الفهرس 
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Abstract
Children with congenital heart diseases have many characteristics that affecting their quality of life depending on the severity of the disease, the children may experience growth retardation, Fatigue on exercise, lack normal muscle strength and, consequently, have delayed development and also have Chest pain and palpitation, significant limitations in adaptive behavior, socialization, communication skills, Psychosocial deficits and limited in school ability, so that they need a huge work and self-efficacy for improving their quality of life from their mothers, depending on that we presented an educational instructions for improving the mothers self-efficacy regarding the quality of life for their children with congenital heart disease. The current study aimed to evaluate the effect of educational instructions on mothers’ self-efficacy regarding quality of life for their children with congenital heart diseases, A quasi- experimental research design used in the present study, the study conducted at inpatient and outpatient of pediatric department of Tanta and Kafer el-shiekh University Hospitals. A convenience sample consist of seventy children and their mothers and the children aged from six to twelve years old , free from any acute or chronic disease and diagnosed by congenital heart disease as; Ventricular septa defect(VSD),Atrial septal defect (ASD),Patent ductus arteriosus(PDA),Pulmonary stenosis. Tool of data collection Tool I: A structured Questionnaire schedule consist of two parts Part 1: a) Sociodemographic data of the children with CHD included: age, sex, and birth order , educational level, medical diagnosis and clinic visits. b) Sociodemographic data of the mothers of the child with CHD included: age, educational level and occupation, residence, marital status, family size and family history. Part 2: Mothers’ knowledge about congenital heart diseases such as meaning of congenital heart diseases , types, predisposing factors , signs and symptoms, complications ,treatments, medication administration and child nutrition, hygiene and activity. Tool II: Quality of Life (QOL)of children: The quality of life scale was adopted from WHO QoL scale which used to determine the level of QoL for children with congenital heart diseases. Tool III: Mothers’ self-efficacy scale. This scale was developed by Schwarzer and Jerusalem (1995).adopted form the researcher. Ten items scale will be used to assess perceived self-efficacy. Phases of the study: 1-Assessment Phase: It was carried out to collect baseline data, to assess the child who meets the inclusive criteria . (Tool I). 2-Planning Phase: it was carried out by Setting objectives, Preparation of the content,The studied mothers divided into seven groups and each group will include ten , all the media needed was setting, the questionnaire Wrote in simple Arabic language. Each mother received an individual questionnaire, and every mother interviewed according to her child health status, the sessions was during the morning shifts, from 9:00am. The completion of each sheet took about 20:30 mins. 3-Implementation Phase: Educational instructions was carried out for each group separately through conduction of successive sessions according to the actual needs assessment of the studied mothers, delivered to 5 sessions, two / week and last week one session, each session was about 30 minutes, methods and media of teaching used lectures, note book etc.), duration of the Data collection took 6 months and the content of the educational intervention presented in 5 sessions. 4. Evaluation Phase: Assessment of mothers’ knowledge, quality of life for their children with congenital heart disease and self-efficacy was carried out using the same assessment tools immediately after (post-test) and one month after implementation of the educational instructions (follow-up), and these were compared to pre-test levels. The main result of the present study: • It was Evident that 41.4 % of the total studied children their age ranged from 8 to 10 years, more than half (54%) of them are female and more than one third (34%) of the them born at the Third birth order.While regarding their Academic level it was found that 24% of the total studied children are at the first level and most of them visits the doctor 3 times per year with Mean SD 3.76±0.984. • It was illustrated that 21.4% of the total studied children their diagnosis Tetralogy of Fallot, while only 1.43 % diagnosed by transposition of great arteries (TGA) and Aortic coarctation. • The present study illustrated that one third of the studied mothers (31.43 %) age between (35-40) years, while more than half of them (67.14 %) their Family number less than 5 with Mean SD 5.00±0.993 and 52.86% of the total studied mothers graduated from a university but (78.57%) of them were a housewife and (84.29%) of them were married. And it was found that more than half (61.43%) of the studied children didn’t have family history of congenital heart diseases. • It was cleared that the majority (95.71 %) of the studied mothers have low knowledge level about congenital heart diseases before the educational instructions, while this improved to 100%,80% respectively immediately post and after one month of the educational instructions.With Mean SD: 5.21±3.848, 19.59±0.860, 14.91±3.538 correspondingly pre, immediately post and after one moth of the educational instructions. And there were significant With P<0.05 before, immediately and after one month of the educational instructions. • The present study clarified that The Mean SD of the total score of the domains of quality of life improved from 79.41±28.494 to 141.30±13.599, 127.51±25.811 respectively immediately after and one month after the implication of the educational instructions, And there were astatically significant differences of Mean scores of the domains of quality of life of the studied children with congenital heart disease ,With P=0.00 before, immediately and after one month of the educational instructions. • It was noticed that The Mean SD of the total level of quality of life of the child with CHD improved from 79.41±28.494 to 141.30±13.599, 127.51±25.811 respectively immediately after and one month after the implication of the educational instructions, And there were astatically significant differences of level of quality of life of the studied children with congenital heart disease ,With P=0.00 before, immediately and one month after the implementation educational instructions. • The majority (95.71 %) of the studied mothers have low self-efficacy level to deal with their child with congenital heart disease before the educational instructions while the total of them (100%) and (94.29%) respectively immediately after and one month after implementation of educational instructions. • The present study evident that there were appositive correlation between total mothers knowledge and level of quality of life of their children with CHD and with r = 0.042, 0.013, 0.123 respectively pre and immediate post and post one month of the implementation of the educational instructions. Conclusion Based on the findings of the present study, it can be concluded that educational instructions about congenital heart disease had positive effect in improving mothers’ knowledge, self-efficacy and quality of life of their children with congenital heart diseases. Recommendation Based on the present study and its findings, the following recommendations are suggested: An educational programme should be conduct in service training programe for nurses periodically to be knowledgeable about congenital heart diseases, nursing care of these children and the warning signs. Further study An educational programme should be conduct about cardiopulmonary arrest to the mothers of children with congenital heart diseases and how to perform basic life support and cardiopulmonary resustation.