Unravelling the Motivational Drivers of Greek Nurses' Migration in a Post‐COVID Era

ABSTRACT

Aims

Nurse migration remains a significant issue in global healthcare, often driven by economic incentives, work environment factors, and professional development opportunities. Greece's prolonged economic crisis and low nurse‐to‐population ratios have further intensified the outflow of skilled nursing personnel. We aimed to examine how demographic, educational, and professional factors, along with working conditions and perceived challenges, influence Greek nurses' motivation to migrate after the COVID‐19 pandemic.

Design

This quantitative study surveyed 121 Greek nurses–both employed and unemployed, from various regions.

Methods

Structured questionnaires featuring closed‐ended, Likert‐scale, and open‐ended items were used. Questions covered demographics, working conditions, migration motives, and perceived challenges. Data were analysed using Pearson's Chi‐Square, Likelihood Ratio tests, and correlation coefficients, with statistical significance set at p < 0.05.

Results

Economic prospects, quality of life, and access to language support emerged as key “pull” factors. Conversely, family obligations, emotional attachments to Greece, fear of discrimination, and inadequate language skills served as barriers to migration. Age and marital status both shaped participants' attitudes; younger nurses were generally more optimistic about overseas opportunities, while those with multiple children expressed greater reluctance. Increased computer literacy and higher education correlated with reduced concerns, and leadership responsibilities were linked to heightened caution about relocating.

Conclusion

Findings underscore the complexity of nurse migration decisions. Policymakers and healthcare institutions should consider providing enhanced career development, language support, and better working conditions to retain Greek nurses and mitigate the impact of ongoing workforce shortages.

Impact

This study highlights critical factors influencing nurse migration, informing policies to improve retention and address workforce shortages in Greece.

Patient or Public Contribution

Participants provided insights on migration motives, enriching understanding of healthcare workforce dynamics and informing policy development for retention.

1. Introduction

Nurses, who comprise nearly half of the global healthcare workforce, have played a pivotal role in the effective response of health systems during epidemics (World Health Organization ^2020a). Their centrality became even more evident amidst the COVID‐19 pandemic, when healthcare providers worldwide struggled to meet the escalating demand for nursing personnel. In many cases, these pressures led to hospitals and healthcare organisations turning to internationally educated nurses, thereby intensifying the global movement of nursing professionals—often referred to as “brain drain” (Organization for Economic Co‐operation and Development ²⁰²⁰).

The emigration of nurses from lower‐ or middle‐income countries to those offering higher wages, better working conditions, and expanded opportunities for career development is far from a new phenomenon (International Council of Nurses ²⁰²¹). However, the pandemic created additional strains, exposing vulnerabilities in health systems worldwide and accentuating preexisting nursing shortages (International Council of Nurses ²⁰²¹).

Within this context, Greece has witnessed a growing propensity among its nursing workforce to seek employment abroad, driven by economic and professional considerations as well as broader social, political, and personal factors (Eurostat 2021; Hellenic Statistical Authority ²⁰²⁰; Ifanti et al. ²⁰¹³; Economou et al. ²⁰¹⁵). Greece currently faces one of the lowest nurse‐to‐population ratios in Europe, exacerbating challenges in delivering quality patient care (Eurostat 2021; Hellenic Statistical Authority ²⁰²⁰; Ifanti et al. ²⁰¹³; Economou et al. ²⁰¹⁵). This shortage has been compounded by the country's protracted economic crisis, which has placed considerable strain on public healthcare funding and limited opportunities for professional growth (Eurostat 2021; Hellenic Statistical Authority ²⁰²⁰; Ifanti et al. ²⁰¹³; Economou et al. ²⁰¹⁵). Consequently, Greek nurses are often left grappling with inadequate compensation, increased workloads, and reduced resources—factors that can intensify their desire to seek better prospects elsewhere (Eurostat 2021; Hellenic Statistical Authority ²⁰²⁰; Ifanti et al. ²⁰¹³; Economou et al. ²⁰¹⁵).

Despite extensive scholarship on healthcare professionals' migration, there remains a gap in understanding the unique beliefs, motivations, and concerns influencing Greek nurses' decisions to relocate in the post‐COVID‐19 era. The objective of this study was to explore how various demographic, educational, and professional characteristics, working conditions, and perceived challenges influence the motivations of Greek nurses to migrate, within the context of the post‐COVID‐19 era.

2. Methods

2.1. Design

This study employed a quantitative, cross‐sectional, descriptive‐correlational survey design to examine the factors influencing Greek nurses' intentions to migrate in the post‐COVID‐19 era. The study used a structured questionnaire to capture nurses' demographic, educational, and professional characteristics, working conditions, motivations, and perceived barriers to migration. The design enabled the statistical analysis of associations between key variables and allowed for the derivation of objective, data‐driven conclusions relevant to nursing workforce policy and planning.

2.2. Sample and Setting

The study population included licensed Greek nurses employed in public or private healthcare facilities, as well as unemployed nurses actively seeking work. Inclusion criteria required participants to be aged 18 or older, hold valid nursing licensure in Greece, and provide informed consent. Nurses were classified as “considering migration” if they responded affirmatively to a screening item regarding their intention to work abroad. Exclusion criteria included nurses who were retired, had resided abroad for extended periods (over 5 years), or failed to complete major sections of the questionnaire.

Recruitment followed a non‐probability, convenience sampling strategy. Participants were recruited voluntarily over a 3‐month period via both online and printed formats. Electronic questionnaires were distributed through email lists, professional nursing forums, and private social media groups. Printed surveys were delivered by hand to public and private healthcare units throughout Thessaly, with particular attention to rural areas and facilities with limited digital access. Participating institutions included all major public hospitals in the capitals of Larissa, Volos, Karditsa, and Trikala; the University Hospital of Larissa; 21 regional health centres under the 5th Regional Health Authority (Primary Health Care Services ²⁰²³); and 31 private healthcare providers (Giannake et al. 2023).

A power analysis was conducted using the estimated population of registered nurses in the Larissa region (approximately 1150) (Primary Health Care Services ²⁰²³). Assuming a confidence level of 95% and an 8% margin of error, the required sample size was calculated as 117 participants. A total of 121 complete responses were obtained, meeting the statistical power threshold for exploratory analysis.

2.3. Instrument

Data were collected using a newly developed structured questionnaire, informed by a review of the international literature on nurse migration. The instrument comprised four major sections: (1) demographics (age, gender, marital status, number of children, education level); (2) employment and working conditions (sector, type of contract, years of experience, leadership role); (3) beliefs and motivations regarding migration (including target destinations, reasons for migrating, and perceptions of nursing abroad); and (4) perceived barriers and emotional factors (such as language concerns, cultural adaptation, and family ties). The survey included a mix of multiple‐choice, 5‐point Likert scale, and open‐ended items, totalling 38 items. Items were adapted from validated migration‐related studies and refined to suit the Greek context.

2.4. Pilot Testing

The questionnaire underwent content validation by a panel of four subject‐matter experts in nursing workforce research, who assessed relevance, clarity, and cultural appropriateness. A pilot study was conducted with 10 registered nurses from different healthcare settings (primary, secondary, and tertiary), representing diverse age groups and employment statuses. Feedback from the pilot participants led to minor linguistic adjustments for clarity and consistency, but no major structural changes were required. Internal consistency reliability, assessed using Cronbach's alpha, was 0.82, indicating strong reliability. The English translation of the questionnaire is available in the Data S1.

2.5. Ethical Considerations

This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The protocol was approved by the Larissa University Hospital Ethics Committee (approval number: 48841/25/10/2019). All participants were informed of the study's purpose, the procedures involved, potential risks, and their rights to withdraw from the study at any point without penalty. Informed consent was obtained through two separate processes depending on the mode of participation. For online respondents, consent was given electronically through a mandatory consent form that appeared before accessing the survey. Participants were required to read a detailed explanation of the study and click “I agree to participate” before proceeding. For participants who completed printed questionnaires, a written consent form was attached as the first page of the survey package. Participants were asked to read and sign this form before completing the questionnaire. All consent procedures emphasised voluntary participation, anonymity, and the right to withdraw at any stage without consequence.

2.6. Data Analysis

All statistical analyses were performed using IBM SPSS Statistics version 26. Statistical significance was defined at an alpha level of 0.05, and all tests were two‐tailed. Prior to analysis, the dataset was screened for missing values, inconsistencies, and outliers. Cases with more than 20% missing responses were excluded from analysis, while isolated missing values were handled using listwise deletion. Outliers were assessed using boxplots and z‐scores; no extreme values required removal. The assumption of normality for continuous variables, such as years of professional experience, was evaluated using the Shapiro–Wilk test.

Descriptive statistics were calculated to summarise demographic and professional characteristics, as well as participants' beliefs and motivations. Frequencies and percentages were used for categorical variables, while means and standard deviations were computed for continuous variables where appropriate.

Inferential statistical tests were selected based on the type of variable and distribution characteristics. Associations between categorical variables were examined using Pearson's Chi‐Square test. In cases where expected cell counts were low or statistical significance was borderline, the Likelihood Ratio test was also reported for confirmation. The strength of associations was quantified using Phi coefficients for 2 × 2 tables and Cramer's V for larger contingency tables.

Likert‐scale items were treated as ordinal variables. Where necessary, ordinal categories were collapsed into broader groupings (e.g., “Agree” and “Strongly Agree”) to satisfy the assumptions of the Chi‐Square test. The Mann–Whitney U test was used to compare ordinal responses between two independent groups, such as participants with and without leadership roles. For normally distributed continuous variables, independent samples t‐tests were applied. When data were not normally distributed, the Mann–Whitney U test or Kruskal–Wallis test was used as a non‐parametric alternative.

Correlations between continuous variables, such as years of experience and language knowledge, were assessed using Pearson correlation coefficients. When normality assumptions were not met, Spearman's rank correlation was considered. Although no formal correction for multiple comparisons (e.g., Bonferroni adjustment) was applied due to the exploratory nature of the study, exact p‐values and effect sizes are reported to aid interpretation and transparency.

Finally, open‐ended responses were reviewed using a descriptive qualitative approach. Two independent reviewers examined the content to identify recurring themes. Given the limited number and brevity of responses, no formal thematic coding was conducted.

3. Results

3.1. Demographic Profile of Participants

The final sample comprised 121 participants. Of the total responses, 92 were collected via online platforms (email, nursing websites, and social media), and 29 were collected via printed surveys. Participant demographics are presented in Table 1. Of these participants, 88.7% (n = 107) were women, and 11.3% (n = 14) were men. With regard to age, the largest proportion fell into the 36–45 age group (54.5%), representing the mid‐career nurses. The 25–35 age group represented 14% of the sample, reflecting those at the start of their careers, while 31.4% were 46–55 years old. Marital status data indicated that 76.9% of participants were married, 9.9% were single, and 5.8% were divorced. In parallel, 36.4% reported having two children, and 20.7% reported having three or more. In terms of educational background, 66.1% of participants held a Technical Education (TE) degree, 21.5% held a University (PE) degree, and 12.4% possessed a secondary‐level diploma. Most had completed a bachelor's program (57%), followed by 41.3% with a master's and 1.7% with a doctorate. Levels of English proficiency varied, as 28.9% self‐reported moderate ability (B1), 28.1% reported advanced ability (C2), and 5.8% stated no knowledge of English. Approximately two‐thirds (66.9%) considered themselves to have very good computer skills, whereas 33.1% rated themselves as moderately competent. Regarding employment, 53.7% worked in primary healthcare services, 22.3% in secondary services, and 24.0% in tertiary. A clear majority (71.9%) held permanent posts, while 28.1% were employed on a temporary or auxiliary basis. In terms of professional experience, 57.9% indicated having 15–20 years of service, 23.1% had 5–10 years, and 19.0% reported 10–15 years. Most participants (82.6%) did not occupy any leadership role, whereas 15.7% did, and 1.7% selected “Other.” When considering geographic distribution, 55.4% were based in the region of Thessaly, 8.3% in Central Greece, and 36.4% in other regions.

TABLE 1.

Participant demographics and characteristics (N = 121).

Characteristic	Category	n	%
Gender	Women	107	88.7
	Men	14	11.3
Age group	25–35 years	17	14.0
	36–45 years	66	54.5
	46–55 years	38	31.4
Marital status	Married	93	76.9
	Single	12	9.9
	Divorced	7	5.8
Number of children	Two children	44	36.4
	Three or more children	25	20.7
Educational tier	Technical Education (TE)	80	66.1
	University (PE)	26	21.5
	Secondary‐level Diploma	15	12.4
Highest degree	Bachelor's	69	57.0
	Master's	50	41.3
	Doctorate	2	1.7
English proficiency	B1 (Moderate)	35	28.9
	C2 (Advanced)	34	28.1
	None	7	5.8
Computer skills	Very good	81	66.9
	Moderate	40	33.1
Healthcare service level	Primary	65	53.7
	Secondary	27	22.3
	Tertiary	29	24.0
Employment status	Permanent	87	71.9
	Temporary/Auxiliary	34	28.1
Years of experience	5–10 years	28	23.1
	10–15 years	23	19.0
	15–20 years	70	57.9
Leadership role	None	100	82.6
	Yes	19	15.7
	Other	2	1.7
Geographic region	Thessaly	67	55.4
	Central Greece	10	8.3
	Other	44	36.4

3.2. Migration Intentions and Destination Preferences

Migration Beliefs, Motivations and Barriers are presented in Table 2. Concerning personal beliefs about migration, one‐third of participants (37.2%) selected Scandinavian countries as a prospective destination, followed by the United Kingdom (33.1%), Germany (12.4%), North America (7.4%), and “Other” destinations (9.9%). Only 10.7% reported any prior migration experience. About half (48.8%) said they already knew the language of their intended destination, while 51.2% did not. When asked about motives for moving abroad, 51.2% chose “All of the above”—meaning a combination of economic, social, professional, and quality‐of‐life considerations—and 29.8% singled out financial reasons as the chief driver. If destination countries offered language support, 65.3% stated they would be more inclined to migrate, 25.6% expressed uncertainty (“Maybe”), and 9.1% said they would still decline.

TABLE 2.

Summary of findings on migration beliefs, motivations and barriers (N = 121).

Variable	Category	n	%
Preferred destination	Scandinavian countries	45	37.2
	United Kingdom	40	33.1
	Germany	15	12.4
	North America	9	7.4
	Other	12	9.9
Prior migration experience	Yes	13	10.7
	No	108	89.3
Knowledge of destination language	Yes	59	48.8
	No	62	51.2
Chief motive for migration	“All of the above” (economic, social, professional, quality of life)	62	51.2
	Financial reasons	36	29.8
	Other motives (e.g., social, professional alone)	23	19.0
Language support as an incentive	Yes	79	65.3
	Maybe	31	25.6
	No	11	9.1
Influence of others' experiences	Yes	81	66.9
	Maybe	23	19.0
	No	17	14.0
Expectation of adaptation difficulties	Maybe	55	45.5
	No	51	42.1
	Yes	15	12.4
Professional adequacy	Sufficient experience	72	59.5
	Underprepared	21	17.4
	Unsure	28	23.1
Perception of nursing abroad	More advanced	88	72.7
	No difference	12	9.9
	Unsure	21	17.4
Likelihood of workplace discrimination	Maybe	56	46.3
	No	35	28.9
	Yes	30	24.8
Career advancement opportunities	Yes	99	81.8
	Unsure	21	17.4
	No	1	0.8
Patient preference for domestic nurses	No	54	44.6
	Maybe	47	38.8
	Yes	20	16.5
Negative emotions as a reason to return	Maybe	62	51.2
	Yes	34	28.1
	No	25	20.7
Expected socioeconomic improvement	High	84	69.4
	Moderate	35	28.9
	Low	2	1.7
Likelihood of Shared Housing	No	77	63.6
	Maybe	27	22.3
	Yes	17	14.0
Family in Greece as a barrier	Yes	64	52.9
	Maybe	34	28.1
	No	23	19.0
Emotional attachments as a barrier	Yes	49	40.5
	Maybe	48	39.7
	No	24	19.8
Perceived quality of life abroad	Improved	78	64.5
	Unsure	36	29.8
	Not improved	7	5.8
Willingness to migrate	Yes	49	40.5
	Maybe	54	44.6
	No	18	14.9
Possibility of returning to Greece	Yes	61	50.8
	Maybe	45	37.5
	No	15	11.7

Asked whether colleagues' or friends' past experiences abroad would influence their decision, 66.9% answered affirmatively, 19.0% were uncertain, and 14.0% said they would not be influenced. Concerning potential adaptation challenges, 45.5% reported they “might” face difficulties, 42.1% believed they would not, and 12.4% were certain they would. Among those anticipating difficulties, the majority (86%) did not pinpoint a specific reason, while smaller subsets mentioned language barriers, cultural differences, distance from loved ones, or communication obstacles.

As to professional adequacy, 59.5% felt sufficiently experienced for nursing work abroad, 17.4% felt underprepared, and 23.1% were uncertain. The majority (72.7%) perceived nursing abroad to be more advanced, 9.9% saw no difference, and 17.4% were uncertain. When asked about possible workplace discrimination, 46.3% said “Maybe,” 28.9% expected no discrimination, and 24.8% anticipated some form of bias. A strong majority (81.8%) believed they would have opportunities for career advancement, and 17.4% remained unsure; only 0.8% thought they would not.

Regarding perceptions of patient preferences in the destination country, 44.6% did not believe local patients would necessarily favour home‐trained nurses, 38.8% were uncertain, and 16.5% expected a preference for domestic professionals. When questioned about whether negative emotions might prompt a return to Greece, 51.2% replied “Maybe,” 28.1% said “Yes,” and 20.7% answered “No.” A large proportion (69.4%) predicted achieving a higher socioeconomic standing abroad; 28.9% foresaw moderate improvement, and just 1.7% expected little or no improvement. Over half (63.6%) believed they would not have to share housing, 22.3% were uncertain, and 14.0% anticipated cohabitation. Having family in Greece was viewed as a potential barrier to migration by 52.9% of respondents, with 28.1% answering “Maybe” and 19.0% stating it would not inhibit them. Emotional attachments to the home country were considered an obstacle by 40.5%, while 39.7% expressed uncertainty, and 19.8% felt no such emotional barrier.

A large segment (64.5%) believed their quality of life would improve abroad, 29.8% were unsure, and 5.8% saw no likely improvement. Overall, 40.5% said they would choose to migrate, 44.6% were uncertain, and 14.9% would not. Finally, 50.8% reported there was a possibility they would return to Greece, 37.5% were unsure, and 11.7% did not foresee returning once they had left. These findings collectively underscore the complexity of nurses' decisions regarding emigration, influenced by a combination of professional, economic, familial, and emotional factors.

3.3. Key Influences on Migration Beliefs and Motivations

Table 3 presents the summary of the main findings and statistical results for each variable related to nurses' migration beliefs, motivations, and perceived barriers.

TABLE 3.

Summary of the main findings and statistical results for each variable related to nurses' migration beliefs, motivations, and perceived barriers.

Variable	Key findings
Gender	No significant correlations emerged between gender and migration beliefs or the likelihood of returning to Greece
Age	Younger participants (25–35, 36–45) viewed nursing abroad as more progressive (χ 2 = 9.217, p = 0.056), felt patients abroad would not favour local nurses (χ 2 = 12.631, p = 0.013), expected higher socioeconomic status (χ 2 = 9.301, p = 0.054; LR = 10.100, p = 0.039), and anticipated better quality of life (χ 2 = 10.234, p = 0.037). Older participants (46–55) were more cautious and uncertain
Family status	Singles and married participants were generally more optimistic about career prospects (χ 2 = 14.137, p = 0.028) and quality of life (χ 2 = 13.122, p = 0.041). Singles were more likely to believe negative emotions could prompt a return (χ 2 = 18.844, p = 0.004), and both singles and married individuals were likelier to consider returning to Greece (χ 2 = 16.383, p = 0.012). Divorced participants were more resolute about not returning
Number of children	Childless participants were less concerned about adaptation difficulties, while those with three or more children expressed the greatest uncertainty
Educational tier	No significant association was observed between the tier of education (Technical, University, Secondary‐level diploma) and migration beliefs
Education level	Advanced degrees were linked to broader, more detailed perspectives on adaptation challenges and to specific primary reasons for migration (χ 2 = 9.200, p = 0.010). Bachelor's holders often emphasised economic factors; Master's holders showed balanced motives; Doctorate holders prioritised specialised career advancement and quality of life
Computer literacy	Participants with very good computer skills reported fewer language‐related concerns (χ 2 = 19.216, p = 0.015) and had higher expectations of achieving a strong socioeconomic standing (p = 0.018). Those with moderate skills were more divided in both respects
Employment status	Permanent employees more often focused on financial reasons for migrating. They were also more likely to believe that negative emotions might prompt a return to Greece (χ 2 = 22.347, p = 0.022). Non‐permanent workers considered a broader range of factors (e.g., quality of life, career growth)
Professional experience	Participants with 15–20 years of experience were significantly more likely to already know the destination country's language (χ 2 = 0.312, p = 0.017), indicating that seasoned professionals had invested more time in acquiring relevant skills
Leadership role	Non‐leaders were more confident about the progressiveness of nursing abroad (78% agreement). Leaders showed higher uncertainty (31.6%) and disagreement (15.8%), highlighting language barriers and adaptation complexities. This difference was significant (χ 2 = 9.542, p = 0.024). Leaders were also more unsure about quality‐of‐life improvements

3.3.1. Influence of Gender and Age on Migration Beliefs, Motivations and Barriers

Despite the observed percentage differences between men and women in certain beliefs, no statistically significant correlations were found.

A statistically significant association was observed between age and perceptions of patient preference for local nurses, χ ²(4) = 12.631, p = 0.013. Younger age groups were more confident that patients in the destination country would not necessarily favour local nurses. In the 25–35 age bracket, 47% believed there would be no such preference, increasing to 53% among those aged 36–45. However, among participants aged 46–55, 60.5% answered “Maybe,” reflecting higher levels of uncertainty.

Although the association between age and perceptions of nursing abroad as more progressive was marginally non‐significant, χ ²(2) = 9.217, p = 0.056, younger nurses (25–45) expressed stronger agreement with this perception. Specifically, 76.5% of those aged 25–35 and 81.8% of those aged 36–45 supported this view, compared to 55.3% of those aged 46–55.

Although the correlation regarding a higher socioeconomic status abroad was marginally not significant according to Pearson's Chi‐Square (χ ²(2) = 9.301, p = 0.054), the Likelihood Ratio (χ ²(2) = 10.100, p = 0.039) suggested that age may indeed play a role. Among those aged 25–35, 58.8% anticipated achieving a high socioeconomic standing, a figure that increased to 78.8% in the 36–45 group, indicating greater optimism. By contrast, within the 46–55 cohort, only 57.9% expected to attain a high socioeconomic status, while 42.1% predicted a moderate level of improvement.

A statistically significant correlation was also found between age and perceived improvement in quality of life abroad, χ ²(2) = 10.234, p = 0.037. Younger participants were notably more optimistic about their future quality of life abroad. In the 25–35 group, 64.7% believed their quality of life would improve abroad, rising to 74.2% among those aged 36–45. In contrast, only 47.4% of participants aged 46–55 anticipated an improvement, and 13.2% perceived that their quality of life would not be better.

Overall, age influences a variety of perceptions regarding migration. Younger groups (25–35 and 36–45) appear more optimistic and self‐assured, expecting greater progressiveness in nursing practices abroad, patient acceptance, and enhancements in both quality of life and socioeconomic status. Older cohorts (46–55) are relatively more cautious and exhibit higher levels of uncertainty. These findings underscore the importance of age as a factor shaping migration attitudes, even when statistical significance is marginal.

3.3.2. Influence of Family Status on Migration Beliefs, Motivations and Barriers

Family status was significantly associated with several migration‐related beliefs. Regarding career opportunities abroad, single and married participants were generally more optimistic, with 91.7% of singles and 82.8% of married individuals believing they would have professional advancement opportunities. In contrast, those who were cohabiting or divorced expressed greater uncertainty. This association was statistically significant, χ ²(3) = 14.137, p = 0.028.

A significant correlation was also observed between family status and beliefs about emotional factors influencing the decision to return to Greece, χ ²(6) = 18.844, p = 0.004. Singles were most likely to believe that negative emotions could prompt their return (66.7%), whereas married individuals showed more uncertainty (58.1% responded “Maybe”), and divorced participants were more resolute, with 57.1% stating that emotions would not influence their decision.

Perceptions of quality‐of‐life improvement abroad were also influenced by family status, χ ²(6) = 13.122, p = 0.041. Singles were the most optimistic (91.7%), while married and cohabiting participants expressed higher uncertainty—30.1% and 55.6%, respectively, answered “Maybe.” Divorced participants were more optimistic than the cohabiting group, with 71.4% expecting improved quality of life abroad.

Finally, family status correlated with the perceived likelihood of returning to Greece after migrating, χ ²(6) = 16.383, p = 0.012. Singles (50%) and married participants (52.7%) were most likely to say they would return. Among cohabiting participants, 50% also considered a return likely, while 37.5% were unsure. Divorced respondents were the most decisive, with 57.1% indicating they would not return.

Overall, family status significantly influenced beliefs about career prospects, emotional coping, expected quality of life, and return intentions. Singles tended to be the most optimistic; married participants were generally balanced but expressed greater uncertainty, while divorced individuals showed more decisive and cautious attitudes toward migration outcomes.

3.3.3. Influence of Number of Children on Migration Beliefs, Motivations and Barriers

A statistically significant association was found between the number of children and perceived adaptation difficulties abroad, χ ²(6) = 12.75, p = 0.047. The effect size, measured by Cramer's V = 0.26, indicates a small to moderate association. Participants without children were less likely to believe they would face adaptation challenges, likely due to the absence of family‐related responsibilities that could complicate relocation. Those with three or more children expressed the highest levels of uncertainty, possibly reflecting the emotional and logistical complexities of moving a larger family. Participants with one or two children held more balanced views, with noticeable proportions expressing either optimism or uncertainty. Overall, the findings suggest that parental status plays a meaningful role in shaping expectations about adjustment in a new country, with childless individuals appearing more confident about the migration process.

3.3.4. Influence of Educational Tier and Educational Level on Migration Beliefs, Motivations and Barriers

No association was observed between the educational tier (Technical, University, Secondary‐level diploma) and migration beliefs. However, a statistically significant relationship was observed between higher educational attainment and a broader, more detailed perspective on adaptation difficulties. Individuals with advanced degrees may have encountered international contexts—through study, research, or professional collaborations—leading them to anticipate a wider range of potential obstacles when relocating abroad. Paradoxically, this same exposure can also result in fewer overall concerns, given their familiarity with international work settings and multicultural environments.

A statistically significant association was observed between education level and principal reasons for migration, χ ²(6) = 27.36, p < 0.001. The effect size, measured by Cramer's V = 0.40, indicates a moderate to strong association. Bachelor's degree holders often prioritised comprehensive motives (“All of the above,” 55.1%) or highlighted economic factors (33.3%), a pattern that may reflect the financial constraints prevalent in Greece. In contrast, Master's degree recipients showcased a more balanced viewpoint: nearly half (48%) selected “All of the above,” 26% cited financial reasons, and 18% underscored quality‐of‐life considerations. Although fewer in number, Doctorate holders focused largely on specialised career advancement and quality of life, suggesting an inclination toward research‐ or academia‐oriented career paths.

3.3.5. Influence of Computer Literacy on Migration Beliefs, Motivations and Barriers

Computer literacy was significantly associated with both perceived language barriers and anticipated socioeconomic status in the destination country. A statistically significant association was found between computer literacy and perceptions of language‐related challenges, χ ²(2) = 9.23, p = 0.010, with a moderate effect size (Cramer's V = 0.37). Participants with very good computer skills expressed fewer concerns about language difficulties abroad, while those with moderate or no computer skills were more likely to view language as a barrier.

Similarly, a significant association was observed between computer literacy and expectations regarding socioeconomic status abroad, χ ²(4) = 21.93, p < 0.001, with a moderate effect size (Cramer's V = 0.38). Among participants with very good computer skills, 77.8% believed they would achieve a high socioeconomic standing, compared to 52.5% of those with moderate skills. The latter group appeared more divided, with 45% anticipating only moderate improvement. These findings suggest that stronger computer proficiency may enhance self‐confidence and readiness to adapt professionally in a new environment, while limited skills could lead to more cautious or uncertain outlooks regarding migration.

3.3.6. Employment Status on Migration Beliefs, Motivations and Barriers

Permanent employees appeared more inclined to emphasise financial reasons for migration, possibly because their stable positions did not meet their economic expectations. Employees under other work arrangements faced greater job insecurity, which may have led them to consider a broader range of factors—such as quality of life and career advancement—when contemplating migration.

A statistically significant association was found between employment status and beliefs about the influence of negative emotions on the decision to return to Greece, χ ²(2) = 7.68, p = 0.021. The effect size, measured by Cramer's V = 0.33, indicates a moderate association. Permanent employees showed a higher likelihood of believing that emotional considerations could influence their decision, while those under different contracts exhibited greater uncertainty.

3.3.7. Professional Experience in Migration Beliefs, Motivations and Barriers

Participants with more professional experience (15–20 years) were more likely to already know the destination country's language compared to those with fewer years of experience (5–10). The Pearson correlation coefficient for years of professional experience and language knowledge was r = 0.312, with a p‐value of 0.017, indicating a statistically significant positive relationship. This may indicate that seasoned professionals have invested more time and resources in acquiring skills, such as language fluency, that facilitate migration. Conversely, less‐experienced individuals may have had fewer opportunities or incentives to learn a foreign language.

3.3.8. Leadership Role on Migration Beliefs, Motivations and Barriers

Participants without a leadership role were more confident in the progressiveness of nursing abroad (78% agreement), whereas leaders reported higher uncertainty (31.6%) and disagreement (15.8%). This difference was statistically significant, χ ² = 9.542, p = 0.024, suggesting that professional responsibilities can shape perceptions of international practices. Leaders often emphasised language barriers and adapting to unfamiliar environments, while non‐leaders identified a wider range of obstacles yet remained more optimistic. These differences extended to anticipated quality of life: 47.4% of leaders answered “Maybe,” compared to 69% of non‐leaders who believed it would definitely improve. The greater uncertainty among leaders likely reflected increased awareness of migration's complexities stemming from their managerial duties.

4. Discussion

This study explored how demographic, educational, and professional factors, working conditions, and perceived barriers influence Greek nurses' migration intentions in the post‐COVID‐19 era. The findings reveal a multidimensional decision‐making process shaped by personal characteristics, workplace stability, and broader systemic challenges. Migration was motivated not solely by economic concerns but also by the promise of improved working conditions, quality of life, and professional advancement. At the same time, barriers such as family obligations, emotional attachments to Greece, and language difficulties tempered participants' willingness to migrate.

The migration of healthcare professionals—particularly nurses—is a complex phenomenon with significant implications for both sending and receiving countries' health systems (Kingma 2008; Buchan et al. ²⁰¹⁴; Glinos et al. ²⁰¹⁵). The primary factors driving nurses to seek employment abroad include financial incentives, working conditions, opportunities for professional development, and overall quality of life (Aluttis et al. 2014; World Health Organization ^2020b). In addition, elements such as family status, socioeconomic security, language proficiency, and cultural adaptation play a pivotal role in the decision to migrate (Dumont and Zurn 2007). The present study, conducted with a sample of 121 participants, highlights a series of factors shaping Greek nurses' attitudes toward migration. The following sections discuss the key findings in light of the existing literature, with a focus on both convergences and divergences that emerge from this research.

Fewer participants were aged 25–35, which may be attributed to being in the initial stages of their career or not yet experiencing the burnout that can prompt thoughts of migration (Heinen et al. 2013). Moreover, older groups (46–55) showed greater uncertainty about migrating, consistent with studies suggesting that an increased age correlates with a desire for stability and reduced risk‐taking when it comes to professional changes (Leineweber et al. 2016).

The majority of participants were married, typically with one or two children. Family responsibilities are a central factor affecting the decision to migrate (Primary Health Care Services ²⁰²³). Participants with three or more children reported the greatest uncertainty or concern regarding adaptation, supporting previous work that underscores how multiple dependents can serve as a barrier to migration. Furthermore, having family remaining in Greece increases the likelihood of returning or at least maintaining a “plan B” if working abroad does not meet initial expectations (Dumont and Zurn 2007).

Most participants had completed either an undergraduate or a postgraduate degree, indicating a rising trend in educational attainment among nurses. Literature suggests that nurses with higher qualifications often seek better professional opportunities, frequently abroad, where their expertise may be more fully recognised (Dumont and Zurn 2007). English proficiency and computer literacy emerged as decisive factors in forming positive attitudes about migrating; effective communication skills and digital competence are now fundamental requirements for securing positions in advanced healthcare systems (European Commission ²⁰¹²).

A large portion of the sample held permanent positions (71.9%), while the remainder served on temporary or auxiliary contracts. Those in precarious roles appeared more vulnerable and open to migration, consistent with evidence that job insecurity can drive professionals to seek more stable opportunities overseas (Stilwell et al. 2004). Moreover, participants with 15–20 years of experience reported feeling better prepared, having already made efforts to learn the destination country's language. Consistent with earlier studies, more experienced nurses often invest time and resources to broaden their skill set, fully aware of the challenges of working abroad (Aluttis et al. 2014).

In this study, most nurses (82.6%) did not hold a leadership position; among those who did, caution prevailed regarding whether nursing in other countries is genuinely more progressive or whether quality of life would improve. This stance may stem from awareness of the complexities within healthcare organisations and the scope of additional responsibilities that managers or senior personnel would face in a foreign system (Ross et al. 2005; Smith et al. ²⁰²⁰).

The findings confirm that economic and professional factors, along with quality of life, are key migration drivers. More than half of participants (51.2%) selected “All of the above,” reflecting a blend of economic, social, and career‐related considerations. Echoing existing international research, both “pull” factors (attractive salaries, better working conditions, career advancement) and “push” factors (underfunded health systems, job insecurity, low wages) act simultaneously (Kingma 2008).

A majority (72.7%) believe that nursing abroad is more advanced, and 81.8% anticipate opportunities for professional growth. Studies indicate that developed health systems in Western Europe or North America frequently offer more extensive career structures, ongoing training, and greater nurse autonomy (Ross et al. 2005). Uncertainty persists, however, about possible discrimination against foreign nurses and patient preferences for local staff. Older age groups, in particular, are more cautious (60.5% replying “Maybe”). Previous research points out that discrimination based on nationality or language can indeed hinder the successful integration of migrant nurses (Glinos et al. 2015; Smith et al. ²⁰²⁰).

Language proficiency was noted as a critical factor: 51.2% do not know the host country's language, which discourages migration. Nevertheless, many participants stated that, with organised language support, they would be more inclined to move abroad (65.3%), aligning with studies highlighting intensive language training as a decisive factor for successful integration (Glinos et al. 2015; Smith et al. ²⁰²⁰).

Family ties in Greece stood out as a major barrier, with 52.9% acknowledging this explicitly, confirming that those with substantial domestic responsibilities encounter more hurdles in relocating (Buchan et al. 2014). Emotional elements such as nostalgia were cited by 40.5% as a primary factor that could lead to regret or a decision to return.

Married nurses generally expressed more uncertainty (“Maybe”) about returning, suggesting a desire for better prospects yet also concern for family stability (Primary Health Care Services ²⁰²³). International literature shows that nurses with larger family units, including children or elderly dependents, face high psychological costs in making a radical change, owing to the adjustment required for all household members (Leineweber et al. 2016).

Around 64.5% anticipate an improved quality of life abroad, and 69.4% foresee achieving a high socioeconomic standing, reflecting strong “pull” factors. Countries such as those in Scandinavia or the United Kingdom, frequently named by participants, are well‐known for offering competitive salaries, favourable working environments, and robust social welfare systems (Pond and McPake ²⁰⁰⁶).

Despite optimism about quality‐of‐life improvements, uncertainty remains: 44.6% answered “Maybe” regarding the possibility of migrating, and 40.5% indicated they would be in favour. Moreover, more than half (50.8%) believed they might eventually return to Greece, corresponding to the notion of “circular migration,” where healthcare professionals move abroad for advanced experience or financial gain but often keep open the option of returning (Pond and McPake ²⁰⁰⁶).

Younger participants perceived nursing abroad as more progressive and displayed lower hesitation about patient preferences, socioeconomic status, and quality‐of‐life improvements. By contrast, older nurses were more doubtful, likely reflecting fewer family obligations and enhanced adaptability among younger cohorts (Dumont and Zurn 2007; Heinen et al. ²⁰¹³).

Single nurses were more optimistic about their prospects. Although married participants recognised the benefits of working abroad, they expressed more caution because relocating to a foreign country involves greater logistical and psychological burdens for the entire family (Dumont and Zurn 2007). Divorced individuals appeared more resolute, possibly stemming from prior life transitions and higher resilience.

Those with three or more children reported the highest levels of uncertainty, tied to the heightened demands of caring for multiple dependents. The cost of housing, childcare, and general living expenses in a foreign setting can intensify reluctance to relocate (Buchan et al. 2014).

Nurses in leadership roles tended toward realism or reluctance regarding improved working conditions abroad, likely aware of complex organisational challenges in the healthcare sector (Ross et al. 2005).

Overall, these findings broadly align with established international patterns in nurse migration. Financial incentives, better working conditions, career progression, and enhanced quality of life function as central “push” and “pull” factors (Primary Health Care Services ²⁰²³). Many participants plan to move to Scandinavian countries or the UK, known for higher wages and advanced nursing practices (Stilwell et al. 2004). Consistent with prior research, the presence of family or emotional ties in the home country significantly complicates decisions (Dumont and Zurn 2007). Although international studies often report younger nurses as more flexible (Heinen et al. 2013), the present research underscores that nurses aged 36–45 formed the largest group in this sample, potentially reflecting the Greek hiring system's delays and limited advancement opportunities, which become more evident over time.

Participants with greater computer literacy and English proficiency felt fewer barriers, reinforcing evidence that technological and linguistic capabilities are critical for integrating into modern hospital environments (European Commission ²⁰¹²). One notable deviation from other contexts may be Greece's prolonged economic crisis, which intensifies the “push” factor. Institutional instability and restricted career advancement in public hospitals likely spur a strong drive toward external opportunities.

This study has several limitations. First, the use of a non‐probability convenience sampling method may limit the generalisability of the findings, as participants self‐selected into the study. Although efforts were made to reach nurses from diverse healthcare settings across Thessaly, the sample may not be fully representative of the entire population of Greek nurses. Second, while the questionnaire was developed and piloted for clarity and internal consistency, it was used for the first time in this study; thus, further validation in larger samples is needed. Third, due to the cross‐sectional design, causal relationships between variables cannot be inferred. Additionally, no formal adjustment for multiple comparisons (e.g., Bonferroni correction) was applied, which increases the risk of Type I errors. However, we have reported exact p‐values and effect sizes to aid interpretation. Finally, open‐ended responses were analysed descriptively due to their brevity and limited volume, and more comprehensive qualitative methods may be required in future research.

5. Conclusions

This study highlights the complex interplay of personal, professional, and systemic factors influencing Greek nurses' migration intentions in the post‐COVID‐19 context. Younger age, higher education, digital literacy, and job insecurity were associated with increased willingness to migrate, while family obligations, emotional ties, and limited language proficiency were key deterrents. Nurses viewed migration not solely as an economic decision but as a means to improve professional growth and quality of life. Leadership roles and longer professional experience moderated migration enthusiasm, suggesting deeper awareness of the challenges associated with relocation.

To reduce nurse attrition, healthcare policymakers should prioritise improving working conditions, providing clear career progression pathways, and offering financial and non‐financial incentives tailored to mid‐career professionals. Pre‐migration training in language and digital skills, particularly for those with limited access, could facilitate better integration abroad. Nursing education programs should also include global health and mobility preparation components to support informed career planning. Ultimately, addressing the push and pull factors identified in this study is essential to retaining skilled nurses and sustaining the healthcare workforce in Greece.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Data S1.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.