Prioritizing drivers of nursing migration: a summative content analysis of influential factors

Abstract

Abstract Background The migration of nurses, nursing students, and graduates has become a global phenomenon shaped by various factors influencing their decision to relocate for education and employment. Understanding these factors is crucial because nurse migration directly impacts workforce availability, retention, and the equity of healthcare services worldwide. This study aimed to rank the factors driving nurse migration from the perspective of nurses in Hamadan Province, western Iran. Methods The research team implemented a summative content analysis on Porsline’s electronic survey system to collect data. Research participants included nurses serving in government hospitals and nursing students from both government and private institutions in Hamadan Province, located in western Iran. A total of 724 nursing students and nurses participated in the study, which was conducted through convenience sampling. They provided open-ended responses to the inquiry: “Have you ever considered migrating abroad as a nursing student, graduate, or practicing nurse?” What reasons and factors have led you to consider migration?”. Results Data analysis, within the framework of the global chain of care theory, identified five key themes, which were ranked and assessed on the basis of frequency and their perceived impact: (1) economic drivers (666 frequency), including factors such as low salaries, high living costs, and the pursuit of improved living standards; (2) the workplace environment and career development (432 frequency), addressing issues such as poor working conditions, workplace hostility, limited career advancement opportunities, and the allure of better prospects abroad; (3) sociopolitical and systemic challenges (92 frequency), encompassing weaknesses in the healthcare system, political instability, and economic uncertainty; (4) personal and family motivations (47 frequency), which include aspects such as family welfare and sociocultural aspirations; and (5) global demand and recruitment (31 frequency), emphasizing the influence of peers and active international recruitment strategies. The findings of this study led to the creation of a new theme (theme 3) outside the theoretical framework, which includes factors such as political instability, health care system weaknesses, and structural constraints—elements not directly addressed in the global chain of care (GCC) theory. Conclusion This study revealed that nurse migration in Iran is predominantly influenced by economic and workplace-related challenges, with distinct variations observed among nursing students, graduates, and practicing nurses. The primary factors contributing to this phenomenon include economic issues, such as insufficient salaries and elevated living expenses, as well as unfavorable working conditions and limited opportunities for career advancement. To mitigate these challenges, policymakers are urged to implement strategies focused on increasing salaries, improving workplace conditions, and providing avenues for professional development. Clinical trial number Not applicable

Keywords

• Migration
• Global chain of care
• Nursing
• Summative content analysis
• Qualitative study