Policies & Health Management

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Assessment of the effects of the internet and social media use on work performance of physicians and nurses at the hospitals in the south of Palestine
(Al-Quds University, 2020-07-26) Nida' Fayez Iamael Hamamdeh; نداء فايز اسماعيل حمامدة
Background: The internet and social media applications in the workplace have increased dramatically. It has both beneficial and harmful effects. Also, it seems to be the tool that affects the job performance in workplace. Aim: This study was conducted to assess the beneficial and harmful effects of internet and social media applications use at workplace on work performance of physicians and nurses in the major referral hospitals in Hebron and Bethlehem cities. Methodology: A cross sectional study was conducted by using self-reported questionnaires: the socio-demographic data sheet, Work related Social Media Questionnaire (WSMQ) and William Anderson Work Performance Scale. The sample of the study included 409 participants (169 physicians and 240 nurses) from four hospitals in Hebron and Bethlehem cities which were Hebron Governmental Hospital, Al- Ahli Hospital, Beit-Jala Hospital and Arab Society for Rehabilitation. Results: Pearson correlation test showed a weak positive statistically significant relationship was found between the WSMQ and William Anderson Work Performance Scale(r=0.198؛ p=.000). On other hand, the findings revealed that the overall mean score for WSMQ was high (mean score 3.57), and the higher mean was for the beneficial WSMQ (mean score 3.17) compared with (2.08) for the harmful WSMQ. The mean for William Anderson Work Performance scale was moderate Performance (3.35), the higher mean was for Organizational Citizenship Behavior-Individual(OCBI) (3.68) followed by In Role-Behavior (IRB) with a mean of (3.24) and the lowest was for Organizational Citizenship Behavior-Organization (OCBO) with a mean of (3.15). Further, the study results showed that the independent variables such as monthly income, specialization, professional title, the devices used to access internet and social media applications and the network used to access internet and social media applications had significant relationships with WSMQ. In addition, the findings showed that gender, marital status and monthly income, employment status, had obstacles that prevented from using internet and social media applications which showed significant relationships with work performance. Multiple linear regression analysis revealed that only specialization had a statistically significant relationship with WSMQ and gender, employment status, and had obstacles prevented from using internet and social media applications were a statistically significant relationships with the work performance. Linear regression revealed that there was a significant linear relationship between social media and work performance (P-value=0.000). Conclusion: This study revealed that there is a weak positive statistically significant relationship between the internet and social media applications and work Performance in workplace among Palestinian doctors and nurses. However, the beneficial effects of social media was higher than harmful in the workplace and the mean for William Anderson Work Performance scale was moderate (3.35). Therefore, the Palestinian health care professionals should be encouraged to use internet and social media applications to improve health outcomes, develop a professional network, increase awareness of new discoveries, and provide health information to the community other than communication. Also, the administrative staff and policy makers in the Palestinian hospitals should regulate the use of internet and social media applications in hospitals by developing a clear policy for their use in the hospitals
Cost Benefit Analysis of Clinical Pharmacist Interventions in MICU: Prospective Interventional Study
(Al-Quds University, 2020-08-02) Asil K.M. Houso; اسيل خالد محمود حوسو
Background: Clinical pharmacy services in the critical care settings have expanded dramatically, they transitioned from dispensing to proactive interventions that yield positive clinical, humanistic and economic impact on patient care and health care institutions. Study problem and justification: Clinical pharmacy services have limited implementation in Palestine. Many intensive care units (ICUs) patients do not get the intended beneficial effects of their treatment due to administration of unnecessary medication and the consequent huge cost burden. These can be reduced by CP interventions within the national context, which needs to be evaluated. Aim: To evaluate the impact of the clinical pharmacist interventions on costs of care and safety of patient by assessing treatment related problems among medical intensive care units` patients in Palestine. Methodology: A prospective interventional study at medical ICU of the major public hospital in Ramallah district was conducted over a 4-month period (between September and December 2020). Patients were randomly assigned to either an intervention (with clinical pharmacist involvement) or a control group (without cp involvement). Treatment related problems were identified in both study groups by the clinical pharmacist, but interventions were only provided to the intervention group. The total economic benefit included both cost savings from intervention and cost avoidance from preventable adverse drug events (ADEs) resulted from CP interventions. The primary outcomes with the clinical pharmacist interventions were net benefit and benefit to cost ratio , which were calculated using previously published methodologies and adjusted to the Palestinian settings . The analysis of CP interventions acceptance by physicians was performed. Results: During the 4-month study period, the 117 patients admitted to the ICU were included into the analysis; 66 patients in the intervention group and 51 in the control group. The interventions made by a clinical pharmacist resulted in direct cost saving of NIS16,195.32 and cost avoidance of NIS22,087.5. Translated into a net savings of NIS232 per intervention and NIS580 per patient. Comparison of benefits (NIS38,282.82) and costs (NIS19,877.65) indicate a net economic benefit to the institution of (NIS 18,405.17) and a benefit cost ratio of 1.93. Conclusion: This prospective interventional study documented the significant role of a clinical pharmacist in a multidisciplinary ICU team. Despite using a conservative approach, integrating a clinical pharmacist in the ICU team was investment that resulted in cost saving and cost avoidance. With further formalizing clinical pharmacy services at hospitals and integrating the clinical pharmacist as a part of the critical care team, an even higher economic benefit is anticipated الخلفية: توسعت خدمات الصيدلة السريرية في قسم العناية الطبية المكثفة بشكل كبير، إذ انتقلت من صرف الأدوية إلى التدخلات الصيدلانية السريرية الاستباقية ذات التأثير الإيجابي من الناحية السريرية والإنسانية والاقتصادية على رعاية وصحة المرضى والمؤسسات الصحية. مشكلة وتبرير الدراسة: يتم تنفيذ القليل من خدمات الصيدلة السريرية في فلسطين وخاصة في اقسام العناية الطبية المكثفة. ولا يتلقى العديد من مرضى العناية المكثفة الفوائد المرجوّة من علاجهم بسبب المشاكل المتعلقة بالعلاج التي تسبب معاناة لا داعي لها وتكاليف مالية ضخمة بسبب عدم توفر صيدلاني سريري ضمن فريق العلاج. الهدف من الدراسة: : تهدف الدراسة إلى تقييم توفير التكلفة لتدخلات الصيدلي السريري في حل المشاكل المتعلقة بالعلاجات المقدمة لمرضى العناية الطبية المكثفة. طرق البحث: أجريت دراسة متابعة و تدخل في قسم العناية الطبية المكثفة في مجمع فلسطين الطبي -رام الله على مدى أربعة شهور. تم اختيار وتوزيع المرضى على مجموعتين، مجموعة تدخل ومجموعة مراقبة من قبل الصيدلاني السريري المعالج. تم تحديد المشاكل المتعلقة بالعلاج في كلتا المجموعتين، ولكن تم تقديم التدخلات الصيدلانية العلاجية فقط لمجموعة التدخل. كان إجمالي الفوائد الاقتصادية على النحو التالي: (أ) التوفير في التكاليف نتيجة تدخل الصيدلي السريري. (ب) تجنب التكاليف المتعلقة بالآثار الجانبية للعقاقير الممكن تجنبها. وكانت مقاييس النتائج الأولية هي صافي التكلفة مع تدخلات الصيدلي السريري والتي تم حسابها باستخدام منهجيات منشورة سابقًا وتم تعديلها لتلائم السياق الفلسطيني. تم تحليل قبول الأطباء لتلك التدخلات لبيان الأثر العلاجي للتدخلات الصيدلانية السريرية. نتائج البحث: خلال فترة الدراسة التى استمرت أربعة أشهر، تم إدخال ١١٧ مريضًا إلى وحدة العناية المكثفة، وتم إدراجهم جميعًا في الدراسة، منهم ٦٦ مريضًا لمجموعة التدخل و٥١ مريضًا لمجموعة المراقبة. خلال فترة الدراسة، نتج عن تدخل الصيدلي السريري توفير مباشر في التكاليف المالية بمبلغ يقدر ب ١٦١٩٥.٣٢ شيقلًا ، وتجنب تكلفة بمبلغ مقداره ٢٢٠٨٧ شيقلًا ،. وبلغ مجموع التوفير۲۳۲ شيقلا لكل تدخل وتوفير بمقدار٥۸۰ شيقلا لكل مريض. من خلال مقارنة الفوائد الاقتصادية ٣٨٢٨٢.٨٢ شيقلًا الى التكلفة ٦٥. ۱۹,۸۷۷ بلغ صافي التوفير ٤۰٥ ,۱۸شيقلًا وبلغت نسبة الفوائد إلى التكلفة ١.٩٣. الخلاصة: على الرغم من استخدام منهج محافظ في جميع التصورات المحتملة، فإن إدماج الصيدلي السريري في فريق العناية الطبية المكثفة كان ذا فائدة اقتصادية من حيث توفير التكلفة المباشرة، وتجنب التكاليف غير المباشرة. ومن المتوقع أن يكون هناك فائدة اقتصادية أعلى من ذلك إذا ما تم اعتماد خدمة الصيدلة السريرية في المستشفيات بشكل رسمي، وتوظيف الصيدلي السريري كعضو بفريق العناية الطبية المكثفة.
determinants of oral health behaviors among adolescents in jerusalem
(Al-Quds University, 2013-06-02) Heba Mohammed Al Kafrawe; هبة محمد الكفراوي
Evaluation of Telemedicine Services at UNRWA Health Centers in Gaza
( Al-Quds University, 2023-08-22) Faten Abd Al-Aziz Mohammed Abo Amra ; فاتن عبد العزيز محمد ابو عمرة
Introduction: Recently, greater attention has been given to information technology, telecommunications, and their use in health care. This study aims to evaluate telemedicine services at UNRWA health centers in the Gaza Strip in order to identify opportunities to enhance the quality of these services, which optimally might contribute to better health outcomes.Methods: A mixed-methods approach was used, in which data were triangulated. In total, 400 randomly selected (systematic sampling approach) clients-attendants of health centers- and 197 care providers participated in the quantitative part of the study. In addition, three focus group discussions with clients, three focus group discussions with care providers, and three key informant interviews were conducted with purposively selected participants. Quantitative data from clients was collected through an interviewed questionnaire, and an online survey has been administered with service providers. The preliminary findings derived from the quantitative part have been used to inform the qualitative data collection. The Statistical Package for Social Sciences software was used for the quantitative data entry and analysis, while the Open Coding Thematic technique was used to analyze the qualitative data.Findings: Results showed that the majority of clients who responded were females (76.3%), 85.2% of respondents had heard of telemedicine before, and 71.8% of participants have used telemedicine. Almost all participants who used telemedicine reported satisfaction with their interactions with service providers. The phone lines always being busy and the excessive waiting times were the major challenges facing clients when using telemedicine services, as reported by them. The majority of clients (95%) used telemedicine services to get medical treatment. Findings revealed that 35.9% of respondents agreed to a high extent and 37.7% agreed to some extent that telemedicine services save their money, and 96.1% agreed that telemedicine has improved access to health services. The vast majority of clients surveyed (95%) reported that the use of telemedicine has shortened their waiting time. Moreover, the majority of respondents (87.5%) believed that telemedicine had a positive effect on their health status and the health of their families. Findings from the service provider survey indicate that care providers were split almost evenly between males and females (50.8% and 49.2%, respectively), and of them, 59.4% had received on-the-job training on telemedicine. Most care providers who filled out the online survey (83.2%) offered telemedicine at least once. Three quarters of service providers reported that telemedicine is effective. However, only 27% of respondents indicated that they trusted the diagnosis that is being made remotely. Service providers reported that telemedicine consultations were made mainly to get medical advice (66.6%) and to inquire about the availability of services (50.3%). Pediatric diseases such as colds, gastroenteritis, and feeding difficulties (89.3%) and general diseases such as rash, musculoskeletal problems, and motor-neuron diseases (77.2%) were the most frequently reported medical conditions that were treated via telemedicine; all are according to the service providers’ responses. The results of the qualitative interviews were congruent with the quantitative findings and provided further illumination and in-depth insights. With regard to statistical significance, males and educated participants were more likely to know about telemedicine services, and people who knew about telemedicine used it more often. Health care providers who received training on telemedicine are more likely to use this type of service. Conclusions: The study underscores the important positive contributions of telemedicine services that can be scaled up to be part of routine services in emergencies and regular times alike. There is a need to further develop protocols and service guidelines in order to better standardize telemedicine services and to intensify training followed by supervision and rigorous follow-up.
evaluation of the quality of cardiac care services at the european Gaza hospital
(Al-Quds University, 2015-11-30) Abdul Latif Mohammad Alhaj; عبد اللطيف محمد الحاج
Healthcare Providers and Beneficiaries’ Perspectives about Patient Safety at UNRWA Health Centers in Gaza
(Al Quds University , 2023-01-16) Samy Soliman Ali Abu Shawish; سامي سليمان علي أبو شاويش
مقدمة: تعتبر سلامة المرضى ذات أهمية قصوى في المشهد الطبي الحديث. يمكن أن يكون لمواقف مقدمي الرعاية الصحية تجاه سلامة المرضى تأثير كبير على نتائج المرضى. عندما توجد ثقافة عمل مشتركة، والتي تعترف وتؤسس أنظمة للحد من المخاطر، وكذلك التعلم من الأخطاء، يمكن أن تؤدي إلى نتائج أفضل للمرضى. على العكس من ذلك، عند وجود مواقف سلبية، مثل عدم الاعتراف بالمخاطر المحتملة والموقف القائل بأن سلامة المريض هي مسؤولية فردية، يمكن أن يكون لذلك تأثير ضار على نتائج المرضى. وكذلك المرضى جزء لا يتجزأ من ضمان سلامتهم أثناء العلاج الطبي. من خلال إدراك حقوقهم ومسؤولياتهم، فضلاً عن المخاطر المحتملة المرتبطة بالإجراءات الطبية، يمكن للمرضى التأكد من أن رعايتهم على أعلى مستوى من الجودة والسلامة. لذلك، تم تحديد ثقافة سلامة المرضى كعنصر حاسم في جودة الرعاية الصحية في الرعاية الصحية. أهداف الدراسة: تستكشف هذه الدراسة تصورات مقدمي الرعاية الصحية والمستفيدين لسلامة المرضى في مراكز الأونروا الصحية في غزة كخطوة نحو تحسين سلامة الخدمات الصحية من خلال تحديد ومعالجة الثغرات المتعلقة بالسلامة. 1. لتقييم تصورات الموظفين تجاه ثقافة السلامة في مراكز الأونروا الصحية في غزة. 2. لاستكشاف تصورات وتجارب المستفيدين حول سلامة المرضى في مراكز الأونروا الصحية في غزة. 3. لاستكشاف محددات ثقافة السلامة في مراكز الأونروا الصحية في غزة من خلال تجارب المستفيدين. 4. تحديد الإجراءات الممكنة لتحسين الممارسة الخاصة بسلامة المرضى في مراكز الأونروا الصحية في غزة. المنهجية: تم في هذه الدراسة استخدام نهج مختلط، حيث تم تثليث البيانات (الكمية والنوعية)، وتستهدف مقدمي الرعاية الصحية والمستفيدين في مراكز الصحة الأولية التابعة للأونروا في قطاع غزة. تم إجراء الجزء الكمي من الدراسة لمقدمي الرعاية الصحية (مدراء المراكز الصحية والأطباء المتخصصين والأطباء العامين وأطباء الأسنان والحكماء والممرضين العمليين والقابلات وفنيي المختبرات وفنيي الأشعة السينية وأخصائيين العلاج الطبيعي والصيادلة) إجمالاً، قام 259 مشاركاً من 6 مراكز صحية تابعة للأونروا تم اختيارها عشوائياً بملء استبيان الدراسة الذي تم تطويره بناءً على استبيان مواقف السلامة (SAQ)؛ بمعدل استجابة 95٪. تم إجراء الاستطلاع ذاتيًا وتم جمع البيانات في الفترة ما بين مايو 2022 إلى يونيو 2022. تم إدخال البيانات وتحليلها باستخدام الإصدار 25 من برنامج الإحصاء SPSS. وفي الجزء النوعي من الدراسة، تم تنفيذه من خلال إجراء تسع مناقشات جماعية مركزة. تم إجراؤها في ثلاثة مراكز صحية وتم اختيارها باستخدام العينات العشوائية الطبقية. تم جمع البيانات النوعية في أغسطس 2022. استخدم الباحث أسئلة مفتوحة في مجموعات التركيز، وحصل الباحث على النتائج الرئيسية من نصوص مجموعات التركيز. ثم تصنيف الأفكار ذات الصلة وتحليل النتائج النوعية. أهم النتائج: تظهر نتيجة الدراسة الكمية أن معظم المشاركين كانوا من الإناث بنسبة 63٪. فيما يتعلق بالعمل في مراكز الأونروا الصحية، 55.2٪ من المستجوبين عملوا حتى 10 سنوات. 26.6٪ لديهم خبرة عملية من 10 إلى 20 سنة، وحوالي 18٪ عملوا لأكثر من 20 سنة. وكشفت النتائج أن 6.6٪ من مقدمي الرعاية الصحية يعتقدون أن سلامة المرضى في مراكزهم الصحية مقبولة، و46.3٪ جيدة جدا، و47.1٪ ممتازة. قيمت الدراسة ستة أبعاد تشكل أساس ثقافة سلامة المرضى في مؤسسات الرعاية الصحية. حصل مجال الرضا الوظيفي على استجابة إيجابية مذهلة بلغت 79.2٪، وهي أعلى نسبة من جميع الدرجات. بالإضافة إلى ذلك، تلقى مجال مناخ العمل الجماعي استجابة إيجابية ساحقة بلغت 77.5٪، متجاوزة نتائج الدراسات التي أجريت في مصر وتونس ومراكز الرعاية الصحية الأولية الحكومية في غزة. بينما كان مجال ظروف العمل هو أضعف مجال مناخي آمن وحصل على 61.9٪ من ردود المشاركين الإيجابية. أظهرت النتائج أن النتيجة الإجمالية لجميع المجالات كانت 73.1٪ أعلى تقريبًا من النتائج التي تم الإبلاغ عنها سابقًا في مستشفيات غزة. تراوحت أبعاد ثقافة السلامة من 60٪ إلى 70٪ من الردود الإيجابية. كشفت النتائج عن مستوى منخفض من الإبلاغ عن الأحداث، ما يقرب من 79.9 ٪ من المشاركين لم يسجلوا أي أحداث سلبية، وأفاد 13.9 ٪ منهم ما بين 1 إلى 2 من الأحداث السلبية، و6.2 ٪ فقط أبلغوا عن ثلاثة أحداث أو أكثر. كما أظهرت نتائج الدراسة النوعية أن معظم المشاركين أظهروا وعياً جيداً بمفهوم السلامة من خلال تجارهم الشخصية، وكذلك بالعوامل التي تؤثر على سلامة المريض والتي كانت مرتبطة بأربعة محددات حسب تصورات المشاركين: المريض، مقدم الرعاية الصحية، جودة الاتصال بين المريض. ومقدم الرعاية الصحية والنظام الصحي. الخلاصة والتوصيات: تقع تصورات مقدمي الرعاية الصحية لثقافة السلامة ضمن المستوى المقبول، وقد تم تحديد مجالات سلامة معينة للتحسين المحتمل. لتحسين الوضع في مراكز الأونروا الصحية، كما أظهرت النتائج ضرورة التركيز على تعزيز الإبلاغ عن الأحداث السلبية. أيضًا أهمية توفير التدريب على سلامة المرضى لمقدمي الرعاية الصحية كجزء من البرامج التعليمية في مراكز الأونروا الصحية. علاوة على ذلك، أهمية تعزيز وتحسين مهارات الاتصال بين مقدمي الرعاية الصحية والمستفيدين، على أساس الاحترام والمصداقية والسرية لضمان رعاية صحية متكاملة وآمنة وذات جودة عالية.
Isolation and Identification of Bacteria from Stored Soil Samples
(Al-Quds University, 2020-12-06) Sajeda Saleh Yousef Nojoum; ساجدة صالح يوسف نجوم
Soil microbial population is large and diverse, and it is affected by biotic factors such as soil type and climate changes. Interaction of various amounts of water, sunlight, nutrients, temperature and acidity are important determinants of the numbers and types of microorganisms in specific portion of soil. Bacillus specie are ubiquitous in soils and are characterized with their ability to form endospores within cells that provides high resistance to desiccation, heat and chemicals. In this study, thirteen different types of stored soils were used to isolate and identify 16S rDNA of bacteria species that have survived for several years in plastic bags at room temperature using Universal Method based on utilizing the Golden Mixture7 (G7) which used from previous study. Different types of bacterial genera/species in stored soil samples were identified as; Lysinibacillus fusiformis strain WS1-3, Bacillus sp. (in: Bacteria) strain CM-CNRG 602, Peribacillus asahii strain OM18, Bacillus cereus strain BCd16, Bacillus cereus strain BHU4, Bacillus amyloliquefaciens strain CS13, Bacillus subtilis strain UIS0380, Lysinibacillus fusiformis strain P-R2A48, Bacillus cereus strain NCIM2157, Bacillus safensis strain MUGA119 with sequence similarities  98%. The presence of bacilli in stored soil samples and the rarity of other types of bacteria including Gram-negative bacteria indicated that spore formers bacteria may dominate since they resisted environmental stress and could persist for many years until suitable environment is available. Depending on results of this study, a numbers of Bacillus spp. were identified in different samples of soil which were stored for several years. This indicated that most common type of bacteria that can live in stored soils for long period of time are Bacillus Spp. The absence of less tolerant species in stored soils for years under aerobic condition may have resulted in the death of these species which are usually present in fresh soil samples while retaining the endospore-forming species.
Nurses' Satisfaction and its Effect on Job Performance: Comparative Study between Joint Commission International Accredited and Non-accredited Palestinian Hospitals
(Al-Quds University, 2023-05-21) Mohammad Husni Mohammad Hamed; محمد حسني محمد حامد
Background: Nurses' job satisfaction and performance have become more important in recent years as a metric for gauging the success of healthcare organizations in implementing their long-term strategy. Several factors contribute to an individual’s job satisfaction, including but not limited to those of a psychological, physiological, and environmental nature. In the literature, there is a strong relationship between job satisfaction and nurses' job performance. Job performance is the most challenging for healthcare organizations because it is inseparably linked to the patient's safety through knowledge, productivity, effectiveness, management, and quality of care. Methods: A quantitative-based, cross-sectional descriptive design was utilized in 2022 to compare the job satisfaction and performance of nurses in two private Palestinian Hospitals. The data was collected from 217 nurses, representing 53.7% of the total targeted population of 404. The data were collected through two self-administered questionnaires and analyzed using SPSS version 28. Results: When comparing JCI-accredited and Non-accredited hospitals, the results indicate a significant correlation between nurses' job satisfaction and performance level. Overall the nurses have a moderate satisfaction level in both hospitals with a total mean equal to (3.43) with a standard deviation (0.96). However, the Accredited hospital has a higher mean of job satisfaction (3.47) compared to (3.38) for the Non-accredited hospital. Moreover, the nurses have a high-performance level in both hospitals with a total mean equal to (3.65) and a standard deviation (0.84). However, the Non-accredited hospital has a slightly higher mean performance level (3.67) compared to (3.64) the accredited hospital. Therefore, there are no statistically significant differences between the JCI accreditation status and nurse ratings of work satisfaction and performance. The results showed that there are statistically significant differences in nurses' job performance in JCI-accredited hospitals related to the hospital Experience, and Educational Degree with P-value equal (0.007, 0.035) respectively. However, the nurse's job satisfaction in the non-accredited hospitals has significant differences related to Gender with a P-value of 0.023. Conclusion: There were no statistically significant differences between nurses' job satisfaction or performance based on hospitals' accreditation status. The results demonstrate the importance of nurses' satisfaction and their performance in ensuring the quality of healthcare organizations' services and health system excellence.
Occupational Hazards Among Anesthesia Staff in Palestinian Governmental Hospitals in the West Bank
(Al-Quds University, 2021-08-03) Basher Mahmud Islem Alamleh; بشير محمود العمله
Background: Anesthesia staff exposed to many occupational hazards while being in the workplace. These risks are divided into biological, chemical, psychosocial, physical, and ergonomic risks. Purpose: The study aims to identify the types of occupational hazards and the factors that affect these hazards among the anesthesia staff in the Palestinian governmental hospitals in the West Bank. Methods: A descriptive-analytical cross-sectional study was conducted using a self-administered questionnaire. The Study participants consist of all anesthesia staff who works in the governmental hospitals which include operating rooms in the West Bank. Study period includes 184 workers; 161 responded to the questionnaire, with a response rate of 87%. Results: The reported results indicate that more than half of the participants were exposed to occupational hazards at a moderate level regardless of their types (63.2%). The highest reported percentages of the type of occupational hazards the participants exposed to were the biological hazards (63.2%), followed by chemical (60.1%), physical (57.17%), psychosocial (56.49%), and ergonomic hazard (56.40%). Besides, biological and chemical hazards were among the more severe compared to other hazards (58.9%, 58.7%), respectively, followed by physical (57.17%), psychosocial (56.49%), and ergonomic hazards (56.40%). Also, the results indicate that the most prevalent occupational hazards that participants reported being exposed to was the exposure to ionizing radiation by exposure to x-ray (76.4%), followed by exposure to inhalation of anesthesia gases (70.31%), and then exposure to the fluids and blood-borne that comes out from the patients (69.94%). The study results showed that the level of awareness and knowledge of the staff of the risk of occupational hazards was high (80.62%). However, the availability of the safety measures was at a moderate level (64.92%). The study results found that there is no significant relationship between the means of exposure to occupational hazards, staff awareness, availability of safety measures, and (gender, marital state, primary work location, monthly income, education level, and job position) variables. In comparison, there were significant differences between the means of exposure to occupational hazards and age in favor of the age category (36 – 45). Also, it founded that there are significant differences with experience on exposure to occupational hazards and staff awareness; the categories with more years of experience were the least likely to be exposed to occupational hazards and the most aware to deal with. Besides that, it founded that there are significant differences with those having training courses in occupational health and exposure to occupational hazards, the staff that had previous training courses were less exposed to occupational hazards. المقدمة: يتعرض موظفو التخدير للعديد من المخاطر المهنية أثناء تواجدهم في مكان العمل. تنقسم هذه المخاطر إلى مخاطر بيولوجية وكيميائية ونفسية وجسدية ومخاطر عدم الملائمة. الهدف من الدراسة: التعرف على هذه المخاطر المهنية والعوامل التي تؤثر عليها في قسم التخدير في المستشفيات الحكومية الفلسطينية في الضفة الغربية. المنهجية: تم اجراء دراسة مقطعية وصفية تحليلية باستخدام استبيان ذاتي. تكونت عينة الدراسة من جميع موظفي التخدير العاملين في المستشفيات الحكومية في الضفة الغربية اثناء فترة الدراسة، وهم ٪ 481 موظفا، أجاب على الاستبيان 464 مشارك، حيث كانت نسبة الاستجابة 88 . النتائج: خلصت النتيجة إلى أن أكثر من نصف المشاركين تعرضوا لمخاطر مهنية بدرجة متوسطة 6٪(. وكانت أعلى النسب المئوية لأنواع التعرض للمخاطر المهنية هي .. بدون تحديد نوعها ) 6 6٪( ، والبدنية ) 78.48 ٪( ، والنفسية .. 6٪( ، تليها المخاطر الكيميائية ) 4 .. المخاطر البيولوجية ) 6 الاجتماعية ) 76.15 ٪( ، ومخاطر عدم الملائمة ). 76.1 ٪(. إلى جانب ذلك ; كانت المخاطر 78.8 ٪( على التوالي ، تليها ، ٪ البيولوجية والكيميائية أكثر شدة من المخاطر الأخرى وكانت ) 78.5 الجسدية ) 78.48 ٪(، والنفسية الاجتماعية ) 76.15 ٪(، ومخاطر عدم الملائمة ). 76.1 ٪(. كما تشير النتائج إلى أن المخاطر المهنية الأكثر انتشارًا التي أبلغ المشاركون عن تعرضهم لها كانت نتيجة التعرض للإشعاع المؤين بالتعرض للأشعة السينية ) 86.1 ٪( ، يليه التعرض لاستنشاق غازات 8٪( ، و ثم يأتي التعرض للسوائل والدم التي تخرج من المرضى ) 65.51 ٪(.وأظهرت ... التخدير ) 4 8٪(. كما أن .. نتائج الدراسة أن مستوى وعي ومعرفة الموظفين بالسلامة المهنية كان مرتفعا ) 66 .)٪ توافر إجراءات السلامة كان عند مستوى متوسط ) 61.56 كما أشارت نتائج الدراسة إلى عدم وجود علاقة ذات دلالة إحصائية بين التعرض للمخاطر المهنية ، والوعي المهني للمخاطر المهنية ، وتوافر إجراءات السلامة تعزى الى متغيرات )الجنس ، الحالة الاجتماعية ، مكان العمل ، الدخل الشهري ، المستوى التعليمي ، والوظيفة(. بينما كانت هناك فروق -. ذات دلالة إحصائية بين وسائل التعرض للمخاطر المهنية تعزى الى العمر لصالح الفئة العمرية ) 6 17 ( . كما تبين أن هنالك علاقة ذات دلالة إحصائية بين التعرض للمخاطر المهنية ، والوعي المهني للمخاطر المهنية ، وتوافر إجراءات السلامة تعزى الى متغير سنوات الخبرة، حيث كانت الفئات التي لديها سنوات خبرة أكثر هي الأقل احتمالا للتعرض للمخاطر المهنية والأكثر وعيا للتعامل معها. إلى جانب ذلك ، وجدت الدراسة أن هناك علاقة ذات دلالة إحصائية مع أولئك الذين حصلوا على دورات تدريبية في الصحة المهنية والتعرض للمخاطر المهنية ، حيث كان الموظفون الذين حصلوا على دورات تدريبية سابقة أقل تعرضًا للمخاطر المهنية. والدورات التدريبية في مجال المخاطر المهنية . الخلاصه: بناءً على نتائج الدراسة ، يوصي الباحث بتعزيز السلامة المهنية بما في ذلك مكافحة العدوى في جميع وحدات المستشفى ذات الصلة. إلى جانب ذلك ، هناك حاجة لإعداد طاقم التخدير سواء خلال فترة تدريبهم الرسمية أو أثناء العمل لحماية أنفسهم من مختلف المخاطر المهنية التي قد يتعرضون لها.
Oral Hygiene; knowledge, attitude, and practices among diabetic patients in Hebron- Palestine
(Al-Quds University, 2022-04-03) Areej Hassan Mohammed Harahsheh; اريج حسن محمد حراحشه
Background: Diabetic patients are at greater risk for several oral health complications, particularly periodontal disease. Periodontal disease has an impact on diabetes control. Good oral hygiene knowledge and practices are recommended to prevent and manage oral health problems. Purpose: To assess the oral hygiene; knowledge, attitude, and practices levels among diabetic patients attending primary healthcare centers to synthesize current evidence base data in order to help in the effective planning of oral health services for diabetic patients in Palestine. Methods: A descriptive, cross-sectional study was conducted using face to face questionnaire. The Study participants consist of diabetic patients attending diabetes clinics in primary healthcare centers in Hebron Health Directorate. The study included 309 participants; 309 responded to the questionnaire, with a response rate of 100%. The questionnaire is divided into four parts: Part one: consist of two parts, section A: Has questions about information on the socio-demographic of participants, section B: Information on the clinical characteristics of participants, Part two: Has questions related to knowledge of oral hygiene, Part three: Has questions related to attitude towards oral hygiene, the questions collect information on oral hygiene practices. The questionnaire has to be designed in a way that it can precisely measure the dependent and independent variables in this research. To assess the level of diabetic patients' attitude about oral hygiene, the Likert scale is used it allows the respondent to choose the degree of agreement or disagreement with each item in the questionnaire when it comes to the stimulus purpose, the different items were measured on 5- point Likert scale to check the participant’s degree of convenience with the statement or not, as below: Strongly disagree (SD), disagree (D), neither agree nor disagree (NAD), agree (A), strongly agree (SA). To assess the level of diabetic patients' knowledge about Oral Hygiene a 3- point scale is used as below: Yes, no, don’t know. To assess the level of diabetic patients' practice about oral hygiene, the Likert scale is used, the different items were measured on 5- point Likert scale to check the participant’s degree of convenience with the statement or not, as below: Always, often, sometimes, rarely, never. Results: The study included a total of 309 patients with diabetes mellitus both types; type 1, and type 2. It was conducted in 5 diabetes clinics in primary healthcare centers in the Hebron Health Directorate. The review found that people with diabetes have a medium level of oral health knowledge (60%), High oral health attitudes (Mean score=4.09), and medium oral hygiene practices (Mean score=3.14). They rarely receive oral health education or information about the relation between diabetes and oral health. They also rarely receive dental referrals from their care providers. A majority of people with diabetes are unaware of the bidirectional link between diabetes and periodontal disease and they have limited knowledge of their risks for oral health problems. The study also found that (66.99%) attending primary healthcare centers in Hebron directorate are type2 diabetic patients, (57.28%) are more than 5 years diabetic patients, (61.81%) are not smoking, (56.63%) are poor HbA1c levels. The study showed a low awareness level that smoking with diabetes increases the incidence of oral problems. There is a significant relationship between control and uncontrol diabetic patients with knowledge and practice, results showed that knowledge and practice are better among patients with control diabetes. Provision of oral health education by diabetes care providers and referral to dentists can improve oral hygiene practices among patients. Conclusion: Diabetic patients have limited knowledge about the risk of diabetes on their oral health, lack compliance with recommended oral hygiene behavior. Knowledge and oral hygiene practices levels are better among patients with controlled diabetes. It is therefore essential to educate patients about their increased risk for oral complications and motivate them for good oral hygiene practice, facilitate access to dental care, and advise them to have regular dental checkups. Keywords: Oral hygiene, Diabetes Mellitus, Oral hygiene Knowledge, Attitude, Practices.
palestinian Nurses' Knowlwdge and Perceptions Regarding Occupational Hazards in Three Jerusalem Hospitals
(Al-Quds University, 2022-05-31) Dalal Daoud Zawahre; دلال داوود زواهرة
Background. Nurses are often exposed to occupational hazards because the nature of their work requires them to be in direct contact with patients and to deal with materials and tools that require extreme caution and care. It has been shown by many previous studies that the nursing staff must have full knowledge of occupational hazards that they may encounter, to perceive the seriousness of the work environment conditions and to take necessary measures and precautions to prevent exposure to workplace hazards. Aims. The aims of this study are (1) to assess Palestinian nurses’ levels of knowledge, perceptions and practices regarding occupational health hazards, (2) to examine whether there is a difference in Palestinian nurses’ levels of knowledge, perceptions and practices regarding occupational health hazards related to their demographic characteristics (3) to examine whether there are relationships between nurses’ knowledge, perceptions and practices regarding occupational health hazards. Sampling. A convenience sample of 217 nurses currently working in three hospitals in Jerusalem were recruited to participate in this study. Instruments. A self-administered questionnaire was adapted from previous studies to assess participants’ sociodemographic characteristics, their knowledge, attitudes and practices about occupational health hazards. Analysis. SPSS software was used to analyze data. Demographic variables were described using frequencies and percentages. Correlational analysis was used to examine the relationships between study variables, including Pearson/Spearman correlation coefficients, one-way analysis of variance (ANOVA) and regression analyses. Results. Participants’ levels of knowledge, perceptions and practices in regard to occupational hazards came in the high rank 3.30 (4), 2.87 (3), 81.3% respectively, viii indicating that most participants had sufficient levels of knowledge, perceptions and practices in regard to occupational health hazards. There were no statistically significant differences in the levels of participants’ knowledge of occupational hazards related to their age, gender or years of experience. While there were statistically significant differences in their knowledge of occupational hazards related to their educational qualification. There were no statistically significant differences in the nurses’ perceptions of occupational hazards related to their age and years of experience. While there were statistically significant differences in their perceptions related to their gender and educational qualifications. There were no statistically significant differences in the nurses’ practices regarding occupational hazards related to their age, gender, educational qualification, and years of experience. There was a statistically significant relationship between participants’ knowledge, perceptions and their practices regarding occupational hazards. Conclusion. Nurses’ knowledge, and practices regarding occupational hazards are related to their educational qualifications. Knowledge, as well as perceptions of occupational hazards are related to their conscious practices of occupational hazards’ prevention. It is important to raise the nurses’ awareness about the occupational hazards and to follow clear plans and policies pertinent to occupational hazards’ prevention in this study’s targeted hospitals. Keywords. Knowledge, Perceptions, Practices, Nurses, Occupational hazards.
Patient Satisfaction toward the Pharmaceutical Care Services provided at the Ministry of Heath Primary Healthcare Pharmacies in Bethlehem Governorate
(Al-Quds University, 2022-12-11) Shireen Jaber Ibrahim Alhoubani; شيرين جابر ابراهيم الحوباني
خلفية الدراسة: رضا المريض هو شهادة إنسانية ناتجة عن الخبرة العملية وعنصر لا يتجزأ من جودة الرعاية الصحية التي تهدف إلى قياس جودة الخدمات الصحية المقدمة. المبرر: حساسية القطاع الصحي حيث أن المؤسسات الصحية الفلسطينية خاصة المؤسسات الحكومية منها ما زالت تكافح من أجل الاستمرارفي تقديم خدماتها على الرغم من التحديات الفنية والسياسية. الهدف العام: تقييم رضا المريض حول الخدمات الصيدلانية التي تقدمها صيدليات وزارة الصحة للرعاية الصحية الأولية في محافظة بيت لحم. منهجية الدراسة: أجريت دراسة مقطعية على مدى شهرين، باستخدام استبيان تم تطويره ذاتيًا ، يحتوي على مقياس ليكرت الخماسي ، وكان مجتمع الدراسة عبارة عن مرضى عشرين صيدلية من صيدليات وزارة الصحة للرعاية الصحية الأولية. النتائج: معدل الاستجابة كان 100%، نسبة الاناث كانت 64% ونسبة الذكور 36%، القيمة المحددة والفاصلة هي 3، كان هناك رضا عام من قبل المرضى تجاه الخدمات الصيدلانية M = 3.10 ، SD = .651 ، تم إظهار أعلى درجات الرضا تجاه البنية التحتية لخدمات الوصفات الطبية M = 3.73 ، SD = .702 أما دور الصيادلة وأدائهم وخصائصهم M = 3.34 ، SD = .772. أما أقل رضا فكان تجاه الوقت في غرفة المشورة M = 2.57 ، SD = 1.176, الوقت في غرفة الانتظار M = 2.85 ، 1.095. كما اظهرت النتائج فروق ذات دلالة إحصائية بين الموقع الجغرافي من حيث خصائص الصيدلي وأدائه ودوره (0.001(p= ، أما مراقبة وفحص الوصفات (0.001(p=، والوقت في غرفة الاستشارة (0،003p=) ، وصرف الأدوية (0،012p=) . كان للخدمات الصيدلانية المقدمة في وسط مدينة بيت لحم رضاً (M = 3.24 ، SD = 0.686) أكثر من تلك التي تقدم في الشمال (M = 2.95 ، SD = .590) من حيث الرضا العام للمرضى (p = <0.001) ، ومع ذلك المرضى الراضون عن الخدمات الصيدلانية الواقعة في جنوب مدينة بيت لحم (M = 3.18 ، SD = 656) أكثر من الشمال (M = 2.95 ، SD = .590) من حيث الرضا العام للمرضى (ع = 0.016). كما وأشارت الدراسة إلى وجود فروق ذات دلالة إحصائية بين مكان إقامة المريض(p = <0.001) ، والوظيفة (p = 0.020) والتأمين الصحي (p = 0.047). أشارت علاقة بيرسون إلى وجود علاقة إيجابية بين الرضا العام للمريض وعدد المستفيدين من الخدمات التي تقدمها صيدليات الصحة الأولية للأسرة (r = 0.177 ، p = <0.001) ، علاوة على ذلك ، علاقة سلبية بين الرضا العام للمريض وبُعد الصيدلية عن مكان إقامتهم (r = -0.141 ، p = 0.005). الخلاصة والتوصيات: أظهرت النتائج رضا المرضى تجاه خدمات الرعاية الصيدلانية المقدمة واقترحت تطوير للبنية التحتية في صيدليات المستوى الصحي الأولي بما في ذلك غرف الانتظار والمشورة ورفع وعي المستهلكين حول حقوقهم في الحصول على الرعاية الصحية المثلى وتوفير كميات أكبر لأنواع الأدوية التي يحتاجها المرضى باستمرار ، كما ويجب على أي مؤسسة صحية تقييم رضا المريض بشكل مستمر
Patient Satisfaction: Comparative Study Between Joint Commission International Accredited and Non-accredited Palestinian Hospitals
(AL-Quds University, 2017-04-03) اباء عبدالرازق مصطفى دعسان; Ebaa Abdulraziq Mustafa Dasan; أسمى الإمام; معتصم حمدان; د. سمير ابو زنيد
Background: Patient satisfaction is one of the important indicators in the health system that should be considered when evaluating the quality of health services provided and the impact of accreditation systems. This study aims to assess the level of patient satisfaction in accredited and non-accredited hospitals in Palestine. Methods: Quantitative descriptive cross-sectional design used to compare patient satisfaction in Palestinian hospitals. The researcher measured the patient satisfaction between October and November 2016 using the SERVQUAL tool to assess five dimensions of quality (reliability, assurance, tangibility, empathy, and responsiveness). The sample size included was 332 inpatients, who were recruited by the researcher through convenient sampling method, and the data was analyzed using SPSS version 18. Results: The patients have a high level of satisfaction with a total mean of (4.34) out of 5 points and a (0.70) standard deviation. The patients have a high level of satisfaction regarding each patient’s satisfaction dimensions with the quality of services provided in the two hospitals. The results indicated that there are statistically significant differences at the level (P ≤ 0.05) between the means of patient satisfaction relating to patient characteristics (with the exception of gender), and also indicated that there are no statistically significant differences related to hospital characteristics. Moreover, for all satisfaction dimension patients have more satisfaction in non-accredited hospitals than accredited ones. There was no statistically significant association between accreditation status and patient satisfaction. Conclusion: The study indicated that there are no significant differences between the means of patient satisfaction attributed to accreditation status. The results reinforce that the patient perspective should also be given much importance in the health system, and certifies that it should be taken into consideration to ensure the quality of services provided by healthcare organizations.
Safety Measures and Risk Management in the Ophthalmic Governmental Hospitals of the Gaza Strip
(جامعه القدس ابو ديس, 2023-03-22) لينا عبد الكريم على نجم; Leena Abedalkareem Ali Nijim
تعد تدابير السلامة وإدارة المخاطر أمرًا أساسيًا في مستشفيات العيون لضمان حصول المرضى على أعلى مستوى من الرعاية. تساعد إدارة المخاطر السليمة على تقليل فرص الأخطاء الطبية والحوادث التي يمكن أن تؤدي إلى إصابات خطيرة أو وفاة. كما أنها تساعد في حماية المستشفى من المسؤولية المحتملة. تتضمن إدارة المخاطر في مستشفيات العيون تحديد وتقييم وإدارة المخاطر التي يمكن أن تؤثر بشكل محتمل على سلامة وجودة الرعاية المقدمة. الهدف: تقييم تدابير السلامة وإدارة المخاطر في المستشفيات العيون الحكومية في قطاع غزة. الطرق: تم استخدام تصاميم وصفية تحليلية شملت مجموعة الدراسة جميع العاملين في المستشفيات العيون الحكومية بما في ذلك الأخصائيون وأطباء البورد والصيادلة والبصريات والممرضون وأطباء التخدير وفنيو التخدير والمسؤولين. أكمل حوالي 86٪ (160/185) من المستجيبين الاستبيان بشكل صحيح. تم ضمان صحة وموثوقية الاستبيان؛ كرو نباخ ألفا يساوي 0.954 للاستبيان بأكمله. تم إجراء تحليل البيانات باستخدام برنامج (SPSS) الإصدار 25. النتيجة: كان مجموع درجات مستويات التدابير الأمنية منخفضًا (44.2٪). كان المتوسط لمجال التدريب منخفضًا (39.0٪) في حين كان المتوسط لمجال ترتيبات سلامة المستشفى معتدلًا (66.0٪). كان مجموع درجات مستويات إدارة المخاطر عاليًا (81.40٪) وتم تصنيف مجال إدارة المخاطر كما يلي: إدارة المخاطر البيولوجية (84.30٪)، إدارة مخاطر الأفراد (80٪)، وإدارة المخاطر الفيزيائية (79.40٪). أظهرت النتائج وجود علاقة إيجابية بين التدابير الأمنية وإدارة المخاطر (P <0.05). أخيرًا، أظهرت النتائج عدم وجود فرق إحصائي في متوسط مستويات التدابير الأمنية وإدارة المخاطر فيما يتعلق بالبيانات الديموغرافية (P> 0.05). أظهرت النتائج أيضًا وجود علاقة إيجابية ومعنوية بين التدابير الأمنية وإدارة المخاطر. (P <0.05). بناء على النتائج التي تم الحصول عليها من المقابلات مع الأشخاص أصحاب المناصب الإشرافية، فإن المستشفيات الحكومية في غزة تواجه مشكلات في مجالات السلامة وإدارة المخاطر بسبب عدم وجود سياسات وإجراءات كاملة، وعدم الشفافية، وعدم إبلاغ الحوادث الطبية بشكل كامل. تعمل وزارة الصحة على إعداد دليل السلامة وهناك لجان متخصصة للتحقق من الأحداث الطبية لتعزيز إجراءات السلامة وإدارة المخاطر.الاستنتاج: تشير النتائج إلى أن مستوى السلامة العام كان منخفضًا، خاصة في مجال التدريب، ولكنه كان معتدلًا في مجال ترتيبات سلامة المستشفى. ومن ناحية أخرى، كان مستوى إدارة المخاطر عاليًا، حيث ترتيب إدارة المخاطر البيولوجية هو الأعلى. كما وجدت الدراسة وجود علاقة إيجابية بين تدابير السلامة وإدارة المخاطر، لاستنادًا إلى هذه النتائج، توصي الدراسة بأن تركز المستشفيات على تحسين تدابير السلامة وإدارة المخاطر لضمان سلامة الموظفين والمرضى
الاحتراق الوظيفي والرغبة في ترك العمل لدى الممرضين العاملين في أقسام أمراض الدم والأورام غير الحميدة في المستشفيات الفلسطينية
(AL-Quds University, 2016-05-14) بلال عبد الرحمن نمر الجوابرة; Belal A N Al Jawabreh; سلام الخطيب; معتصم حمدان; حسين جبارين
Introduction: Nursing is inevitably a demanding and stressful job. Extra stressors like burnout have a severe impact on nurses’ wellbeing, patient safety, and the health organization as a whole. Oncology nursing has been described as one of the most stressful specialty areas (Lederberg, 1989). The oncology field is a complex environment in which to work because it requires nurses who are educated, skilled, and clinically competent to care for patients with cancer. Therefore oncology nurses are valuable resources in the healthcare system. Aim: The aim of the study is to assess burnout level and reasons behind leaving the work at oncology /hematology departments; and to identify their predictors. Methodology: The study population is 230 Palestinian oncology /hematology nurses, the response rate were above 93% .The researcher used a descriptive analytic cross sectional design. The MBI-HSS was used to assess burnout in the study participants. The AWS was used in conjunction with the MBI-HSS to assess the six areas of the work environment that influence burnout Result: The study observed that almost (57.2%) of Oncology/Hematology nurses in Palestinian hospitals had an average level of burnout. Lack of positive reinforcement represented the main source of burnout of the participants (M 3.38 SD 0.90), while the power of labor is the less source (M 2.42 SD 0.72) . Additionally, almost 53% of the participants indicated their intention to leave the department (to another ward) (M 2.65 SD1.43) The findings revealed that place of residency, income and educational level do not,indicate any significant difference, However, it was found that gender, marital status, working system, hospital name and job title are significant variables. Besides, a statistical significant positive correlation was found between the burnout level sub-scales(emotional exhaustion, depersonalization, and personal accomplishment scores and the intention to leave the department (to another ward) among Oncology/Hematology nurses in Palestinian hospitals, Moreover, the findings revealed that the demographic variables do not indicate any significant difference in the intention to leave the department (to another ward) among Oncology/Hematology nurses in Palestinian hospitals. Conclusion: Burnout among oncology /hematology nurses is a serious issue. Results from this study indicate that burnout is a manageable condition which can also beprevented. Good management and leadership, development of nurse practice environment, stress reduction interventions, good lifestyle choices, emotional intelligence, emotion and problem focused coping strategies are linked to high job satisfaction, less stress and therefore reduce the likelihood of burnout among oncology /hematology nurses and this will achieve the optimal level of retention rates. Keywords: Burnout, MBI-HSS, Intention to Leave, Hematology-Oncology nurse
التحرش الجنسي بالعاملات في المستشفيات العامة في الضفة الغربية
(AL-Quds University, 2019-03-04) ميس فيصل عزالدين أبوعصب; MAIS FAISAL IZALDIN ABUASSAB; معصتم حمدان; اسمى الامام; امل ابو عواد
التسويات الدوائية للمرضى المدخلين للاقسام الجراحية: دراسة في مستشفى اريحا
(AL-Quds University, 2018-03-18) محمد ابراهيم 'محمد رشيد' عتيلي; Mohammed Ibrahim 'Moh. Rasheed' Attili; معتصم حمدان; Asma Emam; Hatem Hejaz
Background: Adverse Drug Events (ADEs) at care transition expose patients to susceptible harm. Lack of medication reconciliation is a major factor leading to ADEs. It is highly important to apply medication reconciliation at care transitions to minimize medication discrepancies and reduce medication errors. Some patients are at higher risk due to medication errors: those with chronic diseases and poly-pharmacy, elder patients, those with other co-morbid factors and patients who are admitted to certain surgical procedure. Aim:The study aims to assess prevalence and factors associated with medication discrepancies at admission to surgical operation in hospitals using the Electronic Medical Record (EMR) system and to analyze the factors associated with medication discrepancies. Method: A prospective cross-sectional observational design was employed. The study was done in Jericho Governmental Hospital. The inclusion criteria was all patients who were aged ≥18 years old, who were admitted for any surgical operation in the hospital at least for 24 hours and underwent major surgery. Data were collected in the period between the middle of July to the end of September, 2016, over a period of 75 days. All patients who were admitted to surgical operation and met the criteria were included. Findings: A total of 145 patients who satisfy the criteria were included, 19.3% of them hadat least one medication discrepancy, 93% of these discrepancies were unintentional. Moreover, 93% of the discrepancies were omission of certain medication at time of admission, 20.7% of discrepancies occurred in patients taking 1-2 medications prior to admission and 7.6% in patients taking 3 or more medications. Logistic regression showed significant association between medication discrepancy and having a chronic disease(Exp(B) = 12.910, P <0.001), and with the number of medication consumed prior to admission (Exp (B) = 23.953, P <0.001). Conclusion: The risk of medication discrepancy was higher in patients with chronic disease and polypharmacy. The most frequent medication discrepancy was omission of certain medication consumed prior to admission. Therefore, medication reconciliation should be carried out for susceptible patients who have chronic diseases or consuming medication regularly at time of admission. Moreover, medication discrepancies may occur at any care transition other than admission, so it is highly important to perform medication reconciliation at any care transition.
العوامل التي تؤثر على الامتثال للعلاج بالعقاقير وتغيير نمط الحياة في عيادات الرعاية الصحية الأولية في محافظة بيت لحم
(AL-Quds University, 2014-05-18) امل محمود يونس العزه; AMAL MAHMOUD YOUNIS ALAZZEH; محمد شاهين; د. معتصم حمدان; د. أميه خماس
Antihypertensive treatment is an important challenge and public health issue, compliance to treatment of hypertension is one of the important factors that affect blood pressure control, no enough studies had been done about this issue in Palestine. In this study compliance to drug and lifestyle modification treatment were investigated. The aim of this study was to assess the factors affecting compliance to antihypertensive drug treatment and recommended lifestyle modifications among hypertensive Palestinian patients attending primary health care clinics in Bethlehem district. A descriptive cross sectional design was applied on systematic random sampling, sample of 300 hypertension participant at UNRWA, Government, and Non-Governmental clinic, using an interviewer administrated close ended questionnaire which depended on Health Belief Model. The questionnaires were filled face to face, the response rate was 100% in all clinics, Data analysis was done using (SPSS) version 19 to measure compliance on a 4- point Likert scale. The most important findings were (65.6%) of the participants were female, and (34.3%) were male, participants had a range age of (28-80). Among the total respondents (32.6%) didn’t had any complications, (67.1%) had one problems or more related to hypertension,the majority of the respondents took one to three medication (96%), ( 0.7%) didn't had any medications. (99.1%) took one to three doses of medication per day, (69.3%) of the total respondents didn't skip any dose and (30.7%) skipped one or more dose. And there was a strong significant association between doses skipped per day (p-value = 0.000) perception of severity (p-value = 0.003), perception of barriers (p-value = 0.000 and internal factors (p-value = 0.001) of total respondents and treatment compliance. ForUNRWA respondents there was significant relationship between gender (p-value =0.035), doses skipped in the last three days (p-value =0.035), perception of barriers (p-value =0.001), internal factors (p-value = 0.011) and treatment compliance. For the government respondents there was significant association between doses skipped in the last three days (p-value = 0.000) and body mass index (p-value = 0.013), perception of severity (p-value = 0.039), perception of barriers (p-value = 0.008), cues to action (p-value = 0.019) and treatment compliance. For the NGO there was association between educational status(pvalue = 0.037)and occupational status (p-value = 0.03), perception of barriers (p-value =0.024), internal factors(p-value = 0.008) and treatment compliance. The best predictor variables for treatment compliance were perception of barriers, perception of internal factors and perception of severity of total respondents. For UNRWA respondents the best predictor variables were perception of barriers and perception of internal factors. For Government respondents the best predictive variables were perception of barriers and cues to action. For NGOs the best predictive variables were internal factors and perception of barriers. This study concluded that the most important factors affected treatment compliance of therespondents were doses skipped, gender, body mass index, educational status, occupational status, perception of severity, perception of barriers, cues to action and internal factors. This study concluded that the total respondents were compliance to their drug treatment and lifestyle modification, NGOs respondent were more compliant than UNRWA and Government respondents in drug treatment while Government and UNRWA were more compliant than NGOs in lifestyle modification Key words: Compliance; hypertension; lifestyle modification; drug treatment.
العوامل الغذائية ومخاطرها على الإصابة بمرض الورم الليمفاوي غير الهودجكن بين الفلسطينيين
(AL-Quds University, 2015-09-12) مرام محمد شاكر دحدول; maram mohammed shaker dahdol; رانيا أبو سير; حازم آغا; صبري الصغيّر
Background: The incidence of Non-Hodgkin Lymphoma (NHL) increased worldwide during the second half of the last century and then stabilized during the nineties but subsequently increased. Environmental factors and dietary habits have been reported to play an important role in the etiology of NHL by influencing the immune system. However, no such data are available from Palestine. Objectives: To participate in establishing a platform to study B-NHL in Palestine and further to examine the association between dietary factors and the risk of B-NHL among Palestinian B-NHL patients versus controls. Design: Case-control study. Methods: A case-control study was conducted between 2009-2013 including 306- histological confirmed B-NHL cases and 392 cancer-free controls among adult Palestinians recruited from three major Palestinian hospitals in the West Bank and Jerusalem which have an oncology department in addition to Hadassah Hospital in West Jerusalem. In the primary study analysis, an imbalance was encountered in the regional distribution of cases and controls in the central area. In order to correct for this imbalance, I recruited 71 controls from the primary health care centers in Jericho, Ramallah and Al-Azaria on the basis of frequency matched case-control study in terms of age and gender and region. The study participants were administered a questionnaire which is based on the international Epi-Lymph questionnaire, which focuses on demographic characteristics, types of environmental exposure and on diet and nutritional intake, specifically meat, milk, dairy,vegetables and fruits. Blood samples were also collected from participants for the purpose of DNA purification and viral serology testing. The overall data-base was used to study the association between nutritional factors and the risk of NHL. The data was analyzed by Statistical Package for the SocialSciences(SPSS)and associations were examined by multivariate logistic regression. For food intake analysis, the median value for each food group was calculated from overall distribution of the study population in order to use the value below the median as a reference value to detect associations by logistic regression. Results: High consumption of meat (OR=1.8; 95% CI: 0.8-4.3) and milk (OR=1.3; 95% CI: 0.7-2.6) was found to be positively associated with the risk of B-NHL. Vegetable intake was also positively associated with the risk of B-NHL (OR=1.3; 95% CI: 0.4-4). Similarly, dairy products were significantly associated with an increased risk of B-NHL (OR=2.3; 95% CI: 1.2-4.4). In contrast, a significantly inverse association was encountered between fish consumption and B-NHL risk (OR=0.4; 95% CI: 0.2-0.8), and an inverse association was found between the consumption of fruits and B-NHL risk (OR=0.7; 95% CI: 0.2-2.1). Conclusion:The results of this study showed that dietary intake may affect the risk of NHL as positive associations were found with meat, milk, dairy products and vegetables consumption, while an inverse association with fish and fruits consumption was encountered. Keywords: dietary factors, non-Hodgkin lymphoma, case–control study, Palestine.
العوامل المحفزة للطاقم الطبي: مقارنة بين المستشفيات الحكومية والمستشفيات غير الحكومية في جنوب الضفة الغربية/فلسطين
(AL-Quds University, 2016-12-18) تامر شوقي فرح عوض; Tamer S F Awad; شهناز النجار; Dr. Asma Imam; Dr. Mutaz Dredi
Background: Palestine is a low-income country with very limited resources. Human resources are the most valuable resource for the country. Human resource management determines how to use other resources in order to achieve organizational goals. Aim: To identify and compare the motivational factors of healthcare workers and its determinants in the Palestinian hospitals in the South of West Bank. Methods: A quantitative cross sectional study design was used. Data collection was through self-administered questionnaire. A total of 297 healthcare workers participated in this crosssectional survey from four major hospitals in Bethlehem and Hebron. The study was conducted between June and October, 2015. Data collection tool included 18 motivational factors that were found in the literature. Other demographic characteristics were also collected. Descriptive and inferential statistics were used for data analysis by using SPSS version 16. Findings: Working according to ethics, helping people, recognition, reward and appreciation, ensuring job security, continuous education and opportunities for growth were major motivational factors for choosing work place (P<0.01). On the other hand, ensuring jobsecurity, full/part-time positions, sharing creativity and leadership, continuous education, working and living conditions and opportunities for advancement were major motivational factors to do work properly (P<0.01). Regarding place of work, healthcare workers in nongovernmental hospitals have experienced significantly higher motivational factors for choosing work place than those in governmental hospitals (P<0.05). Moreover, duration of work was an important motivational factor for choosing work place (P<0.05). Conclusion: Improving healthcare workers’ motivation is a vital process towards having better quality of health services. It requires support from managers and enhancing good management practices. The findings of this study suggests that further efforts should be extended in some aspects such as job security, continuous education, recognition, reward and appreciation, working and living conditions and opportunities for growth. Keywords: Motivational factors, healthcare workers, Palestine.

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