Saudi Cultural Missions Theses & Dissertations
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Item Restricted Life journey with a chronic illness: Exploring the lived experience of older chronic illness patients while interacting with the primary health care services in Ha'il City, Kingdom of Saudi Arabia(University of Tasmania, 2025) Albarrak, Talal; Crisp, Elaine; Andrews, Sharon; Foran, PaulaAccording to the World Health Organization, improvement in life expectancy, which is attributed to advancements made in the health sector in the 20th century, directly impacts public health and economic systems. Technological advancement in the health sector has enabled older people to perform many activities in their daily lives. However, this demographic shift has also posed some problems, such as the rising prevalence of chronic diseases and the increased costs of healthcare for families and governments. The older population in the Kingdom of Saudi Arabia (KSA) is mainly affected by chronic diseases. It burdens the healthcare system, especially in the Primary Health Care Centres (PHCCs). PHCCs are the first point of care for these patients and attend to more than 15 million citizens every year in KSA. Although primary, secondary, tertiary, and referral healthcare services are available for the public in KSA, PHCCs still need help with patient satisfaction due to the lack of proper infrastructure and integrated services. This qualitative research employs Max van Manen's hermeneutical phenomenological framework to understand the lived experiences of older people with chronic illness as they interact with PHCCs for their regular health care relating to their illness. The research design is iterative, allowing for dynamic interaction between the researcher and data through six sequential yet iterative steps: engaging with the phenomenon, collecting data through investigating life experiences, reflecting on essential themes, describing the phenomenon through writing and rewriting, maintaining a strong relation to the phenomenon, and balancing the study context. Data was collected via semi-structured telephone interviews, adapted for COVID-19 safety protocols, with older people selected from accessible and representative PHCCs. Ten participants were chosen using specific inclusion and exclusion criteria to ensure relevance and depth. The research blends the strengths of descriptive and interpretative phenomenology, rooted in Edmund Husserl's and Martin Heidegger's philosophical traditions, which emphasise the detailed description and interpretation of human experiences and meanings, and recognise these experiences as situated within specific historical and cultural contexts. The analysis involved identifying and interpreting key themes from the participants' stories and comparing and contrasting these across different participant narratives to reveal patterns and variations. The researcher engaged in a reflective process, linking the findings to existing literature and theoretical frameworks to deepen the understanding of the participant's lived experiences. Critical reflexivity was emphasised to ensure researcher biases did not influence the study's findings. Four major themes emerged: the impact of knowing about the illness; the supportive context provided by family, friends, institutions, and faith; the adaptation to a new life with a chronic disease and multiple care roles; and perceptions of care received through primary health care centres. The research findings highlighted the interplay between emotional, cognitive, and social elements of the patients’ lived experience, emphasising the significant role of the participants' emotional responses in influencing coping mechanisms and overall quality of life. The research also explored the crucial role of family/friends in disease management, and the difficulties of financial issues. The findings also highlighted the need for a more comprehensive and patient-centred approach to healthcare in KSA, which includes considering the experiences and barriers faced by older adults with chronic diseases. These findings included identifying the treatment goals, the use of religion in the process of coping, especially among Muslim adults, and the significance of education in helping patients manage their treatment and psychological care. The following are the recommendations that can be made from the research for enhancing services in the PHCCs across SaudiArabia, focusing on early identification and management of chronic diseases. The research supports screening programs for high-risk groups, frequent follow-up, and adherence to the best practices, including the involvement of specialist physicians. A particular emphasis is placed on the patient's awareness and counselling to overcome the myths associated with chronic diseases and increase patient participation in decision-making. The study recommends forming peer support groups to support chronic disease management or strengthening community networks. The research also advocates for public health campaigns that should address all population groups, focus on chronic diseases, including diabetes mellitus, to overcome cultural and societal misconceptions. To meet mental health needs, it is essential to incorporate mental health care into chronic disease management and educate healthcare workers on mental health. Other recommendations that are likely to improve the quality of healthcare and patient satisfaction significantly, include improving the interpersonal skills of PHCC staff, embracing modern technology, and ensuring that vulnerable populations are financially supported6 0Item Restricted Life journey with a chronic illness: Exploring the lived experience of older chronic illness patients while interacting with the primary health care services in Ha'il City, Kingdom of Saudi Arabia(University of Tasmania, 2024-08) Albarrak, Talal; Paula, Foran; Elaine, Crisp; Sharon, AndrewsAccording to the World Health Organization, improvement in life expectancy, which is attributed to advancements made in the health sector in the 20th century, directly impacts public health and economic systems. Technological advancement in the health sector has enabled older people to perform many activities in their daily lives. However, this demographic shift has also posed some problems, such as the rising prevalence of chronic diseases and the increased costs of healthcare for families and governments. The older population in the Kingdom of Saudi Arabia (KSA) is mainly affected by chronic diseases. It burdens the healthcare system, especially in the Primary Health Care Centres (PHCCs). PHCCs are the first point of care for these patients and attend to more than 15 million citizens every year in KSA. Although primary, secondary, tertiary, and referral healthcare services are available for the public in KSA, PHCCs still need help with patient satisfaction due to the lack of proper infrastructure and integrated services. This qualitative research employs Max van Manen's hermeneutical phenomenological framework to understand the lived experiences of older people with chronic illness as they interact with PHCCs for their regular health care relating to their illness. The research design is iterative, allowing for dynamic interaction between the researcher and data through six sequential yet iterative steps: engaging with the phenomenon, collecting data through investigating life experiences, reflecting on essential themes, describing the phenomenon through writing and rewriting, maintaining a strong relation to the phenomenon, and balancing the study context. Data was collected via semi-structured telephone interviews, adapted for COVID-19 safety protocols, with older people selected from accessible and representative PHCCs. Ten participants were chosen using specific inclusion and exclusion criteria to ensure relevance and depth. The research blends the strengths of descriptive and interpretative phenomenology, rooted in Edmund Husserl's and Martin Heidegger's philosophical traditions, which emphasise the detailed description and interpretation of human experiences and meanings, and recognise these experiences as situated within specific historical and cultural contexts. The analysis involved identifying and interpreting key themes from the participants' stories and comparing and contrasting these across different participant narratives to reveal patterns and variations. The researcher engaged in a reflective process, linking the findings to existing literature and theoretical frameworks to deepen the understanding of the participant's lived experiences. Critical reflexivity was emphasised to ensure researcher biases did not influence the study's findings. Four major themes emerged: the impact of knowing about the illness; the supportive context provided by family, friends, institutions, and faith; the adaptation to a new life with a chronic disease and multiple care roles; and perceptions of care received through primary health care centres. The research findings highlighted the interplay between emotional, cognitive, and social elements of the patients’ lived experience, emphasising the significant role of the participants' emotional responses in influencing coping mechanisms and overall quality of life. The research also explored the crucial role of family/friends in disease management, and the difficulties of financial issues. The findings also highlighted the need for a more comprehensive and patient-centred approach to healthcare in KSA, which includes considering the experiences and barriers faced by older adults with chronic diseases. These findings included identifying the treatment goals, the use of religion in the process of coping, especially among Muslim adults, and the significance of education in helping patients manage their treatment and psychological care. The following are the recommendations that can be made from the research for enhancing services in the PHCCs across SaudiArabia, focusing on early identification and management of chronic diseases. The research supports screening programs for high-risk groups, frequent follow-up, and adherence to the best practices, including the involvement of specialist physicians. A particular emphasis is placed on the patient's awareness and counselling to overcome the myths associated with chronic diseases and increase patient participation in decision-making. The study recommends forming peer support groups to support chronic disease management or strengthening community networks. The research also advocates for public health campaigns that should address all population groups, focus on chronic diseases, including diabetes mellitus, to overcome cultural and societal misconceptions. To meet mental health needs, it is essential to incorporate mental health care into chronic disease management and educate healthcare workers on mental health. Other recommendations that are likely to improve the quality of healthcare and patient satisfaction significantly, include improving the interpersonal skills of PHCC staff, embracing modern technology, and ensuring that vulnerable populations are financially supported.62 0Item Embargo The Impact of Child Protection Training on Nurses’ Self-Efficacy in Detection and Reporting of Child Abuse in Saudi Arabia(Trinity College Dublin, the University of Dublin, 2024) Almutairi, Albandari; Corry, Margarita; Hughes, MaryBackground: The World Health Organisation (WHO) has reported that child abuse and neglect constitute major international health problems that cause unacceptable morbidity and mortality. These forms of maltreatment can have severe physical and psychological effects on children’s development that persist into adulthood. Early detection of abuse and removing children from potentially hazardous and perilous conditions pose significant challenges. Nurses who care for children and families are uniquely positioned to identify children at risk of abuse and neglect during visits and have the opportunity to initiate interventions to prevent future harm. However, barriers such as a lack of experience, training, and confidence in handling abuse cases exist. Several training programmes have been developed to enhance nurses’ abilities to recognise and report child abuse. Studies demonstrate that these training programmes effectively improve nurses’ awareness, detection, and reporting of child abuse and neglect. In Saudi Arabia, The National Family Safety Program provides non-mandatory training to healthcare practitioners to support them in identifying and reporting child abuse cases through the Child Protection Multidisciplinary Training Programme (CPMTP) in multiple healthcare sites. The concept of self-efficacy has been used to assess the outcomes of clinical training programmes in other fields, as positive effects on self-efficacy should translate to desirable practice patterns. To date, few studies have explored the impact of child abuse training on nurses’ self-efficacy in recognising and responding to known and suspected cases of child abuse and neglect. Furthermore, none of these studies have been conducted in Saudi Arabia. Aim: To explore the impact of child abuse training on nurses’ self-efficacy in recognising and responding to known and suspected cases of child abuse and neglect (CAN) in Saudi Arabia. Methods: This study was conducted across three regions of Saudi Arabia, with participation from nurses caring for children, using the Child Abuse Neglect Reporting Self-Efficacy Questionnaire (CANRSEQ). The questionnaire was administered in online and hard-copy formats across all three regions, with a completion time averaging under 20 minutes. Data were analysed using descriptive statistics and correlation analyses using Statistical Package for Social Sciences (SPSS) version 28 software. Findings: The response rate was 77% (n = 247) among staff nurses. The majority (75.5%) had not reported any cases of child abuse or neglect in the past. The findings indicate that 73.2% (n = 164) did not receive any formal CAN cases. Additionally, 19.2% (n = 43) of the respondents had undergone formal training sessions concerning CAN, and 10.4% (n = 23) attended the CPMTP provided by NFSP. The study’s findings showed a significant difference in self-efficacy expectations (EEs) on the SE-CAN scale. However, there was no significant difference in outcome expectation (OE) scores between those who attended CAN training and those who did not, as measured by the OE-CAN scale. The respondents generally reported being more confident in handling known abuse cases than in suspected abuse cases. Self-efficacy in detecting and reporting CAN differed among education groups when measuring the relationship between personal characteristics and professional self-efficacy in nurses. Those who had a postgraduate degree and attended a training programme reported a statistically significant higher self-efficacy score (i.e., EES, EEK, OE; mean = 3.4864 ± 0.56619) compared to those with a bachelor's degree (mean 3.2337 ± 0.59468, p < .05). Conversely, no significant differences were found in self-efficacy based on other personal characteristics such as age, gender, or marital status (p > 0.05). Regarding knowledge of the law, most of the participants, 70.7% (n = 164), believed they had a legal obligation to report cases where a child or young person was at risk of physical or sexual abuse. However, the lowest percentage, 42.1% (n = 98), was recorded for cases where a prenatal report was made, but the birth mother did not receive adequate support services. Conclusion: This study is the first in Saudi Arabia to investigate the impact of child abuse training on nurses’ ability to identify and respond to CAN. The results provide an important contribution to our understanding of nurses’ self-efficacy in managing such cases, as they highlight the specific areas where nurses feel most confident and capable. Additionally, the findings shed light on potential areas for improvement and the need for targeted interventions to enhance nurses’ self-efficacy in specific aspects of CAN. The underreporting of child abuse is attributed to various barriers, but training programmes can significantly improve nurses’ confidence in reporting abuse cases. Notably, nurses are more confident in reporting known cases rather than suspected cases, and the ability to detect abuse is dependent on the type of abuse being investigated (physical, emotional, and sexual abuse). Therefore, training programmes must enhance nurses’ confidence and provide them with clear guidelines for mandatory reporting and support in navigating these challenges.20 0Item Restricted Medication Safety Education in Undergraduate Pharmacy and Nursing Schools in the UK and Saudi Arabia(Imperial College London, 2023) Albadali, Hind; Woloshynowych, Maria; Franklin, BryonyIntroduction: This thesis focused on medication and patient safety from a global perspective (UK and Saudi Arabia), the rationale being the increase in medication error incidents resulting from a lack of proper patient safety education in nursing and pharmacy programmes which contribute to serious patient safety issues. Literature revealed the limitations on achieving positive outcomes in nursing and pharmacy education. Aim: to identify current medication and patient safety education in these countries and to analyse factors affecting adequate teaching and recommendations for improvement. Research Methodology: A systematic narrative review and mixed method research design were used to investigate many educational issues. Data Collection: used literature search for published papers, document review, semi-structured individual interviews and focus group for qualitative data and a questionnaire for quantitative data. Data Analysis: used systematic narrative analysis, thematic analysis and various statistical techniques to analyse data (separate data review for pharmacy and nursing). Results: revealed a disagreement on the explicitness and mode of integration, diverse content delivery, many educational didactic and interactive methods, a growing interest in simulation methods, the inter-professional learning method, curriculum guides and educational framework were rarely used and obstacles to integrating medication safety were identified. Furthermore, students’ confidence in learning about patient safety domains between classroom and clinical settings differed. Conclusion: Although medication and patient safety education is well received, strategies are needed to improve medication and patient safety education to allow for effective integration in the curriculum. UK and Saudi Arabian educational and health sector policymakers should prioritise improving medication and patient safety education. Recommendations: Future researches should investigate the content, methods of delivering medication and patient safety education, curriculum guides, framework for teaching and factors that prevent the effective integration of medication safety education. Students’ confidence in patient safety topics in classroom and clinical settings needs evaluation.17 0Item Restricted Nursing perspectives on the use of effective communication in an intensive care unit setting(Queen's University Belfast, 2024-07-09) Milibary, Amr Adnan M; Duncan, DebbieTitle: Nursing perspectives on the use of effective communication in an intensive care unit setting. Background: The critical role of communication in health care, especially in ICUs, highlights its importance for patient safety and the challenges faced by ICU nurses, such as time constraints, stress and the sharing of complex medical information. The introduction and background discuss how communication breakdowns impact patient outcomes, particularly during shift changes and the Covid-19 pandemic. The study underscores the need for improved training and interdisciplinary collaboration, emphasising both verbal and non-verbal communication. It also explores leadership and technology, including AI, in enhancing ICU communication. Overall, it stresses addressing communication challenges through organisational efforts, cultural sensitivity, education, and technology integration for safe and effective health care delivery. Aim: The main purpose of this literature review is to examine nurses’ perceptions and experiences with using communication in the intensive care unit. The second purpose of this study is to investigate communication barriers amongst nursing staff members, which may have an impact on patient outcomes in previous studies. Methodology: A precise search of electronic databases including MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO was conducted for a systematic literature review on ICU communication from a nursing perspective. Guided by the PEO model and supplemented by a thesaurus, relevant articles were identified. Reference lists were also examined and manual journal searches undertaken. The quality of each study was evaluated using the Critical Appraisal Skills Programme (CASP) checklist. This rigorous approach aimed to comprehensively explore nursing communication in ICU settings, aligning with the review’s objectives. Results: Nine qualitative studies on ICU nurse communication were analysed. Conducted in seven countries between 2014–2022, the studies are summarised, focusing on thematic analysis that identified three main themes: communication challenges and strategies; communication training and support; nurse–patient/family communication. These themes highlight the complexities and importance of tailored communication strategies in health care. The chapter concludes by emphasising the critical role of effective nurse–patient communication in improving ICU patient care outcomes. Conclusions: This review examines the communication experiences of ICU nurses based on nine studies. Key challenges include time constraints, language barriers and resistance to change, exacerbated by pandemics. The findings highlight the need for tailored strategies and support for health care professionals, especially during crises. Cultural factors affect error communication, necessitating transparent, systemic approaches in health care organisations. Effective nurse–patient/family communication is crucial for holistic care, emphasising emotional support and trust. The review underscores the importance of flexible yet systematic communication interventions in ICU settings to meet diverse needs. Keywords: Nursing, Effective communication, Intensive care unit.102 0Item Restricted High-Fidelity Simulation (HFS) Intervention to Increase Advanced Cardiac Life Support (ACLS) Knowledge, Skills Performance and Self- Efficacy (SE) Acquisition and Retention for Saudi Nursing Students: A Feasibility Explanatory Sequential Mixed Method Study(The University of Edinburgh, 2024-08-09) Alshehri, Abdullah Ali; Holloway, AishaBackground As medical technologies advance and patient needs become more complex, care delivery models are undergoing transformation. An essential element for improving the learning experience is the shift from informative to transformative learning. While some countries have incorporated high-fidelity simulation (HFS) into nursing education as a contemporary teaching method, the majority of Saudi nursing schools still adhere to traditional teaching approaches. Aim Using the Medical Research Council (MRC) framework, this study sought to identify and develop a HFS advanced cardiac life support (ACLS)-focused intervention that was piloted among final-year undergraduate Saudi nursing students to investigate the acquisition and retention of ACLS knowledge and skills performance, as well as self-efficacy (SE) gains through HFS compared to traditional teaching methods. Methods This project utilised a sequential explanatory mixed-method design. A two-phased pilot randomised controlled trial (RCT) with embedded qualitative evaluation was conducted. Phase I involved the intervention development and pilot RCT (n= 28), with participants randomly assigned to intervention or control groups. Phase II comprised an embedded qualitative component of semi-structured interviews with a sub-sample of those from the trial (n= 10). The intervention group participants had access to HFS training, whereas the control group learned through traditional teaching methods, such as PowerPoint presentations and demonstrations on a static manikin. The educational content focused on ACLS algorithms. The knowledge variable was measured at three different time points: before the simulation, immediately after, and three months later. Skills performance was assessed twice; the first simulation was conducted at the beginning of the experiment and the second simulation session was three months later. The SE variable scores were obtained at the start of the study and at the end of the quantitative phase after the second simulation session. In the qualitative phase, semi-structured interviews were conducted to ascertain the perceptions of the intervention and control group participants towards the received styles of learning methods at the end of the study. The research was influenced by the effects of the coronavirus disease 2019 (COVID-19). This, in turn, affected the study's sample size due to government restrictions, guidelines, and the personal decisions of the participants. Results The study’s quantitative pilot RCT results showed that the ACLS knowledge exam total scores showed promising increases from baseline to acquisition (p < 0.001) and from baseline to retention (p < 0.004); however, this increase was not evident three months from acquisition for the intervention group (p = 1.000). With regard to skills performance, the intervention group’s ACLS skills acquisition mean score was trending higher (p < 0.001) than that of the control group. After three months, the mean ACLS skills retention score for the intervention group remained higher (p = 0.000) than for the control group. SE scores for the intervention group were moderately higher than for the control group (p < 0.001), showing initial evidence of a positive effect. The SE displayed a strong positive correlation with skills acquisition and a moderate positive correlation with knowledge. In the qualitative phase, students conveyed that HFS offered a more authentic and enjoyable experience, facilitating the application of theoretical knowledge to advanced cases compared to the traditional method, which is more suited to basic skills. The students perceived HFS as a valuable teaching approach that effectively addresses the sensitivity of a mixed-gender working environment and the associated cultural norms in the Kingdom of Saudi Arabia (KSA) context. They confirmed that HFS enhanced their non-technical skills, as well as their SE in handling complex cases upon graduation. The strength of the students’ interest in integrating the HFS into the curriculum further supports the acceptability of the study. Feasibility was confirmed, as the invited students demonstrated a willingness to participate within the nursing school, there was effective communication with the heads of departments in both the nursing school and Simulation and Medical Training Centre, and the setting was prepared to accommodate a substantial number of students for a forthcoming definitive RCT. The availability of diverse materials in the simulation centre and positive perceptions of nursing students regarding the HFS intervention further support the feasibility of the study. Conclusions The HFS intervention was well accepted and feasible with promising results regarding the final year undergraduate Saudi nursing students’ ACLS skills performance and SE. The recruitment methods and data collection procedures used in this study demonstrated feasibility for implementation in a larger, confirmatory RCT in a future definitive RCT. A sample size calculation was conducted to inform a future follow-up definitive RCT, evaluating the HFS intervention over the longer term. A major strength of the study was its adherence to the MRC framework, as well as using the Template for Intervention Description and Replication (TIDieR) checklist to guide detailed reporting of the intervention. A key limitation was the small sample size, constrained by COVID-19 impacts on subject availability and the power to make reliable inferences. More research is required to definitively determine the lasting impacts of high-fidelity ACLS simulation training on nursing education outcomes. Large-scale RCTs with larger samples, longitudinal examinations of skill translation into clinical environments, and multi-site tracking of trained nursing cohorts are recommended to further strengthen the evidence supporting wider curricular integration of simulations.Item Restricted Adaptation and validation of the U.S. hospital survey on patient safety culture 2.0™(SOPS®) : the Saudi version(University of British Columbia, 2024-07-12) Alharbi, Amal Ali; Dahinten, SusanBackground: The U.S. Hospital Survey on Patient Safety Culture 2.0 (HSOPSC, 2.0), released by the Agency of Healthcare Research and Quality in 2019, is the most widely used instrument for measuring patient safety culture in healthcare organizations. However, it has not been cross-culturally adapted nor validated within the context of the Saudi healthcare system. This two-phased study aimed to adapt the U.S. HSOPSC 2.0 to be suitable for use by registered nurses working in Saudi hospital settings, and to assess the construct validity of the revised Saudi tool. My approach to psychometric testing was informed by Messick’s view of unified validity (1980, 1995), and guidelines provided by the International Test Commission (2017). Methods: Instrument adaptation was performed in Phase 1 using a committee-based approach, two focus-group interviews, and expert panel reviews. Construct validity of the adapted tool was assessed in Phase 2 using confirmatory factor analyses, reliability testing, and hierarchical logistic regression, drawing on cross-sectional data collected from 534 registered nurses working in a large tertiary hospital setting in Saudi Arabia. Results: Phase 1 resulted in a 33-item instrument that demonstrated excellent content validity. In Phase 2, confirmatory factor analysis yielded the 26-item Saudi-HSOPSC 2.0 with a 10-factor structure consistent with the U.S. HSOPSC 2.0. Reliability testing yielded acceptable reliability coefficients for eight subscales. Hierarchical logistic regression provided further evidence of the instrument’s construct validity, with seven of the 10 dimensions found to be uniquely predictive of at least one of the three patient safety outcomes. Conclusion: The findings provide initial evidence of the content and construct validity of the Saudi-HSOPSC 2.0. Together, the findings provide evidence supporting five aspects of Messick’s (1980) view of unified validity. Future research should assess the validity of the Saudi instrument within a broader validation context and investigate the potential impact of included negatively worded items. With additional evidence supporting the psychometric properties of the Saudi-HSOPSC 2.0, Saudi administrators and nurse leaders can use it to assess the status of patient safety culture in their hospitals and inform future interventions aimed at improving patient safety and quality of care in Saudi hospital settings.Item Restricted Intensive Care Unit Nurses' Experiences in Caring for Lightly Sedated Mechanically Ventilated Patients: An Extended Literature Review(Queen's University Belsat, 2024-06-14) Ali, Sarah; John, NimmyBackground: Sedation is crucial for critical care patients' comfort and treatment. The trend has moved towards lighter sedation levels than deep sedation. Lightly sedated intubated patients require more focused care in a suitable setting compared to deeply sedated patients. Intensive care unit (ICU) nurses, as carers, hold a pivotal position in care and sedation monitoring. There remains a lack of comprehensive investigation into nurses' psychological and professional experiences during the care management process. Aim: To explore ICU nurses’ experiences of caring for intubated patients under light sedation. Methodology: This dissertation employed the Extended Literature Review (ELR) method by using six electronic databases were systematically searched: the Cumulative Index for Nursing and Allied Health Professionals (CINAHL) Plus, Medline, PsycINFO, Scopus, and Web of Science. English-language studies were included and conducted between 2013 and 2023, examining nurses' caring experiences while managing light sedation with mechanically ventilated patients. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) and the Mixed Methods Appraisal Tool (MMAT) checklists. Results: Eight studies met the inclusion criteria: five qualitative, two mixed methods, and one cross-sectional study. Qualitative studies revealed that ICU nurses face significant challenges in achieving and maintaining light sedation while ensuring patient comfort. Mixed methods studies indicated that nurses were generally satisfied with patient outcomes associated with light sedation approaches. The cross-sectional study demonstrated a high level of compliance among nurses with light sedation guidelines and its implications for intubated patients. Four overarching themes emerged from the analysis, providing insights into ICU nurses' experiences during the care provided for ventilated patients under light sedation.Item Restricted Ethical conflict experienced as a critical care nurse during the COVID-19 pandemic: a systematic review(Queen's University Belfast, 2024-04-30) Alotaibi, Omar; Alotaibi, OmarBackground The COVID-19 pandemic had a devastating effect on healthcare workers and healthcare systems at large. The first case of COVID-19 in the Kingdom of Saudi Arabia was reported on 2 March 2020 and, by 15 July 2021, the Ministry of Health had reported 8020 fatalities from the contagion. The COVID-19 pandemic laid bare the unpreparedness of healthcare systems across the world, and further led to a substantial shift in occupational risks and various stressors pertaining to critical care nursing. Objectives A PEO framework was used to develop the research question to investigate the ethical conflicts that intensive care nurses experienced during the COVID-19 pandemic, and their impact on nurses’ psychological wellbeing and job satisfaction. The study aimed to identify and describe common ethical conflicts faced by critical care nurses during the pandemic, their psychological impacts, and offer recommendations for healthcare and relevant policymakers. Search Strategy The study adopted a qualitative approach, and a systematic literature review was conducted on existing studies. An induction approach was used in respect to the sample size of the selected studies. A systematic search was conducted across three electronic databases including CINAHL Plus, PubMed, and MEDLINE ALL. Studies conducted prior to COVID-19, those conducted on healthcare providers other than intensive care nurses, and sources published in languages other than English were exempted from the study. Results The search produced 738 articles which were further evaluated against the inclusion and exclusion criteria. A total of 12 studies matched the inclusion criteria and met the CASP threshold for quality appraisal. Upon synthesis, changes in practice or work situations (n=7), lack of knowledge (n=3), an organisation’s inefficiency in supporting nurses (n=6), psychological wellbeing (n=7), and job satisfaction (n=4) were the main themes identified encapsulating ethical issues. Conclusion Nurses had to work under unfamiliar conditions typified by a high workload, prolonged use of PPE, and an increased demand for care in ICUs, hence the potentiality for ethical conflicts. Amid the construction of new ICU centres and an increasing workload, nurses had to deal with novel experiences such as adapting to collaboration with new workers, the role of constantly acting as a supporter, and complexities linked to working with non-healthcare professionals. A failure to highlight these complexities may cause critical care nurses to perceive them as routine. Increased isolation also had emotional ramifications which could affect job satisfaction levels among ICU nurses. Involvement in practice during COVID-19 led to depression, psychological distress, insomnia, and anxiety. The study also established that discrimination over the distribution of PPE, fatigue, and burnout had a profound effect on nurses’ job satisfaction levels. There is a need for interventions tailored towards increasing organisational support, improving nurses’ wellbeing, and building capacity. Organisations should also include nurses in the decision-making process, and consider both extrinsic and intrinsic factors of motivation to enhance job satisfaction levels.Item Restricted The Risk Factors of Job Burnout Among Nurses in Saudi Arabia: A Quantitative Method Systematic Review(Saudi Digital Library, 2023-12-13) Alharthi, Ibtisam; Louuise, HodgsonJob burnout, more simply referred to as ‘burnout’, describes a psychological syndrome triggered by chronic, unaddressed stress in the workplace. The high prevalence of burnout among nurses poses a significant challenge, exacerbating the already critical issue of nursing shortages worldwide. Saudi Arabia has recorded particularly high rates of burnout among nurses, at between 32% and 71%, but the factors which cause burnout in the country are not well-understood. This study reports the findings of a systematic review which examines the prevalence and risk factors associated with burnout among nurses in public hospitals in Saudi Arabia. It examines 10 studies conducted between 2018 – 2023 and provides an updated estimate of burnout based on prevalence rates reported across the country. It also identifies the leading factors associated with burnout in the Kingdom of Saudi Arabia, categorising them as either sociodemographic, occupational or psychosocial and discussing the reasons for them. The study estimates that the current prevalence of burnout among nurses in Saudi hospitals is 51.3%, with the highest rates in the north of the country and the lowest rates in the south. The main sociodemographic factors affecting burnout are gender, age, nationality, marital status, education and medical history. The occupational factors include weekly work hours, shift patterns, department, career rank, years of experience and salary level. Psychosocial factors affecting burnout include emotional demands, commitment, influence and work, reward and recognition, role clarity and health and well-being. The study concludes by discussing the implications of the research for advanced nurse practitioners and evidence-based practice and proposes a number of recommendations to reduce the risk of burnout among nurses based on the findings of the systematic review.