KNOWLEDGE AND PRACTICES OF MOTHERS REGARDING FEBRILE CONVULSIONS AND HOME MANAGEMENT IN NIGERIA

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KNOWLEDGE AND PRACTICES OF MOTHERS REGARDING FEBRILE CONVULSIONS AND HOME MANAGEMENT IN NIGERIA

ABSTRACT

Background of study

Children under five years belong to a susceptible group who needs special attention and care during health and illness, which imposes equal responsibility to the mothers and medical personnel (UNICEF, 2008).

A febrile convulsion is the sudden increase of body temperature resulting in loss of consciousness, stiffing of the body, jerky movements of the extremities and twitching of the face (Pina-Garza et al, 2013).

Objective: To assess knowledge, attitude and practices of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital

Methods: The research was a descriptive cross-sectional study because the sample of the population was assessed at a single point in time and there was no need for follow-up of the respondents at the end the study. The sample size was 207 respondents.

Results: a majority (47.8%) of the respondents were between 21-29 years of age, 18.8% were aged 30 – 39 years and 6.8% of the respondents were aged 50 years above.

73.9% of the respondents knew what febrile convulsions are while 85.5% of the respondents confirmed that they are aware that febrile convulsion can be prevented among children of underfive.

Results show that 94.7% of the respondents said that febrile convulsions are not good therefore they should be prevented while 91.8% of the respondents rated modern medicines to be very useful in the prevention of febrile convulsions which implied positive attitude.

On practices of the respondents, 23.2% of the respondents believed that rushing the child to the hospital is the best were of preventing febrile convulsions, 18.8% stated that giving temperature reducing drugs can prevent febrile convulsions, 15.9% tepid sponge with warm water, 15.7% reported giving herbal medicines, 14.0% of the respondents reported giving fluids to the child while 9.1% used cold water for tepid sponging the children with fever and 3.2% reported leaving the child at home.

Conclusion: The knowledge of the respondents was high with majority of the respondents having adequate knowledge on prevention of febrile convulsions. The Mothers had adequate information on prevention of febrile convulsions.

The respondents had a positive attitude towards prevention of febrile convulsions in children under five years.

The respondents had poor practices towards prevention of febrile convulsions in children under five years.

Recommendations

Health facilities need to conduct routine and continuous health education talks for the Mothers on prevention febrile convulsions so as to have constant reminders.  

There is need for further research studies to investigate the factors influencing the prevention of febrile convulsion among children aged five years among the care givers. This will generate information on what motivates Mothers to comply with prevention measure.

 

CHAPTER ONE: INTRODUCTION

This chapter consists of the Study background, Statement of problem, Objectives of study, Research questions about the  knowledge, attitude and practices of Mothers towards prevention of febrile convulsions in children under five at University of Uyo Teaching Hospital, Significance of the study and Conceptual framework.

1.1 Background of study

Children under five years belong to a susceptible group who needs special attention and care during health and illness, which imposes equal responsibility to the mothers and medical personnel (UNICEF, 2008). World Health Organization (WHO, 2011) has estimated that more than 10 million children under five of age die each year in developing countries and seven in ten of these deaths are due to acute respiratory infection mostly Pneumonia, diarrhea, measles, malaria, or malnutrition, or combination of all these. Almost all of these diseases are signaled by rise in body temperature of the children which is called fever and, if the fever is not managed on time, it triggers a condition known as ‘febrile seizures’ or ‘febrile convulsion’ (Reference Library of selected Material IMCI, 2009).

Fever in children is one of the most common manifestations of an illness, which makes the parents seek medical attention early (Sarathy PA., 2009). According to WHO (2009), fever maybe caused by multiple causes including infection, vaccines, biologic agents, tissue injury, malignancy, drugs, autoimmune diseases, granulomatous  diseases, metabolic disorders such as gout and also genetic disorders. Furthermore, all these insults results in the production of endogenous pyrogens, which alter the temperature set point in the anterior hypothalamus leading to elevation in body temperature.

A fever in a child means the child is fighting an infection in the body and is defined as an elevation of body temperature in response to pathological stimulus (Ghai, 2010). American College of Emergency physicians (ACEP) published a clinical policy that the rectal temperature should be more than or equal to 380C (100.40F) to consider a child febrile and fever above 41.50C (106.70F) warrants an aggressive antipyretic therapy because of risk of irreversible organ damage. Fever also increases the risk of febrile convulsion (Gupta P, 2007).

A febrile convulsion is the sudden increase of body temperature resulting in loss of consciousness, stiffing of the body, jerky movements of the extremities and twitching of the face (Pina-Garza et al, 2013).

Febrile convulsion occurs in young children and most common in age group of six months to five years due to sudden rise of body temperature (Friedman et al, 2006). There are two types of febrile convulsions that is to say simple febrile convulsion which last less than 15 minutes and do not occur again during the infection and complex febrile convulsion that occur in several episodes during the infection and may last longer than 15 minutes. Out of this two to threequarters of all febrile convulsions are simple febrile convulsions (Gupta P, 2007).

The mothers are the main persons who constantly take care of the children and they are the first persons to notice the children are ill and first thing they do is to check for fever but fever is either often neglected or inappropriately managed due to lots of misconceptions in various communities and leading to febrile convulsions (Maslove et al, 2009). Although febrile convulsions are mostly benign with excellent outcome but parents experiences are frightening and stressful situations leading to development of high level of anxiety when children suffer from febrile convulsions therefore it is felt that raising awareness about the disorder allaying parental fears and anxieties, and addressing their concerns about recurrence and long term consequences of febrile convulsion will be useful (Karande S, 2007).

Knowledge, attitude and practices of Mothers play an important role in the prevention of febrile convulsions in children under five (Hockenberry et al, 2016).

Globally according to the knowledge, attitude and practice study conducted on the mothers regarding care of the children in febrile conditions in Vanivilas children’s hospital, India, it was revealed that the mothers were lacking knowledge on managing children with fever and had many false beliefs and misconception about fever (Lalitha, 2004).

According to the study conducted by Arash et al, (2013) in Iran on 88 mothers to determine the effect of educational program on knowledge, attitude and practice of mothers regarding prevention of febrile seizure in children revealed that respondents had increased knowledge, but with low attitude and practices.

In Africa, a study conducted by U. M. Chukwuocha et al, (2013) in eastern Nigeria on Prevalent and practices and outcome among 100 mothers of febrile children revealed out that the knowledge of the mothers was high in relation to the attitude and practices.

In Nigeria according to Kiryabwire (2010), a neurosurgeon at Mulago hospital says that children suffer the most bouts of febrile convulsions caused by fever and while seizures are a common occurrence in Nigeria a vast majority of the afflicted shy away from seeking medical attention.

In view of this background, this study was conducted in University of Uyo Teaching Hospital with the aim of assessing knowledge, attitude and practices of Mothers towards prevention of febrile convulsions in children under five years.

1.2 Problem statement

Febrile convulsions are quite common and they cause a lot of fear among Mothers, watching a child having convulsions and Mothers may think a child is dying, though most of the convulsions are benign (Jones et al, 2007). Convulsions also known as seizures occur at home, and as a result Mothers are the first to be involved in their prevention therefore their knowledge, attitudes and practices are determinant prognostic factors (WHO, 2009).

However Mothers knowledge on seizures is lacking, and as a result when faced with the dramatic manifestations of seizures, Mothers are frightened and therefore tend to perform inappropriate first aid gestures resulting in increased morbidity and mortality among children under five years (Anigilaje et al, 2013 and Emmanuel et al, 2013).

According to the Ministry of Health Nigeria, 75% of children presented with febrile convulsions and malaria while 76.3% presented with a febrile convulsion and pneumonia (MOH, 2006). Furthermore this febrile convulsion especially complex convulsion result to complications such as brain damage, epilepsy, mental retardation, decreased IQ or learning difficulties and death.

The government through the Ministry of health has provided treated mosquito nets to the Mothers to prevent malaria which would result in to fever that can complicate to febrile convulsions if not treated. Furthermore Health education on prevention of febrile convulsion among the children under five years has also been done during antenatal and immunization visits. Despite the efforts in place by the government, febrile convulsions are not well prevented. This study therefore assessed the knowledge, attitude and practices of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital.

1.3 Objectives of the study

1.3.1 General objective

To assess knowledge, attitude and practices of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital

1.3.2 Specific objectives
  1. To assess the knowledge of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital.
  2. To determine the attitude of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital.
  3. To establish the practices of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital.

 

1.4 Research questions

  1. What is the knowledge of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital?
  2. What is the attitude of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital?
  3. What are the practices of Mothers towards prevention of febrile convulsions in children under five years at University of Uyo Teaching Hospital?

 

 

1.5 Significance of the study

This study shall provide the Mothers with the valuable information they need in prevention of febrile convulsion that will increase their understanding.

This study shall change the mother’s attitude towards the prevention of febrile convulsions in children under five.

This study shall also enable policy makers gain better insight on the knowledge, attitude and practices of the Mothers towards prevention of febrile convulsions in children under five and will able them evaluate on-going or completed programmes on prevention of febrile convulsions. The information obtained from this study will be of importance in updating reports on towards prevention of febrile convulsions in children under five by the ministry of health.

This study shall also act as the guideline and source of information for other nursing researchers. This study shall increase knowledge needs on the already known facts about prevention of febrile convulsions in children under five.

 

1.6 A Conceptual framework

The conceptual frame work below shows the relationship between the independent and dependant variables. The dependent variable was prevention of febrile convulsions and the independent variables are the Knowledge, attitude and practices of Mothers.

 Figure 1: A conceptual frame work

KNOWLEDGE AND PRACTICES OF MOTHERS REGARDING FEBRILE CONVULSIONS AND HOME MANAGEMENT IN NIGERIA

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