Perennial Chieftaincy Conflict and Nursing Education in Ghana: A Cross-sectional Analysis of Academic Disruption, Clinical Training, and Psychological Distress

Abstract

Background: Recurrent chieftaincy conflict may disrupt educational continuity, clinical training and student well-being, yet evidence from nursing training institutions in Ghana is limited. Objective: This study examined associations between exposure to recurrent chieftaincy conflict and academic interruption, missed clinical practice, consideration of programme withdrawal and psychological distress among nursing students at the College of Nursing, Sampa, Ghana. Methods: A cross-sectional analytical study was conducted among 310 nursing students using a researcher-developed, structured self-administered questionnaire. The instrument assessed sociodemographic characteristics, conflict exposure, academic and clinical disruption, perceived institutional support, resource availability and psychological distress symptoms. Descriptive statistics, chi-square tests, simple linear regression and multivariable binary logistic regression were performed in IBM SPSS Statistics version 25. Statistical significance was set at p < 0.05. Results: Of the 310 participants, 81.9% reported interruption of studies and 68.7% had considered withdrawing because of conflict-related difficulties. Greater frequency of exposure to violent incidents was associated with study interruption (adjusted odds ratio [AOR] 1.51, 95% CI 1.17–1.95; p = 0.002) and missed clinical practice (AOR 1.48, 95% CI 1.15–1.89; p = 0.002). Higher psychological distress scores were associated with study interruption (AOR 3.47, 95% CI 1.24–9.69; p = 0.018) and missed clinical practice (AOR 6.10, 95% CI 2.39–15.60; p < 0.001). Greater perceived institutional support (AOR 0.50, 95% CI 0.28–0.89; p = 0.018) and higher household-income category (AOR 0.69, 95% CI 0.51–0.93; p = 0.016) were associated with lower odds of missed clinical practice. Psychological distress was not associated with current GPA (β = 0.018; p = 0.761). Conclusion: Recurrent chieftaincy conflict was associated primarily with interruption of participation in nursing education, particularly study continuity and clinical attendance. Conflict-sensitive continuity plans, accessible psychosocial support, strengthened security arrangements and flexible approaches to completing clinical requirements should be prospectively evaluated in conflict-affected training institutions.