Spikning av avhandling "Child Injuries at Home - Prevention, Precautions and Intervention with focus on scalds"

Spikning av Anna Carlssons avhandling "Child Injuries at Home - Prevention, Precautions and Intervention with focus on scalds"

 Abstract
The overarching aim of this PhD-thesis was to increase the knowledge about children’s (0-6 years old) exposure to accidents at home by describing parents self-reported precautions taken at home to decrease the risk of child injuries (Ι), the extent of burn and scalds (ΙΙ), the parents’ opinions about the course of events in child accidents (ΙΙΙ) and in an intervention study investigate the effect individual-based extended information has on mothers’ attitudes towards child injury and injury prevention (ΙV) and to taken precautions at home (V). The data collected in the five papers all came from a city in southern Sweden. The study (Ι) has a cross sectional survey design. Data in paper Ι were collected through parents to 10 month old children, answered a questionnaire. The questionnaire prompted responses related to parents’ background and socio-economic factors as well as questions about precautions they had taken to decrease hazards in their home. The questions focused on actions parents had taken upon receipt of preventive advice given to them during the eight-month Child Health Care-nurse assessment. Thirty-two percent of the parents complied with less than half of the suggested precautions.  Univariate odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to investigate the associations between compliance and parents’ different background/socio-economic characteristics. Multiple logistic regression analysis was performed in order to adjust the estimated odds ratios for the influence of potential confounders such as parents’ nationality, educational and occupational level, place of information and habitation. After the adjustment the variable nationality and educational level stayed significant. Data in paper ΙΙ was collected from medical records, in a retro perspective designed register study. Burn injured children (0-6 years old) consulting the University Hospital or the Health Care Centres (n=21), during year 1998 and year 2002, were included. Chi-squared test was used to analyse differences in nominal data and cross-tables was used to analyse the proportions between the characteristics of the injuries and sex, age and nationality. The burn injured children were 148 and 80% of those were scalds, caused by hot liquid (71%) or hot food (29%). The greatest number was boys between one and two years old. Children to foreign born parents were more frequently affected and the extension of injuries often larger. The data collection method, in paper ΙΙΙ, was tape-recorded interviews with a qualitative interview study design, analysed by content analysis, with parents to 20 children (0-6 years old) recently suffered from scalds. Parents told their perceptions about causes to the scalds. The analysis resulted in eight categories and two themes. One theme was ‘Deviation from the normal’ and could be when something unusual happened like a sudden visit by a friend or when a family member was tired, stressed or ill. It could also be when something was broken in the kitchen and routines were changed. ‘Misjudgement of the child’s capabilities’ was the other theme and it concerned the children’s preventive capacity, rapidity and reach. It was hard for the parents to keep up with the fast development in the young children (9 mounth-2 years). The parents expressed that they often didn’t realise the child’s capacities until the accident occurred. The intervention study with a comparison group has a quasi-experimental design (ΙV, V). Individual-based extended information, with empowerment as approach, was given to a group mothers at home-visits and workshops, living in two seperate areas of the city, with a low level of education. In total, 99 mothers of children under the age of seven months participated. The mothers were selected through the local Child Health Care authorities. Observations were made and bivariate analyses were established to see if the intervention had influence on the mothers’ attitudes towards child injuries and injury prevention at home (ΙV) and taken precautions against child accidents at home (V). Mothers who received the intervention significantly improved their attitudes to the first question about were child injuries happens also compared with the mothers in the comparison group (OR=2.3, CI=1.3-4.3). No significant improvement of attitudes to child injury prevention was seen,  neither in relation to the mothers’SOC-scores (ΙV). The results showed that the intervention had a significant impact on improving the precautions the participating mothers introduced to protect their children against burn and scald injuries in the home and further, in relation to a comparison group (V).

Disputationen äger rum fredag 19 mars, kl 10.00 i aulan, Hälsa och samhälle, ingång 49 på Skånes Universitetssjukhus.

Fakultetsopponent vid disputationen är professor emeritus Mahari Gebre-Medhin