Sab i, Yousi Mousa; Ramalu, Sub amaniam S i
A icle
Home coun y economic, poli ical, social push ac o s
and in en ion o mig a e in I aq: psychological dis ess as
media o
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Home coun y economic, poli ical, social
push ac o s and in en ion o mig a e in I aq:
psychological dis ess as media o
Yousi Mousa Sab i & Sub amaniam S i Ramalu
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2024, VoL. 11, no. 1, 2299507
Home coun y economic, poli ical, social push ac o s and in en ion
o mig a e in I aq: psychological dis ess as media o
Yousi Mousa sab ia and sub amaniam s i Ramalub
aDepa men o Heal h adminis a ion, College o Heal h & Medical echnology, sawa uni e si y, samawah, i aq; bschool o
Business Managemen , College o Business, uni e si i u a a Malaysia, Kedah, Malaysia
ABSTRACT
he mig a ion o alen s om one coun y o ano he has become a g owing conce n
wo ldwide. i has been a gued ha he home coun y’s economic, poli ical, and social
push ac o s d i e he in en ion o mig a e among i s alen s. his s udy aims o
in es iga e he di ec and indi ec e ec s o home coun y’s economic ( inancial
di icul ies, economic ins abili y), poli ical (poli ical ins abili y, co up ion), and social (li e
dissa is ac ion, p oblems o amily well-being) push ac o s on he in en ion o mig a e
among medical doc o s in i aq. he indi ec e ec in ol es es ing he media ing e ec
o psychological dis ess in he p oposed ela ionships. his s udy uses a c oss-sec ional
esea ch design o ga he da a om a sample o 460 medical doc o s wo king in
p i a e and public hospi als in i aq. he Pa ial leas squa e (Pls) wo-s ep pa h
modelling was used o es he di ec and indi ec hypo heses. he indings o his
s udy show ha inancial di icul ies and economic ins abili y has a posi i e di ec e ec
on he in en ion o mig a e. howe e , he di ec e ec o poli ical ins abili y, co up ion,
li e dissa is ac ion, and p oblems o amily well-being on he in en ion o mig a e is
insigni ican . addi ionally, he di ec posi i e e ec o inancial di icul ies, economic
ins abili y, poli ical ins abili y, and co up ion on psychological dis ess is signi ican .
likewise, he e ec o p oblem o amily well-being on psychological dis ess is also
signi ican , while he e ec o li e dissa is ac ion on psychological dis ess is no
signi ican . Fu he , he di ec posi i e e ec o psychological dis ess on in en ion o
mig a e is signi ican . a ull media ion e ec o psychological dis ess was ound in he
ela ionship be ween inancial di icul ies, economic ins abili y, poli ical ins abili y,
co up ion, p oblem o amily well-being and in en ion o mig a e. he ela ionships
examined in his s udy o e new di ec ions in he s udy o mig a ion among alen s,
speci ically among he medical doc o s in i aq. he indings can be used by human
esou ce manage s, go e nmen agencies, and policymake s o imp o e he
psychological s a e o medical p o essionals in i aq hospi als.
1. In oduc ion
cu en ly, he global compe i ion o alen is on he ise. his has esul ed in mo e oppo uni ies o
alen ed people o mig a e om hei home coun y, especially hose less de eloped ones, o ind a
be e li e and ca ee openings in mo e de eloped na ions (Dao e al., 2018). in he mig a ion li e a u e,
se e al ac o s ha e been iden i ied as o why mig an s decide o lea e hei homelands and mo e o
o he coun ies (e endic, 2016; Qin e al., 2018). Mig a ion also known as poli ical mig a ion o economic
mig a ion (schae e , 2010; Wal he & co bin, 2018), whe e people a e o ced o abandon hei homes o
escape wa o con inuous bloodshed and o seek g eene pas u es (cas elli, 2018; e endic, 2016). in
ecen decades, he mig a ion o heal hca e p o essionals and physicians, in pa icula , has become a
© 2024 he au ho (s). Published by in o ma uK Limi ed, ading as aylo & F ancis g oup.
CONTACT Yousi Mousa sab i 71yousi [email protected] Depa men o Heal h adminis a ion, College o Heal h & Medical echnology,
sawa uni e si y, samawah, i aq
h ps://doi.o g/10.1080/23311975.2023.2299507
his is an open access a icle dis ibu ed unde he e ms o he C ea i e Commons a ibu ion License (h p://c ea i ecommons.o g/licenses/by/4.0/), which
pe mi s un es ic ed use, dis ibu ion, and ep oduc ion in any medium, p o ided he o iginal wo k is p ope ly ci ed. he e ms on which his a icle has been
published allow he pos ing o he accep ed Manusc ip in a eposi o y by he au ho (s) o wi h hei consen .
ARTICLE HISTORY
Recei ed 26 Decembe
2021
Re ised 20 Decembe
2023
accep ed 21 Decembe
2023
KEYWORDS
alen s; economics
ac o s; poli ical ac o s;
social ac o s; co up ion;
economic ins abili y;
inancial di icul ies;
p oblems o amily
well-being; li e
dissa is ac ion; poli ical
ins abili y; psychological
dis ess; in en ion o
mig a e
REVIEWING EDITOR
Pablo Ruiz, Uni e sidad de
cas illa-la Mancha, spain
SUBJECTS
economics; Business,
Managemen and
accoun ing; Mul icul u al
educa ion; Public
adminis a ion &
Managemen ; Poli ical
Beha io and
Pa icipa ion
2 Y. MOUsa saB i anD s. sRi RaMalU
wo ldwide phenomenon. he magni ude and impac o his phenomenon is illus a ed h ough i s
desc ip ion as mass mig a ion ha has c ea ed a c i ical global heal h wo k o ce c isis (Dywili e al., 2012;
schumann, 2021). he di ec ion o his mig a ion gene ally occu s along he weal h gap, i.e., om
less-de eloped o mo e-de eloped coun ies (schumann, 2021). globally, he main sou ce coun ies o
physicians we e sou h a ica, ghana, Pakis an, colombia, nige ia, india, i aq, and he Philippines, while
he main des ina ion coun ies included he UK, he Usa, canada, aus alia, and ge many (cos igliola,
2011; Kope sch, 2009; labon é e al., 2006; Pang e al., 2002). Physicians a e con inuously mo ing om
one coun y o ano he ha has a pe cei ed highe li ing s anda d in wha is desc ibed as he medical
ca ousel phenomenon (ncayiyana, 1999).
i aq is no immune o his wo ldwide phenomenon, as i wi ness he g owing end o mig a ion
among i s medical doc o s. i s medical ield has been one o he ha des hi due o he immense p es-
su e and lack o eadiness. O e he pas 40 yea s, i aq’s mul iple con lic s and in e nal oubles ha e
na u ally impac ed he coun y’s heal hca e sec o , es ic ing he coun y’s abili y o deal wi h such
eme gencies and se e e heal h challenges (Valenciano & Biondi, 2003). acco ding o al-shawi e al.
(2017), be ween 2004 and 2007, medical s a we e subjec ed o ex ao dina y condi ions o h ea ening,
kidnapping, and assassina ion ollowing he end o he i aq wa in 2003. as a esul , doc o s mig a ed
o mo e s able and sa e na ions, esul ing in alen sca ci y. acco ding o Bu nham e al. (2009), i aq has
been plagued by inancial and adminis a i e co up ion since he 2003 wa , hampe ed he de elopmen
and ehabili a ion o he i aqi heal hca e sys em while also lea ing i unde unded. Fo example, he
go e nmen allo ed only 2.5 pe cen o he na ion’s $106.5 billion budge o he heal h Minis y in 2019,
hu ing heal hca e p o ide s pay and a sho age o equipmen and medica ion (aboulenein & le inson,
2020). acco ding o he Wo ld heal h O ganiza ion, he a io o nine doc o s o e e y 10,000 people in
i aq a e pu ing immense s ain on heal hca e wo ke s, especially in a s a ewide medical ca as ophe.
a hand ul o s udies ha e been conduc ed o s udy in en ion o mig a e among i aqi doc o s in com-
p ehending hei an eceden s and hei pe sonal and psychological expe ience (Jadoo e al., 2015).
se e al pas esea ch on alen mig a ion ha e ocused on in en ion o mig a e among you h (Méndez,
2020), nu ses (Öncü e al., 2021), mig an s om la in ame ica (chinda ka , 2014), and a psychological
pe spec i e o u al mig a ion in i an (Yazdan-Panah & Zobeidi, 2017). ano he esea ch s eam ocused
on ac o s in luencing inal-yea nu sing/midwi e y s uden s’ in en ions o mig a e ollowing g adua ion
(Deasy e al., 2021). in a ano he s udy, B ugha e al. (2016) s udied he easons why mig an doc o s in
i eland plan o s ay, e u n home o mig a e onwa ds o new des ina ion coun ies. o da e, howe e ,
he e is no comp ehensi e s udy ha examines he e ec s o economic, poli ical, and social ac o s on
in en ion o mig a e in i aqi con ex . g ounded wi h psychological dis ess pe spec i e, which is de ined
as ‘ o non-speci ic symp oms o s ess, anxie y and dep ession’ (Vie iö e al., 2021, p. 2), his s udy in o-
duces in en ion o mig a e as an essen ial con ibu ion o mig a ion li e a u e. his s udy p oposes a
con ex in which psychological dis ess is iden i ied as a c i ical componen o ela ed mig a ion li e a u e
ha helps in ha ing a comp ehensi e unde s anding o in en ion o mig a e.
h ough he p ism o his amewo k, we can unde s and how pas s udies ha e indica ed ha eco-
nomic push ac o s, such as weak inancial condi ions in he home coun y can in luence indi iduals o
mig a e (Dodani & laPo e, 2005; Rapopo & Docquie , 2012; Ullah e al., 2019;). Many indi iduals
a emp o mo e and wo k in coun ies wi h be e economic condi ions (Fong & hassan, 2017).
speci ically, Dugge (2005) a gued ha highly skilled p o essionals who desi e o p o ec hei amilies
om po e y mig a e o coun ies wi h g ea e economic de elopmen and he p o ision o highe
wages (Fong & hassan, 2017). he main economic push ac o s a e po e y, lack o job oppo uni ies,
social ad an ages and dissa is ac ion wi h he cu en condi ion (Ki kwood, 2009; lasocik, 2010; Ullah
e al., 2019).
F om he pe spec i e o poli ical ac o s, his s udy conside s poli ical ins abili y as ha ing a s ong
impac on mig a ion. i is also he main d i e in luencing whe he o emain o lea e a coun y. he
poli ical ins abili y in i aq has esul ed in he massi e mig a ion o i s ci izens (al- amimi, 2006; la a &
hussain, 2018). Fu he mo e, ac o s such as clashes be ween e hnic g oups has led o disha mony
among he people (sab i & Ramalu, 2020). his phenomenon con ibu es o mig a ion o o he poli i-
cally s able coun ies o a mo e peace ul li e. Mo eo e , con as ing eligious belie s also lead o injus-
ice and he eluc ance o accep he mino i y (Johnson, 2008). Poli ical ins abili y also leads o highe
cOgen BUsiness & ManageMen 3
c ime a es and secu i y issues (Kamimu a e al., 2018), hus causing people o mig a e o o he coun-
ies wi h be e secu i y (saxenian, 2005). gi en his, we sugges ha poli ical ins abili y is linked o
in en ion o mig a e, concep ualised as a p e e ence o mig a ion o e s aying, ega dless o he eason
(ca ling e al., 2015).
he social ac o s leading o mig a ion among p o essionals a e c ime, he d op in educa ional s an-
da ds, weak coun y s uc u e, c ises in heal h ins i u es, and en i onmen al b eakdown (Jadoo e al.,
2018). simila ly, amily in luences also signi ican ly a ec he decision o p o essionals o lea e hei coun-
y o o igin (Mohamed & abdul- alib, 2020). Fu he mo e, when a coun y ails o ul ill he expec a ions
o i s people, hey would mig a e o o he coun ies o achie e be e p ospec s o hemsel es and hei
amilies. his is he s a ing poin o he mig a ion p ocess (F iebel e al., 2018). compa a i ely, de eloped
coun ies p o ide a e y high quali y o educa ion o he child en o mig an s (F ei as, 2012).
his s udy p oposes ha home coun y (i.e., i aq) push ac o s namely economic ( inancial di icul ies
and economic ins abili y), poli ical (poli ical ins abili y and co up ion), and social ac o s (li e dissa is ac-
ion and p oblems o amily well-being) will in luence mig a ion in en ion among i aqi doc o s, media ed
h ough psychological dis ess. his s udy is amed based on Push-Pull heo y o lee (1966) and o en
(1976). his heo y is applied in global mig a ion s udies by Bod a sson and Van den Be g (2009) and
De Jong and Fawce (1981), who concludes ha an indi idual’s en i onmen al backg ound migh push
hem one way and he economic o inancial p ospec s in he de eloped o des ina ion coun y can
d aw hem he o he way (Van hea e al., 2018). Mig a ion decision could also be in luenced by a ail-
abili y o oppo uni ies o en u e in o business in home and hos coun y (Ruiz-Palomino &
Ma ínez-cañas, 2021). i such oppo uni ies is no a ailable in home coun y, i can be conside ed as a
one o he push ac o s ha in luence decision o mig a e and ice e se. se e al esea che s ha e d aw
on Push-Pull heo y (ami & Mulle , 1995; caliendo & K i ikos, 2010; gilad & le ine, 1986; Ki kwood,
2009; Ma ínez-cañas e al., 2023; hu ik e al., 2008) o a gue ha push- o pull- ela ed mo i a ions
explain how en ep eneu ial in en ion is o med. Va ious push-pull ac o s oge he wi h pe cep ual a i-
ables, namely, pe cei ed isk and oppo uni y ecogni ion was associa ed wi h en ep eneu ship in en ion
in a s udy conduc ed by Ma ínez-cañas e al. (2023). hese s udies sugges s ha Push-Pull heo y gen-
e ally can be used o s udy a ious phenomenon beyond global mig a ion. addi ionally, hob oll’s (1989)
conse a ion o Resou ces (cOR) heo y p o ides a aluable insigh s o unde s anding he links be ween
wo kplace s esso s, psychological dis ess, and mig a ion in en ion.
Ou s udy con ibu es in h ee ways o exis ing li e a u e. Fi s , we o e he s udy o independen i aqi
doc o s who p e e o domicile ab oad ia a posi i e pe spec i e and iden i y psychological dis ess as a
c i ical mig a ion ac o . secondly, we examine he link be ween a ious home coun y poli ical, eco-
nomic, and social push ac o s and in en ion o mig a e. he e is spa seness in da a-d i en esea ch
in es iga ing he in luence o economic ( inancial di icul ies and economic ins abili y), poli ical (poli ical
ins abili y and co up ion), and social ac o s (li e dissa is ac ion and p oblems o amily well-being) on
in en ion o mig a e. Finally, we looked a he ole o psychological dis ess as a media o conce ning
poli ical, economic, and social ac o s and in en ion o mig a e. Whe eas he in luence o poli ical, eco-
nomic, and social ac o s on in en ion o mig a e a e widely documen ed (e.g., agadjanian & go ina,
2019; Migali & scipioni, 2018; Koczan e al., 2021; Wazi e al., 2017; Zanabaza e al., 2021), esea ches
ega ding he in e ac i e e ec s o psychological dis ess be ween poli ical, economic, and social ac o s
and in en ion o mig a e hasn’ been p e iously in es iga ed.
1.1. Theo e ical unde pinnings
1.1.1. Push-pull heo y
se e al heo ies ha e been p oposed in he pas o explain why mig a ion occu s. Mig a ion is iewed
as a means o shi ing om cu en poo li ing si ua ions o be e li ing condi ions, which is a na u al
human endency o su i al. he Dual labo Ma ke heo y, neoclassical Mig a ion heo y, heo y o
Reasoned ac ion, and heo y o Planned Beha io a e ew o he heo ies o en e e ed in mig a ion
s udies. empi ical in es iga ions ha e e ealed ha compa a i ely p edic able c i e ia encou age people
o lea e hei home na ion and eloca e o mo e de eloped hos coun ies (Ba uch e al., 2007). Push
and pull in luences can coexis , wi h an indi idual being pulled bo h by hei en i onmen al backg ound
4 Y. MOUsa saB i anD s. sRi RaMalU
and he economic o inancial p ospec s a ailable in he de eloped o des ina ion coun y (Van hea
e al., 2018). Push ac o s ha e a g ea e impac on people wi h p o essional abili ies and wo k expe i-
ence (güngö & ansel, 2008). in p esen s udy, he Push-Pull heo y is ex ended by looking a ca ee ,
economics, social, and poli ical issues, as well as amily and psychological ac o s in in luencing decision
o mig a e (laila & Fiaz, 2018). cu en ly, sociological o economic causes domina e mig a ion ideas.
O igin- ela ed and in insic o in angible mig a ion aspi a ions a e bo h push ac o s. he cu en s udy
in e p e s he in en s o indi iduals owa d mig a ion using he Push-Pull heo y ( o en, 1976).
1.1.2. Conse a ion o esou ces heo y
he conse a ion o Resou ces heo y (cOR) is a b oad heo y ha explains why people desi e o sa e-
gua d, es o e, and upg ade hei asse s and why hey eel compelled o do so when hey don’ . his
heo y asse s ha humans p ima ily aim o build, sa egua d and nu u e hei esou ces o p o ec
hemsel es and he social bonds ha enable such p o ec ion. Using he heo y, a model is p o ided o
a e ing he loss o esou ces, e aining exis ing esou ces, and a aining he needed esou ces ha
enable p ope beha iou al engagemen s including decisions ela ed o mig a ion (hob oll, 2001).
Resou ce-loss e en s a e likely o cause g ea e losses, which some imes occu epe i i ely. such e en s
o ce people o implemen esou ce-conse a ion s a egies, whe e a ailable esou ces a e used o adap
as e icaciously as possible. Failed coping s a egies cause no only ma e ial loss, bu also psychological
dis ess. ine ec i e loss p e en ion s a egies c ea e mo e esou ce losses, hus leading o loss spi als
(Wes e al., 2018).
2. Li e a u e e iew and hypo hesis de elopmen
2.1. In en ion o mig a e
in en ion o mig a e e e s o a s ong mani es a ion o one’s plan o mig a e (Manchin & O azbaye ,
2018). O he s ha e de ined i as he indi idual’s desi e, plan, and conc e e p epa a ion o mo e ab oad
(sha i e al., 2018). he in en ion o mig a e eliably indica es he indi iduals’ expec a ions o hei
u u e in o he coun ies (ghazali e al., 2015). elango an (2001) delinea ed mig a ion in en ion as an
a i udinal o ien a ion o a cogni i e mani es a ion o he beha io al decision o qui . s udies ha e ound
ha many p o essionals, pa icula ly doc o s mig a e om de eloping coun ies o wo k in de eloped
coun ies. nume ous causes a ec he in en ion o mig a e among p o essionals, including o ob ain a
highe sala y (ghazali e al., 2015). he s udy o sab i and Ramalu (2020) examined he e ec o home
coun y push ac o s on p o essionals’ in en ion o mig a e and concluded ha economic, social, and
poli ical ac o s enhance hei in en ion o lea e he home coun y. Meanwhile, he s udy o Roman e al.
(2020) ound ha he eligious belie s and p ac ices u ned ou o ha e a di e en e ec on he mo i a-
ion o young indi iduals o mig a e. se e al esea che s ha e esea ched employees’ in en ion o mig a e
o di e en con ex s, indus ies, cul u es, and coun ies using o he a iables. consequen ly, he p esen
s udy is impo an o all s akeholde s namely i aqi doc o s, hei hos coun y, and employe s. hence
he e is a need o u he in e oga e his s eam o hough in he i aqi doc o ’s con ex .
2.2. Fac o s con ibu ing o mig a ion among I aqi doc o s
lack o basic economic p ospec s, poli ical o eligious disc imina ion, and ha m ul en i onmen al ci -
cums ances a e push ac o s ha cause mig a ion (ninko ić & Keko ić, 2017). Va ious esea ches ha e
concen a ed on mig a ion’s poli ical and economic ac o s (e.g., e endic, 2016; K asniqi & Williams, 2018;
Qin e al., 2018). Poo social li e and poli ical ins abili y a e he c i ical easons o mig a ion. gene ally,
push ac o s like poli ical, social, and en i onmen al ins abili y in he na i e coun y cause i s people o
mig a e (Fong & hassan, 2017). O he schola s highligh ed mig a ion beyond economic and poli ical
mo i a ions and indica ed ha social and psychological aspec s could in luence mig a ion decisions
(Papa usso & amb ose i, 2017). hese ac o s ha e wo sened he sho age o heal hca e p o essionals
(la a & hussain, 2018), and as a esul o his has hinde ed he imp o emen o he heal hca e sys em
cOgen BUsiness & ManageMen 5
in i aq (al-sama ai & Jadoo, 2018). he assaul on doc o s h oughou he ea lie agg essi e egimes in
i aq has caused men al dis ess among medical p o essionals (la a & Pandya, 2006). likewise, due o he
poo secu i y condi ion, heal hca e p o essionals had no op ion bu o mig a e o de eloped coun ies
(Jadoo e al., 2018). all hese issues ha e di ec ed o a declining doc o -pa ien a io. a ising a e o
hos ili y in no he n and cen al i aq made doc o s a a ge o lawsui s (Jadoo e al., 2015). in his s udy,
home coun y push ac o s ha will in luence in en ion o mig a e ha e been g ouped in o economic
( inancial di icul ies and economic ins abili y), poli ical (poli ical ins abili y and co up ion), and social
ac o s (li e dissa is ac ion and p oblems o amily well-being).
2.2.1. Economic ac o s
2.2.1.1. Financial di icul ies. his s udy sugges s ha inancial di icul ies is a key ac o in d i ing
mig a ion in en ion speci ically among he p o essionals (cao e al., 2016). he au ho s u he a gued
ha when an indi idual expe iences inancial di icul ies in his/he cu en coun y, he/she mig a es o
ano he coun y o secu e be e inancial sou ces. simila ly, gó ecki e al. (2019) also acknowledged ha
inancial di icul ies a e he main ac o o he in en o mig a e. Financial di icul y as a push ac o
causes s ess and es lessness (asaku a & Mu a a, 2006). simila ly, sab i and Ramalu (2020) acknowledged
ha inancial condi ion as a push ac o c ea es es lessness among employees. indi iduals acing inancial
di icul ies a e mo e likely o ace ch onic and acu e s esso s such as amily and ela ionship issues,
di icul y making mon hly paymen s, physical limi a ions, and bad neighbo hood condi ions, o name a
ew. such condi ion will igge indi iduals o ini ia e mig a ion p ocess as pa o coping s a egies o
a ain needed esou ces o su i al (hob oll, 2001).
2.2.1.2.Economic ins abili y.ano he a iable o economics ac o s is economy ins abili y. since an icipa ed
income is he cen al aspec in employmen decision, wo k p ospec s and labo ma ke ac o s a home
and ab oad could signi ican ly con ibu e o he expec a ions o quali ied indi iduals wi h economic
oppo uni y. he economics ac o s can decide he ela i e wo k p ospec s and may dec ease o aise he
p ojec ed income o a pe son acco dingly (hao e al., 2016). Do lo (2003) s a ed ha in he na i e
coun y, economic ins abili y as one o push ac o s could o ce p o essionals o lea e. low economic
s abili y would d i e p o essionals and academics o lea e (Kiang e al., 2014). Many desc ip i e da a on
key economic indica o s indica es ha economic pe o mance does in luence immig a ion a i udes,
especially in coun ies ha we e he mos a ec ed by he c isis (isaksen, 2019).
2.2.2. Poli ical ac o s
2.2.2.1. Poli ical ins abili y. One o he a iables o poli ical push ac o s a e poli ical ins abili y. Mos
s udies on poli ically-d i en mig a ion ocus on he concep o o ced mig a ion i.e., due o deadly
ci cums ances, including wa and e hnic cleansing. Poli ical ins abili y is a c ucial d i e o inc eased
you h mig a ion in en ion (elbahnasawy e al., 2016). Poli ical ins abili y has become a global phenomenon.
Dywili e al. (2012) in es iga ed he ac o s ha in luence in e na ional nu sing mig a ion and disco e ed
ha i is linked o poli ical ins abili y. sab i and Ramalu (2020) in es iga ed he e ec s o poli ical push
ac o s on p o essional mig a ion in en ions. acco ding o he s udy, poli ical ins abili y has a signi ican
impac on mig a ion in en ion. Ba a and Ruggie o (2023) emphasized he ole o domes ic ins i u ions
as a push ac o o emig a ion, sugges ing ha he quali y o go e nance is a key ac o in explaining
emig a ions om poo o ich coun ies.
2.2.2.2.Co up ion.co up ion is de ined as beha io which de ia es om he no mal du ies o a public
ole because o p i a e- ega ding ( amily, close p i a e clique), pecunia y o s a us gains; o iola es ules
agains he exe cise o ce ain ypes o p i a e- ega ding in luence (Bicchie i & ganegonda, 2017). coo ay
and schneide (2016) used he anspa ency in e na ional index ( ii) and he in e na ional coun y Risk
guide (icRg) co up ion index o measu e co up ion. i was ound ha co up ion inc eases in andem
wi h he inc ease in he mig a ion a e o highly-skilled wo ke s. co up ion has ecen ly been iden i ied
as a majo d i e o mig a ion, ac ing on he aspi a ion o people o mig a e o o he coun ies and
a eas. in pa icula , i plays a majo ole in d i ing highly-educa ed people away.
6 Y. MOUsa saB i anD s. sRi RaMalU
2.2.3. Social ac o s
2.2.3.1. Li e dissa is ac ion. One o he a iables o social ac o s is li e dissa is ac ion. li e sa is ac ion is
an aspec o subjec i e well-being (Busse i, 2018; schimmack e al., 2002) and psychological s abili y
(Robe s e al., 2002). i p edic s nega i e heal h consequences (Koi umaa-honkanen e al., 2000), signs
o dep ession (Koi umaa-honkanen e al., 2004), and suicide (Koi umaa-honkanen e al., 2004). he s udy
o Migali and scipioni (2018) examined he e ec o li e dissa is ac ion on in en ion o mig a e. hei
inding indica ed a non-linea ela ionship be ween mig a ion p epa a ion and indi idual income. hey
also epo ed in hei s udy ha dissa is ac ion wi h one’s cu en s anda d o li ing d i e he in en ion
o mig a e.
2.2.3.2. P oblems o amily well-being. P oblems o amily well-being is included in his s udy o
demons a e how he eedom o a ain a be e li e ia mig a ion is undamen al o he en u e-making
cha ac e . indi iduals ansien s hemsel es, pa icula ly in hei basic posi ion as indi iduals who can
mo e owa ds mig a ion as a ype o use as opposed o he di ec ion o c ea ion asc ibed o mos o he
s eams o mig a ion (De haas, 2011). Moen e al. (2016) examined he ela ionship be ween amily well-
being, pa en s’ psychological s a e, and child en’s beha io . Following socio-demog aphic and e hnici y
adjus men s, pa en s wi h high well-being sco es showed lowe isks o psychological dis ess and had
child en who a e mo e sociable and less di icul beha iou ally compa ed o hose wi h low well-being
sco es. P oblems o amily well-being as a push ac o o ces people o lea e hei home coun y o
achie e amily wel a e and com o elsewhe e (suna i e al., 2021).
2.3. Psychological dis ess as a media ing a iable
Psychological dis ess is a nega i e emo ional condi ion ha esembles men al damage, h ea , and he
loss o a signi ican aim. nega i e emo ions a e linked o being hos ile, annoying, sho - empe ed, wo -
ied, and ense (Mclean e al., 2007). gene al disappoin men and discon en wi h one’s cu en employ-
men a e examples o common psychological anguish. Bo h ypes o dis ess impac a pe son’s men al
heal h (gundelach & hen y, 2016; islam & chugh ai, 2019; Williams e al., 2013). P o essionals all a ound
he wo ld a e dealing wi h anxie y and sadness as a esul o hei jobs. Mo e han hal o he medical
wo k o ce in i an’s heal hca e indus y is s essed o a mode a e deg ee (Joules e al., 2014). in his s udy,
psychological dis ess is expec ed o ac as a media ing mechanism in he ela ionship be ween he
economic ( inancial di icul ies and economic ins abili y), poli ical (poli ical ins abili y and co up ion),
social ac o s (li e dissa is ac ion and p oblems o amily well-being) and in en ion o mig a e. economic,
social, and poli ical issues ha e all been linked o mig a ion in en ions in pas s udies (agadjanian &
go ina, 2019). While i has been s a ed ha economic and poli ical ins abili y is among he causes o
mig a ion in en ions in de eloping coun ies (e ling e al., 2020), i has also been no ed ha hose expe-
iencing inancial di icul ies epo ed highe le els o psychological anguish (a u a e al., 2021; Kimhi
e al., 2020).
2.3.1. The p esen s udy
o ou knowledge, no esea ch has comp ehensi ely s udied he na u e o ela ionship be ween home coun-
y economic ( inancial di icul ies and economic ins abili y), poli ical (poli ical ins abili y and co up ion), social
ac o s (li e dissa is ac ion and p oblems o amily well-being) and mig a ion in en ion among i aqi doc o s.
hence, he impac o economic, poli ical, and social issues on i aqi doc o s in en ion o mig a e was examined
in his s udy. he Push-Pull heo y asse s ha an indi idual may be pushed by hei en i onmen al back-
g ound in home coun y and pulled by economic o inancial oppo uni ies in he de eloped o des ina ion
coun y (Van hea e al., 2018). simila ly, he conse a ion o Resou ces heo y asse s ha mig an s’ p ima y
goal is o build, sa egua d, and nu u e hei esou ces o p o ec hemsel es and he social bonds ha enable
such p o ec ion (Van hea e al., 2018), hence e ec s hei decision ela ed o mig a ion. We hypo hesise ha
psychological anguish in he o m o psychological dis ess, as an indi idual-le el componen , may media e
he ela ionship be ween economic, poli ical, and social ac o s and he inclina ion o i aqi doc o s o mig a e.
cOgen BUsiness & ManageMen 7
2.4. Theo e ical amewo k
he p ima y goal o his s udy is o examine he ela ionship be ween a ious home coun y push ac o s
and mig a ion in en ions, as well as he ole o psychological dis ess in media ing he ela ionship.
acco dingly, he heo e ical amewo k is de eloped o achie e his goal, as shown in Figu e 1. he
dependen a iable o his s udy is in en ion o mig a e, while he independen a iables a e home coun-
y push ac o s, namely poli ical (poli ical ins abili y and co up ion), economic ( inancial di icul ies and
economic ins abili y), and social issues (li e dissa is ac ion and p oblems o amily well-being). Psychological
dis ess is p oposed as a media ing componen in he associa ion be ween he independen and depen-
den a iables.
2.5. Hypo hesis de elopmen
his s udy aims o examine he in luence o he home coun y poli ical, social, and economic push ac-
o s on he in en ion o mig a e among i aqi doc o s, wi h he p esence o psychological dis ess as he
media ing ac o . hence, he ollowing hypo heses ha e been de eloped o es he p oposed model o
he s udy.
2.5.1. Rela ionship be ween inancial di icul ies and in en ion o mig a e
he s udy o goš au ai ė e al. (2018) in es iga ed he impac o inancial di icul ies on he in en ion
o mig a e among physicians in li huania. he s udy concluded ha mig a ion decisions a e linked
o inancial ac o s. Meanwhile, Mcauli e and Ruhs (2017) in hei s udy in u key disco e ed ha ,
due o economic agili y, he high- isk beha io o c ossing he sea had become he only iable
op ion. Fu he , many people belie e ha c ossing he sea is less pe ilous han emaining in u key,
ye many choose o emain in u key because hey lack he inancial means o c oss he bo de .
acco ding o he adi ional neoclassical Mig a ion heo y, people mig a e when he ad an ages
ou weigh he cos s (ha is & oda o, 1970). On he o he hand, inancial limi a ions may hinde
someone om mig a ing e en i he e is a ne bene i om eloca ion. s udies examining he ela-
ionship be ween inancial es ic ions and mig a ion om he s andpoin o income shocks a e an
excep ion (Bazzi & Bla man, 2014). Despi e a huge income di e ence, inancially disad an aged indi-
iduals and households equen ly canno mig a e. Few esea ch ound ha mig a ion is a
isk-di e si ica ion echnique o insu ing agains income shocks, which places inancial limi a ions in
a p ominen posi ion in mig a ion esea ch (De haas, 2010; s a k & Bloom, 1985). hence, he ollow-
ing hypo hesis is p oposed:
hypo hesis 1: Financial di icul ies a e posi i ely associa ed wi h in en ion o mig a e
Figu e 1. he heo e ical amewo k o he s udy.
14 Y. MOUsa saB i anD s. sRi RaMalU
o he aVe alues o he la en a iable’s co ela ions (hai e al., 2016). as a esul , he squa e oo o
he cons uc ’s aVe alue should be g ea e han i s co ela ion wi h any o he cons uc in he model
(hai e al., 2016; hensele e al., 2009). he squa e oo o he aVe alue o he cons uc is bigge han
he highes associa ion wi h any o he cons uc in he cu en s udy based on he Fo nell–la cke c i e-
ion. as a esul , disc iminan alidi y has been es ablished. he squa e oo o he aVe alue o co up-
ion is 0.707; o economic ins abili y i is 0.694; o inancial di icul ies i is 0.853; o p oblems o amily
well-being i is 0.803; o in en ion o mig a e i is 0.853; o li e dissa is ac ion i is 0.772; o psycholog-
ical dis ess i is 0.700; and o poli ical ins abili y i is 0.769 ( e e o able 4).
he second app oach en ails examining he indica o s’ c oss-loadings o he cons uc ’s ou e loadings,
which should be highe han he o he cons uc s’ ou e loadings (hai e al., 2017). c oss loadings highe
han he indica o s o he ou e loading e ealed ha disc iminan alidi y is a p oblem. in he cu en
s udy, he esul s indica e ha disc iminan alidi y is es ablished because he c oss loadings o he o he
cons uc s we e no highe han he indica o s o he ou e loading o he cons uc .
4.5. Assessmen o he s uc u al model
Once he measu emen model has been alida ed, he s uc u al model is subsequen ly assessed using
he Pls pa h modeling. he hypo hesized ela ionships a e es ed in his s ep. i was p oposed ha he
Figu e 2. he measu emen model.
Table 4. Disc iminan alidi y.
iVs CRP ei FD FW i M LD PD Pi
CRP 0.707
ei 0.511 0.694
FD 0.448 0.608 0.853
FW 0.427 0.691 0.540 0.803
i M 0.393 0.503 0.460 0.370 0.853
LD 0.507 0.544 0.393 0.685 0.382 0.772
PD 0.572 0.582 0.491 0.568 0.659 0.508 0.700
Pi 0.482 0.670 0.346 0.677 0.371 0.501 0.550 0.769
No e: Poli ical ins abili y (Pi), co up ion (CRP), li e dissa is ac ion (LD), p oblems o amily wellbeing (FW), inancial di icul ies (FD), economic
ins abili y (ei), psychological dis ess (PD) and in en ion o mig a e (i M).
cOgen BUsiness & ManageMen 15
s uc u al model be es ed in wo s ages i.e., assessmen o he di ec ela ionships, and inclusion o he
indi ec (media ing) es (hai e al., 2014; hai e al., 2016).
he ele ance o he s uc u al model’s ou e coe icien s is assessed using he con en ional boo s ap-
ping app oach using 5,000 boo s ap samples and 300 examples (hai e al., 2016). o compa e Pls-seM
esul s wi h a a iable numbe o exogenous s uc u es and/o di e en sample sizes, R-squa e adjus ed is
employed (hai e al., 2016). he modi ied R-squa e alue gene ally educes he R-squa e alue by he
numbe o explaining cons uc s and sample size. he modi ied R-squa e alue is ai ly nea o he R-squa e
alue, indica ing ha no majo di e ences exis be ween he o iginal da ase and he ex ended o o he
da ase s. al hough he R-squa e alue and modi ied R-squa e a ied somewha , no majo changes occu ed;
hus, o he da ase s a e p edic ed o p o ide he same esul s ega ding hese co ela ions.
he R-squa e alue o in en ion o mig a e in his s udy is 0.482, wi h an adjus ed R-squa e o 0.470.
simila ly, psychological dis ess has an R-squa e o 0.499 and an adjus ed R-squa e o 0.489. Using he
blind olding p ocess, he s one es geisse ’s was pe o med o assess he esea ch model’s p edic i e
ele ance (geisse , 1974). he es assesses he goodness-o - i o he Pls s uc u al equa ion modeling
(Dua e & Raposo, 2010). sa le e al. (2010) p oposed using he blind olding p ocess on he s udy’s
endogenous a iable(s) o de e mine he e lec i e models’ p edic i e signi icance. as a esul , he
c oss- alida ed edundancy me ic (Q2) was used in his s udy o es ablish he p edic i e ele ance
(geisse , 1974; hai e al., 2014; Ringle e al., 2012). acco ding o hensele e al. (2009), a (Q2) esul
g ea e han ze o sugges s ha he esea ch model is su icien ly p edic i e. as such, highe (Q2) s a is ics
indica es a highe p edic i e ele ance. in he cu en s udy, Q2 shows a alue o 0.262 o in en ion o
mig a e and 0.183 o psychological dis ess. hai e al. (2016) a gued ha a Q2 alue abo e ze o indi-
ca es p edic i e ele ance.
4.6. Di ec ela ionship
able 5 displays he pa h coe icien alues, p alues, alues, and s anda d e o . Based on hese s an-
da d alues, he hypo hesis was accep ed o ejec ed. he o iginal numbe o cases in he model we e
300 cases wi h 5000 boo s apping samples (hai e al., 2016, 2017; hensele e al., 2016). his s udy
assessed six hypo heses wi h di ec associa ions wi h he in en ion o mig a e. O he six, wo hypo heses
we e p o en o be suppo ed and ou we e no . Mo eo e , six hypo heses which ha e di ec associa-
ions wi h psychological dis ess we e assessed. Ou o he six, i e hypo heses we e p o en o be sup-
po ed and one was no suppo ed. simila ly, hypo hesis es ing he ela ionship be ween psychological
dis ess and in en ion o mig a e was suppo ed. Figu e 3 based on he Pls algo i hm shows he hypo h-
esized ela ionships (pa h coe icien ) among all he cons uc s in he model. he esul o hypo heses
es ing o di ec ela ionships is summa ized in able 5.
hypo hesis 1 p edic ed ha inancial di icul y posi i ely ela es o he in en ion o mig a e. he esul
demons a es a signi ican and posi i e ela ionship be ween inancial di icul y and in en ion o mig a e
(β = 0.161, = 2.459, p = 0.015) hus suppo s hypo hesis 1. hypo hesis 2 p edic ed ha economic ins abil-
i y posi i ely ela es o he in en ion o mig a e. he esul demons a es a signi ican and posi i e ela-
ionship be ween economic ins abili y and he in en ion o mig a e (β = 0.198, = 2.191, p = 0.026) hus
suppo ing hypo hesis 2. hypo hesis 3 p edic ed ha poli ical ins abili y is posi i ely ela ed o he in en-
ion o mig a e. as shown in able 5, a non-signi ican ela ionship be ween poli ical ins abili y and
Table 5. Di ec ela ionship.
Hypo hesis Rela ionship
o iginal sample
(o)
s anda d de ia ion
(s DeV)
T s a is ics
(|o/s DeV|) p Values Decision
H1 FD –>i M 0.161 0.067 2.459 0.015 accep ed
H2 ei –>i M 0.198 0.089 2.191 0.026 accep ed
H3 Pi –>i M −0.037 0.084 0.440 0.658 Rejec ed
H4 CRP –>i M −0.049 0.057 0.842 0.393 Rejec ed
H5 LD –>i M 0.046 0.083 0.564 0.576 Rejec ed
H6 FW –>i M −0.174 0.070 2.450 0.013 Rejec ed
H7 PD –>i M 0.589 0.067 8.823 0.000 accep ed
No e: inancial di icul ies (FD), economic ins abili y (ei), poli ical ins abili y (Pi), co up ion (CRP), li e dissa is ac ion (LD), p oblems o amily
well-being (FW), psychological dis ess (PD), and in en ion o mig a e (i M).
16 Y. MOUsa saB i anD s. sRi RaMalU
in en ion o mig a e was ound (β= −0.037, = 0.440, p = 0.658), hus ejec s hypo hesis 3. hypo hesis 4
p edic ed ha co up ion is posi i ely ela ed o he in en ion o mig a e. he esul demons a es a
non-signi ican ela ionship be ween co up ion and in en ion o mig a e (β= −0.049, = 0.842, p = 0.393)
hus ejec ing hypo hesis 4. hypo hesis 5 p edic ed ha li e dissa is ac ion is posi i ely ela ed o he
in en ion o mig a e. he esul demons a es a non-signi ican ela ionship be ween li e dissa is ac ion
and in en ion o mig a e (β = 0.049, = 0.564, p = 0.576) hus ejec ing hypo hesis 5. hypo hesis 6 p e-
dic ed ha p oblems o amily well-being is posi i ely ela ed o he in en ion o mig a e. able 5 demon-
s a es a signi ican and nega i e ela ionship be ween p oblems o amily well-being and in en ion o
mig a e (β= −0.174, = 2.450, p = 0.013), hus ejec ed hypo hesis 6. hypo hesis 7 p edic ed ha psycho-
logical dis ess posi i ely ela es o he in en ion o mig a e. he esul demons a es a signi ican and
posi i e ela ionship be ween psychological dis ess and in en ion o mig a e (β = 0.589, = 8.823,
p = 0.000), hus suppo ing hypo hesis 7.
4.7. Indi ec ela ionship
in his s udy, six (6) indi ec e ec s a e examined h ough he media ing a iable hypo heses. hese six
hypo heses a e shown in able 6. addi ionally, able 6 p esen s he s uc u al model assessmen wi h he
model’s indi ec pa hs ela ionship, - alue, and p- alue.
Figu e 3. he s uc u al model.
Table 6. indi ec ela ionship.
Hypo hesis Rela ionship sample mean (M)
T s a is ics
(|o/s DeV|) p Values Decision
H8 FD –> PD –> i M 0.071 2.054 00.04 accep ed
H9 ei –> PD –> i M 0.097 2.258 0.024 accep ed
H10 Pi –> PD –> i M 0.129 2.749 0.006 accep ed
H11 CRP –> PD –> i M 0.182 4.632 0.000 accep ed
H12 LD –> PD –> i M −0.075 1.481 0.139 Rejec ed
H13 FW –> PD –> i M 0.116 2.755 0.006 accep ed
No e: inancial di icul ies (FD), economic ins abili y (ei), poli ical ins abili y (Pi), co up ion (CRP), li e dissa is ac ion (LD), p oblems o amily
well-being (FW), psychological dis ess (PD) and in en ion o mig a e (i M).
cOgen BUsiness & ManageMen 17
able 6 shows he coe icien s o he six indi ec hypo heses and hei alues and p alues, which
a e used o de e mine whe he o no he hypo hesised associa ions a e s a is ically signi ican . hypo hesis
8 p edic s he signi ican media ing e ec o psychological dis ess in he ela ionship be ween inancial
di icul ies and he in en ion o mig a e. he esul shows ha psychological dis ess media es he ela-
ionship be ween inancial di icul ies and in en ion o mig a e, and i is signi ican (β = 0.071, = 2.054,
p = 0.04). he e o e, hypo hesis 8 is accep ed. hypo hesis 9 p edic s he signi ican media ing e ec o
psychological dis ess in he ela ionship be ween economic ins abili y and in en ion o mig a e. he
esul shows ha psychological dis ess media es he ela ionship be ween economic ins abili y and
in en ion o mig a e, and he media ion is signi ican (β = 0.097, = 2.258, p = 0.024). he e o e, hypo hesis
9 is accep ed. hypo hesis 10 p edic s he signi ican media ing e ec o psychological dis ess in he
ela ionship be ween poli ical ins abili y and in en ion o mig a e. able 6 shows ha psychological dis-
ess media es he ela ionship be ween poli ical ins abili y and in en ion o mig a e (β = 0.129, = 2.749,
p = 0.006). he e o e, hypo hesis 10 is accep ed. hypo hesis 11 p edic s he signi ican media ing e ec o
psychological dis ess in he ela ionship be ween co up ion and in en ion o mig a e. he esul shows
ha psychological dis ess media es he ela ionship be ween co up ion and in en ion o mig a e, and
i is signi ican (β = 0.182, = 4.632, p = 0.000). he e o e, hypo hesis 11 is accep ed. hypo hesis 12 p edic s
he signi ican media ing e ec o psychological dis ess in he ela ionship be ween li e dissa is ac ion
and in en ion o mig a e. he esul shows ha he media ing e ec o psychological dis ess in he
ela ionship be ween li e dissa is ac ion and in en ion o mig a e is no signi ican (β= −0.075, = 1.481,
p = 0.139). he e o e, hypo hesis 12 is ejec ed. hypo hesis 13 p edic s he signi ican media ing e ec o
psychological dis ess in he ela ionship be ween p oblems o amily well-being and in en ion o mig a e.
he esul shows ha he media ing e ec o psychological dis ess in he ela ionship be ween p ob-
lems o amily well-being and in en ion o mig a e is signi ican (β = 0.116, = 2.755, p = 0.006). he e o e,
hypo hesis 13 is accep ed. able 7 summa izes hypo hesis es ing decision.
4.8. Summa y o hypo hesis es ing
5. Discussion o he s udy indings
his s udy examined he di ec and indi ec e ec s o home coun y economic, poli ical, and social
ac o s on mig a ion in en ions, as media ed by psychological dis ess. hypo hesis 1 has been empi i-
cally alida ed, and he indings sugges ha mig a ion in en ions signi ican ly and posi i ely in lu-
enced by inancial di icul ies. his esea ch has con i med he need o inancial secu i y among
physicians as a mo i a ion o mig a e. his indica es ha he mig a ion o i aqi doc o s has become a
g owing global phenomenon and is cons an ly e ol ing in esponse o he coun y’s ongoing eco-
nomic and social changes. he esul o his s udy is cong uen wi h he Push-Pull heo y and wi h
Table 7. Hypo hesis es ing summa y.
Hypo hesis Decision
H1: he e is a signi ican and posi i e impac be ween FD and i M suppo ed
H2: he e is a signi ican and posi i e impac be ween ei and i M suppo ed
H3: he e is a signi ican and posi i e impac be ween Pi and i M no suppo ed
H4: he e is a signi ican and posi i e impac be ween CRP and i M no suppo ed
H5: he e is a signi ican and posi i e impac be ween LD and i M no suppo ed
H6: he e is a signi ican and posi i e impac be ween FW and i M no suppo ed
H7: he e is a signi ican and posi i e impac be ween PD and i M suppo ed
H8: Psychological dis ess media es he ela ionship be ween FD and i M suppo ed
H9: Psychological dis ess media es he ela ionship be ween ei and i M suppo ed
H10: Psychological dis ess media es he ela ionship be ween Pi and i M suppo ed
H11: Psychological dis ess media es he ela ionship be ween CRP and i M suppo ed
H12: Psychological dis ess media es he ela ionship be ween LD and i M no suppo ed
H13: Psychological dis ess media es he ela ionship be ween FW and i M suppo ed
No e: Financial di icul ies (FD), economic ins abili y (ei), poli ical ins abili y (Pi), co up ion (CRP), li e dissa is ac ion (LD), p oblems o amily
well-being (FW), psychological dis ess (PD) and in en ion o mig a e (i M).
18 Y. MOUsa saB i anD s. sRi RaMalU
hose indings o pas s udies (hajian e al., 2020). hypo hesis 2 was accep ed because economic ins a-
bili y in i aq seems o con ibu e equally o in en ion o mig a e among i aqi doc o s. hese conside -
a ions could explain why, in mos cases, he posi i e e ec s o unemploymen on in en ion o mig a e
pe sis , as hey did in his s udy. his sugges s ha i aqi medical p ac i ione s may be en iced o go
ab oad in sea ch o highe pay, a be e s anda d o li e, as well as p ospec s o ca ee p og ession
no accessible in impo e ished de eloping coun ies. home coun y push ac o s ela ed o ‘economy
o need’ in he o m o inancial di icul ies and economic ins abili y could be he majo eason ha
mo i a e indi iduals s a business in hos coun y once hey mig a e (Ma ínez-cañas e al., 2023).
abili y o ecognize business oppo uni ies coupled wi h suppo o someone in social ne wo ks who
owns a en u e especially i his pe son belongs o he po en ial en ep eneu ’s amily-based ne wo k
could help indi iduals o se up business (Ruiz-Palomino & Ma ínez-cañas, 2021). in he case o med-
ical doc o s, hey migh conside o open up hei own clinic o hospi al in hos coun y wi h he
suppo o hei social ne wo ks.
con a y o he p edic ion, hypo hesis 3 was ejec ed because i aqi medical doc o s belie e hey a e
no necessa ily dis u bed by he amoun o poli ical ins abili y. he p esen s udy indings con i m p e-
ious indings in simila cases abou he ela ionship be ween poli ical ins abili y, co up ion, and mig a-
ion in en ions (holmes & De Piñe es, 2011; Ze e e al., 2013; Balcells & s eele, 2016). his s udy’s
indings a e compa able o hose o Ozal in e al. (2020), which ound ha jus a ound hal o all espon-
den s wi h iolen expe iences desi e o lea e Baghdad. hypo hesis 4 was also ejec ed because i aqi
medical doc o s belie e ha hei in en ion o mig a e is no necessa ily in luenced by co up ion. his
inding sugges s ha co up ion has no impac on he in en ion o mig a e in i aqi con ex . in o he
wo ds, co up ion does no cons i u e a ac o ha compels i aqi doc o s o mig a e ou side he coun y.
he assump ion o hypo hesis 5, which implies a posi i e link be ween li e dissa is ac ion and he
desi e o eloca e among i aqi doc o s, was simila ly no suppo ed in his s udy. he s udy’s indings
demons a ed ha discon en wi h one’s li e had no bea ing on one’s desi e o eloca e. in his s udy,
i aqi doc o s a e o he iew ha ac o s, which may compel hem o mig a e o ano he coun y a e no
due o li e dissa is ac ion o amily p oblems. as o he hypo hesis 6, p oblems o amily well-being
nega i ely a ec he in en ion o mig a e. howe e , he di ec ion o ela ionship is no as hypo hesized;
he e o e, he hypo hesis is ejec ed. al hough he hypo hesis was no suppo ed, he nega i e signi i-
can ela ionship ound be ween p oblems o amily well-being and in en ion o mig a e is qui e in e -
es ing. he nega i e ela ionship be ween p oblems o amily well-being and in en ion o mig a e sugges
ha he g ea e he conce n o p oblems o amily well-being, lowe he in en ion o mig a e. he desi e
o imp o e amily well-being by en u ing in o business could be he impo an home coun y push
ac o ha mo i a e indi iduals o emain in he home coun y (Dawson & henley, 2012). in o he wo ds,
in en ion o become en ep eneu could be nega i ely ela ed o in en ion o mig a e. cai e al. (2014)
discussed he e ec o subjec i e well-being on he in en ion o mig a e in e na ionally i.e., a clea incli-
na ion o mig a e, and asse ed ha people wi h highe subjec i e well-being ha e less in en ion o
mig a e.
in ega d o he hypo hesis 7, he s udy’s empi ical indings e eal ha psychological dis ess has a con-
side able and a ou able impac on mig a ion in en ions. his inding is consis en wi h no ion o Push-Pull
heo y by indica ing ha i aqi doc o s expe iencing psychological anguish a e mo e likely o de elop desi e
o lea e hei homeland. Fu he mo e, his da a shows ha psychological dis ess is mo e likely o occu in
a high-s ess and high- us a ion wo kplace. simila ly, i was disco e ed ha highe wo kplace s ess and
lowe job sa is ac ion we e connec ed o conside ing mig a ing and mo ing wo k cen e s among i aqi doc-
o s; his also ag ees wi h he esul s, since psychological s ess is ega ded a ype o job- ela ed s ess ac o .
as o he media ing e ec o psychological dis ess in he ela ionship be ween a ious economic,
poli ical, and social ac o s and in en ion o mig a e, he p esen s udy ound ha psychological dis-
ess media es he ela ionship be ween inancial di icul ies, poli ical ins abili y, co up ion, li e dissa -
is ac ion, p oblems o amily well-being and in en ion o mig a e, hence suppo s h8, h9, h10, h11
and h13. hese esul s sugges ha i aqi medical doc o s wi h highe le els o psychological s ess
due o inancial di icul ies, economic ins abili y, poli ical ins abili y, co up ion, and p oblems o amily
well-being a e mo e likely de elop in en ion o mig a e. his esul is simila o he esul om he
p e ious esea ch (Mi za e al., 2019; Vuo inen e al., 2021). Finally, he esul s disclaim he p edic ion
cOgen BUsiness & ManageMen 19
o hypo hesis 12, which assumes he media ing e ec o psychological dis ess on he ela ionship
be ween li e dissa is ac ion and in en ion o mig a e. his is simila o he esul whe e psychological
dis ess couldn’ pe o m a media ing unc ion (Khamis, 2016). he plausible eason o he ejec ed
hypo hesis is pa ly due o insigni ican ela ionship ound be ween li e dissa is ac ion on in en ion o
mig a e among i aqi doc o s.
6. Implica ions o he s udy
his s udy o e s a numbe o heo e ical and p ac ical implica ions. he heo e ical implica ions a e dis-
cussed in he i s sec ion while he p ac ical implica ions in he nex sec ion.
6.1. Theo e ical implica ion
he ollowing a e some o he s udy’s heo e ical implica ions. he cu en s udy add essed he laws
o Push-Pull heo y by analysing he media ing in luence o psychological dis ess in he ela ionship
be ween he a ious home coun y push ac o s and mig a ion in en ion. he push ac o s may no
di ec ly in luence in en ion o mig a e, bu a he induce he desi e o mig a e h ough psychological
su e ing. as a esul , he cu en wo k has e ealed he unde lying mechanism (i.e., psychological
dis ess) ha is esponsible o he e ec o push ac o s on in en ion o mig a e. he s udy has con-
ibu ed o a concep ual unde s anding o he e ec o a ious home coun y push ac o s such as
economic ins abili y, inancial di icul ies, co up ion, poli ical ins abili y, li e dissa is ac ion, and p ob-
lems o amily well-being in c ea ing psychological dis ess, which would e en ually boos he in en-
ion o mig a e. as a esul , he indings ha e pushed o a ex ension o o en’s Push-Pull heo y by
including explana ions o why un a o able social, poli ical, and economic ac o led o mig a ion
in en ion. addi ionally, he cu en s udy has p o ided a a he di e en heo e ical app oach, imply-
ing ha poli ical issues may ha e li le e ec on mig a ion in en ions. his in iguing line o inqui y
calls in o doub o en’s Push-Pull heo y’s con en ional claims; i opens new a enues o unde s and-
ing poli ical ac o s, whe he posi i e, nega i e, o neu al. ano he heo e ical con ibu ion is he con-
i ma ion o conse a ion o Resou ces heo y in p edic ing in en ion o mig a e, which s a es ha
people use ime, cogni i e and physical esou ces o comple e a ious asks bu would e en ually
need o eplenish hose esou ces o p e en s ess. hence, his heo y explains he ela ionship
be ween home coun y push ac o s and psychological dis ess, which will ha e c oss o e e ec on
in en ion o mig a e.
6.2. P ac ical implica ions
he p ac ical implica ions o his s udy a e speci ically ocused on he heal hca e sec o in i aq. he ind-
ings p o ided new insigh in o he an eceden s o mig a ion in en ion and how i can be add essed. he
p esen s udy o e s a amewo k o e alua ing he ole o economic, poli ical, and social ac o s ha
could in luence he in en ion o mig a e among doc o s in p i a e and public hospi als in i aq. he s udy
esul s show ha he lack o social and economic ac o s can gene a e psychological dis ess among
doc o s, ul ima ely o cing hem o mig a e o de eloped coun ies in pa icula . he s udy sugges he
op managemen o he hospi als, policymake s, and go e nmen adminis a ion should ocus on imp o -
ing he social and economic ac o s which can help o coun e he wo sening si ua ion in i aq ha is
unbea able o he doc o s. Fo example, i aqi go e nmen should conside imp o e he exis ing sala y
schemes and p o ide a ac i e bene i s o hei medical doc o s. howe e , he poli ical ac o is he only
ac o doc o s could no conside o mig a ion. he indings show ha poli ical ins abili y is no a eason
o he doc o s o lea e he coun y. Findings om he p esen s udy helped iden i y he po en ial ac-
o s o psychological dis ess, inc easing he in en ion o mig a e among heal hca e p o essionals. Based
on he indings, heal hca e p o essionals who a e expe iencing g ea e psychological dis ess a e mo e
likely will conside o mig a e. O ganiza ions in he coun y a e sugges ed o mi iga e he nega i e
impac s o hese ac o s h ough app op ia e human esou ce in e en ions.
20 Y. MOUsa saB i anD s. sRi RaMalU
7. Limi a ions and ecommenda ions o u u e esea ch
he p esen s udy has a numbe o limi a ions ha p o ide a enues o u u e esea ch. Fi s ly, he
da a was aken om only one ci y i.e. Baghdad. Due o he p e ailing pandemic, he esea che could
no isi he whole coun y. al hough he di e en popula ion cha ac e is ics we e aken, hey a e no
enough o ep esen he en i e popula ion. hence, da a should be aken om he whole coun y o
enable a s ong ep esen a ion o he en i e popula ion o u he s udy. secondly, in he mids o he
epidemic, he i ual snowball sampling echnique (non-p obabili y sampling) was employed. i en ailed
he e e als o ela ed pe sons o gi e he needed da a online. such measu e migh c ea e biasness
(Bha dwaj, 2019). in pos -pandemic, u u e esea che s could change he sampling echnique and isi
he hospi als pe sonally o collec he da a by using he p obabili y sampling echnique o educe
biasness. hi dly, he age ac o could ha e con ibu ed o g ea e mig a ion in en ions. he espon-
den s’ age showed a low mean, sugges ing ha he esul s a e no use ul o making gene al policies.
speci ic policies may also no be use ul in he long- e m and subsequen in e en ions may c ea e
disapp o al. hence, such s a egies could help o mula e gene al policies in he u u e. age could be
used o mode a e he ela ionship be ween psychological dis ess and in en ion o mig a e. Fou hly,
he s udy did no include he in o ma ion abou ypes o jobs aken up by he indi iduals who a e
planning o mig a e. s a ing up own business a hos coun y could be one o he mos conside ed
op ions o p o essionals in global economy, hence u u e esea ch should include his aspec o a
be e unde s anding abou mig a ion phenomenon. Fo his, u u e esea ch can assess he a ailabili y
o suppo om social ne wo k who owns a en u e especially amily-based ne wo k which can acili-
a e he s a -up p ocess (edelman e al., 2016; hansen, 1995; Ruiz-Palomino & Ma ínez-cañas, 2021).
Fi hly, u u e esea ch could also examine he e ec o home coun y push ac o s (e.g., inancial
di icul y, economic ins abili y, p oblems o amily well-being) on in en ion o en u e in o business
(Ki kwood, 2009), hence a nega i e ela ionship be ween in en ion o become an en ep eneu and
in en ion o mig a e can be con i med. Finally, he cu en s udy’s esea ch design en ails a su ey
ques ionnai e and is c oss-sec ional in na u e; da a collec ion was ca ied ou a one poin in ime o
he pu pose o hypo heses es ing. Fu u e s udies could employ longi udinal s udies and panel da a
o achie e clea e indings.
8. Conclusion
he cu en s udy has p o ided empi ical e idence o he impo ance o a ious home coun y push
ac o s ela ed o economic, social, and poli ical in in luencing mig a ion in en ions, wi h he p esence o
psychological dis ess as he media ing a iable. in a summa y, he indings len c edence o majo he-
o e ical p emises and p o ided app op ia e answe s o he s udy’s esea ch ques ions. he indings ha e
also con ibu ed o he body o knowledge in he ealm o o en’s Push-Pull heo y and o he suppo ing
heo ies such as he hob oll’s (1989) conse a ion o Resou ces (cOR) heo y, con i ming he in e play o
economic, social, and poli ical elemen s in in luencing mig a ion in en ions. cu en s udies ha ocus on
unde s anding he de e minan s o mig a ion ag ee on he p omo ion o p o ec i e ac o s ha emana e
om he indi idual o he su ounding en i onmen . i is also impo an o ecognize ha success ul
de e minan s o mig a ion may a y om one pe son o he nex based on mul iple ac o s such as
pe sonali y, speci ic challenges, a ailable esou ces, and he en i onmen al con ex . in his pa icula
s udy, howe e , a signi ican ac o ha can boos he p opensi y o mig a e among i aqi doc o s is e i-
den ly ound wi hin equipping and e adica ing challenges wi hin hei mig a ion expe ience. also, he
p edic i e powe o psychological dis ess as a media ing a iable, pa icula ly ega ding s ess, is high-
ligh ed, which should be inco po a ed in o policy design and communica ion and u he in es iga ed.
Finally, i aq as a coun y shown o ha e ypical de e minan s o emig a ion bu , en a i ely, i seems ha
hose ha ha e su e ed wa o a e ex emely ich a e shown o be a ypical in ha he e ec s o
socio-demog aphics a e weakened o e en e e sed in hese si ua ions. he ex en o which his ela ion-
ship can be alida ed by looking a o he ich coun ies in he a ab wo ld and elsewhe e should be
in es iga ed.
cOgen BUsiness & ManageMen 21
Disclosu e s a emen
no po en ial con lic o in e es was epo ed by he au ho (s).
Abou he au ho s
D . Yousi Mousa Sab i eaches o ganiza ional beha iou and human esou ce managemen . D . Yousi holds an in e -
na ional aine ce i ica e om he ge man in e na ional academy o Quali ica ion, De elopmen , aining,
consul a ion and sus ainable De elopmen . he has held a ious adminis a i e posi ions a he p i a e Uni e si ies.
D . Yousi ’s esea ch in e es includes, o ganiza ional beha iou and human esou ce managemen . o da e, he has
published mo e han 30 a icles in bo h local and in e na ional jou nals.
D . Sub amaniam S i Ramalu, is an associa e P o esso o O ganiza ional Beha io and leade ship. D sub amaniam
is a ce i ied P o essional aine o Malaysian ins i u e o Managemen and human Resou ces De elopmen Fund.
he has held a ious adminis a i e posi ions a he Uni e si y. D . sub amaniam’s esea ch in e es includes leade -
ship, o ganiza ional beha iou and human esou ce managemen . he has success ully supe ised 20 doc o al s u-
den s and mo e han 30 Mas e s uden s. o da e, he has comple ed 16 esea ch p ojec s and published mo e han
60 a icles in bo h local and in e na ional jou nals.
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