Background: Nursing incivility, defined as disrespectful behaviour toward nurses, is increasingly recognized as a pressing issue that affects nurses’ well-being and quality of care. However, research on the pathways linking incivility to outcomes is limited, especially in Saudi hospitals. Methods: This cross-sectional study examined relationships between perceived nursing incivility, nurse stress, patient engagement, and health outcomes in four Saudi hospitals. Using validated scales, 289 nurses and 512 patients completed surveys on exposure to incivility, stress levels, activation, and medication adherence. The outcomes included readmissions at 30 days and satisfaction. Results: More than two-thirds of nurses reported experiencing moderate to severe workplace incivility. Correlation and regression analyzes revealed that nursing incivility was positively associated with nursing stress. An inverse relationship was found between stress and patient participation. Serial mediation analysis illuminated a detrimental cascade, incivility contributing to increased nurse stress, subsequently diminishing patient engagement, ultimately worsening care quality. Conclusions The findings present robust evidence that nursing incivility has adverse ripple effects, directly impacting nurse well-being while indirectly affecting patient outcomes through reduced care involvement. Practical implications advocate for systemic interventions focused on constructive nursing cultures and patient empowerment to improve both healthcare provider conditions and quality of care. This study provides compelling information to inform policies and strategies to mitigate workplace mistreatment and encourage participation among nurses and patients to improve health outcomes.

Background: Integrating family-centered care (FCC) and developmental care (DC) principles in neonatal care settings may improve neurodevelopmental outcomes for high-risk neonates. However, the combined impact of FCC and DC has been underexplored. This study aimed to investigate the effects of integrated FCC and DC on neurodevelopment and length of hospital stay in high-risk neonates. Methods: A quasi-experimental pre–post study was conducted among 200 high-risk neonates (<32 weeks gestation or <1500 g) admitted to neonatal intensive care units (NICU) in Saudi Arabia. The intervention group (n = 100) received integrated FCC and DC for 6 months. The control group (n = 100) received standard care. Neurodevelopment was assessed using the Bayley Scales of Infant Development-III. Length of stay and readmissions were extracted from medical records. Results: The intervention group showed significant improvements in cognitive, motor, and language scores compared to controls (p < 0.05). The intervention group had a 4.3-day reduction in the mean length of stay versus a 1.4-day reduction in controls (p = 0.02). Integrated care independently predicted higher cognitive scores (p = 0.001) and shorter stays (p = 0.006) in regression models. Conclusion: Integrating FCC and DC in neonatal care enhances neurodevelopmental outcomes and reduces hospitalization for high-risk neonates compared to standard care. Implementing relationship-based, developmentally supportive models is critical for optimizing outcomes in this vulnerable population.

Mothers of children with autism spectrum disorder (ASD) face considerable psychological distress. Cognitive behavioral therapy (CBT) has shown promise in reducing caregiver burden, but evidence in the Arab world is lacking. Problem-solving appraisal training may optimize CBT’s benefits. This study evaluated a tailored CBT program emphasizing the role of problem-solving appraisal in managing distress through the process of CBT. Sixty mothers were randomly allocated in a 1:1 ratio to either the CBT intervention group or the control group. The CBT group received 3-month sessions incorporating problem-solving appraisal training within a CBT curriculum from October 2022 to April 2023. Problem-solving techniques are focused on equipping individuals with the skills to identify, approach, and effectively resolve problems, leading to a reduction in stress levels and an improved capacity to cope with difficult situations. All mothers completed assessments of socio-demographics such as age, level of education, marital status, occupation, and adequacy of family income, the Depression Anxiety Stress Scale (DASS-21) and the Problem-Solving Inventory (PSI) before and after the program. The CBT group showed significant pre-to-post reductions in depression, anxiety, stress, and general psychological distress compared to controls (all p < 0.05). They also exhibited significant improvements in problem-solving confidence, approach-avoidance style and personal control (all p < 0.05). The customized CBT program markedly improved psychological well-being for mothers of children with ASD in Egypt. Incorporating problem-solving techniques may optimize CBT’s benefits cross-culturally. These findings have implications for the implementation of evidence-based support programs for families impacted by ASD worldwide.

Background. Emergency departments suffer from authoritarian and manipulative leadership styles that affect team dynamics, emotional exhaustion, and quality patient care. However, little research specifically explores these toxic leadership effects on conflict management and nurses' organizational commitment. Objectives. This cross-sectional study aimed to assess the correlations between perceived toxic leadership, conflict resolution strategies, and commitment dimensions among emergency nurses while evaluating conflict tendencies as a mediating mechanism. Methods. A cross-sectional design that included multiple regression and mediation analyses was utilized. The sample consisted of 387 emergency nurses from five major Saudi hospitals surveyed using validated scales that measure perceived toxic leadership, conflict styles, and organizational commitment. Results. High prevalence rates for perceived authoritarian (77), narcissistic (75), and unpredictable (63) leadership were reported. Increased toxicity was positively related to dominating and avoiding conflict styles but negatively related to integrating and compromising strategies. Toxic leadership is also associated with lower affective/normative commitment but higher continuance commitment. Conflict management partially mediated the leadership-commitment relationship, which explained 29 of the total effect. Finally, higher experience and education predicted greater perceived toxicity. Conclusions. The significant correlations between destructive leadership, adverse conflict, and reduced commitment in emergency nurses underscore the need for context-specific leadership training. Fostering supportive environments through multifaceted interventions can counteract toxicity impacts, impart constructive communication techniques, improve nurse well-being, and ensure high-quality patient care. As conflict tendencies and nurse characteristics influence susceptibility to detrimental leadership, tailored programs addressing experience levels are vital.

This multi-disciplinary, cross-sectional, and descriptive study investigated health care students’ face mask use knowledge, attitude, and practices (KAP) and social distancing attitudes. The study was carried out from October to December 2021 and surveyed 543 health care students selected via convenience sampling from the three Shaqra University campuses in Saudi Arabia. Standard multiple linear regressions were conducted on face mask use KAP and social distancing attitude to identify their significant associated factors. The students in this study had poor knowledge and a neutral attitude towards and modest use practices of face masks during the COVID-19 pandemic. Being female, being a nursing student, and having greater self-reported COVID-19-prevention knowledge were related to higher levels of face mask use knowledge. Having higher face mask use knowledge was linked to better attitude and practice. Knowledge of COVID-19 and its prevention and decreased COVID-19 risk perception were associated with better face mask use practices. The students had more positive than negative attitudes toward social distancing. Having known someone who was infected by the virus, lower risk perception, and better face mask use practices were associated with more positive social distancing attitudes. The findings imply the need to ensure that future health care practitioners are knowledgeable, have a positive attitude and good practices concerning face mask use, and have positive attitudes toward social distancing. The study implications are relevant for health care education in Saudi Arabia and elsewhere.

Sterile inflammation (SI) is a non-pathogen-induced inflammation where damage-associated molecular patterns (DAMPs) molecules are released from dying cells, which activate Toll-like receptors (TLRs), leading to insulin resistance (IR) and CVDs. The relationship between inflammation and IR is known. However, the role of SI molecules, that is, HMGB1 and circulating nucleic acids (CNAs), [i.e., eRNA and eDNA], in the development of IR is not known. Glucose intolerance is a fundamental clinical characteristic of metabolic syndrome, which is increasingly prevalent and causing illness globally. Hypoxia resulting from various respiratory disorders often coincides with heightened sympathetic activity, poor nitric oxide (NO) production, and insulin resistance (IR). However, the molecular mechanism remains obscure. Therefore, we hypothesized that SI molecules released during stress might impair NO production and IR. We have shown that stress induces the SI molecule (HMGB1), inhibits insulin-induced NO production, and exerts IR through von Willebrand factor (vWF). The putative vWF sequence could be used as a therapeutic drug for the treatment of IR in the future. These data may have important implications for glucose metabolism in patients with disorders characterized by stress-induced IR.