@article { author = {Elmasri, Yosr}, title = {Comparison of Dependence in Daily Life Activities, Quality of Life and Caregivers' Expressed Emotions in Schizophrenic Patients with and without Relapse}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {193-211}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20599}, abstract = {Background: Schizophrenia is a chronic, relapsing disease, characterized by adverse set of signs and symptoms that strongly affect the patient functional behaviors, quality of life, and quality of caregivers emotional responses. Objective: The aim of this study was to explore the differences between dependence in activities of daily life, quality of life (QOL), and  expressed emotion (EE) in schizophrenic patients with  and without relapse. Methods: A retrospective case-control design was utilized in this study. It included 120 schizophrenic patients and their caregivers divided into two groups. The group with relapse consisted of 60 schizophrenic patients with history of recent relapses and their caregivers and the group without relapse  included 60 patients. The tools used for data collection were interview questionnaire sheet, QOL scale for patients, and Camberwell family interview for caregivers. Results: the results revealed that there were statistically significant differences between the two groups of caregivers under study regarding their expressed emotions, relapse group had more problems related to work than non relapse, more relapse patients had  low QOL, compared to group without relapse.  Also, the QOL scores had a negative statistically significant correlation with the number of relapses. It is concluded that patients group with relapse have more dependence in activities of daily life, lower QOL, and their caregivers have higher expressed emotions. Conclusion: Thus, it is necessary to train caregivers of schizophrenic patients regarding expressed emotions and how to control them for the safe of better prognosis and lower susceptibility to relapse among their patients.}, keywords = {Dependence in Daily Life Activities,quality of life,Caregivers' Emotions,Schizophrenic Patients,relapse}, url = {https://jhiphalexu.journals.ekb.eg/article_20599.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20599_37356f70345d070538efe4f585086d1b.pdf} } @article { author = {Ahmed, Amal}, title = {Evidence-based Practice: Perspectives of Academic Community Health Nurses and Primary Health Care Nurses}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {212-236}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20602}, abstract = {Evidence-based practice (EBP) is an approach that integrates the best current available scientific evidence with the expertise of the health professionals, patient’s preferences and values to make decisions about health condition. EBP provides safe and custom-made care that produces the preferred health outcomes, increases the care satisfaction in care recipients, and reduces the cost of health care. Applying of EBP will facilitate deciding about choosing of the most effective program or intervention, and culturally accepted by a community. EBP as a tool for improving the health care quality will serve the long-term goal of improving the quality of primary care and preventive services. It was very important to explore the views of health care professionals about EBP that concluded their willingness to practice it. While the EBP is a new approach for the Egyptian society, the present study aimed to investigate the perspectives of academic community health nurses and primary health care nurses at local level of Dakahlia governorate. Quasi-interventional study design was used with qualitative data collection approach. The study was based on qualitative investigation of the participants knowledge and views about evidence- based practice, before and after a two days training program that gave an intensive overview about the evidence- based practice. Results of the study showed lack of knowledge among participants about EBP that hindered them to give explicit views before attending the training program. The participants attained knowledge that was sufficient enough to portray their views about EBP after attending the training program. They described EBP to be an objective and practical tool that facilitate decision making in daily practice. They mentioned also that EBP is an approach of life-long learning, but it requires a well-established professional environment. The study concluded that providing essential knowledge about EBP enabled community health nurses to portray perspectives about the values and possibilities of its application. They suggested establishing a partnership system between academic nursing institutions and primary health centers to implement EBP.Based on the illustrated findings the study recommended conducting comprehensive training programs on EBP and to community health nurses, providing raising awareness programs to embed the EBP into the organizational cultures of academic institutions and primary health centers, and carrying out further study on establishing the partnership framework between academic institutions and primary health centers.     }, keywords = {evidence based practice,Community Health,Nurses' Perspectives}, url = {https://jhiphalexu.journals.ekb.eg/article_20602.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20602_9e42a797283adaa1feaf7a10484d97e6.pdf} } @article { author = {Ibrahim, Sahar and Abdel Sattar, Samar}, title = {Auditing of Intercostal Tube Insertion (Thoracostomy) in Abbassia Chest Hospital, Cairo, Egypt}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {237-254}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20603}, abstract = {Background: Intercostals tube/catheter insertion is an invasive procedure usually done outside operating theater. If it is inserted without full aseptic technique, it will lead to a serious infective complication (EMPYEMA). A protocol of insertion must be designed, instructed and followed to do it safely to decrease rate of complication. All personnel involved in insertion of chest drain should be adequately trained and supervised. Objective: This study aimedto detect the compliance of chest tube insertion procedures with the standard Guideline and to detect the relation between, actual practice and occurrence of infection (superficial and deep). Methods: A descriptive prospective study-using auditing technique was conducted at Abbassia chest diseases hospital (one of the Ministry of Health hospitals with a total of 700 beds). Surgical and ICUs were chosen, a 119-inserted tubes were observed while they were introduced.  Those were of patients admitted during a period of 6 months. Results indicated that the infective complication was 66.4%, while complications other than infection were 33.6%.  The study discussed the relation between different practices as ; washing hands before the insertion, wearing personal protective equipment (PPE), using sterile tools, insuring sterility of dressing, avoiding touching environment while putting on sterile gloves  and the occurrence of infection (superficial and deep).}, keywords = {Intercostal Tube,Intercostal Catheter,Invasive procedure,Aseptic technique,Empyema,Chest Drain}, url = {https://jhiphalexu.journals.ekb.eg/article_20603.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20603_97b69af9fd0be361f5c63d1d81769057.pdf} } @article { author = {S, Yassin and R, Abdel Hai and M, Abdel Razik}, title = {Impact of Service-Learning Paradigm on Demand Creation for Primary Health Care in the Rural Community}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {255-282}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20604}, abstract = {Background: Improving the quality of performance of Egyptian physicians in health services delivery requires the introduction of educational strategy that addresses population health issues through service-learning (SL) paradigm. Therefore, the Public Health Department, Cairo University (PHD-CU) has introduced a "hands-on"/Problem Based Learning module for the fifth year medical students. This module is aiming at building the capacity of the students to anticipate and respond to rural community needs and create demands for health care. Objective: the aim of the study was to examine the impact of PHD-CU- service learning module on coverage of the rural families with health education messages, demand creation for primary health care services, and the utilization patterns of rural health unit (RHU) in the target village. Methods: A community-based evaluation study design was used. Cluster sampling technique was used and 1405 families were interviewed during household survey. Focus group discussions were conducted with rural health unit (RHU) staff members and community workers and RHU's service statistics were analyzed. Results: The results showed that 87% of families were exposed to different forms of students’ SL activities, of which 61% were through home visits. About 91% of the home visited families have received health education especially for anti-smoking (58%), prevention of avian influenza (54%) and environmental sanitation (56%). Service statistics showed increase in different services e.g. Antenatal Care Coverage showed an increase by 32 percent points after students' visits. Rural health unit staff expressed appreciation to the students' role in demand creation for health care services.}, keywords = {Service-Learning,Medical Students Training,Problem-Based Learning (PBL),Demand Creation,primary health care,Rural Health Unit,health education}, url = {https://jhiphalexu.journals.ekb.eg/article_20604.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20604_030739021f7e67b2c857be4acd470267.pdf} } @article { author = {Nour Eldin, Moustafa and Abdel Rady, Emad}, title = {Workforce Perceptions of Hospital Safety Culture at One Governmental Hospital in Alexandria}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {283-306}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20605}, abstract = {Background: Safety culture is increasingly recognized as an important strategy to improve patient safety. Objectives: The present study aimed at assessing workforce perception of hospital safety culture at Shark El Madina hospital and to identify differences in perception of safety culture dimensions among different professional categories at the study hospital. Methods: The study utilized a self administered questionnaire titled “Patient Safety Climate in Health Care Organizations” (PSCHO) which is composed of 38 items. A total of 186 completed questionnaires were collected distributed among 64 physicians, 74 nurses and 48 technicians. The mean score of items and dimensions were calculated as well as the percent problematic response (PPR) which isthe fraction of survey participants who answered in ways that are inconsistent with an optimal safety culture. Results: The study revealed that the overall PPR was 46.9%, being highest among nurses (53.1%) %), followed by physicians (44.3%) and lowest among technicians (39.5%). Nurses had higher percentage of PPR than other professional groups in 8 dimensions. The 3 dimensions which had the lowest mean scores among the three professional categories were fear of blame followed by unit recognition and support for safety followed by organizational resources for patient safety. Nurses showed lower mean scores in five out of nine safety culture dimensions. Conclusion and Recommendations: Patient safety culture among health care workers at Shark El Madina hospital is relatively negative. There are differences among professional categories with nurses showing more negative view of safety culture dimensions. It is recommended to establish safety cultural change through education and training of staff, encouragement of no blame environment and provision of resources for patient safety.}, keywords = {Workforce Perceptions,Hospital Safety Culture,alexandria}, url = {https://jhiphalexu.journals.ekb.eg/article_20605.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20605_e58d4ca3e0a2e5e7fc6fd96e3a4e3b92.pdf} } @article { author = {Osman, Nahla and Ayad, Eman and Shokry, Enaam and Darwish, Amira and Mashaly, Reda}, title = {Health and Nutritional Benefits from Wild Probiotic Strains Isolated from Human Breast Milk, Zabady and Laben Rayb}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {307-321}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20606}, abstract = {The objective of this study wasto investigate in vivo scientific validation of seven wild selected potentially probiotic lactic acid bacteria (LAB) strains isolated from human breast milk, Zabady and Laben Rayb. These strains were used in cultured fermented milk as a vehicle for delivery of beneficial bacteria for five weeks to seven Albino rats groups. Feeding cultured milk products increased rats’ body weight compared to control without significant change in body organs’ weights. Hematology parameters of treated rats were comparable to control. All tested probiotic strains showed a hypolipidemic effect either by reducing triglycerides (TG) or by reducing LDL-Ch and atherogenic indices. There was no remarkable effect on oxidative stress in treated rats according to superoxide dismutase (SOD) and thiobarbituric acid reactive substances (TBARS) determining results and histological examination. The rats’ groups fed cultured milk fermented using mothers’ breast milk originated Enterococcus spp. cultures resulted in higher intestinal and fecal LAB comparing to control group. There was considerable suppression in intestinal and fecal contents of Staphylococcus spp. and coliforms among all treated rats’ groups. Safety considerations of these probiotic strains were confirmed when carcinoembryonic antigen (CEA) levels and histological examination of liver tissues showed no changes comparing to control.}, keywords = {Health Benefits,Nutritional Benefits,Wild Probiotic Strains,Human Breast Milk,zabady,Laben Rayb}, url = {https://jhiphalexu.journals.ekb.eg/article_20606.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20606_859f14d69731eb74c7eca519b2b3c2be.pdf} } @article { author = {El-Said, Khaled and El-Gazzar, Ragaa}, title = {Biochemical Changes among Medical Laboratories Staff Occupationally Exposed to Formaldehyde Vapors}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {322-332}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20607}, abstract = {Background: Increased levels of tumour markers: carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), Alpha feto protein (AFP), and neuron-specific enolase (NSE) may indicate the onset of the carcinogenic process. The aminotransferases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are the most commonly measured enzymes that detect hepatocellular injury. Formaldehyde has an important application as a disinfectant and preservative, reason why relevant workplace exposure may also occur in pathology and anatomy laboratories and in mortuaries. Urinary thioethers are excretion products resulting from a series of metabolic reactions which involve oxidation of lipophilic chemicals to water-soluble compounds. Objective: The aim of the present study was to evaluate of the hazardous effects of occupational exposure to formaledehyde among lab technicians through measuring liver enzymes, hepatic tumor marker (AFP, CEA) and levels of urinary thioether as indicator of exposure to  Carcinogenic compounds. Method: the study was conducted on thirty male workers employed in medical pathology and anatomy teaching laboratories. Thirty subjects were recruited as a control group matched for age, sex and socio-economic status. Results: the resultsrevealed a high significant increase in the levels of urinary thioethers in exposed workers than those of control group and high significant elevation in the levels of tumors markers (CEA and AFP) in exposed workers in comparison with control group. Moreover, a significant increase in the levels of liver functions (AST and ALT) was observed in formaldehyde exposed workers. Conclusion: Present data indicate that formaldehyde exposed workers exhibit an increase in tumor markers levels and additionally increase in the levels of urinary thioethers. Safety Preventive measures should be applied for reduction of the formaldehyde vapors in these laboratories.}, keywords = {Biochemical changes,Medical Laboratories staff,Occupational Exposure,Formaldehyde Vapors}, url = {https://jhiphalexu.journals.ekb.eg/article_20607.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20607_412e39325317da54487076311a1b59d8.pdf} } @article { author = {Abaza, Amany}, title = {Multi Drug Resistant Pseudomonas aeruginosa in a Health Care Setting in Alexandria}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {333-347}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20608}, abstract = {Background: The emergence of Multi drug resistant Pseudomonas aeruginosa (MDRPA) among intensive care unit (ICU) patients is increasingly recognized as a public health threat worldwide. Objective: This work aimed to study the occurrence of MDRPA among critically ill patients in a health care setting in Alexandria. Methods: During a 12 months period, different clinical samples (sputum, endotracheal aspirates, blood, urine, and pus) obtained from ICU patients were tested for the isolation and identification of Pseudomonas aeruginosa (P. aeruginosa) strains; that were screened for their antimicrobial susceptibility patterns using single disc diffusion method. Identified MDRPA strains were further tested for their susceptibility to polymyxin E (colistin), polymyxin B, and tigecycline. Polymerase chain reaction (PCR) assay was performed to detect VIM and IMP MBL genes. Results: Of the 105 P. aeruginosa strains isolated from various clinical samples, 20 (19%) were found to be MDRPA, of which 16 (80%) were sensitive to each of colistin and polymyxin B, while only 5 (25%) strains were sensitive to tigecycline. PCR assay revealed that 9 (45%) strains possessed VIM MBL gene and none (0%) harbored IMP MBL gene. Conclusion: The occurrence of MDRPA strains among critically ill patients in this study was noticeable; with colistin and polymyxin B being effective upon the majority of identified MDRPA strains, and VIM MBL gene was found to be significantly harbored.}, keywords = {Multidrug Resistance Pseudomonas aeruginosa,Metallo Beta Lactamases,Polymyxins,Colistin,Tigecycline,VIM gene, IMP gene,MBL gene}, url = {https://jhiphalexu.journals.ekb.eg/article_20608.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20608_73f6343d388331765959c366345e0d32.pdf} } @article { author = {Essa, Rasha and Akl, Ola and Mamdouh, Heba}, title = {Factors Associated with Maternal Knowledge of Newborn Care among Postnatal Mothers Attending a Rural and an Urban Hospital in Egypt}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {348-367}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20609}, abstract = {Objective: The aim of this study was to assess mothers' knowledge on newborn care as well as factors associated with poor knowledge. Methods: The study setting was two maternity hospitals, one urban and other rural, which were randomly selected from the maternity hospitals in Alexandria and El Behera governorates. A convenience sample of 422 mothers of newborns was selected from the previously mentioned settings. A structured interview questionnaire was designed and utilized by the researchers to collect the data. Maternal knowledge on newborn care was assessed and a knowledge score was created by allocating 1 point for each correct response. Knowledge score was classified as 'good', 'satisfactory' and 'poor' scores. Results: The study results showed that 59.5% of mothers had either satisfactory or good overall knowledge. More than half of the mothers (55.7%) demonstrated a poor knowledge about some breastfeeding practices, mainly on initiation of breastfeeding (43.7%), proper attitude towards hypogalactia (42.7%), giving pre-lacteal feeds (38.4%), non-timed lactation (19.9%) and only 17.7% correctly identified the duration of exclusive breastfeeding. Mothers demonstrated satisfactory and good knowledge about the newborn warning signs (67.8%), with more than 70% of mothers recognizing 8 of 9 symptoms and/or signs that needed the urgent attention of a healthcare provider.  According to multivariate analysis, rural women (odds ratio (OR)= 1.62; 95% CI 1.43-2.12),primiparae (OR= 1.77; 95% CI 1.53-2.72), mothers with lower family monthly income (OR=2.04; 95% CI 1.33-3.32) and those who never attended schools (OR=2.00; 95% CI 1.28-3.11) were more likely to have poor knowledge. Conclusion: Mothers had satisfactory orgood levels of knowledge about care of the umbilical cord and recognition of dangerous signs, but knowledge about breastfeeding was poor. Maternal education programs should place more emphasis on first-time mothers and those having lower socio-economic level as evident by lower monthly family income and lack of education.}, keywords = {maternal,Knowledge,factors,Newborn,Egypt}, url = {https://jhiphalexu.journals.ekb.eg/article_20609.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20609_d4b3e271213bafd47aecb759600faf1f.pdf} } @article { author = {Abou El Enein, Nagwa and El Sherif, Abdel Hamid}, title = {Infection Control Practices in a University Blood Bank, Alexandria, Egypt}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {368-390}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20610}, abstract = {Background: The adoption and implementation of sound measures for the control and prevention of infection in blood banks is as important as it is in other clinical departments in the health care organizations. Objectives: assessment of the infection control practices in Alexandria University Blood Bank (AUBB) and identification of annual seroprevalence of viral hepatitis among blood donors in AUBB in the last 10 years. Methods: Cross sectional descriptive study was conducted at AUBB. The sample included 10 physicians, 27 technicians and 18 nurses. Based on the average daily attendance of blood donors, each physician was observed while examining 30 patients. Each nurse was observed while bleeding 30 patients. Each technician was observed while taking samples from 30 patients while each of the technicians working inside the laboratories was observed for 30 occasions. Observation was done by using especially designed checklists. All the blood bank staff under study was interviewed by using specially designed structured questionnaire. Review of the blood bank registers was done to identify annual seroprevalence of viral hepatitis among blood donors in AUBB in the last 10 years. Results: The AUCBB was found to be deficient of many resources required for proper implementation of infection control practices. The majority of health care worker in the blood bank including physicians, technicians and nurses were not trained on infection control procedures. Only 5.5 % of nurses was trained. Half percent (50 %) of the physicians, 39% of the nurses and 66.6 % of technicians washed their hands before starting work but, none of them washed hands between donors. All technicians, 80 % of nurses and 90 % of the physicians wore gloves. There are no policy and procedures for occupational hazards exposure to blood and body fluids or to sharp injuries although there is high incidence of needle stick injuries specially among nurses (94.4%). The vaccination coverage to HBV vaccine is poor especially among nurses. Regarding, the frequency of positive results toTransfusion Transmissible Infections (TTIs) as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors in AUBB in the last 10 years, the average prevalence of HBS Ag positive cases among blood donors was 1.46 % and the average HCV positive is 4.62 %. HIV prevalence was 5 per 100,000. It is observed that the trend is decreasing from the year 2000 to the year 2009. Conclusion and Recommendations: Development of policy and procedure manual for infection control in AUBB with supply of resources such as equipment and materials needed for appropriate implementation of infection control guidelines. Education and training of all Health care workers in blood bank about infection control procedures is recommended. Also, HBV Vaccination of all staff who are working in blood bank and exposed to infection should be mandatory.}, keywords = {Blood Bank,Infection control,Vaccination}, url = {https://jhiphalexu.journals.ekb.eg/article_20610.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20610_8b4c40f4307a09aa0b6822ce7e5677a5.pdf} } @article { author = {Mohamed, Doria and Khattab, Mahmoud and Labeeb, Shokria and Abdel Ghany, Fatma}, title = {Knowledge, Attitude and Practice Regarding Hepatitis C among Patients' Family Caregivers in El Minia Governorate}, journal = {Journal of High Institute of Public Health}, volume = {40}, number = {2}, pages = {391-407}, year = {2010}, publisher = {High Institute of Public Health, Alexandria University}, issn = {2357-0601}, eissn = {2357-061X}, doi = {10.21608/jhiph.2010.20611}, abstract = {Background: Hepatitis C is a global disease. Egypt has the largest endemic of hepatitis C virus (HCV) in the world. Objective:The aim of this study is to identify knowledge, attitude and practice about hepatitis C among patients’ family caregivers in El Minia Governorate. Methods: A total of 90 main responsible family caregivers’  hepatic C patients and their were included in the study. Data were collected for a period of six months starting from March to August 2009. The study was conducted at the hepatic patients homes where the main family’s caregiver are escorting. Data were collected through structured interviewed questionnaire at the patients’ homes by five tools. These tools included; socio-demographic data of the study participants’, as well as assessment of the patient’s environment. The family caregiver participants’ were assessed for their knowledge, practice and attitude by structured questionnaire, checklist and likert scale, respectively. Results: As regard patient sociodemographic date, results it showed that half of them lied in age group 35-50 years. The majority were males (73.3%). On side of the family caregivers participants’, it was found that slightly more than one third were between 20-30 years (35.4%) and females represented the majority (85.6%). Environmental assessment revealed that nearly three quarters (74.4%) lived in home consisting of more than 3 rooms. As regard knowledge level; it was found that the majority of the study participants between fair and poor knowledge level (44.4% and 34.4%, respectively). While more than three-quarters of the study participants were having fair and poor practices level (43.3% and 34.5%, respectively). Concerning the study participants’ attitude; about half of the sample was having agreement responses (54.5%). Statistically significant differences were found (p<0.05) between both gender in aspects of knowledge, attitude and practice. Conclusion: It was concluded that the majority of the study participants’ were between fair and low level in knowledge and practice as well as positive attitude responses among half of them. It is recommended to increase patients and family caregiver’s awareness about HCV transmission and prevention. }, keywords = {Knowledge,Practice,Attitude,hepatitis C,Family caregiver}, url = {https://jhiphalexu.journals.ekb.eg/article_20611.html}, eprint = {https://jhiphalexu.journals.ekb.eg/article_20611_b8109ca45193a524ed9785a25f3b5fc1.pdf} }