Depression, Perceived Health, and Right-of-Return Hopefulness of Palestinian Refugees

Assessment of depression symptoms among cancer patients: a cross-sectional study from a developing country

Cancer patients experience psychological symptoms such as depression during the cancer treatment period, which increases the burden of symptoms. Depression severity can be assessed using the beck depression inventory (BDI II). The purpose of the study was to use BDI-II scores to measure depression symptoms in cancer patients at a large tertiary hospital in Palestine. A convenience sample of 271 cancer patients was used for a cross-sectional survey. There are descriptions of demographic, clinical, and lifestyle aspects. In addition, the BDI-II is a tool for determining the severity of depression. Two hundred seventy-one patients participated in the survey, for a 95% response rate. Patients ranged in age from 18 to 84 years, with an average age of 47 years. The male-to-female ratio was approximately 1:1, and 59.4% of the patients were outpatients, 153 (56.5%) of whom had hematologic malignancies. Most cancer patients (n = 104, 38.4%) had minimal depression, while 22.5%, 22.1%, and 17.0% had mild, moderate, and severe depression, respectively. Education level, economic status, smoking status, and age were significantly associated with depression. The BDI-II is a useful instrument for monitoring depressive symptoms. The findings support the practice of routinely testing cancer patients for depressive symptoms as part of standard care and referring patients who are at a higher risk of developing psychological morbidity to specialists for treatment as needed.

Factors associated with palliative care symptoms in cancer patients in Palestine

Palliative care is critical to redundancy in cancer patients seeking to improve their quality of life. Evaluation should be incorporated into clinical practice routines at all stages of cancer. The Edmonton Symptom Assessment System (ESAS) was used to rate the intensity of ten symptom evaluations designed and validated for cancer patients in various languages and cultures. Therefore, the study aims to assess the symptoms reported using ESAS scores to identify patients who would benefit from palliative care that can improve the integration of palliative care into standard cancer care at An-Najah National University Hospital (NNUH). A cross-sectional study was selected for 271 cancer patients using a convenience sampling method at NNUH. Demographic, clinical, and lifestyle characteristics are described. Furthermore, patients' moderate to severe symptoms (score > 4) were obtained using ESAS-R. The survey consisted of 271 patients, with a response rate of 95%. The average age of the patients was 47 ± 17.7 years, ranging from 18 to 84 years. The male-to-female ratio was approximately 1:1, 59.4% of the patients were outpatients, and 153 (56.5%) had hematologic malignancies. Fatigue (62.7%) and drowsiness (61.6%) were the most common moderate to severe symptoms in ESAS. Furthermore, pain (54.6%), nausea (40.2%), lack of appetite (55.0%), shortness of breath (28.5%), depression (40.6%), anxiety (47.2%) and poor well-being (56.5%) were reported. In conclusion, fatigue and drowsiness were the most reported symptoms according to the ESAS scale among cancer patients, while moderate to severe symptoms were reported in cancer patients using the ESAS. The ESAS is a functional tool for assessing cancer patients' symptoms and establishing palliative care services.

Perceived Risk of COVID-19 and Anxiety in Syrian Refugees in Turkey

Pandemics are amongst the most destructive disasters to have afflicted humankind through history. These disasters entail a disproportionate effect on refugee populations, who are already in a state of high vulnerability. This study aims to assess the perception of risk of COVID-19 in the refugee populations in Turkey, in addition to evaluating anxiety levels during the pandemic. The participants of this study were refugees enrolled in a local nonprofit organization in Istanbul. They were asked to complete questionnaires which asked about COVID-19 and any self-protection measures. The questionnaire also incorporated the General Anxiety Disorder-7 screening test. In this young, male and mostly unemployed population, knowing someone who experienced COVID-19 was associated with a greater likelihood of compliance with hygiene and physical distancing measures. Anxiety levels were above 29%, and the highest scores were in the age group between 25 and 55 years. We argue that comprehensive public health measures against COVID-19 should include focused interventions for refugee populations that take the extra vulnerability (health, financial, and other) into account.

UNRWA's role in promoting health outcomes of Palestinian refugees in Jordan: A systematic literature review

INTRODUCTION

The mandate of the United Nations Relief and Work Agency in the Near East (UNRWA) includes education and health services of registered Palestinian refugees in Jordan and other countries. UNRWA is facing limited funding because of unstable political circumstances. This review aims to spotlight the importance of UNRWA's role in promoting Palestinian refugees' health inside and outside camps in Jordan.

METHOD

This systematic review was conducted through iteratively searching electronic research databases for original, recent, full-text literature regarding the health and social outcomes of Palestinian refugees in Jordan.

RESULTS

The 12 reviewed studies showed that UNRWA's programs through its clinics and schools have a crucial role in improving Palestinian refugees' health outcomes such as adolescents' cigarette smoking prevalence, infant mortality, non-communicable disease management, health-related quality of life, mental/psychological health services, and reproductive health. Access to UNRWA's health services may account for better or comparable health outcomes among Palestinian refugees.

CONCLUSION

Despite the short funding and political pressures, UNRWA has provided aid and services to Palestinian refugees inside and outside refugee camps in Jordan. UNRWA's role is crucial in maintaining decent health outcomes in this vulnerable, underserved population. The further limiting of UNRWA funding may jeopardize the health of millions.

Trauma exposure, mental health and tobacco use among vulnerable Syrian refugee youth in Jordan

BACKGROUND

Little is known about tobacco use among youth exposed to armed conflicts, or the influence of trauma on tobacco use in this context. This study examined patterns of smoking by tobacco product and gender among Syrian refugee youth living in host communities in Jordan and assessed the associations of post-traumatic stress disorder (PTSD) and depression symptoms, trauma exposure and social support with current smoking status in boys and girls.

METHODS

Syrian refugee students (mean [standard deviation] age = 14.9 [1.33] years) were identified through the public school system. Data were collected using an online Arabic questionnaire that included questions about demographics, trauma exposure, current smoking (cigarette and waterpipe), PTSD, depression and perceived social support. Logistic regression was used to assess the adjusted effects of independent variables on current smoking status.

RESULTS

One in 7 boys and one in 14 girls were current smokers, with boys reporting greater tobacco use than girls. Among boys, current smokers reported significantly higher family member loss and lower perceived family social support than nonsmokers; among girls, current smokers also reported significantly higher family member loss as well as greater PTSD symptoms and lower perceived significant other/special person social support.

CONCLUSIONS

Tobacco use is established among this vulnerable group. The findings highlight the potential role of psychosocial support for tobacco prevention and cessation strategies.

Social Determinants of Resilience Among Syrian Refugees in Jordan

The current study explores the level and social determinants of resilience among Syrian refugees residing in Jordan. Having high levels of resilience can help refugees positively adapt to challenges and cope with the burden of stressors associated with warfare, turmoil, and displacement. A sample of 151 Syrian refugees ages 18 to 69 residing in Jordan completed the Arabic version of the Connor-Davidson Resilience Scale. Resilience scores among Syrian refugees in Jordan were generally low. Refugees' place of residence, educational level, employment status, and monthly income were significantly associated with lower resilience scores and together explain approximately 37% of variance in resilience scores. Tailored resilience-building and educational programs are needed to help Syrian refugees develop the ability to withstand, adapt to, and recover from stress and adversity, and maintain or return to healthy mental states. Future research involving longitudinal assessment of resilience is needed to fully understand the role and determinants of resilience in this population. [Journal of Psychosocial Nursing and Mental Health Services, 58(8), 31-38.].

Assessment of the knowledge, attitudes, and practices (KAP) among UNRWA* health staff in Jordan concerning mental health programme pre-implementation: a cross-sectional study

BACKGROUND

Mental health is a major public health priority, especially among refugees. The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) started to integrate mental health and psychosocial support (MHPSS) into its primary healthcare services in Jordan in late 2017. In this study, we aimed to assess of the knowledge, attitudes, and practices (KAP) among UNRWA health staff (HS) in Jordan concerning mental health programme pre-implementation, and their perceived barriers about this MHPSS programme.

METHODS

A cross-sectional study was conducted among doctors, dentists, nurses, and midwives who work at 16 of the 25 UNRWA health centres in Jordan. The assessment was made using a validated self-administered questionnaire. Data analysis was performed using SPSS (version 22).

RESULTS

Of the participants, 73% (161 of 220) believed that their knowledge of MHPSS programmes was insufficient, with no significant difference (p = 0·116) between different categories of staff. Furthermore, 88% (194 of 220) said that they needed more training, 67% (147 of 220) reported that the number of mental health cases is increasing, and 50% (110 of 220) that dealing with these cases is difficult. Reflecting on the past 12 months, 31% of staff (69 out of 220) reported meeting between one and ten children, and 45% (100 out of 220) reported meeting between one and ten adults suspected of having mental illnesses. The most suspected condition was depression (84%; 150 of 220), followed by epilepsy (64%; 140 of 220). The main perceived barriers to implementation included the limited availability of MHPSS policies (87%; 192 of 220), MH professionals (86%; 190 of 220), resources (86%; 189 out of 220), and lack of privacy (14%; 31 out of 220).

CONCLUSIONS

Most health staff had positive attitudes towards MHPSS programme implementation but felt they lacked the required knowledge. There is a need for training and clear technical guidelines. Perceived barriers to MHPSS programme implementation were consistent with the previous studies and need to be tackled with a structured plan of action.

Self-Rated Health and Relative Socioeconomic Deprivation in the Palestinian Refugee Communities of Lebanon

Most Palestinian refugees in Lebanon are marginalized as refugees, poor, and targets of discrimination. This study seeks to understand deprivation among these refugees through an exploration of the relationship between indicators of general health and economic deprivation. A nationally representative sample of 2501 Palestinian refugee households were randomly selected and surveyed in 2010. Social workers interviewed the homemaker in each household using a questionnaire on health, economic, and socio-demographic information. This data was analyzed to understand the associations between health and levels of deprivation. 31% of respondents reported poor health and nearly 52% of households had two or more poverty indicators. The logistic regression found each degree of deprivation associated with a 33% increase in poor health (OR 1.33; CI 1.20-1.47). This study suggests understanding deprivation among impoverished communities requires a nuanced approach. Generalizations about experiences of poverty will generate ineffective policy and intervention strategies.