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Individual Needs and Psychological Safety of Nurses in Saudi Arabia

Year: 2024
Type: dissertation
Abstract: ABSTRACTJumanah A. Almusajin: Individual Needs and Psychological Safety of Nurses in Saudi Arabia(Under the direction of Dr. Mary R. Lynn) Background: Saudi Arabia, like many other countries, is facing a critical nursing shortage accompanied by high rates of turnover (Aboshaiqah, 2016). One of several reasons that nurses turnover is because of their unmet professional needs (Albougami et al., 2020; Falatah & Conway, 2019; Falatah & Salem, 2018). Researchers have reported the concept of ‘psychological safety’ as a predictor of employee turnover (Groh, 2019; Kirk-Brown & Van Dijk, 2016; Liu et al., 2017). However, few studies have specifically investigated nurses’ needs and psychological safety as predictors of turnover intention, and no relevant studies are available at all for the Saudi Arabian context. Hence, to fill gaps in the literature, this dissertation aims to investigate nurses’ individual, environmental, and occupational needs as well as psychological safety (and its antecedent factors) as predictors of turnover intention among nurses at two public hospitals in the eastern province of Saudi Arabia.Methods: This dissertation comprises three publishable manuscripts. The first manuscript is an integrative literature review of nurses’ needs and expectations within the work environment. The second manuscript describes a prospective qualitative study that involved semi-structured interviews with 29 registered nurses at two public hospitals in the eastern province of Saudi Arabia to investigate nurses’ needs. Guided by the Person-Environment-Occupation model, framework analysis was conducted to analyze the data. The third manuscript reports a primary study in which descriptive statistical analysis of survey data was conducted to examine nurses’ level of psychological safety. Pearson correlation coefficients were used to examine the relationships between two independent variables (‘team leader coaching’ and ‘supportiveness of the organization’) and the dependent variable, psychological safety. Multiple linear regression was performed to examine whether (1) team leader coaching and supportiveness of the organization when combined act as significant predictors of psychological safety, (2) psychological safety predicts turnover intention among nurses, and (3) team leader coaching, supportiveness of the organization, and psychological safety individually or in combination predict turnover intention among nurses.Results: The integrative literature review (Manuscript 1) highlights the individual and professional needs of a general population of nurses in different countries. It also sheds light on the unique needs of newly graduated registered nurses and overseas qualified nurses. In general, nurses indicated the need for training and educational opportunities, recognition, involvement in decision-making, fairness, support, a balanced workload, respect, autonomy, work-life balance, higher pay, and a feeling of belonging. The qualitative study (Manuscript 2) focused on providing insights in three themes of nurses’ needs: individual, environmental, and occupational needs. A key finding from the quantitative study (Manuscript 3) is the low level of psychological safety perceived by nurses in Saudi Arabia. Also, a strong positive relationship was found among team leader coaching and supportiveness of the organization, and psychological safety. Team leader coaching (b = .419, p = < .001) and supportiveness of the organization (b = .316, p = < .001) significantly predicted psychological safety (R2 = .463, F = (2,181) = 77.98, p < .001), and psychological safety significantly predicted turnover intention (b = -.591, R2 = .35, p = < .001). In addition, team leader coaching, supportiveness of the organization, and psychological safety predicted nurses’ turnover intention.Conclusion: This study contributes to the body of knowledge about nurse turnover. In particular, nurses’ individual, environmental, and occupational needs as well as their perceptions of psychological safety as a predictor of nurse turnover intention are key findings. Team leader coaching and supportiveness of organization context were found to affect nurses’ level of psychological safety, which in turn influences nurses’ turnover intention. Developing strategies that address nurses’ needs and improve their level of psychological safety would improve nurses’ work experiences and reduce turnover. The work presented in this dissertation can serve as a guide for nurse managers/leaders and healthcare administrators in developing strategies and interventions to enhance nurse retention.
DOI: 10.17615/d7pq-6m77
Language: English
Field: Nursing
Open Access status: green
OpenAlex ID: W6925279359
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