Saudi Cultural Missions Theses & Dissertations
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Item Restricted What are the barriers to the early integration of paediatric palliative care? A systematised review(Saudi Digital Library, 2023-12-03) Aljardahi, Rakan; Mcfeely, ClareBackground: Children with serious illnesses, such as cancers or congenital anomalies, require special care that alleviates the disease burden. Paediatric palliative care (PPC) is comprehensive, interdisciplinary care for patients and their families that begins once a life-threatening disease has been diagnosed. PPC’s early integration with curative treatments has been proven to relieve suffering and enhance both patients’ and families’ quality of life. Nonetheless, few paediatric patients access and receive these services. Aim: To identify and synthesise the barriers to PPC’s early integration. Methods: This systematised review is based on PRISMA guidelines. The Medline, Embase, PsychInfo and CINAHL databases were searched using controlled and non-controlled keywords and a variety of research strategies. This search was limited to peer-reviewed studies published in English between 2018 and 2023. Based on the inclusion criteria, Covidence software was used to screen, extract and assess the retrieved studies, which were evaluated using the CASP and MMAT checklists. Findings were synthesised using narrative synthesis with inductive thematic analysis. Results: Eight studies of medium to high quality met the inclusion criteria. Three main themes were identified: limited resources, the lack of a standardised referral process and fears associated with palliative care. Conclusion: Reflecting the insufficient attention the speciality receives, several modifiable barriers impede paediatric patients from accessing the early benefits of palliative care services. PPC requires financial support, community awareness and a clear referral process. Policymakers play an important role in supporting PPC, and researchers must work to explore policymakers’ perspectives on these barriers and find facilitators.25 0Item Restricted The Impact of the COVID-19 Pandemic on Dental Health Practices and Oral Health Outcomes in Children: A Scoping Review(Saudi Digital Library, 2023-09-15) Alsadoon, Mashael; Lodder, Annemarie; Heilmann, AnjaBackground: Oral health is a critical aspect of overall well-being. The COVID-19 pandemic has significantly affected children's oral health through dental clinic closures, disrupted school-based oral health programs, increased sugary snack consumption, and changes in oral hygiene behaviours Aim: The aim of this study was to undertake a scoping review of the literature on the global impact of the COVID-19 pandemic on dental health practices and oral Health outcomes in children. Methods: A literature search was carried out using three online databases (PubMed, Scopus, and Web of Science) to select studies published between 2020 and 2023. The initial search included 516 results, which were subsequently screened based on their titles and abstracts. After screening process, 16 studies were considered for the final review. Results: The COVID-19 pandemic disrupted access to dental care for children, especially in lower income countries and among those from disadvantaged backgrounds. Health behaviours, such as brushing frequency and dietary habits, varied during the pandemic, with some children improving their oral care and food choices while others experienced declines. Dental caries prevalence increased, affecting children's quality of life, particularly when parents were distressed. Conclusion: The pandemic had adverse effects on the availability of dental clinics and has exacerbated inequality. It has also impacted children's Oral Health-Related Quality of Life (OHRQOL) and behaviour, leading to reduced brushing and increased sugar consumption. Parental involvement and education play a crucial role in addressing these issues.23 0Item Restricted Nurses’ perspectives on the barriers to and facilitators of effective paediatric pain assessment and management: A systematic review(Saudi Digital Library, 2023-11-21) Gadi, Amirah Dawood M; Wilson, IseultBackground: Children’s pain is a universal problem that has far-reaching negative consequences. Despite the recognition that effective pain management is a fundamental human right, some children are still suffering from unrelieved pain. Nurses have a pivotal role in paediatric pain management; however, they are confronted by many barriers. It is therefore of value to explore the barriers and facilitators that nurses experience when caring for children in pain. Aim: This study aims to explore nurses’ perspectives regarding the barriers and facilitators related to the effective assessment and management of pain in children, infants, and neonates. Methodology: A search strategy was formulated, and five databases were searched for relevant articles including ProQuest, Scopus, CINAHL, PsycINFO and PubMed. Each paper identified by the search underwent a quality assessment using a predetermined tool. Relevant information to the research question was extracted, and the major themes were then identified by thematic analysis. Findings: Eighteen studies were included in this review. Recognised barriers and facilitators were categorised into three main themes related to: (i) healthcare professionals; (ii) the child and their parents; and (iii) the organisation. Prominent barriers included nurses' inadequate knowledge of the uses and side effects of medication, limited pain assessment experience, low prioritisation of pain, time constraints, communication and language difficulties with children, as well as uncooperative children, insufficient parental involvement, lack of guidelines and resources shortages, and nurses’ distrust in pain assessment tools. Key facilitators comprised robust knowledge, adequate experience, higher education, in-service training, parental involvement, effective communication with children and parents, clear guidelines, adequate resources, and nurses’ trust in and utilisation of pain assessment tools. Conclusions: This review provides valuable insights into the barriers and facilitators faced by nurses with respect to the assessment and management of pain in the paediatric population. There is a need for targeted educational interventions and policy changes to support nurses’ ability to deliver high-quality pain care. Further research is needed in order to investigate these factors and to examine any other potentially associated determinants amongst paediatric nurses.22 0