الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 264 |  |  |
| | | from | 264 | | |
Abstract
Rheumatic Fever (RF) is a post infectious, immunologic response to untreated or inadequately treated group A β-Hemolytic Streptococcus (GABHS) pharyngitis occurring in genetically susceptibility students. Up to 30% of sore throats in students and young people are caused by GAS, and 0.3% to 3% of young people with an untreated GAS sore throat will develop RF. Rheumatic heart disease (RHD) is the only chronic sequel to ARF, with lifelong consequences. As such, ARF and RHD are potentially preventable diseases with timely, adequate and appropriate antibiotic treatment of streptococcal pharyngitis (Arvind & Ramakrishnan, 2020).
Rheumatic fever had an impact on the most of the life style of the preparatory school age students. It affected the dietary habits of the majority of the students with illiterate parents. Psychological state of most of the studied students was affected. Rheumatic fever requires long-term prophylactic treatment, including painful administration of intramuscular medication, which can result in frequent psychological disorders and treatment dropout. Another
Summary
135
factor that contributes to deteriorate the patient’s quality of life is the presence of cardiopathies, which may cause functional and psychosocial limitations (Oeiyano & Rampengan, 2020).
Significance of the study:
Rheumatic Fever is preventable by treating strep throat with antibiotics, the most serious complication of rheumatic fever is rheumatic heart disease (RHD).School health nurse helps in preventing recurrence of rheumatic fever by teaching the students about disease process, possible sequel, good nutrition, hygienic practice and continual need for prophylactic antibiotics (Anderson et al., 2019).
In Egypt, Rheumatic Fever is still affecting young children with 10% of cases having their first attack before 15 years of age. It represents a serious health problem, as it affected 8-9 per 10.000 of children between 6 to 15 years. Rheumatic heart disease is the only chronic sequel to acute rheumatic fever, with lifelong consequences. Rheumatic heart disease is a serious cardiac condition in children and young adults, although it remains neglected around the world. The problem of RHD is a national issue in Egypt
Summary
136
and is being given priority by the Egyptian Ministry of Health under the auspices of all national experts and leaders concerned. The national RHD prevention and control program was established through PHC RHD centers distributed allover the country that are linked to tertiary level cardiac centers. The program conforms to the international guidelines for identification and management pharyngitis, Rheumatic fever (RF) and RHD (Ghamrawy et al., 2020).
Nursing care of the child with rheumatic fever is complex, rewarding and challenging. The successful recovery and rehabilitation of the child is made possible with careful nursing assessment, diagnosis, intervention and evaluation of all body systems through follow up care of the child (Anderson et al., 2020).
The aim of this study
To assess life style of preparatory school students suffering from rheumatic fever through the following objectives:
1- Assessing preparatory school student’s knowledge related to rheumatic fever.
Summary
137
2- Assessing preparatory school student’s reported practices related to care of rheumatic fever.
3- Assessing effect of rheumatic fever on life style of preparatory school students.
Research Questions:
1- What is the preparatory school student’s knowledge related to rheumatic fever?
2- What are the preparatory school student’s reported practices related to care of rheumatic fever?
3- Is rheumatic fever affect life style of preparatory school students?
4- Is there relation between socio demographic characteristic of preparatory school students and their reported practices related to care of rheumatic fever?
5- Is there relation between socio demographic characteristic of preparatory school students and their life style?
Research design
Adescriptivedesign was used to accomplish this study.
Summary
138
Settings
The study was conducted at health insurance clinics in El-Gharbia Governorate including three cities (Kotor, Tanta & El-santa) that including rheumatic fever centers.
Subject
A convenient sample of 215 preparatory school students representing all students attending at the day of data collection from the previously mentioned setting were included in the study, diagnosed with rheumatic fever and having no other chronic disease taking their service from the previously mentioned setting.
Tools and technique of data collection
Two tools were developed by the investigator in order to obtain the necessary data for the study:
Tool (I):
An self-administered questionnaire prepared by the investigator after reviewing the relevant and recent literature related to Rheumatic Fever written in an Arabic language, it included five parts:
Summary
139
Part I: Socio demographic data of preparatory school students as: age, sex, birth order, class, place of residence (question no. 1-5).
Part II: Socio demographic data of parents as : Father‘s age, father‘s educational level, father‘s job, mother‘s age, mother‘s educational level, mother‘s job, family monthly income, housing type, number of family members, number of rooms in the house, crowding rate (question no. 6-16).
Part III:
A- Medical history of rheumatic fever as: onset of rheumatic fever, diagnosis, symptoms, number of hospitalization (question no. 17-24).
B- Present history of rheumatic fever as: present complaints, complications, type of medication, complications from medication, absence from the school (question no. 25-29).
Part IV: Preparatory school age students‘ knowledge about rheumatic fever as : Definition of rheumatic fever, causes, symptoms, risk factors, investigations, methods of treatment, complications, methods of preventing rheumatic fever, source of his/her information (question no. 30-38).
Summary
140
Part V: preparatory school age student‘s reported practices related to care of rheumatic fever as: Following up health status, place of following up, having instructions to prevent complications and carrying it out. Taking treatment, type of treatment taken, the action when having a fever, the action when having joint pain, protection from sore throat (question no. 39-47).
Tool (II): Life style assessment sheet adopted from Robert et al., (2011) and modified by investigator, this tool included five items:
1- Health maintenance skills and physical functioning activities of daily living such as: diet habits, sleep pattern, hygiene, exercise and hobbies (question no. 1-29).
2- Psychological and spiritual attitudes, such as: satisfaction of life and spiritual aspects such as praying, going to mosque, church (question no. 30-36).
3- Social involvement included: peer relationship, achievement and participation in recreational activities (question no. 37-39).
4- Family relationship such as: relationship with his / her parents &his /her sibling, participation in family activities (question no. 40-42).
Summary
141
5- Self-actualization style such as: student satisfaction about him/her self, if his/ her illness prevents him/her from achieving his/her aims (question no. 43-47).
The results of the study can be summarized as follows:
1. Demonstrates that, 35.8% of the preparatory school students their age ranged between 13-<14years, with a Mean age of 13.61 ± 7.56year. 55.8% of them were female. Mean while 37.2% of them were the second child in the family. Also, 38.1% of them were at second year of Preparatory stage. In relation to the Place of residence 61.9% of them were residing in urban areas.
2. Regarding medical history, shows that, 41.9% of the preparatory school students suffering from rheumatic fever for more than two years. Also, (44.2% &81.9%) respectively of them had a sore throat once a month and diagnosed through symptoms. Moreover, 80.9% of them had recurrent sore throat and tonsillitis at the beginning of the disease. Meanwhile, 83.7% of the studied students went to the doctor at the time of its discovery. Also, 78.6% of the students studied were hospitalized due to rheumatic fever, 70.4% of them
Summary
142
were hospitalized 1-3 times. While, 62.8% of the students studied had past history of surgery.
3. Figure (1) demonstrates that 72.1% of the preparatory school students had unsatisfactory level of knowledge about rheumatic fever. While 27.9% of them had satisfactory level.
4. Demonstrates that, 66.5% of preparatory school students had unhealthy practices regarding care of rheumatic fever. While, 33.5% of them had healthy practices regarding care of rheumatic fever.
5. Demonstrates. That, 46.5% of the preparatory school students had poor level of total life style. Also, 34.9% of them had average level. While, 18.6% of them had good level.
6. Shows that, there were highly statistically significant relation between total knowledge of the preparatory school students and their preparatory stage at (P=<0.01). Also, there were statistically significant relation with their age and residence at (P= < 0.05). While, there were no significant relation with their sex at (P= >0.05)