Health Management الإدارة الصحة

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Applicability of the Learning Organization Concept to the Ministry of Health: Managers' Perspectives
(Al-Quds University, 2009-08-15) Arwa Abdel Wahab Shalabi; اروى عبد الوهاب زكري شلبي
Universally, organizations facing uncertain, changing, or ambiguous contexts need to be able to learn in an efficient and effective manner. In the absence of learning, organizations and individuals simply repeat old practices and improvements are either fortuitous or short-lived. In line with the recently developed learning organization concepts (LO), organizations are increasingly required to be dynamic learning systems in order to develop and thrive. The overall aim of this study is to ascertain the applicability of the LO concepts to the MOH institutions in Gaza from the managers' perspectives. The design of this study is a quantitative, descriptive, analytical cross-sectional one. Selfadministered standardized questionnaire (Dimensions of the Learning Organization Questionnaire) was completed by 662 managers with a response rate of 74.9%. The overall reliability coefficient was high (0.820). The study indicated the total revealed mean of the five LO disciplines was 5.7 (out of 10) with the highest mean for systems thinking discipline (6.1) and lowest mean for the personal mastery discipline. In addition, the dimensions of the LO revealed a total mean of 5.2 out of 10; with the individual learning being the highest (5.3) and the team learning and organizational learning being the lowest (5.1). The extracted findings reflect weak performance of the MOH as a LO from the perspectives of its managers. In other words, the MOH is not yet considered as a LO implying that it is neither facilitating the learning of its members nor transforming itself as needed. The study concluded statistically significant variations in perceptions among the subjects where the PHC managers had elicited higher mean scores than their counterparts in hospitals (P value 0.05). Also, positive differences were revealed between the managerial positions and the elicited mean scores (P value 0.0001). Congruently, managers who were working in the field of finance and administration had higher mean scores than others who work in technical arenas (P value 0.001). Moreover, male managers elicited higher mean scores than their female counterparts (P value 0.005). Regarding the organizational related variables, the availability of organizational strategies, strategic plan for training, follow up after training and the availability of clear structures were associated with higher means scores with statistically significant differences. The dominant organizational learning style was "Habits Style" which is characterized by repetitive processes and blind automaton. The study provided a framework for strengthening the MOH to become a LO that transforms and develops itself. Special attention should be paid to support sharing knowledge and team learning. A basic, yet essential, approach includes promoting issues pertaining to strategic management.
Assessment of Infection Prevention and Control Practices at Operating Rooms in Nongovernmental Organizations Hospitals - Gaza Governorates
(Al-Quds University, 2012-01-02) Jehad Nasri Elmadhoun; جهاد نصري المدهون
Hospital Acquired infections are considered one of the most serious problems in the world. The problem of infection prevention and control in our Palestinian hospitals becomes more serious especially with scarcity of resources and materials; also the lack of supportive policies and direction can exaggerate the situation. The Center for Disease Prevention and Control recommended that educating healthcare workers regarding infection control measures is the highest priority to prevent and control nosocomial infections. The overall aim of this study is to assess the healthcare workers practices at the operating rooms in Nongovernmental Organizations hospitals in Gaza governorates on the light of infection prevention and control protocols. The design of this study is a descriptive analytical cross sectional with mainly quantitative approach and supported by in-depth interviews. The instruments used in this study were self-administered questionnaire, observation checklist for the physical environment of the operating rooms, observation checklist for the health care workers practices and in-depth interviews with the key persons. Six of the Nongovernmental hospitals in Gaza Governorates were included in the study according to eligibility criteria. The study included 169 participants, out of them 154 responded and completed the self-administered questionnaire with a response rate of 91%. Four hundred seventy seven observation checklists were done to assess the healthcare workers practices and 18 observation checklists were done to assess the physical environment of these operating rooms. General measures of validity and reliability were administered. The research findings show that 81.6% of the respondents were exposed to sharp injuries, 88.7% stated that they need more training, 63% don't know about the Palestinian infection prevention and control protocols, 84.4% stated that there are no copies of the protocols in their operating rooms, 81% of the respondents said that the lack of knowledge and education regarding infection prevention and control is the main obstacle that prevents them of using the protocols, about 78.4%, 62.7% attributed the cause to the insufficient training and lack of supportive policy respectively. Only 39.6% of the respondents stated that their management policies support the infection control practices, 46.1% stated that there is no infection control committee in their hospitals, and 72.1% stated that they were never assessed regarding infection prevention and control. The results of observation checklists show the unavailability of the protocols at the operating rooms in the six hospitals and the general adherence to all items of the protocols is weak, about 48.7% for hands washing, 43.5% for surgical scrub, 56.4% for wearing gloves, 41.9% for skin preparation and 51% for sharp disposals. The study revealed statistically significant relationship between the practice and the knowledge, attitudes, training, air quality, flow system, operating room design and materials. The researcher recommends that Nongovernmental Organizations hospitals need to increase their efforts towards improving healthcare workers compliance to protocols by increasing their awareness, knowledge through training and education programs and to disseminate the protocols to make it available to every healthcare worker or at least to be accessible in each department.
Assessment of Medical Waste Management at Private Dental Clinics in the Gaza Strip: Status and Policy Implication
(Al-Quds University, 2016-08-17) Rola Samir Qeshta; رولا سمير قشطة
Medical wastes are generated in hospitals, clinics and places where diagnosis and treatment are conducted. The management of these wastes is an issue of great concern and importance in view of potential public health risks associated with such wastes. This study aims to ascertain the status of medical waste management in private dental clinics in Gaza Governorates, an important segment of dental health care providers. This study is a quantitative, descriptive, analytical, cross-sectional one. The target population was the dental staff working at private dental clinics in the Gaza Governorates. The researcher used a self-constructed, self-administered questionnaire. In total, 276 respondents completed the questionnaire with a response rate of 98.5%. Statistical Package for the Social Sciences Program (SPSS) has been used for data analysis including cross tabulation, percentages, mean, t test and ANOVA. Finding revealed that 61.2% of participants were males and 42.8% were aged 30 to less than 40 years. The majority of respondents (88%) were dentists and holding bachelor degree (85.5%). Of respondents, 61% have less than 10 years of experience, and only 1.8% were having more than 30 years of experience. The majority of respondents (89.5%) not received any training about dental waste management. With regard to policy and guidelines, more than two thirds of respondents (87.3%) were aware of presence of waste management policy and guidelines, but the majority of them (88.8%) informed unavailability of manual guidelines for dental waste management in their clinics. Concerning management of dental waste, the majority of respondents (79.3%) reported absence of supervision on waste management process, and almost all (94.6%) reported the availability of personal protective equipment in their clinics. Nearly half of the participants (44.6%) evaluated their dealing with hazardous waste in their clinics as excellent and 65.2% of the participants have licensed their clinics. Most of participants (90.6%) were personally familiar with dental wastes, also the majority of them (87.6%) had correct knowledge about the definition of dental waste. (98.5%) of respondents knew that they should be wearing personnel protective equipment when handling a dental product. Regarding practice, the majority of the respondents (86%) reported performing separation of the dental waste before disposal, and 88.4 of them reported that they disposed the dental waste after separation. Moreover, the majority of respondents (84.0%) reported disposing cotton, gauze and other items contaminated with blood by thrown it into the general garbage and only 8.3% of them used correct methods. Nearly one third of participants are not satisfied about current dental waste management. Approximately (80%) of the participants had positive attitudes toward the importance of existence of a manual guidelines for dental waste management. The study concluded that majority of dental staff workers working in private clinics are knowledgeable about dental waste management. The practices towards dental waste require further improvement. There is a need for training and monitoring programs accompanied by supervision and learning.
Assessment of Occupational Safety at Al-Shifa Medical Complex
(Al-Quds University, 2016-01-02) Shehada Rezeq Al-Ajrami; شحادة رزق العجرمي
Occupational Safety at healthcare sector has been identified as an essential issue for the health organizations, patients and health care workers. Little is known about occupational safety issues at the Ministry of Health-Gaza. The study employed a descriptive, analytical cross sectional design with a triangulated approach (quantitative and qualitative). Self-administered questionnaire, key informant interviews and observational checklist according to the Occupational and Safety Health Administration were used for data collection. A proportional stratified systematic random sampling was used from healthcare workers working at the complex who conclude the target population. Of the 370 workers selected, 350 responded and completed the questionnaires, with a response rate of 94.5%. The overall reliability coefficient (Cronbach’s Alpha) for the study questionnaire was 0.93 which is acceptable. Statistical Package for the Social Sciences Program has been used for data analysis. The study revealed that the different dimensions of occupational safety had different mean percentages with an average score of 55.6% reflecting moderate perceptions of healthcare workers towards the current status of occupational safety. Healthcare workers’ compliance with the prevention tools and safety procedures dimension had the highest percentage with 71.13%. Identification of workplace hazards and accidents and availability of prevention means dimensions. had moderate percentages with 67.5% and 54.7% respectively. Meanwhile, related factors of workplace hazards and accidents dimension had a mean score of 49%. Availability of occupational safety rules and guideline and their activation and development dimensions had low percentages with 46.3% and 49.2% respectively. In addition, top management commitment to safety issues and safety training programs had low percentages with 46.7% and 43.1% which elicited the lowest percentage dimension. Furthermore, the study results agreed on that, the current occupational safety means and measurements at the complex are available to some extent but not sufficient and not applicable as required. They were met Occupational Safety and Health Administration standards to some extent in the main three hospitals as well as the special surgery building was elicited the better followed by the surgery building, while the obstetric building had the lowest status. Furthermore, the results showed that the main occupational hazards and diseases to witch healthcare workers exposed were infectious respiratory and skin transmitted diseases according to 49.7% , back pain and musculoskeletal disorders according to 30.8% , needle stick injuries and blood transmitted diseases as reported 28.8% , work overload and violence as agreed 24.2%, varicose veins as claimed 12% , electrical hazards according to10% , carcinogenic hazards as reported 5.7% and vision problems according to 4.2% of the participants. The main factors beyond these hazards were lack of specialized safety department or committee ;lack of prevention tools and safety procedures; lack of compliance to safety guidelines and regulations application; scarcity of employees training programs; lack of protection methods and lack of occupational safety knowledge among the employees. Moreover, the findings revealed that respondents with younger age and fewer years of experience had higher occupational safety scores than their counterparts of older age and longer experience years. Also, there were variations in the overall perception in reference to workplace towards surgical hospital. The nurses had higher mean scores than other professional categories. Furthermore, the respondents with lower educational level perceive occupational safety more than those with higher ones. Therefore, the single respondents and those who work shifts had higher scores than married respondents and those who work only morning shifts. On the other hand, the results showed that no statistical differences were found in overall occupational safety status perceptions in reference to age and weekly working hours. The status of occupational safety is moderate and still needs a lot of efforts to enhance the effective management and successful practicing of safety issues in Al-Shifa Medical Complex by increasing attention and awareness at all levels to promote and improve the current status.
Assessment of Physicians Compliance with the Essential Drug List at Governmental Hospitals - Gaza Governorate
(AL-Quds University, 2016-05-10) أحمد عبد الماجد صالح الخضري; Ahmed Abdelmajed Saleh Alkhodary; ختام ابو حمد; Yahia Abed; Sobhy Skaik
Assessment of the Clinical Nursing Supervision at Governmental Hospitals- Gaza Governorates
(Al-Quds University, 2011-06-02) Ramadan Ali Ramadan Hassan; رمضان علي رمضان حسان
The literature indicates that clinical nursing supervision has a significant impact on the quality of nursing care. The overall aim of this study was to assess the clinical nursing supervision at governmental hospitals in Gaza governorates from the perspectives of both supervisors and supervisees in order to increase the effectiveness of the supervision processes and outcomes. The design of the study is a descriptive, analytical cross sectional one. One hospital from each governorate from the five Gaza Strip governorates was randomly selected. All supervisors (head nurses and nursing supervisors) were included and a systematic proportional random sample was selected from the supervisees. In total, 160 supervisors were included and the response rate among them was 83.1%; meanwhile, the sample size for supervisees was 300 subjects and the response rate was 90%. Two questionnaires were developed to reflect the study domains which based on the Proctor’s three interactive functions of clinical supervision (formative, normative and restorative) in addition to personal, organizational and supervision related variables. Data were collected utilizing the self-administered questionnaire approach and the reliability coefficient (Cronbach’s Alpha was very high (more than 0.9 for the two scales). Findings show that relatively young male supervisors were dominating the supervisory positions (72.2% were males) at the surveyed facilities. Training opportunities in supervision for supervisors was limited as (less than 25% received training courses in supervision). The availability and use of supervisory tools was also limited; about 24% of the supervisors were using checklists. Nearly half of the supervisors reported being involved in setting hospitals’ objectives and strategies. Similarly, 50% of the supervisees reported being engaged in the performance appraisal for themselves and for their peers; however, they didn't receive adequate feedback in this regard. The study shows that overall the supervisors were more positively perceiving their supervisory roles (80.2%) than supervisees who received supervision from them (68.6%). The restorative function was the highest perceived function among both the supervisors (84.8%) and the supervisees (71.7%) while the formative function was the least positively perceived function by both supervisors (77.5%) and supervisees (63.8%). The formative function is the core function of the clinical supervision indicating that the current supervisory system is relatively administrative rather than clinical. Supervisees’ perspectives indicated that positive perceptions were elicited about the clinical supervision of head nurses more than the nursing supervisors with statistically significant differences (P value < 0.05). Supervisors who are head nurses, females and having long experience had elicited higher scores than their counterparts with statistically significant differences (P value < 0.05). On the other hand, supervisees who were females, holding diploma certificate supervisees more positively perceiving the supervision they had received than their counterparts with statistically significant differences (P value < 0.05). The researcher recommends strengthening the clinical aspect of supervision, formulation of clinical supervision policy and promoting the use of supervisory tools such as checklists.
Assessment of The Effectiveness of Transition of Care Process in Gaza Governmental Hospitals
(AL-Quds University, 2020-01-11) رولا سامي سليم ابو ضلفة; Rola Sami Saleem Abu Dalfa; معتصم حمدان; د. بسام أبوحمد; د. سناء أبو دقة
Assessment of the Occupational Safety and Health Standards in the Vocational Training Centers in Gaza Governorates
(Al-Quds University, 2012-08-12) Manar Ahmad Hamad; منار احمد حمد
Background: Vocational training is a very important tool in the development of the communities. The vocational trainees are the products of the vocational training and its tool in the development. Their safety and health are very essential elements so they can fulfill their part in the development. Aim: To assess the levels of occupational safety and health standards application in the training workshops in the vocational training centers in Gaza governorates. Methods: The design of the study was descriptive, to determine the occupational safety and health standards, which should be available in the vocational training centers in Gaza Strip. The sample included all the vocational training centers that belong to local and international NGOs and the government sector and all the trainers working in these centers who had direct supervision and vocational training for the trainees with total number109. In addition to the workshops of the centers where training takes, place. Data was collected through self-administered questionnaire completed by one hundred and four trainers and checklist for eighty-three workshops. The response rate was 95% for employees and 100% for workshops. Result: The providers of the vocational training in Gaza strip are very important providers such as UNRWA, MOL, MOW, and the NGO. Most of the centers provide vocational training for decays. The vocational trainers are well qualified, about 54% of them have experience years more than 10 years. The study results showed that about 70% of the trainers had received training on OSH issues but more than 80% of them did not know the concepts of OSH asked in the study. According to more than 80% of the trainers, the centers provide appropriate personal protective equipment (PPE).However, according to the results of the checklist, in about 50% of the workshops there were no PPE neither provided to the trainees nor training on the use of PPE. Only 26% of the trainers said that their centers have special OSH technician. In addition, 76% of the trainers think that their workshops need changes regarding occupational safety and health. Curriculum of occupational safety and health is available in the centers according to 87% of the trainers. Emergency plans are not available in 84% of the workshops. Alarm system is not available in 71% of the workshops. Regarding the occupational hazards in the workshops, 85% of the workshops do not have any precautions against fire hazards. More than 90% of the workshops have good and accepted electrical hazards precautions. The physiological hazards were as following, the illumination was poor in about third of the workshops. Natural ventilation is accepted but more than 60% of the workshops have no ventilation system. The conditions regarding the chemical hazards in the workshops are very poor. The hand tools used by the trainees are in good condition and suitable for the type of work. In about 40% of the workshops, there are no first aid boxes The study results showed that the most common injuries among the trainees were the cuts (38%), burns and eye injuries (15%), fractures (12%) and electric shock (9%).There were statistically significant differences between the center's providers in reference to the occupational hazards. Conclusion: The vocational centers need to pay more attention to the occupational safety and health standards to ensure the safety of the trainers and trainees. Provision of training to the trainers and trainees regarding OSH issues is required.
Causes of visual impairment and blindness amongst patients attending a community mobile clinic in the West Bank
(AL-Quds University, 2003-12-03) أحمد معالي; Ahmad Maali; فارسين شاهين; مرام اسحق; عائشة رفاعي
Compliance with Burn Pain Management Protocol in Governmental Hospitals Gaza Strip
(AL-Quds University, 2020-01-05) يوسف اسماعيل أحمد الشامي; Yousuf Ismael Ahmed Alshami; أشرف الجدي; د. ختام أبو حمد; د. صبحي سكسك
The computerized assessment of some postural health parameters among the Palestinian students aged 7-15 years old
(AL-Quds University, 2004-04-01) جمال حامد محمد النمورة; Jamal Hamed Mohd Nammoura; عبد الحميد الزير; محمد الدواليبي; محمود السوس
The Contributions of the International Funds to Developing the Palestinian Health Care System: Focus on NGOs-Gaza
(Al-Quds University, 2012-09-01) Mohammed Shokri Al-Khaldi; محمد شكري محمد الخالدي
International Fund (IF) has become an important source in developing countries including Palestine. The overall aim of this study was to assess the role of IF in supporting the Palestinian Health System at NGOs sector in Gaza governorates. The study design is cross sectional with triangulation of quantitative and qualitative approaches. The instruments used were interviewed-questionnaire and in-depth interviews with 8 key informants. The study population included 52 NGOs, 48 of them responded (88%). General measures of validity and reliability were administered such as standardization of instrumentation and implementation. The SPSS program has been used for quantitative analysis and open coding thematic analysis for the qualitative analysis. Reliability test analysis was high (0.8) indicating high consistency of the study questionnaire. The research findings show that 85.4% of the NGOs directors were males; most of them were trained at BSc. degree level and had 15 years of experience in average. Most of the NGOs were located in Gaza City (58%) followed by Khanyounis (14.6%). Responses indicated that 95% of NGOs were engaged in providing health services and 54.2% reported working in development oriented activities, 25% in rehabilitation services and 10% were reported working in advocacy and mobilization fields. The overall perceived IF contribution’s score was 2.05 out of 3 (68.46%) indicating that perceptions about IF role were moderate. Reported perceptions about sustainability were more positive and elicited higher mean scores (78.30%). The revealed scores reflecting perceptions about the contributions of IF were as follows efficiency, effectiveness, relevancy and appropriateness was around 75%, evaluation and monitoring domain 73%, transparency and governance 71.41%, meetings of NGOs needs and development domain was 68.79%, while the IF nature domain was 68.63%. Perceptions about responsiveness to the needs of the Palestinian population such as alliveiating human suffering, minimizing the consequences of the occupation and promoting the socio-economic status had elecited moderate scores also. The overall scores reflecting the extent to which IF improves the national health indicators by improving the quality of health serives was moderate (64.86%) indicating gaps in adequacy or utilization of IF. The IF contributions to meeting the Millennium Development Goals such as reducing infant and maternal mortality, fertility, poverty and unempolyment elicited 63.39%. Perceptions about coordination and cooperation were the lowest scores of the study domains (60.67%). More than 70% of respondents stated that their NGOs had suffered from financial deficits mainly due to insufficient funds and the major obstacles in securing fund were political conditions and inadequacy of interactions with donors. The revealed scores reflecting perceptions about the IF contribution to development rather than relief was 75.69%. There were factors affecting and/or affected by the IF in the health field, mainly politics, security, absence of coordination, health NGOs and donors’ vision and goals incompatibility, organizational factors such as NGO strategic management and economical and financial factors. The researcher recommends that donors and NGOs need to proactively coordinate in order to meet the needs of the Plaestinan community. Areas which require more attention include developing mutual vision, closer coordination and paying more attention effectiveness, efficiency and sustainability. NGOs need to improve their capacity to strtagically manage funds in a way that promote meeting public health needs and priorities.
Coronary Computed Tomography Angiography Versus Invasive Coronary Angiography at Gaza Governmental Hospitals: Cost Effectiveness Analysis
(AL-Quds University, 2018-12-09) حسام حسن حسين منصور; Husam Hassan Hosien Mansour; ياسر العجرمي; د. ختام أبو حمد; د. محمد مطر
Drugs Prescribing Patterns and Practices at UNRWA Health Centers – Gaza Governorates
(Al-Quds University, 2012-06-04) Mona Arafat El Baba; منى عرفات البابا
The practice of rational drug prescribing is of great importance for the safety of patients and the health facility expenditure. This study aimed to examine prescription patterns among prescribers working at UNRWA health centers and to determine their level of adherence to WHO standards of drug use indicators. The popula"on of the study consisted of #$% prescribers and the sample si&e was #'# prescribers ()$ males and *+ females,- with response rate %%..%/ and #+'# prescrip"ons from all UNRWA health centers in Ga&a Strip. For data collection- constructed- self administered questionnaire and checklist for drug indicators were used. For data analysis- the researcher used frequencies- means- standard deviation- Chi square and One way ANOVA test. The results showed that ))/ of study par"cipants reported knowing the meaning of essen"al drugs- )6.6/ knew the meaning of generic name- $6.'/ knew the generic name for all prescribed drugs. **.*/ knew the generic name for most of the drugs and )).#/ were familiar with the concepts of standards treatment guidelines. Only '*.$/ used generic name very o7en- $$.$/ used generic name o7en and only '*.*/ received training about prescribing patterns. Also- )).8/ reported that a copy of 9:; was available- )8.6/ were using the 9:;- of them- 6'.8/ found that 9:; was easy to be used. Regarding shortage of drugs- +$.*/ of study par"cipants said that they experienced shortage of drugs and +8.8/ reported that the main shortage was in antibiotics followed by dermatological drugs (*8.'/, and NSA<:s (*#.$/,. The ma=ority of study par"cipants )6.#/ said that there is a monitoring system for prescribing of drugs- )'.$/ said that there is a wri>en technical instruc"ons for prescribing- only '..'/ received wri>en feedback and 8+.'/ received verbal feedback regarding their prac"ce. Concerning drug use indicators- the mean number of prescribed drugs was '.%% per prescrip"on- percentage drugs prescribed by generic name was '8.$- percentage of prescribed an"bio"cs was *'.6- percentage of drugs prescribed from 9:; was 6).*% and percentage pf prescribed in=ec"ons was *.#. The results indicated that the highest rate of prescribing drugs in general and from 9:; was from North governorate- the highest number of prescribed drugs was in general ?les (m @ '.)', and the lowest was in mother ?les (m @ '.%.,. The highest rate of prescribing drugs was in the third #. days of the month (m @ '.6+,. The study concluded that further educational activities should be taken to achieve rational prescribing and standards of drug use indicators.
Employees' Perspectives about Communication at the Palestine Red Crescent Society
(Al-Quds University, 2011-02-27) Helmy Jameel Abu Dalal; حلمي جميل ابو دلال
Communication is an essential factor for the success of any organization. It shapes the organization culture and influences the major functions inside the organization including control, motivation, change, decision making and information exchange. This study aimed to assess employees’ perspectives about communication at the Palestine Red Crescent Society (PRCS). The design of this study is a descriptive, analytic, cross sectional one. Stratified random sampling technique was used to select 300 employees. Self-administered questionnaire was distributed and data was analyzed by using the SPSS. The response rate was 87%. Content validity was validated by experts and Cronbach's Alpha consistency test equals 0.864.The result of this study showed that the majority of employees were males (69.3%) and married (85%). The mean age of the PRCS employees was 35.39 years. The most academic qualification hold was Bachelor's Degree (35.2%). Also the result showed that the most commonly communication tool in use during emergency is the mobile (47%), while during routine work face to face is more preferrable (61.7%). Furthermore, the study revealed that the mean of the knowledge dimension equals 3.97 (79.3%), the mean of the perception dimension equals 4.01 (80.2%), the mean of the filed “skills and practice” equals 4.03 (80.5%) and the mean of the filed communication gaps equals 2.96 (59.2%).About half of the employees were satisfied about the current communication level within the organization. Sixty two of the employees didn’t get any training courses in communication skills. About 50% of PRCS employees were facing conflict in the organization and 68% of them had admitting that there are gaps in communication in the organization. Sixty percent of PRCS employees believed that the PRCS administration gives high concern to develop the communication process within the organization.The study revealed the age group 45-50 were having the highest mean with statistically significant differences than the other age groups. Master Degree/PhD holders, employees having more than 15 years of experience and the administrators elecited higher scores in communication skill and practices than their counterpart groups with statsical significant differences (P value is less than 0.05). In contarty, gender, number of family members and work setting didn’t statistically significantly affecting the perceptions about communication among PRCS employees. The study conclude that inservice education, holding training programs and workshop should be established in order to improve the communication process. Developing the PRCS managers’ skills to communicate and interact with their employees is essential.
Evaluation of Community Based Rehabilitation Programs in the North and Gaza Governorates
(Al-Quds University, 2011-06-18) Soad Jameel S. Radwan; سعاد جميل رضوان
Community Based Rehabilitation (CBR) is a specific and important strategy for people with disabilities. This study aims to evaluate the CBR programs in Gaza and North Gaza governorates inorder to provide information that could contribute to support the services delivery and enhance the effectiveness of the programs to disabled persons. Evaluative techniques including triangulation methods combining both qualitative and quantitative techniques were conducted at the National Society for Rehabilitation and Palestinian Medical Relief Society. A sample of 300 beneficiaries have been chosen through a systematic random sample, and participated through a self-constructed interviewed- questionnaire with a response rate of 69.7%. Also, 10 key informants have been selected purposively for interview. In addition to that, 20 medical files were reviewed randomly. The study results revealed the main causes of disability are acquired in 71.6% of cases with various types, mainly accidents that constituted (52.1%), followed by communicable diseases (16.7%), and wars (14.6%). Among disability types, physical disability is the commonest one that formed 76.1%. The prominent services were relief aids (42.8%), followed by assistive devices (28.6%) and physiotherapy (27.1%). There was lack in livelihood domain where vocational training forms only (0.5%), and lack of the income generation and disabled people employment, while the majority (80.6%) of disabled live under the poverty line. The results indicated that 50.3% of visits are less than one visit monthly. Regarding the services provision, there is no difference between males and females. The researcher show that CBR programs are effective, this was elicited from response of the most of disabled’s needs, and improvement in disabled physical health status (P value 0.001), and psychological state (P value 0.001). At the same time, positive proportional correlation was found between the provided services scores and improvement of quality of life domains that contained indicators like feeling security, satisfaction, change in physical and psychological health state and social participation of disabled people (Pearson correlation 0.376 - P value 0.001). The study reflected good networking with different sectors, but governmental collaboration with CBR programs is still weak. On the other hand, communication and interaction of rehabilitation workers with disabled people was cooperative. The limited number of the rehabilitation workers and lack of volunteers increased the workload, and affect work’s process and quality. The study revealed shortage in the documentation and cases evaluation, poor public awareness about disability issues, and weak of the community ownership. Furthermore, application of the disability law number 4-1999 is inactive. This was indicated through the absence of disabled self- advocacy, and lack of the governmental role in maintaining disabled rights. The study provided a set of recommendations that could strengthen the CBR programs including; establishment of a national strategy aiming to create public awareness about the disability issues, and formulating of a local committee for developing polices, empowering the disabled role in the community, enhancing the voluntary work, and developing of staff capacity.
Evaluation of Diabetic Retinopathy Management in the Gaza Strip
( Al qudis University, 2022-12-11) ماريان جميل سليمان سابا; Marian Jameel Soliman Saba
ملخص الدراسة يؤثر اعتلال الشبكية السكري على ما يقارب ثلث الأشخاص المصابين بداء السكري، والذي يمكن أن يؤدي إلى ضعف البصر والعمى إذا لم يتم اكتشافه وعلاجه في الوقت المناسب. والى اعتلال الشبكية السكري آثار صحية واقتصادية كبيرة على الصعيد العالمي، وخاصة في بلدان مثل فلسطين حيث يتزايد انتشار مرض السكري بشكل كبير. يمكن الفحص الدوري والمنتظم والإجراءات العلاجية المناسبة والمتابعة المنتظمة في منع أو تأخير حدوث العمى. لسوء الحظ، توجد العديد من المعيقات التي تعيق المرضى من إجراء فحص دوري منتظم للعين. هدفت هذه الدراسة إلى تقييم إدارة اعتلال الشبكية السكري في قطاع غزة لتحسين جودة الخدمات المقدمة وبالتالي تحسين النتائج العامة للمريض. منهجية الدراسة تعتبر هذه الدراسة وصفية تحليلية كمية، أي أنها طريقة مختلطة تتضمن جمع بيانات نوعية وكمية. تم جمع البيانات الكمية من مرضى داء السكري الذين تم تشخيصهم سابقا بالاعتلال الشبكية السكري بغض النظر عن درجة الإصابة، والذين استخدموا خدمات اعتلال الشبكية السكري في احدى أماكن الدراسة، وهي المستشفيات الرئيسية الثلاثة التي تقدم خدمات طب العيون. في المجموع، شارك 404 مريضا في الدراسة الكمية. أما الدراسة النوعية، تم جمع البيانات من خلال خمس مجموعات نقاش مركزة مع مرضى السكري الذين يعانون من اعتلال الشبكية السكري، وكذلك تم إجراء مقابلات متعمقة مع خمسة من مقدمي خدمات طب العيون الذين لديهم خبرة في اعتلال الشبكية السكري. تم إجراء تحليل البيانات الكمية باستخدام برنامج SPSS، وتضمن التحليل إجراء أنواع مختلفة من الاختبارات الإحصائية. بالنسبة للبيانات النوعية، تم استخدام طريقة الترميز المفتوح الموضعي التحليلي. نتائج الدراسة أظهرت الدراسة أن 88.1٪ من المشاركين في الدراسة كانوا يعانون من مرض السكري من النوع الثاني مقارنة ب 11.9٪ منهم كانوا يعانون من مرض السكري من النوع الأول، وكان متوسط سنوات المعاناة من مرض السكري 13.07 سنة، وكان لدى 51.5٪ من المشاركين فرد آخر من العائلة مصاب بمرض السكري، وخاصة الأم والأب. 56.1 ٪ من المشاركين وصفوا أنفسهم بأنهم يعانون من زيادة الوزن أو السمنة. وكان حوالي 40٪ من المشاركين يعانون من مرض مصاحب آخر، بشكل رئيسي ارتفاع ضغط الدم، و15.3٪ من المشاركين في الدراسة عانوا من مضاعفات أخرى لمرض السكري، وخاصة من اعتلال الأعصاب الطرفية. معظم المشاركين في الدراسة (90٪) تناولوا أدويتهم بانتظام. وفيما يتعلق بالاعتلال الشبكية السكري، بلغ متوسط سنوات المعاناة من اعتلال الشبكية السكري 4.23 سنوات. من بين المشاركين في الدراسة، أفاد 66.3٪ من المشاركين أن أطبائهم نصحوهم باستشارة طبيب العيون، وأفاد 88.3٪ منهم أن طبيبهم نصحهم بإجراء فحص سنوي للعين، وأفاد 86.7٪ من المشاركين أنهم أجروا زيارات متابعة منتظمة، وكان السبب الرئيسي لزيارة المشاركين هو المتابعة بنسبة 73٪. ومن بين المشاركين في الدراسة، كان لدى 70.4٪ سهولة في الوصول إلى خدمات اعتلال الشبكية السكري، وكان العائق الرئيسي لعدم انتظام زيارات المتابعة هو نقص الدعم الأسري بنسبة 33.7٪، يليه عائق التكلفة إما تكلفة النقل أو تكلفة الخدمة، بنسبة 24.3٪، و23.3٪ على التوالي. بالنسبة للتحاليل المخبرية، 86.1٪ من المشاركين في الدراسة قاموا بعمل التحاليل المخبرية السنوية، وأفاد 89.9٪ منهم أنهم تلقوا تعليقات حول نتائج تحاليلهم المخبرية، وأفاد 42.3٪ فقط من المشاركين بأن لديهم مخزون السكر HbA1c منتظم مقارنة ب 53.6٪ كان مخزون السكر HbA1c لديهم غير منتظم و4.1٪ منهم لا يتذكرون نتيجة التحليل. من بين المشاركين في الدراسة، أبلغ 71٪ عن عدم وجود تغطية تأمينية كاملة وأنه لا يزال يترتب عليهم دفع ثمن الخدمات. وبلغ متوسط مستوى وعي المشاركين في الدراسة حول اعتلال الشبكية السكري 86.8٪. أفاد 51.6٪ فقط من المشاركين أن الخدمات تلبي توقعاتهم. بلغ متوسط وقت الانتظار 57.02 دقيقة، وبلغ متوسط التفاعل بين المريض ومقدم الخدمة 77.4٪. وفيما يتعلق برضا المرضى عن الخدمات المقدمة، بلغ متوسط الرضا 75.56٪ وارتبط بشكل كبير بالعمر والجنس وحالة العمل. في حين أن متوسط جودة حياة مريض اعتلال الشبكية السكري كان 67.91٪، وكان مرتبطا بشكل كبير بالحالة الاجتماعية وسنوات الدراسة وحالة العمل. الخلاصة على الرغم من وجود مستوى جيد من الوعي لدى المرضى حول اعتلال الشبكية السكري، إلا أن أقل من نصف المشاركين قد سيطروا على مستوى مخزون السكر في الدم (HbA1c)، وهو العامل الرئيسي في الوقاية من مضاعفات مرض السكري، بما في ذلك اعتلال الشبكية السكري. ولقد تم توعية المرضى حول اعتلال الشبكية السكري بعد تشخيص إصابتهم به. ويمكن تفسير ذلك من خلال التركيز المحدود على الرعاية الذاتية لمرض السكري، عدم كفاية التثقيف حول الوقاية من مضاعفات السكري المحتملة، وبرامج الفحص المحدودة، وعدم كفاية وقت الاتصال مع مقدمي الرعاية الصحية الأولية، وعدم كفاية عدد مقدمي الرعاية الصحية المتخصصين في التعامل مع اعتلال الشبكية السكري. بالإضافة إلى عدم وجود إرشادات مناسبة لإدارة اعتلال الشبكية السكري في المستشفيات الحكومية. يمكن أن يساعد الكشف المبكر والإدارة السليمة في تقليل المزيد من المضاعفات والفقدان الكلي للبصر. يمكن للبرامج التعليمية التي تستهدف العامة حول مرض السكري واعتلال الشبكية السكري والتعليم الطبي المستمر حول إدارة مرض السكري من تحسين رعاية مرضى السكري والإدارة الذاتية وبالتالي منع اعتلال الشبكية السكري والمضاعفات الأخرى. Abstract
Evaluation of in-patient Rehabilitation Services in Gaza Governorates
(AL-Quds University, 2018-12-15) مبادئ حمدان مصطفى الفرا; Mabadee Hamdan Mostafa AlFarra; بسام أبو حمد; أ. د. يحيى عابد; د. رامي العبادلة
Evaluation of Medical Internship Program at the Ministry of Health in Gaza
(AL-Quds University, 2019-12-13) أحمد صلاح شعبان الشرفا; Ahmed Salah Shaban Alshorafa; خميس الإسي; د. يحيى عابد; د. خالد زمو
Evaluation of Natal-Care Services Provided by Governmental Hospitals in Gaza Governorates
(Al-Quds University, 2012-12-01) Sahar Abdel Wahhab Shalabi; سحر عبد الوهاب شلبي
Birth is an occasion that changes life. It is a natural process, and there must be a good reason to interfere with this natural process in order not to expose women to high rates of intervention, unfamiliar personnel, lack of privacy and other situations that may be felt as harsh. The overall aim of the study is to evaluate the natal care services provided by governmental hospitals in Gaza Governorates. The design of this study is a quantitative, descriptive, analytical, cross-sectional one and was conducted in governmental maternity hospitals in Gaza Governorates. Data were collected from forty low- risk women during labour and birth using an observational checklist that was prepared to assess the practices for normal childbirth in relation to evidence-based childbirth care and to obtain a rough estimate of the frequency of certain practices. And another checklist for medical records to evaluate the quality of documentation of medical records in terms of completeness, and accuracy. Data were analyzed using Statistical Package for the Social Sciences, Version 17.0. The results indicated that non-evidence-based practices are commonly used to support, and manage birth in Gaza Governorates. High levels of obstetric interventions were observed giving evidence of their inappropriate or routine use, and largely deviated from the well-known best practice recommended by World Health Organization for normal birth. It was found that Intra Venous fluids were used for 60% of the observed women, fetal heart sounds were checked during the 2nd stage of labour in 37.5% , 66.7% of them by continuous Cardiotocograph Partogram was filled in 35% of cases, labour was augmented with oxytocin in 62.5% of cases and with artificial rupture of membranes in77.5% of them. Birthing women were not always treated with respect and their privacy was violated many times, with frequent lack of communication with health care providers and lack of support from health care providers and family members. There were clear differences between observation, and documentation. Augmentation of labour was used commonly by oxytocin (62.5 %), but it was less documented in medical records (52.5%). Blood pressure was measured in the observation only in 37.5% of cases but documented in 72.5%. The overall completeness of records was found to be poor (46.4%). The completeness of demographic information (67.5%) was good in general. But it was for some items very poor, such as general examination and vital signs (12.5%), abdominal examination (10%), vaginal examination (2.5%), and Partograms filling (20%). Incomplete and inaccurate documentation of health records were detected indicating poor quality of care which stresses the need to increased attention for documentation of medical records. This study provides recommendations to support evidence-based practices and encourage normal deliveries, and standardization of medical records among governmental hospitals.

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