RAJIV GANDHI UNIVERSITY OF
HEALTH SCIENCE BANGALORE
KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DISSERTATION
1 / NAME OF THE CANDIDATE AND ADDRESS / SAINO THOMASI YEAR M.Sc NURSING
THE OXFORD COLLEGE OF NURSING
I PHASE J.P , NAGAR
BANGALORE-560 078
2 / NAME OF THE INSTITUTION / THE OXFORD COLLEGE OF NURSING
I PHASE J.P, NAGAR
BANGALORE-560 078
3 / COURSE OF STUDY AND SUBJECT / DEGREE OF MASTER OF SCIENCE IN NURSING
PAEDIATRIC NURSING.
4 / DATE OF ADMISSION TO THE COURSE / 9TH JUNE 2008
5 / TITLE OF THE TOPIC / KNOWLEDGE AND PRACTICE REGARDING SELECTION OF APPROPRIATE PLAY MATERIAL AND PLAY AREA AMONG MOTHERS OF CHILDREN BETWEEN 1Month-12 YEARS , IN SELECTED RURAL AND URBAN AREAS OF BANGALORE
6) BRIEF RESUME OF THE INTENDED WORK.
INTRODUCTION
“All work and no play make Jack a dull boy”
The gift of life to a mother is a child. It is a wonderful and pleasant experience to have a baby. This child grows and develops into an adult. Along with the physiological development, the mental capabilities should also be developed. Play has a vital role in framing the same. It is an important vehicle for children’s social, language, emotional and numerological literacy.
Play is not a waste of time. Nor it is just a way to keep young children busy or out of mischief, while parents take care of their own responsibilities. Instead, play is essential for the development of normal, well-adjusted personality. It gives the child a chance to develop physically, emotionally, mentally, socially, and morally in a way that no other single type of activity can. The child who has little chance to play is far less likely to become a well-adjusted adult than is the child who spends most of the day playing. 1
Ginsburg K R, (2007), in his article on the importance of play in promoting healthy child development and maintaining strong parent-child bonds, stated that play is essential for development because it contributes to the cognitive, physical, social, and emotional well-being of children and youth. Play also offers an ideal opportunity for parents to engage fully with their children.2
Children are particularly vulnerable to unintentional injury because of their physical, psychological behavioral characteristics; they live in an environment principally designed for adults. CPSC (Consumer SafetyProduct safety- USA), in a report shows that over a ten-year period, more deaths to children occurred on backyard playgrounds than on public playgrounds, from 1990 to August 2000 . Nearly 150 deaths to children are under the age of 15 involving playground equipment; at least 90 of these occurred in a home setting.
Safety of play materials and play area should be of paramount concern in effective parenting. Many accidents at play can be prevented if parents select appropriate play material and supervise their children during play. Parents must consider play materials on the basis of various levels of children’s growth and development and the safety concerns. Positive approach towards the safety aspects during play can make children feel secure.
6.1 NEED FOR STUDY:
Play is an essential factor in learning among children. With the advanced technology, a variety of play material is available in the market. But whether all play materials available are apt for the child, is a question. The knowledge of appropriate play material while selecting a toy will not only facilitate growth and development, but will also protect the child from injuries and accidents.
Safety refers to the behaviors and practices that protect children from risk or injury. Safety is special consideration in young children as their well-being is directly affected by the condition of their environment. Accidents resulting from minor injuries have an immediate effect on a child’s health. Serious injuries can cause an extended absence and temporarily interrupt a child’s learning and participation. Recognizing the children’s curiosity and desire to explore should make parents concern about the safety during selection of play material. Each year, more than 2,00,000 kids are treated in hospital ERs for playground-related injuries in USA. Many of these injuries could have been prevented with the proper supervision.
Al Bdour M. D and Azab M A, (1998) conducted a study which aimed to provide epidemiological data on serious eye injuries among children that can be used in planning health education and safety strategies for preventing such injuries. Records of 116 children who sustained serious eye injuries and required hospitalization in Princes Basnia Teaching Hospital, Jordan were reviewed. It was found that 74.1% of major injuries occurred during play and sport. Stones and sharp objects were the most common causes accounting to 18.1% and 17.2% respectively. It was concluded that the major reasons of serious eye injuries were unnecessary risk during play, use of dangerous objects and insufficient supervision by adults, especially at home.3
Forby L, Wilke. M, (1982) conducted a study on some characters of infant preferred toys. It was done on mothers of 3, 6, 9 and 12 months old infants, which indicated on a written questionnaire on their children’s favorite toys.
The objects were coded on four different dimensions. It was concluded that a number of age and gender differences were found in the relative frequencies of the object, characteristics investigated. These were explained in terms of the cognitive, motivational and environmental characteristics typical of different developmental levels during the first year of life.4
To assess parental awareness regarding common childhood injuries and to focus on prevention, ArvindSehgal, ShilpaJain conducted a study on two hundred parents .The commonest potential mode of injuries identified was falls 53%. Awareness was found to be greater in the group with higher educational background and socioeconomic status. It concluded that awareness regarding common childhood injuries and their prevention was lacking. There was a felt need that the pediatricians must counsel the parents on this aspect during visits. 5
Out of experience of the investigator, it has been observed that children are given to play with the toys which are either gifted by friends and relatives, or are transferred from the elder sibling to the younger one. There is a dearth of literature regarding selection of appropriate play material and play area in India. This study will provide a framework for the selection of age appropriate and safe play material and play area. Based on the above facts and findings, and out of interest and motivation, the investigator has felt the need to undertake the study which will improve the mother’s knowledge and will facilitate effective child development.
6.2REVIEW OF LITERATURE
6.2.1Reviews of Literature related to the significance of play in child
development.
6.2.2Reviews of Literature related to the associated risk and injuriesdue to improper selection of play material.
6.2.3 Reviews of Literature related to the associated risk and accidents due
to unsafe play areas.
6.2.1 Reviews of Literature related to the significance of play in child development.
Glassy D, Ramano J, (2003), stated in his article that play is essential for learning in children. Toys are the tools of play. Type of play materials provided and how they are used are equally important. Adults caring for children can be reminded that toys facilitate but do not substitute for the most important aspect of nurture-warm, loving, dependable relationships. Toys should be safe, affordable and developmentally appropriate. Children do not need expensive toys. Toys should be appealing to engage the child over a period of time.6
Radall P, (1994), in an article reported that play is a major part of young child’s education. Children deprived of play experiences can develop learning and other problems from which they may take years to recover. Parents should be encouraged to buy toys which are right for their child’s stages of development. “Educational toys” can be useful in stimulating particular aspects of development, e.g. Hand –eye co-ordination, manual dexterity, association of cause and effect. A good variety of toys is important. Children become more quickly bored than adults because their attention span is shorter. A good principle is to buy toys that are challenging without being too difficult.7
Bantz D L, Siktberg L, in an article on teaching families to evaluate age- appropriate toys explained that parents develop an understanding of normal growth and development and how to evaluate and stimulate their child’s development through the use of toys. They will be able to select and create appropriate toys that will not frustrate or over stimulate the child. This promotes and stimulates their child’s gross and motor skills, social development, and cognitive development through the use of toys.8
6.2.2 Reviews of Literature related to the associated risk and injuries due to improper selection of play material.
Someshwar J (2007) presented a case in Pediatric Emergency care. A 4 year girl had vaginal discharge and odor secondary to foreign body. The foreign body was a part of toy. This case was of a particular interest even though in normal course vaginal foreign bodies cause vaginal discharge, because of the unusual nature and source of foreign body.9
Figueiredo R (2006) in his article mentioned that nasal foreign bodies are common accidents in children, sometimes leading to complications such as Epistaxis and Bronchoaspiration. He evaluated 420 cases of foreign nasal bodies removed. He found higher incidence between 0 and 4 years of age, and most frequently found foreign bodies were foam fragments, plastic pieces of little toys, beans and paper fragments. Complications were found in 9.05% of the cases, headed by epistaxis and vestibulitis.10
Van Arsdale (2004) in his article on Lead poisoning from a toy necklace reported a case of a 4 yr old, previously healthy boy who experienced intermittent abdominal pain for several weeks. He was diagnosed for Gastroenteritis, but his symptoms worsened. Abdominal radiograph showed foreign body in stomach. A venous blood lead level revealed an extremely high value of 123microg/dl (level of concern: > or = 10microg/dl). The medallion was tested. Similar medallion purchased from toy vendoring machines were analyzed and were found to contain similar high levels of lead. This case revealed the poisonous effect of lead which children get from toys.11
A study (published in 1999, no author found) was conducted on the possible exposure of infants and children to fragrance allergens from “toy cosmetics”. 25 children’s cosmetic toys were analyzed by gas chromatography-mass spectrometry. In all the products fragrance allergens were frequently found. It concluded stating that children are already exposed at an early age to well known allergens, sometimes at concentrations considered to be unsafe.12
6.2.3 Reviews of Literaturerelated to the associated risk and accidents due to unsafe play areas.
Emanuelson I (2003) conducted a study on safety of childcare products, toys and playground equipment. The aim was to highlight the role of childcare products as causes for mild brain injury (concussion) in small children (0-4 years of age) and to determine the most dangerous products. Childcare products included child and baby furniture, nursing tables, baby walkers, toys, baby carriages, sport equipment for children, playground equipment and security equipment for children. It concluded that home was the most common place of the accident and play and leisure activity were the most common activities. The product type that caused most accidents was the baby walker being the most dangerous and second most frequent accidents was playground equipment.13
Hudson S, Thompson D, (1999) reported on the prevention of playground injuries that Playground accidents are the most common cause of injury children encounter. They identified four areas that can reduce the level of risk on school playgrounds: supervision, age-appropriate design of the play area, fall surfaces under and around playground equipment, and equipment and surface maintenance. The article discusses each of these, and recommends leadership methods and practices that nurses can implement that will eliminate or reduce risk factors.14
STATEMENT OF THE PROBLEM:-
A study to assess the knowledge and practice regarding selection of appropriate play material and play area among mothers of children between 1month -12years, in selected rural and urban areas of Bangalore with a view to develop an informational booklet.
6.3 OBJECTIVES OF THE STUDY:
6.3.1 To assess the knowledge and practice of rural mothers regarding selection of appropriate play materials and play area.
6.3.2 To assess the knowledge and practice of urban mothers regarding selection of appropriate play materials and play area.
6.3.3 To compare the knowledge and practice of mothers of rural and urban areas regarding selection of appropriate play materials and play area.
6.3.4 To develop information Booklet for both rural and urban mothers regarding the selection of appropriate play materials and play area.
6.4RESEARCH HYPOTEHSIS
H-1 There will be a significant difference in the knowledge and practice of rural and urban mothers of children between 1month -12 years of age regarding the selection on play materials and play area.
VARIABLES UNDER STUDY
Extraneous Variables: Demographic variables like age, sex, religion, occupation, socioeconomic status, educational status, sources of information, exposure to mass media.
Dependent Variable: Knowledge and practice of mothers.
6.5 OPERATIONAL DEFINITIONS:
KNOWLEDGE: Refers to the current response of mothers regarding selection of appropriate play material and play area, as assessed by structured interview schedule.
PRACTICE: Refers to the activities undertaken by the mothers regarding the appropriate selection of play materials and play area, as assessed by Observational check list.
MOTHERS: Refers to the immediate care givers in the rural and urban areas of children between 1month -12 years of age.
CHILDREN: Refers to the group of individuals between 1month -12 years of age.
PLAY MATERIAL: The articles which children use while playing, which are age appropriate and include safety criteria such as not having any sharp pointers, are big enough as not to swallow and free from harmful chemicals..
PLAY AREA: Refers to the space in which the children play in the house (indoor).
INFORMATION BOOKLET: Refers to the printed instructions regarding the appropriate selection of play materials and play area.
APPROPRIATE: Refers to correct selection of play materials and play area.
6.6 ASSUMPTIONS
6.6.1 The mothers of rural and area have some knowledge about selection of appropriate play material and play area.
6.6.2 Children who grow up exposed to appropriate play material have proper growth and development.
6.6.3 Safe play area can prevent injuries and accidents.
6.7 DELIMITATION
6.7.1 Study is delimited to only those mothers whose children are between the ages of 1month -12 years.
6.7.2 Study is related to only the knowledge and practice aspects of selection of appropriate play material and play area.
6.8 MATERIALS AND METHOD
6.9 SOURCE OF DATA
Data will be collected from mothers of children between 1month -12 years of age in selected rural and urban areas in Bangalore.
7.0 METHODS OF COLLECTION OF DATA
7.0.1. RESEARCH DESIGN
Comparative Survey Method
7.0.2. RESEASRCH APPROACH
Descriptive Survey Method
7.0.3. SETTING OF THE STUDY
The study will be conducted in selected rural and selected urban area in Bangalore.
7.0.4. POPULATION
Population comprises of mothers in selected rural and urban areas of children between 1month -12 years of age.
7.0.5 SAMPLE SIZE
Total sample of study will consist of 50 mothers of children from selected rural area and 50 mothers of children in selected urban areas, whose children are between the ages of 1month -12 years.
7.0.6. SAMPLE TECHNIQUE
Non-Probability Sampling technique, Purposive sampling.
7.0.7. SAMPLING CRITERIA
INCLUSION CRITERIA
1)Mothers who have children between the ages of 1month -12 years of age.
2)Mothers who are available at the time when the study is been conducted.
EXCLUSION CRITERIA
1) Mothers who are not willing to participate in the study.
7.0.8. TOOL FOR DATA COLLECTION
Tools for data collection are divided into following categories:
Part I – Items on Demographic variables will be listed under Structured Interview Schedule.
Part II – Knowledge of the mothers regarding the selection of appropriate play materials and play area will be assessed by Structured Interview Schedule.
Part III - Observation Check List to assess the practice of mothers regarding selection of appropriate play material and play area.
7.0.9. DATA ANALYSIS METHOD
Descriptive statistics:To describe demographic variables in terms of play material and play area, like percentage, mean, median, Standard Deviation.
Inferential statistics:
1) Parametric student ‘t’ test to find significance of difference of difference between the mean knowledge score of rural and urban mothers of children between 1month -12 yrs age.
2) Non Parametric Chi square test to determine the association between the selected demographic variables and the knowledge level and practice of rural and urban mothers of children between 1month -12 yrs age regarding selection of play material and play area.
7.1 DOES THE STUDY REQUIRE ANY INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS
Yes- Only educational intervention on mothers of children between the ages of 1month -12 years of age in selected rural and urban areas of Bangalore.
7.2 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION?
Ethical clearance can obtained from
The Research committee of the Oxford College of nursing, Bangalore.
The informed consent from the candidates willing to participate in the study.
8. LIST OF REFERENCES
1. Elizabeth B. Hurlick,”Growth and Development”.5th Edition, TMH edition: 265-279
2. Ginsburg KR. “The importance of play in promoting healthy child development and maintaining strong parent child bonds. Pediatrics. Jan 2007; 119(1):182-91
3. Al-Bdour MD, Azab MA.” Childhood eye injuries in North Jordan”.Int Opthalmol. 1998; 22(5):269-73.
4. Furby.L, Wilke M. “Characteristics of infant preferred toys”. J Genet Psychology. Jan 1982; 140(2d Half):207-10.
5. Arvind Sehgal, Shilpa Jain, “Parental awareness regarding childhood injuries’’.Indian Journal of Pediatrics. Dr. K C Chaudhuri Publications,Volume 71; February 2004:125-128.
6. Glassy D, Romano J. “Selecting appropriate toys for young children: The pediatrician’s role. Pediatrics. April 2003; 111(4 Pt 1):911-3.