Saudi Cultural Missions Theses & Dissertations
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Item Restricted Readiness to expand the role of the nurses working in primary healthcare centres in Saudi Arabia to include prescribing: An exploratory descriptive qualitative study(Cardiff University, 2024) Albariq, Khloud Mohmmed; Albariq KhloudAbstract Introduction: Primary healthcare centres (PHCs) in Saudi Arabia are the first point of contact for patients across the country (Al Saffer et al., 2021). However, these PHCs face various accessibility challenges, including unequal distribution of PHCs and their services (Al-Sheddi et al., 2023), a shortage of medical professionals (Al Saffer et al., 2021), a lack of specialised services (Makeen et al., 2020), and long waiting times (Albarhani et al., 2022). One way to enhance accessibility, reduce waiting times, and alleviate various burdens on the healthcare system in Saudi Arabia is to grant nurses prescribing rights (Hibbert et al., 2017; Almotairy et al., 2023). However, Saudi research into the readiness to incorporate the prescribing role into nursing practice in PHCs is currently lacking. This study aims to investigate readiness to incorporate the prescribing role into nursing practice in Saudi PHCs. Methods: An exploratory and descriptive qualitative (EDQ) research was used as the chosen methodology. Twenty-five individual semi-structured interviews were thus conducted with participants who were divided into three groups: this gave ten nurses at the micro-level, five nursing supervisors and five managers at the meso-level, and five policymakers at the macro-level. The collected data was then analysed using reflexive thematic analysis (RTA). Findings: Six key themes emerged from the data analysis. These were improving primary healthcare services, nurse-doctor partnership prescribing, educational preparation, acceptance of the nurse prescribing role, establishing the legality of the nursing prescribing practice, and readiness of primary healthcare centres. Conclusion: Implementing the nurse prescribing role in PHCs services has the potential to improve PHC services through enhancing accessibility and reducing waiting times. A nurse-doctor partnership prescribing approach may be implemented, in which nurses and physicians share prescribing responsibilities while doctors remain responsible for diagnosis. However, nurses’ general lack of pharmacological knowledge is a major obstacle, requiring additional focus on educational preparation. Another potential barrier could be a lack of acceptance of the nurse prescribing role among patients, doctors, and nurses. Several changes are thus necessary to existing systems, including the introduction of clear legislation and regulations and ensuring the readiness of PHCs to smooth the implementation of the NP role.18 0Item Embargo Development and Evaluation of an Educational Resource to Promote Skin-to-Skin Contact between Mother and Neonate in Saudi Arabia(The University of Newcastle, 2024-12) Hawsawi, Abeer; Fernandez, Ritin; Mackay, Maria; Alananzeh, Ibrahim; Al Mutair, AbbasIntroduction Skin-to-skin contact is crucial for both the baby and the mother for a better health outcome but the low practice rate in Saudi Arabia is a national concern. Consequently, there was an urgent need to develop an educational intervention to improve the uptake of skin-to-skin contact. Therefore, this study aimed to develop and evaluate the effectiveness of educational resources to promote skin-to-skin contact in Saudi Arabia. Methodology and methods A multi-method design, grounded in the Knowledge to Action framework, included a scoping review, surveys, and a clinical controlled trial followed by a mixed-methods approach incorporating semi-structured interviews and surveys. The educational resources, available in both English and Arabic, consisted of a pamphlet, a PowerPoint presentation, and a short video. These resources were developed through co-creation, involving healthcare providers, mothers, and university researchers. An online consensus development conference involving 14 participants ensured the cultural and linguistic appropriateness of the resources. A total of 383 participants were recruited from two Saudi hospitals (control, n=192 and intervention, n=191) using a convenience sampling method to test the effect of the educational resource. Data analysis Data were collected using online surveys before and after the educational intervention. Semi structured interviews with eight mothers in the intervention group further explored their experiences with the intervention. The data were analysed using SPSS version 29. Descriptive and inferential statistics, including Chi-square and T-tests, were used to compare outcomes between the control and intervention groups. A p-value of <0.05 was considered statistically significant. Qualitative data from interviews were analysed using thematic analysis. Results The online consensus development conference effectively guided the development and implementation of the educational intervention. The rates of correct skin-to-skin practice and breastfeeding within an hour after birth were significantly higher in the intervention group. Mothers reported a highly positive experience with the educational intervention. Conclusion The online consensus development conference facilitated the design and implementation of an effective intervention, significantly improving adherence to optimal skin-to-skin and early breastfeeding practices, with high maternal satisfaction.28 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 0Item Restricted Physical Activity Promotion in Saudi Arabia: The Potential and Challenges of Outdoor Exercise(Loughborough University, 2024-06-11) Albujulaya, Naif; Stevinson, Clare; Piggin, JoePhysical activity is a gateway to a healthier and more vibrant life, offering multiple physical and mental health benefits. Recent evidence suggests that engaging in outdoor exercise leads to many positive outcomes such as reducing stress, anxiety, & depression, providing Vitamin D and fostering social interactions and that extend beyond the boundaries of engaging in indoor exercise. In addition, the advantages of immersing oneself in nature are numerous and profound. Over the last two decades, research carried out in Saudi Arabia reveals that Saudis exhibit a concerning lack of physical activity. Despite efforts made in the field, there is still a lack of exploration into the factors that influence Saudi adults' involvement in outdoor exercise or strategies to enhance their participation. To fill this knowledge gap, the aim of this thesis is to investigate the possibilities of promoting outdoor exercise in Saudi Arabia. In order to gain a comprehensive understanding of all aspects related to the aim, three studies were conducted to address specific objectives. In the first study (in Chapter 3), the main objective was to analyse the Saudi government policy regarding the promotion of physical activity. This study employed the Comprehensive Analysis of Policy on Physical Activity framework to audit and assess the policy. Official reports and independent sources were examined to provide evidence on progress with implementing the policy objectives. In addition, semi-structured interviews were performed with policy-makers, policy-implementers and independent experts. The results indicated an evidence-based, ambitious policy with several objectives achieved. Greatest progress related to cultural change in permitting women’s sports and general physical activity attitudes and behaviour. Other goals, such as increasing female participation, have met barriers that have hindered progress. In the second study (in Chapter 4), the main objectives were to examine the barriers to exercise that face Saudis and understand the relationship between Saudis physical activity, outdoor environments and wellbeing. A representative sample of Saudi adults completed four standard scales: International Physical Activity Questionnaire - Short Form , Exercise Benefits/Barriers Scale, WHO (Five) Well-Being Index and short-form Nature Relatedness Scale. Additional questions related to physical activity contexts. The results of this study indicate that young adults perceive more barriers than other age groups such as challenges related to the exercise environment, time commitments and discouragement from family, and highlighted that males are more likely to exercise outdoors than females. Outdoor exercise and nature relatedness were significant independent predictors of wellbeing, as were social exercise and sporting activities. In the third study (in Chapter 5), the main objective was to explore in depth factors that influence physical activity, and specifically outdoor physical activity. Twenty-two semi- structured interviews with Saudi adults were conducted and qualitative content analysis was used to analyse the data. Key societal and environmental factors (e.g. discouragement from others, poor facilities, unsafe locations) negatively impacted exercise behaviour, particularly among women. Personal and societal factors were identified as motivations to exercise, such as health or mood improvement and active communities. The findings from the thesis indicate that several factors can impact engagement in outdoor exercise among Saudis. The major barriers included the significant lack of outdoor facilities and the weakness of the government's work towards enabling outdoor exercise. These barriers collectively impact individuals, making them develop a habit of engaging in indoors exercise. On the other hand, engaging in outdoor exercise during childhood, particularly among Saudi males, and seeking health benefits from physical activity are the most noticeable factors that can promote or facilitate outdoor exercise. Knowledge obtained from this thesis can potently help organisations and the Saudi government as a valuable foundation for designing effective interventions and policy modifications to gain the additional benefits of engagement in outdoor exercise.44 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.53 0