The Effect of a Teaching Program on Knowledge and Behavior of Caregivers to Prevent Infection in Preschool-aged Children with Leukemia

Main Article Content

Penporn Yooyen
Wanida Sanasuttipun
Arunrat Srichantaranit


          Purpose: To examine the effects of a teaching program on knowledge and behavior of caregivers to prevent infection in preschool-aged children with leukemia.

          Design: A quasi-experimental design.

          Methods: The study sample was composed of caregivers of preschool-aged children with leukemia receiving chemotherapy and admitting in 4 tertiary public hospitals. The sample was divided into two groups: the experiment group (n = 16) receiving the infection prevention teaching program based on the learning theory of Gagné, Briggs and Wager, and the control group (n = 16) receiving routine nursing care. Data were collected using the caregiver’s knowledge and behavior questionnaires for infection prevention of children with leukemia. Descriptive statistics and ANCOVA were used for data analysis.

          Main findings: Caregivers in the experimental group had significantly higher knowledge score of infection prevention than those in the control group (F = 71.29, p < .05). In addition, caregivers in the experimental group also had significantly higher behavior score in infection prevention than those in the control group (F = 37.31, p < .05).

          Conclusion and recommendations: The infection prevention teaching program is effective in improving caregivers’ knowledge and behavior in infection prevention. This teaching program should be encouraged for routine use in nursing practice so that the preschool-aged children with leukemia will receive proper care at home and be secure from infection.

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How to Cite
Yooyen, P., Sanasuttipun, W., & Srichantaranit, A. (2019). The Effect of a Teaching Program on Knowledge and Behavior of Caregivers to Prevent Infection in Preschool-aged Children with Leukemia. Nursing Science Journal of Thailand, 37(4), 79–92. Retrieved from
Research Papers


1. Heron M. Deaths: leading causes for 2013. Natl Vital Stat Rep. 2016;65(2):1-95.

2. Imsamran W, Chaiwerawattana A, Wiangnon S, Pongnikorn D, Suwanrungrung K, Sangrajrang S, et al. Cancer in Thailand Vol. VIII, 2010-2012. Bangkok: New Thammada Press (Thailand); 2015. 178 p. (in Thai).

3. Tharnprisan P, Khiewyoo J, Sripraya, P, Wiangnon S, Relapse-free rate with childhood acute lymphoblastic leukemia treated under the Thai National Protocol. Asian Pac J Cancer Prev. 2013;14(2):1127-30. doi: 10.7314/apjcp.2013.14.2.1127.

4. Medication Records and Statistic Units, Chulalongkorn Hospital. Statistic of children with cancer in Department of Pediatric. Bangkok: Medication Record and Statistic Units, Chulalongkorn Hospital; 2016. 10 p. (in Thai).

5. Capo G, Waltzman R, Managing hematologic toxicities. J Support Oncol. 2004;(1):65-79.

6. Brandt B. Nursing protocol for the patient with neutropenia. Oncol Nurs Forum. 1990;17(1 Suppl):9-15.

7. de Naurois J, Novitzky-Basso I, Gill MJ, Marti FM, Cullen MH, Roila F, et al. Management of febrile neutropenia: ESMO clinical practice guidelines. Ann Oncol. 2010;21 Suppl 5:v252-6. doi: 10.1093/annonc/mdq196.

8. Supakitvivatkul P. Behaviors of school-age children with leukemia regarding prevention of infection disease and supporting of caregiver [master’s thesis]. Khon Kaen: Prince of Khon Kaen University; 2002. 98 p. (in Thai).

9. Siripoon P, Tangvoraphonkchal J. Effects of a supportive education program on care behavior of beginning to end stage leukemia school age children’s dependent care agents. Journal of Nursing Science and Health. 2014;37(2):48-56. (in Thai).

10. Paprom W, Tangworaphonkchai J. The effect of an oral mucositis care innovation on caregivers’ care behavior among pre-school children with leukemia receiving consolidation phase chemotherapy. Journal of Nursing Science and Health. 2014;37(1):21-9. (in Thai).

11. Jansong W, Chiyawat W. The effect of the nursing intervention based on Pender’s health promotion model on infection prevention behaviors in mothers of 1-5 year-old children with cancer undergoing chemotherapy. Thai Red Cross Nursing Journal. 2016;9(2):159-70. (in Thai).

12. Gagné RM, Briggs LJ, Wager WW. Principles of instructional design. 4th ed. Fort Worth, TX: Harcourt Brace Jovanovich College Publishers; 1988. 392 p.

13. Kanjana A. The effects of empowerment program on maternal caring behavior for children with leukemia undergoing chemotherapy [master’s thesis]. Bangkok: Mahidol University; 2006. 121 p. (in Thai).

14. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. 567 p.

15. Saeui W, Chintanadilok N, Sriussadaporn P, Sanasutipan W. The effects of an empowerment program on the competence of caregivers in caring for preschool children with acute leukemia undergoing chemotherapy. Journal of Nursing Science. 2009;27(2):8-17. (in Thai).

16. Sanpakit K, Phuakpet K, Vathana N. Self-care guide of pediatric patients receiving chemotherapy [handbook]. Bangkok: Roche Thailand; 2016. 10 p. (in Thai).

17. American Cancer Society. Cancer facts & figures 2017 [Internet]. Atlanta, GA: American Cancer Society; 2017 [cited 2017 Dec 30]. Available from:

18. Boonchuay N, Sanasuttipun W, Chintanadilok N, Sanpakit K. The effect of the educational program on knowledge and care behaviors of caregivers of children with thalassemia. Journal of Nursing Science. 2016;34(3):41-53. (in Thai).

19. Khamdee S. Effects of story-telling promoting program on story-telling behavior and program satisfaction in mothers of hospitalized pre-school children [master’s thesis]. Bangkok: Mahidol University; 2012. 128 p. (in Thai).

20. Songthip S. Srichantaranit A, Sanasuttipun W. The effects of supportive-educative nursing system program on knowledge and behaviors of mothers of children with acyanotic congenital heart disease aged 0-2 years. Thai Journal of Cardio-Thoracic Nursing. 2015;26(2):25-38. (in Thai).

21. Prachumchit M, Sanasuttipun W, Srichantaranit A. The effect of post-cardiac surgery medication teaching program on knowledge and behavior of caregivers of pediatric patients with congenital heart disease. Journal of Nursing Science. 2017;35(2):39-51. (in Thai).