Chi-squire analysis was
used to determine the statically significance of association between practice and age group of
under five mothers. The Chi-Square value was .564 shows that there is no significant relationship
between age and practice.
56
Table: 4.5.11 Relationship of type of family with practice of under five mothers.

Nuclear 14 13.28 1.5 6 13.5 6 Not
.137
conjoint 16 7.4 4.60 7 14 7 significant
Figure :4.5.11 Relationship of type of family with practice of under five mothers.
Above the table shows that mean score for nuclear family was 13.28 and standard
deviation was 1. 5 mean score for conjoint family was 7.4 and standard deviation was 4.6. Chi-
squire analysis was used to determine the statically significance of association between practice
and age group of under five mothers. The Chi-Square value was .137 shows that there is no
significant relationship between type of family and practice.
57
Table: 4.5.12 Relationship of education with practice level of under five mothers
Educational status No Mean Sd Median Median Median chi square
< > Value Result
Graduate 4 13.5 0.17 1 13.5 1
Intermediate - 0 0 - - -
High school 9 14 0.50 4 14 4 .981 Not
Middle school 13 13.38 1.35 6 14 6 significant
Primary school - 0 0 - - -
Illiterate 3 14.33 0.28 1 15 1
Figure 4.5.12 Relationship of Education with Practice Level of Under Five Mothers
4.5.12. table shows that mean score for profession was 11 and standard deviation was
was 14 and standard deviation was 0.50, mean score for middle school was 13.38 and standard
deviation was 1.35, mean and standard deviation for primary school was zero and mean score
of the illiterate was 14.33 and standard deviation was 0.28. Chi-squire analysis was used to
determine the statically significance of association between practice and education of under
five mothers. The Chi-Square value was .981 shows that there is no significant relationship
between education and practice.
58
Table: 4.5.13 Relationship of occupation with practice of under five mothers
Occupation No Mean Sd Median Median Median chi square

< > Value Result
Profession 2 12.5 4.5 - - -
.093
Skilled worker 4 14 0.24 1 14 1 Not
Semi-skilled worker 4 14.25 0.3 1 14.5 1 significant
Unskilled worker 2 14.5 0.1 - - -
unemployment 18 13.38 1.5 8 13 8
Figure: 4. 5.13 Relationship of occupation with practice of under five mothers
4.5.13 Table shows that mean score for profession was 12.5 and standard deviation
was 4.5, mean score for semi-profession was zero and standard deviation was zero, mean score
for clerical, farmer was zero and standard deviation was zero, mean score of skilled worker was
14 and standard deviation was 0.24, mean score for semi-skilled worker was 14.25 and standard
deviation was 0.3, mean score for unskilled worker was 14.5 and standard deviation 0.1, mean
score of the unemployment was 13.38 and standard deviation was 1.5. Chi-squire analysis was
used to determine the statically significance of association between practice and occupation of
under five mothers. The Chi-Square value was .093 shows that there is no significant relationship
between occupation and practice.
59
Table: 4. 5.14. Relationship of income with practice of under five mothers
Income No Mean Sd Median Median Median chi square

< > Value Result
1.>19,575 2 12 0.4 - - -
2.9,788-19,574 0 0 0 - - -
3.7,323-9,787 2 14.5 0.1 - - -
4.4,894-7,322 5 13.7 0.2 2 13 2 .339 Not
5.2,936-4,893 19 13.63 1.46 9 14 9 significa
6.980-2,395 2 14.5 0.1 _ - - nt
7.<979 0 0 0 - - -
Figure: 4.5.14 Relationship of income with practice of under five mothers
4.5.14. table shows that mean score for more than 19,575 was 12 and standard
mean score for 7,323-9,787 was 14.5 and standard deviation was 0.1 , mean score of 4,894-
7,322 was 13.7 and standard deviation was 0.2, mean score for 2,936-4,893 was 13.63 and
standard deviation was 1.46 , mean score for 980-2,395 was 14.5 and standard deviation 0.1,
mean score of the <979 was zero and standard deviation was zero. Chi-squire analysis was
used to determine the statically significance of association between practice and income of
relationship between income and practice.
60
Table: 4. 5.15. Relationship of immunization with practice of under five mothers.
Immunization No Mean Sd Median Median Median Chi-square

< > Value Result
Yes 29 13.58 1.6 13 14 13
No 1 14 0 - - - .072 significance
Figure: 4.5.15 Relationship of immunization with practice level of under five mothers
4.5.15. Table shows that mean score for immunized child was 13.58 and standard
deviation was 1.6, mean score for not immunized was 14 and standard deviation was 0. Chi-
practice and immunizations of under five mothers. The Chi-Square value was 0.72 shows that
there is significant relationship between immunization and practice.
61
Table: 4. 5.16 Relationship of number of living children with practice of under five
mothers
Number of NO Mean SD Median Media Media Chi-Square

living < n n Value Result
children >
One 9 13.44 1.31 4 14 4
Two 16 13.75 0.65 7 14 7 .034 significant
Three 5 13.4 0.60 2 13 2
Four and 0 0 - - - -
above
Figure: 4.5.16 Relationship of number of living children with practice of under five
mothers.
4.5.16 Table shows that mean score for one child was 13.44 and standard deviation
was 1.31, mean score for two children was 13.75 and standard deviation was 0.65, mean score
for three 13.4 and standard deviation was 0.6 and mean score of above four was zero and
standard deviation zero. Chi-squire analysis was used to determine the statically significance
of association between practice and number of living children. The Chi-Square value was
0.034 shows that there is significant relationship between number of living children and
practice.
62
practice level of under five mothers.
Past history No Mean SD Median Median Median Chi-square

of URTI < >
Value Result
Yes 30 13.6 1.60 14 14 14 Not

.386 significant
No 0 0 0 - - -
Figure: 4.5.17 Relationship of Past History of Upper Respiratory Tract Infections with
Practice Level Of Under Five Mothers.
4.5.17. Table shows that mean score for past history of URTI was 13.6 and standard
deviation was 1.6 mean score for no past history of URTI was 0 and standard deviation was 0.
practice and past history of URTI. The Chi-Square value was .386 shows that there is no
significant relationship between past history of URTI and practice.
63
Table: 4.5.18 Relationship of breast feeding of child with practice of under five mothers.

Yes 18 13.61 0.86 8 13.5 8 Not
.941 significant
No 12 13.58 1.34 5 14 5
Figure: 4.5.18 Relationship of breast feeding of child with practice of under five mothers.
4.5.18 Table shows that mean score for breast feeded children was 13.61 and standard
deviation was 1.34 mean score for not breast feeded children was 13.58 and standard
deviation was 1.34. Chi-squire analysis was used to determine the statically significance of
association between Practice and breast feeding of child. The Chi-Square value was .386
shows that there is no significant relationship between breast feeding of child and practice.
64
Table: 4.5.19 relationship of age with attitude of under five mothers.
POSITIVEATTITUDE
Age No Mean Sd Median Median Median Chi-square
< > Value Result
15-25 Years 12 32.08 3.06 5 32.5 5
25-35 years 14 33.57 3.16 6 34 6 .564 Not
35-45 years 3 38.33 1.46 1 40 1 significant
Above 45 0 - - - - -
years
Figure: 4.5.19 relationship of age with practice of under five mothers.
This table shows that mean score for age 15-25 years was 32.08 and standard deviation
was 3.06, mean score for age group of 25-35 years was 32.57 and standard deviation was 3.16,
mean score for age group of 35-45 years 38.33 and standard deviation was 1.46 .Chi-squire
analysis was used to determine the statically significance of association between attitude and
age group of under five mothers. The Chi-Square value was .564 shows that there is no
significant relationship between age and attitude.
Table: 4.5.20 Relationship of type of family with attitude of under five mothers.
65
Nuclear 13 34.75 3.47 5 34.5 5 Not
conjoint 16 33.37 3.57 6 34 6 .137 significant
Figure: 4. 5.20 relationship of type of family with attitude of under five mothers.
Above the table shows that mean score for nuclear family was 34.75 and standard
deviation was 3.47 mean score for conjoint family was 33.37 and standard deviation was 3.57
attitude and age group of under five mothers. The Chi-Square value was .137 shows that there is
no significant relationship between type of family and attitude.
66
Table: 4. 5.21 Relationship of education with attitude level of under five mothers
Educational status No Mea Sd Median Median Median chi square
n < > Value Result
Graduate 4 32.25 1.34 1 33.5 1
Intermediate 0 0 0 - - -
High school 9 33.44 2.12 1 32.5 1 .981 Not
Middle school 12 33.08 3.57 5 32.5 5 significant
Primary school 0 0 0 - - -
Illiterate 3 36 1.56 1 39 1
Figure: 4.5.21 Relationship of Education with Attitude Level of Under Five Mothers
was 34.444 and standard deviation was 2.12, mean score for middle school was 13.08 and
standard deviation was 3.57, mean and standard deviation for primary school was zero and
mean score of the illiterate was 36 and standard deviation was 1.56. Chi-squire analysis was
used to determine the statically significance of association between attitude and education of
relationship between education and attitude.

67
Table: 4. 5.22 Relationship of occupation with attitude of under five mothers
Occupation No Mean Sd Median Median Median chi square

< > Value Result
Profession 2 37.5 1.41 - - -
.093
Skilled worker 4 36 1.48 1 36.5 1 Not
Semi-skilled 4 35 1.43 1 36.5 1 significa
worker nt
Unskilled worker 2 34.5 1.16 - - -
unemployment 17 32.55 3.91 8 32 8
Figure: 4. 5.22 Relationship of Occupation with Attitude of Under Five Mothers
4.5.22Table shows that mean score for profession was 37.5. and standard deviation
was 1.41, mean score for semi-profession was zero and standard deviation was zero, mean
score for clerical, farmer was zero and standard deviation was zero, mean score of skilled
worker was 36 and standard deviation was 1.48, mean score for semi-skilled worker was 35
and standard deviation was 1.43, mean score for unskilled worker was 34.5 and standard
deviation 1.16, mean score of the unemployment was 32.55 and standard deviation was 3.91.
attitude and occupation of under five mothers. The Chi-Square value was .093 shows that
there is no significant relationship between occupation and attitude.
68
Table: 4.5.23 Relationship of income with attitude of under five mothers
Income No Mean Sd Median Median Median chi square

< > Value Result
1.>19,575 2 41.5 0.38 - - -
2.9,788-19,574 0 0 0 - - -
3.7,323-9,787 2 32 0 - - -
4.4,894-7,322 5 31.4 1.74 2 31 2 .339 Not
5.2,936-4,893 19 33.61 3.83 8 13.5 8 significant
6.980-2,395 2 36.5 0.9 - - -
7.<979 0 0 0 - -- -
Figure: 4.5.23Relationship of income with attitude of under five mothers
4.5.23 table shows that mean score for more than 19,575 was 41 and standard
mean score for 7,323-9,787 was 32 and standard deviation was 0 , mean score of 4,894-7,322
was 31.4 and standard deviation was 1.74, mean score for 2,936-4,893 was 33.61 and standard
deviation was 3.83 , mean score for 980-2,395 was 36.5 and standard deviation 0.9, mean
score of the <979 was Zero and standard deviation was zero. Chi-squire analysis was used to
determine the statically significance of association between attitude and income of under five
mothers. The Chi-Square value was .339 shows that there is no significant relationship
between income and attitude.
69
Table: 4.5.24 Relationship of immunization with attitude of under five mother.
Immunization No Mean Sd Median Median Median Chi-square

< >
Value Result
Yes 29 33.96 4.92 14 33.5 14

.072 significance
No 0 0 0 - - -
Figure: 4. 5.24 Relationship of immunization with attitude of under five mothers
4.5.24 Table shows that mean score for immunized child was 33.96 and standard
deviation was 4.92, mean score for not immunized was 0 and standard deviation was 0. Chi-
attitude and immunizations of under five mothers. The Chi-Square value was .072 shows that
there is significant relationship between immunization and attitude.

70
Table: 4.5.25 Relationship of number of living children with attitude of under five
mothers.
Number of NO Mean SD Media Media Media Chi-square

living n n n Value Result
children < >
One 8 34.12 2.27 3 68 3
Two 16 32.81 3.41 7 32.5 7 .034 significant
Three 5 36.8 2.50 2 39 2
Four and 0 0 0 - - -
above
Figure: 4.5.25 relationship of number of living children with attitude of under five
mother.
4.5.25 Table shows that mean score for one child was 34.12 and standard deviation was
2.27, mean score for two children was 32.81 and standard deviation was 3.41, mean score for
three 36.8 and standard deviation was 2.5 and mean score of above four was zero and standard
deviation zero. Chi-squire analysis was used to determine the statically significance of
association between attitude and number of living children. The Chi-Square value was .034
shows that there is significant relationship between number of living children and attitude.
71
attitude of under five mothers.
past history no mean sd median median median chi-square

of upper
< > value result
respiratory
tract
infections
yes 29 33.96 4.92 14 34 14 not
no 0 0 0 - - - .386 significant
Figure: 4.5.26 Relationship of past history of urti with attitude of under five mothers.
4.5.26 Table shows that mean score for past history of URTI was 33.96 and standard
deviation was 4.42 mean score for no past history of URTI was 0 and standard deviation was
0. Chi-squire analysis was used to determine the statically significance of association between
attitude and past history of URTI. The Chi-Square value was .386 shows that there is no
significant relationship between past history of URTI and attitude.
72
Table: 4.5.27 Relationship of breast feeding of child with attitude of under five mothers.

Yes 18 33 3.77 7 32 7 Not
.941 significant
No 11 35.27 3.18 5 38 5
Figure: 4.5.27 Relationship of breast feeding of child with attitude of under five mothers.
4.5.27 Table shows that mean score for breast feeded children were 33 and standard
deviation was 3.77 mean score for not breast feeded children was 35.27 and standard
deviation was 3.18. Chi-squire analysis was used to determine the statically significance of
association between attitude and breast feeding of child. The Chi-Square value was .941
shows that there is no significant relationship between breast feeding of child and attitude.
73
Table: 4.5.28 Associations between the mean differences in posttest scores with selected
demographic variable in Experimental Group
S.No Variables X2 value p value Level of
significance
1. Age .564 p>0.05 Not significant
2. Type of family .137 p>0.05 Not significant
3. Education .981 p>0.05 Not significant
4. Occupation 0.93 p>0.05 Not significant
5. Income .339 P<0.05 Not significant
6. Immunization .072 p>0.05 Significant
7. Number of living .034 p>0.05 Significant
children
8. Past history of URTI .386 P<0.05 Not Significant
9. Breast feeding .941 p>0.05 Not significant
74
CHAPTER-V
DISCUSSION
The present chapter is consists the summary of the findings, limitations, interpretations
of the results and recommendations that incorporate the implications of the study.
The primary aim of the study was to evaluate the effectiveness of planned teaching
programme on Upper Respiratory Tract infections among mother of under five children in
Patrapalli, V-Kota, and chittoor district, A.P.
OBJECTIVES OF THE STUDY WERE
1. To determine the knowledge, practice and attitude regarding upper respiratory
infections among mothers of under five children before & after administration of
planned teaching programme in Experimental group.
2. To compare the pre and post test mean knowledge, practice &attitude regarding
Upper respiratory among mothers of under five in experimental group.
3. To compare the post test knowledge, practice &attitude regarding upper respiratory infections
in experimental and in control group.
4. To test the association between the mean difference in post test Scores with selected
demographic variables in experimental.
75
The background variables of the study were Age of the mother, type of the family,
education of the mother, occupation of the mother, income of the family, Immunization of
the child, number of living children, previous history of URTI, breast feeding of child.
Conceptual framework was formed which can serve to guide research which will
further support theory development. The conceptual models attempt to represent. This
theory consists of input, throughput and output components. Minimal use of words. Present
study was burred on Roy’s adaptation theory. A system was consisting of set of interacting
components with in a boundary in a system. System was composed of both structural and
functional components.
A review of literature has helped the nurse educator to get awareness on the present
problem, in depth knowledge, practice and attitude of different aspects on prevention of
Upper Respiratory Tract Infections among mothers, to develop the conceptual frame work
for the study development of tool and plan for data analysis.
Quasi experimental research approach is used to conduct the study. The study was
conducted in Patrapalli village, V-Kota, chittoor district, Andhrapradesh. The population for
the present study consists of mothers who are residing in Patrapalli village, V-Kota, chittoor
district, Andhrapradesh who are willing to participate in the study at the time of data
collection non probability purposive sampling used to select 60 samples that is 30 in
experimental and 30 in control group. A structured interview schedule was prepared by the
nurse educator to assess the knowledge, practice and attitude mothers regarding prevention
76
of Upper Respiratory Infections which includes 3 parts PART A consists of demographic
data like Age of the mother, type of the family, education of the mother, occupation of the
mother, income of the family, Immunization of the child, number of living children,
previous history of Upper Respiratory Infections, breast feeding of child. PART B consists
of 45 items that are categorized into 3 sections based on different aspects of Upper
Respiratory Infections section-1 consists of 15 items on knowledge on Upper Respiratory
Infections, section-2 consists of 15 items on practice on control of Upper Respiratory
Infections, and section-3 consists of 15 items on attitude of Upper Respiratory Infections.
The tool was given for content validity to experts in the field of nursing and medicine.
The reliability of the tool checked by split half method (coefficient of correlation by Karl
Pearson’s formula). The results indicate that the tool was valid and reliable. Pilot study was
conducted on the sample of 5 in experimental and 5 in control group for a period of one
week and the results revealed the feasibility and appropriateness of the tool. The main study
was conducted for a period of 1 month. The data was analyzed with the help of descriptive
and inferential statistics and the findings interrupted.
FINDINGS
The findings are based on the objectives of the study
Objective: I to determine the knowledge, practice and attitude regarding upper
respiratory infections among mothers of under five children before & after
administration of planned teaching programme in Experimental group.
77
In this study shows that 37% of under five mothers having inadequate knowledge and
3% mothers having inadequate practice regarding upper respiratory tract infections, 63% of
under five mothers having moderate knowledge and 86% of under five mothers having
moderate practice regarding upper respiratory tract infections, 0% of under five mothers
having adequate knowledge and 11% of under five mothers having adequate practice
regarding upper respiratory tract infection . In the post test mothers gained better
knowledge, practice and attitude on Upper Respiratory Infections. It is obvious from above
figure that the mothers had 0nly 0% of under five mothers having adequate knowledge after
intervention it improved to 97% ,11% of under five mothers having adequate practice after
intervention it improved to 97% and attitude in pretest 26% of under five mothers having
positive attitude and 74% of under five mothers having negative attitude and in posttest 96%
of under five mothers having positive attitude and 4% of under five mothers having negative
attitude .It was shown under section-II, page no-42-44 and figure no-4,2.2, figure no 4.2.2,
figure no- 4.2.3.
Hence the corresponding research hypothesis RH1: There is significant increase in the
mean knowledge,practice and attitude scores regarding Upper Respiratory Tract Infections
among mothers of under five children in experimental group was accepted.
In this study the knowledge, practice and attitude of experimental group increased after
administration of planned teaching programme. So, the planned teaching programme is
effective.
78
Objective: II To compares the pre and post test mean knowledge, practice &attitude
regarding Upper respiratory among mothers of under five in experimental group.
The mean difference between the pretest and post test knowledge scores in knowledge
section was 6.8 and‘t’ value .000 (P<0.05) is highly significant, it is evident that mean of
practice 5 and‘t’ value 000 (P<0.05) is highly significant and the mean difference of attitude
section .7 and‘t’ value 000 (P<0.05) is highly significant. The total mean difference between
the pre test and the post test knowledge scores is 12.5 the obtained‘t’ value .000 (P<0.05) is
highly significant. It was shown under section-III, table no4. 3.1, figure no4. 3.1. P. no-45.
Hence the corresponding research hypothesis RH2: There is significant increase in
knowledge regarding Upper Respiratory Tract Infections among mothers of under five
children after administration of Planned teaching programmes was accepted.
. Hence it is inferred that the mothers improved their knowledge, practice, attitude
regarding Upper Respiratory Infections. Thus, intervention was effective.
Objective: III. To compare the post test knowledge, practice &attitude regarding upper
respiratory infections in experimental and in control group. The post test knowledge,
practice and attitude regarding upper respiratory infection among under five mothers in
experimental group the mean of posttest.
Knowledge was 12.70+/- 1.51202, mean of posttest practice was 13.66+/- 1.60 and mean of
posttest attitude was .97+/-.183. The mean of posttest knowledge in control group was
6.9o+/- 3.373, mean of posttest practice was 5.56+/- 2.383 and t mean of posttest attitude was
79
.28+/- .550 hence there is statically significant difference in posttest scores. It was shown
under section-IV page number 46 and table number 4.4.1.
Hence the corresponding research hypothesis RH3: There will be a significant
difference in knowledge of upper respiratory infections among mothers between experimental
group & control group was accepted.
Hence it is showing that the experimental group improved their knowledge when
compared with control group only of mothers having adequate knowledge practice and
attitude.
Objective: IV: To test the association between the mean difference in post test Scores
with selected demographic variables in experimental.
The obtained “p” values on linear regression regarding association selected
demographic variables with mean difference knowledge, practice and attitude scores among
mothers on upper respiratory tract infections. The demographic variables such as age, type of
family, education, occupation, income, immunization of the child, number of living children,
past history of URTI, breast feeding of the child has made no significant difference (P<0.05)
in the mean difference in knowledge scores except immunization and number of living
children. It was shown under section-V, page number 74 and table number 4.5.29.
Hence the corresponding research hypothesis RH4: There will be a significant
association between post test knowledge scores & selected demographic variables was
rejected.
80
DISCUSSION
These study was supported by the study done by M.s.Shereena G Edwin, (2007) on
planned teaching programme on knowledge, practice and attitude of the under five mothers
regarding the acute respiratory tract infections. After the planned teaching programme, there
was significant improvement on knowledge, practice and attitude of mothers regarding acute
respiratory tract infections. Knowledge the mean difference was 48.4 and paired‘t’ test was
38.32, attitude of the mothers the mean difference was 4.76 and paired‘t’ test was 11, and
knowledge on practice mean difference was 4.83 and paired‘t’ test is 10.06 and the P value
was found to be P, 0.05 .Hence the study conclude that planned teaching programme was
found to be effective in improving the knowledge, attitude on practice of mothers regarding
acute respiratory infections.
81
CHAPTER-VI
SUMMARY, CONCLUSION, IMPLICATIONS,
LIMITATIONS, RECOMMENDATIONS
SUMMARY
In India under-five children constitute about 13 per cent of the total population of
India. Health of the under-five children in India is not satisfactory. Every year some 12
million children in developing countries die before they reach their fifth birthday, many
during first year of life. Seven in ten of these deaths are due to respiratory infections (mostly
Pneumonia), diarrhea, measles, malaria, malnutrition or a combination of theses illness. Acute
respiratory illness ranges from common cold, cough, ear infection and pneumonia. It is most
common cause of morbidity and mortality in children under the age of five years. Hospital
based statistic shows that about 13 per cent in patient deaths of pediatric ward are due to
Pneumonia. So it is important that by giving health education we can decrease the mortality
and morbidity rate of respiratory tract infections.
FINDINGS
The following conclusions were drawn on the basis of the findings of the study.
 The knowledge of mothers regarding Upper Respiratory Infections in pretest was 0%.
 The practice of mothers regarding Upper Respiratory Infections in pretest was 11%.
 The positive attitude of mothers regarding Upper Respiratory Infections in pretest was
26%.
82
 There was significant increase in the knowledge after administration of planned
teaching programme was 97%.
 There was significant increase in the practice after administration of planned teaching
programme was 97%.
 There was significant change in the positive attitude after administration of planned
teaching programme was 96%.
 None of the demographic variable was influencing the increase in the knowledge,
practice and attitude after planed teaching programme except immunization and number of
living children.
CONCLUSION
This study is concluded that planned teaching programme increases knowledge,
practice and attitude of mothers regarding Upper Respiratory Tract Infections. The
knowledge, practice and attitude may be utilized by mothers to maintain the health.
IMPLICATIONS
The results obtained from study helped the investigator to derive certain implications
for nursing practice, education, research, administration.
Implications for nursing practice:
The study would be useful in nursing in the following ways
83
 Nursing students and staff have to include mother in the care process and they are
educated about care of the children and prevention of complication associated with
upper respiratory tract infection
 Motivate mothers to adapt healthy life styles modification specially healthy dietary
habits, environment sanitation, personal hygiene which will help them lead healthy
leaves
 Nursing students and staff has to be planned to identify the learning needs of mothers
& clarifying about Upper Respiratory Tract Infections.
 Nursing students and staff should be ‘women friendly’ to conduct health education
programs to solve difficult to solve different problems related to their health & suggest
some desirable &acceptable ways to handling them
Implication for nursing education
 The nursing students should be taught to work in prevention of URTI in hospitals & in
community.
 In the student learning experience more emphasis should be laid on prevention of
Upper Respiratory Tract Infections which is commonly seen in under five children
 More opportunity provided to the students to use appropriate AV aids in teaching
process on prevention of Upper Respiratory Tract Infections.
84
Implication for nursing research
 Based on the findings, the professionals and students nurse can conduct health studies
to improve the knowledge, attitude & practice regarding prevention of Upper
Respiratory Tract Infections.
 The study will motivate the students and staff to conduct similar study in large scale
based on comparative analysis
Implication for nursing administration
The finding would be useful
 In planning & organizing continuation education programmes for all categories of
nursing personal for updating knowledge on current issues & trends in relation to
children health.
 To organize health education service to create awareness among mother
 The nursing students and staff should ensure in the use of cost effective audio visual
Materials, mass media in appropriate teaching based on mother’s background factors.
RECOMMENDATIONS
The following recommendation offered regarding the study
 A similar study can be conducted by true experimental method
 A similar study can be replicated in a large sample size
85
 A similar study can be conducted on urban population
 A comparative study can be conducted to know relationship between knowledge &
practices
 A comparative study can be undertaken both in urban & rural mothers.
86
REFERENCES
BOOKS
1. Dorothy R Marlow(2007), Text book of pediatric nursing, 6thedition Elsevier
Publication, Pg.No:917-919.
2. Ghai OP ( ,Text book of essentials of pediatric nursing, 6th edition revised and
Enlarged, CBS Publications. Pg .No:345-350.
3. IAP A Parthasarathy(2009), text book of pediatrics, volume -1, 4th edition, Jaypee
Brother publications, Pg. No: 573-575.
4. K.Park (2009), Text book of preventive and social medicine, 19th edition, Elsevier
Publications, Pg. No: 142-148.
5. UNICEF coverage survey (2009) on management of acute respiratory
Infections, chapter 4 New Delhi Pg.No:12.
6. Wong’s (2011), essentials of pediatric nursing, 8th edition, Elsevier publication,
Mumbai, Pg.No:791-803.
7. K. Park (2012), “ textbook of social and preventive medicine”, 21st edition, published
by Bhanotts publishers, Pg.No:143-149.
8. A santhosh Kumar (2011), “paediatric clinical examination”, 3rd edition, Paras
Medical publishers, New Delhi, Pg.No:29.
9. Rimple Sharma (2013), “essential Paediatric Nursing”, 1st edition, Jaypee
87
Publications, New Delhi, Pg.No: 311-320.
10. Parul Datta (2007). “Text book of pediatric nursing”, 1st edition. Jaypee
Publications, Pg.No:270-274.
JOURNALS
11. Beejapur BS. Effectiveness of planned teaching program on prevention of
Pneumonia among mothers of children having acute respiratory
infection, Nightingale Nursing Times 2010 Oct; 6(7):41-4.
12. Bipin Prajapati, Nitiben talsania M K Lala, K N Sonalia Prevalence of acute
respiratory tract infections in under five children in urban and rural
communities of Ahmadabad district, Gujarat. Health line .The journal
of Indian association of preventive and social medicine, Gujarat
chapter Volume 3 Issue 1 January-June 2012.
13. Broor S, Parveen S, Bharaj P, Prasad VS, Srinivasulu KN, Sumanth KM, et
al. A prospective three-year cohort study of the epidemiology and
Virology of acute respiratory infections of children in rural India.
PLoS One Jun 2007;2:491.
88
14. Edwin SG. Effect of planned teaching programme on knowledge, attitude and
Knowledge on practice of acute respiratory infections among mothers,
Nightingale Nursing Times 2007 Sep; 3(6):50-5.
15. Fleming DW,Cochi SL,Hightower AW,Broome CV ,childhood upper
respiratory tract infections:to what degree is incidence affected by day
care attendance?. Pediatrics journal .1987 jan;79(1):55-60.
16. Flower Little. Assessment of knowledge and practice of mothers of under
five children regarding acute upper respiratory tract infection in selected
rural area in south Bangalore. The nursing journal of India 2007 April;
XCVIII (4):75-76.
17. Gupta Neeru, Jain SK, Ratnesh, Chawla Uma, Shah Hossain, VenkateshS. An
evaluation of diarrheal diseases and acute respiratory infections control
programme in Delhi slum. Indian journal of pediatrics 2007 may;
74(5):471-6.
18. Kapoor SR, Reddaiah UP, Murthy GV. Knowledge, attitude and practices
89
regarding acute respiratory infections. Indian journal of paediatrics
1997, July-Aug; 57(4):533-5.
19. Lakshmamma VT. Home based steam inhalation for treating upper
respiratory infection: an interventional study approach by nurses.
Nightingale Nursing Times 2009 Jan ;4(10): 9-11.
20. Pai Mamatha Shivanada. A study of correlate of acute respiratory tract
infection (ARI) among infants in selected area of Udpai district. The
nursing journal of India 2010 Jan; XCV (1):5-6.
21. Pravez mm1, w wiroonpanich2, m naphapunsakul. Bangladesh Journal of
Medical Science Vol.09 No.3 Jul’10.
22. Rajesh Kumar, Anjum Hashmi, Jamil Ahmed Soomro and Aslam Ghouri
Primary Health Care: Open Access Volume 2 Issue 1 1000108 ISSN:
PHCOA, an open access journal feb; (2012).
23. Saini NK, Gaur DR, Saini V, Lals. Acute respiratory infection in children a
Study of knowledge and practice in rural Haryana. Journal of
Community diseases 1999Jan; 24(1):75-77.
90
24. Samundeeswari V. Mothers’ knowledge and management of upper respiratory tract
infection. Sri Ramachandra Nursing Journal 2010 Mar; 2 :52-3.
25. Sasikala T, Dr. S Jayagowri. Effectiveness of structured teaching programme
on acute upper respiratory infection. Nightingale Nursing Times 2008
June; 4(3): 12-15.
26. Shasikala T.et all, A longitudinal study on ARI among rural under fives.
Indian journal of community medicine 2001 Jan-Mar;26(1):8-
27. Teka T, Dagnew M. Health behaviour of rural mothers to acute respiratory
Infection in children in Gondar, Ethiopia. East African journal 1995
Oct; 12(10):623-5.
ON LINE WEBSITE
28. Census of India: Census data 2001. Office of the Registrar General and
Census Commissioner, New Delhi.
26. National institute of health and family welfare. Reproductive and child health
module for medical officer [primary Health Centre]. Munirka, New
Delhi; May 2000. http://www.pubmedcentral.nih.gov.
91
29. WHO/UNICEF estimates of respiratory disease incidence and mortality
Rates in Indian Children, Geneva, World Health Organization,2011
(www.who.int/immunization monitoring/data/en/).
92
APPENDIX-A
LETTER SEEKING PERMISSION FOR CONDUCTING THE STUDY
PES COLLEGE OF NURSING
Kuppam – 517425, Chittoor Dist, Andhra Pradesh.
Ref: PESIMSR /2012-13 Date:
30.11.12
From
Principal,
PES College of nursing,
Kuppam.
To
The Medical superintendent
PESIMSR,
Kuppam,
Chittoor (D.t),
Respected sir,
Sub: Req. for permission to do pilot study & data collection.
With reference to the above cited subject our 2nd Year M.Sc (N) student has to do pilot
study from 3-12-12 to 8-12-12. So kindly request you to grant permission for one student
to carry out the pilot study and main study at PESIMSR, Kuppam, chittoor district.
Thanking you,
Yours faithfully
PRINCIPAL
93
APPENDIX-A
LETTER SEEKING PERMISSION FOR CONDUCTING THE STUDY
PES COLLEGE OF NURSING
Kuppam – 517425, Chittoor Dist, Andhra Pradesh.
Ref: PESIMSR /2012-13 Date:
30.11.12
From
Principal,
PES College of nursing,
Kuppam.
To
The Medical Officer,
V.kota,
Chittoor (D.t),
Respected sir,
Sub: Req. for permission to do pilot study & data collection.
With reference to the above cited subject our 2nd Year M.Sc (N) student has to do main
study from 17.12.12 to 17.1.13. So kindly request you to grant permission for one student
to carry out main study at V.kota.
Thanking you,
Yours faithfully
PRINCIPAL
94
APPENDIX-B
LETTER SEEKING EXPERTS OPINION CONTENT VALIDITY
FROM
-------------------------,
PES College of Nursing,
Kuppam.
TO
Sub: Requisition for editor’s opinion and suggestion for content validity.
Respected madam/sir,
I am post graduate Nursing student of PES College of nursing Kuppam I

request your good self, if you would kindly accept to edit my research on the topic “a study to
assess the effectiveness of the planned teaching programme on knowledge, practice and attitude
of mothers among under five children regarding upper respiratory tract infection in patrapalli
village, V-kota mandal, chittoor (dist)”.
Undersigned with your valuable suggestions on this topic.
Thanking you
Signature Yours faithfully
Date:
Place:
95
APPENDIX-C
PART-A
DEMOGRAPHIC DATA
1. Age of the mother
a) 15-25 years
b) 25-35 years
c) 35-45 years
d) 45 and above
2. Type of the family
a) Nuclear family
b) Conjoint family
3. Education of the mother (modified kuppuswamy classification)
a) Profession or honors
b) Graduate or post graduate
c) Intermediate or post high school certificate
d) High school certificate
e) Middle school certificate
f) Primary school certificate
g) Illiterate
4. Occupation of the mother (modified kuppuswamy classification)
a) Profession
b) semi- profession
c) Clerical, shop owner, farmer
d) Skilled worker
e) semi- skilled worker
f) Unskilled worker
g) Unemployed
96
5. Income of the family (modified kuppuswamy classification)
a) > 19,575
b) 9,788-19,574
c) 7,323-9,787
d) 4,894-7,322
e) 2,936-4,893
f) 980-2,395
g) <979
6. Immunization of the child
a) Immunized
b) Not immunized
7. Number of living children
a) One
b) Two
c) Three
d) Above Four
8. Past history of upper respiratory infections
a) Yes
b) No
9. Breast fed the child
a) Yes
b) No
97
PART-B
Section-I
STRUCTURED KNOWLEDGE QUESTIONNAIRE RELATED OF
UPPER RESPIRATORY INFECTIONS
1. Upper respiratory infections are one of the [ ]

a) Infectious disease
b) Non infectious disease
c) Hereditary disease
d) Vector born disease
2. Which age group of people are more prone to get URTI [ ]
a) Teenagers
b) Middle age group
c) Under five children
d) Old age
3. Who is more vulnerable to get upper respiratory tract infections [ ]
a) Beast feeded child
b) Handicapped children
c) Immunized child
d) Malnourished child
4. During which season URTI more common [ ]
a) Spring season
b) Summer season
c) Rainy season
d) Winter season
5. Which of the following is the cause of URTI [ ]
a) Viral and bacterial infections
b) Warm infestations
c) chromosomal alterations
d) Parasitic infections
6. Which is the common risk factors of URTI [ ]
a) Allergies and malnutrition or low immunity
b) Children who took all vaccines
c) Children who feeded
d) Handicapped children
98
7. How URTI will transmitte from one person to another person [ ]
a) Through injections
b) Through Blood transfusion
c) Trough contaminated food
d) Through droplet
8. What is meant by rhinitis [ ]
a) Inflammation of nasal mucosa
b) Inflammation of oral mucosa
c) Inflammation of trachea
d) Inflammation of oesophagus
9. Which of the following complaints will present in rhinitis except [ ]
a) Running nose and sneezing
b) Fever and cough
c) Postnasal drip
d) Facial puffiness
10. What is meant by pharyngitis [ ]

a) Inflammation of the teeth
b) Inflammation of gums
c) Inflammation of the food or air passage
d) Inflammation of tongue
11. What are the symptoms you will see in acute pharyngitis [ ]
a) Fever and throat pain
b) Enlargement of lymphoid
c) Loss of consciousness
d) Increased heart rate
12. What is meant by tonsillitis [ ]

a) Inflammation of food passage
b) Inflammation of adenoid tonsils
c) Inflammation of wind pipe
d) Inflammation of salivary glands
99
13. What are the common symptoms present in tonsillitis [ ]
a) Decreased body temperature
b) Difficulty in swallowing
c) Bleeding from gums
d) Increased salivation
14. Which is the most simplest method to identify Upper Respiratory Tract Infections
[ ]
a) Throat examinations
b) Blood tests
c) Bronchoscope
d) Endoscopy
15. What are the following complications will occur due to upper respiratory infections
except [ ]
a) Rheumatic fever
b) Otitis media
c) Bronchopneumonia
d) Growth retardation
100
Section-II
QUESTIONNAIRE RELATED TO PRACTICE
16. Are you Allowing your child to play during respiratory distress [ ]
a) Yes
b) No
17. Are you Providing adequate fluids to your child which is helpful to expel the
thick sputum [ ]
a) Yes
b) No
18. Are you providing warm moist inhalation to your child to reduce nasal blockage
[ ]
a) yes
b) No
19. Are you Using warm salt water gargle to your child to reduce throat pain
[ ]
a) Yes
b) No
20. Are you providing semi Solid diet to your child while child having throat pain
[ ]
a) Yes
b) No
21. Are you Using of Tulasi for your child to relief from symptoms of Upper
Respiratory Tract Infections [ ]
a) Yes
b) No
101
22. Are you taking your child to health centre when your child is having severe
cough, not taking feeds properly and continuous fever [ ]
a) Yes
b) No
23. Are you providing good ventilation and hygienic environment to your child to
reduce URTI [ ]
a) Yes
b) No
24. Are you providing pulses and legumes and nuts to increase immunity and to
decrease occurrence of URTI [ ]
a) Yes
b) No
25. Are you immunizing your child as per schedule which is useful to reduce
URTI [ ]
a) Yes
b) No
26. Are you using clean cloth to cover the nose while sneezing and coughing
[ ]
a) Yes
b) No
27. Are you using separate towels, soaps, to prevent spread of Upper Respiratory
Tract Infections [ ]
a) Yes
b) No
28. Are you following good hand washing to prevents Upper Respiratory Tract
Infections [ ]
a) Yes
b) No
102
29. Are you providing good and hygienic environment to prevent Upper Respiratory
Tract Infections [ ]
a) Yes
b) No
30. Are you following seasonal precautions to prevent Upper Respiratory Tract
Infections [ ]
a) Yes
b) No
103
PART-C
LIKERT 3 POINT ATTITUDE SCALE
POSITIVE ATTITUDE SCALE
S.N ATTITUDE AGREE DISAGRE STRONGL REMARK

O E Y S
DISAGREE
1. Upper Respiratory
Infections are one of
infectious disease?
2. Respiratory infections are
common to under five
children?
3. Viral and bacterial causes
are the common causes
for URTI?
4. Inflammation of nasal
cavity is rhinitis?
5. Running nose is the
symptom of rhinitis?
6. Pharyngitis means
inflammation to food
passage?
7. Throat pain is the one of
the symptom of
pharyngitis?
8. Tonsillitis means
inflammation of adenoid
tonsils?
9. Difficulty in swallowing
is the common symptom
of tonsillitis?
10. By signs and symptoms
we can diagnose the URT
11. Symptoms more than two
weeks needs to medical
care
12. Rheumatic fever is one of
the complication of URTI
13. Hygienic practices will
decrease prevalence of
URTI?
14. Immunization will
prevent URTI?
15. By covering mouth and
nose during coughing and
sneezing can prevent
occurrence of URTI?
104
APPENDIX-D
SCORING KEY
Question No. Answer key Scoring
1. C 1
2. D 1
3. D 1
4. A 1
5. A 1
6. D 1
7. A 1
8. D 1
9. C 1
10. A 1
11. B 1
12. B 1
13. A 1
14. B 1
15. B 1
16. A 1
17. A 1
18. A 1
19. A 1
20. A 1
21. A 1
105
22. A 1
23. A 1
24. A 1
25. A 1
26. A 1
27. A 1
28. A 1
29. A 1
30. A 1
Each correct answer carries one mark;
Answer key for Attitude Scale

S.No. Scoring
Agree 3 marks
Disagree 2 marks
Strongly disagree 1 marks
Total 45
Positive attitude – above 22 scores
Negative attitude- below 22 scores
106
APPENDIX -E
CERTIFICATION OF VALIDATION
This is to certify that the tools developed by -------------------, 2nd year M.Sc nursing
student of PES college of nursing, Kuppam, chittoor district, Andhra Pradesh, on the topic, a
study to assess the effectiveness of the planned teaching programme on knowledge, practice
and attitude of mothers among under five children regarding upper respiratory tract infection
in patrapalli village, V-kota mandal, chittoor (dist) ,2012-1013” is validated by the under
signed experts nursing professionals to proceed with this tool to conduct main study.
Signature of experts with designation Place:

Date:
107
108
109
110
111
112
113
114
115
116
117
APPENDIX-G
PLANNED TEACHING PROGRAMME
ON
UPPER RESPIRATORY TRACT INFECTION
INTRODUCTION:
Many systemic diseases begin in the upper respiratory tract, including measles,
mumps, and smallpox. These may have few, if any, respiratory tract symptoms. Symptomatic
infections that are confined to the upper respiratory tract and are termed upper respiratory
infections (URI's) include rhinitis (the common cold), pharyngitis, epiglottitis, and bronchitis.
Pharyngitis or a sore throat is one of the most common infectious diseases that present to the
primary care physician. Many, many viruses can cause a sore throat but there are only three
bacteria that do so fairly frequently. Otitis media is another very common childhood infection
that originates in the throat.
DEFINITION:
Upper respiratory tract infections are the illnesses caused by an acute infection which
involves the upper respiratory tract: nose, sinuses, pharynx or larynx. This commonly
includes: tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold.
CAUSES:
Upper Respiratory Infection that are listed by the Diseases
 Parainfluenza
 Pneumococcus
118
 Adenovirus
 Respiratory syncytial virus
 Diphtheria
 Measles
 Haemophilus influenzae
 Bornholm disease
 Influenza
 Rotavirus
 Rhinovirus
 Coxsackie B virus
 Streptococcus Group A
 Human metapneumovirus
 Pseudomonas aeruginosa
 Whooping cough
RISK FACTORS
A risk factor is something that increases likelihood of getting a disease or condition.
It is possible to develop a Common Cold or Seasonal Influenza with or without the
risk factors listed below. However, the more risk factors you have, the greater your likelihood
of developing a cold or influenza. If you have a number of risk factors, The vast
119
majority of the population in any given area may get colds or influenza during the course of a
year. The average rate for adults in the US is three or four infections per person per year.
Children get even more.
Risk factors include:
Smoking Maternal smoking during pregnancy and postnatal passive exposure predispose
the children of smokers to recurrent respiratory infections.
Poor Hygiene Colds and influenza are passed through person-to-person contact, so people
who do not wash their hands are at higher risk of spreading and contracting colds. Also,
touching nose, mouth, and eyes with contaminated fingers can spread germs.
Crowded Populations People in crowded living conditions are at an increased risk, as
well.
Medical Conditions Children who have certain medical conditions are at a higher risk for
complications. The underlying disorders associated with recurrent respiratory tract infections
are congenital malformations of the upper or lower respiratory tract and cardiovascular system
 recurrent aspirations,
 Defects in the clearance of airway secretions, especially cystic fibrosis and ciliary
abnormalities, and disorders of systemic and local immunity.
120
 In children with onset of symptoms at an early age, structural or functional anomalies
of the airway or the lung are important causes such as tracheo-oesophageal fistula or
sequestration.
Age: Children and the elderly are at increased risk for complications.
Environmental factors:
That increase the risk include
 Group child care, n
 Number of hours in child care,
 exposure to children at home or in child care,
 Number of smokers and cigarettes smoked in the household,
 Feeding in the supine position,
 Autumn season and
 Shorter duration of breast feeding.
RHINITIS
Introduction
In rhinitis, the inflammation of the mucous membrane is caused by viruses, bacteria,
irritants or allergens. The inflammation results in the generation of large amounts of mucus,
commonly producing a runny nose, as well as a stuffy nose and post-nasal drip. In the case of
121
allergic rhinitis, the inflammation is caused by the degranulation of mast cells in the nose.
When mast cells degranulate, they release histamine and other chemicals, starting an
inflammatory process that can cause symptoms outside the nose, such as fatigue and malaise.
DEFINITION:
Inflammation of the nasal mucosa
CAUSES:
There are hundreds of different viruses that cause the common cold. The most common
viruses belong to groups of viruses known as rhinoviruses or corona viruses. As there are so
many viruses and because the viruses constantly change, the body's immune system is unable
to recognize each new virus which is why children catch colds year after year.
 A cold or upper respiratory infection is a viral infection of the nose and throat.
 The cold viruses are spread from one person to another by hand contact, coughing, and
sneezing.
 Colds are not caused by cold air or drafts.
 Because there are up to 200 viruses that cause colds, most healthy children get at least
six colds a year.
SINGS AND SYMPTOMS:
122
When an allergy affects nose, you sneeze a lot, there is itching in the nose, eyes or
throat, your nose gets runny and blocked and eyes keep watering.
 runny or stuffy nose
 usually a fever and sore throat
 sometimes a cough, hoarseness, red eyes, and swollen lymph nodes in the neck
 Nasal Congestion
HOME CARE
Not much can be done to affect how long a cold lasts. However, we can relieve many of
the symptoms. Keep in mind that the treatment for a runny nose is quite different from the
treatment for a stuffy nose.
Treatment for a runny nose with a lot of discharge.
The best treatment is clearing the nose for a day or two. Sniffing and swallowing the
secretions is probably better than blowing because blowing the nose can force the infection
into the ears or sinuses. For younger babies, use a soft rubber suction bulb to remove the
secretions gently. Put petroleum jelly around the nostrils to protect them from irritation.
Nasal discharge is the nose's way of getting rid of viruses. Antihistamines are not helpful
unless your child has a nasal allergy.
123
Treatment for a dry or stuffy nose with only a little discharge or dried yellow-green
mucus.
Most stuffy noses are blocked by dry mucus. Blowing the nose or suction alone
cannot remove most dry secretions. Using nose drops and then suctioning or blowing out the
fluid in the nose can help. This is called a nasal wash. Nose drops of warm tap water or
saline are better than any medicine you can buy for loosening up mucus.
The importance of clearing the nose of a young infant.
A child can't breathe through the mouth and suck on something at the same time. If
your child is breast- feeding or bottle-feeding, you must clear his nose out so he can breathe
while he's sucking. It is also important to clear your infant's nose before you put him down to
sleep.
Prevention of colds.
A cold is caused by direct contact with someone who already has a cold. Over the
years we are all exposed to many colds and develop some immunity to them. Complications
from colds are more common in children during the first year of life. Try to avoid undue
exposure of young babies to other children or adults with colds, day care nurseries, and church
nurseries.
124
A humidifier prevents dry mucous membranes, which may be more susceptible to
infections. Vitamin C, unfortunately, has not been shown to prevent or shorten colds.
steam inhalations:
Steam inhalation or inhalations containing menthol and essential oils will help ease
nasal congestion. Applying these inhalations or vapors rubs to a child's clothing can also help
clear a blocked nose. Throat lozenges and gargles help soothe a sore throat. However, to avoid
the risk of choking, such preparations should only be used in children who are old enough to
use them properly
PHARYNGITIS
It is an inflammation of the throat. In most cases it is quite painful, and is the most
common cause of a sore throat Like many types of inflammation, pharyngitis can be acute –
characterized by a rapid onset and typically a relatively short course – or chronic. Pharyngitis
can result in very large tonsils which cause trouble swallowing and breathing. Pharyngitis can
be accompanied by a cough or fever.
125
Cause
The majority of cases are due to an infectious organism acquired from close contact with an
infected individual.
Infectious
Viral
These comprise about 40–80% of all infectious cases and can be a feature of many different
types of viral infections.
 Adenovirus – the most common of the viral causes. Typically the degree of neck
lymph node enlargement is modest and the throat often does not appear red, although
it is very painful.
 Orthomyxoviridae which cause influenza – present with rapid onset high temperature,
headache and generalised ache. A sore throat may be associated.
 Infectious mononucleosis ("glandular fever") caused by the Epstein-Barr virus. This
may cause significant lymph gland swelling and an exudative tonsillitis with marked
redness and swelling of the throat. The heterophile test can be used if this is suspected.
 Herpes simplex virus can cause multiple mouth ulcers.
 Measles
126
 Common cold: rhinovirus, coronavirus, respiratory syncytial virus, parainfluenza virus
can cause infection of the throat, ear, and lungs causing standard cold-like symptoms
and often extreme pain.
Bacterial
A number of different bacteria can infect the human throat. The most common is Group A
streptococcus, however others include Corynebacterium diphtheriae, Neisseria gonorrhoeae,
Chlamydophila pneumoniae, and Mycoplasma pneumoniae.
Symptoms of Pharyngitis:
 Pharyngitis may develop gradually. It is often accompanied by the flu or a cold, and
body aches.
 If a fever is present, it will generally be in the range of 101 degrees F or below.
 Symptoms may be associated with swollen and tender lymph nodes in the neck.
 Fever is typically 102 degrees F or higher.
 The throat may appear extremely red and have either white or yellow spots at the back.
HOME CARE:
To relieve sore throat pain, one should follow the same time-honored theory used in
treating a cold:
127
 Good nutrition,
 Adequate rest,
 And plenty of liquids
 Gargling several times a day with a mixture of 1 teaspoon of salt stirred into 8 ounces
of warm water can also temporarily soothe a sore throat, break up congestion, and help
flush out bacteria if present.
 A cup of tea or hot chocolate can relieve a sore throat by warming the irritated
membranes.
 People with cold-congested noses tend to breathe through their mouths. To prevent this
from causing a dry, sore throat; drink extra liquids throughout the day.
TONSILIS
Tonsillitis is inflammation of the tonsils most commonly caused by a viral or bacterial
infection whose symptoms include sore throat and fever.
The overwhelming majority of patients recover completely with or without medication.
In 40%, symptoms have resolved in three days and within one week in 85%, regardless of
whether streptococcal infection (a common cause) is present or not.
Causes
Tonsillitis (inflammation of the tonsils) is most often caused by one of the common viruses.
128
Sometimes it can be caused by bacteria. It’s often difficult to tell the difference between viral
and bacterial tonsillitis.
Bacterial causes include streptococcal infection (caused by Streptococcus Group A).
Left untreated, this kind of infection can cause complications such as scarlet fever, middle ear
infections and, rarely, rheumatic fever (which affects the heart) or glomerulonephritis (which
affects the kidneys). Bacterial tonsillitis is uncommon in children under five.
Common signs and symptoms include sore throat
 red, swollen tonsils
 pain with swallowing
 high temperature (fever)
 headache
 tiredness
 chills
 a general sense of feeling unwell (malaise)
 white pus-filled spots on the tonsils
 swollen lymph nodes (glands) in the neck
 pain in the ears or neck
129
Less common symptoms include:
 nausea
 stomach ache
 vomiting
 furry tongue
 bad breath (halitosis)
 voice changes
 difficulty opening the mouth (trismus)
In cases of acute tonsillitis, the surface of the tonsil may be bright red and with
visible white areas or streaks of pus.
TonsillolithsS occur in up to 10% of the population frequently due to episodes of
tonsillitis.
PREVENTION:
 Good nutrition, liquid diet
 Adequate rest,
 And plenty of liquids
130
 Gargling several times a day with a mixture of 1 teaspoon of salt stirred into 8 ounces
of warm water can also temporarily soothe a sore throat, break up congestion, and help
flush out bacteria if present.
Prevention of URTI:
We live in a social world in which people come into close contact with others every day.
Upper respiratory infection prevention includes:
 avoiding people who are ill;
 if you are ill, remain at home until you are no longer contagious;
 avoid touching your nose, eyes, and mouth;
 cover the cough and sneeze; sneezes and coughs should be covered with the elbow or
sleeve - not the hand; and
 Wash your hands often and properly (20 seconds or more with soap and warm water).
 Lifestyle modifications such as smoking cessation and stress management may
decrease your susceptibility to "catching" the common cold.
131
132

JNT Pro 1

Hochgeladen von

Dokumentinformationen

Originalbeschreibung:

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

JNT Pro 1

Hochgeladen von

Copyright:

Verfügbare Formate

CHAPTER-I

cannot make decisions for themselves. (Wong’s, 2005).

DR Redding BA, 2005).

In India under-five children constitute about 13 % of the total population of India.

diarrhea, measles, malaria, malnutrition or a combination of this illness. Acute respiratory

(Gupta Neeru, et.al., 2007).

A report by Director General of Health Services, Government of India,

and census commissioner, New Delhi, India, 2001).

A Quasi experimental study was conducted in Trichy on the effectiveness planned

teaching programme on knowledge, attitude and practice of acute respiratory infections

knowledge ,attitude and practice of mothers regarding acute respiratory infections.

(M.s.Shereena G Edwin, 2007).

NEED FOR THE STUDY

neonatal pneumonia cause 20 % to 35 % of the mortality among under-5 children.

% to 90 % are due to upper respiratory infections and 10 % to 13 % by acute lower respiratory

tract infections 12 to 14 Further, 96.5 % of mortality due to respiratory events is contributed

outpatients and admissions are due to acute respiratory events.

changes in the existing knowledge. (Park .k, 2007)

A large number of diseases could be prevented with little or no medical interventions.

like staphylococcal pericarditis, emphysema, pneumothorax, and staphylococcal pneumonia.

This increases the risk of child mortality.

During my community posting in patrapalli V- kota mandal, chittoor district I saw

complications of upper respiratory infections.

STATEMENT OF THE PROBLEM

Patrapalli village, V.kota mandal, Chittoor district, Andhrapradesh.

OBJECTIVES OF THE STUDY

programme in Experimental group.

infections in experimental and in control group.

demographic variables in experimental group

It refers to the extent of achievement on knowledge, practice and attitude of

mothers of under five children.

Planned Teaching Programme

It refers to impart knowledge regarding acute respiratory tract infections

among mothers under five children.

Knowledge refers to the understanding of mothers regarding upper respiratory tract

infections by asking the correct answer for particular questions.

during Upper Respiratory Tract Infections.

are suffering from upper respiratory tract infections.

Upper Respiratory Tract Infections

It refers to occurrence of infections to upper respiratory tract infections. Mainly

Rhinitis, Pharyngitis, tonsillitis.

Mothers of Under Five Children

It refers to mothers who have children of birth to five years.

Respiratory Tract Infections among mothers of under five children in experimental

RH2: There will be significant increase in knowledge regarding Upper Respiratory

Tract Infections among mothers of under five children after administration of

Planned teaching programmes

RH3: There will be a significant difference in knowledge of upper respiratory infections

among mothers between experimental group & control group.

Upper Respiratory Tract Infections

2. Administration of planned teaching programme regarding prevention of upper

prevention of Upper Respiratory Tract Infections

3. Demographic variables of the mothers may have influence on knowledge

regarding prevention of Upper Respiratory Tract Infection

1. Mothers who have under five children.

2. Planned teaching program.

3. Mothers who can understand Telugu only.

Conceptual frame work means ‘interrelated concepts or obstructions’ that are

 Closed system and

system. An open system consists of the

Input is considered as assessment of knowledge, attitude, practice of upper respiratory

signs and symptoms, management.