Effect of Instructional Nursing Strategies on Endometriosis Symptoms

Context: Endometriosis is a chronic and incurable condition associated with debilitating pain and sub-fertility that affects approximately 176 million women worldwide. Aim: To measure the effect of instructional nursing strategies on endometriosis symptoms. Methods: A quasi-experimental (pre/post-test) design was utilized. The study was conducted at gynecological clinics at Ain shams University Maternity Hospital. A purposive sample of sixty women who meet the criteria of the study. Data were collected through three tools; endometriosis structured interviewing questionnaire, endometriosis health profile questionnaire, in addition to women compliance follow up record. Results: The study sample age was 32.47±5.24. There was a highly statistically significant improvement in women's knowledge regarding endometriosis after implementing instructional nursing strategy and at follow-up time compared to their knowledge before it at p-value ≥0.001. Also, there was a highly statistically significant improvement in women's practices to alleviate endometriosis symptoms after three months of implementing instructional nursing strategy compared to their self-care practices before it at p-value 0.001. Moreover, women who followed instructional nursing strategies had highly statistically significant improvement on endometriosis-related symptoms, pain, and fatigue after implementing the instructional nursing strategy at p-value ≥0.001. Conclusion: Women with endometriosis who follow instructional nursing strategies will have fewer symptoms, better knowledge, and improved self-care practices. An awareness program should be developed to upraise women's knowledge regarding endometriosis, and self-care management is recommended.

Effectiveness of Evidence-Based Measures on Nausea and Vomiting during First Trimester of Pregnancy

Context: Nausea and vomiting are the most common pregnancy symptoms that negatively affect many pregnant women. Severity varies from mild distaste for certain foods to more severe vomiting. Aim: The present study aimed to examine the effectiveness of applying evidence-based measures on nausea and vomiting during the first trimester of pregnancy. Methods: A quasi-experimental (pre/post-test) design was used. The study was conducted at the antenatal clinics at Ain Shams University Maternity Hospital. A purposive sample of forty-seven pregnant women was included in this study. All women received the evidence-based intervention. Data were collected using three tools. A structured interviewing questionnaire, pregnancy symptoms inventory (PSI), and weekly follow-up record. In addition to Arabic Evidence-based guide for alleviating nausea and vomiting during the first trimester of pregnancy. All pregnant women that suffered from nausea and vomiting followed the evidence-based guidelines designed by the researcher that involved instructions related to lifestyle modification. Besides, one of the following: herbal therapy, acupressure, and aromatherapy to relieve nausea and vomiting. Results: The study sample mean age was 28.1±6.42, with a mean gestational age of 9.43 ±3.88. 72% of them used nothing to overcome nausea and vomiting, while 18% used medication, and only 10% used a lifestyle modification before intervention. All women adopt lifestyle modification; 72.3% use herbal therapy after the intervention. The present study demonstrates a highly significant difference between responses before and after the intervention related to nausea and vomiting (p 0.004). There is a significant association between the evidence-based measure used and the relief of nausea and vomiting at p<0.01. Conclusion: The current study concluded that evidence-based measures positively alleviated nausea and vomiting during the first trimester of pregnancy. A leaflet or booklet about evidence-based measures for alleviating minor discomforts during pregnancy as a hospital protocol for guiding nurses in the application is strongly recommended.

Effect of Educational Program on Nurses' Knowledge, Practices and Patients' Outcomes Post Total Knee Arthroplasty

Context: Total knee arthroplasty (TKA) is a surgical procedure in which the damaged parts of the patient's kneecap, thighbone, and shinbone are replaced with artificial parts. Aim: This study aimed to evaluate the effect of an educational program on nurses' knowledge, practices, and patients' outcomes post total knee arthroplasty. Methods: A quasi-experimental design was utilized in the orthopedic department and outpatient orthopedic clinic affiliated to Benha University Hospital from the beginning of July 2020 to the end of June 2021. A convenience sample of all available nurses (50) working in the orthopedic department. A purposive sample of 64 adult patients from both genders was divided into (32) control and (32) study groups. Three tools were used: The nurses' knowledge assessment questionnaire, nurses' practice observational checklist, and patient’ outcomes assessment sheet. Results: The present study revealed that 58% of nurses age was from 40 to less than 60 years old, 92% were females, 66% had secondary nursing education, 28 % of studied nurses had total satisfactory knowledge pre-program implementation, which reached 80%, 58 %, respectively immediately after and in follow up of program implementation. 22% of studied nurses had a competent level of practice scores pre-program implementation, which improved to 82%, 74 %, respectively, immediately after and in follow up of program implementation. There were highly statistically significant differences between study and control group patients regarding the frequency of most of the general and local complication and lower extremity function scale after two weeks and one month post-surgery at p-value<0.00. Conclusion: Implementing the educational program had statistically significantly improved the knowledge and practices of the studied nurses that could reflect positively on patient condition. The study recommended a continuous educational program for all nurses working in the orthopedic departments. Further study to search the correlation between the nurses' performance and the patient outcomes is recommended.

Assessing Perception of Role Transition among Nurse Interns

Context: Nursing roles today constitute a vast and complex system. Nurse interns need to know their future roles to facilitate and prepare them socially to work professionally and decrease the reality shock when going outside to the labor market. Aim: This study aimed to assess the perception of role transition among nurse interns. Methods: The study was conducted in four hospitals affiliated to Ain Shams University where nurse interns have their training, namely Ain-Shams University Hospital (5 units), El-Demerdash Hospital (2 units), Pediatrics Hospital (3 units), and Cardiovascular surgery hospital. A convenient sample of all available nurse interns who started their internship in 2018 and their total number were100. Data collections included a role perception questionnaire to assess the perception of role and role transition knowledge questionnaire to assess role transition knowledge among nurse interns. Results: The present study revealed that most of the interns had low total roles perception, among 51% of the studied interns, and low total knowledge level regarding role transition among 70% of the studied interns. Conclusion: The study concludes a low total level of role perception among more than half of the studied nurse interns and a low total knowledge level of role transition among nearly three quarters. A statistically significant relationship was revealed between nurse interns' total transition knowledge score and their age, gender, and training program attendance. The study recommended conducting a training program and continuing education for the nurse interns to promote their perceptions about their role and role transition. Further studies for studying the relationship between role transition process and stress among nurse students and assessing the clinical learning needs of nurse interns periodically are recommended. Besides, develop a training program for them to the challenges facing in clinical practice.

Effect of Self-Care Guidelines on Symptoms Burden for Patients with Lung Cancer Undergoing Chemotherapy

Context: Lung cancer is common cancer worldwide. Because of the high-symptoms burden and severe morbidity, effective symptoms management requires comprehensive self-care strategies. Aim: This study was aimed to assess the effect of self-care guidelines on symptoms burden for patients with lung cancer undergoing chemotherapy. Methods: This study was conducted at the outpatient clinics in Radiation Oncology and Nuclear Medicine Center, affiliated to Ain Shams University. A quasi-experimental (pre/posttest) design was employed on a purposive sample of 50 adult patients were recruited for this study. The data were collected through a structured interview questionnaire to assess the patients’ socio-demographic characteristics, medical health profile, and knowledge about lung cancer. Lung Cancer and Chemotherapy Associated Symptoms Self-care Practices’ Assessment Questionnaire and M. D. Anderson Symptom Inventory-Lung Cancer (MDASI-LC) were also used. Results: The present study revealed that 36% of the patients had a satisfactory level of knowledge pre-implementation of self-care guidelines, which improved significantly for 48% of the patients post-implementation at p 0.007. 26.3% of them exhibit a satisfactory level of self-care practice pre-implementation of self-care guidelines that improved significantly (57.9%) post-implementation at p 0.001. Also, lung cancer symptom burdens and symptoms' influence on patients' lives were significantly improved after the implementation compared with preintervention level at p 0.001. A non-significant difference between pre and post-implementation of self-care guidelines regarding symptoms interference with patients' life was revealed at p 0.801. There were statistically negative correlations between patients' total symptom severity and self-care practice pre- and post-self-care guidelines implementation. Conclusion: self-care guidelines have a statistically significant positive effect on decreasing the severity of lung cancer symptoms. While chemotherapy-associated symptoms were slightly improved, there were no significant differences between pre and post-self-care guidelines implementation regarding symptoms interference with patients’ life. Health education programs about the disease and its management should be provided for lung cancer patients.

Nurses Practice Regarding Infection Control Measures during The Second Stage of Labor: A Multicenter Study

Context: Infection prevention remains a significant public health challenge for healthcare systems, especially in maternity and delivery units. Good understanding and compliance of nurses with infection control measures during delivery are essential factors that improve maternal and neonatal outcomes and decrease morbidity and mortality. Aim: This study aimed to assess nurses' practice regarding infection control measures during the second stage of labor in multiple centers. Methods: Cross-sectional descriptive observational study was adopted in this study. The study population included all nurses working in labor rooms of four hospitals (100 nurses), namely Suez Canal University Hospital, Zagazig University Hospital, Ismailia General Hospital, And Zagazig General Hospital. Data collection tool encompassed a structured interviewing questionnaire to assess nurses' general characteristics, physical and organizational barriers that prevent nurses from complying with infection control measures, infection control practice checklist to assess nurses` compliance with infection control measures during the second stage of labor. Results: The highest percentage of the studied nurses' age was between 19-<29 (56.6%, 63.8%). Near half were technical nurses (43.4%, 44.7%). The majority of the studied nurses had not had periodic checks. Also, most of them were vaccinated against viral hepatitis B (86.8%, 91.5%). There was a statistically significant difference between Ismalia and Zagazig hospitals in physical barriers. The highest mean percent for infection control practice was for perineal care 100%, using the invasive device during labor 92%, preparing birthing room and its equipment 75.9%. A satisfactory infection control practice was revealed among 88% of the studied nurses. The satisfactory practice of nurses was 100%, 92.1%, 86.9%, 44.1% in Zagazig General Hospital, Ismalia University Hospital, Zagazig University Hospital, Ismalia General Hospital, respectively. Conclusion: The result of the study concluded that most nurses' practice regarding infection control in the delivery room was satisfactory. The study recommended upgrading and qualifying nurses in the labor room to improve their practical skills in Obstetric Nursing.

Prediction Equation for Spirometric Parameters in Cairo Governorate Adult Population

Context: Spirometry is the most common one used in assessing, diagnosing, and managing patients with different lung diseases. Prediction equations developed in one set of the population may not apply to a different set of populations. Aim: This work aimed to develop prediction equations for spirometry pulmonary function parameters in a sample of the adult Egyptian population in the Cairo governorate. The secondary aim was to compare our derived equations of pulmonary function with international reference figures used in our spirometric lab facilities. Methods: This observational cross-sectional population-based study was carried out at Embaba Chest Hospital upon 610 normal healthy subjects, aged between 20 - 45 years old. All subjects were subjected to history, clinical examination, and pulmonary function tests. These subjects were randomly selected in a cluster from registration records in different official health care facilities or community health centers. Subjects from records were invited by calling through land phone, cell phone, or e-mails. This study compared the international reference figures of mean predicted spirometry values with our derived predicted values of lung function parameters. Results: The predicted equations for FEV1 were [(3.429+(-0.028*Age)+(-0.017*weight)+(0.018*height)], and [1.238+(-0.005*Age)+(-0.006*weight)+(0.014*height)] for males and females respectively. The predicted equations for FVC were [4.556+(-0.016*Age)+(-0.012*weight)+(0.01*height)], and [2.494+(-0.009*Age)+(-0.005*weight)+(0.0100*height)] for males and females respectively. It was found that the Egyptian predicted mean values were within the lower limit of normal LLN and upper limit normal ULN when each of these prediction equations was used. These results were higher than US population with regards to FEV1 4.089(0.498) Vs 3.88(0.04) [p<0.001] in males, but non-significant in females 2.865 (0.171) Vs2.85 (0.33) [p0.449]. FVC was found statistically higher in Egyptian population in female gender 3.513(0.164) Vs 3.36(0.33) [p<0.001] and non-significant difference in males 4.743(0.31) Vs 4.74(0.36) [p0.932] compared to US population. Besides, there were considerable differences between Omani and Jordanian populations and Egyptian populations, on the other hand regarding FEV1 and FEF 25-75% in the male gender. Conclusion: The Linear regression equations had a direct linear correlation with height and inverse linear correlation with age. The implemented reference values utilized in our lab's facilities are particularly suited with the present study’s derived predicted lung function equation. In addition, equations had diverse determination coefficients from those reported by authors in adult Omani and Jordanian populations.

Effect of Enhanced Exercise Program on Pain and Physical Activity for Patients after Total Knee Arthroplasty

Context: Total knee arthroplasty (TKA) is considered the most effective orthopedic procedure for treating knee osteoarthritis. The need for knee replacement is predicted to increase six-fold between 2005 and 2030 to reflect an increasingly yet functionally demanding population. Aim: This study aimed to evaluate the effect of an enhanced exercise program on pain and physical activity after total knee arthroplasty. Methods: Quasi-experimental (pre/posttest) design was utilized in this study. The study was carried out in the orthopedic department, Benha University Hospital, and followed the patients through the orthopedic outpatient clinic from the beginning of May 2020 till the beginning of May 2021. A purposive sample of 64 patients was recruited to achieve the aim of this study. Four tools were used to collect the study data. These are the structured interview questionnaire to assess patients' knowledge regarding total knee arthroplasty, Barthel ADL index scale, Lysholm knee scoring scale, and Numeric Pain Rating Scale to assess the effect of the enhanced exercise program. Results: Showed that nearly two-thirds of the study sample was ≤60 years old, females, and married. The study also showed a statistically significant difference between pre-and post- enhanced exercise program in terms of total knowledge mean score among the study sample, as well as an increase in the total mean score in Barthel ADL index, decrease Lysholm knee scoring, and pain score after one month and after three months of enhanced program exercise implementation. Conclusion: Implementing an enhanced exercise program for patients with total knee arthroplasty effectively improved knowledge, increased physical activity (Barthel ADL index), decreased Lysholm knee scoring, and pain score. The present study recommended including an enhanced exercise program in the treatment plan for patients with total knee arthroplasty to improve patient's knowledge and practices. Also, repeating the study on a larger probability sample to achieve generalization of the findings.

Effect of Educational Program on Health Consequences of Patients with Leprosy

Context: Leprosy remains a leading cause of peripheral neuropathy and disability globally despite the extensive efforts to reduce the disease burden. It is associated with social stigma, and the patients sometimes suffer social discrimination because it often leads to visible physical deformities. Aim: The present study aimed to evaluate the effect of educational program on the health consequences of patients with leprosy. Methods: The study was conducted at outpatient clinics in Dermatology Hospital affiliated to the Ministry of Health and population. A quasi-experimental (pre/post-test) design was used on a purposive sample of 72 leprosy patients. Four tools were used to collect the data for this study: A structured interviewing questionnaire, a patients' reported practices checklist, an attitude assessment scale for patients with leprosy, and health consequences assessment questionnaire for patients with leprosy. Results: The current study reveals a significant improvement in the patients’ knowledge, reported practice, and attitude toward leprosy. A significant improvement in health consequences (problems and needs) after education compared with the preintervention level. An association between the total knowledge, practice, and attitude after health education was significant (p<0.001). An association between the mean and standard deviation of knowledge, practice, and attitude before and after the health education program was significant (p<0.001). Conclusion: Educational program had a remarkable effect on improving patients' knowledge, practice level, patient attitude, and health consequences (problems and needs) of leprosy. The study recommended applying educational programs for patients with leprosy in different health care settings focusing on prevention from disabilities.

Effect of Educational Empowerment on Student Nurses’ Knowledge, Practice, and Attitude toward Genomic Counselling

Context: All over the world, the increased awareness of the importance of early diagnosis of genetic diseases has given them priority in primary health care. However, more recent surveys indicate that genetics content is still lacking in nursing curricula. Aim: Evaluate the effect of educational empowerment on student nurses' knowledge, practice, and attitude toward genomic counseling. Methods: Quasi-experimental (pre/posttest) design was utilized to collect the data of this study. The study was conducted at the Faculty of Nursing affiliated to Ain Shams University. The subjects were all available adolescent nursing students who enrolled in the pediatric and obstetric course in the third year. The study sample was composed of 340 nursing students. Researchers used a self-administered questionnaire that includes characteristics of subjects and the assessment of knowledge, attitude, and practice of students. Results: 47.65% of the studied students had poor knowledge at the pre-educational program phase. In comparison, 55.88% had good knowledge at the post educational program, with a highly significant difference at p-value <0.01. There was a highly significant difference between studied students' attitudes toward genetic disease, health history benefits, genetic examination benefits, genomic counseling, follow-up, and decision-making process domains at pre and post-educational program at p-value <0.001. Also, the results reveal that 79.41% of studied students had unsatisfactory practice at the pre-educational program, while 70.59% of them had satisfactory practice at post educational program. There was a highly positive correlation between knowledge, practice, and attitude of studied students about genomic counseling at the pre-educational program. Conclusion: Educational empowerment positively affected adolescent nursing students' knowledge, attitude, and practice regarding genomic counseling. The study recommended continuous training for adolescent nursing students about genetic counseling to prepare them for their future roles. Future studies are needed to examine the relationship between knowledge, attitude, and practice of adolescent nursing students regarding genomic counseling.