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Towards a new framework for nursing education and training in developing countries
This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The advancement in ICT in recent decades has transformed every aspect of life, including
medical care. The most sophisticated example of this is electronic health (e-health), which in developed counties has been a major contributor to enhancing the overall quality of healthcare services. However, e-health remains primitive in developing countries, whether they are relatively poor like Jordan or wealthy like Qatar. Barriers to successful e-health adoption in developing countries are attributable either to superimposing the technology itself while ignoring staff preparedness to integrated e-health or financial inhibitions to
making such fundamental changes to healthcare delivery. Staff preparedness is related to educating or training healthcare staff, particularly nurses, who have fewer opportunities to attend training, or are sometimes ignored. Hence, the focus of this research is to evaluate the preparedness of nursing community for e-health adaption in the developing countries, taking Qatar and Jordan as case studies, in order to identify existing challenges and the key
requirements to establish an educational framework that can be integrated in nursing
curricula or professional development to promote e-health adaptation by nurses.
This research critically reviews previous literature related to the research project,
identifying the challenges to e-health preparedness, and analyses nursing and midwifery curricula from different countries with regard to e-health and ICT. The findings show that e-health modules are not generally included in any higher education nursing programme, with only a few transcripts showing basic computing or ICT modules. E-health national strategies for both Jordan and Qatar were analysed to identify whether the inclusion of professional training on e-health has been considered as part of e-heath
strategy. In addition, analysis of e-health national strategies for other leading countries in the field of e-heath was conducted, finding that there is a decided gap between developed and developing countries with regard to e-health. The level of readiness in nursing was investigated and to identify the main barriers for using e-health/e-nursing in Jordan and Qatar. The results showed the top challenges facing e-health are educational-related aspects, hence a plan for promoting and providing education on the benefits and use of ehealth processes and applications is advised, with prerequisite ICT training, as the results
showed that nurses lack sufficient knowledge about e-health processes and applications.
The findings from earlier tasks were used to identify the requirements and then propose the framework to achieve main goal of this research in providing a roadmap. The framework was constructed in accordance to with the Technology Acceptance Model (TAM),
followed by evaluation by different expert groups. All the groups voted for the suggested structure of the framework to be taken to the next phase of deployment. The final task was to evaluate the attitude of the nursing community working towards the
possibility of implementing an e-learning system, which has been presented as the main
platform in the proposed framework. The findings have demonstrated a very positive
attitude from the nursing staff towards the idea of using e-learning. There also does not
appear to be any apparent obstacles to deploying the concept of e-health as the audience in question have the necessary computer skills. In summary, this research project has contributed in presenting framework and some useful findings related to e-health in general and in Qatar and Jordan in particular. The proposed framework can be as a roadmap for future e-heath/e-nursing projects, in addition, it can be utilised with some modifications to foster similar electronic applications
Risk prediction models for atherosclerotic cardiovascular disease:A systematic assessment with particular reference to Qatar
Background: Atherosclerotic cardiovascular disease (ASCVD) is a common disease in the State of Qatar and results in considerable morbidity, impairment of quality of life and mortality. The American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) is currently used in Qatar to identify those at high risk of ASCVD. However, it is unclear if this is the optimal ASCVD risk prediction model for use in Qatar's ethnically diverse population.
Aims: This systematic review aimed to identify, assess the methodological quality of and compare the properties of established ASCVD risk prediction models for the Qatari population.
Methods: Two reviewers performed head-to-head comparisons of established ASCVD risk calculators systematically. Studies were independently screened according to predefined eligibility criteria and critically appraised using Prediction Model Risk Of Bias Assessment Tool. Data were descriptively summarized and narratively synthesized with reporting of key statistical properties of the models.
Results: We identified 20,487 studies, of which 41 studies met our eligibility criteria. We identified 16 unique risk prediction models. Overall, 50% (n = 8) of the risk prediction models were judged to be at low risk of bias. Only 13% of the studies (n = 2) were judged at low risk of bias for applicability, namely, PREDICT and QRISK3.Only the PREDICT risk calculator scored low risk in both domains.
Conclusions: There is no existing ASCVD risk calculator particularly well suited for use in Qatar's ethnically diverse population. Of the available models, PREDICT and QRISK3 appear most appropriate because of their inclusion of ethnicity. In the absence of a locally derived ASCVD for Qatar, there is merit in a formal head-to-head comparison between PCE, which is currently in use, and PREDICT and QRISK3