The Effect of an Interactive Booklet on Hand Washing Performance in Children with Attention Deficit and Hyperactivity Disorder (ADHD)

Document Type : Original Article

Authors

1 Pediatric health Nursing, Mansoura University, Egypt

2 Community Health Nursing, Mansoura University, Egypt

3 Sports kinesiology, Damietta University, Egypt

4 Pediatric Health Nursing, Mansoura University, Egypt

Abstract

Background: Children with Attention Deficit and Hyperactivity Disorder (ADHD) often struggle to stay
focused, follow directions, and complete repetitive tasks, which can impede learning routine activities like hand
washing. These challenges underscore the need for tailored interactive educational interventions designed to meet
their unique needs. Therefore this study aimed to assess the effect of an interactive booklet on hand washing
performance in children with Attention Deficit and Hyperactivity Disorder (ADHD). Design: A quasi-experimental
repeated measure comparative design was used to conduct this study. Setting: The study was carried out
at an outpatient clinic affiliated with Mansoura University Children’s Hospital Dakahlia Governorate, Egypt.
Subjects: A purposive sample of 60 children with ADHD were recruited to participate in the study. Tools of data
collection: Three tools were developed, namely a structured interview schedule for socio-demographic
characteristics, a structured interview on children knowledge about hand hygiene, and an observational checklist
for hand washing. Results: The knowledge assessment displayed a significant improvement in the intervention
(booklet) group scores immediately and one month after the intervention (P-value <0.001). Similarly, the
performance assessment demonstrated a marked enhancement in the booklet group scores that was statistically
significant (P-value <0.001) at both immediate and follow-up post-tests with a highly effective size. Conclusion:
The intensive progress in hand washing knowledge and performance among children with ADHD was
demonstrated through the provision of hand washing interactive flipped education. Recommendation: Healthcare
professionals should adopt interactive educational modalities for hygiene training tailored to the cognitive and
behavioral characteristics of children with ADHD. 

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