Effect of An Information Booklet on Practice of Caregivers regarding care of Children with Nephrotic Syndrome in selected Hospitals of Mumbai

 

Chhameshwari Verma

Nursing Tutor, Dept. of Child Health Nursing, College of Nursing, All India Institute of Medical Sciences, Raipur, Chhattisgarh, 492099, India

 

ABSTRACT:

Background of the study: Renal disease which is most commonly seen in children is nephrotic syndrome. In pediatrics the most common form is primarily minimal change nephrotic syndrome. As this disease is responsible for frequent hospitalization, responsibility of parents and health care professionals is increased. Parents are responsible for overall care of children so it is necessary to have knowledge regarding measures to be taken for providing adequate care to children and strict adherence to therapeutic regimen. They should have some ready reference material to collect proper information and instructions about how to go forward to maintain their child’s health.^2,7 Aims: Effect of an information booklet on practice of caregivers regarding care of children with nephrotic syndrome in selected hospitals of Mumbai. Methodology: A descriptive evaluative approach was used. One group pre-test and post-test research design was adopted. A non probability convenience sampling technique was used and 30 sample from selected hospitals of Mumbai were selected. An information booklet was developed and administered. For assessing practice of sample observation checklist was used and analyzed by using descriptive and inferential statistics. Result: Overall improvement in for practice was increased from 42% in pre test to 71% in post test. for post –test practice scores computed SD (standard deviation) was 2.85 and calculated ‘t’ value was 15.74 which proved that information booklet was effective in improvement of practices of sample. Conclusion: The findings of the study showed that there was significant improvement in practice of caregivers regarding care of children with nephrotic syndrome after administration of information booklet.

 

 

 

INTRODUCTION:

“The best prescription is knowledge”

                                                          Dr. C. Everett Koop¹

 

Children are like flowers and they require special attention and care. They are very sensitive to external environment and are not able to express themselves properly. Kidney diseases are one of the fatal problems which affect children ‘s health status.

 

Nephrotic syndrome is most common renal disease among children, which impairs the function of kidney. Nephrotic syndrome is a pattern of presentation of renal disease, rather than a single pathological entity or diagnosis, which damages the kidney’s filtering system that is glomeruli, which filter waste and excess water from blood.^3,4

 

According to the definition of international study of kidney diseases in children (1978), Nephrotic syndrome is defined as the syndrome which is fulfilled in proteinuria exceeds 40mg/m²/hour and serum albumin drops below 2.5gm/litre. The clinical picture is categorized by hypovolemia and edema with their entire sequelae.⁵

 

According to the intemational study of clinical disorder in childhood (ISKDC) 2007:

·       85% of all children have minimal change nephrotic syndrome (MCNS)

·       9.5% have focal segmental glomerulosclerosis (FSGS)

·       2.5% have mesangial nephropathy or other etiologies.⁶

 

The incidence of minimal change nephrotic syndrome in children is also high in India. An article on nephrotic syndrome published in Indian journal of nephrology (2008) shows that pattern of disease presentation varies according to the demographic location. The prevalence of minimal change disease also varies within India. It is <12% in Vellore in the southern part of the country and approximately 33% in Haryana. The reported prevalence of minimal change disease in other countries like in Thailand and Iraq is < 17%.⁸

 

Although minimal change nephrotic syndrome is an acute and curable disease, educating caregivers and family members about disease, management and self care in totality is most crucial factor for better prognosis of child.

 

Statement of Problem:

Effect of an information booklet on practice of caregivers regarding care of children with nephrotic syndrome in selected hospitals of mumbai.

 

OBJECTIVES:

·       To develop an information booklet on care of children with nephrotic syndrome.

·       To assess the practice of the caregivers regarding care of child with nephrotic syndrome before administration of information booklet.

·       To assess the practice of the caregivers regarding care of child with nephrotic syndrome after administration of information booklet.

 

Hypothesis:

H1-There is no difference between pre test and post test practice score of caregivers of children with nephrotic syndrome.

 

METHODOLOGY:

A descriptive evaluative approach was used.

 

Research Design:

One group pre test and post test design was used.

 

Sampling Technique:

Non probability convenience sampling technique was used.

Sample Size and Study Setting:

The sample consisted of 30 caregivers of children with nephrotic syndrome of selected hospitals of Mumbai.

 

Inclusion Criteria:

·       Caregivers of children who were diagnosed with nephrotic syndrome

·       Caregivers of children with nephrotic syndrome irrespective of duration of illness

·       Parent or parent substitutes who takes care to the child.

 

Exclusion Criteria:

1    Caregivers of children with nephrotic syndrome who were not able to understand or read or write Hindi or English or Marathi

2    Caregivers of children with age of more than 14 years suffering from nephrotic syndrome

 

Tool Preparation:

Tool has 2 parts.

Tool 1: Semi structured questionnaire

A] Demographic data of caregivers and children with nephrotic syndrome

 

Tool 2: Observation check list

Practices carried out by caregivers for care of children with nephrotic syndrome.

 

In this study, researcher assessed practices regarding overall practice related to care of children with nephrotic syndrome which included aspects like measuring intake and output, assessment of edema, weight recording, urine testing and dietary measures.

 

Data Collection Process:

The investigator visited the hospitals and obtained permission from the hospital authorities to conduct the study. The samples were selected from the selected hospitals of Mumbai. The investigator identified caregivers of children with nephrotic syndrome and briefed each sample about the study, its purpose and process. A brief assessment was done to confirm whether they fulfill inclusion criteria selected for the study. The contents of the consent form were explained and demographic data was collected. The investigator gave instructions to the caregivers and pretest practice was observed regarding care of children with nephrotic syndrome by using observation checklist. After this information booklet was given to them. 5 days time was given to go through the booklet and clarify the doubts. Then post test was conducted by using the same tool and practices were observed.

 

RESULTS AND DISCUSSION:

In the pre- test practice of the caregivers of children with nephrotic syndrome in relation to various aspects of care of children with nephrotic syndrome was 42% which was increased to 71% in the post test after administration of information booklet.

 

Effect of information booklet on practice score of the sample:

[n=30]

Test	Mean	Sd	Df	R	T	Significance
Pre-test	8.4	2.06	29	0.71	15.74	Significant at 0.01 level
Post-test	14.17	2.85

 

The calculated ‘t’ value 15.74 was more than table value at 0.01 level (‘t’(29) = 2.46) and there was a significant difference in the mean of pre test and post test practice scores. Hence null hypothesis(H0) was rejected which proved that information booklet was effective in improvement of practices of sample. Association of demographic variables with practice of sample showed that age and socioeconomic status was not associated with improvement in practice, whereas secondary educated group had more improvement than primary educated group.

 

CONCLUSION:

During the study, it was observed that all the caregivers of children with nephrotic syndrome needed information especially on care in oedema and identifying the warning signs of nephrotic syndrome. They had also showed interest to know about diet, urine testing and medications. The practices of sample were improved. They expressed that this booklet should be made available to all parents of children with nephrotic syndrome and OPDs should also provide such type of educative material. This indicated a positive response about information booklet which proved the significance of the study.

 

REFERENCES:

1.      Varghese J. Patient and family council. Am J MCH. 2003 Mar; 28(2):81-5.

2.      Smeltzer SC, Bare BG. Brunner and Suddharth's textbook of medical surgical nursing. 7th ed. Philadelphia: Lippincott Publication; 2000.

3.      Ghai OP. Gupta P, Paul VK. Essential pediatrics. 6 ed. New Delhi: CBS Publication; 2004.

4.      Hockenberry MJ, Wilson. Wong's Essentials of pediatric nursing, 8. ed. Noida: Elsevier Publication; 2009.

5.      International study of kidney diseases in children: the primary nephrotic syndrome in children. J Pediatr. 2000:98:561-4.

6.      Childhood nephrotic syndrome. National kidney and urologic diseases information clearing house. 2008. Available from URL: Kidney. Niddk.nih.goo/kudiseases/pubs/nephrotic syndrome.

7.      Minimal change nephrotic syndrome. Available from URL: http://www.medterms.com/ script/main/art.asp? articlekey24095.

8.      Malik A, Spectrum of childhood nephrotic syndrome in India. Ind J Nephrol. 2008;19(3):87-110.

 

 

 

Received on 08.07.2019         Modified on 25.07.2019

Accepted on 08.08.2019       ©A&V Publications All right reserved