Gaza midwives' experiences in providing maternity care during COVID-19.

INTRODUCTION: The Gaza Strip is densely populated. The COVID-19 pandemic has had a detrimental impact on global healthcare systems, and midwifery practices have transformed in maternity care settings. Our research aimed at understanding the Palestinian midwives' experiences in providing maternity care in Gaza during the COVID-19 pandemic at Gaza European Hospital which was the only hospital providing care for people diagnosed with COVID-19. METHODS: To understand the phenomenon of interest, descriptive phenomenology was used. A purposive sample of eight midwives from the European Gaza Hospital was chosen. Between December 2020 and January 2021, semi-structured interviews were used in the data collection procedure. The collected data were analyzed using the Colaizzi approach. RESULTS: The investigation resulted in three main themes: emotionally overwhelmed, work environment challenges, and interpersonal relationship development. CONCLUSIONS: Midwives shared both positive and negative experiences from their time working in the European Gaza Hospital during the COVID-19 pandemic. They were confronted with negative emotions such as fear, stress, and anxiety, as well as environmental challenges. Despite this, they created a new interpersonal bond that was positively reflected. To sustain their psychological well-being, COVID-19 care workers require psychological support at work. A strong need exists for equipping the Maternity Department with the essential equipment and supplies to reduce the working environment load, as well as giving the necessary training to staff to be qualified enough to provide such crucial care.

Depression among Infertile Women in Gaza Strip: Symptom Severity and Predictors.

BACKGROUND: Mental disorders are expected for women suffering from infertility. Depression is a predictable consequence but requires more investigations and considerations. This study is aimed at determining the severity of depression symptoms and its predictors among infertile women in the Gaza Strip, Palestine. MATERIALS AND METHODS: A cross-sectional study was conducted. Three hundred eighty-five infertile women participated and were selected by convenience sampling. The participated women were selected from three large and major in vitro fertilization treatment centers (Al Helo, Al Basma, and Hindawi). A validated Arabic version of the Beck Depression Inventory-II was used. Univariate and multivariate logistic regression was applied to determine potential predictors for depression symptoms, and p ≤ .05 was statistically significant. RESULTS: The mean age of participated women was 29 ± 6.58 years, and the mean duration of marriage and infertility was 7.76 ± 5.31 and 5.43 ± 3.50 years, respectively. Half of the women had some form of depression symptoms (22.3%, 8.6%, and 10.6% showed to have mild depression, moderate, and severe depression symptoms, respectively). Predictors of depression symptoms were as follows: duration of marriage (Wald test: 10.493; CI95%: 0.248-0.774), at least one abortion (Wald test: 21.233; CI95%: 1.863-4.528), primary infertility (Wald test: 6.666; CI95%: 1.148-2.742), and husband cause of infertility (Wald test: 10.878; CI95%: 0.800-0.982). CONCLUSION: Infertility affects the various aspect of women's life. Psychological intervention including counselling, support, and therapy would be necessary to limit the consequences of infertility. Such interventions could be implemented in infertility treatment clinics.

Depression Among Infertile Men in the Gaza Strip, Palestine: The Neglected Aspect of Fertility Care.

BACKGROUND: Infertility is a worldwide public health problem and affects psychological aspects of males' and females' life. However, the problem has not been well investigated in Palestine. Therefore, the purpose of this study was to determine prevalence and predictors of depression among infertile men in the Gaza strip. METHODS: A cross-sectional study was carried out among three hundred eighty five infertile males from January to December 2019. Participants were selected from three main in-vitro fertilization (IVF) centers following simple random sampling. The Arabic version of Beck Depression Inventory was used. Descriptive and inferential analyses were performed using the SPSS V22. Binary analysis was done to determine independent variables and t-test and one-way ANOVA were conducted afterwards. Logistic regression was performed to determine independent factors associated with depression symptoms. The p-value of 0.05 or less was considered statistically significant. RESULTS: Findings showed that 42.6% (164/385) of infertile men had at least one type of depression. Severe depression was presented in 16.6% (64/164) of participants, while 13.2% (51/164) and 12.7% (49/164) showed moderate and mild depression, respectively. Predictors for depression were duration of marriage (>8 years) (CI 95%: 1.099-2.615) and at least one IVF attempt (CI 95%: 0.373-0.873). CONCLUSION: It has been revealed that depression is prevalent among infertile men. Marriage of long duration and several failures in IVF attempts are predictors for depressions. Psychological counseling besides medical interventions seems to be an optimal strategy to alleviate psychological distress associated with infertility.

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine.

Breast self-examination (BSE) is one of many first-line screening practices aimed at early detection and prevention of fatal outcomes of breast cancer. The present study aimed to identify Palestinian women's practices, awareness, and barriers to BSE. Using descriptive-analytical methods, a previously validated questionnaire was administered to a conveniently selected sample of women. The study was conducted among women who visited primary health clinics (PHCs) in Gaza City. A total of 390 participants who met the selection criteria answered the self-administered questionnaires. We used SPSS version 24.0 to analyze the data. The findings suggest that the practice of BSE among women in Gaza is low, with only 40% of the study participants reporting that they never practiced BSE before, even though 76.7% reported that they were aware of BSE. In general, the main barriers to BSE practices were that participants had wrong perceptions and lacked knowledge about BSE. Others also reported fear of detecting breast cancer as a barrier. The practice of BSE among Palestinian women in the Gaza Strip is low and marred with trivial issues as barriers that could be eliminated with dedicated and extensive educational campaigns in the area.

Intimate partner violence against Palestinian women in Gaza strip: Prevalence and correlates.

CONTEXT: Intimate partner violence (IPV) affects gravely the victims and is resulting in negative physical and psychological consequences. AIMS: This paper aimed to determine the prevalence of IPV against women in Gaza strip and associated factors. Moreover, to explore women's seeking behaviors to help. SETTINGS AND DESIGN: Cross-sectional study. METHODS AND MATERIALS: Community internet-based survey was conducted using the Heart Insult Threat Scout questionnaire and the reporting behavior of respondent to violence act. STATISTICAL ANALYSIS USED: A number of 517 ever married women responded and data were entered and analyzed using SPSS software version 23. RESULTS: About 517 women participated. Of which, 23% (119/517) reported exposure to any types of IPV. Multivariate logistic regression showed factors associated with IPV were as follows: husbands who are drug user (OR = 27.577, CI95%: 5.153-147.591; P < 0.001), husband exposure to violence in childhood (OR = 9.174, CI95%: 4.753-7.727; P > 0.001), and family with a special needs child (OR = 2.956, CI95%: 1.131-8.607; P < 0.05). Approximately, two-thirds of the victims tended to keep silent toward violence and dealt with it as a private and family issue; hence, they hesitated to communicate with others or seek any help to protect themselves. CONCLUSIONS: About 23% from the study participants experience violence in their life time. Factors associated with IPV are husband's drug abuse, having a child with special needs, and husband's childhood experience of violence. Qualitative researches are needed to understand the women experience to violence and sociocultural barrier for disclosure.

A Whole Life Of Threats: A Qualitative Exploration Of Lived Experiences Of Palestinian Women Suffering From Intimate Partner Violence.

BACKGROUND: Violence against women is a widespread public health problem in the Palestinian community considered to be a traditional community. It is usually underreported due to cultural and religious issues. The present study was carried out in order to deepen the understanding of the feelings, thoughts, and perceptions of Palestinian women living in the Gaza Strip and suffering from intimate partner violence. METHODS: Hermeneutic phenomenological study was conducted. The recruited 11 Palestinian women suffering from intimate partner violence were selected via purposive means. Semi-structured in-depth interviews conducted from May to Sept 2018 were used to understand their lived experience. Data was analyzed through the Van Manen method. RESULTS: In the process of data analysis, living in a threatening world was the main theme that was extracted from the data. The theme refers to the condition that participants were committed to their marriage and are compelled to remain in a threatening situation. That was interpreted as a whole life of threats, which was labeled as the main theme emerging from three sub-themes. This main theme included 3 subthemes namely "live in a physically threatening environment", "live in psychologically threatening environment", and "live in sexual threatening environment". CONCLUSION: As revealed in our study, the participant suffered extremely from intimate partner violence and its consequences, which negatively affected their lives. However, their concerns about their children and lack of support were barriers for them to get a divorce; therefore, abused women need help to deal with their current lives like access to social and psychological counseling.

Female sexual dysfunction among married women in the Gaza Strip: an internet-based survey.

BACKGROUND: Since sexual function is an important element of human life, sexual dysfunction may negatively affect the quality of life for both males and females. It is a widespread public health problem that is inadequately studied in the Arab world. OBJECTIVE: Determine the prevalence of female sexual dysfunction (FSD) and associated factors in all women who sought reproductive health services in the community and who were in an active sexual relationship. DESIGN: A cross-sectional survey. SETTING: Community. SUBJECT AND METHODS: Married Palestinian women living in the Gaza strip in Palestine who were aged from 18-60 years old and could use the internet volunteered to participate during routine health visits. We used the Arabic version of the Female Sexual Function Index, which is comprised of six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The data were analyzed descriptively and by univariate and multiple logistic regression analysis. MAIN OUTCOME MEASURE: Frequency of FSD and association with demographic, socioeconomic and clinical factors. SAMPLE SIZE: 385 married women. RESULTS: The prevalence of FSD was 61% (n=235). Of those, 26.4% (101/385) had desire disorder, 20.2% (47/235) had arousal disorder, 18.4% (101/385) had orgasm disorder, 6.7% (26/385), 79% (304/385), and 21.2% (82/385) had lubricant disorder, pain disorder, and satisfaction, respectively. Logistic regression analysis showed that independent factors associated with FSD were parity (OR: 2.068; CI 95%: 1.047-3.985; P<.05), marriage dissatisfaction (OR: 6.299; CI 95%: 2.879-13.781; P<.001), and living in stressful conditions (OR: 2.181; CI 95%: 1.380-3.448; P<.001). There was no evidence of statistically significant associations between FSD and polygamy, intercourse frequency, wife's age, wife's job, husband's age, husband's job, education, abortion history, number of children, marital duration and using of family planning methods. CONCLUSION: FSD was common in women participating in our survey. More research on the effect of sexual dysfunction on quality of life is recommended as well as research on the awareness of the presence of dysfunction in women. LIMITATION: The use of an internet survey was the major limitation of the study. Findings may not be generalizable. Further studies are needed to include women who do not have internet access. CONFLICT OF INTEREST: None.

Learn to live with it: Lived experience of Palestinian women suffering from intimate partner violence.

BACKGROUND AND AIM: Intimate partner violence has become a growing concern all over the world and causes numerous consequences and provokes various reactions among women. The present study was aimed to understand the lived experience of Palestinian women who suffered domestic violence by an intimate partner. METHODS: In this hermeneutic phenomenological study, van Manen's methodical steps were used to conduct the study. An in-depth face-to-face semi-structured interview was conducted to 11 survivors of intimate partner violence. Data were analyzed by thematic analysis method. RESULTS: "learn to live with it" was the core theme, which extracted from four subthemes including "failure to change for better," "failure to gain support," "failure to enjoy sexual life," and "failure to make decisions." Learn to live with it refers to participants' acceptance to their unpleasant situation because they could not change it. CONCLUSION: Palestinian women who suffer from violence fail to cope with appropriately due to traditional culture and lack of familial and economic dependence.