Consequences of the hospital nursing research culture: Perspective of staff nurses

Objective

Research plays a critical role in molding nursing as a profession. Healthcare organizations are challenged to build an organizational culture that cultivates the development of nursing research. Creating a culture of nursing research is constantly branded a vital component in advancing nursing science. Therefore, this study described nurses' perceptions about their hospital's nursing research culture.

Methods

Semi-structured personal interviews were used to collect data. Seventeen staff nurses were selected to participate in the study by purposive sampling method from December 2022 to April 2023 in the eastern Philippines. The researchers used Braun and Clarke's thematic approach to analyze the qualitative data.

Results

The analysis revealed three central themes and seven subthemes: influencing behavior and performance of the employee (help in research information and learning, flexibility and adaptability, collaboration and communication among employees), influencing staff nurses' research participation (leadership strategies, training and professional development), and affecting hospitals to adapt to change (organizational performance and success, employee engagement and job satisfaction).

Conclusions

The findings support the benefits of a positive nursing research culture in hospitals due to its critical role in shaping nurses' behavior and performance, participation in nursing research, and hospital adaptation to changes. Collectively, these themes contribute to a deeper understanding of the multifaceted impact that a culture of nursing research can have on various levels of the healthcare system.

Highly Educated Mother's Perception of Childhood Vaccination Hesitancy in Kazakhstan: A Thematic Analysis

Background

Vaccine hesitancy among parents directly affects the child's vaccination status since they are the legal decision-makers regarding vaccinating their children. The study aimed to describe the perceptions of highly educated Kazakhstani mothers about childhood vaccination hesitancy.

Methods

The study utilized a thematic analysis to explore the mothers' perceptions. A sample of 95 participants comprehensively answered the free-text questions in an online questionnaire from January to February 2023. The analysis of the free-text responses followed a semantic thematic analysis approach. The data were coded manually.

Results

From the in-depth analysis of the data, 285 initial codes were extracted. The combination of similar meanings and concept codes led to 14 sub-themes and finally yielded four significant themes: misconceptions about childhood vaccination, fear of the effect of vaccine on children, distrust of the healthcare system, and social learning factors.

Conclusion

The perceptions of Kazakh mothers about childhood vaccination hesitancy may lead to behaviors of delaying and refusing some or all childhood vaccines. Therefore, motivational and educational strategies can be used by healthcare providers to instill trust in parents about childhood vaccines and their safety and effectiveness.

Environmental sustainability in healthcare: A qualitative study of the perspectives of nursing, medical and public health students in Kazakhstan

THE AIM WAS

This study explored the perspectives of nursing, medical and public health students on environmental sustainability in healthcare.

BACKGROUND

The healthcare sector has increasingly recognized the importance of adopting environmental sustainability over the past few years. This growing awareness emphasizes the need to thoroughly assess the connection between health care and environmental responsibility.

DESIGN

Qualitative descriptive-exploratory design.

METHODS

This study explored the views on environmental sustainability in health care of 29 nursing, medical and public health students at three universities in Kazakhstan through focus group discussions. Thematic analysis was used in the data analysis. Data collection was carried out from June to August 2023.

RESULTS

Using semantic thematic analysis, 209 initial codes were extracted, and then similar codes and meanings were grouped, leading to 21 categories until the development of the five significant themes. The five main themes are 'the impact of the environment on health', 'environmental sustainability practices in healthcare care', 'the importance of interdisciplinary collaboration in environmental sustainability in healthcare', 'intrinsic motivation to engage in environmental sustainability practices in healthcare' and 'challenges and barriers to practicing environmental sustainability in healthcare'.

CONCLUSIONS

The study findings suggest the critical aspect of addressing environmental sustainability through interprofessional collaboration and working on intrinsic motivation among health professionals. Furthermore, our study contributes in several ways to our understanding of environmental sustainability in healthcare. Provides a basis for clinicians, educators and policy makers to consider adding sustainability to their agenda to prepare future health professionals.

Designing, implementing, and evaluating a mobile app-based cultural care training program to improve the cultural capacity and humility of nursing students

BACKGROUND

Given the growing cultural diversity among healthcare clients, it is crucial for nursing education to have a clear mission: to effectively train future nurses by incorporating cultural care curricula. The goal is to equip them with the necessary cultural capacity and humility. This study focused on designing, developing, and evaluating a mobile app-based cultural care training program, with the aim of enhancing the cultural capacity and humility of nursing students.

METHODS

This experimental study utilized the five steps of the ADDIE instructional model (analysis, design, development, implementation, and evaluation) to design a mobile app-based cultural care training program. The first three steps involved designing and developing the program, drawing upon Purnell's model for cultural competence and Foronda's rainbow model of cultural humility. In the fourth step, the cultural care training program was implemented in 16 modules among 80 internship nursing students. These students were randomly assigned to either the intervention or control groups, with 40 students in each group. Finally, in the fifth step, the effectiveness of the mobile app-based program was evaluated by administering the Cultural Capacity Scale, and the Foronda Cultural Humility Scale before and one month after the cultural care training. The collected data were analyzed using SPSS22, employing techniques such as paired t-test, chi-square test, and independent samples t-test.

RESULTS

A total of 76 students completed the study, with 39 students in the intervention group and 37 students in the control group. Prior to the mobile app-based cultural care training program, there were no significant differences in cultural capacity and humility scores between the two groups (p > 0.05). However, following the completion of the program, the intervention group exhibited higher scores in cultural capacity and humility compared to the control group (p < 0.05).

CONCLUSION

Based on the findings, it can be concluded that the mobile app-based cultural care training program had a positive impact on the cultural capacity and humility of undergraduate nursing students. These results indicate the importance of nurse educators designing comprehensive training programs that incorporate innovative approaches to enhance cultural capacity and humility among nursing students at all academic levels.

Investigating the Kazakhstani Pediatric Nurses' intravenous catheter management knowledge and confidence: A cross-sectional study

AIM

To assess Kazakh pediatric nurses' knowledge and confidence in peripheral intravenous catheter (PIVC) management and examine the personal and professional factors that influenced them.

BACKGROUND

Despite the significance of having high levels of PIVC insertion and care knowledge and confidence among pediatric nurses, the literature portrays inadequacies in the knowledge of these nurses in various parts of the globe.

DESIGN

This study is cross-sectional and observational, following the STrengthening the Reporting of OBservational studies in Epidemiology checklist in reporting.

METHODS

A convenience sample of 200 pediatric nurses working in the University Medical Center in Kazakhstan were surveyed from November to December 2022 using a paper-based questionnaire to assess the PIVC management knowledge and confidence.

RESULTS

The respondents had poor knowledge of patient assessment, PIVC insertion, maintenance, and removal. Participants reported high confidence in inserting and maintaining PIVCs among pediatric patients. Nurses' education, pediatric nursing experience, and training in PIVC management in the last 12 months were significant predictors of the nurses' knowledge. PIVC insertion and care knowledge directly influenced the nurses' confidence in these procedures.

CONCLUSIONS

Despite the high confidence of the nurses, their actual knowledge of these skills needed to be higher. Some personal and professional factors influence the knowledge and confidence of pediatric nurses.

Socioeconomic, health-care access and clinical determinants of disease severity in Multiple Sclerosis in Chile

BACKGROUND

MS severity may be affected by genetic, patient-related, disease-related and environmental factors. Socioeconomic status, including income and healthcare access, amongst others, may also have a role in affecting diagnostic delay or therapy prescription. In Chile, two main healthcare systems exist, public-healthcare and private-healthcare, nonetheless universal care laws (e.g., access to High Efficacy Therapy-HET), including both systems, have been recently enacted for people with MS.

OBJECTIVE

To assess the role of Socioeconomic Conditions (SEC), clinical variables and public health policies on the impact of disease severity of MS patients in Chile.

METHODS

Multicentric, observational, cross-sectional study including patients from two reference centres (1 national reference centre from the private-health system and 1 regional reference centre from the public-health system). SEC and clinical variables included healthcare insurance (private or public), subclassification of health insurance according to monthly income, sex, age at onset, diagnostic delay, disease duration, diagnosis before HET law (as a proxy of HET delay), and current HET treatment. Progression Index (PI), EDSS ≥6.0 and Progressive MS diagnosis were used as outcome measures. Multivariable binary logistic regression was performed.

RESULTS

We included 604 patients (460 private-health, 144 public-health), 67% women, 100% white/mestizo, 88% RRMS, mean age 42±12 years, mean age at onset 32±11 years, mean disease duration 10±6 years, median diagnostic delay 0 (0-34) years, 86% currently receiving any DMT, 55% currently receiving HET, median EDSS at last visit of 2.0 (0-10), and median PI 0.17 (0-4.5). Lower monthly income was associated with higher EDSS and higher PI. In the multivariable analysis, public-healthcare (OR 10.2), being diagnosed before HET-law (OR 4.89), longer diagnostic delay (OR 1.26), and older age at onset (OR 1.05) were associated with a higher risk of PI>0.2, while current HET (OR 0.39) was a protective factor. Diagnosis before HET-law (OR 7.59), public-healthcare (OR 6.49), male sex (OR 2.56), longer disease duration (OR 1.2) and older age at onset (OR 1.1) were associated with a higher risk of Progressive MS. Public-healthcare (OR 5.54), longer disease duration (OR 1.14) and older age at onset (OR 1.08) were associated with a higher risk of EDSS ≥6.0 while current treatment with HET had a trend as being a protective factor (OR 0.44, p = 0.05).

CONCLUSION

MS severity is impacted by non-modifiable factors such as sex and age at onset. Interventions focused on shortening diagnostic delay and encouraging early access to high-efficacy therapies, as well as initiatives that may reduce the disparities inherent to lower socioeconomic status, may improve outcomes in people with MS.

Influence of student nurses' perceived caring behavior of their instructors on their psychological well-being: a cross-sectional study

AIM

This study aimed to understand the influence of clinical instructors' caring behavior on the psychological well-being of student nurses.

DESIGN

This study survey used the quantitative cross-sectional research design.

METHOD

The sample comprised 405 Saudi nursing students studying at Shaqra University. The study used two instruments: the "Nursing Students' Perceptions of Instructor Caring" and the "Student Well-being Process Questionnaire." Convenience sampling was used to collect data from November 2021 to February 2022.

RESULT

The students' perceived Instructor caring was high. The psychological well-being of students was high. There were significant variations in the students' perceived Instructor's caring in terms of year level. A very weak positive correlation existed between the student nurses' rank in their families and their perceived Instructor's caring. Furthermore, gender, year level, family structure, and the Instructor's caring subscales "supportive learning climate," "appreciation of life's meaning," and "control versus flexibility" were significant predictors of the student's psychological well-being.

CONCLUSION

The study's results support studies that nursing students' psychological well-being is influenced by their gender, family structure, year level, and perceived Instructor's caring behavior.

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.

Influence of the Psychological Effect of COVID-19 on Saudi Student Nurses' Attitudes toward Nursing and Their Future Career Plans

BACKGROUND

The effects of COVID-19 on the attitude of student nurses toward the nursing profession remain unclear because few studies have been conducted on this topic. Thus, this study examines the influence of the psychological effects of COVID-19 on student nurses' attitudes toward the nursing profession and their desire to become nurses.

METHOD

The study utilised a quantitative, cross-sectional, and observational design. It surveyed a convenience sample of 726 student nurses in Saudi Arabia during the first semester of the 2021-2022 academic year.

RESULTS

The students reported low levels of COVID-19 fear, anxiety, stress, phobia, and obsession. The students reported positive attitudes toward the nursing profession and 86.0% highlighted their desire to continue with nursing as their future profession. Gender, knowing someone infected with COVID-19, confidence in the government's pandemic response, fear, anxiety, and phobia were significant predictors of the nurses' attitudes. Community, family members in the profession, "COVID-19-related anxiety", and "preference for the nursing profession" were significant predictors of the student's desire to continue nursing.

CONCLUSIONS

Living in a rural community, having family members in the nursing profession, having low levels of COVID-19-related anxiety, and having positive attitudes toward nursing increased the likelihood of nursing students continuing their nursing careers during the COVID-19 pandemic.

Face Mask Use and Social Distancing Attitude of Healthcare Students: A Multi-Disciplinary Study

This multi-disciplinary, cross-sectional, and descriptive study investigated health care students' face mask use knowledge, attitude, and practices (KAP) and social distancing attitudes. The study was carried out from October to December 2021 and surveyed 543 health care students selected via convenience sampling from the three Shaqra University campuses in Saudi Arabia. Standard multiple linear regressions were conducted on face mask use KAP and social distancing attitude to identify their significant associated factors. The students in this study had poor knowledge and a neutral attitude towards and modest use practices of face masks during the COVID-19 pandemic. Being female, being a nursing student, and having greater self-reported COVID-19-prevention knowledge were related to higher levels of face mask use knowledge. Having higher face mask use knowledge was linked to better attitude and practice. Knowledge of COVID-19 and its prevention and decreased COVID-19 risk perception were associated with better face mask use practices. The students had more positive than negative attitudes toward social distancing. Having known someone who was infected by the virus, lower risk perception, and better face mask use practices were associated with more positive social distancing attitudes. The findings imply the need to ensure that future health care practitioners are knowledgeable, have a positive attitude and good practices concerning face mask use, and have positive attitudes toward social distancing. The study implications are relevant for health care education in Saudi Arabia and elsewhere.

Health education competence: An investigation of the health education knowledge, skills and attitudes of nurses in Kazakhstan

AIMS

This study assessed the nurses' knowledge of, skills on and attitudes toward health education among nurses working at the University Medical Center Corporate Fund (UMC) in Kazakhstan. The personal and professional factors influencing the nurses' knowledge of, skills on and attitudes toward health education were also investigated.

BACKGROUND

Health education is one of the nurses' fundamental responsibilities. Nurses' role in health education is critical in empowering patients and their families to live healthier lives, thus ensuring optimum health, well-being and quality of life. However, in Kazakhstan, where the nursing profession is still establishing its professional autonomy, data concerning the competence of Kazakh nurses in health education is unknown.

DESIGN

A quantitative study, specifically the cross-sectional, descriptive and correlational designs.

METHODS

The survey was performed at UMC in Astana, Kazakhstan. Using a convenience sampling technique, 312 nurses participated in the survey from March to August 2022. The "Nurse Health Education Competence Instrument" was used to collect data. The personal and professional characteristics of the nurses were also collected. Standard multiple regression analysis examined the personal and professional variables influencing the nurses' health education competence.

RESULTS

The respondents' average score in the "Cognitive domain," "Psychomotor domain," and "Affective-attitudinal domain" was 3.80 (SD = 0.66), 3.99 (SD = 0.58) and 4.04 (SD = 0.62), respectively. The nurses' category as a nurse, medical center, attendance to health education training/seminars in the last 12 months, provision of health education to a patient in the last week and perception of health education's significance in nursing practice were significant predictors of the nurses' health education competence contributing an approximately 24.4 %, 29.3 % and 27.1 % of the variance of the health education knowledge (R² = 0.273, Adjusted R² = 0.244), skills R² = 0.320, Adjusted R² = 0.293) and attitudes (R² = 0.299, Adjusted R² = 0.271).

CONCLUSIONS

The nurses reported high levels of health education competence (knowledge, attitudes and skills). The personal and professional factors influencing the nurses' competence in health education are essential to consider when developing interventions and healthcare policies to ensure nurses' competent provision of health education to patients.

Saudi Nurse Interns' Experiences during the COVID-19 Pandemic: A Thematic Approach

BACKGROUND

The learning process for nurses, including internships, was affected during the COVID-19 pandemic, which may have made the nurse internship program more challenging and stressful for participants. Therefore, it is significant to explore the experiences of nurse interns during COVID-19.

AIM

This study aimed to explore Saudi nurse interns' field experiences during the pandemic.

DESIGN

The study utilised descriptive phenomenological qualitative research and a thematic approach.

METHODS

A total of 19 nurse interns participated in the study, which was conducted in Saudi Arabia. Participants undertook an internship program at different government hospitals in five cities in Saudi Arabia. Unstructured individual interviews were conducted to gather data from the participants.

RESULTS

The findings revealed five themes: being passionate, lacking knowledge and skills, being concerned about their families, being cautious, and being unoriented.

CONCLUSION

The study findings document that the struggles of nurse interns in their internship programs during COVID-19 were related to their lack of knowledge, their family, and the working environment.

Predictors of Self-Assessed and Actual Knowledge about Diabetes among Nursing Students in Saudi Arabia

The aim of this study was to investigate the predictors of self-assessed and actual knowledge of diabetes among undergraduate nursing students. Nursing education plays an important role in preparing future nurses and ensuring that they are knowledgeable and competent in diabetes care. A descriptive, cross-sectional study was conducted with a convenience sample of 330 undergraduate Saudi student nurses. We collected data from October to December 2019 using the Diabetes Self-report Tool (DSRT) and Diabetes Basic Knowledge Tool (DBKT). We performed a multiple regression analysis to identify the predictors of self-reported and actual knowledge of diabetes. The students' overall mean (SD) scores in the DSRT and DBKT were 48.31 (5.71), which is equivalent to 80.52% of the total score and 22.54 (8.57), respectively. The students' university, gender, year level and experience in providing direct care to diabetic patients were the significant predictors of self-reported knowledge, whereas their university, age and perceived diabetes knowledge were the significant predictors of actual diabetes knowledge. The findings underscore the necessity to improve student nurses' actual knowledge of diabetes and its management. Our findings provide a solid basis for planning and implementing educational interventions with diabetes-related information to ensure adequate diabetes knowledge among nursing students.

The Influence of Sleep Quality on Patient Safety Learning of Nursing Students

We investigated the influence of nursing students' sleep quality on their patient safety (PS) competence (i.e., knowledge of the dimensions of PS). The investigation surveyed 242 nursing students in a Saudi university. The majority of the surveyed students were characterized as having poor sleep quality. Notably, more male students experienced poor sleep quality than female students. The students reported the highest confidence in "culture of safety" and "managing safety risk"; they exhibited the poorest confidence in "working in teams." Increased length of sleep latency decreased sleep efficiency, and increased daytime sleepiness-related dysfunction was associated with reduced PS competence.

Infection prevention and control awareness, attitudes, and practices among healthcare professionals in South India

INTRODUCTION

Infection is a key challenge in healthcare settings around the world. Healthcare professionals (HCPs), including medical laboratory technologists (MLTs) and nurses, are at risk of infection because they are in close contact with infected patients. This investigation was conducted to evaluate the awareness, attitude, and practices of Infection Prevention Control (IPC) among HCPs working in private tertiary hospitals in two states in South India.

METHODOLOGY

This quantitative study surveyed 571 HCPs in southern India. In September 2021, an online survey was used to collect data on the respondents' demographic and IPC-related variables, as well as their awareness, attitudes, and practices of IPC.

RESULTS

The survey revealed high level of awareness, positive attitudes, and good IPC practices. Among the IPC practices, "changing gloves between contacts with different patients" was the most often practiced and "washing hands after removal of gloves" was the least practiced. Being a nurse, being older, finishing a graduate program, attending a risk assessment training, having sufficient Personal Protective Equipment (PPE) at work, and being aware of the safety guidelines were associated with better awareness. Being a nurse, being older, and holding a diploma were associated with more positive attitudes. Being MLT, attending risk assessment training, having sufficient PPE at work, and being aware of the safety guidelines were associated with better IPC practices.

CONCLUSIONS

Measures to sustain the high awareness, positive attitudes, and good IPC practices by dealing with the factors associated with these variables identified in this study must be planned and implemented.

Willingness to care for older people and associated factors in pre-registered student nurses: A multi-country survey study

BACKGROUND

Addressing nursing students' lack of interest in providing care for the aged population is a global challenge for nursing educators. Despite global interest in student nurses' readiness for older people care, almost all the literature has been identified from single countries, predominantly with high income per capita. At present, no study has been conducted to provide evidence-based data related to this topic from a multi-country perspective.

OBJECTIVE

The study's purpose was to examine the willingness to work with older persons and associated factors among student nurses from nine countries (or regions).

DESIGN

This study utilized a correlational and cross-sectional design.

SETTINGS

This was a multi-country survey study conducted in China, Chile, Egypt, Hong Kong, India, Greece, the State of Palestine (henceforth Palestine), the Philippines, and Saudi Arabia.

PARTICIPANTS

2250 baccalaureate nursing students were recruited from 10 universities in this study.

METHODS

The survey that was used to collect data comprised four parts: socio-demographic data, attitude toward aging, older person care perception, and willingness to work with such group.

RESULTS

Respondents in five regions (including Mainland China, Greece, Hong Kong, Palestine, and Saudi Arabia) stated that older persons were the least favored group for future career choices. In comparison with mainland China, respondents in Chile, India, and the Philippines were significantly more likely to be willing to care for older patients, but those in Egypt and Greece indicated a lower tendency to choose this option. Favorable attitudes toward aging and older person care perception were significantly associated with having the willingness to provide care to gerontologic patients in the future.

CONCLUSIONS

Although attitudes toward aging and older person care perception have long been confirmed as important factors that are linked with willingness in caring for older people, this study adds that location is a more influential factor. Additional research in other countries is needed to advance the knowledge in this important area.

Predictors of nursing students' intention to receive COVID-19 vaccination: A multi-university study in Saudi Arabia

AIMS

This study examined the predictors of student nurses' intention to vaccinate against COVID-19. We measured the nursing students' risk perceptions, anxiety, fears and beliefs on COVID-19 vaccine; attitudes towards it and vaccine literacy (VL).

DESIGN

This study is a multi-university study utilizing the quantitative, cross-sectional and predictive approach.

METHODS

Using convenience sampling (n = 1170), we surveyed 10 Saudi universities from November 26, 2020, to December 31, 2020. Forward stepwise multinomial logistic regression was performed in identifying the factors predicting student nurses' intention to vaccinate against COVID-19.

RESULTS

The overall mean in the risk perception, anxiety and fear was 9.59 (SD = 2.82, possible range = 1-15), 3.95 (SD = 4.77, possible range = 0-20) and 18.17 (SD = 6.65, possible range = 7-35) respectively. They also reported a mean of 29.90 (SD = 6.56, possible range = 8-40) on COVID-19 belief. COVID-19 positive and negative attitudes mean score was 3.64 (SD = 0.92) and 2.72 (SD = 0.90) in a 1-4 range of scores respectively. The functional and interactive-critical COVID-19 VL of the students were at moderate levels. More than half of the respondents (55.9%) intended to be vaccinated against COVID-19, 17.6% did not intend to do so and 26.5% were unsure. High-risk perceptions, low levels of COVID-19 anxiety, positive beliefs and attitudes towards COVID-19 vaccine, and high levels of interactive-critical COVID-19 VL were significant predictors of student nurses' intentions to vaccinate against COVID-19.

CONCLUSION

Policymakers could consider the factors identified in this study and why the students did not intend to receive the vaccine in planning a nationwide vaccination program. The colleges of nursing could also utilize the findings in developing educational programs that aim to improve VL and beliefs and attitudes towards COVID-19 vaccine.

Academic motivation and self-directed learning readiness of nursing students during the COVID-19 pandemic in three countries: A cross-sectional study

BACKGROUND

It is crucial to evaluate student academic motivation and self-directed learning (SDL) readiness while teaching online or flexibly. During the coronavirus disease 2019 epidemic, there were few investigations on the link between academic motivation and SDL readiness.

AIM

This study investigated the connection between academic motivation and SDL readiness and the three academic motivation domains' predictive features.

METHODS

This cross-sectional study used convenience sampling to recruit 1187 nursing students from four nursing colleges in three countries. We utilized the Academic Motivation Scale College Version and Self-directed Learning Readiness Scale for Nurse Education to collect data. Descriptive and inferential statistics were employed to analyze the data.

RESULTS

Extrinsic motivation received the highest mean. Most nursing students exhibited SDL readiness, whereas "desire for learning" was rated the highest dimension of SDL readiness. We found significant differences in nursing students' intrinsic and extrinsic motivation and amotivation between the three countries. Finally, country, gender, and intrinsic motivation were significant predictors of the nursing students' SDL readiness.

CONCLUSION

Among Filipino, Saudi, and Thai nursing students, their SDL readiness is influenced by the intrinsic motivation domain. Therefore, nursing students with higher levels of intrinsic motivation are proactive learners for SDL.

Nurses' spiritual well-being and the COVID-19 pandemic: A Thematic Approach

AIMS

This study explores nurses' perceived spiritual well-being in the workplace during the COVID-19 pandemic.

BACKGROUND

Nurses have been working heavy shifts under challenging workplace conditions during the COVID-19 pandemic, leading to anxiety and psychological stress. These various challenges at work place their spiritual well-being at risk.

DESIGN

Thematic qualitative approach.

METHODS

An unstructured individual online interview was conducted to collect data from 18 nurses from April to August 2021. Data were analyzed using the thematic approach.

RESULTS

This study highlighted the four themes of spiritual well-being of nurses, namely, "Trust in God," "spiritual encouragement," "spiritual attributes in the workplace," and "spiritual growth."

CONCLUSIONS

The study concludes that spirituality is critical in helping nurses overcome the myriad of adversities they face as they assume their important roles during the ongoing pandemic.

IMPLICATION FOR NURSING MANAGEMENT

The study emphasizes that nurses' spiritual aspect nurses during crises is equally important with the other aspects of a nurse's life. Moreover, policies and interventions in hospitals must be implemented to ensure excellent levels of spiritual well-being among nurses.

Validity and reliability of the Subjective Happiness Scale Arabic version among Saudi working women

Objective

Measuring Saudi women's subjective happiness during the present period that has brought great transformations in gender equality in KSA is essential to gather reliable information about the present situation of women in KSA. This study intends to test the validity and reliability of the ‘Subjective Happiness Scale’ Arabic version (SHS-A) when applied to Saudi working women. This study also examines the factors that affect the subjective happiness of Saudi working women.

Methods

This validation study was conducted among 300 Saudi working women to test the psychometric properties of the SHS-A. Validity was evaluated using principal component analysis (PCA) and confirmatory factor analysis (CFA). Multiple regression analysis was also carried out to examine the factors affecting subjective happiness.

Results

The PCA identified one factor that explained approximately 66.0% of the variance of the model. The CFA revealed the following findings: normed fit index = 0.982, comparative fit index = 0.990, Tucker–Lewis index = 0.971, goodness-of-fit index = 0.986, adjusted goodness-of-fit index = 0.929, and root mean square error of approximation = 0.086. The x²/df value was 2.09 (x² = 4.189, p = .123). The Cronbach's alpha of the SHS-A in the first and second samples was 0.824 and 0.830, respectively. Employment position, working hours, and monthly salary were found to influence the subjective happiness of Saudi working women.

Conclusions

This study provides evidence that supports the validity and reliability of the SHS-A when used among Saudi working women. This valid and reliable tool can open further avenues and opportunities for advancing women's research agenda in KSA and other Arabic-speaking countries for economic and societal progress.

•

SHS-A has acceptable validity and reliability for Saudi working women.

•

SHS-A can be used to measure Saudi working women's subjective happiness.

•

SHS-A can be used for research, policymaking, and policy evaluation related to women's happiness.

Structural empowerment and work ethics influence on the work engagement of millennial nurses

AIM

This study investigated the influence of structural empowerment and work ethics on work engagement among millennial Saudi clinical nurses.

BACKGROUND

No extensive research has been conducted on the structural empowerment, work ethics and work engagement of millennial nurses, especially in Arab countries such as Saudi Arabia.

DESIGN

This study utilized descriptive correlation quantitative design.

METHOD

A total of 250 millennial Saudi nurses participated in the online survey containing the Multidimensional Work Ethic Profile-Short Form, Conditions for Work Effectiveness Questionnaire-II and Utrecht Work Engagement Scale.

RESULTS

Descriptive analyses revealed the highest mean for 'delay of gratification' for work ethics (M = 4.38, SD = 0.66), 'access to opportunity' for structural empowerment (M = 4.28, SD = 0.78) and 'dedication' dimension for work engagement (M = 5.02, SD = 1.10). Regression analysis revealed that marital status, employment status, type of hospital, structural empowerment and work ethics influenced the work engagement of millennial Saudi clinical nurses.

CONCLUSIONS

Personal and organisational factors, work ethics and structural empowerment contribute to the work engagement of millennial Saudi clinical nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

This study discusses the importance of formulating strategies such as recognition, rewards and incentives for good nursing practice to foster the work engagement of millennial nurses.

Behind male Saudi nursing students' mental health facade: a husserlian phenomenological approach

BACKGROUND

Every person has a persona (or mask) which is the façade that every person shows to the world. Thus, males use façade to reveal or conceal their true feelings and emotions. Also, the male uses mental health façade to protect themselves from prejudice and judgment. Thus, the study aimed to explore the experiences of male Saudi nursing students of mental health.

METHOD

Husserl's descriptive phenomenology was used as a guiding lens to explore. Eleven participants were involved in the study by using the referral sampling technique. An unstructured interview was performed to gather information from the participants. The seven steps of the descriptive Colaizzi process were followed to investigate and examine the obtained data. The credibility, dependability, confirmability, transferability, and reflexivity criteria were observed to ensure the rigor of the study.

RESULTS

The findings have two major themes. The first theme is the unadulterated smile that describes optimism in the family and mutual guarantee. The second theme is the orchestrated smile, which describes avoiding diverting burdens, social responsibility, protection of self, and reputation.

CONCLUSIONS

The findings document that the mental health façade of male Saudi nursing students is associated with the expectation of family optimism, mutual guarantee, the expectation of society, and self-protection.

Work engagement of nurses and the influence of spiritual climate of hospitals: A cross-sectional study

AIM

This investigation was endeavoured to study the influence of the hospital's spiritual climate on nurse's work engagement in Saudi Arabia.

BACKGROUND

Creating a safe clinical environment for nurses to express their spirituality despite preferences or religiosity is essential to increase work productivity, satisfaction and commitment.

METHOD

This quantitative and cross-sectional research surveyed a convenience sample of 302 nurses employing the 'Utrecht Work Engagement Scale' and 'Spiritual Climate Scale'.

RESULTS

The overall average of the respondents in work engagement was 4.33 (SD = 1.10), with more nurses reporting high or very high work engagement (53.7%). The hospital, age and spiritual climate were recognized as significant predictors of 'vigour'. The hospital's spiritual climate was the only significant factor influencing nurses' 'dedication'. The hospital and spiritual climate significantly influenced the variable 'absorption'.

CONCLUSION

Having a positive hospital spiritual climate was associated with better work engagement among nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings underscore the significance of ensuring that hospitals have positive spiritual climate and a clinical area that respects, accepts and welcomes various spirituality of nurses. Therefore, nurse managers should ensure that the spirituality of nurses has a safe home in the hospital.

Self-compassion influences the caring behaviour and compassion competence among saudi nursing students: A multi-university study

AIM

This research investigated the perceptions of Saudi nursing students regarding self-compassion and examined its influence on their caring behaviour and compassion competence.

DESIGN

This is a quantitative and cross-sectional study.

METHODS

This multiuniversity study surveyed a convenience sample of 961 nursing using the Self-compassion Scale, Compassion Competence Scale and Caring Behavior Inventory-16 version. Standard multiple analysis was performed separately for caring behaviour and compassion competence as dependent variables. For both models, the self-compassion dimensions and the demographic variables were considered predictor variables.

RESULTS

The students reported their self-compassion moderately, with mindfulness receiving the highest mean and self-judgment receiving the lowest mean. Significant differences were observed on self-compassion of students between universities. Caring behaviour and compassion competence were also rated moderately by the students. "Self-kindness" and "common humanity" were identified as significant predictors of caring behaviour, whereas "self-kindness," "self-judgment," "common humanity" and "mindfulness" were significant predictors of compassion competence.

Knowledge about antibiotics and antibiotic resistance among health-related students in a Saudi University

INTRODUCTION

Antibiotic resistance is a threat to public health and safety globally. The inadequate undergraduate education on antibiotic stewardship may contribute to the clinical malpractice of antibiotics, causing serious consequences toward patient health. Thus, this study aimed to evaluate the knowledge of future healthcare workers in Saudi Arabia on antibiotics, antibiotic use, and antibiotic resistance. The factors influencing the students' knowledge were also determined.

METHODOLOGY

A cross-sectional study using a survey questionnaire was carried out among 284 Clinical Laboratory Science, Nursing, and Pharmacy students in Saudi Arabia from January to April 2019. Multiple regression analyses were performed to identify the factors influencing the students' knowledge regarding antibiotics, antibiotic use and antibiotic resistance.

RESULTS

The study found that students have above-average knowledge of antibiotics and antibiotic resistance, whereas their knowledge of antibiotic use was inadequate. Several factors, including gender, program, academic level, awareness about antibiotic resistance, attendance to seminars/training, and belief on the seriousness of antibiotic resistance problem, affect students' knowledge. The findings suggest that the knowledge of students in these areas should be improved.

CONCLUSIONS

Misconceptions are prominent in certain areas, such as in the concept of antibiotics and their uses. The findings prompt immediate interventions to improve students' knowledge of antibiotics and resistance. Curricular contents must be reviewed and enhanced to suit the specific learning needs of students in terms of these concepts.

Professional quality of life and caring behaviours among clinical nurses during the COVID-19 pandemic

AIMS AND OBJECTIVES

To investigate the professional quality of life and caring behaviours among clinical nurses in Saudi Arabia during the COVID-19 pandemic. We also examined the influence of the nurses' socio-demographic and professional characteristics on the professional quality of life. Moreover, the study examined the influence of professional quality of life on caring behaviour among the nurses amid the COVID-19 pandemic.

BACKGROUND

Caring is the core of the nursing profession and considered the heart of the humanistic clinical nursing practice. However, the work nature of the clinical nurses, especially during the COVID-19 pandemic, continues to challenge their professional quality of life and caring behaviours. The factors influencing the professional quality of life and caring behaviours of clinical nurses have not been extensively explored.

DESIGN

Cross-sectional, descriptive study.

METHODS

A purposive sample of 375 clinical nurses in three academic medical centres in Saudi Arabia were surveyed using the professional quality of life version 5 and the short-form 24-item Caring Behavior Inventory from May-August 2020. A standard multiple regression analysis was performed to investigate the predictors of the professional quality of life and caring behaviour. This study adhered to the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

RESULTS

The majority of the respondents reported average level of compassion satisfaction (57.9%), burnout (54.4%) and secondary traumatic stress (66.9%) in the professional quality of life domains. The result also showed highest degree of caring in terms of 'assurance of human presence' while lowest in the 'knowledge and skills' in four subscales of caring behaviour. The following variables significantly predicted compassion satisfaction: education, area of assignment and position. Age, education and religion were identified as significant predictors of burnout while religion, nationality and position were significant predictors of secondary traumatic stress. Positive and negative domains of professional quality of life influenced the caring behaviours among clinical nurses.

CONCLUSIONS

Based on the results of the study, clinical nurses exhibited moderate level of professional quality of life and correlates to their caring behaviours. Moreover, clinical nurses' demographic characteristics predicted their professional quality of life and caring behaviours.

RELEVANCE TO CLINICAL PRACTICE

The importance of ensuring good professional quality of life and caring behaviour among clinical nurses during the COVID-19 pandemic is underscored. Nursing leaders can utilise this baseline evidence and apply programmes for clinical nurses to tackle professional quality of life issues and enhance caring behaviours.

Rathke's cleft cyst infections and pituitary abscesses: case series and review of the literature

PURPOSE

Pituitary abscesses (PAs) are a rare clinical entity which may arise from normal pituitary tissue or underlying lesions within the gland. Rathke's cleft cysts (RCCs) are not commonly associated with the development of PA.

METHODS

Retrospective chart review of three patients with PAs within RCCs at a single university center and review of the literature.

RESULTS

Three cases are reported. The first case presented with fever and headache and a history of prior surgery due to RCC and a recent respiratory tract infection. The second case had a history of recent skin infections and presented with sudden onset headache and hypopituitarism. In the third case, chronic visual field impairment prompted an ophthalmologic evaluation resulting in a diagnosis of an adenoma and an infected RCC. In all three cases, an endoscopic endonasal approach was performed to drain infected tissue and allowed microbiological identification of gram-positive cocci, followed by treatment with antibiotics for at least three weeks. Cases in the literature are scarce and the diagnosis is usually made intraoperatively due to non-specific manifestations and imaging. PAs arising from underlying pituitary lesions are less common than primary PAs. Differential diagnosis should include pituitary apoplexy, hypophysitis and other cystic lesions.

CONCLUSION

PAs occurring in RCCs are infrequent. Clinical manifestations are commonly subacute, without septic symptoms. Imaging is usually non-specific. Preoperative diagnosis is infrequent and a broad differential diagnosis should be considered. Empirical antimicrobial therapy should be initiated and adjusted after obtaining cultures to reduce the rate of recurrence and improve clinical outcomes.

Risk perceptions, fear, depression, anxiety, stress and coping among Saudi nursing students during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has seriously impacted various aspects of the society on a global scale. Schools and universities provide rich resources for adolescents and young adults to develop significant coping mechanisms.

AIM

This study assessed the perceptions of risk, fear, mental health status, and coping strategies among Saudi student nurses amid the COVID-19 pandemic.

METHODS

Using an online survey, the mental health of the students was assessed by the Depression, Anxiety and Stress Scale short form version, whereas the coping was assessed by the Brief-Coping Orientation of Problem Experienced scale.

RESULTS

The students had modest risk perception and fear of contracting COVID-19. "Religion" was reported as the most frequently used coping strategy. Approximately 43.3%, 37.2%, and 30.9% of the respondents manifested some degree of depression, anxiety, and stress, respectively. Poor COVID-19 knowledge, perceived seriousness of COVID-19 in Saudi Arabia, perceived risk of COVID-19 infection, and the use of some coping strategies were predictors of fear. Knowing someone infected with COVID-19, fear, and several coping strategies predicted students' mental health.

CONCLUSION

This study provides data that can be used to create educational and health policies that focus on the mental health of university students, specifically nursing students.

Psychometric analysis of the Nurses' Professional Values Scale-3 Arabic version among student nurses

AIMS

We sought to establish the psychometric properties of the Nurses' Professional Values Scale-3 Arabic version among student nurses.

BACKGROUND

Nurses' professional values are central in the nursing profession; it encompasses principles such as respecting people rights and dignity, compassion, and caring without prejudice.

INTRODUCTION

The professional values of student nurses, most specifically in Saudi Arabia and other Arab countries, can hardly be studied due of the lack of a valid and reliable measure that is linguistically and culturally acceptable.

METHODS

In this cross-sectional study, we came up with the Arabic version of the tool and tested its psychometric properties among 350 student nurses from two universities in Saudi Arabia.

RESULTS

The principal component analysis revealed three distinct factors with eigenvalues above 1.00 and with an explained variance of 70.5%. The computed Cronbach's alpha of the tool was 0.967, while 0.964, 0.960, and 0.886 were computed for activism, caring, and professionalism, respectively. The test-retest scores (n = 85) revealed an Intraclass Correlation Coefficient of 0.827 for the entire scale, 0.826 for the subscale activism, 0.792 for caring, and 0.870 for professionalism.

CONCLUSIONS

The Nurses' Professional Values Scale-3 Arabic version had sound psychometric properties when used among Saudi student nurses.

IMPLICATION FOR NURSING

The tool can provide an accurate assessment of the professional values of Saudi nursing students and other Arabic-speaking student nurses.

IMPLICATION FOR NURSING POLICY

The tool can be utilized by nursing and nursing education policymakers in Saudi Arabia and in other Arab countries in guiding the creation of practice and education policies that gears towards improving nurses' professional values in this part of the world.

Psychometric Properties of the Health Empowerment Scale Arabic Version for Working Women in Saudi Arabia

In a country such as Saudi Arabia where gender equality-related challenges continue to be social issues, measuring the health empowerment of Saudi working women is critical in understanding the real picture of women empowerment in the country during this era of great transformation. Therefore, we conducted this research to evaluate psychometric properties of the Health Empowerment Scale Arabic version (HES-A) in measuring the health empowerment of Saudi working women. We surveyed a sample of 322 Saudi working women from June to August 2020 using an online survey constituting questions on demographic and work-related information and the HES-A. The computed values for the item-level content validity index of the 8 scale items were from .80 and 1.00, whereas the computed value of the scale-level content validity index by average method was .91. The principal component and confirmatory factor analyses revealed a unidimentional scale. The computation revealed an alpha of .92. Education, type of employment, years of working experience, and salary were identified as significant factors influencing the health empowerment. The HES-A exhibited adequate validity and internal consistency for use in measuring the health empowerment of Saudi women. The HES-A can expand the research agenda on health empowerment Arab women. Researchers and policymakers could use the HES-A in assessing the status of health empowerment of Arabic-speaking women, which could inform policies and interventions aimed at ensuring health empowered women in this part of the globe.

Nursing Students' Perceptions, Knowledge, and Preventive Behaviors Toward COVID-19: A Multi-University Study

Background: Knowledge, perception, and preventive behavior should be considered in the planning of effective educational interventions for the coronavirus disease of 2019 (COVID-19) pandemic and in increasing awareness about the health risks brought about by this disease. This research aimed to assess knowledge, perceptions, and preventive behavior toward the COVID-19 infection among student nurses.

Methods: The study has quantitative, descriptive, and cross-sectional design. A convenience sample of 1,226 student nurses from seven universities in Saudi Arabia was surveyed from March 22 to April 4, 2020. A four-part online survey on demographic characteristics, perceptions, knowledge, and preventive behavior of Saudi student nurses was carried out.

Results: Nearly all students were aware of the outbreak (99.2%), and most of them received information on COVID-19 primarily from social media (71.0%). Over three-fourths of the students were confident that the government (89.1%) and Ministry of Health (MOH) (86.5%) were doing a good job responding to the COVID-19 outbreak in the country. The overall average score in the knowledge questionnaire was 9.85 (SD = 1.62, range = 0–12), which is equivalent to 82.1%. The majority of the students always performed most of the preventive behavior identified in the survey, except “washing hands with soap and water for at least 20 s after blowing my nose, coughing, or sneezing” (39.2%) and “daily cleaning and disinfecting frequently touched surfaces” (41.6%). Being female, being in the fourth year, and gaining good perceived knowledge were associated with high actual COVID-19 knowledge. University, gender, age, academic level, and perceived COVID-19 knowledge were the associated factors.

Conclusions: The findings of this study have provided baseline information on the current state of Saudi nursing students' perceptions, knowledge, and preventive behavior toward COVID-19 as the crisis is happening. The findings revealed some areas that should be focused on by nursing education, as well as health agencies, to ensure that the students have adequate knowledge and correct preventive behavior.

Nursing Students' Knowledge, Competence and Attitudes towards Vital Signs Monitoring during Clinical Practice

AIM AND OBJECTIVE

This study assessed the perceived knowledge and competence, and the attitude of Saudi nursing students towards vital signs monitoring for detecting patient deterioration during clinical rotation. It also examined the predictors of students' attitudes.

BACKGROUND

One of the most important uses of vital signs monitoring is the early detection of deterioration. Vital signs monitoring is one of the most frequently assigned tasks to students during clinical rotation. However, the attitudes of nursing students towards vital signs monitoring for detecting clinical deterioration remain unexplored.

DESIGN

Quantitative, cross-sectional design.

METHOD

A convenience sample of 529 baccalaureate nursing students in two universities in Saudi Arabia was surveyed using the V-scale from October 2019-December 2019. A multivariate multiple regression was implemented to examine the multivariate effect of the predictor variables on the five subscales of the V-scale. This study adhered to the STROBE checklist.

RESULTS

The overall attitudes of the students towards VS monitoring can be interpreted as poor to modest. The highest mean was reported in the subscale 'communication'. The subscales 'workload', 'key indicators' and 'technology' received low mean scores. The university, age, gender, academic year level and perceived knowledge had significant multivariate effects on the five subscales of the V-scale.

CONCLUSIONS

The Saudi nursing students had poor attitudes towards vital signs monitoring, specifically towards the use of technology in vital signs monitoring, the workload associated with vital signs monitoring and vital signs as key indicators of patient deterioration.

RELEVANCE TO CLINICAL PRACTICE

The findings reveal the need to improve the curricular content and training of nursing students regarding vital signs and the physiological indicators of clinical deterioration. This study also identified areas that require improvement to ensure positive attitudes among students.

LGI1-antibody associated epilepsy successfully treated in the outpatient setting

We report six patients with anti-LGI1 associated epilepsy. Two patients presented with new-onset generalized tonic-clonic seizures, four developed faciobrachial dystonic seizures and two piloerection. All patients had significant cognitive complaints at the time of diagnosis. All patients described seizure reduction during the first week of carbamazepine, and seizure freedom was obtained at a median of 13 days (range 7-22), sustained after the initiation of immunosuppression. Median time from symptom onset to carbamazepine initiation was 164 days (range 38-206 days). We discuss the particular seizure response to sodium channel blocking antiepileptic drugs, alone or associated with immunosuppression in this antibody mediated seizures.

Perceptions of female Saudi undergraduate nursing students toward family-centered care

BACKGROUND

While family-centered care is considered a vital part of nursing care, nursing students seem to struggle in incorporating family-centered care in the clinical setting. Several factors such as minimal exposure in family interactions throughout their clinical practice, lack of experience in organizing family-centered clinical experiences, access to restricted clinical areas, and inadequate supervision from clinical instructors present as challenges among nursing students in practicing family-centered care.

OBJECTIVES

This study explored the perceptions of nursing students toward family-centered care in Saudi Arabia.

DESIGN

This study used the quantitative approach through the cross-sectional survey method.

SETTINGS

The study was conducted in the Faculty of Nursing of a government university in Saudi Arabia.

PARTICIPANTS

A total population sample comprising 232 female junior and student nurses participated in the study.

METHODS

After the approval of the Ethical Board Committee had been secured, a survey containing a demographic information sheet and the Family-Centered Care Questionnaire was distributed to the students from June 2018 to February 2019.

RESULTS

The overall mean of the students' responses in the questionnaire was 3.76 (SD = 0.67, range = 3.40-4.08), indicating a modest perception toward family-centered care. The dimension "family is the constant" received the most positive response from the students (M = 3.90, SD = 0.77), whereas the dimension "parent-to-parent support" was rated the lowest with a mean of 3.64 (SD = 0.89). Junior nursing students had more positive perception toward family-centered care than the seniors. Weak negative correlations were observed between students' age and family-centered care perception.

CONCLUSIONS

This study provides insights into family-centered care, which could be used in crafting policies and interventions in various health care settings and nursing education in Saudi Arabia. Such insights could foster positive perceptions toward family-centered care among student nurses and guarantee excellent family-centered care nursing practice.

The Self-Compassion Scale Arabic version for baccalaureate nursing students: A validation study

BACKGROUND

The Self-Compassion Scale is an extensively used tool to measure self-compassion among different groups of population, including nurses. The tool has been translated and tested for its psychometric properties in previous studies. Assessing self-compassion among Saudi nursing students is critical as self-compassion is suggested to create a positive effect on one's wellbeing, coping, emotions, and other personal outcomes.

OBJECTIVES

This study determined the validity and reliability of the Self-Compassion Scale Arabic version (SCS-A) for nursing students. It also identified the demographic factors associated with the students' self-compassion.

DESIGN

A quantitative, cross-sectional design.

SETTINGS

The investigation was carried-out in two government universities in Saudi Arabia.

PARTICIPANTS

A sample of 322 Saudi nursing students in the 2nd to 4th year, as well as nurse interns was surveyed (mean age = 21.27, range = 18-27).

METHODS

The Self-Compassion Scale was culturally adapted to come up with the SCS-A. Content validity was established. Exploratory Factor Analysis (EFA) was used to establish the construct validity; whereas for reliability, internal consistency and test-retest reliability were established. Pearson's product correlation, t-test, and One-way Analysis of Variance were used to examine the demographic factors associated with self-compassion, accordingly.

RESULTS

A panel of experts rated content validity as excellent. The EFA revealed six dimensions namely "self-judgment," "self-kindness," "common humanity," "mindfulness," "isolation," and "over-identification", with total variance of 64.1%. Cronbach's alpha values for the six factors were from 0.76 to 0.85, with an overall α of the whole scale at 0.86. Computation revealed ICC values ranging from 0.84 to 0.92, whereas the ICC for the entire SCS-A was 0.81.

CONCLUSION

SCS-A shown satisfactory validity as well as good reliability. SCS-A can be used to collect baseline data on self-compassion, which could be used in developing policies in the universities and training hospitals to ensure that nurse interns and nursing students have compassion toward self. The study also opens opportunities for multi-country and cross-cultural studies on self-compassion among nursing students.

The Compassion Competence Scale Arabic version: A validation study among student nurses and interns in Saudi Arabia

AIM

The aim of this study is to assess the validity and reliability of the Compassion Competence Scale Arabic version for Saudi nursing students and interns.

BACKGROUND

Compassion is an essential element of quality health care in which training nursing students to deliver compassionate care is important. Assessment of compassion competence of Arabic-speaking nursing students requires a valid and reliable tool.

DESIGN

This is a descriptive and cross-sectional study.

METHODS

This investigation was conducted from April to May 2019 in two universities in Saudi Arabia involving nursing students and interns. Cultural adaptation was performed using a forward-backward translation method. Content validity and construct validity through exploratory factor analysis were established. Internal consistency, stability and reliability were also determined for the scale.

RESULTS

The Arabic version has an excellent content validity. The exploratory factor analysis supported a three-factor solution that accounts for 50.62% of the scale's variance. The Cronbach's alpha of the scale was 0.806, whereas the Cronbach's alpha of the subscales ranged from 0.739 to 0.797. The intraclass correlation coefficient of the two-week test-retest scores was 0.84. The university, gender, year level and family type predicted the students' compassion competence.

CONCLUSION

The Arabic version can be used to measure Arabic-speaking nursing students' compassion competence in clinical areas.

Phenotypic spectrum of neonatal CHARGE syndrome

INTRODUCTION

CHARGE syndrome is a genetic disorder of wide phenotypic variability, of autosomal dominant in heritance, caused by pathogenic variants in the CHD7 gene.

OBJECTIVE

To describe the broad pheno typic spectrum of neonatal CHARGE syndrome, heterozygous for the CHD7 gene, and the usefulness of genome sequencing in diagnostic confirmation, considering differential diagnoses.

CLINICAL CASE

34-week preterm newborn, with severe prenatal history of polyhydramnios, increased nuchal trans- lucency, and hyperechogenic cardiac focus, with a TORCH study that ruled out congenital infection. Peripheral facial paralysis, choanal atresia, multiple dysmorphisms, congenital heart disease, and bilateral retinochoroidal coloboma were observed at birth. The neuroimaging study showed hypo plasia of the cochlea and bilateral semicircular canals, and pontocerebellar hypoplasia. The auditory evoked potentials showed deep right-sided sensorineural hearing loss and left anacusis. The patient developed hypocalcemia and immunological alterations, confirming hypoparathyroidism and thy mus hypoplasia. The karyogram was normal and 22q11.2 microdeletion was excluded through mul tiplex ligation-dependent probe amplification (MPLA). A pathogenic variant in the CHD7 gene was detected that confirmed the clinical suspicion of CHARGE syndrome.

CONCLUSIONS

The overlap of clinical characteristics of CHARGE syndrome requires molecular genetic confirmation, considering differences in evolution, therapies, and recurrence risks with other genetic syndromes.

Quality of Life and the Predictive Roles of Religiosity and Spiritual Coping Among Nursing Students: A Multi-country Study

There has been high interest in religious and spirituality practices among college students due to positive benefits to university life. However, no studies have been conducted examining nursing students' religiosity and use of spiritual coping and its impact on their QOL. This cross-sectional, descriptive study measured the QOL and examined the predictive roles of religiosity and spiritual coping among nursing students from four countries. Nursing students reported high overall QOL and health. Significant differences were revealed on the religiosity and spiritual coping of students in terms of demographic characteristics. Findings show frequent attendance to organized and non-organized religious activities lead to better physical and environmental domains, and using non-organized religious activities frequently lead to improved psychological health. More frequent use of non-religious coping strategies was associated with better physical, psychological, and environmental health, and improved social relationships.

Assessment of nursing students perceptions of their training hospital's infection prevention climate: A multi-university study in Saudi Arabia

BACKGROUND

The risk of acquiring and spreading infection must be minimized in nursing students because they are exposed to healthcare-associated infections during clinical training. To achieve this goal, students should be knowledgeable and competent in infection control practice before proceeding to their training hospitals.

OBJECTIVES

This study assessed the nursing students' perception of the infection prevention climate in training hospitals in Saudi Arabia. It also examined the predictors of the students' perceptions.

DESIGN

A quantitative, cross-sectional design was used.

METHODS

This investigation was part of a large study conducted in six Saudi universities. A total of 829 Saudi nursing students were included in this study. Data were collected using the Leading Culture of Quality in Infection Prevention scale and analyzed using descriptive and inferential statistics. Ethical approval was obtained from the King Saud University, and permission was given by the administration of each participating university.

RESULTS

The overall perception of nursing students indicated a modest infection prevention climate. Prioritization of quality and improvement orientation was rated as the highest dimensions, whereas psychological safety and supportive environment were the lowest. The nursing students in University F had the poorest perceptions among the six universities. The predictors of nursing student perception of their training hospitals' infection prevention climates were the university where they studied, their age, and participation in infection prevention seminars.

CONCLUSIONS

This article describes nursing students' perception of the infection prevention climate of their training hospitals in Saudi Arabia. Results may provide a unique theoretical underpinning on the perception and factors that effect an infection prevention climate. Thereby, previous knowledge and literature may be expanded. Results can be used as a guide in establishing clinical policies in efforts toward improving the infection prevention climate.

Influence of workplace incivility on the quality of nursing care

AIMS AND OBJECTIVES

To examine the influence of workplace incivility on the quality of nursing care.

BACKGROUND

Recent evidence describes workplace incivility as a serious concern in the healthcare setting worldwide. Exposure to workplace incivility can alter a nurse's behaviour, thought process and perspective towards the nursing profession. However, there is insufficient evidence to determine whether workplace incivility might be associated with the quality of nursing care in Saudi Arabia.

DESIGN

A quantitative and cross-sectional study.

METHOD

A survey was carried out amongst 378 nurses in two government hospitals in Saudi Arabia from February 2018-May 2018 using the Nurse Incivility and quality of nursing care scales. Multivariate multiple regression was performed to investigate the influence of the uncivil experiences of nurses from different sources on the different aspects of quality of nursing care. The study adhered to STROBE guideline (see Appendix S1).

RESULTS

The overall mean of the quality of nursing care scale was 3.14 (SD = 0.66) from a scale of 1-5, with patient satisfaction receiving the highest mean dimension (mean = 3.27, SD = 0.72) and health promotion the lowest mean dimension (mean = 3.08, SD = 0.74). Experience in the present hospital and the hospital were associated with the overall quality of nursing care. General and nurse incivility exerted a multivariate effect on overall quality of nursing care and its different dimensions.

CONCLUSION

General incivility and nurse incivility were found to negatively impact quality of nursing care and its different dimensions.

RELEVANCE TO CLINICAL PRACTICE

Stronger policies geared towards eliminating workplace incivility should be implemented as uncivil acts can lead to poor quality of nursing care. Nurse administrators and nurses should be pro-active in recognising, preventing, approaching, reporting and intervening with uncivil acts in the hospital to protect these workers from these types of behaviours and avoid their negative impacts on patient care.

Clinical practitioners' perception of the dimensions of patient safety culture in a government hospital: A one-sample correlational survey

AIMS AND OBJECTIVES

To assess the perceptions of clinical practitioners regarding the different dimensions of patient safety culture in their hospital and examine the work-related predictors of patient safety culture perceptions.

BACKGROUND

Patient safety is seen as a progressively critical focus in healthcare areas worldwide. Saudi Arabia aims to improve healthcare quality by providing access to healthcare for its increasing population. Hence, constantly assessing the patient safety culture of healthcare facilities in the country is imperative.

DESIGN

One-sample correlational survey design.

METHODS

The Hospital Survey of Patients' Safety Culture was used to survey the total population sample of 181 healthcare practitioners in a Saudi hospital from December 2018-January 2019. Strengths and weaknesses on PS culture were identified as perceived by the clinical practitioners. Regression analysis was performed to identify the work-related predictors of patient safety culture perceptions. The study followed the STROBE guideline.

RESULTS

Nine of the 12 dimensions measured were identified as patient safety culture weaknesses, including 'management support for patient safety' (49.2%), 'teamwork across unit' (44.2%), 'frequency of events reporting' (43.1%), 'communication openness' (41.3%), 'overall perception of patient safety' (38.7%), 'supervisor/manager expectations and actions promoting patient safety' (32.9%), 'staffing' (23.7%), 'hospital handoffs and transitions' (19.6%) and 'non-punitive response to errors' (15.8%). None of the dimensions were identified as strengths by the respondents. Working hours per week and staff position were identified as significant predictors.

CONCLUSIONS

The study underscores the urgent need to improve the patient safety culture of the hospital.

RELEVANCE TO CLINICAL PRACTICE

Hospital administrators should highlight initiatives on positive patient safety impact plan for clinical practitioners and patients, such as monitoring, reporting and strictly adhering to hospital activities that reduce the risks associated with exposure to medical care.

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.

Compliance with standard precautions during clinical training of nursing students in Saudi Arabia: A multi-university study

INTRODUCTION

Nursing students are susceptible to healthcare-associated infections because of their direct patient interactions during their clinical training. Hence, compliance with standard precautions (SPs) is paramount during their clinical exposure and training. This study investigated the compliance with SPs and its predictors among Saudi nursing students from six universities.

METHODOLOGY

This descriptive, cross-sectional study was conducted in six government universities in Saudi Arabia. A convenience sample of 829 Bachelor of Science in Nursing (BSN) students was surveyed using the Compliance with Standard Precautions Scale. Descriptive and inferential statistics were carried out to analyze the data.

RESULTS

The overall compliance rate of the respondents was 60.1% with a mean score of 12.02 (SD = 4.50). The students reported highest compliance on covering the mouth and nose when wearing a mask, while the lowest compliance was on disposing sharps box before it is full. The university, academic year level, and attendance to infection prevention and control training or seminar in the last six months were identified as significant predictors of the students' compliance with SPs.

CONCLUSIONS

The findings provide valuable insights and guidance for improving the practice of SPs among future nurses, which could result in the reduction of infection exposure and its transmission rates among future nurses in clinical settings.

The Arabic version of the Kogan Attitudes toward Older People Scale among Saudi nursing students: a psychometric analysis

BACKGROUND

With the steadily increasing size of its elderly popu.lation, Saudi Arabia is currently trying to meet the demands for com.petent care for older people. However, the lack of a valid and reliable measurement instrument in the Arab Peninsula hinders related studies among nursing students in this part of the globe. Given the importance of nursing students' attitudes toward working with older people, a specialized tool that can provide an accurate assessment of students' attitudes toward older adults is necessary.

OBJECTIVE

Evaluate the psychometric properties of the Kogan Attitudes towards Older People Arabic version (KAOP-A) among Saudi nursing students.

DESIGN

Descriptive, cross-sectional.

SETTING

Nursing department of a government university.

SUBJECTS AND METHODS

Using total population sampling, Saudi nursing students were surveyed using the KAOP-A. The tool was culturally adapted to the Arabic language using a forward and backward method. Content and construct validity were established accordingly. The internal consistency was established to support the reliability of the tool.

MAIN OUTCOME MEASURES

The validity and reliability of the KAOP-A.

SAMPLE SIZE

164 nursing students.

RESULTS

The KAOP-A had acceptable content and construct valid.ity. The Exploratory Factor Analysis supported a two-factor solution for the KAOP-A with an explained variance of 60.12%. The computed Cronbach's alpha for the entire scale was 0.89. The mean score of the KAOP-A scale was 121.55 (SD=26.92, range=40-204), indicating a slightly positive attitude toward aging among the students. Nursing students belonging to extended type of family and living in rural community, as well as older students and students who reported higher degree of closeness with their grandparents, exhibited more positive attitudes towards older people.

CONCLUSION

The tool can be used to accurately assess student attitudes towards older people, which can inform the creation of educational policies and interventions geared towards creating a more positive outlook on older adult care among nursing students in Saudi Arabia.

LIMITATIONS

We did not perform test and re-test reliability analysis.

CONFLICT OF INTEREST

None.

Functional magnetic resonance imaging in the study of multiple sclerosis

INTRODUCTION

Multiple sclerosis (MS), a neuroinflammatory and demyelinating disease, modifies the normal connectivity among different brain regions involved in specific functions. Functional magnetic resonance imaging (fMRI), based on local changes in oxygen level as a response to the increase in neural activity, provides an approach to neural connectivity and brain dynamics which give us an overview on visual, motor and cognitive dysfunction and their mechanisms.

DEVELOPMENT

An advanced search was performed using PubMed. Terms 'fMRI', 'visual', 'motor', 'cognitive' and 'multiple sclerosis' included in title and abstract were considered. We focus on original articles available in English. Articles were included based on their abstracts, looking for those potentially useful for understanding functional changes in MS. An important amount of studies have used fMRI as a complementary tool in the study of MS and clinically relevant alterations compromising visual, motor and cognitive domains. Since the earliest stages of the disease, local activity, and global neural dynamics appear to be compromised. Even when functional performance is still preserved, a different recruitment of neural resources arises as a compensatory response to disconnection observed in the disease.

CONCLUSIONS

The main findings of fMRI applied to MS are strongly related to the demyelinating nature of the disease and provide an adequate insight into the mechanisms that underlie functional alterations reported in this disease. fMRI also appears to be useful for studying disease evolution and response to treatment in MS and other disorders.