Purpose: This paper aims to evaluate the psychometric properties of the “rater” version of the Authentic Leadership Questionnaire in nursing practice within the context of Saudi Arabia. Design/methodology/approach: The analysis of the psychometric properties of Avolio et al.’s Authentic Leadership Questionnaire (2007). This version of the Authentic Leadership Questionnaire was in the English language. A convenience sampling method was used to obtain data from 215 Saudi early career nurses working at public hospitals affiliated with the Ministry of Health in Saudi Arabia. Data analysis included assessing internal consistency (Cronbach’s alpha) analysis and the exploratory factor analysis using the Statistical Package for Social Sciences version. Face and content validity were evaluated using a content validity index, and Mplus was also used to assess the factor structure of the Authentic Leadership Questionnaire by conducting confirmatory factors analysis. Findings: The results of psychometric testing of the Authentic Leadership Questionnaire provide initial support for the content and construct validity and internal reliability of the instrument among early career nurses in Saudi Arabia. Originality/value: The results supported that the 16 items of the rater’s version of the Authentic Leadership Questionnaire measure nurses’ perceptions of the authentic leadership of their leaders. The psychometric properties of the Authentic Leadership Questionnaire yield a valuable contribution to empirical research within the nursing population. The results of this study suggest that the Authentic Leadership Questionnaire will be useful for health service researchers and nursing leaders seeking to understand and capture authentic leadership qualities in Saudi Arabia.

The therapeutic relationships-form of the nurse-patient-relationship are formed within short durations to address patient care needs quickly and effectively, as well as psychosocial support for family or friends. The purpose of this paper is to focus on challenges that nurses can experience when trying to establish therapeutic relationships with their patients when they are in their communications due to cultural, religious or language challenges. Databases such as PubMed, Scopus, and ProQuest, were used to obtain a comprehensive overview of the literature. The synthesis of the articles grouped together to identify common patterns or themes. The data was integrated into the therapeutic relationship and its elements. The disparities between nurses and their patients may hinder nurses’ abilities to establish a therapeutic nurse-patient relationship with their Saudi patients and families. This interruption in creating such relationships may lead to a decrease in the quality of care. Effective communication seems to be associated with the intimacy of the relationship, which creates a sense of trust. A nurse’s empathy that balances power between both parties provides a perception of respect for the patients. Pre-departure education programs may help expatriate nurses learn about the culture of their hosts prior to their arrival in that country. These programs should provide opportunities for expatriate nurses to learn about, discuss and explore how to ‘fit into’ these cultural practices. Mentoring programs that electronically connect previous nurses who worked in the host country with new recruits in that country should be provided. Thus, the recruited nurses can benefit from their colleagues' experiences and have a more realistic view of what working in that host country is like. This review will help to raise leaders’ awareness about the challenges experienced by expatriate nurses who deliver care to patients with divergent belief systems than their own.

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.

Background: Menstrual hygiene management (MHM) is a vital aspect of adolescent girls’ health and well-being. However, in many Gulf countries, including Saudi Arabia, this issue has received less attention because of cultural taboos, misconceptions, and a lack of knowledge about factors affecting menstrual hygiene practices. Thus, it is crucial to promote adolescent health and develop effective school-based interventions. Aim of the Study: Our aim was to assess menstrual hygiene practices and their determinants among adolescent girls in secondary schools in Bisha, Saudi Arabia. Methods: A cross-sectional descriptive approach was used to study 320 female secondary school students in Bisha City, southwestern Saudi Arabia. Sample: The subjects were selected by using a stratified random sampling procedure. Information was obtained using a previously validated and culturally sensitive self-administered questionnaire on knowledge and menstrual hygiene. Descriptive statistics, chi-square tests, and binary logistic regression analyses were conducted to determine factors associated with good menstrual hygiene practices. Results: A total of 320 adolescent girls participated, of whom 53.8% demonstrated good menstrual hygiene practices. In the multivariable analysis, independent predictors of good practices were increased age (AOR = 2.69, 95% CI:1.59–4.56), urban residency (AOR = 2.62, 95% CI: 1.46–4.69), and good menstrual knowledge (AOR = 2.13, 95%CI: 1.24–3.67). Maternal primary education (AOR = 8.033, CI: 1.44–44.99) and maternal employment in the government sector (AOR = 7.346, CI: 2.29–23.54) also showed strong positive associations with good menstrual hygiene practices. Conversely, experiencing menarche after age 12 was associated with lower odds of good menstrual hygiene (AOR = 0.49). Conclusions: Although a good proportion of girls practiced adequate menstrual hygiene, major knowledge and behavior gaps persist. Providing strong menstrual education in schools and through community-based efforts is critical for supporting the health of adolescent girls and promoting menstrual equity in Saudi Arabia.

Patient safety is a major priority in intensive care units (ICUs), particularly among mechanically ventilated patients receiving intravenous sedation. Alth