الفهرس 
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Abstract
Caregivers who have children undergoing hemodialysis have lower level of knowledge and practice so application of using micro-learning strategy play important role in improving their knowledge and practices The purpose of the study was to Evaluate the effect of micro-learning strategy on caregivers’ knowledge and practices of children undergoing hemodialysis.Research design:A quasi-experimental design (one group pre & posttest) was utilized.Setting:This study was conducted at the Pediatric Hemodialysis Unit, Menoufia University Hospital – Shebien El-Kom city.Sampling:Convenience sample of all caregivers who have children undergoing hemodialysis (n=36) in the previous mentioned setting.Instrument of the study: Instrument 1: a structured interviewing questionnaire: it was created by the researcher in Arabic guided by Ajarmeh et al., (2018) & El-Awady & Mohamed, (2021). It will consist of two parts, as the following:Part I: Concerned with social characteristics of caregivers and medical history of the children. It included age, employment, economic status, educational level, marital status, No. of children. Also, medical history related to renal disease, dialysis, arterio-venous fistula)AVF) which included duration of HD, number of sessions per week, duration of AVF,history of previous AVF, taking regular medication, adverse effect of medication and special nutritional program followed.
Part II: Concerned with caregivers’ knowledge about renal failure it included multiple choice questions such as general knowledge about function of renal system, definition, causes, symptoms of renal failure, treatment options, transplantation, hemodialysis, fistula complication, fluid and dietary management.Instrument 2: caregiver’s reported practice checklist: it was developed by the researcher in English form guided by Ajarmeh et al., (2018), El-Awady & Mohamed (2021) to assess caregivers’ reported practice about daily activities life precautions to prevent AVF failure, hand washing and fistula exercise.
The main results of the study showed that:1. More than one third of the studied caregivers were between 40-50 years old and had secondary education (38.9% & 36.1% respectively); more than three quarters were mothers and were married (83.3% & 91.6% respectively).2. More than one third of children undergoing hemodialysis (41.7%) had chronic renal failure and more than half of them (52.8%) started hemodialysis when they were less than 2 years old. Also, more than three quarters (80.6%) performed arterio-venous fistula operation when they were less than 2 years old.3. More than three quarters of caregivers had high level of knowledge about types of vascular access and complication of fistula (88.9% & 80.6% respectively) post intervention compared to 13.9% & 22.2% respectively on pre intervention.4. More than three quarters of caregivers had correct knowledge about long term care at home, guidelines to prevent fistula infection at home and assessing function of AVF (83.3%, 91.7% & 88.9% respectively) post intervention compared to 22.2%, 19.4% & 11.1% respectively on pre intervention5. Mean and standard deviation of total knowledge on pretest were 11.47 ± 3.88 compared to 41.58 ±2.88 & 36.83 ± 2.75 on post and follow up test. Therefore, there were highly statistical significant differences between pretest and posttest (P<0.0001).6. The caregivers had good knowledge on post and follow up test compared to pretest (95.20% & 90.20% Vs. 3.50% respectively).7. Mean and standard deviation of total reported practices on pretest were 9.08 ± 3.19 compared to 32.77 ± 2.98 & 29.13 ± 3.61 on post and follow up test after application of micro-learning strategy.8. Caregivers had a satisfactory level of their reported practices on post and follow up test compared to pretest (94.00% & 93.00% Vs. 15.0 % respectively).
9. There was a significant correlation between caregivers’ educational level and their total knowledge and practices.
The study concluded that Caregivers who attended micro-learning sessions about hemodialysis had higher level of knowledge after implementation of micro-learning strategy than before. Also, they had more satisfactory level of their reported practices after implementation of micro-learning strategy than before.
Based on results of the study it was recommended that:1) Continuous micro-learning sessions should be applied for all caregivers to increase their information and improve their skill.2) Prepared videos should be available for caregivers and their children to improve their awareness.
3) Written and verbal information should be available in the pediatric units based on the new trends on chronic renal failure to increase and sustain caregivers’ knowledge, attitudes and improve their children care.4) Booklets with illustrated pictures should be available for home management and prevention of complication of CRF and hemodialysis.5) The caregivers should follow guidelines of fistula care to prevent its complication.6) Ongoing assessment of mother’s reported practices to detect any deficit regarding their children home care.7) Application of the present study on a large sample size and for a long period of time to ensure the generalization of the results.