Prevalence of stress and types of coping strategies among adolescents (14-18 years) in collectivist communities.

BACKGROUND: Stress is highly prevalent among adolescents and might lead to maladaptive coping. METHODS: This cross-sectional study assessed the prevalence of stress and determined the types of coping strategies used by adolescents; and identified the predictors of stress levels among this cohort. The study recruited 1344 participants, aged 14 to 18 years, in schools. The study used the DASS-42 and the Brief COPE Inventory Scale for data collection. The findings of this study showed that more than two-thirds of adolescents suffer from stress, and moderate, severe, and extremely severe were 22.8%, 43.0%, and 16.8%, respectively. The most used coping behaviors among these adolescents were religious factors, with a Mean ± SD of (Mean 6.28 ± 1.16), followed by instrumental support (Mean 6.17 ± 1.18). The stress level has a significant negative correlation at (p < 0.001) with active coping (r = -0.183**), self-distraction (r = -0.190**), acceptance (r = -0.140**) and religion (r = -0.097**; P < 0.001). Binary logistic regression analyses revealed that the whole model had R2 (0.232); p < 0.005 and shows that those aged 15 had an odd of 0.272 to develop stress more than those at 18. Fathers' and mothers' education levels strongly influenced adolescents' stress levels. Those with an income between <500 and 500-750 Jordanian Dinars had an odds ratio of 5.241 and 3.514 of developing stress, respectively, compared to their counterparts. APPLICATION TO PRACTICE: This study highlights the significance of developing health intervention programs and counseling services for managing adolescents' psychological well-being and provides valuable insights for policymakers on addressing mental health issues.

The relationship between psychological capital and humanistic caring ability among mental health nurses in Saudi Arabia.

BACKGROUND: The ability to provide humanistic care has a significant impact on the therapeutic relationships in psychiatric services, which in turn influences patients' outcomes. AIM: To examine the relationship between psychological capital and humanistic care ability among mental health nurses in Saudi Arabia. METHODS: A descriptive correlational research design was implemented in this study. A convenience sampling method was used to collect information from 500 mental health nurses from a governmental mental health facility. The data were collected using the psychological capital questionnaire and the caring ability inventory. RESULTS: The results revealed high levels of psychological capital and humanistic care ability among mental health nurses. Psychological capital significantly predicted humanistic care ability ([Formula: see text] 0.630, F(1,498) = 851.16, p< 0.001). Also, there were significant relationships between sociodemographic variables and psychological capital (age, educational level, and professional title) and humanistic care ability (age and years of experience). CONCLUSION: Psychological capital was found to be be positively associated with the humanistic care ability of mental health nurses. The findings of this study suggest that nursing managers should explore strategies from the viewpoint of positive psychology to enhance the psychological capacity of mental health nurses to provide humanistic care abilities, which can effectively improve nurses-patients' relationships and outcomes in clinical practice.

Healthcare providers screening for childhood abuse among adult patients in Saudi Arabia: A cross-sectional study.

INTRODUCTION: Childhood abuse could potentially cause negative health consequences later in life, where they influence individuals' physiological, psychological, and behavioral health. Screening for ACEs is not widely incorporated during routine primary healthcare. The information about past childhood abuse screening among adult patients is elusive. The aim of the study was to investigate healthcare providers (HCPs) practices, skills, attitudes, and perceived barriers related to past childhood abuse screening among adult patients in Saudi Arabia. DESIGN: Cross-sectional study. METHODS: Data were collected from healthcare facilities in the Riyadh and Madinah regions of Saudi Arabia using a self-reported questionnaire. RESULTS: A total of 126 HCPs completed the survey. Less than one-third of the HCPs reported routinely (usually or always) screening for childhood abuse. HCPs were more concerned that they would offend their patients by examining history of adversities. HCP practice location, the extent to which they think it is part of their responsibilities to screen for history of adversities, and their self-reported of adverse childhood experiences were significantly associated with screening practices for childhood abuse. Four perceived barriers were significantly associated with HCP screening. CONCLUSION: Screening for past adversities is vital for identifying childhood trauma among the public; therefore, we might participate in reducing childhood trauma and further controlling consequences in the future. Developing a screening form for childhood abuse or adversities and providing this form in healthcare settings are appropriate at this stage. CLINICAL RELEVANCE: Early screening for ACEs is recommended, which prioritizes health promotion and disease prevention. It is highly needed to increase HCP awareness toward childhood abuse, screening for it, and reflection on it.

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.

Developing the Concept of Adverse Childhood Experiences: A Global Perspective.

BACKGROUND: The relationship between health and adverse childhood experiences (ACEs) has been a major topic in the field of healthcare. In recent years, the study ACEs and health has expanded internationally. PURPOSE: The purpose of this study was to further develop the concept of ACEs using a global perspective. METHOD: Rodgers' Evolutionary Model guided the study. PubMed, CINAHL, and PsychINFO databases were searched. A total of 39 publications were selected for review. FINDINGS: Development of the concept was achieved using a wide global lens. ACEs are influenced by diverse cultural, social, environmental, and economic factors that affect individuals' health worldwide. DISCUSSION: The developed ACEs concept described in this paper includes a global perspective, adding context to the existing definition, thus broadening its application, and expanding its usefulness in international research. A clear concept for ACEs is valuable to nurses who care for children, adolescents and young adults around the world, who have suffered from ACEs and seek health care.

Community-Based Stroke Recognition Education and Response: An Evidence-Based Intervention Project.

BACKGROUND: Stroke has a significant impact on mortality and disability in the United States. This led the aforementioned master's students to create a community-based educational intervention using stroke curriculum from the American Heart Association/American Stroke Association (AHA/ASA). PURPOSE: The purpose of this evidence-based intervention project was to examine the effectiveness of public stroke education utilizing the AHA/ASA's Face, Arm, Speech, Time (FAST) curriculum for stroke symptom recognition and response (Jauch, et al., 2013) at three central Connecticut senior centers. DESIGN: This evidence-based intervention project was based on the theoretical framework of Dorothea Orem's Self-Care Deficit Theory (Petiprin, 2016). Nurses can provide stroke based education to older adults in the community, ultimately empowering participants to recognize and respond to stroke symptoms. METHODS: An educational session on the AHA/ASA FAST curriculum was presented by master's students to groups of senior adults at three different senior centers, followed by a post teach-back session conducted by the students in smaller groups to assess learning. The total number of participants was 62 (n = 62). RESULTS: The majority of participants (87%) were able to accurately teach back the four components of the FAST curriculum after the educational intervention. CONCLUSIONS: FAST was simple to teach and engaging for participants. Using the FAST curriculum in senior center populations increased the participants' awareness of stroke signs and symptoms, and their willingness to activate the 911 emergency system. IMPLICATIONS FOR PRACTICE: Educational interventions in the community with older adults can produce increased awareness of stroke symptoms and willingness to respond when necessary.

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.

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.

Attitudes toward Nursing Profession and Fear of Infectious Diseases among Undergraduate Nursing Students: A Cross-Sectional Study.

The uncertainty surrounding the effect of infectious diseases on nursing students' attitudes toward the nursing profession worldwide exists. This study sought to examine the association between fear of infectious diseases and students' attitudes toward the nursing profession. METHODS: This quantitative descriptive cross-sectional study used a convenience sample of 477 students enrolled in nursing programs from three universities located in urban and non-urban areas in Saudi Arabia. RESULTS: The study revealed a positive attitude toward nursing and minimal fear of infectious diseases. Junior nursing students reported significantly better attitudes and preferences toward the nursing profession than senior nursing students. Students who reported positive attitudes toward the nursing profession significantly had no intension to discontinue or transfer from nursing programs, whereas students with low attitudes reported significant intention to discontinue their enrollment in the nursing programs. Students in urban universities reported higher significant fear of infectious diseases compare to non-urban. The study revealed a significant negative correlation between fear of infectious diseases and students' preference for the nursing profession. CONCLUSIONS: Nurse educators need to support senior nursing students' attitudes toward the nursing profession and reduce their fear of infectious diseases, particularly among students studying in urban areas.

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

INTRODUCTION: More than 20,000 patients with chronic renal disease are receiving hemodialysis treatment in Saudi Arabia. Approximately, 57.4% of nurses in Saudi are expatriates. However, these nurses may not have sufficient cultural knowledge, which may affect perception of nursing care. Our purpose was to understand the lived experiences of middle-aged Saudi Arabian hemodialysis patients. METHOD: This qualitative phenomenological study was conducted in Saudi Arabia in 2021. Data were analyzed using axial coding. RESULTS: Eleven patients aged 32 to 60 years participated. Two themes and three subthemes were identified: (a) hemodialysis's negative consequences (travel restriction, social isolation, and low responsibilities toward families) and (b) level of support (family support, nurses' support, and governmental support). DISCUSSION: Hemodialysis patients find travel and social engagement difficult. Furthermore, they cannot fully meet their family responsibilities due to fatigue and long hemodialysis hours. Health care providers should consider integrating these findings to deliver optimal holistic care.

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.

Adverse Childhood Experiences and Chronic Diseases: Identifying a Cut-Point for ACE Scores.

Adverse Childhood Experiences (ACEs) contribute to many negative physiological, psychological, and behavioral health consequences. However, a cut-point for adverse childhood experience (ACE) scores, as it pertains to health outcomes, has not been clearly identified. This ambiguity has led to the use of different cut-points to define high scores. The aim of this study is to clarify a cut-point at which ACEs are significantly associated with negative chronic health outcomes. To accomplish this aim, a secondary analysis using data from a cross-sectional study was conducted. The Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used for data collection. Descriptive statistics, nonparametric regression, and logistic regression analyses were performed on a sample of 10,047 adults. Data from demographic and self-report health measures were included. The results showed that a cut-point of four or more ACEs was significantly associated with increased rates of chronic disease. Participants with at least one chronic disease were almost 3 times more likely (OR = 2.8) to be in the high ACE group. A standardized cut-point for ACE scores will assist in future research examining the impact of high ACEs across cultures to study the effect of childhood experiences on health.

Patients' satisfaction with nursing care quality and associated factors: A cross-section study.

AIM: This research aimed to evaluate patients' satisfaction with the nursing care quality during their hospitalization. DESIGN: Quantitative cross-sectional descriptive design. METHODS: A convenience sample of 238 patients were recruited from hospitals in two provinces in Saudi Arabia. Patient satisfaction was measured by the Arabic version of the Patients' Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ-Ar). RESULTS: Significant differences were found between Saudi provinces regarding the overall quality of nursing care (M = 4.65, p < 0.001). The study revealed mean significant variations between patient satisfaction with nursing care and sociodemographic factors, including age (p = 0.002), education level (p = 0.047), marital status (p = 0.017), employment status (p = 0.038), urban vs. suburban residence (p = 0.006), length of hospitalization (p = 0.001), and accompaniment by a family member (p = 0.014). Improving patients' experience during their hospitalization requires regular examination of the quality of nursing care services. PATIENT CONTRIBUTION: This research enhances our understanding of patients satisfaction toward the quality of nursing care received during hospitalization.

Predictors of physical activity behavior change among patients with heart failure enrolled in home-based cardiac rehabilitation intervention.

BACKGROUND: Physical activity behavior change is considered one of the most challenging lifestyle modifications in patients with heart failure. Even after participation in a cardiac rehabilitation program, most patients do not engage in the recommended level of physical activity. OBJECTIVE: To determine which baseline demographic, physical activity levels, psychological distress, and clinical variables predicted physical activity behavior change to increasing light-to-vigorous physical activity by 10,000 steps/day following participation in home-based cardiac rehabilitation intervention. METHODS: A prospective design involving secondary analysis was used to analyze data obtained from 127 patients (mean, 61; range, 45-69 years) enrolled in and completed an 8-week home-based mobile health app intervention. The intervention was designed to encourage health behavior change with regard to decreasing sedentary behavior and increasing physical activities performed at light or greater intensities. RESULTS: None of the participants accumulated 10,000 steps or more per day pre-intervention (mean, 1549; range, 318-4915 steps/day). Only 55 participants (43%) achieved an average daily step count of 10,000 or more at week 8 of the intervention (10,674 ± 263). The results of the logistic regression showed that higher pre-intervention physical activity levels and anxiety symptoms and lower depressive symptoms were associated with a higher likelihood of achieving physical activity behavior change (p < .003). CONCLUSION: These data highlight that determining pre-intervention physical activity levels and depressive symptoms can be the key to designing an effective home-based cardiac rehabilitation intervention in patients with heart failure.

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.

COVID-19 Patients' Satisfaction Levels with Nursing Care: A Cross-Sectional Study.

INTRODUCTION: COVID-19 is the most recent coronavirus diseases that was first identified in December 2019 and began its exponential spread globally. The critical role of nurses can be severely impacted during pandemics such as COVID-19 when the world is less prepared. OBJECTIVE: To investigate and measure COVID-19 patients' satisfaction levels with the quality of nursing care provided in the Riyadh Province of Saudi Arabia. METHODS: The study used a cross-sectional questionnaire to collect data from COVID-19 patients who were hospitalized or quarantined for at least 48 h or more. The study utilized the Arabic version of the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ-Ar) to assess patients' satisfaction levels with nursing care. Descriptive statistics, Mann-Whitney U, and Kruskal-Wallis tests were performed to examine the objectives of the study. RESULTS: Ninety-six patients reported relatively high satisfaction levels with the overall nursing care. Patients also reported high satisfaction levels with the provided care, and the information that was provided. There were statistically significant differences in the mean score of patients satisfaction in relation to age, educational level, where patients are originally from, and patients recommendation of the hospitals. CONCLUSIONS: Individual characteristics and attributes played a role in the process of evaluating nursing care services. Measuring nursing care quality clarified the significant role of nurses during the COVID-19 pandemic. This study provides valuable information that could help in identifying weaknesses and reinforcing strengths about nursing care to be fully prepared against pandemics and other health-related crises and emergencies in the future.

Development of the College Student Acute Stress Scale (CSASS).

PURPOSE: The purpose of this study is to develop and validate the College Student Acute Stress Scale, a measure of acute stress specific to college students. DESIGN AND METHODS: A total sample of 440 young adults from a university in the northeast United States were surveyed across three separate research studies. Exploratory principal component analysis, internal consistency reliability, convergent and divergent validity, and test-retest reliability analyses were performed. FINDINGS: Evidence of convergent and divergent validity were obtained, and adequate internal consistency and test-retest reliability were identified. PRACTICE IMPLICATIONS: This study provides evidence for the validity and reliability of a self-report measure of college students' acute stress experiences.

Perceived stress, fatigue symptoms, and posttraumatic stress disorder symptoms among young adult college students.

PROBLEM: University students experience stress and fatigue often affecting their health, academic success, and social adjustment. Many also have histories of childhood trauma that may result in posttraumatic stress symptoms. The purpose of this study was to determine the associations between perceptions of stress, symptoms of fatigue, and symptoms of posttraumatic stress disorder (PTSD) among university students, many of whom report childhood adversity. METHODS: Sixty-nine students from one university campus participated in this study. A cross-sectional design was used to gather data across six self-report measures. FINDINGS: Childhood adversity was associated with PTSD symptoms and acute stress, and PTSD symptoms were related to all three measures of fatigue. PTSD symptoms mediated the relationship between stress and fatigue, but not other fatigue domains. CONCLUSIONS: The implications of an association between PTSD, stress, and fatigue are relevant to students' health and academic success. It is important to note that even subclinical levels of PTSD impact fatigue.

Factors influencing hospital anxiety and depression among emergency department nurses during the COVID-19 pandemic: A multi-center cross-sectional study.

Introduction: The emergency department (ED) is a highly stressful environment, which exposes nurses to infection. ED nurses handle life-threatening conditions, endure long working hours, and deal with anxious patients and their families. Aim: This study aimed to examine factors, which may influence anxiety and depression levels among ED nurses during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A cross-sectional design was used with 251 participants from six hospitals in Saudi Arabia (mean age = 32.7 ± 6.59, range = 21-54 years, 70.5% females). Data were collected using the Hospital Anxiety and Depression Scale (HADS), and the analysis was conducted using structural equation modeling (SEM). Results: Based on the HADS scores, 29.1 and 25.5% of ED nurses were identified as doubtful cases for depression and anxiety, respectively. Additionally, 34.7 and 43.3% of ED nurses were identified as definite cases for depression and anxiety, respectively. Higher anxiety levels were observed among female nurses, nurses with lower physical activity levels, and nurses who worked in urban areas. Low physical activity levels and more than 6 years of work experience correlated with a higher level of depression. None of the hypothesized paths in the anxiety and depression models were significant, except for two observed variables-namely, work location and physical exercise in the anxiety model and physical exercise in the depression model. Conclusion: Emergency department nurses expressed high levels of anxiety and depression during the COVID-19 pandemic, which may negatively affect their performance and reduce care quality. Therefore, health care leaders should implement specialized mental health education programs focused on nursing occupational safety and support to improve ED nurses' psychological well-being. Specific attention should be paid to ED female nurses who work in urban areas, especially those with more than 6 years of experience.