الفهرس 
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Abstract
Based on the findings of the current study, the following recommendations are suggested: 1- In-service educational programs must be designed and implemented for nurses at pediatric surgical department for importance of massage therapy 2- Developing a system for evaluating nurses’ knowledge and practice regarding updated strategies in care of children undergoing abdominal surgeries at pediatric surgical department units. 3- Future studies are suggested with increased sample sizes, a longer interventional period duration, and an objective measure of sleep. Interventions including healthcare is vital to improve sleep quality and recovery during hospitalization and after children hospital discharge. After abdominal surgery, sleep patterns are usually disturbed. Sleep disturbances are common problems among children in hospitals; however, there is still a lack of knowledge in nursing about the effectiveness of sleep-promoting interventions. Massage therapy as an ancient nursing technique is now gaining popularity; it has been shown improvement in sleep. The current study was aimed to determine the effect of massage therapy on sleep disturbances and pain control for children post abdominal surgeries. A quasi-experimental research design was used in the present study. The study was conducted at the Pediatric Surgical Department of Tanta main University Hospital which is affiliated to Ministry of Higher Education and Scientific Research. Purposive sampling of sixty children post abdominal surgeries who were attended the previously mention setting. The sample was divided into two equal groups study and control group (30 children for each) which includes both sexes, age ranged from 3-8 years, post abdominal surgeries, and free from any complications or contraindication for massage therapy. Tools of data collection: Four tools were used in the current study as the following: Tool I: Structured interview Schedule: It consisted of three parts: Part I: Socio-demographic characteristics of the studied children: including their age, sex, academic year, date of admission, medical and surgical history. Part II: Sleep diaries, sleep/wake rhythms of the children. Tool II: Assessment for Sleep Disturbances Scale for Children (SDCS) by using observation checklists. Tool III: Physiological measurement: were used to measure the response of children to pain through measuring heart rate, respiratory rate, and oxygen saturation. Tool IV: Part (1): Pain assessment by using Numerical rating Scale to assess post-operative pain intensity, this scale line number from 0-10. Part (2): FLACC behavioral pain assessment scale It was used for assessing behavioral responses of children toward post-operative pain Results of the present study: - Regarding the age of children, it was observed that more than half (53.3%) of control group their age ranged from 3 – 5 years with mean a mean of 5.336 ± 1.920, while 60.0% of study group their age ranged from 6 – 8 years with a mean of 5.766 ± 1.832. - Regarding to diagnosis, one third of control group (33.4%) and 23.4% of study group had inguinal hernia, more than half (26.7%) of study group and 13.4% of control group had appendectomy - It was noticed there was no statistically significant difference between control and study group before surgery and after surgery before doing massage therapy (t test = 0.865 and 0.245, P= 0.391 and 0.808) respectively, while there was highly statistically significant difference between control and study group post-surgery after doing massage therapy while (t test = 9.609, P= 0.0001). - It was clarified that there was a highly statistically significant difference between control and study group according to assessment for sleep disturbances scale for children post-surgery after doing the massage. - It was noticed that all (100.0%) of control and study groups were normal sleep before the surgery. - It was clarified that the most (80.0%) of control group and 70.0% of study group were clinically significant sleep disturbances after surgery before doing massage therapy. The most (80.0%) of control group had been clinically significant sleep disturbances, while all (100.0%) of study group were normal sleep after surgery after doing massage therapy. - It was observed that the mean score was 41.033 ± 4.106 and 43.333 ± 4.894 of control and study groups respectively before surgery, The mean score was 91.866 ± 4.439 and 93.000 ± 3.787 of control and study groups respectively after surgery before doing massage therapy, The mean score was 91.866 ± 4.439 and 51.133 ± 4.407 of control and study groups respectively post-surgery after doing massage therapy. - The mean score was 85.500 ± 5.975 and 109.820 ± 11.290 beats/min of control and study groups respectively post-surgery after doing massage therapy, with a highly statistically significant difference while (t-test= 12.658, P= 0.0001) - The mean score was 22.8±2.19 and 19.9±1.32 breaths/min of control and study groups respectively post-surgery after doing massage therapy, with a highly statistically significant difference while (t-test= 6.514, P= 0.0001) - The mean score was 92.766 ± 0.971 and 95.733 ± 0.980 (%) of control and study groups respectively post-surgery after doing massage therapy, with a highly statistically significant difference while (t-test= 11.774, P= 0.0001), - 60.0% and 36.7% of study group had mild and no pain respectively post-surgery after doing massage therapy, with highly statistically significant difference. The most (80.0%) and 16.7% of study group had mild and no pain respectively after surgery after doing massage therapy, with highly statistically significant difference. - It was noticed that there was a highly statistically significant difference between Sleep Disturbances Scale and respiratory rate while (r= 0.488, P= 0.006). - It was found that there was a highly statistically significant difference between Sleep Disturbances Scale and Numerical and Face rating scale and FLACC scale while (r= 0.704 and 0.688) and (P= 0.0001). Also, noticed that there was a highly statistically significant difference between heart rate and respiratory rate (r= 0.556, P=0.001). - It was found that there was a highly statistically significant difference between heart rate and respiratory rate (r= 0.475, P=0.008), and there was a statistically significant difference between Numerical and Face rating scale and Sleep Disturbances Scale and FLACC scale while (r= 0.570 and 0.643) and (P= 0.001 and 0.0001) respectively. Also, noticed that there was a statistically significant difference between FLACC scale and Sleep/wake rhythms day, Sleep Disturbances Scale while (r= 0.368 and 0.417) and (P= 0.045 and 0.022) respectively. - It was found that there was a negative statistically significant difference between Numerical and Face rating scale and Sleep Disturbances Scale, heart rate and respiratory rate while (r= 0.476, -0.468, and -0.687) and (P= 0.008, 0.009 and 0.0001) respectively. - Also, found that there was a negative statistically significant difference between FLACC scale and heart rate while (r= 0.371, P=0.044). There was a positive statistically significant difference between respiratory rate and heart rate while (r= 0.559, P= 0.001). statistically significant difference between diagnosis, Sleep Disturbances Scale and respiratory rate while (r= 0.484 and 0.466) and (p= 0.007 and 0.009) respectively. - It was found that there was a negative statistically significant difference between age, respiratory rate, and heart rate while (r= 0.566 and 0.639) and (P=0.001 and 0.0001) respectively. Also, there was a positive highly statistically significant difference between diagnosis and respiratory rate while (r= 0.496, p= 0.005). - It was found that there was a positive statistically significant difference between age, Sleep/Wake Rhythms Day, heart rate, and respiratory rate while (r= 0.485, 0.513, and 0.604) and (P= 0.007, 0.004, and 0.0001) respectively. - There was a positive statistically significant difference between diagnosis and Numerical and Face rating scale while (r=-0.383, P=0.037). - It was observed that there was a positive highly statistically significant difference between age, Sleep Disturbances Scale, respiratory rate and Numerical and Face rating scale while (r=0.636, 0.594, and 0.671) and (P=0.0001, 0.001, and 0.0001) respectively.