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   2016| September-December  | Volume 13 | Issue 3  
    Online since February 15, 2017

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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
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.
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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
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.
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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
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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The relationship between stressful life events and quality of life of adolescent patients
Sherien S.M. Mohammed, NM Abdel Kader
September-December 2016, 13(3):193-199
Background The risk for psychosis increases with the number of life events experienced and is associated with impairments in quality of life (QoL) and functioning. Aim The aim of the present study was to assess the relationship between stressful life events and QoL of adolescent psychiatric patients. Patients and methods A descriptive, correlational design was used in this study. A sample of convenience of 100 adolescent psychiatric patients was recruited from the adolescents’ outpatient clinics of El-Abbassia Mental Health Hospital. Three tools were used in the present study: a sociodemographic and medical data interview, life events inventory, and QoL profile. Results The results showed that more than half of the sample were girls, students, and were not working. More than two-thirds of the sample were diagnosed with conduct, depressive, and bipolar disorders, with a family medical history, and half of the sample had had sexual experience. Findings revealed highly statistically significant negative correlation between life events inventory and the QoL profile. Conclusion Most of the adolescent psychiatric patients experienced a multiple stressful life events that negatively affected their QoL. Therefore, it is recommended that psychosocial treatment should be selected and modified for patients to deal with stressful life events and building adolescents’ self-esteem. In addition to periodic check-ups, further studies for generalization should be carried out and a suitable psychotherapeutic model must be adopted.
  1,201 113 -
Effectiveness of physical rehabilitation on clinical outcomes of patients following stroke
Magda M Mohsen, Naglaa M El-Mokadem, Shimaa E Abdullah
September-December 2016, 13(3):200-210
Background and purpose Stroke is a leading cause of gait impairment, resulting in long-term disability among adults, and frequently results in impaired mobility or motor function. More than half of the people with stroke are not able to walk, and walking impairments are still present among them due to abnormal muscle control, muscle weakness, abnormal muscle tone, abnormal muscle activation patterns, and altered energy expenditure, mostly affecting the paretic side. Thus, the purpose of the current study was to examine the effectiveness of using combined gait training and treadmill walking technique on selected clinical outcomes of patients with stroke. Patients and methods A quasi-experimental design was used to test the research hypotheses. A convenience sample of 50 adult patients with stroke were recruited. Setting This study was conducted in the outpatient clinics of neurology and physiotherapy unites at Shebin El Kom City, Menoufia University Hospital, Menoufia Governorate. Tools Interviewing Questionnaire, the Barthel Index, the Simplified Stroke Rehabilitation Assessment of Movement Scale, the Berg Balance Scale, the Oxford Scale, and the Modified Ashworth Scale were used to collect data. Results There was a statistically significant improvement in voluntary movement of subscale scores of the upper and lower limb and basic mobility after intervention. There was a statistically significant improvement in the mean scores of activities of daily living and body balance after intervention. There was a statistically significant improvement in the mean score of muscle tone and muscle strength after intervention. Conclusion Combined gait training and treadmill walking technique is effective in improving clinical outcomes in patients with stroke. Recommendation Rehabilitation nurses should be encouraged to implement the combined gait training and treadmill walking technique as a routine practice in rehabilitation facilities for patients with stroke.
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