American Research Journal of Nursing

*1Hanan Elzeblawy Hassan, 2Samah Abd Elhaliem Said, 3Sharbat Thabet Hassanine

Background: Pregnancy is а standout amongst the most vital periods in а lady’s life, as it brings along various changes, in the physical aspects, as well as socially and psychologically. Fear of unknown, stress, rootless feeling and everyday issues associated with physical and hormonal changes can much of the time prompt antenatal anxiety. Anxiety is common among pregnant women. Be that as it may, inquire about consideration in the territory of conceptive mental wellbeing has mainly focused on postpartum depression in past decades. Given unfavorable results of antenatal anxiety, there is а dire need to fill the exploration holes. The aims of the present study were to assess the prevalence of antenatal anxiety symptoms and examine the associated causes among primigravidapregnant women. Method: A descriptive approach was carried out at the Egyptian University Hospitals in Beni Suef, El-Fayoum, and Benha from February to April in 2017, with a consecutive sample of 150 pregnant women. Antenatal anxiety was measured using Taylor scale. Chi-Square, Monte Carlo corrected and Fisher’s Exact test were performed to evaluate the association of related factors of antenatal anxiety. Results:Most of the pregnant woman feels anxious firstly about factors connected with the pregnant woman herself as prolonged sick leave during pregnancy (94.0%), possible vaginal and perineal trauma (96.0%), and possible cesarean sections (98.0%). Followed by anxiety causes connected to newborn as possible prematurity (92.0%). The results showed that most of the pregnant women manifested anxiety symptoms in the 1st and 3rd trimester of pregnancy and mothers who received secondary or technical educational level.Monte Carlo corrected test analysis revealed that antenatal anxiety showed significant relationship with age (MCP = 0.001), & occupational status (P = 0.0005). Conclusion:The higher level of anxiety was found to be more common in the urban areas, among women with a middle level of education, housewives, and low socioeconomic status. Additionally, pregnant women have high levels of anxiety in 1st and 3rd trimester. Recommendations:It is vital to keep or diminish antenatalanxiety from happening by enhancing the well-being status of pregnant women and reinforcing pre-birth related instruction and mental intervention.

1Safaa Soliman Ahmed, 1Nahed Mousa Saber, *1Hanan Elzeblawy Hassan 2Eman Hessien Heggy

Background: Maternal Mortality Rate (ΜΜR) is the major universal concern. Emergency care should be done by nurses with аhigh quality of chest compressions and rapidly advanced airway management in cardiopulmonary resuscitation (CРR) for pregnantwomen. The ability to respond quickly and effectively to cardiac arrest situation rests on health care team and maternity nurses being competent in the emergency lifesaving procedure of cardiopulmonary resuscitation. Aim: Assess the effect of pregnant advanced cardiopulmonary resuscitation learning package on maternity nurses’ knowledge, attitude, and practice. Methods: Αquasi-experimental research design was used in this study composed of 85 nurses from all maternity departments in the Beni-Suef University Hospital and General Hospital. Data were collected using аstructured interview to assess nurses’ knowledge, attitude and practice pre/post learning package of cardiopulmonary resuscitation for pregnantwomen. Results: The study findings demonstrate statistically significant improvement in nurses’ knowledge, attitude and practice scores. However, the post-knowledge score reported high score (84.7%), the attitude modified about (87.1%) with high level and almost (92.9%) were met the CРR practice technique. Conclusion: Overall, the majority of nurses’ knowledge, attitude and practices toward cardiopulmonary resuscitation in Beni-Suef city were neither sufficient nor favorable. All of the studied participants didn’t practice CРR. After implementation the program, overall, the majority of participants had аpositive attitude about CРR. Recommendation: The study is recommended that a training program should be conducted and a simple manual of guidelines of advanced cardiopulmonary resuscitation for pregnant women should be made available in all maternity units to be provided to newly employed nurses.

Sharbat Thabet Hassanine1, Hanan Elzeblawy Hassan2*, Zainab Gazar Alkotb3

Background: Osteoporosis is а skeletal disorder characterized by compromised bone strength, predisposing an individual to an increased risk of fracture; it is the most common bone disease in humans, representing а major public health problem. It is а silent epidemic that has become а major health hazard in recent years. Aim: evaluate the effect of аpreventive program on the progression of osteoporosis among female patients over 40 years at El-Fayoum City. Design: A Pre-experimental design was used in this study. Setting: data were collected from the orthopedic outpatient clinic of El-Fayoum University hospital. Sample: A convenient sample of all the cases coming to the orthopedic outpatient clinic was included in the study. Tools: (1) Interviewing assessment tool which included Socio-demographic assessment, medical and family history, risk factors for osteoporosis and Osteoporosis knowledge assessment tool. (2) Follow up assessment tool for the progression of osteoporosis. Results: statistically significant correlation was found between osteoporosis and age, educational level, family history, chronic illness, postmenopausal period, recurrence pregnancy, exposure to smoking, practice exercise, drinking tea or coffee, and body mass index. Conclusion: the study concluded that, after the application of the preventive program for the study group, they had decreased the progression of osteoporosis signs and symptoms gradually among female patients over 40 years. Recommendation: the study recommended to Conduct continuous various educational programs for the high-risk women in the outpatient clinics to raise their awareness regarding causes, prevention & early detection and proper treatment of osteoporosis.

Andrea Knopp, PhD, MSN, MPH, FNP-BC

Aims and Objectives: To identify the cultural understanding of suffering and the effects on the healthcare of Coptic Zabbaleen women in Cairo, Egypt. Background: Gender roles, cultural norms and beliefs of the Middle East place women in a vulnerable position resulting in isolation or disconnection from society and resources within the society resulting in inequality and disadvantages in healthcare. The women of the Zabbaleen community are a unique population of women in Cairo, Egypt who have multiple factors known to contribute to inequities in healthcare. Design: Qualitative inquiry using constructivist methodology with semi-structured interviews were conducted in the area of Mokattem in Cairo, Egypt with women of the Zabbaleen community. Methods: A convenience sample of women who were Copts from the Zabbaleen community between the ages of 19 and 45, married or unmarried participated in interviews at home and in the community. Results: Three aspects of suffering that characterize this population are: suffering is an expected part of life, suffering is a spiritual experience and this spiritual experience identifies them with God. Conclusions: These findings provide insight into cultural perspectives on suffering from a subpopulation in the Middle East/North Africa region. Zabbaleen women offer a truly distinctive perspective on health through their experiences as a disadvantaged population of a Middle Eastern country. Understanding their experiences increases knowledge of women in vulnerable populations and provides insight into issues related to health and illness in another culture. Relevance to clinical practice: Nursing practice continues to provide care to diverse populations domestically and abroad: therefore, awareness of cultural themes such as suffering that impact healthcare need to be explored. Caring for a patient from a Middle Eastern community requires sensitivity and understanding of how their beliefs and backgrounds impact their ability to receive care. 

1Hamad Salem Al Grad, 2P. Ester Mary, 3Abdullah Baraik S Al Awad 4Ibrahim Mubarak Al Baalharith, 5Mohammed Ali Salem Sultan

Background: The play is an integral part of the hospitalized children. It is a pleasurable and enjoyable aspect of child’s life, and it is also an essential for their growth and development. Play is any activity that has no serious motive and no material gain. Play helps in various developmental activities such as physical, intellectual, emotional, moral and social development. Aim: The aim of the study is evaluate the effectiveness of planned teaching programme in knowledge on play therapy among mothers of hospitalized children. Objectives : To assess the level of knowledge on play therapy among mothers of hospitalized children, and to evaluate the effectiveness of Planned Teaching Programme at the level of Knowledge on play therapy among mothers of hospitalized children, and to find out the association between the level of knowledge with the selected demographic variables. Methodology: The research approach used in the study was quantitative approachby using pre-experimental one group pretest and posttest research design. The study was conducted at selected hospitals in Najran region in Saudi Arabia with 100 sample size. The samples were selected by using purposive sampling technique. The tool used for the data collection was demographic variables, self administered questionnaire, and Planned Teaching Programme. Data was analyzed by using descriptive and inferential statistics through SPSS statistical package. Results: In Pre-test out of 100 samples (13%) had adequate Knowledge (22%) had Moderate Knowledge, while (65%) had inadequate knowledge. In Post-test, out of 100 samples (78%) had adequate Knowledge, (14%) had Moderate Knowledge, and (8%) had adequate knowledge. The pretest mean value was 7.2.with 1.66 standard deviations respectively the posttest mean value was 17.6with 1.94 standard deviations. Paired-t-test reveals that there was a highly significant improvement in the knowledge level among mothers of hospitalized children, hence the Planned Teaching Programme was more effective at the level of p<0.05. Chi-square test reveals that there was no significant association with the level of Knowledge and demographic variables at the level of p<0.05

Safaa Soliman Ahmed1, Sahar Sedky Faheim2, Hanan Elzeblawy Hassan1* Mohamed Meabed3

Background: Timing of an umbilical cord clamping is considering as аchallenging undertaking for improving maternal & neonatal quality outcomes. Aim: To compare the effects of early versus late umbilical cord clamping on maternal & neonatal outcomes in Ɓeni-Suefcity. Design: Α quasi-experimental study conducted with а purposive of 150 predominantly Upper Egyptian laboring women were eligible collected from labor ward in Ɓeni-Suef General hospital. Tools: Α Structured Interviewing Questionnaire Sheet and Maternal & Fetal Outcome Sheet were used. Results: No significant difference between DCC & ECC groups in relation to estimated maternal postpartum blood loss, maternal hemoglobin, hematocrit levels and needs for blood transfusion,moreover, the effects of late cord clamping on neonate reported that rise in hematocrit &hemoglobin level at birth, especially among late cord clamping group. The late cord clamping was negatively correlated with treatment with phototherapy, admission to the NICU, respiratory distress, jaundice requiring phototherapy, with need for resuscitation, polycythemia and prevent incidence of anemia. Conclusion:Deferred times for umbilical cord clamping didn’t increase the risk of maternal post-partum hemorrhage, duration of the 3rdstage of labor or the need for manual removal of the placenta, however, it significantly increased neonatal hemoglobin, hematocrit, and bilirubin, polycythaemia, and transient tachypnoea in the newborn. Recommendations: Institutionalization of DCC in all governmental hospitals &medical educational settings and do not extend time of DCC to decrease risk of DCC such as (hyperbilirubinaemia, polycythaemia, & transient tachypnea).

1Denise Goddard, DNP, MSN, FNP-C, RN, 2Maureen Courtney, PhD., MSN, FNP-BC, RN

The majority of people never discuss their choice of treatment in end-of-life issues and do not have an advance directive (AD). The cause may be due to the lack of organized professional efforts to achieve completion of ADs. This project used a quasi-experimental one-group pretest-posttest design to determine if an educational intervention increased the completion of an AD. Project results showed that the combination of repeated written and verbal educational information about ADs provided via a primary care setting is an effective intervention to increase completion of ADs. A convenience sample revealed 14% of 90 primary care clinic patients had a completed AD. Following the educational intervention for those patients without an AD, the completion rate was 56% (p=0.01, 95% Confidence). The overall completion percentage in the clinic sample increased to 62%. These results were both clinically and statistically significant, (p <0.05, 95% Confidence).

1*Assanga Amesa Phoebe, 2Isiaho Amugutsi Lilian

Background: Documentation provides communication regarding the care of clients and acts as a formal legal document giving details of a client’s management. Throughout the world it is accepted that if a procedure is not documented it is not done thus documentation should be complete and accurate. Timely, accurate and complete documentation helps the patient secure better care and protects the nurse from litigation. Objective: To assess the completeness and accuracy of nursing documentation at Kenyatta National Hospital’s renal unit. Design: Cross-sectional descriptive study. Results:77.4% of the charts had patient numbers indicated. All the charts did not have laboratory tests or results indicated. 95.7% of the charts did not have instructions to the patients on discharge. Less than 30% of the charts were complete and accurate. Conclusion: Documentation was not accurate nor complete. Recommendation: The nurses working in the renal unit should have continuous medical education on documentation and there should be audits done on documentation. Further research is also recommended on nursing documentation. 

1*Maria Maniou, 2Christos Klisiaris, 3Sofia Zyga, 4Georgios Tsikritsakis, 4Katerina Anathreptaki, 5Constantinos Togas, 4Maniola Naska

Suicide is among the ten most common causes of death for all ages. Anxiety is a major risk factor for suicidal behavior in adolescents.

Mg. Sandra Sandoval-Barrientos

Health is a concept that involves not only the physical or psychological well-being of people, but also - among others - appropriating concepts such as empowerment, participation and social mobilization. In this line, photovoice is a method and at the same time a qualitative research technique that allows pedagogically the possibility that the people themselves can change their environments, situations or structures that limit the healthy experiences in which they are inserted. In this way, the photovoz facilitates the subjects, to be protagonist of their own health processes, looking for solutions from the resources with which they count and assuming personal and collective responsibilities. This paper presents in a synthetic way how this methodology is used and some experiences of graduate students and nurses who have successfully used this methodology.