Saudi Cultural Missions Theses & Dissertations
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Item Restricted An Exploration of Occupational Therapists’ Understanding of Mental Health in Saudi Arabia: A Qualitative Investigation.(Saudi Digital Library, 2025-03-03) Alrashidi, Raiyad Abbad D Alrashidi; Whitcombe, SteveObjectives: This study explores the understanding of mental health among occupational therapists in Saudi Arabia. The objectives of the research were to examine the professional and cultural factors that influence occupational therapists’ perceptions of mental health, to assess opportunities and challenges faced by occupational therapists working in mental health settings and to explore the perceived value and role of occupational therapy in mental health care in Saudi Arabia. Methodology: This study used an exploratory- descriptive qualitative approach. Data was collected through semi-structured interviews from eight occupational therapists practising in Saudi Arabia. The data was analysed using reflexive thematic analysis, a framework that facilitated identification and development of key themes. Findings: The findings were categorised into four main themes. Firstly, occupational therapists’ perceptions of mental health. The study revealed varying levels of understanding and awareness of mental health which attributed to lack of professional training in this area. Secondly, inadequacies in training and education showed the need for improved professional development opportunities in mental health among occupational therapists in Saudi Arabia. The third theme examined current challenges and cultural influences in that occupational therapists in Saudi Arabia face systematic barriers since there are no policies to support their role in mental health. They are challenges related to stigma surrounding mental health and limited collaboration between OTs and other healthcare professionals. The final theme centred on future perspectives and recommendations, where participants advocated for increased awareness of their role - occupational therapy in mental health situations. There is a need for policy reforms and integration of occupational therapy into mental health services through professional training. Conclusion: This study provides information on whether mental health has been integrated into occupational therapy in Saudi Arabia and examines the opportunities and challenges facing OT professionals working in the mental health field. The study highlights the importance of addressing challenges such as cultural and systematic barriers limiting the integration of metal health in OT and a need to enhance education opportunities promoting the role of occupational therapy in mental health. The findings of this study will inform future policies and research that will support the integration of mental health into occupational therapy.4 0Item Restricted A Focused Ethnographic Study on Kangaroo care of Preterm Infants in a Neonatal Intensive care Unit in Saudi Arabia(University of Dundee, 2025) Almutairi, Amal; McFadden Alison ، Gavine Anna, Malcolm CariBackground: Kangaroo Care (KC), a globally recognised practice involving skin-to-skin contact (SSC) between parents and their preterm infants, is widely endorsed for its physiological, neurobehavioral, developmental, and parental benefits. Despite its significant role in improving survival rates and promoting bonding and breastfeeding, the implementation of KC varies across healthcare settings, often influenced by organisational, practical, and resource-related factors. To initiate this study, a systematic review of the literature was conducted, highlighting a research gap in the Eastern Mediterranean Region (EMR), including Saudi Arabia, where cultural and organisational factors may pose additional barriers to KC adoption. Moreover, KC in Saudi Arabia remains underutilised and insufficiently studied, particularly in NICU setting. Aim: This PhD aimd to explore how KC was perceived, practiced by parents and HCPs in one NICU. It sought to provide insights into the factors that influenced KC implementation, examining the cultural, contextual, and organisational processes, as well as the challenges and opportunities for integrating KC as a standard practice in Saudi neonatal care. Design and methods: A focused ethnographic study was conducted in a large neonatal unit in Saudi Arabia. Data generation, employing purposive sampling with maximum variation, was carried out in three iterative steps: observations and fieldnotes, interviews and a focus group, and document collection. One hundred and fifty hours of observations, 13 interviews with parents (n=13), and 15 interviews and one focus group with HCPs (n=19), and documentary analysis were conducted. Reflexive thematic analysis adapted from Braun and Clarke, (2021) was applied informed by a social-ecological model and family integrated care model. Findings: The systematic review showed generally positive attitudes toward KC among HCPs but identified barriers, including unclear guidelines, staff shortages, and inadequate training. Parents were often uninformed about KC and relied on HCPs for guidance. Practical challenges, such as discomfort with prolonged KC, medical equipment, and lack of private spaces, hindered implementation. The ethnographic study found parents were often unaware of KC before their NICU experience, relying heavily on HCPs for guidance. Initial apprehension, driven by their infants’ fragility and the medicalised NICU environment, highlighted the lack of formal KC training among both parents and HCPs. A hierarchical NICU structure prioritised physician-led decision-making, limiting nurses’ autonomy and excluding parents, particularly in unstable infant cases. Cultural norms, including modesty expectations and traditional gender roles, restricted paternal involvement, while religious practices and open NICU layouts added barriers. Restrictive visitation policies, rigid routines, and an overemphasis on hygiene protocols led to KC being viewed as supplementary rather than integral, deviating from WHO guidelines promoting prolonged SSC. Organisational barriers like inconsistent policies and inadequate staffing further impeded KC implementation. Facilitators included supportive HCP attitudes, particularly among those with international experience, and private NICU spaces that encouraged greater parental participation. Conclusions and implications: The findings of this study emphasise the need for culturally informed, systemic changes to integrate KC as a routine practise of neonatal care in this NICU. There is need for integrating KC into healthcare education, policies, and practices through mandatory training for HCPs, parental education, and infrastructural improvements to ensure privacy. Aligning NICU protocols with WHO guidelines and FiCare can address organisational and cultural barriers, enhancing KC adoption and neonatal outcomes. Future research should focus on scaling up KC implementation, standardising practices, and exploring strategies to promote consistent adherence to evidence-based guidelines.5 0Item Restricted Responsibility for Online Harms: A Critical Analysis of Cyber Governance in Saudi Arabia(Saudi Digital Library, 2025-03) Alsaiedi, Yara M; Basu, Subhajit; Walker, CliveThis thesis investigates the topic of internet governance within the context of Saudi Arabia. It focuses on the component of ‘Responsibility’ for internet governance when applied to the policy area of combating online harms. As such, the research work investigates and evaluates the present framework of responsibility devised to address online harms, considering the assemblage which regulates online content and cybersecurity in the Kingdom of Saudi Arabia. This approach aims to facilitate the prevention and mitigation of the harmful effects of online activities and content, thereby aligning with the objectives outlined in the Saudi state’s long-term project known as Vision 2030. The thesis adopts the hypothesis that effectively addressing online harms requires a primary objective of establishing a robust responsibility structure. This method can best be achieved by facilitating the active participation of all stakeholders in the strategic deployment of responsive – including preventive – measures. Consequently, the thesis advocates a multistakeholderism approach with reference to governance for the prevention and mitigation of online harms in Saudi Arabia. It evaluates the effectiveness and fairness of the responsibility structure in fostering cybersecurity and mitigating the harmful effects of online content in the Saudi context. The formal study employs semi-structured interviews with elite figures and authorities from governmental and private organisations, internet content and service providers, as well as corporate users, which are the small and medium enterprises (SME) as internet users. Additionally, it integrates the policy transfer methodology to draw insights from the experiences of the United Kingdom in the realm of internet governance. In sum, the thesis proposes areas of improvement to develop a comprehensive online harms governance framework in Saudi Arabia. Such amendments are expected to contribute to the recognition and realisation of the declared Vision 2030 goals related to internet governance in the Saudi realm.3 0Item Restricted INTEGRATING LEARNER-CENTERED TEACHING PRACTICES WITH SAUDI ARABIA’S NATIONAL CURRICULUM IN EARLY CHILDHOOD EDUCATION: A MIXED METHODS STUDY(Saudi Digital Library, 2025-06-26) Alibrahim, Alae; GRACE JEPKEMBOI, COMMITTEE CHAIR JULIE PAUL FLANNERY, COMMITTEE CO-CHAIR JENIFFER PONDER KELLY HILL MARIAH WEBERThis study explores how early childhood educators in Northern Saudi Arabia implement learner-centered teaching (LCT) within the framework of the National Curriculum. Employing an explanatory sequential mixed-methods design, the research first collected quantitative data via a survey of 260 teachers, followed by qualitative data through interviews with eight participants. The integrated findings offer a comprehensive understanding of how LCT is practiced in early childhood education. The findings reveal that educators generally recognize the benefits of LCT, particularly in fostering independent learning, critical thinking, and active student participation. Teachers reported using strategies such as open-ended questioning, collaborative learning, and activity-based instruction to support diverse learning needs. However, several barriers hindered full implementation, including large class sizes, limited resources, insufficient professional development, and inconsistent administrative support. Qualitative insights highlighted teachers’ efforts to adapt the National Curriculum in ways that align with student interests and inquiry-based approaches. Many educators view the curriculum as flexible and capable of accommodating child-centered methods. Despite the availability of training opportunities, professional development was often voluntary, leaving gaps in teachers’ preparedness for effective LCT integration. Support mechanisms such as peer collaboration, both online and in-person training, and administrative facilitation of experiential learning activities were also noted. Nevertheless, the inconsistency in access to these supports points to the need for more structured and mandatory professional development programs. Overall, the study underscores both the promise and challenges of implementing learner-centered teaching in early childhood education in the region. While teachers are conceptually aligned with LCT principles, practical constraints and limited institutional backing hinder their ability to apply these methods consistently. These findings suggest a need for policy enhancements that prioritize resource allocation, compulsory teacher training, and structural support to promote meaningful adoption of LCT across early childhood settings.16 0Item Restricted The Ianguage Attitudes of Saudi Arabic Speakers Towards the Speech of Other Major Vernacular Varieties of Arabic(Saudi Digital Library, 2025-03-03) Albogami, Haitham; Griffiths, MarkLanguage attitudes research in Saudi Arabia is in its early stages, and rarely goes beyond the boundaries of Saudi Arabia. There remains a gap in our knowledge of Saudis' attitudes towards non-Saudi dialects. This study examines Saudi Arabic speakers’ attitudes toward the speech of five major vernacular varieties of Arabic: Gulf, Iraqi, Levantine, Egyptian, and Maghrebi. The findings revealed a clear hierarchy of attitudes. Gulf Arabic was rated the highest across most labels, while Maghrebi Arabic was the lowest. Iraqi, Levantine and Egyptian competed in the middle spots, with an association of humour and closeness to MSA with Egyptian and Levantine Arabic respectively. Using a verbal guise technique (VGT) combined with a semantic differential scale and ranking tasks, this study collected and analysed quantitative and qualitative data from Saudi participants. The results suggested that attitudes toward these dialects are influenced by a combination of linguistic, sociopolitical, and cultural factors. Exploratory Factor Analyses were conducted on the five speakers, revealing five different dimensional models. These factor structures uncovered patterns of attitudes, offering a deeper look into stereotypes associated with the five varieties. By integrating culture-specific constructs (e.g., Sadr al-Majlis as a social status indicator), this study highlights the need for culture-appropriate instruments in language attitudes research. The findings highlight how media, cultural proximity, and stereotypes shape these attitudes.9 0Item Restricted Exploring Physiotherapists' Perceptions and Practices in the Use of Psychological Interventions in Sports Rehabilitation in Saudi Arabia: A Survey Study(Saudi Digital Library, 2025-02-24) Alharbi, Abdulelah; Knott, SianBackground: Sports injuries impact athletes both physically and psychologically, causing issues like anxiety, depression, and fear of re-injury. Incorporating psychological interventions and emotional support in rehabilitation enhances recovery outcomes. Physiotherapists, due to their close interaction with athletes, play a key role in addressing these psychological aspects and providing comprehensive care. Aim of the study: Explore the psychological interventions in sports injury rehabilitation among physiotherapists in Saudi Arabia, focusing on their practices, perceptions, and referral behaviours. Design: A quantitative descriptive survey study. Methods: This study included 160 physiotherapists in Saudi Arabia, with 53.8% (n = 86) males and 46.3% (n = 74) females. The Physiotherapist and Sport Psychology Questionnaire (PSPQ) was distributed through social media platforms, including X (formerly Twitter) and LinkedIn, between 29 October 2024 and 29 November 2024. The collected data were analysed using the Statistical Package for the Social Sciences (SPSS) software. Results: A total of 18.1% of physiotherapists reported "always" observing psychological impacts on athletes following injuries, with 36.3% observing this "often." Over half (53.8%) of physiotherapists rated addressing the psychological aspects of injuries as "extremely important." Athletes who coped successfully with injuries were commonly characterized by "realistic expectations" (M = 5.04, SD = 2.260) and "patience with themselves" (M = 5.00, SD = 2.226). In contrast, poor coping was associated with traits such as "anger/aggression" (M = 5.54, SD = 2.166) and "poor concentration" (M = 5.07, SD = 2.108). Among the most frequently employed techniques were “encouraging effective communication” (M = 4.40, SD = 0.841), “enhancing self-confidence” (M = 4.29, SD = 0.908), and “setting short-term goals” (M = 4.26, SD = 0.894), all of which were described as "always used." Additionally, the techniques physiotherapists most valued for further development included “setting realistic goals” (M = 4.40, SD = 0.841) and “enhancing self-confidence” (M = 4.29, SD = 0.908). Despite this, 85.6% lacked access to sports psychologists, 80% had never referred athletes, and 89.4% reported an absence of referral guidelines. Conclusion: This study highlights the significant psychological impact of injuries on athletes, as observed by physiotherapists. Physiotherapists demonstrated a high awareness of the importance of addressing the psychological aspects of rehabilitation. Skills such as “setting realistic goals” and “enhancing self-confidence” were identified as the most valued techniques for both current use and further learning. However, the lack of access to sports psychologists and the absence of formal referral guidelines remain major barriers, with most physiotherapists reporting no referrals or collaboration with psychologists. These findings emphasize the urgent need to integrate psychological support into sports injury rehabilitation to improve outcomes for athletes.3 0Item Restricted The impact of IT flexibility and IT capability on Business-IT strategic alignment: An empirical study in Saudi Arabia(The University of Manchseter, 2025) Alharbi, Nawal Olayan; Mamman, AminuPublic and private organisations face many challenges to attain the objectives of providing services and products to their clients. Most organisations adopt many enablers customised technological tools to tackle their unique operational issues and achieve their strategic goals. Therefore, IT is considered one of the most enablers for organisations to help overcome their challenges. Higher education institutions have developed strategies and are relying more on their IT systems in delivering most of services to their stakeholders. The roles of IT strategy and business strategy in any organisation are often incorporated. However, the organisations’ objectives are likely not to be attained if the business strategy and IT strategy are not aligned in an effective manner. Business and IT strategic alignment has been considered as IT application in which match the business objectives, goals, and requirements. To improve the efficiency and performance of alignment, IT flexibility and IT capability provide a robust lens to assess their impact on organisational objectives. Although, strategic alignment has been the interest of many researchers, investigation of such issue in Saudi higher education sector is still to be undertaken. To address this issue, the aim of this study was to examine how IT is used in Saudi Arabian higher education to attain their organisational objectives. This aim was pursued by meeting the following objectives: First, to investigate the connection between flexibility and capability of IT dimensions. Second, to investigate the effect of IT flexibility and IT capability on the business strategy and IT strategic alignment. Third, to investigate how business strategy and IT strategic alignment have influenced organisational performance. The research employed the University of Hail as a case study to conduct an extensive examination of IT flexibility, IT capability, and IT strategic alignment with business strategy. A qualitative research approach was utilised to collect data through various methods, including interviews and document analysis. The study participants comprised the Deanship, Strategy department, IT department, Heads of Schools, faculty members and students. This study found a significant shift from viewing IT as merely a support function to recognising it as a strategic enabler for achieving organisational goals. It delved into the interrelated nature of IT flexibility, IT capability, business-IT strategic alignment, and organisational performance. These interconnections allowed the organisation to effectively leverage IT for performance enhancements, as evidenced by improvements in key areas such as student services, research output, administrative efficiency, and university ranking. The study made a significant contribution to addressing gaps in IT research and enhanced the understanding of educational and business organisations regarding the effective implementation of Business-IT strategic alignment.30 0Item Restricted The Impact of Privacy Awareness on Sharenting and Privacy Management Practices Among Saudi Parents(Kent State University, 2025) alnemre, Afnan; Hollenbaugh, Erin; Egbert, NicholeIn the digital age, parents frequently engage in the practice of sharenting—sharing their children's photos and information on social media—raising concerns about privacy and its implications for identity theft and other risks. This phenomenon has significant impacts on the violation of children’s privacy and their psychological and social well-being. Guided by communication privacy management (CPM) theory, this study aimed to identify the role of privacy awareness and religiosity in sharenting and privacy management practices among Saudi parents, using a quantitative approach and relying on a survey as a data collection method, N =139 were collected from Saudi parents. The findings revealed that extrinsic religiosity demonstrated positive relationship with all sharenting dimensions self-control, social behaviors and implications also with boundary linkages and boundary permeability in CPM. Also, intrinsic religiosity has a negative correlation with boundary permeability, while the study does not find a relationship between intrinsic religiosity and all sharenting dimensions. Additionally, there was a significant negative correlation between privacy awareness and boundary ownership in CPM. Moreover, the study has shown gender differences in sharenting behavior, showing that mothers post more pictures of children. This research aspires to inform initiatives promoting privacy-conscious digital practices among parents and aims to support the development of child protection policies in Saudi Arabia to safeguard children's online privacy.25 0Item Restricted Bridging the gaps in mortality data and healthcare access: A novel verbal autopsy application using subnational T2DM register in Saudi Arabia.(University of Gothenburg, 2025) Alyazidi, Faleh; Hussain-Alkhateeb, Laith; Petzold, Max; Shakely, DelérAbstract Background: Diabetes mellitus is an increasingly critical health concern in Saudi Arabia, often with other comorbidities and mortality causes, such as cardiovascular disease (CVD). National sociodemographic changes entail the urgent need for reliable insights on the scale and causes of mortality in order to develop appropriate healthcare policy. Where death certification is inadequate, verbal autopsy (VA) can serve as a useful tool to fill crucial gaps in vital data. This thesis aims to explore various contextual dimensions using the validated VA method. Specifically, this thesis aims to explore the community perception of causes of death, measure the circumstantial barriers (social and health system) to accessing healthcare, assess and validate the adequacy of medical certification of cause of death at population level, and investigate the clinical and demographic factors influencing out of hospital deaths among deceased individuals with specific health conditions T2DM and CVD. Methods: Studies I-IV utilized mortality data from the T2DM register at a major hospital in Makkah City, while Study V used data from the CVD registers at two major hospitals. For the first three studies, 302 VA assessments were conducted with the deceased’s next of kin. The VA data were analyzed using the computerized InterVA-5 software, which provided probable causes of death and circumstances of mortality categories (COMCATs). Study I employed Lin’s concordance correlation coefficient (CCC) to assess the concordance between verbal autopsy causes of death (VACoD) as a presumed reference standard and family-reported causes of death. Also, the study employed multiple logistic regression to identify factors influencing community perception of causes of death. Study II applied epidemiological estimations of absolute measures and Causes Specific Mortality Fractions (CSMFs), while also using numerical and graphical assessment to describe trends and patterns in the VA data. The COMCATs were ranked across the causes of death based on their derived probabilities. Study III employed Lin’s CCC to assess the concordance between physician reviewed causes of death (PRCoD) and VACoD at the population level. Study IV employed multiple logistic regression to identify factors influencing out of hospital deaths among deceased with T2DM, while Study V focused on CVD. Findings: Study I demonstrated broad community perceptions of causes of death, with notable misconceptions related to type of death and marital status. Study II found most deaths were seen as inevitable, with the COMCATs ‘recognition’ and ‘traditions’ being identified as avoidable barriers. Study III showed moderate concordance between PRCoD and VACoD, though discrepancies were apparent in the CSMFs, particularly for the most prevalent causes. Studies IV and V uncovered that cause and year of death in addition to nationality significantly influenced out of hospital deaths, with both studies illustrating decreasing trend of out of hospital mortality. Conclusion: This thesis uncovers challenges for Saudi public health policy concerning T2DM-related mortality, identifying issues in access to healthcare, community perceptions, and medical certification. Misconceptions about mortality causes of death hamper prevention strategies, while health system and sociocultural barriers heighten latent problems. The findings underscore the requirement to enhance the medical certification, as discrepancies between PRCoD and VA data suggest challenges in current practices on population level.6 0Item Restricted Analysing Existing Saudi Arabian University Admission Criteria for Accounting Programs(Victoria University, 2025) Alboty, Yazeed; Farley, Alan; Yang, HelenThis research was motivated by the significant role played by effective admission criteria in predicting academic performance, particularly in Saudi Arabian accounting programs. The primary objective of this research is to investigate the appropriateness of Saudi Arabian university admission criteria for undergraduate and postgraduate accounting programs. First, for the bachelor accounting program, this research aims to explore how well existing admission criteria—which test different dimensions of prior knowledge—predict academic performance of accounting students based in Saudi Arabia. It evaluates the validity of the High School Grade Point Average (HSGPA) and College Entrance Exam (CEE)—that is, the General Aptitude Test (GAT) and Achievement Test (AT)—to predict student performance in the Preparatory Year Program (PYP), along with first-year core courses in the accounting program and First Year Grade Point Average (FYGPA) and overall Grade Point Average (GPA) of students at the end of the degree. It also examines how the business college PYP predicts performance in the first year, and overall student GPAs at the end of the degree. The role of gender as a moderator in these relationships is considered. This investigation is based on prior knowledge theory (PKT), which is characterised as a multidimensional, hierarchical entity comprised of various types of knowledge and skills. Tied to the above, for the Master of Accounting program, this research aims to evaluate how effectively one admission criterion predicts the relative academic performance of accounting students in Saudi Arabia. Specifically, it examines the impact of English language proficiency—as measured by International English Language Testing System (IELTS) scores—on the relative performance of Saudi Master of Accounting students in more versus less conceptually oriented accounting courses. This investigation is informed by cognitive load theory (CLT), which addresses the challenge of processing complex cognitive tasks with multiple interactive information elements. The findings demonstrated that when used as sole predictors, the explanatory variables (HSGPA, GA, and AT) all had statistically significant positive correlations with the dependent variables related to predicting academic performance. Multiple regression analyses indicated that HSGPA was the strongest incremental predictor of academic performance, whereas GAT was the weakest, showing no significant incremental predictive power in most cases. This study demonstrates that HSGPA is the strongest predictor of both short- and long-term college outcomes in particular accounting disciplines. Further, the results consistently imply that the individual courses and GPA of the PYP in the business college have predictive value for academic performance. Additionally, the results indicate that gender does moderate the relationship between admission criteria and PYP and academic performance, which is significant in many cases. Last, the results show that English language proficiency measured by the IELTS alone has no significant direct effect on the relative academic performance of Saudi accounting students. Several implications can be drawn from this research for stakeholders and policy makers. It raises questions about the continued use of GAT score as an entry criterion and strongly supports gender-based differential entry criteria. In addition, it provides insight into the efficacy of the PYP.9 0