A study to ascertain gynaecological patients' perceived levels of embarrassment with physical and psychological care given by female and male nurses

Women's experiences of male nursing and midwifery care: An inductive content analysis of blog posts from an open-access parenting site

BACKGROUND

There still remains a gender divide between men and women when it comes to the provision of nursing care. To date, there is a plethora of literature that describes the barriers men face in the profession. However, there is very little with regard to the patients' qualitative experience of male nursing/midwife care.

AIM

The aim of this study was to describe the experiences of women being cared for by a male nurse/midwife.

METHOD

Inductive content analysis was undertaken on blog posts from an online parenting site as they related to the care provided by male nurses and midwives.

RESULTS

A total of 128 blog posts were identified. There were two themes identified-feeling comfortable and feeling cared for. There was a polarized view to the care provided by male nurses and male midwives with respondents either flatly refusing, or wanting a preference as to which gender provided care, to others expressing it was the best care they ever experienced. The provision of care was where the blog posts differed significantly. There were mixed emotions from angered embarrassment at the thought of a male nurse/midwife providing intimate care to being Ok with nonintimate care such as the taking of vital signs.

CONCLUSION

It would appear from the blog posts analyzed that the assimilation of men into clinical areas generally seen as the purview of female nurses is slowly becoming accepted although further research as to the patient perspective of male nursing/midwifery care in these areas is needed.

Attitudes of patients towards being cared for by male nurses in a Jamaican hospital

AIM

To determine the attitudes of patients towards male nurses in a Jamaican hospital.

BACKGROUND

More males in nursing will help to address the nursing shortage and provide diversity in the profession. Patient attitudes towards male nurses will influence recruitment and retention.

METHODS

A cross-sectional study was used. Data were collected using a self-administered questionnaire and an attitudinal measuring scale.

RESULTS

Seventy-three patients responded (response rate 91%). Male nurses were perceived negatively by 51% of respondents. However, only 10% had a negative perception of the care they received from male nurses. More males (80%) than females (54%) had a negative attitude towards receiving an enema from a male nurse.

CONCLUSIONS

Patients generally had a negative attitude towards male nurses but had a positive view if they were cared for by a male nurse. These traits can be used as the basis of changing the gender balance of nurses in Jamaica.

Attitudes on intimate touch during nursing care in China

Although intimate touch is essential to nursing practice, few studies have investigated patients' wishes and how nurses should perform in preserving patient privacy in China. A maximum-variation sample of 18 adults was selected, and semistructured interviews were conducted in two focus groups. Interviews were recorded and transcribed, and thematic analysis was performed. Five themes emerged from the interviews. These findings suggest that nurses should pay more attention to the patient's attitudes, needs and wishes.

Therapeutic Relationship Between Male Nursing Students and Female Patients

This article explores the therapeutic relationship between male nursing students and female patients, through the use of autobiography in a qualitative approach. For this study, 18 male nursing students enrolled in master's and bachelor's programs in Hong Kong were recruited. They were asked to make records in a diary and draw pictures of their therapeutic relationship with female patients from their clinical experiences and then participate in a focus group interview. Content analysis was carried out on the collected data. The essential factors influencing the development of a therapeutic relationship were found to be gender, symbolic meanings, and career features. Good experiences were also discussed. The results shed light on the experiences of male nursing students and how they make sense of their therapeutic relationship with female patients.

Self-Image of Male Nursing Students in Hong Kong

The image of male nurses is closely related to the development of a female-driven nursing occupation. As a minority group in the nursing industry, male nursing students may have a negative self-image in their learning and clinical practicum. This may affect their psychological health and mental status. This study explored the positive and negative self-image of male nursing students. Eighteen participants were recruited from a local nurse-training institute. The participants were undergraduate bachelor’s and master’s students of nursing. The experience and opinions of the participants were collected by multiple methods. The participants’ drawings and audio diaries representing their self-image as nurses were collected in advance of a discussion of ideas raised in the focus group interview. The findings were categorized into three themes: (a) self-roles, functions, and identities; (b) awareness of gender differences; and (c) the future of professional development. The findings of this study provide information on the nurse role, identity, gender differences, and professional development of male nursing students, which will drive the direction of the development of a positive image for male nurses in the future.

Exploring sensitive boundaries in nursing education: attitudes of undergraduate student nurses providing intimate care to patients

BACKGROUND

Nursing students often feel challenged and intimidated to provide intimate care to patients in the health care setting. Student nurses in particular are faced with social, professional, academic and peer expectations and experience high levels of stress when providing this intimate care.

OBJECTIVE

Explore student nurses attitudes to providing intimate care.

METHODS

Year two and year three students of a three year undergraduate nursing programme completed a descriptive Nursing Students Intimate Care (NSIC) survey with open ended questions. This study discusses student responses to the question: Did you feel it was appropriate for a nurse to provide intimate care to a patient of the opposite sex?

RESULTS

Three major themes were identified: societal and self-determined role expectations, comfort and discomfort providing intimate care, and age and gender of the carer and recipient.

CONCLUSIONS

Student nurses face numerous challenges when having to provide intimate care to patients. These challenges are influenced by the age, gender, levels of comfort of the nurse and the patient and is related to the nature of intimate care being provided. Student nurses will benefit from pre-clinical simulated training experiences in providing intimate care. This training needs to specifically consider being sensitive to the needs of the patient, maintaining patient dignity, negotiating, accommodating and implementing plan of care while being competent and professional in their approach to providing intimate care.

Psychometric Evaluation of Uterine Cervical Cancer Screening Embarrassment Questionnaire among Korean Women: Complementary Use of Rasch Model

PURPOSE

Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire.

METHODS

A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion.

RESULTS

Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability.

CONCLUSION

The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.

Experience on Delivery Room Practice of Male Nursing Students

PURPOSE

This study was to understand the meaning of experience in delivery room practice of male nursing students.

METHODS

This is qualitative research using focus groups. Data were collected by group interviews from May 22 to June 20, 2010. The focus group interviews were conducted to 14 male nursing students who had experience clinical practice in delivery room. Data were analyzed through Colaizzi's method, in which meaningful statements were extracted.

RESULTS

Five theme clusters were identified from thirteen themes and twenty four sub-themes. The five theme clusters were 1) cultural perception of gender role, 2) perceived reality of male nurse, 3) difficulty in approaching clients, 4) counter-educational environment, 5) insight and new perception.

CONCLUSION

For the purposes of remedying male nurse students' problems experienced during clinical practice in delivery room, it seems that there is a need for reeducating nurses' perception of male nurse students and develop programs specially dedicated to clinical practice of male nurse students.

Expressing and responding to pain and stoicism in home-care nurse-patient interactions

Addressing pain and suffering are critical issues for home-care nurses. Pain is frequently experienced by people living at home with chronic illnesses, as well as acutely ill people discharged early from hospitals. The purpose of this qualitative ethology study was to explore and describe the interactions and experiences expressing and responding to pain in home-care nurse-patient interactions. A qualitative video ethology design was appropriate to inductively describe micropatterns of communicative behaviour in natural settings. Ten home-care nurse-patient dyads were videotaped over multiple visits. Data consisted of 31 videotaped visits (over 19 hours) and accompanying participant interviews. Recursive and cyclical qualitative analysis was used to describe the patterns of communication with which stoicism or endurance of pain and suffering was supported or challenged. Dominant patterns of interaction were concerned with: negotiating appropriate forms of stoicism; negotiating ways to express, understand and measure pain and suffering; and dealing with intractable or inflicted pain. The methodology of this study allows an in-depth view of typical nurse-patient interactions. It explores the subtle communicative expertise of nurses by investigating the types of communication used in nursing encounters and by explicating behavioural patterns of expressing and responding to suffering. Observational research of interaction-as-it-occurs must continue to better understand how nurses and patients co-construct personal identities of suffering and stoicism.

Male nurses' experiences of providing intimate care for women clients

AIM

This paper reports a study of male nurses' experiences of providing intimate care for women clients.

BACKGROUND

The number of men entering the nursing profession has increased worldwide. As a consequence of the move to a more gender-balanced profession, debate has ensued over how intimate care should be performed when this requires male nurses to be physically close to women clients. As there was little previous work on this topic, we wished to provide nurses, clients and other healthcare professionals with a better understanding of male nurses' experiences of working with women clients and within a healthcare system where they often feel excluded.

METHOD

Semi-structured, open-ended interviews were conducted with male nurses working in various clinical settings in Western Australia. Latent content analysis was used to analyse the interviews, which were carried out between June and July 2004.

FINDINGS

Three themes were identified: the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. Providing intimate care for women clients was a challenging experience for male nurses. Participants described how it required them to invade these clients' personal space. Consequently, they often experienced various negative feelings and used several strategies to assist them during care delivery.

CONCLUSIONS

Nurse educators should assist male nurses to be better prepared to interact with women clients in various settings. Furthermore, workplace environments need to provide additional support and guidance for male nurses to enable them to develop effective coping strategies to manage challenging situations.

Process utility from providing informal care: the benefit of caring

Though economics is usually outcome-oriented, it is often argued that processes matter as well. Utility is not only derived from outcomes, but also from the way this outcome is accomplished. Providing care on a voluntary basis may especially be associated with such process utility. In this paper, we discuss the process utility from providing informal care. We test the hypothesis that informal caregivers derive utility not only from the outcome of informal care, i.e. that the patient is adequately cared for, but also from the process of providing informal care. We present empirical evidence of process utility on the basis of a large sample of Dutch caregivers (n=950). We measure process utility as the difference in happiness between the current situation in which the care recipient is cared for by the caregiver and the hypothetical situation that someone else takes over the care tasks, all other things equal. Other background characteristics on patient and caregiver characteristics, objective and subjective caregiver burden and quality of life are also presented and related to process utility. Our results show that process utility exists and is substantial and therefore important in the context of informal care. Almost half of the caregivers (48.2%) derive positive utility from informal care and on average happiness would decline if informal care tasks were handed over to someone else. Multivariate regression analysis shows that process utility especially relates to caregiver characteristics (age, gender, general happiness, relation to patient and difficulties in performing daily activities) and subjective caregiver burden, whereas it also depends on the number of hours of care provided (objective burden). These results strengthen the idea of supporting the use of informal care, but also that of keeping a close eye on the position of carers.

Misrepresenting random sampling? A systematic review of research papers in the Journal of Advanced Nursing

AIM

This paper discusses the theoretical limitations of the use of random sampling and probability theory in the production of a significance level (or P-value) in nursing research. Potential alternatives, in the form of randomization tests, are proposed.

BACKGROUND

Research papers in nursing, medicine and psychology frequently misrepresent their statistical findings, as the P-values reported assume random sampling. In this systematic review of studies published between January 1995 and June 2002 in the Journal of Advanced Nursing, 89 (68%) studies broke this assumption because they used convenience samples or entire populations. As a result, some of the findings may be questionable.

DISCUSSION

The key ideas of random sampling and probability theory for statistical testing (for generating a P-value) are outlined. The result of a systematic review of research papers published in the Journal of Advanced Nursing is then presented, showing how frequently random sampling appears to have been misrepresented. Useful alternative techniques that might overcome these limitations are then discussed. REVIEW LIMITATIONS: This review is limited in scope because it is applied to one journal, and so the findings cannot be generalized to other nursing journals or to nursing research in general. However, it is possible that other nursing journals are also publishing research articles based on the misrepresentation of random sampling. The review is also limited because in several of the articles the sampling method was not completely clearly stated, and in this circumstance a judgment has been made as to the sampling method employed, based on the indications given by author(s).

CONCLUSION

Quantitative researchers in nursing should be very careful that the statistical techniques they use are appropriate for the design and sampling methods of their studies. If the techniques they employ are not appropriate, they run the risk of misinterpreting findings by using inappropriate, unrepresentative and biased samples.

Cautious caregivers: gender stereotypes and the sexualization of men nurses' touch

AIM

The aim of this research was to explore the experience of men nurses and the ways in which gender relations structure different work experiences for women and men in the same profession.

BACKGROUND

Men are now entering the nursing profession in record numbers and challenging the notion that men are inappropriate in caregiver roles or incapable of providing compassionate and sensitive care. A limitation of the current state of knowledge regarding caring and men nurses is that it is primarily focused on men nursing students, not practising nurses. Little is known about men nurses' practices of caring and how such practices reflect the gendered nature of nursing and nurses' caring work.

METHODS

The theme of men nurses as cautious caregivers emerged from data that were collected in two rounds of semi-structured interviews with eight men nurses practising in Nova Scotia, Canada. Thematic analysis, informed by feminist theory and masculinity theory, was used as the method for analysing the data.

FINDINGS

For men nurses, the stereotype of men as sexual aggressors is compounded by the stereotype that men nurses are gay. These stereotypes sexualize men nurses' touch and create complex and contradictory situations of acceptance, rejection and suspicion of men as nurturers and caregivers. They also situate men nurses in highly stigmatized roles in which they are subject to accusations of inappropriate behaviour. For men nurses, this situation is lived as a heightened sense of vulnerability and the continual need to be cautious while touching and caring for patients. Ultimately, this situation impacts on the ability of men nurses to do the caring work they came into nursing to do.

Preferences for female and male nurses: the role of age, gender and previous experience --year 2000 compared with 1984

BACKGROUND

The situations in which patients prefer a male or female nurse are not clear, as the literature reports differing relationships between gender and preference. Furthermore, most research has focused on female preferences.

METHODS

This questionnaire study investigated the preferences of both males and females for a male or female nurse, depending on four clinical situations. The role of age and previous experience with a male nurse was also taken into account. Gender, age and experience were further examined in relation to attitudes towards professional nursing practice. To determine whether preferences and attitudes have changed over time, the study was replicated in 2000, having been first conducted in 1984. Data were collected from the same general practice waiting room on each occasion.

RESULTS

Consistent with previous research, the degree of intimacy in a clinical situation was found to be predictive of same-gender preferences. Younger females may prefer female nurses more than older females. Experience with male nurses was limited in both samples, but was not predictive of preferences or attitudes.

CONCLUSIONS

Generally speaking, results from 1984 and 2000 were not significantly different. As a quantitative study, this research contributes to an understanding of patient preferences. However, in-depth, qualitative research is recommended to understand better the reasons for preferences and attitudes, for both male and female patients.

Men's lived experiences following transurethral prostatectomy for benign prostatic hypertrophy

The aim of this study was to illuminate the lived experience of prostatectomy recovery by means of semi-structured interviews. Despite the commonality of prostatic enlargement and the corrective transurethral procedure, surprisingly little is known of the impact upon the men's social and psychological well-being. The interviews have produced very rich data, which illustrate the extent to which the men are initially very reluctant to identify 'problems' either with their hospital experience or their subsequent recovery period. However, once respondents appeared to feel more comfortable, we began to learn of their very substantial difficulties both before and after the operation.