Needs assessment of children undergoing hemodialysis therapy

The renal failure children are at risk of several problems and complication due to renal failure and hemodialysis. The aim of the present study was to assess the needs of children under going hemodialysis therapy and asses factors that affect the daily living activities of those children under regular hemodialysis. The present study was carried out at two Hospital; Hemodialysis pediatric units of Benha University Hospital and Teaching Hospital in Benha City in Kaluobia Governorate. This study included one group of 80 patients on regular hemodialysis. Their age ranged from 4 to 16 years. The actual work of the current study started by an initial pilot study that was applied randomly on 10 children to test feasibility, clarity and objectivity of the tools and accordingly some changes were done in the tools to suitable for the subjects. Data collected through a period of 3 months. The study demonstrate that children's ranged between 4-16 years old, and more than half of the sample [61 .25%] of the sample were female and 38.75% were male. Regarding the education, 63.75% of the sample was illiterate. Regarding the number of dialysis week. It was found that all children [100.0%] were under regular dialysis three timed week. Regarding the disease associated with dialysis it was found that the highest percentage [63.75%] of children had heart disease followed by hepatitis [30%], while the lowest percentage [6.25%] of them had hypertension. The present study revealed that more than half of the sample [61.25%] undergoing hemodialysis had correct knowledge about concept of renal failure. While 52.5%, 47.5% of them don't know causes and complication of renal failure. It was found that 80.0% of the children undergoing hemodialysis therapy through fistula, While [20.0%] of them through catheter. It was noticed that 32.5% of children don't care their fistula site. As regard changes of children before dialysis that represented that [47.5%] was fatigue, while about [20.07] didn't have any changes. It was found that [63.75%] of children was active after dialysis. The study showed that 42.5% of children suffer from signs of depression, and also it was found 47.5% of children tired, 11.3% of them were anxious. The study showed that 60.0% of children visit their friends and relatives; while 40.0% of them faced problems when visit their relative. Also growth retardation is a major complication of children under going regular hemodialysis and was found about 72.5% of them had growth retardation. About 12.7% of the children exposed to bleeding, while 11.2% of children expose to infection through the dialysis units. The study showed about 16.3% of children was eating all type of food without any restriction. The present study revealed that 63.7% of children didn't going to school because the time of dialysis. It was found that 82.5% of children are suffering from difficulties in learning, while 12.5% of them had lack of concentration and also about 5.0% had lack of recall. From the present study all children need knowledge about renal failure and hemodialysis. Accordingly, they need to be adapted with the disease physically, socially and psychological we should emphasize on the importance of early intervention program for children under haemodialysis and their parents

Assessment of nurse's role regarding care of children with beta-thalassemia

Thalassaemia is the most, chronic hemolytic anemia in Egypt the estimated incidence of thalassemia heterozygote ranges between 5.6 to 9%. In recent studies over 1000 children affected with beta-thalassemia are expected to be born out of 1.5 million live births per years in the country. This high rate of affected individuals posses a significant public health problem. Nurses play an important role in nursing care of children with beta-thalassemia. The aim of this study was To assess the nurse's knowledge about children with thalassemia and assess the current nursing care given to children with thelassemia. The study was conducted at Benha University Hospital and Benha Specialized Children Hospital. consisted of all nurse's working at the previously mentioned settings [total 100] nurses, data collected by using a questionnaire and Observation check list to observe the actual nursing care given for children during blood transfusion therapy, intravenous therapy, measuring of vial signs and blood pressure. A pilot study was carried out during January 2007 to February 2007, to test the applicability of the tools; it was applied randomly on 10 nurses. The result of the data obtained from the pilot study helped in modification of the tools items were then corrected and necessary changes were then introduced as revealed from pilot study such as adding question about source of nurses information about children with thalassemia. The study reported 71.4% did not attend any training programs in care of children with thalassemia Nurses had poor knowledge about thalassemia 52% of the nurse had poor knowledge about treatment of thalassemia. Nurses were incompetent during blood transfusion therapy. The present study revealed that there was statistical significant correlation between nurse knowledge and their performance. The present study revealed that there was statistical insignificant difference between nurse knowledge and their characteristic. The present study revealed that there was statistical significant difference between nurse's performance and their characteristic. The majority of nurse's had poor knowledge and incompetent practices as regards care of children with thalassemia. So in service training program is an essential for continuous updating nurse's knowledge and performance about care of children with thalassemia and Staff nurse should be attained periodically in service and training program