Professional career development for male nurses

Hesitancy among Iranian nursing students regarding future career trajectory: a qualitative analysis

BACKGROUND

The shortage of skilled nurses is a major concern for health systems worldwide. This may be partly due to the hesitancy of some nurses to enter or remain in the nursing career. This shortage consequently reduces the quality of standard patient care, increases patients' length of stay in a hospital, increases medical costs, and results in patients' dissatisfaction. This study aimed to explore hesitancy among senior undergraduate nursing students to pursue a career in nursing.

METHODS

This qualitative study adopted a thematic analysis approach. The population comprised senior undergraduate nursing students at Isfahan University of Medical Sciences, Iran, who indicated that they were hesitant to pursue a career in nursing. The study sampling was performed from May 2021 till February 2022 and continued until data saturation. Twenty-four interviews were conducted with the selected students. The attributes related to hesitancy among senior undergraduate nursing students to pursue a career in nursing were extracted as themes and sub-themes.

RESULTS

Four themes were identified: academic idiosyncrasies, individual characteristics, poor nursing market regulations (sub-themes: nursing as a tough and intense career, and unfavorable employment contracts), and the peculiarities of the workplace (sub-themes: conflict within work environment, and barriers to professional nursing practice).

CONCLUSIONS

The findings of this study showed that senior undergraduate nursing students weigh their future career options from various academic, personal, professional, and work environment dimensions. The findings provide new insights for decision makers to design and implement innovative strategies to promote retention in nursing careers. We recommend to provide academic counseling for all students and applicants of nursing before they enter the nursing education. Furthermore, we suggest to improve study and work environments, and to implement incentive programs to enhance enthusiasm of nursing students for pursuing a nursing career.

The Influence of Gender Equity in Nursing Education Programs on Nurse Job Satisfaction

(1) Background: One of the strategies to overcome the shortage of nurses is to minimize gender inequity in nursing culture, starting from the undergraduate education program. Although the number of men entering the nursing profession has increased over the years, the portion of male nurses remains low, particularly in Asian countries. Only a few studies have been conducted to identify gender inequity in nursing, and most of these studies used qualitative study design. Therefore, it is necessary to quantitatively identify gender equity in nursing education and the influence it has on nurse job satisfaction. (2) Methods: A total of 165 male nurses participated in this study. Validated questionnaires were used to assess gender equity in nursing education programs, nurse job satisfaction, nurse job esteem, and nursing professional pride. (3) Results: The mean score of gender equity in nursing programs was 62.6, showing a positive correlation with nurse job satisfaction, nurse job esteem, and nursing professional pride. Gender equity positively predicted nurse job esteem. (4) Conclusions: The gender equity in nursing education programs has positive predictive effects on the factors that influence male nurse job satisfaction. In order to increase nurse job retention, educators should incorporate strategies to minimize gender inequity.

The Mediating Effects of Nursing Professional Commitment on the Relationship between Social Support, Resilience, and Intention to Stay among Newly Graduated Male Nurses: A Cross-Sectional Questionnaire Survey

The current shortage of nurses is an important global issue. Most male nurses leave nursing within four years of starting their nursing career. It is crucial to understand the influencing factors on newly graduated male nurses staying in nursing. Previous studies on intentions to stay as nurses were seldom based on theory and failed to consider the differences between genders. Based on the Job Demands-Resources (JD-R) model, this study tested the model that social support, resilience, and nursing professional commitment influence the intention to stay and the mediating effect of nursing professional commitment in the above relationship. This cross-sectional study adopted purposive and snowball sampling methods. Data were collected using online questionnaire, and 272 newly graduated male nurses completed it. The hypothetical model had a good fit with the data. Nursing professional commitment had a complete mediating effect between social support and intention to stay and between resilience and intention to stay. Nursing professional commitment was highly positively correlated to intention to stay. It is suggested that future research and practice should enhance male nurses’ professional commitment to increase their intention to stay. The findings can serve as reference for developing newly graduated male nurse retention programs.

Clinical Work and Life of Mid-Career Male Nurses: A Qualitative Study

In Korea, about 3000 qualified male nurses enter the clinical nursing field annually; however, they face challenges in long-term job retention in general hospitals. Therefore, this study characterized the work and life experiences of mid-career male nurses engaged in clinical nursing care. Participants were nine registered nurses with a minimum of five years' work experience in a general hospital in Korea. Data were collected through face-to-face, in-depth, semi-structured interviews. A phenomenological qualitative design was used with Colaizzi's data analysis method. Three categories, eight theme clusters, and seventeen themes were revealed. The three categories were "limitations and adaptation to work performance", "interpersonal difficulties and coping", and "facing reality and preparing for the future". Findings suggested that mid-career male nurses were considering transitioning to other job roles. These findings help clarify the clinical work experience of mid-career male nurses and their difficulties with job retention. The results provide basic data that may inform the design of policies to practically support male nurses in preserving their careers.

Guidelines for student accoucheurs' acceptance in maternal healthcare

Purpose

The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student accoucheurs studying at the Free State School of Nursing are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal healthcare institutions. This results in poor quality of training of student accoucheurs in maternal healthcare. Considerable studies have been conducted on males in midwifery nursing, but no guidelines have been developed to facilitate student accoucheurs' acceptance and improvement of the quality of training in maternal healthcare, hence the purpose of this study.

Design/methodology/approach

A descriptive, explorative qualitative design was used in this study. Qualitative focused group discussions ( n  = 32) were conducted through purposeful sampling method. Data was analysed thematically.

Findings

Three main categories emerged: student accoucheurs' related factors with social interactions and relations as a theme; maternal healthcare users’ related factors with transcultural diversity and socio-economic status as themes; nurse training institutions and maternal healthcare institutions service providers-related factors with gender inequality in the work place as a theme. Ultimately, the guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in maternal healthcare institutions were developed and recommended for implementation.

Originality/value

The paper developed guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in Free State maternal healthcare institutions.

The working experiences of male nurses in China: Implications for male nurse recruitment and retention

AIMS

To understand the working experiences and career trajectories of male nurses in China.

BACKGROUND

Compared with developed countries, men were far more under-represented in the nursing profession in China. Little is known about the working experiences of Chinese male nurses and the contextual factors that contribute to their low participation rate in the nursing profession.

METHODS

In-depth interviews with twenty-five male nurses and two hospital administrators were conducted. All interviews were analysed using thematic analysis.

RESULTS

Chinese male nurses had better career prospects and promotion chances compared with female nurses. The extremely low participation rate of men in nursing was related to the prejudice among the general public as well as the low professional status and salary. Two unique contextual factors influenced the career trajectories of male nurses in China: (1) the major assignment mechanism in the college entrance examination and (2) the implementation of the two-child policy.

CONCLUSION

Although Chinese male nurses enjoyed many advantages compared with female nurses, they also encountered many difficulties related to working in a female-dominated profession.

IMPLICATIONS FOR NURSING MANAGEMENT

Appropriate measures should be taken to shift public attitudes towards male nurses, improve the professionalization of nursing and promote gender diversity and equity.

Are the Processes Underlying Discrimination the Same for Women and Men? A Critical Review of Congruity Models of Gender Discrimination

Although classic congruity models of gender discrimination (e.g., role congruity theory, lack of fit) predict negative outcomes for both women and men in gender-incongruent domains, the literature has focused almost exclusively on discrimination against women. A number of recent studies have begun to address the question of whether and under what circumstances men can also be the targets of gender discrimination. However, the results of these studies have so far been mixed. Therefore, the question of whether men, like women, also suffer discrimination when in gender incongruent roles and domains remains unclear. The goal of the present paper is to integrate and critically examine the burgeoning literature on gender discrimination against men in order to assess whether the symmetrical predictions of congruity models are supported. Through this close analysis and integration of the literature, I aim to identify remaining gaps in the research on gender discrimination. In particular, I propose that researchers of gender discrimination would benefit from expanding their scope beyond that of paid work.

Experiences of Male Student Nurse Midwives in Malawi During Undergraduate Education

BACKGROUND

Historically, nursing has evolved from being a feminine profession to a profession accepted by both sexes. In the contemporary world, gender mainstreaming has been instituted as a global strategy in promoting gender equality. Though men continue to join nursing, they face many challenges. It is believed that through proper socialization some of the challenges can be addressed. In Malawi, there is dearth of literature on this subject. This resulted in undertaking the study.

OBJECTIVE

The goal of the study was to describe experiences of male student nurses during undergraduate education in Malawi.

METHODS

A qualitative descriptive design was utilised. Focus group discussions were conducted with study participants in purposively selected nursing colleges.

FINDINGS

Male student nurse midwives faced more negative than positive experiences in nursing. The following three major themes were generated: nursing is a feminine occupation, facing discrimination and socialisation experienced.

CONCLUSION

Malawian male student nurse midwives face both positive and negative experiences during their integration in nursing. Formulation and implementation of gender sensitive policies would help in strengthening male nurse education.

There is nothing wrong with being a nurse: The experiences of male nursing students in Taiwan

AIM

Male nurses are reported to experience role strain. Fear of gender stereotyping can be stressful and frustrating for male nursing students, which could make them feel isolated and excluded. The aim of this qualitative study was to investigate how male nursing students in Taiwan perceive the barriers to their experience as nursing students and how they manage these barriers in their study environment and social life.

METHODS

A qualitative research approach was used in this study. Data were collected during 2014 from 24 male nursing students from three nursing educational institutes in Taiwan who participated in order to share their experiences by using a semistructured interview. All the interviews were recorded, transcribed verbatim, and analyzed by thematic analysis.

RESULTS

The main theme that described the experiences of the male nursing students in Taiwan was: "There is nothing wrong with being a male nurse." Contrary to other studies, role strain for the participants was minimal. The students experienced some barriers because of being a male nursing student, both at school and in their social life. Most of these students tended to manage the barriers by developing positive thinking and coping strategies.

CONCLUSION

Nursing educators are encouraged to use the findings from this study to provide appropriate support for male nursing students.

Death and Help Expected from Nurses when Dying

This project was undertaken to ascertain the perceptions of a group of Taiwan’s fourth-year bachelor of science in nursing (BSN) students regarding death and help expected from nurses during the dying process. Within the Chinese culture, death is one of the most important life issues. However, in many Chinese societies it is difficult for people to reveal their deepest feelings to their significant others or loved ones. It was in this context that this project was developed because little is known about how Taiwan’s nursing students perceive death and the dying process. Using an open-ended, self-report questionnaire, 110 senior BSN students recorded their thoughts on: (1) their fears before physical death; (2) afterlife destinations; and (3) the help they would expect from nurses when dying. The data were analyzed using a three-layer qualitative thematic analysis. The students’ reported needs during the dying process were directed towards three main goals: (1) help in reaching the ‘triple targets of individual life’; (2) help in facilitating in-depth support so that both the dying person and significant others can experience a blessed farewell; and (3) help in reaching a destination in the afterlife. The results support the belief of dying as a transition occurring when life weans itself from the mortal world and prepares for an afterlife.

What motivates men to choose nursing as a profession? A systematic review of qualitative studies

AIM

This systematic review was conducted to provide a deeper understanding of male nurses' motivations for choosing nursing as a profession.

METHODS

A systematic literature review of qualitative data was conducted. CINAHL, Pubmed, PsychINFO, Pubmesh, and Embase were searched from January 1970 to December 2013. Qualitative studies which described male nurses' motivations for choosing nursing were selected.

DATA COLLECTION AND ANALYSIS

Relevant data were extracted from the included papers and were coded and then synthesised under four main themes.

RESULTS

Four main themes were identified which described male nurses' motivations for choosing nursing; 'Early exposure to nursing and other health care professionals', 'Choosing nursing as a profession by chance', 'Choosing nursing because of extrinsic motivating factors', and 'Choosing nursing because of intrinsic motivating factors'.

CONCLUSIONS

To help encourage more men to enter and remain in nursing, recruitment and retention strategies need to focus on addressing the gender stereotypes associated with the nursing profession.

Nursing student profiles and occurrence of early academic failure: Findings from an explorative European study

BACKGROUND

In the European context regulated by the Bologna Process principles, there is little evidence to date on the different profiles, if any, of nursing students enrolled in the 1st academic year and their academic outcomes.

AIMS

To describe and compare the nursing student profiles and their academic outcomes at the end of the 1st year across European Bachelor of Nursing Science (BNS) courses.

DESIGN

An exploratory multicentre cohort study involving five countries: Nursing students who were enrolled in nursing programmes for the academic year 2011/2012 in the participating BNS courses, willing to participate and regularly admitted to the 2nd academic year, were included in this study undertaken in 2013. Individual and faculty level variables were collected after having ensured the validity of the tools developed in English and then appropriately translated into the language of each participating country.

FINDINGS

A total of 378/710 (53.2%) students participated in the study. They attended from 390 to 810h of lessons, while clinical experience ranged from 162 to 536h. The students reported a mean average age of 21.4 (Confidence of Interval [CI] 95%, 21.0-22.3) and foreign students were limited in number (on average 3.7%). The students reported adopting mainly individual learning strategies (92.9%), duplicating notes or lecture notes prepared by professors (74.4%), and concentrating their study before exams (74.6%). The majority reported experiencing learning difficulties (49.7%) and a lack of academic support (84.9%). Around 33.2% reported economic difficulties and the need to work while studying nursing on average for 24h/week. Personal expectations regarding the nursing role were different (45.6%) than the role encountered during the 1st year, as learning workloads were higher (57.2%) with regard to expectations. Around one-third of students reported the intention to leave nursing education while the proportion of those reporting early academic failure was on average 5.6%.

CONCLUSIONS

More strategies aimed at harmonising nursing education across Europe, at supporting nursing students' learning processes during 1st year, and identifying factors influencing their intention to leave and their academic failure, are recommended.

Factors Influencing Men Entering the Nursing Profession, and Understanding the Challenges Faced by Them: Iranian and Developed Countries’ Perspectives

Context:

Men entering the nursing profession have been investigated from several different perspectives. Due to male gender characteristics and existing public image, nursing is often not considered as a career choice by men. Whether nursing would benefit from increased number of men is a key question in the literature. The purpose of this integrative review of the literature was to identify factors influencing men to enter the nursing profession. In addition, it sought to understand the challenges they are confronted within this profession.

Evidence Acquisition:

A systematic search of the existing literature was performed using an Internet search with broad keywords to access related articles in both Persian and English databases. Finally, 34 studies (written between 2000 and early 2013) were selected and surveyed.

Results:

Most of the studies were conducted in developed counties. The review identified reasons why males choose nursing, and other challenges facing men entering and working in nursing. Themes that emerged from the literature include educational and societal barriers experienced by men in nursing, recruitment, career choice, and role strain.

Conclusions:

Regarding men’s influences on professional development, and also the importance of gender-based caring, policies for recruitment and retention of men in nursing must be followed hastily. However, there is a need for further research regarding the challenges faced by men entering nursing, in both Iran and other developing countries.

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.

Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy

AIM

To explore the level of moral distress and potential associations between moral distress indices and (1) nurse-physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses.

BACKGROUND

Poor nurse-physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions.

METHODS

A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses.

RESULTS

The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0-84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0-84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0-336). The severity of moral distress was associated with (1) nurse-physician collaboration and dissatisfaction on care decisions (r = -0.215, P < 0.001); and (2) intention to resign (r = 0.244, P < 0.0001). The frequency of occurrence of moral distress was associated with the intention of nurses to resign (r = -0. 209, P < 0.0001).

CONCLUSION

Moral distress seems to be associated with the intention to resign, whereas poor nurse-physician collaboration appears to be a pivotal factor accounting for nurses' moral distress.

IMPLICATIONS FOR NURSING MANAGEMENT

Enhancement of nurse-physician collaboration and nurses' participation in end-of-life decisions seems to be a managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession.

An exploration of spiritual needs of Taiwanese patients with advanced cancer during the therapeutic processes

AIMS AND OBJECTIVES

This study explores the spiritual needs of patients with advanced cancer during their therapeutic process in Taiwan and analyses the influence of Chinese culture in addressing their spiritual needs.

BACKGROUND

Many nurse clinicians have concerns about the difficulties of providing spiritual care for ethnic-Chinese cancer clients within their cultural context, possibly as a result of lack of knowledge and training. There has been little research exploring the potential impact of Chinese cultural values on the spiritual needs of patients with advanced cancer.

DESIGN

Explorative qualitative enquiry was used.

METHODS

Data were collected through participant observation and in-depth face-to-face interviews. Transcribed interview data were analysed by using qualitative content analysis. The purposive sample (n = 33) was drawn from a leading medical center (n = 19) with 3000 beds in the capital and a community-based rural teaching hospital (n = 14) with 581 beds in Taiwan.

RESULTS

Four spiritual needs emerged from the analysis: the need to foster hope for survival and obtain a peaceful mindset, to fulfil the meanings of life and preserve one's dignity, to experience more reciprocal human love and finally, to receive assistance in facing death peacefully.

CONCLUSION

This research has shown that patients with advanced cancer need caregivers, friends and the help of their religion to meet their spiritual needs during the therapeutic processes.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study could assist health professionals to detect the unmet spiritual needs of ethnic-Chinese patients with cancer in the context of their cultural or religious background as early as possible.

The experience of Egyptian male student nurses during attending maternity nursing clinical course

AIM OF THE STUDY

The aim of this study was to explore the learning experience of Egyptian male student nurses during attending maternity nursing clinical course at Cairo University Maternity Hospital.

METHODS

A descriptive design was utilized for collecting the data that are necessary to answer the research question; both quantitative and qualitative data were collected using a semi- structured interview scale. A total of 60 students who just finished the clinic maternity course in college of Nursing, Cairo University were recruited for the study.

RESULTS

More than half of the sample (66.7%) preferred to deal with males rather than female patients. A number of stressors were reported by students during their clinical training such as: high requirement pertained to clinical area training (55%); unfavorable attitude of the clinical instructors (11%); and refusal of women to receive care by a male student nurse (34%). The most embarrassing procedures for the students were: abdominal examination, breast examination and perineal care. The most interesting procedures were assessment of the newborn, attending cesarean section and providing mother classes for mother in both antenatal clinic and postpartum unit, 53% of the students reported that the women were dealing with them with restrictions, while (25%) reported that women refused to deal with them during labor, 50% described their experience in maternity nursing clinical course as useful, while (18%) described it as interesting and (39%) described it as very embarrassing for male student nurses. Among the suggestions made by students to modify their clinical experience were: 1) substituting clinical training by the skill lab for male students and also adding clinical experience in andrology that refers to the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems (76%); 2) teaming with a female student during the clinical area (50%).

RECOMMENDATIONS

Based on the study findings, re-planning of some of the clinical rotations of Maternity Nursing to include substitute clinical experience for the male student should be considered. Furthermore, developing strategies to change male student's attitude toward child-bearing experience and fatherhood is crucial. Finally, male students should be oriented to and encouraged to identify with role model of male obstetricians.

Relationships among social support, professional empowerment, and nursing career development of male nurses: a cross-sectional analysis

The purpose of this study is to explore the relationships among social support, professional empowerment, and nursing career development and to identify the significant factors that affect nursing career development among male nurses. A cross-sectional survey design was used with 314 male nurses in Taiwan. Social support and professional empowerment were significantly and positively correlated with nursing career development among male nurses. Social support, professional empowerment, salary, type of institution, type of clinical level, and nursing discipline were identified as factors that significantly influenced nursing career development. Together, they accounted for 55.9% of the total variation. Professional empowerment was the most critical predictor of nursing career development and accounted for 47.7% of the variation. Nursing managers should follow male nurses' empowerment with interest and specifically address professional empowerment to promote male nurses' career development.

Gender, gender roles and completion of nursing education: a longitudinal study

The current worldwide nursing shortage and high attrition of nursing students remain a challenge for the nursing profession. The aim of this paper was to investigate how key psychological attributes and constructions differentiate between completers and non-completers of nursing education. A questionnaire including measures of gender role identity and perceived gender appropriateness of careers was administered to 384 students early in the first year of the course. At the end of the programme attrition rates were obtained. The findings indicate that males were more likely to leave the course than females. Furthermore, those who completed the course tended to view nursing as more appropriate for women, in contrast to the non-completers who had less gender typed views. The female-dominated nature of nursing, prevalent stereotypes and gender bias inherent in nursing education seem to make this an uncomfortable place for males and those with less gendered typed views. Whilst it is acknowledged that attrition is undoubtedly a complex issue with many contributing factors, the nursing profession need to take steps to address this bias to ensure their profession is open equally to both female and male recruits.

Surviving a life-threatening crisis: Taiwan's nurse leaders' reflections and difficulties fighting the SARS epidemic

AIM

This study explored Taiwan's nurse leaders' reflections and experiences of the difficulties they encountered and survival strategies they employed fighting the severe acute respiratory syndrome epidemic and the background context framing these phenomena.

BACKGROUND

On several continents in 2002-2003, the highly infectious severe acute respiratory syndrome overwhelmed health care systems and health professionals who had to provide care in situations involving high personal risk and stress, some becoming infected and dying. Nurse leaders in Taiwan had to develop new strategies and support systems for nursing care.

DESIGN

A two-step within-method qualitative triangulation research design.

METHODS

Focus group in-depth interviews held with 70 nurse leaders from four Northern Taiwan hospitals involved in the severe acute respiratory syndrome epidemic. Participants then completed an open ended questionnaire. Content analysis was undertaken with data and stages and themes generated. Data were then analysed using Hobfall's concepts of conservation of resources to further discuss participants' reactions and actions in the severe acute respiratory syndrome crisis.

RESULTS

Participants worked under incredible stress to lead the profession through a period of crisis. Five stages arose in the participants' involvement against severe acute respiratory syndrome over 12 weeks: facing shock and chaos; searching for reliable sources to clarify myths; developing and adjusting nursing care; supporting nurses and their clients; and rewarding nurses.

CONCLUSION

Nurse leaders become important executors of intervention in this health disaster, requiring emotional intelligence to manage their internal conflicts and interpersonal relationships effectively. They developed sociopolitical and analytical abilities and crucial requirements for planning and implementing strategies in areas where none previously existed. Building support systems was an important resource for managing conflicts between familial and professional roles. Relevance to clinical practice. Findings will assist nurse leaders to prepare themselves and the profession to better deal with disaster management in similar infectious outbreaks in the future.

Chinese female nurses' perceptions of male genitalia-related care--Part 1

AIMS

To explore Chinese female nurses' experiences of male genitalia-related care.

BACKGROUND

Male patients who require male genitalia-related care may have psychosocial and sexual concerns and needs. Nurses' attitudes and conduct in the provision of male genitalia-related care, if negative, may obviate meeting these needs. Previous research indicates that limited studies have been conducted focusing on nurses' perceptions, responses and attitudes towards male genitalia-related care. There is a dearth of knowledge about the practice of Chinese female nurses delivering male genitalia-related care, particularly given that physical contact between Chinese adults of different genders outside marriage is traditionally prohibited.

DESIGN

This study is an exploratory qualitative study.

METHODS

Through purposive sampling, eight subjects were approached and semi-structured interviews were conducted. Digitally recorded interviews were transcribed verbatim and thematic analysis was conducted. The strategies of long engagement, member checking, peer debriefing and journal writing were used to establish trustworthiness.

RESULTS

Two themes emerged from interviews: 'association with sexuality' and 'consequences'. The theme 'association with sexuality' comprised the sub-themes of 'being sexual', 'impact on intimate relationship' and 'emotional responses'. The theme 'consequences' was constituted by the sub-themes of 'care with preconditions', 'unavoidable responsibilities' and 'limited involvement with implicit approval'.

CONCLUSIONS

This study suggests that Chinese female nurses' perceptions, responses and attitudes towards male genitalia-related care may be negative, with the consequence that the quality of male genitalia-related care might be compromised. The Chinese culture of sexual conservativeness may play a critical role.

RELEVANCE TO CLINICAL PRACTICE

Risks may be embedded in the practice of male genitalia-related care by Chinese female nurses. Particular attention, therefore, should be drawn to the possibility of adverse effects of Chinese female nurses delivering male genitalia-related care on them and their patients.

Methodological challenges in cross-language qualitative research: a research review

OBJECTIVES

Cross-language qualitative research occurs when a language barrier is present between researchers and participants. The language barrier is frequently mediated through the use of a translator or interpreter. The purpose of this analysis of cross-language qualitative research was threefold: (1) review the methods literature addressing cross-language research; (2) synthesize the methodological recommendations from the literature into a list of criteria that could evaluate how researchers methodologically managed translators and interpreters in their qualitative studies; (3) test these criteria on published cross-language qualitative studies.

DATA SOURCES

A group of 40 purposively selected cross-language qualitative studies found in nursing and health sciences journals.

REVIEW METHODS

The synthesis of the cross-language methods literature produced 14 criteria to evaluate how qualitative researchers managed the language barrier between themselves and their study participants. To test the criteria, the researcher conducted a summative content analysis framed by discourse analysis techniques of the 40 cross-language studies.

RESULTS

The evaluation showed that only 6 out of 40 studies met all the criteria recommended by the cross-language methods literature for the production of trustworthy results in cross-language qualitative studies. Multiple inconsistencies, reflecting disadvantageous methodological choices by cross-language researchers, appeared in the remaining 33 studies. To name a few, these included rendering the translator or interpreter as an invisible part of the research process, failure to pilot test interview questions in the participant's language, no description of translator or interpreter credentials, failure to acknowledge translation as a limitation of the study, and inappropriate methodological frameworks for cross-language research.

CONCLUSIONS

The finding about researchers making the role of the translator or interpreter invisible during the research process supports studies completed by other authors examining this issue. The analysis demonstrated that the criteria produced by this study may provide useful guidelines for evaluating cross-language research and for novice cross-language researchers designing their first studies. Finally, the study also indicates that researchers attempting cross-language studies need to address the methodological issues surrounding language barriers between researchers and participants more systematically.

Dying and caring on the edge: Taiwan's surviving nurses' reflections on taking care of patients with severe acute respiratory syndrome

In 2003, Taiwan's nurses were terrified by severe acute respiratory syndrome (SARS), and four of them sacrificed their life in the course of their work with SARS patients. This study attempted to identify the stage-specific difficulties encountered by Taiwan's surviving frontline nurses during the anti-SARS process. A two-step within-method qualitative triangulation research design was used to obtain the in-depth and confidential thoughts of 200 participants during the precaring, tangible caring, and postcaring stages. Six major types of stage-specific difficulties with and threats to the quality of care of SARS patients were identified according to each specific stage of the caring process. Four themes were further explored; these are discussed to provide a background context in obtaining better understanding of the multifaceted needs of nurses during this crisis. Consequently, a conceptual framework was developed to depict this complex phenomenon.

Change in career aspirations and job values from study time to working life

AIM

The main aim of this paper is to uncover whether the actual career choices and job values of newly qualified nurses are in accordance with the predictions they made at the commencement of their nursing education.

BACKGROUND

A cohort of Norwegian nurse students was followed from the beginning of their education in 1998 through nursing school and 2,years after graduating.

METHODS

Questionnaire data from 221 nursing students at three points in time: 1998, 2001 and 2003 were analysed with frequency distributions and paired samples t-tests. For 140 respondents data from all three points were available.

RESULTS

Initially motives like human contact, helping others, job security were important, and 92% had a wish for further education. Career preferences were often midwifery, public heath and nursing practice in high tech areas. Towards the end of the bachelor course (2001), there was more ambiguity in the helping motives. On one hand, the students wanted to be altruistic but on the other hand, they wanted gratitude in return when giving help to patients. Seventy five per cent of the students had plans for further education within a period of about 2 years after graduation. Midwifery, public health work and high tech practice were still preferred. Findings from 2003 indicated only 16% had started or finished further education 2 years after graduation. When appraising future job challenges in 2001 and 2003, there is a decrease in emphasis on the values human contact and part-time work and an increase in emphasis on high salary and job security.

CONCLUSIONS

During the student period, the bachelor programme was regarded as a basis for further education, but 2 years after graduation only 16% had realized further education. Preferences related to job values regarding a prospective job reveal a decrease in the importance of human contact and an increase in the importance of a high salary and job security from 2001 to 2003.

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.