A multisite survey of managerial competence and organizational commitment among nurses working at public hospitals in Saudi Arabia.

AIMS: The purpose of this study was to determine the relationship between managerial competence level and organizational commitment among nurses in Saudi Arabia. BACKGROUND: Nurse managers who have a high degree of managerial competency and/or organizational commitment are seen as role models by their employees and can affect employees' sense of belonging to the organization. METHODS: A cross-sectional, multisite study was conducted with 226 eligible nurses working at six public hospitals in Saudi Arabia. Data were collected from March through June 2021 through an online self-administered survey. Multivariate regression was used to determine the relationship between managerial competence and organizational commitment while controlling for demographic variables. RESULTS: Both managerial competence (M = 152.9, SD = 48.41, range: 54-216) and organizational commitment (M = 49.4, SD = 22.15, range: 18-121) were reported to be slightly moderate among the sample. A significant positive association also existed between managerial competence and organizational commitment variables (r = .510, p < .05). CONCLUSIONS: Future studies addressing potential issues for improving managerial competence and organizational commitment in clinical environments are recommended. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse administrations should use highly standard guidelines to improve nurses' managerial competence and organizational commitment.

Mediating role of self-efficacy in the relationship between family social support and hypertension self-care behaviours: A cross-sectional study of Saudi men with hypertension.

BACKGROUND: Self-efficacy and family social support are significantly associated with hypertension self-care behaviours. However, little is known about their mechanism in Saudi Arabia. This cross-sectional study aimed to examine the relationships among family social support, self-efficacy, and self-care behaviours among men with hypertension in Saudi Arabia. METHODS: Data were collected from May to August of 2018. The Hypertension Self-Care Profile and the Perceived Social Support from Friends and Family scales were used to measure the study variables. Multiple linear regression was used to analyse the relationships between the variables, and the Baron and Kenny test was used to assess if self-efficacy mediated the relationship between family social support and hypertension self-care behaviours. RESULTS: Respondents (N = 158) from the Jizan and Al-Sharqia regions of Saudi Arabia completed the survey. Family social support and self-efficacy were significantly associated with hypertension self-care behaviours. In regression, self-efficacy was the only variable significantly associated with hypertension self-care behaviours. Self-efficacy fully mediated the relationship between family social support and hypertension self-care behaviours. CONCLUSIONS: Interventions to enhance hypertension self-care behaviours among Saudi men could focus on increasing individual's self-confidence to perform specific healthy behaviours. Family support can also contribute to the performance of hypertension self-care behaviours.

Evaluating the Effectiveness of a Self-Management Program on Patients Living with Chronic Diseases.

Background: Chronic diseases are a major public health concern globally, and the position in Saudi Arabia is no exception. The Chronic Disease Self-Management Program (CDSMP) is a widely used intervention process to address care of chronic conditions. However, its effectiveness in a Saudi context has not been extensively studied. Therefore, this study aimed at evaluating the post-intervention outcomes of the CDSMP in Saudi Arabia. Materials and Methods: The study utilized a qualitative design on patients with chronic conditions. Data were collected through two focus group sessions with 15 participants who had completed the CDSMP. A thematic analysis technique was used for data analysis. Results: Three key themes emerged from analysis of the qualitative data obtained through the focus groups: the perceived benefits from participation in the CDSMP workshop; the impact of the CDSMP workshop on improving health status and quality of life; and, the cultural acceptability of the CDSMP. The study also found that the CDSMP was effective in improving participants' self-management skills and quality of life. Additional benefits included increased motivation for behavioral change, enhanced confidence regarding self-care of chronic conditions, improved communication with healthcare providers, and better coping strategies. Conclusion: This study provides valuable insights into the effectiveness of the CDSMP in addressing chronic conditions in Saudi Arabia. The program's emphasis on self-management skills and peer support aligns with the cultural values of Saudi Arabia. However, applying the CDSMP across various chronic conditions should be addressed in future interventions.

Nursing students' awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare: A cross-sectional study.

BACKGROUND: Increasing technology use in healthcare has led to a focus on improving aspects of telehealth delivery to facilitate healthcare. Thus, students' understanding of the importance of telehealth and telenursing must be improved, as this plays a crucial role in shaping the future of healthcare. This study aimed to examine nursing students' awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare. METHODS: A cross-sectional study was conducted on a convenience sample of 204 nursing students attending a public university in Saudi Arabia. An online questionnaire, supplemented by additional instruments, was used for data collection. The required bivariate and multivariate analyses were used to analyze the collected data. RESULTS: The study revealed that nursing students exhibited moderately high levels of awareness, knowledge, and attitudes regarding technology use for high-quality healthcare. Significant differences in the mean frequencies of internet use and knowledge (p < .05) and technology proficiency and knowledge (p < .05) were reported. The Pearson coefficient correlation test demonstrated that awareness was associated with knowledge (r = 0.350, p < .001), attitude (r = 0.660, p < .001), and years of technology use (r = -0.157, p = .025). Furthermore, attitude was significantly associated with knowledge (r = 0.295, p < .001) and years of technology use (r = -0.150, p = .032). In the regression, the awareness, knowledge, and attitude models were all significant (p < .05). CONCLUSIONS: The study's findings emphasize the need for targeted interventions to enhance nursing students' technological proficiency and awareness of telenursing. The predictive relationships among awareness, knowledge, and attitude also emphasize the need for a comprehensive and integrated educational approach. Future qualitative research studies should explore nursing students' perceptions of telenursing and how this could lead to high-quality healthcare.

Trust: How It Affects the Use of Telemedicine in Improving Access to Assistive Technology to Enhance Healthcare Services.

Background: Modern telemedicine (TM) technologies play a crucial role in enhancing access to Assistive Technology in healthcare services. However, the full benefits of this technology will not be realized unless it is widely accepted among service users (patients). This study aimed to investigate the impact of patient trust and perceived risk on the acceptance of TM for Assistive Technology in healthcare. Materials and Methods: A comprehensive survey instrument was developed and refined through expert feedback and a pilot study, leading to data collection from 917 participants. The theoretical framework guiding this research was based on the Trust factors in TM, which helped in conceptualizing the factors influencing patient acceptance of TM. Results: The study revealed a significant gap in patient trust in TM and highlighted the multifaceted nature of perceived risk, emphasizing the need to consider individual risk factors separately. Results also indicated that trust in technological reliability and the perceived effectiveness of TM were critical factors influencing its adoption. The findings underscore the importance of building trust among service users and promoting the reliability of TM for achieving desirable medical outcomes. Conclusion: In conclusion, to facilitate widespread acceptance of TM for Assistive Technology, a multi-faceted approach involving healthcare providers, organizations, and governments is essential to address patient concerns, enhance trust, and promote the benefits of this technology.

The Effectiveness of the Chronic Disease Self-Management Program in Improving Patients' Self-Efficacy and Health-Related Behaviors: A Quasi-Experimental Study.

The Stanford Chronic Disease Self-Management Program (CDSMP) is a valuable educational resource for supporting patients' self-management behaviors. However, no evidence supporting its effectiveness in the Saudi Arabian population exists. Therefore, this study aimed to evaluate the effectiveness of the 6-month CDSMP in individuals with chronic conditions in Saudi Arabia within a primary care context. A quasi-experimental design was conducted in 110 adults living with ≥1 chronic disease in Saudi Arabia. The patients in the experimental group (n = 45) participated in a six-session CDSMP, whereas those in the control group (n = 65) continued their usual care. Baseline and 6-month assessments were conducted using relevant questionnaires to assess outcome measures. Analysis of covariance revealed that the participants who underwent the CDSMP had significantly higher self-efficacy levels in managing their conditions (F = 9.80, p < 0.01) and a greater tendency to adopt healthy behaviors to successfully manage their chronic illnesses (F = 11.17, p < 0.01). The participants who underwent the CDSMP also showed significant improvements in all health-related outcomes compared with those in the control group (p < 0.01). These findings indicated that the program had a positive effectiveness in self-efficacy, self-management behaviors, and health-related outcomes among adults with chronic diseases in Saudi Arabia. The CDSMP may be integrated into primary care settings to help patients successfully manage their chronic conditions.

Exploring Healthcare Providers' and Women's Perspectives of Labor Companionship during Childbirth: An Interpretative Phenomenological Analysis Study.

A labor companion of choice during childbirth is crucial for improving women's birth experience and confidence to give birth. Labor companions provide various benefits, including enhanced communication, emotional support, non-pharmacological pain relief, and better healthcare. However, little is known about the supportive actions of labor companions with respect to women's needs during labor and birth, as well as healthcare providers' perceptions of labor companions. Therefore, this study was conducted to explore the perceptions of healthcare providers and women regarding labor companions. The study utilized an interpretative phenomenology research design. Data collection involved conducting semi-structured interviews with 14 participants. The sample consisted of mothers, physicians, and nurses, ensuring a diverse range of perspectives. An interpretative phenomenological analysis was conducted for data analysis. Five themes were identified: (a) impact of companionship, (b) benefits for healthcare providers, (c) companion roles, (d) loneliness and alienation of mothers, and (e) challenges of implementation. The findings indicated that the presence of a companion reduces the need for unnecessary medical interventions and eases the workload of healthcare providers. Without a companion, mothers often feel lonely and disconnected during the birthing process. The presence of companions is often hindered by space limitations in delivery rooms, the absence of clear policies, and lack of childbirth education programs for companions. Clear policies, education programs, and adequate space are essential for implementing and promoting labor companionship during childbirth.

Enhancing Nurses' Disaster Management and Preparedness: Evaluating the Effectiveness of an Online Educational Program Through a Quasi-Experimental Study.

Background: Disaster management is an ongoing international concern, and nurses play essential roles in minimizing negative impacts on the health of communities. However, many nurses have limited knowledge and skills on how to respond to disasters effectively. Therefore, this study was conducted to determine the effectiveness of a newly developed educational program on improving nurses' disaster management and preparedness. Methods and Design: A quasi-experimental study was conducted on 88 nurses working at a public hospital. The educational program included six modules covering various aspects of disaster management. Pre-and post-tests were administered to evaluate changes in perceptions of disaster management competencies. Independent sample t-test, Pearson coefficient correlation, and One-way ANOVA tests were all run using SPSS. Results: A significant proportion of nurses (78.4%) reported ongoing training in disaster management, while a smaller percentage (21.6%) expressed a contrary opinion. Nurses also had a moderate level of agreement with the disaster preparedness program (Pretest: 2.26 ± 0.34; post-test: 2.29 ± 0.31). Further, the results showed small improvements in nursing perceptions of the operational plan after the educational program (Pretest: M=2.76, SD=0.63; Post-test: M=2.89, SD=0.44), although the differences between pre-and-post assessments were not significant (P > 0.05). The mean values for overall familiarity in the pre-test were 3.16 ± 1.39, while in the post-test, they slightly increased to 3.26 ± 1.18. The findings also showed no statistically significant differences reported in nurses' attitudes and familiarity towards disaster preparedness based on the gender, marital status, nationality, working shifts, and working hours variables (P > 0.05). Conclusion: This study demonstrated the significance of providing nurses with the essential knowledge that helps respond to disasters. Online educational programs can help improve nurses' preparedness to better manage disasters. Future research should investigate additional variables that could enhance nurses' knowledge and skills related to disaster response.

Validation of the Arabic Version of the Patient Activation Measure (PAM-13) for Application within the Primary Healthcare Context in Saudi Arabia.

BACKGROUND: Empowering patients with behavioral issues or chronic conditions to actively participate in their healthcare can help improve health outcomes. However, in the Saudi Arabian context, evaluation tools for achieving this goal are lacking, considering cultural and healthcare system factors. Therefore, this study aimed to determine the psychometric properties of the Arabic version of the Patient Activation Measure. METHODS: This cross-sectional validation study was conducted on a sample of 225 patients receiving treatment from primary healthcare centers located in Riyadh, Saudi Arabia. Item analyses and reliability and construct validity testing of the tool were conducted. RESULTS: The item-total correlation coefficients ranged from 0.31 (item 2) to 0.57 (item 11). The item-total correlation coefficients for all 13 items were above 0.30. The reliability was 0.80. A two-factor model ("knowledge and beliefs" and "confidence and skills") reflecting the instrument was constructed. The raw model did not sufficiently fit the data (χ2 = 170.98, degree of freedom (df) = 64, p < 0.001; Tucker-Lewis index (TLI) = 0.79; comparative fit index (CFI) = 0.83; root mean square error of approximation (RMSEA) = 0.86 [90% confidence interval {CI} = 0.07-0.10]). After all significant correlations between the items' error terms were modeled, an adequate fit was achieved (χ2 = 76.76, df = 51, p < 0.01; TLI = 0.94; CFI = 0.96; RMSEA = 0.04 [90% CI = 0.02-0.07]). CONCLUSIONS: the Arabic version of the Patient Activation Measure can be utilized by healthcare providers to assess the activation levels and unique needs and preferences of Arabic-speaking individuals and tailor interventions accordingly to provide necessary support.

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

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

Quality Perceptions, Expectations, and Individual Characteristics among Adult Patients Visiting Primary Healthcare Centers in Saudi Arabia: A Cross-Sectional Study.

Quality is a main concern of primary healthcare centers, and pursuing quality can lead to service improvement as well as affordable healthcare. The purpose of this cross-sectional study was to describe patients' healthcare quality perceptions and expectations and determine the relationships between them and associated factors. The study was conducted on a convenience sample of 470 patients visiting primary healthcare centers. Data were collected between April and July 2022 using an anonymous questionnaire. Bivariate and multivariate analyses were conducted. Most participants reported high levels of quality perceptions and expectations. Bivariate analyses showed a significant correlation between quality perceptions and expectations. Both being single and having a higher level of education were statistically different in terms of quality perception and expectations, respectively. Further, being single, highly educated, and employed had significant differences in terms of expectations. In regression, primary education and expectations influenced quality perceptions. Marital status, profession, and perception were the only variables that significantly influenced participants' expectations. Patients' healthcare quality perceptions and expectations are important for ensuring the efficiency of healthcare services. Primary healthcare centers are the key avenue for disease prevention and early detection. The optimization of primary healthcare centers' quality and addressing its potential issues should be performed through interdisciplinary teamwork.

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

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

Caregiving burden, psychological distress, and individual characteristics among family members providing daily care to patients with chronic conditions.

PURPOSE: This study determined the relationship between care burden and psychological distress among 163 family caregivers of patients with chronic conditions. DESIGN AND METHODS: This was a cross-sectional study. The Zarit Caregiver Burden for Family Caregiver's Support and Kessler Psychological Distress scales were used for data collection. Multivariate analysis was run using SPSS. FINDINGS: Most participants reported low levels of care burden and psychological distress. A significant association existed between care burden and psychological distress (ß = 0.611, p < 0.05). PRACTICE COMPLICATIONS: It is critical to implement programs to help promote caregivers' understanding of caring and involvement in treatment.

Professional Quality of Life Among Nurses: Compassion Satisfaction, Burnout, and Secondary Traumatic Stress: A Multisite Study.

Introduction: Increased stressors and decreased job satisfaction are major challenges in nursing. Important factors of better professional quality of life include compassion satisfaction, burnout, and secondary traumatic stress. It is critical to assess these factors to help improve nurses' clinical practices. Objective: The purpose of this study was to determine the relationships between the three factors and associated factors. Methods: A cross-sectional, multisite study was conducted on a convenience sample of 464 nurses working at three public hospitals in Saudi Arabia. The Professional Quality of Life Version 5 was used to collect data. Bivariate and multivariate analyses were run using SPSS. Results: Scores were slightly moderate on the compassion satisfaction, burnout, and secondary traumatic stress levels. Compassion satisfaction was statistically significantly and negatively associated with burnout. A statistically significant relationship was reported between compassion satisfaction and secondary traumatic stress. Further, there was a statistically significant association between burnout and secondary traumatic stress. In regression, only the secondary traumatic stress model was statistically significant. Conclusions: Nurse managers should use highly standard guidelines to reduce secondary traumatic stress levels. Further actions addressing potential issues for improving compassion satisfaction and reducing burnout levels among nurses are also recommended.

Facilitators of and barriers to success in nursing internship programs: A qualitative study of interns' and faculty members' perspectives.

BACKGROUND: Through internship programs, nursing students learn information and skills in multiple hospital departments. Internships can also help with transitioning from student roles to graduate roles. However, the factors contributing to successful clinical internships in different education and health systems have not yet been sufficiently explored. OBJECTIVE: The purpose of this study was to explore the factors that contribute to successful clinical internships in both public and private hospitals in Saudi Arabia. DESIGN: This study uses a qualitative descriptive design. SETTING: Due to precautionary measures for COVID-19 and the inclusion of participants from different locations across Saudi Arabia, this study was conducted virtually. PARTICIPANTS: The study was conducted with a purposive sample of 16 nursing interns and four instructors. METHODS: Data were collected via semi-structured interviews to provide a wide variety of perspectives from nursing students and instructors. Each interview was recorded, transcribed verbatim in Arabic, and then translated into English. Collected data were analyzed using a thematic analysis approach. RESULTS: Three facilitators of success and four barriers to success emerged in the study. Facilitators of success included the program curriculum, hospital internship program, and contribution to the nursing board exam. Barriers to success were as follows: exploitation, lack of self-confidence, lack of incentives, and the long duration of the programs. CONCLUSIONS: The findings of this study could contribute to the creation of more effective clinical internship. It is recommended that clinical internship programs be enhanced and that appropriate support be given to nursing students.

Eye Movement Desensitization and Reprocessing versus Cognitive Behavior Therapy for Treating Post-Traumatic Stress Disorder: A Systematic Review and Meta-Analysis.

This meta-analysis review compared eye movement desensitization and reprocessing and cognitive behavior therapy efficacy in reducing post-traumatic stress disorder (PTSD), anxiety, and depression symptoms. A systematic search for articles published between 2010 and 2020 was conducted using five databases. The RevMan software version 5 was used. Out of 671 studies, 8 fulfilled the inclusion criteria and were included in this meta-analysis. Three studies reported that eye movement desensitization and reprocessing reduced depression symptoms better than cognitive behavior therapy in both children, adolescents, and adults (SDM (95% CI) = -2.43 (-3.93--0.94), p = 0.001). In three other studies, eye movement desensitization and reprocessing were shown to reduce anxiety in children and adolescents better than cognitive behavior therapy (SDM (95% CI) = -3.99 (-5.47--2.52), p < 0.001). In terms of reducing PTSD symptoms, eye movement desensitization and reprocessing and cognitive behavior therapy did not demonstrate any statistically significant differences (SDM (95% CI) = -0.14 (-0.48-0.21), p = 0.44). There was no statistically significant difference at the three-month follow-up and at the six-month follow-up for depression (p = 0.31), anxiety (p = 0.59), and PTSD (p = 0.55). We recommend randomized trials with larger samples and longer follow-up times in the future.

Organizational Factors Associated with Evidence-Based Practice Knowledge, Attitudes, and Implementation among Nurses in Saudi Arabia.

Evidence-based practice (EBP) is crucial in keeping nurses aware of the current knowledge and improving clinical decision-making. The integration of nurses' EBP competencies and organizational support has been suggested to create an effective arena in implementing EBP. The purpose of the study was to examine organizational factors influencing nurses' EBP knowledge, attitudes, and implementation and identify staff nurses' perceptions of EBP nursing leadership and hospital supports in Saudi Arabia. Data were collected from a convenience sample of staff nurses (N = 227) working in four hospitals using a cross-sectional, correlational descriptive design. Level of education (p < 0.05), EBP training (p < 0.05), unit type (ICU (p < 0.001) and ER (p < 0.01)), perceived nursing leadership (p < 0.001), and work environment (p < 0.05) supports were found significantly associated with nurses' knowledge. Magnet recognition (p < 0.01) and knowledge (p < 0.001) had significant influence on nurses' attitudes. Unit type (ER) (p < 0.05), knowledge (p < 0.001), and attitudes (p < 0.001) were associated with implementation. Encouragement to attend EBP trainings from nursing leadership was perceived by most nurses (51.1%). Nurses reported their hospitals support EBP through training (68.2%). Findings support the need for healthcare systems to create a culture that facilitates EBP implementation to enhance nurses' EBP competencies and improve patients' outcomes. Nursing managers may consider preparing nurses through education.

Prevalence and factors associated with psychological distress among family caregivers: A cross-sectional study.

PURPOSE: This study was aimed to examine the prevalence and factors associated with psychological distress among Saudi family caregivers. DESIGN AND METHODS: This was a cross-sectional, descriptive correlational study conducted on 163 participants. The Kessler Psychological Distress Scale-6 was used to collect data. Bivariate and multivariate analyses were run in SPSS. FINDINGS: Results indicated that psychological distress was significantly associated with employment status, education level, monthly money spent on caring, time spent on caregiving, and chronic disease type variables. PRACTICE IMPLICATIONS: Implementing effective programs to raise family caregivers' understanding of psychological distress and improve their engagement in treatment is important.

Virtual Education During COVID-19: Exploring Factors Associated With E-Learning Satisfaction Among Saudi Nursing Students.

BACKGROUND: Because of the COVID-19 pandemic, education and learning processes have been shifted to a completely virtual, online format. Students' satisfaction has been linked to better learning outcomes. PURPOSE: The purpose was to determine factors associated with students' satisfaction with e-learning among Saudi nursing students. METHODS: A cross-sectional, correlational descriptive study was conducted among 139 nursing students from different nursing programs in Saudi Arabia using a self-reported online survey. RESULTS: Previous experience with and readiness for e-learning influenced students' overall satisfaction with e-learning and satisfaction with assessment. Only readiness for e-learning was associated with satisfaction with teaching and generic skills and learning experiences. CONCLUSIONS: This study may enhance faculty members' understandings of factors influencing students' satisfaction with e-learning. Therefore, the urgent national distance education plan may need further development to meet students' needs.

Development and Pilot Analysis of the Bruise Visibility Scale.

The accuracy of assessing and documenting injuries is crucial to facilitate ongoing clinical care and forensic referrals for victims of violence. The purpose of this cross-sectional, pilot study was to evaluate the inter-rater reliability and criterion validity of a newly developed Bruise Visibility Scale (BVS). Methods: The instrument was administered to a diverse sample (n = 30) with existing bruises. Bruises were assessed under fluorescent lighting typical of an examination room by three raters who were randomly selected from a pool of eight experienced clinical nurses. Colorimetry values of the bruise and surrounding tissue were obtained using a spectrophotometer. Results: The BVS demonstrated good single (ICC = 0.71, 95% CI = 0.54 - 0.84) and average agreement (ICC = 0.88, 95% CI = 0.78 - 0.94) between raters. A significant, positive moderate correlation was found between mean BVS scores and overall color difference between the bruise and surrounding skin (Pearson's r = 0.614, p < 0.001). Conclusion: With further research, the BVS has the potential to be a reliable and valid tool for documenting the degree of clarity in bruise appearance.