Job empowerment is an increasingly important element in determining employee's performance and commitment to the organization. Howe ever, little attempt was done to investigate staff nurses perceptions of job empowerment and organizational commitment. This study was conducted in an attempt to explorer the relationship between (l00) staff nurses perceived job empowerment and their commitment to the organization, based on kanter s structural theory of organizational behavior. Data were collected from Assiut health insurance hospital (EI- Mabarrah) by using; the demographic data sheet, organizational description opinionaire (ODO) organizational commitment questionnaire (OCQ) and a modified version of the condition of work effectiveness questionnaire (CWEQ). The result revealed that strong positive relation ship was found between nurses perception of access to opportunities and their commitment to the organization .in addition, overall empowerment was correlated positively with nurses perception of their immediate managers power. In accordance with authors, the results suggest that empowered individuals are more likely to delegate are more committed, and are willing to sacrifice individuals needs for the good of the organization.

Hemodialysis, the backbone of the modem treatment of irreversible kidney disease, in the treatment course, the patient faces pressures at different levels, and subjected to a high degree of stress that might impacts patients' psychosocial health and Coping with the medical condition. Objective: The purpose of this study was to determine the stressors of hemodialysis patients. Subjects and methods; Design: A descriptive design was utilized to conduct this study. Subjects and methods Sample/Setting: Eighty-eight subjects were included in the study; they ranged in age from 20 to 61 years. Subjects were obtained from the hemodialysis center at Assiut University Hospital. Tools: Socio-demographic data sheet elicited information related to subjects' age, gender, education, occupation. Information related to type of hospital payment and times on dialysis were also gathered. The stressors were measured on the Hemodialysis Stressor Scale (HSS). Results revealed that, Highly reported stressors (in decreasing order of occurrence) included number of treatment per week, time requirement for treatment, severe headache, anxiety, waiting for transplant, muscle cramps, limitation of fluid and limitations of physical activities. Conclusion and recommendation: The findings of this study showed that patients experienced various types of stressors. Nurses can provide support, information, and alternative solutions when assisting patients in coping with these different stressors associated with hemodialysis.

Low back pain has been shown to be an important health and socioeconomic problem of occupational diseases. Some authors in our locality have documented near to half (45%) of our nurses having ongoing back pain. Various risk factors have been documented such as work environment, manual handling, heavy lifting, repetitive work, and strenuous tasks. Also, a history of back trouble, particularly if recent and prolonged, is highly predictive of new episodes of prevalence of the back problem in nurse. So, if we can estimate the magnitude of the low back pain in nursing students we can protect the future nurse from low back pain. The aim of the study: To identifY the prevalence of back pain among the nursing student in Nursing Faculty at Assiut University and determine the risk factors for that back pain and design proposal intervention protocol. Subjects and Methods: SUbjects consisted complete cohort of 466 female nursing students of Nursing Faculty at Assiut University using self-administered structured Arabic questionnaires. Prevalence of back pain in low, mid, and upper back was determined. Full clinical history and local examination of back in students who had positive back pain complaints for exclusion of other causes of back pain such as pelvic, or major skeletal deformity. Result: The prevalence of back pain was 54%. There is no significance difference between students who have back pain and no back pain except for irregular menses. Prevalence of back pain over I year (chronic) was 33.5%, but acute back pain (less than one month) was 43.5%. There were no statistically significant differences between back pain and year of the study. Conclusions and Recommendation: Overall, our study showed that back pain was more common among an Egyptian cohort than in other study. We also concluded that preventive strategies might be started before enrollment in faculty of nursing, continued during the time of faculty, and continued after graduated from the faculty by proper distribution of nurse to different department according to the medical history and examinations of back. Recommended that, a full and thorough examination of the locomotor's system after graduation from the Faculty of Nursing for ideal distribution of nursing students to suitable departments according to their fitness, also training program for the prevention of back injury should be continued, as research have shown that training programs were effective in increased knowledge of injury risk factors and a 30% in back injuries. Key words: Back pain, Prevalence, Nursing student.

Diabetes is a chronic disease of life long duration, and its management requires a fundamental change in the patient's life style. The success of long term maintenance therapy for diabetes mellitus depends largely upon the patients' compliance with a therapeutic plan. Therefore, the aim of this study was to assess compliance to therapeutic regimen of diabetics' patients attending out-patient clinic and in-patient department at Assiut University Hospital. Hundred patients were selected randomly from the previous setting, their age ranged between 20- 80 years, from both sex. Interview questionnaire were used for data collection, developed and completed by the researcher for each subject to assess compliance of diabetic patients to therapeutics regimen. It includes 3 parts, the first part, cover the sociodemographic data, the second part, includes medical data history of associated disease, and the third part, includes closed ended questions related to compliance of diabetic patients to therapeutics regimen as compliance with dietary, treatment, exercise regimen, smoking cessation, periodic check up (eye examination, blood pressure monitoring), periodic laboratory test for glucose in blood & urine and self care practice. The results showed that, more than half of the patients 60% had good compliance with dietary regimen, the majority of patients 78% had good compliance with treatment regimen and 75% of the patients had good compliance for periodic check up for glycemic status. However, 45%, 70% and 88% had poor compliance with foot care, smoking cessation, blood pressure monitoring and eye examination respectively. It can be concluded that, the majority of the patient had good compliance with diet, treatment regimen and laboratory test for glycemic status while, the diabetic patients had poor compliance with smoking cessation, blood pressure monitoring, eye examination and exercise program. Hence, it is recommended that, every effort should be made to imitate and promote behavioral changes in diabetic people. To achieve this, an appropriate education and training should be provided for all patients and their relatives in a written booklet, in a sample language with posters about the managements and prevention of diabetic complications. To improve compliance with therapeutic regimen, collaboration of patients with the health team members is needed, and the compliance regimen should be individualized, realistic, flexible, considering the patient's like and dislikes and must suit the patients life style. Key words: Compliance, Diabetes, Therapeutic regimen.

It is necessary for the surgeon to remove a portion of the colon in an attempt to treat ulcerative colitis, cancer or other colonic obstruction or severe trauma. The opening that is created on the abdominal wall is referred as a colostomy. In temporary colostomy can give the wound a chance to heal through selecting the proper diet pattern to maintain a balanced diet to provide all vitamins, minerals and calories needed for good health. The main problems with diet in this case include the big three: Wind, diarrhea and constipation, fore that in the present investigation, a special dietary pattern was recommended to attain the ideal management of patients with temporary colostomy in order to enable the patients to tolerate a regular diet that has been modified to their specific needs and maintain bowel control. Therefore the study aims to set up an optimal special dietary pattern for temporary colostomy patients and to evaluate the special dietary pattern for patients. Subjects and methods This study was conducted at Assist University Hospital in Surgery Department. The sample consisted of 30 adult patients (during the period from January 2002 to January 2003) previously had temporary colostomy from both sex after the age 20 years old. Sample was divided into three groups, namely: 10 patients with special pattern diet (SPD).lO with normal diet + vitamin supplements and the reminder 10 with normal diet served as control. The present study was carried out for two months. The nutritional status for temporary colostomy patients was assessed including data about age, sex, level of education, general blood pictures specific blood analysis triglycerides content (TG), total cholesterol content (TC), low density lipoproteins (LDL), high density lipoprotein (HDL), blood sugar content, uric acid; and anthropometrics measurements, body mass index, and food habits, and the questionnaire schedule was give to the patients twice, once at the beginning of implementation of the program, and the latter at the final step of implementation of the program. The result revealed that the recommended dietary pattern for the patients of temporary colostomy give in the present study succeeded to maintain a balanced diet to provide all the vitamins, minerals and calories needed for their good health. Likewise, special nutritional guidelines and suggestion were introduced. Conclusion and recommendation, it implies the importance of arising patients and their families' awareness concerning diet therapy to avoid possible diet related problems and to maintain good health. Key words: Dietary Pattern, Temporary Colostomy.

It is necessary for the surgeon to remove a portion of the colon in an attempt to treat ulcerative colitis, cancer or other colonic obstruction or severe trauma. The opening that is created on the abdominal wall is referred as a colostomy. In temporary colostomy can give the wound a chance to heal through selecting the proper diet pattern to maintain a balanced diet to provide all vitamins, minerals and calories needed for good health. The main problems with diet in this case include the big three: Wind, diarrhea and constipation, fore that in the present investigation, a special dietary pattern was recommended to attain the ideal management of patients with temporary colostomy in order to enable the patients to tolerate a regular diet that has been modified to their specific needs and maintain bowel control. Therefore the study aims to set up an optimal special dietary pattern for temporary colostomy patients and to evaluate the special dietary pattern for patients. Subjects and methods This study was conducted at Assist University Hospital in Surgery Department. The sample consisted of 30 adult patients (during the period from January 2002 to January 2003) previously had temporary colostomy from both sex after the age 20 years old. Sample was divided into three groups, namely: 10 patients with special pattern diet (SPD).lO with normal diet + vitamin supplements and the reminder 10 with normal diet served as control. The present study was carried out for two months. The nutritional status for temporary colostomy patients was assessed including data about age, sex, level of education, general blood pictures specific blood analysis triglycerides content (TG), total cholesterol content (TC), low density lipoproteins (LDL), high density lipoprotein (HDL), blood sugar content, uric acid; and anthropometrics measurements, body mass index, and food habits, and the questionnaire schedule was give to the patients twice, once at the beginning of implementation of the program, and the latter at the final step of implementation of the program. The result revealed that the recommended dietary pattern for the patients of temporary colostomy give in the present study succeeded to maintain a balanced diet to provide all the vitamins, minerals and calories needed for their good health. Likewise, special nutritional guidelines and suggestion were introduced. Conclusion and recommendation, it implies the importance of arising patients and their families' awareness concerning diet therapy to avoid possible diet related problems and to maintain good health. Key words: Dietary Pattern, Temporary Colostomy.

Diabetes foot ulcers are common complications of diabetes mellitus; they are the major cause of morbidity, mortality, and disability. The aim of this study is to evaluate the impact of implementing a designed nursing intervention protocol on prevention of diabetic foot complication. Subjects and methods, Design: pre- post test study design was utilized, the study was conducted on 60 male and female patients in diabetic educational center at Assiut University Hospital, three tools were used for data collection. Tool I: interview questionnaire sheet, tool 11: foot assessment sheet, and tool Ill: an observational checklist .Designed nursing intervention protocol was conducted through 4 theoretical and practical sessions and evaluation was done by using the three previous tools every one month till three months after implementation of the protocol of care to assess patients' knowledge and practice about foot care and to assess patients' foot condition. The finding of the study revealed changes and improvement in patients knowledge and practice about foot care which were indicated by significant difference (p0.05) between before and after implementing of nursing intervention protocol. It can be concluded that, most of patients had poor knowledge and performance of foot care while after implementation of a designed intervention protocol, the number and percent of the subjects who had calluses, blisters, dryness, and fissure subside due to improvement of patients' knowledge and practice about good and proper foot care. Recommendations, based on the results of the present study the following are recommended, periodic implementation of a designed nursing intervention protocol about foot care for all diabetic patients in hospital setting, and in out patients setting during follow up visits to provide diabetic patients with the necessary and required knowledge and skills about foot care. Diabetic patients should be encouraged to do daily self examination of feet and to adopt proper foot care practice; this can be helped by providing them with illustrated, colorful and simplified pamphlets.

Diabetes foot ulcers are common complications of diabetes mellitus; they are the major cause of morbidity, mortality, and disability. The aim of this study is to evaluate the impact of implementing a designed nursing intervention protocol on prevention of diabetic foot complication. Subjects and methods, Design: pre- post test study design was utilized, the study was conducted on 60 male and female patients in diabetic educational center at Assiut University Hospital, three tools were used for data collection. Tool I: interview questionnaire sheet, tool 11: foot assessment sheet, and tool Ill: an observational checklist .Designed nursing intervention protocol was conducted through 4 theoretical and practical sessions and evaluation was done by using the three previous tools every one month till three months after implementation of the protocol of care to assess patients' knowledge and practice about foot care and to assess patients' foot condition. The finding of the study revealed changes and improvement in patients knowledge and practice about foot care which were indicated by significant difference (p0.05) between before and after implementing of nursing intervention protocol. It can be concluded that, most of patients had poor knowledge and performance of foot care while after implementation of a designed intervention protocol, the number and percent of the subjects who had calluses, blisters, dryness, and fissure subside due to improvement of patients' knowledge and practice about good and proper foot care. Recommendations, based on the results of the present study the following are recommended, periodic implementation of a designed nursing intervention protocol about foot care for all diabetic patients in hospital setting, and in out patients setting during follow up visits to provide diabetic patients with the necessary and required knowledge and skills about foot care. Diabetic patients should be encouraged to do daily self examination of feet and to adopt proper foot care practice; this can be helped by providing them with illustrated, colorful and simplified pamphlets.

Gastro-esophageal reflux disease (GERD) is a very common problem and significantly affects the quality of patients' life. Dietary and life style choices contribute to the development of GERD. The aims of the present study was to assess the life style of GERD patients, formulate life style modification regimen, implement the recommended life style and diet regimen, as well as to assess the impact of life style modification on the control of GERD symptoms. Subjects and Methods, sixty adult male and female patients were selected randomly from those attending the outpatient clinic of the department of Tropical Medicine and Gastroenterology. They were divided into two groups (study and control groups, 30 patients for each). Their age ranged from 20 - 50 years. Those who have diabetes, liver cirrhosis, achalazia and peptic ulcer (duodenal and gastric were excluded from the study. Two tools were utilized for data collection, tool I: covered the sociodemographic data and life style assessment data sheet. Tool 2 covered medical data sheet to assess typical and atypical symptoms of GERD. The designed life style modification protocol was developed by the researcher and included information relevant to diet, smoking, rest, exercise and activity and lying down after meal. Lecture/ discussion, posters, counseling and written protocol were utilized. The patients of the study group were given treatment for GERD (pump inhibitor and domeperidon) in addition to dietary regimen designed specifically for patients with GERD and life style modification for 4 weeks. Those in the control group were given treatment only for 4 weeks. Results, this study revealed that, 53.3% still improved (reflux symptoms control and reduction) during follow up period after 2 weeks after stop of treatment but still on life style modification protocol and 46.7% reflux symptoms relapsed, while in control group . 100% relapsed after stop of treatment. The study concluded that, the effectiveness of the designed life style modification protocol in the control of reflux symptoms. Enrichment of subjects about the disease reduced the occurrence of the problems. The researcher recommended that, the importance of raising GERD patient's awareness about the importance of life style modification plus medical treatment provide GERD patients with simple Arabic booklet about life style modification regimen and another study carried on large sample and follow up period more than this period. Key words: Life Style Modification, Gastro-esophageal Reflux, Symptoms Control.

There is no doubt that every member of the society would agree that all health care providers should be competent in practice. Nursing is a profession requires intellectual and technical skills to provide quality patient care. For nurses to work efficiently and effectively the areas of competency must be identified for specific roles and setting. Clinical teaching is vital for the preparation of professional nurses who can function competently and independently in a diversity of nursing situations Aim: this study was aimed to evaluate the proposed competency based performance as an indicator for assessing clinical competency of nursing students as well as to determine the opinionnaire of nursing students and instructors about the assessment system Subjects and Methods: The study was conducted at the Faculty of Nursing and at Assiut University Hospitals. The study sample consisted of all nurse students who were enrolled in the fourth academic year (171) as well as 12 clinical instructors: Three tools were used for collection of data: two for students, and one for clinical instructors. I-Assessment System Tool (Dolan (2003). It includes six competency indicators namely care delivery, communication, safety, organization and management, teaching, and professional judgment. Validity and Reliability of the tool were 0.85- 0.93. The second and third tools were respectively students and clinical instructor's opinionnaires. Results: there were statistically significant improvements in all almost domains at both the post and retention phase, and there were statistically significant improvement as regard the total competencybased achievements of students at the post and retention phases have statistically significantly improved. Conclusion and Recommendations plans are urgently needed for instructors' workshops about competency assessment, the Faculty must consider the need for more staff members in its plan for the future, to help in evaluation of students and to prepare a competent nursing student, and further researches are needed to evaluate the outcomes of competencies not only in terms of individual nurses student, but also in terms of patient and unit outcomes.