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Knowledge Regarding First Aid of Childhood Emergency Conditions among
Caregivers Attending Primary Health Care Centers
Article in "Imperial Journal of Interdisciplinary Research (IJIR) · December 2017
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Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-11, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Knowledge Regarding First Aid of Childhood
Emergency Conditions among Caregivers
Attending Primary Health Care Centers
Rania Harere1, Yahya Makhdoom1, Hisham Sonbul2 &
Mohammed Habadi3
1
Joint program of Family & community Medicine, KSA, Jeddah.
Department of Emergency Medicine, King Abdulaziz University Hospital, Jeddah.
3
Department of Family & community Medicine, Jeddah University, KSA, Jeddah.
2
ABSTRACT
Background and objective: As injury and trauma
are the leading cause of morbidity and mortality in
children worldwide, the objectives of this study were
To measure the knowledge toward first aid for
common emergency conditions in childhood among
parent of 14 years old children and younger, who
attend primary health care centers in Jeddah, Saudi
Arabia, 2015 - 2016. And to investigate the factors
that affects this knowledge.
Subjects and Methods: A cross sectional study
design was carried out among parents of 14 years
old children and younger attending primary health
care clinics in Jeddah, Saudi Arabia, 2015-2016. A
multistage stratified random sampling method was
first used to identify primary health care centers
from each sector. Data were obtained using selfadministered questionnaire.
Results: A total of 390 caregivers were participated
in the study, the mean age of them was (33.2±
8.4).From the participants only 22 (5.6 %) achieved
the passing score, which is 12 right answers out of
14 questions. The average total score of right
answers was 6.7 ± 2.9 ranging between (0-13).
Multiple statistical analyses showed that the
pediatric first aid knowledge was significantly higher
in caregivers with graduate level of education, those
who perceived formal first aid training course, and
those who experienced child’s injury before. In
addition, multiple correlation studies demonstrate
that the score of knowledge correlates positively with
the age, the monthly income and the number of
previously taken first aid courses. However, it
correlates negatively with the number of children at
home.
Conclusion: The results of present study revealed
that parents have an inadequate knowledge of
pediatric first aid principles. It is recommended to
Imperial Journal of Interdisciplinary Research (IJIR)
improve pediatric first aid knowledge and practice in
our population by offering courses, educational
campaigns, and more methods of public health
education to reach the largest population.
1. Introduction:
1.1 Background:
According to the global burden of injury 2000,
injuries is the leading cause of death and disability in
the world. All population is affected regardless of
their age, sex, income, and region. It was also stated
that 1600 people around the world die from injury
daily. On the other hand, thousands of injured person
survives, however, many of them acquired
permanent disabilities as a result of these injuries.(1)
The injury was defined as an acute exposure to
force such as (mechanical, thermal, electrical,
chemical or radiant) in the amount that exceeds the
threshold of the physiological tolerance. This
exposure resulting in a lesion at the organic level of
the body, or causing an insufficiency of the vital
elements, which could lead to disability or death. As
a result of the fact that children are curious and
impulsive, their bodies and awareness are still
developing, and they are not familiar with the
environmental hazards, they are more prone to
accidental injuries.(2,3) According to Tracy ET et al
2013 trauma and injury are the cardinal causes of
death and acquired disability in children in the
United states and worldwide.(4,5) In China, injury
accounts for the third of all deaths in children aged 1
to 4 years, and almost one-half of all deaths in
children between 5 to 9 years of age.(2)
Children are exposed to certain injuries according
to their age and development. Infants explore objects
by putting them in their mouth. Toddlers are curious
and try to touch everything by reach; on the other
hand, preschool children try to imitate adult
behaviors by putting themselves in danger. School
age children have more risky behaviors when playing
outside.(3)
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Vol-3, Issue-11, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
Every year 200,000 child are injured on a
playground in the US.(3) In 2013, a US study
revealed that falls remain the leading cause of injury
in children from 0 to 9 years old. Whereas, in
children from 10 to 18 years old, motor _vehicle
collision is the most common cause of injury in this
age group.(4) In China, the most common type of
injury included falls, collisions, and sprains.(2) A
retrospective study was done at Aga Khan University
Hospital in Pakistan in 2001 revealed that most
injuries in children less than 15 years old who
presented to the emergency department were home
injuries. Home injuries were followed by injuries at a
playground, school, and street. Furthermore, the
commonest type of injuries as stated by the study
was fall, such as fall from stairs or height, followed
by road traffic accident, foreign body ingestion, and
inhalation.(6) In Qatar, the most frequent type of
accidental injuries among children under five years
of age was fall 71.8%. Exposure to mechanical force
was reported in 22.4% of cases, burn in 20.1% was
followed this.(7)
In Saudi Arabia a cross- sectional household
survey included children and adolescents less than 18
years old was done in Riyadh 2011, to determine the
incidence and pattern of injury in this age group. Of
the participants 22.2% were having injuries in the
previous year. The most common reported type of
injuries was fall as well like the other countries. The
incidences of falls were 40.4%, followed by road
traffic accident 15.5%, then food intoxication 8.8%.
Moreover, the study also revealed that males were
more affected by injuries than females by an
incidence of 26% and 18% for both groups
respectively.(8)
As a matter of fact that injury and trauma are the
leading cause of morbidity and mortality in children
worldwide, In 2005 American Academy of Pediatric
brought its' national pediatric first aid course and
book and named it as Pediatric First Aid Training for
Caregivers and Teachers (PedFACTS).(3) The course
is designed to teach the caregivers and teachers the
education and training they need to care effectively
for sick or injured children. It defined the First Aid
as the initial medical care that someone gives to a
child who is injured or suddenly become sick, it
aimed to keep the child medical condition from
becoming worse. Nevertheless, it doesn't take place
of proper medical treatment. The quick response and
appropriate first aid approach in childhood
emergencies can be life-saving and improves the
child chance of a good outcome.(5) Since parents and
caregivers are the first contacts to children in case of
any injury or emergency, it's crucial for them to be
familiar with the appropriate first aid steps.
1.2 Study Rational:
1. The investigator’s interest in teaching first
aid for parents and caregivers rose since the
Imperial Journal of Interdisciplinary Research (IJIR)
2.
3.
internship, after multiple experiences in the
ER rotation of receiving trauma cases of
children that are managed inappropriately
before
reaching
hospital.
Hence,
implementing a good first aid program for
parents could change this; measuring
candidates’ knowledge should be done first.
The researcher works in primary health care
center, a place that could be the first contact
with the injured children and their families,
and it is also a place of education and
primary prevention.
Up to the researcher knowledge and
investigation the study was not done locally.
1.3 Aim of the study:
To investigate the parents and caregivers’ knowledge
toward first aid for common emergency conditions in
children, which may later aim to implement a first
aid training programs for parents, so our community
will get trained parents and caregivers who master
correct first aid measures, and are able to save their
children before reaching hospitals.
1.4 Objective of the study:
2. To measure the knowledge toward first aid for
common emergency conditions in childhood
among parent of 14 years old children and
younger, who attend primary health care clinics
in Jeddah, Saudi Arabia, November-December
2016.
3. Literature Review
Different study was done in several countries to
assess the knowledge of pediatric first aid among
parents and caregivers. A study was conducted in
Turkey at the University of Ankara in 2010 to
determine parental knowledge of pediatric first aid
management according to American Academy of
Pediatrics' guidelines. In the study 631 parents were
involved. The participants were asked to fill a selfadministered questionnaire that contained 37
multiple-choice questions. The median value of
correct answer was 61.9% in parent who never get
any first aid training. Nevertheless, those who had
first aid training course during the previous year
achieved better result with a 77.5% median value of
correct answers. The result of the study showed that
there is a lack of parents' knowledge regarding
pediatric first aid. The level of knowledge was not
related to the age, gender or education of parents. (9)
Another study was done in the US at 2004, to
determine the parental knowledge of pediatric first
aid according to American Academy of Pediatrics'
guidelines. In this study, 654 adults were surveyed
by self-administered questionnaire contains multiplechoice questions. The results of the inquiry showed
that roughly half of the participants were familiar
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Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-11, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
with 60% of the questions. And the knowledge was
unaffected by age, gender or education. These results
indicate that many adults are unfamiliar with correct
pediatric first aid measures according to the
American Academy of Pediatric guidelines.(10)
In Singapore, a cross-sectional study was done to
Asses knowledge, attitude and practice of childhood
injuries and their prevention by primary caregivers.
Parents and caregivers who had children less than 15
years old were interviewed at home. The result of the
study showed limited parents' knowledge about
home injuries and the appropriate first aid
management. Only 50% of the participants were
familiar with the proper care of chocking. And
23.8% knew how to deal with a child who had burns
and scalds. Of the participants, only 20% have
attended first aid course though most of the parents
and caregivers respond positively to attend first aid
training courses. This study indicated positive
correlations between the mother's educational level,
and the first aid knowledge and prevention
measures.(11)
Regarding emergency conditions such as febrile
convulsion and anaphylaxis; a study was done in
Bombi India to investigate the knowledge, attitude
and practice of the parents of children with febrile
convulsion. In the survey,140 parents had
participated. Of participant, 59% couldn't recognize
the seizure, and 90% didn't interfere before arriving
with the child to the hospital. The commonest
immediate effect on parents was fear of their child
from death; this was followed by long-term effect
like insomnia, anxiety, and fear from epilepsy or fear
from recurrent febrile convulsion. Most of the parent
didn't know the fact that fever could cause
convulsion. Only 15% of them had a thermometer at
home, and 20% knew the normal range of body
temperature. Furthermore, only 21% of the parents
knew the correct preventive measures of febrile
convulsion.(12)
Another study was done in Japan regarding
parents' thoughts and actions during their child's first
febrile convulsion as well, revealed that parents
without previous knowledge of febrile convulsion
managed the attack less appropriate than parents with
experience. Besides, they showed a higher rate of
anxiety in comparison to parents with prior
knowledge about the assault.(13)
In concern to anaphylaxis and food allergy in
children, Gupta RS et al surveyed 2945 parents in
Chicago in 2010 to investigate their knowledge,
attitude, and beliefs about food allergy. Of the
participants, 95% accurately identified signs of a
milk-induced allergic reaction. Therefore, the study
exhibited good baseline knowledge, however, several
misconception and beliefs regarding the frequency
and strength of symptoms in the different age group
where identified.(14)
Imperial Journal of Interdisciplinary Research (IJIR)
In Australia, a cross-sectional study revealed that
parents' knowledge was deficient in recognizing the
symptoms of anaphylaxis, and when to use the Epipen. The majority of the parents in the study reported
the skin rash and shortness of breath as symptoms of
the anaphylactic reaction. However, few parents
described specific symptoms that indicated upper
airway obstruction, such as noisy breathing, hoarse
voice, difficulty in swallowing or talking or signs of
hypotension.(15)
No previous studies have been done in our
country to determine parents' knowledge and attitude
toward pediatric first aid for common emergency
condition. Nevertheless, one cross-sectional analytic
study was done by Bashir SM and Bakarman MA to
determine the knowledge and attitude of primary
school staff in Jeddah, Saudi Arabia in response to
health related emergency. A 118 female school staff
who were in charge of health related problems in
school where surveyed. Data was collected using a
self-administered questionnaire. Of the participant
57.8% from the governmental sector and 57% from
the privet sector were able to answer correctly the
questions reflecting their knowledge. These results
indicated an insufficient knowledge and defective
practice in first aid administration in the primary
schools. Furthermore, the difference in age, work
experience and level of education had no significant
change on the score. However, staffs that were
perceived first aid training had a significantly higher
score than those who didn't perceive any training
before. Of those who were trained, the practice and
overall test score were decreased with increasing in
duration since last time they had the training. Even
though the result from the study indicated
insufficient knowledge among primary school staff
in first aid, the overall altitude towards first aid
training was positive.(16)
In regard to teaching first aid; According to
Campbell S 2012 joining first aid training in the
primary level children and updating skills regularly
through life could give individuals the confidence to
respond to emergency situations.(17)
A systematic review was done to evaluate the
ability of school children to learn and perform first
aid, the propose of the study was building an
evidence- based educational pathway to intergrades
first aid training to school curricula. The result of the
study revealed that children and adolescents from 5
to 18 years old could learn certain first aid
techniques. Moreover, it was shown that children and
adolescents from 11 to 18 years are ready to offer
help, and that first aid training is beneficial to
increase their confidence and performance. Based on
this study an evidence-based educational pathway
concerning first aid learning for different age groups
was developed and could be integrated into school
curricula.(18)
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Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-11, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
4. Methodology:
3.1Study Area:
The study carried on in Jeddah. Jeddah is the
major urban center of western Saudi Arabia.
Moreover, it’s the largest city in Makah Province.
The city is divided into five major sectors. Each
sector contains multiple primary health care centers.
All primary health care centers in Jeddah, Saudi
Arabia, were involved in the study.
3.2 Study design:
This study is a cross sectional study.
3.3 Study Population:
All parents and caregivers for 14 years old
children or younger, who visited the primary health
care centers in November and December 2016 were
enrolled.
3.4 Sample size& Sampling Technique:
The Raosoft software was used to calculate the
sample size taking into account that the total number
of children in Jeddah KSA who age from 0 to 14 was
372, 227 child in 2015. And according to the
following criteria: confidence interval as 95% with
5% acceptable margin of error, and 50% responsible
distribution. The sample size was 384 participants
who were randomly selected from visitors attending
different primary health care centers in all five
sectors in Jeddah. These centers were selected by
using a Multistage stratified random sampling
technique.
3.5 Data collection:
Data collection tool
Participants were asked to fill a self-administered
questionnaire formulated by the researcher. The
questionnaire was divided into three parts.
 The first part: was about demographic data
including age, sex, educational level,
occupation, the number of children in home,
and the presence of a house maid or not.
 The second part: assessed the previous
training and experience in pediatric firs aid.
 The third part: was to Asses participants’
knowledge level of basic first aid principles.
15 multiple-choice questions was chosen
from another study(2) after taking the
author’s permission and reviewed according
to the AAP guidelines 2005.
Validity & Reliability of the questionnaire:
After formulating the questionnaire, it was
translated into Arabic language and then back into
English with a consistency and similarity of >80%
between the two English versions to assure its
validity, after that it was signed by three consultant.
The reliability of it was tested by pilot study on 10%
of the sample size. The questions were
straightforward and the language kept simple. There
was no time limit to complete the questionnaire.
(Appendix)
Data collection technique
Imperial Journal of Interdisciplinary Research (IJIR)
Questionnaires was carried out by the investigator
during the primary health care centers’ working
hours, and submitted to the participated parents and
caregivers in person, after giving a brief introduction
about the study.
Variables
Dependent variables
The knowledge of parents toward first Aid.
Independent Variable
Parents’ demographic parameters, and the
previous training and experience in first aid.
3.6 Data entry and analysis:
 All collected data was verified by hand and
coded before its entry into a personal
computer.
 Statistical Package for the Social Sciences
(SPSS) statistical program version 20 was
used for data entry and analysis.
 A p-value of less than 0.05 was considered
as a level of significance throughout the
study.
 Statistical analysis was done using
frequency distribution for qualitative
variables, and mean, the standard deviation
for quantitative variables, the independent
sample t-test, ANOVA test and correlation.
3.7 Pilot Study:
A pilot study was conducted in maternity and
children hospital (Al-Musadaiya) in Jeddah, Saudi
Arabia, to test the questionnaire applicability. Forty
parents and caregivers participated in the pilot study.
As feedback, the questionnaire was clear and
questions were understandable. Approximately 15 20 minutes were needed to fill in the questionnaire
by participants.
3.8 Ethical consideration:
1. Permission from the Joint Program of
Family and Community Medicine was
obtained.
2. Permission from the head of Research and
Ethics committee in MOH was also
obtained.
3. A verbal consent from the directors of
primary health care centers and each
participant in the study was taken.
4. Confidentiality of information was assured
except for the study purposes.
3.9 Budget:
The study was self-funded.
5. Results:
Socio-demographic characteristics:
A total of 390 caregivers were participated in the
study, the mean age of them was (33.2±8.4). From
the participant 88.5% were female. Mothers were the
main caregivers of children (82.1%) followed by
fathers (10.3 %), the rest (7.7%) were grandmothers,
sisters, and aunts. The majority of the caregivers
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Vol-3, Issue-11, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
were married (85.9%). According to the level of
education and employment, most of the participants
(48.8%) had a graduate level of education, followed
by (29%) secondary or high school level. From the
participants only (2.6%) had postgraduate
educational level, and (3.1%) were illiterate. The
majorities of the sample size (85.2%) were
housewives and (31.8%) were employed. Most of the
families was living in rented flat (58.1%), and only
(35.7) were having housemaid. Table 1 demonstrates
the socio demographic characteristic of the studied
group.
Table 2 demonstrates caregivers’ previous training
and experience in pediatric first aid. From the
participant only 24% had received previous first aid
training, and the majority of them (51%) had only
one training course. More than half (52.7%) of the
studied caregivers admitted to have a first aid kit at
home. While 32.4% of the participants their children
were exposed to previous injury at home, only 26.2%
had performed first aid measures. Of the participants
only 45.4% assigned their name and contact
information to receive future planned pediatric first
aid courses.
Table 1: Socio-demographic characteristics.
Characteristic
No
Percentage
Gender
Males
Females
Relation to the child
Mother
Father
Others
Marital status
Married
Single
Divorced
Widowed
Type of housing
Owned flat
Rented flat
Owned villa
Rented villa
Others
Qualification
Primary
Intermediate
Secondary
University
Postgraduate
Illiterate
Occupation
Employed
Retired
Private
Not working
Housewife
Presence of maid
Yes
No
58.2
138
249
35.7
64.3
Table 2: Previous training and performance of first
aid.
No Percentage
Previous training
in first aid
Yes
94
24.1
No
1
2
3
4
5
Yes
296
47
30
12
2
1
205
75.9
51.1
32.6
13.0
2.2
1.1
52.7
No
184
47.3
Child exposure to
injury
Yes
126
32.4
No
263
67.6
Performed
first
aid to injured
child
Agree to receive
pediatric
FA
course
Yes
102
82.9
No
21
17.1
Yes
177
45.4
No
213
54.6
Number
courses
of
First aid kit at
home
45
345
11.5
88.5
320
40
30
82.1
10.3
7.7
335
29
17
9
85.9
7.4
4.4
2.3
97
226
46
10
10
24.9
58.1
11.8
2.6
2.6
24
40
113
190
10
12
6.2
10.3
29.0
48.8
2.6
3.1
Item
124
10
9
20
31.8
2.6
2.3
5.1
Imperial Journal of Interdisciplinary Research (IJIR)
227
From the studied caregivers 79.7% thought that
sterile gauze is important item that should be present
in the FA kit followed by wound blaster (77.4%),
and alcohol swab (74.9). However only 16.9 thought
that torch is important in the FA kit.
Table 3: Essential content of the first aid kit as
reported by the caregivers
No
Percentage
Sterile gauze
311
79.7
Wound blaster
302
77.4
Alcohol Swab
292
74.9
Adhesive band
281
72.1
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Scissors
218
55.9
Gloves
216
55.4
Ambulance
157
40.3
Tongs (tweezers)
109
27.9
Torch
66
16.9
number
Febrile
convulsion—
remove object that could
cause injury
Epistaxis-- pinch the soft
parts of the nose and tilt
the head downward.
Swelling -- apply cold,
then wrap and elevate the
injured body part
30.26
26.67
24.62
Table 4: Average score percentage of the correct
answers to the study questions
First aid knowledge
Electrical shock – turn off
Percentage
80.0
the power source
Cut wound--safe the cut
part in ice bag, and apply
pressure to control bleed,
and go to emergency or
call ambulance.
Fall and sever injury -avoid moving the child at
all, and call emergency
61.8
Allergy--recognize sign &
symptom of allergy
58.46
Chocking of 9m old--hang
the child upside down and
beat the area between
shoulders.
Wound-- apply firm, direct
pressure on the wound to
control bleeding.
56.41
Infection-- reduce infection
by flushing the injured
area with running water
45.9
Chemical burn to face-flash with large amount of
water and call ambulance.
45.64
Swallowed
poisons-removes traces of the
poisonous from the child’s
mouth first and then go to
emergency
or
call
ambulance.
Fainting-- lay the child on
his or her back and loosen
any tight clothing
36.92
Burn blister—keep clean,
intact and cover it
32.56
59.5
48.97
36.67
Imperial Journal of Interdisciplinary Research (IJIR)
Figure 1: Average score percentage of the correct
answers to the study questions.
According to AAP the Passing score is 80%.
Which is in our questionnaire, 12 right answers out
of 14 questions.
From the participants only 22 (5.6%) achieved the
passing score; the average total score of right
answers was 6.7 ± 2.9 ranging between (0-13).
Participants lacked the knowledge of appropriate
first aid regarding swelling that resulted from twisted
ankle only (24.62%) were aware of the need to ably
ice bag, wrap the ankle and elevate the injured body
part. Similarly, only (26.67%) were aware to the
need of pinching the nostril together and tilting the
head downward to stop the bleeding nose. From
caregivers (32.6%) knew the importance of
protecting the convulsive child, and removing any
near objects that could hurt him/her. However, there
was a relatively good level of knowledge regarding
the first step that should be taken in electrical shock.
The responses to the other injuries and emergences is
shown in table 3, (Figure1).
The relation between the level of knowledge and
socio demographic characteristic:
The level of pediatric first aid knowledge was
different between the studied populations according
to different factors.
In relation to the level of knowledge and gender,
female had higher level of FA knowledge compared
with male with an average score of knowledge
(45.0%) and (40.5%) for both groups respectively.
However, the difference was not statistically
significant (p-value 0.153).
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Table 5demonstrates a significant difference (pvalue 0.007) in the levels of caregivers’ knowledge
according to their social status. Widowed caregivers
had the highest level of knowledge (60%), followed
by divorced (50%), then the married (44.4%), and
the least level of knowledge were related to the
single caregivers (36%).
Caregivers with graduated level of education had
a statistically significant (p<0.001) higher level of
knowledge (51%) than secondary school (40.5%),
intermediate school level (33.6%), and primary
school level (34.7%), they also had higher level of
knowledge than caregivers with a post graduate level
who had an average score rate of (48.6%). In
addition, caregivers who had housemaid at home had
better level of knowledge (55.2%) than those who
did not have housemaid (38.7%).
A correlation study showed a significant positive
weak (R=0.269) correlation (p<0.001) between the
level of knowledge and the age of the caregivers
(Figure 2).
There was also a significant positive (p<0.001)
moderate correlation (R=0.456) between the level of
Knowledge and the monthly income (Figure 3).
In addition, The level of pediatric first aid
knowledge was negatively correlates with the
number of children at home, and this correlation was
statistically significant (p= 0.003), and weak (R= 0.15) (Figure 4).
Sociodemographic
character
No
Average
score of first
aid
knowledge
%
Gender
Male
45
40.5
Female
345
45.0
Widowed
9
60
Divorced
17
49.8
Married
335
44.4
Single
29
36
Graduate
190
50.95
Postgraduate
10
48.67
Secondary
113
40.59
Primary
24
34.72
Intermediate
40
33.67
Illiterate
12
31.67
Presence
house maid
Yes
No
of
138
55.27
249
38.69
<
0.001
Table 5: The relation between the level of knowledge
and socio-demographic characteristic.
Figure 2: The relation between the age of the
caregiver and the average score of knowledge
P
value
0.153
Social status
Level
education
0.007
Figure 3: The relation between the monthly income
of caregivers and the average score of knowledge.
of
<
0.001
Imperial Journal of Interdisciplinary Research (IJIR)
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Figure 4: The relation between the number of
children at home and the average score of
knowledge.
Table 6: The relation between the level of knowledge
and previous first aid training and experience:
Item
No
Average
P
score of
Value
first aid
knowledge
%
Previous
FA
training
Yes
94
59.2
No
296
39.7
Yes
126
48.0
No
263
42.7
Yes
177
39.6
No
213
48.4
Previous
injury
<0.001
Figure 5: The relation between the number of first
aid courses and the average score of knowledge.
child
0.032
Participation
in
future FA courses
0.003
Caregivers who had received previous FA
training courses had significant better level of
knowledge (59.2%) than those who had not received
any training before (39.7 %).
Subjects who had experienced previous child’s
injury had statistically significant (p-value 0.032)
better level of knowledge than those who had not,
with an average score of knowledge for both groups
(48% vs. 42.74%) respectively.
Results from in depended sample t-test showed
that caregivers who refused to participate in future
planed pediatric first aid course had a higher level of
knowledge than those who agreed to participate, with
an average score of correct answer (48.3%) in
comparison to (39.6%) for both groups respectively
with a significant p value (p-value 0.003) (Table 6).
In relation to the previous first aid practice, the
results showed a significant (p-value 0.028) positive
weak (R=0.229) correlation between the number of
previously taken first aid courses and the average
score of knowledge (Figure 5).
Imperial Journal of Interdisciplinary Research (IJIR)
Figure 6: The relation between the knowledge of
important FA kit items and FA knowledge.
There was a significant positive correlation
between the knowledge of important FA kit items
and the pediatrics’ FA knowledge.
6. Discussion:
Injury is a common cause of morbidity and
mortality in children. However, appropriate first aid
can help decreasing this morbidity and mortality.
Therefore, it’s crucial for all parents and caregivers
to be trained proper first aid skills, to be directed to
reach these courses, and having a positive attitude
toward training and performing first aid.
There are relatively little previous studies
assessing pediatric first aid knowledge among
parents. And no study was conducted in Saudi
Arabia for the same purpose. The results of present
study revealed that parents have an inadequate
knowledge of pediatric first aid principles. Our
results were approximately compatible with the
results of the international studies done before. A
study on pediatric first aid knowledge was conducted
in US 2004 indicated a lack of parents and
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Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-11, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
caregivers’ knowledge according to the American
Academy of pediatrics guideline. Half of the
participants were familiar with only 60% of the
questions, while the passing score according to the
AAP guidelines is 80%.(10) In another survey, which
was done in Turkey by Tekin D & Suskan E at 2010
also, showed a lack of parents and caregivers’
knowledge regarding pediatric first aid.(9)
In both prior studies, the level of first aid
knowledge was not affected by age, socioeconomic
status and level of education. Nevertheless, in our
study there were significant positive correlations
between the level of knowledge and the age and the
level of education of the participants. A study in
Singapore as well revealed positive correlation
between maternal educational level and the level of
knowledge.(11) In our study, the majority of
participants were females (88.5%) as compared to
(11.5%) males. And women in Saudi Arabia have
limited education and job positions, mainly teachers
and health care workers (physician and nurses),(19)
where first aid training is sometimes required and
offered to the workers in these jobs; another
explanation is the positive relation between the
educational level of participants and the first aid
knowledge.
Caregivers who had received previous FA training
courses had better level of knowledge than those who
had not received any training before. This result is
compatible with most previous studies that compare
the level of first aid knowledge among groups that
received previous training, and those who didn’t.(911,16,20)
In our study, only 24% of the participant had
formal training even though 83% did first aid
measures to their children in case of trauma or
emergency. Whether the performed actions were
appropriate or not, was unclear, and here is the point
the performed first aid should be appropriate as
recommended to be effective and reduces the risk of
morbidity and mortality.(3) More than one half (54.6
%)of caregivers refuse to give their contact
information to receive pediatric first aid training
course; surprisingly this group had a significantly
better level of knowledge (48.4%) than caregivers
who agreed to participate (39.6%). This might be due
to their high perception about their good knowledge.
Moreover, Caregivers who had experienced previous
child’s injury had statistically significant better level
of knowledge than those who had not, this could be
related to their previous experience that gave them
the motive to ask, read and learn.
There was negative correlation between the level
of caregivers’ first aid knowledge and the number of
children at home. Nevertheless, the level of
knowledge correlates positively with the monthly
income, presence of housemaid and the level of
education. This could be explained by the pattern of
small number of children in high social level
families.
Imperial Journal of Interdisciplinary Research (IJIR)
Regarding febrile convulsion, only 30% of the
participants were aware of the most important and
appropriate step that should be taken in case of
convulsion. These finding was in agreement with the
results of the study, which was conducted in king
Abdul-Aziz University hospital at 2015 to assess the
maternal knowledge of acute seizure. The results
demonstrated that mothers had a significant lack of
information, negative behavior, and poor managing
practice.
Of
participants
14%
performed
inappropriate measures such as sprinkling water to
the face, shaking or forcing object or medication in
mouth during the attack, an action that increase the
risk of aspiration.(21) Kanemura H et al also explained
in their survey that parents without previous
knowledge of febrile convulsion managed the attack
less appropriate than parents with previous
knowledge, they also showed a higher rate of anxiety
during and after the attack.(13)
The cross-sectional survey that was conducted in
Riyadh at 2011 revealed that most common reported
type of injury was falling,(8) and according to our
study only 59.5% of caregivers were aware of the
importance of avoid moving the severely injured
child after falling.
7. Conclusion:
This study indicated that parents and caregivers
attending primary health care centers in Jeddah,
Saudi Arabia have an inadequate knowledge of
pediatric first aid principles.
In addition, the level of knowledge was positively
related with the age, level of education, monthly
income, and previous first aid training. And there
was also positive correlation between the average
score of knowledge and the number of FA courses
taken before.
8. Recommendation:
1.
2.
3.
Type As there is deficient in caregivers’
knowledge to provide the essential and
appropriate first aid measures to the injured or ill
child in our population, it is crucial to improve
the first aid knowledge and practice in adults,
adolescent, and even children.
As the matter of fact that the only universal
factor that correlates positively with the level of
pediatric first aid knowledge is first aid training
course, it's recommended to offer public courses
and educational campaigns, and these should be
provided in all sectors and regions in Saudi
Arabia, and to be reachable to all area and social
classes.
More methods of pediatric first aid education
should be offered to reach the largest number of
target population, such as brief video clips,
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Imperial Journal of Interdisciplinary Research (IJIR)
Vol-3, Issue-11, 2017
ISSN: 2454-1362, http://www.onlinejournal.in
4.
5.
posters in schools, malls, hospitals and primary
health care centers.
Future study could be done to assess different
methods of education and their effect on
knowledge.
It’s also recommended to develop an evidence
based educational path way of first aid for each
age group and integrated it to school curricula.
The researcher strongly believes that education
in first aid should be universal: everyone can
learn first aid and everyone should.
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