Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
Browse
33 results
Search Results
Item Restricted Muslim Nurses' Perspectives on Islamic Prayer in Hospital Settings in Saudi Arabia(Saudi Digital Library, 2026) Alanazi, Sattam; Schneider, JoanneIntroduction: Islamic prayer is a central religious practice in the daily lives of Muslims and represents one of the five pillars of Islam. Saudi Muslim nurses often perform their prayers while fulfilling professional responsibilities during work shifts; however, limited research has examined their experiences of Islamic prayer. Therefore, this study explored Saudi Muslim nurses' perspectives on Islamic prayer using the Spiritual Development Framework. Methods: A cross-sectional sample of 260 Saudi nurses participated in the study. The first three aims examined the relationships between Islamic prayer practice and the three dimensions of the Spiritual Development Framework: awareness, belonging, and lifestyle. Islamic prayer was measured by the frequency of prayer practice both at work and outside of work. Results: Associations were examined using rank-biserial correlations. The findings indicated small-to-moderate positive associations, primarily for prayer practice outside of work. The fourth aim tested a model examining whether awareness, belonging, and lifestyle collectively explained quality-of-life outcomes. Age and awareness significantly and positively explained physical quality of life, whereas age and belonging significantly and positively explained mental quality of life. Discussion: Islamic prayer performed at work was not significantly associated with dimensions of spiritual development, whereas prayer practiced outside of work was positively associated with all three dimensions of the Spiritual Development Framework. These findings suggest that workplace conditions may limit nurses' ability to experience the spiritual benefits of prayer. Providing designated quiet prayer spaces may help Muslim nurses concentrate during prayer and enhance the spiritual value of this religious practice.4 0Item Restricted Impact of spirituality on burnout among critical care nurses.(Saudi Digital Library, 2026) Alshahrani, Mohrah Ali Zamiel; Claire, KerrBackground: Critical care nurses work in demanding settings where burnout can affect wellbeing, retention, and care quality. Spirituality is linked with meaning, connection, and inner coping resources, and it may relate to burnout. Aim: This review explored what is known about the impact of spirituality on burnout among critical care nurses. Methods: A systematic review was completed using transparent reporting standards. A PEO framework shaped the question and search terms. Searches were conducted in CINAHL, Ovid MEDLINE, Embase, and Scopus for English peer-reviewed studies published from 2015 to 2025. Screening followed the PRISMA 2020 steps. Study quality was appraised using the JBI checklist for analytical cross-sectional studies. A meta-analysis was not suitable due to differences in measures and statistics, so a narrative synthesis was used. Results: Nine studies met the criteria from 939 records. All had quantitative cross-sectional designs, with 8,409 nurses in total. Most studies were from Middle Eastern and Asian settings, with two from Western contexts. Most studies reported an inverse association between spirituality-related measures and overall burnout, with small to moderate effects. Spirituality was more consistently associated with reduced depersonalisation and higher personal accomplishment than with emotional exhaustion. Conclusion: Spirituality may relate to better burnout profiles in critical care nurses, but evidence is limited by cross-sectional designs, varied measures, and uneven regional coverage. Longitudinal and intervention research with consistent measures and stronger confounder control is needed12 0Item Restricted EXPLORING NURSING EDUCATORS' PERCEPTIONS AND EXPERIENCES OF IMPLEMENTING HIGH FIDELITY MANNEQUIN BASED SIMULATION IN SAUDI ARABIA: A CONSTRUCTIVIST GROUNDED THEORY STUDY(Saudi Digital Library, 2026) Alhajlan, Maha; Wakefield, Ann; Janice, ChristieIntroduction: High-Fidelity Mannequin-Based Simulation (HFMBS) has become an important strategy for strengthening nursing education. Simulation offers a safe environment for developing clinical judgment, confidence, and readiness for practice; however, its effective use depends heavily on educators’ understanding and implementation. In Saudi Arabia, despite national priorities to use technology and improve healthcare quality, the integration of HFMBS into nursing curricula remains inconsistent, and little is known about how nurse educators experience using simulation. Aim: To generate a grounded theory, explaining nurse educators' perceptions and experiences of implementing HFMBS in Saudi Arabia. Methods: Constructivist grounded theory was used. Data were collected from 23 semi-structured interviews with 20 educators recruited from one university through purposive and theoretical sampling until theoretical saturation was reached. Data were analysed using Charmaz’s coding procedures (initial, focused, and theoretical) supported by constant comparison, memo-writing, and diagramming. Ethical principles and strategies to ensure rigour, including reflexivity and peer debriefing, were maintained throughout. Results: The grounded theory “Taking Responsibility for Implementing High-Fidelity Mannequin Based Simulation (HFMBS)” The theory comprises one core category, taking responsibility for implementing HFMBS, and three related categories: Conceptualising HFMBS, Becoming an Expert in HFMBS, and Being Supported by the Organisation in Implementing HFMBS. It explains how educators were more likely to assume personal or collective responsibility when they conceptualised HFMBS as a safe experiential learning method, felt competent, and perceived strong organisational support. When they felt underprepared, unsupported, or viewed HFMBS as ‘playing for fun,' they tended to shift responsibility to the organisation, contributing to partial or inconsistent implementation. Conclusion: This study generated a novel grounded theory, which explains how nurse educators’ perceptions, expertise, and organisational support shape taking responsibility and ensuring the full implementation of HFMBS in nursing education in Saudi Arabia. The theory offers insight into the interacting factors underpinning the successful implementation of simulation and therefore provides a potentially useful framework for educators, institutional leaders, and policymakers involved in the implementation of HFMBS.2 0Item Restricted Effect of Organizational Policies on Nurses' Job Satisfaction and Quality of Patients' Care at Sharaf Hospital, Hail Health Cluster(Saudi Digital Library, 2026) العنزي, سلمان; Zakaria, Abeer MohamedBackground: The vast majority of healthcare workers who are largely responsible for providing patients with high-quality care in rapidly changing and developing health systems are nurses. The financial, technical, political, and physical constraints on healthcare systems affect every real-world scenario. Aim: This study aimed to determine the effect of organizational policies on nurses' job satisfaction and quality of patients' care at Sharaf Hospital, Hail Health Cluster. Method: Three instruments—the Perceptions of Politics Scale, the Job Satisfaction Questionnaire (JS-Q 34 items), and the Quality Care Questionnaire (QCQ)—were used to collect data from a convenience sample of 125 nurses and 135 patients in all departments of Sharaf Hospital-Hail Health Cluster using a descriptive correlational design. Results: There was a highly statistically significant association between nurses' overall organizational policies and overall job happiness; half of them (50.4%) had a moderate level of organizational policies, 60.8% had a low level of job satisfaction, and 38.5% had a moderate level of quality care. Conclusion: Organizational policies positively improves nurses' job satisfaction which in turn enhance quality of patients’ care. Recommendations: Investigating the long-term effects of organizational policies on nurses' job satisfaction and retention as well as raising awareness of organizational policies and procedures to enhance compliance , professional practice and quality of patients’ care.5 0Item Restricted Enhancing Patient Care in Nursing: Evidence-Based Approaches to Managing Chronic Obstructive Pulmonary Disease(Saudi Digital Library, 2026) sayed, majidah; dornan, markBackground: Chronic obstructive pulmonary disease (COPD) remains a leading cause of preventable morbidity and mortality globally. In the United Kingdom alone, COPD accounts for approximately one million hospital bed days and over £3 billion in annual healthcare costs. Despite established guidelines from GOLD, NICE, and the British Thoracic Society, a persistent gap remains between evidence-based recommendations and frontline medical-surgical nursing practice. Medical-surgical nurses are well positioned to deliver structured COPD interventions, yet their contributions remain underutilised due to inadequate respiratory training, role ambiguity, and fragmented care systems. Aim: This study aimed to evaluate evidence-based nurse-led interventions for COPD management within medical-surgical settings and assess their impact on patient outcomes. Method: A systematic review was conducted in accordance with PRISMA guidelines. Five electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, and Cochrane Library) were searched, yielding seven primary studies for inclusion after rigorous screening. Studies were critically appraised and synthesised using an analytical framework integrating the Chronic Care Model, GOLD guidelines, and the Social-Ecological Model. Findings: Structured nurse-led interventions – including self-management education, pulmonary rehabilitation, advance care planning, and psychosocial support – demonstrated meaningful improvements in quality of life, reduced hospital admissions, enhanced exercise capacity, and, in some cases, reduced mortality. Multicomponent programmes sustained beyond twelve months yielded the most pronounced and durable benefits, while six-year follow-up data provided compelling evidence of long-term reductions in mortality and cardiovascular complications. However, socio-demographic factors such as income, health literacy, geographic location, and the quality of nurse–patient relationships significantly moderated intervention effectiveness, with social determinants capable of undermining even well-designed programmes. Conclusion: Nurse-led, evidence-based COPD interventions can substantially improve patient outcomes when adequately resourced and sustained. Realising this potential requires investment in respiratory-specific nursing education, standardised discharge pathways, routine psychosocial screening, digital health infrastructure, and policy frameworks that formally recognise and support the contribution of nursing in chronic disease management. Keywords: COPD, nurse-led interventions, evidence-based practice, medical-surgical nursing, self-management, systematic review36 0Item Restricted Acceptance and Feasibility of Delivering an Evidence Based Digital Intervention for Palliative Care Education: A Mixed Method Study(Saudi Digital Library, 2026) Alosimi, Areej; Alosimi, AreejBackground: There is a growing need for palliative care as a result of a rise in the number of people diagnosed with non-communicable diseases. Palliative care is based on multidisciplinary teamwork, and the provision of care is significantly aided by the work of nurses. Therefore, education is an essential element in elevating the standard of palliative care in general. The subject of palliative care has not yet been introduced into nursing curricula in Saudi Arabia. Undergraduate students' understanding of palliative care may be improved via the use of digital learning, which is not only an effective method of education but also a persuasive one. Objectives: The primary aim of this study was to evaluate the feasibility of delivering palliative care education to nursing students via digital learning in Saudi Arabia. Primary Objectives: 1: To present initial findings on the feasibility and acceptance of implementing a digital palliative care educational intervention for undergraduate nursing students in Saudi Arabia, specifically to assess engagement, attrition, recruitment, and adherence to the intervention. 2: To evaluate participants’ perceptions and satisfaction with the intervention. Secondary Objectives: to determine whether specific outcomes change following the intervention, particularly to assess the impact on participants' confidence and knowledge levels before and after the intervention. Methods: This study employed a convergent parallel mixed-methods research (MMR) design using a single-group feasibility approach. Participants were undergraduate nursing students from Shaqra University, Saudi Arabia. The palliative care digital intervention contains 4 modules, and the program duration was 4 weeks. The study's primary outcomes focused on feasibility indicators, including recruitment rate, attrition rate, intervention adherence, outcome measure feasibility, and overall program experience. The secondary outcomes explored changes in palliative care-related knowledge and confidence levels by using the palliative care nursing quiz and the palliative care self-efficacy scale. Quantitative data on primary and secondary outcomes were collected before and after the intervention. Qualitative data were gathered through semi-structured interviews to explore participants' experiences and perceptions of the intervention. Key findings: A total of 52 nursing students were recruited. The conclusions from quantitative data demonstrated the feasibility of the major outcomes. Participants showed improvements in secondary outcome measures following the intervention: Knowledge (M=8, SD 4.30) and Confidence (M=24, SD 7.26). Thematic analysis of interviews from 13 participants identified four key themes (Students’ perceptions of intervention usability, Usefulness of the intervention, Levels of engagement and Suggestions for future improvement). The data were assessed and compared to predefined feasibility and success criteria following quantitative and qualitative data analysis. The study procedures, data collection methods, and feasibility indicators—including recruitment rate, attrition rate, intervention adherence, and outcome measure feasibility—were feasible and effective. Implications This is the first research in Saudi Arabia looking into the feasibility and acceptability of a digital palliative care curriculum for undergraduate nursing students. This thesis tackles the need for increased palliative care education in Saudi Arabia by creating a theory-based online education module tailored to the needs of the target participants. This educational intervention is an important step toward addressing a shortage of resources in Saudi palliative care education, as instructional opportunities on this issue are currently unavailable in educational institutions. The findings, based on quantitative and qualitative data, provide convincing evidence for the feasibility and applicability of digital palliative care teaching for enhancing undergraduate students' knowledge and confidence. This feasibility study revealed the potential of digital education in this sector and laid the groundwork for a large randomised controlled trial (RCT) through the use of an innovative approach. The findings suggest that the digital palliative care education intervention is feasible, practical, and well-received among undergraduate nursing students. This study highlights promising opportunities for future research, particularly a definitive trial to assess the program’s long-term effectiveness and impact within the Saudi Arabian context.30 0Item Restricted A Cross-Sectional Study of Fatigue and Burnout Predictors among Shift-Working Nurses in Saudi Arabia(Saudi Digital Library, 2025) Alanazi, Salman Alhumaidi; Trainor, Lisa HannaA literature review on shift work's impact on nurses' health linked night shifts, rotating schedules with a high frequency of nights and long hours or overtime with fatigue, burnout, and poor mental health. The review identified significant inconsistencies in the literature regarding which specific shift patterns (e.g., 12-hour vs. 8-hour, rotating vs. fixed nights) had the most critical risk for burnout. It also highlighted a research gap concerning the role of occupational fatigue as a direct mechanism linking shift type to burnout and a scarcity of quantitative data from Saudi Arabia and the larger Middle East and North Africa (MENA) region. This gap provided the rationale for the accompanying journal paper, which aimed to investigate these relationships within a Saudi Arabian context. A cross-sectional quantitative design was employed. Data was collected using an online self-administered questionnaire that was designed to collect social demographic data, fatigue using the Three-Dimensional Work Fatigue Inventory (3D-WFI), and burnout using the Copenhagen Burnout Inventory (CBI). Of the 188 targeted nurses working at King Khalid Hospital in Saudi Arabia who were sent invitation emails, 148 of them returned a fully completed survey questionnaire. The findings showed that night shifts are significantly associated with the highest levels of fatigue, while burnout was linked to the morning and rotating shifts. Fatigue and burnout, as found in this study, are distinct phenomena driven by different mechanisms. Fatigue appears to be a primarily physiological response to circadian disruption inherent in night work. In contrast, burnout is more likely a psychosocial response to the high-demand, high-pressure organisational environment of daytime and rotating shifts. Shift-specific interventions should be tailored to meet each shift's needs, such as mitigating physiological fatigue for night staff and a separate approach to address the organisational stressors that cause burnout among day and rotating shift nurses.37 0Item Restricted A Focused Ethnographic Study of Hospital Nurses’ Perceived Barriers to Healthcare Error Reporting in the United Kingdom(Saudi Digital Library, 2025) Almutairi, Amani; Lowrie, RichardPatient safety remains a critical concern in healthcare, as it is vulnerable to errors that may occur during the delivery of care. A recommended strategy for preventing these errors by key international organisations is the proper reporting of patient safety incidents. However, underreporting of errors persists, undermining progress toward safer clinical environments. Nurses, as the largest professional group within healthcare and central to patient care delivery, play a vital role in error reporting. However, evidence suggests that nurses often choose not to report incidents, indicating a disconnect between established reporting frameworks and clinical practice. Research to date has identified a complex interplay of personal, organisational, and socio- cultural factors contributing to this problem. However, much of the existing literature originates from Asian contexts, with limited exploration in the UK, where underreporting persists despite national guidelines and adverse event reporting systems. Furthermore, the predominance of quantitative methods has restricted a deeper understanding of nurses’ lived experiences, while also making it difficult to capture organisational and socio-cultural factors, which are often unique to each context. To address these gaps, this study proposes a qualitative, focused ethnographic approach to investigate perceived barriers to error reporting among hospital nurses in NHS Scotland. The Royal Infirmary of Edinburgh, a tertiary teaching hospital, will serve as the study site. Semi- structured interviews will be conducted following ethical approval and formal organisational access, with data analysed thematically. The anticipated findings will inform policy, practice, education, and future research. Additionally, by reducing preventable harm and enhancing reporting systems, this study has the potential to improve patient safety, optimise resource use, and deliver positive economic impact.8 0Item Restricted The Association of Patient Portal Engagement with Critical Diabetes Care Indicators and Healthcare Utilization Among Adults with Type 2 Diabetes(Saudi Digital Library, 2025) Altamimi, Mujahid M; Imes, Christopher CType 2 diabetes mellitus (T2DM) remains a significant health problem that is increasing in prevalence. Despite recent advances in drug development and well-publicized guidelines for glycemic, blood pressure (BP), and cholesterol management, achieving the major goals of T2DM remains suboptimal. Patient portals can facilitate disease self-management by allowing patients to access and interact with their health records and communicate with their health care providers. Patient portals provide patients with T2DM the information and tools needed to achieve goal hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-c), and BP measurements. Methods This project aimed to comprehensively evaluate the long-term effects of patient portal use on critical T2DM care indicators (HbA1c, LDL-c, and BP assessed using mean arterial pressure [MAP]) and healthcare utilization metrics over four years of follow-up. A retrospective observational cohort study of patients with T2DM treated at UPMC was conducted. Propensity score matching was used to create comparable high and low portal engagement groups. Linear mixed-effect modeling was used to examine the longitudinal association between portal engagement and critical T2DM care indicators. Further, a comprehensive portal feature analysis and its association with improved HbA1c over time were completed using linear mixed-effect modeling. Negative binomial regression modeling was employed to evaluate the association of patient portal use with the utilization of the healthcare system. Results The study included 96,391 patients and identified 10,573 (11%) high-engagement users. This group, compared to 21,146 matched low-engagement users, was predominantly female (53 vs 51%), White (90 vs 82%), and exhibited a more favorable socioeconomic profile. Engaged portal users presented with lower baseline HbA1c (7.4 vs 7.7%) and a greater number of prescriptions (27 vs 25). The longitudinal analysis revealed a modest yet statistically significant negative association between portal engagement and HbA1c affecting both the baseline and the rate of change over time (P<0.01). The analysis of LDL-c showed an association between higher portal engagement and improved LDL-c trajectories (P<0.01). No significant association was found between MAP and portal use. The portal features of clinical data review and patient-provider communication had the strongest associations with better glycemic control. Portal use was also associated with significantly higher outpatient encounters but lower emergency visits. Discussion Patient portal engagement can lead to modest but meaningful improvements in HbA1c and LDL-c for patients with T2DM. These improvements assist patients in meeting treatment goals and potentially reduce the risk of complications. The proactive care pattern among engaged users can lead to consistent management of T2DM, limit complications, and ultimately lead to potential cost savings for both patients and the healthcare system. Future research should explore the development and testing of new portal functionalities and include patients and nurses in the process of design and implementation of new portal features.25 0Item Restricted Shared decision-making during pregnancy and childbirth in Saudi Arabia: A mixed-methods study(Saudi Digital Library, 2025-07-13) Alruwaili, Tahani Ali; Fooladi, Ensieh; Crawford, KimberleyBackground Shared decision-making (SDM) is fundamental to quality pregnancy and childbirth, representing a collaborative approach between healthcare providers (HCPs) and women. In Saudi Arabia's obstetrician-led maternity care system, the implementation of SDM and the experiences of women and their husbands remain understudied, particularly in the context of unique cultural, religious, and healthcare factors. Aim To explore women’s and their husbands’ experiences of shared decision-making with healthcare providers during pregnancy and childbirth in Saudi Arabia. Methods The study employed a convergent parallel mixed-methods design guided by the Three-Talk Model for SDM, which conceptualises SDM as a process involving team talk, option talk, and decision talk. The quantitative strand involved a nationwide, online survey conducted between January and May 2023, targeting women aged 18 and above who were either pregnant or had experienced pregnancy/childbirth in the past 12 months. Low to very low SDM and respect were defined as scores of ≤24 on the Mothers’ Autonomy in Decision-Making (MADM) scale and ≤49 on the Mothers on Respect Index (MORi), respectively. Using the same inclusion criteria, the qualitative strand conducted semi-structured interviews with women and husbands, recruited through convenient sampling from two maternity hospitals and social media. Interview data were analysed thematically and mapped onto the Three-Talk Model for SDM. Data from both phases were integrated during the interpretation phase to provide comprehensive insights into SDM experiences. Results The survey of 505 women revealed that 34.1% (95% confidence interval [CI], 29.6–38.9) reported low to very low SDM. Statistical analysis identified significant factors associated with low SDM, including seeing different obstetricians of a different gender at each visit (adjusted odds ratio [AOR] 2.0, 95% CI, 1.0–3.9), not meeting the same obstetrician throughout the pregnancy (AOR 2.6, 95% CI, 1.2–5.6), and having an instrumental vaginal birth (AOR 6.67, 95% CI, 1.6–28.1). A strong positive association emerged between low to very low SDM and reporting of low to very low respect (χ2 = 83.8173, p < 0.001). The qualitative data from 19 women and 5 husbands identified the following three major themes aligned with the Three-Talk Model: (1) Team Talk; communication and relationship building were limited by discontinuity of care, time constraints, language barriers, emotional readiness, and gender preferences; (2) Option Talk; information exchange highlighted the importance of clarity, despite reported insufficient details and perceived HCP biases towards intervention; and (3) Decision Talk; autonomy and SDM revealed varying levels of autonomy influenced by hierarchical healthcare structures, religious beliefs, and family involvement. Many participants mistook signing consent forms for engaging in SDM, indicating a gap in understanding of SDM processes. Participants’ experiences centred primarily on interactions with obstetricians, with minimal midwifery involvement. Conclusion The findings reveal challenges in implementing SDM within Saudi maternity care, including discontinuity of care, language barriers from non-Arabic-speaking obstetricians, gender preferences, and rigid institutional hierarchies. These findings highlight the need for healthcare reforms, including professional interpretation services, improved continuity of care, and exploration of midwifery-led models. Future maternity care policies should consider the complex interplay of religious beliefs and family dynamics when developing strategies to improve SDM in Saudi pregnancy and childbirth.62 0