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Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9648
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Item Restricted The experiences of caregivers who utilise respite care services for people with mental illness: A phenomenological exploration(Saudi Digital Library, 2024) Almoaber, Zahra Hassan; Moxham, Lorna; Patterson, Christopher; Curtis, LizBackground: In recent years, there has been a growing focus on caregiving for individuals with a mental illness (MI), particularly concerning the profound impact this role has on caregivers. Research highlights the essential function of respite care services, which play a critical role in alleviating the significant burden many caregivers face. By providing temporary relief from their demanding responsibilities, these services help to reduce stress and offer invaluable peace of mind, ensuring that those receiving care remain safe and well-supported during the caregiver's absence. Despite the increasing recognition of the need for respite care, much of the existing research has predominantly centred on caregivers of individuals with dementia, as well as those caring for individuals with physical or intellectual disabilities. A thorough review of the literature identified a substantial gap in understanding the unique experiences and challenges encountered by caregivers of individuals with mental illness, in relation to utilising respite care. Only a limited number of studies have examined the specific needs and actual experiences of these caregivers, underscoring a crucial area that requires further exploration and support. Aim: This study investigates the experiences of respite care among informal caregivers who provide care for individuals with mental illness. Research Design Methodology: This study used a qualitative methodological approach to investigate the experiences of caregivers of individuals with mental illness while utilising respite care; an interpretative phenomenological approach was conducted in the study to inform the philosophy of the study. Method: A purposive sample of caregivers of individuals with mental illness who utilise respite care (N=14) contributed narrative data through individual in-depth semi-structured face-to-face interviews. The transcripts of these interviews were analysed using van Manen's (2014) approach to data analysis. This process allowed for the identification of elements, themes, and an essence of meaning resulting from the participants' narratives. Findings: Through an analysis of the participants’ narratives, eight elements were identified, resulting in the development of four themes and the essence of meaning. The identified themes include 1) Feeling overwhelmed, 2) The process of obtaining respite, 3) Facility suitability, and 4) The need to keep going. The essence of meaning is summarised as “Constant Caring is Constant.” Discussion: This PhD thesis presents an in-depth analysis of the findings, supplemented by a comprehensive exploration based on an established theoretical perspective of the stress process model. The discussion elucidates the contextual and conceptual aspects of the experiences of caregivers for individuals with mental illness who engage in respite care. Caregivers consistently provide support and assistance to individuals with mental illness, a commitment that often leads to significant stress. Many caregivers encounter considerable challenges in locating appropriate respite services, yet they recognise the importance of persevering in their roles to ensure continued care for those they support. Conclusion and Implications for Practice: Findings from this thesis is vital for the effective provision of respite care. Research indicates that caregivers can significantly benefit from respite services, leading to improvements in both their mental and physical health, as well as an enhanced quality of life. However, there is an urgent need to enhance the delivery of these services. To address the need, service providers should focus on improving communication with caregivers, offering flexible scheduling options, and tailoring services to meet the specific needs of each individual caregiver. Furthermore, it is essential to prioritise training and education for respite care workers, particularly in the areas of managing challenging caregiving situations and providing emotional support to caregivers. Increasing awareness of respite care services is also a crucial consideration. Collaborative campaigns with healthcare providers and community organisations can effectively educate caregivers about the various options available to them. Keywords: caregivers of individuals with mental illness; lived experience; respite care phenomenology; Max van Manen.32 0Item Restricted Cultural representation in Evolve 1: A critical multimodal study.(Saudi Digital Library, 2025) Asiri, Yahya; García Marrugo, AlexandraThis research investigates the cultural representation in Evolve 1, an English as a Foreign Language (EFL) textbook designed for learners in the Middle East and North Africa (MENA) region. While a plethora of studies have explored culture in EFL textbooks, few have adopted both multimodal semiotic and mixed-method approaches. This study analyzes cultural representation both linguistically and visually, combining quantitative measures with qualitative semiotic analysis to provide a more comprehensive understanding of how culture is represented in Evolve 1. The analysis draws on corpus-based methods for linguistic data and applies van Leeuwen’s (2008) social actor representation frameworks (for both visual and linguistic representation) alongside Martin and Rose’s (2007, 2008) tools for analyzing tenor, field, and genre. The study seeks to answer two central questions: (1) Who is represented in the Evolve 1 textbook? and (2) How are they represented? Findings show that although visual representation appears balanced quantitatively, closer analysis reveals the dominance of certain subgroups within cultural categories. Key disparities emerge in gender roles, family structures, and visual strategies across cultures. Notably, representations of MENA cultures tend to be dynamic and internally diverse, challenging simplistic or monolithic portrayals. This study contributes to ongoing efforts to ensure equitable and culturally sensitive representations in global EFL materials. References: van Leeuwen, T. (2008). Discourse and Practice: New Tools for Critical Analysis (1st ed.). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780195323306.001.0001 Martin, J. R., & Rose, D. (2008). Genre relations : mapping culture. Equinox Pub. Martin, J. R., & Rose, D. (2007). Working with discourse : meaning beyond the clause (2nd ed.). Continuum.21 0Item Restricted Nurses’ Competency in the Provision of Diabetes Self-Management Education to Hospitalised Patients in Saudi Arabia(Saudi Digital Library, 2025) Algharash, Hassan; Lynette, Cusack; Rebecca, MuntDiabetes is a significant chronic condition, and one of the ten most common causes of mortality globally. The population of Saudi Arabia has a high rate of diabetes, placing an enormous burden on the healthcare system. Therefore, when the Saudi Arabian government launched the 2030 Vision, one of the main components was to improve the quality of life of people with diabetes. People with diabetes need to self-manage their chronic condition by maintaining their blood glucose levels within a target range to reduce the risk of developing diabetes-related complications. Therefore, it is essential that they receive diabetes self- management education. Nurses in acute care settings, such as medical and surgical wards, are in a position to provide opportunistic diabetes self-management education to inpatients with diabetes. Specialist diabetes educators are not available to inpatients in many hospitals within Saudi Arabia. Therefore, nurses in hospitals must be competent in both diabetes management and patient education to enhance patients’ quality of life. The aim of this study was to understand the attitudes, knowledge and skills of nurses working in Saudi Arabian Ministry of Health hospitals to undertake diabetes self-management education for inpatients, and the facilitators and/or barriers to providing diabetes self- management education to inpatients. The competency in delivering health and patient education framework was employed to guide the study. This framework brings together nurses’ knowledge, skills and attitudes in both their management of diabetes and in delivering patient education. A sequential explanatory mixed- methods design was utilised where quantitative data were collected and analysed first, informing the qualitative data collection and analysis. In the first phase, a paper-based questionnaire was distributed to nurses working in medical and surgical wards in four Saudi Arabian hospitals, attracting 157 responses. The data were analysed using descriptive statistics and multiple linear regression. In the second phase, 12 nurses participated in semi- structured interviews. The qualitative data were analysed using inductive content analysis. The results from both phases were then integrated using a joint display approach. The survey results focused on diabetes management revealed that nurse respondents have outdated knowledge and skills. However, nurse respondents indicated they felt confident and had a positive attitude towards managing inpatients with diabetes. The study also found nurse respondents had a good understanding of and a positive attitude towards inpatient education. In the qualitative phase three main categories were identified: 1) barriers to providing inpatient education, 2) barriers to acquiring diabetes management knowledge, and 3) enablers of providing diabetes self-management education. Data integration highlighted that there are significant environmental factors that are barriers to nurses providing diabetes self-management education to inpatients, such as lack of access to continuing professional development, limited time, an absence of higher management support and lack of patient education resources. To ensure nursing care aligns with the 2030 Vision, nursing leaders must be proactive to address the suboptimal diabetes knowledge and skills, and the environmental barriers to providing effective patient education. Without addressing the current barriers, the quality of care of patients with diabetes will continue to be compromised.28 0Item Embargo Design and synthesis of novel antibacterial peptoids(Saudi Digital Library, 2025) Bahatheg, Ghayah Ali; kumari, Naresh; Black, David StC; Kuppusamy, RajeshOne of the current global challenges is tackling antibacterial multidrug resistance. The defense mechanisms of pathogenic bacteria and biofilm formation have significantly reduced the efficacy of conventional antibiotics. Though antimicrobial peptides (AMPs) have emerged as promising alternatives due to their unique mode of action, their clinical application is limited by issues such as toxicity and high production costs. To overcome these limitations, this project focused on designing and evaluating antibacterial peptidomimetics, specifically oligo-N-substituted glycine’s (peptoids) with amphiphilic structures. In Chapter 2, a series of antibacterial cationic naphthyl-phenyl or naphthyl-indole-based peptoids were synthesized. Compounds 20a and 22 demonstrated the strongest antibacterial activity against 12 S. aureus strains with MIC of 3.2 µg mL−1 and 2.1 µg mL−1, respectively - compared to ciprofloxacin with MIC of 128-256 µg mL−1. Against E. coli, Compounds 12c and 13c were the most active peptoids (MIC = 12 µg mL−1). In Chapter 3, the dimeric amino and guanidino peptoids were synthesized using aromatic moieties to enhance the activity. Amongst these, peptoid 10j showed excellent activity against S. aureus and E. coli with MIC values of 0.8 μg mL−1 and 6.2 μg mL−1, respectively. Also, compounds 10c and 10k were the best peptoids for disrupting S. aureus biofilm. In Chapter 4, a series of substituted phenyl dimeric peptoids was designed by introducing various functional groups to modulate activity. Peptoids 11h and 11i emerged as the most potent, with MICs ranging from 0.75 to 2.6 μg mL−1 against S. aureus and 6.0 to 10.9 μg mL−1 against E. coli. Notably, peptoid 11f showed the highest biofilm-disrupting activity. In the final chapter, peptoids 9j (from Chapter 3) and 10i (from Chapter 4) were subjected to guanidine modifications, generating a library of 30 substituted guanidino peptoids. The majority of these peptoids displayed excellent activity against S. aureus, with MIC values ranging from 1 to 8 μg mL−1, and showed consistent efficacy against E. coli, with average MICs between 4 and 8 μg mL−1. Peptoid 19b stood out as the most effective biofilm disruptor. Throughout the project, the investigation into the mechanism of action revealed that the antibacterial effect might be attributed to the disruption of bacterial cell membranes. Additionally, hemolytic assays confirmed that the most active peptoids were non-toxic to mammalian red blood cells ( HC₅₀ = 25 - 50 μM).14 0Item Restricted Design and Pilot Testing of a Mobile Health Application for the Chronic Care of Sickle Cell Disease in Adolescents and Young Adults in Saudi Arabia: Mixed Methods Study(Saudi Digital Library, 2025) Almarzooq, Fatimah; Pitt, Victoria; Inder, Kerry; Alqudah, Muhammad; Gollapalli, MohammedBackground Saudi Arabia has one of the highest burdens of sickle cell disease, leading to significant healthcare challenges and profoundly affecting the lives of individuals and families. This has been linked to the high prevalence of consanguineous marriage. The adolescent and young adult sickle cell disease-related mortality rate in Saudi Arabia is relatively high, due to a lack of an adolescent self-management transition program to adulthood care. Research on mobile health applications for adolescents and young adults living with sickle cell disease in Saudi Arabia is limited. This thesis explores the design of a mobile health application for adolescents and young adults living with sickle cell disease and evaluates its impact on health-related quality of life, self-management practices, and coping strategies for stressors. Aim The aim of this study was to design, develop and pilot test a mobile health application based on the electronic health enhanced chronic care model for adolescents and young adults living with sickle cell disease in Saudi Arabia referred to as the SCD-care app; evaluate the usability and feasibility of the SCD-care app; and compare health-related quality of life, self-management practices, and coping strategies for stressors pre and post-use of the SCD-care app. Methods This pilot study used an explanatory sequential mixed method design conducted in one Saudi government-funded teaching hospital in the city of Al Khobar in Saudi Arabia. After designing and developing the SCD-care application, pre- and post-intervention quantitative surveys were administered to assess health-related quality of life, self-management practices, and coping strategies for stressors among consenting adolescent and young adults with sickle cell disease. Correlational analyses were used to analyse the quantitative findings. Qualitative in-depth semi-structured interviews were conducted with participants post-intervention and analysed thematically. Further evaluation was conducted on the usability and feasibility of the application. Results from the two methods were integrated and discussed to inform the recommendations for policy, practice and future research. Results The SCD-care app demonstrated a significant positive impact on adolescents and young adults with sickle cell disease in Saudi Arabia. Of 93 potential participants, 53 completed the pre-intervention phase, with 43 completing all study phases. Ten adolescent and young adults participated in the qualitative phase. Quantitative findings showed statistically significant improvements in health-related quality of life, self-management practices, and coping strategies for stressors. Participants reported a 25% increase in overall health-related quality of life post-intervention (p<0.001), with gains in domains such as social functioning, energy, emotional well-being, and general health prescription. Self-management practices improved markedly, with participants 3.4 times more likely to practice self-management post-intervention (p=0.004). Additionally, coping strategies shifted toward active coping, with significant reductions in maladaptive coping, including denial (p=0.014) self-blame (p=0.008) and substance use (p=0.028). The application demonstrated high usability as evidenced by satisfaction scores, while quantitative evaluation of feasibility faced limitations due to server data loss. Qualitative analysis supported these findings, with participants highlighting the app’s usability and supportive features, particularly the reminder functions and educational content. Participants reported increased confidence in managing their condition and made design related suggestions. Themes emerging from qualitative exploration of the usability and feasibility of the SCD-care app included usability and supportiveness. Overall, the SCD-care app enhanced health-related quality of life, self-management practices, and coping with stressors among adolescents and young adults with sickle cell disease in Saudi Arabia. This study’s limitations include its single-hospital setting, small sample size, and non-randomised design, which may affect the generalisability of the findings. There were challenges in participant recruitment and the short duration of the pilot. Conclusion This study successfully designed, developed and piloted the SCD-care app, demonstrating its potential to enhance general well-being for adolescents and young adults with sickle cell disease in Saudi Arabia. Guided by the electronic health chronic care model and an explanatory sequential mixed method approach, the findings demonstrated statistically significant improvements across dimensions of health-related quality of life, self-management practices, and coping strategies and identified the application as a usable tool for addressing the diverse challenges associated with managing sickle cell disease.7 0Item Restricted Defining the Effect of BTK Inhibitors on Haemostasis and Thrombosis(Saudi Digital Library, 2025) Alanazi, Majed Awadh; Jackson, DeniseABSTRACT Bruton’s tyrosine kinase (BTK) is a cytoplasmic kinase that is a member of the Tec kinase family that has an essential role in B-cells and haematopoietic cells including platelets. In addition, BTK plays a role in ITAM-mediated platelet activation pathways. In terms of primary haemostasis, BTK is important in platelet activation pathways that lead to formation of a platelet plug. In contrast, secondary haemostasis involves the activation of clotting factors that also contribute to the formation of a blood clot. During this process, the damaged blood vessel releases thrombogenic agents. One of these components is thrombin, that activates clotting factors including fibrinogen to convert to fibrin to form a blood clot. BTK is involved in the GPVI/FcR gamma chain, CLEC-2 and FcgammaRIIa mediated signalling pathways that are activated when platelets are stimulated, and it is thought to play a role in the formation of this platelet plug. However, BTK plays an important role in activating normal B lymphocytes leading to maturation and proliferation. In B-cell lymphoproliferative disease such as chronic lymphocytic leukaemia (CLL), waldenstroms macroglobulinaemia (WM), mantle cell lymphoma (MCL), small lymphocytic lymphoma (SLL) and autoimmune disorders. BTK protein and mRNA are highly overexpressed compared to normal B cells leading to promotion of maturation, proliferation and apoptosis. As a result, covalent irreversible BTK inhibitors that target Cysteine 481 in kinase domain such as Ibrutinib and Zanubrutinib, have been developed to target and inhibit BTK to treat these conditions. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, is successful in providing advances in B-Cell-associated CLL and related disease. However, concerns are raised against the BTK inhibitor-related bleeding events, which have led to cautious monitoring of patients on Ibrutinib. The pathophysiological aspects have suggested a decreased signalling of 1 GPVI/FcR gamma chain and CLEC-2 pathways and some kinases like HER2, ITK, JAK3, EGFR, and Tec. To investigate the potential causes of bleeding associated with BTK inhibitors, this study will examine the impact of Ibrutinib, the more selective BTK inhibitor Zanubrutinib, and the novel BTK degrader NX-2127. Unlike traditional BTK inhibitors, NX-2127 functions through targeted protein degradation, leading to the proteasomal degradation of BTK rather than its inhibition. This study aims to define the mechanisms of platelet glycoprotein receptor shedding, the effects of BTK inhibitors and degraders on primary and secondary haemostasis, and their roles in thrombus formation and growth. We hypothesise that BTK inhibitors, including Ibrutinib (BGB-1672) and Zanubrutinib (BGB-3111), as well as the BTK degrader NX-2127, have differential effects on haemostasis and thrombosis, with NX-2127 potentially displaying distinct effects due to its mechanism of action. The findings from this thesis demonstrated that Ibrutinib, but not Zanubrutinib or NX- 2127, induced significant platelet receptor shedding (GPIbα, GPV, GPIX, and αIIbβ3), contributing to reduced platelet adhesion and impaired thrombus formation. Functional assays showed that Ibrutinib, but not Zanubrutinib, altered clot firmness and platelet-dependent clot stability, while secondary haemostasis remained unaffected across all treatments. NX-2127 did not impair platelet function despite inducing BTK degradation. These results support the hypothesis that BTK inhibitors have differential effects on haemostasis and thrombosis, and suggest that BTK degrader NX-2127 may offer therapeutic advantages with a reduced bleeding risk.18 0Item Restricted Predicting Client Default Payments Using Machine Learning in Production Environment(Saudi Digital Library, 2025) Alanazi, Reem; LavendiniThis project investigates the application of machine learning techniques to predict client default payments in a credit card setting. Using a dataset of 30,000 Taiwanese clients, the study addresses the challenges of class imbalance, predictive accuracy, and fairness in credit risk assessment. An XGBoost model was developed and enhanced through feature engineering, resampling techniques (SMOTE/ADASYN), and class weighting to improve recall for defaulters while maintaining overall accuracy. Interpretability was achieved using SHAP values, providing transparency into model decisions. To mitigate demographic disparities, particularly across education levels, a fairness-constrained Random Forest was integrated into a two-stage cascade framework, reducing false positives while preserving high recall. The final cascade model achieved 84% accuracy, with 93% recall for non-defaulters and 53% recall for defaulters, significantly outperforming baseline benchmarks. Fairness audits revealed that education-based disparities could be reduced with minimal performance trade-offs, while age-based fairness was largely maintained. The project demonstrates a practical, interpretable, and ethically aware pipeline for credit default prediction, with deployment considerations and directions for future research in cost-sensitive learning, advanced fairness constraints, and real-time monitoring17 0Item Restricted An investigation of the engagement of cGAS STING signaling upon DNA damage in cancer cells(Saudi Digital Library, 2023) ALASMARI, SUMAIAH SAEED ALI; Gantier, MichaelDNA damage is a common in feature of cancer cells, potentially causing nuclear and mitochondrial DNA to leak into the cytoplasm through various mechanisms. Accumulation of cytoplasmic DNA can lead to the engagement of the cGAS-STING pathway, which in turn modulates the immune response in the tumor microenvironment. While STING signaling has been shown to have anti-cancer activity through interferon-β production, recent evidence suggests that it may also drive the secretion of proinflammatory and pro-tumorigenic factors, particularly in the context of the DNA damage response to radio and chemotherapies. In this PhD project, we found that pharmacological inhibition of the cGAS-STING pathway can reduce the production of pro-tumorigenic IL-6, in select cancer cells. However, some cancer cells that rely on non-canonical STING signaling were resistant to this inhibition. Interestingly, we also discovered that STING inhibition could result in enhanced cancer cell growth, which we attributed to a decreased basal interferon activity in these cells. To limit the production of pro-inflammatory factors upon DNA damage while retaining the antiproliferative effects of the STING-interferon axis, we investigated the inhibition of downstream modulators of NF-κB signaling, such as ERK1/2. Additionally, we discovered that a novel STING-TBK1 inhibitor, IDX, modulated both canonical and non-canonical STING signaling. Our further analyses indicated that the inhibitory activity of IDX on non-canonical STING driven NF-κB signaling was independent of ERK1/2 MAP kinases. We also found that an inhibition of cGAMP extracellular secretion through inhibition of VRAC-LRRC8A, significantly reduced the amplification of DNA-damage driven inflammation mediated by cGAS-STING in cancer tissues. These findings suggest that strategies that limit the diffusion of cGAMP may help reduce the production of pro-tumorigenic pro-inflammatory factors during chemo and radiotherapies. Collectively, the works from this PhD have shed light on the complex role of the cGAS-STING pathway in cancer and have highlighted novel potential strategies for improving the efficacy of cancer radio and chemotherapies through the modulation of this pathway.9 0Item Restricted Leadership and Policy: An Ethnographic Exploration of Inclusive Education for Students with Hearing Loss in a Saudi Primary School(Saudi Digital Library, 2025) Alomair, Latifah Abdulaziz; Round, Penny; Fernandes, VenesserThis study explores how inclusive education (IE) is implemented for students with hearing loss (SwHL) in a Saudi primary school, focusing on the leadership roles of senior, middle, and teacher leaders. It also examines how national education policies influence school-level inclusion. Using an ethnographic approach, data were collected through interviews, observations, document analysis, and fieldnotes involving school leaders, teachers, parents, students, and an official. An integrated framework—drawing from Hitt and Tucker’s (2016) leadership domains, UNESCO’s (2005) IE principles, and the Saudi Arabian School Leadership Standards (2020)—guided the analysis of five key leadership practices: establishing an inclusive vision, building professional capacity, fostering inclusive teaching and learning, developing an inclusive organisation, and strengthening partnerships with families. Findings reveal gaps between policy and practice, such as the absence of specific IE guidelines, the lack of formal leadership roles for special educators, and insufficient structured inclusion training. While school leaders support inclusion, efforts often lack strategic direction. Nonetheless, teachers independently adapt teaching methods to support SwHL, even if inconsistencies arise due to a lack of structured training and reliance on special educators. SwHL generally participate in classroom activities and peer interactions; however, the use of labels, while not resulting in overt social or educational exclusion, creates unintended distinctions. This signals a need for greater awareness among schools to foster a more fully inclusive environment. This research contributes to understanding IE leadership in Saudi Arabia, offering practical insights on translating policy into practice. It underscores the need for explicit guidelines, structured professional development, formalised middle leadership roles, and collaborative approaches to enhance inclusion. As Saudi Arabia advances toward Vision 2030, these findings inform the policies and leadership practices essential for fostering equitable learning environments where all students can thrive.13 0Item Restricted EVALUATION OF A NEW PSYCHOEDUCATION INTERVENTION FOR WOMEN WITH GESTATIONAL DIABETES IN SAUDI ARABIA: A MIXED METHODS STUDY(Saudi Digital Library, 2025) Alshammari, Mutairah; Lee, Regina; Stubbs, Michelle; Chan, SallyBACKGROUND Gestational diabetes mellitus (GDM) is a type of diabetes that occurs during pregnancy. Although GDM occurs in the second or third trimester, it poses significant short and long-term complications for both the mother and the newborn. Moreover, its maternal complications extend beyond physical health including psychological impacts such as stress, anxiety, and depression. These psychological consequences can weaken pregnant women’s abilities to follow the recommended treatment plans and self-management practices. Therefore, effective strategies to overcome the physical and psychological burdens of GDM are needed. Psychoeducation interventions, which integrate psychosocial support along with health education to improve self-care practices, and coping skills, may serve as a promising solution for pregnant women with GDM. Considering the widespread use of the Internet, integrating digital health tools into psychoeducation interventions may offer valuable support for pregnant women with GDM, which could enhance their engagement and treatment adherence. METHODS This thesis used an experimental mixed methods design, which consists of two phases. In phase 1, a qualitative descriptive study was carried out using semi-structured phone interviews. The objective of this phase was to obtain deep understanding of the experiences and perspectives of pregnant women with GDM regarding GDM self-management. Data from this phase were used to guide the development of the psychoeducation intervention in phase 2. In phase 2, a randomised controlled trial (RCT) was carried out. The objective of the RCT study was to evaluate the effectiveness of the psychoeducation intervention in enhancing self-efficacy and self-care behaviours (primary outcomes), as well as evaluating its effect on knowledge, anxiety and depression and birthing outcomes, (secondary outcomes). Participants assigned to the intervention group were invited for interviews (process evaluation) after completion of the RCT to evaluate the newly developed psychoeducation intervention. RESULTS In phase 1 (qualitative interviews), thirteen pregnant women with GDM were recruited. Themes generated from the qualitative thematic analysis included experience and previous knowledge, current deficit, and factors impacting GDM self-management. These themes highlighted the need for comprehensive education interventions that address the physical and psychological well-being of pregnant women with GDM, and the need for ongoing support through direct communication channels. In the phase 2 (RCT), 84 participants were assigned randomly into intervention (n=42) and control groups (n=42). The intervention group received a 4-week psychoeducation intervention delivered via face-to-face group sessions and WhatsApp platform, while the control group received usual care at the selected hospitals. The primary outcomes measured included UK-Diabetes Management Self-Efficacy Scale (DSMES-UK), and the Summary of Diabetes Self-Care Activities (SDSCA). The secondary outcomes measured included GDM knowledge questionnaire, Depression, Anxiety and Stress Scale - 21 Items (DASS-21), and birthing outcomes. Data were collected at three time points: baseline, immediate post intervention at 4th week and at 6th week after the intervention. Birthing outcomes were collected only once after the participants gave birth. Findings at 4- and 6-week showed significant improvement in self-efficacy, self-care behaviours, knowledge, and anxiety in the intervention group compared to the control group. Findings at 4-week time point showed significant improvement in depressive symptoms, but this improvement failed to reach the significant level at 6-week time point. No significant difference was observed between groups in birthing outcomes. In the qualitative process evaluation, twenty-two participants from the intervention group were recruited. The participants’ feedback on the psychoeducation intervention was positive. The participants supported that the 4-week psychoeducation intervention enhanced knowledge, emotional well-being, self-efficacy, motivation and healthy changes in lifestyle practices. They voiced that they received detailed, practical, and accessible contents. They appreciated the value of sharing their experiences, which fostered a sense of connection and strengthened their bonds. The participants offered recommendations for enhancing the psychoeducation intervention including the inclusion of a multidisciplinary team, and the inclusion of family members. CONCLUSION The overall study findings supported the feasibility and usefulness of the psychoeducation intervention for pregnant women with GDM. The quantitative outcomes indicated positive effects of the psychoeducation intervention on self-efficacy, self-care behaviours, knowledge, and depression and anxiety. The qualitative process evaluation supported the perceived benefits of the psychoeducation intervention. Conducting future studies with longer follow-up periods to investigate the long-term effects of the psychoeducation intervention is recommended. Future studies should also consider involving family members and evaluate the effectiveness of such approach on social support and relationships.2 0