Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Relationship between Role Clarity and Psychological Safety in the Healthcare Sector in Saudi Arabia: A Mixed-Methods Research Study(Saudi Digital Library, 2026) Tammar, Ahmad; Leka, Stavroula; Jones, StevenThe aim of this thesis was to examine the relationship between role clarity and psychological safety in Saudi Arabia’s healthcare sector during the Health Sector Transformation Program (HSTP), and explored their combined influence on employee well-being. A pragmatic paradigm and concurrent mixed-methods design were adopted. The quantitative study was based on a survey of 270 healthcare employees using validated instruments, while the qualitative study involved 33 semi-structured interviews exploring employees’ experiences of clarity and safety during reform. Data were analysed through multivariate regression and mediation models for the quantitative study, and thematic analysis for the qualitative study, with integration at the interpretation stage. Quantitative findings showed that role clarity was significantly associated with psychological safety at individual, team, and organisational levels. Role clarity was also related to well-being, with team psychological safety partially mediating this association. Leadership role showed a small effect, but tenure and employment status were not significant. Qualitative findings revealed how inclusive leadership, recognition, and clear communication fostered psychological safety, while reform-related ambiguity, shifting responsibilities, and reliance on informal channels undermined it. Hierarchical and cultural dynamics influenced whose voices were heard, with lower-status staff more hesitant to speak up. The integration of findings demonstrated that role clarity is a crucial job resource that supports psychological safety and well-being, but its benefits are amplified in supportive team climates. Using the Job Demands-Resources model, Status Characteristics Theory, and the Readiness for Change framework, the study showed how organisational, relational, and contextual factors interact to shape outcomes. The thesis provides empirical evidence of the clarity-safety-well-being relationship, refines theoretical frameworks by emphasising their interactive and contingent nature, and offers context-specific insights from a reforming, non-Western healthcare system. Findings have practical implications for leadership development, role design, and communication strategies during organisational transformation.18 0Item Restricted IDENTIFYING FACTORS THAT AFFECT SAUDI NURSES’ INTENTIONS TO REPORT MEDICATION ERRORS IN ARAR HOSPITALS(Saudi Digital Library, 2023-12) Aldughmi, Ohoud; Bobay, KathleenBackground: Medication errors are common health safety issues in the Kingdom of Saudi Arabia (KSA). To avoid medication errors, Saudi hospitals need to identify the causes of such errors and encourage nurses to report them. Currently, most Saudi nurses do not report errors due to the Saudi blaming culture and fear of reprisal. Therefore, Saudi nurses need a psychologically safe environment that encourages them to admit and report errors. Identifying Saudi nurses’ perceptions, attitudes, norms, behaviors, and intentions regarding reporting medication errors will help Saudi healthcare organizations to support and encourage a reporting culture. Purpose: The purpose of this study is to identify factors that affect the intention of Saudi nurses to report medication errors. Method: A quantitative cross-sectional online survey method was used for this study. The study population is Saudi registered nurses who were working at the time of the study in medical, surgical, and intensive care units at Prince Abdulaziz Bin Musaad Hospital and North Medical Tower in the city of Arar in the KSA. The survey used in this study includes a theory of planned behavior questionnaire, a psychological safety scale, and demographic questions. The data analysis employed descriptive statistics, Pearson correlation coefficients, and hierarchical multiple linear regression to assess significant predictors of reporting medication errors. Internal consistency reliability was tested for the scales. Results: The results of this study confirm that Saudi nurses in two Arar hospitals have moderate intentions to report medication errors. The findings demonstrate that the theory of planned behavior constructs (attitude toward behavior, subjective norms, and perceived behavioral control) are significant predictors to explain Saudi nurses' intention to report medication errors. Psychological safety was not found to be a significant predictor in isolation, but it became a statistically significant predictor after interaction terms were added to the model. The interaction between attitude toward behavior and psychological safety was found to be negative and significant, but the interaction between subjective norms and psychological safety was found to be positive. The results indicated that the TPB survey had good reliability and internal consistency. Conclusions: The findings of this study may suggest that subjective norms and attitudes toward behavior are factors that should be assessed before implementing improvement interventions for reporting medication errors. However, further research with larger samples and various groups is necessary to determine significant predictors of Saudi nurses' intentions to report medication errors.48 0