الفهرس 
Introduction
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Abstract
Caring of institutionalized elders especially those chronically ill, dependent, and frail is tiring and stressful experience may result in draining, both emotionally and physically for the formal caregivers. Those are subjected to numerous negative outcomes which include; experiences of objectives and subjective burden and emotional stresses. The risk for caregivers’ stress is the outcome of combined factors that worked in a cyclical pattern to the point that burnout may be a logical and an expected result. The negative effects of stress and burnout spill into every area of the caregivers’ life including physical, psychological, and social life. This can hinder the caregivers’ ability to provide care and affect quality of life of both caregivers and elderly persons.
So, it is important for caregivers to learn how to cope with situations inducing stress; through learning effective ways to care for themselves, assessing, reducing, coping with stress and managing specific harmful stressors. In this respect, the gerontological nurse play an important role in identifying the need of caregivers of institutionalized elders for support group and stimulates its development.
The aim of this study was to determine the effect of the support group sessions on stress and burnout of caregivers of institutionalized elders.
The research design of this study was quasi experimental. The study was carried out in all governmental homes for elderly persons in Alexandria (7 elderly homes). from all governmental elderly homes, the two elderly homes which include caregivers who had high degree of stress and burnout according to the results of Perceived Stress Scale and Maslach Burnout Inventory Scale were selected to implement the support group sessions for caregivers working in these elderly homes. These elderly homes are; Dar El Hana and Dar El Hedaya for females.
The subjects of this study were comprised two groups; group (1) comprised all caregivers working at the previously mentioned 7 elderly homes for at least 1 year, work full time (6 hours / day, 6 days per week), and accepted to participate in the study. Their number amounted to 77 caregivers. group (2) consisted of 113 elderly residents at Dar El Hana and Dar El Hedaya (females). They were received care from caregivers with high degree of stress and burnout and aged 60 years and more and accepted to participate in the study. Each participant was interviewed individually to collect the necessary information. Data was collected by using six tools:-
1. ”Caregivers’ Socio-demographic and Clinical Data Structured Interview Schedule” which was designed by the researcher and the schedule comprising caregivers’ personal profile, social and recreational activities, and their health profile.
2.”Perceived Stress Scale” developed by Cohen et al (1983) (212). It measures the perceived stress in response to situations in person’s life. It was translated into Arabic and examined for its validity and reliability.
3.”Maslach Burnout Inventory Scale” developed by Maslach et al (1996) (161). It measures the frequency of dimensions of the three aspects of burnout syndrome namely; emotional exhaustion, depersonalization, personal accomplishment. It was translated into Arabic and examined for its validity and reliability.
4. Elders’ Socio-demographic and Clinical Data Structured Interview Schedule which developed by the researcher. It used to elicit elders’ socio-demographic data and their Health history.
5.”Barthel Index” developed by Barthel (1965) (213). It was developed to assess elders’ activity of daily living. It is valid and reliable tool.
6.”Mini-Mental State Examination” developed by Folestein et al (1975) (215).It is valid and reliable tool and used to assess cognitive function of the elders