



































 

 
 

Relationship of Quality of Life, Resilience, and Associated Factors 
Among Emergency Nurses During Covid-19 

in Saudi Arabia 
 

NOOF KHELIF ALANEZI 
 

Nursing Service Department Sharaf Hospital, Hail City E- mail: 
nkalanezi@moh.gov.sa 

 

Abstract 

Background: The COVID-19 pandemic made a lot of effects in the people 

life during 2020, plus of this it corresponding to a lot of bad 

consequences results in increasing of death. While in the medical field 

nursing had effected by this pandemic in their quality of life and all of 

activities.  

Propose:This study was conducted at King Khalid Hospital (KKH) in 

Saudi Arabia.to determine the relationship between quality of life, 

resilience, and associated factors among ED nurses during COVID-19 

pandemic.  

Methods:The study sample consisted of (77) nurses working in KKH who 

are available during the period of the study. The data was collected by 

using a questionnaire design for the study of nursing demographic data 

and a cross-sectional, descriptive survey design for nurse regarding to 

tool included QOL, resilience scales tool included QOL, resilience 

scales.Data were analyzed using Statistical Packages for Social Sciences 

(SPSS) (Version 20) presented in tables and figures.  

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mailto:nkalanezi@moh.gov.sa


 

 
 

Results: The study showed thatseventy-seven working nurses completed 

survey with a score of 98.7%. The majority (n = 77, 98.7%) were 

between 24 and 54 years old, and the mean years of work experience 

was 13 (SD= 0.817). There was only Few of the male nurses 7.7 %( n 

= 6) respondents. The correlation of the environment (r=0.43, P<0.035) 

(M=27.1) and Psychological factors was (0510, P<0.003) (M=20.3) was 

high. While when comparing the scores of qualities of life of ED nurses 

in the other factors like social (M= 10.6) were low among ED nurses. We 

found a poor score of QOL by 38% and poor resilience by 11.3%. 

Conclusion: on light of the study results it can be concluded that 

resilience was the strongest factor and its related to quality of life among 

daily activities  

recommendation: The study recommended that emphasis should be 

placed on comparing with pre-pandemic data or tracking developments 

during the pandemic. 

Keywords: COVID-19; ED nurses; quality of life; resilience; Saudi Arabia. 

1. Introduction  

The Corona Virus in December- 2019(COVID-19) pandemic made a lot of 

effects in the people life during 2020, plus of this it corresponding to a 

lot of bad consequences results in increasing of death .while in the 

medical field nursing had effected by this pandemic in their quality of life 

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and all of activities (1). A lot of psychological situations appear among 

health care stuff such as worry of infection, tension and pressure 

disorders(2). Resilience has a big role in improving the healthcare 

systems. Resilience is defined as a person's ability to generate many 

new and unconventional ideas, and it expresses the fluidity of his 

thoughts and his ability to change them to suit and adapt to different and 

emergency situations he faces. It also means the extent to which 

individuals absorb and accept new ideas according to changing 

circumstances and multiple perspectives (3). The quality of life (QOL) and 

the Resilience are very important for the individual to continue to work, 

so that the individual has the best production, and is successful in their 

work, and for successful professional adaptation more than one direction, 

the individual must adapt first with himself and then adapt to the work 

environment and conditions and adapt with colleagues and employers(4). 

Individuals as they provide strategies for coping and awareness of 

variables such as sequins and a diversion of positive feeling and support 

for psychological hardness to strengthen resilience (5). According to (5) 

“rigidity, also called 'temporary resilience' is a personality pattern 

associated with resilience, good health, and performance under stressful 

conditions", which can predict individuals' adaptation to stressful and 

traumatic events. During the eighties, the scientist kolbas developed the 

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concept of flexibility to create a method that faces pressures, stress and 

hardship at work and protects from various emerging symptoms. The 

main parts of this method consist of three methods: flexibility, challenges, 

and boldness that produce the ability to use resources, improve recovery 

ability and enhance positive performance (6). (7)show that Boldness is the 

attitudes that constitute courage and motivation to deal with stressful 

events. Nurses have faced a lot of pressures such as teaching, research, 

and also community management. Therefore, toughness represents a 

personal trait that predicts health and performance (7). Studies have 

confirmed that this will affect the quality of life and consequently the 

ability of nurses to be flexible and lead to leaving the environment. 

Academic and work, where nursing is the main engine and the beating 

heart of any health institution, and accordingly (8). 

Personal and professional changes alter the quality of life and 

consequently affect resilience and exposure to anxiety and turmoil, as in 

Taiwan, where the study indicated that nurses have the ability to adapt 

and balance with the demands of work and life and identify strategies to 

maintain a healthy quality of life where nurses faced the emerging 

challenges of demand for education, support students their educational 

needs during the unprecedented COVID-19 pandemic and the 

requirements for social distancing(1).Quality of life is a measure of life 

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experiences that are determined by happiness and satisfaction. Individuals 

can  also  be  supported  and  encouraged,  and  standards  developed  for  a 

sense  of  awareness,  health  promotion,  well-being  and  the  required

flexibility (6). (9) found  that  the  overall  level  of  fine  of  life  among  nursing 

become slight (mean = one hundred sixty five; SD = 26.eight). Bivariate 

analysis  showed  that  non-Saudi  nationality,  older  age,  more  paintings 

experience,  marital  popularity,  full-time  employment,  rotating  shift  and 

specialized  devices  had  been  massive  elements  contributing  to  higher 

QOL ratings (p < .05). A total of 290 healthcare professionals responded 

to  the  survey.  The  mean  overall  quality  of  life  score  was  3.37  ±  0.97,

general  health =  3.66  ±  0.88,  domains,  i.e.  physical  =  11.67  ±  2.16,

psychological = 13.08 ± 2.14, social = 13.22 ± 3.31, and environment =

12.38  ±  2.59. Respondents over  40  years  of  age,  male  gender,  married 

status,  being  a  physician,  having  work  experience  >15  years  and  no 

overtime  had  higher  imply  ratings  in  numerous  areas  of  pleasant  of  life

(QOL), and standard QOL, and widespread health  (p < zero.05) (10). (11)

found  extra  than  a  third  of  nurses  members  (n  =  127;  36.6%)  revel  in 

burnout.  guys  had  better  best-of-lifestyles  scores  than  women  within  the 

areas  of  bodily  health  (p  =  0.001;  d  <  0.five),  mental  (p  =  0.001;  d  <

zero.five) and social relationships (p = zero.048; d < zero.five). girls had 

been more fatigued than guys (p = 0.001; d < 0.five). Flexibility, online revel



 

 
 

in, and an amazing aptitude for online gaining knowledge of have been related to each 

area of QOL. Remarkably, 21% to 54% of nursing students' QOL ratings indicated 

terrible high-quality of existence. Also Elasticity changed into the strongest predictor of 

each domain of QOL. The nursing nurses who have suggested improved great of 

existence are those who've been capable of adapt to the changes and demanding 

situations imposed during the COVID-19 pandemic. Resilience had a fantastic and direct 

effect at the university of Nursing and QOL students. Having a workspace at domestic 

and being nicely prepared for on-line studying had advantageous indirect outcomes on 

great of life, through flexibility (12). Thus, this study amied todetermine the 

relationship between quality of life, resilience, and associated factors 

among ED nurses during COVID-19 pandemic. 

2. Metods  

2.1. Methods and dezin 

A This examine used a cross-sectional, descriptive survey design had 

conducted on the King Khalid health facility in Hail metropolis, Saudi 

Arabia. The have a look at will cover a set of nurses who paintings 

inside the King khaled sanatorium in Hail city. Questions for the look at 

organization which might be consistent with questions regarding dating of 

best of existence, Resilience, and related elements among Ed nurses for 

the duration of Covid-19 at KKH hospital might be obtained. fitness care 

vendors who do no longer cope with Covid-19 patients could be 

excluded, in addition to fitness care providers who do not want to 

participate in the study, and who've less than three hundred and sixty 

five days of sensible revel in. The take a look at will be applied within a 

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duration of two months. As for the sample size, The range of fitness 

care companies nurses who deal without delay with Covid-19 sufferers in 

the King Khaled sanatorium in Hail town can be approximately (N=77). 

The reliability of the WHOQOL-BREF become assessed by means of 

standardized Cronbach’s alpha coefficient, and the validity become 

measured by convergent validity, essential factor evaluation and 

confirmatory factor evaluation(13). The reliability of the scale by way of 

Cronbach's alpha; the coefficient for the CD-RISC-10 is zero.82 with a 

95% confidence interval [0.82; 0.86], which may be very close to the 

authentic model (.eighty five)(14). The reaction alternatives have been 

rated on a five-factor Likert scale; rankings had been transferred to a 

hundred-factor scale, with a higher rating indicating higher QOL. The CD-

RISC-10 is a self-suggested shorter model of the authentic CD-RISC-25 

questionnaire measuring one's belief of resilience. The response options 

have been rated on a 5-factor Likert scale, on a scale of 0 (no longer 

actual in any respect) to four (actual nearly all the time), with a higher 

score indicating higher resilience. 

 

2.2 Instrument of This Study 

This examine used a cross-sectional, descriptive survey design. The take 

a look at was performed all through [25 MARCH to 20 MAY 2022] at an 

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Emergency Department (ED) nursing at a KKH health facility/HAIL Nurses 

self-administered the questionnaires, along with a 

a. WHO great of existence–BREF (WHOQOL-BREF) (Casamali,et 

al,.2019). 

b. Connor-Davidson Resilience Scale 10 (CD-RISC-10) ( Wollny,et 

al,.2021). 

c. 12 work-associated and demographics questions and Cronbach's  

scores for every QOL area and resilience scale have been 

calculated for this look at. 

d. The institutional review board of the college permitted the look at. 

Nameless records had been amassed via an electronic survey sent to all 

faculties of nurses. The survey took about 15 to half-hour to complete. 

Statistics will recoded, taken care of, and organized for analysis using 

the SPSS model 26.0 software bundle (IBM Corp, Armonk, ny, united 

states of america).The obtained information will mentioned at the quit of 

this semester. The acquired consequences from this challenge might be 

stated in booklet and /or meetings participations. 

2.3 Ethical considerations 

This study had approval by the Research and Ethics Committee, Nursing 

faculty, Deanship of Development and Quality Hail University and Ministry 

of Health. Institutional Review Board (IRB). The study will be conducted 

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according to the guidelines laid down for medical research involving 

human subjects Informed voluntary consent will be taken from each 

participant and information will be obtained from each participant in a 

private setting. The data will be accessible only by the principal 

investigator and co-investigators and confidentiality will ensured throughout 

the study, with explanation of study objectives with strict confidentiality 

and the name and identity will be optional. 

2.4. Data analysis 

Data analysis was conducted using the IBM SPSS statistics software 

(version 25.20). Descriptive analysis, including means, standard 

deviations, frequencies, and percentages, was used to describe the study 

variables. The independent samples t-test and one-way ANOVA were 

used to assess the statistical significance of the mean differences in the 

nurses' perceptions of quality of life and perceived stress across the 

levels of measured binary and multi-level categorical demographic and 

professional characteristics. Pearson's correlation coefficient (r) test was 

used to assess the associations between the metric variables. 

3. Results  

3.1.Sociodemographic and professional characteristics Table 1 presents 

the characteristics of the study sample of Seventy-seven working nurses 

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completed survey with a score of 98.7%. The majority (n = 77, 98.7%) were between 24 

and 54 years old, and the mean years of work experience was 13 (SD= 0.817). There was 

only Few of the male nurses 7.7 %( n = 6) respondents. The correlation of the 

environment( r=0.43, P<0.035 )(M=27.1) and Psychological factors was (0510, P<0.003) 

(M=20.3) was high while, when comparing the scores of quality of life of ED nurses in 

the other. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Table 1. The demographic and professional characteristics of nurses 

(N =77) 

Variable  Categories  Frequency 

(%)  

Mean (SD) 

Gender    

 Male 6 (7.7)  

 Fmale 71 (91.0)  

Age (Years)    

 24-34 years 39 (50.0)  

 34-44 years 23 (29.5)  

 44-54 years 15 (19.2)  

Nationality    

 Saudi 32 (41.0)  

 non-Saudi 45 (57.7)  

Years working as a 

nurse 

   

 1-3 years 16 (20.5)  

 4-6 years 13 (16.7)  

 7 years-above 48 (61.5)  

Shift worked    

 day shift 58 (74.4)  

 mid shift   

 night shift 11 (14.1)  

Hours/shift    

 8 hours 60 (76.9)  

 10 hours 3 (3.8)  

 12 hours 14 (17.9)  

Work status    

 full-time 65 (83.3)  

 part-time 6 (7.7)  

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 per diem 6 (7.7)  

Age    

Nursing experience    13 (SD= 0.817). 

 

 

3.2. The linear regression was conducted for each independent variable in table 2 

below. The independent variables with P < .20 were entered in the multiple regression 

models to predict each QOL domain. There was a high correlation between workspace 

Environment and Psychological factors with resilience score (r=0.43, P<0.035 and 0.510, 

P<0.003) respectively. 

Table 1. Multiple Regression Model Summaries for QOL Domains 

QOL Domain R R2 Adjusted 

R2 

F P 

Physical health .594 .353 .287 5.377 .000 

Psychological .510 .260 .185 3.459 .003 

Social relationship .593 .351 .285 5.336 .000 

Environment .436 .190 .108 2.310 .035 

 

3.3. Description of quality of life and resilience 

The basic descriptive statistics of quality of lifeand resilience are shown 

in Table 2. The mean score for quality of life was 20.1 and the mean 

score for resilience was 30.2. The domain of satisfaction with social 

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relationship had the lowest mean score (10.6) in comparison to the other 

domains, while the domain of environment satisfaction had the highest 

mean score (27.1).Psychological factors was (0510, P<0.003) (M=20.3)was 

high.While when comparing the scores of quality of life of ED nurses in the other factors 

like social (M= 10.6) were low among ED nurses. We found poor scores of QOL by 38% 

and poor resilience by 11.3%. 

Table 3. The relationship between sample characteristics, quality of life 

andresilience (N =77). 

Scale/Subscales 

(Domains) 

M (SD) Range Reliability 

( ) 

Poor 

Scorea,b 

n % 

Quality of Life Scale (WHOQOL-BREF) 

Physical health (7 items) 22.5(4.1) 23-100 0.86 9 17.1 

Psychological (6 items) 20.3(3.4) 18-100 0.70 13 28.2 

Social relationship (3 

items) 

10.6(2.2) 12-100 0.61 17 38.1 

Environment (8 items) 27.1(5.1) 25-100 0.72 3 3.9 

Resilience Scale (CD-RISC-10) 

Resilience (10 items) 30.2(3.7) 12-40 0.82 4 11.3 

 

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Fig 1.shows the percentages of quality of life factors.

While when comparing the scores of quality of life of ED nurses in the other 

social (M= 10.6) were low among ED nurses. 

3.4. Relationship between poor score of quality of life

The basic descriptive statistics of 

resilience are shown in 

was 21.8% and resilience was 11.3%

 

 

 

shows the percentages of quality of life factors.

While when comparing the scores of quality of life of ED nurses in the other 

) were low among ED nurses.  

3.4. Relationship between poor score of quality of life and Resilience

The basic descriptive statistics of poor score of both quality

are shown in Fig. 2. The mean poor score of quality of life 

was 21.8% and resilience was 11.3% 

 

shows the percentages of quality of life factors. 

While when comparing the scores of quality of life of ED nurses in the other factors like 

and Resilience 

poor score of both quality of lifeand 

of quality of life 

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Fig 2.shows the percentages of 

4. Discussion 

The results of this study discuss factors related to QOL among E

COVID-19 pandemic. The advice resilience score for the nurse in our have a look at was 

30.2 (SD, 3.7) comparing with some other 

have become a strong variable that used to measure the 

Also in this study Notably, 17% to 38% of nurses had indicating poor QOL on 

measurement factors and 11.3% of nurses indicated poor resilience.

study showed that 21% to 54% of nursing students' Q

life (16). 

Previous studies reported that one of the factors that negatively affected the relationships 

between nurses and the environment surroundin

nurses faced educational challenges that showed the link between flexibility and work. 

Studies also proved that a good work environment is something that provides a personal 

 

.shows the percentages of poor score of both quality of life 

resilience  

 

The results of this study discuss factors related to QOL among ED nurses during the 

The advice resilience score for the nurse in our have a look at was 

30.2 (SD, 3.7) comparing with some other have a look at 38.2(SD 5.2) which Resilience 

have become a strong variable that used to measure the factors (15). 

Also in this study Notably, 17% to 38% of nurses had indicating poor QOL on 

measurement factors and 11.3% of nurses indicated poor resilience. Similar to another 

study showed that 21% to 54% of nursing students' QOL scores indicated poor qual

Previous studies reported that one of the factors that negatively affected the relationships 

between nurses and the environment surrounding their work is social distancing. Also, 

nurses faced educational challenges that showed the link between flexibility and work. 

Studies also proved that a good work environment is something that provides a personal 

 

quality of life and 

es during the 

The advice resilience score for the nurse in our have a look at was 

5.2) which Resilience 

Also in this study Notably, 17% to 38% of nurses had indicating poor QOL on 

Similar to another 

L scores indicated poor quality of 

Previous studies reported that one of the factors that negatively affected the relationships 

g their work is social distancing. Also, 

nurses faced educational challenges that showed the link between flexibility and work. 

Studies also proved that a good work environment is something that provides a personal 

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space to manage challenges and develop capabilities to gain flexibility, thus enhancing 

workmanship(17). 

The correlation of the environment (r=0.43, P<0.035)(M=27.1) and Psychological factors 

was (0510, P<0.003) (M=20.3)was high. While when comparing the scores of quality of 

life of ED nurses in the other Factors like social (M= 10.6) were low among ED nurses. 

Compared with another study more than a third of nursing members (n = 127; 36.6%) 

experienced fatigue. Men had higher quality-of-life scores than women in the areas of 

physical health (p = 0.001; d < 0.5), psychological (p = 0.001; d < 0.5) and social 

relationships (p = 0.048; d < 0.5). Women were more fatigued than men (p = 0.001; d < 

0.5) (11). 

5.1 Conclusion 

The COVID-19 epidemic has caused major disruption to nurses working 

in the ED. this study discussed the multiple factors associated with 

Quality of life among nurses working in the ED at COVID-19 pandemic. 

Resilience was the strongest expectation Variable across all four QOL 

domains and the only importance a variable related to physical and 

mental health and Domains of Social Relations QOL. These findings 

illustrate the significance of Resilience amongst nurses operating inside 

the emergency and help department develop proof-primarily based 

applications to build resilience that may enhance satisfactory of existence 

among nursing. 

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5.2 Recommendations  

There are several recommendations that will underpin future study. Firstly, 

future interventional studies investigating the effects of flexibility on quality 

of working life should be considered. Secondly, emphasis should be 

placed on comparing with pre-pandemic data or tracking developments 

during the pandemic. Finally, longitudinal studies are needed to 

understand career quality trajectories and the resilience of emergency 

healthcare professionals in the pandemic and beyond. 

 

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17- Giusti, E. M., Pedroli, E., D'Aniello, G. E., StrambaBadiale, C., 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 )

Volume 06 | Issue 09 | September 2023 | http://ijojournals.com/index.php/hsn/index 20


	a. WHO great of existence–BREF (WHOQOL-BREF) (Casamali,et al,.2019).
	b. Connor-Davidson Resilience Scale 10 (CD-RISC-10) ( Wollny,et al,.2021).
	c. 12 work-associated and demographics questions and Cronbach's α scores for every QOL area and resilience scale have ben alculated for this look at.
	d. The institutional review board of the college permitted the look at.
	Nameless records had been amassed via an electronic survey sent to all faculties of nurses. The survey took about 15 to alf-hour to complete. Statistics will recoded, taken care of, and organized for analysis using the SPSS model 26.0 software bundle (IBM Corp, Armonk, ny, united states of america).The obtained information will mentioned at the quit of this semester. The acquired consequences from this challenge might be stated in booklet and /or meetings participations.
	2.3 Ethical considerations
	5.1 Conclusion
	5.2 Recommendations 

