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.

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.

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.

Colorectal cancer is one of the leading causes of cancer death in both developed and developing nations. Early and late problems may be faced by patients after colostomy surgery. Assessment and management of stoma complications are the responsibility of nurses across the continuum of care and played a central role in the clinical appreciation and postoperative management as evidenced by interest in managing postoperative outcomes and treating the complications. Therefore, the aim of this study was to identifY the postoperative outcomes among patients undergoing pem 1 anent colorectal diversion. Subjects and Methods, sixty patients were selected from the General Surgical Units in Assiut University Hospital and Upper Egypt Cancer Institute their age ranged between 30- 70 years with mean age of 50.30 ± 11.28 yrs. Tools used for data collection were Socio-demographic and Medical Data Sheet; Physical and Social Assessment Sheet; Nutritional Assessment Form and Rosenberg's Global Self Esteem scale (RGSEs). Structured interview was utilized for data collection. The results of the study showed that, 5% had stoma retraction, stomal fistula and mucocutaneous separation and 8.3% had stomal infection and 21.7% had skin breakdown and skin irritation. Half of the sample had gases, and 23.3% suffered from leakage. Social problems and low self-esteem were found among more than half of study subjects. The most of the patients had underweight, subnormal values of hemoglobin, albumin and white blood cells were found. The study concluded that, patients undergoing permanent colorectal diversion exhibited different physical, social, self-esteem and nutritional changes and need effective measures to prevent Ireduce these complications. Recommendations, another further study on a larger sample and for 6 months to one year as a minimum time for follow up is recommended, encourage preoperative physical, social, psychological and nutritional preparation for colostomy' patient and design a rehabilitation program for patients with permanent colostomy. Key words: Postoperative Outcome, Colorectal Diversion, Cancer .

Colorectal cancer is one of the leading causes of cancer death in both developed and developing nations. Early and late problems may be faced by patients after colostomy surgery. Assessment and management of stoma complications are the responsibility of nurses across the continuum of care and played a central role in the clinical appreciation and postoperative management as evidenced by interest in managing postoperative outcomes and treating the complications. Therefore, the aim of this study was to identifY the postoperative outcomes among patients undergoing pem 1 anent colorectal diversion. Subjects and Methods, sixty patients were selected from the General Surgical Units in Assiut University Hospital and Upper Egypt Cancer Institute their age ranged between 30- 70 years with mean age of 50.30 ± 11.28 yrs. Tools used for data collection were Socio-demographic and Medical Data Sheet; Physical and Social Assessment Sheet; Nutritional Assessment Form and Rosenberg's Global Self Esteem scale (RGSEs). Structured interview was utilized for data collection. The results of the study showed that, 5% had stoma retraction, stomal fistula and mucocutaneous separation and 8.3% had stomal infection and 21.7% had skin breakdown and skin irritation. Half of the sample had gases, and 23.3% suffered from leakage. Social problems and low self-esteem were found among more than half of study subjects. The most of the patients had underweight, subnormal values of hemoglobin, albumin and white blood cells were found. The study concluded that, patients undergoing permanent colorectal diversion exhibited different physical, social, self-esteem and nutritional changes and need effective measures to prevent Ireduce these complications. Recommendations, another further study on a larger sample and for 6 months to one year as a minimum time for follow up is recommended, encourage preoperative physical, social, psychological and nutritional preparation for colostomy' patient and design a rehabilitation program for patients with permanent colostomy. Key words: Postoperative Outcome, Colorectal Diversion, Cancer .