Benha Journal of Applied Sciences (BJAS) print: ISSN 2356–9751

Vol. (7) Issue (4) (2022), (169-180) online: ISSN 2356–976x

http://bjas.journals.ekb.eg

Assessment of Knowledge and Attitude of Maternity Nurses regarding Umbilical

Cord Stem Cells Collection and Banking
Asmaa.M. Esmail1, Samia.A.Abood2, SamahA.saed2 and Zeinab.R.AbdElmordy2
1
Nursing specialist at Bahteem hospital at Ministry of Health
2
Obstetrics& Gynecological nursing, Faculty of Nursing, Benha Univ., Benha, Egypt
E-mail: [email protected]
Abstract
Back ground: Umbilical cord blood banking and collection is the process of collecting and storing umbilical
cord blood in the immediate period after the birth of a baby. Cord blood is considered as an alternative to bone
marrow for treatment of blood immune system and metabolic disorders because of its rich source of stem cells
and considered the therapy for over 80medical condition. Design: A descriptive study design was utilized
.Setting: The study was conducted at obstetrics & gynecological department at Benha University hospital.
Sampling: A convenient sample included 60 nurse. Tools of data collection: Two tools were used tool (I)A
structured interviewing questionnaire to assess nurse's knowledge regarding umbilical cord stem cell
collection and banking. tool(II) Modified likert scale to assess maternity nurse's attitude. Results: More than
two thirds of maternity Nurses had poor knowledge regarding umbilical cord stem cell collection and
banking , additionally, more than half of studied sample had negative attitude .Also, there was a highly
positive statistically significant correlation between total knowledge and total attitude scores of the studied
nurses regarding umbilical cord stem cell collection and banking. Conclusion: Nearly more than two thirds
and more than half of the studied nurses had poor knowledge and negative attitude regarding umbilical cord
blood stem cell collection and banking respectively. Recommendation: An educational guideline regarding
stem cell collection and banking should be available at all maternity departments to help nurses to acquire the
basic knowledge and practices.

Keywords: Attitude, Knowledge, Stem Cells, Umbilical Cord.

1. Introduction cartilage, hepatic, skin, pancreatic, muscle,

Stem cells (SC) exist in all multicellular epithelial, neurologic, endothelial, and bone.
organisms and are characterized by the capacity to Furthermore, UCB is increasingly being used as a
regenerate through mitotic cell division and source of stem cells within the treatment of over
differentiate into a variety of specialized cell eighty diseases, including blood cell disorders,
types. The two main types of mammalian stem myelomas, leukemia, genetic disorders, immune
cells are adult stem cells that are found in adult system deficiencies, and lymphomas [4].
tissues and embryonic stem cells that are isolated The stem cells obtained from umbilical
from the inner cell mass of blastocysts [1]. cord blood are less likely to be rejected in
Umbilical cord is the vital direct interlink transplants than bone marrow stem cells as the
between mother and fetus, which always depicted result of being immunologically immature,
as the relationship of an emotional bonding of umbilical cord blood stem cells produce
motherhood .After delivery the blood that remains significantly fewer natural killer cells, creating a
in the placenta and umbilical cord is referred as substantial decrease in rejection, and can be used
cord blood and contains numerous haematopoietic as a truly ethical therapy. Consequently, cord
stem cells that have the ability to differentiate into blood stem cells require less rigorous antigen
other cells and the ability to self-degenerate [2]. tissue matching for transplants than bone marrow
Umbilical cord blood (UCB) is the blood stem cells. In fact, the rate of rejection for cord
which is found in the umbilical cord and has the blood stem cell transplants is half the rate of
same ingredients as that of the other blood rejection for bone marrow transplants [5].
available in any organ , in addition of being a very Umbilical cord blood banking (UCB) is
rich source of hematopoietic stem cells. the process of collecting and storing umbilical
Hematopoietic stem cells are still primitive or cord blood, in the immediate period after the birth
immature, which can possibly frame into platelets of a baby. Cord blood can be collected, and stored
,red or white blood cells. With some scientific either publicly or privately. Public cord blood
intervention, stem cells may even have the banks operate in all developed countries, and
capacity to shape into other cell types that make within most developing countries. By 2014, the
up the human body [3]. international cord blood banking network
Additionally, cord blood stem cells are comprised over 160 public cord blood banks in 36
pluripotent, which is the capability to differentiate countries, with over 731,000 umbilical cord blood
into not solely different blood cell types, however, units stored [6],[7].
probably into various sorts of tissue, including
170 Assessment of Knowledge and Attitude of Maternity Nurses regarding Umbilical Cord Stem
Cells

Additionally, a cord blood bank is utilized maternity nurses will help in developing cord
for storing UCB for future use. In response to the blood banking as an essential aspect of Egyptian
possibility of using cord blood in treating blood healthcare team[13].
diseases and immune systems, both private and There was no study conducted at faculty of
public cord blood banks have been developed. nursing, Benha university regarding assessment of
Likewise, UCB can be collected without danger to knowledge and attitude of maternity nurses
the mother or infant donor. The collection of UCB regarding umbilical cord blood stem cell
from the placenta is performed within ten to collection and banking, hence, this study was
fifteen minutes after the placental delivery conducted.
through puncturing one of the umbilical veins Aim of the study:
with a needle, and is done under sterile technique The study aimed to assess knowledge and
and collected into a sterile bag containing an attitude of maternity nurses regarding umbilical
anticoagulant to prevent clotting [8]. cord stem cell collection and banking.
Umbilical cord blood collection is Research questions:
primarily carried out by obstetricians, midwives 1. What is the nurse's knowledge about
and nurses who have received training in such umbilical cord blood collection?
area. Cord blood is collected by a non-invasive 2. What is the nurse's attitude about umbilical
and painless technique after cutting the umbilical cord blood collection and stem cells
cord from the newborn. The two methods of cord banking?
blood collection are in-utero and ex-utero methods Operational definitions:
more commonly used. The in-utero method -stem cell: refers to unspecialized cells of the
involves the collection of cord blood after the human body , able to differentiate into any cell of
newborn’s delivery but before the delivery of an organism and have the ability of self-renewal.
placenta, whereas in the ex-utero method, the cord -umbilical cord stem cell collection: refers to
blood is collected after the delivery of the The cord blood which can be collected from
placenta [9]. the umbilical cord of a baby after its birth and
Nurses is the most important health care consists of hematopoietic and mesenchymal stem
provider in the entire machinery that deals with cells.
stem cell banking, nurses can be involved in - umbilical cord stem cell banking: Refers to
collecting cord blood or assisting doctors in stem the entire procedure of collecting blood from the
cell infusion procedures. Another study conducted umbilical cord after or before the placenta is
in Egypt concluded that nurses must be aware of removed and stored in a special place.
every step of the stem cell collection process, Subjects and method:
from understanding that the source of blood is Study design: A descriptive design was used to
venous to following strict protocol when conduct the study.
collecting umbilical cord blood into special closed Study Setting
collection kits provided by private and public The study was conducted at obstetrics and
blood banks [10]. gynecology department affiliated to Benha
Significance of the Study: University Hospital.
The international cord blood banking Sampling
network comprised over 160 public cord blood Type: A convenient sample.
banks in 36 countries, with over 731.000 Size: 60 nurse(all available nurses at obstetrics and
umbilical cord blood units stored by( 2014). gynecology department)
Despite the numerous benefits of the stem cell Tools of data collection
obtained from the blood of the umbilical cord, it Two tools were used and included:
considered medical waste, and also all women Tool(I):A Structured interviewing questionnaire
prefer to eliminate of placenta after delivery that included 2 parts:
happens due to a lack of knowledge about its Part (1):General characteristics of studied nurses
benefits and uses in addition to the negative and included 7items as(age, educational
attitude of maternity nurses about cord stem cell qualification, residence, current job, years of
collection [11],[12]. experience, attendance of training courses ,site of
In addition, from the researchers’ clinical attendance courses
experience, poor knowledge and negative attitude Part (2): Assessment of maternity nurse’s
regarding cord blood collection and stem cells knowledge regarding umbilical cord stem cell
among maternity nurses were found .Nurses collection and banking, It was adapted from (14)
especially in maternity field have to be informed and included [17] closed ended questions in form
about the most modern advances and receive the of multiple choice question such as (definition of
required training. So that, increase the level of umbilical cord, anatomy of umbilical cord,
knowledge and improve attitude regarding indication of umbilical cord blood, disadvantages
umbilical cord blood banking among the of cord blood collection, proper time of clamping

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Asmaa.M. Esmail, Samia.A.Abood, SamahA.saed and Zeinab.R.AbdElmordy 171

umbilical cord blood ,Values of umbilical cord Benha university hospital before data
blood, Places of cord blood storage , Preparation of collection.
umbilical cord blood collection , length of time for  The aim of the study was explained to all
cord blood storage , Definition of stem cells , participants to obtain their consent to
Characteristics of stem cell , Sources of stem cells participate in the study.
in the body ,Types of stem cells , Ethical  Data included in the tools did not touch
consideration of obtaining stem cells from tradition, culture, religious and ethical
umbilical cord , definition of cord blood stem cell issues.
banking , Procedures for preserving umbilical cord  Studied nurses were interviewed
blood stem cells in banks , Costs of storage of stem individually to maintain confidentiality.
cells and cord blood banking).  All tools of data collection were burned
Knowledge scoring system after statistical analysis to maintain
Nurse's knowledge was calculated for each confidentiality of the participants.
item as the following :Each item was assigned a Pilot study:
score (2) for correct answer and a score (1) for A pilot study was conducted on 10%of the total
incorrect answer. the total score was considered sample (6 nurses). In order to test the applicability
and classified into 3 categories: of the tools, clarity of questions, estimate the time
- Good knowledge ≥75%. needed for each nurse to fill in the questions and to
- Average knowledge from 60 - <75%. identify the problems that may be encountered
- Poor knowledge <60%. during the study. According to the results of the
Tool (II):Modified likert scale(Appendix II): It pilot study some corrections of items were
was designed to assess maternity nurse's attitudes performed ,so nurses included in the pilot study
regarding umbilical cord stem cell collection and were not included in the main study sample.
banking. It was adapted from[14] The scale was Field Work:
consisted of 22 items such as(collection of The study was carried out from the beginning
umbilical cord blood immediately after delivery is of April 2021 to the end of June 2021 covering 3
necessary, blood is not necessary for life, baby's months, then the researcher visited the previous
cord blood may be used for different purposes mentioned study setting 3 days per weekly
,storage of cord blood is necessary, stem cell cross (Sunday, Tuesday and Thursday) from 9.00 Am to
matching is necessary before use ,cord blood is 2.00 Pm to collect data according to the schedule of
useful only for baby, Stem cells transplantation obstetrics and gynecological department to fulfill
should be widely practiced). the aim of the study. The following phases were
Scoring system of attitude adopted preparatory phase and implementation
Each item of the attitude scale was given a score phase
based on three points likert scale. Each statement Preparatory Phase:
was scored as (3) for agree, (2)for uncertain and The preparatory phase was the first phase of the
(1)for disagree. The total score of attitude was study and included reviewing of related past,
considered and classified into 2 categories: current, local and international literatures as well as
- Positive attitude ≥ 60%. theoretical knowledge of various aspects of the
- Negative attitude< 60%. study using books, articles, internet, and magazines
Tools validity and reliability: to develop tools of data collection. During this
The tools of data collection were tested by three phase, the researcher visited the selected study
panel experts of obstetrics and gynecology nursing settings. Development of the tools of data
to test the tool for clarity, relevance, applicability collection were done under supervisors’ guidance
and validity of the contents. Reliability was applied and experts’ opinions were considered.
for testing the internal consistency of the tools by Implementation phase:
administration of the same subjects under similar At The beginning the researcher introduced herself
conditions on one or more occasions through to nurses then explained the aim of the study to
Cronbach's Alpha coefficient test, it was revealed each nurse. Oral consent was obtained from every
that the Internal consistency of knowledge nurse. Then the researcher interviewed two nurses
questionnaire was 0.94, and the Modified likert during the day in separate place to maintain the
scale was 0.87 confidentiality of the study. Then, the researcher
Ethical consideration: used the structured interviewing questionnaire (tool
 Approval to conduct the study was I) to assess the studied nurse's general
obtained from scientific Research Ethical characteristics and maternity nurse's knowledge
Committee at Faculty of Nursing Benha regarding umbilical cord blood stem cell collection
University. and banking. At last, the researcher used Modified
 An official letter was obtained from dean likert scale (tool II) to assess the studied nurses'
of faculty of nursing to the director of attitudes regarding umbilical cord stem cell
collection and banking and the average time needed

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172 Assessment of Knowledge and Attitude of Maternity Nurses regarding Umbilical Cord Stem
Cells

for the interviewing to every nurse was 20- banking and have a consent form parents before
30minites and this was repeated until all nurses the process of collecting stem cells respectively.
were interviewed. Also, less than two thirds of the studied nurses
Statistical analysis: (60.0%, 61.7% and 58.3%) agreed that, stem cell
Data collected from the studied sample was cross matching is necessary before use , it is
revised, coded and entered using Personal necessary to know benefits, uses and possible
Computer. Computerized data entry and Statistical harms of stem cells collection and It is necessary
analysis were fulfilled using the Statistical Package to match the tissues of the donor and the patient to
for Social Sciences (SPSS) version 25. Data were avoid the patient's body rejecting the stem cells
presented using descriptive statistics in the form of which may occur because the immune system
frequencies, percentages. Chi-square test (X2) was attacks the new cells which may lead to failure
used for comparisons between qualitative variables. operation respectively. On other hand, more than
Spearman correlation measures the strength and half (58.3%, 55.0%and 55.0% 45.8%) of the
direction of association between two ranked studied nurses disagreed that, cord blood is useful
variables. A highly statistical significant was for life, baby's cord blood may be used for
considered at p-value <0.001,astatistical significant different purposes and the process of collecting
was considered at p-value <0.05 and non- umbilical cord blood doesn't pose any danger or
significant at p-value>0.05. cause any harm to the mother or the fetus
Results: respectively.
Table (1): showed that, about two fifth of Table (4) showed that, there was a highly
the studied nurses (40.0%) were in age group 30 < statistically significance relation between the total
35 years old with the mean age of 30.47±6.07 knowledge score of the studied nurses and their
years. Less than half of the studied nurses (43.3%) general characteristics (age, educational
had technical nursing education. Regarding qualification, residence as well as years of
current job, the majority (86.7%) of the studied experience(p ≤ 0.001).
nurses were nurses. Less than two thirds (63.3%) Table (5) showed that there was a statistically
of the studied nurses were from rural area and less significance relation between the total attitude
than half (46.6%) of them had 10 < 15 years of score of the studied nurses and their general
experiences. Majority of the studied nurses characteristics (age, residence as well as years of
(95.0%) not attended training courses regarding experience) (p ≤ 0.05). As well, there was a highly
umbilical cord blood stem cell collection statistically significance relation between the total
Table (2) showed that, most of studied attitude score of the studied nurses and their
nurses (90.0%) reported correct answer regarding educational qualification (p ≤ 0.001).
definition of umbilical cord. Moreover, Less than Table (6) indicated that there was a
two thirds (61.7% and 58.3%) of the studied highly positive statistically significant correlation
nurses reported correct answer regarding anatomy between total knowledge and total attitude scores
of umbilical cord and indication of umbilical cord of the studied nurses regarding umbilical cord
blood respectively. On other hand, the majority of stem cell collection and banking among studied
studied sample (95%,91.7%,91.7%,93.3%and sample( p ≤ 0.001).
91.7%)reported incorrect answer regarding length
of time for cord blood storage, definition of stem
cells, definition of cord blood stem cell banking,
procedures for preserving umbilical cord blood
stem cells in banking , costs of storage of stem
cells and cord blood banking respectively.
Fig. (1): showed that 71,6 % of the studied
sample had incorrect knowledge regarding
umbilical cord stem cell collection and banking
while 16,7 had correct knowledge.
Fig. (2): showed that53.3% of the studied
sample had negative attitude regarding umbilical
cord stem cell collection and banking while46.7%
had positive attitude .
Table (3) showed that ,about two thirds of
the studied nurses (68.3% and 65.0%) agreed that,
it is necessary to attend workshops regarding
umbilical cord blood stem cell collection and

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 Asmaa.M. Esmail, Samia.A.Abood, SamahA.saed and Zeinab.R.AbdElmordy 173

Table(1) Frequency Distribution of the studied sample according to their general characteristics (n=60).
General characteristics No %
Age (years)
20 <25 years 7 11.7
25<30 years 13 21.6
30<35 years 24 40.0
≥35 years 16 26.7
Mean ±SD 30.47±6.07
Educational qualification
Diploma nurse. 17 28.3
Technical nurse. 26 43.3
Bachelor degree. 13 21.7
Master degree 4 6.7
Current job
Nurse 52 86.7
Specialized nurse 6 10.0
Head nurse 2 3.3
Residence
Rural 38 63.3
Urban 22 36.7
Years of experience
> 5 years. 7 11.7
5 < 10 years. 12 20.0
10 < 15 years. 28 46.6
≥15 years 13 21.7
Mean ±SD 30.98 ±5.09
Attendance of training courses
Yes 3 5.0
No 57 95.0
Site of training (n=3)
Outside the hospital 3 100.0
At hospital 0 0.0

Table (2) Frequency distribution of studied sample knowledge regarding umbilical cord stem cell collection and
banking (n=60)
Knowledge Items Correct answer Incorrect answer
No % No %
Definition of umbilical cord 54 90.0 6 10.0
Anatomy of umbilical cord 37 61.7 23 38.3
Indication of umbilical cord blood 15 25.0 45 75.0
Disadvantages of cord blood collection 19 31.7 41 68.3
Proper time of clamping umbilical cord 35 58.3 25 41.7
Values of umbilical cord blood 18 30.0 42 70.0
Places for cord blood storage 16 26.7 44 73.3
Preparation of umbilical cord blood 8 13.3 52 86.7
collection
length of time for cord blood storage 3 5.0 57 95.0
Definition of stem cells 5 8.3 75 91.7
Characteristics of stem cell 11 18.3 49 81.7
Sources of stem cells in the body 16 26.7 44 73.3
Types of stem cells 9 15.0 51 85.0
Ethical consideration of obtaining stem 20 33.3 40 66.7
cells from umbilical cord
Definition of cord blood stem cell banking 5 8.3 75 91.7
Procedures for preserving umbilical cord 4 6.7 56 93.3
blood stem cells in banks
Costs of storage of stem cells and cord 5 8.3 75 91.7
blood banking

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 174 Assessment of Knowledge and Attitude of Maternity Nurses regarding Umbilical Cord Stem Cells

Fig. (1) Percentage distribution of studied sample' total knowledge regarding umbilical cord stem cell collection and
banking (n=60)

Fig. (2) Percentage distribution of studied sample' total attitude regarding umbilical cord stem cell collection and banking
(n=60)

Table (3) Frequency distribution of studied sample' attitude regarding umbilical cord blood stem cell collection and
banking (n=60).

Items Agree Uncertain Disagree

No % No % No %
Collection of umbilical cord blood immediately after 18 30.0 17 28.3 25 41.7
delivery is necessary.
Cord blood is useful for life. 13 21.7 12 20.0 35 58.3
Baby's cord blood may be used for different purposes. 17 28.3 10 16.7 33 55.0
It's necessary to maternity nurse to have Experience 27 45.0 18 30.0 15 25.0
for cord blood collection.
Stem cell cross matching is necessary before use. 36 60.0 15 25.0 9 15.0
Storage of cord blood is necessary. 29 48.3 11 18.3 20 33.4
Like to attend workshops regarding umbilical cord 41 68.3 12 20.0 7 11.7
blood stem cell collection and banking.
It's necessary to have a consent form parents before 39 65.0 16 26.7 5 8.3
the process of collecting stem cells.
It is necessary to know benefits, uses and possible 37 61.7 14 23.3 9 15.0
harms of stem cells collection.
Cord blood is useful only for baby. 13 21.7 23 38.3 24 40.0
Health care of mother and baby is affected by 12 20.0 16 26.7 32 53.3
collection of cord blood.
Stem cells transplantation should be widely practiced. 26 43.3 13 21.7 21 35.0
Competency regarding stem cell knowledge and 35 58.3 12 20.0 13 21.7
practice is important for you as a health care provider.
The government should exhibit all researches 34 56.7 17 28.3 9 15.0
regarding umbilical cord stem cells from embryo or
aborted fetus

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Asmaa.M. Esmail, Samia.A.Abood, SamahA.saed and Zeinab.R.AbdElmordy 175

Cont.Table(3) Frequency distribution of studied nurses' attitude regarding umbilical cord blood stem cell collection
and banking (n=60).

Items Agree Uncertain Disagree

No % No % No %
The process of collecting umbilical cord blood doesn't pose 15 25.0 12 20.0 33 55.0
any danger or cause any harm to the mother or the fetus.
It is necessary to match the tissues of the donor and the 35 58.3 13 21.7 12 20.0
patient to avoid the patient's body rejecting the stem cells
which may occur because the immune system attacks the
new cells which may lead to failure operation
Ease of bacterial infection of the umbilical cord blood 30 50.0 13 21.7 17 28.3
during the process of collecting stem cells.
Preserving umbilical cord blood in stem cell banks is a 29 48.3 9 15.0 22 36.7
personal decision and must be taken by parents thinking
and planning for the umbilical cord blood bank before
birth
Cord blood doesn't contain enough stem cells to treat 12 20.0 16 26.7 32 53.3
adults
Storing of the umbilical cord blood is not waste of time and 22 36.6 13 21.7 25 41.7
effort.
Stem cell storage is a rewarding wading process 18 30.0 11 18.3 31 51.7
Cord blood stem cells extraction is easy and simple in 16 26.7 14 23.3 30 50.0
comparison present in the bone marrow

Table (4) Relation between total knowledge score of studied nurses and general characteristics (n=60)

General characteristics Knowledge X2 P-value

Poor Average Good
(n=43) (n=7) (n=10)
No % No % No %
Age (years)
20 < 25 years 7 16.3 0 0.0 0 0.0 26.3 0.000**
25 < 30 years 12 27.9 0 0.0 1 10.0
30 < 35 years 20 46.5 3 42.9 1 10.0
≥35 years 4 9.3 4 57.1 8 80.0
Educational qualification
Diploma nurse. 17 39.5 0 0.0 0 0.0 37.9 0.000**
Technical nurse. 23 53.5 1 14.3 2 20.0
Bachelor degree. 3 7.0 5 71.4 5 50.0
Master degree 0 0.0 1 14.3 3 30.0
Residence
Rural 32 74.4 5 71.4 1 10.0 14.7 0.000**
Urban 11 25.6 2 28.6 9 90.0
Years of experience
< 5 years. 7 16.3 0 0.0 0 0.0 30.4 0.000**
5< 10 years. 11 25.5 1 14.2 0 0.0
10 < 15 years. 23 53.5 3 42.9 2 20.0
≥15 years 2 4.7 3 42.9 8 80.0

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 176 Assessment of Knowledge and Attitude of Maternity Nurses regarding Umbilical Cord Stem Cells

Table (5) Relation between studied nurses’ total attitude score and general characteristics (n=60).

Positive Negative X2 P-value

(n=28) (n=32)
General characteristics No % No %
Age (years)
20 < 25 years 2 7.1 5 15.6 10.7 0.01*
25 < 30 years 4 14.3 9 28.1
30 < 35 years 9 32.1 15 46.9
≥35 years 13 46.4 3 9.4
Educational qualification
Diploma nurse. 2 7.1 15 46.9 20.6 0.000**
Technical nurse. 11 39.3 15 46.9
Bachelor degree. 12 42.9 1 3.1
Master degree 3 10.7 1 3.1
Residence
Rural 12 42.9 26 81.2 9.4 0.002*
Urban 16 57.1 6 18.8
Years of experience
< 5 years. 0 0.0 7 21.9 14.3 0.003*
5 < 10 years. 6 21.4 6 18.8
10 < 15 years. 11 39.3 17 53.1
≥15 years 11 39.3 2 6.2

Table (6) Correlation between total knowledge score and total attitude score among studied nurses (n=60).

Total knowledge
Total attitude R P-value
0.631 0.000***

Discussion: cord blood banking in selected hospital of Ambala,

The current study was aimed to assess knowledge and Haryana" and revealed that more than half of the
attitude of maternity nurses regarding umbilical cord studied nurses were between 20 to 25 years of age.
stem cell collection and banking. This aim was These results are congruent with [17] in their study
significantly achieved within the framework of the which "assess the effect of an educational guideline on
present study research question. maternity nurse’s knowledge regarding process of cord
Regarding general characteristics of the studied blood collection" and mentioned that, less than half of
nurses, the finding of the current study revealed that, the studied nurses had technical nursing institute. Also,
two fifth of the studied nurses were in age group 30 < the highest proportion of them working as staff nurse.
35 years old with the mean age of 30.47±6.07 years. From the researcher’s point of view ,education
These results similar with the result of study performed is considered as one of the decisive and highly
by (15)about ―Urban Chinese nurses’ knowledge, influential factors in behavior. The present study
attitudes and practices toward umbilical cord blood showed that, less than half of the studied nurses had
donation‖, and found that half of the participants were technical nursing education and the majority of the
between 25 to 35 years of age with mean age of 30.98 studied nurses were assigned as nurses. These results
± 5.09 year. might be due to preference of bachelor degree nurses to
On other hand, this result is disagreed with work at private hospitals and travel abroad, and when
[16]who conducted" a study to assess the knowledge working in the governmental hospitals, bachelor degree
and attitude of nurses regarding stem cell and umbilical nurses work as a head nurses not as bedside nurse.

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Asmaa.M. Esmail, Samia.A.Abood, SamahA.saed and Zeinab.R.AbdElmordy 177

This finding is in agreement with [18] who conducted a On other hand, the majority of studied nurses reported
study about "Nurse's knowledge about umbilical cord incorrect answer regarding types of stem cells and
blood banking and it’s barriers at Assuit university" costs of storage of stem cells and cord blood banking
and clarified that, most of studied sample were respectively. As well as, most of studied nurses
working as nurse. reported incorrect answer regarding length of time for
On the other hand, this result is disagreed with(9) who cord blood storage and procedures for preserving
conducted" a study to assess the Stem cells Knowledge umbilical cord blood stem cells in banks respectively.
and attitude among health care providers in Qassim These results are in accordance with [23]who
region KSA" and reported that more than half of the conducted "a study to assess the knowledge and
studied nurses had bachelor degree. attitude of nurses regarding stem cells and umbilical
The present study revealed that, less than half of the cord blood banking in a selected tertiary care facility"
studied nurses had 10 < 15 years of experiences. These and revealed that more than half of studied sample had
results are consistent with (17)who mentioned that, less poor knowledge about the processing of umbilical cord
than half of the studied nurses had >10years of blood banking.
experiences. From the researcher point of view, these
From the researcher’s point of view, These results findings could reflect the importance of continuing
attributed to the nurses who working at obstetrics and education that help nurses to update their knowledge
gynecological department had high years of and practices, especially where the majority of the
experience. studied sample is young adults who have the ability to
On other hand, this finding is in disagreement acquire knowledge and change their attitudes and
with [19]who conducted "a study to assess effect of practices.
teaching program on nurse’s performance regarding According to the studied sample's total
bone marrow transplantation" and mentioned that the knowledge regarding umbilical cord stem cell
majority of the studied nurses have 1 <5 years of collection and banking, the finding of the current study
experience. revealed that, less than three-quarters of the studied
In relation to the residence of the studied nurses had poor level of total knowledge about
nurses, it was found that, less than two thirds of the umbilical cord stem cell collection and banking.
studied nurses were from rural area. This result is These results are approved with the study performed
consistent with [20] who conducted "a study to assess by [24]who conducted "a study to assess the
the effectiveness of structured teaching program knowledge regarding umbilical cord stem cell therapy
regarding collection of cord blood for stem cell among staff nurses "and found that, the majority of
therapy in terms of knowledge among staff nurses in staff nurses had poor knowledge and only tenth of
selected hospitals at Bangalore" and revealed that more them had average knowledge about stem cell therapy
than half of the studied nurses were from rural area. and umbilical cord collection .But the present study is
This finding is in disagreement with [21]who inconsistent with [16]who reported that more than half
conducted" a study to assess pediatric nurse’s of the nurses under study had average knowledge.
knowledge, awareness and attitude towards application From the researcher point of view, the This
of stem cells therapy in children" and reported that result may be due to absence of pre-employment
more than half of nurses under the study were residing orientation, and training courses, low educational level
at urban area. and increased work load which may hinder the ability
Regarding nurses' knowledge about to read and upgrade their knowledge regarding
umbilical cord stem cell collection and banking, the umbilical cord stem cell collection and banking.
finding of the current study revealed that most of the Hence, there is a need for continuing training in this
studied nurses reported correct answer regarding area to acquire adequate knowledge among all nurses.
definition of umbilical cord. Moreover, less than two
thirds of the studied nurses reported correct answer Regarding to nurses' attitude about umbilical
regarding anatomy of umbilical cord and indication of cord blood stem cell collection and banking, the finding
umbilical cord blood, respectively. These results are of the current study showed that about two thirds of the
approved with the study performed by [15]who stated studied nurses agreed that, it is necessary to attend
that more than three quarters of the studied nurses had workshops regarding umbilical cord blood stem cell
correct knowledge regarding definition, anatomy of collection and banking and have a consent form parents
umbilical cord and indication of umbilical cord blood. before the process of collecting stem cells respectively.
In the same line, these results are congruent with [22] These results are supported with the study done by
who conducted "a study in Malaysia about Association [25]who conducted" study to assess health care
between nurses' knowledge and attitudes toward stem professionals’ knowledge, attitudes and practices relating
cell application in medicine" and revealed that the to umbilical cord blood banking and donation" and found
majority of the studied sample have correct knowledge that more than half of the studied sample agreed that it is
about anatomy of umbilical cord and indication of necessary to attend courses on umbilical cord blood stem
umbilical cord blood. cell collection.

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178 Assessment of Knowledge and Attitude of Maternity Nurses regarding Umbilical Cord Stem Cells

In the same line, the finding of the current study nurses and general characteristics, the present study
indicated that less than two thirds of the studied nurses revealed that there was a highly statistically significance
agreed that, stem cell cross matching is necessary before relation between the total knowledge score of the studied
use, it is necessary to know benefits, uses and possible nurses and their general characteristics (age, educational
harms of stem cells collection and it is necessary to qualification, residence as well as years of experience).
match the tissues of the donor and the patient to avoid This might be explained as, good level of knowledge
the patient's body rejecting the stem cells which may was higher among nurses in age group ≥35 years with
occur because the immune system attacks the new cells high education and more years of experience.
which may lead to failure of operation respectively. These results are in agreement with the study
From the researcher point of view, These results achieved by [6]about knowledge and practice of
may be attributed to professional roles within the pediatric providers in umbilical cord blood banking and
maternity setting, individual provider practices. found that level of education, years of experience had a
These results are in agreement with the study significant effect on nurses’ awareness level about
performed by [26] who conducted "study to assess umbilical cord blood banking.
attitudes and practices of midwives in Irish hospitals" In the same line, these results are congruent
and found that more than half of nurses under study with [17]who revealed that there was a highly
reported that stem cell cross matching is required before statistically significance relation between total
use and it is essential to perform cross matching to avoid knowledge score of the studied nurses and their years of
the patient's body rejecting. experience.
On other hand, more than half of the studied On other hand, this finding is in disagreement
nurses disagreed that, cord blood is useful for life, baby's with [24] who mentioned that there was no association
cord blood may be used for different purposes and the found between knowledge score and the selected
process of collecting umbilical cord blood doesn't pose demographic variables like age, year of experience and
any danger or cause any harm to the mother or the fetus educational status.
respectively. These results are approved with the study From researcher's point of view, Regarding to
performed by [27]who conducted "a study about the relation between studied nurses’ total attitude score
―Implementing delayed umbilical cord clamping in and general characteristics, the present study revealed
Nepal—Delivery care staff’s perceptions and attitudes that there was a highly statistically significance relation
towards changes in practice "and found that less than between the total attitude score of the studied nurses and
two thirds of the studied sample disagreed that cord their educational qualification. This might be explained
blood would be useful in regenerating organs in future. as, positive attitude was higher among nurses with high
Also, minority of nurses believed it would be useful to education.
treat cancer and chronic illness. These results are in agreement with the study
Concerning nurses' total attitude regarding achieved by [8]to "assess the knowledge and attitude of
umbilical cord stem cell collection and banking, the staff nurses regarding umbilical cord stem cells "and
finding of the current study revealed that more than half found that there was highly significant relation between
of the studied nurses had negative attitude regarding total attitude of studied nurses and their educational
umbilical cord stem cell collection and banking. These level.
results are supported with the study done by [28]who In the same line, these results are supported
conducted a study to assess the knowledge and attitude with the study done by[28]who stated that there was a
of maternity nurses regarding cord blood collection and positive statistically significant correlation between total
stem cells and found that the majority of the studied attitude scores and educational level.
sample had negative attitude toward cord blood Also, the present study indicated that there was
collection and stem cells before intervention. a statistically significance relation between the total
From the researcher's point of view, These attitude score of the studied nurses and age, residence as
results may be due to decrease awareness of nurses about well as years of experience. These results are approved
umbilical cord stem cell collection and banking due to with the study performed by [29]about ―Stem Cells and
lack of continuous training and instruction from Cord Blood Collection: Knowledge and Attitude of
supervisors. Maternity Nurses in Maternity and Children Hospital‖
But this result disagrees with the study and revealed that, there was statistically relation between
performed by [23] and found that the most of the total attitude of studied nurses and their age and years of
subjects had neutral attitude concerning stem cells and experience.
umbilical cord blood banking. Additionally, [22] who From researcher's point of view, it is expected
conducted" a study in Malaysia about Association that This could be explained as, positive attitude was
between nurses' knowledge and attitudes toward stem higher among nurses with more years of experience and
cell application in medicine", and revealed that the more age as they have a good experience and can deal
majority of the studied sample have good attitude toward effectively with these procedures .
stem cell therapy. In the same line, these results are congruent
From researcher's point of view, According to with [31]who revealed that, there was a positive
the relation between total knowledge score of studied

Benha Journal Of Applied Sciences, Vol. (7) Issue (4) (2022(

Asmaa.M. Esmail, Samia.A.Abood, SamahA.saed and Zeinab.R.AbdElmordy 179

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