BackgroundEffective nurse–patient communication is important in improving quality of health care. However, there are several barriers to nurse–patient communication in Saudi Arabia. This is attributed to the increasing number of non-Saudi expatriate nurses providing health care to patients. In particular, there are differences in culture, religion and language among non-Saudi nurses and patients. This integrative review aims to identify and synthesize quantitative and qualitative evidence on the current practice in nurse–patient communication in Saudi Arabia and its effect on service users’ quality of care, safety and satisfaction.MethodsAn integrative review based on Whittemore and Knafl’s approach (Whittemore and Knafl, J Adv Nurs 52:546–553, 2005) was used to conduct the review. Peer-reviewed articles containing any of a series of specific key terms were identified from sources such as CINAHL, EMBASE, Medline, PubMed and PsychINFO. The review included studies that focused on nurse–patient communication issues, communication barriers, and cultural and language issues. The search was limited to papers about the Saudi Arabian health system published in English and Arabic languages between 2000 and 2018. A data extraction form was developed to extract information from included articles.ResultsTwenty papers were included in the review (Table 1). Ten papers employed quantitative methods, eight papers used qualitative methods and two used mixed methods. The review revealed two major themes: ‘current communication practices’ and ‘the effect of communication on patients’. Some of the communication practices rely on non-verbal methods due to a lack of a common language, which often results in the meaning of the communication being misinterpreted. Many non-Saudi nurses have limited knowledge about Saudi culture and experience difficulty in understanding, and in some cases respecting, the cultural and religious practices of patients. Further, limited nurse–patient communication impacts negatively on the nurse–patient relationship, which can affect patient safety and lead to poor patient satisfaction.ConclusionsCurrent nurse–patient communication practices do not meet the needs of Saudi patients due to cultural, religious and language differences between nurses and patients. The barriers to effective nurse–patient communication adversely effects patient safety and patient satisfaction. Further research from the perspective of the patient and family is needed.

Background This study aimed to examine the validity and reliability of the Arabic version of the patient-centered communication instrument. Methods A self-administered instrument was used over 4 months by 318 participants living with cancer in Saudi Arabia. The instrument contained 36 items assessing patient-centered communication (PCC-36) experiences. The PCC-36 instrument was translated into Arabic following the World Health Organization guidelines for translating instruments before undergoing psychometric evaluation. This involved confirmatory factor analysis for each of the PCC-36 functions and testing the reliability and internal consistency of the PCC-36 measures. Results The Arabic-translated PCC-36 version demonstrated a good correlation between items, with confirmatory factor analysis showing a good fit of the data (comparative fit index = 0.922, Tucker–Lewis index = 0.910, root mean square error approximation = 0.059, ${\chi ^2}$ = 1214.4, df = 579, P < 0.001). Internal consistency of the total six PCC-36 functions was confirmed by a Cronbach’s alpha of 0.97. Conclusions The study proved that the PCC-36 Arabic version is a valid and reliable instrument for the measurement of patient communication experiences in cancer care in Saudi Arabia, with similar properties to the original, and that this instrument may be used in 22 different Arab countries to measure and improve cancer patients’ communication experiences.

To evaluate through histological and histomorphometric analysis of human biopsies the guided bone regeneration (GBR) potential of allograft, xenograft, and alloplastic materials in combination with resorbable membranes in sockets following extraction.  This randomized controlled clinical trial comprised three experimental groups and one negative control group (n=8). Thirty-two patients were randomized and pos-extraction sockets received either an allograft (human cancellous bone, freeze dried, DIZG, Berlin), xenograft (BioOss; Geistlich Biomaterials, Switzerland), or alloplast (biphasic calcium sulphate, Bondbone, MIS) graft material, while sockets of the negative control group were left empty for spontaneous healing. At re-entry after three months, bone core biopsies of the treated sites were obtained using a 3.2 mm trephine drill. Bone samples were histologically processed for histomorphometric, qualitatively and quantitatively, analyses with respect to percentages of new vital bone, graft particle content, soft tissue, and bone marrow. Statistical analyses were performed through Kruskal-Wallis test, and  p -values were recalculated using Monte Carlo permutation tests ( p <0.05). All three groups presented bone volume suitable for the placement of a dental implant. The xenograft yielded significantly less amount of vital bone in comparison to the allograft and alloplast groups. Comparing the percentage of residual graft particles, there was a significantly greater amount in the xenograft group in contrast to the allograft and alloplast. Similarly, a significant amount of soft tissue (as a function of percentage) was observed within the xenograft group relative to the other groups. No significant differences were detected in the percentage of residual graft particles between the allograft and alloplast groups. Additionally, there was  no significant differences observed in vital bone percentage between the allograft, alloplast and control groups. Regarding the evaluation of bone marrow percentage, the only significant difference detected was between the xenograft and the alloplast material. All studied bone substitute materials exhibited bone apposition and adequate properties for their efficient use in alveolar ridge preservation procedures. Of the three grafting materials, allograft evidenced the greatest GBR potential with the highest percentage of vital bone and the lowest percentage of residual graft particles, while xenografts presented the lowest GBR potential after three months in vivo.

Background The patient communication experience is an important outcome measure that guides quality improvements in healthcare settings specifically in cancer care. Therefore, this study aimed to explore the patient’s communication experiences with nurses in cancer care settings. Methods Semi-structured face to face interviews were conducted with 21 participants who received cancer care at two Saudi Arabian tertiary healthcare facilities between Aug 2019 to Dec 2019. The study used a qualitative descriptive design. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data using six stages of Braun and Clarke. Results Four major themes were identified and a total of eleven sub-themes. The major themes were; (1) The importance of patient-nurse relationships, (2) Providing appropriate information to patients, (3) Responding to patients emotional needs and (4) Verbal communication between nurses and cancer patients. Conclusions Some participants felt that their communication with nurses was limited, but generally, most felt that communication was acceptable irrespective of barriers such as language, culture, religion, gender, workload and healthcare preferences. Participants drew a comparison between Saudi and non-Saudi nurses as well as between nurses and doctors communication skills. They felt that Saudi nurses had good communication skills, but non-Saudi nurses were more competent in some aspects such as kindness, politeness, respectful and non-verbal communication. They also felt that doctors were more accurate in their information than nurses.