RESILIENCE-BUILDING INTERVENTION for EMERGENCY NURSES IN PALESTINIAN HOSPITALS (RBI-ENPH)

RESILIENCE-BUILDING INTERVENTION ON PSYCHOLOGICAL WELL-BEING AND ADVANCED LIFE SUPPORT PERFORMANCE AMONG EMERGENCY NURSES IN PALESTINIAN HOSPITALS: A QUASI-EXPERIMENTAL STUDY

The goal of this quasi-experimental clinical trial is to evaluate the effect of a culturally adapted, six-week resilience-building programme on psychological well-being and clinical performance in emergency nurses working in Palestinian hospitals. The main questions it aims to answer are:

Does the six-week resilience-building programme improve the psychological well-being of emergency nurses? Does the intervention enhance their Advanced Life Support (ALS) performance during a simulation-based assessment? Researchers will compare the intervention group receiving the resilience-building programme to a non-equivalent control group to see if the intervention leads to significant improvements in adaptive coping, mental health, and simulated clinical performance.

Participants will:

Participate in a six-week resilience-building programme integrating cognitive-behavioural techniques, mindfulness, stress inoculation training, and mental rehearsal (intervention group only).

Complete validated questionnaires to measure psychological well-being and resilience before and after the study period.

Complete a standardized, high-fidelity simulated scenario to assess their Advanced Life Support (ALS) clinical performance.

Study Overview

• Status: Not yet recruiting
• Conditions: Resilience, Psychological
• Intervention / Treatment: Behavioral: Culturally Adapted Resilience-building Programme

Detailed Description

Emergency nurses in Palestine operate under severe clinical and contextual stressors, including prolonged political conflict, acute resource shortages, and high patient acuity. Chronic exposure to these multifaceted stressors often leads to elevated psychological distress, which not only impacts the nurses' mental health but also has the potential to impair their clinical performance in high-stakes, life-saving situations. Addressing both psychological well-being and clinical competence is critical in this high-pressure environment.

Guided by Roy's Adaptation Model, this research addresses a critical gap in the literature by evaluating a dual-outcome intervention. The study hypothesizes that by enhancing adaptive coping mechanisms, nurses will not only improve their personal psychological resilience but also maintain or improve their objective clinical performance under stress.

To achieve this, the study utilizes a quasi-experimental, non-equivalent control group pre-test/post-test design. To prevent treatment contamination between groups, allocation to either the intervention or control group is conducted at the hospital level.

The intervention consists of a culturally adapted, six-week resilience-building programme. It is specifically designed for the Palestinian context and integrates elements of cognitive-behavioural techniques, mindfulness, stress inoculation training, and mental rehearsal. The study will evaluate the programme's effectiveness by assessing changes in psychological well-being and objective clinical performance (specifically, Advanced Life Support [ALS] skills) before and after the study period. By utilizing high-fidelity simulated scenarios alongside validated psychometric tools, this study aims to provide robust, evidence-based recommendations for integrating psychological resilience training into clinical performance frameworks and nursing education.

• Study Type: Interventional
• Enrollment (Estimated): 140
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: saqr moufeed alkorom; Phone Number: +972598601546; Email: saqer.al-qoroum@nu-vte.edu.ps

Study Locations

• Palestinian Territories
  • West Bank
    • Nablus, West Bank, Palestinian Territories, 00970
      • Saqr
      • Contact: saqr moufeed alkorom; Phone Number: +972598601546; Email: saqer.al-qoroum@nu-vte.edu.ps

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Registered nurses currently employed in the Emergency Department of the selected Palestinian hospitals.

Nurses working full-time Willingness to commit to the 6-week intervention program and complete all simulation-based assessments.

Provided written informed consent to participate in the study.

Exclusion Criteria:

• Nurses who have participated in formal resilience or stress management training programs within the past year.

Nurses currently receiving medical or psychological treatment for diagnosed mental health conditions.

Nurses with physical or medical conditions that prohibit them from performing Advanced Life Support (ALS) chest compressions during the simulation assessment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Group (Resilience Programme); Participants in this arm will receive the culturally adapted, six-week resilience-building programme.	Behavioral: Culturally Adapted Resilience-building Programme; A six-week programme integrating cognitive-behavioural techniques, mindfulness, stress inoculation training, and mental rehearsal. The programme is specifically adapted for the Palestinian emergency nursing context to enhance adaptive coping mechanisms and psychological well-being.
No Intervention: Control Group; Participants in this arm will not receive the resilience-building programme and will continue with their standard practice

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychological well-being and resilience score	Psychological resilience is measured using the Connor-Davidson Resilience Scale (CD-RISC-10). The scale consists of 10 items. The total score is calculated by summing all item scores. The total score ranges from a minimum of 0 to a maximum of 40. Higher scores indicate greater psychological resilience and better adaptive coping.	Baseline and after 6 weeks.
Advanced Life Support (ALS) Clinical Performance Percentage	Clinical performance is assessed during a simulated Pulseless Ventricular Tachycardia scenario using the CPR Performance Assessment Checklist Based on AHA Guidelines. The assessment evaluates 15 critical actions. The total score is calculated as a percentage, ranging from 0% to 100%. Higher scores indicate better clinical performance and adherence to standard protocols, with scores of 90% or above categorized as "Excellent	Baseline and after 6 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychological Distress (Depression, Anxiety, and Stress) Scores	Psychological distress is measured using the Depression, Anxiety and Stress Scale (DASS-21). The scale evaluates three subscales: Depression (7 items), Anxiety (7 items), and Stress (7 items). The score for each subscale is calculated by summing the specific items and multiplying the sum by 2. Each of the three subscale scores ranges from a minimum of 0 to a maximum of 42. Higher scores indicate greater levels of depression, anxiety, and stress, reflecting poorer psychological well-being.	Baseline and after 6 weeks.

Collaborators and Investigators

• Sponsor: Nablus University for Vocational and Technical Education

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: July 9, 2026
• First Submitted That Met QC Criteria: July 9, 2026
• First Posted (Actual): July 14, 2026

Study Record Updates

• Last Update Posted (Actual): July 14, 2026
• Last Update Submitted That Met QC Criteria: July 9, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 2026421-16646

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No