Cognitive behavioural therapy (CBT) is one of the best-evidenced psychosocial interventions for psychosis and is recommended by the National Institute for Health and Care Excellence and the American Psychiatric Association. CBT was developed and derived from Western cultural values, which may not be appropriate for non-Western cultures. Trials of CBT in Western countries have indicated that participants from ethnic minority groups demonstrate low rates of engagement, retention, and recruitment. This indicates that the principles underlying CBT may conflict with individual beliefs and cultural values in non-Western countries. Therefore, we interviewed 15 people diagnosed with schizophrenia and 15 with their family members to explore the beliefs and attitudes of people diagnosed with schizophrenia and their family members concerning the proposed CBT intervention for psychosis in the Saudi context. The findings revealed that most participants accepted the proposed intervention. Important factors that influenced participants’ engagement and motivation in the CBT intervention were related to the therapist’s qualities (sex, empathy, and competence), family involvement, religion, and the number and format of CBT sessions for psychosis. Key learning aims: (1) To explore the beliefs and attitudes of people diagnosed with schizophrenia concerning the proposed CBT intervention for psychosis and how to improve it to make it more appropriate for their needs and cultures. (2) To explore the beliefs and attitudes of family members of people diagnosed with schizophrenia concerning the proposed CBT intervention for psychosis and how to improve it to make it more appropriate to their needs and culture.

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: 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.

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.

Background: Theoretical frameworks are essential for understanding and predicting medication adherence behaviours. The Theory of Planned Behaviour (TPB) posits that behavioural intentions, shaped by attitudes, subjective norms, and perceived behavioural control, are the proximal determinants of behaviour. This cross-sectional study examined associations between TPB constructs and antiplatelet medication adherence among Saudi patients following percutaneous coronary intervention (PCI). Methods: A cross-sectional survey was conducted among 236 Saudi adults post-PCI at two tertiary cardiac centres in Riyadh. TPB constructs (attitude, subjective norms, perceived behavioural control, intention) were assessed using a validated questionnaire. Adherence was measured via the Morisky Medication Adherence Scale-8 (MMAS-8). Hierarchical multiple regression examined associations between TPB constructs and adherence, controlling for demographic and clinical variables. Results: The results demonstrated significant associations with adherence. In the final regression model, intention (β = 0.273, p < 0.001), perceived behavioural control (β = 0.189, p = 0.007), and subjective norms (β = 0.142, p = 0.038) were significantly associated with adherence. Attitude was not significantly associated (β = 0.087, p = 0.194). The TPB constructs explained an additional 18.7% of variance in adherence beyond demographic and clinical factors. Conclusions: The TPB provides a useful framework for understanding antiplatelet adherence patterns in Saudi post-PCI patients. These findings suggest that interventions addressing behavioural intentions, perceived control over medication-taking, and normative influences from significant others may potentially enhance adherence outcomes. Theory-informed nurse-led interventions incorporating strategies such as implementation intentions and family involvement are recommended.

Background: Lifestyle behaviours and medication adherence are interrelated components of cardiovascular secondary prevention, yet their co-occurrence in Middle Eastern post-percutaneous coronary intervention (PCI) populations remains poorly characterised. This study described smoking status and physical activity patterns, assessed antiplatelet medication adherence, and explored associations between lifestyle factors and adherence among Saudi patients following 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 on smoking status, cigarette consumption, self-reported physical activity frequency (defined as the frequency of engagement in regular exercise such as walking, swimming, or other structured physical activity), and self-reported medication adherence measured via the Morisky Medication Adherence Scale-8 (MMAS-8). Descriptive statistics characterised lifestyle and adherence patterns. Bivariate analyses (chi-square tests) and multivariate binary logistic regression were used to explore associations between lifestyle factors and adherence, adjusting for comorbidities including hypertension, diabetes mellitus, arthritis, and heart disease. Results: Participants were predominantly male (73.7%) and older adults (83.9% aged >50 years). Smoking prevalence was 23.3% (n = 55 of 236 participants), and physical inactivity was highly prevalent, with 57.2% of the sample (n = 135) reporting never engaging in regular exercise. Adherence was suboptimal, with 55.4% of participants (n = 129) classified as having low adherence (self-reported, measured via the MMAS-8). In multivariate analysis, arthritis was the only statistically significant predictor of adherence (adjusted odds ratio [AOR] = 2.81, 95% confidence interval [CI]: 1.01–7.84, p = 0.048; note, however, that this finding does not survive Bonferroni correction for multiple comparisons and should be interpreted as hypothesis-generating). Smoking (AOR = 0.52, 95% CI: 0.19–1.45, p = 0.213) and physical inactivity (AOR = 0.45, 95% CI: 0.09–2.25, p = 0.332) showed inverse but statistically non-significant trends with adherence. Conclusions: Unhealthy lifestyle behaviours and low medication adherence were each highly prevalent and co-occurred in this post-PCI population, though associations between lifestyle factors and adherence were not statistically confirmed except for arthritis. These descriptive findings are hypothesis-generating and provide a rationale for future adequately powered prospective studies and trials evaluating integrated nursing interventions that simultaneously address smoking, physical inactivity, and medication non-adherence in Saudi cardiac care settings.