Effect of Pre-Designed Instructions for Mothers of Children with Hypospadias on Reducing Postoperative Complications

Abstract

Hypospadias is a common congenital anomaly with a prevalence estimated to be as high as 1 in 125 live male births. Complications after surgical procedures are possible. The incidence of complications can be reduced by meticulous preoperative planning, and judicious postoperative care. So the aim of the study was to investigate the effect of pre-designed instructions for mothers of children with hypospadias on reducing postoperative complications. A convenient sample consists of 60 mothers of children with hypospadias were included in the study. The sample was divided into 2 equal groups; the control group and the study group. Pre-post quasi experimental design was utilized to perform the aim of the study. The study was conducted in the pediatric surgical department and urology outpatient clinic at one Pediatric Hospital in Cairo. Three tools were carried out; first a questionnaire sheet (pre-post test) to assess mothers' knowledge about hypospadias, and includes also demographic data, second tool; observational checklist to evaluate mothers’ practices regarding hypospadias, third tool, postoperative complications assessment sheet, which was examined occurrence of early postoperative complications. And pre-designed instructions were provided for those mothers preoperatively. The study results revealed that a highly significant difference was present between the control and the study group regarding mothers' knowledge in post-test. The majority of mothers in the control group and the study group had inadequate level of knowledge about hypospadias in pre-test. While more than two fifth of mothers in the study group had adequate level of knowledge in post-test. The results proved that the mothers' practices in post-test were increased more than in pre-test, less than half of the mothers in pre-test were not satisfied about performing diaper care correctly, however in post-test more than three quarters of those mothers were performed this procedure correctly, and there were highly statistical significant difference between pre and post-test. Regarding early postoperative complications; the results demonstrated that more than two thirds of children in pre-test, while less than two fifth in post-test suffering from postoperative complications as; infection, urinary tract obstruction and bleeding. The difference between pre and post-test was significant. The current study concluded that the pre-designed instructions for mothers of children with hypospadias were efficient by means of marked improvement of the knowledge and practices of the study group, which support the research hypotheses. So the results indicated that children with hypospadias were fewer early postoperative complications in the study group than the control group. The study recommended that important of pre-designed instructions for mothers of children with hypospadias for reducing postoperative complications. Also highlighting additional researches about assessment of mothers' knowledge and practice in relation to care provided to their children with hypospadias. In addition to a longer follow-up is necessary to monitor the late post operative complications.

Keywords: Hypospadias, children, preoperative, pre-designed instructions, postoperative complications, mothers' knowledge, practices.