Exploring wellbeing and its influencing factors among nursing students in Saudi Arabia

Abstract

Nursing students may experience high levels of stress and psychological burden, which affects their wellbeing. In the Saudi Arabian context, existing evidence suggests these levels exceed those reported by their international counterparts. Despite this, limited research has explored how wellbeing is understood and experienced by nursing students within the unique cultural and academic environment of Saudi Arabia. Gaining a deeper understanding of students’ wellbeing and the factors that influence it is essential for developing effective strategies that support their academic success and overall health. This will ultimately contribute to improved outcomes for these future nurses and their patients in the healthcare system. The overarching aim of this study was to explore wellbeing and its influencing factors among nursing students in Saudi Arabia. A multi-method research design was adopted in two separate stages. The quantitative stage involved a cross-sectional survey of undergraduate nursing students (n = 307), using validated instruments to measure general wellbeing, academic wellbeing, and resilience. Descriptive and inferential statistics were used to assess the current state of these variables and their associations with demographic factors. In the qualitative stage, semi-structured interviews were conducted with 12 nursing students to gain an in-depth understanding of the factors influencing their wellbeing. The qualitative data were analysed thematically using Braun and Clarke’s approach. A total of 307 nursing students completed the quantitative survey, with a response rate of 93%. The mean scores for general wellbeing, academic wellbeing, and resilience were 70 ± 2.33, 76 ± 13.4, and 19 ± 6 respectively, indicating moderate to high levels overall. Among the demographic variables, gender and family income were found to significantly influence nursing students’ wellbeing. Female students scored slightly higher on academic wellbeing (ß = 3.17, p < 0.01) and slightly lower on resilience (ß = -1.18, p = 0.05) compared to male students. Additionally, students from families with moderate income reported significantly higher general wellbeing scores compared to those with low income (ß = 3.71, p = 0.02). The qualitative findings revealed that students perceived wellbeing as a state of “stress-free living”, “strong family connections” ,“finding joy and happiness”, “living with a sense of purpose”, “having good health”, and “living in a nurturing environment”. The factors influencing their wellbeing were organised into three overarching themes: individual factors, social factors, and environmental-educational factors. This thesis brings new knowledge to the field of nursing education by offering the first in-depth exploration of how nursing students in Saudi Arabia understand and experience wellbeing. Through a multi-method approach, it has established baseline data on general, academic, and psychological wellbeing, while also uncovering the unique, culturally embedded ways in which students define and pursue wellbeing. Notably, the study identified key influences, including family, peers, and educators, that operate in both supportive and detrimental ways, revealing complexities not captured in widely used Western models, for example, PERMA or the Dynamic Model for Wellbeing.