Journal of Global Public Health and Healthcare Innovation

(Annual (One issue per year))

ABSTRACT

Background

Children receiving chemotherapy are at increased risk of infection, and prevention depends not only on hospital-based care but also on caregivers’ ability to implement recommended practices at home. In Pakistan, evidence on infection-prevention practices among mothers of children receiving chemotherapy and the behavioural factors associated with these practices is limited.

Objectives

To assess infection-prevention practices among mothers caring for children receiving chemotherapy and to examine their associations with knowledge, attitude, and Health Belief Model (HBM) constructs.

Methods

We conducted a hospital-based, cross-sectional analytical study among mothers aged ≥ 18 years who were the primary caregivers of children aged 0–14 years receiving chemotherapy at the Department of Paediatric Oncology, Children’s Hospital, Pakistan Institute of Medical Sciences (PIMS) Islamabad, Pakistan. Mothers were consecutively recruited between May and December, 2025. Data were collected through face-to-face, interviewer-administered interviews using a standardised Urdu-language questionnaire. The primary outcome was a continuous self-reported infection-prevention practice score derived from 15 behaviour-based items and standardised to a 0–100 scale. Knowledge, attitude, and six HBM constructs were assessed using corresponding standardised scores on the same scale. Associations with infection-prevention practice scores were determined using univariable and multivariable linear regression, with continuous predictors expressed per 10-point increase in score. Effect estimates are reported as β coefficients with 95% CIs.

Results

A total of 86 mothers were included. The mean infection-prevention practice score was 53.6 (SD 18.7). Mean knowledge and attitude scores were 60.9 (18.2) and 56.8 (17.1), respectively. After adjustment, higher maternal educational attainment was associated with higher practice scores (β 1.54 [95% CI 0.18 to 2.90]; p=0.027), as were greater perceived benefits (β 0.96 [0.02 to 1.90]; p=0.046) and self-efficacy (β 1.22 [0.32 to 2.12]; p=0.01). Greater perceived barriers were associated with lower practice scores (β −1.02 [−1.91 to −0.13]; p=0.025). Knowledge, attitude, perceived susceptibility, perceived severity, and cues to action were not statistically associated with practice scores after adjustment.

Conclusion

In this single-centre cross-sectional study, mothers reported a mean infection-prevention practice score of 53.6 on a 0–100 scale. Higher educational attainment, greater perceived benefits, and higher self-efficacy were associated with higher reported practice, whereas greater perceived barriers were associated with lower practice. These findings suggest that caregiver-centred infection-prevention strategies should extend beyond information provision to address practical barriers and strengthen caregivers’ confidence in implementing recommended behaviours.

Keywords: Paediatric Oncology; Childhood Cancer; Infection Prevention; Caregivers; Mothers; Health Belief Model; Self-Efficacy; Supportive Care; Pakistan