Factors Affecting Nursing Student’s Intention to Work in Rural Areas: A Cross-Sectional Study

Abstract

Background
Nurses are essential healthcare providers worldwide; however, unequal distribution of nurses between rural and urban areas remains a major challenge, particularly in low-income countries such as Nepal. Understanding nursing students’ intention to work in rural areas is important for addressing rural workforce shortages. This study aimed to assess the intention of nursing students to work in rural areas and identify factors associated with their intention.
Methods
An analytical cross-sectional study was conducted among 119 final-year PCL nursing students in Pokhara Metropolitan City from March to September 2022. Enumerative sampling was used to include all nursing colleges offering PCL nursing program within the metropolitan city, while proportionate stratified sampling was applied to select participants from each college. Data were collected using a self-developed structured questionnaire. Descriptive and inferential statistics were used to summarize the data and to identify factors associated with students’ intention to work in rural areas.
Results 
More than half of the respondents (52.1%) intended to work in rural areas. The most commonly perceived motivating factors were high healthcare needs in rural areas (86.6%), a favorable local working environment (76.5%), and the friendliness of rural communities (75.6%). Lack of equipment and resources (66.4%) and limited opportunities for continuing education (59.7%) were the major perceived demotivating factors. Locating near to family was the only factor significantly associated with the intention to work in rural areas (p=0.045).
Conclusions
More than half of the students intended to work in rural areas. Family proximity emerged as an important motivating factor associated with rural work intention. Findings may help policymakers and educational institutions develop strategies to strengthen the rural nursing workforce in Nepal.