Background: One of the greatest challenges that will face health systems globally in the twenty-first century will be the increasing burden of chronic diseases. Chronic diseases are one of the most important barriers that have a direct and negative impact on health promotion for women. Aim of this study was to identify the barriers to health promotion activities for women with chronic disease. Subjects and methods: A cross-sectional study design was utilized to achieve the aim of the current study. Setting: This study was conducted in primary health care centers and outpatient clinics of governmental hospital located in Port-Said City. Subjects: Purposive samples of 744 adult women who surfing from chronic disease. Tools of data collections: two tools were used to collect data. Tool I: A structured questionnaire sheet. Tool II: Barriers to Health Promoting Activities for Disabled Persons Scale (BHADP) obesity was determined based on body mass index (BMI). Results the majority (79.4%) of the study sample had high level barrier of health promotion. the five highest leading barriers items were: Embarrassment about my appearance; Lack of support from family, friends; Lack of help from health care professionals; Bad weather and; No one to help. 38.6%) of women who have a high score of levels of Health Promotion Barriers' suffering of Diabetes Mellitus. There was a strong significant correlation between the levels of Health Promotion Barriers' and body mass index, level of education and duration of chronic disease with p-value ≤ 0.001. This study concludes that women with chronic diseases had a high score of health promotion barrier. The study recommends a greater emphasis on assessing and managing perceived barriers to health promotion activities in health education and policy development and proposes a conceptual model for understanding perceived barriers to action.

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Hemodialysis now is an important and standardized treatment that is used as a life-saving treatment for more than 800,000 people worldwide who have end-stage renal disease. Protecting patients from adverse events at hemodialysis units is fundamental responsibility of all health team generally and nursing especially. Aim: To evaluate the effect of nursing instructions on nurses' knowledge, practice and suggestions regarding adverse events in hemodialysis. Research design: A quasi experimental design was utilized. Setting: The study was conducted in hemodialysis unit at King Khalid Hospital in Hail City; Kingdom of Saudi Arabia. Sample: Convenient sample of 26 nurses working in hemodialysis unit. Tools: First; Self-administered nurses' knowledge questionnaire; Second; Safety and quality observational checklist in hemodialysis session. Results: There was a statistical significant improvement between levels of nurses' knowledge and practice before and after nursing instructions, no relation between levels of nurses' knowledge and their levels of practice post nursing instructions and there was a difference in nurses' suggestion ranks regarding adverse events prevention pre and post nursing instructions. Conclusion: Implementation of nursing instructions regarding adverse events in hemodialysis was effective in improving the level of nursing knowledge and practice. Recommendations: Applying nursing instructions in other places with a large sample to enhance and confirm the current results.

Gastro-esophageal reflux disease (GERD) is a chronic disease defined as the ascent of the gastric content that causes symptoms or structural damage of the esophageal mucosa. In GERD, lifestyle modification plays a key role in prevention or treatment and appropriate modification is recommended as the first step in therapeutic system. Aim was to evaluate the effect of lifestyle modification sessions on knowledge, self-management and physical symptoms of patient with Gastro-esophageal Reflux Disease. Research design a quasi -experimental design was used. Setting was conducted in medical outpatient clinics of governmental hospital located in Port-Said City; Egypt. Sample A purpose sample consists of (64) adult new patients Random al location technique used to divide the sample into control (32) and study group (32). Tools: four tools were used for data collection1) Patient's interview questionnaire; 2) The Gastro-esophageal Reflux Disease Questionnaire; 3) The Gastro-esophageal Reflux Disease Questionnaire: it adopted questionnaire and 4) lifestyle guidelines success indicators Sheet. Results: revealed that there was statistical significant improvement of knowledge, self-management and physical symptoms among study group who received life style modification sessions than in control group. Conclusion & recommendation: The results of the study showed the effectiveness of the lifestyle modification sessions in improving the self-management of GERD patients and the physical symptoms of the disease through improved patient knowledge of the disease according to their needs. Therefore the study recommends the guidelines addressed as part of the medical management approach.