Abstract:Technology is required to design learning experiences that increase educational quality and prepare graduates for complex nursing practice at diverse health care settings, which stimulate learning outcomes, and improve student satisfaction.  Aim of the study:to explore the effect of Web 2.0 tools application on nursing administration students' self-directed learning. Methods:  An experimental research design was conducted by all nursing administration students (N = 120), enrolled in the 4^th year – first term, at the Faculty of Nursing – Damanhour University, Egypt. Tools: three tools: Students’ Web 2.0 tools Acceptance and Assimilation Questionnaire; Self-rating Scale of Self-directed learning (SRSSDL); Students’ Satisfaction Questionnaire; and students’ demographic data.  It proved valid and reliable to measure study variables.  Results:  The present study revealed that highly significant differences were found between experimental and control nursing administration students' groups for both total Web 2.0 tools acceptance and assimilation and all its factors and for total self-directed learning and all its domains, after web 2.0 tools application. Additionally, highly significant differences were found between experimental nursing administration students' groups, at pre- and post-Web 2.0 tools application for both total Web 2.0 tools acceptance and assimilation and all its factors and for total self-directed learning and all its domains. Conclusion:  it was concluded that positive effect on nursing administration students' self-directed learning was assumed after Web 2.0 tools application, at Faculty of Nursing – Damanhour University.  Recommendations:Hands-on training about using web tools, develop institutional policies and guidelines on Web 2.0 technologies uses, redesign learning experiences, and inclusion of Web 2.0 tools technologies for nursing curriculum.
Keywords:Nursing Administration, Web 2.0 tools, Self-directed learning.

Abstract:Urinary incontinence is a complex and serious condition that can affect menopausal women. It is not only a serious medical condition but also an undeniable psychosocial problem and it has a severe impact on a woman's quality of life. Aim of the study: was to determine the effect of kegel's exercise on severity of urinary incontinence and quality of life among menopausal women. Research design: A quasi experimental research design with a pretest-posttest control group was utilized. Settings: The study was conducted at obstetric and gynecological outpatient clinic and Urological outpatient clinic at National Medical Institution in Damanhour, Albehera Governorate. Subjects: A purposive sample of 80 menopausal women with urinary incontinence was selected according to eligibility criteria. They were divided into two equal groups 40 (study group and control group). Tools of data collection: Four tools were used for data collection namely:A structured interview schedule, the PRAFAB- Questionnaire scale, Brink digital pelvic muscle scale and the king’s health questionnaire. Results: the study results revealed that there was a statistically significant difference between the study and control groups in favor of the former in relation to severity of urinary incontinence, pelvic floor muscle strength and quality of Life after twelve weeks of intervention where P = .000. Conclusion: The study concluded that Kegel's exercise has significant positive effect on strengthens pelvic floor muscle, reducing severity of UI and significantly improves the quality of life of menopausal women with urinary incontinence.
Keywords:Kegel's exercise, Menopausal women, Quality of life, Urinary incontinence.

Abstract:Vaginal candidiasis is a very common condition that affects about 75% of females at least once in their lifetime, among whom approximately 40-50% will experience further episodes (1). Aim: The aim of this study was assess self-care practice & awareness regarding vaginal candidiasis among female nursing students at King AbdulAziz University. Study Design: Descriptive design was conducted on female nursing students. Setting: The study was carried out in the female nursing students at faculty of nursing at King Abdul-Aziz University. Sample: A convenient sample of nursing students .The inclusion criteria for this study will include all students enrolled in the faculty of nursing “214 nursing students” will selected during a period of one month. Tools: A self-administered questionnaire sheet was developed by the researcher to collect data including socio-demographic characteristics of student, students' total knowledge about vaginal candidiasis and students' stated health practices regarding prevention of vaginal candidiasis Result: Based on the present study results, the mean ages of students were 20.1±0.5 years. In addition, more than two thirds (66.8%) of the students have poor knowledge regarding the prevention of vaginal candidiasis, and   more than one quarter (29.9%) of them have good knowledge. Conclusion: There is a significant association between the students’ age, grade, mother’s education and family monthly income and the numbers of change sanitary pad during menses per day and their daily hygienic practices of genitalia, drying of under wear and their number of times. Recommendation: This study recommended that organized and implemented a health education program by specialized academic nursing staff to educate student nurses as regards all updates of reproductive tract infections and its preventive measures.
Keywords:Vaginal Candidiasis, Self-care practice, Prevention, Hygienic care.

Abstract:Functional dyspepsia (FD) is a chronic disorder in the upper digestive tract. FD is distressing and affects the quality of life. There are many treatment options available; therapeutic nutrition is one of these treatments. Nurses play a significant role in understanding the importance of nutrition basics and explaining the facts about healthy food choices to patients and expected to deliver healthy diet education to ensure that patients ' nutritional needs are met. Aim: This study aimed to investigate the effect of a therapeutic nutritional educational program on clinical outcomes among patients with functional dyspepsia. Methodology: A quasi-experimental research design was used. The study was carried out at the gastrointestinal outpatient clinic at Alexandria Main University Hospital. A convenient sample of forty patients was included from the previously mentioned setting. Data of the study was collected using three tools named; Tool I: Socio-demographic and clinical data of patients with functional dyspepsia. Tool II: Dietary history and dietary intake; and Tool III: Physical symptoms of functional dyspepsia. Results: Patients with functional dyspepsia who followed the nutritional educational program showed significant decrease in the severity of dyspepsia symptoms. Conclusion: The study results revealed that the clinical outcomes have been improved after the application of the therapeutic nutritional educational program. Recommendation: A Nutritional educational program should be implemented to a larger population and from different settings.
Keywords:functional dyspepsia, nutritional educational program, clinical outcomes.

Abstract:Polycystic ovary syndrome (PCOS) is areproductive age endocrine problems in females. The PCOS prevalence is increasing widely rapid but the women haven’t  sufficient knowledge.Aim: todetermine polycystic ovary syndrome knowledge &awareness of female non medical undergraduate students  by using a descriptive design the study conducted at non medical faculties in portsaid city on a total of 1000 girl. Data collection by, structured interviewed questionnaire Results findings indicated that The level of awareness of PCOS among non medical famle students was 3.7% which was agood knowledge, on the other hand ,52.4% of females do not have prior knowledge about PCOS .44.9%, 40.2%, 11.4%, and 2% have known about PCOS via internet, family &friends, medical team, and general information respectively anf finally 1.5% via the past history,there were highly statisatically significant correlation bettween total PCOS Knowledge and age ,faculty ,shool years,and family history p value less than .001 .Conclusion:The current study indicated that, level of knowledge and awearness of PCOS of non medical famle students was poor Recommendation: Polycystic ovary syndrome is vital health concern its assessment is needed to  be a part of  care monitoring and improvement courses .
Keywords:knowledge &awareness , Polycystic ovarian syndrome.

Abstract:Radiotherapy plays an important role in the management of lung cancer, with over 50% of all lung cancer patients receiving this modality at some point during their treatment. In the radical setting, the ultimate aim of radiotherapy is to achieve local tumor control while limiting damage to the surrounding normal tissue nursing teaching program play a critical role in reducing acute radiotherapy side effects. Objective: Determine the impact of nursing teaching program on reducing acute radiotherapy side effects among lung cancer patients. Setting: The study was conducted at in the Radiotherapy Unit at Ayadi Almostakble Charity Hospital at Alexandria and the affiliated out patients clinics. Subjects: A convenience sample of 70 patients determined to have lung cancer and scheduled for radiotherapy. They were sequentially divided into 2 equal groups; the first was the control groups which comprised 35 patients and exposed to routine hospital care only, the second was the study group and comprised 35 patients and they received the nursing teaching program. Tools: Three tools were usedTool I: Socio-demographic and clinical data., Tool II: Lung cancer patient’s knowledge structured interview schedule,Tool III: Assessment of radiotherapy side effects and patients self -care structured interview schedule,Results:The study result revealed that all (100%) of control group patients had poor knowledge pre and post self- care practice guidelines application, however the study group patients showed marked improvement in their knowledge within the study group with significant difference ( χ2= 18.720,P = 0.000*).Furthermore, it was observed that there was significant difference between control and study group patients pre and 2,3 weeks post self- care practice guidelines application ( χ2= 5.384, P = 0.020*, χ2=28.571, P = 0.000*, χ2=13.732, P = 0.000*) respectively. patient total score of self-care practice, it was found that all control group (100%) had poor self- care practice preprogram, while the vast majority (91.5%) of them had poor self-care practice post 2, 3 weeks of program application.  However, all study group (100%) had  poor self- care practice preprogram, while the majority (71.4%)of them had faire self- care practice 2 weeks post program application, compared to the vast majority of them (57.1%) of them had good self-care practice 3 weeks post program application. The difference was highly statistically significant within the study group patients (P= 0.000*), and between control and study group patients 2 and 3 weeks post self- care practice guidelines application (P= 0.000*, p=0.000*,) respectively. Conclusion: applying the nursing teaching program had statistically significant improvement of patients’ knowledge, self-care practice of acute radiotherapy side effects. Recommendations: In service training program should be carried out for nurses working in oncology department, especially radiation therapy department about acute radiotherapy side effects and self-care practice guidelines.  
Keywords:Self-Care Practice Guidelines Program, Acute Radiotherapy Side Effects, Lung Cancer.

Abstract:Egypt has the highest prevalence of hepatitis C worldwide and the incidence of HBV infection is rising steadily. All efforts should be exerted to decrease their incidence especially among youth who are the productive workforce. Aim; assess and raise knowledge and practices regarding hepatitis B/C infection risk and means of preventionamongUniversity students.Subjects and method; a quasi-experimental research design was used among 300 Egyptian students from three different non-medical colleges with 100 students representing each college at Minia University. Two tools were used; demographic data & hepatitis history questionnaire and predesigned self-administered questionnaires, then condensed interventional lecture is given to them and therefore reassessment is done for 2nd tool. Results; three hundred students were included & majority of them were females, live in urban area (92.7% & 92% respectively with mean age (20.4 ± 0.93 Yrs.). There is significant increase in students' knowledge about HCV/HBV causes, modes of transmission, complications, prevention & treatment post intervention (p= 0.000). Positive correlation was found between study participants' knowledge and practice. Conclusion; definite increase in participants' knowledge with correction of some misconception and practice about HCV/HBV infection risk and means of prevention are found post intervention. Recommendations; There is an urgent need for beginning nationwide programs to raise the Egyptian knowledge & practice about HBV and HCV infection risk and means of prevention. As young people are the cornerstone of production so, raising their awareness about hepatitis B/C infection risk and means of prevention is helping to achieve a future free from these deadly diseases.
Keywords:hepatitis B/C infection risk, hepatitis C/B means of prevention, university students, non-medical colleges.

Abstract:An appropriate and effective nurse-patient communication is of the most important aspect of caring for patient connected to mechanical ventilation. Aim: To assess Relationship Between Communication Difficulties and Psychological Distress among Mechanically Ventilated Patients. Research design: A descriptive correlational design was utilized in this study. Subjects A purposive sample consisting of 66 adults male and female patients recently extubated from mechanical ventilation sample size(66) patients. Tools: Data were obtained through three main tools; Socio-demographic sheet, Communication difficulties Scale sheet, and Depression, Anxiety, and Stress scale (DASS) Results: The majority of the recently extubated patient rated extremely severe anxiety during being ventilated, half of studied sample rated moderate stress, about half of them rated severe depression as a result of presence of communication barrier. This study delineated that more than half of the study sample rated that their communication during being ventilated about physical needs, applied care, asking about health status, and communication with family member as moderate to extremely. There was a statistically significant relation between communication difficulty with depression, anxiety, and stress. Recommendations: Reinforce role of nurse to use augmented alternative communication methods with mechanically ventilated patients.
Keywords:Communication difficulties- - DASS-mechanically ventilated psychological distress.

Abstract:Chemotherapy extravasation remains an accidental complication of chemotherapy administration and may result in serious damage to patients. Since patients are the first to feel any symptoms of possible extravasation and are relied upon to report them, their education is a crucial step in chemotherapy extravasation prevention and treatment. Aim: This study aimed to evaluate the impact of implementing interventional guidelines on eliminating extravasation events for patients receiving chemotherapy. Design:  Quasi experimental research design was utilized. Setting: The study was conducted at the inpatient and out-patient departments at Oncology Hospital at Mansoura University Hospitals. Subjects: A purposive sample of (60) patients receiving chemotherapy was randomly divided into two groups with equal size (control and study). Tools: Three tools were used to collect the data and achieve the aim of the study as follows: Tool I: Structured Interview Questionnaire. Tool II: Factors contributing to venous extravasation questionnaire. Tool III: Extravasation assessment questionnaire. Results: There was an inverse relationship between patients’ knowledge and the occurrence of extravasation, this was reflected in the fact that when patients' information increased, the extravasation occurrence in the study group was decreased at r = -0.468 and P 0.009, than that occur in the control group at r = 0.205 and P 0.276. Conclusion: The study concluded that; there were a numerous factors that can eliminates extravasation occurrence, which include improving patients' knowledge, appropriate; venous assessment, cannula size, cannula site, and efficient cannula secure, that can reduce the rate of extravasation. Recommendation: The current study recommended that Standardized teaching guidelines should be applied in Arabic, updated, colored booklet and be available at inpatients and outpatient for patients undergoing chemotherapy in order to help eliminating extravasation occurrence.
Keywords:Chemotherapy, extravasation, and intervention.

Abstract:Empathy and attitudes have been found to influence the quality of care provided by gerontological nurses to elders. In this respect, nurses need to be well prepared to meet the needs of the growing population of the elders, as they may not have personally experienced aging –related challenges, such as disability and disease. Objective: To determine the effect of aging simulation activities on gerontological nursing students' empathy, attitudes and willingness to work with elders. Setting: The study was conducted in the Gerontological Nursing Department, Faculty of Nursing, Mattrouh University, Egypt. Subjects: all the fourth year nursing students at Faculty of Nursing – Matrouh University, who registered in the Gerontological nursing course at the eight semesters during the academic year 2018-2019. They comprised 29 students. Tools: Six tools were used for data collection:  Nursing students`socio-demographic and emotional experience structured interview schedule, Jefferson Scale of Empathy- Health Professions Students (JSE-HPS), Kiersma- Chen Empathy Scale (KCES), Modified Willingness to care for the Elderly Scale, The older person questionnaire (OPQ), and Intent to work with the elderly scale. Results: statistically significant differences were observed between the mean score obtained by students before and after the program implementation as regard to empathy, attitudes of students and their willingness to work with elders. Conclusion: Incorporating aging simulation activities into the clinical gerontological nursing education is an advantageous educational strategy to develop empathy in nursing students, improve their attitudes and willingness to work with older adults. Recommendations: Integrating the aging simulation activities into the gerontological nursing curriculum will enhance students `understanding of the challenges that older adults face and improve future interaction and the quality of nursing care provided.
Keywords:Attitudes; aging simulation; empathy; elders; gerontological nursing students; willingness to work.

Abstract:Instructional guideline should be practiced by female patients undergoing  mastectomy to promote healing process of surgical wound, reduce potential complications, and obtain optimal level of independency to practice activities of daily livingAim: The current study aimed to assess effect of instructional guideline on biopsychosocial functional status of patients undergoing mastectomy through the following: 1) Assessing patients’ knowledge regarding mastectomy & its instructional guideline  2) Assessing patients’ bio-psychosocial functioning including physical, psychological, social and spiritual status.3) Developing, implementing and evaluating instructional guideline on bio-psychosocial functional status of patients undergoing mastectomy. Design: Quasi experimental design was used to achieve the aim of the current study. Setting: The study was conducted at breast surgery department in Emergency hospital and breast surgery outpatient clinics affiliated to Ain Shams University hospitals.Subject: A purposive sample of 60 patients undergoing mastectomy was selected to conduct this study. Tools: 1) Patients` structured interviewing questionnaire2) Biopsychosocial functioning status assessment tool. Results: the results of present study revealed that there are statistically significant improvement in total level of patients’ knowledge post instructional guideline with (t= 3.6 and p value =0.001*). In addition to, statistical significant differences were found among patients included in the study post instructional guideline comparing to pre instructional guideline regarding their physical, social, psychological and spiritual status functioning with (P value = 0.000**). Conclusion: Instructional guideline had positive effect on biopsychosocial functional status of patients undergoing mastectomy.Recommendations: The importance of conducting educational program including patients undergoing mastectomy that should be up-dated periodically in order to enhance health outcomes for these patients.
Keywords:biopsychosocial functional status, instructional guidelines, mastectomy.

Abstract:Thermal imbalances are very common during surgery. Hypothermia exposes the patient to post-operative shivering, cardiac dysfunction, coagulopathy, bleeding, wound infection, delayed anesthesia recovery, prolonged hospital stay and increased hospitalization cost.Aim:  The aim of this study was two folds: first to assess the predictors of intra-operative hypothermia (IH) second to estimate it's incidence among patients undergoing major abdominal surgeries.Design: Descriptive/predictive research design was used. Setting: This study was conducted in general surgery operating rooms, at Kaser EL-Aini Hospital-affiliated to Cairo University Hospitals.Subjects: A convenient sample of 100 adult male and female patients who had undergone major abdominal surgeries. Tools: Three tools were utilized to gather data(a) Demographic data tool,(b) Predictors of intra-operative hypothermia assessment tool and (c) Intra-operative hypothermia severity measuring tool. Results:  the findings of this study revealed that the mean age and SD of the studied sample were (42.3 ± 7.15) years.  Most common predictors of IH among the studied sample were preoperative fasting time, duration of anesthesia, operating room temperature, intra-operative blood loss, type of operation & pre operative temperature as indicated by linear regression analysis. Conclusion: The current study concluded that prolonging preoperative fasting time, duration of anesthesia, decreased preoperative patient's temperature, operation room temperature and increase intra-operative blood loss were the predominant predictors for the  occurrences of (IH).Recommendation: Replication of the study on larger probability sample selected from different geographical areas in Egypt is recommended to obtain more generalizable data
Keywords:predictors - intraoperative hypothermia –-abdominal surgery.

Abstract:Regular eye examinations help in early detection and enhance timely treatment for diabetic retinopathy (DR). Theaim of the present study: Was to identify determinants delaying the early detection of diabetic retinopathy. Design: Descriptive exploratory design was utilized. Setting: The study was conducted in ophthalmology outpatient clinic at Sohag University Hospital.Sample: Convenient sample of 120 adult male and female patients diagnosed with diabetic retinopathy was included as a study sample.Data collection tools: Two tools were used in data collection, the first tool: Structured Interview Questionnaire for demographic and medical data and the second tool: questionnaire for determinants delaying the early detection of diabetic retinopathy. Results: The main findings revealed that lack of patients' knowledge; the financial cost and hospital services were the most prominent determinants delaying early detection of diabetic retinopathy. Conclusion: Determinants delaying the early detection of diabetic retinopathy are lack of knowledge, financial factors and hospital services determinants. Recommendations: Increasing patients' awareness about diabetes complications also regarding importance of regular eye checkup through the different mass media as well as apply developed program in the study setting.
Keywords:Determinants, Delaying, Detection, Diabetic retinopathy, Nursing instructions.

Abstract:Cervical cancer is a preventable disease, it is still a major public health burden in many developing countries. Cervical cancer vaccines provide protection against persistent cervical infections. Theaim of this study was to assess knowledge and attitude of first year female students in Tanta medical campus regarding cervical cancer and its vaccine. This study followed a descriptive cross section design. The study was carried out atthe Medical Campus, Tanta University, which includedFaculties of (Nursing, Medicine, Pharmacy,Dentistry and Science). The subjectsincluded675 femalestudents from the above mentioned setting. Tools of data collections; Two tools were used to collect data of the study.Tool I: Structured interview sheet it included, socio-demographic data and knowledge of female students regarding cervical cancer and its vaccine. Tool II: it included, assessment of female students attitude regarding cervical cancer and its vaccine. Results The main results of this study revealed that, the majority (81.5 %) of the studied female students had poor knowledge, also (53.2%) of them studied had negative attitude. Positive correlation between total scores levels of knowledge and attitude of the studied female students at first year in Medical Campus of Tanta University regarding cervical cancer and its vaccine.Conclusion; The present study concluded that there was  poor level of knowledge and negative attitude about cervical cancer and its vaccine among studied female students The study recommended that there is urgent need for establishment of basic cancer education program for university female students to increase their knowledge and change their attitude regarding cervical cancer and its vaccine as well as provide students with the necessary information and health measures needed for protection and early detection of  cervical cancer.
Keywords:  Cervical cancer, Cervical cancer vaccines, Female students, Medical Campus.

Abstract: Negative pressure wound therapy has been very beneficial in the wound care of many different kinds of wounds ranged from pressure ulcers to open fractures.
Aim: The aim of the study was to investigate effect of intervention training module on surgical nurses' knowledge and practical skills regarding wound vacuum assisted closure therapy. Methods: Aquasi experimental study with one group pre/post-test was used design was used in this study. Setting: surgical unit, surgical ICU units in both of King Fahd hospital, Albaha city, KSA; and Damanhour National Medical Institution, Beheria Governorate, Egypt. Subject:  A sample of 140 nurses were selected from the participating hospitals. Tools: Tool I: A Structured Interviewing assessment questionnaire regarding knowledge of wound VAC therapy: It is consisted of two sections:   section 1: Nurses’ demographic data sheet: and section 2: Questionnaire to assess nurses’ knowledge regarding wound VAC therapy. Tool II: An observational performance checklist regarding VAC therapy: was used for the practical part of the module to assess nurses' performance. Results: the current study revealed that, most samples had nursing diploma. There were significant statistical differences were found between mean total knowledge score of studied sample pre-and post the educational module. Significant statistical differences were found in mean practice scores in post than pre-the educational module. There was a strong positive correlation was found among age, experience, knowledge and practice for studied nurses. Moreover, Saudi nurses were having a higher mean total and subtotal Knowledge and Practice Scores than Egyptian nurses. Conclusion: Nurses' performance toward VAC was improved after application of a training program on VAC. Recommendations: Constructing continuing educational nursing programs and centers in all hospitals which responsible updating and upgrading nurses' knowledge and practice; workshops which emphasizing on the evidence-based practices about new trends regarding wound care technologies within the hospitals, as well as emerging these new trends in novice graduated nurses, the nursing education department in hospital should follow up this educational programme implementation in all hospital surgical unities.
Abbreviations: Vacuum Assisted Closure Therapy, VAC; Surgical Nursing, SN; AbdulAziz University Hospital, KAUH; Negative-pressure wound therapy, NPWT; Centers for Medicare and Medicaid Services (CMS), surgical intensive care unit (SICU)
Keywords:Negative pressure wound therapy, Vacuum Assisted Closure Therapy, Surgical Nursing, Intervention Training Module; Knowledge and Practical Skills.

Abstract:Osteoporosishas been a common health issue among Saudi women especially in the post menopause. It is a diseases that is characterized by bone fragility and decrease in bone mass  Investigation of nurses knowledge and awareness, and perception of osteoporosis among Saudi students is crucial not only to expand their knowledge about patient care but to enhance self-care behavior among them. Aim: The current study is aimed to evaluate health belief, self-efficacy, perceived risk factors, and awareness regarding osteoporosis, among female nursing students in faculty of applied medical sciences, Albaha University. Methods: This study is a descriptive study. The data was collected via a web based questionnaires using a Google Form, it composed of 54 questions. Overall knowledge score was calculated by summing up scores gained by correctly answering each of the knowledge and awareness questions. As well as Osteoporosis Self-Efficacy Scale which composed of 12 questions which contains two subscales: calcium and exercise. By simple random sampling, 93 female nursing students were selected. The questionnaires link were sending to all students who were enrolled in nursing program where every student has an equal chance of getting selected to be the part sample. The collected data were processed and analyzed by statistical package of social sciences (SPSS version 22)
Results:according to the study results, among 93 female nursing students, the age ranged between 18 and 23 years. Analysis showed that (71.0%) students of students had a poor awareness of osteoporosis, whereas (23.7%) of students had a moderate one, whereas only (5.4%) of students had a proper awareness of osteoporosis with mean score of (12.67+0.63).  There is a highly significant correlation between Students' awareness and their level of education and their age while there is no significant with their perceived risk factors. 
Conclusions:
Students showed limited knowledge and self-efficacy regarding osteoporosis .this finding raises a red flag about nursing  education  and inform decision makers about the need to mandate educational and self efficacy improvement program in the undergraduate stage . Further assessment and efforts should be undertaken for improving the curricula to increase awareness among these students
Keywords:Health belief, Self-Efficacy, Awareness Regarding Osteoporosis, Female Nursing Students.

Abstract:Leader member exchange is the quality of the exchange relationship between supervisors and their employees of an organization. It has a great effect for employees and organization itself. Aim: This study aimed to investigate the relationship between leader member exchange and intention to quit among staff nurses. Design: A descriptive, correlational design was used. Setting: This study was conducted at Ain Shams University Hospital. Subjects: 170 staff nurses were included in the study. Tools of data collection: Two tools used namely Leader Member Exchange Questionnaire and Staying or Leaving Index. Results: More than two thirds of staff nurses had moderate perception level regarding leader member exchange, while less than one quarter of staff nurses had high intention to quit their jobs. Conclusion: There was statistical significant negative correlation between leader member exchange and intention to quit among staff nurses. Recommendations: Hospital managers have to establish staff retention strategies to minimize intention to quit. Supervisors have to develop respectful, friendship relation with their staff.
Keywords:Intention to quit, Leader member exchange, Staff nurses.

Abstract:Breastfeeding is considered a natural process for infant feeding involving two main methods; which exclusive and partial with the latter being trendiest. Nevertheless, exclusivity is considered the absolute and suitable scheme with finest domino effect. However, is lead to a good mental, emotional and physical collaboration between the mother and her newborn for desired outcome The study aimed to t determine primigravida mother’s knowledge, attitude and practice towards exclusive breast feeding who attended antenatal outpatient clinic at Assuit maternal health University Hospital-Egypt. Design: A quantitative and descriptive design was carried out in the study. Sample: - included 216 primigravida mothers were recruited into this study. Tools: A structured interview questionnaire was utilized for collecting the data. Results: A total of 216 of primigravida mothers were included in the study with a response rate of 100%. The majority of them were in the age groups of 23–27 (57.0%). Concerning the knowledge score, (60.0%) of primigravida mothers were grouped to having good knowledge and regarding attitudinal score, (22%) of the studied primigravida mothers were categorized to having negative attitude towards exclusive breast feeding (EBF) and the remaining (78%) were categorized as having positive attitude. Conclusion: knowledge with recommended duration of mothers showed that they had poor knowledge as regard initiation of breastfeeding and administration of colostrum. Also, there was a positive attitude about exclusive breastfeeding among mothers, frequency of feeding and social aspects of breastfeeding. Recommendations: The study is cleared necessitates revamping the importance of ante-natal mother education about breastfeeding practices and follow-up of mothers towards initiation of breastfeeding early in the first half an hour of postnatal period.
Keywords:knowledge, attitude, practice, primigravida mothers, exclusive breast feeding.

Abstract:Background: Neuropathic pain is complex symptom to cope with; it has strong impact on patient life. Its treatment needs combining pharmacological and nonpharmacologic therapies. Aim: Was to evaluate the effect of using aromatherapy massage on neuropathic pain among patients with type II diabetes mellitus. Hypotheses; H1: The study group who will receive aromatherapy massage will have less neuropathic pain component mean scores than control group who receive only conventional treatment among type II diabetic patients. H2: The study group who will receive aromatherapy massage will have less neuropathic pain quality mean scores than control group who receive only conventional treatment among type II diabetic patients. Setting: Was conducted at the medical inpatient wards and the outpatient clinic of Diabetes and Endocrine disorders at Kasr EL-Aini Hospital-Cairo University Hospital. Sample: Convenient sample of 60 diabetic patients over consecutive six months. Design: Quasi experimental design simple interrupted time series pre-post-test nonequivalent control group design. Tools: Demographic and medical data form, Douleur Neuropathique Questionnaire, Pain DETECT questionnaire and Neuropathic Pain Questionnaire. Results: The study found that 30 % of both study and control group their age was 60≤70 with mean of age (51.3 ± 11.3) and (55.7 ± 7.9) years respectively.  Among study group: There was marked reduction in neuropathic pain components and qualities mean scores after 2nd and 4th weeks of the intervention. Conclusion: Aromatherapy massage is an effective nursing intervention to reduce neuropathic pain among type II diabetic patients. Recommendation: Aromatherapy massage should be included in the nursing management plan among diabetic patients.
Keywords:Aromatherapy, diabetes mellitus, massage, neuropathic pain.

Abstract:Background: Venous leg ulcer (VLU) is the most severe and incapacitating outcome of chronic venous insufficiency in the lower limbs and accounts for 80 percent worldwide. It is a slow-healing wound. So, the nurse plays a crucial role in providing effective instructions and measures to improve patient’s knowledge and enhance leg ulcer healing. Aim: the aim of the current study was to evaluate the effect of nursing instructions on patient’s knowledge and VLU healing. Research hypothesis: H1: VLUs patients who receive nursing instructions will have high knowledge mean score compared to those who receive hospital routine care. H2: VLUs patients who receive nursing instructions will exhibit high wound healing mean score compared to those who receive hospital routine care. Design: A quasi-experimental design (Comparison group pre/posttest design) was utilized. Setting: This study was conducted in Vascular Disease Outpatient Clinic and Inpatient ward, at Kaser EL-Aini Hospital-affiliated to Cairo University Hospital. Subjects: A convenient sample of 60 adult male and female patients with confirmed diagnosis of VLUs were enrolled in the current study and divided into study and control group 30/ each. Tools: Three tools  were utilized to gather data (1) Demographic and medical data form, (2) Patient’s knowledge assessment tool of VLUs management and (3) Bates-Jensen Wound Assessment tool. Results: The study findings revealed that the mean age of the study and control group were (44.5±10.1) and (44.0±9.3) years respectively. Also 50 % and 23.3% of study and control group had venous leg ulcer from 1 < 3 months respectively in addition, 33.3% and 50% of study and control group their BMI over 30 kg/m² respectively. All patients of the study group had satisfactory level of knowledge ≥75% at the 2nd and 4th weeks after nursing instructions. Concerning leg ulcer healing (83.3%) of study group had minimum wound regeneration while (53.4%) of the control groups had moderate wound regeneration at the 4thweeks. Besides, there was a positive correlation between total knowledge score and healing of VLUs of the study sample r=.0.9 at p= 0.0001. Conclusion: The current study concluded that effective nursing instructions is very important in improving patient’s knowledge regarding VLUs management and enhance wound healing. Recommendation: Illustrative booklet related to VLUs healing measures should be available to well-known by all heath team members mainly nurses as well patients to enhance quality of self-care. Continuing education must be provided for nurses working in such area of specialty.
Keywords:venous leg ulcer -patient’s knowledge- ulcer healing- nursing instructions.

Abstract:Non-steroidal anti-inflammatory drugs (NSAIDs) a class of drug that prescribed extensively throughout the world to relieve or reduce pain, and their safety profile became of increased concern for a number of years, they have been shown to be associated with increased risk of cardiovascular events and gastrointestinal bleeding, therefore, in 2015, the FDA strengthened the warnings regarding cardiovascular risk with non-aspirin NSAID use based on data collected over the last 10 years.
Aim:
The study is aimed to:

• 
  Study the prevalence of NSAID consumption by Almoosa Specialist Hospital patients and evaluate their awareness about their adverse effects and precautions.
• Identify physician’s major barriers to choose NSAIDs wisely, and accordingly suggest developing a structured evident based pathway to properly prescribe them, and to reduce the demand of risky ones in patients with potential factors to develop adverse events.
• Assess the impact of choosing NSAIDs wisely on patient safety in healthcare setting

Methods:
Cross-sectional survey was distributed to a random sample of adult patients ranging from 35 – 65 years old to assess their knowledge about NSAIDs, and a retrospective, before and after study was conducted to evaluate prescribing pattern of NSAIDs and their related adverse events. Physicians received educations on a standardized evident based pathway to properly prescribe NSAIDs.  Prescriptions were collected and analyzed during April to June in 2019 (pre-intervention) and during the July to august in 2019 (post-intervention). The intervention required adherence to the agreed pathway for prescribing. Compliance to that pathway was measured and compared between pre- and post-intervention periods.
Results:
The standardized evident based pathway intervention was associated with a decrease in the proportion of Diclofenac prescriptions (Risky NSAIDs) by 20%, (P= 0.0001). The proportion of Naproxen prescriptions (safe NSAIDs) increased by 500%, (P= 0.35). Admissions due to Kidney related adverse event and gastrointestinal adverse events was decrease from 941 to 593 (37%) and from 1022 to 751 (26.5%), respectively. The result was significant at P= 0.0001 level.
Conclusions:
Standardizing NSAIDs prescribing pattern by formulation of an evident based pathway or flow chart for physicians to properly prescribe NSAIDs, in addition to continues education and monitoring was associated with reduction in consumption of risky NSADs (Diclofenac) and increasing the prescriptions of the more safe NSAIDs (Naproxen), consequently, reducing kidney and gastrointestinal related adverse events.
Keywords:NSAIDs is Non-steroidal anti-inflammatory drugs.

Abstract:Postoperative discharges teaching and follow-up are important services which can prevent unnecessary delays in discharge and assure the accessibility of adequate support afterward. Aim of the studywas to evaluate the effectiveness of discharge educational program on quality of life and post- operative complications for children after cardiac surgery.Setting: The study was conducted at the cardiac surgery ward at Bahteem hospital affiliated to Ministry of Health in Bahteem city.Design: A quasi- experimental design was used to achieve the goal of this study.Subjects: 80 children accompanying their mothers were selected purposively and divided equally into study and control groups. Tools of data collection: Five tools were utilized; personal and medical data assessment sheets, knowledge assessment questionnaire, pediatric cardiac specific quality of life formats, pediatric quality of life scaleand post-operative complications assessment sheet. Results: There was a highly statistical significant difference between study and control groups regarding total level of mother's knowledge (p˂0.001).The totalquality of life and total cardiac specific quality of life for children was not significant between the two groups before discharge education (p= 0.306 & 0.423) respectively, but after discharge education, a significant difference was observed between the two groups at one month and three months of program implementation (p˂0.000). Besides, post-operative complications were significantly lower for children in the study group at one month and three months of program implementation than in the control group (p˂0.000). Conclusion: Based on the results of the current study, it can be concluded that, the discharge program plays an important role in increasing mother's knowledge, improving children's quality of life and decreasing post-operative complications.Recommendation: All children scheduled for cardiac surgery and their families are in need to an adequate knowledge and self-care skills to improve short and long-term outcomes after discharge.
Keywords:Cardiac surgery, children, discharge educational program, post-operative complications, quality of life.  

Abstract:Pain and anxiety are the most common complications after cesarean section. The use of medications is the most common strategy for alleviating these problems. However, the adverse effects of these drugs and lack of access to them for some patients, has led to an increase in application of non-drug methods such as foot reflexology. Purpose: to examine the effect of Nursing Management Protocol and Reflexology versus Hospital Routine Care on pain and anxiety among post cesarean section primipara. Research hypothesis: there is less pain and anxiety among post cesarean section primipara who have both nursing management protocol and reflexology than those who apply hospital routine care. Research Design: a randomized clinical trials design. Sample Size: A total of 60 participants were divided into two groups after gaining their acceptance. The study group received both Nursing Management Protocol and Reflexology, the control group received Hospital Routine Care. Setting: postpartum unit of the Teaching Hospital, and University Hospital at Menoufia Governorate. Instruments: a Structured Interview Questionnaire, Post cesarean section pain and anxiety level was measured using a NRS and SF-MPQ for pain and Spielberger questionnaire for anxiety before and after intervention at 2hrs, 6hrs, 12hrs and 18hrs after delivery Method: Post cesarean section pain level and anxiety were measured four times using a subjective post cesarean section pain scales NRS and (SF-MPQ) for pain and Spielberger questionnaire for anxiety before and after intervention at 2hrs, 6hrs, 12hrs and 18hrs after delivery. Findings: there were a highly statistically significant difference in the study group regarding pain scores after intervention at 2hrs, 6hrs, and 18hrs after delivery at P value (.001, .396) respectively but a statistically significant difference after intervention at 12hrs after delivery, while there was non statistically significant difference regarding pain scores before and after intervention at  2hrs, 6hrs, 12hrs, and 18hrs in the control group. It revealed that there was a highly statistically significant difference regarding total anxiety scores before and after intervention at 2hrs, 6hrs, 12hrs and 18hrs after delivery in the study group. While, there was a statistically significant difference regarding total anxiety scores before and after intervention at 6hrs, 12hrs and 18 hrs after delivery, but non significant at 2hrs in control group. Conclusions: The study group, there was a highly statistically significant difference regarding pain scores after intervention only at 2hrs and 6hrs after delivery while highly statistically significant difference before and after intervention regarding total anxiety scores before and after intervention at 2hrs, 6hrs, 12hrs and 18hrs after delivery. The control group, there was non statistically significant differenceregarding pain scores after intervention at 2hrs, 6hrs, 12hrs and 18hrs after delivery, while.While, there was a statistically significant difference regarding total anxiety scores before and after intervention at 6hrs, 12hrs and 18 hrs after delivery, but non significant at 2hrsafter delivery.Recommendation: Foot Reflexology by a specialist should be added to the Nursing Management Protocol for management of postpartum pain and reduction of anxiety level.
Keywords:Nursing Management Protocol, Reflexology, Hospital routine Care, Post Cesarean Section Pain, Primipara, NRS and (SF-MPQ).

Abstract:Clinical training plays a crucial role in shaping nursing as a profession. Unfortunately, there are different challenges facing nursing students during their learning process. Some of these challenges are related to educators, clinical environment, hospital staff, patients and the nursing students themselves. Design: descriptive design was utilized Aim: to assess the challenges facing medical surgical nursing students at Alexandria University Hospital. Setting: The study was carried out in the Faculty of Nursing. Alexandria University, Egypt. Subjects: The subject of this study consisted of a convenience sample of 200 students. Tool: Challenges and learning issues questionnaire was used in order to collect the data. It included two parts: Part I: Student’s socio-demographic data, Part II: Students opinions about educator's role, environment, hospital staff and students’ role. Results: Although, the majority of students appreciate the educator’s role whether supportive, educative or  evaluative, The students' experiences indicated numerous problems related to clinical environments, hospital staff, patients and students themselves. Conclusion: Clinical environment filled with multiple challenges which results in tension and stress that have negative effects on students’ learning encounter. Recommendation: Encourage participation of hospital nursing staff in clinical education as the strategies to improve the clinical education
Keywords:Challenges, students, clinical training.

Abstract:Disruptive behavior in nursing education has been identified as an emergent and serious problem that substantially disrupts the teaching–learning process and the educational environment. Also, it contributes to the educators' or the administrative staff's dissatisfaction. So, finding suitable strategies to deal with such behavior and control it is extremely serious.Objective: This study aims to explore the nurse educators' and the administrative staff's perspective and management of nursing students' disruptive behavior in the educational environment.Setting: This study was carried out in all academically departments at the Faculty of Nursing, Alexandria University as well as the library and student affairs department.Subjects: The subjects of this study will comprise approximately 150 nurse educator work at the Faculty of Nursing, Alexandria University. In addition, all administrative members approximately 19 enrolled at the Faculty of nursing. Tools: Two tools were used by the researcher for the purpose of data collection;Nurse Educators' Perspective and Management of Nursing Students' Disruptive Behavior Structured Interview Schedule, and the Administrative staff's Perspective and Management of Nursing Students' Disruptive Behavior Structured Interview Schedule. Results: It was found that 49.1% and 48.2 % of the nurse educators in the classroom and the clinical setting respectively had moderate perspective regarding management of students' disruptive behavior. While, 75.0% and 71.4% of the students' affairs and library staff respectively had low perspective regarding the management of students' disruptive behavior. Conclusion: the current study denotes that the management that was mostly used by nurse educators and the administrative staff was: telling students the rules and procedures clearly at the beginning of the year, addressing the disruption individually, directly and immediately, and talking with the student in a calm, respectful and non-threatening manner. Recommendations: Educational workshops should be conducted to all nurse educators and the administrative staff at the faculty of nursing to increase their knowledge and competencies regarding dealing with students' disruptive behavior. Also, developing school regulations and policies for disruptive behavior and its consequences should be available to all students, educators and the administrative staff.
Keywords:Nurse Educators' Perspective, Administrative Staff Perspective, Nursing Students' Disruptive Behaviors Management, Educational Environment (clinical area and classroom).

Abstract:Rapid and proper maternal intervention can lower the disability and enhance the affected child's likelihood of survival and make a significant difference in the outcome. Objective: to evaluate mothers' knowledge and its related practices regarding first aid at home among children before and after implementing of an educational program. Method: A quasi-experimental research design (pretest and posttest) was used to evaluate the effect of a health education intervention on changing knowledge about home injuries and the basic first aid measures of 80 Egyptian mother's having children under 5 years of age. Results: About 83.8% of the mothers were housewives and 32.5% of them were illiterate. Mean score percent of total knowledge increased from 11.93 ± 18.27 pretest to 62.27±30.38 posttest with (p < 0.001). Conclusion: Application of health education program among mothers having children less than five years improves mothers' knowledge regarding home accidents.
Keywords:Educational interventional program, mothers', children, home first aid measures.

Abstract:The study investigated the influence of Cola nitida on urine output after its consumption in relation to urine sodium, potassium and chloride concentrations in the male and female human subjects. Sixty (60) non-obese volunteers (30 males and 30 females) and non-habitual Cola nut chewers, aged 18-28years were used for the study. They were sub-divided into three (3) subgroups: underweight (n=10), normal weight (n=10) and overweight (n=10) for each gender. Subjects with hypertension, kidney and heart-related conditions were excluded from the study. Three environmental conditions were involved: The normal chamber temperature, with a room temperature (RT) of 27⁰C and a relative humidity (RH) of 70%, the raised chamber temperature, with RT of 37⁰C and RH of 90%.In the aforementioned conditions, the subjects sat quietly in the sweat chamber for 20 minutes. The third condition was the normal chamber temperature with exercise, when RT and RH were maintained at 27⁰C and 70% respectively and the subjects pedalled a bicycle ergometer at moderate workload of 750J/minute for 20 minutes. The three conditions were before taking Cola nitida. Before entering the sweat chamber, the subject was told to void the bladder in preparation for the timed urine volume measurement and immediately after the experiment in the sweat chamber, the subject also voided urine for measurement.0.5g/kg body weight of Cola nitida was administered to each subject and chewed as a bolus, under each of the three experimental conditions. After ingestion, 50ml of deionized water was given to each volunteer to flush the masticated Cola nitida down the gut and the subject was allowed to rest for 90 minutes before being admitted into the sweat chamber. Estimation of urine sodium, potassium and chloride were carried out. Conclusively, Cola nitida significantly influenced fluid loss via the urinary system, with no significant changes observed in the respective urine electrolytes. If Cola nitida conserved the said electrolytes under the different experimental conditions, this might lead to an imbalance of the electrolytes within the body fluids. Therefore, some caution should be applied in the consumption of Cola nitida by human subjects (even among those already adapted to Cola nut eating).
Keywords:  Cola nitida, urine sodium, potassium and chloride concentrations, hypertension, kidney.

Abstract:it was to examine the effect of Nursing Management Protocol and Reflexology versus Hospital Routine Care on pain intensity among post cesarean section primipara. Research Design: A randomized clinical trials design was used. Sample Size: A total of 90 participants were divided into three groups after getting their acceptance. G1 received both Nursing Management Protocol and Reflexology, G2 received Nursing Management Protocol only and G3 received Hospital Routine Care. Settings: The postpartum unit of the Teaching Hospital, and University Hospital at Menoufia Governorate were selected. Instruments: A Structured Interview Questionnaire, a VAS and an SF-MPQ were used. Method: Post cesarean section pain level was measured four times using a subjective post cesarean section pain scales, NRS and an SF-MPQ were used before and after intervention; 2hrs, 6hrs, 12hrs and 18hrs after delivery. Findings: There was a highly statistically significant difference in group (1) regarding pain scores after intervention; 2hrs, 6hrs, and 18hrs after delivery where P values were .001, .0001, .396 respectively but there was a statistically significant difference after intervention; 12hrs after delivery. There was a statistically significant difference in group(2) regarding pain scores after intervention at 6hrs after delivery while non significant difference regarding pain scores before and after intervention; 2hrs, 12hrs, 18hrs in group(3). Conclusions: It was concluded that reflexology and nursing management protocol decreased pain intensity among women in group(1) more than those who of group (2) and group (3).Recommendation: Foot Reflexology by a specialist should be added to the Nursing Management Protocol for management of postpartum pain.
Keywords:Nursing Management Protocol, Reflexology, Hospital routine Care, Post Cesarean Section Pain, Primipara, NRS and an SF-MPQ.

Abstract:  Background: Applying standard precautions at all times and to all patients, will minimize the risks of infections.
Purpose of study: To identify the effect of a training program regarding practicing universal precaution measures for infection control among maternity nurses. Methods: Research Design: - Quasi experimental design. Sample: Convenient sample of 100 nurses Setting: obstetric & gynecological department in University hospital and Shebin El-kom Teaching hospital. Tools: Two instruments were used throughout the course of study (1) interviewing questionnaire, (II) Observation checklist (pre and post-test) was used to determine nurses’ practice regarding implementation of universal precautions. The evaluation of the effectiveness of educational was assessed after 3 months by reassessing the nurses' knowledge and practices regarding universal precautions of infection control. Results:  Our data showed highly significant difference in nurse's practices of universal precaution of infection control pre and post intervention .After intervention the majority of nurse's showed improvement in their knowledge and practice regarding universal precaution of infection program Conclusion: The use of educational program is effective in improving maternity nurses’ knowledge and practices toward universal precaution of infection control. Recommendation Conducting follow –up tests for nurses to ensure their competence related to practice of universal precaution of infection control to maternity nurses.
Keywords:infection control- Universal precautions– maternity nurses.

Abstract:Background: postpartum period is a very important time for both women and the newborn baby. Women may experience many changes, both physically and emotionally in the first few hours and days after childbirth. Women may look at neonate and feel happy but at the same time, may feel exhausted from a lack of sleep and new responsibilities. physical activity is also improve overall emotional well-being and mental health outcomes. The purpose of the study to assess the relationship between sleep quality, physical activity and postpartum mood.
Research Questions:
(I): Is there  a relationship between sleep quality and physical activity?
(II): Is there a relationship between sleep quality and postpartum mood?
(III): Is there is a relationship between physical activity and postpartum mood?
Methods: Describtive correlational design was utilized. Sample: A purposive sample of 144 of postpartum women. Setting: The study was carried out at postpartum department at University and Teaching Hospital in Shebin El-Kom at menoufia Governorate. Instruments: An interviewing questionnaire, the Pittsburgh Sleep quality Index (PSQI) Questionnaire, the Edingburgh Postnatal Depression Scale, Physical Activity Questionnaire. Results: There was a highly statistically significant difference between sleep quality and postpartum mood there was a highly statistically significant difference between physical activity and postpartum mood, there was no statistically significant difference between sleep quality and physical activity. Conclusion: postpartum mood is associated with sleep quality. There is positive a relationship between physical activity and postpartum mood and there is no difference between sleep quality and physical activity. Recommendations: Encouraging family support to postpartum women to improve sleep quality. Educating family to provide positive psychological support for postpartum women to decrease postpartum blues. 
Keywords:Sleep Quality, Physical Activity, Postpartum Mood.

Abstract:Hoarding is defined as the acquisition of and failure to discard a large number of possessions, which results in debilitating clutter and subsequent impairment and distress.This study aimed toexamine the association between saving cognition and distress tolerance as predictor factors for hoarding behavior. An exploratory descriptive research design was utilized in this study. Setting: The study was carried out in Faculty of Nursing, Assiut University, and Faculty of Nursing, Sohag University, Egypt. Subject: The total number of nursing students from two faculties' was587 students.Tools: Data were collected through, Personal data sheet, Distress Tolerance Scale, Saving Cognitions Inventory and Hoarding Rating Scale-Interview.Results: there were statistically significant relation between saving cognition scale and distress scale (r= 0.244) with (P. value=0.001). There were statistically significant correlation between distress tolerance scale and hoarding(r= 0.143) with(P. value=0.001). Conclusion: There were positive correlation between hording and saving cognition. Saving cognition and distress tolerance are predictor factors for hoarding behavior.Recommendations: It was recommended that:Future researches are needed to replicate the results in samples with clinically significant levels of hoarding.
Keywords:Saving cognition, Distress tolerance, Hoarding.
Title:Exploration of Saving cognition and Distress tolerance as predictor factors for hoarding behavior
Author:Nadia Ebraheem Sayied, Sanaa Mostafa khalifa
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract:Non-Hodgkin lymphoma is the sixth most common cancer worldwide and more common than the other general types of lymphoma. Aim of the study was to evaluate the effect of nursing intervention program for mothers of newly diagnosed children with non-Hodgkin lymphoma.A research design was quasi-experimental study carried out at the Lymphoma Outpatient Clinic in Children's Hospital, affiliated to Ain Shams University. A purposive sample of 54 mothers accompanying their children newly diagnosed with non-Hodgkin lymphoma. One tool was used for data collection; it was a structured interviewing questionnaire to assess: the mothers' demographic characteristics, past obstetric history, knowledge about non- Hodgkin lymphoma, reported practices related to care of their children and parenting stress index. Results: More than three quarters of the studied mothers had satisfactory total knowledge about non-Hodgkin lymphoma post implementation of nursing intervention program compared to slightly more than quarter of them pre implementation with statistically significant difference. Also, mothers’ reported practices related to care of their children were statistically improved post implementation. Moreover, mothers' sever stress level was significantly decreased post implementation. Conclusion: It can be concluded that, the research hypothesis is justified since the implementation of the nursing intervention program led to significant improvements in mothers’ knowledge and practices as well in reducing stress levels regarding the care of their children with non-Hodgkin lymphoma. Recommendation: Nursing intervention program for all mothers having children with non-Hodgkin lymphoma must be conducted in lymphoma outpatient clinics and oncology units.
Keywords:Nursing intervention, non-Hodgkin lymphoma, children, mothers and parent stress.

Abstract:EBP is important to keep clinical instructors’ knowledge up-to-date, enhance clinical judgment, and augment the existing provider-client decision-making process. Aim: to assess beliefs about and implementation of evidence-based practice (EBP) among clinical instructors. Study design: Cross-sectional descriptive study was utilized to conduct this study. Setting: this study was conducted in faculty of nursing, Minia University. Subject: convenient sample of all available (78) clinical instructors who were working in a six Departments  in Faculty of Nursing at Minia University at the time of conducting the study. Data collection tools: 1) the Evidence-Based Practice Beliefs (EBPB) Scale. 2) the EBP implementation (EBPI) scale. Results: the present study revealed that 77% of the participants agreed and strongly agreed with the statement that evidence-based guidelines can improve clinical practice and the statement that EBP resulted in the best clinical care for patients and more than half of clinical instructors don't implemented evidence-based practice in their clinical practice. In addition,  there was positive fair association between  evidence based practice beliefs of clinical instructors with evidence based practice implementation which r= .484 and P – value .000. Conclusion: This study shows that clinical instructors  have a positive attitude towards evidence-based practice, but practice it to a lesser extent. there was positive fair association between  evidence based practice beliefs of clinical instructors with evidence based practice implementation. Recommendations: It is essential to develop training and mentoring strategies such as educational program about evidence based practice  to promote a culture of EBP that ensures effective care, a safe clinical environment, stakeholder satisfaction and better use of available resources.
Keywords:Evidence based practice, beliefs, implementation, clinical instructors.

Abstract:Delegation is a highly recommended strategy for nursing staff at all levels that defined as is a process of entrusting someone else to accomplish parts of one's own job to meet specific client's and organization's goals. Failing to delegate effectively is caused by many obstacles that can result in waste of manpower, time, resources, and failing in job. The aim of the present study: was to assess barriers of effective delegation as perceived by nursing staff. Design: Descriptive exploratory design was utilized. Setting: the study was conducted in inpatients and selected intensive care units (ICUs) at New Kasr AL Aini teaching hospital- Cairo University Hospitals. Sample: A convenient sample of 300 nursing staff (nurse supervisors, head nurses, and staff nurses). Data collection tools: A self-administered questionnaire (Nursing staff attitudes towards effective delegation) was utilized to collect data. Results: The main findings revealed that overburdening delegatees, delegators' fear of liability or accountability, absence of positive incentives, and lack of adequate resources were the most prominent barriers of effective delegation. Conclusion: nursing staff were moderately agree that effective delegation can be hindered by many barriers related to delegator, delegatee, or situational barriers with the highest mean percentage of agreement regarding the delegators' related barriers.Recommendations: Creating an environment that facilitates and supports practicing delegation process through emphasizing on the importance of effective delegation, assessing its barriers and developing strategies to overcome.
Keywords:Barriers, Effective Delegation, Nursing Staff, University Hospital.

Abstract:Uterine prolapse is the most frequently reported cause of poor health among women of reproductive age and postmenopausal. It is known to cause physical and psychosocial problems affecting the quality of women life. The current study aimed to evaluate the effect of the evidence-based nursing intervention on relieving uterine prolapse symptoms and degree. Design: An intervention research design (time series) was adopted. A purposive sampling technique was used to recruit 40 women at gynaecological outpatient and family planning clinics in El-Nabawy El Mohandes Hospital, Fayoum. Four tools of data collection were used:Structured interviewing questionnaire, Pelvic organ Prolapse Quantification system, uterine prolapse associated symptoms follow up sheetand self-reported changing in symptoms and degree post-intervention tool. Results: revealed that there was a statistically significant improvement in women’s knowledge regarding the uterine prolapse and its management. Also there was a highly statistical significant difference between mean score of uterine prolapse symptoms before, one and three months after the intervention that reflected upon relieving uterine prolapse degree. Conclusion: women’s knowledge, the uterine prolapse symptoms and degree improved after the intervention. Recommendation: Evidence based nursing intervention as pelvic floor muscles exercise and changing lifestyle should be an integral part of the gynaecological treatment for uterine prolapse in the maternity hospitals. 
Keywords:Evidence Based Nursing intervention, uterine prolapse, reproductive age.

Abstract:Osteoarthritis, a progressively destructive joint disease causing varying degrees of unrelenting pain and excess suffering that affect negatively on patients’ quality of life. The studyaimed tto assess, plan, implement and evaluate the effect of Nursing Education program on Knowledge, Uncertainty,Mastery,Pain, and Quality of Life for Knee Osteoarthritis Patients. Methods: Research design:A qui-experimental research design was utilized. Subjects and methods: A purposive sample of (80) adult patients were recruited for the conduction of this study. The study was conducted at orthopedic unit and outpatient clinics at Fayoum University Hospital. Tools: tool I: A self-administered questionnaire, tool II: Mishel Uncertainty in Illness, Mastery Scale, and the Arthritis Helplessness Index, tool III: Total quality of life, tool IV: Numerical Pain scale, and tool V: Nursing educational program was developed for patients with knee Osteoarthritis. Results: study sample involved 80 patients participants whose mean age was 47.50±12.18 years. More than half of them were females (61.3%), married (67.5%). More than one-third of them were hand workers (37.5%) and living in an urban area (55.0%). more than half of nurses had unsatisfactory knowledge about osteoarthritis before the nursing education while the majority of them (82.5%) had a satisfactory level of knowledge after implementation of the nursing education program.There were a statistically significant differences regarding  Mishel Uncertainty in Illness scale, pain intensity, Mastery scale, and quality of life for patients pre and post-implementation of nursing education program. Conclusions: there were statistical significant differences regarding patients’ knowledge, Uncertainty in Illness, pain intensity, Mastery, and quality of life for patients pre and post-implementation of nursing education. Recommendation: Relevant written and visual information to facilitate educating patients about proper coping with osteoarthritis.
Keywords:Nursing, Knowledge, Uncertainty, Mastery, Pain, Quality of Life, Osteoarthritis.

Abstract:Falling lead to some problems as fractures, soft tissue injuries, longstanding pain, impaired functional mobility, decrease quality of life, increased death, and so increase healthcare costs. Purpose: This study aimed to examine the effect of environmental home modification on falling risk reduction of elderly in a rural community. Design: A quasi- experimental design (pre-posttest) was utilized to conduct this study. Setting: The study was carried out at two villages (Ghemreen village and Manshat Sultan village) in Menoufia governorate through home visits-Egypt. Sample: the researcher selected only elderly people who have history of falling. They were 130 elderly people. The researcher divided them into two groups (case and control), 65 (case) and 65 (control). Tools: I: - A structured Interview questionnaire developed by the researcher II: - Modified Fall Efficacy Scale III: - Home Safety Self-Assessment Tool. Results: There was remarkable reduced number of falls and fall related injuries after intervention. As a result of home modification done, the number of risky homes was decreased. Conclusions: Implementation of environmental home modification was effective in risk reduction of falling among study group compared to control group. It was successful in reducing number of falls and fall related injuries. Recommendation: Careful assessment of elderly homes to identify the risks and the possibility of overcoming them.
Keywords:Home Modification, Elderly, falling, risk reduction.

Abstract:Background: Worldwide, infertility affects 15%-20% of couples and most of them seek medical help including Assisted Reproductive Technology (ART) treatments. Assisted reproductive technologies (ART) have been developed as a superior method of treatment for most infertility disorders. In vitro fertilization (IVF) is one of the most important techniques of Assisted Reproductive Technology (ART). The provision of optimal care is the most important goal in nursing, through recognizing and meeting couples’ educational needs. To promote couples' satisfaction, they should understand and participate in their medical decision making for better health outcome. Therefore, this study aimed to design health education booklet about in vitro fertilization for infertile couples. To accomplish the designing of the health education booklet throughout the present study, it was important to assess the infertile couples' knowledge, subjective practice and attitude in relation to in vitro fertilization (IVF).It has been carried out using a cross-sectional research design. The data was collected from 149of infertile couples. Six tools were used for data collection after reviewing the relevant literatures. There was poor score level of knowledge and improper practice regarding (IVF) among the majority of the couples undergoing IVF. Conclusion: majority of the studied infertile couples had poor knowledge and improper practice about (IVF). More educated people had more knowledge. All experts and infertile couples mentioned that the designed education booklet about in vitro fertilization is a good educational method that raised their awareness about this matter. It is proposed that in addition to the booklets/ brochures, mass media should have a role to increase couples’ knowledge about ART.
Keywords:Infertility; Assisted reproductive techniques; In vitro fertilization; printed material.

Abstract:The Vaccination Program applied all over the world to reduce the prevalence of diseases that can be avoided by vaccination. The study aimed to assess the knowledge, attitude, and practice of parents in Riyadh City, Saudi Arabia among the preschool child vaccination schedule.Design: Cross-sectional design. Setting: in the primary health care settings.Tools: Structured self-administered questionnaire was established which contain five parts. Tool 1: Demographic data of parents such as age, relationship to the child & education. Tool II: Source of knowledge about vaccination such as family and friends, doctor or nurse, leaflets and brochures, and interested in researching the subject. Tool III: Knowledge of parents about importance, effect, complications, and benefits of vaccination. Tool IV: Attitude of parents toward vaccination. Tool V: Practice of vaccination as restrained by culture/religion, and commitment to vaccination.Results: The findings show that majority of the parents have good knowledge about vaccination; however, there are also few of them who are restrained by religion, culture, information from friends and relatives, and their personal experience about childhood vaccination. The Parents trust the doctors and nurses as sources of information about vaccination more than any other sources like media. Majority of the parents perceived the childhood vaccination schedule as effective.Conclusion: The study concluded that there is a satisfactory coverage of the Saudi Childhood vaccination schedule as shown by the good level of knowledge and practice of parents toward childhood vaccination schedule. However, there are still parents who have misconceptions and hesitations to comply with the vaccination schedule.Recommendation: The study recommends that the public health sector should strengthen implementation of the vaccination schedule by improving access and coverage of the information drive about vaccination.
Keywords:Childhood vaccination schedule, Knowledge, Practice, Experience, Parents.

Abstract:Nesting position considers one of the most essential developmental supportive interventions used within the Neonatal Intensive Care Unit (NICU) to maintain the intrauterine position for the preterm neonates. It helps to improve neuromuscular development and promotes behavioral organization. Whereas preterm neonates may spend months in the NICU, they are exposed to many factors that may interfere with the maturation and organization of preterm neonates’ central nervous system. Aim of the study was to determine the effect of nesting position on behavioral organization among preterm neonates. Research Design: A quasi experimental research design was used. Setting: This study was conducted at the NICU of Damanhour National Medical Institute, Damanhour City, Al-Behira governorate, Egypt. Subjects:  A convenient sample of 60 preterm neonates who fulfilled the inclusion criteria comprised the study subjects as: gestational age ranged from 32 - < 37 weeks and begin enteral feeding. Those neonates were equally divided into a study group (received nesting intervention) and a control group (received NICU routine care with traditional positions without nest). Tools: Two tools were used tocollect necessary data namely; Characteristics and Medical History of Preterm Neonates and Preterm Neonate’s Behavior Assessment Scale. Results: The total percent score of the preterm neonates’ reactions on autonomic / visceral subsystem behavioral scale revealed that, in the first assessment 80% of the neonates in both groups exhibited suspected abnormal behavioral response,in the second assessment 63.3% of neonates in the study group had “normal behavioral response” in comparison with 26.7% of those in the control group. Moreover, in the third assessment 83.3% of the neonates in the study group compared to 60% of those in the control group had “normal behavioral response”. Additionally, the total percent score of the preterm neonates’ reactions on state regulation and attention- interaction subsystem behavioral scale reflected that, in the first assessment 73.3% of the neonates in both groups had definite abnormal behavioral response, in the second assessment 76.7% of neonates in the study group experienced “suspected abnormal behavioral response” compared to 56.7% of those in the control group. Amazingly, in the third assessment, 80% of neonates in the study group compared to 40% of those in the control group exhibited “normal behavioral response”. The differences were statistically significant in both the second and third assessments. Conclusion: It can be concluded that nesting position was effective in improving behavioral organization of preterm neonates. Recommendation: applying nesting position for all preterm neonates as a part of routine care within NICUs and as standard of developmental supportive care.
Keywords:Nesting Position, Preterm Neonates, Behavioral Organization.

Abstract:Episiotomy is the most common obstetric intervention in the world. Episiotomy care is very essential, if neglected it can lead to severe complications like infection, wound gapping etc. Therefore, it is very important to give special attention to maintain perineal hygiene and episiotomy care.. The present study aimed to determine the effect of perineal self care instructions on episiotomy pain and healing among postpartum women. A quasi-experimental research design was used. The study was conducted at the postpartum unit of Abou Homos general hospital, Albehera Governorate. The study comprised 80 postpartum women who were divided into two groups (study and control).  Three tools were utilized for data collection; a socio-demographic and obstetric data sheet, Pain intensity visual analogue scale (VAS), and The standardized REEDA scale. Results revealed a statistically significant difference between both groups after 48 hours as regards intensity of episiotomy pain. As well, were There statistically significant differences between both groups after 48 hours postpartum regards perineal redness, and perineal oedema.. It could be concluded that Puerperal women who had received perineal self care instructions experienced lower episiotomy pain and faster episiotomy healing than those who hadn't received instructions. It was recommended that health professionals must be properly trained and updated regarding guidelines based on evidence, , and its harmful consequences to women’s physical and psychic health.
Keywords:postpartum Women, Perineal Self Care, Episiotomy Pain and Healing.

Abstract:Coma is a relatively common condition in critical pediatric care nurses need to a quire a wide range of theoretical and practical knowledge in order to provide the appropriate level of care for pediatric patients. Aim of the study: The aim of the study was toevaluate the effect of training program on nurses’knowledge and practice toward care of children with coma at Pediatric Intensive Care Unit (PICU). Research design: A quasi-experimental design was used. Setting: This study was conducted at the Pediatric Intensive Care Unit in Benha Specialized Pediatric Hospital. Sample: A Convenient sample of nurses (n=43) and purposive sample of comatose children (n=80) were included from the above mentioned setting. Those children were divided equally into two groups (study and control).Tools of data collection: Two tools were used namely; a structured interviewing questionnaire format, nurses’knowledge and practice regarding care of children with coma.Results: Revealed that, there was significant improvement in nurses’ knowledge and practice toward care for children with coma as well as after program implementation, Moreover, Most children in the study group was improvement feeding and scores of Glasgow scale coma rather than the control group.Conclusion: The study was concluded that, the theoretical and practical an educational intervention had a positive effect in improving nurses’ knowledge and practice toward care for children with coma at PICU. There was also a positive correlation between levels of nurses’ knowledge as regards their practice. Recommendation: Nurse’s educators should develop educational intervention provided to all nurses caring for unconscious pediatric patient to improve and update their knowledge and practice.   
Keywords:Coma, critically ill children, pediatric intensive care unit, training program, nurses' knowledge and practice.

Abstract:Gastritis is an inflammation of the stomach lining. It can be acute or chronic it has remained a wide spread health problem among elderly due to presence of chronic health problems. Aim: evaluate the effect of nursing instructions guidelines for older adult for controlling gastritis. Design: A quasi experimental design. Setting: at menoufiya university hospital, Shebine El-koom teaching hospital. Sampling: A purposeful samples of 60 elderly according to specific criteria Tools: two tools were used for data collection. First tool: was an interviewing Questionnaire, (a) Socio – demographic characteristics (b) Medical history of elderly with gastritis (c) Elderly knowledge about gastritis (d) Health needs and problems of elderly with gastritis. (e)  Elderly daily living activities with gastritis.Second tool: medical record analysis regarding diagnosis. Results: The most of elderly had satisfactory 'knowledge about controlling gastritis among elderly with gastritis, the most of elderly had correct practices related activities of daily living among elderly with gastritis, There is improvement of measure for prevention gastritis post education program around three quarter were controlled. Conclusion: The developed educational intervention led to significant improvements in elderly knowledge, practices, health need and post educational intervention. The study concluded that the around two third of them were achieved health needs in post education program.The most of elderly had unsatisfactory knowledge about gastritis. Which improved to satisfactory knowledge for majority of elderly respectively post program implementation? More than three quarters of them their knowledge became satisfactory post program. The educational program produced improvement in elderly knowledge related to practices through program Recommendations: Implement education health program to prevent elderly gastritis should be provided for elderly with gastritis in every health care setting provide care for elderly about balance diet, risky habits that lead to gastritis.
Keywords:Elderly, Gastritis, Health education program, Gastric pain, level of prevention.

Abstract:Sickle cell disease is an autosomal recessive disease that causes considerable morbidity and mortality. The aim of the study is to evaluate the effect of self-care management program on pain and fatiguein sickle cell children.Research design:A quasi-experimental design was used to complete this study.Settings:The study was conducted at the hematology department at Benha Specialized Pediatric Hospital and Benha University Hospital at Benha City. Sample: A purposive sample of 100 childrenwith sickle cell anemia was included from the above mentioned settings. Fulfilled the following criteria aged from 9-18 years. Tools:Five tools were used to collect the study data: Tool I: A structured interviewing questionnaire format. It was developed by the researchers and includes three parts to collect data: Part 1: Personal characteristics of mothers. Part 2:Personal characteristics and illness history data of the studied children.Part 3:Children’knowledge regarding sickle cell anemiaToolII:Pediatric pain coping strategies scale. Tool III: Pain assessment scale (Numeric Rating Scale). Tool IV:Assessment of Fatigue scale in Pediatric patient aged 7-18 for Parents.  Tool V:Children self-care practicesto avoid pain and fatigue.  Results:Overall the results have a highly statistically significant differences (P<0.001) pre and post program implementation regarding pain and fatigue scales.Conclusion: The results suggest the effectiveness of self-care management program on the reduction of pain and fatigue in sickle cell children. Therefore, self-care management programs are advisable in order to empower children and assist their management of health-related problems. Recommendations:The study recommended the importance of educational program for children and families regarding self-care management.
Keywords:Self Care Management,Pain, Fatigue & Sickle CellChildren.

Abstract:Health education guidelines using mobile what’s-App application considers as a health intervention method manages in increasing knowledge and subsequently enhancing self-management of patients undergoing cardiac catheterization with healthy lifestyles. This may be due to the fact that information delivered using mobile phone was attractive and could be retrieved anywhere Additionally, patients who were once helpless could now conveniently express their concerns directly to healthcare providers through What’s-app for discussion and clarification. The positive and encouraging atmosphere created in what’s-app group, make patients were keen to learn new knowledge every day. Aim: This study aims to evaluate the effect of nursing guidelines using mobile what’s app application on self-management of patients undergoing diagnostic cardiac catheterization. Design: A quazi experimental design was used. Setting: This study was conducted at cardiac catheterization unit and cardiac rehabilitation unit at Ain Shams University Hospital at Cairo in Egypt. subjects: A purposive subject of thirty (30) Adult patients from both gender undergoing diagnostic cardiac catheterization through using right femoral artery access site were recruited from the previously mentioned units. Data collection tools: (1) Patients’ interviewing questionnaire, (2) Patient cardiac catheterization self-management assessment tool. (3) Nursing guidelines using mobile what’s app application. Results: There was a statistically significance differences between pre & post health education guidelines implementation on cardiac patients’ self-management .Conclusions: health education guidelines implementation through mobile what’s-app application was helpful on the improvement of the patients' knowledge and self-management physically, socially and psychologically. Recommendations: Periodic in service – training advanced care programs regarding health education through using mobile what’s-app application for patients undergoing diagnostic cardiac catheterization is essential for improving health outcomes of these patients.
Keywords:Cardiac Catheterization, self-management, Nursing Guidelines & What’s App Application.

Abstract:All patients in the ICUs may require oxygen during their disease course. Monitoring of the oxygenation level for patients is a basic principal during oxygen therapy administration. Adequate knowledge and skillful practice while nurses using pulse oximeter is an indication for patient safety and quality of care. Aims of the study: that study includes two aims 1^st is to assess critical care nurses’ practice of oxygenation monitoring using pulse oximetry in ICUs. The 2^nd is to evaluate the effect of implementing a designed nursing protocol on nurses' knowledge and practice regarding oxygenation monitoring by pulse oximetry in ICUs. Research design: Quasi-experimental research design has been utilized. Settings: General, Trauma and Chest ICUs at Aswan university hospital. Tools: Two tools were used, structured knowledge questionnaire and observation checklist sheet. Results:  72.0% of the study sample was females, aged from 20 to <30 years and 76.0% were technical nurses. The hypotheses were supported as the mean and standard deviation of knowledge improved from 11.84±3.22 to 18.74±2.1 post implementation of the designated nursing care protocol. Practice mean and standard deviation improved from 12.94±7.68 to 25.30±1.51 post the implementation. There were highly statistically significant difference P<0.01. Conclusion: implementation of designed oxygenation monitoring protocol showed a significant improvement in nurses` knowledge and practice. Recommendations: New nurses are in need for orientation program, written protocol located in ICU, supervision, in-service training programs, workshops and conferences on oxygenation monitoring using pulse oximeter.
Keywords:critical care nurse, oxygenation, pulse oximeter, nurses’ knowledgeand practice.

Abstract:The increase in nurses enrolling in postgraduate programs as well as the need to improve their completion requires academics to establish environments conducive for postgraduate studies. The challenges experienced during postgraduate studies have to be identified to establish conductive environments. Aim: to identify challenges faced by postgraduate nursing students. Methods: A qualitative descriptive study design was used at faculty of Nursing, at Ain Shams University. Sample: include all master and doctorate postgraduate nursing students at the last semester of their studies; was 236). Tools: A Self- administered questionnaire for students. Results: Findings of the present study showed that the majority of the postgraduate nursing students considered student-related challenges as real challenging, two-thirds of the postgraduate nursing students considered institution-related challenges as real challenging, more than three-fourth of the postgraduate nursing students considered supervisor-related challenges as real challenging. Conclusion: student-related challenges are the highest challenges faced by postgraduate nursing students, while the institution-related had the lowest. Among the student-related challenges, the financial ones were the most challenging. As for the institution-related, the academic challenges were the most challenging Recommendations: An annual survey should be conducted by the faculty to identify the challenges faced by the students and the necessary measures that should be taken to address the challenges to provide a congenial learning environment.
Keywords:postgraduate studies, challenges, strategies, Thesis writing, postgraduate student.

Abstract:Nipple trauma occurs in 29–76% of breastfeeding mothers within the first postpartum week which causes pain and discomfort for the mothers to continue breastfeeding. Aim of the study: Compare the effect of breast milk, peppermint water and breast shell on treatment of traumatic nipple in puerperal lactating mothers. Research design: A quasi-experimental research design was utilized.  Settings: The study was conducted in postnatal clinics at Abu EL-Matamer Central Hospital and Housh Issa Central Hospital affiliated to Ministry of Health in El-Beheira Governorate. Subjects: Convenient sample of 120 puerperal lactating mothers with nipple trauma diagnosed in their first postpartum week were selected according to eligibility criteria. The selected subjects were randomly divided into three equal study groups.  Tools of data collection: Five tools were used for data collection namely: A structured interview schedule; breast feeding observation checklist; visual analogue pain intensity scale; nipple soreness rating and nipple trauma score. Results: Findings demonstrate that the mean score of nipple pain, nipple soreness and nipple trauma were significantly decreased among the breast milk, peppermint water, and breast shell groups in the seventh and fourteenth day of intervention. There were a statistically significant difference between the three groups in favor of the peppermint water group in relation to nipple pain, nipple soreness and nipple trauma in the seventh and fourteenth days of intervention. Conclusion: The study concluded that peppermint water treatment was more effective in nipple trauma healing and pain relief than breast milk and breast shell treatment.
Keywords:Nipple trauma, Breast Milk, Peppermint Water, Breast Shell, Puerperal mothers, Lactation.

Abstract:Intrahospital transport of a critically ill patient has been associated with technical and life-threatening adverse events. Aim of the study: To explore intrahospital transport related health consequences among critically ill patients and different selected factors contributing to both negative and positive health consequences. Research Design:A descriptive exploratory research design was utilized. Research questions: Q1:- What are the intrahospital transport related health consequences among critically ill patients? Q2:- What are different selected factors contributing to both negative and positive health consequences? Setting: Intensive Care Unit of Cairo University Hospitals. Sample: A purposive sample of  62 critically ill adult patients. Tools of data collection: Two  tools were utilized to collect data pertinent to the current study. Tool 1: Personnel Characteristics & medical data sheet, tool 2: Checklist of intrahospital transport related health consequences and different selected factors contributing to both negative and positive health consequences during intrahospital transport of a critically ill Patient. Results: the current study revealed no dominance in gender (50% male and 50% female) and 40.3% were in age group 40 < 50 years. No death occurred but there were 207 adverse events that occurred in 52 (83.9 %) of the 62 transports with more than one adverse event occurred during single transport in 39 transports (62.9%). Each of Airway/pulmonary complications and Hemodynamics instability formed about third of total negative health consequences (30%).Only five factors recorded a significant statistical correlation with negative health consequences these factors are the transport team, equipment & materials, connections, transport duration, intervention during transport. Conclusion: During intrahospital transport critically ill patients are at risk for significant adverse events. Moving these patients should only happen when there is appropriate monitoring and other necessary equipment in the presence of trained personnel who are familiar with the care of such patients Recommendations:The rate of health consequences occurs during intra-hospital transport require existence of an intrahospital transport protocol or plan is, obviously, not just useful, but very important.
Keywords:Critically ill patients, Health consequences, Intrahospital transport.

Abstract:Effective time management is an extensive concept that is related with promoting head nurses skills and staff  nurses' creativity and their greatly affect success of organization. Aim of the study: The present study aimed to evaluate the effect of educational program about time management for head nurses on nurses' work creativity. Researchdesign: A quasi experimental design was used in this study. Study setting: The study was conducted in inpatient units of Medical and Surgical departments at Benha University Hospital, the total number of the studied units were (27) units. The study sample was: All the available head nurses and their assistants (55), and convenient sample of nurses (110). Tools for data collection: Three tools were used: Time Management Knowledge Questionnaire, Self-Administered Questionnaire and Level of Creativity Questionnaire. The results showed that,there was a highly statistical significant improvement in head nurses and their assistant' knowledge and skills regarding time management thorough program. Moreover, there was a highly statistical significant improvement in nurses' level of work creativity. Thestudy concluded that,there was a highly statistical positive correlation between head nurses and their assistant' time management skills and nurses' work creativity.The study recommended that: Hospital quality unit had to initiate an In-service education and training courses for staff in the different departments of the hospital in managerial skills especially time management. Nursing faculties should integrate creative thinking education in study courses.
Keywords:Effective time management, Head nurses and Staff nurses' work creativity.

Abstract:For over 35 years shock wave lithotripsy considered as minimally invasive line of treatment for patients with urolithiasis,successful outcomes and risk of complications depending on several aspects including patient's educations and proper preparation of the patients. Nursing preparation of the patients including detailed health information's about the plan of treatment can impact the success of the procedure. Objectives: this study aims to determine the impact of nursing protocol on stone clearance rate and acute complications following shock wave lithotripsy in patients with renal and ureteric calculi. Setting: Shock Wave Lithotripsy Unit, Urology Department of Alexandria Main University Hospital, Alexandria, Egypt.Subjects:Data was collected from 60 patients with renal and ureteric calculi treated for the first time with shock wave lithotripsy. A socio demographic, clinical characteristics structured questionnaire, were developed by the researcher and used for data collection. Each patient was interviewed individually for about 30 minutes after brief explanation of the study objective and assuring information confidentiality. Results: stone clearance rate were significantly improved after implementation of the nursing protocol and influence decreased side effects rate. As well as; lowered exposure rate for acute complications following shock wave lithotripsy in patients with renal and ureteric calculi. Conclusion: Medical health knowledge and nursing information significantly affect patients` outcomes and rate of treatment success. Recommendation: Nursing preparation and education in shock wave lithotripsy unit is necessary to provide patients with necessary oral and written information regarding their health conditions.
Keywords:stone clearance rate, shock wave lithotripsy, urolithiasis.

Abstract:Women with unhealthy lifestyle will threat their health status in long time and will enter into old age with a set of chronic disease and morbidity. One of the most important periods to be focused on it for promoting women’s health, is their reproductive age. Aim of the study: Was to determine the effect of health teaching program on promoting the healthy lifestyle behaviors of women at the reproductive age based on Pender’s model. Subjects and method: A quasi-experimental research design was utilized in this study. This study was conducted at maternal and child health (MCH) centers affiliated to the Ministry of Health in Tanta city, El-Gharbeya Governorate, Egypt. Study subjects: A convenient sample of 214 women at the  reproductive age were  included in the study. Three tools were used in this study.Tool I: Structured interview schedule: included the socio-demographic data and family history. Tool II: Health promoting lifestyle profile II (HPLPII): consisted of six sub-scales which encompassed the six healthy lifestyle dimensions (nutrition, physical activity, health responsibility, stress management, interpersonal relations, and spiritual growth). Tool III: Pender’s determinants of healthy behaviors among the studied women: consisted of four constructs of the Pender’s HPM (perceived benefits, perceived barriers, interpersonal influences, and perceived self-efficacy).Results: There was a statistically significant improvement in the mean score of the total healthy lifestyle behaviors (HLBs) among the studied women throughout the study phases (P=0.001). Where, the mean score of their total score of HLBs improved from 52.40 ±5.86 pre-program intervention to 70.05±6.28 immediate post and 68.65±7.74 three months post-program intervention. Conclusion and recommendations: The health teaching  program based on Pender’s model was effective and HLBs of the studied women at the reproductive age were improved. Therefore, health teaching  programs based on Pender’s model should be planned and offered at regular basis to all women to improve their adherence to healthy lifestyle, particularly during the reproductive years.
Keywords:Healthy lifestyle behaviors -Women - Reproductive age - Pender’s model.

Abstract:Cystoscopy is endoscopy of the urinary bladder via the urethra. It may be performed for either diagnostic or therapeutic purposes. There is limited data on the difficulty of the procedure and the factors associated with significant pain, physical and emotional discomfort experienced by those patients during cystoscopy procedure. Objectives: this study aims to determine physical and emotional discomfort experienced by patients undergoing cystoscopy. Setting: The study was conducted in a urology department of Alexandria Main University Hospital, Alexandria, Egypt.Subjects:The study was conducted with a total of 90 patients aged between 18 and 60 undergoing cystoscopy procedure. A socio demographic, clinical characteristics structured questionnaire, were developed by the researchers and used for data collection. Each patient was interviewed individually for about 30 minutes after brief explanation of the study objective and assuring information confidentiality. Pain score was recorded after the procedure using the numeric analogue scale (NAS). State Trait Anxiety Inventory (STAI) scale used to measure emotional discomfort reported by the patient after cystoscopy. Results:The results of this study revealed that; physical discomfort total score was (66.7%) of the patients which indicate moderate discomfort. As regard assessment of pain level (37.8%) experience moderate and high level of pain, while; approximately half of the patients report high level of emotional discomfort. Pain, headache and dizziness, urgency and dysuria were the most commonly reported component of physical discomfort (93.3, 61.1, 100%) respectively, while anxiety (27.7%) was the most commonly reported item of emotional discomfort. Conclusion:cystoscopy procedure was well tolerated with mild to moderate physical discomfort and high level of emotional discomfort among patients undergoing cystoscopy. Recommendation: The results of this study recommended that; detailed explanation to patients who underwent cystoscopy can reduce the pain and anxiety level associated with the procedure.
Keywords:Cystoscopy, physical discomfort, pain, emotional discomfort.

Abstract:In the past decades delayed childbearing has become increasingly and become common in both high- and low income countries. In the recent years, there is a significant growth in mean maternal age at first childbirth. The percentage of live births to women aged 35 and over has increased almost twice from 9.1% in 2005 to 16.3% in 2016. And also at the same time, the rates of deliveries among mothers over 40 rose from 1.8% in 2005 to 2.6% in 2016.  The study aimed to investigate relation between mother age and pregnancy outcome and neonatal outcome in the Department of Obstetrics and Gynaecology, atSohag University hospital. Design: A descriptive design was used for the study. Sample: - included 300 women, their ages was above the age 35 years and older. Tools: A structured self administered questionnaire was used for data collection. Results: from a total 300 elderly pregnant mothers, mother' age ranged from 35 - 45 years, most of the pregnant mothers were in the age group 35 to 39 years (87.53%). Multi gravida was (71%) and grand multi para (20.22%) was constituted the largest group. Most of the pregnant mothers were belong to lower socio-economic status (90%). The incidence of pregnancy complications such as, diabetes mellitus and chronic hypertension among pregnant mothers were increased and cesarean rate was increased (34%). Incidence of abortions was (9.12%), preterm delivery (6.25%), oligohydramnios (6.25%), APH was (6.25%) and PROM (5.90%), low birth weight baby (13.19%), NICU admission (6.94%), IUGR (3.81%) all of these were high.  Preference of pregnant mother for male child (23.95%) and lack of awareness (21.52%) were the two major reasons for the continuity of pregnancies and deliveries until late age. Conclusion: There was increasing in pregnancy complications and adverse fetal outcomes among older pregnant women more than 35 years. Recommendations: Older Women should be encouraged to do prenatal screening and prenatal diagnosis, use of ante partum testing to ensure safe motherhood and a healthy fetus. Young mother  should be educated about the risks of delayed child bearing at older age that  increase the risk of both early and late complications of pregnancy.
Keywords:mother age, pregnancy, outcomes.

Abstract:Standard précautions have been introduced as means to protect health care workers from exposure to blood borne pathogens. Aim of the study: Was to determine the factors affecting compliance level regarding standard precautions measures among the operating room nurses.Research design: Descriptive design was utilized to meet the aim of the present study.Setting: This study was conducted in operating room unit at Fayoum University Hospital.Methodology: A purposive sample of all operating room nurses (no=40) who are working in operating room unit at Fayoum University Hospital was selected as a study sample.Tools: Two tools were used in data collection, included: self-administer interview questionnaire and observation checklist sheet.Results: The study revealed that operating room nurses' had satisfactory level of knowledge regarding standard précautions measures of infection control. Meanwhile had unsatisfactory level of practice for compliance standard precautions measures in operating room. As were many factors affecting on nurses 'compliance as; nurses' related factors and hospital' related factors.Conclusion: Major factors that negativelyaffect on compliance with standard precautions are shortage of nurses numbers and lack of equipment and supplies that needed for compliance standard precautions measures. Meanwhile, major factors that positively affect on compliance with standard precautions are that the operating room nurses' had satisfactory level of knowledge about standard precautions of infection control and cooperation between nursing staff members.Recommendations: Apply developed program in the study setting for operating room nurses regarding compliance standard precautions of infection control for continues updating their knowledge. The study should be replicated on large sample and different hospitals setting in order to generalize the results.
Keywords:Compliance, Standard Precautions, Operating Room Nurses.

Abstract:Background: Childhood obesity represents one of the most important and challenging public health problems that contribute to severe complications from childhood through adulthood. Aim: The study aimed to assess overweight and obesity among preschool children in day care centers in Alexandria. Study design: A cross-sectional descriptive comparative design was used to carry out this study.  Study setting: the study was carried out in 20 private and nongovernmental organizations' day care centers affiliated to the Ministry of Social Solidarity in Alexandria; they represented 10% of total day care centers in the two selected zones namely; El- Montazah (143) and Middle zone (66). Study tools: three tools were used to collect the necessary data; World Health Organization (WHO) 2006 new international child growth charts (weight for height), children's profile structured interview schedule, 24 hours diet recall interview schedule for mothers .Study subjects: All obese and overweight children in the selected day care centers (252 children) were identified to represent group (A) in the study. A matching sample of normal body weight children (252 children) was selected randomly to represent group (B) for comparison, (total= 504 children). Results: The findings of the present study revealed that the prevalence of overweight and obesity among studied preschool children were 22% and 10% respectively. Several factors such as birth order, feeding pattern, energy intake and physical activity were associated with overweight and obesity. Conclusion: overweight and obesity were prevalent among preschoolers in day care centers in Alexandria city. Dietary habits and physical activity are of great importance of devolving these problems. Parents of overweight or obese children underestimated their child’s weight status. Recommendation: routine screening for overweight and obesity of the children in day care centers through periodic anthropometric measurements and increase awareness about prevention of childhood obesity.
 Keywords: Childhood obesity, Overweight, day care center, preschoolers.

Abstract:The incidence of burn injuries is increasing in Africa. Nearly 3.2% of South Africa population is burned annually. Purpose: The current study aimed to find out there a relationship between malnutrition and wound healing in hospitalized patients withburns. Methods: Design: A descriptive correlational research design was utilized.The study was performed in the burn unit at a General Hospital. Sample: The study was conducted with a convenience sample of 70 patients with burns. Tools: Three tools were used to collect the study data: a structured interview, the malnutrition risk assessment scale (MUST) and the modified pressure ulcer scale for healing (PUSH) version 3.0. STROBEchecklist was also used for reporting this. Results: The study revealed that more than one-third ofthe study sample was at high risk for malnutrition.However, there was no statistically significant relationship between malnutrition risk and wound healing. The study concluded that there was no relationship between malnutrition and wound healing in hospitalized patients withburns?
Keywords:Burn, Malnutrition, Risk, Patients, Healing.

Title:Is there a relationship between malnutrition and wound healing in Hospitalized patients withburns?
Author:EMAN SM Shahin, Amal Bakr Abo El-Ata, HANAN Hassan Elezaby, NESRINE Ezzat Mohamed Abdel-Karim
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract:Sleep health essential behaviour, sleep is a multidimensional, bio behavioural process that is essential to human health and function. Many factors that disturb Sleep among hospitalized patients negatively influence the quality of life. The objective; of the study was assessment factors affecting sleep-quality for patients in medical and surgical departments.Design;A descriptive design was applied in the current study. Setting; the study was conducted at the Medical and Surgical Departments at Ain Shams University Hospitals and El-Demerdash Hospital. Participants; A purposive sample of 212 patients was included. Methods; Three tools were used for data collection; Structured Interview Questionnaire, Assessment Questionnaire for Factors affecting Sleep quality and Sleep-Quality Questionnaire. Results of the study showed that there were highly statistically significant correlation between the sleep-quality for studied patients and department, classification of department, hospital length of stay and hospital room and a highly statistically significant positive correlation between the sleep-quality of studied patients and health & illness factors, environmental factors, and emotional factors. There was a statistically significant correlation between the sleep-quality for studied patients with age and gender.
Keywords:Factors affecting sleep; Sleep-quality; Sleep.

Abstract:Major gastric surgeries are among the most widespread operations in older adults’ patients reached growing rates of postoperative mortality and morbidity. The surgical opening is often approaching the diaphragm with a serious consequence of pulmonary complications which presented with miscellaneous atypical presentations making both diagnosis and management a challenge. The prudent use of therapeutic lung expansion guides like incentive spirometry and deep breathing exercises become imperative to increase lung volume and prevent such life-threatening complications. Here comes the responsibility of gerontological nurses toward facilitating the use of these modalities and factors that decrease geriatric patients’ awareness and hinder their education. Aim: The aim of the current study is to compare the effect of deep breathing exercises versus incentive spirometer on pulmonary complications among geriatric patients undergoing upper abdominal surgeries. Methods: Setting: This study was conducted at two surgical units affiliated to General Alexandria Main University Hospital, Egypt; specialized in upper abdominal surgeries. Subjects:  A total of 60 male and female older adults hospitalized to undergo upper gastric surgeries, selected using the consecutive sampling technique, and divided into three groups: two experimental groups (interventional group) and one control group (routine hospital care). Data were collected through five tools: Mini Mental State Examination, Socio-demographic and health profile of the geriatric patients structured interview schedule, Katz activities of daily living scale (six activities of daily living according to three levels of dependency; fully independent, partially dependent, and totally dependent), ARISCAT Risk index (7-independent risk factors), and Melbourne Group Scale (MBG, 8-item checklist). Results:  Lung expansion manipulations had statistical significant reduction on the outcrop of pulmonary complications following upper gastric surgeries in geriatric patients, as only 6.7% of those target patients in the study groups presented with these complications on the 6th postoperative day, compared to 60% of their counterparts in the control group.
Conclusion:  Application of either deep breathing exercises or incentive spirometer proved to be equally influential in diminishing the incidence of pulmonary complications denoting the period following upper gastric surgical operation for elderly subjects. The postoperative pulmonary complications for elderly who underwent these serious surgeries in the deep breathing exercise or incentive spirometer group proved to be lower than those in the matching group with a statistically significant difference between the groups. Recommendations: The pursuit of deep breathing exercises and/or use of incentive spirometer should be established as a routine interventional measure for older adult's patients undergo upper gastric surgeries in clinical settings. Developing of educational classes, posters, or brochures related to importance and steps of lung expansion modalities for both geriatric patients and gerontological nurses should be launched and stepped in the pre and post-operative period.
Keywords:Deep breathing exercises, Geriatric patients, Gerontological nurses, Incentive spirometer, Lung expansion modalities, Postoperative pulmonary complications, Upper abdominal surgeries.

Abstract:Catheter Associated Urinary Tract Infection (CAUTI) is widespread Health Acquired Infection that influence patient’s welfare and duration of hospitalization. Aim: Determine effect of implementing Indwelling Urinary Catheter (IUC) maintenance nursing care guidelines on CAUTI occurance in intensive care unit (ICU). Design: A quasi-experimental design pretest and post-test phase was used . Setting: The study was conducted in ICU affiliated to  Suez Canal University Hospital. Tools: Three tools utilized in this study; nurses’ knowledge questionnaire regarding IUC maintenance nursing care guidelines, nurses´ practice e observational checklist and patient observational assessment sheet. Result: The nurses total score for both knowledge and practice improved significantly after implementation of IUC maintenance nursing care guidelines (p-value= 000). Also, nurses’ knowledge and practice founded to be correlated positively to each other during both pretest phase and post-test phase (p-value= .000, .006) respectively. Improving nurses´ practice to more than one-fold result in decreasing CAUTI from decrease from 54.48 to 31.9 per 1000 catheter day. Conclusion: IUC maintenance nursing care guidelines enhance nurses’ knowledge and practice and decrease CAUTI rate in Suez Canal University Hospital ICU.
Keywords:IUC maintenance nursing care guidelines, Nurses´ knowledge and practice.

Abstract:Postpartum hemorrhage is the single most important cause of maternal death that accounting for about 27% of all maternal deaths and it is responsible for 19.7 % of all maternal death in Egypt. The studyaimed to assess nurses’ compliance with guidelines for reduction of postpartum hemorrhage during third stage of labor and early postpartum period. Design & Settings: A descriptive exploratory research design was conducted at labor and postpartum units in three governmental maternity hospitals in Alexandria namely: El-Shatby Maternity Hospital;  Dar El - Walada Hospital and Dar - Ismaeel Hospital Subjects: All nurses working at the previously mentioned settings were included in the study.Tools: Three tools were used to collect the necessary data: Socio-Demographic Structured interview schedule; Postpartum Hemorrhage Questionnaire and nurses’ compliance to guidelines for reduction of postpartum hemorrhage observational checklist.RESULTS: The majority of nurses were fairly compliant with guidelines for reduction of post partum hemorrhage, while an equal proportion (3.7%) of them was either good or poor complaint with the guidelines. However, that no statistical significant relationship was found between nurses’ knowledge and their compliance.Conclusion: It can be concluded that all nurses were fairly compliant with guidelines for reduction of post partum hemorrhage. Recommendations: Providing nurses with an instructional booklet regarding postpartum hemorrhage to enhance their knowledge and practices with periodic participation of nurses in training programs about postpartum hemorrhage to improve their knowledge, skills and ensuring from their compliance with guidelines for reduction of postpartum hemorrhage.
Keywords:compliance -postpartum hemorrhage.

Abstract:Obsessive compulsive disorders experience caused distress for patients themselves and family members due to the burden of the disease which includes the feelings of frustration, anger and guilt, addition to impairment in social activities.  Aim:  so the aim was to determine the level of Accommodation for both patients and family with adult obsessive compulsive disorders Design: The study followed a descriptive design. Setting: this study was conducted in the psychiatric out patient's clinics of the Psychiatry, Neurology and Neurosurgery Center affiliated to Tanta University in addition to the out patient's clinic of Tanta mental health hospital, affiliated to the ministry of health at Tanta city. Subjects: a purposive sample of 50 patients with OCD and their families fulfilling the inclusion criteria of the study. Tools:  Tools used were, (I) Family Accommodation Scale for Obsessive-Compulsive Disorder, Self-Rated Version (FAS-SR) and tool (II) Family Accommodation Scale for Obsessive-Compulsive Disorder Patient Version (FAS-PV). Results:  The results reveled 40% of the studied subjects aged from 30-40years with Mean ± SD 32.42  9.114 year, 60% of the studied patients were the majority of the patients 96% co habituated with their family. Most of the studied families (70%) had a high level of accommodation regarding their patients Obsessive-Compulsive symptoms and there was a high positive significant relationship between levels of family accommodation as reported by patients and their families. Conclusion: Based on the results it can be concluded that, regarding to the level of Family accommodation, the most of studied families had a high level of accommodation regarding their patients' Obsessive-Compulsive Symptoms as reported by the family members themselves. Recommendation: Family support may be needed to help relatives in dealing with frustrating patient's behaviors and to encourage more positive communication and reduce anger expression.
Keywords:Obsessive Compulsive Disorders (OCD), Family Accommodation (FA), Symptoms, Response.

Abstract:Health education is a critical component of nursing roles and community health nursing students, as the future nurses, across their educational process should be well prepared to be competent health educators at different community settings. Aim: The study aimed to assess health education challenges facing the nursing students at different community clinical settings at the faculty of nursing Alexandria University as well as to evaluate their satisfaction with the process of health education. Study design: Descriptive design was used to carry out this study. Study setting: The study was conducted at the Faculty of Nursing, Alexandria University. Study tools: Three tools were used for data collection from the students namely: Tool I: Socio-demographic Characteristics Structured Interview Questionnaire, Tool II: Health Education related Challenges Assessment Questionnaire, and Tool III: Health education Satisfaction Visual Analogue Scale. Study subjects: The study subjects consisted of234undergraduate nursing students during the second semester of their fourth academic year 2018-2019 and who were registered at the community health nursing department from the above-mentioned setting. Results: The findings of the present study reveal that the highest mean percentage of barriers were belonging to the health education termination phase (53.7±22.4) followed by the implementation phase (48.3±16.5).  Additionally, the student’s dissatisfaction level is the highest also in accordance with the termination phase followed by the conduction phase (59%,47% respectively). There a significant relationship between student satisfaction with the health education process and their gender at different community clinical settings especially schools and as well as the Family Health Center/MCH rotations where p-value was 0.049, and 0.001 respectively. Conclusion: The 4^th year nursing students at different community health clinical settings faced several barriers and challenges before, during and after giving their health education messages. These barriers namely: students' related barriers, content and audiovisual materials barriers, clients and environmental-related barriers, as well as evaluation barriers.  Recommendation: Nursing students have intense needs for practical training on conducting effective health education messages, developing audiovisual materials, soft skills especially communication skills, identifying the different health education barriers and how to overcome these barriers.
Keywords:Clinical learning environment, Health education, Barriers, Challenges, Nursing Students, Satisfaction, Community Health Nursing.

Abstract:The profession of nursing is considered a high and human profession because of its association with human health, preserving its life, alleviating its suffering and sense of pain. Nurses have an essential role in the healthcare system and services provided to patients. The effect of this role affected by the shortage of nurses globally, as well as in Saudi Arabia. The study aimed to explore the high school female student’s perspective toward nursing as a career. Design: Cross-sectional design. Setting: in High Schools for female in Riyadh. Sample: Convenience sample consisted of 517 students at the previously mentioned study setting. Tools: data obtained using nursing intentquestionnaire 3 parts. Including demographic data with eight questions in which response alternatives was specified to ensure comparability of the response and to facilitate analysis. The other two parts were adopted from a similar research work, including (a) the statements on knowledge with 12 questions, attitude with 10 questions and intention towards nursing with 5 questions and (b) the causes that prevent students from being nurses with 10 questions. Results: The findings of this study shows that although the students have good attitude toward nursing profession, majority of them not considered it as the best future career. Many factors affected their decision mainly the family and friends. In addition to that, society view and apperception of the profession plays in important role in the student's decision toward to purse nursing as a future career. Conclusion: Based on the findings of this study, it was evident that the intention of young female Saudi toward nursing profession still considered as a low. There is an evolving need to lunch a public awareness programs about the correct contemporary image of nursing profession compared with before. Recommendations: Public and practice health sectors are encouraged strongly to reflect the positive image of the profession and act as a role model in a way that improves the image of the nursing profession and encourages others to become a nurse. Solutions are suggested that improvement the imaging of the nursing profession to others through education and outreach community activities to improve public perception and value of the nursing profession.
Keywords:Nursing, Perception, Career, Knowledge, Influence, intention, Attitude.

Abstract:Leadership has become an important aspect of management practice in the changing health care environment. Globally, leadership development programs have become common in the last two decades to address the pressing need to prepare adequate numbers of leaders as well as help develop and improve leadership skills and abilities. Aim: This study aims at identifying the effect of leadership program on leadership practice among nurse managers. Design: Quasi experimental research design was used. Setting: This study conducted at Aswan University Hospital. Total study subjects included 40 nurse managers. Tools of data collection: Two tools were used to achieve the aim of this study namely; knowledge questionnaire sheet and leadership practice scale. Results: There was a highly statistically significant difference between nurse managers total leadership knowledge before, and immediately after implementing the program. While, there was a statistically significant difference between before and after three months of implementation the program. The present study finding showed that, the lowest leadership practice level was among nurse managers at pre training phase.  Moreover, as observed among nurse mangers at post and follow up training phases the total leadership practice level was increased markedly. Conclusion: There were statistically significance correlations between total leadership knowledge and of total leadership practice among nurse managers. Recommendations: Establishing more leadership development programs. Creating different strategies for promotion based on competences and performance.
Keywords:Nurse Manager, leadership style, leadership effectiveness, leadership.

Abstract:Breast cancer (BC) is the most common cause of female cancer-related mortality worldwide. Mammography is the primary test recommended for early detection of BC. Pain and anxiety are the most reported feelings during screening mammography. Aim of the study: To determine the effect of nursing interventions, based on providing health education, and teaching deep breathing exercise, on pain and anxiety related to screening mammography. Research design: A quasi- experimental research design was utilized in this study. Setting: This study was carried out at the Alexandria Regional Center for Women Health and Development, Alexandria, Egypt. Subjects: 100 adult women scheduled for screening mammographyin the above mentioned study setting. Tools: Three tools were developed ,adapted and adopted for data collection:a-Women' Knowledge Structured Interview Questionnaire to assess subjects' educational needs related to mammography, b-Visual Analog Scale (VAS) for anxiety to evaluate women's anxiety levels before, and during mammography. c- Pain Assessment Scale to evaluate pain intensity.Results: The mean age of the participants was (39.96 ±10.40), and 41.54 ±10.45 years old in both study, and control groups respectively. The nursing interventions had statistical significant reduction on pain, and anxiety levels of women undergoing screening mammography, as 60.0% of women in the study group experienced mild pain during the procedure, and 32% of them reported feeling relaxed or not anxious.Conclusion: Nursing interventions have the potential to south pain and anxiety in women undergoing screening mammography.  Recommendations: Development of mammography comfort practices should be considered equal to other imaging examinations assisted by nurses.

Abstract:Hemodialysis patients are more prone to develop complications related to their VA such as infection, clotting, rupture, aneurysm formation and stenosis lead to morbidity, hospitalization. Therefore, patient undergoing hemodialysis procedure requires special nursing care with high skilled personnel trained in the art of hemodialysis procedure to decrease those kinds of complications. Aim of the study: to evaluate the effect of nursing intervention on prevention of vascular access complications for patients undergoing regular hemodialysis. Study Design: Quasi-experimental research design was conducted in this study. Subject of the present study comprised from patients and nurses.120 adult patients were selectedfrom hemodialysis unit - Mansoura University Main Hospital & 30 nurses enrolled in the studies who are working in previously mentioned setting and directly contact, caring with those dialysis patients. Tools:Three tools were used for data collection, Structure Interview Patients Questionnaires Sheet,Structure Interview Nurses Questionnaires Sheetand Patient’s Outcome Assessment Sheet.Results: Knowledge and practice of the nurses improved significantly after nursing intervention implementation, where P ≤ 0.005, Vascular access complications greatly increased in the 1^st & 2^ed month for control group than study group with significant statistically difference, where P ≤ 0.005. Conclusions: There was significant improvement in nurse’s knowledge and practices leading to improvement function of vascular access, decrease complications and result in better outcomes for patient. Recommendation: Training and continuing education of the clinical practice guidelines for staff nurses are important to improve care provided in the hemodialysis units and maintenance their vascular access.
Keywords:Cannulation, Hemodialysis, Knowledge, Nursing intervention, practice, vascular access.

Abstract:The fact that hormonal imbalance leads to infertility has long been documented, evidence is also accumulating that oxidative stress plays a great role in female infertility. The present study comprises of 83 infertile women and 59 control subjects attending Rasheed Shekoni specialist hospital Dutse. All the analytes were analyzed using ELIZA technique. Serum levels of LH, FSH, PRL and 8-isopg F_2α of infertile subjects were statistically (p<0.005) higher than that of control of subjects. Conclusively, the infertility may be due to hormonal imbalance, oxidative stress or a combination of both factors.
Keywords:Infertility, Oxidative Stress, 8-isoPGF_2α, fertility hormones.

Abstract:Stroke survival rates have improved a lot over the last few years. There is a serious gap between stroke patients being discharged and transitioning to physical recovery programs. In an effort to improve recovery and quality of life, the American Heart Association has urged the healthcare community to prioritize exercise as an essential part of post-stroke care. With the right recovery programs that prioritize exercise for rehabilitation, stroke survivors can “relearn” crucial motors skills to regain a high quality of life. The purpose of this study is to create an infographic about the effectiveness of exercise and drug interventions on mortality outcomes in patients with stroke. 
Keywords:Exercise, Drug interventions, Stroke, Infographic.

Abstract:Upper gastrointestinal endoscopy is a diagnostic and therapeutic procedure that provide good view of the mucosal surfaces of the upper GI tract and management of many gastrointestinal conditions. Improving the outcomes of upper GI endoscopic patients requires the best efforts of nurses in multiple settings and roles, working collaboratively with other health team. The aim of this study was toevaluate the effect of designed guidelines on nurses̓ performance and patients̓ outcome regarding upper gastrointestinal endoscopy.Design: A quasi-experimental design was utilized to achieve the aim of this study.Setting: The study was conducted at gastrointestinal endoscopy unit at Ain Shams University Hospital. Sample: A convenient sample of all staff nurses working in gastrointestinal endoscopic unit. In addition, a purposive sample of 60 adult patients undergoing upper gastrointestinal endoscopic procedure was selected according to certain inclusion criteria and was divided into control and study group of patients. Tools of data collection: Self-administered questionnaire sheet for nurses, observational checklist for nurses and Patients’ outcome evaluation tool. Results: The results of this study showed that, total satisfactory level of nurses' performance (knowledge and practice) regarding caring of upper gastrointestinal endoscopic patient and Patients’ outcomes (complications and satisfaction) improved post implementation of the designed guidelines for nurses caring for upper GI endoscopic patients.Conclusion: Total satisfactory level of nurses' performance (knowledge and practice) and Patients’ outcomes (complications and satisfaction) improved post implementation of the designed guidelines for nurses caring for upper GI endoscopic patients.Recommendations: The study recommended the importance of implementing an educational training program to improve nurses’ performance regarding caring of upper gastrointestinal endoscopic patients and improving patients' outcomes.
Keywords:Upper gastrointestinal endoscopy, Designed guidelines, Nurses' performance patients' outcomes.

Abstract:Hypertension is a significant public and medical health issue worldwide. The primary goal of hypertensive patient management is to prevent adverse events, and decrease mortality through a patient’s compliance with their therapeutic regimen. The aim of this study was to assess the compliance level with the therapeutic regimen among hypertensive patients. Setting: The study was conducted at the Outpatient Clinic of Main University Hospital, Alexandria, Egypt. Materials and Method: This is a descriptive study. (100) adults hypertensive patients attending the pre-mentioned health setting. Sociodemographic and clinical data interview schedule and Hill Bone Compliance to High Blood Pressure Therapy Scale, were  utilized for data collection. Results: The mean age of the studied patients  were (42.59 ± 9.73) years old. The majority of the studied patients were male and employed (59.0%, 68.0%) respectively.  About two thirds of the studied patients (66.0%) were poor compliance with their therapeutic regimen . Statistically significant differences  were detected between total compliance score and age, gender,  employment status, educational level, marital status, income, family  history, duration of hypertension, smoking, as well as associated diseases  (p=0.001, 0.024, 0.007, <0.001, 0.013, 0.004, 0.002, 0.002 , 0.004 ,  0.009) respectively. Conclusion: the vast majority of the studied hypertensive patients were poorly compliant with their therapeutic regimen compared to  minority of them between average and good compliance. Recommendations: Applying a health teaching program for hypertensive patients to improve their knowledge and their  perception about compliance with the therapeutic regimen.
Keywords:Compliance, Therapeutic regimen, Hypertension.

Abstract:Maintaining adherence to antiepileptic medications can be considered the most important challenge in the management of epileptic patients. Non adherence to antiepileptic medication might lead to uncontrolled seizures, increased health care costs and death. Several factors could be associated with patients' ability to maintain adherence.Aim: The aim of this study was to identify the factors associated with medication adherence among epileptic patients.Setting: This study was conducted at the Outpatient Clinic of The Alexandria Epilepsy Center at El Hadara Orthopedic and Traumatology University Hospital, Alexandria, Egypt. Subjects: A convenience sample of 100 adult epileptic patients was selected from patients showing up at the study setting for receiving care and follow up. Tools: Three tools were used for data collection. Biosociodemographic data structured questionnaire (Tool I) and Factors Associated with Epileptic Patients' Adherence to Medications Checklist (Tool II) were developed by the researcher. Tool III: Korean Version of the Hill-Bone Medication Adherence Subscale (HBMA-K) was adopted and used to collect the necessary data related to factors which might be associated with medication adherence among epileptic patients. Results: (47) out of 100 epileptic patients had poor adherence to antiepileptic medications. The main factors associated with their poor adherence were related to the educational, social, economic, disease and therapy related, physical and psychological domains. Age, level of education, onset of disease, presence of aura and seizures precipitating factors were significantly associated with medication adherence (P =.000, .002, .000 .000 and.000) respectively. Conclusion: It was concluded that, nearly half of the studied epileptic patients were poorly adherent to their antiepileptic medications. Educating epileptic patients about the importance of their adherence to antiepileptic medications should be encouraged.  
Keywords:Medication, Adherence, Medication adherence, Epilepsy, Epileptic patients.

Abstract:Diabetic kidney disease (nephropathy) occurs in patients with diabetes mellitus (DM) and decreased kidney function that can be caused by many different causes, including hypertensive nephrosclerosis and acute kidney failure that has not been resolved.  Aim: This study aimed to evaluate the effect of self-management education program among patients at risk for diabetic nephropathy. Research Design: A quasi-experimental design was used. Setting: The study was conducted in Ain Shams University Hospital at diabetes outpatient clinic. Sample: A purposive sample comprised; Total number of 96 patients, their age ranged from 25 to 50 years, Diagnosed patients at risk for diabetic nephropathy on 1st, 2nd and 3rd stages from medical record. Tools: for data collection, 1st tool: An Interviewing questionnaire for the clients divided into three parts; Socio-demographic data, Past and present medical history related to diabetes mellitus and patients knowledge regarding diabetic nephropathy (pre/post self-management program). 2nd tool: Healthy practices assessment for patients at risk for diabetic nephropathy sessions (pre/post self-management program). Results: 46.8% of patients aged 45- ˂50 years, and 53.2 % were female. Regarding the type of diabetes, 63.6% of patients had Type II diabetes. Conclusion: There have been extremely statistically significant differences between patients` knowledge, their practice and their kidney health pre/post self-management education program.  Overall, the study has indicated that diabetes self-management education program had a positive effect on the improvement of self-care practices for patients at risk for diabetic nephropathy, which is attributable to better effect of patients` condition. Recommendations: raising community awareness and social support for diabetic patients through designing family program that have potentially important positive influence on patients’ self management.
Keywords:Diabetic nephropathy, glomerular filtration rate, Diabetes self-management education.

Abstract: Preeclampsia can cause life threatening problems during childbirth. Recently, physical stretching exercise is recommended in pregnant women with preeclampsia to reduce the developing complication. Aim: This study aimed to evaluate the effect of self-independent physical stretching exercise on Feto-maternal Outcomes among Mild Preeclamptic Pregnant Women. Design: Quasi-experimental prospective study research design was utilized. Setting: The present study conducted in antenatal clinic as well as labor units at Benha University Hospital in Benha city, Egypt. Sample: Purposive sample composed of 140 pre-eclamptic women at 28 weeks of gestation and age up to 30 years were included in this study. Tools: Data were collected through three tools I: Structured interviewing questionnaire: to assess socio-demographic characteristics and obstetric history of pregnant women. II: Antenatal follow up sheet: for clinical assessment of blood pressure, self-reported practices after performing physical stretching exercise. III: Maternal and Fetal Outcome Record: To assess maternal complication and fetal outcome. Results: the study revealed that there was high statistically significance decrease of study group`s systolic and diastolic blood pressure throughout follow up visits at p-value was 0.000, there was progressive improvements in all items of self-reported practices sheet as in the 6^th follow up visit, after practicing physical stretching exercise and also that there were highly statistical differences in the study & control group after delivery in all items of fetal assessment tool. Conclusion: The present study concluded that practicing self-independent physical stretching exercises are effective,  easier and safer for mild pre-eclamptic women. Recommendations: Involvement of physical stretching exercise programs in routine prenatal carefor pre-eclamptic women to be provided by specialized health care provider.
Keywords:Self Independence Physical stretching exercise, Feto-maternal Outcomes, Mild Pre-eclamptic Women.

Abstract:there is a noticeable prevalence of type 2 diabetes in Egypt in adults. Traditionally; DM is controlled by dietary modifications, hypoglycemic medications, exercises program, patient education and follow up. Among exercise program to control hyperglycemia are breathing exercises which are simple, effective and economically costless practice.This study aims to: examine the effect of sitting breathing exercises on blood glucose level among patients with type 2 Diabetes Mellitus.Research Design: A quasi-experimental research design one group pre – posttest design was used in this study. Subjects: A purposive sample was used and included sixty patients with type 2 diabetes mellitus in inpatient medical unit of Damanhur National Medical Institute, El-Beheria governorate, Egypt, 2019. Tool: Two tools were used for data collection: Bio-Socio-demographic and clinical data questionnaire and Blood Glucose Level pre and post sitting breathing exercise questionnaire. Results showed that the mean PPG before and after intervention during the second and third visit was reduced less than first visit with statistical significance in both 2^nd and 3^rd visits. Conclusion: post prandial blood glucose level can be improved through practicing simple sitting breathing exercise.Recommendations: Provide record sheet to help patient monitor himself periodically and start in-services training program for nursing about applications of sitting breathing exercise.
Keywords:DM, breathing exercise, blood glucose level.

Abstract:College student burnout is described as feelings of exhaustion due to academic demands, having cynical and detached attitude regarding school work, and feelings of incompetence with regard to academic ability. It can contribute to absenteeism, decreased motivation to succeed. Self-efficacy is people’s judgment of their capabilities to organize and execute courses of action required to attain selected   performances. The aimof this study was to find out the relation between academic burnout and self-efficacy among university nursing Students.The study was conducted at the Collage of Nursing, Hail University. Correlational research design was used on 123 male and female nursing students at 2^nd, 3^rd and 4^thyear. The data collection tools consisted of a self-administered questionnaire covering socio-demographic data, Maslach Academic Burnout and Self –Efficacy Scale. The study revealed that there was a positive correlation with statistically significant difference between academic burnout and self-efficacy scores among nursing Students. Recommendation of the study is establishing a program to decrease university nursing students’ academic burnout which consequently improves their self-efficacy.
Keywords:Academic burnout, self-efficacy, nursing student.

Abstract:Endometriosis is a life-threatening gynecological health problem for women in their reproductive age that cause chronic pelvic pain, subfertility, bowel and urinary dysfunction.  This study aimed to evaluate the effect of implemented nursing strategy based on health promotion model on alleviating endometriosis related symptoms. A quasi experimental study was conducted at out-patient gynecological clinic at Ain Shams Maternity University Hospital. A purposive sample was used to recruit ninety women already diagnosed with endometriosis. Three tools of data collection were used first was structure interviewing questionnaire, second tool was Health Promotion Lifestyle Profile-II, and third tool was, Endometriosis Health Profile questionnaire (EHP-30). The result of the study displays that, highest endometriosis related symptoms are fatigue, dyspareunia, chronic pelvic pain, and dysmenorrhea that represent 86.4%, 86.4%, 81.8% and 65.9% respectively among women in control group as compared to 84.8%, 86.9%, 80.4%, and 65.2% of intervention group pre intervention. In addition, there is a statistical significant difference between women in both groups regarding endometriosis related symptoms pre-intervention (X2 = 1.95     P=0.83).  While, there is a highly statistical significant difference between women in both groups regarding endometriosis related symptoms post-intervention (X2 = 8.37     P=0.001). Furthermore, there is a highly statistical significant improvement on health promoting lifestyle profile II and endometriosis health profile after implementation of nursing strategy. Conclusion and recommendations: The study concluded that implemented nursing strategy based on health promotion model was effective on alleviating endometriosis related symptoms. Accordingly, the following recommendation is proposed: Implemented nursing strategy based on health promotion model to alleviate endometriosis related symptoms at out-patient gynecological clinic and other health care services providing care for women suffering from endometriosis.
Keywords:Nursing Strategy, Health Promotion Model, Endometriosis Related Symptoms.

Abstract:Lymphedema is a serious complication post-mastectomy and remains to be a great source of morbidity for breast cancer survivors with axillary lymph node dissection. Prevention of lymphedema after mastectomy is important for long-term survival and improvement the QOL. Aim of the study: The study aimed to evaluate the effect of pre-discharge educational interventions on womens’ knowledge and self-care practices related to prevention of arm lymphedema after mastectomy. Subjects: The sample consisted of 80 females undergoing mastectomy along the period of 6 months. Tool: six main tools were used for data collection, Tool I: Interview questionnaire sheet, Tool II: Performance observational checklist of exercises, Tool III: Self-reported instructions for arm lymphedema prevention, Tool IV: Arm measuring tool, Tool V: Upper Extremity Functional Index and Tool VI: lymphedema tracking tool. Results: All of study sample was females; nearly half of them were in age group (40- <50), most of patients in both groups had poor knowledge related to lymphedema prevention pre intervention and most of study group had good knowledge post intervention while most of control group had poor knowledge pre and still poor after surgery. Most of control group had lymphedema post-surgery. Conclusions: It was concluded that, pre-discharge educational interventions improved knowledge and self- care practices regarding arm lymphedema prevention post mastectomy and minimizing arm morbidity during the follow up period for women of the study group. Recommendation: It is recommended that, conducting a comprehensive health education program for women following breast cancer surgery to ensure adherence to self- care & prevention of lymphedema and availability of instructional guides for all mastectomy patients.
Keywords:breast cancer, mastectomy, lymphedema prevention, self- care, pre discharge educational interventions.

Abstract:are in need for different types of support the aim of this study to evaluate the impact of continuous positive air way pressure (CPAP) in improving Quality of life for patients with obstructive sleep apnea.Patient and Methods: Quiz experimental (before and after) research design was conducted at the Sleep center in Chest Department at Assiut University Hospital. Sample: A convenience sample of 100 adult patients from both sexes with OSA. Tools: a Patients' interviewing questionnaire sheet, Pulmonary function tests, the St. George’s Respiratory Questionnaire (SGRQ), Respiratory disturbed index (RDI) after full polysomnographic study, and designed nursing intervention protocol. Results: The study findings revealed that 52% were female, 44% of the studied patients were illiterate, read and write. Moreover, 88% of them were overweight and obese the BMI <25, added to them about 28% of them were smoker. Majority of the studied patients had tired and fatigued & day time sleepiness. All of studied patients had moderate and severe OSA and not present any mild case.Conclusion: OSA patients before used CPAP machine had moderate level of air way limitation, severe OSA, fear from a wearing of CPAP mask, tired, fatigue & reduce of HRQL. After nursing intervention about important of continuous using of CPAP machine appear reduced feeling of fear from machine and from CPAP mask, reduced of tired, fatigue, sleepiness and increased number of normal sleeping hours, and improving of patients knowledge about CPAP machine and improved work of respiratory systems and health related quality of life.
Keywords:OSA, CPAP, Polysomnography, Respiratory Disturbed Index and The St. George’s Respiratory Questionnaire (SGRQ).

Abstract:Body of evidence for the potential health benefits of phytoestrogen food is increasing, especially in the management of hot-flushes which is the most menopausal vasomotor symptom. Aim: This study aimed to evaluate the effect of educational intervention regarding phytoestrogen food on hot-flushes among menopausal women. Design: A quasi-experimental research design utilized to conduct this study. Setting: The present study conducted at Faculty of Nursing and Technical Institute of Nursing employees' offices, Mansoura University, Egypt. Sample: A purposive sample of forty-six menopausal women was included in this study. Tools: Data were collected through three tools I: Self-administered questionnaire to assess socio-demographic characteristics and menopausal women’s knowledge regarding phytoestrogen and hot-flushes. II: Menopausal Hot-Flushes Index to measure frequency and severity of hot-flushes III: Hot-Flush Related Daily Interference Scale to assess the effect of hot-flushes on a woman’s daily activities. Results: This study revealed that, there was an improvement in knowledge of menopausal women regarding hot-flushes and phytoestrogen at the follow-up after six months than before educational intervention with highly statistically significant differences. Also, there was a decline in the frequency and severity of hot-flushes after educational intervention than before. Conclusion: The present study concluded that educational intervention improved the menopausal women knowledge regarding phytoestrogen food effect on hot-flushes which affect on decreasing the frequency and severity of hot-flushes and lower hot-flushes daily interference scores overtime. Recommendation: Raising menopausal women awareness regarding importance of phytoestrogen food by approaching camping in rural and urban areas.
Keywords:potential health benefits, phytoestrogen food, hot-flushes, menopausal women.

Abstract:Accurate nursing management of postoperative pain is imperative to provide optimum pain relief. Knowledge deficits, inadequate skills and inaccurate beliefs among nurses may impede the management of postoperative pain.Aim: This study aimed to assess nurses' competence in pain management among patients post laminectomy.Setting:This study was conducted at the inpatient neurological department at the Main University Hospital, at Alexandria University, Egypt. Subjects:All the available nurses (32 nurses) who were providing nursing care of patient’s post laminectomy were included in the study.Tool: Two tools were adapted and used to collect the necessary dataabout the nurses' knowledge, skills and attitude. Results:More than75% of the studied nurses had a very low level of competence in post laminectomy pain management. Statistically significant relationships were found betweenthe studied nurses educational level, attendance in training program and their knowledge where p = 0.002 and 0.007 respectively.  Conclusion:It was concluded that, the studied nurses had inadequate knowledge, a negative attitude, and did not perform adequate skills to manage pain among post-laminectomy patients.
Keywords:Nurses' competence, Pain, Pain management, Post laminectomy.

Abstract:Rheumatoid arthritis is a chronic disabling autoimmune joint disease that may affect other body parts and have serious effects on elderly patients general health status, it requires a multipronged approach for its management, and elderly patients have an important role to play in terms of their rheumatoid arthritis disease self-care behaviors.Aim: Evaluate the effect of nursing interventions on self-care behaviors and knowledge for rheumatoid arthritic elderly patients.Methods: A quasi-experimental design was used. Setting: This study was conducted in rheumatology and rehabilitation outpatient clinic of Mansoura university hospital. 30 rheumatoid arthritis elderly patients were included in the study (pre and post) group. Data were collected by using four tools: Structured Interview Assessment, Elderly Patient Knowledge Questionnaire about Rheumatoid Arthritis, Self-Care Behavior Scale of Rheumatoid Arthritis patients and Rheumatoid Arthritis Outcome Score. Results: there is a statistical significant difference  in the total mean score of knowledge and self care behaviors and it’s categories of rheumatoid arthritis study participants  before and after implementation of the proposed interventions (P1₌0.001) (P2₌0.001) respectively. Conclusion: Significant improvements in the total mean score of knowledge and self-care behaviors after implementation of the proposed interventions. The higher level of knowledge and self-care behaviors, the better quality of life and rheumatoid arthritis disease prognosis of study participants.Recommendations: Comprehensive training for rheumatology nurses and family caregivers about rheumatoid arthritis treatment, complications and nursing management, instruct rheumatoid arthritis elderly patients to share their experiences about the disease with other patients and health care providers during follow up and distribute the developed booklets and flyers to all rheumatoid arthritis elderly patients to have a source of knowledge available at any time they need.
Keywords:Elderly, knowledge, Rheumatoid Arthritis, Self-Care Behaviors.

Abstract:The central venous pressure remains the most frequently used variable to guide fluid resuscitation in critically ill patients which may be influenced by several elements such as intra-thoracic pressure and cardiac function. Aim: The current study aimed to investigate the effect of safety guidelines during different measuring techniques on central venous pressure readings in mechanically ventilated patients. Method: A prospective comparative study design was utilized in the current study. This study was conducted at the Internal Anesthetic Intensive Care Unit (IAICU), Emergency Hospital, Tanta University Hospitals. A purposive sample of 50 adult mechanically ventilated patients admitted to the previously mentioned setting. Two tools were used in data collection; central venous catheter assessment tool and central venous pressure monitoring schedule.Results: Safety guidelines were more effective in declining the percentage of central venous catheter complications such as infection and occlusion. Also, statistically significant differences were observed at three techniques of measuring central venous pressure (p< 0.05). The mean differences of central venous pressure were (2.03, 2.23, 2.47 and 2.01cm H2O) between positive end expiratory pressure =5 at supine position and baseline positive end expiratory pressure = 0. Also, they were (0.98, 1.24, 1.12 and 1.00 cm H2O) between reverse trendelenburg position and baseline positive end expiratory pressure = 0 at supine position for four consecutive readings.Conclusion: The results of the current study concluded that there was a direct good relationship between implementing safety guidelines and central venous pressure monitoring which reflected on readings. Also, central venous pressure was affected significantly during an increase in positive end expiratory pressure and changing position. Both supine and reverse trendelenburg position with positive end expiratory pressure =5 are suitable for the estimation of central venous pressure. Approximately, an increase in positive end expiratory pressure to 5 cm H2O was associated with about 2.0 cm H2O elevation in central venous pressure value at the supine position. Additionally, an increase in positive end expiratory pressure to 5 cm H2O was associated with about 1.0 cm H2O elevation in central venous pressure value reverse trendelenburg position (2.00 versus 1.00).
Keywords:Safety Guidelines, Different Measuring Techniques, Central Venous Pressure and Mechanically Ventilated Patients.

Abstract:Atrophic vaginitis is one of the most significant determining factors of sexual function and urogenital health, with a considerable effect on the quality of life of postmenopausal women. It affects 10 to 40% of postmenopausal women worldwide. Aim: the study aimed to assess knowledge and practices of elderly women about atrophic vaginitis and to assess the impact of health education program on improving knowledge and practice of elderly women regarding atrophic vaginitis. Subjects and Methods: Quasi-experimental study design was used and conducted at out-patient clinics of Sohag University Hospitals, 100 elderly women were participated in this study. An interview structured questionnaire developed by the researchers that included four parts was used to collect necessary data; personal characteristics, women's history of vaginitis, their knowledge, and practices. The questionnaire was filled two times before and after program implementation.Results: 49% of the participated women reported that they had history of vaginitis and none of them seek medical help. The total knowledge of participated women improved highly significantly following the program intervention from 9.00±5.16 to 16.71±3.91 grades (p<0.001). Also, the total practice score of women recorded a statistically significant rise following the program intervention from 1.53±0.98 to 2.36±1.20 grades (p<0.05). Conclusion: Educational health programs for atrophic vaginitis are very beneficial and proved their importance in raising women knowledge and improving their practices. Recommendation: Application of other educational health programs to improve awareness, practice, and attitudes in addition to helping women adopt coping strategies for other postmenopausal manifestations.
Keywords:  Atrophic Vaginitis, Health Education, knowledge, Postmenopausal Women, Program, practice.

Abstract:Total knee arthroplasty (TKA) is considered international standard of care and one of the most common successful surgical interventions for treating degenerative knee arthritis. Health education is very essential for patients undergoing (TKA) as patients have numerous fears and expectations as regards their postoperative outcomes. The aimof this study was to evaluate the efficacy of implementing preoperative health education program on post-operative outcomes of patients undergoing total knee arthroplasty. Materials and method: quasi experimental design was utilized at orthopedic department at Mansoura University Hospital. A purposive sample of (60) patients undergoing TKA was randomly divided into two groups with equal size (control and study). Tools: Two tools were used to collect the data and achieve the aim of the study as follows: Tool I: Structured Interview Questionnaire includes three parts; demographic and medical data, patients’ knowledge assessment, and patients’ self-reported practices, Tool II: patients’ outcomes assessment questionnaire. Results: The present study showed significant improvement in the level of total knowledge, self- reported practices and total Knee Injury and Osteoarthritis Outcome Score (KOOS) in the study group in comparison to the control group post educational program. The study concluded that; pre-operative educational program has a positive effect on postoperative outcomes of patients undergoing total knee arthroplasty. The current study recommends;developing educational and rehabilitation programs to improve postoperative outcomes of patients undergoing total knee arthroplasty.
Keywords:Health education program, postoperative outcomes, Total knee arthroplasty.

Abstract:Self-esteem of children is how children value themselves, while self-efficacy is a child’s belief in his or her ability to succeed in a particular situation; this study is about effect of nursing intervention program on self-esteem and self-efficacy of children undergoing hemodialysis. Aim of the study : This study aimed to evaluate the effect of nursing intervention program on self-esteem and self-efficacy of children undergoing hemodialysis. Setting: At children hemodialysis unit in menoufia university hospitals. Design: A quasi-experimental design (Pretest/ Posttest design). Subjects: A convenience sample of all available children who are undergoing hemodialysis in the previous setting (no=58) were included in this study.Tools: three tools were used 1- Interview questionnaire sheet. 2- Self-esteem scale. 3- Self efficacy scale. Results: reveals that only (14%)  of the  sample has high self-esteemin pre intervention ,which increased to( 84%) in the post intervention then increased to (86%) during follow up, only (12%)  of the  sample has high self-esteemin pre intervention ,which increased to( 94%) in the post intervention then decreased to (88%) during follow up and there is a  positive high significant correlation between self-esteem and self-efficacy . Conclusion: Children undergoing hemodialysis have low levels of both of self-esteem and self-efficacy pre intervention program , There is an increasing and enhancement of levels of both of self-esteem and self-efficacy of children undergoing hemodialysis post intervention program , in follow up and There is a strong positive correlation between self-esteem and self-efficacy among children undergoing hemodialysis pre and post intervention program.  Recommendations: An educational program and training program for health care givers, parents and teachers about how to foster both of self-esteem and self-efficacy and to relieve psychological distress. Also Media attention to the phenomenon of low self-esteem and low self-efficacy in children undergoing hemodialysis and provide broadcast awareness programs help to solve the problems of this phenomenon.
Keywords:Self esteem; Self efficacy; Hemodialysis; Children.
Title:Effect of a Nursing Intervention Program on Self-esteem and Self-efficacy of Children Undergoing Hemodialysis

Abstract:The aim of the research was to evaluate the efficacy of safety measures and discharge planning guidelines on nurses for enteral nutrition of comatose patients. Research Design: Quasi-experimental design has been used to assess the impact of tailored intervention guidelines on the understanding and performance of nurses and to attain the research objectives. Setting: The research was carried out at Benha and Zagazig University Hospitals ' intensive care units. Sample: 60 Sample of convenience chosen from the accessible nurses working in Benha and Zagazig University Hospitals ' intensive care units. Tools: two developed tools were used, The first tool was the interview questionnaire for nurses, which covered two parts: Part 1: demographic data for nurses (age, education level, years of experience and marital status); Part 2: questionnaire sheet for assessing nurses ' understanding of safety measures during enteral nutrition delivery and the design of the discharge plan. The second tool: an observational checklist to evaluate: the practice of nurses in implementing the safety measure and the execution of the discharge plan during enteral nutrition. Results: The findings of the research showed that: more than three-quarters of nurses (88.3 per cent) had inadequate understanding prior to the completing of the guidelines.  On the other side, after the guidelines were implemented, more than two-thirds (75%) of nurses had a strong degree of understanding. More than half of nurses (55%) also had a decent degree of understanding after two months of application. Before the guidelines were implemented, more than three-quarters of staff (83.3%) had an unsatisfactory amount of exercise. However, the bulk of nurses (78.3 percent) had a level of excellent practice compared to pre-intervention after the instructions were applied.   After two months of applying the guidelines, the significant statistical correlation coefficient was found at p-values < 0,001 between the knowledge, practice and specific demographic data of nurses. Conclusion: The study concluded that there was a statistically significant improvement in the overall knowledge and practice of nurses in the application of safety measures during enteral nutrition, in particular following guidelines. Recommendations: Based on the outcomes of the research, we suggested that: ongoing safety measure training should be implemented to refresh the understanding of nurses by providing enteral nutrition to comatose patients. In addition, he stressed how to develop a comatose discharge plan as part of safety measures in the training of nurses.
Keywords:Safety Measures , Discharge Planning, Enteral Nutrition, Comatose Patients.

Abstract:The Impact of social Media on Consumer Behaviour in Nigerian marketing.
The study used a sample size of 130 populations, from accessible population of 200. (spss) was used to carry out the analysis. Data were analyzed using the regression of the correlation to own the t-test hypotheses. The advent of social media has created a new landscape which lays out a new grid of personalconnections. Businesses see enormous opportunities and are eager to tap into the trend of social media on consumer behaviour in Nigerian Marketing, whereas consumers are put back to the canter in the business world because of social media.There are many studies explaining reasons to tap into social media and to help companies togain a better position in the transition;
Keywords:social Media, Consumer Behaviour, Nigerian marketing.
Title:The Impact of social Media on Consumer Behaviour in Nigerian marketing
Author:CHRISTIAN FRIDAY AKPAN
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract:Chronic gastritis is a serious disorder that refers to a group of conditions that cause chronic inflammation of stomach mucosal lining and it can be controlled through efficient lifestyle modifications side by side with use of the prescribed medications.This study aims to: assess life style of patients with chronic gastritis.Research Design: Descreptive research design was used in the study. Subjects: A Convenience sample included 150 male and female adult patients diagnosed with chronic gastritis in endoscopic and Hematemesis unit in of Damanhur National Medical Institute, El-Beheria governorate, Egypt, 2019. Tool: One tool was used for the purpose of data collection "Life style assessment of patients with gastritis interview schedule" to investigate life style for patients with chronic gastritis.Results more than half of the patients were male and in the age 50 to 60years. The result shows that, more than half of the smoker patients 67.4% were smoking cigarettes, while 32.6% of them were smoking shisha, in addition, it was found that, less than half of the studied patients 42.7% had sleeping problems at night, and more than half of them 53.1% had insomnia. The majority of the studied patients 98.0% reported that, they used to drink beverages containing caffeine as coffee, tea and nescafe, and more than half of them 66.7% used to drink them three and more times per day.Regarding the current mood, it was noticed that, the majority of the studied patients 81.3% were in nervous mood, and all of them were always in this mood. Conclusion: unhealthy patient's life style as exercise, stress, alcohol intake and beverages containing caffeine were among patients' life style. Recommendations: Involve life style modifications within patient's management plan and involve patients and family this plan of care.
Keywords:Chronic gastritis, life style, patients.

Abstract:The link between physical inactivity and coronary heart disease is well recognized. Meta-analyses of the benefits of exercise based cardiac rehabilitation indicate it can reduce total mortality and cardiac mortality. Exercise training results in multiple health benefits, many of which are particularly relevant to patients recovering from cardiac illness. The purpose of this study is to create an infographic about the effectiveness of exercise and drug interventions on mortality outcomes in patients with coronary heart disease. 
Keywords:Exercise, Drug interventions, Coronary heart disease, Infographic.

Abstract:community health nurse consider cornerstone and play important role in vaccination session. The aim of the study was to assess the nurse’s role in vaccination sessions in primary health care units in El-Hossania city at Sharkia governorate. Subject and Methods: research design: Descriptive study design was used in this study. Subjects: the study included 86 community health nurses. Setting: working in primary health care units in El- Hossania city. Tools of data collection: data collected by questionnaire to assess socio- demographic data and nurse knowledge, observation check list to observe nurses practice. Results demonstrate that 55.8% from studied nurses had inadequate knowledge about vaccination and 60.5% from studied nurses had inadequate practice. Conclusion: There are more than half of studied nurses had inadequate knowledge about their role throughout vaccination session. Meanly two third of them had inadequate practice throughout vaccination session. Only one third of them had good practice. Recommendations: Health education programs to community health nurses should be offered at regular intervals about vaccines, different types of vaccines and nature of each vaccine. Educate nurses about proper method of cold chain and it’s important for safety of vaccine and keeps its potency.
Keywords:nurse's knowledge, nurse's practice and vaccination session.

Abstract:Nursing students are prone to stress due to the transitional nature of college life. Students are subjected to different kinds of stressors such as the pressure of academics with an obligation to succeed, an uncertain future and difficulties of integrating into the system. High levels of stress are believed to affect student’s health and academic functions. The aim of this study was to explore the relation between stress and psychological wellbeing among university nursing students. A descriptive correlation, cross – sectional research design was utilized to conduct the current study. The study was conducted at faculty of nursing, Menoufia university. systematic random sample (200 students) from the above mentioned setting were recruited . Data were collected using (1): A structured interview questionnaire to assess; socio-demographic characteristics of nursing students. (2): Student nurse stress index. (3): Psychological wellbeing scale. The collected data were analyzed using SPSS version 16. Graphics were done using Excel program. Quantitative data were presented by mean (X) and standard deviation (SD). Qualitative data were presented in the form of frequency distribution tables as number and percentage. It was analyzed by chi-square (χ2) test and Kruskal Wallis and test correlation coefficient is used to measure the direction and strength of the correlation between variables. The results revealed that, the mean age is (18.2±0.44), and most studied subjects were females (82%), The majority of studied subjects were single (98%), more than one third had moderate stress level, one third of the studied subjects (33%) had mild level of psychological wellbeing and there was highly statistically negative correlation between stress and psychological wellbeing of the studied subjects. Conclusion: there was highly statistically negative correlation between stress and psychological wellbeing of the studied subjects. Recommendation:Based on the results of this study it was  recommend that: (1) Screening for high-risk students should be done and referral when necessary.(2) Guidance and counseling unit should be part of the faculty management system to help the  students to discuss issues affecting their psychological wellbeing .(3)Replication of the study using a larger sample in different settings to generalize the results.
Keywords:Stress, psychological wellbeing, University nursing students.

Abstract:Heart failure is a life-threatening condition in which the heart can no longer pump enough blood to meet the metabolic needs of the body (American Heart Association, 2017). Heart failure has a broad-ranging impact, affecting almost every important aspect of patients’ lives. Patients suffering from heart failure frequently feel physical suffering and anxiety. A massage provides both physical and emotional wellness. Aim of the study: to examine the effect of back massage on anxiety and physiologic responses in patients with heart failure. Setting: The study was carried out at the coronary care unit at Menoufia University Hospital. Sample: A convenient sample of 84 patients of both sexes with congestive heart failure. Design: A quasi experimentdesign (study/control) was utilized. Tools: A Semi Structured Demographic Questionnaire; State Anxiety Inventory Scale; New York Heart Association Classification of Heart Failure and Biophysiological Parameters Sheet were used to collect data. Results: There was a highly statistically significant decrease in the mean score of total anxiety and improvement in physiologic responses (systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate and oxygen saturation) between study and control group post intervention, P< .001.Conclusion: After back massage for 3 consecutive days, the participants’ systolic and diastolic blood pressure, heart rate, and respiratory rate were significantly lower than pre intervention, while their oxygen saturation levels significantly increased.Recommendation:  Massage therapy should be used to balance the vital signs and reduce anxiety level of patients with heart failure admitted to the coronary care units.
Keywords:Anxiety, Back Massage, Congestive Heart Failure, Physiologic Responses, Coronary Care Unit.

Abstract:Training about infection control standards is very important issue in health care organizationsand lead toimprovementin knowledge and practice resulting in controlling infection. Aim: The purpose of this study was to develop a training of trainers program about using personal protective equipment at health care organizations. Study Design: A cross sectional designwas used to accomplish this study. Data collection: The data was collected from October 2017 to April 2018. Setting: The study was conducted at different health care settings of Mansoura distract. Study sample: Convenient sample was used and about 59 members of infection control team participated as trainers at the present study.  Tools: Three tools were used in this study includedself-administered demographic and occupational characteristics questionnaire,self-administered knowledgeassessment questionnaire, structured interview to assess knowledge related practice of trainers in designing and implementing a training program. Results: The result of this study showed that trainer’s knowledge and practice were poor in pre program and improved in post training program. Conclusion:  This study concluded that after implementation the trainingprogram there was aremarkable improvement of trainer’s knowledge and practice; this was clear in post-test results. Recommendations: Continuous training of trainers program and refreshing courses should be conducted for trainers to update their knowledge and practice about training of personal protective equipment.
Keywords:personal protective equipment, infection control, training of trainers.

Abstract:Diabetic foot ulcers (DFUs) contribute significantly to the morbidity and mortality of patients with diabetes mellitus and still one of the commonest sequelae following trauma or infection mainly around the distal ends of limbs where the vascularity is relatively decreased due to effects of diabetes. Aim: was to evaluate the effect of applying topical insulin in healing process of diabetic foot ulcer among diabetic patients. Subject and Method: Quasi-experimental design was utilized in this study on a purposeful sample of (60) diabetic foot ulcer patients, divided into two equal groups, study group who receive topical insulin dressing and control group who receive routine hospital dressing at diabetic foot unit at Mansoura University Hospital. The data collection period was extended from 1/4/2017 to the end of February 2018.
Tools: Two tools were used in this study; (1) Socio-demographic characteristics and medical data; (2) Diabetic foot Ulcer Scale for Healing (DFUSH). Results: There was a significant improvement in diabetic foot ulcer healing for the study group compared to their control, where p value (˂0.05). Conclusion: Topical application of insulin has a very powerful effect in healing process for diabetic foot ulcer. Recommendation:Using topical insulin dressing for patients with Diabetic foot ulcer.
Keywords:Healing process, Diabetic Foot ulcer, Topical insulin, Diabetes.

Abstract:Determine female sexual dysfunction during reproductive age: types and associated risk factors. Methods: Design: Cross-sectional study design .Setting: Study was conducted at inpatient wards of Obstetrics and Gynecology departments in Mansoura University Hospital, International Hospital; known as New General Hospital now, Old General Hospital, and Sandoub Insurance Hospital. In addition to 3 Maternal and Child Healthcare Centers (MCH) in Mansoura City (i.e., Meetkhamees MCH, Weechelhagar MCH, and 1st Health office MCH). Subject: Simple random sample of 600 married women; in reproductive age (i.e., 18 to 49 years), were selected by choosing attendant woman seeking care or a woman accompanying her. Tools: Two tools are used; structured interviewing schedule and Female Sexual Function Index questionnaire (FSFI).Results: The study findings revealed that female sexual dysfunction was present in 71.7% and sexual function was present only in 28.3% of them. Lack of desire (48.2% ), lack of sexual arousal (72.2%), vaginal dryness (41.3%), lack of orgasm (78.2%), lack of satisfaction (71.3%), and pain during or after sexual activity (71.7%). FSD was significantly affected by age, type of family, marriage dissatisfaction, most causes of dissatisfaction were marital disharmony, financial troubles, forced to marriage, and family violence, pregnancy, using contraceptive methods as safe period, and subcutaneous capsules , and factors related to their husbands as reluctance for practicing intercourse, senility,  or choosing bad time Conclusion: Female sexual dysfunction is a complex and highly prevalent problem that affects a large number of women with low reporting rates as they are embarrassed to talk about their sexual life, and reluctant to seek medical help. It is classified into sexual interest ⁄ arousal disorders, orgasmic disorders, and genito-pelvic pain ⁄ penetration disorders. Various factors affect female sexual function as age, type of family, level of education, family income, residency, pregnancy, parity, number of children, circumcision, and the type of used Recommendation: Educational programs must be conducted to raise the awareness of maternity nurses, and women regarding female sexual dysfunction to be oriented by the normal sexual function, sexual dysfunction symptoms, decreasing, and aggravating factors to seek for appropriate help.
Keywords:Female Sexual dysfunction, Reproductive age.

Abstract:Even though smoking is a major reason for the development and progression of chronic obstructive pulmonary disease (COPD) and quitting smoking is the only way to stop its progression, a significant number of smokers still continue to smoke after being diagnosed with COPD. This may be attributed to little information exists on how smoking cessation influences pulmonary functional parameters as PFT and SPO2 and clinical parameters as ADL, functional exercise capacity, respiratory symptoms and anxiety. Furthermore, the nurse plays an important role to help smokers to quit smoking; assess, advice, explain, motivate and refer to specific health services. This study aimed to: Compare between pulmonary functional and clinical parameters among smokers versus Ex-smokers chronic obstructive pulmonary disease patients. Research design: A descriptive comparative research design was used. Setting: This study was carried out at the Outpatient Clinic and Inpatient Chest Departments of the Alexandria Main University Hospital. Subjects: A convenience sample of 60 male and female adult patients from 40-60 years old currently diagnosed with chronic obstructive pulmonary disease. Tools: Two tools were used: Tool I: Pulmonary function assessment tool and Tool II: Clinical parameters assessment tool. Results: As for pulmonary function assessment, there were statistical significant differences among smoker and ex-smoker group regarding FEV1, FVC and oxygen saturation and there was no statistical significant difference regarding FEV1/FVC ratio. In relation to clinical parameters, there were statistical significant differences among smoker and ex-smoker group regarding Activities of daily living (ADL), functional exercise capacity that were assessed by (6MWT), respiratory symptoms (cough, sputum production, wheezing and grade of dyspnea that was assessed by mMRC) and there was no statistical significant difference regarding anxiety level. Recommendations: Study the similarities and differences between smokers and ex-smokers severe and very severe COPD patients and Study the psychological impact of smoking cessation of COPD patients.
Keywords:chronic obstructive pulmonary disease, clinical parameters, ex-smokers, pulmonary functional parameters, smokers.

Abstract:Hemodialysis requires access to blood vessels capable of providing rapid extracorporeal blood flow. Arteioveous fistula (AVF) is commonly used as vascular access for patients who require hemodialysis. Hemodialysis nursing is a specialized area of nursing practice focusing on needs of patients with renal failure and their families across the life span. Aim: The aim of the study was to evaluate the effect of implementing nursing guidelines on reducing post-operative AVF complications among end stage renal disease patients. Design: A quasi experimental design was utilized for data collection. Setting: The study was conducted in Surgical &Hemodialysis unit at EL Fayoum University Hospital. Sample: A purposive sample composed of 60 adult post-operative AVF patients from both gender which will be randomly and alternatively divided into two equal study &control groups (30 for each).Tools of data collection: data collection tool included: Interview Patient’s assessment sheet, knowledge assessment sheet, Patient’s practices observational checklist andobservational checklist of post-operative AVF clinical outcome. Results: The study revealed that there was a significant difference in decrease of AVF complications among study group after implementing nursing guidelines Conclusion: The application of nursing guidelines is effective on reducing post-operative AVF complications. Recommendation: Developing instructional booklet to be given to all admitted patients who will perform AVF. of pain.
Keywords:  Arteioveous fistula, End stage renal disease.

Abstract:Unsafe use pesticide in agricultural sector often has been associated with several concerns. For safety of farm-workers, health educator are responsible for training them in the safe use of pesticides. Combining evidence-based interventions into health education programs is generally more cost-effective than implementing a single intervention into the health care system. Aim: The aim of this study was to assess the effect of Evidence-Based Health Education Program for Controlling Pesticides Hazards at Farms on practice of farm-workers. Setting: The study was carried out at El-Mansoura district. The included villages were Shoha, Beddin and Al-Malha. Design: Quasi-experimental research design was utilized throughout this study. Sample: two types of sample were used; village sample’s and farm-workers’ sample. Only (3) villages at El-Mansoura district agreed to participate in the study. Sample size of farm-workers was 158 (n=158) selected from included villages.Tools: 1) Demographic and occupational structured interview sheet 2) Farm workers' practice in handling pesticides observation checklist pre and immediately post application of evidence-based health education program 3) Farm-workers' feedback structured interview after application of health education program. Results: The study revealed that there was significant improvement in farm-workers’ practices, where the mean of total practice score of them had significantly improved from 78.43±12.86 pre application of program to 118.23±7.24 immediately post application of program. Conclusion: It can be concluded that application of evidence-based health education program for controlling pesticides hazards at farms would be a safe and custom-made intervention that ensures the preferred health outcomes. The application of developed evidence-based health education program resulted in improvement in farm-workers practice to control pesticides exposure and hazards at farms.Recommendation: Dissemination of evidence-based health education program for controlling pesticides hazards at farms by the professional health educator in different settings. 
Keywords:evidence-based health education program, farm-workers, practice, safe pesticide handling.

Abstract:Cancer-related fatigue is one of the most prevalent symptoms patients with cancer experience, both during and after treatment and in disease-free survivors. Anxiety have been found to correlate with Cancer-related fatigue. Back massage, a nursing intervention, is one of the complementary treatment approaches that have an important place in the control of fatigue and anxiety suffered by patients receiving chemotherapy. Aim of the study: To evaluate the effect of back massage on fatigue and anxiety among cancer patients receiving chemotherapy. Research design: A quasi-experimental design was utilized. Setting: The study was conducted at the outpatient oncology clinic at Fayoum University Hospital. Methods: A purposive sample of 60 adult patients from both genders who were randomly and alternatively divided into two equal groups study and control (30 patients in each). Tools:  data collection tool included:  Interview patient’s assessment sheet, state-trait anxiety inventory scale(STAI), brief fatigue inventory scale (BFI). Results: The study revealed that there was a significant decrease in the level of fatigue and the mean anxiety scores among study group after implementing back massage. Conclusion: Back massage given during chemotherapy is effective nursing intervention in reducing anxiety and fatigue among studied patients. Recommendations: Apply back massage as a supportive care for cancer patients receiving chemotherapy.
Keywords:Back Massage, Fatigue, Anxiety, Cancer, Chemotherapy.

Abstract:Shared governance is a structure that places staff at the center of the decision-making process, it is an ongoing process that should be embedded in an organization to be successful setting also it is a vehicle that can be used to increase work engagement among nurses so that it is vital to improve nursing, clients and organizational outcomes that ultimately advance health care within our communities.Aim:The present study aimed to assess staff nurses` perception of shared governance and its relation to their work engagement at critical care units.Research Design:Descriptive correlational research design was utilized to conduct this study.Setting:The study was conducted in critical care units at Benha University Hospital.Sample: Convenience sample consisted of 130 staff nurses who worked at the previously mentioned setting. Tools of data collection: Data was collected through two main tools namely (I) Index of Professional Nursing Governance Questionnaire (IPNGQ) and (II) Utrecht Work Engagement Scale (UWES). Results: The findings of this study showed thatabout half of staff nurses (47.7%) had positive perception regarding shared governance. And (35%) of them had positive perception regarding traditional governance and the lowest percent of them (17.3%) positive perception regarding self-governance. And about two third of staff nurses (63.2%) had high level of engagement regarding their work.Conclusion: About half of staff nurses had positive perception regarding shared governance. And more than one third of them had positive perception regarding traditional governance and about two third of staff nurses had high level of engagement regarding their work. There was a positive highly statistical significant correlation between nurses' perception of shared governance and their level of work engagement.  Recommendations: Hospital administrators should provide nursing staff with professional development to enhance their engagement, Hospital administrators should maintain supportive work environment and encourage staff nurses to share in decisions.
Keywords:Staff Nurses, Shared Governance, IPNGQ, Work Engagement, UWES, and Critical Care Units.

Abstract:Stress is a popular problem that affects nursing undergraduates and has a negative impact on their physical, social and psychological wellbeing. Aim of the study was to evaluate the effect of nursing intervention on stress and psychological wellbeing among university nursing students. A quasi experimental research design two group (study and control group pre/ posttest) was used to achieve the aim of the study. The study was carried out at Faculty of Nursing, Menoufia University. A purposive sample of (n=100 students) selected from first year nursing students at the Faculty of nursing who have scores of 64 or less to 106 on psychological wellbeing scale and have scores of 34 - 66 on student nurse stress index.. Three tools were used for data collection (1): A structured interview questionnaire which includes socio-demographic characteristics of nursing students. (2): Student nurse stress index. (3): Psychological wellbeing scale. The collected data were analyzed by using SPSS (Statistical Package for Social Sciences) version20. Student's t-test, one a way ANOVA (F-test) and paired T-test were used for parametric data. Pearson's Correlation analysis was used to show strength and direction of association between two quantitative variables. Results: There was a statistically significant reduction on the level of stress and improvement on psychological wellbeing level in study group after implementing nursing intervention than control group Conclusion: The nursing intervention has a positive effect on reducing stress level and improving psychological wellbeing level among nursing students. Recommendation: Generalize the application of nursing intervention program to all nursing students to reduce their stress and improve their psychological wellbeing.
Keywords:Nursing intervention, stress, psychological wellbeing, university nursing students.

Abstract:The advancing accountability of nurses and nurse educators requires students to develop knowledge, skills, and judgment on a continuum of focus from individual patients to the broader context of care. Aim: This study is aimed at assessing nursing faculty assistants’ opinions regarding the importance of standards for clinical teaching skills. Design: A descriptive cross-sectional was used Setting: it was conducted at the Faculty of Nursing, Ain-Shams University in the different clinical departments where nursing students are trained and on a group of Nursing faculty assistants There were 23 demonstrators and 49 assistant lecturers.Tools of Data collection: Data collection tool included An opinionnaire sheet for faculty assistants was developed by the researcher based on the related literature.Results:   There were high agreement of faculty assistant upon the fifteen standards. The mean percent scores of agreement ranged between 86.11 for the first standard of personal attributes and appearance, and 95.69 for the third standard of voice characteristics and 94.08 for the fourteenth criterion of evaluation and feedback skills. Meanwhile, the median scores for all criteria were 100.00 only 18.1% of them attended training in adult learning. The total agreement ranged between 86.11 % to 100.0%.Conclusion: applicability as shown by the high performance of the faculty assistants using proposed standard. Recommendations:The study recommends development and validation of clinical teaching skills standards based on these assessment findings. Faculty assistant staff should have the opportunity to discuss their clinical work, validate their decision-making, and examine clinical issues with faculty members to foster their clinical experience and help in the development of self-confidence.
Keywords:Clinical teaching, Skills, Standards.

Abstract:Persistent neonatal pain due to numerous painful procedures like blood sampling can result in serious consequences on the premature neonates. Non-pharmacological pain relieve  measures like oral glucose and kangaroo mother care are the recommended modalities to treat acute procedural pain in preterm babies to promote physiologic stability and positive developmental outcomes. This study aimed to: assess the effect of kangaroo mother care versus oral glucose for pain control in preterm infant at neonatal intensive care unit. Methods: A quasi-experimental research design was conducted on a sample of 100 neonates at neonatal intensive care unit affiliated to Sandoob Health Insurance Hospital that recruited randomly to receive either kangaroo care or oral glucose during venipuncture. Data was collected using an infant evaluation form and premature infant pain profile tool (PIPP). Results: The primary outcome of the study showed that there was significant difference in PIPP score among preterm neonates with in two groups at 30 second after venipuncture (P <0.001).Mean PIPP score were lower in kangaroo group (6.84 ± 1.49) than in oral glucose group (9.24 ± 1.36). In addition the secondary outcomes revealed that kangaroo group preterm infant had less time of crying during blood sample and gain more weight than preterm infant in oral glucose group.  Conclusion: It was concluded that, both kangaroo mother care and 25% oral glucose solution have analgesic effect during blood sampling but kangaroo care proved to have significantly superior analgesic effect during blood sample, less crying time, increase body weight and no incidence of feeding intolerance among preterm neonates in comparison to oral glucose. Recommendations: it is recommended that applying  Kangaroo mother care to all preterm neonates before exposure to invasive procedure to control  pain and reduce crying duration that consequently reflect positively on preterm infants outcomes.
Keywords:Preterm Neonates, Procedural Pain, Sucrose and Kangaroo Care.

Abstract:Breast cancer is a treatable disease if early discovered. But the discovery of it depends on the high alert of the community toward the killer disease. On one hand there is a great effort done by the health workers around the world. But on the other hand the number of deaths from breast cancer increases. Middle aged women are the more at risk than older and younger generations .we tried to focus on the awareness of the disease in one of the African countries in which the number of patients is rapidly increasing.
Keywords:Self Breast Examination, Middle aged women.