Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
Browse
16 results
Search Results
Item Restricted Heart disease, health outcomes, and healthcare utilisation among middle-aged and older Australians: a longitudinal study using HILDA survey data(The University of Queensland, 2024) Alkalabi, Meshal; Keramat, Syed AfrozSTUDY 1 ABSTRACT Background Heart disease is a major public health concern globally, with substantial impacts on health outcomes among middle-aged and older adults. Understanding its influence on general health, mental health, self-assessed health, and health satisfaction is crucial for developing effective interventions tailored to this demographic in Australia. The study aims to investigate the longitudinal burden of heart disease on self-reported health outcomes among middle-aged and older Australians, focusing on general health, mental health, self-assessed health, and health satisfaction. Methods This study utilised longitudinal data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, focusing on individuals aged 40 years and older across four survey waves: 2009, 2013, 2017, and 2021. The study included 12,751 participants aged 40 and older, with 32,931 observations. Fixed-effects Generalised Least Squares (GLS) and fixed-effects ordered logistic regression models were applied to assess the association between heart disease and four health outcomes. Robustness checks were conducted using Generalised Estimating Equations (GEE) and random-effect GLS models. The analysis adjusted for sociodemographic, behavioural, and healthrelated variables. Results The results suggest that heart disease was negatively associated with general health, mental health, self-assessed health, and health satisfaction among middle-aged and older Australians. Specifically, participants with heart disease scored lower on general health (β = -4.67, 95% CI: -5.56 to -3.77, p < 0.001), mental health (β = -0.98, 95% CI: -1.84 to -0.12, p = 0.025), self-assessed health (β = -0.76, 95% CI: -0.94 to -0.58, p < 0.001), and health satisfaction (β = -0.50, 95% CI: -0.65 to - 0.35, p < 0.001) compared to those without heart disease. The heterogeneous analysis further revealed that gender differences influenced health outcomes, with females experiencing more pronounced declines across all health measures than males. Additionally, the marginal effects analysis indicated that heart disease reduced the likelihood of achieving the highest levels of self-assessed health and health satisfaction. Conclusion This study found that heart disease is linked to poorer health outcomes, including general health, mental health, self-assessed health, and health satisfaction among middle-aged and older Australians. To enhance the overall well-being of this population, communities, government and nongovernment organisations, and other stakeholders should prioritise routine healthcare prevention, targeted interventions, and treatment strategies, particularly for individuals affected by heart disease.. Keywords: Heart disease; general health; mental health; self-assessed health; health satisfaction STUDY 2 ABSTRACT Background Heart disease poses a significant burden on healthcare systems, particularly among middle-aged and older adults in Australia. Despite existing research on healthcare utilisation patterns, longitudinal studies focusing on how heart disease affects healthcare use over time among older Australians remain limited. The study aims to examine the longitudinal burden of heart disease on healthcare utilisation among middle-aged and older Australians, focusing on the number of doctor visits, hospital admissions, and nights spent in the hospital. Methods This longitudinal observational study utilised data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, covering the years 2009, 2013, 2017, and 2021. The study included 12,857 participants aged 40 and older, with 33,822 observations. The primary outcomes were the number of doctor visits, hospital admissions, and nights spent in the hospital. Heart disease status was the main exposure variable, and random-effects negative binomial regression models were used to examine associations, adjusting for socio-demographic, behavioural, and healthcare access factors. Results Participants with heart disease had significantly higher healthcare utilisation across all measures. The rate of doctor visits increased by 24% (IRR: 1.24, 95% CI: 1.20–1.28, p < 0.001), while hospital admissions nearly doubled (IRR: 1.91, 95% CI: 1.76–2.07, p < 0.001), and nights spent in the hospital were significantly longer (IRR: 1.89, 95% CI: 1.75–2.04, p < 0.001) compared to those without heart disease. Older age (≥ 70 years), female sex, multiple chronic conditions, and not being in the labour force were significant predictors of increased healthcare utilisation, indicating a compounded healthcare burden in these subgroups. Conclusion Heart This study shows that middle-aged and older Australians with heart disease have higher healthcare utilisation compared to those without the condition. Heart disease is a significant public health concern that necessitates comprehensive, long-term management strategies focused on prevention. Inadequate management of heart disease could lead to worsening health outcomes and place further strain on the healthcare system. Keywords: Heart disease, healthcare utilisation, longitudinal study, older adults, HILDA survey, doctor visits, hospital admissions, Australia.37 0Item Restricted The therapeutic role of Non-invasive Temporal Interference (TI) stimulation in Traumatic Brain Injury(Imperial College London, 2024) Alkhawajah, Batool; Sastre, Magdalena; Hervas, Laura AbelleiraThe therapeutic role of Non-invasive Temporal Interference (TI) stimulation in Traumatic Brain Injury Traumatic Brain Injury (TBI), characterized by cranial compression leading to neural loss and white matter damage. IT is associated with the development of severe neurological disorders such as Alzheimer's and dementia. Temporal interference (TI) stimulation has emerged as a recent therapeutic modality for severe neurological and psychiatric disorders, such as Alzheimer's disease (AD) and dementia. TI stimulation delivers two frequencies to the brain, generating an electrical field with nuanced frequency differentials, thereby non-invasively targeting specific brain regions. Experimental validation on animal models and healthy subjects has revealed significant improvements in cognitive function following TI stimulation. Recognizing shared pathological mechanisms between TBI and AD, our laboratory has initiated investigations into the potential anti-inflammatory effects of TI stimulation in the context of TBI. A conducted experiment applied TI stimulation targeting the ipsilateral hippocampus in a mild Closed head injury (CHI) model, with a single impact, resulting in observed memory enhancement. However, the cellular and molecular consequences of TI stimulation on the brain remain an unexplored realm. This research project seeks to delineate these changes through various staining techniques targeting Glial Fibrillary Acidic Protein (GFAP), microglia, and neurogenesis. Floating brain sections from three distinct groups: CHI-TI, CHI control, and sham were subjected to staining, enabling the quantification of alterations in the hippocampal region and cortex. Our findings unveil that TI stimulation augments activated microglial populations, diminishes astrocyte presence, and exerts no apparent impact on neural proliferation. This scientific endeavour contributes to the elucidation of the neurobiological effects of TI stimulation, paving the way for a deeper understanding of its therapeutic potential in TBIs.17 0Item Restricted The use of social media and its impact on the mental health of the Saudi Arabian community.(Queen’s University Belfast, 2024-09-08) Almabdi, Adel; McLaughlin, DerekAbstract Background: The Kingdom of Saudi Arabia (KSA) is a nation with unique cultural, geographical, and economic features, predominantly characterized by a young Muslim population. In recent years, significant modernization and urbanization have influenced Saudis' lifestyles and mental health. Cultural attitudes and economic factors shape these mental health issues, with social media playing a pivotal role in societal interactions and mental well-being. Objectives: This study systematically reviewed the current peer-reviewed literature on the impact of social media on the mental health of the Saudi Arabian community. The goal was to synthesize key findings on both the positive and negative effects of social media use, offering insights for individuals, educators, policymakers, and healthcare systems to encourage healthier technology usage and enhance mental healthcare access. Search Strategy: A systematic search was conducted using keywords and Boolean operators across MEDLINE, PubMed, CINAHL, and PsycINFO databases to identify relevant peer-reviewed literature. The inclusion criteria focused on articles published between 2018 and 2024, written in English, and conducted in Saudi Arabia, specifically cross-sectional studies. Results: Thirteen articles met the inclusion criteria and were critically assessed using the appraisal tool for cross-sectional studies (AXIS). The studies were generally of acceptable quality, with well-defined research questions and appropriate methodologies. The findings were categorized into seven themes: prevalence of mental health issues, social media addiction and psychological distress, gender disparities, impact on adolescents, misinformation, the complex relationship with well-being, and family dynamics within the cultural context. Conclusion: This review highlighted that while social media fosters communication and information sharing, it also correlates with addiction, psychological distress, and misinformation. High rates of mental health issues, particularly among healthcare professionals and adolescents, underscore the need for targeted interventions and policies. Future research should focus on longitudinal studies and interdisciplinary collaborations to effectively understand and address these impacts.18 0Item Restricted Assessing Wellbeing and Student Achievement During COVID-19 Lockdown in Saudi Arabia(Flinders University, 2042-10) Alharthi, Shatha; Skrzypiec, GraceThe COVID-19 pandemic during 2020-2021 resulted in unprecedented school closures and prolonged remote learning for Saudi Arabian students with unknown consequences at the time for perceived academic performance, mental health, and wellbeing. Prior research had suggested that reduced social interaction could negatively affect wellbeing and contribute to impaired mental health (e.g., depression and anxiety), while also resulting in lower academic performance. However, little was known about the direct impact of the pandemic on academic outcomes and mental health of middle school students in the Saudi Arabian context, particularly during extended periods of remote learning while facing social and educational challenges stemming from the worldwide crisis. A sequential explanatory mixed methods design was used to investigate this gap in knowledge by exploring the association between middle school students’ perceived academic achievement and their levels of wellbeing, depression, and anxiety during the COVID-19 lockdown. In the two-phase study design, an online survey was used to collect quantitative data from 401 Saudi male and female middle school students aged 11-18 in Mecca and Taif cities, KSA. The impact of COVID-19 lockdown on student wellbeing questionnaires, informed by procedures from a global study conducted by the Global Research Alliance (GRA), enquired about students’ self-perceived academic achievement, wellbeing levels, mental health status, and other essential factors such as demographic information, socioeconomic status, and frequency of activities during the lockdown. The qualitative phase involved semi-structured interviews with eight Saudi female students from the same population, to delve deeply into adolescents’ experiences, perceptions, and insights related to their experiences in lockdown. Structural Equation Modelling (SEM) using Mplus was the primary data analysis procedure used to test the relationships between the identified factors of self-perceived academic achievement. Results from the SEM revealed that variations in self-perceived academic achievement were significantly associated with wellbeing, gender, and socioeconomic status. Unexpectedly, depression, anxiety, the amount of schoolwork, and age did not exert a definitive impact on perceived academic achievement. Over half of the students perceived their performance during the lockdown as better than their peers, and they demonstrated adaptability, either maintaining or improving their academic performance amidst challenging circumstances. The study found that students’ mental health and wellbeing were largely protected, which was attributed to strong family support, religious practices, and adaptability within a supportive home environment. While most students did not show enduring signs of depression or anxiety, specific subgroups faced distress during the lockdown. Challenges related to remote learning, such as internet connectivity issues and online education platform quality, were evident; however, students exhibited coping in overcoming these obstacles to a significant extent. The study findings underscore the significance of promoting family support, religious involvement, and educational readiness within the Saudi education framework to enhance student wellbeing and academic achievement during school closures. The findings advocate for enhancing the preparedness of education systems for future disruptions to in-person, classroom learning. Recommendations include investing in high-quality online education platforms, enhancing teacher training for online instruction, and engaging families to support students in lockdown. Future research should focus on longitudinal studies to assess the lasting impacts of pandemic-driven disruptions on student wellbeing and academic performance, as well as on understanding students’ coping mechanisms during educational crises.18 0Item Restricted Test Anxiety: A Comparative Study of Post-Graduate Taught Students in the UK and Saudi Arabia(University of Glasgow, 2024) Alshammari, Wafa; Swingler, Maxine; Biello, Stephany; Elliot, DelyTest anxiety (TA) is a multifaceted concept that has led to the development of numerous micro-level theories to elucidate its nature. However, only a handful have employed mid-level theories to comprehend TA in cross-cultural scenarios. This research endeavours to adapt the bioecological and biopsychosocial theories in a framework to discern the variations in TA experiences among students across different cultures and educational settings. To realize this aim, the study outlines three objectives: (i) to define, differentiate, and categorize TA, (ii) to examine the factors influencing TA, and (iii) to investigate the coping mechanisms that might mitigate the effects of TA across diverse cultural settings. These objectives are addressed through a series of three complementary studies: a systematic review, seeking to incorporate multiple cultural perspectives and encompassing 81 papers from 2000 to 2019 based on the PRISMA method, a quantitative survey (N = 429), and qualitative interviews (N = 15). The latter two phases focused on four distinct groups, comprising local Saudi students, local British students and European and Eastern international students studying in the UK. The research yielded several key findings. First, TA is more prevalent among all studied groups in the UK than in Saudi Arabia . Second, exosystem and mesosystem factors make the British education system more conducive to TA, while macrosystem and microsystem factors result in a more nuanced experience for Saudi and Eastern students . Third, contrary to popular belief and the existing literature, holding that coursework induces less TA than conventional examinations, this study demonstrates that the characteristics of coursework, such as the number of deadlines, uncertainty about the requirements, lack of familiarity with assessment type, perceived inability to secure full marks, and long duration of stress, can intensify TA. Responses to these factors are heavily influenced by cultural norms and students’ individual backgrounds . There is an interplay between coping mechanisms, cultural values (which might encourage procrastination), and the education system (coursework vs conventional examinations). Coping strategies vary across cultures, influenced by distinct cultural values and the education system. In addition, seeking psychological counselling for TA can be hindered by perceived barriers, namely cultural factors and lack of awareness. The academic implications drawn from this study are twofold: (i) while bioecological/biopsychosocial theory aptly describes TA across varied cultural contexts, it is crucial to recognize the proactive roles of individuals and the variance in cultural values, which can shape reactions and attitudes to TA; (ii) TA, coping strategies, and academic factors are intricately connected and are complex, warranting exploration from multi-level perspectives . From a professional standpoint, this research offers several insights. First, stakeholders, including universities, employers, and the public, should reconsider the values underpinning the nexus between students' social standing, career trajectories, and their evaluations. Second, UK academic institutions should implement policies ensuring that assessments prioritize mental well-being. Third, Saudi and Eastern universities need to expand their awareness campaigns, targeting not only their student body but also families and the broader community to combat competitiveness and the culture of high expectations.14 0Item Restricted DUAL BURDEN: HCV ANTIBODY POSITIVITY AND DEPRESSION DIAGNOSIS IN UNITED STATES ADULTS(New York University, 2024-06-24) Alserhani, Asma; Coyle, ChristianaBackground: Hepatitis C virus (HCV) infection and depression are significant public health concerns, with previous studies suggesting a complex relationship between the two conditions. This study aimed to investigate the association between HCV infection and depression among U.S. adults using a nationally representative sample. Methods: A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2015-2020. The study included 8,443 participants aged 18 years and above who completed the depression screening questionnaire and underwent HCV testing. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), and HCV infection was determined by the presence of HCV RNA. Multivariable logistic regression was used to examine the association between HCV infection and depression while adjusting for potential confounders. Results: In the bivariate analysis, HCV-positive individuals had a significantly higher prevalence of depression compared to HCV-negative individuals. However, after adjusting for potential confounders in the multivariable analysis, the association between HCV status and depression was no longer statistically significant. Age, marital status, and smoking status emerged as significant predictors of depression in the adjusted model. Conclusion: This study found a significant association between HCV infection and depression in the bivariate analysis, but this relationship was attenuated after adjusting for potential confounders. The findings highlight the importance of considering multiple risk factors when assessing the mental health of individuals with HCV infection and underscore the need for targeted interventions to prevent and treat depression in high-risk groups.21 0Item Restricted Experiences of Mental Health Recovery in the Kingdom of Saudi Arabia(University of Technology Sydney, 2024-07-11) Hawsawi, Tahani; Wilson, Amanda; Appleton, JessicaThis thesis explores mental health recovery in Saudi Arabia from the perspectives of consumers, carers, and nurses. Using an exploratory descriptive qualitative design informed by social constructionism, the study involved semi-structured interviews with 16 consumers, 10 carers, and 8 nurses. Thematic analysis revealed that consumers view recovery as a transformative process, emphasising self-help and social support while facing barriers such as stigma and poor interpersonal skills. Carers highlighted the importance of the bond between carers and consumers, advocating for co-designed care planning. Nurses defined recovery primarily in terms of clinical improvements, recognising both biomedical and therapeutic approaches as facilitators. Common themes across all groups included the conceptualisation of recovery as a transformative journey requiring hope and determination, the significance of interpersonal skills, and the impact of stigma as a barrier. This study found that mental health recovery in Saudi Arabia is socially constructed and influenced by cultural norms and community interactions. The findings suggest that effective recovery-oriented practice in Saudi Arabia requires a shift from the dominant biomedical model towards a more holistic, culturally sensitive approach that integrates consumers' and carers' perspectives and emphasises consumer-centred, trauma-informed care.58 0Item Restricted Prevalence of Depression among University Students in Saudi Arabia An Adopted Systematic Review(University of Manchester, 2024-03-27) Alzahrani, Raghad; Shields, GemmaThe prevalence of depression is one of the critical mental disorders that affect a large population. The symptoms of the disorders include sad mood, anhedonia, low self-esteem insomnia, general fatigue, lack of appetite, and decreased concentration. The global prevalence rate is estimated at 4.4% across the populations, and a 49% prevalence of depression and anxiety symptoms among university students in Saudi Arabia. Studies on the prevalence of depression have confirmed that various factors such as sociocultural, biological, and psychological are the main contributors to depression and affect people of all ages. Depression disorders affect the level of quality of life for individuals, which leads to changes in physical activities, emotional functions, and behavioral changes. This study focuses on the prevalence of depression among university students in Saudi Arabia. This group of the population encounters a critical transition from one level of education to another, which requires them to be self-reliant and responsible individuals for them to survive, and from a transition from adolescence to adulthood, which turns out to be stressful at times. The stress mostly emanates from trying to blend into a new lifestyle, maintaining the pressure to excel academically, being away from home, and uncertainty about the future. The prevalence of depressive disorders is the most typical disease affecting many different factors of humanity. University students in Saudi Arabia may be at increased risk of depression owing to the pressure and stress they encounter. Therefore, the purpose of this study is to focus on the level of prevalence of depression among undergraduate university students in Saudi Arabia. A total of 460 journal sources were screened, which resulted in 3 appropriate journal sources for the final inclusion in the study on the prevalence of depression. A systematic review was used to evaluate several kinds of literature on the prevalence of depression among undergraduate university students.35 0Item Restricted Gender and intersectionality: Understanding and Addressing Women's Mental Health and Mental Health Policy within the Cultural Context of Saudi Arabia(University Of Glasgow, 2024-02-06) Alghamdi, NadiaAhmed Alhamd; Melville, CraigBackground: Intersectionality concerns the interconnected nature of social categories (e.g., race, gender, age, education) and how these ‘intersect’ to produce privilege and oppression. In the current context, this helps to understand women's mental health in socially disadvantaged positions, especially how intersections among gender inequality and factors such as socioeconomic status contribute to women’s mental health inequalities and experiences. Yet this remains an under researched area. This study’s overarching aim concerns understanding Saudi Arabian women’s mental health disorders, risks, challenges, and issues. For this, it has three objectives: to review the effects of intersectionality on this group within extant quantitative literature; to identify and explore the significant interactions among variables relating to this population’s social disadvantage and mental ill-health (e.g., gender and the risk of depression); and to analyse Saudi Arabia’s current mental health policy and gender equality. This study’s more specific aims involve furthering understanding of the effects of content, context, and actors behind mental health policies and programmes on Saudi women to help address their mental health needs. It takes the form of three studies. Study 1. This systematic review investigated quantitative methods used to study the intersectionality of multiple social disadvantages in women with common mental disorders. It reviewed studies on the intersectional effects of gender with multiple social disadvantages from the PROGRESS-Plus inequity framework and examined the quantitative methods these studies employ. The most common and means of studying intersectionality in mental health studies in the included studies was statistical interaction analysis. Other methods such as multilevel modelling and mediation decomposition analysis were also used. These robust statistical methods facilitate research on intersectional effects on mental health and improve understanding of the complex intersection of gender and other social disadvantages concerning women’s risk of common mental disorders. Study 2: This study analysed the National Survey of Saudi Food and Drug Authority dataset, a nationally representative sample of individuals aged 18–88 in Saudi Arabia (3,408 participants: 1,753 males and 1,655 females). Evaluating variable risks of depression using the PHQ-2 screening questionnaire, it found significant correlations between depression risk and the variables of gender, education, family income, and employment status. Although a subsequent multivariate analysis found the only significant predictors of depression risk to be female gender and education below the bachelor level. No interaction effects were observed, implying an additive effect of gender and education on the risk of depression. Study 3: This study analysed Saudi Arabia's mental health policies and gender equality. Using Walt and Gilson's health policy analysis framework, it highlights the need to address gender inequalities in the country's mental health policies. It provides evidence-based mental health policy recommendations relating to women in Saudi Arabia about enhancing their mental health and well-being and establishing an equal health system. Conclusions: Examining women’s mental health through an intersectionality lens can help policymakers address Saudi Arabian women’s mental health issue . To reduce inequalities, advances must be made in women’s education, training, employment, socioeconomic status, access and participation, equality, and overall independence. However, this must take place within a wider targeted and tailored reform agenda (legal, policy, political, PR, cultural, religious, economic, careers, educational) within which women must actively participate. Urgent inclusive, deep, and far-reaching intersectional initiatives, adjustments, research and reforms are needed to elevate Saudi women’s circumstances, experiences, and mental health and thereby address the current issue and ultimately improve society overall.41 0Item Restricted THE INTRICATE RELATIONSHIP BETWEEN TOURISM AND HEALTH: A SYSTEMATIC REVIEW(University of Surrey, 2024-02-26) Alqahtani, Saad; Chen, JasonBackground: There exists a direct relationship between tourism, travel and health. According to the United Nations World Tourism Organization (2015), tourism can directly promote health and wellness through the provision of strategically reinvented health-related services. It is from this perspective that the rise of medical tourism became apparent. Medical tourism is the practice of travelling abroad for medical services. Under normal circumstances, wellness tourism is aimed at advancing the motivation of relaxation, mental therapies, and an improved quality of life for the tourists. There is a direct link between travel/tourism and health as the former directly impact an individual’s state of health in association with social, physical and mental wellbeing (Alipour et al., 2020: Lee et al., 2020). Moreover, according to Hartwell et al. (2018), tourism presents a direct influence on psychological, emotional, spiritual and cognitive dimensions of a normal person’s wellbeing. The above arguments by Alipour et al. (2020) and Lee et al. (2020) support a previous finding indicating that there is a causal relationship between tourism and health based on the observation that older tourists tend to be healthier and active as compared to non-tourists (Ferrer et al., 2016). Research aim: To identify, evaluate, and synthesise evidence from the published research on the relationship between tourism and health to set precedence for the future research on the identified gaps. Research objectives: 1) To summarise and synthesise the existing evidence on the relationship between tourism and health 2) To identify knowledge gaps in the extant literature in relation to the nexus between tourism and health 3) Establish precedence and set a background for the future research on the relationship between tourism and health 4) To make relevant recommendations that will inform decision-making practices by companies operating within the tourism sector on the provision of health-oriented services 5) To make recommendations that will influence the perceptions and decisions made by tourists in visiting destinations solely for meeting their health and wellness needs Methods: Philosophy: The interpretivist-constructivist was preferred because it tends to focus on plausibility, authenticity, justifiability, coherence, criticality, comprehensibility, compulsion, and assessability of a certain topic of interest. The interpretivism-constructivism approach is justified because the researcher is aiming to derive meaning from the existing secondary sources on the relationship between tourism and health. Design: The systematic review design was used to determine the extent and nature of evidence published on the aspects of tourism and health. Search process: The online databases from which the evidence was retrieved include MEDLINE (PubMed) and Google Scholar. The combined keywords were [Tourism OR travel OR vacation] AND [health OR well-being OR medical OR mental health OR physical health OR wellness] AND [impact OR effect OR association] AND [population OR community OR individual]. The PRISMA 2020 flow diagram was used as a guide to the evidence search process. Quality appraisal: The mixed methods appraisal tool (MMAT) was adopted in the appraisal of methodological quality of the included studies. Results: The initial search retrieved 534 reports that were evaluated based on the inclusion/exclusion and eligibility criteria leading to the final list of 15 articles (2 qualitative and 13 quantitative). Evidence was then retrieved from the 15 articles. The intricate relationship between tourism and health was revealed in four perspectives. First, medical tourism positively impacts tourists’ physical and psychological health, wellness in the form of positive emotions and life satisfaction due to the tourist’s autonomy, experience, and intrinsic motivation. Second, higher perceptions of community well-being arose from greater economic performance of medical tourism. Given the perceived positive impacts of tourism, the community’s attitudes toward medical tourism influenced the overall satisfaction with the practice and eventually, the community’s willingness to pay higher taxes and participate in the promotion of medical tourism. Third, the negative health impacts of tourism include increased crime rates, overcrowding and congestion that heighten the residents’ stress levels leading to ill health. Finally, medical tourists’ require to be motivated, and the factors that influence their intentions to visit a destination include follow-up care, advanced and affordable medical technology, tourism activities for companions, strong government support, extra support for patients, price, variety of treatments, accessibility and service, and infrastructure at the destination, perceived risks, and medical facilities associated with the destinations. The factors that influence revisit intentions are health evaluation, international certified doctors, doctors’ expertise, quality of medical treatment, advanced medical treatment, high healthcare quality, hospital contact information, waiting time until treatment, and availability of medication. Limitations: The scope of the review was limited as only 15 articles were included. There was inadequate theoretical development in the studies due to failure to incorporate key elements pertaining to this relationship such as public awareness and tourism campaigns in cementing medical tourism, responding to health crises such as pandemics, the dynamics of medical tourists’ behaviours during pandemics, the role of policy, regulation, technology, ethics and sustainability as fundamental pillars of medical tourism. Moreover, methodological limitations were evident in the sampling strategies and data collection methods used. Most of the studies adopted purposive and convenience sampling strategies, which are non-probabilistic. This introduced sampling bias that affected the credibility and generalisability of the results. Additionally, interviews are subjective while cross-sectional designs do not depict causal relationships. Implications for practice and future research: This review positively contributes to the tourism industry. Since the number of health-conscious visitors is on the rise, businesses with stake in tourism, hospitality, and travel sectors should position themselves to offer services that appeal to such tourists. They can segment their clients according to their needs and invest in the required services and products to generate more revenues. Furthermore, since the review outlines the factors that motivate medical tourists to either visit or revisit an attraction destination, it is beneficial to the destinations that offer health and wellness services. These destinations will adopt the factors that motivate medical tourists to visit, and as a result, improve their competitiveness in that sphere of service provision. This will open up innovation in the sector in relation to enhancing medical tourism. The future research should pursue additional variables including the role of the tourism sector in responding to health crises such as pandemic, the dynamics of medical tourists’ behaviours during pandemics, the role of policy, regulation, technology, ethics and sustainability as fundamental pillars of medical tourism. The future research should consider investigating this relationship from the lenses of multiple motivational theories including Maslow’s Hierarchy of Needs, Theory of Planned Behaviour (TPB), Self-Determination Theory (SDT), and Expectation Confirmation Theory (ECT). Mixed methods, experimental, and quasi-experimental designs are recommended for future research to establish causal relationships among variables developed from the relationship between tourism and health. Conclusions: The review posits that tourism is not only for leisure purposes but serves even more interesting purposes such as promotion of health and wellness. It is evident that medical tourism is on the rise and its social, wellness, cultural, and economic value is acknowledgeable. Therefore, more efforts should be invested in medical tourism for the benefit of businesses, visitors, healthcare systems, and communities and their economies. Nevertheless, research is underdeveloped in this area, and thus, justifies the need for continued research to fill the existing knowledge gaps.26 0