Policies & Health Management السياسات والإدارة الصحية

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The Adherence of Physicians and Nurses' to Ethical Practices from Patients’ Perspective and its effect on Patients’ Satisfaction at Al-Makassed Hospital
(Al-Quds University, 2023-10-30) Reem Ata Mohammad Sharia; ريم عطا محمد شريعة
Professional and ethical values are an integral part of healthcare, represented in the code of ethical conduct. It regulates and directs the behavior of healthcare workers and is reflected in patient satisfaction and the quality of healthcare services. Aim of the study: To assess the patients' perspectives regarding the ethical practice of physicians and nurses at Al-Makassed Hospital and how this perception affects patient satisfaction with the hospital services provided. Methods: A quantitative descriptive cross-sectional design was used for this study. A designed questionnaire was used, to collect data from 250 patients from the Internal, Orthopedics, and Surgery Departments at Al-Makassed Charitable Hospital in Jerusalem. Questionnaires were distributed, explained, and collected by trained students after signing the consent form by the participants. Descriptive and inferential statistics were applied using SPSS v24. Results: The response rate in this study was 88.4%, with 110 (49.8%) male and 111 (50.2%) female patients, and 51% of the participants were in the age group 30-60 years old. Only 17.6% of the participants have a bachelor's degree and above, and 73.7% are covered by Palestinian Government health insurance. Most respondents (74.7%) do not have work, and 57.9% have a monthly household income of fewer than 2000 shekels.The results showed that the level of respecting the patient and working for his/her interest is very high (88.2%), the level of protecting the patient from harm is high (79.6%), the level of preserving the patient's freedom to agree to the treatment plan is high (77.8%), the level of Justice and Equality is high (72.7%) and the level of confidentiality and privacy is high (76.2%).
Assessing the Supply and Demand for Dentists in Jenin District
(AL-Quds University, 2011-06-26) محمود ناجي محمود الحمدان; Mahmoud Naji Mahmoud Alhamdan; معتصم حمدان; محمد شاهين; Ahmad Rahal
Assessment of Nurses Perception towards Medication Errors in Palestinian Hospitals
(AL-Quds University, 2015-07-04) رضا رضوان صبري سلمي; Reda Radwan Sabri Silmi; معتصم حمدان; Hussein Hallaq; Hussein Jabareen
Background: Medication errors are one of the most common causes of accidental errors affecting patients’ safety and can cause serious consequences for patients. Medication errors are underreported worldwide, particularly in developing countries. Which lead to the lack of information regarding the problems of medication errors. Aim: To assess the input from nurses’ regarding several issues in medication error, exploring their perception towards medication error causes, types, rate, and reporting. which might help in pinpointing some areas in medication safety issues where there is potential for making improvement to be reflected in the nurses practices regarding medication managements at hospitals. Methods: A cross-sectional design was used. Data was collected using a self-administered questionnaire. The study was conducted in three hospitals; public, private, and NGO. A total of 267 nurses participated in the study Findings: The overall response rate was (57.17%). Female were 59.8%, and males 40.2%. The most perceived causes of MEs were lack of pharmacological knowledge and skills (82%), and heavy workload and shortage of staff (77.7%). As for the most common types of MEs, wrong medication dose (57.5%) and wrong time (53.2%) were the most prevalent. The mean number ofcommitted MEs in the past 12 months was 1.94, and the mean number of reporting medication errors in the past 12 months was 1.6. With regard to the most common type of medications involved in MEs, antibiotics was given the highest frequency in MEs. Regarding the level of harm resulted from medication error that occurs in the past 12 months, the higher frequency was for MEs causing temporary harm to patients (28.2%). Moreover, participants from the NGO and public hospitals scored higher than private hospital participants inregard to shortage of nursing staff and heavy work overload cause (P<0.001). Also 57.9% of participants with bachelor’s degree indicated the effect of lacking pharmacological knowledge and skills more than diploma and graduate studies participants (P<0.001). Finally a statistically significant relationship was found in the frequency of committing MEs (P=0.001) and frequency of reporting MEs (P<0.001) in relation to the hospital ownership. Conclusions: the results of the study indicate that there are areas of potential improvements in Palestinian hospitals. Medication safety interventions should be formulated to address strategies to reduce and eliminate medication errors.
Assessment of Quality Standards and Nursing Performance of Perioperative Nursing Care in Operating Rooms at Governmental Hospitals in the West Bank
(AL-Quds University, 2014-05-13) أسماء محمد أحمد عبد الحق; asma mohammad ahmad abdelhaq; اسمى الإمام; معتصم حمدان; د. شاهيناز نجار
Background: Improving the quality of health care becomes the primary concern of all health care institutions. Operating Room (OR) nurses are part of the healthcare providers and they should be knowledgeable about the quality of health services in order to perform their roles in improving patient‘s safety. Aim: The purpose of this study was to assess the application of quality care and nurses performance standards in operating rooms in the Palestinian governmental hospitals in the West Bank. Method: A quantitative cross sectional descriptive design was used. The population of the study consisted of all operating room nurses working at 10 Governmental Hospitals in the West Bank/Palestine. A self-administered questionnaire was distributed to 129 nurses, out of which (77.5%) responded, Data was analyzed by using the statistical package of social science (SPSS) version 17. Findings: The results of this study showed that the overall level of quality care standards application was moderate in the following standards; nursing assessment (63.2%), cleaning and sterilizing surgical instruments (81.3%), positioning patients according to the type of surgery (75.45%), using of homeostasis devices (71.25%), wound management(82.8%)andinfecationcontrol(77.78%). And it was high in the following standards; counts in surgery and sample preparation (91.5%), and preparation for surgery (89.36%). On the other hand low in reporting errors (58.68%). OR nurses, who were older, applied the quality care standards of cleaning and sterilizing surgical instruments more than younger (P< 0.035). Female nurses applied preparation for surgery standards more than male nurses (P<0.028). On the other hand there was no significant difference in the application of quality care standards in the operating rooms this is due to the academic level, training period, training site, years of experience. Also, results showed that OR nurses who worked in hospitals that have less numbers of operating rooms, applied quality standards (cleaning and sterilizing surgical instruments (P<0.008%)preparation for surgery P<0.017, positioning patients according to the type of surgery (P<0.001), wound management (P<0.014%), reporting errors (P<0.002) more than those who work in hospitals that have more numbers of operating rooms. OR nurses who work in hospitals that have low numbers of nurses applied quality standards of Using homeostasis devices (P<0.002) and Infection control (P< 0.011) more than those work in hospitals that have more numbers of nurses in OR wards. The overall application of performing standards was moderate in standard of Ethics (71.8%)، but it was low in the following standards; resources utilization (58.25%), professional practice evaluation 58.95%,leadership 57.1%, education 44.58%, quality of practice 44.3% and collaboration 28.08%). Nurses who had less experience years, applied performance standard of Education more than more experienced (P< 0.019). On the other hand there was no significant difference for academic level, training periods، scientific qualification, training site, age, gender, and standards of performance application. Also results showed that OR nurses who work in hospitals which have high numbers of OR nurses ( more than 13) applied the following performance standards: ethics (P< 0.017), collaboration (P<0.003), resources utilization (P<0.028), leadership (P<0.001) more than who work in hospitals that have low numbers of OR nurses. And OR nurses who work in hospitals which have less numbers of operating rooms (1-3) applied the following performance standards: professional practice evaluation (P<0.001), resources utilization (P<0.000), quality practice (P<0.009), Education (P<0.009), Ethics (P<0.020), more than those work in hospitals that have more numbers of operating rooms.Conclusions and recommendations: The study employed an assessment of the quality standards and nursing performance of perioperative nursing care in operating rooms at Governmental Hospitals in the West Bank. The compliance of OR nurses with quality standards was moderate whereas the compliance with performance standards was low which was reflected on nurses's performance and patient safety. So, there is a need for improving quality culture in Governmental Hospitals by introducing a policy and strategies for applying quality standards and performance appraisal of OR nurses. Additional studies needed to clarify the causes that prevent the application of quality and performance standards.
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
The Association between Dietary Consumption and weight status Among University Female Students at Al-Quds University- Palestine
(Al-Quds University, 2024-09-01) Raghda Adel Omar Amro; رغده عادل عمر عمرو
Introduction: This cross-sectional study examines the link between dietary consumption and weight status among female students at Al-Quds University, aiming to address a gap in understanding how these factors influence obesity and weight management. Methods: A cross-sectional study of 2,364 female students from Al-Quds University was conducted to analyze how food and beverage consumption patterns, combined with socioeconomic and lifestyle factors, influence body mass index (BMI). Data were collected through questionnaires on dietary intake, physical activity, and lifestyle habits, and then statistically analyzed using version 23.0 of the Statistical package for Social Sciences software (SPSS) to determine correlations with BMI. Results The analysis shows a significant positive correlation between high-calorie, fast-food consumption and increased BMI among the participants, with a p-value of <0.05. Diets rich in vegetables and lower in processed foods were associated with healthier weight statuses (p < 0.05). Furthermore, lifestyle factors such as physical activity (p = 0.033) and sleep duration (p < 0.001) also significantly influenced weight status. Socioeconomic factors, including family affluence and family size, showed a strong correlation with BMI, with lower affluence being linked to higher obesity rates (p < 0.001). Additionally, smoking status, breakfast frequency, and the amount of water consumed were also significant predictors of BMI (p < 0.05). Conclusion: The findings highlight the importance of dietary interventions and weight management strategies for female university students, which should be incorporated into public health policies and educational programs to combat obesity and promote healthier lifestyles
attitudes of the employees in the health sector towards the draft national health insurance
(AL-Quds University, 2011-01-08) وردة محمد ابراهيم المشاعلة; Warda Mohammad Ibrahim Mashaala; محمد شاهين; منى حميد; اسعد الرملاوي
Burnout and the Intention to Leave among Oncology Hematology Nurses in Palestinian Hospitals
(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
Comparison of Palestinian Immunization Adherence Rates for Refugee and Non-Refugee 2-Years Old Children
(AL-Quds University, 2006-06-28) سليمان عطا توفيق غوشة; Suliman Atta Tawfiq Ghosheh; زياد عابدين; Mohamad Shaheen; Ted Tulchinsky
Compliance to iron supplementation among pregnant women receiving antenatal care at UNRWA clinics - West Bank
(AL-Quds University, 2012-05-05) نادرة يوسف عبودة سمحة; NADERA YUSUF ABBOUDAH SAMHA; نهى الشريف; معتصم حمدان; امية خماش
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 and Motivational Factors of Healthcare Staff: A Comparison between Governmental and Non-Governmental Hospitals in the South of West Bank / Palestine
(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.
determinants of oral health behaviors among adolescents in jerusalem
(Al-Quds University, 2013-06-02) Heba Mohammed Al Kafrawe; هبة محمد الكفراوي
Effects of Siege on the Provision of Health Services at the Ministry of Health Hospitals in Gaza during the period 2006-2014
(Al-Quds University, 2016-01-06) ماهر محمود عبد الهادي شامية; Maher Mahmoud Shamia
تهدف هذه الد ا رسة التعرف إلى تأثير الحصار على تقديم الخدمات الصحية في مستشفيات و ا زرة الصحة في غزة خلال الفترة 6002 م 6002 م، وأي ً اً د ا رسة لفعالية است ا رتيجيات المواجهة والتكيف - التي اتبعتها الو ا زرة للتخفيف من آثار الحصار على الو عً الصحي للسكان. استخدم الباحث المنهل الوصفي التحليلى الكمي، ويتكون مجتمع الد ا رسة من مقدمي الخدمات الصحية في المستشفيات الحكومية بقطاع غزة، من جميع التخصصات، حيث بل حجم العينة) 200 ( مشارك تم اختيا رهم من ) 2( مستشفيات، تم فرزها عشوائي اً، والذين أجابوا على ا ستبانة التي تم بناؤها حسب ،٪ الطار الذي و ًعتد منظمة الصحة العالمية ل بنات البنائية الست، وكان معدل ا ستجابة 00.0 وتم استخدام برنامل ) SPSS ( لتحليل البيانات، وكانت مصداقية وموثوقية ا ستبانة عالية في جميع المجا ت. وأظهرت الد ا رسة تأثي ا رً سالب اً للحصار على تقديم الخدمات بشكل عام، كما أن الآثار السلبية للحصار أثرت على العناصر البنائية الست، وفق الترتيب التالي: الأدوية والمستهلكات اولأجهزة والمعدات الطبية الأعلى تأث ا رً، يليها الحوسبة ونظم المعلومات الصحية، بينما كان الأقل تأث ا رً تمويل و ا زرة الصحة. وفيما يتعلق باست ا رتيجيات المواجهة، فقد ت مًنت است ا رتيجيات المواجهة المختلفة الترشيد في استخدام الدوام والمهمات الطبية والتكاليف التش يلية، وا ستعانة بالوفود الطبية من خار غزة، والحد من العمليات الج ا رحية المجدولة، وش ا رم بعض الخدمات من المنظمات غير الحكومية، او ستثما ا رت ال ًخمة في مجال بنام القد ا رت والتدريب. وتشير الحصامات إلى اختلاف النتائل حول التصو ا رت السلبية لتأثير الحصار، ولم تكن ذات د لة إحصائية تبع اً للعمر والجنس والمسمى الوظيفي، وعلى العكس، فحاملو درجة البكالوريوس، اولموظف ون الذين يتلقون رواتبهم من الحكومة في ا رم اب، وموظفو مستشفى ناصر ومستشفى الشفام والأطبام، كانت انطباعاتهم أكثر سلبية تجاه تأثي ا رت الحصار من نظ ا رئهم، مع فروق ذات د لة إحصائية. أ وصت هذه الد ا رسة ب ًرورة ا لت ا زم باستم ا ررية توفير وتعزيز الخدمات التشخيصية والعلاجية في المستشفيات، كما ينب ي تعزيز قدرة المستشفيات على تقديم خدمات تستجيب لمطالب السكان، كما ينب ي تكثيف الجهود لنهام ا حتلال والحصار وا نقسام السياسي من قبل الجميع.
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
factors affecting compliance to anti-hypertensive drug treatment and lifestyle modification among patients attending primary health care clinics in Bethlehem
(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.
Factors Affecting Job Satisfaction of Dietitians in West Bank Hospitals, Palestine
(Al-Quds University, 2024-05-19) Maysaa Rifat Fathi Shaikh Ibrahim; ميساء رفعت فتحي شيخ ابراهيم
In the health sector, human resources are a crucial part of the system, with dietitians forming an important segment of the healthcare workforce in Palestine, classified under allied medical professions. Given the critical role that job satisfaction plays within human resources, this study employs it as a key metric to evaluate the professional landscape for dietitians. Objective: This research aimed to assess the level of job satisfaction among dietitians working in hospitals throughout the Palestinian West Bank. Methods: Employing a cross-sectional design, the study utilized a self-administered questionnaire distributed in October 2023 to all 35 dietitians practicing in the region. The instrument was validated and tested for reliability. It included sections addressing employment status and job satisfaction, the latter measured via a five-point Likert scale. Results: Despite the presence of 51 hospitals in the West Bank (excluding Jerusalem), only 35 dietitians were employed. A majority 63.6% reported satisfaction with their roles. The highest satisfaction levels were observed in "Communication with medical staff and patients. "Other dimensions such as "Area of Practice," "Adjustments in Staffing and Patient Numbers" "Work Environment (Infrastructure)," and " Policies and Protocols " also demonstrated high satisfaction. "Performance Development" and "Incentive Systems," however, received moderate and neutral levels of satisfaction, with the "Incentive System" experiencing the lowest satisfaction rates. An important result was the average dietitians to patient ratio was 1:19. Conclusion: The findings indicate a generally positive perception of job satisfaction among dietitians in the West Bank, particularly in communication and operational aspects of their roles. V However, areas related to performance incentives and development require attention to enhance overall job satisfaction. These results highlighted the need for targeted interventions to improve employment conditions and retention strategies within hospital settings.
Free medical samples effect on the behavior of doctors in the southern West Bank
(AL-Quds University, 2013-07-13) بسام محمد يونس ابو جحيشه; Bassam Mohammed Younes Abu Jheishah; أسمى الإمام; د. حسين الحلاق; د. سعيد السراحنة
Background: Pharmaceutical companies introduced the idea of free samples with a view to promotion and marketing of their products. The promotion is an effective tool which is used for introducing products to the clients. The drug companies are spending huge amounts of money on promotion. Promotion strategy has effects directly on the consumers despite the fact that in pharmaceutical advertising the efforts are directed toward the service providers and not to the medicine consumers. Therefore this research looked at the effect of free samples on the behavior of doctors in dispensing of medicines. Methodology: This study aimed to identify the effect of free medical samples on the behavior of physicians in the southern West Bank, according to the following variables: gender, age, years of experience, the country where he studied, specialty, level of education, and the workplace. The study sample consisted of 269 randomly selected physicians from all doctors practicing medicine in Hebron and Bethlehem. The response rate was 81.8%. A descriptive analytical design was used to achieve the goal of the study. A questionnaire based on the literature review was developed and tested for validity by panel of experts and internal consistency by calculating Cronbach alpha which was 0.74 Results: The study findings that the respondents have average estimated degrees (69.75%) about the activities undertaken by pharmaceutical companies for introducing its brands. And the overall score for physicians’ behaviors regarding drug prescriptions was average (64.25%). And, there were seven statements with high percentages, eight items average and one paragraph low. And the overall score for the free medical samples effect on thebehavior of doctors was average (65%). And it ranged between 29.25%-72.50%. And findings that there were no statistically significant differences at α≤0.05 in the effect of free samples on the doctors behavior in the South of West-Bank related to the following variables: sex, age, years of experience, qualifications, country of study, specialization,work place, the number of monthly visits by Representatives, and the amount of promotion activities practiced by pharmaceutical companies. And there were significant differences at α ≤0.05 in the impact of free samples on doctors behaviors related to type of company that provides pharmaceutical propaganda, and to type of promotion activities. Recommendations: The study recommends that must educate physicians to the importance of adherence to biomedical ethics. And the physicians should participate in medical conferences (update) information in the pharmaceutical industry to enable them to apply it in the treatment of patients Also recommends to create mechanisms that shall enable and motivate physicians to follow-up their patients, especially those receiving new medications. And to motivate physicians to access and review research studies on pharmaceutical products and their effectiveness. And to create and adopt policies to regulate the relationship between doctors and pharmaceutical companies by the Ministry of Health.
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.

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