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- ItemDETERMINANTS AND OUTCOME INDICATORS FOR PATIENT SAFETY CULTURE AMONG HEALTHCARE WORKERS AT AN-NAJAH NATIONAL UNIVERSITY HOSPITAL, NABLUS, PALESTINE: A CROSS-SECTIONAL STUDY(An-Najah National University, 2025-04-16) Kharof, HamzaBackground: Globally, patient safety culture (PSC) is key to improving healthcare efficiency. In Palestine, PSC enhances patient trust, reduces medical errors, and raises care standards. Despite challenges, organizations aim to improve healthcare sustainability by implementing efficient reporting and training systems. This study aimed to assess the PSC among healthcare staff at An-Najah National University Hospital (NNUH), the only accredited academic medical center in the West Bank. Methods: A convenience sample of 232 healthcare providers, excluding part-time, new staff with less than six months of experience, and contracted services, participated between June 25, 2023, and July 8, 2023. Data collection utilized an online platform (SurveyMonkey) and the Arabic-translated version of the Hospital Survey on Patient Safety Culture (HSOPSC 2.0) to Results: This study assessed patient safety culture (PSC) at An-Najah National University Hospital, revealing positive evaluations, with teamwork and continuous improvement as strengths. Response to error and staffing were areas for improvement. Conclusion: adopting proactive strategies is crucial to build a strong PSC organization; these findings are essential for hospital leadership to support staff and formulate effective patient safety programs. Keywords: Patient Safety, Perception, HSOPSC, Healthcare Providers.
- ItemTREATMENT SATISFACTION AND ATTITUDES TOWARD TAKING MEDICATIONS AMONG HYPERTENSIVE PATIENTS: A CROSS-SECTIONAL STUDY FROM PALESTINE(An-Najah National University, 2025-02-13) Kareman, YaseenBackground: Millions of patients are living with hypertension worldwide. This study aimed to assess the attitudes of hypertensive patients toward taking antihypertensive medications and their satisfaction with the treatment. Methods: This research employed a cross-sectional design with a questionnaire as the instrument for data collection. This study was conducted in the primary healthcare centers of the Ministry of Health in Nablus, West Bank, Palestine. In addition to the demographic and clinical variables, the questionnaire also included the Arabic translated and culturally adapted Drug Attitude Inventory (DAI-10) and the Arabic version of the Treatment Satisfaction Questionnaire for Medication (TSQM). Results: In this study, 356 patients with hypertension were included. More than half of the patients (57.6%, n = 205) were on amlodipine. Additionally, valsartan was used by 117 (32.9%) of the patients. The vast majority of the patients (95.2%) believed that they benefited from their antihypertensive drugs, and in their opinion, the benefits of their antihypertensive drugs outweighed the drawbacks. The vast majority of the patients (95.2 %) believed that they benefited from their antihypertensive drugs, and in their opinion, the benefits of their antihypertensive drugs outweighed the drawbacks. The Drug Attitude Inventory (DAI-10) measures the attitudes and adherence of hypertensive patients toward their antihypertensive medications via 10 statements. The DAI-10 scores were affected by the time since diagnosis (p = 0.004), presence of a documented food or drug allergy (p < 0.001), body mass index (p = 0.004), perceived effectiveness of the antihypertensive medications (p = 0.010), side effects (p = 0.001), convenience (p = 0.040), and global satisfaction scores (p < 0.001). The perceived effectiveness of antihypertensive medications was affected by side effect scores (p = 0.002), convenience scores (p < 0.001), and global satisfaction scores (p < 0.001). The global satisfaction scores were affected by the time since diagnosis (p = 0.008), DAI-10 score (p < 0.001), perceived effectiveness of antihypertensive medications (p < 0.001), and side effects (p < 0.001). Conclusions: The findings of this study revealed positive attitudes and high levels of satisfaction with antihypertensive medications among patients, especially with respect to the perceived effectiveness and convenience of antihypertensive medications. The time elapsed since diagnosis with hypertension, the presence of documented allergies, and high BMI are important factors that can predict negative attitudes and low satisfaction with treatment. Healthcare providers and decision makers should consider measures to improve, maintain, and support positive attitudes and satisfaction with treatment among hypertensive patients. Keywords: Attitudes, Satisfaction, Hypertension, Antihypertensive medications, Treatment, Cardiovascular disease, Primary healthcare
- Item.The RELATIONSHIP BETWEEN SYMPTOMS SEVERITY, MENTAL HEALTH, LIFESTYLE FACTORS, AND GUT MICROBIOME AMONG IRRITABLE BOWEL SYNDROME PATIENTS, A CROSS-SECTIONAL STUDY,WEST BANK,PALESTINE(An-Najah National University, 2025-03-24) Sa'd al deen YasmeenBackground: irritable bowel syndrome (IBS) is a popular functional disorder, which is characterized by chronic abdominal pain, variation in bowel habits and bloating. IBS is one of the global disorders that constitute a burden on both healthcare organizations and patients' quality of life. Its pathophysiology is complex and involves an interaction of psychosocial and environmental factors. Also, dysbiosis of gut microbiota and gut-brain axis plays an important role in this disorder and affects patients' mental health which can affect symptoms of IBS. So the study objective is to determine the relationship between the symptoms of IBS patients and their mental health, life style, certain types of diet, and gut microbiota diversity and compare it with healthy control. Methods: in this cross-sectional study, we aimed to find the relationship between IBS patients' mental health, physical activity, MEDAS, and gut microbiota composition, and compare it between healthy control and between themselves according to the severity of symptoms. The total number of IBS patients who participated in this study was 237 and 30 healthy control participants. All participants fulfilled the questionnaire to evaluate their mental health, physical activity, adherence to the MEDAS diet, smoking habits, and the severity of symptoms for IBS patients to assess their severity of symptoms using the Birmingham IBS questionnaire. For analysis of gut microbiota, stool samples were collected from all the control and 30 IBS matching patients. DNA extraction was followed by a semi-quantitative PCR to quantify the following bacterial species (Butyricicoccus, Enterobacteriaceae, Fecalibacter, Akkermansia, Bacteroides, Bifidobacterium, Escherichia, Streptococcus, Lactobacillus, and Roseburia) from all stool samples. Statistical analyses were performed to evaluate the relationship between mental health, physical activity, adherence to the MEDAS diet, smoking habits, and severity of IBS symptoms, as well as between the patient and healthy control. Results: Microbiota diversity analysis using alpha and beta diversity, got a good variance between healthy control and IBS patients, which was evaluated using Bray-Curtis dissimilarity with a value of 0.88. Mental health distress, physical activity, sleep problems, duration of, and smoking had a significant relationship between them, while no significant relationship was detected between BMI and MEDAS diet adherence. When using the Shannon index to assess alpha diversity between groups of patients with different severity of symptoms, different microbiota diversity was shown, with a significant relationship between smoking, sleep problems, and mental health distress. While no variation was shown between BMI, physical activity, and MEDAS diet adherence. Conclusion: This study shows differentiation in gut microbiota diversity between IBS patients and healthy controls. As well as, between groups of patients with different severity of symptoms. There is a significant relationship between mental health distress, smoking, and sleep problems for both. Physical activity between IBS patients and healthy control got significant relationship. These findings emphasize the significance of taking into consideration managing IBS patients based on their lifestyle and mental health status, together with traditional medication which can improve gut microbiota diversity.
- ItemIMPACT OF MARKETING MIX (7PS) ON HOSPITAL SELECTION AMONG PALESTINIAN PATIENTS: A CROSS-SECTIONAL STUDY(An-Najah National University, 2025-02-11) Snober, OsamaBackground: The influence of the marketing mix (7Ps: Product, Price, Place, Promotion, People, Process, and Physical Environment) on hospital choosing is a significant study domain, since healthcare facilities must consistently enhance their offerings to attract and keep consumers. This study was conducted to identify the key components of the marketing mix that most significantly impact patients' decision-making when choosing a hospital in Palestine. Methods: The study used a cross-sectional design to provide a snapshot on patients' preferences and decision-making criteria about hospital choosing in Palestine. The study was conducted in various regions of Palestine to ensure a representative sample that reflected the diverse socio-cultural and economic backgrounds of the population through selecting private hospitals and governmental hospitals in the north of the West Bank. Results: In this study, a total of 385 participants completed the questionnaire. The participants rated how the 7Ps (Product, Price, Place, Promotion, People, Process, and Physical Environment) influenced their choices on hospitals. Multiple linear regression showed that higher product ratings were predicted by moderate or household income (B = 2.12, p-value < 0.001) and having a governmental health insurance (B = -0.74, p-value = 0.030). Similarly, higher people ratings were predicted by moderate or household income (B = 1.57, p-value = 0.002). Moreover, higher process ratings were predicted by moderate or household income (B = -0.41, p-value = 0.048) and spending less nights at the hospitals (B = -0.83, p-value = 0.025). In addition, higher physical environment ratings were predicted by moderate or household income (B = -0.70, p-value = 0.011). Furthermore, higher place ratings were predicted by older age (B = 0.68, p-value = 0.007). Conclusions: The marketing mix (7Ps) strongly influences Palestinian hospital selection, providing healthcare providers with useful information. Patients choose hospitals based on specialist healthcare services, quality of treatment, financial accessibility, and physical surroundings. Patient preferences were shaped by improved services, expert personnel, and reasonable pricing. In addition, income, health insurance status, and the absence of chronic conditions were substantially related with better marketing mix ratings, notably in product, people, and process. These results show that hospitals must strengthen specialized services, provider-patient connections, price transparency, and infrastructure to be patient-centered.
- ItemSYNTHESIS AND CHARACTERIZATION OF SILVER NANOPARTICLES USING PALESTINIAN THYMUS CAPITATUS, WITH EVALUATION OF ITS POTENTIAL ANTI-OXIDANT, ANTIMICROBIAL, AND ANTICANCER ACTIVITIES(An Najah National University, 2025-03-06) Asmar, LaraIntroduction: Nowadays, the demand for thyme oil is growing because of the wide variety of its applications. Thymus capitatus, or Thymbra capitat, belongs to the Lamiaceae family and was the main herbal plant in this research that aimed to study the potential synthesis of silver nanoparticles utilizing Thymus capitatus essential oil as a reducing and stabilizing agent and to assess its antioxidant, anticancer, antimicrobial, and anti-inflammatory properties for potential biomedical applications in medicine. Methodology: The essential oil of T. capitatus was obtained through hydrodistillation. The chemical composition of the essential oil was identified and characterized using GC/MS spectrometry. The green synthesis of AgNPs was accomplished by dropwise adding diluted T. capitatus oil to a 0.1 M aqueous solution of AgNO3. Characterization of synthesized AgNPs was accomplished by several techniques, including UV-visible spectrometry, dynamic light scattering, atomic force microscopy, and zeta potential analyzer. An antimicrobial assay for both synthesized AgNPs was performed against six different types of the most common bacteria in addition to the fungi Candida albicans. Also, the cytotoxicity of synthesized AgNPs and T. capitatus EO was studied on many different cell types, including, Hep3B, B16F1, 3T3, MCF-7, HeLa, and HEK293 cell lines. The evaluation of antioxidant activity was conducted using a DPPH test. The effectiveness of the synthesized AgNPs and T. capitatus EO in reducing inflammation was assessed through the COX (human) inhibitor screening assay kit. Results: The EO yield of extraction was 1.16 %W/W, the major chemical components of the EOs were carvacrol with the highest percentage (37.47%), P-cymene (27.96%), and γ-terpinene (26.3%). The green synthesis of T. capitatus AgNPs was accomplished after several trials to determine the optimal synthesis parameter. Finally, we had a dark-brown colloidal sample of AgNPs. The UV-visible spectral peak was obtained at 425 nm wavelength. The AFM image shows a mostly spherical shape of the synthesized AgNPs with a diameter range between 40 and 80 nm. In contrast, the average effective diameter obtained by DSL analysis was 119.80 ±1.7 nm, and the zeta potential value was -43.86 ±2.2. Both synthesized AgNPS and T. capitatus EO have good antioxidant activity compared to the reference Trolox. However, the potency of synthesized AgNPs was 5-fold greater than T. capitatus EO, with IC50 values of 2.27 ±0.91, 10.47 ±1.11, and 48.97 ±1.20μg/ml for Trolox, synthesized AgNPs, and T. capitatus oil, respectively. The synthesized AgNPs had antimicrobial activity about 5-folds greater than T. capitatus pure oil against all bacterial strains that were used in addition to candida albicans, with MIC values ranging between (0.016 _ 0.290 μg/ml) for AgNPs, and (0.078 and 1.562 μg/ml) for pure T. capitatus EO. Both T. capitatus EO and synthesized AgNPs showed promising results against HeLa, MCF-7, NIH3T3, HEK293, Hep3B, and B16F1 cell lines. Synthesized AgNPs have an average percent inhibition of 80% at 200 μg/ml concentration. Finally, results indicate a great anti-inflammatory activity for synthesized AgNPs and the pure oil, also, both of them were more selective for COX-2 than COX-1, especially the synthesized NPs, whose IC50 value (2.83 µg/ml) toward COX-2 was almost 14% of the IC50 value (19.42 µg/ml) for the oil. Conclusion: The green synthesis of AgNPs can be performed by using Palestinian T. capitatus EOs as a reducing agent. Furthermore, these AgNPs can be used to develop a new treatment line for cancer therapy due to their anticancer activities