AN EXPLORATORY STUDY TO ASSESS THE KNOWLEDGE AMONG MOTHERS OF UNDER FIVE CHILDREN REGARDING THUMB SUCKING IN SELECTED VILLAGE

OF MOGA, PUNJAB

RAMANDEEP KAUR SANDHU SIMARJIT KAUR MANDEEP KAUR HARDEEP KAUR PUSHWINDER KAUR SANDEEP KAUR MUNJAL KARAMJIT KAUR MUNJAL HARPREET KAUR PAWANPREET KAUR JAGJIT SINGH RANPREET SINGH GURSEWAK SINGH KULDEEP SINGH

BABA MANGAL SINGH INSTITUTE OF NURSING, BUGHIPURA, MOGA 2013

CERTIFIED THAT THIS IS THE BONAFIDE WORK OF

MS. RAMANDEEP KAUR SANDHU MS. SIMARJIT KAUR MS. MANDEEP KAUR MS. HARDEEP KAUR MS. PUSHWINDER KAUR MS. SANDEEP KAUR MUNJAL MS. KARAMJIT KAUR MUNJAL MS. HARPREET KAUR MS. PAWANPREET KAUR MR. JAGJIT SINGH MR. RANPREET SINGH MR. GURSEWAK SINGH MR. KULDEEP SINGH

AT THE COLLEGE OF NURSING SUBMITTED IN THE PARTIAL FULLFILLMENT OF THE REQUREMENT FOR THE DEGREE OF GENERAL NURSING & MIDWIFERY OF BABA FARID UNIVERSITY OF HEALTH SCIENCES FARIDKOT, PUNJAB 2013 Prof. Mrs. Swapan Melchisedec M.Sc. (N) PSYCHIATRIC NURSING Principal

Baba Mangal Singh Institute of Nursing, Bughipura

AN EXPLORATORY STUDY TO ASSESS THE KNOWLEDGE AMONG MOTHERS OF UNDER FIVE CHILDREN REGARDING THUMB SUCKING IN SELECTED VILLAGE OF MOGA, PUNJAB A THESIS SUBMITTED IN THE PARTIAL FULLFILLMENT OF THE REQUREMENT FOR THE DEGREE OF GENERAL NURSING & MIDWIFERY OF BABA FARID UNIVERSITY OF HEALTH SCIENCES FARIDKOT, PUNJAB 2013 SUPERVISOR:Ramandeep Kaur Sandhu Simarjit Kaur Mandeep Kaur Sandeep kaur Munjal Karamjit Kaur Munjal Pushwinder Kaur Hardeep Kaur Harpreet Kaur Pawanpreet Kaur Jagjit Singh Ranpreet Singh Kuldeep Singh Gursewak Singh

CERTIFICATE OF SUPERVISOR
This is to certify that Ramandeep Kaur Sandhu, Simarjit Kaur, Mandeep Kaur, Sandeep kaur Munjal, Karamjit Kaur Munjal, Pushwinder Kaur, Hardeep Kaur, Harpreet Kaur, Pawanpreet Kaur, Jagjit Singh, Ranpreet Singh, Kuldeep Singh, Gursewak Singh have undertaken their G.N.M. thesis on the topic, An exploratory study to assess the knowledge among mother of under five children regarding thumb sucking in Bughipura Village of Moga, Punjab. Under my supervision and guidance in Baba Mangal Singh Institute of Nursing, Bughipura, Moga and their work is generally their own.

SUPERVISOR:

DATE:-

Dedicated to Beloved Parents And Teachers

ACKNOWLEDGEMENT
I will praise you, lord with my heart I will tell of the wonderful things you have alone. This project is a collection of different minds and their hands, and could not exist without the support and input of them, that we express on one written page. So we wish to express our deepest gratitude and warmest appreciation to all of them, who have contributed and inspired us to the overall success of the undertaking directly or indirectly. So it is our duty to express the regard fro their support.

First and foremost, we bow our head for Lord respect whose abundant grace and blessing lead us through out the study.

It is difficult to find adequate words to express our gratitude to our supervisor and guide respected Madam Miss Rajman Kaur. She brough our ideas into focus. We appreciate all her contributions of supervision, advice, time and ideas to make our research experience productive and stimulating.

We convey our sincere thanks to respected Principal, Prof. Mrs. Swapna Melchisede M.Sc. (Psychiatric Nursing) for her guidance, invaluable suggestions, efficient supervision, constant encouragement and interest in throughout the completion of thesis.

It gives us great pleasure to thank with deep sense of gratitude to all the mothers of under five children of their whole hearted participating in study without whose cooperation this study would be impossible.

Now we feel our duty to express appreciation gratitude to all experts. Mrs. Rupinder Kaur (M.Sc. (N) in community Health Nursing), Miss Veerpal Kaur (M.Sc. (N) Obstetrics), Miss Harjinder Kaur (M.A. English).

We express our heartful thanks to Miss. Ranjan Kaur for valuable suggestions and guidance for this research work. We are grateful to Sarpanch of Village Bughipura for granting us permission to conduct the research study in the village and giving valuable suggestions

We feel the shortage of words to express our love and gratitude to our parents, brothers and sisters who have always been very understanding and supportive financially and emotionally. The last but not least, we express our love to our friends who helped us selfless and we respect for their extending efforts and understanding.

Ramandeep Kaur Sandhu Simarjit Kaur Mandeep Kaur Sandeep kaur Munjal Karamjit Kaur Munjal Pushwinder Kaur Hardeep Kaur Harpreet Kaur Pawanpreet Kaur Jagjit Singh Ranpreet Singh Kuldeep Singh Gursewak Singh

CHAPTER I INTRODUCTION

INTRODUCTION
Many of the things we need can wait, The child cant, his name is today To him we cannot answer tomorrow. GABRIECA MISTAL It begins at birth. The very first art after birth is to suck our mothers milk. This is an act of affection and compassion. It is a fact that without sucking mothers milk one cannot clear the way of life. Growth and development include not only the physical changes, which will occur from infancy to adolescence, but cultural changes such as changes in emotions, personality, behaviour thinking and speech that children develop as they begin to understand and interact with the world around them. To understand a childs changing and emerging growth and development is an important part of parenting. The habit of putting the thumb in the mouth for comfort or to relieve stress is called thumb sucking. Some psychiatrist believe that thum sucking provides a mother substitute and is caused by a need to cling to the mother. Moreover, ultrasound scans have revealed that thumb sucking can start before birth, as early as 15 weeks of conception whether this behaviour is voluntary or due to

random movements of the fetus in the womb is not conclusively known. Thumb sucking is a behaviour, not a disorder. Child places his fingers or thumb, behind the teeth, in contact with roof of the mouth and sucks the lips and teeth tightly closed.

NEED FOR STUDY

It is human to have a long childhood; it is civilized to have an even longer childhood. Long childhood makes a technical and mental virtuoso out of man, but it also leaves a lifelong residue of emotional immaturity in him. -Erik Hamburger Erikson (1902-1904) Thumb suckling in very early babies can be seen as an adorable habit by many parents. However, as toddlers begin to teeth, many parents are concerned that habitual sucking of thumb can damage emerging teeth or jaw structure. Is something to worry about? Why do babies suck their thumbs? All children suck their thumb at same age? Between 75% and 95% of all infants suck their thumb, making thumb sucking the most prevalent kind of non-nutritive oral activity in infants and young children. Thumb sucking continues in approximately 45% of American preschool children but in only 30% Swedish children of the same age. In a significant percentage American 7-11 years old, thumb sucking persists. Among in it, American Indian and African children thumb sucking is rare. Babies who are bottle fed are also more likely to suck their thumb rather than babies who are breast fed. This is probably because breast feeding usually satisfies the babys need to suck. It is the baby who decides when she is ready to let go of the nipple. An American dental association says the thumb sucking does not cause permanent problem with a teeth or jaw line unless it is continued beyond 4-5 years of age. In teething babies thumb sucking does not cause tooth decay.

In 1922 Charis Barlow3 warned that thumb sucking introduced dirt and germs into the mouth, caused adenoid inflammation, weakened the digestion and spoiled the mouth and thumb shape. Some pediatricians now recommended that no action against thumb sucking be initiated during the first 2 or 3 years. In any year , 1% to 30% of children suffer clinically significant psychiatric disorders that should be treated and suicide is the 10th leading cause of death among children aged 1-14 years (Weiz and Jenson, 1999); Workman and prior 1997. The global burden of disease study indicates that by the year 2020, childhood neuropsychiatric disorders will increase by more than 50% ultimately to become the fifth leading cause of death. From investigators, own experience and observation while posted in the pediatric ward of Krishna Hospital and Civil Hospital., community posting and at Dr. Vidya Sagar Mental Hospital, Amritsar, studied about thumb sucking and founded many children sucking thumb. So we planned this study to give a need based health education to the mother. Many other findings also proved that lack of knowledge regarding thumb sucking of mothers of under five children is one of the significant problems in India and there is a great need of research on this topic. So the investigators thought of assessing and improving the knowledge of mothers. Therefore, this study had been undertaken to assess the knowledge among mothers of under five children regarding thumb sucking.

STATEMENT OF THE PROBLEM

An exploratory study to assess the knowledge among mothers of under five children regarding thumb sucking in selected village Bughipura Moga, Punjab.

PURPOSE OF THE STUDY

The purpose of the study is to assess the knowledge deficit areas of mothers of under five children regarding thumb sucking and to prepare the guidelines. So that the mothers of under five children will adopt safe and correct methods to stop thumb sucking habit in her child and prevent further complications related to thumb sucking.

OBJECTIVES OF THE STUDY

1. To assess the knowledge level of mothers of under five children regarding thumb sucking. 2. To find out the relationship between the knowledge and selected demographic variables such as age, education, occupation of mother and father, family monthly income, type of family, caste and source of information. 3. To prepared guidelines for mothers of under five children regarding thumb sucking.

ASSUMPTIONS
The mothers of the under five children may have some knowledge regarding thumb sucking. The mothers of under five children may feel free to clear their doubts regarding thumb sucking.

OPERATIONAL DEFINATIONS
1. Assess In this study asses refers to process by which the knowledge of mothers is evaluated regarding thumb sucking. 2. Knowledge it refers to the factual information that mothers of under five children already have regarding thumb sucking.

3. Mothers of below five children it refers to the mother having children under five years living in the selected village in Moga. 4. Thumb Sucking Sucking is the infants chief pleasure; they get love, affection and satisfaction. According to psychoanalytic theory an infant do thumb sucking if it lacks sufficient oral satisfaction through sucking to obtain food. Psychiatrist believed that thumb sucking reflects a Clinging need or act as a substitute for mother.

DELIMITATIONS OF THE STUDY

The study is limited to the mothers of under five children who; 1. Are living in the selected village of Moga. 2. Knows either English or Punjabi language. 3. Were willing to participate in the study.

CONCEPTUAL FRAMEWORK
A conceptual framework for nursing practice is a systematically constructed, scientifically based and logically related set of concepts. A conceptual model is a network of concept in relationship that account for broad nursing phenomenon. The conceptual framework deals with the interrelated concepts that are assembled together in some rational schemes by writing of their relevance to a common theme (Polit and Beck, 2004) SHOOTER explains that conceptual framework formulize the thinking process so that others may read and know the frame of reference basic to research problem. RED MAN (1975) ROGI (1973) suggested that a conceptual model determines how the world is viewed and what aspect of world is to be taken in account.

The conceptual framework was based on concept drawn from DORTHY OREMS SELF CARE DEFICIT MODEL. The framework of present study is based on Modified Dorathy Orems Self Care Theory (1997). Orem represents five theoretical concepts. Self care Self care agency Self care deficit Self care demand Nursing system

Self care: it is the behaviour that exist in concrete life situations directed by persons to self or to environment to regulate factors that affect their own development and functioning in interest to life, health or well being. In the present study mothers of below five children are the agent.

THEORY OF SELF CARE HAS THREE COMPONENTS:Universal self care requisites: These include activities which are essential to the health and vitality. Development self care requisites: These includes the interventions and teachings designed to return a person to or sustain a level of optimal health and well being. Health deviation self care requisites: This on compasses the variations in self care which may occur as a result of disability, illness and injury. Self care agency: it is the humans ability or power to engage care agencies are the sample of the study i.e. mothers aged between 20 to 35 years. The mothers ability

engaged in self care can be affected by the conditioning factors such as age of mother, education of mother, caste, occupation of father, type of family etc. Self care deficit: it is an ability to meet own therapeutic self care demands, those actions necessary to maintain function and promote development, deficit, inability to fulfillment of needs of baby. Self care demand: it is an action or the totality of self care action to be performed for some duration in order to meet self care requisites by using valid methods e.g. to maintain good mother child relationship. Nursing System: it describes and explains the relationships that must be brought about and maintained for nursing to be performed. Three nursing systems are described by Orem based on dependency they are; wholly compensatory, partially compensatory and supportive education system. In this study mothers have ability to meet their childs need with proper guidance. Wholly compensatory nursing system: where is the nurse compensates for the mothers of under five children totally inability who has to perform these activities. Partially compensatory nursing system: Where is the nurse compensating for mothers of under five children partially inability who has to perform these activities. Supportive and educative: Where is the nurse assist the mothers in decision making and acquiring skill and knowledge regarding thumb sucking. In supportive education , nursing system health education is given to mothers of under five children regarding thumb sucking.

ORGANIZATION OF THE REPORT

The study is presented in following five chapters;

I. II. III.

Chapter; Introduction of the study Chapter; Review of literature Chapter; Research Methodology is presented which includes research approach, research design, selection and description of field for study, population and selection of sample, sampling techniques, criteria for sample selection, development of the tool, description of tool, criteria measures, content validity, try out of the tool, pilot study, reliability of the tool, ethical consideration, data collection procedure, difficulties faced during the study, plan of data analyses.

IV.

Chapter; Analysis and interpretation of data in terms of descriptive and inferential statistics and discussion.

V.

Chapter; Summary, Conclusion, Implications and Recommendations

Summary
This chapter is focused on the introduction of the study, need for the study, statement of the problem, purpose of the study, objectives of the study, assumptions, delimitations of the study, operational definitions, conceptual framework and organization of the report.

CHAPTER II REVIEW OF LITERATURE

REVIEW OF LITERATURE
Introduction:Review of literature is key step in research process. Review of literature refers to an extensive, exhaustive & systematic examination of publication relevant to the research projects. Nursing research may be considered a continuing process in which knowledge gained from earlier studies is an integral part of research, is general. The review of literature is defined as Broad comprehensive in depth, systematic and critical review of scholarly publication unpublished scholarly print material and audio visual material (CR Kothari, 2000)8 Thus review of literature helps in many ways starting from selection & formulation of problem, Providing conceptual frame work for study, assess feasibility. In this study the review of literature falls, under following headings:a) Review of literature r/T to knowledge regarding thumb sucking. b) Review of literature r/T to practice, of thumb sucking in children.

REVIEW OF LITERATURE RELATED TO KNOWLEDGE

Brooks MB9; as advisor and counselor of mothers, a physician can contribute greatly to preventive medical care of infants. Advice can be given piecemeal, but according to a problem. At birth the mother is reminded of the importance of emotional environment in shaping of the life and personality of the child. The most important thing the mother and father do during the first year is enjoy their body. At six months each monthly visit includes a discussion period. Tewari A, Gauba K, Goval A (1994)11 concluded that he knowledge about infant dental care (as a Part of Primary Preventive Programme) was delivered by the existing health

team of CHC viz. Medical doctors, multipurpose workers, health workers, Anganwadi workers, after due training from the dental experts, in the rural community of Raipur Rani. D.D.D.J.H. Sillman Associate visiting Dentist:- In a group of sixty children in which serial studies were made from birth to 14 year of age, there were twenty thumb-suckers. Records were made before thumb-sucking started, while it was in effect & after it had stopped. Parental & expert responses to thumb-sucking underwent significant changes during the twentieth century.

REVIEW OF LITERATURE RELATED TO KNOWLEDGE

Thomas Chandler12, an American physician, was the first to raise medical concerns about thumb sucking. In his 1878 article in the Boston Medical & Surgical Journal, the precursor of the new England Journal of Medicine, he emphasized its dire dental consequences. John B. Watson14; The behaviorist John B. Watson rejected instinct as an explanation for human behavior. In the psychological care of the infant and child (1928) he promoted child-rearing practices based on his belief that children are made, not born, and that almost all behavior result from conditioning. W.H. Littlefield B.D.S. (Durham), H.D.D. (Edinburgh) (2004)15. Thumb sucking is common habit occurring in about 17% of children. Ti is definite cause of dental irregularity and the majority of thumb-suckers have a malocclusion either caused or aggravated by the habit.

Yassaci S, Rafieian M, Ghajari R16; Department of orthodontics, Shahid Sadoughi University of Medical Sciences & Health Services, Yazd, Iran, States that any kind of stress has a negative effect on the mood of people & stress resulting from war is no exception. Charles Anderson Aldrich and Mary Aldrich (1938)18; Charles Anderson Aldrich & Mary Aldrich, the authors of babies are human beings (1938) by contrast, viewed thumb sucking as a prenatal sport designed to exercise the facial muscles. Luther Holt19; Recommended mittens or a splint to the elbow to prevent thumb sucking. Charis Barlow (1922)20; He warned that thumb sucking introduced dirt and germs into the mouth and thumb shape, caused adenoid inflammation, weakened the digestion and spoiled the mouth and thumb shape.

CHAPTER- III METHODOLOGY

METHODOLOGY
Research methodology refers to the methods the researcher use in performing research operations (Kothari C.R.2004) Methodology of research indicates the general patterns of organizing procedure to gather valid and reliable data for an investigation. This chapter deals with methodology adapted for An Exploratory study to assess the knowledge among mothers of under five children regarding thumb sucking in selected village, Bughipura Moga. It includes the following: Research approach Research design Selection description of field study Population and selection of samples Sample size and sampling techniques Criteria for sample selection Development of the cool Description of the tool Criteria measures Content validity Try out of the tool Pilot study Reliability of tool Ethical consideration Data collection during the study

Data collection procedure Difficulties faced during the study Plan of data analysis Summary

Research Approach Research approach is most significant part of any research. The appropriate choice of research approach depends on the purpose of the study it is aimed to assess the knowledge among mothers of under five children regarding thumb sucking in selected villages of Moga, Punjab. Research Design A research design incorporates the most important methodology design that a researcher workers in conducting a research study (Polit and Beck, 2004). The central purpose of research design is to maximize the amount of control that an investigator held over the research situation and variables. Independent Variables In this study the independent variables are age of a mother, education of mother, occupation of mother, education of father occupation of father family monthly income, type of family caste. Dependent Variables In this study the dependent variables is knowledge of mother of under five children regarding thumb sucking.

Selection and description of for study The village selected for the study was of district Moga, Punjab. The total population of the village is approximately 3130. The reason for selecting this village was easy availability of sample administrative approach, co-operation. Permission was taken from the sarpanch of for conducting the study. Population Acc. to Polit and Beck (2004) a population is an aggregate or totality of all subjects that possess a set of specifications. The target population of present study mothers of under five children aged 20-25 yrs living in selected village of Moga, Punjab. Sampling is process of selecting a portion of the population to represent the entire population (Polit and Beck, 2004). The subjects of the present study were selected by using convenient sampling techniques. Sample was taken from the village Bughipura of Moga. Sample and Sampling Technique The investigators selected a sample of 30 mothers of under five children with age group 20-35 yrs in the village Bughipura, Moga, Punjab by using convenient sampling technique. Criteria Fro Sample Selection Mother of under five children living in the selected village of Moga. Mother of under five children could speak either English or Punjabi. Mothers of under five children willing to participate in the study.

Development of the Tool As the study was to assess the knowledge regarding thumb sucking among mother of under five children in selected village of Moga. There fore the tool was prepared to assess the children five children living in selected village of Moga. Description of the Tool A structured multiple choice questionnaire to assess the knowledge of mothers of under five children regarding thumb sucking. The review of literature expert opinions and investigators own experiences provided the basis for construction of tool. Tool consist of following Parts:Part-1 sample Characteristics The part consist of items for obtaining personal information about subject such as age of mother, education of a mother, occupation of mother, education of father, occupation of father, family monthly income type of family. Pat-2 a Structured Questionnaire to assess the knowledge of mothers of under children regarding thumb sucking A total of 18 question were included and such question were include and each question has a score of 1 marks each question has four responses out of which respondent had to choose the correct one. For correct response the score was 0, so the maximum score was 30 minimum score was 0. Criteria Measures The criteria measure used in the study if knowledge score on child care of under five children. The knowledge score refers to the total obtained scores of the knowledge items in structured questions by mother of under five children in selected village Bughipura.

Levels of Knowledge Good Average Below Average Content Validity

Score 76-100% (24-30) 51-75% (16-23) 50% (0-15)

Content validity of the tool was confronted by experts opinion regarding the relevance of item. According to their valuable suggestions, some corrections and modification in the language of question ere made. The final tool consists of 18 questions after making necessary changes. Try Out of the Tool Try out of the tool was done for clarity, relevance and feasibility of conducting the study. Permission was taken from the sarpanch of selected village Bighupra, Moga. Ethical Considerations With the view of ethical considerations the researcher discus the type and purpose of the study with sarpanch of selected village Bughipura, Moga and written permission was taken, therefore also the mother of under five children were explained about the purpose of the study and verbal consent was taken from them for their participation in the study. Pilot Study Pilot and Hungler (2004) stated that pilot study is miniatures of some part of actual study in which instrument are administrate red to the subject drawn from the some population. The purpose of the study was to found out the feasibility and reliability of the study. The pilot study was conducted in 15th march 2013 to ensu5re the reliability of the tool and feasibility of the tool.

Reliability of the Tool Reliability of the tool was computed by split half method and was calculated by karl Pearsons coefficient formula, which was found to be r=0.98. Hence, the tool was highly reliable. Data Collection Procedure Data collection was done from 15th march to 10th April 2013. The purpose and objectives were discussed with sarpanch of selected village Moga. The respondents were selected both in morning and evening time. The time given for the answer was half an hour on the last day of data collection guidance on thumb sucking was given to mothers under five children. Difficulties Faced During the Study Data collection was time consuming. Many times investigator had to wait for subjects. Plan for Data Analysis Analysis and interpretation of data was done by using description and inferential statistics such as mean, percentage, stand age, deviation, correlation coefficient and T-test etc.

SUMMARY
This chapter deals with the research approach design, selection and description of field for study. Population and selection of sample, sampling techniques, criteria for sample selection, development of the tool, pilot study, reliability of the tool, ethical consideration, data collection procedure, difficulties faced during the study, Plan of Data analysis.

CHAPTER IV ANALYSIS AND

INTERPRETATION

DATA ANALYSIS AND INTERPRETATION OF DATA

Data analysis enables the researcher to reduce summarize, organize, evaluate and communicate numerical information. This chapter deals with the analysis and interpretation of data obtained from sample of 30 mothers of under five children of age group 20-35 yrs. In selected village of Bughipura, Moga, Punjab. The data collected during the course has been analyzed by using descriptive and inferential statistics. In descriptive statistic mean, percentage and standard deviation were used for analyzing the distribution of respondents according to their demographic characteristics. Result o study are shown in form of tables & figures.

OBJECTIVE OF THE STUDY

1. To assess the knowledge level among mothers of under five children regarding thumb sucking. 2. To find out the relationship between the knowledge and selected demographic variables such as age of mother, education of mother, occupation of mother, family monthly income, type of family, caste and source of information. 3. To prepare guidelines for mothers of under five children regarding thumb sucking.

ORGANIZATION OF DATA
The raw data collected were entered in a master sheet and analyzed and interpreted using descriptive or inferential statistics. The data was organized and presented under following sections:-

Section I: Sample characteristics Section II: Findings related to knowledge with different demographical variables like age of mother, education of mother, occupation of mother and father, family monthly income, number of children and source of information.

SECTION I SAMPLE CHARACTERISTICS TABLE I PERCENTAGE DISTRIBUTION OF SAMPLE CHARACTERISTICS (N=30)

S. NO. SAMPLE CHARACTERISTICS PERCENTAGE 1. Age of mother in years 20 23 24 27 28 31 32 35 2. Education of mother Illiterate Primary Secondary Graduate and above 3. Occupation of father Housewife 16 53.3% 8 2 5 15 26.6% 6.8% 16.6% 50% 5 8 10 7 16.6% 26.6% 33.3% 23.5% n

Labourer Govt. Job Private job 4. Education of father Illiterate Primary Secondary Graduate and above 5. Occupation of father Govt. Job Private job Labourer Farmer 6. Family monthly income in rupees <5000 5001-10000 10001-15000 >15001 7. Type of family Nuclear Joint 8. Caste General

3 4 7

10% 13.3% 23.4%

5 6 10 9

16.6% 20% 33.4% 30%

5 14 3 8

16.6% 46.6% 10% 26.8%

16 6 4 4

53.4% 20% 13.3% 13.3%

18 12

60% 40%

20

66.6%

BC SC 9. No. of children 1 2 3 >3

4 6

13.4% 20%

6 16 5 3

20% 53.4% 16.6% 10%

TABLE 1 AND FIG 3 (a) TO 3 (J)

Showing that a significant number of mother of under five children i.e. 23.5% belong to age group 32-35 years, followed by age group 28-31 yrs (33.3%) and 26.6% in age group 24-27 yrs and minority of mother i.e. 16.6% were in age group 20-23 yrs. According to education of mother a significant number of mother of under five children i.e. 50% are from graduate and above followed by illiterate (26.6%) and 16.6% were secondary and lowest percentage is 6.8% of graduate or above. According to education majority of mother of under five children i.e. 53.3% were housewives followed by 23.4% of private job, 13.3% of govt. job and lowest percentage is 10% of labourer. In education of father, a significant number of mother of under five children i.e. 33.4% whose husbands educational status was secondary followed by graduate and above 30% and primary (20%) and the minority of mother of under five children i.e. 16.6% were whose husbands educational status was illiterate or noting.

In occupation of father a significant number of under five children i.e. 46.6% whose husbands occupation status was private job followed by 26.8% farmer and govt. job (16.6%) and the minority of mother of under five children i.e. 10% were whose husband were labourer. Regarding family monthly income in rupees majority of mothers of under five children 5.4% were having family monthly income of < 5000 Rs. Followed by 20% who had their family monthly income 500/- 10000 Rs. And 13.3% who had their family monthly income 10001-15000 Rs. And majority of mothers of under five children i.e. 13.3% were having family monthly income is >15001 Rs. According to type of family 60% of mothers belonged to nuclear families followed by 40% to joint families. Regarding caste 66.6% of mothers of under five children belonged to general category, 20% belonged to SC category and the minority of mothers of under five children belonged to BC category is 13.4%. According to No. of children, 53.4% mothers of under five children are having 2 children followed by 20% having 1 child and 16.6% having 3 children. The minority of mothers of under five children i.e. 10% are having children >3. According to source of information a significant number of mothers of under significant number of mothers of under five children i.e. 46.6% gained knowledge about thumb sucking from family members followed by 26.8% of mothers of under five children taken information from friends and relatives, 16.6 had taken from mass media. Minority of the mothers of under five children i.e. 10% taken the information from health personnel.

23.50%

16.60%

20-23 yrs 26.60% 24-27 yrs 28-31 yrs 33.30% 32-35 yrs

3 (a) Percentage distribution of mothers of under five children according to age of mother.

26.60% 50% 6.8% 16.60% Illiterate Primary Secondary Graduate and above

3 (b) Percentage distribution of mothers of under five children according to education of the mother.

23.40%

13.30%

53.30%

Housewife Labourer Govt. Job

10%

Private Job

3 (c) Percentage distribution of mothers of under five children according to occupation of the mother.

16.60% 30% Illiterate Primary Secondary 33.40% Graduate andabove

20%

3 (d) Percentage distribution of mothers of under five children according to education of the father.

16.60% 26.80%

Govt. Job 10% 46.60% Private Job Labourer Farmer

3 (e) Percentage distribution of mothers of under five children according to occupation of the father.

13.30%

20% 53.40%

< 5000 Rs. 5001-10000 Rs. 10001-15000 Rs.

13.30%

>15001 Rs.

3 (f) Percentage distribution of mothers of under five children according to family monthly income.

40%

60%

Nuclear Joint

3 (g) Percentage distribution of mothers of under five children according to type of family.

20%

13.40% 66.60%

General BC Sc

3 (h) Percentage distribution of mothers of under five children according to caste.

10% 16.60%

20%

1 2 3 >3 53.40%

3 (i) Percentage distribution of mothers of under five children according to no. of children.

16.60% 10% 46.60%

Family members Friends and relatives

26.80%

Health Personnel Mass Media

3 (j) Percentage distribution of mothers of under five children according to source of information

SECTION - II
Objective 1:- To assess the knowledge level of mothers of under five children regarding thumb sucking

TABLE 2 Percentage distribution of knowledge score level of mothers of under five children regarding thumb sucking.

S. NO.

Level Knowledge

of Score level

Percentage

1. 2. 3.

Good Average Below Average

24 30 16 23 05

4 8 18

13.4% 26.6% 60%

Maximum Score = 30 Minimum Score = 0

Table 2 and fig. 4 depicts that 13.4% of the mothers of under five children were having good knowledge where as 26.6% of them had average knowledge and 60% had below average knowledge regarding thumb sucking. Thus it was indicated that significant number of mothers of under five children were having level of knowledge below average.

SECTION - III
Objective 1:- To find out the relationship between the knowledge and selected demographic variables such as age of mother, education of mother, occupation of mother, education of father, occupation of father, family monthly income, type of family, caste, number of children and source of information.

TABLE 3 Mean knowledge score of mothers of under five children regarding thumb sucking according to age of mother. N=30 MEAN KNOWLEDGE SCORE Sr. no. a. b. c. d. Age in years 20-23 24-27 28-31 32-35 n 5 8 10 7 Mean 21.8 24.12 30 20.22 SD 5.32 4.94 5.51 3.99

Maximum Score = 30 Minimum Score = 0

Table 3 and fig. 5 depicts that 13.4% of the mothers of under five children of age group 28-31 yrs. Had highest mean knowledge score (30) regarding thumb sucking followed by

(24.12) in the age group 24-27 yrs and 21.8 in age group of 20-23 yrs and age group of 32-35 had lowest mean knowledge score (20.22) regarding thumb sucking. Hence, it can be concluded that age of mother had high impact on the knowledge of mothers of under five children regarding thumb sucking.

TABLE 4 Mean knowledge score of mothers of under five children regarding thumb sucking according to occupation of father. N=30 MEAN KNOWLEDGE SCORE Sr. no. a. b. c. d. Occupation of father Govt. job Private job Labourer Farmer n 5 14 3 8 Mean 17.33 17.42 11.8 14.23 SD 5.09 5.76 3.40 4.08

Maximum Score = 30 Minimum Score = 0

Table 4 and fig. 6 shows that highest mean score of mothers of under five children according to occupation of the father regarding thumb sucking was 17.42 whose husbands were doing private job, followed by mothers of under five children whose husbands were doing govt. job (17.33), farmer (14.23) and lowest mean knowledge score of mothers of under five children is 11.8 whose husbands were labourer. Hence, it can be concluded that occupation of father had impact on the knowledge of mothers of under five children regarding thumb sucking.

TABLE 5 Mean knowledge score of mothers of under five children regarding thumb sucking according to family monthly income. N=30 MEAN KNOWLEDGE SCORE Sr. no. a. b. c. d. Family monthly income < 5000 5001-10000 10001-15000 >15001 n 16 6 4 4 Mean 13.17 16.04 17.12 20.14 SD 4.07 5.32 5.23 2.37

Maximum Score = 30 Minimum Score = 0

Table 8 and fig. 7 shows that highest mean knowledge score of mothers of under five children according to family monthly income regarding thumb sucking was 20.14 whose family monthly income was > 1500 Rs., followed by mothers of under five children whose family monthly income was 10001 15000 Rs. (17.12), mothers of under five children whose family monthly income was 5001 10000 Rs. (16.04) and lowest mean knowledge score of mothers of under five children is 13.17 mothers of under five children whose family monthly income was < 5000 Rs. Hence, it can be concluded that occupation of family monthly income had impact on the knowledge of mothers of under five children regarding thumb sucking.

TABLE 6 Mean knowledge score of mothers of under five children regarding thumb sucking according to type of family. N=30 MEAN KNOWLEDGE SCORE Sr. no. a. b. Type of family Nuclear Joint n 18 12 Mean 15.41 14.19 SD 5.05 5.07

Maximum Score = 30 Minimum Score = 0

Table 9 and fig. 8 shows that highest mean knowledge score of mothers of under five children (15.41) regarding thumb sucking who belonged to nuclear families and the lowest mean knowledge score (14.19) of mothers of under five children who belonged to joint families. Hence, it can be concluded that type of family had no impact on the knowledge of mothers of under five children regarding thumb sucking.

TABLE 7

Mean knowledge score of mothers of under five children regarding thumb sucking according to occupation of caste. N=30 MEAN KNOWLEDGE SCORE Sr. no. a. b. c. Caste General BC SC n 20 4 6 Mean 16.31 13.63 11.8 SD 4.91 4.21 4.06

Maximum Score = 30 Minimum Score = 0

Table 10 and fig. 9 shows that highest mean knowledge score of mothers of under five children. (16.31) belonged to general category followed by mothers of under five children belonged to BC category (13.63) and the lowest mean knowledge score of mothers of under five children (11.8) belonged to SC category. Hence, it can be concluded that religion had high impact on the knowledge of mothers of under five children regarding thumb sucking.

TABLE 8

Mean knowledge score of mothers of under five children regarding thumb sucking according to No. of children. MEAN KNOWLEDGE SCORE Sr. no. a. b. c. d. No. of children 1 2 3 >3 n 6 16 5 3 Mean 18.52 15.08 10.7 11.75 SD 5.88 4.43 4.41 2.22

Maximum Score = 30 Minimum Score = 0

Table 11 and fig. 10 shows that highest mean knowledge score of mothers of under five children (18.52) regarding thumb sucking who have 1 child, followed by (15.08) the mothers of under five children who have 2 children, (11.75) the mothers of under five children who have >3 children and the lowest mean knowledge score (10.7) of mothers of under five children who have 3 children. Hence, it can be concluded that no. of children had high impact on the knowledge of mothers of under five children regarding thumb sucking.

MAJOR FINDINGS OF THE STUDY

Majority of the mothers of under five children 26.6% were in the group 24-27 years, 50% of mothers of under five children had graduate and above. The majority of mothers of under five children 53.3% were housewives, 33.4% of mothers of under five children were those whose husbands had secondary education level, 46.6% of mother of under five children were those whose husbands were doing private jobs, 53.4% of the mothers belonged to the < 5000 Rs. Group of family monthly income. The majority of mothers of under five children 60% were from nuclear family and 66.6% belonged to general category, 53.4% of mothers of under five children had 2 children and 46.6% had family members as their source of information. Majority of mothers of under five children 60% were having below average knowledge, followed by 26.6% of them have average knowledge and only 13.4% of them had good knowledge about thumb sucking. Highest mean knowledge score of mothers of under five children (30) were in age group 28-31 years and the lowest mean knowledge score of mothers of under five children (20.22) were in the age group 32-35 years. Highest mean knowledge score of mothers of under five children (17.42) were in group of private job in occupation of father and the lowest mean knowledge score of mothers of under five children (11.80) were in group of labourer in occupation of father. Highest mean knowledge score of mothers of under five children (20.14) were in the group of >15001 Rs. In family monthly income and the lowest mean

knowledge score of mothers of under five children (13.17) were in group of < 5000 Rs. in family monthly income. Highest mean knowledge score of mothers of under five children (15.41) were in group of nuclear family and the lowest mean knowledge score of mothers of under five children (14.19) were in group of joint family. Highest mean knowledge score of mothers of under five children (16.31) were in group of general category and the lowest mean knowledge score of mothers of under five children (11.8) were in the group of SC category of caste. Highest mean knowledge score of mothers of under five children (18.52) were in group of mothers with 1 child and the lowest mean knowledge score of mothers of under five children (10.70) were in group of mothers with 3 children.

CONCLUSION
60% of under five mothers had below average, 26.6% of them had below average knowledge and only 13.4% of under five mothers had good knowledge regarding thumb sucking. In the present study age of mother, education of mother, occupation of mother, occupation of father, family monthly income, caste, no. of children, source of information had significant impact on the knowledge regarding thumb sucking among the mother of under five children were as type of family had no impact on knowledge regarding thumb sucking among the mothers of under five children.

DISCUSSION
This chapter deals with findings of present study An exploratory study was conducted to assess the knowledge level among mothers of under five children regarding thumb

sucking. In this chapter an attempt had been made to discuss the findings of the study in accordance with the objectives of the research study. The study was conducted upon 30 mothers of under five children who are living in village Bughipura of District Moga. The convenient sampling technique was used to collect the samples before collecting data. Investigators gave brief introduction about self, purpose of study and instructions regarding filling of questionnaire and gain confidence. The discussion is presented under the following headings. Assessment of knowledge level. Relationship between the knowledge and selected demographic variables such as age of mother, occupation of mother, education of father, occupation of father, family monthly income, type of family, caste and no. of children. The 1st objective was concerned with the assessment of the knowledge level: A significant no. of mothers of under five children i.e. 60% had below average knowledge, followed by 26.6% of them had average knowledge and 13.4% of them had good knowledge about thumb sucking. The 2nd objective is to find the relationship between the knowledge and selected demographic variables such as age of mother, education and occupation of father, family monthly income, type of family, caste, no. of children. The study showed that relationship between knowledge and age of mother was found significant. It means that age of mother had high impact on the knowledge of mothers of under five children regarding thumb sucking.

 There was a relationship between knowledge and education of mother significant. It means the education of mother had high impact on the knowledge of mothers of under five children regarding thumb sucking. There was a relationship between knowledge and occupation of father significant, which shows occupation of father had high impact on the knowledge of mothers of under five children regarding thumb sucking. The study showed that family monthly income had high impact on the knowledge of mothers of under five children regarding thumb sucking. The study showed that type of family had no impact on the knowledge of mothers of under five children regarding thumb sucking. The study showed that caste had high impact on the knowledge of mothers of under five children regarding thumb sucking. Relationship between knowledge and no. of children was found significant. It means that no. of children had high impact on the knowledge of mothers of under five children regarding thumb sucking.

SUMMARY
This chapter deals with analysis, interpretation, major findings, and discussion about data collected from village Bughipura of District Moga. Descriptive and inferential statistical used for analysis and relationship between variables was tested by computing mean and standard deviation values.

CHAPTER-V SUMMARY, IMPLICATION, LIMITATIONS AND RECOMMENDED

SUMMARY, CONCLUSION, IMPLICATION AND RECOMMENDATIONS

This chapter deals with brief account of the study including conclusion drawn from findings, implication of the study for a nursing education, nursing administration, nursing research, limitation and recommendations. In less than five yrs old, unhealthy care of under five children lead to a lot of case with malnutrition. So the national goal is to reduce and control malnutrition. The knowledge regarding child care prevents many health problems like malnutrition.

Summary
The present study was undertaken by the investigators for assessing the knowledge among mothers of under five children regarding thumb sucking in selected village, Bughipura, Moga, Punjab. The study was exploratory in nature having 30 samples of mothers of under five children. The mother under five children was selected by convenient sampling techniques. A structured questionnaire was given to samples and health teaching was given to mother of under five children to improve their knowledge level regarding thumb sucking. Statement of the Problem An exploratory study to assess the knowledge among mothers of under five children regarding thumb sucking in selected village Bughipura, Moga, Punjab. Purpose of the Study The purpose of the study is to assess the knowledge deficit areas of mothers of under five children regarding thumb sucking and to prepare the guidelines. So that the mothers of

under five children will adopt safe and correct methods to stop thumb sucking habit in her child and prevent thumb sucking and further complications.

OBJECTIVES OF THE STUDY

Ro assess the knowledge level of mothers of under five children regarding thumb sucking. To find out the relationship[p between the knowledge and selected demographic variables such as age of mother, education of mother, occupation of father, family monthly income, type of family, caste number of children and source of information Assumptions :The mother of the under five children may have some knowledge regarding thumb sucking. The mothers of under five children may feel free to clear their doubts regarding thumb sucking. Conceptual Frame Work Conceptual framework of the study was based on Modified Dorathy Oremss Self care Theory (1997) Independent Variables In this study the independent variables are age of a mother, education of mother, occupation of mother, occupation of father, family monthly income, type of family, caste, number of children. Dependent Variables In this study the dependent variables is knowledge of mother of under five children regarding thumb sucking.

Description of the Tool A structured multiple choice questionnaire ton assess the knowledge of mother of under five children regarding thumb sucking. The review of literature, expert, opinions and investigators own experiences provided the basis for construction of tool. Tool of consist of following parts: Part-1 Sample Characteristics The part consist of items fro obtaining personal information about subject such as age of mother, education of mother, occupation of father, family monthly income, type of family, cast, number of children and source of information. Part-2 a Structured Questionnaire to assess the knowledge of mother of under five children regarding thumb sucking This part consists of multiple choice questions regarding thumb sucking. A total of 30 questions were included and each question had a score of 1 mark each. Each question has four responses out of which respondent had to choose correct one which will score 1 if right and 0 if wrong. Validity and Reliability of the Tool Five expert did the validity of the tool, reliability of the tool were calculated by split half method. Try Out of the Tool Try out of the tool was done fro clarity, relevance and feasibility of conducting the study. Permission was taken from sarpanch of Bughipura Village.

Data Collection Procedure Data collection was done from 15th march to 10th April 2013. The purpose and objectives were discussed with sarpanch of Bughipura village and formal written permission was obtained from them to collect data. The respondent were selected both in morning and evening time. The time was given for the answer was half n hour. On last day of data given to mother of under five children.

MAJOR FINDINGS OF THE STUDY

Majority of mothers of under five children 60% were having below average knowledge followed by 26.6% of them have average knowledge and only 13.4% had good knowledge about thumb sucking. Highest mean knowledge score of mother of under five children (17.42) were in group of private job in occupation of father and the lowest mean knowledge score of mother of under five children (11.80) were in group of laborer in occupation of father. Highest mean knowledge score of mothers of under five children (20.14) were in group of > 15001 Rs. in family monthly income and the lowest mean knowledge score of the mothers of five children (13.17) were in group of 5000Rs. in family monthly income. Highest mean knowledge score of mothers of under five children (15.41) were in group of nuclear family and the lowest mean knowledge score of mothers of under five children (14.19) were in group of joint family. Highest mean knowledge score of mothers of under five children (16.31) were in group of general category and lowest mean knowledge score of mothers of under five children (11.8) were in group of SC category of caste.

CONCLUSION
From the present study, it is concluded that 13.4% of the mothers of under five children good knowledge where as 26.6% of them had average knowledge and 60% had below average knowledge regarding thumb sucking.

LIMITATION
The study is limited to the mothers of under five children who; Were living in the selected village of Moga. Knows either English or Punjabi Language. Were willing to participate in the study. Implication The finding indicate that most mother of under five children were having below average knowledge regarding thumb sucking, so it necessary to improve their knowledge regarding thumb sucking. Nursing Education The psychiatry curriculum in nursing should give emphasis on creating awareness among mothers of under five children regarding thumb sucking. Nursing Practice Nurses should teach the mothers of under five children about prevention of thumb sucking and tips to stop thumb sucking. Hereby, for improve and creating awareness among others of under five children regarding thumb sucking. Nursing Administration Nursing administration gas to play a vital role in creating awareness among the mother of under five children regarding thumb sucking by organizing a health teaching and conducting program to teach mothers. Nursing Research More study can be done on the behavioral problems of the child, lack of love and affection; inadequate breast feeding, nutritional practices of children very few studies

have been done in Indian knowledge level of the mother can be improved through providing planned different teaching techniques on the knowledge deficit areas regarding thumb sucking by multipurpose health worker.

RECOMMENDATIONS
Based on the finding of the study, the following recommendations are offered: The study can be replicated on the larger samples to generalize the findings. A comparative study can be done to evaluate the difference between the knowledge of mother of rural and urban area regarding thumb sucking. A study can be done to assess the attitude of mothers regarding thumb sucking.

SUMMARY
This chapter dealt with the Summary, Conclusion, Limitation, Implication and Recommendations.