Diabetes Care Knowledge-Practice Gap Among Primary Healthcare Nurses in Saudi Arabia: A Cross-Sectional Assessment of Competency and Training Needs.
- 1Family Medicine, Khobar Health Network, Eastern Cluster, Ministry of Health, Al Khobar, SAU.
- 2Nursing, Khobar Health Network, Eastern Cluster, Ministry of Health, Al Khobar, SAU.
Abstract
Introduction
Primary healthcare nurses deliver most routine diabetes contact, yet regional studies rarely test whether nurses self-rated confidence matches objective knowledge. This study assessed diabetes knowledge, self-efficacy, and satisfaction among primary care nurses, and examined concordance between knowledge and self-rated confidence.Methods
This cross-sectional study was conducted among primary care nurses at 11 primary health centers in Eastern Province, Saudi Arabia. A structured questionnaire combining a 36-item diabetes knowledge test and 17-item self-efficacy scale (5-point Likert) was piloted on 10 respondents (Cronbach's alpha=0.948) before administration to the main analytic sample of 100 nurses. Knowledge and self-efficacy scores were compared using Spearman correlation, Mann-Whitney U, and Kruskal-Wallis tests (p<0.05).Results
Mean knowledge score was 53.7% (SD 18.9); 59% had poor knowledge (<60% correct). Self-efficacy was moderate-to-high overall (mean 3.66/5). Knowledge and self-efficacy scores were only weakly-to-moderately correlated (Spearman's rho=0.38, p<0.001); 33% of nurses showed knowledge-confidence discordance (20% underconfident, 13% overconfident). Prior diabetes-specific training was associated with significantly higher self-efficacy (p=0.005) but not objective knowledge (p=0.47). Qualification level was associated with knowledge scores on univariate analysis (p=0.016) but not after adjusting for training, experience, and chronic-unit exposure (p=0.088). Glucagon injection technique was the lowest-rated competency (mean 2.57/5); satisfaction with training received was low (mean 2.24/5) and uncorrelated with objective knowledge (p=0.48).Conclusion
Primary care nurses show a measurable disconnect between diabetes-related confidence and objective knowledge: existing training is associated with strengthened self-assurance without a proportional association with improved knowledge. Structured, competency-verified training targeting glucagon administration and Ramadan-specific counseling is needed to close this gap and safeguard patient outcomes.
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BibTeX
@article{ali2026diabetes,
title = {{Diabetes Care Knowledge-Practice Gap Among Primary Healthcare Nurses in Saudi Arabia: A Cross-Sectional Assessment of Competency and Training Needs.}},
author = {Ayat Ali Al Ali and Abdulrahman Fouad Alkhateeb and Sanaa Sadiq Alsaad and Abdullah Albahussain and Ahlam Saeed Almadhi},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116567},
url = {https://europepmc.org/article/MED/42903511},
note = {CC BY},
}
RIS
TY - JOUR
TI - Diabetes Care Knowledge-Practice Gap Among Primary Healthcare Nurses in Saudi Arabia: A Cross-Sectional Assessment of Competency and Training Needs.
AU - Ayat Ali Al Ali
AU - Abdulrahman Fouad Alkhateeb
AU - Sanaa Sadiq Alsaad
AU - Abdullah Albahussain
AU - Ahlam Saeed Almadhi
PY - 2026
DA - 2026/09/20
JO - Cureus
DO - 10.7759/cureus.116567
UR - https://europepmc.org/article/MED/42903511
AB - Introduction Primary healthcare nurses deliver most routine diabetes contact, yet regional studies rarely test whether nurses self-rated confidence matches objective knowledge. This study assessed diabetes knowledge, self-efficacy, and satisfaction among primary care nurses, and examined concordance between knowledge and self-rated confidence.Methods This cross-sectional study was conducted among primary care nurses at 11 primary health centers in Eastern Province, Saudi Arabia. A structured questionnaire combining a 36-item diabetes knowledge test and 17-item self-efficacy scale (5-point Likert) was piloted on 10 respondents (Cronbach's alpha=0.948) before administration to the main analytic sample of 100 nurses. Knowledge and self-efficacy scores were compared using Spearman correlation, Mann-Whitney U, and Kruskal-Wallis tests (p<0.05).Results Mean knowledge score was 53.7% (SD 18.9); 59% had poor knowledge (<60% correct). Self-efficacy was moderate-to-high overall (mean 3.66/5). Knowledge and self-efficacy scores were only weakly-to-moderately correlated (Spearman's rho=0.38, p<0.001); 33% of nurses showed knowledge-confidence discordance (20% underconfident, 13% overconfident). Prior diabetes-specific training was associated with significantly higher self-efficacy (p=0.005) but not objective knowledge (p=0.47). Qualification level was associated with knowledge scores on univariate analysis (p=0.016) but not after adjusting for training, experience, and chronic-unit exposure (p=0.088). Glucagon injection technique was the lowest-rated competency (mean 2.57/5); satisfaction with training received was low (mean 2.24/5) and uncorrelated with objective knowledge (p=0.48).Conclusion Primary care nurses show a measurable disconnect between diabetes-related confidence and objective knowledge: existing training is associated with strengthened self-assurance without a proportional association with improved knowledge. Structured, competency-verified training targeting glucagon administration and Ramadan-specific counseling is needed to close this gap and safeguard patient outcomes.
SN - 2168-8184
ER -