Backgroun Hospitalization and surgery are stressful events children face especially during the early years. Through play activities, children can reduce the level of preoperative anxiety and fear. Aim The aim of the current study was to evaluate the effect of selected play activities on preoperative anxiety level and fear among children undergoing abdominal surgeries. Sample A convenient sample of 50 school-age children undergoing abdominal surgeries participated in the current study. Design One-group pre–post-test time series quasi-experimental research design was used to achieve the aim of the current study. Setting The current study was conducted at the General Pediatric Surgical unit at Cairo University Specialized Pediatric Hospital. Tools Data were collected through the following tools: structured interview questionnaire, State-Trait Anxiety Inventory for Children (STAIC), and the Glasses Fear Scale (GFS). Results The results revealed that preoperative anxiety scores on STAIC and preoperative fear scores on GFS were lower among the studied children after using the selected play activities than before. A highly statistically significant difference was detected between total mean score of STAIC and GFS in the pretest and after the first, second, and third play sessions and at 30 min before surgery. Conclusion The current study concluded that the selected play activities were effective in reducing the level of anxiety and fear among children undergoing abdominal surgeries. Recommendations It was recommended that establishing preoperative play activities for children undergoing abdominal surgeries is essential for preparation of the child for surgery.

Background Epilepsy is a major health problem that oftenoccursseen among intellectual schools. Students with seizures annoy their teachers. The aim of this study was to evaluate the effect of nursing intervention on improving intellectual education teachers’ performance toward students with epilepsy atSharkia Governorate. A quasi-experimental design was used in this study. A purposive sample composed of 163 teachers from 13 intellectual schools working at least two years. Three tools were used: Tool (I): Teacher’s knowledge about epileptic student, self-administered questionnaire. Tool (II): Teacher’s practice observation checklist. Tool (III): Teacher’s attitudes toward students with epilepsy scale. Results Most of the studied teachers were married. In addition, statistically significant improvements were detected in the teachers’ knowledge, practices, and attitudes, from pre-sessions to immediately after and 3 months of post sessions where the total mean score of their knowledge increased from9.61±3.30in pre-sessions, to 19.35±1.73 immediately post sessions and 18.67±2.61, at 3 months of post sessions. The total mean score of their practices increased from 3.31±5.081 pre-sessions to 26.72±5.46 immediately post sessions and 24.83±6.71, at 3 months of post sessions. The total mean score of their attitudes increased from 13.62±2.25 in pre-sessions, to 16.38±1.83 immediately post sessions.Therefore, it is recommended that in-service training courses to be conducted periodically among all intellectual schools teachers’.

Background Oligohydramnios may increase the perinatal morbidity and mortality rate and is associated with adverse fetal outcomes. Aim The aim of this study was to assess the effect of oral versus intravenous fluid therapy on maternal and neonatal outcomes for women with oligohydramnios. Study design This was a quasi-experimental study model. Setting Th study was conducted at a high-risk pregnancy department at a specific private hospital in El-Mansoura City, Egypt. Participants and methods A purposive sample of 45 pregnant women with oligohydramnios was included in the study, and the women were divided equally into three groups, with 15 women per each group: the first group was administered intravenous (i.v.) isotonic solution, second group was administered i.v. hypotonic solution, and the third group was administered oral water. Data were collected during the period of 6 months from the first of December 2016 to the end of August 2017. Tools Four tools were used to conduct this study: maternal characteristics questionnaire, sonographic report for measuring amniotic fluid index (AFI) in oligohydramnios women before and after hydration, fluid chart, and maternal and neonatal assessment sheet. Results The AFI was significantly increased from 0.35±0.07 to 1.7±0.5 in the i.v. isotonic group whereas the AFI was significantly increased from 0.37±0.08 to 1.9±0.9 in the i.v. hypotonic group. Moreover, the AFI was more markedly increased from 0.37±0.07 to 2.7±0.8 in the oral water group. The maternal and neonatal outcomes did not differ significantly among the groups but were more markedly increased in the oral water group. Conclusion Oral hydration is as effective as intravenous hydration in significantly increasing the AFI in the third trimester oligohydramnios. The AFI was more markedly increased in the oral water. Maternal and neonatal outcomes did not differ significantly among the groups. Recommendations Oral hydration is recommended for pregnant women with oligohydramnios till delivery.

Background Urinary tract infection (UTI), the most common bacterial infections, affects humans throughout their life span. The more complicated UTI and the recurrent nature increase the risk of hospitalization by two-folds leading to economic stress on the patient. There is also an associated increase in morbidity and mortality. Aims The aim of the study was to evaluate the effect of health guidelines on prevention and recurrence of UTI among diabetic patients. Sample The sample was a purposive one, which composed of 186 diabetic patients of both sexes. It included control and study groups of 93 patients each, with specific criteria. Design A quasi-experimental design was used to conduct the study. Setting This study was carried out in the urology outpatient clinic at the National Diabetic Institute, affiliated to Cairo University Hospitals. Tools Two tools were used for data collection: (a) an interviewing questionnaire for the diabetic patients concerning sociodemographic characteristics and medical-related data and (b) assessment tool of patient’s knowledge regarding preventive measure and care of UTI. Results The study showed that after the application of health guidelines, and follow-up for 1 year, the recurrence of UTI was seen in less than one-tenth of the study group compared with nearly one-third of the control group. Conclusion The results revealed a significant effect of health guidelines on prevention of recurrence of UTI among diabetic patients. Recommendations The findings of this study lead us to recommend conducting educational programs for the diabetic patient in the outpatient clinic to raise their awareness related to the preventive measures and care of UTI and design a simple illustrated booklet in Arabic language for them.

Background Patient education has a vital role in caring for patients with chronic obstructive pulmonary disease (COPD), and a corner stone of self-management in chronic illnesses. Aim of the study This study aimed to evaluate the effect of educational programs on the knowledge and self-management of patients with COPD. Methods This study was carried out on 40 COPD patients at outpatient follow-up Medical Clinics at Tanta University Hospital. The researchers interviewed them using an interview schedule to assess the sociodemographic characteristics, patients’ medical history, physical examination, and knowledge regarding COPD and an observational checklist to assess self-care practice of the patient. Results The results have shown significant differences in relation to decrease in the signs of cough, sputum, and shortness of breath immediately and after 2 months of implementing the self-care management program, but there were no significant differences in relation to other signs of the disease. The majority of patients (95%) had poor knowledge, and all of them had unsatisfied practice regarding self-management skills for COPD before implementation. Immediately postimplementation of the educational program, the study showed highly statistically significant improvement in total score of knowledge, where the majority of them had a fair knowledge and good practice regarding COPD; these scores decreased in post-test 2. Conclusion This study concluded that the education of patients regarding knowledge for COPD and healthcare practice is very effective in improving their self-management skills, but they need reinforcement follow-up. Therefore, this study recommended that the healthcare personnel should provide health education for COPD patients on self-care to their improve knowledge which helps prevent complications and maintain their life.

Background Nurses are one of the most diverse and largest workforces in the health-care system. Their work usually affects different concerns of their life. The aim of the present study was to investigate the impact of quality of working life (QoWL) on the psychological well-being (PWB) and marital adjustment among female nurses. Research design A descriptive-analytical study design was used to carry out this study. Setting This study was conducted at all maternal and child health centers in Zagazig City. Patients and methods A purposive sample composed of 208 female nurses who were working in the previously mentioned settings were recruited. Tools of data collection: four tools were used for data collection. They were the sociodemographic data sheet, the QoWL scale, Ryff’s PWB scales, and ENRICH marital satisfaction scale. Results The study results revealed that more than two-thirds of female nurses had a low QoWL and all of them had stress at their work. Majority of the studied nurses showed low level of PWB and marital adjustment. Also, there was positive correlation between QoWL, psychosocial well-being, and marital adjustment among female nurses with high statistical significance. Conclusion It was concluded that most of the studied samples had a low level of QoWL, PWB, and marital adjustment and there was statistically significant positive correlation between these variables. Recommendations This study recommended that further researches are needed to identify the predicted factors of low QoWL and factors that affect PWB and marital adjustment.

Background Family caregivers of patients with chronic mental illness experience psychological stresses. Such stresses affect the psychological well-being of relatives, who have moderately high levels of burden and frequently get inadequate support from mental health professionals. Aim The aim of this study is to examine the relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients. Research design A descriptive correlational design was used in this study. Setting This study was conducted at the psychiatric outpatient clinic in Azzazi Psychiatric Mental Health Hospital at Abu Hammad in Sharkia Governorate. Patients A purposive sample of 150 mentally ill patients’ caregivers, who accompany their patients to the psychiatric outpatient clinics, was recruited. Tools of data collection Four tools were utilized for data collection: sociodemographic data sheets, family burden scale, psychological well-being scale, and multidimensional scale of perceived social support. Results More than half of the caregivers aged from 40 to 60 years. Most of the patients were diagnosed as having schizophrenia. More than two-fifths of the caregivers were parents and had high level of burden. Nearly two-thirds had moderate level of psychological well-being, and approximately half of the caregivers had moderate level of social support. Conclusion There were negative statistically significant correlations among family burden, psychological well-being, and social support. However, a positive statistically significant correlation was detected between social support and psychological well-being. Recommendations It is recommended that training programs should be designed for caregivers to enhance psychological well-being and social support and decrease the level of burden among caregivers of mentally ill patients.

Background Dengue fever (DF) is emerging as a serious global health problem. Nurses serve as the frontline health care workers who assist in the diagnosis and treatment of dengue and other febrile illnesses. Aim The aim of this article is to assess the effect of educational sessions about DF on nurse’s knowledge and attitude at Zagazig Fever Hospital. Patients and methods A quasi-experimental design was used in carrying out the study during the period from November 2017 to January 2018. The study was conducted in Zagazig Fever Hospital, Sharkia Governorate. The sample included 71 nurses (39 diploma nurses and 32 bachelor nurses), working at the outpatient and the emergency clinic according to the inclusion criteria. Two tools were used. Tool 1 was a questionnaire that consisted of two parts: part A was used to collect data relating to demographic characteristics of the nurses, whereas part B involved nurse’s knowledge about DF using a self-administered questionnaire. Tool 2 was a self-administered questionnaire that was designed to assess nurses’ attitude toward DF. Results The comparison of pretest and post-test scores of nurses’ knowledge and attitudes revealed highly statistically significant improvement (P<0.001), which justified the research hypotheses of educational sessions’ implementation. The total score of their knowledge increased from 9.9% in pre-implementation session to 87.3% 1 month after the implementation, and the total score of their attitudes increased from 60.6% before the sessions, to 91.5% 1 month after the sessions. Conclusion The post-test score was higher than the pretest score for both knowledge and attitudes of nurses regarding DF. Recommendations Primary prevention of infectious diseases like DF should be given priority, and education about it should be provided in fever hospitals, through in-service health educational training session to be provided to all nurses in the fever hospitals, especially the newly appointed ones before they start their work.

Background Menopause characterizes the end of the female reproductive period. Psychological problems such as anxiety and depression are reported among women in the menopausal period. Aim The aim was to find out the effect of menopausal symptoms on psychological problems such as anxiety and depression among middle-aged women. Participants and methods A descriptive cross-sectional design was used. This study was conducted at eight colleges from Zagazig University. A convenience sample composed of 200 menopausal women was recruited. Four tools were used for collection of data: interview questionnaire, menopause rating scale, Beck depression inventory scale, and Taylor manifest anxiety scale. Results More than three-quarters of the studied women were aged 50 years and older, with the mean age being 53.6±6.3 years. Nearly half of them had severe menopausal symptoms. More than one-third had mild depression and more than half of them had severe anxiety. Conclusion Nearly half of the studied women had severe menopausal symptoms. More than one-third had mild depression and more than half of them had severe anxiety. There were positive statistically significant correlations among total menopausal symptom, anxiety, and depression scores. Moreover, there were statistically significant relations between total menopausal symptom score and both educational level and duration of menopause. Recommendations The present study emphasizes that depression and anxiety are commonly prevalent among the middle-aged women; therefore, women should be screened in the menopause transition period, especially for clinically significant depression and anxiety, as some changes in women lifestyle like diet and exercises can improve good mood. Moreover, training programs should be designed for middle-aged women to decrease psychological problems associated with menopause, and delivery of mental health services in this group is essential.

Background Nurses with a high level of psychological capital have the essential motivational and cognitive properties that can be used in any given work situation to protect them from work-related stress and burnout. Aim This study aims to examine the impact of psychiatric nurses’ psychological capital on their burnout and coping style. Participants and methods A descriptive correlational design was utilized in this study. This study was conducted at three psychiatric hospitals: El Azazi Hospital for mental illness, Banha Hospital for mental illness, and at the Psychiatric Department at Zagazig University Hospital. A simple, random sample composed of 139 nurses who are working at a previous mentioned setting was recruited for this study. Five tools were utilized in this study for data collection, sociodemographic data sheet, burnout scale, psychological capital questionnaire, brief coping inventory, and emotional approach coping scale. Results The present study revealed that the level of burnout was moderate among the studied nurses, more than half of them had low level of psychological capital, about half of them had low level of problems − focused coping and near half of them had a high level of emotion-focused coping. Conclusion On the basis of the finding of this study, it can be concluded that the burnout is a psychological problem among psychiatric nurses. Unfortunately, about one-half of the studied psychiatric nurses has moderate level of burnout and has low level of psychological capital. Also, about half of them utilize the emotion-focused coping style more frequently than problem-focused coping. When nurses have a high level of psychological capital, their level of burnout decreased. Recommendation Intervention programs for nurses should be carried out to enhance their level of psychological capital (self-efficacy, hope, optimism, and resilience), improve their coping ability, and reduce their level of burnout are recommended.

Background Women in health care represent an ancient and widespread profession. Violence against women is a pervasive violation of fundamental human rights of women. Pregnancy is a risk factor for increase in violence, especially in health care facilities. Research design A descriptive design was used in this study. Settings The study was conducted at Zagazig University Hospitals. Sample A convenience sample was used, including 231 pregnant health care workers (HCWs). A structured questionnaire sheet was constructed by the researchers to collect data of this study and included four parts. Tools The first part is a structured questionnaire constructed by the investigators to collect the data. The second part is the obstetric history. The third part is the information related to workplace violence assessment. The fourth part included maternal and neonatal assessment sheet. Results More than two-thirds (68.3%) of pregnant HCWs had been exposed to workplace violence. Pregnant HCWs working in most departments experienced violence, with highest frequency observed in the emergency department. Verbal violence (47.2%) was the most common form of violence followed by psychological (30.7%), physical (19.5%), and finally sexual violence (2.6%). Pregnant HCWs faced many maternal and fetal complications, with the complications of first and second stages of labor and fetal distress being 7.8 and 67.1%, respectively. Approximately 43.3% of pregnant HCWs were more likely to deliver by cesarean. However, 37.7% have premature rupture of membrane (PROM), and 27.7% have low-birth-weight, and 20.8% preterm births.. Conclusion Pregnant HCWs face many maternal and fetal complications because of violence, such as abortion, deterioration in the progress of labor, cesarean delivery, fetal distress, PROM, low-birth weight, and preterm birth. Recommendation Special attention should be directed to control violence against pregnant HCWs, especially those who have a history of exposure to violence.

Background High noise levels may be harmful to preterm infants and have negative short-term effects on cardiovascular and respiratory systems. A nebulizer session before suction is the most common stressful procedure for preterm infants. Earplugs protect preterm infants from noise and improve their physiological state. Aim This study aimed to evaluate the effect of earplugs on the physiological response of preterm infants during a nebulizer session. Patients and methods The study, a one group time series quasi-experimental research design, was done on a purposive sample of 30 preterm infants attending the Neonatal Intensive Care Unit (NICU) of El Manial University Hospital (Kasr Al Ainy). A total of 30 preterm infants was involved first as a control group and then as the earplug group. Neonatal assessment, noise, and physiological response tools were utilized for data collection. A sound level meter was used to measure the level of noise before the nebulizer session. Results Results of the study have shown that there was a statistically significant difference in preterm infants before and after using earplugs regarding the mean change of heart rate, oxygen saturation, and systolic and diastolic blood pressure during and after a nebulizer session (P<0.00). The mean change of respiratory rate was significant only during the nebulizer session but it was not significant after the procedure. Conclusion The findings of the study concluded that the use of earplugs is effective to decrease the effect of noise on the physiological response of preterm infants during a nebulizer session. Recommendations The educational program is needed to raise awareness among neonatal nurses and other health-care providers about the effect of noise reduction methods such as an earplug on the physiological state of preterm infants.

Background In recent years, there has been increased interest in the role played by families in the treatment of patients with schizophrenia. Some family interventions may significantly reduce clinical difficulties and may have a positive effect, both emotionally and economically. Aim The aim of this study is to investigate the effect of psycho-educational program on perception of burden and attitudes toward mental illness among caregivers of patients with schizophrenia. Research design A quasi-experimental design was used in this study. Setting This study was conducted at an outpatient clinic in El-Azazi Hospital for Mental Health in Abo-Hamad City. Patients A convenient sample of 50 caregivers of patients with schizophrenia was included. Tools of data collection Three tools were used for data collection: sociodemographic data sheets, Caregiver Burden Scale, and Opinions about Mental Illness Scale. Procedure The sample was randomly divided into a control group (25 caregivers) and an experimental group (25 caregivers), who participated in a family psycho-educational program. The psycho-educational program consisted of thirteen 60-min sessions, held during a period of 2 months. Caregivers in the experimental group were evaluated at inclusion and at the end of the program. Caregivers in the control group were evaluated at inclusion and 2 months later. Results Most caregivers experienced severe burden, and also significant percent of caregivers had negative attitudes toward mental illness before intervention. Compared with the control group, the experimental group showed significantly reduced caregivers’ burden and improved attitudes toward mental illness after intervention. Conclusion The psycho-educational program for family members of patients with schizophrenia significantly reduced caregivers’ burden and improved caregivers’ attitudes toward mental illness. Recommendations There is a need to facilitate access to psycho-educational programs in mental health centers and clinics and to integrate this intervention into the regular treatment plans for patients with schizophrenia.