Abeer Nuwayfi Alruwaili

Background: The rapid advancements in artificial intelligence (AI) technologies across various sectors, including health care, necessitate the need for a comprehensive understanding of their applications. Specifically, the acceptance and readiness of nursing students as future health care professionals to adopt AI-based health care technologies, along with the factors influencing these attitudes, are critical for facilitating the effective integration of AI in health care settings. Objective: This study aimed to assess the readiness and acceptance of nursing students regarding the use of AI-based health care technologies in the nursing skills training in Saudi Arabia. Methods: A descriptive cross-sectional research design was used. A convenience sampling technique was applied to recruit 322 participants. Data were collected between June and September 2023 using a self-administered questionnaire that included the technology readiness index (TRI) and the technology acceptance scale. Results: Approximately 92.2% (297/322) of participants exhibited positive attitudes toward AI, and 74.8% (322) demonstrated innovativeness, indicating a generally favorable perception of AI. However, more than half of the students (59% [190/322] and 59.3% [191/322], respectively) reported feelings of discomfort and negative perceptions regarding AI use. Regarding TRI, 69.6% (224/322) of participants showed moderate readiness, while 30.4% (98/322) exhibited a high level of TRI. A substantial majority (320/322 99.4%) expressed acceptance of AI-based technologies in their training, with only 0.6% (2/322) reporting nonacceptance. Older students (aged >22 y) exhibited significantly higher levels of AI acceptance and readiness compared to younger students (P<.001). In addition, female students demonstrated significantly greater readiness and acceptance levels than male students (P=.003). Further, third-level students reported the highest mean scores in both acceptance and readiness (66.77 and 16.69, respectively; P=.002), while first-level students had the lowest (60.59 and 15.15). Among course groups, students enrolled in Maternal and Child Health Nursing reported the highest mean scores (65.19 and 16.30), whereas those in Community Health Nursing reported the lowest (57.50 and 14.38; P<.001). Conclusions: The findings indicate that nursing students demonstrated a generally positive level of readiness and acceptance toward the use of AI and related technologies in education and training. However, these levels remained moderate overall, highlighting the need to enhance awareness and deepen students’ understanding of AI’s potential to improve training effectiveness and health care quality.

Respiratory Distress Syndrome (RDS) remains a leading cause of mortality among preterm infants weighing < 2000 g, particularly in resource-limited settings. While Kangaroo Mother Care (KMC) has shown promise in stable preterm infants, its effectiveness for those requiring respiratory support remains unclear. This study evaluated nurse-led implementation of KMC for preterm infants with RDS. A prospective, multicenter, randomized controlled trial was conducted across four neonatal intensive care units in Tanta, Egypt (January 2023–June 2024). Two hundred forty preterm infants (<2000 g) with RDS were randomly assigned to either nurse-implemented KMC (n = 120) or standard care (n = 120). The KMC protocol, implemented for a minimum of 6 h per day until hospital discharge, integrated continuous skin-to-skin contact, exclusive breastfeeding promotion, and structured parental education. Outcomes included 28-day survival, respiratory status (Silverman-Anderson Scores), nosocomial infections, maternal-infant bonding, growth trajectories, and clinical course metrics. The KMC intervention significantly improved 28-day survival (adjusted HR = 0.42, 95% CI 0.28–0.63, p < 0.001) and reduced nosocomial infections by 55% (RR = 0.45, 95% CI 0.27–0.75, p < 0.001). KMC recipients demonstrated faster respiratory improvement, shorter CPAP duration (−2.2 days, p < 0.001), and higher rates of exclusive breastfeeding at discharge (74.2% vs. 48.3%, p < 0.001). Maternal competency scores showed progressive improvement with enhanced bonding and responsiveness. Nurse-implemented KMC is a safe, effective intervention for preterm infants with RDS, yielding significant improvements in survival, clinical outcomes, and family-centered care metrics. These findings support the expansion of nursing roles in implementing KMC for high-risk infants in resource-limited settings. ClinicalTrials.gov (NCT06707376).

Workplace violence (WPV) remains a formidable concern among nurses worldwide, with up to 60% in Saudi Arabia reportedly experiencing some form of aggression. In tertiary care hospitals, robust hierarchies and cultural norms intensify underreporting, thwarting evidence-based prevention and obscuring vital data. This qualitative study investigated the perceived barriers to WPV reporting among nurses in tertiary care settings in the Aljouf region of Saudi Arabia, specifically addressing how organizational and cultural factors converge to discourage formal incident reporting. A qualitative descriptive design was employed, guided by Ajzen’s Theory of Planned Behavior and the Social Ecological Model. Thirty-six registered nurses, purposively sampled from three tertiary hospitals, participated in six semi-structured focus groups conducted in Arabic or English, depending on participant preference. Data were thematically analyzed in NVivo, with methodological rigor ensured through triangulation and inter-coder reliability. Three principal themes emerged: (1) Emotional and Psychological Barriers (78%), encompassing distress, anxiety, and fears of professional blame; (2) Organizational Ineffectiveness (65%), marked by convoluted reporting processes and perceived managerial indifference; and (3) Cultural and Hierarchical Influences (57%), reflecting deference to authority and normalization of violence. These themes illustrate how attitudes, subjective norms, and perceived behavioral control shaped by socio-cultural dynamics collectively contribute to persistent underreporting. Mitigating WPV underreporting in Saudi tertiary care hospitals requires streamlined, user-friendly reporting channels, leadership accountability, and holistic psychosocial support. Implementing interprofessional education aimed at dismantling hierarchical imbalances can foster a zero-tolerance ethos toward violence. Longitudinal and comparative research should further examine evolving reporting behaviors to refine context-specific, culturally attuned strategies for addressing WPV. Not applicable.

Neonatal nurses in high-risk Neonatal Intensive Care Units (NICUs) navigate complex, time-sensitive clinical decisions where accuracy and judgment are critical. Generative artificial intelligence (AI) has emerged as a supportive tool, yet its integration raises concerns about its impact on nurses’ decision-making, professional autonomy, and organizational workflows. This study explored how neonatal nurses experience and integrate generative AI in clinical decision-making, examining its influence on nursing practice, organizational dynamics, and cultural adaptation in Saudi Arabian NICUs. An interpretive phenomenological approach, guided by Complexity Science, Normalization Process Theory, and Tanner’s Clinical Judgment Model, was employed. A purposive sample of 33 neonatal nurses participated in semi-structured interviews and focus groups. Thematic analysis was used to code and interpret data, supported by an inter-rater reliability of 0.88. Simple frequency counts were included to illustrate the prevalence of themes but were not used as quantitative measures. Trustworthiness was ensured through reflexive journaling, peer debriefing, and member checking. Five themes emerged: (1) Clinical Decision-Making, where 93.9% of nurses reported that AI-enhanced judgment but required human validation; (2) Professional Practice Transformation, with 84.8% noting evolving role boundaries and workflow changes; (3) Organizational Factors, as 97.0% emphasized the necessity of infrastructure, training, and policy integration; (4) Cultural Influences, with 87.9% highlighting AI’s alignment with family-centered care; and (5) Implementation Challenges, where 90.9% identified technical barriers and adaptation strategies. Generative AI can support neonatal nurses in clinical decision-making, but its effectiveness depends on structured training, reliable infrastructure, and culturally sensitive implementation. These findings provide evidence-based insights for policymakers and healthcare leaders to ensure AI integration enhances nursing expertise while maintaining safe, patient-centered care.

Nurses in neonatal intensive care units face critical challenges in managing emergencies where timely, accurate interventions are essential for survival. Traditional nursing education often lacks the hands-on, immersive training required to build complex emergency skills, contributing to persistent neonatal mortality globally. Virtual reality (VR) simulation, grounded in Kolb’s Experiential Learning Theory, offers a promising solution by replicating realistic and repeatable clinical scenarios. While VR has shown potential in nursing education, its specific impact on high-risk neonatal emergencies remains underexplored. To evaluate the effectiveness of a VR simulation program in enhancing nurse competency and improving neonatal outcomes during emergency care, grounded in Kolb’s Experiential Learning Theory. A concurrent triangulation mixed-methods design was implemented over two weeks across four pediatric hospitals. Through stratified random sampling, 128 NICU nurses were allocated to VR simulation (n = 64) or traditional training (n = 64) groups. Quantitative data were collected using validated instruments (OSCE: CVI = 0.92, MCQ: α = 0.86) measuring clinical skills, knowledge retention, and decision-making accuracy. Qualitative data were gathered through semi-structured interviews (n = 24) exploring experiential aspects. The VR group showed significant improvements in clinical skills (OSCE: +16.1 points, p < 0.001, d = 1.58), decision-making accuracy (+ 16.7%, p < 0.001), and reduced stabilization times (-6.2 min, p < 0.001). Patient safety events decreased by 52% (p < 0.001). Thematic analysis revealed enhanced professional competence (83%), reduced clinical anxiety (75%), and positive learning experiences (88%), despite minor technical challenges. VR simulation demonstrates superior effectiveness for neonatal emergency training, significantly improving both nurse competency and patient outcomes. While geographic specificity and brief follow-up duration limit generalizability, findings support VR’s potential for enhancing emergency preparedness. Future research should address longitudinal outcomes and implementation across diverse healthcare settings. Not applicable.

In the realm of healthcare, the adoption of Evidence-Based Practice (EBP) is paramount to ensure the delivery of optimal patient care. Despite its critical significance, disparities persist in the knowledge and skills pertaining to EBP among students. This study aims to assess Saudi nursing students’ perceived knowledge, attitudes, and application of EBP, alongside their perceptions of organizational culture and readiness that support EBP implementation. The study employed a cross-sectional descriptive correlational design. A convenience sample of 183 undergraduate nursing students was selected from three governmental Saudi universities from June to August 2023. A self-reported, three-part online survey was utilized and included: a demographic questionnaire, the Student Evidence-Based Practice Questionnaire (S-EBPQ), and the short version of Organizational Culture and Readiness for School-wide Integration of Evidence-based Practice (OCRSIEP-E). Participants were recruited based on specific inclusion criteria, including senior nursing students, recent graduates, and those with research or EBP training. Most participants demonstrated satisfactory (54.6%) or high (31.7%) knowledge of EBP, while 13.7% reported poor knowledge. In EBP retrieving and reviewing, 48.1% found their skills satisfactory, 32.2% high, and 19.7% poor. For EBP sharing and application, 41% rated their skills as high, 36.1% satisfactory, and 23% poor. Attitudes toward EBP were 64.5% positive and 35.5% negative. Female students had higher knowledge (M = 4.61) than males (M = 3.90; p < 0.01) and higher EBP sharing scores (M = 4.42 vs. M = 3.90; p < 0.05). Research involvement also influenced knowledge (M = 4.54 vs. M = 4.08; p < 0.05) and EBP sharing (M = 4.43 vs. M = 3.88; p < 0.05). Students’ perceptions of organizational support varied, with mean scores of 3.49 for culture-supporting culture, 3.59 for resources availability, and 3.47 for mentorship support. The study reveals generally positive EBP knowledge and attitudes among nursing students but highlights significant gaps in critical skills such as retrieving, reviewing, and applying evidence, as well as inconsistencies in organizational support. Institutions can address these gaps by integrating structured EBP training, mentorship programs, research engagement opportunities, and enhanced faculty support to foster a stronger evidence-based practice culture. Not applicable.

The growing prevalence of age-related cardiovascular diseases (CVDs) poses significant health challenges, necessitating the formulation of novel treatment approaches. GATA4, a vital transcription factor identified for modulating cardiovascular biology and cellular senescence, is recognized for its critical involvement in CVD pathogenesis. This review collected relevant studies from PubMed, Google Scholar, and Science Direct using search terms like ‘GATA4,’ ‘cellular senescence,’ ‘coronary artery diseases,’ ‘hypertension,’ ‘heart failure,’ ‘arrhythmias,’ ‘congenital heart diseases,’ ‘cardiomyopathy,’ and ‘cardiovascular disease.’ Additionally, studies investigating the molecular mechanisms underlying GATA4-mediated regulation of GATA4 and senescence in CVDs were analyzed to provide comprehensive insights into this critical aspect of potential treatment targeting. Dysregulation of GATA4 is involved in a variety of CVDs, as demonstrated by both experimental and clinical research, comprising CAD, hypertension, congenital heart diseases, cardiomyopathy, arrhythmias, and cardiac insufficiency. Furthermore, cellular senescence enhances the advancement of age-related CVDs. These observations suggested that therapies targeting GATA4, senescence pathways, or both as necessary may be an effective intervention in CVD progression and prognosis. Addressing age-related CVDs by targeting GATA4 and senescence is a broad mechanism approach. It implies further investigation of the molecular nature of these processes and elaboration of an effective therapeutic strategy. This review highlights the importance of GATA4 and senescence in CVD pathogenesis, emphasizing their potential as therapeutic targets for age-related CVDs.

Background: Transformational leadership is recognized as a crucial factor influencing nurses’ work experiences and well‐being. However, the mechanisms through which transformational leadership affects nurse well‐being, especially concerning organizational justice and quality of work life, are not fully understood. Aim: This study investigates the direct and indirect effects of transformational leadership on nurse well‐being, focusing on the mediating roles of organizational justice and quality of work life. Methods: Using a sequential explanatory mixed methods design, quantitative data were collected from 580 nurses across five hospitals in Saudi Arabia with validated tools: the Global Transformational Leadership Scale, Organizational Justice Scale, Quality of Nursing Work–Life Scale, Emotional Exhaustion Subscale of the Maslach Burnout Inventory, Job Satisfaction Scale, and Perceived Stress Scale. Qualitative data were obtained from 25 focus group discussions using a validated semistructured discussion guide. Quantitative analyses included hierarchical multiple regression and mediation analyses, while qualitative data wereanalyzed thematically. Results: Transformational leadership significantly reduced emotional exhaustion ( β = −0.48, p < 0.001), increased job satisfaction ( β = 0.53, p < 0.001), and lowered perceived stress ( β = −0.46, p < 0.001). Mediation analyses showed significant indirect effects through organizational justice and quality of work life (indirect effects: −0.34 to 0.38, p < 0.001). Qualitative findings highlighted the importance of inspirational motivation, individualized consideration, intellectual stimulation, and idealized influence. Conclusions: Transformational leadership directly and indirectly enhances nurses’ well‐being through improved organizational justice and quality of work life. These findings emphasize the need for healthcare organizations to foster transformational leadership and promote fair, supportive work environments to enhance nurse well‐being.

Background: Cardiovascular diseases are the leading cause of mortality globally. Myocardial infarction (MI), a major type of cardiovascular disease, presents long-term challenges for patients. Recognizing patients’ perceived health needs and the factors that influence them is crucial for providing comprehensive care and improving outcomes. Aim: This paper explores the perceived health needs, levels of depression, and social support among MI patients, as well as investigates the correlations between these factors. Methods: A cross-sectional study was conducted at King Salman Specialist Hospital from March to June 2024, enrolling 244 MI patients through convenience sampling. Data collection was performed using the following three validated questionnaires: the Cardiac Patient Learning Needs Inventory (CPLNI) to assess the learning needs of MI patients, the Patient Health Questionnaire-9 (PHQ-9) to evaluate depression levels, and the Oslo Social Support Scale (OSSS-3) to measure social support. Statistical analysis was carried out using IBM SPSS Statistics, Version 27. Results: Patients aged 40 years or older and those who were employed exhibited greater learning needs (p < 0.001). Female patients were more depressed than males (p = 0.008). Higher social support was reported by the female patients, those with a family history of MI, and those who were employed (p = 0.002, 0.002, and 0.003, respectively). The total mean score for perceived learning needs was 3.72, with the highest needs in “other pertinent information”, “medication information”, and “anatomy and physiology”. Depression was indicated in 45.1% of MI patients, with significantly higher depression levels in female than in male patients. Additionally, a significant positive correlation was found between social support and perceived learning needs (r = 0.205, p = 0.001), as well as a negative correlation between social support and depression (r = −0.441, p < 0.001). Conclusions: Addressing both the physical and psychological needs is essential for MI patients. Comprehensive educational programs and mental health support services are necessary for improving outcomes. Personalized patient education and routine depression screenings should be integrated into post-MI care. Future research should examine longitudinal changes in learning needs and mental health status.