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Self-initiated expatriate nurses in Kuwait: the positive role of psychological capital in facilitating their adjustment and performance

El Amine, N. R., R. Cascón and J. Aldás

Source: Journal of Health Organization and Management

Abstract

This study examines the role of psychological capital (PsyCap) and motivation in the adjustment and performance of self-initiated expatriate (SIE) nurses in Kuwait’s health system, where 95% of the nursing workforce is foreign. Unlike previous research that equates expatriate success solely with adjustment, this study also considers performance as a key outcome. A cross-sectional study was conducted using a convenience sample of 149 SIE nurses from a private Kuwaiti hospital. Data on PsyCap, motivation, adjustment, and performance were collected through an online survey. Partial least squares structural equation modeling (PLS-SEM) was used for analysis. The results indicate that PsyCap has a significant impact on adjustment, motivation, and performance. Furthermore, motivation mediates the relationship between PsyCap and performance. However, motivation does not significantly influence adjustment, nor does adjustment influence performance. To reduce turnover intentions among SIE nurses, hospitals should foster positive PsyCap in candidates and enhance it through training and supportive leadership, ultimately improving both adjustment and performance. This study underscores the pivotal role of PsyCap in enhancing both adjustment and performance among SIE nurses, as well as the mediating effect of motivation in the PsyCap-performance relationship. It also demonstrates that adjustment and performance are distinct dimensions of expatriate success.

Recommended citation

El Amine, N.R., R. Cascón-Pereira and J. Aldás-Manzano (2026). «Self-initiated expatriate nurses in Kuwait: the positive role of psychological capital in facilitating their adjustment and performance». Journal of Health Organization and Management 1-26. https://doi.org/10.1108/JHOM-03-2025-0122

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