Objectives:To summarize available peer-reviewed publications about public knowledge and awareness of diabetes mellitus (DM) among the population of Saudi Arabia.Methods:We followed the standard reporting guidelines outlined in the PRISMA statement for the preparation of this systematic review. In February 2018 we conducted literature searches of PubMed, Scopus, BIOSIS Citation Index, and Web of Science using the following keywords: “Knowledge” OR “Awareness” AND “Diabetes Mellitus” AND “Saudi Arabia.” Records were screened, and relevant studies were selected and synthesized narratively.Results:Nineteen articles are included in our systematic review. These studies included the following populations: DM patients (n=13), healthcare workers (n=3), medical students (n=1), secondary school students (n=1), and general population (n=1). Most studies found a lack of public awareness of the risk factors and complications of DM. Among medical students and healthcare workers, knowledge about the epidemiology of the disease and angle of insulin injection was deficient.Conclusion:This review highlights the need for increased knowledge and awareness of DM among the Saudi population. The means of improving knowledge and awareness of DM needs to be integrated into existing healthcare systems and processes to better inform patients, families, and communities about this chronic disease.PROSPERO REG. NO: CRD: 42018098787

Nurses with effective communication skills play a critical role in minimising the stress associated with hospitalisation for both patients and their families. Effective communication has become increasingly reported as a key component in effective health care outcomes, which is even more crucial in countries such as Saudi Arabia with a large foreign healthcare workforce. The presence of a large expatriate workforce with a different language from the host society and the ensuing complexity of sociocultural linguistic and heath beliefs systems has been poorly researched. This study aimed to investigate barriers and facilitators of nurse-patient communication in Saudi Arabia using the Nurses' Self-Administered Communication Survey. The survey was distributed to a random sample of 291 nurses working in medical and surgical departments at five hospitals in Saudi Arabia. The results indicate that the Philippine and Saudi Arabian nurses perceived greater barriers to communication with respect to personal/social characteristics, job specifications and environmental factors then nurses of other nationalities. In addition, nurses with shorter experience in Saudi Arabia perceived greater barriers to communication with respect to the clinical situation of patient and environmental factors than the nurses with longer experience. Lastly, nurses who had not attended specialist courses on communication skills acquisition perceived greater barriers to communication with respect to personal characteristics and job specifications than nurses who had attended such courses. This study highlights the need to better prepare expatriate nurses before they enter the workforce in Saudi Arabia on cultural competence and language skills.

Leaders are in best position to facilitate the changes because they are considered as change agents. Transformational leadership is defined as a leadership approach that causes changes in individuals and social systems. The purpose of this study was to determine leadership styles of nurse managers and their outcomes in government hospitals in Hail City (Saudi Arabia). The study respondents were head nurses and nurses working in 4 government hospitals. The Multifactor Leadership Questionnaire was used to measure nurse manager leadership styles as perceived by nurses and the nurse managers themselves. There were no significant differences between the perceived leadership styles of the nurse managers themselves and the perception of the nurses on the nurse managers' leadership styles (P = 0.719). When determining whether there was a significant association between the perceived leadership styles of the nurse managers and the outcomes of that leadership, the results yielded a significant (moderate) relationship between a transformational leadership style and the outcomes of leadership in terms of extra effort (P = 0.000), effectiveness (P = 0.000), and satisfaction (P = 0.000).

Aim: This study aimed to determine the relationship between the leadership styles of nurse managers and the job satisfaction of staff nurses in hospital settings in Ha'il City, Saudi Arabia. Methods: The study employed a quantitative correlational research design. The research respondents were staff nurses working under the supervision of nurse managers, who they evaluated for leadership styles, using the multifactor leadership questionnaire developed by Bass and Avolio (1992). At the same time, the staff nurses rated their job satisfaction using the work quality index questionnaire by Whitley and Putzier (1994). Purposive sampling was employed to generate samples of staff nurses from four governmental hospitals in Ha'il City. Findings: The leadership styles of nurse managers, as perceived by the staff nurses, revealed that they were often displaying transformational leadership (M = 2.88), sometimes displaying transactional leadership (M = 2.31) and occasionally displaying laissez-faire leadership (M = 1.38). The staff nurses' level of job satisfaction yielded responses of 'somewhat satisfied' for professional work environment (M = 4.78) and professional relationships (M = 4.95) and 'neutral' for autonomy (M = 4.45), work worth (M = 4.5), role enactment (M = 4.34) and benefits (M = 4.23). Transformational leadership correlated with the level of job satisfaction, and yielded an r-value of 0.258, which connoted a low correlation, with a p-value of 0.000. There was a significant relationship between the nurse managers' transformational leadership style, as perceived by the staff nurses, and the staff nurses' level of job satisfaction. This implies that, because the nurse managers often manifested transformational leadership, the staff nurses' level of job satisfaction slightly increased. Moreover, there was a significant relationship between laissez-faire leadership and level of job satisfaction (p-value of 0.006), with a correlation coefficient of ˗0.204 indicating a negative correlation between variables. Conclusion: The nurse managers displayed transformational leadership behaviour more than transactional and laissez-faire leadership styles. The staff nurse 255 respondents were somewhat satisfied with their work environment and professional relationships; however, they were unsure whether they were satisfied with factors such as autonomy, work worth, role enactment and benefits -as reflected in their neutral responses. Transformational leadership styles positively correlated with the nurses' job satisfaction.

The current investigation aims to assess the level of clinical competence and self-efficacy of fourth-year nursing students, and its relationship to the students' demographic characteristics. To achieve this, the researchers used a quantitative-comparative approach. The respondents of the study were fourth-year nursing students from the University of Hail, Kingdom of Saudi Arabia, who were identified through convenience sampling with all fourthyear students. The clinical competence questionnaire and general selfefficacy scale tools were adapted for use in the study. Descriptive statistics were used to determine the participants' demographic characteristics, level of clinical competence, and level of self-efficacy. The Pearson r test was also utilized to explore the relationship between the study variables. Both the level of clinical competency (m = 3.50, SD = 1.252) and self-efficacy (m = 3.23, SD = 0.837) of the students was high. The Pearson r test indicated no significant correlation between the students' clinical competence level and gender. However, a significant correlation was noted between the students' clinical competence level and program type, civil status, and age. No significant correlation was found between the students' self-efficacy level and gender, civil status, or age, yet a significant correlation was found between the students' self-efficacy level and program type. A significant correlation was also noted between clinical competence level and selfefficacy level. The students had high clinical and self-efficacy levels, which nursing students must display to perform acceptably within standard roles and responsibilities in clinical settings. Hence, the fourth-year nursing students had the clinical capabilities to organize and implement the necessary courses of action.