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Background: Development of effective guideline for delirium management is still seeking nowadays. As nurses are in the first confrontation line for delirium, their prospective in identifying barriers are essential in developing integrated strategies and clinical guidelines. Objective: To explore the barriers focusing on intensive care unit (ICU) nurses’ point of views to provide an evidence-based support for effective nurse-led delirium management in ICU settings. Methods: Whittemore and Knafl framework was recruited to build up this integrative review. PRISMA guidelines were followed to search about barriers of nurse-led delirium management. Articles published up to June 2024 in five databases; Web of Science, Scopus, PubMed, CINAHL and EMBASE using related keywords were involved. Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of articles included in this review and then reported nurse-led delirium barriers were mapped according to COM-B model. Results: Twenty-three articles out of 1,020 research articles were included in this review after carefully checked according to the exclusion and inclusion criteria. based on MMAT, 7 articles achieved 100%, 11 articles were achieved 80%, and 5 articles achieved 60%. Nurses’ knowledge deficit is the most common psychological capability barriers of nurse-led delirium management, while complexity of delirium screening tools was found to be a physical capability barriers. High workload, lack of staff, lack of time, lack of documentation and lack/ shortage of guidelines were barriers mapped to physical opportunity, while communication barriers in particular patient’s intubation and sedation were mapped to social opportunity barriers. Motivation was represented by addressing delirium as a major problem, self-confidence, psychological support and considering nurse’s views. Conclusions: Nurse’s knowledge deficit, complexity of delirium screening tools, high workload, lack of time, lack of documentation, lack/ shortage of guideline, and impaired communication were barriers of nurse led delirium management. This study is promising in ease of application in clinical practice since delirium barriers in ICU settings were well-presented in a COM-B framework that may facilitate therapeutic strategies and related decision making. [ABSTRACT FROM AUTHOR]

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

This study aimed to investigate the predictors of poor quality of life and its relationship with medication adherence among patients with heart failure. Methods: A cross-sectional correlational study was performed on 229 patients with HF receiving care at the Cardiac Center of King Salman Specialist Hospital from March to June 2024. Data were collected using a structured questionnaire comprising patient demographics, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) to assess QoL, and the General Medication Adherence Scale (GMAS) to measure medication adherence. Results: The mean medication adherence score among patients with heart HF was 17.53 ± 6.94. The level of adherence was moderate among most patients (47.2%), high (29.7%), and poor (23.1%). Regarding QoL, the mean total score for overall QoL was 42.16 ± 20.53. Specifically, the mean scores were 15.24 ± 8.65 and 10.53 ± 5.82 for the physical and emotional dimensions of QoL, respectively. More than half of the patients experienced poor QoL, while moderate QoL was observed in 31.9% and good QoL in 17% of patients. Furthermore, there were moderate negative correlations between medication adherence and physical QoL (r= − 0.51), emotional QoL (r = − 0.59), and overall QoL (r = − 0.59), all of which were statistically significant (p < 0.001). Conclusion: Moderate-to-poor levels of medication adherence and QoL were found among HF patients receiving care in Hail City. Therefore, interventions to improve medication adherence among patients with HF must be prioritized to enhance health outcomes and QoL. It is also crucial to address the factors that negatively influence medication adherence to overcome the barriers that hinder optimal medication adherence. [ABSTRACT FROM AUTHOR]

Background: Nurses have a crucial role in managing, educating, and caring for diabetic patients. However, their knowledge should be regularly assessed to avoid preventable complications and reduce costs. Therefore, the present study assessed the perceived and actual knowledge about diabetes among nurses in Hail province of Saudi Arabia and investigated predictors of such knowledge. Methods: A cross-sectional study was conducted among 325 conveniently sampled nurses from all public hospitals and primary healthcare centres in Hail province from September to December 2022. A pre-designed questionnaire was used to collect demographic and practice-related characteristics of the nurses. In addition, data on nurses' perceived and actual knowledge about diabetes were collected using the Diabetes Self-Report Tool (DSRT) and Diabetes Basic Knowledge Tool (DBKT) self-report questionnaires, respectively. The mean knowledge scores for demographic and practice-related variables were compared using the independent-samples t-test and one-way analysis of variance. Multiple linear regression was used to identify significant predictors of perceived and actual knowledge. The correlation between perceived and actual knowledge was investigated using Pearson's correlation coefficient. A P-value ˂0.05 was considered statistically significant. Results: Based on a highest maximum score of 60 using the DSRT, the mean score of perceived knowledge was 38.4 ± 12.0, corresponding to a percentage mean score of 64%. On the other hand, based on a highest maximum score of 49 using the DBKT, the mean score of actual knowledge was 23.2 ± 9.6, corresponding to a percentage mean score of 47.3% of correct responses. Being Indian, having a diploma or a bachelor's degree, and having a poor or fair self-perception of competence in diabetes care were predictors of lower perceived knowledge scores, whereas having no access to diabetes guidelines was a predictor of higher scores. However, being non-Saudi and having experience of at least 16 years were predictors of higher actual knowledge scores. The correlation between actual and perceived knowledge about diabetes was negligible and statistically non-significant (r = 0.011, P = 0.055). Conclusion: Nurses affiliated with public health facilities in Hail province lack adequate knowledge about diabetes, with no correlation between what is perceived to be known and what is actually known. Indian citizenship, having a diploma or bachelor's degree, not having access to diabetes guidelines, not attending courses/workshops, and having a poor or fair self-perception of competence in diabetes care can significantly predict nurses' perceived knowledge. However, being non-Saudi (Filipino or Indian) and having at least 16 years of experience can significantly predict their actual knowledge of diabetes. [ABSTRACT FROM AUTHOR]

The article "Letter to the Editor: Expanding the Discourse on Decent and Precarious Work in Nursing" responds to a previous study on decent and precarious work among nursing and care workers. The authors highlight the impact of decent work on nursing outcomes and offer additional perspectives on ethical ideologies, whistleblowing, and psychological ownership in relation to decent work conditions. They suggest that investing in leadership programs and enhancing organizational values can improve working conditions in healthcare. The authors commend the previous study for its contribution to nursing research and hope to encourage further research and practical interventions in this area. [Extracted from the article]

Background: Successful implementation of Basic life support (BLS) is critical to improving survival rates and outcomes, especially among healthcare workers. To our knowledge, there is no available literature pertaining to the level of BLS knowledge of health care professionals in Yemen. Methods: Data was collected for this cross-sectional descriptive study from June to August 2020, using a 10-item questionnaire related to cardiopulmonary resuscitation (CPR) and BLS, along with questions on socio-demographic characteristics. Participants were nurses in public and private hospitals located in Al-Rahida and Al-dimna cities, Taiz governance and Hodeidah city, Hodeidah governance in Yemen. Results: Out of 220 distributed questionnaires, 200 were returned with a response rate of 90.9%. More than a half (53.65%) of answer choices for BLS knowledge were correct. There was a significant difference in knowledge score based on level of education where those who had Bachelor degree had more knowledge (P = 0.000). Those who said they had received training in CPR or received information about CPR had significantly higher scores than those who did not receive (P = 0.000). Conclusions: BLS knowledge among nurses in Yemen is below an acceptable level to ensure maximum survival in the event of cardiac arrest. Disseminating BLS information and training in a cost effective and efficient manner will provide a large benefit in terms of lives saved with minimal costs. [ABSTRACT FROM AUTHOR]

Background: Endotracheal suctioning (ETS) is one of the most common invasive procedures performed by critical care nurses (CCNs) to remove accumulated pulmonary secretions, ensure airway patency for adequate ventilation and oxygenation as well as prevent atelectasis in intubated patients. Objectives: To assess the practice of CCNs in intensive care units (ICUs) before, during, and after performing the ETS procedure and identify factors affecting their practice. Methods: A cross-sectional and non-participant observational design was conducted in the ICUs of four hospitals in Hodeida city, Yemen. The data were collected using a 25-item observational checklist in the period from May to August 2019. Results: More than half (55%) of CCNs scored undesirable (< 50%) regarding their adherence to ETS practice guidelines while the rest scored moderate (50–75%), with none of showing desirable adherence (> 70%) to the guidelines. There was no significant association between gender, age, education level, or length of experience of CCNs in the ICUs and their practice during performance ETS procedures. However, training (p = 0.010) and receiving information about ETS (p = 0.028) significantly improved the CCNs' practice. Conclusion: Most CCNs at the ICUs of Hodeida hospitals do not adhere to evidence-based practice guidelines when performing ETS procedures, possibly resulting in numerous adverse effects and complications for patients. CCNs receiving information and training show better ETS practice than do their counterparts. Therefore, it is necessary to provide the nursing staff with clear guidelines, continuous education and monitoring to improve their practices. [ABSTRACT FROM AUTHOR]

Background: Successful implementation of Basic life support (BLS) is critical to improving survival rates and outcomes, especially among healthcare workers. To our knowledge, there is no available literature pertaining to the level of BLS knowledge of health care professionals in Yemen. Methods: Data was collected for this cross-sectional descriptive study from June to August 2020, using a 10-item questionnaire related to cardiopulmonary resuscitation (CPR) and BLS, along with questions on socio-demographic characteristics. Participants were nurses in public and private hospitals located in Al-Rahida and Al-dimna cities, Taiz governance and Hodeidah city, Hodeidah governance in Yemen. Results: Out of 220 distributed questionnaires, 200 were returned with a response rate of 90.9%. More than a half (53.65%) of answer choices for BLS knowledge were correct. There was a significant difference in knowledge score based on level of education where those who had Bachelor degree had more knowledge (P = 0.000). Those who said they had received training in CPR or received information about CPR had significantly higher scores than those who did not receive (P = 0.000). Conclusions: BLS knowledge among nurses in Yemen is below an acceptable level to ensure maximum survival in the event of cardiac arrest. Disseminating BLS information and training in a cost effective and efficient manner will provide a large benefit in terms of lives saved with minimal costs. [ABSTRACT FROM AUTHOR]

Background: Catheter-associated urinary tract infection is a global problem but it can be prevented with the appropriate implementation of evidence-based guidelines. This study was conducted to assess the level of compliance of healthcare workers with the catheter-associated urinary tract infection prevention guidelines during the insertion of a urinary catheter. Methods: An observational study using a descriptive cross-sectional design was conducted at Sana'a City hospitals, Yemen. All the nurses and physicians from the governmental, teaching, and private hospitals were eligible to participate in the study. The data collection was performed through convenience sampling from March 2020 to December 2020, using a structured observational checklist prepared specifically for this study. Results: The majority of the urinary catheter insertions were performed by nurses. There were no written policy or procedures for an urinary catheter insertion and no in-service education or training departments in the majority of the hospitals. The overall mean score of compliance was 7.31 of 10. About 71% of the healthcare workers had a high or acceptable level of compliance and 29% had an unsafe level of compliance. Compliance was low for maintaining aseptic technique throughout the insertion procedure, using a single use packet of lubricant jelly, performing hand hygiene immediately before insertion, and securing the urinary catheter once inserted. Factors affecting the healthcare workers compliance were gender, the working ward/unit of the healthcare workers, the availability of a written policy/procedure and a department or unit for in-service education. Conclusion: Yemeni healthcare workers' overall compliance was acceptable but it was unsafe in several critical measures. There is an urgent need for developing, implementing, and monitoring national guidelines and institutional policy and procedures for catheter-associated urinary tract infection prevention. Periodical in-service education and training programs and adequate access to the necessary materials and supplies are paramount. [ABSTRACT FROM AUTHOR]

Aims and objectives. To explore the information needs of Yemeni patients who have undergone coronary artery bypass graft surgery before hospital discharges and to examine the differences in the patients' learning needs according to age, gender, level of education and working condition. Background. Postcoronary artery bypass graft (CABG) patients need more information before their discharge from the hospital. This need of information must be assessed and provided for them before their discharge from hospital to help them with adequate care and recovery at home. Design. A descriptive, correlational design. Methods. Data were collected from 120 CABG patients before their discharge from Al- Thawra Hospital, Sana'a, Yemen, by using modified Cardiac Patients Learning Needs Inventory (CPLNI) instrument. The Statistical Package for the Social Sciences was used to analyse the collected data. Results. The information about chest and leg wound care, medication information, other pertinent information and complications were indicated to be the most valued by CABG patients prior to discharge. There was a statistically significant difference between patients' total learning needs according to their socio-demographic characteristics. Male patients needed more information than female patients ( p = 0·004). Younger ( p = 0·021) and middle-aged ( p = 0·032) patients needed more information than older ones. Highly educated ( p = 0·000) and school-level ( p = 0·002) patients needed more information than those in the uneducated group. Working patients needed more information than non-working ones ( p = 0·000). Conclusion. This study suggests that CABG patients have high information needs within 24-48 hours before hospital discharge. In addition, the results of this study showed that there are statistically significant differences in patients' learning needs according to their demographic characteristics. Relevance to clinical practice. Assessment of CABG patients' information needs before their discharge from hospital helps in developing effective educational programme that will help these patients in their recovery at home. [ABSTRACT FROM AUTHOR]

Background: Many patients with type 2 diabetes mellitus (T2DM) face barriers to maintain a healthy lifestyle. This study investigated the perceived barriers to healthy eating and physical activity and compared them by demographic and diabetes-related characteristics among patients with T2DM. Methods: A cross-sectional study was conducted among 534 patients with T2DM attending primary healthcare centers in Hail City from January to June 2023. Data analyzed at a significance level of < 0.05. Results: Barriers to healthy eating and physical activity were perceived by 34.9% and 28% of patients, re-spectively. Personal and environmental barriers to healthy eating were perceived more frequently than social barriers (43.0% and 26.9%, respectively). Personal and environmental barriers to physical activity were perceived by 28.0% of patients, followed by social barriers (27.9%). The most frequently perceived barrier to healthy eating was a lack of motivation (61.6%), followed by insufficient information about healthy diets (32.2%). Regarding physical activity, a lack of motivation was the most frequently perceived personal barrier (32.0%), while a lack of a supportive work environment was the most frequently perceived social barrier (33.7%). Patients who were aged between 30 and 40 years, were highly educated, were diagnosed with DM within less than five years, and used insulin injections as a strategy to manage DM reported significantly higher levels of perceived barriers to healthy eating compared to their counterparts. In contrast, patients who were female, married, had poor financial status, and used insulin injections reported significantly higher levels of perceived barriers to physical activity compared to their counterparts. Conclusion: Over one-third of patients with T2DM seeking medical care in Hail City perceive barriers to healthy eating, mainly a lack of motivation, insufficient diet information. Educational programs that consider the unique characteristics of patients should be developed. [ABSTRACT FROM AUTHOR]

Background: As nursing education embraces e-learning as a vital component of its pedagogical approach, understanding the interplay between students' readiness for E-learning and their academic self-efficacy becomes imperative in nurturing successful learning outcomes amidst evolving educational paradigms. Purpose: This study aimed to explore the relationship between e-learning readiness, academic self-efficacy, and the academic achievement of nursing students within the dynamic educational environment. Design: This study employed a cross-sectional design. Methods: A total of 208 nursing students were recruited through convenience sampling at the end of the second semester in 2022. The evaluation included the utilization of Grade Point Average, the Online Learning Readiness Scale, and the Academic Self-Efficacy Scale. Findings: Previous research has indicated a significant positive correlation between academic achievement and readiness for e-learning, suggesting that higher levels of readiness for e-learning among nursing students lead to improved academic achievement (p ≤ 0.001). Additionally, the findings of the current study revealed a notable positive correlation between academic achievement and academic self-efficacy (p ≤ 0.001). Conclusion: This study provides valuable insights into the critical role of academic self-efficacy and e-learning readiness in enhancing academic achievement among nursing students. [ABSTRACT FROM AUTHOR]

Background: The emergence of dengue in malaria-endemic countries with limited diagnostic resources, such as Yemen, can be problematic because presumptive treatment of febrile cases as being malaria is a common practice. Co-infections with dengue and malaria are often overlooked and misdiagnosed as being a mono-infection because of clinical similarities. In Hodeidah city, Yemen, the capacity to conduct the diagnosis can be aggravated by the war context. To assess the magnitude of the problem, we determined the proportions of malaria, dengue and co-infection in relation to clinical characteristics among febrile outpatients. Methods: This cross-sectional study included 355 febrile outpatients from Hodeidah city during the malaria transmission season (September 2018 –February 2019). Sociodemographic and clinical characteristics were collected using a pre-designed, structured questionnaire. Malaria was confirmed using microscopy and rapid diagnostic tests (RDTs), while dengue was confirmed using RDTs. Results: Mono-infection proportions of 32.4% for falciparum malaria and 35.2% for dengue were found, where about two-thirds of dengue patients had a recent probable infection. However, co-infection with falciparum malaria and dengue was detected among 4.8% of cases. There was no statistically significant difference between having co-infection and mono-infection with malaria or dengue in relation to the sociodemographic characteristics. On the other hand, the odds of co-infection were significantly lower than the odds of malaria among patients presenting with sweating (OR = 0.1, 95% CI: 0.05–0.45; p <0.001), while the odds of co-infection were 3.5 times significantly higher than the odds of dengue among patients presenting with vomiting (OR = 3.5, 95% CI: 1.20–10.04; p <0.021). However, there were no statistically significant differences between having co-infection and mono-infection (malaria or dengue) in relation to other clinical characteristics. Conclusions: Mono-infection with malaria or dengue can be detected among about one-third of febrile outpatients in Hodeidah, while almost 5.0% of cases can be co-infected. Sociodemographic and clinical characteristics cannot easily distinguish malaria patients from dengue-infected or co-infected ones, reinforcing the necessity of laboratory confirmation and avoidance of treating febrile patients as being presumed malaria cases. [ABSTRACT FROM AUTHOR]

Background: Emergency department (ED) nurses are exposed to the risk of secondary traumatic stress (STS), which poses a threat not only to nurses' health and psychological well-being but also adversely affects the execution of their professional duties. The quality and outcome of their nursing services are negatively affected by STS. Purpose: The purpose of this study is to comprehensively investigate the prevalence and intensity of Secondary Traumatic Stress (STS) among Emergency Department (ED) nurses. It aims to identify and analyze the socio-demographic, occupational, and psychological factors that influence the severity and variation of STS experienced by these nurses. Methods: The study utilized a sequential explanatory mixed methods approach, including two phases. Phase 1 employed a cross-sectional study design, utilizing a convenience sample of 181 nurses to explore the levels of STS and the factors associated with it. Following this, Phase 2 was structured as a qualitative descriptive study, which involved conducting semi-structured interviews with a purposefully selected group of ten ED nurses. Data collection took place at three major hospitals in Saudi Arabia during the period from January to June 2022. Results: A total of 181 participants were included in the study. The mean STSS score reported by the nurses was 51 (SD = 13.23) out of the maximum possible score of 85, indicating severe STS among ED nurses. Factors associated with an increase in the levels of STS among ED nurses included being female, older in age, married, possessing higher education and experience, having a positive relationship with colleagues, receiving organisational support, and dealing with a higher number of trauma cases. Several themes emerged from the qualitative interviews including: ED Characteristics: Dual Impact on STS, Emotional Resonance and Vulnerability, Personal Life Stressors, The Ability to Cope, and Social Support. Conclusion and implications for practice: Future strategies and interventions targeting STS should be prioritized to effectively manage its impact on ED nurses. It is crucial to develop targeted interventions that address the specific factors contributing to STS, as identified in this study. Additionally, these findings aim to enhance awareness among nursing administrators, managers, and supervisors about the critical factors associated with STS. This awareness is essential for accurately assessing and developing interventions that mitigate STS among nursing staff. [ABSTRACT FROM AUTHOR]

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

Background: The development of the nursing profession depends significantly on how communities perceive it. This study aims to identify the views and attitudes of Arabic communities, specifically those in Sudan, Yemen, and Egypt, toward the nursing profession. Methods: A descriptive comparative study was used to identify the perception of Arabic communities (Sudan, Yemen, and Egypt) toward the nursing profession. The study was conducted in three Arabic countries (Sudan, Yemen, and Egypt) using an online approach by sending the link of questions to the targeted population using emails, WhatsApp, and social media. There were 529 participants from the three Arabic countries. The study was analyzed by SPSS software using descriptive and inferential statistics. Results: A majority (75.6%) of the participants were aged <40 years, with most (82.9%) being between 21 and 30 years of age. There was a generally positive perception toward the nursing profession among these communities: 97.6% of Sudanese, 94.9% of Yemenis, and 96.1% Egyptian. There was a borderline statistical significance between the Sudanese and Egyptians' age and their perception toward their profession. Gender is the only factor influencing the perception in Sudan and Egypt, and while women have a higher positive perception in Egypt, men have a higher positive perception in Sudan. Conclusion: Overall, the perception of Sudanese, Yemeni, and Egyptian communities toward the nursing profession is acceptable. The only influencing factor on the level of perception was Egyptian females who have high positive perception toward the nursing profession and Sudanese males who have high positive perception toward nursing profession We recommend further research to assess the perception toward nursing from different sociocultural backgrounds and on a larger sample size. [ABSTRACT FROM AUTHOR]

This cross-sectional study investigated the reasons behind academic cheating in a cohort of nursing students in Saudi Arabia. The study involved 482 nursing students from two government universities in Riyadh. We used a newly developed self-reported questionnaire called the Reasons for Cheating Scale (RCS) to collect data. The highest-scoring reasons for academic cheating in the study population included the desire to obtain high grades, encouragement from friends to cheat, and the perception that exams were too difficult. Male students scored significantly higher than female students for reasons such as not understanding the course material, unclear test questions and instructions, pressure from families to excel, difficulty of the course material, and ignorance of effective study methods (P < 0.05). Age also had a role, as students aged 15-20 years had significantly higher scores for the item "Exams are too hard", whereas those aged =25 years had higher scores for "Difficulty of the course material" (P < 0.05). Additionally, students in the preparatory year had significantly higher scores than those in other years for reasons such as difficult exams, unclear test questions and instructions, fear of failing, difficulty of the course material, and the desire to please their families (P < 0.05). Overall, the desire to obtain high grades emerged as the main reason for academic cheating in our cohort of nursing students in Saudi Arabia. The findings suggest that sociodemographic characteristics, including sex, age, and academic year, should be considered when addressing the issue of cheating among nursing students. [ABSTRACT FROM AUTHOR]

Purpose: To determine the status of glycemic control and its associated factors among adult patients with type 2 diabetes mellitus (T2DM) in Hodeidah City, Yemen. Methods: This cross-sectional study involved T2DM patients attending an outpatient clinic at the Military Hospital in Hodeidah, from January to March 2017. Relevant socio-demographic characteristics, clinical factors and self-management behaviours were recorded in face-to-face interviews. Blood pressure, body weight, and height measurements were also obtained. Glycosylated hemoglobin (HbA1c) and lipid profile were evaluated. Urine samples were also obtained and analysed by albuminuria assay. Results: Of 246 participants, 73.2 % showed poor glycemic control (HbA1c ≥ 7 %). Female patients, those aged ≥ 40 years, the illiterate, and Khat chewers were more likely to have poor glycemic control. Moreover, longer disease duration, insulin administration and albuminuria were significantly associated with poor glycemic control. In contrast, a healthy diet, physical exercise, proper self-monitoring of blood glucose levels and taking medicines as prescribed significantly increased the likelihood of good glycemic control. Conclusion: A majority of the Yemeni diabetic patients have poor glycemic control. To achieve better awareness, diabetes educational programs that highlight the benefits of self-management are recommended. [ABSTRACT FROM AUTHOR]

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

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency, the most common genetic enzymopathy worldwide, is associated with an acute haemolytic anaemia in individuals exposed to primaquine. The present study aimed to determine G6PD deficiency among Yemeni children in malaria-endemic areas as well as to assess the performance of the CareStart™ G6PD rapid diagnostic test (RDT) for its detection. Methods: A cross-sectional study recruiting 400 children from two rural districts in Hodeidah governorate was conducted. Socio-demographic data and blood samples were collected and G6PD deficiency was qualitatively detected in fresh blood in the field using the CareStart™ G6PD RDT, while the enzymatic assay was used to quantitatively measure enzyme activity. Performance of the CareStart™ G6PD RDT was assessed by calculating its sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) against the reference enzymatic assay. Results: The ranges of enzyme activity were 0.14-18.45 and 0.21-15.94 units/g haemoglobin (U/gHb) for males and females, respectively. However, adjusted male median G6PD activity was 5.0 U/gHb. Considering the adjusted male median as representing 100 % normal enzyme activity, the prevalence rates of G6PD deficiency were 12.0 and 2.3 % at the cut-off activities of ≤60 and ≤10 %, respectively. Multivariable analysis showed that gender, district of residence and consanguinity between parents were independent risk factors for G6PD deficiency at the cut-off activity of ≤30 % of normal. The CareStart™ G6PD RDT showed 100 % sensitivity and NPV for detecting G6PD deficiency at the cut-off activities of ≤10 and ≤20 % of normal activity compared to the reference enzymatic method. However, it showed specificity levels of 90.0 and 95.4 % as well as positive/deficient predictive values (PPVs) of 18.0 and 66.0 % at the cut-off activities of ≤10 and ≤20 %, respectively, compared to the reference method. Conclusions: G6PD deficiency with enzyme activity of ≤60 % of normal is prevalent among 12.0 % of children residing in malaria-endemic areas of Hodeidah governorate, with 2.3 % having severe G6PD deficiency. Gender, district of residence and consanguinity between parents are significant independent predictors of G6PD deficiency at the cut-off activity of ≤30 % of normal among children in malaria-endemic areas of Hodeidah. The CareStart™ G6PD RDT proved reliable as a point-of-care test to screen for severely G6PD-deficient patients, with 100 % sensitivity and NPV, and it can be used for making clinical decisions prior to the administration of primaquine in malaria elimination strategies. [ABSTRACT FROM AUTHOR]