Impact of Educational Program on the Management of Chronic Suppurative Otitis Media among Children

Hindawi Publishing Corporation International Journal of Otolaryngology Volume 2015, Article ID 624317, 8 pages http://dx.doi.org/10.1155/2015/624317 Research Article Impact of Educational Program on the Management of Chronic Suppurative Otitis Media among Children Yousseria Elsayed Yousef,1 Essam A. Abo El-Magd,2 Osama M. El-Asheer,3 and Safaa Kotb4 1 Department of Pediatric Nursing, Faculty of Nursing, Sohag University, Egypt ENT, Faculty of Medicine, Aswan University, Egypt 3 Pediatrics, Faculty of Medicine, Assiut University, Egypt 4 Public Health, Faculty of Nursing, Assiut University, Egypt 2 Correspondence should be addressed to Essam A. Abo el-magd; Received 14 June 2014; Revised 19 September 2014; Accepted 19 September 2014 Academic Editor: David W. Eisele Copyright © 2015 Yousseria Elsayed Yousef et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Chronic suppurative otitis media (CSOM) remains one of the most common childhood chronic infectious diseases worldwide, affecting diverse racial and cultural groups in both developing and industrialized countries. Aim of the Study. This study aimed to assess the impact of educational program on the management of children with CSOM. Subjects and Methods. An experimental study design was used. This study included 100 children of both sexes of 2 years and less of age with CSOM. Those children were divided into 3 groups: group I: it involved 50 children with CSOM (naive) who received the designed educational program; control group: it involved 50 children who were under the traditional treatment and failed to respond; group II: those children in the control group were given the educational program and followed up in the same way as group I and considered as group II. Tools of the Study. Tool I is a structured questionnaire interview sheet for mothers. It consists of four parts: (1) personal and sociodemographic characteristics of child and (2) data about risk factors of otitis media (3) assessment of maternal practice about care of children with suppurative otitis medi (4) diagnostic criteria for suppurative otitis media. Tool II is the educational program: an educational program was developed by the researchers based on the knowledge and practices needs. This study was carried out through a period of 9 months starting from September 2013 to May 2014. The educational program was implemented for mothers of children with CSOM in the form of 5 scheduled sessions at the time of diagnosis, after one week, 1, 3, and 6 months. Results. There were significant differences between children who received the educational program and control group regarding the response to treatment after one and 3 months. The percentages of complete cure increased progressively 32%, 60%, and 84% after 1, 3, and 6 months in group I while they were 24%, 44%, and 64% in group II, respectively. Cure (dry perforation) was 64%, 36%, and 12% among children of group I after 1, 3, and 6 months while it was 64%, 44%, and 24% in group II, respectively. The percentages of compliance to the educational program improved with time in both groups: 44%, 64%, and 80% in group I and 32%, 48%, and 56% in group II after 1, 3, and 6 months, respectively. The percentages of cure were statistically significantly higher among children with complete compliance with the educational program in both groups in comparison to those with incomplete compliance (P = 0.000 for both). Conclusions. From this study we can conclude that the majority of children with CSOM had one or more risk factors for occurrence of the disease; the educational program is effective for management of CSOM (whether cure or complete cure); the higher the compliance of mothers with the program the higher the response rate; regular followup and explanation of the importance of the program played an important role in the compliance with the program. 1. Introduction Chronic suppurative otitis media (CSOM) is defined as a chronic inflammation of the middle ear and mastoid cavity, which presents with recurrent ear discharges or otorrhoea through a tympanic perforation. The disease usually begins in childhood as a spontaneous tympanic perforation due to an acute infection of the middle ear, known as acute otitis media (AOM), or as a sequel of less severe forms of otitis media (e.g., secretory OM). The infection may occur during the first 6 years of a child’s life, with a peak around 2 years [1–3]. It is the commonest childhood infectious disease worldwide 2 International Journal of Otolaryngology [4, 5]. The multifactorial nature of otitis media must be stressed. Inadequate antibiotic treatment, frequent upper respiratory tract infections, nasal disease, multiple episodes of AOM, being a member of a large family, and poor living conditions with poor access to medical care are related to the development of CSOM. Poor housing, hygiene, and nutrition are associated with higher prevalence rates. Bottle-feeding, passive exposure to smoking, attendance in congested centers such as day-care facilities, and a family history of otitis media are some of the risk factors for otitis media (Kenna, 1994) [6–9]. The World Health Organization (WHO) global estimate for disabling hearing impairment (degree of severity more than 40 dB) has more than doubled from 120 million people in 1995 to 278 million in 2005. A total of 364 million people have mild hearing impairment, while 624 million are estimated to have some level of hearing impairment and 80% of these live in low- and middle-income countries [10, 11]. Worldwide, there are between 65 and 330 million people affected, of whom 60% receive significant hearing loss. This burden falls disproportionately on children in developing countries [12]. Patients with CSOM respond more frequently to topical therapy than to systemic therapy. Successful topical therapy consists of 3 important components: selection of an appropriate antibiotic drop, regular aggressive aural toilet, and control of granulation tissue. Aural toilet is a critical process in the treatment of CSOM. For the best results, aural toilet should be performed 2-3 times per day just before the administration of topical antimicrobial agents. Failures of topical antimicrobial therapy are almost always failures of delivery [13]. 2. Aim of the Study This study aimed to assess the impact of educational program on the management of children with chronic suppurative otitis media. 2.1. Research Questions (1) Is there an effect of the designed educational program on the cure of children with CSOM? (2) Is there a difference between the response of naı̈ve children with CSOM who received the program and those who received the program after failure of traditional treatment? 2.2. Significance. Worldwide, there are between 65 and 330 million people a (...truncated)