INTRODUCTION:

WHO has consistently regarded nutrition as central to its mandate since the Organization was established in 1948. From the earliest stages of fetal development, at birth, through infancy, childhood, adolescence, and on into adulthood and old age, proper food and good nutrition are essential for survival, physical growth, mental development, performance and productivity, health and well-being. It is an essential foundation of human and national development. Nutrition is a fundamental pillar of human life, health and development across the entire life span.

The fundamental WHO goal of Health for All means that people everywhere, throughout their lives, have the opportunity to reach and maintain the highest attainable level of health. This is impossible in the presence of hunger, starvation, and malnutrition.¹Child's health includes physical, mental and social well-being. Most parents know the basics of keeping children healthy, like offering them healthy foods, making sure they get enough sleep and exercise and insuring their safety. It is also important for children to get regular checkups with their health care provider. These visits are a chance to check your child's development. They are also a good time to catch or prevent problems.²

NEED FOR THE STUDY:

Malnutrition is globally the most important risk factor for illness and death, contributing to more than half of deaths in children worldwide; child malnutrition was associated with 54% of deaths in children in developing countries in 2001. Protein-energy malnutrition (PEM), first described in the 1920s, is observed most frequently in developing countries but has been described with increasing frequency in hospitalized and chronically ill children in the United States.³

It is very important to detect children with PEM as early as possible. It can be prevented and controlled by comprehensive approach. The mother of under-fives children could play a significant role in identifying growth and development of their children. Educating such mothers is very necessary.⁴

RESEARCH METHODOLOGY:

RESEARCH APPROACH:

A research approach tells the researcher what data to collect and how to analyze it. It also suggest possible conclusions to be drawn from the data. In view of the nature of the problem under study and to accomplish the objectives of the study. Descriptive survey approach was considered as appropriate to describe the knowledge and attitude of mothers regarding PEM in preschool children.

RESEARCH DESIGN:

The research design is the plan, structure and strategy of investigations, of answering the research question, is the overall plan or blue print the research selects to carry out this study.

The research design selected for this study is descriptive survey design. The survey is carried out for providing on accurate portrayal of knowledge and attitude of mothers regarding PEM in preschool children.

Setting of the Study:

This study was conducted at Kodigehalli and Sanjeevini nagar urban areas, where this areas situated in Sahakar nagar, Bangalore city.

Population:

The sample for the present study were 60 mothers living in Kodigehalli and Sanjeevini nagar urban areas, Bangalore were selected purposefully.

Sampling Technique:

Non probability sampling technique was selected based on the judgment of the researcher to achieve objectives of the research at hand. In that Purposive sampling technique, a type of non-probability sampling approach was found to be appropriate for the present study.

Criteria for Selecting the Sample:

The following criteria were set for selection of the sample.

Inclusion Criteria:

a) Mothers who are present in the houses at the time of study

b) Mothers who are willing to participate in the study.

c) Mothers who know to read and understand Kannada or English.

Exclusion Criteria:

a) Mothers who are not willing to participate in this study.

b) Mothers who do not know to read and understand Kannada or English.

RESULTS:

Objectives of the Study:

1. To assess the knowledge of mothers regarding PEM in preschool children.

2. To assess the attitude of mothers regarding PEM in preschool children.

3. To find out the association between Socio demographic variables of mothers with knowledge and attitude regarding PEM in preschool children.

On The Basis of Above-Mentioned Objectives, the Data Is Presented in the Four Sections:

Section-I: Frequency and percentage distribution of demographic variables of mothers.

Section II: Assessment of knowledge of mothers on the different aspects of PEM in preschool children.

Section III: Assessment of Attitude of mothers on the different aspects of PEM in preschool children.

Section IV: Assessment of association between Socio demographic variables of mother with knowledge and attitude regarding PEM in preschool children.

Section-I:

Table No -1: Demographic profile n=60

Sl No	Demographic variables		No. of mothers	Percentage %
1	Age	18 - 22 yrs	10	16.7%
		23 - 27 yrs	42	70.0%
		28 - 32 yrs	8	13.3%
2	Type of family	Nuclear family Joint family	46 14	76.7% 23.3%
3	Religion	Hindu	36	60.0%
		Muslim	14	23.3%
		Christian	10	16.7%
4	No. of children	One	10	16.7%
		Two	42	70.0%
		Three	8	13.3%
5	Educational status	Higher primary	20	33.3%
		High school	22	36.7%
		Pre-University	16	26.7%
		Degree	2	3.3%
6	Occupation	Housewife	38	63.3%
		Govt employee	14	23.3%
		Self employee	8	13.3%
7	Income per month	Rs10001-15000	28	46.7%
		Rs15001-20000	20	33.3%
		> Rs.20000	12	20.0%
8	Type of diet	Vegetarian	24	40.0%
		Mixed	36	60.0%
9	Past history of Malnutrition to your child	Yes	10	16.7%
9	Past history of Malnutrition to your child	No	50	83.3%
10	Sources of Health information	Family member/friend	28	46.7%
		Mass media	16	26.7%
		Neighbors	8	13.3%
		Health workers	8	13.3%

Table 1– shows the socio-demographic profiles of the mothers for the study of “A Descriptive study to assess the knowledge and attitude of mothers regarding protein energy malnutrition in pre-school children at selected urban areas of Bangalore”

INTERPRETATION:

The Demographic table gives the following results:

1. In relation to the age of the mother’s data reveals that out of 60 mothers, 16.3 % were in the age group of 18-22 yrs, 70 % of the mothers were in the age group of 23-27 yrs , 13.3 % of the mothers are in the age group of 28-32 yrs.

2. In relation to the type of family the data reveals that out of 60 mothers, 76.7% of the mothers were from nuclear family,23.3% of the mothers were from joint family.

3. In relation to the religion of mother the data reveals that out of 60 mothers 60 % of the mothers were from Hindu family, 23.3 % of the mothers were from Muslim family, 16.7 % of the mothers were from Christian family.

4. In relation to the No of children the data reveals that out of 60 mothers 16.7 % were having only one child, 70 % were having two children, 13.3% were having three children.

5. In relation to the Educational status the data reveals that out of 60 mothers 33.3 % were having the education of Higher primary school, 36.7 % were having the education of High school, 26.7 % were having the education of pre-university, 3.3% were having the education of Degree.

6. In relation to the Occupation the data reveals that out of 60 mothers 63.3 % were House wife, 23.3%were Govt employee, 13.3% were working as a self employ

7. In relation to the Family Income per month the data reveals that out of 60 mothers 46.7 % were having income in between 10001-15000, 33.3% were having income in between Rs.15001-20000, 20% were having income of More than Rs. 20000.

8. In relation to the Type of food the data reveals that out of 60 mothers 40 % were vegetarians, 60 % were mixed.

9. In relation to the past history of malnutrition to your child the data reveals that out of 60 mothers 16.7% said yes and remaining 83.3% said no.

10. In relation to the Source of information, the data reveals that out of 60 mothers 46.7 % had received information from Family members and friends, 26.7 % had received information from mass media, 13.3 % had received information through neighbours, 13.3% had received information from Health workers.

1. Age distribution:

Distribution of the mothers in relation to their age reveals that, 16.3 % were in the age group of 18-22 yrs, 70 % of the mothers were in the age group of 23-27 yrs, 13.3 % of the mothers are in the age group of 28-32 yrs.

2. Type of family:

Distribution of the mothers in relation to their type of family system reveals that 76.7% of the mothers were from nuclear family, 23.3% of the mothers were from joint family.

3. Religion:

Distribution of Mothers in relation to their religion reveals 60 % of the mothers were from Hindu family, 23.3 % of the mothers were from Muslim family, 16.7 % of the mothers were from Christian family.

4. No. of Children:

Distribution of the mothers in relation to their No. of children the data reveals that 16.7 % were having only one child, 70 % were having two children, 13.3% were having three children.

5. Educational Status:

Distribution of the mothers in relation to their educational status reveals 33.3 % were having the education of Higher primary school, 36.7 % were having the education of High school, 26.7 % were having the education of pre-university, 3.3% were having the education of Degree.

6. Occupation:

Distribution of the Mothersin relation to their Occupation reveals 63.3 % were House wife, 23.3% were Govt employee, 13.3% were working as a self employ.

7. Monthly income of the Family:

Distribution of the mothers in relation to their Monthly income of the Family reveals 46.7 % were having income in between 10001-15000, 33.3% were having income in between Rs.15001-20000, 20% were having income of More than Rs. 20000.

8. Diet Pattern:

Distribution of the mothers in relation to their Diet Pattern reveals 40 % were vegetarians, 60 % were mixed.

9. Past History of Malnutrition:

Distribution of the Mothers in relation to their past history of malnutrition in children reveals 16.7% said yes and remaining 83.3% said no

10. Treatment for previous lactating problems:

Distribution of the mothers in relation to the Source of information reveals 46.7 % had received information from Family members and friends, 26.7 % had received information from mass media, 13.3 % had received information through neighbours, 13.3% had received information from Health workers.

SECTION II

Objective 1: To assess the knowledge of mothers regarding PEM in preschool children.

Table 2: Percentage of Knowledge N=60

Knowledge	No. of questions	Min –Max score	Knowledge score
Knowledge	No. of questions	Min –Max score	Mean ±SD	%
General information	3	0 - 3	1.90±0.77	63.3%
Importance and sources of protein	6	0 - 6	2.60±0.85	43.3%
PEM and its causes	5	0 - 5	1.93±0.97	38.6%
Types and Clinical features	7	0 -7	2.32±1.08	33.1%
Prevention and control	9	0 -9	3.73±1.30	41.4%
OVERALL	30	0 -30	12.48±2.57	41.6%

Table 2 shows the mothers percentage of knowledge on PEM in preschool children. Mothers are having Maximum knowledge in general information (63.3%), 43.3% of knowledge in Importance and sources of protein, 38.6% knowledge in PEM and its causes, 41.6% knowledge in prevention and control and minimum knowledge in Types and clinical features (33.1%). On an average overall knowledge score on PEM is 41.6% and mean score of 12.48, SD-2.57.

Table 3: Level of Knowledge n=60

Level of knowledge	No. of mothers	Percentage%
Inadequate	14	23.3%
Moderate	46	76.7%
Adequate	0	0.0%
Total	60	100%

Table No.3 shows the level of knowledge of mothers regarding PEM in preschool children. 23.3% of them having inadequate knowledge and 76.7% of them having moderate knowledge, none of them having adequate knowledge.

Criterion Measures: - Knowledge: 30

S. No.	Criteria	Score
1	Inadequate	0 -10
2	Moderate	11 -20
3	Adequate	21-30

SECTION- III

Objective 2: To assess the Attitude of mothers regarding PEM in preschool children.

Table 4: Each Questionwise Assessment of Attitude n=60

Statements	0		1		2
	n	%	n	%	n	%
1. Growth monitoring is a vital step to prevent Protein Energy Malnutrition.	24	40.0%	34	56.7%	2	3.3%
2. We should not practice continued feeding to the children during diarrheal attack	21	35.0%	9	15.0%	30	50.0%
3. We should use clean water and utensils in the preparation of food for feeding a child with protein energy malnutrition	9	15.0%	38	63.3%	13	21.7%
4. It is not required to prepare special feeding formula and food for children who have PEM	29	48.3%	21	35.0%	10	16.7%
5. It is a good practice to feed a baby with bottle feeding	19	31.7%	24	40.0%	17	28.3%
6. I believe exclusive Breast feeding up to 6 months can prevent the risk of PEM	16	26.7%	24	40.0%	20	33.3%
7. Giving supplementary foods after 6 months and continue breast feeding up to 2 years will prevent PEM	24	40.0%	16	26.7%	20	33.3%
8. I believe protein energy malnutrition is caused by deficiency of nutrients	6	10.0%	30	50.0%	24	40.0%
9. I believe, Protein energy malnutrition is not having any treatment	24	40.0%	27	45.0%	9	15.0%
10. If my child develops PEM, it is important to take to the health service setting for its management	24	40.0%	34	56.7%	2	3.3%

Table 8: Association Between Level of Knowledge and Demographic Variables

Demographic variables		Level of knowledge				Total	Chi square test
		Inadequate		Moderate
		n	%	n	%
Age	18 - 22 yrs	6	60.0%	4	40.0%	10	c2=9.08 P=0.01 DF=2, significant**
	23 - 27 yrs	7	16.7%	35	83.3%	42
	28 - 32 yrs	1	12.5%	7	87.5%	8
Type of family	Nuclear family	12	26.1%	34	73.9%	46	c2=0.83 P=0.36 DF=2, not significant
	Joint family	2	14.3%	12	85.7%	14	c2=0.83 P=0.36 DF=2, not significant
Religion	Hindu	8	22.2%	28	77.8%	36	c2=2.21 P=0.33 DF=2, not significant
	Muslim	5	35.7%	9	64.3%	14
	Christian	1	10.0%	9	90.0%	10
No. of children	One	3	30.0%	7	70.0%	10	c2=1.57 P=0.45 DF=2, not significant
	Two	8	19.0%	34	81.0%	42
	Three	3	37.5%	5	62.5%	8
Educational status	Higher primary	9	45.0%	11	55.0%	20	c2=8.79 P=0.03* DF=2, significant
	High school	4	18.2%	18	81.8%	22
	Pre-University	1	6.3%	15	93.7%	16
	Degree	0	0.0%	2	100.0%	2
Occupation	Housewife	10	26.3%	28	73.7%	38	c2=0.84 P=0.66 DF=2, not significant
	Govt employee	2	14.3%	12	85.7%	14
	Self employee	2	25.0%	6	75.0%	8
Income per month	Rs10001-15000	3	10.7%	25	89.3%	28	c2=4.68 P=0.10 DF=2, not significant
	Rs15001-20000	7	35.0%	13	65.0%	20
	> Rs.20000	4	33.3%	8	66.7%	12
Type of diet	Vegetarian	8	33.3%	16	66.7%	24	c2=2.23 P=0.13 DF=2, not significant
	Mixed	6	16.7%	30	83.3%	36	c2=2.23 P=0.13 DF=2, not significant
Past history of Malnutrition to your child	Yes	0	0.0%	10	100.0%	10	c2=5.98 P=0.01* DF=2, significant
	No	14	28.0%	36	72.0%	50	c2=5.98 P=0.01* DF=2, significant
Sources of Health information	Family member/friend	5	17.9%	23	82.1%	28	c2=3.85 P=0.27 DF=2, not significant
	Mass media	3	18.8%	13	81.3%	16
	Neighbors	2	25.0%	6	75.0%	8
	Health worker	4	50.0%	4	50.0%	8

Table 9: Association Between Level of Attitude and Demographic Variables

Demographic variables		Level of Attitude						Total	Chi square test
		Unsatisfactory		Moderate		Satisfactory
		n	%	n	%	n	%
1. Age	18 - 22 yrs	4	40.0%	6	60.0%	0	0.0%	10	c2=13.03 P=0.01* DF=2, significant
	23 - 27 yrs	5	11.9%	35	83.3%	2	4.8%	42
	28 - 32 yrs	1	12.5%	4	50.0%	3	37.5%	8
2.Type of family	Nuclear family	8	17.4%	33	71.7%	5	10.9%	46	c2=1.86 P=0.39 DF=2, not significant
	Joint family	2	14.3%	12	85.7%	0	0.0%	14	c2=1.86 P=0.39 DF=2, not significant
3.Religion	Hindu	9	25.0%	24	66.7%	3	8.3%	36	c2=6.37 P=0.17 DF=2, not significant
	Muslim	0	0.0%	12	85.7%	2	14.3%	14
	Christian	1	10.0%	9	90.0%	0	0.0%	10
4.No. of children	One	1	10.0%	7	70.0%	2	20.0%	10	c2=4.82 P=0.31 DF=2, not significant
	Two	9	21.4%	31	73.8%	2	4.8%	42
	Three	0	0.0%	7	87.5%	1	12.5%	8
5.Educational status	Higher primary	6	30.0%	14	70.0%	0	0.0%	20	c2=12.93 P=0.05* DF=2, significant
	High school	4	18.2%	16	72.7%	2	9.1%	22
	Pre-University	0	0.0%	14	87.5%	2	12.5%	16
	Degree	0	0.0%	1	50.0%	1	50.0%	2
6.Occupation	Housewife	7	18.4%	26	68.4%	5	13.2%	38	c2=4.87 P=0.30 DF=2, not significant
	Govt employee	1	7.1%	13	92.9%	0	0.0%	14
	Self employee	2	25.0%	6	75.0%	0	0.0%	8
7.Income per month	Rs10001-15000	4	14.3%	20	71.4%	4	14.3%	28	c2=9.77 P=0.04 DF=2, not significant
	Rs15001-20000	1	5.0%	18	90.0%	1	5.0%	20
	> Rs.20000	5	41.7%	7	58.3%	0	0.0%	12
8.Type of diet	Vegetarian	4	16.7%	19	79.2%	1	4.2%	24	c2=0.92 P=0.62 DF=2, not significant
	Mixed	6	16.7%	26	72.2%	4	11.1%	36	c2=0.92 P=0.62 DF=2, not significant
9.Past history of Malnutrition to your child	Yes	1	10.0%	8	80.0%	1	10.0%	10	c2=7.44 P=0.02*DF=2, significant
	No	9	18.0%	37	74.0%	4	8.0%	50	c2=7.44 P=0.02*DF=2, significant
10.Sources of Health information	Family member/friend	2	7.1%	25	89.3%	1	3.6%	28	c2=9.42 P=0.14 DF=2, not significant
	Mass media	3	18.8%	10	62.5%	3	18.8%	16
	Neighbors	2	25.0%	6	75.0%			8
	Health worker	3	37.5%	4	50.0%	1	12.5%	8

Table no 9 shows the association between demographic variables and mothers’ level of attitude. Age of the mothers, educational status, past history of malnutrition to their children are significantly associated with their level of attitude. Association between demographic variables and their level of attitude was analyzed using pearson chisquare test

Hypothesis Testing:

H ₂: There will be a significant association between Attitude score of the mothers with their selected demographic variables regarding PEM in preschool children.

· Age of the mother is having the significant association with the attitude score at 5% level (’P’ value =0.001, c2value =13.03)

· Education status of mother is having significant association with the attitude score at 5% level (P=0.05, c2value=12.93)

· Past history of malnutrition to their children is having significant association with attitude score at 5% level. (P=0.02, c2=57.44)

· Type of family, religion, No. of children, occupation, type of diet, and family income, source of information are not having significant association with the attitude scores.

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Received on 13.03.2024 Revised on 05.11.2024

Accepted on 08.04.2025 Published on 21.05.2025

Available online from May 23, 2025

Int. J. of Advances in Nursing Management. 2025;13(2):97-103.

DOI: 10.52711/2454-2652.2025.00020

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Attitude	No. of questions	Min –Max score	Attitude score
Attitude	No. of questions	Min –Max score	Mean score	%
1. Growth monitoring is a vital step to prevent Protein Energy Malnutrition.	1	0 - 2	0.63	31.5%
2. We should not practice continued feeding to the children during diarrheal attack	1	0 - 2	1.15	57.5%
3. We should use clean water and utensils in the preparation of food for feeding a child with protein energy malnutrition	1	0 - 2	1.07	53.5%
4. It is not required to prepare special feeding formula and food for children who have PEM	1	0 - 2	1.10	55.0%
5. It is a good practice to feed a baby with bottle feeding	1	0 - 2	0.68	34.0%
6. I believe exclusive Breast feeding up to 6 months can prevent the risk of PEM	1	0 - 2	0.97	48.5%
7. Giving supplementary foods after 6 months and continue breast feeding up to 2 years will prevent PEM	1	0 - 2	1.07	53.5%
8. I believe protein energy malnutrition is caused by deficiency of nutrients	1	0 - 2	0.93	46.5%
9. I believe, Protein energy malnutrition is not having any treatment	1	0 - 2	1.30	65.0%
10. If my child develops PEM, it is important to take to the health service setting for its management	1	0 - 2	0.75	37.5%
OVERALL	10	0 - 20	9.27	46.4%

Level of attitude	No. of mothers	%
Unsatisfactory	10	16.7%
Moderately satisfactory	45	75%
Satisfactory	5	8.3%
Total	60	100%