Mental Health Status of Expatriate Nurses in Northcentral Saudi Arabia


Mental health status may vary by nationality among expatriate workers; no conclusive data is available in Saudi Arabia. We invited expatriate nurses employed in governmental hospitals in Al-Qassim, Saudi Arabia to fill out an electronic survey that contained questions on demography (including nationality), lifestyle, job, depression, anxiety, and stress (assessed with DASS-21 scale). We categorized each outcome into normal, mild to moderate, and severe, and used adjusted multinomial logistic regressions for analyses. Nurses (n = 999) were from India (54.1%), the Philippines/Indonesia (37.0%), Pakistan (4.9%) and Arab countries (4.0%). Indian nurses were three times (OR = 2.93; 95% CI 1.84, 4.67), Pakistani nurses were 2.5 times (OR = 2.54; 95% CI 1.07, 6.00), and Arab nurses were five times (OR = 5.65; 95% CI 2.40–13.31) more likely to suffer from severe depression compared to Filipino/Indonesian nurses (reference group). Results were similar for stress. Depression and stress varied significantly by nationality among expatriate nurses.

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The authors thank the administrators and the staff of General Directorate of Ministry of Health in the Al-Qassim region for facilitating the distribution of this survey to nurses working in the hospitals. We are also grateful to the nurses who took the time to participate in this study. The authors thank Ms. Erin Strotheide for her editorial contributions to this manuscript.


This study was funded by the Deanship of Research at Qassim University, but it had no involvement in the collection, analysis or interpretation of data, in the writing of the report, or in the decision to submit the article for publication.

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Correspondence to Nazmus Saquib.

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This study was approved by the Qassim Ethics Research Committee.

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Zaghloul, M.S., Saquib, J., AlMazrou, A. et al. Mental Health Status of Expatriate Nurses in Northcentral Saudi Arabia. J Immigrant Minority Health 21, 1233–1240 (2019).

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  • Depression
  • Anxiety
  • Stress
  • Nationality
  • Nurses
  • Saudi Arabia