Palestinian Nurses Research Articles

Assessment of Knowledge and Practice on Prevention of Pressure Ulcer among Nurses in Palestine- Cross Sectional Study

Pressure Ulcers (PUs) are localized skin injuries caused by long-term compression of soft tissue between an external pressure source and a bony prominence. They are one of the iatrogenic causes of extra morbidity for hospitalized patients. This study aimed to assess knowledge and practices regarding preventing PUs among nurses in Palestine. A cross-sectional study was conducted on 430 nurses in various Palestinian hospitals and health centers between February 15, 2024, and April 14, 2024. Convenience sampling was used to collect samples for this study. The collected data were analyzed using the Statistical Package for Social Sciences (SPSS) Version 27. Data analysis included descriptive and inferential statistics. The study showed that 65.61% of participants correctly answered questions about PU prevention. Regarding practice, 55.3% of nurses demonstrated a good level, with an average score of 2.37. Additionally, there was a significant association between demographic variables and levels of knowledge and practice in PU prevention, with P values ranging from 0.01 to 0.05. The study found that male nurses had higher knowledge and practice scores than female nurses, with significant differences in mean scores. The overall level of knowledge and practice among Palestinian nurses was found to be good; however, there is room for improvement in several aspects of both knowledge and practice. Variables such as gender, age, marital status, qualification, and job experience were found to have significant correlations with the level of knowledge and practice among nurses.

Occupational stress and associated sources and risk factors among nurses in Gaza strip, Palestine: A cross-sectional survey.

To determine the occurrence of occupational stress among Palestinian nurses, and their associated sources and risk factors. A cross-sectional descriptive design. A total of 250 registered nurses from eight governmental hospitals, using a convenience sampling method. Data collection were conducted using the 30-items self-reported Occupational Stress Scale from December 2022 to March 2023. Descriptive statistics, independent sample t-test, one-way ANOVA, and multiple linear regression analysis were applied to analysis data. Data analysis included descriptive statistics, independent sample t-test, one-way ANOVA, and multiple linear regression analysis. The prevalence of high occupational stress levels was 64.8% (Mean = 3.9 out of 5). The main sources of stress are too much responsibility and work, understaffing, lack of promotion and recognition, inadequate pay, time pressure, and management style. The results regression analysis demonstrated that male nurses with a Masters or PhD degree and those working in fixed shifts experienced higher occupational stress. Moreover, participants who worked overtime hours were more susceptible to stress. The research indicates that occupational stress presents a notable challenge for nurses in the Gaza Strip, Palestine. It suggests that in order to alleviate this stress, decision-makers in healthcare policy and hospital management should prioritize the execution of strategies aimed at addressing the primary stressors and risk factors identified. This study adhered to the STROBE guidelines. A total of 250 registered nurses were taken part in this study by answering a self-administered study survey.

Stress and work engagement among nurses in intensive care units: Palestinian perspective

Purpose Work engagement denotes to a state of positive and affective motivation of elevated power joined with high educational levels and a great concentration on occupation and it is negatively affected by psychological problems. This study aims to assess the stress and work engagement among Palestinian nurses working in intensive care units. Design/methodology/approach A cross-sectional design was adopted. A convenience sample consisting of 225 intensive care nurses from governmental hospitals was recruited to participate. Data collection used the Nursing Stress Scale and Utrecht Work Engagement Scale-9, and demographic data were used to gather data throughout the period from February 10 to March 30, 2023. Findings Findings demonstrated that nurses’ stress levels were high (M = 105.9 ± standard deviation [SD] = 11.91). Concerning work engagement, the nurses endorsed moderate work engagement levels with a mean of 3.7 (SD = 0.4). Regarding work engagement subscales, the mean of vigor was 3.7 (0.6), dedication with a mean of 3.7 (0.6) and absorption with a mean of 3.7 (0.6). Also, the findings showed that stress, gender and monthly income were predictors of work engagement (p < 0.05). Research limitations/implications Despite the significant results, this study had the following limitations: the design was cross-sectional, which limits the ability to explore the cause and effect of the study variables, thus longitudinal studies are recommended. In addition, the study adopted a self-reported questionnaire based on participants’ understanding, culture and work context which could influence their responses. Originality/value The intensive care nurses had high stress levels and moderate work engagement. Stress, gender and monthly income were predictors of the work engagement. Thus, interventions should be encouraged to minimize stress, which has a significant influence on work engagement.

Are Palestinian Nurses Burned Out or Engaged: The Impact of Job Demands on Job Performance?

The impact of job demands on job performance is not always straightforward but relies on whether employees are burned out or engaged. Although such relationships were established previously based on job demands–resources (JD-R) theory in Western developed countries, evidence from Eastern developing countries is very limited. During the peak of COVID-19, this study was conducted to examine the impact of job demands on nurses’ job performance via the mediating role of work burnout and work engagement. By employing the tenets of the JD-R theory, the theory was tested through collecting data from 202 nurses who were working in Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data. The findings disclosed that work burnout was negatively related to job performance, and work engagement was positively related to job performance. Unexpectedly, job demand had a negative relationship with work burnout and a positive relationship with work engagement. However, work burnout and work engagement mediated the relationship between job demand and job performance. A discussion of the findings, contributions, implications, limitations and future directions is provided.

Factors Contributing to Time-Wasting Activities among Palestinian Nurses: A Cross-Sectional Study

Background. Nurses face significant challenges as they attempt to manage an increasing number of complex responsibilities within limited time frames. This article explores the factors contributing to time-wasting behaviors among nurses in Palestine and emphasizes the significance of effective time-management skills in nursing practice. Methods. Surveys were collected from a total of 714 nurses working in multiple healthcare facilities located in the north of the West Bank, Palestine. An 11-item time-wasting scale was developed and validated. Factors influencing time-wasting behaviors among nurses were then investigated using multiple linear regression in SPSS version 25. Results. Attending time management courses significantly reduced time-wasting behaviors. Additionally, factors such as age, gender, and educational level did not appear to correlate with time-wasting behaviors. However, workplace, type of organization, and attendance of time management courses did impact nurses’ time management skills. Conclusion. This article underscores the importance of time management skills in nursing practice. Inefficient time management can have detrimental effects on patient care and nursing outcomes. To mitigate these challenges, healthcare institutions and nursing education programs should prioritize time management training for nurses.

Using of non-pharmacological pain methods, and the perceived barriers, among nurses in critical care unit in Palestine

BackgroundPain is alleviated in one of the two common approaches, pharmacological or non-pharmacological intervention. Using non-pharmacological methods may have beneficial effect and priority on decreasing patients’ level of pain and decreasing the side effects of pharmacological methods in ICU patients. This study aimed to assess ICU Palestinian nurses use and barriers of non-pharmacological pain management.MethodsA quantitative descriptive cross-sectional design was used to collect responses from a convenient sample of 215 nurses working in six hospitals in Plaestine. The timeframe for data collection was from August 2022 to December 2022. This study had three instrument packages. The first part is demographic data. The second is a tool that used 4-point Likert scale to examine ICU nursing use of non-pharmacological pain methods and it consisted of 16 items. The third is six items of perceived barriers to use non-pharmacological pain methods. All statistical procedures were analyzed using Statistical Package of Social Science (SPSS) version 28.ResultsMore than two-thirds of the nurses used non-pharmacological pain methods in ICU. 60% of the nurses have high levels of use, 10.2% have very high levels. The two highest perceived barriers to use nonpharmacological method were the lack of time, workload, and patient instability with 83.7% (n = 180), and 77.2% (n = 166), respectively. Demographic variables were not significantly associated with the use of non-pharmacological pain management methods, except age.ConclusionAdopting culturally sensitive non-pharmacological pain methods to decrease ICU patients’ level of pain, may positively reflected on patients’ outcome and on healthcare system. Developing, implementing and continuous monitoring of guidelines regarding using nonpharmacological for nurses and physicians are recommended which will be reflected positively on patients’ outcomes. Great efforts to overcome the barriers of lack of time and workload is impertive to increase the clinical usage of nonpharmacological pain methods.

The effect of a simulation-based training program in basic life support on the knowledge of Palestinian nurses: a quasi-experimental study in governmental hospitals

BackgroundBasic Life Support (BLS) plays an important role in increasing the survival rate of hospitalized heart attack patients. There are no previous studies on the effect of BLS training among Palestinian nurses. This study aimed to evaluate the effect of simulation-based BLS training program on nurses’ knowledge Palestinian nurses at governmental hospitals.MethodsA quasi-experimental, pre & post-test design was used. 700 nurses were recruited proportionally using a simple random sampling method among 2980 nurses from 13 public hospitals in the Gaza Strip. This study was conducted from June to August 2022. A practical BLS test consisting of 10 multiple-choice questions according to American Heart Association guidelines (2020) was collected and sociodemographic characteristics. SPSS software, version 24 was used for the statistical analysis. Descriptive statistics and weighted mean were used. T-Test and One-way analysis of variance (ANOVA) were applied to determine differences in means among groups.ResultsMost of the participating nurses (55.7%) were male, while (44.3%) were female. The majority of nurses (84.4%) are under 40 years of age. The weighted mean scores in the pre-test ranged from 52.2 to 75.1% and the mean scores was (6.16 ± 1.97). After applying conventional BLS training, the weighted mean scores ranged from 85.6 to 97.3% and the mean scores was (9.19 ± 1.04). The study revealed that the nurses’ knowledge increased after applying simulation-based training program. The mean of knowledge scores was statistically significant between the pre and post-test on the basis of the current work hospital (P-value < 0.001).ConclusionThis study affords significant evidence of the positive effects of the BLS training program in improving nurses’ knowledge; we recommend advanced BLS training for all healthcare providers, doctors, and nurses working in hospitals and healthcare centers. Nursing managers can implement systematic strategies to enhance nurses’ knowledge and practice in BLS to target low-scoring Governorates.

Nursing Informatics Competency and Self-Efficacy in Clinical Practice among Nurses in Palestinian Hospitals

This study purposed to determine the levels of nursing informatics competency and self-efficacy in clinical practice and influencing factors on self-efficacy among Palestinian nurses in hospitals. A descriptive-correlational design was adopted. The nurses who worked in the North West Bank of Palestine (N = 331) were recruited. The data were collected using the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) which consists of 30 items rated on a 5-point Likert scale, ranging from 1(not competent) to 5 (expert), and scored by calculating the mean as follows: novice/low (1.00–2.59), beginner/moderate (2.60–3.39), and competent/high (3.40–5.00); and the New General Self-Efficacy Scale (NGSE) that consists of eight items rated on a 5-point Likert scale, ranging from 1(strongly disagree) to 5(strongly agree) and scored according to the average of the scale, whereas the average of > 3 indicated high self-efficacy, and ≤ 3 reflected low self-efficacy. The data were collected during the period from September to November 2020. Findings showed that the total mean score for the nursing informatics competency scale was 2.9 (SD = 0.7), which indicated that the nurses had a moderate level of nursing informatics competency. The average score for the self-efficacy scale was 3.5 (SD = 0.8), which reflected that nurses had high self-efficacy. Self-efficacy in clinical practice increased with age and with nursing informatics competency. Thus, it is necessary to enhance nurses’ informatics competency by developing continuous educational programs about this technology for nurses and engaging nurses in such programs to enhance their competencies in this system.

Shift work and job satisfaction among Palestinian nurses: a cross-sectional study

BackgroundRotating shift work is associated with job dissatisfaction, sleeping disturbances, and health problems compared with working only in the daytime. Whether the relationship between rotating shift work and job satisfaction differs between the sexes among nurses in occupied Palestinian territory is unclear. We investigated this relationship and compared it with that among regular day workers. MethodsWe did a cross-sectional study in Hebron district in August to October, 2008, involving all registered nurses with at least 1 year of practice. Those who worked fixed evening or night shifts or who were on leave were excluded. Job satisfaction was assessed with the Generic Job Satisfaction scale, containing ten items with scores from 1 to 5; a higher score indicated a higher (better) job satisfaction. Associations were assessed with β coefficients and 95% CIs and χ2 tests in linear regression analyses. Statistical analyses were done with Stata (version 10). The threshold for significance was set at p=0·05. The study was approved by the Palestinian Ministry of Health. Written informed consent was obtained from all participants. FindingsOf 472 eligible nurses, 426 (90%) were included in the study: 259 women and 167 men, among whom 217 worked shifts and 209 who worked only during the daytime. The mean job satisfaction score among female nurses was 32·6 (SD 6·4) and among male nurses was 31·7 (SD 7·0). Crude analyses showed that male and female shift workers reported lower job satisfaction than those working day shifts (mean score 30·8 [SD 6·5] vs 33·8 [6·4]). After adjustment for age, number of children, years of education, and job title, this effect remained statistically significant only among male nurses, as the men with rotating shift-work reported job scores 3·5 points lower than those working only during the daytime (β coefficient –3·5, 95% CI –5·9 to –1·1; p=0·005) whereas for women the β coefficient value was 0·10 (95% CI –1·8 to 2·1, p=0·90). InterpretationMale nurses working rotating shift patterns reported lower job satisfaction than men working only during the daytime, whereas no difference was found for female nurses. Because both exposure and outcome were measured using self-reported information and the study design was cross-sectional, interpretation of the results should be made with caution. However, further studies should investigate whether shift work affects the quality of patients’ care. FundingNorwegian Programme for Development, Research and Education.

Palestinian nurses' knowledge, attitudes, and practices regarding enteral nutrition: Cross-sectional study

BackgroundEnteral nutrition support plays a key role in minimizing malnutrition in critically-ill patients, and its provision is originally a nurse's responsibility. Thus, nurses need to have a sufficient knowledge and a positive attitude with regard to enteral nutrition. In Palestine, literature regarding nurses' knowledge, practices, and attitudes of enteral nutrition is rare. ObjectiveThis study aimed to investigate Palestinian nurses' knowledge, practices, and attitudes regarding enteral nutrition. MethodInterview based pre-tested questionnaire was used during data collection procedure. Cronbach Alpha was also used to determine the reliability of knowledge, attitude and practice questionnaire. Descriptive statistics, independent t-test, and ANOVA were performed. ResultsA total of 325 registered nurses were involved in the final analysis. The mean of the knowledge score is (9.6 ± 2.8) out of 20. It was confirmed that sociodemographic characteristics has no influence on nutrition knowledge score among nurses. The findings also reveal that certain aspects of enteral nutrition practices were consistent with the current guidelines such as flushing the tube and backrest elevation. On the other hand, certain practices showed inconsistency and differences with international guidelines such as checking gastric residual volume. Results also showed that nurses attitudes were positive towards enteral nutrition. ConclusionIt was found that nurses' have inadequate knowledge regarding enteral nutrition. The findings also showed that enteral nutrition practices among nurses were somewhat incongruent with best current evidence. However, it was noted that they have positive attitudes towards enteral nutrition. Promoting research utilization is highly needed as well as establishing evidence-based guidelines.

Associations between stressful working conditions and psychosomatic symptoms among Palestinian nurses: a cross-sectional survey

BackgroundStressful working conditions among nurses have adverse effects on their physical and mental health. We investigated associations between self-reported stressful working conditions and psychosomatic symptoms among nurses in the Hebron district, occupied Palestinian Territory, and whether there are differences the sexes in the perceptions of working conditions and psychosomatic symptoms. MethodsWe did a cross-sectional survey between Oct 7 and Dec 10, 2012, among registered nurses in all health sectors in Hebron district. A nine-point ordinal scale of working conditions was used to categorise perception of stress as low, medium, or high, and seven psychosomatic symptoms were recorded on a checklist coded as never (0), seldom (1), occasionally (2), or often (3), allowing for a total score between 0 and 21. All analyses were done with STATA (version 10). P values of less than 0·05 were significant. Participation in the study was voluntary, and written informed consent was obtained from each participant. The study was approved by the Regional Committee for Medical and Health Research Ethics, Norway. Permission to do the study was obtained from the Palestinian Ministry of Health. FindingsAmong 372 eligible nurses, ten were on extended leave from work, 16 declined to participate, and four had incomplete data, giving a final sample of 342 nurses (92% response rate). 212 (62%) were women and 130 (38%) were men. Low levels of stress were reported by 42 (12%) nurses, medium levels by 206 (60%), and high levels by 94 (28%). The mean score of psychosomatic symptoms for the group was 10·4 (SD 4·02, range 0–21). Scores did not differ significantly between men and women. Mean symptom scores differed between nurses with self-reported highly stressful working conditions and those with low levels of stress (12.6 vs 8.4, difference 4·1, 95% CI 2·7–5·5; p<0·001). Among male nurses, those with self-reported highly stressful working conditions had a mean psychosomatic symptom score of 13.0, compared with that was 7.7 among those working in low-stress conditions (difference 5·3 units, p<0·001). This effect remained significant after adjustment for the covariates age, education, number of children, work schedule, and years of experience (12·6 vs 7·7, difference 4·9 units, 95% CI 2·6–7·2). Among female nurses, the scores among those with high-stress working conditions was 12.4 and for those with low-stress working conditions was 9.0 (difference 3·4 units, p<0·001). After adjustment the difference remained similar (12·4 vs 9·0, difference 3·5 units, 95% CI 1·7–5·3, p<0·001). InterpretationWe found that psychosomatic symptoms increased as self-reported perception of stressful working conditions increased, irrespective of sex. The study had a cross-sectional design and both exposure and outcomes were measured using self-report and, therefore, interpretation of the results should be made with caution. Longitudinal epidemiological studies are recommended. Future studies should investigate whether stressful working conditions affect the quality of patients’ care in health services. FundingNorwegian Programme for Development, Research and Education.

Psychological Impact of the COVID-19 Pandemic on Nurses Employed by the Palestinian Ministry of Health in Gaza

Introduction: Coronaviruses hit the world at the end of 2019, but the first two cases inGaza Strip were diagnosed on 21 March in the quarantine centers. Nurses working with infected or suspected cases are at high risk to get the disease which may generate anxiety among them. Therefore, this study aimed to assess the psychological impact of COVID-19 pandemic on Palestinian nurses employed by the Palestinian Ministry of Health in Gaza Strip, Palestine. Materials and methods: A toal of 424 nurses completed an online questionnaire packet that included demographic data and the 7-item Generalized Anxiety Disorder Scale (GAD-7). Results: Results from this study revealed that while only 22.4% of the participants worked at quarantine centers designated to take care of infected/suspected cases of COVID-19, but a huge number of them (77.6%) got in direct contact with infected people. Variant levels of anxiety were reported by participants with 35.4% of them having mild, 23.6 % moderate and 13.4 % severe levels of anxiety while 27.6% did not manifest anxiety. Factors contributed to the level of anxiety include having a family member diagnosed with COVID-19, a family member died with COVID-19 and getting in direct contact with people infected/ suspected to have COVID-19. Conclusions and implications for practice: The high level of exposure to contamination of Corona virus represent risk factor of nurse's fear and anxiety through their contact with patients, friends, relatives and family members. Psycho-social support programs as setting channels of one-to-one online or phone counseling for nurses may be effective to alleviate negative psychological effects and to enhance the mental health of nurses.

Burnout among Palestinian Nurses Working in Governmental and Private Hospitals at Nablus District

Background: Burnout is a syndrome that typically characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. World Health Organization (WHO) recognized burn out as a mental health problem that defined as “a syndrome conceptualized as resulting from chronic work-place stress that has not been successfully managed. Objectives: The study aimed to assess burnout among nurses and to determine the difference, if any, in burnout of nurses working in Government and Private Hospitals. Methods: A cross-sectional, descriptive, correlational design was used to assess burnout among nurses, and to explore the difference burnout level among nurses at four hospitals in Nablus district which are Nablus Specialty Hospital, Specialized Arab Hospital, which are private hospitals, in addition to Al Watani Hospital and Rafidia Surgical Hospital which are governmental hospitals. Out of the 420 nurses in Nablus district hospitals, 195 were selected as study participants using stratified random sampling. Data collection tools: A self-administered questionnaire of three parts: Demographic information, Occupation information and the Maslach Burnout Inventory (MBI) was used to measure burnout. Statistical Analysis: Descriptive and inferential statistics were employed in the analysis using the Statistical Package for the Social Sciences software (SPSS version 22). Frequencies were used to describe the demographic characteristics and work conditions. In addition to paired t-test and ANOVA to compare the means between governmental and private hospitals, and to determine any significance inferential statistics were generated at alpha level of P 0.05. Results: The majority of the participated nurses (95.4%) exhibited relatively high levels of Depersonalization, and (63.1%) nurses expressed moderate levels of Emotional exhaustion while 28.2% reported high Emotional exhaustion level. Conclusion: The study showed that nursing burnout is a substantial problem among nurses working in Governmental and Private Health sector hospitals. Also the study highly revealed that nurses’ work conditions and demographic characteristics have a significant effect and crucial role on the nurses feeling of burnout.

Palestinian Nurses’ and Doctors’ Perceptions and Practices Regarding the Prevention of Injuries to Children in the Home: An Explorative Qualitative Study

ABSTRACTUnintentional injuries are a growing global public health problem that causes mortality, morbidity, and disability among children. These injuries are common among under-fives and form a significant burden on healthcare systems, particularly in low- and middle-income countries. Nurses and doctors have a major role to play in the prevention of home injuries, as expressed in many international reports. In Palestine, there is a paucity of research in this area. Therefore, this study aims to explore nurses’ and doctors’ perceptions and practices regarding the prevention of home injuries among children aged under-five years. A qualitative approach was followed, whereby semi-structured interviews were undertaken with 24 nurses and doctors who worked with children in a primary health care setting. The derived data were analyzed using thematic analysis. This study found that most of the nurses and doctors who were interviewed reported positive attitudes toward working on this topic; the majority of them attempted to work on injury prevention. Nevertheless, they needed further support to fulfil this potential role, as they faced many barriers in their daily practice in this area. Policy makers could potentially take advantage of this attitude and support them by providing training, resources, and time for them to implement this role.

Mental distress and job satisfaction in Palestinian nurses exposed to workplace aggression: a cross-sectional study

BackgroundNurses who are exposed to workplace aggression from patients, patient relatives, or colleagues are at risk for mental health disorders and job dissatisfaction. The aim of this study was to assess the prevalence of exposure to workplace aggression and the association between mental distress and job satisfaction in nurses working in the Hebron district of the occupied Palestinian territory. MethodsIn this cross-sectional study, nurses were recruited to answer a questionnaire covering sociodemography and workplace aggression (WHO questionnaire), including exposure to physical and verbal aggression and bullying. We assessed mental distress with the General Health Questionnaire (GHQ-30) and job satisfaction with the Generic Job Satisfaction scale. Associations between workplace aggression and mental distress and satisfaction were estimated from χ2 tests and linear regression analyses using Stata/IC10. The study was approved by the ministry of health. Written informed consent was provided by all participants. FindingsIn 2012, we recruited 372 registered nurses from the Hebron governorate. 28 (8%) nurses were excluded, and the final sample (n=344) included 213 (62%) women and 131 (38%) men. The prevalence of aggression of any kind was 27%. 17 (5%) nurses had been exposed to physical aggression, 83 (24%) had been exposed to verbal aggression, and 25 (7%) had been exposed to bullying. Men reported a higher prevalence of bullying than women (12% of men vs 5% of women). The prevalence of exposure to physical aggression, verbal aggression, and bullying was highest in young nurses. After adjusting for covariates, nurses exposed to verbal aggression reported 2·9 units (95% CI 0·02 to 5·6; p=0·04) more mental distress than non-exposed nurses. Bullying was associated with a 2·6 unit (95% CI −5·1 to −0·14) reduction in job satisfaction score. InterpretationNearly a third of nurses in this study reported exposure to some sort of aggression. Nurses exposed to verbal aggression reported more distress than nurses who had never been exposed to verbal aggression. Bullying was associated with reduced job satisfaction. Because the study had a cross-sectional design and both exposure and outcomes were measured using self-report, the results should be interpreted with caution. FundingThe Norwegian Programme for Development, Research and Education (NUFU pro x1 50/2002 and NUFUSM-2008/10232) and The National Norwegian State Education Loan Funds.

Job satisfaction and mental health of Palestinian nurses with shift work: a cross-sectional study

BackgroundShift work is associated with sleep disturbances, mental health problems, and job dissatisfaction. Disparities between male and female nurses in the effect of shift work on mental distress and job satisfaction have been scarcely studied. We aimed to examine differences between female and male nurses in the associations between shift work and job satisfaction and mental health. MethodsIn this cross-sectional study, male and female nurses were recruited to rate their job satisfaction on the Generic Job Satisfaction Scale and to complete the General Health Questionnaire (GHQ-30). Associations between shift work, mental distress, and satisfaction were estimated from χ2 tests and linear regression analyses using Stata/IC10. The study was approved by the ministry of health. Written informed consent was provided by all participants. FindingsIn 2012, we recruited 372 registered nurses from the Hebron governorate in the occupied Palestinian territory. 28 (8%) nurses were excluded, and the final sample (n=344) included 213 (62%) women and 131 (38%) men. 338 nurses rated their job satisfaction, and 309 nurses completed the GHQ-30. After adjusting for covariates, men with shift work reported significantly lower job satisfaction (β-coefficient −3·3, 95% CI −6·2 to −0·5) than men with day schedules. Women with shift work reported significantly higher levels of mental distress (3·6, 95% CI 0·3 to 7·0) than women with day schedules. Distress was reported by more women than men, but this difference concerned only nurses working day shifts. No differences in job satisfaction associated with shift work was seen between men and women. We found no demonstrable interaction between sex and shift work for job satisfaction (β-coefficient −1·6, 95% CI −4·4 to 1·2) or distress (−0·03, 95% CI −5·3 to 5·3). InterpretationShift work was associated with low job satisfaction in male nurses and high distress in female nurses. Because the study had a cross-sectional design and both exposure and outcomes were measured using self-report, the results should be interpreted with caution. Further studies should investigate whether shift work affects the quality of patient care. FundingThe Norwegian Programme for Development, Research and Education (NUFU; NUFU pro x1 50/2002 and NUFUSM-2008/10232) and The National Norwegian State Education Loan Funds.

Job Stressors, Coping and Resilience among Nurses in Gaza Strip

Aim: This study aims were to find type of work stressors, used coping strategies, and resilience factors and relationship between stressors and coping strategies as mediating factors and resilience as outcome among Palestinian nurses working in Gaza Strip. Method: This study builds on existing evidence by considering exposure to work-related stressors, as well as on factors associated with later coping and resilience. The sample consisted of 275 randomly selected nurses from representative health services in Gaza, who completed the Nurse Stress Scale, The Connor-Davidson resilience scale, and Brief-COPE. Results: The most commonly reported job stressors were attending death of a patient, physician not being present when a patient dies, criticism by a supervisor, and fear of making a mistake while treating their patients. The mean score of nurses work stressors was 88.7. Nurses commonly used religious coping such as feeling comfort in religious beliefs, thinking what next steps they have to take, having strategy about what to do about situation what to do, and learn to live with situation as coping strategies with stress. While, use drugs to feel better and to get through was the least commonly used coping strategies. Nurses said that overcome the stressors and had resilience by believing that things happen for a reason, God is helping, and they were pride of their achievements. The results showed that fear of making a mistake in treating a patient was negatively predicting total coping strategies. While stressor such as a physician ordering what appears to be inappropriate treatment for a patient was positively predicted coping strategies. The results indicated that stressor such as physician not being present when a patient dies and too many non-nursing tasks required, such as clerical work was predicting resilience negatively. While stressors such as criticism by a physician and having not enough time to complete all of their nursing tasks were positively predicted resilience among nurse. Conclusions and recommendations: The results of this study highlight the need to empower the role of the nurse educators, managers and administrators to find ways to make nursing workplace more pleasant and less stressful, especially to the nurses in their initial years of work. The findings of the study will assist human resource managers of the current study setting to determine coping strategies that might help in reducing amount of stress experienced by nurses in their day to day challenging and demanding nursing roles.

Palestinian nurses' lived experiences working in the occupied West Bank.

Since the construction of the separation wall between Israel and the West Bank, Palestinians living in occupied West Bank have endured intense conflict, and severe restrictions on people's movement, trade and healthcare access, all of which resulted in spiralling poverty. These issues have created challenges for nurses that, to date, have not been explored. To explore the lived experience of Palestinian nurses working in the occupied West Bank. Qualitative phenomenological study using interviews with Palestinian nurses working in public hospitals in the West Bank. Seventeen nurses were interviewed. Despite ongoing experiences of trauma and humiliation, personal/professional role conflicts, political workplace bias and blurred role boundaries, these nurses persevered because of their commitment to caring and sense of moral duty to 'the people of this land'. Nurses in conflict areas are subject to layers of trauma. Palestinian nurses in the West Bank not only experience ongoing personal trauma, loss and humiliation of living in a conflict zone but they also experience additional professional trauma. The findings provide first-person reports of the unique challenges of nurses working in the occupied West Bank. Understanding the experiences of nurses working in occupied territories provides authentic information for local authorities and the global healthcare community. Practice improvements must be addressed and implemented. Local and global organizations that mobilize support, invest in human capital, and protect human rights in areas of conflict may benefit from understanding the experiences of nurses in this study.

Shift work, mental distress and job satisfaction among Palestinian nurses.

BackgroundAssociations between shift work (SW) schedules, mental distress and job satisfaction have never been completely described.AimsTo examine gender-specific associations of SW with mental distress and job satisfaction in nurses in Hebron District, Palestine, in 2012.MethodsDetailed information on work schedules (day versus shift), socio-demographic status, mental distress (General Health Questionnaire, GHQ-30) and job satisfaction (Generic Job Satisfaction Scale) in nurses employed in Hebron District, Palestine, was obtained through a questionnaire survey. Associations of SW and outcomes were examined by linear regression analysis.ResultsOf 372 nurses eligible for the study, 309 and 338 completed surveys regarding mental distress and job satisfaction, respectively. The sample comprised 62% women and 38% men. After adjusting for covariates, women working shifts reported significantly higher levels of mean mental distress [β coefficient 3.6; 95% confidence interval (CI) 0.3–7.0] compared with women working regular day shifts. Men working shifts reported significantly lower levels of job satisfaction (–3.3; 95% CI –6.2 to –0.5) than men working regular day shifts. Women reported higher levels of mental distress than men, but this was unrelated to work schedule.ConclusionsIn this study, nurses working shifts reported higher levels of mental distress and lower levels of job satisfaction, although these associations were weaker when adjusted for potential covariates. There was no evidence of a gender differential in the association between SW and mental distress and job satisfaction.

Workplace aggression, psychological distress, and job satisfaction among Palestinian nurses: A cross-sectional study

BackgroundNurses can be exposed to aggressive behavior from patients, patient's relatives, colleagues and visitors. PurposeTo determine the prevalence of workplace aggression among Palestinian nurses in the Hebron district and to examine cross-sectional associations between exposure to workplace aggression and the occurrence of psychological distress and job satisfaction. MethodsOf 372 nurses eligible for the study, 343 were included (response rate of 92.2%). The sample comprised 62% females and 38% males. The participants responded to questions about their socio-demographic status, workplace aggression (WHO questionnaires), psychological distress (General Health Questionnaire, GHQ-30), and job satisfaction (Generic Job Satisfaction Scale). ResultsNinety-three (27.1%) of the respondents reported exposure to workplace aggression of any kind. Seventeen (5%) reported exposure to physical aggression, 83 (24.2%) reported exposure to verbal aggression, and 25 (7.3%) reported exposure to bullying. The patients and the patients' relatives were the main sources of physical and verbal aggression, whereas colleagues were the main source of bullying. Males reported a higher prevalence of bullying than females. Younger nurses reported a higher prevalence of exposure to physical aggression, verbal aggression and bullying. Verbal aggression was associated with more psychological distress. Bullying was associated with lower job satisfaction. ConclusionsMore than a quarter of the nurses reported that they had been subject to some sort of aggression at the workplace. Verbal aggression was associated with higher psychological distress. Workplace bullying was associated with lower job satisfaction. Increased awareness and preventive measures to address this problem among health care workers are warranted.