Impact of the October 7 Gaza war on post-traumatic stress symptoms and quality of life in Palestinian nursing

The October 7, 2023, Gaza War imposed profound psychological and occupational burdens on Palestinian nurses, including those in the West Bank who were indirectly affected by the conflict. This study assessed the prevalence of post-traumatic stress symptoms (PTSS) and quality of life (QoL) outcomes among nurses working in the West Bank. A descriptive cross-sectional study was conducted from January to March 2025 with 350 registered nurses recruited through stratified random sampling. Data were collected using the Impact of Event Scale-Revised (IES-R) to measure PTSS and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) to assess QoL. Statistical analyses included descriptive statistics, t-tests, and one-way ANOVA, with standardized effect sizes (Cohen's d for t-tests and eta-squared, η², for ANOVA) reported to indicate practical significance. Nurses reported high PTSS across intrusion (mean = 1.94), avoidance (mean = 1.79), and hyperarousal (mean = 1.78) subscales. The total PTSS score (mean = 5.51 out of a possible 12) indicated a substantial symptom burden. Nearly half (49.2%) experienced violence at Israeli checkpoints, which was associated with significantly higher PTSS (mean = 6.09 vs. 4.90; p < .001; Cohen's d = 0.49) and lower QoL (mean = 3.13 vs. 3.34; p = .001; Cohen's d = 0.36). QoL scores were poorest in physical health (55.25%), psychological well-being (56.5%), and environmental conditions (48.25%), but higher in social relationships (63.9%). The Gaza War has had a marked psychological impact on nurses in the West Bank, particularly for those exposed to checkpoint violence. Targeted, trauma-informed mental health interventions, resilience training, and systemic reforms to improve safety and working conditions are urgently needed to protect and support the nursing workforce in conflict settings.