Global prevalence of needle stick injuries among nurses: A comprehensive systematic review and meta-analysis.

BACKGROUND: Nurses usually provide direct patient care. However, they account for the majority of healthcare workers (HCWs) injured by needles or other sharp objects. OBJECTIVES: To assess the prevalence of needle stick injuries (NSI) among nurses worldwide; according to WHO regions, the socioeconomic development index (SDI) of countries, and the developmental status of individual countries, and in the Middle East. DESIGN: Systematic review and meta-analysis. METHODS: We searched PubMed, Scopus, and Web of Science databases. We calculated the pooled NSI prevalence estimates using a random-effect meta-analysis with the Comprehensive Meta-Analysis software. The report of the study was in accordance with the PRISMA 2020 statement. RESULTS: The overall worldwide NSI prevalence pooled from our analysis was 40.97% (95% confidence interval [CI]: 31.29-50.63%, p = .00001). A subgroup analysis of NSI prevalence according to WHO regions revealed the highest prevalence in Southeast Asia (49.9%, 95% CI: [23.4-76.3%]) and the lowest in the United States of America (25.1%, 95% CI: [18.1-32.1%]), respectively. The pooled prevalence in developed and developing countries was 30.5% (95% CI: 27.3-33.8%) and 46.6% (95% CI: 33.7-59.5%), respectively. According to the SDI, NSI prevalence was highest in low-middle SDI countries (48.9% [95% CI: 30.7-67.2%]). CONCLUSION: Our results showed a high NSI prevalence among nurses worldwide. Developing countries had a significantly higher NSI prevalence than developed countries, especially low-middle SDI countries. RELEVANCE TO CLINICAL PRACTICE: This study highlighted the prevalence of NSI risk among nurses practising in clinical settings worldwide. The study findings suggest that continuous training programs should be implemented for nurses to enhance their knowledge, performance and attitude toward NSI prevention in clinical settings. NO PATIENT OR PUBLIC CONTRIBUTION: Contributions from patients or the public are irrelevant because the purpose of this study was to examine the global prevalence of NSIs in nurses.

Nursing workforce competencies and job satisfaction: the role of technology integration, self-efficacy, social support, and prior experience.

BACKGROUND: The nursing profession has significant importance in delivering high-quality healthcare services. Nursing practitioners who have essential competencies and who are satisfied with their job are vital in achieving optimum patient outcomes. Understanding the effects of technology integration on nurse workforce competencies and job satisfaction is crucial due to the fast progress of technology in healthcare settings. Furthermore, many elements, including self-efficacy, social support, and prior experience have been recognized as possible mediators or moderators within this association. The primary objective of this quantitative research was to examine the influence of nursing education and the integration of technology on the competencies and job satisfaction of nursing professionals. Additionally, this study aimed to explore the potential mediating and moderating effects of self-efficacy and social support in this relationship. METHODS: This cross-sectional, quantitative study employed an online survey questionnaire with standardized scales to measure nursing workforce competencies, job satisfaction, self-efficacy, social support, and prior experience. It was completed by 210 registered nurses from various healthcare settings in the Kingdom of Saudi Arabia. Data were analyzed by descriptive statistics, Pearson correlation analysis, multiple regression analysis, and structural equation modeling performed with SPSS 23 and SmartPLS 3.0 software. RESULTS: The study's findings revealed that nursing workforce competencies and job satisfaction were significantly predicted by nursing training and technology integration. The relationship between nursing training and technology integration, as well as nursing workforce competencies and job satisfaction, was partially mediated by self-efficacy and social support. Furthermore, prior experience moderated the relationship between nursing education and technological integration, nursing workforce competencies, and job satisfaction. CONCLUSIONS: The study's findings suggest that nursing training and technology integration can improve nursing workforce competencies and job satisfaction and that self-efficacy and social support play an important role in mediating this relationship. Furthermore, prior experience can have an impact on the efficacy of nursing training and technology integration programs for developing nursing workforce competencies. The study has several practical implications for nursing education, training, and professional development programs, as well as strategies used by healthcare organizations to improve nursing workforce competencies and job satisfaction. To maximize their impact on nursing workforce competencies and job satisfaction, this study recommends that nursing training and technology integration programs focus on enhancing self-efficacy and social support. Furthermore, the study emphasizes the significance of prior experience when designing and implementing nursing training and technology integration programs.

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

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

Management of the COVID-19 pandemic: challenges, practices, and organizational support.

BACKGROUND: Health organizations currently face tremendous challenges in the management of the COVID-19 pandemic. To do this, successful and proven scientific practices and support are needed. AIM: This study aimed to explore the challenges, practices, and organizational support dealt with by nursing managers in the management of the COVID-19 pandemic. METHOD: A qualitative content analysis study evaluated 35 nursing managers in five university hospitals through a semi-structured interview. The Consolidated Criteria for Reporting Qualitative Research were used for this qualitative study. RESULTS: Three main themes emerged: Challenges include the development of a COVID-19 crisis management plan, a shortage in nursing staff, and psychological problems. Practices include; changes in work schedules for nursing staff, the exchange process, hospital preparation, and training and education. And organizational support includes both support at an organizational level and support at an individual level. CONCLUSION: This study revealed that nursing managers are faced with many challenges in the management of COVID-19, requiring good practices and organizational support. This study offers evidence for nursing managers to expect problems that may arise during the pandemic. RECOMMENDATIONS: The COVID-19 pandemic requires the development of an integrated plan, and this plan must be disseminated to the hospital's nursing and medical teams to better equip them for the current and future crises.

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

AIMS AND OBJECTIVES: To assess the perceptions of clinical practitioners regarding the different dimensions of patient safety culture in their hospital and examine the work-related predictors of patient safety culture perceptions. BACKGROUND: Patient safety is seen as a progressively critical focus in healthcare areas worldwide. Saudi Arabia aims to improve healthcare quality by providing access to healthcare for its increasing population. Hence, constantly assessing the patient safety culture of healthcare facilities in the country is imperative. DESIGN: One-sample correlational survey design. METHODS: The Hospital Survey of Patients' Safety Culture was used to survey the total population sample of 181 healthcare practitioners in a Saudi hospital from December 2018-January 2019. Strengths and weaknesses on PS culture were identified as perceived by the clinical practitioners. Regression analysis was performed to identify the work-related predictors of patient safety culture perceptions. The study followed the STROBE guideline. RESULTS: Nine of the 12 dimensions measured were identified as patient safety culture weaknesses, including 'management support for patient safety' (49.2%), 'teamwork across unit' (44.2%), 'frequency of events reporting' (43.1%), 'communication openness' (41.3%), 'overall perception of patient safety' (38.7%), 'supervisor/manager expectations and actions promoting patient safety' (32.9%), 'staffing' (23.7%), 'hospital handoffs and transitions' (19.6%) and 'non-punitive response to errors' (15.8%). None of the dimensions were identified as strengths by the respondents. Working hours per week and staff position were identified as significant predictors. CONCLUSIONS: The study underscores the urgent need to improve the patient safety culture of the hospital. RELEVANCE TO CLINICAL PRACTICE: Hospital administrators should highlight initiatives on positive patient safety impact plan for clinical practitioners and patients, such as monitoring, reporting and strictly adhering to hospital activities that reduce the risks associated with exposure to medical care.

Exploring the linkages between social media use, self-esteem, and academic performance among nursing students in Saudi Arabia: A descriptive correlational study.

Background: The prevalence of social media influence in education makes it necessary to investigate how it might affect nursing students' academic achievement and sense of self. To our knowledge, the associations between academic performance, self-esteem, and social media usage among nursing students from Saudi Arabia remain understudied. Objective: This study aimed to examine the relationships between academic performance, self-esteem, and the utilization of social media platforms by Saudi Arabian nursing students. Methods: This descriptive correlational study employed a convenience sample of 220 nursing students (response rate 95.2%). An online survey with questions about demographics, students' academic performance, social media usage, and self-esteem was used for data collection from 1 March to May 2023. Pearson correlation coefficients, independent t-tests, Analysis of Variance, and hierarchical regression were used for data analysis. Results: Social media use had an average score of 3.60 ± 0.66, self-esteem was 2.13 ± 0.27, and academic performance was 3.95 ± 0.58. The students' academic performance related positively to the utilization of social media platforms (r = 0.210, p <0.01). There were statistically positive correlations between academic purpose and social motives domains of utilizing social media and academic performance (r = 0.304, p <0.01; r = 0.208, p <0.01) respectively. The amount of time students spent on social media was not related to their self-esteem (r = 0.047, p >0.05). The students' self-esteem was unrelated to their academic achievement (r = 0.059, p >0.05). Conclusions: Utilizing social media channels can assist nursing students in improving their academic achievement. Therefore, nursing educators and decision-makers in nursing education have the opportunity to establish collaborative learning environments by integrating social media. This approach aims to improve communication, enhance the learning experience, and ultimately improve the academic achievements of nursing students.

Effectiveness of designing a knowledge-based artificial intelligence chatbot system into a nursing training program: A quasi-experimental design.

BACKGROUND: Chatbots have gained popularity in the healthcare industry due to their ability to provide prompt and accurate responses to a wide range of inquiries. This has been particularly beneficial for nurses who often require quick access to information and may have questions related to patient care. PURPOSE: To evaluate the effectiveness of designing a knowledge-based artificial intelligence chatbot system for a nursing training program. METHODS: The study utilized a Quasi-experimental design and collected data from a purposive sample of 73 nurses using Google Forms. The tools used in the study included 1) a structured questionnaire for nurses (a) Demographic data (b) Nurses' knowledge regarding chatbots, 2) Nurses' knowledge about artificial intelligence, 3) Nurses' perception of the application of chatbots in nursing, and 4) Nurses' opinions about the use of nursing chatbots or traditional methods of education. RESULTS: There was a highly statistically significant improvement in nurses' knowledge-based chatbot systems post-intervention (p = 0.001). CONCLUSION: Integrating an artificial intelligence chatbot system into a nursing training program provides nurses with easy access to reliable and evidence-based knowledge. The chatbot offers immediate answers, explanations, and up-to-date resources, empowering nurses to make informed decisions, stay updated, and served as a communication platform connecting nurses through a common language and enhance their practice. RECOMMENDATION: Incorporating a knowledge-based chatbot system into a nursing training program. Furthermore, further research should be conducted to explore the long-term impact of chatbot systems on nursing practices and education.

Effectiveness of Acceptance and Commitment Therapy on Psychotic Severity Among Inpatients With Primary Psychoses: A Randomized Controlled Trial.

This study investigated the effectiveness of acceptance and commitment therapy (ACT) compared to treatment as usual in managing psychotic symptoms, emotional dysregulation, recovery and psychological flexibility in inpatients with primary psychoses. The Primary outcome assessed the positive and negative syndrome scale, while the secondary outcomes were to assess difficulties in the emotion regulation scale, recovery assessment scale and acceptance and action questionnaire. An open-label, two-arm parallel randomized controlled trial was conducted. Participants diagnosed with primary psychoses were randomly assigned to either the ACT (n = 33) or treatment-as-usual (n = 32) group. The intervention included six structured sessions of ACT. ACT significantly reduced psychotic symptoms from 128 to 104 (Z = 5.01) compared to treatment as usual from 130 to 117 (Z = 4.88). Emotional regulation improved significantly in the ACT group from 73 to 55 (Z = 4.835) compared to treatment as usual from 73 to 70 (Z = 2.406). Recovery increased in the ACT group from 50 to 88 (Z = 5.01) compared to treatment as usual from 51 to 61 (Z = 4.93). Psychological flexibility improved in the ACT group from 33 to 25 (Z = 4.98) compared to treatment as usual from 33 to 31 (Z = 4.75). Between-group differences after intervention were significant for psychotic symptoms, emotional regulation, recovery and psychological flexibility (Z = 2.356, 4.652, 3.881 and 4.453, respectively). Accordingly, the current study demonstrates the effectiveness of ACT in reducing psychotic symptoms and improving emotional regulation, recovery and psychological flexibility in patients with primary psychoses. Integrating ACT into standard care protocols can enhance treatment outcomes, offering a comprehensive approach to managing complex mental health conditions. Trial Registration: ClinicalTrials.gov identifier: NCT06160869.

Bullying Behaviors and Stress (Acute and Perceived) among Undergraduate Nursing and Midwifery Students: The Moderating Role of Gender and Academic Majors.

BACKGROUND: Nursing and midwifery professionals' well-being may be affected by various factors, including the bullying of new nurses. PURPOSE: To analyze the relationship between bullying behaviors, perceived stress, and acute stress among undergraduate nursing and midwifery students in Saudi Arabia, as well as the moderating role of gender and academic majors in this relationship. METHOD: A cross-sectional correlation design was used, and data were collected from 322 undergraduate nursing and midwifery students enrolled in four major nursing universities in Saudi Arabia. RESULTS: Educational level, environment, and personal attacks had a significant negative impact on perceived and acute stress (social and non-social), while hostility toward academic achievement and direct negative behaviors had significant positive impacts on perceived and acute stress (social and non-social). Female nursing students reported a stronger impact of bullying behavior on their perceived stress, while male students reported a greater impact on social and non-social stress. Nursing students reported a stronger impact of bullying on perceived stress, while midwifery students reported a greater impact on social and non-social stress. DISCUSSION: Nursing educators should raise awareness about the harmful effects of bullying and emphasize the importance of creating a safe, supportive learning environment.

Are pediatric nurses prepared to respond to monkeypox outbreak?

BACKGROUND: Emphasizing the crucial significance of maintaining a national nursing workforce well-prepared with the necessary knowledge, skills, and abilities to respond effectively is the growing frequency of natural and environmental disasters, coupled with public health emergencies such as the COVID-19 pandemic. So, the study aimed to explore pediatric nurses' preparedness to monkeypox outbreak, and their stress during this outbreak in Egypt. METHODS: A cross-sectional study was conducted on a 416 nurses direct care for children at selected governmental hospitals in Egypt. Demographic form, Questionnaire for Infectious Disease Outbreak Readiness & Preparedness, factors affecting nurses' preparedness, and the generalized anxiety disorders scale-7 were the tools of the study. RESULTS: (81.5%) of studied nurses had unsatisfactory level of preparedness to monkeypox outbreak. (96.4%) and (95.4%) of them were affected their preparedness by high workload and inconsistent income with the of risk of infection factors. Also, (57.2%) of them had high stress level. CONCLUSIONS: The study revealed the importance of ensuring adequate supplies of PPE are available and provided, and protocols must be implemented to ensure availability in case of an outbreak. Moreover, nurse staffing levels and workload distribution should be regularly reviewed to create reasonable nurse-patient ratios.

Predictors of Leadership Competencies Among Nurse Executives in the Kingdom of Saudi Arabia.

Background: Awareness and development of nurse executives' leadership competencies has been considered a key strategy for the success of healthcare organizations. However, only a few studies about nurse executives' leadership competencies are available in the literature, and no study has been conducted about the topic within Saudi Arabian context. The aim of this study was to assess the leadership competencies of nurse executives and the predictors of these competencies. Methods: This quantitative study used a descriptive, cross-sectional, and correlational design. The study recruited a total convenience sample of 136 nurse executives who voluntarily consented to participate. The respondents self-rated the online survey, "Leadership Competency Assessment Tool: Self-Assessment." Data collection was conducted between September 2022 and November 2022. Test of correlation and multiple regression analyses were conducted. Results: The overall mean score of nurse executives' leadership competencies was 3.38 out of 5.0, which was below the level of having excellent leadership competencies. Four dimensions had mean scores below the level of having excellent leadership competencies, namely, communication and relationship building (3.48), knowledge of the healthcare environment (3.29), leadership (3.45), and business skills (3.15), while nurse executives had excellent leadership competencies only in the professionalism dimension (3.51). Age (p=0.04), highest educational attainment (p=0.01), current role (p<0.01) and length of experience (p=0.02) as nurse executive, monthly salary (p=0.03), nationality (p=0.04), and having seminars/trainings in leadership and management (p=0.01) were considered predictors of the leadership competencies of nurse executives. Conclusion: Nurse executives reported a low level of leadership competencies, thus implying necessary actions for improvement. There were personal factors that influenced the level of nurse executives' leadership competencies. To achieve quality outcomes and maintain a high level of nursing care in hospital organizations, these findings must be considered in planning strategies related to the improvement of the leadership competencies of nurse executives.

Exploring Knowledge, Safety Practices, and Anxiety Level among Women of Reproductive Age During COVID-19 Outbreak: A Cross-Sectional Study.

Background: The global outbreak of coronavirus disease 2019 (COVID-19) and its consequences compromise the health of Women of Reproductive Age (WRA). The aim of this study was to assess the level of knowledge, safety practices, and anxiety levels among WRA during COVID-19 outbreaks. Materials and Methods: A cross-sectional, correlational design was used to recruit a convenience sample of 453 WRA in Saudi Arabia. Data were collected using an electronic self-administered questionnaire of Spielberger state-trait anxiety and an adapted authors-developed knowledge and practices scale using an extensive literature review. Data were collected between September and December 2020 targeting all women in the country. Pearson correlation coefficient has been used to test correlation utilizing the Statistical Package for the Social Sciences (SPSS) 25. Results: The mean score of anxiety was 46.0 (13.40). Women have a high mean score of knowledge (24.50, standard deviation (SD) = 3.40) while having a low mean score of practices (19.70, SD = 3.10) indicating inappropriate practices. A significant difference was found in anxiety (t479 = 2.52, p = .012) and knowledge (t479 = -1.98, p = .048) between pregnant and non-pregnant women, while no statistically significant difference was found in relation to practices. The mean score of anxiety was higher among pregnant women than non-pregnant women, while a slightly higher mean score of knowledge was observed for non-pregnant women compared to pregnant ones. Conclusions: Although women had good knowledge about safety precautions, their practices did not indicate that. There is a need to educate women about safety practices and interventions that buffer their anxiety levels.

Expectations of Patients and Their Families After the Treatment of Substance Use Disorder.

BACKGROUND: Substance use disorders are economically and socially devastating to families and societies. Expectations of the patients and their families during the posttreatment phase of substance use disorder need to be emphasized to maintain a patient's sobriety and prevent relapse. AIM: The aim of this study was to examine the prediction power of personal and sociodemographic factors of patients and their families to treatment outcomes. METHODS: A descriptive, correlational, cross-sectional design was used. Data were collected from 80 patients treated for substance use disorders from a major psychiatric hospital and their family members regarding social, health, and psychological expectations. A three-step multiple hierarchical regression analysis was used to predict the power of personal and sociodemographic characteristics of patients' and their families' expectations to treatment outcomes. RESULTS: Heroin use, codeine use, family education, and family support were significant predictors of rehabilitation expectation ( p < .05). Level of education and heroin use were predictors for lower levels of rehabilitation expectation, whereas family support and codeine use were indicators for higher scores of rehabilitation expectation. CONCLUSION: Emphasis should be given to expectations of the patient and their family through appropriate psychoeducation and enhanced understanding and partnership.

Mental health nurses' perception of self-harm among people receiving psychiatric care in the Kingdom of Saudi Arabia.

Mental health nurses (MHNs) play an important role in dealing with those receiving psychiatric care for self-harming behaviour. How nurses perceive this group of people is pivotal to timely prevention of such harmful behaviour. This project aimed to assess MHNs perception of self-harming behaviour among those receiving psychiatric care in the Kingdom of Saudi Arabia (KSA). Descriptive research was conducted with 400 nurses at governmental hospitals affiliated to the Ministry of Health and Population (MOHP) in the KSA. Data were collected using an online survey and questionnaire: the survey was divided into two sections: one concerned with demographic characteristics of the participants, the second section focusing on their workplace characteristics. The Self-Harm Antipathy Scale-Swedish Revision (SHAS-SR) was used to assess perceptions of self-harm among MHNs. This scale included 19 items categorized into five subscales. Finding showed that more than half of nurses had a low perception of those who self-harmed. Additionally, there was a highly significant association between the nurses' total self-harm perception scores and their workplace characteristics. Promoting person-centred care to those who self-harm through the creation of a collaborative nurse-patient relationship, may improve insight and understanding of the behaviour. Continuous professional development for staff who provide care for those who self-harm would promote better understanding of the behaviour. In addition, workshops, presentations and modelling good practice, are all key for transferring information into real-world applications for MHNs to provide better care for those who self-harm.

Association between Facebook Addiction, Depression, and Emotional Regulation among Women.

Facebook has grown to be one of the most widely used communication platforms. A new condition linked with widespread use has emerged with its expanding popularity: Facebook addiction. A descriptive cross-sectional research design was used in the current study, in two randomly selected villages (Elmanial and Batra) and one town (Talkha city) affiliated with Dakahlia Governorate, Egypt. Data were collected from women only through using a self-administered socio-demographic questionnaire, Facebook addiction scale, Beck depression inventory-II, and emotional regulation scale. The study found 83.7% of the studied women reported moderate emotional regulation; 27.9% had moderate Facebook addiction, and 23.9% reported mild depression. The study concluded there was a significant negative correlation between Facebook addiction and emotional regulation.

Health locus of control, resilience and self-efficacy among elderly patients with psychiatric disorders.

This study aimed to assess the relationship between health locus control, resilience and self-efficacy in older adults with psychiatric disorders. This study was conducted using a cross-sectional design. Sample: A purposive sample of 291 older adults receiving psychiatric outpatient care at Alabbasya Hospital for Mental Health in Cairo was recruited for this study. The data were collected by the following tools: sociodemographic data sheet, the multidimensional health locus of control scale, the general self-efficacy scale, the brief resilience scale and the general health questionnaire. The study participants reported low levels of health locus of control, low levels of self-efficacy and normal levels of resilience. Furthermore, we found a strong positive correlation between resilience and general self-efficacy. The study concluded that older people with psychiatric disorders reported low levels of health locus of control and self-efficacy, while they experienced normal resilience levels. There was a strong positive correlation between resilience and general self-efficacy among the study participants. The results of this study can guide healthcare professionals in developing tailored interventions and support programs to improve this population's quality of life and overall mental health outcomes.

Knowledge, Attitudes, and Practices of Hypertensive Patients Towards Stroke Prevention Among Rural Population in Saudi Arabia: A Cross-Sectional Study.

Introduction: Stroke is a significant health problem and is considered one of the leading causes of mortality and permanent disability worldwide. Hypertension is a primary risk factor for stroke. Thus, hypertensive patients' knowledge, attitudes, and practices (KAP) are essential in preventing stroke. Objective: To examine hypertensive patients' KAP towards stroke prevention among rural population in Saudi Arabia. Methods: The study utilized a cross-sectional design. The data were collected using a convenience sampling technique from hypertensive patients in the northwestern rural areas of Riyadh Province. A self-administered questionnaire was adapted from the Stroke Recognition Questionnaire (SRQ) and utilized to assess KAP towards stroke prevention among rural hypertensive patients. The STrengthening of the Reporting of OBservational studies in Epidemiology (STROBE) checklist was used to report the study. Results: A total of 196 hypertensive patients participated in the study. The total mean scores categorization into three quartiles showed that most respondents had poor levels of KAP towards stroke prevention. Weak positive correlations were found between KAP of patients. There were statistically significant differences between respondents' attitudes and practices with their age, education, marital status, and occupational status. Discussion: This study denoted poor levels of KAP towards stroke prevention among hypertensive patients living in rural areas. This study showed the importance of further considering rural population by which improving their health and quality of life. Extending health educational programs and behavior-changing strategies to rural areas is essential to increase hypertensive patients and general public awareness about their stroke prevention and other health-related concerns.

Stigmatization and discrimination towards human immunodeficiency virus seropositive patients in psychiatric and mental health facilities.

Stigmatization and discriminatory attitudes of nurses towards human immunodeficiency (HIV) patients have been reported in many countries. The current study was undertaken to assess the knowledge, attitudes and factors associated with stigmatizing attitudes and discrimination among psychiatric and mental health nurses and nurse interns towards patients diagnosed with the human immunodeficiency virus; utilizing a single-centre hospital-based survey design. Primary data were collected using a previously validated questionnaire in a large mental health care hospital in Riyadh, Saudi Arabia. Knowledge, attitudes, acts of discrimination and associated factors on the part of mental health nurses towards those diagnosed with the HIV were identified. The study described herein is in accordance with the STROBE guideline. A total of 241 psychiatric and mental health nurses completed the questionnaire, yielding a completion rate of 74.4%. Overall, more than half of the nurses demonstrated gaps in knowledge and reported higher stigmatizing attitudes and acts of discrimination. Factors associated with stigmatization and/or discrimination include higher exposure to seropositive patients, no formal HIV training, lower religiousness, lower awareness of HIV testing policy and lower level of knowledge about HIV infection. There is an urgent need to implement a training program that will help to reduce stigma among nurses caring for people diagnosed with this illness.

Adverse Childhood Experiences and Health in Rural Areas of Riyadh Province in Saudi Arabia: A Cross-Sectional Study.

Adverse childhood experiences (ACEs) and their consequences are a worldwide problem. ACEs are primary stressors that have a long-term impact on the body and mind during development. They are linked to a variety of chronic illnesses in adults. Information about ACEs and health and risk behaviors is scarce among rural populations. The study aimed to examine ACEs, chronic diseases, and risk behaviors, as well as to explore the relationship between them and number of sociodemographic factors among adults living in rural areas in Riyadh Province, Saudi Arabia. A cross-sectional design and a convenience sampling method were utilized to collect information. A self-reported questionnaire, including an ACEs questionnaire as well as direct health and risk behaviors questions, was used. In total, 68.2% of the respondents reported at least one ACE, and 34.2% reported four or more ACEs. Emotional and physical abuse were the most reported forms. Hypertension and chronic respiratory disease were the most reported chronic diseases. Depression and anxiety were associated with ACEs, indicating that those who reported four or more ACEs were more likely to develop depression and anxiety. ACEs contribute to many negative health outcomes; thus, identifying the prevalence of ACEs among the rural population is essential for future health-related actions. It is also important that chronic diseases and risk behaviors be specifically identified among the rural population in order to prioritize these actions. Future research should further investigate ACEs and other determinants of health among the rural population, taking into consideration the inclusion of more diverse people, such as older adults and those from other rural areas.