Background/Objectives: Artificial intelligence (AI) is increasingly integrated into healthcare decision-making. Public trust in AI remains a critical determinant of its acceptance and effective use. Evidence on the factors shaping trust in AI within Middle Eastern contexts, particularly Saudi Arabia, remains limited. Therefore, we aimed to identify the determinants of trust in AI for health-related decision-making and to examine a theory-informed mediation pathway in which patient satisfaction mediates the association between patient–doctor relationships and trust in AI. Methods: We conducted a cross-sectional, facility-based survey of adults in Saudi Arabia, using an electronic questionnaire distributed in four primary healthcare centers. We performed multiple linear regression to assess the association of trust in AI for health-related decision-making with patient satisfaction, patient–doctor relationships, sociodemographic characteristics, and healthcare-related factors. A mediation analysis was also employed to evaluate the indirect and direct association linking patient–doctor relationships, patient satisfaction, and trust in AI. Results: Our findings showed that patient satisfaction was positively associated with trust in AI (β = 0.54, 95% CI: 0.18–0.90), while patient–doctor relationships showed an inverse association (β = −0.34, 95% CI: −0.48 to −0.20), possibly reflecting a greater reliance on physicians’ clinical judgment and a reduced perceived need for AI-supported decision-making. Trust in AI varied across age groups, with a lower trust observed in older age categories compared with younger adults. No strong associations were observed for sex, education, body mass index, or healthcare-related factors. Patient–doctor relationship quality was indirectly associated with trust in AI via patient satisfaction (ACME = 0.138, 95% CI: 0.043–0.246), alongside a direct association with trust in AI (ADE = −0.313, 95% CI: −0.456 to −0.160). This means that patient–doctor relationships influenced trust in AI both directly and indirectly through patient satisfaction, suggesting that, while interpersonal care may reduce the reliance on AI (direct effect), enhancing patient satisfaction can partially offset this effect and promote trust in AI (indirect effect). Conclusions: These findings highlight that fostering patient-centered care and satisfaction may be crucial for promoting public trust in AI, which has important implications for AI governance, ethical deployment, and the design of AI-supported healthcare systems.

Background: Psychological stress is a common concern among university students, which is also pronounced among nursing students due to the academic and clinical demands of their training. Persistent stress can negatively affect students’ mental well-being, academic performance, and professional development. Social support has been identified as an important protective factor. However, evidence on the relationship between perceived social support and stress among nursing students in Middle Eastern educational contexts remains limited. Methods: A cross-sectional survey was conducted among nursing students. The survey included the Multidimensional Scale of Perceived Social Support (MSPSS) and the 10-item Perceived Stress Scale (PSS-10), along with sociodemographic and academic characteristics. Multivariable linear regression was used to examine the association between perceived social support and perceived stress after adjusting for age group, sex, program type, living arrangement, and employment status. Differences in stress across levels of social support were also examined using analysis of variance (ANOVA). Results: A total of 182 nursing students participated in the study. The mean perceived social support score was 4.95 (SD = 1.42), while the mean perceived stress score was 15.49 (SD = 2.82). We found that higher perceived social support was significantly associated with lower perceived stress (β = −1.9, 95% CI: −3.4 to −0.44), indicating that a one-point increase in the MSPSS score was associated with a 1.9-point decrease in perceived stress. Other sociodemographic factors were not significantly associated with stress. ANOVA indicated significant differences in stress across social support levels (F(2,179) = 6.91, p = 0.001). Conclusions: Perceived social support was significantly associated with lower levels of perceived stress among nursing students. These findings highlight the potential importance of strengthening supportive social environments to promote psychological well-being in nursing education.

Background: Quality of life (QoL) among university students is an important indicator of overall health and academic success. Although these factors are interrelated, few studies have simultaneously examined their structural associations with QoL among university students in Saudi Arabia. This study investigated the associations among demographic characteristics, lifestyle behaviors, psychological distress, and quality of life using structural equation modeling (SEM). Methods: We conducted a cross-sectional study among undergraduate students enrolled in public universities in Riyadh, Saudi Arabia. The survey included demographic characteristics, the Depression Anxiety Stress Scale-21 (DASS-21), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and measures of sleep quality, sleep duration, and physical activity. Confirmatory factor analysis was performed to evaluate the measurement model. We fitted SEM to examine associations among demographic characteristics, lifestyle behaviors, health status, and quality of life. Results: A total of 198 undergraduate students were included in the analysis. The measurement model demonstrated satisfactory psychometric properties. The SEM demonstrated acceptable model fit (χ²/df = 2.00, Comparative Fit Index = 0.937, Tucker–Lewis Index = 0.914, Root Mean Square Error of Approximation = 0.071, Standardized Root Mean Square Residual = 0.070). Male students reported poorer sleep quality (β = −0.405, p < 0.001), shorter sleep duration (β = −0.208, p = 0.019), and lower physical activity (β = −0.299, p < 0.001) than female students. Students with a GPA of 4.50 or above reported higher physical activity than those with lower GPAs (β = 0.182, p = 0.027). Better sleep quality (β = 0.169, p = 0.024) and very good or excellent self-rated health (β = 0.492, p < 0.001) were positively associated with quality of life, whereas sleep duration was not significantly associated with quality of life (p = 0.225). Conclusions: Quality of life among undergraduate students was associated with multiple interconnected demographic and lifestyle factors. Our findings highlight the importance of integrated university health-promotion strategies that simultaneously address sleep health, healthy lifestyle behaviors, and psychological well-being to improve students’ overall quality of life. Longitudinal studies should be conducted to clarify the temporal relationships among these factors.

Background: Religious coping is an important psychosocial resource that may influence how individuals adapt to chronic illnesses and engage in health-related behaviors. While studies have associated religion with the effective management of diabetes, the involvement of religious coping, both positive and negative, in the self-care of diabetic patients has been underexplored. The aim of this study was to quantify the association of religious coping with diabetes self-care among adults in Saudi Arabia. Methods: We used a cross-sectional study among 413 adults with diabetes. Positive and negative religious coping were assessed using the Brief Religious Coping Scale (Brief RCOPE), and diabetes self-care was measured using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. Multivariable linear regression models were used to examine associations between religious coping and diabetes self-care after adjustment for sociodemographic and clinical characteristics. We also used quantile regression to assess whether associations varied across the distribution of diabetes self-care scores. Results: The finding showed that positive religious coping was significantly and positively associated with diabetes self-care (β = 0.44, 95% CI: 0.18 to 0.70), while negative religious coping did not show significant association (β = 0.04, 95% CI: −0.13 to 0.22). Quantile regression analyses demonstrated significant positive associations between positive religious coping and diabetes self-care at the 25th percentile (β = 0.41, 95% CI: 0.10 to 0.73), 50th percentile (β = 0.50, 95% CI: 0.11 to 0.89), and 75th percentile (β = 0.48, 95% CI: 0.03 to 0.92), with the strongest association observed at the 90th percentile (β = 0.95, 95% CI: 0.42 to 1.48). Negative religious coping was not significantly associated with self-care at any quantile. Conclusions: Our finding showed significant association between positive religious coping and diabetes self-care, whereas negative religious coping showed no significant association. The findings suggest that positive religious coping may represent an important psychosocial resource associated with diabetes self-care. Future longitudinal studies incorporating objective clinical outcomes are needed to further examine the role of religious coping in diabetes management.

Background: Internet Gaming Disorder (IGD) is a growing mental health concern among university students, often linked to impulsivity and low resilience. However, traditional regression-based research often fails to evaluate latent measurement structures or simultaneously test indirect pathways within a single analytic framework. This study applied structural equation modeling (SEM) to examine the direct and indirect associations between impulsivity, resilience, and IGD symptom severity among Saudi university students, evaluating resilience as a potential mediator and testing measurement equivalence across sex. Methods: Data from 207 students (58.9% male) were analyzed using the lavaan package in R. Confirmatory factor analysis (CFA) evaluated the measurement model for the IGDS9-SF, CD-RISC-10, and S-UPPS-P. Structural paths were tested with indirect effects estimated via bootstrapping (5000 resamples), alongside multi-group invariance testing to examine equivalence across sex. Results: The measurement model demonstrated acceptable fit (CFI = 0.93, TLI = 0.91, RMSEA = 0.058 [90% CI: 0.044, 0.069], SRMR = 0.063). Significant direct associations were observed: impulsivity with IGD severity (β = 0.38, p < 0.001) and resilience with IGD severity (β = −0.26, p < 0.001). The bootstrapped indirect association of impulsivity with IGD through resilience was statistically significant (β = 0.083, 95% CI [0.031, 0.149]), consistent with partial mediation in this cross-sectional sample. Factor loadings were equivalent across sex (metric invariance supported); the impulsivity–IGD association was stronger in males (β = 0.46) than females (β = 0.27; χ²(1) = 4.65, p = 0.031), though this comparison should be treated as preliminary. Conclusions: Impulsivity was associated with IGD both directly and indirectly through lower resilience. These SEM-based findings are consistent with resilience as a partial mediator of the impulsivity–IGD association, suggesting potential value in multi-target mental health interventions in university nursing and counseling settings. Longitudinal research is needed to establish causal ordering.

Background: Effective nurse–patient communication is fundamental to quality care delivery, yet language barriers pose significant challenges in multicultural healthcare environments. In Saudi Arabia’s diverse healthcare landscape, nurses frequently encounter patients who do not speak Arabic, potentially compromising care quality and patient safety. Objective: To explore multilevel factors influencing communication between Saudi nurses and non-Arabic-speaking patients, using Bronfenbrenner’s ecological systems theory as a conceptual framework. Design: A qualitative descriptive study employing semi-structured interviews analyzed through reflexive thematic analysis. Setting: Four healthcare facilities (two governmental and two private hospitals) across Saudi Arabia. Participants: Eighteen Saudi registered nurses with experience caring for non-Arabic-speaking patients, recruited through purposive sampling. Methods: Semi-structured interviews (n = 18) were conducted in Arabic or English between November 2025 and February 2026. Data were analyzed using Braun and Clarke’s reflexive thematic analysis, organized within Bronfenbrenner’s ecological levels. Collaborative reflexive coding and member-checking with six participants supported analytical rigor. Results: Five main themes emerged: (1) Individual-level competencies and preparedness (microsystem), (2) Interpersonal dynamics and cultural sensitivity (microsystem), (3) Unit-level resources and organizational support (mesosystem), (4) Institutional policies and language services (exosystem), and (5) Healthcare system and societal influences (macrosystem). Participants identified language proficiency gaps, cultural misunderstandings, inadequate interpreter services, and systemic barriers as primary challenges affecting communication quality. Conclusions: Communication between Saudi nurses and non-Arabic-speaking patients is influenced by complex, interconnected factors across multiple ecological levels. Interventions should address individual competency development, organizational support systems, and policy-level changes to ensure equitable, safe, and effective communication for all patients.