The tendency and affecting factors of nursing students' Xenophobia toward refugees from the perspective of ecological systems theory: A convergent parallel mixed method study

Aim: This study aims to develop a comprehensive understanding of nursing students' xenophobic tendencies toward refugees and affecting factors from the perspective of Ecological Systems Theory. Background: Nursing students' xenophobia toward refugees may negatively affect their care for patients. To effectively prevent xenophobia, it is essential to identify its underlying factors. Design: A convergent parallel mixed method. Methods: This study was conducted with third and fourth-grade nursing students at a university in Turkey. In the quantitative phase, online surveys were used, employing convenience sampling, with 227 participants. In the qualitative phase, purposive sampling was used and data were collected through in-depth interviews with 17 participants on the Zoom platform. Data were obtained using the Participant Information Form, Xenophobia Scale and Semi-Structured Interview Form. Results: Nursing students who are male, in their third year, have low economic status, lack immigrant friends, lack immigrants in the family members, receive information about immigrants from social media and live in regions with a high concentration of immigrants have higher levels of xenophobia (p<0.05). In the qualitative phase, our study results showed that negative experiences with refugees, economic and social worries, perception of security threats, cultural conflicts and negative media messages toward refugees can lead to xenophobia. In addition, students stated that lessons about immigrants and caring for them in clinics can improve their ability to empathize with immigrants. Conclusion: Nursing curriculums should cover immigrant care and interaction to combat xenophobia, which can improve empathy skills and raise awareness.