Military checkpoint exposure and predictive factors of quality of life among nurses during the 7th of October war in Palestine: a cross-sectional observational study

BACKGROUND: During the 7th of October war in Palestine, nurses faced extreme stress from checkpoint delays, violence, and limited access to supportive healthcare systems. OBJECTIVE: To assess military checkpoint exposure and predictive factors of QoL among nurses during the 7th of October war in Palestine. METHODS: A cross-sectional study was conducted in May 2025 among 350 nurses in Palestinian hospitals. A self-administered questionnaire collected sociodemographic data, war-related exposures, and WHOQOL-BREF scores. Data were analyzed using SPSS version 29, with multiple linear regression identifying predictors of QoL. RESULTS: More than half of the nurses (52%) reported passing through military checkpoints to reach work, and 70.6% experienced violence, predominantly psychological. Poor QoL was most prevalent in the environmental (75.4%), psychological (60.3%), and physical (60%) domains. Passing through checkpoints (β = -0.261, p < .001), experiencing violence (β = -0.224, p < .001), and having a close relative injured or killed (β = -0.246, p < .001) were significant negative predictors, whereas higher education level was a positive predictor (β = 0.227, p < .001). CONCLUSION: Nurses' QoL was severely compromised during the conflict, particularly in environmental and psychological domains. Checkpoint exposure, violence, and personal loss emerged as the strongest negative predictors, while higher education was associated with better QoL. Addressing these factors through institutional safety measures, targeted psychosocial support, and workforce protection policies is critical to sustaining nursing capacity in politically unstable and high-risk environments.