الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Bladder cancer is a common urologic cancer that has the highest recurrence rate of any malignancy. In Egypt the most common type is transitional cell carcinoma. Other types include squamous cell carcinoma and adenocarcinomas (Sadeghi and Edris, 2017).Transurethral resection of the bladder tumor (TUR-BT) remains the gold standard ‘first step’ in bladder cancer management (both diagnosis and tumor removal), there can be a high rate of residual tumor left behind after TUR-BT. With some series showing as many as 34-76% of patients with a tumor on repeat TUR-BT at 2- 6 weeks. Incomplete initial resection has been associated with a higher risk of tumor recurrence, despite the administration of adjuvant intravesical therapies, emphasizing the importance of the completeness of TUR-BT (Babjuk and Favaretto, 2017).The aims of the study were 3 folds: the first was to assess patients’ knowledge about bladder cancer and trans-urethral resection of bladder tumor, the second was to design nursing instructions for patients undergoing transurethral resection, and the third was to evaluate the effect of implementing nursing instructions on patients’ outcomes.To fulfill the aims of this study, the following research hypothesis was formulated: The incidence of transurethral resection complications in patients who will receive the nursing instructions will be less than patients who will receive the routine care. A quasi – experimental research design was utilized to conduct this study. To accomplish the aims; data were collected in the Urology and Nephrology Hospital at Assuit University Hospital. A sample of 60 adult male patients in the urologic department and outpatient clinic at Urology and Nephrology Hospital at Assiut University Hospital. Age ranged from 20 to 65 years. The patients were dividing into two equal groups (study and control) 30 patients for each. The study group received the nursing instructions while the control group received the routine hospital care.The following tools were utilized for data collection; Tool (I): ”Pre\post structured interview questionnaire ”, Tool (II): ”Pain numeric rating scale”The main findings of the present study were:-1.The majority of the studied patients their ages were more than 60 years old. Also there was predominance of male in both study& control groups (83.3% and 93.3%) respectively. As regard the marital status, the majority of patients in the study and control groups were married (100% and 90%) respectively. Concerning the patient’s educational level, (83.3% and 70%) respectively in the study and control groups were illiterate. In relation to patients’ occupation, the majority of patient’s in the study& control groups were not working (76.7% and 66.7%) respectively2.More than one - third of patients in the study group, and less than fifth of the control group were having hypertension, while less than fifth of the study control groups were having diabetes. The majority of the study group and control group were consuming tea / coffee (100 % and 96.7%) respectively. As regard cigarette smoking the majority of the patients’ in control group had smoked cigarette more than study ones (93.3 %, 83.3 %) respectively. .3.The mean score vital signs’ recording for study and control group in different times of patients’ follow up was higher than those of the study group especially for temperature, pulse during post-operative phase (36.77±0.59, 74.77±8.4) respectively. Also, there was a statistical significant difference between both groups in pre-operative phase and before discharge as regard temperature, pulse and diastolic blood pressure readings. 4.The majority of patients (96.7% and 100%) in study and control groups had unsatisfactory knowledge about causes of bladder cancer. There was no statistically significant difference between study and control groups before the application of nursing instructions.
5. There was statistically significant difference for the study group post implementing nursing instructions as regards knowledge level of patients about transurethral resection of bladder tumor.6.The mean knowledge score, after application of the nursing instructions, the study group had higher mean knowledge score than the control group with statistically significant difference between both groups.7.There was highly statistically significant relation was documented between patients’ knowledge about bladder cancer and transurethral resection of bladder tumor. Those who are educated had knowledge when compared with illiterate patients, there was highly statistically significant relation between patients who were working and other weren’t working, there was highly statistically significant relation between patients knowledge whose age more than sixty years and patients whose age ranged from (40-60) yrs. >8. There was statistically significant difference between study group and control group as regards post procedure complications such as urinary tract infection, bleeding, pain, and fever during hospitalization and 2 weeks post discharge.