The objective of the study is to determine the impact of urinary incontinence (UI) on the quality of life (QoL) of the Saudi elderly population. Besides, we investigated individuals' help-seeking behaviors and the religious and cultural aspects of UI among the Saudi elderly. Methods We conducted a cross-sectional study using a random sample of 150 Saudi older adults of both genders. The participants were outpatient clinics of government and private hospitals in Riyadh from January-March 2019. Volunteer medical students interviewed and distributed a standard questionnaire form (Arabic version of the ICIQ-SF [International Consultation on Incontinence Questionnaire] with 33 additional questions, four of which came from them from the King's Health Questionnaire (KHQ) to the targeted population. Results In this study, there were 124 elderly participants (response rate 83%), of whom 62.9% were women. The mean age was 71.9 (±7.8). The "moderate" and "severe" ICIQ scores account for 78 (62.9%) and 32 (25.8%), respectively. There was a significant association between the ICIQ scores severity of UI and increasing BMI, nocturnal diuresis, urinary tract infection, and lung diseases. However, 36.3% of participants did not seek help due to misconceptions about UI and aging, unavailability of treatment, and embarrassment of sharing such symptoms with others. The participants suffered from limitations of social life (36.3%), a negative impact on their physical activity (18.5%), personal hygiene (21.8%), and their self-esteem (32.3%). About 17% and 33.1% of participants repeat ablution and prayers of participants, respectively. Conclusions Urinary incontinence (UI) is a common and distressing problem in the elderly. A large proportion of the participants had a detrimental effect on their quality of life. A substantial percentage of older adults did not seek help. As a result, we recommended raising awareness about UI, QoL, the misconceptions, and encourage them to overcome the stigma of embarrassment and seek medical help.

Background and Aim According to previously reported studies in the literature, a significant number of patients do not receive enteral nutrition in pediatric intensive care unit (PICU) because of avoidable barriers. Optimal nutrition is a fundamental goal in PICU. This study aims to identify the barriers of enteral nutrition in PICU. Setting and Design A cross-sectional study of the results of a 25-item questionnaire-based survey distributed during the Annual International Critical Care Conference by the Saudi Critical Care Society. Methods and material A 7-point Likert-type scale was used to rank the participants’ responses, and the relative importance index (RII) approach was used to analyze the relative contribution of each indicator to its main theme. The factor and parallel analysis methods were used to assess the factorial and unidimensionality of the enteral feeding barriers scale. Results A total of 223 PICU healthcare workers from various intensive care settings responded to the survey. The top-three perceived barriers for commencing enteral feeding were due to the patient being hemodynamically unstable (M = 3.6 and SD = 1.70), delays and difficulties in obtaining small bowel access in patients not tolerating other types of enteral nutrition (M = 3.4 and SD = 1.52), or severe fluid restriction, particularly in postoperative cardiac surgery (M = 3.3 and SD = 1.59). The top perceived overall barriers to enteral feeding were the dietician-related issues (M = 3.3, SD = 1.32), barriers related to enteral feeding delivery (M = 3.16 and SD = 1.13), and medical practice-related (M = 3 and SD = 1.10) issues. The lowest reported overall barriers were the resource-related obstacles (M = 2.7 and SD = 1.26). Conclusion Being hemodynamically unstable and other dietician-related reasons were the top overall barriers in commencing enteral feeding.

Background The study aims to evaluate the perceptions of pediatric residents under the night float (NF) on-call system and its impact on well-being, education, and patient safety compared with the traditional 24-h on-call system. Methods The study is prospective in nature and conducted on two pediatric resident training centers who apply the NF on-call system as a pilot project. Senior residents (PGY-3 and PGY-4) enrolled in the two training centers were invited to participate before and 6 months after the implementation of the change in the on-call system. A self-administered online questionnaire was distributed. Responses were rated using a five-point Likert-type scale (1 = strongly disagree; 5 = strongly agree). The items covered three main domains, namely, residents’ well-being, ability to deliver healthcare, and medical education experience. Pre- and post-intervention scores were presented as means and compared by t-test for paired samples. Results A total of 42 residents participated in the survey (female = 24; 57.1%). All participants were senior residents; 25 (59.6%) were third-year residents (PGY-3), whereas 17 (40.4%) were fourth-year residents (PGY-4). The participants reported that many aspects of the three domains were improved with the introduction of the NF system. The system was perceived to exert less adverse health effect on the residents (mean: 2.37 ± 1.01) compared with the 24-h on-call system (mean: 4.19 ± 0.60; P < 0.001). In addition, the NF system was perceived to lead to less exposure to personal harm and result in less negative impact on quality of care, better work efficiency, reduced potential for medical errors, more successful teaching, and less disruptions to other rotations compared with the 24 h on-call system (P < 0.001). Conclusion The perception of senior residents toward the 24-h on-call system pertains to negative impacts on well-being, education, and patient safety compared with on-call systems with restrictive duty hours, such as the NF system, which is perceived to be less harmful, to exert positive impacts on the quality of delivered healthcare services, and more useful from pedagogic aspect.

Background: This study aims to evaluate the pediatric residents’ perceptions of the Night Float (NF) on-call system and its impact on their well-being, education and patient safety and compare it with the previous traditional 24-hour on-call system. Methods: This is a prospective study conducted in two pediatric residents training centers who applied the NF on call system as a pilot project. The senior residents enrolled in the two training centers were invited to participate in this study before changing the on-call system and 6 months after starting the new NF on-call system. A self-administered online questionnaire was distributed to them. A five-point Likert-type scale was used to rank the residents’ responses, covering three main domains; residents’ well-being, ability to deliver health care, and their medical education experience. Pre- and post-intervention scores were presented as means and compared using the t-test for paired samples. Results: A total of 42 residents participated in the survey. Of these, 24 (57.1%) were females. All participants were senior residents; 25 (59.6%) were third year residents while 17 (40.4%) were fourth year residents. Participants felt that most aspects of the three domains were improved by the introduction of the NF system. The NF system had less adverse health effect on the residents (Mean 2.37±1.01), compared to the 24 hours on-call system (Mean 4.19±0.60), P ˂0.001. The NF system had less exposure to personal harm, less negative impact on the quality of care, better work efficiency, reduced potential for medical error, more successful teaching and fewer disruptions to other rotations compared to the 24 hours on-call system, (P ˂0.001). Conclusion: In this study, we found that the NF on-call system positively impacts residents’ well-being, education and patient care. This pilot study demonstrates that the restricted duty hours are useful from pedagogic aspect and sets the ground for Pediatric residency training programs in Saudi Arabia to consider resident duty hour reform. Trial registration: Not applicable

Background: The study aims to evaluate the perceptions of pediatric residents under the night float (NF) on-call system and its impact on well-being, education, and patient safety compared with the traditional 24-hour on-call system.Methods: The study is prospective in nature and conducted on two pediatric resident training centers who apply the NF on-call system as a pilot project. Senior residents (PGY-3 and PGY-4) enrolled in the two training centers were invited to participate before and six months after the implementation of the change in the on-call system. A self-administered online questionnaire was distributed. Responses were rated using a five-point Likert-type scale (1 = strongly disagree; 5 = strongly agree). The items covered three main domains, namely, residents’ well-being, ability to deliver healthcare, and medical education experience. Pre- and post-intervention scores were presented as means and compared by t-test for paired samples.Results: A total of 42 residents participated in the survey (female = 24; 57.1%). All participants were senior residents; 25 (59.6%) were third-year residents (PGY-3), whereas 17 (40.4%) were fourth-year residents (PGY-4). The participants reported that many aspects of the three domains were improved with the introduction of the NF system. The system was perceived to exert less adverse health effect on the residents (mean: 2.37 ± 1.01) compared with the 24-hour on-call system (mean: 4.19 ± 0.60; P ˂ 0.001). In addition, the NF system was perceived to lead to less exposure to personal harm and result in less negative impact on quality of care, better work efficiency, reduced potential for medical errors, more successful teaching, and less disruptions to other rotations compared with the 24 hour on-call system (P ˂ 0.001).Conclusion: The perception of senior residents toward the 24-hour on-call system pertains to negative impacts on well-being, education, and patient safety compared with on-call systems with restrictive duty hours, such as the NF system, which is perceived to be less harmful, to exert positive impacts on the quality of delivered healthcare services, and more useful from pedagogic aspect.Trial registration: Not applicable

Background:This study aims to evaluate the pediatric residents’ perceptions of the Night Float (NF) on-call system and its impact on their well-being, education and patient safety and compare it with the previous traditional 24-hour on-call system. Methods: This is a prospective study conducted in two pediatric residents training centers who applied the NF on call system as a pilot project. The senior residents (PGY-3 & PGY-4) enrolled in the two training centers were invited to participate in this study before changing the on-call system and 6 months after starting the new NF on-call system. A self-administered online questionnaire was distributed to them. A five-point Likert-type scale was used to rank the residents’ responses (1 means strongly disagree & 5 means strongly agree), covering three main domains; residents’ well-being, ability to deliver health care, and their medical education experience. Pre- and post-intervention scores were presented as means and compared using the t-test for paired samples.Results: A total of 42 residents participated in the survey. Of these, 24 (57.1%) were females. All participants were senior residents; 25 (59.6%) were third year residents while 17 (40.4%) were fourth year residents. Participants felt that most aspects of the three domains were improved by the introduction of the NF system. The NF system was perceived to have less adverse health effect on the residents (Mean 2.37±1.01), compared to the 24 hours on-call system (Mean 4.19±0.60), P ˂0.001. The NF system was perceived to have less exposure to personal harm, less negative impact on the quality of care, better work efficiency, reduced potential for medical error, more successful teaching and fewer disruptions to other rotations compared to the 24 hours on-call system, (P ˂0.001).Conclusion: The senior residents’ perception about the 24-hour on-call system has shown a negative impact on the residents’ well-being and education of residents and patient safety compared to an on-call system with more restrictive duty hours. The perception of the restricted duty hours was perceived to be less harmful, more useful from pedagogic aspect and has positive impact on the quality of delivered health care services.