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PubMed1987

Gender and the attribution of the nurse practitioner and physician status.

The purpose of this study was to discover whether sex-role sterotypes were used to identify members of two professions, nurse practitioners and physicians. Participants reported whether they believed a videotaped health care provider was a physician or a nurse practitioner. Results showed that male providers tended to be identified as physicians, whereas female providers tended to be identified as nurse practitioners. Findings indicate that understanding and enactment of the nurse practitioner and physician roles are still affected by gender issues and that both physicians and nurse practitioners remain subject to the force of sex-role stereotypes.

Attitude↗
PubMed2003

Sex and gender: the challenges for epidemiologists.

Gender issues are now receiving more attention on global and national health agendas. However, the evidence base for policy and practice in this area remains limited and conceptual confusion is still common. This article reviews the challenges facing epidemiologists and other researchers who aim to make their work more "gender sensitive." It begins by exploring the concepts of biological "sex" and social "gender" and assesses their implications for the health of both women and men. It then reviews a range of strategies for mainstreaming sex and gender into health research. The article concludes with brief comments on the links between gender equity and wider equality concerns.

Epidemiologic Studies↗
PubMed2002

Career choice influences in Australian anaesthetists.

All female members and a randomly selected group of male members of the Australian Society of Anaesthetists (n = 488) were surveyed by questionnaire as part of a broader study of gender issues in anaesthesia. This paper reports on reasons for career choice and the importance of role models. Responses were received from 199 women and 98 men (60.9% of those surveyed), representing all States and one Territory. Most males (95.9%) and a majority of females (55.7%) worked full-time. Reasons for career choice varied with gender, with a significantly greater proportion of women (39.7%) than men (8.7%) choosing anaesthesia because of controllable hours, particularly the ability to work part-time. Experiences in anaesthesia during internship and residency were important for 19.1% of women and 14.1% of men, although very few mentioned undergraduate exposure. Other important factors in career choice were the application of physiology and pharmacology in patient care, practical and procedural aspects of practice, and chance. A majority of women (56%) and men (55%) named specific role models who were influential and encouraging in their choice. These results are similar to those of other studies.

Adult↗
PubMedDate not supplied

Formal training in women's issues in psychiatry: a survey of psychiatry residency training directors.

OBJECTIVE: The authors describe the availability of formal residency training opportunities in women's issues in psychiatry and explore the potential relationships between the availability of training and characteristics of residency programs. METHOD: The authors surveyed psychiatry residency training directors to identify program characteristics and training opportunities. RESULTS: Certain didactic subjects were available in greater than 80% of residencies. Clinical training opportunities were less available and often not required. CONCLUSIONS: Selected didactic training in gender issues is commonly available in a majority of residencies. Nevertheless, general clinical instruction and didactic instruction in several important topics are less available.

Adult↗
PubMed2001

Women's work and symptoms during midlife: Korean immigrant women.

PURPOSE: To describe how Korean immigrant women tend to describe their work experiences within their daily lives and how they relate their work to the symptoms experienced during midlife. DESIGN: Cross-sectional study using methodological triangulation. Using a convenience sampling method, 119 Korean immigrant women were recruited for the quantitative phase, and 21 among the 119 women were recruited for the qualitative phase. Data were collected using both questionnaires and in-depth interviews. The data were analyzed using descriptive and inferential statistics and thematic analysis. FINDINGS AND DISCUSSIONS: The symptoms that the women experienced during midlife were influenced by their work experience, which was complicated by their cultural heritage, gender issues embedded in their daily lives, and immigration transition. IMPLICATIONS: Complexities and diversities in women's work need to be incorporated in menopausal studies.

Cross-Sectional Studies↗
PubMed2004

Gender bias among children in India in their diet and immunisation against disease.

This paper conducts an econometric analysis of data for a sample of over 4000 children in India, between the ages of 1 and 2 years, with a view to studying two aspects of the neglect of children: their likelihood of being immunised against disease and their likelihood of receiving a nutritious diet. The starting hypothesis, consistent with an universal interest in gender issues, was that girls were more likely to be neglected than boys. The analysis confirmed this hypothesis. In respect of vaccinations, the likelihood of girls being fully vaccinated, after controlling for other variables, was 5 percentage points lower than that for boys. In respect of receiving a nutritious diet, the treatment of girls depended very much on whether or not their mothers were literate: there was no gender discrimination between children of literate mothers; on the other hand, when the mother was illiterate, girls were 5 percentage points less likely to be well-fed relative to their brothers and the presence of a literate father did little to dent this gender gap. But the analysis also pointed to a broader conclusion which was that all children in India suffered from sharper, but less publicised forms of disadvantage than that engendered solely by gender. These were the consequences which stemmed from children being born to illiterate mothers and being brought up in the more impoverished parts of India.

Child Nutritional Physiological Phenomena↗
PubMed2001

An evaluation of Health Workers for Change in seven settings: a useful management and health system development tool.

This paper presents the findings of a multi-centre study assessing the impact of Health Workers for Change (HWFC) workshops in seven different primary care sites, based on the common core protocol described in this paper. The paper discusses a common methodology used by the studies, consisting of a triangulation of qualitative and quantitative methods. Such methodologies are inherently complex as they require comparisons across systems, sites and procedures. The studies were conducted in six sites in Africa and one site in Argentina. Generally, the intervention resulted either in positive change or in no change, except in the area of staff relationships where conflicts were more frequent after the intervention than before. This may reflect a willingness to confront problems or contentious issues. Implementing the HWFC workshops improved provider-client relations, facility level functioning and aspects of staff interrelationships, and had some impact at the system level. All studies indicated that overall health system development is essential for improved service provision including quality of care. The findings also indicated that this intervention complemented and could assist health sector reform efforts and can play a role in sensitizing health workers to gender issues. The paper concludes with a discussion of the robustness of the methodology used in the studies.

Africa↗
PubMed2003

The best of both worlds: a consideration of gender in team building.

As teams continue to supplant individuals as the fundamental work unit, healthcare organizations increasingly are turning to high-performance care and service groups as keys to success. In this article, the author presents research and findings of an ethnographic case study of a mixed-gender work team of healthcare administrators. Focusing on gender issues and their impact on outcomes, the study offers insights for promoting cultural change and improving nursing practice systems that will influence health policy and support a new architecture for the healthcare industry.

Anthropology, Cultural↗
PubMed2000

Impact of a program to diminish gender insensitivity and sexual harassment at a medical school.

PURPOSE: To measure the effect of an intervention to reduce gender insensitivity and sexual harassment at one medical school. METHOD: Stanford University School of Medicine undertook a multifaceted program to educate faculty and students regarding gender issues and to diminish sexual harassment. The authors developed a survey instrument to assess the faculty's perceptions regarding environment (five scales) and incidences of sexual harassment. Faculty were surveyed twice during the interventions (1994 and 1995). RESULTS: Between the two years, the authors measured significant improvements in mean ratings for positive climate (p = .004) and cohesion (p = .006) and decreases in the faculty's perceptions of sexual harassment (p = 0006), gender insensitivity (p = .001), and gender discrimination (p = .004). The faculty also reported fewer observations of harassing behavior during the study period. CONCLUSIONS: An intervention program to diminish gender insensitivity and sexual harassment can measurably improve a medical school's environment.

Data Collection↗
PubMed2005

The nature of nursing care and rehabilitation of female stroke survivors: the perspective of hospital nurses.

AIMS AND OBJECTIVES: The aim of this study was to explore the nature of nursing care and rehabilitation of female stroke survivors, as described by hospital nurses. The objectives were to uncover how the nurses perceived the care of female stroke survivors and to explore whether, and in what way, the nurses paid attention to the fact that the patients were women. BACKGROUND: Nursing care is an important aspect of the rehabilitation of stroke survivors. Little attention has been paid to gender differences in the health care system in general and in the nursing profession in particular, although it is reasonable to think that gender issues may have important implications in the rehabilitation process following a stroke. DESIGN: Design was phenomenological with feminist perspective. METHODS: The nurses were interviewed in-depth. In the data analysing process we were inspired by Giorgi's phenomenological method. RESULTS: The nurses were focusing primarily on functional and practical aspects of the women's situation. They perceived the rehabilitation process predominately from a professional rather than the patient point of view, and from a non-conscious and primarily gender-neutral perspective. CONCLUSIONS: The results indicate that the nurses perceived nursing care primarily in terms of practical actions to promote the body's functional and practical abilities. Little attention was directed to the stroke survivors' experiences of their life body, nor to the fact that the patients were women. RELEVANCE TO CLINICAL PRACTICE: In order to promote care from the perspective of the female stroke survivors, we believe it is necessary to attend to the life experiences of the patient, which also mandates paying attention to how gender has an impact on their diseased bodies, every day life, values and preferences in the situation.

Adult↗
PubMed2005

The study of men and masculinity as an important multicultural competency consideration.

Gender issues in multicultural competencies do not generally include the study of men and masculinity. This article outlines a rationale for the inclusion of men and masculinity by drawing parallels with Whiteness and privilege as integral aspects of multicultural competency. Additionally, by including the study of men and masculinity into multicultural competency, issues such as heterosexism, patriarchy, homophobia, and sexism that are aspects of dominant masculinity can be addressed. Simultaneously, training clinicians to work with men may mean more effective and improved services than currently available. The article concludes with several multicultural competencies for clinicians when working with men that use Sue, Arredondo, and McDavis (1992) framework of multicultural competencies.

Cultural Diversity↗
PubMed1998

Eating disorders in Japan: finding the right context.

Eating disorders have traditionally been described as a typically 'Western' illness. Cases that occur outside Western countries are often regarded as atypical. Peculiarities are thus emphasized. However, eating disorders are now prevalent in Japan, among non-Western immigrants in Europe, and in other societies. The author focuses on the universality of the background of eating disorders and looks at them as 'culture change syndromes'. Change in the family and in women's roles are the central themes. The majority of the subjects experienced very little emotional relationship with their parents when they were children. It is misleading to say that eating disorder patients lack femininity and that they should be encouraged to be more feminine, more passive. Gender issues concerning treatment settings such as the doctor-patient relationship, the doctor-nurse relationship influence the treatment process. Typical anorexics described in a 1788 Japanese document are briefly presented in order to challenge further the idea of eating disorders as a Western illness.

Adolescent↗
PubMed2003

'Hirsutism': a psychological analysis.

Hirsutism, i.e. 'excess' body hair in the 'male' distribution, is a medical term applied only to women. Although associated with social and psychological difficulties including anxiety, social avoidance and a confusion of gender identity and although it raises important gender issues, there has been little systematic study. No prior research has focussed on the relationship between women's perceived degree of hirsutism and psychological distress. A survey of 53 women with polycystic ovary syndrome (PCOS), which often produces 'excess' hair growth, was carried out to assess any psychological consequences of perceived hirsutism. Results indicated raised levels of psychological distress overall, but no significant relationships between perceived hirsutism and distress. Four semi-structured interviews were then conducted to facilitate more in-depth exploration of hirsute women's experience. Analysis suggested idealized cultural norms for hair growth prevail and excess hair growth contributes to gender inconsistencies and feelings of deviance and stigma. Effective concealment of hair growth and 'passing' for normal appear to facilitate relatively high levels of functioning and allows idealized cultural norms to be maintained.

Adaptation, Psychological↗
PubMed2003

Hospital ergonomics: a qualitative study to explore the organizational and cultural factors.

The primary objective was to identify the characteristics of the health care industry with respect to organizational and cultural factors and consider how these might impact on the practice of ergonomics. Qualitative methodology was chosen as a suitable approach. This was supported by a middle ground philosophical position. Twenty-one interviews were carried out with academics and practitioners using a questionnaire proforma which developed iteratively over the 18 months of the project. A progressive four stage sampling strategy was used starting with purposive sampling to spread the net. Suggested contacts were then followed up (snowball sampling), before the third stage of intensity sampling to focus on participants with specific experience in hospital ergonomics. A final strategy of analysis sampling sought extreme and deviant cases to achieve theoretical saturation. The analysis resulted in three categories: organizational, staff and patient issues. The organizational issues included both the size and complexity of the National Health Service. For example, three hierarchical lines were identified in the management structure: an administrative line, a professional line and a patient-focused clinical management line. One of the surprising findings for the staff issues was the perceived lack of ergonomic information about female workers as a population group and traditional female employment sectors. The patient issues incorporated three dimensions associated with the caring role: the type of work; expectations; and possible outcomes. The work tends to be dirty and emotional, with a professional subculture to allow the handling of other peoples' bodies. This subculture was linked to a 'coping' attitude where staff put the patients' needs and well-being before their own. The change in patient expectations (from being apologetic through to demanding their rights) is mirrored in a changing model of care from paternalism to partnership. A lack of ergonomic research was identified for female workers in the health care industry relating to both the type of work and gender issues.

Employment↗
PubMed2002

Gender and human rights dimensions of HIV/AIDS in Nigeria.

Until very recently, researchers paid little attention to sex or gender issues in HIV/AIDS. When differences between females and males on health matters were considered at all the focus was clearly on womens' reproductive lives and not on factors affecting the spread of the disease. There was hardly any consideration of the influence of inequalities on the spread of HIV/AIDS and on outcomes of infection between the sexes. Hitherto, health policies and programmes focused on biological aspects of diagnosis, treatment and prevention. In this paper, the author seeks to provide an understanding of the social factors as well as identification of the capacity of human rights to develop an effective response to the disease. It is a gender perspective on human rights with specific implications for women in the context of HIV/AIDS.

Disease Outbreaks↗
PubMedDate not supplied

Group work is political work: a feminist perspective of interpersonal group psychotherapy.

When practicing as group leaders, mental health nurses often incorporate Irvin Yalom's (1995, 1998) concepts of social microcosm and here-and-now. This article examines these concepts from a feminist perspective and offers an approach to group psychotherapy that processes gender issues and fosters collective consciousness-raising. A feminist perspective in group therapy challenges us to view the social microcosm as a reenactment of sociopolitical contexts and the here-and-now as a medium for developing personal and social responsibility. Therapy is not only about individual and interpersonal change in group members, but is an opportunity for healthy social change. Therapy becomes political work, raising the social consciousness of each participant as well as the group as a whole.

Adult↗
PubMed2003

Strategies for resolving aboriginal adolescent pregnancy in eastern Taiwan.

BACKGROUND: Adolescent pregnancy has become a main issue in the health care system for aborigines in eastern Taiwan. Using aboriginal nurses to provide information on sexual behaviour may have potential as a means of promoting healthy sexual practices among aborigines. Aim. To explore aboriginal nurses' perspectives on strategies for resolving the high prevalence rate of Aboriginal adolescent motherhood in eastern Taiwan. DESIGN AND METHODS: A qualitative research design was employed and intensive individual interviews and focus groups were conducted among a convenience sample of aboriginal nursing staff in eastern Taiwan. Content analysis was used to analyse the data. RESULTS: Nine strategies were identified. They can be divided into family, school and society aspects. The family aspect included 'enhancing parents' sex education' and 'enhancing the understanding of older people about sex education in villages'. The school aspect included 'enhancing sex education in school', 'offering interrelationship courses for adolescents', 'offering gender issue courses for adolescents' and 'enhancing school teachers' sex education training'. The social aspect included 'advocating the sense of family in church', 'advocating social norms in church' and 'discussing appropriate sexual behaviour in adolescent church fellowships'. CONCLUSIONS: Health care providers can design intervention programmes to reinforce the ability of family, school and society to deliver sex education. In addition, training and cooperating with Aboriginal nurses to execute these programmes may also decrease teenage pregnancy rates in the future.

Adolescent↗
PubMed1994

Bedrock and beyond: an examination of the clinical utility of contemporary theories of female psychology.

Libido theory and the idea of an innate matrix of bisexuality are an inadequate basis on which to understand female psychology. Rather, it is the mutual influence of sexuality, aggression, object relations, and a superego that inherits the object-related conflicts of early childhood, intertwined as these are with gender issues, that determine the way a woman experiences herself. A woman can have a basically confident, narcissistically valued sense of femaleness and at the same time be troubled by intense feelings of inadequacy and deprivation. Instead of arbitrarily attributing these feelings to penis envy and a sense of castration, based on the idea of bisexuality as bedrock, this paper suggests that we consider primary femininity as bedrock, but that the superego, as heir to unresolved preoedipal and oedipal object-related conflicts, functions to maintain these painful emotions. Clinical material illustrates the utility of these ideas.

Adult↗