RESUMEN
Although a large number of Muslim refugees have resettled in the United States for the last decades, few studies have looked into maternal healthcare access and utilization among Muslim refugee women in the country. This qualitative study was conducted to explore the factors influencing maternal healthcare access and utilization among Muslim refugee women resettled in the United States. In-depth interviews were conducted among Afghan, Iraqi, and Syrian refugee women (n = 17) using an interview guide informed by Social Cognitive Theory and its key constructs. The interviews were recorded and transcribed verbatim, imported into MAXQDA 2020 (VERBI Software), and analyzed based on qualitative content analysis. Data analysis revealed several themes at the micro, meso, and macro-levels. Micro-level factors included women's attitudes toward hospitals and prenatal care, as well as their life skills and language proficiency. Meso-level factors, such as cultural norms and practices, social support and network, as well as health care provider characteristics, were also identified. Macro-level factors, such as the complex healthcare system and access to insurance, also appeared to influence maternal healthcare access and utilization. This study revealed the complex contextual factors that refugee populations face. Given the population's heterogeneity, a more nuanced understanding of refugee maternal health is required, as are more tailored programs for the most vulnerable groups of refugee women.
Asunto(s)
Accesibilidad a los Servicios de Salud , Islamismo , Investigación Cualitativa , Refugiados , Humanos , Femenino , Refugiados/psicología , Refugiados/estadística & datos numéricos , Adulto , Estados Unidos , Servicios de Salud Materna/estadística & datos numéricos , Embarazo , Irak/etnología , Adulto Joven , Afganistán/etnología , Aceptación de la Atención de Salud/etnología , Siria/etnología , Atención Prenatal/estadística & datos numéricosAsunto(s)
Antiprotozoarios , Leishmaniasis Cutánea , Fosforilcolina , Humanos , Masculino , Leishmaniasis Cutánea/tratamiento farmacológico , Leishmaniasis Cutánea/diagnóstico , Fosforilcolina/análogos & derivados , Fosforilcolina/uso terapéutico , Preescolar , Antiprotozoarios/uso terapéutico , Resultado del Tratamiento , SiriaRESUMEN
Community-led, shared book reading programs may help improve refugee children's reading abilities and attitudes towards reading. We Love Reading (WLR)-a light-touch, community-led, shared book reading program-was evaluated in a pre-registered, wait-listed, randomised controlled trial (AEARCTR-0006523). 322 Syrian refugee mother-child dyads (children: 4-8-year-olds, 50.0% female) in Jordan were tested at two timepoints, 15 weeks apart. WLR did not significantly affect child literacy or child-reported child attitudes toward reading (ps > 0.05). Mothers did report improved child attitudes toward reading from WLR (p = 0.046, η2 = 0.013). The intervention did not lead to improvements in family relationships (ps > 0.05). WLR may have promise in improving attitudes toward reading in forcibly displaced children but did not affect literacy or child-reported attitudes toward reading; these results provide insight into what changes are needed for effective shared book reading interventions in this population.
Asunto(s)
Lectura , Refugiados , Humanos , Refugiados/psicología , Femenino , Niño , Masculino , Siria , Preescolar , Jordania , Alfabetización , Adulto , Libros , Madres/psicologíaRESUMEN
Social media has become a source of disseminating information to the public during the COVID-19 outbreak which has been a great advantage for healthcare centers. However, foreign anti-vaccination campaigns on social media increased the disbelief in vaccine safety. To our knowledge, the effects of social media on COVID-19 vaccine acceptance are not well-studied in low-income countries. The primary objective of this survey is to investigate Syrians' dependence on social media platforms to get information about vaccines, and to what extent it affects their vaccination decision. A web-based cross-sectional study was conducted in Syria from May 26th to July 26th, 2022 using an online questionnaire as Google Form posted on various social media platforms. The questionnaire consisted of 53 questions related to each of the socio-demographic characteristics, beliefs, and knowledge about COVID-19 vaccination, willingness to get vaccinated, and social media frequency use and its effects. Univariate and multivariate logistic regression was performed to identify factors associated with vaccination behavior. A total of 780 questionnaires were completed; around 42.2% of study participants did not get the vaccine, and 24% would take it only under compulsory rules. Also, only 3.08% of the participants answered correctly on the knowledge-evaluation questions. Results of the univariate analysis showed that being female, living in an urban residential area, and having good vaccine knowledge were positive predictors of vaccine receiving. The unvaccinated group had a higher likelihood of being college students, not trusting in the vaccine, knowing relatively less about the vaccine, and not having previously been exposed to the virus. No significant correlation between vaccination status and using social media was shown in our investigation. However, our results show the importance of social media information in health-related decisions in war-torn countries and emphasize further investigations to confirm causality and determine the best health policy choice.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Medios de Comunicación Sociales , Humanos , Medios de Comunicación Sociales/estadística & datos numéricos , Siria , Estudios Transversales , Masculino , Vacunas contra la COVID-19/administración & dosificación , Femenino , Adulto , COVID-19/prevención & control , COVID-19/epidemiología , Encuestas y Cuestionarios , Persona de Mediana Edad , Conocimientos, Actitudes y Práctica en Salud , Vacilación a la Vacunación/psicología , Vacilación a la Vacunación/estadística & datos numéricos , Adulto Joven , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , SARS-CoV-2 , Vacunación/psicología , Vacunación/estadística & datos numéricos , AdolescenteRESUMEN
STUDY OBJECTIVE: This study aims to assess the prevalence of both classic and non-classic pain sites in patients with ischemic heart disease, emphasizing the importance of recognizing and not disregarding non-classic symptoms. METHODS: This cross-sectional study included 100 patients diagnosed with coronary artery disease (CAD) who were admitted to two major hospitals in Syria. classic pain was identified as pain located in the precordial area, with or without radiation to the neck, jaw, left shoulder or arm. Patients' demographics and previous medical history were documented to investigate any potential associations with non-classic pain. RESULTS: 62% of the patients experienced non-classic pain, while 12% had no precordial pain. For those without precordial pain, the most common pain site was the left chest (66.7%). Non-classic pain was significantly associated with smoking, with 72.2% of smokers experiencing non-classic pain compared to 35.7% non-smokers (p = 0.001). Additionally, patients with previous heart disease were more likely to have non-classic pain (71.7%), compared with patients with no history of heart disease (51.1%) (p = 0.03). Other factors such as age, sex, and diabetes were not statistically significant. CONCLUSION: Non-classic pain is common, affecting 62% of individuals, primarily in the right shoulder, right arm, and back. This type of pain could be associated with smoking and prior heart disease. Misdiagnosing coronary artery disease can have serious consequences, as patients with non-classic symptoms may miss important pre-hospital procedures like ECG.
Asunto(s)
Enfermedad de la Arteria Coronaria , Humanos , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Prevalencia , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Anciano , Siria/epidemiología , Dolor en el Pecho/epidemiología , Dolor en el Pecho/etiología , Dolor en el Pecho/diagnóstico , Factores de Riesgo , Fumar/epidemiología , Fumar/efectos adversos , Dimensión del Dolor , AdultoRESUMEN
INTRODUCTION: Since the Syrian Civil War began in 2011, the official number of refugees under temporary protection in Turkiye is reported to be 3,522,036 in 2023. Most of the Syrians living outside the refugee camps have worse conditions in terms of access to healthcare centers and social opportunities, compared to those living in camps. The Sanliurfa province hosts the third highest number of Syrians (370,291) in Turkiye. There are no data about the seroprevalence of Toxoplasma gondii (T. gondii), rubella (rub), or cytomegalovirus (CMV) among Syrian refugees in Sanliurfa. We aimed to investigate the seroprevalence of T. gondii, rub, and CMV infections among female Syrian refugees of reproductive age (15-49 years) living in Sanliurfa province. METHODOLOGY: A cross-sectional study was conducted in different districts of Sanliurfa. A total of 460 households were selected using the probability sampling method. One married female Syrian refugee aged between 15 and 49 years, was chosen in each household, leading to a sample size of 410 female Syrian refugees. The seropositivity of T. gondii, CMV, and rub IgM and IgG in blood samples were analyzed using enzyme immunoassays (Abbott Architect, Illinois, USA). RESULTS: The seropositivity rates of T. gondii, CMV, and rubella IgM and IgG were 4.4% and 59.8%; 3.9%; and 99%; and 1.9%, and 99.5%, respectively. CONCLUSIONS: A screening program should be implemented for T. gondii, CMV, and rub infections for Syrian refugees. Seronegative women should be vaccinated against rub and educated about the transmission and preventive routes of toxoplasmosis and CMV infection.
Asunto(s)
Infecciones por Citomegalovirus , Refugiados , Rubéola (Sarampión Alemán) , Toxoplasmosis , Humanos , Femenino , Refugiados/estadística & datos numéricos , Adulto , Estudios Seroepidemiológicos , Toxoplasmosis/epidemiología , Adolescente , Adulto Joven , Rubéola (Sarampión Alemán)/epidemiología , Siria/epidemiología , Siria/etnología , Persona de Mediana Edad , Estudios Transversales , Infecciones por Citomegalovirus/epidemiología , Turquía/epidemiología , Toxoplasma/inmunología , Anticuerpos Antivirales/sangre , Citomegalovirus/inmunología , Citomegalovirus/aislamiento & purificación , Inmunoglobulina M/sangreRESUMEN
PURPOSE: On February 6, 2023, two earthquakes of magnitude 7.7 and 7.6 occurred consecutively in Turkey and Syria. This study aimed to investigate the predisposing factors for wound infection (WI) and the microbiological characteristics of wounds after earthquake-related injuries. METHODS: This descriptive study evaluated pediatric patients' frequency of WI, and the clinical and laboratory parameters associated with the development of WI were investigated. RESULTS: The study included 180 patients (91 female). The mean age of the patients was 123.9 ± 64.9 months and 81.7% (n = 147) of them had been trapped under rubble. Antibiotic treatment to prevent WI had been administered to 58.8% (n = 106) of all patients. WI was observed in 12.2% (n = 22) of the cases. In patients who developed WI, the incidence of exposure to a collapse, crush syndrome, compartment syndrome, multiple extremity injury, fasciotomy, amputation, peripheral nerve injury, thoracic compression, blood product use, intubation, and the use of central venous catheters, urinary catheters, and thoracic tubes were more frequent (p < 0.05). The need for blood product transfusion was associated with the development of WI (OR = 9.878 [95% CI: 2.504-38.960], p = 0.001). The negative predictive values of not developing WI at values of white blood cell count of < 11,630/mm3, creatine kinase < 810 U/L, potassium < 4.1 mEq/L, ALT < 29 U/L, AST < 32 U/L, and CRP < 45.8 mg/L were 93.7%, 96.8%, 90.8%, 93.3%, 100%, and 93.5%, respectively. Gram-negative pathogens (81%) were detected most frequently in cases of WI. Seventy-five percent of patients were multidrug- and extensively drug-resistant. CONCLUSION: This study leans empirical approach of our disaster circumstances. In cases with risk factors predisposing to the development of WI, it may be rational to start broad-spectrum antibiotics while considering the causative microorganisms and resistance profile to prevent morbidity.
Asunto(s)
Terremotos , Infección de Heridas , Humanos , Femenino , Masculino , Niño , Infección de Heridas/epidemiología , Infección de Heridas/microbiología , Turquía/epidemiología , Preescolar , Adolescente , Siria/epidemiología , Factores de Riesgo , Antibacterianos/uso terapéutico , Incidencia , LactanteRESUMEN
Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Accidente Cerebrovascular , Humanos , Siria/epidemiología , Femenino , Masculino , Adulto , Persona de Mediana Edad , Estudios Transversales , Accidente Cerebrovascular/epidemiología , Encuestas y Cuestionarios , Factores de Riesgo , Adulto Joven , Adolescente , AncianoRESUMEN
This article adopts a socio-economic and political lens to elucidate the interplay of factors that heighten the vulnerability of Syrian refugee agricultural workers and their exposure to pesticides in Lebanon. It provides a comprehensive understanding for the interconnected social, political and economic factors at the global, regional, national and local levels and how they increase the vulnerability of Syrian refugee agricultural workers, particularly their exposure to pesticides. The global factors highlight the shifts from colonialism to state-controlled economies to neoliberal policies. These changes have prioritized the interests of large agricultural schemes and multinationals at the expense of small and medium-sized agriculture. Consequently, there has been a boost in pesticides demand, coupled with weak regulations and less investment in agriculture in the countries of the Global South. The article explains how the dynamic interaction of climate change and conflicts in the Middle East and North Africa region has negatively impacted the agriculture sector and food production, which led to an increased potential for pesticide use. At the national and local levels, Lebanon's social, political and economic policies have resulted in the weakening of the agricultural sector, the overuse of pesticides, and the intensification of the Syrian refugee agricultural workers' vulnerability and exposure to pesticides. The article recommends that researchers, policymakers, and practitioners adopt a political-economic-social lens to analyze and address the full dynamic situation facing migrant and refugee workers in Lebanon and other countries and promote equity in the agricultural sector globally.
Asunto(s)
Agricultores , Exposición Profesional , Plaguicidas , Política , Refugiados , Líbano , Humanos , Siria , Agricultores/estadística & datos numéricos , Agricultura , Factores SocioeconómicosRESUMEN
The prevalence of overactive bladder (OAB) is known to be higher in patients with type 2 diabetes (T2DM). However, few studies have examined specific risk factors contributing to its progression among diabetes mellitus (DM) patients, so this study aimed to investigate the risk factors specific to diabetes mellitus that influence overactive bladder in the Syrian population. This cross-sectional study was conducted at four endocrinology centers in four Syrian provinces: Damascus, Aleppo, Homs, Hama, and Latakia. The study was comprised of patients who had been diagnosed with both T2DM and OAB and had visited these centers from February 2020 to January 2023. The Arabic version of the Overactive Bladder Symptom Score (OABSS) scale was used to categorize the participants based on the severity score into two groups: the mild OAB group and the moderate-severe OAB group. A logistic analysis was conducted to assess the risk factors associated with the OAB among patients with diabetes. Among the 153 patients diagnosed with both DM and OAB, significant distinctions were found between the two groups concerning the severity of overactive bladder, age, duration of diabetes, symptomatic diabetic peripheral neuropathy (DPN), and ankle reflex (P < 0.05). Furthermore, a multivariate analysis revealed that age (OR 1.48, 95% CI 0.89-2.19), duration of diabetes (OR 1.94, 95% CI 0.53-2.23), and symptomatic DPN (OR 2.74, 95% CI 1.39-4.13) independently acted as risk factors for the advancement of OAB. The severity of OAB in Syrian patients with diabetes is closely associated with the severity of DM. Factors such as age, duration of diabetes, and symptomatic DPN are independent predictors of the severity of OAB. Patients who experience symptomatic DPN are at an increased risk of developing OAB.
Asunto(s)
Diabetes Mellitus Tipo 2 , Índice de Severidad de la Enfermedad , Vejiga Urinaria Hiperactiva , Humanos , Vejiga Urinaria Hiperactiva/epidemiología , Vejiga Urinaria Hiperactiva/etiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Siria/epidemiología , Femenino , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estudios Transversales , Anciano , Adulto , Prevalencia , Neuropatías Diabéticas/epidemiología , Neuropatías Diabéticas/etiologíaRESUMEN
BACKGROUND: Although Türkiye (Turkey) hosts the largest number of Syrian refugees, studies on food insecurity are limited. This study examined the prevalence and risk factors of food insecurity among Syrian refugees living in Istanbul, which has the highest number of refugees in Türkiye. METHODS: A cross-sectional survey was conducted among Syrian refugees in Istanbul between September 2021 and March 2022. The main income earners of 103 households were interviewed by a research dietitian, with the assistance of an Arabic speaking interpreter through hour-long face-to-face. Data on sociodemographic characteristics (age, gender, nationality, marital status, educational status, the family income, the major source of family income, and the number of family members living in the household etc.) and household food insecurity status were collected. Household food insecurity status was assessed with the eighteen-item Household Food Security Survey Module. RESULTS: The household food insecurity rate was 90.3%, and those of adults and children were 88.4% and 84.8%, respectively. It was observed that family income level was significantly associated with food insecurity. A one-unit increase in monthly income increased food security by 0.02 times (p < 0.001). The number of employed refugees in the food security group was higher than that in the food insecurity group (p = 0.018). A significant difference was found in the rate of occupation type of the major income earner between the groups (p = 0.046). CONCLUSIONS: High rates of food insecurity, particularly severe food insecurity, were found among Syrian refugees living in Istanbul. While more research is warranted to explore the root causes and efficacy of the current support system, it requires the immediate attention of policymakers at the national and international levels to implement effective policies and interventions.
Asunto(s)
Inseguridad Alimentaria , Refugiados , Humanos , Refugiados/estadística & datos numéricos , Refugiados/psicología , Siria/etnología , Femenino , Masculino , Estudios Transversales , Adulto , Turquía/etnología , Prevalencia , Factores de Riesgo , Persona de Mediana Edad , Adolescente , Adulto Joven , NiñoRESUMEN
BACKGROUND: Medical research productivity is globally increasing, with a lagging progress in third-world countries due to significant challenges, including inadequate training and brain drain. Syria had been showing a slow upward trend until the war broke out and severely hindered academic growth and productivity. A deeper understanding of the factors influencing research productivity in this context are fundamental to guide educational policies and resource allocation. Previous cross-sectional studies that evaluated the perspectives of Syrian academics on the issue were limited by the small sample size of published healthcare workers, making it difficult to identify the factors that enabled them to pursue research. METHODS: To address this challenge, we employed a case-control design. We isolated published early-career Syrian healthcare workers and compared their characteristics and perceptions to unpublished matched controls. Authors in the fields of medicine, dentistry, and pharmacy affiliated with any Syrian University were identified through an extensive search of PubMed and Google Scholar.These authors were invited to complete a questionnaire that covered participants' research contributions, alongside their self-assessed knowledge, attitudes, and barriers towards research. The questionnaire was publicly published to recruit an equal sample of matching controls, with half consisting of unpublished researchers and the other half of participants without prior research contributions. RESULTS: Six-hundred-sixteen participants were recruited. Their knowledge, attitudes, and perceived barriers explained 46% and 34% of the variability in research involvement and publication, respectively (P < 0.001). Getting involved in and publishing research studies associated with higher research-related knowledge and attitudes (P < 0.001). Respondents' assessment of research-related barriers and their academic scores did not differ between cases and controls. Superior research-related knowledge and attitudes were associated with male gender, higher English competency, and better internet connectivity. Meanwhile, extracurricular training and mentors' support were associated with more positive research-related attitudes and less perceived barriers. CONCLUSIONS: Research productivity of medical professionals in Syria exhibits a positive correlation with their knowledge and favorable attitudes towards medical research. Noteworthy, the demographic variations are linked to disparities in research-related knowledge and motivation. In conclusion, these results suggest a potential avenue for enhancement through concentrated efforts on improving extracurricular training interventions and mentors' support.
Asunto(s)
Investigación Biomédica , Siria , Humanos , Estudios de Casos y Controles , Masculino , Femenino , Adulto , Personal de Salud/educación , Encuestas y Cuestionarios , Conflictos Armados , EficienciaRESUMEN
BACKGROUND: Human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) can cause severe and fatal complications; knowledge about these diseases is essential for promoting safe sex practices and modifying behaviours that are harmful to one's health. This study investigates Syrian people's understanding, attitudes, and behaviors towards HIV/AIDS and STIs, aiming to identify factors promoting safe sex practices and modifying harmful behaviors. METHODS: This online cross-sectional study was conducted in Syria between 3 September and 23 November 2022, involving all 18+ individuals. The questionnaire was adapted from a previous study containing 74 questions from five sections: socio-demographic information, knowledge and practice regarding STIs, knowledge and practice regarding HIV/AIDS, attitude towards HIV/AIDS, and attitude regarding STIs and analyzed using descriptive and multivariate logistic regression. RESULTS: The study involved 1073 participants mostly aged between 18-30, with 55.3% females. Over half had good awareness of STIs and HIV/AIDS, with 55% and 63% respectively. Specifically, the overall knowledge level of STI type, signs/symptoms, risks of transmission, preventive methods, and complications for untreated STIs were (45.7%), (52.9%), (58.1%), (66.1%), and (59.6%), respectively. Medical field respondents had higher knowledge of HIV (P-value < 0.05, OR = 2). CONCLUSION: Our results show that Syrian people have a knowledge level of STIs and HIV was moderate. However, the attitude toward STIs was negative, as less than half of the participants had a good attitude. It is essential to solve these knowledge gaps, especially in low-income countries such as Syria.
Asunto(s)
Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Enfermedades de Transmisión Sexual , Humanos , Siria , Femenino , Masculino , Adulto , Estudios Transversales , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/transmisión , Adolescente , Adulto Joven , Infecciones por VIH/transmisión , Infecciones por VIH/psicología , Infecciones por VIH/prevención & control , Encuestas y Cuestionarios , Persona de Mediana Edad , Conducta SexualRESUMEN
BACKGROUND: The clinical learning environment (CLE) plays a crucial role in shaping the learning experiences and professional development of medical professionals. Understanding and optimising this environment is essential for improving doctors' knowledge acquisition, clinical skills, and overall well-being. The development of the Postgraduate Hospital Educational Environment Measure (PHEEM) and its translation to numerous languages has been a milestone in clinical education. Even though PHEEM was recently translated into Arabic, its psychometric properties in this form remain unevaluated. Therefore, this study aims to conduct a comprehensive psychometric analysis of the Arabic version of the PHEEM questionnaire. METHODS: This is a cross-sectional questionnaire survey validation study. The defined population were medical residents in Damascus, Syria. A paper-based survey as well as an online-based one were conducted using several non-probability sampling methods namely, convenience, river and, snowball sampling between June 15, 2023, and June 21, 2023. Both exploratory (EFA) and confirmatory (CFA) factor analyses were conducted. Several psychometric criteria were applied including scree plot, eigenvalue > 1.5 and the 'proportion of variance accounted for' criterion. RESULTS: A total of 543 participants completed the questionnaire (56.9% female). Kaiser-Meyer-Olkin measure for sample adequacy was high (0.937) and the P-value for Bartlett's test was < 0.001. EFA revealed five meaningful factors which were labelled: perception of teachers, learner's engagement and social participation, external regulation, work culture, and living conditions. These factors had the following eigenvalues: 12.6, 2.18, 2.03, 1.86, and 1.41 respectively, with a total explained variance of 43.45%. Cronbach's Alpha was 0.938. CFA confirmed the model structure of EFA (SRMR = 0.067 and RMSEA = 0.066). The Average Variance Explained (AVE) value of any given factor was > 0.7. DISCUSSION: The Arabic PHEEM inventory demonstrated satisfactory psychometric properties. The extracted domains are of theoretical relevance to the psychosocial-material conceptual framework for learning environment. Nonetheless, this validation was performed in the Syrian context; therefore, future studies in other Arabic countries are recommended to support the applicability of Arabic PHEEM in the wide Arab World.
Asunto(s)
Internado y Residencia , Psicometría , Humanos , Siria , Estudios Transversales , Femenino , Masculino , Encuestas y Cuestionarios , Adulto , Reproducibilidad de los Resultados , Traducciones , Análisis FactorialRESUMEN
Older people constitute an overlooked vulnerable population in humanitarian crises. Lebanon is a small country that hosts the largest number of refugees per capita in the world. With exacerbating socioeconomic conditions, exclusionary policies against refugees, and a fragmented humanitarian system, the status of older Syrian refugees (OSRs) requires special attention. This study aimed to explore OSRs' unmet needs, coping strategies, available humanitarian services, and some indicators of the humanitarian inclusion standards focusing on the shelter, health, nutrition and food security, and water, sanitation and hygiene sectors. We conducted a convergent mixed-methods study between December 2021 and March 2022 in the North and Bekaa, including a cross-sectional survey with 461 participants and 14 semi-structured interviews. Results show that OSRs lived in inappropriate shelters (cold, leaking rainwater), especially in informal tented settlements. High rent prices pushed refugee households with elderly to prioritize paying rent at the expense of other needs such as food and medication, particularly when food cash transfer is the sole source of income, jeopardizing food security and intake. Access to dignifying and accessible bathing facilities was compromised in ITSs with shared facilities. Substantial medical costs hindered OSRs access to healthcare such as surgeries. Due to the crisis, chronic medications are not always available in dispensaries for subsidized cost, pushing OSRs to non-compliance and selling food assistance to buy medications. Soaring fuel prices hindered OSRs access to heating and transportation to receive healthcare. No efforts were reported in collecting data on OSRs' needs, targeting them with information on services, or soliciting feedback for programming, especially in the absence of any age-tailored interventions. Findings shed light on the precarious living conditions of OSRs in Lebanon and add to the body of evidence documenting their invisibility to the humanitarian response. An age-inclusive response is needed through holistic, tailored, and sustainable interventions.
Asunto(s)
Altruismo , Refugiados , Humanos , Refugiados/psicología , Líbano , Siria , Femenino , Masculino , Anciano , Estudios Transversales , Persona de Mediana Edad , Necesidades y Demandas de Servicios de Salud , AdultoRESUMEN
BACKGROUND: The COVID-19 pandemic has had a significant impact on the education sector, leading to the closure of colleges and schools and disrupting the learning process for an uncertain duration. In response, electronic learning has emerged as a suitable method for continuing the educational process during the lockdown. This study aimed to assess the attitudes, practices, and barriers to e-learning among medical students at Syrian Private University. METHODS: A cross-sectional survey study was conducted at the Faculty of Medicine of the Syrian Private University (SPU) in Damascus, Syria. The study used a convenience sampling approach and was carried out from June 2021 to January 2022. Data were collected using a self-administered questionnaire structured into two sections. The first section included 12 sociodemographic questions. The second section assessed students' attitudes, practices, and barriers related to e-learning, and consisted of 14 questions on attitudes, 11 questions on practices, and 9 questions on barriers. RESULTS: Of the 519 participating students, over half (55.1%) exhibited a negative attitude towards e-learning. However, more than 60% reported engaging in e-learning activities such as downloading educational content and participating in virtual study groups. The main barriers identified were unstable internet connections (92.7%) and challenges in communication with educators (82.7%). Bionomical logistic regression revealed that negative attitudes were predicted by housing status, academic year, health status, lack of engagement with colleagues in e-learning practices, and the reported barriers of difficulty adjusting learning style, lack of technical skills, poor communication with educators, limited access to devices, and limited space conducive for studying (P < 0.05). CONCLUSION: While medical students at SPU were actively engaged in e-learning, over half held negative attitudes. These negative attitudes were associated with the various barriers that students reported. The findings can inform stakeholders in our institution and other Syrian universities about the challenges of implementing e-learning in medical colleges.
Asunto(s)
COVID-19 , Educación a Distancia , Estudiantes de Medicina , Humanos , COVID-19/epidemiología , Estudios Transversales , Estudiantes de Medicina/psicología , Siria , Masculino , Femenino , Adulto Joven , Adulto , Encuestas y Cuestionarios , SARS-CoV-2 , Pandemias , Educación de Pregrado en Medicina , Actitud del Personal de SaludRESUMEN
BACKGROUND: In conflict settings, as it is the case in Syria, it is crucial to enhance health information management to facilitate an effective and sustainable approach to strengthening health systems in such contexts. In this study, we aim to provide a baseline understanding of the present state of health information management in Northwest Syria (NWS) to better plan for strengthening the health information system of the area that is transitioning to an early-recovery stage. METHODS: A combination of questionnaires and subsequent interviews was used for data collection. Purposive sampling was used to select twenty-one respondents directly involved in managing and directing different domains of health information in the NWS who worked with local NGOs, INGOs, UN-agencies, or part of the Health Working Group. A scoring system for each public health domain was constructed based on the number and quality of the available datasets for these domains, which were established by Checci and others. RESULTS & CONCLUSIONS: Reliable and aggregate health information in the NWS is limited, despite some improvements made over the past decade. The conflict restricted and challenged efforts to establish a concentrated and harmonized HIS in the NWS, which led to a lack of leadership, poor coordination, and duplication of key activities. Although the UN established the EWARN and HeRAMS as common data collection systems in the NWS, they are directed toward advocacy and managed by external experts with little participation or access from local stakeholders to these datasets. RECOMMENDATIONS: There is a need for participatory approaches and the empowerment of local actors and local NGOs, cooperation between local and international stakeholders to increase access to data, and a central domain for planning, organization, and harmonizing the process. To enhance the humanitarian health response in Syria and other crisis areas, it is imperative to invest in data collection and utilisation, mHealth and eHealth technologies, capacity building, and robust technical and autonomous leadership.
Asunto(s)
Gestión de la Información en Salud , Siria , Humanos , Encuestas y Cuestionarios , Conflictos ArmadosRESUMEN
Background: The Syrian conflict has been ongoing since 2011. Practical and scalable solutions are urgently needed to meet an increase in need for specialised psychological support for post-traumatic stress disorder given limited availability of clinicians. Training forcibly displaced Syrians with a mental health background to remotely deliver specialised interventions increases the availability of evidence based psychological support. Little is known about the effectiveness of online therapy for forcibly displaced Syrian women provided by forcibly displaced Syrian women therapists. Purpose: To pilot an evidence-based trauma therapy, Eye Movement Desensitisation and Reprocessing (EMDR), carried out online by trained forcibly displaced Syrian women therapists for forcibly displaced Syrian women who require treatment for post-traumatic stress disorder (PTSD). Methods: 83 forcibly displaced Syrian women, living in Türkiye or inside Syria, with diagnosable PTSD, were offered up to 12 sessions of online EMDR over a period of 3 months. This was delivered by forcibly displaced Syrian women therapists who were trained in EMDR. Data were gathered, using Arabic versions, on PTSD symptoms using the Impact of Events Scale Revised, depression symptoms using the Patient Health Questionnaire-9 and anxiety symptoms using the Generalised Anxiety Disorder Assessment-7 at baseline, mid-point, and end of therapy. Results: PTSD scores, depression scores and anxiety scores all significantly reduced over the course of treatment, with lower scores at midpoint than baseline and lower scores at end of treatment than at midpoint. Only one participant (1%) exceeded the cutoff point for PTSD, and 13 (16%) exceeded the cutoff points for anxiety and depression at the end of treatment. Conclusion: In this pilot study up to 12 sessions of online EMDR were associated with reductions in PTSD, anxiety and depression symptoms in Syrian women affected by the Syrian conflict. The training of forcibly displaced Syrian mental health professionals to deliver online therapy is a relatively low cost, scalable, sustainable solution to ensure that those who are affected by the conflict can access specialised support. Further research is needed using a control group to confirm that the observed effects are due to EMDR treatment, as is research with post-treatment follow-up to ascertain that benefits are maintained.