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   Table of Contents - Current issue
Coverpage
May-August 2018
Volume 15 | Issue 2
Page Nos. 93-204

Online since Monday, November 12, 2018

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ORIGINAL ARTICLES  

Self-concept and self-esteem among adolescent pregnant women at General Assiut Hospital, Assiut City p. 93
Naglaa Abd El-Mageed Mohamed, Ghadah Abd El-Rahman Mahmoud
DOI:10.4103/ENJ.ENJ_45_17  
Background Psychological status plays an important role in adolescent mothers. It may cause alterations in their self-concept and self-esteem. Aim The aim of this study was to assess the degrees of self-concept and self-esteem among adolescent pregnant women at General Assiut Hospital, Assiut Governorate (Elshamla Hospital). Patients and methods A cross-sectional research design was applied in this study. The setting was antenatal outpatient clinic of General Assiut Hospital (Elshamla Hospital). A convenient sample of 320 adolescent pregnant women was recruited in this study. Three tools were used in this study for collecting the data: a structured interview questionnaire, self-image questionnaire, and self-esteem scale. The study started at April 2016 and ended at February 2017. Results The main findings revealed that the age range of teenage pregnant women was 14–17 years old, and most of them lived in urban areas. There is a high hospital-based rate of teenage pregnancy (34%) at General Assiut Hospital, Assiut City, Egypt. Moderate self-concept and self-esteem are seen among the most teenage pregnant women (93 and 96%, respectively). Finally, there is a strong relationship between sociodemographic characteristics, especially age and fluctuations of self-concept and self-esteem, among these women. Conclusion There is a strong relationship between sociodemographic characteristics, especially age and fluctuations of self-concept and self-esteem, among these women. Recommendations Implementing prenatal training courses for nurses about the role of psychological support in raising self-concept and self-esteem in teenage pregnancy is recommended.
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Relationship between leadership styles and clinical decision-making autonomy among critical care nurses p. 102
Nadia T Mohamed
DOI:10.4103/ENJ.ENJ_4_1  
Background Participation of nurses in an organization’s decision making varies depending on many factors, including the influence of nurse managers, head nurses, leadership, and collaboration with physicians. Aim The aim of the present study was to explore the relationship between leadership style and decision-making autonomy among critical care nurses at New Kasr Al-Aini Teaching Hospital. Participants and methods A descriptive exploratory research design was utilized. The study was conducted at New Kasr Al-Aini Teaching Hospital which is affiliated to Cairo University Hospital. The study was done on a convenient sample of 200 staff nurses who are working in critical care units. Data were collected using the Clinical Decision-Making Questionnaire which contains two main parts: the first part was demographic data and the second part was a Clinical Decision-Making questionnaire, adopted from Fareed (2016), and a Leadership Styles Questionnaire, which was designed by the researcher based on an extensive review of the related literature to measure three common styles of leadership. Results There was high agreement on total perception of respondents about clinical decision-making autonomy; the highest mean percentage of respondents’ perception was on arranging patient investigations and supervising junior staff dimensions, followed by providing health education and making decisions to change patient medication dimensions. The least mean percentage was on work environment dimension. Regarding dominant leadership style the majority of staff nurses’ perceive their leader on democratic, followed by authoritarian, and lastly laissez-faire leadership style. Conclusion There was no statistically significant relationship between nurses’ clinical decision-making autonomy and leadership styles. Recommendation Critical care nurses’ managers should foster nurses’ autonomy by enabling them to exercise clinical decision-making autonomy, and by actively supporting nurses’ decisions and accountability.
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Faculties’ and nursing student’s compliance with seasonal influenza vaccination p. 112
Ola M Esheaba, Houaida A El Wogoud Helal
DOI:10.4103/ENJ.ENJ_13_18  
Background Annual influenza vaccination was considered mandatory not only for health-care workers but for nursing students as well. Receiving the vaccine will help to decrease morbidity related to seasonal flu in health-care settings. Nursing faculties play a significant role as a model for their students as future nurses in attaining high level of compliance with the vaccine. Aim The study aimed to assess the faculties’ and nursing student’s compliance with seasonal influenza vaccination. Design This was a cross-sectional descriptive study. Setting The study was carried out during the 2 days’ flu vaccine campaign held in College of Nursing, Jeddah, King Saud Bin Abdel Aziz University, for health sciences in November 2016. Patients All students and faculty were recruited in the study. Tool An influenza vaccination’s compliance-structured questionnaire was used to collect data. Results Vaccination coverage rate was 60.9% among nursing students, while it was 43.3% among the faculty, 20% of total patients received the flu vaccine for the first time. The study revealed that the main reasons for receiving the vaccine were reduction of frequency and severity of flu attack after receiving vaccine in the previous years. However, the most common reasons for not being vaccinated were having concerns about vaccine safety, especially among pregnant students, negative personal experience, and known allergy to chicken eggs. In addition, the study revealed that the main source of information about the vaccine campaign was through the college announcement, either by e-mail or posters. Conclusion From the results of the current study, we can conclude that the immunization rate among students and faculty fall below the healthy people target, and their compliance was not related to their demographic characteristics. Recommendation The study recommended dissemination of information about vaccine safety and benefits among nursing students and faculties. Development of policy to mandate flu vaccine administration in nursing colleges should be enforced.
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Effect of swallowing training program on dysphagia following cerebrovascular stroke p. 125
Enas Ebrahiem E Abo Elfetoh, Sarah Fathy M Karaly
DOI:10.4103/ENJ.ENJ_10_18  
Background Cerebrovascular stroke (CVS) is a neurological deficit lasting for more than 24 h and occurs as a result of interrupted arterial blood flow to parts of the brain. One of the most common complications following CVS is dysphagia which is a biomechanical disorder that occurs when functional impairments of the nervous system or musculature impede the transport of liquids and solids to the gastrointestinal tract which may increase the risk of morbidity due to malnutrition, dehydration, and aspiration pneumonia accompanied with dysphagia in stroke patients. The swallowing training program is expected to reduce the risk of complications related to dysphagia. Aim The aim was to determine the effectiveness of swallowing training program on dysphagia following CVS. Patients and methods A quasi-experimental design was used. This study was conducted at the neurological inpatient units which were affiliated to Ain Shams University Hospital. A purposive sample consists of 40 hospitalized, CVS adult patients from the previous mentioned setting. Two tools were used for data collection: (a) Patients’ structured interviewing questionnaire, which included the patients’ sociodemographic and clinical data and (b) swallowing observational checklist which included two parts, (i) assessment of oral motor structures and reflexes and (ii) swallowing rating scale. Results At the fourth observation for dysphagia manifestations, the present study revealed that more than two-third of the studied patients during their swallowing for potatoes, custard, teaspoon of water, eating biscuits, and sips of water were reached at L7 (normal swallowing). This study concluded that the training program of swallowing for dysphagic patients poststroke is effective in improving patients' swallowing. The program proved the effectiveness of the compensatory postures and oral motor exercises for those patients. Recommendation Develop continuing in-service training programs for nurses who work in the neurological units on the assessment of dysphagic patients, the compensatory postures, and oral motor exercises to be carried out with dysphagic patients.
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Effect of pre-discharge instructions on patients’ activities and functional ability post spinal cord injury p. 135
Soheir M Weheida, Entisar Gaad-Elmoula Shabaan, Amal Fehr
DOI:10.4103/ENJ.ENJ_44_17  
Background Spinal cord injury (SCI) disrupts spinal cord function, and patients after SCI require long-term physical and occupational therapy, as the injuries interfere with activities of daily (ADL) living and function ability. This study may bring into light the amount of care and dependency that individuals with SCI will face as they are discharged from hospital and re-integrate back into their usual life. Aim This study aimed to evaluate the effect of predischarge instructions on ADL and functional ability of patients with SCI. Patients and methods The study was conducted in Neurosurgery and Physical Medicine Department at Aswan University Hospital. Sample This study included 120 adult patients of both sexes. These patients were divided equally into two groups: study and control. Data were collected from them within 1 year from January 2015 to January 2016. Inclusion criteria were recent admission because of SCI with no previous spinal surgery, no other medical problems and muscle-skeleton deformity that may interfere with educational instructions outcome, and had no hindering factors to communicate verbally. A control patient group with the same inclusion criteria was matched with the study group but was not given predischarge instructions. Four tools were used: 1. Structured interview questions and Medical Data Sheet; 2. Knowledge Questionnaire and Lifestyle Assessment Questionnaire: 3. ADL Questionnaire. 4. Compliance Discharge Instructions. Results Findings revealed that only 8.3% of pre instruction patients were oriented about range of motion exercises, and 6.6% about healthy lifestyle as compared with the satisfactory post instructions knowledge (96.6%, 95.0% respectively), at P values=.000*). Conclusion Statistical significant difference between pre & post instruction of discharge knowledge regarding range of motion exercises, lifestyle, ADL and overall discharge compliance. Recommendations Encourage a simple illustrated booklet to patients’ post SCI includes all therapeutic instructions could help increasing patient’s awareness, understanding, and perform activities.
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Predicators of successful aging among academic emeritus p. 144
Basma S Abd El-Mottelb, Ebtesam Mo'Awad, Sohier B El-Din
DOI:10.4103/ENJ.ENJ_5_18  
Introduction Successful or healthy aging is a worldwide concept in gerontology. Older people such as academic emeritus can live healthy and can be economic contributors as well. They continue to be creative, grow, learn, have a network of friends and family, and share their experience in teaching, research, and community services. Gerntological health nurses can play a vital role in promoting health and well-being of the elderly by taking a holistic view of the biopsychosocial health predictors that contribute to successful aging. Aim The aim of this study was to assess the predictors of successful aging among Cairo University academic emeritus. Sample A convenience sample of 100 academic emeritus were selected. Setting The study was conducted in four health sciences sector faculties at Cairo University. An exploratory descriptive research design was utilized. Tool A structured successful aging questionnaire was developed that included three parts (personal characteristics, assessment of successful aging predictors such as physical health, mental/cognitive well-being, psychological well-being and social engagement, questions about what contributes to successful aging. Results The results of the study have shown that the majority of academic emeritus were independent, adopted a healthy lifestyle, maintained high resilience, have no depression or cognitive failure and have supportive social networks. Regression analysis showed that the age and total scores of successful aging predictors were significantly associated (P=0.000). Conclusion Physical independence, lifestyle, cognition, resilience, low depression, and social network contribute to successful aging. Recommendations Increase the awareness of the elderly about the predictors of successful aging through health education programs and replication of the study on a nationwide scale project.
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Effect of systemic lupus on patient’s self-esteem and quality of life p. 156
Enaam Abd El latif, Zeinab Hassan, Amany Gomaa
DOI:10.4103/ENJ.ENJ_7_18  
Introduction With improvements in mortality in systemic lupus erythematosus, the functional status of these patients, assessed using health-related quality of life instruments, is increasingly being recognized as an important outcome measure in clinical research. Domains of health-related quality of life of particular importance to patients with systemic lupus erythematosus include fatigue, ability to work, good health, independence, social and family life, learned helplessness (reflecting the unpredictability of lupus), pain, and the home environment. Aims This study aimed at assessing the effect of systemic lupus on self-esteem and quality of life of patients with systemic lupus. Patients and methods A total of 40 patients with systemic lupus were selected from a rheumatoid out-patient clinic at Ain Shams University hospitals. They answered three questionnaires, including self-esteem scale, quality of life scale, and sociodemographic datasheet. Results Of all the studied sample, females represented the higher percentage with 75%, 70% had severe degree of disease, 55% had higher percentage of weight gain, most of them were single, and most of them had deformity (72.5%). Results also indicated that there is a statistically significant negative correlation between self-esteem and systemic lupus and between quality of life and systemic lupus. Statistically significant positive correlation was found between quality of life and self-esteem. Conclusion This study concluded that the prevalence of systemic lupus is much higher among women in this Egyptian sample, and it significantly correlates negatively with both self-esteem and quality of life. Significant positive correlation was between quality of life and self-esteem. The study recommends providing patient with booklet about address of center to serve patients with systemic lupus. Make health education for women around 30 years of age to protect themselves from systemic lupus complication and increase their quality of life. Future studies with different methods, such as interview and focus group, could be used to achieve in-depth knowledge regarding systemic lupus.
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The impact of a hospital-based awareness program on the knowledge of pregnant women about hepatitis b virus p. 162
Hanaa K Helmy, Amel Abd Elazim Mohamed, Amany A Goda
DOI:10.4103/ENJ.ENJ_12_18  
Background Pregnant women are at a higher risk of getting infected with hepatitis B virus (HBV) and may transmit the infection to their fetuses and newborns. The aim of this study was to evaluate and improve the knowledge of pregnant women about HBV. Patients and methods A convenient sample of 80 pregnant women attending the obstetric clinic of Beni Suef University Hospital participated in this educational program. The knowledge of women about HBV was first assessed by using an interview questionnaire. The awareness program included five sessions, each session focused on improving the awareness of the pregnant women over one aspect. Later, all women were assessed again over their knowledge about the five aspects using the same questionnaire. Results Baseline assessment showed that only 23.8% women had optimal knowledge about HBV, 32.5% about what HBV is, 27.5% about transmission, 25% about fetal complications, 23.8% about other complications, and 30% about prevention. Educated women, working women, and those residing in urban areas had better knowledge (P<0.05). After the awareness program, the knowledge of the pregnant women improved to 97.5% with optimal knowledge (P<0.001), 93.8% about the nature of HBV, 93.8% about transmission, 96.2% about fetal complications, 92.5% about other complications, and 97.5% about prevention. Conclusion This study found that there was a positive impact on the knowledge of pregnant women about HBV after taking the hospital-based awareness program. Recommendation Further research should focus on the effect of HBV awareness programs over the practice and attitudes of women towards HBV vaccination.
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Knowledge and perception of women at risk for osteoporosis: Educational intervention p. 169
Hanan S Sobeih, Amal T Abd Elwahed
DOI:10.4103/2090-6021.245116  
Background Women’s awareness and perceptions about risk for osteoporosis must increase and should be the priority in the future through educational programs. Aim The aim of this study was to evaluate the effect of educational intervention on the knowledge and perception of women at risk for osteoporosis. Patients and methods The study was conducted in the outpatient clinics (Antenatal Outpatient Clinic and Orthopedic Clinic) affiliated to Ain Shams University Hospitals. The purposive sample included 60 women above 35 years of age. Three tools were used before educational intervention, after educational intervention, and after 8 weeks of educational intervention. First, an interviewing questionnaire sheet was used, which included three parts: part I, sociodemographic data and obstetric history; part II, predisposing factors of osteoporosis; and part III, women’s knowledge about osteoporosis. Second, a perception questionnaire sheet was used to measure the level of women’s health beliefs as regards osteoporosis. Third, women’s complaint tool was used to measure the studied women’s complaints of preclimacteric symptoms. Results In total, 83.3% of the studied women had dental problems and women with galactorrhea represented 15%; 10% of the studied women had a family history of hip fracture in the elderly. In total, 8.3% of the studied women had been using cortisone for more than 6 months and 3.3% were smokers and suffered from weight loss. There were statistically significant differences as regards their knowledge after application of program. Significant differences were detected as regards benefits of exercise and susceptibility to disease occurrence from 0% and 30% before intervention to 90% after intervention. However, there were percentage changes from 10 to 95% as regards seriousness of disease development and benefits of Ca+ intake. Moreover, there were changes in health motivation from 20 to 100%. There was improvement as regards psychological symptoms and miscellaneous complaints. There were correlations among total knowledge, perception, and their complaints. Conclusion The current study supports the first hypothesis by significantly improving the level of the studied women’s knowledge and perception, and the second hypothesis. As regards women’s complaints of preclimacteric symptoms, the results revealed significantly decreasing psychological problems and miscellaneous complaints. Moreover, there was a positive correlation among knowledge, perception, and their complaints as regards osteoporosis. Recommendations Illustrated booklet about osteoporosis must be available in outpatient clinics and brochures on phytoestrogen-rich diet should be available for each woman.
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Scalp cryotherapy: effects on patients receiving chemotherapy p. 178
Hanan M Mohammed
DOI:10.4103/ENJ.ENJ_8_18  
Background Alopecia is a common adverse effect of chemotherapy treatment for cancer; for some patients, it results in complete hair loss. The effect of hair loss among patients remains an important nursing issue. Aim The aim of this study was to examine the effect of scalp cooling on the development of alopecia in female patients receiving cancer chemotherapy. Sample Fifty female patients with first-stage primary breast cancer fit for primary chemotherapy were randomly allocated to two equal groups using block randomization. The study group patients were to use the scalp cooling, whereas the control group patients did not use it. Design A randomized clinical trial design was used in this study. Sitting This study was conducted at the Surgical Oncology Department and Dermatology Clinic at Ain Shams University Specialized Hospital. Tools Data collection tools included demographic and clinical data sheet, modified WHO hair loss scale, self-reported hair loss scale, and hair re-growth scale. An instruction brochure for patients was prepared by the researchers. Results The results demonstrated protective effect of cooling as assessed by modified WHO hair loss scale, where at the end of follow-up, 92% of the study group patients had successful protection, compared with 64.0% in the control group (P=0.02). Moreover, by self-reported hair loss scale, 68.0% of the patients in the study group reported less hair loss not requiring a wig, compared with only 12.0% of those in the control group (P<0.001). Moreover, hair re-growth improved in the study group compared with the control group during the first and second month of follow-up (P=0.007 and 0.02, respectively). Conclusion It is concluded that scalp cooling provides significant successful protection from hair loss during cancer chemotherapy course, and for 2 months after completing the treatment. Recommendations It is recommended that scalp cooling should be initiated 15 min before infusion, maintained during, and for 30 min following completion of chemotherapy session. Further study of the long-term effect of scalp cooling on protection from alopecia, with psychological and clinical assessment is proposed.
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Nurse physician work-related relationship as perceived by both of them p. 188
Elham Y El-Hanafy
DOI:10.4103/ENJ.ENJ_42_17  
Background Nursing and Medicine are among the few disciplines that work closely and complement each other. They share a common commitment to patient well-being. However a common type of conflict in health agencies is the physician–nurse conflict that is caused by lack of daily interaction between nurse and physician and lack of understanding of each other’s role. Hence, basic to good relationship between doctors and nurses is the clear understanding of the nurse’s role, which is ambiguous, compared with the physician’s role. Aim The aim of this study was to explore the nurse–physician relation, as perceived by both of them. Design A descriptive correlational research design was utilized. Sample A convenience sample of the study included all nurses and physicians who had a minimum of 1 year of experience. Setting The study was conducted in Damanhur National Medical Institute. Tool Data were collected by a questionnaire developed by the researcher on the basis of relevant literature. Results The main results of the study showed that physicians are more satisfied than nurses with their relationship. The nurse–doctor relationship was characterized by cooperation. However, nurses had a feeling of inequity with physicians, especially in the disciplinary actions. Recommendation Improve the relationship between doctors and nurses through sharing in journals, seminars, and conferences. It is also recommended that the hospital administrator should empower nurse staff with adequate authority to implement the hospital policies.
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Resilience, burden, and quality of life in Egyptian family caregivers of patients with schizophrenia p. 196
Souzan Abd El-Menem Abd El-Ghafar, Amal A Abd El-Nabi, Hosam El-Din Fathalla
DOI:10.4103/ENJ.ENJ_1_18  
Background Caring for mentally ill patients affects the family caregivers’ physical and mental health, which leads to enormous burdens. Consequently, family caregivers need resilience to help relieve these burdens and regain their quality of life. Objective The present study was designed to assess the levels of resilience, burden, and quality of life among family caregivers of patients with schizophrenia and their relationships. Settings The study was conducted at the psychiatric outpatient clinic of Mental Health Hospital in Tanta City (which is affiliated to General Secretariat of Mental Health) and psychiatric outpatient clinic affiliated to Tanta University. Design A descriptive correlational design was used in the study. Patients and methods A convenient sample of family caregivers of patients with schizophrenia (N=109) was recruited. Tools Connor-Davidson Resilience Scale, Burden of Care Inventory, and the WHO Quality of Life Scale were used. Results The present study indicated a significant positive correlation between resilience level and quality of life. On the contrary, caregiving burdens were negatively correlated with both resilience and quality of life. Moreover, family caregivers have moderate level of resilience, and approximately two-thirds of them have poor overall quality of life and experiencing moderate to severe burden. Conclusion The present study concluded that decreasing family caregivers’ burden and enhancing their quality of life are imperative. This can be done by emphasizing the significant role of resilience. Recommendations A rehabilitation program and ongoing family interventions should be established for family caregivers to enhance their resilience and consequently to decrease their burdens and improve their quality of life.
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