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Number of Participants from Hospitals In Exploratory study of the factors that influence nutrition interventions in the United Arab Emirates’ healthcare system Item Type Thesis Authors Algurg, Reem S.E.S. Rights <a rel="license" href="http://creativecommons.org/licenses/ by-nc-nd/3.0/"><img alt="Creative Commons License" style="border-width:0" src="http://i.creativecommons.org/l/by- nc-nd/3.0/88x31.png" /></a><br />The University of Bradford theses are licenced under a <a rel="license" href="http:// creativecommons.org/licenses/by-nc-nd/3.0/">Creative Commons Licence</a>. Download date 04/10/2021 14:53:45 Link to Item http://hdl.handle.net/10454/13964 University of Bradford eThesis This thesis is hosted in Bradford Scholars – The University of Bradford Open Access repository. Visit the repository for full metadata or to contact the repository team © University of Bradford. This work is licenced for reuse under a Creative Commons Licence. Exploratory study of the factors that influence nutrition interventions in the United Arab Emirates’ healthcare system Reem Saleh Easa Salah ALGURG Submitted for the degree of Doctor of Philosophy School of Management University of Bradford 2014 Abstract Reem Saleh Al Gurg Exploratory study of the factors that influence nutrition interventions in the United Arab Emirates’ healthcare system. INTRODUCTION: Non-communicable diseases are on the increase worldwide, causing more than 36 million deaths each year. Evidence of the link between the role of nutrition and reducing non-communicable diseases is predominant in the literature. The factors influencing intervention strategies/policies and activities, however, need attention. AIM: The study aims to examine the factors that influence nutrition interventions within the United Arab Emirates’ healthcare system. METHOD: This research adapts an interdisciplinary approach where a triangulation mixed methodology is applied. Both qualitative and quantitative methods are used, through the analysis of ten interviews with policy makers, four case studies and 161 questionnaires. Furthermore, the research framework, which emerged from the literature search and qualitative analysis, is tested and validated by rigorous quantitative analysis using SPSS. The statistical analysis, using factor analysis, MANCOVA and ranking analysis aims to provide solid support for the resulting factors. MAIN FINDING: The study identifies five factors that influence nutrition interventions in a healthcare system, and could enhance the effectiveness of nutrition interventions. The factors are 1) quality and processes, 2) training and use of technology, 3) senior management involvement and responsibility, 4) patient diversity, and 5) multidisciplinary teams. CONCLUSION: This study contributes to the emerging literature on management in nutrition interventions and the theory and importance of preventative measures in relation to nutrition. This study provides a roadmap for policy makers to adopt in order to enhance the role of nutrition interventions in healthcare settings. KEYWORDS: Healthcare policy; mixed methods; nutrition; healthcare management; healthcare strategy; non-communicable diseases; public health; preventative healthcare system. i In the name of Allah most gracious, most merciful, I dedicate this work to My late father (Saleh) Who taught me persistence and determination, may his soul rest in peace My mother (Maryam) Who always inspires me with her love and prayers My daughters (Wid and Haya) Who have been sources of love and laughter ii Acknowledgements First, I would like to express my greatest gratitude to the Almighty Allah, the only one who has given me the opportunity, strength, courage and blessing to pursue this work. Conducting the research and writing this thesis required the patience, persistence and motivation of many people, whom I would like to personally acknowledge. I would like to express my appreciation to my supervisor Prof M. Zairi, who has opened the door to the world of research. I would like to thank my supervisor Dr Craig Johnson for his many useful academic discussions. Special thanks are also extended to the staff at the School of Management and the University of Bradford, to Dr James Wallace for his insight on quantitative statistical help and to Jackie Franklin for her continuous assistance. I also want to thank the Culture Department of the Emirates’ Embassy for their help and financial support granted through the Ministry of Higher Education (UAE). There are a number of people who deserve special thanks and to whom I am greatly indebted. I would also like to thank Dr Mansoor Al Awar for continuously encouraging education and opening doors for this research to see the light. I would also extend my thanks to Dr Mayada Mousa for her support, encouragement and insight and to HBMSU staff and faculty for their enthusiasm. In addition, I would like to thank Dr Abdullah Al Khayat, Dr Yousef AlBastaki, Dr Shawqi Khoory, Dr Mahmoud Fikri, Dr Salah Badawi and Ms Afra Katteh for their time and effort in the preliminary stages of data collection. I would like to thank each and every participant, for taking the time to answer interview questions and fill out the questionnaire. Special thanks go to Dr Ayesha Al Mutawa, Noura Al Khoori and Aisha Jany for their help and networks. A special thanks to my family and friends for their visits, prayers and encouragement throughout the four years. I am indebted to my mother and sister for taking care of my children while I spent endless hours in the JB Priestly library. Finally, to my husband who has stood by me throughout this journey, and has taken a leap of faith in me to fulfil my dream, I thank you. iii Table of Contents Abstract ........................................................................................................................................ i Acknowledgements .................................................................................................................... iii Table of Contents ........................................................................................................................ iv List of Figures .............................................................................................................................. ix List of Tables ................................................................................................................................ x Glossary ...................................................................................................................................... xii List of Abbreviations .................................................................................................................. xvi CHAPTER 1: INTRODUCTION ............................................................................................................ 1 1.1 Introduction .................................................................................................................... 1 1.2 Background to the research............................................................................................. 1 1.3 Importance of the study .................................................................................................. 4 1.4 Research question ........................................................................................................... 5 1.5 Research theoretical significance .................................................................................... 7 1.6 Contribution and originality of the study......................................................................... 9 1.7 Summary ......................................................................................................................... 9 CHAPTER 2: MILESTONES IN HEALTHCARE MANAGEMENT ............................................................ 11 2.1 Introduction .................................................................................................................. 11 2.2 Factors influencing healthcare systems in the 21st century ........................................... 11 2.2.1 Demographics .................................................................................................................. 12 2.2.2 Changes in consumer and user expectations .................................................................. 13 2.2.3 Healthcare innovations in technology ............................................................................. 15 2.2.4 Cost: healthcare financing ............................................................................................... 17 2.2.5 Burden of NCDs on worldwide economies ...................................................................... 18 2.3 Milestones of healthcare delivery over recent decades ................................................. 19 2.3.1 Quality in healthcare ....................................................................................................... 20 2.3.2 Evidence based medicine: history and implementation ................................................. 23 2.3.3 Decision-making processes in healthcare ....................................................................... 25 2.3.4 Integration of care ........................................................................................................... 27 2.4 Summary ....................................................................................................................... 29 CHAPTER 3: NUTRITION INTERVENTIONS AT DIFFERENT LEVELS .................................................... 31
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