Association between multimorbidity and cognitive decline in the elderly population of the Eastern Province, Saudi Arabia.

BACKGROUND: Cognitive decline affects the quality of life, and dementia affects independence in daily life activities. Multimorbidity in older adults is associated with a higher risk of cognitive impairment. This research aims to study the relationship between cognitive decline and multimorbidity in the elderly population in the Eastern Province, Saudi Arabia. MATERIALS AND METHODS: This cross-sectional research was conducted from July to October 2022 among adults over 60 years. All patients with two or more comorbidities were contacted for a face-to-face interview and cognitive testing to estimate cognitive function by trained family physicians using St. Louis University Mental State Examination. ANOVA and Chi-square test were used to test for statistical significance. Binary logistic regression was used to show the odds of having cognitive impairment and multimorbidity. All tests were performed at 5% level of significance. RESULTS: The study involved 343 individuals; majority (74.1%) aged 60-75 years and were males (67.9%). Hypertension, diabetes, and chronic pain were reported by 56%, 48%, and 44% participants, respectively. Thirty percent participants had 3 or more comorbidities. About 36% had mild neurocognitive disorder and 31.2% had dementia. The results showed that age, gender (female), diabetes, stroke, chronic pain, and multimorbidity were significantly associated with cognitive impairment. In our study, hypertension, coronary artery diseases, depression, and anxiety were not significantly associated with risk of cognitive decline. CONCLUSION: Our study found that multimorbidity is significantly associated with cognitive decline. Controlling comorbidities and preventing risk factors in midlife could help in delaying the progression of the disease.

Burden of routine orthopedic implant removal a single center retrospective study.

BACKGROUND: Open reduction and internal fixation represent prevalent orthopedic procedures, sparking ongoing discourse over whether to retain or remove asymptomatic implants. Achieving consensus on this matter is paramount for orthopedic surgeons. This study aims to quantify the impact of routine implant removal on patients and healthcare facilities. A retrospective analysis of implant removal cases from 2016 to 2022 at King Fahad Hospital of the University (KFHU) was conducted and subjected to statistical scrutiny. Among these cases, 44% necessitated hospitalization exceeding one day, while 56% required only a single day. Adults exhibited a 55% need for extended hospital stays, contrasting with 22.8% among the pediatric cohort. The complication rate was 6%, with all patients experiencing at least one complication. Notably, 34.1% required sick leave and 4.8% exceeded 14 d. General anesthesia was predominant (88%). Routine implant removal introduces unwarranted complications, particularly in adults, potentially prolonging hospitalization. This procedure strains hospital resources, tying up the operating room that could otherwise accommodate critical surgeries. Clearly defined institutional guidelines are imperative to regulate this practice. AIM: To measure the burden of routine implant removal on the patients and hospital. METHODS: This is a retrospective analysis study of 167 routine implant removal cases treated at KFHU, a tertiary hospital in Saudi Arabia. Data were collected in the orthopedic department at KFHU from February 2016 to August 2022, which includes routine asymptomatic implant removal cases across all age categories. Nonroutine indications such as infection, pain, implant failure, malunion, nonunion, restricted range of motion, and prominent hardware were excluded. Patients who had external fixators removed or joints replaced were also excluded. RESULTS: Between February 2016 and August 2022, 360 implants were retrieved; however, only 167 of those who met the inclusion criteria were included in this study. The remaining implants were rejected due to exclusion criteria. Among the cases, 44% required more than one day in the hospital, whereas 56% required only one day. 55% of adults required more than one day of hospitalization, while 22.8% of pediatric patients required more than one day of inpatient care. The complication rate was 6%, with each patient experiencing at least one complication. Sick leave was required in 34.1% of cases, with 4.8% requiring more than 14 d. The most common type of anesthesia used in the surgeries was general anesthesia (88%), and the mean (SD) surgery duration was 77.1 (54.7) min. CONCLUSION: Routine implant removal causes unnecessary complications, prolongs hospital stays, depletes resources and monopolizing operating rooms that could serve more critical procedures.

Comparing Lifestyle and Behavior of Post-Bariatric Surgery and Participants with Obesity: A Community-Based Cross-Sectional Study.

Background: There is a paucity of research dedicated to exploring behavioral change in patients following bariatric surgery. However, there is a need for comparison analysis of individuals with obesity who have received surgical treatment and those who have not opted for any surgical procedures for weight loss. This study is designed to scrutinize the lifestyle choices, behavioral patterns, psychological elements, and eating habits of individuals who have undergone bariatric surgery, in contrast to those with obesity who have not undergone such a procedure. Methods: This study is a secondary analysis from Sharik Diet and Health National Survey (SDHNS) dataset, which is a cross-sectional investigation covering the period from 2020 to 2022. The study focused on demographic factors like age, gender, educational attainment, and monthly earnings. Furthermore, other variables such as physical activity, leisure and workplace sitting habits, smoking patterns, strategies for managing weight, and eating and consumption behaviors were also examined. Results: Out of the initial 15,980 participants reached, 4,069 satisfied the study's inclusion criteria. Bariatric surgery was reported by 806 participants (19.8%). Upon comparing three obesity status groups - The participants who underwent bariatric surgery with or without obesity, those with obesity who did not opt for any surgical weight loss measure, the analysis found that the three obesity status groups were significantly different in 21 variables from a total of 26. Moreover, a logistic regression analysis revealed that 11 variables influenced persistent obesity in the post-surgery phase, as opposed to those who successfully lost weight. These variables included advanced age, limited education, being female, lower income, waterpipe smoking habits, and the consumption of carbonated drinks. Conclusion: This study showed that inability to lose weight after bariatric surgery are linked to poor lifestyle choices and behavior compared to those who were able to lose weight after the surgery.

Time of surgery and surgeon level in supracondylar humerus fractures in pediatric patients: A retrospective study.

BACKGROUND: Supracondylar humerus fractures account for more than 60% of all elbow fractures and about 1/5 of all pediatric fractures. Unfortunately, these fractures can be associated with risk of complications including neurovascular injuries, malunions and limb deformities. Controversy exists regarding the effect of time of surgical intervention and/or level of surgeon performing the surgery on outcome of these fractures. AIM: To determine whether time of surgical intervention and/or surgeon level influence the outcomes of surgically managed pediatric supracondylar humerus fractures. METHODS: We retrospectively studied 155 pediatric patients presenting with a supracondylar humerus fracture in a level 1 trauma center from January 2006 to December 2019. The data extracted included demographic data, fracture characteristics, surgical data, and follow-up outcomes. The collected data was analyzed and P values of < 0.05 were considered statistically significant. RESULTS: Of the cohort, 11% of patients had documented post-operative complications, of which the majority occurred in surgeries performed after day time working hours and in fractures requiring open reduction. While the lowest complication rate was found in surgeries performed by pediatric orthopaedic surgeons, this did not reach statistical significance. CONCLUSION: In pediatric patients undergoing surgery for supracondylar fractures, we found a higher complication rate when surgeries were not performed during working hours. Surgeon level and training had no significant effect on the risk of post-operative complications.

Comparative analysis of lifestyle behaviors and dietary intake among obese and non-obese individuals following bariatric surgery: a secondary data analysis from 2020 to 2022.

Objective: The aim of this research is to perform a comparative examination of lifestyle habits and dietary consumption between obese and non-obese subjects who have undergone bariatric surgery. This is done with the intent of investigating the disparities in obesity outcomes attributable to these elements. Method: This study involves a secondary analysis of cross-sectional data obtained from the Sharik Diet and Health National Survey (SDHNS). To ensure a representative distribution of participants, the SDHNS employs a proportional quota sampling strategy, with stratification based on age, sex, and geographic location within Saudi Arabia's 13 administrative regions, utilizing the ZDataCloud® system for this purpose. The data, collected between 2020 and 2022 from over 15,000 participants, were screened to identify the eligible records of individuals who underwent bariatric surgery. Results: Within the entire sample, a mere 5.0% (806 individuals) had undertook bariatric surgery, with females comprising 54% of this specific subgroup. The average age within this group was 38.85 years (SD 13.02) and range (18-87). Post-operative results showed that 33% of these individuals remained classified as obese. Utilizing the backward likelihood ratio regression model, it was determined that factors including age, decreased consumption of fresh juices and chicken, as well as current tobacco use, were significantly associated with persistent obesity. Conclusion: The findings of this study suggest an association between the non-obese group and healthier lifestyle choices, including the consumption of high-protein diets and fresh juices, alongside a decreased prevalence of smoking. These observations underscore the significance of maintaining a healthy lifestyle for positive weight loss outcomes following bariatric surgery.

The Utilization of Pediatric Hip Spica Tables Among Orthopedic Surgeons: Locally Customized versus Company-Manufactured (Cross-Sectional Study).

Background: Hip spica tables are widely used among pediatric orthopedic surgeons to maintain the hip position during cast application and drying processes for a better outcome. Locally customized spica tables can be a significant concern if their limitations significantly interfere with the quality of care. Objective: This study aims to explore the current practice of pediatric hip spica table application among hospitals in the GCC countries and report comprehensive data that help surgeons enhance their practice. Methods: This is a cross-sectional study on pediatric orthopedic surgeons using a self-administered Online Questionnaire. The respondents were grouped as those using locally customized tables, where further information about the material and characteristics were collected, and those using company manufactured tables. Both groups answered analytical questions related to their current practice of hip spica tables. Results: Sixty-three surgeons completed the survey. More than half the physicians in this study are using locally customized spica tables (n= 41, 65%). Compared to company-manufactured tables, locally customized tables were associated with a higher rate of difficulties when taking an X-ray, when the patient weighs more than 50.0 kg, and with anesthesia, although not statistically significant. Conclusion: Obtaining a good quality spica table at a suitable price is a primary obstacle pediatric orthopedic surgeons face. This study shows no statistically significant difference between locally customized and company-manufactured tables regarding the outcomes and that spica tables have room for development to optimize their utilization.

Prevalence of Type 2 Diabetes Mellitus in the General Population of Saudi Arabia, 2000-2020: A Systematic Review and Meta-Analysis of Observational Studies.

Background: The prevalence of type 2 diabetes mellitus (T2DM) has increased worldwide, including in Saudi Arabia. Objective: To systematically review the available literature and assess the pooled prevalence of T2DM in Saudi Arabia between 2000 and 2020. Methods: Observational studies that reported quantitative estimates of the prevalence of T2DM as their main outcome, included the general population of Saudi Arabia, and were published between 2000-2020 and in English were retrieved using three electronic databases (namely, CINAHL, Medline via PubMed, and Web of Science). Retrieved studies were screened, and relevant data were extracted. The Joanna Briggs Institute Critical Appraisal guideline was used to assess the methodological quality of included studies. A random-effects model was used to estimate the prevalence of T2DM. Results: Twenty-three studies were included in the systematic review, of which 19 were included in the meta-analysis (total pooled population: 258,283). The overall pooled prevalence of T2DM in Saudi Arabia was 16.4% (95% CI: 11.6-17.5). However, there was heterogeneity in the results of the studies [I2 = 99.31%, P < 0.0001] and the summary values varied from 3.18% (95% CI: 1.46-5.95) to 94.34% (95% CI: 89.53-97.38). Although the prevalence of T2DM by age varied across studies, in most studies, it was higher among the older age groups. In addition, the prevalence of diabetes widely varied across the different geographical regions of Saudi Arabia. Conclusions: This is the first meta-analysis that determined the pooled prevalence of T2DM in Saudi Arabia, and it revealed a high prevalence over the past two decades. However, owing to data collection inconsistencies in the identified studies, neither the modifiable (such as obesity, educational status, emotional support, etc.) nor the non-modifiable (such as gender and age) risk factors of T2DM could be determined, thereby indicating the need for a nationally collective effort in determining these factors.

Effect of smoking on coronavirus disease susceptibility: A case-control study.

INTRODUCTION: Tobacco use has changed since the onset of the coronavirus disease (COVID-19) pandemic. The effect of smoking on COVID-19 susceptibility has not yet been determined. In this study, we aimed to assess the association between smoking and COVID-19 susceptibility. METHODS: This retrospective case-control study was conducted at the quarantine center of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, between April and June 2020. A total of 142 adults participated in the study, 73 of whom tested positive for COVID-19 and were matched for both sex and age with participants in the control group. Telephone interviews were conducted to assess the risk factors associated with that exposure. RESULTS: Different variables are investigated for their impact on COVID-19 infection susceptibility. The current study's findings indicated that smokers comprised only 27.5% (n=39) of the participants. There was no association between the COVID-19 swab results and smoking status (χ2=1.857; p=0.395). Furthermore, there was no significant association between any of the smoking parameters and susceptibility to COVID-19, except for the smoking period (t= -2.105, p=0.041). The odds of having a positive swab result among cigarette smokers were lower than those among pipe, waterpipe, and electronic cigarette smokers (OR=0.600; p=0.394). An association was also observed between COVID-19-positive swab results and contact with an individual with COVID-19 or respiratory disease (χ2=79.270 and χ2=18.929, respectively, p≤0.001). CONCLUSIONS: This study revealed no association between smoking status and COVID-19 swab test results. Further research with a bigger sample size is suggested to confirm the relationship between smoking and COVID-19 susceptibility.

The effect of exercise on the quality of life in an academic environment.

Regular physical activity has a direct association with an improvement in perceived health-related quality of life (HRQL). Because many Saudis are reportedly inactive, Imam Abdulrahman bin Faisal University established a walking challenge for all university employees to encourage a better lifestyle and to promote health awareness. This study aims to measure the differences in the participants' HRQL scores before and after the challenge. A before and after study was conducted using HRQL survey that was sent to all university employees before the implementation of a pedometer-based walking challenge at the study setting, and after the challenge ended. A randomized snowball sample method was used to recruit participants. The differences in the overall HRQL before and after the challenge were calculated. A RAND SF20-items scale was used to measure the participants' HRQL scores, along with other information such as academic qualifications. Most of the participants were between 31 and 50 years old, and 40% were males. There was a statistically significant difference in the overall HRQL scores before and after the walking challenge intervention. The HRQL score increased from 50.77 before the challenge to 55.53 after the challenge (paired t-test = - 4.322, P < 0.0001). An odds ratio (OR) showed that the odds of having higher HRQL scores increased by 88% after the walking challenge, compared to before the walking challenge (OR = 1.88; 95% CI = 1.269-2.809; P = 0.002). Physical activity by itself can improve a community's overall health and quality of life. Similar interventions are encouraged in all public and private sectors in the country.

The Impact of the Working Hours Among Malaysian Nurses on Their Ill-Being, Intention to Leave, and the Perceived Quality of Care: A Cross-Sectional Study During the COVID-19 Pandemic.

Purpose: This study explores the effect of working duration on nurses and their ill-being (ie, anxiety, depression, fatigue, and sleepiness), intention to leave, and the quality of nursing care. Methods: A questionnaire survey was employed for a convenience sample of 400 nurses at Malacca General Hospital in Malaysia who voluntarily participated in this cross-sectional study. The Statistical Package for the Social Sciences (SPSS) was used to treat and analyze the data. Descriptive statistics were generated, and Post Hoc analyses and ANOVA tests were conducted. Results: Findings indicated that working hours duration was significantly associated with nurses' anxiety (F (4, 394) = 10.362, p <0.001), depression (F (4, 395) = 23.041, p< 0.001), fatigue (F (4, 395) = 24.232, p< 0.001), sleepiness (F (4, 395) = 4.324, p < 0.002), quality of nursing care (F (4, 395) = 16.21, p <0.001) and intention leave their job, (F (4, 395) = 50.29, p <0.001). The results also revealed that working more than 14 hours was negatively associated with their perceived quality of nursing care and positively associated with their perceived ill-being and intention to leave. Conclusion: Shift length is an important issue, and nursing managers must consider shift length as it can adversely correlate with the nurses' perceptions of work and life.

Hospital Work Conditions and the Mediation Role of Burnout: Residents and Practicing Physicians Reporting Adverse Events.

Background: "Patient Safety" in everyday practices is a target of healthcare leaders, and adverse events reported by healthcare providers directly reflect patient safety in the health system. Recognising how residents and practising physicians rate adverse events concerning their work conditions and burnout must be explored. Objective: This study aims to explore the mediation effect of burnout dimensions (emotional exhaustion and burnout-interpersonal disengagement) between the effects of work conditions on perceived patient safety by exploring the adverse events that residents and practising physicians reported. Methods: A quantitative and cross-sectional study collected data from 249 residents and practising physicians in a huge teaching hospital and primary health care centre (PHC) in the Eastern Province of Saudi Arabia. Hayes Macro regression analysis was employed to evaluate the multiple mediation effect of burnout dimensions, with 5000 bootstrapping and a confidence interval (CI) of 95% for statistical inference and p≤0.05 for the significance level. Results: Leadership support (B= 0.39, t= 6.24, p<0.001) and physician engagement (B=0.43, t=6.50, p<0.001) were associated with a decreased rate of adverse events to patient safety, whereas workload (B=-0.23, t=-3.73, p<0.001) was negatively associated with an increased rate of adverse events. Burnout was shown to mediate the relationship between the effects of physician's leadership support (R2=0.26, F=27.50, p<0.001), work engagement (R2=0.25, F=27.07, p<0.001) and workload (R2=0.23, F=24.23, p<0.001) on the rate of adverse events. Conclusion: This study provides insights into burnout dimensions and their consequences on patient safety indicators (ie, adverse events). Work conditions (ie, leadership support, physician engagement, and workload) directly affect the rate of adverse events and indirectly through mediators like burnout-emotional exhaustion and burnout-interpersonal disengagement.

Using mobile health applications to enhance physical activity in Saudi Arabia: a cross-sectional study on users' perceptions.

BACKGROUND: This research aims to assess the users' perceptions of usability and quality of mobile health applications used for promoting physical activity in Saudi Arabia. METHODS: This was a quantitative cross-sectional study. A survey was developed based on the Technology Acceptance Model (TAM) and the Mobile Application Rating Scale (MARS) and distributed among the Saudi population through social media to assess the users' perceptions of using mobile applications to enhance physical activity. The survey questionnaire consisted of 27 questions in six sections, including demographics (nine items), perceived usefulness (three items), perceived ease of use (three items), attitudes (three items), user experience (six items) and subjective quality (three items). All the participants were in Saudi Arabia and >15 y of age. RESULTS: A total of 195 m-Health users participated in the survey. Of the total participants, 25.1% were overweight and 21.0% were obese. The workout frequency of most users was rarely (32.3%) and three to four times a week (29.2%). In addition, 55.9% of the users agreed that the application they use served all fitness levels and >80% either agreed or strongly agreed that it was easy for them to learn how to use the application. More than 70% of users agreed or strongly agreed that the application enhanced their knowledge of workouts and physical activity and >90% would recommend the application to others. There were no differences identified between the male and female participants and younger (<40 y) and older (>40 y) participants with respect to perceived usefulness and ease of use, attitudes, experiences and subjective quality. However, significant differences were observed between participants <40 y and >40 y of age in terms of perceived ease of use of mHealth applications. CONCLUSION: mHealth users across Saudi Arabia believe that the mHealth applications have good usability and quality factors. As a result, they can motivate people and help them achieve their goals in relation to physical activities.

A Retrospective Analysis from A Single Center Perspective On Complications After Fixing Distal Radius Fracture In Pediatric Population.

Background: The Distal radius fractures in the pediatric age group have similar complications to any other fracture. One interpretation of the high fracture incidence in the distal third of the radius is the relative weakness of the metaphyseal part. Objective: The aim of this study is to provide an evaluation of Surgical complications of distal radius through satisfactory reduction and proper fixation by K-wires through bone growth plates. Methods: A retrospective single-center study in a tertiary hospital in Eastern Saudi Arabia from 2000 to 2021, using the hospital's electronic records system. The Inclusion criteria of this study involve all distal radius fracture cases who underwent surgical fixation by k-wire or plating system and are up to 14 years old. The exclusion criteria include loss of follow-up, incomplete data, and age of more than 14 years. Results: the study included 103 patients. The side of injury was almost equally distributed between the left and right sides. The odds of having at least one complication increase by 2.5 folds if the site of fracture is at the diaphysis. Further, if the distance of the fracture line to the epiphysis is more than 20 mm, the odds of reporting at least one complication post-procedure is 4.4 times higher than if it was at the level of the epiphysis. The majority of diaphyseal fractures required less than 6 weeks for radiological healing, which is significantly different from other sites which were evaluated. Conclusion: Complications of distal radius fracture due to Surgical intervention could be confounded by the complexity of the fracture itself. In our study, we found the distance of the fracture from the physis was inversely proportional to the likelihood of complications. For a comprehensive appreciation of physeal plate, we recommend extended follow-up for those who present with signs of severe distal radius fracture, especially in case of associated ulnar fracture.

Determining the nurses' perception regarding the effectiveness of COVID-19 protocols implemented in Eastern Province: Saudi Arabia.

Background: The global impact of Coronavirus Disease 2019 (COVID-19) has been profound, affecting public health, the global economy, and overall human life. Past experiences with global pandemics underscored the significance of understanding the perception of HCWs and hospital staff in developing and implementing preventive measures. The World Health Organization (WHO) provided protocols to manage the spread of COVID-19 and assist healthcare workers and health systems globally in maintaining high-quality health services. Objective: This study aims to assess nurses' perception, awareness, and compliance regarding the implementation of COVID-19 protocols and explore factors influencing their perception. Methodology: A quantitative cross-sectional survey-based study was conducted, distributing a constructed survey among nurses in the Eastern Province of Saudi Arabia. Results: Out of 141 participants, most adhered to protocols such as hand sanitization, social distancing, and proper personal protective equipment (PPE) usage. The predominant age group among respondents was 31 to 40 years (n = 71, 50%). A significant portion of participants reported holding a bachelor's degree (n = 86, 61%), with only 14% possessing advanced degrees (n = 19). Nearly a third of the nurses in the study had accumulated 6 to 10 years of professional experience (n = 49, 34.8%). A noteworthy percentage of nurses were engaged in daily shifts exceeding 8 h (n = 98, 70%). Gender differences were observed, with females exhibiting a higher tendency to avoid shaking hands and social gatherings. Saudi nationals were more inclined to shake hands and engage in gatherings. Non-Saudi nurses and those aged between <25 to 40 years demonstrated proper donning/doffing practices. Nurses with over 6 years of experience avoided social gatherings, while those working >8 h adhered better to PPE usage, proper donning/doffing, and disposal of PPE in designated bins. Conclusion: Understanding COVID-19 protocols is crucial for tailoring interventions and ensuring effective compliance with COVID-19 preventive measures among nurses. More efforts should be made toward preparing the healthcare nursing to deal with the outbreak. Preparing healthcare nursing with the right knowledge, attitude, and precautionary practices during the COVID-19 outbreak is very essential to patient and public safety.

Awareness and Use of Virtual Clinics following the COVID-19 Pandemic in Saudi Arabia.

Studies have shown that virtual clinics enjoyed high use and high patient satisfaction during the COVID-19 pandemic. Thus, virtual clinics are expected to be the new normal mode of receiving care after the COVID-19 pandemic. This study aimed to assess public awareness and use of virtual clinics following the pandemic and identify factors associated with virtual clinic use. Methods: A cross-sectional design was employed in which data were collected via a structured online questionnaire based on the Technology Acceptance Model (TAM) domains: perceived usefulness, perceived ease of use, and social influence. Participants were selected based on the non-probability sampling of convenience. Univariate, bivariate, and binary logistic regression models were used for analysis. Results: A total of 405 responses were received; of those, 286 (70.6%) were aware of the existence of virtual clinics and 99 (34.6%) were post-pandemic users. Among users, 50% used virtual clinics more than two times, 72% used virtual clinics to seek care for themselves, with the vast majority using it via voice calls (83.8%), and for visits to the family medicine clinic (55%). Young adults, females, single adults, those with a higher level of education, the employed, and those with lower income were more likely to use virtual clinics (p < 0.05). The logistic regression model showed that 20% of the variation in virtual clinic use was explained by perceived usefulness and perceived use (p < 0.001). Conclusion: This study showed high awareness of virtual clinics among the population following the COVID-19 pandemic, with one-third being active users. Age, gender, marital status, education, income, employment status, perceived usefulness, and ease of use are associated with virtual clinics' awareness and use. Considering those factors is important when planning for sustained use of e-health and virtual care.

Factors associated with anxiety symptoms among medical laboratory professionals in Khobar: Single institution study.

Background: A clinical professional has a challenging role during the coronavirus disease (COVID-19) pandemic in providing timely and accurate results with limited resources and a rapid increase in the number of samples to be tested. However, during the ongoing pandemic, the anxiety level of Medical Laboratory Professionals (MLT) has not been studied in Saudi Arabia within the hospital environment. Aim: To determine the associated factors related with anxiety level of MLT at King Fahd Hospital of the University (KFHU) during the COVID-19 pandemic. Methods: The study design was a cross-sectional quantitative study. Data were collected by administering a paper-based questionnaire that was distributed among MLT at KFHU. The questionnaire consisted of three sections. The first two sections were prepared by the researchers and included participant demographics and questions related to COVID-19. The third section used the Hamilton Anxiety Scale to assess anxiety levels. Result: The study revealed that 70.4% of MLT showed no signs of anxiety, while 19.2% showed mild/moderate anxiety levels, and approximately 10.4% showed severe to extreme anxiety levels. In addition, a significant association between the anxiety level and difficulty breathing among MLT wearing personal protective equipment was observed. Moreover, a significant association between sex and anxiety level was identified. Females MLT had higher percentages of severe anxiety (12.8% vs. 5.1%) and mild/moderate anxiety (24.4 vs. 7.7%) than males. Conclusions: Protecting the mental health status of MLT is an essential part of public health measures to fight the COVID-19 pandemic.

Digital health transformation in Saudi Arabia: A cross-sectional analysis using Healthcare Information and Management Systems Society' digital health indicators.

Background: The digital revolution has had a huge impact on healthcare around the world. Digital technology could dramatically improve the accuracy of diagnosis, treatment, health outcomes, efficiency of care, and workflow of healthcare operations. Using health information technology will bring major improvements in patient outcomes. Purpose: This study aims to measure the readiness for digital health transformation at different hospitals in the Eastern Province, Saudi Arabia in relation to Saudi Vision 2030 based on the four dimensions adopted by the Healthcare Information and Management Systems Society: person-enabled health, predictive analytics, governance and workforce, and interoperability. Methods: The study was conducted with a cross-sectional design using data collected through an online questionnaire from 10 healthcare settings, the questionnaire consists of the four digital health indicators. The survey was developed by Healthcare Information and Management Systems Society for the purpose of assessing the level of digital maturity in healthcare settings. Results: Ten healthcare facilities in the Eastern Province, both private and governmental, were included in the study. The highest total scores for digital health transformation were reported in private healthcare facilities (median score for private facilities = 77, public facilities = 71). The 'governance and workforce' was the most implemented dimension among the healthcare facilities in the study (median = 80), while the dimension that was least frequently implemented was predictive analytics (median score = 70). In addition, tertiary hospitals scored the least in digital transformation readiness (median = 74) compared to primary and secondary healthcare facilities in the study. Conclusion: The results of the study show that private healthcare facilities scored higher in digital health transformation indicators. These results will be useful for promoting policymakers' understanding of the level of digital health transformation in the Eastern Province and for the creation of a strategic action plan.

Students' Perception of Quality of Learning Experience (Structure, Process and Outcome): Discipline Versus Problem Based Medical Curriculum and the Mediation Role of Process Quality.

Problem-based learning (PBL) is now incorporated into the curricula of most medical schools around the world. In comparison to the traditional curriculum, less is known about the influence of the adoption and implementation of a problem-based curriculum on the perceived structures, processes, and outcomes of learning experiences reported by students. The purpose of this study was twofold: (1) to compare the quality of learning experience of students enrolled in traditional discipline-based and problem-based medical curricula and (2) to explore the mediation effect of the process quality between the relationship of the structural quality and students' perception of learning experience outcomes. Through the distribution of an electronic survey, all 3rd and 4th year medical students enrolled in the discipline-based curriculum and the problem-based curriculum were invited to participate in the study. The students from both curricula completed the Student Experience Survey (SES), which was developed by the National Center for Academic Accreditation and Evaluation. Descriptive statistics, independent sample t-test and Hayes Macro regression analysis were used. Students enrolled in the problem-based curriculum had higher perceived support and sufficient advice with higher perceived quality of learning experiences compared with students enrolled in the traditional curriculum, however they reported less enjoyment of their university life. The structural factors (t = 19.83, p ≤ 0.001) and process factors (t = 9.21, p ≤ 0.001) were associated with an increase in students' reported outcomes by 0.67 and 0.49, respectively. These findings explain the mechanism by which the structural factors, such as maintaining adequate facilities and support, may help in enhancing the process quality (e.g., learner-centered learning), which in turn can enhance learning experience outcomes.

Healthcare Providers' Satisfaction with Implementation of Telemedicine in Ambulatory Care during COVID-19.

INTRODUCTION: Telemedicine has become a critical aspect of healthcare provision during the coronavirus pandemic (COVID-19). However, healthcare providers' utilization of and satisfaction with telemedicine technologies could have a significant impact on the quality of care provided to patients during COVID-19. The current study explores the key factors that could affect healthcare providers' satisfaction with telemedicine in ambulatory care during the pandemic. OBJECTIVES: This research study aims at identifying the factors that could influence the healthcare providers' satisfaction level with the use of telemedicine in ambulatory care services in Saudi Arabia during COVID 19. METHODS: This is a descriptive quantitative cross-sectional study. The research team has utilized the Service Quality Model (SERVQUAL) to assess the healthcare providers' satisfaction with telemedicine in ambulatory care through a questionnaire that was adapted from previous studies. This questionnaire includes the following dimensions: tangibility, reliability, responsiveness, assurance, and empathy. It was distributed to all ambulatory care physicians in a public hospital-based ambulatory health center in Eastern Region, Saudi Arabia. RESULTS: The study findings showed that Saudis are significantly more satisfied with telemedicine compared to non-Saudis. Age, gender, experience, medical specialty, and computer literacy skills were not found to have any significant effects on the level of the provider's satisfaction. CONCLUSION: This research provides new insight and understanding of the relationship between the frequent use of the health information system and the level of physician satisfaction. This major finding puts more emphasis on the importance of education and training when it comes to the adoption of telemedicine through the frequent use of health information systems and applications. These encouraging findings provide a vital piece of information for healthcare organizations interested in a further adoption of telemedicinal practices and applications.

The Relationship between Emotional Intelligence and Pain Management Awareness among Nurses.

Background: Pain management, a crucial part of nursing care, is considered one of the most basic patient rights. To properly treat patients' pain, nurses need a high degree of pain management awareness (PMA). The researchers hypothesized that nurses' pain management awareness is affected by their emotional intelligence (EI). Purpose: Because there is a dearth of studies on this topic, the purpose of this study was to describe the relationship between emotional intelligence and pain management awareness in a sample of nurses. Methods: The study employed a descriptive design with a quantitative approach to analyze data from a survey designed with the simple random sample technique. The questionnaires were completed by 330 nurses working at six governmental hospitals in Saudi Arabia. The Statistical Package for the Social Sciences (V23) and Analysis of Moment Structures (V23) were used to determine the reliability and validity of the questionnaires and analyze the causal relationships among the variables. Results: The results revealed a significant positive relationship between nurses' emotional intelligence and their pain management awareness. Conclusions: These findings suggest that having emotional intelligence is an important nurse characteristic for effective pain management awareness and possibly the provision of pain management care. Clinical Implications: Hospital and nurse managers as well as administration should consider using the emotional intelligence variables utilized in this study to develop ways to improve pain management awareness among nurses. Such efforts may help improve hospital and patient outcomes related to pain management.