Exploring International Students’ Personal and Social Resources: Enhancing Academic Well-Being in the Medical Environment

Abstract

(1) Background: Attending universities in foreign countries is a great challenge for international students, especially when adapting to a new culture and meeting specific university requirements. In this context, the present study investigates the relationship between students’ personal (i.e., psychological capital) and social resources (i.e., teachers’ support, perceived support of family, friends, and significant others), the satisfaction and frustration of their psychological needs (i.e., autonomy, competence, and relatedness), and how these factors contribute to their overall well-being (i.e., academic engagement and burnout). (2) Methods: A sample of 185 international students enrolled at a medical university in Romania completed six questionnaires. Stepwise linear regression analysis was conducted to verify the study’s hypotheses. (3) Results: The results indicated that students’ engagement was positively associated with psychological capital, teachers and family support, and autonomy need satisfaction. Also, autonomy needs’ satisfaction was negatively related to burnout, while autonomy and relatedness needs’ frustrations were positively associated. (4) Conclusions: Based on these findings, specific strategies were proposed to significantly enhance international students’ well-being in the medical university environment.

1. Introduction

Attending a university in a foreign country becomes a great challenge for students, as they need to adapt to a new society, culture, and language while fulfilling academic requirements (Ammigan & Jones, 2018). The cultural and psychological changes that arise from the interactions between different cultures, both at the group level and within individuals, known as acculturation (Berry, 2005), often generate stress and adjustment problems (Smith & Khawaja, 2011). Previous research identified at least three main categories of acculturative stressors (Smith & Khawaja, 2011; Xiao, 2025): educational—which include challenges related to language, academic stress caused by demands, performance expectations, teaching style, or support services offered by the host institution; socio-cultural—arising from the cultural norms that may cause difficulties to establish new social networks to compensate for being away from friends and family; and pragmatic stressors, which encompasses practical issues (e.g., tuition fees or accommodation costs). Findings have shown that educational factors are the most critical in the stress experienced by international students during the transition (Ammigan & Jones, 2018; Xiong et al., 2025), especially in their first year (Abdelkader et al., 2024). Coping with these challenges and efficiently adapting to the academic environment depends on their personal and social resources (Liu et al., 2022). For instance, personal resources like psychological capital—which enclose the ability to bounce back from adversity (i.e., resilience), belief in their ability to succeed in specific situations (i.e., self-efficacy), and hope and optimism regarding successful actions (Luthans et al., 2007a), are positively associated with well-being and negatively with burnout, anxiety, and depression (Perry et al., 2023). Social resources, including frequent peer interactions, connections with others, and support from teachers or family and friends, help students overcome cultural barriers and educational challenges. These resources foster language acquisition, enhance learning experiences, reduce stress acculturation, and improve overall well-being (Aljaberi et al., 2021; Perry et al., 2023; Yeh & Inose, 2003; Yu et al., 2021).

Medical education is widely recognized as a highly stressful field (Perry et al., 2023). On the one hand, the training is long term and involves a heavy and complex information load. On the other hand, students face daily emotionally charged situations related to communication with patients, dealing with serious illnesses, or facing terminal stages of care (Iorga et al., 2020). While these challenges affect all students, they are often even more prominent for international students, who also have to cope with acculturation stress (Hobfoll, 1989). Many studies show that personal and social resources are critical for effective adaptation (Liu et al., 2022; Yeh & Inose, 2003). However, very few of them adopt an integrated approach, especially in the case of medical international students, which consider both kinds of resources in relation to the fulfilling and frustrating aspects of psychological needs, which are fundamental for intrinsic motivation to learn and can also contribute to maladaptive behaviors (Vansteenkiste & Ryan, 2013). Consequently, to fill this gap and grounded on the Conservation of Resources theory (COR) and Self-Determination Theory (SDT), the present study explored the relationships between personal and social resources, satisfaction and frustration of psychological needs, and academic well-being of first-year international students at a general medical university in Romania. Because academic activity can be closely related to work, as both involve performing various tasks, attending courses, and achieving certain performance levels (B. Kim et al., 2018; Tuominen-Soini et al., 2012), our research adopted Bakker and Oerlemans’s (2011) perspective of well-being, and it focused on two key aspects: student engagement and student burnout (Paloș et al., 2019). Student engagement is a positive facet of well-being characterized by vigor, dedication, and absorption, reflecting high involvement, energy, and commitment to study (Schaufeli et al., 2002). Highly engaged students demonstrate increased energy levels and a strong desire to invest effort and persevere in completing tasks (i.e., vigor). They are deeply involved and enthusiastic about their studies (i.e., dedication) and are fully immersed in what they do (i.e., absorption) (Martínez et al., 2019). Engagement affects students’ persistence in completing tasks, their academic performance, and satisfaction with the learning experience (Barratt & Duran, 2021). In contrast, student burnout represents a negative aspect, manifesting as an erosion in engagement, characterized by exhaustion resulting from academic demands, a cynical, detached attitude toward studying, and the feeling of incompetence as a student (Schaufeli et al., 2002). The need to adapt to a new cultural context, the pressure to meet specific academic requirements, and the multiple tasks to be completed can significantly increase students’ feelings of exhaustion, which, combined with the depletion of emotional resources, can lead to a cynical attitude towards these demands (Fu & Charoensukmongkol, 2022). The mismatch between students’ expectations, the reality of university life, and the difficulty of establishing new interpersonal relationships needed to build a social support network can also lead to high burnout (Smith & Khawaja, 2011; Yeh & Inose, 2003). Thus, exhaustion and an overwhelming inability to cope with these situations can decrease student engagement (Barratt & Duran, 2021). To lower burnout and enhance academic engagement, it is essential to identify and understand those resources that enable interventions to support international students in achieving well-being. Therefore, we investigated the predictive value of psychological capital (PsyCap) as a personal resource and four social resources (i.e., teachers’ support, perceived support of family, friends, and significant others) alongside psychological needs satisfaction and frustration (i.e., autonomy, relatedness, and competence) on academic well-being (i.e., student engagement and burnout) of freshman international medical students. The results bring additional theoretical knowledge about the nature of these resources and their relationships in a context that enables or frustrates the satisfaction of needs. From a practical point of view, understanding these relationships provides a foundation for developing intervention programs offered by university support services (e.g., Lupșa et al., 2020). Training programs can also be designed for teachers to learn strategies to help students adapt more effectively, leading to increased engagement and decreased burnout (e.g., Xiong et al., 2025).

2. Theoretical Background

2.1. COR—Personal and Social Resources

COR is a motivational framework that explains the objective nature of stress and how people respond after assessing their situation (Hobfoll et al., 2018). The theory emphasizes the shared cultural dimension of stress and the resources available to cope with it (Hobfoll, 2002; Holmgreen et al., 2017). According to COR, individuals are motivated to obtain, protect, and enhance their valued resources (Hobfoll, 2011), which can be personal (such as characteristics or skills that help build resilience to stress), social (like supportive relationships that protect essential resources), or material (Hobfoll et al., 2018; Holmgreen et al., 2017). By acquiring and maintaining these resources, individuals can achieve their goals and effectively cope with stressful challenges (Holmgreen et al., 2017). Stress occurs when people face a loss of resources or threats to their resources, which leads them to engage in behaviors that minimize losses and maximize gains. Both loss and gain of resources have a spiral nature, but losses occur much more quickly than gains and take longer to recover (Hobfoll et al., 2018). Resources do not exist in isolation but are mutually supportive, the social context being able to create those favorable conditions for endowing and generating new resources, forming a “resource caravan” (Carmona-Halty et al., 2024; Hobfoll et al., 2018; Holmgreen et al., 2017). For instance, positive teacher–student relationships can enhance students’ academic psychological capital and support the satisfaction of their basic psychological needs (e.g., feeling heard, valued, and encouraged), illustrating how interpersonal support fosters the development and reinforcement of personal resources within this caravan (Carmona-Halty et al., 2024).

2.1.1. Psychological Capital as Personal Resources

A key personal resource is psychological capital (PsyCap), with an essential role in supporting well-being (Barratt & Duran, 2021), increasing engagement, and facilitating learning (Barratt & Duran, 2021; Paloș et al., 2019), as well as in protecting against burnout (Barratt & Duran, 2021; Fu & Charoensukmongkol, 2022). As a multidimensional construct, PsyCap comprises four elements (Lupșa et al., 2020; Luthans et al., 2007b): self-efficacy—the people’s belief that they can mobilize resources to complete a task; optimism—a characteristic of individuals who approach tasks with confidence and expect success; hope—which gives energy to persevere in pursuing goals despite challenges, and resilience—the ability to adapt quickly to demands and adversities and to recover fast (Alessandri et al., 2018; Luthans et al., 2007a). Previous studies have shown that the global PsyCap construct is more effective in explaining outcomes than its individual components considered separately (Lupșa et al., 2020). Furthermore, PsyCap can trigger the COR-based gain spiral, a process in which acquiring resources leads to further resource gains and positive consequences (Alessandri et al., 2018). Research indicates that people with greater PsyCap have higher academic engagement and lower levels of burnout (Fu & Charoensukmongkol, 2022; Vîrgă et al., 2022). Self-efficacy, hope, optimism, and resilience (i.e., PsyCap) act as “a resource reservoir” (Hobfoll, 2002, p. 318) that can foster positive spirals of psychological resource development, boosting students’ energy, dedication, and absorption (i.e., engagement) (Martínez et al., 2019) and acting as a buffer to reduce burnout (Fu & Charoensukmongkol, 2022). Moreover, individuals with high PsyCap draw resources from the social context to a greater extent, which, in interaction with personal resources, helps them experience lower burnout and adapt more quickly to their surroundings (Fu & Charoensukmongkol, 2022). Based on the above arguments, we assumed that:

H1. 

Students’ engagement positively relates to personal resources (i.e., psychological capital—H1a), while students’ burnout negatively relates to personal resources (i.e., psychological capital—H1b).

2.1.2. Teachers’ and Social Support as Social Resources

A key social resource is social support, which refers to the person’s perception of the availability or receipt of resources from others when needed (Li et al., 2018; Zimet et al., 1988). These resources enhance people’s well-being and can come from a variety of sources, including family, friends, significant others, and teachers (García-Martín et al., 2016; Gong & Xu, 2024; Mayer et al., 2023; Li et al., 2018; Zimet et al., 1988). Teachers’ support can take several forms, including informational (e.g., providing knowledge, guidance), instrumental (e.g., offering materials, challenging tasks), emotional (e.g., showing affection, trust), appraisal support (e.g., giving feedback or recognizing student’s effort in completing tasks) (Gong & Xu, 2024), or socio-emotional (e.g., ensuring a safe environment, encouragement, appreciation) and instrumental support (e.g., offering help in solving different situations or tasks) (Kang et al., 2024). Research indicates that socio-emotional support facilitates students’ engagement in tasks and perseverance in learning (Gong & Xu, 2024; Kang et al., 2024), while appraisal support has a significant impact mainly on learning self-regulation and the students’ autonomy need satisfaction (Gong & Xu, 2024). B. Kim et al. (2018) found that support from teachers and other institutional sources is more substantial than that from family and friends, being more practical and specific. However, talking about the cross-cultural adaptation process of international students, Shu et al. (2020) indicated that students perceive more significant support from friends than from their university. Additionally, support from family was found to be insignificant in helping with school adaptation (Shu et al., 2020).

Some research suggests that social support can serve as a buffer, protecting individuals from stress and helping them cope (B. Kim et al., 2018; Li et al., 2018; Zimet et al., 1988). Others found that social support may directly aid people in preventing burnout by promoting effective coping strategies, enhancing responsiveness, and encouraging adaptive behaviors (Li et al., 2018; Liu et al., 2022; Mayer et al., 2023). For instance, students’ social relationships and their satisfaction with the social support they receive decrease acculturative stress (Yeh & Inose, 2003). Those who benefit from social support are more resilient to stress and have better physical and mental health (Hobfoll, 2002). Further, social support is positively associated with well-being and negatively with burnout, anxiety, and depression (Perry et al., 2023). Both personal and social resources are crucial for supporting students’ well-being, reinforcing each other, and creating the resource caravan (Alessandri et al., 2018; Fu & Charoensukmongkol, 2022): high psychological capital is essential for acquiring and utilizing new resources from the social context, which, in turn, positively impacts personal resources (Kerksieck et al., 2019). Based on the above findings, the second hypothesis was formulated:

H2. 

Students’ engagement positively relates to social resources (i.e., teachers’ support and perceived social support from family, friends, and significant others—H2a), while students’ burnout negatively relates to social resources (i.e., teachers’ support and perceived social support from family, friends, and significant others—H2b).

2.2. SDT—Needs’ Satisfaction and Needs’ Frustration

SDT illustrates the mechanisms of psychological growth that arise from interacting with social environment elements that satisfy psychological needs, leading to increased well-being, strengthening internal resources, and improving individuals’ coping capacity (Ryan & Deci, 2017; Vansteenkiste & Ryan, 2013). Thus, a context that fulfills the autonomy, relatedness, and competence needs is essential for people’s development and well-being (B. Chen et al., 2015; Van den Broeck et al., 2016; Neufeld, 2023). On the contrary, needs’ frustration is linked to negative outcomes and ill-being (Vansteenkiste & Ryan, 2013). When the social context prevents these needs’ satisfaction, it leads to feelings of frustration, which is different from simply having unsatisfied needs (Vansteenkiste & Ryan, 2013). In frustration, the social environment (e.g., family, teachers) plays an active and direct role, while unsatisfied needs arise from a passive or indifferent social environment that fails to support individuals’ needs (Vansteenkiste & Ryan, 2013). The need for autonomy is defined by the person’s desire for their actions to stem from freedom of choice and personal will. In contrast, autonomy frustration occurs when individuals feel controlled by the external environment or self-imposed strains (Vansteenkiste & Ryan, 2013). The need for relatedness refers to the desire to be loved, establish close relationships with others, and feel a sense of belonging within a group, while relatedness frustration is linked to exclusion and loneliness (B. Chen et al., 2015). The need for competence relates to developing and mastering skills to effectively face environmental challenges (Van den Broeck et al., 2016), and competence frustration is associated with feelings of failure and doubt regarding one’s abilities (B. Chen et al., 2015). The need for autonomy is considered a resource related more to the organization of activity and the task, competence is task-related, and the need for relatedness is viewed as a social resource (Breaugh, 2021).

The satisfaction or frustration of psychological needs impacts students’ engagement and burnout, although research findings have been inconsistent (B. Chen et al., 2015; Buzzai et al., 2021). For instance, Babenko et al. (2018) reported positive correlations between engagement and the satisfaction of autonomy and competence, while Karimi and Sotoodeh (2019) identified significant relationships involving all three needs but noted that the impact of the need for relatedness was smaller compared to autonomy and competence. Buzzai et al. (2021) found that students’ engagement is positively predicted by autonomy and relatedness satisfaction, whereas the frustration of autonomy is a negative predictor. On the other hand, satisfying the need for autonomy and competence leads to reduced burnout, while the need for relatedness increases burnout (Babenko et al., 2018). Contrary to these results, Breaugh (2021) discovered that the need for relatedness is essential in lowering the effect of stress due to the support that the person receives from interpersonal relationships with friends and colleagues. Longo et al. (2016) determined positive associations between satisfaction and vigor for all three needs and negative relationships between needs’ frustration and exhaustion. Zhang and Jiang (2023) found negative associations between all three needs’ satisfaction and burnout and positive associations with all three needs’ frustration. Consequently, we expect that:

H3. 

Students’ engagement positively relates to needs satisfaction (H3a), while students’ burnout negatively relates to needs satisfaction (H3b).

H4. 

Needs’ frustration negatively relates to academic engagement (H4a) and positively relates to academic burnout (H4b) after controlling for the effect of personal and social resources and needs satisfaction.

The Present Study

This study explored the predictive value of PsyCap as a personal resource and four social resources (i.e., teachers’ support, perceived support of family, friends, and significant others) alongside psychological needs satisfaction and frustration (i.e., autonomy, relatedness, and competence) on academic well-being (i.e., student engagement and burnout) of freshman international medical students. International medical students face demanding academic and psychological challenges (e.g., intensive training, language barriers, and cultural adaptation), which can heighten the risk of disengagement, burnout, and reduced well-being (Prasath et al., 2022). Academic engagement protects against burnout and dropout intentions (Calcatin et al., 2022), while the satisfaction of psychological needs promotes resilience and motivation (Neufeld & Malin, 2019). Additionally, PsyCap reduces distress and enhances well-being (Prasath et al., 2022), while teachers and family support foster need satisfaction and engagement (He et al., 2025). Using a cross-sectional design and stepwise linear regression, we examined how these variables predict academic engagement and burnout, shaping students’ well-being. This approach provides initial empirical grounding for future longitudinal and mediation studies exploring resource dynamics over time. The findings can inform the design of targeted counseling services and institutional support programs that more effectively address the specific needs of international medical students.

3. Materials and Methods

3.1. Participants and Procedures

The convenience sample included 185 international students enrolled in the first year of the English and French language programs at the “Victor Babeș” University of Medicine and Pharmacy, Timișoara, Romania. The study program and duration for international students are the same as those for Romanian students, lasting six years in a full-time format. The undergraduate program falls under the field of Health Sciences.

The sample consisted of 85 men (45.9%) and 100 women (54.1%), with ages ranging from 17 to 29 years (M = 20.17; SD = 2.56). Most of these students came from Italy (28.6%), France (10.8%), Germany (10.3%), Tunisia (9.1%), and Syria (8.6%). The enrollment for the English-taught program was 160 students, while the French-taught program was 60 students. Questionnaires were distributed to all students, but only 185 were completed. Of these, 140 responses (75.7%) came from the English-taught program, and 45 (24.3%) came from the French program. These results represent an 84.09% completion rate for international students enrolled in both programs. Participants were included in the study if they met the following criteria: (a) being enrolled as first-year students in either the English- or French-taught programs; (b) willingness to participate and complete the questionnaires. Students who did not complete the questionnaires fully or who were not in their first academic year were excluded from the study. Age, gender, and nationality were not criteria for inclusion or exclusion, as the focus was on the academic year cohort, specifically, first-year international students, as this stage is typically associated with the most significant adaptation challenges in this population (Xiong et al., 2025).

The students enrolled in the anatomy course were informed about the purpose of the study and the voluntary nature of their participation. They were assured that their responses would remain confidential and that they could withdraw from the research without repercussions for their educational activities. Those who agreed to participate received a link to a Google Forms document containing the questionnaires they needed to complete. The first part of the online questionnaire included a question that explicitly requested consent to participate, and the next section, with the research items, opened only when the participants expressed their consent. Following this, students provided demographic information, including age, gender, country, language used in the university program, and whether an introductory Romanian language course was attended. The role of this question was to determine if international students had the opportunity to learn the local language, which would increase their chances of integrating more easily into the academic environment. The second part of the questionnaire comprised the six scales used to assess the study variables. All the procedures followed the ethical standards of the Ethical Committee of the “Victor Babeş” University of Medicine and Pharmacy of Timişoara, Romania (75/16 December 2024), under the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

3.2. Instruments

All questionnaires were administered in their original English versions to ensure methodological consistency across the international student sample. Although forty-five students were enrolled in a French-taught program, they reported sufficient English proficiency to participate. Importantly, none of the participants were native English speakers. Some instruments had already been adapted to educational contexts in their initial development (e.g., academic engagement, core burnout, psychological needs satisfaction and frustration), while others were slightly modified in this study to better reflect the university student setting (e.g., psychological capital, perceived social support, and teacher support). Although the use of a shared language supported consistency in data collection, we acknowledge that it may have also reduced the potential for cultural nuances to emerge clearly (Harzing, 2005).

Student engagement was evaluated with the Utrecht Work Engagement Scale for Students (UWES-S; Schaufeli et al., 2002). The instrument has 17 items and comprises three dimensions: dedication (e.g., “I find my studies full of meaning and purpose”), vigor (e.g., “When I’m doing my work as a student, I feel bursting with energy”), and absorption (e.g., “I feel happy when I am studying intensely”), rated on a 7-point Likert scale from never to always. The authors recommend using a total scale score due to the close relationship between the three dimensions (Schaufeli et al., 2006). The Cronbach’s alpha for the entire scale was 0.94.

Student burnout was assessed using the 15-item Maslach Burnout Inventory (Schaufeli et al., 2002). The entire questionnaire was administered, but the focus was on exhaustion (e.g., “Studying or attending a class is really a strain for me”) and the cynicism scales (e.g., “I have become more cynical about the potential usefulness of my studies”), which represent core burnout (Green et al., 1991; Paloș et al., 2019). Exhaustion refers to fatigue caused by study demands, while cynicism is linked to indifference towards academic activities (Schaufeli et al., 2002). Participants needed to answer on a 7-point Likert scale, ranging from 0 (never) to 6 (always). Alpha Cronbach for the core-burnout scale was 0.89.

Psychological capital was assessed using the PsyCap Questionnaire (Luthans et al., 2007b), consisting of 24 items that measure four psychological resources: self-efficacy (6 items—“I feel confident presenting information to a group of colleagues”), hope (6 items—“At the present time, I am energetically pursuing my learning goals”), resilience (6 items—“I can get through difficult times at university because I’ve experienced difficulty before”) and optimism (6 items—“When things are uncertain for me at university, I usually expect the best”). Responses were given on a 6-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). The composite score was used because findings from previous research demonstrated that “overall PsyCap offers predictive insights that go beyond what can be explained by the four first-order latent variables” (Luthans & Avolio, 2014, p. 125; Wernsing, 2014). Alpha Cronbach for the entire questionnaire was 0.90.

Teacher support was evaluated using a scale from the Questionnaire on the Experience and Evaluation of Work (QEEW—van Veldhoven & Meijman, 1994), which measures support from direct supervisors. This scale consists of 5 items adapted for the educational context to assess teacher support. Students responded on a 5-point Likert scale (1—never, 5—always) (e.g., “If necessary, can you ask your teachers for help?”). The internal consistency for the scale was 0.92.

Perceived social support was evaluated with a 12-item Multidimensional Scale of Perceived Social Support questionnaire (MSPSS; Zimet et al., 1988). The instrument assesses three different sources of support students get: from their family (e.g., “I get the emotional help and support I need from my family”), friends (e.g., “I have friends with whom I can share my joys and sorrows”), and significant others (e.g., “There is a special person with whom I can share my joys and sorrows”). Participants express their agreement on a 7-point Likert scale, ranging from 1 (very strongly disagree) to 7 (very strongly agree). High scores indicate a high level of support received. Cronbach’s alpha value for the entire scale was 0.93 and ranged between 0.87 and 0.94 for the subscales.

Psychological needs’ satisfaction and frustration were measured with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSNF; Van der Kaap-Deeder et al., 2020). The scale assessed the satisfaction and frustration of the three psychological needs (i.e., autonomy—“I feel a sense of choice and freedom in the things I undertake”; “I feel forced to do many things I wouldn’t choose to do”; competence—“I feel confident that I can do things well”; “I have serious doubts about whether I can do things well”; and relatedness—“I feel that the people I care about also care about me”; “I feel excluded from the group I want to belong to”). The alpha Cronbach’s for the entire instrument was 0.76 and ranged between 0.71 and 0.90 for the other sub-scales.

3.3. Data Analysis

The data were analyzed using the statistical software package SPSS 23.0.

Table 1. Correlation matrix.

Variables	1	2	3	4	5	6	7	8	9	10	11	12	13
1. SE	(0.94)
2. SB	−0.15 *	(0.89)
3. PsyCap	0.53 **	−0.06	(0.90)
4. TS	0.53 **	−0.12	0.50 **	(0.92)
5. FPS	0.44 **	−0.09	0.36 **	0.40 **	(0.87)
6. FrPS	0.27 **	−0.13	0.30 **	0.36 **	0.53 **	(0.94)
7. SOPS	0.26 **	−0.11	0.25 **	0.32 **	0.60 **	0.66 **	(0.90)
8. Autonomy_S	0.69 **	−0.29 **	0.55 **	0.57 **	0.39 **	0.34 **	0.32 **	(0.79)
9. Relatedness_S	0.45 **	−0.24 **	0.46 **	0.39 **	0.48 **	0.56 **	0.47 **	0.60 **	(0.82)
10. Competence_S	0.52 **	−0.23 **	0.61 **	0.43 **	0.33 **	0.26 **	0.21 **	0.58 **	0.62 **	(0.86)
11. Autonomy_F	−0.13	0.68 **	0.04	0.09	−0.20 **	−0.19 **	−0.20 **	−0.22 **	−0.23 **	−0.18 *	(0.71)
12. Relatedness_F	−0.14	0.65 **	−0.06	−0.14	−0.32 **	−0.40 **	−0.37 **	−0.31 **	−0.55 **	−0.30 **	0.66 **	(0.90)
13. Competence_F	−0.17 *	0.56 **	−0.13	−0.10	−0.24 **	−0.23	−0.22 **	−0.28 **	−0.41 **	−0.40 **	0.64 **	0.75 **	(0.84)
M	70.39	23.11	3.60	18.74	24.34	22.57	22.65	15.60	16.30	16.11	11.14	8.85	10.54
SD	17.76	11.63	0.55	4.79	4.65	5.89	6.03	3.18	3.26	3.00	3.47	4.46	4.24

Note: N = 185; SE = student engagement; SB = student burnout; PsyCap = psychological capital; TS = teacher support; FPS = family perceived support; FrPS = friends perceived support; SOPS = significant others perceived support; Autonomy_S = autonomy satisfaction; Autonomy_F = autonomy frustration; Relatedness_S = relatedness satisfaction; Relatedness_F = relatedness frustration; Competence_S = competence satisfaction; Competence_F = competence frustration; ** p < 0.01; * p < 0.05; Alpha Cronbach values are presented on the main diagonal in italics.

presents the descriptive statistics, internal reliability, and Pearson correlation for all the two-tailed study variables. All our variables had normal distributions with skewness and kurtosis that ranged within reasonable limits (below 2.0 for skewness and 7.0 for kurtosis) (H. Y. Kim, 2013).

Stepwise linear regression analysis was conducted to verify the study’s hypotheses (

Table 2. Stepwise linear regression analysis predicting student engagement and burnout.

Variables	Student Engagement			Student Burnout
	R2	ΔR2	β	R2	ΔR2	β
Step 1	0.277 **	0.277 **		0.004	0.004
PsyCap			0.526 **			−0.060
Step 2	0.408 **	0.131 **		0.024	0.021
PsyCap			0.310 **			0.015
TS			0.297 **			−0.087
FPS			0.248 **			0.007
FrPS			−0.034			−0.085
SOPS			−0.038			−0.037
Step 3	0.552 **	0.144 **		0.125 **	0.101 **
PsyCap			0.113			0.211 *
TS			0.119			0.042
FPS			0.202 **			0.058
FrPS			−0.039			−0.047
SOPS			−0.054			−0.026
Autonomy_S			0.484 **			−0.295 **
Relatedness_S			−0.044			−0.063
Competence_S			0.100			−0.166
Step 4	0.563	0.010		0.582 **	0.457 **
PsyCap			0.088			−0.071
TS			0.107			−0.021
FPS			0.204 **			0.123
FrPS			−0.029			0.028
SOPS			−0.040			0.054
Autonomy_S			0.486 **			−0.159 *
Relatedness_S			0.028			0.178 *
Competence_S			0.101			−0.040
Autonomy_F			−0.069			0.403 **
Relatedness_F			0.167			0.493 **
Competence_F			−0.008			−0.013

Note: N = 185; PsyCap = psychological capital; TS = teacher support; FPS = family perceived support; FrPS = friends perceived support; SOPS = significant others perceived support; Autonomy_S = autonomy satisfaction; Autonomy_F = autonomy frustration; Relatedness_S = relatedness satisfaction; Relatedness_F = relatedness frustration; Competence_S = competence satisfaction; Competence_F = competence frustration; ** p < 0.01; * p < 0.05.

). The two dimensions of students’ well-being (i.e., student engagement and burnout) were chosen as criterion variables. PsyCap as a personal resource, social perceived support (i.e., teachers’ support, family, friends, and significant others) as social resources, and psychological needs satisfaction and frustration (i.e., autonomy, relatedness, and competence) were chosen as predictor variables. Thus, the hierarchical regression followed a theoretically informed order. Personal and social resources were introduced in the first and second steps of the analysis because, according to COR theory, they are essential to efficiently adapting to challenging and demanding situations (Fu & Charoensukmongkol, 2022; Paloș, 2024). PsyCap was included first, as it represents internal, relatively stable individual traits. In the second step, social resources were added (support from teachers, family, friends, and significant others), as they reflect external influences on student well-being. Psychological needs were entered into the third and fourth steps because their satisfaction and frustration are mainly linked to social resources, contributing to the well-being experience (X. Chen et al., 2024). Psychological needs’ satisfaction was introduced in the third step, capturing positive appraisals of the educational context, followed by needs’ frustration in the final step, to assess the added predictive value of need-thwarting experiences after accounting for more adaptive psychological and contextual factors.

4. Results

Table 1 presents the correlation matrix for all variables in the study. The results partially supported the first hypothesis that students’ engagement positively relates to personal resources (i.e., psychological capital—H1a), while students’ burnout negatively relates to personal resources (i.e., PsyCap—H1b). Thus, engagement was positively related to psychological capital (r = 0.53, p < 0.000; r² = 0.28), whereas the relationship between burnout and PsyCap was non-significant. The second hypothesis: Students’ engagement positively relates to social resources (i.e., teachers support and perceived social support from family, friends, and significant others—H2a), while students’ burnout negatively relates to social resources (i.e., teachers support and perceived social support from family, friends, and significant others—H2b) also received partial statistical support. Thus, there were positive associations between engagement and all social resources: teachers’ support (r = 0.53, p < 0.000; r² = 0.28), and perceived support from family (r = 0.44, p < 0.000; r² = 0.19), friends (r = 0.27, < 0.000; r² = 0.07), and significant others (r = 0.26, p < 0.000; r² = 0.06), with small and medium effects (H2a). On the contrary, none of the social resources were associated with students’ burnout (H2b). The analysis totally supported the third hypothesis: Students’ engagement positively relates to needs satisfaction (H3a), while students’ burnout negatively relates to needs satisfaction (H3b). The results indicated positive significant relations between engagement and satisfaction of autonomy (r = 0.69, p < 0.000; r² = 0.47), relatedness (r = 0.45, p < 0.000; r² = 0.20), and competence (r = 0.52, p < 0.000; r² = 0.27), with medium and large effects (H3a). Conversely, there were negative significant associations between burnout and needs satisfaction of autonomy (r = −0.29, p < 0.000; r² = 0.08), relatedness (r = −0.24, p < 0.000; r² = 0.06), and competence (r = −0.23, p < 0.000; r² = 0.05), with small effects (H3b).

The analyses partially supported the fourth hypothesis: Needs’ frustration negatively relates to academic engagement (H4a) and positively relates to academic burnout (H4b) after controlling for the effect of personal and social resources and needs satisfaction. Table 2 illustrates the regression analysis results with the two dependent variables (i.e., student engagement and burnout).

Thus, for student engagement as a criterion variable (H4a), in the first step, personal resources account for 27.7% of the variance, and the model was significant [F(1, 183) = 70.09, p < 0.000], with PsyCap as a significant predictor (β = 0.53, p < 0.000). By adding in the second step of the model the social resources, and controlling the influence of the PsyCap, the predictive value of the second model increase to 40.8% [(ΔR² = 0.131; F(5, 179) = 24.67, p < 0.000)], with teacher support (β = 0.30, p < 0.000), and family perceived support (β = 0.25, p = 0.002) as significant predictors. In step three, needs satisfaction was introduced in the model and increased its predictive value to 55.2% [(ΔR² = 0.144; F(8, 176) = 27.16, p < 0.000)], with only autonomy satisfaction (β = 0.48, p < 0.000) as a significant predictor. In step four, needs frustration was introduced in the model and showed an explanatory potential of 56.3%, with none of the predictors reaching significant values [(ΔR² = 0.010; ns; F(11, 173) = 20.23, p < 0.000)]. The final model that includes all predictors explained students’ academic engagement at a rate of 56.3%. Regarding student burnout as a criterion variable (H4b), the analyses showed that personal (i.e., PsyCap) and social resources (i.e., teachers’ support, family, friends, and significant others) were not significant predictors for burnout. In the third step, needs satisfaction was introduced in the model and accounted for 12.5% of the variance [(ΔR² = 0.101; p < 0.000; F(8, 176) = 3.14, p < 0.000)], with autonomy satisfaction as a significantly negative predictor (β = −0.30, p = 0.005). In the fourth step, adding needs frustration in the model and controlling the influence of resources and need satisfaction, the explanatory value increased to 58.2% [(ΔR² = 0.457; p < 0.000; F(11, 173) = 21.94, p < 0.000)], with autonomy (β = 0.40, p < 0.000) and relatedness (β = 0.49, p < 0.000) frustration as positive significant predictors. The final model that included all predictors explained students’ academic burnout at a rate of 58.2%. In summary, regression analyses partially supported H4, showing that needs frustration was unrelated to academic engagement. However, it was positively related to academic burnout in the case of frustration of autonomy and relatedness needs after controlling for the effect of personal and social resources and needs satisfaction.

To sum up, our analysis revealed distinct patterns for the two dependent variables, academic engagement and burnout. Academic engagement was significantly predicted by PsyCap, teacher support, and family support, with only autonomy satisfaction emerging as a strong positive predictor. In contrast, the frustration of psychological needs did not significantly impact engagement. Regarding academic burnout, the results indicated that frustration of autonomy and relatedness needs were significant positive predictors, implying that higher levels of frustration in these areas are associated with greater burnout. Autonomy satisfaction was found to negatively predict burnout, acting as a protective factor. However, PsyCap and social support variables did not show a significant direct effect on burnout in the final model. These findings underline the critical role of needs satisfaction and frustration in shaping students’ academic well-being, suggesting that increasing autonomy and reducing needs frustration could be effective in promoting engagement and preventing burnout.

5. Discussion

The present study aimed to investigate the predictive value of PsyCap as a personal resource and four social resources (i.e., teachers’ support, perceived support of family, friends, and significant others) alongside psychological needs satisfaction and frustration (i.e., autonomy, relatedness, and competence) on academic well-being (i.e., student engagement and burnout) of freshman international medical students. Our results showed that freshman students’ engagement was positively associated with PsyCap, teachers and family support, and autonomy need satisfaction. In other words, students with high psychological capital who are confident that they can solve tasks they face and achieve success mobilize resources to meet challenges and adapt quickly to adversities. They also benefit significantly from the support of teachers who cultivate an educational environment that responds to their need for autonomy. Furthermore, their family support helps them to engage enthusiastically in their studies and remain persistent in completing tasks and achieving their academic goals.

These findings align with previous research, which states that Psycap is a personal resource that increases an individual’s ability to cope with stress and the demands of different tasks (Siu et al., 2014), enhancing academic engagement (Paloș, 2024; You, 2016). Further, teacher support is a more robust predictor of engagement than family support, which is unsurprising, as teachers spend the most time working with students while their families are away, findings also sustained by B. Kim et al. (2018). Also, teacher–student relationships in which teachers invest in their students, are accessible to them, and employ teaching-assessment strategies that stimulate deep learning can increase student engagement in academic activities (B. Kim et al., 2018). Likewise, the need for autonomy satisfaction is a strong predictor of engagement, which partly confirms results from previous studies (e.g., Babenko et al., 2018; Buzzai et al., 2021; Karimi & Sotoodeh, 2019; Longo et al., 2016). This evidence offers insights into the patterns of association between social support and academic engagement. Particularly, teacher support initially showed a significant positive relationship with engagement. However, once need satisfaction variables were included in the model, this relationship became nonsignificant. This suggests that teacher support may contribute to engagement by sustaining students’ psychological needs, especially autonomy. In other words, teacher support might promote engagement by helping students feel more autonomous, competent, and connected, rather than directly affecting engagement. In contrast, family support remained a significant predictor of academic engagement across all steps. This pattern implies that family support may have a direct positive association with student engagement, one that is not fully accounted for by the satisfaction of psychological needs. Family support likely provides emotional and practical resources that are linked to engagement independently of autonomy, competence, or relatedness satisfaction.

Surprisingly, fulfilling competence and relatedness needs did not predict academic engagement. These findings contradict other research, which had previously identified significant relationships between engagement and competence (Babenko et al., 2018; Buzzai et al., 2021; Longo et al., 2016), as well as studies by Buzzai et al. (2021) and Longo et al. (2016) that found relationships with the need for relatedness. Possible explanations for our findings could be threefold. First, to foster competence, students should receive optimal stimulation and challenge to practice their skills and obtain feedback, which, in turn, helps them build confidence (Ten Cate et al., 2011). Students who initiate specific activities that reflect their values, select learning methods that suit their preferences, or organize their academic tasks tend to be more engaged in their studies (Buzzai et al., 2021; Karimi & Sotoodeh, 2019). However, in our context, international students are only required to pass exams, without any specific classifications or additional benefits tied to grades. This lack of performance differentiation may undermine their sense of competence, as it reduces opportunities for challenge, achievement, and recognition. Second, students’ social networks may already fulfill their need for relatedness, or, depending on their cultural background (Van den Broeck et al., 2016), they may value the need for connection less. Third, a spillover effect may explain why competence and relatedness did not significantly predict engagement. Autonomy-supportive environments might indirectly fulfill these needs as well, reducing their unique predictive value (Janić et al., 2025). Unexpectedly, needs’ frustration was unrelated to student engagement, which contradicts Buzzai et al.’s (2021) study, which observed a negative effect of autonomy frustration on student engagement.

Regarding students’ burnout, our findings indicated that autonomy satisfaction is negatively related to burnout, while autonomy and relatedness frustrations are positively associated. Specifically, when students’ need for autonomy is less satisfied, they tend to experience higher levels of exhaustion and a detached attitude toward their studies (i.e., increased burnout). These findings partly align with Babenko et al. (2018), who found that both the lack of autonomy and competence satisfaction contribute to increased burnout, but also with those of Longo et al. (2016), who indicated that the lower the satisfaction of all three needs, the higher the exhaustion experienced by students. Additionally, increased frustration of needs for autonomy and relatedness leads to more significant burnout among students, consistent with the findings of Zhang and Jiang (2023) and partly with the results of Longo et al. (2016), which indicated that exhaustion rises in students when all three needs are frustrated. The outcomes related to PsyCap and relatedness satisfaction were somewhat unexpected. PsyCap was initially unrelated to burnout but became a positive predictor once psychological need satisfaction was considered. A similar pattern occurred with relatedness satisfaction after adding need frustration. These counterintuitive results may indicate a suppression effect, where correlated predictors reveal hidden associations (MacKinnon et al., 2000). Another possible explanation is that people with high PsyCap or strong social ties stay engaged even when their needs are unmet, which may increase emotional exhaustion. For instance, students who feel a strong connection to others might face high pressure to meet social expectations, avoid disappointing their family or peers, or maintain harmony in their relationships. In an academically challenging environment, these social demands can lead to emotional exhaustion and burnout (Paloș et al., 2019). This dynamic reflects the internal conflict described in SDT, where unbalanced need experiences can undermine well-being, even in the presence of strong personal or social resources (Adigun et al., 2023; B. Chen et al., 2015).

In the academic environment, research on student well-being has often focused on engagement and burnout. Although these areas of research are not new, there is a scarcity of investigation that addresses how personal and social resources, alongside the satisfaction and frustration of psychological needs, interact within the COR framework, particularly in medical education. Relevance is quite high for international medical students, who face not only high academic demands but also challenges such as cultural adjustment, language barriers, and limited social support (Liu et al., 2022; Xiong et al., 2025). Such stressors may limit both the availability of resources and the satisfaction of psychological needs (Fu & Charoensukmongkol, 2022). Consequently, our research focuses explicitly on international medical students, providing a new perspective on these interactions. We found that personal resources (e.g., PsyCap) and social resources, particularly teacher and family support, as well as the need for autonomy satisfaction, are strongly associated with higher levels of academic engagement among international students. Conversely, personal and social resources were not related to academic burnout, which contradicts previous studies highlighting these resources’ direct and mediated effects on burnout (Fu & Charoensukmongkol, 2022; Perry et al., 2023; Yeh & Inose, 2003). Instead, burnout was predicted by the lack of autonomy satisfaction and the frustration of autonomy and relatedness needs. Interestingly, while need satisfaction was related to both dimensions of well-being (i.e., engagement and burnout), need frustration was related only to the negative aspect (i.e., burnout). Another surprising finding was that the need for competence did not predict either dimension of well-being. A possible reason could be the non-competitive environment where these students learn, as there is neither competition among colleagues nor the opportunity to obtain various institutional benefits (e.g., scholarships, tax exemptions). On the other hand, some studies have suggested that fulfilling the need for autonomy also affects the satisfaction of the need for competence (Ryan & Deci, 2017; Vansteenkiste & Ryan, 2013). However, because needs shape academic well-being over and above the effects of personal and social resources, designing educational interventions has to consider this aspect.

5.1. Limitations and Further Directions

While the present results have significant theoretical and practical value, certain limitations need to be mentioned. First, the sample size, while representative of the international students enrolled at the university, is relatively small. Second, the study’s cross-sectional design did not allow for causal conclusions. For a deeper understanding of well-being and its relationships with various outcomes, longitudinal studies incorporating activity diaries might be beneficial (Van den Broeck et al., 2016). Third, self-reported questionnaires may have biased responses due to social desirability. Replacing them with objective measures (e.g., psychophysiological or other external measures) might improve the validity of the findings (Holden et al., 2025). The use of English-language instruments with culturally diverse non-native English-speaking students can be another limitation, as it may restrict the expression of cultural nuances (Harzing, 2005). However, since the study focused on psychological capital, social resources, and psychological needs for first-year international medical students, rather than cross-cultural comparisons, this limitation is expected to have had a minimal impact on the findings. A further constraint is that the students’ cultural backgrounds were not considered (Van den Broeck et al., 2016). Still, existing research indicates that satisfaction of the three basic needs is linked to well-being across cultures, while frustration of these needs contributes to ill-being (B. Chen et al., 2015). It is important to note that the benefits derived from meeting these needs are not culture-dependent, but how they are valued (Van den Broeck et al., 2016) and fulfilled varies by culture (B. Chen et al., 2015). Future research should explore cultural differences and how they may act as moderators or mediators in satisfying or frustrating psychological needs. Furthermore, a comparative study between international and domestic students could highlight the cultural impact on well-being. Finally, although the questionnaire used to assess satisfaction and frustration of psychological needs is widely recognized and validated in several countries, some concerns have been raised about the scale that measures frustration (Murphy et al., 2023). However, Holden et al. (2025, p. 9) encourage its continued use, suggesting a conceptual shift from “need satisfaction versus need frustration” to “need fulfilling versus need unfulfilling”. Nevertheless, the results provide valuable insights into the significance of teachers’ and families’ support in fulfilling international students’ needs for autonomy and relatedness and the consequences of frustrating these needs on their well-being. These findings should not be underestimated, as they suggest practical directions for developing focused interventions to improve international students’ well-being.

5.2. Theoretical and Practical Implications

The present study significantly contributes to our understanding of academic well-being by exploring it within the framework of COR and SDT, which considers personal and social resources and the satisfaction and frustration of psychological needs. Theoretically, the study provides further evidence that needs satisfaction and frustration may lead to different outcomes (Van den Broeck et al., 2016). Thus, satisfaction was related to positive and negative outcomes, such as engagement and burnout, while frustration was more associated with negative ones, such as burnout. In other words, even the satisfaction of some needs to a lesser extent can lead to unfavorable outcomes, not just their frustration (e.g., Unanue et al., 2017). Future studies should replicate these findings across diverse cultural and institutional contexts to assess their generalizability. Practically, our findings can be a starting point for designing specific interventions that increase engagement and reduce burnout. As a powerful personal resource that increases academic well-being (Barratt & Duran, 2021), PsyCap can be developed through interventions that consider it a holistic construct while also focusing on each dimension (Vîrgă et al., 2022). Thus, university counselors can collaborate with professors to design interventions for international students, aiming to strengthen the three most susceptible dimensions to change: self-efficacy, optimism, and resilience (Lupșa et al., 2020). For instance, self-efficacy can be raised through the instructional process (e.g., constructive feedback). Moreover, teaching students effective stress management strategies or implementing brief interventions based on cognitive-behavioral approaches can help foster optimism, hope, and resilience (Lupșa et al., 2020). Furthermore, teachers’ role is essential in stimulating engagement and reducing student burnout. For instance, Gong and Xu (2024) found that providing specific feedback and encouraging students’ efforts helps them self-regulate the learning process (i.e., appraisal teacher support). Likewise, providing information, guidance, clear explanations, and examples related to their experience (i.e., informational teacher support) increases their engagement. This approach also fosters students’ needs for autonomy, competence, and relatedness (Gong & Xu, 2024). The transition of international students to a new culture is stressful, which adds to the pressure of adapting and coping with specific academic demands (Ammigan & Jones, 2018; Lillyman & Bennett, 2014). In these circumstances, creating a safe learning environment in which students feel understood and encouraged (i.e., emotional teacher support) but also providing adequate materials, clearly specifying expectations and learning objectives (i.e., instrumental teacher support) helps them experience a sense of control over the learning process (Gong & Xu, 2024; Lillyman & Bennett, 2014), enhancing engagement and minimizing burnout. The satisfaction of autonomy needs, as well as their thwarting and the need for relatedness, are the strongest predictors of academic international students’ well-being after their psychological capital. Teachers can build an autonomy-supporting learning environment by actively listening to students’ perspectives, providing them with time and opportunities to work autonomously, praising the quality of their work, and offering constructive feedback (X. Chen et al., 2024; Ten Cate et al., 2011). When students’ autonomy needs are fulfilled, it helps satisfy the other two needs (Ryan & Deci, 2017) and significantly enhances their academic well-being.

6. Conclusions

The academic experience for international students comes with significant challenges that require both personal and social resources for effective adaptation (e.g., Perry et al., 2023; Yu et al., 2021). Our results show that academic well-being is shaped by their PsyCap and the quality of social support they receive. Teacher support is essential for learning and adaptation, and fostering environments that sustain autonomy and reduce experiences of exclusion can increase engagement and protect against burnout (e.g., Gong & Xu, 2024; B. Kim et al., 2018). Family support offers stable emotional resources beyond the academic context (e.g., Shu et al., 2020). These findings emphasize the need to help students become aware of how to mobilize their personal and social resources to strengthen adaptability and well-being (e.g., Barratt & Duran, 2021; Vîrgă et al., 2022). For educators, this means creating learning environments that meet students’ psychological needs and encourage peer collaboration (e.g., He et al., 2025). Institutions should provide tailored counseling services, and, at the policy level, well-being should be integrated into internationalization and funding strategies to support not only mobility but also mental health, academic resilience, and social integration (e.g., Xiao, 2025; Xiong et al., 2025).