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. 2023 Jun 15;10(9):6398–6407. doi: 10.1002/nop2.1889

Mothers participation in caring for hospitalized children with acute gastroenteritis: A quasi‐experimental study

Haniyeh Nankali 1, Fatemeh Cheraghi 2,✉, Tayebeh Hasan Tehrani 3, Younes Mohammadi 4, Mahnaz Azadimoghtader 5
PMCID: PMC10415989  PMID: 37318191

Abstract

Aims

To identify informational and practical deficits of mothers of hospitalized children with acute gastroenteritis and to determine the effect of intervention on enhancing mothers' participation in providing care.

Design

This study was a two‐group pre‐ and post‐test quasi‐experimental study.

Methods

Sample size was eighty mothers of hospitalized children younger than 5 years with acute gastroenteritis in each group using consecutive sampling method. Based on the needs assessment, the training and practical demonstration were performed individually in the intervention group. The control group received usual and standard care. The care practice of mothers were observed before and three times after the intervention at a 1‐day interval. The confidence level was 0.95.

Results

After intervention, there was a significant increase in the mothers' care practice in the intervention group and a significant difference between the two groups. The participatory care approach could enhance mothers' practice in providing care to the hospitalized children with AGE.

Keywords: diarrhoea, hospitalized children, patient care management, vomiting

1. INTRODUCTION

Acute gastroenteritis (AGE) often affects children younger than 5 years and is the second leading cause of death in the world after pneumonia in children (Hasan et al., 2021). In 2021, 5.0 million children under 5 years of age died. Globally, infectious diseases, including pneumonia, diarrhoea, and malaria, remain a leading cause of under‐five mortality (UNICEF, 2021). AGE is the second most common non‐traumatic cause of emergency hospitalization in children aged 1–5 years (Posovszky et al., 2020). AGE is caused by a variety of viral, bacterial, and parasitic pathogens. Rotavirus is the most common cause of hospitalization for diarrhoea (Hockenberry et al., 2019; Mojahed et al., 2022). AGE is transmitted by contaminated food or water and or from person to person due to poor hygiene (Hockenberry et al., 2019). In a systematic review study, 48 articles related to AGE were extracted, which were performed on the Iranian paediatric population over fourteen provinces from 1987 to 2021. From 17,789 patients with AGE, 5900 positive cases were found to report Rotavirus. Therefore, Rotavirus has the highest prevalence among other viral AGE. The most frequent rate of AGE was during the winter (44.26%) (Mojahed et al., 2022).

Fluid loss due to vomiting and diarrhoea can rapidly lead to dehydration, with disturbances of electrolyte homeostasis, circulatory function and organ and tissue perfusion (Hockenberry et al., 2019; Posovszky et al., 2020). The diarrhoea disease starts at home, and treatment continues at home after returning from a health facility (Haroun et al., 2010). Early intervention can reduce complications, such as dehydration and malnutrition (Abbas et al., 2018). The World Health Organization program for the control of diarrheal disease emphasizes the use of oral rehydration therapy (ORT), nutrition, medications, and parent education on managing diarrhoea (Hanif et al., 2018).

Management of paediatric diarrhoea at home can lead to a reduction in hospital admissions and shorter hospital stays (Van den Berg & Berger, 2011). Guidelines on AGE home management in children provide advice preventing or treating dehydration, including breastfeeding or formula milk, signs and symptoms of dehydration, adequate fluids intake, especially oral rehydration solution (ORS) to treat or prevent dehydration (Shafizadeh et al., 2019; Van den Berg & Berger, 2011). Personal hygiene is important, especially washing hands frequently with soap or other disinfectants after changing nappies and before preparing, serving or eating food (Abbas et al., 2018; Hockenberry et al., 2019). Therefore, the management of AGE in children, as well as health education for parents, is among the top priorities of the health care system (Posovszky et al., 2020). Sanyod and colleagues identified that parents' perceived self‐efficacy in caring for hospitalized children was a strong predictor of parent participation in childcare (Sanyod et al., 2021). In the same direction, Smith and colleagues, in a concept synthesis based on 30 studies, showed the importance of supporting parents, valuing parents' awareness and skills, and developing effective parent‐professional relationships as participatory processes (Smith et al., 2015).

Parent participation in caring for hospitalized children has been a core element of family‐centered care (FCC) (Sanyod et al., 2021) because the family is the constant in the child's life at home and in the hospital (Sundal & Vatne, 2020). Parent participation is defined as the active involvement of parents for the child in the hospital setting, whereby parents take part in the care of their child across the entire hospital episode based on interactions with healthcare providers (Mol et al., 2018; Shdaifat et al., 2022). Parent participation improves the quality of nursing care for children and families in paediatric clinical settings (Vasli & Salsali, 2014). One aspect of parent participatory care is decreasing the adverse effects of hospitalization on children and their parents. Adverse effects of hospitalization, such as separation from parents, anxiety, and unfamiliar environment, mean that children have a strong need for their parents, particularly their mothers (Coyne & Cowley, 2007). Another aspect is creating a mutual relationship and trust between nurses and parents, sharing information, supporting information, educating parents about the care and treatment process, delegating needed home care to parents, and involving parents in providing care and making decisions (Aarthun et al., 2019; Coyne et al., 2013; Sanyod et al., 2021; Vasli & Salsali, 2014). A study indicated that participatory care allowed for the correction of errors and monitoring of the care provided by the mother, improving the mother's competence and independence (North et al., 2020). Accordingly, the parents' ability to cope with the parental role in the hospital appears to enhance by involving parents in children's health care decisions (Aarthun et al., 2019). Moreover, the practical assistance of parents reduces demands on nurses, improves the competence and independence of the mother and helps the child recover faster (North et al., 2020).

Few studies have explicitly studied the effects of an intervention on parental participatory care. In a quasi‐ experimental study health education had positive effect on the competence of 118 mothers in the home management of diarrhoea in children under 5 years of age. Intervention included home visits, group sessions and pamplets (Haroun et al., 2010). Albrecht and colleagues developed and evaluated the effectiveness of a digital knowledge translation tool for parents about paediatric AGE. In the emergency department (ED) over a 6‐month, 500 parents were randomized to receive the whiteboard animation video (about health decision‐making and therapeutic management of paediatric AGE) or a sham control video. This digital tool showed positive effect on parents education (Albrecht et al., 2018). In other clinical trial study, the empowerment training program consisted of five 1‐h sessions was performed with a sample of forty mothers of children undergoing chemotherapy. This empowerment program could improve mothers' knowledge about chemotherapy and sharing experiences in solving chemotherapy‐associated problems (Lashgari et al., 2021).

Mother is the primary caregiver for the child in almost all societies in the world. Hence, the health practices along with knowledge of the mothers directly affect health promotion, disease prevention and care management in children (Dodicho, 2016; Hanif et al., 2018; Lashgari et al., 2021). An important determinant of health in child with AGE is the knowledge and practice of the child's mother regarding care management (Mutalik & Raje, 2017). Hence, Paediatric nurses should facilitate mothers' participation and competence to care for their children (Coyne & Cowley, 2007; Vasli & Salsali, 2014). This study had two purposes: first, to identify mothers' informational needs about the management of AGE and their practice deficits. Second, to determine the effect of educational‐practical intervention on enhancing mothers' participation in providing care to hospitalized children younger than 5 years with AGE compared to control group.

2. METHODS

2.1. Study design and sample

The present study was a two‐group pre‐ and post‐test quasi‐experimental study. This study was carried out in the paediatric ward of Besat hospital from May to December 2021. First, the samples size was calculated using the G Power 3.1.3 program based on the results of a pilot study (sample of pilot study was 29 in the intervention group and was 30 in the control group). The sample size based on the pilot study was estimated with effect size 0.50, significance level of 0.95, and power of 0.90, and it was 38 participants in each groups. However, Student t‐test revealed not significantly different between two groups. In order to determine whether this finding was real or due to chance and to avoid a type II error, we needed to expand the sample size. Consequently, sample size was calculated for the medium effect size 0.30 with a significance level of 0.95, power of 0.80. The analysis accounted for a 10% attrition rate. Therefore, the sample size increased to 80 mothers of hospitalized children <5 years of age with AGE in each groups. With the consecutive sampling method, participants were assigned to the intervention and the control group to prevent the mothers' interaction between two groups. First, based on need assessment through the observation, from the 130 observed mothers who met the inclusion criteria, 80 mothers with deficit in knowledge and practice in management of AGE was selected as the intervention group. Then, the next 80 participants were assigned to the control group. Sample loss did not occur because the healthcare team encouraged mothers to participate in the study (Figure 1). Inclusion criteria were included: accompanying the mother with the hospitalized child, and the duration of the hospitalization was more than 5 days. Exclusion criteria were children with critical or other health problems, such as seizures or any illness that changed the treatment protocol and made the mothers worry and anxious, and non‐signature of the consent form.

FIGURE 1.

FIGURE 1

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Trial profile.

2.2. Data collection

The data collection tools were a demographic information questionnaire, a children's clinical profile form, and a Care Management of Gastroenteritis (CMG) checklist for mothers of hospitalized children with AGE. The demographic information questionnaire included age, sex, birth order, and type of feeding (Breast or formula milk, complementary feeding, regular diet) of children also age, occupation and education level of mothers and fathers. Clinical profile form included primary cause of current hospitalization, duration of diarrhoea (days), frequency of defecation, watery stool, fever and vomiting at home, and level of dehydration based on WHO criteria.

The CMG checklist was developed based on relevant literature (Abbas et al., 2018; Hockenberry et al., 2019; Shafizadeh et al., 2019; Van den Berg & Berger, 2011) by researchers for the current study to observed and monitor the care practice and skills of mothers of hospitalized children with AGE under the age of five. It consists of 56 items with three‐point Likert (Yes = 2, Not need to observe = 1, No = 0) in four domains. The domains assess the aspects of hygiene principles (16 items), fluid therapy and diet (18 items), take care of fever (15 items), and skin care (7 items). The total score range is 0–112.

The validity of the scales confirmed based on the viewpoint of 10 paediatric nurses, faculty members, and three paediatricians. In the present study, two raters completed the CMG checklist. The Content Validity Index (CVI) score of was between 0.72 and 0.93 for items. Cohen's kappa value was 0.77 (95% confidence interval [CI] 0.62–0.85). Cronbach's alpha coefficients were 0.89 in total and 0.85 for hygiene principles, 0.82 for fluid therapy and diet 0.83, for take care of fever, and 0.79 for skin care domains. Therefore, the inter‐rater reliability and internal consistency of the CMG checklist was proper.

2.3. Intervention

The content of intervention and the “Caring for Children with Diarrhea and Vomiting: Recommendation for Mothers” booklet has been taken from relevant literature (Abbas et al., 2018; Anigilaje, 2018; Hockenberry et al., 2019; National Collaborating Centre for Women's and Children's Health, 2009; Ugboko et al., 2020). It took more than 2 months to compile and approve the content of the intervention and the booklet and prepare the trainer. The trainer was a paediatric nursing student (the first author) who worked for 10 years in clinical settings, including paediatric wards. Two paediatric nurse educators and two clinical paediatric nurses assessed and approved the booklet and intervention content.

The educational content was a combination of theoretical and practical education. The purpose of the intervention was to empower the mothers by increasing their knowledge and enhancing care skills and practices, which was needed to participate in care for hospitalized children under the age of five with AGE. The content of health education was information, recommendation, and advice for mothers, including the cause of illness, understanding the natural course of the disease, symptoms management. Examples of AGE‐related information were preventing spread; oral rehydration salt (ORS) solution; fluid and nutritional management; breastfeeding and other milk feeds; times of washing hands with soap (after going to the toilet (children) or changing diapers (caregivers) and before preparing; serving or eating food); and not sharing towels used by infected children. Moreover, the red flag symptoms were mentioned. The practical training was about the technique of hand washing; ORS preparation and administration (giving 5 mL/kg of ORS solution after each watery stool); wet sponge; changing nappies; and skin care.

Intervention feasibility criteria are acceptability, recruitment and retention, and satisfaction. Intervention acceptability is acceptance of treatment when the participant completes all tools. Intervention satisfaction measures by comparing recruitment and retention between both groups and questionnaire completed by all participants (Desjardins et al., 2021). In the current study, sample dropout did not occur. The intervention group participated in need assessment, intervention and sharing management experiences and practice.

The duration and content of each mother's training varied according to the needs assessment of participants. In other words, the intervention was adjusted based on individual needs assessment. In general, the intervention consisted of one to three sessions for 20–35 min on two consecutive days in the morning and afternoon.

2.4. Data collection method

After approval of the study and the selection step, explaining the purpose of the study and was obtained written consent from the participants in both groups to join the study. The care practice of mothers were observed in both groups four times through the CMG checklist items. In the intervention group, observations were performed before (when need assessment was accomplished) and three times after the intervention at a 1‐day interval. In the control group, observations were performed four times at a 1‐day interval. The observations were accomplished in the morning, evening and or night depending on the caring procedures, in the room of the hospitalized child. The duration of each observation was until all items on the checklist were completed (about 4–7 h in each day). A volunteer nurse, who was a familiar face to mothers, was selected as an observer among the ward staff nurses to reduce the impact of the observer's presence. The observer was not involved with the care of the children whose mothers participated to the study; she simply stayed in the patient room (Figure 2).

FIGURE 2.

FIGURE 2

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Intervention flow diagram.

In the intervention group, first based on the basic need assessment, the informational and practical deficits of participants were identified and listed. Then, the trainer (first author) via role modelling, explanation, repeating and comments performed Individual training. During the training, the trainer provided participants with a practical demonstration of the expected care practice using the correct technique. In addition, mothers were asked individually to perform the each skill and the performance assessed by the trainer. Additional practice was provided when the mothers did not understand what needed to be done and feedback was given if they made mistakes during the caregiving or procedure. At the end of the training, the mothers were provided with the “Caring for Children with Diarrhea and Vomiting: Recommendation for Mothers” booklet to study. The second and third authors supervised training sessions.

In the control group, the participants received usual and standard care only. However, on the discharge day, concerning ethical considerations, verbal descriptions, answer their questions, practical demonstrations, and the booklet given to them for better home care.

2.5. Ethical considerations

The Institutional Review Board (Project No. “14000124469”) and the Research Ethic Board (Ethical number: “IR.UMSHA.REC.1399.1078”) of Hamadan University of Medical Sciences approved this study. Written informed consents were obtained, and the purpose of the study was explained to the participant mothers. They were given the possibility to leave the study whenever they wanted. It is also important to note that the results of the study were anonymously reported to comply with the ethical criteria.

2.6. Data analysis

Data were analysed using SPSS‐26 software. Kolmogorov–Smirnov test (KS‐test) showed that the data distribution was normal. Mean and SD were calculated for categorical variables. Chi‐square and independent t‐tests were used to examine the homogeneity and analysis of variance with repeated measures, independent t‐test were performed to compare the outcomes between the control and intervention groups. The confidence level was 0.95.

3. RESULTS

Eighty mothers of hospitalized children under the age of five with AGE in each group (a total of 160) participated in the present study. The mean age of participating mothers was 30.03 ± 6.45 years in the intervention group and was 31.13 ± 6.08 years in the control group. The mean age of children with AGE was 2.66 ± 1.20 years in the intervention group and was 3.18 ± 1.09 years in the control group. The findings of the study indicated that the intervention and control groups had similar demographic characteristics (Table 1). The mean of duration of diarrhoea was 5.58 ± 5.56 day before admission. The body temprature of 37 percent of childern was above 38.5c in admission day (Table 2). Based on the first study purpose: “to identify mothers' informational needs about the management of AGE and their practice deficits”, the needs assessment of 130 observed mothers in the intervention group showed that the knowledge and practice of the majority of mothers were low about the diet of children during diarrhoea (71% in intervention group) and vomiting (64.3% i in intervention group), the need for hand washing before preparing or serving food (63.9% in intervention group). Mothers made some mistakes in the ORS preparation and administration (65.7% in intervention group), technique of hand washing (61% in intervention group), and wet sponge (54.3% in intervention group).

TABLE 1.

Demographic characteristics.

Characteristics Intervention group (n = 80) Control group (n = 80) Statistic test p‐value
n (%) Mean ± SD n (%) Mean ± SD
Gender of hospitalized children a
Male 42 (52.5) 38 (47.5)

χ 2 = 3.71

p = 0.083
Female 38 (47.5) 42 (52.5)
Age of hospitalized children (year) b 2.66 ± 1.20 3.18 ± 1.09

t = 2.03

p = 0.056
Birth order of hospitalized children
First 46 (57.5) 42 (52.5)

χ 2 = 0.59

p = 0.073
Second & more 34 (42.5) 38 (47.5)
Feeding of hospitalized children
Breast or formula milk 24 (30) 16 (20)

χ 2 = 3.71

p = 0.558
Complementary feeding 10 (12.5) 4 (5)
Regular diet 46 (57.5) 60 (75)
Age of mothers (year) b 30.03 ± 6.45 31.13 ± 6.08

t = 0.78

p = 0.435
Education level of mothers a
Under diploma 14 (17.5) 12 (15)

χ 2 = 2.01

p = 0.287
Diploma 24 (30) 30 (37.5)
BS 30 (37.5) 20 (25)
MS 12 (15) 18 (22.5)
Age of fathers (year) b 40.69 ± 7.88 39.71 ± 6.07

t = 0.98

p = 0.328
Education level of fathers a
Under diploma 14 (17.5) 8 (10)

χ 2 = 1.36

p = 0.151
Diploma 36 (45) 38 (47.5)
BS 24 (30) 24 (30)
MS 6 (7.5) 10 (12.5)
Social status
Urban 52 (65) 48 (60)

χ 2 = 0.21

p = 0.999
Rural 28 (35) 32 (40)
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Abbreviations: BS, Bachelor; MS, Masters; n, number; SD, standard deviation.

a

The results obtained from the chi‐2 test.

b

The results obtained from independent t‐test.

TABLE 2.

Clinical profile of acute gastroenteritis in hospitalized children in admission day.

Clinical profile Intervention group (n = 80) Control group (n = 80)
n (%) Mean ± SD n (%) Mean ± SD
Duration of diarrhoea at home (days) 5.58 ± 5.56 5.18 ± 5.42
Primary cause of hospitalization
Fever & diarrhoea 38 (47.5) 34 (42.5)
Vomiting & diarrhoea 42 (52.5) 46 (57.5)
Watery stool 62 (77.5) 60 (70)
Fever <38.5c 74 (92.5) 75 (93.75)
Vomiting 25 (42.5) 20 (25)
Abdominal pain 22 (27.5) 19 (23.75)
Frequency of defecation at home
<10/day 54 (67.5) 55 (68.75)
>10/day 26 (32.5) 25 (42.5)
Dehydration (WHO criteria)
Severe 20 (25) 18 (22.5)
Moderate 60 (75) 62 (77.5)
Others (at home)
Refusal to feed 56 (70) 58 (72.5)
Abdominal distension 24 (30) 22 (27.5)
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Abbreviations: c, centigrade; n, number; SD, standard deviation.

Based on the second purpose, comparison of pre‐ and post‐test findings within and between the intervention group and the control group was performed. In the intervention group, comparison of pre‐ and post‐test findings showed a significant increase in the mean scores of mothers' care practice (p < 0.01). After intervention, regarding the mean scores, the mean score in the third measurement, 5 days after the intervention, was higher than two other measurements (Table 3).

TABLE 3.

Comparison the mean scores of mothers' practice within each group.

Variables Pre‐test Post‐test Statistic test a
Day one after Day three after Day five after
Mean ± SD Mean ± SD Mean ± SD Mean ± SD
Intervention group 24.47 ± 7.91 58.01 ± 12.63 68.6 ± 6.54 78.91 ± 6.21

f = 248.39

df 1 = 3

df 2 = 237

p < 0.01*

Control group 25.08 ± 5.53 25.98 ± 6.78 24.83 ± 6.78 25.63 ± 3.88

f = 0.676

df 1 = 3

df 2 = 237

p = 0.569
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Abbreviation: SD, standard deviation.

a

The results obtained from analysis of variance with repeated measurement.

*

It is significant.

Comparison of findings between the two groups before the intervention did not show a statistical difference, but after the intervention indicated a significant difference in terms of the mean scores of mothers' care practice (p < 0.001) (Table 4).

TABLE 4.

Comparison the mean scores of mothers' practice between two groups.

Time Mean difference Std. error Statistic test b 95% confidence interval of the difference
Lower Upper
Pre‐test
Intervention group 0.61 2.38

t = 0.093

df = 158

p = 0.926

 0.43 8.93
Control group 4.25 2.35
Post‐test a
Intervention group 42.85 2.68

t = 5.33

df = 158

p < 0.001*

27.07 32.03
Control group 34.55 1.26
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Note: Std. error = standard error.

a

Based on mean and SD of care practice in three measurements.

b

The results obtained from independent t‐test.

*

It is significant.

4. DISCUSSION

Study findings suggested that the participation of mothers in the care of children with AGE could improve the mothers' knowledge and enhance skill in providing care for hospitalized children. The needs assessment revealed the amount of information and care practice of mothers to participate in caring for children with AGE. The intervention was adjusted based on individual needs assessment for each mother. Pre‐intervention, there was no statistical difference between the intervention and control groups. However, after the intervention, there was a significant increase in the mothers' care practice in the intervention group. Five days after the intervention, the mothers' care practice was higher than two other measurements at a 1‐day interval. Moreover, in the intervention group, pre‐ and post‐test measurements comparison showed a significant increase in the mothers' care practice. The most important findings of the needs assessment were mothers' knowledge and practice deficit about the feeding during AGE, the technique and times of hand washing, ORS preparation and administration, and wet sponge.

The results of the needs assessment were consistent with other studies. A study showed that 63.34 percent of mothers had little knowledge on ORS therapy (Divasha et al., 2020). The findings of another study indicated lack of competence of mothers in dealing with diarrhoea and diet management due to moderate level of knowledge and practice (Khalili et al., 2013). Workie et al. (2018) study showed that 58 percent of mothers had poor practice in home management and prevention of diarrhoea in children under 5 years of age (Workie et al., 2018). On the other hand, in a descriptive cross‐sectional study, about 59.2 percent of educated and employed mothers had good knowledge, and 53.1 percent had good practice in home management of diarrhoea in their children under 5 years old (Momoh et al., 2022). In another study, the knowledge score of participating mothers was high. Most mothers preferred to feed their children with banana during diarrhoea (92.5%) (Kaçan et al., 2022).

The comparison findings of present study were in line with previous studies. Empowering mothers increase their competence and participation in caring for their children (Aarthun et al., 2019) and improves their caring role (Valizadeh et al., 2012). The participation of mothers in caring and empowerment interventions can enhance the quality of care (Quast et al., 2016). A clinical trial study showed that the participation care approach reduced the mothers' anxiety during discharge time. The authors recommended that this method be used in the care of hospitalized children (Nouhi et al., 2014). Other study showed that health education intervention with personal discussion could improve mothers' knowledge and competence regarding the three rules of home management (increase in fluids, continuation of feeding, and receiving medical care) for their children under the age of five during episodes of diarrhoea (Haroun et al., 2010). A randomized controlled trial showed that a nurse‐guided clinical decision support system could increase standardized use of ORS (oral rehydration solution), without differences in other outcome measures in children with AGE (Geurts et al., 2017).

The participatory care approach is used to increase the competence and empowerment of mothers or parents in the management of children with other health problems or diseases. A quasi‐experimental study showed that the nurse‐parent interaction in the care of hospitalized chronically ill children could increase mothers' knowledge, competence in caring, and satisfaction with care at the hospital (Aein et al., 2012). An interventional study indicated an improvement in the participation of mothers of children with asthma in identifying problems and better asthma management. The authors recommended that the participation of parents in care management could reduce complications in controlling the diseases (Rajabi et al., 2016). In another interventional study, the empowerment training increased mothers' knowledge about symptoms and reduced gastrointestinal complications in children undergoing chemotherapy (Lashgari et al., 2021). The educational‐behavioural intervention improved mothers' knowledge and ability to care for their premature neonates and mother‐neonate interaction in hospitals and after discharge (Askary et al., 2020).

There were some limitations in the present study. This study was hospital‐based, participants mothers may have obtained information or practical training about AGE management from nurses or other sources. The limited‐time opportunity of the participants was another limitation due to the short hospitalization period of the children with AGE (5–7 days). Hence, theoretical and clinical training was done in 2 days. Another limitation was the short duration of the present study. Therefore, there was no follow‐up care at home and no record of readmissions due to AGE re‐infection or complications.

Specific recommendations arise from the study's findings. Regarding the effectiveness of the participatory care approach, a similar study is necessary to follow up and enhance the caregiving practice of mothers in managing AGE at home. The sample in this study was only the mothers, fathers or other caregivers needs to be considered in a future study. Further, more study is required to explore parents' knowledge about paediatric AGE management in the community and how this influences parents' participation in care. In addition, studies should be conducted to establish a systematic protocol for the parents of hospitalized children under their care and to confirm its effectiveness.

5. CONCLUSIONS

Based on the findings of this study, the participatory care approach was effective in improve mothers' knowledge and enhance caregiving skills and practice for the hospitalized children <5 years of age with AGE. Hence, paediatric nurses play a critical role in increasing the mothers' knowledge and should be facilitate the mothers' participation in providing care to hospitalized children with acute infection disorders, such as the AGE disease.

5.1. Relevance to clinical practice

Our findings provide evidence that the mothers' participation is a suitable approach to care for hospitalized children in paediatric settings. The present field study's strength is that it provided strategies to enhance the quality of paediatric nursing care for hospitalized children with AGE. The other strength is the individual educational‐practical intervention that is implemented based on the mothers' needs assessment. An important determinant of child health is the knowledge and practice of the child's mother, especially regarding infection disorders, such as the AGE disease. Participatory care provides an opportunity for nurses to supervise and correct misunderstandings and practical errors of mothers or other caregivers on caregiving practices in the hospital.

AUTHOR CONTRIBUTIONS

Tayebeh Hasan Tehrani participated in content analysis and in interpretation of the results. Haniyeh Nankali participated to design study, collected data. Younes Mohammadi analysed data, interpreted the results. Fatemeh Cheraghi drafted and revised the manuscript, participated in designed study, and interpreted the results. Mahnaz Azadi Moghtaderith supervised the data collection. All authors read and approved the final manuscript.

FUNDING INFORMATION

The authors received no financial support for the research, and publication of this article.

CONFLICT OF INTEREST STATEMENT

The authors declared no conflict of interest with respect to the research, authorship, and/or publication of this article.

CONSENT FOR PUBLICATION

The results were anonymously reported to comply with the ethical criteria. Therefore, we did not ask for an informed consent for publication from the participant parents. All authors have read the final version of the paper. All authors confirm the present paper. All authors had access to data and a role in writing and approving the submitted version.

ACKNOWLEDGEMENTS

We would like to thank the vice‐chancellor of education and the vice‐chancellor of research and technology at Hamadan University of Medical Sciences, Iran. We would express sincere appreciation to participated mothers who did not hesitate their own collaboration and the nurses of paediatric units for their support. The authors received no financial support or material support for the research, authorship, and publication of this article.

Nankali, H. , Cheraghi, F. , Tehrani, T. H. , Mohammadi, Y. , & Azadimoghtader, M. (2023). Mothers participation in caring for hospitalized children with acute gastroenteritis: A quasi‐experimental study. Nursing Open, 10, 6398–6407. 10.1002/nop2.1889

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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