# Barriers and Facilitators to Patient Education Among Nurses in Multicultural Hospital Settings: A Cross-Sectional Study

## TL;DR

This study explores what helps and hinders nurses in Saudi Arabia from providing patient education in multicultural hospital settings.

## Contribution

The study identifies specific barriers and facilitators to patient education in Saudi hospitals with diverse nursing workforces.

## Key findings

- Language and cultural differences were the top patient-related barriers to patient education.
- Staff shortages and heavy workload were the most significant nurse-related barriers.
- Facilitators included having clear policies, PE training, and integrating education into workflows.

## Abstract

Background: Patient education (PE) is an essential component of quality healthcare and chronic disease management. However, effective implementation often faces patient-, nurse-, and organization-related barriers. This is particularly relevant in multicultural healthcare settings such as Saudi Arabia, where a highly diverse nursing workforce may influence PE practices. Aim: To examine the barriers and facilitators influencing patient education practices among nurses working in multiple hospitals in Saudi Arabia. Methods: A descriptive cross-sectional study was conducted among 289 registered nurses recruited through convenience sampling from various hospitals in Saudi Arabia. Data were collected using a validated self-administered questionnaire consisting of demographic items and structured scales assessing PE barriers and facilitators. Descriptive statistics were used to analyze the data. Results: Language differences (64.3%) and cultural barriers (59.2%) were the most commonly reported patient-related obstacles. Among nurse-related barriers, staff shortages (72.4%), heavy workload (72.0%), and time constraints (59.9%) were prominent. Organizational barriers included limited educational resources (39.4%) and unsupportive environments (35.6%). Key facilitators identified by nurses included availability of policies and procedures (63.6%), provision of PE training (63.7%), and integration of PE into clinical workflow and nurse appraisals. Conclusions: Despite strong professional support for PE, multiple barriers hinder its implementation in Saudi hospitals. Addressing these challenges requires institutional strategies such as workforce reinforcement, policy integration, and resource allocation. Future efforts should also include integrating patient perspectives, developing culturally tailored education resources, and evaluating the impact of targeted interventions to strengthen PE delivery in diverse hospital settings.