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Quality of life among healthcare workers in the hospitals and primary healthcare centers in Gaza Strip: a cross-sectional study

BMC Psychology volume 13, Article number: 69 (2025) Cite this article

Abstract

Background

Quality of life (QoL) is an important measure of overall well-being linked to physical, mental, social, and environmental aspects of health. This study aimed to assess the QoL among healthcare workers (HCWs) in hospitals and primary healthcare centers (PHCs) in Gaza Strip, Palestine.

Methods

A cross-sectional study was conducted among 1850 HCWs in Gaza Strip, Palestine. Data were collected by using self-administered questionnaires in the paper-based format containing a sociodemographic profile and the World Health Organization Quality of Life Brief questionnaire. Factors associated with QoL were examined using an independent t-test, Chi-square test, and multivariate logistic regression models.

Results

The study included HCWs with a mean age of 38.62 years old, of whom 61.9% were male. The mean QoL score was 55.98 (standard deviation: 11.50), with 55.5% reporting a good QoL. Multivariate logistic regression analysis revealed that age, smoking status, workplace, and work shifts were associated with the overall QoL score (p < 0.05). Older age (≥ 35 years), working in a hospital, and working the morning shifts were identified as protective factors for QoL, while smoking and working the evening-night shifts were inversely associated with QoL.

Conclusions

This study found that HCWs in Gaza Strip exhibited moderate levels of QoL. Age, smoking status, workplace, and work shifts were associated with overall QoL. Strategies to improve HCWs’ QoL, such as lifestyle interventions, additional support through training or educational programs, and reducing work schedules, could be considered under high-pressure situations.

Peer Review reports

Introduction

Quality of life (QoL) is a multidimensional construct that refers to an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns [1]. QoL serves as a critical measure of overall well-being towards social, physical, psychological, and environmental features [2]. Healthcare workers (HCWs) play a central role in delivering essential medical services and promoting public health [3]. The demanding nature of the occupation, including the work environments, workloads, and sociodemographic factors, can impact HCWs’ QoL, which, in turn, may lead to health issues and a decline in the quality of healthcare services [4,5,6,7,8,9,10,11,12,13]. Previous studies have shown that emergency medicine personnel reported higher levels of worry and anxiety, as well as lower levels of general health during armed conflicts [14], which might contribute to lower QoL. Understanding QoL and its influencing factors among HCWs is crucial for maintaining their health, especially when faced with challenges such as limited resources, inadequate infrastructure, system overloads, and political instability.

Epidemiological evidence demonstrates conflicting results regarding QoL among HCWs in high-stress environments (e.g., disasters, calamities, disease outbreaks, and war) [15,16,17,18,19,20]. A systematic review of 19 studies indicated that healthcare professionals experienced a deterioration in psychological health and QoL during the Corona Virus Disease 2019 (COVID-19) pandemic [15]. In contrast, a multi-center study conducted in Syria found that 50% of HCWs reported good QoL during the challenging conditions of the COVID-19 pandemic [16]. A national cross-sectional study of physicians in Romania showed a high level of quality of professional life, particularly in the environment domain [18]. Research on the QoL of HCWs in conflict-affected regions remains limited. In Gaza Strip, HCWs are facing complex socioeconomic and work-related challenges due to the long-standing Palestinian-Israeli conflict [21]. The imposed siege since 2006, along with the dispute between Palestinian parties in Gaza and West Bank, has impacted all aspects of the health system and medical staff [22]. Economic issues, including inadequate salaries and financial instability, contribute to lower perceived financial well-being among HCWs [23]. Furthermore, movement restrictions on goods have contributed to interruptions and shortage of medical supplies and essential medicines [24], shaping the difficult working conditions HCWs endure daily. The blockade has hindered the importation of essential medical supplies, resulting in shortages of medications, vaccines, and other critical items, which directly impacts healthcare service quality. HCWs in Gaza are continually exposed to war and ongoing political violence, increasing the risk of poor QoL. However, to our knowledge, data on QoL and its associated factors among HCWs in Gaza Strip are unavailable. Given the challenging socioeconomic conditions in Gaza Strip, evaluating the QoL of HCWs is urgently needed.

The objective of the study was to evaluate the QoL of HCWs, and explore the associations of sociodemographic features, lifestyle, and work-related factors with QoL in governmental hospitals and primary healthcare centers (PHCs). This study focused on HCWs in Gaza, a demographic pivotal to the healthcare system yet facing systemic challenges. The goal was to identify potential coping strategies and interventions to enhance the QoL of healthcare providers and develop sustainable healthcare systems under worsening socioeconomic situations.

Methods

Study population and sampling

A representative cross-sectional study was conducted from February to May 2020 in Gaza Strip, Palestine. The surveys covered 10 hospitals and 15 PHCs of the Ministry of Health from five governorates of the Gaza Strip: North Gaza, Gaza, Middle Area, Khan Younis, and Rafah. The sample size was calculated to be 712 based on previous data using the formula: n = Z2 P (1–P)/d2 at a 95% confidence interval (CI)] [25]. A multistage stratified random sampling method was performed to obtain a representative sample of HCWs. Stratification of population was applied considering the population distribution in all five areas, and then two hospitals and three PHCs from each governorate were randomly selected. Finally, we recruited 398, 746, 280, 226, and 200 participants from North Gaza, Gaza, Middle Area, Khan Younis, and Rafah, respectively. The study included HCWs aged ≥ 18 years old with at least one year of working experience at the Ministry of Health. HCWs were excluded if they were volunteers or unemployed. The sample consisted of physicians, nurses, paramedics, and non-medical personnel. Of 2000 eligible participants invited to the survey, 1900 completed the questionnaire, and 1850 responses were included in the final analysis due to complete and consistent data.

Data collection tools

Collection of sociodemographic, lifestyle and work-related data

Information on demographic and socioeconomic characteristics, lifestyle data, work-related factors, and medical history of chronic diseases was collected using self-constructed face-to-face interviews in the paper-based format by well-trained investigators. Demographic and socioeconomic characteristics included age (< 35 and ≥ 35 years old), gender (male and female), marital status (single/divorced/widowed and married), educational attainment (diploma, bachelor’s degree, and master’s degree or higher), profession (physician, nurse, paramedical and non-medical), and monthly income [< 2000 and ≥ 2000 new Israeli shekels (NIS)]. Smoking status was categorized into never- and former- or current-smokers according to the classifications by the National Center for Health Statistics [26]. Work-related factors included working experience (< 5, 5–10, > 10–15, and ≥ 15 years), workplace (hospitals, PHC, and administration), work shifts (morning shift, night shift, and evening-night shift), and type of work (full-time and part-time). Medical history of chronic diseases, including coronary artery disease, stroke, hypertension, diabetes, and hyperlipidemia, was collected and dichotomized into “yes” or “no”.

Assessment of quality of life

The World Health Organization Quality of Life Brief Questionnaire (WHOQOL-BREF), a condensed version of the WHOQOL-100, was utilized to assess the QoL of the participants [27]. The WHOQOL-BREF is composed 26 items designed for measuring QoL of overall level (2 items) and four main domains, including environment (8 items), social interactions (3 items), psychological health (6 items), and physical health (7 items). Each item is scored on a 5-point Likert scale, ranging from 1 (very poor/very dissatisfied/ never/none) to 5 (very good/very satisfied/always/extremely). The score for each domain is the sum of the relevant items. To align the domain scores with the WHOQOL-100 scale, the sum is multiplied by 4. The final scores are then converted to a scale from 0 to 100 using standard formulas [27]. Higher scores for overall QoL and each domain indicate better QoL.

Transformed score = (score − 4) × (100/16),

 

Physical domain = ((6 − Q3) +(6 − Q4) + Q10 + Q15 + Q16 + Q17 + Q18) × 4,

 

Psychological domain = (Q5 + Q6 + Q7 + Q11 + Q19 +(6 − Q26)) × 4,

[27]

Social domain = (Q20 + Q21 + Q22) × 4,

 

Environmental domain = (Q8 + Q9 + Q12 + Q13 + Q14 + Q23 + Q24 + Q25) ×4.

 

Reliability of the WHOQOL-BREF

The validity of the WHOQOL-BREF has been tested in different Arab countries [28,29,30], demonstrating excellent reliability [31]. The forward-backward translation method, recommended by Beaton et al., was applied to translate WHOQOL-BREF from English into Arabic [32, 33]. The cultural adaptation of the Arabic Version was performed as follows: (1) The original English version was translated into Arabic language by two independent translators, and a common forward translated version was established by the synthesis of these translations. (2) The provisional Arabic version was back-translated by two other translators independently. (3) An expert committee of researchers was formed to compare the back-translation with the original version for inconsistencies, and presented the final version. (4) The prefinal version was tested with 10 Palestinians, who provided feedback on the completeness and applicability (grammar, organization, and appropriateness) of the scale. The internal consistency was evaluated using Cronbach’s alpha coefficient. The overall internal consistency for all 26 items was 0.88. Specifically, the internal consistency for physical health, psychological health, social relationship, and environmental domain was 0.86, 0.88, 0.87, and 0.88, respectively.

Statistical analysis

GraphPad Prism 5 and SPSS (Statistical Package of the Social Sciences) Version 26 were used for data analyses. The distribution of the overall QoLscore and domain scores was checked for normality using the Kolmogorov-Smirnov test and normal Q-Q plots. Continuous variables were presented as mean and standard deviation (SD) for normally distributed data, and as median (interquartile range) for non-normally distributed data. Categorical variables were summarized as frequency and proportions (%). Smoking status was defined as non-smokers and smokers (former- and current-smokers).Two-sided t-tests and one-way analysis of variance (ANOVA) were conducted to identify differences in QoL scores based on age, gender, marital status, education levels, monthly income, smoking status, medical history of chronic diseases, profession, workplace, years of working experience, work shifts, and type of work. Multivariate logistic analysis was conducted to determine any significant relationships between sociodemographic, lifestyle and work-related factors and the overall QoL. All statistical tests were two-tailed, and the level of statistical significance was set at 0.05.

Results

Demographic characteristics

Overall, the mean age of participants was 38.62 years (range: 24–63 years), with most participants (59.6%) aged over 35 years. Over three-quarters of the participants were married (78.1%). Additionally, 68.6% of participants had a bachelor’s degree, and 65.3% were nurses. A total of 64.9% of HCWs had 5 to 15 years of working experience. Furthermore, 61.8% of participants had a monthly salary of less than 2000 NIS and 24.4% reported having a medical history of chronic diseases (Table 1).

Table 1 Sociodemographic characteristics of the study participants (N = 1850)
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The overall and domain scores of QoL

The mean score of overall QoL among HCWs was 55.98 ± 11.5. Of the four domains of QoL, the social relationship domain had the highest mean score (64.44 ± 17.23), and the environmental domain demonstrated the lowest score (51.61 ± 16.11), as shown in Table 2.

Table 2 Overall QoL and QoL scores across the domains (N = 1850)
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Univariate analysis of the associated factors of overall QoL and QoL domains

Associations between sociodemographic data and QoL are illustrated in Figs. 1, 2, 3 and 4. Across QoL domains, educational attainment was associated with the physical domain (p = 0.033). The social domain significantly differed by age group (p = 0.007) and marital status (p = 0.006). High scores on the environmental domain were associated with female sex (p = 0.020). The overall score of QoL showed no statistically significant differences in terms of gender, age, marital status, educational level, and monthly income. An additional file shows more details [see Additional file 1].

Fig. 1
figure 1

Association between gender and quality of life in univariate analysis

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Fig. 2
figure 2

Association between age and quality of life in univariate analysis

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Fig. 3
figure 3

Association between marital status and quality of life in univariate analysis

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Fig. 4
figure 4

Association between educational attainment and quality of life in univariate analysis

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Table 3 shows the associations of lifestyle and work-related factors with QoL. We observed significant differences between the mean score of overall QoL and smoking (p = 0.001), workplace (p = 0.005), and work shifts (p = 0.027). Non-smokers had significantly higher mean scores in all domains of QoL compared to smokers (p < 0.05). The psychological domain significantly differed by working experience, with a lower score for those who had more than 15 years (p = 0.001). The physical domain significantly differed by profession, with non-medical participants scoring higher than those in other professions (p = 0.025). Hospital workers showed a better QoL than other workers in the physical (p = 0.003), psychological (p = 0.007), and social domains (p = 0.002). HCWs working in the morning shifts had higher mean scores in overall QoL in comparison with the evening-night shift workers (p = 0.027). Similar results were observed for physical (p < 0.001) and social domains (p = 0.003). Part-time workers had a significantly better QoL in the psychological domain compared to full-time staff (p = 0.003).

Table 3 Association between lifestyle and work-related factors and the mean score for overall QoL and the four domains among HCWs (N = 1850)
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Multivariate analysis of the associated factors of QoL in HCWs

QoL scores were further converted into categorical variables according to the mean score. Participants were divided into two groups: those with scores above the mean (good) and those with scores below the mean (poor), as shown in Table 4. Overall, more than half of the participants (55.5%) had good QoL. The lowest proportion of HCWs with good QoL was in the psychological domain (48.8%), while the highest was in the social domain (63.4%).

Table 4 Distribution of QoL (N = 1850)
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The results of multivariate logistic analysis showed that age, smoking status, workplace, and evening-night shift were significantly associated with the overall QoL (p < 0.05). Participants older than 35 years were more likely to have good QoL compared to younger participants (OR = 1.32; 95% CI: 1.01–1.74). Participants who smoked had a 0.70 times lower likelihoodof having good QoL compared to non-smokers (95% CI: 0.54–0.90). Participants who worked in hospitals had a 1.83 times higher likelihood of having good QoL compared to those who worked in administration (95% CI: 1.22–2.75). Finally, the evening-night shift workers had a 0.62 times lower likelihood of having good QoL compared to those working the morning shifts (95% CI: 0.44–0.88). However, gender, marital status, profession, monthly income, medical history of chronic diseases, work experience, work shifts, and type of work were not significantly associated with QoL (Table 5).

Table 5 Multivariate analysis of the associated factors of overall QoL in HCWs (N = 1850)
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Discussion

To our knowledge, this is the first study to assess the QoL among HCWs and explore potential associations between sociodemographic features, lifestyle, and work-related factors and QoL at the Gaza Strip’s governmental hospitals and PHCs in the context of the long-standing Palestinian-Israeli conflict. We found a moderate overall QoL level among HCWs. In multivariate analysis, age, smoking status, workplace, and work shifts were significantly associated with overall QoL, indicating that a healthy lifestyle and work environments, such as flexible shift scheduling, contributed to optimum QoL scores despite the worsening socioeconomic conditions.

The findings from this study indicate a moderate overall QoL level among HCWs in Gaza Strip, consistent with previous studies from low-income and middle-income countries. Al Houri et al. [16] conducted a population-based survey in Syria that included 700 HCWs and observed that half of the participants perceived a good QoL. Another study aiming to assess healthcare practitioners’ QoL and associated factors also reported that the majority of personnel were satisfied with the quality of their living conditions including environmental health and workplace in both rural and urban areas of Saudi Arabia [34]. A similar population-based cross-sectional survey consisting of nurses working in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, found that they scored higher on general health, and increasing salaries and reducing shift time were associated with higher QoL [35]. By contrast, in a cross-sectional study of Ugandan nurses and HCWs, participants reported low overall work-related QoL [36]. However, few studies have focused on the QoL of healthcare professionals during armed conflicts [14]. Our findings showed that the overall QoL was moderate among HCWs in the conflict-affected Gaza Strip.

With respect to four domains of QoL, we found that the physical and environmental domains had lower QoL scores, while the social and psychological domains had higher QoL scores. This suggests that adequate screening for physical health and coping strategies for improving suboptimal working conditions in Gaza Strip should be precisely considered to promote better QoL. The findings in the physical domain in this study are consistent with previous studies conducted in Jordan and Afghanistan [37, 38]. In the Romanian healthcare context, physicians reported high QoL scores across all four domains, particularly in environmental health during the COVID-19 pandemic [18]. Conversely, in nurses from Lebanon, a country with notable similarities in geographical features, cultural habits, and socioeconomic demands to the Gaza Strip, the environmental domain scored the lowest [39]. As a focal point of the Palestinian-Israeli conflict, the Gaza Strip faces worsening socioeconomic conditions and safety concerns, which may be crucial contributors to the decline of physical and environmental health. The overburdening of health services, war-related traumatic events, and the blockade all impact physical well-being [21]. A possible explanation for the highest score in the societal domain in the current study might be psychological well-being [40], support from family, social or friends [41], and resilience [42], in addition to the societal structure of Arab countries, which emphasizes the creation of social bonds.

A growing body of evidence supports the impact of work-related, lifestyle, and sociodemographic factors on HCWs’ QoL. In terms of work-related factors, non-medical HCWs demonstrated better QoL in the physical domain while HCWs with less than five years of experience had better QoL in the psychological domain than the more experienced HCWs. Italia et al. found that work seniority was negatively associated with better QoL overall [10], whereas Anshasi et al. suggested that longer career experience adversely affected only the physical domain of QoL [39]. In conclusion, we could infer that the less senior staff are less exposed to work-related stress and overload. Non-medical staff who have less direct contact with patients and are less likely to work night shifts, exhibit optimal levels in the physical domain of QoL.

The study highlighted that workplace and work shifts were the primary factors associated with overall QoL and its various domains. Working in hospitals had a significantly positive effect on the physical, psychological, and social domains of the QoL. In contrast, a systematic review of 10 studies summarized evidence on the high level of quality of professional life among primary healthcare nurses [20]. Several studies emphasized the consequences of shift work patterns (e.g. rotating shifts, split shifts) on the QoL. A previous study of HCWs in Southeast Nigeria revealed that night shifts were significantly associated with poor environmental well-being and physical health, and day shift was positively related to psychological health and social relationships [43]. The present investigation found that the morning shifts were a positive predictor for the QoL in the physical and social domains, contributing to the current understanding of how different work schedules affect QoL in Gaza Strip.

Regarding the type of HCWs’ contract, working as a part-time employee was a positive predictor for a good QoL in the psychological domain. This can be a normal outcome for part-time contracted HCWs as they might be exposed to less work-related stress and occupational pressure. Additionally, we found that decreased monthly income associated with part-time contracts did not impact QoL. Similarly, Bąk-Sosnowska et al. revealed that full-time nurses were less satisfied with their occupation status than part-time workers [44]. These findings highlight the importance of considering employment contract nuances and their potential implications for QoL among HCWs. Part-time employment may reduce work-related stress and impove psychological well-being, while full-time employment may pose job satisfaction challenges. Healthcare organizations and policymakers must recognize these differences and implement supportive measures to enhance HCWs’ QoL, regardless of their employment status.

The associations between smoking habits and QoL have been found in previous studies. A meta-analysis concluded that a healthy lifestyle, such as smoking cessation, and a supportive work environment contribute to optimum professional QoL scores [45]. This study suggested that HCWs who smoked had lower QoL scores across all domains. Evidence from a cross-sectional study comprising 217,561 participants indicated that cigarette smoking was significantly associated with higher levels of perceived stress [46], suggesting that interventions targeting smoking cessation and stress reduction may be promising strategies for improving QoL in low- and middle-income countries.

For sociodemographic information of the participants, gender, age, marital status, and education level were the main factors that significantly concerned the different domains of the QoL. In the present study, the environmental domain was significantly affected by gender, with females achieving a higher score. This might be due to female workers having more life satisfaction than male workers, as proposed by Van Daleen et al. [47], whereas the environmental domain examines the participants’ satisfaction towards living conditions, transportation, health services, and accessibility to the needed information. Our findings suggested that females in Gaza Strip had higher satisfaction with their living environments, transportation, and healthcare services, which reflected the unique sociocultural context and gender dynamics within the healthcare sector. Regarding social status, those who were married and aged 35 years or older had a higher score in the social domain of QoL. Marriage and getting older will increase social networks, which, in turn, affect relations and social support. Several studies have demonstrated that partnerships were positively associated with QoL and social well-being [10, 48], which were compatible with our findings. Further research is needed to explore the specific mechanisms and contextual factors contributing to these associations, and to develop targeted interventions in order to promote social well-being among HCWs. Education level is an additional factor influencing HCWs’ QoL, whereas having a post-graduate certificate was positively associated with the physical domain of QoL. In contrast, another study performed in pediatric medical staff found that having higher education after a bachelor’s degree will lower the score of the QoL in all domains [49]. In addition to different study populations, specific work-related challenges, cultural factors, and societal expectations across different regions and healthcare systems may also contribute to differential impacts of education level on QoL.

This study has several strengths. First, the study provides an in-depth analysis of QoL and related factors among HCWs in Gaza Strip, which has important public health implications for policy frameworks aimed at helping healthcare professionals address systemic challenges and develop sustainable healthcare systems under high-pressure situation. Additionally, the large representative population enhances the generalizability of our findings to the entire population of Palestinian HCWs. However, the current study has several limitations in interpreting the findings. First, due to the observational nature, the cross-sectional design of the study limits the ability to establish causal relationships and reverse causality cannot be ruled out. Second, although we have considered and evaluated a range of possible confounders, including age, gender, marital status, educational attainment, profession, monthly income, as well as lifestyle and work-related factors, other unmeasured confounding factors may exist that could either attenuate or overestimate the associations between the studied variables and QoL. Third, although the Arabic version of the WHOQOL-BREF has demonstrated good reliability in various Arab countries (e.g., Sudan, Saudi Arabia, and Kuwait) [28,29,30, 50], a pilot study should be conducted among a subgroup of the HCWs in Gaza Strip to confirm its reliability in this specific context. Fourth, recall bias was inevitable due to the self-reported nature of survey data. Moreover, social desirability and other response biases that prevailed in face-to-face research, cannot be entirely ruled out, although the respondents were assured anonymity and confidentiality, and no personal identifying information was required. Fifth, the composite outcome did not include emotional, mental, and social states, and psychological resilience, which may also affect individual QoL in complex conditions. Finally, QoL in HCWs who were from refugee families may be lower than those who were not, which should be considered in further studies.

Conclusion

In summary, the study provided evidence that HCWs in Gaza Strip exhibited moderate levels of QoL. Older age, abstaining from smoking, working in hospitals, and morning shifts were associated with higher QoL. The current study provides insights into which aspects of QoL may be particularly relevant for future investigations amidst ongoing political violence. It is recommended that the health sector implement surveillance and prevention programs focused on the mental and physical health of healthcare staff, as well as lifestyle interventions to prevent disorders and improve overall QoL. Public policies should emphasize additional support through training or educational interventions as well as reducing work schedules, particularly for younger HCWs and those working night shifts. Future longitudinal studies are needed to investigate the impact of war-related traumatic events or the broader environmental context on QoL, and identify trajectory patterns for changes in QoL.

Data availability

The data set used for this study is available upon reasonable request. The data is not publicly available due to privacy reasons.

Abbreviations

QoL:

Quality of life

HCWs:

Healthcare workers

PHCs:

Primary healthcare centers

COVID-19:

Corona Virus Disease 2019

CI:

Confidence interval

NIS:

New Israeli shekels

WHOQOL-BREF:

the World Health Organization Quality of Life Brief questionnaire

SPSS:

Statistical Package of the Social Sciences

SD:

Standard deviation

ANOVA:

Analysis of variance

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Acknowledgements

We would like to thank all participants who accepted to participate in this study and the administrators of healthcare facilities who participated in the study for their generous support to nurses, doctors, research assistants, and nutritionists who helped in data collection.

Funding

This study was supported by the Key Research and Development Program of Shaanxi (2022SF-185) and the Fundamental Research Funds for the Central Universities (qngz2016004 and xzy032019008). The founders had no role in the study design, implementation, analysis, decision to publish, or reparation of the manuscript.

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Author notes

  1. Lina Wang is considered as the co-author.

  2. Joma Younis and Lina Wang contributed equally to this work.

Authors and Affiliations

  1. General Practice Department, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China

    Joma Younis & Wei Zhang

  2. School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China

    Joma Younis, Lina Wang, Hong Jiang, Yahui Fan, Zhaofang Li, Mei Ma, Le Ma, Zhaozhao Hui & Linlin Hua

  3. Ministry of Health, Gaza, Palestine

    Joma Younis & Amal Abed

  4. Advanced Medical Center, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Linlin Hua

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  1. Joma Younis
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Contributions

LM, JY, and ZH generated the idea for the study and formulated a research plan. JY wrote the original draft preparation. LW, AA, HJ, YF, ZL, MM, WZ, and LH revised the manuscript and interpreted the data. LM and ZH supervised the study. All authors acquired, analyzed, and interpreted the data. All authors have read and approved the final manuscript. LW is considered as the co-author, JY and LW contributed equally to this work.

Corresponding authors

Correspondence to Zhaozhao Hui, Linlin Hua or Wei Zhang.

Ethics declarations

Ethics approval and consent to participate

All participants provided informed consent. The study was approved by the Palestinian Health Research Committee (PHRC) at the Directorate General of Human Resources Development, Ministry of Health, Gaza (PHRC/HC/663/19). All methods were carried out in accordance with relevant guidelines and regulations. All data and information were kept confidential, and analysis and reporting were anonymous. There were no physical risks as there was no intervention such as blood sampling during the study.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Younis, J., Wang, L., Abed, A. et al. Quality of life among healthcare workers in the hospitals and primary healthcare centers in Gaza Strip: a cross-sectional study. BMC Psychol 13, 69 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40359-025-02386-9

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  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40359-025-02386-9

Keywords

BMC Psychology

ISSN: 2050-7283

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