Gout is the most common inflammatory arthritis today, affecting 4% of the adult US population. It is a serious disease that can significantly affect physical function and quality of life (QOL), where it has been advocated as an important outcome domain in studies of chronic gout. Aim of the study: To assess factors affecting quality of life and work productivity among patients with gout. Descriptive design: Was used to conduct the current study in rheumatology outpatient clinics, at Benha Teaching Hospital during the period from beginning of March 2018 till the beginning of September 2018. Subjects: Purposive sample of 168 patients recruited according to the study formula based on the total number of patients who admitted to the study settings during 2017. Tools: Three tools were utilized for data collection, structured interviewing questionnaire sheet, Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) and Work Productivity and Activity Impairment Questionnaire. Results: Showed that both QOL as well as work productivity and activity impairment were best predicted by pain severity, diet aggravating frequency of attacks, nature of work as well as age. Besides, there was a negative and significant correlation (p= <0.001**) between quality of life and work productivity and activity impairment. Conclusion: Factors affecting QOL and Work productivity and activity impairment among patients with gout were concerning pain severity, diet aggravating frequency of attacks, nature of work as well as age. Besides, the impairment on different aspects of life is often negatively associated with impairment in work productivity and activity, where they were mainly affected by gout. Recommendation: Health educational instructions is required regarding pain management and diet regimen for patients with gout.

Context: Systemic chemotherapy plays a pivotal role in curative therapy for patients with hematological neoplasms and several types of advanced solid tumors. Extravasation describes an anticancer agent's accidental leakage from a vessel into the surrounding tissues, leading to irreversible local injuries and severe disability. Despite its considerable clinical importance, evidence-based information on extravasation in chemotherapy is lacking. Aim: This study aimed to evaluate the effect of an educational program on nurses' performance regarding the prevention and management of intravenous extravasation chemotherapy. Methods: The following hypotheses were formulated to achieve the study aim. H1: Nurses' performance related to the prevention and management of intravenous extravasation chemotherapy will be improved after implementing the educational program compared to the pre-program. H2: There will be a significant correlation between nurses’ knowledge and practice post-program implementation. A quasi-experimental research design was utilized to conduct the current study in the oncology unit at Benha University Hospital. A convenience sample consisted of all available nurses (n=40) working in the oncology unit were recruited to achieve the aim of this study. Two tools were used, the nurses' knowledge assessment questionnaire and the nurses' practice observational checklist regarding the prevention and management of intravenous extravasation chemotherapy. Results: This study shows that most nurses had an unsatisfactory level of total knowledge and inadequate total practice regarding the prevention and management of intravenous extravasation chemotherapy pre-program implementation (85% and 56%). This result improved significantly regarding all knowledge and practice elements immediately post-program implementation, where the majority of the nurses had a satisfactory level of their total knowledge and adequate total practice (95% and 94%) that was slightly decreased three months after program implementation (75%) for both knowledge and practice. Conclusion: The majority of the nurses surveyed had an unsatisfactory performance level (knowledge and practice) concerning the prevention and management of intravenous extravasation chemotherapy pre-program implementation. In contrast, most of the studied nurses had statistically significant improvement in their performance immediately and after three months from program implementation, which supported the current study hypotheses. The study recommended continuous in-service training programs and establishing guidelines to help the oncology nurses revise, acquire, and develop their knowledge and practice regarding preventing and managing intravenous extravasation chemotherapy.

Background: Traumatic Head Injury (THI) is a disruption in the normal function of the brain that caused by a blow or jolt to the head. The role of critical care nurses is a vital at the acute care by giving priority of the immediate assessment, stabilization of the airway and circulation and prevention of secondary injury. The aim of this study was to evaluate the effect of an educational program on the nurses' performance and health outcomes for patients with traumatic head injury. Study design: A quasi-experimental design was used. Settings: This study was conducted in the emergency unit and the emergency intensive care unit at Banha University Hospital. Subject: A convenient sample of (50) registered nurses caring for patients with THI and (50) patients with THI were included in the study. Tools: Three tools were used for data collection; I-self-administered questionnaire tool, II-the nurses' practice observational checklist and III-patients' health outcomes assessment. Results: All of the nurses had unsatisfactory knowledge and practice regarding caring for patients with THI pre-program implementation which improved immediately post program implementation (30% and 24%), respectively. The mean of the studied patients regarding total trauma scale pre-program implementation was 16.89  10.61 that improved immediately post program implementation 13.24  12.08. Conclusion: There was a highly statistical significant improvement in the level of nurses' performance and health outcomes for patients with THI after implementation of the educational program. Recommendations: The importance of continuous in-service training programs about THI for refreshing and updating the nurses' knowledge and practice regarding THI.

Background: Palliative care is specialized medical care for advanced cancer patients which focus on improving quality of life and patients' satisfaction by reducing their pain. Aim of study: Was to evaluate the effect of palliative care protocol on cancer patients' outcomes. Design: A Quasi-Experimental research design was utilized to conduct the study. Setting: This study was conducted at outpatient palliative care clinic and inpatient oncology unit in Benha University Hospital and National Cancer Institute in Cairo. Subjects: Convenient sample of 100 adult cancer patients of both sexes were recruited. Tools of data collection: Three tools were used to collect data included; I: Patients' assessment questionnaire regarding to their demographic characteristics, medical history and knowledge. II: Pain assessment. III: Patient's satisfaction. Results: There were high statistically significant improvements in patients' knowledge on 2nd and 4th week post palliative care protocol intervention about cancer and palliative care. Also, the pain intensity of the studied patients reduced on 2nd and 4 th week post palliative care protocol intervention with high statistically significant differences in their behavior and satisfaction. Conclusion: Implementation of palliative care protocol for cancer patients had improved their health outcomes with significant improvement in their level of knowledge, satisfaction and pain. Recommendations: Applying ongoing a palliative nursing intervention among cancer patients to help them manage pain and reduce symptoms.

Background: Self-foot reflexology is effective in patients with type 2 diabetes mellitus (T2DM) by reducing symptoms of peripheral neuropathy, as numbness and pain, tingling and stimulate the circulation of blood to the feet directly which help in reducing the loss of sensation to the foot. Aim of study: Was to evaluate effect of foot reflexology technique on diabetic neuropathy patients' health outcomes. Design: A quasi-experimental design will be utilized to achieve the aim of this study. Setting: The study was conducted at inpatient and outpatient internal medicine department at Benha University Hospital. Subjects: A Purposive sample of 95 patients in the previous mentioned setting. Tools of data collection: I: Structured questionnaire assessment which composed of demographic data of patients, medical health history and neuropathy specific quality of life. II: Clinical base data assessment which composed of modified neuropathy sensory disability scale, blood glucose level and peripheral circulation test. Results: All (100%) of studied patients aged between 45-≤60 years old, all items of neuropathy-specific quality of life, modified neuropathy sensory disability, peripheral circulation and blood glucose level were improved post reflexology intervention for 90%, 87%, 72% & 60% of studied patients, respectively compared with pre-reflexology intervention with significant difference p≤0.01. Conclusion: Reflexology intervention is endorsed in improving QOL, diabetic peripheral neuropathy sensory, lowering blood glucose level and improve peripheral circulation of the diabetic neuropathic studied patients. Recommendations: Increase public awareness about efficacy & tolerability of foot reflexology in improving health outcomes as quality of life, sensation, blood glucose level and peripheral circulation of diabetic neuropathic patients.