Saudi Cultural Missions Theses & Dissertations
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Item Restricted Life journey with a chronic illness: Exploring the lived experience of older chronic illness patients while interacting with the primary health care services in Ha'il City, Kingdom of Saudi Arabia(University of Tasmania, 2025) Albarrak, Talal; Crisp, Elaine; Andrews, Sharon; Foran, PaulaAccording to the World Health Organization, improvement in life expectancy, which is attributed to advancements made in the health sector in the 20th century, directly impacts public health and economic systems. Technological advancement in the health sector has enabled older people to perform many activities in their daily lives. However, this demographic shift has also posed some problems, such as the rising prevalence of chronic diseases and the increased costs of healthcare for families and governments. The older population in the Kingdom of Saudi Arabia (KSA) is mainly affected by chronic diseases. It burdens the healthcare system, especially in the Primary Health Care Centres (PHCCs). PHCCs are the first point of care for these patients and attend to more than 15 million citizens every year in KSA. Although primary, secondary, tertiary, and referral healthcare services are available for the public in KSA, PHCCs still need help with patient satisfaction due to the lack of proper infrastructure and integrated services. This qualitative research employs Max van Manen's hermeneutical phenomenological framework to understand the lived experiences of older people with chronic illness as they interact with PHCCs for their regular health care relating to their illness. The research design is iterative, allowing for dynamic interaction between the researcher and data through six sequential yet iterative steps: engaging with the phenomenon, collecting data through investigating life experiences, reflecting on essential themes, describing the phenomenon through writing and rewriting, maintaining a strong relation to the phenomenon, and balancing the study context. Data was collected via semi-structured telephone interviews, adapted for COVID-19 safety protocols, with older people selected from accessible and representative PHCCs. Ten participants were chosen using specific inclusion and exclusion criteria to ensure relevance and depth. The research blends the strengths of descriptive and interpretative phenomenology, rooted in Edmund Husserl's and Martin Heidegger's philosophical traditions, which emphasise the detailed description and interpretation of human experiences and meanings, and recognise these experiences as situated within specific historical and cultural contexts. The analysis involved identifying and interpreting key themes from the participants' stories and comparing and contrasting these across different participant narratives to reveal patterns and variations. The researcher engaged in a reflective process, linking the findings to existing literature and theoretical frameworks to deepen the understanding of the participant's lived experiences. Critical reflexivity was emphasised to ensure researcher biases did not influence the study's findings. Four major themes emerged: the impact of knowing about the illness; the supportive context provided by family, friends, institutions, and faith; the adaptation to a new life with a chronic disease and multiple care roles; and perceptions of care received through primary health care centres. The research findings highlighted the interplay between emotional, cognitive, and social elements of the patients’ lived experience, emphasising the significant role of the participants' emotional responses in influencing coping mechanisms and overall quality of life. The research also explored the crucial role of family/friends in disease management, and the difficulties of financial issues. The findings also highlighted the need for a more comprehensive and patient-centred approach to healthcare in KSA, which includes considering the experiences and barriers faced by older adults with chronic diseases. These findings included identifying the treatment goals, the use of religion in the process of coping, especially among Muslim adults, and the significance of education in helping patients manage their treatment and psychological care. The following are the recommendations that can be made from the research for enhancing services in the PHCCs across SaudiArabia, focusing on early identification and management of chronic diseases. The research supports screening programs for high-risk groups, frequent follow-up, and adherence to the best practices, including the involvement of specialist physicians. A particular emphasis is placed on the patient's awareness and counselling to overcome the myths associated with chronic diseases and increase patient participation in decision-making. The study recommends forming peer support groups to support chronic disease management or strengthening community networks. The research also advocates for public health campaigns that should address all population groups, focus on chronic diseases, including diabetes mellitus, to overcome cultural and societal misconceptions. To meet mental health needs, it is essential to incorporate mental health care into chronic disease management and educate healthcare workers on mental health. Other recommendations that are likely to improve the quality of healthcare and patient satisfaction significantly, include improving the interpersonal skills of PHCC staff, embracing modern technology, and ensuring that vulnerable populations are financially supported6 0Item Restricted Life journey with a chronic illness: Exploring the lived experience of older chronic illness patients while interacting with the primary health care services in Ha'il City, Kingdom of Saudi Arabia(University of Tasmania, 2024-08) Albarrak, Talal; Paula, Foran; Elaine, Crisp; Sharon, AndrewsAccording to the World Health Organization, improvement in life expectancy, which is attributed to advancements made in the health sector in the 20th century, directly impacts public health and economic systems. Technological advancement in the health sector has enabled older people to perform many activities in their daily lives. However, this demographic shift has also posed some problems, such as the rising prevalence of chronic diseases and the increased costs of healthcare for families and governments. The older population in the Kingdom of Saudi Arabia (KSA) is mainly affected by chronic diseases. It burdens the healthcare system, especially in the Primary Health Care Centres (PHCCs). PHCCs are the first point of care for these patients and attend to more than 15 million citizens every year in KSA. Although primary, secondary, tertiary, and referral healthcare services are available for the public in KSA, PHCCs still need help with patient satisfaction due to the lack of proper infrastructure and integrated services. This qualitative research employs Max van Manen's hermeneutical phenomenological framework to understand the lived experiences of older people with chronic illness as they interact with PHCCs for their regular health care relating to their illness. The research design is iterative, allowing for dynamic interaction between the researcher and data through six sequential yet iterative steps: engaging with the phenomenon, collecting data through investigating life experiences, reflecting on essential themes, describing the phenomenon through writing and rewriting, maintaining a strong relation to the phenomenon, and balancing the study context. Data was collected via semi-structured telephone interviews, adapted for COVID-19 safety protocols, with older people selected from accessible and representative PHCCs. Ten participants were chosen using specific inclusion and exclusion criteria to ensure relevance and depth. The research blends the strengths of descriptive and interpretative phenomenology, rooted in Edmund Husserl's and Martin Heidegger's philosophical traditions, which emphasise the detailed description and interpretation of human experiences and meanings, and recognise these experiences as situated within specific historical and cultural contexts. The analysis involved identifying and interpreting key themes from the participants' stories and comparing and contrasting these across different participant narratives to reveal patterns and variations. The researcher engaged in a reflective process, linking the findings to existing literature and theoretical frameworks to deepen the understanding of the participant's lived experiences. Critical reflexivity was emphasised to ensure researcher biases did not influence the study's findings. Four major themes emerged: the impact of knowing about the illness; the supportive context provided by family, friends, institutions, and faith; the adaptation to a new life with a chronic disease and multiple care roles; and perceptions of care received through primary health care centres. The research findings highlighted the interplay between emotional, cognitive, and social elements of the patients’ lived experience, emphasising the significant role of the participants' emotional responses in influencing coping mechanisms and overall quality of life. The research also explored the crucial role of family/friends in disease management, and the difficulties of financial issues. The findings also highlighted the need for a more comprehensive and patient-centred approach to healthcare in KSA, which includes considering the experiences and barriers faced by older adults with chronic diseases. These findings included identifying the treatment goals, the use of religion in the process of coping, especially among Muslim adults, and the significance of education in helping patients manage their treatment and psychological care. The following are the recommendations that can be made from the research for enhancing services in the PHCCs across SaudiArabia, focusing on early identification and management of chronic diseases. The research supports screening programs for high-risk groups, frequent follow-up, and adherence to the best practices, including the involvement of specialist physicians. A particular emphasis is placed on the patient's awareness and counselling to overcome the myths associated with chronic diseases and increase patient participation in decision-making. The study recommends forming peer support groups to support chronic disease management or strengthening community networks. The research also advocates for public health campaigns that should address all population groups, focus on chronic diseases, including diabetes mellitus, to overcome cultural and societal misconceptions. To meet mental health needs, it is essential to incorporate mental health care into chronic disease management and educate healthcare workers on mental health. Other recommendations that are likely to improve the quality of healthcare and patient satisfaction significantly, include improving the interpersonal skills of PHCC staff, embracing modern technology, and ensuring that vulnerable populations are financially supported.62 0Item Restricted Work Productivity among Australian Palliative Care Nurses during the COVID-19 Pandemic: The Role of Compassion Fatigue and Compassion Satisfaction(La Trobe University, 2024-07) Baqeas, Manal; Copnell, BevSimilar to their counterparts worldwide, Australian palliative care nurses played a significant role in responding to the COVID-19 pandemic and reported feeling overwhelmed. This research focused on the work productivity of palliative care nurses in Australia during the pandemic and associations between work productivity and professional quality of life, including compassion fatigue (CF), comprising burnout (BO) and secondary traumatic stress (STS), and compassion satisfaction (CS). A scoping review was first conducted on CF and CS among palliative care providers (nurses and other professionals). A correlational, cross-sectional research design was employed. Measures were collected in 2021 using an online survey with a sample of 208 nurses working in a range of palliative care settings. Participants demonstrated moderate levels of BO, STS, and CS. Work productivity was negatively associated with burnout but positively associated with CS and with STS in a nonlinear manner. Following identification of potential confounding variables and moderators of the relationships between work productivity and measures of professional quality of life, a regression model was developed to maximise the prediction of work productivity. As well as burnout, STS and CF, this model included nurses’ gender, work setting, and religiosity, and whether they had been diagnosed with COVID-19. During the pandemic, participants reported various challenges and difficulties. Fear of being infected contributed to the pressures they felt. However, they also acquired new skills, were given new responsibilities, implemented new work practices, and paid better attention to infection prevention. The work productivity of palliative care nurses can be enhanced by improving their professional quality of life. Evidence-based policy and practices are needed to address heavy workloads, staffing shortages, inadequate staff training, and risk of infection, along with improving leadership and providing better access to professional psychological support. Such changes would help optimise the quality of care provided for patients at end of life.7 0Item Restricted Supportive Relationships between Maternity Nurses/Midwives and Childbearing Women in Saudi Arabia: A Mixed-Methods Study(The University of Newcastle, Australia, 2024-05) Almorbaty, Hadeer Yahya; Mollart, Lyndall; Chan, SallyBackground: Childbearing experience could be more satisfactory for women with quality relationships with maternity staff. In many situations, women and maternity staff can face relationship challenges. Aim: To examine perceived enabling practices for building supportive relationships between Arabic-speaking childbearing women and maternity nurses/midwives, and explore facilitators and barriers to these relationships. Design and Method: A mixed-methods study with two phases: Phase One included validation of Arabic Neo-Enabling Practice Scale (Neo-EPS) for women and maternity nurses/midwives; and an online survey using Arabic Neo-EPS with a convenience sample of 213 postnatal women and 114 maternity nurses/midwives from maternity hospitals across Saudi Arabia (KSA) via social-media and snowballing. Phase Two included15 women and 15 maternity nurses/midwives were interviewed to explore the perceived factors impacting the relationships with women. Result: Phase One found the Arabic Neo-EPS has good content validity and test-retest reliability. Women's Arabic Neo-EPS mean scores were significantly lower than maternity nurses/midwives'. Non-Saudi maternity staff had higher perceptions of supportive relationships. Level of education was significant in influencing the difference between women and maternity nurses/midwives ' scores. Phase Two: Four themes confirmed the importance of integrating all aspects of support in the relationships with women. Professionalism and compassion were perceived as facilitators. Unsupportive behaviours were perceived as barriers. Cultural diversity might impact the practice of building relationships. Discussion: Woman-centred care positively affected women's experience. Staff workload impacted on supportive relationships. Women’s culture should be considered. Non-Saudi maternity nurses/midwives had higher levels of perceptions on supportive relationships they built with women compared to Saudi staff. Conclusion: To the best of our knowledge, this is the first study in KSA. Healthcare leaders need to support the development of nurses/midwives' coping strategies and self-reflection for high-quality maternity care. Implementation of continuity care requires KSA policymakers to have an organisational shift from standardization to woman-centred care.14 0Item Restricted Exploring Nurses’ Compliance Behavioural Factors with EHR Data Privacy Policy in Saudi Arabia: A Q- Methodology Study(University of Nottingham, 2024-03) Alhassani, Nabil Dakhilallah; Windle, RichardBackground: The widespread implementation of electronic health records (EHRs) worldwide has raised health data privacy and security issues for healthcare providers, patients, and regulators. Yet, relatively little is known about healthcare professionals’ intentions to remain complaint with current EHR data privacy policy, and it has not been extensively tested in either general or specific cultural contexts. Many influential factors that potentially influence attitudes and intentions toward data privacy is unknown. Thus, this study explores nurses’ behavioural intentions regarding healthcare data privacy. Aims and objectives: This study aims to explore the driving factors and barriers that influence nurses’ intentions to comply with EHR data privacy policies in Saudi Arabia. Method: This study employed a Q-Methodology approach to investigate nurses’ compliance behaviour toward the EHR privacy policy. A series of Q statements (known as a concourse) was constructed from relevant literature review and guided by the Decomposed Theory of Planned Behaviour and Deterrence Theory derived from our scoping review. Participants were then requested to sort these statements to indicate their agreement using a grid, ranging from “strongly agree” to “strongly disagree. ” This was followed by a post-sorting interview, in which all responses were narratively coded. Exploratory factor analysis was employed to determine every statement in the Q sample, in order to analyse and group correlation scores for the statements, identifying different factors or positions taken by different nurses in relation to their intentions to comply with EHR data security. Finally, factors were interpreted, complemented by the narrative qualitative views of participants. Findings: Two factors emerged from the analysis, indicating that nurses in both factors generally value patient privacy. In total, 26 out of 54 nurses were loaded on the two factors, then the post-sorting interview was used to interpret the nurses’ sorting activity. The first factor, “Professionally Pragmatic,” included 19 nurses who believed that the hospital environment, the desire to benefit patients, and relevant legal consequences played a major role for those who wished to comply with the EHR privacy policy. Consequently, they had to be pragmatic in their policy compliance. The second factor, “Professionally Obligated,” included 7 nurses who ii believed that hospital and patient-related work obligations motivated them to adhere to the EHR privacy policy. Implications: This study provides a better understanding of the factors that contribute to nurses’ behavioural intentions regarding compliance with EHR data privacy policies. It contributes to current knowledge of the nurses’ behavioural intentions regarding compliance with EHR data privacy policies. Several theories were generated from the study’s outcomes regarding the factors that influenced nurses’ compliance with the EHR privacy policies, which needed to be tested in upcoming studies. Despite the fact that this study examined the level of personal compliance, it is evident that nurses face workplace obstacles in protecting sensitive EHR information.38 0Item Restricted Nurses' knowledge and attitudes towards non-pharmacological interventions for managing pain in the Intensive care unit: an extend literature review.(The Queen’s University of Belfast, 2024-03-22) Almatrafi, Rehab; Martin, DaphneBackground: Effective pain management in critical care units is crucial for patient outcomes and satisfaction. Although pharmacological approaches are commonly used, they can have adverse effects. Non-pharmacological interventions (NPIs) offer alternative methods for pain management and reduce reliance on medications. Aim: This literature review aimed to explore nurses’ knowledge of and attitudes towards NPIs for pain management in intensive care units (ICUs). It also sought to identify factors hindering nurses from using NPIs in the ICU. Search strategy: A total of 20 keywords were used, and six databases were consulted: CINAHL, MEDLINE, PsycINFO, Embase, Scopus and Web of Science. They were selected for their relevance to the research topic. The search strategy was verified by a subject librarian and a supervisor, and a systematic approach was followed. Additionally, the reference lists of relevant articles were hand-searched. The quality of the included studies was assessed using appropriate tools. Results: The review included six studies: two qualitative studies, three cross-sectional studies and one mixed-methods study. These studies examined nurses’ knowledge and attitudes concerning NPIs for pain management in the ICU. Overall, the results indicated that nurse training, education and policy support are crucial for enhancing the use of NPIs and improving nurse knowledge. Conclusions: Nurses’ knowledge of NPIs in the ICU was low to moderate, with a positive attitude towards their use. This lack of understanding may hinder the development of educational programmes for nurses, which could increase the use of NPIs. Barriers affecting nurses’ knowledge and attitudes concerning NPIs include professional barriers, ICU setting barriers and hospital policy barriers. Therefore, healthcare systems should establish a supportive environment, equip nurses with knowledge and skills, and encourage patient and family engagement in treatment plans.32 0Item Restricted Followership of Nurses in Saudi Arabia: A Mixed Methods Study(The University of Adelaide, 2024-03-14) Alanazi, Sulaiman Mohammed; Wiechula, Richard; Foley, DavidIntroduction: This thesis presents a mixed-methods study of a sequential explanatory design aimed at exploring the current state of followership research in relation to health care clinicians, with a particular focus on understanding followership among nurses in the context of Saudi Arabia. Recognising the critical but often overlooked role of followership in the healthcare sector, this research explores the various dimensions, styles, impacts, and perceptions of followership. Scoping Review: The study begins with a scoping review to identify and map the existing body of research on followership in healthcare. The review examines studies across a range of methodologies, including quantitative, qualitative, and mixed methods, as well as systematic reviews and meta-analyses. This phase sets the stage for understanding the current state of followership research, identifying gaps, and establishing a context for the subsequent phases. Quantitative Phase: The quantitative section of the study focuses on nurses in Saudi Arabia. It aims to explore the prevalent followership styles among nurses and how these styles correlate with their sociodemographic profiles. This phase employs a cross-sectional design and the Kelley followership questionnaire-revised, providing valuable statistical insights into the nature and distribution of followership styles within this specific demographic. Qualitative Phase: Complementing the quantitative analysis, the qualitative phase delves into the personal perceptions and experiences of nurses regarding followership in Saudi Arabia. Through semi-structured interviews with seven registered nurses, this phase uncovers themes related to the understanding of followership, involvement in decision-making, and the barriers and facilitators to effective followership. This in-depth exploration offers a nuanced view of how followership is perceived and enacted in the healthcare setting. Integration Phase: The final phase of the study integrates the findings from the scoping review, quantitative, and qualitative research. Using a sequential explanatory mixed methods approach and a joint display analysis, this phase synthesizes the data to draw comprehensive conclusions. The integration phase offers a holistic view of followership among healthcare clinicians, particularly nurses in Saudi Arabia, identifying key themes and implications. Conclusions and Implications: The research reveals that while followership is a crucial element in healthcare, it remains under-researched and often misunderstood. The study highlights the importance of effective followership in improving clinical team performance and patient safety. It also identifies the need for more research in areas such as the impact of followership on clinical practice and the development of practical followership interventions. Recommendations include the integration of followership concepts into healthcare education and training, and the promotion of environments that value and enhance followership skills. This thesis contributes to the understanding of followership in healthcare and provides a foundation for future research in this critical area.35 0Item Restricted The relationship between Extended work hours and stress among nurses in Saudi Military Hospitals(Barry University, 2024-01-12) Aljuaid, Hana; Chlaudette, ChinAbstract Background: Nursing professionals generally experience high levels of stress due to the nature of roles and responsibilities, however, it is likely also due to extended work hours. While there is existing information on long work hours and stress among nurses working in general healthcare facilities, there is a severe lack of information on the subject matter regarding nurses working in Saudi Arabian military hospitals. Purpose: The purpose of this quantitative study was to investigate the relationship between extended working hours and levels of stress among nurses working in Saudi Arabian military hospitals. Theoretical Framework: Conservation of resources (COR) theory provided theoretical guidance for this study. Methods: A correlational design was used to examine the relationship between extended working hours and levels of stress amongst nurses in Saudi Arabian military hospitals. The participants completed a short demographic survey and ENSS questionnaire. Correlational followed by a regression analysis was used to establish what relationship exists between stress and experience. Results: Statistical analysis showed that hypotheses one through three were not supported. Hypothesis one, a Pearson correlation analysis, discovered that there is no statistically significant relationship between stress levels and shift length (r = 0.015, p = 0.408). Hypothesis two, a Pearson correlation analysis, discovered that there is no statistically significant relationship between stress levels and years of work experience (r = -0.005, p = 0.47). Hypothesis three, a standard multiple regression analysis, revealed that neither of the two predictors—shift length or years of work experience—were v significant predictors of stress levels F (2,230) = 0.03, p = 0.97, with a multiple correlation coefficient R2 value of 0. Conclusions: The results of this study contribute to an understanding of the relationship between extended work hours and stress among nurses in Saudi military hospitals. This area had not yet been addressed in previous studies. The main findings of this study highlighted that the positive social perspectives and strong work ethic of Filipino nurses can prevent these negative circumstances from occurring since these perspectives and ethics reduce the chances that nurses will experience higher levels of stress when working long/extended nursing shifts.37 0Item Restricted Psychological Impact of the COVID-19 Pandemic on Nurses Delivering Care in Hospitals(Saudi Digital Library, 2023) Alruwaili, Bashayer Muidh; Parkinson, DenisBackground: Nurses have faced significant challenges during the COVID-19 pandemic, with one major issue being the increased mental health concerns. These could impact the quality of healthcare provided by nurses, along with patient care and safety, as a result of multiple factors, including heavy workloads and long hours. Numerous other factors affecting nurses can influence these outcomes. Therefore, it is crucial to provide accessible resources to help nurses reduce their mental health problems and improve their overall psychological well-being. Such resources would be able to offer effective strategies to support nurses as they care for patients during these challenging times. Aim: To review and synthesize published research about the impact of COVID-19 on the psychological well-being of nurses and identify effective strategies that can assist nurses with mitigating mental health issues during the pandemic. Methodology: This study will provide a narrative review of the evidence. The researchers conducted an extensive review of the literature by utilizing various online biomedical databases, including PubMed, MEDLINE, CINAHL, and Scopus. Result: After limiting the search dates to December 2019 –2023, the literature search identified a total of 132 articles. The primary focus of the study is the COVID- 19 period, which led to the exclusion of studies published before December 2019 from consideration. Critical Appraisal and Skills Programme (CASP) tools were utilized to evaluate the credibility and quality of the articles, leading to the inclusion of 19 articles that were considered appropriate for this review. Conclusion: This review identified the impact of the COVID-19 pandemic on nurses' mental health, particularly due to certain factors such as increased workloads and fear of infection, which significantly affect their well-being. Ensuring nurses' mental health is vital for maintaining high-quality patient care. Offering efficient support and accessible resources can mitigate stress levels and enhance resilience. Given the long-term consequences of the pandemic on healthcare systems, continuous support and monitoring for nurses' mental well-being are essential. Strengthening nurses' capacity to provide patient care can be achieved through a culture that promotes well-being and provides sustained support.8 0Item Restricted Occupational Stress and Burnout in Nurses Working Extended Shifts: A Systematic Review(Saudi Digital Library, 2023-11-09) Almajed, Hamedh; Kerr, ClaireBackground: Extended nursing work hours have become common internationally, due to inadequate staffing levels and increasing population demands. Extended work hours can have adverse effects on the psychological well-being of nurses, including the manifestation of occupational stress and burnout.Aim: This review aims to explore if and how nurses working extended duty hours experience occupational stress and/or burnout.Methodology: A systematic search was conducted on four electronic databases: CINAHL Plus, MEDLINE, PubMed, and PsycINFO. A methodical search strategy was developed in collaboration with an expert librarian. Medical subject headings, keywords, and synonyms were utilised. Reference lists of papers eligible for inclusion in the review were also hand searched. The quality of each study was evaluated using the Joanna Briggs Institute's quality appraisal tool for cross-sectional studies. Meta-analyses were not possible; thus, findings were synthesised narratively.Results: Five studies were included, all focusing on the impact of extended shifts. One study focused on the nurses’ experience of occupational stress mainly; one study focused on the nurses’ experience of burnout; and two studies focused on the contributing factors of stress and burnout. The methodological quality of these studies was deemed satisfactory. The prevalence of 12-hour shifts was high, and evident across various countries. Long working hours and other variables such as inadequate rests, break-times, and fatigue contributed to the nurses’ experience of occupational stress and burnout. Conclusions: Extended shifts in nursing are a widely observed practise internationally. This systematic review sheds light on the effects of extended shift patterns and the prevalence of occupational stress and burnout among nurses. A better understanding of these concepts may help in building organisational initiatives and strategies to support nurses who work long shifts.14 0