الفهرس 
Introduction and Aim of the StudyOnly 14 pages are availabe for public view
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Abstract
Gastrointestinal disorders are very common and most children will have experienced some symptoms several times throughout their lives. Gastrointestinal disorders have significant impact not only on child’s physical and emotional well-being but also on quality of life of parents. Appropriate maternal interventions either pharmacological or non-pharmacological of the common GI disorders early and successfully, prevents the GI disorder from progressing to an emergency situation (Fookes, 2019).
Aim of the study:
The study aimed to assess mothers’ pharmacological and non-pharmacological interventions in caring of their children suffering from common gastrointestinal disorders.
1) Technical Design:
The technical design included research design, setting, study subject and tools of data collection.
Research Design:
A descriptive design was used to conduct this study.
Research Setting:
This study was conducted at Paediatric Out-patient clinics at:
• Childrens’ Hospital affiliated to Ain Shams University Hospitals.
• Polak El-Dakror Hospital in Giza governorate affiliated to Ministry of Health and Population/Egypt.
Study subject:
A Purposive sample of 120 mothers accompanying their children suffering from common gastrointestinal disorders at the previously settings regardless their characteristics such as (age, level of education and employment) were included in this study over a period of three months.
Exclusion criteria:
Children were suffering from any psychological problems, chronic illness, metabolic or genetic disorders and congenital anomalies of gastrointestinal system.
Tools of data collection:-
Data were collected through the following tools:
I: A structured interview questionnaire (Appendix II):
It was designed by the researcher after reviewing the recent and relevant literature James et al., (2014), Gopalan and Sibal, (2015), Abo Salim et al., (2016), Paul and Basude, (2016) and written in simple Arabic language to suit the understanding level of the studied mothers. It was consisted of the following parts:
Part I: characteristics of the studied subjects. This part consisted of 4 items as the following:-
1. The studied mothers’ characteristics including age, level of education, employment, marital status and residence.
2. The studied children’s characteristics including age, gender, education and child’s rank in the family.
3. The children’s medical history including the child’s complain, its duration and frequency.
4. The family characteristics and housing condition including number of family members, type of family, house condition, separate bath room, water supply, sewage disposal, electricity and number of rooms.
Part II: Mothers’ knowledge. This part consisted of 39 questions to assess mothers’ knowledge regarding two items as the following:
a) The common GI disorders: It consisted of 25 questions divided into:
- Knowledge about components and function of gastrointestinal system, definition of the GI disorders, its types, causes related to the mother, causes related to the child, associated symptoms, complications and its prevention (9 questions).
- Mothers’ knowledge regarding vomiting, diarrhea, constipation and abdominal pain. Each disorder included 4 questions about its definition, causes, associated symptoms and complications (16 questions).
b) The pharmacological and non-pharmacological interventions in caring of their children suffering from common gastrointestinal disorders: It consisted of 14 questions to assess mothers’ knowledge regarding pharmacological and non-pharmacological interventions in caring of their children suffering from the common GI disorders.
Part III: Mothers’ reported practices:
This part was used to assess theoretical knowledge regarding mothers’ reported practices. It concerned with mothers’ non-pharmacological interventions for managing vomiting, diarrhea, constipation and abdominal pain in their children.
Scoring system:
The correct and complete answer was scored two grades, the correct and incomplete answer was scored one grade and the incorrect or didn’t know answer was scored zero. These scores were summed-up and converted into a percent score. The score ranged from the following:
- Score < 60 % referred to unsatisfactory level of knowledge.
- Score ≥ 60 % referred to satisfactory level of knowledge.
II: Observational checklists (Appendix III):
The observational checklists were adopted from Meggitt (2003), WHO/UNICEF (2005), Ford (2010), Lynn (2011), Colombo (2012) and Pittet et al. (2017). It consisted of six observational checklists to assess the mothers’ reported practice regarding:
A) Mothers’ pharmacological interventions in caring of their children suffering from common GI disorders. It consisted of 3 checklists namely:-
1. Administration of oral medication adopted from Lynn, (2011) was consisted of 9 steps each step scored 1 to make total scores of 9.
2. Administration of oral rehydration solution adopted from WHO/UNICEF, (2005) was consisted of 9 steps each step scored 1 to make total scores of 9.
3. Administration of suppository adopted from Ford, (2010) was consisted of 9 steps each step scored 1 to make total scores of 9.
B) Mothers’ non-pharmacological interventions in caring of their children suffering from the common GI disorders. It consisted of 3 checklists namely:-
1. Hand washing procedure adopted from Pittet et al. (2017) was consisted of 7 steps each step scored 1 to make total score of 7.
2. Preparation of food adopted from Meggitt, (2003) was consisted of 10 steps each step scored 1 to make total scores of 10.
3. Preparation of herbal products adopted from Colombo, (2012) was consisted of 7 steps each step scored 1 to make total scores of 7.
Scoring system:
The total scores of mothers’ reported practices were 51 marks for 51 steps. Each step was scored as ”One” if the step is done and scored ”Zero” if the step was not done. The total level of mothers’ reported practices were classified into:
(Score <60%) referred to unsatisfactory level of practice.
(Score ≥60%) referred to satisfactory level of practice.
2) Operational design
The operational design for this study consisted of three phases namely preparatory phase, pilot study and fieldwork.
1- Preparatory phase:
It included reviewing of related literature using textbooks, journals, scientific periodicals and web-sites was conducted to develop the study tools and to get acquainted with the various aspects of the research problem.
Validity and reliability:
The tools were revised by a jury of three expertises from different academic categories (professors and assistant professors) of the pediatric nursing department’s staff at the Faculty of Nursing-Ain Shams University. The jury reviewed the tools for clarity, relevance, comprehen-siveness, understanding and applicability. Reliability of the designed tools was done statistically by Cronbach’s alpha test reached (0.85).
Pilot study:
The pilot study was carried out involving 10% of the expected total study sample (n=12). The results of the data obtained from the pilot study were used to test the clarity and applicability of the study tools. According to the results of the pilot, no corrections or radical modification of items were performed so, the study subjects involved in the pilot study were included of the study sample.
Field work:
The actual field work was carried out over a period of three months from the first week of October, 2018 up to the end of December, 2018 for data collection. The researcher was available in the study settings 2 days per week (Sunday and Tuesday) one day for each hospital from 8 am to 2 pm by scheduled rotation. After explaining the study aim for the study sample, the tools were distributed and filled in by the researcher during the interval waiting time. The time required for each interview ranged from 15 - 20 minutes.
3) Administrative design:
An official letter requesting permission to conduct the study was submitted from the dean of Faculty of Nursing- Ain Shams University to the director of each of the previously mentioned settings to collect the necessary data for the current study. The letter included the aim of the study and study tools in order to get permission and cooperation for collection of data.
Ethical consideration:
The research approval was obtained from Scientific Research Ethical Committee affiliated to Faculty of Nursing- Ain Shams University before starting the study. Mothers’ right was secured that all data collected was used only for research purpose. The researcher explained the aim and the nature of the study to subjects and took their approval to participate in the study prior to any data collection. All the study subjects had the right to withdraw at any time from the study.
4) Statistical design:
Data collected from the studied sample were revised, coded and entered using computer. Data entry and statistical analysis were fulfilled using the Statistical Package for Social Sciences (SPSS) software version 21. The obtained data were organized, tabulated, analyzed and represented in tables and graphs as required. Data were presented using qualitative statistics in the form of frequencies, percentages, mean, standard deviation (SD), chi-square (2) and correlation cooffient (r).
Level of significance was accepted at P value:
- Non signifiant difference > 0.05*
- Significant difference < 0.05*
- High statistical significant difference < 0.001*
Results:
Findings of the current study can be summarized as the following:
• One third (33.3%) of the studied mothers were in the age group of 30:<35 years, ( SD 30.3±5.7 years) and 37.5% of them had middle education. Most (82.5%) of them were housewives and all (100%) of them were married.
• More than half (60.8%) of the studied mothers were living in rural residence.
• Less than half (42.5%) of the studied children were in the age group of 1:<3, ( SD 2.6+0.9 years). Regarding to the studied children’s gender it was found that 60% of them were males and the rest of them were females.
• Nearly three quarters (73.3%) of the studied children were diagnosed as gastroenteritis.
• More than half (61.7%) of the studied mothers had satisfactory level of knowledge regarding pharmacological and non-Pharmacological interventions in caring of their Children suffering from the common GI disorders.
• The finding of the current study showed that more than one third (36.7%) of the studied mothers had satisfactory level of reported practice.
• There was significant statistical difference in mothers’ total knowledge level and their age (χ2= 14.80, p= .002), level of education (χ2= 36.78, p= .00) and employment (χ2= 8.94, p= .003). But there was an insignificant statistical difference in mothers’ total knowledge level according to their residence place (χ2= 1.00, p= .58)
• There were significant statistical differences in mothers’ total reported practice level and their level of education (χ2= 22.32, p= .00) and employment (χ2= 6.74, p= .009). But there were an insignificant statistical differences in mothers total reported practice level and their age (χ2= 3.67, p= 0.30) and residence place (χ2= 0.66, p= .38).
• Highly statistical significant positive correlation between mothers’ total knowledge and their total reported practices (r=0.53, p=.00).
Conclusion:
The current study concluded that, the most pharmacological interventions used by the studied mothers in caring of their children suffering from common gastrointestinal disorders were antidiarrheal and antibiotic drugs. While, the most non-pharmacological interventions used by them were the dietary modification and herbal products. In addition, more than half of the studied mothers had satisfactory level of knowledge. While, more than one third of the studied mothers had satisfactory level of reported practice regarding pharmacological and non-pharmacological interventions in care of their children suffering from common gastrointestinal disorders.