Perceptions, experiences and preferences of patients receiving the clinician's touch during intimate care and procedures: a qualitative systematic review protocol

Does the gender of nurses matter to patients? A qualitative analysis of gender preferences of patients

Background

This study argues that the gender of a nurse could give patients the emotional and psychological support they need in their healing process. Nonetheless, in many developing countries, these intricate preferences of patients are usually ignored due to poor staffing and logistical capacities of health facilities. As a contribution to this professional and operation gap, this paper explores patients' preference for nurses' gender in health care at the Komfo Anokye Teaching Hospital in Ghana. The paper further explores the importance of these preferences to the delivery of patient-centred care in Ghana and across Africa.

Objective

The paper has two specific objectives: (a) to explore patients' preferences for the gender of nurses who attend to them while on admission; and (b) to find out the range of factors that inform these preferences.

Methods

Qualitative exploratory descriptive design was used to select adult patients who were not seriously ill and nursed by male and female nurses at the medical and surgical wards of the Komfo Anokye Teaching Hospital in Ghana for at least 5 days from January to March 2017 and before their discharge. Participants were recruited using purposive sampling technique. A semi-structured interview guide was used to elicit information from 14 participants after seeking their written informed consent. The data were analysed using content analysis.

Results

Two major themes emerged. These were: the Preferred Gender of a Nurse in Nursing Care and the Reasons for the Preference or no Preference for Nurses' Gender in Nursing Care. Under each of these themes, the associated aspects were also discussed. Patients had varying preference for a particular nurse during care but gender was not particularly significant in patients' preference for nurses. Majority of the participants emphasized their preference for nurses with professional expertise and good virtues to determine a preferred nurse and both genders of nurses can possess these qualities. However, nurses of the same gender as the patient were preferred for intimate procedures to ensure privacy and satisfaction.

Conclusion

The gender of a nurse is not on top of the preferences list of patients in the study context. This may be attributed to the long-term practice that the participants have not had the chance to be choosing a preferred nurse's gender, so most patients are tolerant and familiar with both male and female nurses. Instead, patients' preferences are determined by the performance and quality of service provided by nurses. Age, maturity and social connections were also found to influence patients' preferences.

Men in the service of humanity: Sociocultural perceptions of the nursing profession in South Africa

Background. The classification of nursing as a female-gendered profession, along with patriarchally determined cultural gender roles, makes it difficult for men to select nursing as a career and to excel in their caring capacity as nurses.Objective. To gain in-depth insights into and an understanding of male nursing students’ perceptions of the nursing profession.Methods. A generic qualitative approach, which was explorative, descriptive and contextual, was used to conduct the study. Sixteen male nursing students at two nursing education institutions in KwaZulu-Natal Province, South Africa, were purposively sampled to participate in the study. Data were collected using semi-structured interviews and unstructured observation. Thereafter, thematic analysis was used to analyse the data. Results. Three main themes were developed from the interview data. The participants perceived nursing as the extension of women’s work, with low social status ‒ nursing is not considered to be a profession for men. During the provision of nursing care, feelings of discomfort and embarrassment were experienced. They feared misinterpretation of their care, especially when caring for the naked body when alone with a patient. They resorted to the use of cautious caring, where they do not provide physical care alone, but seek support, especially from female nurses. Conclusion. Male nursing students require role models to support them in their academic journey towards becoming competent practitioners. A male-friendly environment should be created to enable them to provide quality nursing care to all patients. The society needs to be empowered in understanding that men choose the nursing profession to provide care, and that they are capable of caring for the sick.

Perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures: a qualitative systematic review

BACKGROUND

Clinical practice frequently involves the practitioner touching patients' bodies in areas that are highly personal. If inappropriately performed, such intimate touch may result in much anxiety, confusion and misinterpretation. Examination of evidence is necessary to guide practice in this area to mitigate risks and foster optimal clinician-patient relations and care.

OBJECTIVES

The objective of this qualitative systematic review was to identify and synthesize findings on the perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review considered studies that included patients who had received a clinician's touch during intimate care and procedures.

PHENOMENA OF INTEREST

The current review considered qualitative studies that evaluated patients' perceptions, experiences and preferences of a clinician's touch during intimate care and procedures.

TYPES OF STUDIES

The current review considered studies that collected qualitative data and included studies using designs such as phenomenology, grounded theory, ethnography, action research, qualitative description, focus group methodology and feminist research. In the absence of research studies, other text such as opinion papers and reports were considered.

CONTEXT

The current review considered studies that included patients' perceptions, experiences and preferences of a clinician's touch during intimate care and procedures. Intimate care is likely to occur in any clinical setting where patients need assistance with personal care, where physical examinations occur, or in settings were gynecologic, genitourinary, lower intestinal, dermatologic, cardiac or other procedures involving highly personal areas of the body are performed.

SEARCH STRATEGY

A three-step search strategy was used to find published and unpublished studies in English from 1970 to 2016, searching various databases which included searches of reference lists of studies selected for appraisal.

METHODOLOGICAL QUALITY

Included studies were assessed for methodological quality independently by two reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) prior to inclusion. Of the two studies included in the review, one did not discuss ontological and epistemological assumptions, and the other did not include the personal assumptions and role of the researcher.

DATA EXTRACTION

Data were extracted using the data extraction tool from the JBI-QARI. The data extracted included details about the phenomenon of interest, populations and study methods.

DATA SYNTHESIS

Qualitative findings were synthesized using JBI-QARI.

RESULTS

Two studies were included in this review. Seven findings were organized into three categories and one synthesized finding, "clinician respect". The finding suggests that clients prefer engaged and meaningful communication prior to and during an intimate touch encounter, expect autonomy over their bodies and desire shared decision making relative to how and by whom intimate touch is provided.

CONCLUSION

The synthesized finding from this review suggests that:More research is needed to explore the perceptions and preferences for intimate touch among diverse populations, generations, cultures and contexts. Particular exploration is needed for populations with additional vulnerabilities to misunderstandings, anxiety and abuse, such as pediatric and geriatric patients, and patients with physical, mental and cognitive impairments.