Background: Mineral bone disorders pose significant challenges for patients with end-stage renal disease, contributing to morbidity and mortality. Nurse-led educational intervention program is effective strategy to empower patients in managing disease. Aim: The study aimed to evaluate the effectiveness of a nurse-led educational intervention program on symptoms, quality of life and progression of mineral bone disorders among patients with end-stage renal disease. Methods: Research design: A quasi-experimental non-randomized design. Sample and setting: A non-randomized sample of 120 patients with end-stage renal disease (control group = 60 patients, study group = 60 patients) was recruited and followed for 6 months in the hemodialysis unit of the internal medicine department at Assiut University Hospitals. Each patient in the study group received orientation and training from researchers on essential knowledge, and dietary recommendations to reduce phosphate intake, as well as exercises to improve bone health and provided with a handout booklet. Tools: The study utilized a patient assessment sheet, a numeric pain rating scale, and the EuroQol-5 dimension to measure outcomes. Results: The ages of patients in both groups ranged from 20 to 50 years. A nurse-led educational intervention program demonstrated a significant effect (p < 0.01) as regard all outcome measures; reducing symptoms, improving quality of life and limiting disease progression. Conclusion: A nurse-led educational intervention program notably reduced symptoms, enhanced quality of life, and slowed the progression of mineral bone disorders in patients with end-stage renal disease. Recommendation: Implementation of a nurse-led educational intervention program as a strategic approach to improve patient outcomes in managing mineral bone disorders associated with end-stage renal disease.

Background: Critically ill patients suffer from sleep pattern disturbances in intensive care units, negatively affecting their recovery. With this, nurses are faced with a great challenge to deal with these disturbances in critically ill patients. Aim: This study aimed to explore the effectiveness of alternative methods to nursing strategies for promoting night sleep pattern among coronary intensive care patients. Methods: The study was conducted at the coronary intensive care unit (CCU) of the Aswan University Hospital (Aswan– Egypt). Pertinent data were collected utilizing two tools. The first tool was the quality of sleep sheet, which included two parts: personal bio demographic data and a Richards–Campbell sleep questionnaire for monitoring the sleep qualities of ICU patients. The second tool was the stress factors in the ICU questionnaire used to measure stress perception. A quantitative survey was carried out to meet the aim of this study, and the purposive sample included 85 conscious CCU patients. Results: Implementation of the alternative methods to nursing strategies revealed highly significant impacts regarding the domains in stress factor perception (p < 0.000) and items of sleep quality in the ICU. Significant differences were found in the means of sleep depth, latency, returning to sleep, sleep quality, and noise in the ICU (p < 0.005). Conclusion: Alternative nursing strategies improved the sleep quality of ICU patients using the following alternative methods performed by nurses, which included aromatherapy, body massage, listening to calm music, and decrease of stress factors in the ICU. Therefore, it is recommended to use these alternative nursing strategies in intensive care units to improve the patients’ night sleep pattern.

Keywords: Alternative strategies Sleep pattern Coronary intensive care Nursing