Saudi Cultural Missions Theses & Dissertations
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Item Restricted Systematic Review of Asthma Exacerbations Impact on Children’s Quality of Life in Low-Income Countries and Lower-Middle-Income Countries(King's College London, 2024-09-25) Alrashed, Rana; Laurence, YokoBackground: Asthma is a major cause of morbidity and disability in children, especially in low-income countries and lower-middle-income countries (LICs and LMICs). This systematic review evaluates the impact of asthma exacerbations on the quality of life (QoL) of children and adolescents in LICs and LMICs. Methods: A comprehensive literature search was conducted in major medical databases, including PubMed, Medline, Embase, Global Health, and Cochrane Library. Studies involving children and adolescents aged 0-18 years residing in LICs and LMICs were included. The review considered a range of study designs, including cross-sectional studies, randomized controlled trials, systematic reviews, and meta-analyses. The quality of the included studies was assessed using the relevant Joanna Briggs Institute (JBI) checklists. Results: The review found seven relevant studies. The cross-sectional studies showed that poorly controlled asthma and frequent exacerbations have a significant negative impact on various aspects of children's QoL, including physical functioning, emotional well-being, and social interactions. The narrative review and meta-analysis supported these findings, emphasizing the considerable burden of asthma on the overall well-being of children in low-resource settings. The randomized controlled trial provided evidence that targeted interventions, such as comprehensive asthma education and management programs, have the potential to improve the QoL of affected children. Conclusions: This systematic review emphasizes the significant negative impact of asthma exacerbations on the quality of life of children in LICs and LMICs. Factors such as socioeconomic status, access to healthcare, and environmental exposures were identified as key determinants of the QoL in this population. The findings emphasize the urgent need for interventions and policies to address the challenges faced by children with asthma in LICs and LMICs and improve their overall well-being.5 0Item Restricted Diet related quailty of life of school-age children with type 1 diabetes mellitus(University of Leeds, 2024) Alharbi, Faten Fahad; Orfila, Caroline and Holmes MelvinManaging type 1 diabetes mellitus (T1DM) is challenging: blood glucose monitoring several times a day; total carbohydrate calculation to determine and adjust insulin requirements prior to mealtimes; insulin administration, either through multiple daily injections (MDI) or a pump; and diet modification. These necessary survival measures consume inordinate amounts of time and effort in the life of a person with diabetes. Ensuring that carbohydrate intake meets essential amounts also presents a major challenge. All of these requirements can have a serious impact on the quality of life (QoL) of school-age children. However, no recent studies have evaluated the impact of T1DM on the diet-related quality of life (D-QoL) of schoolchildren in the United Kingdom (UK). An additional deficiency is the limited availability of quantitative data, which might hinder the creation and acceptance of strategies for the development of improvements in this area. The overall aim of this research was therefore to employ quantitative measures as much as possible for an investigation of the impact of T1DM on the D-QoL of school-age children from their parents’ perspective, as well as to assess the children's intake of carbohydrate-rich foods. A newly designed two-part instrument was employed for these purposes: a D-QoL survey was adapted specifically for assessing the QoL of schoolchildren with T1DM, and a semi-quantitative food frequency questionnaire (SFFQ) was designed for evaluating the dietary intake of schoolchildren both with and without T1DM. In addition, thematic analysis was applied for the analysis of open-ended questions. A total of 181 schoolchildren (n = 42) with T1DM, and (n = 139) without T1DM aged 4 to 18 years old were included in this study. D-QoL scores were calculated based on averaged responses of each participant, with higher values indicating enhanced QoL. The results of the calculations seemed to indicate that most parents scored their children’s QoL in the medium category. Pearson’s correlation coefficient was applied for testing the relationships between a child’s age, duration of diabetes, HbA1c level, D-QoL scores, and total carbohydrate intake. No significant correlations were found between factors, with the exception of the age of schoolchildren with T1DM and their total carbohydrate intake, which was confirmed through a further linear regression: their total carbohydrate intake increased by 7.225 g for each year of their age. An independent sample t-test was used for comparing the differences in the average daily intake of total carbohydrates and sugar between school-age children with and without T1DM. The results showed that the average carbohydrate intake of schoolchildren with T1DM was 17.8% lower (-17.8%) than that of those without T1DM. The thematic analysis results revealed parents’ perceptions of a lack of T1DM related knowledge on the part of school staff. As well, the analysis demonstrated a dearth of carbohydrate information and portion sizes on school menus. Barriers to participation in social events such as parties, special occasions, and school activities involving food provided by others were another D-QoL-associated issue commonly cited by the families of children with T1DM. While broad generalization of the study results is limited by pandemic-related restrictions that affected sample size, the work reported here has broken new ground and serves to illuminate avenues for future research, which could benefit from input from children with T1DM, their parents, dietitians, healthcare professionals (HCPs), school staff, and catering providers. This research can guide future studies aimed at addressing T1DM-related issues in school settings, especially with regard to developing school menus that detail readily comprehensible carbohydrate content.12 0Item Restricted Factors associated with return-to-work after heart and/or lung transplant: A systematic review of qualitative research(Monash University, 2024) Mobarki, Yara Mohammed; Keegel, TessaAim This study aims to identify factors associated with Return-To-Work (RTW) following heart and/or lung transplantation by conducting the first systematic review that draws on qualitative research. Design A systematic review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD42024596250). A support group for people with lived experience of heart and/or lung transplant, the Heart and Lung Transplant Trust Victoria (HLTTV), was consulted to help shape the research question and provide insights into the needs of transplant recipients returning to work post-transplant. A conceptual model from the heart and lung transplant literature was used as a theoretical framework. Data Sources A comprehensive search of five databases Ovid MEDLINE, Ovid Embase, CINAHL, Web of Science, and PsycINFO along with a bibliographic hand search, was completed in consultation with a search expert (AP) on August 22, 2024. The inclusion criteria focused on peer-reviewed qualitative studies published in English from the year 2000 onwards. Review Methods Screening was conducted by at least two researchers at each stage of the review. Data were extracted using a systematic reporting table. Quality of the included studies was assessed using a validated qualitative checklist. Thematic analysis was employed to synthesize the findings, the identified themes analysed compared to the conceptual model. Results The review included seven qualitative studies published between 2009 and 2024, encompassing 136 participants. Six major themes influencing RTW were identified including: physical barriers (e.g., fatigue, organ rejection, infections, and immunosuppressant side effects), psychological barriers (e.g., fear of rejection and health decline, low self-esteem), and environmental barriers (e.g., job discrimination, inadequate job opportunities). Social adaptation, workplace support, and professional and family support emerged as essential facilitators. Limitations of the review include the original focus of the qualitative studies being general social engagement, with RTW included as part of social engagement in some studies, as well as inclusion participants with other solid organ transplants. Conclusion Return to work (RTW) after heart and/or lung transplantation requires a comprehensive, multilevel support approach. Review findings are incorporated into a conceptual model illustrating how individual, interpersonal, community, and societal factors can influence RTW outcomes. Future research should examine workplace accommodations, rehabilitation, and healthcare support to improve the RTW process for heart and/or lung transplant recipients.11 0Item Restricted Orthodontic treatment effect on the oral health-related quality of life, oral function, and facial aesthetics in a group of Swedish adolescents, a longitudinal study(Karolinska Institutet, 2024) Asiri, Elham; Pegelow, MarieBackground: Malocclusion is one of the most prevalent oral conditions that negatively impact patients' physiological and psychological well-being. This longitudinal research aims to investigate how orthodontic treatment affects OHRQoL in a Swedish cohort of adolescents. Material and methods: Sixty-nine patients with different malocclusions who have had orthodontic treatment at Karolinska Institutet, aged 13 to 19, participated in this study. The patients answered OHRQoL questionaries at three different times: Before starting orthodontic treatment, during, and after finishing orthodontic treatment. The questionnaire consisted of three components: Oral Health Impact Profile-14 (OHIP-14), Jaw Functional Limitation Scale-20 (JFLS-20), and Orofacial Aesthetic Scale (OES). The data were statistically analyzed using the R software package. Friedman test assessed if answers differed significantly before, during, and after treatment. Multiple pairwise tests were used to identify which time points were different. Repeated ANOVA of mean was used in sum scores over time. Results: Significant change in mean values of aesthetic sum scores of all malocclusions at three time points; baseline to during (p-value 0.02), during to after (p-value 0.01), and from baseline to after treatment (p-value 0.00). For OHIP-psychosocial impact domain, significant improvement was found when a combination of all groups was tested from baseline to after treatment. For separate questions, the following questions was significantly decreased in time point before to after treatment: OHIP_10: “Been embarrassed”, Est_03: “Your mouth’s appearance (smile, lips, visible teeth)”, Est_04: “Appearance of your rows of teeth”, Est_05: “Shape/form of your teeth”, Est_08: “Overall, how do you feel about your face, mouth, and teeth” (p-value 0.00). Est_06: “Colour of your teeth” (p-value 0.02). Conclusion: Orthodontic treatment has a positive effect on OHRQoL in Swedish adolescents, especially in the aesthetic and psychosocial domain.11 0Item Restricted Seizure Control and Developmental Outcomes After Epilepsy Surgery in Infants(University College London, 2024) Alanazi, Samar; Eltze, ChristinBackground: Managing epilepsy in infants is challenging, even with antiseizure medications, and is associated with developmental delays. This study evaluated epilepsy surgery in infants, focusing on seizure control, developmental outcomes, and quality of life. Method: We conducted a retrospective analysis of infants who underwent epilepsy surgery ≤12 months of age at Great Ormond Street Hospital between January 2007 and October 2023. Data included neuroimaging, cognitive, language, and quality of life assessments. Seizure outcomes were classified using the Engel system. Results: Thirty-eight patients (22 female) were included. The median age at onset was 6 weeks. Patients had structural abnormalities, including hemimegalencephaly (n=12, 31.6%) and focal cortical dysplasia (n=10, 26.3%). Surgery was performed at a median age of 6.5 months (IQR=4 months) and included hemispherotomy (47.4%), lesionectomy/lobectomy (31.5%), and multilobar disconnection (18.4%). Six patients (15%) required a second surgery. After a median follow-up of 4 years (IQR=6 years), 23 patients (60.5%) achieved seizure freedom, and 21 patients (55.3%) discontinued antiseizure medications. Hemiplegia was the most common motor impairment both pre- and post-surgery. Paired pre- and post surgery cognitive data were available for 21 patients, with 53% maintaining and 21% showing improvement in cognitive trajectories. Paired language data were available for 16 patients, with 34% maintaining and 13% showing improvement in language trajectories. Patients achieving seizure freedom exhibited more favourable language trajectories. Post-surgery quality of life data for 13 patients (34.2%) showed scores below normative levels. Conclusion: Epilepsy surgery significantly reduces seizures, but developmental outcomes vary, highlighting the need for ongoing evaluation.14 0Item Restricted The Effect of Health Disparities on Quality of Life and Work Productivity and Its Association with Medication Prescribed and Surgeries Performed in Females with Urinary Incontinence(University of Cincinnati, 2024-08-03) Almadfaa, Rawan; Hincapie, Ana L.Background: Urinary incontinence (UI) imposes a significant negative impact on a patient’s physical, socioeconomic, and psychological well-being. The prevalence of UI has been continuously rising in the last two decades, and more frequently in females. Health disparities adversely affect minority people from receiving adequate healthcare. Nearly 40% of the U.S. population identified themselves as a race/ethnicity minority in 2020. The objectives of this work are to describe the currently prescribed medications and performed surgical treatments, and to assess racial and ethnic disparities in receiving treatment for UI females. Also, we want to assess the relationship between health disparities using The National Institute of Minority Health and Health Disparities (NIMHD) framework and quality of life (QoL) as well as racial and socioeconomic health disparities and work productivity in female patients with UI. Methods: This was a retrospective observational study using electronic health care data and the National Institute of Diabetes and Digestive and Kidney Diseases database (NIDDK) trials data. We included females diagnosed with UI. We used frequencies of the medications and surgical treatment for female patients with UI to assess the trends of treatment utilization. Racial and ethnic disparities in receiving treatment were also assessed using binary and multinomial logistic regressions. The relationship between health disparities and QoL and work productivity was assessed using multiple linear regression models and proportional-odds regression model. Results: Oxybutynin was the most frequently prescribed medication with 77,920 prescriptions, followed by mirabegron with 48,052 prescriptions. There was a total of 23,898 UI surgeries performed, and sling was the dominant one. Black or African Americans and Asians were less likely to receive UI surgery compared to White females. Black or African Americans also were more likely to get oxybutynin and less likely to get mirabegron to treat UI compared to Whites. Also, ethnic disparities exist in receiving treatment. In the biological domain of NIMHD framework, our findings showed that obesity, depression/frustration, previous prolapse surgery, hysterectomy, and diabetes were significant predictors of lower QoL. Regarding the behavioral domain, limiting physical activity due to UI, and smoking were linked with worse QoL. In the physical/built environment domain, mobility limitations by car or bus contribute to reduced QoL. Sociocultural factors like ethnicity, marital status, income, education, and language significantly influence QoL. work productivity of Hispanic or non-Hispanic other group was greatly affected compared to whites (OR: 1.77, p value: 0.0007 and OR:1.618, p value= 0.0167 respectively). Higher education and income were linked to better work productivity. Also, married females who were greatly affected in work productivity were significantly lower compared to non-married females (OR: 0.590, p value: <.0001). Conclusion: This work showed that Sling was consistently the most performed surgery every year for UI females. Oxybutynin and mirabegron were the most prescribed medications. Racial and ethnic health disparities were shown in receiving treatment for female patients with UI. Health disparities influence UI females’ QoL. Also, racial and socioeconomic disparities play an important role in individuals’ work productivity.10 0Item Restricted Isolation and Its Impact: Understanding Patient–Caregiver Experiences During Isolation for Haematopoietic Stem Cell Transplantation(Queen's University Belfast, 2024-06-24) Mayan, Soumaya; Martin, DaphneBackground: Haematopoietic stem cell transplantation (HSCT) is a complex procedure requiring long-term preparation. Patients undergoing the procedure have increased risks of developing infections and life-threatening complications, so the standard practice has been to isolate them before and after the procedure. Although isolation in a separate ward helps increase the chances of successful transplantation and survival, it has an immense negative effect on patients’ psychological state. Aim: This study aimed to examine the effects of isolation on patients and their caregivers. Specifically, it focused on the psychological/emotional state, health related quality of life, and coping skills of patients and their families. Methodology: An integrative literature review methodology was used to draw the data for this study. The search was limited to articles published in English in the past decade (September 5, 2013, until present), which focused on the experiences of adult patients/caregivers in the context of HTSC isolation. A thorough literature search helped extract 19 studies which were included in the sample. This approach helped obtain qualitative and quantitative data from different locations. Results: The review showed that isolation has a severe effect on patients and caregivers, leading to stress, anxiety, and depression. It is also associated with extreme uncertainty and the loss of control, which, coupled with a plethora of unpleasant and taxing symptoms, negatively impact health related quality of life. Patients and caregivers were found to demonstrate various coping behaviours, such as communication with friends and family, spending time on hobbies, engaging in religious/ spiritual activities, and others. However, maladaptive coping was also found to be common, which points to the importance of teaching patients and families how to overcome stress. Conclusions: Given the adverse effects of isolation on patients and their families, it is extremely important to provide them with relevant psychological support and resource26 0Item Restricted The impact of a cancer diagnosis and its subsequent treatment on the HRQOL of children in Saudi Arabia in light of international practices for newly diagnosed cases A quantitative systematic review(Saudi Digital Library, 2023-12-13) Alhussain, Fayzah; Langmack, GillThe global impact of cancer on health-related quality of life (HRQOL) is significant, especially for children undergoing oncological treatment. While research on HRQOL among child cancer survivors is abundant, there is a lack of representation among those actively undergoing treatment. Furthermore, Saudi Arabian data remains less explored. Objective This systematic review aims to bridge this research gap by quantitatively evaluating the HRQOL of children in Saudi Arabia during their active cancer treatment phase. The study also juxtaposes these findings with global practices, emphasising demographic, medical and parental predictors of HRQOL. Methods A comprehensive search was conducted across prominent databases including MEDLINE, CENTRAL, EMBASE, PsycINFO, and CINAHL. The search explored studies conducted in Saudi Arabia investigating HRQOL during oncological treatment for children and adolescents, alongside studies from other countries exploring newly diagnosed cases. The JBI-Critical Appraisal Checklists were used to assess the quality of each study. The outcomes were synthesised using narrative methods. Results A systematic review of nine studies was conducted, encompassing 859 paediatric cancer patients. It was observed that all children undergoing cancer treatment experienced a decline in HRQOL. In Saudi Arabia, the psychosocial domain was particularly impacted, more so than the physical domain. The newly diagnosed phase was identified as having the most compromised HRQOL compared to the other stages of the illness. Longitudinal studies showed improvement over time. Several predictors influenced HRQOL including clinical, demographic and parental factors. Conclusion Paediatric cancer patients face profound physical, emotional and psychosocial challenges. Tailored interventions and paediatric palliative care integration are urgently needed to enhance HRQOL. This study underscores the need for more in- depth clinical research in Saudi Arabia, focusing on diverse aspects of HRQOL to optimise treatment outcomes for children with cancer.42 0Item Restricted Inequalities in Oral Health-Related Quality of Life among children in Saudi Arabia(2023-07-16) AlMajed, Omar Sami; Sabbah, Wael; AlAyadi, HayaAbstract Aim: To examine Oral Health-Related Quality of Life (OHRQoL) and their determinants among Saudi Arabian elementary school children. Method: The study's author utilized baseline data from a longitudinal randomized controlled trial conducted in Riyadh, Saudi Arabia (Alayadi et al., 2021). The study participants were elementary school students who attended public schools. A stratified cluster random sampling technique was employed to randomly select sixteen schools from a list provided by the Ministry of Education. The study enlisted individuals who were between six and twelve years of age as participants. The study focused on both primary and permanent teeth. Children with any medical issues were excluded from the study. A total of 1086 individuals were included, and both clinical evaluations and parental questionnaires were used to collect data. The criteria established by the World Health Organization (WHO, 2013) were used in order to evaluate the oral health of the children who took part in the research project. Furthermore, an adapted version of the WHO parental survey was used to gather information about the demographic and socioeconomic attributes (like age, gender, monthly income, and educational background of both parents) and behaviours of the study group. Results: The results of the study revealed significant associations between age and untreated caries with Oral Health-Related Quality of Life (OHRQoL) among children in Saudi Arabia. Older children and those with untreated caries had higher rates of experiencing suboptimal oral health outcomes. However, no statistically significant associations were found between gender, family income, parental education, oral hygiene frequency, dental visits, and OHRQoL. Conclusion: We found that Age and Untreated caries were significantly and positively associated with OHRQoL.50 0Item Restricted الاكتئاب لدى المرأة العانس وعلاقته بجودة الحياة(جامعة الجزائر, 2023-05-17) Alqahtani, Nada; نعيمة، زطوطوهدفت الدراسة الحالية الى الكشف عن العلاقة بين الاكتئاب لدى المرأة العانس وعلاقته بجودة الحياة، وجرت الدراسة على عينة من النساء العوانس قوامها (100) عانس لم يسبق لها الزواج، وقد اعتمدت في ذلك على المنهج الوصفي (الارتباطي – المقارن) لملائمته لطبيعة الدراسة، وذلك في المجتمعين السعودي والجزائري. استعملت الباحثة مقياس بيك (back) للاكتئاب، ومقياس جودة الحياة للإجابة على تساؤلات الدراسة وفرضياتها التي نصت على (سرد الفرضيات) كما اعتمدنا على الحزمة الإحصائية للعلوم الاجتماعية (spss) في المعالجة الإحصائية للمعطيات. اسفرت النتائج على عدم وجود فروق في جودة الحياة بين المرأة العانس (السعودية والجزائرية) ووجود علاقة عكسية بين الاكتئاب وجودة الحياة.291 0