SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted Equity and Access to Healthcare Services: A qualitative analysis of the maternity care experiences of Arab migrant women in Scotland(University of Dundee, 2025) Gashgari, Dawood; Symon, Andrew; Lee, ElaineBackground: Globally, migration has surged over the past two decades, with the UK emerging as the fifth top destination, hosting over 9.5 million foreign born residents (IOM, 2021). There has been a gradual increase in the number of new female migrants in the country. These trends emphasise the importance of meeting the maternity care access needs of new migrants, ensuring equitable access to services, and adapting these services to diverse cultures. This study’s initial scoping review mapped the literature about maternity care access experiences among newly arrived migrants in EU/EFTA countries. It identified limited studies about newly arrived migrant women in Scotland, a country experiencing population growth due to migration. Among migrant group that received little attention despite their numbers are newly arrived migrant women from Arab countries. Aim: To explore and describe the maternity care access experiences of newly arrived Arab migrant women who have given birth in Scotland, and for whom English is not their first language. Methods: A Qualitative Descriptive study was conducted using the Levesque et al. (2013) 5As access to healthcare framework. Twenty participants from various Arab countries and with different migration statuses were selected from Scotland’s four largest cities through purposive sampling strategy. In-depth semi-structured telephone interviews were conducted, focusing on their experiences. Thematic Analysis (TA) was employed to analyse the interviews. Findings: Participants reported varied experiences at different stages of maternity care, with more challenges than facilitators in accessing care. An overarching theme ‘Expectation and reality’ and four other themes were identified from the data. These are: 1) Perceived availability and appropriateness of maternity care; 2) Motivators and inhibitors when seeking maternity care; 3) Communication; and 4) Encounters with healthcare professionals. Discussion and Conclusion: The study highlights lack of familiarity and discrepancies between expected and actual care experiences, affecting experiences and perceptions of maternity services. Participants faced several challenges at both service and organisational levels, leading to criticism and resistance behaviours such as appointment avoidance and exaggerating conditions. The study shows how initial self-directed barriers could transform into motivators, and vice versa, which influenced participants’ decisions to seek, accept, or avoid care. It also identifies substantial communication barriers due to language difficulties and the inadequacy of interpretation services. This, along with a lack of tailored informational materials, significantly affected access to and understanding of maternity care services. Positive interactions with healthcare professionals fostered feelings of equality and welcome, while negative encounters often resulted in perceptions of discrimination. Recommendations include improving information provision and adopting women-centred, culturally sensitive practices to enhance maternity care for migrant women.15 0Item Restricted Readiness to expand the role of the nurses working in primary healthcare centres in Saudi Arabia to include prescribing: An exploratory descriptive qualitative study(Cardiff University, 2024) Albariq, Khloud Mohmmed; Albariq KhloudAbstract Introduction: Primary healthcare centres (PHCs) in Saudi Arabia are the first point of contact for patients across the country (Al Saffer et al., 2021). However, these PHCs face various accessibility challenges, including unequal distribution of PHCs and their services (Al-Sheddi et al., 2023), a shortage of medical professionals (Al Saffer et al., 2021), a lack of specialised services (Makeen et al., 2020), and long waiting times (Albarhani et al., 2022). One way to enhance accessibility, reduce waiting times, and alleviate various burdens on the healthcare system in Saudi Arabia is to grant nurses prescribing rights (Hibbert et al., 2017; Almotairy et al., 2023). However, Saudi research into the readiness to incorporate the prescribing role into nursing practice in PHCs is currently lacking. This study aims to investigate readiness to incorporate the prescribing role into nursing practice in Saudi PHCs. Methods: An exploratory and descriptive qualitative (EDQ) research was used as the chosen methodology. Twenty-five individual semi-structured interviews were thus conducted with participants who were divided into three groups: this gave ten nurses at the micro-level, five nursing supervisors and five managers at the meso-level, and five policymakers at the macro-level. The collected data was then analysed using reflexive thematic analysis (RTA). Findings: Six key themes emerged from the data analysis. These were improving primary healthcare services, nurse-doctor partnership prescribing, educational preparation, acceptance of the nurse prescribing role, establishing the legality of the nursing prescribing practice, and readiness of primary healthcare centres. Conclusion: Implementing the nurse prescribing role in PHCs services has the potential to improve PHC services through enhancing accessibility and reducing waiting times. A nurse-doctor partnership prescribing approach may be implemented, in which nurses and physicians share prescribing responsibilities while doctors remain responsible for diagnosis. However, nurses’ general lack of pharmacological knowledge is a major obstacle, requiring additional focus on educational preparation. Another potential barrier could be a lack of acceptance of the nurse prescribing role among patients, doctors, and nurses. Several changes are thus necessary to existing systems, including the introduction of clear legislation and regulations and ensuring the readiness of PHCs to smooth the implementation of the NP role.27 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.56 0