Coronavirus disease 2019 (COVID-19) infection has become a clinical threat to healthy people as well as immunocompromised patients and those with pre-existing chronic diseases around the world. This study, which used a cross-sectional correlational design, aimed to assess the levels of fear and health anxiety and to investigate their predictors during the current outbreak of COVID-19 in immunocompromised and chronic disease patients in Saudi Arabia. Sociodemographic and clinical data, fear of COVID-19, and health anxiety measurements were collected by online surveys from June 15 to July 15, 2020. Univariate and multiple linear regression analysis was used to identify predictors. A total of 1,030 patients in 13 provinces in Saudi Arabia completed the questionnaire. A significant number of patients with chronic diseases experienced considerable levels of fear and anxiety during the COVID-19 outbreak. It was found that 21.44% of participants met the criteria for anxiety cases, and 19.4% were considered borderline anxiety cases. In regression analysis, significant predictors of fear and health anxiety were female gender, lower education, middle-aged, divorced or widowed, receiving immunosuppressants, type of chronic disease (Crohn’s disease, hypertension, and cardiovascular diseases), and media use as a source of knowledge about COVID-19. Immunocompromised and chronic disease patients are vulnerable to fear and anxiety during epidemic infectious diseases such as COVID-19. Optimizing this population’s compliance with appropriate infection prevention and control strategies is crucial during the infectious outbreaks to ensure their safety, to decrease the risk of infection and serious complications, and reduce their fear and health anxiety. Effective positive psychological interventions and support strategies also need to be immediately implemented to increase psychological resilience and improve the mental health of these patients. Due to the COVID-19 outbreak, chronic disease patients in Saudi Arabia need special attention from health authorities, policymakers, and healthcare professionals to manage maladaptive forms of health anxiety and fear.

AimTo explore and understand work stress and its sources among oncology nurses in a Saudi university‐teaching hospital.DesignQualitative descriptive study using semistructured interviews.MethodsFourteen oncology nurses working in a university‐teaching hospital were interviewed between October ‐ December 2016. Qualitative content analysis according to the Krippendorff method was used to explore work‐related stressors among oncology nurses in Saudi Arabia.ResultsTwo categories were emerged including “extent of work stress” and “work‐related stressors”. The second category included the following subcategories of workload and staff shortage, emotional demands, lack of social support, language barriers, and lack of respect from patients and family members and cultural differences.

Nursing is known to be a stressful profession that can lead to physical and psychological health issues and behavioural problems. In oncology, workload among nurses is believed to be increasing in conjunction with rapidly increasing numbers of patients with cancer and staff shortages worldwide, therefore it is essential to sustain a quality oncology nurse workforce. Numerous studies have presented evidence on job strain, effects of coping strategies, and nurses' work performance within healthcare settings, but few have focused on oncology settings and none of these on nurses working in Saudi Arabia. The purpose of this review was to summarize empirical and theoretical evidence concerning job-related stressors in nurses, particularly oncology nurses, and the interrelationships among job strain, coping strategies, and work performance in this population. Search strategies identified studies published on studies in peer-reviewed journals from 2004 to 2016. Twenty-five nursing studies were found examining the relationships among the concepts of interest. Common job-related stressors among oncology nurses were high job demands, dealing with death/dying, lack of job control, and interpersonal conflicts at work. Job strain was found to be significantly linked to coping strategies, and negatively associated with work performance among nurses in general. There is no existing empirical evidence to support the relationship between coping strategies and work performance among oncology nurses. The present evidence is limited, and a considerable amount of research is required in the future to expand the oncology nursing literature. Research is needed to investigate job-related stressors and their effects on oncology nurses.

Relationships between caregiving stress, mental health and physical health in family caregivers of adult patients with cancer: implications for nursing practice Aim: This study was conducted to investigate the relationships between caregiving stress, mental health and physical health in family caregivers of adult patients with cancer at a University Teaching Hospital in Jeddah city, Saudi Arabia. Methods: A cross-sectional correlational study was carried out with a convenience sample of 160 family caregivers of adult patients with cancer. Data were collected using a selfadministered questionnaire including the Modified Caregiver Strain Index, the DUKE Health Profile and sociodemographic items. The data were analysed using the Statistical Package for the Social Sciences (SPSS). Descriptive and inferential statistics and correlations were performed. Results: Participants experienced a certain level of caregiving stress (M = 9.01, SD = 5.645). Many factors were found to be correlated to higher caregiving stress in this study. Caregiving stress showed significant moderate negative correlations with mental and physical health (p < 0.01). Statistically significant differences were found between age, gender, nationality, education, monthly income, and caregiving stress or DUKE Health Profile scores (p < 0.05). Conclusions: Caregiving stress affects family caregivers' mental and physical health. Such stress can disrupt the caregiving performance of family caregivers. Discovering the causes of caregiving stress among the family caregivers of adult patients with cancer may help to determine the main elements affecting patient care and can assist oncology nurses in providing support and services to caregivers. Educational strategies/intervention programs in the hospitals may be required to reduce caregiving stress levels and improve the health and well-being of family caregivers of adult patients with cancer.

Aims and objectives: To assess the knowledge and attitudes of healthcare providers regarding sexual health care in cancer patients in Saudi Arabia and explore possible barriers influencing their attitudes. Background: A growing body of research emphasises the importance of healthcare providers addressing the sexual problems of cancer patients. The literature, however, shows that cancer treatment-related sexual problems are not frequently discussed by healthcare providers as expected. In Saudi Arabia, sexual health care in oncology daily practice has not been addressed sufficiently. Methods: A cross-sectional correlational study was conducted with a convenience sample of 150 healthcare providers from a university teaching and referral hospital providing cancer and palliative care in Jeddah City, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Sexual Healthcare Attitudes and Knowledge survey. Descriptive and inferential statistics and Pearson's correlations were performed. A content analysis was used to enhance understanding and support study's findings. Results: Participants had a poor knowledge related to sexual health care in cancer patients, and the low mean attitudes score also represents negative attitudes and higher levels of barriers. Participants had insufficient knowledge about assessment and evaluation of sexual health in cancer patients, and did not know about sexual dysfunction resulting from cancer and its treatment. Knowledge and attitudes had a significantly positive correlation. Conclusion: The study findings indicate there is room for improvement in the sexual health-related knowledge among oncology nurses, doctors and radiation oncologists. Helping healthcare providers overcome barriers to discussing cancer patients' sexual issues needs a careful evaluation of the knowledge, attitudes and barriers that keep them from discussing such issues. Relevance to clinical practice: It is imperative to improve healthcare providers' sexuality knowledge about cancer patients through introducing sexual health-based continuing education programmes, availability of resources (educational materials and clinical checklists) and training in oncology daily practice.

Research examining leadership in nursing has increased over the past decade, with more emphasis on the role of nurse managers/ leaders in healthcare organizations (Azaare & Gross, 2011;Barr & Dowding, 2019). Leadership focuses on how leaders can influence change and encourage their followers to generate change (Barr & Dowding, 2019). Leadership includes the ability to influence followers through guiding, motivating and directing in order to achieve effective organizational outcomes (Cai et al., 2019;Ellis & Hartley, 2009). As leaders, nurse managers are responsible for creating hospital environments where nurses feel supported and motivated (Abualrub & Alghamdi, 2012). Evidence shows that the following leadership theories have been extensively investigated in a variety of professions, including nursing: transactional leadership, transformational leadership, situational leadership and authentic leadership (Schreuder et al., 2011). Also, there are many leadership styles that nurse managers and leaders use to lead staff nurses in clinical settings such as classical leadership (autocratic, democratic, laissez-faire, bureaucratic and situational) and contemporary

Background Cancer patients receiving chemotherapy experience acute and delayed nausea and vomiting. These side effects obligate the patients to use pharmacological and nonpharmacological methods. The effect of ginger tea as an antiemetic modality on preventing chemotherapy-related nausea and vomiting has not been confirmed in previous studies. Objective The aim of this study was to assess the effect of ginger tea, when given together with the standard antiemetic regimen, on preventing nausea and vomiting in patients with gynecological cancers receiving cisplatin-based regimens. Methods This study used a quasi-experimental research design with 2 groups (control and intervention groups, 50 participants each). A sociodemographic and medical survey and the Modified Rhodes Index of Nausea, Vomiting, and Retching were used to collect the data. Descriptive analyses, t test, and χ 2 test were used to analyze the data. Results The total mean Modified Rhodes Index of Nausea, Vomiting, and Retching scores were lower in the intervention group in all measurements compared with the control group, and the differences between the total mean scores for symptom experience, development, and distress between the groups were statistically significant in the third (P < .05), fourth (P < .01), and fifth (P < .05) measurements. No ginger-related side effects were noted in this study. Conclusions Ginger tea reduced the experience, development, and distress of nausea, vomiting, and retching in the intervention group. The use of ginger tea may be recommended for chemotherapy-associated nausea and vomiting in cancer patients receiving cisplatin-based regimens. Implications for Practice Oncology nurses can lead the implementation of ginger tea intervention to prevent chemotherapy-related nausea and vomiting.

Abstract:Cancer prevalence is increasing in the Kingdom of Saudi Arabia. While the exact etiology of this trend is unknown, it can perhaps be partially attributed to an increased life expectancy and changes in lifestyle habits. One of the main challenges to the provision of appropriate cancer and palliative care is the critical shortage of oncology healthcare professionals, including nurses. The Kingdom of Saudi Arabia is characterized by its Islamic faith, culture, and unique traditions that may contribute to uniquely stressful situations for oncology nurses working in Saudi oncology care settings. This article provides an overview of cancer care and oncology nursing in the Kingdom of Saudi Arabia based on literature reporting challenges experienced by nurses delivering this care within the Saudi Arabian healthcare system and its cancer care services. Published literature written in English on cancer care and oncology nurses in the Kingdom of Saudi Arabia were identified through a search of publicly available databases such as Medline, CINAHL, and Google Scholar as well as government sources. Reference lists were hand searched. Search terms used were Kingdom of Saudi Arabia, Saudi Arabian healthcare system, nursing education, nursing, Saudi nurses, oncology nursing, cancer, and cancer care. Common challenges facing oncology nursing in the Kingdom of Saudi Arabia are related to high job demands, staff shortages, communication and language barriers, and cultural differences that may lead to stressful work environments and reduce the quality of care provided to their patients. While many steps have been undertaken by the Saudi Ministry of Health to reform the healthcare system, a number of challenges remain. The need for greater availability of cancer care and palliative care settings in all Saudi regions is strongly indicated. Nursing administrators/managers should take these factors into consideration to enhance the Saudi oncology care nursing work environment and to improve the quality of nursing care for patients with cancer and their families.