Leadership style and organisational commitment among nursing staff in Saudi Arabia

Aims

To examine how nurse managers’ leadership styles, and nurses’ organisational commitment in Saudi Arabia relate.

Background

Effective leadership is influential in staff retention; however, recruiting and maintaining nurses is an increasing problem in Saudi Arabia.

Methods

Using a survey design, the Multifactor Leadership Questionnaire and the Organisational Commitment Questionnaire were distributed to a sample of 219 nurses and nurse managers from two hospitals in Saudi Arabia.

Results

Transformational leadership was the most dominant leadership style. After controlling for the influence of manager/staff status, nationality and hospitals, transformational leadership was the strongest contributor to organisational commitment. Perceptions of both transformational and transactional leadership styles, increased with age for nurse managers and nursing staff.

Conclusion

Introducing the Full Range of Leadership model to the Saudi nursing workforce could help to prepare Saudi nurses for positions as nurse managers and leaders.

Implications for Nursing Management

The study provides insight into the type of leadership that is best suited to the dynamic and changing health care system in Saudi Arabia. It is possible that transformational leaders could influence and induce positive changes in nursing.     

The nursing profession in Saudi Arabia: an overview

ALMALKI M., FITZGERALD G. & CLARK M. (2011) The nursing profession in Saudi Arabia: an overview. International Nursing Review 58 , 304–311 Aim: The study aims to provide an overview of the nursing profession in Saudi Arabia, including its history, educational development, workforce and professional practice. Background: Saudi Arabia is faced with a chronic shortage of Saudi nurses, accompanied by high rates of turnover. Expatriate nurses form a large proportion of the nursing workforce in Saudi healthcare facilities, with Saudis comprising only 29.1% of the total nursing workforce. Despite the fact that the proportion of Saudi nurses is very low in general, this rate is lower in the private health sector where local nurses comprise only 4.1% of the total. Methods: Data relating to the nursing profession in Saudi Arabia were extracted from published literature identified through search of a range of publically available databases such as Medline, CINAHL, Google Scholar, Saudi health databases, Saudi health journals, government reports and relevant texts. Obtained information was evaluated for relevance and grouped on a thematic basis. Conclusion: The status of nursing in Saudi Arabia should be enhanced in order to make it a worthwhile career. The media should engage in helping to promote a positive image of the nursing profession. The education sector should reconsider the length of nursing training (5 years compared with 3 years in many developed countries) while maintaining competent and safe practice. Reducing the financial burden on the nursing student through provision of additional financial support would encourage more students. In particular, nurses should be paid a full salary during the intern year as currently occurs with medical students.     

Personal contemporary observations of nursing care in Saudi Arabia

Observations were made of the Saudi Arabian health-care delivery system, in regards to nursing care and the relationship between service provider and client. Current challenges facing the health-care system were also examined to determine how they affect nursing practice.     

Professional Development of Nursing in Saudi Arabia

Purpose: To describe the development of nursing in Saudi Arabia and to recommend further directions for development of professional nursing in that country.
Organizing Construct: A comprehensive needs assessment was performed in 1996 by an onsite consultant to: (a) evaluate the existing nursing system at the ministry, regional, and hospital levels, (b) describe the functional interrelationships of a nursing division within the Ministry of Health, and (c) prepare a work plan outlining the program elements that a nursing division could address to foster high-quality health care in the public sector.
Methods: The needs assessment was conducted through direct observation, interviews, and review of existing documents in the Ministry of Health and representative hospitals, health centers, and health institutes. Data were collected about six factors as they pertained to the Ministry of Health Nursing Services: (a) key organizational and managerial activities, (b) the external environment, (c) the social system, (d) employees, (e) nursing services and research, and (f) formal organizational arrangements.
Findings and Conclusions: The data showed a young country and an equally young nursing profession struggling to meet the needs of a growing population. The highest priority for the advancement of nursing in Saudi Arabia is the creation of a kingdom-wide system of nurse regulation. Pressing needs include regulation of professional standards, licensure of all nurses practicing in the Kingdom, accreditation of educational programs, and formation of a national nurses association.     

Health care and nursing in Saudi Arabia

Aim:  This paper reviews healthcare provision in Saudi Arabia and the development of nursing together with its current challenges.
Background:  Health care in Saudi Arabia is developing fast with multiple governmental and independent service providers. Economic growth has impacted upon health needs through population and health behaviour change. The development of the indigenous nursing workforce has been slow resulting in much nursing care being delivered by migrant nurses.
Conclusion:  There is a need to increase the proportion of indigenous nurses so that culturally appropriate holistic care can be delivered. Without shared culture and language, it will be difficult to deliver effective health education within nursing care to Saudis.     

Palliative Care in Saudi Arabia

The palliative care service started at the King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia over a decade ago by Dr. Isbister is slowly expanding. Excellent facilities for investigations and curative treatment are available in the hospital, and these are useful when supportive facilities are needed. Nevertheless, there are problems. Most of the staff is western, and this is a hindrance when psychosocial and spiritual support is needed by Saudi patients. Patients have poor facilities for follow-up in between outpatient visits every month. The team has overcome the problem of poor availability of opioids, but these essential drugs are not available to the patients at the national level. Educational and research services have begun.     

Pattern of disability among patients attending Taif rehabilitation center,Saudi Arabia

Purpose. Despite the growing awareness of the community about the economic, psychological and medical impact of disability, limited research has been carried out to determine the pattern of disabilities in Saudi Arabia.

Methods. This is a cross-sectional study of hospital records of patients who were admitted to Armed Forces Rehabilitation Center, Taif, Saudi Arabia, during the period from 1999 – 2005. A total of 850 patient records were reviewed. Data were collected on age, sex, nationality, data of admission and discharge and type of disability. Univariate and multivariate logistic regression analyses were performed to determine predictors of long stay at the hospital.

Results. Trauma as an etiology of disability was more common than non-traumatic incidents among male and middle age patients (16 – 45 years). Traumatic accidents mostly result in quadriplegia (72.8%). Male, single, less than 45 years old, patients with traumatic accidents and patients with paralytic types of disability were significantly more likely to stay longer at the hospital (≥6 months).

Conclusions. The home care program should be expanded to minimize duration of stay at the rehabilitation centers with lower cost as well as health education of the public would help in encouraging disabled patients to adapt to daily life activities.     

Pattern of disability among patients attending Taif Rehabilitation Center, Saudi Arabia

Purpose. Despite the growing awareness of the community about the economic, psychological and medical impact of disability, limited research has been carried out to determine the pattern of disabilities in Saudi Arabia.

Methods. This is a cross-sectional study of hospital records of patients who were admitted to Armed Forces Rehabilitation Center, Taif, Saudi Arabia, during the period from 1999 - 2005. A total of 850 patient records were reviewed. Data were collected on age, sex, nationality, data of admission and discharge and type of disability. Univariate and multivariate logistic regression analyses were performed to determine predictors of long stay at the hospital.

Results. Trauma as an etiology of disability was more common than non-traumatic incidents among male and middle age patients (16 - 45 years). Traumatic accidents mostly result in quadriplegia (72.8%). Male, single, less than 45 years old, patients with traumatic accidents and patients with paralytic types of disability were significantly more likely to stay longer at the hospital (≥6 months).

Conclusions. The home care program should be expanded to minimize duration of stay at the rehabilitation centers with lower cost as well as health education of the public would help in encouraging disabled patients to adapt to daily life activities.     

The Nurse Practitioner in Saudi Arabia: Potentials and Threats

The provision of the nurse practitioner (NP) began in the mid-1960s and is defined more clearly nowadays in many developed countries, such as the United States, Canada, United Kingdom, and Australia. Their scope of practice is legally well defined in these nations. However, the countries of the Middle East, including Saudi Arabia, face the problem of lack of enough numbers of NPs and even lack well-defined NPs’ roles and duties. Several challenges face the effective adoption of the NP title and roles in Saudi Arabia, where it cannot be identified successfully without a clear recognition, definition, scope, legislation, or a regulatory framework     

Headache syndromes amongst schoolchildren in Riyadh,Saudi Arabia

We evaluated 1,400 randomly selected Saudi children in grades 1 through 9 to determine the prevalence of migraine and tension-type headache. Of the 1400 distributed questionnaires, 1,181 (84.3%) were completed properly and so served as the basis for analysis. There were 573 boys (48.5%) and 608 girls (51.5%). Ages ranged from 6 to 18 years. Five hundred eighty-eight children (49.8%; 272 boys and 316 girls) had recurrent headache episodes not related to febrile illness in the year preceding the survey. Eighty-four children (7.1%; 37 boys and 47 girls) had recurrent episodes of migraine, and 504 (42.7%; 232 boys and 272 girls) had recurrent episodes of nonmigraine headache. For both boys and girls, the age-specific prevalence rate for nonmigraine headache rose steadily from around 15% at aged 6 to 7 years to nearly 60% after aged 15. For migraine, there was a sharp increase in the prevalence rate (from around 2% to around 9%) at aged 10 to 11, also in both boys and girls. Age-adjusted prevalence for migraine between aged 6 and 15 was 6.2%. Due to the relatively poor sensitivity of some of the IHS criteria in children, this figure may underestimate the true magnitude of migraine in the population studied.     

Substance use disorders in Saudi Arabia: review article

Objective: The objective was to review all the available published studies and reports with particular reference to substance abuse in Saudi Arabia.

Methods: Data were collected from a PubMed search and reviewing national journals, the United Nations Office on Drug and Crime (UNODC) reports, World Health Organization (WHO) reports and conference presentations over the last two decades.

Results: Among Saudi patients in addiction treatment settings, the most commonly abused substances were amphetamine (4–70.7%,), heroin (6.6–83.6%), alcohol (9–70.3%) and cannabis (1–60%). Over the past decade, there was an increase in the use of cannabis and amphetamine and decrease in the use of heroin and volatile substances. Peer pressure and psychosocial stresses were risk factors for initiation as well as relapse of substance abuse. Anxiety, depression and hepatitis were the most common co-morbid disorders among the Saudi patients.

Conclusion: Substance abuse is a public health problem in Saudi Arabia. It was associated with many psychiatric disorders, medical diseases and educational, occupational, legal and social consequences. School- and community-based prevention programmes are highly required in Saudi Arabia as a first-line strategy in the fight against substance abuse.     

Saudi service users’ perceptions and experiences of the quality of their mental health care provision in the Kingdom of Saudi Arabia (KSA): A qualitative inquiry

This paper presents, as part of a larger mixed‐methods design, a study generating a theoretical understanding of issues pertinent to the quality of mental health care in the KSA from the perspective of those using services. Semi‐structured interviews were undertaken with thirty service users admitted to inpatient psychiatric wards, using an interview guide developed by the researchers, based on relevant literature. Findings from the thematic analysis showed five themes: (1) The hospital as a prison: a custody versus care dilemma, (2) quality of interactions between staff and service users, (3) quality of services, (4) staff qualities and (5) suggestions for achieving quality of care. A theoretical model drawing upon Donabedian Health Care Model for Evaluating quality of care and the Andersen Behavioural Model of Health Service Use is evident from the data. Structural aspects of care include staff experience and qualifications and key enablers around social and financial support, service users’ health needs and status and the physical infrastructure and ward rules. These drive processes of care based upon robust rates of interaction between staff and service users and appear central to quality of mental health care in KSA. Quality of mental health care in KSA is manifested by a therapeutic ethos with a high degree of interaction between professional carers and service users, with the former being highly educated, competent, compassionate, with a high degree of self‐awareness, and specialized in mental health. We have uncovered elements of Fanon and Azoulay’s ‘Cultural Originality’ as well as contemporary examples of Goffman’s mortification of the self.     

Clinical environmental stressors and coping behaviors among undergraduate nursing students in Saudi Arabia: A cross-sectional study

ObjectivesThis study aimed to explore the level of stress, stressors sources, and coping strategies used among female Saudi undergraduate nursing students during their clinical practice.MethodsA cross-sectional design was used. Using a convenience sampling technique, female nursing students in Riyadh, Jeddah, and Alahsa who enrolled in clinical courses were recruited from a governmental university from January to May 2022. Data were collected using a self-report questionnaire including socio-demographic characteristics, the Perceived Stress Scale (PSS), and the Coping Behavior Inventory (CBI).ResultsThe degree of stress perceived by the 332 participants ranged from 3 to 99 (54.77 ± 0.95). Stress from assignments and workload was the most common type of stressor perceived by nursing students, with a score of 2.61 ± 0.94, followed by stress from the environment, with a score of 1.18 ± 0.47. Meanwhile, the students used staying optimistic as the most adopted strategy, with a score of 2.38 ± 0.95, followed by the transference strategy, a score of 2.36 ± 0.71, and the problem-solving strategy scored 2.35 ± 1.01. The coping strategy of avoidance is positively correlated with all of the stressor types (P < 0.01), while the problem-solving strategy is negatively correlated with stress from peers and daily life (r = ?0.126, P < 0.05). Transference is positively correlated with stress from assignments and workload (r = 0.121, P < 0.05), and stress from teachers and nursing staff (r = 0.156, P < 0.01). Lastly, staying optimistic is negatively correlated with stress from taking care of patients (r = ?0.149, P < 0.01), and with stress from lack of professional knowledge and skills (r = ?0.245, P < 0.01).ConclusionsThese research findings are significant for nursing educators to identify nursing students’ main stressors and coping strategies used. Effective countermeasures should be taken to promote a healthy learning environment, decrease the level of stressors and improve students’ coping strategies during clinical practice.     

Prevalence of depression symptoms among female adolescents in Saudi Arabia

Objective

Epidemiological studies on the prevalence of elevated depression symptoms among female adolescents in Saudi Arabia report a wide variation, ranging from 13.9% to 80.2%. However, different methods of assessment and sampling have been used. The aim of the current study is to estimate the prevalence of elevated depression symptoms amongst female adolescents in Saudi Arabia using a gold-standard self-report measure, the Mood and Feelings Questionnaire (MFQ).

Design and Measures

A cross-sectional study was conducted with 515 female students aged 13−18 years, recruited from public schools. Participants completed the Arabic versions of the MFQ, Rosenberg Self-Esteem Scale and Multidimensional Scale of Perceived Social Support.

Results

Mean MFQ score for this sample was 26.35 and almost half of participants (48.2%) had scores above the cut-off. Severity of depression varied with age, with those aged 13 showing reduced symptoms, and was negatively correlated with self-esteem and perceived social support. There were no associations with other demographic factors.

Conclusion

Elevated levels of depression symptoms were common in this sample. This highlights the need to improve public mental health in this community and to improve methods of identifying and treating depression in female adolescents.     

The use of the nutritional supplements during the covid-19 outbreak in Saudi Arabia: A cross-sectional study

BackgroundCOVID-19 causes moderate to severe illness and is spreading globally. During a pandemic, vitamins and minerals are vital to health. Therefore, the prevalence and epidemiology of supplement use in Saudi Arabia during the COVID-19 pandemic must be known.MethodsThis cross-sectional study was conducted in Saudi Arabia using an online survey. The study was conducted from June to March 2022 on both adults and children. The link to the survey was shared on social media platforms. The survey included questions on participants' demographics, vaccination status, supplements they used, and side effects of supplements. Participation in this study was optional, and there was no obligation to participate. There was a declaration about the aim of the study and different objectives before starting the survey.ResultsThe present study reported that most of the participants reported that they used vitamin C (64.6 %), zinc (51.9 %), multivitamins (46.1 %), black seeds (26.7 %), garlic (Allium sativum) (15.4 %), omega-3 (22.1 %), vitamin D (22.2 %), echinacea (10.1 %), manuka honey (26.0 %), curcumin (13.6 %), ginger (22.5 %), royal jelly (12.9 %), and propolis (7.5 %) before and during the COVID-19 pandemic period. These supplements were used more frequently by subjects during the pandemic than before.Discussion and conclusionThe respondents' risk of these supplements’ use may partially reflect the public's behavioral response during a pandemic. Future studies can document the health beliefs and motivations of nutritional supplement users.