الفهرس 
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Abstract
Splenomegaly is described as splenic enlargement, either in terms of size or mass. moreover, It is not regarded as a disease of its own, but rather as a potential symptom associated with different disorders. An abnormally enlarged spleen has attached pathological process and requires investigations. Mechanisms of splenomegaly can generally be classified as reactive, congestive, or infiltrative. Treatment of the underlying illness and safeguarding the child against splenomegalyrelated consequences are the goals of splenomegaly management. Although splenectomy is sometimes necessary for some illnesses, its benefits must be evaluated against the risk of sepsis episodes that could be fatal. Children who have splenomegaly of any kind are more likely to experience a splenic rupture, so extra caution must be taken to prevent the suffering of children from stomach injuries. The recent findings aimed to Evaluate the effect of educational program on mothers‘ knowledge and practices of their children with splenomegaly. A quasi-experimental research design was used in the present study. The study was conducted at Pediatric Medical Department and hematology department at tanta university hospital. sixty mothers and their children with Splenomegaly were included in the study , and collected from above previously mentioned settings and they were selected randomly. Tools of data collection: Two tools were used in the current study as the following: Tool 1. Mothers’ knowledge regarding splenomegaly questionnaire: it was developed by the researcher after reviewing the related literature guided by ( Shereen M et.al, 2016) . and included three parts: Part 1:BioSocio-demographic characteristics such as: Part1:Data related to mothers such as age, level of education, occupation, residence, number of children in family. Part 2 : Data related to children such as age, sex, birth order, number of siblings. Part 2 : Past and present medical history b- Children Such as previous hospitalization, medical and family history child‘s diagnosis, and length of hospital stay. c- Associated health problems of children with splenomegaly. It will be constructed by the researcher after reviewing the literature to assess health problems facing children with splenomegaly such as bleeding tendency , anemia , fatigue and the high risk of infection . Part 3: Mothers, knowledge regarding splenomegaly Mothers, knowledge about splenomegaly, It will include Meaning of splenomegaly, causes, signs and symptoms, management and complication that may be occur. Tool 2: Mothers’ reported practice regarding care provided to their children with splenomegaly It was determined by the researcher (Shereen M et.al , 2016) to assess the actual mothers‘ reported practice as regards hand washing, temperature measurement, tepid compresses, breathing exercises, upper limb exercises ,lower limb exercises, relaxation techniques for sleep and rest, compliance to medication , and healthy balanced diet . Results: • It was found that one third of the studied mothers (33,33%) aged 30 years to less than 40 years old. • It was observed that one third of the studied children (30.00%) aged between 6 to less than 8, with Mean SD 7.08±2.219 . • It was observed that more than two thirds of them (66,67%) & (60,00%) were male and the first children to their families respectively. • concerning to children’s medical history, it was clear that more than two thirds of the studied children 70.00% had previous admission to hospital, and the number of their admissions was ranged from (4-7) times with mean Mean SD 5.15±1.325. • Concerning the cause of admission, it was noticed that 43,33% of them had fever as the main cause of hospitalization. Concerning the associated problems with splenomegaly, more than half 58,33% of studied children had anemia that consider the most common associated problem of splenomegaly of the studied children. In addition, More than one third of the studied children 35% , admitted to the hospital at least 4 times due to infection. • It was observed that more than three quarters of mothers 78,33% had low level of knowledge about splenomegaly before program implementation. While, most of them 96.67%, 76.67% had a high level of knowledge regarding splenomegaly immediate and post 1 month respectively. • It was observed that ( 83.33%) of studied mothers had un satisfactory level of reported practice preprogram. While majority of them (96.67%&70.00%) had satisfactory level of practice regarding care of splenomegaly immediate and 1 month after program implementation respectively, where p=o,ooo. • There was a significant positive correlation between the studied mother’s total knowledge scores and their total reported practices scores pre, immediate and1 post program implementation , where p= 0,006. • It was observed that there was a high statistical significant difference between the studied mothers knowledge and their ages, educational level where p value = (0.001, 0.000) respectively. In addition, there was statistical significance difference between the studied mothers knowledge and their occupation and residence where p value =( 0.018, 0.002) respectively. • As regards to the relation between the mothers characteristics and their practice, • there was high statistical significant difference between the studied mothers, practices and their ages , level of education where p value = (0.000, 0.000) respectively , In addition, there was statistical significance difference between the studied mothers practice and their occupation and residence, where p value= (0.000, 0.000) respectively Conclusion Based on the findings Regarding the current study, it is concluded that there was a significant positive effect of the educational program which implemented for mother’s care of their children with splenomegaly. In addition, significant improvement in mothers’ level of knowledge and practices regarding their children with splenomegaly with calculated p < 0,000. Recommendations Based on the study findings, the following recommendations were suggested: 1.Implement regular educational programs for mothers to enhance their caregiving skills for children with splenomegaly 2.Educational booklet should be available in pediatric units containing updated information about the care of splenomegaly. 3.In service training programs should be done for mothers periodically to raise their awareness about the care of splenomegaly 4.All hospitals need a proper protocol of investigations and management of children with splenomegaly must be provided to all pediatrics hospitals vaccine, H.infleunzae and pneumococcal, Hep. B should be made available, accessible and affordable for those children who has sickle cell disease and thalassemia.