الفهرس 
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Abstract
Chronic kidney failure is considered a growing health problem across the world. Pediatric Patients with chronic renal failure are in need of renal replacement therapy and they should be treated with hemodialysis. Both chronic kidney failure and hemodialysis cause a series of problems and consequences to the pediatric patients and their families. Additionally, mothers are particularly faced with constant feeling of uncertainty about the child’s condition and have significant worries and stress concerning treatment and HD. They face many barriers such as physical, psychological, social, financial and school achievement barriers. Pediatric nurse should be aware of mothers’ barriers to minimize their suffering. So, this study was carried out to identify barriers facing mothers in their caring of children undergoing HD.
The study was conducted in at the kidney dialysis Unit in the Alexandria University Children’s Hospital at El Shatby and dialysis unit in health insurance student’s Hospital. A convenient sample of 70 mothers of children undergoing HD, whose age ranged 6-18 years and free from any other associated chronic diseases comprised the study sample.
Barriers facing mothers in their caring of children undergoing HD Interview Schedule was the tool used to collect the needed data. It consists of two main parts: part one includes demographic and medical about the mothers and their children undergoing HD. It was developed by the researcher after reviewing the relevant and recent literature. Part two encompass Barriers that facing Mothers in their caring of children undergoing hemodialysis structured Interview Schedule, which included physical, psychological, social, financial, information, school achievement and administrative barriers.
Mothers responded to these statements on a four Likert Scale that ranges as follows: always , sometimes , rarely and never .Every mother was individually interviewed to collect the necessary data.
The main results of the present study revealed the following:
- Nearly half of the mothers (48,5%) were 40 to more than 40 years old
- Nearly half of the mothers (47,1%) were illiterate.
- The majority of the mothers (88,6%) were housewives and nearly two thirds of them (60%) live in rural and suburb areas
- Nearly half of children (47,1%) were 10 to 15 years old and (57,1%) of them were females.
- The birth order of children was the second for 32,9%.
- The onset of illness was from one year to less than three years for 32,9% of children.
- All mothers (100%) had complete awareness regarding the meaning of CRF.
- Regarding physical barriers, feeling exhausted from Inability to sleep regularly due to fear on child and from Waking-up a lot at night to check child’s condition were the highest perceived physical barriers by the mothers as reported by 50% and 47,1% of them respectively, followed by exhausted due to bringing-child for dialysis in the hospital which reported by 41.4% of the mothers and 35.8% of them were sometimes exhausted from farness of home from dialysis place.
- Concerning psychological barriers, feeling sadness for suffering and pain of her child and Feeling worry from dependence of her child on hemodialysis throughout his life were always the highest perceived physical barriers by the mothers as reported by 72,9% and 71,4 % of them respectively. being upset for seeing her child sad, from child’s suffering, from inability of her child to eat foods like peers and feeling worry when the results of unsatisfactory investigations of her child appear were always perceived as barriers by almost majority of the mothers.
- As regards financial barriers, 57.1% of the mothers were always perceived high cost of regular follow up and care needs as a barriers. Nearly three quarters of the mothers were sometimes upset from Lack of sources that provide adequate information about child’s condition and lack of community services that help children.
- With respect to social barriers, being upset from other children’s feeling of sadness due to their brother/sister disease, effect of child’s disease on social visits, Difficulty in doing recreational activities and Imposed protection on child were always perceived as abarrier (as reported by 48.6%, 47.2%, 37.1%,37.1% of mothers respectively)
- Concerning information barriers, being upset from ignorance and lack of information about child’s disease and ignorance of health services’ places for child were sometimes perceived as a barrier for 71.5, 67.1% of the mothers respectively).
- Concerning school achievement barriers, Feeling worry on the future of the child, from inability of child to concentrate in activities like peers and of effect of child’s disease on school achievement were always information barriers facing mothers (81.4%, 54.4%, 62.8 % respectively).
- As regards administrative barriers, Interference of follow-up visits with mothers’ work appointments were always the highest administrative barriers as reported by 34.3% of the mothers.)
- School achievement barriers were the highest barriers facing mothers of children undergoing HD with a mean score of (72.06), followed by financial barriers (66.29), psychological barriers (64.76), physical barriers (38.43) and social barriers (44.60). Administrative barriers were the least perceived ones by mothers with a mean score of (35.62).
- Mothers’ education were the only variable that had statistical significant difference with information barrier. Moreover, mothers’ education, occupation and health problems were variables that had statistical significant relation with administrative barrier. In addition, mothers’ occupation was the only variable that had statistical significant relation with financial barriers.
- Mothers’ health problems was the only variable that had statistical significant relation with psychological barriers.