Assessing suboptimal health status in the Saudi population: Translation and validation of the SHSQ-25 questionnaire.

Background: Suboptimal Health Status (SHS) is realised as a vital feature for improving global health. However, the Arabian world does not have a validated instrument for screening SHS in their population. Therefore, the study aimed to evaluate the psychometric properties of Arabic-translated SHS (ASHSQ-25) in the Saudi Arabian population. Methods: We conducted a cross-sectional study among the conveniently sampled 1590 participants from the Saudi population (with a 97.4% response rate). The data was gathered through an online survey and then exported into SPSS and AMOS version 26.0 for analysis. Mann-Whitney and Kruskal-Wallis tests were used to identify the median difference between demographic groups. The one-tailed 90% upper limit of SHS scores was chosen as the cut-off criteria for SHS. Reliability and confirmatory analysis were performed for the psychometric evaluation of ASHSQ-25 in the Saudi Arabian context. Results: This study demonstrates that the ASHSQ-25 has good internal consistency, interclass correlation coefficient (ICC) = 0.92; 95% confidence interval (CI) = 0.91-0.93) and reliability (Cronbach's α = 0.92). The confirmatory factor analysis (CFA) results indicated a good fit of the databased on the CMIN/degrees of freedom (df) = 4.461, comparative fit index (CFI) = 0.94, Tucker Lewis index (TLI) = 0.93, and Root Mean Square Error of Approximation (RMSEA) = 0.05. The result factor loadings for each item were high (≥ 0.55), except for one item from the immune system subscale. The SHS cut-off point for ASHSQ-25 was 33, leading to a 23.7% prevalence of SHS. Conclusions: This study reveals that ASHSQ-25 has appropriate internal consistency and structural validity to assess SHS in an Arabic-speaking population; therefore, it is recommended.

Cognitive Flexibility's Role in Reducing Academic Stress During the COVID-19 Pandemic.

Background: Cognitive flexibility (CF) in the psychological literature has been described as an individual's ability to produce several solutions and retain control in novel situations. Recently, the COVID-19 pandemic appeared to be an ideal scenario that demanded the application of adaptive thinking by students to deal with several challenges of the pandemic. Aim: This study aimed to assess the role of CF in reducing academic stress among university students due to the sudden and strict implementation of online education during the COVID-19 pandemic. Methods: This study employed a cross-sectional survey design and data collection was completed during the 2020-2021 academic year. The study sample comprised 328 university students from Saudi Arabia. The online survey method was used, and study tools comprises of reliable and valid psychological measures to assess CF, academic stress, the negative impact of the COVID-19 pandemic, and emotional symptoms. IBMSPSS25 was used for statistical analysis of data. Multiple regression analysis was applied to determine the role of CF in reducing academic stress after controlling for other factors such as gender, age, academic year, negative impact of COVID-19 on daily life, and unpleasant emotional experiences. Results: CF was significantly decreased the risk of experiencing academic stress (b = ‒0.196, t = ‒3.54; p < 0.001; 95% CI = ‒3.53 to ‒0.11) after controlling for the negative impact of the COVID-19 pandemic on daily life (b = 0.119, t = 2.09; p < 0.05; 95% CI = 0.02-0.63) and emotional repercussions (b = 0.109, t = 1.91; p < 0.05; 95% CI = ‒0.01-0.15). Conclusion: The current findings suggest that CF could be fostered among university students as a useful mental tool to cope with academic stress during less-structured educational and social circumstances that may impact their daily lives and emotional wellness.

Psychometric Properties of Suboptimal Health Status Instruments: A Systematic Review.

BACKGROUND: Suboptimal health status (SHS) measurement has now been recognized as an essential construct in predictive, preventive, and personalized medicine. Currently, there are limited tools, and an ongoing debate about appropriate tools. Therefore, it is crucial to evaluate and generate conclusive evidence about the psychometric properties of available SHS tools. OBJECTIVE: This research aimed to identify and critically assess the psychometric properties of available SHS instruments and provide recommendations for their future use. METHODS: Articles were retrieved by following the guidelines of the PRISMA checklist, and the robustness of methods and evidence about the measurement properties was assessed using the adapted COSMIN checklist. The review was registered in PROSPERO. RESULTS: The systematic review identified 14 publications describing four subjective SHS measures with established psychometric properties; these included the Suboptimal Health Status Questionnaire-25 (SHSQ-25), Sub-health Measurement Scale Version 1.0 (SHMS V1.0), Multidimensional Sub-health Questionnaire of Adolescents (MSQA), and the Sub-Health Self-Rating Scale (SSS). Most studies were conducted in China and reported three reliability indices: (1) the internal consistency measured by Cronbach's α value ranged between 0.70 and 0.96; (2) the test-retest reliability; and (3) the split-half reliability coefficient values ranged between 0.64 and 0.98, and between 0.83 and 0.96, respectively. For the values of validity coefficients in the case of SHSQ-25 > 0.71, the SHMS-1.0 ranged from 0.64 to 0.87, and the SSS ranged from 0.74 to 0.96. Using these existing and well-characterized tools rather than constructing original tools is beneficial, given that the existing choice demonstrated sound psychometric properties and established norms. CONCLUSIONS: The SHSQ-25 stood out as being more suitable for the general population and routine health surveys, because it is short and easy to complete. Therefore, there is a need to adapt this tool by translating it into other languages, including Arabic, and establishing norms based on populations from other regions of the world.

Risk of depression, anxiety, and stress among the Saudi general population during the COVID-19 pandemic.

BACKGROUND: Promoting mental health and wellness is crucial for healthy communities. This study aims to assess the vulnerability of experiencing psychological reactions such as depression, anxiety, and stress within the general population in Saudi Arabia during the COVID-19 pandemic. METHODS: A cross-sectional online survey was completed by 754 participants recruited from thirteen regions of Saudi Arabia. The information on background variables was obtained by using a set of close-ended questions. The DASS-21, a screening tool was used to assess the risk of depression, anxiety, and stress. Pie-chart displayed the levels of risk to experience psychological reactions. The Chi-square test and Adjusted Odd Ratios (AOR) reported the risk factors associated with experiencing psychological reactions in the study population. RESULTS: The vulnerability to mild to extremely severe levels of stress, anxiety and depression were (36.5%), (34.9%), and (43.5%), respectively. Findings demonstrated that females were at higher risk to experience anxiety (AOR = 1.56; 95% CI 1.11-2.18) and stress (AOR = 1.48; 95% CI 1.10-2.10) as compared to males. Unmarried individuals had higher vulnerability for anxiety (AOR = 1.60; 95% CI 1.04-2.44) and depression (AOR = 1.55; 95% CI 1.02-2.37) as compared to married individuals. Those who lost their job during the pandemic had a higher risk to experience anxiety (AOR = 2.02; 95% CI 1.10-3.74) and depression (AOR = 2.01: 95% CI 1.09-3.87) as compared to those who remain employed. Diagnosis with COVID-19 was associated with anxiety (AOR = 2.40; 95% CI 1.27-4.52) and stress (AOR = 2. 0; 95% CI 1.10-3.69). Participants with chronic medical conditions were almost twice at risk to experience stress (AOR = 2.0; 95% CI 1.38-2.87) depression (AOR = 2.14; 95% CI 1.53-2.99) and anxiety (AOR = 2.59; 95% CI 1.78-3.78) as compared to those without such conditions. CONCLUSIONS: Findings imply the allocation of adequate psychological resources to prevent long-term psychological repercussions in at-risk populations such as females, unmarried individuals, those who lost their jobs, diagnosed with COVID-19 and those with chronic medical conditions.

Using Spiritual Connections to Cope With Stress and Anxiety During the COVID-19 Pandemic.

During the initial phases of the COVID-19 pandemic, stress and anxiety were pervasive among the masses due to high morbidity and mortality. Besides the fear of coronavirus was also particularly driven by social media. Many people started to look for faith and spiritual connections to gain comfort. The role of spiritual ties and religious beliefs in relation to coping with pandemic stress has acquired the attention of researchers in some parts of the world. This cross-sectional survey aimed at assessing the intensity of stress and anxiety symptoms experienced by people and how much they were alleviated by employing spiritual connections. The study sample comprises 795 respondents with 52% males and 48% females living in Saudi Arabia. The brief online study questionnaire collected data about background variables, anxiety and stress scale from DASS-21, and items from the WHOQOL (SRBP) instrument assessed the use of spiritual beliefs to cope. Multiple regression models were tested to determine the role of spiritual connections after adjusting demographic variables. Results illustrated that after adjusting for gender and age, participants' anxiety symptoms decreased by (ß = -0.27; p = 0.000) units with each unit increase in the use of spiritual connections, and participants' stress symptoms reduce by (ß = -0.36; p = 0.000) units with each unit increase in coping with spirituality. Additionally, females' risk to experience anxiety and stress symptoms was more than males [(ß = 0.88; p = 0.01) and (ß = 0.92; p = 0.000)], respectively. An increase in age decreases the likelihood of experiencing anxiety symptoms and stress symptoms by (ß = -0.75; p = 0.02) and (ß = -0.11; p = 0.000) units, respectively. Findings support the protective role of spiritual connections despite small beta coefficients. The social and cultural context in Saudi Arabia favors deep-rooted connections with spirituality and faith. Our findings support the fact that the reliance on spiritual connections helped older people to deal with exaggerated fear during the initial phase of the COVID-19 pandemic and reduces the risk of experiencing anxiety and stress symptoms. Females and younger participants were relatively vulnerable to developing these symptoms. We discussed these findings considering some recent studies that reported similar relationships and made recommendations for future research.

Interaction between cognitive styles and genders when using virtual laboratories and its influence on students of health college's laboratory skills and cognitive load during the Corona pandemic.

This study examined the interaction between cognitive style-gender within Virtual Laboratories (VL) and its influence on students of health college's Laboratory Skills (LS) and Cognitive Load (CL) during the Corona pandemic. This research method is a combination of quasi-experimental research and survey research; consisting of two male and two female experimental groups (contemplative and impulsive). Each group had 20 students from General Health colleges. In the third level, with the microbiological course, eight experiments were studied by a Virtual laboratory (Praxilabs) during the eLearning study in 2020's first semester. Results showed that VL-using Students of General Health colleges studying microbiology had better CL and LS, besides significantly distinguishing between males and females using VLs in CL and LS where males benefited more. Also, a significant difference was established between CS (contemplative/impulsive) VL-using students in CL and LS to the benefit of the contemplative cognitive style. There LS significantly differ due to gender-CS interaction; however, CL does not have any differences because of this interaction.

Coping during COVID-19 Pandemic in Saudi Community: Religious Attitudes, Practices and Associated Factors.

The COVID-19 pandemic has affected many societies' life aspects and activities including social and Islamic practices; more attention should be given to investigate the interaction between Islamic worships and the spread of the disease. Here, we performed a cross-sectional study using an online questionnaire to assess the preventive Islamic attitudes and practices during the COVID-19 lockdown period from the Saudi publics' perspectives. Mann-Whitney, Kruskal and logistic regression tests were used to analyze the data. The results revealed that most participants had positive Islamic attitudes and practices. However, elders and males were less obeyed to preventive measures during performing worship (p < 0.05). While younger, females and not married were less obeyed when dealing with COVID-19 related death (p < 0.05). Even though, elders were less likely to have poor social and Islamic practices concerning adherence to preventive measures during the pandemic (OR = 0.38; 95% CI: 0.176-0.816) than younger. Furthermore, males, Saudi participants, lower education level, lower Islamic attitudes scores were more likely to have poor social and Islamic practices concerning adherence to preventive measures during the pandemic (OR = 1.65; 95% CI: 1.126-2.421; OR = 1.57; 95% CI: 1.067-2.322; OR = 3.09; 95% CI: 1.721-5.563; and OR = 1.89; 95% CI: 1.309-2.753, respectively), than their corresponding targeted counterparts. Thus, despite the high preventative perceptions of Islamic attitudes and practices of the Saudi community, our study highlighted some risk groups with less preventative practices. Thus, targeted health education interventions are highly recommended for these risk groups to enhance the commitment to government instructions.

Assessing the Level of Awareness of COVID-19 and Prevalence of General Anxiety Disorder among the Hail Community, Kingdom of Saudi Arabia.

BACKGROUND: The COVID-19 pandemic has caused a major public health problem around the world. Therefore, the aim of the study was to assess the awareness and prevalence of General Anxiety Disorder (GAD) with regard to COVID-19 among the Hail community, in the Kingdom of Saudi Arabia, in order to help health authorities to effectively control the pandemic. METHODS: A cross-sectional online survey was completed by 412 participants living in Hail, Saudi Arabia. The questionnaire assessed demographic characteristics, knowledge, attitudes, and practices for the prevention of COVID-19, as well as psychological feelings in terms of GAD as an impact of the COVID-19 pandemic. RESULTS: The study found that most of the respondents demonstrated good knowledge, attitudes, and practice for COVID-19 prevention. The elderly and employed demonstrated significant positive attitudes and practices (p < 0.05). Participants with a positive attitude were almost two and a half times (OR = 2.4; 95% CI: 1.54-3.99) more likely to have good practices. Additionally, the rural respondents were less likely (OR = 0.45; 95% CI: 0.21-0.96) to have a positive attitude. Married participants were more than one and a half (OR = 1.60; 95% CI: 1.04-2.44) times more likely to have a positive attitude. The prevalence of GAD was 21.8% and was significantly increased among participants with inadequate knowledge (OR = 2.01; 95% CI: 1.25-3.22), females (OR = 1.92; 95% CI: 1.19-3.09), individuals with chronic diseases (OR = 1.71; 95% CI: 1.02-2.86), and non-Saudi participants (OR = 2.44; 95% CI: 1.02-5.85). CONCLUSIONS: Ensuring a sufficient combination of relatively good levels of knowledge, positive attitudes, and desired practices serves as a good approach to preventing the spread of COVID-19. However, the increased prevalence of GAD requires the attention of policymakers. Therefore, a great emphasis should be placed on health awareness campaigns, with a focus on misconceptions and the provision of counseling.

Acceptability of COVID-19 vaccination in Saudi Arabia: A cross-sectional study using a web-based survey.

The success of COVID-19 vaccination depends on individual's vaccine acceptance. There has been misinformation on the media that doubts its effectiveness, safety, and long-term risk. Such controversy could affect the acceptance toward the uptake of the COVID-19 vaccine. The objective of this study was to assess the factors influencing the acceptance and hesitancy toward the COVID-19 vaccine in Saudi Arabia. A cross-sectional study was conducted. An online survey was conducted with four parameters: Demographics, medical history, knowledge and information sources about COVID-19 and vaccine, and hesitancy/acceptance of vaccinations. Bivariate analysis between several survey items and the acceptance of COVID-19 vaccine was conducted using Chi-square test. Logistic regression was used to assess to what degree each variable affects the acceptance and the hesitancy toward the COVID-19 vaccine. Approximately 64% show a desire to accept the vaccine while 18.3% were extremely hesitant to take the vaccine. Non-demographic factors that were associated with the acceptance toward the COVID-19 vaccine were the source of health information about COVID-19 (OR:1.63; 95% CI:1.07-2.47), perception toward whether the vaccine is effective on other variants of the virus (OR:7.24; 95% CI:4.58-11.45), previous uptake of the influenza vaccine (OR:1.62; 95% CI:1.07-2.47), and potential mandatory of vaccination in order to travel internationally (OR:16.52; 95% CI:10.23-26.68). This study provides an insight into factors - other than the sociodemographic - influencing the acceptance of the COVID-19 vaccine in Saudi Arabia. The government should address the COVID-19-related misinformation and rumors to increase acceptance of COVID-19 vaccination.

Assessment of the Quality of Life during COVID-19 Pandemic: A Cross-Sectional Survey from the Kingdom of Saudi Arabia.

The COVID-19 outbreak emerged as an ongoing crisis at the beginning of the year 2020. Its horrific manifestation at the community level significantly affects various dimensions of the quality of life (QoL) of all individuals. The study aimed to examine some of the predictors of the QoL during the first wave of the COVID-19 pandemic in Saudi Arabia. A cross-sectional online survey questionnaire was used to gather data on the participants' sociodemographic backgrounds, physical health status, psychological reactions, and QoL. We adapted 12 items from the World Health Organization Quality of Life Instruments (WHOQOL-BREF) to assess the QoL. The Depression, Anxiety and Stress Scale-21 (DASS-21) was used to assess depression, anxiety, and stress. The median and inter-quartile range were used to describe the QoL scores. A multinomial regression analysis was computed between QoL score quartiles and associated factors, and the statistical significance was set at p < 0.05. The results of the multinomial regression analysis demonstrated that males (OR = 1.96; 95% CI = 1.31-2.94); participants aged 26 to 35 years (OR = 5.1; 95% CI = 1.33-19.37); non-Saudi participants (OR = 1.69; 95% CI = 1.06-2.57); individuals with chronic diseases (OR = 2.15; 95% CI = 1.33-3.48); those who lost their job (OR = 2.18; 95% CI = 1.04-4.57); and those with depression (OR = 5.70; 95% CI = 3.59-9.05), anxiety (OR = 5.47; 95% CI = 3.38-8.84), and stress (OR = 6.55; 95% CI = 4.01-10.70) were more likely to be in the first quartile of the QoL scores. While the full model predicting the total QoL score was statistically significant (R2 = 0.962, F (750, 753) = 16,705.4, p < 0.001), the three QoL dimensions explained 0.643, 0.283, and 0.036 of the variability in environmental, social, and religious/spiritual dimensions, respectively. The COVID-19 pandemic has significantly influenced various aspects of individuals' QoL, as well as their physical and psychological health. Community-based interventions are needed to mitigate the pandemic's negative effects and enhance the health and QoL of the general population.

Associations between Health and Academic Success at a Florida University: An Exploratory Cross-sectional Study.

The aims of the study were to explore the associations between college students' perception of their overall physical and psychological health and four measures of academic performance. College students (N = 265) completed a 65-item Web-based survey in a university's student health services building during the spring 2015 semester. Poorer psychological health was associated with seriously considering dropping out of college and missing more classes during the current school year "due to physical or psychological health reasons." Poorer physical health was associated with enrollment in more credit hours. Students who reported a grade point average (GPA) below 2.0 missed more classes "because of physical or psychological reasons" during the current school year than those with a 2.0 or higher GPA. A longitudinal study is needed to clarify whether better health leads to more successful academic performance or vice versa and which specific health indicators play the largest role.