الفهرس 
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Abstract
Human papillomaviruses (HPV) are the most common sexually transmitted infection. Globally, 50%-80% of sexually active individuals will acquire an HPV infection in their lifetime. Almost 95% of all cervical cancer cases are linked to HPV and the majority of all HPV-associated morbidity and mortality is due to cervical cancer. Cervical cancer accounts for 4% of all cancers diagnosed worldwide. There are approximately 530,000 new cases of cervical cancer a year that are attributable to HPV as well as about 265,700 deaths per year and there are wide disparities in the burden of cervical cancer (Laurent et al., 2018).
Persistent infection with Human papilloma virus (HPV), the sexual transmitted disease is considered to be the main cause of cervical cancer. Cervical cancer ranks as the fourth most frequent cancer among women in the World and the second most common female cancer in the women aged 15 to 44 years in World .According to the World Health Organization (WHO), it is expected about 27 million of new cases of cervical cancer and 17 million of deaths by the disease in 2030 (Araldia et al., 2018 and Bruni et al., 2017).
The aim of the Study to evaluate the Effect of nursing guideline about genital Human papilloma virus infection on perception of female university students’. This aim was achieved through following:
• Assessing the students’ Knowledge about genital Human papilloma virus infection.
• Assessing the students’ attitude about genital Human papilloma virus infection.
• Design and Implement nursing guidance about genital Human papilloma virus infection based on students need assessment.
• Evaluate the effect of nursing guideline about genital Human papilloma virus infection on the perception of female university students’.
Research hypothesis:
The University Female Students who receive the nursing guideline will have high perception regarding genital Human papilloma virus infection.
Quasi-experimental design was used in this study, a convenience sampling technique was done in the study .The total sample size was two hundred seventy five (275) female students of the first and the second academic year in the faculty of nursing at Alexandria University who agreed to participate in the study at previously mentioned study setting through the 2nd term of the academic year 2018-2019. Follow up using guideline (booklet &its effect) took another term in academic year 2019-2020.These numbers were determined based on a convenience total number of the female students enrolled in the first and the second academic year (2018-2019).
The tools were designed by the researchers based on the related literature. The data was collected by using the following tools:
Tool I: An Arabic structured Interviewing Questionnaire (Appendix I):
It is divided into three parts as follow:
• Part I: assessed student’s general characteristics are included in the study as Personal data of the study sample: such as age, level of education, marital status, level of mother’s education and student’s mother occupation (from question No.1 to 6).
• Part II: This part was designed to the assess pervious obstetrical and surgical history (from question No.7 to 14).
• Part III: This part was used to assess students’ knowledge regarding genital Human papilloma virus infection and its vaccination (from question No.15 to 44) that included the following:(definition, methods of transmission, Risk factors of Human papilloma virus, methods of prevention, complications of it and routine examination, the vaccine and doses of vaccine)
• A session was provided after determining baseline of the students’ knowledge.
Tool II: Likert Scale: was used to evaluate the attitude of the females student’s towards human papilloma virus infection before and after using guideline. It includes 13 statements, the level of attitude was assigned to each answer representing Agree, Uncertain, and disagree.
Supportive material: Nursing guidelines were designed by researcher based on the identified need post the assessment of knowledge and attitude to Increase the perception of the female students about genital Human papilloma virus Infection and the importance of the screening and the vaccination.
Main results of the present study were as follows:
• There was a marked improvement in the general knowledge about genital human papilloma virus infection of the studied students post implementation of the nursing guidelines with statistically significant difference at (P= < 0.05) between pre, post and follow up implementation of nursing guidelines.
• There was a marked improvement in knowledge about the screening tests of genital human papilloma virus infection of the studied students post implementation of nursing guidelines with highly statistically significant difference at (P < 0.01) between pre, post and follow up implementation of nursing guidelines.
• There was a marked improvement in knowledge about vaccination for genital human papilloma virus infection of the studied students post implementation of nursing guidelines with statistically significant difference (P < 0.05) between pre, post and follow up implementation of nursing guidelines.
• There was a marked improvement in attitude about genital human papilloma virus infection of the studied students post implementation of nursing guidelines with highly statistically significant difference at (P < 0.01) & (P < 0.05) between pre, post and follow up implementation of nursing guidelines.
• There were 80.6% and 80.2% of the studied students felt satisfied about learning new information about HPV as well as the guideline simplified and clear respectively. Also, 74.4% of the studied students were satisfied about the training sessions which helped them to develop their information and attitudes.
• There was statistically significant relation between the total knowledge post nursing guidelines about genital Human papilloma virus infection of the studied students and their age as well as academic year at (P < 0.05).
• There was highly statistically significant relation between the total attitude post nursing guidelines about genital Human papilloma virus infection of the studied students and their age at (P < 0.01). Also, there was statistically significant relation with their academic year While, there was statistically insignificant relation with their marital Status and the educational level of their mother at (P > 0.05).
• There was a positive correlation between total knowledge of the studied students and their total attitude post nursing guidelines about genital Human papilloma virus infection.
• There was a positive correlation between total knowledge of the studied students and their total satisfaction post nursing guidelines about genital Human papilloma virus infection.
• There was a positive correlation between the total attitude of the studied students and their total satisfaction post nursing guidelines about genital Human papilloma virus infection.
Conclusion:
In conclusion, based on students’ knowledge and attitude regarding genital HPV infection and its vaccine, the majority of students do not know and have negative attitude before applying nursing guideline. However, after the immediate intervention and the 6 months follow up of the application of nursing guideline, there was a highly significant improvement in knowledge and positive attitude. Therefore, the present study hypothesis was significantly approved with the aim of the present study.
Recommendations:
In the light of the study results, the study recommended the following:
• There is a need for raise on awareness campaigns to improve the poor knowledge of the female university students and reverse their common attitude .The adolescents should also be provided with statistics by showing the prevalence of the HPV at an early age, in order to change their behavior and reduce the risk of HPV infection to provoke them to the HPV vaccine. Hence, this is considered a step towards the prevention of cervical cancer.
• Curriculum development should integrate the topic of Human papilloma virus infection and vaccination in order to increase the students’ understanding of HPV and promote positive attitudes towards their preventive health behaviors.
• Further researches are needed on a wide scale to assess the factors that affect the knowledge so that, not only young women, but all adolescents students will get inspired to prevent the risk of HPV infection and use vaccination.