Publications by authors named "Naglaa Youssef"

16 Publications

  • Page 1 of 1

Predictors for Severity of SARS-CoV-2 Infection Among Healthcare Workers.

J Multidiscip Healthc 2021 25;14:2973-2981. Epub 2021 Oct 25.

Department of Hepatogastroenterology and Infectious Diseases, Al-Azhar University, Cairo, Egypt.

Background: Healthcare workers (HCWs) are still at higher risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections than the general population. Identifying risk factors associated with severe SARS-CoV-2 infections is of paramount importance to protect HCWs and the non-infected patients attending different healthcare facilities.

Purpose: To recognize the predictors for severity of SARS-CoV2 infection among HCWs working in either COVID-19 or non-COVID-19 healthcare settings. Also, to assess compliance of HCW to standard precautions of infection control and explore the possible risk factors for SARS-CoV-2 infection among HCWs.

Methods: A cross-sectional study was conducted among HCWs with suspected or confirmed SARS-CoV-2 infection, from different Egyptian governorates. They were asked to fill in a web-based self-reporting questionnaire. The questionnaire assessed the demographic and socio-economic characteristics of participants, compliance of HCWs to standard precautions of infection control and COVID-19 presentation.

Results: Our study enrolled 204 HCWs (52.3% physicians). Infection of SARS-CoV-2 was confirmed in 61.3% by RT- PCR; 35.8% were admitted to hospital, and of these, 3.9% were admitted to the intensive care unit. While 30.4% had mild disease, 48.5% had moderate disease, 17.2% had severe disease and 3.9% had critical disease. Regression analysis for variables predicting COVID-19 severity among study healthcare workers showed that associated chronic diseases and management at home were the main independent variables predicting severity of their SARS-COV-2 infection, while the variables age, sex, residence, occupation or drug history of immunosuppressives had no role in severity prediction.

Conclusion: Associated chronic diseases and management at home were the main independent variables predicting severity of SARS-COV-2 infection among HCWs. So, HCWs with chronic diseases should not work in COVID-19 designated hospitals, and there should be a screening strategy for their infection with SARS-COV-2. HCWs must not be negligent in adhering to strict precautions of infection control. HCWs infected with SARS-COV-2 must be managed in hospital not at home.
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October 2021

A multi-centric study on validation of the Fear Scale for COVID-19 in five Arabic speaking countries.

Brain Behav 2021 11 17;11(11):e2375. Epub 2021 Oct 17.

Community Medicine Department, Alzaiem Alazhari University Faculty of Medicine.

Background: The Eight-item Fear Scale is a unidimensional scale evaluating the perceived feelings of fear associated with the thought of the coronavirus.

Aim: The Arabic version of this scale did not exist; hence, this study aimed to translate and evaluate the psychometric properties of the Fear Scale in participants aged 18 years and above in five Arabic countries: Egypt, Lebanon, Libya, Saudi Arabia, and Sudan by using a cross-sectional survey design.

Method: The English version of the COVID-19 Fear Scale was translated into Arabic following the guidelines and disseminated through social media. Factorial and convergent validity and internal reliability were evaluated.

Results: The total number of participants was 2783; the majority was young (41.9%) and female (60.5%). Fear scores were moderate in four countries and severe in Egypt. The scale showed good structural validity, with the items explaining up to 70% of the variance. The scale items correlated significantly with the total scores, and the Cronbach alpha was above 0.9.

Conclusion: The study concluded that the Arabic Fear Scale is a psychometrically robust scale that can be used to evaluate the perceived feelings of fear with the thought of the coronavirus or pandemic in general.
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November 2021

Knowledge, Applicability, and Barriers of Telemedicine in Egypt: A National Survey.

Int J Telemed Appl 2021 9;2021:5565652. Epub 2021 Jun 9.

Hepatogastroenterology and Infectious Diseases Department, Al-Azhar University, Cairo, Egypt.

Objectives: The study is aimed at evaluating knowledge, attitude, and barriers to telemedicine among the general population in Egypt.

Methods: A questionnaire-based cross-sectional design was carried out among the general Egyptian population. A convenience sampling method was used to approach the eligible participants from University Teaching Hospitals of eight governorates from May to July 2020.

Results: A total of 686 participants filled the questionnaire (49.4% were males, mean age 36.7 ± 11.2 years old). Half of the participants stated that they previously used a telemedicine tool, mainly to follow up laboratory results (67.3%). Video or phone calls (39.3%) and mobile applications (23.7%) were the most commonly recognized telemedicine tools by the participants. The included participants exhibited a high level of knowledge and attitude towards telemedicine. On the other hand, 21.9% stated that telemedicine services could jeopardize patient privacy. 32.8% reported that telemedicine service could lead to disclosing medical information to people who are not authorized to do so. Almost half of the participants agreed to strongly agreed that telemedicine service could increase medical errors. 60.80% of the participants said that they are more likely to prefer telemedicine than traditional ways. However, 13.70% stated that telemedicine is more likely to be challenging to use.

Conclusion: The Egyptian population has high knowledge about the applications of telemedicine. In addition, the vast majority of Egyptians appear to perceive the benefits of telemedicine positively and are willing to use it. However, some barriers that have been found must be taken into consideration to adopt telemedicine successfully, especially for people who are old, are low educated, and live in remote areas. Future studies should address the utility of telemedicine in improving the quality of healthcare and patient's health outcome and quality of life.
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June 2021

Mental health status of health-care professionals working in quarantine and non-quarantine Egyptian hospitals during the COVID-19 pandemic.

East Mediterr Health J 2020 Oct 13;26(10):1155-1164. Epub 2020 Oct 13.

Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.

Background: Variable models of care have been adopted in different countries in response to the COVID-19 pandemic. Egypt has assigned certain hospitals specifically for the quarantine of COVID-19 patients, where operational medical teams work continuously for 14 days, after which they are released for self-isolation at home for a similar period.

Aims: The study aimed to evaluate and compare perceived adverse psychological symptoms (stress, anxiety, depression), and insomnia by health-care professionals working in quarantine and non-quarantine hospitals during the COVID-19 pandemic in Egypt, and to explore associated factors with adverse psychological symptoms and insomnia.

Methods: An online cross-sectional survey was performed in April 2020, using a snowball sampling method. Sociodemographic information perceived general health, healthy lifestyle, insomnia (using Insomnia Severity Index), adverse psychological symptoms (using the Depression, Anxiety and Stress Scale-21), worries and concerns about COVID-19, future perspective about COVID-19, and coping strategies were collected.

Results: Five hundred and forty health-care professionals participated; 10.2% (n=55) worked in quarantine hospitals. Younger age (ORa=0.96, 95% CI:0.93-0.99, ORa=0.95; 95% CI:0.92-0.97; ORa=0.96 CI:0.93-0.99), being not ready/sure of readiness to work in quarantine hospital (ORa=1.91, 95% CI:1.22-3.00; ORa=2.01, 95% CI:1.28-3.15; ORa=1.91, 95% CI:1.22-2.98), and insomnia (ORa=5.22, 95% CI:3.38-8.05; ORa=7.58, 95% CI:4.91-11.68; ORa=6.38 95% CI:4.19-9.73) significantly predicted stress, depression and anxiety, respectively. Being female (ORa=1.59, 95% CI:1.04-2.42; ORa=2.09, 95% CI:1.38-3.16) could also significantly predict stress and anxiety.

Conclusion: Female and younger age health care professionals were more prone to report adverse psychological symptoms. More and earlier screening for health-care professionals dealing with COVID-19, in addition to providing psychological support, is highly encouraged.
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October 2020

Changes in the morphological traits and the essential oil content of sweet basil ( L.) as induced by cadmium and lead treatments.

Naglaa A Youssef

Int J Phytoremediation 2021 30;23(3):291-299. Epub 2020 Sep 30.

Faculty of Science, Botany & Microbiology Department, Sohag University, Sohag, Egypt.

The purpose of this study was to inspect the suitability of sweet basil ( L.) for phytoremediation of heavy metal contaminated areas in urban areas of Egypt through study the impact of the most common pollutants in Egypt: cadmium (Cd) and lead (Pb) on morphological traits, and essential oil (EOs) content of sweet basil. The experiment was done under greenhouse conditions. The applied treatments tested in this experiment for Cd concentrations were 5, 10, 15, 20, 25 ppm and for Pb: 100, 350, 750, 1,000, 1,500 ppm. The composition and amount of EOs had been determined using gas chromatography-mass spectrometry (GC-MS). The results indicated that the contaminated soil had a negative impact on morphological traits development of basil (, the decline in fresh and dry weight). The increase in Cd and Pb concentrations enhanced the EOs yield of sweet basil. In general, basil cultivation in the Cd and Pb contaminated soils could cause undesirable impacts on morphological traits; however, the presence of these metals has a major influence on the EOs yield, composition, and phytoremediation of the soil.
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February 2021

Retreatment of chronic hepatitis C patients who failed previous therapy with directly acting antivirals: A multicenter study.

Int J Infect Dis 2020 Jul 20;96:367-370. Epub 2020 Apr 20.

Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Egypt.

Aim Of The Study: The current study aimed to evaluate the efficacy of different DAAs regimens in the treatment of chronic hepatitis C (CHC) Egyptian patients who failed to achieve SVR after their treatment with SOF-based regimens.

Methods: This was a retrospective observational multicenter study that included CHC patients that failed to achieve cure on SOF-based regimens who were re-treated using different DAAs regimen and were allocated according to national guidelines for the treatment of hepatitis C. Primary outcome was to assess the SVR12 rate among prior non-responders after retreatment with a second course of DAAs.

Results: Our study included 172 patients who failed to achieve SVR after treatment with SOF-based treatment regimen [age: 51.2 ± 11.3, 58.7% men]. Included patients were retreated using SOF/DCV/RBV, SOF/ r/PAR /OMB /RBV, SOF/DCV/SIM, SOF/LDV ± RBV or SIM/SOF. SVR12 was successfully attained in 95.35% (164/172) of the included non-responders.

Conclusion: The current multicenter study proved the efficacy of various DAAs regimens issued by the National Committee for Control of Viral Hepatitis for retreatment of relapsed CHC Egyptian patients.
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July 2020

Psychometric properties of the Arabic version of the International Consultation on Incontinence Questionnaire on Long-Term Catheter Quality of Life.

Int J Nurs Pract 2020 Jun 18;26(3):e12807. Epub 2019 Dec 18.

Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.

Aim: To translate the International Consultation on Incontinence Questionnaire (ICIQ) Long-Term Catheter Quality of Life (LTCqol) questionnaire (ICIQ-LTCqol) from English to Arabic and evaluate its psychometric properties.

Background: Currently, no tool for Arabic-speaking patients is available to measure the quality of life in patients using long-term urinary catheters.

Design: Translation and psychometric assessment of questionnaire.

Methods: The internal consistency and construct validity of the translated Arabic version of the ICIQ-LTCqol were evaluated in a convenience sample of 141 participants recruited from a hospital in Egypt from April to September 2017. Test-retest reliability was assessed for a sample of 15 participants who completed this version at two time points. Construct validity was assessed by factor analysis.

Results: The translated Arabic version of the ICIQ-LTCqol showed satisfactory test-retest reliability and internal consistency, with the Cronbach α = .75. Confirmatory factor analysis confirmed the same two factors ("catheter function" and "lifestyle") structure as found in the English version of the tool supporting the construct validity of the translated questionnaire.

Conclusion: This original and significant study allows, for the first time, researchers and clinicians working with Arabic-speaking patients, the opportunity to evaluate the quality of life in long-term urinary catheter users.
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June 2020

Bioaccumulation of heavy metals air pollutants by urban trees.

Int J Phytoremediation 2020 21;22(2):210-222. Epub 2019 Aug 21.

Department of Botany, Faculty of Science, Minia University, Minia, Egypt.

Leaf and bark of trees are tools for assessing the effects of the heavy metals pollution and monitoring the environmental air quality. In this study, the possibility of using leaves and bark of two urban trees, namely, and as a bioindicator of atmospheric pollution was evaluated by determining the composition of heavy elements in the tree leaves, bark, soil, and the atmospheric dust. Two common tree species, namely, and were selected in the heavily industrial zone of surrounding Minya governorate, Upper Egypt. Two urban areas with heavy traffic load (sites 1 and 2), three industrial zones (sites 3, 4, and 5) and an uncontaminated area as a control were selected (site 6). Sampling from leaf, bark, soil, deposited dust of trees was carried out in winter and summer seasons (from November 2016 to March 2017). The concentrations of heavy metals in dust, soil, leaves, and bark possess the same trend: PbCuCd. The highest concentration of cadmium, lead, and copper was found in the leaf of and higher than bark samples of the studied species, supporting the idea suggesting that tree leaves can be used as a good indicator of heavy metals accumulation. A high and statistically significant correlation ( < .05) was found between Pb concentrations in the atmospheric dust and those in the leaves of both species throughout the two growing seasons, confirming that the main source of incorporated Pb is the atmospheric dust. Otherwise, the obtained results showed that tree does not seem to be a good accumulator of Cu. According to the obtained results, and trees are more likely to capture cadmium and lead from air, so planting these trees in industrial areas with such atmospheric pollutants would be beneficial.
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January 2020

The effect of cryotherapy application before versus after subcutaneous anticoagulant injection on pain intensity and hematoma formation: A quasi-experimental design.

Int J Nurs Sci 2018 Jul 21;5(3):223-229. Epub 2018 Jul 21.

Medical-Surgical Nursing Department, Faculty of Nursing, Cairo University, Egypt.

Objective: To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection (SCAI) on pain intensity and hematoma formation.

Methods: A quasi-experimental design was utilized. A convenient sample of 105 adult patients, who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI, were recruited over a period of six months. Patients were randomly allocated into three groups: A Control group who received the routine hospital care (G1, = 35) and two intervention group who received cryotherapy for 5-min (G2: cryotherapy applied before SCAI,  = 35; G3: cryotherapy applied after SCAI,  = 35). Demographic and medical history data sheet, Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data.

Results: The pain intensity among the patients in the two intervention groups (G2:  = 1.0; G3:  = 0) was significantly lower than in the control group (G1,  = 3.0). No significant difference was found between G2 and G3( = 0.728). Applying cryotherapy after SCAI (G3) decreased the frequency of hematoma formation (48hrs = 31.4% & 72hrs = 28.5%) compared to applying it before injection (G2, 100%) or not applying it (G1, 100%). The size of hematoma in G3 was smaller than that in G2 ( < 0.01).

Conclusion: Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size. Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.
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July 2018

Egyptian liver library: An indexed database for liver disease evidence in Egypt.

Arab J Gastroenterol 2019 Jun 4;20(2):109-113. Epub 2019 Jun 4.

Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.

Liver diseases are among the most challenging health care problems worldwide. In Egypt, we established different care programs to combat liver diseases including schistosomiasis and viral hepatitides. A lot of research work addressing liver diseases in Egypt have been published with special focus on these two major fields. Other liver disease seems to be neglected although present and contributing to the liver disease burden in Egypt. In this report we reviewed the available evidence published from Egypt and elucidate areas of weakness and future research needs. Our search for Egyptian liver disease evidence retrieved 4683 articles, 67% of them were relevant to the topic. Out of the relevant articles; 1646/3265 (50.4%) were discussing clinical science, 1131 (34.7%) were discussing basic science and 488 (14.9%) were discussing both basic and clinical sciences. Cairo university (16.8%, n = 513) and Mansoura university (9.3%, n = 285) had the largest number of publications related to liver disease in Egypt respectively. The most commonly reported diseases were hepatitis C in 719/3361 articles (21.4%), parasitic liver infestations in 663 articles (19.7%), hepatocellular carcinoma in 544 articles (16.2%), liver fibrosis or cirrhosis in 537 articles (16%), and drug induced liver injury in 516 articles (15.4%). Most of the reviewed articles (36%) were discussing treatment of chronic liver diseases (n = 1201) followed by diagnostics (28%, n = 940), pathogenesis and pathophysiology (21%, n = 706). This review will direct attention to areas with less research like hepatitis B related liver disease, HIV/HCV co-infections, and non-alcoholic fatty liver disease (NAFLD) to encourage future research in these topics. In conclusion; our results ring a bell inviting the development of a roadmap for liver research in Egypt targeting to put future policies to cover areas of weakness in liver research with an ultimate goal of tackling liver disease and its overwhelming socioeconomic burden in our developing country.
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June 2019

Real-world results of direct-acting antivirals use for the treatment of chronic hepatitis C in old patients.

Eur Geriatr Med 2019 Apr 24;10(2):295-302. Epub 2019 Jan 24.

Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Background And Aim: Old people with chronic hepatitis C (HCV) were considered a difficult-to-treat category with more frequent adverse events until recently. Interferon-free direct-acting antivirals (DAAs) improved treatment adherence and quality of life of old patients. In this study, we aimed at reporting the real-world efficacy and safety of DAAs, in addition to predictors of sustained virological response (SVR) in old chronic HCV population.

Methods: This is a prospective observational intention-to-treat analysis that included old chronic hepatitis C genotype-4 patients (> 65 years) treated in a single specialized viral hepatitis treatment center in Egypt. Treatment regimens were allocated according to national guidelines for treatment of hepatitis C. Primary outcome was undetectable HCV-RNA at 12-week post-treatment by PCR. Secondary outcomes were identification of predictors of SVR and assessment of safety related issues.

Results: Our study included 864 patients (64% females) with mean age of 67.7 ± 2.8 years. Overall SVR rate was 98.9% while SVR rates for sofosbuvir/daclatasvir/ribavirin, paritaprevir/ombitasvir/ritonavir/ribavirin, sofosbuvir/daclatasvir, sofosbuvir/ledipasvir/ribavirin, sofosbuvir/simeprevir/daclatasvir/ribavirin, sofosbuvir/simeprevir, interferon/sofosbuvir/ribavirin and sofosbuvir/ribavirin were 100%, 100%, 100%, 100%, 100%, 99.3%, 98% and 94.2%, respectively. DAAs were well tolerated. None of the patients discontinued the treatment due to adverse effects. Higher albumin, higher platelet count, lower bilirubin and lower stage of fibrosis were among predictors of favourable response.

Conclusion: Different DAAs regimens were safe and effective in old Egyptian patients with chronic HCV.
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April 2019

Egyptian and Jordanian nurse educators' perception of barriers preventing the implementation of evidence-based practice: A cross-sectional study.

Nurse Educ Today 2018 May 10;64:33-41. Epub 2018 Feb 10.

Health Research Institute, University of Canberra, ACT, 2601, Australia. Electronic address:

Background: Studies discussing nurse educators' attitudes, knowledge/skills, practicing of evidence-based practice (EBP) and barriers encountered towards implementation is somewhat limited.

Objective: The study aimed to identify the attitudes, perceived knowledge/skills, and implementation of evidence-based as perceived by nurse educators, in Egyptian and Jordanian universities, and to assess factors preventing them from adopting it in nursing program.

Design/setting/respondents/methods: A cross-sectional design was conducted including two groups from Egypt and Jordan. Two questionnaires: (i) The Evidence-Based Practice Questionnaire (EBPQ) and (ii) The Developing Evidence-Based Practice Questionnaire (DEBPQ) and a demographic data sheet were used. Data were analyzed using SPSS version 20 and descriptive and inferential statistics tabulated.

Results: Majority of the respondents (85.5%) were females, <40 years old (62.1%), and from medical-surgical nursing departments (49.2%). The mean score of EBPQ was 4.96 ± standard deviation 0.91. Frequency of practicing EBP and attitudes toward EBP scores were similar between nurse educators in both countries (p > 0.05). However, the Jordanian staff had a remarkably higher perceived knowledge/skills of EBP than their Egyptian counterparts (Mean Rank = 79.98 & 57.63 respectively, at p = 0.004). There was a statistically significant positive, moderate correlation between attitudes, knowledge/skills and frequency of practicing EBP among nurse educators in both countries. The highest correlation observed for attitudes and frequency of practicing EBP was among Jordanian staff (r = 0.707, p < 0.000). Egyptian nurse educators had significantly higher perceived barriers to finding and reviewing evidence than their Jordanian counterparts (p = 0.000). However, both groups had similar perceived barriers related to changing practice and support from colleagues.

Conclusions: Egyptian and Jordanian nurse educators, equally, hold positive attitudes toward adopting EBP. However, they encounter many barriers to implement it.
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May 2018

Herpes Zoster reactivation in patients with chronic hepatitis C under treatment with directly acting antiviral agents: A case series.

Arab J Gastroenterol 2017 Mar 18;18(1):39-41. Epub 2017 Mar 18.

Endemic Hepatogastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

We report a series of cutaneous Herpes Zoster (HZ) reactivation cases in patients with hepatitis C virus (HCV) infection treated with directly acting antiviral (DAA) agents. Five cases were detected among 2133 treated patients with DAAs at one of the specialized viral hepatitis treatment centers in Egypt. A control group including 2300 age and sex matched HCV patients who were previously treated with pegylated interferon and ribavirin did not show any HZ reactivation reports while on treatment. None of cases had an evidence of immunosuppression or a risk factor for HZ reactivation. The DAAs used regimens were sofosbuvir/daclatasvir in 4 cases and sofosbuvir/simeprevir in one case. HCV clearance with antiviral therapy may bring immune changes causing reactivation of other latent viral infections like HZ. A high index of clinical suspicion may be needed to guarantee early and prompt management of such cases.
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March 2017

Health-related quality of Life in patients with chronic hepatitis C receiving Sofosbuvir-based treatment, with and without Interferon: a prospective observational study in Egypt.

BMC Gastroenterol 2017 Jan 21;17(1):18. Epub 2017 Jan 21.

Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK.

Background: The Egyptian government introduced the first directly acting antivirals (DAAs) into Egypt through the government funded National Treatment Program. As yet, there has been no investigation into the effects of these new DAAs therapies on patient reported outcomes (PROs). This study aimed to (1) assess the PROs (health-related quality of life (HRQoL), mental health and perceived social support) of HCV patients receiving DAAs therapy prior, during and at the end of therapy; (2) evaluate PROs of Interferon-free (dual) users versus Interferon-containing (triple) users cross the three different time periods; and (3) identify the predictors of HRQoL of DAAs therapy users cross the three different time periods.

Methods: A prospective observational design was used. Patients with chronic HCV undergoing treatment following the Egyptian National Guidelines at one of the national treatment centers were approached. Data collection occurred in the period from February to October 2015. Data was collected at three time points: (1) baseline (time 0: T0), before initiating therapy); (2) 5/6 weeks after initiation of therapy (time 1 of therapy: T1) and at the end of the therapy (Time 2: T2). Four PROs questionnaires were utilized for data collection: (1) Multidimensional Scale of Perceived Social Support (MSPSS), (2) The Depression Anxiety Stress Scales (DASS-21), (3) the Liver Disease Symptom Index-2.0 (LDSI-2.0) for testing disease specific HRQoL and (4) the Center for Adherence Support Evaluation (CASE) Index, alongside the background data sheet.

Results: Sixty-two patients participated. There was a change in HRQoL, symptom experience and mental health across the three different time periods. HRQoL was impaired more after starting the course of therapy (T1) than at baseline (T0) and end of therapy (T2), z ≥ -2.04, p ≤ .04. Also, symptom experience deteriorated more during the treatment period than at the baseline, Z ≥ -1.97, p ≤ .04. Anxiety and stress were significantly higher during the treatment period than at the end of treatment. Perceived social support was significantly higher during the treatment period than at baseline and end of therapy, Z ≥ -2.27, p ≤ .023. During the course of therapy, triple users were more likely to report poorer HRQoL and anxiety than dual users (p ≤ .04). By the end of therapy, the two arms of therapy had no significant differences in any of the PROs. At baseline, the predictor model significantly (p = .000) explained 37.5% of the variation in the HRQoL prior to therapy. Depression was the main variable that contributed to (41.3%) predicting change in HRQoL prior to therapy. During therapy, the model significantly (p = .000) explained 76% of the variation in the HRQoL-T1. Stress-T1, body mass index (BMI)-T1 and HRQoL-T0 significantly and respectively predicted 44.4, 46.5 and 31.1% of the variation in HRQoL-T1. At the end of therapy, the model significantly (p = .000) predicted 80.5% of the variation in the HRQoL-T2. HRQoL-T1 and anxiety-T2 significantly predicted 72.3 and 61.6% of the variation in HRQoL-T2.

Conclusions: Baseline HRQoL, depression and BMI should be systematically assessed before starting the antiviral therapy for early detection and the improvement of the impairment before the initiation of therapy. Anxiety should be frequently assessed and followed up through the course of antiviral therapy. The triple group required more nursing and practitioner attention due to increased anxiety levels and impaired HRQoL during the treatment therapy.
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January 2017

Factors associated with health-related quality of life among patients with liver cirrhosis in Egypt.

J Egypt Public Health Assoc 2015 Mar;90(1):14-9

aMedical-Surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt bSchool of Health Sciences, University of Stirling, Stirling, Scotland, UK.

Background: Although the disease burden of liver cirrhosis in Egypt is high and there are few resources for its management, there is limited research on the health-related quality of life (HRQOL) of Egyptian patients with liver cirrhosis.

Aims: To describe the HRQOL of liver cirrhotic patients in Egypt and to analyse factors associated with this construct.

Patients And Methods: A cross-sectional study with a convenience sample of 401 patients from three hospitals in Cairo, Egypt, was carried out in June-August 2011. Patients were interviewed to complete a background data form, Short Form-36, the Liver Disease Symptom Index-2.0 and the Multidimensional Scale of Perceived Social Support.

Results: Patients had low HRQOL, with mental health perceived to be poorer than physical health. In regression analyses, severity of symptoms, disease stage, comorbidities and employment status were associated significantly with physical health, accounting for 19% of the variance. For mental health, 31.7% of the variation was explained by severity of symptoms, employment status and perceived spouse and family support.

Conclusion And Recommendations: These findings highlight the needs of patients with liver cirrhosis in Egypt. Engaging the patients' family in care planning may decrease patients' burden and improve their HRQOL. This study also provides a rationale to develop future research in symptom management to enhance HRQOL.
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March 2015

Translating and testing the Liver Disease Symptom Index 2.0 for administration to people with liver cirrhosis in Egypt.

Int J Nurs Pract 2012 Aug;18(4):406-16

School of Nursing, Midwifery and Health, University of Stirling, Stirling, Scotland, UK.

The Liver Disease Symptom Index (LDSI) 2.0 is a simple, short and specific liver disease questionnaire in English, but an Arabic version does not exist, therefore we translated the LDSI-2.0 into Arabic and tested its psychometric properties in a pilot cross-sectional study. A convenience sample of 38 patients with liver cirrhosis from one hospital in Cairo, Egypt, were interviewed for approximately 45 min. Patients completed a background data sheet, the translated LDSI-2.0 and the Short Form (SF)-36v(2). Construct convergent validity was examined by correlating LDSI-2.0 items with the SF-36v(2) eight domains. Reliability was estimated using measures of internal consistency, test-retest reliability and internal consistency reliability. Median completion time was 10 min. The correlation between the translated LDSI-2.0 items and the SF-36 domains confirmed that there was moderate to high overlapping between the two measures, suggesting convergent validity of the LDSI-2.0. The LDSI-2.0 showed good to very good retest reliability (kappa value 0.62-0.94). Chronbach's alpha coefficient for the multi-item scales ranged from 0.73 to 0.96. The Arabic LDSI-2.0 therefore has satisfactory validity, retest reliability and internal consistency.
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August 2012