Self-perceived MHPSS competency and war-related exposure among nurses in Gaza: a cross-sectional study

To assess self-perceived mental health and psychosocial support (MHPSS) competencies among nurses working in Gaza and examine differences according to demographic, professional, and war-exposure characteristics. Nurses in conflict settings frequently provide psychosocial support while working under insecurity, mass casualties, disrupted services, and personal exposure to traumatic events. However, evidence regarding nurses’ MHPSS competencies in Gaza remains limited. A cross-sectional descriptive study was conducted among 102 nurses working in governmental hospitals, private hospitals, and health service points in Gaza. Data were collected between January–April 2026 using a structured self-administered questionnaire comprising demographic and professional characteristics, a 42-item MHPSS competency scale, and a 5-item war-related exposure scale. The response rate was 68%. Descriptive statistics, independent-samples t tests, one-way analysis of variance, and Pearson correlation analysis were performed. The overall mean MHPSS competency score was 2.83. Relatively higher scores were observed for strengthening support systems, problem-solving, professional boundaries, and knowledge of psychosocial resources, whereas lower scores were found for classification of mental disorders, anxiety-related disorders, support for unaccompanied children, and suicide-risk assessment. Self-perceived competency scores did not differ significantly according to demographic or professional characteristics. War-related exposure showed a weak positive correlation with overall MHPSS competency ( r = 0.247, 95% CI = 0.055–0.421, p = 0.012), explaining approximately 6.1% of the variance in self-perceived competency(r² = 0.061). Older nurses and those with more than 10 years of experience reported significantly higher war-exposure scores. Nurses in Gaza reported an overall self-perceived MHPSS competency score below the theoretical competent level, with relatively higher self-perceived competency in supportive-care domains and lower self-perceived competency in specialized psychosocial assessment and risk management. Although war exposure was positively associated with self- competency, the association was weak, suggesting that factors beyond war exposure contribute to self-perceived competency development. Unlike previous studies conducted in conflict-affected settings such as Yemen, Syria, and Ukraine, this study simultaneously examined nurses’ self-perceived MHPSS competency and war-related exposure in Gaza, providing context-specific evidence from one of the world’s most protracted humanitarian crises. Given the cross-sectional design and convenience sampling, causal inferences and generalizability should be interpreted with caution. These findings support the need for context-specific MHPSS education, ongoing clinical supervision, strengthened referral pathways, and staff-support strategies.