Background: Muscle cramps occur frequently among elderly hemodialysis patients, which can be avoided by the application of intradialytic stretching exercises. Purpose: Determine the effect of intradialytic stretching exercises on muscle cramps among elderly patients undergoing hemodialysis. Setting: The study was conducted at hemodialysis unit in Meet Khaqan Health Center affiliated to Shebin El-Koum Fever Hospital. Sample: The study subjects comprised of a convenience sample of 50 elderly patients who were registered in dialysis unit's files. Instruments: First, Structured interviewing questionnaire. Second, cramp questionnaire chart and visual analogue scale. Results: There was a highly statistically significant difference in the level of muscle cramps pre and post implementation of intradialytic stretching exercises (p < 0.001**). Conclusion:There was a significant reduction in the muscle cramps level after application of the intradialytic stretching exercises. Thus, these exercises are an effective and simple measure to prevent or reduce severity of muscle cramps among elderly hemodialysis patients. Recommendations: Intradialytic stretching exercises should be combined with routine nursing care for hemodialysis patients.

Cerebral palsy is the most prevalent motor disability in children. The term "cerebral palsy" represents a group of conditions brought on by faulty brain development or brain injury that happen shortly after birth or early in life. The study aimed to evaluate the effectiveness of acceptance and commitment-based interventions on stress, future anxiety, and quality of life among mothers of children with cerebral palsy. Setting: The study was conducted in the outpatient clinic (Nero-psychiatric clinic) at EL Mogamma EL Teby AL Shamal, Shebin El-Kom City. Subjects: A purposive sample of 150 mother's children with cerebral palsy from the previously mentioned setting was included in the study. Instruments: Four tools were used; a semi-structured interviewing questionnaire, a stress level scale, a future anxiety scale, and a quality of life scale. After acceptance and commitment-based intervention and follow-up, the total score of stress and future anxiety levels in the study group are significantly lower than in the control group. Furthermore, the total score of quality of life levels significantly increased in the study group than in the control group after acceptance and commitment-based intervention and on follow up. Conclusion: Acceptance and commitment therapy was an effective intervention in reducing stress levels and future anxiety and improving the quality of life among mothers of children with cerebral palsy. Recommendation: As the primary source of information for mothers when giving the child necessary treatment, nurses in the outpatient clinic, physiotherapy clinic, and pediatrics department should be trained well and supplied with information and training on the cerebral palsy program. Also, an in-service training program for nurses on the value of acceptance and commitment therapy and how to use it to reduce future anxiety, and stress and improve quality of life.

Background: Postpartum period is associated with emotional disturbances with the tendency occurrence of post-partum depression and change in sleep quality. Cognitive behavioral therapy has been suggested as the primary line treatment for managing postnatal depression and it is also successful in dealing with post partum sleep problems. Aim: to investigate the effectiveness of cognitive behavioral therapy intervention on depressive symptoms and sleep quality among postnatal women. Design: A quasi-experimental design was utilized. Setting: The study was conducted at three Maternal and Child Health Centers; three from ten health centers were selected by multistage random selection included; Shebin El-Kom (two centers) and Tala (one center) districts affiliated to Menoufia governorate, Egypt. Subjects: A purposive sample of 260 postpartum women selected from previous chosen settings. Instruments: three instruments were utilized included: An interviewing questionnaire contained; socio-demographic characteristics and current obstetric history of the studied women, The Edinburgh Postnatal Depression Scale and Sleep Quality Scale. Results: 81.5% of studied women suffer from possible depressive symptoms (risk for depression) in pre intervention, decreased to 53.5% in post intervention with statistical significance differences between pre and post intervention p =.000. Furthermore, there were statistical significance improvements in the levels of sleep quality among studied women p =.000 as evidenced by, 23.1% of studied women with severe sleep problem in pre intervention, decreased to 8.4% in post intervention as a consequence of intervention; 35.7% of studied women with mild sleep problem in pre intervention improved to 51.2% in post intervention. In addition, there was negative correlation between total score of depressive symptoms and sleep quality after cognitive behavioral therapy intervention. Conclusion: Cognitive behavioral therapy was an effective maneuver in reducing the symptoms of postpartum depression and improves sleep quality in postnatal women. Recommendation: Health education intervention based on preventive CBT should be provided to postnatal women to deal effectively with changes in sleep quality and manage depressive symptoms associated with postpartum period.

Hemodialysis is a prolonged process that affects all life aspects of the patient and his family that needs for supporting caregiver to decrease burden and powering coping strategies. Purpose: to evaluate the effect of family centered empowerment intervention on burden and coping strategies among caregivers of elderly patients undergoing hemodialysis.