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OBJECTIVE: This study aimed to determine the direct and indirect costs of sickle cell disease (SCD) in Saudi Arabia. METHODS: Data were collected from 217 participants aged ≥18 years in the eastern region of Saudi Arabia, using a prevalence-based cost-of-illness approach. The Institute for Medical Technology Assessment Medical Consumption Questionnaire and Institute for Medical Technology Assessment Productivity Cost Questionnaire were used to assess costs. A multistage process was used, encompassing patient data collection over 3 months, cost calculation from clinic visits and drug prices, and extrapolation for annual estimates. RESULTS: The study revealed substantial societal costs of SCD, with an average per-patient cost of SAR181 899 (US$48 506), covering healthcare and productivity losses. Healthcare costs, including hospitalization, informal care, and medication, averaged SAR80 306 (US$21 415). In addition, productivity costs, including unpaid work and presenteeism, averaged SAR101 594 (US$27 092). Obtaining higher levels of education, such as a diploma and BSc degree or higher, has been found to significantly decrease the costs associated with SCD (P = .016, P = .001). Furthermore, when comparing different employment statuses, students (B = -0.301, P = .058) were found to have marginally lower SCD costs, suggesting that their expenses were lower than those of individuals in other employment categories. The predictive model used in this study explained 11.2% of the variation in costs. CONCLUSION: Our study highlights a significant economic burden of SCD in Saudi Arabia and highlights the need for targeted strategies to alleviate financial challenges and improve patient well-being.

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PURPOSE: This study aimed to investigate the prevalence of postpartum depression (PPD) and stress, as well as factors influencing PPD, among women in Saudi Arabia. METHODS: This study employed a cross-sectional online survey and recruited participants during postpartum visits to the Clinic of Gynecology and Obstetrics in Al-Khobar, Saudi Arabia. Data collection was done using Arabic versions of the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, and a sociodemographics and obstetric history questionnaire. Descriptive and inferential analyses were conducted, including multiple linear regression using a stepwise method. RESULTS: Data from the 270 participants showed low levels of postpartum depressive symptoms with a mean score of 2.54±4.5 and low levels of perceived stress with a mean score of 2.49±6.2. While 94.4% of the participants reported low levels of stress and PPD, 5.6% reported elevated levels (≥10 for PPD, ≥14 for stress). The stepwise regression analysis showed significant results (p<.001), accounting for 34% of the variance in PPD. The factors significantly influencing PPD included the type of family, stress, number of abortions, disease during pregnancy, and family income. Importantly, perceived stress emerged as a factor influencing PPD. CONCLUSION: Although the majority of participants exhibited low levels of PPD, about 1 in 18 showed elevated levels. The identification of significant influencing factors highlights the need for targeted interventions to effectively address mental health concerns in postpartum women.

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BACKGROUND: Psychosocial hazards in the workplace were identified as a considerable risk to employee mental health as well as their general well-being. Few studies were found to examine its relationship with work engagement and mental health. Thus, this study examines the relationships between psychosocial factors, work engagement, and mental health within the faculty in Saudi Arabia using structural equation modeling. METHODS: The cross-sectional study was conducted with a sample size of 375 faculty. Data collection was done using a self-administered online survey that included instruments such as the Copenhagen Psychosocial Questionnaire (COPSOQ), Utrecht Work Engagement Scale (UWES), and General Health Questionnaire (GHQ-12). SmartPLS 3 software facilitated data analysis and included the assessment of factors. Structural equation modelling was used to examine the interplay between psychosocial factors, work engagement, and mental health. RESULTS: The robust measurement model was characterized by high loadings (0.719 to 0.970), Cronbach's alpha (0.595 to 0.933), and composite reliability (0.807 to 0.968). Convergent and discriminant validity were confirmed using AVE and various criteria. The fit of the saturated model was superior. Burnout explained significant variance (0.585) with predictive relevance for all constructs. Notably, the impact of burnout on family conflict and the influence of stress on burnout were found to have significant effect sizes. CONCLUSION: The study uses structural equation modeling to examine the relationships between psychosocial factors, work engagement, and mental health among faculty in Saudi Arabia. The robust measurement model demonstrated high reliability and validity, while the saturated model demonstrated excellent fit. These findings contribute to our understanding of psychosocial dynamics, work engagement, and overall health among faculty in Saudi Arabia.

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BACKGROUND: Understanding the factors contributing to happiness in the nursing profession is essential, particularly considering the high levels of stress associated with the job. This study aimed to explore the role of emotion regulation in mediating the relationship between personality traits and nurses' happiness. OBJECTIVE: This study aimed to explore the relationship between personality traits and happiness by examining the mediating role of emotion regulation. METHODS: A cross-sectional study was conducted with 324 Jordanian and 408 Saudi nurses. Data, including the Big Five personality traits, happiness levels, and measures of emotional regulation, were collected through an online survey. The model's fit and explanatory capability were verified by Structural Equation Modeling (SEM) using SmartPLS 3. RESULTS: In the structural model, agreeableness had a significant effect on happiness, influencing both reappraisal and suppression. Extraversion strongly influences happiness, positively affects reappraisal, and negatively affects suppression. Neuroticism hampers happiness and reappraisal, and has a detrimental effect on suppression. Openness had a positive effect on suppression, whereas consciousness positively affected happiness. Mediation analysis revealed direct effects on happiness, with varying indirect contributions from emotional regulation. Multiple-group analysis revealed no significant differences between Jordan and Saudi Arabia in the association between personality traits and happiness. CONCLUSION: The findings emphasize the nuanced effects of agreeableness, extraversion, neuroticism, consciousness, and openness on happiness, mediated by emotional regulation. Implementing specific interventions to improve emotional regulation can increase nurses' happiness regardless of their personality traits. The lack of significant differences between Jordanian and Saudi nurses implies that these relationships are consistent across cultures, offering valuable information for cross-cultural healthcare interventions.

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AIM: This study aimed to examine the factors that influence the level of flourishing among nursing students. DESIGN: Cross-sectional study. METHODS: A multistage sampling technique was used to recruit 328 undergraduate nursing students from a nursing college. Data were collected from February to June 2023 using the Global Flourishing Study (GFS) questionnaire, which assesses six domains of flourishing and their determinants. To ensure reliability and validity, a pilot study was conducted and a thorough validation process was employed. RESULTS: The Flourishing Index ranged from 24.0 to 100.0, with an average score of 74.2 (SD = 14.8). Well-being, disposition and behaviour, as well as external factors, correlated strongly positively with the Flourishing Index (r = 0.741, r = 0.565, r = 0.596, all p < 0.001). The Flourishing level was significantly negatively correlated with religion (r = -0.381, p < 0.001). Married participants had a significantly negative association with flourishing (p = 0.009). Disposition and behaviour were significantly and positively associated with flourishing (p = 0.017). The regression model had goodness of fit (R2 = 0.628) and was significant overall (F = 108.703, p = 0.001). The Flourishing model was established based on well-being, external factors, religion, disposition and behaviour, and marital status. CONCLUSION: Positive correlations between flourishing and well-being, disposition and external factors suggest areas of improvement. Conversely, the negative association with religion emphasizes the necessity of culturally sensitive approaches. Future studies with larger and more diverse samples, as well as additional variables, are crucial to obtain a deeper understanding of the factors that influence flourishing among nursing students in Saudi Arabia.

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BACKGROUND: Postpartum depression is a frequent mental health issue that affects many women due to this stressful phase. The aim of the study is to gain insight into the coping strategies employed by postpartum women and to explore how these strategies are influenced by various demographic and maternity factors. METHODS: The study adopted a quantitative, cross-sectional design. Data were collected from 239 postpartum women receiving care at a Gynecology and Obstetrics Clinic using self-reported tools, which include the Brief COPE survey and the socio-demographics and obstetric/maternal history form from October 2022 to April 2023. RESULTS: The study findings indicate that individuals aged over 40 tend to use more emotional-focused coping compared to those aged 21-30 (p = 0.002) and 31-40. Additionally, both genders of children were associated with more emotional-focused coping (p = 0.007) compared to only having boys. Cesarean section delivery (p = 0.001) was associated with more avoidant-focused coping than normal vaginal delivery. Avoidant-focused coping was significantly predicted by problem-focused coping (p < 0.001), emotional-focused coping (p = 0.034), age (p = 0.003), and gender of children (only boys, p < 0.001; both boys and girls, p = 0.019). Furthermore, problem-focused coping was significantly predicted by age (p = 0.004), gender of children (male child, p = 0.002; both boy and girl: p = 0.014), and avoidant-focused coping (p < 0.001). CONCLUSIONS: The study examined how postpartum women cope with the challenges of motherhood and how this relates to their demographic and maternity factors. The results suggest that healthcare professionals should promote effective coping strategies and discourage avoidance-oriented approaches in postpartum interventions.

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Background: This study aims to assess healthy lifestyle behaviors among undergraduate students and determine the association between electronic health literacy with lifestyle behavior among undergraduate Jordanian university students. Methods: A descriptive cross-sectional design was used. The study recruited 404 participants utilizing undergraduate students from public and private universities. The e-Health literacy scale was used to assess the level of health information literacy among university students. Results: Data were collected from 404 participants who reported very good health status, the majority of the participants were female 57.2% with an average age of 19.3 years. The results showed that participants had good health behavior in terms of exercise, taking breakfast, smoking status, and sleeping status. The results have shown an inadequate level of e-Health literacy 16.61 (SD = 4.10) out of 40. The vast majority of students, in terms of their attitudes toward the Internet, thought that Internet health information was very useful/useful (95.8%). Also, they thought that online health information was very important /important (97.3%). The results showed that students who were attending public universities had higher e-Health literacy scores rather than those who were attending private universities, t (402) = 1.81, p = .014. The mean e-Health literacy score for nonmedical students was higher than those for medical students (p = .022). Conclusion: The study's findings provide important insights into the health behaviors and electronic health literacy of undergraduate students in Jordanian universities, and offer valuable guidance for future health education programs and policies aimed at promoting healthy lifestyles in this population.

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BACKGROUND: Mental health nursing is a demanding and stressful profession that impacts nurses' professional quality of life. Psychological resilience can be a protective factor. However, the relationship has not been extensively studied. This study aims to examine the relationship between psychological resilience and professional quality of life and identify potential predictors of ProQOL subscales among mental health nurses. METHODS: The study employed a cross-sectional design to collect data from 179 mental health nurses. Data was collected using two standardized questionnaires: the Connor-Davidson resilience scale and the professional quality of life scale. Participants were recruited through convenient sampling during a 3-month period from April to June 2022, and the data were collected using an online survey tool called QuestionPro. RESULTS: The study found a strong positive correlation between psychological resilience and compassion satisfaction (r = 0.632, P < 0.001). However, there was a negative significant correlation between resilience with burnout (r = -0.470, P < 0.001) and secondary traumatic stress (r = -0.210, P = 0.005). The study also found that higher resilience levels were associated with higher levels of compassion satisfaction and lower levels of secondary traumatic stress. Additionally, higher burnout scores were associated with higher levels of secondary traumatic stress. The study also identified that age and the number of children had weak associations with compassion satisfaction, while workplace was a significant predictor of burnout and secondary traumatic stress. CONCLUSION: The study emphasizes the importance of resilience, burnout, and secondary traumatic stress in the well-being of healthcare professionals, especially nurses. The findings suggest that assessing nurses' resilience and professional quality of life can raise psychological resilience awareness and help managers create the necessary working conditions to improve nurses' professional quality of life.

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Objective: To examine the interrelated impacts of work-related stress, compassion satisfaction (CS), and job satisfaction on burnout (BO) and secondary traumatic stress (STS) among nurses using structural equation modelling (SEM). Methods: A cross-sectional design was used to survey 727 nurses at a teaching hospital in eastern Saudi Arabia. Three scales were used: the Quality of Life (ProQOL) scale, the Nursing Stress Scale (NSS), and the Job Satisfaction Survey (JSS). Data were analysed using SPSS and Analysis of Moment Structures (AMOS), and SEM analysis was conducted to confirm the interrelations among variables. Results: The final model had a good fit for the obtained data (X 2 = 2.726, RMSEA = 0.032). Stress is directly related to BO and STS, and the following variables were directly related to STS: job satisfaction, BO, and CS. Lastly, BO mediated the relationship between stress and STS. Conclusion: It is crucial to analyze the effect of stress, CS, and job satisfaction which seems to have a positive and negative impact on nurses' BO and STS. Therefore, implementing a management strategy to manage stress and satisfaction can enhance nurses' quality of life, support the maintenance of positive attitudes, and enhance the standard of patient care.

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Objectives. Presenteeism is a significant problem among the working force, and nurses are not an exception from these phenomena. The purpose of the study was to determine the productivity loss due to presenteeism from three dimensions and to evaluate the associated factors among nurses. Methods. A cross-sectional study was conducted among 309 nurses to evaluate presenteeism using the Stanford presenteeism scale (SPS), the health performance questionnaire (HPQ) and the work productivity short inventory (WPSI). Results. The study found that nurses had a high level of presenteeism using the SPS (21.0 ± 4.3) and the HPQ (80.0 ± 18.2). On both scales, presenteeism was significantly associated with nurses who were older than 32 years, with experience of more than 10 years, having children and specifically having two children. The results of the WPSI showed that the productivity loss of presenteeism per nurse annually was USD 1959 and for all nurses was USD 605,283. Conclusion. Eventually, evaluating the presenteeism level will help policymakers to understand the working conditions and related personal characteristics.

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Despite improvements in renal replacement therapy (RRT) for end-stage renal disease (ESRD), it continues to have serious negative impacts on quality of life (QOL) and emotional status. This study determines the association between demographic characteristics and the negative emotional states of depression, anxiety, and stress in Saudi Arabia. A comparative cross-sectional study was conducted in the Eastern Region of Saudi Arabia. Convenience sampling was used to recruit participants comprising hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (Tx) patients. They completed the Short Form-36 Survey and the Depression, Anxiety, Stress Scale (DASS). The physical component summary (PCS) score was similar for HD (41.7) and PD (41.5), but higher among Tx (45.2). The mental component summary (MCS) score was similar between HD (48.0) and Tx (48.8), but lower in PD (42.3). The majority of patients in all groups had normal levels of depression, anxiety, and stress. Overall, the study found that PCS was higher among Tx patients compared to HD and PD, while MCS was higher among HD and Tx patients than PD patients. Most patients' levels of depression, anxiety, and stress were within the normal range. Those findings will provide policymakers and health managers with the significant factors which can affect the QOL of dialysis and Tx patients.

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Aim: To evaluate the level and identify predictors of nursing students' knowledge and attitudes of pain management. Design: A cross-sectional design was used to analyse nursing students' knowledge and attitudes about pain management, with the Knowledge and Attitude Survey Regarding Pain (KASRP). Methods: A self-administered questionnaire was used to collect data from a convenient sample of Saudi nursing students. A total of 193 nursing students from a nursing school at a Saudi university completed the questionnaires. Results: The student mean knowledge of pain management was 42.6 (SD 9.1) . The items answered correctly most frequently concerned pain medication and administration. On the other hand, the most commonly incorrect items were mainly related to assessment and pharmacological interventions. Logistic regression analysis found that gender was significantly associated with level of knowledge and attitudes regarding pain management.

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OBJECTIVE: This study aimed to investigate the forms and frequency of verbal abuse (VA) among nursing student interns and determine the prevalence of psychological disorders (i.e. depression, stress, and anxiety) within this group. MATERIALS AND METHODS: A cross-sectional study was conducted in an urban teaching hospital in KSA. Nursing student interns responded to the Verbal Abuse Questionnaire and Depression Anxiety Stress Scales. RESULTS: A total of 54 interns completed the questionnaires; 55% of them had been exposed to one type of VA at least once a year, and 5% of them had experienced VA several times a week. 'Ignoring' was the most frequently experienced form of VA (50.8%), and feeling overwhelmed was the most commonly experienced emotional reaction (51.1%) to VA. 'Stop talking to the abusive person' was the most frequently reported behavioural reaction to VA (57.9%). Most of them (59.3%) did not report a sign of depression, but 18.5% of them had severe to extremely severe depression. Most interns (70.4%) did not report a sign of anxiety, but approximately 11.1% of them had severe to extremely severe anxiety. A majority (70.4%) of the interns did not report a sign of stress, and only 5.6% of them reported experiencing severe stress. CONCLUSION: VA is a major problem that is encountered in clinical settings, especially by future nurses. The present findings underscore the need to further examine the levels and forms of VA that are experienced by them and their reactions to such stress-inducing behaviours.

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BACKGROUND: Hemodialysis treatment is a costly procedure that requires specific resources. It has a considerable burden on patients, caregivers, and healthcare system. The aim of this study was to estimate the economic burden borne by the Ministry of Health (MOH) in Jordan, with a focus on direct medical, direct non-medical, and indirect cost. MATERIALS AND METHODS: The study was conducted at MOH hospitals in Jordan, from August to November 2010. A total of 138 patients and 49 caregivers were involved in the study. An economic evaluation study was used to analyze the burden of hemodialysis treatment at MOH, Jordan. Direct medical costs were estimated through micro and macro costing from the provider's perspective. Patients' and caregivers' costs were included to calculate direct non-medical costs. Human capital approach was employed to evaluate the productivity loss for indirect cost and premature death and potential year life loss was used to estimate the premature death cost. RESULTS: The total burden of hemodialysis at MOH, Jordan was USD17.70 million per year. Cost per session was $72 and the annual cost per patient was $9976. Direct medical cost was $7.20 million (41%) and direct non-medical cost was $2.02 million (11%). On the other hand, indirect cost (productivity loss) was $8.48 million (48%). All 722 patients on hemodialysis at MOH hospitals consumed 2.7% of MOH budget. CONCLUSIONS: Costs of treating and managing patients on hemodialysis at MOH hospitals in Jordan are substantial. Therefore, efforts should be taken to slow down the progress of renal failure to save resources and a comparative study with other modalities, such as continuous ambulatory peritoneal dialysis and kidney transplantation, should be considered.

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