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Lizy Sonia Benjamin,1 Eddieson Pasay-an,2 Petelyne Pangket,3 Aidah Sanad Alqarni,4 Ferdinand Gonzales,4 Lailani Sacgaca,5 Dawlat Ahmed Mahmoud,1 Maysa M Mohsen,4 Yahya Showkan Ali Hamdi,6 Sumathi Robert Shanmugam7 1Department of Medical-Surgical Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 2Department of Nursing Administration, College of Nursing, King Khalid University, Abha, Saudi Arabia; 3Department of Medical Surgical Nursing, University of Hail, Hail City, Saudi Arabia; 4Department of Fundamental of Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 5Department of Nursing, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia; 6Nursing Service, Aseer Central Hospital, Aseer, Saudi Arabia; 7Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Sumathi Robert Shanmugam, Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia, Email srshanmugm@pnu.edu.saIntroduction: Nursing students frequently encounter the challenge of balancing their studies with the demanding requirements of hands-on practice and this can greatly affect their mental wellbeing. This study aimed to investigate the impact of sleep and psychological well-being on the academic and clinical performance of nursing students in Saudi Arabia.Methods: This study used a cross-sectional approach with 218 student nurses selected through convenience sampling from King Khalid University, Abha, Saudi Arabia. The sleep quality, psychological wellbeing, academic performance and clinical performance questionnaires were adopted to measure the variables. The Google Forms survey was used to gather the data, which were collected in August through October 2023. t-test and chi-square were used to analyze the data.Results: The sleep quality was higher with good/very good performers (p < 0.001). There was a significant difference with academic performance on positive relations (p < 0.007) and purpose in life (p < 0.004). Additionally, there was a significant difference in autonomy (p < 0.01), environmental mastery (p < 0.026), positive relations (p < 0.001), and purpose in life (p < 0.001) with clinical performance. Among students with good academic performance, those who were older than 25 years of age (p < 0.043) and level 3 students (p < 0.001) were found to have a significant correlation. Furthermore, those who were 25 years of age (p < 0.012) and level 3 students (p < 0.001) were also found to have a significant correlation with clinical performance.Conclusion: The sleep quality, positive relations, purpose in life, autonomy, and environmental mastery are all important factors for academic and clinical success. Moreover, older students and level 3 students may be more likely to have the skills and knowledge necessary to succeed in these areas. Further research exploring factors influencing academic and clinical success must be conducted.Keywords: sleep quality, psychological well-being, academic performance, clinical performance, nursing students, Saudi Arabia

Sameer A Alkubati,1 Salman Hamdan Alsaqri,1 Gamil G Alrubaiee,2 Mokhtar Abdu Almoliky,1 Talal Ali Hussein Alqalah,1 Eddieson Pasay-An,3 Awatif Mansoor Alrasheeday,4 Shimmaa Mohamed Elsayed5 1Department of Medical Surgical Nursing, University of Hail, Hail, Saudi Arabia; 2Department of Community Health, University of Hail, Hail, Saudi Arabia; 3Fundamental of Nursing Department, King Khalid University, Abha, Saudi Arabia; 4Nursing Administration Department, University of Hail, Hail, Saudi Arabia; 5Critical Care and Emergency Nursing Department, Damanhour University, Damanhour, EgyptCorrespondence: Sameer A Alkubati, Department of Medical Surgical Nursing, University of Hail, Hail, Saudi Arabia, Tel +966506575284, Email alkubatisa@yahoo.comBackground: A continuous and high frequency of alarms from monitoring and treatment devices can lead to nurses’ sensory exhaustion and alarm fatigue in critical care settings.Aim: The purpose of this study was to evaluate the level of alarm fatigue and determine the relationship between nurses’ sociodemographic and work-related factors and the level of alarm fatigue in critical care settings in Hail City, Saudi Arabia.Methods: Between May and July 2023, 298 nurses who worked in the emergency, intensive care, and critical care units of all the public hospitals in Hail City participated in a cross-sectional survey. Sociodemographic and work-related sheet and the Nurses’ Alarm Fatigue Questionnaire were used to collect data.Results: The total mean score of alarm fatigue was 26.38± 8.30 out of 44. The highest score was observed for the item “I pay more attention to the alarms in certain”, while the lowest score were observed for the items “I turn off the alarms at the beginning of every shift” with mean scores of 2.51 and 1.61, respectively. Nurses who were males, older than 30 years and Saudi citizens had significantly higher mean scores of alarm fatigue than their counterparts. In addition, significantly higher mean scores of alarm fatigue were noticed for nurses experienced for 10 years or more and who had regular morning shifts. Multiple linear regression showed that male (p=0.014), age (p=0.012), and Saudi nationality (p < 0.029) were the independent factors affecting the level of fatigue alarm among nurses.Conclusion: Nurses working in critical care settings at hospitals in Hail city are exposed to average levels of alarm fatigue, which can be influenced by sex, age, nationality, and experience of nurses. Therefore, it is imperative to manage alarm fatigue in critical care units by considering work-related and personality-related factors to ensure patient safety.Keywords: alarms, fatigue, nurses, intensive care units, emergency

Objective: This study aimed to assess nurses' perceptions of patient safety culture (PSC) and its relationship with adverse events in Hail City, Saudi Arabia., Design: A cross-sectional study was conducted between 1 August 2023 and the end of November 2023 at 4 governmental hospitals and 28 primary healthcare centres., Setting: Hail City, Saudi Arabia., Participants: Data were collected from 336 nurses using 3 instruments: demographic and work-related questions, PSC and adverse events., Results: Nurses had positive responses in the dimensions of 'teamwork within units' (76.86%) and 'frequency of events reported' (77.87%) but negative responses in the dimensions of 'handoffs and transitions' (18.75%), 'staffing' (20.90%), 'non-punitive response to errors' (31.83%), 'teamwork across units' (34.15%), 'supervisor/manager expectations' (43.22%) and 'overall perception of patient safety' (43.23%). Significant associations were found between nationality, experience, current position and total safety culture, with p values of 0.015, 0.046 and 0.027, respectively. Nurses with high-ranking perceptions of PSC in 'handoffs and transitions,' 'staffing' and 'teamwork across hospital units' reported a lower incidence of adverse events than those with low-ranking perceptions, particularly in reporting pressure ulcers (OR 0.86, 95% CI 0.78 to 0.94, OR 0.82, 95% CI 0.71 to 0.94 and OR 0.83, 95% CI 0.70 to 0.99, respectively) (p<0.05). Nurses with high-ranking perceptions of PSC in UK 'handoffs and transitions' reported a lower incidence of patient falls. Similarly, those with high-ranking perceptions in both 'handoffs and transitions' and 'overall perception of patient safety reported a lower incidence of adverse events compared with those with low-ranking perceptions, especially in reporting adverse drug events (OR 0.83, 95% CI 0.76 to 0.91 and OR 0.75, 95% CI 0.61 to 0.92, respectively) (p<0.05)., Conclusion: From a nursing perspective, hospital PSCs have both strengths and weaknesses. Examples include low trust in leadership, staffing, error-reporting and handoffs. Therefore, to improve staffing, communication, handoffs, teamwork, and leadership, interventions should focus on weak areas of low confidence and high rates of adverse events., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Fatigue has been reported to be the most common symptom experienced by patients receiving hemodialysis (HD) therapy. Fatigue can lead to a reduction in their ability to engage in both routine and self-care activities, which can negatively affect their self-confidence and quality of life. This study aimed to determine the level of fatigue and the factors that affecting its level among patients receiving uHD., Methods: A cross-sectional design was utilized to explore the level of fatigue among patients receiving maintenance HD using the Mul-tidimensional Assessment of Fatigue (MAF) scale. Data were collected from four dialysis centers in two Saudi Arabia cities, Hail and Al-Qassim, between January 2022 and October 2022., Results: The questionnaire was completed by 236 patients. Older patients, male patients, and retired pa-tients reported significantly higher levels of fatigue ( p  < 0.001). In contrast, marital status, educational level, and financial status did not significantly affect the level of fatigue among patients ( p  = 0.193, 0.285, and 0.126, respectively). Patients who had seven or more dependents reported more fatigue than those who had lower levels of fatigue or who did not have dependents ( p  = 0.004). In addition, patients who had a regular exercise regimen reported significantly lower fatigue than those who did not have an exercise regimen ( p  = 0.011). Multiple linear regression demonstrated that employment status (student), comorbidity condition (one chronic disease), dialysis duration, satisfaction with dialysis time, and dialysis time were found to affect the fatigue scores (R2 = 0.302, p ˂ 0.001)., Conclusion: The findings of this study gives a broader understanding of factors influencing fatigue among patients with HD that will help to develop strategies of more focused interventions to reduce fatigue among patients with HD.

Introduction: Understanding the emotional intelligence (EI) and self-esteem of Indian and Saudi nursing students is important because their future nurse-patient relationships may be influenced by factors related to their unique cultural contexts. Hence, this study sought to investigate the EI and self-esteem of nursing students in Saudi Arabia and India., Methods: A descriptive-comparative research design was used to compare 660 nursing students from Saudi Arabia and India who were enrolled in the study from September 2022 to January 2023. Nursing students were recruited from University A in Riyadh and University B in Abha, Saudi Arabia, and from University C in India., Results: The study found significant differences in EI scores based on year of study (p < .011), age (p < .024), residence (p < .005), and academic performance (p < .008). Students in later years, over 20 years old, from urban areas, and with good grades, had higher EI scores. Conversely, only age showed a significant difference in the self-esteem scores (p < .002). The year of study (p > .670), residence (p > .430), and academic performance (p > .526) did not significantly affect self-esteem. Finally, urban residence and good academic performance were significant predictors of EI (p < .005), while none of the demographics predicted self-esteem (p > .005)., Conclusion: Higher emotional intelligence among nursing students can be associated with several variables, such as being in the higher years of study, older age, residing in an urban area, and good academic performance, whereas self-esteem appears to be hardly affected by these indicators but probably influenced by other aspects that were not measured. This implies that educators in relation to self-esteem should know the relationship between emotional intelligence and nursing practice besides healthcare establishments; they need to enhance their teaching methods so that learners can have more resilient attitudes towards work, provide quality patient care, and promote a better learning environment for nurses who will become stronger professionally in the future., (© 2024. The Author(s).)

Introduction: Perception of illness (PI) and self-medication (SM) have been thoroughly explored in the existing literature. However, there is a lack of understanding about the mediating effect of health literacy on PI and SM in a non-homogenous population like Saudi Arabia. As such, primary healthcare nurses who have constant interaction with the outpatients have difficulty addressing self-medication. This study aimed to investigate health literacy as mediator between PI and SM among outpatients in the Kingdom of Saudi Arabia (KSA)., Methods: This study employed a cross-sectional approach and was conducted at 10 major primary healthcare (PHC) clinics serving 30 million individuals in 13 different regions of KSA. The 424 outpatients who participated in this study were selected through convenience sampling. Data collection started in November 2022 and concluded in February 2023., Results: The mean of the Brief Health Literacy Screening Tool, self-medication scale (SMS), and PI scores were 13.01 ± 3.32, 27.46 ± 7.01, and 45.56 ± 7.69, respectively. There was a significant relationship between the age and BRIEF scores (p = 0.039), and the level of education was significantly related to all variables, as were nationality and BRIEF scores (p = 0.001). Finally, occupation was significantly related to BRIEF and SMS scores (p = 0.001 and 0.003, respectively). Completing college and being non-Saudi had positively significant effects on health literacy (p < 0.01). The structural equation model (SEM) found no effect of PI on health literacy or SM behaviour (p = 0.263 and 0.84, respectively), but health literacy did have an effect on SM behaviour (p<0.001)., Conclusion: Health literacy is an important factor in self-medication behavior and that PI is not directly related to health literacy or self-medication behavior, but that health literacy does influence self-medication behavior. Therefore, primary healthcare givers should promote public health literacy alongside the control of other conditions as one of the most effective ways to decrease the prevalence of self-medication and the risks associated with it., (© 2024. The Author(s).)

Background: Patients on hemodialysis (HD) are more likely to experience sleep problems and fatigue that may affect their health outcomes. Management of these patients with social support may improve their sleep quality and fatigue as well as their health., Aim: This study aimed to assess the influence of social support on sleep quality and fatigue levels among HD patients., Methods: A cross-correlational study was conducted among 260 conveniently sampled HD patients from four dialysis centers in Hail and Al-Qassim cities of Saudi Arabia from Jun 2022 to January 2023. Besides sociodemographic data, the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Assessment of Fatigue (MAF) and the Oslo Social Support Scale (OSSS-3) were used to assess sleep quality, fatigue levels and social support, respectively. Chi-square test was used to determine the association between categorical variables, while Pearson's correlation coefficient was used to test the correlation between sleep quality, fatigue, and social support., Results: Poor sleep and high fatigue were significantly higher in older patients compared to younger patients ( p <0.001), while strong social support was significantly lower in older patients than younger and middle-aged ones ( p = 0.001). On the other hand, poor sleep and high fatigue were significantly higher in males than females ( p = 0.022 and p <0.001, respectively), while strong social support was significantly higher in females than males ( p <0.001). Married patients showed significantly poorer sleep than single ones ( p = 0.019), but single patients received significantly stronger social support. Retired patients showed significantly poorer sleep, higher fatigue and weaker social support than other groups ( p <0.001). There was a significant negative correlation between fatigue and sleep quality among HD patients, where patients with more fatigue had poorer sleep ( r = -0.510, p <0.001). A significant positive correlation was found between social support and sleep quality, where patients with stronger social support had more normal sleep ( r = 0.415, p <0.001). However, a significant negative correlation was found between social support and fatigue, where patients with stronger social support had lower levels of fatigue ( r = -0.479, p <0.001)., Conclusion: Saudi patients on HD who have stronger social support have better sleep quality and reduced fatigue levels than those with less social support. There is a need to design and implement intervention studies with structured social support programs, and to evaluate their effectiveness on improving sleep and reducing fatigue among HD patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Alshammari, Alkubati, Pasay-an, Alrasheeday, Madkhali, Edison, Bakthavatchaalam, Alshammari, AlRashidi and Alshammari.)

Background: Considering the positive influence of simulation from previous literature may encourage educators to regard it as a valuable teaching strategy in nursing schools. This literature review aims to investigate whether the use of simulation improves undergraduate nurses' self-confidence during clinical practice., Methodology: This study employed a literature-based design. Five academic databases, including CINAHL, EBSCO, ProQuest, PubMed and Medline, were utilised to extract relevant studies using appropriate keywords and Boolean operators. Studies published in the last 15 years (2005-2020) were included in the search. Studies were retrieved using the Exclusion and Inclusion criteria. The Critical Appraisal Skills Programme (CASP) was used to critically appraise the studies., Results: A total of 15 primary research studies were extracted for review. Four major themes emerged from the review: Improved self-confidence to carry out clinical tasks, Increased ability to work in teams, Improved self-confidence to perform community work and Improved self-confidence in communicating with patients and team members., Conclusion: Clinical simulation is a useful tool in increasing the self-confidence of nursing students to perform clinical tasks, make clinical judgements, communicate with patients and team members and improve their teamwork. To improve the quality of care received by patients, it is recommended that clinical simulations be integrated into the nursing curriculum in Saudi Arabia. Increasing the confidence of students has been shown to be associated with greater confidence in performing clinical tasks., (© 2023. The Author(s).)

(1) Background: Sleep quality is one of the most important clinical outcomes of hemodialysis (HD) patients, as it can affect their physical and mental health. This study aimed to investigate sleep quality and its affecting factors among patients with HD. (2) Methods: A cross-sectional design was used to investigate the quality of sleep among HD patients in two cities in Saudi Arabia. The data were collected during the period from January to December 2022. A convenience sample of 250 HD patients was selected in this study. Data were collected using the Arabic version of the Pittsburgh Sleep Quality Index (PSQI). (3) Results: About two-thirds of participants (63.6%) had normal sleep, while one-third had poor sleep (36.4%). There was a significant relationship between the participants' age and the quality of sleep, where participants who were aged more than 50 had poorer sleep than those who were younger ( p < 0.001). Male and married participants significantly had poor sleep more than female and single participants ( p = 0.011 and 0.015, respectively). In addition, participants who were retired, had a higher number of dependents, did not adhere to exercise, and had more comorbidities had significantly poorer sleep than other groups ( p = 0.002, 0.016, 0.023, and <0.001, respectively). The level of education, financial status, distance from home to dialysis center, and participants' satisfaction at the time of dialysis had no influence on the quality of sleep among HD patients. The multiple linear regression shows that exercise ( p = 0.017), the number of comorbidities ( p = 0.008), and the duration of dialysis ( p < 0.020) were the independent factors affecting the quality of sleep among HD patients. (4) Conclusions: About one-third of HD patients in this study had poor sleep. There were significant differences between patients' age, gender, marital status, and sleep-quality levels. Moreover, participants who retired, had a higher number of dependents, did not adhere to exercise, and had more comorbidities had significantly poorer sleep than other groups. Future studies should develop appropriate interventions to address the problem of poor sleep quality among HD patients.

(1) Background: Nurses' attitudes toward electronic health records (EHRs) is a very valuable issue that needs to be evaluated, understood, and considered one of the main factors that can lead to its improvement or handicap its implementation. This study aimed to assess nurses' attitudes toward EHRs and associated factors that affect the implementation of EHRs in different hospitals in Saudi Arabia. (2) Methods: A cross-sectional study was utilized to collect data from 297 nurses working in public hospitals and primary healthcare centers in Ha'il Province from January to May 2023. Data were collected using the Nurses' Attitudes Towards Computerization questionnaire and a sociodemographic and work-related characteristics sheet. (3) Results: Most of the participants' attitude scores (81.1%, n = 241) were more than or equal to 60, representing positive attitudes, whereas 18.9% ( n = 56) of the nurses' scores were less than 60, which is interpreted as negative attitudes. There was a significant relationship between nurses' attitudes toward EHRs and a participants' sex, where males had a more positive attitude than females ( p < 0.001). Particularly, young nurses and those who had previous computer experience had a more positive attitude than older nurses and those who had no computer experience ( p = 0.044 and < 0.001, respectively). Saudi nurses holding a master's degree had significantly more positive attitudes toward EHRs than non-Saudi nurses holding a bachelor's or diploma degree ( p = 0.007 and 0.048, respectively). Nurses with less experience (less than five years) in the nursing field had a significantly positive attitude. Multiple linear regression showed that sex ( p = 0.038), level of education ( p = 0.001), and previous computer experience ( p < 0.001) were independent factors of nurses' knowledge of EHRs. (4) Conclusion: The majority of nurses had positive overall attitudes toward using EHRs. Nurses who are Saudi nationals, male, younger, have previous computer experience, and have less than five years of experience had a more positive attitude toward EHRs than nurses who are non-Saudi, female, older, have no computer experience, have bachelor's or diploma degree, and have less than five years of experience, respectively. Sex, education level, and previous computer experience were independent factors of nurses' knowledge of EHRs.

Introduction: Patients' assessment of care navigating cardiovascular disorders is imperative in improving the quality of care provided. The purpose of this study was to explore the perspectives of people living with cardiovascular disorders on the care they received and its relationship with general self-efficacy., Methods: This investigation employed a cross-sectional correlational approach. The study sample was comprised of patients with cardiovascular disorders from both the King Khalid Hospital and the King Salman Specialist Hospital, in Hail City, Saudi Arabia. Convenience sampling was used, resulting in 104 participants. A survey using a self-administered questionnaire was employed to collect the data, which ran from 10 March to 20 May 2023., Results: The participants perceived that they occasionally (2.75 ± 1.053) received care, and they perceived themselves to have better self-efficacy (25.28/40). Of note, the age (0.062), years of being diagnosed with having the disease (-0.174), sex (0.180), educational attainment (0.125), and occupation (0.206) were found to have no significant relationship with the patient assessment of care with chronic cardiovascular disease (PACIC). However, civil status (0.867) was found to have a strong positive correlation to the PACIC. No significant relationship was found between age and GSE (0.070) and PACIC (0.62), civil status with GSE (0.013), years being diagnosed with having the disease with GSE (0.095), and PACIC (0.174) educational attainment with GSE (0.088) and PACIC (0.125) or occupation (0.115) with GSE. However, sex (0.795) was found to have a strong correlation with general self-efficacy (GSE). Of note, patient activation (0.390) and goal setting (0.360) had a moderate positive correlation while problem solving (0.228) and follow-up (0.278) had a weak positive correlation to GSE. Meanwhile, the delivery system (0.507) had a strong positive correlation to GSE. This study illuminates the value of self-efficacy and patient involvement as self-management techniques for cardiovascular illnesses. Future cardiovascular illness self-management initiatives should concentrate on enhancing patient self-efficacy by adopting the PACIC.

Background and Aim: Because they are unaware of the potential adverse effects of medications, people frequently self-medicate as a form of self-care. This study aimed to investigate the factors associated with health literacy and the propensity to self-medicate among the primary healthcare clientele of the city of Hail, Saudi Arabia., Methods: This research employed a cross-sectional approach with the participation of 383 primary health center clientele of the Hail Region of Saudi Arabia. Participation was enacted via convenience sampling from December 2022 to February 2023. The data were collected using a self-administered questionnaire. The investigation utilized descriptive statistics as well as multiple linear regression and correlation for the data analysis., Results: Participants who were aged 30 years and above, single, had a college degree, were non-Saudi, had a white-collar occupation and received information from the internet/Google/YouTube had a significant relationship ( p < 0.05) with health literacy. On the self-medication scale (SMS), there were significant relationships with age, marital status, educational level and occupation ( p < 0.05). The nationality and source of information factors related to health had a positively significant effect on health literacy ( p < 0.01), while middle age (24-29 years) had a positive effect on the self-medication scores ( p < 0.01). There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS) scores (r = 421, p < 0.001)., Conclusion: Age of 30 years old or above, single status, a college degree, non-Saudi status, white-collar occupation and receiving information from the internet/Google/YouTube were all significant for health literacy. There were also significant relationships with the SMS scores for age, marital status, educational level and occupation. The factors affecting health literacy were older participant age, nationality and the source of information regarding health. Conversely, among the participants, being in the middle-aged group (24-29 years) was a factor that affected their self-medication scores. There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS).

Background: One of the defining characteristics of safe and highly reliable patient care is effective team communication. It is becoming increasingly crucial to improve communication among healthcare team members since social and medical conditions change quickly. Main aim: The present study seeks to assess nurses' perception of the quality of communications between physicians and nurses and associated factors in the emergency departments of selected government hospitals in Saudi Arabia. Methods: A cross-sectional study was carried out in five hospitals in Jazan and three hospitals in Hail City, Saudi Arabia, on a convenience sample of 250 nurses total using self-administered questionnaires. Independent sample t-tests and one-way ANOVA were used for the data analysis. Ethical considerations were adhered to throughout the conduct of the study. Results: The mean score of all domains of nurses' perceptions of the quality of nurse-physician communication in emergency departments was 60.14 out of 90. The highest mean score was observed in the openness subdomain, followed closely by relevance and satisfaction, with mean percentages of 71.65% and 71.60%, respectively. Age, level of education, years of experience, and job position had significant positive correlations with nurses' perceptions of the quality of nurse-physician communication. ( p = 0.002, 0.016, 0.022, and 0.020, respectively). Post hoc tests showed that nurses older than 30, those with diplomas, those with more than 10 years' experience, and those in supervisory positions had more positive perceptions of the quality of nurse-physician communication. On the other hand, there was no significant difference in the mean scores of quality of nurse-physician communication with regard to participants' sex, marital status, nationality, and working hours ( p > 0.05). Multiple linear regression showed that none of the independent factors affected the nurses' perceptions of the quality of nurse-physician communication in emergency departments ( p > 0.05). Conclusions: Overall, the quality of communication between nurses and physicians was not satisfactory. Future research should be meticulously planned, using validated outcome measures, that will capture and reflect the goals of communication among healthcare teams.

It is essential to understand why patients choose to leave the hospital in direct opposition to medical advice. This understanding could help to identify individuals who are at risk of adverse outcomes. In realizing this need, this study aimed to explore the factors contributing to the decision of patients to leave the hospital against medical advice., Materials and Methods: This research employed a descriptive-analytical approach. It was conducted in the city of Hail, Kingdom of Saudi Arabia. The participants were 13 patients who had opted to leave against medical advice from the Emergency Department of the government-subsidized hospitals. The researchers employed both purposive and snowball sampling. In snowball sampling, the researchers used referrals from initial participants to generate additional participants. Moreover, purposive sampling was used to find the individual that would best contribute to addressing the research issue. The data gathering was conducted from April to June 2022., Results: Five themes emerged based on the accounts of the 13 participant patients. These included (1) health literacy, (2) self-diagnosing, (3) unclear explanations regarding their condition, (4) prolonged waiting times, and (5) communication issues., Conclusion: The factors contributing to patients leaving against medical advice resulted in the five themes mentioned above. While interactions between patients and healthcare professionals may be challenging, pertinent health information must still be handed down clearly to patients.

Previous studies have revealed various factors related to nurses' resilience and predictors of resilience. However, there are no studies analysing the association of three variables-mental well-being, coping strategies, and stress-with resilience. This study aims to assess the impact of mental well-being, levels of stress, and coping strategies on resilience using path analysis. This study used a cross-sectional approach that involved 763 nurses from 16 major hospitals in the eastern and northern regions of Saudi Arabia during the COVID-19 pandemic. The data gathering was conducted from August to November 2022. The staff nurses possessed positive mental wellness (3.75 ± 1.08), moderate stress levels (3.06 ± 1.21), adequate coping skills (3.33 ± 1.23), and a low level of resilience (2.90 ± 1.040). Age had a small effect on resilience (β = 0.040; p < 0.001) but work experience (β = -0.019; p > 0.139) and marital status (β = 0.019; p > 0.072) were not significant. Conversely, mental well-being (β = 0.043; p < 0.001) and stress (β = -0.089; p < 0.001) had a small effect on resilience, but coping strategies (β = 0.561; p < 0.001) had a large effect on resilience. Therefore, coping strategies must be reinforced at all times to assist nurses and other healthcare professionals in identifying contributing elements that maintain these workers' resilience in the face of unforeseen and protracted pandemics and other life events.

Introduction: As they are satisfied with life, nurses who demonstrate spiritual intelligence and well-being at work are tremendous assets to an organisation. This study aimed to determine the mediating effect of spiritual intelligence on the well-being and life satisfaction of nurses in the context of COVID-19. Methods: This research employed a cross-sectional study design. It was conducted in the Hail region of Saudi Arabia. The participants were government hospital nurses who were chosen using a multi-stage sampling method. A total of 1121 (75% response rate) nurses participated in the study. Data gathering was conducted from July to September 2022. Results: The life satisfaction level of the participants was deemed positive. Their well-being was better (10/15), and they rated high in spiritual intelligence (90/120). Life satisfaction had a strong association with well-being (r = 0.640, p < 0.001), but a weak association with spiritual intelligence (r = 0.391, p < 0.001). In comparison, well-being had a moderate association with spiritual intelligence (r = 0.551, p < 0.001). The direct effect of well-being on spiritual intelligence was positive and significant (β = 0.7817, p < 0.0001), and that of spiritual intelligence on life satisfaction was positive and significant (β = 0.1082, p = 0.0257). The direct effect of well-being on life satisfaction was also positive and significant (β = 1.5985, p < 0.0001). Conversely, well-being had an indirect impact on life satisfaction (β = 0.0846), and this effect was significant. Overall, the impact of well-being on life satisfaction was positive and significant (β = 1.6831, p < 0.0001). Conclusion: The nurses in this study were deemed satisfied, to have better well-being, and better spiritual intelligence. Life satisfaction has a strong association with well-being but a weak one with spiritual intelligence, while well-being has a moderate association with spiritual intelligence. Overall, spiritual intelligence was found to have a mediating effect on the relationship between well-being and life satisfaction. These findings suggest that an increase in spiritual growth can serve as the foundation for people to live better and more integrated lives.

Although numerous scholars have studied resilience during the COVID-19 pandemic, research exploring its relationship with emotional intelligence is scarce. The aim of this study was to determine the relationship between the resilience and emotional intelligence (EI) of staff nurses during the COVID-19 pandemic. Data for this quantitative correlational study were gathered from the staff nurses of hospitals in the city of Hail, Saudi Arabia. The researchers employed simple random sampling, which yielded 261 staff nurses. Nationality (t = 6.422; p < 0.001) was found to have a significant relationship with resilience. Sex (t = 5.22; p < 0.001), ward assignment (t = 5.22; p < 0.001), age (F = 6.67; p < 0.001), and years of experience (F = 6.67; p < 0.001) revealed significant relationships with emotional intelligence. Resilience had a moderate positive relationship with EI (r = 0.55; p < 0.023), a weak positive relationship with self-emotion (r = 0.21; p < 0.003), and a very strong relationship with emotional appraisal (r = 0.85; p < 0.001). Improving emotional-intelligence skills is critical for assisting nurses during pandemic outbreaks. This can increase their individual and social resilience, while also improving their professional and life outcomes. These research findings suggest that emotional intelligence should be integrated into clinical practice and that EI data should be integrated into decision-making.

How does psychology vary across human societies? The fundamental social motives framework adopts an evolutionary approach to capture the broad range of human social goals within a taxonomy of ancestrally recurring threats and opportunities. These motives-self-protection, disease avoidance, affiliation, status, mate acquisition, mate retention, and kin care-are high in fitness relevance and everyday salience, yet understudied cross-culturally. Here, we gathered data on these motives in 42 countries (N = 15,915) in two cross-sectional waves, including 19 countries (N = 10,907) for which data were gathered in both waves. Wave 1 was collected from mid-2016 through late 2019 (32 countries, N = 8,998; 3,302 male, 5,585 female; M age  = 24.43, SD = 7.91). Wave 2 was collected from April through November 2020, during the COVID-19 pandemic (29 countries, N = 6,917; 2,249 male, 4,218 female; M age  = 28.59, SD = 11.31). These data can be used to assess differences and similarities in people's fundamental social motives both across and within cultures, at different time points, and in relation to other commonly studied cultural indicators and outcomes., (© 2022. The Author(s).)

Background: This study aims to use the artificial neural network as a novel approach to explore factors that determine and predict successful performance of nursing interns in Saudi Arabia on the Saudi Nursing Licensure Examination (SNLE)., Materials and Methods: The study employed a cross-sectional, analytic approach. A total of 62 nursing interns were recruited by convenience sampling from the University of Hail to participate. Data collection was conducted from September to December 2019. Descriptive statistics were used to describe the demographic characteristics of the nursing interns and their responses regarding examination determinants. Neural network analysis was used to identify factors that are highly predictive of the success of the nursing interns on the SNLE., Results: Overall, the nursing interns were undecided (3.94 ± 0.14) about the influential factors determining their success. Their study hours (100%) and grade point average (GPA) (96.9%) were identified as strong determinants reflective of the tenacity and vigor of the nursing interns, based on the predictive power of the model. Meanwhile, age (45.7%), marital status (21.3%), gender (15.2%), and the type of academic program (5.9%) were considered the least important of the sociodemographic variables., Conclusion: Exam preparation activities such as preparation programs, review classes, and exam simulations must be promoted and enhanced to increase the passing tendencies of the nursing interns in the SNLE. The GPA and increased study hours make the most significant contributions to success on the SNLE as compared to other variables such as age, gender, marital status, and the academic program. This study serves as a springboard for nursing educators and administrators in laying tailored strategies to strengthen the nurse interns' GPA and time management., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Objectives: This study investigates the differences between nursing students' surface and deep approaches to learning across their demographic profiles. Further, this study explores the association between the participants' ages, year levels, and learning approaches., Methods: From December 2019 to February 2020, we used a quantitative-comparative- correlational study design at the University of Hail KSA. A survey-based questionnaire was used to collect data from 349 randomly selected nursing students. One-way analysis of variance (ANOVA) and t-tests were used to examine the difference between the surface learning and the deep learning approaches of the participants across their profiles. Pearson's correlation coefficient was used to determine the relationship between participants' learning approaches, ages, and year levels., Results: A significant difference in the deep learning approach was noted for age (F (3, 345) = 35.71; p  = 0.01] and program type (bridging/regular) [t (347) = -8.81, p  = 0.01]. A moderately positive significant correlation was found between age and both deep (r = 0.47, n = 349, p  = 0.01) and surface (r = 0.45, n = 349, p  = 0.01) learning approaches., Conclusion: This study shows that nursing students use both surface and deep learning approaches alike and are able to capitalise on either learning style. Both learning approaches are important and valuable in nursing education. The age of the student is correlated with the learning approach. Older students have higher scores for both deep and surface learning approaches. Academia must develop creative learning environments that can encourage students to use both approaches and to advance the transition to deep learning., (© 2020 The Authors.)

Objectives: This study aimed at exploring and comparing the vulnerability to COVID-19, demographic variables and perceived stress of frontline nurses., Methods: This study employed a quantitative comparative-correlational approach. Using the snowball sampling technique, we conducted this study involving 176 frontline nurses from hospitals of the Hail region, KSA., Results: The frontline nurses showed high perceived infectability (x = 4.36) and germ aversion (x = 5.65) but were moderately stressed (19.19). Of the examined variables, only years of experience resulted in significant differences in germ aversion ( F [3] = 8.980, p  < 0.01). There was no statistically significant difference in perceived infectability and stress. Perceived infectability ( r  = -0.152, p  < 0.05) and germ aversion ( r  = 0.007, p  > 0.05) were negatively correlated to perceived stress., Conclusion: In this study, frontline nurses perceived moderate to high stress vulnerability to COVID-19. There were significant differences in germ aversion based on the duration of experience. It is noteworthy that perceived vulnerability to COVID-19 did not impact stress. Paying attention to concerns of nurses can potentially improve preventive practices and positive behaviours in combating the pandemic., (© 2020 The Author.)