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   2019| September-December  | Volume 16 | Issue 3  
    Online since August 20, 2020

 
 
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ORIGINAL ARTICLES
Family health practices regarding household waste management in El-Zawia El-Hamra District
Wafaa K Ibrahim, Mona A.B Abd Ellatef, Asmaa T Mohamed
September-December 2019, 16(3):101-114
DOI:10.4103/ENJ.ENJ_7_19  
Background Household waste management is attracting growing attention, as it can be readily noted that too much trash lies uncollected on the roads, causing inconvenience, pollution of the environment, and posing a threat to public health. Aim The study aimed to evaluate the effect of a health awareness program on family knowledge and health practices regarding household waste management. Design A quasi-experimental design was used. Setting The study was conducted in El-Zawia El-Hamra District. Sample The number of families in El-Zawia El-Hamra District is ∼11 350 families. Overall, 2% of the total number of families was recruited in this study. The sample number is equal to 228 families (200+28 for pilot study) from the total actual sample. Purposive sample comprised 200 families in this study. Tools A structured interview questionnaire was used for data collection. It was divided into five parts: the first part included family’s sociodemographic data, the second part included the medical history of head of the family, the third part included family’s knowledge regarding household waste in El-Zawia El-Hamra area, the fourth part included family’s reported practices toward household waste management, and the fifth part included satisfaction of the family regarding El-Zawia El-Hamra District services and cleaning work in the region. Results The current study showed highly statistically significant differences between the families’ total knowledge and their reported practices before and after implementation of the health awareness program. Conclusion The application of health awareness program improved the families’ knowledge and their reported practices regarding household waste management. Recommendations Conducting of continuous health awareness programs for families on how to manage waste healthily in the larger neighborhoods of Greater Cairo the usage of the media, especially television, as it is the most effective means of information for families.
  802 93 -
Effect of an educational guideline on nurses’ performance caring for patients post liver transplantation
Sarah F Mahmoud Karaly, Enas E Elsayed Abo Elfetoh
September-December 2019, 16(3):115-127
DOI:10.4103/ENJ.ENJ_8_19  
Background Care of the liver transplant (LT) patients presents the critical care team with one of the more complex and challenging endeavors. Aim This study aims to assess the effect of an educational guideline on nurses’ performance caring for patients post-LT. Design A quasi-experimental design was used. Setting This study was conducted in the critical care unit at Ain Shams Specialized Hospital at Cairo in Egypt. Patients and methods A convenient sample of all available nurses’ (30) caring for patients post-LT in the previously mentioned unit. Data collection tools Nurses’ knowledge self-administered questionnaire sheet and nurses’ practice observational checklist. Results The present study revealed that most of the nurses had got unsatisfactory level of performance (knowledge and practice) regarding caring for patients post-LT in the critical care unit as per the educational guidelines implementation (16.6 and 33.3%, respectively). Meanwhile the majority of the study sample had a statistically significant improvement in their knowledge and practice regarding caring for patients post-LT in the critical care unit after the implementation of the educational guidelines (96.6 and 93.3%, respectively), while this improvement lowered slightly post 3 months at follow-up (90 and 86.6%, respectively). Conclusion This study concluded that the educational guideline for nurses in the critical care unit is effective in improving their performance regarding caring for patients post-LT. Recommendations The importance of conducting periodic in-service training advanced care programs for nurses in critical care units for improving their performance and quality of care that is provided to the patients post-LT.
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The relationship between staff nurses’ satisfaction with their schedule and patients’ satisfaction with quality of care
Noor A Abd-El-Aziz, Eglal A.A Wahab
September-December 2019, 16(3):147-154
DOI:10.4103/ENJ.ENJ_5_20  
Introduction Nurse satisfaction and nurse scheduling are the major factors that improve quality of patient care. Long working hours contribute to poor patient outcomes, which affects patient satisfaction and quality of care. Aim The aim was to investigate the relationship between staff nurses’ satisfaction with their schedule and patients’ satisfaction with quality of care. Design A descriptive correlational design was used for this study. Participants and methods The study was conducted in 1-Day Surgeries Hospital, Nasr City, Cairo. Two samples were included in the study: convenient sample of nurses (36 nurses), and a random sample of patients (50 patients). Data were collected using two tools: a developed questionnaire about nurses’ satisfaction with their schedule and an adopted questionnaire about patients’ satisfaction with quality of care. Results The results revealed that the total mean percent of nurses satisfied with their schedule was 68.1%, which indicates moderate satisfaction. Moreover, the mean percent of total patients satisfied with the quality of care was 64.5%, which indicates moderate satisfaction. In addition, there was no statistically significant positive correlation (r=0.051, P=0.767) between patients’ satisfaction with quality of care and nurses’ satisfaction with their schedule. Conclusion Nurses were moderately satisfied with their schedule, and also, patients were moderately satisfied with quality of care. There was no statistically significant positive correlation between nurses’ satisfaction with their schedule and patients’ satisfaction with quality of care. Recommendations The authors recommend to increase staff participation in schedule and include preferences as a motivator to improve nurses’ morale and satisfaction; to include nurses, who work extended shifts, in health promotion and disease prevention programs; and to decrease weekly working hours with high working-time autonomy and workplace flexibility.
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The effect of empowerment program for mothers of children undergoing hemodialysis on arteriovenous fistula care
Asmaa M Hassan, Naglaa F Mahmoud
September-December 2019, 16(3):128-140
DOI:10.4103/ENJ.ENJ_3_20  
Background Children undergoing hemodialysis (HD) have many complications, and arteriovenous fistula care through empowerment programs based on educational needs assessments will help to improve mothers’ knowledge and health practice. Aim The present study aimed to investigate the effect of empowerment programs for mothers of children undergoing HD on arteriovenous fistula care. A quasi-experimental research design (pretest/post-test design) was utilized in this study. The study was conducted in the Center for Pediatric Nephrology and Transplantation in Cairo University Children Hospitals. Patients and methods A purposeful sample of 30 mothers and their children from the previously mentioned setting was included. Tools of data collection included tool I: a structured interview questionnaire sheet to assess mothers and their children’s personal characteristics, tool II: assessment sheet for mothers’ knowledge, and tool III: included observational checklists about hand washing and fistula hand exercises. Results The results of this study indicated highly statistically significant differences concerning mothers’ knowledge, and practice preimplementation/postimplementation of the empowerment program and there was a positive correlation between total mothers’ knowledge and practice regarding AVA care postimplementation of the empowerment program. Conclusion The current study concluded that the empowerment program positively improved mother’s knowledge and practice regarding AVA care after implementation than before and recommends that empowerment programs should be established to prepare, educate, and encourage mothers for care of their children undergoing HD.
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Nursing staff perception about the quality of health-care system in primary health-care centers in Beni Suef Governorate
Fatma N Fahim, Eglal Ahmed Abd Elwahab, Hoda A El-Guindy
September-December 2019, 16(3):141-146
DOI:10.4103/ENJ.ENJ_4_20  
Introduction Quality of health care is an important component of long-term socioeconomic development. Health-care systems are thus encountering an increased demand for high quality care while the resources they can command from society are decreasing. Primary health care (PHC) aims to prevent disease or injury before it ever occurs. Aim This study aimed to assess nurses’ perception about the quality of health-care system in PHC centers in Beni Suef Governorate. Research design Descriptive cross-sectional design was used. Participants and methods The study was conducted at PHC centers in Beni Suef Governorate. Randomly selected65 (PHC) centers excluding maternal child health centers. The total sample size was 455 nurses of different categories of nursing staff working in the selected 65 PHC centers in Beni Suef Governorate. A self-administered questionnaire for nurses’ perception about the quality of health-care system in PHC centers was adopted from Hassan (2013). Results The highest mean score of nurses’ perception (37.92±6.26) was teamwork formation and its type. The lowest mean score (12.06±2.51) was elements of quality. More than half (51.9%) of the participants had a high perception level of quality health-care system, Also, more than one-quarter (35.8%) of them had moderate perception level while a minority (12.3%) of them had low perception level. Conclusion There was high and moderate perception among most nursing staff in PHC centers. Recommendations Reinforce nurses’ perception toward the quality of health-care system by applying Egyptian guidelines and standards for PHC centers.
  563 62 -
Prevalence of urinary tract infections among pregnant women at Sohag University Hospital
Mona A.D Mahmoud, Amel D Kamel, Safaa I Ahmed, Azza A.A El-Hamed
September-December 2019, 16(3):162-174
DOI:10.4103/ENJ.ENJ_7_20  
Background Urinary tract infections (UTIs) are among the most common bacterial infections that affect pregnant women, which if left untreated can lead to perinatal morbidity and mortality. Aim The study aimed to assess the prevalence of UTIs among pregnant women. Participants and methods A descriptive/exploratory design was adopted. The study was conducted at the Obstetrics and Gynecology Outpatient Clinic of Sohag University Hospital. A convenience sample of 440 pregnant women, irrespective of age, parity, or gestational age, was recruited for the study. Three tools were used to collect data: first, structured interviewing schedule; second, UTI symptomatology tool; and third, laboratory investigation record. The research investigator developed the structured interviewing schedule and UTI symptomatology tool. Results The study results indicated that the mean age of the pregnant women was 22.8±6.2 years. Overall, 37.3% of the pregnant women had secondary education, 75.7% were living in rural area, and 87.3% were housewives. Moreover, 46.3% of the pregnant women were multigravida, whereas 51.6% of them were multiparous. The prevalence of UTIs among the pregnant women was 42.3%. The types of UTIs isolated were symptomatic UTI diagnosed in 59% and asymptomatic UTI was identified in 41% among pregnant women who had UTIs. The prevalence of symptomatic UTIs and asymptomatic UTI among the total pregnant women was 25 and 17.3%, respectively. Synthetic underwear, decreasing fluid intake, multigravidity, occupation, and educational level were risk factors that might affect the incidence of UTIs. Conclusion The prevalence of UTIs among pregnant women was high. Overall, 41% of pregnant women who had UTIs were asymptomatic. Synthetic underwear, decreasing fluid intake, multigravidity, occupation, and educational level were risk factors that might affect the incidence of UTIs. Recommendation It is important to do routine urine analysis for all pregnant women on every visit.
  426 33 -
Effect of palliative care program on nurses’ performance regarding prostate cancer and patients’ outcomes
Eman A Metwaly, Amal H Hamad
September-December 2019, 16(3):195-205
DOI:10.4103/ENJ.ENJ_13_20  
Background Patients with chronic illnesses may experience extreme symptoms, including physical, spiritual, and psychosocial effects. Preventing and managing these symptoms while optimizing the quality of life throughout the dying process is the goal of palliative care. Aim To evaluate the effect of palliative care program on nurses’ performance regarding prostate cancer and patient’s outcomes. Sample and methods: research design A pretest/posttest quasi-experimental design was used to achieve the aim of the study. Setting The study was conducted in the Oncology and Urology Departments at Zagazig University Hospital, Sharkia, Egypt. Patients A purposive sample of 30 nurses and 30 patients had been selected. Tools of data collection Four tools were used: a structured interviewing questionnaire for nurses, observational checklists for palliative care, a structured interview questionnaire for patients, and symptom index. Results The results of the present study showed that 83% of studied nurses had satisfactory level of knowledge in the postprogram phase. Moreover, 83.3% of studied nurses had satisfactory level of practice after the program implementation. There was improvement in patients’ compliance regarding nutrition, medication, and lifestyle after applying the palliative care program, with mean±SD of 9.1±1.71, 12.1±2.5, and 10.3±3.4, respectively. Moreover, 80% of the studied patients had decreased symptoms after the program, though the decrement was not significant. Conclusion In light of the current study results, it can be concluded that the palliative care program had a positive effect on improving nurses’ knowledge and practice, which reflected then on improving patients’ outcomes. Recommendation In-service training for newly recruited nurses will help to update their knowledge and improve their practice.
  390 33 -
Relationship between nurse manager leadership style and staff nurses’ work engagement
Walaa A Mousa, Nehad E EldinFekry, Amal H Elewa
September-December 2019, 16(3):206-213
DOI:10.4103/ENJ.ENJ_16_20  
Background Nowadays, organizations are in a constant state of change, hence the guidance of visionary leadership is vital to the success of any organization. Supportive leadership behaviors are very important for employees’ engagement. Aim The study aimed to investigate the relationship between nurse manager leadership style and staff nurses’ work engagement (WE). Design A descriptive correlational design was used. Participants and methods The study was conducted at a teaching hospital that is affiliated to Cairo University Hospitals. A proportional randomly selected sample was used (N=271) of staff nurses. Two questionnaires were used for data collection. The first consist of two parts, first, personal characteristic data sheet; and second, multifactor leadership questionnaire (21 items), and the second questionnaire was the Utrecht work engagement scale (17 items). Results The results of the study revealed that the highest mean percent score of nurses’ leadership style perception was regarding transformational and transactional leadership style (75.09 and74.87%, respectively) and the lowest mean score was regarding laissez-faire leadership style (62. 29%). Moreover, the highest mean percent score of nurses’ WE was dedication (91.51%), and the lowest mean percent score for absorption (80.42%) domain. Most staff nurses had a high level of WE (89.3%). In addition, there was a highly strong significant positive correlation between each of transformational, transactional leadership styles of unit nurse manager, and staff nurses’ WE (r=0.325 and P=0.000, and r=0.260, and P=0.000), whereas there was a negative significant correlation between laissez-faire leadership style of unit nurse manager and staff nurses WE (r=–0.125 and P=0.040). Conclusion The study concluded that there was a highly strong significant positive correlation between each of transformational and transactional leadership styles of unit nurse manager and staff nurses WE. However, there was a negative significant correlation between laissez-faire leadership style of unit nurse manager and staff nurses’ WE. Recommendation The study recommended that hospital administrators should support staff with adequate rewards to motivate them. Nurse managers should perform regular meetings with their staff nurses to identify staff work problems and help them to find solutions which improve their WE. Moreover, hospital administrators should perform regular assessment of unit nurse managers’ skills, knowledge, and behavior before enrollment in the leadership position.
  353 41 -
Comparison of pain response to vein puncture versus heel lance among preterm infants undergoing blood sampling
Sanaa G.Y Mohamed, Sohier A Elhamid Dabash, Hanan Mohamed Rashad, Eman A Moselhi
September-December 2019, 16(3):155-161
DOI:10.4103/ENJ.ENJ_6_20  
Background Pain in neonates is largely underestimated and neglected. Accurate pain assessment is the first step toward effective pain management. Skin-breaking procedures such as heel lances, vein punctures, and arterial punctures are the most frequently performed painful procedures in neonatal ICUs. Few studies have been done to compare preterm infants’ pain response to heel lance vs venipuncture. Aim The aim was to compare pain response to venipuncture vs heel lance among preterm infants undergoing blood sampling. Materials and methods A comparative descriptive research design was used on a convenient sample of 60 preterm infants less than 37 weeks of gestation who were undergoing blood sampling for complete blood count, blood chemistry, or glucose estimation. Neonatal assessment sheet, blood sampling assessment sheet, and premature infant pain profile scale were used to collect data from two neonatal ICUs of both Cairo University Children Hospital (El Monira) and El Manial University Hospital (Kaser El Aini). After a written consent from parents, the same preterm infant pain response was continuously monitored 30 s before procedure and up to 6 min during the procedure over 2 days (one for venipuncture and one for heel lance). Results The total mean premature infant pain profile score significantly increased during venipuncture than heel lance. Behavioral state was significantly more unstable during vein puncture than heel lance. Venipuncture procedure significantly increased heart rate and decreased oxygen saturation more than heel lance. Conclusion Preterm infants perceive pain as demonstrated by premature infant pain profile scale and vein puncture is the more painful procedure than heel lancing for blood sampling in preterm infants. Recommendations Premature infant pain profile scale should be included in the routine assessment for preterm infants.
  337 41 -
Using chamomile for alleviating oral mucositis among patients with head and neck cancer receiving radiotherapy
Asmaa M AbdElwadoud, Safaa M Hassanein, Dalia S El-Deen, Inas Abdou
September-December 2019, 16(3):186-194
DOI:10.4103/ENJ.ENJ_12_20  
Background Radiotherapy-induced oral mucositis remains one of the main and most common adverse effects affecting all patients receiving radiotherapy for head and neck cancer (HNC). Aim To evaluate the use of chamomile on alleviating oral mucositis among patients with HNC receiving radiotherapy. Design A quasi-experimental nonequivalent control group interrupted time series design was utilized. Research hypotheses H1: patients who receive chamomile gel will have a statistically significant difference regarding oral mucositis grade compared with the control group who receive only routine hospital care. H2: patients who receive chamomile gel will have statistically significant lower mean severity scores of pain intensity associated with oral mucositis compared with those who receive only routine hospital care. H3: patients who receive chamomile gel will have statistically significant lower mean severity scores of patient-reported oral mucositis symptoms compared with those who receive only routine hospital care. Sample A convenient sample of 60 patients with HNC was recruited along 6 months. Tools Four tools were used to collect data: Structured Interview Questionnaire, National Cancer Institute Scoring for Mucositis, Patient-Reported Oral Mucositis Symptoms Scale, and Pain Numeric Rating Scale-11. Results In spite of the increase in oral mucositis grade among the study and the control groups, there was a statistically significant difference between both groups, and the increase in oral mucositis grade in the study group was significantly less than the control group. Moreover, there was a statistically significant difference in pain severity mean scores, as well as patient-reported oral mucositis symptom mean scores in favor of the study group that received chamomile gel compared with the control group that received only routine hospital care. Conclusion Chamomile gel was effective in reducing oral mucositis grade, severity of pain, as well as patient-reported oral mucositis symptoms in the study group compared with the control group.
  327 43 -
Nurses’ perception about pain assessment and management in neonatal intensive care units
Nour R Adam, Soheir Abd El Hamid Dabash, Eman Abd El Fattah Hassan, TamerAbd El Hamid Daihoum
September-December 2019, 16(3):175-185
DOI:10.4103/ENJ.ENJ_8_20  
Background Pain assessment in high-risk neonates is highly challenging. In the clinical setting, neonates’ pain responses have to be observed and assessed using behavioral and physiological indicators, which can vary across premature infants and full-term infants, depending on their physiological and neurological development stages. Aim To assess nurses’ perception about pain assessment and management in neonatal intensive care units (NICUs). Patients and methods A descriptive exploratory research design was used on a convenient sample consisted of 60 nurses who were working in four NICUs in Cairo University Hospitals. Nurses’ perception about pain assessment and management in NICUs questionnaire was used, which included four parts regarding personal data, nurses’ perception about pain assessment, management, and barriers in NICUs. Results Most of the nurses had high perception level about pain assessment, management, and barriers in NICUs, and the minority of the nurses had moderate perception level. There was a statistically significant relation between nurses’ perception level and their age, nursing qualifications, and years of experience. Conclusion The results of the current study concluded that most of the NICU nurses had high perception level about pain assessment, management, and barriers. Major barriers that face nurses in NICUs include lack of time in relation to high work load, shortage of nursing staff, and lack of medication supplies. Recommendations It is recommended to implement training programs for new nurses about neonatal pain assessment and management in all NICUs during the orientation period. Neonatal pain assessment tool should be available in all NICUs.
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