Resilience of community mental health nurses in Palestine

Earlier this week a new article lead authored by Mohammad Marie, and co-authored by Aled Jones and me, was published in the International Journal of Mental Health Nursing. The title of the article is Resilience of nurses who work in community mental
health workplaces in Palestine
, and is the second paper arising from Mohammad’s completed PhD. As the article appears in gold open access form copies can be directly downloaded from the journal’s website for free: or indeed, by clicking either the hyperlinked title or image above.

The larger part of Mohammad’s qualitative dataset is interviews conducted with CMHNs working in the West Bank. Fifteen practitioners took part, from a total population of 17. For the record, that’s 17 community mental health nurses for a population of some three million people. That’s an astonishingly low number by UK standards; for more on mental health needs and services in Palestine, the place to go is Mohammad’s first paper (Mental health needs and services in the West Bank, Palestine) about which I previously blogged here.

Here is the abstract from this latest paper:

People in Palestine live and work in a significantly challenging environment. As a result of these challenges they have developed resilient responses which are embedded in their cultural context. ‘Sumud’, in particular, is a socio-political concept which refers to ways of surviving in the context of occupation, chronic adversity, lack of resources and limited infrastructure. Nurses’ work in Palestine is an under-researched subject and very little is known about how nurses adjust to such challenging environments. To address this gap in the literature this study aimed to explore the resilience of community mental health nurses (CMHNs) who work in Palestine. An interpretive qualitative design was chosen. Fifteen face-to-face interviews were completed with participants. Thirty-two hours of observations of the day-to-day working environment and workplace routines were conducted in two communities’ mental health centres. Written documents relating to practical job-related policies were also collected from various workplaces. Thematic analysis was used across all data sources resulting in four main themes, which describe the sources of resilience among CMHNs. These sources are ‘Sumud and Islamic cultures’, ‘Supportive relationships’, ‘Making use of the available resources’, and ‘Personal capacity’. The study concludes with a better understanding of resilience in nursing, which draws on wider cultural contexts and social ecological responses. The outcomes from this study will be used to develop the resilience of CMHNs in Palestine.

The idea of ‘Samud’ which is referred to above is an important one in Mohammad’s work, and (as I have learned) for Palestinian people. Drawing on the work of Toine Van Teeffelen, here is what Mohammad says about it in his thesis:

[Samud] is the art of living to survive and thrive on their homeland in spite of hardship and under occupation practices. These skills of how to live are used in different aspects of life such as economic, political and social. They can also be used at many levels: individual, family and within the Palestinian community. Moreover, Sumud has been divided into two types: tangible resources such as the infrastructure supporting basic needs (for example, schools and hospitals) which enable the existence of the Palestinians on their land and help them to be more resilient. In addition intangible sources of Sumud also exist, which include: belief systems, religion and social and family support which help the Palestinians to cope with their chronic daily collective suffering.

For Mohammad, Samud is closely related to the more familiar (to me, at any rate) idea of resilience. Or, more properly put, Samud connects to social ecological variants of resilience which place as much emphasis on the social and cultural as they do on the individual.

I’ll stop here and leave people to download and read this new paper for themselves. For those interested, Mohammad, Aled and I are working on further publications from this doctorate: so more will follow in due course.

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