The role of non-governmental organizations in the health sector in the occupied Palestinian territory: a cross-sectional qualitative study

Background Non-governmental organizations (NGOs) have had an important role in the Palestinian health sector before and after the creation of the Palestinian Ministry of Health (PMoH) in 1994. Few studies have addressed the role of NGOs in the Palestinian health sector. The aim of this study was to investigate the current role of local and international NGOs (INGOs) in the development of the Palestinian health system’s policies and programmes. Methods A qualitative study of nine semi-structured interviews was conducted with key representatives from the main actors in the Palestinian health sector: the PMoH, five local NGOs and three INGOs. After obtaining verbal consent, interviews were conducted from October to December 2014, and focused on the NGO’s scope of work, priority setting, regulation, coordination and influence on national health policies. Findings The majority of the local NGOs focused on primary healthcare and rehabilitation, while most of the INGOs worked on health development and emergency response. Local NGOs and INGOs complemented the work of the PMoH in health-service provision. Both were constrained by the predetermined national health strategy set by the PMoH without the active involvement of other actors. INGOs’ activities were constrained by pre-determined international health agendas, available funding and restrictions related to the military occupation. The coordination mechanism between the PMoH, local NGOs, and INGOs is limited to a health and nutrition cluster, a partnership of organisations that is committed to providing needs and evidence-based responses, with little effect on policies and plans. Despite available methods to avoid duplication and fragmentation of work and to fill service provision gaps, some NGOs agreed that the limited coordination and discontinuity of certain projects restrict their ability to fully meet the health needs of the Palestinian population.We thank all the organisations and individuals who agreed to participate in the interviews and the faculty and staff from the Institute of Community and Public Health at Birzeit University for their support, advice and guidance

Evaluating Course Syllabus: Basis for Reframing into a Learner-Centered Syllabus for Outcome-Based Nursing Education

The shift from customary content-based pedagogical to learnercentered practice is imperative in the 21st century. This research aims to evaluate the course syllabus developed by the faculty members and if the syllabus meets the criteria for the learner-centered syllabus. The study employed a quantitative –comparative design to properly represent the phenomenon. The study was conducted at the selected universities in the Kingdom of Saudi Arabia. Overall, the respondents of the study consist of 100 faculty members and the 50 students from the participating universities in the Kingdom of Saudi Arabia. The researchers adapted the learning-focused syllabus instrument to gather the data. Results show that the faculty members rated the learning goals and objectives to moderate (1.58), while students rated it low (1.42). Likewise, the learning assessment revealed a moderate result (1.76) for faculty members and low (1.38) for the students; the learning activities have moderate (1.69) result for the faculty and low (1.36) for the students. As regards scheduling, faculty members and students reported moderate results having a 2.06 and 2.09 respectively. The classroom environment revealed moderate results both the faculty members (1.62) and the students (1.52). Statistically, there is no significant difference on the category of syllabi when faculty respondents were grouped according to years of teaching (0.699.05). The findings show that the course syllabus evaluated is in a transitional phase towards learner-centered. As such, the progress of the syllabus is potential to meet the criteria for an outcomebased nursing education. However, the varying results as reported suggest reconciliation of the views of the faculty members and the students

Beliefs about illness and treatment decision modelling during ill-health in Arabic families

Background: The use of self-prescribed antibiotics and other unproven herbal remedies is common in the Arab world. Understanding how family members decide to manage illness is an important priority for health care providers. Purpose: This paper presents a new model that can be viewed as an extension to the Health Belief Model and help clarifies the cognitive processes families use to manage illness in an Arab family in Jordan. It aims to generate an understanding of family beliefs about the causes of illness and appraisal of how best to manage illness in an Arab family. Methods: A qualitative approach using a family interview method was used to collect data. Twenty-five families participated in semi-structured interviews designed to elicit representational models of illness and treatment-decisions. Results: Thematic analysis revealed two forms of intertwined beliefs: core beliefs (fatalistic) and secondary beliefs (biomedical, supernatural and situational beliefs). Four key elements were identified as underpinning the involvement of family in treatment decision: perceived threat of illness, efficacy of treatment option, cost or availability and family prior experience. Conclusion: An understanding of the health belief model and related cognitive appraisal processes used by families may assist health care providers to engage with and overcome some of the social, cultural, and structural variables that could influence how family members decide to manage illness in Jordan

Assessing the Readability and Usability of Online H-E-L-P Intervention for IPV Survivors

Purpose: The purpose of this study was to assess the readability and usability of an online HELP (Health, Education, and Legal Program) intervention for women experiencing IPV (Intimate Partner Violence) by asking graduate nursing students to review in class nine online HELP intervention modules. Design: A descriptive online survey administered to 15 graduate nursing students\ud was used to assess the readability and usability of an online HELP intervention. Methods: Participants were asked to perform the following activities: 1) reading the nine HELP modules on PowerPoint as posted on Blackboard (a web-based course management program), 2) filling in five blank lines under each heading (HEALTH, EDUCATION, LEGAL, and PROGRAM), by writing words or terms on the line after each heading, 3) ranking the words within each heading (with #1 as the highest and #5 as the lowest), 4) engaging in a class discussion of the rationale for the ranking, 5) re-ranking, and 6) voting on the ranking. The results were compiled to yield a master rank and vote order for each heading between 12 (received 12 votes) and 15 (received 15 votes) of the words that were ranked #1. Results: The words that were ranked #1 under each heading and the number of votes received were: Under HEALTH: Depression (15), Anger (14), Anxiety (13), and Pain (12); EDUCATION: Safety (15), Injury (14), Social Support (13) and Parenting/Child Care (12); LEGAL: Protection from Abuse (15), Attorney (14), Court/Hearing (13), and Rights (12); PROGRAM: Internet (15), Online (14), Intervention (13) and Resources (12). Conclusions: HELP intervention is readable and usable however, HELP needs to be piloted to ensure that survivors of IPV participants can access and benefit from HELP intervention

Feasibility and clinical utility of Bates-Jensen wound assessment tool among nurses caring of patients having pressure ulcers

Aims: One of the vital roles of nurses is to perform pressure ulcer risk assessment that enables them to appropriately assess and track healing progress of wound and pressure ulcers among patients. Our aim was to assess the feasibility and clinical utility of the Bates-Jensen Wound Assessment Tool (BWAT) among nurses caring of patients with pressure ulcer. Methods: A descriptive cross-sectional design used to collect data from 177 registered nurses caring of patients who developed or have a risk of developing pressure ulcers working in three hospitals in Jordan. Results: The mean feasibility score of the BWAT was 28.3 out of 36 (SD=3.4) with a median score of 29. Most of nurses reported that the BWAT was easy to use on a scale of 1-4 (best) (M=3.40/4, SD=0.62) and can successfully assess wound characteristics (M=3.40/4, SD=0.59). The mean utility score of the BWAT was 21.3 out of 28 (SD=2.7) with a median of 21. Nurses had a perception that using the BWAT enhances care of patients with wounds (M=3.36/4, SD=0.61) and makes communication easier between nurses and physicians.  Conclusion: This study provided evidence that support the use of the Bates-Jensen Wound Assessment Tool for patients with pressure ulcer. Nurses perceived BWAT as easy to use, understandable, and relevant for assessing patients with pressure ulcers. Funding statement: This work was supported by supported and funded by The Deanship of Scientific Research at The University of Jordan, Amman, Jordan [number1953/2017/19]

Psychosocial Correlates of Diabetes Self-management Practices

Background: Self-Management is a crucial regimen for patients with diabetes mellitus. Many factors have affected patients\u27 self-management practice including psychosocial factors. Literature revealed contradictory results concerning the psychosocial correlates of patients\u27 self-management practices. Therefore, this study assessed the psychosocial correlates of diabetes self-management practices among Jordanian diabetic patients. Methods: A descriptive, cross-sectional, correlational design was utilized to collect data (conducted in the middle region of Jordan in 2015) from 341 Jordanian outpatients with diabetes using self-reported questionnaires (Social Support Scale, CES-D, and Summary of Diabetes Self-Care Activities) and chart review. Results: Participants reported practice rate of 2.85/ 7 (SD=1.3), with diet practice the most (M=3.66, SD=1.5) and exercise the least (M=1.53, SD=2.1). Participants reported receiving social support (M=3.23, SD=1.3) less than needed (M=3.39, SD=1.3). High levels of depressive symptoms were reported (M=17.1, SD= 11.4). Diet practices had significant positive correlation with family support attitude (r= .266, P= .000) and negative correlation with depressive symptoms (r= - .114, P= .037). Testing blood sugar significantly correlated with both support needed (r= .144, P= .008) and support received (r= .166, P= .002). Conclusion: Jordanian DM patients were found to practice less than optimum DM self-management practices, and to consider diet practices than exercise practices. This study confirmed that the subcategories of DM self-care management should be considered rather than considering the general plan

Impact of plastic surgery medical training on medical students' knowledge, attitudes, preferences, and perceived benefits: Comparative study

Introduction: Misconceptions surrounding the discipline of plastic surgery are widespread among not only the public, but medical students and professionals, as well. The purpose of this study was to explore how the inclusion of plastic surgery rotation into the medical curriculum affects medical students’ knowledge, attitudes and preferences regarding plastic surgery specialization and referral.  Design and Methods: A descriptive-correlational design was utilized to collect data from 200 medical students in the final two years of education from two separate six-year medical programs in Jordan. Data was collected using self-reported questionnaires regarding knowledge of surgical procedures allocation, attitude towards plastic surgery, preference of specialization, and benefits of plastic surgery to physicians and patients.Results: Analysis showed that medical students of plastic surgery integrate rotation (program A) had a higher average score of correct procedure-allocation (M = 12.57, SD = 3.14), compared to non-integrated plastic survey rotation program (program B) (M = 8.29, SD = 3.05) 8.29. About 83% of students in program A had their knowledge on plastic surgery from direct exposure to a plastic surgeon, compared to 43% of program B, and 24% of students in program A reported that their perception of plastic surgery influenced by media compared to 62% of those in program B.Conclusions: medical students who have been exposed to plastic surgery education are more confident about procedures of plastic surgery specialty and had more reliable sources of knowledge about plastic surgery than those who were not exposed to plastic surgery rotation

The Reality of the Practice of Crisis Management in the Union of Health Work Committees in Gaza In Light of the Corona Pandemic

The aim of the research is to identify the reality of the practice of crisis management in light of The Corona Pandemic, and to achieve the research objectives, the researchers used the descriptive and analytical approach using the comprehensive survey method for the total research community, which numbered (110) individuals, while (90) were recovered: That the level of crisis management practice came with a relative weight (75.60%). Among the most important recommendations made by the research: Work to disburse a health risk premium to all workers in health centers, in addition to paying attention to training and building work teams in various fields, including the crisis team

The Reality of the Quality of Health Services in the Union of Health Work Committees in Gaza In Light of the Corona Pandemic

Abstract: The aim of the research is to identify the reality of the quality of health services in light of the Corona Pandemic, and in order to achieve the research objectives, the researchers used the descriptive and analytical approach using a comprehensive survey method for the total research community, whose number reached (110) individuals, while (90) were recovered: The level of health service quality is of relative weight (76%). Among the most important recommendations made by the research: Work to pay a health risk premium to all workers in health centers, in addition to paying attention to training and building work teams in various fields to improve the quality of health services provided

The Association of Persistent Symptoms of Depression and Anxiety with Recurrent Acute Coronary Syndrome Events: A Prospective Observational Study

The purpose of this study was to examine the role of persistent symptoms of depression and anxiety in a second acute coronary syndrome (ACS) event. Data presented in this study were from an RCT study. A follow-up for 24 months after baseline to detect a second ACS event among 1162 patients from five hospitals. Hierarchal Cox regression analyses were used. The results showed that persistent depression only (HR 2.27; 95% CI: 1.35–3.81; p = 0.002), and comorbid persistent depression and anxiety (HR 2.03; 95% CI: 1.03–3.98; p = 0.040) were the significant predictors of a second ACS event. Secondary education level compared to primary educational level (HR 0.63; 95% CI: 0.43–0.93; p = 0.020) and college or more education level compared to primary educational level (HR 0.47; 95% CI: 0.27–0.84; p = 0.011) were the only demographic variables that were significant predictors of a second event. The study reveals that attention must be paid by healthcare providers to assess and manage persistent depression; particularly when it is co-morbid with anxiety