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ORIGINAL ARTICLES
Effect of education program on nurses’ knowledge and practice regarding care of central venous line in pediatric hemodialysis: evidence-based practice guidelines
Madiha H Bayoumi, Naglaa F Mahmoud
May-August 2017, 14(2):87-99
DOI:10.4103/ENJ.ENJ_16_17  
Introduction Catheter-related blood stream infections (CRBSIs) are the main cause of hemodialysis (HD) failure in infants and children. Active prevention of CRBSIs required multiple interventions and adherence to evidence-based practice guidelines. Aim The aim of this study was to investigate the effect of education program on nurses’ knowledge and practice in pediatric HD unit evidence-based practice (EBP) guidelines. Participants and methods A quasiexperimental design was utilized. The study was conducted in the Pediatric Hemodialysis Unit at Benha University Hospital and the Hemodialysis Unit at Benha Fever Hospital. A convenient sample of 40 nurses from the previously mentioned setting was included in the study. Two tools were used: a questionnaire sheet for assessing nurses’ personal data and knowledge about CRBSIs and EBP guidelines, and an observational checklist to assess nurses’ practice toward care of pediatric HD catheter. Results The study results showed that there was a highly statistically significant improvement in total knowledge level of nurses immediately after implementation and 6 months after implementation of education program guidelines. Moreover, there was a highly statistically significant relation in nurses’ practice and their educational level, occupation, years of experience, and attendance of training course, before implementation/immediately after implementation and 6 months after implementation. Conclusion The current study concluded that the nurses who received evidence-based guidelines educational program as regards central vascular catheter maintenance and care showed high score level in nurses’ knowledge and practice after implementation of the program than that before recommendation. The study recommended that training and continuing education of the EBP guidelines for staff nurses are important to improve care provided in the pediatric hemodialysis units.
  2,064 206 -
Innovation behavior levels and its relation with TIGER-based nursing informatics competencies among critical care nurses
Magda Abd El Hamed Abd El Fattah
May-August 2017, 14(2):59-69
DOI:10.4103/ENJ.ENJ_13_17  
Background Currently, worldwide nursing experts have been inspiring nurses to pursue innovation in nursing in order to improve nursing outcomes. As a consequence, practicing nurses ought to have the capability to be receptive to the innovation in their practice environment; therefore, a new specialty called ‘nursing informatics’ (NI) has emerged to keep pace with these emerging innovations. Aim The aim of this study was to measure the relationship between innovation behavior levels and TIGER-based NI competencies among critical care nurses. Participants and methods A descriptive correlational design was used in carrying out this study. This study was conducted in a Critical Care Unit at an International Private Hospital in Egypt. The convenience sampling method was used to select 30 participants who met the inclusion criteria to join the study. Data were collected using a three-section questionnaire as follows: (i) demographic data sheet; (ii) Innovation Behavior Questionnaire; and (iii) Nursing Informatics Competency Assessment Tool. Results More than half of the participants had a moderate level of innovation behavior. Moreover, more than one-third of the studied sample rated themselves as competent in NI. In addition, a significant positive relationship was found between innovation behavior and overall NI competency levels as perceived by the participants. Conclusion This study contributes to the identification of informatics competency levels that are pertinent to the role of critical care nurses. Moreover, this study signifies that the innovative behavior of critical care nurses would help in generating proactive approach concerning developing a NI competency level in the future. Recommendation Future studies should relate the demonstrated and perceived NI competency levels in critical care units and other work settings. Moreover, integration of the NI and nursing innovation courses as one of the core courses, and not as an elective, in the nursing curriculum is recommended.
  1,577 142 -
Relationship between job satisfaction and professional identity among psychiatric nurses
Abeer Refaat A Kabeel, Sahar Abd El-Mohsen Mosa Eisa
January-April 2017, 14(1):9-16
DOI:10.4103/2090-6021.206939  
Background Job satisfaction depicts how an individual is satisfied with the job. The more satisfied nurses are within their job, the more fulfilled they are supposed to be. Professional identity development is one of the main concerns of nursing education and practice. Nurses are considered to be the vertebral column of any healthcare organization. The WHO believes that mental health nurses, as part of a multidisciplinary team, are especially relevant in the management of mental illness. Aim The aim of the study was to determine the relationship between professional identity and job satisfaction among psychiatric nurses. Methods This was a descriptive correlation research design. The research questions for this study were as follows: (a) How do psychiatric nurses perceive their professional identity? (b) What is the level of professional job satisfaction of psychiatric nurses? (c)What are the relationships between perceptions of professional identity and job satisfaction among psychiatric nurses? This study was conducted at Abbassya Mental Health Hospital in Egypt. A convenient sample of 50 nurses was used for assessment. Tool 1: The background data sheet included age, sex, educational level, position, and years of experience of nurses. Tool 2, Nurses’ professional identity tool: This tool was designed and validated by Kabeel to determine the level of nurses’ professional identity. Tool 3: Mueller and McCloskey Satisfaction Scale as developed and advanced by Ellenbecker and colleagues. Results A positive and significant correlation was determined between nurses’ job satisfaction and professional identities. Conclusion Professional identity is a factor affecting job satisfaction. Recommendations The nurse’s professional identity should be the subject of workshops, in-service programs, and other nursing education activities in various work settings, and in nursing schools and faculties’ curricula. Replication of this study is recommended on other specialty nurses in a large sample size.
  965 166 -
Hospital magnet designation attributes for nursing excellence that promotes patient safety culture: certified versus noncertified hospitals
Magda Abd El Hamed Abd El Fattah, Gehad Ahmed Abo El Ata, Fathi Abdulla Morsy
May-August 2017, 14(2):152-167
DOI:10.4103/ENJ.ENJ_18_17  
Background Magnet designation gives a valuable mechanism for evaluating and transforming nursing practice environments that can be attributed to nursing excellence and patient safety culture. Aim The aim of this study was to compare between ISO 9001-certified and noncertified hospitals regarding hospital magnet designation attributes for nursing excellence and patient safety culture. Design A descriptive, comparative, correlational study design was used. Setting This study was conducted at nine critical care units in an ISO 9001-2008-certified hospital and six critical care units in a non-ISO 9001-2008-certified hospital in Cairo, Egypt. Sample A total of 180 critical care nurses who were working in an ISO 9001-2008-certified hospital and 90 critical care nurses working in a noncertified hospital were included in the study. Tools Data were collected by the modified Essentials of Magnetism and patient safety culture questionnaires. Results A significant correlation existed between the overall patient safety culture and hospital magnet designation dimensions in the ISO 9001-certified hospital. In the meantime, insignificant correlations were found between total patient hospital magnet designation and safety culture dimensions in the ISO 9001-noncertified hospital. Conclusion The results concluded that hospital magnet designation attributes in the ISO 9001-certified hospital and the non-ISO 9001-certified hospital are necessary to encourage the critical care nurses to promote patient safety culture. Recommendations Hospital management should conduct educational training programs regarding multidisciplinary teamwork building, communication behaviors during hospital handoffs, and risk management for critical care nurses working in both ISO 9001-certified and noncertified hospitals.
  1,081 41 -
The modifiable and nonmodifiable risk factors for miscarriage
Tawheda M Khalifa El-Saidy, Tahany El-Sayed El-Sayed Amr
September-December 2016, 13(3):169-177
DOI:10.4103/2090-6021.200178  
Background Miscarriage is a failed intrauterine pregnancy that ends before 20 weeks of gestation. Many factors can lead to miscarriage, such as age, smoking, caffeine intake, infections, medications, and chronic diseases. Aim The aim of this study was to identify the modifiable and nonmodifiable risk factors for miscarriage. Subjects and method A descriptive exploratory study design was used. This study was carried out at primary healthcare centers and obstetric outpatient clinics of Shaqra and Merat general hospitals in the Kingdom of Saudi Arabia. The study included a total of 260 adult women. A structured interviewing questionnaire and modifiable risk factor assessment questionnaire were used. Results The mean age of the participants was 36.8±5.2 years. The reported types of miscarriages were spontaneous (30.8%), incomplete (24.2%), and recurrent (17.7%) miscarriage. The reported modifiable risks were work that requires constant motions and hard effort (37.0%), and pregnant women working more than 40 h/week (28.4%). Lifestyle risk factors included drinking more than 200 mg caffeine/day (87.9%), eating too much spice (39.6%), eating dates daily (37.3%), drinking cola constantly (37.0%), passive smoking (35.8%), and obesity (32.3%). Moreover, there were some obstetric risk factors for miscarriage, such as no spacing between pregnancies, hormonal imbalance, ovarian cyst, and genital infections. Conclusion There was a relationship between lifestyle and risk for miscarriage. Miscarriage can be prevented by reducing the associated modifiable risk factors to low levels before and during pregnancy. Recommendations The following are recommended: regular follow-ups for pregnant women, especially those who had high parity; maintaining healthy lifestyle; encouraging preconception precautions, including intake of folic acid and treatment of health problems; immediate postnatal care; and follow-up for mothers with negative Rh to prevent complications.
  903 107 -
Emotional intelligence among visually impaired and sighted female adolescents
Azza Medhat Mansy, Zeinab Abd El Halim, Enayat Abd Al Wahab
May-August 2017, 14(2):70-77
DOI:10.4103/ENJ.ENJ_14_17  
Background Emotional intelligence (EI) has a positive impact on adolescents’ personal as well as scholastic life. Thus, emotionally intelligent adolescents either visually impaired (VI) or sighted have higher levels of psychological adjustment and emotional well-being, and present a higher quality and greater quantity of interpersonal networks and social support. Aim This study aimed to assess EI among VI and sighted female adolescents. Subjects and methods and methods A purposive sample of 120 female adolescents (60 with VI and 60 sighted adolescents) was selected from El-Noor and El-Amal School for the Blind Female and El Saneya Prep/Secondary School. Two tools were used to measure the current study variables. A Structured Adolescents’ General Profile Questionnaire and EI Scale was used. Results Findings revealed statistical significance differences between the studied VI and sighted female adolescents as regards the total EI and its subscales except for general mood Conclusion To conclude, EI during adolescence is essential in the modern society as life is becoming very complex and conflicting day by day for both VI and sighted adolescents as EI guides an individual’s thoughts, actions, and in adjusting to stressful life events easily. There must be counselors to teach students the basics of EI and how they could develop positive self-concept and enhance their self-esteem.
  845 110 -
Parents’ perception and acceptance of parenting
Sanaa A Mohamed
January-April 2017, 14(1):31-40
DOI:10.4103/2090-6021.206942  
Background Parenting is the process of promoting and supporting the physical, emotional, social, financial, and intellectual development of a child from infancy to adulthood. The definitive objective of parenting is to promote the well-being and development of children. Aim The aim of the present study was to explore parents’ perception and acceptance of parenting. Methods A descriptive qualitative research design was applied to achieve the aim of the study. A convenient sample of 150 parents of school-aged children and adolescents with different acute and chronic health problems were recruited from outpatient clinics that were affiliated to Cairo University Pediatric Hospitals (El-Monira). Two tools were used in the study; a sociodemographic data sheet for parents and their children, and a structured interviewed questionnaire sheet to explore parents’ perceptions and acceptance of parenting. Results The results of the present study revealed that approximately half of the parents expressed that they had not accepted their relationship with their children, and two-thirds of those parents did not interact with their children, as well as did not attended training classes related to parenting. In addition, more than half of parents perceived parenting as a hard task. Finally, the findings showed that parents obtained their perception and acceptance of parenting from three thematic areas: parenting as being embraced by Islam, transferring of cultural values and traditions, and parenting as a challenge. Conclusions The present study concluded that each parent perceived parenting from strong interplay of Islamic teachings, sociocultural values and traditions, in addition to the challenges and difficulties of being a parent. Parents had low levels of perception and acceptance of parenting of their school aged and adolescent children. In addition, there was a significant relationship between parents’ perception and the selected sociodemographic variables. The study recommends that outpatient clinics should provide educational programs about parenting regarding different aspects of parents’ perception and acceptance of parenting.
  826 97 -
Oral health intervention program among primary school children at El-Qalyubia Governorate
Eman M Seif El-Nasr
May-August 2017, 14(2):100-108
DOI:10.4103/ENJ.ENJ_15_17  
Background Oral health is a major public health issue affecting all groups of the population. Poor oral health during childhood is directly associated with poor oral health outcomes during childhood and throughout adulthood. Aim The aim of this study was to evaluate the effect of an Oral Health Intervention Program among primary school children. Patients and methods A quasiexperimental study was used to fulfill the aim of the study. This study was conducted at two experimental schools in El-Qaliubiya Governorate. A purposive sample of all students in the fifth grade who fulfilled the inclusion criteria from the two schools was included in the study. Two tools were developed: the oral health structured interviewing questionnaire, which included two parts (personal data and oral health knowledge), and observational checklist for oral hygiene practice. Results The results revealed that the mean age of the study participants was 10.63±0.63. As regards the causes of tooth decay, 50 and 66%, respectively, recognized the causes before and after the intervention program, and 33 and 63%, respectively, identified the consequences of tooth decay before and after the intervention program. A highly statistically significant difference was found between the study participant’s total knowledge before and that after the intervention program (P<0.000), and a highly statistically significant difference was found between study participant’s practices of oral hygiene before and that after the intervention program (P<0.000). Conclusion Primary school children represent a high-risk group for oral health problems, and this study indicated that the oral health intervention program was effective in increasing knowledge and practices toward oral health. Recommendations It is recommended to empower periodic screening for school students to detect oral problems, disseminate the oral health intervention program to parents, school teachers, and nurses for early detection of student’s dental problems, and connect to referral system for care, which is integrated in school insurance program.
  781 120 -
Effectiveness of planned educational program on vaginitis and its preventive measures on adolescent female nursing student’s knowledge
Entisar M Youness Ahmed, Ayat Masoud Omar
January-April 2017, 14(1):1-8
DOI:10.4103/2090-6021.206938  
Background Reproductive tract infection (RTI) is generally seen as a silent epidemic. It is one of the major public health problems among adolescents that cause a considerable proportion of gynecological morbidity and maternal mortality in the developing countries. Vaginitis is one of the most prevalent infections among RTIs. Aim The aim of this study was to assess the effectiveness of planned educational program on vaginitis and its preventive measures on adolescent female nursing student’s knowledge. Methods A quasiexperimental pretest and post-test one-group only design was adopted for this study. The study was conducted at the Faculty of Nursing, Al-Fayoum University. Purposive sampling technique was used on a sample of 208 students. A structured self-administrative questionnaire was used. Results The study revealed a highly statistically significant difference as regards total knowledge score level between pretest and post-test scores among students, which indicated an improvement in their knowledge about vaginitis. Conclusion The implementation of the planned educational program was effective in improving the knowledge of adolescent female nursing students as regards vaginitis and its preventive measures. Recommendations It is recommended that continuous nursing education be organized and implemented by specialized nursing staff to educate students as regards all updates of RTIs and its preventive measures.
  727 152 -
Challenges and work crisis facing critical care nurses
Ghada S.K Mahran, Asmaa A.M Taher, Nadia M.A Saleh
September-December 2017, 14(3):235-241
DOI:10.4103/ENJ.ENJ_27_17  
Background Nursing turnover and shortage are acknowledged as worldwide issues. Therefore, understanding the challenges that faces the nurses and overcome these challenges is essential in retaining them. Study was aimed to assess the challenges and work crisis facing critical care nurses. Subjects and Methods Research design : A descriptive, exploratory, qualitative research design was used. Setting Trauma ICU, ICC unit, and general ICU at Assiut University Hospital. Subjects (45) staff nurses. Tool of data collection A structured interview questionnaire consists of two parts; Personal characteristics and Challenges and Crisis Questionnaire Assessment tool through 2016. Results About 68.88% of the study sample were aged between 20 and 30 years and were married, and 44.44% had experience of 1–5 years. 88.88% of them reported large number of patients in ICUs, 82.22% reported increase in workload and increased numbers of night shifts. 97.8% fear of the possibility of infection from patients and 73.3%, have conflict between nurses and doctors. (84.5%) recorded working atmosphere filled with tension and stress. (93.3%) have sense of responsibility for some of the equipment and materials, and some critical cases. (91.1%) had family life at risk. Conclusion Admission of a large number of patients in the ICUs, increase in workload, exposure means for family life owing to choose the profession of nursing, and stability in family life disorder because of increased working hours and long shift were the most common challenges facing nurses. Recommended Training programs should be provided to develop coping skills among staff, and nurses’ mangers should take active steps to create positive work environment.
  791 84 -
Staff nurses’ intention to leave nursing profession and their organizational commitment in selected hospitals at Beni-Sueif city
Rady Mubarak Ahmed, Eglal Ahmed Abdelwahab, Hoda Elguindy
January-April 2017, 14(1):17-24
DOI:10.4103/2090-6021.206940  
Background Nurses’ intention to leave their profession has been found to forecast their actual decision to leave. Therefore, it is alarming that many nurses have an intention to quit their profession and might be indicative that nurses are not committed to their profession. Aim The current study aimed at exploring the intention to leave the nursing profession and organizational commitment among staff nurses in a selected hospital at Beni-Suef city. Participants and methods An exploratory descriptive study was designed. The sample of the study consisted of 180 staff nurses who had at least 5 years of experience in the study setting and who agreed to participate. Data were collected using two adopted questionnaires: staff nurses’ organizational commitment questionnaire and staff nurses’ intention to leave the nursing profession questionnaire. Results This study revealed that staff nurses had a higher intention to leave their hospital and the profession and had a moderate level of total organizational commitment. There was a statistically significant negative correlation between organizational commitment and intention to leave the nursing profession. Conclusion This study concluded that the majority of staff nurses at Beni-Suef General Hospital were female, married, had nursing diploma, and had 10 years or more of experience within the hospital. They had a higher intention to leave the hospital and the profession and moderate level of organizational commitment. Recommendation The study recommends that the hospital manager develop retention strategies for staff nurses and that decision makers develop policies to prevent this problem. Future research is warranted for investigating the contributory factors of this problem.
  705 129 -
Stressors encountered by patients undergoing open-heart surgery at a Cairo University Hospitals
Amaal F Ahmed, Nahla S Khalil, Warda Y Morsy
May-August 2017, 14(2):78-86
DOI:10.4103/ENJ.ENJ_23_17  
Background Coronary artery bypass grafting (CABG) as one of the treatment modalities for patients with coronary artery diseases has a major physical, psychological, and emotional impact on the patients. Therefore, these patients must routinely be assessed for the effect of stressors, especially before and after surgery. Aim The aim of this study was to assess stressors encountered by patients undergoing open-heart surgery at a Cairo University Hospitals. Research questions a) What are perceived preoperative stressors in patients undergoing open heart surgery during hospitalization? b) What are the perceived post operative stressors in patients undergoing open heart surgery during hospitalization? Research design A descriptive exploratory design was utilized. Sample A convenience sample consisting of 60 patients was included in the current study. Setting This study was carried out at a Cardiothoracic Department and an ICU of a cardiothoracic surgery, affiliated to one of the Cairo university hospitals. Tools Demographic data, medical data; and Intensive Care Unit Environmental Stressor Scale (ICUESS) were utilized to collect data pertinent to the current study. Results Preoperative stressors in the current study were found to be due to: continuous lighting, use of curtains as spacers between beds, nurses working in urgency, repeated awakening patients up to give medicines, workers’ loud voice, the death of other patients, hearing other patients’ complaints and sleep disturbance. However postoperative stressors were due to: inability to sleep, seeing families and friends only for few minutes and seeing each visitor individually, having pain, thirst, presence of nasal, oral and chest tubes, unfamiliarity with time, day or date. Conclusion and Recommendations Routine preoperative assessment of patients undergoing CABAG is recommended to identify and reduce stressors. Furthermore, preoperative patients’ education should be incorporated into routine nursing practice to reduce anxiety and prevent postoperstive complications.
  734 90 -
Efficacy of teaching self-management strategies on auditory hallucinations among schizophrenic patients
Nadia E Sayied, Zamzam A Ahmed
May-August 2017, 14(2):168-178
DOI:10.4103/ENJ.ENJ_25_17  
The study aimed to evaluate the effectiveness of teaching self-management strategies on auditory hallucinations among schizophrenic patients. A quasiexperimental design (pre–post test design) was utilized in this study. The study was carried out at Inpatient Unit at Neuropsychiatry and Neurosurgical Hospital at Assiut University. The study consisted of 30 patients with chronic schizophrenia. Three tools were used to collect data from this study: tool 1, a structured interview tool for the sociodemographic and clinical data of patients with schizophrenia who are suffering from auditory hallucinations; tool 2, phenomenology scale of hallucinations, which is a semistructured interview and was a modified version; and tool 3 structured interviewing tool of self-management strategies to control auditory hallucinations. The study results revealed that there was a statistically significant difference as regards hallucination and coping strategies of self-management to control auditory hallucination before and after intervention. On the basis of the present study it can be concluded that patients can use self-management strategies to reduce the severity of auditory hallucination and help them to cope and succeed in dealing with their own illness. In the light of the result of the present study it is recommended that the psychiatric healthcare provider (psychiatric nurse and/or psychiatrist) provides accurate information to schizophrenic patients who have auditory hallucinations about different self-management techniques. Schizophrenic patients with auditory hallucination should be trained on self-management coping strategies to control their hallucination.
  686 130 -
Factors associated with nurses’ readiness for organizational change at Beni Sueif University Hospital
Fatma F El-Sayed, Abeer M Seada, Hoda A El-Guindy
May-August 2017, 14(2):141-151
DOI:10.4103/ENJ.ENJ_24_17  
Background Organizations are forced to stay and respond to environmental changes in order to survive. Nurses’ readiness for organizational change is considered a key aspect of any organizational change efforts and can be a determining factor of successful change. Patients and methods This study aimed to investigate factors associated with nurses’ readiness for organizational change. A descriptive exploratory design was used in this study. The study was conducted in all In-patient Care Units at Beni Sueif University Hospital. A convenience sample of staff nurses working in the above-mentioned setting constituted the study sample (N=179). Results The studied sample had moderate readiness and low resistance for organizational change. There was a statistically significant positive correlation between nurses’ readiness for organizational change and both professional nursing practice environment and structural empowerment. A negative correlation was found between nurses’ readiness for organizational change and both dispositional resistance to organizational change and emotional climate. Recommendations Nursing leaders’ efforts must be directed toward creating magnet environment that promotes nurses’ readiness for change by providing them with access to opportunity to learn and grow and access to support and create an autonomous work practice. Enhancement of emotional work climate among nurses is of great importance to promote their readiness for organizational change.
  744 63 -
Organizational attributes and its relation to organizational citizenship behavior among academic nursing staff
Marwa M Abdel Alim, Rasha I El-Sayed
January-April 2017, 14(1):25-30
DOI:10.4103/ENJ.ENJ_5_17  
Introduction Nowadays, there is persistent development and competition among educational institutions. To enhance their competitive advantage, nursing colleges should maintain a high level of citizenship behavior among their staff members. Objective The purpose of this study was to determine organizational citizenship behavior (OCB) among academic nursing staff and its relation to training and development, work–life policies, empowerment, commitment, and organizational trust in the nursing faculty at Port Said University. Participants and methods A descriptive corelational design was used in the present study. The sample consisted of 81 teaching staff. A structured questionnaire sheet was utilized for data collection. Results The study results revealed that most academic staff have high OCB and that work–life policies have a positive correlation with OCB. Recommendation The study recommended that university and faculty management should reconsider their training programs and development opportunities and faculty management should provide favorable working conditions and improve work–life policies.
  679 121 -
Effect of ventilator bundle implementation on weaning indicator among mechanically ventilated patients at a selected private healthcare sector
Mohamed Abd Elmonem El-Sharkawy, Warda Youssif Mohamed, Nahla Shaban Ali
January-April 2017, 14(1):50-57
DOI:10.4103/ENJ.ENJ_10_17  
Background Mechanical ventilator (MV) has serious complications; thus, the ultimate goal of MV is ventilator discontinuation. Ventilator bundle is a group of practices aimed to improve the patient outcomes. Aim The aim of this study was to examine the effect of ventilator bundle implementation on weaning indicator among mechanically ventilated patients. Research design A quasiexperimental design was utilized. Sample A purposive sample of 60 mechanically ventilated patients was enrolled. Patients were matched for age, sex, and medical characteristics and then randomly assigned to two groups. The study group included patients for whom all elements of the ventilator bundle were applied completely, whereas the control group included patients for whom the ventilator bundle elements were not applied completely. Setting This study was conducted in the ICUs of a selected private hospital in Cairo. Tools of data collection Three tools were utilized: sociodemographic and medical data sheet, ventilator bundle compliance checklist, and Burns’ Wean Assessment Program checklist. Results There was a significant statistical difference between the compliant (study group) and the noncompliant (control) group as regards weaning indicator scores (t=4.20; P=0.001). There was a significant difference between patients of the two groups as regards the compliance with individual ventilator bundle elements with respect to head-of-bed elevation (χ2=4.85, P=0.046), sedation interruption (χ2=6.4, P=0.03), and assessment of readiness to extubate (χ2=5.2, P=0.02). Conclusion Implementation of ventilator bundle plays a pivotal role in weaning from a MV. Recommendation Applying the ventilator bundle practices with focusing on the head-of-bed elevation, daily sedation interruption, and assessment of readiness to extubate is highly recommended. Moreover, the use of a structured tool to assess readiness for weaning can help in managing the mechanically ventilated patients. Furthermore, replication of the study on a larger probability sample from different geographical locations in Egypt ensures generalizability of the study.
  630 108 -
Effect of LI4 (Hoku point) massage with ice on labor duration during the active phase of labor among women delivering at El Manial University Maternity Hospital
Magda A Fawaz, Nadia B El-Sharkawy
September-December 2016, 13(3):178-185
DOI:10.4103/2090-6021.200179  
Background Childbirth is one of the most painful experiences for women during their reproductive life. The aim of this study was to assess the effect of large intestine 4 (LI4) massage with ice on labor duration during the active phase of labor. A randomized controlled trial was adopted for this study. Mothers were recruited from the labor unit at El Manial University Maternity Hospital. A total of 200 laboring women were randomly selected after admission to the labor unit according to certain criteria. The sample was divided into two groups (100 each): group A and group B. Women in group A received LI4 massage with ice on their hands and women in group B received routine care. Two tools were developed and filled by the researchers, a structured interview sheet and a partograph, to assess the labor progress and duration. Results We found no statistically significant differences between groups with respect to maternal sociodemographic characteristics. The duration of the active phase (4 cm dilatation to full dilatation) was shorter in the study group compared with the control group. This difference showed a highly significant difference (X=4.5±0.53 compared with 5.39±0.89) (P≤0.05). Conclusion and recommendations The study concluded that LI4 massage with ice on the hands is an easy, cost-effective, and noninvasive technique to reduce the duration of labor.
  655 76 -
Effect of instructions on selected self-care practices among type-1 diabetic children
Azza Abdel Moghny Attia, Eman Abdel Fattah Hassan
May-August 2017, 14(2):179-189
DOI:10.4103/ENJ.ENJ_19_17  
Background Type 1 diabetes (T1D), which tends to develop in childhood, needs certain self-care practices to achieve optimal glycemic control. Aim The study aimed to evaluate the effect of instructions on selected self-care practices among T1D children. Patients and methods A quasi-experimental one-group design with pre–post assessment was used in this study, which was carried out in the Pediatric Diabetes and Endocrine Unit at El Monira University Pediatric Hospital, on a purposive sample of 100 diabetic children. The data were collected using a structured interview questionnaire and four observational checklists for self-care practices of insulin injection by syringe and by pen, blood glucose test, and foot care. Results Children’s age ranged between 6 and 14 years, with female predominance. Their readiness for self-care was high, especially for insulin injection, and none of the children had adequate performance of any of the procedures before the intervention. At the postintervention phase, there were statistically significant improvements in all procedures, reaching 76% for insulin injection by syringe, 82 for injection by pen, 77% for blood glucose testing, and 58% for feet care (P<0.001). In total, 80% adequate performance after the intervention was detected (P<0.001). In multivariate analysis, the applied intervention was the main independent statistically significant positive predictor of the child’s performance score, with child age and performance of exercise having a less but statistically significant influence. All children (100%) recommended the program for other diabetic children. Conclusion The study concluded that children’s practice scores of self-care activities improved significantly after the intervention, and readiness of children plays an active role in improving these scores. The participation of parents, particularly with very young children, and more emphasis on foot care are needed. The study recommends that the intervention should be implemented in settings providing care to children with T1D. Feet care for children with T1D was done by parents until the children realize the importance of caring and examining their feet periodically. The impact of the program on glycemic control needs further research.
  652 46 -
Effect of ingestion of yogurt containing Lactobacillus acidophilus on vulvovaginal candidiasis among women attending a gynecological clinic
BSN Safaa Fares, Shadia Abd el Kader, Azza Ali Abd El Hamid, Hassan Mostafa Gaafar
January-April 2017, 14(1):41-49
DOI:10.4103/ENJ.ENJ_8_17  
Background Vaginal infection is the most common complaint during childbearing. Aim The aim of the present study was to assess the effect of yogurt intake on relieving symptoms of vulvovaginal candidiasis (VVC). Design This study was quasi-experimental in nature. Setting The study was conducted at the outpatient gynecological clinic at El Fayoum General Hospital. Sample A purposive sample of 200 women with VVC assigned into two groups was used in the study. The first group (control group) received medical care only, whereas the second group (study group) received medical care and yogurt. The researcher determined certain days for the research group and other days for the control group. Tools Researcher designed this tool. The first tool was a structure interview and the second was assessment and follow-up schedule for the symptom of VVC. Results The findings of our study indicated no statistically significant differences between groups as regards sociodemographic characteristics. The mean age was 27.97±5.73 years in the study group, whereas it was 27.18±5.35 years in the control group. As regards educational level there was no statistically significant difference between groups (χ2=1.754, P=0.15). Regarding monthly income there was no statistically significant difference between groups (χ2=1.245, P=0.21). Moreover, as regards assessment symptom of VVC there was a statistically significant difference between groups. Conclusion Yogurt contains probiotic bacteria such as Lactobacillus acidophilus that are beneficial against mucosal candida infections and their beneficial actions by suppressing the growth of candida, and thus yogurt intake can relieve symptoms of VVC. Recommendation Yogurt intake (one large cup without sugar daily) can relieve symptoms of VVC.
  545 81 -
Health Belief Model-based educational program about cervical cancer prevention on women knowledge and beliefs
Sabah Ramadan Hussein Ahmed, Amany Saad Mohamed Esa, Ons Said MohamedEl-zayat
January-April 2018, 15(1):39-49
DOI:10.4103/ENJ.ENJ_38_17  
Background Awareness of cervical cancer causes and the implementation of screening program can help in reduction of morbidity and mortality among women. Aim The aim of this study was to examine the effect of nursing educational program based on Health Belief Model (HBM) on women knowledge and beliefs about cervical cancer prevention. Study design This was a quasi-experimental study (pretest and posttest evaluations). Setting This study was conducted in El-Maasara Maternal and Child Health Center, Helwan City, Egypt. Participants and methods A convenience sample of 150 married women was included. The study was conducted from beginning of August 2016 to the end of January 2017 covering a period of 6 months. Two tools were used to conduct this study: a structured cervical cancer knowledge questionnaire and HBM scale. Knowledge and beliefs were assessed using the study tools and then an educational program was designed based on the results of the pretest. The program was implemented followed by evaluation of its effect using the same tools. Results All the women had poor knowledge score regarding cervical cancer prevention before the program. However, after the program, 16 and 84% of the women had an average and good knowledge, respectively, on cervical cancer prevention. This difference was significant (P<0.001). There were a significant increase in the scores of the perceived susceptibility, perceived severity, perceived barriers, perceived benefits, and the cues to action after the program compared with the scores before the program. Conclusion After implementation of the nursing educational program regarding cervical cancer prevention for married women, knowledge improved significantly, and there were significant improvements in perceived severity, barriers, benefits, and the cues to action scores after program compared with the scores before program (P≤0.001). These study results supported the study hypotheses. Recommendations Propagation of educational programs based on HBM on cervical cancer prevention to various age groups would help raise public awareness about cervical cancer and take action for its prevention.
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Effect of nursing care standards on nurses’ performance in caring for patients with cardiac arrhythmias
Rawia A Ibrahim, Kamelia F Abd-Allah, Osama S Arafa, Sabah S Mohammed
September-December 2017, 14(3):251-258
DOI:10.4103/2090-6021.233665  
Background Nursing care should be guided by clearly defined standards to ensure a high quality of care. Standards of care are authoritative statements that describe a common or acceptable level of patient care or performance. Aim The aim of this study was to evaluate the effect of nursing care standards (NCSs) on nurses’ performance in the care of patients with cardiac arrhythmias in the coronary care unit (CCU) at Benha University Hospital. This research was based on the hypothesis that the mean score of nurses’ knowledge and practice level after NCS implementation may be higher than their score before NCS implementation. Participants and methods A quasi-experimental research design was utilized. This study was conducted in the CCU at Benha University Hospital. Two groups of participants were included in the study: experts and staff nurses working in the CCU. Three data collection tools were used in the different phases of this study: first tool, an experts opinion sheet was designed to test the face and content validity of the designed NCSs; second tool, a self-administered questionnaire was administered to nurses to assess their knowledge; and third tool, a nurses’ practice observational checklist based on the designed NCSs was completed. Results The results of the study showed that the majority of the jury was satisfied with the general form (face and content validity) of the NCS. The jury agreement ranged between 85.7 and 100%. Furthermore, the findings revealed a statistically significant improvement in the total mean knowledge scores of nurses in all items of the study after implementing the standards (P=0.000) as compared with the preimplementation period. There was also statistically significant improvement in the total mean practice scores of nurses in all items of the study after implementing NCSs (P=0.000). Conclusion There is a statistically significant improvement in nurses’ performance in the care of patients with cardiac arrhythmias in the CCU after NCS implementation. The study recommends that NCSs for management of patients with cardiac arrhythmias should be revised, updated, and available in the CCU in both Arabic and English language.
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Nontunneled hemodialysis catheter among acute renal failure patients: nurses’ knowledge and practices at El Fayoum Insurance Hospital
Rasha M Saber Mohammed, Warda Y Mohammed, Yousria A ElSalam Seloma
September-December 2017, 14(3):217-225
DOI:10.4103/ENJ.ENJ_9_17  
Background Hemodialysis requires access to blood vessels capable of providing rapid extracorporeal blood flow. A nontunneled catheter can be placed for initiation of acute hemodialysis. If dialysis for more than a week or so is likely, a cuffed, tunneled catheter can be used instead. Hemodialysis nursing is a specialized area of nursing practice focusing on the needs of patients with renal failure and their families across the lifespan. Aim The aim of the present study was to assess nurses’ knowledge and practices related to management of nontunneled hemodialysis catheter among acute renal failure patients. Design A descriptive exploratory research design was used in the present study. Setting The present study was carried out at the hemodialysis unit of El Fayoum Insurance Hospital. Sample A purposive sample of 50 male and female nurses working in the hemodialysis unit of El Fayoum Insurance Hospital was selected over a period of 6 months. Tools of data collection Two tools were developed by the investigator to collect data: tool 1–nurses’ knowledge self-administered questionnaire consists of two parts − part one covers nurses’ personal background data, whereas part two covers knowledge assessment data; tool 2–nurses’ practice observational checklist. Structured interviews and direct observation were utilized for data collection. Results The entire study sample had unsatisfactory level of knowledge, and all of them had unsatisfactory levels of practice regarding nontunneled hemodialysis catheter management. There was a significant, positive statistical correlations between age, years of experience, and total knowledge scores. In addition, there was a significant statistical correlation between age, years of experience, and total practice scores, and there was a significant statistical correlation between total knowledge and total practice scores. Conclusion The results of the present study showed a real gap between nurses’ knowledge and practices as compared with evidence-based guidelines of the Centers of Disease Control and Prevention. Knowledge regarding nontunneled hemodialysis catheter management was unsatisfactory, and the level of nurses’ practice was unsatisfactory. Recommendation The hospital should provide regular, continual training for nurses regarding use of nontunneled hemodialysis catheter, and ongoing clinical and educational competencies evaluation should be carried out.
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Impact of physical exercise on daily living activities among women with early osteoarthritis
Reda M El-sayed Ramadan, Jehan Sayyed Ali, Reda Mohamed-Nabil Aboushady
September-December 2016, 13(3):186-192
DOI:10.4103/2090-6021.200180  
Background Osteoarthritis (OA) is the most common rheumatic disease of the knee and causes uncontrolled pain and disability. It affects millions of people across different races at different ages and of both sexes. Daily physical exercise is the first line of management for women with early OA to maintain muscle strength, physical fitness, and overall health. Aim The aim of the study was to evaluate the impact of physical exercise on the activities of daily living in women with early OA. Participants and methods A quasiexperimental design ‘time-series’ was used to achieve the objectives of the study. A total of 46 women were recruited from the outpatient clinic of El-Demerdash University Hospital. Tools of data collection Three tools were developed and used by researchers to collect the data: (a) a structured interview questionnaire; (b) scale of daily living activities; and (c) a physical exercise questionnaire for women with OA. The women performed exercises at the rate of one session per week for a period of 1 month in the presence of researchers, who clarified any queries. Results The women were aged 43–65 years, with a mean age of 41.8±14.67 years. There are significant differences regarding pain intensity, degree of difficulty, and need for assistance after practicing physical exercises. Conclusion A regular exercise program improved the daily living activity levels of women with early OA. There was also a significant improvement in pain, knee flexion, muscle strength, and functional capacity after practicing physical exercise. Recommendation Nurses have an active role in raising awareness about the importance of physical exercise in the treatment of early OA. Hospitals should implement a plan of action to include exercise in early OA treatment for women.
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Societal factors that induce career change decision among nurses working at different Sohag city hospitals
Hind I Ali
May-August 2017, 14(2):130-140
DOI:10.4103/ENJ.ENJ_17_17  
Background Nurses who have positive professional images will have stronger relations with their patients, peers, and community as a whole. Decision to leave might be an indication that nurses are not committed to their profession. Aim This study aimed to determine the societal factors that induce career change decision among nurses working at different Sohag city hospitals. Study participants The study participants comprised all categories of nursing staff from all age categories and different educational levels. Methods/Tools Societal Satisfaction Questionnaire and Anticipated Career Change Questionnaire were used for data collection. Results On the basis of the analysis of the participant’s responses, the result revealed that there was a highly statistically significant positive correlation between societal satisfaction and participants’ decision to leave the nursing career. Conclusion The study revealed that different sets of societal factors are associated with career change decision among nurses, which are mainly concerned with society’s view of nursing and mass media projection. These data can be useful for understanding nurse workforce challenges, improving mass media recognition, providing feedback to Egyptian nursing leaders as regards the best workplace practices, and informing decisions surrounding workforce policy.
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Vascular complications and risk factors among patients undergoing cardiac catheterization
Mohamed El Sayed Ebeed, Nahla S Khalil, Manal S Ismaeel
September-December 2017, 14(3):259-268
DOI:10.4103/2090-6021.233668  
Aim and objectives The aim of the present study was to investigate the incidence of vascular complications and risk factors for vascular complications among patients undergoing the cardiac catheterization procedure. Background Cardiac catheterization is one of the most crucial methods to assess and manage coronary artery diseases. Although it has a reduced morbidity and mortality, this invasive procedure is not free of complications. Methods The descriptive exploratory design was used in this study. Demographic data, medical history and vascular complication assessment data were collected from a convenience sample of 100 patients, who underwent cardiac catheterization via the femoral artery. Results Incidence of minor vascular complications revealed that the studied individuals had femoral oozing before sheath removal and femoral ecchymosis after sheath removal. Regarding the incidence of major vascular complications, the studied individuals had femoral haematoma after sheath removal. The common factors that placed patients at a greater risk for developing vascular complications were old age, female sex, illiteracy, and non-ST elevation myocardial infarction. Conclusion The current study concluded that the most common vascular complications were oozing before sheath removal, and ecchymosis and haematoma after sheath removal, and the common risk factors for vascular complications were old age, female sex, increased BMI and femoral sheath size.
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