الفهرس 
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Abstract
Children with thalassemia are prone to many disorders that lead to low self-care and poor quality of life. So, Self- determination theory (SDT) play an integral role in the management of those children.The purpose of the study was to:Assess the effect of the self- determination theory based intervention on self – care and quality of life among school age children with thalassemia.Research design: - A quasi- experimental design (pre/posttest) was utilized.Setting: -This study was conducted at the pediatric thalassemia unit in El- Menoufia University Hospital.Sample:- a) A purposive sample of 70 children with thalassemia at the previously mentioned setting was included in the current study.Instruments of the study: - Instrument 1: A structured interviewing questionnaire to assess general characteristics of the studied sample: It was developed by the researcher guided by Zaghamir et al., (2019). It consisted of two parts: Part one: Social characteristics of studied children and medical date. It included questions about age, gender, diagnosis, Suffer from other diseases, consanguinity with parents, family history of thalassemia, family history of blood diseases, time 134 of starting treatment, hemoglobin level, number of blood transfusion / year and spleen removal. Part two: Children knowledge about thalassemia. It included: definition, causes, types, symptoms, Management and prevention of thalassemia. Instrument 2: Basic Psychological Needs Satisfaction and Frustration Scale BPNSFS): It was adopted from Ryan & Deci (2000) & Vansteenkiste et al., 2015) to assess child’s autonomy, relatedness and competency either satisfaction or frustration. Each item contains 4 questions and rated on a 4-point Likert scale.Instrument 3: Self Care Assessment Worksheet: It was developed by the researcher guided by Saakvitne & Pearlman (1996). It is a structured interviewing questionnaire. It consisted of four dimensions such as physical self-care (42Q), Psychological self-care (9Q), Social self-care (4Q) and school self-care (6Q).Each item was rated on a 3-point Likert scale.Instrument 4: Standardized Quality of Life (QOL) Questionnaire: It was adopted from Ware & Sherburne (1992). It consisted of six dimensions with 29 items such as general health (6 items), Limitation of daily activity (9 items), Physical health problems (4 items), Emotional health problems (3 items), pain perception (1 item), Energy and emotions (6 items). Each item is rated on a 3-point Likert scale.Domain scores were scaled in a positive direction (i.e., higher scores donate higher QOL).The main results of the study showed that:1. The mean age and SD of studied children was 9.1 ± 1.8 and majority of them were females (55.7%).135 2. Mean score and SD of children’s knowledge about thalassemia was1.7±0.6, 3.6±1.1 and 3.3±1.1 on pre, post and follow up tests respectively.3. There was significant improvement in children’s level of autonomy, relatedness and competency satisfaction on posttest and follow up test than pretest.4. Children who received self- determination theory based intervention had higher levels of physical self-care practices on posttest (95.6±11.3) and follow-up test (94.9±11.3) than on pretest (88.9±14.1).5. Children who received self- determination theory based intervention had higher levels of psychological self-care practices on posttest (16±4.1) and follow-up test (12.1±0.6) than on pretest (5.3±0.6). 6. Children who received self- determination theory based intervention had higher levels of social self-care practices on posttest (9 ±2.6) and follow-up test (9 ±2.6) than on pretest (8.5 ±3.1). 7. Children who received self- determination theory based intervention had higher levels of school self-care practices on posttest (11.7 ±2.4) and follow-up test (11.5 ±2.3) than on pretest (10.6 ±3.2). 8. Children who received self- determination theory based intervention had better scores of quality of life dimensions on posttest and follow-up test than on pretest.The study concluded that:- Children who received knowledge about thalassemia through application of self-determination theory had higher level of knowledge on posttest than 136 pretest. Also, Children with thalassemia who received self-care based on self-determination theory had higher level of autonomy, relatedness and competency satisfaction on posttest than pretest. In addition, they had higher level of self-care practices and their quality of life improved on posttest than pretest.Based on the results of the study it was recommended that:1. Self-determination theory based intervention about thalassemia should be designed and implemented in all pediatric thalassemia units to improve children’s knowledge, self-care practices and quality of life on the basis of their actual needs.2. Self-determination theory based intervention about thalassemia should be designed and implemented in all pediatric thalassemia units to improve caregiver knowledge and practices to provide optimum care for the children.3. Further studies should be applied on a larger sample to determine the effect of self-determination theory based intervention to ensure the generalizability of results.