SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Embargo Healthcare Management for Children with Burn Injuries from the Perspectives of Parents/Carers: A Qualitative Systematic Review(Queen’s University Belfast, 2025) Albishi, Manal; McConnell, KarenBackground: Paediatric burns are a global public health concern, leading to physical, psychological and social consequences for affected children. Despite the challenges faced by parents and caregivers during the hospitalisation and recovery phases, their perspectives on healthcare management remain underexplored. Aim: This systematic review aimed to synthesise the perspectives of parents and carers concerning the healthcare management of their children with burn injuries. The findings aim to inform clinical practice, policy and future research to enhance family-centred care and improve outcomes for children with burn injuries and their parents. Methodology: A systematic search was conducted across five electronic databases: CINAHL, Medline, PsycINFO, Maternity & Infant Care, and ProQuest. Supplementary searches were conducted in Google Scholar. The inclusion criteria focused on qualitative studies exploring parents’ and carers’ perspectives on paediatric burn management. The search results were screened in Covidence by two reviewers independently. Data relating to the experiences of parents and caregivers on the healthcare management of paediatric burns were extracted by one reviewer. The quality of the included studies was assessed by one reviewer using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research. A second reviewer checked 20% of the extracted data and quality appraisals. Data were then synthesised through thematic analysis by the method established by Thomas and Harden. Results: Fourteen studies were included in this review. The quality of the included studies ranged from six, indicating low quality, to ten, indicating high quality. Three main themes emerged: (i) parents’/caregivers’ perspectives on burn care challenges and support during hospitalisation and after discharge, highlighting barriers to and facilitators of parental involvement in their children’s treatment, non-professional support needs during hospitalisation, and financial, logistical and transition to home challenges; (ii) caregivers’ experiences of healthcare providers, showcasing both positive and negative experiences and gaps in communication and information needed for carers; and (iii) current and future concerns regarding the recovery and treatment of burn-injured children, including physical, psychological and social challenges. Conclusion: Effectively implementing family-centred care in paediatric burn care and incorporating social support are vital to address caregivers’ needs during hospitalisation and after discharge care. Improving healthcare providers’ communication skills, fostering a supportive environment for healthcare providers and integrating multidisciplinary care are essential to addressing parental challenges and optimising patient outcomes. Additionally, incorporating telehealth and parental feedback into care protocols can further enhance care delivery and collaboration among healthcare providers and caregivers, contributing to enhanced patient outcomes. Finally, cooperation among healthcare providers, policymakers and researchers is needed to bridge the gaps in paediatric burn management, improve outcomes, and support caregivers and burned children.27 0Item Restricted Systematic Review of Asthma Exacerbations Impact on Children’s Quality of Life in Low-Income Countries and Lower-Middle-Income Countries(King's College London, 2024-09-25) Alrashed, Rana; Laurence, YokoBackground: Asthma is a major cause of morbidity and disability in children, especially in low-income countries and lower-middle-income countries (LICs and LMICs). This systematic review evaluates the impact of asthma exacerbations on the quality of life (QoL) of children and adolescents in LICs and LMICs. Methods: A comprehensive literature search was conducted in major medical databases, including PubMed, Medline, Embase, Global Health, and Cochrane Library. Studies involving children and adolescents aged 0-18 years residing in LICs and LMICs were included. The review considered a range of study designs, including cross-sectional studies, randomized controlled trials, systematic reviews, and meta-analyses. The quality of the included studies was assessed using the relevant Joanna Briggs Institute (JBI) checklists. Results: The review found seven relevant studies. The cross-sectional studies showed that poorly controlled asthma and frequent exacerbations have a significant negative impact on various aspects of children's QoL, including physical functioning, emotional well-being, and social interactions. The narrative review and meta-analysis supported these findings, emphasizing the considerable burden of asthma on the overall well-being of children in low-resource settings. The randomized controlled trial provided evidence that targeted interventions, such as comprehensive asthma education and management programs, have the potential to improve the QoL of affected children. Conclusions: This systematic review emphasizes the significant negative impact of asthma exacerbations on the quality of life of children in LICs and LMICs. Factors such as socioeconomic status, access to healthcare, and environmental exposures were identified as key determinants of the QoL in this population. The findings emphasize the urgent need for interventions and policies to address the challenges faced by children with asthma in LICs and LMICs and improve their overall well-being.5 0Item Restricted Ethical Implications of Social Media Marketing Targeting Children: A Case Study of YouTube's Influence on Consumer Behaviour.(DE MONTFORT UNIVERSITY, 2024-09) Shabbaj , Ebraheem; Obey GM, PriscillaThe dissertation delves into the ethical considerations surrounding social media marketing aimed at children, specifically focusing on YouTube. Since YouTube has emerged as a key source of entertainment for children and a significant platform for advertisers, this study seeks to explore the impact of marketing strategies such as influencer marketing, branded content, and interactive ads on children's purchasing behaviour. The research aims to provide a comprehensive understanding of these marketing tactics using a mixed-methods approach involving content analysis of popular YouTube channels and surveys with parents. The findings indicate that YouTube marketing significantly shapes children's consumer behaviour, largely due to their relationships with influencers they perceive as friends. This makes children more receptive to ads that seamlessly integrate with their entertainment experiences. Moreover, the study highlights concerns about unclear advertising disclosures that many children struggle to comprehend. The research offers recommendations for policymakers, marketers, parents, and digital platforms. These suggestions include stricter regulations, more transparent advertising practices, improved parental guidance, and culturally sensitive content. The insights gleaned from this study contribute to the ongoing discourse about ethical marketing practices and lay the groundwork for future research aimed at protecting young audiences online.29 0Item Restricted Determinants of Traumatic Dental Injuries Among Adolescents in England A secondary analysis of the Children’s Dental Health Survey 2013(University College London, 2024-09) Asiri, Ali; Tsakos, Georgios; Blokland, AlexBackground: Adolescents are particularly vulnerable to traumatic dental injuries (TDI), which have a higher global prevalence in this age group. This study aimed to explore the associations between various demographic, clinical, behavioral, and socioeconomic risk factors with TDI among 12- and 15-year-old adolescents in England. Methods: This is a cross-sectional study and secondary data analysis of the Children’s Dental Health Survey 2013 (CDHS2013), using a nationally representative sample. A total of 2,126 adolescents were included after excluding cases with missing data (differences between the analytical sample and those with missing data were negligible). The analysis employed appropriate survey weights and examined demographic (age, sex, ethnicity), clinical (positive overjet, dental caries), behavioral (smoking, alcohol drinking), and socioeconomic factors (free school meals (FSM) eligibility , area deprivation, rural/urban classification) using multivariable logistic regression to model associations with TDI. Results: The overall prevalence of TDI in the sample was 10.98%. In the fully adjusted model, male adolescents were more likely to experience TDI compared to females (OR=0.64, 95% CI= 0.43-0.95). Adolescents who had never consumed alcohol had 37% lower odds of developing TDI (OR=0.63, 95% CI= 0.42-0.94). All other demographic and behavioral risk factors, as well as clinical and socioeconomic factors were not significantly associated with TDI. Conclusions: The study identified two key risk factors for TDI: being male and alcohol consumption. These findings highlight the importance of emphasizing on these risk factors while planning for preventive interventions and public health campaigns on TDI. Future research should adopt longitudinal designs to better assess the temporal relationship between these risk factors and TDI and include a broader range of variables for a more comprehensive understanding of TDI etiology.34 0Item Restricted The Association Between Head and Neck Injuries Requiring Medical Attention and Behavioural Problems Among 7- and 14-Year-Old Adolescents Living in the United Kingdom A Secondary Data Analysis of the UK Millennium Cohort Study (MCS)(University College London, 2024-09) AlRugaibah, Norah; Blokland, Alex; Sifaki, MariaBackground: Injuries are major public health problems that affect children’s lives. Behavioural problems have been linked to increased risk of injury incidence. However, few studies discussed the association between externalising and internalising behavioural problems and head and neck injuries among children and adolescents. Aim: This study aims to examine the association between head and neck injuries requiring medical attention and behavioural problems among 7- and 14-year-old youth living in the UK. Methods: A secondary analysis of data from the Millennium Cohort Study (MCS) was conducted using the fourth and sixth sweeps when the participants were 7 and 14 years old. The outcome indicated whether the child had sustained any head and neck injuries since the last survey. Behavioural problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) subscales of externalising and internalising behaviour. In the analysis both scales were dichotomised (10% highest scores) to discern those experiencing severe difficulties. Demographic, family, and socioeconomic factors were used as covariates. Weighted analysis using regression modelling was used to examine the associations between behavioural problems and head and neck injuries. Results: The prevalence of head and neck injuries for 7- and 14-year-olds were 9.35% and 6.23% respectively. Externalising behavioural problems at age 7 were reported for just under 10% of the children, and nearly 9% were reported to experience Internalising problems. At age 14, over 10% of the sample presented with externalising behavioural problems, and nearly 8% with Internalising behaviours. Children aged 7 years who presented with externalising difficulties had a significantly higher risk of head and neck injuries in the crude model (OR=1.41, 95%CI: 1.02–1.93). However, this association became non-significant after controlling for child characteristics. In the crude model, there was no difference in head and neck injury odds between children with internalising behavioural problems and their peers at age 7 (OR=1.00, 95%CI: 0.67–1.48). The association remained non-significant after subsequent adjustments. For 14-year-olds, those who with externalising problems appeared to have higher odds of head and neck injuries compared to their peers, although not statistically significant in the crude model (OR=1.25, 95%CI: 0.79–1.98) or after adjustments (final model: OR=1.27, 96%CI: 0.80 – 2.02). There was no difference between children aged 14 experiencing internalising difficulties and their peers in the crude model (OR=0.69, 95%CI: 0.35–1.36) or after adjustments (final model: OR=0.69, 96%CI: 0.36 – 1.32). Conclusion: This study indicated that children aged 7 with externalising behavioural problems were at higher risk for head and neck injuries. However, after adjusting for confounding factors, this association became non-significant. In early adolescence (age 14), such injuries were not significantly associated with externalising difficulties. Internalising problems showed no significant association with head and neck injuries in either age group.22 0Item Restricted The Knowledge of Autism Spectrum Disorder Among Male and Female Public Education Teachers in Jeddah, Saudi Arabia.(Nottingham Trent University, 0024-07) Alobaidi, Batool; Dillon, GayleThis study investigated teachers' knowledge of autism spectrum disorder (ASD) in Jeddah, Saudi Arabia, and examined what factors influenced the knowledge that teachers had. In Saudi Arabia, ASD is common but often diagnosed late (Hayat et al., 2019). This highlights the need to assess teachers' ASD knowledge, as they are well-positioned to notice signs of ASD. Understanding teachers' awareness can guide targeted training programs, improving early detection and support for students with ASD. Participants included 197 male and female teachers from public schools who completed the Autism Spectrum Knowledge Scale-General Population (ASKSG, 2019) and the Knowledge about Childhood Autism among Health Workers (KCAHW, 2008) scale. The findings revealed that participants demonstrated an average level of knowledge across both scales, scoring below average on the ASKSG but above average on the KCAHW, suggesting a potential gap in understanding ASD. Teachers with prior contact with individuals with ASD spectrum exhibited significantly higher ASD knowledge compared to those without such exposure, underscoring the impact of firsthand experience. Contrary to expectations, no significant differences in ASD knowledge were found based on gender, teaching experience, or school level taught between all educational levels, be it primary, secondary, or high school. The results aligned with previous regional studies (Alharbi et al.,2021; Otaif et al.,2019) documenting weak to moderate ASD knowledge among Saudi Arabian educators. Due to the findings from previous studies in Saudi Arabia until this study, which find that teachers' ASD knowledge has not improved, the study accentuates the pressing need for intensified and reinvigorated ASD training initiatives tailored to teachers, emphasising immersive, experiential learning modalities. By addressing the identified knowledge gaps and recognized limitations, further research efforts can help to provide a comprehensive understanding of teachers' knowledge of ASD. These studies will help to develop comprehensive and tailored programs to provide teachers with the knowledge needed to support children with ASD best.8 0Item Restricted Childhood Obesity and Weight Stigma: A Public Health Nutrition Approach(University of Glasgow, 2024-04-20) Abuznada, Salma; Combet, Emilie; Garcia, AdaPoor understanding of obesity, its causes and consequences contribute to weight-related stigma in the UK. Children’s understanding of obesity shapes their views and perceptions towards obesity as a disease, body image, and weight stigma behaviours. Exploring children’s and adolescents’ knowledge, perceptions and views of obesity, weight stigma, and nutrition is essential to establishing effective health promotion programmes that cater to young people’s needs, understanding and perspectives. Successful programmes also need continuous monitoring and evaluation, which are currently lacking in the UK. Perceptions and views around obesity among the public vary in different cultures and among healthcare professionals. These different perspectives lead to debates on defining, managing and treating obesity. Weight stigma research in adults tends to focus on weight stigma due to the poor understanding of obesity both among the public (especially women of white ethnicity) and healthcare professionals rather than children and adolescents. This thesis uses systematic reviews and a mixed-methods approach to explore weight stigma across the age spectrum, including children, adolescents and adults. Furthermore, the research investigates children’s and adolescents’ views on obesity and nutrition knowledge. Study 1 systematically reviewed existing observational, quantitative and qualitative studies focusing on the sources, frequency and implications of weight stigma on children’s and adolescents’ mental health, well-being and eating behaviours. The Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) were followed for study selection, screening and data extraction. Synthesis Without Meta-Analysis (SWiM) guidelines were applied to report the synthesis and results. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Heart, Lung, and Blood Institute (NHLBI) was used to assess the quality of the included studies. Twenty observational studies were included in the final text analysis. Synthesised evidence highlighted that bullying and victimisation play a fundamental role in developing and perpetuating weight-related stigma. Weight-related bullying was correlated with participants’ low self-esteem. Most of the included studies (N=15/20) were of fair quality (average score 5 to 8), although two were of poor quality (average score 0 to 4), and most of the quality criteria were not met. One of the main gaps identified during the literature search in Study 1 was children and adolescents were poorly represented in the studies, with an overemphasis on white adult women. After identifying existing gaps in the literature (e.g., the overemphasis on recruiting white women), Studies 2, 3 and 4 were developed to explore underrepresented groups and gain a deeper understanding of their views and opinions of obesity and weight stigma. Children’s and adolescents’ views and opinions of obesity and nutrition knowledge were explored in Study 2, using a cross-sectional questionnaire and phone interviews. The questionnaire was structured in six sections, exploring sociodemographic characteristics, anthropometric measurements, views and perceptions of obesity, nutrition knowledge, general health, and eating habits and lifestyle. Online interviews followed a narrative focusing on obesity knowledge and experience, obesity perception and the relationship between nutrition and obesity. Study 2 recruited a total of n=317 participants, 54% boys, 72% White/British, with a median age of 16 years (interquartile range (IQR) 15- 18). There was an overall lack of understanding of obesity and its causes and consequences. There was also a lack of consensus and agreement about whether obesity is a sign of disease, a disease, or merely a body shape. There was agreement that obesity can be a personal responsibility (median=4: likely, IQR 3: neutral – 4: likely). Food knowledge was low, with 83% correctly answering three questions or fewer out of six. Although participants reported and believed that they knew what obesity was, most participants linked obesity to body image and placed the responsibility of having obesity on the individuals or their parents. This can lead to increased stigmatising behaviours and isolation of children and adolescents with obesity. Proper education about obesity is imperative to help support children in understanding the general concepts behind obesity’s complexity as a disease. Study 3 used a cross-sectional questionnaire and phone interviews to explore weight stigma and its implications on weight stigma attitudes and body image perceptions in children. In Study 3 (n=667, 62% boys, 70% White/British, median age 16 years (IQR 15-18)), 50% of participants who experienced weight stigma had a BMI ≥30 kg/m². Almost two-thirds of participants who experienced weight stigma (n=259) said it happened at local community places (e.g., clubs, during extracurricular activities) (n=149, 58%). Over a quarter (n=67,26%) reported that it was extremely harsh. Participants who self-reported having obesity (n=214) experienced more weight stigma (n=114, 53%) than those who believed they have overweight (n=87, 41%) or underweight (n=13, 6%). More than half of the sample (n=408, 61%) were dissatisfied with their body image. Most participants who self-reported having obesity were dissatisfied with their body image, demonstrating a significant relationship between self-reported weight problems ‘underweight, overweight, obesity’ and body image satisfaction levels ‘dissatisfied, neutral and satisfied’". In summary, unsurprisingly, most participants who reported weight stigma had a BMI ≥30 kg/m2. Interestingly, more boys than girls who reported experiencing weight stigma believed there was weight stigma in society. To better understand the contribution and impact of childhood lived experiences of weight stigma on adult perceptions and beliefs around overweight and obesity, Study 4 employed similar methods to Study 3. In Study 4 (n=738, 52% men, 76% White/British, 39% BMI ≥30 kg/m2, median age=26 years (IQR=24-31)), less than a quarter of participants had experienced weight stigma as children (n=154, 21%). More women (n=108/154, 70%) experienced weight stigma during childhood than men (n=46/154, 30%, p≤0.001). Participants were mostly undecided about whether obesity is a disease (median=3: undecided, IQR=1: strongly disagree – 3: undecided). Experiencing weight stigma in childhood was positively associated with parents reporting their children’s weight stigma experiences. Parents dissatisfied with their body image (n=62) were more likely to be dissatisfied with their children’s body image (n=23/62, 37%) than satisfied (n=17/62, 24%). Understanding and awareness of obesity are essential in developing public health strategies and health education programmes that are child-oriented and specific to children and adolescents regarding location and intervention tools. The findings in this thesis highlight the negative impact of weight stigma on children and adolescents' physical and mental health. Moreover, a poor understanding of obesity was evident in this research. The work of this research is beneficial in informing programs explicitly targeting the gaps explored and found. This thesis attempts to improve the knowledge of public and academic domains in elements surrounding perceptions, views, and attitudes regarding obesity and weight stigma, the reasonings behind perceptions, and strategies to address obesity stigmatising behaviour.18 0Item Restricted Exploring Teachers’ Beliefs and Practice Regarding Children’s Creativity in Visual Art from Three to Six Years Old in Riyadh, The Kingdom of Saudi Arabia(University of Leeds, 2023-12-01) Aldosari, Dimah Hamad M; Clarke, PaulaThis qualitative study aimed to explore preschool teachers’ beliefs and practices regarding preschool children’s creativity in the visual arts in Riyadh, Saudi Arabia. Saudi Arabia has neither a programme at preschool nor a university course designed to support children’s creativity, which could pose a problem for preschool teachers when defining what creativity is and how to support it. The research was based on the theories of Bourdieu, Bronfenbrenner and Vygotsky (Bourdieu, 2010; Vygotsky, 1979; Bronfenbrenner, 1979; 2005; Routledge, 2016; Harkonen, 2007; Thuketana and Westhof, 2018; Reunamo et al., 2014), which assert that cultures and societies have an influence on children’s development, especially their creativity. For this case study, three methods were developed and applied in four sequential phases with 11 teachers in three cases of preschools in Riyadh. The methods were semi-structured interviews (first and fourth phases), observation (second phase), and a photography task (third phase). The study revealed that the teachers agreed that children’s development is influenced by their culture and society. However, the teachers were uncertain about the definition of ‘creativity’. Teachers’ beliefs led their practice in supporting the creativity of the children, which reflected several barriers that teachers face, some of which are not easy to overcome. These barriers were a source of inspiration for the teachers to discern what to advise policymakers. This research can help educators to explore definitions of children’s creativity and support it with the use of the observation schedule developed in this study to observe children’s creativity. It can also help teachers define what policymakers could provide for them to support children’s creativity in preschools. Finally, this research could inform further studies in the area of creativity, especially through the use of the methods developed for this study as there may be a lack of applicable research methods related to this subject.31 0Item Restricted What are the barriers to the early integration of paediatric palliative care? A systematised review(Saudi Digital Library, 2023-12-03) Aljardahi, Rakan; Mcfeely, ClareBackground: Children with serious illnesses, such as cancers or congenital anomalies, require special care that alleviates the disease burden. Paediatric palliative care (PPC) is comprehensive, interdisciplinary care for patients and their families that begins once a life-threatening disease has been diagnosed. PPC’s early integration with curative treatments has been proven to relieve suffering and enhance both patients’ and families’ quality of life. Nonetheless, few paediatric patients access and receive these services. Aim: To identify and synthesise the barriers to PPC’s early integration. Methods: This systematised review is based on PRISMA guidelines. The Medline, Embase, PsychInfo and CINAHL databases were searched using controlled and non-controlled keywords and a variety of research strategies. This search was limited to peer-reviewed studies published in English between 2018 and 2023. Based on the inclusion criteria, Covidence software was used to screen, extract and assess the retrieved studies, which were evaluated using the CASP and MMAT checklists. Findings were synthesised using narrative synthesis with inductive thematic analysis. Results: Eight studies of medium to high quality met the inclusion criteria. Three main themes were identified: limited resources, the lack of a standardised referral process and fears associated with palliative care. Conclusion: Reflecting the insufficient attention the speciality receives, several modifiable barriers impede paediatric patients from accessing the early benefits of palliative care services. PPC requires financial support, community awareness and a clear referral process. Policymakers play an important role in supporting PPC, and researchers must work to explore policymakers’ perspectives on these barriers and find facilitators.32 0Item Restricted Nurses’ perspectives on the barriers to and facilitators of effective paediatric pain assessment and management: A systematic review(Saudi Digital Library, 2023-11-21) Gadi, Amirah Dawood M; Wilson, IseultBackground: Children’s pain is a universal problem that has far-reaching negative consequences. Despite the recognition that effective pain management is a fundamental human right, some children are still suffering from unrelieved pain. Nurses have a pivotal role in paediatric pain management; however, they are confronted by many barriers. It is therefore of value to explore the barriers and facilitators that nurses experience when caring for children in pain. Aim: This study aims to explore nurses’ perspectives regarding the barriers and facilitators related to the effective assessment and management of pain in children, infants, and neonates. Methodology: A search strategy was formulated, and five databases were searched for relevant articles including ProQuest, Scopus, CINAHL, PsycINFO and PubMed. Each paper identified by the search underwent a quality assessment using a predetermined tool. Relevant information to the research question was extracted, and the major themes were then identified by thematic analysis. Findings: Eighteen studies were included in this review. Recognised barriers and facilitators were categorised into three main themes related to: (i) healthcare professionals; (ii) the child and their parents; and (iii) the organisation. Prominent barriers included nurses' inadequate knowledge of the uses and side effects of medication, limited pain assessment experience, low prioritisation of pain, time constraints, communication and language difficulties with children, as well as uncooperative children, insufficient parental involvement, lack of guidelines and resources shortages, and nurses’ distrust in pain assessment tools. Key facilitators comprised robust knowledge, adequate experience, higher education, in-service training, parental involvement, effective communication with children and parents, clear guidelines, adequate resources, and nurses’ trust in and utilisation of pain assessment tools. Conclusions: This review provides valuable insights into the barriers and facilitators faced by nurses with respect to the assessment and management of pain in the paediatric population. There is a need for targeted educational interventions and policy changes to support nurses’ ability to deliver high-quality pain care. Further research is needed in order to investigate these factors and to examine any other potentially associated determinants amongst paediatric nurses.23 0