الفهرس 
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Abstract
Chronic kidney disease is a worldwide serious childhood health problem that further progress to end stage renal disease which requires renal dialysis or kidney transplantation in order to survive. End stage renal disease is a devastating disorder associated with excessive mortality and cardiovascular morbidity, and specific problems occur in children, such as impaired growth and psychosocial adjustment, all of which severely impact upon the quality of life (Anderson et al., 2017). Therefore, the diagnostic and therapeutic approach of chronic kidney disease must emphasize primary prevention, early detection, and aggressive management to delay or even prevent progression to end stage renal disease (United States renal Data System {USRDS}, 2013). Furthermore, the mortality rate for children with chronic kidney disease remains 30 times higher than for children without kidney disease.
Mothers of children with chronic kidney disease suffer from target burdens due to care of their children, besides accompanying them to health care settings. Therefore, empowerment program had been implemented for those mothers to feed them with important knowledge and practice about care of children with chronic kidney disease and reach adulthood safely.
The present study aimed to evaluate the effect of empowerment program for mothers to improve quality of life of their children with chronic kidney disease, the sample composed of forty children with chronic kidney disease who are on regular hemodialysis and fifteen children with chronic kidney disease follow up at the Conservative Clinic of the Pediatric Nephrology Unit from both sex and their mothers who were able to read and write and regardless their age.
A quasi experimental research design was done at Children’s Hospital affiliated to Ain Shams University Hospitals (Hemodialysis unit and Conservative Nephrology Out-patient clinic).
Tools were designed by the researcher in an Arabic language after reviewing the related literature and after reviewing from the researcher’ supervisors and consisted of:
1- Questionnaire Sheet:
It was designed and developed by the researcher after reviewing related literatures, and it was written in Arabic language to assess and evaluate mother’s knowledge regarding to care of their children with chronic kidney disease and consisted of the following parts: mother’s characteristics as well as their knowledge regarding to nutrition, fluids and medications of chronic kidney disease.
2- Observation Sheet:
Observation sheet was adapted from (Bowden & Greenberger, 2012), and modified by the researcher to suit the nature of study and to assess mothers’ reported practice regarding to care of their children with chronic kidney disease as measurement of childs’ temperature, respiration, and intake & output, range of motion exercise and breathing & coughing exercise).
3- Child’s Medical Record:
This record was used to check data related to children with chronic kidney disease including; children’s characteristics, past medical history, physical assessment and laboratory investigation.
4- Pediatric Quality of Life Inventory Version 4.0:
(The PedsQL 4.0 generic core scale) which developed by (Varini, 2014), and translated in Arabic language by the researcher to suit the nature of the study and to assess the health related quality of life of children with chronic kidney disease.
5- Family Empowerment Scale:
The scale was developed by (Koren et al., 1992), and translated into Arabic language to suit the nature of the study and was used to assess mothers empowerment at family level, child’s services level and community/political participation level.
6- Empowerment Program:
• The researcher planed and implemented empowerment program based on actual need assessment of the studied sample (mothers), it covered the theoretical knowledge and practical procedures.
• Empowerment program was distributed to each study subject.
• Each mother was assessed pre and post implementation of empowerment program using the previously mentioned tools.
The results of the study can be summarized as follows:
1- The majority of the studied mothers had satisfactory level of knowledge regarding to chronic kidney disease after empowerment program compared to one fourth of them before empowerment program.
2- Three fourths of the studied mothers had satisfactory practice regarding to care of children with chronic kidney disease after empowerment program compared to about one third of them before empowerment program.
3- About two thirds of the studied children had moderate and high quality of life before empowerment program and this percentage increase to all of the studied children after empowerment program intervention.
4- Mean score of total level of family empowerment was 2.35 before empowerment program, while this mean increased to 2.95 after empowerment program.
5- There was a statistically significant difference between the studied mother’s ages and their knowledge.
6- There was a statistically significant difference between the studied mother’s level of education and their practice.
from the results of the present study, the following can be concluded:
The result of the present study concluded that there was positive effect of empowerment program on improving knowledge and practice of the studied mothers as well as, quality of life of children with chronic kidney disease.
from the previous findings, the following recommendations are suggested:
1- Encourage use of empowerment programs periodically for mothers having children with chronic kidney disease to help them improve their care of their children with chronic kidney disease and reduce complications of chronic kidney disease.
2- Further studies should be conducted to assess risk factors of rapid progression of chronic kidney disease to end stage renal disease.
3- Further researches are needed to improve quality of life of children with chronic kidney disease.