الفهرس 
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Abstract
Hemodialysis is the most common method used to manage CRF patients, but even with better procedures and equipment, HD is still associated with many adverse events as well as it is considered an inconvenient therapy that requires a coordinated effort from patients and health care team. So patients who are undergoing HD require active interventions and health education about how to deal with AEs related to HD.
This study aimed to determine the effect of implementing an instructional module on controlling AEs of HD process among patients with CRF.
•Research Design:
A quasi experimental design was utilized.
•Materials and method
The present study was conducted at the HD units of the Alexandria Main University (University Hospital) and Gamal Abed El Nasser Hospital (Health insurance) in Alexandria. The study subjects comprised a convenience sample of 60 adult patients admitted to the above mentioned settings. Patients were divided randomly into two equal groups (study and control groups) 30 patient in each group.
−The subjects were selected according to the following criteria:
•Adult patients diagnosed with CRF undergoing HD.
•HD not less than six months.
•Able to communicate verbally.
−Tools of the study: Two tools were used for data collection.
Tool I: Assessment of patient’s knowledge interview schedule.
This tool was developed based on review of literature and used to assess the following points:
•Patient’s knowledge related to definition, causes and management of CRF.
•Patient’s knowledge related to meaning, aim and adverse events of HD.
•Patient’s knowledge about self care practices for each adverse event of HD. Additionally, Biosociodemographic and clinical data were attached.
Hemodialysis adverse events (AEs) and patient self care structured interview schedule.
This tool was developed by the researcher based on review of the literature to assess AEs of HD, severity of AEs, as well as self care practices toward these AEs, and their effectiveness. It consisted of two parts as the following:
• The first part aims to gather data about the most frequent AEs of HD for the patient’s. These AEs were divided according to body systems.
• The second part was concerned with assessing and describing how the patients deal with each AEs and the effectiveness of each action taken to minimize or overcoming AEs of HD.
- The instructional module: It was developed by the researcher based on review of literature. It included the instructional program schedule and the illustrated booklet which included the most important instructional points with more than 200 illustrated pictures.
• The content of the constructed tools and instructional module were revised by a jury of 5 experts in the field of medical, surgical nursing, and nursing education departments of the Faculty of Nursing at Alexandria University, as well as 2 experts in Nephrology at Main University hospital to test content validity, completeness and clarity of the items. Comments and suggestions of the jury were considered and the tools were modified accordingly.
• A pilot study was carried out on 10 patients to test the clarity and the applicability of the tools (I, II) and to identify the difficulties that may be faced during the application of the tools; accordingly, the necessary modification was done.
• Each patient in both groups was assessed for Biosociodemographic and clinical data
• Knowledge assessment by using (tool I) used twice for every patient in both groups. First time, before the start of the instructional module. Second time, within the first week after completion of the implementation of the instructional module for the study group.
• All patients were interviewed after 6 weeks of implementing instructional module to assess the impact of education related to self care practices performed and its effectiveness for AEs by study group who received teaching and to compare it with the control group who didn’t receive teaching by using tool II.
• The conclusion:
• Patients in the study group who received an instructional module demonstrated more self care practices to manage and control AEs of HD, as well as improving their abilities to perform effective self care measures rather than patients in the control group who exhibited less control on their AEs of HD.
• The main recommendations:
− An educational booklet about CRF, HD, AEs of HD and self care practices related to AEs of HD should be provided to each patient.
− Planning sessions of discussion should be done between newly and previously HD patients in order to exchange their experiences regarding disease itself, HD, AEs of HD as well as how to deal with it.
− Continuing educational sessions and workshops should be provided for nurses about HD, its AEs, as well as nursing measures to relieve these AEs.