Saudi Cultural Missions Theses & Dissertations
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Item Restricted Gestational Diabetes Mellitus and Physical Activity: Exploring the Issues among Asian Population in the UK and Advocating for Policy Change: A Mixed-Method Study(University of Nottingham, 2024-07) Alaslani, Hadeel; Adams, Gary; Shaw, IanBackground and aim: Gestational Diabetes Mellitus (GDM), a glucose intolerance disorder resulting in hyperglycaemia, affects approximately one in every 23 pregnancies in the United Kingdom (UK). Compared to other ethnic groups in the UK, Asian-born women have a higher rate of GDM (5.8%). Physical activity is reported to have numerous benefits for both the expectant mother and foetus, such as improving insulin sensitivity and reducing the risk of developing GDM. This study examines the patterns of physical activity that impact GDM occurrence among Asian pregnant women living in the UK by: 1) assessing the association between patterns of physical activity engagement by Asian pregnant women and GDM occurrence; 2) gaining insight into Asian women’s knowledge of GDM and identifying barriers to and enablers of physical activity during pregnancy. Method: This research employed an explanatory sequential mixed method design comprising two phases. Data for the first phase were collected from 75 participants using a Pregnancy Physical Activity Questionnaire (PPAQ). In the second phase, semi-structured interviews were conducted with 13 participants. Findings: Chi-squared test and logistic regression analysis revealed no significant association between physical activity based on different variables during pregnancy and GDM occurrence in the first phase. However, sports/exercise, occupational, and light-intensity physical activities indicated a protective effect against GDM. Thematic analysis in the second phase identified four themes aligned with the socioecological model framework underpinning the study context. Both quantitative and qualitative findings were integrated into a joint display table to enable an in-depth evaluation of the interactions among intrapersonal, interpersonal, and environmental factors influencing changes in physical activity behaviour among pregnant Asian women. Conclusions and recommendations: This thesis has made a unique contribution to existing knowledge on physical activity during pregnancy and the occurrence of GDM among Asian women in the UK. Application of the socioecological model provided evidence of changes in physical activity behaviour and the influence of individual, social, and environmental factors. These findings are significant for various domains, including public health, and groups such as policy health advisors, and healthcare professionals concerned with female prenatal health. Future studies should support practice in culturally appropriate strategies for promoting physical activity by ensuring that solutions are culturally relevant rather than a one-size-fits-all approach. Understanding Asian culture will allow healthcare providers to effectively address the specific requirements of this demographic of pregnant women rather than simply adopting current guidelines, which may be inadequate.9 0Item Restricted Exploring Factors Influencing the Adoption of AI Tools in Auditing: A Mixed-Methods Study(Virginia Commonwealth University, 2024-07-12) Alsudairi, Fahad; Yoon, Victoria; Osei-Bryson, Kweku-Muata; Etudo, Ugochukwu; Senechal, JesseArtificial Intelligence's (AI) rise has created value for organizations and society, prompting scholars to study its spread across many areas. However, the impact of AI adoption on governmental organizations still needs to be explored. Governmental entities face unique challenges distinct from private organizations, and existing research often focuses on the perspectives of AI experts or senior management, neglecting the insights of lower-level employees who will use the system daily. This study investigates the multifaceted factors influencing the intention to adopt AI tools within a governmental auditing bureau in Saudi Arabia. To the best of our knowledge, no previous study has specifically delved into AI adoption within the context of governmental auditing in the literature. This study employs an exploratory mixed-method approach based on IS guidelines by Venkatesh et al. (2013, 2016). This research combines qualitative and quantitative methods to comprehensively investigate the factors influencing the intention to adopt AI tools in auditing. Initially, the study identifies key factors and develops a conceptual model grounded in qualitative data and theoretical background. The model is then validated and tested through a survey using a larger sample within the governmental bureau. The findings support many hypotheses, emphasizing the significance of technological factors such as AI complexity, perceived scalability, relative advantage, and security in the intention to adopt AI tools in auditing. The study also highlights the need to align governmental auditing tasks and AI tools, and the importance of Task Technology fit. Organizational factors, such as leadership support and strategic AI implementation, are crucial for successfully adopting AI. Additionally, environmental factors underscore the pivotal role of higher authorities in facilitating and supporting AI adoption in governmental organizations. This study offers several contributions. It extends organizational AI adoption literature by broadening the understanding of AI adoption factors, emphasizing the value of studying government organizations due to their unique nature, and providing insights into the factors affecting AI adoption from the end-user's viewpoint. It offers practical benefits for the governmental auditing agency and similar governmental organizations. Educationally, this dissertation functions as a rich case study within the Information Systems (IS) field, providing a valuable educational resource. Possible limitations include sample selection constraints, sample size in Phase I, and the limited contextual scope of the study. Directions for future research include examining the dynamics of AI implementation over time through longitudinal studies, testing the conceptual model across different governmental sectors and similar cultural and socio-political contexts, and investigating how AI tools affect auditors' compensation and job satisfaction.73 0Item Restricted The knowledge, attitudes, and beliefs of registered nurses about end-of-life care in the Kingdom of Saudi Arabia(Saudi Digital Library, 2023-06-27) Alshammari, Fares; Lapkin, SamBackground: End-of-life care is currently not well integrated into health care services in the Kingdom of Saudi Arabia (KSA) (Aboshaiqah, 2019; Alshammaray et al., 2019). Patients frequently receive end-of-life care in non-specialist palliative care settings with care provided by generalist registered nurses (RNs) rather than specialist palliative care nurses (MOH, 2022). Evidence indicates that end-of-life care provided in specialist palliative care settings differs significantly from that offered in non-specialist palliative care settings (Achora & Labrague, 2019; Karbasi et al., 2018;). This has been attributed, in part, to the fact that generalist RNs may not be well prepared to provide effective end-of-life care due to inadequate knowledge and poor attitudes and beliefs about end-of-life care (Aboshaiqah, 2019; Abudari et al., 2014). Therefore, exploring and understanding knowledge, attitudes and beliefs about end-of-life care of RNs working in KSA Ministry of Health (MOH) hospitals is an important step to better inform policy and practice. Aims: This thesis sought to examine the knowledge, attitudes and beliefs about end-of-life care among RNs working in MOH hospitals in the KSA. The barriers and facilitators that influence the quality of end-of-life care provided to patients in MOH hospitals in the KSA has also been explored. Methods: A sequential explanatory, mixed-methods study was conducted. In the quantitative phase, an online cross‐sectional survey was distributed to 1,293 registered nurses working in five different hospitals in the KSA. The Palliative Care Quiz for Nursing (PCQN) was used to gather information about registered nurses’ knowledge of end-of-life care, the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD) was used to assess nurses’ attitudes towards end-of-life care. Beliefs about end-of-life care were examined using the Care for Terminally Ill Patient (CTIP) tool. Following the survey, a subset of registered nurses participated in online individual semi-structured interviews. These interviews were audio- recorded and transcribed verbatim before being analysed using thematic analysis. The integration of the results was guided by the Theory of Reasoned Action (TRA) and used joint display tables to provide a comprehensive understanding of the factors that influence the knowledge, attitudes and beliefs about end-of-life care of RNs working in the KSA. Results: Out of the 1,293 registered nurses who were eligible to participate, 415 (34.90%) completed the entire online survey. The results showed that participants had poor knowledge about end-of-life care, with a mean score of 8.50 out of 20. Participants held mostly positive attitudes toward caring for dying patients and their families, but they also expressed some negative attitudes towards talking with patients about death, their relationship with patients’ families and controlling their emotions. More than half of the participants held the belief that a combination of curative and palliative care, provided by an interdisciplinary team, was the most effective approach for end-of-life patients. The majority of participants also believed that discussing end-of-life care with patients or families leads to feelings of hopelessness. Notably, RNs' knowledge, attitudes and beliefs were significantly associated with their age, religion, ward type, level of education, and frequency of providing end-of-life care. Sixteen participants were interviewed. The individual interview data identified the barriers and facilitators that registered nurses experience when providing end-of-life care. Barriers included a lack of communication skills, family, cultural and religious resistance to end-of-life care, and the dynamic of truth-telling. In addition, RNs also identified a lack of knowledge in pain management, the cultural and religious needs of patients, as well as psychological, psychosocial, and emotional needs. The factors that facilitated the provision of quality end-of-life care included gaining support from colleagues and patients’ families. Other facilitators included prior experience and education in end-of-life care, willingness to provide culturally and religiously appropriate care, and the involvement of a multidisciplinary team. The integration highlighted that RNs’ past experiences, prior education, age, gender, religion, culture, and workplace settings impact on their knowledge, attitudes and beliefs towards end-of-life care. The integration also revealed that RNs’ knowledge, and the subjective norms of patients, families, and their colleagues can influence an RN’s attitudes and beliefs, and thus their behaviours toward providing end-of-life care. Conclusion: This project has generated new knowledge about RNs’ knowledge, attitudes and beliefs about end-of-life care. RNs require additional education and training to provide high-quality end-of-life care for patients in general hospital settings. To achieve this, RNs should be supported through the development of protocols and policies about end-of-life care decision-making and training to enhance communication skills. A multidisciplinary approach to coordinating and providing end-of life care should be funded and implemented. Education providers and leaders in healthcare settings should consider developing programs for undergraduate nurses and nurses in clinical practice to enable RNs to provide high-quality and effective end-of-life care to patients in generalist and specialist end-of-life care settings.24 0