الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Children with CKD often experience a series of body changes from the condition itself and from the immunosuppressive therapy used for treatment. Polyuria and polydipsia with subsequent enuresis, kidney disease related edema, CKD related growth impairment, and devices placed in the body, including those used for dialysis access, all influence in physical, emotional and sexual growth of these children. The physical health of children with progressive CKD and end stage renal disease (ESRD), has improved with advances in nutrition, medical care, and transplantation (Assadi, 2013).
Caregivers of children undergoing dialysis therapy suffer from target burdens due to care of their children besides accompanying them to health care setting. Therefore, self learning package had implemented for those caregivers to feed them with important knowledge and practice about the disease as well as help their children to grow normally compared with their peers.
The present study aimed to assess knowledge, practice and attitude of caregivers’ regarding caregivers of their children undergoing dialysis therapy, plan and implement self learning package for caregivers of children undergoing dialysis therapy and evaluate the impact of self learning package on caregivers’ knowledge, practice and attitude. A- purposive sample included 33 child undergoing dialysis therapy from both sex and their caregivers (mother, father or family member) who were able to read and write regardless their age. A quasi experimental research design was followed at dialysis units at Benha University Hospital, Kaluobia governorate and Mansoura University Children’s Hospital
Tools were designed by the researcher in an Arabic language after reviewing the related literature and consisted of:
1- Questionnaire Sheet:
It was designed and developed by the researcher after reviewing related literatures. It was written in an Arabic Language to assess caregivers’ knowledge regarding renal failure, dialysis therapy in addition to coping pattern and quality of life.
2-Observation Check Lists:
Observation check lists were modified by the researcher from Bowden & Greenberger (2003), to suit the nature of study and to assess caregivers’ reported practice regarding care of their children: fistula care, range of motion exercise, breathing & coughing exercises and hand washing.
3-Likert Type Rating Scale:
The tool was designed by the researcher in the light of Votroubek & Tabacco (2010), and translated to Arabic language to assess the caregivers’ attitude regarding care of their children undergoing dialysis therapy.
4- Child’s Medical Record:
This record was used to check data related to children undergoing dialysis therapy including; Children’s characteristics, medical history, history of consanguinity and dialysis characteristics, physical assessment and laboratory investigation.
5- Pediatric Quality of Life Inventory Version 4.0 : (The PedsQL 4.0 generic core scale) which developed by Varini et al (2001)., and translated in Arabic language to suit the nature of the study and to assess the health related quality of life of children.
6- Modified Likert Scale (Child’s Coping):
It was designed by the researcher in the light of related literature. Items of the scale consisted of 20 statements and each statement graded into, always, sometimes and never to measure coping of the children undergoing dialysis therapy.
7- Self Learning Package:
• A self learning package based on actual need assessment of the studied sample (caregivers). It was designed and implemented to cover the theoretical knowledge and practical procedures related to care of children undergoing dialysis therapy.
• Self learning package was distributed to each study subject.
• Each caregiver was assessed pre/ post and follow-up implementation of self learning package.
The results of the study can be sum
1-Near to half of the studied caregivers had average level of knowledge regarding renal failure and dialysis therapy through follow-up self learning package compared to few of them before self learning package.
2-Near to two thirds of the studied caregivers had satisfied reported practice during follow-up self learning package compared to none of them before self learning package.
3-Few of the studied caregivers had positive attitude before self learning package and this percentage increased to more than two thirds of them during follow-up self learning package.
4-More than three quarters of the studied children had moderate quality of life during follow-up self learning package compared to few of them before self learning package
5- Near to three quarters of the studied children had positive coping patterns during follow-up self learning package compared to the minority of them before self learning package.
from the results of the present study, the following can be concluded:
There was positive effect of self learning package on improving knowledge, practice and attitude of the studied caregivers as well as, quality of life and coping patterns of their children undergoing dialysis therapy.
from the previous findings, the following recommendations are suggested:
1-Emphasizing on the important of improving quality of life and coping patterns of caregivers of children undergoing dialysis therapy.
2-Periodic assessment of stressors facing caregivers of children undergoing dialysis therapy that could affect coping patterns and quality of life.