Association of cumulative job dissatisfaction with depression, anxiety and stress among expatriate nurses in Saudi Arabia

Aims We aimed to (a) determine the prevalence of depression, anxiety and stress among expatriate nurses in Saudi Arabia, and (b) assess how dissatisfaction with salary, workload and teamwork, individually and in combination, was associated with those conditions. Background Prevalence estimates for depression, anxiety and stress among nurses are higher than those in the general population. Available data on the mental health of expatriate nurses are limited. Methods Expatriate nurses (n = 977) from governmental hospitals completed an electronic survey on demography, lifestyle, job factors, depression, anxiety and stress (assessed with DASS-21 scale). Multinomial logistic regressions were used for analyses. Results Dissatisfaction with workload and teamwork was significantly associated with both mild/moderate and severe depression in adjusted models. Dissatisfaction with workload was significantly associated with both anxiety and stress, but teamwork was not. There was a significant dose-response relationship between the number of domains of dissatisfaction and depression, anxiety and stress (p for trend was < 0.001). Conclusions Dissatisfaction with salary, workload and teamwork is associated with depression, anxiety and stress in expatriate nurses. Implications for Nursing Management Hospital and nursing administrators should identify specific aspects related to workload and teamwork and offer solutions to reduce mental health distress among nurses.