الفهرس 
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Abstract
C
ounseling is a process that enables clients to make and follow through on decisions. Education is an integral component of the counseling process that helps clients to make informed decisions. Providing quality counseling is an essential component of client-centered care. Key principles of providing quality counseling are listed below and may be used when providing family planning services. (Bruce et al,2014).
The use of family planning services can be influenced by knowledge, skills and attitude of providers’. Family planning saved the lives of women and children by helping to avoid unsafe abortion, limiting the risk of pregnancy and childbirth, reducing the number of births, and limiting pregnancy to the healthiest ages. (Robey, 2013).
The community health nurse plays a significant role in family planning, with an emphasis on improving the quality of maternal and child care focus on teaching mothers the art of breast-feeding and caring for a newborn, and participation in the national program of family planning. The family planning program is targeted at reducing the number of abortions, improving sanitary standards, and teaching contraceptive technologies and related physiology, (Stanhope, 2014).
Aim of the study:
The objective of this study was to evaluate the effect of training program for nurses about counseling skills related to family planning in rural health units through:
• Assessing nurses’ knowledge, performance and attitude related to counseling skills and family planning.
• Designing and implementing training program for nurses related to counseling skills and family planning.
• Evaluating the effect of designed training program for nurses’ role as counselor and its impact on women attending in the rural health units.
Technical design:
Research Design
A quasi experimental design was used.
Setting
The study was conducted at all rural health units in Toukh health administration at Al Qalyubia Governorate which contains 9 rural health units. Their names Dandana center, Kafr el-gammal center, Kafr al-haddadin center, Namul health center, Al manzalah center, Moshtouhur center, El deir center, Al hissha center, Mitkenanah center.
Sampling
Purposive sample in the previously mentioned settings was divided into two groups:
1. All samples of nurses selected according to inclusion criteria were; nurses assigned for health education activities and family planning clinics only.
2. A sample of women (total number of women attended the health units at month (at July month, 2015) was 368 women (32 women in Dandana center, 26 in Kafr el-gammal center, 41 in Kafr al-haddadin center, 27 in Namul health center,36 in Al manzalah center, 53 in Moshtouhur center, 44 in El deir center, 32 in Al hissha center, 77 in Mitkenanah center that were included in the study sample to measure pre- post program effect (taken 25% = 92 women).
Tools for Data Collection: The following tools for data collection will be used:
First tool:
A-Self-administered questionnaire for nurses, It was developed by the researchers based on review of literature. It was consisted of;
1-Socio-demographic data such as: age, educational level, marital status, qualification, and working conditions as regards: working hours, past experience, previous training.
2- Nurse’s knowledge related to counseling skills and family planning (pre-post): such as definition of family planning,
objectives, methods, side effect of each method.(Constructed by researcher) definition of counseling, objective, principles of counseling, characteristic of health counselor, counseling process, method, materials, and effective communication.(modified from Bertrand and Lisanne ;2011) .
B-Interviewing questionnaire for mothers: was designed to assess women’s satisfactory level about family planning services and nurse role (Constructed by researcher) (pre-post)
Second tool:-
Nurse’s attitude scale toward family planning supported the use of family planning; agree about benefits of spacing children and family planning for the health of the child and mother. (Adapted from Darity, and Thiebaux, 2009). (Pre-post).
Third tool:-
2- Observational checklist for Nurse’s performance about counseling skills (pre-post): Observational checklist was designed to assess nurses’ performance as a health counselor; it covered the following skills; appropriate communication and counseling session conduction (modified from Kim, Young Mi; 2011).
The finding of the present study could be summarized as follows:
The result shows that the study sample in the age of 25<30 years representing (40.3%), and only 13% in the age of 40+ years with a mean age 32.1± 5.27 years, 88.7% of the study sample were married. The table also showed that 83.9% had a diploma nurse (three years), regarding to nurse’s Occupation 95.2% was a nurse while only 4.8% was a midwife. As regards the years of experience in family planning field 67.7% had less than 5 years’ experience while only 11.3% had more than 15 years’ experience in family planning field. Regarding to nurse’s training 75.8% were not trained in family planning. .
Also the results indicated that, 35.5% of study sample had a satisfactory total score level in preprogram while increased to 95.2% after taking program. With statistical significant difference between pre & post program (X2 = 48.73, P value < 0.001).
The results reported that the study sample had a positive attitude toward counseling in family planning represented 51.6% in preprogram & 83.8% in post program. With a highly statistically significant (X2= 14.76, P value < 0.001).
Also the results shows that 8.1% have done counseling skills in preprogram while in post program 83.9% have done it. With a highly statistically significant (X2 = 53.62P value < 0.001).
It was observed from the results of this study that the mother age of 30<35 years representing 48.8%, and only 7.5% in the age of 35 - 40+ years with a mean age 28.3 ± 2.153 years, 40.0% of the study sample had secondary education while 13.3% had a nursing diploma. The table also showed that mother’s occupation 81.3% was housewife while only 18.8% was employee.
Regarding mother’s satisfaction with counseling service in preprogram was 32.5% of mother’s were with counseling service in preprogram while in post program 71.2% were satisfied with it. With a highly statistically significant (X2= 24.058, P value < 0.000).
The finding of the present study, suggested the following recommendations:
1- Regular training program for the nurses and staff nurse by health team that responsible on training at ministry of health about health needs and health problems of family planning and new strategies in family planning.
2- Establish a system of supervision, recognition the good performance of nurses responsible on family planning counseling and give them motivation and rewarding to increase job satisfaction and continue quality of services.
Further Research:
About quality of family planning services and client’s satisfaction level in maternal and child health centers at large sectors.