Pediatric Nursing

Abstract: Women’s satisfaction and perceived control in childbirth are important attributes of the childbirth
experience and quality of care indicators. This article presents findings from the pre-intervention phase of a
multi-centre implementation study in Egypt, Lebanon and Syria, to introduce a labour companionship model in
these countries. A sample of 2620 women giving birth in three public teaching hospitals from November 2014 to
July 2015 in Beirut and Mansoura, and from November 2014 to April 2015 in Damascus were interviewed by
trained field workers. Additional information was abstracted from medical charts. An adapted version of the
Mackey Childbirth Satisfaction Rating Scale was used to measure women’s satisfaction and the shortened
version of the Labor Agentry Scale was used to assess perception of control. The total satisfaction score was high
in all sites with the lowest being in Egypt. Perceived control was directly related to satisfaction. Women with low
education levels had higher levels of childbirth satisfaction. Women who had fewer children from Egypt and
Lebanon, and those who received care by a team including both male and female physicians in the Syrian
hospital were more likely to be dissatisfied than their counterparts. Variations in the management and provision
of care between the three countries may explain the differences in satisfaction levels observed. Further
qualitative research is needed to deepen our understanding of the concepts of control and satisfaction in the
Arab culture as well as to establish the factors associated with women’s positive childbirth experiences to inform
the provision of quality maternity care.

Preterm infants born before 37 weeks are not mature enough to coordinate sucking, breathing and swallowing. As they get stronger, they can start to get milk through a tube goes into the stomach through the nose or mouths.Infant body position after feeding has been considered an important factor affecting gastric emptying. Our study aims to assess the effect of enteral feeding tubes' insertion sites and preterm infants' position on feeding tolerance. This quasi-experimental design was conducted in the neonatal intensive care unit at Bilques Central Hospital between May 2016 &January 2017. A convenient sample of 98 simple preterm infants were divided randomly into control and experimental groups. The results of this study revealed that there was a positive relation between age on initiation of minimal enteral feeding and duration to reach full enteral feeding. Number of non-significant aspirated gastric residuals were more in preterm infants in the control group than those in ...

Background/Objective: Febrile convulsions (FCs) are the most common convulsive disorder of childhood, and represent a benign condition in children. FC occurrence can affect negatively on the familial quality of life and the parents may experience anxiety and fear with every time child develops fever. Therefore, parents and care givers should be educated about febrile convulsion and its home management. The aim of this study was to evaluate the effect of implementing an educational module on mother's knowledge, home management and attitude about febrile convulsion. Methods: A quasi experimental research design using one group pre & post-test was used. The study sample included 107 mothers of children with febrile convulsion according to statistical consultant and statistical formula. The inclusion criteria were: all mothers of children with first or recurrent FC and the children age was from 6 months to five years. The study was conducted at the Emergency department, outpatient clinic and medical word affiliated to Mansoura University Children's Hospital, Egypt. Results: It was found that, fifty two percent (52.3%) of studied children were boys with the mean age were Mean ± SD 2.76 ± 1.30 for children and 30.29 ± 6.41 for mothers. Percentage of studied mother with good knowledge at base line was low (11.2%) while, this percentage was improved to 65.4% with a mean knowledge score 3.98 ± 2.18 before module and 9.70 ± 1.56 after module implementation. In addition, sixty four percent (64.4%) of studied mothers had inappropriate practice and home management compared to less than half (44.9%) after module implementation; the difference was statistically significant (p = .005). Only 25.3% of mothers had positive attitude about febrile convulsion before module implementation and this percentage was improved to 57.9% after module implementation with the mean score of attitude 18.42 ± 5.84 before module and 24.71 ± 6.76 post module implementation and the difference was statistically significant (p = .025). Conclusions: The study concluded that, the use of educational intervention programs and mothers support group were influenced positively in improving mothers' knowledge, home management & attitude about FC and its management; but still some mothers having inappropriate home management and negative attitude. Therefore, it is recommended further education in the pediatric clinic or via mass media.

Background/Objective: Febrile convulsions (FCs) are the most common convulsive disorder of childhood, and represent a benign condition in children. FC occurrence can affect negatively on the familial quality of life and the parents may experience anxiety and fear with every time child develops fever. Therefore, parents and care givers should be educated about febrile convulsion and its home management.  The aim of this study was to evaluate the effect of implementing an educational module on mother's knowledge, home management and attitude about febrile convulsion.Methods: A quasi experimental research design using one group pre & post-test was used. The study sample included 107 mothers of children with febrile convulsion according to statistical consultant and statistical formula. The inclusion criteria were: all mothers of children with first or recurrent FC and the children age was from 6 months to five years. The study was conducted at the Emergency department, outpatient c...

Background: Misuse of antibiotics in the treatment of URTI among children is becoming a major contributor to the emergence of antibiotic resistance that is becoming a major public health problem worldwide. Mothers must be equipped with essential knowledge and skills about proper antibiotics use for their children with URTIS to avoid antibiotic resistance. Aim: The aim of this study was to assess maternal knowledge and treatment practices regarding the use of antibiotics among their children with URTIS. Method: A cross-sectional descriptive design was conducted on a convenience sample of 100 mothers throughout 3 months who attending the General Outpatient Clinics number 4 and 5 and inpatient Cardiology and Medical departments at Mansoura University Children Hospital (MUCH). Data was collected by using a structured interview questionnaire sheet that consisted of three parts; characteristics of the studied mothers and their children, mothers' knowledge about antibiotics and mothers' practices regarding the use of antibiotics for their children with URTI. Results: More than half of the studied mothers (64.0%) had poor knowledge about antibiotics and the majority of them (84.0%) had satisfactory practices regarding use of antibiotics for their children with URTI. A relationship was founded between mothers' knowledge and their residence, educational level and occupation with statistical significance (p≤0.05). Also; a relationship was founded between the studied mothers' practices regarding giving antibiotic suspension for their children with URTI and their educational level with statistical significance (p≤0.019). Conclusion: it is concluded that more than half of the studied mothers had poor knowledge about antibiotics and the majority of them had satisfactory practices. Also, the studied mothers' knowledge is affected by their residence, educational level and occupation. As well as, the studied mothers' practices are affected only by their educational level. Recommendation: it is recommended to implement health educational program for mothers about antibiotic use to improve their knowledge and practices towards the safe use of antibiotics for their children with URTI.

Abstract: Despite efforts to decrease unnecessary use of antibiotics, misconceptions about antibiotics use persist
and continue to be more prevalent among mothers of children with URTIs. Aim: This study aimed to study the
effectiveness of learning package application on the use of antibiotics for mothers of children with URTIs. Method:
A quasi-experimental design was conducted on 214 mothers with their children regardless their gender, age, free
from chronic diseases, diagnosed with URTIs and managed by antibiotics, who attended the General Outpatient
Clinics at Mansoura University Children's Hospital (MUCH). Tools: A structured interview questionnaire sheet
for mothers' knowledge and practical knowledge, observational checklist for mothers' practices about
administration of antibiotic suspension and learning package evaluation checklist. Results indicated that, the
majority of the studied mothers had good knowledge (85.5%) and most of them (98.6%) had competent practices
immediately post the learning package application with highly statistical significant differences (p=0.00).
Conclusion: There was an improvement in mothers' knowledge, practical knowledge and practices after
application of learning package. Recommendations: Provide in-services, up to date and regular training programs
to improve mothers' knowledge and practices regarding the use of antibiotics for their children with URTIs.
Further studies are recommended to repeat this study on a larger sample size and on a wide scale in various
governorates of Egypt.
Keywords: Antibiotics, Bacterial resistance, Children, Knowledge, Learning package, Mothers, Practices and
Upper respiratory infections.

Background: Nocturnal Enuresis (NE) is a common, genetic, complex, heterogeneous and one of the most frustrating and disturbing problems for both children and their parents. Aim of the study: To evaluate the effectiveness of the bidirectional multimodal intervention program on nocturnal enuresis reduction among school age children in Mansoura City, Egypt. Settings: The study was carried out in the Involuntary Urination Outpatient Clinic at Mansoura University Children Hospital (MUCH) and the Enuresis Clinic at Shams Center of Pediatrics and Newborns. A purposive sample of 126 parents and their children suffering from NE. Tools of data collection: A Structured Interview Questionnaire form for the Studied Parents and a Structured Interview Questionnaire form for the Studied Children were used. Results: 4.8% versus 100% and 94.4% of the studied parents had good total knowledge scores as well as none versus 100% and 95.2% of them had satisfactory total reported practices scores about NE pre, immediate post and post 3 months of program implementation respectively. Moreover, 93.7% of the studied children had bedwetting more than once a week pre-program; while, post 3 months after program implementation, 55.6% of them had bedwetting once a week. Conclusion: Parents' level of knowledge and their reported practices about NE was significantly improved post program. Bedwetting frequency among the studied children was decreased post 3 months after program implementation. Recommendations: Continuous educational program for parents of children with NE is essential to update their knowledge and skills about advanced treatment strategies.

Background: The good academic achievement of the students' primary school is a crucial requirement in every system of education and present as worthy of constant concern. Academic self-efficacy means the students' judgments about own ability to successfully attain educational goals. Aim: The current study aimed to explore the relationship between the perceived academic self-efficacy, self-rating achievement and academic achievement among primary school students in Mansoura city. Method: Descriptive cross-sectional design was utilized. The study subjects comprised 764 students as randomized sample of the fourth, fifth and sixth grades from the four randomly selected primary schools in Mansoura city. Tools: Structured Interview Questionnaire, Academic Self-Efficacy Scale and List of Initial Required Studying Skills were used to collect data. Results: A statistical significant variation was found in the studied students' self-efficacy, self-rating achievement and academic achievement total mean scores as p= (0.001,0.001and 0.04), respectively. A positive correlation between the students' total mean scores of self-efficacy, self-rating achievement and academic achievement was found, as r=(0.642 and 0.642), respectively, with a statistical significant variation p (≤0.001 and ≤0.001) respectively. Conclusion: A statistical significant difference is present in the studied students' self-efficacy, self-rating achievement and academic achievement total mean scores. A positive correlation between the students' total mean scores of self-efficacy, self-rating achievement and academic achievement was found. Recommendations: The study recommends conducting further research studies regarding the primary school students' self-rating achievement and academic achievement in Egypt.

Background and Aim: Preterm infants' pain is prevalent in the Neonatal Intensive Care Units (NICUs), with numerous invasive procedures happening daily. Repeated and untreated pain have both short-and long-term sequelae. Therefore, the aim of this study was to investigate the effect of auditory versus olfactory stimulation interventions on preterm infants' pain response during venipuncture. Method: A quasi-experimental comparative research design was utilized. A purposive sample of 90 preterm infants was elected from the NICU at Mansoura University Children Hospital. Preterm infants were divided equally into three groups: auditory, olfactory and control groups. A Preterm Infant Assessment Tool, Premature Infant Pain Profile (PIPP), and Neonatal Infant Pain Scale (NIPS) were used for data collection. Results: There was a statistical significant difference between the control, music, and lavender groups concerning their PIPP total mean scores before and after venipuncture and their NIPS total mean scores during venipuncture (p < 0.001). Conclusion: Preterm infants in the music and lavender groups had a considerable reduction in their pain response compared to the control group during venipuncture. Recommendations: Auditory and olfactory stimulation interventions are recommended as simple, safe and low-cost non-pharmacological methods that facilitate positive effects for preterm infants during painful procedures at NICUs.

Background: Childbirth is an anxiety-producing situation for many women. Intra-partum professional midwifery support can help women cope better with their labor pain and fears as well as raise their childbirth satisfaction. Aim: Investigate the effect of intermittent maternal supportive care on pain intensity and childbirth outcomes. Method: A quasi-experimental research design was used. A purposive sample of 88 laboring women was enrolled. The current study was carried out at the Labor Unit of Mansoura University Hospital (MUH). Five tools were used for data collection: A Structured Interviewing Schedule, the Visual Analogue Scale (VAS), the Childbirth Attitudes Questionnaire (CAQ), the Neonatal Assessment Sheet, and the Mackey Childbirth Satisfaction Rating Scale. Results: Among the intervention group, the severe labor pain and the high childbirth fear levels were significantly reduced post intervention in comparison of the control group. Among the intervention group, three-quarters and the majority of the newborns had normal Apgar scores at the first minute and initiated breastfeeding within the first hour after birth respectively compared to the control group. The childbirth satisfaction level among the intervention group was statistically significantly higher compared to the control group. Conclusion: Intermittent maternal supportive care during labor effectively improves outcomes for laboring women and their newborn infants. Recommendations: Intermittent maternal supportive care should be implemented routinely in all maternity hospitals to improve childbirth outcomes.

Introduction: Nocturnal enuresis is a common distressing disorder that carries a significant burden. This disorder has psychological, social and financial implications for the families and their children. Aim: This study aimed to assess the effect of applying health education learning package (HELP) on mothers having children with nocturnal enuresis. Method: A quasi-experimental research design with repeated measures was utilized. A convenient sample of (88) mothers and their children (88) was recruited from the urinary incontinence outpatient clinic that affiliated to Mansoura University Children's Hospital (MUCH), Egypt. Seven structured tools were used for data collection. Results: There were statistically significant differences in mothers' knowledge, practices and attitude post-application of the HELP regarding nocturnal enuresis compared to pre-application (P=0.000). Additionally, the frequency of bedwetting and urination problems as polyurea and urinary tract infection among the affected children were decreased. Conclusion: Applying of health education learning package regarding nocturnal enuresis showed a significant improvement in mothers' knowledge, practices and attitude. As well, the associated clinical manifestations among the affected children were decreased post-application of the HELP. Overall, the studied mother found the HELP is useful and effective in solving problems of the mothers and children related to nocturnal enuresis.