Academic journal article Journal of Nursing Scholarship

Depression, Perceived Health, and Right-of-Return Hopefulness of Palestinian Refugees

Academic journal article Journal of Nursing Scholarship

Depression, Perceived Health, and Right-of-Return Hopefulness of Palestinian Refugees

Article excerpt

Over 65 million people are either a refugee, internally displaced, or seeking asylum; half of whom are women and children (United Nations High Commissioner for Refugees (UNHCR), 2015). Refugees represent 21.3 million or 32.8% of the world's displaced population, people who were forced to leave their homes, usually due to armed conflict. Of the 21.3 million refugees worldwide, 5.2 million Palestinian refugees are registered by the United Nations Relief and Works Agency (UNRWA), which exists for the singular purpose of providing humanitarian relief, protection, and basic health, social, education, and human development assistance to Palestinian refugees in need (UNRWA, n.d.a). A Palestinian refugee is a person "whose normal place of residence was Palestine during the period 1 June 1946 to 15 May 1948, and who lost both home and means of livelihood as a result of the 1948 conflict" (UNRWA, n.d.a, "Who are Palestine refugees," para. 1). Since 1948, the Arab-Israeli conflicts have forced Palestinians to leave their homes and seek refuge in the Occupied Palestinian Territories of the West Bank and Gaza Strip and neighboring countries (Tessler, 2017). The Hashemite Kingdom of Jordan hosts more Palestinian refugees, 2.1 million, than any country in the world, and three generations of Palestinian refugees and descendants have been born and reared in Jordan (UNRWA, n.d.c).

Forced displacement is traumatic and often an unwanted social change that can lead to a loss of identity and physical, psychological, and socioeconomic livelihood (Lori & Boyle, 2015; Marie, Hannigan, & Jones, 2016; UNHCR, 2017). For many refugee women, intimate partner and gender-based violence and associated mental health conditions have been identified as additional issues (Al-Modallal, 2012, 2016). The poor physical health, living, and socioeconomic conditions of Palestinian refugees in Jordan have been documented (Tiltnes & Zhang, 2013), although current literature about their psychological health could not be found. In neighboring countries to Jordan, 19% of Palestinian adult refugees in Lebanon were found to have mental health disorders, with 8% having depression (Llosa et al., 2014). The prevalence of depression was 11% among Palestinian adult refugees in the Occupied Palestinian Territory of the West Bank (Madianos, Sarhan, & Koukia, 2012). Depression has significant health, social, and financial impacts on individuals and society, particularly in conflict-affected populations (Ayer et al., 2015). Depression is the leading cause of disability worldwide, and the burden of depression is 50% higher for women than for men (World Health Organization [WHO], 2017). Depression is a focus that deserves attention in order to reduce its burden in a culturally appropriate manner.

Displacement is often a protracted reality for most refugees. More than half of all refugees have been displaced for 10 years or longer, and once refugees have been displaced for 6 months, they are unlikely to return to their home country (UNHCR, 2017). The United Nations General Assembly Resolution 194 Right of Return guarantees refugees the right to return to their home at the earliest feasible date (UNRWA, n.d.b). Seventy percent of Jordanians have Palestinian ancestry; thus, returning to Palestine is a desire of Palestinian refugees living in Jordan, given that a solution to the Israeli-Palestinian conflict is not imminent and most Palestinian refugees have spent their entire lives in Jordan and have never been to Palestine (Tessler, 2017; Young, 2011). Little is known about right-of-return hopefulness and how a presumed positive motivational state could affect the psychological well-being of the Palestinian refugee population.

Purpose of the Study and Conceptual Framework

The purposes of the study were to describe depressive symptom severity, perceived health, and right-of-return hopefulness; explore the association of perceived health and right-of-return hopefulness to depressive symptom severity; and examine the influence of perceived health, right-of-return hopefulness, gender, and poverty on depressive symptom severity among Palestinian refugees in Jordan. …

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