الفهرس 
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Abstract
Pneumothorax, a common air leak syndrome in the neonatal period, is defined as abnormal air accumulation between the visceral and parietal pleura. It can increase intrathoracic pressure, resulting in partial or complete collapse of the lung on the affected side. The clinical manifestation of pneumothorax depends on the degree of collapse of the lung, which can impair pulmonary gas exchange and hemodynamic stability and may result in a life-threatening condition. Pneumothorax occurs more frequently in newborns than in any other age group, with an incidence rate of 1% to 2% in the general population and 6% to 7% in very low birth weight (VLBW) infants with a birth weight of less than 1,500 g. Moreover, symptomatic pneumothorax occurs in 0.08% of all live births and 5% to 7% of VLBW infants (Kim et al., 2022).
Aim: Assess nurses’ performance regarding care of neonates suffering from pneumothorax.
Research Questions:
1. What is the level of nurses’ knowledge regarding care of neonates suffering from pneumothorax?
2. What is the level of nurses’ practices regarding care of neonates suffering from pneumothorax?
3. What is the level of nurses’ attitudes regarding care of neonates suffering from pneumothorax?
1-Technical design:
A- Research design:
Adescriptive study was utilized to conduct the study.
B- Research setting
This study was conducted at the Neonatal Intensive Care Units (NICUs) at EL-Fayoum University Hospital affiliated to EL-Fayoum University and Fayoum General Hospital affiliated to Ministry of Health at Fayoum Governate.
C- Research subject:
A convenience sample included all available nurses (100) at the NICUs of mentioned settings 33 nurses in EL-Fayoum University Hospital, 67 nurses in EL-Fayoum General Hospital regardless their age, gender, level education, years of experience and previous training course. In addition to (100) neonates suffering from pneumothorax.
D- Tools of data collection:
Tools were used in data collection are three tools, Tool one: Predesigned Questionnaire Sheet in the light of relevant studies, it was consisted of the following parts: part one: A: characteristics of nurses. B: characteristics of neonates. Part two: Assessment of nurses’ knowledge for neonates suffering from pneumothorax. Tool two: Observational checklists were adopted from, Perry & Potter, (2015), Lynn & Lebon, (2013) and Khalaf, (2015). It was used to assess nurses practice regarding care of neonates suffering erom pneumothorax. Tool three: Attitude rating scale to assess the nurse attitudes regarding care of neonates suffering from pneumothorax (Khalaf, 2015; Likert, 1932).
Validity and reliability:
The tools were exposed for the group of three expertes in the field of neonatal medicine and nursing to test its content validity. The reliability was statistically tested with cronbach alpha. The Cronbach’s alpha test which is a test used to measure internal consistency was used in the analysis (values throughout the assessment were 0.731 for total knowledge, 0.923 for total practices and 0.631 for total attitude.
Pilot study:
A pilot study was carried out on 10% of the total sample size (10) nurses to test the content, the effectiveness and time consumed to fill in study tools. Based on the results of the pilot study, the necessary modifications were done. Therefore those subjects were excluded from the study.
Field Work:
The researcher was available two days (Sunday and Tuesday) weekly from (10Am to 2Pm) by rotation in NICU of Fayoum General Hospital and NICU in EL-Fayoum University to collect data. The nurse was interviewed for filling in questionnaire by researcher and its time consumed 15 minutes and every checklist consumed 10 minutes and attitude scale take 5 minutes to filling it. he average number of nurses assessed / week was 4-5 nurse. The researcher filling in data during neonatal nurses’ leisure time. The nurses’ knowledge regarding care for neonates suffering from pneumothorax was assessed time. Inaddition the researcher observed the nurse while providing the care for neonates suffering from pneumothorax. The researcher started by introducing herself to each nurse, giving a clear and brief idea about the aim of the study and its expectations.
Ethical Considerations:
Ethical and administrative committee approvals were obtained. A consent was obtained from each participated nurse and confidentiality of data and results was considered. Every nurse has the right to withdraw from the study at any time and without giving any reasons. The researcher assured maintaining anonymity and confidentiality of subjects’ data.. The information collected were treated confidentially and used only for the study purpose.
Administrative Design:
Written letter was issued from the Dean of Faculty of Nursing, Ain Shams University to the directors of the previously mentioned study settings to seek their approval for carrying out the study. An official permission was obtained from the director of each study setting, after explanation of the aim, expected outcomes and duration of the study.
Results:
The main study findings were as the following:
• The mean age of the studied nurses was 31.02 ± 5.4 years and (82%) of them were female. Moreover, nearly half (48%) of their educational level was health technical institute and (55%) of them their years of experience were > 10 years.
• (92%) of them did not attend training courses about nursing care for neonates with pneumothorax.
• The mean age of the studied neonates was 35.06 ± 1.9 weeks and (56%) of them from 34-<37 weeks and (45%) of them had weight ranged between 1500- <2000 gram. Moreover, (84%) of neonates were diagnosed with respiratory problems.
• The total nurses’ knowledge regarding neonates suffering from pneumothorax, displayed that more than three quarters (79%) of studied nurses had poor total level knowledge about pneumothorax while, 11% and 10% of them had average and good knowledge respectively.
• The total nurses’practices about all procedure related to regarding neonates suffering from pneumothorax clarifies that The majority (95%) of the studied nurses had incompetent practices, while the manority (5%) of them had competent practices regarding neonates suffering from pneumothorax.
• The total nurses’ attitude regarding neonates suffering from pneumothorax revealed that (82%) of the studied nurses had positive attitude regarding care of neonates suffering from Pneumothora, while the rest of the 18% had negative attitude regarding care of neonates suffering from pneumothorax.
• There were no statistically significant relation between all characteristics of the studied nurses and total level of nurses’ knowledge regarding for the neonates.
• Negative weak correlation between the studied nurses’ total level of knowledge and their practices at p -value 0.69 in relation to care of neonates suffering from pneumothorax. Moreover, there were negative weak correlations between nurses ’ total level of nurse attitudes and their total level of knowledge and practices at p -value 0.87and 0.19 regarding care of neonates suffering from pneumothorax respectively.
Conclusion
Based on findings of the current study, it can be concluded that more than three quarters of studied nurses had poor total level of knowledge about pneumothorax while, the minority of them had average and good knowledge., as well as, the majority of the studied nurses were incompetent in total level of practices related to care of neonates suffering from pneumothorax, most of the studied nurses had positive attitudes regarding care of neonates suffering from pneumothorax. Also, there was a negative weak correlations between nurses ’ total levels of knowledge practices and attitudess in relation to care of neonates suffering from pneumothorax.
The study recommends:
• Continuous supervision and evaluation of nurses’ performance should be performed regarding care of neonates suffering from pneumothorax in the NICUs to achieve and maintain qualityof care.
• Encourage nurses to improve and update their knowledge and practices through attending training programs, conferences and workshops about care of neonates suffering from pneumothorax.
• Procedure book should be available at NICUs as a unifield reference for all nurses who providing care for neonates suffering from pneumothorax.
• Continuous supervision and evaluation of nurses’ performance should be performed regarding developmental care during caring for neonates with pneumothorax in hospitals to achieve and maintain the quality of care.
• Further studies with a larger sample of the nurses working in NICUs at different Hospitals to generalize the results.