Public Health

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Organizational climate at UNRWA as perceived by clinical staff working in the West Bank field
(Al-Quds University, 2004-02-16) Maysoon Mousa Said Obeidi; ميسون موسى سعيد عبيدي
تقييم برامج التأهيل المبني على المجتمع المحلي في مخيمات اللاجئين– قطاع غزة
(جامعة القدس, 2007-01-14) حسين حسين أبو منصور; Hussein Hussein Abu Mansour
The present study aims to evaluate the Community Based Rehabilitation (CBR) programs in the Gaza Strip Camps. It also aims identify the level of CBR services, recognize the problems faced by the CBR in the provision of its services to the disabled, highlight the strength and weakness points in its programs, provide necessary data which will help the decision makers to plan for developing the rehabilitation services. The study population was composed of 305 disabled individuals who benefit of the services of the rehabilitation programs in the Gaza Strip camps (151 males, 154 female). The population was selected through the random simple sample. The population also included 151 male/female employees whom are the rehabilitation services providers in the CBR centres in the Gaza Strip refugee camps (47 male, 104 female) with various age and education levels. The study findings suggested that the level of the rehabilitation services is very effective and more than 60% of service providers have a university degree or higher while 57.6% have practical experience in the rehabilitation field for more than 4 years. The study results showed that 82.8% of the services providers’ age are less than 39 years. On the other hand, 84% of the beneficiaries of the rehabilitation services have preparatory education or less, 81.6% have monthly income less that 1500 NIS, 75.5% unmarried, 31.1% of the service providers are males and 68.9% are females. No significant statistical differences were found between the study population according to gender and income level. However, significant statistical differences were found in relation with education level, age categories and marital status. On the one hand, no significant statistical differences were found according the gender of rehabilitation service providers. On the other hand, significant statistical differences were found in relation with education level, age categories and years of experience among service providers. Recommendations: to encourage the service providers to conduct specialized studies, to urge continuing education and training based on need assessment, to introduce external experts, to equip the centres with modern equipment, to enhance the cooperation & coordination with international, governmental & non-governmental organizations. Moreover, to support the beneficiaries' needs, specially, services' fees, meeting the beneficiaries & to support forming rights pressure committees. In addition, to make a brave decision concerning the process of implementation of disabled individuals' rights law & follow up of the implementation. Also, to conduct evaluative studies of the rehabilitative services in Palestine & their impact on the disabled persons & their needs
Evaluation of Current Screening Test for Asymptomatic Bacteriuria during Pregnancy at First Antenatal Visit in Rimal Health Center UNRWA ,Gaza 2007
(Al-Quds University, 2008-01-26) Rasmiya Khamis Ghsoub; رسمية خميس غصوب
Urinary tract infection is a common problem during pregnancy and if it is not diagnosed and treated properly, bad sequels could occur affecting the mothers and their outcome of pregnancy. The main objective of this study is to determine the prevalence of urinary tract infection (UTI) and asymptomatic bacteriuria (ASB) during pregnancy, as well as to evaluate the validity of current screening test (nitrite dipstick) at first antenatal visit. This is a cross sectional study conducted among pregnant women in Rimal Health Center which is a Primary Health Care Center; UNRWA in Gaza City. The total study population was 160 pregnant women attending antenatal care at first antenatal visit from 12th April 2007 to 25th July 2007. Midstream urine was collected and tested with culture, dipstick and microscopic examinations. Validity of tests was measured by sensitivity, specificity, positive predictive value and negative predictive value. Antibiotic sensitivity was also done. Thirty one out of 160women were identified positive urine culture with prevalence of 19.4%, 18/160 was asymptomatic (11.25%) while 13/160 was symptomatic (8.15%). Among the 31 culture positive, the commonest organism was staphylococcus aureus (29%), followed by E-coli (25.80%) and klebsiella (22.58%). Ciprofloxcine was shown as the 1st sensitive drug in all cultures (93.54%) followed by cefuroxim (83.87%) and co-amoxiclave and norfloxacine were equal (70.96%) while amoxicillin, co-trimoxazol and erythromycine had the lowest sensitivity. Maximum resistance was seen to co-trimoxazol (67.74%) followed by doxycycline (29.03%). Symptoms of UTI, weeks of gestation and the previous history of premature deliveries were statistically significant risk factors for the occurrence of ASB. Age, gravidity, parity, educational level, previous CS, history of urinary catheterization and previous history of UTI were not significant risk factors for this disease. Nitrite dipstick had low sensitivity (29%), high specificity (97.7%), with positive predictive value of 75% (PPV) and negative predictive value of 85% (NPV). Asymptomatic bacteriuria in pregnancy is a major public health problem and nitrite dipstick reagent is not sufficiently sensitive to be of use in screening of asymptomatic bacteriuria in pregnancy and many of patients would be missed for management. So, the researcher recommends the use of urine culture for screening of all pregnant women at first antenatal visit.
Evaluation of Quality Improvement Project implemented at the Ministry of Health at Gaza Strip
(Al-Quds University, 2010-10-10) Khalid Abdel Sattar Abu Ghali; خالد غالي
Universally, in the last decades quality in health continues to be a matter of interest for policy makers, health providers and managers. In Palestine, since the establishment of the Palestinian Authority, the Ministry of Health pays great attention to improve the quality of health services as manifested in many measures including the establishment of the quality improvement(QI) project. The study has been conducted to assess to which level the Quality Improvement Project met its objectives and the QI concepts and activities have been institutionalized into the Ministry of Health units. The researcher developed a self administered questionnaire to gather data from all those involved in quality improvement activities and focused on evaluating the impact of the QI project on their work settings particularly in terms of sustainability and institutionalization. From those who have been trained in quality and participated in its activities, 81 participants completed a self administered questionnaire (response rate 71%). Using the SPSS the study indicated that males constituted the largest proportion of participants (86.4). Age category 41-50 represented the highest age category and similarly 53% of participants were living in Gaza area. Physicians constituted 43% followed by nurses 33% and administrators 16%. Participants from Hospitals constituted the main bulk of participants indicating un-fair distribution of participants. Additionally, head of departments constituted almost half of participants. Factor analysis revealed eight factors (dimensions) labeled as; policy, leadership, core value, resources, structure, capacity building and information and communication. The findings showed that the mean of factors was ranged from 3.26- 2.19. The highest mean was seen with leadership factor (mean 3.36) whereas the lowest level of perception was seen with information and communication factor (mean 2.19). Although participants have been trained on quality improvement approaches, few of them engaged in quality improvement activities, or have good knowledge about quality, therefore, quality should be seen as a continuous process that requires follow up and monitoring. From institutionalization perspective, more focus should be directed on increasing communications and information about quality. Unless quality initiatives are adequately communicated, it could not be institutionalized. For increasing institutionalization, focus should be directed at developing and empowering an effective rewarding system that acknowledges proper performance. To institutionalize quality as a part of the organizational culture it is important to develop an effective organizational structure supportive to quality.
Evaluation of Reproductive Health Services at Jabalia and Al-Bureij Women's Health Centers
(Al-Quds University, 2015-01-01) Maha Sabry mustfa El Akkad; مها صبري مصطفى العقاد
Worldwide, Reproductive Health problems are among the top leading causes of morbidity and mortality among women of reproductive age. In the Gaza Strip, programs that offer Reproductive Health services exist in most health service organizations; however, not all of these programs provide comprehensive services. Among the programs that provide comprehensive Reproductive Health services are the two Women Health Centers in Jabalia and Al-Bureij refugee Camps. The two Centers also provide legal, psychosocial, and physiotherapy services. The study aimed to evaluate the Reproductive Health services in the two women health Centers in order to improve the quality and effectiveness of the provided services. This study is a mixed methods; it involves both quantitative and qualitative data. The quantitative were collected from beneficiaries of Reproductive Health clinics within the two Centers. In total, 375 randomly selected women participated in the quantitative study, with 89.3% response rate. The qualitative data were collected through nine in-depth interviews with senior managers and providers, and six focus group discussions with beneficiaries of two Centers' service, with participation of 38 women. The researcher insured reliability, validity and trustworthiness of the study tools. Different descriptive and inferential statistical tests were used to analysis the quantitative data while Open Coding Thematic analysis was used to analyze the qualitative data. The quantitative study revealed that the participants were women aged between 16 and 65 years with average of 11.86 years of schooling. The majority of participants (96.8%) were married. Only 16% of the participants were employed and about 52% of them have monthly income of less than 1,000 ILS per month. Both quantitative and qualitative studies revealed that women's health status and their wellbeing have been improved as a result of utilizing the two center services. The vast majority of the participants (98.7%) have received the services they were supposed to, and these services met their health needs as indicated by 95.2% of participants. From beneficiaries' perspectives, the overall mean percentage of accessibility, affordability, and availability of selected services was 81.18%. And for providers’ respect of privacy, confidentiality and dignity, the mean percentage was 87.68. It was 83.4% for the infrastructure and equipment, while it was 85.30% for skilled and competency of the health providers. General satisfaction of women related to the provided Reproductive Health services was 87.8%, congruently; the qualitative findings have shown high level of satisfaction with the provided legal, psychosocial, and physical therapy services. The study has showed that there is a limited financial sustainability of services as the two Centers are funded by external donors. To conclude, offering integrated reproductive services was very efficient and effective way of providing services; more efforts are needed to increase the utilization of postnatal care service and utilization of services by youth and single women.
Quality of life and Depression among Children with End Stage Renal Disease attending Hemodialysis units in Gaza Governorates
(Al-Quds University, 2015-01-05) Jomaa Waleed. Younis; جمعة وليد يونس
Background The Quality of life and the depression among End Stage Renal Disease children and the NON –ESRD children, an important health problem with higher incidence and clinical severity, gain its importance from defining the quality of life and depression among these groups and from the way, they react in the case of ESRD. Since more children with ESRD are reaching adult age, the best care in the pediatric nephrology units requires attention to the psychosocial and developmental factors with the intention to support the successful transition of pediatric patients to adulthood. Aim: the aim of this study was to compare the quality of life (QOL) and depression among children with end stage renal disease attending to hemodialysis in Gaza governorates. Methodology: The design of this study was case control study to compare the quality of life and depression among children, study sample consists 47(cases) 95(control).This design was to describe the quality of life and depression in children with ESRD in compare with the children have other chronic disease at five hospital of the ministry of health, Data collection instrument (demographic sheet and Quality of life questionnaire and Birlesone Depression scale) face to face interview. Results: The results showed that the mean of depression in case was 20.13% and for control was 12.63%. There were statistically significant differences in depression between the two groups toward End Stage Renal failure. The mean of the total quality of life for End Stage Renal failure was 48.98% compared to 52.75% in control group. There were statistically significant in quality of life toward control group. Physical functioning mean for End Stage Renal failure was 14.02% and for control was 21.24%. There were statistically significant in Physical functioning toward case group. Emotional functioning for End Stage Renal failure was 14.04% and control mean was 9.68%. There were statistically significant in emotional functioning toward control group. Social functioning mean in End Stage Renal failure was 9.96% and 8.32% for control group. There were statistically significant in social functioning toward End Stage Renal failure. School functioning mean in End Stage Renal failure was 11.38% and 12.77 %for control group. There were statistically significant in school functioning toward control group. Conclusion: the findings showed that end-stage renal disease children have positive perceptions about their quality of life (emotional, social), negative perception of (physical, school), compared to control group who have positive perception (physical, school)about their quality of life and negative perception of (social, emotional), and confirm high level of depression among ESRD than control group. Key words: End-Stage Renal Disease, Depression, Children, Quality Of
Effects of Exposure to Radiation on the Immunity Status of Medical Radiographers at Governmental Hospitals-Gaza Governorates
(Al-Quds University, 2016-01-01) Mousa Hafez Alnahhal; موسى حافظ النحال
Long-term exposure to low doses of ionizing radiation may affect cells, tissues, and body systems and result in various adverse health effects. Immunity system is known to be highly radiosensitive; therefore it’s susceptible to radiation. Medical radiographers are occupationally exposed to chronic levels of ionizing radiation that may affect their immune response. So, the aim of this study was to investigate effects of exposure to radiation on the immunity status of medical radiographers at governmental hospitals-Gaza governorates. The study design was a case control study conducted in six main hospitals. A total of 92 medical radiographers exposed to chronic ionizing radiation compared with control group of 97medical laboratories who never exposed to chronic radiation. The cases and controls had the same age, gender, years of experience, and smoking status. A questionnaire and blood tests were the tools of the study. The study reported a response rate of 83.6 % for exposed group and 74.6 % from control group for the questionnaire. While the response rate of the venous blood samples was 58.8 % and 60.2 % for exposed and non-exposed groups respectively controls in case of venous blood sampling. The results revealed that several health complains such as headache were higher among medical radiographers (46.7%) compared to medical laboratories (10.3%) with highly statistically significant level (p.0.000). Regarding immunity systems, the study found that clinical symptoms such as gastritis, sore throat, repeated infections, and sinusitis were prevailing among exposed group compared with non-exposed group with statistically significant differences (p<0.05). Other clinical symptoms such as skin diseases, fever, and pallor did not reached the statistically significant levels (p>0.05). About venous blood samples, our study results found that mean difference of Immunoglobulin G and A were higher among medical radiographers (1279±359), (215±108) compared with the control group (1225±209) and ((1202±89) with no statistically significant level (p=0.324 and 0.498) respectively. In addition, white blood cells and lymphocytes counts showed some variations between exposed and control group with no statistically significant differences. In conclusion, significant health complaints and clinical symptoms were recorded among medical radiographers compared with the matched control group. Thus, personnel monitoring for ionizing radiation, periodic medical examination, and increasing level of protection for MRs is of utmost importance.
Risk Factors of Hyperbilirubinemia among Admitted Neonates in Gaza Governorates: Case Control Stud
(Al-Quds University, 2016-01-01) Safaa' Awaad Abu Mostafa; صفاء عواد ابو مصطفى
Neonatal hyperbilirubinemia is a widespread and significant clinical condition amongst neonates worldwide that about 60% of term neonates and 80% of preterm neonates develop jaundice in the first week of life. The study aimed to identify the main risk factors either socio-demographic, maternal, or neonatal factors that contribute to neonatal hyperbilirubinemia among hospitalized neonates in Gaza governorates. The design of this study is case-control study. The study sample consisted of 180 neonates (90 cases and 90 controls). Cases were selected from Al- Nassir pediatric hospital and Naser Medical Complex while controls were selected from Martyrs Khanyounis clinic and Martyrs Al-Remal clinic. The researcher used an interview structured questionnaire; face and content validity were done. The collected data analyzed by SPSS version 20 and different statistical tests were used for data analysis including descriptive statistics, bivariate analysis using Chi-square and multiple logestic regression using Odds Ratio and confidence interval 95%.Socio-demographic factors were studied by bivariate test using by person’s chi-square, the results revealed that there was a significant association between family income andneonatal hyperbilirubinemia (P value < 0.05), other factors were statistically insignificant risk factors including mother age, mother education and mother occupation (P value > 0.05). Among maternal factors; bivariate test by by person’s chi-square revealed that there were significant associations between hyperbilirubinemia andmother's blood group, maternal anemia and pregnancy disorders (P value < 0.05). On the other hand; there were no significant association between hyperbilirubinemia and parity, mother's Rh type, Premature RuptureOf the Membranes, oxytocin use, delivery type, gestational diabetes, pregnancy induced hypertension, urinary tract infection, vaginal infection, perinatal hemorrhage, and discharge from postnatal department (P value > 0.05).Concerning neonatal factors; bivariate analysis using by person’s chi-square showed that birth weight, and feeding practices that include; feeding method, feeding initiation time, feeding difficulty, feeding frequency, and number of wet diapers/24hourswere statistically significant risk factors for developing hyperbilirubinemia (P value < 0.05). Others factors including newborn order, cephalhemama and bruising, and history of previous sibling with jaundice showed statistically insignificant risk factors for developing hyperbilirubinemia ( P value > 0.05). Multiple logistic regression analysis was used to detect the independent factors associated with neonatal hyperbilirubinemia. The results showed that there were statistically significant association between hyperbilirubinemia and family income groups; < 1800NIS (AOR: 23.345, 95% CI: 2.083-261.688) and > 2300 NIS (reference group), maternal anemia groups; yes (AOR: 5.383, 95% CI: 1.035-27.998)and no(reference group), and birth weight groups; 2500 - 3000gram (AOR: 0.117, 95% CI: 0.028-0.498) and > 3000gram (reference group). All feeding practices showed statistically significant association with hyperbilirubinemia occurrence except number of wet diapers / 24 hours as following: feeding method groups; exclusive (AOR: 0.017, 95% CI: 0.003-0.093), bottle (AOR: 0.006, 95% CI: 0.000-0.141), and mixed (reference group), feeding initiation time groups; 1st hour (reference group) and more than 4 hours (AOR: 0.046, 95% CI: 0.004-0.586), feeding difficulty groups; yes (AOR: 0.079, 95% CI: 0.019-0.328), and no(reference group), lastly feeding frequency groups; on demand (reference group), every 2-3 hours (AOR: 0.108, 95% CI: 0.026-0.448)], and more than 3 hours(AOR: 0.003, 95% CI: 0.000-0.045).In conclusion, our study implies the need for paying attention on ongoing screening and close monitoring for neonates at high risk. In addition, emphasize on health education regarding an effective feeding practices to reduce rates of hospitals readmissions and morbidities of neonatal hyperbilirubinemia. مقدمة: يعتبر اليرقان عند الأطفال حديثي الولادة من أكثر المشاكل الصحية شيوعا في جميع أنحاء العالم حيث أن حوالي 60٪ من الأطفال مكتملي النمو و80٪ من الخدج يصاب باليرقان في الأسبوع الأول من الحياة. أهداف الدراسة: لقد هدفت هذه الدراسة إلى التعرف على عوامل الخطر التي تؤدي إلي حدوث اليرقان بين المواليد في محافظات قطاع غزة. منهجيةالدراسة كانت منهجية الدراسة عبارة عن دراسة مقارنة (الحالات والشواهد) بين حالات مرضية وحالات سليمة، وتكونت عينة الدراسة من 180 مولود (90 مريض باليرقان و 90 سليم)، وقد تم اختيار الحالات المرضية من مستشفى النصر للأطفال ومجمع ناصر الطبي في حين تم اختيار الحالات السليمة من مراكز الرعاية الصحية الأولية ( عيادة شهداء خان يونس وشهداء الرمال). لقد تم استخدام استبيان محكم أعد لقياس متغيرات الدراسة وقام الباحث بإجراء اختباراتالصدق له، وقد تم استخدام برنامج الحزمة الإحصائية للعلوم الإنسانية في تحليل البيانات التي تم جمعها حيث تم إجراء العديد من الاختبارات الإحصائية بما في ذلك إحصاءات وصفية، التحليل الثنائي باستخدام اختبار الكاي ومعامل الانحدار المتعدد. أهم النتائج - كشفت نتائج التحليل ثنائ المتغير أن هناك علاقة ذات دلالة إحصائية بين بين اليرقان والعوامل الاجتماعية والديموغرافية مثل دخل الأسرة الشهري (P value < 0.05) ، بينما العوامل الأخرى مثل (عمر الأم، عمل الأم، والمستوي التعليمي للأم) فلم تظهر علاقة ذات دلالة إحصائية (P value > 0.05). - من بين العوامل المتعلقة بالأم؛ فقد بين التحليل ثنائي المتغير وجود علاقة ذات دلالة إحصائية بين اليرقان و(نوع فصيلة الدم للأم، وفقر الدم ، واضطرابات الحمل(P value < 0.05) - من ناحية أخرى؛ أظهرت النتائج أنه لا توجد علاقة ذات دلالة احصائية بين اليرقانو(عدد الولادات، نوع العامل الرايسيسي للأم، التمزق المبكر للأغشية المحيطة بالجنين، استخدام الأكسيتوسين، نوع الولادة، سكري الحمل، ضغط الحمل، التهاب المسالك البولية، التهاب المهبل، نزيف ما حول الولادة، الخروج المبكر بعد الولادة من المستشفى(P value > 0.05). - أما العوامل المتعلقة بالمولود، أظهر التحليل ثنائي المتغير أن وزن الطفل عند الولادة، وممارسات الرضاعة (طريقة الرضاعة، صعوبة التغذية ،وقت أول محاولة للرضاعة، المسافة الزمنية بين وجبات الرضاعة، وعدد الحفاضات الرطبة خلال 24 ساعة) أنها عوامل ذات دلالة إحصائية للإصابة باليرقان(p value < 0.05)، كما أظهرت عوامل أخرى تعلقت بترتيب الطفل في الإنجاب وحدوث ورم دموي رأسي أو وكدمات، وتاريخ أخ سابق مصاب باليرقان عن عدم وجود علاقة ذات دلالة احصائية (p value > 0.05). - وقد تم استخدام الانحدار المتعدد للكشف عن العوامل المستقلة الهامة المرتبطة بالإصابة باليرقان عند المواليد، وأظهرت النتائج أن دخل الأسرة،وفقر الدم عند الام، ووزن الطفل عند الولادة، وغالب ممارسات الرضاعة (طريقة الرضاعة، ووقت أول محاولة للرضاعة، وصعوبة الرضاعة، والمسافة الزمنية بين وجبات الرضاعة) عوامل خطر ذات دلالة إحصائية لحدوث اليرقان عند حديثي الولادة في قطاع غزة. أهم التوصيات في الختام، حيث أن نتائج الدراسة أظهرت أن العديد من عوامل الخطر التي تؤدي إلي اليرقان يمكن التحكم بها وتفاديها، فإننا نوصي بضرورة الاهتمام بالفحص الشامل والمراقبة الدقيقة لحديثي الولادة خاصة الأكثر عرضة منهم لعوامل الخطر. وأخيرا تعزيز التثقيف الصحي بشأن ممارسات التغذية الفعالة أملا في الوقاية والكشف المبكر وللحد من حالات الدخول المتزايدة من مرضي اليرقان.
Risk Factors of Chronic Kidney Disease among children in Gaza Governorates: A Case Control Study
(Al-Quds University, 2016-01-01) Mahmoud Said Al-Absi; محمود سعيد العبسي
Chronic Kidney Disease (CKD) is one of the emerging worldwide critical health problems encountered in child life. The disease in children is a fatal illness and the infants with advanced renal diseases are at higher risk of death in the first 2 years of life. This case control study aimed to determine the main risk factors of CKD among children in Gaza governorates (GGs). The sample study consisted of 400 child; 200 cases and 200 controls. The participants were selected from those medical files at Al-Ranteesy hospital while the controls were chosen from the main governmental primary health care centers in each governorate. A questionnaire was constructed and data was collected by the researcher through a face to face interview with the mothers of children. The results of the study showed that the most frequent renal cause of CKD was Nephrotic Syndrome (30%) followed by Vesico-ureteral Reflux (20%), and Focal Segmental Glomerular Sclerosis (18%). While the most congenital renal cause was kidney atrophy (23%), and born with one kidney (20%). Among socio-demographic risk factors, percentage of cases sample were (57%) male, and (43%) female. Other risk factors include lower educational level for mother, child birth weight, small gestational age, child obesity, history of HTN and anemia. The study found that there is no relation between the extensive use of antibiotics and analgesic. However, analgesic drugs use during pregnancy can lead to CKD at childhood, nevertheless it was not associated with antibiotic drugs use. Maternal obesity, and low amniotic fluid shows positive association with child CKD. Mothers with chronic health problems especially HTN and DM and maternal age during pregnancy, are not consider risk factors. A significant positive association with living area in camps and villages, living near hazards, and unsafety drinking water was confirmed. The study concluded that most of the risk factors appeared are avoidable. It is found necessary to follow up at maternal and antenatal care, encouraging child health screening for UTI and other urologic problems, controlling of environmental hazard can decrease the risks of CKD in GGs. Key words: Chronic Kidney Disease in children, Risk factors, Gaza Governorates.
إثبات الدعوى الجزائية بالأدلة الرقمية ـــــــ دراسة مقارنة ـــــــ
(AL-Quds University, 2016-01-09) مهند علي محمد ربعي; Muhannad ali M rebie; جهاد الكسواني; الدكتور عبد الله نجاجرة; الدكتور نائل طه
Preconception Care: Does it make a Difference in Pregnancy Outcomes?
(Al-Quds University, 2019-05-22) Maha B. Timraz; مها بسام تمراز
تضم رعاية ما قبل الحمل مزيجا من التدخلات الوقائية و العلاجية التي تهدف إلى الكشف المبكرعن المخاطر التي قد تؤثر على صحة المرأة و الطفل و علاجها من خلال تحديد العوامل التي يجب العمل عليها قبل، أو في وقت مبكر من الحمل. تبحث هذه الدراسة عن تأثير برنامج رعاية ما قبل الحمل المقدم في مراكز الأونروا الصحية للرعاية الأولية على نتائج الحمل. أجريت هذه الدراسة الشبه تجريبية بطريقة التثليث الكمي و الكيفي, و أسفرت عملية أخذ العينات العشوائية الطبقية عن اختيار 5 عيادات رعاية أولية للأونروا لتمثل مختلف محافظات قطاع غزة، حيث شاركت 800 سيدة من خلال اجراء مقابلات معهن (400 سيدة تلقين خدمة رعاية ما قبل الحمل و 400 سيدة لم تتلق نفس الخدمة). وأجريت مقابلة مع عينة مستهدفة مكونة من 11 موظف من مقدمي الخدمة بالإضافة إلى عمل 6 مجموعات بؤرية ضمت 60 سيدة تم اختيارهن لأسباب متنوعة (30 من المستفيدات من الخدمة و 30 من غير المستفيدات منها) و ذلك بغرض إثراء و تفسير بعض النتائج. من الجدير بالذكر أن الأداة الرئيسية التي استخدمت في الجزء الكمي للدراسة هي عبارة عن استبيان تم تصميمه من قبل الباحث بإشراف مباشر من مشرف البحث بالإضافة لاستعراض السجلات الرقمية لكل من السيدات المشاركات في البحث, في حين تم استخدام بروتوكول شبه منظم للطريقة النوعية. تم تحليل البيانات الكمية باستخدام الحزمة الإحصائية للعلوم الاجتماعية وتم استخدام تقنية الترميز المفتوح لتحليل الجزء النوعي. أظهرت النتائج أن 47% من السيدات المستفيدات من البرنامج قد عرفوا عن الخدمة من خلال القابلات، 44.1 ٪ قد التحقوا فعليا بالبرنامج لأنهن كن يخططن للحمل. بالنسبة لغير المستفيدات من البرنامج، أفادت 31.5٪ من السيدات إلى أن سبب عدم التحاقهن ببرنامج رعاية ما قبل الحمل يعود لعدم معرفتهن بوجود هذه الخدمة. فيما يتعلق بالخدمات المقدمة في إطار برنامج رعاية ما قبل الحمل، أفادت 71.7 ٪ من السيدات الملتحقات بالبرنامج بأنهن قد تلقين النصائح الصحية، بينما تلقت حوالي 99 ٪ من السيدات فحوصات مثل قياس ضغط الدم و فحص نسبة السكر في الدم و فحص مشاكل الأسنان وأيضا تلقين حمض الفوليك، وأفادت 82.3 ٪ من السيدات بأنهن أخذن معلومات حول أهمية حمض الفوليك. ومع ذلك 75.8 ٪ من المستفيدات قد التزمن بشكل مستمر باستعمال حمض الفوليك. أظهرت النتائج أن 92.2 ٪ من المستفيدات من برنامج رعاية ما قبل الحمل أخذن حمض الفوليك قبل الحمل بينما فقط 15.1 ٪ من غير المستفيدات قد تناولن حمض الفوليك. بلغت النتيجة الإجمالية التي تعكس التصورات حول مدى ملاءمة الخدمات المقدمة 73.8٪ ، حيث أشار 47.9٪ من المستفيدات إلى أنه تمت مشاركتهن في الخدمة المقدمة لهن. وبلغت النتيجة الإجمالية التي تعكس مدى التنسيق وسلاسة الخدمة 69.7 ٪. كان متوسط وقتالانتظار 47.8 دقيقة،وقد وصفت 54.5 ٪ من المستفيدات وقت الانتظار على أنه طويل و 48.3 ٪ أشرن إلى أن وقت تلقي الخدمة الفعلي كان أقل من 5 دقائق. فيما يتعلق بتأثيرات البرنامج ، فإن 57.9 ٪ من المستفيدات من برنامج رعاية قبل الحمل و 67.4 ٪ من غير المستفيدات واجهن مضاعفات خلال فترة حملهن الأخيرة, حيث أصيبت 53 ٪ من المستفيدات بينما حوالي 55.8 ٪ من غير المستفيدات بالتهاب في الجهاز البولي التناسلي، تجدر الإشارة بأن 51.7 ٪ من الملتحقات بالبرنامج قد تعرضن للإصابة بفقر الدم مقابل 71.4 ٪ من غير المستفيدات وكانت الفروقات السابقة الذكر ذات دلالة إحصائية. كانت نسبة النساء اللاتي ولدن عن طريق الولادة القيصرية 25.3 ٪ بين المستفيدات من البرنامج و 18 ٪ بين غير المستفيدات منه. أفادت الدراسة بأن 22.8% من متلقي خدمة رعاية ما قبل الحمل مقابل 32.5 ٪ من غير المستفيدات واجهن مضاعفات خلال الولادة الأخيرة ، وخاصة النزيف (36.3 ٪ و 51.5 ٪ للمستفيدات من برنامج رعاية ما قبل الحمل وغير المستفيدات على التوالي). حوالي 63.7٪ من المستفيدات من البرنامج مقابل 67.4٪ من غير المستفيدات أتممن كامل مدة الحمل، بلغ متوسط وزنالمواليد للسيدات المستفيدات من البرنامج 3274.5 بينما 3225.4 لغير المستفيدات. بلغت نسبة التشوهات الخلقية بين المواليد للسيدات المستفيدات من البرنامج 3.8 ٪ مقابل 2.5 ٪ لغير المستفيدات. قد تعزى الاختلافات السابقة و الغير متوقعة إلى حقيقة أن البرنامج يستهدف السيدات المعرضات للخطر بشكل خاص لغرض تحسين النتائج, والتي يمكن أن تكون أسوأ من دون البرنامج. وخلصت الدراسة إلى أن برنامج رعاية ما قبل الحمل المقدم قد أحرز نتائج أفضل للأمهات، لكنه ما زال يحتاج إلى مزيد من التعزيز لتحقيق نتائج أفضل. لذلك يجب التحسين و الاستثمار في عدد من المجالات من بينها آلية الاستهداف للمستفيدات وتفاعل الموظفين مع المستفيدات والامتثال للتعليمات الفنية الخاصة بالاستشارات و الفحوصات.ومن المهم أيضا تعزيز المراقبة والإشراف.
Assessing Drug Dispensing Safety Practices at Community Pharmacies in The Gaza Strip
(Al-Quds University, 2020-01-11) Reem Bashir Khamis Ghannam; ريم بشير خميس غنام
Medication safety has long been recognized as a key issue within the broader patient safety agenda. Medication errors can cause unwanted adverse drug events and, in some cases, can lead to life-threatening injuries. In Palestine, community pharmacies are engaged mainly in dispensing medications, including antibiotics, without prescription. However, the quality of the service provided by community pharmacies in developing countries has often been questioned and is often suboptimal. This study aimed to evaluate the current medication safety practices in the community pharmacies at Gaza Strip. The study employed a descriptive, analytical cross-sectional approach with an explanatory sequential mixed method (quantitative and qualitative). Interview based questionnaires (five point Likert scale) and key informant interviews were used for data collection. Two-stages systematically randomized sample was used to select the eligible community pharmacies and the eligible participants. The calculated sample size was 270, out of them, 258 completed the questionnaires, with a response rate of 95.5%. An adapted Medication Safety Self-Assessment instrument (10 dimensions) was used to collect the quantitative data. The reliability coefficient for the study instrument was excellent 0.95. Semi structured, face to face, in-depth interviews were conducted with seven key informants from community pharmacies and five patients as a second data collection technique. The data was analyzed by SPSS version 23, findings revealed that the overall mean score of the medication safety practices was satisfactory 3.20, SD = 0.56, T-value =5.81, and P-value =0.000. The analysis showed that the Drug Standardization, Storage, and Distribution scored the highest level of implementing the medication safety practices 3.57, T-value=11.91 and P-value=0.000 , followed by the Staff Competency and Education 3.55, T-value=12.47 and P-value=0.000, Use of Devices and medical supplies 3.51, T-value=7.89 and P-value=0.000, Environmental Factors, Workflow, Staffing Patterns 3.42, T-value=11.45 and P-value=0.000, and Drug Information 3.33, T-value=7.09 and P-value=0.000. The least score was for the Drug Labeling, Packaging, and Nomenclature 2.69, T-value=4.92 and P-value=0.000, and Patient Information 2.81, T-value=4.26 and P-value=0.000. The findings showed insignificant variation in medication safety practices in reference to gender, age, salary, qualification, and work experiences, except for governorate, and specialization where P-value was ˂0.05. The researcher strongly recommends using a multifaceted implementation strategies targeting the use an electronic prescription with patient personal information, clinical history, and complete medication history, properly manage the look-alike drug names and packaging, and using validated tools to identify potential risk factors to avoid medication errors in addition to using continuous quality improvement programs in the community pharmacies. إن سلامة الدواء قضية رئيسية ضمن أجندة سلامة المرضى، وإن الأخطاء الدوائية لها العديد من الآثار الجانبية وفي كثير من الأحيان قد تؤثر سلبيا على حياة المرضى. في فلسطين، تعتبر عملية صرف الأدوية هي المهمة الأساسية للصيدلياتالمجتمعية، بما في ذلك جميع الأدوية التي تصرف بدون وصفة طبية. ومع ذلك، فإن جودة الخدمة التي تقدمها الصيدليات المجتمعية في البلدان النامية كثيراً ما كانت موضع تساؤل وغالبًا ما تكون دون المستوى الأمثلولذلك تهدف هذه الدراسة إلى تقييم ممارسات السلامة الدوائية الحالية في الصيدليات المجتمعية داخل قطاع غزة. صممت الدراسة على أنها دراسة مقطعية وصفية تحليله متسلسلة توضيحية (كمي ونوعي) باستخدام الاستبيانات القائمة على المقابلة ومقابلات أصحاب الخبرة كوسيلة لجمع البيانات. تم استخدام عينة عشوائية من مرحلتين بشكل منتظم لتحديد صيدليات المجتمع المؤهلة والمشاركين المؤهلين. كان حجم العينة المحسوب 270 صيدلية، شارك منهم 258 في تعبئة الاستبيانات، وكان معدل الاستجابة 95.5 ٪. تم عمل ملائمة لأداة السلامة الدوائية العالمية MSSA (10 أبعاد) بما يناسب الصيدليات المجتمعية في غزة لجمع البيانات الكمية كان معدل الثبات لأداة الدراسة ممتازًا 0.95.ثم أجريت مقابلات شبه منظمة، وجها لوجه،مسموعة، متعمقة مع سبعة من الصيادلة الذين يعملوا في صيدليات مجتمعية رئيسية ف قطاع غزة،وخمسة من المرضى الذين يعانوا من أمراض مزمنة. تم تحليل المعطيات بواسطة الإصدار 23 من SPSS، وكشفت النتائج أن النتيجة الكلية المتوسطة لممارسات سلامة الدواء كانت مرضية بمعدل 3.20 (64.05٪). وأظهر التحليل أنالبعد الخاص بمعايرة وتخزينوتوزيعالادوية سجل أعلى مستوى من تطبيق ممارسات السلامة الدوائية بمعدل 3.57 (71.44٪)، يليها كفاءة الموظفين وتعليمهم بمعدل 3.55 (71.10٪)، ثم استخدام الأجهزة والمستلزمات الطبية بمعدل 3.51 (70.20٪)، العواملالبيئية، سير العمل،وأنماط التوظيف بمعدل 3.42 (68.44٪)، ثم معلومات الدواء بمعدل 3.33 (66.69٪). بينما كانت أقل درجة كانت في وصف الدواء وتعبئته وتسميته بمعدل 2.69 (53.7٪) ومعلومات المرضى 2.81 (56.2٪). وأظهرت النتائج تباينًا ضئيلًا في ممارسات سلامة الدواء فيما يتعلق بنوع الجنس والعمر والراتب والمؤهلات وخبرات العمل، باستثناء المحافظات والتخصص حيث يؤثر كل منها على الممارسات المتعلقة بسلامة الأدوية كانت قيمة P ˂0.05.ركزت المقابلات بشكل أساسي على شرح نتائج الجزء الكمي واستكشاف الواقع من وجهات نظر أخرى. يمكن التوصية باستخدام أداة التقييم الذاتي لسلامة الدواء (MSSA) لتقييم ممارسات سلامة الدواء داخل الصيدليات المجتمعية.وتوصي الباحثة بشدة باستخدام استراتيجيات تنفيذ متعددة الأوجه تستهدف استخدام طرق الكترونية في تسجيل الوصفة الطبية مع المعلومات الشخصية للمريض، والتاريخ المرضي، وإدارة أسماء الأدوية المتشابهة وتعبئتها بشكل صحيح، واستخدام أدوات تم التحقق منها لتحديد عوامل الخطر المحتملة لتجنب الأخطاء الدوائية بالإضافة إلى استخدام برامج التحسين المستمر للجودة (CQI) في صيدليات المجتمع.
الضغوط النفسية واليات التكيف لدى معلمي المرحلة الثانوية في محافظة رام الله والبيرة
(Al-Quds University, 2020-06-03) سماح وديع عبد الحميد حمودة; Samah Wadea Abed Alhamed Mohammad
The current study aimed to identify the degree of psychological stress and coping mechanisms for secondary school teachers in Ramallah and Al-Bireh Governorate. The study used the relational destrictive method. To achieve this purpose, and to answer study questions and verify the validity of their hypotheses, a questionnaire on psychological stress among teachers was developed and included (28) items, and they were four axes, namely: administrative pressure among teachers, student pressure faced by the teacher, pressure by the teaching, and pressure Which relationships with colleagues. And the questionnaire of mechanisms to adapt to psychological stress and included (28) items, distributed on the axis of the mechanisms that can be used with psychological pressure. Its reliability and validity have been verified. The sample reached (320) from secondary school teachers in Ramallah and Al-Bireh Governorate.The results of the study showed a set of results, including: The degree of psychological stress among secondary school teachers in Ramallah and Al-Bireh Governorate was medium, where the arithmetic average of it reached (3.34), and the results of the level of mechanisms for adapting to psychological pressure among secondary school teachers in Ramallah and Al-Bireh Governorate Medium, with a mean (3.49). The results showed that there are statistically significant differences in the degree of psychological pressure among secondary school teachers and coping mechanisms in Ramallah and Al-Bireh Governorate according to the variable of years of experience, while there are no statistically significant differences according to variables: gender, number of children, type of housing, educational qualification, age Years of experience, specialization, marital status, income, place of residence, number of classes a teacher teaches. The results also showed that there were statistically significant differences in the level of coping mechanisms with psychological stress among secondary school teachers in Ramallah and Al-Bireh Governorate according to the variable of the place of residence, while there were no statistically significant differences according to variables: gender, number of children, type of housing, educational qualification , Age, specialization, marital status, income, place of residence, number of classes the teacher teaches. The study came out with several recommendations, the most important of which are: Establishing programs and activities that include providing psychological, social and economic support to all secondary school teachers in the Ramallah and Al-Bireh governorate, to include all teachers from all disciplines. The study also recommended that the Ministry of Education should pay attention to the mental health of teachers in general, and secondary school teachers in particular by forming a specialized team to study the psychological state of them and provide the necessary reports and recommendations to ensure their mental health.
Quality of Life among Adults With Hearing Impairment in Gaza Governorates
(Al-Quds University, 2020-08-19) Fatma Ali Mosa Ramadan; فاطمة علي موسى رمضان
Background: Hearing impairment is one of the chronic health condition and one of disabilities connected strongly with cognition, self-image, exchanging information and affect Quality of life thus understanding the impact of hearing loss on quality of life is of great importance. Quality of Life has emerged as an important parameter for assessing the challenges among adult with hearing impairment in order to contribute in improvement of their quality of life. Objective: Is to assess QOL among adults with hearing impairment in Gaza Strip. Design and Setting: Descriptive, analytical, cross-sectional study has been performed in 215 adults with hearing impairment aged 19 years and above on follow-up through schools, community organizations are providing services for individuals with hearingdisability. The study was conducted at 6-selected areas which provide services and deal with people with hearing impairment which are distributed at the governorates of the GS; Mostafa Al-Rafeaia Secondery school (Gaza City governorate), Deer Albalah ; Al-Dameer assosiation (Mid Zone governorate), Palestinian Red Croscent Society ; Alamal school and Faculty of Capacity Development (Khan Yunis governorate), Disabled Rehabilitation and Social Training Association (Alamal school at Rafah, Alhanan school at Deer al-Balah, Besan school at Nusirat camp, Jabalia school at Jabalia camp ) and The Center for Disability Services at the Islamic University. After recording the participants’ socioeconomics, demographics and health characteristics, they filled out the WHOQOL-BREF questionnaire and the relationship between various variables and the QOL score was evaluated. Results:The resultsshowed that the mean score of study participants’ QOL was (64.1%). It showed that the psychological dimension had the first rank with the percentage (67.8%), and the environmental field ranked the last with a weighted mean (60%). The results of the study showed that there are statistically significant differences (α ≤ 0.05) between the total quality of life with the variables of the family's level of understanding of the hearing impaired and interacting with them, the variable of the presence of another disability associated with hearing impairment, as well as the variable of using hearing aids such as headphones while it showed that there were no statistically significant differences (α ≥ 0.05) between participants on the total quality of life with the other variables such as sex, age,the level of education, personal status (single, married), the average household income, the extent of commitment to health follow-up, and suffering from any health problem. Moreover, the results of the study showed that hearing difficulties appear in every generation, but their prevalence increases among the elderly. Hearing-impaired persons suffer from emotional, behavioral and adaptive problems with others, which leads to symptoms such as anxiety, depression and confusion, and hearing loss and ear problems such as tinnitus have a negative impact on mental health. Conclusion : The findings demonstrated that participants with hearing impairments had a medium level of perception about their QOL. This study identified common problems and challenges encountered by adults with hearing impairments which now are not assessed regularly in Gaza society. The study has proved a wide effects on self-confidants, social roles and ability to function independently in every field of life , it affect the psychological side in the first place in addition to mental ,and social wellbeing.
Perceptions and Experiences of Sub-fertile Couples Served at the In Vitro Fertilization Centres in the Gaza Strip
(Al-Quds University, 2020-12-20) Shahd Bassam Abu Hamad; شهد بسام أبو حمد
Background: Infertility is a difficult experience with many overwhelming challenges originated from medical, social, financial and psychological factors. This study explores experiences and challenges that infertile/sub-fertile couples face when they utilize in vitro fertilization services in Gaza and flags priority areas for supporting them. Method: The study followed a quantitative, analytical cross-sectional approach. Data were collected from a convenient sample of 320 participants attending In Vitro Fertilization centers in the Gaza Strip. After consenting, a qualified data collection team administered face to face interviews with participants at the centers serving them. The study tool has been constructed by the researcher to incorporate medical, social, psychological and financial dimensions. Tool validation has been done through experts’ review and statistical testing. The SPSS software has been used for data entry, cleaning and analysis. Results: The mean age of respondents was 29.8 years, and the mean age of their husbands was 34.9 years. Despite that 76.6% of husbands are working, almost two thirds of them earn less than New Israeli Shekels 1000; 33.4% reported receiving social assistance, half of them indicated that their monthly income is not sufficient to meet their basic needs. Still, 82.2% didn’t receive any financial support when they seek In Vitro Fertilization services. One average, interviewed participants reported living with their infertility for around 5.5 years, three quarters of them were told about the reason of infertility, among them, 63.3% reported that disturbed spermatogenesis is the reason for couples’ infertility. Two thirds of cases have secondary infertility, 63.4% reported being pregnant before. Of the total surveyed women, 14.7% reported developing health problems attributed to infertility management. Sub-fertile couples reported starting seeking infertility management early, with 40% doing that within less than 1 year of marriage. On average, couples approached around 5 doctors for infertility management and tried two centers, nevertheless, only 13.2% were provided with medical documents that can be used when they approach other centers. More than half (56.9%) of the respondents confirmed visiting a traditional healer. The vast majority of couples reported exposure to social pressure (89.4%), especially by in-laws to conceive which increased their stress. The level of satisfaction reported by respondents about the services received was particularly high (93.34%). More importantly, General Health Questionanire-12 scores indicate significant level of psychosocial stress with one quarter showing signs of psychological distress (using 6 as cut off point) and three quarters reporting psychological distress when using 3 as a cut-off point. The overall quality of life score (wellbeing) was 71%, lower than the general population scores with the social domain eliciting the highest score (79.13%) and the environmental domain eliciting the lowest scores 65.93%. The main challenges facing sub-fertile couples were financial difficulties (91.6%), discrimination (76.6%) especially by in-laws, psychosocial stress (53.1%) and side effects of hormonal therapy (20.6%). Family was the main source of support for sub-fertile couples, as 82% reported being supported by their husbands, 55% by their in-laws and 54.4% by their parents. Psychosocial services are rarely provided at In Vitro Fertilization centers; instead focus was more on hormonal therapy and medical treatments. Conclusion: Sub-fertile couples face numerous challenges and should be better supported financially and psychosocially. Beneficiaries’ rights to get adequate information, counseling and informed choices should be maintained. Regulatory measures to promote and standardize services at IVF centers is a priority. Also, social discriminatorynorms and stigma around infertility should be addressed.
Resistance of Uropathogens at Governmental Hospitals in the Gaza Strip
(Al-Quds University, 2020-12-20) Sameh Attiah Mohammed Alkhodari; سامح عطية محمد الخضري
Misuse and overuse of antimicrobials are considered the main causes of uropathogenic resistance. World Health Organization encouraging countries to implement antimicrobial stewardship programs, for appropriate use of drugs that could minimize drug resistance across time. The overall aim of this study is to determine the occurrence of uropathogens, to explore the pattern of their resistance to antimicrobials and test for difference among gender, age groups, and hospitals. In addition, the study assessed the effect of the implementation of the microbiology standard operating procedure (SOP) and the level of adherence by the laboratories of four governmental hospitals in the Gaza Strip. A retrospective study (from 1/1/2019 to 31/12/2019) examined 11,890 urine culture records of the Microbiology Department of European, Al-Shifa, Al-Nassr, and Al-Durra Hospitals. All data were tabulated and analyzed. Data analysis was performed using SPSS edition 22. Variables were compared using cross-tabulation the statistical tests of significance were performed; chi-square (X2) test, independent T-test, one-way ANOVA test, P-value ≤ .05 was considered statistically significant. Three focus groups, three key informants, seven individual interviews have been conducted and fifteen laboratory technicians responded to a questionnaire. All of them from the microbiology department at the governmental hospitals in the Gaza strip. A semi-structured question the effect and level of adherence to the participants was used.The study was initiated after obtaining a permission from the Helsinki Committee. The findings showed that E. coli was the most common uropathogens in Gaza Strip (59.9%) followed by Klebsiella spp. (24.9). The prevalence of UTI in females is higher than males (71%), however, resistance of isolates to antimicrobials is higher in males. In addition, there is general increased resistance of the isolates against tested antibiotics, which limits the empirical treatment options. Penicillin is no longer suitable for UTI treatment because the microorganism’s resistance against this antibiotic group is closed to 90%. Resistance to ampicillin (92.4%), amoxicillin (91.1%), followed by co-trimoxazole (68.2%), cefalexin (64.9%), doxycycline (61.9%), nalidixic acid (53.6%), cefuroxime (53.0%), ceftriaxone (48.9%), ceftazidime (43.1%), ciprofloxacin (36.9%), gentamicin (25.8%). The least resistance was demonstrated against amikacin (3%) and meropenem (8%). The adherence to the SOP by the staff is high but not perfect and requires follow up by laboratory administration. Furthermore, there is no integration between the physician protocol and laboratory SOP. In conclusion, the resistance of uropathogens varied from one hospital to another, among gender and among age groups. Factors contributing to the increasing resistance in general and at Al-Shifa Hospital in particular should be investigated in further studies. There is a need for an antimicrobial stewardship program to prevent exacerbation of the problem, and decrease MDR in the community. In addition, SOP needs more follow up and integration with all of the other hospital departments. Keywords: Uropathogens, Antimicrobial resistance, Urinary tract infection, Gaza strip, Palestine
The Relationship between Learning Organization and Organizational Survival in Non-Governmental Organizations in the Gaza Strip
(Al-Quds University, 2021-01-09) Mohammed Fadel Khaled Ashour; محمد فضل خالد عاشور
The uncertainty and different challenges in the world today have made it difficult for the Non-governmental organizations to respond fast to the unexpected and change environment. Only those organizations that can adapt to these fast changes have a chance of survival because these changes force the organization to pursue best practices to achieve success. This study aims to assess the relationship between learning organization and organizational survival at Patient's Friends' Benevolent Society in the Gaza Strip. The design of this study is an analytical descriptive study through quantitative data. It is a census survey, where the sample includes all healthcare providers at the Patient's Friends Benevolent Society, the total numbers of the respondent are 150. A self-report structure questionnaire was used in this study. To measure the validity of the instrument, the questionnaire was submitted to a group of expert persons to evaluate the face and content validity, and internal consistency was done. To measure the reliability of the instrument, the researcher used the Cronbach alpha coefficient. The values of Cronbach's Alpha were in the range of 0.848 and 0.925, which indicates good reliability of the entire questionnaire. The result of the correlation analysis showed that there is a positive significant relationship between learning organization dimensions and organizational survival domains, and the result of the regression showed that learning organization has a significant effect on organizational survival (R Square of 0.736, p-value=0.000). The results revealed that the learning organization's dimensions and organizational survival domains in Patients Friends Benevolent Society are profitable to a moderate degree with weight-mean 59.60% and 57.40% respectively. The results of multivariate analysis showed there is a relationship between socio-demographic characteristics and learning organization and organizational survival toward educational level (F = 3.409, P = 0.029), years of services (F = 3.656, P = 0.014), specializations (F = 2.317, P = 0.037), and the training courses (T =2.386, P =0.019). The study concluded that adopting the learning organization helps the organization to be innovative, adaptive, and encourages employee empowerment which increases the chance of survival. The availability degree of the learning organization dimensions and organizational survival domains reflect there is a negative indicator and need more attention from decision-makers. The study recommends the Non-Governmental Organizations to adopt the learning organization approach to obtain diverse strategies that enhancing their survival. Also, the study recommends the Patient's Friends Benevolent Society to implement training and educational programs for employees that are concerned with the steps, methods, and skills that enable them to reach the learning organization approach to increase the chance of organizational survival.
Assessment of exposure to quarries and pulmonary function among quarry workers in Beit Fajjar village
(Al-Quds University, 2021-05-25) Aya Ali Hasan Taqatqa; آية علي حسن طقاطقة
Assessment of exposure to quarries and pulmonary function among quarry workers in Beit Fajjar village. Background: Occupational health has been defined as ―Promotion and maintenance of the highest degree of physical, mental and social well - being of workers in all occupations; (WHO, 2012). Workers in the quarry industry face numerous risks emerging from airborne particulate inhalation, and thisexposure mightpose a major health and safety concern. Aim: This study aims to identify theassessment of exposuretothe quarry industry and pulmonary function among quarry workers in BeitFajjar-Palestine. Methodology: A descriptive cross-sectional study was conducted in 2020, with a sample of 200 quarry workersthat were conveniently recruited for this study. Data was collected bya data collection sheet, which included personal information of the workers;years of work for workers, and other personal variables, in addition to the ―questionnaire”that is used for chronic respiratory illness assessmentin Epidemiological Research‖.Spirometer device was used in this study to measure the lung functions with main concentration on three parameters: Forced Vital Capacity (FVC), Forced expiratory volume in 1st second (FEV1), and FEV1% (FEV1/FVCV). Results: All of the participants weremale at the worker site. Workers ‗agewasbetween 20 to 50years. Most of participants (77%) did not use personal protective equipment (PPE). 92 percent of the study participants work in quarries for more than 35 hours a week, meaning that the majority of them are at risk of inhaling quarry dust. 77% of the study sample is a smoker, which is a high prevalence. The most common reported respiratory symptoms by the participant were having cough and shortness of breath. Normal lung function test was among only 30% of respondents. Decreased pulmonary function was found among a significant percentage of the industry workers, 48% was found to have a moderate to a severe decrease in FCV, and 31% had a moderate to a severe decrease in FEV1, and 45% had moderate to severe decrease FEV1%. VIII By using independent sample t-test, there was no significant difference in mean FEV1 and FEV1% upon using protective equipment kit, smoking, family history of respiratory disease, worker‘s history of respiratory disease diagnosis, presence of shortness of breath, cough, nasal congestion, and educational level ( p > 0.05), While there was a statistically significant difference of mean FEV1% for the favor of workers without wheezing (88.5 % ) as compared to those who reported wheezing (81.1% )(P = 0.002) . In correlation demographic and work-related variables with FEV1 and FEV1% there was no statistically significant correlation between FEV1, FEV1% and Age, practical, and total working hours per week (p > 0.05). And there is a statistically significant difference of mean FEV1% upon the work place, with favor for the stone crushing industry workers (with FEV1% 89.4%) as compared to the stone pits (with FEV1% of 83.7%). By using multivariate stepwise regression the model revealed that practical experience is the only predictor of FEV1, with very weak R2, justifying nearly 2% of the variation in the dependent variable (FEV1) which is considered a very weak explanation of the variation in the dependent variable and working place represented in the stone pit or crushing is the only significant predictor of FEV1%, in favor for stone crushing facility workers (89.41%, SD 10.47%) as compared to stone pits (83.76%, SD 16.73%), with a very weak explanation of the variation of the dependent variable R2 (0,041). Conclusion: This study showed chronic exposure to quarry dust was associated with deterioration of lung function indicated by reduced lung function indices among quarry workers. This finding reflects the need for periodic evaluation of lung function to help in preventing any deterioration in the respiratory health of these workers. Also, it emphasizes the need for advocacy that will drive the responsible body for this occupation to put clear legislations and enforce these workers to wear the proper PPEs. IX ملخص
Emotional Intelligence and its Relationship with Job Stress and Organizational Commitment among Nurses in Governmental Hospitals in the Gaza Strip.
(Al-Quds University, 2021-05-31) Mohammed Kamel AL Asmar; محمد كامل الأسمر
Nursing is a stressful profession and nurses face multiple stressors in their work environment daily and continuously. Emotional Intelligence had a very important effect on job stress and organizational commitment. This study aims to identify the role of emotional intelligence and its relationship with job stress and organizational commitment among nurses in governmental hospitals in the Gaza Strip. This study is quantitative, descriptive cross sectional design; 318 nurses completed self-administered questionnaire from 340 with 93.5% response rate. Sample was selected using a stratified proportionate random sample from five governmental hospitals. The researcher used international scales for emotional intelligence, organizational commitment and nursing stress scale. Data were analyzed by SPSS using a variety of descriptive and inferential statistics including independent sample t-test, one-way ANOVA, Pearson correlation test, and Multiple Linear Regression were performed at a significance level of P-value < 0.05. Findings showed thatthere is a significant positive relationship between participants’ emotional intelligence and their job stress (R Square = 0.116, p-value=0.039), The results revealed that there is no significant relationship between participants’ emotional intelligence and their organizational commitment (R Square = 0.109, p-value=0.052), and that there is a significant inverse relationship between participants’ job stress and their organizational commitment (R Square = -0.179, p-value=0.001). The results revealed that the high scores in emotional intelligence, organizational commitment and nursing stressors frequency & severity, 59.7%, 68.2% and 47.0% &87.5% respectively. For emotional intelligence dimensions; motivation domain scored the highest (69.25%). Regarding organizational commitment dimensions; normative commitment scored the highest (69.80%). With regard to nursing stressor frequency; workload domain scored the highest (51.5%). In addition, the highest nursing stressor severity was noted is “Uncertainty concerning treatment” (94.5%). Additionally, there is a relationship between socio-demographic characteristics and emotional intelligence toward years of experience (F = 6.072, P = 0.000), salary (F = 2.897, P = 0.035) and educational level (F = 4.521, P = 0.001). Also there is a relationship between socio-demographic characteristics and organizational commitment: age (F = 3.620, P = 0.007), marital status (F = 4.376, P = 0.005), salary (F = 3.211, P = 0.023) and years of experience (F = 11.466, P = 0.000). Finally, the study concludes that contribute of nurses’ job stress and emotional intelligence to their organizational commitment, which showed that an increase in job stress among nurses, leads to a decrease in the organizational commitment by (76.0%). Moreover, with an increase in the nurses’ empathy, their organizational commitment increases by (14.9%) and with an increase in the nurses’ self-awareness, also their organizational commitment increases by (11.7%).
Knowledge, attitudes and practices of mental healthcare providers regarding the evidence-based practice in the Gaza Strip
(Al-Quds University, 2021-06-05) Sally Suhail Ibrahim Saleh; سالي سهيل إبراهيم صالح
Evidence-based practice is spreading in many healthcare disciplines. One of its main features is the reliance on the partnership among the three fundamental components, the best research evidence, the clinician expertise, and the client preference. This study is a mixed method one that includes both quantitative and qualitative components. A total of 135 participants (66 men, 69 women) participated in the quantitative part with a response rate of 83.3%, and 10 participants joined the qualitative part. The quantitative component followed the census approach in which the researcher recruited all the mental healthcare providers in the Gaza Strip. The method of sampling for the qualitative part was purposive sampling. The quantitative data was collected via online questionnaire. The qualitative data was collected through face-to-face interviews. The reliability of the total scale is very good as the alpha Cronbach= 0.756. The quantitative data was analyzed using the SPSS software by conducting descriptive, frequency, and inferential statistics. The qualitative data was analyzed via the content thematic analysis using the NVivo software to find out the most common themes and codes. Findings show that those who had up to bachelor degree represented 37.7% of the respondents, and those who had postgraduate studies represented 62.3%. Most of the participants (78.5%) were graduated from local universities, and 77.8% of the participants were working in technical positions. The results show that 81.5% of the participants used the evidence- based practice during the daily practice, but the frequency and the sources of evidence were not sufficient. The overall knowledge score among the participants was 66.05% and the overall attitude score toward the evidence- based practice was 60.76%. The overall practice score was 71.27%, but the actual implementation was not good enough. The qualitative results showed that the knowledge, attitudes and practices are not systematic nor sufficient to fulfil the mental health needs. In addition, they were humble and depended on personal motives mainly. The institutional factors were obvious in inhibiting the evidence- based practice due to the lack of sufficient infrastructure, poor system for the evidence- based practice, lack of policies, unsupportive management, and poor culture. The institutional barriers to implement the evidence- based practice included lack of policies, and absence of good appraisal system. The individual barriers to implement the evidence- based practice included poor research and statistical analysis skills and lack of knowledge about the evidence- based practice and its significance. The inferential statistics show that there were no significant differences in relation to the age, residency, profession, type of university or the profession type indicating that issues around evidence-based is a cross-the-board. The study concluded that the knowledge, attitudes, and practices about the evidence- based practice needs further improvement and development through initiating supporting policies and strategies that promote the use of evidence base in daily practices.

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