Barriers to nurse-patient communication in Saudi Arabia: an integrative review

Exploring the experiences of female undergraduate nursing students in providing home healthcare to older adults

BACKGROUND

In light of the growing ageing population in Saudi Arabia and Saudi nurses' hesitation to work with the older population, it is important to understand the experiences of nursing students on their clinical placement in home healthcare.

METHODS

This study is a descriptive qualitative study based on five focus groups of 3-5 students each. Data were collected from female senior baccalaureate nursing students at a female governmental university in Saudi Arabia, and during their placement in home healthcare. Data were analysed using thematic analysis.

RESULTS

Five main themes emerged : struggling with their own family; struggling with cultural and social beliefs; struggling during clinical training; struggling with domestic caregivers; and reflections for the future were considered important impressions in clinical experience.

CONCLUSION

The culture of Saudi Arabian society is an important factor in shaping the training experience of female nursing students either positively or negatively, specifically in the context of home healthcare nursing for older patients. The results of this study show how important it is for students to be prepared for the clinical environment, the nature of the work, and the role of the home healthcare nurse in order to improve their clinical learning.

Impact of Nurse Manager's Attributes on Multi-Cultural Nursing Teams: A Scoping Review

BACKGROUND

As global migration increases, nurse managers' effectiveness in multi-cultural nursing work environments is crucial due to the rising cultural diversity within healthcare teams. Despite the increasing international recruitment of qualified nurses to address the worldwide nursing shortage, no studies have synthesised the impact of nurse managers' attributes on nurses in multi-cultural nursing teams. Therefore, it was conducted a literature review aimed to synthesise the available literature on how nurse managers' personality traits, competencies, behaviours, and leadership styles influence nurse outcomes in multi-cultural nursing teams.

METHODS

Scoping review conducted according to the Joanna Briggs Institute guidelines to map the relationship or influence of nurse managers' personality traits, competencies, behaviours, and leadership styles on the outcomes of nurses in multi-cultural settings across various clinical environments. Searches were conducted across electronic databases such as CINAHL and MEDLINE, along with grey literature.

RESULTS

This review included 39 studies, highlighting 29 personality traits, 9 competencies, 115 behaviours, and 5 leadership styles that impact nurses' outcomes. Key findings emphasise the importance of nurse managers being supportive, culturally competent, and effective communicators, with transformational leadership style being particularly beneficial.

CONCLUSIONS

These findings provide insights for planning and developing training programmes to equip current and future nurse managers with skills to effectively lead in multi-cultural care settings.

Understanding person-centered care within a complex social context: A qualitative study of Saudi Arabian acute care nursing

Policy reforms implemented in Saudi Arabia in recent years aim to modernize the culture and infrastructure of healthcare delivery and are expected to integrate person- and patient-centered care principles throughout the national healthcare system. However, in a complex multicultural environment where most nurses are international migrant workers, unique challenges emerge that frame the delivery of care. Better understanding is needed about what nurses perceive to be high-quality, person-centered care in Saudi Arabia and how they manage to enact it in practice. Semi-structured interviews were conducted with 21 nurses working in two tertiary hospitals in Riyadh, the capital city. Participants included Saudi citizens (n = 9) and expatriates (n = 12) who were asked to describe their perceptions of quality nursing care and explain the obstacles that they encounter in providing such care. Nurses reported extensive efforts to achieve individualized, empathetic, developmentally appropriate care. Their descriptions of care aligned with principles of patient-centeredness in care but were not separable from challenges at the patient, organizational, and regional levels, including staffing and supplies shortages, gaps in regional care coordination, inadequate language translation services, variability in cultural beliefs about healthcare communication, and overt discrimination against expatriate workers. Nurses reported creative strategies to achieve professional nursing values while navigating a dynamic landscape of constraints. The findings add to literature suggesting that person-centeredness in care cannot be understood outside the social and organizational conditions that shape it.

Regional perspectives on patient safety policies and initiatives: a focus group study with patient safety leaders in the Middle East and Asian regions

Preventing and reducing risks and harm to patients is of critical importance as unsafe care is a leading cause of death and disability globally. However, the lack of consolidated information on patient safety policies and initiatives at regional levels represents an evidence gap with implications for policy and planning. The aim of the study was to answer the question of what patient safety policies and initiatives are currently in place in the Middle East and Asian regions and what were the main strengths, weaknesses, opportunities and threats in developing these. A qualitative approach using online focus groups was adopted. Participants attended focus groups beginning in August 2022. A topic guide was developed using a strengths, weaknesses, opportunities and threats framework analysis approach. The Consolidated Criteria for Reporting Qualitative Research checklist was used to ensure the recommended standards of qualitative data reporting were met. 21 participants from 11 countries participated in the study. Current patient safety policies identified were categorised across 5 thematic areas and initiatives were categorised across a further 10 thematic areas. Strengths of patient safety initiatives included enabling healthcare worker training, leadership commitment in hospitals, and stakeholder engagement and collaboration. Weaknesses included a disconnect between health delivery and education, implementation gaps, low clinical awareness and buy-in at the facility level, and lack of leadership engagement. Just culture, safety by design and education were considered opportunities, alongside data collection and reporting for research and shared learning. Future threats were low leadership commitment, changing leadership, poor integration across the system, a public-private quality gap and political instability in some contexts. Undertaking further research regionally will enable shared learning and the development of best practice examples. Future research should explore the development of policies and initiatives for patient safety at the provider, local and national levels that can inform action across the system.

Palliative Care Practices and Knowledge of Home Care Nurses in Saudi Arabia: A Cross-Sectional Study

Palliative Care (PC) is an interdisciplinary specialty focused on relieving symptoms and optimizing quality of life for people living with serious illnesses and their families. A great need for PC exists in Saudi Arabia due to its aging population and prevalence of cancer and other chronic diseases. Home healthcare can make PC more accessible to patients, but clinicians must be equipped with the PC knowledge and skills to perform their roles. This study was a descriptive, correlational examination of PC practices and knowledge of home care nurses recruited from military hospitals in Saudi Arabia. We surveyed participants using the Palliative Care Quiz for Nursing (PCQN) and the Modified Global Home Health Nursing Care Assessment Questionnaire. The mean PCQN score was 8.40, indicating low levels of PC knowledge. A nurses' demographic and physical, spiritual, religious, cultural, linguistic, ethical, and legal aspects of care revealed significant associations. Given the low levels of PC knowledge and skills, we recommend focusing on education, training, and research. Universities should review their curriculum to ensure PC content. Hospitals should provide training programs focused on all aspects of PC, specifically emotional and spiritual, without limiting training to physical aspects of care. Future research is also needed to inform policy in this area.

Assessment of Patient Safety Culture Among Nurses Working at Tertiary Care Hospitals in Aljouf Region, Saudi Arabia

INTRODUCTION

Patient safety is a fundamental element in healthcare quality and a major challenge in achieving universal health coverage, especially in low- and middle-income countries. The first step to improve patient safety is to evaluate the safety culture in hospitals. This study aimed to investigate the patient safety culture among nurses and determine the factors affecting it.

METHODS

This cross-sectional study was conducted among 423 nurses working at tertiary care hospitals in the Al-Jouf region in Saudi Arabia.

RESULTS

The highest score for patient safety among nurses was for teamwork within units (16.41 ± 2.44). The lowest score was for nonpunitive response to errors (5.87 ± 1.92). In addition, 83% of the participants did not report any events in the past 12 months. More perception of patient safety was significantly higher among females than males in dimensions of teamwork within units, frequency of events reported, and staffing. Furthermore, teamwork within units, management support for patient safety, staffing, non-punitive response to errors, and handoffs and transitions were significantly higher among participants in direct contact with patients. The Hospital Survey on Patient Safety Culture (HSOPSC) scale is significantly higher among non-Saudi nurses, nurses with bachelor's education, nurses with less working hours per week, and those who had training on patient safety.

CONCLUSION

The current study showed that the majority of the participants did not report any events in the past 12 months. The highest score for patient safety culture dimensions among nurses was for teamwork within units while the lowest score was for nonpunitive response to errors.

Verbal workplace violence in the health sector in Saudi Arabia: A cross-sectional study

Psychological abuse, such as verbal abuse, has received less attention than physical violence because of the manifested bodily harm caused by physical violence; however, verbal abuse has the highest percentage of violence worldwide. The consequences of verbal abuse in Saudi Arabia are similar to those in other countries. This study aims to determine the prevalence of verbal workplace violence in 12 months, the circumstances related to the event, and the consequences to both the attacker and the target person at all healthcare providers in the Kingdom of Saudi Arabia. This cross-sectional study included all healthcare providers registered with the Saudi Commission for Health Specialties who had worked for more than one year in the health sector in Saudi Arabia by May 2019. The researchers distributed questionnaires to the participants via email. Descriptive statistics were used to represent the basic properties of the data. Correlations between categorically measured variables were explored using the chi-square test for independence. Overall, 7398 healthcare workers (HCWs) voluntarily participated in the study. Overall, 49.1% encountered verbal abuse. Those who worked in the private sector and in shifts, particularly evening shifts, were significantly exposed to verbal abuse. Furthermore, pharmacists, followed by physicians, had the highest prevalence of workplace violence. Workplace verbal violence is highly prevalent, making it a major concern. Patients and their relatives are mostly the offenders of HCWs. Psychological ordeal, increased overwork, and reduced work capacity are the consequences of verbal abuse. Most victims do not report verbal violence, and this may result in an incorrect estimation of the problem. Therefore, encouragement to report verbal violence and additional research in Saudi Arabia are required.

Expectations of clients, insurers, and providers: a qualitative responsiveness assessment among private health insurance sector in Kampala-Uganda

BACKGROUND

There is less attention to assessing how health services meet the expectations of private health insurance (PHI) actors, clients, insurers, and providers in developing countries. Interdependently, the expectations of each actor are stipulated during contract negotiations (duties, obligations, and privileges) in a PHI arrangement. Complementary service roles performed by each actor significantly contribute to achieving their expectations. This study assessed the role of PHI in meeting the expectations of clients, insurers, and providers in Kampala. Lessons from this study may inform possible reviews and improvements in Uganda's proposed National Health Insurance Scheme (NHIS) to ensure NHIS service responsiveness.

METHODS

This study employed a qualitative case-study design. Eight (8) focus group discussions (FGDs) with insured clients and nine (9) key informant interviews (KIIs) with insurer and provider liaison officers between October 2020 and February 2021 were conducted. Participants were purposively selected from eligible institutions. Thematic analysis was employed, and findings were presented using themes with corresponding anonymized narratives and quotes.

RESULTS

Client-Provider, Client-Insurer, and Provider-Insurer expectations were generally not met. Client-provider expectations: Although most facilities were clean with a conducive care environment, clients experienced low service care responsiveness characterized by long waiting times. Both clients and providers received inadequate feedback about services they received and delivered respectively, in addition to prompt care being received by a few clients. For client-insurer expectations, under unclear service packages, clients received low-quality medicines. Lastly, for provider-insurer expectations, delayed payments, selective periodic assessments, and inadequate orientation of clients on insurance plans were most reported. Weak coordination between the client-provider and insurer did not support delivery processes for responsive service.

CONCLUSION

Health care service responsiveness was generally low. There is a need to commit resources to support the setting up of clearer service package orientation programs, and efficient monitoring and feedback platforms. Uganda's proposed National Health Insurance Act may use these findings to: Inform its design initiatives focusing on operating under realistic expectations, investment in quality improvement systems and coordination, and efficient and accountable client care relationships.

Therapeutic communication and its associated factors among nurses working in public hospitals of Gamo zone, southern Ethiopia: application of Hildegard Peplau's nursing theory of interpersonal relations

BACKGROUND

Therapeutic communication can assist nurses in achieving their goals. Effective nurse-patient communication can improve clinical outcomes and boosts patient satisfaction. But, there is an arming gap in therapeutic communication between nurses and patients in Ethiopia, which hinders the quality of nursing care. Some studies have been done on therapeutic and its barriers. Nevertheless, those studies did not fully address factors from different perspectives and were supported by nursing theories or models. Therefore, this study aimed to fill these gaps in the study setting.

METHODS

Institution-based cross-sectional study was conducted among 408 nurses working in public hospitals of Gamo zone from December 1, 2021, to January 30, 2022. Out of the six hospitals in the Gamo zone, three were selected by simple random sampling method. The data were collected by an interview-administered Open Data Kit survey tool and analyzed by SAS version 9.4. Descriptive statistics were computed and a generalized linear model was used to identify associated factors.

RESULTS

In this study, a standardized percentage of the maximum scale of therapeutic communication was 52.32%. Of the participants, 40.4% had high, 25.0% moderate, and 34.6% had low levels of therapeutic communication. Age, marital status, and qualification showed significant and positive relationships with the overall therapeutic communication. However, sex, working unit, nurse burnout, lack of empathy from nurses, challenging nursing tasks, lack of privacy, use of technical terms by nurses, lack of confidence in nurses, stress, unfamiliarity with the nursing job description, shortage of nurses, insufficient knowledge, lack of participation in decision making, and having contagious disease showed a significant and negative relationship with overall therapeutic communication.

CONCLUSIONS

This finding indicates a gap in therapeutic communication between nurses and patients, and modifiable factors are identified. Therefore, giving opportunities for nurses to improve their qualifications, a special attention to nurses working in stressful areas, sharing the burden of nurses, involving nurses and patients in decision-making, and motivating and creating a positive working environment is vital to improving therapeutic communication.

Workplace bullying and violence in health sector in Saudi Arabia

Workplace bullying violence (BV), with psychological and physical impacts, is increasing globally. However, studies from Saudi Arabia investigating which specialties are most exposed, and linking them with other factors, such as sociodemographic conditions, are scarce. This study aimed to estimate the prevalence of workplace BV over a 12-month period and determine the circumstances related to the event, consequences for the attacker, and targeted personnel among all healthcare providers in the Kingdom of Saudi Arabia (KSA). This analytical cross-sectional study included all health providers registered with the Saudi Commission for Health Specialties who worked for more than 1 year in the healthcare sector (governmental or private) in the KSA until May 2019. In total, 7398 healthcare workers were electively enrolled in the study; 51.3% were men, and 48.7% were women, with a mean age of 40 ± 8.62 years. They were mostly (60%) non-Saudi. Overall, 26.6% encountered BV. Those who worked in the private sector, in shifts, especially evening shifts, were significantly more exposed. Furthermore, pharmacists had the highest prevalence of workplace violence. The prevalence of BV is moderately high; however, it is a serious issue faced by healthcare workers, especially those working night shifts. Pharmacists were more likely to experience bullying. This demonstrates that more support, specific strategies, and policies are required to reduce the occurrence of workplace BV, protect healthcare providers, and prevent attacks. Underreporting these situations may give an incorrect indication of the magnitude of the problem; thus, more education and further studies in the KSA are needed.

Patients' Perceptions of Safety in Primary Healthcare Settings: A Cross-Sectional Study in the Qassim Region of Saudi Arabia

This study assessed patients' perceptions of safety and experiences in primary healthcare in the Qassim region of Saudi Arabia. Between July and September 2022, 730 patients from primary healthcare centers were surveyed using a multi-staged cluster random sampling approach. The Patient-Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire was used to measure patients' perceived safety and experience in primary healthcare settings within the past year. Descriptive analyses were performed to report patients' perceived safety experiences. The statistical analysis examined individual items and scales. A considerable proportion of patients reported encountering safety problems, ranging from 11% (vaccine-related) to 27% (diagnosis-related). Diagnostic errors were the most common perceived safety problem (26.7%), followed by communication issues (24.1%) and medication errors (16.3%). Between 26% and 40% experienced harm, including financial problems (40%), increased care needs (32.4%), physical health issues (32%), limitations in activities (30.6%), increased healthcare needs (30.2%), and mental health concerns (26.8%). Patient-reported safety experiences reported in our study offer valuable insights into primary care safety in Saudi Arabia. Collecting routine patient feedback is crucial for addressing identified safety problems and implementing standardized procedures.

Physical workplace violence in the health sector in Saudi Arabia

Physical workplace violence (WPV) occurs worldwide, causing psychological and physical injuries. However, reports from Saudi Arabia investigating which specialty is the most exposed are scarce. This study aimed to determine the prevalence and circumstances related to physical WPV among all healthcare providers in Saudi Arabia in 12 months, as well as the consequences for both attackers and targets of physical WPV. This cross-sectional study included all healthcare providers registered with the Saudi Commission for Health Specialties who had worked for more than 1 year in the health sector in Saudi Arabia until May 2019. Researchers distributed the questionnaire to the participants via email. Descriptive statistics were used to describe the basic features of the data. Correlations between the categorically measured variables were explored using a chi-square test of independence. Overall, 7398 healthcare workers (HCWs) voluntarily participated in the study, 51.3% being men and 48.7% being women. The mean age was 40 ± 8.62 years), and most participants were of non-Saudi origin. Overall, 9.3% HCWs had encountered physical violence. Male HCWs, pharmacists, nurses, and HCWs of non-Saudi origin were significantly more exposed to physical violence. Furthermore, those with direct physical contact with patients and those working with male patients only were more exposed to physical violence. Physical WPV is an important issue faced by HCWs, particularly those who work night shifts or have direct contact with patients. Results showed that more support, specific strategies and policies to reduce violence occurrence, and protection for healthcare providers are required.

Predictors and outcomes of patient safety culture at King Abdulaziz Medical City, Jeddah, Saudi Arabia. A nursing perspective

BACKGROUND

Patient safety culture assessment is viewed as the starting point from which action planning begins and helps hospitals get a good idea of the patient safety features that need immediate attention, identify the strengths and weaknesses of their safety culture, help units find their most common patient safety problems, and compare their scores to those of other hospitals. This study aimed to assess nurses' perceptions of patient safety culture composites in a Saudi hospital in the Western region and to explore the association between patient safety culture predictors and outcomes, taking into consideration nurses' characteristics.

METHODS

This study employed a cross-sectional descriptive design with a convenience sample of 184 nurses who are working at inpatient care units at King Khaled Hospital- King Abdulaziz Medical City in Jeddah, Western region, Saudi Arabia. The data were collected through a structured questionnaire consisting of nurses' demographics and work characteristics, and the Patient Safety Culture Hospital Questionnaire (HSOPSC), which proved valid and reliable. Descriptive status, correlation, and regression analysis were applied to patient safety culture composites for statistical analysis.

RESULTS

The overall positive response rate of the predictors of patient safety culture in the HSOPSC survey was 63.46%. The mean percent score for predictors ranged from 39.06% to 82.95%. "Teamwork within units" (82.95%) was the highest mean, followed by "organizational learning" (81.88%) and "feedback and communication about errors" (81.25%). In addition to the overall perceived patient safety (59.0%), safety grade, frequency, and number of events are also reported as safety outcome measures.

CONCLUSIONS AND RECOMMENDATIONS

Regardless of the percentage of the safety culture domains, this study agrees that all the domains should be considered high-priority and focused areas for continuous improvement. The results confirmed the need for continuous staff safety training programs to improve their perception and performance of the safety culture.

The Lived Experience of Middle-Aged Saudi Patients With End-Stage Chronic Renal Disease on Hemodialysis Treatment

INTRODUCTION

More than 20,000 patients with chronic renal disease are receiving hemodialysis treatment in Saudi Arabia. Approximately, 57.4% of nurses in Saudi are expatriates. However, these nurses may not have sufficient cultural knowledge, which may affect perception of nursing care. Our purpose was to understand the lived experiences of middle-aged Saudi Arabian hemodialysis patients.

METHOD

This qualitative phenomenological study was conducted in Saudi Arabia in 2021. Data were analyzed using axial coding.

RESULTS

Eleven patients aged 32 to 60 years participated. Two themes and three subthemes were identified: (a) hemodialysis's negative consequences (travel restriction, social isolation, and low responsibilities toward families) and (b) level of support (family support, nurses' support, and governmental support).

DISCUSSION

Hemodialysis patients find travel and social engagement difficult. Furthermore, they cannot fully meet their family responsibilities due to fatigue and long hemodialysis hours. Health care providers should consider integrating these findings to deliver optimal holistic care.

Shift handover quality in Saudi critical care units: determinants from nurses' perspectives

BACKGROUND

Nurses' effective handover communication is vital for patient safety and quality of care. Few studies have empirically tested how certain factors influence the quality of handover in the Saudi context.

METHODS

A descriptive correlational design was used with a convenience sample of all nurses (N = 201) working in Saudi hospital CCUs in 2022. Demographics and handover quality instruments were used to collect the necessary data in addition to two open-ended questions that asked about perceived barriers and facilitators to handover. The analysis was conducted using descriptive statistics and regression analysis.

RESULTS

The majority of nurses reported good-quality handover. The regression analysis showed that staffing, cognitive capacity, the focus of attention, relationships, and safety climate factors contributed positively to the variance of handover quality. In contrast, intrusions, distractions, anxiety, time stress, and acute and chronic fatigue factors negatively affected the prediction of handover quality (p < 0.05). Nurses added types of shifts and languages as barriers to handover while emphasizing training and the use of standardized tools for handover as facilitators.

CONCLUSION AND RECOMMENDATIONS

Nursing handover is a multidimensional phenomenon. By understanding the determinants that contribute to or hinder handover quality, it is possible to develop targeted interventions aimed at improving communication and the quality of shift handover in CCUs. The current study's findings highlight the need for nurses to work in a more supportive environment, receive better training, and follow a standardized handover protocol. Additionally, nurse managers should pay more attention to nurses' well-being to control or mitigate the effect of psychological precursors on the quality of nurses' handover. Future research should investigate handover practices and outcomes on units that have both good and bad practice environments.

Knowledge of the Patients' Bill of Rights and Influencing Factors Among University Nursing Students

Background Nursing students, the future nursing workforce, are expected to be exposed to ethically challenging situations in their workplaces, and they must be knowledgeable about patients' rights to provide holistic care. However, limited research was cited on the knowledge of nursing students regarding the Bill of Rights and the factors influencing their knowledge. Purpose This study aimed to assess nursing students' knowledge of the patients' bill of rights and determine what factors influence this knowledge in Saudi Arabia. Methods A descriptive cross-sectional research study was conducted with a convenience sample of nursing students (N = 210) in a Saudi nursing college. Data were collected using a questionnaire that consists of three parts: demographic characteristics, knowledge of the patients' bill of rights, and six open-ended and reflective questions. Descriptive statistics and response analysis are used. Results The statistics showed that the total knowledge score about patients' rights ranged from 19 to 34, with a mean of 26.11 ± 2.32, among nursing students. About two-thirds of students reported adequate knowledge (n = 118, 65.5%), compared to those who had inadequate knowledge (n = 62, 34.5%). In addition to academic level and age, students reflected on many factors that shape their ethical knowledge, such as integrated, interprofessional learning experiences, workshops, a supportive and ethical learning environment, and the presence of an ethical committee. Conclusion Continuous efforts to foster ethics education with inspiring learning content and innovative instructional material are vital to improving nursing students' knowledge and readiness. Interprofessional education (IPE) sessions and awareness programs are effective strategies to improve their ethical awareness and knowledge.

Culture, religion, language and the assessment and management of children's pain by expatriate nurses in Saudi Arabia: A qualitative study

PURPOSE

Unrelieved pain among hospitalized children is a common problem that affects all aspects of children's health and their quality of life. Cultural and language differences between nurses and patients have been shown to impact the quality and safety of nursing care and management for children with pain. The aim of this study was to identify the cultural factors, barriers, and facilitators impacting the assessment and management of children's pain by expatriate nurses in Saudi Arabia.

DESIGN AND METHODS

A qualitative descriptive design was employed in this study. A sample of 16 nurses was conveniently recruited and interviewed through face-to-face semistructured interviews. Each interview lasted between 30 and 60 min and was audio-recorded. Content analysis was used to analyze the transcripts. Transcripts were carefully read, significant statements were highlighted, coded, categorized, and clustered thematically.

RESULTS

Three main themes were identified, namely, (I) low priority of children's pain, (II) culture and religious challenges, and (III) communication challenges.

PRACTICE IMPLICATIONS

Cultural and language differences described by expatriate nurses hindered their care of children with pain. A systematic education for expatriate nurses, children, and families is urgently needed to enhance inter/cross-cultural understandings and improve childcare in Saudi Arabia. This study identifies the unique challenges faced by expatriate nurses in Saudi Arabia. The findings reveal how a lack of knowledge about cultural values and beliefs can lead to misunderstandings and conflicts between nurses, children, and families and can have an impact on childcare and pain. It also highlights the need to improve pain management practices in multicultural healthcare settings, similar to those of Saudi Arabia and neighboring Arab nations, and across the globe.

Beyond challenges and enrichment: a qualitative account of cross-cultural experiences of nursing patients with an ethnic minority background in Norway

BACKGROUND

Substantial mass migrations to the Scandinavian countries have made them heterogeneous and multicultural societies. Migration has also influenced the workforce, especially the healthcare system that has had to accommodate a culturally diverse population. This qualitative study aimed to explore nurses' experiences in caring for patients with an ethnic minority background.

METHODS

Focus group interviews with a total of 21 nurses were conducted. Thematic analysis was performed on the transcribed and translated interviews.

RESULTS

The findings of this study revealed three major themes: various experiences concerning language barriers and the use of interpreters, the impact of religious and cultural values, and caring for patients with an ethnic minority background is professionally interesting but demanding.

CONCLUSIONS

Caring for culturally diverse patients offers both challenges and opportunities to enhance cultural competence and cultural sensitivity among nurses. Various culturally divergent needs of patients such as family visits, food preferences, expression of pain, and gender sensitivity are interlinked and depend on effective communication during encounters with nurses and the healthcare system at large.

Experience and Educational Needs of Arab Parental Caregivers Regarding their Children Newly Diagnosed with Type 1 Diabetes in Saudi Arabia: A Qualitative Study

Type 1 diabetes (T1DM) is a common chronic health condition in children that necessitates close monitoring and care. Parents face numerous challenges when caring for children with T1DM, particularly at home owing to self-care. There is little information available about Arab parents’ experiences and educational needs when caring for children with TIDM. The purpose of this study was to explore the experiences and educational needs of Arab parental caregivers in Saudi Arabia who live with and care for children diagnosed with T1DM. An inductive qualitative descriptive design was used in this study. The data were amassed over a 4 month period through audio-recorded semi-structured interviews with 16 Arab parents of children aged 18 years and under who had been diagnosed with T1DM within the previous 6 months. Data were analyzed through a qualitative content analysis. The results could be classified into 3 categories related to the parents’ experience of caring for a child newly diagnosed with T1DM and their educational needs and can be described as follows: (1) management of uncertainty regarding T1DM; (2) management of new daily life situations; and (3) self-care management within the family. The Arab parents of children with T1DM accentuated the need for continuous professional support to manage uncertainty due to changes in everyday life situations. The findings confirmed the significance of culturally and contextually relevant education regarding T1DM for parents, children, and school personnel. Educational interventions and support in the community are recommended to improve daily life situations for families and children with T1DM.

Communication barriers to education to referrals from the perspective of referrals to health centers and health care providers

Introduction

One of the most important factors affecting the increase of clients' satisfaction is how health care providers (HCP) communicate with clients. On the other hand, different factors can hinder proper communication and thus education, which is one of the main tasks of HCP. Therefore, the purpose of this study was to investigate communication barriers to education to referrals from the perspective of referrals to health centers (RHC) and HCP.

Method

This descriptive-analytical study was conducted on RHC and HCP in Kerman in 2021. Using a multi-stage sampling method, 162 HCP and 414 RHC were included in the study. The data collection tool was two researcher-made questionnaires. Data were analyzed using SPSS 16.

Findings

From the perspective of RHC and HCP, most communication barriers were related to environmental and then socio-cultural factors. Among the demographic variables of HCP, level of education showed a significant relationship with the physical-psychological, verbal-non-verbal, and informational domains. And in relation to RHC, a significant relationship was found between education and job in the socio-cultural field and environmental barriers (p < 0.05).

Conclusion

HCP face a variety of barriers in educating people, most of which are related to environmental factors. Given the cost-effectiveness of education to the public, it is essential that planners and policymakers use strategies to eliminate environmental factors as well as the placement of indigenous HCP in health facilities to reduce communication barriers.

The impact of mindfulness training on supportive communication, emotional intelligence, and human caring among nursing students

PURPOSE

This study was aimed to investigate the impact of mindfulness training on supportive communication and human caring ability among nursing students.

DESIGN AND METHODS

Sixty nursing students were randomly divided into the mindfulness group who accepted 8-week mindfulness training and the control group who attended two 2-h lectures about mindfulness in 8 weeks. All of them completed the Supporting Communication Scale (SCS), Emotional Intelligence Scale (EIS), and Caring Ability Inventory (CAI) before training (T1), after it (T2), and at 3-month follow-up (T3).

FINDINGS

The mindfulness group showed higher scores on SCS, EIS, and CAI than the control group at both T2 and T3, and improvements in emotional intelligence partially mediated the training effects on supportive communication.

PRACTICE IMPLICATIONS

Mindfulness training could be applied to improve the abilities of communication and human caring during nursing education.

International Portuguese Nurse Leaders' Insights for Multicultural Nursing

Cultural diversity among patients and healthcare workers in the Portuguese healthcare organizations will increasingly challenge nurse managers to develop favorable nursing work environments and to improve culturally congruent care.

AIM

This study aimed to identify nurse managers' interventions that improve favorable nursing work environments in multicultural nursing teams and culturally congruent care for patients, based on Portuguese nurse leaders' experience in international settings.

METHODS

A qualitative and exploratory study was conducted as the first stage of a sequential exploratory mixed study design. A convenience sample of Portuguese nurses with leadership experience of multicultural teams was recruited to participate in one focus group. Qualitative data were recorded and transcribed for content analysis. Text segments were organized into themes and categories with the support of the qualitative software IRaMuTeQ.

RESULTS

Nurse managers' interventions, such as adapting the leadership style, thanking nurses for their work, adjusting the unit to attend to patients' worship practices, and supporting foreign nurses in learning the local language, were categorized into three main themes and five categories-transcultural nursing leadership assumptions, capitalizing nurses, improving culturally congruent care, team problems and strategies, and improving effective communication.

CONCLUSIONS

These findings corroborate international studies, advocate for capable nurse managers to lead in a globalized world, and are suitable to develop a transcultural nursing leadership questionnaire.

Pediatric nurse-patient communication practices at Pentecost Hospital, Madina: A qualitative study

Purpose

Delivering quality health care requires effective communication between health care providers and their patients. Nurse-patient effective communication remains a challenge in Ghana, despite criticism and concern expressed by the public. The study, therefore, aims to assess the effective nurse caregivers’ communication practices among pediatric nurses at Pentecost Hospital, Madina.

Methods

A qualitative exploratory and purposive sampling technique were used. Participants were engaged in Focus group discussions or face-to-face interviews. In all, 4 focus group discussions were conducted with 7 participants in each group and 15 face-face in-depth interviews, with a total sample size of 43. The data was content analyzed. Interviews were taped recorded and transcribed verbatim.

Results

The data analysis yielded 3 themes and 11 subthemes. The main themes were: effective communication practices, factors influencing effective communication, and attitudes towards effective communication. The study revealed how the participants communicated with patients who are deaf-mute, anxious, and those who refused treatment. In addition, participants reported how they used techniques such as silence, listening, and leading cues in communicating with patients and their relatives.

Conclusion

Effective communication between pediatric nurses, patients, and their parents is ascertained to be a key tool in the delivery of quality health care. However, several factors are found to hinder this therapeutic communication. Hence, further studies are needed to improve effective communication skills among pediatric nurses and their patients to enhance health care for children.

Adult patient communication experiences with nurses in cancer care settings: a qualitative study

Background

The patient communication experience is an important outcome measure that guides quality improvements in healthcare settings specifically in cancer care. Therefore, this study aimed to explore the patient’s communication experiences with nurses in cancer care settings.

Methods

Semi-structured face to face interviews were conducted with 21 participants who received cancer care at two Saudi Arabian tertiary healthcare facilities between Aug 2019 to Dec 2019. The study used a qualitative descriptive design. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data using six stages of Braun and Clarke.

Results

Four major themes were identified and a total of eleven sub-themes. The major themes were; (1) The importance of patient-nurse relationships, (2) Providing appropriate information to patients, (3) Responding to patients emotional needs and (4) Verbal communication between nurses and cancer patients.

Conclusions

Some participants felt that their communication with nurses was limited, but generally, most felt that communication was acceptable irrespective of barriers such as language, culture, religion, gender, workload and healthcare preferences. Participants drew a comparison between Saudi and non-Saudi nurses as well as between nurses and doctors communication skills. They felt that Saudi nurses had good communication skills, but non-Saudi nurses were more competent in some aspects such as kindness, politeness, respectful and non-verbal communication. They also felt that doctors were more accurate in their information than nurses.

Leadership Style, Work Engagement and Organizational Commitment Among Nurses in Saudi Arabian Hospitals

Purpose

The purpose of this paper is to examine how nurse managers’ leadership styles, work engagement, and nurses’ organizational commitment are related in Saudi Arabia.

Methods

This study used a cross-sectional design using an online survey instrument targeted at nurse managers and nurses working in Saudi Arabian hospitals. Multi-factor leadership questionnaire (MLQ), organizational commitment questionnaire (OCQ), and Utrecht Work Engagement Scale (UWES) were used in the Questionnaire. The survey link is forwarded to HR administrators of 71 hospitals, which includes public, private, and public–private partnership hospitals. The survey link was active from 27th November 2021 to 18th December 2021, and at the end of the survey, 394 responses were received. After removing the incomplete responses, 390 participant responses are considered for data analysis. t-tests and correlation analysis are used to analyze the data.

Results

Among the participants, 84.4% of the participants were nurses and 15.6% were nurse managers. Significant difference (p < 0.05) of opinions is observed among nurse managers in relation to transformational and transactional leadership styles and engagement. Transformational and transactional leaderships are positively correlated with organizational commitment and nurses’ engagement.

Conclusion

Differences in leadership style perceptions among nurses and nurse managers reflected issues in nursing management, which have to be addressed in light of rapid infrastructural changes owing to Saudi vision 2030.

Nursing Care Experiences With Syrian Refugees in Southern Turkey: A Metaphor Analysis

BACKGROUND

Healthcare professionals' "cultural prejudices" toward individuals' cultural beliefs, attitudes, and perceptions affect the care they provide. Their awareness of their bias is closely associated with the quality of healthcare provided.

PURPOSE

This study was designed to assess nurses' perceptions regarding providing care to Syrian refugee patients using metaphors and to evaluate their views based on these metaphors.

METHODS

The participants in this qualitative study consisted of 80 nurses who worked in Level 1 and Level 2 health institutions. Data were collected using an interview form prepared by the researchers. The form included descriptive characteristics of the nurses and two expressions used to determine the nurses' opinions on providing care for Syrian refugee patients. The nurses were given an incomplete sentence, which was "Providing care for a Syrian refugee patient…because…," and were asked to complete the blanks. The data were analyzed using the content analysis method.

RESULTS

On the basis of "providing care for Syrian refugee patients," four categories of metaphors were determined: occupational awareness, health promotion, a difficult process/resistance, and providing service in vain. The participants generated 50 metaphors, with "humanity," "a baby/little child," and "a barrier" as the three most used metaphors, belonging to the "occupational awareness" and "a difficult process/resistance" categories, respectively.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The metaphors of nurses regarding giving care to Syrian refugee patients were mostly concentrated in the categories of "occupational awareness" and "a difficult process/resistance." Metaphors generated by the nurses offer a powerful research tool to reveal, understand, and explain nurses' personal perceptions and to develop and support nursing care accordingly. In addition, the subject of transcultural nursing should be discussed more extensively in nursing education programs. Understanding the social context of refugees is very important during the nursing care process.

Support interventions for nurses working in acute psychiatric units: A systematic review

Diverse support interventions have been implemented to provide support for nurses working in acute psychiatric settings. These interventions aimed at modifying the psychological and social factors, as they either prevent stress responses or reduce its effects to improve the psychological well-being of staff. This study aimed to examine effective stress reduction interventions for nurses and to identify key elements of these successful interventions. Studies included in this review were conducted in acute psychiatric settings. A comprehensive search of electronic databases was conducted for support intervention studies between 2010 and 2021. The search yielded 315 studies that were reduced to seven studies after being reviewed by two independent reviewers. The studies were coded, and key elements were identified. Seven studies that were included consisted of a randomised controlled trial, quasi-experimental design and single-group design. Interventions included mindfulness-based stress reduction, burnout prevention programmes, communication skills, educational programme, group intervention, resilience training programme and stress management. Four key elements emerged from these interventions, namely, educational support, interpersonal skills, psychological support and adaptive coping. The findings highlighted the diverse interventions in supporting psychiatric nurses to cope with stress. However, there is a dearth of studies in acute psychiatric settings that were mostly done in emergency settings. Knowledge gained from this review may assist with practice improvement as managers can implement the identified interventions.

Contribution

This is the first systematic review focusing on supportive interventions for nurses in acute psychiatric settings. The knowledge gained from this review will add to the existing research knowledge base in the field.

Barriers to nurse-patient communication in primary healthcare centres in Bahrain: Patient perspective

Objectives

Effective and efficient communication is a core element in healthcare systems, especially between healthcare providers and patients. This study aimed to identify communication barriers between nurses and patients in primary healthcare centers in Bahrain.

Methods

This is a cross-sectional study conducted across primary healthcare centers in Bahrain. Four hundred and two patients were recruited using convenience sampling. A self-administered questionnaire comprising 29 items on communication barriers was used.

Results

A total of 402 patients consented to participate. The majority of participants reported the following statements had large effects on communication: “shortage in the number of nurses compared to the large number of patients” (254/401, 63.3%), “lack of desire of nurse to communicate with patients” (246/402, 61.2%), and “negative attitude of the nurse toward the patient” (238/401, 59.4%). Further, “difference in language between nurses and patients,” “lack of self-confidence by nurses,” and “nurses overwhelmed by work” were ranked as top three statements with a significant influence on communication between nurses and patients.

Conclusions

Communication between healthcare providers and patients is pivotal for an optimal healthcare service. Based on the findings of this study and the literature, we recommend formal training of health care workers in improving communication skills and including this not only in medical curriculum but also in the form of continuing medical education (CMEs)1.

Whole-Person Development of Undergraduate Nursing Students: A Multi-University Study

AIM

This study examines how nursing students in Saudi Arabia view their holistic development during university study and the association between their perceptions and academic performance.

BACKGROUND

Holistic nursing education fosters broad development and emphasizes students' cognitive, emotional, social, physical, and spiritual potentials.

METHOD

This descriptive and correlational study utilizes the Whole Person Development Inventory to collect data from 998 student nurses enrolled in six governmental universities in Saudi Arabia.

RESULTS

The professional dimension recorded the highest mean, followed by the intellectual, spiritual, physical, and psychological dimensions. The social dimension received the lowest overall mean. Intellectual, psychological, social, and spiritual development has an association with high academic performance.

CONCLUSION

This study encourages policymakers and various stakeholders concerned with nursing education in the country and worldwide to be intentional and systematic in adapting the whole-person development approach in nursing education.

Older Adults’ Interpretation of Nurses’ Nonverbal Communication in Cameroon: A Grounded Theory Inquiry

Communication is central to nursing care. Yet, the nonverbal aspect of communication tends to be neglected or underestimated in nursing studies. Research has shown that older patients interpret nurses’ communication messages during the clinical encounter. This article conceptualizes older adults’ interpretation of and need for nonverbal communication (NVC) to enhance patient-centered communication advocated by the World Health Organization. The Corbin and Strauss (2015) inductive Grounded Theory approach was used to collect data from 3 hospital units in Cameroon using in-depth interviews with eight older adults, thirteen nurses, and four student nurses between July 2018 and January 2020. Open coding, axial coding, and selective coding were used for analysis, which reveals that interpretations of NVC can be positive or negative. It means that older adults view nurses either as angels or as difficult persons, depending on the nurses’ positive or negative NVC and behaviors. These interpretations lead to consequences ranging from a preference for some nurses to noncompliance with care. The results further show that older adults need active listening, humor, and affection from nurses. Information regarding older adults’ interpretation of and need for NVC can be used to improve curriculum content and to develop skills in and awareness of NVC with older adults. It is recommended that further research expand on effective nonverbal techniques during COVID-19 times where the meaning of facial expressions and voice inflection can be disrupted.

Culture-Specific Observations in a Saudi Arabian Digital Home Health Care Program: Focus Group Discussions With Patients and Their Caregivers

Background

There is growing evidence of the need to consider cultural factors in the design and implementation of digital health interventions. However, there is still inadequate knowledge pertaining to the aspects of the Saudi Arabian culture that need to be considered in the design and implementation of digital health programs, especially in the context of home health care services for patients who are chronically and terminally ill.

Objective

This study aims to explore the specific cultural factors related to patients and their caregivers from the perspective of physicians, nurses, and trainers that have influenced the pilot implementation of Remotely Accessible Healthcare At Home, a connected health program in the Home Health Care department at King Saud University Medical City, Riyadh, Saudi Arabia.

Methods

A qualitative study design was adopted to conduct a focus group discussion in July 2019 using a semistructured interview guide with 3 female and 4 male participants working as nurses, family physicians, and information technologists. Qualitative data obtained were analyzed using a thematic framework analysis.

Results

A total of 2 categories emerged from the focus group discussion that influenced the experiences of digital health program intervention: first, culture-related factors including language and communication, cultural views on using cameras during consultation, nonadherence to web-based consultations, and family role and commitment and second, caregiver characteristics in telemedicine that includes their skills and education and electronic literacy. Participants of this study revealed that indirect contact with patients and their family members may work as a barrier to proper communication through the Remotely Accessible Healthcare At Home program.

Conclusions

We recommend exploring the use of interpreters in digital health, creating awareness among the local population regarding privacy in digital health, and actively involving direct family members with the health care providers.

A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes

Background

Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana.

Methods

A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis.

Results

The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds.

Conclusion

Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06993-1.

Effects of multimedia-based fall prevention education on the knowledge, attitudes, or behaviors of patients

OBJECTIVES

Patient safety is regarded as a critical quality monitoring indicator for medical institutions. The effects of a multimedia-based patient education intervention on knowledge, attitudes, and behaviors regarding fall prevention were observed.

METHODS

The study had a quasi-experimental research design and enrolled 140 participants. Seventy participants in the experimental group received multimedia-based patient education and a health education leaflet, while those in the control group received only the health education leaflet. A structured questionnaire was used for data collection at baseline, and a posttest was applied after the intervention.

RESULTS

The participants were predominantly treated in the gastroenterology department (45.7%), followed by the pulmonology department (33.6%). A total of 86.4% of patients had not experienced a fall within 3 months. After the intervention, the average scores for all variables in the experimental group were higher than those in the control group. The results indicate that attitudes, knowledge, and behaviors regarding fall prevention among patients in the pulmonology department were higher than those among patients in the gastroenterology department; the differences were statistically significant.

CONCLUSION

The individualized health education content was of substantial significance for patients with different disease backgrounds and facilitated changes in their knowledge, attitudes, and behaviors regarding falls.

RELEVANCE TO CLINICAL PRACTICE

Multimedia-based patient education influenced inpatients' knowledge, attitudes, and behaviors for preventing falls.

The quality of patient-nurse communication perceived before and during the COVID-19 pandemic: an Italian pilot study

Background and Aim of the work.

Therapeutic communication is essential for assessing the quality of patients’ care. The present study aimed to assess how the forced use of the mask influenced the communication before and during the Covid-19 pandemic.

Methods.

An online questionnaire was administered including two socio-demographic items, such as sex, as male and female, and role, as nurse or patient, and the Quality of Communication Questionnaire (QOC) for twice, referring to the period before and during the pandemic.

Results.

178 subjects participated in the study, of which 60 (33.7%) were patients and 118 (66.3%) were nurses. During the pandemic, patients reported no significant differences in the perception of the quality of nurse-patient communication. While nurses recorded a lower perception of communication quality during the pandemic period than before.

Conclusions.

The patient willingly accepted the use of the face mask unlike nurses considered it a further obstacle to an effective communication between nurse-patient. However, it could be considered the emotional and caring overload that each nurse had stored during the Covid-19 pandemic, in addition to the fear of contagion that had gripped the lives of nurses on a daily basis.

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.

An evaluation of instruments measuring behavioural aspects of the nurse-patient relationship

The Fundamentals of Care Framework is an evidence-based, theory-informed framework that conceptualises high-quality fundamental care. The Framework places the nurse-patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse-patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse-patient relationship instruments by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty-seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring 'focus', 'anticipate' and 'evaluate'. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse-patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework.

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.

Impact of work environment perceptions and communication satisfaction on the intention to quit: an empirical analysis of nurses in Saudi Arabia

OBJECTIVE

In consideration of the current nursing shortage in Saudi Arabia, we aimed to investigate the association among perceptions of work environment, communication satisfaction, and intentions to quit nursing profession among nurses. In addition, we aimed to investigate the mediating effect of communication satisfaction on the association between nurses' perception of work environment and their intentions to quit nursing profession.

METHODS

This predictive correlational study was conducted at one of the major hospitals in Saudi Arabia from January 2020 to March 2020. It included a convenience sample of 367 full-time registered nurses who completed three types of close-ended questionnaires. We used IBM SPSS version 24.0 to analyze the collected data. Regression analyses were used to test the study's hypotheses. All regression assumptions were assessed and confirmed. Significance for all tests was set at p ≤ .05.

RESULTS

The findings indicated an affirmative association between work environment perception and communication satisfaction (b = .764, p < .05) among nurses. In addition, findings showed that work environment perception (b = -.187, p < .05) and communication satisfaction (b = -.226, p < .05) have negative impacts on the nurses' intentions to quit; indicating that as work environment perception or communication satisfaction increases, the intention to quit decreases among nurses. Further, a mediation effect of communication satisfaction on the relationship between work environment perception and intention to quit was confirmed.

CONCLUSION

This study presents a novel conceptual framework developed based on the literature about the predisposing factors for nurses' intentions to quit nursing profession. Our results suggest that work environment perception and communication satisfaction among the most contributing factors for nurses resignation. Effective communication was established as a crucial factor for establishing attractive and healthy working environment. Nursing managers can benefit by applying these findings to develop appropriate strategies to inhibit the shortage of nurses in Saudi Arabia.

Holistic nursing care among operating room nurses: Strengthening the standard of practice in Saudi Arabia

BACKGROUND

Holistic practices have been found beneficial for patients as well as nurses. They increase both the nurses and the patients' health-promoting behaviors, spirituality, and interpersonal relationships.

OBJECTIVE

This study aimed to determine holistic nursing care and compare its differences based on individual characteristics.

METHODS

This study employed a quantitative-cross sectional approach. It was conducted at the hospitals of Hail region, Kingdom of Saudi Arabia, from February 2020 to March 2020. Selected through convenience sampling, 154 operating room nurses participated in the study. Frequency and percentages were used to analyze the demographic information, and t-tests and analysis of variance were used to test for differences.

RESULTS

Holistic nursing dimensions such as physiological (4.72 ± 0.40), socio-cultural (4.53 ± 0.45), psychological (4.66 ± 0.32), and spiritual aspects (4.22 ± 0.73) were consistently carried out in the operating room. On the physiological dimension, no significant differences were found in years of experience [(t) -0.073; p > 0.942], gender [(t) -1.113; p > 0.27], or age [(F) 0.558; p > 0.57), but there was a significant difference with nationality [(t) -3.328; p < 0.001]. On the socio-cultural dimension, the length of experience [(t) 0.599; p > 0.550], gender, [(t) -1.420; p > 0.158], and age [(F) 0.148; p > 0.862] were not significant, but a significant difference was found with nationality [(t) -7.516; p < 0.001]. Regarding the psychological dimension, the length of experience [(t) -1.101; p > 0.276], gender [(t) -1.545; p > 0.129], and age [(F) 1.259; p > 0.287] were not significant, but there was a significant difference with nationality [(t) -5.492; p < 0.001]. Finally, with the spiritual dimension, no significant difference was found on length of experience [(t) -1.101; p > 0.276] or age [(F) 0.584; p > 0.559], but there were significant differences on gender [(t) -3.890; p < 0.001] and nationality [(t) -3.653; p < 0.001].

CONCLUSION

Nationality is a causal factor to physiological, socio-cultural, psychological, and spiritual dimensions, while gender is significant to spiritual aspect. Regardless of nationality or gender, nurses must be knowledgeable regarding the significance of adopting holistic care to improve the quality of their care to their patients.

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.