An Emerging Integrated Middle-Range Theory on Asian Women's Leadership in Nursing

Barriers to advancing women nurses in healthcare leadership: a systematic review and meta-synthesis

Background

Women comprise the majority of the nursing profession, yet nurses are underrepresented in healthcare leadership. We aimed to explore barriers for women nurses to advance in healthcare leadership to inform organisational interventions for career advancement.

Methods

In this systematic review and meta-synthesis, studies examining advancing women nurses and midwives in leadership within healthcare and academia in the international literature were included. Six databases (MEDLINE, EMCARE, EMBASE, PsycINFO, PubMed, and CINAHL PLUS) were searched for studies published in English between January 1 2000 and October 17 2023. The Grading of Recommendations Assessment, Development, and Evaluation tools (GRADE) was followed to assess confidence in the findings. Retrieved full texts were assessed for methodological rigour using the Critical Appraisal Skill Programme Qualitative Studies checklist and the Joanna Briggs Institute Cross-sectional and Prevalence Studies checklists. Reported barriers for women nurses' leadership attainment were identified and generated themes were mapped to the Abilities, Motivation, and Opportunities (AMO) framework.

Findings

There were 32 eligible studies; 18 qualitative, 11 quantitative, and 3 mixed-methods. Studies included high-income countries (n = 20), middle-income countries (n = 7) and across countries (n = 3) with two unspecified. Samples included registered nurses, nurse academics, executives, and leaders. The key barriers highlighted were related to: role modelling and leadership development (ability); multiple complex and interacting factors, including gender stereotyping, perception of professionalism, human relations policies, and gender bias (motivation); and systemic issues, such as organisational setting, structure, and support (opportunity).

Interpretation

The prevailing belief in the literature is that caregiving is a feminine occupation and along with societal expectations of women's subordinate position, these present substantial obstacles that limit women nurses from advancing into healthcare leadership. Ultimately, these factors restrict women nurses in career advancement and need to be addressed at a systems and organisational level.

Funding

The National Health and Medical Research Council (NHMRC), Australia.

Inclusive leadership to guide nursing's response to improving health equity

The purpose of this manuscript is to examine traditional models of leadership in nursing, and to provide a roadmap and specific recommendations for nurses at all levels to lead our profession through the next decade in achieving health equity. We examine current leadership frameworks in nursing and discuss ways to contemporize these frameworks to more explicitly center the expertise of clinicians and communities from historically marginalized backgrounds. Next, we examine the racial, gender, and able-bodied biases that impact nurses, and call upon nurses to examine and dismantle these biases. We discuss the roles of health systems and academic organizations in developing inclusive leaders, including through community engagement and true service-learning partnerships. Finally, we provide a set of recommendations for all nursing leaders across career stages to embrace inclusivity as they work to improve health equity.

Transformation of women's leadership through producing natural-dyed hand-woven fabrics (ethnographic study on Palue weavers)

OBJECTIVE

The purpose of this study was to find an explanation for the transformation process of the Palue female weavers' leadership, which changes along with changes in the use of color materials in the sarong from chemical colors that are harmful to health and not in accordance with tradition to natural color materials that are safer and in accordance with tradition.

METHODS

An ethnographic approach was used in this study. Data collection was carried out for 17 months through direct involvement in the activities of producing natural-dyed and hand-woven traditional fabrics done by 15 families.

RESULT

The results showed that a transformation of leadership took place in each of these families.

CONCLUSION

Replacing chemicals with natural ingredients that are safer in sarong coloring, not only makes women healthier but also makes them a leader in the home industry as well as becoming more empowered and daring to pass on their sarong-making skills to the next generation because natural color materials are safe for children. Women are the managers of the home industry of making naturally dyed hand-woven fabrics, involving their husbands and children. There has been a cultural change in which husbands have been willing to help their wives with the dyeing and weaving works. Leadership by women in this home industry has an impact on the decision-making process in the family, cooperatives and community.