الفهرس 
Introduction andOnly 14 pages are availabe for public view
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Abstract
Hemiplegiaisparalysisofeithertheleftorrightsideofthebodyaccompaniedwithlossoffunction,poorbalance,speechdeficitthatmightresultfrominjurytothemotorcentersofthebraineitherduetoischemiaorhemorrhage(Kusaka, et al., 2014).
Hemiplegiaisaconditionwhereaverticalhalfofapatient’sbodyisweaknessorparalysisoccurringonthedominantsideofthebody,andpoorcoordinationresultingfromthenewrelianceonthedominationmaymakeeatingdifficultandunpleasant(ShindeandAnjum,2014).Hemiplegiaisamoresevereformofhemiparesis’whereinonehalfofthebodyisonlyweakened.Itisalsoverydifferentfromtheconditionsofparaplegia&quadriplegia,whicharecommonlyconfusedwithhemiplegia.Paraplegiaisparalysisinbothlegs,belowthewaist.Quadriplegiaisparalysisbelowtheneckandisalsousuallytheresultofaspinalcordinjury(Dimond, et al., 2013).
ThenursingrolesinhomehealthcareHHCaretherolesofclinicianthatprovidedirectcaretotheclientsandfamilies,whichincludeeducator,researcher,administratorandconsultantareseeninhomehealthcare.Theexperiencedhomehealthnursemanagerortheadministratorcanfulfillthisrole(Melnick,etal.,2013).
Themostimportantgoalofteachingincommunitybasedcareistoassistthehemiplegicadultsandcaregiversinachievingindependence.Thequalityofteachingenhancestheabilityofclientandfamilytobesuccessfulinprovidingoftheirownneeds.Whentheclientslearningneedsareconsideredwithinthecontextoftheclientfamilyandcommunity,betteroutcomeswillresult.Theseoutcomesincludeimprovedcare,facilitatedrecoveryandreductionofdiseasecomplicationandresumptionofactivitiesofdailyliving(ADLS)(Marsick, et al., 2015).
AimoftheStudy
Theaimofthisstudywastoassessthecaregivers’awarenessregardinghemiplegiaamongtheiradultpatientsthroughassessing:
5. Caregivers’knowledgeregardinghemiplegiaamongadult.
6. Caregivers’expectedpracticesregardinghemiplegiaamongadult.
7. Caregiversregardinghealthneedsandhealthproblemsamongadultpersonswithhemiplegia.
8. Caregivers’perceivedstresstowardadultpersonswithhemiplegia.
SubjectandMethods
Researchdesign:
Descriptivestudywasusedtoassessthecaregivers’awarenessregardinghemiplegiaamongadults.
Setting:
ThisstudywasconductedinstrokeoutpatientclinicsinEl-MiniaUniversityHospitalatthecaregiverswhocamewiththeirpatientstotheclinicforfollowup.
Sampling:
Thesamplewascollectedthroughthreemonths.Purposivesamplingwasselected.AllcaregiverswhowereattendingoutpatientstrokeclinicsofEl-MiniaUniversityhospital.Thetotalnumberofcaregiversatoutpatientstrokeclinicsinthreemonthswas70persons.Itincludedbothmaleandfemalecaregivers,caregiverswhoareco-operativeandCaregiverswho’stheiradultpatient’s≥20yearsold.
Thefollowingtoolswereusedfordatacollection:
Firsttool:aninterviewingquestionnairecomposedof(1)intosixparts
Part1:Demographiccharacteristicsofcaregivers.
Part2:Caregivers’knowledgeregardinghemiplegicdisability.
Part3:Practicesstatedbycaregiversrelatedtocaringoftheirhemiplegicadults.
Part4:physicalassessmentsheetsthisisanassessmentquestionnaire,whichismodifiedfromBARTHELINDEXtoassessthelevelofdependenceforpatients(Dijkhuizen,Annemarie, et al., 2016).
Part5:Assessmentofcaregiveraccordingtoburdendistressrelatedtotheircareforhemiplegic.
Part6Assessmentofcaregivers’accordingtofeelingofstresstowardtheirhemiplegicadultbyusingperceivedstressscale(PSS)(Cohen, et al., 2012).
Pilotstudy:
Thepilotstudywasconductedtotestthesimplicityoflanguageoftools.Itwasconductedtoevaluateapplicabilityofthestudytoolswhichusedindatacollectioninadditiontothetimerequiredtofilleachtool.Itwascarriedouton7caregiversofhemiplegicadultswhichhadbeenincludedinthisstudy.TheywerechosenrandomlyfromtheoutpatientstrokeclinicofElMiniaUniversityHospital.
Thestudyresultscanbesummarizedasfollows:
Thehalfofthecaregiverswasinamoderateleveloftotalknowledgeregardinghemiplegia.Themajorityofthecaregivershaven’tcorrectdonepracticerelatedtocareofhemiplegicadultand58.7%ofthehemiplegicadultsweredependenttodoactivityofdailyliving..
Morethanhalfofcaregivershadmildtomoderatefeelingofburdenasaresultofpresumedcaregiverroleandthemajorityofcaregivershadmildtomoderatefeelingofstressasaresultofpresumedcaregiverrole.
Thestudyresultsfoundastatisticalsignificancedifferencebetweeneducationallevel,occupationandlevelofknowledge(P<.000)amongstudygroupregardinghemiplegia,buttherewasn’tsignificantdifferencebetweenmaritalstatusandlevelofknowledgeofthemregardinghemiplegia(P<0.378).Therewerestatisticalsignificancedifference(P<0.3)betweencaregiverknowledgeandtheirstresstowardtheircareforhemiplegicadultbuttherewasn’tstatisticalsignificantdifferencebetweencaregiverknowledgeandtheirfeelingofburden(P≤0.739).Also,therewerenostatisticallysignificancedifferencesbetweenactivityofdailylivingandcaregivers’knowledgelevelwhichp-value≥.279.
Thestudyfindingfoundnostatisticallysignificancedifferencesbetweencaregiverspracticelevelandtheirknowledgelevel,theirstressandburdenscalewhich(P<.653;.355&532)respectively.
Accordingtothefindingsitisrecommendedthat:
1-Applyandimplementhomehealtheducationbyallstrokecareunits,neurologicaloutpatientclinicsandphysiotherapyclinics.
2-Providethecommunitywiththepreventiveinformationespeciallyattheprimarylevelaboutthestrokediseaseandhemiplegiatoincreasethepublic’sawarenessaboutriskfactorsofhemiplegiaanditscausesandhealthylifestylethroughthedisseminationofmassmediasuchasantismokingmedia,wellbalanceddietregime,physicalexercise,continuesfollowupsystem,andothershealthpromotionprograms.
3-Developateamofdischargeplaningovernmentalandprivatehospitalstoberesponsibleaboutprovidingthepatientsandtheirfamilycaregiverswiththeneededknowledgeandpractice,whichwouldbeappliedathome.
4-DesignafollowupsystemfromtheMinistryofHealthforadultwithhemiplegiaduringthefirstyearofacutestroketofollowtheprogressivelevelandevaluatetheirlifestyleandattitudetowardthedisabilityanditspreventivemeasurestohemiplegicadultandtheircaregiverswhichinclude
• Thedesiredlaboratorytest.
• Physicalexamination.
• Physiotherapy.
• Educationalsessions.
5-CollaborationbetweenMinistryofHealthandMinistryofSocialAffairstohelpandsupportcaregiversrolethroughsavingmoney,drugs,andhomehealthcarefacilitiesaidssuchaswheelchairorwalker.
6-Furtherresearchesareneededtostudythedifferentfactorsthatincreasethecaregivers’burdenandtheircomplaintstofindoutthesuitablesolutions.
7-Designandimplementnursinginterventionprogramaboutcaringofhemiplegicadult,atoutpatientclinicduringfollowupvisits.
8-Advocateforadequatefundingforprogramsthatsupportfamilycaregiver.
9-Participateindischargeplanning,identifyingwhatfamilycaregiverscanandcannotdo,andanythinginthehomeenvironmentthatcouldpreventasuccessfulrecovery