الفهرس 
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Abstract
Acute rheumatic fever is an autoimmune response to an infection by group a Streptococcus. This means the immune system creates antibodies in response to the infection, but as well as attacking the infecting bacteria; certain body tissues are also damaged. Tissue such as cardiac tissue, joints, skin, and the central nervous system. Repeat attacks of acute rheumatic fever can lead to chronic rheumatic heart disease and permanent damage to the heart valves (Welsh, 2012). School age children are experience a time of slow progressive physical growth, while their social and development growth accelerates and increases in complexity. The focus of their world expands from family to teachers, peers, and other outside influences. The child at this stage becomes increasingly more independent while participating in activities outside the home. It is during this time that children move toward abstract thinking and seek approval of peers, teachers and parents. Their eye-hand-muscle coordination allows them to participate in organized sports in school or the community. They typically values school attendance and school activities (Kyle & Carman, 2013). The aim of the present study was to determine the effect of rheumatic fever on quality of life among school age children, the following research questions were formulated: - Is there a relation between socio demographic characteristics of school age children and rheumatic fever? - Is rheumatic fever effect on physical aspect of quality of life of school age children?- Is rheumatic fever effect on psychological aspect of quality of life of school age children? - Is there a relation between the knowledge and practices of school age children and their mothers to relieve rheumatic fever symptoms? The study was conducted in cardiac outpatient clinics at Benha university Hospital and Health Insurance Hospital in Benha City.A descriptive design was used in carrying out this study. The sample of study were purposive and included 100 school age children with RF and 25 mothers of primary school age children. They were selected randomly, taking into consideration the following criteria for the school age children: Diagnosed with rheumatic fever, free from other medical problems, age from 6-18 years and accepted to participate in the study. Tool was used for data: A structured interviewing questionnaire A structured interviewing questionnaire: consisted of the following five parts. First part:Socio-demographic characteristics of the studied sample. This part included three items. A. Socio-demographic characteristics of school age children. It included questions about age, sex, school grade, birth order, and scholastic achievement. B. Socio-demographic characteristics of mothers such as age, educational level, occupation, income, and family size. C. House condition such as residence, housing type, number of bedroom, source of healthy water and sewage disposal. Second part: Medical history of school age children , it consist of seven question, child`s age at the first attack of rheumatic fever, number of rheumatic fever attack, manifestations, treatment of rheumatic fever, penicillin sensitivity test, complications of rheumatic fever and information source about rheumatic fever. Third part: School age children and their mother`s knowledge about rheumatic fever. It included nine questions for child and for his/her mothers of primary school age children only. The questions covered areas such as, meaning of rheumatic fever, predisposing factors, causes, clinical manifestations, diagnosis, complication, prevention of recurrence of rheumatic fever attack and treatment. Fourth part: Concerned with school age children and their mother`s practices through asking questions of rheumatic fever (mothers of primary school age children only) to relieve rheumatic fever manifestations. Fifth part: Concerned with quality of life scale (Pediatric Quality of Life Inventory scale (Peds QL): to measure the physical status, psychology status, and school activities of the school age children with rheumatic fever modified by investigator (Varni,1998). The current study revealed the following results: • School age children mean age was (13, 27± 2, 87) years, 60% of them were female, 45% of school age children were in preparatory school, 51% were the first child in their family. Regarding the Level of scholastic achievement, 39% of the school age children succeed with pass degree. • 77% of mothers were aged 35 and more years, 62% of them had secondary education, and 80% were housewives. While 66% had enough family income per month and 57% had five and more family members. • 78% of school age children were living in rural area, 85% of them were living in a separate house, 72% had two rooms per house, while 93% of them had sanitary source of water inside the house and 70% had cesspool sewage disposal. • 58% of school age children exposed to the first attack of rheumatic fever at the age of 5 and less than 10years, 47% of them had twice attack of rheumatic fever, while all studied school age children suffered from pain, swelling and redness in some joints and the pain transmitted from one joint to another. 98% of them treated with penicillin, 98% of them did the penicillin sensitivity test at only the first time of taking penicillin, while, 84% didn`t suffer from any complications of rheumatic fever and 99% acquired their information about rheumatic fever from doctor. • All of primary school children had poor knowledge, 85.33 of preparatory and secondary school children had poor knowledge, 88% of primary school children`s mothers had poor knowledge about rheumatic fever. • 54.67%of preparatory and secondary school age children had unsatisfactory practices of rheumatic fever and all primary school age children had unsatisfactory practices of rheumatic fever. • 84%of mothers had unsatisfactory practices about rheumatic fever and only 16% of them had satisfactory practices about RF. • 47% of children had poor quality of life physical status, 39% of them had good psychological status of quality of life, and 45% of them had good school activity of quality of life, while 62% of them had average total quality of life items.• There was highly statistically significant relation between primary school age children total knowledge about rheumatic fever and total knowledge of preparatory and secondary school age children about rheumatic fever. • There was highly statistically significant relation between total practices of primary school age children and total practices of preparatory and secondary school age children to relieve RF manifestations. • Regarding comparison between total quality of life of primary school age children and total quality of life of preparatory and secondary school age children. There was statistically significant relation between school activities of primary school age children and school activities of preparatory and secondary school age children. On the other hand there was no statistically significant relation between physical status, psychological status and total quality of life between primary school age children and preparatory and secondary school age children. • Regardingstatistical relations between socio-demographic characteristics of school age children andnumber of rheumatic fever attacks. There were highly statistically significant relations between number of rheumatic fever attacks and age of school age children and their school grade, but there were no significant relation between number of rheumatic fever attacks and school age children` sex or theirscholastic achievement. • There were statistically significant relations between total knowledge of school age children and fever, carditis, erythema marginatum, and chorea which the school age children suffered from it. On the other hand there were no significant relations between total knowledge of school age children and arthritis which the school age children suffered from it. • There was no significant relation between total knowledge of primary school age children` mothers and manifestations which the school age children suffered from it. • There was significant relation between total practices of rheumatic fever of school age children and fever which the school age children suffered from it. On the other hand there were no significant relations between total practices of rheumatic fever of school age children and carditis, arthritis, erythema marginatum and chorea which the school age children suffered from it. • There was no significant relation between total practices of rheumatic fever of mothers and fever which the school age children suffered from it, while there were significant relations between total practices of rheumatic fever of mothers and carditis and arthritis which the school age children suffered from it and there was highly significant relation between total practices of mothers and chorea which the school age children suffered from it. Based on the study findings, it is recommended that: - Health education program should be given for school age children who had rheumatic fever and their mothers about periodic checkup for early detection, and treatment of RF and improving quality of life of children. - Further studies need to be focusing on improving quality of life of children with RF and to investigate the incidence and contributory factors leading to RF and the adequate intervention.