Knowledge, attitudes and practices (KAP) towards COVID-19 among Palestinians during the COVID-19 outbreak: A cross-sectional survey.

Coronavirus disease 2019 (COVID-19) is a highly contagious illness that spreads rapidly through human-to-human transmission. On March 5, the government of Palestine declared a state of emergency in order to curb the spread of the virus, a declaration that it extended for a fifth time on July 5th. The degree to which a population complies with corresponding safety measures is surely affected by the people's knowledge, attitudes and practices (KAP) towards the disease. To explore this hypothesis, we gathered data from 1,731 Palestinians between April 19thand May 1st, 2020 through a KAP questionnaire. The participant pool represented a stratified sample of Palestinians living across a number of governorates in the Gaza Strip and the West Bank, with 36.5% from Gaza and (63.5%) from the West Bank. Gender was almost equally distributed within the sample with (51%) men respondents and (49%) women respondent. The questionnaire included 17 questions about participants' knowledge and awareness of COVID-19, 17 questions regarding the safety measures they had taken in the wake of the outbreak and 3 questions asking them to assess the efficacy of the government's response to the pandemic. Our data shows that 79% of the respondents have good awareness about transmission of the virus, 55.6% were knowledgeable of the symptoms exhibited by an infected individual, 81% were aware of the preventative measures and 82% demonstrated awareness of the risk groups. Most participants complied with preventative measures (77%) and 62% the study participants agreed that stricter measures have to be enforced by the government to limit the spread of the virus. Our study revealed that younger participants and people with higher educational level demonstrated more awareness of the virus. Also, Women were reported to be more aware of preventative measures and to have complied more with good practices. We report that residents of the West Bank have complied more with the right practices when compared to residents of Gaza. Based on the results of this study, we conclude that health education programs aimed at improving the public's understanding of COVID-19 are important in helping the population maintain appropriate practices and should be target people with lower educational level, and that findings such as those discussed in this report may provide valuable feedback to lawmakers working to stop the spread of the virus.

Crossword puzzles improve learning of Palestinian nursing students about pharmacology of epilepsy: Results of a randomized controlled study.

OBJECTIVE: This study was conducted to investigate if crossword puzzles as active learning tools can improve the knowledge retention of nursing students in pharmacology of epilepsy and improve their performance in writing the correct spelling of antiepileptic drugs (AEDs). METHODS: The present study was a randomized controlled prospective parallel study in which a control group design with pretests and posttests were used among nursing students. Students were randomly allocated to either control group (n = 114) who received routine learning or intervention group (n = 110) who received crossword puzzles. Both control and intervention groups had to complete multiple-choice question (MCQs) and spelling pretests and posttests. RESULTS: Scores of the MCQs and spelling pretests were not statistically different (p-value > 0.05) for participants in all achievement categories in both control and intervention groups. In the intervention group, scores in the first and second MCQs and spelling posttests were significantly higher than their corresponding scores in the pretest scores for participants from the all achievement categories (p-value < 0.05) and scores of the first and second MCQs and spelling posttests were not significantly different (p-value > 0.05). Data analyses showed that there were significant normalized changes between scores of students in across all achievement categories. CONCLUSION: Findings of this study suggested that crossword puzzles were effective in improving the learning of nursing students about the pharmacology of epilepsy and writing correct spelling of AEDs. Educators should consider using crossword puzzles as active learning tools to improve knowledge of nursing students about the pharmacology of epilepsy.

Language of written medical educational materials for non-English speaking populations: an evaluation of a simplified bi-lingual approach.

BACKGROUND: Debates have arisen in various non-English speaking countries over the chosen language of instruction in medical education, whether it has to be the English language or the mother tongue. English-based education supporters argue that English is the leading international language of medicine and research, and a crucial tool for Continuing Medical Education (CME), as well as for students who seek practice abroad. On the other hand, mother-tongue-based medical education supporters present it as a way to endorse communication and comprehension between medical practitioners and health care system users, to bridge the gap between practitioners and the paramedical staff, and to overcome linguistic dualism and the language thinking disparity while studying in another. This study aimed to evaluate one of the simplified bi-lingual approaches in terms of medical-educational-written texts for a non-English speaking population: Arabic speaking medical students in specific. METHODS: 1546 Arabic-speaking-medical students from different countries participated in a one-step-interactive-experimental-online test. The test assessed participants' scientific comprehension of three distinct written paragraphs: The first paragraph used conventional mother tongue (Arabic), the second combined English terminology and simplified mother tongue (hybrid), and the third used an English excerpt (English). Two multiple-choice questions (First question in Arabic, second in English) followed each paragraph. Response time was communicated for each paragraph. Participants were asked to select their favorable method. Repeated Measures ANOVA models and Paired Samples t-Test were used for statistical analysis. RESULTS: Participants scored a mean of [0.10] for the Arabic paragraph, [0.72] for the hybrid paragraph, and [0.24] for the English paragraph (P <  0.001). Results showed a significantly higher mean of points and correct answers within the fastest time for the hybrid paragraph [0.68] compared to the Arabic [0.08] and English [0.18] paragraphs (P <  0.001). Moreover, 50% of participants preferred the hybrid paragraph over the other two paragraphs. CONCLUSIONS: Taking into consideration the large number of participants and the statistically significant results, authors propose that simplified Arabic combined with English terminology may present a viable alternative method for medical-educational-written texts in Arabic-speaking population.

Public health nurses' experiences of using interpreters when meeting with Arabic-speaking first-time mothers.

OBJECTIVES: The aim of this study was to investigate public health nurses' experiences of using interpreters when meeting with Arabic-speaking first-time mothers. DESIGN AND SAMPLE: An inductive qualitative design was used. Individual interviews were conducted with Swedish public health nurses (n = 11) with experience of working in child health care with interpreters when meeting with Arabic-speaking first-time mothers. MEASURES: Data were analyzed using qualitative content analysis. RESULTS: The analysis of the interviews resulted in one overarching theme: Having to accept and learn to incorporate interpreters when meeting with Arabic-speaking first-time mothers. Three subthemes were identified: (a) enabling an understanding of the situation of the mothers; (b) contributing to a trustful relationship; and (c) creating disturbing elements in the dialogue. CONCLUSIONS: Using interpreters optimized the conversation between the public health nurse and the Arab-speaking first-time mother; however, the complexity of using interpreters was also apparent.

Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial.

BACKGROUND: Iron deficiency and iron-deficiency anaemia are associated with oxidative stress, but their role is largely unclear. Information is scarce on the effects of iron supplementation on biomarkers of oxidative stress in humans. AIMS: This study evaluated the effectiveness of iron supplementation and nutrition education on improving the levels of haemoglobin and ferritin, and decreasing oxidative stress among iron-deficient female adolescents in Gaza, Palestine. METHODS: A total 131 iron-deficient female adolescents were recruited and allocated randomly into 3 different groups. The iron supplementation group (A) received 200 mg of ferrous fumarate weekly during the 3-month intervention, the iron supplementation with nutrition education group (B) received iron supplements with nutrition education sessions, and the control group (C) did not receive any intervention. The levels of haemoglobin, ferritin and malonyl dialdehyde were measured at baseline, after 3 months (at which point the intervention was stopped), and then 3 months later. Trial registration number: ACTRN12618000960257. RESULTS: Haemoglobin levels increased significantly after supplementation in both groups A and B. At the follow-up stage (3 months after stopping the intervention), iron and haemoglobin levels in group B continued to increase and malonyl dialdehyde decreased. In Group A, haemoglobin, ferritin and malonyl dialdehyde levels decreased after 3 months of stopping the intervention. No changes were seen in Group C. CONCLUSIONS: A nutrition programme should be adopted and integrated into comprehensive intervention programmes to target iron-deficiency anaemia among female adolescents in Palestine.

Does It All Stay in the (Normative) Family? Attitudes About Family Among Female Jewish and Muslim Health-Profession Students in Israel.

Family individualization occurs, if at all, at a different pace and to a different extent in various societies and in various parts of society. Its impact has led to new scholarship in the social and caring professions, for which the concept of family is central in both professional education and practice. It is assumed that attitudes toward changing marital norms, family forms, and family relationships affect professionals' performance. This study, conducted in Israel in 2014 with 157 female health-profession students-102 (65%) Jews and 55 (35%) Muslim Arabs-focuses on attitudes about the family. Three patterns of attitudes emerged: individualized traditionalism-a mix of traditional and individualized attitudes, present among both the Jewish and the Muslim students; individualized autonomy, present mostly among the Jewish students; and classic traditionalism, present mostly among the Muslim students. Implications of these findings for the education and practice of health care professionals are also discussed.

Importance of integrating a cultural module in the community nursing curriculum.

INTRODUCTION: The Bedouin Health module was one of the proposed interventions funded by the European Union in 2007-2008, with a focus on health services and utilisation of these services for the Bedouin people in the north of Jordan. AIM: This study aimed to evaluate the sustainability of integrating this module into the community health nursing courses at Al al-Bayt University, Jordan. METHOD: Two focus group discussions were carried out with five faculty members and five students involved in the implementation of the Bedouin Health module. Leading questions were prepared for both groups. RESULTS: Four main themes emerged across both focus groups: self-expression, sustainability, acceptance, and motivation. CONCLUSION: The findings of this study identify how crucial it is for nursing students and faculty members to be culturally competent when practising community health care in the Bedouin community.

The Role of Social Media in Promoting Women's Health Education in Saudi Arabia.

Social media has the potential to improve women's health in developing countries through health education and promotion. In the Arab world, women's health interventions are lacking. However, with a high penetration rate of social media in the Arab world, there is good opportunity to utilize social media platforms such as Twitter to promote women's health. In this paper, we analyze the Tweet feeds of Saudi-based Twitter account to promote women's health. A total of 5167 Tweets were extracted and analyzed retrospectively, using NVivo Ncapture between June 2014 and March 2015. There were a total number of 3449 followers by March 20, 2015. Results showed that a majority of the Twitter followers (61%, n=2104) were seeking gynecological information, followed by pregnancy related information (27%, n=931), breast-feeding advice (9%, n=310), and other health related information (3%, n=103). Results also showed an increased level of health awareness and comprehension among Twitter followers. Further research is needed to promote women's health in Saudi Arabia and the Arab world through social media platforms such as Twitter and similar platforms including Instagram, Facebook, and YouTube which are also popular in the Arab world.

Reading anxiety, classroom anxiety, language motivation, reader self-perception, and arabic achievement of Arab-American students learning arabic as a second language.

The present study assessed the relations between reading anxiety, classroom anxiety, language motivation, and readers' self-perception for a sample of Arab-American students in Arabic classes. The effects of sex, grade, and years studying Arabic on academic achievement were examined as well. Measures were administered to 118 middle school students (56 boys, 62 girls; M age = 13.0 yr., SD = 0.8), and teachers reported academic grades in Arabic. Reading anxiety was significantly correlated with classroom anxiety and reader self-perception. Classroom anxiety scores were significantly correlated with motivation and reader self-perception. Significant positive correlations were found between language motivation and reader self-perception scores, and between years studying Arabic and reader self-perception scores. Boys in the second year of Arabic had significantly lower classroom anxiety than girls, and students in Grade 7 had higher reader self-perception than those in Grade 8. Classroom anxiety, language motivation, and reader self-perception significantly predicted Arabic achievement. Pedagogical implications are discussed.

A culturally competent education program to increase understanding about medicines among ethnic minorities.

BACKGROUND: It has been previously suggested that the risk of medicine-related problems-i.e., negative clinical outcomes, adverse drug reactions or adverse drug events resulting from the use (or lack of use) of medicines, and human error including that caused by healthcare personnel-is higher among specific ethnic minority groups compared to the majority population. OBJECTIVE: The focus of this study was on reducing medicine-related problems among Arabic-speaking ethnic minorities living in Denmark. The aim was twofold: (1) to explore the perceptions, barriers and needs of Arabic-speaking ethnic minorities regarding medicine use, and (2) to use an education program to enhance the knowledge and competencies of the ethnic minorities about the appropriate use of medicines. SETTINGS: Healthcare in Denmark is a tax-financed public service that provides free access to hospitals and general practitioners. In contrast to the USA or the UK, serving ethnically diverse populations is still a relatively new phenomenon for the Danish healthcare system. Ethnic minorities with a non-Western background comprised a total of 6.9 % of the Danish population. METHODS: Data were collected through qualitative research. Four focus group interviews were conducted before and four after the education program. Thirty Arabic-speaking participants were recruited from language and job centers in Copenhagen. Participants received teaching sessions in Arabic on appropriate medicine use. The education program was evaluated by two methods: a written quiz for knowledge evaluation and focus group interviews for process evaluation. It took place during the first semenester of 2012. Results The majority of the participants were dissatisfied with the knowledge about medicines inherited from their parents. They also expressed their frustrations due to communication problems with Danish doctors. According to the impressions and quiz results of participants, the program was relevant, rich in information and effective. The program helped bridge the gap between participants and doctors. The commonality of the culture, language and gender shared by the researcher pharmacist and participants enhanced the success of the program. CONCLUSION: The education program may potentially reduce medicine-related problems by providing participants with knowledge and competencies about appropriate medicine use. We recommend implementing education programs for ethnic minorities using the cultural competence approach to the appropriate use of medicines. Ideally, programs should be implemented in places that are frequented by ethnic minorities, and taught by health professionals with the same ethnic background as participants.

The cultural gap delivering health care services to Arab American populations in the United States.

The relationship between Middle Eastern patients and populations of Arab origin with western health care professionals are by no means free of cultural misunderstandings. The relationship is often strained by mutual cultural misunderstanding as well as communicative and linguistic hardship. Even though people from the Middle East do vary racially, they do have shared values and behavior. This can include the importance of family cohesion, and interactive attitudes toward ailments and health. Some issues and concerns in providing health care could vary from attaining adequate information to communicated suggested behavioral change by a patient. Culturally and linguistically appropriate guidelines are warranted to provide an understanding of the cultural distinctiveness of Arab Eastern patients by shortening the gap between the Arab cultures with the western medical culture thus improving their healthcare needs.

Adaptation and psychometric evaluation of the Multidimensional Scale of Perceived Social Support for Arab immigrant women.

We adapted the Multidimensional Scale of Perceived Social Support (MSPSS) for use with Arab immigrant women (MSPSS-AW) and estimated the psychometric properties of the adapted version with a sample of 539 Arab immigrant women living in the United States. Confirmatory factor analysis (CFA) supported the proposed three-factor solution. Internal consistency reliability coefficients for the three subscales ranged from good to very good. Additional evidence for construct validity of the MSPSS-AW subscales was demonstrated through relationships with theoretically related measures. We conclude that the MSPSS-AW is reliable and valid for use with Arab immigrant women.

Role of shame in the stigmatization of people with human immunodeficiency virus: a survey of female college students in 3 Arab countries.

AIDS stigma is a challenge to controlling HIV/AIDS epidemic especially in more conservative cultures. This study explored the impact of knowledge about HIV and AIDS, and the impact of shame, on the stigmatization of people living with HIV/AIDS in the Arab world. Survey data were collected from 277 female college students in 3 Arab countries: Kuwait, Bahrain and Jordan. Only in Bahrain was knowledge about HIV and AIDS inversely related to negative attitudes toward people with HIV/AIDS. AIDS-related shame, however, was a strong predictor of AIDS stigma in all 3 countries. HIV education is needed for young people in Arab countries, especially women, both for their own health and to reduce the problem of AIDS stigma.

Young Syrian adults' knowledge, perceptions and attitudes to premarital testing.

BACKGROUND: The issue of premarital testing is a controversial and complex issue. Syria is an Islamic country that is moving towards modernization that involves changes in social structures and urbanization of attitudes, beliefs, views and values. PURPOSE: The purpose of this study was to identify young Syrian adults' knowledge, perceptions and attitudes about premarital testing. METHODS: Descriptive, cross-sectional design was utilized. The study was conducted at a mid-sized university in Syria. A stratified simple random sampling was used to recruit the university students in the last 2 years of their graduation. A total of 942 students participated in the study using a questionnaire developed to measure the participants' knowledge, attitudes and perception of premarital testing. RESULTS: Although university students had a considerable knowledge of premarital testing, they had a limited knowledge about certain aspects. Moreover, although they had some positive attitudes, they still had negative attitudes and perceptions towards other aspects of premarital testing. CONCLUSION AND IMPLICATION: The study results could assist in the development of health education programmes in Syria and other Arab countries to increase their awareness and influence their attitudes towards premarital testing. The study limitation was that the sample was chosen from one part of Syria.