الفهرس 
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Abstract
First of all, I would like to express my deepest gratitude and sincere thanks to ALLAH, whose magnificent help giving me force and patience to accomplish this work.
I would like to express my deepest gratitude, whole hearted thanks, and sincerest cordial appreciation to Dr. Gehan Galal El Bialy assistant professor of Nursing Administration, Faculty of Nursing, Alexandria University for being behind the valuable guidance, endless help, continuous motivation, constant moral support, and encouragement. I feel greatly honored to have been working under her supervision of this study.
I would like to express my deepest gratitude, appreciation and respect to Dr. Sohier Abo Elfadl, A. Hegazy, Lecturer of Medical Surgical Nursing, Faculty of Nursing, Alexandria University, for her expert assistance over the supervised period. Her extreme patience, flexibility, valuable guidance, personal attention, encouragement and faith in my abilities have motivated me and allowed me to grow as a researcher. I would like to express my deepest appreciation to Prof. Dr. Mohamed Hussin, professor of Biostatistics, Higher Institute of Public Health, for his guidance regarding statistical presentation. I also greatly indebted and grateful to Dr. Amany Ahmed Farag, Lecturer of Nursing Administration, Faculty of Nursing, Alexandria University, for her continuous guidance in statistics.