Gender Issues in Nursing - Literature review Example

Introduction Gender is a key socio cultural influence on healthcare. Nurses involved in mental healthcare are faced with several gender-related issues in their everyday practice. These issues include gender differences related to mental health, issues faced when dealing with patients of the opposite sex. Nursing is a profession that has always been considered as a women’s profession. However, this is slowing changing and there is growing number of men who are choosing nursing as a career. Mental health in the case of men and women is not created equal. Different cultures consider different things normal. There are several issues that male and female nurses are faced with when treating patient’s of the opposite sex, particularly mental health patients. It is important for nurses to therefore be aware of and sensitive to these issues so that appropriate treatment and management strategies can be put in place. This review looks at the gender issues faced by nurses today by reviewing three studies from literature. For this critical appraisal, EBSCO host research databases were used. CINAHL, Academic search complete, Psychology and behavioural sciences collection and Health source: Nursing / academic edition were chosen. The focus of this review is gender and professional identity in psychiatric nursing, caring for female patients, and men’s attitudes towards health. The article by Boschma, Yonge and Mychajlunow (2005) examines gender-specific transformation of nursing practice in institutional mental health-care based on the archival records on two psychiatric hospital. The other article, Caring for female patients: the experience of male nurse by Keogh and Gleeson (2006), presents the results of two small qualitative studies. These studies examined the experiences of psychiatric nurses and general nurses while caring for patients of the opposite sex. The third article “Rural men and mental health: Their experiences and how they managed” reports on a study that interviewed rural men in order to explore their mental health experiences in a rural setting. The three articles are summarized below to help understand in depth the gender issues that nurses face. Article 1: Depression, Hopelessness, and Suicidal Ideation Among the Elderly: A Comparison Between Men and Women Living in Nursing Homes and in the Community Study summary This article by Pnina Ron was published in 2004 in the Journal of Gerontological Social Work. This study has attempted to make a comparison between the levels of suicidal ideation hopelessness, and depression among elderly females and males with regard to their living arrangement, i.e., nursing homes vs. Community living. Old age in the case of many elderly people is characterized by various: physiological, functional, social, cognitive, financial, and other losses. More often than not, the outcomes of these losses include environmental isolation, feelings of loneliness, anxiety, depression, and a complete loss of motivation to live. Given the rise in life expectancy and the multitude wide array of losses that are associated with aging, almost one in every five elderly persons will spend some part of his/her life in a long term care institute. Living in such institutions can negatively impact the mental health of elderly since this results in feelings of lost control over their own life, and a complete inability to make decisions regarding even everyday issues. This study found significantly higher levels of helplessness, hopelessness, and depression among residents of nursing homes as compared with those in the community, gender differences in both environments. Additionally it also found a correlation between the other demographic variables and the three dependent variables considered in the study. This study indicates that there is a need to pay interdisciplinary attention to the mental health of elderly who live in nursing homes, particularly in the initial stages of adjustment. Study population The research population included two groups--community and nursing homes residents. 1. The community group comprised 149 frail elderly women and 78 frail elderly men. The participants were in need of partial assistance in their ADL function. They were interviewed while they were waiting for their appointment at clinics that were randomly sampled within a certain geographical urban area. Convenience sampling was used to select the subjects at the clinic. Variables such as perceived functional situation, knowledge of the Hebrew language, and present place of residence were some of the defining characteristics used. 2. 91 elderly persons (58 women; 33 men) aged 67-86 who were residents of “independent and frail” quarters at three nursing homes within the same geographical area as the sampled clinics were randomly sampled and comprised the nursing home group. One of three residents was selected from a list of 214 fluent Hebrew speakers corresponding to the research population. Since one of the nursing homes shortlisted had only 12 residents, convenience sampling was used to identify additional residents to ensure that a balance is maintained between residents of all three nursing homes. Research findings In this study, gender was found to be a significant predictor of the feelings of suicidal ideation, depression, and hopelessness. In both sample groups It was found that women, particularly those living in the community, experience suicidal ideation, depression, and hopelessness more than men. A significant and positive correlation was observed between gender and suicidal ideation, depression, and hopelessness among the elderly. The women had higher average scores than the men on all dimensions. The greatest difference between the averages was observed in the case of depression. It was summarized that the feelings of depression could occur among widows of a lower socioeconomic status who had experienced the Holocaust. The sense of hopelessness could be higher among older nursing home residents of low socioeconomic status who have lost their spouse. T These findings were supported by the findings of other research studies, which argue that women are more depressive than men are and tend to express suicidal tendencies more than men do. The sex role socialization processes in addition to different emotional structure probably enable women to express emotions to a higher degree, including negative ones. Article 2: Rural men and mental health: Their experiences and how they managed This study by Don Gorman, Elizabeth Buikstra, Desley Hegney, Susanne Pearce, Cath Rogers-Clark, Jim Weir and Bronwyn McCullagh was published in 2007 in the International Journal of Mental Health Nursing. In this study, rural men were interviewed with the aim of exploring their mental health experiences within their environment. The results indicate that rural men are faced with a number of challenges that increase their risk of mental illness. Additionally, these challenges also decrease the possibility of them actually seeking professional support to help them overcome the challenges. Although they so receive some support from their family and friends, the men in the study acknowledged that professional support could have aided recovery. It is important for mental health nurses to be aware of the significant resilience that individuals have and how it can be used and also of the barriers to professional support. Study population and methodology Participants included rural men from Queensland aged 18 years and above who had lived through periods of extreme emotional difficulty that had at some point in time led to strong feelings of depression and/or suicide and who were willing to share their experiences. Participants themselves decided whether or not they met the inclusion criteria for the study. The study included 10 men; these men shared their experiences with the researchers. Consent was obtained by mailing an Information Sheet and Plain Language Statement and Consent Form to potential participants. Ethical approval was obtained from the Human Research and Ethics Committees of the University of Southern Queensland and the Toowoomba Health Service District. Data were collected by, in-depth face-to-face interviews, 1 to 3 hours in duration. Participants were questioned whenever there was a need to explore and clarify issues that were of particular interest to the study. A comparative narrative approach for multiple cases was used. The narratives from the transcribed interviews were constructed in keeping with Emden guidelines. The study revealed several factors that the participants indicated had helped them cope during the challenging phases. These factors were broadly categorized as 1) the individual and their inner strength and 2) support and strategies. Factors such as positive thinking, self-awareness, self-control, the meaning of life, as well as appreciation and hope were included in the first category. The second category is related to factors other than the individual himself that have helped cope with the challenges. These include seeking help and treatment; talking about the challenges; life changes; the feeling of being needed; support received from family and friends; and distractions. The most notable finding of this study is that the men in the study used very similar strategies and strengths to overcome their challenges. This finding may also indicate that the resilience factors seen in this cohort may also be observed in other resilient men. Additionally, these factors may help men who are looking for strategies that will help them deal with mental illnesses. The research findings also indicate that it was not always a conscious decision to use certain resources. This was more a process that occurred without the concerned individual even being aware of it until they retrospectively realized that it helped them. In a few cases, the process was initiated by other people namely family and friends; however, the benefits were not recognized until much later. This study also indicated that social support and family bonds are important factors that increase the resilience of rural men Article 3: Caring for female patients: the experiences of male nurses Study summary This article by Brian Keogh and Madeline Gleeson presents the results of two qualitative studies that looked at the experiences of five male registered general nurses and six male registered psychiatric nurses while caring for patients of the opposite sex. The interviews attempted to describe the experiences of male nurses caring for women with emphasis on physical touch involving interventions. Common themes from both the studies are presented here. Male nurses were often apprehensive about physical touch. They used various coping strategies to deal with their fears of being accused of inappropriate touch. Several factors also had an impact on male nurses when physical touch was used as an intervention. The findings of this study also suggest that the undergraduate curriculum should include learning about caring for female patients. Study population and methodology The study used a qualitative descriptive design was used for the data collection process that involved semi-structured interviews. Ethical approval was obtained from the university to which the researcher was affiliated with. Five male general nurses and six male psychiatric nurses were purposively selected for the first and second study, respectively. The interviews attempted to describe the experiences of male nurses’ caring interventions with female patients, with particular emphasis on interventions involving physical touch. Themes were generated from both the studies. Common themes from both studies included the following: 1) Fear of sexual allegations when caring for persons of the opposite sex: This was related to the general feelings of anxiety experienced by male nurses when caring for female patients wherein they felt that their caring interventions involving touch might be considered sexually inappropriate. 2) Factors influencing caring interventions with the opposite sex: Several factors influenced male nurses when they used physical touch during caring interventions. These factors included the patient’s health status, patient’s age, and knowing the patient. 3) Learning about caring interventions for the opposite sex: This is concerned with the participant’s perceptions of learning about physical touch while caring for patients of the opposite sex. Research findings Findings of this study indicate that male nurses are more often than not very apprehensive about using physical touch when caring for female patients. They are constantly anxious about the fact that their caring interventions for female patients will be misinterpreted as being sexually inappropriate. It is important to provide guidance to male nurses during pre-registration programmes on the appropriate use of touch in caring interventions. Review discussion Thus, while all three articles discussed in this study deal with different issues, they have a common thread in that they all focus on gender issues in nursing care. The first study talks about gender differences related to mental illnesses, the second study talks about coping strategies used by rural males when they are faced with mental illnesses, and the third study talks about the problems faced by male nurses when caring for patients of the opposite sex. Despite the very distinct nature of each of the problems discussed, all these fall under the purview of gender-related issues and serve the function of giving a good overview of the various problems under this category. All these studies talk about the need to sensitize nurses during the training stage itself about these gender related issues because this has a direct impact on caring interventions. All three studies are very limited with respect to their sample size and hence have limited generalizability. They all suggest that further research is required for each of these issues since the implications of these issues in nursing practice are many. Nurses should thus be aware that when the elderly are placed in nursing homes, they should be closely monitored to prevent them from experiencing negative feelings that result from the social-environmental loss. Women, in particular widows, who are living in the community and those with a history of anti-depressive drug use and previous suicide attempts need particular attention. Nurses should be aware of and sensitive to this and provide appropriate interventions. Given that men are more likely to conceal problems such as depression when compared with women, nurses should provide them the necessary support to help them express their feelings. Since misinformed attitudes regarding mental health problems is one of the major barriers to rural men seeking help during difficult times, nurses working in a rural setting, have to put in additional efforts to carry out such health promotion activities. It is important for nurses to help rural men understand that what they are experiencing is not something experienced by them alone but also by several other rural men. It is necessary to challenge existing societal perceptions of nursing being a female profession. It is necessary to carry out further research to explore and elaborate on the experiences of nurses with regard to gender-related issues in clinical settings. This will help develop alternate strategies for caring interventions in clinical practice. References Gorman, G., Buikstra, E., Hegney, D., Pearce, P., ath Rogers-Clark, C., Weir, J., et al. (2007). Rural men and mental health: Their experiences and how they managed. International Journal of Mental Health Nursing, 16, 298–306. Keogh, B., & Gleeson, M. (2006). Caring for female patients: the experiences of male nurse. British Journal of Nursing, 15(21), 1172-1175. Ron, P. (2004). Depression, hopelessness, and suicidal ideation among the elderly. Journal of Gerontological Social Work, 43(2), 97-116. Read More