Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
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Item Restricted Assessing Dental Patients' Acceptance and Trust of Dentists in COVID-19-related Services: A Cross-Sectional Study(Saudi Digital Library, 2025) Alzunaydi, Ayoub; Aguilar, Maria L; Psoter, Walter JBackground: Dentists have traditionally been underutilized in public health crises, despite their clinical expertise and trusted role within communities. The COVID-19 pandemic highlighted the need for an expanded healthcare workforce, yet the extent to which dental patients trust and accept dentists providing pandemic-related services remains unclear. Objective: This study aimed to assess dental patients’ acceptance and trust in dentists conducting COVID-19 testing, vaccination, and public health communication while examining the influence of demographic and insurance-related factors. Materials and Methods: A cross-sectional, self-administered, structured questionnaire-based study was conducted at multiple clinics within the University of Florida College of Dentistry. A total of 150 adult dental patients participated, providing self-reported responses on their trust in dentists discussing COVID-19 topics and their acceptance of dentists administering COVID-19 services. Data were analyzed using descriptive statistics and logistic regression to identify associations between demographic variables and trust levels. Results: Trust in dentists discussing COVID-19 topics was high, particularly for face masking (85.4%) and COVID-19 disease (76.4%), but was lower for discussing vaccination (70.2%). Patient acceptance of dentists administering COVID-19 vaccines was divided, with 51% expressing comfort and 49% expressing hesitancy. Private insurance holders were significantly less trusting of dentists in administering COVID-19-related services, while Medicare recipients exhibited the highest levels of trust. Age trends suggested older individuals were more trusting, while demographic variables such as sex, race, and ethnicity were not statistically significant predictors of trust. Conclusion: These findings highlight the potential role of dentists in public health crises beyond traditional oral healthcare. While dentists are trusted for public health communication, hesitancy in accepting them as vaccine providers suggests a need for further public education and policy reinforcement. Recognizing dentists as part of the frontline healthcare workforce could enhance healthcare system resilience in future crises.22 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.24 0