Saudi Cultural Missions Theses & Dissertations

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    Developing an intervention to enhance the engagement and motivation of stroke patients with cognitive impairment in physiotherapy rehabilitation programmes in Saudi Arabia
    (Universit of Nottingham, 2023) Alshaibani, Fahad; Yates, Katie Robinson; Pip Logan, Jen
    Introduction Globally, a stroke occurs every two seconds, making it the second leading cause of death after ischemic heart disease. Strokes reduce quality of life and increase disabilities and are often associated with cognitive impairment (CI) with an increased dependency, risk of mortality, development of depression and poor quality of life. Indeed, the incidence of CI after stroke is relatively high, reported to affect 40-70% of stroke survivors, therefore CI after stroke is an important research priority as agreed by stroke patients, caregivers, as well as health professionals. Post-stroke rehabilitation promotes functional recovery and independence of stroke survivors but CI after stroke is negatively associated with poorer functional outcomes. The presence of CI after a stroke can also affect the rehabilitation process as such stroke survivors may be less motivated and interested in rehabilitation programmes and engage in fewer therapy sessions. The concept of engagement and motivation is identified as a cognitive state, therefore, motivation and engagement in the physiotherapy treatment programme tend to be insufficient in stroke survivors with CI. This thesis aimed to develop an intervention to improve engagement and motivation in physiotherapy treatment for stroke survivors with CI in the Kingdom of Saudi Arabia. Methods A mixture of methods approach with three interlinked studies was conducted within the development stage of the Medical Research Council (MRC) framework for the development of complex interventions. A scoping review (study one) was conducted to explore the engagement and motivation strategies used in physical therapy practice for stroke patients with cognitive impairment. Qualitative interviews (study two) with physiotherapists were conducted to identify the individuals and environmental facilitators and barriers to applying engagement and motivation strategies in the Saudi physiotherapy rehabilitation context. These findings were combined with the use of a theoretical domain framework to develop a behaviour change intervention. The intervention was presented in programme theory using a logic model to demonstrate the visual pipeline consequence, highlighting the evidence-based findings, facilitators and barriers, selected behaviour change techniques, mechanism of action and intervention outcomes. After designing the logic model and explaining the intervention components, stakeholders were engaged using the nominal group technique (study three) to discuss the applicability of the behaviour change intervention in the local rehabilitation context and refine the logic model. Results The scoping review included 17 studies and indicated a lack of robust evidence on strategies used in physical therapy practice and how these strategies were applied and improved the level of engagement and motivation of stroke patients with CI during treatment. The engagement and motivation strategies identified were therapeutic interactions and communication, an enriched environment, the use of technology, and applying strategy training. The qualitative interviews conducted with twelve physiotherapists identified five facilitators, “Promising impacts”, “Professional responsibilities and treatment priority”, “Positive connections with patients and their families”, “Training and educational support”, and “Physiotherapists self-attitude” and four barriers, “Information and case identification”, “Organisational culture”, “Patient belief and circumstances”, and “Physiotherapists` awareness and self-confidence”. The stakeholder engagement activity was conducted with fifteen stakeholders including physiotherapists, heads of departments, quality managers and clinical researchers. The participants agreed that educational workshops and restructuring the physiotherapy department environment were extremely important (67%) or important (33%) behaviour change techniques to enhance professionals' skills and improve stroke rehabilitation services. Regarding changing protocols, more than a quarter of the participants (27%) were not sure that changing protocols would be an effective strategy to enhance physiotherapists' skills and stroke patient outcomes. They attributed this to physiotherapists' negative attitude regards using the rehabilitation protocols, the long process to change protocols, frequent changes in the rehabilitation protocols and organisational pressure to develop protocols for accreditation purposes. These responses were used to amend the logic model and intervention. Conclusion This thesis highlighted the complexity of patient engagement and motivation, as well as the role of individual and environmental factors in supporting stroke patients with CI engagement and motivation in rehabilitation programmes. The study explored the facilitators and barriers to applying engagement and motivation strategies in the Saudi rehabilitation context and acknowledged the individual and organisational barriers. Consequently, a theoretically driven behaviour change intervention was developed to improve the engagement and motivation of stroke patients with CI in physiotherapy rehabilitation programmes. The thesis concluded with recommendations and suggestions regarding improving the rehabilitation services for stroke patients with CI, considering engagement and motivation and further researching different strategies to support them. It also provided recommendations for policymakers in the Saudi rehabilitation context to improve the services provided for stroke patients with CI and the importance of multidisciplinary collaboration to support patients' outcomes and treatment services. Following the intervention development, research is needed to deliver and evaluate the behaviour change intervention for improving the engagement and motivation of stroke patients with CI.
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    Literature Review on How Can a B2B Company Enhance Its Customer Engagement and Account Based Marketing report
    (Saudi Digital Library, 2023-12-25) Alawami, Ahmed; Mansour, Ali; Yao, Junhang; Agarwal, Khushaal; Jaakkola, Matti
    Account-based Marketing has been well received in the B2B market. The need for companies to target high value accounts has become paramount in building account relationship and retaining long-term revenues. However, a well-design ABM plan to a specific account requires close monitoring and analysis of not only the macro environment of the account but also the internal stakeholders with regard to individual buying preferences. Besides the technicality by offering matching products, how to effectively create and deliver perceived value beyond monetary value becomes a challenge. Therefore, this paper draws from the available literature and with semi- structured expert interviews to address the question of “What are the best practices in 1-1 ABM that could help shift perception through relationship management and thus increase share of wallet and ensure long-term profitability?” From our findings, it is imperative for AMBers to not only utilise relevant marketing channels in delivering the functional value, but also the message that builds a unique story which goes beyond the perceived-value of product; that is, in line with account’s strategy and co-create with them to nurture a long-term partnership.
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    A Scoping Review of the Predictors of the Work Engagement of Nurses in the Workplace and Methodological Limitations of Existing Evidence
    (Saudi Digital Library, 2023-12-01) Albalawi, Abdulrahman; Plumpton, Kay
    Abstract Recently, there has been growing interest among policymakers about the importance of increasing the engagement of nurses in their work, as this can boost their productivity and performance as well as improve the quality of health care services. This encouraged several researchers to examine the predictors of the engagement of nurses in their work. Despite the emerging nature of this research field, there is a lack of scoping reviews that explore the scope of evidence in this research area. Further, there is a limited understanding of the methodological limitations of studies in this research field. This can be valuable, as it can guide future research on how to improve the methods used. Therefore, this study aims to explore the scope of evidence on the key predictors of the engagement of nurses in their work, identify the methodological limitations of research in this research area, and provide recommendations for future research. A scoping review was used. This scoping review used the Arksey & O'Malley (2005) framework as a guide. This scoping review employed six databases in order to identify the relevant research studies, including Science Direct, Elsevier, Scopus, JSTOR, PubMed, and Web of Science. The scoping research found that the engagement of nurses is influenced by a wide range of factors, including leadership style, organisational and supervisory support, organisational justice and fairness, rewards and recognition, job characteristics, age, trust and autonomy, and personal resources. Several methodological limitations were found in the available literature, including limited longitudinal studies, the lack of qualitative studies, the limited study of the moderators and mediators, the failure to control for confounding factors, the lack of studies with random sampling, the limited studies from a wide range of countries (South America, Africa, Russia, etc.), the lack of agreement on the measures used, and the failure to take gender differences into account. Researchers are recommended to conduct studies with a longitudinal or qualitative design, study the effect of moderators and mediators on the relationship, control for confounding factors, use random sampling, use the Core Outcome Sets (COS), and take gender differences into account. Keywords: engagement, nurses, healthcare, motivation, healthcare.
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    The Impact of Using Social Media on Students’ Engagement and Attainment in Nursing Education in Saudi Arabia
    (King's College London, 2023-10-11) Almutairi, Malak; Simpson, Alan
    Abstract Background The availability of social media has transformed global connectivity within education systems. Social media has been used in various educational contexts. The widespread use of social media has prompted a demand for a better understanding of how it might be used in nursing education. Most nursing students in Saudi Arabia are active users of social media, but the potential benefits of such media for educational purposes may not be fully realised. While research has previously explored the positive effects of using social media on a range of learning outcomes in nursing education, studies have not specifically focused on how these positive features have an impact on students’ engagement and attainment as vital components of successful learning. Aim To investigate the impact of social media use on student engagement and educational attainment in pre-licensure nursing programmes in Saudi Arabia. Methods To accomplish this aim, two distinct studies were conducted. The first study was a systematic review of literature examined the value of social media use in improving nursing students’ engagement. The second study conducted over two phases, used a mixed methods embedded design, which are: (i) quantitative study phase: in which the secondyear nursing cohorts from two universities participated in the intervention, using Twitter, with total of (n=254) students were divided into experimental and control groups for 4 quantitative analysis. A questionnaire measured student engagement before and after applying the intervention. Attainment data were collected through the faculty. (ii) qualitative study phase was semi-structured interviews with lecturers and focus groups with students were conducted to explore their perceptions and experiences of using social media in nursing education. Findings The synthesised findings from the systematic review yielded five themes that showed social media uses for nursing students’ engagement, as follows: 1) interaction and communication, 2) managing stress, 3) positive online community, 4) time spent, and 5) digital literacy and e-professionalism. In the second study, the quantitative phase incorporating the Twitter intervention, resulted in a significant improvement in engagement compared to control (experimental group (88.5% ± 14.9%) versus control (51.8% ± 10.4%) p<0.001). Attainment for the experimental group was also significantly increased compared to control, (experimental group 91.6 ± 4.5 versus control 83.9 ± 5.7; p< 0.001). In the qualitative phase, a total of six male and female academics were participated, in addition, twenty male and female students recruited to participate in the focus groups from both universities. Three core themes were found: a theme linked to considerations of using the application, a theme that linked to features of the experience that linked to engagement, and finally, recognition of the utility of the platform to influence the grades attained. Discussion 5 The systematic review undertaken as first part of this research revealed that using social media to support nursing students’ learning has positive benefits in terms of promoting several aspects of their engagement, such as rapid interaction and communication. Further empirical studies, however, should aim to measure social media’s effects on nursing students’ engagement with their courses and their academic attainment. Thus, the main study comprised a multicentre empirical investigation demonstrated that using social media such as Twitter can improve students’ engagement with their curriculum; in this instance, the increased engagement was associated with a significant increase in the grades attained. The qualitative data further revealed that students found the use of the platform challenging but rewarding and appreciated the ease of communication afforded by such a platform to enhance engagement with their faculty and peers. Overall, it was felt this enhanced engagement contributed to improved grades. A limitation of the study was that the intervention was used only in one semester and was a such a novel interaction that it may not be sustained if employed throughout the curricula. It must be remembered the intervention was conducted during the pandemic; results obtained from online learning approaches during that period may not represent those produced during traditional face-to-face curriculum delivery. Conclusion This study demonstrates that systematic use of social media is effective in nursing education. Using Twitter showed to enhance students’ engagement with their curricula, resulting in improved academic achievement. Further research should investigate the long term use social media for educating nursing student.
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    Evaluation of Self-Directed Learning Activities at King Abdulaziz University: A Qualitative Study of Faculty Perceptions
    (Saudi Digital Library, 2023-04-03) Balkheyour, Ammar Adnan; Tombs, Michal
    Background: Self-directed learning (SDL) is an essential method for lifelong learning and professional development, especially in the medical field. SDL has been incorporated into the internal medicine curriculum at the Faculty of Medicine in Rabigh at King Abdulaziz University, Saudi Arabia. Aims: The study aimed to determine the faculty perceptions of the effectiveness of the SDL activities currently offered at the Department of Internal Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Saudi Arabia. This was an evaluative study structured around Stufflebeam’s model of evaluation regarding input and process components. Methods: A qualitative study was conducted through semi-structured interviews. The sample type was non-probability convenience. Seven faculty members from the target academic department were included in the study. The interviews were transcribed, and their content was analysed using the thematic analysis method. Results: Thematic analysis led to the generation of four themes: faculty’s perceptions of SDL, curriculum design, student engagement, and learning environment. Conclusions: During input evaluation, the faculty perceived SDL activities as a reading task for the students that was required for discussion. Faculty support and training in conducting such activities were needed. Faculty had different opinions about the objectives and content of SDL sessions; however, they agreed that SDL sessions aligned with internal medicine objectives and addressed the students’ need. There was a lack of assessment tools for learning in SDL sessions. During process evaluation, all participants were dissatisfied with the students’ poor engagement, and they made suggestions to improve SDL. Challenges in the learning environment were reported, including issues in the scheduling of the academic activities and library access. Based on the results, recommendations were made for educational strategies and future research.
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    Non-Traditional Language Learners: Exploring The Factors Affecting Engagement In Online Learning At A University Level In Saudi Arabia
    (2023-06-07) Alharbi, Amera; Wright, Vicky; Borthwick, Kate
    The most significant disruption to education systems in living memory was caused by the covid pandemic (Hussein et al., 2020). E-learning before the Covid pandemic has become an attractive approach to students with different characteristics as non-traditional learners. They study alongside full or part-time work, have family commitments, or are older learners. Studies report diverse findings about the motivation and engagement of this student body (Alshebou, 2019; Arjomandi et al., 2018; Gately et al., 2017, Novotný et al., 2019 Rothes et al., 2017; Sánchez- Gelabert et al.,2020). Due to a scarcity of non-traditional students’ motivation studies (Rothes et al., 2017) and engagement studies (Rabourn et al., 2018), this qualitative case study aims to understand non-traditional language learners’ motivation and engagement in online learning during uncertain times, Covid pandemic. Researchers have acknowledged the connection between motivation and engagement (Finn & Zimmer, 2012; Skinner& Pitzer, 2012) and declare that learners' motivation affects the quality of their engagement (Lawson & Lawson, 2013; Lawson & Masyn, 2015). As a result, this study aims to fill gaps and employ a motivational framework that has not been used in L2 studies: Maehr's (1984) Personal Investment Theory (PIT) to pave the way to understanding participants' motivation (goals and self) and exploring how language learners engage following Redmond et al. (2018) engagement model in online learning. The participants were six female students who studied foundation level at a Saudi university and adopted a blended pedagogical approach. Due to the worldwide shift to online learning, those learners in this academic year were unique in being the only learners who experienced solo online learning at the university. Data sources include surveys, engagement self- report, interviews, observation, and blackboard analytics. The findings reflected that the lockdown situation tended to exacerbate a number of the existing inequalities apparent in OL which affected learners’ learning motivation and engagement experience. The motivation framework supports understanding the learners' goals and sense of self. The findings showed that the participants had multiple goals while learning in the research context. In addition, many contextual factors impacted their self-views. The analysis of the non- traditional five engagement dimensions for the engagement model stressed the interplay of these dimensions (cognitive, behavioural, emotional, social, and collaborative) in language learners' experiences in online learning. At the cognitive level, online learning affected students' comprehension and enhanced learners' self-regulation skills. The approach also impacted participants at the behavioural level regarding their participation, focus and careful listening, persistence, and self-working on activities. Mixed emotions were evident in the participants' emotional engagement during their online learning experiences. To communicate effectively in the online learning environments, the participants created a social community that enables them to engage socially with classmates and collaborate to support one another's learning. This helped them have a sense of belonging in the online community. The findings showed contextual factors influencing non-traditional language learners in online learning in this specific context. While self- efficacy was the central theme in the internal factors, the teacher was the critical factor in the institutional factors that affected student engagement in online learning.
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