Stress, Trauma, Psychological Problems, Quality of Life, and Resilience of Palestinian Families in the Gaza Strip

Aim: The aim of the study was to investigate the relationships between stressor due to restriction of Palestinian movement, traumatic events due to war on Gaza and psychological symptoms, quality of life, and resilience. Methods: A sample consisted of 502 randomly selected subjects from five areas of the Gaza Strip. Measures for collecting data include Stressful Situations due to Siege Scale, Gaza Traumatic Events Checklist, Brief Symptom Checklist-BSI-19, World Health Organization Quality of Life, and Resilience scale. Results: The most common stressful situations due siege were: feelings of being living in a big prison cannot finish some construction and repair work in their house due to shortage of cement and building materials, prices were sharply increased in the last few years. Participants commonly reported traumatic events such as hearing shelling of the area by artillery, hearing the sonic sounds of the jetfighters, hearing the loud voice of drones, and watching mutilated bodies in TV. Males had significantly experienced severe traumatic events than females. People live in cities reported more traumatic events than those live in a village or a camp. As a reaction to stress and trauma Palestinians participants reported anxiety symptoms such as nervousness or shakiness inside, feeling tense or keyed up; while depression symptoms reported were feeling sad, and weak in parts of their body. However, feelings of worthlessness and thoughts of ending life were seldom. Females reported less stress and trauma, but they showed anxiety and somatization symptoms than males. Only 12.5% said that they evaluate their life as good, and 27.1% said they enjoy their life. Better quality of life is an indicator of wellbeing; females had higher level of quality of life. While, physical health activities of daily living were more in males was. Palestinians used religious ways of coping with the stress and trauma, and 98% said God is helping all the time, they were proud of their achievements, and had strong sense of purpose in their life. There were statistically significant positive relationship between stress due to the siege and closure and traumatic events, psychological symptoms, depression, somatization, and anxiety. However, there was statistically significant negative relationship between total score of stress due to the siege and closure and the total resilience factor and subscales, and quality of life. Total traumatic events were positively correlated with psychological symptoms, depression, somatization, and anxiety. Conclusion and implications: In this study, siege and blockade situation was very stressful. Such stressors due to siege had negative influence families especially older age fathers who live in refugee camp and unemployed and living in poor families. Such findings are trigger to start national and international advocacy campaigns to left the siege on Gaza Strip and allow free movements and association, which may decrease stressors and consequences and improve the economic situation of the families and decrease poverty of the families. Traumatic experiences due to eight days war on Gaza impact on mental health and quality of life highlight the need for developing new training program including subjects such trauma, impact of trauma, stress management, symptoms related to trauma such as PTSD, anxiety, depression and ways of dealing such symptoms especially for fathers who live in the cities