الفهرس 
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Abstract
Diabetes multiuse is a global problem with harmful
human effects. Globally, DM is the fifth leading cause of
death. The prevalence of diabetes is rapidly rising
worldwide at an alarming rate. According to the WHO
(2012), at least 171 million people worldwide had diabetes
in 2000, which represents 2.8% of the population, and it is
estimated that this number will be doubled by the year
2030.
International Diabetes Federation, (2013)
reported that, Egypt ranking to be the 9
th in the number of
people with diabetes (20-79 years), with 7.5 Million in
2013 (Vs. 4.78 Million in 2010) and to be at the 6
th position
with 13.1 Million in 2035. Diabetes is a major emerging
clinical and public health problem in Egypt.
Diabetic females are at higher risk for developing
vaginal infections than females without diabetes, and, in
addition, if the Diabetic females is not well controlled and
blood sugars are consistently high, that creates an
environment of high sugar in the mucus membranes, and of
course, that includes the vagina, and this creates a good
environment for the overgrowth of both bacteria and yeast.
The increased risk of getting a UTI in DM can be
explained by the following mechanisms. Diabetic
neuropathy leads to a dysfunctional bladder, thus creating
the chance for UTI development. Autonomic neuropathy involving the genitourinary tract causes dysfunctional
voiding and urinary retention, which leads to decreased
bacterial clearance by micturition, thus facilitating bacterial
growth. Bladder dysfunction may be found in 26%– 85% of
diabetic women.
The aim of the study is applying of web causation
epidemiological model to prevent genitourinary tract
infection among female with diabetes mellitus. Through,
assessing female’s knowledge regarding genitourinary tract
infection and diabetes mellitus, identifying female’s
practices related to genitourinary tract infection, developing
and implementing an intervention program for the diabetic
female related to prevention of genitourinary tract infection
and evaluating the effect of intervention program on
diabetic female’s knowledge and practices.
The study was conducted at diabetic outpatient clinic
in El Demerdash Hospital, because it received patients
from different socio demographic status, and highly
population rate. The process of data collection was carried
out in the period from September 2016 completed by
February 2017. Purposive sample technique was including
100 diabetic female complain from genitourinary tract
infection.Data was collected by using:
I. Interviewing Questionnaire will be developed to
assess the following:
A. Socio demographic characteristic of diabetic female as
(age, educational level, family size, family income...
etc.).
B. Assessment of female’s knowledge about diabetes
mellitus and genitourinary tract infection as concept,
causes or risk factor, clinical manifestations,
management and prevention …etc.
C. Assessment of female’s practices about genitourinary
as hygienic care related to menstruation (type of
napkins, frequency of change and cleaning, and
bathing during menses) and cleaning before and after
sexual relation...etc.
II. Physical assessment through:
A. Hand hygiene checklist: It was adapted from Steed et
al. (2011).
B. Urine analysis by using urine strips to determine the
degree of infection, it was adopted from Pillieri (2014).
C. Perineal care checklist, it modified from (Rajan et
al., 2008).The study reveals that:
Generally socio-demographic characteristics of diabetic
female are causative factors for developing genitourinary
tract infections as age, low level of education, insufficient
income.
More than two thirds (69%) of diabetic female had
family history of diabetes mellitus.
Three quarters (78%) of diabetic female had satisfactory
knowledge about controlling of diabetes by periodic
follow up investigation at post program implementation.
More than three quarters (78%) of diabetic female
change underwear clothes daily followed by less than
three quarters (73%) change the menstrual pad during
the night and (68%) wear cotton underwear at post
program implementation.
Majority (91%) of them remove pubic hair regularly at
post program implementation.
The majority (83%) of diabetic female was compliance
with hand hygiene, followed by (75%) compliance with
perineal care steps and (72%) of them follow urine
analysis steps at post program implementation.
There is highly statistically significant relationship
between socio-demographic characteristics and total
score of diabetic female knowledge toward age
(30:<35), level of education, work condition and cleaning of bath room and causative factors of
genitourinary tract infection at post implementation.
There is highly statistically significant relation between
genitourinary tract infections lack of personal hygiene
care as cleanliness of the underwear as well as the
frequency with which it is changed are important factors
regarding the risk of getting genitourinary tract infection.
Highly statically significant relation application of web
causation model (causative factors) as lack of personal
hygienic care, poor glycemic control using
contraceptive methods, and its effect on genitourinary
tract infection.
The study recommended that: