الفهرس 
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Abstract
Summary Sickle cell anemia (SCA) is a genetic disease characterized by a
modification in the shape of red blood cells (RBCs) from a smooth, flexible shape
to a crescent or “sickle” shape. The misshapen cells lack plasticity and can block
small blood vessels, impairing blood flow to the organs of the body, which leads
to shortened RBC survival and subsequently causes anemia. SCA affects nearly
every organ system and is associated with high morbidity and mortality. SCA has a significant negative effect on quality of life (QoL), due to the impact on physical
and emotional health, social life, and school. For this reason, complementary and
supportive cares are necessary for enhancing and improving the quality of life of
children with sickle cell anemia. Therefore, nurses working in Pediatric
hematology Unit must develop their skills and knowledge in order to help children
to adapt and cope with their critical situations through providing the appropriate
model based nursing intervention and instructions.
The purpose of the study was: to examine the effect of an application of the
PRECEDE-PROCEED planning model to enhance quality of life of children with
sickle cell anemia.
Research design:-
A quasi-experimental design was used to examine the effect of an
application of the PRECEDE-PROCEED planning model to enhance quality of
life of children with sickle cell anemia.
Settings:-
This study was conducted in Pediatrics’ Hematology unit and Pediatric
Outpatient Clinic at Menoufia University Hospital, Shebin-Elkom City.
Summary
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Sample:-
A purposive sample of 31 children who were diagnosed with SCA from
the above mentioned setting.
Instruments of the study:-
Two instruments were utilized for data collection:
Instrument one: - A structured interview questionnaire sheet. It was
divided into four parts
Part one: characteristics of studied children (age, gender, educational level and
parent’s age, educational level and jobs).
Part two: Predisposing Factors Assessment Sheet.(It included questions
about Children Knowledge about SCA disease and Children attitudes regarding
healthy life style that affect quality of life (healthy food, dental care, sleep,
exercises, follow up and self-actualization).
Part three: Reinforcement Factors Assessment Sheet (It included questions about
measure support and encouragement.
Part four: Enabling Factors Assessment Sheet.
Instrument two: Pediatric Quality of Life Scales, it was divided into two parts
Part 1: The Pediatric Quality of Life Initiative (PEDS QL) version 4.0
Generic Core Scale which includes: Physical activities, Feelings, Social
Functioning and School Functioning
Part 2: The Peds QoL version 3.0 Sickle Cell Disease Module which includes:
Communication and treatment
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The main results of the study showed that:
1. More than half of studied children (54٫8%) were boys
2. More than two thirds of studied children (61%) were diagnosed with sickle
cell anemia at age of 6 months with a mean of 5.25 ± 2.38 months.
3. All studied children (100%) had poor knowledge on pretest meanwhile the
vast majority of them (93.5%) had good knowledge on post and follow up
tests.
4. Almost half of studied children (48.4%) had negative attitude on pretest
meanwhile the majority of them (93.5% and 80.6% respectively) had
Positive attitude on post and follow up tests.
5. Majority of studied children (93.5%) had weak predisposing factors,
reinforcing and enabling factors on pretest meanwhile more than three
quarter of them (80.6%) had strong factors on post and follow up tests.
6. Majority of studied children (93.5%) had Poor quality of life on pretest
meanwhile approximately two thirds of them (61.3% and 74.2%
respectively) had moderate quality of life on post and follow up tests.
7. There was a positive highly statistical significant correlation between total
score of total precede tool and total score of quality of life at the 0.01 level.
The study recommended that:
1. Recommendations for practice:-
Integrating of PRECEDE-PROCEED planning model into the daily
routine care at all pediatric hematology units.
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2. Recommendations for hospital polices:-
3. Simple written guidelines about SCA disease, complication prevention and
management in addition to different method of teaching such as group
discussion and presentation should be available at all hematology units for
parents of children with SCA.
Acomprehensive booklet regarding promoting QOL for SCA should be
available at each hematology units
4. Recommendations for education:-
In service educational training program should be designed and provided
for children with SCA and parents to educate them ways to enhance QoL
of their children in all hematology outpatient clinic of hospital.
5. Recommendations For research
Application of the present study on a large sample size and for a long
period of time to ensure the generalization of the results.