Mosul Journal of Nursing

Background: Acute diarrhea in children under the age of five is the leading cause of morbidity and mortality worldwide. It is important to identify factors associated with diarrhea in order to develop appropriate preventative and therapeutic approaches Aim: To assess hygiene and sanitation risk factors of diarrheal disease in children under five years old admitted to Dr. Jamal Ahmad Rashid Pediatric Teaching Hospital in Sulaimani City. Methods: A quantitative design (descriptive study) case control approach was used, data collected from the period 3rd of March to 3rd of June 2021 at Dr. Jamal Ahmed Rashid Pediatric Teaching Hospital in Sulaimani City, using a non probability purposive sample technique to select (105) children diagnosed with acute diarrhea as case group, and (105) non diarrheal children as a control group in outpatients unit in same hospital. Researcher collected the data by direct interview with mothers, data were analyzed by using the statistical package for social science (SPSS) version 21. Results: Out of 105 diarrheal groups 42.9 % of mothers their age between 25-34 years old, 39% were graduated from primary school, 86.7% were unemployed, 55.3% were insufficient, 62.9% were in urban area, and 74.3% of their families consist of less than five members. 49.5% of children their age were 12 months or younger, 53.3% were male, 34.3% were second birth order, 69.5% were normal birth weight, and 89.5% were complete vaccination. Significant association were found between mother age, level of education, child age, gender, methods of cleaning child after defecating, mother washing hands after toilet, after cleaning child perineum, before feeding child, methods of storing food for later use with diarrhea. Conclusions: Young and low educated mother, low family income, infant age, male gender, poor hygiene practice, were the main risk factors of diarrhea. To minimize the rate of childhood diarrhea, there is a need to improve awareness of mothers regarding sanitation and personal hygiene and rotavirus vaccination.

A descriptive predictive design was used to guide this study. The study was conducted in Al-Qadisiyah University. The study included a convenience sample of 400 undergraduate students. The study instrument includes students’ sociodemographic sheet of age, gender, marital status, and grade. It also includes Stages of Change Scale for Grain Consumption, The Decisional Balance Scale for Grain Consumption, The Self-Efficacy Scale for Grain Consumption. Data Collection: Data were collected using an online google form for the period from March 5th, 2021 to April 22nd, 2021. Data were analyzed using the statistical package for social science, version 26. The descriptive statistical measures of frequency, percent, mean, and standard deviation were used to describe subjects’ sociodemographic characteristics. The inferential statistical measures of linear regression, Independent-Sample T-Test, and One-Way Analysis of Variance. The study results revealed that around a half were in the Contemplation Stage of Change for consuming grains, followed by those who are in the Preparation Stage of Change, and those who are in the Maintenance Stage of Change. According to the findings, the higher the family\'s socioeconomic position, the higher the perceived value of eating grains. Grains consumption has more drawbacks when one\'s BMI rises. There is a need by the community health nurses; in collaboration with Iraqi Ministry of Health and Mass Media, to initiate health education materials that raise the health awareness of individuals who are both overweight and obese about the vital role of consuming grain. There is a need to incorporate materials that highlight the vital role of consuming each of grain regularly into the curricula of various educational levels in Iraq.

Background: Breast cancer is the most common cancer in women worldwide. During and after treatments, breast cancer patients may vulnerable for problems and in need of support. Receiving social support may reduce patients’ stress, help to cope with the situation, and improve patients\\\\' quality of life. Aim: The aim of the study was to assess perceived social support, quality of life, and explore the association between them in a sample of females\\\\' breast cancer. Methodology: Three hundred Forty-Two patients with breast cancer who visited the outpatient clinic at Hiwa Hospital in Sulaimani City were recruited to the current cross-sectional study. The data was collected at least 3 months post-chemotherapy, the direct interview was used to fill a questionnaire that includes participants\\\\' characteristics, source of social support, types of treatment, Multidimensional Scale of Perceived Social Support to assess perceived social support, and European Organization for Research and Treatment of Cancer (EORTC QLQ C-30, EORTC QLQ BR-23) to assess patients\\\\' quality of life. Statistic Package of Social Science 24 software was used for statistical analysis. Results: Participants\\\\' mean age was (42.65 ± 7.71), total social support score was (52.68 ± 20.09) on a scale of (12 to 84), about half (47.4%) received it moderately. The family was the highest source of social support (19.89 ± 7.80). Global health state score was (68.52 ± 19.80), emotional was the most affected functional subscale (52.10 ± 29.60). Regarding the symptom’s subscale, the financial deficit (55.95 ± 33.07) was the most disrupted symptom followed by fatigue (43.60 ± 21.16). Furthermore, sex function (32.99 ± 28.79) was a more impaired aspect among breast cancer-specific functions, and hair loss (59.84 ± 41.37) was the most symptom reported by the patients. Moreover, perceived social support is associated and correlated with participants\\\\' quality of life, (p ˂ 0.05). Conclusion: Kurdish breast cancer patients perceived moderate social support, the global health status was moderate to good, most affected function was emotional and sex functions, financial deficit, fatigue, and hair loss were most disrupting symptoms. Social support enhanced patients’ QoL in term of enhancing functions and minimized symptoms.

There is effect of Carbimazole on oxidative stress with Hyperthyroidism. To assess the oxidative stress and total antioxidant capacity in hyperthyroid patient and evaluate the effect of Carbimazole on oxidative stress and total antioxidant status. Case series study design. The study was conducted in departments of general surgery outpatient private clinic of and AL-Jumhori teaching hospital. The study period between Dec .1st, 2020 and April.1st, 2021. Thirty patients newly diagnosed with hyperthyroidism and thirty healthy volunteers as control group were participated in the study. Malondialdehyde (MDA) and total antioxidant status (T-AOC) were measured control group and also measured in patients with hyperthyroidism before and after taking Carbimazole therapy for two months duration. Indicated an increase in mean serum MDA level (4.74 ± 3.62 ng/ml), also there was a significantly lower level of T-AOC (6.72 ± 3.08 U/ml) in patients with HTH disorder before therapy in comparison with the control group (1.83 ± 0.47 ng/ml), (10.38 ± 2.32 U/ml), respectively. After two months of antithyroid therapy (Carbimazole), there was a significant reduction in MDA levels (2.51 ± 1.99 ng/ml),(P-value = 0.001) and a significant increase in serum T-AOC level (8.57 ± 3.09 U/ml), (P-value = 0.001) in comparison to their values before therapy. The present study demonstrated that hyperthyroid patients have increased level of malondialdehyde and decreased levels of total antioxidants capacity than the control group while hyperthyroid patients treated with Carbimazole for two months have decreased level of MDA and increased levels of T-AOC than their levels before treatment. This result may give a new insight that Carbimazole may exhibit its effect in the management of hyperthyroidism by acting as an antioxidant.

Objective; of the this study was to investigate the effect of sitagliptin on blood glucose ,oxidative stress and total antioxidant status (TAS) in people with type 2 diabetes mellitus. Design: Case-control study Selection; The patients were selected from main diabetic clinics in al-Wafaa’ Diabetic Clinic and from private clinics in Mosul city during the period from 1st of November 2020 to the 30 t h April 2021. Methods; It was conducted randomly 60 patients (32 males , 28 females ) of Non-insulin diabetes mellitus , who were already on routine anti-diabetic therapy ,those separated into 2groups. First Group : included 30 patients( 17 males,13 females) of T2DM treated with oral metformin alone Second group : included 30 patients( 15 males ,15 females) of T2DM treated with combination of Sitagliptin + metformin for at least 3 months , measured fasting plasma glucose, glycosylated hemoglobin another 30 healthy subjects , age ,sex matched with the patients, were considered as a control groups . Malondialdehyde (MDA) and Total antioxidant status (TAS) were measured in all groups Results; of this study, serum MDA levels were found high and TAS concentrations was lower in diabetic patients of both groups than the healthy control, the combination of sitagliptin + metformin caused significant reduction( P-value > 0.05) in the level of glycosylated hemoglobin ( HBA1c ) and malondialdehyde (MDA) in comparison with group that received metformin monotherapy ,as well as ,non-significant change in fasting blood group( FBG) and total antioxidant status (TAS )in both groups As a conclusion of the present study sitagliptin can attenuated MDA in patient with NIDDM and greater reduction in serum level of HBA1c than the use of metformin monotherapy.

The initial COVID-19 clinical manifestations are similar to all viral pneumonia species, with varying severity degree. World Health Organization (WHO) revealed that 80% of patients with COVID-19 demonstrated gentle or no clinical intercession and 20% of the influenced cases experienced serious sicknesses, for example, shortness of breathing and various organ disappointments. It has been accounted for that 2% of severe cases can be deadly. furthermore, it is analyzed and founded through a research facility test that contamination can prompt intense respiratory issues especially among older patients and individuals with fundamental ceaseless ailments. Notwithstanding, some tainted individuals are transporters of the infection without side effects while others may experience the ill effects of a mellow disease and recuperate effectively. To assess of students\' knowledge toward Sign and Symptoms of Patients with Covid-19 in Nursing College at University of Mosul. To achieve the aim of these study, Across - sectional design was used with the application of structured questionnaire and this study is conducted in Nursing College at University of Mosul. Simple random sampling technique was conducted using a survey instrument to obtain responses from students includes 218 students from all stages of collage. The data were analyzed by using SPSS version 24. Result of the study indicates that (42.7%) from students at age (20-24) Also, the results show (41.7%) of students were from fourth stage of collage. With regard to the gender (65.1%) of them were females. Also, the result shows statistically significant differences in the students’ knowledge toward the signs and symptoms of COVID-19. It was evident from the study that majority of the students have inadequate knowledge regarding signs and symptoms of COVID_19 also shows that there were no significant differences between students\' knowledge and stage of education.

Oral health care is a crucial aspect of oncology nursing practice; therefore, this study was conducted to evaluate oncology nurses’ knowledge and practice with oral mucositis (OM) of cancer patients undergoing chemotherapy. One hundred nurses were participated from Hiwa and Shahid Shaswari Garmian hospitals, in addition to a demographic, a questionnaire was designed and constructed by the researcher to assess the nurse’s knowledge and practice through the mucositis undergoing chemotherapy. The mean age of participants was 32.15±7.63 years, 53% of nurses were males 67% of them held a Diploma degree in nursing, while 55% had (1-5) years of experience in oncology field. in addition to (78%) of participants lived in Sulaimaniah city. Finally, 84% of the participants received education program regarding oral mucositis. The Oncology nurses had good levels of knowledge in topics related to anatomy of oral cavity (64%), Pathology of oral cavity with oral mucositis patients (73.59%) and a significant differences were found between Nurses practice on mucositis of oral cavity and age , level of academic qualification , years of experience in oncology field and nurses were received education program regarding oral mucositis(p<0.05).Good levels of Nurses\' knowledge directly affected on good level of their Practice.

Study Design: A descriptive predictive design was used to guide this study. Study Objectives: This study to (1) identify the association between teachers’ age, body mass index, years of employment, and their intention to undergo colorectal cancer screening, and (2) investigate the difference in teachers’ health beliefs about colorectal cancer screening between the groups of gender, educational qualification, marital status, and family history of having colorectal cancer. Setting: This study was conducted in secondary schools in Kirkuk City. Sample and Sampling: The study included a convenience sample of 397 secondary school teachers. Study Instrument: The study instrument is composed of teachers’ sociodemographic sheet, the body mass index, and the Health Beliefs Scale for Colorectal Cancer Screening. Data Collection: Data were collected using an online survey “Google form”. Data were collected for the period from March 6th, 2021 to April 10th, 2021. Study Results: There was a statistically significant positive association between participants’ age and their Perceived Susceptibility of contracting colorectal cancer. On the other hand, there was a statistically significant inverse association between participants’ body mass index and their Perceived Susceptibility of contracting colorectal cancer. There was a statistically significant inverse association between participants’ years of employment and their Perceived Benefits of colorectal screening. Conclusions: The student researcher recommends that there is a need to devote health promotion activities, particularly that encourage older teachers, those who are overweight and/or obese, those who have a family history of colorectal cancer, single, and have lower educational qualification to undergo colorectal screening.

Background: Central venous catheter is essential in the management of patients undergoing bone marrow transplants, however, insertion of it has often the potential of inducing major complications. Aim: The aim of the study was to assess central venous catheter-related complications in patients underwent bone marrow transplants. Methodology: A retrospective study was carried out at Shahid Shaswary Garmian for bone marrow transplantation in Sulaimani City on 112 adult patients who underwent bone marrow transplants from June 2016 to May 2021. The patient\'s medical records were used to collect data regarding; patients\' and CVCs characteristics, intravenous infusions, CVC-related complications; the number and type of complication. Results: The age of 52.7% was between 40-60 years, most of them were male, primary school, and from urban. The medical diagnosis for (43.8%) was multiple myeloma, majority underwent autologous transplant, Hickman line was used for 48.2%, internal jugular vein was a most used vein, the length of stay with a catheter for almost 70% was between 2 to 3 weeks, and the majority had 2 dressing per week, most of the participants received 2 bags of Fresenius, 51.8% received blood, and 92% received platelet. The catheter-related complications occurred in 65.2% of participants, the number and type of complications were varied; 42% had one, 19.6% two, and 3.6% three complications, the proportion of fibrin was 42.9% followed by infection 32.1, occlusion 10.7%, and hematoma 7.1%. The incidence of complications was higher in leukemic patients, who had allogeneic transplants and used Hickman line 88.9%. In addition, using internal jugular vein for insertion 90%, long stay with the catheter (≥ 4 weeks) 89.3% and fewer number of dressing (1 dressing/week) 100% were more problematic. Conclusions: The incidence of central venous catheter-related complications was high, almost two-thirds had at least one complication. The most common complications were fibrin and infection. The incidence of complications affects by patients\' medical diagnosis, type of transplant and catheter, vein used for insertion of the catheter, the duration of stay with a catheter, and the number of dressings for catheters sit.

Background: End-of-life care refers to all aspects of the care relating to dying, and bereavement which are provided towards the end of life, end of life care is nowadays essential in nursing care, due to the increasing number of patients who require attention in the final stages of their life, the negative attitude among nurses is one of the most common barriers to the quality end of life care. Objective: To assess attitude of the nurses working at Hiwa Cancer Hospital toward pediatric end of life care in Sulaimani city. Methods: Quantitative approach / Descriptive analytic study design has been carried out on (111) nurses working in Hiwa cancer hospital. Data were collected using standard questionnaires which is Frommelt Attitude toward Care of the Dying scale data analyzed using statistical package of social science version (24). Results: The findings of this study show that out of twenty-four items of nurses attitude about end of life care , nurses have good attitude in twelve items, fair attitude in nine-items and poor attitude in three items, with total mean and standard deviation 2.345±0.68 and good level of attitude as general, present study demonstrate that level of education, work place, received training course about end of life care, attending seminar, workshop about pediatric end of life care had significant association with the attitude of nurses towards pediatric end of life care. Conclusion and Recommendation: Overall nurses have good attitude about end of life care. It’s essential for nurses who were at fair or poor attitude about end of life care to be familiarized with the concepts of EoLC through trainings, workshops and formal or informal education in both academic and hospital settings.

Children are the most liable group for accidental injuries. Nursery and kindergarten teachers have a major role in preventing accidents and saving lives of those injured children, the study aimed to study the effect of first aid training program on nursery school teachers` knowledge and practice. after obtaining a formal consent from the clinical nursing department. A convenient sample of 56 teacher from both public and private nursery and kindergarten were selected in this pretest/posttest study . A pre designated questionnaire sheet was used to collect data from teachers which include :demographic data, question about knowledge and measures about first aid practical skills for affected children . There was an observed improvement in the number and percentage of the correct answers of all items of knowledge and practical measures between pretest and posttest after implementing a training program on a statistical significant difference of a p-value of 0.0001. There was an observed increase in the teachers` knowledge and practical skills after applying first aid training program by the investigator. The study recommend for an obligatory engagement in a training first aid programs for nursery teachers pre and post their employment.

Background and aim: Nurses’ awareness and experiences about covid-19 are essential aspects to facilitate their clinical practice, communicate and understand patients’ needs. Awareness refers to the consciousness level of nurses that produces appropriate nursing implementation. Whilst experiences helps nurses adapt to work in a critical environment. The aim of the study was to assess nurses’ awareness and experiences during the covid-19 pandemic. Methods: It is a cross-sectional descriptive study design was conducted among nurses who are working at the teaching hospitals of Duhok city. The current study was carried out for four months, and the period of data collection lasted from 10th of June to 10th of October 2021. The data were taken from the participants by the direct interview method according to the questionnaire structured to the study. Results: The finding refers that there was a significant correlation between the ages of participants with their awareness about covid-19. Also, Nurses’ awareness was significantly affected by age and educational background. As for experience, no any noticeable effect and nurses stated that lack of staff and the provision of supplies during the covid-19 pandemic. . Conclusion: Nurses’ awareness and experience are essential at the time of managing covid-19 patients. They were having sufficient awareness level about the manner of infectious outbreak. Their demographic characteristics such as age and educational background also positively affected their awareness which made them devoted to providing nursing care in order to obtain a good recovery and control the pandemic.

Background: Nursing education is not only about cognitive field but also include the affective and psychomotor domains. Nursing involves “hands-on” psychomotor skills and clinical decisions in the affective and psychomotor domains which needs to be evaluate in a method that cover both domains. The most important goal of student’s assessment is promoting learning process and improvement of educational programs quality. through different methods of assessment OSCE(An objective structured clinical examination) could be mentioned as an appropriate way for evaluating the medical students specially nursing students.it is undeniable that the student’s attitude toward evaluation methods, as a main client of education programs, could be highly effective and valuable for educational systems objective: present study is conducted to investigate the student’s views toward OSCE, to find out the present problems in this evaluation method. Design: A qualitative, exploratory study. Methods: For this qualitative study, twenty-five students who experienced OSCEin their university were selected purposively. The data were collected by using semi structured interviews. The interviews were verbatim transcribed and analyzed according to the qualitative content analysis based on Graneheim and Lundman method. Findings: Two main themes emerging during data analysis were: 1- Management aspects problem, that includes 3 categories: 1) supervisor’s behavior, 2) time management,3) Facilities, and 2- Educational aspects problem including three categories of 1) Simulation, 2) Educational background, 3) Question design which are key factors in conducting a more rational and helpful OSCE exam. Conclusion: the result of the present study could be highly effective in promoting both clinical skills evaluation and educational programs. Using this kind of methods requires revision on education method, using more student-center methods in teaching and providing facilities to bring students to the real world of profession helping them to improve their ability in clinical decision making for their career prospect.

Background: End-of-life care refers to all aspects of the care relating to dying, and bereavement which are provided Background: The year 2019 was marked by the emergence of Coronavirus Disease 2019 (COVID-19). The disease started in China and began to spread through movement and travel between countries in which it spread widely. This virus reached many countries and paralyzed public life for almost half of the world\'s population, where they were forced to Staying in their homes for long periods due to the imposed quarantine People who have been forced to stay at home to limit the spread of the virus. There have been many studies that have sought to analyze the impact of this epidemic from different perspectives; However, this study will pay attention to how it affects and how it may affect the psychology of children aged 6-12 years in the future after schools are closed for several months. Material and methods: This review aimed to review the literature on psychological state problems faced by children during the COVID-19 pandemic. The literature was searched within the following databases: PubMed, Google Scholar, Academia, and every one sorts of articles published within the last six months (March 2021 – September 2021) which were relevant to the topic matter of the audit. a complete of twenty-two articles it had been selected through the initial screening and 5 articles were included within the final review. Results: A review of all five articles showed that the current research focuses on assessing several aspects of mentality Affecting children\'s mental health due to COVID-19. Many social and demographic variables such as gender, number of family members, duration of quarantine, and psychological variables such as poor social support, and not playing with other children With increasing stress, anxiety, symptoms of depression and insomnia, there is growing evidence to suggest this That COVID-19 can be an independent risk factor for psychological stress in children and can have a long-term impact on them psychologically as well as in terms of educational level and social relations with others in the future.

Background: Educators should exhibit emotional intelligence in order to develop the necessary teaching skills. Individuals\' emotional intelligence stages have been shown to be more significant than conventional cognitive abilities in dealing with a variety of issues (Supardi, S. 2014). Objectives: This study aimed to assess the teachers\' knowledge of emotional intelligence according to demographic characteristics. Methods: A descriptive design was carried out from 27th February 2021 through 29th July 2021 to assess the teachers\' knowledge towards emotional intelligence in Mosul city. A probability sampling (simple random technique) was used, consisted of 60 teachers, that consist (30) male, (30) female, were from primary schools of Nineveh Education Directorate. The researcher prepared a scale consisting of 40 multiple-choice questions to test teachers\' knowledge of emotional intelligence. The questions include general information about emotional intelligence, self-awareness, self-management, social awareness, and social management. To achieve the objectives of the study. Results: the findings of this study indicates that the level of teachers\' knowledge towards emotional intelligence and their demographic characteristics was low. Recommendations: This study recommends a considerable shortage in the level of special education teachers\' knowledge of emotional intelligence, which is one of the main requirements for special education teachers, especially as they deal with children with developmental disorders. Therefore, the authorities responsible for teachers must intensify the qualification and development courses to increase teachers\' knowledge of emotional intelligence.

Pediatric Cardiac catheterization is considered one of the most diagnostic and interventional procedures available to the cardiologist. Pediatric Cardiac Catheterization has decreased morbidity and mortality for cardiovascular defects, and this invasive process is not free of complications. The study\'s objective is to assess the nurse\'s knowledge and practices regarding pediatric cardiac catheterization. Descriptive -analytical designs are used in the current study. A purposive non-probability sample of ( 30 ) Nurses were recruited who worked in Sulaimani Cardiac Hospital. The present study shows that most participants were males aged between (45-49). years. The study demonstrated that nurses\' knowledge in pediatric cardiac catheterization was satisfied, and more than half of them worked with \"good practice.\" Further, the study\'s result indicates a significant positive statistical correlation between (nurses\' knowledge and Nurses\' practice at Pre-cardiac, Intra-cardiac, Post-cardiac). The study recommends specific special training courses for all the nurses working with children undergoing pediatric cardiac catheterization to reinforce their skills and promote their experience, and further studies are also recommended

Micro RNAs (miRNAs) are small nucleic acids and they are non-coding type of RNA, which are composed of 19-25 nucleotides and work as significant post-transcriptional gene controls of multiple biological roles. Commonly, miRNAs negatively control gene expression by adhering to their particular messenger RNAs in which they generally bind to the 3\'-UTR (UN translated region) of their target mRNAs and repress protein production by destabilizing the mRNA and translational silencing. (mRNAs), for both mRNA degeneration or translational restraint, depending on the level of their complementation with target its mRNA chains. Unusual expression of those miRNAs was found to be associated etiologically with several diseases such as breast carcinoma. Diverse cellular pathways involved in breast cancer is developing such as cell proliferation, apoptosis,metastasis, chemoresistance, and cancer recurrence which are controlled by the oncogenic miRNA (oncomiR) or suppressor miRNA for tumor (tsmiR). In the present study, the representation levels of miR-571 and miR-20a, the most two studied miRNAs in breast cancer, were estimated in 40 breast cancer patients at Hiwa Hospital, Sulaimani city. Real-Time-Reverse Transcription-PCR (RT-PCR) was applied to evaluate the expression of miR-571 and miR-20a. The clinical data including breast cancer with different grades, a cancer patient with chemotherapy state ( pre-chemotherapy), and ( post-chemotherapy) conditions. Results exhibited that both miR-571 and miR-20a expression is correlated with disease stage among patients taking chemotherapy. According to the results, chemotherapy increased the expression of miR-571, but reduced the expression of miR-20a in patients with breast cancer. We also found that chemotherapy had more effect on miR-571 expression in comparison with miR-20a. Furthermore, the effect of chemotherapy was higher in the early stages of breast cancer in comparison to other disease stages. In the coclusionusing both miR-571 and miR-20a as important biomarkers for detecting the the beneficial effects of chemotherapy on breast cancer.

It is an observational cross-sectional study, the data collected by convenience sampling method from 44 infected case in Ranya general hospital and private clinics for admission from neurological department and physiotherapy private centers after cases had right or left side weakness by side effect covid19 , from 10. January. 2021 to 01. august.2021, the study include all the participants diagnosed by covid19 and had side effect neurological disease post pandemic covid19. For the study materials the data was collected by face to face questionnaire from that include sociodemographic data, and questions about covid 19 and cerebrovascular accident, the data were analyzed by SPSS software to produce, in the result about the patient’s gender, most of them were male and for the patients BMI classification, majority of them were classified as an overweight, and cardiovascular diseases risk factors as follow; majority of them had diabetes mellitus (72.2%), and blood pressure and high cholesterol atrial fibrillation and history of heart diseases had high role to occurrence neurological disease with covid19 or post covid19 . And hospitalized during COVID-19 disease, with high intensity sing and symptom increase risks for cerebrovascular accidents, type of ischemic stroke.

Background: Diabetes is a lifelong condition characterized by extreme blood glucose (or blood sugar) levels, which can cause major damage and complications to the heart, blood vessels, eyes, kidneys, and nerves over time. Objectives: Investigation of the effectiveness of patient’s instructional program using an assessment of patient’s knowledge, through the utilization of a knowledge test. Methods: The study carried out at Azady teaching hospital in Duhok Governorate. A quasi-experimental design (pre-post-test) study had been adopted through the present study with the application of the pre- post-test approach for both studied and controlled groups during the period 30 of March 2021 to 20 January 2022. In order to get reliable data and a representative sample, a nonprobability (purposive) sample was selected. The sample included in the present study is (54) patients. The sample is divided into two groups; (27) patients as the study group is exposed to the instructional program and (27) patients are not exposed to the program, considered as the control group. It is a questionnaire format for the research purpose and is composed of three parts. The first part delves into the social and demographic aspects of patients consisting of (14) items, which include (Age, gender, marital status, educational level, family income, diabetes duration, diabetes type), while the second part related to patients knowledge about diabetes and its complication, which consists of (7) items as multiple-choice questions. The third part consists of (12) items related to patients’ knowledge regarding management and control of their diabetes. Results: After applying for the instructional program, results were reported highly significant differences toward the effect of the program's contents through raising knowledge grades of studied respondents toward controlling their diabetes and preventing diabetes complications particularly at the post1 period. Recommendation: Instruction programs should be designed for all diabetic patients with both types of diabetes to improve their knowledge about the management of their diabetes and its complications and their knowledge should be updated periodically.