Parents’ Attitudes and Adherence to Unintentional Injury Prevention Measures in Ankara, Turkey

Abstract

Background: Childhood unintentional injuries are perceived as a leading public health issue since they are one of the preventable causes of paediatric mortality and morbidity. Whether and how parental factors are related to childhood injury has been researched insufficiently. Aims: To investigate parents’ attitudes to preventive measures of unintentional childhood injury, and the parental adherence to these measures. Study Design: Cross-sectional, descriptive study. Methods: The data were collected from the parents of children younger than ten years of age admitted to university hospital outpatient clinics for any reason and who agreed to be involved in the study. The first part of the questionnaire included sociodemographic profiles of participating children. Serious injuries were considered to be any injury that requires hospital admission. The second part of the questionnaire was prepared to evaluate parents’ adherence to injury prevention rules. A total score calculation about the adherence of the parents to the injury prevention rules was worked out the addition of the scores of each answer given in each age group. Answers for each item given by the parents were scored as wrong (0), sometimes (1) or correct (2). The score for each item was added and the result normalized to 100 points. Only complete questionnaires were used for analysis. Results: A total of 1126 children and parent pairs agreed to participate in the survey. It was found that 13.8% of the participating children had experienced at least one serious injury. Although three-quarters of the parents had received information about injury prevention, the overall injury prevention scores were found to be low. As children’s age increased, the total injury prevention scores of parents decreased significantly. Injury prevention scores were shown to increase significantly with high education and maternal occupation. However, scores were shown to decrease significantly with increased child age and family size. Conclusion: Our study shows that parental adherence to the child safety measures aimed at decreasing the unintentional injury risk of children is not satisfactory in Turkey. In particular, parents of 5-9-year-old children, big families (more than five people), parents with less than 8 years of education and non-working mothers should be the main target groups for intervention strategies according to our study results.

Keywords

• Children, injury prevention, parents, unintentional injury

References

1. 1. National Center for Health Statistics (2010) National Health Interview Survey 2009 Data Release. Available at: http://www.cdc.gov/nchs/nhis/ nhis_2009_data_ release.htm (Accessed 20 December 2014)
2. 2. Vincenten JA, Sector MJ, Rogmans W, Bouter L. Parents' perceptions, attitudes and behaviours towards child safety: a study in 14 European countries. Int J Inj Contr Saf Promot 2005;12:183-9.
3. 3. World Health Organization (2014) The Bellagio Group on Child Survival. The Lancet series, Child survival. WHO press release, Geneva. Available at http://www.who.int/child-adolescent-health/NEWS/news_27.htm (Accessed 02 April 2015)
4. 4. Morrongiello BA, McArthur BA, Bell M. Managing children’s risk of injury in the home: Does parental teaching about home safety reduce young children’s hazard interactions? Accid Anal Prev 2014;71:194-200.
5. 5. Özcebe, H. Child health policies and status of child health in the world. In: Halk Sağlığı Temel Bilgiler. Hacettepe Üniversity Press, Ankara; 2006:418-52. (Turkish)
6. 6. Atak N, Karaoğlu L, Korkmaz Y, Usubütün S. A household survey: unintentional injury frequency and related factors among children under five years in Malatya. Turk J Pediatr 2010;52:285-93.
7. 7. İnce T, Yalçın S, Yurdakok K. The frequency of serious accidents in childhood and risk factors. Çocuk Sağlığı ve Hastalıkları Dergisi. 2014;57:173-82.
8. 8. Bass JL, Mehta KA. Developmentally oriented safety surveys: Reported parental and adolescent practices. Clin Pediatr (Phila) 1980;19:350-6.

9. 9. LeBlanc JC, Pless IB, King WJ, Bawden H, Bernard-Bonnin AC, Klassen T, et al. Home safety measures and the risk of unintentional injury among young children: a multicentre case-control study. CMAJ 2006;175:883-7.
10. 10. Mason M, Christoffel KK, Sinacore J. Reliability and validity of the injury prevention project home safety survey. Arch Pediatr Adolesc Med 2007;161:759-65.
11. 11. Tercero F, Anderson R, Pena R, Rocha J, Castro N. The epidemiology of moderate and severe injuries in a Nicaraguan community: a householdbased survey. Public Health 2006;120:106-14.
12. 12. Alptekin F, Uskun E, Kisioglu AN, Ozturk M. Unintentional non-fatal home related injuries in Central Anatolia, Turkey: frequencies, characteristics, and outcomes. Injury 2008;39:535-46.
13. 13. Hyder AA, Sugerman DE, Puvanachandra P, Razzak J, El-Sayed H, Isaza A, et al. Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study. Bull World Health Organ 2009;87:345-52.
14. 14. Mickalide A, Carr K. Safe Kids Worldwide: Preventing unintentional childhood injuries across the globe. Pediatr Clin North Am 2012;59:1367- 80.
15. 15. Li L, Scherpbier R, Wu J, Zhu X, Zhang W, Zhang L, et al. Legislation coverage for child injury prevention in China. Bull World Health Organ 2015;93:169-75.
16. 16. Vladutiu CJ, Nansel TR, Weaver NL, Jacobsen HA, Kreuter MW. Differential strength of association of child injury prevention attitudes and beliefs on practices: a case for audience segmentation. Inj Prev 2006;12:35- 40.
17. 17. Morrongiello BA, Walpole B, McArthur BA. Brief report: Young children's risk of unintentional injury: a comparison of mothers' and fathers' supervision beliefs and reported practices. J Pediatr Psychol 2009;34:1063- 8.
18. 18. Eichelberger MR, Gotschall CS, Feely HB, Harstad P, Bowman LM. Parental attitudes and knowledge of child safety. A national survey. Am J Dis Child 1990;144:714-20.
19. 19. Greaves P, Glik DC, Kronenfeld JJ, Jackson K. Determinants of controllable in-home child safety hazards. Health Educ Res 1994;9:307-15.
20. 20. Bourguet CC, McArtor RE. Unintentional injuries: risk factors in preschool children. Am J Dis Child 1989;143:556-9.
21. 21. Khanom A, Hill RA, Brophy S, Morgan K, Rapport F, Lyons R. Mothers' perspectives on the delivery of childhood injury messages: a qualitative study from the growing up in Wales, environments for healthy living study (EHL). BMC Public Health 2013;13:806.
22. 22. Laursen B, Nielsen JW. Influence of sociodemographic factors on the risk of unintentional childhood home injuries. Eur J Public Health 2008;18:366- 70.
23. 23. Bennet Murphy LM. Adolescent mothers’ beliefs about parenting and injury prevention: results of a focus group. J Pediatr Health Care 2001;15:194-9.
24. 24. Ablewhite J, Kendrick D, Watson M, Shaw I. The other side of the story - maternal perceptions of safety advice and information: a qualitative approach. Child Care Health Dev 2015;41:1106-13.
25. 25. Hooper R, Coggan CA, Adams B. Injury prevention attitudes and awareness in New Zealand. Inj Prev 2003;9:42-7.
26. 26. Moussa A, Hamid S, Elaheh A, Reza MM. Parent's and children's judgements about their outdoor environment in relation to children's injuries. J Pak Med Assoc 2013;63:1504-8.
27. 27. Chen X, Yang J, Peek-Asa C, Li L. Parents' experience with child safety restraint in China. BMC Public Health 2014;14:318.
28. 28. Chen X, Yang J, Peek-Asa C, McGehee DV, Li L. Parents’ knowledge, attitude, and use of child restraints, Shantou, China. Am J Prev Med 2014;46:85-8.
29. 29. Winston FK, Durbin DR, Kallan MJ, Moll EK. The danger of premature graduation to seat belts for younger children. Pediatrics 2000;105:1179-83.