The study encompassed 502 adult Saudis: 106 males (21.1%) and 396 females (78.9%), their mean age was 22.93 ± 6.76 with a median of 20 years. The majority were unmarried (80.3%). Overall, 74.3 % were at university level of education or higher, out of the 106 males,70 (66.0%) were at university level of education or higher, while out of 396 females, 303 (76.5%) were at university education or higher (Table1). In general, 81.5 % preferred female nurses, while only 32.5 % preferred Saudis to provide nursing care. Among those who experienced Saudi caregivers, only 40.8% rated the service as excellent. Less than half of male participants reported that they would marry a nurse, and as much as 71% of the total sample would be ashamed if they have a nurse in their family (Table 2).
Table 1. Distribution of the study sample according to socio-demographic characteristics
Sociodemographic characteristics, n = 502
|
Frequency
|
%
|
Sex
|
Male
|
106
|
21.1
|
Female
|
396
|
78.9
|
Age in years
|
15-
|
166
|
33.1
|
20-
|
223
|
44.4
|
25+
|
113
|
22.5
|
Mean ± SD
|
22.9 ± 6.8
|
Marital status
|
Married
|
99
|
19.7
|
Unmarried
|
403
|
80.3
|
Education
|
Below secondary
|
23
|
4.6
|
Secondary (High school)
|
106
|
21.1
|
* University or higher
|
373
|
74.3
|
House
|
Private
|
352
|
70.1
|
Rented
|
150
|
29.9
|
Female nurse in the family
|
Yes
|
149
|
29.7
|
No
|
353
|
70.3
|
SD: Standard deviation.
University or higher: Enrolled or completed their degrees.
* Out of the 106 males,70 (66.0%) were at university level of education or higher, while out of 396 females, 303 (76.5%) were at university level of education or higher.
Table 2. Preferences of nursing care and stigma of the nursing profession (N = 502)
Question
|
Response
|
Frequency
|
%
|
Preference of care giver according to gender
|
Male nurse
|
93
|
18.5
|
Female nurse
|
409
|
81.5
|
Preference of care giver according to nationality
|
Saudi
|
163
|
32.5
|
Non-Saudi
|
102
|
20.3
|
Never mind
|
237
|
47.2
|
Getting care by Saudi females
|
Yes
|
299
|
59.6
|
No
|
203
|
40.4
|
Rating of Saudi female nursing care*
|
Excellent
|
122
|
40.8
|
Very good
|
112
|
37.5
|
Good
|
55
|
18.4
|
Bad
|
10
|
3.3
|
Stigma of nursing
(ashamed to have a nurse in my family)
|
Strongly agree
|
246
|
49.0
|
Agree
|
113
|
22.5
|
Neutral
|
84
|
16.7
|
Disagree
|
36
|
7.2
|
Strongly disagree
|
23
|
4.6
|
Preference to marry a female nurse**
|
Yes
|
46
|
43.4
|
No
|
60
|
56.6
|
*Asked to those who received care by Saudi female nurses (299) **Asked to males only.
Regarding awareness about the nursing profession, Table 3 shows that 61% of participants considered nursing as subordinate to physicians. Moreover, as much as 68.9% were unaware that nurses could achieve higher managerial positions, and about one-third of participants were unaware about the title of graduates from nursing collegiate programs. Additionally, participants demonstrated lack of knowledge concerning the length of time required to acquire a bachelor degree in nursing. In total, the median awareness score was only 50.0%, meaning that, half of participants scored less than 50.0% of the total score of 100%.
Table 3. Awareness about the nursing profession (N = 502)
Knowledge Item
|
|
Frequency
|
%
|
Nursing duties
|
Provide medical care, follow-up and health education
|
196
|
39.0
|
Complementary to physician
|
306
|
61.0
|
Job title of graduates of nursing programs below bachelor
|
Nurse specialist
|
67
|
13.3
|
Technical nurse
|
249
|
49.6
|
Don't know
|
186
|
37.1
|
Job title of graduates of bachelor program
|
Nurse specialist
|
286
|
57.0
|
Technical nurse
|
52
|
10.4
|
Don't know
|
164
|
32.7
|
Duration of bachelor’s degree (Including internship)
|
Two years
|
22
|
4.4
|
Three
|
54
|
10.8
|
Four
|
97
|
19.3
|
Five
|
152
|
30.3
|
Don't know
|
177
|
35.3
|
Nursing has several specialties
|
Yes
|
387
|
77.1
|
No
|
115
|
22.9
|
A nurse can be promoted to a hospital manager
|
Yes
|
156
|
31.1
|
No
|
346
|
68.9
|
*Median score as percentage of the total score, (IQR)
|
50.0, (50.0 - 66.7)
|
IQR: Inter-quartile-range (Q1 – Q3).
* Score range 0-6 (0-100%), higher score indicates better knowledge.
The median score of perceived barriers of the nursing profession was 51.85% of the maximum score. Differences in Language, and culture were perceived as barriers to get engaged in the nursing profession by 12% and 31.7% respectively. More than one third participants reported that gender-mixed working environment is a barrier for nursing practice, and about one-fifth consider that being a female nurse will delay marriage. In addition, 64.5% of participants claim that nursing profession affects female social life negatively (Table 4).
Table 4: Perceived barriers of public to engagement in the nursing profession, n = 502
Perceived barriers
|
Strongly agree
|
Agree
|
Neutral
|
Disagree
|
Strongly disagree
|
Freq.
|
%
|
Freq.
|
%
|
Freq.
|
%
|
Freq.
|
%
|
Freq.
|
%
|
Communication with different language
|
9
|
1.8
|
51
|
10.2
|
100
|
19.9
|
148
|
29.5
|
194
|
38.6
|
Communication with different culture
|
45
|
9.0
|
114
|
22.7
|
121
|
24.1
|
109
|
21.7
|
113
|
22.5
|
Being Saudi is viewed as a skilled nurse*
|
9
|
1.8
|
32
|
6.4
|
179
|
35.7
|
150
|
29.9
|
132
|
26.3
|
Poor public image of nursing profession
|
43
|
8.6
|
54
|
10.8
|
74
|
14.7
|
161
|
32.1
|
170
|
33.9
|
Mixed working environment
|
60
|
12.0
|
120
|
23.9
|
55
|
11.0
|
118
|
23.5
|
149
|
29.7
|
Delayed marriage of a female nurse
|
35
|
7.0
|
67
|
13.3
|
107
|
21.3
|
150
|
29.9
|
143
|
28.5
|
Nursing profession affects female social life
|
Extremely
|
Moderately
|
Marginally
|
Not at all
|
84
|
16.7
|
240
|
47.8
|
128
|
25.5
|
50
|
10.0
|
**Median score as percentage of the total, (IQR)
|
51.85, (44.44 - 59.26)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Freq: Frequency
IQR: Interquartile range (Q1 -Q3) *Reverse score order **Score range 0-27 (0-100%).
Table 5 demonstrates factors associated with awareness and perceived barriers regarding the nursing profession. Higher level of education, having a nurse in the family, and marriage are associated with a higher awareness score. The perceived barrier score was higher among more educated individuals: 55.6%, 51.9%, and 48.2% for graduates of high school, university versus those who just can read and write respectively. Of note, the perceived barrier score was higher among those having a nurse in the family.
Table 5. Association between sociodemographic characteristics, awareness and perceived barriers of the nursing profession (N = 502)
Sample characteristics
|
Awareness
|
Perceived barriers
|
Median
(IQR)
|
Pf
|
Median
(IQR)
|
Pf
|
Gender
|
Male
|
66.7
(50.0-83.3)
|
0.126
|
51.9
(44.4-59.3)
|
0.863
|
|
Female
|
50.0
(50.0-66.7)
|
51.9
(44.4-59.3)
|
Age in years
|
15-
|
50.0
(33.3-66.7)
|
0.069
|
51.9
(44.4-59.3)
|
0.881
|
|
20-
|
50.0
(50.0-66.7)
|
51.9
(44.4-59.3)
|
|
25+
|
66.7
(50.0-83.3)
|
51.9
(44.4-59.3)
|
Marital status
|
Married
|
66.7
(50.0-83.3)
|
0.001*
|
51.9
(44.4-59.3)
|
0.225
|
|
Unmarried
|
50.0
(33.3-66.7)
|
51.9
(44.4-59.3)
|
Education
|
Read & write
|
50.0
(33.3-66.7)
|
0.001*§
|
48.2
(48.2-59.3)
|
0.043*¥
|
|
High school
|
50.0
(33.3-66.7)
|
55.6
(48.2-63.0)
|
|
University and higher
|
66.7
(50.0-66.7)
|
51.9
(44.4-59.3)
|
House
|
Private
|
50.0
(50.0-66.7)
|
0.541
|
51.9
(44.4-59.3)
|
0.704
|
|
Rented
|
66.7
(33.3-66.7)
|
51.9
(44.4-59.3)
|
Female nurse in the family
|
Yes
|
66.7
(50.0-66.7)
|
0.046*
|
55.6
(48.2-63.0)
|
0.032*
|
No
|
50.0
(33.3-66.7)
|
51.9
(44.4-59.3)
|
f Mann-Whitney test for two groups and Kruskal-Wallis test for more than two groups
*P < 0.05 (Significant), IQR: Interquartile range (Q1 -Q3)
§ Post-hoc test indicated significant difference between University & higher versus Read & write
¥ Post-hoc test indicated significant difference between University & higher versus High school.
Table 6 shows that the unmarried and the lower educational levels were mor likely to have poor knowledge. Those without a nurse family member had lower perceived barriers of nursing profession (AOR = 0.661, 95% CI: 0.443-0.985) while those who just read and write had higher perceived barriers (AOR = 1.679, 95% CI:1.062 – 2.655) compared to the highly educated respondents.
Table 6. Multiple stepwise logistic regression analysis of possible factors in relation to awareness and perceived barriers of the nursing profession (N = 502)
Sample characteristics
|
Awareness
|
Perceived barriers
|
AOR
95% CI
|
AOR
95% CI
|
Marital status
|
Married
|
1
|
|
|
Unmarried
|
1.99
1.10 – 3.61
|
|
Education
|
Read & write
|
2.74
1.15 – 6.51
|
1.68
1.062 – 2.66
|
|
High school
|
1.81
1.12 – 2.92
|
|
|
University and higher
|
1
|
1
|
Female nurse in the family
|
Yes
|
|
1
|
No
|
|
0.66
0.44 – 0.99
|
Dependent variables; Perceived barriers (≤ median = 0, >median =1), Knowledge (Below median=1, Median or above =0)
AOR = adjusted odds ratio CI = confidence interval