Nursing Management إدارة التمريض
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- ItemThe Impact of Glucagon-Like Peptide-1 Receptor Variants on the Response of Palestinian Type 2 Diabetes Patients to Dipeptidyl Peptidase-4 Inhibitor Therapy(Al-Quds Univeersity, 2025-12-06) Rahaf Khaled Mohammed Zeer; رهف خالد محمد زيرBackground: Type 2 Diabetes Mellitus (T2DM) is a chronic disease characterized by hyperglycemia due to dysfunction of beta cells or insulin resistance. Dipeptidyl peptidase-4 (DPP-4) inhibitors or gliptins are one of the new medications used for T2DM. Glucagon-like peptide-1 receptor (GLP1R) is one of the indirect targets for this drug. Genetic variants in GLP1R have been studied in different populations, but not in Palestine, to test their association with the glycemic response to gliptins. This study aims to investigate the association between rs6923761 (G: wild-type, A/C: variant) and rs10305457 (C: wild-type, T/G/A: variant) in the GLP1R gene and the response to gliptins in T2DM Palestinian patients. Materials and Methods: This retrospective cohort study recruited 200 T2DM patients between February 2025 and August 2025 from Al-Eizariya Governmental Health Directorate. These patients administered gliptins for at least six months. To test the effect on response to gliptins, two readings of HbA1c were obtained from their medical records with a 6-month gap, one at the initiation of gliptin therapy and the other after six months. Other demographics and clinical data were also obtained from the medical records. DNA extraction was performed using whole blood collected from all study participants. A fragement of GLP1R gene sequence that includes both SNPs was amplified using PCR, and Next Generation Sequencing (NGS) was used to determine the genotypes. Multivariable binary logistic regression was used to evaluate the association between each SNP and the response to gliptins with adjusting for covariates. A general linear model (GLM) test was also used to test the same association but with including a covariate that wasn’t added to the regression model, and with the response rate as a dependent variable. Results: The average age of patients recruited in this study was 63.5 ± 8.63. 54% of the participants were females, and the rest were males. For rs6923761, GG, GA, and AA genotypes were observed in 66%, 28.5%, and 5.5% of participants, respectively, with G and A allele frequencies of 80.25% and 19.75%, while for rs10305457, CC, CT, and TT genotypes occurred in 74.5%, 23%, and 2.5% of participants, with C and T allele frequencies of 86% and 14%, respectively. Participants who achieved ≥10% reduction in HbA1c were classified as responders, while those with <10% reduction were considered non-responders. Around 46% of participants were considered responders to gliptins according to this criterion. For rs6923761, 72.7% of AA carriers were responders, followed by 52.6% of GA carriers and 40.2% of GG carriers. For rs10305457, 80% of TT carriers were responders, compared with 50% of CT carriers and 43% of CC carriers. HbA1c was significantly reduced after six months of add-on treatment with gliptins among the participants (p<0.001). A statistically significant decrease in BMI (p=0.024) and creatinine levels (p=0.019) was also detected. Systolic (SBP) and diastolic blood pressures (DBP) showed no significant changes. When evaluating the association between rs6923761 SNP and the response to gliptins while adjusting for covariates using multivariable binary logistic regression, it was found that this SNP significantly affects the response to gliptins. AA carriers had the highest odds of response when compared to GG (p=0.005) and when compared to GA (p=0.036). Carriers of the A allele also showed higher odds of response compared with GG (p=0.032). The rs10305457 SNP showed no significant association with gliptin response in any genetic model after adjusting for covariates in the binary logistic regression. GLM was used to include the other types of T2DM medications used by the participants as a covariate in addition the previous covariates added in the regression analysis. In rs6923761 under the codominant model, AA carriers exhibited the highest adjusted response rates when compared to GA (p=0.043) and GG (p=0.014). Under the recessive model, AA carriers had statistically significant higher response than the carriers of the G allele group (p=0.005). Under the dominant model, there was no significant association between GG and the A allele carriers group in their response to gliptins (p=0.158). For rs10305457, no significant association with response rate was seen under codominant, dominant, or recessive models. Conclusion: This study showed that the rs6923761 SNP in GLP1R was significantly associated with glycemic response to gliptins. This result indicates the importance of pharmacogenetics in personalized diabetes care. This result can also explain the inter-individual differences in response to gliptins. More studies are still required in this field including larger sample size and different areas across Palestine.
- ItemThe Influence of the Work Environment on Family-Centered Care Among Nurses in Neonatal Intensive Care Units in Governmental and Private Hospitals in the West Bank, Palestine(Al-Quds Univeersity, 2025-12-13) Majd Awni Abdalhadi Jada'a; مجد عوني عبدالهادي جدعBackground: Family-centered care is crucial to newborn services because it provides parents with the necessary support and safety in Neonatal Intensive Care Units (NICUs), which are naturally stressful places. The purpose of this study was to evaluate how nurses' work environments in neonatal intensive care units affected their ability to provide family-centered care. Material and method: This study was carried out by using cross-sectional design, with a convenience sample adopted in total of 210 Neonatal Intensive Care Units nurses. The data collection was gathered by work practice environment and family centered care scales.Data were collected between February 1 and May 1, 2025. Result: The findings revealed that hospital type was the only significant outcome affecting the current family-centered care. Also, nurses in non-governmental hospitals showed higher mean scores (2.60 ± 0.48) compared to those in government hospitals (2.32 ± 0.42, p < 0.001). Post hoc analysis represented significant differences that master's degree nurses were higher than both diploma (p = 0.005) and bachelor's degree nurses (p = 0.025), with no significant difference between diploma and bachelor's nurses (p = 0.132). Age revealed a weak negative relationship with current family-centered care (r = -0.146, p = 0.035), while nursing experience and patient numbers had no significant correlations with either scale. A positive practice environment displayed a weak association with both scales (r = 0.18, p = 0.009; r = 0.15, p = 0.027). Interestingly, a weak negative correlation existed between current and necessary family-centered care (r = -0.23, p = 0.001). Hospital type (B = 0.274, p < 0.001) and practice environment (B = 0.138, p = 0.009) emerged as significant predictors of current family-centered care perceptions. Conclusion:The results highlight the significance of promoting both institutional and educational support in nursing practice by indicating that perceptions of the need for family-centered care are considerably improved by increased educational attainment and supportive practice settings.
- ItemThe Relationship between Nursing Teamwork and Job Satisfaction at Palestinian Hospitals in the Southern West Bank(Al-Quds University, 2025-08-23) Mamdouh Mohammad Ahmad Taqatqa; ممدوح محمد أحمد طقاطقة: Nurses constitute the largest number of hospital employees and are considered among the most prominent healthcare providers, improving the quality of care and patient safety. This requires them to work collaboratively to complete and accomplish the tasks assigned to them. Teamwork contributes to building trust, effectivecommunication, and reducing errors. Task completion is not limited to effective teamwork; nurses' job satisfaction helps them maintain their jobs and provide high-quality services. Therefore, teamwork and job satisfaction are among the most important factors in the success of providing the best possible healthcare services. Aim:The main aim of this study was to assess the relationship between nursing teamwork and job satisfaction at Palestinian Hospitals in the Southern West Bank. Study Design: quantitative descriptive correlational cross-sectional study. Convenience sample, The total population that the study targeted was 1666 nurses, while the calculated sample size was 313, so 360 questionnaires were distributed to nurses at the targeted hospitals, and 336 were returned, representing a response rate of 93,3%. Study tool: a valid and reliable questionnaire that consisted of 79 questions and was divided into three sections. The first section covered demographic information and hospital-related characteristics, the second section covered teamwork (Kalisch et al., 2010), and the third section covered job satisfaction elements (Fairbrother et al., 2010). results: Results show that nurses report high levels of teamwork and job satisfaction. More than half of nurses (51.8%) reported that they practiced teamwork most of the time, and 28.9% reported always working in teams, with an overall mean teamwork score of M = 3.81. Among the teamwork dimensions, mutual trust and shared mental model had the highest score mean M = 3.91, followed by support M = 3.84, team orientationM = 3.74, andteam leadership M = 3.62. Regarding job satisfaction, the majority of nurses reported high (54.5%) and average satisfaction (42.9%), with a mean score of M = 3.64. The highest subscale of job satisfaction was relationships M = 4.06, followed by intrinsic satisfaction M = 3.68, while extrinsic motivation was rated the lowestM = 3.32. Spearman's ordinal correlation revealed a strong, positive, and statistically significant relationship between teamwork and job satisfaction (r = 0.720, p < 0.001), indicating that higher perceptions of teamwork are associated with greater job satisfaction. Positive relationships were also observed between all subscales of teamwork and job satisfaction. Conclusions: This study aimed to assess the relationship between nursing teamwork and job satisfaction in Palestinian hospitals located in the southern West Bank. The study results demonstrated a strong, positive, and statistically significant relationship between teamwork and job satisfaction. The results also showed that nurses who reported high levels of mutual trust, teamwork orientation, support, a shared mental model, and effective leadership are more likely to demonstrate high levels of job satisfaction. This study concluded with several recommendations, the most important of which is that nursing directors, hospital administration, and the Palestinian Ministry of Health should work to improve teamwork among nurses by developing and implementing new policies and creating training programs that promote a culture of teamwork. This will provide a suitable and comfortable work environment in which nurses enjoy high levels of job satisfaction, which in turn will be reflected in the quality of health services provided to patients. Keywords: Relationship, Nursing Teamwork , Job Satisfaction , Palestinian Hospitals, southern West Bank.
- ItemThe relationship between Flexible work schedule, nursing staff wellbeing, nursing performance, and burnout among nursing staff in South West Bank in governmental and nongovernmental hospitals(Al-Quds University, 2025-08-24) Mohamed Abd Alkareem Ahamd Albadarin; محمد عبد الكريم احمد البدارينIn the evolving landscape of healthcare, flexible work schedules (FWS) have emerged as critical interventions to improve staff well-being and performance, particularly among nurses who face high job demands and emotional strain. In Palestine, nurses are burdened by staffing shortages, unpredictable shifts, and limited institutional support, contributing to increased burnout and reduced job satisfaction. Aim This study aims to assess the relationship between flexible work schedules, nursing staff well-being, performance, and burnout among nurses working in governmental and non-governmental hospitals in the South West Bank. Methodology: A cross-sectional quantitative study was conducted among 320 nurses, with 291 valid responses analyzed (response rate: 94.4%). Participants were selected through proportionate Convenience sampling from both governmental and non-governmental hospitals in the South West Bank during May to June 2025, including Hebron and Bethlehem districts which includes. A structured self-administered questionnaire measured key variables: type of work schedule, well-being, performance, and burnout. Data were analyzed using SPSS version 26. Statistical methods included descriptive analysis, independent samples t-tests, ANOVA, Pearson correlation, and multiple regression. Results: Findings indicated that 51.2% of nurses reported working under flexible schedules, 35.1% under fixed schedules with minimal choices, and 13.7% under fixed schedules without choices. Flexible scheduling was significantly associated with higher well-being, and improved performance, along with lower levels of burnout (p < 0.05). Nurses in non-governmental hospitals reported a higher prevalence of flexible work arrangements and better psychological and occupational outcomes compared to those in governmental hospitals. Out of the 291 participants, the majority (51.2%) reported working under a flexible schedule, followed by 35.1% who indicated having a fixed schedule with minimal choices. A smaller proportion (13.7%) worked under a fixed schedule without choices. Overall, the results indicate moderate perceptions of work flexibility among participants, with a total mean score for work flexibility of 2.90. Nurses reported moderate levels of overall well-being (M = 2.9, SD = 1.1), showing some variation in aspects such as emotional energy, restfulness, and interest in daily life. Findings also reflect moderate levels of self-reported nursing performance (M = 2.88, SD = 1.05). The total burnout score averaged 31.7 out of a maximum of 50, suggesting a moderate level of burnout within the sample. Female nurses reported higher levels of flexibility (M = 2.96) and performance (M = 3.05), whereas male nurses exhibited greater well-being (M = 62.02). Burnout levels did not significantly differ between the sexes (p = .180). Marital status had significant effects on well-being (p = .008) and performance (p = .003), with divorced nurses achieving the highest scores, potentially reflecting varying support systems or personal motivations. Education level was significantly associated with well-being (p < .001), with diploma holders reporting the highest mean score (M = 65.29). Years of experience significantly influenced both flexibility (p = .031) and performance (p = .010). This study found a statistically significant positive correlation between flexible work schedules and the well-being of nursing staff (r = 0.290, p < .001), along with a strong negative relationship between burnout and well-being (r = –0.271, p = .014). Additionally, there is a notable negative association between flexible work schedules and burnout among nurses, as indicated by a Pearson correlation coefficient of –0.256 (p < .001). Conclusion: Flexible work schedules significantly enhance nurse well-being, performance, while reducing burnout. To address nurse turnover, emotional exhaustion, and performance deficits, Palestinian healthcare institutions should adopt evidence-based scheduling policies that prioritize flexibility. The study recommends policy reforms supporting flexible work schedule implementation, leadership training to manage flexible teams, and further research to explore long-term impacts across different hospital settings. Keywords: Flexible work schedules, nursing performance, well-being, burnout, Palestine, hospitals, hospitals, nurse workforce, occupational health.
- ItemInfluence of Professional Value on Clinical Decision-Making among Nurses in Neonatal Intensive Care Units(Al-Quds University, 2025-08-13) Ahlam Ismael Mughanam Alshaer; احلام اسماعيل مغنم الشاعرThe clinical decision making is critical in neonatal care because nurses must routinely make rapid judgments based on their expertise to provide the best possible outcomes for extremely vulnerable neonates. Effective clinical decision making is a critical component of neonatal nursing practice since it reduces dangers and improves patient well-being. The Professional values represent the core principles, ethical standards, and beliefs that shape professional behavior and decision-making. In the context of neonatal care, these values direct nurses in providing safe, compassionate, and responsible care to newborns and their families, emphasizing integrity, respect, and a commitment to achieving the highest quality of clinical outcomes. Aim of the study This study aims to assess the influence of professional value on clinical decision making among nurses in neonatal intensive care units west bank of Palestine, and to identify key factors that predict clinical decision-making in this critical care environment. Methods A cross-sectional, descriptive correlational design was conducted on 184 full-time NICU nurses recruited from eleven governmental hospitals in the West Bank. Selected through convenience sampling due to institutional access constraints during political unrest. Data were collected using two validated instruments; the nursing professional value using the NPVS-3 and the clinical decision making nursing scale. Results According to the analysis, nurses demonstrated a high level of professional commitment, with an average professional value score of 94.5 ± 14.6 out of a possible 140. Among the subdomains, "caring" scored the highest (M = 34.2 ± 5.5), reflecting its central role in nursing practice. Clinical decision-making (CDM) also showed strong engagement, with a high overall mean score of 179.1 ± 8.9. The subscale "Search for alternatives or options" had the highest score (M = 48.6 ± 1.4), while "Canvassing of objectives and value" scored the lowest (M = 41.7 ± 7.1). A multiple linear regression revealed that age, gender, years of nursing and NICU experience, and professional value significantly predicted CDM (R² = 0.735, p = 0.001). Notably, professional value were the strongest predictor (B = 0.496, p = .001), followed by gender, indicating that both ethical grounding and demographic factors influence nurses’ decision-making in NICUs. Conclusions The current study confirmed that nurses in NICUs demonstrate a high level of commitment to professional value, with the value of "caring" being particularly prominent. Also, the results also showed increase the clinical decision-making, particularly in the "search for alternatives" dimension. The study also concluded that clinical decision-making among NICU nurses is influenced by several factors, most notably professional value, which showed a strong, positive relationship. The multiple linear regression model was able to explain 73.5% of the variance in decision-making, demonstrating the robustness of the studied factors and their importance in improving the quality of healthcare. Keywords: "clinical decision making", professional value, "neonatal intensive care unit", nurses, Palestine\