A Descriptive Study to Assess the Knowledge regarding Paediatric Deep Breathing and Coughing exercises among parents of children in a selected Hospital, Kottayam

 

Joslin John¹, Annu Thankachan², Anu Roy², Anu Saji², Ashna Jaimon²,

Priya Ann Siby², Riya Babu², Sajithamol V. S², Sani Sara Mammen²,

Sethulakshmi M. S²

¹Assistant Professor, Dept. of Child Health Nursing, Caritas College of Nursing, Kottayam, Kerala.

²Third Year B.Sc. Nursing Students, Caritas College of Nursing, Kottayam, Kerala.

 

Abstract:

The present study was conducted in a selected hospital, Kottayam, to assess the knowledge of parents regarding paediatric deep breathing and coughing exercises. The objectives of the study were to assess the knowledge of parents regarding paediatric deep breathing and coughing exercises and to find the association between knowledge and selected demographic variables. Convenience sampling technique was used to select 50 samples. A self-administered questionnaire was used to assess the knowledge. The data obtained was analysed by using descriptive and inferential statistics. Data analysis reveals that among 50 parents, 54% of subjects have good knowledge, 34% have average knowledge, 12% have excellent knowledge and none of them had poor knowledge. The association between knowledge and selected demographic variables was analysed using chi-square test.  There was no association between level of knowledge and demographic variables. The findings of the study have implications in nursing practice, nursing education, nursing administration and nursing research. Nurses play a major role in providing health teaching on paediatric deep breathing and coughing exercises.

 

 

 

INTRODUCTION:

Deep breathing helps to deliver nutrient rich oxygen throughout the body. The delivery of the oxygen also helps to eliminate waste in the body and helps to maintain healthy self¹. Deep breathing is a technique that can be used anywhere. When we are in a state of stress, our bodies are in a “fight or flight” response, with an increase in heart rate and rapid, shallow breathing². Taking just a few moments each day to practice some deep breathing exercises can decrease stress, relax mind, body and helps to sleep better. Deep breathing exercises are proven to be very effective in the prevention of respiratory infections also.

 

NEED FOR THE STUDY:

Acute respiratory infection is an acute infection of any part of the respiratory tract and related structures including para nasal sinuses, middle ear and plural cavity. It may cause inflammation of respiratory tract anywhere from nose to alveoli³. The incidence of ARI is highest in young children especially below five years of age and decreases with increasing age⁴_.

 

Parents have the vital role in the prevention of respiratory tract infection in the children. Parents can teach children about deep breathing exercise through various methods according to the age groups. Prevention of respiratory tract infection is the first step in moulding a healthy child. Deep breathing techniques are effective in the prevention of respiratory tract infection.

PROBLEM STATEMENT:

A descriptive study to assess the knowledge regarding paediatric deep breathing and coughing exercises among parents of children in a selected hospital, Kottayam.

 

OBJECTIVES:

The objectives of the study are:

·       Assess the knowledge of parents regarding paediatric deep breathing and coughing exercises.

·       Find the association between knowledge of parents and selected demographic variables.

 

OPERATIONAL DEFINITIONS:

Knowledge: In this study, knowledge refers to the awareness of parents regarding the paediatric deep breathing and coughing exercises, which is measured using a structured self-administered questionnaire.

 

Parents: In this study, parents refer to the father or mother of the child who are in the age group (1-10years) admitted or consulted in the paediatric department in a selected hospital, Kottayam.

 

Paediatric deep breathing and coughing exercises: In this study paediatric deep breathing and coughing exercises include flower and candle breathing, bubble bee breathing, using stuffed animals, rainbow breathing which helps to increase the lung capacity and prevent respiratory tract infections.

 

HYPOTHESIS:

The hypothesis is tested at 0.05 level of significance.

H_1:   There is a significant association between level of knowledge and selected demographic variables.

 

ASSUMPTIONS:

·       Respiratory infections are very common among children under 10 years of age.

·       Practice of deep breathing and coughing exercise can prevent and manage respiratory infection among children.

 

Delimitations:

The study is delimited to the parents of 1–10-year-old children, admitted or consulted in the paediatric department of a selected hospital

 

REVIEW OF LITERATURE:

A study was conducted to assess the effectiveness of Strelnikova breathing exercise on respiratory sign and parameters among children with lower respiratory tract infections (LRTI) in Masonic hospital, Coimbatore. The research study made use of quasi experimental non-equivalent control group pre-test and post-test design. There are 30 samples in both experimental and control group. In experimental group the intervention of Strelnikova breathing exercise was taught to children and made them to do the exercises daily for 30 minutes in the morning, afternoon and evening for 5 days. In control group the existing hospital routine was practiced. There is significant difference in respiratory sign, peak flow rate and oxygen saturation level (p<0.05) between experimental group and control group. The investigator concluded that Strelnikova breathing exercise was beneficial and there was a significant reduction in respiratory signs and improvement in respiratory parameters in experimental group (P<0.05) among children with lower respiratory tract infections⁵.

 

A quasi-experimental study was done to assess the effectiveness of breathing exercise as a play way method on respiratory signs and pulmonary parameters among children [six to twelve years] with LRTI at paediatric ward of GGSMH Faridkot, Punjab. A total of 90 children were selected for this study, 45 in experimental and 45 in control group. Data was collected through structured interview schedule and standardized tool. It is concluded that breathing exercise as a play way method is found to be more effective in reducing respiratory signs and in improving pulmonary parameters as compared to control group [p<0.001]⁶.

 

Non-equivalent control group design was done to assess the effectiveness of breathing exercise on LRTI among school children at tertiary hospitals, Guntur District, Andhra Pradesh. There are 60 samples were selected and divided into two groups by using convenient sampling technique. Data collected using structured questionnaire and check list. The result shows that there was statistically significant difference in pre-test and post-test scores [p<0.001]. This showed that there was an effectiveness of Strelnikova exercises on lower respiratory tract infection⁷.

 

Research Design: 

The research design is the plan, structure and strategy of investigation of answering research question. It is the plan or blueprint the researcher select to carry out their study. Research design for the present study is non-experimental descriptive design.

 

Setting of the Study:

This study was conducted in the Paediatric department of Caritas Hospital, Thellakom, Kottayam, which involves BT 1^st, Paediatric Ward, SP 2 and Paediatric outpatient department. It is a multi-speciality Hospital with a bed strength of 635. The Paediatric OPD runs six days in a week and there are 60 inpatient beds in the Paediatric department.

 

Population:

In this study, population refers to all the parents whose children are at the age group of one to ten years of age, who are accompanying their children in the Paediatric departments of Caritas Hospital.

 

Sample Size:

In this study, number of samples include 50 parents, who are accompanying their children in the Paediatric department of Caritas Hospital. The sample size was limited to 50 parents considering the time allotted for data collection.

 

Sampling Technique:

Non-probability convenience sampling technique was used to select 50 samples.

 

Criteria for Sample Selection:

Inclusion criteria:

Parents who are,

1    Having children between the age group of one to ten years.

2    Willing to participate in the study.

3    Accompanying their children in the Paediatric ward.

 

Exclusion criteria:

Parents who have chronically ill children.

 

Tool:

The tool used for the study was a structured knowledge questionnaire. This instrument consists of two parts;

Part A: Demographic Proforma:

This questionnaire was prepared by the investigator. It requests information regarding the age of parents, sex, religion, family type, family income, place of living, education, occupation, number of children and source of information.

Part B: Self-administered knowledge questionnaire to assess the knowledge of parents regarding deep breathing and coughing exercises among children.

 

Score Interpretation:

This questionnaire consists of 30 multiple choice questions under different areas.

Each question had four options with one correct answer and three distractors. Each correct answer carries one mark and wrong answers a score of zero, with a total of 30 marks. Overall score was categorized as follows;

0-6           =              Poor

7-14        =              Average

15-21     =              Good

22-30     =              Excellent

 

 

RESULTS:

Table 1: Frequency and percentage distribution of subjects based on age, sex, family type, family income and place of living n=50

 

Table 2: Frequency and percentage distribution of subjects based on education, occupation, number of children and previous knowledge n=50

 

The above table reveals that 36% of the samples were in the age group of 31-35 years, 82% of samples were female, half of samples were in the nuclear family and next half were in the joint family,42% of samples have a family income of 11,000-50,000 rupees, 70% of samples were living in the urban area,40% of samples were educated up to degree,50% of samples were professionals,52% of samples have 2 children,56% of samples have previous experience regarding paediatric deep breathing and coughing exercises .

 

Fig1.Pie graph showing the distribution of subjects based on the level of knowledge.

The above graph reveals that among 50 parents, 54% of subjects have good knowledge, 34% have average knowledge, 12% have excellent knowledge and none of them had poor knowledge.

 

Table 3: Mean and standard deviation of the overall knowledge score

 

As depicted in the above table 2, the mean knowledge score was 16.5 with a standard deviation of 4.25. The range of score was nine to twenty-eight. The maximum score of the questionnaire was 30.

 

The study revealed that among 50 subjects, 27(54%) have good knowledge, 17(34%) have average knowledge, six (12%) have excellent knowledge and none of them have poor knowledge. There is no significant association between level of knowledge and selected demographic variables like age, sex, religion, family type etc.

 

CONCLUSION:

Knowledge of parents regarding paediatric deep breathing and coughing exercises was assessed. The finding showed much of parents, 27(54%) had good knowledge,17(34%) has average knowledge,6(12%) has excellent knowledge none of them have poor knowledge.  In the present study, there is no significant association between demographic variables such as age, sex, religion, family type etc.

 

NURSING IMPLICATIONS:

The finding of the study has implications in the field of nursing education, nursing practice, nursing administration, and nursing research.

 

Nursing Education:

●      Nurses play a major role in providing health teaching on paediatric deep breathing and coughing exercises for parents in hospital and community setting.

●      Student nurses should be deeply knowledgeable about the paediatric deep breathing and coughing exercises, to manage the breathing problems of children.

 

Nursing practice:

●      Paediatric nurses have an additional responsibility to provide situation based incidental health teaching for parents or caregivers for children.

●      Nurses should be informed with up-to-date information, regarding paediatric deep breathing and coughing exercises.

●      The student nurses should improve their knowledge level and should be able to apply it on further care of patients with breathing problems.

 

Nursing Administration:

●      These administrators should teach the staff nurses and motivate them to provide health education to parents regarding paediatric deep breathing and coughing exercises.

●      Awareness programs must be planned and conducted in hospitals and in other areas regarding the same.

●      Administrators can also plan and organize continuing nursing education program for the nursing personnel.

 

Nursing Research:

●      There are only few research studies has been conducted to assess the knowledge regarding paediatric deep breathing and coughing exercises.

●      The impact of paediatric deep breathing and coughing exercises is to be investigated further.

 

RECOMMENDATIONS:

●      The study can be replicated on a large sample of children and their parents for wider generalization of the findings

●      Attitude and practice of parents regarding paediatric deep breathing and coughing exercises can also be evaluated.

●      The study can be replicated on a large sample of children and their parents for wider generalization of the findings

●      An experimental study can be conducted with a structured teaching program.

●      Similar studies can be conducted in different settings.

 

REFERENCE:

1.      Ashalatha PR, Deepa G, Textbook of Anatomy and Physiology for Nurses. 3^rd ed. New Delhi: Jaypee Brothers Medical Publishers; 2011. p. 179-91.

2.      Joyce M Black, J H Hawks. Medical Surgical Nursing. Clinical Management for positive outcomes. 3^rd edition. Mumbai: Elsevier publishers; 2012. p. 1525-29.

3.      Park K. Park's textbook of preventive and social medicine.24^th ed. New Delhi: Banarsidas Bhanot publishers; 2017. p. 860-65.

4.      Mariyln J, Kockenberry, Wilson D, Wongs Essentials of pediatric nursing. India: Elsevier Mosby; 2008.p. 38,39.

5.      Vimala A, Effectiveness of Strelnikova breathing exercises on respiratory signs and parameters among children with Lower Respiratory Tract Infections of Masonic Hospital, Coimbatore. International Journal of Applied Research. 2012Jan [ cited 2012 April]. Available from: https://www.researchgate.net/publication/ 225088883_effectiveness of strelnikova breathing exercises on respiratory signs and parameters among children with lower respiratory tract infections LRTI.

6.      Karamjeet K, Effectiveness of breathing exercises among children of Faridkot, Punjab. International Journal of Scientific and Engineering Research .2018 Nov [ cited 2019 Dec ].Available from : https://www.ijser.org/onlineResearchPaperViewer.aspx?A-study-to-assess-the-effectiveness-of-Breathing-Exercises-AS-A-Play-way-Method-on-respiratory-signs-and-pulmonary-parameters.pdf

7.      Padmaja D, Gomathi S, Effectiveness of breathing exercises among school children at tertiary hospitals, Guntur, Andhra Pradesh. ACTA Scientific medical sciences.2019 Dec [cited 2020 Jan]; 4(1): 90-95. Available from:https://www.researchgate.net/publication/338140337_effectiveness_of_breathing_exercises_regarding_lower_respiratory_tract_infections_among_children

 

 

 

 

Received on 11.08.2021       Modified on 23.09.2021 Accepted on 14.10.2021      ©A&V Publications All right reserved Research J. Science and Tech. 2022; 14(1):41-46. DOI: 10.52711/2349-2988.2022.00006