Description
The Role of Nursing Management in Enhancing Quality
of Care in Outpatient Departments in Saudi Arabia: A
Systematic Review
by
Afnan Mohammed Alharbi
G230002550
Master of Healthcare Administration
Under supervision of
Dr. Navya Rajashekharan Nair
202420
College of Health Sciences
Saudi Electronic University
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Background
Effective nursing management is the backbone of high-quality outpatient care, ensuring
that healthcare services run smoothly while meeting patient needs. Worldwide, healthcare
organizations are adapting their operations to serve expanding, diverse patient populations
(Durrani, 2016). In Saudi Arabia, Vision 2030 guides the nation’s healthcare transformation by
focusing on infrastructure improvements, service enhancements, and optimized patient care
delivery (Alasiri & Mohammed, 2022). Outpatient departments (OPDs) serve as foundational
healthcare components that maintain patient pathway control and deliver preventative and
specialized medical services. Patients contact these departments first to receive treatment and
care for their diverse medical requirements, including chronic disease management, specialized
consultations, and preventive services (Samadbeik et al., 2024). Despite substantial progress,
OPDs in Saudi Arabia face considerable challenges, such as overcrowding, long wait times, and
inconsistencies in care quality. These issues decrease both outpatient service effectiveness and
patient satisfaction and negatively impact overall health outcomes (Alrasheedi et al., 2019). As
service demand continues to rise, healthcare facilities must adopt continuous management
improvements. Nursing management plays a critical role in addressing these challenges by
ensuring the efficiency, quality, and sustainability of healthcare services in OPDs. Nursing
managers oversee daily operations, coordinate patient care, allocate resources, and ensure
compliance with healthcare regulations (Ball & Griffiths, 2022). Effective nursing leadership is
essential for improving patient outcomes, reducing operational inefficiencies, and enhancing team
collaboration (Alkorashy & Al-Hothaly, 2022). Additionally, nursing administration is responsible for
implementing standardized care protocols, professional development programs, and quality
assurance measures to maintain high service standards (Alsadaan et al., 2021). However, nursing
managers in Saudi OPDs face significant challenges, including balancing administrative duties with
clinical responsibilities, addressing staff shortages, and managing a multicultural workforce (Al
Mutair, 2015). Expatriate nurse integration and the influence of Islamic healthcare practices further
shape nursing management approaches (Alsadaan et al., 2021). Given these complexities,
strengthening nursing leadership is vital for ensuring high-quality outpatient care and achieving the
goals of Vision 2030.
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Problem statement
Despite the recognized importance of nursing management in healthcare, there is a limited
understanding of its specific impact on outpatient care quality in Saudi Arabia. Research shows a
lack of understanding regarding how nursing leadership affects the satisfaction levels of patients
and operational efficiency and service delivery consistency in OPD settings (Al Mutair, 2015).
Nursing managers encounter multiple implementation obstacles when deploying standardized
care procedures and managing various teams and providing professional development support for
their staff members (Ball & Griffiths, 2022). Multiple healthcare factors including the integration of
foreign nursing professionals along with Islamic healthcare practices make nursing management in
OPDs more complex (Alsadaan et al., 2021). To achieve patient care excellence and Vision 2030
objectives it is essential to study the nursing management approaches that will improve OPD
performance.
Research gap
Research about nursing management in Saudi Arabia’s outpatient departments (OPDs)
dedicates most attention to the problems of overcrowding and delayed care and inconsistent
delivery practices. The current research lacks extensive analysis of how nursing leadership
specifically handles these problems and enhances care quality for patients. The existing research
lacks adequate investigation of how nursing management affects operational performance
together with resource usage and patient caregiver satisfaction. The research need becomes
evident because of the difficulties healthcare teams present alongside the integration of foreign
nurses and challenges with Vision 2030 transformation efforts. This study seeks to connect these
knowledge gaps by analyzing the strategies alongside their resulting outcomes that boost OPD care
quality throughout Saudi Arabia.
Research question/s
1. What role does nursing management play in achieving better patient care quality as
well as satisfaction in outpatient departments throughout Saudi Arabia?
2. What obstacles prevent nursing managers from coordinating between
administrative work and clinical functions within Saudi Arabian OPDs?
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3. Which approaches would nursing management use to boost efficiency and shorten
wait periods in outpatient departments without compromising care standards??
Aim of the study
This study aims to examine the role of nursing management in enhancing the quality of care in
outpatient departments (OPDs) in Saudi Arabia by identifying key challenges, evaluating its impact
on patient satisfaction, and exploring effective strategies for improving operational efficiency.
Objectives of the study
The objectives of this study are to:
•
Analyze the impact of nursing management on patient care quality and satisfaction in
outpatient departments (OPDs) in Saudi Arabia.
•
Identify key challenges faced by nursing managers in balancing administrative duties and
clinical responsibilities in OPDs.
•
Evaluate the effectiveness of current nursing leadership strategies in improving operational
efficiency and reducing wait times.
•
Explore best practices and evidence-based strategies for enhancing nursing management
to optimize patient outcomes in OPDs.
•
Evaluate how cultural and systemic elements impact nursing management practices within
Saudi Arabian OPDs.
Significance of study
This research is significant because it investigates the essential role of nursing management
in improving outpatient department (OPD) care quality within Saudi Arabia. The healthcare system
transformation under Vision 2030 along with rising patient numbers requires effective nursing
leadership to achieve better patient satisfaction while shortening wait periods and optimizing
resource distribution. The research examines evidence-based management strategies and critical
challenges to offer policymakers and healthcare administrators and nursing professionals’
implementation guidelines that drive operational improvement and quality care delivery. The study
examines cultural and systemic factors affecting nursing leadership in Saudi Arabian OPDs which
will lead to better outcomes for healthcare services and patient experiences.
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Review of Literature
Introduction
Healthcare institutions across the world are now implementing rapid transformations
because patient demographics are increasing in diversity. The hospital authorities in Saudi Arabia
adopted Vision 2030 to speed up the development of infrastructure and service delivery standards
in outpatient departments. Healthcare delivery begins at OPDs because patients first connect with
these departments to manage chronic diseases while receiving preventive services and specialized
medical evaluation. The healthcare sector continues to grow quickly but patient satisfaction along
with healthcare results suffer from the combination of crowded facilities and extended waiting
periods with inconsistent care services. The leadership role of nursing management stands
essential for resolving OPD care issues in Saudi Arabia, yet research assessing its particular
contribution to quality improvement remains scarce. This review examines scholarly research
about how Saudi OPD care quality benefits from nursing management approaches, together with
the principal barriers and successful strategies and results.
Quality of Nursing Care in Saudi Arabia
Saudi Arabia’s healthcare system has progressed well, yet healthcare professionals identify
multiple critical areas that require improvement, specifically in outpatient departments (OPDs).
According to Al Mutair (2015) Saudi Arabia continues improving healthcare services yet faces
obstacles because of inadequate nursing staff training and inconsistent professional standards.
Healthcare delivery shows inconsistent results because nurses are scarce and this leads to worse
patient outcomes (Alasqah et al., 2022). Alkorashy and Al-Hothaly (2022) explain how nursing care
serves as a crucial component for achieving Vision 2030 healthcare transformation success. The
authors argue that nursing care stands as a fundamental aspect requiring transformation because
healthcare delivery protocols need to match international quality benchmarks (Alkorashy & AlHothaly, 2022). When properly managed, nursing operations function as a critical driver toward
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enhancing medical care quality. The study conducted by Ali et al. (2024) demonstrates how nursing
practice environments with adequate staff and resources and proper backing systems generate
outstanding patient results (Ali et al., 2024). Nursing managers in outpatient departments face dual
challenges with administrative responsibilities and clinical obligations which results in poor
execution of quality improvement initiatives (Alsadaan et al., 2021).
Impact of Vision 2030 on Healthcare Transformation
The Saudi Arabian government launched Vision 2030 which led to extensive
healthcare changes through improved service quality and operational efficiency and better patient
satisfaction. The research by Alasiri & Mohammed (2022) analyzes Saudi Arabian healthcare
development since Vision 2030 began allocating funds to healthcare infrastructure development
and workforce training alongside technological advancements. The healthcare system faces
ongoing difficulties in outpatient departments because patient number growth exceeds treatment
capacity, leading to space shortages and delayed medical services (Alasiri & Mohammed, 2022).
Patient navigation through healthcare challenges becomes possible through nursing management,
which optimizes resource distribution and establishes strategies to improve patient movement.
Results from Almutairi et al. (2024) illustrate how Saudi OPD patients determine their satisfaction
levels based on waiting durations and service quality received. The intricacy of patient journey
management creates high stress and burnout for nurses who handle these responsibilities at the
nursing manager level. Additionally, Alrasheedi et al. (2019) demonstrate a robust connection
between waiting periods and patient satisfaction ratings and argue that improved patient results
can come from shorter wait times through skilled nursing administration.
Challenges Faced by Nursing Management in OPDs
The quality of care in OPDs suffers from multiple challenges that nursing managers must
overcome. Overcrowding persists as a continuous challenge for emergency departments across
Saudi Arabia, as Almass et al. (2023) report alongside OPD wait time’s issues. Patients experience
lower satisfaction rates while waiting longer because staffing shortages combine with delayed
interventions and poor department connections. Hospital systems encounter distinct difficulties
when integrating expatriate nurses because cultural adaptability and professional norms
integration, along with language differences, create barriers to smooth patient care delivery (Alasiri
& Mohammed, 2022). Nursing management strongly depends on both the retention of nursing staff
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and their job satisfaction levels. The research of Alsadaan et al. (2021) examines how nurse
retention in Saudi Arabia struggles with elevated staff turnover and the lack of professional
advancement possibilities. Healthcare services demand continues to rise while nursing managers
face strong pressure to provide quality care with restricted resources (Alsadaan et al., 2021).
Professional nursing handlers require effective management strategies that focus on workforce
development, enhancing workplace satisfaction, and maintaining a sustained nursing workforce.
Role of Nursing Management in Enhancing Patient Satisfaction
The effectiveness of nursing management is a key factor in improving patient satisfaction
levels in Saudi outpatient departments (OPDs). Almutairi et al. (2024) highlight that the provision of
quick medical care and the timely addressing of patient needs rely heavily on effective nursing
management. To enhance patient experiences, three crucial strategies should be implemented:
properly adjusting staffing levels, strengthening nurse-patient relationships, and reducing waiting
times. Nursing managers must actively educate their staff on the importance of patient satisfaction
and its impact on healthcare outcomes (Alrasheedi et al., 2019). Research by Alotaibi (2024) shows
that improving patient-centered care directly boosts patient satisfaction metrics. Nursing
managers have to guarantee that OPD care provides customized treatment that shows respect for
individual patient requirements (Alotaibi, 2024). The improvement of technical care must be
accompanied by the development of patient-centered interactions that are both compassionate
and empathetic.
Strategies for Improving Quality of Care in OPDs
Several approaches have been presented to enhance the quality of care delivery in Saudi
OPDs. The creation of standardized care protocols represents a crucial necessity for maintaining
both reliable and superior quality care, according to research by Alkorashy and Al-Hothaly (2022).
Standardized care procedures create uniform treatment delivery, which results in equal patient
attention and care no matter which healthcare facility patients enter. According to Alasqah et al.
(2022), nursing staff must participate in continuous professional development because ongoing
training and education keep care standards at their highest level. Furthermore, Ali et al. (2024)
highlight that the development of productive nursing practice spaces with sufficient resources
alongside dedicated support and strong leadership results in better patient care outcomes (Ali et
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al. 2024). Nursing managers need to make staff well-being, along with professional development
and collaborative efforts, their top priorities to provide high-quality care.
The literature review highlights nursing management as a key factor in improving care
quality in Saudi OPDs. Despite Vision 2030’s progress, OPDs still face congestion, delays, and
inconsistent care. Nursing managers struggle with administrative and clinical duties, staffing
issues, and cultural diversity. Effective nursing leadership enhances patient satisfaction, optimizes
resource use, and reduces wait times, ultimately leading to better healthcare outcomes.
Methodology
Study design
A systematic review design will be used to examine secondary data sources. This research method
organizes and collects previous studies along with other secondary data regarding nursing
management for outpatient department quality care enhancement for the sake of health facilities in
Saudi Arabia. This review has critically analyzed research reports with published works in order to
discover the key gaps in existing literature without having to engage in new primary data collection.
Ethical considerations
The sole reliance on secondary data gives precedence to integrity and literature
management in the process of research ethics. Protection of intellectual property calls for
immediate and careful attention, as it represents an important ethical consideration. The
systematic review takes care to ensure that recognized academic citation style is used for each
source quoted to prevent the possibility of plagiarism. Correct practices of source citations ensure
fulfillment of ethical principles and show academic regard toward scholars in the field. The issue of
confidentiality and privacy of health clients under study is a most fundamental ethical
consideration. Knowledge of how much protection is maintained for patients’ personal data is
limited because of the use of secondary data instead of collecting data through interviews.
Honesty and transparency are used in the research, as they ensure study dignity from the beginning
to the end. The systematic review uses a transparent method s so as to uphold the laid criteria for
selection and data analysis to achieve objective results and repeatable results. The actual and
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unaltered presentation will show the gathered data because it is considered as evidence from
selected published studies. The research reliability and credibility call for the preservation of
research integrity at all times. Such analytical information will reflect building trustworthy
conclusions with no modicum of risk of selective information integration. With the help of research
ethics, one gets accurate outcomes of the study and builds trust among the community.
Study instrument
The study will utilize a systematic review protocol as its primary research tool. These protocols are
essential for establishing clear selection criteria and review frameworks that ensure accurate and
consistent methodologies (Jahan et al., 2016). The systematic review will look into peer-reviewed
articles, government reports, institutional studies, and healthcare databases. We’ll examine the
functioning of outpatient departments (OPDs) in Saudi Arabia with nursing management strategies,
leadership models, patient service quality, and staffing levels in mind.
Sampling strategy
This research relies entirely on secondary data. Studies sampled are set on the basis of their
relevance to the research question. The design will comprise studies from various databases that
focus on OPD nursing management within the context of the Saudi Arabian healthcare system
(Palinkas et al., 2015). Research will cover both urban and rural healthcare establishments across
the country within the framework of healthcare facilities.
Data collection
Data collection will involve sourcing secondary data from peer-reviewed articles, government
reports, institutional studies, and healthcare databases. The studies selected will be relevant to the
subject of nursing management practices and quality of care in Saudi Arabian OPDs. Databases
such as PubMed, Scopus, and Google Scholar will be used for identification purposes in selecting
pertinent studies. Once abstracts and full texts have been reviewed, those studies will be selected.
Data extraction will concentrate mainly on key characteristics, key outcomes, and findings from
those studies, followed by a synthesis of existing literature to answer the research questions
regarding nursing management in OPDs.
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Data analysis
Thematic synthesis will be adopted for analyzing the results of the study. The analysis will weave
together such elements and recurrent varieties in nursing management practices as quality of care
delivery and leadership methods, staffing requirements, and patient outcomes. The results of the
research from disparate studies are linked together by thematic analysis, which produces an
enlarged understanding of how nursing management influences quality in delivering care to OPDs.
The analysis will examine current strengths of practices along with challenges by investigating the
solutions described in the literature.
Research Plan and timeline
Month/s
Tasks
•
Conduct literature search: Choose relevant databases (like
PubMed, Scopus, and Google Scholar) and use keywords to find
studies on nursing management and quality care in OPDs in Saudi
February
Arabia.
•
Select and review studies: Review studies, read abstracts and full
texts, and decide which studies to include based on the research
question.
•
Data extraction: Extract relevant data from selected studies,
including study characteristics, outcomes, and findings.
March
•
Data analysis (thematic synthesis): Analyze data, identify
recurring themes and patterns, and organize findings into thematic
categories.
April
•
conclusions. Ensure proper citation and referencing of all sources.
•
May
Drafting the report: Write the research findings, discussion, and
Final review and submission: Make final revisions based on
feedback, ensure quality of work, and submit the completed research
report.
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Reviewed and Approved by the Supervisor
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Choose an item.
College of Health Sciences
Research Project template
Submitted in Partial Fulfillment of the Requirements for the Degree of (your program)
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Type of Paper (Original research, Review article, Case study, etc.)
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Title
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First name Lastname, First name Lastname
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Abstract: A single paragraph of about 200 words maximum. For research articles, abstracts should give a pertinent overview of the
work. We strongly encourage authors to use the following style of structured abstracts, but without headings: (1) Background: Place
the question addressed in a broad context and highlight the purpose of the study; (2) Methods: briefly describe the main methods or
treatments applied; (3) Results: summarize the article’s main findings; (4) Conclusions: indicate the main conclusions or interpretations. The abstract should be an objective representation of the article and it must not contain results that are not presented and
substantiated in the main text and should not exaggerate the main conclusions. Do not include tables, figures, or references in your
abstract or use abbreviations.
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Keywords: keyword 1; keyword 2; keyword 3 (List three to ten pertinent keywords specific to the article yet reasonably common
within the subject discipline.) Long phrases and words with multiple meanings should not be used as keywords.
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0. How to Use This Template
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The template details the sections that can be used in a manuscript. The section titles given are for articles. Review papers
and other article types have a more flexible structure. Remove this paragraph and start section numbering with 1.
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1. Introduction
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The introduction should briefly place the study in a broad context and highlight why it is important. It should define
the purpose of the work and its significance. The current state of the research field should be carefully reviewed and
key publications cited. Please highlight controversial and diverging hypotheses when necessary. Finally, briefly mention the main aim of the work and highlight the principal conclusions. The contents of the introduction are organized
in a funnel fashion, moving from broad to specific issues. Cite only references that are directly pertinent and omit any
data from the work being reported. It should contain roughly 1000 words.
Advice on writing (It is recommended to include at least three broad sections):
1. Establishing the foundation entails defining the central topic and incorporating research findings from the previous decade.
a. Subject overviews: What you studied and why it is significant?
b. A review of relevant prior research: What is already known?
2. Establishing the study’s position justifies why this research is being conducted.
a. Indicating a research gap in the field: Describe the current research gap.
b. Posing a research inquiry: Define your question and hypothesis.
3. Justification for this research: Identifies the objective of the study.
Describe the purpose of the study: How are you planning to respond to the research question?
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2. Materials and Methods
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The Materials and Methods should be described with sufficient details to allow others to replicate and build on the
published results. Methods and protocols should be described in detail. Studies involving humans, and other studies
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that require ethical approval, must list the authority that provided approval and the corresponding ethical approval
code.
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2.1 Research design: write about the type of research design used in this study.
2.2 Participants/Sample/Study sample:
• Describe the Source Population and Target Population, if needed.
• Write about the Sample, Sample Size and Sampling procedure.
• Inclusion criteria:
• Exclusion criteria:
• Ethical considerations
• IRB approval
2.3 Measures included in the research:
• Write about the measures that will be used to test the hypothesis.
• What are the variables that are included in the study? (Skip it if using a questionnaire)
• Which method will be used for measurements?
• Describe methods that will be used for locating, selecting, extracting, and synthesizing data.
• Measurement tool:
▪ Write about the Measurement Tool that will be employed in the research.
▪ If a questionnaire will be used, consider the following points, or skip it:
▪ Write in brief how the questionnaire was developed or whether it was adapted (provided references).
▪ Write about the type of questionnaire: structured, semi-structured, etc.
▪ Discuss the sections in the questionnaire.
▪ Write about questions, whether open-ended or closed-ended.
▪ If you have developed the questionnaire based on the theme, you should discuss it here.
▪ Describe the variables included in the questionnaire.
• Inclusion of the following parts is a must if you are using a questionnaire:
▪ Translation of the questionnaire
▪ Pilot study (if applicable)
▪ Validity and Reliability of the questionnaire
2.4 Data Collection: (consider the following points to write this section)
▪ Informed consent: when and how will you get it.
▪ Time and duration of data collection: when was the survey conducted or when was data collected.
▪ Mode of data collection: how was the data collected, social media, email, face-to-face, telephonic conversation;
or the data was taken from any primary source etc.
▪ What was the average time taken to complete the response?
2.5 Data Analysis: (consider the following points to write this section)
▪ Data sifting: Write how the collected data was summarized before analyses.
▪ Statistical software: Describe which statistical tool was used e.g., IBM SPSS 23.0
▪ Descriptive statistics: Indicate what type of descriptive statistics was used for what.
▪ Statistical test: What statistical tests were used to test the hypothesis, or to determine any association or correlation between the variables? Write about the statistical tests used to determine significance. Whether normality was tested?
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3. Results
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This section may be divided into subheadings. It should provide a concise and precise description of the experimental
results, their interpretation, as well as the experimental conclusions that can be drawn.
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Precautions:
• Do not repeat the same data in text, tables, and graphs.
• Do not illustrate all the data in a similar manner, e.g., do not put all the data in tables or in graphs. Make it
diverse as per the data.
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Do not use tables or graphs for what can be described in words.
Use the language wisely and do not make statements like, “Table 1 shows the failure of effect in the study
sample”. It is a direct statement, but instead, the data in the Table should be explained what led to the failure.
Choose either Text, Table, or graph, whichever makes better sense for your data:
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Figures, Tables, and Schemes
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All figures and tables should be cited in the main text as Figure 1, Table 1, etc.
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Figure 1. This is a figure. Schemes follow the same formatting.
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Table 1. This is a table. Tables should be placed in the main text near to the first time they are cited.
Title 1
entry 1
entry 2
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Title 2
data
data
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Title 3
data
data 1
Tables may have a footer.
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The text continues here (Figure 2 and Table 2).
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4. Discussion
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Authors should discuss the results and how they can be interpreted from the perspective of previous studies and of the
working hypotheses. The findings and their implications should be discussed in the broadest context possible. Future
research directions may also be highlighted.
• Starts with narrow findings from your research and ends with comparing and discussing your findings with
relevant reports.
• Similar elements in the discussion section are used to interpret the results.
• Discussion answers those questions by using your results.
• The discussion explains the meaning of achieved outcomes.
• The discussion provides the contribution of your research to the area of study.
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You may use the following sequence of sections (though may not be fit for all):
1. Statement of Principal Finding: start by writing in short about the key findings which answer the research questions. If the research question was not answered completely, you should explain what was not answered and
why.
2. Strengths and Weaknesses of the study: you should discuss the strengths and limitations of the methodology.
3. Strengths and Weaknesses in relation to other studies: the next step is to amplify the discussion by commenting
on the key findings of your study in relation to studies available in the literature.
4. Possible implications of the study
5. Unanswered questions
6. Future research
7. Final thoughts/recommendations
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5. Conclusions
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This section is mandatory.
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Acknowledgments: In this section, you can acknowledge any support given sections. This may include administrative and technical
support of any kind.
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Appendix
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The appendix is an optional section that can contain details and data supplemental to the main text.
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References
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Reference examples are covered in the seventh edition APA Style manuals
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