Background: Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip.

Objective:To determine the effectiveness of an educational program on a family caregiver's prevention and management of pressure ulcers of bedridden patients after discharge from El-Wafa Medical Rehabilitation Hospital, Gaza Strip, Palestine. Materials and Methods:Preexperimental, prospective, with pretest and posttest, design was followed. The study recruited a convenient sample of 80 caregivers of the bedridden patients who were admitted to El-Wafa Medical Rehabilitation Hospital. Pretest questionnaire was administered for the eligible subjects. The educational training package was delivered in three sessions within 1 week. Posttest questionnaire was filled after 3 weeks to assess the effectiveness.Results: About 58.8% of the caregivers were women and 53.8% aged younger than 30 years. The performance of the caregivers has significantly improved after the program in most of the items (P < 0.05). Scores of subscales: wound care and dressing, proper nutrition, maintaining personal hygiene, incontinence training and knowledge about ulcers were all significantly higher after training (P < 0.05). The difference between the total domains after the program (M = 3.47) was significantly higher than the total domains before the program (M = 3.30; t test 4.87; P = 0.00). Conclusion:The study revealed a high effectiveness of this educational-training program in managing and preventing pressure ulcers for bedridden patients by caregivers at their homes. Application of this preventive program should be extended to cover all rehabilitative and governmental hospitals in Palestine to reduce the burden of pressure ulcers on the families and the health-care system. AbstractEljedi et al.: Effect of an educational program on pressure ulcer

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Aims: To identify the possible effects of hypertensive disorders of pregnancy (HDP) on maternal health outcomes of women attended primary health care centers (PHCCs) in Gaza Strip – Palestine. Study Design:  A cross-sectional comparative design. Place and Duration of Study: The study was conducted at 6 PHCCs from August 2016 to May 2017. Methodology: Two groups of 215 hypertensive mothers and 215 normotensive mothers in the last pregnancy were recruited by 3-stage stratified random sampling technique. A detailed questionnaire filled through face to face interviews in addition to medical records revision in 2017. Pearson's Chi-square and t-tests were used to compare the outcomes between the two groups. Results: HDP in 215 women were classified as pregnancy-induced hypertension (n = 153, 71.2%) and chronic hypertension (n = 62, 27.8%). The mean age of HDP women was 28.8 ± 6.8 years. About 40.9% live in refugee camps; 23.7% had gravida ≥ 7; 54.6% had BMI > 30 and 21.9% had a history of twice or more abortions. Only 20% of HDP women received preconception care. Cesarean section and assisted delivery were significantly higher among hypertensive mothers (37.2% and 26.9%) compared with non-hypertensive (16.3% and 8.4%) respectively (P = 0.001). Incidence of preeclampsia/eclampsia, antepartum hemorrhage and postpartum hemorrhage, were significantly higher among HDP women (29.3%, P = 0.001; 14%, p=0.001; 7%, P = 0.003 respectively) while no significant differences in abrupio placenta (0.9%; P = 0.25), placenta previa (0.5%, P = 0.75) HELLP syndrome (0.9%, P = 0.24) were found between the two groups. 20.9% mothers with pregnancy-induced hypertension were not recovered and developed chronic hypertension. Conclusion: Women with HDP are at higher risk to have adverse maternal outcomes compared to normotensive women in GS. Preconception care, early diagnosis and prenatal follow-up would improve maternal and fetal prognosis.

Background: Preventing, preparing for, responding to, and recovering from disasters have become a priority for everyone. Gaza Strip in Palestine is constantly exposed to wars and disasters. One of the most prominent respondents to disasters in the health care system is emergency nurses. This study aimed to identify the role perception of Palestinian emergency nurses in Gaza Strip during disaster and their level of knowledge about disaster management.Methods: The analytical descriptive cross-sectional approach was used.  The study sample consisted of all nurses working in emergency departments at the governmental hospitals in Gaza Strip. The eligible nurses were 180; only 162 filled the questionnaire with response rate 90% after signing the consent form. Data were analyzed using mean, t test and ANOVA.Results: The findings indicated that 75.9% of emergency nurses were male. About 53% were 20-29 years old. Most of them hold bachelor degree (73.5%) while only 4.3% had a master degree. The study found that the level of “role perception of nurses during disasters” was 81.5% (e.g., ability to participate in an emergency plan, provide psychosocial support, have high confidence during emergencies, etc.), followed by field of “nurses’ knowledge of disasters” with 78.03% (e.g., past experience, updated information, etc.).Conclusions: Although the Palestinian emergency nurses have an acceptable level of knowledge and role perception during disasters, they still need to raise their level of knowledge, preparedness and skills by integrating clearly defined theoretical and training sessions on disaster management in nursing curricula and through in-service activities for employees.