Subtypes of nursing students' volunteer motivation in COVID-19: a latent profile analysis

The emergence of COVID-19 led to its rapid spread in China and around the world [1]. It poses major health risks worldwide, causing concern. The pandemic has caused about a surge in demand for healthcare, prompting nations to assess how to allocate resources, including personnel [2]. Nursing students are stepping forward as volunteers to assist with this growing need [3, 4]. Nursing students with specialized knowledge and skills can enhance the resilience of the healthcare system by volunteering to actively combat the epidemic [5]. According to Dyson's survey in London, 7 out of 137 nursing students were volunteering at the time of the survey [6]. In Brunei, the prevalence of university nursing students volunteering was 75.4% [7].

Volunteering is the selfless act in which individuals provide assistance to those in need within the framework of an organization [8]. It is characterized by altruism, voluntary participation, public benefit, and free-of-charge services [9]. Volunteering has practical significance not only for the beneficiaries, but also for the volunteers themselves [10]. On the one hand, nursing, as a highly specialized discipline, plays an indispensable role in public health and health promotion. As a reserve of future nurses, nursing students possess medical knowledge and skills that enable them to provide basic medical advice and health guidance to the beneficiaries. This can encourage the adoption of a healthier lifestyle and prevent the occurrence of diseases; on the other hand, participation in voluntary service is conducive to the physical and mental health of the participants [11‐13], while studies show that volunteering enhances mental resilience and empathy [14‐16]. Additionally, research on people over 50 has shown that volunteering can decrease mortality and enhance psychosocial well-being [17]. Therefore, promoting volunteering among nursing students holds significant importance.

Despite the general benefits of nursing students' participation in volunteering has been shown to have general benefits, such as promoting their overall health and improving their physical and mental well-being [18], studies have found that the actual involvement of nursing students in volunteering varies. Motivation for volunteering is related to volunteering behavior [9]. It has been suggested that motivation has a greater predictive effect on an individuals’ decision to participate in volunteering and continue to volunteer [19]. Volunteer motivation pertains to the internal drive of volunteers to perform volunteer service based on their need, recognition, or interest in the service itself [20]. During the COVID-19 pandemic, there is an expectation of increased volunteerism from nursing students [7, 21]. This is due to their intrinsic motivation driven by a strong sense of altruism [3, 22, 23]. Others have noted that volunteers were motivated by concerns about receiving lower grades, being excluded from future research opportunities, and even a perceived sense of coercion [24].

According to resource conservation theory [25], beneficial social support, positive psychological qualities, and environmental factors are considered valuable resources. Individuals with abundant resources are likely to have more enthusiasm and energy to motivate them to adopt more positive behaviors. Therefore, individuals' perceived social support and environmental pressure may influence their motivation to volunteer and their volunteer behavior. Gu et al. found that nurses had a moderate level of motivation to volunteer during the COVID-19 pandemic,which was negatively correlated with their perceived stress levels [26]. Previous studies have shown that the social support is a motivating factor for medical students to volunteer [3, 27]. Additionally, nursing students have reported that support and encouragement from family or the community had a positively impacted on their volunteering activities [23]. Furthermore, Amal identified several factors that affect the motivational willingness of nursing students to volunteer, including marital status, grade level, altruism, personal safety, and knowledge level [7]. A cross-sectional study conducted during an infectious disease pandemic in Saudi Arabia also revealed that gender, age, and grade level were significant motivational factors that influenced undergraduate nursing students' willingness to volunteer [28].

A systematic review found that health and nursing students' motivations for volunteering included domain value, understanding, enhancement, career, incentive, government, social, and demographics [29]. This motivation is explained by Clary & Snyder, namely increasing values such as altruism, learning and experience opportunities, personal growth and development, career-related clinical skills and experiences, and strengthening social relationships [30]. Therefore, nursing students' motivation for volunteering varies [19, 31], and there is a significant degree of heterogeneity [29]. There is a need to explore in-depth analysis of nursing students' motivations for volunteering. However, the majority of current studies have concentrated on the present level of nursing students' motivation to volunteer [7, 32]. Latent profile analysis (LPA) [33] is an individual-centered analytical technique that can improve differentiation among group categories by elucidating response characteristics and the proportion of individuals on various entries or dimensions. Therefore, this study aims to examine the possible categories of epidemic volunteer motivation among nursing students in colleges and universities and the variations in their characteristics via latent profile analysis. This will offer guidance for colleges, universities, and related departments in formulating practical and scientific volunteer service management programs, encouraging student participation in volunteer activities, and enhancing social health and well-being.

The survey results indicate that nursing students in colleges and universities exhibit a high level of motivation for volunteering, with over half of them expressing a strong motivation to volunteer. Consistent with prior research, the majority of nursing students were willing to participate in volunteer activities, driven by a sense of responsibility and mission [40, 41]. We found that the protective dimension was lower in the C1 group than in the other dimensions of the group, This suggests that when motivating nursing students to volunteer, the use of self-protection dimensions, such as the ability to improve loneliness and forget about annoying things, should be carefully considered.

Our study found that the C2 group scored higher on the dimensions of values and career development compared to others dimensions, indicating that some nursing students were more willing to volunteer out of a desire to practice altruism and humanitarianism, as well as being motivated to volunteer to promote their future career development. Volunteers who are highly motivated to volunteer by altruistic and humanitarian values (VFI values) were more likely to select volunteering activities involving patient contact [23]. A systematic review found that the VFI subscales with the highest scores among medical and nursing volunteers in healthcare settings were VFI Values and Enhancement [42]. A values-centric approach may be common among nursing students who volunteer with patients. Clary et al. found that recruitment appeals are most effective when matched with the internal state of volunteers, and Kpanake et al. concluded that broad value-based motivational messaging would be the best way to attract medical volunteers in epidemic response [35, 43]. Therefore, orienting nursing students towards values-centric motivations may increase their participation in patient contact activities.

The study results indicate that perceived social support is a predictor of higher motivation to volunteer. Improving nursing students' perceived social support can stimulate their motivation to volunteer. This finding is consistent with previous research, where perceived social support was positively associated with medical students' motivation [44]. Furthermore, a qualitative study on nursing students' volunteering behaviours found that their motivation for volunteering was influenced by their perception of social support [45]. The Pygmalion Effect suggests that social support can have a positive impact on people's behaviour [46]. When individuals engage in pro-social activities, such as volunteering, they are more likely to receive social recognition and praise. Social support can enhance an individual's self-worth and promote pro-social behaviour, leading to positive outcomes. The conservation of resources theory suggests that positive psychological quality, helpful social support, and contextual factors are considered to be valuable resources [25]. Individuals with abundant resources may have more enthusiasm and energy to engage in positive behaviors [47, 48]. Beneficial social support motivates individuals to be enthusiastic enough to engage in more positive behaviors, such as volunteering. These studies provide a theoretical reference to reveal the impact of perceived social support on voluntary behavior. Therefore, in promoting nursing students' participation in volunteering activities, it is possible to mobilize their surrounding family and friends to increase individuals' perceived social support and motivation to volunteer. It is suggested that volunteer organization managers and educators should pay attention to creating a positive social supportive environment. Society, schools and healthcare organizations should give multi-level social support to nursing students, such as parents and educators should give them prompt emotional support and guidance on volunteering to enhance students' sense of belonging and identity. Social and healthcare organizations should also detail the volunteering mechanism for nursing students, clarify the content of volunteering and provide targeted training.

Furthermore, this study demonstrates that the perceived stress levels of nursing students in college have an impact on their motivation to volunteer. Specifically, and higher levels of stress are associated with lower levels of motivation to volunteer. This finding is consistent with previous research, which has shown that individuals with lower perceived stress are more likely to be motivated to volunteer [26]. Deci and Ryan [49] proposed self-determination theory, self-determination Theory suggests that human behavioral motivation results from the interaction of intrinsic needs and extrinsic environmental factors. These intrinsic needs include the pursuit of autonomy, competence, and relatedness. If external conditions do not support the fulfilment of these three fundamental psychological needs, then they do not support to internal motivation, and the individual's work attitude and behavioural performance are negatively affected to some extent [50]. Baard [51] et al. have shown that a work environment that meets an individual's need for autonomy, competence, and relatedness can enhance intrinsic motivation. In addition to the external environment, self-determination theory also emphasizes the impact of autonomy, competence, and belongingness on individual behavioral motivation. Individuals are most motivated to act when they have autonomy over their volunteering behavior and a sufficient sense of competence and belongingness. If individuals feel too much pressure and constraint in volunteering, their autonomy and sense of competence may be weakened, thus affecting their motivation to volunteer. Therefore, as individuals perceive that more stress is generated in their environment, internal motivation decreases, so as nursing students' stress perception scores continue to rise, motivation to volunteer decreases. Therefore, in the process of promoting nursing students' participation in volunteer activities, administrators and educators of volunteer organizations should pay attention to students' mental health and provide psychological support and assistance to reduce students' stress and improve their self-confidence and competence.

Our study found that women demonstrate higher motivation to engage in voluntary activities than men, supporting prior research [52]. This may be due to women being perceived as more approachable and attentive to interpersonal connections and emotional communication. Their tendency towards empathy and willingness to assist others may lead them to participate in volunteer work more often than men. In addition, there is a common perception that women are more socially responsible and compassionate than men. This can lead to a greater focus on resolving social issues and helping the disadvantaged, which may result in a higher likelihood of engaging in volunteer work. Women's inclination towards volunteering may also be influenced by their emotional and social needs. Volunteering provides a social platform for women to communicate and engage with others, while fulfilling their emotional needs, such as a sense of self-worth and satisfaction. Nursing students in their fourth year of college are relatively less motivated to volunteer, which may be related to the lack of time to volunteer when they are in their internship and graduation year, and several studies [28, 53] have shown that time is a strong influencing factor that prevents nursing students from volunteering. It is possible that senior academic students experience stress due to various factors such as clinical placements, employment, and career planning.

This study used latent profile analysis to identify the category characteristics and their influencing factors of university nursing students' motivation for volunteering in the COVID-19. Nursing students' volunteering motivation can be categorized into three latent profiles: low-low protective motivation (9.3%), general-high career values motivation (37.5%), and high motivation (53.2%). Multinomial logistic regression results indicate that social support comprehension, stress perception scores, gender, and grade level influence different latent profiles. These findings provide new insights for management programmes and policy formulation regarding volunteerism among university nursing students during the epidemic.