Medical and Health Sciences

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https://hdl.handle.net/20.500.11888/18295

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    DETECTING THE CONSTRUCT VALIDATION OF SOME DEPRESSION SCALES IN THE PALESTINIAN CONTEXT
    (An-Najah National University, 2025-07-24) Massarwa, Remaa
    This study aimes to evaluate the construct validity of three globally recognized depression assessment the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS), and the Montgomery-Asberg Depression Rating Scale (MADRS), and examine their relevance within the unique sociocultural and psychological context of Palestine, where mental health struggles are intensified by ongoing adversity and war. To achieve this, the study adopted a quantitative research approach, utilizing both descriptive statistics and factor analysis. Specifically, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed to thoroughly assess the structure of each instrument. The research sample included 860 participants aged 15-60, drawn from the West Bank, Jerusalem, and the 1948-occupied territories. EFA was carried out on subgroup of 280 participant, while CFA was performed on a larger group of 580 participant. Data were collected through an online questionnaire, with participants selected using a convenience sampling technique. The results revealed that the 17-item version of Beck Depression Inventory exhibited the strongest psychometric prosperities, including high validity and reliability, making it particularly effective tool for depression screening with the Palestinian context. In contrast, the 20 item Hamilton Depression Rating Scale (HDRS-20) failed to meet acceptable model fit criteria, rendering it ineffective without substantial modification. The MADRS-10 scale, after minor modifications, achieved acceptable validity and reliability, suggesting its applicability in this context. Additionally, the PDS-22 scale created in this research showed considerable validity and consistency. Considering previous results, current recommend the following: 1. Embracing the BDI-17 as the most valid measure for evaluating depression in mental health facilities within Palestine. 2. Continuing to enhance the PDS-22 should be further improved for wider use, including in clinical setting and research endeavours.
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    ASSESSING THE IMPACT OF GROUP COUNSELING CBT PLAY THERAPY FOR TREATING EMOTIONAL AND BEHAVIORAL ISSUES IN ADHD CHILDREN
    (An-Najah National University, 2025-08-31) , Mai
    This thesis investigates effectiveness of Group Counseling Cognitive Behavioral Therapy (CBT) Play Therapy on addressing emotional and behavioral issues among children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), study employed quasi-experimental design involving 60 children, divided into an experimental group receiving CBT Play Therapy intervention and control group receiving no intervention, Data were collected using Conners 3rd Edition, validated assessment tool that measures ADHD symptoms across multiple domains, including inattention, hyperactivity/impulsivity, and oppositional behavior. Pre-test and post-test scores were analyzed to evaluate intervention's impact, with findings revealing significant reductions on ADHD symptoms among experimental group compared to control group, Specifically, results indicated substantial improvements across all measured subscales, with effect sizes demonstrating intervention's effectiveness, Demographic variables such as gender, monthly income, educational background, and parental involvement were also examined to understand their influence on treatment outcomes. The study concludes that Group Counseling CBT Play Therapy is viable and effective intervention for reducing ADHD-related behavioral and emotional issues on children, findings underscore importance of integrating therapeutic play approaches on clinical settings to support developmental needs of children with ADHD, the study recommends Implementing structured Group Counseling CBT Play Therapy in schools and clinics with trained facilitators, integrate systematic parent involvement, and conduct 3–6-month follow-ups to track maintenance of gains; future research should test optimal dosage, compare against individual CBT and behavioral parent training, and examine moderators (e.g., gender, socioeconomic status, parental involvement).
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    THE IMPACT OF SYMPTOMS EXPERIENCED BY PATIENTS UNDERGOING HEMODIALYSIS TREATMENT ON THEIR QUALITY OF LIFE: A CROSS-SECTIONAL STUDY FROM PALESTINE
    (An-Najah National University, 2025-08-18) Attoun, Alaa
    Background: The present study aimed to evaluate the extent to which physical and psychological symptoms associated with hemodialysis treatment influence patients’ self-efficacy in managing their chronic illness, as well as the overall impact of these symptoms on their quality of life. Methods: A cross-sectional study design was performed to investigate the research objectives. Data were collected from hemodialysis patients at selected centers in the West Bank, Palestine, including An-Najah National University Hospital in Nablus and Al-Hussein Government Hospital in Beit Jala. The physical and psychological symptoms experienced by patients were measured using the Dialysis Symptom Index (DSI). Self-efficacy in managing chronic illness was evaluated using the Self-Efficacy for Managing Chronic Disease 6-Item Scale, while health-related quality of life was assessed through the EuroQol 5-Dimension 5-Level (EQ-5D-5L) instrument and the EQ Visual Analog Scale (EQ-VAS). Results: In this study, a total of 306 hemodialysis patients were included. The mean age of the patients was 58.1 ± 13.3 years. In multivariable models, higher self-efficacy was predicted by lower BMI, urban residence, living with family, and higher education (p < 0.001 for BMI, place of residence and education; living conditions p = 0.001). Lower self-efficacy was predicted by diabetes (p < 0.001), constipation (p < 0.001), chest pain (p < 0.001), depression (p < 0.001), difficulty with sexual arousal (p < 0.001), more hemodialysis sessions per week (p < 0.001) and longer session length (p = 0.001); marital status also showed an association (p = 0.006). Mobility, self-care problems, anxiety/depression and low health ratings were additional significant negative predictors of self-efficacy (all p < 0.001). Similarly, the mean health rating of the patients was 60.3 ± 18.3. Higher self-efficacy can be significantly predicted by having a healthy weight, living in urban areas, living with family, and having higher education (p value < 0.05). Conclusions: The results highlight the importance of addressing both the clinical and psychosocial components of patient treatment to improve both patients’ sense of self-efficacy and their physical and mental health.
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    LIVED EXPERIENCES OF ANESTHESIA PROVIDERS IN IMPLEMENTING EFFECTIVE PREVENTION STRATEGIES TO ENHANCE PATIENT SAFETY: A DESCRIPTIVE PHENOMENOLOGICAL STUDY
    (An-Najah National University, 2025-08-20) Abu Ras, Mostafa
    Introduction: The safety of patients during anesthesia is a significant concern owing to the intricate and high-risk characteristics of the treatment. Objective: To investigate the lived experiences of anesthesia practitioners in executing preventive measures to improve patient safety, identify factors contributing to medical errors, and offer evidence-based suggestions for clinical practice and education. Methods: This qualitative study employed a descriptive phenomenological methodology. Sixteen anesthesia experts, comprising 11 anesthesiologists and 5 nurse anesthetists, from three governmental hospitals in Palestine were interviewed through in-depth, semi-structured interviews. Colaizzi’s (1978) seven-step process facilitated the analysis by enabling the extraction of salient statements, the construction of meanings, and the identification of themes. Findings: Seven principal themes emerged from the participants' experiences: patient safety as a core obligation, causes and classification of anesthesia errors, education, training, and protocols, coping mechanisms and professional support, communication and teamwork, impact of errors on patient safety and institutional dimensions, and Support for Anesthesia Providers to Reduce Errors. The participants emphasised the importance of ongoing training, improved interprofessional communication, and better institutional support for maintaining patients’ safety. Conclusion: The study concludes that anesthesia practitioners face daily struggles related to workload, communication, and systemic deficiencies, underscoring the need for continuous training, institutional support, and a strong safety culture.
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    EVALUATING NURSES’ TRAINING REQUIREMENTS, PRACTICE PATTERNS, AND BARRIERS IN INTRAVENOUS MEDICATION PREPARATION AND ADMINISTRATION: INSIGHTS FROM A TERTIARY HOSPITAL IN PALESTINE
    (An-Najah National University, 2025-09-25) Shalabi, Israa Rajeh
    Background: Intravenous (IV) medication is a task that requires a high level of attention. When administering and preparing IV medications, mistakes can be made that have lethal consequences. Importantly, sufficient training is needed to explain certain elements of IV administration, particularly the difficulties faced by nurses. In a tertiary hospital in Palestine, this study evaluated the training requirements, practice behaviors, and obstacles faced by nurses when preparing and administering IV medications. Methods: A cross-sectional descriptive study was conducted with 216 nurses in a tertiary hospital. Instruments, which are validated self-administered questionnaires covering demographic details, knowledge, attitudes, practices and barriers, were used. The statistical analysis was performed via IBM SPSS. Mann‒Whitney U tests, Kruskal‒Wallis tests, and Spearman correlations were used to examine associations between variables. Results: The results showed that nurses had average confidence in the IV administration of medicines. Gender, age, and educational background did not significantly differ. The level of knowledge was positively correlated with English proficiency (r=0.183; p=0.026), indicating that a better performer on English tests scored better in the knowledge assessment. Some of the internet librarians registered weak positive correlations with knowledge (r=0.145; p=0.056), showing that having access to the internet to obtain resources could strengthen the level of knowledge. The attitudes toward IV medicine administration were rated positively by most of the respondents, with median and interquartile range (IQR) values of 21 and interquartile ranges of 19-21. The years of service yielded a slight positive correlation with the attitude score (r=0.151; p=0.049). Notably, internet access was moderately positively correlated with attitudes (r=0.245; p≤0.01), implying that easier access to digital resources makes nurses more confident in how they practice. With respect to practice behavior, ICU nurses performed slightly better concerning IV administration protocol adherence than their counterparts in inpatient wards did (p = 0.019). English proficiency had a moderate positive correlation with practice scores (r = 0.168, p = 0.033), whereas internet availability was associated most strongly with higher practice behavior scores (r = 0.312, p < 0.001). The most common barriers cited were workload and time constraints, with nurses in urban environments reporting heavier workloads than those in rural areas did (p = 0.004). A statistically significant negative correlation was found between knowledge and barriers perceived by respondents (r = -0.207, p = 0.006), meaning that better knowledge reduces the perception of barriers to IV administration. Internet access had the strongest negative correlation with the perception of knowledge barriers (r = -0.231, p < 0.001), meaning that online access reduces training needs. Conclusions: Despite the existing positive attitudes of nurses and their adherence to IV administration and medication protocols, systematic barriers and knowledge gaps have been revealed, particularly regarding workload, time, and resources. These observations further suggest that proficiency in English, internet access, and experience all aid in the knowledge, attitudes, and practices of nurses. These challenges should be highlighted through the provision of education programs and resources to encourage nurse competency and safe patient practice.