Migration Intention and the Related Factors among Nursing Students in Iran: A Cross-Sectional Study

Migration Intention and the Related Factors among Nursing Students in Iran: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Migration Intention and the Related Factors among Nursing Students in Iran: A Cross-Sectional Study Hanieh Hasankhani, Atefeh Ghanbari, Saman Maroufizadeh, Nazila Javadi-Pashaki This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5946006/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Nurses’ migration as key personnel in healthcare organizations can negatively affect the nursing profession and the healthcare system. The intention and desire to migrate among nursing students, as the future nursing workforce, can pose additional challenges to the healthcare system. Methods In a descriptive cross-sectional study, 248 nursing students of the nursing and midwifery faculties of Guilan University of Medical Sciences were selected by multi-stage and convenience sampling method. The data was collected through a researcher-made questionnaire about the desire to migrate and the factors related to it. Results The results overall, revealed that the mean age of the students was 22.81 ± 3.55 years, the majority of students were female (%54.0), single (%92.3), engaged in bachelor’s degree (%88.3), interested in nursing (%70.6) and were in favor of emigrating from the country (%61.7). The average score of willingness to migrate was 66.3 ± 20.3. According to the regression results, experience living abroad (b = 13.12, P = 0.017), choosing nursing as a channel for immigration (b = 8.78, P = 0.017), medium foreign language proficiency (b = 6.36, P = 0.007), origin attraction (b = 0.39, P < 0.001) and destination attraction (b = 0.54, P < 0.001) exhibited a statistically correlation relationship with desire to migration (p < 0.05). Conclusion The desire of nursing students to migrate in this study was above average. Therefore, policymakers need to design and implement strategies such as improving the economic conditions of nurses and reforming educational policies to enhance the attractiveness of the nursing profession within the country and retain nursing graduates. migration migration intention student nursing Introduction Nursing, the largest and most crucial workforce in healthcare, interacts with patients more than any other care team member ( 1 ). Adequate nurse staffing is essential for strengthening health systems and achieving health targets ( 2 ). Therefore, the lack of nursing staff can affect the efficiency and effectiveness of the health system ( 3 ). However, a global nursing shortage ( 4 ) impacts nurses, healthcare delivery, and populations worldwide ( 5 ). In 2022, the International Labor Force (ILO) estimated a shortage of about 13 million nurses by 2030 ( 6 ). The global shortage of nurses is influenced by several factors, including the uneven distribution of nurses worldwide, poor working conditions, the weak educational foundation of healthcare workers, the age of nurses, lower enrollment in universities, the increasing number of alternative job opportunities for women, occupational burnout, higher demand for healthcare, the lack of professional identity, and the migration of nurses to other countries ( 3 ). Individual nurses seeking to improve their wages, the desire for wider professional experience, better and more specialized training, increased promotional opportunities, and a higher standard of living lead to work abroad ( 7 ). Migration is not a new phenomenon, but the specific and interdisciplinary study is relatively recent ( 8 ). The Oxford Dictionary defines migration as the movement of people to a new area or country to find work or better living conditions ( 9 ). Nurse migration has become more prominent due to changing demographics and increased healthcare demands. Many countries now depend on internationally trained nurses to address domestic shortages ( 10 ). Nurse migration affects both source and destination countries ( 11 ) and has become a significant topic for both host and donor countries, which are trying to retain nurses who are inclined to migrate ( 12 ). In this regard, Brain drain is defined as the loss of highly skilled or educated individuals from one country, region, institution, or job sector to another, often due to better pay, improved living conditions, and expanded opportunities ( 13 ). Brain drain highlights that experienced and skilled professionals often seek higher income and better living conditions, leading them to migrate to wealthier regions. Healthcare immigrants are viewed as valuable intellectual assets for a country ( 14 ). Migration is the result of the interplay of various forces such as political, social, economic, legal, historical, cultural, and educational ( 5 ). The results indicate that ineffective policies regulations and strategies, poor planning and human resource planning, inadequate workforce planning and recruitment, incompetent implementation plans continued change of government officers, and lack of leadership management were some main factors affecting the shortage in the nursing workforce ( 2 ). In a review of some literature, examining the level of desire to migrate, India 75% ( 15 ), Israel 55% ( 16 ), South Africa 77.4% ( 17 ), Ireland 85% ( 18 ), Serbia 70% ( 19 ), Indonesia 91.3% ( 20 ) and in South Korea 70/8% ( 21 ). Furthermore, a study conducted in Spain in 2019 revealed that lack of employment or precarious employment is the most important reason ( 22 ). In 2016, a study in Poland revealed that nurses leave the country because of professional reasons ( 23 ). In 2016, Valizadeh and his team conducted a study in Iran. They discovered that job dissatisfaction, social or political unrest, and less social welfare are some of the factors that increase the pace of immigration. Making money for the financial security of the family is one of the most important incentives for permanent immigration ( 3 ). In another research study conducted by Haghdoost and colleagues in Iran in 2022, they observed that better education and work situations in the destination country and low job security in Iran were introduced as the most important social security factors in migration ( 24 ). In 2021, Emine ÖNCÜ in Turkey reached the socio-political factors and working conditions were the main push-pull factors in migration ( 25 ). Review of the literature on factors related to the desire to migrate indicates that studies addressing this issue are relatively few, according to these studies, the average desire to migrate among students has been high. Materials and Methods Study design and sampling This study was a cross-sectional study conducted in 2023, investigating migration intentions and its related factors in nursing students. The research involved all first to eighth-semester undergraduate, master, and PhD nursing students from Shahid Beheshti School of Nursing and Midwifery affiliated with Guilan University of Medical Sciences, Iran. Sampling was carried out as a census, the multi-stage and convenience sampling method, with 248 students selected to participate in the study. The inclusion criteria included willingness to participate in the study, and full-time enrollment in nursing. Incomplete questionnaire completion and unwillingness to continue participating in the study were set as an exclusion criterion. Instrument The data collection tool was researcher-made, created by reviewing related literature and based on the questionnaire developed by Janalizadeh Choubbasti and colleagues on the sociological causes of the desire to emigrate among scientific elites ( 25 ). It includes personal-social, academic-occupational information, and the main questions on the desire to migrate and the factors related to it. The personal-social section includes 7 questions: age, gender, marital status, source of income, average income, experience living abroad, and relatives abroad. The academic-occupational section includes 6 questions: grade, Grade Point Average (GPA) of the previous grade, interest in nursing, choosing nursing as a channel for immigration, foreign language proficiency, and type of work experience in the nursing profession. The last part was a two-part questionnaire. The first part contained 30 questions and consisted of four dimensions related to migration intentions and related factors: intention to migrate (questions 1–6), origin attraction ( 7 – 15 ), origin repulsion ( 16 – 23 ), and destination attraction ( 24 – 30 ). The last part was an open-ended section designed to identify new variables, reported as the frequency of mentioned cases. The questions in this questionnaire were based on a five-point Likert scale, ranging from "fully disagree" (score 0) to "fully agree" (score 4). Quantitative content validity was assessed by measuring the content validity ratio (CVR) and content validity index (CVI). For calculating CVR, 10 experts at a nursing school in Rasht rated each item as either "essential," "useful but not essential," or "not essential" on a three-point Likert scale. Cronbach’s alpha coefficients were: 0.98 for migration intention, 0.87 for origin attraction, 1.0 for origin repulsion, and 0.98 for destination attraction, indicating acceptable internal consistency. In this study, the reliability value of the questionnaire, determined using Cronbach’s alpha method, was 0.95. A test-retest with 30 participants was conducted over two weeks, confirming reliability with Cronbach’s alpha values of 0.98 for migration intention (ICC = 0.96), 0.99 for origin attraction (ICC = 0.98), 0.98 for origin repulsion (ICC = 0.97), and 0.97 for destination attraction (ICC = 0.95). Data analysis In this study, the values of quantitative variables were presented as mean (standard deviation) and median (interquartile range), while the values of qualitative variables were shown as frequency (percentage). The Kolmogorov-Smirnov test was used to check the normality of quantitative variables. In univariate statistical analysis, independent t-test, one-way analysis of variance, and Pearson correlation coefficient were used to investigate the relationship between the score of willingness to migrate and the individual-educational characteristics of students. Additionally, the relationship between the propensity to migrate score and the initial attraction, initial repulsion, and destination migration scores was investigated using Pearson’s correlation coefficient. In multivariate analysis, a multiple linear regression model was employed to determine the factors related to the desire to migrate. The data were analyzed using SPSS version 16 software, and a significance level of 0.05 was considered. Results All participants completed the questionnaire. The mean age of students was 22.81±3.55 years, and 54% were female. Most participants were single (92.3%) with a mean income of 43.47±33.17 million Rials. Most participants' source of income was dependent (74.2%), 97.6% had no experience living abroad, and 62.1% of participants had no relatives abroad. Regarding the academic-occupational part, 48.8% of students had medium proficiency in foreign languages, most participants were undergraduate students (88.3%), and 69% had work experience as nursing students. The mean GPA of the previous grade was 18.29±1.37, and 70.6% of students declared that they were interested in nursing. Only 4% chose nursing as a channel for immigration (Table 1). Initially, the study data underwent a normality assessment. The Kolmogorov-Smirnov test results indicated that parametric statistical tests were inapplicable (P<0.001). Subsequently, the mean score for migration intention was 66.3±20.3, and 61.7% of respondents intended to migrate abroad. The mean score for origin attraction was 32.6±16.0, origin repulsion was 65.2±14.4, and destination attraction was 73.0±17.6 (Table 2). Variables in the model, based on multiple regression analysis results, included experience living abroad (b=13.12, P=0.017), choosing nursing as a channel for immigration (b=8.78, P=0.017), medium foreign language proficiency (b=6.36, P=0.007), origin attraction (b=0.39, P<0.001), and destination attraction (b=0.54, P<0.001). These variables exhibited a statistically significant correlation with the desire to migrate (P<0.05). The coefficient of determination (R²) was 0.673, indicating that 67.3% of the variance in the migration intention scores of nursing students is explained by their personal-social, academic-occupational characteristics, and the scores of origin attraction, origin repulsion, and destination attraction factors. Out of the 248 students participating in the study, 30 responded to open-answer questions, resulting in a response rate of 12%. A total of 49 codes (including repeated codes) were obtained from the sample responses, ranked by frequency as follows: Unfavorable job conditions: 46.93% Unfavorable economic conditions in the country: 26.53% Better quality of life abroad: 8.16% Political conditions in the country: 12.24% Unfavorable educational conditions: 6.12%. Discussion Migration intentions of nursing students This study explored the migration intentions and related factors among nursing students. Our results yielded some interesting findings. The research initially focused on examining the desire to migrate. Similar studies, such as those by Emine ÖNCÜ et al. in Turkey ( 24 ), Nguyen et al. in Uganda ( 26 ), Efendi et al. in Indonesia ( 18 ), Silvestri et al. in sub-Saharan Africa and Southeast Asia ( 27 ), Hendel et al. in Israel ( 14 ), Lee and Moon in South Korea ( 28 ), and Poudel et al. in Nepal ( 29 ), have evaluated the desire to migrate, finding it to be over 50% on average. It should be noted that most nursing students in different countries expressed a desire to migrate. Related Factors to Migration Intention The findings of this study, based on multiple regression analysis, reveal that experience living abroad, choosing nursing as a channel for immigration, medium foreign language proficiency, origin attraction, and destination attraction significantly correlate with migration intention. A study conducted in Serbia found that having previous living experience abroad was significantly associated with working abroad. Similarly, a study in Indonesia found that overseas experience increased migration plans by 4.6 times ( 17 , 18 ). The findings regarding foreign language proficiency revealed that acquiring a foreign language might increase the possibility of migration ( 17 , 18 ), whereas a lack of language proficiency acts as a barrier to migration ( 28 ). Although Poudel's study showed that those who did not choose nursing as their first choice had higher migration intentions ( 29 ), our study found a significant correlation between migration intention and choosing nursing as a channel for immigration. Regarding destination attraction, a study in Turkey identified that the most important factor motivating nursing students to immigrate was the desire to live in a freer country with a better quality of life ( 24 ). Another study highlighted that job opportunities and wage differences between the origin and the destination were the strongest variables explaining the desire to migrate ( 30 ). In interviews conducted in Nepal, respondents mentioned low income, limited job opportunities, poor job conditions, insufficient educational quality, and a lack of professional independence in their country of origin ( 29 ). A study in South Africa evaluated higher income as the most important factor attracting people to migrate ( 15 ). Based on various study results and the high destination attraction score in this study, it appears that destination attraction significantly contributes to migration intentions. Enhancing origin attraction and reducing repulsion factors through targeted measures might help lower the desire to migrate among students. Factors Influencing the Intentions to Migrate in Open-Answer Questions According to this study, respondents described their intentions to leave due to several factors. In a study conducted in Iran, elite migration from the perspective of students was influenced by economic, administrative, educational, professional, globalization, social, and cultural factors ( 23 ). Another qualitative review identified economic, cultural-social, scientific-research, managerial, legal, and infrastructural factors as significant ( 13 ). In the study by Lee and Moon in South Korea, economic factors and job conditions in nursing were evaluated as the most important factors affecting migration ( 7 ). Conclusion This is the first study of its kind performed in Iran, focusing on factors related to migration intentions among nursing students. Our main objective was to evaluate the factors influencing the migration intention of students, who represent the future generation of the nursing community. Many of those factors are beyond the scope of this discussion and require detailed and expert reviews. As international migration of nurses is expected to remain high, future studies may benefit from exploring additional theories and using mixed-method approaches for a more comprehensive analysis of these concepts. Declarations Ethics approval and consent to participate: Not applicable. Consent for publication : Not applicable. Competing interests : The authors declare that they have no competing interests. Ethics approval and consent to participate The study was approved by the Research Ethics Committee of the Guilan University of Medical Sciences with the ethics code IR.GUMS.REC.1402.170. Participants were informed about the study aim, confidentiality of their data, anonymity, data privacy and voluntariness of participation, and then written informed consent was obtained from all of them. They were guaranteed the right to withdraw from the research at any time and the confidentiality of their personal information. Funding: This research received no specific grant from funding agencies in the public, commercial or not-for-profit sectors. Author Contribution All the authors were involved in designing the study. NJ: Conceptualization, Methodology, Investigation, Data Curation, Visualization, Project administration, and Writing Original draft preparation. HH: Methodology, Investigation, Data Curation, and Writing Original draft preparation. AGH: Conceptualization, Methodology, Supervision, Writing- Reviewing and Editing. SM: Formal analysis, Writing- Reviewing and Editing. All authors read and approved the final manuscript. Acknowledgements This study is part of the master’s thesis in medical-surgical nursing that has been approved by the ethics committee of Guilan University of Medical Sciences (IR.GUMS.REC.1402.170). The authors would like to thank all the nursing students and the nursing schools affiliated with the Guilan University of Medical Sciences, the Vice Chancellor for Research of Guilan University of Medical Sciences, and all those who helped us in this study. Availability of data and material: The data that support the findings of this study are available from the corresponding author, upon reasonable request. Data availability The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. References Carter J. 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Korean nursing students' intention to migrate abroad. Nurse Educ Today. 2013;33(12):1517–22. Poudel C, Ramjan L, Everett B, Salamonson Y. Exploring migration intention of nursing students in Nepal: A mixed-methods study. Nurse Educ Pract. 2018;29:95–102. Foroutan Y, SOCIO-DEMOGRAPHIC STUDY OF, THE ASSOCIATION BETWEEN IDENTITY AND MIGRATION. Natl Stud. 2011;13(2):24. bozorgzad SKS, Mohseni RA. Investigating the socio-economic factors of the result on the tendency of elites to migrate abroad. Strategic Stud sport youth. 2019;19(48). Tables Tables 1 to 3 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Tables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Adequate nurse staffing is essential for strengthening health systems and achieving health targets (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Therefore, the lack of nursing staff can affect the efficiency and effectiveness of the health system (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). However, a global nursing shortage (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) impacts nurses, healthcare delivery, and populations worldwide (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In 2022, the International Labor Force (ILO) estimated a shortage of about 13\u0026nbsp;million nurses by 2030 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe global shortage of nurses is influenced by several factors, including the uneven distribution of nurses worldwide, poor working conditions, the weak educational foundation of healthcare workers, the age of nurses, lower enrollment in universities, the increasing number of alternative job opportunities for women, occupational burnout, higher demand for healthcare, the lack of professional identity, and the migration of nurses to other countries (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Individual nurses seeking to improve their wages, the desire for wider professional experience, better and more specialized training, increased promotional opportunities, and a higher standard of living lead to work abroad (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMigration is not a new phenomenon, but the specific and interdisciplinary study is relatively recent (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The Oxford Dictionary defines migration as the movement of people to a new area or country to find work or better living conditions (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Nurse migration has become more prominent due to changing demographics and increased healthcare demands. Many countries now depend on internationally trained nurses to address domestic shortages (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Nurse migration affects both source and destination countries (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) and has become a significant topic for both host and donor countries, which are trying to retain nurses who are inclined to migrate (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In this regard, Brain drain is defined as the loss of highly skilled or educated individuals from one country, region, institution, or job sector to another, often due to better pay, improved living conditions, and expanded opportunities (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Brain drain highlights that experienced and skilled professionals often seek higher income and better living conditions, leading them to migrate to wealthier regions. Healthcare immigrants are viewed as valuable intellectual assets for a country (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMigration is the result of the interplay of various forces such as political, social, economic, legal, historical, cultural, and educational (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The results indicate that ineffective policies regulations and strategies, poor planning and human resource planning, inadequate workforce planning and recruitment, incompetent implementation plans continued change of government officers, and lack of leadership management were some main factors affecting the shortage in the nursing workforce (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). In a review of some literature, examining the level of desire to migrate, India 75% (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), Israel 55% (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), South Africa 77.4% (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), Ireland 85% (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), Serbia 70% (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), Indonesia 91.3% (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and in South Korea 70/8% (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Furthermore, a study conducted in Spain in 2019 revealed that lack of employment or precarious employment is the most important reason (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). In 2016, a study in Poland revealed that nurses leave the country because of professional reasons (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). In 2016, Valizadeh and his team conducted a study in Iran. They discovered that job dissatisfaction, social or political unrest, and less social welfare are some of the factors that increase the pace of immigration. Making money for the financial security of the family is one of the most important incentives for permanent immigration (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In another research study conducted by Haghdoost and colleagues in Iran in 2022, they observed that better education and work situations in the destination country and low job security in Iran were introduced as the most important social security factors in migration (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). In 2021, Emine \u0026Ouml;NC\u0026Uuml; in Turkey reached the socio-political factors and working conditions were the main push-pull factors in migration (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eReview of the literature on factors related to the desire to migrate indicates that studies addressing this issue are relatively few, according to these studies, the average desire to migrate among students has been high.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and sampling\u003c/h2\u003e \u003cp\u003eThis study was a cross-sectional study conducted in 2023, investigating migration intentions and its related factors in nursing students. The research involved all first to eighth-semester undergraduate, master, and PhD nursing students from Shahid Beheshti School of Nursing and Midwifery affiliated with Guilan University of Medical Sciences, Iran. Sampling was carried out as a census, the multi-stage and convenience sampling method, with 248 students selected to participate in the study. The inclusion criteria included willingness to participate in the study, and full-time enrollment in nursing. Incomplete questionnaire completion and unwillingness to continue participating in the study were set as an exclusion criterion.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInstrument\u003c/h3\u003e\n\u003cp\u003eThe data collection tool was researcher-made, created by reviewing related literature and based on the questionnaire developed by Janalizadeh Choubbasti and colleagues on the sociological causes of the desire to emigrate among scientific elites (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). It includes personal-social, academic-occupational information, and the main questions on the desire to migrate and the factors related to it.\u003c/p\u003e \u003cp\u003eThe personal-social section includes 7 questions: age, gender, marital status, source of income, average income, experience living abroad, and relatives abroad. The academic-occupational section includes 6 questions: grade, Grade Point Average (GPA) of the previous grade, interest in nursing, choosing nursing as a channel for immigration, foreign language proficiency, and type of work experience in the nursing profession.\u003c/p\u003e \u003cp\u003eThe last part was a two-part questionnaire. The first part contained 30 questions and consisted of four dimensions related to migration intentions and related factors: intention to migrate (questions 1\u0026ndash;6), origin attraction (\u003cspan additionalcitationids=\"CR8 CR9 CR10 CR11 CR12 CR13 CR14\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), origin repulsion (\u003cspan additionalcitationids=\"CR17 CR18 CR19 CR20 CR21 CR22\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), and destination attraction (\u003cspan additionalcitationids=\"CR25 CR26 CR27 CR28 CR29\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). The last part was an open-ended section designed to identify new variables, reported as the frequency of mentioned cases. The questions in this questionnaire were based on a five-point Likert scale, ranging from \"fully disagree\" (score 0) to \"fully agree\" (score 4).\u003c/p\u003e \u003cp\u003eQuantitative content validity was assessed by measuring the content validity ratio (CVR) and content validity index (CVI). For calculating CVR, 10 experts at a nursing school in Rasht rated each item as either \"essential,\" \"useful but not essential,\" or \"not essential\" on a three-point Likert scale. Cronbach\u0026rsquo;s alpha coefficients were: 0.98 for migration intention, 0.87 for origin attraction, 1.0 for origin repulsion, and 0.98 for destination attraction, indicating acceptable internal consistency. In this study, the reliability value of the questionnaire, determined using Cronbach\u0026rsquo;s alpha method, was 0.95. A test-retest with 30 participants was conducted over two weeks, confirming reliability with Cronbach\u0026rsquo;s alpha values of 0.98 for migration intention (ICC\u0026thinsp;=\u0026thinsp;0.96), 0.99 for origin attraction (ICC\u0026thinsp;=\u0026thinsp;0.98), 0.98 for origin repulsion (ICC\u0026thinsp;=\u0026thinsp;0.97), and 0.97 for destination attraction (ICC\u0026thinsp;=\u0026thinsp;0.95).\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eIn this study, the values of quantitative variables were presented as mean (standard deviation) and median (interquartile range), while the values of qualitative variables were shown as frequency (percentage). The Kolmogorov-Smirnov test was used to check the normality of quantitative variables. In univariate statistical analysis, independent t-test, one-way analysis of variance, and Pearson correlation coefficient were used to investigate the relationship between the score of willingness to migrate and the individual-educational characteristics of students. Additionally, the relationship between the propensity to migrate score and the initial attraction, initial repulsion, and destination migration scores was investigated using Pearson\u0026rsquo;s correlation coefficient. In multivariate analysis, a multiple linear regression model was employed to determine the factors related to the desire to migrate. The data were analyzed using SPSS version 16 software, and a significance level of 0.05 was considered.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eAll participants completed the questionnaire. The mean age of students was 22.81±3.55 years, and 54% were female. Most participants were single (92.3%) with a mean income of 43.47±33.17 million Rials. Most participants' source of income was dependent (74.2%), 97.6% had no experience living abroad, and 62.1% of participants had no relatives abroad. Regarding the academic-occupational part, 48.8% of students had medium proficiency in foreign languages, most participants were undergraduate students (88.3%), and 69% had work experience as nursing students. The mean GPA of the previous grade was 18.29±1.37, and 70.6% of students declared that they were interested in nursing. Only 4% chose nursing as a channel for immigration (Table 1).\u003c/p\u003e\n\u003cp\u003eInitially, the study data underwent a normality assessment. The Kolmogorov-Smirnov test results indicated that parametric statistical tests were inapplicable (P\u0026lt;0.001). Subsequently, the mean score for migration intention was 66.3±20.3, and 61.7% of respondents intended to migrate abroad. The mean score for origin attraction was 32.6±16.0, origin repulsion was 65.2±14.4, and destination attraction was 73.0±17.6 (Table 2).\u003c/p\u003e\n\u003cp\u003eVariables in the model, based on multiple regression analysis results, included experience living abroad (b=13.12, P=0.017), choosing nursing as a channel for immigration (b=8.78, P=0.017), medium foreign language proficiency (b=6.36, P=0.007), origin attraction (b=0.39, P\u0026lt;0.001), and destination attraction (b=0.54, P\u0026lt;0.001). These variables exhibited a statistically significant correlation with the desire to migrate (P\u0026lt;0.05). The coefficient of determination (R²) was 0.673, indicating that 67.3% of the variance in the migration intention scores of nursing students is explained by their personal-social, academic-occupational characteristics, and the scores of origin attraction, origin repulsion, and destination attraction factors.\u003c/p\u003e\n\u003cp\u003eOut of the 248 students participating in the study, 30 responded to open-answer questions, resulting in a response rate of 12%. A total of 49 codes (including repeated codes) were obtained from the sample responses, ranked by frequency as follows:\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eUnfavorable job conditions: 46.93%\u003c/li\u003e\n \u003cli\u003eUnfavorable economic conditions in the country: 26.53%\u003c/li\u003e\n \u003cli\u003eBetter quality of life abroad: 8.16%\u003c/li\u003e\n \u003cli\u003ePolitical conditions in the country: 12.24%\u003c/li\u003e\n \u003cli\u003eUnfavorable educational conditions: 6.12%.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eMigration intentions of nursing students\u003c/h2\u003e \u003cp\u003eThis study explored the migration intentions and related factors among nursing students. Our results yielded some interesting findings. The research initially focused on examining the desire to migrate. Similar studies, such as those by Emine \u0026Ouml;NC\u0026Uuml; et al. in Turkey (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), Nguyen et al. in Uganda (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), Efendi et al. in Indonesia (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), Silvestri et al. in sub-Saharan Africa and Southeast Asia (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), Hendel et al. in Israel (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), Lee and Moon in South Korea (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), and Poudel et al. in Nepal (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), have evaluated the desire to migrate, finding it to be over 50% on average. It should be noted that most nursing students in different countries expressed a desire to migrate.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eRelated Factors to Migration Intention\u003c/h3\u003e\n\u003cp\u003eThe findings of this study, based on multiple regression analysis, reveal that experience living abroad, choosing nursing as a channel for immigration, medium foreign language proficiency, origin attraction, and destination attraction significantly correlate with migration intention. A study conducted in Serbia found that having previous living experience abroad was significantly associated with working abroad. Similarly, a study in Indonesia found that overseas experience increased migration plans by 4.6 times (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). The findings regarding foreign language proficiency revealed that acquiring a foreign language might increase the possibility of migration (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), whereas a lack of language proficiency acts as a barrier to migration (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough Poudel's study showed that those who did not choose nursing as their first choice had higher migration intentions (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), our study found a significant correlation between migration intention and choosing nursing as a channel for immigration. Regarding destination attraction, a study in Turkey identified that the most important factor motivating nursing students to immigrate was the desire to live in a freer country with a better quality of life (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Another study highlighted that job opportunities and wage differences between the origin and the destination were the strongest variables explaining the desire to migrate (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn interviews conducted in Nepal, respondents mentioned low income, limited job opportunities, poor job conditions, insufficient educational quality, and a lack of professional independence in their country of origin (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). A study in South Africa evaluated higher income as the most important factor attracting people to migrate (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Based on various study results and the high destination attraction score in this study, it appears that destination attraction significantly contributes to migration intentions. Enhancing origin attraction and reducing repulsion factors through targeted measures might help lower the desire to migrate among students.\u003c/p\u003e\n\u003ch3\u003eFactors Influencing the Intentions to Migrate in Open-Answer Questions\u003c/h3\u003e\n\u003cp\u003eAccording to this study, respondents described their intentions to leave due to several factors. In a study conducted in Iran, elite migration from the perspective of students was influenced by economic, administrative, educational, professional, globalization, social, and cultural factors (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Another qualitative review identified economic, cultural-social, scientific-research, managerial, legal, and infrastructural factors as significant (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). In the study by Lee and Moon in South Korea, economic factors and job conditions in nursing were evaluated as the most important factors affecting migration (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis is the first study of its kind performed in Iran, focusing on factors related to migration intentions among nursing students. Our main objective was to evaluate the factors influencing the migration intention of students, who represent the future generation of the nursing community. Many of those factors are beyond the scope of this discussion and require detailed and expert reviews. As international migration of nurses is expected to remain high, future studies may benefit from exploring additional theories and using mixed-method approaches for a more comprehensive analysis of these concepts.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003e \u003cb\u003eConsent for publication\u003c/b\u003e:\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003e Competing interests\u003c/b\u003e:\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e \u003cp\u003e The study was approved by the Research Ethics Committee of the Guilan University of Medical Sciences with the ethics code IR.GUMS.REC.1402.170. Participants were informed about the study aim, confidentiality of their data, anonymity, data privacy and voluntariness of participation, and then written informed consent was obtained from all of them. They were guaranteed the right to withdraw from the research at any time and the confidentiality of their personal information.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eThis research received no specific grant from funding agencies in the public, commercial or not-for-profit sectors.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAll the authors were involved in designing the study. NJ: Conceptualization, Methodology, Investigation, Data Curation, Visualization, Project administration, and Writing Original draft preparation. HH: Methodology, Investigation, Data Curation, and Writing Original draft preparation. AGH: Conceptualization, Methodology, Supervision, Writing- Reviewing and Editing. SM: Formal analysis, Writing- Reviewing and Editing. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003e This study is part of the master\u0026rsquo;s thesis in medical-surgical nursing that has been approved by the ethics committee of Guilan University of Medical Sciences (IR.GUMS.REC.1402.170). The authors would like to thank all the nursing students and the nursing schools affiliated with the Guilan University of Medical Sciences, the Vice Chancellor for Research of Guilan University of Medical Sciences, and all those who helped us in this study.\u003c/p\u003e\u003ch2\u003eAvailability of data and material:\u003c/h2\u003e \u003cp\u003eThe data that support the findings of this study are available from the corresponding author, upon reasonable request.\u003c/p\u003e\u003ch2\u003eData availability\u003c/h2\u003e \u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCarter J. The Dangerous Impact of the National Nursing Shortage: As Health Care\u0026rsquo;s Most Critical Workforce Shrinks, Dire Threats to Quality Patient Care Will Grow. 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTamata AT, Mohammadnezhad M. A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. Nurs open. 2023;10(3):1247\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eValizadeh S, Hasankhani H, Shojaeimotlagh V. Nurses' Immigration: causes and problems. Int J Med Res Health Sci. 2016;5(9S):486\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEmanuel-Frith M. Effects of nurse migration on healthcare improvement. BMJ. 2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKline DS. Push and pull factors in international nurse migration. 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Religion. 2019;64:8650.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoyce S, Lash R, de Leon Siantz ML. Migration experiences of foreign educated nurses: a systematic review of the literature. J Transcult Nurs. 2016;27(2):181\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraithwaite J. Changing how we think about healthcare improvement. BMJ. 2018;361:k2014.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoshiri E, Mohammadi N, Yarahmadi S. Who gets the benefits from nurse migration? Nurs Pract Today. 2022;9(2):81\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVega-Mu\u0026ntilde;oz A, G\u0026oacute;nzalez-G\u0026oacute;mez-del-Mi\u0026ntilde;o P, Espinosa-Cristia JF. Recognizing new trends in brain drain studies in the framework of global sustainability. Sustainability. 2021;13(6):3195.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eValizadeh S, Hasankhani H, Shojaeimotlagh V. Nurses\u0026rsquo; Immigration: causes and problems. Int J Med Res Health Sci. 2016;5(9S):486\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWalton-Roberts M, Runnels V, Rajan SI, Sood A, Nair S, Thomas P, et al. Causes, consequences, and policy responses to the migration of health workers: key findings from India. Hum Resour Health. 2017;15:1\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHendel T, Kagan I. Professional image and intention to emigrate among Israeli nurses and nursing students. Nurse Educ Today. 2011;31(3):259\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGeorge G, Reardon C. Preparing for export? Medical and nursing student migration intentions post-qualification in South Africa. Afr J Prim Health Care Fam Med. 2013;5(1):483.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDeasy C, O Loughlin C, Markey K, O Donnell C, Murphy Tighe S, Doody O, et al. Effective workforce planning: Understanding final-year nursing and midwifery students\u0026rsquo; intentions to migrate after graduation. J Nurs Adm Manag. 2021;29(2):220\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSantric-Milicevic M, Matejic B, Terzic-Supic Z, Vasic V, Babic U, Vukovic V. Determinants of intention to work abroad of college and specialist nursing graduates in Serbia. Nurse Educ Today. 2015;35(4):590\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEfendi F, Oda H, Kurniati A, Hadjo SS, Nadatien I, Ritonga IL. Determinants of nursing students' intention to migrate overseas to work and implications for sustainability: The case of Indonesian students. Nurs Health Sci. 2021;23(1):103\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee E. Factors influencing the intent to migrate in nursing students in South Korea. J Transcult Nurs. 2016;27(5):529\u0026ndash;37.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGea-Caballero V, Castro‐S\u0026aacute;nchez E, D\u0026iacute;az‐Herrera M\u0026Aacute;, Sarabia‐Cobo C, Ju\u0026aacute;rez‐Vela R, Zabaleta‐Del Olmo E. Motivations, beliefs, and expectations of Spanish nurses planning migration for economic reasons: A cross‐sectional, web‐based survey. J Nurs Scholarsh. 2019;51(2):178\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSzpakowski R, Zając PW, Dykowska G, Sienkiewicz Z, Augustynowicz A, Czerw A. Labour migration of Polish nurses: a questionnaire survey conducted with the Computer Assisted Web Interview technique. Hum Resour health. 2016;14:79\u0026ndash;88.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaghdoost AA, Noorihekmat S, Talaei B, Malekpour Afshar R, Salavati B, Behzadi F, et al. An Investigation of Factors Associated with Emigration of the Health Workforce in Iran in 2022. Iran J Cult Health Promotion. 2022;6(2):205\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u0026Ouml;nc\u0026uuml; E, Vayısoğlu SK, Karadağ G, Ala\u0026ccedil;am B, G\u0026ouml;v P, Selcuk Tosun A, et al. Intention to migrate among the next generation of Turkish nurses and drivers of migration. J Nurs Adm Manag. 2021;29(3):487\u0026ndash;96.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJanalizadeh Chub Basti H, Aliverdinia A, Pourqazi S. A Sociological Study of Scientific Elite's Tendency to Emigrate from Iran. Strategy Cult. 2014;7(25):153\u0026ndash;78.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNguyen L, Ropers S, Nderitu E, Zuyderduin A, Luboga S, Hagopian A. Intent to migrate among nursing students in Uganda: measures of the brain drain in the next generation of health professionals. Hum Resour Health. 2008;6(1):1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSilvestri DM, Blevins M, Afzal AR, Andrews B, Derbew M, Kaur S, et al. Medical and nursing students' intentions to work abroad or in rural areas: a cross-sectional survey in Asia and Africa. Bull World Health Organ. 2014;92:750\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee E, Moon M. Korean nursing students' intention to migrate abroad. Nurse Educ Today. 2013;33(12):1517\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePoudel C, Ramjan L, Everett B, Salamonson Y. Exploring migration intention of nursing students in Nepal: A mixed-methods study. Nurse Educ Pract. 2018;29:95\u0026ndash;102.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eForoutan Y, SOCIO-DEMOGRAPHIC STUDY OF, THE ASSOCIATION BETWEEN IDENTITY AND MIGRATION. Natl Stud. 2011;13(2):24.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ebozorgzad SKS, Mohseni RA. Investigating the socio-economic factors of the result on the tendency of elites to migrate abroad. Strategic Stud sport youth. 2019;19(48).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 3 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"migration, migration intention, student, nursing","lastPublishedDoi":"10.21203/rs.3.rs-5946006/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5946006/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eNurses\u0026rsquo; migration as key personnel in healthcare organizations can negatively affect the nursing profession and the healthcare system. The intention and desire to migrate among nursing students, as the future nursing workforce, can pose additional challenges to the healthcare system.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn a descriptive cross-sectional study, 248 nursing students of the nursing and midwifery faculties of Guilan University of Medical Sciences were selected by multi-stage and convenience sampling method. The data was collected through a researcher-made questionnaire about the desire to migrate and the factors related to it.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe results overall, revealed that the mean age of the students was 22.81\u0026thinsp;\u0026plusmn;\u0026thinsp;3.55 years, the majority of students were female (%54.0), single (%92.3), engaged in bachelor\u0026rsquo;s degree (%88.3), interested in nursing (%70.6) and were in favor of emigrating from the country (%61.7). The average score of willingness to migrate was 66.3\u0026thinsp;\u0026plusmn;\u0026thinsp;20.3. According to the regression results, experience living abroad (b\u0026thinsp;=\u0026thinsp;13.12, P\u0026thinsp;=\u0026thinsp;0.017), choosing nursing as a channel for immigration (b\u0026thinsp;=\u0026thinsp;8.78, P\u0026thinsp;=\u0026thinsp;0.017), medium foreign language proficiency (b\u0026thinsp;=\u0026thinsp;6.36, P\u0026thinsp;=\u0026thinsp;0.007), origin attraction (b\u0026thinsp;=\u0026thinsp;0.39, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and destination attraction (b\u0026thinsp;=\u0026thinsp;0.54, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) exhibited a statistically correlation relationship with desire to migration (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe desire of nursing students to migrate in this study was above average. Therefore, policymakers need to design and implement strategies such as improving the economic conditions of nurses and reforming educational policies to enhance the attractiveness of the nursing profession within the country and retain nursing graduates.\u003c/p\u003e","manuscriptTitle":"Migration Intention and the Related Factors among Nursing Students in Iran: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-13 18:28:13","doi":"10.21203/rs.3.rs-5946006/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"88f9f685-182f-464a-a871-1397514e37ea","owner":[],"postedDate":"February 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-03-28T09:39:02+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-13 18:28:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5946006","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5946006","identity":"rs-5946006","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}