Mother & Childhood Nurs. تمريض صحة الأم والطفل
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- ItemRisk Factors of Domestic Violence Among Pregnant Women and Its Effect on Maternal and Fetal Outcomes: A Cross-Sectional Study in Bethlehem and Hebron Areas.(Al-Quds Univeersity, 2025-12-20) Shahd Issam Ahmad Ashour; شهد عاشورIntroduction: Domestic violence refers to physical, sexual, or psychological abuse inflicted by one spouse or partner upon the other, with women constituting the majority of victims (Rakovec-Felser, 2014). In 2002, the WHO recognized domestic violence as a public health crisis due to its significant impact on the well-being of victims and its associated societal implications. Approximately 30% of women globally face physical or psychological violence during marriage, with heightened risks during pregnancy, affecting both maternal and fetal health (WHO, 2024). During pregnancy, victims may experience adverse outcomes like miscarriage and preterm labor (Ayele et al., 2023). In the Palestinian Territories, about 29% of women are impacted with a prevalence of 24% in the West Bank (OCHA, 2019), reinforcing the need for focused intervention. Various predictors of pregnancy-related domestic violence include low education, history of violence, and socioeconomic status (Mahapatro et al., 2022). International studies back the negative consequences of intimate partner violence (IPV) on pregnancy, including increased risks of preterm birth and low birth weight. Despite existing research, gaps remain in understanding the specifics within Palestinian society. Aim: The aim of this study is to assess the prevalence of domestic violence, identify the risk factors among pregnant women and its effects on maternal and fetal outcomes in the Bethlehem44 and Hebron areas. Methodology: This study employed a cross-sectional design and was conducted in seven governmental and private hospitals and clinics in the Hebron and Bethlehem districts. The sample included 360 mothers who delivered, and the data was collected from them within six weeks postpartum. Data was collected using a structured questionnaire that had been tested for validity and reliability. Ethical approval was obtained from the Ethics Committee of Al-Quds University (part of this questionnaire was designed by me based on the results of previous studies, and the section measuring violence used an existing, validated, and used Revised Conflict Tactics Scale previously employed in several studies), along with permissions from the Palestinian Ministry of Health and the administrations of private hospitals. Verbal consent was also obtained from all participating mothers. The data collection process lasted approximately four months, and the data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 27. Results: About one-third of women (33.4%) reported exposure to domestic violence, with psychological violence being the most prevalent form. Lower educational level and having a middle-aged or older husband were associated with a higher likelihood of violence. Exposure to violence was significantly associated with psychological distress, including anxiety, stress, and PTSD. Pregnancy complications and psychological symptoms were common, particularly infections, hyperemesis, stress, and severe anxiety. Adverse fetal outcomes, such as low birth weight and preterm birth, were frequently reported, and many newborns required special medical care. Conclusions: This study highlights that domestic violence during pregnancy is a common problem in the Southern West Bank, with psychological violence being the most prevalent form. Lower maternal educational level and having an older husband were identified as significant risk factors for exposure to domestic violence. Exposure to violence was significantly associated with adverse maternal psychological outcomes, including anxiety, stress, and post-traumatic stress disorder. Pregnancy-related complications were also frequently reported among exposed women. In terms of fetal outcomes, domestic violence was associated with adverse outcomes such as low birth weight and preterm birth, and a considerable proportion of newborns required special medical care. Overall, the findings emphasize the importance of addressing educational and social risk factors and integrating mental health screening and support into antenatal care services.
- ItemThe Relationship Between Health-Related Quality of Life and Early Diagnosis of Breast Cancer Among Palestinian Women in the Northern West Bank: A Cross-Sectional Study(Al-Quds Univeersity, 2026-01-03) Shahd Fahmi Ibraheem Akkawi; شهد فهمي إبراهيم عكاويIntroduction: Breast cancer is a global health issue, and each country around the world reported cases. Most of the studies reported the impact of the diagnosis of BC in different stages on the health-related quality of life among patients; thus, it is essential to understand the role of health-related quality of life in the early diagnosis of BC among women, since the women are at higher risk than men. Aim: To assess the relationship between the health-related quality of life (level and its domains) and the early diagnosis of BC among Palestinian women in the northern of the West Bank in Palestine. Methods: A cross-sectional study was conducted in the northern of the West Bank in three cities (Nablus, Jenin, and Tulkarem). Data were collected from 385 participants; response rate was 100%. Researchers used a self-reported questionnaire consisting of three sections: sociodemographic characteristics, clinical data, diagnosis of BC, and the health-Related Quality of Life (HRQoL) EORTC QLQ-BR-SURV40 scale. The convenience sampling technique was used to collect data from two private clinics and three PMoH clinics. For data analysis, the SPSS version 24 program was used, and the researchers applied the following tests: frequency and percentages, mean and standard deviation, independent T-test sample, and chi-square test. Results: This research, which included 385 Palestinian women, indicated that 91.4% of participants had moderate to high overall Health-Related Quality of Life (HRQoL) (moderate or high QoL). The majority of participants (71.2%, N=274) were present for screening, and most of them (89.9%, N=346) reported seeking healthcare immediately upon recognizing signs and symptoms. Mammography was the most common screening method (83.4%, N=321). In contrast to the non-diagnosed participants, women with a current diagnosis of BC (9.9%, N=38) had significantly lower HRQoL and higher symptom complaints across all domains (e.g., Body Image p < 0.001, Arm symptoms p < 0.001). Diagnosis condition was also shown to be highly statistically significant with marital status (p < 0.001), with single women having the highest prevalence (36%, N=9) to have BC compered to married, divorced or widowed women, and with having a previous history of BC (p < 0.001) and a first-degree relative with a history of BC (p = 0.045). Conclusion: While the study found that the overall HRQoL among the total sample was excellent, a key finding was the significantly poorer HRQoL and higher symptom severity reported by women with a BC diagnosis across all four domains. These results support the worldwide recognition of the diagnosis's detrimental physical and psychological impact. The data also demonstrated a high proportion of immediate medical consultation and effective screening techniques (utilize mammography) among the participants. Statistically significant characteristics associated with a BC diagnosis were marital status and current job status.
- ItemPrevalence of Multiple Births in Selected Five Hospitals in West Bank: Consequences on Maternal and Neonatal Health(Al-Quds University, 2021-01-06) Sawsan Ibrahim Hassan Hamarsheh; سوسن ابراهيم حسن حمارشةThe aim of this study was to determine the prevalence of multiple births, mode of conception whether spontaneous or medically assisted conception, and their consequences on maternal and neonatal health among Palestinian women in selected five hospitals in the West Bank. This retrospective study targeted five hospitals distributed in south, middle, and north West Bank from January 2010 to December 2011. This study included data of all women who delivered more than one live born baby with gestational age ≥24 weeks. The data was obtained from the medical records department through reviewing the files of the mothers, and their newborns. A total of 912 multiple births were recorded in the medical records during the study period: 820 were twin births and 92 were triplet and quadruplet births. A total of 896 multiple births were studied: 808 were twins and 88 were triplets and quadruplets. The findings showed that 2.2% (n=912/41,244) of all births were multiple births. Of those, 89.9%were twins, and 10.1% were triplets and quadruplets. According to the method of conception, 68.3% (n=478/700) of twins were spontaneously conceived and 31.7% (n=222/700) were conceived by medical assisted reproduction (MAR). For the higher-order multiple births (triplets and quadruplets), 83.7% (n=67/80) were conceived by MAR and 16.3% (n=13/80) were spontaneously conceived. In-vitro fertilization (IVF) and Induction of ovulation (IOO) were the methods of choice among multiple births mothers. After comparing multiple births of the two groups; spontaneous and MAR group, results showed that the women with twins and triplets in the MAR group were younger, with lower parity, higher infertility rate, and with the most usage of the cervical stitch. Women with twins in the MAR group had a higher rate of preterm delivery (61.7% vs. 51.5%) as well as cesarean delivery (78.3% vs. 52.2%). Women with triplets in the spontaneous conception group (SC) were more likely to have complications with anemia (36.4% vs. 19.6%) and hypertensive complications (18.2% vs. 5.2%). There was no maternal mortality in any of the studied groups. Correspondingly, the medically assisted twins compared to spontaneously conceived twins had lower mean gestational age (35.4, SD 2.7 vs. 36.1, SD 2.9 weeks), and lower mean birth weight (2275.6, SD 614.7 g vs. 2402.2, SD 582.2 g) with higher incidence of neonates born premature at (<37 weeks) of gestation (61.7% vs. 51.0%), more neonates weighed <2,500 g (62.4% vs. 50.5%), more neonates were admitted to the NICU (51.5% vs. 39.6%), and had longer hospital stay, as there were more neonates with respiratory problems (35.7% vs. 26.4%), and more needed phototherapy (20.7% vs. 11.0%). Among neonates of triplets, the results indicated that both groups (spontaneous, MAR) were similar for the gestational age (32.5, SD 2.8 vs. 32.3, SD 2.6 weeks) and birth weight (1704.5, SD 426.6 g vs. 1618.9, SD 466.2 g). The incidence of respiratory disorders was higher in the MAR group (92.3% vs. 83.3%), hematologic problems were much higher (30.1% vs. 16.7%), the use of phototherapy (60.1% vs. 40.0%), and hospital stay was longer. The mode of conception did not influence the rate of mortality among the twin and triplet groups. The IOO-treatment had the lowest negative influence on gestational age of twin pregnancy, also it contributed to lower cesarean delivery rate, whereas it contributes to higher mortality rate among triplets. The IUI- treatment had a negative influence on the birth weight and gestational age of twins and contributed to higher hypertensive complications for mothers. The IUI-treatment contributed to higher incidence of PPROM for mothers of triplets. In conclusion, this study suggests that twin births resulting from the use of assisted reproductive technologies are more likely to have obstetric complications and neonatal complications; however, ART had higher adverse neonatal outcomes for triplets. Our results concerning the obstetrical and neonatal outcomes after IUI treatment need further confirmation. The recommendations are to adopt policies that consider the multiple births in vital statistics assessment and to adopt strategies aimed at reducing the multiple births rates resulting from medical assisted treatments.
- ItemKnowledge, Attitude and Practice of Nurses and Midwives Toward Mothers with Miscarriage/Stillbirths in West Bank, Palestine(Al-Quds University, 2025-12-03) Aya Ahmad Jameel Awad; اية احمد جميل عوضBackground Miscarriage / stillbirth and recurrent abortions are examples of pregnancy loss, which is an extremely upsetting experience that need both compassionate and skilled treatment. When it comes to providing afflicted mothers with emotional, physical, and psychological assistance, nurses and midwives are essential. The research on knowledge, attitudes, and practices in providing care for women who have lost a pregnancy is reviewed in this theoretical study. that although there is some fundamental knowledge, there are still difficulties, especially when it comes to offering emotional assistance. In order to provide grieving mothers with more compassionate and patient-centered care, the study emphasizes the necessity of continuing education, communication training, and supporting policies. Aim of the study: To assess the Knowledge, Attitude and practice of Nurses and Midwives toward mothers with miscarriage /stillbirth . Methodology : This study used a cross-sectional, quantitative design. a convenience sample of 123 nurses and midwives employed in Palestinian government and private hospitals' labor and postpartum departments. A Self-administered created by the researcher following a thorough analysis of earlier research was used to collect data. Thirty-three items made up the final instrument, which included important areas of clinical practices, attitudes, and knowledge in pregnancy-loss treatment. During their work shifts, participants anonymously filled out the questionnaire, and all information was kept private. This analytical approach made it possible to identify gaps in the care given to grieving moms and to conduct a thorough evaluation of present procedures. Results: The study involved 123 nurses and midwives Although there were gaps in areas like the function of vitamin D and the interpretation of the effect toxoplasmosis on infection, the overall level of knowledge was good (70.6%). Participants' attitudes on providing care for mothers who have lost a pregnancy were indifferent (M = 3.55), but they generally had positive opinions about nonjudgmental support and communication. Clinical practices were modest (M = 3.50), with in-hospital procedural treatment being less common than instructional practices. Age, education level, years of experience, and hospital type all showed significant disparities in knowledge, attitudes, and practices. There was no significant link found between knowledge and either attitude or practice, however there was a high positive correlation found between attitude and practice (r = 0.525, p < 0.001). Conclusion: The study revealed that although nurses and midwives generally demonstrate good levels of knowledge, their attitudes toward caring for mothers experiencing pregnancy loss remain neutral, and their practices are at a moderate level. Notable gaps persist in specific clinical aspects of care as well as in the provision of emotional and psychosocial support. Furthermore, nurses’ and midwives’ competency levels were found to be significantly influenced by factors such as age, educational attainment, years of professional experience, and hospital type. These findings highlight the need to strengthen training programs, enhance communication skills, and establish clear institutional guidelines to promote compassionate, comprehensive, and evidence-based care for grieving mothers.
- ItemAccess, Utilization and Compliance to Family Planning Methods among Women and the Role of Health Care Providers as Educators(Al-Quds University, 2025-03-27) Areej Awni Mohammed Nawara; أريج عوني محمد نوارةAbstract The use of contraceptives is necessary for the spacing of each birth to reduce complications that may occur to the mother and her child, and improve the mother's and her child's health status. The studies aimed to assess women's access, utilization, and compliance with family planning (FP) methods, as well as the role of healthcare providers (HCPs)in educating them in the Gaza Strip (GS). The study uses a cross-sectional descriptive design to explore access, utilization, compliance, and the role of HCPs in FP education. Data will be collected through self-administered questionnaires from 361 women attending primary healthcare centers in the southern and mid-zone GS. A combination of quota and consecutive sampling was applied. The questionnaire includes sections on socio-economic factors, FP use, access, compliance, and HCPs roles. The study tools have been selected, and the rate of Cronbach's alpha is 0.910 to measure stability. A pilot study on 36 women was done to explore the appropriateness of the study instruments; data were analyzed using SPSS version 25. Ethical approval ensures confidentiality and voluntary participation.Findings revealed significant factors affecting FP access utilization and compliance, including spousal communication 85.6%, husband’s influence 82.5%, and healthcare providers’ guidance 70.6%. Also, the study revealed that women were using contraceptives 70.8%, the copper IUD, 21.7%. Implants 2.2%. The level of women's access to different contraceptive options, including access to hormonal methods like pills and patches, and condoms, 62,8%, and access to copper IUDS, 62.2%. Additionally, the study found a contraceptive compliance rate of 78%. Health education programs about contraceptives are 83%. Socio-demographic factors such as age, education, employment, and income were found to influence access and compliance with FP methods, P<0.05, with younger 43.6%, less educated (53.1% women, 45.3% husbands), and unemployed women 16.7%. Increasing reproductive wellness includes both access to and use of FP methods. Healthcare professionals are essential in informing people about their alternatives so they can make well-informed decisions. The success of FP programs increases when rules are effectively followed. To enhance compliance, HCPs need more training in FP counselling and to be given access to a variety of strategies. To promote trust and improve communication between patients and providers, healthcare professionals must receive ongoing education.