Search

BackgroundExposure to traumatic events in childhood is associated with the development and maintenance of various psychiatric disorders, but most frequently with posttraumatic stress disorder (PTSD). The aim of this study was to evaluate the types of traumatic events experienced and the presence and predictors of PTSD symptoms among adolescents from the general population from ten low- and middle-income countries (LMICs).MethodsData were simultaneously collected from 3370 trauma-exposed adolescents (mean age = 15.41 [SD = 1.65] years, range 12–18; 1465 (43.5%) males and 1905 (56.5%) females) in Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, the Palestinian Territories, the Philippines, Romania, and Serbia, with Portugal, a high-income country, as a reference point. The UCLA PTSD Reaction Index for the DSM-5 (PTSD-RI-5) was used for the assessment of traumatic events and PTSD symptoms.ResultsThe most frequently reported traumatic events were death of a close person (69.7%), witnessing violence other than domestic (40.5%), being in a natural disaster (34.4%) and witnessing violent death or serious injury of a close person (33.9%). In total, 28.5% adolescents endorsed two to three DSM-5 PTSD criteria symptoms. The rates of adolescents with symptoms from all four DSM-5 criteria for PTSD were 6.2–8.1% in Indonesia, Serbia, Bulgaria, and Montenegro, and 9.2–10.5% in Philippines, Croatia and Brazil. From Portugal, 10.7% adolescents fall into this category, while 13.2% and 15.3% for the Palestinian Territories and Nigeria, respectively. A logistic regression model showed that younger age, experiencing war, being forced to have sex, and greater severity of symptoms (persistent avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) were significant predictors of fulfilling full PTSD criteria.ConclusionsNearly every third adolescent living in LMICs might have some PTSD symptoms after experiencing a traumatic event, while nearly one in ten might have sufficient symptoms for full DSM-5 PTSD diagnosis. The findings can inform the generation of PTSD burden estimates, allocation of health resources, and designing and implementing psychosocial interventions for PTSD in LMICs.

Aim: The aim of this study was to explore the prevalence of domestic violence, among pregnant women attending primary health care clinics in Gaza Strip. Method: Descriptive analytic, cross sectional design. The sample consisted of 400 pregnant women from the five governorates of Gaza Strip. Tools of the study included socio-demographic characteristic questionnaire and Conflict Tactics Scale. Results: The study showed that psychological assault reported by pregnant women was 6.11%, physical assault was 2.8%, physical injury was 1.3%, and sexual assault was 0.4%. However, psychological assault was significantly higher in women living in camps than women living in cities or villages, women in age group of 36 and above years, uneducated women, uneducated husbands, and having 8 and more children. Moreover, physical assault was significantly more in uneducated women and in women in families with 8 and more. While, physical injury was significantly more in women with uneducated husbands and families with 8 and more children. Clinical implications: Our study showed that pregnant Palestinian women exposed to physical violence and psychological violence. More specific programs should be established in Gaza to enable women of using new coping strategies with difficulties. Also, training programs including primary health care professional such physicians, nurses, social service experts, and midwives should be provide to enable them of early detection of victims of violence and provide social support to these women.

Aim: This study aims were to find type of work stressors, used coping strategies, and resilience factors and relationship between stressors and coping strategies as mediating factors and resilience as outcome among Palestinian nurses working in Gaza Strip. Method: This study builds on existing evidence by considering exposure to work-related stressors, as well as on factors associated with later coping and resilience. The sample consisted of 275 randomly selected nurses from representative health services in Gaza, who completed the Nurse Stress Scale, The Connor-Davidson resilience scale, and Brief-COPE. Results: The most commonly reported job stressors were attending death of a patient, physician not being present when a patient dies, criticism by a supervisor, and fear of making a mistake while treating their patients. The mean score of nurses work stressors was 88.7. Nurses commonly used religious coping such as feeling comfort in religious beliefs, thinking what next steps they have to take, having strategy about what to do about situation what to do, and learn to live with situation as coping strategies with stress. While, use drugs to feel better and to get through was the least commonly used coping strategies. Nurses said that overcome the stressors and had resilience by believing that things happen for a reason, God is helping, and they were pride of their achievements. The results showed that fear of making a mistake in treating a patient was negatively predicting total coping strategies. While stressor such as a physician ordering what appears to be inappropriate treatment for a patient was positively predicted coping strategies. The results indicated that stressor such as physician not being present when a patient dies and too many non-nursing tasks required, such as clerical work was predicting resilience negatively. While stressors such as criticism by a physician and having not enough time to complete all of their nursing tasks were positively predicted resilience among nurse. Conclusions and recommendations: The results of this study highlight the need to empower the role of the nurse educators, managers and administrators to find ways to make nursing workplace more pleasant and less stressful, especially to the nurses in their initial years of work. The findings of the study will assist human resource managers of the current study setting to determine coping strategies that might help in reducing amount of stress experienced by nurses in their day to day challenging and demanding nursing roles.

The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures.