SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted Developing an Evidence-Based Educational Framework to Support the Trauma Care Competencies of Intensive Care Unit Nurses in Saudi Arabia(King’s College London, 2024-02) Almarhabi, Maha Ahmed; Philippou, Julia; Cornish, Jocelyn; Raleigh, MaryBackground The management of trauma patients in intensive care units (ICU) has a significant impact on patients’ survival and outcomes. Trauma care during this phase is complex, and care management requires skilled and knowledgeable nurses to deliver competent care and improve patient safety and outcomes. To ensure the delivery of competent care within the high-tech and constantly changing ICU practice, continuous and in-service education/training are needed. Research on trauma care education beyond emergency in critical care environments is scarce, especially in contexts that have a workforce with diverse educational backgrounds. Overarching aim To develop an educational framework that informs the basis of and/or theoretically drives interventions for supporting ICU nurses' trauma care competencies, meeting the needs of a mixed-culture workforce context in Saudi Arabia. Design and Methods The study was guided by the Medical Research Council (MRC) framework for developing complex interventions and consisted of three phases, drawing upon the development stage of this framework: Phase 1 involved a systematic review and meta-analysis that examined the effect of educational interventions on trauma ICU nurses' competence. Additionally, a review of educational learning theories was also completed to base the educational framework development on established theoretical ground. Phase 2 consisted of the main study, which was an exploratory multiple embedded case study design that incorporated three hospitals from two different regions within the Kingdom of Saudi Arabia. Key informants or stakeholders were members of the nursing workforce recruited from the adult intensive care units (ICUs). Data were collected through semi-structured interviews complemented by documentary reviews of trauma-related education syllabi, competencies, and care protocols. This was to provide an in-depth understanding of the local context, practice, and education needs in ICU trauma care and to explore the factors influencing nurses’ in-service education in Saudi Arabia. This followed by, Phase 3 involved stakeholders' focus groups aimed at refining the initially developed education framework based on interview data and reaching an agreement on the optimal implementation of in-service education across various ICU settings in Saudi Arabia. The datasets from interviews and focus groups were analysed according to the Framework analysis approach, while documents were reviewed using qualitative content analysis. Findings In phase 1, the systematic review demonstrated the positive effect of trauma care education interventions on nurses’ competence. However, this review identified limited interventions primarily focused on managing traumatic brain injury (TBI) patients. Additionally, the findings are weakened by the absence of theoretical frameworks that go beyond simply delivering and measuring the impact of interventions. Such frameworks should encompass a deeper understanding of context, practice, educational needs, and components, including education format and delivery methods. The absence of these elements limits their generalisability. (Published paper 1) In phase 2, sixty-eight multinational nursing key informants—clinical staff, clinical educators, nurse managers and leaders—were included from the three hospitals. The findings were conceptualised into main categories comprising a number of major themes and subthemes. The first category provides an extensive contextual exploration of trauma care and education in Saudi Arabia. Two interrelated themes relevant to trauma emerged from the data analysis: (i) care practice and (ii) education practice. The trauma care practice highlighted the limited competencies and education support in trauma care, as well as the perceived challenges and educational needs of nurses. The trauma education practice described the staff learning behaviours, supervision practices and in-service education systems in the participants’ settings. These findings were also supported by reviewing the relevant documents. (Published paper 2) In phase 3, the focus groups agreed with the insights provided by the interviewees and suggested a number of ways in which they could help create a favourable environment for nurse training and sustain nurses’ motivations. Based on findings from phases 2 and 3, a main category presented the education content that ICU nurses need to form the trauma ICU education framework. Stakeholders wanted in-service education by subject experts characterised by: (i) relevant educational content; (ii) a range of educational techniques; and (iii) flexible delivery and format. Moreover, a category addresses the factors that enable and inhabit the successful implementation of the education framework in the studied context. Nurses identified factors that encouraged them to participate in this in-service education, including adequate planning, sufficient resources, and a supportive work environment, whilst heavy workloads, scheduling issues, cost, and low-quality training and educators, balancing of life and wellbeing hindered their participation. (Published paper 3) Conclusion The PhD study presented in this thesis systematically developed a novel and evidence-based in-service education framework that has not been investigated before in the Saudi Arabian context or globally. It constitutes a unique and significant contribution to the body of knowledge regarding the understanding of theory and practice in multicultural nursing workforce education within complex clinical environments. It is anticipated that the framework will yield positive benefits in staff educational training due to its novel methodological approach, combining an exploratory multiple-case study and an empowering education model, underpinned by the MRC development stage, which was successful in developing this context- specific framework. The developed in-service education framework is set to undergo feasibility testing at the post-doctoral level. The use of multiple cases can enhance the transferability of the developed education framework; however, it is necessary for researchers in other contexts to evaluate its adaptability, feasibility and effectiveness. The engagement of key clinical stakeholders in the ICUs, along with thorough consideration of context and practice, is a significant element for the development of the educational framework. Therefore, to enhance the quality, efficiency and feasibility of trauma care in-service education, it is essential to ensure that educational content is highly relevant and motivating for individuals, while also considering the impact of various organisational factors operating in local clinical settings that can influence nurses' in-service and continuing education.8 0Item Restricted Exploring the Barriers to Physical Activity During Pregnancy in Saudi Arabia: A Systematic Review(Swansea University, 2024-09-30) Alhussain, Maha; Ikpeme, MoBackground: Engaging in regular physical activity (PA) during pregnancy is crucial for improving maternal and fetal health outcomes. Activities range from light exercises, like walking, to more structured moderate-intensity activities. Guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommend pregnant women engage in at least 150 minutes of moderate-intensity PA per week, yet global adherence rates, particularly in Saudi Arabia, remain low due to various barriers. Methods: A comprehensive literature search was conducted across six databases, including Embase, Web of Science, Medline, PubMed, ASSIA, and APA PsycInfo. The review focused on studies addressing barriers to PA among pregnant women in Saudi Arabia. The SPICE framework guided the search strategy, and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess study quality. Results: Out of 1,138 studies identified, five were included in the final review. Key barriers identified included sociodemographic factors such as age, education, and number of pregnancies. Cultural beliefs and lack of knowledge were significant barriers, with many women believing exercise could harm their pregnancies. Social influences, particularly family discouragement, and environmental factors, such as lack of access to safe exercise facilities, further hindered PA. Additionally, women cited fatigue, lack of time, and motivation as major personal barriers to engaging in regular exercise during pregnancy. Conclusion: The review identified several barriers that prevent pregnant women in Saudi Arabia from engaging in regular PA. Cultural beliefs, social norms, and limited knowledge about the benefits of PA contribute to these challenges. Environmental factors and personal barriers like fatigue and time constraints also play a significant role in reducing PA levels during pregnancy. Addressing these barriers through education and access to resources may help improve PA participation rates and enhance maternal health outcomes.8 0Item Restricted Physical Activity Promotion in Saudi Arabia: The Potential and Challenges of Outdoor Exercise(Loughborough University, 2024-06-11) Albujulaya, Naif; Stevinson, Clare; Piggin, JoePhysical activity is a gateway to a healthier and more vibrant life, offering multiple physical and mental health benefits. Recent evidence suggests that engaging in outdoor exercise leads to many positive outcomes such as reducing stress, anxiety, & depression, providing Vitamin D and fostering social interactions and that extend beyond the boundaries of engaging in indoor exercise. In addition, the advantages of immersing oneself in nature are numerous and profound. Over the last two decades, research carried out in Saudi Arabia reveals that Saudis exhibit a concerning lack of physical activity. Despite efforts made in the field, there is still a lack of exploration into the factors that influence Saudi adults' involvement in outdoor exercise or strategies to enhance their participation. To fill this knowledge gap, the aim of this thesis is to investigate the possibilities of promoting outdoor exercise in Saudi Arabia. In order to gain a comprehensive understanding of all aspects related to the aim, three studies were conducted to address specific objectives. In the first study (in Chapter 3), the main objective was to analyse the Saudi government policy regarding the promotion of physical activity. This study employed the Comprehensive Analysis of Policy on Physical Activity framework to audit and assess the policy. Official reports and independent sources were examined to provide evidence on progress with implementing the policy objectives. In addition, semi-structured interviews were performed with policy-makers, policy-implementers and independent experts. The results indicated an evidence-based, ambitious policy with several objectives achieved. Greatest progress related to cultural change in permitting women’s sports and general physical activity attitudes and behaviour. Other goals, such as increasing female participation, have met barriers that have hindered progress. In the second study (in Chapter 4), the main objectives were to examine the barriers to exercise that face Saudis and understand the relationship between Saudis physical activity, outdoor environments and wellbeing. A representative sample of Saudi adults completed four standard scales: International Physical Activity Questionnaire - Short Form , Exercise Benefits/Barriers Scale, WHO (Five) Well-Being Index and short-form Nature Relatedness Scale. Additional questions related to physical activity contexts. The results of this study indicate that young adults perceive more barriers than other age groups such as challenges related to the exercise environment, time commitments and discouragement from family, and highlighted that males are more likely to exercise outdoors than females. Outdoor exercise and nature relatedness were significant independent predictors of wellbeing, as were social exercise and sporting activities. In the third study (in Chapter 5), the main objective was to explore in depth factors that influence physical activity, and specifically outdoor physical activity. Twenty-two semi- structured interviews with Saudi adults were conducted and qualitative content analysis was used to analyse the data. Key societal and environmental factors (e.g. discouragement from others, poor facilities, unsafe locations) negatively impacted exercise behaviour, particularly among women. Personal and societal factors were identified as motivations to exercise, such as health or mood improvement and active communities. The findings from the thesis indicate that several factors can impact engagement in outdoor exercise among Saudis. The major barriers included the significant lack of outdoor facilities and the weakness of the government's work towards enabling outdoor exercise. These barriers collectively impact individuals, making them develop a habit of engaging in indoors exercise. On the other hand, engaging in outdoor exercise during childhood, particularly among Saudi males, and seeking health benefits from physical activity are the most noticeable factors that can promote or facilitate outdoor exercise. Knowledge obtained from this thesis can potently help organisations and the Saudi government as a valuable foundation for designing effective interventions and policy modifications to gain the additional benefits of engagement in outdoor exercise.37 0Item Restricted An exploration of the intersecting determinants of the digital divide: a qualitative case study of sheffield elderly population(The Universty of Sheffield, 2024-03-18) Alghamdi, Ashwaq; Vannini, SaraBackground: In order to address the issue of the digital divide, we must approach it from both a broad and a specialized perspective. Prior interdisciplinary studies, such as those conducted by Dr Efpraxia D. Zamani and Dr Vannini, have focused primarily on the issue of digital poverty in South Yorkshire. While the study focused on populations and areas at risk of digital exclusion, it did not examine the specific challenges faced by the elderly. My research is aimed at gaining a deeper understanding of the digital divide within Sheffield's elderly community in particular. This is in order to develop solutions tailored to their specific needs. Aim: The study aims to identify and explore the intersecting barriers that contribute to the digital divide among senior citizens in Sheffield in order to develop tailored strategies to address this problem. Methodology: A qualitative, inductive approach is used in this case study in order to collect data by conducting semi structured interviews with adults who have experience with seniors' digital interactions (Parent/Grandparent). In this regard, online interviews were conducted with a total of five participants. For the purpose of interpreting and deciphering patterns within the qualitative data related to the digital divide, thematic analysis was utilized. Findings: Digital engagement among Sheffield's elderly is influenced by the history of migration, education, and digital skills. In most cases, they use mobile technology, are influenced by their peers, but often turn to their family for assistance with technological issues. These individuals face a variety of challenges, such as the complexity of their devices, linguistic barriers, and psychological factors. The recommended solutions advocate linguistically inclusive training, government-sponsored tech centers, and outreach to diverse communities. Conclusion: To address Sheffield's growing digital divide, it is necessary to provide culturally appropriate training, adequate technical support, which takes into account continuous updates, and government-sponsored technology centers. It is essential to prioritize awareness campaigns, provide resources in multiple languages, as well as provide personalized digital training that takes into account the different interests and motivations of individuals. By introducing technology gardens, support groups, and user-friendly platforms, digital inclusion will be further enhanced.11 0Item Restricted Barriers Affecting Supply Chain Management And Performance In Saudi Arabia(University of The West of England, 2022-09-14) Alharbi, AbdulMalik; Langes, SupramanimThe main aim of this research was to identify and evaluate the barriers of supply chain management to SCM performance in Saudi Arabia. Its several objectives included to explore the role of supply chain management in performance of Saudi organisations by conducting literature review, to identify and analyze the barriers to supply chain management in the country, to classify the barriers facing the effectiveness of supply chain management that might hinder supply chain performance in Saudi organisations, and to establish and analyze how supply chain barriers can be managed effectively through supply chain risk management (SCRM). The questionnaire results of 74 participants presented valuable insight and outcomes. Overall, it has been found that Saudi organisations agreed to the role of various barriers in supply chain performance. Most prevalent barriers included culture, covid-19 pandemic, dependence on a single route, data availability, purchase and supply policies, engagement and connectedness, and organizational structure. Yet, none of these barriers are found to be creating issues for supply chains of companies in KSA. This is evident from effective usage and dedication to supply chain risk management, and better supply chain management performance in the country in terms of better coordination among customers, departments, and between their supply chain and suppliers, and consequently, higher sales25 0Item Restricted Exploring the Barriers Faced by Children with Special Needs and Disabilities when Accessing Libraries: A Qualitative Study of School Libraries in Saudi Arabia(Saudi Digital Library, 2023) Shaher, Nawal; Bawden, David; Wales, TimPurpose: The aim of this dissertation is to examine the barriers faced by children with special needs and disabilities when accessing libraries in Saudi Arabia and to contribute to inclusive practices and equal access to educational resources. Methodology/Approach: This qualitative study conducted semi-structured interviews with educators and librarians to gather primary data. Key findings: This study reveals insights into perceptions of librarians and teachers and the findings emphasise the importance of physical and intellectual access, highlighting the role of adaptive technologies in ensuring equitable access to educational and library resources. The study also uncovers obstacles encountered by students with special needs and disabilities when using library services and underscores the need for increased awareness and implementation of Individualised Education Plans among librarians and teachers. Findings also highlight the importance of well-defined policies and decision-making processes for acquiring adaptive and educational technologies in school libraries and the need for proper training and preparation for library staff in effectively serving students with special needs and disabilities. Originality / value: This dissertation contributes to bridging the gap in literature by shedding light on the unique challenges faced by children with special needs and disabilities in Saudi Arabian school libraries, offering insights for the development of inclusive library services and enhancing educational experiences for this demographic. It also underscores the importance of considering cultural, social, and systemic factors in addressing library accessibility issues in diverse contexts.29 0Item Restricted Barriers to communication between Mental Health Nurses and their patients: a systematic review of the literature(Saudi Digital Library, 2023-11-03) Alanazi, Shau; Hughes, ColinBackground: Effective communication between mental health nurses and patients is critical for positive health outcomes and patient satisfaction (Aryankhesal et al., 2019). Various barriers, however, can impede effective communication in this context. Understanding these barriers is key to enhancing communication and, ultimately, outcomes for patients (Martínez‐Martínez et al., 2019) via the delivering of high- quality mental healthcare. Objectives: This dissertation aimed to systematically review evidence on communication barriers between mental health nurses and patients. The specific objectives were as follows: 1) Explore the impact on care quality and patient outcomes due to poor communication; 2) Understand the causes and types of barriers; 3) Identify communication barriers from nurses' and patients' perspectives; 4) Assess proposed strategies to address barriers in order to improve patient outcomes. Search Strategy: A comprehensive search strategy was developed and executed across a number of major databases including MEDLINE, CINAHL, Cochrane Library, PsycINFO and EMBASE. Additional manual searching of reference lists of included studies supplemented the database search. The search was limited to studies written in English and published between 2013 and 2022 that examined various aspects of communication barriers, including causes, types, impacts, and strategies, specifically within the context of mental health nurse-patient interactions. Both qualitative and quantitative primary research, as well as reviews, were considered eligible for inclusion. Results: The systematic search and screening process identified six studies that met the eligibility criteria for final review and analysis. All six studies utilised qualitative 8 approaches with sample sizes ranging from 9 to 85 participants. The studies represented diverse geographic contexts, including Finland, USA, China, Iran, Canada, and Belgium. Three key themes were identified from the synthesised data via thematic analysis: 1) Communication barriers stemming from factors related to nurses, patients, and healthcare organisations; 2) Underlying causes encompassing stigma, language barriers, technology gaps, clinical environment, and workload; 3) Proposed strategies emphasising training programmes, optimising workloads, addressing personal biases, and addressing disparities in digital access to enhance communication. The review highlighted that prevailing communication barriers negatively impact therapeutic nurse-patient relationships and the overall quality of mental healthcare. Conclusion: The findings revealed that communication barriers in mental healthcare settings are multidimensional, arising from an interplay of personal, interpersonal, and organisational factors. Evidence-based training programmes, cultural competency building, workload adjustments and thoughtful technology integration could help attenuate existing barriers and enhance communication quality. Sustainable solutions, however, should be comprehensive rather than piecemeal or fragmented. This review makes a robust contribution to the empirical evidence regarding an important yet underexplored topic, with meaningful implications for enhancing clinical practice, education, and health policy. Future research could further build on these findings using quantitative, qualitative, or mixed methods approaches.32 0Item Restricted Examining Efficiency of Building Information Modelling to Minimize Waste in Saudi Construction(Saudi Digital Library, 2023-08-14) Aladmawi, Tariq; Manege, SylvesterSaudi Arabia is currently undergoing rapid population and economic growth, which has spurred a heightened demand for construction projects to cater to housing, developmental, and social needs. These projects also serve to diversify the country's economy, moving beyond its primary export commodity. Nevertheless, the construction sector confronts a significant challenge in managing construction waste. With the surge in construction demand, ensuring quality and meeting client expectations becomes imperative. Thus, the adoption of practical technologies is being pursued to enhance productivity and promote sustainability in Saudi Arabia's construction industry. One such approach is Lean Construction (LC), rooted in Lean methodologies and thinking, which aims to minimize construction waste and uphold client values. LC leverages tools like Building Information Modeling (BIM) to enhance the functioning of building organizations. This paper examines the effectiveness of implementing BIM as a tool within Lean Construction to mitigate waste in Saudi Arabia's construction sector. By integrating this technology, the industry anticipates improved building quality and timely completion, alongside reduced construction waste facilitated by BIM's infrastructure. This study also addresses sectoral weaknesses by identifying prevailing industry barriers. Keywords: Lean Construction (LC), Building Information Modeling (BIM), Lean Thinking, Saudi Arabia (KSA), Barriers28 0