~ 81 ~ International Journal of Research in Paediatric Nursing 2020; 2(2): 81-89 E-ISSN: 2664-1305 P-ISSN: 2664-1291 IJRPN 2020; 2(2): 81-89 http://www.paediatricnursing.net Received: 07-05-2020 Accepted: 10-06-2020 Hanaa Diab Khalafallha Cairo University, Faculty of Nursing, Ph.D. in Pediatric Nursing, Egypt Nesren Sayed Mohamed Bahnsawy (1). Cairo University, Faculty of Nursing, Ph.D. in Pediatric Nursing, Egypt (2) King Saud Bin Abdulaziz University for Health Sciences, KSA, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, College of Nursing, Pediatric Nursing, Riyadh, Saudi Arabia Corresponding Author: Hanaa Diab Khalafallha Cairo University, Faculty of Nursing, Ph.D. in Pediatric Nursing, Egypt Effect of nursing instructions for mothers on selected cast outcomes among their infants with congenital clubfoot Hanaa Diab Khalafallha and Nesren Sayed Mohamed Bahnsawy DOI: https://doi.org/10.33545/26641291.2020.v2.i2b.41 Abstract Congenital clubfoot is a complex deformity that is readily apparent at birth and affects the muscles, ligaments, bones and joints of the developing foot and ankle. Aim of the current study was to evaluate the effect of nursing instructions for mothers on selected cast outcomes among their infants having congenital clubfoot. In order to represent the current research, the design of quasi-experimental was implemented. The study was conducted in the orthopedic out-patient clinic in the Cairo University Specialized Pediatric Hospital (CUSPH). Purposive sample of 60 mothers of infants with clubfoot was participated in the current study; mothers and their children were split into two equal groups: 30 as a control group and 30 as a study group. The data was collected using the following tools: structured interview questionnaire, mother's knowledge and practices assessment questionnaire (pre/posttest), recording cast complications sheet and selected cast outcomes assessment sheet. The results revealed that, there were statistically significant differences between total mean score of mother's knowledge and practices in the study group after receiving the nursing instructions than mothers in the control group. Infants in the study group exposed to less cast complications and better outcomes than infants in the control group. The result concluded that, the mothers in the study group who received nursing instructions had a higher overall mean score of clubfoot knowledge and practices rather than a control group. As well as the infants of the mothers who received the nursing instructions there were fewer complications of casting and better outcomes. Keywords: Congenital clubfoot, mothers, infants, nursing instructions, cast complications and outcomes 1. Introduction Clubfoot is a common type of birth defect that affects muscles and bones in the feet. New born can be born with the defect in one or both feet. It is estimated that the prevalence of congenital clubfoot worldwide is 1 to 4.5 per 1,000 live births and a 2:1 ratio of male to female, with about 50 percent of cases being bilateral. Every year, there are about 200,000 children born with clubfoot globally, 80% of whom are in low- and middle-income countries [1] . The causes of clubfoot are still unknown but found factors that lead to clubfoot are environmental, genetic, abnormal position in the utero, and anatomical factors. This is twisting which causes the toes to point toward the opposite leg [2] . If it is left untreated clubfoot deformity causes pain, difficulty in walking and inability to wear normal shoes [3] . In infancy, the majority of club feet can be corrected in about six to eight weeks with proper gentle manipulations and casting [4] . The most common complications of cast in paediatric group are skin breakdown, pressure sores, discomfort or pain in the cast site, skin inflammation, swelling and joint stiffness. Additionally, risks associated with casting include loss of range of motion (ROM), muscle wasting and impaired circulation. Casts placed to treatment and encourage the mothers to assess cast daily to detect complications early and provide care for their infants at home [5] . The treatment is based on the critical interpretation of the functional anatomy of the feet in order to correct the position of the legs and gradually change the position of it through the manipulation and casting [6] . The most methods for clubfoot treatment are the Ponseti approach, which has been described as highly suitable for use in resource-limited environments [7] . The casting and Ponseti method had the greatest impact on the treatment of clubfoot, markedly reducing the need for extensive surgery [8] . The nurse roles are very crucial and it includes health teaching for the mothers to keep the cast clean and dry. Provide sponge bath, change diapers often to keep the clean cast. If the cast gets dirty, wipe it with a damp cloth. Check the circulation in foot every hour for the first 6–8 hours after a new cast