الفهرس 
Introduction and Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Urolithiasis is global health problem affect 2% to 20% of population worldwide. Small stone may pass spontaneously while large one requires medical or surgical treatment. Now a day extra corporeal shock wave lithotripsy becames one of the most important treatment options for treatment of kidney stones less than 2 cm and ureteral stones less than 1.5 cm due to its non-invasive nature. On the other hand, some possible physical and psychological complications may result from extracorporeal shock waves lithotripsy (ESWL) that may negatively affect patient’s quality of life. Nurses have major role in providing a series of scientific and reasonable nursing guidelines for patients undergoing ESWL. Nursing guidelines aim to provide good patients preparation before ESWL and adequate patients care during procedure, in-addition to educating patients about life style modifications to decrease recurrence of renal stones post procedure. The current study aimed to evaluate the effect of implementing nursing guidelines on clinical outcomes for patients undergoing extracorporeal shock waves lithotripsy for urolithiasis. A convenience sample consisted of 100 adult patients diagnosed with renal stone undergoing ESWL for urolithiasis. The study subjects were divided into two groups: group (1): Study group: - 50 patients who received routine hospital care and nursing guidelines by researcher. group (2): Control group: - 50 patients who received routine hospital care only by nursing staff. The studied groups had the following criteria Inclusion criteria: Adult patients (18-60 years), Patient undergoing ESWL for the first session. Exclusion criteria: Patients with urinary tract infection, hypertension (Diastolic >100), Pacemaker, cerebral aneurysm, bleeding disorders, gastrointestinal and bowel elimination disturbances, non-intact skin, skin bruising or skin itching and sleep pattern disturbances. Tools of Data collection: Tool (I): Patients’ Structured Interview Scheduled Sheet: This tool was developed by the researcher after reviewing of the related literature. It was consisted of two parts as follow: Part one: Socio-demographic characteristics of patients. Part two: patients’ medical data interview questionnaire. Tool (II): Patients’ Health Relevant Data Interview Questionnaire: It was consisted of two parts as follow: Part one: Numeric pain rating scale (NPRS-11): This scale was developed by McCaffary (1989) and it was adopted by the researcher to assess patients’ level of pain. Part two: Hospital anxiety and depression scale (HADS): This scale was developed by Zigmond (1986) and it was adapted by researcher to assess patients’ level of anxiety Tool (III): Clinical Outcomes Assessment Sheet: This tool was consisted of two parts as follow: Part one: Patients’ assessment for complications of extracorporeal shock waves lithotripsy Part two: Structured patients’ knowledge assessment interview questionnaire The main results of the present study: 1. It was found that there was a highly statistical significant differences between study and control group regarding to their level of pain through periods of study (immediate, first week and second week post ESWL) with P value= 0.001. 2. It was found that there was a highly statistical significant differences between study and control group regarding to their level of anxiety through periods of study (immediate, first week and second week post ESWL) with P value= 0.001. 3. It was found that there was a highly statistical significant differences between study and control group relating to their urinary pattern, amount of urinary output and complain of hematuria through periods of study (first week and second week post ESWL). Also, there was a highly statistical significant differences between both groups regarding feeling of bladder empty only during second week after ESWL with P value= 0.001. 4. It was found that there was a highly statistical significant differences between study and control group regarding to their complaint of nausea, vomiting and loss of appetite through periods of study (first week and second week post ESWL) with P value= 0.001 and0.006. 5. It was noted that there was a statistical significant differences between study and control group regarding to their complaint of constipation through periods of study (first week and second week post ESWL) with P value= 0.029, 0.027. Also, there was a highly statistical significant differences between both groups regarding to their complaint of diarrhea only during first week post ESWL with P value=0.008. 6. It was revealed that there was a statistical significant difference between both groups regarding to their disturbances in the integumentary system only during first week post ESWL (p value 0.035). 7. It was noted that there was highly statistical significant differences between study and control group regarding to their sleep pattern through periods of study (first week and second week post ESWL) with P value= 0.001. 8. It was revealed that majority of study group (96.0%) and all (100%) of the control group had low level of knowledge about lifestyle modification and there was no statistical significant differences between both groups before implantation of health educational guidelines. It was noted that there were highly statistical significant differences between both groups regarding to their level of knowledge through periods of study (first week and second week assessment periods) with P value= 0.001. 9. It was revealed that there was a positive highly significance correlation between patients’ severity of pain and their level of anxiety in both groups before, immediately, first week and second week after ESWL (P= 0.001).