Barriers to effective community health nursing: a quantitative analysis of challenges faced by nursing students in Saudi Arabia

Abstract

Introduction Community health nursing (CHN) is central to primary healthcare delivery, but undergraduate nursing students may encounter educational, organizational, resource-related, and sociocultural barriers that affect their readiness for community-based practice. This study aimed to identify and quantify perceived barriers to CHN practice among nursing students in Saudi Arabia and to examine their relationships with self-reported educational preparedness and organizational support. Methods A quantitative cross-sectional survey was conducted among nursing students enrolled in Saudi universities. A structured online questionnaire assessed perceived CHN practice barriers, educational preparedness, and organizational support. The instruments underwent cultural adaptation, forward-backward translation, expert-panel content validation, pilot testing, and internal-consistency assessment. Descriptive statistics, non-parametric tests, correlation analyses, and exploratory multiple linear regression were used. Results A total of 139 nursing students completed the survey. Participants reported minor-to-moderate overall barriers (M = 2.69, SD = 0.96). Resource barriers were rated highest, with shortage of equipment (M = 2.93, SD = 1.38) and lack of educational materials (M = 2.86, SD = 1.32) identified as the most salient challenges. Educational preparedness (M = 3.25, SD = 0.98) and organizational support (M = 3.46, SD = 1.03) were rated moderately positive. Small-to-moderate positive correlations were observed between barriers and educational preparedness (r = 0.269, p = 0.001) and between barriers and organizational support (r = 0.242, p = 0.004); these findings were interpreted cautiously as potentially reflecting awareness effects, conceptual overlap, or shared-method variance. The multivariable regression model was not statistically significant and explained a small proportion of variance (R2 = 0.089, p = 0.052). Discussion Nursing students in Saudi Arabia perceived meaningful, though not severe, barriers to effective CHN practice, with resource limitations and skills gaps as primary concerns. The findings support strengthened curriculum-practice integration, expanded simulation and community-immersion experiences, improved placement resources, and targeted faculty development aligned with healthcare transformation priorities.