Home injuries in preschoolers. A household quandary Who is to blame? - - PowerPoint PPT Presentation

Home injuries in preschoolers. A household quandary —Who is to blame?

• DR. NADEEYA MOHAMAD NOR

FACULTY OF MEDICINE AND HEALTH SCIENCES UNIVERSITI SAINS ISLAM MALAYSIA (USIM)

Introduction

• injury and violence are the major cause
• f death in children and young people

(under 18)

• 90% accounts for Unintentional injury

(falls, burns, road traffic injury, drowning & poisoning).

• burden of injury highly noticeable among

the lower and middle income countries

Findings from National Health Morbidity Survey (NHMS) Malaysia,

• Prevalence was higher among preschool children (NHMS 2011) despite the

fact that the home is considered to be a safe place for them.

• In Malaysia, injury at home ranked second to motor-vehicle accident (NHMS

2006).

• prolonged psychosocial implications that can

affect both child and the caretaker.

• decrease in quality of life, social relations and

learning ability Impacts of injury (Polinder et al. 2005):

Contributing factors to Preschool Unintentional Injury (PUI)

(Garzon 2005)

Objectives

• TO DETERMINE PREVALENCE OF HOME

INJURY AMONG CHILDREN AGED 1-4 YEARS OLD LIVING IN THE URBAN AREA.

• TO EXAMINE MATERNAL AND CHILD

FACTORS THAT PREDICT HOME INJURIES IN CHILDREN.

Primary outcome: Home Injury among children aged 1-4 years Factors studied: Sociodemographic characteristics, Mothers’ Knowledge towards home injury, Mothers’ Perception towards injury prevention, Mothers’ Injury Prevention practice, Mothers’ Parenting scale, Mothers’ Social support, Child injury proneness Guided self-administered questionnaire Cross sectional study design

Methodology

Simple random sampling technique was used to select 5 Maternal and Child Health (MCH) clinics in the Urban area of Kuala Lumpur 500 mothers of children aged 1-4 years attended selected MCH Clinics agreed to be the respondents

Results

Figure 1: Distribution of marital status (N=500) Figure 2: Distribution of working status (N=500)

Mean (SD) Age: 30.18 (4.5) years

Figure 3: Distribution of level of education (N=500)

Maternal Characteristics

Figure 4: Distribution of child’s age group (N=500) Figure 5: Gender distributions of the children (N=500)

Mean (SD) score of child injury proneness: 22.80 (9.73)

Child Characteristics

• Knowledge towards home injury: Mean (SD) total score: 10.27 (2.21)
• Perception towards injury prevention: Mean (SD) total score: 35.89 (4.74)
• Injury prevention practice: Good practice: 373 (74.6%) Poor practice: 127 (25.4%)
• Parenting practice among mothers:

Over-Reactivity - Mean (SD): 3.70 (0.86) Laxness - Mean (SD): 3.65 (1.05) Hostile- Mean (SD): 2.19 (1.11)

Description on Other Factors studied

• Social support received by mothers:

Spouse - Mean (SD): 5.26 (0.73) Family - Mean (SD): 5.20 (0.65) Friends - Mean (SD): 4.76 (0.74)

Figure 6: Distribution of Home injury in children (N=500) Figure 7: Distribution of type of injury (N=143)

Prevalence of Home Injury in Preschoolers (1-4 years old)

Figure 8: Distribution of injured child according to gender (N=143) Figure 9: Distribution of treatment to the injured child (N=143)

Prevalence of Home Injury in Preschoolers (1-4 years old)

Variables Injured child (N=143) Non injured child (N=357) Adjusted OR 95% CI P Mother’s age, mean (SD) 28.74 (4.03) 30.76 (4.63) 0.904 0.857-0.955 <0.001 Injury prevention practice, n (%)

• Poor

50 (39.4) 77 (60.6) 1.768 1.097-2.852 0.019

• Good

93 (24.9) 280 (75.1) Parenting style (laxness-type), mean (SD) 3.86 (0.83) 3.63 (0.87) 1.395 1.067-1.824 0.015 Social support (spouse), mean (SD) 5.12 (0.82) 5.31 (0.70) 0.632 0.405-0.986 0.043 Child gender, n (%)

• Boy,

99 (37.9) 162 (62.1) 2.323 1.469-3.672 <0.001

• Girl

44 (18.4) 195 (81.6%) Child injury proneness, mean (SD) 26.03 (11.30) 21.51 (8.71) 1.038 1.014-1.062 0.002

Predictors of Home Injury in Preschoolers using Multiple Logistic Regression (MLR)

This study highlights,

• Home injury among preschoolers is prevalent (28.6%), mainly among the

boys (69.2%), with fall as the commonest type of injury.

• Both Maternal and Child characteristics predict Home injury in preschool

children.

• Young mothers, poor injury prevention practices, lack of social support from

spouse with a relaxed-parenting style predict child injury at home.

• Being a boy and behaving towards injury prone also predict home injury

among the children.

Discussion

Recommendation

1) Identifying high risk family for targeted family intervention

Hazard awareness & minimisation Supportive family Supervise children, Anticipate child behaviour, avoid laxness-parenting

2) Incorporating Module on Home Injury Prevention Programme during the premarital courses and also antenatal courses. 3) Educate and empower the children on behaviours that may expose them towards injury and how to prevent them.

Recommendation