Background: Stroke is one of the major healthcare challenges, being one of the leading causes of death, disability, and dependency in the activity of daily living worldwide Homecare of stroke patients is having a great role in the patient recovery. Patient family caregivers and relatives can play an important role in the care of patients. But how to continue proper care of the patient at home after discharge, they don't know what to do and don't have practice as well. In this view, the researcher believes that it might be a great help for caregivers and the patients to teach theirs about stroke and home care of stroke patients. Objective: The study aims to evaluate the effectiveness of a planned health teaching on the caregiver's knowledge and competence of home care of stroke patients. Therefore, improve the patients' functional ability. Methods: The two group pre and post-test, quasi-experimental design was conducted among 50 caregivers of stroke patients, assigned to 25 caregivers as a control group and 25 caregivers as an experimental group. The study was done in the university hospital at El Fayoum city from 1st March 2019 to 31st August 2019. Four tools were used for data collection after reviewing relevant data as the following; a structured interviewing questionnaire, caregiver's knowledge questionnaire regarding stroke, caregiver's practices regarding bed position, Position Change and Transfer, and Range of Motion Exercises, and patient function ability assessment according to Barthel index. Results: revealed that there was a poor score level of knowledge and competence of home care practices before the intervention. However, there was an improvement of score level in the control and experimental group post-intervention, but the higher score was observed in the experimental group. The mean score level of patient functional ability in the experimental group improved than the control group through follow up. Highly statistical significance was found between control and experimental group post-intervention related to knowledge and practices. A positive significant correlation between caregiver's practices and patients function ability in the experimental group was found. Conclusion: planned health teaching is important after patients discharge to increase the caregiver's knowledge and competence of home care practices of post-stroke patients; resulting in improved patient functional ability.

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Background: Palliative care is defined as a treatment given to control pain and undesirable symptoms of chronic or serious illnesses where there is no reasonable anticipation of a cure for patients. Determination patient and early referral to palliative care decrease suffering and improve symptom management in these patients; also it can reduce overall health care utilization and costs if initiated early in the disease course. Aim of the study was to evaluate the effect of Palliative Care Plan On end-stage renal disease Patients Undergoing Hemodialysis. Study design: A quasi-experimental design was used in the conduction of this study. Setting: This study was carried out at hemodialysis unit at Alazhar University Hospital at new Damietta city. Subjects: A convenient sample of 35 patients. Tools of Data Collection: The following tools were used to collect the necessary data:1) Structured interview sheet, 2) Self-care questionnaire, 3) Dialysis symptom index, and 4) Palliative care plan. Results: increased total mean score of patients knowledge and practice t ,with highly statistically significant differences at pre vs post test& pre vs follow up test (p <0.01) for both tests. Conclusion: the palliative care plan had positive effect in decreasing and control severity of those symptoms in patients undergoing hemodialysis. Recommendations Dialysis units should equipped by palliative care programs. Set up a counseling room in hemodialysis

Background: Tai Chi (TC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. Objective: The aimed of the study is to evaluate the effects of Tai Chi exercise on physiological and psychosocial well-being during adjuvant chemotherapy among breast cancer patients. Methods: A purposive sample of 70 patients undergoing chemotherapy diagnosed of breast cancer. Quasi-experimental design was utilized to conduct this study at the outpatient clinic regarding breast cancer with chemotherapy health insurance (Alfardose Clinic) Mansoura, Egypt. A structured interviewing questionnaire included patient demographic and medical data, psychological changes associated with chemotherapy and Hospital Anxiety and Depression Scale to assess Well-Being were used as a tool for data collection. Results: There were highly statistically improvement in studied samples' regarding drowsy, tiredness, depression and worry symptoms post and follow up of implementation Tai Chi Exercise. Conclusion:The participants of the study felt that Tai Chi had been greatly beneficial to them, both in terms of improving physiological and physical well-being. Recommendations: Tai Chi Exercise should be applied to all breast cancer patients undergoing chemotherapy because of its effectiveness in improving the physiological and psychological status after implementing the program.

Background: Endoscopy is a nonsurgical procedure used to examine a person's digestive tract. Using an endoscope, a flexible tube with a light and camera attached to it, the doctor can view pictures of the digestive tract on a color TV monitor. Aim of this study was to evaluate impact of application of nursing guidelines on health outcomes for patients undergoing gastrointestinal endoscopes. Subjects and methods: A quasi-experimental research design was used. A convenient sample was used; it includes all nursing staff working with patient undergoing GI endoscopy (40 nurses) and 240 adult patients. This study conducted at GI endoscopy unit at Al-Azhar University Hospital at new Damietta city. Three tools used for data collection. Tool (1) is a pre/post-patient structured interview. Tool (2) is a pre \ post nurse structured interview. Tool (3) is an observational check list for nurses' practice. Results, show a significant improvement in the nurses' knowledge and practice scores after nursing guidelines implementation regarding the care of patients with GIT endoscopy at (p-value = 0.00, 0.02 & 0.04) respectively. Positive significant correlation between nurses' knowledge and practice before and after guidelines implementation in the following items (general preparation-pre-procedure) post procedure items and total practice score. Conclusion, there was significant improvement in nurse's knowledge and practice about care of patients undergoing GI endoscopy after implementation of nursing guidelines. As well as improving patient outcomes. The study recommended that Continuous and adequate education and training of nursing staff working at gastrointestinal endoscopy units with regular and continuous evaluation of nurses' practice.