Immunizations protect children from deadly infectious diseases. Yet, there is still insufficient understanding of the factors associated with parents' non-adherence to immunizations in contexts ...outside of Western countries. The aim of this study is twofold: (a) to investigate non-adherence to immunizations for children aged 6 months to 6 years in Saudi Arabia based on the number of immunizations missing or delayed by more than one month; and (b) to examine the underlying factors that predict the extent of non-adherence based on the Health Belief Model framework.
A cross-sectional study was carried out in 22 randomly selected primary health care centers. Structured interviews were also conducted to collect data using the modified Health Belief Model questionnaire. Multiple regression analysis was used to assess the predictors of the extent of non-adherence.
Based on data from 220 participants, 51.8% of parents did not adhere with childhood immunizations. There was no significant relationship between parents' sociodemographic characteristics and the extent of their hesitancy about children's immunizations. The linear combination of perception of infectious disease severity, perception of their children's susceptibility, perception of immunization benefits, perception of fewer barriers to obtaining immunizations, cues to action related to immunizations, and self-efficacy predicted the extent of non-adherence to immunizations (F (11.220) = 2.595, p < 0.001) and explained 12% of its variance. Yet, only perceived children's susceptibility, perceived barriers, and self-efficacy independently predicted parents' non-adherence.
Saudi Arabia's high proportion of non-adherence to childhood immunizations should be addressed. For instance, a health education program could be developed to increase parents' awareness that their children are susceptible to health risks. Paying a special attention to existing barriers in accessing and receiving the immunizations is crucial. In addition, building parents' self-efficacy, which is confident in making healthy decisions, such as keeping their children's immunizations up to date, is important.
Intimate partner violence (IPV) is a serious public health issue at the global level, with cultural differences in its nature and prevalence. Most of the current evidence related to IPV comes from ...Western countries; however, there is a lack of evidence of IPV in developing countries such as Saudi Arabia. The issue of IPV has been investigated in Saudi Arabia only recently, and data have been inconsistent and inconclusive. Hence, we conducted a systematic review of the extant literature devoted to IPV prevalence, risk factors, and outcomes as well as Saudi women’s help-seeking behaviors. Various databases, such as PubMed, CINAHL, Medline, PsycINFO, and reference lists of the reviewed studies, were searched to identify relevant studies by using different keywords. The review included 16 studies that met the inclusion criteria, which revealed several findings. There is no national representative prevalence study of IPV in the Saudi context. Various IPV definitions were used with limited evidence for the reliability and validity of the used IPV measures. IPV is a prevalent issue among Saudi women, but rates are comparable to those of other countries. There are various individual, relational, and sociocultural factors that increase women’s vulnerability to IPV victimization. However, limited information is available regarding IPV protective factors. More importantly, IPV experiences negatively affect Saudi women’s physical and mental health status. Saudi women rarely seek formal support for IPV. This review also highlights the lack of IPV data and inconsistencies in defining and measuring IPV. More rigorous research regarding IPV is needed to help develop relevant preventive and intervention programs.
Intimate partner violence (IPV) during pregnancy is a significant issue. Nevertheless, the prevalence of IPV and its adverse outcomes in pregnant women in Saudi Arabia are not well documented. This ...study examines the prevalence of IPV, its relationship with women’s background characteristics, and its effect on adverse pregnancy outcomes. A cross-sectional study was conducted using a convenience sample of 684 women who were either pregnant or in the first six weeks postpartum in Riyadh, Saudi Arabia. IPV severity was measured using the Composite Abuse Scale. The results showed that 28.9% of the women included in this study experienced IPV. Smoking habit, income, polygamous marriage, presence of chronic diseases and sexual dysfunction, and number of children were significantly associated with IPV severity. In each one-unit increase in total IPV severity, the possibility of the occurrence of preterm labor, vaginal bleeding, dehydration, gestational diabetes, urinary tract infection, spontaneous abortion, and intrauterine growth retardation significantly increases. Furthermore, regarding the types of abuse, we found that for each one-unit increase in verbal abuse, the possibility of the occurrence of preterm labor, dehydration, urinary tract infection, and intrauterine growth retardation significantly increases. Moreover, for each one-unit increase in physical abuse and one-unit increase in controlling behavior, the possibility of the occurrence of intrauterine growth retardation significantly increases. The current results highlight the importance of paying substantial attention to IPV and its types as a health issue that increases the risk of adverse pregnancy outcomes in women. A clinical assessment during pregnancy is needed to identify and manage cases of IPV survivors and ultimately reduce their risk of IPV.
The objectives of this study were to measure the prevalence of mental distress and to explore the relationship between violence against women (VAW), social support, self-esteem, and mental distress ...in women in Riyadh, Saudi Arabia. A questionnaire-guided, cross-sectional, interview-based study was conducted with 1,932 women, in primary healthcare centers. Around 29% reported moderate to severe distress levels, whereas 40% of women reported lifetime exposure to at least one type of violence. Linear regression analysis found that VAW was positively associated with mental distress with a unit increase associated with a 0.13 (0.58, 1.15) increase in distress level, whereas, for both social support and self-esteem, a unit increase in violence was associated with −0.23 (−0.47, −0.32) and −0.22 (−0.49, −0.33) unit decrease in the mental distress. Structural equation modeling found that violence had direct significant negative effects on social support (β = −.156, p < .001) and self-esteem (β = −.135, p < .001). Both social support (β = −.266, p < .001) and self-esteem (β = −.183, p < .001) had direct significant negative effects on distress. VAW exerted a direct significant positive effect on distress (β = .171, p < .001) as well as an indirect effect (β = .068, p < .001). Both social support (β = .044, p < .001) and self-esteem (β = .025, p < .001) were significant mediators of the effect of violence on mental distress. VAW can lead to mental distress and low self-esteem. Identification, counseling, and social support for women are important to improve their self-confidence and reduce the adverse effects of violence.
To examined the impacts of chronic pain on depression and poor sleep quality dimensions as well as the mediating function of poor sleep quality in the pathway between chronic pain and depression.
...Between March 2019 and February 2020, we conducted a cross-sectional study on 233 chronic pain patients in 2 tertiary hospitals in Riyadh, Saudi Arabia.
Of the 233 patients, 36% had depression, while 66.1% had poor sleep quality. Chronic pain intensity and pain disability significantly explained 10.9% of depressed affect variance, 4.9% of anhedonia variance, 17.3% of somatic complaint variance, 4.5% of interpersonal difficulty variance, 7.4% of sleep efficiency variance, and 15% of perceived sleep quality variance. The result also showed a positive, direct effect of chronic pain on poor sleep quality, which in turn positively and directly affect depression. However, chronic pain had only indirect effect on depression.
Among chronic pain patients, the high rates of poor sleep quality and depression requires a special attention. Chronic pain intensity and disability predict depression and sleep quality dimensions differently. The result underlines the need of managing poor sleep quality to address depression in the context of chronic pain.
To examine the pathway in which health literacy affects diabetic patients' quality of life (QoL) with self-care management skills and glycemic control levels (hemoglobin A1c HbA1c) mediating the ...relationship.
A cross-sectional study carried out between April 2019 and September 2019. A convenience sample of participants with type 2 diabetes mellitus were recruited from 3 primary healthcare centers, Al Ahsa, Saudi Arabia. Data were collected using structured interviews and HbA1c levels were collected from medical files. Structural equation modeling was also used.
Among the 256 participants, 27.3% had a marginal level of health literacy and 35.5% had an inadequate level of health literacy. Health literacy positively affects self-care management, glycemic control (HbA1c), and QoL directly and indirectly. Self-care management partially mediates this relationship.
Healthcare providers need to assess health literacy and develop interventions that enhance diabetic patients' health literacy because it influences self-care management skills, glycemic control, and patients' QoL. Health literacy should be considered as a key for health education and healthcare encounter to improve health outcomes.
Background: Women have unique health concerns in the context of chronic illness. Although health literacy has been linked to health-related quality of life, the pathway by which some factors mediate ...this relationship has not been well examined among Saudi women with chronic disease. Purpose: This study was designed to examine the relationship between health literacy and health-related quality of life and determine the mediating roles of healthy lifestyle and patient-centered care in explaining this relationship. Methods: A cross-sectional study was used. A random sample of 20 primary healthcare centers in Saudi Arabia was selected. A convenience sample of 300 women diagnosed with a chronic illness was recruited from these centers. Structural equation modeling was used to test the proposed relationships. Results: Controlling for women's age and education, the hypothesized model adequately fit the data. Health literacy and its dimensions were found to positively and directly affect both patient-centered care (β = 0.614, B = 0.189, p ＜ .001) and healthy lifestyle behaviors (β = 0.550, B = 1.211, p ＜ .001). Furthermore, both patient-centered care (β = 0.390, B = 1.301, p ＜ .001) and healthy lifestyle behaviors (β = 0.322, B = 0.150, p ＜ .001) were found to positively and directly affect health-related quality of life, whereas health literacy had significant, direct (β = 0.285, B=0.292,p＜.001) and indirect (β=0.417,B=0.428, p＜.001) effects on health-related quality of life through patient-centered care and healthy lifestyle behaviors. Conclusions/Implications for Practice: Special consideration should be given to health literacy, patient-centered care, and healthy lifestyle behaviors to enhance health-related quality of life in women with chronic illness. Gender-specific health services and interventions are needed to improve women's health literacy.
Aims
The aim of this study was to examine the pathway through which intimate partner violence (IPV) severity and child abuse severity influence obesity among women who have experienced IPV.
...Background
Intimate partner violence is a public health issue that is found to be related to obesity. Yet, little is known about the pathways that link both IPV and child abuse experiences to obesity. The roles of posttraumatic stress disorder and depressive symptoms in the relations between IPV and obesity are still not well known.
Design
A cross‐sectional study of 299 women who have experienced IPV.
Methods
A convenience sample of abused women was recruited from nine primary healthcare centres in Saudi Arabia. Data were collected in 2015, using self‐report questionnaires and physical measures for obesity. Non‐parametric analysis of variance was conducted to explore group differences. Structural equation modelling was used to examine the hypothesized model.
Results
Among the sample, 52.5% was classified as obese based on body mass index. Obese women had significantly higher levels of IPV, physical child abuse, depressive symptoms and posttraumatic stress disorder symptoms. The study showed that both IPV severity and child abuse severity indirectly influenced obesity through depressive symptoms.
Conclusion
The alarming rate of obesity among abused women suggests that these women are at great risk for obesity, which necessitates clinical consideration. The study findings highlight the need to treat depressive symptoms to manage and prevent obesity among IPV and child abuse survivors. Specifically, nurses should tailor interventions that address mental health outcomes of abuse in managing obesity.
目的
本研究旨在探讨亲密伴侣暴力(IPV)严重程度和儿童虐待严重程度影响经历过亲密伴侣暴力的女性肥胖的途径。
背景
亲密伴侣暴力是一个公共健康问题,被发现与肥胖有关。然而,对于将亲密伴侣暴力和儿童虐待经历与肥胖联系起来的途径知之甚少。创伤后应激障碍和抑郁症状在亲密伴侣暴力与肥胖之间关系中的作用尚不清楚。
设计
对299名经历过亲密伴侣暴力的女性进行横向研究。
方法
从沙特阿拉伯的9所初级保健中心随机抽取受虐女性样本。 2015年采用自我报告问卷和肥胖的物理测量方法收集数据。进行非参数方差分析以探讨组间差异。使用结构方程建模检验假设模型。
结果
在抽取的样本中,52.5%根据体重指数被列为肥胖女性。 肥胖女性的亲密伴侣暴力、儿童躯体虐待、抑郁症状和创伤后应激障碍症状的水平明显更高。该研究表明,亲密伴侣暴力的严重程度和儿童虐待的严重程度通过抑郁症状间接影响肥胖。
结论
在受虐女性中,令人担忧的肥胖率表明,这些女性患肥胖的风险很大,在临床上必须加以重视。研究结果强调了治疗抑郁症状的必要性,以管控和预防亲密伴侣暴力和儿童虐待幸存者的肥胖。具体而言,护理人员应定制干预措施,以解决肥胖管控过程中虐待的心理健康问题。
This study aimed to examine the association between cultural competency, structural empowerment, and effective communication among nurses in Saudi Arabia. A cross-sectional correlational design was ...used. The study questionnaire utilized three scales: the Culture Competence Scale, Conditions for Work Effectiveness Questionnaire-II, and Communication Competency Assessment Scale. All the scales were culturally adapted and translated using an integrated method. The questionnaire was distributed through an online survey using a convenience sampling approach. Data were collected from 396 participants. The findings showed statistically significant association between cultural competency and effective communication (r = 0.747, p < 0.001) and between structural empowerment and cultural competency (r = −0.123, p = 0.014). Moreover, the overall model with effective communication and structural empowerment as predictors, controlling for nurses’ nationality significantly explains 56% of the variance in cultural competency. Structural empowerment did not significantly predict cultural competency (b = −0.052, β = −0.069, p < 0.052, 95% CI = −0.104, −0.001), while effective communication was found to be a significant positive independent predictor of cultural competency (b = 0.745, β = 0.741, p < 0.001, 95% CI = 0.677, 0.811). The findings underline the need to make effective communication courses mandatory in undergraduate nursing curricula. Healthcare systems should be built such that they support the empowerment of the nursing workforce from different nationalities and establish effective communication policies to enhance cultural competency among nurses. Future research in this area is needed to validate the result of this study.
•Intimate partner violence (IPV) severity and resilience predict the level of hair cortisol concentration among women.•Higher levels of IPV severity leads to lower hair cortisol concentration.•The ...effect of IPV severity on cortisol level is a biomarker of HPA axis function.•Victimization leads to physiological changes and that hair cortisol is an indicator of women’s health status.
Intimate partner violence (IPV) is associated with various health issues, which may be explained by hypothalamic‐pituitary‐adrenal (HPA) axis dysfunction. There is a lack of research examining hair cortisol concentrations as a biomarker of HPA function alterations in the context of IPV with consideration to women’s resilience. The study assessed whether IPV severity and resilience are associated with hair cortisol concentrations among Saudi women. This cross-sectional explanatory design used a convenience sample of 156 Saudi women from health care settings. A structured interview that included self-reported responses was performed, and hair samples were collected. The samples were analyzed using a salivary ELISA kit. The result showed a significant difference in hair cortisol concentration between women who have experienced IPV and women who have not experienced IPV. As well, controlling for depressive and post-traumatic stress disorder, IPV severity (β = −.281, 95 % CI = −.046 to −.003) and resilience (β = −.225, 95 % CI = −.038 to −.005) were significant predictors of lower hair cortisol concentrations. The effect of IPV severity on cortisol levels as a biomarker of HPA axis function could explain the poor health conditions among IPV survivors. This study highlights that IPV victimization leads to physiological changes and that hair cortisol is an indicator of women’s health status.
PDF
