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 A Mixed Method Study Exploring The Efficacy of Personalised Digital Prehabilitation Programme, Fit4surgery (F4S), For Patients Undergoing Major Surgery in Decreasing The Anaesthesia and Surgical Complications(Saudi Digital Library, 2025) Alzahrani, Matar; Babu, NaiduBackground: Patients undergoing major thoracic surgeries such as lung cancer resection and lung volume reduction surgery are at high risk of postoperative complications, reduced functional capacity, and prolonged recovery. Prehabilitation has emerged as a promising strategy to enhance patients’ physical and psychological readiness for surgery. However, traditional prehabilitation services face limitations in accessibility and scalability. This thesis aimed to evaluate the feasibility, acceptability, and clinical impact of a novel digital prehabilitation intervention, the Fit4Surgery (F4S) app. Methods: A mixed-methods design was adopted across five integrated studies. A matched case-control analysis using propensity score matching compared patients who underwent pulmonary rehabilitation (PR) to those who did not, assessing outcomes including postoperative pulmonary complications (PPC), hospital length of stay (LOS), and quality of life (QoL). Concurrently, the F4S app was developed using the Double Diamond design framework, underpinned by Self-Determination Theory. Its feasibility, usability, and impact were evaluated through physical performance measures, validated QoL instruments, and patient engagement metrics. Qualitative interviews explored patient experiences and barriers to engagement. Results: Participation in PR was associated with a 60% reduction in PPC and a LOS reduction of up to 1.8 days. The F4S app demonstrated high levels of feasibility and acceptability, with strong patient satisfaction and engagement. Statistically and clinically significant improvements were observed in exercise capacity and QoL domains, with sustained gains up to 6 months post-surgery. Positive correlations were found between app engagement and functional outcomes. Qualitative findings highlighted the app’s usability, its role in enhancing patient autonomy, and its psychological benefits. Conclusion: This thesis provides robust evidence supporting the role of digital prehabilitation in optimising surgical outcomes. The F4S app, developed through a user-centred, theory-driven process, represents a scalable and accessible solution to conventional rehabilitation barriers. Its implementation could enhance perioperative care, improve clinical outcomes, and support patient-centred recovery. Future research should focus on large-scale randomised controlled trials and explore long-term cost-effectiveness, digital equity, and broader applicability across surgical populations.5 0Item Restricted General Anaesthetic Techniques and the Incidence of Acute Kidney Injury: Systematic Review and Meta-analysis(Queen Mary University of London, 2024) Samman, Abeer; Ackland, GarethBackground: Acute kidney injury (AKI) is a critical postoperative complication. This study compares the incidence of AKI in adults undergoing non-cardiac surgery with propofol-based total intravenous anaesthesia (TIVA) versus sevoflurane-based volatile anaesthesia (VA). Methods: A systematic review and meta-analysis of studies from 2000 to 2024 was conducted. The primary outcome was AKI incidence using KDIGO criteria, analyzed with a random-effects model. Secondary outcomes using RIFLE and AKIN criteria were qualitatively synthesized. Results: Seven studies involving 6,795 participants showed a lower AKI incidence in the TIVA group (3.63%) compared to the VA group (6.21%), with a pooled risk ratio of 0.586 (95% CI: 0.332 to 1.036, p = 0.066). Results were not statistically significant, and heterogeneity was high (I² = 73.0%). Conclusion: TIVA may reduce AKI incidence compared to VA, but further studies are needed. Novel biomarkers like NGAL and KIM-1 could improve early AKI detection and management.30 0