Saudi Cultural Missions Theses & Dissertations
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Item Restricted Stress and Burnout in Critical Care Nurses in Saudi Arabia: A Systematic Literature Review(Queen's University Belfast, 2025-03) Aljohani, Abdulelah; Rice, BilliejoanBackground: Burnout is a significant occupational health problem in critical care nurses, particularly working in intensive care units and emergency departments. The intensive work of critical care, involving long shifts, high patient acuity, and emotional stress, is a contributing factor to burnout, impacting job satisfaction, patient care quality, and nursing staff turnover. In Saudi Arabia, regional health disparities, nursing shortages, and reliance on expatriate nurses add to the issue, requiring closer examination. Aim: The aim of this systematic review seeks to synthesise current evidence on risk factors and the prevalence for stress and burnout among critical care nurses in the Kingdom of Saudi Arabia. Methods: Systematic literature search was conducted by utilising PUBMED, CINAHL, and EMBASE databases. Inclusion was rigorous, and studies regarding the prevalence, risk factors, and Saudi Arabian critical care nurses’ exposure to burnout: a total of ten articles were included in the review. Meta-analyses were not feasible; thus, the results were synthesised narratively and categorised into two major categories: Levels of burnout and factors contributing to burnout. Results: There are high to moderate levels of burnout present in Critical care nurses, and there is regional variation between Riyadh, Makkah, and Jazan. Intensive care units’ nurses exhibited more emotional exhaustion, and emergency department nurses exhibited physical exhaustion as a result of workload intensity. There was added stress due to expatriate nurses, including uncertainty in jobs, cultural challenges, and language. Organisational factors, including shortages in staff, shift working, and rigid hospital hierarchies, also contributed to burnout. Conclusion: Burnout among Saudi Arabian critical care nurses’ is a serious workforce issue with direct effects on patient safety, healthcare efficiency, and retention. Addressing burnout requires policy changes, mental health support, and workforce reforms to improve nurse well-being and patient care. Future research should focus on longitudinal studies and intervention-based strategies for sustainable solutions.5 0Item Restricted Perceived Barriers and Facilitators by Critical Care Nurses and The Impact of Cultural Variations Between Nurses and Patients on End-Of-Life Care at Intensive Care Units(University of Cincinnati, 2024-10-18) Alali, Khairayah; Smith, Carolyn R.Background: Due to the complexity of medical conditions in the intensive care unit (ICU), mortality rates are typically high in most hospitals. End-of-life care (EOLC) begins when curative treatments are no longer beneficial, shifting the focus to comfort and quality of life for patients and families. Despite EOLC being a standard part of ICU management, healthcare professionals encounter complexities and uncertainties when transitioning from life-saving treatments to comfort-focused care. Additionally, EOLC in the ICU is influenced by the cultural backgrounds of both nurses and patients. The nursing culture in Saudi Arabia reflects a diverse workforce, with a significant reliance on expatriate nurses from various countries, leading to cultural and language differences that can influence EOLC. Objectives: To explore the perceived barriers and facilitators of critical care nurses in providing EOLC in intensive care units, how cultural variations between nurses and patients impact care, and how nurses address and meet the cultural needs of dying patients. Method: The study employed a qualitative descriptive method, utilizing semi-structured interviews that were conducted virtually through Zoom. Purposeful sampling techniques and a homogeneous sampling approach were used to recruit participants. Open-ended questions were used from an interview guide to prompt the critical care nurses to share their viewpoints and experiences. Results: The exploration of the perceived barriers and facilitators of critical care nurses during EOLC for terminally ill patients in the ICU revealed three main themes: (a) EOLC barriers, (b) EOLC facilitators, and (c) suggestions to improve the EOLC and overcome barriers. The exploration of how cultural variations between nurses and patients impact care, and how nurses address and meet the cultural needs of dying patients revealed five main themes: (a) cultural practices and traditions of patients & families, (b) cultural competence during EOLC, (c) culturally competent nursing care decisions and actions (d) challenges in providing culturally competent nursing care, and (e) suggestions to improve cultural competence. Conclusion: This study identified barriers to EOLC, including family acceptance, understanding of EOLC, unrealistic expectations, over-involvement, poor policy awareness, staffing shortages, high workloads, care continuity, and insufficient training. Nurses showed a strong commitment to respecting patients' cultural and religious practices but faced challenges in delivering culturally competent care. Recommendations include better family education, clear communication, integrating EOLC training into nursing education, addressing language barriers, implementing advance directives, and fostering a collaborative team environment with adequate resources and flexible visiting hours. These steps can enhance the quality and compassion of EOLC.31 0