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COVID-19 has provided a unique boost to the use of digital healthcare technology, putting many vulnerable people at risk of digital exclusion. To promote digital healthcare equity, it is important to identify the challenges that may inhibit cancer patients and family caregivers from benefiting from such technology. This study explored the challenges that cancer patients and family caregivers experience in using digital healthcare technology platforms during the COVID-19 pandemic. A qualitative descriptive study using face-to-face semistructured individual interviews was carried out. A purposive sample of 21 participants was recruited from a public cancer hospital in Saudi Arabia. Qualitative content analysis with an inductive approach was utilized. The factors that challenged the ability of participants to benefit from digital healthcare technology were similar. Four themes related to the challenges the two groups experienced emerged: access to platforms, use of platforms for cancer health-related purposes, attitudes toward these platforms, and individual user preferences. This study identified numerous areas for improvement regarding digital healthcare technology platform implementation, which could increase future benefits and equal use. This study's findings also provide useful information to investigators who intend to create digital nursing interventions for both groups amid COVID-19 and other worldwide health crises., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: The model of early rehabilitation for people with burns is still relatively novel in developing countries such as Egypt. The study examined the effect of a nurse-led rehabilitation program on functional outcomes in patients with severe hand burns., Design: A quasi-experimental design was used in this study., Methods: The study was completed in the burn unit of a teaching university hospital in Alexandria, Egypt, with a convenience sample of 80 patients with severe hand burns. Participants were consecutively assigned to one of two groups: control ( n = 40), which received only routine hospital care and clinical interventions, or intervention ( n = 40), which received routine hospital care and clinical interventions and a 4-week nurse-led rehabilitation program (health education including audiovisual aids and burn rehabilitation education booklet, social support, and hand rehabilitation exercises). To assess functional outcomes, both groups were given pre- and posttests of the Disabilities of the Arm, Shoulder and Hand outcome and the Hand Motor Function Observational Checklist questionnaires. Descriptive and inferential statistics were conducted., Results: Functional outcomes were significantly improved in the intervention participants compared to the control participants ( t = 5.710, p < .001). The differences in index scores between the two groups were statistically significant ( p < .001)., Clinical Relevance: The study provides information for burn rehabilitation nurses in developing countries to develop and test early interventions that improve functional outcomes in this population., Conclusions: A 4-week nurse-led program may be a beneficial intervention for improving functional outcomes in adult patients with severe hand burns who are undergoing rehabilitation., (Copyright © 2024 Association of Rehabilitation Nurses.)

Aims and Objectives: To examine the predictors and outcomes of patient safety culture (PSC) among oncology nurses working in public Saudi hospitals according to participant characteristics and evaluate the relationship between PSC domains., Background: PSC is crucial in healthcare systems, particularly in oncology and chemotherapy units, and its assessment can enhance the standard service provided and cancer care quality. There is currently limited research on the status, predictors and outcomes of PSC in cancer care settings in developing countries, including Saudi Arabia., Design: A cross-sectional correlational study., Methods: A convenience sample of 101 oncology nurses working in two large Saudi tertiary care hospitals participated in this study. The Hospital Survey on Patient Safety Culture validated instrument and demographic and work surveys were completed by the participants. The study methods were compliant with the STROBE checklist. Descriptive statistics and multiple linear regressions were used to analyse the data., Results: The areas of PSC strength were related to organizational learning-constant improvement, feedback and communication about errors, and transitions and handoffs. Manager/supervisor actions and expectations, hospital management support, communication openness, experience in the current unit and oncology unit/area were the predictors of PSC. In terms of PSC outcomes, the oncology nurses reported either no or one to two adverse events and a substantially good patient safety rating., Conclusion: The level of PSC was lower than expected. Communication openness, experience in the current unit and oncology unit/area were the strongest predictors of PSC. Investing in oncology nursing practice that addresses these concerns and prioritizes patient safety is critical in Saudi cancer care settings to increase patient safety., Relevance to Clinical Practice: The findings contribute to a better understanding of the predictors and outcomes of PSC, which should be considered when establishing effective nursing interventions or strategies for PSC in cancer care settings., Patient or Public Contribution: No patient or public contribution., (© 2023 John Wiley & Sons Ltd.)

Objectives: A lack of confidence among oncology nurses might be problematic when providing palliative care. No valid and reliable tool is currently available in Saudi Arabia to assess oncology nurses' confidence in providing palliative care. This study aims to explain the process of translation, adaptation, and validation of the Palliative Care Self-Efficacy Scale (PCSS) to support its use in the Saudi context., Methods: This was a methodological study of translation, cultural adaptation, and content validation of PCSS. The process of translation and adaptation was conducted according to the World Health Organization guidelines, including forward and backward translations, an expert panel review, and pretesting and cognitive interviewing, resulting in a final version. Two independent bilingual oncology nurses familiar with palliative care terminology translated the PCSS from English to Modern Standard Arabic. Next, the concise PCSS translation developed from the 2 translations was back-translated to English by 2 English-speaking translators and then compared to the original PCSS. The Arabic version PCSS was evaluated by Saudi professionals ( N  = 5) in oncology and palliative care nursing using a Likert scale for essentiality, relevance, clarity, and appropriateness. The content validity was examined using the calculation of the content validity ratio, item-level content validity index (I-CVI), and modified kappa statistics. The thinking aloud method was also used to interview Saudi oncology nurses ( N  = 8) who had palliative care experience., Results: The relevance, clarity, and appropriateness of the first Arabic version PCSS were validated. It had a level of content validity index of 1.00 for all items after improvements were made based on the recommendations of experts and oncology nurses., Significance of Results: The PCSS demonstrated face and content validity in the assessment of oncology nurses' confidence in providing palliative care. The PCSS is suitable for use in palliative cancer care units in Saudi Arabia to identify the educational needs of nurses to promote their confidence and improve the quality of care. Additional reliable and valid language versions of the PCSS allow for international and national comparisons, which may be useful for oncology nursing administrators or managers who are accountable for the quality of palliative care during the strategic health-care planning process in cancer services.

COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87-2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74-1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90-2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The prevalence and illness burden of chronic obstructive pulmonary disease (COPD) are both high. Currently, limited guidance is available to support the establishment of effective health programs to increase self-management practices in patients with COPD., Objectives: To explore the effect of a comprehensive blended health education program on self-management practices in patients with mild-to-moderate COPD in Jeddah City, Saudi Arabia., Methods: A quasi-experimental research study was carried out with a convenience sample of 60 discharged or stable patients with COPD following treatment. Participants were divided into an intervention group (n = 30) that received usual hospital care and blended health education program, and a control group (n = 30) that obtained the usual hospital care without involvement in the health education program from May 2021- to August 2021. Data were collected before and three months after the intervention using the COPD Self-Management Scale and patient socio-demographic and clinical information surveys., Results: Statistically significant differences were found between the control and intervention groups after three months of the intervention based on total COPD Self-Management Scale scores. There were no statistically significant relationships between the participants' mean COPD Self-Management Scale scores in both groups with their socio-demographic and clinical characteristics before and after the intervention., Conclusions: A nurse-led, comprehensive blended health education program was found to be an effective method for improving COPD patients' self-management practices. COPD nurses and nurse researchers must collaborate to identify the most common interventions with the best cost/benefit ratios and greater positive effects on early COPD patients' self-management practices and general well-being., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of this article., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aim(s): The study aimed to test a model that examined the relationships between authentic leadership, psychological safety, work engagement and team effectiveness and subsequent effects of team effectiveness on job turnover intentions and nurse satisfaction with quality of care., Background: Nurse leaders who exhibit authentic leadership have been shown to contribute to the development of healthy work environments. In workplaces with demonstrated authentic leadership, nurses are more engaged and have lower job turnover intentions., Method(s): A non-experimental, cross-sectional design was used to test the hypothesized model via structural equation modelling. A total of 456 nurses were included., Results: Structural equation modelling analysis indicated a good fit for the hypothesized model. Authentic leadership had a positive, significant and direct relationship with team effectiveness, nurses' work engagement and psychological safety. Team effectiveness was found to be negatively related to job turnover intentions but positively related to nurse satisfaction with quality of care., Conclusion(s): Results of this study may help nursing leaders have a better understanding of the essential role of leadership style in increasing healthy work environments., Implications for Nursing Management: Applying authentic leadership style in nursing practice could help to reduce the shortage of nurses stemming from the high turnover intentions of nurses., (© 2022 John Wiley & Sons Ltd.)

Background: Nursing education suffers from a lack of high-quality clinical experiences for students, especially among medical specialty groups such as cancer patients, in Saudi Arabia. A paucity of empirical evidence is supporting simulation in education and the transfer of psychomotor skills to patient care. In particular, although generally recognized as an essential oncology nursing skill, effective strategies for teaching the management of chemotherapy extravasation to students have not been investigated., Purpose: To investigate the effects of high-fidelity simulation (HFS) technology on the competency of nursing students in the management of chemotherapy extravasation and the transfer of this skill from traditional learning labs to clinical settings., Methods: A quasi-experimental study comprising a two-group pretest-posttest with repeated measures was used. The intervention was a scenario-based, HFS. Third-year students (n = 68) from a nursing program were randomly allocated to either intervention or control groups. Competency was measured in both groups using the same standardized assessment checklist., Results: Competency scores were lower in the control group compared to the intervention group at both posttesting times. These results, however, were not statistically significant. There was no statistically significant difference between the groups regarding skill transfer., Conclusions: Nursing faculty can use either HFS or traditional learning methods to effectively teach students how to manage chemotherapy extravasation and transfer this skill to clinical settings., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of this article., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aims: The aims of this integrative review were to describe leadership styles from the nursing literature in Saudi Arabia and to identify the current state of evidence about relationships between leadership styles and nurse, patient and organization outcomes in Saudi Arabia., Design: Integrative review was used as a design for this study., Methods: The following search terms were used with databases: 'Saudi Arabia', 'leadership theory*', 'leadership style*', 'leadership model*', 'management style' and 'nurse*'. Methodological quality was assessed using two different quality rating tools for quantitative and qualitative studies. Databases used for this review included Nursing & Allied Health Database, Cochrane Database of Systematic Reviews, PubMed, CINAHL, Embase, PsycINFO, Scopus, Web of Science and ProQuest Dissertations & Theses., Results: Nine manuscripts representing eight studies were included in this review. The papers reviewed included quantitative (n = 6), qualitative (n = 2) and mixed methods studies (n = 1). Results were grouped into different themes, identified as nursing leadership styles in Saudi Arabia, leadership styles and nurses' outcomes, and demographics and leadership styles., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background: Cancer patients receiving chemotherapy experience acute and delayed nausea and vomiting. These side effects obligate the patients to use pharmacological and nonpharmacological methods. The effect of ginger tea as an antiemetic modality on preventing chemotherapy-related nausea and vomiting has not been confirmed in previous studies., Objective: The aim of this study was to assess the effect of ginger tea, when given together with the standard antiemetic regimen, on preventing nausea and vomiting in patients with gynecological cancers receiving cisplatin-based regimens., Methods: This study used a quasi-experimental research design with 2 groups (control and intervention groups, 50 participants each). A sociodemographic and medical survey and the Modified Rhodes Index of Nausea, Vomiting, and Retching were used to collect the data. Descriptive analyses, t test, and χ2 test were used to analyze the data., Results: The total mean Modified Rhodes Index of Nausea, Vomiting, and Retching scores were lower in the intervention group in all measurements compared with the control group, and the differences between the total mean scores for symptom experience, development, and distress between the groups were statistically significant in the third (P < .05), fourth (P < .01), and fifth (P < .05) measurements. No ginger-related side effects were noted in this study., Conclusions: Ginger tea reduced the experience, development, and distress of nausea, vomiting, and retching in the intervention group. The use of ginger tea may be recommended for chemotherapy-associated nausea and vomiting in cancer patients receiving cisplatin-based regimens., Implications for Practice: Oncology nurses can lead the implementation of ginger tea intervention to prevent chemotherapy-related nausea and vomiting., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Aims and Objectives: To discover the current state of self-management practices and levels of self-efficacy among adults with cancer under treatment in Jeddah City, Saudi Arabia, and to identify their associated factors., Background: The prevalence of cancer and cancer treatment-related problems is increasing in Saudi Arabia. However, effective cancer care programmes are not provided in this country., Design: Cross-sectional correlational study., Methods: This study was conducted with a convenience sample of 130 adults with cancer under treatment from May 2020-August 2020 at the largest tertiary care hospital providing cancer care in the western region, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Self-Care Inventory, Strategies Used by People to Promote Health, and sociodemographic and clinical surveys. Descriptive statistics and stepwise linear regression analysis were performed., Results: The total score for self-management practices was 84.38 (SD = 13.66) and self-efficacy, as a strong associated factor of self-management, earned a total score of 104.24 (SD = 15.87). Stepwise regression analysis identified self-efficacy, age and education level as important associated variables, explaining 57.6% of the total variance in self-management practices. Significant effects of age, gender, marital status and duration of cancer on patients' self-efficacy were also found., Conclusions: The levels of self-management practices and self-efficacy to manage cancer treatment-related problems demonstrated by patients with cancer in this study were rated as a medium. Self-efficacy, age and education level were the significant factors associated with self-management practices of patients in Saudi Arabia. Age, gender, marital status and duration of cancer were identified as associated factors of self-efficacy., Relevance to Clinical Practice: Enhancing patient's adherence to self-management practices and increase patient's self-efficacy through adopting educational intervention programmes, considering patient's sociodemographic and disease-related characteristics, and continuous patient education must be taken into consideration in the cancer management plan., (© 2021 John Wiley & Sons Ltd.)

Coronavirus disease 2019 (COVID-19) infection has become a clinical threat to healthy people as well as immunocompromised patients and those with pre-existing chronic diseases around the world. This study, which used a cross-sectional correlational design, aimed to assess the levels of fear and health anxiety and to investigate their predictors during the current outbreak of COVID-19 in immunocompromised and chronic disease patients in Saudi Arabia. Sociodemographic and clinical data, fear of COVID-19, and health anxiety measurements were collected by online surveys from June 15 to July 15, 2020. Univariate and multiple linear regression analysis was used to identify predictors. A total of 1,030 patients in 13 provinces in Saudi Arabia completed the questionnaire. A significant number of patients with chronic diseases experienced considerable levels of fear and anxiety during the COVID-19 outbreak. It was found that 21.44% of participants met the criteria for anxiety cases, and 19.4% were considered borderline anxiety cases. In regression analysis, significant predictors of fear and health anxiety were female gender, lower education, middle-aged, divorced or widowed, receiving immunosuppressants, type of chronic disease (Crohn's disease, hypertension, and cardiovascular diseases), and media use as a source of knowledge about COVID-19. Immunocompromised and chronic disease patients are vulnerable to fear and anxiety during epidemic infectious diseases such as COVID-19. Optimizing this population's compliance with appropriate infection prevention and control strategies is crucial during the infectious outbreaks to ensure their safety, to decrease the risk of infection and serious complications, and reduce their fear and health anxiety. Effective positive psychological interventions and support strategies also need to be immediately implemented to increase psychological resilience and improve the mental health of these patients. Due to the COVID-19 outbreak, chronic disease patients in Saudi Arabia need special attention from health authorities, policymakers, and healthcare professionals to manage maladaptive forms of health anxiety and fear., Competing Interests: The authors have declared that no competing interests exist.

Aim: This study was conducted to investigate the relationships between caregiving stress, mental health and physical health in family caregivers of adult patients with cancer at a University Teaching Hospital in Jeddah city, Saudi Arabia., Methods: A cross-sectional correlational study was carried out with a convenience sample of 160 family caregivers of adult patients with cancer. Data were collected using a self-administered questionnaire including the Modified Caregiver Strain Index, the DUKE Health Profile and sociodemographic items. The data were analysed using the Statistical Package for the Social Sciences (SPSS). Descriptive and inferential statistics and correlations were performed., Results: Participants experienced a certain level of caregiving stress (M = 9.01, SD = 5.645). Many factors were found to be correlated to higher caregiving stress in this study. Caregiving stress showed significant moderate negative correlations with mental and physical health (p < 0.01). Statistically significant differences were found between age, gender, nationality, education, monthly income, and caregiving stress or DUKE Health Profile scores (p < 0.05)., Conclusions: Caregiving stress affects family caregivers' mental and physical health. Such stress can disrupt the caregiving performance of family caregivers. Discovering the causes of caregiving stress among the family caregivers of adult patients with cancer may help to determine the main elements affecting patient care and can assist oncology nurses in providing support and services to caregivers. Educational strategies/intervention programs in the hospitals may be required to reduce caregiving stress levels and improve the health and well-being of family caregivers of adult patients with cancer., (© 2019 Nordic College of Caring Science.)

Aims and Objectives: To assess the knowledge and attitudes of healthcare providers regarding sexual health care in cancer patients in Saudi Arabia and explore possible barriers influencing their attitudes., Background: A growing body of research emphasises the importance of healthcare providers addressing the sexual problems of cancer patients. The literature, however, shows that cancer treatment-related sexual problems are not frequently discussed by healthcare providers as expected. In Saudi Arabia, sexual health care in oncology daily practice has not been addressed sufficiently., Methods: A cross-sectional correlational study was conducted with a convenience sample of 150 healthcare providers from a university teaching and referral hospital providing cancer and palliative care in Jeddah City, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Sexual Healthcare Attitudes and Knowledge survey. Descriptive and inferential statistics and Pearson's correlations were performed. A content analysis was used to enhance understanding and support study's findings., Results: Participants had a poor knowledge related to sexual health care in cancer patients, and the low mean attitudes score also represents negative attitudes and higher levels of barriers. Participants had insufficient knowledge about assessment and evaluation of sexual health in cancer patients, and did not know about sexual dysfunction resulting from cancer and its treatment. Knowledge and attitudes had a significantly positive correlation., Conclusion: The study findings indicate there is room for improvement in the sexual health-related knowledge among oncology nurses, doctors and radiation oncologists. Helping healthcare providers overcome barriers to discussing cancer patients' sexual issues needs a careful evaluation of the knowledge, attitudes and barriers that keep them from discussing such issues., Relevance to Clinical Practice: It is imperative to improve healthcare providers' sexuality knowledge about cancer patients through introducing sexual health-based continuing education programmes, availability of resources (educational materials and clinical checklists) and training in oncology daily practice., (© 2020 John Wiley & Sons Ltd.)

Background: Chemotherapy-related cognitive dysfunction, one of the most frequently reported symptoms in patients with cancer, has a negative impact on the daily lives of patients. No research has examined cognitive dysfunction and its potential predictors in adult patients with cancer receiving chemotherapy in Saudi Arabia., Purpose: The purpose of this study was to examine the sociodemographic, clinical, and psychological factors associated with cognitive dysfunction in adult patients with cancer receiving chemotherapy., Methods: A cross-sectional correlational study was carried out with a convenience sample of 100 adult patients with cancer receiving chemotherapy at a university teaching hospital in Saudi Arabia. The Montreal Cognitive Assessment, the Hospital Anxiety and Depression Scale, and sociodemographic and clinical surveys were completed by participants. Descriptive statistics and linear regression were used to analyze the data., Results: The data showed that the participants experienced moderate-to-severe cognitive dysfunction. Participants performed poorly in the divided attention and memory cognitive domains. Age, educational level, and depression factors were found to be significant predictors of cognitive dysfunction., Conclusions/implications for Practice: Cognitive dysfunction is commonly seen in patients with cancer receiving chemotherapy. Chemotherapy, age, and psychological factors increase susceptibility to cognitive dysfunction in adult patients with cancer. Oncology nurses should be aware that patients with cancer may be extremely vulnerable to cognitive dysfunction. Furthermore, age and psychological factors must be considered when developing symptom management and supportive care intervention programs to reduce the incidence of negative cognitive outcomes in this population.

Aim: To explore and understand work stress and its sources among oncology nurses in a Saudi university-teaching hospital., Design: Qualitative descriptive study using semistructured interviews., Methods: Fourteen oncology nurses working in a university-teaching hospital were interviewed between October - December 2016. Qualitative content analysis according to the Krippendorff method was used to explore work-related stressors among oncology nurses in Saudi Arabia., Results: Two categories were emerged including "extent of work stress" and "work-related stressors". The second category included the following subcategories of workload and staff shortage, emotional demands, lack of social support, language barriers, and lack of respect from patients and family members and cultural differences.

Nursing is known to be a stressful profession that can lead to physical and psychological health issues and behavioural problems. In oncology, workload among nurses is believed to be increasing in conjunction with rapidly increasing numbers of patients with cancer and staff shortages worldwide, therefore it is essential to sustain a quality oncology nurse workforce. Numerous studies have presented evidence on job strain, effects of coping strategies, and nurses' work performance within healthcare settings, but few have focused on oncology settings and none of these on nurses working in Saudi Arabia. The purpose of this review was to summarize empirical and theoretical evidence concerning job-related stressors in nurses, particularly oncology nurses, and the interrelationships among job strain, coping strategies, and work performance in this population. Search strategies identified studies published on studies in peer-reviewed journals from 2004 to 2016. Twenty-five nursing studies were found examining the relationships among the concepts of interest. Common job-related stressors among oncology nurses were high job demands, dealing with death/dying, lack of job control, and interpersonal conflicts at work. Job strain was found to be significantly linked to coping strategies, and negatively associated with work performance among nurses in general. There is no existing empirical evidence to support the relationship between coping strategies and work performance among oncology nurses. The present evidence is limited, and a considerable amount of research is required in the future to expand the oncology nursing literature. Research is needed to investigate job-related stressors and their effects on oncology nurses.