Quality of life as an individuals, perception of his/ her position in life in the context of the culture and value systems in which he /she lives and in relations to their goals expectations standards and concerns. This study was the first geographical location which helps such group of patients to describe changes in quality of life of patients with chronic heart failure undergoing permanent artificial pacemaker. Descriptive re- search design was adapted to conduit the study on 80 patients whit pacemaker implantation in coronary catheterization lab., at Assiut university Hospital. A structural interview sheet was developed for data collection to assess the quality of life among patients with permanent pacemaker. The tool content modified was done and translated into Arabic by researchers. Descriptive statistics calculated were frequency, percentage, chi-square and p-value. In the present study the patients characteristics, regarding age the majority of patients were in the age between 40-65 years although the majority of them were female and unskilled. 93.75% of total study patients were living in the rural areas 53.75% of them reported it as less them 6 months but 46.25% of them as more than 6 months. No significant relation was observed between patients education and self-concepts, although between patients psycho-logical assessment and duration of pacemaker implantation but there was a significant difference between patients occupation and physical activity.

Quality of life as an individuals, perception of his/ her position in life in the context of the culture and value systems in which he /she lives and in relations to their goals expectations standards and concerns. This study was the first geographical location which helps such group of patients to describe changes in quality of life of patients with chronic heart failure undergoing permanent artificial pacemaker. Descriptive re- search design was adapted to conduit the study on 80 patients whit pacemaker implantation in coronary catheterization lab., at Assiut university Hospital. A structural interview sheet was developed for data collection to assess the quality of life among patients with permanent pacemaker. The tool content modified was done and translated into Arabic by researchers. Descriptive statistics calculated were frequency, percentage, chi-square and p-value. In the present study the patients characteristics, regarding age the majority of patients were in the age between 40-65 years although the majority of them were female and unskilled. 93.75% of total study patients were living in the rural areas 53.75% of them reported it as less them 6 months but 46.25% of them as more than 6 months. No significant relation was observed between patients education and self-concepts, although between patients psycho-logical assessment and duration of pacemaker implantation but there was a significant difference between patients occupation and physical activity.

Sleep disturbance is very common in patient with end stage renal disease (ESRD) on dialysis. ESRD patients reports a significantly poor subjectively quality of sleep in comparison to the general population.(ll the most frequently reported complaints are insomnia, restlessness syndrome, sleep disordered breathing and excessive daytime sleeplessness (EDSi2 ) The aim of this study was to assess the quality of sleep among patients with end stage renal disease (ESRD) undergoing hemodialysis unit of Assiut University hospital. The sample of study include 108 patients with end stage renal disease (ESRD) undergoing hemodialysis both male and females. A structural interview questionnaire sheet was used, it include sociodemographic, Pittsburgh sleep quality index (PSQI) (Buysse et aI, 1989) was translated into Arabic in order to assess the quality of sleep among patient with ESRD undergoing hemodialysis. The PSQI is useful in identifYing good and poor sleepers. A global PSQI score 75 indicate that a person is (poor sleeper). The results. The mean total and subtotal good and poor scores of PSQI, the mean total score were (34.3%) were good sleepers and (65.7%) were poor sleepers. Various strategies should be recommended to improve sleep. Sleep medication, anemia correction more frequent dialysis and assessment sleep.

Sleep disturbance is very common in patient with end stage renal disease (ESRD) on dialysis. ESRD patients reports a significantly poor subjectively quality of sleep in comparison to the general population.(ll the most frequently reported complaints are insomnia, restlessness syndrome, sleep disordered breathing and excessive daytime sleeplessness (EDSi2 ) The aim of this study was to assess the quality of sleep among patients with end stage renal disease (ESRD) undergoing hemodialysis unit of Assiut University hospital. The sample of study include 108 patients with end stage renal disease (ESRD) undergoing hemodialysis both male and females. A structural interview questionnaire sheet was used, it include sociodemographic, Pittsburgh sleep quality index (PSQI) (Buysse et aI, 1989) was translated into Arabic in order to assess the quality of sleep among patient with ESRD undergoing hemodialysis. The PSQI is useful in identifYing good and poor sleepers. A global PSQI score 75 indicate that a person is (poor sleeper). The results. The mean total and subtotal good and poor scores of PSQI, the mean total score were (34.3%) were good sleepers and (65.7%) were poor sleepers. Various strategies should be recommended to improve sleep. Sleep medication, anemia correction more frequent dialysis and assessment sleep.

Sleep disturbance is very common in patient with end stage renal disease (ESRD) on dialysis. ESRD patients reports a significantly poor subjectively quality of sleep in comparison to the general population.(ll the most frequently reported complaints are insomnia, restlessness syndrome, sleep disordered breathing and excessive daytime sleeplessness (EDSi2 ) The aim of this study was to assess the quality of sleep among patients with end stage renal disease (ESRD) undergoing hemodialysis unit of Assiut University hospital. The sample of study include 108 patients with end stage renal disease (ESRD) undergoing hemodialysis both male and females. A structural interview questionnaire sheet was used, it include sociodemographic, Pittsburgh sleep quality index (PSQI) (Buysse et aI, 1989) was translated into Arabic in order to assess the quality of sleep among patient with ESRD undergoing hemodialysis. The PSQI is useful in identifYing good and poor sleepers. A global PSQI score 75 indicate that a person is (poor sleeper). The results. The mean total and subtotal good and poor scores of PSQI, the mean total score were (34.3%) were good sleepers and (65.7%) were poor sleepers. Various strategies should be recommended to improve sleep. Sleep medication, anemia correction more frequent dialysis and assessment sleep.

Back ground and purpose: Hemodialysis patient are susceptible to muscle cramps, both during dialysis sessions as well as in the interdialytic interval, these cramps are often very painful disruptive to dialysis management & adversely affect quality of life there no well defined mean of preventing or treating these cramps. Exercises have been used with apparent success in some patient. Exercises is very important element in the overall health of people at any age stretching exercises may be the best measure to reduce or prevent cramps from occurring. So the present study was designed to determine the effect of stretching exercises protocols on reduction of leg cramp during hemodialysis among patient with renal failure. Quasi- experiment ( research design was applied. This study was conducted in kidney dialysis department of Assiut university hospitals. The subjects of this study consists of 60 patient with muscle cramps during hemodialysis. three tools included in the study, tools of soci - demographic data ,tools of patient information about muscle cramps & management & tool of evaluated patient knowledge & skills after performance exercises. Results: there was lack of knowledge & skills related to muscle cramps before nursing instruction protocol but there was statistical significant difference after performance of exercises. It was found also that high significance difference between before & after performance of exercises. Conclusions: the importance of performance exercises for patient undergoing dialysis to prevent cramps. there is clearly a need for effective education regarding recognition ,individual patient need & appropriate intervention strategies in muscle cramps in dialysis patient & nurses, in partnership with patient, relatives & careers & other health professional can help to empower the individual to mange their cramps.

Back ground and purpose: Hemodialysis patient are susceptible to muscle cramps, both during dialysis sessions as well as in the interdialytic interval, these cramps are often very painful disruptive to dialysis management & adversely affect quality of life there no well defined mean of preventing or treating these cramps. Exercises have been used with apparent success in some patient. Exercises is very important element in the overall health of people at any age stretching exercises may be the best measure to reduce or prevent cramps from occurring. So the present study was designed to determine the effect of stretching exercises protocols on reduction of leg cramp during hemodialysis among patient with renal failure. Quasi- experiment ( research design was applied. This study was conducted in kidney dialysis department of Assiut university hospitals. The subjects of this study consists of 60 patient with muscle cramps during hemodialysis. three tools included in the study, tools of soci - demographic data ,tools of patient information about muscle cramps & management & tool of evaluated patient knowledge & skills after performance exercises. Results: there was lack of knowledge & skills related to muscle cramps before nursing instruction protocol but there was statistical significant difference after performance of exercises. It was found also that high significance difference between before & after performance of exercises. Conclusions: the importance of performance exercises for patient undergoing dialysis to prevent cramps. there is clearly a need for effective education regarding recognition ,individual patient need & appropriate intervention strategies in muscle cramps in dialysis patient & nurses, in partnership with patient, relatives & careers & other health professional can help to empower the individual to mange their cramps.

Back ground and purpose: Hemodialysis patient are susceptible to muscle cramps, both during dialysis sessions as well as in the interdialytic interval, these cramps are often very painful disruptive to dialysis management & adversely affect quality of life there no well defined mean of preventing or treating these cramps. Exercises have been used with apparent success in some patient. Exercises is very important element in the overall health of people at any age stretching exercises may be the best measure to reduce or prevent cramps from occurring. So the present study was designed to determine the effect of stretching exercises protocols on reduction of leg cramp during hemodialysis among patient with renal failure. Quasi- experiment ( research design was applied. This study was conducted in kidney dialysis department of Assiut university hospitals. The subjects of this study consists of 60 patient with muscle cramps during hemodialysis. three tools included in the study, tools of soci - demographic data ,tools of patient information about muscle cramps & management & tool of evaluated patient knowledge & skills after performance exercises. Results: there was lack of knowledge & skills related to muscle cramps before nursing instruction protocol but there was statistical significant difference after performance of exercises. It was found also that high significance difference between before & after performance of exercises. Conclusions: the importance of performance exercises for patient undergoing dialysis to prevent cramps. there is clearly a need for effective education regarding recognition ,individual patient need & appropriate intervention strategies in muscle cramps in dialysis patient & nurses, in partnership with patient, relatives & careers & other health professional can help to empower the individual to mange their cramps.

Urinary diversion operations (urostomy) patients require a great deal of emotional and physical adjustment. They usually face many problems such as loss of body function and relationship with others, and change in life style. They need to adapt to the external appliance, stoma alteration in toileting habits, skin irritation problems, infection and odor problems. Self care of these patients considered the most important factor that can minimize the complaints and complications. The aim of this study was to evaluate the impact of nursing intervention among urostomy patients, regarding practicing self care. The sample comprised 100 urostomy patients, divided into two groups: 50 study and 50 control. For both groups, patients knowledge about urostomy and related self care performance were assessed before intervention, immediately after, and after six months follow up at out patient clinic. Data were analyzed using Epi-info 6.04 computer software package. Findings revealed statistically significant improvements in knowledge and performance among patients in the study group. The rates of complaints and complications were found to be lower in the study group than in the control one. The study suggests that urostomy patients should receive self care training regarding urostomy during hospitalization. Follow up at out patient clinic is highly recommended as well.

Urinary diversion operations (urostomy) patients require a great deal of emotional and physical adjustment. They usually face many problems such as loss of body function and relationship with others, and change in life style. They need to adapt to the external appliance, stoma alteration in toileting habits, skin irritation problems, infection and odor problems. Self care of these patients considered the most important factor that can minimize the complaints and complications. The aim of this study was to evaluate the impact of nursing intervention among urostomy patients, regarding practicing self care. The sample comprised 100 urostomy patients, divided into two groups: 50 study and 50 control. For both groups, patients knowledge about urostomy and related self care performance were assessed before intervention, immediately after, and after six months follow up at out patient clinic. Data were analyzed using Epi-info 6.04 computer software package. Findings revealed statistically significant improvements in knowledge and performance among patients in the study group. The rates of complaints and complications were found to be lower in the study group than in the control one. The study suggests that urostomy patients should receive self care training regarding urostomy during hospitalization. Follow up at out patient clinic is highly recommended as well.