DOI: 10.12688/healthopenres.14062.1 ISSN: 2753-6416

Nursing Uniform Acceptance and Mental Well-Being in Bangladesh: A Machine Learning Approach

Titas Roy, Masuda Akter, Amit Halder, Md. Ikbal Hossain, Sopon Akter, Anar Koly, Shimpi Akter, Anjan Kumar Roy, Pothik Hossain, Md. Israfil Hossain, Md Jamil Ahmad, Safayet Jamil, Andrew Costa, Humayun Kabir
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Background Uniforms convey identity, discipline, and professionalism in nursing and may contribute to mental well-being. Although the current olive-colored nursing uniform in Bangladesh has shown relatively low acceptance, limited knowledge about how this relates to mental well-being. Therefore, this study employed machine learning techniques to identify the factors related with mental well-being. Methods This cross-sectional study was conducted among nurses and nursing students in Bangladesh from May 18, 2025, to August 2, 2025. A convenience sampling technique was applied to recruit participants. We used the WHO-5 Well-Being Index scale to measure mental well-being, and uniform acceptance was assessed using an eight-item measure. Statistical analysis included Mann–Whitney U, Kruskal–Wallis tests, and Spearman’s rank correlation, while two machine learning models, including Random Forest and XGBoost, were employed to predict mental well-being. Data were analyzed using R version 4.5.2. Results Of the 1403 participants surveyed, 525 were nurses, and 878 were nursing students. The average age of nurses was 28.16 ± 3.63 years, and that of nursing students was 21.78 ± 1.44 years. The mean mental well-being scores for nurses and nursing students were 6.07 ± 7.17 and 7.40 ± 8.08, respectively. The acceptance score was the most important predictor of mental well-being for both nurses and nursing students. Among nurses, other important predictors included educational qualification, work experience, and monthly family income. Among nursing students, the nursing program and age were also important predictors. Conclusions The findings highlight that increasing the acceptance of the uniform may enhance the mental well-being of nurses and nursing students. Future uniform policies should consider the preferences of nurses and nursing students to may improve their acceptance, mental well-being, and enhance patient care.

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