Author's School

School of Medicine

ORCID

https://orcid.org/0000-0001-9197-6188

Author's Department/Program

Nursing Science

Language

English (en)

Date of Award

5-15-2026

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Patrick L. Hill

Committee Members

Sarah Farabi, Joshua Oltmanns, Sarah Ailey, Stephanie Mazzucca-Ragan

Abstract

Background/Introduction – Current research highlights three critical aspects of nurse wellbeing: the subjective personal perspective, multifaceted complexity, and variation across individuals. A particular gap in past research is a lack of understanding of how neurodivergence may impact nurses’ workplace wellbeing. Neurodiversity is the variation in human minds and neurocognitive functioning, and neurodivergence is the divergence from what society would consider the norm. Like wellbeing, it is difficult to capture, recognize, and define, which causes confusion among neurodivergent individuals and employers alike. With up to 20% of individuals displaying neurodivergent traits in the workplace, it is important to recognize that those traits could be considered barriers with opportunities for change, or strengths of the individuals in these workplaces. This dissertation sought to add to our limited knowledge regarding neurodivergence in nursing workplaces. Promoting wellbeing among neurodivergent nurses is critical for both their health and improving nursing care in general.

Purpose/Objective – Investigating neurodivergence in nursing is critical for at least three reasons. First, improved awareness of neurodivergence will provide better understanding of neurodivergent populations. Second, awareness will bring grace and understanding to coworkers who demonstrate neurodivergent traits. Third, the nursing role itself is often defined through advocacy for others, which may present unique challenges and opportunities for those nurses with neurodivergent traits. The aims of this study were to investigate incidence and wellbeing of neurodivergent nurses compared to nurses who do not identify as neurodivergent, and to explore the workplace experiences of neurodivergent nurses in their own words.

Methods – A two-part dissertation including a cross-sectional study of 300 nurses (averaged age 38 years, SD=12.5, Range=19-85, and average experience of 12 years, SD=9.5, Range=1-44) and a thematic analysis of 20 neurodivergent nurse experiences (averaged age 38 years, SD=8, Range=25-62, and average of 13 years’ experience, SD=7, Range=1-30) was conducted focusing on wellbeing using in-depth interviews. Study 1 participants were asked if they identified as neurodivergent and if they were professionally diagnosed and were grouped accordingly. Participants were then surveyed using various measures of wellbeing, health, and burnout. Additionally, the Disability Pride Scale was modified to reflect neurodivergent pride. Independent samples t-tests were used to compare groups. Study 2 participants were interviewed, and transcripts were analyzed thematically.

Results/Findings – For Study 1, nurse participants were asked if they identified as neurodivergent, or if they would place themselves in any of the categories of neurodivergent diagnostic options provided to them. Up to sixty percent of nurses identified as neurodivergent. Results showed neurodivergent nurses scored higher than their peers on emotional regulation, general and workplace psychological distress, burnout, pain, energy, physical health, and emotional wellbeing. Neurodivergent nurses scored lower on purpose and general health. Compared to their peers, nurses who reported having been formally diagnosed scored higher on measures of emotional regulation, general and workplace psychological distress, neurodivergent pride, perceived social support and caring from their administration, burnout, health decrease in the past year, pain, physical health, and emotional wellbeing. Five themes emerged from the neurodivergent nurse interviews: 1) Recognizing signs, symptoms, and diagnosis, 2) Strengths and challenges, 3) Support and accommodations, 4) Neurodivergent nursing, and 5) Wellbeing and sense of pride.

Conclusion – Findings suggest the incidence of neurodivergence in the nursing population is higher (up to 57% of this sample) than previous estimates of 15-20% in the general population. Incidence rates though continue to be difficult to capture, as they differed depending on formal diagnosis and self-identification. These differences are possibly due to nurses not recognizing the term “neurodivergent,” internal ableism, or limited awareness. Data indicated that neurodivergent nurses have different workplace experiences, which highlights an opportunity to improve wellbeing for this nursing sub-population. For example, neurodivergent nurses reported lower workplace wellbeing, higher levels of burnout, and less purpose. Nurses formally diagnosed reported higher levels of wellbeing and pride compared to those who self-identified. Additionally, self-identifying nurses scored significantly lower on measures of caring in relation to their administrators. These examples provide an opportunity for future research to explore how employers can evaluate if their facilities support neurodivergent nurse needs, as well as whether a formal diagnosis provides greater support to them.

DOI

https://doi.org/10.48765/6jat-mp69

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