PHDtheses:Nursing

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    Determinants of Treatment Defaulting among Tuberculosis Patients- Khartoum State, Sudan-2018
    (AL-Neelain University, 2018) ZINAB ELRASHID ELGAILI ALMOKASHFY
    Background: Persons who default from tuberculosis treatment are at risk for clinical deterioration and complications including worsening drug resistance and death. Although tuberculosis care is provided free of charge in Sudan, a high number of patients voluntarily discontinue their treatment before the end. Treatment Default is a major obstacle in the fight against the disease. The aim of the study: was to study the determinants of tuberculosis treatment default among defaulters in Khartoum (Sudan) State in order to improve treatment adherence among tuberculosis patients. Research methodology: the study was descriptive cross-sectional Facility-based study carried out on 204 defaulter patients in tuberculosis management units (Khartoum State (Sudan). A standardized administered questionnaire was used the data was collected by the researcher and three data collectors. Pre-test was canied out. The data were analyzed using statistical package for social sciences version 20. Results: In age between 20-40 years (58.8% of sample), Men (68.1%) were more likely to be non-adherent than women (31.9 %). Patients residing in urban areas constitute 74% of the sample. There was a statistically significant association between the Patients feelings of being stigmatized versus psychological family support (P value 0.000). There was a statistically significant association between patients feeling of being stigmatized and commitment to visits scheduled by the doctors (P-value 0.02). On the other hand, there was association (P value=.016) between commitment to visits scheduled versus the doctor and financial problems. Long duration of treatment was considered the reason of default among 64.2% of the defaulters. Period of discontinuation of treatment among patients was more common in the early months from the beginning of treatment 81.9%. 60.8% of participants had Knowledge about complication of non-treatment adherence and the rest were no. regard to Previous Knowledge of pts about complication of not adherence of TB treatment,29% spread of the disease to other, 62.9% the body resistance to treatment, 2.4% increasing the cost of treatment, 2.4% major side effects and 3.2% spread of the disease to others- the body resistance to treatment of participants Previous Knowledge about complication of defaulting TB treatment. Conclusion: two third of defaulters proximately In ages between 20-40 , men were more likely to be non-adherent than women .Patients residing in urban areas constitute. There was a statistically significant association between the patient feelings of being stigmatized by psychological family support (P value 0.000). There was a statistically significant association between patients feeling of being stigmatized versus commitment to visits scheduled by the doctors (P-value 0.02).. Period of discontinuation of treatment among patients was more common in the early months from the beginning of treatment . two third of participants had Knowledge about complication of non-treatment adherence and the rest were no. regard to Previous Knowledge of pts about complication of not adherence of TB treatment ,most of patients proximately mentions one complication. Recommendations: the necessity of early health education and counseling for patients, their families and all members of the community about the importance of taking the full dose of tuberculosis treatment and explaining the complications of defaulting treatment; we should also explain the modes of transmission to reduce the stigma and improve the economic status of patients in order to decrease the rate of default.
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    Level of Job Satisfaction among Nurses working in intensive care units and coronary care units -Khartoum state
    (Al-Neelain University, 2018) NourElhuda Mohammed Ibrahim.
    Abstract Introduction: Job satisfaction is defined as beliefs and emotions individuals have about their job.Job satisfaction among nurses promotes effective coronary and intensive care management as well as safe patient care. Objective: To Study level ofjob satisfaction among nurses working in intensive care unit (ICU) and coronary care unit (CCU)in governmental hospitals in Khartoum state. Method: Descriptive cross-sectional hospital based study conducted in six governmental hospitals in Khartoum state; those include Khartoum teaching hospital, Al-Shaab Teaching Hospital, National Center of Neurological Sciences neurosurgery, Omdurman Teaching Hospital, Sudanese’s Chinaness Friend ships hospital, Khartoum North Teaching Hospital, and Ahmed Gasim for cardiac and renal transplantation. That included 105 nurses working in ICU and CCU as participants. A standardized structured self-administered questionnaire contained of five liked scale (very dissatisfied, .moderate dissatisfied, neither satisfied nor dissatisfied .moderate satisfied, .very satisfied).Was used to collect data that divided into two categories: Personal domains, (socio-demographic data) and job related factors consisted of three domains(safety, social and psychological domains). Data was analyzed by the computerized method Statistical Package for Social Sciences (SPSS) version 20. Result: The job satisfaction level was satisfying in 60% of nurses, around 33% of them were very satisfied with their job and 27% were found to be moderately satisfied with their job. The most domains affecting job nurses satisfaction are nurse age very satisfied 42(40. 0%), vacation very satisfied43 (41.3%), nursing work under stress very satisfied 42(39.6%) and enough payment very satisfied 33 (32.0 %) Those are most factors affecting job satisfaction among nurses working in the (ICU&CCU). Conclusion: according to result finding. Participating nurses demonstrated high levels of job dissatisfaction to those domains, work environment, enough payment, opportunists for nursing career development and promotion.The ability to express concern some domain were significantly associated with job satisfaction. However there was a stronge relationship between the job satisfaction, work environment, enough payment, supervisor and scheduling. Recommendations: Regarding Ssafety domain of job satisfaction strategies to make the environment atmosphere comfortable and enough payment to the nurse's.to word social domain to provide maternity leave time and child care facilities and enhanced good relation with nurse's manager and other health personal and about psychological dimension of job satisfaction to provide opportunities for career advancement and opportunities to participate in nursing research. مستخلص الدراسة مقدمة:يعرف رضا العملاء بأنه المعتقدات والأعساف عن عملهم.ويعزز رضا الوظيفي بين الممرضين والممرضات وإدارة الرعاية الصحية التاجية والجودة الفعالة وكذلك رعاية المرضى الآمن.الهدف:دراسة مستوى الرضا لوظيفي من بين الممرضين و الممرضات الذين يعملون في وحدة العناية المركزة ووحدة العناية لمرضى الشرايين التاجية في المستشفيات الحكومية في ولاية الخرطوم.الطريقة:دراسة وصفيه عرضية اجريت في ست مستشفيات تعليمية في المستشفيات التعليمية الاتية ( مستشفى الخرطوم والشعب و المركز القومي للأمراض وجراحة الجهاز العصبي وام درمان والصداقة الصيني وبحرى واحمد قاسم لأمراض وجراحة القلب والكلى) في ولاية الخرطوم شملت العينة 105 ممرض وممرضة تم اختيار العدد الكلى للممرضين والممرضات الموجودين في وحدات العنايات المكثفة كمشاركين. تم جمع البيانات باستخدام استبيان مقياس منظم تمهيد الذاتي الوارد من نطاق البيانات الشخصية الاجتماعية – الديمغرافية والعوامل ذات الصلة برضا العمل الوظيفي تتكون من ثلاثة نطاقات(السلامة، الاجتماعية والنفسية)من خمسة متغيرات غير راضي، غير راضي جدا ،لا راضي ولا غير راضي،. راضي وراضي جدا.تم تحليل البيانات من قبل الحزمة الإحصائية الحاسوبية للعلوم الاجتماعية الإصدار 20 .النتيجة: كان مستوى رضا الوظيفي مرضى في 60٪ من الممرضين و الممرضات، حوالي 33٪منهم كانت راضية جدا و 27٪أن تكون راضية مع وظيفتها.أكثر واحد نطاق يؤثر على الممرضين والممرضات هو العمر راض جدا 42 (40.0%) والعطلة راض جدا(41.3%) 43، والعمل التمريض تحت ا لإجهاد راض جدا(٪ 42 (39.6 وكافية الدفع راض جدا 33 (32.0 )تلك هي معظم العوامل التي تؤثر على رضا العمل بين الممرضين والممرضات الذين يعملون في وحدة العناية المركزة ووحدة العناية لمرضى الشرايين التاجية .خاتمة:وفق النتائج النتيجة.أظهر الممرضين والممرضات المشاركين مستويات عالية عدم الرضا عن العمل لهؤلاء نطاق بيئة العمل، قلة الدفع ،اتاحة فرص التطوير الوظيفي والترويج.الى القدرة على التعبير عن القلق بعض نطاق كانت مرتبطة بكثير مع رضا العمل. ومع ذلك ،كان هناك علاقة احصائية بين رضا العمل، بيئة العمل، كافية الدفع، المشرف والجدولة .التوصيات:فيما يتعلق بنطاق السلامة من رضا العمل وضع استراتيجيات لجعل جو بيئة العمل مريحة و كافية دفع الدخل او الاجر إلى الممرض والممرضة .إلى وارد نطاق الاجتماعية توفير وقت مغادر الأمومة ومرافق رعاية الطفل وتعزيز علاقة جيدة مع مدير الممرض والممرضة وغيرها من الصحة الشخصية وحول البعد النفسي الرضا الوظيفي لتوفير فرص التقدم الوظيفي وفرص للمشاركة في بحوث التمريض .
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    Effectiveness of Nurses` Training Program in Prevention of Intravenous Infiltration and Extravasation among Children at Khartoum State Children's Hospitals – Sudan
    (Al-Neelain University, 2018) Howaida Mohammed Gassmalla Hassan
    Abstract Background and Objective: Infiltration and extravasation are complications of intravenous therapy involving unintended leakage of solution into the surrounding tissue. Consequences range from local irritation to amputation. Studies emphasize the need for regular education for nurses to tackle current deficiencies in knowledge and skills including evidence-based education. The study aimed to evaluate the effectiveness of the nurses` training program in the prevention of intravenous infiltration and extravasation among children in Khartoum state hospitals. Methodology: An Interventional hospital based study pre -post training for the same group, was conducted in four children's governmental hospitals in Khartoum state, Ahmed Gasim Children's Hospital, Mohammed Elamin Hamid Children's Hospital, Gafar Ibn Auf Children's Referral Hospital, and ELbuluk Children's Hospital.165 participants were selected using a simple random sampling technique. Data was collected by a structured face to face interview questionnaire to assess nurses’ knowledge, and an observational checklist to assess nurses’ practice, based on Standards of Practice developed by the Infusion Nursing Society (INS).Reliability of the tools was tested by a pilot study. Pre and post intervention-training covering knowledge and practice was done. Data were analyzed by using the computer Statistical Package for Social Sciences (SPSS) version 20. Results: The study revealed that; only (1.8%) of the participants had good level of knowledge about definition of extravasation preprogram which improved to (78.8%) post program. (3.6%) of the participants had good level of knowledge that the insertion site must be visible preprogram, knowledge improved to (97.0%) post program, moreover the study showed that (20.0%) of the participants had poor practice, they flushing intravenous cannula with sterile water, which improved to (90.3%) post training. In addition to that 57.6% of the participants had poor practice, they dilute vesicant medications with less amounts than required, compared to (88.5%) post training. The overall results showed significant differences between levels of participants' knowledge and practice pre/post study (P value 0.001). Conclusion: The training program had a significant positive effect on the participants' knowledge and practice .It was concluded that training programs should be considered as a part of nurses' improvement. The study recommended that education, guideline, in-service training, and standards for intravenous therapy should be adopted in all paediatric hospitals to ensure the best practice in each hospital. مستخلص الدراسة خلفية البحث والاهداف: التسريب الوريدي والانصباب الدمى من مضاعفات العلاج بالاوردة حيث يتسرب المحلول حول الانسجة المحيطة بالوريد. عاقبة ذلك التسريب تتراوح بين التحسس الموضعى الى البتر . وتؤكد الدراسات على الحاجة إلى التدريب المنتظم القائم على الأدلة للممرضين والممرضات لمعالجة القصور في المعرفة . هدفت الدراسة الحالية إلى تقييم تأثير برنامج تدريبي للممرضين فيما يتعلق بالاجراءات الوقائية للتسريب الوريدي والانصباب الدمى بين الاطفال بمستشفيات الاطفال فى ولاية الخرطوم.طرق البحث دراسة تدخلية (قبل وبعد التدريب) اجريت فى اربع مستشفيات اطفال فى ولاية الخرطوم (مستشفى احمد قاسم ,محمد الامين حامد, جعفر ابنعوف والبلك) تم اختيار165مشارك عن طريق العينة العدلية البسيطة بمحتلف سنوات الخبرة . تم جمع البيانات باستخدام الاستبيان بالمقابلة وجها لوجه وقائمة تدقيق لتقييم معرفة وممارسة الممرضين والممرضات للاجراءات الوقائية للتسريب الوريدي والانصباب الدمى بين الاطفال. وقد تم استخدام الوسيلتين قبل االبرنامج التدريبى وبعد ثلاثة أشهر من البرنامج التدريبى . تم تحليل البيانات ببرنامج الحزم الاحصائية للعلوم الاجتماعية النسخة 20. النتائج: اظهرت نتائج الدراسة ان (1.8%) من المشاركين عرف الانصباب الدمي قبل البرنامج التدريبى تحسنت المعرفة الى (78.8%)بعد التدريب وان (3.6%) من المشاركين لديهم معرفة بأن موضع إدخال القسطرة الوريدية يجب ان يكون مرئيا قبل البرنامج التدريبى, تحسنت المعرفة بعد التدريب الى (97.0%).وكذلك كشفت الدراسة ان (20.0%) من المشاركين لديهم ممارسة غير علمية بتمرير الماء المقطر لغسل القسطرة الوريدية قبل البرنامج التدريبى تحسنت الممارسة بعد البرنامج التدريبى الى (90.3%) بالاضافة الى ان(57.6%) من المشاركين خفف الادوية المنفطة (الحارقة) بكمية اقل من المطلوب تحسنت الممارسة بعد البرنامج التدريبى الى (88.5%). الخلاصة: أظهرت نتائج الدراسة الحالية وجود فروق ذات دلالة إحصائية ايجابية بين مستويات معرفة وممارسة المشاركين المكتسبة قبل وبعد البرنامج التدريبى وذلك بعد ثلاثة أشهر.التوصيات: اعتماد معايير وتوجيهات عند العلاج بالاوردة وعلاج المضاعفات الناتجة مثل التسرب الوريدي والانصباب الدمى. انشاء مراكز للتعليم المستمر ومراكز التطوير فى كل مستشفي .انشاء فريق للعلاج الوريدي والابلاغ عن مضاعفات العلاج الوريدى لضمان افضل تطبيق عملى .المزيد من البحوث لمعرفة مدي الاصابة بالتسريب الوريدي والانصباب الدمى بين الاطفال.
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    The effect of an educational program on mothers' knowledge and care practices of thalassemic children in Jordan 2018
    (Al-Neelain University, 2019) Seirin Mohammad Hammed AL-khresheh
    Background: Thalassemia is the most common blood disorder among children in Jordan that characterized by abnormal hemoglobin production. Major effort has been done in Jordan in response to the critical need to discover beta thalassemia in early stage to decrease incidences of genetic disorders rates from thalassemia. Objectives: To evaluate the effectiveness of an educational program on mothers' knowledge and care practices of thalassemic children in Jordan. Methods : A quantitative study using quazi-experimental research design with pre-post test was used. A convenience sampling technique was used to select participants. Forty-Five mothers and their children were selected from the three governmental hospitals during the period between 1st of June to 30 of November 2018.Data were collected through an interview- structured questionnaire. Evaluating the knowledge and care practices after health education session program using the tool composed of questions related to the health education session’s content and training mothers about administration of Dieferal. Data were analyzed collectively using /SPSS version 16. The intervention composed of an educational program about thalassemia evaluated the knowledge and care practice mothers of thalassemic children. A pre-test was done for mothers before one month of implementing the health education program and the post-test was done after the implementation program in the three thalassemia center. Results: Results showed that the mean age of mothers' was (35.7, SD=13.3) years,44.4%of them were between 30 to 39 years old,88% were married, 53.3% had monthly income more than 300 JD,37.7% had high level of education, The mean age of the thalassemic children was (7.8, SD= 5.0).Where as 53.3% of thalassmic children are male, 51.1% of them between 6-10 years. Results of assessment phase pre intervention showed that the knowledge level and care practices of thalassemia among mothers is low. Results showed that post intervention the mothers' overall level of knowledge about thalassemia had significantly increased (t= 96.75, P=.000) compared with the pre intervention results. The overall knowledge score ranged from 34 to 49 with a mean of 45.11.Significant improvements in mothers' knowledge scores were observed on all subscales of the knowledge scale. Conclusions and recommendation: These results indicated the effectiveness of the educational program in improving the knowledge and practices of mothers of thalassemic children about the thalassemia disease There is a need to implement similar health educational program at the other thalassemia centers in Jordan for all mothers' of thalassemic children. A Similar study can be conducted on larger samples to generate findings. خلفية الدراسة:فقر دم حوض البحر الابيض المتوسط هو أكثر أمراض الدم الشائعة بين الأطفال تم بذل جهد كبير في الأردن استجابة للحاجة الماسة إلى اكتشاف فقر دم حوض البحر الابيض المتوسط الكبرى في المرحلة المبكرة لخفض حالات الإصابة بمرض الاضطرابات الوراثية الناجمة عن الإصابة بالمرض.الأهداف: تهدف الدراسة الى قياس و تقييم فعالية برنامج تعليمي حول معرفة وممارسات الرعاية الصحيه لامهات أطفالفقر دم حوض البحر الابيض المتوسط في الأردن. طريقة الدراسة : تم استخدام دراسة كمية باستخدام تصميم البحوث التجريبية مع اختبار قبلي وبعدي الى البرنامج التعليمي. تم استخدام تقنية أخذ العينات لاختيار المشاركين. تم اختيار 45 أمًا وأطفالهن من الثلاثة المستشفيات الحكومية خلال الفترة ما بين 1 حزيران إلى 30 تشرين الثاني 2018. تم جمع البيانات من خلال استبيان منظم المقابلة .تم تقييم معرفة و ممارسات والرعاية لامهات اطفالفقر دم حوض البحر الابيض المتوسط قبل و بعد اعطاء برنامج التثقيف التعليمي الصحي باستخدام استبانة تتألف من الأسئلة المتعلقة بمحتوى جلسة التثقيف الصحي والتدريب على كيفية اعطاء علاج الديسفرال تم / تحليل البيانات باستخدام .SPSS 16. ولتقييم مدى فاعلية تطبيق البرنامج التعليمي والتدريبي تم إجراء اختبار مسبق للأمهات قبل تنفيذ برنامج التثقيفي الصحي . سنة (SD = 13.3النتائج:أوضحت النتائج أن متوسط عمر الأمهات كان ( 35.7 , 44.4٪ منهن بين 30 الى 39 سنة ، 88٪ منهن متزوجات ، 53.3٪ لديهن دخل شهري أكثر من 300 دينار ، 37.7٪ لديهن نسبة عالية. مستوى التعليم ،. كان متوسط عمر أطفالفقر دم حوض البحر الابيض المتوسط53.3٪ من الأطفال المصابين هم من الذكور ، 51.1٪ منهم بين 6-10 سنوات. أظهرت نتائج المرحلة السابقة للتقييم أن مستوى معرفة المرضفقر دم حوض البحر الابيض المتوسط ومهارات الممارسه لاعطاء علاج الديسفرال .بين الأمهات منخفض. وأظهرت النتائج بعد تدخل البرنامج التعليمي أن المستوى العام لمعرفة الأمهات حول افقر دم حوض البحر الابيض المتوسطقد زاد بشكل كبير (96.75= t ، P = .000) مقارنة مع نتائج التدخلات السابقة. تراوحت نقاط المعرفة الإجمالية بين 34 و 49 بمتوسط 45.11. لوحظ تحسن كبير في درجات معرفة الأمهات في جميع مقاييس المعرفة..الاستنتاجات والتوصيات: أشارت هذه النتائج إلى فعالية البرنامج التعليمي في تحسين معرفة وممارسات أمهات الأطفال المصابين بفقر دم حوض البحر الابيض المتوسط هناك حاجة لتنفيذ برنامج تعليمي صحي مماثل في مراكز فقر دم حوض البحر الابيض المتوسط الأخرى في الأردن لجميع أمهات الأطفال المصابين بالمرض. يمكن إجراء دراسة مماثلة على عينات أكبر لتعميم النتائج
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    The Impact of an Educational Program for Nurses on how to Assess and Manage Pain in Children in Governmental Pediatric Hospitals in Khartoum State
    (Al-Neelain University, 2014) Salwa Ali Mousa Mohammed
    الأطروحة ملخص خلفية : وفقًا للجمعية الدولية لدراسة الألمIASP - 1994 الألم هو تجربة حسية وعاطفية غير سارة مرتبطة بتلف الأنسجة الفعلي أو المحتمل أو موصوف من حيث هذا الضرر". الألم هو أحد الأعراض الحرجة في العديد من الأمراض: يساعدنا الألم في تجنب الأذى الجسدي ، لكن الألم غير المريح قد يكون ضارًا بطبيعته ، نفسياً وفيزيولوجيًا ، وقد يؤدي عدم التدخل المبكر وعلاج الألم إلى حدوث اضطراب وتعطل في الأسر.   تعتبر إدارة الألم مسألة معقدة أصبحت ذات أهمية متزايدة في مهنة التمريض ، لدرجة أن تقييم الألم أصبح يعرف باسم العلامة الحيوية الخامسة. تصبح هذه المشكلة أكثر أهمية عند محاولة إدارة الألم لدى مرضى الأطفال. يصبح تقييم الألم معقدًا مع الأطفال نظرًا لأن الممرضة يجب أن تفسر مرحلة نمو الطفل وعمره الزمني. يشمل دور الممرضة في إدارة الألم عملية التمريض بأكملها. تقوم الممرضة بتقييم وجود الألم ، وتخطط لاستراتيجيات إدارة الآلام الدوائية وغير الدوائية مع الفريق الطبي ، وتنفذ الخطة ، وتقيم فعالية التدخلات. تهدف هذه الرسالة إلى دراسة تأثير برنامج تعليمي للممرضات على كيفية تقييم وعلاج الألم للأطفال في مستشفيات الأطفال الحكومية في ولاية الخرطوم " الأهداف الرئيسية للدراسة: - لتقييم معرفة الممرضات في تقييم الألم وعلاجة , قبل وبعد البرنامج التعليمي. - لتقييم التزام الممرضات بالمبادئ التوجيهية لتقييم الألم وعلاجه. - معرفة مدى توفر أدوات تقييم الألم في مستشفيات الأطفال الحكومية. تصميم الدراسة:دراسة تدخلية قبل وبعد التدريب في المستشفى. فترة الدراسة: وقد أجريت الدراسة خلال 2014-2019. مجتمع الدراسة: جميع فئات الممرضات العاملات في مستشفيات الأطفال الحكومية بولاية الخرطوم المنهجية: تم جمع البيانات عن طريق إجراء مقابلات مع المرشحين باستخدام الاستبيانات التي غطت الأهداف قيد الدراسة وتم تحليل البيانات باستخدام برنامج الكمبيوتر SPSS (الحزمة الإحصائية للعلوم الاجتماعية). النتائج: تم الحصول على البيانات من عينة من 169 ممرضة أطفال ، وكان معظم الممرضات المشاركين 31 إلى 40 سنة و 92.3 ٪ من الإناث ، وكان معظم المشاركين ممرضات معتمد و 68.6 ٪ لديهم أكثر من 5 سنوات خبرة طب الأطفال ، معظم الممرضات ( 85.5٪) قالوا إنهم لا يتلقون أي تدريب سابق على الألم. لا يوجد لدى مستشفيات الأطفال الحكومية في ولاية الخرطوم أدوات لتقييم الألم وإرشادات مكتوبة لتقييم الألم وإدارته عند الأطفال. زادت المعرفة بين الممرضات في الأطفال حول كيفية تقييم الألم لدى الأطفال إلى 36.6 ٪ بعد التدريب، زادت المعرفة بين الممرضات حول مستويات تقييم الألم المختلفة لدى الأطفال من (11.8 ٪) في االتدريب القبلي إلى (89.3 ٪) بعد التدريب ، والأغلبية (93.5%) بدأت من الممرضات المشاركين في استخدام علاج الألم الدوائية وغير الدوائية ، لم يوثق معظم (89.9 ٪) من الممرضات المشاركين مستوى الألم من المرضى كإجراء تمهيدي وبدون تغيير في الاختبار البعدي. الخلاصة: يمكن تحسين العجز في علاج الألم عن طريق تنفيذ برامج تعليم تقيم وعلاج الالم . سجل الممرضون انخفاضًا في المعرفة والمعرفة تجاه الألم قبل البرنامج التعليمي ، في حين كان التحسن الكبير في معرفتهم وموقفهم بعد تقديم تعليم الألم واضحًا. التوصيات: 1. توفير أدوات تقييم الألم و و تدريب الممرضات على استخدامها في مستشفيات الأطفال الحكومية بولاية الخرطوم. 2. التدريب المهني والمتابعة للممرضات العاملات في المجال السريري لإدخال تحديث تقييم الألم وعلاجة . 3. توفر البروتوكولات والمبادئ التوجيهية المكتوبة لتقييم الألم وعلاجة لمستشفيات الأطفال الحكومية. 4. تقديم أوراق مصممة في ملف المريض فيما يتعلق بتقييم الألم وإدارته عند الأطفال. Abstract Back ground: According to the International Association for the Study of Pain (IASP - 1994), "Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”. Pain is a critical symptom in many illnesses. Pain helps us to avoid physical harm, but unrelieved pain might be inherently harmful, both psychologically and physiologically. Lack of early intervention and pain treatment may lead to a state of impairment and disruption in families. Pain management is a complex issue that has become increasingly significant in the nursing profession, so that the assessment of pain has become known as the fifth vital sign. This issue becomes even more crucial when attempting to manage pain in pediatric patients. Assessing pain becomes complicated with children as the nurse must account for the child’s developmental stage and chronological age. The role of the nurse in pain management encompasses the entire nursing process. The nurse assesses for the presence of pain, plans pharmacological and non-pharmacological pain management strategies with the medical team, implements the plan, and evaluates the effectiveness of the interventions. This thesis is to study the impact of an Educational Program for nurses on How to assess and manage pain for Children in government Pediatric Hospitals in the Khartoum State." Main objectives of the Study: -To assess the knowledge of nurses in pain assessment & management, before and after the educational program. -To assess the adherence of nurses to guidelines of pain assessment and management. -To know the availability of pain assessment tools in government pediatric hospitals. Study design: An Interventional study pre-post training hospital-based study. Study Period: The study was conducted during the 2014-2019. Study population: nurses working in these pediatric governmental hospitals in Khartoum State. Study settings: Governmental Pediatric Hospital in Khartoum state. Methodology: Data was collected by interviewing candidates using questionnaires that covered objectives under study, teach the education program by small group discussion, Six months later after program implementation data was recollected again using the same methods and Data was analyzed by using SPSS Results: Data was obtained from a sample of 169 pediatric nurses , Most of participant nurses were 31 to 40 years old and 92.3% were females , Most of participants were certified nurses and 68.6% had more than 5 years pediatric experience , Most of nurses (85.5%) claimed not receiving any previous pain training Governmental pediatric hospitals in Khartoum state do not have pain assessment tools and written guidelines for pain assessment and management in children. , knowledge among nurses in children regarding how to assess pain in children increased to 36.6% in posttest , Knowledge among nurses about different pain assessment scales in children increased from (11.8%) in pretest to (89.3%) post-test , Majority (93.5%) of participant nurses started to use Pharmacological & non pharmacological pain management as posttest which was significant , Most ( 89.9%) of participant nurses did not document patients level of pain as a pretest and there was no change in posttest. Conclusion: Nurses scored low in having knowledge and attitudes towards pain prior to pain education, so educational program has positive impact on pain assessment and management. Recommendations: 1. Provide pain assessment tools and nurses educated and demonstrated on their use in governmental pediatric hospitals in Khartoum state. 2. Professional training and follow-up for nurses working in the clinical field to introduce update pain assessment and management. 3. Availability of protocols and written guidelines of pain assessment and management for Governmental pediatric hospitals. 4. Provide designed papers in the patient's file concerning pain assessment and management in children.
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    The Effect of Educational program on Women with Breast Cancer regarding Management of Acute Side Effects of Radiotherapy In National Cancer Institute NCI (Wad Madani )Gezira state 2014 - 2015
    (Neelain University, 2018) Eman Yassin Ali Fadol
    Abstract The purpose of this study was to determine the effect of implementing a teaching module on managing acute side effects of radiotherapy in breast cancer patients. M ethodology: This study is a quasi-experimental design (pre-test/post- test). The study sample consisted of One hundred (100) subjects’ selected using non probability Convenience sampling methods from the specified population, which comprised breast cancer patients treated with radiotherapy at radiotherapy unit of National Cancer Institute — University of Gezira. The sample size collected over a period of seven months, from June 2016 to January 2017, they received lectures and education about all aspects related to radiotherapy and it’s side effect over two week. The participants Knowledge and attitude about different aspects of radiotherapy Was assessed before and after the implementation of structural educational program. The ’[00| Of data collection: used in the present study is a structured interviewing questiormaire which was used to collect data on: l. socio- demographic characteristics; 2- pre-test and post-test based on Pender's
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    Evaluation of Quality of Wound dressing among Nurses in Surgical wards in Three Teaching Hospitals in Khartoum State 2012 - 2013
    (Neelain University, 2014) AMANI MUKHTAR MUSTAFA
    Abstract Introduction: Quality of wound dressing was very important in order to prevent infection, improve quality of life in order to amputation and even death, in addition to enhance patient’s satisfaction. Objective: - This cross sectional descriptive study was carried out to evaluate the quality ofwound dressing among nurses including dressing techniques, available resources and patients’ satisfaction with nursing care of wound and hospital services in three teaching hospitals in Khartoum State. Material and Method: Design: a descriptive cross sectional hospital base study. Total coverage sample were used involving seventy eight nurses, and none probabilityof convenient sampling of one hundred and seven patients with wounds were admitted to surgical wards in three teaching hospitals (Khartoum, Omdunnan and Khartoum North teaching hospitals). Data were collected by i observational checklists for Nurses performing wound dressing and available resources via hospitals and interviewing questionnaire for patients to assess _ their satisfaction. Data were analyzed by SPSS version 16 and were calculated to evaluate nurses who performed wound dressing and patient’s satisfaction. Statistical significance was accepted when P value equals to or less than 0.05. Results: The result showed that 81% of participants performed the dressing by one nurse while 19 % were performed by two nurses during the procedure. Also more than 90% of participants did not follow barrier nursing (wash hands, wear gown, cap and face mask) in preparation of sterile field. Conceming sterilization less than 20% per three hospitals who depended on autoclave by proper methods while 80% depends on hot_ oven for sterilization for both instruments and gauze plus surgical towels. In addition that all of participants did not maintain sterility during procedure such as surgical hand washing, wearing of sterile gloves and handling of instruments. The researcher conducted from the satisfaction of the patients that hospitals facilities and services in relation to wound care,, 32% was bad and, 49% was very bad. Conclusion: Most of participants had poor skills and did not apply proper good quality of wound care that may lead to poor out come and unsatisfactory patients. Recommendation: ' There is a need for health care facilities to develop policy and educational programmes for refreshment courses for stafl’ and put protocol of standard wound dressing for each surgical ward in the hospitals.
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    Quality of Reproductive Health Information, Education and Communication Printed Materials- Khartoum locality and East Nile locality (May 2013---- March 2014)
    (Al Neelain University, 2014) Soad Mohamed Abdalla A1nassry
    Background: Regular using infomiation, education and communication printed materials during antenatal and post natal period, through individual or group approach, brings desirable changes in health practices of mothers resulting in a healthy mother and baby and is one key issue for maintaining safe motherhood. The objectives: the aim of this study was to re-test information, education and communication (IEC) printed materials in reproductive health , to analyze the process and mechanisms of development of the information, education and communication printed materials with extensive review of existing materials regarding availability and distribution at Khartoum and East Nile localities at Khartoum state. Materials and methods: This was a descriptive cross-sectional facility- based study. The data were collected from 385 mothers in reproductive age, 72 mothers fiom Khartoum locality and 313 mothers from the East Nile locality. Trained field data collectors conducted the re-testing of infonnation, education and communication printed materials from April 2013 to May 2013. Availability and distribution of information, education and communication materials at various health facilities were assessed at the same time. This involved 16 public and private health centers at Khartoum locality and 37 health centers (public and private), 3 hospitals,'6 dispensaries and one mobile clinic at East Nile locality. Data were analyzed using the Statistical Package for Social Sciences (SPSS), version 16. Results: The apprehension of IEC messages addressing appropriate nutrition and clothing for pregnant mother and birth spacing were apprehended by 75 % of the respondents and IEC material addressing serious signs and symptoms during pregnancy was apprehended by 83.3%. However, respondents in both localities had difficulty in apprehending the IEC materials addressing the delivery plan. This is represented 60.4% in both localities .The study revealed that the IEC printed materials were acceptable, attractive, relevant and persuasive. However statistically significant differences were encountered between educational level and acceptability (p- VII value =0.000), relevance (p-value =0.035) and persuasiveness (p-value = 0.000). The availability of the IEC materials in both localities represents 66.7%. Conclusions: The IEC printed materials, addressing appropriate nutrition & clothing for pregnant mother, serious sign and symptoms during pregnancy and birth spacing were well apprehended by majority of respondents in both localities but; they had difficulty in apprehending the IEC materials (delivery plan). Considering the analysis of the process of development of IEC printed materials; it was found that IEC team generally did not follow universally accepted guidelines and tips for developing the IEC printed materials. The author recommends that proper planning for production anddistribution strategy ensures efficient and effective use of these IEC printed materials.
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    Socio-cultural Determinants of Health-Seeking Behavior for Reproductive Health Care among Women (15-49 years) in Sharq-Alneel Locality in Sudan; 2018
    (Al Neelain University, 2018) Samia Sayed Abdulmageed Mursi
    Introduction Reproductive health has been accounted as a challenge to the health care policy makers around the globe, which has more commonly been threaten by the cultural and social forces. Socio-cultural determinants such as lack of gender equity and the low status of women in households and communities hinder women’s ability to seek reproductive health care when a complication occurs Objective To investigate the sociocultural determinants of health-seeking behavior of reproductive healthcare among Sudanese women in Sharq-Alneel locality. Methodology A cross-sectional community-based study was conducted among Sudanese women in the reproductive age of (15-49) years. The study included (576) who were selected from 4 Administrative Units. A multistage cluster sampling technique was adopted to recruit a 576 women participants. A pretested face-to-face structured questionnaire composed of 64 close-ended questions was used to collect quantitative data. Data was collected by trained data collectors from the same locality. Binary and multinomial logistic regression models were used to analyze the results using SPSS version 22. Results Contraceptives use among women was 34%. Husband refusal for contraception was the highest, 65.4%, compared to other determinants. Multinomial logistic regression analysis showed insignificantly different in terms of who had decision making on family planning in the family within family types, housing type, and educational level of women. About seventy one percent of women follow-up in antenatal care for more than 4 visits. In multinomial logistic regression education, number of children, family type, residence and complication were found to be significant determinants for ante-natal care visits. Determinants of home delivery versus health facility one showed women with no education were 33.5 times more likely to seek home delivery compared to those who obtained university education. Conclusion Social, cultural, and demographic factors affecting healthcare-seeking behavior towards reproductive health among Sudanese women in Sharq-Alneel locality is evident in this study. Women above age of 33 years, and had achieved high level of education demonstrated a great power in decision making for utilizing health facility for delivery and other reproductive healthcare services. Recommendations Special attention is needed at community level for health education towards culture and believes affecting reproductive health of women to promote reproductive health and improve quality of care. مستخلص البحث تعتبر الصحة الإنجابية تحديًا لصانعي سياسة الرعاية الصحية في جميع أنحاء العالم ، وتشكل القوى الثقافية والاجتماعية المحددات المؤثرة مثل عدم المساواة بين الجنسين في احقية تلقي الرعاية الصحية وانخفاض مركز المرأة في الأسر والمجتمعات مما يعوق قدرة المرأة على طلب رعاية الصحة الإنجابية عند حدوث مضاعفات. الهدف التحقيق في المحددات الاجتماعية والثقافية للسلوك الساعي للصحة في مجال الرعاية الصحية الإنجابية بين النساء السودانيات في محلية شرق النيل. المنهجية أجريت دراسة مجتمعية بين النساء السودانيات في سن الإنجاب من الخامس عشر الي التاسع واربعون عاماً. شملت الدراسة اختيار العينة من اربع وحدات إدارية. اعتمد أسلوب أخذ العينات متعددة المراحل لتوظيف خمس مائة وست وسبعون امرأة. تم استخدام استبيان منظم وجهاً لوجه يتكون من اسئلة مغاقة لجمع البيانات . تم جمع البيانات من قبل جامعي البيانات المدربين من نفس المكان. تم استخدام نماذج الانحدار اللوجستي ثنائي ومتعدد الحدود لتحليل النتائج باستخدام برنامج الاحصاء للعلوم الإجتماعية. النتائج استخدام موانع الحمل بين النساء كان اربع وثلاثون في المائة كان رفض الزوج لموانع الحمل هو الأعلى مقارنة بالمحددات الأخرى. أظهر تحليل الانحدار اللوجستي متعدد الحدود اختلافًا قليلًا من حيث من كان له اتخاذ القرار بشأن تنظيم الأسرة في الأسرة داخل أنواع الأسرة ونوع السكن والمستوى التعليمي للمرأة. حوالي سبعين في المائة من النساء يتابعن الرعاية السابقة للولادة لأكثر من اربع زيارات. في تعليم الانحدار اللوجستي متعدد الحدود ، وجد أن عدد الأطفال ونوع الأسرة والإقامة والمضاعفات محددات هامة لزيارات الرعاية السابقة للولادة. وأظهرت محددات الولادات في المنزل مقابل الولادات في المرفق الصحية أن النساء اللواتي لم يحصلن على أي تعليم كانوا أكثر احتمالا لطلب الولادة في المنازل مقارنة بالذين حصلوا على التعليم الجامعي. استنتاج اوضحت الدراسة وجود عوامل اجتماعية وثقافية وديموغرافية تؤثر على سلوك الرعاية الصحية نحو الصحة الإنجابية بين النساء السودانيات في محلية شرق النيل. أظهرت الدراسة ايضاً ان النساء فوق سن ثلاث وثلاثون عاما ، واللاتي حققن مستوى عال من التعليم قوة كبيرة في صنع القرار لاستخدام المرافق الصحية لللإستشارات في رعاية الصحة الإنجابية. توصيات التركيزعلي التثيف الصحي على مستوي المجتمع نحو الثقافة ويؤمن بأن الصحة الإنجابية للمرأة تعمل على تعزيز الصحة الإنجابية وتحسين نوعية الرعاية.
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    Knowledge, Attitude and Practices of Mothers towards Home Management of Fever in Children under five - At Masaad Village- Gezira State-Sudan 2013 Dissertation Submitted in Partial Fulfilment for the Requirement of the PhD in Paediatric Nursing ~
    (Neelain University, 2013) Hanadi Mohammed Elhassen Mukhtar
    Background: Fever is a common medical problem in children which ofien prompts parents to seek immediate medical care. 20 and 40% of patents reported such an illness each year. As a result, fever is probably the conmionest reason for a child to be taken to the doctor. Feverisli illness is also the second most common reason for a child being admitted to hospital. The overall objective was to study mothers’ knowledge, attitudes and practices about home management of childhood fever in order to provide data for further study or suggest plan for actions. » ' Methodology: community based cross -sectional descriptive study conducted at Masaad village in the Gazera Statel The study subjects were 332 mothers of under five of children. Cluster sampling technique was used to draw the study sample. A standardized administered questionnaire was developed, pretested and used to generate quantitative data and four focus groups discussion for qualitative data. Data were analyzed using SPSS version 15. Results: About 80% of the respondents defined fever as hotness of all body. However 84% of the respondents did not know the normal body temperature.79% _ of the respondents did not know the beneficial effects of fever. In addition about 80% of the respondents recognized fever by touching the child's body by the palm of the hand. Aspirin from drug seller was the commonest drug used by most of respondents to treat fever. Moreover application of tepidsponing using cold water on the head of the child was the commonest physical method used by 63%of respondents. 62% of respondents their source of knowledge was doctors. Convulsion was the commonest (57%) harm effect experienced by respondents. The study point out highly significant relationship between educational level of respondents and knowledge about normal range of body temperature P value 0.001. While the study revealed insignificant relationship between educational level and methods of recognition of fever P value 0.232.Study point out insignificant relationship between suitable type of water for tepidsponing and educational level 0.824 and age p value 0.771. Conclusion the result revealed that the knowledge of mothers about fever was poor and there were excessive and widespread uses of antipyretics by mothers to their children at ages less than five years that could be hannful for their children. X