Mrs. Lovera Sureshmrs. Rama Ranjitha B

Submitted to:Submitted by

Mrs. Lovera SureshMrs. Rama Ranjitha B.

Head of the Department1st year M. Sc. Nursing

Paediatriac NursingPaediatric Nursing

2007-2009

Sarvodaya College of Nursing,

Bangalore – 560 079

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. / NAME OF THE CANDIDATE & ADDRESS / Mrs. B. Rama Ranjitha
1st year M. Sc. Nursing
Sarvodaya College of Nursing,
11/9, Agrahara Dasarahalli,
Magadi Main Road,
Bangalore – 560 079
2. / NAME OF THE INSTITUTION / Sarvodaya College of Nursing,
Bangalore – 560 079
3. / COURSE OF STUDY AND SUBJECT / 1st year M. Sc. Nursing
Paediatric Nursing
4. / DATE OF ADMISSION OF COURSE / 01 JUNE 2007
5. / TITLE OF THE STUDY / “A Study To Evaluate The Effectiveness Of Planned Health Education On Otitis Media Among Mothers In Selected Urban SlumsOf Bangalore”
6. / BRIEF RESUME OF THE INTENDED WORK
6.1 Introduction
6.2 Need for the study
6.3 Statement of the problem
6.4 Objectives of the study
6.5 Operational definitions
6.6 Sampling criteria
6.7 Hypothesis
6.8 Review of related literature / Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
7. / MATERIALS AND METHODS
7.1 Source of data : Mothers who are having under five children in selected urban slums of Bangalore.
7.2 Method of data collection – Interview technique
7.3 Does the study require any investigation or intervention to be conducted on the patient or other human beings or animals?
NO
7.4 Has ethical clearance has been obtained from your institution?
Yes, ethical committee report is here with enclosed.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

6. Brief resume of THE intended work

6.1 Introduction:

“The ear is the leader must ring with the voices of the people”.

- Woodrow T. Wilson

The ear is the organ of hearing. Hearing is a very important sense in that it not only enables us to perceive many sounds within the environment, but it also facilitates oral communication. As such hearing gives us the opportunity to exchange ideas and opinions through speech.1

Hearing is a basic element in helping one to feel safe and secure and be a part of the environment. The functioning of the auditory system and of the auditory center in the brain permits individual to maintain a certain degree of safety and security. A number of conditions, congenital, inflammatory, mechanical, physical and degenerative may interfere with the hearing process.2

In India among children between 19th century and 20th century the number of ear infections diagnosed in doctor’s offices tripled to about 25 million. The national data from national ambulatory medical care surveys (NAMCS) estimated that there were 5.18 million episodes of AOM. The last two decades of the 20th century saw a dramatic rise in otitis media externa, largely due to increased pollution and increased use of early childhood day care. Most children will have temporary and minor hearing loss during and after an ear infection, because fluid can linger in the ear. Although this fluid can go unnoticed. It can cause significant hearing problems may cause speech to develop slowly.3

Ear infections are one of the most common reasons why parents take their children to the doctor. While there are different types of ear infections, the most commonest is called “otitis media”. Otitis media was defined by the technical expert panel as ‘the presence of middle ear effusion in conjunction with the rapid onset of one or more signs or symptoms of inflammation of the middle ear’.4

There are different kinds of otitis media, when the middle ear becomes infected, it is called acute otitis media. Acute means ‘sudden’ otitis is the word for ‘inflamed ear’ and media means ‘middle’When the middle ear is actually infected with bacteria rather than just inflamed, it is more serious. A chronic ear infection may be the result of an acute ear infection that does not clear completely or the result of recurrent ear infections.When the fluid is present in middle ear space without symptoms of an acute infection it is known as otitis media with effusion refers to fluid in the middle ear space but without the symptoms of an acute infection.5

Young children are prone to ear infections because of their developing head and neck structures. One of the developing structures is the Eustachian tube, that is shorter and more horizontal than in adults allowing infection to spread and preventing fluids in the middle ear from draining. The Eustachian tube usually reaches adequate function between the ages of 5 to 7, which coincides nicely with a dramatic decrease in the frequency and severity of ear infections in children.6

6.2 Need for Study

Health education is a tool when successfully imparted, the recipient motivated to use that information for the maintenance and restoration of his / her health.

Otitis media is the second most common disease of infants and young children, after upper respiratory tract infection. By the end of the third year of life, 50% to 70% of all children have had atleast one episode of acute otitis media. Most of the children under age of five years have 2-3 episodes of otitis media each year. It is more common during winter months.2

The incidence in India has increased in the past two decades due to various factors including pollution. Despite this, there is little awareness and indigenous knowledge about the condition. The prevalence of otitis media at present is 2253.The current annual incidence of otitis media is 7.1 billion cases.7

In Indira Gandhi Institute Child Health during the period of 2005-06, 123 cases of otitis media have been notified. In 2007 till August 135 cases were found. This shows that every year increasing of otitis media cases.

Daly KA, Pirie PL, Rhodes KL, Hunter LL (2007). conducted a study on relationship between otitis media risk factors, socio-demographic characteristics on mother’s knowledge and attitude regarding early onset of otitis media. The results of the study infant history of upper respiratory infection and maternal otitis media history are risk factors for early otitis media in Infants. Mother’s pre-partum knowledge and attitudes regarding otitis media are predict their post partum avoidance of risk factors.8

Dally K.A, Ruth E, Selvius M (1997). conducted a study on knowledge and attitudes of women on otitis media risk, implications for prevention. The findings of the study shows that women were more knowledgeable about otitis media signs and symptoms than about risk factors and prevention.9

The role of the nurse has expanded in recent years, at present the nurse acts not only as a care provider but also functions as a counsellor, educator etc. Now a days educating the mother regarding child health is one of the predominant features of nursing care. Nursing education helps to promote the health of the child, prevents recurrence. Otitis media is preventable and curable disease. Nurses play a vital role in educating mothers regarding risk factors, causes and prevention aspects.

Although, certain factors associated with the development of ear infections can’t be changed (such as family history of frequent ear infections). There are certain choices that can minimise the risk of children developing ear infections like breast feeding, immunisation and reducing exposure to respiratory tract infections by educating the mothers about preventive measures of otitis media, they can easily detect the infections and follow measures to prevent otitis media.10

During the field visits the investigator observed that most of the children were suffering from otitis media. The mother has deficient knowledge regarding causes and prevention of otitis media. To understand the degree of knowledge and to enhance the same, the investigator has undertaken this study to assess the knowledge and administered planned health education programme on otitis media.

6.3 Statement of the Problem:

“A Study To Evaluate The Effectiveness Of Planned Health Education On Otitis Media Among Mothers In Selected Urban Slums Of Bangalore”.

6.4 Objectives of the Study

1)To assess the knowledge of mothers having under five children regarding otitis media.

2)To evaluate the effectiveness of planned health education on otitis media among mothers having under five children.

3)To associate the relationship between knowledge of mothers on otitis media with demographic variables.

6.5 Operational definition

Effectiveness: It refers to optimum knowledge acquired by the mother on otitis media after health educational programme.
Planned Health Education: It is systematically developed programme with teaching aids, designed toimpart knowledge on otitis media, among mothers of under five children.
Mothers: Refers to persons who are having under five children.

6.6 Sampling Criteria

1. Inclusion Criteria

Mothers who are willing to participate.
Mothers who are havingunder five children.

2. Exclusion Criteria

Mothers who have children with terminal illness.

6.7 Hypothesis:

H1: Planned health education will improve the knowledge and practices of mothers having under five children regarding otitis media.

6.8 Review of related literature

Winther B, Alper CM(2007) conducted a study on temporal relationships between colds, upper respiratory viruses detected by polymerase chain reaction and otitis media in young children followed through a typical cold season. The findings of the study are otitis media is a complication of viral infection both with and without concurrent cold like illnesses, thus downwardly biasing coincidence estimates that use cold based illnesses as the denominator.11

GuptaNomeeta (2004) conducted a study on efficacy and tolerability assessment of cefprozil in children below 3 years of age group with otitis media. The study comprised of 208 males and 126 females. The findings of the study are cefprozil caused a significant improvement in all the signs and symptoms after 10 days treatment period. 152 patients presenting with ear ache at first visit, only 10 patients still had ear ache at second visit.12

Heikkinen T, Chonmaitree T (2003) conducted a study on importance of respiratory viruses in acute otitis media. The study findings revealed that viruses appear to enhance,the inflammatory process in the middle ear and they may significantly impair the resolution of otitis media. Prevention of predisposing viral infections by vaccination against the major viruses would probably be the most effective way to prevent acute otitis media. Alternatively early treatment of the viral infection with specific antiviral agents would also be effective in reducing the occurrence of acute otitis media.13

Nakatani M (2001) conducted a study on treatment of chronic suppurative otitis media. He studied 5 patients underwent a series of seven 0.05 ml injections of Broncasma Berma. Broncasma Berma, an inactivated bacterial vaccine, has been safely used through out the world from 30 years for the prevention of treatment of various infections process. At last the result were markedly diminished ottorrhoea and their tympanic membranes were almost completely dry.14

Glezen W (2000) conducted an experimental study on prevention of acute otitis media by prophylaxis and treatment of virus infections. The study findings revealed that influenza virus infections not only disrupt Eustachian tube function, but also impair recovery from infection and facilitate attachment of bacterial pathogens to respiratory epithelial cells. At last he concluded that, immunisation of young children with either inactivated or live attenuated influence vaccine will significantly reduce the incidence of acute otitis media.15

Daly K.A (1998) conducted a prospective study on ‘epidimiology of otitis media onset by six months of age’. This study examined prenatal, innate and early environmental exposures associated with acute otitis media onset and recurrent otitis media by age 6 months with 596 infants from a health maintenance organisation. This study shows that 39% had an episode of acute otitis media and 20% had recurrent otitis media by age of 6 months. This study concluded that prenatal factors were not linked to early acute otitis media onset with multivariate analysis, but environmental and innate factors play an importance role in early acute otitis media onset.16

Gupta V, Gupta A, Sivarasan K (1998) conducted a study on chronic suppurative otitis media,among one hundred and fifty seven cases to find out the commonest offending organism. They found staphylococcus aureus is the commonest organism in chronic suppurative otitis media with cholesteatoma. The disease was found to be more common in second decade and that too in males but this could be due to social bias against female.17

7. MATERIALS AND METHODS

7.1 Source of data

Mothers who are having under five children in selected urban slums of Bangalore.

7.2 Methods of collecting data

I)Research design- Quasi experimental design

II)Setting - In selected urban slums of Bangalore

III)Sampling technique- Simple random sampling

IV)Sample size- 50

V)Method of data collection-Interview technique

VI)Tool for data collection- structured interview schedule

VII)Method of data analysis and

Interpretation - The data will be analysed by using descriptive statistics and inferential statistics

VIII)Duration of the study- 4 weeks

IX)Variables :

Independent variables -Planned health education on otitis media.

Dependent variables - Knowledge on otitis media.

X)Projected Outcome: The study will impart knowledge on otitis media among mothers having under five children.

7.3 Does the study require any investigation or intervention to be conducted on the patient or other human beings or animals?

7.4 Has ethical clearance has been obtained from your institution?

Yes, ethical committee report is here with enclosed.

8. BIBLIOGRAPHY

1)Chapbell G.M. Text book of paediatrics. 4th ed. Churchill livingstone medicine division of Longman Group UK Ltd;1998. P.545-69.

2)Marlow D.R, Reddings B.A. Text book of paediatrics nursing. 6th ed. Philadelphia: W.B. Saunders Company;1998. P.106-15.

3)Park K. Text book of preventive and social medicine. 18th ed. Jabalpur: Banarasidas Bhanot Publishers; 2005. P.196-9.

4)Charles D, Bluestone M.D. Text book on otitis media in infants and children. 2nd ed. Philadelphia: W.B. saunders company;2000. P.1236-45.

5)Lugon Turner’s. Diseases of nose, throat and ear. 10th ed. Bombay: K.M. Varghese company publications; 1999. P.278-310.

6)Dhingra P.N. Text book of diseases of nose, throat and ear. 2nd ed. New Delhi: B.T. Churchill Livingstone Pvt. Ltd; 2001. P.62-76.

7)Jack L. Paradise,Howard E. Prevalence and risk factors of otitis media. Official Journal of American academy of paediatrics[serial online] 1997 Mar 1[cited 2007 Aug 5]; 99(3): [P.318-33]. Available from: URL:http// aapublications. org/cgi/content/abstract

8)Daly K.A, Pirie P.L, Rhodes K.L, Hunter L.L. Early onset of otitis media. [serial online] 2007 Feb [cited 2007 Aug 8]; 97(2): [P.21-3]. Available from: URL:

9)Daly K.A, Ruth E, Selvius M. Knowledge and attitudes of women on otitis media risk and implications for prevention. Official journal of American of paediatrics. 1997 Dec 9; 100(6): P. 931-6.

10)Gupte Suraj. A short text book of paediatrics. 10th ed. New Delhi: J.P. brothers publications; 2000. P.225-7.

11)Winther B, Alper CM. Temporal relationship between colds, upper respiratory viruses detected by polymerase chain reaction and otitis media in young children. Paediatrics [serial online] 2007 Jun [cited 2007 Oct. 31]; 119(6): [P.1069-75]. Available from: URL: .com

12)Gupta Nomeeta. Efficacy and tolerability of cefprozil in otitis media. Indian Journal of paediatrics. 2004 Apr 5; 71(4): P.319-24.

13)Heikkinen T, Chonmaitree T. Importance of respiratory viruses in otitis media, Indian Journal of paediatrics.2003 Sep 6; 22(1): P.50-5.

14)Nakatani. Treatment of chronic suppurative otitis media. Indian Journal of otology. 2001 May 10; 62(3): P.529-30.

15)Glezeen. Prevention of acute otitis media. Indian Journal of paediatrics.2000 Aug 5; 32(4): P.320-2.

16)Daly Kathleen A. Epidiomology of otitis media onset. Official Journal of American academy of paediatrics. 1998 Jan 7; 20(9): P.5-8.

17)Gupta V, Gupta A, Sivarasank. Chronic suppurative otitis media and anaerobic microbiological study. Indian J.otology. 1998 Jun 2; 20(2): P.3-5.

9. Signature of the Candidate:

10. Remarks of the Guide:

11. Name & designation of (in block letters):

11.1 Guide:

11.2 Signature:

11.3 Head of the Department:

11.4 Signature:

12. 12.1 Remarks of the Chairman & Principal :

12.2 Signature: