Work adjustment amongst expatriate and local nurses in Kuwait : a comparative investigation using the JD-R model

This study examines the work adjustment of expatriate nurses working in the healthcare sector from a developed country perspective. The central aim of this study is to focus on the relationship between job demands, job resources, burnout, engagement and work adjustment among expatriate nurses, and to identify the predictors affecting their work adjustment and engagement. With specific reference to public general hospitals in Kuwait, in which expatriate nurses are employed alongside locals, the study investigates the ways in which the job demand-resource (JD-R) model is applicable to the study of expatriate nurses, as well as whether the job demands and resources of expatriate nurses is different from that for local ones. Although the JD-R model, in recent years has received a lot of attention from scholars and practitioners, still there is a gap in the literature regarding its application in an international work context. Only a few studies have so far examined the link between the JD-R model and expatriate work adjustment. The study employed a systematic literature review. On this understanding of the purpose of this study, a literature review was undertaken. Given this deficit in the literature, the aim of this study is to make a theoretical contribution to how the JD-R model can be applied to analysing and understanding work adjustment in the international work context through conducting a comparative-empirical study of the expatriate and local nurse workforces. In order to achieve this, the study employed exploratory sequential mixed methods. For the qualitative study, non-probability purposive sampling (n = 25) was administered at five public general hospitals in the state of Kuwait. For the quantitative study, a cross sectional questionnaire was administered by registered nurses (n =537) working on different wards in five public general hospitals in Kuwait. The findings of this study confirm that the framework can indeed successfully be applied to examine the job Demands-Resource model and work adjustment of the expatriate nurse workforce. Several differences were found between the local and expatriate nurses' perceptions regarding their job demands, resources and work adjustment. Also, the study found that the mediation model made the main contribution. This is a new interpretation and understanding of how the variables related to job demands and job resources are mediated by and related to work adjustment. The findings of this study suggest a distinct need for future investigation to explore whether the model can be applied to other workforces involving healthcare professionals or other occupational sectors to see its transferability. From a practitioner's perspective, Job Demand Resource model provides a deeper insight into how job demands and resources lead to burnout and excessive work engagement, enabling practitioners to incorporate these factors in ways which fosters a congenial work environment; yet, these findings must be treated with caution. Overall, the study encompasses several theoretical, empirical and practical contributions to the field.