Saudi Cultural Missions Theses & Dissertations
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Item Restricted Web-Based Intervention to Help Nurses to Manage Work-Related Stress in Saudi Arabia: A Feasibility Study(University of Nottingham, 2024-10) Allehyani, Yasser; Blake, HollyBackground: The prevalence of work-related stress (WRS) among healthcare employees globally is higher than that of other professions, with nurses reporting the highest rates. WRS results in functional limitations and decreased productivity at work, and high rates of presenteeism, sickness, absenteeism, and turnover, incurring massive costs for health systems. WRS poses a severe occupational risk for healthcare personnel that can negatively impact their health and the wider economy, but despite well-known prevalence in Saudi Arabia, little is known about particular local issues in this national context. Aims and objectives: This study aims to utilise a novel web-based intervention for work-related stress (WBI-WRS) to support behavioural self-management for nurses with WRS. This digital technology-based intervention can potentially meaningfully affect outcomes such as stress, mental well-being, turnover intentions, and presenteeism. These intervention techniques can improve the general standard of patient care inside healthcare organisations by favourably affecting nurses impacted by WRS. Method: The participants were chosen from a tertiary hospital in Saudi Arabia. Convergent parallel mixed methods research with a feasibility study design was used. This was achieved by testing several variables, including the rate of participant attrition. participant recruitment, participant engagement with the intervention, the appropriateness of the outcome measures, and their experiences with the intervention’s various components. Secondary outcomes of this exploratory study included pre-post measurements of perceived stress, mental well-being, turnover intention, and presenteeism. Quantitative data were collected from a single group before and after the intervention to evaluate primary and secondary outcomes at baseline and six weeks after the WBI-WRS. Semi-structured interviews with 17 nurses were used to gather qualitative insights. Findings: From 81 initial recruits, sixty-eight nurses participated in the quantitative intervention feasibility study and completed three monthly follow-ups to evaluate the research design. It was determined that the research procedure and quantitative and qualitative data collection and analysis were practical. The intervention showed an attrition rate of 28% (n=19 drop-outs). Based on their experiences with the intervention, all nurses who completed the intervention expressed satisfaction with its impacts; the feasibility of outcome measures was the sole criterion that needed any degree of adjustment. Thematic analysis of qualitative interviews with 17 nurses (11 female and 6 male, aged between 18 and 55 years old) revealed five thematic topics from interviews concerning their perceptions of the WBI-WRS usability and prospective utility, participation in the toolkit, the impact of the toolkit, and their general attitude towards it: (1) Overview of Work-Related Stress; (2) WBI-WRS Toolkit Features; (3) Experiences with WBI-WRS Toolkit; (4) WBI-WRS Toolkit Impact; and (5) Improving the Toolkit. These topics gave insights into the characteristics required for nurses to use the WBIWRS successfully. As nurses demonstrated improvement in their secondary outcome measures following the WBI-WRS, the quantitative results supported the feasibility of the primary outcomes. Implications: A feasibility trial has been conducted to assess the WBI-WRS Toolkit. The study showed that the toolkit is accessible, acceptable to, and appropriate for nurses practising in Saudi Arabia. The efficacy and long-term usefulness of the WBI-WRS for nurses and other healthcare professionals in the Saudi context now need to be tested in a definitive trial.9 0Item Restricted Acute Remote Medicine Based Assessment of High Risk Atherosclerosis Patients(Imperial College London, 2024-07-21) Alshahrani, Nasser Saeed; Khamis, RamziAlthough there have been significant advancements in medical and interventional therapies, myocardial infarction (MI) remains a major cause of death in the UK. Unplanned readmission rates in the UK are high despite a global trend towards short hospital stays post-MI, sitting at approximately 10% at 30 days post-discharge and even higher at 6 months. The 30-day mortality rate post-ACS in the US is 7.3%, with comparably high rates observed in Europe and the UK. The use of telemedicine technology can provide remote, clinically necessary, diagnostic information, thus eliminating the necessity for patients to visit the hospital. Telemonitoring could improve the management of post-ACS care and reduce the number of unexpected readmissions. Despite these potential benefits, there are considerable barriers to its implementation. This thesis present four chapters discussing the impact and efficacy of home telemonitoring for cardiac patients post-ACS. I first used a systematic review and meta-analysis to investigate the existing research on the use of telemedicine for patient management post-ACS. Second, I designed and validated a clinical decision support system algorithm for the remote management of patients post-ACS in a nonhospital setting. Third, I conducted a randomised controlled trial (acronym: TELE-ACS) that used a specialised hybrid remote telemonitoring system to monitor patients following their hospital discharge post-ACS. Fourth, I conducted a 6-month cost-benefit analysis of the TELE-ACS protocol and assessed its impact on the health-related quality of life in patients following ACS. The results demonstrate that a remote monitoring approach in combination with clinical decision algorithm protocol based on patient symptoms, 12-lead ECG data, BP levels, and oxygen saturation levels, significantly decreased the rate of hospital readmissions, emergency department visits, unplanned coronary revascularisations, and patient-reported symptoms for patients post-ACS. Therefore, the TELE-ACS protocol represents a financially viable approach to reducing readmissions in ACS patients.23 0