title: Post-Traumatic Stress Disorder Among Health Care Providers Following the Israeli Attacks Against Gaza Strip in 2014: A Call for Immediate Policy Actions.
abstract: OBJECTIVE
  This study aimed to assess the level of posttraumatic stress disorder and to examine the relationship between exposure to war stress and posttraumatic symptoms among health care providers following Israeli offensives against Gaza Strip in 2014.
  
  
  METHODS
  A cross-sectional design was used for this study. We targeted all nurses and doctors working in three governmental hospitals in the Gaza Strip and worked with victims of the last war, more specifically, those who were working in emergency departments, intensive care units, operating rooms, surgical departments, and burn units. A demographic sheet and Impact Event Scale-Revised were used in this study. The Impact Event Scale-Revised has three sub-scales; intrusion, avoidance, and hyper-arousal.
  
  
  RESULTS
  The results showed that 291 (89.8%) of 324 participants had scores more than 35 (threshold cut-off point) on the Impact Event Scale-Revised. Scores ranged from zero to 80 with a mean of 52.13. Females had higher levels of stress (55.79) than males (51.63) and nurses (54.85) had more stress than physicians (47.38). The most frequent symptoms of trauma subscales was "avoidance" (mean=20.04), followed by "intrusion" (mean=17.83), and then "hyper-arousal" (mean=14.27). Levels of trauma symptoms were not affected by place of living, hospital of work, while level of education had impacted level of trauma.
  
  
  CONCLUSIONS
  The findings showed that health care providers suffered from severe posttraumatic symptoms after exposure to prolonged war stress. This level of trauma among health care providers warrants intervention programs to reduce stress and trauma among Gaza health care providers after the war.
authors.affiliation: College of Nursing, Islamic University of Gaza, Gaza, Gaza Strip, Palestine. Electronic address: naselnoor@iugaza.edu.ps.
authors.forename: Nasser Ibrahim
authors.initials: NI
authors.lastname: Abu-El-Noor
authors.affiliation: College of Nursing, Islamic University of Gaza, Gaza, Gaza Strip, Palestine. Electronic address: yjeesh@iugaza.edu.ps.
authors.forename: Yousef Ibrahim
authors.initials: YI
authors.lastname: Aljeesh
authors.affiliation: College of Nursing, Islamic University of Gaza, Gaza, Gaza Strip, Palestine. Electronic address: arodwan@iugaza.edu.ps.
authors.forename: AbdalKarim Said
authors.initials: AS
authors.lastname: Radwan
authors.affiliation: College of Nursing, Islamic University of Gaza, Gaza, Gaza Strip, Palestine. Electronic address: maziz@iugaza.edu.ps.
authors.forename: Mysoon Khalil
authors.initials: MK
authors.lastname: Abu-El-Noor
authors.affiliation: College of Nursing, Islamic University of Gaza, Gaza, Gaza Strip, Palestine. Electronic address: iqddura@iugaza.edu.ps.
authors.forename: Ibrahim Abdel-Ilhady
authors.initials: IA
authors.lastname: Qddura
authors.affiliation: College of Nursing, Islamic University of Gaza, Gaza, Gaza Strip, Palestine. Electronic address: k.khadourah@gmail.com.
authors.forename: Khalid Jamal
authors.initials: KJ
authors.lastname: Khadoura
authors.affiliation: University College of Applied Sciences, Gaza, Palestine. Electronic address: snawajha@hotmail.com.
authors.forename: Samer Khader
authors.initials: SK
authors.lastname: Alnawajha
mesh_terms: D000328:Adult; D000068337:Armed Conflicts / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D006291:Health Policy; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D008877:Middle East; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D013315:Stress, Psychological