الفهرس 
DeclarationOnly 14 pages are availabe for public view
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Abstract
Joint contractures occurs because of changes in the articular structures (bone, cartilage, capsule) and non-articular structures (muscle, tendon, and skin). Those changes lead to decrease in the joint flexibility and further affect the activities of daily living . Critical care Nurses play an important role in caring of patient at the ICU to prevent joint contractures, that helps to reduce patient further complications. Therefore the Aim of this study was to evaluate effect of nursing guidelines on occurrence of joint contractures among critically ill patients in Intensive Care Unit. Quasi-experimental research design was used to conduct this study. The sample of this study consisted of 60 patients, who were admitted to the Intensive care unit at Sohag University Hospital and divided into two equal groups . Two tools used in this study . Tool one ”Patient assessment tool” it included 3 main parts : Part I: Sociodemographic and clinical data, Part II ” Physiological parameters”, and Part III: Laboratory tests and Glasgow coma scale (GCS). Part II and III of tool one were recorded as APACHE ii score . Tool two tool included two parts :Part I ” functional mobility scale ” : it used to assess level of mobility and Part II ”Joint range of motion assessment tool” Each patient in the study group received nursing guidelines regarding range of motion exercises and proper positioning. The control group patients received the routine hospital care including only positioning through right, left and sitting position without any consideration of proper alignment of the joints. Both groups were monitored for development of joint contractures at 15th The main results: It revealed no statistically significant difference regarding age and gender . Also revealed no statistically significant difference between both groups regarding the diagnosis . On the other hand, the result showed no statistically significant difference between study and control group regard the APACHE II score with mean (22.4 ± 4.7&24.9 ± 5.1), respectively . In addition the current study revealed no significant in both group as regard neurological assessment using GCS. Summary 62 There were statistically significant statistical differences of joints angles regarding all directions of major five joints among study group at 1st and 15th day ( p< 0.000). Regarding comparison between study and control groups about effect of joint contractures guidelines at 15th day there were significant statistical differences at shoulder, elbow, hip, knee and ankle. It can conclude that applying nursing guidelines regarding range of motion exercises and proper positioning are very important for critically ill patients especially those who have limited mobility to prevent occurrence of joint contractures.