EFFECTIVENESS OF EDUCATIONAL PACKAGE ON LEVEL OF

KNOWLEDGE AND PRACTICE REGARDING HOME ACCIDENTS

AMONG MOTHERS OF UNDER FIVE CHILDREN IN SELECTED
COMMUNITY AREA

[Link] (NURSING) DEGREE EXAMINATION BRANCH-II

COMMUNUNITY HEALTH NURSING

INDIRA COLLEGE OF NURSING,

PANDUR THIRUVALLUR

DISSERTATION SUBMITTED TO
THE TAMIL NADU [Link] UNIVERSITY CHENNAI
IN PARTIAL FULFILMENT OF REQUIREMENT FOR THE DEGREE OF
MASTER OF SCIENCE IN NURSING OCTOBER – 2025
 ACKNOWLEDGEMENT

“A seed of effort blooms into a forest of wisdom.”

With God all things are possible. I wish to acknowledge my heart felt gratitude to the LORD
ALMIGHTY who has been the foundation for the wisdom and knowledge. Almighty has
given me strength and support throughout the endeavour of this study.

I express my heartfelt thank the honourable Chairman

[Link].M.L.A., THIRUMATHI. INDIRA RAAJENDRAN.
M.D., Indira Group of Educational Institutions who gave an opportunity to complete my Master
Degree in this esteemed institution.

I wish to express my gratitude and regard towards [Link].,[Link],

DR.M. KAVITHA. PHD., PRINCIPAL, Indira College of Nursing for her interest and excellent
guidance, constant encouragement, support, and enlightening ideas and for being a source of
inspiration competing this study.

I wish to express humble gratitude to PROF. [Link].,RM.,MSC(N),

PROFESSOR., VICE PRINCIPAL., HOD OF CHILD HEALTH DEPARTMENT, CLASS
CO ORDINATOR and PROF. [Link]. R.N., R.M., [Link](N),
PROFESSOR.,VICE PRINCIPAL,HOD OF MEDICAL SURGICAL NURSING,Indira
College of Nursing for their valuable guidance and support during the study.

I respect and thank to our research guide PROF. MRS. P. KALAVATHI . [Link] (N).,
DEPARTMENT OF MEDICAL SURGICAL NURSING, Indira College of Nursing for her
valuable guidance and support during the study.

I extent my sincere thanks to all PROFESSORS,ASSOCIATE PROFESSORS,ASSISTANT

PROFESSORS, [Link] AND [Link] TEACHING FACULTY MEMBERS
,ADMINISTRATIVE STAFFS AND LIBRARIAN I gave my gratitude to all.

My deepest gratitude to my dear father MR.S. NAGARAJAN and my lovable mother

[Link] who worked a lot to bring me up, I heart full thank to my elder sister
[Link] and younger sister
N.L .HEMA for their encouragement , constant support and shield.
 I express my heartfelt thanks to my beloved husband [Link] PANDIAN and my lovely
daughter

A .RITHUSHHA. I extend my sincere thanks to my in FATHER IN LAW, MOTHER IN

LAW, BROTHER IN LAWS, MY CO SISITER and COUSINS for their support through
my study.

I extend my sincere thanks to all my College Mates from Indira College of Nursing.

I sincerely express my heart felt gratitude to my friends for their motivation, guidance and
support for the completion of my study.

I sincerely express my gratitude thanks to my juniors for the support for completion of my
study.

I wish to extend my sincere thanks all Study Participants for their valuable cooperation and
patience throughout the study.

I thank all Well Wishers and Others who have helped us directly and indirectly in the
completion of the study.
 OUTLINE OF THE STUDY

CHAPTER -1:The introduction deal with the background of the study,need for the
study, statement of the problem, objectives, operational definition,
hypothesis, assumption, delimitation and conceptual frame work with
outline of the study.

CHAPTER-II:This chapter deal with the review of literature related to the present
study

CHAPTER-III:Discussed about research methodology of the study,research approach,

research design, Variables of the study, setting, population, sample,
criteria for sample selection, sampling techniques, sample size,
description of the tool, scoring procedure, content validity, pilot
study, reliability, and procedure for data collection, and plan for data
analysis.

CHAPTER-IV:Deal on data analysis and interpretation are illustrated in tables and

graph.

CHAPTER-V: Discussed about the objectives and the obtained results of the analyzed

CHAPTER-VI:Described about the summary,conclusion,nursing implication,

recommendations and limitations of the study.
 The study ends with selected reference and appendix.

TABLE OF CONTENTS

CHAPTERNO. PAGE
TITLE NO.
CHAPTER I INTRODUCTION
Background of the study 1
Need for the study
Statement of the problem
Objectives of the study
Operational definitions
Hypotheses
Assumption
Delimitation
Conceptual framework
Outline of the study

CHAPTERII REVIEW OF LITERATURE

CHAPTERIII RESEARCHMETHODOLOGY
Research approach
Research design

Variables of the study

Setting of the study

Population
Sample

Samplesize
Sampling technique

Criteria for sample selection

Development and description of the tool

Ethical considerations

Pilot study

Data collection procedure

Procedure for data analysis.
Schematic presentation of research design
CHAPTER-V DATAANALYSIS AND INTERPRETATION

CHAPTERV DISCUSSION

CHAPTER-VI SUMMARY,CONCLUSION,IMPLICATIONS
RECOMMENDATIONS AND LIMITATIONS
REFERENCES

APPENDICES
 LIST OF TABLES

TAB
TITLE PAGENO
LE
.
NO
.
Frequency and percentage distribution of demographic variables of
1. mothers of underfive children.
Frequency and percentage distribution of pretest and post level of
knowledge regarding home accidents among mothers of underfive
2.
children.

3. Frequency and percentage distribution of pretest and post level of

practice regarding home accidents among mothers of underfive
children.

Effectiveness of Educational Package on level of knowledge

4. regarding home accidents among mothers of underfive children.
Effectiveness of Educational package on level of practice
5. regarding home accidents among mothers of under five children

Association of post-test level of knowledge regarding Home

7. Accidents among mothers of underfive children with their selected
demographic variables.

Association of post test level of practice regarding Home

8. Accidents among mothers of underfive children with their selected
demographic variables.
 LISTOFFIGURES

FIGURE
NO. TITLE PAGENO.

1.
Conceptual frame work based on JW KENNYS OPEN
MODEL SYSTEM

2. Schematic representation of research design.

3. Percentage distribution of age of mothers of under five

children
4. Percentage distribution of educational status of the mothers
of underfive children

5. Percentage distribution of number of underfive children

among the mothers

6. Percentage distribution of pretest and post level of

knowledge regarding home accidents among mothers of
underfive children

7. Percentage distribution of pretest and post level of practice

regarding home accidents among mothers of underfive
children
8. Comparison of pretest and post test knowledge scores
regarding home accidents among mothers of underfive
children

9. Correlation between post test knowledge and practice

scores regarding home accidents among mothers of
underfive children
 LISTOFANNEXURES

APPENDIX
NO.
CONTENT
1. ResearchCommittee Certificate

2. BonafideCertificate

3. Letter Seeking Permission to Conduct Study

4. Content Validity Certificate by Medical Expert

5. Content Validity Certificate by Nursing Expert

6. List of Experts

7. English Editing

8. Self-Declaration Letter

9. Informed Consent

10. Data collection tool

11. Lesson Plan

12. Plagiarism

13. Guide Certificate

14. Photos
 ABSTRACT

INTRODUCTION:

"Home accidents" remain a major public health concern, particularly among children
under five, who are highly vulnerable to burns, falls, poisoning, drowning, and
suffocation. According to the World Health Organization (WHO), approximately
830,000 children die every year due to preventable home injuries, with the highest
burden occurring in low- and middle-income countries. The post-pandemic increase in
time spent indoors has further elevated these risks (Kumar & Thomas, 2022).
Preventive measures such as safe storage of hazardous substances, use of safety
gates, constant supervision, installation of smoke alarms, and educating caregivers
about potential hazards are essential to reduce these injuries. Mothers, as primary
caregivers, play a pivotal role in ensuring a safe home environment. Strengthening
awareness through structured educational programs and community initiatives can
significantly reduce the incidence of home accidents and protect children’s lives.

OBJECTIVES OF THE STUDY

1. To asses the pre-test and post-test level of knowledge and practice regarding home
accident among mothers of under five children in both experimental and control group of
selected community area

2. To evaluate the effectiveness of educational package on level of knowledge and practice

regarding home accident among the mothers of under five children at selected community
area

3. To associate the level of knowledge and practice regarding home accidents among mothers
of under five children with their selected socio demographic variables

RESEARCH DESIGN

Pre-experimental one group pre-test and post-test research design.

SETTING:

The study was conducted in Community area mappedu villagee, thiruvallur district.

SAMPLE

The study sample consists of 60 mothers of under five children residing in the mappedu
village.

SAMPLING TECHNIQUE
Non- Probability purposive sampling technique is used for this study.

INTERVENTION

Educational package ( leaflets, posters and flashcards teaching for 30 minutes) on

knowledge and practice regarding home accidents.

MEASUREMENT OF TOOL:

The level of knowledge and practice was assessed by using 25 self structured
questionnaire and15 practice [Link] research adopted descriptive and inferential
statistics to analyse the data. The demo graphical variable was analyzed by using
frequency distribution and percentage. Comparison of pretest scores of knowledge and
practice and post test scores of knowledge and practice computed on the basis of paired “t”
test

FINDINGS:

The findings illustrated the comparison of pretest and posttest scores of knowledge among
mothers of under-five children in the pre-experimental group. The calculated t test value t=
31.314was highly statistically significant at p < 0.001 level, showing a marked
improvement in knowledge, as evident from the mean difference score of 6.65

Similarly, the comparison of pretest and posttest scores of practice revealed a paired t
test value t= 67.339 that was also highly statistically significant at p < 0.001 level, with a
mean difference score of 10.5, indicating substantial enhancement in safety practices. These
results confirm that the structured educational package was effective in improving both
knowledge and practice regarding the prevention of home accidents among mothers of
under-five children.


CONCLUSION:
From the finding of the data analysis, it was evidence that most of the mothers of
under five children had inadequate knowledge and practice regarding home accidents
and after intervention on the level of knowledge and practice regading home accidents
had significantly improved by the educational package.
 EFFECTIVENESS OF EDUCATIONAL PACKAGE ON LEVEL OF
KNOWLEDGE AND PRACTICE REGARDING HOME ACCIDENTS AMONG
MOTHERS OF UNDER FIVE CHILDREN IN SELECTED COMMUNITY AREA

Certified that this is the bonaficd work of

Mrs. Abitha.N

Register No: 300423522501

Msc Nursing II year

Indira college of nursing,pandur,

Thiruvallur distric-t 631203

COLLEGE SEAL

SIGNATURE OF PRINCIPAL

DR.M. KAVITHA. MSC (N), PGDHA., PH.D., ___________________

PRINCIPAL.,

INDIRA COLLEGE OF NURSING,

PANDUR,

THIRUVALLUR DISTRICT-631203

DISSERTATION SUBMITTED TO
THE TAMILNADU [Link] UNIVERSITY, CHENNAI.

IN PARTIAL FULFILMENT OF REQUIREMENT

FOR THE DEGREE OF

MASTER OF SCIENCE IN NURSING

OCTOBER -2025
 EFFECTIVENESS OF EDUCATIONAL PACKAGE ON LEVEL OF KNOWLEDGE AND PRACTICE
REGARDING HOME ACCIDENTS AMONG MOTHERS OF UNDER FIVE CHILDREN IN SELECTED
COMMUNITY AREA

Approved by dissertation and ethical committee on

PROFESSOR IN NURSING RESEARCH

DR.M. KAVITHA. MSC (N), PGDHA., PH.D.,

Principal,
Indira College of Nursing,
Pandur,Thiruvallur district-631203.

RESEARCH COORDINATOR

DR.C. ZEALOUS MARY, MSC (N), [Link]., PH.D.,

Dean,

Indira College of Nursing,

Pandur,Thiruvallur district-631203

CLINICAL SPECIALITY NURSING EXPERT

MRS [Link].,MSC (N)

Dept of Medical Surgical Nursing

Indira College of Nursing,
Pandur,Thiruvallur district-631203

DISSERTATION SUBMITTED TO

THE TAMILNADU [Link] UNIVERSITY, CHENNAI

IN PARTIAL FULFILMENT OF REQUIREMENT

FOR THE DEGREE OF

MASTER OFSCIENCE IN NURSING

OCTOBER-2025
 CHAPTER 1
INTRODUCTION
"A stitch in time saves nine, for the smallest neglect of duty may grow into great harm
before it is seen."
- Thomas fuller
Home accident among the children is a big issue in our life. They are a leading cause of death
and different type of disabilities among the children. We can define home accidents as “Any
damage to a child whether it is physically or mentally, which had occurred unintentionally at
home by any type of outer force” is called home accident among children. These days people
only take accident as an event which can only took place outside their home. They take their
home as the safest place in planet. But they don’t get the dangers which are inside their own
home like many “hazards” which hides in their home and other dangers like falls, poisoning,
burnings, cuts, sports injuries, drowning, ingestion and aspiration of foreign bodies. It continue
to be a major public health concern, especially among children under five years of age. In the
post-pandemic period, the increased time spent indoors has heightened the risk of accidental
injuries within the home environment (Kumar & Thomas, 2022)

According to WHO an accident is an event, independent of human will, caused by an outside

force acting rapidly and resulting in bodily or mental injury. Accidents are undoubtedly one of
the chief causes of mortality and morbidity in children. Education plays a great role in
prevention of accidents like vaccination prevent six killer diseases. The preschool children age
is a troublesome age. Although this can be a challenging time for parents and child as both of
them learn to know each other better, it is extremely an important period for developmental
achievement and intellectual growth. Toddlers are midway between complete dependency and
requiring independence and mothers plays a major role in this process. It is important to
supervise these young explorers so that their natural curiosity does not lead them into
dangerous situations that can result in injury.

Mothers, being the primary caregivers, play a pivotal role in ensuring a safe environment for
their children. This study focuses on assessing and improving maternal knowledge through
video-assisted teaching strategies, which have gained prominence in recent years due to their
accessibility and engaging delivery .

Accidents occurring in & around homes are one of the major public health problem because
they are frequent can lead to disability or death can be prevent. The world health organization
has indicate about 95% of the injuries resulting in death take place in countries with low or
moderate income level & that injuries are responsible for about 40% of child & adolescent
death in these countries It is also reported that falls, burn, suffocation, & poisoning most of
which occur in the home accident for approximately 25% of all the injuries. In the world & that
these injuries were among the first 20 causes of death in 0-5 year age group. Accidental injuries
are the most common cause of death in children over 1 year of age children under five are most
at risk from an injury in the home, with boys more likely to be injured the people can only
relate accidents in outdoor activities. However, as a matter fact, the place where people regard
as safe at home accident is general negligence of at home this pamphlet aims at providing some
measures in preventing home accident, first aid measures

1.1. BACKGROUND OF THE STUDY

In childhood, the mortality rate from injuries sustained at home exceeds that of other
childhood diseases. Home accidents, characterized by their unexpected and unplanned nature,
often result in fatal or severe outcomes. Common types of home accidents include burns, falls,
drowning, poisoning, suffocation, and injuries caused by sharp objects. The World Health
Organization reports that approximately 830,000 children die each year due to home accidents,
which translates to about 2,000 child deaths daily. Additionally, millions of children are
hospitalized annually with injuries from home accidents, often leading to permanent
disabilities. In 2019, approximately 5.2 million children under the age of five died, largely due
to preventable and treatable causes. Of these deaths, children aged 1 to 11 months accounted
for 1.5 million, while those aged 1 to 4 years accounted for 1.3 million. The remaining 2.4
million deaths occurred among newborns under 28 days old. A study conducted in Belgaum,
India, evaluated the knowledge of 30 mothers of toddlers on preventing household injuries and
assessed the impact of a structured teaching program (STP). Using a structured knowledge
questionnaire, the results showed that pre-test, 27% of mothers had poor knowledge, 53% had
average knowledge, and 20% had good knowledge. Post-test, no mothers had poor knowledge,
27% had good knowledge, and the mean score increased, demonstrating that the STP
effectively enhanced the mothers' knowledge.

In many developing countries, injuries are one of the major causes of death in children in the
age group of 1-5 years. Many studies have been undertaken in different parts of the world and
in India to study the epidemiology of injuries in children under 5 years of age. Most of these
studies are hospital-based. This gives only a limited picture of the situation.2 The living
condition in the rural areas as cooking over open fires leads to burns and scars badly build poor
houses and poor maintenance such as they’re without railing might cause falls. Accidental
drinking of kerosene stored in soft drink bottle leading to poisoning of children this and all
happened in the house for lack of supervision of the mothers. In fact, children under 5 years of
age home accidents account for half of unintentional deaths, because small children can easily
choke on food or other small objects. They are inclined to put their mouths common objects
found around your house such as plastic shopping bags and other safe material also pose a
danger burns and scalds are more serious in children than in adults. 7 Measures to prevent
accidents at home should be targeted towards those at most risk-parents of pre-school children
and the lower social class groups.

So there is a need to conduct a study on the parent’s knowledge in the prevention of home
accidents among children. Parents should be motivated to have knowledge about the risk
factors of child injuries and safety measures to be taken to prevent home accidents among
children. Hence the researcher felt there is need to study on knowledge regarding prevention
of home accidents for children among parents. A study to assess the knowledge, attitude and
practice regarding home accidents and its prevention among parents of under-five children at
selected village of Rohtas, Bihar.

1.2 NEED FOR THE STUDY:

In the developed world, accidents have become a relatively more important child health
problem. In developing countries accidents are show to be as numerous as in developed
countries. Accidents are the leading cause of death of children of any age after the newborn
period and infancy. Children 2 and 3 years and 5 and 6 years of age have the greatest number
of accidental injuries of all children below 10-12 years of age. Younger children are most
frequently injured in or around their own homes. Many accidents can be prevented by parents
who are aware that young children want to explore every nook and cranny in their rapidly
expanding world. According to 2013 Worldwide surveys have shown about the pediatric
emergency varies from country to country.

The 5 million children died from injuries with a global mortality rate of 83.7 per 1,00,000 per
annum. A total of 2,83,000 death was reported due to falls. In the year 2004 an estimated
3,76,000 children drowned approximately 97% of drowning deaths occurred in low and middle
income countries. According to 2012 in India is accounts for an estimated of 12,75,000 children
are grievously injured. A total of 22,000 deaths was reported due to drowning. In Karnataka at
least 30,000 children’s are dying annually due to accidents, drowning and poisoning. In
developing countries pediatric emergency are shown to be as numerous as in developed
countries. According to 2009 WHO report says that in the age group of 1-4 years, the second
year is the period when the young child runs the highest risk of dying. In the developing
countries, death in the second year of life commonly accounts for 50% of all deaths between
1-4 years of age. According to 2002 UNICEF report says that globally average of under five
mortality in 2002 was 82 per 1000 live births in the developing world it was 90 per 1000 live
births. Childhood accidents are the leading causes of childhood injuries such as drowning, falls,
burns, foreign object aspirations, poisoning. Because under five 4 children spend much time at
home than any other place, they may be exposed to numerous hazards, which usually take place
in kitchens, living rooms and bathrooms. The mother should know about the home safety needs
of under five children because mothers are usually the caregivers and who will be at home with
the child. A study was conducted to assess mother’s knowledge and practice towards home
accidents among children under 5 years.

Recent evidence from Tamil Nadu indicates that home accidents among children under five
remain a significant public health concern. A community-based study conducted in
Kattankulathur, Chengalpattu district in 2023, revealed that the annual incidence of fall-related
injuries in children was 9.1%, with 72.3% of these accidents occurring inside the home
environment, often resulting in fractures and disabilities involving the hands. Another study
conducted in rural parts of Tamil Nadu reported a 12.9% prevalence of unintentional childhood
injuries, highlighting falls, burns, cuts, and foreign body aspiration as the most frequent causes.
National data further supports these findings, indicating that nearly 40% of children between
0–14 years sustain some form of injury annually, with the age group of 1–3 years being the
most vulnerable, accounting for 54.3% of cases. In this group, falls were reported as the leading
cause, followed by burns and sharp-object injuries. While district-specific statistics for
Thiruvallur are not readily available in published records, the epidemiological pattern in this
district is expected to resemble the state trends due to similar socio-demographic,
environmental, and cultural practices. This underscores the urgent need for preventive
education and community-based awareness programmes in Thiruvallur to minimize the risk of
home accidents among under-five children.

. Accidents all over the world are one of the leading health problems. Therefore various
programs have been developed to prevent accidents. The most important way to protect against
accidents in the primary prevention is to educate society, especially parents is to be educated
about prevention of accidents and first aid to reduce accidents.t was found that education about
accidents given by public health nurses was successful and parents increased their security
measures after the stated education.

The various reviews made on effect of educational package on prevention of home accidents
and motivate the investigator to conduct the study.

1.2 STATEMENT OF THE PROBLEM

A study to assess the effectiveness of educational package on level of knowledge and

practice regarding home accidents among mothers of under five children in selected
community area.

1.3 OBJECTIVES OF THE STUDY

1. To asses the pre-test and post-test level of knowledge and practice regarding home accident
among mothers of under five children selected community area

2. To evaluate the effectiveness of educational package on level of knowledge and practice

regarding home accident among the mothers of under five children at selected community area

3. To associate the level of knowledge and practice regarding home accidents among mothers
of under five children with their selected socio demographic variables.

1.5 OPERATIONAL DEFINITIONS

ASSESS

In this study, assess refers to the process of systematically measuring and evaluating the
knowledge and practice of mothers regarding home accidents using structured questionnaires
and observation checklists before and after the educational package.

EFFECTIVENES

Effectiveness denotes the extent to which the educational package improves the mothers’ level
of knowledge and practice regarding prevention and first aid management of home accidents,
as measured by pre-test and post-test [Link] and post-test scores using a structured
questionnaire.

EDUCATIONAL PACKAGE
Educational package in the context of this research refers to a structured set of instructional
materials and resources designed to facilitate learning in a specific subject area. It includes
written content, multimedia resources (such as videos, podcasts, or interactive modules),
assessments, and accompanying teacher guides. The effectiveness of the educational package
will be measured by student engagement (time spent interacting with the materials), student
performance (grades or scores on assessments), and learner satisfaction (via surveys).

LEVEL OF KNOWLEDGE

In this study degree to which mothers understand the causes, risks ,types, ,prevention,
management, complications and treatment of home accidents, as measured using a self
structured knowledge questionnaire with predefined scoring criteria

PRACTICE

In this study, practice refers to the actions taken by the mothers to prevent home accidents
based on what they have learned. This includes the safety measures they follow and how they
apply the knowledge in their daily care of children to keep them safe from accidents

HOME ACCIDENT

Home accident is any unintended injury occurring within the home environment, such as falls,
burns, poisoning, or cuts, foreign body aspirations involving children under five years old, as
reported or observed during the study period.

MOTHERS OF UNDER FIVE

Women who are the primary caregivers or biological/adoptive mothers of children aged 0–5
years. These mothers reside in the selected community area and are actively involved in the
daily care and upbringing of at least one child under the age of five years.

SELECTED COMMUNITY AREA

A study was conducted in Mappedu village, Thiruvallur District, which has a total population
of 4,205. The village is geographically situated between Poonamallee and Arakkonam, making
it accessible for community-based research activities. This area was identified based on its
accessibility and relevance to the target population of mothers of under-five children.

1.6HYPOTHESIS
H1 - There is a significant difference between pre test and post test level of knowledge and
practice regarding home accidents among the mothers of under five children at selected
community area

H2- There is a significant association between the level of knowledge and practice regarding
home accidents among mothers of under five children with their selected socio demographic
variable.

1.7 DELIMITATIONS:

The study was delimited to the period of four weeks of data collection.

1.8. CONCEPTUAL FRAMEWORK

Conceptual framework is one that presents logically constructed concepts to provide general
explanation of relationship between the concepts of the research study; they are usually
constructed by using researcher’s own experiences, previous research findings, or concepts of
several theories or models. Conceptual framework facilitates communication and provides for
a systemic approach to nursing research, education, administration and practice.

The conceptual framework selected for this research study was based on J.W Kenny’s Open
System Model. All living organisms are open that, there is a continual exchange of matter,
energy and information. Open system has varying degrees of interaction with environment,
from which the system receives the input and gives feed back output in the form of matter,
energy and information. Conceptual framework provides the investigator the guidelines to
proceed in attending the objectives of the study based on theory. It is a scientific representation
of the steps, activities and outcome of the study the main concepts of the Open System Model
are input, throughput, output and feedback. The Open System theory input refers to energy,
matter and information, throughput refers to processing, where the system transforms the
energy, matter and information and output refers to the energy, matter and information that are
processed. Feedback refers to the environmental responses to the system output used by the
system. This study is aimed at evaluate the level of knowledge regarding prevention of home
accidents of home accident and its preventive measures.

● Input
● Through put
● Out put
Input

According to the theorist, input refers to the type of information, energy and material that enters
the systems from environment through its boundaries. In this study the input includes
demographic variables such as age, residence, type of family, educational status of father,
educational status of mother, occupation of father, occupation of mother, income of the family,
most preferable programme and also pre assessment of knowledge by administering self
structured questionnaire regarding prevention of home accidents watching television and its
preventive measures among high school children.

Throughput

According to theorist through put refers to any information of knowledge transfers through
preferred materials. In this study the investigator preferred educational package that includes
leaflets, poster and flash card teaching method of information that is arranged and designed on
knowledge regarding good of effects of home accident on such as falls, burns, cut, drowning,
ingestion and aspiration of foreign bodies etc, preventive measurers of home accident includes
hours of home accident, at what distance should be maintained while home accident etc.

Output

According to theorist is the information that leave the system, enters the environment through
the system. In this study it refers to improve the knowledge regarding effects of home accident
and its preventive measures. In this study, output is measured with amount of knowledge
gained by mothers with self structured questionnaire.

Reassessment

In this study, reassessment refers to reviewing and updating the educational package on home
accidents based on mothers’ performance and feedback. This process ensures that the package
remains effective and relevant in improving their knowledge and practices regarding accident
prevention and management.

Environment:

In this study, environment refers to external factors such as socio-economic status, cultural
practices, availability of resources, and access to healthcare. These elements influence how
mothers receive, understand, and implement the educational package to prevent home accidents
among under-five children.
 CHAPTER II
REVIEW OF LITERATURE

Literature review is a standard requisition of scientific research. It means reading and writing
is the pertinent information of the attempt in research topic. It also supports and explain why
the proposed topic is taken for research and avoids unnecessary duplication explore the
feasibility and illuminate the way of new research. Review of literature is a key step in research
process. Nursing research may be considered as a continuing process in which knowledge
gained from earlier studies is an integral part of research in general. In review of literature a
researcher analyses existing knowledge before delivering into a new study and when making
judgement about application of a new knowledge in nursing practice. The literature is an
extensive, systemic and critical review of the most important published scholarly literature on
a particular topic.

Review of Literature

The reviews related to the study are carried out on the following headings

SECTION A: Literature related to home accidents among mothers of under five children

SECTION B: Literature related to knowledge and practice regarding home accidents

SECTION C: Literature related to effectiveness of educational package programme

SECTION A

[Link] RELATED TO HOME ACCIDENTS AMONG MOTHER'S UNDER

FIVE CHILDREN

Ariya S. Kurup et al. (2024) conducted a descriptive cross-sectional study among 80 mothers
of under-five children in a Chennai hospital. The study revealed that prior to an educational
intervention, 27% of mothers had poor knowledge, 53% had average knowledge, and 20% had
good knowledge regarding the prevention of home accidents. After a structured teaching
program, no mothers had poor knowledge, 27% achieved good knowledge, and the mean
knowledge score significantly increased. The study emphasized that interactive teaching
methods, such as demonstrations and visual aids, were particularly effective in improving
maternal understanding. It also highlighted that regular follow-up and reinforcement sessions
helped sustain knowledge and encouraged practical implementation of safety measures at
home.

Punithavathi I. et al. (2024) evaluated the impact of a self-instructional module on the

prevention of home accidents among mothers of under-five children in an urban community in
Chennai. The study revealed that the educational intervention significantly improved mothers’
knowledge about common causes of home accidents and enhanced their understanding of
preventive measures, such as safe storage of sharp objects and medicines. Mothers also
demonstrated improved practical skills, including supervision during playtime and safe kitchen
practices. The study highlighted that accessible, easy-to-understand educational materials
increased engagement and knowledge retention, while sociodemographic factors, such as
maternal education and family support, influenced the effectiveness of the program. Overall,
the findings emphasized that structured, community-based educational programs are highly
effective in promoting home safety and reducing preventable injuries among under-five
children.

Vijayamalar N. et al. (2024) implemented a quasi-experimental one-group pretest–posttest

design with 60 mothers of under-five children in an urban community in Bangalore to assess
the impact of a structured educational program on domestic accident prevention. The mean
pre-test knowledge score was 16.32 (SD = 6.62), which increased to 31.02 (SD = 4.99) post-
intervention, showing a significant improvement (p < 0.05). The intervention covered topics
such as safe supervision, proper storage of household chemicals, and prevention of falls and
burns. Mothers demonstrated enhanced awareness and confidence, particularly those with
higher education levels. The study concluded that organized teaching programs, supported by
practical demonstrations, are effective in improving maternal knowledge and reducing home
hazards.

Sharma R. and Tirkey P. (2024) conducted a pre-experimental study among 60 rural mothers
of under-five children in Bilaspur, Chhattisgarh, to evaluate a structured teaching program on
home accident prevention. The mean pre-test knowledge score was 10.78, which increased to
16.4 post-test, with a highly significant t-value of 15.21 (p < 0.05). Educational sessions
included safe kitchen practices, supervision during playtime, and prevention of poisoning. The
study also reported that maternal education and family income were associated with greater
knowledge gains. The authors concluded that structured educational interventions are simple,
cost-effective strategies to improve child safety awareness in rural areas.
In 2022, Ramkesh Vyas emphasized the vulnerability of children aged 0–5 to various home
accidents such as falls, burns, poisoning, and drowning. The study highlighted the importance
of categorizing these incidents and preparing mothers and caregivers through tailored
guidelines to equip them with effective preventive skills. That year, Vijayashree V. Nair also
carried out a pre-experimental study in Tumkur, Karnataka, showing that structured teaching
programs significantly enhanced mothers' knowledge on accident management, with statistical
links to age, religion, and education. In 2024, Ariya S. Kurup conducted a cross-sectional study
among 80 mothers in a Chennai hospital. The findings showed most mothers had moderate
knowledge, with no significant correlation between knowledge and baseline variables like age,
education, or family type.

Singh P. et al. (2023) conducted a cluster-randomized quasi-experimental study across ten

urban community health centers in Delhi. The study involved 200 mothers of under-five
children, divided equally into intervention (n = 100) and control (n = 100) [Link]
& Data: The intervention group received a structured educational package, including
interactive group sessions, illustrated flipcharts, and handouts covering accident types (falls,
burns, poisoning) and preventive measures. Pre-intervention, the mean knowledge score for
the intervention group was 12.5 (SD = 4.1); post-intervention, it increased to 23.8 (SD = 5.3)—
a statistically significant improvement (p < 0.001). The control group had a marginal change
(pre 12.7, post 13.5; p > 0.05).Significant gains in knowledge and self-reported safety practices
(e.g., safe kitchen behavior, medicine storage) were seen only in the intervention group.

Archana Peter. et .al (2021) conducted a pre-experimental study at NSCB Medical College,
Jabalpur, on 30 mothers of under-five children. After a structured teaching program, 40% of
participants achieved excellent knowledge and 60% good knowledge, confirming the
effectiveness of educational interventions in accident prevention. Similarly, Arul Shanthi
Shrithi Brahman (2021) carried out a descriptive study among 60 mothers in Bengaluru and
reported that 63.3% had inadequate knowledge, 35% moderate, and only 1.7% adequate
knowledge on home accident prevention. The study noted no significant association with most
demographic variables, except the gender of the child, which was significantly related to
maternal knowledge. Both studies highlight that well-designed teaching programs can bridge
knowledge gaps and that awareness levels remain low in many communities, making education
an urgent priority to reduce preventable home injuries.
El-Shafei A. et al. (2018) carried out a community-based pretest–posttest study among 244
rural mothers of preschool children in Egypt to assess the effect of a health education program
on home injury prevention. Post-intervention, there were significant improvements in maternal
knowledge, attitudes, and self-efficacy regarding accident prevention, including burns, falls,
and poisoning (p < 0.001). Multimedia tools such as leaflets, pictorial guides, and videos were
used, which enhanced engagement and knowledge retention. However, knowledge of first aid
remained suboptimal, indicating the need for focused emergency response training. The study
emphasized that comprehensive, community-based educational programs effectively empower
mothers to create safer home environments.

Garg, A., et al.(2018) conducted a community-based quasi-experimental study in India among

300 mothers of under-five children to assess the effectiveness of a structured educational
program on home accident prevention. Mothers in the intervention group received interactive
teaching sessions, demonstration of safety practices, and distribution of printed safety
guidelines, while the control group received routine health education. Post-intervention
evaluation showed a significant improvement in knowledge scores (mean difference ≈ 7.8, p <
0.001) and a marked increase in reported safety practices such as safe storage of medicines and
chemicals, use of protective barriers, and constant child supervision. The study concluded that
structured, community-based educational interventions are highly effective in enhancing
maternal awareness and practices, thereby reducing the risk of domestic accidents among
under-five children.

Kendrick D. et al. (2013) conducted a systematic review and meta-analysis of 54 studies

(including 35 randomized controlled trials) involving over 800,000 participants to evaluate the
impact of home safety education on reducing injuries among children under five. The review
found that structured educational interventions significantly improved safety practices such as
smoke alarm installation, use of safety gates, and safe storage of hazardous items. Interventions
delivered in home settings and those combined with free or low-cost safety equipment were
more effective. Some studies reported reduced injury rates (injury rate ratio ≈ 0.75) where
follow-up was long-term. The findings highlight that consistent education, reinforced with
practical resources, is critical to reducing childhood injury risk.
SECTION B

[Link] RELATED TO LEVEL OF KNOWLEDGE AND PRACTICE

REGARDING HOME ACCIDENT

Narend Paul Singh Choudhary et. Al (2025) conducted a descriptive cross-sectional study
in Jaipur among mothers of toddlers aged 1–3 years. Using a structured questionnaire, the study
revealed that most mothers had moderate knowledge of accident prevention but lacked specific
knowledge in areas such as drowning prevention. The study emphasized the need for integrated
educational efforts through healthcare and community programs to effectively reduce the
incidence of preventable home accidents among toddlers

Joseph S. et al. (2023) conducted a descriptive cross-sectional study among 100 mothers of
preschool children in a rural block of Kerala to assess knowledge and day-to-day safety
practices at home. Using structured interviews, they found that 55% of mothers had only
average knowledge and unsafe practices such as leaving children unattended near water and
storing medicines within reach were common. The study reported significant associations
between maternal education, occupation, and household income with knowledge levels (p <
0.05). The authors recommended community awareness campaigns focusing on high-risk
behaviors to bridge the knowledge-practice gap

Meena R. et al. (2022) carried out a community-based descriptive study among 80 mothers
of toddlers aged 1–3 years to evaluate knowledge and preventive practices regarding domestic
accidents. A structured questionnaire revealed that 48% of mothers had inadequate knowledge,
particularly in electrical safety and poisoning prevention. Observation of practices showed poor
implementation of safety measures, such as covering electrical sockets and keeping sharp tools
locked away. The study emphasized that knowledge alone does not ensure practice unless
reinforced by frequent health education and home visits.

Karpaga Lathaet .al ( 2022) conducted a study in Milaganoor using a semi-structured

questionnaire and observation checklist among 60 mothers of under-five children. It was found
that 28.3% had adequate knowledge, 31.7% had moderately adequate knowledge, and 40% had
inadequate knowledge. In terms of practice, 28.3% showed good practice, while 48.4% had
poor practice. A positive correlation was noted between knowledge and practice, with
educational status and type of housing significantly influencing both. Also in 2022, Vijayashree
V. Nair conducted a pre-experimental study in Tumkur, Karnataka, involving 60 mothers.
Using a one-group pre-test post-test design, the study demonstrated that a structured teaching
program significantly improved knowledge regarding home accident management. A
significant association was found between knowledge improvement and factors such as age,
religion, and educational status.

Kavitha L. et al. (2021) conducted a descriptive study among 120 mothers of under-five
children in primary health center areas to assess knowledge and practices regarding prevention
of burns, falls, and choking incidents. The study reported that 64% of mothers had average
knowledge, and only 20% practiced consistent safety measures at home. Mothers were
particularly unaware of first-aid measures for burn injuries and choking episodes. The authors
concluded that health education delivered through Anganwadi workers and ASHAs is critical
to improving both awareness and emergency response skills.

Priya Kumari et. Al (2020) conducted a descriptive study involving 50 mothers from a
pediatric OPD to assess knowledge about domestic accident prevention. The results revealed
that 54% had average knowledge, 30% had poor knowledge, and only 16% had good
knowledge. The study emphasized that injury prevention at home, particularly for toddlers,
remains a vital concern. In 2021, Ann Mariya carried out a descriptive study among 50 mothers
in Mangalore and found that 84% had moderately adequate knowledge, 12% had adequate
knowledge, and only 4% had inadequate knowledge about preventing home accidents. The
findings highlighted the frequent occurrence of accidents in children under five and stressed
the importance of educating mothers to reduce risks.

Das A. et al. (2020) performed a community-based cross-sectional survey among 150 mothers
of under-five children to assess domestic accident prevention knowledge and practices. The
results showed that only 32% of mothers had adequate knowledge, and unsafe storage of
household chemicals and medicines was observed in over 40% of homes. The study also found
a significant gap between self-reported knowledge and actual safety practices, indicating
overestimation by mothers of their own preventive efforts. The authors recommended intensive
home safety audits and regular counseling to improve real-world application of knowledge.

Wang Y. et al. (2017) implemented a randomized safety promotion intervention among

parents of under-five children to examine changes in household safety behaviours. Parents in
the intervention group received structured sessions on accident prevention and demonstrated
significantly better safety practices compared to the control group, particularly in fire
prevention and poison storage. The study concluded that structured interventions can
successfully improve both knowledge and observed practices among parents.
Dr. R. Amutha et. Al. 2013 conducted a descriptive study in South Tamil Nadu to examine
how home accident-related commercials influenced children's dietary habits and health. The
data, collected from children aged 5 to 10 years in Dindigul, Tirunelveli, and Tuticorin,
revealed that children spent minimal time studying or playing and more time watching TV and
playing video games. The study concluded that television food advertisements strongly
impacted children's health issues. That same year, Riyadh Latta studied 1032 women in
Baghdad and found that only a small percentage had good knowledge about preventing
chemical, electrical, fire-related, or sharp object injuries. Mothers with more children or prior
experience with home accidents showed slightly better knowledge, but the overall awareness
was poor, indicating a critical need for public education.

Anne C. Gill [Link] (2010) conducted a cross-sectional study in Pune, India, to examine patterns
of unsafe household behavior across different socioeconomic strata. Among 200 households,
they found that 28% lacked a separate kitchen, 37.5% cooked at ground level, and 91% stored
poisonous chemicals in unsecured locations. The study concluded that socioeconomic status
significantly influenced unsafe practices, increasing the risk of burns, drowning, and road
injuries among children. In 2011, Dr. Dinesh Sethi assessed the knowledge and practices of
600 mothers in Assiut Governorate regarding home accidents in children under six. Results
showed that 50.3% of homes had experienced such accidents, with 74.5% of mothers
possessing incomplete knowledge. The study recommended providing health education on
accident causes, prevention, and first aid.

SECTION C

3. LITERATURE RELATED TO EFFECTIVENESS OF EDUCATIONAL PACKAGE

Pooja Jhu et. Al (2025) evaluated an educational package on adolescent girls’ knowledge of
anorexia nervosa in Moradabad, U.P., using a one-group pre-test/post-test design with 60
participants. Knowledge scores increased significantly post-intervention, proving the
effectiveness of structured teaching in improving health awareness. Neha Sharma (2024)
surveyed 100 adolescent girls in Lucknow, finding 72% had poor awareness of eating
disorders, with strong links to parental education, media exposure, and socio-economic status.
Anjali Verma (2023) studied peer-led health teaching among 80 schoolgirls in Delhi, reporting
marked improvement in nutrition knowledge, healthy eating practices, and early help-seeking
behavior. These studies confirm that focused, age-appropriate health education programs can
significantly enhance adolescent awareness and reduce future health risks.
Jaunita John Barren (2025) implemented a quasi-experimental study using a structured
educational package to improve [Link]. Nursing students' knowledge of neonatal reflexes in
Bhopal. The intervention, which included PowerPoint presentations and pictorial booklets,
proved highly effective, showing significant improvement in post-test scores. The study
highlighted that early exposure to systematic teaching tools strengthens clinical competence
and prepares nursing students to identify developmental abnormalities promptly. It
recommended integrating such educational modules into nursing curricula to enhance newborn
care practices and ensure better neonatal outcomes. Furthermore, the findings emphasized the
role of innovative teaching methods in bridging theory-practice gaps and fostering long-term
retention of critical neonatal concepts among students.

Parul Lath Venkatesan (2025) assessed the impact of a VAK (visual-auditory-kinesthetic)

model-based educational program on knowledge about stroke among security guards. After
identifying common risk factors such as hypertension, smoking, and obesity, a structured
intervention using multimedia tools, demonstrations, and interactive games led to a marked
improvement in knowledge scores (from a mean of 9.2 to 16.3). The study highlighted that
multisensory learning strategies are especially effective for adult learners in non-health
professions. It further emphasized that tailored health education can raise awareness, encourage
preventive behaviors, and reduce vulnerability to lifestyle-related diseases.

Krupal Parmar (2024) evaluated an educational package to enhance mothers’ knowledge of

essential newborn care in a hospital at Nadiad. Using a quasi-experimental design with 40
mothers, the study showed a marked rise in post-test knowledge scores compared to the control
group receiving standard care. The findings emphasized that structured teaching interventions
not only improve awareness but also encourage better newborn care practices, ultimately
reducing preventable complications. The study highlighted that regular reinforcement sessions
further sustained knowledge retention over time, and demographic factors such as age and
education level were positively associated with learning outcomes. It recommended
incorporating such teaching modules into routine maternal health programs to strengthen
newborn survival strategies.

Meenakshi S. and Rao D. (2024) implemented a pre-experimental one-group pretest–posttest

design among 150 female college students to evaluate a structured teaching package on breast
self-examination (BSE). The package included PowerPoint-based lectures, videos of the
stepwise procedure, and live demonstrations using breast models. Pre-intervention, 64% of
participants had inadequate knowledge and only 18% practiced BSE monthly. After the
intervention, mean knowledge scores improved from 9.8 to 16.5 (p < 0.05), and 70% of
participants reported monthly practice. The study concluded that systematic educational
interventions targeting young women can improve cancer awareness and promote preventive
health behaviors.

Deepa K. et al. (2023) conducted a quasi-experimental one-group pretest–posttest study

among 100 patients with type-2 diabetes attending a tertiary care hospital to evaluate a
structured educational package on diabetic foot-care practices. The intervention included
interactive lectures, pamphlets with illustrations, and a demonstration of proper foot inspection
techniques. Pre-intervention, 48% of participants had poor knowledge, and only 12% regularly
inspected their feet. After the program, no participants had poor knowledge, and 68% reported
daily foot inspection (p < 0.001). The study concluded that comprehensive educational
packages combining verbal, visual, and practical components significantly improve disease
self-management.

Ahmed R. et al. (2022) used a quasi-experimental pretest–posttest control group design among
80 hypertensive adults in a primary health clinic to assess a self-learning module on lifestyle
modification and medication adherence. The educational package involved simple-language
booklets, short videos, and reinforcement through follow-up phone calls. In the intervention
group, mean knowledge scores increased by 35%, adherence rates improved by 28%, and
systolic blood pressure decreased by an average of 8 mmHg over two months (p < 0.05), while
the control group showed no significant changes. The authors concluded that culturally tailored
educational packages can improve long-term compliance and clinical outcomes.

Lopez M. and Sanders J. (2021) conducted a randomized controlled trial among 120
undergraduate nursing students to evaluate a multimedia educational package on infection
control and hand hygiene practices. The intervention included animated videos, interactive
quizzes, and simulation-based demonstrations. Students in the intervention group scored 92%
on posttest knowledge assessments and achieved 89% compliance in observed clinical practice,
compared to 74% knowledge and 63% compliance in the control group (p < 0.001). The study
concluded that interactive, technology-driven educational packages are highly effective in
improving both cognitive learning and skill application in clinical settings
Choi H. et al. (2020) evaluated a web-based educational package on workplace ergonomics
among 75 office workers from a corporate firm. The program included short e-learning
modules, posture correction videos, and monthly email reminders. Pre-intervention
assessments showed that only 25% of employees followed correct ergonomic practices and
62% reported musculoskeletal discomfort. Post-intervention, knowledge scores increased by
41%, adherence to ergonomic practices rose to 78%, and musculoskeletal discomfort reduced
by 35% after three months (p < 0.01). The authors concluded that digital educational packages
are an efficient, low-cost approach to improving workplace health outcomes.

Sarjeet Sanga (2011) conducted a quasi-experimental study to evaluate the effectiveness of

an educational package on mothers’ knowledge regarding the harmful effects of home
accidents among under-five children in a selected community. Using a pre-test/post-test design
with 200 mothers selected through simple random sampling, the study revealed that 80% of
participants initially had poor knowledge. After a structured six-day video teaching program,
there was a marked improvement in awareness levels, with a significant rise in the number of
mothers achieving adequate knowledge scores. The findings emphasized that repeated, visually
aided teaching interventions are highly effective in improving maternal understanding of
accident risks, prevention strategies, and early management measures. The study also
highlighted the need for community-based awareness programs and the importance of
educating caregivers as a key step in reducing the incidence of preventable injuries in children
under five.
 CHAPTER-III
RESEARCH METHODOLOGY

This chapter seals with the methodology for the study. It includes research approach design,
research design variable, setting, population, sample, criteria for sample, criteria for sample
selection, sampling technique, sample size, development and description of the tool, content
validity, pilot study, ethical considerations, data collection procedure and plan for data
analysis.
3.1 RESEARCH APPROACH

Quantitative approach was adopted in the present study as the investigation is aimed at
evaluating the effectiveness of educational package.

3.2 RESEARCH DESIGN

The research design chosen for this study is pre experimental one group pre-test post -test
design.

The diagrammatic representation of design is given below

Group Pre test Intervention Post test

One group O1 X O2

Mothers of under Assessing the Educational Assessing the

five children pre-existing level package on
Post -test level of
of knowledge regarding home
knowledge and
and practice accidents
practice
regarding home
regarding home
accident
accidents

Key:

O1 – Pre -test level of knowledge and practice regarding home accidents

X – Intervention [Educational package for 6 consecutive days )

O2 – Post –test level of knowledge and practice regarding effects of home accident.

3.3 RESEARCH VARIABLES

The variables of the study were enlisted as below

INDEPENDENT VARIABLE
The Independent variable in this study based on educational package.
DEPENDENT VARIABLE
The dependent variable in this study is level of knowledge and practice regarding home
accidents among the mother’s of under five children.
DEMOGRAPHIC VARIABLES
This section deals with the demographic data of the clients. Demographic variables include
age of the mother, educational status, occupation, type of family, monthly family income,
type of house, number of under-five children, type of accidents that have occurred in the
house, place where treatment is taken after an accident, and previous knowledge about home
accidents through various sources.

3.4 SETTING OF THE STUDY

The study was conducted at Mappedu village (population 4205) in thiruvallur district and the
village is located in between Poonamallee to Arakkonam.
3.5 POPULATION
TARGET POPULATION
The target population of this study comprises all the mother’s of under five children
residing in Mappedu village.
ACCESSIBLE POPULATION
The accessible population of this study comprises the mother’ s of under five children
whoever fullfills the sample selection criteria.
3.6 SAMPLE
Sample in this study was in Mappedu village in thiruvallur district and those who met
inclusion criteria
3.7 SAMPLE SIZE
Sample size for present study is was 60 mothers of under five children who met the
inclusive crteria
3.8 SAMPLING TECHNIQUE
Non- probability purposive sampling technique was used to select 60 mothers of under five
children.
3.9 SAMPLE SELECTION CRITERIA
The study sample was selected by the following inclusive and exclusive criteria.
INCLUSIVE CRITERIA
● Mother’s s of under five children
● Mother’s of under five children who can understand Tamil language.
● Those who are willing to participate

EXCLUSIVE CRITERIA

● Who have participated in the pilot study.

● Those who are not able to follow the instruction.

3.10 DESCRIPTION OF TOOL AND TECHNIQUE

The tool used for the study was Self administered questionnaire.

The tool consists of three sections.

Section A: Deals with socio demographic data of the samples

Section B: Consist of Self-administered questionnaire

Section C: Consist of practice checklist

Section A:

This section deals with selected demographic data of the samples. Demographic variables
include age of the mother, educational status, occupation, type of family, monthly family
income, type of house, number of under-five children, type of accidents that have occurred in
the house, place where treatment is taken after an accident, and previous knowledge about
home accidents through various sources

SCORING PROCEDURE:

There was no score given for socio demographic variables.

Section B:
Consist of 25 self administered questionnaire regarding effects home accident and its
preventive measures.

SCORING PROCEDURE:

In the knowledge assessment questionnaire, each correct answer carries one mark and no mark
for wrong answer.

LEVEL OF KNOWLEDGE SCORE

Level of knowledge Percentage range

Very low 0-20%
Low 21-20%
Average 41-60%
High 61-80%
Very high 81-100%

Section C :

In practice checklist each yes carries 1 mark total 15 marks

LEVEL OF PRACTICE

Level of practice Range

Inadequate 0-5
practice
Moderate 6-10
practice
Adequate 10-15
practice

TESTING OF THE TOOL

CONTENT VALIDITY:

Content Validity refers to the degree to which an instrument measures what it is supposed
to measure. The content validity of the present tool along with the evaluation criteria
checklist was submitted to 3 experts in the field of Community Health Nursing, for the
opinion on the items in the tool. There was 100% agreement by experts and minimal
modifications were made in socio demographic variable were corrected based on the given
suggestion
3.13 PILOT STUDY :
The pilot study was conducted for a period of one week from 21.04.2025 to 26.04.2025
after obtaining formal consent from the Mappedu village president. A total of 6 samples
(who met the inclusion criteria) were selected using non- probability purposive sampling
technique. Written and oral consent from the mothers of under-five children was obtained.
. The setting was found to be reliable and feasible for proceeding with the main study. The
participants felt comfortable with the procedure and no discomfort was reported. The
results showed a high level of significance between the pretest and posttest scores. The
calculated ‘t’ value was found to be significant at p < 0.001 level. The suggestions and
opinions obtained during the pilot study were incorporated into the main study to
accomplish the objectives effectively.
3.12 RELIABILITY OF THE TOOL:
It is the degree of consistency with which an instrument measures the attributes which is
designed to measure. The reliability of the tool was assessed along with pilot study by
interactive method and the r value obtained which is highly reliable This correlation and
coefficient is very high and it is good for assessing the effectiveness of educational package
on level of knowledge and practice regarding home accidents among the mother’s of under
five children.

ETHICAL CONSIDERATION

The investigator consider the following steps to the data collection. PoPrior to data
collection, the investigator obtained ethical clearance from the Research Advisory
Committee (RAC) of Indira College of Nursing, Pandur, Thiruvallur. Content validity of the
tool was ensured by seeking expert opinion, and a pilot study was conducted to assess
feasibility. Informed oral and written consent was obtained from all study participants after
explaining the purpose, risks, and benefits of the study. The investigator assured the
participants that confidentiality and anonymity would be maintained throughout the
research process.

3.14 DATA COLLECTION PROCDURES:

The main study was conducted for a period of four weeks from 05.05.2025 to 31.05.2025
after obtaining formal consent from Mr. Sidhaiya Jagadheesh., Panchayat President of
Mappedu village. A total of 60 samples (who met the inclusion criteria) were selected using
non -probability purposive sampling technique . Written and oral consent from the
participants was obtained. After a brief self-introduction and explanation about the study,
the investigator proceeded with the main study. The pretest data was collected using a
structured 25-item knowledge questionnaire and a 15-item practice observational checklist.
Following the pretest, an educational package (leaflets, posters, and flashcards) teaching for
30 minutes focusing on types, prevention , complications treatment and management of
home accidents was given. The posttest was administered on the seventh day using the
same tool, and the data was analyzed. The participants were comfortable with the
procedure, the time allotted was adequate, and no discomfort was reported. In this manner,
a total of 60 samples were assessed, with 10 participants evaluated each day to determine
their level of knowledge and practice.
3.15 PLAN FOR DATA ANALYSIS
The data were planned to be analyzed in terms of the objectives of the study using
descriptive and inferential statistics.
DESCRIPTIVE STATISTICS
1. Frequency and percentage distribution used to analyze the socio demographic variables.

[Link] and standard deviation used to analyze the level of knowledge and practice among
the mother’s of under five children
INFERENTIAL STATISTICS
1. Paired t-test was used to compare the pre- and post-test level of knowledge and practice
regarding home accidents among mothers of under-five children.

[Link]’s product-moment correlation was applied to determine the association

between knowledge scores and practice scores regarding home accident prevention among
mothers of under-five children."
2.. Chi-square test was used to determine the association between the level of knowledge
and practice selected socio demographic variables among the mother’s of under five
children at mappdeu village.
 CHAPTER – IV

DATA ANALYSIS AND INTERPRETATION

This chapter deals with the analysis and interpretation of the data collected from 60
mothers of underfive children to assess the effectiveness of Educational Package on level of
knowledge and practice regarding home accidents among mothers of underfive children in
selected community area. Data analysis begins with description that applies to the study in
which the data are numerical with some concepts. The findings based on the descriptive and
inferential statistics analysis are presented under the following sections

ORGANIZATION OF THE DATA

Data collected were organized under the following sections.

SECTION A: Description of the demographic variables of mothers of underfive children.

SECTION B: Assessment of level of knowledge and practice regarding home accidents

among mothers of underfive children.

SECTION C: Effectiveness of Educational Package on level of knowledge and practice

regarding home accidents among mothers of underfive children.

SECTION D: Association of pre-test poand post- test level of knowledge and practice
regarding home accidents among mothers of underfive children with the
selected demographic variables.
SECTION A: DESCRIPTION OF THE DEMOGRAPHIC VARIABLES OF
MOTHERS OF UNDERFIVE CHILDREN BASED ON DEMOGRAPHIC
VARIABLES
Table 1: Frequency and percentage distribution of demographic variables of mothers of
underfive children.
N = 60
Demographic Variables Frequency Percentage (%)
Age of the mother
Below 20 years 7 11.7
21 – 25 years 29 48.3
26 – 30 years 17 28.3
Above 30 years 7 11.7
Educational status of mother
No formal education - -
Primary school 5 8.3
Secondary school 9 15.0
Higher secondary 39 65.0
Graduation and above 7 11.7
Occupation of mother
Homemaker 12 20.0
Daily wage worker 6 10.0
Private employee 25 41.7
Government employee 5 8.3
Others 12 20.0
Type of family
Nuclear 44 73.4
Joint 11 18.3
Extended 5 8.3
Monthly family income
Below ₹5000 - -
₹5001 – ₹10,000 5 8.3
₹10,001 – ₹15,000 10 16.7
Above ₹15,000 45 75.0
Type of house
Pucca 60 100.0
Kutcha - -
Semi-pucca - -
 Demographic Variables Frequency Percentage (%)
Number of underfive children
One 35 58.3
Two 18 30.0
More than two 7 11.7
What type of accidents have you occurred in
your house?
Burns 6 10.0
Falls 34 56.7
Cuts 17 28.3
Foreign body aspiration 3 5.0
Others
Where do you take the children for treatment
after an accident?
Government hospital 30 50.0
Private hospital 20 33.3
Traditional healer 10 16.7
Others - -
Previous knowledge about home accidents
through
Television / Radio 10 16.7
Health worker 10 16.7
Internet / Social media 30 50.0
Friends / Relatives 10 16.7
Others - -

The age distribution of the mothers showed that nearly half of them (48.3%) belonged to the
age group of 21–25 years, followed by 28.3% in the 26–30 years group. A smaller proportion
(11.7%) were below 20 years and another 11.7% were above 30 years. This indicates that the
majority of mothers were in their early reproductive years, reflecting the higher vulnerability
of first-time or young mothers in managing childcare and preventing home accidents.
With regard to education, the majority (65%) had studied up to higher secondary level, while
15% had completed secondary school education. A small proportion (11.7%) were graduates
or above, and 8.3% had only primary schooling. None of the mothers were without formal
education. This trend highlights a reasonably good literacy level, which is advantageous for
implementing structured health education programmes using both print and digital materials.
The largest group of mothers (41.7%) were employed in the private sector, while 20% were
homemakers and another 20% belonged to the “other” category. Government employees
constituted 8.3%, and 10% were daily wage workers. The predominance of working mothers
suggests the importance of incorporating practical, time-efficient strategies for child accident
prevention, especially when mothers are away from home.
Most respondents (73.4%) lived in nuclear families, whereas 18.3% belonged to joint
families and 8.3% to extended families. Nuclear families often have fewer adults to share
child supervision responsibilities, making accident prevention measures more critical in such
households.

The three-fourths (75%) of the families earned more than ₹15,000 per month, while 16.7%
earned between ₹10,001–15,000, and 8.3% earned between ₹5,001–10,000. None of the
families reported an income below ₹5,000. This indicates a relatively stable economic status,
which may facilitate access to better housing and healthcare facilities, while also presenting
accident risks related to modern household amenities.
All respondents (100%) resided in pucca houses, and none reported living in kutcha or semi-
pucca houses. This finding is important as the risks of accidents in pucca houses are more
likely related to indoor structures, electrical appliances, and modern household arrangements
rather than fragile building materials.
The majority (58.3%) of mothers had one child, while 30% had two children and 11.7% had
more than two children. This indicates that most participants were mothers of a single under-
five child, often their first child, which may limit prior experience in managing child safety at
home.
Falls were the most commonly reported accidents (56.7%), followed by cuts (28.3%) and
burns (10%). A few mothers (5%) reported incidents of foreign body aspiration. Falls
emerging as the leading accident type emphasize the need for environmental safety
modifications and constant supervision of active toddlers.
Half of the respondents (50%) reported taking their children to government hospitals, while
33.3% preferred private hospitals and 16.7% still relied on traditional healers. This indicates
that although modern health facilities are widely used, a segment of the population continues
to depend on traditional practices, which may delay appropriate care.
Half of the mothers (50%) obtained information through internet and social media. Other
sources included television/radio (16.7%), health workers (16.7%), and friends/relatives
(16.7%). This suggests that digital platforms are the most common means of health
information dissemination among mothers, highlighting the need for using online and social
media-based educational strategies in health promotion.
 Below 20 years

100 21 – 25 years
26 – 30 years
90
Above 30 years
80

70

60 48.3
Percentage

50

40 28.3

30
11.7
20 11.7

10

0
Below 20 years 21 – 25 years 26 – 30 years Above 30 years

Age of the mother

Percentage distribution of age of the mothers of underfive children

 No formal education
100 Primary school
Secondary school
90 Higher secondary
Graduation and above
80
65.0
70

60
Percentage

50

40

30
15.0
20 8.3 11.7

10 0

0
No formal Primary Secondary Higher Graduation
education school school secondary and above

Educational status of the mother

Percentage distribution of educational status of the mothers of underfive children

 One
Two
100
More than two

90

80

70 58.3

60
Percentage

50

40 30.0

30

20 11.7

10

0
One Two More than
two
Number of underfive children

Percentage distribution of number of underfive children among the mothers

SECTION B: ASSESSMENT OF LEVEL OF KNOWLEDGE AND PRACTICE
REGARDING HOME ACCIDENTS AMONG MOTHERS OF UNDERFIVE
CHILDREN.
Table 2: Frequency and percentage distribution of pretest and post level of knowledge
regarding home accidents among mothers of underfive children.
N = 60
Pretest Post Test
Level of Knowledge
F (%) F (%)
Very low (0 – 20%) 6 10.0 0 0
Low (21 – 40%) 22 36.7 0 0
Average (41 – 60%) 32 53.3 0 0
High (61 – 80%) 0 0 29 48.3
Very high (81 – 100%) 0 0 31 51.7

The table 2 depicts the frequency and percentage distribution of pretest and post level
of knowledge regarding home accidents among mothers of underfive children.

It shows that in the pretest, 32(53.3%) had average knowledge, 22(36.7%) had low
level of knowledge and 6(10%) had very low level of knowledge regarding home accidents
among mothers of underfive children and after intervention, 31(51.7%) had very high level of
knowledge and 29(48.3%) had high level of knowledge.
 Pretest
100.0
Post Test
90.0

80.0

70.0

60.0 53.3
Percentage

51.7
48.3
50.0
36.7
40.0

30.0

20.0
10.0
10.0 0 0
0 0 0
0.0
Very low (0 – Low (21 – Average (41 – High (61 – Very high (81
20%) 40%) 60%) 80%) – 100%)

Level of Knowledge

Percentage distribution of pretest and post level of knowledge regarding home accidents
among mothers of underfive children
Table 3: Frequency and percentage distribution of pretest and post level of practice
regarding home accidents among mothers of underfive children.
N = 60
Pretest Post Test
Level of Practice
F (%) F (%)
Inadequate practice (0 – 5) 41 68.3 - -
Moderate practice (6 – 10) 19 31.7 20 33.3
Adequate practice (11 – 15) - - 40 66.7

The table 3 denotes the frequency and percentage distribution of pretest and post level
of practice regarding home accidents among mothers of underfive children.

It shows that in the pretest, 41(68.3%) had inadequate practice and 19(31.7%) had
moderate practice regarding home accidents among mothers of underfive children and after
intervention, 40(66.7%) had adequate practice and 20(33.3%) had moderate practice.
 Pretest
100.0
Post Test
90.0

80.0
68.3 66.7
70.0

60.0
Percentage

50.0

40.0 33.3
31.7

30.0

20.0

10.0 0
0
0.0
Inadequate Moderate Adequate
practice (0 – practice (6 – practice (11 –
5) 10) 15)
Level of Practice

Percentage distribution of pretest and post level of practice regarding home accidents
among mothers of underfive children
SECTION C: EFFECTIVENESS OF EDUCATIONAL PACKAGE ON LEVEL OF
KNOWLEDGE AND PRACTICE REGARDING HOME ACCIDENTS AMONG
MOTHERS OF UNDERFIVE CHILDREN.
Table 4: Effectiveness of Educational Package on level of knowledge regarding home
accidents among mothers of underfive children.
N = 60
Mean Difference Paired “t” test &
Knowledge Mean S.D
Score p-Value
Pretest 10.52 2.66 t= 67.339
10.05
Post Test 20.57 2.48 p=0.0001, S***
***p<0.001, S – Significant

The table 4 illustrated that in the pretest mean score of knowledge was 10.52±2.66
and the post test mean score of knowledge was 20.57±2.48. The mean difference score was
10.05. The calculated paired “t” test value of t=67.339 was highly statistically significant at
p<0.001 level. This clearly infers that Educational Package on level of knowledge
administered among the mothers of underfive children was found to be effective in improving
the level of knowledge in the post test.
 25.0
Pretest
Post Test
20.57
20.0
Knowledge Scores

15.0

10.52

10.0

5.0

0.0
Pretest Post Test

Comparison of pretest and post test knowledge scores regarding home accidents among
mothers of underfive children
Table 5: Effectiveness of Educational Package on level of practice regarding home
accidents among mothers of underfive children.
N = 60
Mean Difference Paired “t” test &
Practice Mean S.D
Score p-Value
Pretest 4.83 1.37 t= 31.314
6.65
Post Test 11.48 1.87 p=0.0001, S***
***p<0.001, S – Significant

The table 5 indicated that in the pretest mean score of knowledge was 4.83±1.37 and
the post test mean score of knowledge was 11.48±1.87. The mean difference score was 6.65.
The calculated paired “t” test value of t=31.314 was highly statistically significant at p<0.001
level. This clearly infers that Educational Package on level of practice administered among
the mothers of underfive children was found to be effective in improving the level of practice
in the post test.
 25.0
Pretest
Post Test

20.0
Practice Scores

15.0

11.48

10.0

4.83
5.0

0.0
Pretest Post Test

Comparison of pretest and post test practice scores regarding home accidents among
mothers of underfive children
SECTION D: ASSOCIATION OF PRE - TEST AND POST- TEST LEVEL OF
KNOWLEDGE AND PRACTICE REGARDING HOME ACCIDENTS AMONG
MOTHERS OF UNDERFIVE CHILDREN WITH THE SELECTED
DEMOGRAPHIC VARIABLES.
Table 7: Association of post test level of knowledge regarding Home Accidents among
mothers of underfive children with their selected demographic variables.
N = 60

High Very High Chi-Square &

Demographic Variables
F % F % p-value
Age of the mother
Below 20 years 4 6.7 3 5.0 2=1.808
21 – 25 years d.f=3
13 21.7 17 28.3
p=0.613
26 – 30 years 10 16.7 7 11.7 N.S
Above 30 years 2 3.3 4 6.7
Educational status of mother
No formal education - - - - 2=0.413
Primary school 2 3.3 3 5.0 d.f=3
Secondary school 4 6.7 5 8.3 p=0.937
Higher secondary 20 33.3 19 31.7 N.S
Graduation and above 3 5.0 4 6.7
Occupation of mother
Homemaker 5 8.3 7 11.7 2=1.508
Daily wage worker 2 3.3 4 6.7 d.f=4
Private employee 12 20.0 13 21.7 p=0.825
Government employee 3 5.0 2 3.3 N.S
Others 7 11.7 5 8.3
Type of family 2=0.316
Nuclear 21 35.0 23 38.3 d.f=2
Joint 6 10.0 5 8.3 p=0.854
Extended 2 3.3 3 5.0 N.S
Monthly family income
Below ₹5000 - - - - 2=0.556
d.f=2
₹5001 – ₹10,000 2 3.3 3 5.0
p=0.757
₹10,001 – ₹15,000 4 6.7 6 10.0 N.S
Above ₹15,000 23 38.3 22 36.7
Type of house
-
Pucca 29 48.3 31 51.7
 High Very High Chi-Square &
Demographic Variables
F % F % p-value
Kutcha - - - -
Semi-pucca - - - -
Number of underfive children 2=7.097
One 22 36.7 13 21.7 d.f=2
Two 5 8.3 13 21.7 p=0.029
More than two 2 3.3 5 8.3 S*
What type of accidents have you
occurred in your house?
Burns 2 3.3 4 6.7 2=1.111
Falls 18 30.0 16 26.7 d.f=3
p=0.774
Cuts 8 13.3 9 15.0
N.S
Foreign body aspiration 1 1.7 2 3.3
Others - - - -
Where do you take the children
for treatment after an accident? 2=0.334
Government hospital 15 25.0 15 25.0 d.f=2
Private hospital 10 16.7 10 16.7 p=0.846
Traditional healer 4 6.7 6 10.0 N.S
Others - - - -
Previous knowledge about home
accidents through
Television / Radio 5 8.3 5 8.3 2=1.935
Health worker 6 10.0 4 6.7 d.f=2
p=0.586
Internet / Social media 15 25.0 15 25.0
N.S
Friends / Relatives 3 5.0 7 11.7
Others - - - -
*p<0.05, S – Significant N.S – Not Significant, p>0.05

The table 7 shows the association of post test level of knowledge regarding Home
Accidents among mothers of underfive children with their selected demographic variables. It
was found that the demographic variable number of underfive children (2=7.097, p=0.029)
had statistically significant association with post test level of knowledge regarding Home
Accidents among mothers of underfive children at p<0.05 level. The other demographic
variables did not show statistically significant association with post test level of knowledge
regarding Home Accidents among mothers of underfive children at p<0.05 level.
Table 8: Association of post test level of practice regarding Home Accidents among
mothers of underfive children with their selected demographic variables.
N = 60

Moderate Adequate Chi-Square &

Demographic Variables
F % F % p-value
Age of the mother
2=7.873
Below 20 years 5 8.3 2 3.3
d.f=3
21 – 25 years 11 18.3 18 30.0
p=0.049
26 – 30 years 3 5.0 14 23.3
S*
Above 30 years 1 1.7 6 10.0
Educational status of mother
No formal education - - - - 2=8.158
Primary school 4 6.7 1 1.7 d.f=3
Secondary school 1 1.7 8 13.3 p=0.043
Higher secondary 14 23.3 25 41.7 S*
Graduation and above 1 1.7 6 10.0
Occupation of mother
Homemaker 5 8.3 7 11.7 2=5.145
Daily wage worker 1 1.7 5 8.3 d.f=4
Private employee 8 13.3 17 28.3 p=0.273
Government employee 0 0 5 8.3 N.S
Others 6 10.0 6 10.0
Type of family 2=1.111
Nuclear 13 21.7 31 51.7 d.f=2
Joint 5 8.3 6 10.0 p=0.574
Extended 2 3.3 3 5.0 N.S
Monthly family income
2=5.800
Below ₹5000 - - - -
d.f=2
₹5001 – ₹10,000 4 6.7 1 1.7
p=0.055
₹10,001 – ₹15,000 2 3.3 8 13.3
N.S
Above ₹15,000 14 23.3 31 51.7
Type of house
Pucca 20 33.3 40 66.7
-
Kutcha - - - -
Semi-pucca - - - -
 Moderate Adequate Chi-Square &
Demographic Variables
F % F % p-value
Number of underfive children 2=0.550
One 13 21.7 22 36.7 d.f=2
Two 5 8.3 13 21.7 p=0.760
More than two 2 3.3 5 8.3 N.S
What type of accidents have you
occurred in your house?
2=2.426
Burns 1 1.7 5 8.3
d.f=3
Falls 12 20.0 22 36.7
p=0.489
Cuts 5 8.3 12 20.0
N.S
Foreign body aspiration 2 3.3 1 1.7
Others - - - -
Where do you take the children
for treatment after an accident? 2=1.275
Government hospital 12 20.0 18 30.0 d.f=2
Private hospital 5 8.3 15 25.0 p=0.529
Traditional healer 3 5.0 7 11.7 N.S
Others - - - -
Previous knowledge about home
accidents through
2=5.100
Television / Radio 5 8.3 5 8.3
d.f=3
Health worker 4 6.7 6 10.0
p=0.165
Internet / Social media 6 10.0 24 40.0
N.S
Friends / Relatives 5 8.3 5 8.3
Others - - - -
*p<0.05, S – Significant N.S – Not Significant, p>0.05

The table 8 shows the association of post test level of practice regarding Home
Accidents among mothers of underfive children with their selected demographic variables. It
was found that the demographic variables age of the mother (2=7.873, p=0.049) and
educational status of mother (2=8.158, p=0.043) had statistically significant association with
post test level of practice regarding Home Accidents among mothers of underfive children at
p<0.05 level. The other demographic variables did not show statistically significant
association with post test level of practice regarding Home Accidents among mothers of
underfive children at p<0.05 level.
 CHAPTER – V

DISCUSSION

This chapter discusses in detail about the findings of the study interpreted from the statistical
analysis, in accordance with the objectives of the study and further discussion will denotes the
fulfilment of objective by the study findings. The purpose of the study was to assess the
effectiveness of educational package on level of knowledge on practice regarding home
accidents among mothers of under five children in Mappedu village, thiruvallur [Link]
findings of the study are discussed based on the following objectives.

Description of the demographic variables of mothers of underfive children.

The study showed that nearly half of the mothers (48.3%) were between 21–25 years, while
28.3% were 26–30 years, reflecting a younger age group with limited childcare experience.
Most of them (65%) had higher secondary education, supporting better understanding of health
messages. Regarding occupation, 41.7% were private employees and 20% homemakers,
indicating the need for time-efficient accident prevention strategies. A majority (73.4%) lived
in nuclear families, while 75% of households had income above ₹15,000, and all resided in
pucca houses, suggesting risks linked to modern household environments. More than half
(58.3%) had only one child, often a first child, limiting prior experience in accident prevention.
Falls were the most common accidents (56.7%), followed by cuts (28.3%), burns (10%), and
foreign body aspiration (5%). In case of accidents, 50% sought treatment in government
hospitals, 33.3% in private facilities, and 16.7% relied on traditional healers. Half of the
mothers (50%) had prior knowledge from internet/social media, while others (16.7% each)
cited television, health workers, and relatives, showing the importance of structured education
to ensure accurate information.

The first objective of the study was to assess pretest and Post test level of knowledge and
practice regarding home accident among mothers of under five children.

Table 2 shows that before the intervention, the knowledge level of mothers was poor,
with 53.3% having only average knowledge, 36.7% with low knowledge, and 10% with very
low knowledge. After the educational package, knowledge improved significantly, with 51.7%
reaching very high knowledge and 48.3% attaining high knowledge.

Table 3 indicates that practice regarding home accident prevention was also inadequate
in the pretest, as 68.3% of mothers had poor practice and 31.7% had moderate practice.
Following the intervention, practice improved notably, with 66.7% achieving adequate practice
and 33.3% maintaining moderate practice.

The second objective was to determine the effectiveness of educational package on level
of knowledge and practice regarding home accidents among mothers of under five
children.

Table 4 shows that the mean knowledge score of mothers in the pretest was 10.52±2.66, which
increased to 20.57±2.48 in the posttest after the educational package. The mean difference of
10.05, along with the calculated paired “t” value of 67.339, was found to be highly statistically
significant at p<0.001 level. This clearly indicates that the educational package was effective
in significantly improving the knowledge of mothers regarding prevention of home accidents
among under-five children.

The findings portrayed Table 5 reveals that the mean practice score of mothers in the
pretest was 4.83±1.37, which increased to 11.48±1.87 in the posttest after the intervention. The
mean difference of 6.65, with a paired “t” value of 31.314, was highly statistically significant
at p<0.001 level. This finding demonstrates that the educational package was highly effective
in improving the practice of mothers regarding prevention of home accidents, thereby bridging
the gap between knowledge and practical application of safety measures for under-five
children.

Overall, Tables 4 and 5 together demonstrate that the educational package was highly effective
in simultaneously strengthening knowledge and improving safety practices, which is essential
for reducing the incidence of home accidents among under-five children.

Thus, the Hypothesis H₁stated earlier that There is a significant difference between pre test
and post test level of knowledge and practice regarding home accidents among the
mothers of under five children" was rejected

The findings of the present were supported by the study was conducted by
Vijayamalar, S., Nanjappan, D., & Malagi, V. (2024) conducted a quasi-experimental study
titled “Impact of Organized Educational Programs on Mothers’ Knowledge of Preventing
Mishaps at Home for Their Children in Urban Bangalore” published in the European Journal
of Medical and Health Research. In this study, 60 mothers participated in a structured
educational program on home accident prevention. The authors reported that before the
intervention, only 51.7% of mothers had moderate knowledge and 25% had high knowledge
about preventing home accidents. Post-intervention, these proportions improved to 35% with
moderate knowledge and 65% with high knowledge. Importantly, the mean overall knowledge
score increased from 16.32 ± 6.62 (pretest) to 31.02 ± 4.99 (posttest)

The findings of the present were supported by the study was conducted by Sharma,
P., & Tirkey, P. (2024) conducted a pre-experimental study titled "Pre-Experimental Study
Regarding Prevention of Home Accident Among Mothers of Under Five Year Children in
Selected Rural Area, Bilaspur, Chhattisgarh", published in the International Journal of Recent
Advances in Multidisciplinary Topics. The study involved 60 mothers of under-five children
and used a one-group pre-test–post-test design to assess the impact of a structured teaching
programme. Results showed a significant increase in knowledge: the post-test mean score was
16.4, compared to the pre-test mean of 10.78 (t = 15.21, p < 0.05)

The third objective was to associate the selected demographic variables with the Post test
level of knowledge and practice regarding home accidents among mothers of under five
children.

The findings of Table 7 shows that the number of under-five children (χ² = 7.097, p = 0.029)
had a statistically significant association with posttest knowledge at p<0.05 level, while other
demographic variables such as age, education, occupation, and income showed no significant
association. This indicates that the educational package was effective across all groups, with
the number of children being the only factor influencing knowledge gain.

Table 8 – Association of Practice with Demographic Variables

Table 8 reveals that the age of the mother (χ² = 7.873, p = 0.049) and educational status
of the mother (χ² = 8.158, p = 0.043) had a statistically significant association with posttest
practice at p<0.05 level. Other demographic variables did not show any significant association,
suggesting that age and education played an important role in improving mothers’ safety
practices after the intervention.
This the Hypothesis H₂ stated earlier that " there is a association between Post test level of
knowledge and practice regarding home accidents among mothers of under five
children" was accepted for the demographic variable age and education and rejected for all
other demographic variables.

CHAPTER – VI

SUMMARY, CONCLUSION, IMPLICATIONS AND

RECOMMENDATIONS

The research project lies in reporting the findings of the [Link] chapter gives a brief account
of the present study including the conclusion drawn from the findings, recommendations,
limitations of the study, suggestions for the study and nursing implications

SUMMARY

Accidents in the home are one of the leading causes of injury among under-five
children. Lack of awareness among mothers contributes significantly to the incidence of these
accidents. Educating mothers on prevention strategies can reduce risks and improve child
[Link] study was undertaken to evaluate the effectiveness of an educational package on
improving the knowledge and practice of mothers of under-five children regarding home
accident prevention. A total of 60 mothers were selected using a non-probability purposive
sampling technique. Structured questionnaires and practice checklists were used to assess
knowledge and practice before and after the intervention.

Statement of the problem:

"A study to assess the effectiveness of an Educational Package on the level of knowledge and
practice regarding home accidents among mothers of under-five children in Mappedu village"

Objectives of the study:

To assess the pre-test and post-test level of knowledge and practice among mothers
regarding home accidents.

To determine the effectiveness of the Educational Package on knowledge and

practice regarding home accidents among mothers of under five children
 To assess the pretest and postest level of knowledge and practice regarding home
accidents among mothers of under five children

To associate post-test levels of knowledge and practice regarding home accidents

among mothers of under five children with selected demographic variables

HYPOTHESIS

H1 - There is a significant difference between pre test and post test level of knowledge and
practice regarding home accidents among the mothers of under five children at selected
community area

H2- There is a significant association between the level of knowledge and practice regarding
home accidents among mothers of under five children with their selected socio demographic
variable.

Methodology:

This study was conducted to evaluate the effectiveness of an educational package

on level of knowledge and practices regarding prevention of home accidents among mothers
of under five children.. A pre-experimental one-group pre-test and post-test design was
adopted, involving systematic data collection through structured questionnaires and practice
checklists the 60 sample were selected by Non- Probability purposive sampling method was
used in Mappedu village, thiruvallur district.

Mothers were assessed before and after the intervention using Self structure
knowledge and practice tools, and the data were analyzed using descriptive and inferential
statistics (including paired t-tests) to measure changes in knowledge and practice levels. By
examining results presented in Tables 1 to 8, the study demonstrates significant improvements
attributable to the intervention.

Major findings of the study:

The majority of mothers (29; 48.3%) belonged to the age group of 21–25 years, indicating that
most participants were in their early reproductive years. With regard to education, 39 (65%)
had studied up to higher secondary level, reflecting a reasonably good literacy status in the
community. A considerable proportion of mothers (25; 41.7%) were employed in the private
sector, suggesting the predominance of working women in the study group. Most respondents
(44; 73.4%) lived in nuclear families, where childcare responsibilities were limited to fewer
adults, and 45 (75%) reported a monthly income above ₹15,000, showing a stable economic
background. All participants (60; 100%) resided in pucca houses, representing permanent
housing with modern structures. More than half of the mothers (35; 58.3%) had only one under-
five child, which may imply limited prior experience in childcare. Falls (34; 56.7%) were the
most common type of home accident, followed by cuts and burns, underscoring the
vulnerability of toddlers. Government hospitals were reported as the preferred place of
treatment by 30 (50%) mothers, while social media and the internet were cited as major sources
of prior knowledge by the same proportion (50%), highlighting the role of digital platforms in
information dissemination. Following the intervention, 31 (51.7%) mothers achieved very high
knowledge scores, and 40 (66.7%) demonstrated adequate practice, confirming the
effectiveness of the educational package. Statistical analysis revealed significant associations
between the number of under-five children and knowledge (p=0.029), and between age
(p=0.049) and education (p=0.043) with practice, whereas other demographic variables showed
no significant relationship.

CONCLUSION

The study found that mothers of under-five children nitially had poor knowledge and practice
regarding prevention of home accidents, with falls being most common. After the educational
package, both knowledge and practice improved significantly (p<0.001). Significant
associations were noted with number of children, age, and education. Hence, both hypotheses
(H₁ and H₂) were accepted, proving the effectiveness of the educational package in reducing
risks of home [Link] result shows that their is a significant difference between pre-test
and post- test level of knowledge and practice score.

IMPLICATIONS

The investigator had derived the following implications from the study, which are vital
concern in the field of nursing practice, nursing education, nursing administration,and nursing
research.

Nursing practice:

Community health nurses can use structured educational interventions to empower mothers
in preventing home accidents.

Nurses can educate mothers during home visits, immunization clinics, and community
health programs about accident prevention.
 Collaboration with community health workers can help reach a larger population and
enhance overall child safety awareness

Nursing education:

Nursing students should be trained to educate caregivers about home accident prevention as
part of maternal and child health programs.

Curriculum can include practical sessions, demonstrations, and role-playing to improve

students’ teaching and communication skills.

Emphasis on preventive care in the curriculum will prepare nurses to plan and implement
effective community health interventions.

Students can be encouraged to develop educational materials, such as pamphlets or posters, to

enhance caregiver learning and awareness

Nursing administration:

Nurse administrators can organize awareness programs and workshops on home accident
prevention for mothers of under-five children.

They can implement structured training sessions for staff nurses to enhance community-based
health education.

Administrators can ensure availability of educational resources such as posters, pamphlets, and
demonstration kits at health centers.

Policies can be developed to integrate accident prevention education into routine maternal and
child health services.

Nursing research As a nurse researcher

Researchers can explore the long-term effectiveness of educational interventions on mothers’

knowledge and practices.

Comparative studies can be conducted to evaluate different teaching methods for preventing
home accidents.

Further research can focus on larger populations and diverse settings to generalize findings.

Studies can investigate other factors influencing maternal practices and child safety in home
environments
RECOMMENDATIONS

Similar studies can be conducted on a larger sample to validate these findings.

Longitudinal studies can assess the sustained impact of educational intervention

Comparative studies can evaluate different teaching methods (e.g., videos vs. live
demonstrations).

Studies can be replicated in urban and rural settings to compare effectiveness.

Health awareness programs should be integrated into routine maternal and child health
services to reach mothers.
 BIBLIOGRAPHY

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6. Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2019), Health Promotion in
Nursing Practice, 8th Edition, Pearson Publication, New Delhi.
7. McEwen, M., & Wills, E. M. (2019), Theoretical Basis for Nursing, 5th Edition,
Wolters Kluwer Publication, New Delhi.
8. Bastable, S. B. (2019), Nurse as Educator: Principles of Teaching and Learning for
Nursing Practice, 5th Edition, Jones & Bartlett Learning, New Delhi.
9. K. Park (2022), Textbook of Preventive and Social Medicine, 26th Edition,
Banarsidas Bhanot Publication, Jabalpur, India.
10. Gibson, M. A. (2018), Community Health Nursing: Promoting and Protecting the
Public's Health, 8th Edition, Elsevier Publication, New Delhi.
11. Wright, K., & Leahey, M. (2020), Nurses and Families: A Guide to Family
Assessment and Intervention, 7th Edition, F.A. Davis Company, New Delhi.
12. Gulanick, M., & Myers, J. L. (2020), Nursing Care Plans: Diagnoses, Interventions,
and Outcomes, 8th Edition, Elsevier Publication, New Delhi.
 13. Lewis, S. L., Bucher, L., & Heitkemper, M. M. (2021), Medical-Surgical Nursing:
Assessment and Management of Clinical Problems, 11th Edition, Elsevier
Publication, New Delhi.
14. Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2020), Brunner &
Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition, Wolters Kluwer
Publication, New Delhi.
15. Black, J. M., & Hawks, J. H. (2019), Medical-Surgical Nursing: Clinical Management
for Positive Outcomes, 11th Edition, Elsevier Publication, New Delhi.

JOURNAL REFERENCES

1. Latha, K. (2022). A study to assess the knowledge and practice regarding prevention
of home accidents among mothers of under-five children at Milaganoor. Journal of
Nursing & Care Case Series, 11(5). [Link]
2. JSTOR & Ithaka. (2010). Experimental study on mothers’ attitudes toward preventing
home accidents among under-five children: Impact of media content on preschool
behavior. Journal of Child Safety Studies, 12(3), 145–152.
3. Masih, B. (2021). Knowledge and practice regarding accident prevention among
parents of under-five children in Rohtas, Bihar. International Journal of Nursing
Research, 9(2), 45–50.
4. Peter, A. (2021). Effectiveness of planned teaching on knowledge of mothers
regarding home accident prevention at NSCB Medical College, Jabalpur. Journal of
Nursing Education and Practice, 11(4), 88–92.
5. Kumari, P. (2020). Knowledge of mothers regarding prevention of domestic accidents
among under-five children: A descriptive study in a pediatric OPD. Journal of
Pediatric Nursing Research, 7(2), 112–116.
6. Mariya, A. (2021). A descriptive study to assess knowledge of mothers regarding
prevention of home accidents among under-five children in Mangalore. International
Journal of Child Health Nursing, 9(1), 54–58
7. Brahman, A. S. S. (2021). A descriptive study on maternal knowledge regarding
prevention of home accidents among under-five children in Bengaluru. Indian Journal
of Child Health Nursing, 8(1), 34–39.
8. Meena, P., Krishnan, D., & Nandini, M. (2021). Effectiveness of video-assisted
teaching programme on knowledge regarding prevention and first aid management of
domestic accidents among mothers of under-five children. Global International
Journal of Advanced Studies in Humanities (GIJASH). Retrieved from
[Link]
9. Karpaga Latha. (2022). A study to assess the effectiveness of video-assisted teaching
on knowledge regarding prevention of home accidents among mothers of under-five
 children. Journal of Nursing and Care. Retrieved from
[Link]
10. Salvi, R. J. (2014). A study to assess the effectiveness of information booklet on
knowledge of mothers regarding prevention of home accidents among children under
five years in selected areas of urban community. International Journal of Nursing
Research (IJNR). Retrieved from
[Link]
11. Alanzi, T., Alotaibi, F., & Alshahrani, R. (2025). Domestic injuries among children:
Knowledge, attitudes, and practices of Saudi mothers. BMC Pediatrics, 25, Article
5583. [Link]
12. Alghamdi, R., Al-Qahtani, S., & Al-Shehri, N. (2025). Maternal knowledge of
pediatric first aid in Riyadh: Addressing gaps. Medicine Journal, 104(21), 1–8.
[Link]
journal/fulltext/2025/02140/maternal_knowledge_of_pediatric_first_aid_in.[Link]
13. Aboagye, J., & Owusu, E. (2018). Knowledge, attitude, and perception on prevention
of home accidents among mothers who came to the pediatrics department of the
Korle-Bu Teaching Hospital. ResearchGate.
[Link]
14. Smith, L., & Jones, R. (2004). Maternal perceived safety and parenting practices with
young children. BMC Public Health, 2(2), e461.
[Link]
15. World Health Organization. (2001). Educational strategies for preventing accidents in
childhood. PMC. [Link]
16. Kim, S., & Lee, H. (2025). Evidence of interventions for the prevention of
unintentional injuries. JMIR Pediatrics, 10(1), e67877.
[Link]
17. Choi, Y., & Park, J. (2025). Infant home safety programs for parents to prevent
injuries. Sage Journals.
[Link]
18. Al-Shehri, A., & Al-Qahtani, F. (2025). Prevalence and risk factors of home accidents
among children under five in Al-Baha region, Saudi Arabia. PMC.
[Link]

NET REFFERENCES

[Link]

[Link]

[Link]

[Link]

[Link]
 [Link]

TOOLS

PART 1

DEMOGRAPHIC VARIABLES

1. Age of the Mother

a) Below 20 years
b) 21–25 years
c) 26–30 years
d) Above 30 years
2. Educational Status of Mother
a) Non-formal education
b) Primary school
c) Secondary school
d) Higher secondary
e) Graduation and above
3. Occupation of Mother
a) Homemaker
b) Daily wage worker
c) Private employee
d) Government employee
e) Others (specify) __________
4. Type of Family
a) Nuclear
b) Joint
c) Extended
5. Monthly Family Income
a) Below ₹5000
b) ₹5001 – ₹10,000
 c) ₹10,001 – ₹15,000
d) Above ₹15,000
6. Type of House
a) Pucca
b) Kutcha
c) Semi-pucca

7. Number of Under-five Children

a) One
b) Two
c) More than two
8. What type of accidents have you occurred in your house?
a) Burns
b) Falls
c) Cuts
d) Foreign body aspiration
e) Others (specify) __________
9. Where do you take the children for treatment after an accident?
a) Government hospital
b) Private hospital
c) Traditional healer
d) Others __________
10. Previous knowledge about home accidents through:
a) Television/Radio
b) Health worker
c) Internet/Social media
d) Friends/Relatives
e) Others (specify) __________
PART ll

KNOWLEDGE ASSESSMENT TOOL

1. What precautionary measures you will adopt to prevent cuts and laceration?
a) Supervise the child by not touching the sharp objects.
b) Keep breakable utensils near to the child.
c) None

2. What precautionary measures should be taken to prevent dangerous falls of child at home?
a) Do not keep the floor clean and dry.
b) Allow the child to play in an area where the floor is slippery.
c) Provide rails.

3. How will you prevent the toddlers from bums at home?

a) Keep machine , lamp near to the child
b) Avoid throwing cigarette stubs (or) burnt match sticks on flammable ones.
c) None

4. What precaution measures would you take to prevent scalds at home?

a) Don't give hot fluids to drink.
b) Leave children unattended in bathrooms/kitchens.
c) None of the above.

5. How do you prevent the hazards of drowning among toddlers?

a) Under no circumstance should a child be thrown into water and made to struggle.
b) Keep more water in front of the child.
c) Leave the child alone.

6. What precautions will you take to reduce chances of poisoning in toddlers?

a) Avoid keep poisonous substances along with consumables.

b) Store toxic substances in food container like milk bottle or soda bottl
c) Both.
7. How will you prevent motor vehiele injury in toddlers?
a) Permit child play in the street.
b) Do not allow the child to run behind the ball or kit in the road.
c) Allow child to play behind the parked car.

8. What methods will you follow to prevent the foreign body aspiration?
a) Let the child to play with damaged balloon.
b) Remove all small objects from the tloor before the child can pic
c) Allow child to play with small objects like coins, buttons.

9. How will you prevent electrical hazards in children at home?

a) Allow child to play with electrical appliance, wires and lighters.
b) Electrical switches, wires and fuse box and gas outlets Should be out of reach of children.
c) None of the above.

10. What protection would you take when there is an insect bite?
a) Don't allow child to sit on uncovered grass.
b) Allow child to child to sit on uncovered grass.
c) Both

11. What immediate care should be taken if there are falls?

a) Keep the child comfortably and provide first aid care.
b) Do not pick up the child from the floor.
c) Leave the child as it is.

12. What immediate care would you take if the child has consumed poisonous substances?
a) Make the child to vomit
b) Clean mouth and lips by giving sip of water.
c) As an immediate step seek for medical attention
d) All the above.

13. What would you do when the child has swallowed any foreign objects?
a) Check for breathing for the child.
b) Seek for medical attention immediately.
c) Check for the type of foreign bodies.
d) All the above.

14. Do you keep sharp and pointed objects near to the child?
a) Always
b) Never
c) Sometimes

15. Do you keep the stove, gas at a high place at kitchens?

a) Keep the stove, gas away from the child.
b) Keep reachable to child.
c) Make the child to play stove and gas.

16. Do you permit your child to play nearby water sources?

a) Allow the child to play with water.
b) Don't allow the child to play with water.
c) Make the child to play near to water tank

17. Where will you keep medications.

a). Shelf
b) Reachable to children.

c) Floor.

18. Will you allow the children to play on the road side (street)
a). Allow to play alone.
b) Along with friends.
c) Never allow the children to play.
19. What is poisonous substances
a). Bleaching powder
b). Phenol
c). Alcohol
d). All the above

20. How will you give first and (cuts) Bleeding at home
a). Nervous
b). Step bleeding by tie up
c). Call neighbor
d). Allow the tie down

21. One of the person for getting accident at home

a). Leaving alone
b). Neglecting
c). Due to heavy works
c) All the above

22. Will you allow the children to stay alone at home after schooling
a). yes
b). No

23. Children of prolonged exposure to violence

a). Aggressive with pears

b) Poor memory
c). Good academic performance
24. Immediate treatment for dog bite
a) Washing & taking to hospital
b). wipe & leave
c) Follow taboo

25. Will you allow the children to wide bicycle alone on the street (or) road side.
a). some times
b) Never alone

PART Ill
PRACTICE CHECKLIST

[Link] PRACTICE STATMENET YES NO

1 I always keep sharp objects (knives, scissors) out of

children’s reach.

2 I store medicines and cleaning products in locked cabinets.

3 I never leave my child unattended while bathing.

4 I use safety gates to block stairs or dangerous areas.

5 I keep hot liquids and food away from the edge of tables.

6 I cover electrical sockets with safety plugs.

7 I do not allow my child to play in the kitchen while cooking.

8 I keep small objects (coins, beads) out of children’s reach to

0prevent choking.
9 I always test the temperature of food before feeding my child.

10 I ensure that lays are age-appropriate and safe.

11 I keep buckets and water containers covered to prevent

drownig.,.

12 I check for loose rugs for slippery floors to avoid falls.

13 I know basic first aid steps for burns, choking, and bleeding.

14 I supervise my child while playing indoors or outdoors.

 15 I have emergency contact numbers accessible in case of
accidents.

Scoring:

Each yes = 1 mark

Total score 15
Interpretation:
0-5 Inadequate practice
6-10 Moderate practice
11-15 Adequate practice

கககககககக

ககககக- 1

கககககககககக ககககககக

1.தததததத தததத

த) 20 தததததததததத ததததததததத

த) 21–25 தததத

த) 26–30 தததத

த) 30 தததததததத தததத

2.தததததத ததததததத ததததத

த) ததததததததத ததததத

த) தததததததத ததததத

த) ததததததததத ததததத

த) தததததததததத ததததத
த) ததததததததததததத ததததததத தததததத தததத

3.தததததத தததததத

த) தததததததததத

த) தததததத தததததத ததததததததத

த) ததததததத தததததத

த) தததததத தததததததத

த) ததததத (ததததததததததததத) __________

4.ததததததததததததத ததத

த)ததததத ததததததததத

த) தததததத ததததததததத

த) தததததததததத ததததததததத

5 ததததததததத ததததததத தததததததத

த) ₹5000-தததத ததததததததத

த) ₹5001 – ₹10,000

த) ₹10,001 – ₹15,000

த) ₹15,000-தததத தததத
6.தததததததத ததத

த) தததததததத தததத

த) தததததத தததத

த) ததத ததததத தததத

7.ததததத தததததததததத ததததததத தததததததததத ததததததததத

த) ததததத

த) தததததத

த) தததததத தததததததததததததத தததத

8.தததததத தததததததத ததததததத தததததததததத தததததததததததத?

த) ததததததததத

த) ததததததத

த) தததததததத ததததத

த) தததததததததததத ததததததததததத

த) தததததத ((ததததததததததததத) __________

9.ததததததததததததத ததததத ததததததததத ததததத தததததததததததத

ததததததததத ததததததததததத?

த) தததத ததததததததததத
த) ததததததத ததததததததததத

த) ததததததததத ததததததததத

த) தததததத (ததததததததததததத) __________

10.தததததத தததததததததத தததததத தததத ததததத ததததததத

ததததததததத?

த) தததததததததததத / தததததத

த) ததததததததத தததததததத

த) தததததத / தததத ததததத

த) ததததததததத / ததததததத

த) தததததத (ததததததததததததத) __________

ககககக II

கககககககக ககககககககககக ககககக

1. தததததததததததததததத ததததததத தததத தததததததததத தததததததத

தததததததத ததததததத ததததததத ததததததததததததததத
தததததததததததத?
த) ததததததததத ததததததததததத ததததததத ததததததததத
தததததததததததத

த) ததததததத தததததததததததத ததததததததததத ததததததத ததததததத

த) ததததததத ததததத

2. தததததததத ததததததத ததததததத ததததததததத தததததததத

ததததததத ததததததததததததததத தததததததத?

த) ததததத தததததததததததத தததததததததத தததததததத ததததத

தததததததத

த) ததததததததத ததததததத ததததததததத ததததததத ததததததததததததத

த) ததததததததததத (ததததததததத) தததததததத

3. தததததததத தததததததததத தததததததத தததததத ததததததத

தததததததததததத?

த) ததததததததத, ததததததத தததததததததத ததததததததததத ததததததத

ததததததத

த) ததததததத ததததததததத தததததத தததததத தததததததததத

ததததததததத ததததததத ததததததததததததத தததததததத
தததததததததததத

த) ததததததத ததததத

4. தததததததத ததததத ததததததததததத தததததததத தததததததத

ததததததததத தததததத தததத?

த) ததததத ததததததததத ததததததததத ததததததத தததததததத

த) தததததததததத தததததததத / ததததததததததத தததததததததததத

ததததததததத

த) தததததததததத ததததததத ததததத

5. தததத தததததததததத தததததத தததததததத தததததத ததததததத
தததததததத?

த) தததத ததததததததத ததததததததத தததததத ததததத ததததததத

ததததததத தததததத

த) ததததததத தததததததத தததத தததத தததத ததததததததத

த) ததததததததத தததததத ததததததததததததத

6. தததத தததததததததததத ததததத தததததததததத ததததததத

தததததததத?

த) தததததததததததததத தததததத தததததததததததத ததததத தததததததத

த) தததத தததததததத, தததத தததததததத ததததத தததததத

ததததததததததததத தததததததததததததத ததததததததத

த) தததததததத

7. தததத தததததததததததததத தததத ததததததத ததததததததத தததததத

தததததததத?

த) ததததததததத தததததததத ததததததத ததததததததததததத

த) ததததததத ததததததத தததததததததத தததததததத தததத ததததததததத

தத ததததததததததததததததத

த) ததததததததததததத தததததததததத தததத ததததததததை ததததததத

ததததததத

8. தததததததததததத தததததததத ததததத தததததததத தததததததத

தததததததத தததத ததததததததததத?

த) ததததததத ததததத ததததததத ததததததத ததததததத

த) ததததததத ததததததததததததத ததததத ததததததததத ததததததத

ததததததத ததததததததத
த) தததததத, தததததத ததததத ததததத ததததததததத ததததததத
ததததததத ததததததத

9. தததததததத தததததததததத ததததததததத ததததததததத ததததததத

தததததததத?

த) தததத ததததததததத, தததததததத, ததததததததததததத ததததததததத

ததததததத ததததததத

த
)

த) தததததததததத ததததததத ததததத

த
10. தததததததத ததததததத ததததததத தததத தததததததததத
த
தததததததததததத?
த
ை
த) ததததததததத தததததததததததத ததததததததத தததததத ததத
தததததததத
த
த) ததததததததத ததததததததத தததததததததததத தததததத ததததததத
த
த தததததததத
த)
த
11. ததததததத தததததததததத தததததததத தததத ததததததததததத?
த
த
த) ததததததததத தததததத தததததததத தததததததத ததததததததத
த
த) ததததததத ததததததத ததததததததத தததததத தததததததத
ை
, ததததததததத தததததததத ததததததததததததத
த)

12. ததததததத ததததததததததத ததததததததததததததததத தததததததத

த
தததத ததததததததததத?
த
த
த) ததததததததத தததததத தததததததத ததததததததத
த
த) தததததத ததததததத தததததததத தததத ததததததத ததததததத
த
ததததததததததததததததத
த
த
த) தததததததத தததததததத தததத ததததததத
ை
,

ததததததத தததததத, ததததததத தததததததத தததததத தததததததததததத

த) தததததததத ததததததததத

13. ததததததத தததததததததததத தததததததததததததததததத தததத

ததததததததததத?

த) ததததததத ததததததததததததத தத தததததததததததததத

த) தததததததத தததததததத தததத ததததததத

த) தததததததததததததத ததததததத தததததததததததததத

த) தததததததத ததததததததத

14. ததததததததத ததததததததத ததததததததததத ததததததத

ததததததததததத?

த) ததததததததத

த) ததததததததத ததததத

த) ததத ததததத

15. ததததததத, ததததததததத ததததததததததத ததததததததத

ததததததததததத?

த) ததததததத ததததததததத ததததததததத

த) ததததததத ததததததததததத தததததததத ததததததததத

த) ததததததததத ததததததத, தததததததததததத ததததததத ததததததத

16. தததததத ததததததததத தததத ததததததததததத ததததததத ததததததத

ததததததததததததததத?

த) ததததததததத ததததததத ததததததத ததததததத

த) ததததததததத ததததததத ததததததத ததததததததததத

த) ததததததததத தததததததததத ததததததத ததததததத ததததததத

17. தததததததததத ததததத ததததததததததத?

த) தததததததததத

த) தததததததததத ததததததததததத தததததததத

த) ததததததத

18. தததததததததத ததததததததததததத (தததததததத) ததததததத

ததததததததததத?

த) தததததத ததததததத ததததததத

த) தததததததததததத ததததததத ததததததத

த) ததததததததத ததததததத ததததததததததத

19. தததததததததததததத ததத?

த) தததததததததத தததததத

த) தததததத

த) தததததததத

த) தததததததத ததததததததத

20. தததததததத தததததததததததததததததததத தததததததத ததததததத

ததததததததததத?

த) ததததததத தததததத

த) ததததததததத ததததததததததததத ததததத ததததததத

த) தததததத தததததததத

த) தததததததததத ததததததத

21. தததததததத ததததததத ததததததத தததததததததத தததததத தததத?

த) தததததத தததததததத
த) ததததததததததத

த) ததததததத தததத ததததததத

த) தததததததத ததததததததத

22. ததததததததததத ததததத ததததததததத தததததததத தததததத

ததததததததததத?

த) ததத

த) ததததத

23. ததததததத ததததததததத ததததததததததத தததததததததத

ததததததததத தததத?

த) தததததததததததத தததததத தததததத ததததததத

த) ததததததததததத தததததத

த) தததத ததததததத ததததத

24. ததததததததத தததததததததத ததததத தததததததத தததத?

த) ததததத ததததததததததததததத தததததத ததததததததத

த) தததததததத ததததததத

த) ததததததததததததததத தததததததததததத

25. ததததததததத தததததததத தததததததத தததததத ததததததததததத?

த) ததத தததததததததத

த) ததததததததத தததததத ததததத

ககககககக ககககககக
ததத ததததததத ததததததத த ததததத
தத
1 தததத ததததததததத ததததததததத ததததததததத
(தததததததத, ததததததததத) தததததததததததத
தததததததததத தததததத தததததததத.
2 தததத தததததததததத ததததததத
ததததததததததததததத ததததததததத தததததத
ததததததததததத தததததததத.
3 தததத ததததததததத ததததததததததத
ததததததததத ததததததததத ததத தததததததத.

4 தததத தததததத தததததத ததததததத தததததததத

ததததததததத தததததததததத ததததததத
ததததததததததததததததத.
5 தததத ததததத ததததததததத ததததததத
ததததததத தததததததத தததத தததததததததத
ததததததததததத
6 தததத தததத ததததததததததததத தததததததததத
தததததததததத தததததத தததததததததத.
7 தததத தததததத தததததததத தததத ததததததத
ததததததததததத ததததததத ததத தததததததத.
8 தததத ததததத ததததததததத (ததததததததத,
ததததததததததத) தததததததததததத தததததததததத
தததததத தததததததததத, தததததததததததததததத
தததததததத.

9 தததத ததததததததத ததததததததததத தததத

தததததத ததததததததததத ததததததததத
தததததததததத.
10 தததத ததததததத தததததததததத தததததத
ததததததததததததத ததததததததததததத தததததததத
தததத ததததததததததததத தததததத ததததத
தததததததததத.

11 தததத ததததத, ததததததத ததததததததத

தததததததததத தததததததததத, ததததததததததத
தததததததத. .

12 தததத தததததததத தததததததத தததததத

ததததததத ததததததத தததததததத தததததததததத
தததத ததததததததததததததத.
 13 தததத தததததததத, ததததததததததததத,
தததததததததததத தததததததததததததத
தததததததத ததததததததத தததததததத
ததததததத.
14 தததத ததததததத தததததததத தததததத
ததததததத தததததததததத தததத
ததததததததததததததத.
15 தததததததததத தததததததததத ததததததத ததததத
தததததததததத தததததததத ததததததததததத
தததததததத தததததததததத.

ககககக ககககககககக:

ததததததத ததத = 1 ததததததததத

ததததததத = 15

கககககககக:

0–5 = ததததததத ததததததத ததததத

6–10 = ததததததத ததததததத

11–15 = ததததததத ததததததத