kufa Journal for Nursing sciences

Objectives: The study aims to assess the patients' health related quality of life and find out the association between the gender, age, marital status, educational level, employment, body mass index, severity of disease vessels, and number of implanted stents with health related quality of life.
Methodology: descriptive study design is starting in October / 2nd. /2012 to the 30th/ July/ 2013 was carried out at Iraqi center for heart diseases, Ibn Al-Nafees for cardiac surgery hospital and Ibn- Al-Betar specialist center for cardiac surgery in Baghdad City. purposive (non-probability) sample consist of 100 patients collected through interview method by using questionnaires composed of two parts, first part composed of demographic and medical history data and second part includes short form 12 item health survey scale to measure health related quality of life. Reliability of the questionnaires was determine by calculating Cronbach s' Coefficient alpha = .882. Descriptive data analysis was done through frequency, percentage mean, standard deviation and relative sufficiency and inferential data analysis was done by contingency coefficient.
Results: The results of the present study revealed that the patients have low level in quality of life for the general health and vitality domains, moderate level in quality of life for physical function, bodily pain and mental health domains, and high level in quality of life for role physical, role emotional and social health domains after percutaneous coronary intervention, and the findings revealed there were significant association between age and physical function and role physical; marital status and general health, bodily pain and vitality; level of education and general health at P-0.05 value.
Recommendations: According to present findings the researcher recommends to prepare educational program related to quality of life domains for patients after PCI .

Objective(s): The study objectives are to evaluate of nurses' practices concerning chest pain management that are provided for patients in the emergency unit and to finding out the relationship between the nurse's practices and the demographic characteristics that includes (age, gender, level of education, years of experience, and training session).
Methodology: A descriptive study which was using the quantitative design. The study was conducted at the Medical City/ Baghdad Teaching Hospital; Al-Karama Teaching Hospital, and Al-Kindi Teaching Hospital Starting in Sep. 2nd 2012 up to the 15th of April 2013. To achieve the objectives of the study, A non-probability (purposive) samples of (70) a nurse who was consisted of all nurses who provide emergency nursing care for patients which suffering of chest pain and according to special criteria. Data were collected by an application of direct check list observation as a means of data collection. Nurses were observed while they are working in the emergency unit during the day. Instrument validity was determined through content validity, by a panel of experts. Reliability of the instrument was determined through the use of Pearson correlation coefficient for the researcher and co-observes reliability approach, which was (0.85). Analysis of data was performed through the application of descriptive statistics (frequency, percentage, mean of score, Relative sufficiency) and inferential statistics (Chi-square (X2) test).
Results: The results of the study indicated the evaluation of the mean of scores and relative sufficiency for nurse's practices to management of chest pain for patients in the emergency unit was out of comparison and there is no significant association between training session of sample and nurses' practices scores. While there is high significant association between ages, gender, level of education, years of experience in emergency unit and nurses' practices.
Conclusion: The study concluded most of nurses that work in emergency unit have inadequate practices to manage chest pain.
Recommendations: The study recommends to prepare special training programs for nurses in this area to reinforce their practices and promote their experiences and providing opportunity for nurses in emergency unit to continuing updating their education to maintain knowledge and practices.

Background: The nature of the nursing profession requires professionals who are confident, responsible, motivated and able to work and respond independently in a changing health care environment (Garrison 1992). Hence, the trend in nursing education has moved towards an adult approach to teaching in which students must be self-directed to be able to meet the new challenges. Self-directed learning (SDL) approach is one of the programmers which has been established based on adult teaching approach. SDL does not only provide a means for effective learning of knowledge and skills but also serves as a vehicle for enabling nursing students to acquire and develop independent learning skills; as well as develop a sense of accountability and responsibility that equips them with the essential attributes they require for their future nursing career.
Objective: The overall aim of this review is to evaluate the effectiveness of self-directed learning on the professional development of pre-registration nursing students.
Methodology: Systematic review of the literature was conducted. A search for published and unpublished studies between 1985 and 2009 was done using all major electronic databases. A four step search strategy was devised which consisted of using different terminology and keywords to ensure that all material relevant to the review was captured. The review included randomized controlled trial and quasi-experimental studies that compared between SDL and the traditional method of teaching published between 1985 and 2009. The year 1985 was deemed appropriate because SDL has been utilized in nursing education in early 1980(s) and 1990(s) in some countries. The review included studies that addressed pre-registration nursing students. The review focused on studies that addressed SDL approach as an intervention and compared it to traditional method of teaching. Nevertheless, some Canadian studies addressed traditional method of teaching as an intervention and compared it to SDL as the predominant approach in Canada is SDL and students' were dissatisfied with this approach. Therefore, these studies were also considered as it is still compare between SDL and traditional method of teaching. A variety of outcomes measures was used to evaluate the effectiveness of SDL. These include, improvement in knowledge, psychomotor skills acquisition, students' satisfaction with SDL and problem solving skills. A total of eight papers were considered applicable to the review based on the information provided in the title and the abstract. These studies then processed to the critical appraisal process. Two independent reviewers assessed the methodological quality of the retrieved papers using Joanna Briggs Institute (JBI) checklist for experimental studies and agreed for the papers for inclusion. After critical appraisal, a total of seven papers were included in this review of which six are RCTs and one is quasi-experimental design. Data were extracted using a modified data extraction instrument of JBI. The data extracted were crosschecked by another examiner. The heterogeneous nature of the included studies prevented meta-analysis; therefore, the results of these studies presented in a narrative summary. The studies' results were grouped by themes that were pulled out of the outcomes of those studies.
Results: Most of the studies reached to a conclusion that SDL is an effective approach for learning but not more than the traditional method of teaching. SDL found to facilitate the acquisition of skills, knowledge and problem solving skills effectively. Also, it is a satisfying approach and meets students' needs.
Recommendation: The nature of nursing profession indicates that, nursing is beyond the level of knowledge and skills acquisition. It requires a mixture of different capabilities which include the confidence, responsibility, decision making and lifelong learning so it is not just limited to skills and knowledge. Therefore, since nursing programs must be congruent with today' world changes and meet the demands of adult learners, nursing schools which still incorporate traditional method of teaching, should think of introducing SDL programs for long term outcomes.

Background: A number of studies have reported a clear association between maternal overweight and adverse obstetric and perinatal outcomes. Pregnancy obesity associated with greater risk of pregnancy complications, caesarean delivery and greater birth and placenta weight. longer stay in hospital after delivery..
Objective: 1. To assess (BMI)of younger pregnant women. 2.To assess (BMI) of older pregnant women. To compare (BMI) between younger and older pregnant women.
Methodology: Non-probability (purposive sample) of (100) pregnant women (50%) of them younger and (50%) was older pregnant women, who visit Bab AL-Moadam primary health center. This study started in 15th of March 2013 to 20th of May 2013. The data are collected through the use of constructed questionnaire, which consists of two parts. part 1: consists of (3) items about demographic characteristics, part 2: consists of (2) items about Body Mass Index of younger and older pregnant women before and after pregnancy. Descriptive statistical analysis procedures (frequency, percentage ,Chi square test, T-paired test ).
Results: Revealed that the Body Mass Index of older pregnant women and younger pregnant women increase related to pregnancy but the older pregnant women were more affected by increase maternal weight more than younger pregnant women and the interpretation of these results related to the relationship between women age and their weight.
Conclusions: Body Mass Index of the women increase and this increase related to pregnancy and the age of women.
Recommendations: the study recommended that all the pregnant women should be maintenance their weight and become within normal rang to avoid the complication during and before pregnancy.

Background: Urolithiasis is one of the common health problems which endanger renal function due to ureteral obstruction and hydro nephrosis.
Objective: to assess activity of C. dactylon in dissolving urinary stone in comparison with stander drugs.
Methodology: As atrial of augmenting litholytic activity of the commonly used drugs a 20 male patients were divided into two equal groups one is control and taking amoxicillin, bicarbonate and diclofenac the second one is test group taking extract of Cynodon dactylon in addition to these agents. All patients monitored with clinical and ultrasonic findings.
Result: The results showed that 90% improvement in clinical and ultrasonic parameters noticed in test group in comparison with only 70% improvement in control group. This was statistically significant by chi square test at P < 0.05.
Conclusion: The aqueous extract of C. dactylon showed a significant improvement in prognosis of lower ureteric stones based on clinical and ultrasound findings.
Recommendation: further follow up of larger test samples of patients with lower ureteric stones is mandatory for accurate evaluation of litholytic activity of C. dactylon.

Background: Breast cancer is a life threatening disease that can affect women's sense of self-esteem, her sexuality. Globally, breast cancer is the most common cancer among women. Breast self-examination (BSE) makes women more "breast aware", which in turn may lead to an earlier diagnosis of breast cancer.
Objectives: The study aims to assess the knowledge of students at the high nursing school about the risk factors and early symptoms for breast cancer. To identify the students' knowledge about Breast Self- Examination. And to assess the practice of students for BSE.
Methodology: A descriptive cross-sectional study, conducted at the high school of nursing in Basra city during December 2012. The study sample included 210 students. Self-administered questionnaire was used to gather information about socio-demographic characteristics, knowledge of students about risk factors and symptoms of breast cancer, breast self-examination knowledge, and BSE practice.
Results: More than half of the students had were a poor knowledge about breast cancer risk factors and presentations, only (15.7%) had a good knowledge. It was reported (79.5%) of them she know that the exposure to radiation is a main risk factor. While (76.7%) of the sample agree that family history one of the reasons for breast cancer. In addition (67.6 %) of the sample did not agree that breast cancer can happen with women who never breastfed a child. High school of nursing students had insufficient knowledge about breast self-examination and the main source of information was the media as reported by (36.3%) of the students, (32.9%) of the students mentioned that breast self-examination should be practiced monthly, (55.2%) of them knew the right way to carry out breast self-examination. Regarding BSE practice (14.8%) of students reported that they had performed breast self-examination monthly. The most common reason for not doing breast self- examination was (not knowing how to perform it) as reported by (31.4%) of the participants followed by having no symptoms (29.9%). There was a significant relation between breast self-examination practice and knowledge about breast cancer and knowledge about breast self- examination.
Conclusions: Nursing students have poor knowledge of breast cancer and its associated risk factors. Students were not also so familiar with practicing BSE.
Recommendations: 1- Construct course teaching and practical program for the students in course curriculum to increase their knowledge about breast cancer, and BSE. 2- Schedule visiting to BSE center for the students and their teachers to increase their knowledge and skills in examination of the breast and to encourage them for practicing BSE

Background: It has been recognized for more than 40 years that patients experience different levels of anxiety when faced with impending surgery. The degree to which each patient manifests anxiety is related to many factors.
Objective: This study aims to identify the effect of age and previous surgery experience on preoperative anxiety.
Methodology: For the purpose of this study a sample of 200 patients who were admitted in 5th April 2009 to the 10th November 2009; in general surgery units of teaching hospitals ( Rezgari & Hawler ) in Erbil city were interviewed to assess their level of anxiety before surgery and identify effect of age and previous surgery on anxiety. The instrument used for this purpose was a questionnaire that included socio-demographic information and the State-Trait Anxiety Inventory (STAI) of Spilberger. STAI is a validated scale which includes 20 items related to measurement of state anxiety. High scores indicate high levels of anxiety.
Results: Most of the patients showed moderate to severe anxiety level; (moderate=50% and severe=38.3%) others showed mild anxiety level (11.7%). A statistically significant relationship was seen between age and previous surgery experience before surgery. Young patients with first surgery experience showed higher level of anxiety.
Conclusions: According to the results of the study patients undergoing major surgery need to be assessed regarding level of anxiety before surgery. This anxiety should be reduced through appropriate interventions, especially in young patients with no previous surgery experience that have been found to experience high levels of anxiety.

Objectives: to assess the efficacy and safety of combined Deferoxamine-defeosiraxregime and deferasiraox alone in group of thalassemia major patients
Methodology: Forty two patients studied for one year, 29 patients of Deferoxamine (20mg/kg/day infusion, two days /week) and Deferasiraox. Efficacy of both regimes assessed by serum ferritin. safety assessed by liver enzyme, creatinine and blood urea.
Results: Those patients who were on Deferasiraox alone showed significant them chosen for deferasiraox (40 mg/kg/day), 13 patients combined therapy reduction of serum ferritin (4482), to mean of serum ferritin (3132±336) range (595-8743 ng/l). The study clarified no significant changes in liver enzymes and blood urea, fortunately decline in (ALT), from mean value of (82_+16IU), to mean value (56_+6IU).
Conclusion: combined Deferosirax-Desferoxamine therapy is effective regime to maintained negative iron balance owing to more time iron chelation coverage, and acceptable compliance.
Recommendation:-more clinical trial therapy needs to be done on larger group of patients, and for longer period of time to insure the safety of combined therapy. Deferasirox till now proved to be effective and safe enough to be used with great deal of compliance for patients with iron over load.

Objective: Our objective to assess the prevalence complications & their association with health & functional status
Methodology: Analyses complications of thirteen patients underwent autologous bone marrow transplant in June 2008 to December 2010 at bone marrow transplant specialty center in Baghdad Medical City; data were derived of daily follow-up and record to all clinical and medical information's.
Results: No statistically significant association was found between ages with gender, also clinical diagnosis with gender, & number courses of chemotherapy with clinical diagnosis (P-0.05). Especially (53.84%) were males which more than females (46.15%), the patient's age in the study was between with mean of 22-27 yrs. (53.84%) married, (30.76%) student, positive family history toward malignant disease in (61.52%), Non-Hodgkin Lymphoma diagnosed in (53.84%), 3 courses chemotherapy receiving in (38.46%), harvested stem cell was peripheral stem cells in (61.52%), week engraftment present was in 4 weeks in (53.84%). Statistically significant association was found between clinical diagnoses with source of stem cells (P-0.05). mucositis was in grade 4 in (60%). The cumulative prevalence of any complications underwent transplant was above cut-off point, mean of score was (2) headache, depression, change in test, dry mouth, oral bleeding, hair loss, fever, and (1.92) nausea, vomiting, (1.76) anorexia, flushing skin, while (1.61) constipation.
Recommendations: the study recommended preparation health education program for patients and nursing staff to give best nursing care for bone marrow transplant patients and how communication with them, & booklet provided for all patient show how to oral hygiene and personal hygiene to reduce risk reduction.

Objective: The aim of the study to determining the women's knowledge regarding contraceptive, and to identify the relationship between women's knowledge and Socio-demographic characteristics (Age, educational level, residence and employment).
Methodology: A descriptive study design was conducted to achieve the objectives of the study. The study was carried out in the antenatal care unit of Al-Quads primary health care center in the Mosul governorate / Iraq during 2010. A random sampling consist of 62 women in age group between (15-44) years. Data were collected by using questionnaire through an interview technique. The data were analyzed by using the statistical package for social sciences program.
Results: The results shows that the most of the study sample was used medical methods in the process of family planning (51.61%), and women's knowledge are good towered the family planning and mean of women's knowledge (1.66). The results revealed that there are non-significant deference between women's knowledge and some demographic characteristics except the educational level.
Conclusion: The researchers concluded that the women's knowledge regarding family planning generally were good, and there are no significance difference between women's knowledge and their demographic data except educational level.
Recommendations: The researchers recommended that increase use of communication channels with community, such as publications and audiovisual material. This can have a great impact in enhancing women's knowledge, promoting contraceptive use, and dispelling fears and misconceptions.

Background: Nocturnal enuresis has been observed that bedwetting often occurred in several members of the same family. A study shows that 70% of children who have enuresis have a parent who has a history of the disorder. Another study shows that Nocturnal Enuresis (bed wetting) is a relatively common disorder fraught with emotional physical and social effects.
Objectives: The aim of the study is to detect certain factors related to enuresis, such as (genetic factor, family history, stress, urinary tract infection, diabetic mellitus and sleeping disorder).
Methodology: A descriptive study, conducted in outpatient in Raparen Pediatric Teaching Hospital in Erbil City, in the April 1st 2011 to May 30th 2012. A convenience sample size of 50 mothers with their children aged (5-15) years old were selected to achieve the aim of this study.
Results: The results revealed that 62% of the study sample were females, the age of total sample 76% were range between (5-7) years old, more than half of the sample had previously bed wetting, 72% of the them start bed wetting at age 5 years old, and 40% of them had bed wetting day and night highest frequency 74% and 32% risk factors of enuresis were by genetic factors and urinary tract infection respectively, while 26% and (22% ) of them their sisters or brothers had enuresis too, respectively.
Conclusion: Present study concluded that enuresis is a pediatric public health problem that associated with young age children, family history of enuresis and history of urinary tract infections in addition to a lot of maternal & child demographic data. Majority of the sample had previously bed wetting, most of them start bed wetting at age 5 years old.
Recommendation: The study recommended the parents to be more attention and give care about their children during toilet training.

Objective: to identify the nurses' knowledge regarding nursing documentation.
Methodology: Observational study was conducted throughout the period (June-October - 2011) The sample consisted of (150) nurse working in two main teaching hospitals in Nineveh governorate (Al-Salam and Al-Jamhori). Self-administered questionnaire was developed after reviewing many related literatures. Validity of the tool was identified through consultation of seven experts, while reliability was checked through the split-half technique to measure the internal consistency (r = 0.87). The final draft of the tool composed of two aspects; principles and purposes. Each item of the tool had two options (No = 0; Yes = 1). Data were collected through an interview method.
Results: More than half of items (53.97%) concerning principles, and (28.57%) of items of purposes were got level of knowledge, while the other items got moderate level of knowledge, but none of them got high level of knowledge. Educational level of nurses had significant association with aspects documentation (Principles and Purposes).
Conclusion: The study concluded that knowledge regarding purposes of documentation was better than knowledge regarding principles of documentation, while there were some deficit in what and how to document.
Recommendation: It recommended that nursing documentation might be covered widely in the nursing school curriculums, in addition to carry out such researches aiming to assess or evaluate nursing records.

Objective: Across section analytic study was carried out to identify the effect of folic acid on birth of pregnant women at Al-Najaf government and to determine the statistical significant differences between folic acid and some variables.
Methodology: A purposive sample of (1054) of pregnant women was selected of Al-Zahra maturity pediatric hospital, data was collected through the interview of women. Question forma was designed and contained (3) parts demographic variables, reproductive variables and variables related to effect of folic acid.
Results: Descriptive and in fevential statistical procedures were used to analyze the data. The result of the study revealed that the age of women was ranged between (21-25) years and the highest percentage of them house wife (640). The result indicate that a significant association between takes folic acid and congenital anomalies. The present study was revealed that the percent of normal deliveries (38.9%), while in cesarean sections (58.8%). In normal deliveries the percent of congenital anomalies was (1.2%), and the percent of congenital anomalies in cesarean sections was (0.9%).
Conclusion: The study concluded that there was a significant difference between taking folic acid and congenital anomalies.
Recommendation: According to these finding it is recommended to emphasize on prenatal care early as possible and education improve health services presented to the mother during pregnancy that the health team must take the role in reducing the incidence of congenital anomalies by taking folic acid.

Objective: To find the impact of Tuberculosis disease upon quality of life of patients who undergo Directly Observed Treatment Short Course (DOTS).
Methodology: A descriptive design is carried out at Respiratory and Chest Diseases out Patients' Clinic, of Nov 20th, 2012 to July 11th, 2013, in order to find out the impact of tuberculosis disease upon quality of life of patients who undergo Directly Observed Treatment Short Course (DOTS). A non-probability (Purposive) sample of (60) Tuberculosis patients. The data collection process has been performed in February 13th, 2012 to the April 6th, 2012. The data were described analyzed through the use of descriptive statistics such as (frequencies, percentage, mean of score and comparative significant) and inferential statistics such as (Chi-square, and T-test).
Results: The results of the study showed that Tuberculosis negatively influence upon patients quality of life domains.
Conclusion: The study concludes that the maximum effect of presented by the social domain, followed by the psychological, level of independency, then the physical domain. While the minimum impact, presented by spiritual domain, followed by the environmental domain.
Recommendation: The study recommended that necessary to do a health educational programs to increase health awareness among peoples who attendants the outpatient clinics and special health centers for tuberculosis disease, as well as the use of mass media by the health authorities.

Objectives: The study aims to evaluate the nurse's practices toward patients with Tracheostomy in respiratory care units, and to find out the significant differences between their practices and some variables.
Methodology: Descriptive analytical design of the study was conducting on 100 nurses, starting in November 15th 2011 to the March 20th 2012. The study was carried out of five hospitals: ( 24 nurses of Surgical specialties hospital, 26 nurse Baghdad teaching hospital, 17 nurse Al-kadhemia teaching hospital, 18 nurses of AL-Yarmook Teaching hospital, And AL-Karama Teaching hospital 15 nurse ) in Baghdad city. The questionnaire was composed of two parts and introductory page that invite the nurses who participate in the study, part one: is demographic- characteristics sheet which consist of 19 items, which included Gender, age, level of education, workplace, and year of experiences. Part two: form questionnaire composed of (20) items of the practice nurse on the nursing care of the patient with Tracheostomy in a respiratory resuscitation unit. The researcher used the appropriate statistical methods in the data analysis, which included descriptive data analysis and inferential data analysis.
Results: The findings of present study revealed that 51% of the nurses were females, majority of them at age 18-27 years ago, most of the nurses were institute education graduated were of (53%), 51% of the nurses was single, 57% of the nurses was years of experience, majority at (1-5) years of experience, the results indicated that there were highly significant between nurse's practices and training course at P-0.05.
Conclusions: the results of study concluded that the nurses have highly significant between nurse's practices and training course
Recommendation: The study recommends to preparing programmed lectures for the nurses, and need for a broader study and a larger sample.

Objective: The study aimed of construction of nursing assessment rehabilitation tool for cardiac medical ward patients at Baghdad hospital.
Methodology : A descriptive, purposive sample of (60) nurses was selected of cardiac medical ward of hospitals (Ibn AL Biter Hospital For Cardiac Surgery, Iraqi center for heart disease and Ibn AL Nafees hospital ) in Baghdad city of the 15th of February 2013 to the 15th of August 2013.The constructed tool was continues of three sections: section one included the give open end-question about the physically; psychologically; socially and environmental) for construction of nursing assessment rehabilitation tool for cardiac medical ward nurse (20). section two include the nurses' demographic characteristic; section three was the initial assessment construction tool that contained (16) parts including: (general patient information, evaluation of ( skin, hair and nail), evaluation eye, evaluation ear, evaluation (mouth, nose and throat) evaluation (head and neck), evaluation (respiratory system), evaluation (cardiac) heart evaluation peripheral vascular, abdomen assessment, assessment urinary system, reproductive system, breast assessment, musculoskeletal assessment, neurological assessment), descriptive and inferential statistical methods were used to analyze the data
Results: The findings revealed that the most of the study sample were male with nursing institute graduate and the majority of them employed with limited experience in cardiac medical ward in spite of that no one of them got a training course in cardiac medical ward at Baghdad hospital, the present study revealed that, the distribution of nurses' responses to the items indicated that the (general patient information ) 44.7%, evaluation of (skin, hair and nail) 32.8%, evaluation eye 38.1%, evaluation ear 41.0% evaluation (mouth, nose and throat) 28.7%, evaluation (head and neck) 52.3%, evaluation (respiratory system) 63.2%, evaluation (cardiac) heart 76.3%, evaluation Peripheral vascular 60.2%, abdomen assessment 38.9%, assessment urinary System 45.5%, reproductive system 25.4%, breast assessment 13.9, % musculoskeletal assessment 43.7 %, neurological assessment 35.0 %).

Objective: To evaluate the effectiveness of an educational program on the practices of the nursing staff concerning the electrocardiographic procedural errors in Missan governorate.
Methodology: An experimental design was carried out at Qalat Salih general hospital in 3rd February, 2013 to 26th of June, 2013. The program and instruments were constructed by the researcher for the purpose of the study. Random sample comprised of (60) nurses was divided into two groups, study group consisted of (30) nurses exposed to the nursing educational program and control group consisted of (30) nurses were not exposed to the program. The measurement of effectiveness of nursing educational program through the observational checklist includes (30) items concerning nurses' practice in preparation the ECG machine, location of limb leads and precordial electrodes placement and nursing intervention. Reliability of instrument was determined through the use of test and retest and the instrument validity was determined through a panel of experts. The analysis of the data was used descriptive statistics (frequencies, percentages, weighted and the arithmetic mean and standard deviation) and statistical inferential (sufficiently relative test, Fisher test, chi square and Levin test) In order to find the differences between the study group and the control group
Results: The study findings indicated that there were highly significant differences between pre and posttests in the study group in overall main domains related to nurses' practice
Conclusion: The study concluded that the effectiveness of educational program regarding nurses' practice concerning the electrocardiographic procedural errors is a positive and clear.
Recommendation: The nurses staff can be encouraged and motivation for being participated in the special training programs and conference with leading ECG specialists who have long experience in teaching ECG procedure to fulfill the nurses needs concerning defects and limitation in their practices.

Objective(s): A descriptive evaluation study is conducted on primary health care centers, primary health sectors, health directorates in Baghdad Governorate and General Health Directorate/ Ministry of Health of November 27th 2011 to June30th 2012.
Methodology: A probability multistage sample of (54) subjects which is selected of school health units. Data are collected throughout the utilization of the developed questionnaire and interview technique and keeping records of all available contacts. Interviews are conducted with the chief of school health unit in each stage level. Questionnaire has been divided into three main parts consist, in (A) especially for health directorate, in (B) for health sectors, and in (C) for primary health care centers each form contains the basic components; consists of manpower and health facilities; consists objectives, system components, resources, feedback and attributes.
Results: consists prevention and behavioral indicators and disease prevalence indicators, total items of questionnaire was (217) items. Reliability of the questionnaire was determined through pilot study and validity determined through a panel of experts consists of (13) experts. Data were analyzed by using of descriptive data analysis (frequencies and percentages). The study results indicate that the system is average adequacy, simple, moderate flexible, highly acceptance, representative, low utility, unstable system. The study recommended computerizing as addition to manual documentation. Statisticians may coordinate the monthly surveillance forms. Engage the nurse in school units in primary health care centers. Involving all health institutions and centers related to school health in the surveillance system program.
Conclusions: Lack of cooperation between the public and private. In the absence of mechanisms to provide feedback or disseminate data to the decision makers, the usefulness of school health surveillance system was very limited. The system adequate in primary health care centers more than health sectors and health directorates. The system has low utility in primary health centers and high ones in both health sectors and health directorate. System attributes are simple, moderate flexible, high acceptance, Representative and unstable system, moderate data quality.
Recommendation: Provision of laboratory and radiological facilities and integration of their data in school surveillance. Review the surveillance forms to ensure reporting useful data. Besides enhancing representativeness of school health, there is need to have a regular feedback and information dissemination mechanism. Available data may be computerized as addition to manual documentation. Statisticians may coordinate the monthly surveillance forms. Engagement of the nurse at school units in primary health care centers. Involving all health institutions and centers related to school health in the surveillance system program. Customizing special financial of school health isolation of the general budget.

Objective: to assess Adolescent Student's Knowledge toward Premenstrual Syndrome in Nursing Secondary Schools at Al-Diwanyia Governorate.
Methodology: A descriptive analytic study was carried out to assess adolescent student's knowledge toward premenstrual syndrome in nursing secondary schools at Al-Diwanyia governorate in February 2013 to July 2013.A purposive sample consist of (282) adolescent student with premenstrual syndrome in nursing secondary schools at Al-Diwanyia governorate (Al-Diwanyia- Al-Hamzah- Al- Shamyia- Afak). A questionnaire was constructed for the purpose of the study, it was composed of three parts, part one: consist of demographic information, part two: consist of menstrual cycle characteristics, part three: consist of questions regarding adolescent student's knowledge toward premenstrual syndrome, it comprise of one main domain and five sub domains. Reliability of the questionnaire is determined through the pilot study and the validity through a panel of (13) experts. Descriptive statistical analysis procedures and inferential statistical analysis procedures were employed for data analysis, all the statistic procedures were tested at P-0.05 .
Results: The result revealed that the majority of the study sample 44.6 % had insufficient knowledge toward premenstrual syndrome. The assessment of knowledge is not affected by demographic characteristics and menstrual cycle characteristics, that mean the studied questionnaire can be amend for all individuals of the studied population.
Recommendations: The study recommended to development of school health services for better detection and management of PMS in the adolescent population. Curriculum of nursing secondary schools should contain efficient knowledge about menstrual cycle disorders especially PMS. Encouraged affected girls to seek medical advise of the medical staff. Enhance adolescents students knowledge regarding PMS as well as adapt healthy life style through booklet, educating programs, mass media, articles.

Objective: To assess nurse's knowledge about nosocomial infection at hospital in Baghdad city.
Methodology: A descriptive study was carried out at hospitals in the city of Baghdad and included (Baghdad teaching hospital, Gazi al-hariri hospital, Al-karama hospital, Al-yarmok hospital, and al-kadhmia hospital). Starting in 5 of August 2012 to 20 of February 2013. A non-probability (purposive) sample of 100 nurses who worked in hospitals in the city of Baghdad. The questionnaires was designed and constructed by the researcher according to review of literature and related study. The content validity of the instrument was established through penal of 14 experts. Reliability of the Instrument was determined by test-retest method which was estimated as average (r=0.802). Data was gathered by interview technique using the questionnaire format and data was analyzed by application of descriptive and inferential statistical methods.
Results: The majority of nurses was male, with age group 30-39 years old, nursing institute graduated, the majority of nurses have less than 5 years of employment in the hospital and low number of training course about nosocomial infection. The result indicated that most of the nurses (69%) have poor knowledge toward NI. There is significance relationship at P <0.05 between nurse's educational level and their knowledge toward NI. There is no significance relationship at P >0.05 between nurse's (age, gender, years of employment in the hospital, and training course of nosocomial infection) and nurse's knowledge toward NI.
Conclusion: The study concluded that the nurses not have appropriate knowledge toward nosocomail infection
Recommendations: The training course is necessary to increase nurses' knowledge toward nosocomial infection. This training course should be regularly done and updated in view of changing knowledge and practices

Objectives: The aim of present study was focused the light on the pathological changes in the some liver enzymes and triglycerides. Low Density Lipoprotein (LDL). High Density Lipoprotein (HDL), in the patients suffers of diabetes mellitus type 2.
Methodology: The present study carried out on (21) patients effected with diabetes mellitus of (100) persons were examined in the education of Al-Sader hospital Al-Najaf in October, November and December 2012. The study include measurement of the glucose level, some of blood parameters, triglycerides, cholesterol, High Density Lipoprotein (HDL) and Low Density Lipoprotein (LDL), the biostatic use difference between the maximum and minimum values (range).
Results: Our findings were revealed increase in the triglycerides in ten patients, the range of triglycerides are (205-398) mg/dl, and while the cholesterol level also increased in ten diabetic patients (range 227-408)mg/dl. So the GPT and GOT was elevated in seven diabetic patients (range 48-59) I/U, but the low lipid density (LDL) was revealed decrease in the (18) males diabetic patients (range 72-112) our observations were appeared some parameters of blood, the present study was noticed decrease the RBCs count in (13), diabetic females (range 2.7-3.9) million corpuscles and increase in the blood platelets count in ten females diabetic patients (range 410-520) /cm3 in blood.
Conclusion: Increase in TG, cholesterol and GPT,GOT,LDL in diabetic patient, decrease in RBCs count and increase in Thrombocytes count in female diabetic patient.
Recommendations: Further studies are needed to show the relation-ship between diabetes with endocrine disorder and immunological level

Objective: aimed to assess the nurses' knowledge concerning cardiopulmonary resuscitation and to find out the association between the knowledge scores of the nurses and their demographic variables of age, gender, level of education, years of experience, and training session.
Methodology: A descriptive cross-sectional design was conducted on the al-najaf city's teaching hospital (Al-Sader Medical City). Starting in December 11th, 2012 to July 30th, 2013. A non-probability (purposive) sample of (85) nurses, those who were working in the coronary care unit, intensive care unit ,emergency unit, respiratory care unit, operation room and surgical ward, and medical ward, at al-Sader medical city. The data were collected through the utilization of the developed questionnaire, and it is consist two part, Part 1 Included (7) items, and Part 2 (39) items. Data collected by means of structured self-report technique with the subjects. Reliability of the questionnaire was determined through pilot study and validity determined through a panel of experts consist of (13) experts.
Results: revealed that majority of nurses had poor knowledge regarding cardiac arrest and cardiopulmonary resuscitation. There was non-significant association between the nurses' knowledge toward cardiopulmonary resuscitation procedure and their gender, age group. The study result indicate that there was significant association between the overall nurses' knowledge toward CPR and their Academic qualification. Also there is no relationship between the nurses' knowledge toward cardiopulmonary resuscitation procedure and their Years of work experience, Area of Assignment, Formal training, and CPR Performance on patient.
Conclusion: The researcher can conclude that the majority of the nurses had poor knowledge concerning cardiac arrest and cardiopulmonary resuscitation.
Recommendation: The study recommends that the referral hospitals should develop procedure manuals that provide detailed information about all the most recent advances, discoveries and practices in CPR The procedure manual should be subject to an annual audit, and active steps should be initiated to remedy identified deficiencies.

Background: Diabetes mellitus is considered a major risk factor for developing coronary artery disease, and is associated with a marked increase in the complications post cardiac revascularization in both women and men in addition to its impact on the patients Quality of life.
Objectives: the study aims to assess the impact of diabetes mellitus upon the physical activity for patients post coronary artery bypass graft surgery and to find out the relationship between the physical activity and socio-demographic and clinical data of the diabetic patients.
Methods: descriptive study was conducted to identify the impact of diabetes mellitus upon the physical activity of patients who undergoing CABG surgery at least three months ago. The study starting in November 10th 2012 to the July 10th 2013 on the 100 patients in three centers and hospitals in Baghdad city (Ibn Al-bittar center for cardiac surgery, Iben Al-Naffes Hospital and Al-Iraqi Center for Cardiac Disease), the instrument was consist of two part which of clinical- demographic data (gender, age group, marital status, educational level, cholesterol, BMI) and physical activities instrument that consist of eight items that measure the basic and moderate activities of daily living, the reliability of the study was measured through test retest method=0.93, the researcher use the descriptive and inferential statistics to analyze data .
Results: the result of the study shows that (57%) of the study samples have diabetic in comparison (43%) with Non-diabetic patients, (46%) of the diabetic patients were males, (28%) of the subject were at the age group 51- 60 years, (46%) were married, (13%) illiterate. (31%) have high cholesterol level and (26%) were overweight. Added to that the study shows a highly statistical difference in the physical activity between diabetic and non-diabetic patients, a highly statistical association between physical activity and clinical-demographic data (gender, age group, cholesterol level and BMI) of the diabetic patients were also found.
Conclusions: the study conclude that the physical activity of the diabetic patients is less than non- diabetic patients and the clinical - demographic data (gender, age group, cholesterol level and BMI) of the diabetic patient affect with highly significant association (p≤0.01) on their physical activity post CABG surgery.
Recommendations: according to the findings of the study the researchers recommend to Prepare a special programs and guide booklet that encourage patients to improve their physical activity post CABG surgery which include diet modification, adherence to treatment, regular exercise, and other life style modification.

Background: The goal of conducting healthcare related researches is to improve the delivery of healthcare services by implementing their evidences into practice. Our knowledge with regard to those factors that promote or discourage research utilization among nurses in clinical practice is limited.
Aim: The focus of the study is the identification of barriers and facilitates of research utilization in nursing practice from the perspective of nurses in Suez Canal University Hospital.
Methods: A cross sectional design is used. A questionnaire incorporated 29 structured barriers to research utilization was distributed to 68 nurses. Items' scores obtained were used for determining the questionnaire's internal consistency reliability (ICR) and construct validity, and to reflect the degree to which the item was perceived to be a barrier to research utilization.
Results: Cronbach's coefficient α (CCα) for the whole scale was 0.86, items were found to be loaded by .47 or more on their predetermined theoretical factors and were significantly dependent on these factors (p<0.01). The greatest perceived barriers to research utilization were the inadequacy of facilities for implementation, the delay in publishing research reports, the unclear implications of research utilization for practice, the physicians' non-cooperation and the insufficient time to read researches. All necessary facilitators mentioned by the nurses were related to the organizational factors.
Conclusion: The tool showed a high reliability and validity estimate. Most of the barriers and all the necessary facilitators were related to organizational factors.

Objectives: to study the impact of thyroid stimulating hormone (TSH) levels and thyroid dysfunction on the pathogenesis of gallstones and their compositions.
Methodology: a study is applied including measuring of TSH levels in serum blood of (100) patients with gallstones diagnosed by sonographically or current cholecystectomy (April 2009 - April 2011) with regarded to the differences between sex of patients and predominated of gallstone type with age. The researcher used statistical analysis) Chi X2 test ( to the data.
Results: the search results showed significant increase in the rate of pathogenesis in female, but TSH levels is higher in male than female (p < 0.001). And cholesterol gallstone type is predominated (p < 0.0001). Current results were stated that the thyroid dysfunction had a role in the formation of gallstones.
Conclusion: there is a significant association between the gallstones and thyroid dysfunction
Recommendations: the study recommends that must handling and treatment the thyroid dysfunction and hormonal dysfunction especially TSH.

Objective: To calculate under five years mortality rates in Mosul City and to find out the most common cause of death among children.
Methodology: A retrospective study is applied to calculate under five years mortality rates in Mosul City and to find out the most common cause of death among children of 1st December 2011 up to the 15th January2012. The period of the study during (2008-2009-2010-2011), data are collected in Ibn- Sena Teaching Hospital in Nineveh governorate of review of records. In addition to causes of death , age of child and residence .The data were analyzed by using descriptive statistical measures which included (Frequency, Percentage) as well as the use of inferential statistical measures which include the chi-square test.
Results: The results of the show that the most common of mortality child is respiratory disease, septicemia and congenital.
Conclusion: The researcher concluded that the high rate of childhood mortality recognized in Mosul city during period of this study (2008 -2011) together with the presence of high fertility rate.
Recommendation: The study recommends that is an urgent need for strategy for prevention of childhood mortality in Iraq through health services provision and socioeconomic development and improvement of family planning facilities.

Objectives: Design this study to determine whether there was a relationship between gingival diseases and ABO blood groups.
Methodology: Data were collected 1 2 9 subjects who were randomly selected students referred to the Faculty of Dentistry. The study based on periodontal condition, blood group, and medical history. The effects of blood subgroups on periodontal health, gingivitis and periodontitis were investigated separately.
Results : In the present study, all the cases were first segregated into groups based on Loe and Silness index
as: group I (mild (initial) gingivitis), group II (moderate (early) gingivitis), and group III (sever (established) gingivitis), and were further divided into four grades based on Ramfjord's Periodontal Index. Blood samples were analyzed to determine blood group and Rhesus factor.
Conclusions: ABO blood subgroups and Rh factor may constitute a risk factor on the development of periodontal disease. However, long-term studies are needed to make a more comprehensive assessment of the effects of ABO group on periodontal diseases.

Background: spontaneous abortion constitutes one of the most important adverse pregnancy outcomes affecting human reproduction, and its risk factors are not only affected by biological, demographic factors such as age, gravidity, and previous history of miscarriage, but also by individual women's personal social characteristics, and by the larger social environment
Objective: To identify Environmental effects on Women's with Spontaneous Abortion.
Methodology: Non-probability (purposive sample) of (200) women, who were suffering of spontaneous abortion in maternity unit of four hospitals at Baghdad City which include Al-Elwia Maternity Teaching Hospital, and Baghdad Teaching Hospital at Al-Russafa sector. Al-karckh Maternity Hospital ,and Al-Yarmook Teaching Hospital at Al-karckh sector. The data are collected through the use of constructed questionnaire, which included: demographic characteristics, reproductive characteristics, causes of spontaneous abortion ,and Environment domain of quality of life. Data were collected through the use of questionnaire, Study implemented for the period of February 3rd 2013 to April 26th 2013. A pilot study was carried out to test the reliability of the questionnaire and content validity was carried out through the 20 experts. Descriptive and inferential statistical analyses were used to analyze the data.
Results: The results of the study revealed that (26.5%) of women their average age (25-29) years, and the their body mass index (48%) at normal weight, (27.5%) of study sample was graduated of primary school, (25%) of their husband graduated of institute or college, (80%) of samples are housewives, (54.5%) of their husband employed,(48%) of study sample is within low category of socioeconomic status, and about the reproductive information (66%) of women were primi and multi gravid, (25%) of women have two birth, (52.5%) have previous one abortion. There are association between occupation status of husband, and the nature of work of wife and husband with environmental domain, and with reproductive parameters it presents association between women's gravida and environmental domain.
Conclusions: There are significant association between environment domain of and women's sociodemographic at (occupation status of husband, and the nature of work of wife and husband) and with reproductive parameter at (gravida).
Recommendations: The study recommended conduct structured teaching programmed (STP) to antenatal mothers with history of miscarriage conducted by the investigator included meaning, causes, and prevention of miscarriage. It also includes the do's and the don'ts during 1st trimester of pregnancy, and collaborative action can Ministry of Health take in distribution of awareness for women towards the problem by conducting booklet or lecture about miscarriage

background: Most of immigrants suffer of severe types of psychological disturbances, such as depression and anxiety as a result of the exposure to markedly stressful life events. The present study was conducted in April 2nd, 2008 through October 2nd, 2008.
Objectives: This study aims to assess the psychosocial disturbances of immigrants in AL-Najaf refugee camp.
Methodology: A non-probability sampling of 100 immigrants who were living in AL-Najaf refugee camp in 2006-2008, because of the security situation in Iraq. A questionnaire was constructed to achieve the study objectives; it consists of three major parts with 40 items. These parts are the demographic characteristics, psychological aspects (depression and anxiety), and social aspects. To determine the reliability and the validity of the questionnaire, the pilot study was done and the questionnaire was reviewed by group of experts. Data were collected through interview as a mean of data collection. Data were analyzed through a descriptive statistical analysis (percentage and frequencies) and inferential statistical analysis.
Results: The findings of the study indicated that there was a severe psychological distress and poor social aspects among immigrants; In addition, there was a significant relationship between the psychological aspects (depression and anxiety) and social aspects. Moreover, there is a significant relationship between the psychological aspects with age, occupation, and family member.
Conclusion: The study concluded that immigrants were inflicted with psychological disturbances at different levels; most of them are at a poor level of social aspects.
Recommendations: The study recommends that early attention of social institutions and the Mistry of Health to address immigrants' to prevent psychological illnesses among immigrants. Also, create a mental health team to continuously visiting the immigrants in the refugee camp to evaluate their psychological health and reinforce their adaptive abilities during the migration period.

Background: Breast cancer is the most common malignant tumor among women and the second most common type of cancer after lung cancer, 10.4% of all cancer incidences, and the fifth most of cancer deaths. Breast cancer is the top cancer in Iraqi's women, comprising about 34% of all females cancer, and it is the second leading cause of cancer related to mortality in women today after lung cancer. In Iraq, breast cancer constitute about one third of total cancer.
Objectives: To assess women's knowledge and concern about breast cancer and to identify the relationships between women's knowledge to demographic data and to reproductive profile.
Methodology: Design: A cross section of a purposive study was carried out at Al-Sadder Medical City- Center of breast examination for early detection of breast cancer in Najaf Province, in the period of February 15th to April 30th -2012. Sampling: A purposive sample of 100 women were interviewed. Tools: Questionnaire format was designed into 5 parts for data collection through interviewing of the attended women with breast cancer to contain the: Demographic profile; Reproductive profile; Risk factors of breast cancer; resources of women's knowledge; Item's statements about women's knowledge. The data were statistically analyzed through 1. Descriptive statistical method. 2. Inferential statistical method.
Results: The present results found that 75% of women's age were of 45-54 years. Most of them were with (primary educational level or less; housewives with a moderate socioeconomic status).
Conclusions: The study concludes that aged women had the most incidences of breast cancer, P. <0.001. The
incidences of breast cancer to none pregnant or delivered women; medical history; and to family history with breast cancer were increased, P.< 0.05.
Recommendations: 1. Establishing of educational health programs for women concerning breast cancer 2. Improving of nurse's knowledge on advising and teaching of women about breast self examination. 3. Encouraging of breast cancer studies.