Background: Hepatic encephalopathy is a neuropsychiatric complication associated with liver cirrhosis. It occurs in up to 80% of patients with cirrhosis. Aim: To evaluate effect of nursing teaching guidelines on patients' knowledge regarding minimizing hepatic encephalopathy. Research design: Pre/post-test research design was utilized. Setting The study was conducted at Tropical Medicine and Gastroenterology department at El-Rajhi liver Hospital. Subjects and Methods: Thirty adult patients with liver cirrhosis. Tool: Structured interview questionnaire was utilized for data collection with three parts (sociodemographic, medical data and pre/post knowledge questionnaire). Results: The present study revealed that there was a highly statistically significant difference in the level of knowledge before, immediately post and after three months from application of nursing teaching guidelines. There was no statistically significant relation was documented between patient's knowledge and occurrence of hepatic encephalopathy, ascites and bleeding after three months from application of nursing teaching guidelines. Conclusion: It was concluded that level of knowledge regarding minimizing hepatic encephalopathy was improved after application of the nursing teaching guidelines. Recommendations: A written teaching guidelines hand book in simplified term should be available and distributed for cirrhotic patients about preventive measures of hepatic encephalopathy.

Back ground:Peptic ulcer is an excavation that forms in the mucosal wall of the stomach, pylorus, duodenum and in the esophagus. Tele-nursing has a great contribution to ensuring continuity of care for patients following hospitalization. Aim: To evaluate effect of tele-nursing instructions on adherence to therapeutic regimen and improving symptoms for patients with peptic ulcer.Patients and Methods: Research design: Aquasi experimental research design (study and control). Setting: Tropical Medicine and Gastroenterology department at El -Rajhi liver Hospital at Assuit University hospital .Sample:A purposive sample of 60 male and female patients diagnosed with peptic ulcer.Tools: Tool (I):Patient's assessment sheet.Tool II: Morisky Medication Adherence Scale (MMAS-8).Results: Statistically significant difference in adherence level of study group before and after telenursing instructions (2.03±1.67&6.93±0.91) respectively. While in control group there was no statistically significant difference in adherence level (2.13±1.38& 3.6±1.43).Also , there was improving in symptoms for patients with peptic ulcer among study group than control group after applying tele-nursing instructions.Conclusion:Telenursing instructions improved adherence level of patients to therapeutic regimen and improved symptoms for patients with peptic ulcer Recommendations: Further studies aimed at improving patient adherence using telenursing strategiesf or patients with peptic ulcer should be applied.

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Background: Hepatic encephalopathy is a common complication occurs in 30-70% of cirrhotic patients. Aim: To evaluate effect of patient's compliance with nursing instructions on minimizing hepatic encephalopathy. Research design: Quasi-experimental design. Setting: Tropical Medicine and Gastroenterology department at El -Rajhi liver Hospital in Assuit University Hospital. Patients and Methods: Sixty adult patients child B or C liver cirrhosis. Tools: I: Structured interview patient questionnaire. II: Compliance assessment questionnaire. III: West-Haven criteria.Results: There was a statistically significant difference between study and control group patients regarding severity of hepatic encephalopathy through three months (p<0.005) and a highly significant relation was documented between compliance of patients with nursing instructions and severity of hepatic encephalopathy (p<0.001). Conclusion and recommendations:Hepatic encephalopathy was minimized among patients who complied with nursing instructions. Simplified illustrated and comprehensive Arabic language instructions hand book should be available for patients about preventive measures of hepatic encephalopathy.