The Influential Factors in the Awareness, Attitude, and Practice of Mothers with Toddlers in Preventing Domestic Accidents

Background &

Accidents are a chain of events that lead to damage and detectable disease. Although some consider home to be the safest place, about a third of incidents occur at home. One of the high-risk groups in domestic accidents is toddlers. Physiological patterns associated with the developmental stages of toddlers make this group susceptible to such events, so that accidents are the main cause of death in the first five years of children's lives worldwide. Health education programs can empower parents to prevent domestic accidents. On the other hand, the effectiveness of health education programs is mostly dependent on having accurate information about mothers' awareness, attitude, and practice. Considering that more evidence is needed to take necessary measures to implement related interventions, this study aimed to determine the factors related to awareness, attitude, and practice of mothers of toddlers in preventing domestic accidents.

This was a descriptive correlational study conducted on 280 mothers with toddlers referred to community health centers from April to September 2019. In this study, multistage cluster sampling method was used to collect data. Each area of the north and south regions of Hamadan city was considered as a cluster and two comprehensive health centers were selected from each cluster through simple random method and among the selected comprehensive health centers, mothers were selected through convenience sampling method and based on inclusion criteria. Inclusion criteria were living in Hamadan city, having at least one toddler, not having a toddler with incurable diseases, and not being pregnant. Also, exclusion criteria included reluctance to continue participation in the study despite the initial agreement. Data collection tools were demographic questionnaires, history of injury, and a researcher-made questionnaire based on awareness, attitude, and practice in preventing domestic accidents that were completed by the samples. In order to determine the validity of the questionnaire, qualitative content validity was used, and test-retest was used to check the reliability of the instruments. After writing the proposal and approving the plan, the researcher referred to the comprehensive health centers of Hamadan city and identified the mothers of toddlers with inclusion criteria and invited them by telephone or with the help of the staff to participate in the project. All mothers were given the necessary explanations about the objectives, procedure, and duration of the study (6 months), and written informed consent was obtained from them. At the beginning of the study, the subjects were given the data collection tools and the self-assertion questionnaires were completed. In order to provide a calm environment for answering questions, mothers (as representatives of parents) were asked to leave their children to their companions before receiving clinic services (vaccination, and growth monitoring) and answer questions in the educational class of the relevant centers. After completing the questionnaires, data were analyzed using Kolmogorov-Smirnov tests to ensure normal distribution, Kruskal-Wallis to determine the relationship between qualitative demographic variables and awareness, attitude towards behavior and practice, and Spearman correlation test to determine the relationship between quantitative demographic variables with awareness, attitude towards behavior and practice in SPSS 16 software.

According to the results, (44.6%) of the mothers of toddlers had a university education and (72.8%) of the mothers were housewives. Also, (58.3%) of toddlers were girls and (46.7%) of parents kept their children in kindergarten. Mean scores of awareness with a value of 18.1 ± 1.5 was the highest point obtained by mothers (good), mean scores of mothers' attitudes with a value of 18.8 ± 4.6 regarding the adoption of preventive behaviors were regarded as weak, and the mean score of practice with a value of 24.3 ± 10.1 was regarded as good. Also, a positive significant relationship was observed between the age of the toddler and the level of awareness, between the family dimension and the number of children, and between the age of the toddler with the mother's attitude towards behavior, between maternal education and awareness and practice, between father's education with awareness, attitude and practice, between father's employment status with awareness and attitude, between mother's employment status with awareness, and between childcare status with attitude (P <0.05). Among the total number of people surveyed, 15 toddlers were injured in the accident. Burning, poisoning, asphyxia, and drowning were respectively the accidents occurring in the children with a history of injury. (72%) of these cases had resulted in temporary disability and 13 victims were girls. All reported cases had occurred in the age group of one to one and half-year-old toddlers.

Considering the poor average scores in attitude and practice of mothers and also considering the important role of education in promoting preventive behaviors of accidents, it is necessary to educate mothers more in order to improve their awareness, attitude, and practice regarding the prevention of children's accidents. Also, the findings of this study and similar researches in this field can be a guideline for planners and authorities to use the present findings to perform interventions to improve the awareness, attitude, and practice of mothers about the prevention of domestic accidents in toddlers.