Background: Universally, hysterectomy is considered as the second most frequent surgery after cesarean section performed on women in the reproductive age. After a hysterectomy, women no longer have menstrual periods, so they cannot become pregnant. Like most other countries, hysterectomy is the most common major gynecological operation in Palestine. However, the psychological, physical, and sexual consequences of hysterectomy are conflicting, and the findings are mixed. While some studies report that patients experience more significant improvement in their mental health, sexual desire, and overall satisfaction, other studies show that patients report various adverse outcomes, with detrimental effects on sexual functioning being the main concern. Objective: This study aimed to describe women's experiences of hysterectomy and identify their fears, concerns, and what coping mechanisms do they adopt to enhance the quality of their lives. Methodology: Qualitative descriptive phenomenological research design was used in this study. The study aims to gain insight into the experiences of fifteen patients after hysterectomy using semi-structured in-depth interviews. The interview was conducted in both private and governmental hospitals using purposeful sampling. Results: Giorgi's phenomenological analysis process was used as a tool for analyzing data. Analysis of the interview transcripts led to five themes, including a total of eighteen subthemes. The first theme is physical change that has pain, insomnia, eating habits, and immobility as subthemes. The second theme is psychological changes with depression, de-socialization, anxiety, and aggressiveness as its subthemes. The third theme is defense mechanisms with praying, listening to music, reciting the Holy Quran, walking, and sports as subthemes. The fourth theme is self-esteem and body image with confidence, appearance, and concerns as subthemes. Lastly, the fifth them is sexuality with excitement and sexual pattern as subthemes. Conclusion: The results of this study demonstrated that hysterectomy had significant adverse effects on patients' body image, and self-esteem. Moreover, the study identified common meanings and themes associated with hysterectomy stressors. These are difficulties or limitations in physical and psychological aspects perceived by patients after hysterectomy. The health care provider must be aware of these potentially problematic issues to provide competent health care.

Nurses and midwives are necessary at all aspects of primary health care; they need a lot of devotion with respect to patient administration and bringing care. The time and devotion spent by nurses and midwives in nursing duty may lead to burnout and psychological distress. There is a lack of study in Palestine that investigate the burnout syndrome and the level of psychological distress among nurses and midwives in primary health care clinics. Therefore, this study estimates the propagation of overwork and psychological distress among primary health care nurses and midwives working in the north of the West Bank. A quantitative, cross-sectional survey design was applied using a self-administered questionnaire pack. The questionnaire pack had Maslach Burnout Inventory (MBI) and the General Health Questionnaire (GHQ-28) to evaluate the level of burnout and psychological distress among 295 nurses and midwives working in the Palestinian governmental primary health care centers in the north of the West Bank. Data were analyzed using the SPSS system version 20. The prevalence of distress and burnout was 10.6% among 207 nurses and midwives who participated in this study. High levels of burnout were found in 36.7% of the respondents in the area of emotional exhaustion, 14% in the area of depersonalization, and 17.9% in the area of reduced personal accomplishment. However, 22.6% had a positive score in the GHQ-28 which proves the very existence of psychological distress amongst the respondents. The current study explained the relationship between nurses' burnout syndrome and the level of psychological distress. It also indicates that this burnout and psychological distress are common among nurses working in PHC. This study concluded that PHC nurses in the north of the West Bank need more attention to deal with their psychological conditions. Nursing managers and others in the Palestinian ministry of health are in good position to support nurses, especially when nurses express different sources of stress. Nurses' burnout and psychological distress levels have special characteristics relating to the unique structure of health care in Palestine.

Objective: To investigate access to and use of health services, particularly maternal and child health care, in the UK by Palestinian women. Design: A qualitative study using a pragmatic approach for exploration and description. Data were transcribed ad verbatim and analysed using framework analysis and the NVivo 9 computer program. Setting: Interviews were conducted in participants' homes, the researcher's home and in Arabic schools. Participation: Twenty-two interviews were conducted. Participants were living in different geographic areas in Manchester, and were recruited through Arabic schools and the main mosque in the city. Findings: Four themes emerged from the qualitative interviews, which were: ‘cultural variations’; ‘knowledge of the NHS and the UK health-care system’; ‘health care services and their utilisation, focusing on maternal and child health-care services’; and ‘communication, information provision and needs’. Conclusion: Culturally competent care is required to reduce the inequity of maternal and child health-care services; this study recommended the following points: In delivering the information for BME groups, it is inappropriate to implement a ‘one-size-fits-all’ programme; culturally appropriate care could be satisfactorily achieved through effective and continuous training programmes based on culture, ethnicity and religion for all health professionals; and effective interpretation services are vital so there is no need to rely on family members and friends as was clearly the case for the participants in this study.

Hysterectomy is the most common major gynecological operation in worldwide and Arabic countries. However, the psychological, physical and sexual consequences of hysterectomy are conflicting and the findings are mixed. While, some studies report that patients have experience greater improvement in their mental health, sexual desire and overall satisfaction. Others show that patients report various negative outcomes, with detrimental effects on sexual functioning being the main concern. My previous study demonstrated that hysterectomy had significantly negative effects on patients’ body image, self-esteem, and identified common meanings and themes associated with hysterectomy stressors, which includes difficulties or limitations in physical and psychological aspects perceived by patients after hysterectomy. In this chapter, author will expand that discuss in details the different factors that influence the perspective of women about body after hysterectomy. Mainly, author will focus on religious, cultural, and psycho-social aspects. All of these factors are interacting with health status of women and effect the situation and productivity of women in her family and culture. Different strategy need to be adopted in order to overcome this problem using evidence and analysis of our Arabic culture and structure. Recommendation of study to health care profession as physician, nurses, midwives and other health care provider to be aware of these potential problematic issues in order to provide a competent health care for women based of her needs.

Genetic disorder is a health problem that is caused by a defect in the individual's DNA. In Palestine, there is no statistics about mortality rate of children who suffer from genetic disorders. Although, It, children, disorder is notacable that the new cases from the same family have been increased without any genetic counseling or prevention. Therefore, the study aim is to describe parents’ knowledge and attitudes toward genetic counseling and testing, and to determine if knowledge affects attitudes. A cross sectional study using a questionnaire to evaluate knowledge and likert scale to evaluate attitude was used in this study. The sample size was 121 participants who were attended the two referral hospitals in West Bank from February 2016 to September 2016. The study showed that there is a significant positive relationship between parents’ educational level and their knowledge regards genetic disorder (P value= 0.003). The most significant related risk factors for genetic disorder were ignoring premarital genetic testing for (99.2%); consanguineous marriage (71.1%); and family history of genetic problem for (55.4%).The study founded that most of parents of children with genetic problem had a good knowledge regards genetic disorder (63%).Whereas, the attitudes of these parents were positive for a majority of items that measure attitude level (81% for agreed answer). The relationship between knowledge and attitudes was positive and research hypothesis regards the effect of knowledge on attitude of parents had been accepted. This study recommended to increase awareness of parents about genetic testing; the important of premarital testing; and to avoid consanguinity. These are considered as a golden tool to decrease genetic problem in Palestine.