STRESS AMONG MOTHERS OF HOSPITALIZED CHILDREN:

A DESCRIPTIVE STUDY

GROUP 1

Ms. ANAGHA N

Ms. DEVIKA K V

Ms. ALEENA V R

Ms. HANNA SHARIN

Ms. EMILDA MARIYA

Ms. NIKHITHA THILAKAN

Ms. GAYATHRY VIJAYAKUMAR

Mr. MUHAMMED SAWAD THATTATTIL

VINAYAKA COLLEGE OF NURSING, SULTHAN BATHERY

RESEARCH PROJECT SUBMITTED TO KERALA UNIVERSITY OF

HEALTH AND SCIENCE IN PARTIAL FULFILMENT OF THE
REQUIREMENT FOR THE DEGREE OF BACHELOR OF SCIENCE IN
NURSING

2023

I
 STRESS AMONG MOTHERS OF HOSPITALIZED CHILDREN:

A DESCRIPTIVE STUDY

BY

Ms. ANAGHA N

Ms. DEVIKA K V

Ms. ALEENA V R

Ms. HANNA SHARIN

Ms. EMILDA MARIYA

Ms. NIKHITHA THILAKAN

Ms. GAYATHRY VIJAYAKUMAR

Mr. MUHAMMED SAWAD THATTATTIL

In partial fulfilment of the requirement of the degree of

Bachelor of science in nursing

under the guidance of

Mr.Tiju Thomas

Associate Professor

Department of community health nursing

Vinayaka College of Nursing,

Sulthan Bathery

Wayanad

2023

II
 DECLARATION BY THE CANDIDATES

We hereby declare that this dissertation/thesis entitled “stress among mothers of

hospitalized children; a descriptive study” is a bonafide genuine research work carried
out us under the guidance of Mr. Tiju Thomas, Associate Professor, HOD Community
Health Nursing Vinayaka college of nursing. This work is being submitted to the
Vinayaka College of Nursing Sulthan Bathery.

Ms. ANAGHA N

Ms. DEVIKA K V

Ms. ALEENA V R

Ms. HANNA SHARIN

Ms. EMILDA MARIYA

Ms. NIKHITHA THILAKAN

Ms. GAYATHRY VIJAYAKUMAR

Mr. MUHAMMED SAWAD THATTATTIL

Date:

Place: Sulthan Bathery

III
 CERTIFICATE BY THE GUIDE

This is to certify that the dissertation entitled “STRESS AMONG MOTHERS OF

HOSPITALIZED CHILDREN” is a bonafide research work done by Ms. Anagha N,
Ms. Devika KV, Ms. Aleena VR, Ms. Hanna Sharin, Ms.Emilda Mariya, Ms.Nikhitha
Thilakan, Ms. Gayathry Vijayakumar, Mr. Muhammed Sawad Thattattil in partial
fulfilment of the requirement for the degree of Bachelor of Science in Nursing.

Mr.Tiju Thomas

Associate Professor

HOD, Dept.Community Health Nursing

Vinayaka College of Nursing

Sulthan Bathery

Date:

Place: Sulthan Bathery

IV
 ENDORSEMENT BY HEAD OF THE INSTITUTION

This is to certify that the dissertation entitled “Stress among mothers of hospitalized
children: a descriptive study” is a bonafide research work done by Ms. Anagha N, Ms.
Devika KV, Ms. Aleena VR, Ms. Hanna Sharin, Ms. Emilda Mariya, Ms. Nikhitha
Thilakan, Ms. Gayathry Vijayakumar, Mr. Muhammed Sawad Thattattil in partial
fulfilment of the requirement for the degree of Bachelor of Science in Nursing

Prof.Sindhu.C V

Principal

Vinayaka College of Nursing

Sulthan Bathery

Date:

Place: Sulthan Bathery

V
 This study is dedicated to………..

GOD ALMIGHTY

AND OUR BELOVED

TEACHERS, PARENTS

AND DEAR FRIENDS

VI
 ACKNOWLEDGEMENT
“Gratitude makes sense of our past, brings peace for today, and creates a vision

for tomorrow”

Little drops of water make a mighty ocean. A thesis, however significant it is, cannot
be claimed to be the work of an individual alone. There were many persons who stood
by us in all our efforts to complete this endeavour successfully. The beautiful
fragrance that accompanied us throughout successful completion of a task would be
incomplete without an expression of appreciation to the people who made it possible.

Gratitude can never be truly expressed in words, but this is the only perception which
makes the words to flow from the depth of the heart.

VII
We praise and thank the Lord Almighty for his abundant grace, blessings and
unconditional love throughout our life.

We owe a deep sense of gratitude to all those who have contributed to the
successful completion of this dissertation.

Our thanks to Dr. Madhusudhanan, Managing Director Vinayaka Educational

and Charitable Trust for giving us an opportunity to study in this estimated
institution.

We express our thanks to Dr. Omana Madhusudhanan, Managing trustee,

Vinayaka Educational and Charitable Trust, who helped us in making this project
a great success.

Our bounden duty to express at the outset, heartiest gratitude to Professor Sindhu
CV, Principal Vinayaka College of Nursing, for her inspiring guidance, valuable
suggestions, timely support and constant encouragement which made the study a
fruitful and successful one

We are extremely grateful to Prof. Lathadevi, Administrator Vinayaka College of

Nursing. for providing all the facilities for the completion of this study.

We would like to express our gratitude to our Vice principal, Prof. Thushara
Thomas Vinayaka college of Nursing, for her guidance, constructive suggestions
and encouragement, which has made our study a successful one.

Our heart wells up with deep sense of gratitude to Mr.Tiju Thomas, our respected
guide and Head of Department of Community Health Nursing, Vinayaka College
Of Nursing. If not for him the study would have missed much of its present form and
substance. His keen support, exemplary guidance, incessant encouragement, sustained
patients, valuable suggestions and constrictive evaluation have enabled me to shape
up this research as a worthy contribution to the field. We are proud and pleased to
thank him for always being available and guiding us admits his busy work schedule,
when ever we need him the most.

VIII
Words are not sufficient to acknowledge Mrs Rinda K Y, Assistant Professor, our
co-guide, Vinayaka College of Nursing, for laying the foundation of scientific
research and rendering the needed corrections, suggestions and support throughout the
study.

We would also like to express our deep and sincere gratitude to our Experts who has
contributed their valuable time and suggestions in validating the research tool and
enlightening guidance.

Our special thanks to the all teaching faculty of our college for their support and
encouragement throughout the study.

Our thanks and appreciations also go to our Respondents who willingly helped with
their full cooperation which has made the research study achieve its smooth
completion.

We also like to express our gratitude to all Non-Teaching Staffs of our college for
their love, support and co-operation.

A special word of thanks and gratitude to all our Colleagues and Friends for their
constant support, concern and love which has made this study a good learning
experience and all well-wishers who contributed for the success of the study.

Though only certain names appear on this page of dissertation many people have put
their effort for the completion of this dissertation. Last but not the least, our sincere
gratitude to all those who supported me directly or indirectly in any aspect all
throughout the study.

With heartfelt and everlasting gratitude………

Ms. ANAGHA N

Ms. DEVIKA K V

IX
 Ms. ALEENA V R

Ms. HANNA SHARIN

Ms. EMILDA MARIYA

Ms. NIKHITHA THILAKAN

Ms. GAYATHRY VIJAYAKUMAR

Mr. MUHAMMED SAWAD THATTATTIL

Date:

Place: Sulthan Bathery

LIST OF ABBREVIATIONS

X
NICU : Neonatal Intensive Care Unit

Df : Degree of freedom

r : Reliability

WHO : World Health Organization

SD : Standard Deviation

ABSTRACT

XI
Hospitalization of child is often critical event and it cause stress for the family
members especially for the mothers. The hospitalization of ill child and all the
medical procedures that are associated with hospitalization are sources of stress for
the mother. The child’s hospitalization requires certain adaptation on the part of the
mothers and rearrangement of their everyday life activities. A growing child is always
a big concern for parents especially the mother. When a child is hospitalized, mothers
feel worry about their child’s course of illness and if there will be any long-lasting
consequences for health conditions. There may be uncertainty as to what caused
illness, shock about the gravity of the situation, or guilt feelings if hospitalization was
due to an accident or something perceived as have been under the mother’s control.
Usual routines are disrupted and they may feel isolated even if family members and
friends surround them. Having a hospitalized child causes disequilibrium with in the
family structures and function.

In this study, Descriptive non experimental design was used. The sample consists of
100 mother’s of hospitalized children. Sample were selected under non probability
convenient sampling technique. The study was conducted in mother’s of hospitalized
children in selected hospitals in Wayanad. The data was collected by the
administration of Modified perceived stress scale and the collected data was analysed
using inferential statistics.

The finding of the study shows that 8% of mothers had severe stress,64% of mothers
had moderate stress and 24% of mothers had mild stress.

Keywords

Stress, mothers of hospitalized children, demographic variable, modified stress scales

XII
 TABLE OF CONTENT

List of Tables

List of Figures

List of Appendices

Chapters Title Page number

1 INTRODUCTION 1

2 REVIEW OF
LITERATURE

3 METHODOLOGY

4 ANALYSIS AND
INTERPRETATION

5 RESULT

6 DISCUSSION,
SUMMARY AND
CONCLUSION

REFERENCES

APPENDICES

XIII
 LIST OF TABLES

SL.NO TITLE PAGE NO.

1. Distribution of subjects according to age 30

2. Distribution of subjects according to education 31

3. Distribution of subjects according to mother’s 32

occupation
4. Distribution of subjects according to marital 33

status
5. Distribution of subjects according to their 34

religion
6. Distribution of subjects according to husband’s 35

job
7. Distribution of subjects according to the 36

ownership of house
8. Distribution of subjects according to residence 37

9. Distribution of subjects according to distance 38

from hospital to residence

10. Distribution of subjects according to family type 39

11. Distribution of subjects according to income 40

12. Distribution of subjects according to number of 41

children
13. Distribution of subjects according to age of 42

hospitalized child
14. Distribution of subjects according to gender 43

15. Distribution of subjects according to order of 44

XIV
 child
16. Distribution of subjects according to disease 45

condition
17. Distribution of subjects according to previous 46

history of hospitalization
18. Distribution of subjects according to recurrent 47

hospitalization within 3 months

19. Distribution of subjects according to length of 48

hospital stay
20. Distribution of subjects according to insurance 49

21. Distribution of subjects according to dependant 50

member in family
22. Distribution of subjects according to membership 51

in any social group

24. Overall mean and standard deviation among 52

stress of mothers.
25. Frequency and percentage wise distribution of 52

level of stress among mothers of hospitalized

children in selected hospitals in Wayanad.
26. Association of level of stress with demographic 53

variables of mothers of hospitalized children.

XV
 LIST OF FIGURES

SL.NO TITLE PAGE NO.

1. Schematic representation of study. 25

2. Percentage of subjects according to age. 30

3. Percentage of subjects according to education. 31

4. Percentage of subjects according to mother’s 32

occupation.
5. Percentage of subjects according to marital 33

status.
6. Percentage of subjects according to their religion. 34

7. Percentage of subjects according to husband’s 35

job.
8. Percentage of subjects according to the 36

ownership of house.
9. Percentage of subjects according to residence. 37

10. Percentage of subjects according to distance from 38

hospital to residence.
11. Percentage of subjects according to family type. 39

12. Percentage of subjects according to income. 40

13. Percentage of subjects according to number of 41

children.
14. Percentage of subjects according to age of 42

hospitalized child.
15. Percentage of subjects according to gender. 43

16. Percentage of subjects according to order of 44

child.
17. Percentage of subjects according to disease 45

XVI
 condition.
18. Percentage of subjects according to previous 46

history of hospitalization.
19. Percentage of subjects according to recurrent 47

hospitalization within 3 months.

20. Percentage of subjects according to length of 48

hospital stay.
21. Percentage of subjects according to insurance. 49

22. Percentage of subjects according to dependant 50

member in family.
23. Percentage of subjects according to membership 51

in any social group.

XVII
 LIST OF APPENDICES

SL.NO TITLE PAGE.NO

1 LIST OF EXPERTS FOR CONTENT 74
VALIDATION
2 PERMISSION LETTER 77
3 ACCEPTANCE FORM 78
4 CONTENT VALIDATION CERTIFICATE 79
5 CRITERIA CHECKLIST FOR VALIDATION 80
6 DEMOGRAPHIC VARIABLES 82
7 MODIFIED STRESS SCALE 86
8 DEMOGRAPHIC VARIABLES 88
MALAYALAM
9 MODIFIED STRESS SCALE MALAYALAM 93
10 MASTER SHEET 96

XVIII
 CHAPTER 1
INTRODUCTION
“A mother’s love for her child is like nothing else in the world. It knows no law,

no pity; it dares all things and crushes down remorselessly all that stands in its

path.” -Agatha Christie

Stress has been defined as “psychological and physical strain or tension

generated by physical, emotional, social, economic, or occupational circumstances,
events, or experiences that are difficult to manage or endure”.The word “stress” is
derived from the Latin word “string” which means “to be drawn tight”. Stress literally
means “a condition of extreme, difficulty, pressure or strain.1

Illness and hospitalization are often critical events that a child is faced with
and the stress of it can affect all family members. Maternal stress and anxiety can also
affect the child in two ways, transferring stress to the child and interfering with the
mother’s ability of childcare. Currently, in many countries, given the importance of
family-centered care, the mother stays at the child’s bedside for the entire time of
hospitalization and participates in the process of taking care of the child.3

Stress is a body’s reaction to a change that requires a physical, mental or

emotional adjustment or response. Stress can be come from any situation and thought
that makes you feel frustrated, angry, nervous or anxious. Stress affects an individual
positively or negatively by way of an evolutionary concept named the fight or flight
response. One potentially stressful life event is the birth of a child. It is not surprising
then that the birth of a sick child, who is then cared for in a hospital, can be
particularly stressful for mother. In day-to-day life, all have stress especially women
have more and being a mother in routine life is a stressful one. When child is admitted
in hospital the effects of stress will be more. There are various stressors: firstly,
environmental stressor noise, pollution, traffic, and crowding, secondly physiological
stressor includes illness, injury, inadequate sleep and nutrition and social stressor
includes financial problems, work demands, social events and losing a loved one. On
the other hand, due to any ‘perceived losses’ or due to any illness. Lack of self -
concept due to not being able to work effectively that is called internal stressor.
Furthermore, any loss of job due to prolonged illness which is visible and affecting
the individual is a type of external stressor.2

Stress can be caused by events that are pleasing as well as events that creates
crisis in our lives. But stress is normal part of daily life and the effect of stress are not
always negative. In small quantities, stress is good; it can motivate us and help us to
became more productive, but too much stress or a strong response to stress can be
harmful. Stress can arise from many situations or thought that makes one feels
frustrated, angry, or anxious. Everyone sees situations differently and has different
coping skills, so, no two persons will respond exactly the same way to a particular
situation. Situations that are considered stress provoking are known as stressors.
Many professionals suggest that there is a difference between what we perceive as
positive stress, and distress as negative stress but we often term stress to describe
negative situations. This leads many people to believe that all the stress is bad for us,
but it is not true actually (Stress and stress management 2010). Stress is often coined
as medical term or a psychological phenomenon because of its possibilities in
deteriorating the health conditions of a person and the stimulus that trigger fight or
flight response respectively. Modern time is the age of anxiety and stressor which
itself will be affected by number of stressors as concluded by Coleman (1976).3

Having a child admitted to the hospital is a challenging life experience for

parents that can evoke a myriad of emotional responses marked by considerable stress
and feelings of uncertainty. Much of the research conducted on parents' experiences
of a child's admission to the hospital has focused on identifying potential causes of
stress. Common parental stressors identified include the hospital environment,
inconsistent communication, alterations in a child's appearance and parental role, and
uncertainty relating to a child's illness and future prognosis (Board and Ryan-Wenger,
2003, Colville et al., 2009, Jee et al., 2012).4

Several studies indicate parents of hospitalized children experience reduced

sleep duration, increased night-time awakening and difficulty falling asleep
(Matthews et al., 2014, McCann, 2008, McLoone et al., 2013).

In the general population, night-time sleep deprivation has been shown to

significantly impact cognitive and psychological function, with reports of an increase
in mood disorders such as anxiety and depression (Dinges et al., 1997, Nilsson et al.,
2005, Pilcher and Huffcutt, 1996). Even one night of sleep deprivation has been found
to compromise advanced cognitive thinking and decision-making ability (Harrison &
Horne, 1999). During their child's hospitalization, parents are required to understand
complex medical information and participate in decision-making. The consequences
of poor sleep quality on parents' psychological well-being and decision-making are
not well-understood. However, reports of poor sleep quality in hospital suggest that
parents may experience negative mood and difficulty in making decisions under such
circumstances.5

Hospitalization is always associated with tension, worry and pressure. The

process of hospitalization is a very traumatic experience whether it’s a male or a
female. The stress related to hospitalization may be diverse – due to poor resources
(financial or lack of caregivers to stay with the patient) or some variables related to
the ward environment. The strangeness of the hospital environment can act as a
potential source of stress. Sophisticated instruments with flashing lights can be
extremely anxiety provoking. Feelings of stress and anxiety are often associated with
the lack of information on diseases and medical procedures. The pain is caused by the
imposed treatments, unfamiliarity with the hospital environment also the major cause
of stress for the mothers. Parents have an important role in the promotion of their
children's health, being the primary agents involved in direct care, providing access to
health services and modelling attitudes and behaviours that influence children's well-
being. In most hospitals there are no action plans or training programs to reduce stress
for the parents and because of staff familiarity with the hospital environment; they do
not assume that the hospital environment and setting can be a stress causing factor for
the mothers of hospitalized children.6

The mothers may experience some physical, mental, behavioural and

emotional symptoms. Physical symptoms are fatigue, weakness, digestion changes,
dizziness, fainting, sweating, trembling, tingling hands and feet, headache,
breathlessness, pain, infection and hypotension. Mental symptoms including lack of
concentration, short term memory loss, difficulty in making decisions, confusion,
disorientation and panic attacks. Behavioural symptoms are appetite changes,
increased intake of alcohol and other drugs, increased smoking, restlessness, nail
biting and mood swings. Emotional symptoms are depression, impatience,
convulsions, tearfulness, disorientation of personal hygiene and appearance.6
 Mothers of hospitalized children have to face a lot of problems, both
physically and psychologically. Mothers have to cope up with these changes and
accept their new role in society and family. So, there is a need of promoting and
improving the coping strategies and to reduces the level of stress among mothers of
hospitalized children. In most hospitals there are no action plans or training programs
to reduce stress for the parents and because of staff familiarity with the hospital
environment, they do not assume that the hospital environment and setting can be a
stress causing factor for the mothers of hospitalized children 2

Need and significance of the problem

Stress in mother’s life firstly in the physical domain includes feeling worried
when see other sick children around, feeling lack of facilities for food and water in the
hospital, feeling difficulty in sleeping, secondly in the physiological domain includes
difficulty in breathing, feeling lack of appetite, feeling fatigue and restless, then in
emotional domain includes get irritated and aggressive easily, feeling lonely and
helpless, need of sympathy and affection then in cognitive domain includes feeling
doubtful about children illness, imagine that children’s condition worse, do not get
proper information about children condition than in socio economic domain includes
feeling separated from family due to children hospitalization, lack of social support
and treatment charges are not affordable.7

The percentage of children being hospitalized and their problems has

undergone considerable change in the last two decades. Many of these children are
sick newborns, injured children and children with current disabilities that have stayed
alive because of the development of technology and have at present become
incapacitated or have been suffering from a chronic illness and need long
hospitalization periods.8

In developing world, mean expected age of mothers who are suffering from
stress is18-23yrs. A Recent study showed that 57% mothers have mild stress and 78%
women are adopting strategies to overcome this problem. Association between the
psychological problems and coping strategies shows that there is a strong significant
association between the psychological problems and coping strategies. Score of both
psychological problems and coping strategies are observed to be lying between 21-
60.9
 In 2000, approximately 18% of the 36 million United States hospital
admissions were for paediatric patients between birth and 18 years of age. Preschool
age children accounted for approximately 3.6%of these paediatric hospitalizations.
The primary reasons for hospitalization of children include asthma, pneumonia, fluid
and electrolyte disorders, epilepsy and convulsions, infection, gastroenteritis,
chemotherapy and radiation therapy.10

In India, a study conducted in a paediatric ward of a tertiary care hospital

found that mothers of hospitalised children experienced high level of stress, anxiety
and depression which were associated with longer hospital stays and poorer health
outcome of the children (Singh et al, 2016). 11

A recent study was conducted to assess the level of stress among the 50
mothers of hospitalized children in India. Findings of the study showed that 54% (27)
of mothers of hospitalized children were having moderate stress, 36% (18) of them
were having mild stress and 10% (5) of them were having severe stress. The findings
of the study also showed that majority (72%) of mothers of hospitalized children
adopted partially adoptive coping strategies and the least (28%) of them adopted
adaptive coping strategies and none of them had maladaptive coping strategies.12

Another study conducted in India found that mothers of children with chronic
illness experienced high levels of stress compared to mothers of healthy children, and
that this stress was associated with poorer quality of life for both the mothers and
children (Gupta et al,2019).13

A study conducted in a tertiary care hospital in Kerala found that mothers of

hospitalized children experienced high level of stress, anxiety and depression which
were associated with longer hospital stays and poorer health outcomes for the children
(Sudhakar et al 2019).14

These highlights the significant impact that hospitalization of children can

have on the mental health and well-being of mother, both in Kerala, India and
worldwide. It is important for health care providers to recognize and address
emotional needs of mothers during this difficult time, in order to improve outcome for
both mothers and their child So the present study focused to assess the level of stress
among mothers of hospitalized children, therefore it helps the caregivers to plan
effectively and to provide quality nursing care for the betterment of child’s well-
being.14

Statement of the problem

A study to assess the level of stress among mothers of hospitalized children in

selected hospitals at Wayanad, Kerala.

Objectives of the study

 Assess the level of stress among mothers of hospitalized children.

 Determine the association between level of stress of mothers of hospitalized

children with selected demographic variables.

Assumptions

 Mothers of hospitalized children may experience stress.

 There may be significant association between level of stress among mothers of

hospitalized children with selected demographic variables.

Delimitation

 Study was limited to selected hospitals in wayand district.

 The study was conducted only among mothers of hospitalized children of age
group 0-12 years.

Operational definitions

Assess

In this study, assess refers to checking the level of stress among mothers of
hospitalized children.

Stress

In this study, stress refers to a state of worry or mental tension caused by a

hospitalization of the children.
Mothers

In this study, it refers to mothers who have children of age group of 0-12 years.

Hospitalized children

In this study, hospitalized children refers to the children who got admitted to hospital
from the age group of 0-12 years.

Hypothesis

H1: There is significant association between level of stress of mothers of hospitalized

children with selected demographic variable.

Selected variables

In this study selected variables include age of the mother, mother’s education,
mother’s job, marital status, religion, husband’s job, ownership of house, place of
residence, distance from hospital to residence, type of family, family income, age of
child, gender of child, no. of children, order of child, disease condition, previous
history of hospitalization, recurrent hospitalization within last three months, length of
stay in hospital, insurance, dependent member in the family and social group memb
 CHAPTER 2
REVIEW OF LITERATURE

Literature review is a process that involves findings, reading, understanding,

and forming conclusions about the published research and theory on a particular topic.
The investigator studied and review the related literature to broaden the understanding
and gain insight into the problem under study.15

Review of literature refers to an extensive, exhaustive and systematic

examination of publications relevant to the research topic. Before any research and be
started whether it is a single study or an extended project, literature review of
previous studies and experiences related to the proposed investigations should be
done. One of the most satisfying aspects of literature review is the contribution it
makes to the new knowledge insight and general scholarship of researches. The
review of literature of the present study has been taken from different sources like
textbooks, journals, articles published and unpublished research studies and electronic
media.16

REVIEW OF RELATED LITERATURE

A cross-sectional study was conducted from Aug 2018 to Sep 2018 in the
pediatric ward of Patan Hospital, Lalitpur, Nepal. Purposive sampling was done.
Sample size was calculated using Cochran’s formula on the prevalence of stress level
of 47.1%. After using correction formula, the final sample size was calculated to be
90. Mothers who were not willing to participate in the study, whose children were
admitted through Out Patient Department (OPD) or transferred from other wards, and
admitted for less than 24 hours or more than 3days were excluded from the study.
This exclusion was based on literature showing less than 24 hours or more than 3 days
in PICU, NICU or critical care already have high stress level. Ethical approval was
obtained from the Institutional Review Committee (IRC) of PAHS. 17

A cross-sectional study performed on mothers of 225 hospitalized children at

the pediatric ward in Besat hospital, Hamedan in 2008. The sample size was
determined considering a 95% confidence level and an 80% statistical power using
simple random sampling without replacement on a limited population. Most mothers
(48.4%) were between 25 and 35 years of age and the least (9.3%) were above 35
years of age (Table 1). The education level of 80 (35.6%) mothers were elementary,
59 (26.2%) guidance education, 45 (20%) high school level, 28 (12.4%) were illiterate
and 13 (5.8%) had university education. Two-hundred and twelve (94.2%) of the
mothers had a husband and 13 (5.8%) had no husband. Two-hundred eighteen
(96.9%) of the mothers were housewives and seven (3.1%) were employed.
Regarding the years of marriage, 89 (39.6%) of the mothers had 5 to 10 years of
marriage, 79 (35.1%) had less than 5 years and 57 (25.3%) had more than 10 years of
marriage. Residential location; 153 (68%) of the mothers were living in villages and
72 (32%) were living in cities. Regarding the number of children, 96 (42.7%) of the
mothers had only one child, 86 (38.2%) had two children and 43 (19.1%) had three or
more children.18

An Exploratory study was conducted by Amandeep Kaur, KanwaljithKaur

Gill to assess the level of stress and coping strategies among the parents of children
admitted in pediatric ward in the selected hospital Ludhiana Punjab. The study was
undertaken in one hospital of Ludhiana, Punjab. The study was non-experimental
(exploratory) in nature having 100 parents (either mother or father) of the children
who were admitted in the pediatric ward of the selected hospital. Parents were
selected by convenient sampling technique. Firstly, the level of stress was assessed by
using self-structured stress assessment scale and then the coping strategies of the
parents were assessed by using coping checklist. The study conclusion was drawn that
66% of parents had moderate level of stress and 32% had mild and 2% had severe
stress. 64% of the parents were using adaptive coping strategies whose children were
admitted in paediatric ward and 36% were using maladaptive coping strategies to deal
with the stress during the hospitalization of their child.19

A Descriptive correlational study was conducted by Hosnia Sayed Mohamed

& Eman AbdElaziz Mohamed on Stress Among Mothers of Hospitalized Children at
Qena Governorate. Self-Structured Questionnaire for Stress Assessment was used as
instrument for data collection in this study. The study was conducted among 213
mothers of 213 children who were available at inpatient paediatric wards of General
Hospital in Qena&Qena University Hospital. Based on the findings of this study
paediatric hospitalization was the most fearful and stressful situation faced the
mothers. 20

An exploratory study was conducted to assess the psychosocial functioning of

the mothers of infants admitted to a neonatal intensive care unit with the mothers of
infants born 18 at preterm. The study was done in Christ Church Women’s Hospital,
New Zealand. Among 100 samples were selected and the sampling was selected by
stratified random sampling technique. The data was collected by the interview
schedule method and adaptability scale. The study was conducted using a descriptive
and exploratory single group design. The result findings showed that 30% of mothers
of infants born with preterm had mild stress, 46% mothers had moderate stress and
24% mothers had severe stress. The study concluded that most of the mothers 46%
suffered from moderate stress due to his infants born at preterm stage.21

A Descriptive no experimental study was done by Dinsha P, Juliet V.

Augustine, Nasriya P.N., Bincy P The Level of Stress Among Mothers of Children
Under five Admitted in a Selected Hospital to determine the association of the level of
stress among mothers of children under five with selected demographic variables. The
study was conducted at ASTER MIMS hospital Calicut on conveniently selected 60
mothers using structured questionnaire. A descriptive non-experimental approach was
chosen for this study. Data were analysed using descriptive and inferential statistics.
The result of the study revealed that 21.67% mothers were having mild level of stress,
78.33% of having moderate level of stress and none of them having severe stress
related to hospitalization of under five children. Among them, 61.66% of the mothers
of children under five were between 0–2 years, 21.66% were between 2–3 years and
16.66% were between 3–5 years. Regarding to severity of child disease 35% was
having mild diseases, 45% were children have moderate diseases and 20% of children
have severe disease. With regards to occurrence of disease 28.33% have all the times,
58.33% of children were affected the disease hardly of times and 13.33% have
sometimes.22

A Descriptive-analytical research study conducted by Mimoza Canga1, Irene

Malagnino2, Giulia Malagnino2, Vito Antonio Malagnino for “Evaluating different
stressors among parents with hospitalized children”. This study was conducted from
January to July 2019, at the General Paediatrics Department in Fieri Regional
Hospital. The sample was composed of 200 parents, of which 86 (43.3%) were males
and 114 (56.7%) were females. The parents chosen as our sample had their children
hospitalized for at least 5 days. Even at their most stressful times, they were willing to
complete the questionnaire, which was accepted by both parents. The participants' age
range varied from 18 to 40+ years; they came from different areas and had different
education levels. The questionnaire included demographic data such as age,
employment, education, residence, and other stressors, such as child's dental visits,
waiting for diagnosis, and sleep bruxism. These factors cause stress to the parents of
hospitalized children. The questionnaire was designed based on the resolution of
Albanian National Committee no. 9, date 11.11.2011. The questionnaire's purpose
was to identify how stressed were the parents of the children depending on different
stressors. This 7-month study claims that stress varies on the level of education, age,
gender, etc. This questionnaire's compilation lasts about 20 min and is completely
anonymous.23

A descriptive study was conducted to assess the level of stress and coping
strategies among parents of neonates and to correlate stress and coping strategies
among parents of neonates. The descriptive survey method was used. Convenient
sampling technique was used 7 to collect data from the 40 mothers. Data was
analyzed using descriptive and inferential statistics. The findings showed that 28
(70%) of mothers had moderate stress, 12 (30%) had severe stress and none of them
had mild stress. The study also showed that 35 (87.50%) mothers used partially
adaptive coping strategies and 5 (12.5%) of the sample is used adaptive coping
strategies. The study concluded that mother always in stress because of babies’
admission in hospital. So any interventional programme on stress were helped the
mother to minimize the stress and she will develop certain coping strategies. Most of
mothers was satisfied with communication with staff to she must teach them stress
management technique.24

A descriptive study was conducted by Janula Raju, Chithra R. A, Suguna.M,

AmnaHussianMadani to “Assess the Level of Stress among Mothers of Hospitalized
Children: A Challenge for Quality Nursing Care” performed on mothers of 40
hospitalized children. The study was conducted at paediatric unit of selected hospitals.
Convenient sampling technique was used for collecting data. Data were collected
using a two-part questionnaire. The first part included the mother’s and the child’s
demographic data, the second part of the questions was asking about the stressors.
Most of the mothers (65%) were reported that the severity of illness and when the
child is not able to eat or drink are making them high level of stress. The findings
indicated that a significantly strong positive correlation was found to exist between
age of child and the level of stress (P=0.554). The results of this research indicated
that the mothers of hospitalized children were experiencing a variety of stressors. So,
health care professionals must plan interventions for mothers to cope with these
stressors while their child is hospitalized.25

A cross sectional analytical study was conducted in mothers of children

admitted in paediatric ward through emergency department of Patan Hospital, Patan
Academy of Health Sciences, Nepal, from April 2018to February 2019. Purposive
sampling was used to interview mothers using validated Nepali version Dass 21 to
find out the stress level and related factors (child, hospital environment, economic
burden and hospital staffs). The SPSS was used for data analysis. Among 90 mothers,
42 (46.7%) showed extremely severe stress and 19 (21.1%) in severe stress.
Uncertainty of future of child’s illness 72(80%), facilities of hygienic drinking water
66 (73.3%) in hospital, cost of treatment 47 (52.2%), and inadequate explanation by
nursing staffs about procedures 39 (40%) were related factors of stress.26

A cross sectional study was carried out on a sample of 120 parents of

hospitalized children in a selected hospital using purposive sampling technique. The
data were collected using self-report questionnaire –modified Psychological General
Well-being index- 22 items for measuring the psychological well-being level of the
parents. Ethical consideration was obtained from IEC, Regional College of Nursing
and informed consent was taken from the subjects. The study finding showed that
Majority of the subjects, i.e., 62.5% (75) have average psychological well-being
followed by 22.5% (27) having poor psychological well-being and 15.0% (18) have
good psychological well-being. The chi square test results reveal that psychological
well-being has a significant association the parent’s religion, family income,
occupation and duration of hospitalization of the child. Hence, parents psychosocial
functioning is important for children's physical and mental health outcomes.27
 A Non-experimental study was conducted to assess the stress level among
parents with child suffering from chronic disease conditions in selected hospitals of
Pune city, using as structured Questionnaire on parent’s stress level 150 parents were
chosen for the study through non-probability sampling technique. Validity was done.
The reliability was done for the tool and the score was 0.7. Which indicated that the
tool can be used to conduct study. Overall results showed that, 61.17% of parents are
under severe stress levels and 3.5% of parents had mild stress levels. 35.33% were
having moderate stress.28

A descriptive study was conducted among 130 parents with neonates admitted
to NICU of Manipal Teaching Hospital from July to September 2015. The sample was
collected by convenience sampling technique. Parental Stress Scale: Neonatal
Intensive Care Unit (PSS: NICU) used to measure parental stress. A parent and
neonate demographic sheet provided information for determining different stress
response. The data were analysed using descriptive and inferential statistical method.
The mean and standard deviation of total stress score was 3.51±0.74 and
3.58±0.70overall stress and stress occurrence score respectively. The highest stress
experienced by parents was relationship with baby and parental role (3.87 ±78)
followed by how the baby looked and behaved (3.78±77), sight and sounds of NICU
(2.88±1.18). Mothers were found more stressful in regarding their parental role than
fathers and economically inactive parents were more stressful in concerning their
parental role. The infant characteristics of gestational age resulted in significantly
different scores concerning the baby’s appearance and behaviour.29

A Quasi experimental study was conducted by Nadya Golfenshtien about

Interventions for Reducing Parenting Stress in Families with Paediatric Conditions:
An Integrative Review. Quality assessment was conducted by two doctorly prepared
nursing researchers using the Downs and Black’s checklist for randomized and non-
randomized studies of health care interventions. Interventions were categorized as
follows: interventions with supporting and cognitive components (n = 3),
interventions with empowerment and skill development components (n = 18),
interventions targeted to children’s condition (n = 9), and interventions focusing on
the parent–child relationship (n = 5). Most interventions reduced immediate parenting
stress levels (n = 23), but failed to demonstrate long-term gains.30
 An exploratory study was conducted to assess the level of stress among
mothers of hospitalized new borns with hypothermia. The study was conducted in
Govt. hospital in Maharashtra. 80 samples were taken in the study and purposive
random sampling technique was used. The data was collected by observation and
interview method and also used attachment and sense of competence scale. The
descriptive and exploratory single group design was used in the study. The stress of
the mothers was predicted by the mother’s estimation of their infant’s worst pain and
dissatisfaction with pain information received. The result findings showed that 58% of
the mothers are suffering from moderate stress, 18% of them are suffering from mild
stress and 24% of them are suffering from severe stress. The result concluded that
most of the mothers are having moderate stress.31

A descriptive study was conducted on the rate of stress in mothers of

hospitalized infants and to determine the primary factors in order to reduce their
tension. In this descriptive cross-sectional study, a total of 80 mothers were selected
by convenient sampling technique. The questionnaire was designed based on
researcher’s investigation and the NICU pattern containing 8 demographic questions
and 43 tension factor questions. The SPSS statistical software and descriptive and
analytical statistical methods of T-test, ANOVA, and Pearson correlation were used
for data analysis. The result revealed that 43% mothers suffered from stress. The
highest tension score was related to the care methods with 33%, and the 10% lowest
score was related to the staff behaviour with mothers. The study was concluded that
the majority of mothers face stress regardless of their demographic differences and
that the highest stress factor was related to the care methods and the lowest was
related to staff behaviour. Therefore, the nursing staff must be aware of the factors
causing stress so that they can apply appropriate practices to decrease the
complications.32

An exploratory study was conducted to assess maternal stress, perceptions of

their infant, and alterations in mood among the mothers of hospitalized critically ill
newborn. The study was conducted in the Special Care Nursery (SCN) at Christiana
Care Health Services among 60 samples and the sampling was selected by purposive
random sampling technique. The interview schedule method was used to collect data.
Data were primarily evaluated by using analysis of variance (ANOVA)/multivariate
analysis of variance (MANOVA). The result findings showed that majority 69% of
mothers were having severe stress, 19% of them were having mild stress and 12% of
them were having moderate stress. Mothers with high stress scores on the maternal
Stressor Scale had different coping strategies than those with less stress scores. The
study concluded that most of the mothers were having severe stress. A high level of
maternal depressive symptomatology was associated with altered methods of coping,
general stress, and perception of infant health.33

A descriptive correlational study was conducted on optimism, anxiety and

coping in parents of children hospitalized for spinal surgery. The study was conducted
in Vanderbilt university school of nursing, Nashville, USA. They have selected 60
parents by purposive random sampling technique and administered the life orientation
test to assess optimism and the ways of coping questionnaire. The findings of study
revealed that among 68% of parent’s positive reappraisal was most often used
emotion focused coping strategy and 32% of parents seeking social support were the
most often used problem focused coping strategies.34
 CHAPTER 3
METHODOLOGY

Research methodology is a systematic, theoretical analysis of the methods

applied to a field of study. Research methodology maybe understood as a science of
studying how research is done scientifically. It comprises the theoretical analysis of
the body of methods and principles associated with a branch of knowledge. It is a way
to systematically solve the research problem. The methodology is the general research
strategy that outline the way in which a research project is to be undertaken and
among other things, identifies the methods to be used in it. These methods describe in
the methodology define the modes of data collection or sometimes how a specific
result is to be calculated.

The methodology consists of research approach, research design, variables,

setting of the study population, sample size, sampling technique, sampling criteria,
development and description of the tool, content validity of the tool, and reliability of
the tool, pilot study, data collection process and plan for the data analysis. Designing
research involves development of plan or strategy that will guide the collection and
analysis of data. The study was designed to assess “The level of stress among the
mothers of hospitalized children in selected hospitals”

Research approach

A research approach guides the researches what to research. When and how to
collect data, the method of information, how to analyze and interpret the result.

The research approach, used for the study was non- experimental approach. It
is concerned with describing the characteristics of a particular individual or of a group
whereas determine the frequency with which something occurs or its association with
something else.

Research design

Research design is the conceptual structure within which research is

conducted. It constitutes the blue print for collection, measurement and analysis of
data. The purpose of a design is to achieve a greater control and thus improve validity
of study in examining the research problem. The research design selected for the
study was descriptive research design.

Research variables

Variables are attributes, characteristics of elements that can have more than
one value. Variables are the qualities, quantities, properties of characteristics of
people, things or situations that may change or vary, but they are also measurable. In
this study research variable is level of stress among the mothers of hospitalized
children.

Demographic Variables

Demographic variables are characteristics or attributes of subjects that are

collected to describe the sample. They are also called sample characteristics.
The demographic variables that are used in the study are age of the mother,
mother’s education, mother’s job, marital status, religion, husband’s job, ownership of
house, place of residence, distance from hospital to residence, type of family, family
income, age of child, gender of child, no. of children, order of child, disease
condition, previous history of hospitalization, recurrent hospitalization within last
three months, length of stay in hospital, insurance, dependent member in the family
and social group membership

Setting of the study

The setting of the study is when the population or the of it that is being studied
to located and where the study is carried is out.

The study was conducted at Vinayaka hospital and Assumption hospital

Sulthan bathery, Kerala.

Population

Population is a group whose member’s possess specific attributes that research

is interested in studying

In this study the population consist of mothers of hospitalized children.

Sample
 The sample is a subset of a population selected to participate in research study.
Sample for the study consist of 100 mothers of hospitalized children in selected
hospital based on inclusion and exclusion criteria.

Sample Size

In this study sample size was 100

Sampling technique

Sampling technique refers to the procedure the researcher would adopt in

selecting the samples. It is a definite plan for obtaining a sample from a given
population. The sampling technique adopted in the present study was convenient
sampling technique.

Inclusion criteria

Refers to the specific trait of the study subjects which population should
possess. the study included samples with the following traits.

 Mothers who were willing to participate

 Mothers who can understand Malayalam.

Exclusion criteria

Refers to criteria that specify characteristics that a population does not have.
The study excluded the samples with the following characteristics.

 Mothers who were physically and mentally unstable

 Mothers of critically ill children.
 Mothers who have differently abled children.

Data collection tool

Data collection tools are the procedure or instruments used by the researcher to
measure the key variables in the research problem.

The following tools was used in the collection of data;

Section A: Demographic variables

Section B: Modified stress scale

Development of the tool

Tool development is a complex and time-consuming process. It consists of

defining the construct to be measured, formulating the assumption for the content
validity, estimating the reliability and conducting study.

The following methods were used for the development of tool:

 Review of relevant literature

 Review of related tools developed by others
 Discussion with experts
 Personal experience
 Development for the blueprint
 Construction of demographic performa and stress rating scale
 Content validity
 Testing of tool
 Reliability

Description of the tool

Tool consists of two sections:

Section A

Demographic data including age of the mother, mother’s education, mother’s job,
marital status, religion, husband’s job, ownership of house, place of residence,
distance from hospital to residence, type of family, family income, age of child,
gender of child, no. of children, order of child, disease condition, previous history of
hospitalization, recurrent hospitalization within last three months, length of stay in
hospital, insurance, dependent member in the family and social group membership

Section B

It consists of modified perceived stress scale

Scoring

The scoring pattern attributed to the 24 items to measure the stress among mothers of
hospitalized children is as follows. Each items have 3 answers as always, sometimes,
never and the score ranges from 0-2. The positive response to each item is given the
score 2 and for the negative response 0, in reverse scoring positive response 0 and for
the negative response 2. Then the scores of the 24 items are added up and this gives
the total score of stress among mothers. So, the total score is 48.

Table 1

Score Percentage Interpretation

0-16 0-33 Mild stress
17-32 35-67 Moderate stress
33-48 69-100 Severe stress

Content validity of the tool

The content validity of the tool was ensured by seeking help from experts. It is the
degree to which an instrument measures what it is intended to measure. The tool was
submitted to 12 experts from various departments of nursing education. Modifications
given by the experts were incorporated.

Reliability of the tool

The reliability refers to the degree of consistency with which the attributes or
variables are measured by an instrument. There are several ways to measure the
reliability for the research tools, which depends on several factors, such as the nature
of instrument as well as aspects of reliability the researcher wants to measure the
purpose of the reliability of the tool was to find the accuracy of the measuring
instruments.

The rating scale was used to test the reliability of tool. The reliability was
established by using inter-rater reliability. The reliability obtained was (r =0.8), which
indicate that the tool was reliable.

Pilot study
 A pilot study is referred to a small-scale preliminary try out of the method to be
used in actually large study, which acquaints the research with problems that can be
corrected in proportion for the large research study or is done to provide the
researcher with an opportunity to try out the procedure, methods, and tools of data
collection. The pilot study conducted at MES Hospital Sulthan bathery from 22/07/23
to 23/07/23 to assess the feasibility of the study. A written permission was obtained
from concerned authority prior to the study. Twenty mothers of hospitalized children
were selected by convenient sampling technique. The purpose of the study was
explained to each subject and obtained their consent from them. The collected data
was analyzed using inter-rater reliability method. The reliability after the pilot study is
0.8 and the pilot study revealed that the study is feasible, practical and acceptable.
The findings of the pilot study was used for calculating the sample size for main
study.
Research approach Non experimental approach

Target population Mothers of hospitalized children in

selected hospitals at Wayanad

Setting of study Vinayaka hospital & Assumption

hospital

Sample size 100

Sampling technique Convenient sampling technique

 Demographic variables
Instruments  Modified perceived stress
scale

Data collection by administration of

rating scale

 Analysis of data by descriptive and

inferential statistics.
 Frequency, percentage, mean, median,
standard deviation of stress score.
 Chi-square values between stress
 Analysis

Figure 1. Schematic representation of study

Data collection procedure

To conduct the research study in the selected setting, formal written permission
was obtained from the college Principal before the data collection. The purpose of the
study was explained to them, confidentiality was assured and written consent was
obtained from them.

The data collection for the main study was done from Vinayaka college
Sulthan bathery and Assumption hospital, Sulthan bathery on 17/08/23 to 19/08/23.
The sample size that we used for the study was 100 mothers of hospitalized children.
The sampling technique that mainly used for the study was convenient sampling
technique. On the first day 40 samples were collected from Assumption Hospital and
the remaining samples were collected from Vinayaka hospital.

Ethical consideration

The research problem and objectives were approved by the research

committee and head of the institutes. Explanation regarding the purpose of study was
given to mothers of hospitalized children. Confidentiality of the data was ensured.
Consent from each sample is also taken.

Plan for data analysis

Data analysis is the process of organizing and synthesizing the data and testing
of the research assumption using the data.

The data obtained was analyzed using descriptive and inferential statistic on the
basis of objectives and assumptions of the study.
  Demographic proforma was analyzed in terms of frequency and percentage
 The stress of mothers was analyzed by using frequency, percentage, mean,
mean percentage and standard deviation.
 Association between stress of mothers with selected demographic variables
was calculated by using chi-square test.

Summary

The chapter explained the methodology for the study, it includes research
approach, research design, research variables, setting of research, population, sample,
sampling technique, sampling criteria, tool used in the study, selection and
development of tool, content validity, pilot study, reliability of tool, data collection
process, data anal
 CHAPTER 4

ANALYSIS AND INTERPRETATION

Analysis of data can be referred as the systematic organization and synthesis

of research data and the testing of research hypothesis using the data. Analysis is
described as categorization, organization, manipulation and summarizing the data to
obtain the answer to research question.

The purpose of the analysis is to reduce the data to an intelligible and

interpretable from so that the relation of the research problem can be studied.

This chapter deals with the analysis and interpretation of data gathered from
100 mothers of hospitalized children to assess the level of stress during their child’s
hospitalization using modified stress scale. The data has been analysed and interpreted
in the light of objectives and hypothesis of the study.

Organization of findings

SECTION I

Frequency and the percentage distribution of mothers of hospitalized children based

on the demographic variables.

SECTION II

Distribution of samples based on the level of stress among mothers of hospitalized

children in each dimension.
SECTION III

Association of level of stress with the demographic variables of mothers of

hospitalized children

SECTION I

Table 2

Distribution of subjects according to age of mothers in years

N= 100

Age in years Frequency Percentage

18-26 29 29%
27-35 51 51%
36-44 16 16%
Above 44 4 4%
Figure 2

Percentage distribution according to age

 60%
AGE
51%
50%

40%

30% 29%

20%
16%

10%
4%

0%

The data from table 2 and figure 2 reveals that there were 51(51%) from age group
27-35 years, 29(29%) of mothers of age between 18-26 years,16(16%) from age
group of 36-44 years and 4(4%) from above 44 years.

Table 3

Distribution of subject according to mothers’ education

N= 100

Education Frequency Percentage

Uneducated 2 2%

Primary education 2 2%

High school 6 6%

Higher secondary 31 31%

Graduate 59 59%
 Figure 3

Percentage distribution of subject according to mothers’ education

EDUCATION
2% 2%
6%

31%

59%

The data from table 3 and figure 3 reveals that there were 59(59%) of the mothers are
graduate,31(31%) of them studied up to higher secondary,6(6%) of them studied up to
high school, 2(2%) of them have only primary education and 2(2%) are illiterate.

Table 4

Distribution of subject according to mother’s occupation

N= 100

Occupation Frequency Percentage

House wife 52 52%

Government job 7 7%

Private job 35 35%

Self employed 3 3%
 Daily wages(coolley) 3 3%

Figure 4

Percentage distribution according to mother’s occupation

MOTHER'S OCCUPATION
60% 52%
50%
35%
40%
30%
MOTHER'S OCCUPATION
20%
7%
10% 3% 3%

0%
E
IFE

ES
ED
B

AT
JO

AG
OY
EW

IV
T

W
PR

PL
EN
US

EM

ILY
M
HO

RN

DA
LF
VE

SE
GO

The data from table 4 and figure 4 reveals that there were52(52%) as house
wife,35(35%) have private job, 7(7%) have government job, 3(3%) are self-employed
and 3(3%) are daily wages.

Table 5

Distribution of subjects according to marital status

N= 100

Marital status Frequency Percentage

Married 98 98%

Separated 2 2%

Figure 5
 Percentage of subjects according to marital status

MARITAL STATUS

2%

MARRIED

SEPARATED

98%

The data from table 5 and figure 5 reveals that 98(98%) of the mothers are
married and 2(2%) of mothers are separated.

Table 6

Distribution of subjects according to their religion

N= 100

Religion Frequency Percentage

Hindu 38 38%

Muslim 29 29%
 Christian 33 33%

Figure 6

Percentage distribution according to religion

RELIGION
38%

40% 33%
29%
35%

30%

25%

20%

15%

10%

5%

0%
HINDU CHRISTIAN MUSLIM

RELIGION

The data from table 6 and figure 6 reveals that data shows that were 38(38%) of
Hindus,33(33%) of Christians and 33(33%) of Muslims.

Table 7

Distribution of subjects according to husbands’ job

N= 100

Occupation Frequency Percentage

Government 6 6%
Private 53 53%

Daily wages 22 22%

 Self employed 18 18%
Unemployed 1 1%

Figure 7

Percentage distribution of subject according to husband’s occupation

HUSBANDS JOB
60%

50%

40%

30%
53%
20%

10%
6% 22%
0% 18%
GOVERNMENT
PRIVATE 1%
DAILY WAGES
SELF EMPLOYED
UNEMPLOYED

GOVERNMENT PRIVATE DAILY WAGES SELF EMLOYED UNEMPLOYED

The data from table 7 and figure 7 reveals that 53(53%) are private employees,22(22
%) of daily wages, 18(18%) are self-employed, 6(6%) are government employees,
and1(1%) is unemployed.

Table 8

Distribution of subjects according to the ownership of house

N= 100

Ownership of house Frequency Percentage

Own 94 94%
 Rent 6 6%

Figure 8

Percentage distribution of subjects according to ownership of house

OWNERSHIP OF HOUSE
94%
100%
90%
80%
70%
60%
50%
40%
30%
20% 6%
10%
0%
OWN HOUSE RENTED HOUSE

OWN HOUSE RENTED HOUSE

The data from table 8 and figure 8 reveals that 94(94%) have own house and 6(6%)

lives in rented house.

Table 9

Distribution of subjects according to residence

N= 100

Place of residence Frequency Percentage

Village 57 57%
 Urban 30 30%

Semi urban 13 13%

Figure 9

Percentage distribution of subject according to their place of residence

RESIDENCE

13%

30% 57%

VILLAGE URBAN SEMIURBAN

The data from table 9 and figure 9 reveals that there were 57(57%) people resides in
village, 30(30%) of them resides in urban area and 13(13%) resides in semi urban
area.

Table 10

Distribution of subjects according to distance from hospital to residence

N= 100

Distance from hospital to Frequency Percentage

residence
 Below 5 km 17 17%

5-10 km 34 34%

Above10 km 49 49%

Figure 10

Percentage distribution of subject according to distance from the hospital to

house

DISTANCE FROM HOSPITAL TO HOUSE

DISTANCE FROM HOSPITAL TO HOUSE

ABOVE10 KM

5-10 KM

BELOW 5 KM

0% 10% 20% 30% 40% 50% 60%

The data from table 10 and figure 10 reveals that 49(49%) are from above 10 km,

34(34%) of are from 5-10km, and 17(17%) of people are from below 5 km.

Table 11

Distribution of subjects according to family type

N= 100
 Type of family Frequency Percentage

Nuclear family 70 70%

Joint family 30 30%

Figure 11

Percentage distribution of subjects according to family type

TYPE OF FAMILY
70%

70%

60%

50%

40% 30%

30%

20%

10%

0%
NUCLEAR FAMILY JOINT FAMILY

TYPE OF FAMILY

The data from table 11 and figure 11 reveals that 70(70%) of family are nuclear
family and 30(30%) of family are joint family.

Table 12

Distribution of subjects according to income

N= 100
 Income Frequency Percentage

Below 15000 21 21%

15001-25000 30 30%

25001-35000 23 23%

35001-45000 16 16%

Above 45000 10 10%

Figure 12

Percentage distribution of subject according to income

INCOME
INCOME

0.3
30%

25%
0.21 0.23
20%

15% 0.16

10%
0.1
5%

0%
B ELOW 15000
15001-25000
25001-35000
35001-45000
AB OVE 45000

The data from table 12 and figure 12 reveals that 30(30%) of them have between
15001 to 25000, 23(23%) have between 25001 to 35000, 21(21%) of them have
below 15000, 16(16%) of them have 35001 to 45000 and 10(10%) of them have
above 45000.

Table 13

Distribution of subjects according to number of children

N= 100
 No.of children Frequency Percentage

1 40 40%

2 48 48%

3 12 12%

Figure 13

Percentage distribution of subjects according to number of children

NUMBER OF CHILDREN

0.12
3

0.48
2

0.4
1

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

NUMBER OF CHILDREN

The data from table13 and figure 13 reveals that 48(48%) of them have 2 children,

40(40%) of them have 1 child and 12(12%) of them have 3 children.

Table 14

Distribution of subjects according to age of hospitalized child

 N= 100

Age of hospitalized child Frequency Percentage

0-1 years 17 17%

1-3 years 31 31%

3-5 years 32 32%

Above 5 years 20 20%

Figure 14

Percentage distribution of subjects according to age of hospitalized child

AGE OF HOSPITALIZED CHILD

17%
20%

31%
32%

0-1 years 1-3 years 3-5 years above 5

The data from table 14 and figure 14 reveals that 32(32%) of them have child between
3-5 years,31(31%) of them have child between 1-3 years, 20(20%) of them have child
above 5 years and 17(17%) of them have child between 0-1 years.

Table 15

Distribution of subjects according to gender

 N= 100

Gender Frequency Percentage

Male 52 52%

Female 48 48%

Figure 15

Percentage of distribution of subject according to gender

GENDER
GENDER
53%

52% 52%

51%

50%

49%

48% 48%

47%

46%

45%
MALE F EMALE

The data from table 15 and figure 15 reveals that 52(52%) of hospitalized children are
male and 48(48%) of them are female children.

Table 16
 Distribution of subjects according to order of child

N= 100

Order of child Frequency Percentage

1 51 51%

2 42 42%

3 7 7%

Figure 16

Percentage distribution of subjects according to order of child

The data from table 16 and figure 16 reveals that 51(51%) of hospitalized children are
1st child, 42(42%) of children are 2nd child and 7(7%) of hospitalized children are 3rd
child of their parents.
 Table 17

Distribution of subjects according to disease condition

N= 100

Disease conditon Frequency Percentage

Congenital 3 3%

Medical 97 97%

Figure 17

Percentage distribution of subjects according to disease condition

DISEASE CONDITION
97%
100%
90%
80%
70%
60%
50% DISEASE CONDITION
40%
30% 3%
20%
10%
0%
CONGENITAL
MEDICAL

The data from table 17 and figure 17 reveals that 97(97%) are medical condition
3(3%) are congenital disease.
 Table 18

Distribution of subjects according to previous history of hospitalization

N= 100

History of hospitalization Frequency Percentage

Yes 61 61%

No 39 39%

Figure 18

Percentage distribution of subject according to their previous history of

hospitalization

HISTORY OF HOSPITALIZATION

0.39
NO

HISTORY OF HOSPITALIZATION

0.61
YES

0% 10% 20% 30% 40% 50% 60% 70%

The data from table 18 and figure 18 reveals that 61(61%) of the children have
previous history of hospitalization and 39(39%) doesn’t have previous history of
hospitalization.
 Table 19

Distribution of subject according to recurrent hospitalization within three

months

N= 100

Recurrent hospitalization Frequency Percentage

Within 3 months

Yes 21 21%

No 79 79%

Figure 19

Percentage distribution of subjects according to recurrent hospitalization within

3 months

RECURRENT HOSPITALIZATION

21%

YES
NO

79%

The data from table 19 and figure 19 reveals that 79(79%) doesn’t have recurrent
hospitalization and 21(21%) have recurrent hospitalization.
 Table 20

Distribution of subjects according to length of hospital stay

N= 100

Length of hospital stay Frequency Percentage

Less than 2 days 22 22%

2-4 days 58 58%

5-7 days 20 20%

Figure 20

Percentage distribution of subject according to length of hospital stay

LENGTH OF HOSPITAL STAYS

20% 22%

LESS THAN 2 DAYS

2-4 DAYS
5-7 DAYS

58%

The data from table 20 and figure 20 reveals that 58(58%) have 2-4 days of hospital
stay, 22(22%) of them have less than 2 days of hospital stay and 20(20%) have 5-7
days of hospital stay.
 Table 21

Distribution of subjects according to insurance

N= 100

Insurance Frequency Percentage

No 81 81%

Yes 19 19%

Figure 21

Percentage distribution of subjects according to insurance

INSURANCE
19%

81%

YES NO

The data from table 21 and figure 21 reveals that 81(81%) does not have insurance
and 19(19%) have insurance.
 Table 22

Distribution of subject according to dependent member in family

N= 100

Dependent member Frequency Percentage

Yes 38 38%

No 62 62%

Figure 22

Percentage distribution according to dependent member in the family

70 DEPENDENT MEMBERS
62%
60

50
38%
40

30 DEPENDENT MEMBERS

20

10

0
YES
NO

The data from table 22 and figure 22 shows that 62(62%) does not have dependent
members and 38(38%) of family have dependent members.
 Table 23

Distribution of subjects according to membership in any social groups

N= 100

Member of social group Frequency Percentage

Yes 11 11%

No 89 89%

Figure 23

Percentage distribution of subject according to membership in any social group

MEMBERSHIP IN SOCIAL GROUP

11%

YES
NO

89%

The data from table 23 and figure 23 reveals that 89(89%) are not in any social group
and 11(11%) are members of social group such as kudumbasree.
SECTION II

Table 24

Distribution of samples based on the level of stress among mothers of hospitalized

children in each dimension.

MEAN STANDARD DEVIATION (SD)

23 8.44

Table 25

Frequency and percentage wise distribution of level of stress among mothers of

hospitalized children in selected hospitals at Wayanad.

Level of stress Frequency Percentage

Mild 28 28%

Moderate 64 64%

Severe 8 8%
From table (25) it can be inferred that 28% of mothers had mild level of stress due to
their child’s hospitalization, 64% of mothers had moderate level of stress and 7 % of
mother’s had severe level of stress.

SECTION III

Table 26

Association of level of stress with demographic variables of mothers of hospitalized

children.

Level of significance =0.05

Demographic Chi-square Table value DF Inference

variable value

Age of mother 10.77 7.82 3 Significant

Education 6.34 9.49 4 Not significant

Mother’s occupation 0.195 9.49 4 Not significant

Marital status of 1.239 7.82 3 Not significant

mother

Religion 1.669 7.82 3 Not significant

Husbands' occupation 4.237 9.49 4 Not significant

Ownership of house 0.195 5.99 2 Not significant

Place of residence 0.826 5.99 2 Not significant

Distance from hospital
to residence
3.344 5.99 2 Not significant

Type of family 3.72 5.99 2 Not significant

Family income per 4.294 9.49 4 Not significant

month

Age of child 5.62 7.82 3 Not significant

Gender of child 10.217 5.99 2 Significant

No. Of children 1.838 7.82 3 Not significant

3
Order of child 0.586 7.82 Not significant

Disease condition of 1.149 7.82 3 Not significant

child

Previous history of 0.408 3.84 1 Not significant

 hospitalization

Recurrent 2.549 7.82 3 Not significant

hospitalization within
last three months

Length of stay in 2.816 7.82 3 Not significant

hospital

Insurance 0.066 5.99 2 Not significant

Any dependent 7.145 3.84 1 Significant

member in family

Member of any social 1.563 3.84 1 Not significant

groups

Table values: χ2(3) = 7.82, χ2 (2) = 5.99, χ2 (1) = 3.84

The data shows that the association between demographic variables and stress
among mothers of hospitalized children. The computed chi-square value has
association with the demographic variables with age of mother (χ2 = 10.77), gender of
the child (χ2 = 10.21) and dependent member in the family (χ2 = 7.14) and there is no
association between demographic variables such as education of the mother
(χ2=6.34), mothers occupation (χ2=0.19) marital status of mother (χ2= 1.23) religion
(χ2= 1.66) husbands occupation (χ2=4.23) ownership of the house (χ2=0.19) place of
residence (χ2=0.82) distance from hospital to residence (χ2=3.34) type of family (χ2=
3.72) family income per month (χ2=4.29) age of child (χ2=5.62) number of children
(χ2= 1.838) order of child (χ2 = 0.58) disease condition of child (χ2 =1.14) previous
history of hospitalization (χ2= 0.40) recurrent hospitalization within last three months
(χ2 = 2.54) length of stay in hospital (χ2= 2.81) insurance (χ2=0.06) and member of
any social group (χ2 = 1.56).
 CHAPTER 5
RESULT

The chapter deals with the analysis and interpretation of the data collected to
analyse the stress among the mothers of hospitalized children in selected hospitals at
Wayanad. The data collected was tabulated and analysed using descriptive and
inferential statistics to meet the objectives of the study and to test the hypothesis.

Objectives of the study

 Assess the level of stress among mothers of hospitalized children.

 Determine the association between level of stress of mothers of hospitalized

children with selected demographic variables.

Hypothesis

H1: There is significant association between level of stress of mothers of hospitalized

children with selected demographic variable.

The study result was presented in following sections

Section I:

Frequency and percentage distribution of mothers of hospitalized children based on

the demographic variables.

Section II:

Distribution of samples based on the level of stress among mothers of hospitalized

children in each dimension.

Section III:

Association of level of stress with demographic variables of mothers of hospitalized

children.
Section I. Frequency and percentage distribution of mothers of hospitalized
children based on demographic variables.

 Highest percentage (51%) of the mothers of hospitalized children were in the

age group 27-35 and least percentage of them were in the age group of > 44
years.
 More than half of the subjects (59%) of the mother’s hospitalized children are
graduates, and least of them were illiterate (2%) and had primary education
(2%).
 Most (52%) of mothers of hospitalized children were housewives and the least
(3%) of them were on daily wages and self-employed.
 Majority (98%) of mothers of hospitalized children were married and (2%) are
separated.
 Majority (38%) of mothers of hospitalized children were belonged to Hindu
religion whereas the least (29%) of them were Muslim.
 Majority (53%) of fathers of hospitalized children were working in private
sector, and least (1%) are unemployed.
 Most (94%) of them lives in their own house and (6%) of them lives in rented
home.
 Majority (57%) of them were live in rural area and least (13%) lives in semi
urban.
 Nearly half of the subject (49%) of them have more than 10 km from hospital
to residence and least (17%) less than 5km.
 Highest percentage (70%) of mothers of hospitalized children belongs to
nuclear family whereas the least (13%) belongs to joint family
 Highest percentage (30%) of mothers of hospitalized children had monthly
income between 15001-25000 and the least (10%) of them had income above
45000.
 Majority (32%) of the hospitalized children were in the age group of 3-5 year
and least percentage (17%) were in the age group of 0-1 year.
 More than half of the subjects (52%) of the hospitalized children are male and
least (48%) were females.
  Nearly half (48%) of mothers of hospitalized children have 2 children and
least (12%) of them have 3 children.
 Most (51%) of the hospitalized children are first child and least (7%) were
third child.
 Most of the children (97%) were admitted due to medical condition and least
(3%) were admitted due to congenital problem.
 Majority (61%) of the children have previous history of hospitalization.
 Majority (79%) of children doesn’t have recurrent hospitalization and (39%)
of children doesn’t have any previous history of hospitalization within last 3
months and 21% of children have recurrent hospitalization within last three
months.
 More than half of the subjects (58%) of children stayed in hospital for 2-4
days and least (20%) were stayed in hospital for 5-7 days.
 Majority (81%) of hospitalized children doesn’t have insurance and least
(19%) have health insurance.
 Majority (62%) of the family of hospitalized children doesn’t have dependent
members and others (38%) have dependent member in family
 Majority (89%) of mothers of hospitalized children are not members of any
social group and others (11%) are members of social groups.

Section II: Distribution of sample based on the level of stress among mothers of
hospitalized children.

The data revealed that majority of the mothers 64% of had moderate level of stress,
whereas 28% of mothers had mild level of stress and only 8% of mothers had severe
level of stress.

Section III: Association of level of stress with demographic variables of mothers

the data shows that the association between demographic variables and stress
among mothers of hospitalized children.

The computed chi-square value has association with the demographic variables with
age of mother(χ2 = 10.77), gender of the child (χ2 = 10.21) and dependent member in
the family (χ2 = 7.14) and there is no association between demographic variables such
as education of the mother(χ2=6.34), mothers occupation (χ2=0.19) marital status of
mother (χ2= 1.23) religion (χ2= 1.66) husbands occupation (χ2=4.23) ownership of
the house(χ2=0.19) place of residence (χ2=0.82) distance from hospital to
residence(χ2=3.34) type of family (χ2= 3.72) family income per month(χ2=4.29) age
of child (χ2=5.62) number of children (χ2= 1.838) order of child (χ2 = 0.58) disease
condition of child (χ2 =1.14) previous history of hospitalized children of
hospitalization (χ2= 0.40) recurrent hospitalization within last three months (χ2 =
2.54) length of stay in hospital (χ2= 2.81) insurance(χ2=0.06) and member of any
social group (χ2 = 1.56).

Table values: χ2(3) = 7.82, χ2 (2) = 5.99, χ2 (1) = 3.84

Level of significance at 0.05

The data reveals that there is association between demographic variables such as age
of mother, gender of the child and dependent member in the family and stress among
mothers of hospitalized children.
 CHAPTER 6
DISCUSSION

SUMMARY AND CONCLUSION

This chapter deals with the discussion of the study finding in light of available
literature, summary of the study and conclusion.

Statement of the problem

“A study to assess the level of stress among mothers of hospitalized children in

selected hospitals at Wayanad”.

Objectives

 Assess the level of stress among mothers of hospitalized children.

 Determine the association between level of stress of mothers of hospitalized

children with selected demographic variables.

Hypothesis

H1: There is significant association between level of stress of mothers of hospitalized

children with selected demographic variable.

Methodology

The researcher uses a non-experimental research approach with a descriptive

survey design. The research variable in the study was level of stress among mothers
of hospitalized children. The study was conducted in Vinayaka hospital Sulthan
bathery and Assumption hospital Sulthan bathery. In the present study the target
population consist of mothers of hospitalized children in selected hospitals in
Wayanad. In this study convenient sampling technique was used. The SD and Mean
was 8.44 and 23. the sample size of the study was 100. the inclusion criteria include
Mothers who were willing to participate, Mothers who can understand Malayalam.,
Mothers of children with long period of hospital and the exclusion criteria includes
Mothers who were physically and mentally unstable, Mothers of critically ill patients,
Mothers who had physically or mentally challenged children. The tool used in the
study was modified stress scale. The pilot study was conducted at MES Hospital
Sulthan bathery on 22/07/2023 among 20 subjects. The data collected was tabulated
and analyzed using descriptive and inferential statistics to meet the objectives of the
study and to test the hypothesis.

Major findings of the study

 Highest percentage (51%) of the mothers of hospitalized children were in the

age group 27-35 and least percentage of them were in the age group of > 44
years.
 More than half of the subjects (59%) of the mother’s hospitalized children are
graduates, and least of them were illiterate (2%) and had primary education
(2%).
 Most (52%) of mothers of hospitalized children were housewives and the least
(3%) of them were on daily wages and self-employed.
 Majority (98%) of mothers of hospitalized children were married and (2%) are
separated.
 Majority (38%) of mothers of hospitalized children were belonged to hindu
religion wereas the least (29%) of them were muslim.
 Majority (53%) of fathers of hospitalized children were working in private
sector, and least (1%) are unemployed.
 Most (94%) of them lives in their own house and (6%) of them lives in rented
home.
 Majority (57%) of them were live in rural area and least (13%) lives in semi
urban.
 Nearly half of the subject (49%) of them have more than 10 km from hospital
to residence and least (17%) less than 5km.
 Highest percentage (70%) of mothers of hospitalized children belongs to
nuclear family whereas the least (13%) belongs to joint family
 Highest percentage (30%) of mothers of hospitalized children had monthly
income between 15001-25000 and the least (10%) of them had income above
45000.
 Majority (32%) of the hospitalized children were in the age group of 3-5 year
and least percentage (17%) were in the age group of 0-1 year.
  More than half of the subjects (52%) of the hospitalized children are male and
least (48%) were females.
 Nearly half (48%) of mothers of hospitalized children have 2 children and
least (12%) of them have 3 children.
 Most (51%) of the hospitalized children are first child and least (7%) were
third child.
 Most of the children (97%) were admitted due to medical condition and least
(3%) were admitted due to congenital problem.
 Majority (61%) of the children have previous history of hospitalization and
(39%) of children doesn’t have any previous history of hospitalization.
 Majority (79%) of children doesn’t have recurrent hospitalization within last 3
months and 21% of children have recurrent hospitalization within last three
months.
 More than half of the subjects (58%) of children stayed in hospital for 2-4
days and least (20%) were stayed in hospital for 5-7 days.
 Majority (81%) of hospitalized children doesn’t have insurance and least
(19%) have health insurance.
 Majority (62%) of the family of hospitalized children doesn’t have dependent
members and others (38%) have dependent member in family
 Majority (89%) of mothers of hospitalized children are not members of any
social group and others (11%) are members of social groups.

Conclusion

The main aim of the study was to assess the stress among the mothers of hospitalized
child. The study concluded that there is a stress among mothers of hospitalized child
out of the selected 100 samples majority 64% of mothers having moderate stress, 28%
of mothers having mild stress and 8% of mothers having severe stress. Our study
result revealed that majority of mothers have only moderate stress. increasing the
number of samples can vary the result.
Nursing Implications

The study result shows that there is significant association between stress among
mothers of hospitalized children with the age of mother, gender of the child and
dependent member in the family. The finding of the present study has implication in
the field of nursing practice, nursing education, nursing administration and nursing
research.

Nursing Practice

 The nurses play a significant role in reducing the stress through advice and
motivation.

 Health personnel can serve us the foundation for understanding the relation
between stress and its coping strategies.

 Nurses use psychological support to help to establish therapeutic relationship.

These relationships are built through psychological, social, and spiritual care.

 The nurses should be knowledgeable and should maintain good inter personnel
relationship and include family members in all health education programmes.

 As a nurse we see the patient and their family throughout their stress and are
in a unique position to monitor patient’s stress.

Nursing Education

 Nurses as an educator needs to understand the level of stress among the

mothers of hospitalized child.

 Nursing personnel should be equipped with adequate knowledge and skill to

educate the mothers of hospitalized child related to stress and its management.

 As a nurse educator we need to contribute to the existing body of nursing

knowledge about the needs of psychological and emotional supports to
mothers of hospitalized child.
  Concepts such as comprehensive nursing and mother participation should be
taught and more emphasis should be given on the hospital environment and
routines.

Nursing Research

The ultimate goal of the research is to develop, refine and expand the body of
knowledge.

 Research can help the nurse to develop confidence as well as faith in mothers
of hospitalized child.

 Nursing research can be done in the area to identify the stress among mothers
of hospitalized child.

 The mothers of hospitalized children have stress full and inability to coping
with family system.

 The nursing research can be utilized for the family health nursing
interventional strategies.

Nursing Administration

Nursing administration plays a pivotal role in the supervision and management of

nursing professionals.

Plan and policy making for the nursing staff to effectively involve them in health
education programmes.

To utilize various teaching programs on stress and its management to enhance the
knowledge of nursing students

Nurse administrator can educate nurses for various workshops and health awareness
programme in community as well as in hospital setup. To organize in-service
education programmes for nurses to make them aware about stress and its related
health problems.
Limitations

The limitation of the present study were

 As the study was conducted only in a selected hospitals in Wayanad, it

imposes limits in the generalization of findings.
 The study was conducted using convenient sampling technique which restrict
the generalization that could be made.
 As the study was restricted to 100 samples so generalization cannot be done.
 We have only identified the level of stress, not the causation of the stress or
its management.

Recommendations for further research

Based on the study findings the following recommendations are stated:

 A similar study could be conducted with a large sample size to confirm the
result of study.
 A comparative study regarding the stress of mothers and its management can
be done.
 Organization of stress management programme for mothers of hospitalized
child.
 A similar study can be conducted using structured interview method for which
the reliability of data can be assured.

Summary

This study has brought out various implications of this study and has also provided
suggestions for future study. The constant encouragement and guidance of supervisors
and cooperation of the subjects to participate in the study has contributed to the
successful completion of the study.
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 APPENDIX A

List of Experts Validated the Tool

1. Prof. Sindhu C.V

Prinicipal

Vinayaka College of Nursing, Wayanad

2. Prof. Thushara Thomas

Vice prinicipal

HOD Mental Health Nursing

Vinayaka College of Nursing, Wayanad

3. Prof. Neethu Francis

HOD Medical Surgical Nursing

Vinayaka College of Nursing, Wayanad

4. Mr.Tiju Thomas

Associate professor

HOD Community Health Nursing

Vinayaka College of Nursing, Wayanad

5. Mrs.Rinda K Y

Assistant professor

Vinayaka College of Nursing Wayanad

6. Mr.Proshob Mathew Mathai

Assistant professor

Vinayaka College of Nursing Wayanad

74
7. Mrs.Sabitha A.B

Assistant professor

Vinayaka College of Nursing, Wayanad

8. Mrs.NithyaMol C.J

Lecturer

Vinayaka College of Nursing, Wayanad

9. Mr.ShijuVargheese

Lecturer

Vinayaka College of Nursing, Wayanad

10. Mrs.Shabna

Lecturer

Vinayaka College of Nursing, Wayanad

11. Mrs.Neethu George

Lecturer

Vinayaka College of Nursing, Wayanad

12. Mrs.Anila Jose

Lecturer

Vinayaka College of Nursing, Wayanad

75
 APPENDIX-B
PERMISSION LETTER
From,
Third year Bsc. Nursing
Vinayaka College of Nursing
To,
The Principal
Vinayaka College of Nursing
Sulthan Bathery
Subject: Request for seeking permission to conduct the research study.
Respected madam,
As a part of our academic requirement, we are conducting a research study
“A STUDY TO ASSESS THE LEVEL OF STRESS AMONG MOTHERS OF
HOSPITALIZED CHILDREN IN SELECTED HOSPITALS AT WAYANAD.”

We here by assure you that the data collected will not be misused for any other
purposes and will maintain the professional discipline. We are humbly requesting you
to grand us the permission to conduct the study.

Kindly permit and do the needful.

Sulthan bathery

Thanking you,

Your’s faithfully

Ms.Anagha N

Ms.Aleena VR

Ms.Devika KV

Ms.HannaSharin

Ms.EmildaMariya

Ms.NikhithaThilakan

76
 Ms.GayathryVijayakumar

Mr.MuhammedSawadThattattil

APPENDIX-C

LETTER SEEKING EXPERT FOR CONTENT VALIDITY OF

TOOL
From,

Third year Bsc. Nursing

Vinayaka College of Nursing

To,

……………………..
Subject: Request for consenting to validity of tool
Respected madam/sir,

As a part of our BSc Nursing programme, we have research study in third

academic year. Our research topic is “A STUDY TO ASSESS THE LEVEL OF
STRESS AMONG MOTHERS OF HOSPITALIZED CHILDREN IN SELECTED
HOSPITALS AT WAYANAD.”We therefore submit our tool for your expert
validation and guidance. We humbly request you to through the tool to provide us
with your suggestions.

Guided by,

Mr. TIJU THOMAS

Associate professor
Vinayaka College Of Nursing
Your's faithfully

Ms.Anagha N
Ms.Aleena VR

Ms.Devika KV

Ms.HannaSharin

Ms.EmildaMariya

77
 Ms.NikhithaThilakan

Ms.GayathryVijayakumar

Mr.MuhammedSawadThattattil

APPENDIX-D

ACCEPTANCE FORM FOR TOOL VALIDATION

Name:………

Designation:…………

Name of the institution:………

Statement of acceptance/non-acceptance to validate the tool

Topic:“A STUDY TO ASSESS THE LEVEL OF STRESS AMONG MOTHERS OF

HOSPITALIZED CHILDREN IN SELECTED HOSPITALS AT WAYANAD.”

Signature:

Place:

Date:

78
 APPENDIX-E

CONTENT VALIDATION CERTIFICATE

I hereby certify that I have validated the tool of I group, III year BSc Nursing students
of Vinayaka college of nursing who is undertaking the following study

Topic: “A STUDY TO ASSESS THE LEVEL OF STRESS AMONG MOTHERS

OF HOSPITALIZED CHILDREN IN SELECTED HOSPITALS AT
WAYANAD.”

Signature of the expert:

Designation and Address:

Place:

Date:

79
 APPENDIX-F

CRITERIA CHECKLIST FOR VALIDATION

Instruction: Please review the items in the tool and give your valuable suggestions
regarding accuracy, relevance and appropriateness of the content. Kindly place a tick

( )mark on appropriate column.

SECTION 1: DEMOGRAPHIC VARIABLES

QUESTION AGREE DISAGREE REMARKS

NUMBER

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16

80
 17
18
19
20
21
22
CRITERIA CHECKLIST FOR VALIDATION
Instruction: Please review the items in the tool and give your valuable suggestions
regarding accuracy, relevance and appropriateness of the content. Kindly place a tick
( )mark on appropriate column.

SECTION 2: RATING SCALE TO ASSESS THE LEVEL OF STRESS

QUESTION AGREE DISAGREE REMARKS

NUMBER
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19

81
 20
21
22
23
24

DEMOGRAPHIC VARIABLES
Instructions: kindly read the following items and carefully mark on appropriate
column

1. Age of mother
a) 18-26 years ( )
b) 27-35 years ( )
c) 36-44 years ( )
d) above 44 years ( )
2. Mother’s education
a) illiterate ( )
b) primary ( )
c) high school ( )
d) higher secondary ( )
e) graduate & above ( )
3. Mother’s job
a) home maker ( )
b) government ( )
c) private ( )
( )
d) daily wage
( )
e) self employment
4. Marital status of mother
a) married ( )
b) seperated ( )

82
 c) divorced ( )
d) widowed ( )
5. Religion
a) hindu ( )
b) christian ( )
c) muslim ( )
d) others ( )
6. Husband’s job / occupation
a) government ( )
b) private ( )
c) dailywages ( )
d) self employed ( )
e) unemployed ( )
7. Ownership of house
a) own ( )
b) rent ( )
c) quarters ( )
8. Place of residence
a) rural ( )
b) urban ( )
c) semi urban ( )
9. Distance from hospital to residence
a) less than 5 km ( )
b) 5-10 km ( )
c) 10 km and above ( )
10. Type of family
a) nuclear family ( )
b) joint family ( )
c) blended family

83
11. Family income per month
a) less than 15000 ( )
b) 15000-25000 ( )
c) 25001-35000 ( )
d) 35001-45000 ( )
e) above 45000 ( )
12. Age of child
a) 0-1 years ( )
b) 1-3 years ( )
c) 3-5 years ( )
d) 5-12 years ( )
13. Gender of child
a) male ( )
b) female ( )
c) others ( )
14. No.of children
a) 1 ( )
b) 2 ( )
c) 3 ( )
d) more than 3 ( )
15. Order of child
a) first ( )
b) second ( )
c) third ( )
d) fourth & above ( )
16. Disease condition of child
a) congenital ( )
b) medical ( )

84
 c) surgical ( )
d) undiagnosed ( )
17. Pevious history of hospitalization
a) yes ( )
b) no ( )
18. Recurrent hospitalization within the last three months
a) no ( )
b) yes ( )
i. More than 6 times ( )
ii. 4 to 5 times ( )
iii. 3 times and less ( )
19. Length of stay in hospital
a) <2 days ( )
b) 2-4 days ( )
c) 5-7 days ( )
d) >7 days ( )
20. Insurance
a) no ( )
b) yes ( )
i. Government ( )
ii. Private ( )
21. Dependent member in the family
a) yes ( )
b) no ( )
22. Are you member of any social group
a) no ( )
b) yes: if yes please specify---------------------------- ( )

85
 MODIFIED STRESS SCALE
Instruction: Kindly read the following items and carefully put tick mark on
appropriate column

Sl.n Statements/Events Always Sometimes Never

o
(2) (1) (0)

1 I feel worried when I see other sick

children around

2 I am unable to do any work

3 I feel lack of facilities for food and

water in the hospital

4 I feel difficulty in sleeping

5 I feel annoyed in the hospital due to

noisy environment

6 I feel difficulty in breathing

7 I feel lack of appetite

8 I feel frequency of micturition and

diarrhea

9 I feel fatigue and restless

10 I feel disturbed sleep and headache

11 I get irritated and aggressive easily

12 I feel lonely and helpless

86
13 I feel constantly fear of my child
recovery

14 I need sympathy and affection

15 I feel mentally exhausted and

frustrated

16 I am unable to take initiativeness in

any activity

17 I am doubtful about my child’s illness

18 I imagine that child’s condition is

worse

19 I feel uneasy when the doctors and

nurses are unapproachable

20 I don’t get proper information about

child’s Condition.

21 I feel that I am separated from my

family because of child’s
hospitalization

22. I am having lack of social support

23. I feel socially isolated

24. Treatment charges are not affordable

Interpretation of the score

Score Percentage Interpretation

0-16 0-33 Mild stress

17-32 35-67 Moderate stress

33-48 69-100 Severe stress

87
 APPENDIX-G
Demographic variables
1.അമ്മയുടെവയസ്സ്

a) 18 – 26
b) 27 – 35
c) 36 – 44
d) 44 ന്മുകളിൽ

2. അമ്മയുടെവിദ്യാഭ്യാസയോഗ്യത

a) വിദ്യാഭ്യാസരഹിത

b) പ്രാഥമികവിദ്യാഭ്യാസം

c)ഹൈസ്കൂൾ

d) ഹയർസെക്കന്ററി

e) ബിരുദതാരി

3. അമ്മയുടെജോലി

a) വീട്ടമ്മ

b) സർക്കാർജോലി

c) സ്വകാര്യജോലി

d) ദിവസകൂലി

e) സ്വയംതൊഴിൽ

4. അമ്മയുടെവൈവാഹികനില

a) വിവാഹിതയാണ്

b) വിയർപിരിഞ്ഞു (നിയമപരമല്ലാതെ )

c) വിവാഹമോചിത

88
 d) വിധവ

e) അവിവാഹിത

5. മതം

a) ഹിന്ദു

b) ക്രിസ്ത്യൻ

c) മുസ്ലിം

d) മറ്റുള്ളവ

6. ഭർത്താവിന്റെജോലി

a) സർക്കാർജോലി

b) സ്വകാര്യജോലി

c) ദിവസക്കൂലി

d) സ്വയംതൊഴിൽ

e) തൊഴിൽരഹിതൻ

7. വീടിന്റെഉടമസ്ഥത

a) സ്വന്തംവീട്

b) വാടകവീട്

c) സ്റ്റാഫ്‌ക്വാട്ടേഴ്‌സ്

8. താമസിക്കുന്നസ്ഥലം

a) ഗ്രാമം

b) നഗരം

c) അർദ്ധനഗരം

9. ആശുപത്രിയിൽനിന്നുംതാമസസ്ഥലത്തേക്കുള്ളദൂരം

a) 5 കി. മിൽകുറവ്

b) 5 – 10 കി. മി

c) 10 കി. മി, അതിൽകൂടുതൽ

89
10. കുടുംബം (തരം )

a) അണുകുടുംബം

b) കൂട്ടുകുടുംബം

c) മിശ്രിതകുടുംബം

11. പ്രതിമസകുടുംബവരുമാനം( രൂപയിൽ )

a) 15000 ൽകുറവ്

b) 15001 - 25000
c) 25001 – 35000
d) 35001 – 45000
e) 45000 ൽകൂടുതൽ

12. കുട്ടികളുടെഎണ്ണം

a)1
b) 2
c) 3
d) 3 ൽകൂടുതൽ

13. കുട്ടിയുടെവയസ്സ്

a) 0-1
b) 1-3
c) 3-5
d) 5 ൽകൂടുതൽ

14. കുട്ടിയുടെലിംഗഭേദം

a) ആൺ

b) പെണ്ണ്

c) മറ്റുള്ളവ

15. ആശുപത്രിയിൽപ്രവേശിപ്പിച്ചകുട്ടിയുടെജനനക്രമം

90
 a) ഒന്നാമത്തെകുട്ടി

b) രണ്ടാമത്തെകുട്ടി

c) മൂന്നാമത്തെകുട്ടി

d) നാലോഅതിൽകൂടുതലോ

16. കുട്ടിയുടെരോഗവസ്ഥ

a) ജന്മനാഉള്ളത്

b) മെഡിക്കൽ(ശാസ്ത്രക്രിയപരമല്ലാത്തത് )

c) ശാസ്ത്രക്രിയപരമായ

d) കണ്ടുപ്പിക്കപ്പെടാത്തത്

17. കുട്ടിയെഇതിനുമുൻമ്പ്ചികിത്സക്കായിആശുപത്രിയിൽ

പ്രവേശിപ്പിച്ചിട്ടുണ്ടോ?

a) ഉണ്ട്

b) ഇല്ല

18. കഴിഞ്ഞമൂന്ന്മാസത്തിനുള്ളിൽആവർത്തിച്ചുള്ളആശുപത്രി

വാസം

a) ഇല്ല

b) ഉണ്ട്,ഉണ്ടെങ്കിൽ

1) 6 തവണയിൽകൂടുതൽ

2) 4-5 തവണ

3) 3 തവണയോഅതിൽകുറവോ

19. നിലവിലെആശുപത്രിവാസത്തിന്റെകാലയളവ്

a) 2 ദിവസത്തിൽതാഴെ

b) 2-4 ദിവസം

c) 5-7 ദിവസം

d) 7 ദിവസത്തിൽകൂടുതൽ

20. ഇൻഷുറൻസ്

a) ഇല്ല

91
 b) ഉണ്ട്, ഉണ്ടെങ്കിൽ

1) സർക്കാർ

2) പ്രൈവറ്റ് (സ്വകാര്യം )

21. കുടുംബത്തിൽഏതെങ്കിലുംആസൃതഅംഗംഉണ്ടോ?

a) ഉണ്ട്

b) ഇല്ല

22. നിങ്ങൾഏതെങ്കിലുംസാമൂഹികകൂട്ടായ്മയിൽഅംഗംആണോ?

a) അല്ല

b) ആണ്( ദയവായിവ്യക്തമാക്കുക )

സമ്മർദ്ദത്തിന്റെ തോത് വിലയിരുത്തുന്നതിനുള്ള റേറ്റിംഗ് സ്കെയിൽ

[നിർദ്ദേശങ്ങൾ :- അന്വേഷകൻ നിങ്ങളോട് സമ്മർദ്ദവുമായി
ബന്ധപ്പെട്ട ചില ചോദ്യങ്ങൾ ചോദിക്കും. ആശുപത്രിയിൽ
പ്രവേശിപ്പിച്ച ശിശുക്കളുടെ അമ്മമാർ
പ്രതികരണങ്ങൾക്കനുസരിച്ച് നൽകിയിരിക്കുന്ന ഉചിതമായ
സ്ഥലത്ത് ഒരു ടിക്ക് (√) അടയാളപ്പെടുത്തുക. നിങ്ങളുടെ
ഉത്തരങ്ങൾ രഹസ്യമായി സൂക്ഷിക്കുന്നതയിരിക്കും.]

92
ക്ര. മ
പ്രസ്താവന എപ്പോ ചിലപ് ഒരിക്കലു
നമ്പർ ഴും പോൾ മില്ല
1
ചുറ്റുമുള്ളമറ്റുരോഗികളായ
കുട്ടികളെകാണുമ്പോൾഎനിക്
ക്വിഷമംതോന്നാറുണ്ട്
2
എനിക്കൊരുജോലിയുംചെയ്യാൻപ
റ്റുന്നില്ല
3
ആശുപത്രിയിൽഭക്ഷണത്തിനും
വെള്ളത്തിനുമുള്ളസൗകര്യങ്
ങളുടെഅഭാവംഎനിക്ക്അനുഭവപ്
പെടാറുണ്ട്
4
എനിക്കുറങ്ങാൻബുദ്ധിമുട്
ട്തോന്നാറുണ്ട്
5
ആശുപത്രിയിൽശബ്ദംകാരണംഎനി
ക്ക്അസ്വസ്ഥതതോന്നുന്നു
6
എനിക്ക്ശ്വസിക്കാൻബുദ്ധി
മുട്ടുള്ളത്പോലെഅനുഭവപ്പെ
ടുന്നുണ്ട്
7
എനിക്ക്വിശപ്പില്ലായ്മഅനു
ഭവപ്പെടുന്നുണ്ട്
8
എനിക്ക്ആവർത്തിച്ചുമൂത്ര
മൊഴിക്കാൻതോന്നാറുണ്ട്
9
എനിക്ക്ക്ഷീണവുംആസ്വസ്ഥത
യുംതോന്നാറുണ്ട്
10
എനിക്ക്തലവേദനഅനുഭവപ്പെടാ
റുണ്ട്
11
ഞാൻഎളുപ്പത്തിൽപ്രകോപിതയാ
കും
12
എനിക്ക്ഏകാന്തതയുംനിസ്സഹാ
യതയുംഅനുഭവപ്പെടാറുണ്ട്
13
കുട്ടിയുടെഅസുഖംഭേദമാകുമോ
എന്നതിൽഎനിക്ക്ആശങ്കതോന്
നാറുണ്ട്
14
ഞാൻപിന്തുണആഗ്രഹിക്കുന്നു
15
എനിക്ക്മാനസികമായിതലർച്ചെ

93
 യുംനിരാശയുംഅനുഭവപ്പെടാറു
ണ്ട്
16
മറ്റുപ്രവർത്തനങ്ങളിൽമുൻ
കൈഎടുക്കാൻഎനിക്ക്കഴിയുന്
നല്ല
17
കുട്ടിയുടെഅസുഖത്തെപറ്റിഎ
നിക്ക്സംശയംതോന്നാറുണ്ട്
18
കുടുംബങ്കങ്ങളെആശുപത്രിയി
ൽപ്രവേശിപ്പിക്കാതിരിക്കു
ന്നതിൽഞാൻആസ്വസ്ഥയണ്
19
ഡോക്ടർമാരുംനേഴ്സ്മാരുംവേ
ണ്ടശ്രദ്ധതരാതിരിക്കുമ്പോ
ൾഎനിക്ക്നിരാശതോന്നാറുണ്
ട്
20
കുട്ടിയുടെരോഗവസ്ഥയെകുറി
ച്എനിക്ക്ശെരിയായവിവരങ്ങൾ
ലഭിക്കുന്നില്ല
21
കുട്ടിയുടെആശുപത്രിവാസംഞാ
ൻകുടുംബത്തിൽനിന്നുംഅകന്
നുനിൽക്കുന്നതായിതോന്നാറു
ണ്ട്
22
എനിക്ക്സാമൂഹികപിന്തുണകുറ
വാണ്
23
എനിക്ക്സാമൂഹികമായിഒറ്റപ്
പെട്ടതായിതോന്നുന്നു
24
എനിക്ക്ചികിത്സചിലവുകൾതാ
ങ്ങാൻആവുന്നില്ല

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 APPENDIX-H

MASTER SHEET
Sl. 1 2 3 4 5 6 7 8 9 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 Tota
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