Barriers to Education of Syrian Refugee Girls in Jordan: Gender-Based Threats and Challenges.

PURPOSE: The purpose of this study was to uncover and describe the barriers to education as experienced by Syrian refugee girls in the Za'atri Syrian Refugee Camp in Jordan. DESIGN: A qualitative nonexperimental design utilizing focus group discussions (FGDs), individual interviews, and participant and nonparticipant observation was used for this study. Four FGDs were facilitated in three dropout education centers (nonformal school) in the Za'atri Syrian Refugee Camp. Data were collected over a period of 5 months from December 2017 to April 2018. METHODS: Using an FGD format, the United Nations Human Rights ABC module in the Arabic language was used to educate, to empower with knowledge and skills, and to elicit participants' responses to perceived barriers to exercising their universal human rights, especially their right to education. Data were collected using a demographic tool, digitally recorded FGDs, an observation notebook, a flip chart, and a detailed interview schedule. Fifteen in-depth, individual, 1½-hr interviews of self-selected participants were conducted. Narrative statement and content analysis were used to analyze the data for each FGD. A constant comparative method was used to compare and verify codes, categories, and themes within and between groups. FINDINGS: The complex interplay of patriarchy, tradition, and religious practices, combined with the added vulnerabilities of protracted warfare displacement, prevent Syrian girls from being their own agents, prevent their access to education, and expose them to even greater health risks through coercion into early marriage. Several themes explained the process by which the interactive nature of patriarchy, traditional cultural, and religious practice influenced the girls' right to education and their right to make their own decisions about marriage. These are (a) gender role and the social position of girls in the family, (b) gender role and the cultural disvaluing of girls' education, (c) economic survival priorities and child labor, and (d) the intersection of environmental stressors with preservation of family honor as motivators for early marriage. Repeated exposure to threats and physical abuse seem to be the mechanisms that reinforce the girls' perceived gender-based vulnerabilities, submissiveness, and educational truancy. CONCLUSIONS: Syrian refugee girls seem to consistently face conflicts and daily adverse experiences that pose serious physical and psychological risks to their health with potentially far-reaching negative health consequences. Gender-based physical and psychological threats and abuses, along with the coercive practice of early marriage, while viewed as a way of protecting them, put Syrian refugee girls at greater health risk, psychological threat, and social and economic challenge. Evidence on refugees who experienced violence shows that they are more likely to experience post-traumatic stress disorder (PTSD), dissociative disorders, depression, and anxiety, along with a host of life-threatening physical comorbidities. CLINICAL RELEVANCE: Syrian refugee girls are at high risk for gender-based abuse and violence. Nurses can play an important role in reducing the health risks associated with gender-based abuse by assessing clients for symptoms of physical and psychological abuse, including symptoms of PTSD, depression, anxiety, and suicidal ideation. Maternal and child health assessment and health-promoting interventions should be included in the healthcare plan. Understanding the sociopolitical conditions, as well as the cultural and religious backgrounds, that shape the lived experiences of displaced girls is also essential for offering a congruent, culturally sensitive plan of care and for creating targeted and relevant educational and treatment intervention strategies and referrals.

Prevalence and Predictors of Diabetes Mellitus and Hypertension in Armenian Americans in Los Angeles.

Purpose The purpose of this study was to describe the prevalence of diabetes mellitus (DM) and hypertension (HTN) along with associated risk factors among Armenian Americans living in Los Angeles. Methods After Institutional Review Board approval, a sample of 877 Armenian Americans was collected for 5 consecutive years (2011-2015) at a health fair. Collected data included: sociodemographic variables; cardiometabolic data, including systolic (SBP) and diastolic (DBP) blood pressure, glucose (Glu), and lipids; anthropometric data, including height (Ht), weight (Wt), body mass index (BMI), waist circumference (WC), and hip circumference (HC). Retrospective descriptive correlation, test of significance, and logistic regression analyses were performed. Results Findings showed that about 50% of the participants had abnormal waist/hip ratio and approximately one-quarter of the subjects had glucose levels that were indicative of high risk for DM. Logistic regression analysis revealed that high SBP ( P = .04), above normal WC ( P = .03), and high triglycerides ( P = .04) were significant in predicting DM. Moreover, age ( P =.0001), family history of cardiovascular disease ( P= .01), and above normal WC ( P = .04) were found to be significant predictors of HTN. Conclusion Waist circumference indicated to be a strong predictor for DM and HTN. Early detection and timely interventions are important to prevent DM and HTN and their associated complications. For an underserved population, health fairs become one effective avenue for screening, referral, and evaluation.

Cognitive appraisal of stress and health status of wage working and non-wage working women in Jordan.

This cross-sectional correlation study addresses the stress appraisal of 93 Jordanian wage working and non-wage working single and married women in Jordan and the relationship of appraised stress to their physical and psychological health. Data were collected using a demographic interview guide that included a Likert-type scale addressing perceived global social stress, the Cornell Medical Index (CMI), and the Perceived Stress Scale (PSS). Perceived stress had no significant relations with physical and emotional health as measured by the PSS, but significant relations were found between social stress and indicators of health. In fact, social stress was the single most significant predictor of overall health, physical health, and emotional health. The findings on the health profile of participants and social stress have important implications for future research and for illness prevention and health promotion initiatives.

Multiple role stress and patterns of coping of Egyptian women in clerical jobs.

Egyptian women are increasingly becoming a significant work force; however, many of these women continue to occupy low-income jobs. In the study reported here, 190 women in Egypt employed in clerical jobs were asked about the satisfaction and stress they experience in their work and maternal roles. They were also asked about their coping approaches and the demands in their daily lives. The Women's Role Interview Protocol was used to collect data. The results were analyzed within the symbolism of the Arab/Egyptian language using thematic and content analysis. A prevailing theme is the interconnectedness among all women's roles when describing their stress, satisfaction, and coping. Another major theme that transcends all roles is the perception of inequality and how it affects their daily lives. Emergent stressors were grouped under employment role stress, maternal role stress, marital role stress, and relational role stress. Women coped through learning to be self-reliant and by using cognitive and emotion-focused coping approaches. Women's stress was embedded in inequality in gender roles, and the women are empowered to cope through relying on endurance and outliving conflict.