Clinical Uncertainty and Resilience in Crisis Settings (CURE): A Mixed-Methods Study on Healthcare Providers’ Lived Experiences in Gaza

Swiss partners

• SUPSI: Maria Domenica Caiata Zufferey

 MENA partners

• Israa University: Hassan Abu Obaid

Presentation of the project

Healthcare professionals in Gaza deliver care under conditions of chronic scarcity, infrastructural fragility, and recurrent political and military crises—yet continue to practice despite pervasive clinical uncertainty. In such a setting, clinical decisions are made without complete diagnostic information, standard treatment options, or reliable prognostic indicators.
While existing research has examined epidemiological and operational challenges in Gaza’s health system, little is known about how clinicians live with and respond to uncertainty.

This mixed-methods study investigates the prevalence, sources, and impacts of clinical uncertainty among healthcare providers in Gaza, and explores how they experience, interpret, and navigate it in daily practice, with particular attention to ethical challenges, adaptive strategies, decision-making, and resilience. The study employs a sequential design: a quantitative survey to assess patterns of uncertainty and perceived effects on patient care and provider well-being, with data analyzed through descriptive and inferential statistics; followed by qualitative interviews to generate narratives of lived experience, analyzed using a general inductive approach.

The study focuses on emergency medicine, surgery, internal medicine, and primary care, to reflect different dimensions of uncertainty: high-stakes decision-making (emergency medicine, surgery), management of chronic and complex conditions (internal medicine), and the uncertainties of first contact and continuity of care (primary care).

Participants include physicians, nurses, and allied health professionals directly involved in patient care. Eligibility requires at least two years of experience and consent. Using stratified sampling, 350–400 clinicians will be recruited for the survey, while 20–25 will be purposively selected for interviews to ensure diversity by specialty, gender, geography, and experience. Data collection combines digital and paper surveys, and in-depth interviews conducted in Arabic and translated into English for collaborative analysis.

Findings will map sources and impacts of clinical uncertainty, document clinicians’ strategies and resilience, and inform recommendations for clinical education, health policy, and humanitarian programming. By centering the lived realities of Gaza’s healthcare providers, the project will generate evidence with global relevance for strengthening decision-making
and resilience in crisis-affected health systems.