The Saudi Arabian 2030 vision and the nursing profession: the way forward

Actual Scope of Nursing Practice in Saudi Ministry of Health Hospitals

BACKGROUND

Articulating a clear scope of practice for all nursing categories is essential for improving patient safety, quality of care, and nurse retention. However, this is not the case in many countries, including Saudi Arabia. This study aimed to analyze the actual scope of practice for nursing staff in Saudi Ministry of Health hospitals.

METHODS

The study used a cross-sectional exploratory design. The sampling method used in the study was the quota sampling technique. The scale utilized in this study was the Actual Scope of Practice (ASCOP) scale. Data were collected in March 2021 through an electronic form questionnaire completed by 286 nurses in two hospitals in Al-Hasa province in Saudi Arabia.

RESULTS

The overall mean score for ASCOP was 4.64 out of 6. When participants were grouped according to select characteristics (various nursing staff categories, educational levels, years of experience, nationality, gender, and type of work setting), the results revealed no statistically significant differences in overall ASCOP mean scores, except for gender and nationality.

CONCLUSIONS

The overall mean scores of nursing activities performed in practice do not significantly differ across nurses with different professional categories (health assistant, nursing technician, nursing specialist, and senior nursing specialist), indicating no clear scope of practice for each nursing category, in turn leading to role overlap among them in practice. The current study's findings can guide decision-makers to develop a clear scope of practice for nurses. The findings should also urge the decision-makers to reevaluate the usefulness of having multiple professional categories of nurses who are allowed to carry out almost the same job duties.

Factors Affecting the Satisfaction of Women Employees in Health Sector: A Perception Study in Saudi Arabia

Purpose

Broad evidence points out that women workers in Saudi Arabia face a range of inequitable work practices despite continued efforts for gender equality. The study aims to assess the satisfaction of Saudi women working in the health sector among certain factors in the work environment, factors that enable them to gain opportunities and benefits and make decisions.

Patients and Methods

This is a cross-sectional study, which involved the use of closed-ended surveys on 261 Saudi women working in the healthcare sector.

Results

Most of the females were aged between 25 and 34 years (59%) and more than half of them worked in the governmental sector (53%). Fifty-eight percent of the females hold clinical jobs, 25% of the administrative jobs were 37% of them have more than 19 years of working experience. The finding showed a significant association between female workers in health sector satisfaction with factors related to the workplace environment, training, and development, and their involvement in decision-making.

Conclusion

Most women felt empowered when they received equitable tasks and were able to reach managerial-level positions in their organizations. Establishing a positive work environment characterized by opportunities has the potential to enhance women workers' satisfaction.

Flourishing among undergraduate nursing students: Insights from a cross-sectional study in Saudi Arabia

AIM

This study aimed to examine the factors that influence the level of flourishing among nursing students.

DESIGN

Cross-sectional study.

METHODS

A multistage sampling technique was used to recruit 328 undergraduate nursing students from a nursing college. Data were collected from February to June 2023 using the Global Flourishing Study (GFS) questionnaire, which assesses six domains of flourishing and their determinants. To ensure reliability and validity, a pilot study was conducted and a thorough validation process was employed.

RESULTS

The Flourishing Index ranged from 24.0 to 100.0, with an average score of 74.2 (SD = 14.8). Well-being, disposition and behaviour, as well as external factors, correlated strongly positively with the Flourishing Index (r = 0.741, r = 0.565, r = 0.596, all p < 0.001). The Flourishing level was significantly negatively correlated with religion (r = -0.381, p < 0.001). Married participants had a significantly negative association with flourishing (p = 0.009). Disposition and behaviour were significantly and positively associated with flourishing (p = 0.017). The regression model had goodness of fit (R2  = 0.628) and was significant overall (F = 108.703, p = 0.001). The Flourishing model was established based on well-being, external factors, religion, disposition and behaviour, and marital status.

CONCLUSION

Positive correlations between flourishing and well-being, disposition and external factors suggest areas of improvement. Conversely, the negative association with religion emphasizes the necessity of culturally sensitive approaches. Future studies with larger and more diverse samples, as well as additional variables, are crucial to obtain a deeper understanding of the factors that influence flourishing among nursing students in Saudi Arabia.

The Relationship Between Psychological Empowerment and Clinical Decision-Making Among Staff Nurses in Governmental Hospital in Al-Baha, Saudi Arabia

Background The Saudi Arabian government has published its 2030 vision for improving health care to meet worldwide standards for the nursing profession. To fulfill this vision, building large-scale healthcare facilities is necessary. Among the most common occupations, nursing is vital to health care systems. Although working in health care institutions is challenging, demanding, and comprehensive, they are created to save lives and enhance patient satisfaction. Therefore, health care organizations must seek to develop psychologically empowered and decision-making nurses who can help meet clients' demands and enhance patient care, safety, quality, and outcomes. This study aims to determine the association between psychological empowerment (PE) and clinical decision-making (CDM) among staff nurses. Methods This study employed a quantitative cross-sectional correlation design. Three Saudi Ministry of Health-affiliated hospitals in the Al-Baha region were included. The sample size was calculated using the Raosoft online sample size calculator, with a total of 318 participants. The study sample included nurses working in inpatient, outpatient, and critical care departments. Convenience sampling techniques with inclusion and exclusion criteria were employed. An online survey with three sections was used for data collection: sociodemographic characteristics, the psychological empowerment instrument, and the nursing decision-making instrument. Data collection began at the beginning of February 2023 and was completed by the beginning of April 2023. Results The participants were 318 nurses working in critical areas, inpatient, and outpatient departments at three governmental hospitals in the Al-Baha region. Overall, 285 participants (89.6%) had a high level of PE, and the majority, 263 participants (82.7%), exhibited flexible-oriented decision-making. Approximately three-quarters of the sample, 281 participants (88.4%), were female, and more than half of the staff nurses, 187 participants (58.8%), were married. The majority of participants, 250 (78.6%), had a bachelor's degree. Regarding professional experience, most staff nurses, 134 participants (42.1%), had between one and five years of experience, and the majority worked in inpatient units, 160 participants (50.3%), while 104 (32.7%) worked in critical care. Conclusion The current study found a significant association between nurses' PE and CDM. Nurses with the highest PE were the most flexible in their CDM. Moreover, the findings of this study offer some points that nurse managers and leaders can use to generate empowerment and make their staff better decision-makers. One recommendation is to develop training and coaching programs to enhance PE among staff nurses, thereby raising their work meaningfulness, which would reflect in better CDM. Additionally, this study recommends that future research be conducted to examine how PE affects CDM.

Nurses' ethical responsibilities: Whistleblowing and advocacy in patient safety

BACKGROUND

In the dynamic landscape of healthcare, nurses play a crucial role as ethical stewards, responsible for whistleblowing, nurse advocacy, and patient safety. Their duties involve ensuring patient well-being through ethical practices and advocacy initiatives.

AIM

This study investigates the ethical responsibilities of nurses regarding whistleblowing and advocacy in reporting concerns about patient safety.

RESEARCH DESIGN

A cross-sectional study utilized cluster and simple random sampling to gather a representative sample of actively practicing registered nurses. Data collection involved a demographic form, Nurse Whistleblowing Intentions Scale, Nursing Advocacy Scale, and Clinical Decision-Making Scale.

PARTICIPANTS AND RESEARCH CONTEXT

The study utilizing a robust sample size determination formula for reliable findings included 96 diverse nurses, predominantly females. Engaged actively in direct patient care across various outpatients clinics. The recruitment process specifically sought individuals with expertise in safety protocols and reporting, contributing to a nuanced understanding of the study's focus.

ETHICAL CONSIDERATIONS

Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. A thorough ethical review was conducted to guarantee participant protection and adherence to ethical principles.

RESULTS

Surveyed nurses demonstrated positive whistleblowing (Overall Mean Score: 3.58), high advocacy (Overall Mean Score: 12.2), and nuanced ethical decision-making for patient safety (Overall Mean Score: 15.78). Demographic factors, such as nationality and ethical training, significantly impacted whistleblowing intentions, while age, gender, and ethical training correlated with nursing advocacy behavior. Associations with experience and qualification emerged in ethical decision-making.

CONCLUSION

The gained insights foster targeted interventions, improving ethical practices, advocacy, and informed decision-making in nursing. This study explores the intricate link between demographics and ethical considerations among surveyed nurses, acting as a catalyst for ongoing initiatives to strengthen the ethical foundation in healthcare sector.

Nursing practice in modern healthcare environments: A systematic review of attributes, characteristics, and demonstrations

AIM

To identify Attributes, Characteristics and Demonstrations of nursing practice from both nurses' and people perspectives in today's healthcare environments. A secondary aim was to identify relevant differences between female and male nurses in the context of ACDs.

DESIGN

This systematic review was informed by the Joanna Briggs Institute Convergent Integrated Approach to Mixed Study Systematic Reviews.

METHODS

The search included articles ranging from the years 2000 to 2023 across 10 electronic databases and multiple grey literature outlets. McMaster critical review forms and the Mixed Methods Appraisal Tool were used to appraise article quality. The Convergent Integrated Approach to Mixed Study Systematic Reviews was used to guide data synthesis.

RESULTS

Twenty articles were included in this review, 13 qualitative, five quantitative and two mixed-methods studies. Three themes emerged, including knowledge, practice skills and interpersonal relationships. Differences in Attributes, Characteristics and Demonstrations of professional practice between women and men in nursing were also explored.

CONCLUSION

Findings suggest that evolving healthcare environments challenge nurses to remain focused on patient-centred and compassionate care. The review also supports nurses caring in a manner that empowers people, increases well-being, and reduces suffering.

IMPACT

Identified characteristics and attributes of nursing practice, including emphasis on continuous learning, interpersonal relationships and compassion, have a profound impact on nursing. Nurses should remain adaptable, compassionate and patient-focused in an ever-evolving healthcare environment. These foundational care principles are necessary for improving patient outcomes, enhancing trust between people and healthcare providers, and increasing inclusivity and diversity in the nursing workforce.

WIDER GLOBAL COMMUNITY

Nurses worldwide should strive to embody these attributes to provide high-quality, patient-centred care in an inclusive environment in today's demanding healthcare environment. Gender-specific differences in the perception and expression of professional Attributes, Characteristics and Demonstrations can inform inclusion and diversity efforts in the workplace.

REPORTING METHOD

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Understanding nursing perspective towards barriers to the optimal delivery of enteral nutrition in intensive care settings

BACKGROUND

The management process of Enteral Nutrition (EN) typically involves the interaction between a team of health care practitioners. Nurses being the closest to the patients, have crucial responsibilities and play a major role in feeding delivery along with other medical treatments. This study was conducted to investigate the perception of the nurses working in adult and paediatric intensive care Units (ICUs) regarding the EN barriers and identify the factors that influenced their perception.

METHODS

The data in this cross-sectional study was collected via online survey between 15 October 2021 and January 2022. All nurses working in adult or paediatric ICUs across Saudi Arabia were eligible to participate. The tool used for the data collection was adapted from Cahill et al. (2016) and then reviewed and modified by the researchers. The survey collected information about the demographics of the nurses, and it included 24 potential EN barriers where the participants were asked to rate their importance on a scale from 1 to 5. Descriptive statistics were performed to describe the variables, univariant analysis were performed to compare the perceptions of the nurses regarding the EN barriers based on their characteristics followed by stepwise linear regression analysis.

RESULTS

A total of 136 nurses working in adult and paediatric ICUs were included in this study. The results showed that the most important barriers as perceived by the nurses was "Frequent displacement of feeding tube, requiring reinsertion" [3.29 ± 1.28], "Delays in initiating motility agents in patients not tolerating enteral nutrition" [3.27 ± 1.24] and "Enteral formula not available on the unit". [3.27 ± 1.24]. Our results showed that the responses of the participants statistically varied based on their work settings, gender, region, and educational level for some items in the survey (P-value ≤ 0.05). In the regression analysis, gender was the only variable statistically influenced the total Likert rating scores of the participants (r = -0.213, p-value = 0.013).

CONCLUSION

This study identified several barriers that exist in the nursing practice of EN in critical care settings. There are distinct differences in the perception of the nurses to these barriers based on their characteristics. Understanding such differences is important for implementing future strategies for units that needed the most help in prioritizing EN delivery.

Prevalence of Varicose Veins and Its Risk Factors among Nurses Working at King Khalid University Hospital Riyadh, Saudi Arabia: A Cross-Sectional Study

This quantitative observational cross-sectional study assessed the prevalence and level of risk scores for varicose veins among nurses, and the association between varicose veins and sociodemographic, occupational, and lifestyle risk factors. Using simple random sampling, from August-December 2022, 250 nurses from different departments at King Khalid University Hospital completed a validated self-administered questionnaire and underwent an observational physical examination. Most nurses (191) had low-risk scores for varicose veins, 46 nurses had moderate-risk scores, and 13 nurses had high-risk scores. From the outpatient clinics, 61.5% of nurses had significant high-risk scores for varicose veins. Those with a statistically significant association had a family history of varicose veins (p < 0.001) and other chronic medical conditions (p = 0.04). Physical activity, especially race-walking/running (p = 0.006), showed a statistically significant association with the varicose veins score. The years as a staff nurse were statistically significant among the occupational risk factors (p = 0.003). The adjusted multivariable regression model showed three significant predictors: a positive family history, running/walking, and total years as a staff nurse (p < 0.001, p = 0.02, and p < 0.001, respectively). Nurses working at outpatient clinics, positive family history, years as a staff nurse, and other chronic conditions are risk factors for varicose veins, while race-walking/running is a protective factor.

Exploring the Factors behind Nurses' Decision to Leave Clinical Practice: Revealing Causes for Leaving and Approaches for Enhanced Retention

Nursing turnover has emerged as an urgent concern with a substantial influence on the financial efficiency and quality of care in healthcare frameworks worldwide. This study determined important factors associated with nurses' intentions to leave and what would bring them back. This was a cross-sectional, multisite study of nurses in three public hospitals. Convenience sampling was used to recruit 205 nurses from the selected hospitals. A questionnaire was used to measure demographic and professional background information, current job satisfaction, and the intention to leave work and return. Bivariate and multivariate analyses were run using SPSS. This study revealed that both job satisfaction (M = 47.26, SD = 11.59, range: 19-76) and intent to leave a current job (M = 14.18, SD = 4.36, range: 4-20) were reported at moderate levels. There were significant differences reported between the scores of nationality and job satisfaction (p < 0.05) and between the means of income level and intention to leave (p < 0.05). There was also a significant, negative association between satisfaction and intention to leave (r = -0.551, p < 0.05). In regression, income level (β = 0.159, p = 0.021), incentives (β = 0.186, p = 0.002), hospital type (β = 0.189, p = 0.005), and intention to leave (β = -0.454, p < 0.001) significantly influenced satisfaction. Gender (β = -0.122, p = 0.037) and nationality (β = -0.210, p = 0.007) were found to influence the intention to leave among participants significantly. In conclusion, this study indicated that job satisfaction and intention to leave are important factors affecting nurses' enthusiasm. Incentives also had a positive impact on increasing nurses' satisfaction levels. Future research studies should investigate what factors might lead to improved monthly salaries and provide more incentives among nurses.

Self-esteem among nursing students at a public university in Saudi Arabia: A cross-sectional study

Background

Self-esteem is a subjective assessment of one's own value and worth as a person. Self-esteem is recognized as an indicator of a person's mental health, with lower levels associated with mental conditions such as stress and depression. In the context of nursing education, self-esteem has been linked to student's academic performance, clinical competence, and overall well-being. Existing literature suggests that self-esteem among student nurses varies across countries and cultures. Assessing the self-esteem level among student nurses is essential for identifying students at risk of experiencing academic difficulties or mental health problems.

Objective

The study aimed to assess the self-esteem level among student nurses at Al-Majmaah University, Saudi Arabia.

Methods

A cross-sectional design was employed and conducted with 346 nursing students conveniently selected at Majmaah University in Saudi Arabia in May 2023. A self-reported questionnaire utilizing the Rosenberg Self-Esteem Scale (RSES) was employed. Data were analyzed using SPSS Statistics software, including descriptive and inferential statistical techniques.

Results

The findings revealed that 265 students (76.6%) had moderate self-esteem levels, 53 students (15.3%) had low self-esteem, and 28 students (8.1%) had high levels of self-esteem. Examination of self-esteem in relation to socio-demographic variables resulted in statistically significant correlations with the year of study, physical health, psychological health, and father's education (p <0.05).

Conclusion

The study's results offer valuable insights for nurse educators, which can serve as a compass for designing educational and awareness programs to boost self-esteem among student nurses. These initiatives hold significance in equipping students with the necessary attributes for their upcoming roles as professional nurses. Nonetheless, further investigations are warranted to delve into self-esteem and associated factors.

Assessing the psychometric properties of the Arabic version of the Nursing Practice Readiness Scale among Saudi nursing students

Readiness to practice nursing is essential for nursing students to ensure that they are conscientious, have a sense of responsibility, and are rational in performing their clinical practice. This study tested the psychometric properties of the "Nursing Practice Readiness Scale" Arabic version (NPRS-A) to assess Saudi nursing students' readiness to practice nursing in clinical settings. This study used a methodological design to examine the psychometric properties of the NPRS-A among 373 nursing students in Saudi Arabia. The findings provide evidence of the NPRS-A's good content validity. The PCA revealed five distinct components with a "cumulative variance explained" of 69.2%. The test of difference on the nursing practice preparedness between students from different levels showed that students in the 2nd year were less prepared than junior and senior nursing students. The correlation test showed that a higher GPA and higher self-reported readiness are more ready to practice nursing in clinical settings. The research showed an overall Cronbach's alpha of 0.957. The establishment of the NPRS-A is significant, not only in Saudi Arabia but other Arabic-speaking countries. Nurse educators and nursing education policymakers can use this version to assess nursing students' learning needs to be prepared to practice nursing.

Anxiety, Depression, Self-Esteem, Internet Addiction and Predictors of Cyberbullying and Cybervictimization among Female Nursing University Students: A Cross Sectional Study

BACKGROUND

Cyberbullying and cybervictimization, which have been linked to the growth of the Internet and issues with mental health, can have serious psychological and academic consequences for young individuals, yet they have received relatively little scientific attention at universities. These phenomena have become an alarming social issue due to their rising rate and devastating physical and psychological effects on undergraduate university students.

AIM

to estimate the prevalence of depression, low self-esteem, cybervictimization, anxiety, cyberbullying, and Internet addiction among Saudi female nursing university students and to identify the factors that predict cybervictimization and cyberbullying.

METHODS

Convenience sampling was used to select 179 female nursing university students with an average age of 20.80 ± 1.62 years for the purpose of conducting a descriptive cross-sectional study.

RESULTS

The percentage of students who reported having low self-esteem was 19.55%, depression (30.17%), Internet addiction (49.16%), anxiety (34.64%), cyberbullying (20.67%), and cybervictimization (17.32%). There was an inverse relationship between students' self-esteem and their risk of engaging in cyberbullying (AOR = 0.782, 95% CI: 0.830-0.950, p = 0.002) or becoming cybervictims (AOR = 0.840, 95% CI: 0.810-0.920, p < 0.001). Further, Internet addiction predicted both cyberbullying (AOR = 1.028, 95% CI: 1.012-1.049, p = 0.003) and cybervictimization (AOR = 1.027, 95% CI: 1.010-1.042, p < 0.001). The likelihood of experiencing anxiety was linked to cyberbullying (AOR = 1.047, 95% CI: 1.031-1.139, p < 0.001) and cybervictimization (AOR = 1.042, 95% CI: 1.030-1.066, p < 0.001).

CONCLUSION

Importantly, the findings suggest that programs designed to help university students avoid participating in cyberbullying activities or becoming cybervictims should take into account the influence of Internet addiction, mental health issues, and self-esteem.

Fear Related to COVID-19, Mental Health Issues, and Predictors of Insomnia among Female Nursing College Students during the Pandemic

Fear of infection has been sparked by the advent of the novel coronavirus disease (COVID-19). Insomnia in college students, especially its correlations and predictions with mental diseases, remains a research concern. Aim: To estimate the prevalence of fear related to COVID-19, depression, anxiety, and insomnia among female nursing college students throughout the pandemic and to determine the predictors of insomnia. Methods: A web-based cross-sectional descriptive study used 145 female nursing college students. Results: Students reported fear related to COVID-19, depression, and anxiety at rates of 79.3%, 30.2%, and 35.2%, respectively. Insomnia disturbed 24.7% of students. Anxiety predicted worsening insomnia in the student (AOR = 1.08, 95% CI: 0.92−0.97, p < 0.001). Fear related to COVID-19 was also a predictor (AOR = 0.96, 95% CI: 1.07−1.21, p < 0.05). Additionally, when depression severity declined, the chance of insomnia improved (AOR = 0.87, 95% CI: 0.85−0.91, p < 0.001). Insomnia was more common in chronically unwell students (AOR = 1.50, 95% CI = 1.01−2.24, p < 0.05). Conclusion: During the COVID-19 pandemic, university students’ mental health should be monitored, and all essential safeguards should be taken, including resource allocation, awareness raising efforts, and the building of a mental health counseling facility.

A Mixed-Methods Sequential Explanatory Study of the Factors That Impact Nurses' Perspectives toward Nurse Practitioners' Roles in Saudi Arabia

Nurse practitioners' roles need to be clearly defined in Saudi Arabia. Therefore, we aimed to explore potential factors that impact nurses' perspectives toward nurse practitioners' roles and whether they are interested in becoming nurse practitioners. A mixed-methods study design was employed using a questionnaire and focus groups. The survey was sent to nurses working at a public hospital in the Riyadh region. Participants (N = 77) reported that having more nurse practitioners would improve quality of care and patient safety. Additionally, most participants stated that an increased supply of nurse practitioners would have a positive impact on effectiveness, equity of care, and healthcare costs. In regression analysis, participants with favorable perspectives towards nurse practitioners were significantly more likely to have interest in becoming nurse practitioners (odds ratio [95% confidence interval]:1.04 [1.01-1.07]). In the qualitative domain, three positive factors were identified: effective collaboration with other staff, better contribution to quality care and patient safety, and better contribution to evidence-based practice. Two barriers were also determined: lack of motivation to become a nurse practitioner and unclear scope of practice. Results showed that nurse practitioners can provide quality healthcare services that meet patients' different needs. The growing role of this speciality warrants further research to show its value in daily practice.

Psychological Empowerment of Nurses Working in Pediatric Units in Saudi Arabia

Background: This study investigated the psychological empowerment (PE) of nurses in pediatric units and examined the significant difference between the level of PE and the personal work profiles of nurses working in pediatric units in Saudi Arabia. Methods: A quantitative descriptive study design was employed between May and July 2020 using a self-administered electronic survey that collected personal work profile data and applied the Psychological Empowerment Scale. The data were analyzed using SPSS 22.0 software for descriptive statistics, t-tests, and ANOVA. Results: Most of the study participants (69.6%) were non-Saudi nurses, and 71.9% worked in specialized areas. The mean PE score of the four dimensions across the 12 items was high. The mean score for the dimension meaning was the highest, whereas the lowest mean score was for the dimension self-determination. Nurses from different nationalities had significantly different PE levels. Conclusions: Expatriate nurses were more psychologically empowered. The findings will be of interest to all who wish to attract and retain local nurses by fostering PE in the work environment and involving nurses in decision-making processes, thus enabling them to act as leaders for increased work motivation.

Understanding Learning Styles in Undergraduate Nursing Programs of the Kingdom of Saudi Arabia: An Integrative Literature Review

Background:

In Saudi Arabia, nursing education is developing fast due to high nursing demand. Alongside this development, nurse educators must identify and understand nursing students learning styles to ensure the multidimensional development of students learning experiences. Students' preferred learning style is an essential element in determining students' unique ways of processing new knowledge, information, and skills.

Objective:

This literature review aimed to identify the learning styles of undergraduate Saudi nursing students based on the premises of three learning style models: Kolb’s Model, Felder-Silverman Learning, and Visual, Aural, Read/Write, and Kinesthetic (VARK) Learning Styles Inventory.

Methods:

An integrative review of published studies on Saudi nursing students' learning styles was conducted while adhering to predefined eligibility measures. The research strategy for this study was based on online international databases, such as PubMed, Medline, CINAHL, EBSCO, Google Scholar, and Saudi health databases and journals. The keywords used were: “nursing education,” “learning style,” “learning preference,” “academic learning style,” “undergraduate nursing students,” and “nursing students in Saudi Arabia.”

Results:

Seven studies met the inclusion criteria. Most of the reviewed literature reported a prominent preference for kinesthetic, accommodating, converging, visual, and active learning styles in nursing students regardless of their age, gender, and level of education in various universities in Saudi Arabia.

Conclusion:

Students learning styles emphasize the importance of practical experience and students' hands-on practice as the best style that improves nursing students learning experience. The Saudi Arabian education system must adjust to fit students' preferred learning styles and focus on advanced state-of-the-science learning tools in nursing education.

Followership in nurses working in Saudi Arabian hospitals: A cross-sectional study

AIM

To explore the followership styles and their associations with nurses' sociodemographic profiles in Saudi Arabia.

BACKGROUND

In Saudi Arabia, nurses' role is seen as less important and passive. However, whether they were actually passive followers has not been examined. No previous research has examined nurses' followership styles in Saudi Arabia.

METHODS

This cross-sectional study used a convenience sample of nurses. The Kelley followership questionnaire-revised was used to determine the prevalence of the five followership styles. Participants' demographic characteristics, which included age, gender, nationality, education level, years of experience, and role, were collected to investigate their associations with followership styles. An online survey was designed and distributed using SurveyMonkey®. Data were analyzed with logistic regression and expressed as odds ratios.

RESULTS

This study included 355 nurses. Findings revealed that the predominant followership style was exemplary (74%), followed by the pragmatist (19%), conformist (4%), and passive styles (3%). Logistic regression analysis revealed that expatriates, higher education, and a leader role had an independent association with an exemplary followership style. Male gender was associated with a passive style. Younger age, male gender, Saudi Arabian nationality, undergraduate qualification, no previous leadership experience, a follower role, and fewer years of experience increased the odds of having a pragmatist style.

CONCLUSION AND IMPLICATIONS

Followership styles were influenced by sociodemographic and work-related factors. Young nurses with less experience tend to be pragmatist followers. Nursing managers should integrate followership styles when planning leadership and team development courses to ensure maximum team effectiveness as leadership and followership are interdependent.

The influence of authentic leadership on nurses' turnover intentions and satisfaction with quality of care in Saudi Arabia: A structural equation modelling study

AIM(S)

The study aimed to test a model that examined the relationships between authentic leadership, psychological safety, work engagement and team effectiveness and subsequent effects of team effectiveness on job turnover intentions and nurse satisfaction with quality of care.

BACKGROUND

Nurse leaders who exhibit authentic leadership have been shown to contribute to the development of healthy work environments. In workplaces with demonstrated authentic leadership, nurses are more engaged and have lower job turnover intentions.

METHOD(S)

A non-experimental, cross-sectional design was used to test the hypothesized model via structural equation modelling. A total of 456 nurses were included.

RESULTS

Structural equation modelling analysis indicated a good fit for the hypothesized model. Authentic leadership had a positive, significant and direct relationship with team effectiveness, nurses' work engagement and psychological safety. Team effectiveness was found to be negatively related to job turnover intentions but positively related to nurse satisfaction with quality of care.

CONCLUSION(S)

Results of this study may help nursing leaders have a better understanding of the essential role of leadership style in increasing healthy work environments.

IMPLICATIONS FOR NURSING MANAGEMENT

Applying authentic leadership style in nursing practice could help to reduce the shortage of nurses stemming from the high turnover intentions of nurses.

Organizational culture and readiness for evidence-based practice in the Kingdom of Saudi Arabia: A pre-experimental study

AIM

This study aims to establish postgraduate students' perceptions of the organizational culture and readiness for evidence-based practice of their workplaces in the Kingdom of Saudi Arabia.

BACKGROUND

Nurse shortages and a reliance on a transient nurse workforce have long been a challenge in the Kingdom of Saudi Arabia. Developing a home-grown nurse workforce, a key objective of the Government of Saudi Arabia, can help to address this. Evidence-based practice offers a mechanism to address this. Evidence-based practice implementation is heavily reliant on the prevailing organizational culture. Establishing the organizational culture and readiness for evidence-based practice is crucial for sustainable evidence-based practice implementation.

METHODS

A pre-experimental pilot study collected data from the same participants at three different points. As part of this, a questionnaire measuring organizational culture and readiness for evidence-based practice was administered twice. Descriptive, inferential and correlational statistics were employed to analyse the data.

RESULTS

Results demonstrated improved participant perceptions of the organizational culture and readiness for evidence-based practice of their workplaces between the first (M = 76.58, SD = 19.2) and second (M = 92.10, SD = 23.68) data collection points, indicating moderate movement towards a culture of evidence-based practice. Strengths, challenges and opportunities for improvement were identified.

CONCLUSION

This study established participants' perceptions of the organizational culture and readiness for evidence-based practice of their workplaces, affording insight into context-specific strategies to embed evidence-based practice in health care organizations.

IMPLICATIONS FOR NURSING MANAGEMENT

Assessing an organization's culture and readiness for evidence-based practice (EBP) can afford insight on the strengths, challenges and opportunities that exist to equip nurse managers to advance evidence-based practice at individual, professional and organizational levels. This study demonstrated the importance of promoting an environment conducive to EBP and putting in place the necessary resources to support evidence-based practice implementation. Nurse managers can play a central role in this.

Turnover-attachment motive of Saudi Arabia nursing workforce: A Cross-Sectional study

AIM

This study aimed to explore the association of turnover-attachment motive with socio-demographic data among Saudi and foreign nurses in a hospital in the Eastern Province of Saudi Arabia.

METHODS

A cross-sectional correlation study was conducted among n = 180 registered Saudi and foreign nurses working at a private tertiary hospital in the Eastern Province, Saudi Arabia. The turnover-attachment motive survey was used to evaluate the eight motivational forces. Data were analysed using JASP version 16 statistical software and Orange 3 version 3.26.0. The data were subjected to correlation analysis and multiple linear regression.

RESULTS

Only 8% of participants were identified with a high intention to leave driven by alternative, behavioural, normative and constitutive forces. Younger healthcare workers tend to have higher intentions to quit the job; the 29-33 age group has a statistically significant negative effect, increasing intention to leave. It was found that those with 5-6 years of clinical experience at Dr. Sulaiman Al Habib Hospital, Al Khobar and no experience abroad had statistically significantly lower intention to leave.

CONCLUSION

This study presented the factors influencing nursing staff to stay or leave work in a hospital in the Eastern Province of Saudi Arabia that can be a basis for reviewing existing policies and procedures to improve nurses' working conditions.

Gap Analysis: Quality and Women's Satisfaction Regarding Postnatal Care

Background:

Improving the quality of maternal health is one of the eight major developmental goals of the World Health Organization. Women's satisfaction with maternity healthcare services is a crucial indicator of quality health care.

Objective:

This study aimed to evaluate the gap between the quality of maternity care and women's satisfaction with postnatal care.

Methods:

This study used a descriptive cross-sectional study design. The sample size was 300 postpartum Saudi women. The data were collected from the postnatal care unit at the King Khalid Hospital, Jeddah, Saudi Arabia, The study used the SERVQUAL and Postnatal Satisfaction with Nursing Care Questionnaires to measure the studied variables.

Results:

The mean ± SD (3.73 ± 0.466) of women perceived that the provided care was of high quality and the mean ±SD (3.20±0.511) of women's satisfaction with postnatal care was moderate. The gap between expected and perceived quality of maternity care was reported to be -1.27. There is a significant positive relationship between the quality of maternity care and women's satisfaction.

Conclusion:

The study concluded that the participants were generally satisfied with the postnatal care and overall maternity care provided in the King Khalid Hospital. However, they showed the desire to get more empathetic care. Patients' satisfaction should be evaluated periodically to establish baseline data and provide postnatal care interventions tailored to women's expectations. There is a need to increase training for enhancing healthcare providers' empathetic and communication skills to improve the relationship between the staff and women.

The Association between Cultural Competency, Structural Empowerment, and Effective Communication among Nurses in Saudi Arabia: A Cross-Sectional Correlational Study

This study aimed to examine the association between cultural competency, structural empowerment, and effective communication among nurses in Saudi Arabia. A cross-sectional correlational design was used. The study questionnaire utilized three scales: the Culture Competence Scale, Conditions for Work Effectiveness Questionnaire-II, and Communication Competency Assessment Scale. All the scales were culturally adapted and translated using an integrated method. The questionnaire was distributed through an online survey using a convenience sampling approach. Data were collected from 396 participants. The findings showed statistically significant association between cultural competency and effective communication (r = 0.747, p < 0.001) and between structural empowerment and cultural competency (r = −0.123, p = 0.014). Moreover, the overall model with effective communication and structural empowerment as predictors, controlling for nurses’ nationality significantly explains 56% of the variance in cultural competency. Structural empowerment did not significantly predict cultural competency (b = −0.052, β = −0.069, p < 0.052, 95% CI = [−0.104, −0.001]), while effective communication was found to be a significant positive independent predictor of cultural competency (b = 0.745, β = 0.741, p < 0.001, 95% CI = [0.677, 0.811]). The findings underline the need to make effective communication courses mandatory in undergraduate nursing curricula. Healthcare systems should be built such that they support the empowerment of the nursing workforce from different nationalities and establish effective communication policies to enhance cultural competency among nurses. Future research in this area is needed to validate the result of this study.

The experience of novice nurse faculty in Saudi Arabia

OBJECTIVES

To understand the experience of novice nurse faculty members in Saudi Arabia and the influences on novice nurse graduates in their academic role.

METHODS

A qualitative descriptive study grounded in naturalistic inquiry was used to better understand the experience of novice faculty in Saudi Arabia. Purposive sampling was used to recruit 10 novice nurse faculty from nursing schools in Saudi universities. Data were collected until saturation was achieved. The researcher interviewed participants using a video conferencing platform, and all interviews were digitally audio-recorded. Content and thematic analysis were used to analyze the data.

RESULTS

There were four major themes: teaching on a peninsula, navigating in the dark, grappling with the faculty role, and working hard to create hope for a better tomorrow.

CONCLUSIONS

The findings add to the literature regarding the novice faculty experience, self-confidence, and the strategies needed to enhance their teaching performance.

Developing trends of initial nursing education in China from 2006 to 2017: A descriptive analysis based on national-level data

INTRODUCTION

There is currently a global nurse shortage. Initial nursing education is the primary preparation for a robust nursing workforce that must be strengthened.

OBJECTIVES

To describe the developing trends of initial nursing education in China from 2006 to 2017 and to analyze related characteristics and issues.

DESIGN

A descriptive study with secondary data analysis.

METHODS

The numbers, educational-level composition and regional distribution (i.e., East, Central, West, and Northeast regions) of students recruited into initial nursing education programs from 2006 to 2017 were analyzed. Changes in the numbers of the nursing workforce from 2006 to 2020 were compared with the changes in education sector to facilitate an interpretation of the development trend of initial nursing education.

RESULTS

The number of recruits into initial nursing education programs has increased from 0.38 million in 2006 to 0.44 million in 2008, and maintained between 0.5 million and 0.54 million during 2009 to 2017. Students recruited to secondary diploma, advanced diploma, and baccalaureate degree programs accounted for 50.55% (71.46% in 2009), 39.36% and 10.09% of the total in 2017, respectively. There were 3.34 nurses per 1000 population in 2020, a substantial increase from 1.09 in 2006. The regional distribution of recruits was imbalanced, with more recruits per 1000 population in the West (0.49), Central (0.40), Northeast (0.34) and the least in the East (0.26) in 2017. The distribution of nurses was relatively balanced among the four regions.

CONCLUSIONS

The development in initial nursing education in China is significant from 2006 to 2017. The education sector recruited and graduated about 0.5 million nursing students respectively per year in recent years. If simply considering the number of recruits, it could meet the workforce demands, however, to further upgrade nurses' educational preparation, the recruits into advanced diploma and baccalaureate degree programs need to be increased. A maldistribution of recruits among regions persists, while the distribution of nurses is relatively balanced. Multiple strategies should be adopted to achieve a balance between the supply and demand of nurses, with providing more higher-educated nurses in all regions across mainland China.

Approach to Developing a Core Competency Framework for Student Nurses in Saudi Arabia: Results from Delphi Technique

Background: Competence, while firmly established as a primary conceptual framework in nursing education, continues to lack clarity and uniformity across borders and contexts. While a wealth of research has been carried out on the various dimensions of this concept, including the drafting and implementation of frameworks for nursing competence, no unifying international framework has been forthcoming. Indeed, the continued development of more localized approaches, based on geography or specialization, would appear to be the most realistic objective. It is incumbent on nurse educationalists and researchers to build on existing frameworks and develop evidence-based tested methodologies for competence assessment in localized contexts. Currently, there is a dearth of such evidence-based frameworks in the Middle East and in the Kingdom of Saudi Arabia (KSA) in particular. This study aimed to formulate and validate a competence framework for undergraduate nursing students in KSA. Results: Following documentary analysis, framework drafting and a three round Delphi process, a consensus was reached as to elements, comprising six discrete domains, to be included. The identified competence domains provide a framework to guide the implementation of a competence-based assessment and move towards a competency-based curriculum for nursing education in KSA. Conclusions: The study concluded that providing a competency-based model and expanding and standardization of competency concept in different dimensions of nursing profession is a necessity; considering that clarification of the concept of competency, the recognition of its dimensions, characteristics and the factors affecting it help in determining the criteria and standardizing the competency tools.

Sources of Stress among Saudi Arabian Nursing Students: A Cross-Sectional Study

Introduction: Nursing students experience higher levels of stress than those in other health-related disciplines; however, there are limited data exploring stress among these students in a Saudi context. Aim: This study examines sources of stress among nursing students at an academic institution in Jeddah, Saudi Arabia, using a descriptive quantitative cross-sectional research design. Methods: Data were collected from a convenience sample of 500 undergraduate nursing students, with a response rate of 71.8%, using an adapted Stress in Nursing Students (SINS) questionnaire. Results: Nursing student sources of stress fell into three categories: academic concerns, clinical practice, and social factors. Discussion: The results demonstrate commonality between other countries’ sources of stress for nursing students but highlight cultural factors unique to Saudi Arabia. This study shows opportunities for cross-cultural learning and areas needing cultural tailoring to reduce stress among nursing students.

A pre-experimental pilot study exploring EBP Beliefs and EBP Implementation among post-graduate student nurses in Saudi Arabia

AIM

This study aimed to measure the impact of a dedicated EBP module on the knowledge, skills and capability for EBP of students undertaking the inaugural MSc in Nursing: Advanced Practice programme in the KSA.

BACKGROUND

Evidence-based practice (EBP) yields multiple benefits for all key stakeholders of healthcare. Key to this are healthcare professionals armed with necessary EBP knowledge and skills. Nurses, the largest professional group in healthcare, can be instrumental in effecting sustained EBP implementation. In the Kingdom of Saudi Arabia (KSA) achieving this is hindered by a chronic shortage of nurses and a heavy reliance on expatriate nurses who are often a transient workforce, resulting in a high turnover. The Government of Saudi Arabia 2030 Vision aspires to address the indigenous nurse shortage and the quality of healthcare. In 2017 the inaugural MSc in Nursing: Advanced Practice programme was established in the KSA to prepare Saudi nurses for emerging advanced practice roles. A dedicated EBP module was a core component of the programme.

METHODS

A pre-experimental pilot study conducted over 18-months collected data from the same participants at three different points. Two validated EBP questionnaires measuring EBP Beliefs and EBP Implementation were administered to post-graduate students undertaking the MSc in Nursing: Advanced Practice programme in one Higher Education Institution in the KSA. Descriptive, inferential and correlational statistics were employed to analyse the demographic data, group mean scores and distribution on the EBP scales, as well the correlation between EBP Beliefs and EBP Implementation.

FINDINGS

Findings demonstrated that the educational intervention did improve participants' EBP beliefs and implementation. Participants reported positive beliefs about EBP at all 3 data collection points (M = 57.4 SD = 7.0; M = 62.54 SD = 7.21; M = 55.31 SD = 15.81, respectively). EBP implementation was low prior to undertaking the module but improved thereafter as illustrated across the 3 data collection points (M = 15.14 SD = 11.9; M = 27.64 SD = 14.35; M = 25.9 SD = 20.43). On both measures, higher scores indicate higher EBP beliefs and implementation.

CONCLUSION

This study established the EBP Beliefs and EBP Implementation of a sample of postgraduate nursing students in the KSA. Findings revealed a substantial improvement in both EBP Beliefs and EBP Implementation following the EBP module. Findings support the use of a dedicated module to prepare nurses to use EBP and to practice at an advanced level while simultaneously preparing them for leadership roles in healthcare in KSA. In so doing, this will help to advance the healthcare goals of the KSA 2030 vision.

Nationalisation of Health Workforce in Saudi Arabia’s Public and Private Sectors: A Review of Issues and Challenges

Presently, Saudi Arabia depends largely on expatriate health workforce for delivery of health services. This article provides an overview of Saudization policy introduced by the Kingdom of Saudi Arabia and analyses its underlying impact on health workforce in public and private sectors. It also examines key strategic initiatives undertaken by the government for health workforce development and challenges of replacing expatriates in the country as envisaged in the Vision 2030. There are concerns about low participation of females in nursing, mainly due to a poor image attached to the profession, and further exacerbated by religious and cultural factors. There is a strong need to adopt a health workforce development policy that integrates local culture, values and social ties. Government needs to follow a multipronged approach to change the mindset of citizens to take up health care jobs, particularly nursing and pharmacist professions.

Psychometric evaluation of the Arabic version of the patient-centered communication instrument for adult cancer patients

BACKGROUND

This study aimed to examine the validity and reliability of the Arabic version of the patient-centered communication instrument.

METHODS

A self-administered instrument was used over 4 months by 318 participants living with cancer in Saudi Arabia. The instrument contained 36 items assessing patient-centered communication (PCC-36) experiences. The PCC-36 instrument was translated into Arabic following the World Health Organization guidelines for translating instruments before undergoing psychometric evaluation. This involved confirmatory factor analysis for each of the PCC-36 functions and testing the reliability and internal consistency of the PCC-36 measures.

RESULTS

The Arabic-translated PCC-36 version demonstrated a good correlation between items, with confirmatory factor analysis showing a good fit of the data (comparative fit index = 0.922, Tucker-Lewis index = 0.910, root mean square error approximation = 0.059, ${\chi ^2}$ = 1214.4, df = 579, P < 0.001). Internal consistency of the total six PCC-36 functions was confirmed by a Cronbach's alpha of 0.97.

CONCLUSIONS

The study proved that the PCC-36 Arabic version is a valid and reliable instrument for the measurement of patient communication experiences in cancer care in Saudi Arabia, with similar properties to the original, and that this instrument may be used in 22 different Arab countries to measure and improve cancer patients' communication experiences.

Factors that influence the preceptor role: a comparative study of Saudi and expatriate nurses

OBJECTIVES

The aim of this study was to compare expatriate and Saudi nursing staff's perceptions of factors that influence their role as preceptors of nursing students.

METHODS

Descriptive comparative study using a self-administered survey was completed by a convenience sample of eligible nurses (n=285). It was conducted in five different hospitals within the Ministry of Health in the Kingdom of Saudi Arabia.

RESULTS

Most preceptors were expatriate nurses (70.5%), while Saudi preceptors represented only 29.5%. The findings show that there is a difference between Saudi and expatriate nurses in their perception of the role, that cultural factors influence the role of expatriate preceptors and that organisational factors influence both groups.

CONCLUSIONS

Expatriate preceptors felt that there were cultural obstacles that hindered their role. These findings will contribute to the development of a more contemporary and culturally sensitive preceptorship model.

Challenges Facing the Nursing Profession in Saudi Arabia: An Integrative Review

There is a paucity of recent literature identifying the issues facing the nursing profession in Saudi Arabia. The aim of this integrative review is to highlight the ongoing challenges facing the nursing profession in Saudi Arabia despite attempts to make a difference and suggests recommendations for the future. Literature published from 2000 to 2020, inclusive, relevant for nursing challenges in Saudi Arabia was accessed and reviewed from multiple sources. In Saudi Arabia, inadequate numbers of Saudi nurses have prompted an increase in recruitment of expatriate nurses. This has created its own issues including, retention, lack of competency in English and Arabic, as well as Arabic cultural aspects, insufficient experience, and a high workload. The result is job dissatisfaction and increased attrition as these nurses prefer to move to more developed countries. For national nurses, the issues are the need to recruit more and retain these nurses. There are a range of cultural factors that contribute to these issues with national nurses. There is a need to improve the image of nursing to recruit more Saudi nurses as well as addressing issues in education and work environment. For expatriate nurses there is a need for a better recruitment processes, a thorough program of education to improve knowledge and skills to equip them to work and stay in Saudi. There is also a need for organizational changes to be made to increase the job satisfaction and retention of nurses generally. Healthcare in Saudi Arabia also needs leaders to efficiently manage the various issues associated with the nursing workforce challenges.

Factors influencing nurses' intention to work in the oncology specialty: multi-institutional cross-sectional study

Background

Nursing care for terminally ill cancer patients is routinely provided by oncology nurses in Saudi Arabia. Shortages and retention of oncology nurses is an important concern for healthcare leaders.

Objectives

To identify and describe predictors of nurses’ intention toward working in the oncology specialty amongst three groups: undergraduate nursing students, oncology registered nurses and postgraduate oncology nursing students. In particular, the study sought to analyse association between individual characteristics, job-related factors, palliative care knowledge, attitude toward caring for dying patients, general self-efficacy, job satisfaction and intention to work in oncology.

Methods

A cross-sectional study was conducted involving 477 participants in five major hospitals in Saudi Arabia. The Palliative Care Quiz for Nursing, Frommelt Attitudes Toward Care of the Dying Scale, General Self-Efficacy Scale and Minnesota Satisfaction Questionnaire short form were used for data collection. Multilevel logistic regression analysis was used to identify predictors associated with intention to work in oncology.

Results

43.9% (n = 208) of the sample reported an intention to work in oncology. Only one variable was a significant predictor of intention to work in oncology across all three groups studied: a more positive attitude toward caring for dying patients (Odds ratio (OR) = 1.09 [95% confidence interval (CI) 1.04–1.16]), (OR = 1.08 [95% CI 1.04–1.12]), (OR = 1.078 [95% CI 1.053–1.103] with P ≤ 0.001 for undergraduate, registered and postgraduate groups respectively. At post-graduate level, higher levels of palliative care knowledge and general self-efficacy were significantly associated with increased intention, whilst at undergraduate level, general self-efficacy was a significant predictor. Job satisfaction was a significant predictor of intention amongst registered nurses.

Conclusions

Attitude toward caring for dying patients and general self-efficacy appear to be the most important predictors of intention to work in the oncology nursing specialty. However, the significance of influencing factors varied between the different groups of nurses studied. Perhaps surprisingly, palliative care knowledge was an influential factor amongst the postgraduate group only. The study results provide important insights for nursing leaders and policymakers in Saudi Arabia to inform the future planning of nursing workforce strategies to address shortages and retention of oncology nurses.

The Effect of Incentive Management System on Turnover Rate, Job Satisfaction and Motivation of Medical Laboratory Technologists

Objectives:

We investigated factors affecting turnover and assessed satisfaction with an existing Incentive Management System and to which extent it motivates employees. We also provide recommendations to improve the Incentive Management System.

Methods:

A cross-sectional questionnaire study utilizing a convenience sample from of a population of 250 Medical Laboratory Technologists.

Findings:

100 medical laboratory technologists responded to the survey. We found discrepancy in wage allocation to be the most prominent factor affecting turnover intention with 51% strongly agreeing, followed by low incremental system with 48%. Other factors were: limited opportunities for promotion, insufficient allowances and benefits, and lack of continuing education and professional growth opportunities with 49%. 26% of respondents found lack of autonomy/independence to be a factor. Poor workgroup cohesion was least ranked (17%). 39% reported dissatisfaction with workload, 31% were dissatisfied with their provided allowance, with management support, and the working hours, and opportunities for promotion (44%). Opportunities for career growth and higher pay were highest ranked as incentives to remain, and additional vacation time and supportive colleagues to be the least relevant factors. There was a significant correlation between age and motivation levels (r = 0.223, p = 0.026).

Discussion and Conclusions:

Burnout and turnover can be costly to healthcare organizations, due to the impact on productivity and healthcare quality. Human resource departments must ensure to not only attract skilled employees, but also influence their motivation and retention due to the impact on productivity and health care quality. Incentive management systems support practices to enhance skills, knowledge, abilities and retention rates for healthcare employees. Our study findings support the continued improvement of Incentive Management Systems within the healthcare organization to reduce turnover rates, maximize quality outcomes, and increase the levels of commitment and motivation of employees.

Saudi service users' perceptions and experiences of the quality of their mental health care provision in the Kingdom of Saudi Arabia (KSA): A qualitative inquiry

This paper presents, as part of a larger mixed-methods design, a study generating a theoretical understanding of issues pertinent to the quality of mental health care in the KSA from the perspective of those using services. Semi-structured interviews were undertaken with thirty service users admitted to inpatient psychiatric wards, using an interview guide developed by the researchers, based on relevant literature. Findings from the thematic analysis showed five themes: (1) The hospital as a prison: a custody versus care dilemma, (2) quality of interactions between staff and service users, (3) quality of services, (4) staff qualities and (5) suggestions for achieving quality of care. A theoretical model drawing upon Donabedian Health Care Model for Evaluating quality of care and the Andersen Behavioural Model of Health Service Use is evident from the data. Structural aspects of care include staff experience and qualifications and key enablers around social and financial support, service users' health needs and status and the physical infrastructure and ward rules. These drive processes of care based upon robust rates of interaction between staff and service users and appear central to quality of mental health care in KSA. Quality of mental health care in KSA is manifested by a therapeutic ethos with a high degree of interaction between professional carers and service users, with the former being highly educated, competent, compassionate, with a high degree of self-awareness, and specialized in mental health. We have uncovered elements of Fanon and Azoulay's 'Cultural Originality' as well as contemporary examples of Goffman's mortification of the self.

Linking nurses' job security to job satisfaction and turnover intention during reform and privatization: A cross-sectional survey

BACKGROUND

Reforming health care systems can influence the workers. Among the aspects that could be influenced are the perception of job security, job satisfaction and turnover intention. However, nurses' perception on job security, job satisfaction and turnover intention during health care reform and privatization is a topic yet to be explored.

OBJECTIVES

To examine the link between job security, job satisfaction and turnover intention during the reform and privatization of a health care system.

DESIGN

A cross-sectional survey design was utilized in this study.

METHODS

The survey was composed of sociodemographic items, global job satisfaction item, global turnover items and job security scale. Data were analysed using SPSS, and univariate, bivariate and multivariate analyses tests were used.

RESULTS

Although job satisfaction partially mediated the association between job security and organisational turnover during health care reform, it completely mediated the association between job security and professional turnover intention.

CONCLUSIONS

Further research is needed to examine this finding.

IMPLICATION FOR NURSING MANAGEMENT

The findings of this study benefit nurse managers and leaders for their evidence-based management. Moreover, this study will help them focus on practices that satisfy the staff and improve the job security by improving the communication and work on changing the policy.

Awareness, Attitudes, Prevention, and Perceptions of COVID-19 Outbreak among Nurses in Saudi Arabia

The newly discovered coronavirus (COVID-19) has become a pandemic, infecting thousands of people around the world. This study examines nurses' demographic information (age, gender, marital status, area of practice, total years of experience in the current hospital, work region, monthly salary, educational level, workplace, nationality, working hours per day, total nursing experience, and the respondents' main source of information on COVID-19), awareness, attitudes, prevention, and perceptions of COVID-19 during the outbreak in Saudi Arabia. A cross-sectional descriptive design of 500 nurses working at government and non-governmental hospitals in five regions in Saudi Arabia were selected using convenience sampling. The Kruskal-Wallis test was applied and the Mann-Whitney test was utilized as a post hoc test. The majority of nurses in this study, 96.85%, had excellent knowledge of COVID-19. Some (83.2%) of nurses reported significant prevention knowledge and treatment skills about COVID-19, while 7.6% had little knowledge about prevention. More than half of the nurses (60.4%) had high positive attitudes toward caring for COVID-19 patients. In conclusion, female nurses, married nurses, and bachelor's degree nurses had greater awareness, better attitude, and prevention clinical experience towards COVID-19. Meanwhile, non-Saudi nurses had higher self-reported awareness, positive attitudes, optimal prevention, and positive perceptions compared to Saudi nurses. This study provides baseline information immediately needed to enable health authorities to prioritize training programs that support nurses during the COVID-19 pandemic.

Linking the Saudi Arabian 2030 vision with nursing transformation in Saudi Arabia: Roadmap for nursing policies and strategies

The Saudi government is currently facing multiple challenges in achieving “The Gold Standard” in nursing practice. This is not limited to educational challenges, staffing shortage, paucity of international and national benchmark evidence, absence of clear and defined scope of nursing practice, and lack of appropriate policies and regulations. This study presented a comprehensive plan for developing a policy based on current challenges, recognition of policy goals, assessment of potential options and alternatives, identification of stakeholders, proposition of recommended solutions, and implementation of the framework to transform nursing standards and link these changes with the Saudi Vision 2030. However, amendments are required in the present strategic plan for the better management of the nursing profession. It is doubtful that the current nursing profession status quo is capable of meeting the golden standards for health care. Thus, the transformation of the nursing profession in Saudi Arabia is necessary.

Nurse Practitioner: Is It Time to Have a Role in Saudi Arabia?

Low recruitment of Saudi nationals into the nursing profession, coupled with a growing population, has led to a severe nursing shortage in Saudi Arabia, particularly of nurses with advanced qualifications in clinical nursing. While the role of nurse practitioner has been successfully integrated into the healthcare systems of the U.S., Canada, the UK and Australia for decades, the advanced practice registered nurse (APRN), which includes nurse practitioners and clinical nursing specialists, is still not being implemented effectively in Saudi Arabia due to a variety of regulatory, institutional and cultural barriers. The author looks at some of those barriers and offers recommendations of how they might be overcome. Given that in many parts of the world, nurse practitioners are considered an essential component to meeting healthcare demands, the author considers the question of whether APRNs can find a role in Saudi Arabia’s healthcare system.

Caring for Women With Postpartum Depression in Saudi Arabia: Nurses' and Midwives' Opinions About Their Roles

The current cross-sectional study was conducted to investigate nurses' and midwives' opinions about their roles in caring for women with postpartum depression (PPD) in Saudi Arabia. Convenience sampling was used to recruit 181 nurses and 141 midwives. A self-administered questionnaire was used to collect data. Participants lacked experience assessing and managing PPD and providing health education and counseling to mothers about PPD. Moreover, participants underestimated the importance of their roles in preventing PPD risk factors, and detecting, assessing, and managing PPD. Findings show significant differences between nurses' and midwives' opinions, with more frequency of agreement among nurses than midwives regarding their roles in caring for women with PPD. Continuing health education programs for nurses and midwives are recommended to improve knowledge, skills, and awareness of their roles in assessing and managing PPD. [Journal of Psychosocial Nursing and Mental Health Services, 58(7), 42-51.].

Nursing Education in Saudi Arabia: History and Development

Nursing education in Saudi Arabia commenced in 1948 with the introduction of a nursing diploma program for males. Numerous bodies have worked as nursing education providers since then, leading to an unsteady growth of the field due to the lack of a unified curriculum coupled with an absence of regulating bodies. The absence of nursing leaders and the lack of reliable nursing workforce data during the past few decades have contributed to a lack of maturity and growth of the Saudi nursing landscape compared to the international nursing trends. This review explores the history of nursing education and its development within the context of Saudi Arabia.

Familial/inherited cancer syndrome: a focus on the highly consanguineous Arab population

The study of hereditary cancer, which accounts for ~10% of cancer cases worldwide is an important subfield of oncology. Our understanding of hereditary cancers has greatly advanced with recent advances in sequencing technology, but as with any genetic trait, gene frequencies of cancer-associated mutations vary across populations, and most studies that have located hereditary cancer genes have been conducted on European or Asian populations. There is an urgent need to trace hereditary cancer genes across the Arab world. Hereditary disease is particularly prevalent among members of consanguineous populations, and consanguineous marriages are particularly common in the Arab world. There are also cultural and educational idiosyncrasies that differentiate Arab populations from other more thoroughly studied groups with respect to cancer awareness and treatment. Therefore, a review of the literature on hereditary cancers in this understudied population was undertaken. We report that BRCA mutations are not as prevalent among Arab breast cancer patients as they are among other ethnic groups, and therefore, other genes may play a more important role. A wide variety of germline inherited mutations that are associated with cancer are discussed, with particular attention to breast, ovarian, colorectal, prostate, and brain cancers. Finally, we describe the state of the profession of familial cancer genetic counselling in the Arab world, and the clinics and societies dedicated to its advances. We describe the complexities of genetic counselling that are specific to the Arab world. Understanding hereditary cancer is heavily dependent on understanding population-specific variations in cancer-associated gene frequencies.

Building the health workforce: Saudi Arabia's challenges in achieving Vision 2030

BACKGROUND

Saudi Arabia's Vision 2030 represents a major structural shift in all economic sectors. Health care is one of the largest sectors significantly contributing to achievement of the vision OBJECTIVES: To provide an overview of health workforce in Saudi Arabia and identify various critical issues and challenges that need to be addressed in achieving health system goals envisaged in the Vision.

METHODS

This paper is based on extensive review of literature conducted to stimulate pertinent descriptive information on health workforce in Saudi Arabia.

FINDINGS

Saudi nationals constitute 44% of all health workforce and 29.5% of all physicians employed by the health system. Among Saudi nationals, there is a significant underrepresentation of females except in the nursing profession. The health workforce is beleaguered with numerical inadequacy, skill imbalance, gender disparity, and access issues.

CONCLUSION

Health system needs to adopt a rigorous approach by investing heavily on medical, nursing, and other specialized fields of education. Planning for the health workforce needs to adopt appropriate strategies that reflect all aspects including the number, skills, and gender distribution for meeting the future health needs of population to facilitate achievement of Vision.

A multi-university assessment of patient safety competence during clinical training among baccalaureate nursing students: A cross-sectional study

AIMS AND OBJECTIVES

To assess the perceived patient safety competence during clinical training of Saudi nursing students.

BACKGROUND

Ensuring safety in healthcare settings requires improvements in the educational and clinical practice of professionals. Experts stressed that shared patient safety culture must be of primary importance; they also emphasised the resolute need for theoretically driven research approaches for patient safety competence in healthcare organisations and educational institutions.

DESIGN

Descriptive, cross-sectional design.

METHODS

This study was conducted in six government universities in Saudi Arabia. A sample of 829 nursing students was surveyed using the health professional education in patient safety survey. Descriptive and inferential statistics were used to analyse the data. The study adhered to the STROBE guideline for cross-sectional studies (See Supporting Information Appendix S1).

RESULTS

The percentage of agreement on the items of the health professional education in patient safety survey ranged from 61.5%-76.5%. The dimension "understanding human and environmental factors" received the highest perceived competence, whereas the dimension "working in teams" received the lowest competence. Significant differences in students' patient safety competence from different universities were reported. Male students perceived their competence in "working in teams" higher than the female students. Students in their internship year had significantly higher levels of competence in all the six dimensions of the health professional education in patient safety survey than students in the third- and fourth-year levels.

CONCLUSIONS

Saudi nursing students have positive perceptions towards their patient safety competencies. Significant differences were found in the patient safety competence of nursing students between universities, gender and year of study.

RELEVANCE TO CLINICAL PRACTICE

The results provide valuable insights and guidance for improving the patient safety competence of nursing students. The findings can be used to guide the creation of policies and interventions that may ensure the continuous development of patient safety competence of nursing students as they navigate the clinical area.