الفهرس 
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Abstract
Summary
Learning disabilities (LD) have become one of the most frequent challenges for teachers, the family, and for the students who have them. It is imperative to note that one of the most common problems experienced by school children is learning disability. The term “learning disabilities” is used to describe consistent and prolonged problems in learning. These problems are generally in the areas of reading, writing, spelling and mathematics. Learning disabled children excel in some areas rather than the problem area. There are others who are slow in acquiring school- related skills (Taura & Abdulkadir, 2021).
Aim of the study:
The aim of the study was to evaluate the effect of nursing intervention program on psychological stress and competencies among parents of children with learning disabilities.
Research hypothesis:
Nursing intervention program had positive effect on parental psychological stress and competencies toward their children with learning disabilities.
Research design:
A quasi – experimental study was utilized to conduct this study.
Research setting:
The study was conducted at four private centers of learning disabilities at Zagazig city (the most important center in each zone (eastern, western, northern, southern) Namaa center, Ataa center, early intervention & child development center, and tamkeen center.
Research subjects:
- Type of sample
The subjects of the present study, a convenient sample collected from all parents of children with learning disabilities attending regularly any of four previously mentioned settings over a six months period.
- Sample size
It was collected from 70 parents of those children (all of attending regularly parents) according to the following criteria.
- Inclusion criteria for parents:
1- Ages from 20 years to above.
2- Both sexes.
3- Parents living in the same dwelling.
- Inclusion criteria for children:
1- School age children range between 6 to12 years old.
2- Both sexes.
3- Normal I.Q.
4- Free from visual problems, hearing problems or psychiatric problems.
Tools of data collection:
Data was collected by used the following tools:
Tool (1): Socio-demographic data sheet: It was designed by the researcher. It was composed of two parts:
a. For children: It included age, sex, education, child order…..etc.
b. For parents: It included age, sex, marital status, family members, residence, and level of education, occupation, and family income.
Tool (2) parent stress index:
It was developed by Abdin, (1983), to measure parenting stress of children with chronic illness. Arabic version was translated by Elbeblawy, (1988), was utilized in this study. It consisted of 99 items. Each item presented with five graded response: strongly agree, agree, uncertainty, disagree, and strongly disagree. The items are grouped into two main groups of stressor, namely child related- stress and parent-related stress.
Child related domain: this domain assesses the presence of child behaviors and characteristics that are stressful to parents. It includes six subscales, namely child distractibility and hyperactivity (9 items), child reinforcing parents (6 items), child’s mood (5 items), child acceptability to parent (7 items), child adaptability (10 items), and child demandingness (9 items).
Parent related domain: this domain assesses parents stressors related to personal adjustment and family functioning. It has seven subscales, namely parent sense of competence (13 items), parent attachment (7 items), restriction of parental role (7 items), parental depression (9 items), relationship with spouse (6 items), social isolation (6 items) and parental health (5 items).
Tool (3) parenting sense of competence scale (PSOC):
It was developed by Johonson and Mash`s, (1989). Is a 16-item questionnaire measuring parental satisfaction and efficacy and assess how confident parents feel in their ability to handle their child’s problems. It yields two subscales: (a) (satisfaction), addressing parent self-perceptions regarding the skills and understanding required to be a good parent (9 items) and (b) (efficacy), the degree to which respondents feel comfortable and capable in their roles as parents and the value they assign to the parental role (7 items).
- Scoring system:
*Scoring System of Stress Index:
The stress items were respectively scored 5 to 1 for the responses from ’’strongly agree’’ to ’’strongly disagree’’ for each subscale and domain, and for the total scale, the scores of the items were summed-up and the total divided by the number of the items, giving a mean score for the part, this was converted to a percent score.
Score % = (the observed score / the maximum score) × 100
The total score was from 97-485 grades:
• Low stress <50%
• Average stress 50-75%
• High stress >75%
* Scoring System of Parenting Sense of Competence Scale (PSOC)
The responses are on a 6-point Likert-type scale: ’’strongly agree’’, ’’agree’’, ’’mildly agree’’, ’’disagree’’, and strongly disagree’’. These are scored from 1 to 6; the scoring was reversed for negatively stated items so that a higher score means more satisfaction and more parent efficacy. For each of the two subscales and for the total scale, the scores of the items were summed-up.
Score % = (the observed score / the maximum score) × 100
The total score was from 16-96 grades:
• Low Competence <50%.
• Average Competence 50-75%.
• High Competence >75%.
A pilot study was carried out after the adaptation of the tools and before starting the data collection. It was conducted on (10%) of the expected sample size to test the clarity, feasibility and applicability of the study tools. In addition, it served to estimate the approximate required time for interviewing the school students as well as to find out any problems that might interfere with data collection. All participants in the pilot study were excluded later from the actual sample.
The main results obtained from the present study were as follows:
• 57.1% of the studied parents had high stress at pre-program implementation compared to 15.7% at post program implementation.
• 5.7% of the studied parents had high competence at pre-program implementation compared to 31.4% post-program implementation.
• There were a statistical significant relations between the studied parent level of before stress index and their level of education, with p-value <0.05; while there was highly statistically significant relation between after stress index and level of education, with p-value (p<0.001).
• There were a statistical significant relations between the studied parent level of before stress index and their level of education, job and residence, with p-value <0.05; while there was highly statistically significant relation between after stress index and level of education, Job and residence, with p-value (p<0.001).
• There were a statistical significant relations between the studied parent level of before stress index and their family income, caregiver, parent child relationship and parent relationship, with p-value <0.05; while after stress index there was highly statistically significant relation with family number, family income, caregiver, parent child relationship and parent relationship, with p-value (p<0.001).
• There were a statistical significant relations between the studied parent level of before level of competence and their level of education, with p-value <0.05; while after level of competence there was highly statistically significant relation with level of education, with p-value (p<0.001).
• There were a statistical significant relations between the studied parent level of before level of competence and their level of education, job and residence, with p-value <0.05; while after level of competence there was highly statistically significant relation with level of education, Job and residence, with p-value (p<0.001).
• There were a statistical significant relations between the studied parent level of before level of competence and their family income, caregiver, parent child relationship and parent relationship, with p-value <0.05; while after level of competence there was a highly statistically significant relation with family number, family income, caregiver, parent child relationship and parent relationship, with p-value (p<0.001).
• There were no a statistical significant relations between the studied parents low, average and high regarding before level of stress index and their before level of competence.
• There were high statistical significant relations between the studied parents low, average and high regarding after level of stress index and their after level of competence.
• There were a positive correlation and highly significant between total score of the studied parenting stress index and total score parents’ competence and ability to raise their children, with p-value (<0.001**) at post-program.
Based on the results of the current study; it can be concluded that:
• The educational program had a positive effect on parental psychological stress and competencies toward their children with learning disabilities.
In the light of the finding of the study, the following points are recommended:
• Parents of children with LDs should be considered for treatment and family intervention strategies to improve family life.
• Parents of children with LDs need multidisciplinary support and supervision from the health service and personnel in school.
• Parents of children with LDs need support in their decision making, and focusing on the entire family is essential as a part of the early interventions.