“A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAMME ON KNOWLEDGE REGARDING

FIRST AID FOR BURNS AND ITS PREVENTION
AMONG PARENTS OF UNDER FIVE
CHILDREN IN SELECTED RURAL
AREA, TUMKUR DISTRICT”.

PROFORMA FOR REGISTRATION OF SUBJECT FOR

THE DISSERTATION

SUBMITTED BY

SUNIL. M.B

COMMUNITY HEALTH NURSING

ARUNA COLLEGE OF NURSING

RING ROAD, MARALUR

TUMKUR.

2009-2010

1
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,
KARNATAKA, INDIA.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

01 NAME OF THE : SUNIL. M.B
CANDIDATE AND M.Sc.NURSING, 1st YEAR,
ADDRESS
ARUNA COLLEGE OF
NURSING,
RING ROAD, MARALUR,
TUMKUR.

02 NAME OF THE : ARUNA COLLEGE OF

INSTITUTION NURSING.

03 COURCE OF STUDY AND : MASTER DEGREE IN

SUBJECT NURSING, COMMUNITY
HEALTH NURSING.

04 DATE OF ADMISSION TO : 10-06-2009

COURSE

05 STATEMENT OF PROBLEM : “A STUDY TO EVALUATE THE

EFFECTIVENESS OF
STRUCTURED TEACHING
PROGRAMME ON
KNOWLEDGE REGARDING
FIRST AID FOR BURNS AND
ITS PREVENTION AMONG
PARENTS OF UNDER
FIVE CHILDREN IN
SELECTED RURAL AREA,
TUMKUR DISTRICT”.

2
6. BRIEF RESUME OF THE INTENDED WORK:

INTRODUCTION:

“COOL THE BURN”

Children are the future of every country and all societies strive to ensure their
health and safety Since India’s independence, continuous efforts have been made to
improve the status of children. The large burden of communicable, infectious and
nutritional disorders is gradually on the decline due to massive efforts and investments by
successive Indian government, even though it is an unfinished agenda. Parallel to these
changes, it is also becoming apparent that children saved from disease of yesterday are
becoming victim of injury on road, at home and in public, recreational places. 1 Children
are naturally curious. As soon as they are mobile, begin to explore their surroundings and
play with new objects, at the same time though, they come into contact with objects that
can cause severe injuries playing with fire or touching hot objects can result in burns. 2

A burn is defined as an injury to the skin or other organic tissue caused by thermal
trauma, it occurs when some or all of the cells in the skin or other tissues are destroyed
by hot liquids (scalds), hot solids (contact burns), or flames (flame burns). Injuries to the
skin or other organic tissue due to radiation, radioactivity, electricity, friction or contact
with chemicals are also considered as burns. 3

Burns may be distinguished and classified as thermal burns, inhalational burns,

first degree or superficial burns, second degree or partial-thickness burns, third-degree or
full-thickness burns. Chemical burns electrical burns, radiation burns.2

Risk factors of burns includes, according to data collected from the national burn
information exchange reveal that 75% of all burn injuries result from the actions of the
victim, with many of these injuries occurring in the home environment. Contact with
scalding liquids is the leading cause of burn injury. Toddlers suffer more scald injuries
than any other age group. Scald injuries are frequently the results in the performance of
everyday tasks such as bathing, cooking, overturned coffeepots, overheated foods, liquids
cooked in micro wave ovens and hot tap water have been identified as specific causes.

3
Approximately 10% of residential fire deaths are caused by children playing with
matches or other ignition sources. Additionally faulty chimney’s, flue vents, fixed heating
units, fireplaces, central heating systems. Wood burning stoves, as well as human error,
all have been implicated.4 Burns in children under the age of five year old at higher risk
of hospitalization often occur from a mixture of curiosity and awkwardness. In children
under the age of four years, the level of motor development does not match the child’s
cognitive and intellectual development and injuries can thus occur more easily. 5

Clinical features of burns includes, First degree partial thickness burns, Second
degree partial thickness burns, Third degree full thickness burns, Fluid and Electrolyte
imbalance, Alterations in Respiration, Decreased cardiac output, Substantial pain, Altered
level of consciousness, Psychological alterations, withdrawal, suppression.4

Infants under the age of one year are in a particular category, as their mobility
starts to develop and they reach out to touch objects. Scald burns are the most frequent
type of burns among children under the age of six years on observation that appears to
come across geographic and economic groups. Typical scald burns occur when a child
pulls down a container of hot fluid, such as a cup of coffee, onto his or her face upper
extremities and trunks.2

According to WHO data, approximately 10% of all unintentional injury deaths

are due to fire related burns. Studies from high income countries suggest that smoke
inhalation is the strongest determinant of mortality from burns, mostly from house fires
or other conflagrations. For children over three years of age, smoke inhalation is strongly
associated with mortality. Burns from fire contribute to the majority of burn related
deaths in children, scalds and contact burns are an important factor in overall morbidity
from burns and a significant cause of disability.2

A study in four low income countries found that 65% of childhood burns had
occurred in and around the home. The kitchen is usually the most common part of the
house. In this room, children may upset receptacles with hot liquids, by exploding stores,
stand on hot coals or be splashed with hot cooking oil. Studies have also found that, the
children of parents who smoke while in bed are at higher risk of burns than those who do

4
not have parents who smoke. Two peak times of the day have been reported for incidents
involving burns, the late morning, when domestic tasks are being done, and around the
time for the evening meal.2

Childhood burns are largely environmentally conditioned and preventable. It

would therefore seem natural that the prevention of burns should focus on a mixture of
environmental modifications. Parental education and product safety, special attention
needs to be paid to the kitchen. The scene of the majority of burns programmes are
needed to ensure proper supervision of children and their general well being, particularly
of those with disabilities parents should receive better information about all types of
burns. There must be much greater awareness everywhere about the dangers of storing
flammable substances in the home.2

Many times death results because of delay in reaching the casualty to appropriate
medical care and low lack of knowledge regarding first aid and treatment on the contrary,
if help is provided to casualty as soon as possible following the accident or injury, a life
could be saved. The first aider should also have adequate knowledge and skills about
what he is doing and be encouraging and reassuring to the victims. This helps lower
mortality and morbidity rates, complications due to injury or delay in the treatment and a
lesser monetary burden on the casualty. 6 it is therefore desirable that all individuals have
basic training and knowledge regarding first aid. 7

‘First aid’ is the first assistance or treatment given to an injured person (casualty)
for any injury or sudden illness before the arrival of qualified medical care by using
facilities and material available at that time. Giving of first aid is an art which is acquired
by getting interested in the field and by training. 6

Burns are significant cause of mortality and morbidity among infants and children
being depend on their matter or caretaker and they are unable to recognize hazardous
situations leading to burn injury. 8 Burns in children result in the loss of precious life, or if
the child survives, in much suffering from physical, emotional social and economic
problems. These burn accidents to children happen in the bustle of family life and
frequently without any warning. 9

5
 It is very important to look into safety and security of children. This will promote
sound psycho-social development of children. Safety and security can be ensured by
providing clean, safe and comfortable physical environment. 10

6.1 NEED FOR THE STUDY:

11
Burn injury is second leading cause of accidental death in children. According
to the WHO global burden of disease estimates for 2004, just over 3, 10,000 people died
as a result of fire-related burns, of which 30% were under the age of 20 years. Fire related
burns are the 11th leading cause of death for children between the ages of less than 5
years. Overall children are at high risk for death from burns, with a global rate of 3.9
deaths per 1, 00,000 populations. Among all people globally, infants have the highest
death rates from burns. Globally nearly 96,000 children under the age of 20 years were
estimated to have been fatally injured as a result of a fire related burn in 2004. 2

The death rate in low income and middle income countries was eleven times
higher than that in high income countries, 4.3 per 1, 00,000 as against 0.4 per 1, 00,000.
Burns related deaths show great regional variability. Most of the deaths occur in poorer
regions of the world among the WHO regions of Africa and South East Asia and the low
income and middle income countries of the eastern Mediterranean region.2

A survey in India found that only 22.8% of patients had received appropriate first
aid for their burns. The remainder had either received no first aid or else inappropriate
treatment such as raw eggs, toothpaste, mashed potato or oil being rubbed into the burn.
Education on the effect of immediate application of cool water to burns should be
promoted widely as an affective first aid treatment. 12

A retrospective study was conducted to study the incidence, severity, extent, cause,
risk factors and overall mortality. 309 children of burn injuries treated over last 10 years
in Kasturbha Hospital, Manipal, and Karnataka, India. The study found that the children
of less than 5 years were affected more (76% Vs 23.9%). Females were affected more
than males (74% Vs 25.9%). Most of the children received burn injuries in the range of 0-

6
20%. Body surface are (63%), electric burn 3.2% scald (72.5%) followed by flame
(22.7%) were most common cause of burn injuries. Overall pediatric burn mortality was
7.4%. 13

In much of rural Southeast Asia, kerosene stoves and oil lamps are still in regular use.
The combination of “open flames” in overcrowded dwellings, poorly serviced equipment
and the wearing of highly flammable sari result in many more flame burns. Asian
children are at increased risk of burns due to the use of several unique cooking methods
14
such as the heating of food on the floor. Sadly, the usual fate of a child with an
extensive third degree burn in a low income country is death. The risk of mortality from
burns covering over 30% of total body surface area is roughly 50%. The risk of burns
covering more than 50% of total body surface area is nearly 100%. 15

In high income countries children under the age of five years old at the highest risk of
hospitalization from burns. Nearly 75% of burns in young children are from hot liquid,
hot tap water or steam. Infants under the age of one year are still at significant risk for
burns, even in developed countries. The burns they suffer are most commonly the result
of scalds from cups containing hot drinks or contact burns from radiators or hot water
pipes.

The following give an indication of the situation in some high income countries.

1. In Canada, in a single year there were over 6000 visits to emergency departments
in the province of Ontario due to burns. Almost half the cases of burns are among
children under five years of age.
2. In Finland an 11 year study found that scalds were responsible for 42.4% of
children being admitted to two pediatric burns units. Among children under 3
years of age 100% of burns were the result of hot water. In the 11-16 years group,
50% of burns were due to electricity, with the other 50% resulting from fire and
flames.
3. In Kuwait the incidence of burns in children under 15 years of age was 17.5 per 1,
00,000 population. Scalds, followed by flames were the leading causes of burns.

7
 In low income and middle income countries, children under the age of five years have
been shown to have a disproportionately higher rate of burns than in the case in high
income countries.

1. In Kenya, for example, 48.6% of children presenting to the Kenyatta National

Hospital were under the age of five years. Although scalds were the most common
type of burns those caused by open flames were also prominent.
2. In Maiduguri, north east Nigeria, the commonest cause of burns was scalds
(64.4%) children under the age of three years were disproportionately represented.
3. In Brazil and India infants account for nearly half of all childhood burns. 2

Burns are one of the most neglected areas of health care in developing countries.
These countries have 90% of global burn injuries with 70% of these injuries occurring in
the children. Burns typically occur in the home environment and should be amenable to
prompt appropriate first aid. In India more than 10,000 burn associated deaths and over 1
million non fatal moderate to severe burns occur each year. 2

Community based cross sectional survey was carried out in a slum in Delhi, India
from September 2003 to December 2003, accommodated 1597 people belonging to 400
families covered in this study. The researcher found that, a total of 57 persons (14.25%)
had received burns in the past one year, majority (43.8%) of them were below 15 years of
age. Half of the victims (50.80%) were either illiterate or children below 7 years. Most of
the victims (89.5%) had received burns at home. Sixteen persons (28%) had received
burn injury more than once. Scalds with hot liquids/ steam were the leading cause of burn
injury (43.8%). Flame related burn injuries were observed in 33% of cases followed by
those due to crackers (14%), electric shock (5.3%) and iron (35%). This study reveals that
the overall prevalence of burn injury was found to be 14.2%. The peak incidence being in
children <5 years and most of the injuries in the present study occurred at home and the
hot objects/liquids were the commonest ones. There was a matter of serious concern and
requires intensive health education to avoid undesirable remedies in the form of coconut
oil, ghee, toothpaste etc.

8
 Educational programmes convey knowledge to parents. For prevention purposes
educational programmes are often combined with programmes involving legislation and
standards, education and counseling on their own, though whether at the individual level
or within schools, appear to be an effective in reducing the incidence of burns. Educating
parents about the use of safety equipments has been shown to result in increased
knowledge. Educational programmes appears more successful when coupled with
increasing access to safety products or on with changes in the law. Community
programmes to ensure good supervision of children, and to educate parents about burns
and to advice against the storage of flammable substances in the home, have all been
proposed as primary prevention strategies for burns. 2

Nearly 75% of the population of India reside in rural areas like elsewhere in these
areas also women are primary caregivers of their off spring and are usually the first to
16
react in case of any injuries to their children. Children living in rural areas have
significantly higher rates of hospitalization due to injuries than these living in urban
areas. 17

Following a burn , the child should be stabilized. This is usually done by family, first
responders and should follow the basic rules of what should and should to be done in
these circumstances. The overall aim must be to cool the burn, prevent ongoing burning
and prevent contamination. There are many studies assessing the first aid of burns, and
from these ,examples of good practices-such as to “cool the burn” -are drawn. Cooling
the burn surface is one of the oldest methods of treatment.2

Studies have revealed that primary caregivers have lack of knowledge on home safety
and first aid management of scalds and burns. In case of a crisis, basic knowledge on
prevention and first aid measures for burns will help to reduce morbidity and mortality
rate due to burns in under-five children. There is need to conduct studies on knowledge,
among primary caregivers. Hence the researcher decided to carry out a study regarding
parent’s knowledge about first aid for burns and its preventive measures that can be given
by themselves to prevent further complications and it is anticipated that the parents may
be benefited in terms of knowledge gain, so that they can effectively deal with children in
preventing and managing burns.

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6.2 REVIEW OF LITERATURE

Review of literature is a key step in research process. It is an extensive,

exhaustive and systematic examination of earlier or contemporary publication relevant to
research. It is essential for the research study and the researcher to analyze the existing
knowledge before going into a new area of study. This will help make a stepping stone in
the progress of study.

A qualitative study was conducted to gain an in depth understanding of people’s

perceptions of childhood burns and their prevention in rural areas. The sample consists of
50 parents of childhood under 5 years of age. The study was conducted in a rural
community. The researcher found that home as the most common place for childhood
burn injuries and the household members or caregivers responsible because of their lack
of supervision and carelessness regarding first aid, the parents reported prevailing
harmful practices which are likely to make injuries worse. The researcher concluded that,
a safety education programme could be an effective intervention to improve knowledge
and practices of parents in the rural area with regard to prevention of burn injuries in
children. 18

A study was conducted to assess risk factors and to suggest preventive measure
for pediatric burn injuries in the Czech Republic. The study included 1064 children aged
0-16 years. The data was collected from the Czech Ministry of Health on national
pediatric burn hospitalizations during 1996 to 2006.Personal, equipment and
environmental risk factors were identified from hospital records. The researcher found
that, the incidence of burn admissions among 0-14 years olds increased from 85 to 96 per
1,00,000 , between 1996 to 2006,mainly13% increase among 1-4 year olds. Around 31%
of all burn hospitalizations were in 1 year-olds, 79% of burns occurred at home, 70%in
the kitchen, 14% in the living room or bed room and 11% in the bathroom of the 18%
occurring outdoors. Scalds from hot liquids accounted for 70% of all burns. This study
reveals that, there is a need for passive preventive measures. Educational programmes
should be developed for parents and caregivers. 19

10
 A study was conducted to explore the patterns of severe burns injuries with a view
to identifying, whether they could be prevented with better parent education. Study
included, infants requiring admission or outpatient treatment in the burns unit between
July 2005 and September 2007. The researcher found that, immobile infants are at
significant risk of burns and majority of burns sustained in the home. The injuries were
scalds (43%), contact burns (39%) , total body surface area ranged from (0.5% to 30%).
This study reveals that, infants less than 6 month old are at significant risk of burn and is
usually caused by hazards in the home environment. These infants are vulnerable to
inadequate first aid. Better parental education helps to reduce the number of injuries in
this group. 20

A retrospective study was conducted to identify scald demographics and

etiologies. The study included 170 pediatric patients, aged 0 to 5 years, admitted to the
burn center during 2005 to 2006 .Of this total, 124 of the patients were admitted for scald
burns, accounting for 59% of all pediatric burn admissions. Scald burn patients
demographics included male (52%), female (48%) with a mean age of 1.7 years. The
researcher found that, the main etiologies of scald burns included hot water (25%), soup
(24%) and coffee or tea (21%) occurred in the kitchen (83%) and mainly in child’s home
(94%) mother was primary caregiver (78%). Focus group participants (85%) reported
receiving no prior burn prevention education and preferred to receive prevention
instruction. This study reveals that, scald prevention education is needed to create
awareness of the frequency, severity and danger associated with pediatric scalds. 21

A study was conducted to determine the causes magnitude and management of

burns in children under five years of age. In this study a total of 204 under fives were
enrolled. Questionnaires were used to elicit, if the parents/ caretaker had the knowledge
of the cause of the burns, what was done immediately after burn injury, first aid given
immediately after burn, source of the knowledge of first aid. The researcher found that,
(54.9%) were aged between 1-2 years. 78.4% had scalds while 21.6% had flame burns.
Most of the burns (97.5%) occurred accidentally, 68.6% of these burn injuries occurred in
the kitchen ,immediately after burn 87.3% of the children had first aid applied on their
wounds ,while 12.7% didn’t apply anything, of the agents used, honey was the most used

11
(32.8%) followed by cold water (16.7%). The source of knowledge on these agents was
from medical personnel (14%). This study reveals that, causes of childhood burns are
largely preventable requiring active social/ medical education and public enlighten
campaigns on the various methods of prevention. 22

A retrospective study was conducted to report findings from a primary prevention

programme that trained paramedics to conduct home safety surveys provide family safety
education and identify common pediatric injury risks in the home. The researcher found
that, two hundred sixty two families participated and had children averaging 21st months
of age,98% (250/255) had a smoke detector and 65% (140/215) had a fire extinguisher,
with 77% (192/250) and 76% (107/140) of these respective devices functional
27%(55/202) had a fire evacuation plan. For bathwater sites 56% had temperatures
measured less than 120 degrees F,53% (134/249) had house hold chemicals out of reach
of children, but most reported storage in an unlocked location. Paramedics distributed 63
smoke detectors, 46 fire extinguisher vouchers, 234 first aid kits and 225 educational
packets. This study reveals that, participating families had high rates of fire/burn hazards
and unsafe storage practices. Paramedics can recognize common hazards in the home and
provide education and mitigation to reduce risks of pediatric injury and contribute home
safety devices in a community injury prevention program.23

A study was conducted on “characteristics of pediatrics burns patient”. In Rujia

hospital at China. Study was carried out by review of all medical records of acute
pediatric burn patients of age less than or 6 years old admitted. A total of 1494 pediatric
burn patients are admitted. Scalding was the main causes of pediatric burns. Children 0-3
years old were the most common victims of scalding, chemical burns and contact burns.
Domestic burns resulted in 86.5%. The median total body surface area was 4% of mild
burn, 18% for extreme burns. This study concluded that education should focus on
parents and care takers of under five children regarding burns.24

A study was conducted on “Burns and scalds first aid home treatment in London.
Among 142c patients admitted in various hospitals. Of these 64 patients who had first aid
treatment before admitted in hospital.23 patients applied gelatin violet, 7 patients applied
raw eggs, 13 patients applied both, 11 patients applied engine oil, 8 patients applied

12
kerosene oil, 1 patient applied corn flour paste, one patient applied palm oil, Vaseline,
honey and sand. This study shows that a prospective study was needed to educate people
to apply only cold water for burn injuries must be emphasized.25

A descriptive study was conducted to determine first aid knowledge and practices
of ill or injured children in parents. Convenience samples of 654 adult parents were
selected. The data was collected by the administration of multiple choice questionnaires.
The researcher found that, mean age (SD) was 38.5 (13.8), 56% were female, 56% had at
least a high school education. None of these surveyed answered all questions correctly
with roughly half being familiar with 60% of the questions. Knowledge of specific
guidelines ranged from 21% to 92%, subjects especially lacked knowledge regarding the
need to cover victims of large burns, only 43% aware. This study reveals that, many
adults are unfamiliar with the first aid measure. Further education is required to improve
knowledge of first aid practice. 26

A prospective study was conducted to identify the adequacy of first aid care
following minor burns in children at west mead children’s hospital. There were 109
children comparison of the adequacy of first aid delivered by parents and carers, general
practitioners, local hospitals were done. This study reveals that, burns included scalds,
contact, and flame, chemical or electrical burn. Adequate initial first aid had been given
by parents or carers in only 24 of 109 cases (22%). The 85 children who presented to
medical care after inadequate initial first aid was given by parents, carers included 14 of
14 (100%). This study shows that, there is a need to educate parents regarding
appropriate first aid for burns. 27

A case control study was conducted to characterize the prevention of burns in

children and risk factor associated with their occurrence in a developing country as a
basis for future prevention programs in burn unit of the national institute of child health
in Lima. A questionnaire was administered to all consenting 140 guardians of children
admitted to the burns (cases) and general medicine (controls) units. The researcher found
that, altogether 77.5% of the cases burns occurred in the patients home with 67.8% in the
kitchen 74% were due to scalding. Most involved children younger than 5 years lack of
water supply (odds ratio (OR) 5.2, 95% confidence interval (a) 2.1 to 12.3) low income

13
(OR 2.8, 95% CI 2.0 to 3.9) and crowding (OR 2.5, 95% CI 1.7 to 3.6) were associated
with an increased risk. The presence of a living room (OR 0.6, 95% CI 0.4 to 0.8) and
better material education (OR 0.6, 95% CI 0.5 to 0.9) were protective factors. This study
reveals that, burns prevention interventions should be directed to low socioeconomic
status groups and these interventions should be designed accordingly to local risk
factors.28

A study was conducted to analyze the epidemiology and current causative factors
of hospitalized burn injuries among the approximately 1.6 million children between the
age of birth through 15 years. The data was used as a basis for developing a targeted
preventive program to protect children from burns. Epidemiologic data for 760 children,
aged 0 to 15 years admitted to the burn centers over a 4 year period were collected and
analyzed. The researcher found that, the overall hospitalization rate was 11.8 per 1,00,000
person, children aged 2 years had the highest burn incidence (36.9/1,00,000 per year). A
total of 77.4% of the children had body surface are burns less than 40% scalds accounted
for 46.2% of the burns whereas 42.9% were caused by flame. Most of the injuries
occurred at home (93%). This study reveals that, a public health education campaign on
this issue would help to reduce the incidence of childhood burn injuries. 29

A study was conducted to identify types of burns in children and mother’s

attitudes towards and knowledge on burn prevention data were collected from the
mothers of children attending 5 day care centers and kindergartens in Seoul. The
researcher found that, the most frequent type of burn accidents were caused by hot water
(55.4%) and were frequently related to everyday habits. The first aid treatment following
a burn was weak. The majority of the mothers had not instructed their children on who to
contact in the cape of a fire, first aid for burns or how to take escape in the case of a fire.
The mothers showed a lack knowledge on first aid for burns, escaping from a fire and
appropriate water temperature. This study reveals that, a prevention program could be
developed that includes fire prevention habits and first aid for burns. 9

14
6.3 STATEMENT OF THE PROBLEM

“A study to evaluate the effectiveness of structured teaching programme on

knowledge regarding first aid for burns and its prevention among parents
of under five children in selected rural area, Tumkur District”.

6.4 OBJECTIVES OF THE STUDY

1) To assess the knowledge of parents regarding first aid for burns and its prevention
during the pre-test.

2) To evaluate the effectiveness of structured teaching programme (STP) on knowledge

of parents regarding first aid for burns and its prevention.

3) To evaluate the effectiveness of structured teaching programme (STP) by comparing

pre and post test knowledge of parents regarding first aid for burns and its prevention.

4) To assess the association between the post test knowledge of parents regarding first
aid for burns and its prevention and selected socio demographic variables.

6.5 OPERATIONAL DEFINITIONS

1. Evaluate :In this study, it refers to judge the worth of STP regarding first aid for
burns and its prevention.
2. Effectiveness : In this study, it refers to the significant gain in knowledge by the
parents regarding first aid for burns and its prevention after structured teaching
programme.
3. Structured teaching programme : In this study, It is systematically developed
programme with teaching aids, designed to impart knowledge, regarding first aid for
burns and its prevention among parents.
4. Knowledge : In this study, it refers to the awareness and understanding regarding
first aid for burns and its prevention as evaluated by structured questionnaire.

15
5. First aid : First aid is the first assistance or treatment given to an injured
person(casualty) for any injury or sudden illness before the arrival of qualified
medical care by using facilities and materials at that time.
6. Burn : A burn is defined as an injury to the skin or other organic tissue caused by
thermal trauma.
7. Prevention : It refers to the action taken prior to the occurrence and development of
risk factors in population group, which removes the possibility that risk factors will
ever occur.
8. Parents : It refers to both father and mother who begets, nurtures and raises a child.
9. Under five children: Under five refers to children under the age of 5 years. The
infant, toddlers and pre-schoolers together categorized as under five children.
10. Rural area: Rural area is a group of people living in a geographical area where it
doesn’t have much facility and away from the cities and towns and fulfill the criteria
of rural.

6.6 HYPOTHESIS

 H1: There will be significant difference between pre-test and post-test knowledge
scores among parents of under five regarding first aid for burns and its prevention.

 H2: There will be a significant association between level of knowledge of parents

and selected socio- demographic variables.

7. MATERIALS AND METHODS

7.1 SOURSE OF DATA : Data will be collected from parents of under five
Children from selected rural area at Tumkur.

Research approach : Evaluative approach.

Research design : Pre experimental design (one group pre-test and post-
test Design).

16
 Schematic representation of research design:

S O1 X O2

S- Study group.

O1- Pre test, knowledge.

X-Intervention (structured teaching programme)

O2- post test, knowledge.

Study Setting : The study will be conducted at selected rural

area at Tumkur.

Sampling technique : Non-probability Convenient sampling technique

Population : Parents of under five children
Sample size : 60
Pilot study : A pilot study will be planned and conducted with
10% of sample size.

7.2 SAMPLING CRITERIA

i) Inclusion criteria

1. Parents having children 0-5 years.

2. Parents who residing in rural area.

3. Parents know language of Kannada or English.

4. Parents who are willing to participate in the study.

17
 ii) Exclusion criteria

1. Parents who are not available at the time of data collection.

2. Parents who residing in urban area.
3. Parents who are unable to read and understand kannada and English.
4. Parents who are having children of more than 5 years old.
5. Parents who are not willing to participate in the study

7.3 ASSUMPTIONS
1. It is assumed that parents may have less knowledge regarding first aid for
burns and its prevention.
2. The structured teaching programme will improve the knowledge of
parents on first aid for burns and its prevention.

7.4 METHOD OF DATA COLLECTION

Data collection is planned through the interview schedule by using structured

questionnaire.

TOOL-1

PART- A: Proforma for collecting Socio demographic data.

PART- B: Structured questionnaire to assess the knowledge regarding First

aid for burns and its prevention.

TOOL-2

PART- A: STP on first aid for burns and its prevention.

The data will be analyzed by using descriptive statistics and inferential

Statistics.

* Descriptive statistics: It includes mean, frequency, Percentage, range,

standard deviation

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 * Inferential statistics: It includes paired t test, Chai - Square test.

* Duration of the study : 4 weeks.

* Research variables

Independent variables : Structured teaching programme

regarding first aid for burns and its prevention

Dependent variables : Knowledge of parents regarding first aid

for burns and its prevention.

* Demographic Variables : Age, Gender, Education, Occupation,

family income, type of family , Source of information regarding first aid for
burns, housing condition, mode of cooking..

7.5 ETHICAL CLEARANCE:

1) Informed consent will be obtained from the chosen sample?

Yes

2) Has ethical clearance being obtained from the institution?

Yes

3) Does the study require any intervention to be conducted on parents of

under five children?

Yes

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8. LIST OF REFERENCES

1. NIMHANS BISB fact sheet child injury, Available from URL.

http://www.censusidia.gov.in/census_data_2001/India_at_glanie/broad_aspx.

2. Margie Peden, Kayede, Ogegbite, Joan Ozanne-Smith, Adnan A Hyder.. (et al), World
report on child injury prevention, world health organization 2008, P P 79-93. Available
from URL: http://whqlibdoc.who.int/publications/2008/www.

3. Facts about injuries: burns Genova, World Health Organization and international
society for burn injuries, 2006. Available from URL:
(http://www.who.int/entity/violence_injury_prevention/publications/other_injury/en/bu
rns_factsheet.pdf.accessed17April2008)

4. Black. M. Joyce, Hawks Hokanson Jane, Keene. M Annabelle, Medical Surgical

Nursing, Vol-2, 6th Edition. PP 1331-1338.

5. Chung ECH. Burn injuries in China: a one year survey at the united Christian Hospital,
Hong Kong practice, 1996, 18:631-636.

6. First aid to the injured St. Johns Ambulance association book published by volunteers
of St. John’s ambulance brigade. Pg 5-6.

7. First aid to the injured Saint Johns Ambulance Association. Introduction to First Aid 1 st
Edition, published by lieutenant general R S Hoon, Pg 9-10.

8. P.Lal M. Rahi, T. Jain, G.K Ingle Epidemiological study of burn injuries in a slum
community of delhi, Indian journal of community Medicine. Vol. 31, No. 2 (2006-4-
2006-6).

9. Han J S, Kim DH , A study of the types of burns in children and mothers preventive
attitudes to and knowledge of burns. Korean Journal of child health nursing 1998 Feb;
4(1): 97-104.

10. Gulani K.K, Community Health Nursing, principles and practices, first edition, Pg.
390

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11. Corvo M, Isoardip, Startari R, Guerci S, Bernardo L. Burn injuries of children in first
care, Medical and surgical practices, 2005 May-Aug; 27(3-4):26-30.
12. Ghosh A, Bharat R., Domestic burns prevention and first aid awareness in and around
Jamshedpur, India: Strategies and impact. Burns, 2000 Nov, 26(7):605-608.
13. Kumar P, Chirayil PT, Chittoria R. Ten years epidemiological study of pediatric burn
in manipal. Department of burns and plastic surgery, Kasturba Medical College,
Manipal, Karnataka, India, 2000 May: 26(3):261-4.
14. Jang Y CKWON OK, Lee J W OL SJ. The optimal management pediatric steam burn
from electric rice cooker STSG, Burn care rehabilation 2001:22:15-20.
15. Forjuoh SN. The mechanisms, intensity of treatment and outcomes of hospitalized
burns: issues for prevention. Journal of burn care and rehabilitation, 1998, 19:456-
460.
16. Park K. Park’s Text book of preventive and social medicine, 2007 published by M/s
Banarasidas Bhanat 19th Edition Pg 414.
17. Brownell M Friesen D, Mayer T: Childhood injury rates in Manitoba Canadian
Journal of public health 2002, 93:50-56.
18. Mashreky SR, Rahman A, Linnan M, Rahman F, Khan TF.. (et al) Centre for injury
prevention and research, Dhaka, Bangladesh. Perceptions of rural people about
childhood burns and their prevention: Public health; 2009 Aug; 123(8): 568-72.
19. Celko AM, Grivna M, Danova J, Barss P. Third faculty of medicine prague. Severe
childhood burns in the republic, Bulletin, World Health Organization. 2009 May:
87(5):374-81.
20. Burlinson CE, Wood FM, Rea SM Royal Perth Hospital, Australia. Patterns of burn
injury in the perambulatory infant burns: Journal of the international society for burn
injuries 2009 Feb: 35(1): 118-22.
21. Rimmer RB, Weigands, Foster KN, Wadsworth MM, Jacober K.. (et al), Arizona burn
center, USA. Scald burns in young children a review of Arizona burn center pediatric
patients. Journal of burn care and research. 2008 Jul-Aug: 29(4): 595-605.
22. Justin-Temu M, Rimoy G, Premji Z, Matemu G. Department of pharmaceutics,
MUHAS. causes, magnitude and management of burns in under fives in district
hospital in Dares salaam, Tanzania. East African journal of public health, 2008 Apr:
5(1) 38-42.
23. Hawkins ER, Brice JH, Overby BA, welcome to the world: Findings from an
emergency medical services pediatric injury prevention program. Department of

21
 emergency medicine, Chapel Hill, NC, USA, pediatric emergency care. 2007 Nov;
23(11): 790-5.
24. Xin.W. Yin.Z. Characteristics of peadiatric Burns patient. Burns 2006; Aug
32[5]:613-18.
25. Olatain.P.B Burns and scalds, First aid Home treatement .Annuals of Burns and
Disasters.2004; June[12]:16
26. Singer AJ, Gulla J, Thode HC Jr, Cronin KA, Department of emergency medicine,
stong brook, USA. pediatric first aid knowledge among parents. Pediatric emergency
care. 2004 Dec; 20(12): 808-11.
27. McCormack RA, La Hei ER, Martin HC, Gosford Hospital , Gosford, NSW,
Australia. First aid management of minor burns in children: a prospective study of
children presenting to the childrens hospital at westmead, sydney. 2003 Jan 6; 178(1):
31-3.
28. Delgado J, Ramiraz-Cardich ME, Gilman RH, Lavarello R, Dahodwala N (et al).
Benefit association PRISMA, Lima, Peru. Risk factors for burns in children:
crowding poverty and poor maternal education. Journal of the international society
for child and adolescent injury prevention. 2002 mar; 8(1) 38-41.
29. Lari AR, Panjeshahin MR, Talei AR, Rossignal A M, Alaghehbandan. R. Department
of microbiology, Tehran. Epidemiology of childhood burn in fars province Iran. The
journal of burn care and rehabilitation 2002 Jan-Feb: 23(1): 39-45.

9. Signature of the candidate :

10. Remark of the Guide :

11. Name and Designation :

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11.1. Guide :

11.2. Signature :

11.3. Co-Guide :

11.4. Signature :

11.5. Head of the Department :

11.6. Signature :

12.1. Remark of the chairman :

Or Principal

12.2. Signature :

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