Background: Sickle cell anemia (SCA) is a hereditary chronic genetic blood. Aim: To evaluate the impact of nursing instructions protocol on health promotion life style for patients with sickle cell anemia. Research design Quasi-experimental research design. Setting: New Valley (El Kharga general hospital). Patient and Methods Thirty adult patients with sickle cell anaemia. Tools: "Structured interview patient questionnaire". Tool (II): Health promotion Model-Instruments to measure health promoting lifestyle. Results: More than half of the studied sample was male with mean age (27.96±8.84). There was a highly statistically significant difference in the Patients' health promotion was increased after the implementation of the booklet; particularly in the areas of the health responsibility, physical activity, nutrition and Non-significant difference in interpersonal relations. Conclusion: The study findings supported all research hypotheses as it had been proven that the nursing instruction protocol had statistical significant effect on minimizing pain and improving health promotion lifestyle. Recommendations: It is important to educate patients about how to modify life style to healthy life, relieve and manage sickle cell anemia complications.

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Background and objectives: Ascites is a condition of pathologic fluid collection within the abdominal cavity. The aim was to evaluate the impact of designing nursing instructions on knowledge and activity of daily living for cirrhotic patients with ascites. Research design: Quasi experimental (Pre / post-test). Setting: Tropical Medicine and Gastroenterology Department of Al-Rajhi Liver Hospital. Sample: A purposive sample of sixty male and female adult patients diagnosed with ascites due to liver cirrhosis. Tools: Tool (I): A structured interview questionnaire. Tool (II): Activity of daily living scale. Results: A statistically significant difference between pre, post 3 month and 6 month of implementing the designing nursing instruction regarding patient's knowledge and activity of daily living with p-value <0.01. Conclusion: A great improvement in patient's knowledge and independently in performing activity of daily living post the implementation of the designing nursing instructions than pre assessment. Recommendation: Patients should be provided with sufficient relevant written information to remind them about what they can do to cope with their disease.

Inguinal hernia is a common type of hernia in which a loop of the intestine protrudes directly through a weak area of the abdominal wall in the groin region. This study aimed to assess the effect of nursing guidelines on patients undergoing inguinal hernia repair outcomes. A study was conducted in the general surgical departments at Assiut University Hospital. A consecutive sample of (60) patients was obtained. This sample was divided into study and control group (30) each. Tools utilized for data collection were interview questionnaire sheet and patients' evaluation sheet. Results showed that all the studied patients were male, aged above (30) years, married, manual workers and smokers. The level of patients' knowledge in study and control group preoperative was unsatisfactory (100%) while before discharge level of knowledge for study group was satisfactory (67.7%), also the level of complications decreased in study group than in control group. Conclusion: level of knowledge for patients who take designed nursing guidelines was higher than who didn't take any designed nursing guidelines also level of complications was lower in study group. Recommendation: each patient is given booklet include designed nursing guidelines about inguinal hernia disease and surgery .

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.