Conflict and well-being: a comparative study of health-related quality of life, stress, and insecurity of university students in the West Bank and Jordan

Navigating health challenges: the interplay between occupation-imposed movement restrictions, healthcare access, and community resilience

BACKGROUND

Transportation plays a significant role in health, community resilience, and access to basic needs such as healthcare, social services, education, and job opportunities. Health and community resilience are, however, impacted by a multitude of complex and unequal factors, such as transportation restrictions exacerbated by the Israeli occupation. The goal of the research was to examine the intricate relationships that exist in Palestine between movement restrictions imposed by occupation, health outcomes, and community resilience.

METHOD

A self-structured questionnaire, devised based on expert conversations and previous literature, was used in this descriptive, quantitative study to explore health and resilience outcomes. Age, gender, marital status, place of residence, and means of transportation were among the various factors that were utilized to describe the socio-demographics of the study sample (n = 202). The researchers employed stepwise multiple regression and descriptive statistics for the data analysis.

RESULTS

Study findings indicated that transportation restrictions have significant direct and indirect health consequences. A significant direct effect is observed, signifying a negative correlation between restrictions and health; increased transportation restrictions are consistently correlated with a decline in health. The study emphasized how place of residence affects health outcomes, with higher scores for campers and people living in green line areas. It also underscores that public means of transportation are found to be better for health outcomes than private cars.

CONCLUSION

This study emphasized that roadblocks, checkpoints, and military incursions make it difficult for Palestinians to receive medical care, which has a detrimental impact on their health and well-being. It also underscores the need for significant reforms in Palestinian health and transportation systems to enhance infrastructure and healthcare access. The Palestinian Authority should invest in public transportation and community resilience programs to address transportation-related health issues, especially in villages, due to frequent settler attacks.

Palestinian Muslim College Students' Attitudes to Mental Health Treatment: A Comparative Study

This study examined the association between the degree of religiosity, combined with cultural beliefs, social stigmas, and attitudes towards mental-health treatment in two groups, who, despite having similar cultural and religious affiliation, have experienced different socio-political contexts: Palestinian Muslim college students living in the Occupied Palestinian Territory (OPT) and Israel. The study was guided by Tanhan and Young's (2021) conceptual framework. Methods: A snowball recruitment strategy was applied, using a cross-sectional survey. A total sample size was 214 students, 105 from the OPT and 109 from Israel. Results indicate that students from the OPT (n = 105) did not differ from those living in Israel (n = 109) on religiosity using the Islamic Belief scale, or Attitudes Towards Mental Health treatment (F(1, 189) = 1.07, p = 0.30). However, students from the OPT had higher confidence in mental-health professionals (M = 15.33) than their counterparts (M = 14.59), and women had higher confidence (M = 16.03) than men (M = 13.90). The reliance on traditions for Muslim students over Western mental-health approaches is a critical factor in predicting the attitudes towards students' mental problems and their chosen treatment. Sociopolitical context played a significant role in shaping attitudes toward mental-health providers.

War-related quality of life is associated with depressive symptoms and hopelessness among Palestinians: sense of belonging and resilience as mediating variables

Background

The current study was designed to test the correlation between quality of life, depressive symptoms, and hopelessness, and whether sense of belonging and resilience mediating the correlation between quality of life, depressive symptoms, and hopelessness in a society characterized by high level of political violence and prolonged trauma.

Methods

Structural equation modeling (SEM) was performed to test the conceptual model, where quality of life was identified as a predictor variable, sense of belonging and resilience as mediating variables, and depressive symptoms and hopelessness as outcome variables. The participants of the study were 437 Palestinian adults: 190 males and 247 females, they were recruited using online methods; emails, Facebook, and Twitter.

Findings

Results indicated that quality of life negatively correlated with depressive symptoms (r = -0.603; p < 0.01), and hopelessness (r = -0.453; p < 0.01), and positively correlated with resilience (r = 0.534; p < 0.05), and sense of belonging (r = 0.428; p < 0.01). Results of SEM indicated the correlation between quality of life, depressive symptoms, and hopelessness was fully mediated by the sense of belonging and resilience.

Conclusions

Our study sheds light on resilience and sense of belonging as protective factors against ongoing traumatic experiences among Palestinians. Future research should be addressed to understand better the features of resilience and sense of belonging that can help maintain psychological functioning in conditions of chronic and ongoing violence, the personal and historical antecedents of such protective factors, and the factors that can directly or indirectly undermine them.

Health-related quality of life of a conflict-affected population in Colombia

PURPOSE

We assessed the validity of the EQ-5D instrument; explored correlations between area of residence's conflict intensity and individual health-related quality of life (HRQoL); and identified factors associated with HRQoL in a conflict-affected population in Colombia.

METHODS

We conducted a household survey among residents of the Meta province, collecting longitudinal information about HRQoL (EQ-5D-3L instrument), health, demographic and socio-economic indicators, for years 2014 (pre-2016 peace accord), 2018 (post-peace accord) and 2019 (follow-up). After examining EQ-5D's validity, we analysed panel data using multivariate random effects models to explore associations between area conflict levels (and other factors) and HRQoL. We scrutinised these results further through multivariate linear regressions using cross-sectional data, and provided preliminary estimates of quality-adjusted life years (QALYs) gained since the Colombian peace accord.

RESULTS

In total, 1309 individuals provided information for years 2014 and 2018; 1106 individuals were followed-up in 2019. Mean EQ-5D scores in 2014, 2018 and 2019 were 0.898, 0.846 and 0.902, respectively. The tests confirmed the validity of EQ-5D. Our estimations indicated a dose-response relationship between conflict levels and HRQoL: people in lightly and heavily affected areas had 0.019 and 0.037 lower EQ-5D scores (respectively) than people in non-affected areas. Other relevant factors included age, marital status, education, assets and health status. We estimated QALY gain of 0.0343 per individual and 20,752 for all Meta adults since the peace accord.

CONCLUSION

We found EQ-5D to be a valid instrument for HRQoL measurement in a conflict-affected population. Area conflict intensity was negatively associated with individual HRQoL.