Achieving donors satisfaction and motivation to become regular blood donor.

Sample Answer for Achieving donors satisfaction and motivation to become regular blood donor. Included After Question

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Hi there,

I need to write research proposal as instruction below and attached doc;

I need to do systematic review on articles talked about blood donors satisfaction and motivation is Saudi Arabia.

My Title: Achieving donors satisfaction and motivation to become regular blood donor.
Research summary:
The blood donor system in the Kingdom of Saudi Arabia depends on a combination of voluntary and involuntary donors. Blood products are crucial to health systems and donations by voluntary unpaid donors are highly needed to ensure safety and sustainability of blood supply. Globally, however, just about 5% of those eligible to donate do so and about half of those never return to donate again. This review aims towards what discourages first-time donors, what predicts their retention, and what motivators may promote retention of this group.
The aim of this study is to explore the attitudes, beliefs and motivations of Saudis toward blood donation

Master of Healthcare Administration Research Project Title of research A proposal for research project Prepared by Your name Supervised by: Dr. ………………….. Date ❖ Title: Achieving donors satisfaction and motivation to become regular blood donors. ❖ Research summary: • The blood donor system in the Kingdom of Saudi Arabia depends on a combination of voluntary and involuntary donors. Blood products are crucial to health systems and donations by voluntary unpaid donors are highly needed to ensure safety and sustainability of blood supply. Globally, however, just about 5% of those eligible to donate do so and about half of those never return to donate again. This review aims towards what discourages first-time donors, what predicts their retention, and what motivators may promote retention of this group. • The aim of this study is to explore the attitudes, beliefs and motivations of Saudis toward blood donation. The research proposal must: – be a minimum of 1,000 words and maximum of 3500 words – be fully referenced 1. Background & Problem Statement 2. Review of Literature 3. Methodology (it should be systematic review) 4. Research Plan and Timeline (3 months ) 5. Results 6. References International Journal for Quality in Health Care, 2018, 30(10), 751–759 doi: 10.1093/intqhc/mzy104 Advance Access Publication Date: 10 May 2018 Review Review Patient satisfaction and experience of primary care in Saudi Arabia: a systematic review Downloaded from https://academic.oup.com/intqhc/article/30/10/751/5025759 by guest on 22 December 2022 MOHAMMED SENITAN1,2, ALI HASSAN ALHAITI3, and JAMES GILLESPIE1 1 Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, 2006 Sydney, Australia, Department of Public Health, Faculty of Health Sciences, Saudi Electronic University, 6481, 12231 Riyadh, Saudi Arabia, and 3Nursing Rehabilitation Department, King Fahad Medical City, 6481, 12231 Riyadh, Saudi Arabia 2 Address reprint requests to: Mohammed Senitan, No. 2W19/Level 2, Charles Perkins Centre D17, The University of Sydney, NSW 2006, Australia. Tel: +61 286276130; Fax: +2205 (02) 8627 0141; E-mail: [email protected] or [email protected] Editorial Decision 26 March 2018; Accepted 23 April 2018 Abstract Purpose: This systematic review aims to explore patient satisfaction (PS) among patients who used Ministry of Health (MoH) primary care centres in Saudi Arabia, with a focus on their communication with physicians. Data sources: Medline, CINAHL, Embase, Global Health, the Saudi Medical Journal, Annals of Saudi Medicine, the Journal of Family and Community Medicine and Google Scholar. Study selection/Data extraction: The review focused on studies concerning PS in Saudi MoH primary care centres published between 2005 and 2017. Two independent reviewers conﬁrmed that the included studies met the selection criteria, assessed the quality of the selected studies and extracted their signiﬁcant characteristics. All of the articles were examined in terms of the ﬁve main domains that determine the patient–physician communication identiﬁed by Boquiren, Hack, Beaver et al. (What do measures of patient satisfaction with the doctor tell us? Patient Educ Couns 2015;98:1465–73). Results: The literature search retrieved a total of 846 studies. Only 10 studies met the selection criteria. All of the studies reported at least one domain of PS. There was a strong relationship between the level of education, income and satisfaction rate. Most of the studies reported PS in terms of the domains of availability and accessibility, and communication. Few of the studies covered the other domains, such as relational conduct, views on the physician’s technical skills/knowledge and the personal qualities of physicians. Conclusion: There was a contradiction between the patients’ responses to the surveys on the domains of PS and their actual experience. While the patients reported that they were satisﬁed with primary care centres, they frequently attended the emergency department directly. This indicated that they were unlikely to be fully satisﬁed with the primary healthcare centre. Key words: patient satisfaction, patient experience, Saudi Arabia, primary care, communication, physicians, quality of care Introduction Patient satisfaction (PS) with the healthcare system has received substantial attention in the evaluation of modern healthcare. While PS measurements have been widely used to measure the quality of healthcare, they remain proxy measures [1]. Communication between the physician and patient is a signiﬁcant component of PS that can affect overall satisfaction [2, 3]. The Ministry of Health (MoH) healthcare system was established in 1926 and consists of three levels: primary, secondary and tertiary healthcare services available through the MoH network [4]. © The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: [email protected] 751 752 Table 1 Domains of PS with doctors’ measurements Domain PS physician measurements A. Communication Attributes • Listening skills • Eliciting patient information • Providing explanations • Ensuring patient understanding • Providing information • Addressing patient’s concerns and questions • Treating the patient with respect • Professional demeanour • Allowed patient a shared role in medical care and decision-making • Patient trust and conﬁdence • Patient felt understood and heard • Patient felt that s/he and their health problem was taken seriously • Professional knowledge and expertise • ‘Humaneness’ (empathy, sensitivity, concern, caring, friendliness, kindness) • Patient did not feel rushed; spent adequate time with physician • Physician was accessible B. Relational Conduct C. Technical Skill D. Personal Qualities Purpose To better understand this issue, this paper examined the main domains of PS that explain the patient–physician relationship. The domains were adapted from Boquiren and colleagues [1], who concluded that the measurement of PS is necessary to assess, plan, deliver and improve medical services. In their review, they also identiﬁed ﬁve domains to productively assess the efﬁcacy, quality and feasibility of healthcare institutions [1]. The ﬁrst domain emphasises the importance of good ‘communication’ between the patient and medical staff, highlighting the inﬂuence of the physician’s listening skills and comprehensibility. The second domain values ‘relational conduct’ via the interpersonal skills of the medical staff and how they address the patient with respect and courtesy. The third domain reﬂects the ‘technical skills’ of the clinic staff, and the available equipment in the healthcare institution. The professional level, knowledge and expertise of physicians play an important role in establishing patient trust and compliance with treatment. The fourth domain considers the ‘personal qualities’ and human nature of the hospital staff, emphasising their compassion and caring towards the patient. Finally, the ﬁfth domain underlines the ‘availability/accessibility’ attributes of healthcare institutions by analysing the ease of obtaining appointments, waiting times and the availability of preferred doctors for accommodating patient wishes [1]. Table 1 shows the subdomains of these ﬁve domains. Method This paper used the systematic review method. Two independent reviewers conﬁrmed that the cross-sectional studies included in the review met the selection criteria. They also assessed the quality of the studies and extracted their signiﬁcant characteristics. The selected studies were assessed based on the ﬁve main domains identiﬁed by Boquiren and colleagues (‘communication, relational conduct, technical skills, personal qualities and availability/accessibility’) that determine the patient–physician relationship [1]. Data sources and search strategy This review searched four major databases: Medline, CINAHL, Embase and Global Health. A manual search for articles on research into PS in Saudi Arabia was also conducted to retrieve articles that were not shown in the database searches. Three journals were also identiﬁed based on their relevance to the topic: the Saudi Medical E. Availability and Accessibility Journal, Annals of Saudi Medicine and Journal of Family and Community Medicine. All searches were performed in English. We also used Google Scholar to search for any relevant articles using similar terms. Based on the most relevant articles identiﬁed, we performed a forward citation search to identify further studies to be included in this review. We decided to use search terms that were relevant to the four main concepts (PS, PHC centre, MoH and Saudi Arabia). For example, the term ‘General Practice’ or ‘Medical Centre’ under the PHC centre concept identiﬁed a wide range of articles in the literature. We also used the term trees of different databases, such as MeSH for Medline. When collecting studies from the manual searches of journals and Google Scholar, we recognised that using a greater number of terms complicated the search and produced vague results and thus, for these searches, we used the concept terms. Study selection All of the studies included in the analysis were required to meet the following inclusion criteria: (1) original research; (2) focused on PS in MoH PHC centres in Saudi Arabia and (3) published between January 2005 and January 2017 as there was a comprehensive review that cover years from (1985–2004) which considered in this review [7]. Studies were excluded if they focused on settings other than MoH PHC centres. Quality appraisal Quality appraisal is a critical step in systematic reviews. It aims to assess the quality of the methodology used in a study and determine the extent to which a study has addressed the possibility of bias in its design, conduct and analysis. The Joanna Briggs Institute (JBI) critical appraisal tools have been developed by the JBI and collaborators, and approved by the JBI Scientiﬁc Committee following extensive peer review [8]. In this review, the quality of the studies was evaluated using these tools in the form of a checklist for analytical cross-sectional studies (see Table 2) [8]. Downloaded from https://academic.oup.com/intqhc/article/30/10/751/5025759 by guest on 22 December 2022 Primary healthcare (PHC) is provided through healthcare centres. PHC centres are the ﬁrst place where patients encounter the healthcare system [4]. Alyasin and Douglas [5] found that 65% of emergency visits to the hospital were for non-urgent cases. The main reasons for visits to the emergency department were lack of trust in PHC centres and the quality of care received in PHC centres not meeting expected standards. When patients were asked about their satisfaction with PHC centres, their satisfaction rate with the care provided by local PHCs was reported as mostly neutral or dissatisﬁed [5]. The critical issue in Saudi PHC is patient–physician communication, as most physicians in Saudi Arabia are from different backgrounds and speak different languages. According to Almutairi [6], cultural and language differences were two barriers to patient–physician communication. This could create the major barrier to patient trust in PHC, as the PS questionnaires revealed. Senitan et al. Patient experience of PHCs in KSA • Patient-centred care 753 Table 2 Critical appraisal results for included studies using the JBI cross-sectional critical appraisal checklist Study Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Alfaqeeh et al. [9] Al-Ali and Elzubair [10] Mohamed et al. [11] Ghazwani and Al Jaber [12] Mahfouz et al. [13] Alshammari [14] Almoajel, Fetohi and Alshamrani [15] Aljasir and Alghamdi [16] Maram BanaKhar et al. [17] Abdalla et al. [18] Y Y Y U N Y N Y N Y Y Y Y Y Y Y Y Y Y Y Y N Y Y NA Y N U NA NA NA NA NA Y NA N NA NA U NA U N N U N N N N N U U NA NA NA NA NA Y NA NA NA Y U Y Y Y Y Y U N Y Y Y Y Y Y Y Y Y U Y A data extraction form was developed and used to extract data from the included studies. Table 1 shows the ﬁve main domains used for the PS measurements. overall satisfaction reported in the included studies ranged from 50% to over 90% [9, 11, 12, 14–18]. In eight studies, the overall satisfaction was over 75%, which aligns with the previous review by Al-Ahmadi and Roland (2005) [7] (Table 3). Results The ﬁve domains of patient–physician communication Data extraction The systematic search The database search retrieved 846 articles from Medline, CINAHL, Embase and Global Health. After removing duplicates, 723 articles remained. Of these, a further 167 were removed as they were out of the speciﬁed date range. The titles of the remaining 567 articles were screened. A further 544 articles were excluded after screening the titles. Twelve articles were fully screened, of which six were included in the analysis. Another four articles were added from Google Scholar and forward citation searches. This gave a ﬁnal count of 10 articles to be included in this review. Figure 1 illustrates the selection procedure utilised to obtain the studies analysed for this review. Characteristics of the included papers The included papers were quantitative cross-sectional studies. The papers in this review covered most of the regions in Saudi Arabia, including Riyadh province [9], Dammam [10], Majmaah [11], Abha [12, 13], Hail [14, 18], Jubail [15], Al-Laith [16] and Jeddah [17]. These studies provided a range of comparisons in terms of their survey approaches and their direct or indirect application of the ﬁve PS domains. Some of these studies mentioned the validity and reliability of PS questionnaires tools [9–14, 16]. Appendix presents the responses and a detailed description of all the factors showing positive and negative results regarding PS and the limitations faced by the researchers while collecting the survey responses. Communication attributes Six studies reported the communication domain [9, 10, 12, 14–15]. However, while some studies clearly reported the communication subdomains between physicians and patients, some did not. Overall, the PS scores on the communication domain ranged from 50% to 89.5%. Table 4 shows the included studies report of the ﬁve domains.. In Al-Ali and Elzubair’s study [10], 49% of patients were not satisﬁed with physician communication. The mean satisfaction score of rapport among the participants in this study was 77% [10]. The highest communication satisfaction score came from elderly patients with a low level of education, suffering from chronic conditions and with ﬁxed appointments with a physician. Alfaqeeh et al. [9] concluded that the patients and physicians had good communication. Almoajel, Fetohi and Alshamrani [15] reported that 70% of patients were satisﬁed with their doctors’ listening skills. Additionally, 60% of patients reported that their physicians treated them nicely, while 14% disagreed with this statement [15]. Furthermore, 21% of patients reported that the time spent with their physicians was not enough. Thus, this domain had substantial differences in PS. Alshammari [14] reported that the communication domain received the third highest score (M = 3.64) of PS. In Ghazwani and Al Jaber’s study [12], 86% of patients were moderately to highly satisﬁed with the communication they had with their physicians and only 13% were not satisﬁed. Abdalla et al. [18] reported that the satisfaction rate for physicians was the highest; however, listening to patients’ complaints scored the lowest satisfaction scores. Overall satisfaction Overall satisfaction refers to the question at the end of the PS questionnaire asking about the participants’ general or overall satisfaction. Overall satisfaction was reported in almost all studies. The Relational conduct Only three studies reported the relational conduct domain [9, 14, 15]. The subdomains overlapped with the subdomains of personal qualities. Downloaded from https://academic.oup.com/intqhc/article/30/10/751/5025759 by guest on 22 December 2022 Y, Yes, N, NO, U, Unclear, NA, Not Applicable. The checklist includes eight questions, and the responses was recorded in the form of yes, no, unclear or not applicable. The questions are listed below: Q1: Were the criteria for inclusion in the sample deﬁned? Q2: Were the study subjects and the setting described in detail? Q3: Was the exposure measured validly and reliably? Q4: Were objective, standard criteria used for measurement of the condition? Q5: Were confounding factors identiﬁed? Q6: Were strategies to deal with confounding factors stated? Q7: Were the outcomes measured validly and reliably? Q8: Was appropriate statistical analysis used? 754 Identification Senitan et al. Records identified through database searching Saudi Journals (n = 0) (n = 846): Medline = 42, CINAHL = 15, Embase = 310, Google Scholar (n = 3) Global Health = 479 Forward Citation (n = 1) Records after duplicates removed Included Records screened Records excluded (n = 711) (n = 723) Full-text articles assessed for eligibility Full-text articles excluded (n = 2) (n = 12) Studies included in synthesis (n = 10) Figure 1 Preferred reporting items for systematic reviews and meta-analyses. [19] Table 3 Overall satisfaction Study Overall satisfaction (%) Alfaqeeh et al. [9] Al-Ali and Elzubair [10] Mohamed et al. [11] Ghazwani and Al Jaber [12] Mahfouz et al. [13] Alshammari [14] Almoajel et al. [15] Aljasir and Alghamdi [16] Maram BanaKhar et al. [17] Abdalla et al. [18] 88 NA 82 87 82 NA 77 96.9 89 73.6 For instance, Alshammari [14] reported that the interpersonal dimension, which has six subdomains, with four domains (personal interest, reassurance, respect, and support and time offered to their patients) under relational conduct and two domains (friendliness, courtesy) under personal qualities. Almoajel, Fetohi and Alshamrani [15] found that 82% of patients reported that the reception staff treated them well, 84% of patients agreed that their physicians treated them with respect, while 62% of patients agreed that their physicians did not listen to their complaints. Alshammari [14] reported that the interpersonal dimension (M = 3.78) had the highest score of the PS domains, which was represented by six items, among which four (personal interest, reassurance, respect, and support and time offered to the patients by their physicians) were related to relational conduct. Technical skill/knowledge Five studies reported the technical skill/knowledge domain [11, 13, 14, 17, 18]. Alshammari [14] identiﬁed the technical domain as the second-highest scoring dimension (M = 3.76), represented by four items measuring the skill, experience and training of physicians, thoroughness of treatment, examination and accuracy of diagnosis, and positive outcomes of medical care. Mohamed et al. [11] reported that cleanliness (33%), technical competence of staff (24.2%), respect and good handling (23.2%), good service (8.3%) and others (11.2%) had the highest percentages. Mahfouz et al. [13] reported that the proportion of patients from urban areas who were dissatisﬁed due to lack of thoroughness (the extent to which the patient receives complete care and service) of the service (30.3%) was signiﬁcantly higher than the corresponding ﬁgure (15.6%) among rural patients (P < 0.05). Also, Mahfouz et al. [13] reported that 25% of patients were dissatisﬁed as they felt that their physicians gave them inadequate information. Personal qualities Four studies reported the personal qualities domain [10, 13, 14, 17]. In Alshammari’s study [14], the highest PS score was M = 3.78, representing friendliness, courtesy, personal interest, reassurance, respect, and support and time offered to the patient by the physician. Mahfouz et al. [13] reported a difference in PS in the personal qualities domain between urban and rural patients. The patients from urban areas were more dissatisﬁed (18.2%) compared with rural patients (6.1%) (P < 0.05). Downloaded from https://academic.oup.com/intqhc/article/30/10/751/5025759 by guest on 22 December 2022 Eligibility Screening (n = 723) Patient experience of PHCs in KSA • Patient-centred care 755 Table 4 Checklist for the inclusion of ﬁve domains in the reviewed studies Communication attributes Relational conduct Technical skill and knowledge Personal qualities Availability and accessibility Total Yes Alfaqeeh et al. [9] Al-Ali and Elzubair [10] Mohamed et al. [11] Ghazwani and Al Jaber [12] Mahfouz et al. [13] Alshammari [14] Almoajel, Fetohi and Alshamrani [15] Aljasir and Alghamdi [16] Maram BanaKhar et al. [17] Abdalla et al. [18] Total yes Y Y N Y N Y Y N N Y 6 Y N N N N Y Y N N N 3 N N Y N Y Y N N Y Y 5 N Y N N Y Y Y N N N 4 Y N N Y Y Y Y Y Y Y 8 3 2 1 2 3 5 4 1 2 3 26 Y, Yes; N, No. Almoajel, Fetohi and Alshamrani [15] measured the humaneness of the physicians and medical staff in a PHC centre in Jubail city. They found that 84% of patients were satisﬁed that their physicians treated them with respect, whereas 15% were not satisﬁed or not sure. While Al-Ali and Elzubair [10] found that PS with physician empathy was not high, they did not report the percentage or meaning of ‘not high’. The most recent studies (two from 2014 and one from 2016) reported the personal qualities domain, showing that this domain is becoming more and more important in PS [10, 14, 15]. Availability and accessibility Eight studies reported the availability and accessibility domain, making it the most frequently reported domain in this review [9, 12–18]. Aljasir and Alghamdi [18] reported that the majority of patients were satisﬁed with PHC working hours, physicians and nurses, which were rated as acceptable or good. Almoajel, Fetohi and Alshamrani [15] found that 86% of patients were satisﬁed with the accessibility of their clinics, reporting that the distance between their home and the PHC centre was acceptable. Alshammari [14] reported that the lowest-scoring domain in their PS study was accessibility (M = 3.56). The accessibility and availability domain was represented using ﬁve items measuring the access to and the convenience of medical care. Availability was indicated using two items: the ease of seeing the physician of choice and the number of physicians at the centre. Ghazwani and Al Jaber [12] reported that 28% of patients were dissatisﬁed with pre-clinic items that were directly related to the steps performed before meeting the physician. The pre-clinic satisfaction rates were the lowest for PHC accessibility, availability of parking areas, comfortable waiting areas, short waiting times and measurement of the patient’s vital signs before meeting the physician. Mahfouz and colleagues [13] reported that in the accessibility domain, 35% of patients were not satisﬁed with the lack of signs to emergency rooms in PHC centres, and 19.4% reported insufﬁcient parking places. Unlike Aljasir and Alghamdi’s study [16], 30% of patients in urban areas were dissatisﬁed with the working hours of PHC centres, compared with 11% of rural patients. Discussion The reviewed studies are in some ways contradictory. For example, Alshammari [14] reported that the accessibility and availability score was the lowest, and yet when examining the subdomains of this factor, the time offered to patients by the physicians, represented under personal qualities, was the highest scoring item. The accessibility domain was used differently in this study compared with the other studies as it discussed access when patients were inside the PHC centre, access for the distance from home to the PHC centre, and certain other access factors. Further, Almoajel et al. [15] showed that 84% of participants reported that their physicians treated them with respect. However, 62% reported that the physician and medical staff did not listen to their complaints. For Maram BanaKhar et al. [17], 52.9% of patients reported that the number of physicians was adequate and 89% were satisﬁed. However, 58.6% answered the same question with ‘no’ and their satisfaction was reported at 82%. While in some responses patients identiﬁed issues with PHC, these were not reﬂected in their overall satisfaction. This review showed that the experience of patients was different from the high satisfaction rates reported. A study conducted in Kuwait on overall PS found that the overall satisfaction of participants was 99.6%. However, when the same participants were asked about their satisfaction with each service, their mean satisfaction rate dropped to 88.6% [20]. This result aligns with other studies. For example, Williams and Calnan [21] showed that while general levels of consumer satisfaction were high, questions of a more detailed and speciﬁc nature revealed greater levels of expressed dissatisfaction. Historically, PS measurements were introduced in 1961 from the consumer movement, which viewed patients as consumers of healthcare [1]. This means that PS is related to the expectations of the patient, where patient experience is related to the quality of the health services provided. As most physicians in Saudi Arabia are from overseas, a clearer and deeper examination of the communication domain is needed. An analysis of the communication subdomains is essential to strengthen our understanding of the communication between physicians and patients. Future research should address this gap by comparing patient experiences and satisfaction within the same sample. Research is needed to enhance the use of different PS measurements that represent the actual status of PHC for the Saudi population. Future research should also examine patient experience measurements of PHC in Saudi Arabia. This paper (1) examined literature from January 2005 to January 2017 on PS of PHC and the relationship between patients Downloaded from https://academic.oup.com/intqhc/article/30/10/751/5025759 by guest on 22 December 2022 Domain article 756 and physicians in Saudi Arabia. It (2) highlighted the quality of the literature and (3) addressed the knowledge gap in terms of the quality of PHC from the patient’s perspective. It provides stakeholders and researchers with the information to reassess the priority areas in providing better quality measurements in Saudi PHC. The aims of this paper (4) aligned with the aims associated with the transition of the Saudi MoH healthcare system to a privatised system and the Saudi 2030—vision to improve the quality of PHC. Limitations Conclusion The overall satisfaction reported in almost all studies was ranging from 75% and above. Six studies reported the domains of communication. Only three studies reported the relational conduct domain. Five studies reported the technical skills/knowledge domain, while four studies reported the personal qualities domain. Eight studies examined the availability and accessibility domain, making it the most commonly reported domain in this review. There was a contradiction in the patients’ responses to the tools assessing PS and their actual experience. The participants’ level of education and income may contribute to the overestimation of PS. While the patients reported that they were satisﬁed with PHC centres, they frequently attended emergency departments directly. This indicated that they were unlikely to be satisﬁed with the PHC centres. More research is needed to examine the link between patients’ experiences and satisfaction in Saudi Arabia. Acknowledgement We would like to thank the librarian in Charles Perkins Centre for the recommendation about the most relevant databases and search terms. References 1. Boquiren VM, Hack TF, Beaver K et al. What do measures of patient satisfaction with the doctor tell us? Patient Educ Couns 2015;98:1465–73. 2. Marcinowicz L, Chlabicz S, Grebowski R. Understanding patient satisfaction with family doctor care. J Eval Clin Pract 2010;16:712–15. 3. Wang MC, Mosen D, Shuster E et al. Association of patient-reported care coordination with patient satisfaction. J Ambul Care Manage 2015;38: 69–76. 4. Almalki M, FitzGerald G, Clark M. Health care system in Saudi Arabia: an overview/Aperçu du système de santé en Arabie saoudite. East Mediterr Health J 2011;17:784. 5. Alyasin A, Douglas C. Reasons for non-urgent presentations to the emergency departments in Saudi Arabia. Int Emerg Nurs 2014;22:220–25. 6. Almutairi KM. Culture and language differences as a barrier to provision of quality care by the health workforce in Saudi Arabia. Saudi Med J 2015;36:425–31. 7. Al-Ahmadi H, Roland M. Quality of primary health care in Saudi Arabia: a comprehensive review. Int J Qual Health Care 2005;17:331–46. 8. The Joanna Briggs Institute. Critical appraisal tools for use in JBI systematic reviews. Checklist for analytical cross-sectional studies. Adelaide: The Joanna Briggs Institute. 2017. 9. Alfaqeeh G, Cook EJ, Randhawa G et al. Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia. BMC Health Serv Res 2017;17:106. 10. Al-Ali AA, Elzubair AG. Establishing rapport: physicians’ practice and attendees’ satisfaction at a primary health care center, Dammam, Saudi Arabia, 2013. J Fam Community Med 2016;23:12–7. 11. Mohamed EY, Sami W, Alotaibi A et al. Patients’ satisfaction with primary health care center services, Majmaah, Kingdom of Saudi of Saudi Arabia. Int J Health Sci 2015;9:163. 12. Ghazwani EY, Al Jaber OA. Study of satisfaction of diabetic patients attending the diabetic clinic at primary health centers in Abha city, Saudi Arabia. 2014. 13. Mahfouz A, Abdel Moneim I, Khan M et al. Primary health care emergency services in the Abha district of southwestern Saudi Arabia. 2007. 14. Alshammari F. Patient satisfaction in primary health care centers in Hail City, Saudi Arabia. Am J Appl Sci 2014;11:1234. 15. Almoajel A, Fetohi E, Alshamrani A. Patient satisfaction with primary health care in Jubail City, Saudi Arabia. World J Med Sci 2014;11: 255–64. 16. Aljasir B, Alghamdi M. Patient satisfaction with mobile clinic services in a remote rural area of Saudi Arabia/Niveau de satisfaction des patients visa-vis des services sanitaires mobiles dans une zone rurale isolee en Arabie saoudite. East Mediterr Health J 2010;16:1085. 17. Maram BanaKhar SA-K, Fllatah S, Al-Abdul Aziz H et al. Patient satisfaction with primary health care services. Jeddah: King Abdul Aziz University, 2006. 18. Abdalla A, Saeed A, Magzoub M et al. Consumer satisfaction with primary health care services in Hail City, Saudi Arabia. Saudi Med J 2005; 26:1030–2. 19. Moher D, Liberati A, Tetzlaff J et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann InternMed 2009;151:264–49. 20. Al-Eisa IS, Al-Mutar MS, Radwan MM et al. Patients’ satisfaction with primary health care services at capital health region, Kuwait. Middle East J Family Med 2005;3:10–6. 21. Williams SJ, Calnan M. Key determinants of consumer satisfaction with general practice. Fam Pract 1991;8:237–42. Downloaded from https://academic.oup.com/intqhc/article/30/10/751/5025759 by guest on 22 December 2022 This systematic review has three main limitations. Firstly, the limited number of studies analysed in this review may not represent the actual PS with MoH PHC centres in Saudi Arabia. Secondly, this review was restricted to English publications due to the lack of relevant research literature in Arabic. Finally, while the quality of some of the studies was low, they were nonetheless included to represent what the available literature says about PS in Saudi Arabia. Senitan et al. Setting/City Type of study Sample size Alfaqeeh et al. [9] Riyadh province Quantitative (935) Patients 52.9% urban population, 47.1% rural population Al-Ali and Elzubair [10] Dammam Quantitative (27) Physicians (374) Patients Aim/s Results Limitations • The restricted access of the lead researcher to Overall a high rate of satisfaction in patients of To identify barriers and male respondents. all PHCs. facilitators for PHC access • The patient questionnaire: some questions in urban and rural areas of Main barriers among rural patients: were not answered, which may not be related Accessible location and opening times of the Riyadh province. to the settings. PHC. Cleanliness of the PHC. Availability of health-related promotion and prevention services to improve health outcomes for the community. This study reported signiﬁcant differences between ‘being treated with dignity and respect’ and ‘treatment explained and understood’ among urban and rural patients attending PHC centres. Patient attending rural PHC centres were satisﬁed that their doctors treated them with dignity and respect at all times, compared with urban patients, who were more likely to state that they were satisﬁed only some of the time that their doctors treated them with dignity and respect. Overall, this study concluded that patients and physicians have good communication. The reason for good satisfaction between Physician and patient was explained by author that physicians were from countries who share similar language and religion. Not available 51.9% of physicians had a good rapport with To assess the percentage of their patients. physician–patient Factors contributing to a signiﬁcant relationship relationships with good with rapport were: rapport in the PHC and the percentage of satisﬁed Physician’s age (P = 0.016), experience (P = 0.043) and professional status (P = 0.031). patients. 50.5% of the attendees were satisﬁed with their rapport with their physician. The factors contributing to a signiﬁcant relationship with PS were: Attendee’s age (P < 0.0001), educational level (P < 0.0001), having a chronic illness (P < 0.0001), having an appointment (P < 0.0001), physicians’ professional status (P < 0.0001), and a nonsurgical specialty (P < 0.0001). Table continued Downloaded from https://academic.oup.com/intqhc/article/30/10/751/5025759 by guest on 22 December 2022 Case study Patient experience of PHCs in KSA • Patient-centred care Appendix Summary of results obtained from the included studies 757 758 Appendix Continued Setting/City Type of study Mohamed et al. [11] Majmaah Ghazwani and Al Jaber, [12] Sample size Aim/s Results Limitations Quantitative Patients (370) To assess the satisfaction level among patients attending the PHC centre in Majmaah City, Kingdom of Saudi Arabia; To explore the reasons behind the satisfaction level. To determine the social factors impacting on the satisfaction level. The use of self-report was a limitation because respondents were speaking for themselves or their children, and this may have introduced surrogate bias. Another limitation may be recall bias since respondents addressed their current experience and sometimes previous experiences also. Abha Quantitative Patients (600) To evaluate the satisfaction rate of patients with the main aspects of PHC centres at a chronic diseases clinic. To identify the healthcare areas that showed low satisfaction. To identify barriers to PS. Alshammari, [14] Hail Quantitative Patients (453) To identify the factors contributing to PS in PHC centres in Hail city, Saudi Arabia. Almoajel et al. [16] Jubail Quantitative Patients (200) To evaluate the satisfaction level among patients at different PHC centres. To evaluate the available health education programmes. The overall satisfaction level among patients was 81.7%. The factors affecting the level of satisfaction were the cleanliness of the facilities and the technical competence of the staff (33.1% and 24.2%). Unsuitable buildings (29%) were the most stated factor contributing to dissatisfaction. This was followed by dissatisfaction with the number of staff available, followed by the unavailability of dentistry. Unsuitable buildings. A strong relationship was found between PS levels with PHC centres and patients’ education levels. Of the 600 respondents, 87% were satisﬁed (i.e. 44% were moderately satisﬁed, and 43% were highly satisﬁed), while 13% were dissatisﬁed. Low levels of satisfaction were observed among diabetic patients. The highest rate of dissatisfaction was in patients aged

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