BACKGROUND No study has examined the stress level and coping strategies among critical care nurses in Saudi Arabia. OBJECTIVES Examine perceived stress and coping behaviors among nurses in intensive care units in Saudi Arabia, and the influence of coping mechanisms on stress. DESIGN Descriptive cross-sectional. SETTING Two tertiary training hospitals in Riyadh, Saudi Arabia. SUBJECTS AND METHODS Nurses from cardiac, surgery and pediatric intensive care units responded to an online survey. Perceived Stress Scale-10 (PSS-10) and the Brief COPE Inventory were used as primary research tools. Multivariate methods were used to analyze the data. MAIN OUTCOME MEASURES Stress levels, coping strategies, and associated factors. SAMPLE SIZE 154 nurses. RESULTS The majority of the respondents reported a moderate level of stress in the past month (87.0%). Mean (SD) scores for nurses working in the cardiac ICU indicated significantly higher levels of stress compared to surgical ICU (18.18 [3.88] vs 6.17 [3.21], P =.025). Belief in religion was the most common coping behavior while the use of substances was the lowest (mean scores [SD] 6.70 [ 1.72] vs 2.22 [0.81]). In the multivariate analysis, behavioral disengagement ( P =.016) and self-blame ( P <.001) intensified the PSS-10 score, whereas acceptance ( P =.048) reduced the PSS-10 score. CONCLUSION The additional knowledge that behavioral disengagement and blaming aggravate stress can serve as the basis in formulating work-related stress reduction strategies among nurses caring for critical patients. LIMITATIONS The use of self-reports, convenience sampling, and selected demographic factors may have limited the scope and generalizability of the findings and induced social desirability bias.

Aims and Objectives To investigate the workplace incivility of nurses working in two Saudi hospitals and analyse its influence on the nurses’ professional quality of life (ProQOL). Background The prevalence and economic impact of workplace incivility cannot be overstated and disregarded. To the current authors’ knowledge, no extensive study on this topic has been conducted in Saudi Arabia. The influence of workplace incivility to ProQOL of nurses from different cultural backgrounds has never been thoroughly investigated. Design Descriptive, cross‐sectional design. Methods A sample of 378 nurses working in two government hospitals in Saudi Arabia were surveyed using the Nursing Incivility Scale and the ProQOL Scale version 5 from February to May 2018. A multivariate multiple regression analysis was conducted to analyse the multivariate effect of workplace incivility on the nurses’ ProQOL. The study adhered to the STROBE guideline (See Supporting Information File 1). Results The nurses perceived a moderate level of workplace incivility from the different sources of uncivil acts measured in this study. Among the five sources of incivility explored in this study, the nurses reported the majority of workplace incivility experienced from patients/visitors (M = 2.44, SD = 0.80), while the lowest was from supervisors (M = 1.90, SD = 0.66). The mean scores of the respondents in the compassion satisfaction, burnout and secondary traumatic stress subscales were 36.50 (SD = 6.30), 26.43 (SD = 4.81) and 26.47 (SD = 6.06), respectively. General incivility, supervisor incivility, physician incivility and patient/visitor incivility showed a significant multivariate effect on the three ProQOL subscales. Conclusions Nurses’ experience of workplace civility and its sources were associated with ProQOL. Relevance to clinical practice. The findings of this study can be used as guide in establishing human resource policies towards achieving nurses’ needs, reducing workplace incivility and improving ProQOL.

Aims and objectives To examine the influence of workplace incivility on the quality of nursing care. Background Recent evidence describes workplace incivility as a serious concern in the healthcare setting worldwide. Exposure to workplace incivility can alter a nurse's behaviour, thought process and perspective towards the nursing profession. However, there is insufficient evidence to determine whether workplace incivility might be associated with the quality of nursing care in Saudi Arabia. Design A quantitative and cross‐sectional study. Method A survey was carried out amongst 378 nurses in two government hospitals in Saudi Arabia from February 2018–May 2018 using the Nurse Incivility and quality of nursing care scales. Multivariate multiple regression was performed to investigate the influence of the uncivil experiences of nurses from different sources on the different aspects of quality of nursing care. The study adhered to STROBE guideline (see Appendix S1). Results The overall mean of the quality of nursing care scale was 3.14 (SD = 0.66) from a scale of 1–5, with patient satisfaction receiving the highest mean dimension (mean = 3.27, SD = 0.72) and health promotion the lowest mean dimension (mean = 3.08, SD = 0.74). Experience in the present hospital and the hospital were associated with the overall quality of nursing care. General and nurse incivility exerted a multivariate effect on overall quality of nursing care and its different dimensions. Conclusion General incivility and nurse incivility were found to negatively impact quality of nursing care and its different dimensions. Relevance to clinical practice Stronger policies geared towards eliminating workplace incivility should be implemented as uncivil acts can lead to poor quality of nursing care. Nurse administrators and nurses should be pro‐active in recognising, preventing, approaching, reporting and intervening with uncivil acts in the hospital to protect these workers from these types of behaviours and avoid their negative impacts on patient care.

Aims: This study examined the predictors of student nurses' intention to vaccinate against COVID-19. We measured the nursing students' risk perceptions, anxiety, fears and beliefs on COVID-19 vaccine; attitudes towards it and vaccine literacy (VL).Design: This study is a multi-university study utilizing the quantitative, cross-sectional and predictive approach.Methods: Using convenience sampling (n = 1170), we surveyed 10 Saudi universities from November 26, 2020, to December 31, 2020. Forward stepwise multinomial logistic regression was performed in identifying the factors predicting student nurses' intention to vaccinate against COVID-19. Results:The overall mean in the risk perception, anxiety and fear was 9.59 (SD = 2.82, possible range = 1-15), 3.95 (SD = 4.77, possible range = 0-20) and 18.17 (SD = 6.65, possible range = 7-35) respectively. They also reported a mean of 29.90 (SD = 6.56, possible range = 8-40) on COVID-19 belief. COVID-19 positive and negative attitudes mean score was 3.64 (SD = 0.92) and 2.72 (SD = 0.90) in a 1-4 range of scores respectively. The functional and interactive-critical COVID-19 VL of the students were at moderate levels. More than half of the respondents (55.9%) intended to be vaccinated against COVID-19, 17.6% did not intend to do so and 26.5% were unsure. High-risk perceptions, low levels of COVID-19 anxiety, positive beliefs and attitudes towards

Aims and ObjectivesTo investigate the professional quality of life and caring behaviours among clinical nurses in Saudi Arabia during the COVID‐19 pandemic. We also examined the influence of the nurses’ socio‐demographic and professional characteristics on the professional quality of life. Moreover, the study examined the influence of professional quality of life on caring behaviour among the nurses amid the COVID‐19 pandemic.BackgroundCaring is the core of the nursing profession and considered the heart of the humanistic clinical nursing practice. However, the work nature of the clinical nurses, especially during the COVID‐19 pandemic, continues to challenge their professional quality of life and caring behaviours. The factors influencing the professional quality of life and caring behaviours of clinical nurses have not been extensively explored.DesignCross‐sectional, descriptive study.MethodsA purposive sample of 375 clinical nurses in three academic medical centres in Saudi Arabia were surveyed using the professional quality of life version 5 and the short‐form 24‐item Caring Behavior Inventory from May–August 2020. A standard multiple regression analysis was performed to investigate the predictors of the professional quality of life and caring behaviour. This study adhered to the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.ResultsThe majority of the respondents reported average level of compassion satisfaction (57.9%), burnout (54.4%) and secondary traumatic stress (66.9%) in the professional quality of life domains. The result also showed highest degree of caring in terms of ‘assurance of human presence’ while lowest in the ‘knowledge and skills’ in four subscales of caring behaviour. The following variables significantly predicted compassion satisfaction: education, area of assignment and position. Age, education and religion were identified as significant predictors of burnout while religion, nationality and position were significant predictors of secondary traumatic stress. Positive and negative domains of professional quality of life influenced the caring behaviours among clinical nurses.ConclusionsBased on the results of the study, clinical nurses exhibited moderate level of professional quality of life and correlates to their caring behaviours. Moreover, clinical nurses’ demographic characteristics predicted their professional quality of life and caring behaviours.Relevance to clinical practiceThe importance of ensuring good professional quality of life and caring behaviour among clinical nurses during the COVID‐19 pandemic is underscored. Nursing leaders can utilise this baseline evidence and apply programmes for clinical nurses to tackle professional quality of life issues and enhance caring behaviours.