Health Management

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    prevalence of wasting and stunting among governmental primary school children in gaza governorates
    (Al-Quds University, 2003-04-15) Adly Bahjat Skeik; عدلي بهجت عطا سكيك
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    خدمة السكان الضعفاء : الثقافة الداخلية بجمعية الهلال الاحمر الفلسطيني ومدى انسجامها مع مبادىء الجمعية
    (AL-Quds University, 2003-07-12) خالدة توفيق محمد خالد السيفي; Khalidah Toufic M. K. El -Saifi; عائشة الرفاعي; اسمى امام; رفيقي الحسيني
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    فحص اسباب ضعف البصر والعمى عند المرضى المراجعين للعيادات المتنقلة للعيون في الضفة الغربية
    (AL-Quds University, 2003-12-03) أحمد معالي; Ahmad Maali; فارسين شاهين; مرام اسحق; عائشة رفاعي
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    توجيهات ومعرفة الشبيبة الفلسطينية بقضايا الصحة الانجابية في الضفة الغربية
    (AL-Quds University, 2004-01-25) محمد عيسى محمد رزق; Mohammad Issa Mohmmad Riziq; عائشة الرفاعي; اسعد الرملاوي; خلود الخياط
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    التقييم المحوسب لبعض مؤشرات الصحة القوامية بين تلاميذ المدارس الفلسطينية بأعمار 7 15 سنة
    (AL-Quds University, 2004-04-01) جمال حامد محمد النمورة; Jamal Hamed Mohd Nammoura; عبد الحميد الزير; محمد الدواليبي; محمود السوس
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    البكتيريا المسببة للأمراض على لحم الدجاج النيء في الضفة الغربية، فلسطين: السالمونيلا ، كامبيلوباكتر
    (AL-Quds University, 2006-06-18) ابراهيم عامر محمد غنام; Ibrahim Amer Mohammad Ghannam; محمود ابو حديد; Dr. Hatem Eideh; Dr. Yacoub Dhaher
    Large epidemiological data from many countries confirm that contaminated chicken meat contribute significantly to foodborne diseases worldwide. Thus, reduction of contamination of raw chicken meat would have a large impact in reducing incidence of these foodborne diseases. Therefore, our study was designed to investigate the prevalence of the major human illnesses causing bacteria, particularly, Salmonella, Campylobacter, and Listeria monocytogenes in the retail chicken meat in West Bank, Palestine. To achieve this goal, one hundred and two random chicken meat samples were collected from different retail markets and governorates in the West Bank, Palestine. They were studied for total aerobic bacterial content, and for the presence of human pathogens such as Salmonella, Campylobacter, and Listeria monocytogenes using conventional culturing and biochemical methods. Our results indicate that: (6/102) 5.9% of the samples contain Listeria monocytogenes, (21/102) 20.6% contain Salmonella Spp. and (37/102) 36.27% contain Campylobacter Spp. Samples containing Campylobacter Spp were further subdivided to Campylobacter coli which was present in (21/102) 20.59%, Campylobacter jejuni which was present in (11/102) 10.78%, and Campylobacter lari which was present in (5/102) 4.90 % of the total samples. Comparing our results to similar studies done on raw chicken meat in other countries, the prevalence of these pathogens in West Bank, Palestine lies within the range. For example: the highest prevalence of Salmonella (22/40) 55% is in Spain and the lowest (3/205) 1.5% is in north Ireland, the highest prevalence of Campylobacter (393/448) 91.8% is in Turkey and the lowest (32/99) 32.3% is in South Africa, and the highest prevalence of Listeria monocytogenes (17/46) 37% is in Japan and the lowest 3/66 (4.5%) is in Brazil. These variations in isolation rates between countries depend on the country where the study was carried out, the chicken breeding environment and methods, processing and marketing procedures, the sampling plan and the sensitivity of the methodology used in the study. Statistical correlation analysis was done to see if there is any significant relationship between the presence of these pathogens and the total aerobic plate count, carcass gross weight, governorate from which the sample was taken, slaughtering time, and chicken meat market type. The results of this analysis showed that only the prevalence of Salmonella significantly differ between those samples bought from poultry market or street side poultry market, while none of the other studied pathogens is significantly associated with the market type. Also none of the other studied factors is significantly associated with the presence of these three pathogens. In contrast significant relationship (P<0.001) was found between the total aerobic plate count, the slaughtering time, marketing type, and governorate of sample origin. Therefore, based on these results, setting up a cost-effective pathogens monitoring and surveillance systems, augmented by good agricultural and hygienic practices and well-designed longitudinal research activities on the whole chicken meat production chain, are strongly recommended.
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    وجهات نظر المرضى الذين مكثوا في مستشفى غزه الأوروبي حول الخدمات المقدمة
    (AL-Quds University, 2008-11-08) محمد عبد الحافظ محمد الحاج; Mohammed Abed El Hafez Mohammed Elhaj; بسام ابو حمد; لا يوجد
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    أثر رسوم الخدمات على مستوى استخدام خدمات الرعاية الصحية الحكومية في مديرية بيت لحم ومستشفى بيت جالا الحكومي
    (AL-Quds University, 2009-02-21) منى عبد عبد الفتاح عمار; Muna Abd Abdelfatah Amar; مصطفى حمدان; اسمى امام; سامر حميدي
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    Applicability of the Learning Organization Concept to the Ministry of Health: Managers' Perspectives
    (Al-Quds University, 2009-08-15) Arwa Abdel Wahab Shalabi; اروى عبد الوهاب زكري شلبي
    Universally, organizations facing uncertain, changing, or ambiguous contexts need to be able to learn in an efficient and effective manner. In the absence of learning, organizations and individuals simply repeat old practices and improvements are either fortuitous or short-lived. In line with the recently developed learning organization concepts (LO), organizations are increasingly required to be dynamic learning systems in order to develop and thrive. The overall aim of this study is to ascertain the applicability of the LO concepts to the MOH institutions in Gaza from the managers' perspectives. The design of this study is a quantitative, descriptive, analytical cross-sectional one. Selfadministered standardized questionnaire (Dimensions of the Learning Organization Questionnaire) was completed by 662 managers with a response rate of 74.9%. The overall reliability coefficient was high (0.820). The study indicated the total revealed mean of the five LO disciplines was 5.7 (out of 10) with the highest mean for systems thinking discipline (6.1) and lowest mean for the personal mastery discipline. In addition, the dimensions of the LO revealed a total mean of 5.2 out of 10; with the individual learning being the highest (5.3) and the team learning and organizational learning being the lowest (5.1). The extracted findings reflect weak performance of the MOH as a LO from the perspectives of its managers. In other words, the MOH is not yet considered as a LO implying that it is neither facilitating the learning of its members nor transforming itself as needed. The study concluded statistically significant variations in perceptions among the subjects where the PHC managers had elicited higher mean scores than their counterparts in hospitals (P value 0.05). Also, positive differences were revealed between the managerial positions and the elicited mean scores (P value 0.0001). Congruently, managers who were working in the field of finance and administration had higher mean scores than others who work in technical arenas (P value 0.001). Moreover, male managers elicited higher mean scores than their female counterparts (P value 0.005). Regarding the organizational related variables, the availability of organizational strategies, strategic plan for training, follow up after training and the availability of clear structures were associated with higher means scores with statistically significant differences. The dominant organizational learning style was "Habits Style" which is characterized by repetitive processes and blind automaton. The study provided a framework for strengthening the MOH to become a LO that transforms and develops itself. Special attention should be paid to support sharing knowledge and team learning. A basic, yet essential, approach includes promoting issues pertaining to strategic management.
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    Status of Communication among Health Care Providers at UNRWA Health Centers in Gaza Governorates
    (Al-Quds University, 2010-07-31) Rezeq Eid Abed Ramadan; رزق عيد عبد رمضان
    is very important issue in any health care setting. This study aims to explore the status of communication among healthcare providers who are working at the United Nations Relief and Work Agency for Palestinian Refugees in Gaza governorates. A descriptive analytical design was used. The study population is comprised of all health care providers who were working in the main five health centers; one health center from each governorate. Self-administered questionnaire was distributed to all the study population. The response rate was 95.5% . The SPSS package was used in the analysis of the collected data. Findings revealed that the most commonly used communication among the UNRWA health teams was verbal communication (67%). Also the findings showed that the most commonly preferred tool of communication among the UNRWA health teams were (face to face-spoken (84.1%), telephone (6.4%), written messages (2.8%), email (2.1%) and intercom (1.4%). In addition, results showed that only 26.3% of healthcare providers had studied communication during their undergraduate program and 19.1% got training courses about communication. Through calculating all the points pertaining to knowledge about communication, 25.3% of health care providers had adequate knowledge about communication. Communication was vital for patients care from the perspectives of 89.5% of HCPs. Collectively, 87.3% of HCPs had positive perceptions about communication. Regarding practices relevant to communication, the elicited score was 62.8%. Participants’ ranking of HCPs communication characters were as follows; mutual respect (72.1%), transparency (67.8%), equity (66.4%), political balance (63%), and positive competition (61.2%). Statistically significant variations were found in relation to profession, education, position and the country of graduation. The study recommends improving communications among UNRWA health care providers through provision of training programme on communication skills , and enhancement of communication infrastructure.
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    Workload in Nursing Stations at Primary Health Care Governmental Centers in Gaza Governorates
    (Al-Quds University, 2010-08-01) Ibraheim Al Hour; ابراهيم الهور
    Nursing is considered as the backbone in providing health services to meet needs of clients and communities. This study aims to understand the workload status in nursing stations at Governmental Primary Health Care (PHC) centers in Gaza Governorates. A quantitative descriptive cross-sectional study was carried out in order to develop workload measurement, which could serve as a management tool for decisions pertaining to staffing level. The instruments used were self-administered questionnaire and an observational checklist. All the nurses (117) who were working at the selected 9 PHC centers were included in the study sample, out of them, 91 responded, with a response rate of 78%. In total, 91 checklists were administered at the service delivery points at nursing stations in the selected PHC centers. The researcher and a trained assistant collected the data. Cronbach’s Alpha reliability test was 0.73. The research findings show that there were no workload standards for nurses at PHC centers. Nurses reported having positive perceptions about their workload, as 71.2% of them believed that staffing level is based on the job requirements and the activities needed to perform the required tasks. Additionally, around half of nurses believed that there is fairness and transparency in distributing nursing resources. Knowledge of nurses about the term workload found to be high (76.9%). In addition, the majority of nurses reported that it is essential to develop workload measurements (82%). The study revealed that 61.4 % of nurses believed that there is work overload. Reasons for work overload included; increasing intensity of work, inadequate staff, increasing paperwork, absence of clear job descriptions, improper appointment system, lack of resources and lack of suitable working environment. In contrary, negative perceptions were reported by nurses about their working environment (30%), suitability of working area (39%) and 50% reported having unhygienic working environment in relation to work climate. The study results show that the majority of nurses were working in the Mother and Child Health (MCH) stations (Mean number of nurses 3.1) followed by daily care and Antenatal Care (ANC) (mean 1.9), Dental Care (mean 1.5), Non Communicable Diseases (NCD) (1.4) and Family Planning (FP) (1.2). The highest mean of observed clients cases per hour were in dental units (9.33 cases), followed by MCH (6.52), NCD (5.96), daily care (5.18), ANC (4.78), and FP (3.39). The time consumption distribution per procedure in minute was as follows; dental (14), FP (13.3), NCD (9.6), ANC (9.4), Daily care (8.1) and MCH (7.4). The study revealed that there were no statistically significant differences between workload values and sex, age and years of experience. Perceptions about workload showed statistically significant relationships with job title and qualification. Workload is heavier in the north of Gaza than other place. The differences across the governorates were statistically significance (p value=0.045). The distribution of daily work volume by region shows that the Mid Zone center has elicited the highest in terms of working hours while Rafah elicited the lowest in this regard. The observed average time for each case ranged between 6.6-11.9 minutes. The study recommends considering workload measurement in staffing nursing station in a systematic manner. Paying attention to work load status, ensuring fair distribution of work responsibilities and improving working conditions is essential.
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    Job Autonomy As Perceived By Nursing Managers In Governmental Hospitals In The MOH- Gaza Governorates
    (Al-Quds University, 2011-01-02) Khalil Mostafa Shaqfa; خليل مصطفى شقفة
    Job autonomy plays an important role in nurses’ job satisfaction, retention and quality of patient care. It is argued that for nursing managers, job autonomy and job satisfaction may be interrelated. Thus, the assessment of job autonomy among nursing managers in health organizations is important for policy and administration purposes as well as professional purposes. The overall aim of this study was to assess the job autonomy among nurses as perceived by nursing managers in the governmental hospitals in Gaza governorates in order to promote professionalism in nursing. A descriptive, analytical cross sectional design was used. Subjects of this study were 301 nurses who represented all the formally assigned nursing managers in governmental hospitals. Self-administered questionnaire was used and 238 participants completed the questionnaire with a response rate of 83%. Data were analyzed using the SPSS program. The content validity was validated by ten experts. The reliability test using Cronbach Alpha coefficient was 0.707. The study extracted six dimensions for autonomy which are: general perspective, (m=3.47), managerial style (m=3.82), job description (m=3.69), job satisfaction (m=4.09), nursing career (m=3.69) and work preference (m=3.06). The highest mean score among dimensions is job satisfaction domain and the lowest is work preference domain (m=3.06). The vast majority of nursing managers (94.2%) preferred to be supervised by a person from the same profession, in addition, nursing managers called for allowing the Chief Nursing Manager in the MOH to overall supervise all nurses in the organization (39.0%). The majority of nursing managers who were working in clinical settings (60.9%) believed that they had adequate autonomy within their work arenas. However, 72.6% of nurse managers believed that the current management style at the MOH inversely affects nursing autonomy. The study results also showed that there were no statistically significant differences in reference to the job title and education level (Pvalue = 0.131 and 0.097 respectively). In contrary, results revealed that there are statistical significant differences at 0.05 between males (M = 3.52 out of 5) and females (M = 3.33); in the favor of males (P value = 0.003). Also, the result showed that there are statistical significant differences in perceptions about autonomy in reference to age were younger felt more autonomous than older counterparts (P value = 0.004). It is concluded that there is a great need to enhance job autonomy among nursing managers through having clearer roles and responsibilities, adopting more effective leadership practices, and developing more flexible work system.
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    Workload Status at Nursing Stations in UNRWA Health Centers – Gaza Governorates
    (Al-Quds University, 2011-01-29) Riyad Awad Diab; رياض عوض احمد دياب
    It is needless to say that nursing is an essential component in any health system. Nurses provide critical and crucial functions in healthcare organizations, through delivering nursing care and safeguarding clients. This study aims to assess the workload status at nursing stations at UNRWA health centers in Gaza Governorates in order to contribute to the delivery of safe and effective nursing care to clients. A quantitative cross-sectional study was conducted in order to develop a workload measurement, which could serve as a management tool for decisions pertaining to staffing level. Also, the study assessed nurses’ perceptions about their workload. The instruments used in this study were self-constructed questionnaire and an extraction/observation sheet. All the nurses (163) who were working in the randomly selected 10 health centers were included in the study, out of them, 128 responded and completed self-administered questionnaires, with a response rate of 78.5%. In total, 258 nursing procedures were assessed for time unit values at the service delivery points at nursing stations in the selected health centers. The researcher collected the data by himself. General measures of reliability and validity such as standardization of methods and procedures were administered. Cronbach's Alpha reliability test was 0.903. The research findings show that there were no in use workload standards for nurses at UNRWA health centers. Nurses’ perceptions reflected relatively moderate scores regarding the overall domains constituting the entire workload status (66.75%), with the highest scores for working hours’ domain (70.25%), followed by staffing domain (66%), system domain (65.5%) and facilities domain (65.25%). Also, in response to a direct question, 91% of nurses believed that they are work overloaded and they attributed their feeling of being overloaded to factors such as increasing paperwork, inadequate staffing, increasing intensity of work, having additional non-nursing job duties and external interruptions/noise. The researcher calculated the average measurement of the time unit values per nursing procedure in minuets and it was as follows; documentation and counselling ‘3:49’; blood pressure measurement ‘0:55’, weighting baby ‘0:19’, weighting adult ‘0:18, minor dressing ‘4:37’, umbilical care ‘0:49’, doppler‘3:58’, abdominal examination ‘2:03’, immunizing a child with two injections ‘1:06’ and giving one injection in the injection room ‘1:15’. Also the time unit values consumed in minutes per client in each station were as follows; non- communicable diseases ‘3:08’, postnatal care ‘13:40’, antenatal care ‘8:58’, family planning ‘6:04’, injection ‘1:15’, health screening ‘2:49, immunization ‘3:31’ and dressing ‘4:37’. The researcher recommends reconsidering the time unit values calculated in this study to better estimating workload in UNRWA health centers. Factors affecting nurses’ workload extracted in this study need to be considered particularly facilities and system domains. Decreasing paper work, ensuring appropriate staffing level and implementing job rotation programs are important for having fair and appropriate workload.
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    Job Autonomy as Perceived by Physicians Working in Shifa Hospital
    (Al-Quds University, 2011-02-02) Hani Abdul Kareem Sammour; هاني عبد الكريم سمور
    Job Autonomy is a very important part of job enrichment. It promotes employee's empowerment which leads to improving trust, self-awareness and self efficiency; its application can promote motivation and satisfaction. Objective: The overall aim of this study is to assess the level of job autonomy among physicians working in Shifa Hospital and to determine the personal and organizational factors that may influence job autonomy. Methodology: A descriptive analytic cross sectional study was conducted among physicians working in Shifa Hospital using self-administered questionnaire. A total of 195 questionnaires were distributed to the study population using two stages sampling method (stratified then systematic) from the surgical, medical and maternity wards. A sum of 168 questionnaires were received with a response rate of 86%. The researcher used the SPSS for checking validity, processing and analyzing the data. Results: The mean level of job autonomy among physicians working in Shifa Hospital was 6.67 out of 10 and P-value < 0.05 ( the physicians' perception of job autonomy was 6.57, P-value 0.000, the level of technical autonomy was 7.13, P-value 0.000 and the level of administrative autonomy was 6.07 and P-value 0.563). There were no statistical significance differences in the level of job autonomy between departments (means were 6.87, 6.66 and 6.61 for maternity, medical and surgical departments respectively and the P-value 0.65). Certain personal factors were found to be statistically significant at P-value less than 0.05. Physicians who were highly skilled, working as head of departments, holding PHD degree, older than 40 years and experienced more than 15 years had elicited higher scores on the job autonomy scale than their counterparts with statistical significance differences at P-value less than 0.05. On the other hand, gender and department of work didn’t reflect in statistically significant differences among physicians as the P-value was higher than 0.05. The organizational factors that have been studied were found to be present at variable degrees and all of them were found to have a positive relationship with the level of autonomy at a statistical significant level. Teamwork was found to be present with the highest mean (7.55 and P-value 0.000) then the bureaucratic level of the structure (mean 7.23 and P-value 0.000) then job description at a mean 6.47 and P-value 0.000. Patient safety and accountability were present at a mean 6.14 and 6.05 respectively but not at a statistical significant level. Standardization was not adequately present (mean 5.74 and P-value 0.030). The organizational structure had the highest relationship with the job autonomy (r 0.550 and P-value 0.000) then teamwork (r 0.525 and P-value 0.000). The bureaucratic level had correlation coefficient 0.438 and P-value 0.000. Issues like having job description, patient safety, accountability and standardization had revealed controversial findings and require further exploration and investigations. Recommendation: The study provided a set of recommendations regarding promoting physicians’ autonomy, enhancing standardizations and clarifying roles and responsibilities. It is essential to increase physicians’ involvement in the organizational issues and the management of care to patients. .
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    Employees' Perspectives about Communication at the Palestine Red Crescent Society
    (Al-Quds University, 2011-02-27) Helmy Jameel Abu Dalal; حلمي جميل ابو دلال
    Communication is an essential factor for the success of any organization. It shapes the organization culture and influences the major functions inside the organization including control, motivation, change, decision making and information exchange. This study aimed to assess employees’ perspectives about communication at the Palestine Red Crescent Society (PRCS). The design of this study is a descriptive, analytic, cross sectional one. Stratified random sampling technique was used to select 300 employees. Self-administered questionnaire was distributed and data was analyzed by using the SPSS. The response rate was 87%. Content validity was validated by experts and Cronbach's Alpha consistency test equals 0.864.The result of this study showed that the majority of employees were males (69.3%) and married (85%). The mean age of the PRCS employees was 35.39 years. The most academic qualification hold was Bachelor's Degree (35.2%). Also the result showed that the most commonly communication tool in use during emergency is the mobile (47%), while during routine work face to face is more preferrable (61.7%). Furthermore, the study revealed that the mean of the knowledge dimension equals 3.97 (79.3%), the mean of the perception dimension equals 4.01 (80.2%), the mean of the filed “skills and practice” equals 4.03 (80.5%) and the mean of the filed communication gaps equals 2.96 (59.2%).About half of the employees were satisfied about the current communication level within the organization. Sixty two of the employees didn’t get any training courses in communication skills. About 50% of PRCS employees were facing conflict in the organization and 68% of them had admitting that there are gaps in communication in the organization. Sixty percent of PRCS employees believed that the PRCS administration gives high concern to develop the communication process within the organization.The study revealed the age group 45-50 were having the highest mean with statistically significant differences than the other age groups. Master Degree/PhD holders, employees having more than 15 years of experience and the administrators elecited higher scores in communication skill and practices than their counterpart groups with statsical significant differences (P value is less than 0.05). In contarty, gender, number of family members and work setting didn’t statistically significantly affecting the perceptions about communication among PRCS employees. The study conclude that inservice education, holding training programs and workshop should be established in order to improve the communication process. Developing the PRCS managers’ skills to communicate and interact with their employees is essential.
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    Perspectives of the MOH Hospitals' Nurses about the Impact of Training Programs on their Performance
    (Al-Quds University, 2011-04-18) Nayef Ibrahim Ouda; نايف ابراهيم عودة
    Universally, the area of health care delivery is highly affected by training. The need for training programs for hospitals' nurses is greater today than ever before in order to keep them exposed for the state-of-the art techniques in this field. The overall objective of this study is exploring the impact of nursing training programs on nurse's performance in Gaza hospitals in order to assess the effectiveness of these programs. This study is a descriptive, analytical cross-sectional one, conducted on a sample of 258 nurses selected from the three major general MOH hospitals in the Gaza Strip. The participants were selected through a systematic stratified sampling method in proportional to the total number of nurses in each of these three hospitals. The study covered nurses who had participated and those who did not participate in training programs to assess the impacts of the provided training programs. Also, the performance appraisal forms were reviewed and total scores were obtained. Data was collected through a self-administered questionnaire which was developed by the researcher. The research was conducted during the period from June through September 2010. Response rate was 81.5%. Data was entered and analyzed using the SPSS program. The study revealed that males constituted 58.6 % while females constituted 41.4 % of the sample. More than half of the respondents were less than 35 years old, 26.7% of them aged between 40-50 years. Half of the respondents were holding bachelor degree in nursing; 5.2% of the respondents were holding Master degree. The study findings revealed that respondents who participated in training course/s represented 39.0% of the total respondents. The general reactions of the trainees who participated in the provided training programs were positive (p-value less than 0.05). Around 70 % of the respondents reported having training programs at their hospitals while the remaining did not have. The Performance of those who participated in training programs did not improve at significant level (Mean in 2008 was 81.4, Mean in 2009 was 82.2), while the performance of those who did not participate in training programs has improved at significant level training (Mean in 2008 was 81.1, Mean in 2009 82.3). This implies that the provided training didn t improve trainees performance. There were no statistically significant variations in perceptions about the impact of training in reference to a particular hospital. Results showed statistically significant differences in gender as males showed more willingness to participate in training programs than their females counterparts (P value 0.01). Similarly, nurses aged less than 30 years were more motivated to take training than their older colleagues with statistically significant differences among the two groups (P value 0.01). Findings also showed inverse relationship between level of education and the desire to undertake further training courses. The majority of participants were uncertain about the appropriateness of the selection process for the training program (54%). The study recommended that policy makers at MOH should design more effective training programs and to pay more attention to follow up and monitoring the impact of training programs. Evaluation of the impact of the training programs should be given a priority and training should be assessed in reference to performance.
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    Assessment of the Clinical Nursing Supervision at Governmental Hospitals- Gaza Governorates
    (Al-Quds University, 2011-06-02) Ramadan Ali Ramadan Hassan; رمضان علي رمضان حسان
    The literature indicates that clinical nursing supervision has a significant impact on the quality of nursing care. The overall aim of this study was to assess the clinical nursing supervision at governmental hospitals in Gaza governorates from the perspectives of both supervisors and supervisees in order to increase the effectiveness of the supervision processes and outcomes. The design of the study is a descriptive, analytical cross sectional one. One hospital from each governorate from the five Gaza Strip governorates was randomly selected. All supervisors (head nurses and nursing supervisors) were included and a systematic proportional random sample was selected from the supervisees. In total, 160 supervisors were included and the response rate among them was 83.1%; meanwhile, the sample size for supervisees was 300 subjects and the response rate was 90%. Two questionnaires were developed to reflect the study domains which based on the Proctor’s three interactive functions of clinical supervision (formative, normative and restorative) in addition to personal, organizational and supervision related variables. Data were collected utilizing the self-administered questionnaire approach and the reliability coefficient (Cronbach’s Alpha was very high (more than 0.9 for the two scales). Findings show that relatively young male supervisors were dominating the supervisory positions (72.2% were males) at the surveyed facilities. Training opportunities in supervision for supervisors was limited as (less than 25% received training courses in supervision). The availability and use of supervisory tools was also limited; about 24% of the supervisors were using checklists. Nearly half of the supervisors reported being involved in setting hospitals’ objectives and strategies. Similarly, 50% of the supervisees reported being engaged in the performance appraisal for themselves and for their peers; however, they didn't receive adequate feedback in this regard. The study shows that overall the supervisors were more positively perceiving their supervisory roles (80.2%) than supervisees who received supervision from them (68.6%). The restorative function was the highest perceived function among both the supervisors (84.8%) and the supervisees (71.7%) while the formative function was the least positively perceived function by both supervisors (77.5%) and supervisees (63.8%). The formative function is the core function of the clinical supervision indicating that the current supervisory system is relatively administrative rather than clinical. Supervisees’ perspectives indicated that positive perceptions were elicited about the clinical supervision of head nurses more than the nursing supervisors with statistically significant differences (P value < 0.05). Supervisors who are head nurses, females and having long experience had elicited higher scores than their counterparts with statistically significant differences (P value < 0.05). On the other hand, supervisees who were females, holding diploma certificate supervisees more positively perceiving the supervision they had received than their counterparts with statistically significant differences (P value < 0.05). The researcher recommends strengthening the clinical aspect of supervision, formulation of clinical supervision policy and promoting the use of supervisory tools such as checklists.
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    Utilization of the operating theaters in governmental hospitals in Gaza Governorates
    (Al-Quds University, 2011-06-11) Tayser M. ELSultan; تيسير محمود محمد سلطان
    Extensive operating room utilization is a goal of most 0perating rooms directors and hospital administrators. Assessing the procedures and processes performed in operation rooms is the first step of evaluating the quality of care and efficiency of utilization of these rooms. This study aims to assess the current utilization of operating theaters and the time factor involved in these theaters in governmental hospitals in Gaza Governorates in order to improve the quality of current operation rooms and facilities. A triangulated cross sectional quantitative, qualitative study was conducted in order to assess the procedures and processes implemented in these theaters. The instruments used in this study were self-constructed questionnaire, reviewing of 100 medical records for availability and completeness of these records and in depth interview for 9 mangers (doctors and nurses). All the medical staff (220) who were working in the operating theaters in three governmental hospitals were included in the study, out of them, 198 responded and completed self-constructed questionnaires, with a response rate of 90%. The researcher collected the data by himself. General measures of reliability and validity were used, Cronbach s alpha reliability test was 0.8954. The study findings show that, most procedures which are done by doctors (surgeons and anesthesiologists) prior to surgery are done properly, but these procedures are not always done properly by the surgical department nursing staff. The study findings also show that most of needed records are available and completed in the patient s file but there is a real problem in completeness of some file records especially records related to the anesthesia and recovery sheets (80% are not completed), and also history and physical examination sheets(74% are not completed). The study results also show that there is absence of policy, standards and protocol which are essential for regulating the performance of the procedures, in addition to absence of job description which lead to role ambiguity. Moreover the number of daily working hours of the routine operating list are not appropriated with the number of operations, which it was considered the most important reason of the postponement of some cases from such list and then increasing the number of patients on the waiting list. The researcher concluded that most of procedures are performed in a traditional way and not regulated by protocols according to standards, and the policy is an old one and not revised or reformed since a long time passed on scientific base. The researcher recommended that the policy should be reformed, and standards and protocols should be established in order to improve the quality of health care services in operating theaters, the researcher also recommend for a further study to investigate barriers and motives for implementing procedures according to standards from healthcare providers perspectives
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    Evaluation of Community Based Rehabilitation Programs in the North and Gaza Governorates
    (Al-Quds University, 2011-06-18) Soad Jameel S. Radwan; سعاد جميل رضوان
    Community Based Rehabilitation (CBR) is a specific and important strategy for people with disabilities. This study aims to evaluate the CBR programs in Gaza and North Gaza governorates inorder to provide information that could contribute to support the services delivery and enhance the effectiveness of the programs to disabled persons. Evaluative techniques including triangulation methods combining both qualitative and quantitative techniques were conducted at the National Society for Rehabilitation and Palestinian Medical Relief Society. A sample of 300 beneficiaries have been chosen through a systematic random sample, and participated through a self-constructed interviewed- questionnaire with a response rate of 69.7%. Also, 10 key informants have been selected purposively for interview. In addition to that, 20 medical files were reviewed randomly. The study results revealed the main causes of disability are acquired in 71.6% of cases with various types, mainly accidents that constituted (52.1%), followed by communicable diseases (16.7%), and wars (14.6%). Among disability types, physical disability is the commonest one that formed 76.1%. The prominent services were relief aids (42.8%), followed by assistive devices (28.6%) and physiotherapy (27.1%). There was lack in livelihood domain where vocational training forms only (0.5%), and lack of the income generation and disabled people employment, while the majority (80.6%) of disabled live under the poverty line. The results indicated that 50.3% of visits are less than one visit monthly. Regarding the services provision, there is no difference between males and females. The researcher show that CBR programs are effective, this was elicited from response of the most of disabled’s needs, and improvement in disabled physical health status (P value 0.001), and psychological state (P value 0.001). At the same time, positive proportional correlation was found between the provided services scores and improvement of quality of life domains that contained indicators like feeling security, satisfaction, change in physical and psychological health state and social participation of disabled people (Pearson correlation 0.376 - P value 0.001). The study reflected good networking with different sectors, but governmental collaboration with CBR programs is still weak. On the other hand, communication and interaction of rehabilitation workers with disabled people was cooperative. The limited number of the rehabilitation workers and lack of volunteers increased the workload, and affect work’s process and quality. The study revealed shortage in the documentation and cases evaluation, poor public awareness about disability issues, and weak of the community ownership. Furthermore, application of the disability law number 4-1999 is inactive. This was indicated through the absence of disabled self- advocacy, and lack of the governmental role in maintaining disabled rights. The study provided a set of recommendations that could strengthen the CBR programs including; establishment of a national strategy aiming to create public awareness about the disability issues, and formulating of a local committee for developing polices, empowering the disabled role in the community, enhancing the voluntary work, and developing of staff capacity.