الفهرس 
INTRODUCTION
Childhood diseasesOnly 14 pages are availabe for public view
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Abstract
Hygiene is a basic practice that can effectively interrupt the infection transmission pathways. Hygienic behaviors of mothers will invariably affect their own as well as their families’ health; particularly their children. Personal hygiene, home hygiene and child’s hygiene are primarily the responsibilities of the mother and addressing the mothers’ adherence to such practices is indispensable to child’s health promotion efforts. The Health Belief Model is one of the behavioral models that has long been used to study preventive behaviors according to the net perceptions of individuals of risk and seriousness of health issue in addition to effectiveness of and barriers to the recommended behavior.
Aim of the study:
The current study applied the Health Belief Model to study the hygienic practices of mothers of sick children in a public pediatric hospital in Alexandria through the following:
1. Assessing the knowledge of the mothers of regarding the importance and means of hygiene.
2. Assessing the beliefs of the mothers about their children’s vulnerability to infection as well as their beliefs about hygiene.
3. Investigating and observing the hygienic practices of mothers.
A proposal of hygiene promotion program was recommended aided by the findings of our study.
Target population and Study sample:
To achieve this aim, a cross-sectional study was performed on a sample of 300 mothers staying with their children admitted into El Anfoushy Pediatric hospital in Alexandria based on the hypothetical assumption that 25% of the mothers adhere to hygienic practices. A subsample comprising of 100 mothers were randomly selected for observation.
Technical design:
An interview questionnaire, formulated in Arabic, was constructed and completed by the researcher over a period of 8 months exploring different areas of hygienic behavior of mothers.
The questionnaire was used to obtain the following data:
1. Personal and socio-economic information of the mothers.
2. Knowledge of mothers about importance, effect and means of hygiene.
3. Perceptions of the mothers concerning childhood infections and hygienic behavior based on the principles of HBM.
4. Adherence of mothers to hygienic practices regarding their children.
A checklist including a number of observations referring to the degree of adherence of mothers to hygienic practices was used to monitor the behavior of the selected subsample.
The main findings of the study can be summarized in the following points:
The study sample comprised of 300 mothers, most of which were in their mid-twenties, with a mean age of 26.18 years and ranging from 18 to 37 years. 40% of the mothers received preparatory education followed by 25% who finished secondary schooling. Based on their and their spouses’ education, occupation, income and housing data, almost one half of the study sample (49%) belonged to the middle socio-economic class.
The overall knowledge level of the mothers about hygiene was fair in 47.7% of the sample followed by 36% of the mothers with poor knowledge levels. Mothers generally showed a slightly better knowledge of the means of hygiene with a mean score of 13.39 as compared to their knowledge of the importance of hygiene with a mean score of 11.17.
Mass media was reported as the main source of information about hygiene by 75% of the sample. Health workers were reported by 57% of the mothers who mentioned doctors as information source and 30% who mentioned nurses.
The majority of the mothers (86%) had a high level of health perception. The great majority of the sample had high levels of perceived susceptibility, severity and perceived benefits (86.3%, 88.7% and 96.7% respectively). However, the higher percentage of mothers (55.7%) showed moderate levels of perceived barriers. The mothers’ self efficacy perception was high in 60% of the sample with a mean score 24.94 out of 30.
The mean scores obtained for different elements of HBM were close in perceived severity and susceptibility (15.05 and 15.36 respectively). Scores were even higher for perceived benefits with a mean of 16.25. Perceived barriers had the lowest mean score compared to the other elements (13.97).
The hygienic practices of mothers were both interviewed and observed with distinctly different findings. Mothers who reported good practice levels significantly represented one half of the study sample (50.3%, p<0.0001). The majority of the remaining half representing 46.3% of the mothers reported fair levels of practice. However, observation of a subsample of mothers revealed only a significant 11% who showed good practice levels and 52% with fair practices.
The practices of mothers were explored across different areas within the interview with mean scores of 14.25 and 13.01 out of 18 for mother’s personal hygiene and child’s hygiene respectively. Mean score obtained for environmental hygiene was 7.35 out of 9. These findings reflected that the highest percentage of mothers (71%) have good practice levels regarding the hygiene of the child’s belongings and surroundings followed by 65% with good personal hygienic practices and less than half of the mothers (47%) with good practices regarding the child’s hygiene.
Practice was significantly correlated to knowledge, self efficacy and health beliefs. The strongest positive correlation existed between practice and self efficacy (r=0.784, p<0.0001). Moderate positive correlations existed between practice and both perceived susceptibility and perceived severity (r=0.529 and 0.574 respectively, p<0.0001 for both). The only negative correlation was a weak one that significantly existed between perceived barriers and practice (r=-0.179, p=0.002). Another weak correlation was a significant positive one between knowledge and practice (r=0.145, p=0.012).
Regression showed a significant effect of mother’s education on her knowledge scores. Raising the mother’s educational level significantly raised her knowledge score by 1.267 grades (p<0.0001). Mother’s education was also shown to have a significant effect on her overall health perception, together with her age and knowledge scores. The higher the mother’s age, education and knowledge score the higher her total health belief score by 0.437, 0.988 and 0.058 grades respectively (p<0.0001, p<0.0001 and p=0.02 respectively).
The mother’s socioeconomic score showed the only significant influence on her self efficacy among her knowledge score and demographic variables. Raising the mother’s socioeconomic score significantly raised her self efficacy score by 0.168 grades (p<0.0001).
Knowledge and the different elements of HBM all had significant influence on the mothers’ practice scores. Raising the scores of knowledge, self efficacy, perceived susceptibility, severity and benefits all significantly increased the practice score by 0.160, 1.333, 0.188, 0.284 and 1.233 respectively (p<0.0001 for all except perceived susceptibility, p=0.009). On the other hand, increasing scores of perceived barriers significantly decreased the practice scores by 0.684 grades (p<0.0001).
Based on the findings of the present study, the following recommendations were pointed out:
A. Proposed Health Education Program:
- The proposed program aims at increasing the mothers’ awareness and creating a positive attitude about hygiene as a means to reduce infection causation and transmission among different family members.
- The program targets mothers seeking health service at MCH centers, Family Health centers and pediatric hospitals’ clinics.
- In order to achieve its objectives, the program comprises three educational sessions. Each session constitutes a twenty minutes’ health talk, a twenty minutes’ group discussion and brainstorming.
- Audiovisual aids supporting the educational activities of the program include illustrative posters and a pamphlet to be distributed on the third session summarizing the program health messages.
- These messages include the health risks caused by inadequate hygiene, hand hygiene and hygienic feeding practices.
B. Recommendations for Health Workers:
- In-service training of health workers in hygiene education.
- The chief staff should supervise, manage, and evaluate the educational activities on hygiene promotion performed in their facilities as well as the staff training.
- Nurses working at health offices and paediatric hospitals have a great potential in contacting mothers and delivering hygiene information.
- Potential health settings for hygiene education include paediatric hospital wards and waiting rooms, health offices, and primary healthcare facilities.
- Methods used for hygiene education include posters, brochures, pamphlets, videos and slideshows whenever facilities are available.
C. Recommendations for the Community:
- Mass media and community based activities are very useful tools for hygiene education and promotion. These necessitate adequate training of media and community workers in hygiene education.
- Public educational campaigns can utilize a number of community settings such as nurseries, schools, and markets to disseminate hygiene information.
- School hygiene education should be integrated in the comprehensive community hygiene promotion approaches.
- Some of the key messages that should be addressed by hygiene education programs include hygienic feeding practices, the hygienic care of the child’s fingernails, hand hygiene, and locally available and affordable means of cleaning and disinfection.
D. Further Research:
- Hygiene as a study topic should be subdivided and addresses in more detailed research in the context of different settings including health facilities, community settings, educational facilities, and households.
- The behavioural and social aspects of hygiene are candidates for further analysis as well as studying different areas of hygiene such as personal hygiene, home hygiene, and environmental hygiene as practiced by different groups of individuals.
- Multidisciplinary research involving different study branches should take more interest in the subject of hygiene.