The role of work schedule characteristics in shaping nurses’ emigration intention in Iran

Background: Nurse emigration exacerbates the growing nursing shortage. As undesirable work schedules are linked to job burnout and emigration intention, this study aimed to comprehensively investigate the association between work schedule characteristics and nurses' intent to emigrate in Iran. Methods: This was a cross-sectional study conducted on ۵۶۰ nurses working in the medical and surgical wards of four affiliated university hospitals in the eastern part of Iran in ۲۰۲۵. Sampling was performed using a multistage cluster sampling method with proportional allocation, followed by simple random sampling within each ward. Data were collected using a demographic questionnaire, an adapted tool from the Trinkoff instrument for work schedule characteristics, and a dichotomous question (Yes/No) assessing intent to emigrate. Data analysis was performed using logistic regression in Stata software version ۱۷, with a significance level of P < ۰.۰۵. Results: A total of ۳۹.۱% of nurses reported an intent to emigrate. In the adjusted model, daily working hours of ۱۳ to ۱۸ hours were associated with a significantly increased intent to emigrate (OR = ۲.۱۲; ۹۵% CI: ۱.۱۲ - ۳.۹۹). Nurses working rotating shifts had a higher likelihood of intent to emigrate compared with those working morning shifts (OR = ۲.۸۹; ۹۵% CI: ۱.۷۳ - ۴.۸۳), and this likelihood was even higher among those working combined morning and night shifts (OR = ۵.۲۶; ۹۵% CI: ۲.۵۴ - ۱۰.۸۹). Furthermore, quick returns (short rest periods between shifts) were identified as a significant predictor (OR = ۲.۱۶; ۹۵% CI: ۱.۲۸ - ۳.۶۵). Conclusion: The findings of this study indicate that long daily working hours, rotating and combined shifts, and quick returns are among the most significant factors associated with nurses' intent to emigrate. Recommendations for health policymakers and administrators include implementing strict limits on daily working hours to eliminate quick returns and restructuring schedules to significantly increase predictability and nurse autonomy. Addressing these stressors can reduce emigration intent and enhance healthcare system stability.

کلیدواژه ها:

Shift Work Schedule ، Emigration and Immigration ، Personnel Staffing and Scheduling ، Nursing Staff ، Work Schedule Tolerance