Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Experiences of Psychological Well-Being Amongst Paramedics During The COVID-19 Pandemic(Saudi Digital Library, 2025) Alalhareth, Musalli; Peters, RosemaryParamedics are critical frontline healthcare providers during emergencies. However, they often work in high-stress environments with a myriad of challenges, which affect their psychological wellbeing. The COVID-19 pandemic intensified these challenges, potentially worsening the paramedics’ mental health. Yet paramedics’ psychological experiences remain underexplored compared to other healthcare workers. This study sought to systematically review literature on the psychological wellbeing of paramedics during the COVID-19 pandemic to identify stressors, coping mechanisms, and assess the role of organizational support. The review synthesized four analytical themes. On the theme of psychological issues, it emerged that paramedics faced high rates of stress, anxiety, PTSD, emotional exhaustion, and depersonalization. Major stress and risk factors included fear of infection, inadequate PPE, long shifts, social stigma, leadership failures, and poor communication. The study identified various protective factors and coping mechanisms including personal resilience, humor, exercise, therapy, supportive leadership, peer support, and incentives. However, some used maladaptive strategies like alcohol overuse. There was substantial variation of experience by role and context. Student and less-experienced paramedics, and older staff faced more severe impacts while frontline paramedics experienced higher distress compared to second responders. This study makes several recommendations for improving the mental wellbeing of paramedics during emergencies. Organizations should improve communication, ensure PPE supply, provide psychological screening, promote healthy coping strategies, and tailor support by role and demographic. Educational institutions should integrate stress management and ethics training into paramedics’ curricula. Strategic interventions are vital for enhancing resilience and reducing attrition in future public health crises.23 0Item Restricted i Exploring Preparedness and Adaptive Capacity for Disaster Management during Hajj in Makkah City, Saudi Arabia(University of Tasmania, 2025) Althagafi, Ibrahim; Lindsay Smith, Dale Edward , Pieter Van DamAlthough the number of deaths from natural disasters has decreased over the years due to factors such as early warning systems and risk reduction, the losses from such disasters have not reduced and are still unequal across different regions. Kingdom of Saudi Arabia (KSA) is particularly vulnerable to natural and human made disasters, and faces additional risks related to the Hajj, one of the largest religious events in the world. This event is very important in the Islamic faith and millions of people attend it every year, increasing the chances of crowd-related disasters, health complications, and the pressure on the health care systems. Hajj as a mass gathering event with participants from different parts of the world presents numerous public health issues such as infectious diseases transmission and care of the chronically ill in the context of physical and environmental stressors of the pilgrimage. These dynamics call for proper disaster management measures that are suitable for religious mass gatherings given that such events are frequent in Saudi Arabia. The purpose of this study is to examine disaster preparedness and adaptive capacity during Hajj in Makkah City, Saudi Arabia, and to assess the strategies and the knowledge, skills, and preparedness of the healthcare providers for disaster management. It outlines the organisational and contextual factors that determine preparedness and looks at how the sociodemographic factors influence the preparedness of the healthcare providers, administrators and the pilgrims. The bioecological theory of human development underpins the study, integrating the Process-Person-Context-Time (PPCT) model's dimensions of individual characteristics (person), dynamic strategies (process), sociocultural and organisational environments (context), and time factors (time). It will explore the roles and interactions of these elements that help formulate a disaster resilience framework addressing the specific needs of similar large-scale religious gatherings. Employing a mixed-methods case study approach design this study integrates quantitative data from a survey of 161 healthcare providers with qualitative insights from semi-structured interviews of six healthcare providers, five health administrators, and five pilgrims/community members. This data is analysed using SPSS and NVivo software. The results reveal varying knowledge, skills, confidence, and implementation strategies. In terms of knowledge, which included understanding disaster, familiarity with disaster preparedness procedures, and management, 45.3% of participants demonstrated a high level of understanding. Skills, assessed through technical skills, soft skills, and experience in mass gatherings, revealed that 44.1% of healthcare providers possessed high disaster management skills. Confidence in disaster preparedness was notably high, with 54.4% of providers expressing strong confidence in managing disasters during Hajj. Implementation, which encompassed viii viii infrastructure readiness, healthcare facilities and resources, emergency response and coordination, risk assessment and mitigation, and monitoring and evaluation, saw 55% of providers displaying a high level of knowledge in implementing disaster preparedness measures. Challenges identified included language barriers, conflicting stakeholder roles, logistical issues, staff shortages, and extreme heat. However, opportunities for gaining disaster management skills, leadership experience, practical training application, and improved team collaboration enhanced overall preparedness and resilience. The religious aspect of Hajj preparation significantly motivated healthcare providers, many of whom view their work as a form of worship and charity, seeking spiritual rewards through their service. Applying the PPCT model to Hajj disaster preparedness highlighted the roles of individual characteristics, continuous learning, unique ecological challenges, and historical factors, underscoring a comprehensive approach to disaster preparedness. Additionally, insights from the Asia-Pacific Ministerial Conference on Disaster Risk Reduction (APMCDRR) 2022 conference resonated with the study's findings, emphasising the need for a holistic approach to building resilience. This connection emphasizes the need to integrate the global approaches and best practices in disaster risk reduction into the Hajj context. However, there are some areas of knowledge and skills that needed further development; suggesting the need for enhanced training, better coordination between agencies, and a more holistic approach to disaster management in terms of individual and organizational resilience. The study recommends that there should be better training in crowd control, disaster management and cultural sensitivity for the healthcare workers. It underlines the importance of improving the healthcare system in Makkah City and cooperation between different agencies; including the command center and integrated health strategies. Measures that include awareness campaigns for pilgrims, disaster preparedness through early warning systems, emergency plans and drills are also emphasized. Additionally, the study recommends the use of technology in the delivery of healthcare services such as electronic health records and telemedicine; and the alignment of strategies with the PPCT model which includes person-centered training, process improvement, contextualization, and time-sensitive planning and evaluation.41 0Item Restricted Exploring the Applications of Artificial Intelligence in Enhancing Pre-Hospital Care: A Scoping Review(Queen’s University, Belfast, 2024) Alfaifi, Yahya; Clarke, SusanArtificial Intelligence (AI) has the potential to significantly improve pre-hospital care, especially in emergency medical services (EMS). However, its current application remains scattered, with varying integration levels across care stages. This scoping review aims to map and assess existing research on AI applications within pre-hospital care without focusing on specific AI technologies, such as machine learning (ML), deep learning (DL), or decision support systems (DSS). The review reflects the current research landscape, capturing how AI is utilised across critical stages such as call-taking, dispatch, and on-scene assessment. Using the framework developed by Arksey and O’Malley (2005), a systematic search was conducted across multiple databases to identify studies relevant to AI in pre-hospital care. The scope was deliberately broad to capture a comprehensive view of the available literature, focusing on identifying areas where further research is needed. The findings indicate that DSS is commonly used to support decision-making in call-taking and dispatch, while more advanced AI applications like ML and DL show potential in predictive analytics and real-time decision-making. However, these technologies are still in their early stages of real-world implementation. This review highlights the gaps in AI research, particularly in the later stages of prehospital care, such as transport and handover. Further exploration is necessary to unlock AI’s full potential in enhancing EMS operations and outcomes.50 0Item Restricted The Impact of Prehospital Blood Transfusion for Trauma Patient with Haemorrhagic Shock(University of Glasgow, 2024) Alotaibi, Rawan; McGuire, AndrewTrauma significantly contributes to the annual global mortality rate. One of the major causes of death resulting from traumatic injury is haemorrhagic shock. Early resuscitation with blood and blood products in low ratios is recommended by the Advanced Trauma Life Support (ATLS) in patients with evidence of Class III and IV haemorrhage. Therefore, the aim of this dissertation is to determine the impact of Prehospital Blood Products Transfusion (PHBT) on mortality rate compared to crystalloid solutions in trauma patients experiencing haemorrhagic shock. Method: A systematic literature search was performed across three electronic databases (Ovid Medline, Embase Advanced Search and CINAHL Complete (EBSCO) database) for data published between 01 January 2013 to 20 October 2023. Eligibility criteria included randomised controlled trials (RCTs) and comparative cohort study comparing prehospital blood products transfusion with standard care. All included studies were screened and assessed utilising the Critical Appraisal Skills Programme (CASP) tool to evaluate their quality. Results: From an initial 2425 articles collected, 870 duplicates were removed, and a further 1534 were excluded. Following title and abstract screening of the 21 studies that has a full-text review, six studies met the predefined inclusion criteria. From these studies, PHBT did not cause any reduction in mortality rates compared with crystalloid fluids. Conclusion: While PHBT is increasingly being adopted as an intervention in pre-hospital settings, the results from the systematic literature search did not reveal a reduction in mortality rates in favour of PHBT recipients compared to crystalloid solution. Conducting a RCT would be required to fully address the proposed research question21 0Item Restricted Disaster Preparedness Among Emergency Medical Services Worker in Saudi Arabia(Saudi Digital Library, 2023-05-03) Almukhlifi, Yasir Matar D; Hutton, Alison; Crowfoot, GaryDisasters are unexpected events that impose destructive consequences which can adversely overwhelm countries' healthcare response systems. Countries are required to prepare their healthcare workers for disaster response effectively. A greater level of preparedness is associated with a more effective response to disasters. Emergency Medical Services (EMS) workers are vital and essential to effective disaster response in Saudi Arabia. This research aims to examine the perception of knowledge, skills, and preparation for disaster preparedness among EMS workers in Saudi Arabia. It further seeks to explore the needs of EMS workers and perceived barriers and facilitators of disaster preparedness within this context. This study used an explanatory sequential mixed method design to examine disaster preparedness among EMS workers in Saudi Arabia. A descriptive cross-sectional survey using the Disaster Preparedness Evaluation Tool (DPET) was distributed to EMS workers in military and government hospitals across three Saudi Arabian cities (Riyadh, Jeddah, and Dammam) in phase one of the study. This phase aimed to explore the perceived disaster knowledge, skills, and preparedness levels of EMS workers in Saudi Arabia. The findings from Phase One were used to inform phase two by providing direction for interview questions. Participants who expressed their interest in phase one were interviewed in phase two. This phase aimed to explore the facilitators, barriers, and cultural factors that affect disaster preparedness among EMS workers in Saudi Arabia. Two-hundred-and-eighty-seven EMS workers participated in this study. In phase one, participants reported moderate knowledge, skills, and preparedness levels for disasters. However, EMS workers were underprepared in certain areas of disaster preparedness, specifically a lack of isolation and decontamination skills during bioterrorist or biological attacks (CBRNE). Interview findings showed that three factors influenced their preparedness levels: personal preparedness, workplace preparedness, and socio-cultural influences. Participants reported difficulties in accessing workplace policies and procedures, a lack of standardisation in managing and implementing EMS regulations, and irregularity in providing drills and exercise regimes in Saudi Arabia. Results also highlighted the socio-cultural impact on disaster knowledge, skills, and preparedness of EMS workers. Prevailing social-cultural expectations in Saudi Arabia are biased against women. This results in a predominantly male and patriarchal structure within the EMS profession. Consequently, women in this study had fewer opportunities to enhance their knowledge, skills, and preparedness than their male EMS peers. This research was able to explore the perception of EMS workers’ disaster knowledge, skills and preparedness from a geographically and demographic representative sample of the Saudi Arabia EMS workforce. Important insights from the study could advance the EMS workforce and increase disaster preparedness. These include providing equitable, standardised, and inclusive education and training opportunities for all EMS workers in Saudi Arabia. In addition, local, postgraduate programs would further support Saudi Arabia’s disaster preparedness. Saudi Arabian workplaces will benefit from recruiting more female EMS workers and standardising staff rotation. This will empower EMS workers within all healthcare systems in Saudi Arabia. The Saudi Association of Emergency Medical Services (SAEMS) should implement these changes and be provided with appropriate governance powers to regulate the profession.55 0