Introduction: Healthcare providers’ understanding of how self-efficacy and social support affect medication adherence and depression in dialysis patients can lead to holistic interventions and improve outcomes. This study aimed to investigate how self-efficacy and social support indirectly influence the relationship between medication adherence and depressive symptoms in patients with chronic kidney disease (CKD) undergoing dialysis. Methods: We employed a cross-sectional observational study design with 668 CKD patients from outpatient departments (OPDs) and dialysis centers in the Hail region of Saudi Arabia. The data were collected between April and May 2024. Results: The participants had a relatively high level of self-efficacy (median = 82.00/100) and greater perception of social support (median = 75.500/84) with minimal to mild depressive symptoms (median = 15.00/63); however, 50% of participants scored ≥ 5 (out of 10) on the level of adherence to their medication regimen. Depression was prevalent, with a mean score of 5.03 on the PHQ-9 scale, and was positively correlated with nonadherence. Social support and self-efficacy were negatively correlated with depression, and both partially mediated the link between depression and non-adherence. Conclusions: This study found that, despite high social support and self-efficacy, a significant number of patients with CKD on dialysis exhibited medication non-adherence. Depression has emerged as a key factor influencing adherence, even in the presence of social support and self-efficacy. These findings suggest that depression is crucial for CKD management. Healthcare providers, owing to their frequent interactions with patients with CKD, are ideally placed to screen for depression and incorporate management strategies into patient care plans. By addressing both the biological and psychological aspects of CKD, they can empower patients to take a more active role in their treatment, ultimately leading to improved health outcomes.

Aim: To examine breast cancer perception, health-promoting lifestyle behaviours, and screening practices, and their sociodemographic and psychosocial correlates, among women in Abha, Saudi Arabia. Methods: A cross-sectional survey of 1,002 women aged ≥18 years in Abha (May–December 2025), recruited online through social media and instant messaging. Validated Arabic versions of the Breast Cancer Perception Scale (BCPS) and HPLP-II were self-administered online, with self-reported breast self-examination (BSE), clinical breast examination (CBE), and mammography history. Multiple linear regression identified predictors of HPLP-II and BCPS scores. Results: Perceived knowledge (3.64 ± 1.05), treatment belief (3.43 ± 0.77), fear (3.25 ± 1.30), and perceived risk (3.40 ± 0.89) were moderately high; perceived need for health checks (2.78 ± 1.23) and stigma (2.89 ± 1.14) were lower. HPLP-II mean was 2.63 ± 0.46 (spiritual growth highest 2.96 ± 0.50; physical ac-tivity lowest 2.23 ± 0.60). Ever-screening: BSE 61.1% (95% CI 58.1–64.1), CBE 22.5% (95% CI 20.0–25.1), mammography 12.8% (95% CI 10.8–14.8). Perceived knowledge (β = 0.059), treatment belief (β = 0.120), and stigma (β = 0.058) were positively, and perceived need for health checks (β = −0.259), perceived risk (β = −0.130), and fear (β = −0.028) negatively, associated with HPLP-II. Married women had higher lifestyle and perception scores; more educated and publicly employed women had higher perception scores. Conclusion: Despite moderately high perceived knowledge, clinical screening particularly mammography remains very low, and physical activity, a modifiable breast cancer risk factor, is the weakest lifestyle do-main. Awareness alone does not translate into screening; interventions should address fear and symptom-contingent care-seeking, embed screening referral in primary care, involve families, and promote culturally appropriate physical activity.

Introduction: This cross-sectional study examined associations between Social Media Use (SMU), Body Shape Concern (BSC), and Self-Esteem (SE) among Saudi student nurses. We assessed demographic differences in these variables and tested whether SE moderated the SMU–BSC relationship. Methods: We conducted a cross-sectional correlational study with 324 student nurses recruited through convenience sampling at King Khalid University. Data were collected via Google Form between January and February 2025 using the SMU Questionnaire, BSQ-8A, and Rosenberg Self-Esteem Scale. Results: Higher SMU and greater BSC were each associated with lower self-esteem (ρ = −0.334 and −0.492, p < 0.001, shared variance = 11.2% and 24.2%). SMU and BSC were positively correlated (ρ = 0.393, p < 0.001). Female students reported marginally higher SMU and BSC than males, but effect sizes were negligible (Cohen’s d = 0.07 and 0.02). Second-year students scored highest across all three variables, with small effect sizes (η² = 0.02–0.03). SE did not moderate the SMU–BSC relationship (interaction term: p = 0.113), though both SMU and SE independently predicted BSC. Conclusions: Among Saudi student nurses, higher social media use and greater body shape concern were associated with lower self-esteem. Female and second-year students showed marginally higher scores, though effects were small. Contrary to the vulnerability-stress hypothesis, self-esteem did not moderate the social media–body concern relationship. Interventions may need to combine media literacy with self-esteem enhancement rather than relying on self-esteem approaches alone.

Academic success among nursing students is vital for developing the professional skills necessary to ensure the safety and quality of patient care. This study examines the relationship between learning approaches (Deep, Strategic, and Surface), achievement motivation, and academic performance among nursing students. This study employed a sample of 770 participants, balanced by country (n = 110 per country) but not by year of study. With 110 nursing students recruited from each of the seven participating countries through a multi-phase process designed to ensure cross-national data integrity. The research was conducted across seven different countries: Egypt, India, Indonesia, Jordan, Oman, Saudi Arabia, and Sudan. The Approaches and Study Skills Inventory for Students, Achievement Motivation Scale and academic performance tools were adopted in this study to assess the study approaches, achievement motivation and academic performance of the nursing students respectively. Deep learning (DL) was found to be the strongest positive factor (p < .001) for predicting high achievement, each unit increase in DL is associated with an 8.7% increase in the odds of being a high achiever (OR = 1.087), not the probability. Conversely, surface learning (OR = 0.864) and marital status (OR = 0.124) were significant negative factors; each increased the likelihood of an individual achieving a lower level of academic achievement. Deep learning and the active cognitive search for meaning have a significant association with academic success for nursing students. This shows that deep learning is significantly more important than achievement motivation or SL. However, a "pedagogical gap" exists as engagement in all three types of learning declines during the last year, demonstrating that maintaining deep engagement is the most important, yet most at-risk, factor for achieving excellence in both clinical and academic practice.

Introduction: This study explores how students develop, negotiate and represent their mental health alongside their professional identities. The aim is to understand how nursing students construct and negotiate their mental health identities in academic and clinical environments. Method: Using Interpretative Phenomenological Analysis (IPA), this qualitative research employed nine nursing students enrolled in the Bachelor of Science in Nursing (BSN) programme at King Khalid University in Saudi Arabia. Semi-structured interviews were conducted in Arabic, the participants’ native language, and professionally translated to English for analysis. Interviews were analyzed using a six-stage IPA protocol and an integrated coding framework operationalizing concept from Social Identity Theory, Symbolic Interactionism, and Identity Negotiation Theory. Results: The data led to five themes: (1) Navigating the Stigma Boundary: The ‘tough nurse’ imperative, strategic silence or selective disclosure as identity management. (2) Developing the ‘Mental Health’ Label: Repertoires and levels of surveillance/monitoring. (3) The Clinical–Classroom Divide: Contexts affecting identity performance and role transitions. (4) Help-Seeking as Identity Betrayal: The cost to identity of seeking formal help and preference for informal support. (5) Reconciling Personal and Professional Identities: Future self-prototype construction, divergent personal–professional developments, and post-trauma story-telling. Conclusion: Nursing students’ mental health identities are socially constructed and strategically negotiated across contexts. This multi-theoretical model advances understanding beyond deficit-oriented frameworks, showing that help-seeking is limited by identity barriers.

Background: Returning to work after childbirth is one of the major factors leading to early cessation of breastfeeding. Article 154 of the Saudi Labor Law gives employed nursing mothers the right to a daily breastfeeding break. However, little information is available regarding employed mothers’ experiences of returning to work while breastfeeding. To date, no qualitative studies have examined this transition experience among employed mothers in Hail City. Methods: This study employed a qualitative descriptive phenomenological design based on Husserl’s transcendental phenomenology and Colaizzi’s seven-step model. The researchers recruited 13 breastfeeding mothers (aged 27 to 32 years), who worked in various sectors such as government, education, healthcare, and private sectors, via purposeful and snowballing methods. Interviews were carried out face-to-face in Arabic, lasted approximately 30 to 50 min, and occurred one to eight months after the mothers returned to work. Saturation was reached when three consecutive interviews did not produce any new code or theme. All interviews were audiotaped and transcribed verbatim in Arabic and translated into English, with the translation verified by a bilingual researcher who cross-checked a random sample of transcripts against the original Arabic audio recordings to ensure conceptual and linguistic accuracy. Data analysis was completed using Colaizzi’s seven steps, with NVivo software used only to manage the data. Trustworthiness was established using Lincoln and Guba’s criteria, including member checking, triangulation of sources, thick description, maintenance of an audit trail, and reflexive bracketing. Five of the 13 mothers reviewed and confirmed the summary of findings during member checking. Results: Five themes described the essential structure of the experience: (1) return anticipation, preparation, and quiet resolve; (2) the workplace as an unaccommodating space, with twelve of thirteen mothers lacking a lactation room, and most reporting no protected time and no safe milk storage; (3) the gulf between the law on paper and the law in practice: only two mothers knew of their Article 154 entitlement, and in participants’ accounts access rested on informal arrangements with supervisors rather than on stated workplace policy; (4) straddling two worlds, the guilt, anxiety, and divided identity of performing maternal and professional roles at the same time; and (5) circles of support, with family help, coworker solidarity, and personal determination described as key facilitators. Taken together, the accounts of the participants in this sample pointed to a fundamental structure of solitary negotiation. Mothers continued breastfeeding largely through personal and family effort, with little institutional support available to them. Conclusions: In this sample of employed mothers in Hail City, breastfeeding after return to work was sustained largely through personal and family effort rather than enforceable rights. These findings are specific to one city and one group of mothers, so they may not apply to other settings. They still point to the possible value of enforcing and raising awareness of Article 154, providing workplace lactation facilities, training supervisors, and offering anticipatory breastfeeding counseling during maternity leave.