الفهرس 
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Abstract
Leukemia’s are abnormal cells reproduce very quickly and do not function as healthy white blood cells to help fight infection. When the immature white blood cells, begin to crowd out other healthy cells in the bone marrow, the child experiences the symptoms of leukemia. In this aspect, Gale and charette (2012) defined leukemia as a malignancy originating in the stem cells of the hematopoietic system which results in uncontrolled proliferation of abnormal immature cells.
Most people feel overwhelmed when are told they have leukemia. Many different emotions arise as confusion, frequent mood swings and significantly higher risk for depression, anxiety, and other indicators of psychological distress. These emotions are part of the process that many people go through in trying to come to terms with their illness. Partners, family members and friends often experience similar feelings and frequently need as much psychological support and guidance in coping with their feelings (Lederberg, & Halland, 2010).
A significant proportion of leukemic children have moderate-to-high needs for help to cope with their illness and its treatment. Many also report that they didn’t have adequate information to help them make decisions. Untreated psychological conditions can result in greater pain, poorer
physical functioning, higher medical costs and longer hospital stay as well as impacting on the person’s ability to work. This also places an added burden on the health system (Memorial Cancer Institute’, 2013).
On the other hand appropriate levels of support are proven to be effective in reducing distress, decreasing anxiety and depression, increasing knowledge and improving the quality of life of leukemic children. The pediatric nurse is often the first individual to interact with family during hospitalization or primary care settings. For that nurses need to take an active role in early screening, case finding, and assessment they provide psychological support and educational intervention (Cancer Council, 2013).
Communication skills help nurses develop an awareness of a range of communication frameworks and how they might be utilized in contemporary child health nursing to communicate with children, their families, fellow healthcare professionals and each other in their day to day working lives. This will help children’s nurses to communicate with confidence, sensitivity and effectiveness; to meet the individual needs of children and their families (Craven & hairline, 2009).
AIM OF THE STUDY:
The present study aimed to assess the effect of training programs for nurses about psychological support to children with leukemia and their families through:
1- Assessing psychological techniques used by nurses to support children with leukemia and their families (pre- assessment).
2- Accordingly, developing training programs for nurses toward psychological support to children with leukemia and their families.
3- Implementing the development program for nurse’s toward psychological support to children with leukemia and their families.
4- Evaluate the effect of the training program on the nurse’s towed psychological support for children with leukemia and their families (post-assessment).
Research Hypothesis:
The training program will affect positively on the performance the nursing staff about psychological support techniques (communication skills – stress- management technique) used for the children with leukemia and their families.
The present study was carried out through:
I- Technical design. II- Operational design
III- Administrative design. IV- Statistical design.
I. Technical Design:
The technical design entails the study design, setting, subjects, and tools for data collection.
A- Research Design:
The present study is a quasi-experimental research design.
B- Research Setting:
This study was conducted at inpatient departments of both pediatric hematology and oncology units of Ain Shams University.
C- Subjects:
The study subjects included all the available number of the nurses of both pediatric hematology and oncology units of Ain Shams University. The total number of the nurses was forty-four nurses divided into equal two groups.
D- Tools of data collection:
Data for this study were collected by using the following tools: All of tools were designed and developed by the investigator based on the available literature.
I. A structure, interviewing sheet, designed by the investigator based on the available literature.
II. Communication skills checklists.
III. Psychological support tool.
IV. Nursing Interventions Program.
I. Interviewing questionnaire:
Part (1): It deals with Socio-demographic characteristics of the nurses under the study.
Part (2): It related to the nurses taking training on psychological support techniques.
II. Communication skills checklists:
The checklist is concerned with communication skills, as the
verbal communication skill, and Active listening skill.
III. Psychological support assessment tool:
Part (1): Stress-management techniques divided into four parts, as a relaxation technique, time-management, counseling or group therapy, and maintaining an overall healthy lifestyle.
Part (2): Four roles for the nurses to support the children with leukemia and their families during therapeutic communication divided into four parts, as a social role, professional role, guideline role, educational role.
IV. Nursing Interventions Program, an Arabic booklet for the training program about psychological support techniques:
Training program intervention developed after identifying the nurse needs by the investigator to improve psychological support techniques (therapeutic communication - stress management techniques), for the nurse’s dealing with the children with leukemia and their families.