Health literacy as mediator between perception of illness and self-medication behaviour among outpatients in the Kingdom of Saudi Arabia: implication to primary healthcare nursing.

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

Factors Contributing to Leaving against Medical Advice (LAMA): A Consideration of the Patients' Perspective.

It is essential to understand why patients choose to leave the hospital in direct opposition to medical advice. This understanding could help to identify individuals who are at risk of adverse outcomes. In realizing this need, this study aimed to explore the factors contributing to the decision of patients to leave the hospital against medical advice. MATERIALS AND METHODS: This research employed a descriptive-analytical approach. It was conducted in the city of Hail, Kingdom of Saudi Arabia. The participants were 13 patients who had opted to leave against medical advice from the Emergency Department of the government-subsidized hospitals. The researchers employed both purposive and snowball sampling. In snowball sampling, the researchers used referrals from initial participants to generate additional participants. Moreover, purposive sampling was used to find the individual that would best contribute to addressing the research issue. The data gathering was conducted from April to June 2022. RESULTS: Five themes emerged based on the accounts of the 13 participant patients. These included (1) health literacy, (2) self-diagnosing, (3) unclear explanations regarding their condition, (4) prolonged waiting times, and (5) communication issues. CONCLUSION: The factors contributing to patients leaving against medical advice resulted in the five themes mentioned above. While interactions between patients and healthcare professionals may be challenging, pertinent health information must still be handed down clearly to patients.

The Impact of Mental Well-Being, Stress, and Coping Strategies on Resilience among Staff Nurses during COVID-19 in Saudi Arabia: A Structural Equational Model.

Previous studies have revealed various factors related to nurses' resilience and predictors of resilience. However, there are no studies analysing the association of three variables-mental well-being, coping strategies, and stress-with resilience. This study aims to assess the impact of mental well-being, levels of stress, and coping strategies on resilience using path analysis. This study used a cross-sectional approach that involved 763 nurses from 16 major hospitals in the eastern and northern regions of Saudi Arabia during the COVID-19 pandemic. The data gathering was conducted from August to November 2022. The staff nurses possessed positive mental wellness (3.75 ± 1.08), moderate stress levels (3.06 ± 1.21), adequate coping skills (3.33 ± 1.23), and a low level of resilience (2.90 ± 1.040). Age had a small effect on resilience (ß = 0.040; p < 0.001) but work experience (ß = -0.019; p > 0.139) and marital status (ß = 0.019; p > 0.072) were not significant. Conversely, mental well-being (ß = 0.043; p < 0.001) and stress (ß = -0.089; p < 0.001) had a small effect on resilience, but coping strategies (ß = 0.561; p < 0.001) had a large effect on resilience. Therefore, coping strategies must be reinforced at all times to assist nurses and other healthcare professionals in identifying contributing elements that maintain these workers' resilience in the face of unforeseen and protracted pandemics and other life events.

Relationship between the Health Literacy and Self-Medication Behavior of Primary Health Care Clientele in the Hail Region, Saudi Arabia: Implications for Public Health.

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

Incidence of patients leaving against medical advice in government-subsidized hospitals: a descriptive retrospective study.

Introduction: this study aimed to determine the prevalence of leaving against medical advice (LAMA) in the local context and the associated predictors to help develop effective strategies to reduce its likelihood. Methods: this study employed a retrospective approach using medical records of the 16233 patients between 2016 and 2020 at various government-subsidized hospitals in the Hail region of Saudi Arabia. Results: the prevalence of LAMA was the highest in 2019 (91.9%) and 2017 (21.45%) among insured and non-insured patients, respectively. Furthermore, it was the highest among patients aged 20-25 years and the lowest among patients aged 46 years and above. The incidence of LAMA was the highest (15.48% for males and 29.53% for females) in 2016. In 2016-2019, the most common reason for LAMA was "wanted medication only," while in 2020, the "fear of infection with COVID-19" was the main reason. High blood sugar was the most common diagnosis among the patients under consideration during the study period. Significant association was found between LAMA and patient's insurance status (t = 4.3123; p < 0.002); however, no association was found between LAMA and age (t = -0.8748; p > 0.658) and gender of patients (t = 1.9008; p > 0.302). Conclusion: strategies such as developing a suitable environment for patients and taking due care of their needs, providing individual consulting services, enhancing staff relations, and providing support to patients in need are vital. The likelihood of LAMA can be minimized by informing hospitalized patients and their relatives about the adverse effects of LAMA.