Rayhanah R. Almutairi

Background/Objectives: Digital programs may extend physical activity support beyond clinic visits, but qualitative evidence on how adults with chronic diseases in Saudi Arabia perceive them is limited. This study explored perceptions, expectations, and acceptability among such adults who had continued using the physical activity function of Sehhaty, the Ministry of Health’s national health application, which served as the reference point. Methods: A COREQ-reported qualitative descriptive study was conducted in chronic disease units at three tertiary centres in Riyadh between December 2025 and February 2026. Semi-structured interviews were held with a purposive sample of 14 adults (38–72 years; 8 women, 6 men) with type 2 diabetes mellitus, hypertension, cardiovascular disease, or combinations, all of whom had used the program independently for 4–16 weeks. Recruitment and analysis proceeded iteratively across two stages (18 approached). Data were analysed using reflexive thematic analysis. Results: Four themes were developed: reframed expectations of what a technology-based presence could offer; a gap between perceived usefulness and everyday usability; the dual motivational and discouraging potential of numerical feedback; and the expectation that programs fit Islamic practice, family involvement, and climate constraints. Conclusions: For these participants, acceptability depended on ease of use, natural Arabic wording, reminders and suggestions that fit prayer times, family routines, and summer heat, and feedback that recognised health circumstances. Because all participants were sustained users, the findings do not estimate acceptability in the wider population.

Almost twelve million American family members provide care for a family member with Alzheimer’s disease and related dementias (ADRD), providing for their daily physical and psychosocial needs. The burden of caregiving for a family member with dementia may cause overwhelming stress and adversely affect the caregiver’s physical and mental health. Clinicians and researchers alike continue to identify strategies to reduce caregiver burden and keep family caregivers healthy. Artificial intelligence (AI), an emerging and evolving technological method for simulating human learning, reasoning, problem-solving, and decision-making, is being applied to caregiving for persons with ADRD. This systematic review identified current AI use within the context of caregiving for persons with dementia. Applying the PRISMA model, eight databases (AgeLine, APA PsycINFO, CINAHL, MEDLINE, Health Source, SocIndex, Psych & Behavioral Science Collection, and PubMed) were searched from 2004 to 2024. After removing duplicates and studies not meeting inclusion/exclusion criteria, 15 articles underwent thematic analysis. Three categories of AI applications emerged: robotics, communication, and interventions. Although many studies were small-scale, with few study participants, and examined acceptability or feasibility of using AI, our evaluation of the included studies for quality and risk of bias indicated 73% were of high (i.e. low risk of bias) and 27% were of moderate quality (i.e. moderate risk of bias). As knowledge about AI continues to develop, the potential for transforming and improving caregiving for persons with dementia increases exponentially.

Background/Objectives: High-quality multiple-choice questions (MCQs) are essential for valid assessment in graduate-level nursing programs, yet developing such items is resource-intensive for educators. Large language models such as ChatGPT may generate educational assessment content; however, evidence regarding their effectiveness in producing graduate-level nursing examination items remains limited. This study compared the perceived quality of ChatGPT-generated and educator-authored MCQs for graduate-level nursing examinations and examined exploratory associations between assessor characteristics and quality ratings. Methods: A comparative cross-sectional study was conducted among 27 international nurse educators who independently evaluated 50 MCQs (25 ChatGPT-generated and 25 educator-authored) using an expert-reviewed rubric assessing eight quality domains, with the primary outcome being the between-source difference in perceived quality ratings. Participants were blinded to question source. Results: ChatGPT-generated MCQs received nominally higher ratings than educator-authored items across most domains, but effect sizes were uniformly small (Cohen’s d = 0.11–0.33). No significant differences were observed in perceived difficulty or distractor plausibility; after Bonferroni correction for multiple domain comparisons, differences in cognitive level, scenario relevance, and instructional alignment remained significant. Conclusions: ChatGPT-generated MCQs achieved perceived-quality ratings broadly comparable to educator-authored items when supported by structured prompting and expert refinement, although expert review remains necessary before classroom use, and these results should be regarded as preliminary. These findings support AI-assisted item development as a complementary strategy pending replication in larger, more rigorous studies.

Background: Perceived inequity in work allocation has well-documented consequences for nurse job satisfaction, organizational commitment, and patient safety. Despite this recognition, empirical research examining how nurses in Middle Eastern healthcare contexts conceptualize allocation justice remains limited. This qualitative study explored Saudi registered nurses’ perceptions of work allocation justice, identified the organizational factors shaping those perceptions, and examined their implications for nurse well-being and quality of care. Methods: A qualitative design employing reflexive thematic analysis was used, grounded in constructivism. Semi-structured individual interviews were conducted with 17 purposively sampled registered nurses from three Riyadh-based healthcare facilities. Credibility was established through data, method, and analyst triangulation; peer debriefing; and member checking (12 of the 17 participants were purposively selected for member checking to represent the full range of experiences; 11 of those 12 confirmed thematic plausibility). Thematic saturation was reached at interview 13. Results: Six interconnected themes emerged: (1) Understanding Work Justice; (2) Personal Experiences; (3) Influencing Factors; (4) Psychological and Professional Impacts; (5) Institutional and Administrative Support; and (6) Future Perspectives. Participants define fairness as contextual equity and relational respect rather than simple numerical equality. Inequities were driven by staffing constraints, leadership styles, and policy gaps, leading to burnout and reduced organizational commitment. Conclusions: Saudi nurses experience meaningful allocation inequities arising from structural constraints, leadership variability, and the absence of written allocation policies. Addressing these inequities requires coordinated action on policy transparency, objective criteria, and psychologically safe communication channels. These findings provide contextually grounded, evidence-informed guidance for developing equitable nursing work environments that support workforce retention and patient safety.

Purpose: This study examined the use of personal and social resourcefulness when experiencing anger, anxiety, sadness, decision-making, and financial distress among adult-child and spousal caregivers of persons with dementia. Methods: Baseline data on 10 Resourcefulness Scale ^© items measuring personal and social resourcefulness in response to anger, anxiety, sadness, decision-making, and financial distress were obtained from 127 adult-child and 112 spousal caregivers of persons with dementia. Results: Adult-child and spousal caregivers similarly used personal resourcefulness for financial distress (62%–68%) and both personal and social resourcefulness when angry (67%), sad (87%–92%), and making decisions (77%–98%). Spousal caregivers used both personal and social resourcefulness when anxious (37%), while adult-child caregivers used only personal resourcefulness (46%). The findings were similar across age, race, and gender subgroups. Conclusions: Future research should explore the effects of other situational factors (e.g., caregiving burden) on resourcefulness. Gerontological healthcare professionals should assess the caregiver–care recipient relationship when determining and tailoring interventions.

Background: Caring for older adults with multimorbidity represents one of the most challenging aspects of contemporary nursing practice. While research has examined clinical outcomes and care models, limited attention has been given to how nurses develop resilience and adapt their professional practice to meet these complex care demands. This study aimed to examine how nurses build resilience and adapt their professional practice when caring for older adults with multimorbidity in acute care environments. Methods: This qualitative study employed in-depth semi-structured interviews with 15 registered nurses across general and specialized hospital settings. Data were analyzed using interpretive phenomenological analysis to understand the essence of nurses’ adaptation and resilience-building experiences. Results: Three superordinate themes emerged: (1) Professional evolution through complexity navigation, (2) Emotional resilience and meaning-making in challenging care situations, and (3) Collaborative networks as sources of strength and learning. Nurses demonstrated remarkable capacity for professional growth, developing sophisticated coping mechanisms and finding meaning in their challenging work. Conclusions: Nurses caring for older adults with multimorbidity undergo significant professional development, building resilience through experiential learning, peer support, and meaning-making processes, though these gains are accompanied by real emotional costs, including moral distress and exhaustion. Understanding these adaptation mechanisms is crucial for supporting nursing workforce sustainability and optimizing patient care quality.

Background: Family-centered care (FCC) is a foundational principle in pediatric healthcare, yet its implementation in culturally specific contexts remains poorly understood. In Saudi Arabia, Islamic values, collective family structures, and gendered caregiving norms shape how mothers engage with pediatric intensive care in ways that existing Western-derived FCC models do not fully capture. The aim of this study was to explore Saudi mothers’ experiences of family-centered care during their children’s pediatric intensive care unit (PICU) admissions, focusing on perceived barriers, cultural negotiations, and evolving advocacy strategies. Methods: A qualitative descriptive study was conducted with 17 Saudi mothers whose children had been admitted to PICUs across major hospitals in Saudi Arabia within the preceding 12 months. Semi-structured interviews lasting 40–70 min were conducted in Arabic using a pilot-tested, 15-item guide. Data were analyzed through Braun and Clarke’s six-phase reflexive thematic analysis. Trustworthiness was strengthened through member checking, reflexive journaling, negative case analysis, and investigator triangulation. Reporting adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ). Result: Five interconnected themes emerged: (1) confronting crisis and uncertainty, (2) renegotiating maternal identity, (3) brokering culture within biomedicine, (4) forging trust with care teams, and (5) evolving into advocates. These themes trace a developmental arc from initial disorientation through progressive empowerment, shaped at every stage by culturally grounded resources and constraints. Mothers functioned as cultural brokers performing invisible labor that healthcare systems neither recognized nor supported. Conclusions: Saudi mothers in PICUs engage in sophisticated cultural mediation between family systems and biomedical institutions under conditions of acute stress. Findings underscore the need for structurally embedded cultural responsiveness in PICU policy, including continuous cultural assessment, care-team continuity, and family advocacy support.

Gender shapes healthcare experiences, yet its influence on palliative care (PC) in Middle Eastern contexts remains under-researched. Understanding how male and female patients differently experience PC is essential for delivering gender-sensitive nursing care. A cross-sectional study was conducted among 200 cancer patients recruited from healthcare facilities in Saudi Arabia. PC quality perceptions were measured using the Palliative Care Experience and Quality Questionnaire (PCEQQ), assessing communication, symptom management, emotional support, and overall quality. Independent-samples t-tests compared mean scores between male (n = 99) and female (n = 101) participants. Chi-square tests and logistic regression examined gender differences in access and associated factors. Female patients reported significantly higher overall satisfaction (M = 4.12 vs. M = 3.85, p = 0.008) and communication quality (M = 4.10 vs. M = 3.65, p = 0.002) compared to males. Females also demonstrated greater PC awareness (69.3% vs. 47.5%, p = 0.008) and access rates (64.4% vs. 47.5%, p = 0.013). Emotional support ratings approached significance, favoring females (p = 0.052), while symptom management showed no significant gender differences. These findings suggest that gender significantly shapes the PC experience in Saudi Arabia, with the most robust disparity appearing in provider, patient communication. Nurses should adopt gender-sensitive strategies to bridge the engagement gap for male patients, who may face cultural barriers to accessing supportive care.

Background: Lifestyle behaviours and medication adherence are interrelated components of cardiovascular secondary prevention, yet their co-occurrence in Middle Eastern post-percutaneous coronary intervention (PCI) populations remains poorly characterised. This study described smoking status and physical activity patterns, assessed antiplatelet medication adherence, and explored associations between lifestyle factors and adherence among Saudi patients following PCI. Methods: A cross-sectional survey was conducted among 236 Saudi adults who had undergone PCI within the preceding 12 months at two tertiary cardiac centres in Riyadh, Saudi Arabia. Data were collected on smoking status, cigarette consumption, self-reported physical activity frequency (defined as the frequency of engagement in regular exercise such as walking, swimming, or other structured physical activity), and self-reported medication adherence measured via the Morisky Medication Adherence Scale-8 (MMAS-8). Descriptive statistics characterised lifestyle and adherence patterns. Bivariate analyses (chi-square tests) and multivariate binary logistic regression were used to explore associations between lifestyle factors and adherence, adjusting for comorbidities including hypertension, diabetes mellitus, arthritis, and heart disease. Results: Participants were predominantly male (73.7%) and older adults (83.9% aged >50 years). Smoking prevalence was 23.3% (n = 55 of 236 participants), and physical inactivity was highly prevalent, with 57.2% of the sample (n = 135) reporting never engaging in regular exercise. Adherence was suboptimal, with 55.4% of participants (n = 129) classified as having low adherence (self-reported, measured via the MMAS-8). In multivariate analysis, arthritis was the only statistically significant predictor of adherence (adjusted odds ratio [AOR] = 2.81, 95% confidence interval [CI]: 1.01–7.84, p = 0.048; note, however, that this finding does not survive Bonferroni correction for multiple comparisons and should be interpreted as hypothesis-generating). Smoking (AOR = 0.52, 95% CI: 0.19–1.45, p = 0.213) and physical inactivity (AOR = 0.45, 95% CI: 0.09–2.25, p = 0.332) showed inverse but statistically non-significant trends with adherence. Conclusions: Unhealthy lifestyle behaviours and low medication adherence were each highly prevalent and co-occurred in this post-PCI population, though associations between lifestyle factors and adherence were not statistically confirmed except for arthritis. These descriptive findings are hypothesis-generating and provide a rationale for future adequately powered prospective studies and trials evaluating integrated nursing interventions that simultaneously address smoking, physical inactivity, and medication non-adherence in Saudi cardiac care settings.