Motives and attitudes in choosing the nursing profession among students at Medical University – Sofia

Pharmacia 73: e190962 DOI 10.3897/pharmacia.73.e190962 Research Article Motives and attitudes in choosing the nursing profession among students at Medical University – Sofia Vidin Kirkov1 , Nely Gradinarova1 , Kremena Ivanova1 1 Medical University of Sofia, Faculty of Public Health „Prof. Tzecomir Vodenitcharov, MD, DMSc“, Sofia, Bulgaria Corresponding author: Vidin Kirkov () Received 8 March 2026 ♦ Accepted 9 April 2026 ♦ Published 4 May 2026 Citation: Kirkov V, Gradinarova N, Ivanova K (2026) Motives and attitudes in choosing the nursing profession among students at Medical University – Sofia. Pharmacia 73: e190962. https://doi.org/10.3897/pharmacia.73.e190962 Abstract Choosing the nursing profession is a complex process in which individual motivational factors intersect with societal needs, particularly in the context of increasing demands on nursing staff and a chronic shortage of healthcare professionals. This study aims to analyze the motives and attitudes influencing the choice of the nursing profession among students at the Medical University of Sofia. The empirical study was conducted between September and November 2025 and included 174 nursing students from all years of study. The results highlight the predominance of value-based and humane motives in professional choice and emphasize the need for targeted policies for career guidance and the sustainable development of nursing staff within the healthcare system. Keywords Attitudes, motives, nurse, professional development, students Introduction Issues related to occupational choice have attracted scholarly attention since antiquity, including the works of ancient Greek philosophers such as Socrates and Plato and the French thinkers Pascal, Voltaire, and Rousseau. They have been the subject of attention of representatives of a variety of philosophical, educational, economic, and other schools and teachings, from the humanism of the Renaissance to rationalism in the era of the initial accumulation of capital (Vodenitcharov 1986, 1992; Kirkov 2025). The choice of a professional path is a multilayered process in which personal attitudes and social needs intersect. In this context, the operating mechanisms for managing and regulating the reproduction of labor potential are tested precisely through decisions related to profession- al orientation. The educational system, the processes of professional guidance and selection, and the mechanisms for qualification and retraining of the workforce play a significant role in the formation of this choice. In view of the growing demands of modern society, as well as the dynamic social and scientific and technical development, it can be expected that in the future the processes of professional self-determination and development of young people will be faced with even higher and more complex requirements (Kirkov 2024, 2025). The nursing profession is a central part of the modern health system, playing a key role in the organization and delivery of health care. Health care, as a set of diagnostic, curative, preventive, promotional, rehabilitative, and other activities, requires complex interaction between different professional groups, with nurses standing di- Copyright Kirkov V et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 2 Kirkov V et al.: Motives and attitudes in choosing the nursing profession among students ... rectly next to the patient at every stage of care. The historical context of the development of nursing traces the transformation from the religious and charitable care of the 19th century to the modern goals of the profession, based on scientific principles and standardized practices (Baly 1995; McCrae 2003). The profession officially emerged in the 19th century with the creation of the first systematized nursing curricula, most famously in the person of Florence Nightingale, who laid the foundations of modern nursing by emphasizing hygiene, professional training, and health statistics. Over time, nursing has evolved from a role as an adjunct to medical practice to an autonomous profession with its standards of training, ethics, and professional regulation. This development is also reflected in concepts of division of labor in health care, which delineate clear boundaries and competencies between physicians, nurses, pharmacists, and other professionals to maximize the effectiveness of patient care (Straus et al. 1963; Hall 2005). The choice of the profession of „nursing“ is a complex and multifactorial process that cannot be explained solely by rational economic reasons. The leading motives that determine the decision to choose and apply for the specialty of „nursing“ can be conditionally divided into two main groups. The first group includes humane motives related to the desire to provide care for sick people, support the healing process, and actively participate in the protection and improvement of public health. The nursing profession is perceived as a socially significant, humane, and morally engaging activity aimed at supporting the patient and the patient’s relatives. The second group of motives is related to personal fulfillment and professional development and includes the pursuit of secure professional fulfillment, employment opportunities in the country and abroad, relative financial stability, professional independence, and the opportunity to fully apply and develop personal abilities and skills within the health system. The shortage of nurses in many countries has further stimulated the interest of academic researchers in the motivational aspects behind the choice of profession, which are often related to working conditions, opportunities for professional development, and social recognition (Mudallal et al. 2017). The purpose of this article is to present and analyze the motives and attitudes toward choosing the profession of „nursing“ among students of this specialty from all courses of study at the Faculty of Public Health „Prof. Tsekomir Vodenitcharov, MD, DSc“ of the Medical University – Sofia. The study is based on a combination of empirical data and a theoretical overview. Materials and methodology of the research The subject of the study is students in the specialty „nursing“ at the Medical University – Sofia. The study was conducted during the period September 2025–November 2025 in the city of Sofia, and 174 students studying in the specialty of nursing participated. The study used a wide range of sociological and statistical methods: documentary method, survey method— nursing students from MU-Sofia were surveyed with an independently developed questionnaire, descriptive analysis, analysis of variance, Pearson χ2 test, and graphical analysis to visualize the results obtained. The indicators were assessed at a significance l (...truncated)