Saudi Cultural Missions Theses & Dissertations

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A Cross-Sectional Study of Fatigue and Burnout Predictors among Shift-Working Nurses in Saudi Arabia
(Saudi Digital Library, 2025) Alanazi, Salman Alhumaidi; Trainor, Lisa Hanna
A literature review on shift work's impact on nurses' health linked night shifts, rotating schedules with a high frequency of nights and long hours or overtime with fatigue, burnout, and poor mental health. The review identified significant inconsistencies in the literature regarding which specific shift patterns (e.g., 12-hour vs. 8-hour, rotating vs. fixed nights) had the most critical risk for burnout. It also highlighted a research gap concerning the role of occupational fatigue as a direct mechanism linking shift type to burnout and a scarcity of quantitative data from Saudi Arabia and the larger Middle East and North Africa (MENA) region. This gap provided the rationale for the accompanying journal paper, which aimed to investigate these relationships within a Saudi Arabian context. A cross-sectional quantitative design was employed. Data was collected using an online self-administered questionnaire that was designed to collect social demographic data, fatigue using the Three-Dimensional Work Fatigue Inventory (3D-WFI), and burnout using the Copenhagen Burnout Inventory (CBI). Of the 188 targeted nurses working at King Khalid Hospital in Saudi Arabia who were sent invitation emails, 148 of them returned a fully completed survey questionnaire. The findings showed that night shifts are significantly associated with the highest levels of fatigue, while burnout was linked to the morning and rotating shifts. Fatigue and burnout, as found in this study, are distinct phenomena driven by different mechanisms. Fatigue appears to be a primarily physiological response to circadian disruption inherent in night work. In contrast, burnout is more likely a psychosocial response to the high-demand, high-pressure organisational environment of daytime and rotating shifts. Shift-specific interventions should be tailored to meet each shift's needs, such as mitigating physiological fatigue for night staff and a separate approach to address the organisational stressors that cause burnout among day and rotating shift nurses.
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THE RELATIONSHIP BETWEEN BURNOUT, EMOTIONAL INTELLIGENCE, AND JOB SATISFACTION AMONG NURSE FACULTY IN SAUDI ARABIA
(Saudi Digital Library, 2025) Alotaibi, Megran H; Barnes, Hilary
Nurse faculty burnout is a prevalent issue worldwide that has played a significant role in increasing the likelihood of nursing staff shortage and low job satisfaction. It also may affect the quality of teaching and the personal lives of faculty members. Emotional intelligence and job satisfaction have been recognized as significant predictors of professional success in healthcare organizations, business, and education. However, there is a lack of research exploring relationship between nurse faculty burnout, emotional intelligence, and job satisfaction. Examining this relationship can provide valuable insights for developing interventions that enhance both nursing education and the nursing workforce. The purpose of this descriptive correlational study was to describe the level of Saudi Arabian faculty nurses’ burnout, emotional intelligence, and job satisfaction. Another purpose was to examine the relationship between burnout, emotional intelligence, and job satisfaction among nurse faculty members in Saudi Arabia. The study also explored the mediating role of emotional intelligence between nurse faculty burnout and job satisfaction. A convenience sample of 104 nurse faculty members employed in Saudi Arabia was used. Maslach’s Theory of Burnout and Mayer and Salovey’s Model of Emotional Intelligence guided this study. The findings indicated that nurse faculty in Saudi Arabia experienced moderate levels of burnout and job satisfaction. An inverse relationship was observed, with higher burnout associated with lower job satisfaction. Burnout was also identified as a predictor of job satisfaction. In addition, nurse faculty reported high levels of emotional intelligence, which were significantly related to both burnout and job satisfaction. Faculty with higher emotional intelligence tended to experience lower burnout and greater job satisfaction. The findings also indicated that emotional intelligence did not mediate the relationship between burnout and job satisfaction. The findings of the study have significant implications for the advancement of nursing science and research, education, practice, and nursing education leadership. The results add valuable knowledge to the existing body of literature on the current state of nurse faculty burnout, emotional intelligence, and job satisfaction. The findings of the study highlight the need to focus on addressing burnout and improving job satisfaction to prevent further declines. It is recommended to develop and implement evidence-based policies and procedures that reduce burnout, foster and sustain emotional intelligence, and enhance job satisfaction, thereby supporting faculty retention, high-quality nursing education, and positive student outcomes. Higher education institutions should use the high emotional intelligence of nurse faculty as a strength to enhance teaching effectiveness, promote faculty well-being, and guide future research directions.
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Emotional Intelligence Contributions and its Relation with Job Performance, Burnout among Nurses at king Khalid Civilian Hospital, Saudi Arabia
(Saudi Digital Library, 2025) alenazi, ayman; Sleem, Wafaa Fathi
Emotional intelligence (EI) plays a crucial role in the nursing profession, It represents a critical asset for nurses, contributing significantly to both job performance and the prevention of burnout. Aim: Tо assess emotional intelligence contributions and it's relation with job performance, burnout among nurses at King Khalid Civilian Hospital, Saudi Arabia. Method: A descriptive correlational design was used to achieve the aim of the study. The study included convenience sample of available staff nurses (n=133) working at all inpatient units during the time of data collection. Three tools were used to collect the data namely; Emotional Intelligence Scale, Observation Checklist Performance and Maslach Burnout Inventory. Results: the majority (88.7%) of studied nurses had high level of emotional intelligence contributions, the majority (93.2%) ofthem had excellent hob performance. In addition, the majority (94.7%) of studied nurses had low level of burnout, total emotional intelligence had statistically positive significant relation with total job performance, total emotional intelligence had statistically negative significant relation with burnout. Conclusion: El contributions improve the job performance of nurses and decrease nurse's burnout at King Khalid Civilian Hospital. Recommendations: Implementing regular self-reflection practices, such as journaling or mindfulness exercises, organizing training sessions focused on emotional intelligence skills, pursuing additional training and certifications to enhance your skills and knowledge, which can lead to improved confidence and job performance, conducting a comparative study of emotional intelligence levels among nurses in different specialties and its correlation with job performance and burnout.
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The Relationship between Burnout and Employee Outcomes: The Moderating Role of Performance Appraisal Satisfaction and Organisational Commitment
(Saudi Digital Library, 2025) Guzaiz, Doaa; Andrews, Rhys; Entwistle, Tom
Burnout in the workplace has increased over time across all industries and geographies. When employees experience burnout, they typically give in to psychological as well as physical strain, whereas the consequences for their organisations include higher rates of absenteeism and turnover. Faculty members working in universities are also susceptible to burnout and the challenges they encounter with regards to burnout are unique. To better understand the potential levers available to managers to address employee burnout, this study examines the relationship between burnout, organisational commitment (OC), and performance appraisal satisfaction (PAS) among faculty members of two public universities in Saudi Arabia and the effects that these factors have on job satisfaction and job performance. Drawing on Ability, Motivation and Opportunity framework and Job Demand-Resources model, a mixed method approach is employed utilising 213 survey responses and 23 semi-structured interviews. The results indicate that burnout is negatively related to job satisfaction, but that there is no relationship between burnout and job performance. Meanwhile, PAS is positively related to job satisfaction but is unrelated to job performance. By contrast, OC was found to be positively related to both job satisfaction and job performance. Importantly, PAS positively moderates the burnout-to-job satisfaction relationship, whereas it negatively moderates the burnout-to-job performance relationship. Similarly, OC had the effect of positively moderating the effect of burnout on job satisfaction but no effect on the burnout-to-job performance relationship. The responses received during the interviews suggested that performance appraisals fail to deliver enhanced performance in the workplace in the absence of appropriate penalties for individuals who underachieve and incentives for faculty members to outperform such as recognition and opportunities for professional development. The findings regarding the need for enhanced resources to mitigate burnout and enhance the job satisfaction and performance of faculty members will be of interest to higher education policymakers and to line managers.
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Mental Health of Paramedicine Students in the United Kingdom and the Kingdom of Saudi Arabia
(Saudi Digital Library, 2025) Alzahrani, Adnan Atiah; Johnson, Judith; Keyworth, Chris
Research has shown higher mental health concerns among healthcare students, with paramedicine students experiencing particularly high levels of psychological distress due to exposure to traumatic incidents, high-pressure training environments, and demanding clinical placements. Unlike other healthcare professions, paramedicine students often encounter potentially traumatic events early in their training, yet they frequently suffer in silence without seeking appropriate support. There is limited research on paramedicine student’ mental health, especially from cross-cultural perspectives, and insufficient understanding of how to improve their wellbeing. This thesis aimed to deepen the understanding of mental health challenges faced by paramedicine students. This thesis presents five studies examining paramedicine students from the Kingdom of Saudi Arabia (KSA) and the United Kingdom (UK). The first study was a systematic review and meta-analysis investigating the global prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) among paramedicine students. Building on these findings, the next two studies used semi-structured interviews to explore the causes of stress and poor wellbeing among paramedicine students (Study 2) and to investigate their preferences, barriers, and facilitators for accessing mental health support (Study 3). To quantify mental health outcomes and their predictors in cross-cultural settings, the fourth study used a cross-sectional survey design investigating burnout and depression rates, along with their associations with clinical experiences and psychosocial factors. The fifth study employed longitudinal survey methods to monitor changes in mental health outcomes over six months, examining how clinical exposure and perceptions of demand, control, and support influence wellbeing trajectories. Key findings This thesis revealed alarmingly high rates of mental health disorders among paramedicine students globally. The systematic review and meta-analysis (Study 1) found pooled prevalence rates of 56.4% for moderate anxiety, 34.7% for depression, and 17,9% for PTSD - all significantly higher than those reported among qualified paramedics and the general population. Regarding factors contributing to poor mental health, the cross-cultural qualitative analysis (Study 2) identified four key themes: exposure to potentially traumatic events during clinical placements; relationship and communication challenges with faculty, peers, and training supervisors; problematic programme atmosphere, including inadequate preparation and support; and career-related concerns about job prospects and professional acceptance. These themes were consistent across both cultural contexts, although with some variation in emphasis. The investigation of support preferences and access barriers (Study 3) revealed that students preferred tailored, culturally sensitive interventions rather than generic student support services. Three main preferences emerged: specialised support addressing paramedicine-specific challenges; privacy protection to safeguard academic and career prospects; and opportunities for peer socialisation and communication. Major barriers included mental health stigma from multiple sources, university environment factors, personal beliefs about help-seeking, operational challenges in accessing services, and concerns regarding professional competency assessments. The cross-sectional survey (Study 4) found significant differences between countries, with students from KSA reporting higher levels of depression but lower burnout scores compared to UK students. Clinical experiences, perceived psychological demands, and lower social support emerged as key predictors of poor mental health outcomes across both cultures. The longitudinal study (Study 5) indicated that mental health outcomes remained relatively stable over six months, with baseline scores being the strongest predictors of follow-up wellbeing. Nevertheless, perceived control and social support showed protective effects against mental health deterioration, while high psychological demands predicted poorer outcomes over time. Implications and conclusions This thesis demonstrates that paramedicine students face significant mental health challenges that exceed those of other healthcare student populations and qualified practitioners. The findings highlight the urgent need for specialised, culturally sensitive mental health interventions integrated into paramedicine curricula. Without targeted support addressing the unique stressors of paramedicine training - including early trauma exposure, demanding clinical environments, and professional identity development - these mental health issues may persist into professional practice, potentially impacting both practitioner wellbeing and patient care quality. The thesis offers the first comprehensive cross-cultural evidence base for developing evidence-informed interventions to support the mental health and wellbeing of this vital healthcare workforce during their formative training years
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An exploration of burnout in nurses working in intensive care in Saudi Arabia: An explanatory sequential mixed methods study
(Saudi Digital Library, 2025-06-30) Altokhais, Abdulmajeed Saad; Principal supervisor, Professor Melanie Greenwood, and co-supervisor Dr Russell James.
Nurses working in highly demanding and challenging environments, such as intensive care units, are prone to experiencing burnout compared to those in less demanding environments. In Saudi Arabia, the large number of nurses from other countries who work in intensive care contributes to the complexity of caring for critically ill people. Cultural complexity, high workloads and low morale may contribute to burnout in nurses, however how these factors affect nurse working in intensive care in Saudi Arabia is not well understood. Understanding these challenges, therefore, can help to mitigate burnout among nurses working in intensive care, improve patient outcomes, and assist recruitment and retention. This study aimed to investigate burnout among nurses working in the intensive care setting and to establish the factors which lead to burnout and which promote well-being and resilience among those nurses in Saudi Arabia. An explanatory sequential mixed methods design was used, and the data collection occurred across two phases. The first phase of the study sought to understand factors that contribute to nurses experiencing burnout. Paper-based questionnaires were distributed to nurses working in intensive care units across four tertiary hospitals in Riyadh, the capital of Saudia Arabia. The questionnaire contained two sections included the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS (MP)) scale used to explore the prevalence of burnout and the factors which contributed to the perception of burnout with the addition of participants’ demographic data and responses to the work characteristics questions. Data from the questionnaires were analysed using SPSS statistical software version 29. In Phase One, a total of 804 (80.4% response rate) nurses completed the questionnaire, with results indicating that more than half of the nurses experienced high levels of emotional exhaustion and depersonalisation, while more than half of those surveyed experienced moderate to low levels of personal accomplishment within the workplace. The analysis of demographic and work characteristic data, along with the MBI-HSS (MP) subscales, indicated that several factors may lead to burnout in nurses working within the intensive care setting. The demographic factors that contributed were gender, age, marital status, living arrangements, number of children, and nationality, while the work characteristics that contributed were work experience, type of intensive care, daily working hours, number of night shifts per month and number of patients per shift, attempts to maintain personal well-being, feeling stressed going to work, access to emotional support, feeling valued at work, salary satisfaction, and intention to leave. The findings from Phase One informed Phase Two, which used semi-structured interviews to delve deeper into and comprehend factors which led to nurses’ feelings of burnout and to identify their personal resilience against burnout. The interviews with consenting participants were undertaken online via Zoom or Microsoft Teams and analysed using a thematic analysis framework. In Phase Two, 20 semi-structured interviews were conducted with nurses who had completed the questionnaire and work in the intensive care setting. Three themes were identified from the thematic analysis: (i) “Being an intensive care nurse is challenging”; (ii) “The impact of the work upon me”; and (iii) “How I cope”. The first theme presented the nature of the work in intensive care settings in Saudi Arabia, highlighting the organisational challenges that participants encountered. The second theme reveals the physical, mental, psychosocial and professional impacts of working in intensive care in Saudi Arabia. The last theme captured the techniques participants used to cope with the challenges in the work environment. A pragmatic approach was used during data integration which influenced how this research was undertaken, presentation of the results and the structure of this thesis. Further, pragmatism helped explain the multiple realities that nurses encountered in their working environment in the intensive care setting in the cultural context of Saudi Arabia. The significant findings in this study are related to the unique cultural environment that exists in the nursing profession in Saudi Arabia and the interplay between the factors that contribute to and are protective against burnout. The contributing factors were the cultural and language challenges, which relied on nurses’ professional experience and adjustments to an altered scope of practice, and the protective factors, which included nurses’ capacity to build resilience, and how support systems created a complex dynamic that affected the participants’ performance and well-being. Whether nurses adapt or the environment adapts will be crucial in determining whether these nurses experience burnout or even leave the profession. Several recommendations stemming from this study are proposed to healthcare organisations, including policymakers, hospital leaders and nurse managers to improve work conditions in intensive care settings, which could potentially increase the adaptation to the work environment and, therefore, reduce burnout levels among nurses. In addition, it is crucial that stakeholders and hospital management understand the challenges that intensive care nurses encounter every day which impact their well-being as well as the quality of care. Policies and systems in hospitals, therefore, should be changed to help improve work conditions, which could potentially increase nurse retention and improve the quality of patient care.
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Stress and Burnout in Critical Care Nurses in Saudi Arabia: A Systematic Literature Review
(Queen's University Belfast, 2025-03) Aljohani, Abdulelah; Rice, Billiejoan
Background: Burnout is a significant occupational health problem in critical care nurses, particularly working in intensive care units and emergency departments. The intensive work of critical care, involving long shifts, high patient acuity, and emotional stress, is a contributing factor to burnout, impacting job satisfaction, patient care quality, and nursing staff turnover. In Saudi Arabia, regional health disparities, nursing shortages, and reliance on expatriate nurses add to the issue, requiring closer examination. Aim: The aim of this systematic review seeks to synthesise current evidence on risk factors and the prevalence for stress and burnout among critical care nurses in the Kingdom of Saudi Arabia. Methods: Systematic literature search was conducted by utilising PUBMED, CINAHL, and EMBASE databases. Inclusion was rigorous, and studies regarding the prevalence, risk factors, and Saudi Arabian critical care nurses’ exposure to burnout: a total of ten articles were included in the review. Meta-analyses were not feasible; thus, the results were synthesised narratively and categorised into two major categories: Levels of burnout and factors contributing to burnout. Results: There are high to moderate levels of burnout present in Critical care nurses, and there is regional variation between Riyadh, Makkah, and Jazan. Intensive care units’ nurses exhibited more emotional exhaustion, and emergency department nurses exhibited physical exhaustion as a result of workload intensity. There was added stress due to expatriate nurses, including uncertainty in jobs, cultural challenges, and language. Organisational factors, including shortages in staff, shift working, and rigid hospital hierarchies, also contributed to burnout. Conclusion: Burnout among Saudi Arabian critical care nurses’ is a serious workforce issue with direct effects on patient safety, healthcare efficiency, and retention. Addressing burnout requires policy changes, mental health support, and workforce reforms to improve nurse well-being and patient care. Future research should focus on longitudinal studies and intervention-based strategies for sustainable solutions.
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FACTORS PREDICTING TEACHER BURNOUT: THE MODERATION ROLE OF PERCEIVED SOCIAL SUPPORT
(Journal of Special Needs Education (NASE Malaysia), 0019-12-20) ALSAGOOR KHALID; Prof. Dr.Loh Sau Cheong
The terminal objectives of this study are to examine: the direct effects of stressors on teacher burnout and the moderation effects of social support on the relation between stressors and teacher burnout. A total sample of 202 special education teachers in the Kingdom of Saudi Arabia completed a 68-item digital countrywide survey questionnaire delivered through email to all special education teachers. For current study, hypotheses were tested based on structural equation modelling (SEM). Results revealed that: (1) role overload had shown significant direct effects on the three dimensions of teacher burnout; (2) role ambiguity had shown significant direct effects on the three dimensions of teacher burnout; (3) role conflict had shown significant direct effects on depersonalization and decreased personal accomplishment; (4) no moderation effect for social support on the relationship between stressors and the three dimensions of teacher burnout.
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FACTORS PREDICTING BURNOUT OF SPECIAL EDUCATION TEACHERS IN THE KINGDOM OF SAUDI ARABIA
(Universiti Malaya, 2024) ALSAGOOR, KHALID; Cheong, Loh Sau
Teacher burnout affects student achievement and imposes financial burdens on districts and states. This study explores factors predicting burnout, focusing on direct effects of role ambiguity, conflict, and work overload, as well as indirect effects via affective organizational commitment and teaching satisfaction. Additionally, it examines moderating effects of perceived social and supervisor support. A sample of 414 special education teachers in Saudi Arabia completed the Maslach Burnout Inventory and scales for various stressors and supports. Structural Equation Modeling (SEM) using AMOS revealed that: (1) role overload had a significant direct effect on emotional exhaustion (β = 0.389, t = 5.184, P < 0.01), reduced personal accomplishment (β = 0.211, t = 3.797, P < 0.01), depersonalization (β = -0.161, t = -3.392, P < 0.01), and total burnout (β = 0.173, t = 5.828, P < 0.01); (2) role conflict was directly related to decreased accomplishment (β = 0.350, t = 4.194, P < 0.01) and total burnout (β = 0.135, t = 3.465, P < 0.01); (3) role ambiguity affected emotional exhaustion (β = 0.230, t = 4.506, P < 0.01), reduced accomplishment (β = 0.305, t = 3.862, P < 0.01), depersonalization (β = 0.137, t = 2.738, P < 0.01), and total burnout (β = 0.271, t = 7.045, P < 0.01); (4) teacher satisfaction mediated the impact of role overload on emotional exhaustion (β = 0.103, t = 2.573, p < 0.05); (5) affective organizational commitment facilitated the effects of role overload on emotional exhaustion (β = 0.143, t = 2.367, p < 0.05), role conflict on burnout (β = 0.204, t = 6.811, p < 0.05), and role ambiguity on total burnout (β = 0.316, t = 2.715, p < 0.05); (6) perceived social support moderated the effects of stressors on burnout components, such as reducing role overload’s impact on emotional exhaustion (β = -0.226, t = -7.500, p < 0.01); and (7) supervisor support moderated effects of role overload on burnout components, like reducing its impact on emotional exhaustion (β = -0.256, t = -8.868, p < 0.01). These findings suggest that enhancing teaching satisfaction and commitment could mitigate burnout, adding theoretical insights into stressors–burnout relationships among special education teachers in Saudi Arabia.
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Intensive Care Nurses' Experiences of Burnout During the COVID-19 Pandemic in Saudi Arabia: A Constructivist Grounded Theory Study
(King's College London, 2024) Alzailai, Nawal; Xyrichis, Andreas; Barriball, Louise
Background: Burnout amongst healthcare staff, particularly amongst intensive care unit (ICU) nurses, is a critical issue that intensified during the COVID-19 pandemic. Previous research, especially within the Saudi context, has identified significant levels of burnout in ICU nurses. However, a notable gap exists in the use of qualitative methodologies to deepen our understanding of ICU nurses’ burnout in the Saudi context. Moreover, comprehending the experiences of nurses who suffered from burnout during the pandemic, focusing on the factors that contributed to their stress, has been essential for identifying developmental needs and for shaping interventions aimed at mitigating burnout amongst nurses. Despite this, the existing literature lacks a reliable theory or model that adequately captures the phenomenon of burnout within highly demanding environments like ICUs, particularly under the unpredictable and greatly challenging circumstances of disasters. Aim: To construct a theory grounded in burnout experiences of ICU nurses in Saudi Arabia during the COVID-19 pandemic, intended to act as a foundation for future research that explores burnout in high-stress environments for nurses or other healthcare staff working in similar contexts. Methods: Building from one scoping review and one systematic review, a constructivist grounded theory design was employed for this study, as proposed by Charmaz (2014a). Conducted in four distinct adult ICU departments of a tertiary hospital in Saudi Arabia, the research involved 22 ICU nurses experienced in caring for COVID-19 patients and 10 decision-makers, recruited through initial purposive sampling and subsequent theoretical sampling until theoretical saturation was reached. Data were collected through semi-structured, in-depth interviews. Field notes and a reflexive methodological journal were maintained throughout the research process. Interviews were transcribed verbatim and translated into English where necessary. The analysis followed “Charmazian” principles, which include initial, focused and theoretical coding; constant comparison; theoretical sampling and sensitivity; memo writing; and diagramming. Ethical approval was secured from King’s College London and from the relevant Institutional Review Board in Saudi Arabia. Results: The theory generated by this investigation suggests burnout is a process, resulting from multiple interrelated factors within and beyond an individual’s working environment. This process occurs in three dynamic stages affected by the coping and supportive resources that the nurse has used/received. The core category that emerged, ‘we fought and now we need to be healed’, encapsulates the essence of the nurses’ experiences with perceived burnout and their vital need for recovery and support. This finding led to the development of the BuRN-ICU19 model, a comprehensive framework representing the ICU nurses’ experiences with burnout during the COVID-19 pandemic and informed by results from two fundamental reviews: a scoping review and a systematic review. Conclusion: This thesis offers novel insights into the experiences of burnout among ICU nurses in Saudi Arabia during a disaster situation. It highlights the critical need for targeted interventions and policy reforms to alleviate burnout in, improve the well-being of and effectively support ICU nurses in demanding situations. The BuRN-ICU19 model presents a valuable framework for future research and practical application in ICU nursing, with potential implications extending beyond the Saudi context.
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