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BackgroundRheumatoid arthritis (RA) is the most common inflammatory polyarthritis It can cause persistent joint pain, joint damage and long-term disability (especially in the hands and feet).The overall goals of management are to prevent or control joint damage, maximize function and decrease pain. The Quasi- experimental studyObjectivesTo assess patient's knowledge and practices in relation to disease and degree of self- care activities before the implementation of rehabilitation guideline and evaluate the effect of rehabilitation guideline on patient's knowledge and practice as well as on improving the activity of daily living (ADL) of patients.MethodsPatients from rheumatology department and rheumatology outpatient clinic of Assiut University Hospital. Twenty five female patients with RA, The collection of data was achieved by using three tools, tool(1) The Health Assessment Questionnaire (HAQ) include three parts, part1, include socio-demographic data about patient; part 2 Assessment of patient's knowledge and practice regarding RA, and part3, Assessment the effect of RA on ability of patient to function in activity daily living (ADL), tool(2), Michigan Hand outcome Questionnaire. tool(3) suggested measure for hand grip strength (GST-2013®).ResultsThe results of the study showed that there were highly significant statistical improvement (p<0.001) were noticed regarding knowledge about RA, and highly significant improvement regarding to total scores of common daily activity (z ≤2.58**). There were highly significant improvement related to over hand function, work performance and hands/wrist problem interference especially related to pain there were highly significant improvement (z=6.4, 4.8) in post 1 and post 2.ConclusionsBased on the finding of the study might be improve treatment in RA by manipulation of education program regarding medication, nutritional counseling, physical exercises and joint protection.Disclosure of InterestNone declared

Rheumatoid arthritis (RA) is the most common inflammatory polyarthritis It can cause persistent joint pain, joint damage and long-term disability (especially in the hands and feet).The goals of management are to prevent or control joint damage, maximize function and decrease pain. Methods: The study was conducted in the Rheumatology department and outpatient clinic at Assiut university hospital, sample including Fifty female patients with RA, divided in two equal groups. Used The Health Assessment Questionnaire (HAQ), The Foot & Ankle Disability Index (FADI) and Michigan Hand outcome Questionnaire to collected of data. The study showed that there were highly significant statistical improvement (p < 0.001) regarding knowledge, total scores of common daily activity in both groups ( z ≤ 2.58 **) , foot and ankle functional status and ADL (z ≤ 2.58 **) and regarding to over hand function , and hand grip strength .Conclusion: based on the finding of the study might be improve treatment in RA by manipulation of education program regarding medication, nutritional counseling and physical exercises. Recommendations: Establishment specialized exercises program for patients with RA should be mainly included in treatment course.

Leg or foot amputation is the removal of a leg, foot or toes from the body. The aim of the study was to evaluate the effect of applying for a rehabilitation program on knowledge, the physical and psychosocial function of patients had lower limb amputation. A convenience sample of sixty adult patients divided randomly into two groups (study group and control group). First tool "patient' assessment sheet" second tool "psychosocial adaptation tool" Results concluded that; (100%) patients in both groups had an unsatisfactory level of knowledge about lower limb amputation at the time of admission. While post-operative and at the time of follow-up; control group still had an unsatisfactory level of knowledge and most of the study group patients became having a satisfactory level of knowledge. Conclusion: providing written program for patients was much more effective on the outcome and decrease complications of patients who had lower limb amputation than those patients in the control group who received resident's oral instructions. Recommendations: a nurse rehabilitator is of great value in both vascular surgery department and the outpatient clinic and a rehabilitation program is of great importance for the amputated patients.

Continuous positive air way pressure is a first line and gold standard for obstructive sleep apnea syndromes, the aim of this study was to evaluate the effect of nursing intervention on adaptation of patients with obstructive sleep apnea syndrome with continues positive air way presser. Patient and Methods: (Quiz experimental (pre and post test) research design was conducted at the Sleep center in Chest Department at Assiut University Hospital. Sample: A convenience sample of 100 adult patients from both sexes with obstructive sleep apnea syndromes and under treatment with continuous positive air way pressure. Data collection Tools: 3 tools were used including I: Patients' interviewing questionnaire sheet. II: STOP-BANG questionnaires. III: Respiratory disturbed index. Results: The study findings revealed that all of studied patients had obstructive sleep apnea syndromes, moderate or severe. All, of patients not know the benefit and effect of continuous positive air way pressure. But, after application of the nursing intervention the patient's level of knowledge about its important, using and caring of the machine by the patients improved. Conclusion: After the application of nursing intervention about the important of machine, the feeling of discomfort with the machine and mask are improved, number of normal sleeping hours increased with improvement of respiratory systems work.

Urinary diversion operations (urostomy) patients require a great deal of emotional and physical adjustment. They usually face many problems such as loss of body function and relationship with others, and change in lifestyle. They need to adapt to the external appliance, stoma alteration in toileting habits, skin irritation problems, infection, and odor problems. Selfcare for these patients is considered the most important factor that can minimize the complaints and complications. The aim of this study was to evaluate the impact of nursing intervention among urostomy patients regarding practicing self-care. The sample comprised 100 urostomy patients, divided into two groups: 50 study, and 50 control. For both groups, patients' knowledge about urostomy and related self-care performance were assessed before intervention, immediately after, and after six-months follow-up at outpatient clinic. Data were analyzed using Epi-info 6.04 computer software package. Findings revealed statistically significant improvements in knowledge and performance among patients in the study group, compared to the control group. The study group became more knowledgeable about the definition, function, anatomy, and physiology of urostomy, and in self-care performance. The rates of complaints and complications were found to be lower in the study group than in the control one. The study suggests that urostomy patients should receive their self-care training regarding urostomy during hospitalization. Follow-up at outpatient clinic is highly recommended as well.

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