الفهرس 
Purpose of the studyOnly 14 pages are availabe for public view
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Abstract
Childhood is the period when nail-biting is most commonly seen. Nail-biting is not a life-threatening condition. It is one of the oral habits that can harm teeth and adjust the structure. However, the border between its healthy and unhealthy associations still need conclusive establishment. When this habit becomes problematic, they interfere with the person’s wellbeing. It is a common behavior in both sexes. Nail-biting often does not begin until the age of three or four years.The purpose of the study was to: -Examine the effect of Pender’s health promotion intervention on nail biting among school age children.Research hypothesis:-The following research hypothesis was formulated to achieve the purpose of the study: School age children who receive Pender’s health promotion intervention had fewer occurrence of nail biting on posttest than on pretest. Research design: - A Quasi- experimental design was used (pre, post-test and follow-up tests) .Setting: -
This study was conducted in Islamic primary school in Shebein Elkom in Menoufia Governorate.Sampling: -A purposive sample of 40 school age children ranged from 6-12 years old with nail biting habit and their parents were selected from Islamic primary school in Shebein Elkom in
Menoufia Governorate.Instruments of the study: -Five instruments were utilized for data collection:
Instrument one: Knowledge of mothers Structured Interviewing Questionnaire. It was divided into two parts: Part one: characteristics of studied children and their parents. Part two: Mother’s knowledge about nail biting habit.Instrument two: Observational assessment sheet for nails abnormality:-It was developed by the researcher after a review of related literature Siddiqui et al.,(2017) related to signs of nail biting habit such as short fingernail, red and sore finger tips,
damage tissues around nails and nail deformation. Also, it contained a list of children’s name,
telephone number and shape of nails.Instrument three: Nail biting likert scale: -The scale was adapted from the Massachusetts General Hospital (MGH) hair-pulling scale (Keuthen, Baer and Shera et al., 1995). Then, the design was modified by the researchers to collect data about frequency and intensity of urges of nail biting, ability to control this urges, attempts to resist nail biting, control over nail biting. The items were summed to represent a total score that ranged from 0 to 28.Instrument four: Pender’s Health Promotion Structured Questionnaire:The questionnaire was based on Pender’s Health Promotion Model. It was developed by Pender, (2011) and adopted by the researcher to collect data about parent’s and children’s perceptions about nail biting repetitive habits experience, perceived benefits and barriers,interpersonal influences, situational influences and behavioral outcomes.Instrument five: Measuring tape: -It is a long, soft and flexible ruler used to measure the length of things. It is made from plastic or fiber glass with linear measurement markings. There is a centimeter scale on the back which is printed in centimeters. It ranges from 0 to 150 centimeters. Nail length was measured in millimeter. The length of all the fingernails of children was measured. The length is defined as the longest distance from the base of nail to its tip (Twohig & Woods.2001).The main results of the study showed that: The mean score of mothers’ knowledge on pretest was 2.87±3.36 compared to 11.37±2.23 and 14.80±0.46 on post and follow-up tests respectively. The total mean score of severity of nail biting on pretest was 15.40±3.39 compared
to 11.42±3.77 and 7.97±4.12 on post and follow-up tests respectively. The majority of studied children had higher level of perception of benefits and barriers of nail biting habit on posttest than pretest. More than half (52.5%) of studied children had moderate level of self-efficacy on posttest compared to 17.5% on pretest respectively. One third of mothers had high-level of perception regarding nail biting behavior on pretest compared to 100.0% and 62.5% on post and follow- up tests respectively. Children had the highest mean scores of nails length 4.39 ±.99 and 5.17 ±1.23 on post and follow-up tests respectively compared to 3.85 ±0.83 on pre-test.The study concluded that:School age children who received Pender’s health promotion intervention had fewer
occurrence of nail biting on posttest than on pretest.Based on the results of the study, it was recommended that:1. Further studies should be implemented on a larger sample of children and their parents in other pediatrics departments to ensure the generalizability of results.2. The implementation of Pender’s health promotion intervention should be monitored for longer follow-up periods (such as 6 months, 1 year) to determine its effectiveness on decreasing nail biting habit.
3. Ongoing in-service health education programs based on application of Pender’s health
promotion model for children with nail biting should be designed and implemented into schools and pediatric health care settings to improve management of children with bad oral habits.4. Integration of oral health promotion program (OHPP) into school curriculum may enhance information, attitude, and oral health practices .