الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Nurses as professional health care providers and patient advocates have a role to play in safeguarding the health, dignity and security of children. Through direct delivery, screening measures, and health promotion efforts, the nurse can identify children with school refusal and provide early treatment and reducing the incidence and prevalence of school refusal and overcoming anxiety, depression and other general symptoms associated with it. So this study aims at evaluating the effect of an intervention strategy on overcoming school refusal behavior among children at basic school education A quasi-experimental design was used on 120 subjects. (60 students and 60 parents) from El-Bagor district in Menofiya Governorate. The aim of the study was to: - Evaluate the effect of an intervention strategy on overcoming school refusal behavior among children at basic school education. The following tools were used to fulfill the aim of the study:- Tool (1) School Refusal Assessment Scale: Tool (1) School Refusal Assessment Scale: -This tool was developed by Kearney and Silverman (1995). It was translated by the researcher into Arabic language and tested for its content validity by group of five experts in the psychiatric medicine and nursing staff in psychiatric and community, and modifications were carried out by correcting some items in language only. Then test-retest reliability was applied. The tool proved to be strongly reliable (r. = 0.8222). - Child version and Parent version contained 24 items to assess the conditions of school refusal behavior. - Each was scored from 1-3 answers where 1=never, 2 =sometimes, 3 =always. (Appendix V) Tool (2) Depression Scale for Children (CES-DC): -This tool was developed by Faulstich, et al., (1986). It was revised by five experts in the psychiatric medicine and nursing staff in psychiatric and community. The modified scale contained 20 items measuring the thoughts and behaviors indicative of depression; commonly used as a screening instrument. - Each response to an item was scored as follows: 1 = “Not At All” 2 = “A Little and 3 = “A Lot. Scores ≥ 40 means depression, score < 40 means without depression (Appendix IV). Tool (3) Spence children’s Anxiety scale:- -This tool was developed by Spence and Ron, (1999) to assess anxiety of child. It was translated by the researcher into Arabic language and tested for its content validity by group of five experts in the psychiatric medicine and nursing staff in psychiatric and community, and modifications were carried out by correcting some items in language only. Then test-retest reliability was applied. The tool proved to be strongly reliable (r. = 0.8). - Child version contained 45 items and Parent version contained 39 items. - Items of child version were scored from 1-3 where 1= never, 2= sometimes and 3 =always. - Items of Parent version were scored from 1-3 where 1= never, 2= sometimes and 3 =always. Scores ≥ 40 means anxiety, score < 40 means without anxiety (Appendix III). Tool (4) General symptoms checklist questionnaire -This tool was developed by the researcher. It consisted of 44 items to assess somatic symptoms. Items were scored from 1-3 where1= never, 2= sometimes and 3 =always. - It was tested for its content validity by group of five experts in the psychiatric medicine and nursing staff in psychiatric and community. Some items were added to the questionnaire and modifications were carried out accordingly. Then test-retest reliability was applied. The tool proved to be strongly reliable (r. = 0.83) (Appendix II).-interviewing questionnaire :An -5 A- Socio-demographic data sheet:- - Included socio-demographic data of child and his parent such as age, sex, occupation, and level of education of the parent and age, sex, age of school entry of the child and number of family members living at home, (Appendix, I ) (B) Pre-post knowledge questionnaire:- - The questionnaire was developed by the researcher to determine parents’ level of information about school refusal, (e.g. definition, etiology, signs and symptoms, forms, levels and management). -The responses of the parents were scored from 1-3 scores to assess level of general knowledge. One degree for wrong answer, two degrees for incomplete answer and three degrees for right answer. - Pre-post knowledge questionnaire tested for its content validity by a group of five experts in the community medicine and psychiatric nursing staff. The required modification was carried out accordingly. Then test-retest reliability was applied. The tool proved to be strongly reliable (r. = 0.83) -The total score for general knowledge of parents about school refusal was classified into: Poor knowledge if the parent knew less than 50% of the right answers of the questionnaire (a score less than 19), fair knowledge if the parent knew from 50% - 80% of the right answers of the questionnaire (A score from 19 – 31) and good knowledge if the parent knew more than 80% of the right answers of the questionnaire (a score more than 31) (Appendix, I). The main results of the study showed that: 46.7% of the studied students were at age group from 7-8 years old 61.7% of the studied students were male while 38.3% were female. The highest frequency 65% enters school at age of 6 years and 38.3% at second level of school. Also it was found that 46.7% were second birth order and 80% were lived with their family. Regarding reasons of school refusal behavior, there was a statistically significant improvement in post intervention strategy. Regarding anxiety there was a statistically significant improvement in post intervention strategy. Regarding depression there was a statistically significant improvement in post intervention strategy. Regarding general symptoms associated with school refusal behavior there was a statistically significant improvement in post intervention strategy. There was highly statistically significant improvement of knowledge of parents post intervention strategy. There was no statistically significant difference between total knowledge score and Sociodemographic characteristics of studied parent. There was positive correlation between school refusal behavior and depression but not statistically significant, while there was positive correlation between school refusal behavior and anxiety with statistically significant difference.