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- ItemPrevalence and Determinants of Bullying Among School-age Children in Gaza Strip(Al-Quds University, 2022-12-19) Ibdaa Ayyoub Mohammed Rayyis; ابداع أيوب محمد الريستعتبر ظاهرة التنمر مشكلة رتيسية تؤثر على الصحة العامة في جميع أنحاء العالم و يمكن الوقاية منها. إنها أكثر انتشارًا بين الأطفال في سن المدرسة ، ولها آثار ضارة قصيرة وطويلة الأجل على الصحة الجسدية والنفسية للضحايا. الهدف من الدراسة: هدفت هذه الدراسة إلى قياس معدل انتشار التنمر و العوامل المصاحبة للتنمر بين طلاب المدارس في قطاع غزة. منهجية الدراسة: تعتبر هذه الدراسة مقطعية وصفية كمية، و قد تم جمع البيانات من خلال إجراء مقابلات شخصية مع الطلاب لتعبئة الاستبيان. شمل مجتمع الدراسة على 490 طالب (263 ذكور و 227 إناث) تتراوح أعمارهم ما بين 12 إلى 17 عام من بيوت القطاع ، حيث تم استخدام عينة عشوائية من إطار عينة دراسة خاصة بصندوق الأمم المتحدة للشئون السكانية. وقد تم تحليل البيانات باستخدام الحزمة الاحصائية للعلوم الاجتماعية حيث أجريت التوزيعات ، الترددات ، النسب المئوية و الجداول، كما تم حساب النسب المتوسطة و العامة و الجداول المتقاطعة و استخدام اختبار مربع كاي و اختبار الانحدار اللوجيستي لإيجاد العلاقة بين المتغيرات. نتائج الدراسة: أظهرت الدراسة وجود معدل انتشار واسع لظاهرة التنمر بين الأطفال في سن المدرسة في قطاع غزة يصل إلى 78.8%. كما و أظهرت الدراسة علاقات ذات دلالة إحصائية بين التنمر و بعض العوامل الديموغرافية والاجتماعية والاقتصادية مثل الجنس، العمر، ومتوسط الدخل الشهري للأسرة، مكان السكن و عدد أفراد الأسرة. إلا أن النتائج لم تظهر علاقات ذات دلالة احصائية بين التنمر و نوع الأسرة وترتيب الميلاد.كما أظهرت النتائج أن العوامل المتعلقة بالأسرة مثل انخفاض تعليم الوالدين ، وبطالة الآباء ، والعلاقة السيئة مع الوالدين والعنف بين الأشقاء والأبوين ، وعنف الوالدين والأشقاء، وسوء معاملة الوالدين ، كانت مرتبطة إحصائيًا بمخاطر عالية للتعرض للتنمر. لم يتم ربط الحالة الاجتماعية للوالدين والوضع الوظيفي للأمهات بزيادة مخاطر التعرض للتنمر. كما أن النتائج أظهرت وجود علاقة ذات دلالة إحصائية بين التنمر و بعض العوامل المتعلقة بالمدرسة مثل الذهاب إلى المدارس العامة، وتحقيق معدل فصلي يتراوح من 50٪ -70٪ في المدرسة ، وجود علاقات سيئة مع المعلمين والأقران ، والحضور في مناخ مدرسي سام. حيث ساهمت هذه العوامل في إرتفاع مخاطر التعرض للتنمر. ارتبطت عوامل اعتلال الصحة الجسدية مثل الإعاقة والسمنة وعدم الرضا عن المظهر الخارجي وعدم الرضا عن وزن الجسم بشكل كبير بالتعرض للتنمر. ارتبط استخدام التكنولوجيا وعوامل الإنترنت مثل حيازة الهواتف الذكية والأجهزة التكنولوجية ، والوصول المستمر إلى الإنترنت في المنزل وعدد الساعات التي يقضيها طالب المدرسة على الإنترنت أسبوعيًا بشكل كبير بالتعرض للتنمر. لم يكن استخدام الإنترنت خارج المنزل مرتبطًا بزيادة مخاطر التعرض للتنمر. الخلاصة: يعتبر التنمر مشكلة شائعة بين الأطفال في سن المدرسة في قطاع غزة. هناك حاجة لتنفيذ تدخلات ضد التنمر على مستويات متعددة. على المستوى المحلي ، من المهم تطوير برامج وسياسات وبروتوكولات التدخل لمكافحة التنمر لجميع الموظفين والطلاب وأولياء الأمور. على مستوى المدرسة ، يجب أن تلعب المدارس دورًا هاماً من خلال توفير بروتوكولات وقوانين وإجراءات واضحة لمنع التنمر، وزيادة وعي الطلاب بهذه الظاهرة ، ودعم الشراكات بين الآباء والمعلمين والمتخصصين في الصحة العقلية لقطع دائرة المتنمر والضحية والمتفرجين والمساهمة في مناخ مدرسي إيجابي. أما على مستوى الأسرة ، فيجب على الآباء خلق عادات صحية ضد التنمر، وبناء ثقة أطفالهم بأنفسهم ، وتعليمهم مهارات حل المشكلات ، وتشجيعهم على مشاركة أفكارهم وخبراتهم لاكتشاف أي تورط في سلوكيات التنمر في وقت مبكر وتقليل قابليتهم للمشاركة في مثل هذه السلوكيات. أخيرًا ، هناك حاجة لإجراء دراسات بحثية لدراسة ظاهرة التنمر بين الأطفال.
- ItemPrevalence and Determinants of Uncontrolled Blood Pressure among Hypertensive Patients at Governmental Primary Health Centers in the Gaza Strip(Al-Quds University, 2023-01-15) Aya Riziq Ibrahim Alboraey; آية رزق ابراهيم البرعيIntroduction: Hypertension is a leading cause of premature death worldwide and the burden of hypertension is higher in low- and middle-income countries, where two-thirds of cases are reported, primarily due to increased risk factors. Globally, the magnitude of uncontrolled blood pressure is becoming of public health importance in developing countries. Aim: The overall aim of this study was to assess the prevalence and determinants of uncontrolled blood pressure among hypertensive patients at governmental primary health centers in the Gaza Strip. Methods: This study is a mixed methods study that involves both collecting quantitative and qualitative data. The quantitative data is a descriptive-analytical cross-sectional design. The quantitative data were collected from patients who utilize the health services within the study settings. In total, 400 patients participated in the study (213 males and 187 females who utilized the health services among governmental primary health centers in the Gaza Strip. The qualitative data were collected through in-depth interviews with healthcare providers and health experts from the Ministry of Health in the Gaza Strip. Analysis of quantitative data was conducted using the SPSS program, the analysis involved conducting frequency distribution, cross-tabulation, general scores, mean percentages, chi-square, and logistic regression tests were used. For qualitative data, an open coding thematic analysis method was used. Findings: The results of the study showed that about one-third of the study participants have uncontrolled blood pressure (36.3%). The percentage of uncontrolled blood pressure was higher among male participants (55.8%) compared to female participants (44.2%). The findings of the study have shown that there was a significant association between uncontrolled blood pressure and demographic and socioeconomic factors such as having a high BMI (Body Mass Index) (25-29.9) and (≥30). Disease-related factors have a significant association with uncontrolled BP such as shorter duration of high blood pressure and participants who missed taking their medication over the past two weeks for any reason. Low general psychological health has a significant association with uncontrolled blood pressure. Additionally, not having enough knowledge about hypertension is significantly associated with uncontrolled blood pressure. Conclusion: Uncontrolled blood pressure is a real problem for hypertensive patients in the Gaza Strip, More studies are needed to evaluate the determinants of controlling status of blood pressure on a larger, more diverse, and representative group of participants. There is a need to develop unified national guidelines for the treatment of hypertension. The guidelines should include a description of the treatment modalities, including lifestyle modification as part of the treatment plan by the health care providers. Additionally, patients particularly those who have uncontrolled BP, it is highly recommended that the MoH (Ministry of Health) develop follow-up management plans for them to ensure a higher level of compliance. The management plan should include a multi-disciplinary team that involves physicians, nurses, nutritionists, and psychologists. Finally, more studies are needed to evaluate the determinants of controlling status of blood pressure on a larger, more diverse, and representative group of participants.
- ItemEvaluation of Quality Improvement Project implemented at the Ministry of Health at Gaza Strip(Al-Quds University, 2010-10-10) Khalid Abdel Sattar Abu Ghali; خالد غاليUniversally, in the last decades quality in health continues to be a matter of interest for policy makers, health providers and managers. In Palestine, since the establishment of the Palestinian Authority, the Ministry of Health pays great attention to improve the quality of health services as manifested in many measures including the establishment of the quality improvement(QI) project. The study has been conducted to assess to which level the Quality Improvement Project met its objectives and the QI concepts and activities have been institutionalized into the Ministry of Health units. The researcher developed a self administered questionnaire to gather data from all those involved in quality improvement activities and focused on evaluating the impact of the QI project on their work settings particularly in terms of sustainability and institutionalization. From those who have been trained in quality and participated in its activities, 81 participants completed a self administered questionnaire (response rate 71%). Using the SPSS the study indicated that males constituted the largest proportion of participants (86.4). Age category 41-50 represented the highest age category and similarly 53% of participants were living in Gaza area. Physicians constituted 43% followed by nurses 33% and administrators 16%. Participants from Hospitals constituted the main bulk of participants indicating un-fair distribution of participants. Additionally, head of departments constituted almost half of participants. Factor analysis revealed eight factors (dimensions) labeled as; policy, leadership, core value, resources, structure, capacity building and information and communication. The findings showed that the mean of factors was ranged from 3.26- 2.19. The highest mean was seen with leadership factor (mean 3.36) whereas the lowest level of perception was seen with information and communication factor (mean 2.19). Although participants have been trained on quality improvement approaches, few of them engaged in quality improvement activities, or have good knowledge about quality, therefore, quality should be seen as a continuous process that requires follow up and monitoring. From institutionalization perspective, more focus should be directed on increasing communications and information about quality. Unless quality initiatives are adequately communicated, it could not be institutionalized. For increasing institutionalization, focus should be directed at developing and empowering an effective rewarding system that acknowledges proper performance. To institutionalize quality as a part of the organizational culture it is important to develop an effective organizational structure supportive to quality.
- ItemEvaluation of Current Screening Test for Asymptomatic Bacteriuria during Pregnancy at First Antenatal Visit in Rimal Health Center UNRWA ,Gaza 2007(Al-Quds University, 2008-01-26) Rasmiya Khamis Ghsoub; رسمية خميس غصوبUrinary tract infection is a common problem during pregnancy and if it is not diagnosed and treated properly, bad sequels could occur affecting the mothers and their outcome of pregnancy. The main objective of this study is to determine the prevalence of urinary tract infection (UTI) and asymptomatic bacteriuria (ASB) during pregnancy, as well as to evaluate the validity of current screening test (nitrite dipstick) at first antenatal visit. This is a cross sectional study conducted among pregnant women in Rimal Health Center which is a Primary Health Care Center; UNRWA in Gaza City. The total study population was 160 pregnant women attending antenatal care at first antenatal visit from 12th April 2007 to 25th July 2007. Midstream urine was collected and tested with culture, dipstick and microscopic examinations. Validity of tests was measured by sensitivity, specificity, positive predictive value and negative predictive value. Antibiotic sensitivity was also done. Thirty one out of 160women were identified positive urine culture with prevalence of 19.4%, 18/160 was asymptomatic (11.25%) while 13/160 was symptomatic (8.15%). Among the 31 culture positive, the commonest organism was staphylococcus aureus (29%), followed by E-coli (25.80%) and klebsiella (22.58%). Ciprofloxcine was shown as the 1st sensitive drug in all cultures (93.54%) followed by cefuroxim (83.87%) and co-amoxiclave and norfloxacine were equal (70.96%) while amoxicillin, co-trimoxazol and erythromycine had the lowest sensitivity. Maximum resistance was seen to co-trimoxazol (67.74%) followed by doxycycline (29.03%). Symptoms of UTI, weeks of gestation and the previous history of premature deliveries were statistically significant risk factors for the occurrence of ASB. Age, gravidity, parity, educational level, previous CS, history of urinary catheterization and previous history of UTI were not significant risk factors for this disease. Nitrite dipstick had low sensitivity (29%), high specificity (97.7%), with positive predictive value of 75% (PPV) and negative predictive value of 85% (NPV). Asymptomatic bacteriuria in pregnancy is a major public health problem and nitrite dipstick reagent is not sufficiently sensitive to be of use in screening of asymptomatic bacteriuria in pregnancy and many of patients would be missed for management. So, the researcher recommends the use of urine culture for screening of all pregnant women at first antenatal visit.
- Itemالضغوط النفسية واليات التكيف لدى معلمي المرحلة الثانوية في محافظة رام الله والبيرة(Al-Quds University, 2020-06-03) سماح وديع عبد الحميد حمودة; Samah Wadea Abed Alhamed MohammadThe current study aimed to identify the degree of psychological stress and coping mechanisms for secondary school teachers in Ramallah and Al-Bireh Governorate. The study used the relational destrictive method. To achieve this purpose, and to answer study questions and verify the validity of their hypotheses, a questionnaire on psychological stress among teachers was developed and included (28) items, and they were four axes, namely: administrative pressure among teachers, student pressure faced by the teacher, pressure by the teaching, and pressure Which relationships with colleagues. And the questionnaire of mechanisms to adapt to psychological stress and included (28) items, distributed on the axis of the mechanisms that can be used with psychological pressure. Its reliability and validity have been verified. The sample reached (320) from secondary school teachers in Ramallah and Al-Bireh Governorate.The results of the study showed a set of results, including: The degree of psychological stress among secondary school teachers in Ramallah and Al-Bireh Governorate was medium, where the arithmetic average of it reached (3.34), and the results of the level of mechanisms for adapting to psychological pressure among secondary school teachers in Ramallah and Al-Bireh Governorate Medium, with a mean (3.49). The results showed that there are statistically significant differences in the degree of psychological pressure among secondary school teachers and coping mechanisms in Ramallah and Al-Bireh Governorate according to the variable of years of experience, while there are no statistically significant differences according to variables: gender, number of children, type of housing, educational qualification, age Years of experience, specialization, marital status, income, place of residence, number of classes a teacher teaches. The results also showed that there were statistically significant differences in the level of coping mechanisms with psychological stress among secondary school teachers in Ramallah and Al-Bireh Governorate according to the variable of the place of residence, while there were no statistically significant differences according to variables: gender, number of children, type of housing, educational qualification , Age, specialization, marital status, income, place of residence, number of classes the teacher teaches. The study came out with several recommendations, the most important of which are: Establishing programs and activities that include providing psychological, social and economic support to all secondary school teachers in the Ramallah and Al-Bireh governorate, to include all teachers from all disciplines. The study also recommended that the Ministry of Education should pay attention to the mental health of teachers in general, and secondary school teachers in particular by forming a specialized team to study the psychological state of them and provide the necessary reports and recommendations to ensure their mental health.