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.

Background: Chronic heart failure (CHF) in older adults requires sustained self-management and close follow-up, yet day-to-day care is often carried out by families with support from primary healthcare nurses. In Saudi Arabia, where family caregiving is culturally normative, collaboration between nurses and patients’ families may be pivotal to effective CHF management, but remains insufficiently understood in primary healthcare contexts. Methods: A qualitative study informed by an interpretive phenomenological approach was conducted. Participants (n = 24; 12 nurses and 12 family caregivers) were recruited using purposive sampling from primary healthcare centers in Riyadh, Saudi Arabia. In-depth, semi-structured interviews were conducted in Arabic or English, audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis following Braun and Clarke’s six-phase framework. Strategies to enhance trustworthiness included member checking, peer debriefing, maintenance of an audit trail, and reflexive journaling. Results: Twenty-four participants (12 nurses and 12 family caregivers) were interviewed. Four interrelated themes were generated from both nurses’ and family caregivers’ accounts. (1) “We Are Caring Together”: Collaboration was experienced as shared responsibility for daily CHF management, grounded in trust; (2) Navigating Roles and Boundaries: Participants described unclear expectations, role overlap, and tension between professional authority and family knowledge; (3) Communication as the Engine of Collaboration: Effective partnerships depended on clear information exchange, caregiver-tailored education, and continuity of contact, while communication gaps created uncertainty and delayed support-seeking; and (4) Cultural and System Constraints Shaping Collaboration: Strong family obligation motivated caregiving but also intensified moral pressure and limited help-seeking, while time pressure and fragmented services constrained meaningful engagement and continuity across settings. Conclusions: Nurse–family collaboration in CHF management is relational, shaped by trust, role negotiation, and communication, and constrained by cultural norms and system pressures. This study contributes to the literature by demonstrating how moral obligation, hierarchical professional norms, and system fragmentation distinctively shape collaboration in the Saudi primary care context, extending existing conceptualizations derived primarily from Western individualist settings. Strengthening collaboration requires explicit role clarification, health literacy–informed caregiver education, continuity of contact, and organizational supports. Findings are limited by purposive sampling, single-city context, and exclusion of patient perspectives.

Background: Effective patient education is fundamental to promoting medication adherence following percutaneous coronary intervention (PCI). However, the extent and nature of educational gaps in Middle Eastern cardiac care settings remain inadequately explored. This study examined medication-related communication quality, patient knowledge gaps, and their associations with antiplatelet adherence among Saudi adults post-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 using a structured questionnaire assessing clarity of medication information (side effects, dosing, purpose), medication knowledge, and adherence measured via the Arabic Morisky Medication Adherence Scale-8 (MMAS-8). Descriptive statistics, bivariate analyses, and multivariable logistic regression examined associations between communication quality indicators, sociodemographic factors, and adherence outcomes. Results: Substantial educational deficits emerged: (1) 26.3% never received side-effect information, (2) 11.0% never learned medication purpose, and (3) 6.8% did not identify their antiplatelet medication type. Only 40.5% consistently received clear medication explanations during hospitalization. Understanding of medication instructions was inadequate, with 14.0% reporting that they never understood their instructions. Adherence was suboptimal, with 54.9% demonstrating low adherence (MMAS-8 score < 6). In adjusted logistic regression, never receiving side-effect information was associated with higher odds of low adherence (adjusted OR 2.14, 95% CI 1.18–3.89) after controlling for age, sex, education, time since PCI, diabetes, and home support. Conclusions: Significant gaps in medication education and patient–provider communication exist within Saudi cardiac care settings. These deficits represent potentially modifiable targets for nursing intervention. Structured, nurse-led educational protocols addressing medication purpose, side effects, and administration could be evaluated as strategies to enhance patient understanding and support antiplatelet adherence.

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.

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.

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.