Cultural context plays a central role in shaping how nurses are perceived by the public, with implications for workforce recruitment, professional recognition, and health system sustainability, according to a new observational study recently published in the journal Collegian.

This study, conducted in the Emilia-Romagna region of northern Italy, examined how people from different ethnic backgrounds perceive the nursing profession. These findings are particularly relevant for clinicians and health system leaders because many countries face persistent nursing shortages and an increasing reliance on internationally diverse populations and workforces.

“The image of nursing is a complex concept influenced by various social and cultural factors, often portrayed in a subordinate manner by the media and stereotypes,” wrote the authors of the study, led by Ivan Rubbi, PhD, at the Nursing School, University of Bologna, Faenza, Italy.

The authors noted that the COVID pandemic contributed to a more positive public image of nurses by increasing recognition of their role and professional value. Public perception directly influences job satisfaction, performance, and the attractiveness of nursing as a career for prospective students and recent graduates.

“Recent studies recommend monitoring public perception changes over time, particularly in response to political and social transformations,” Rubbi and colleagues added. In the Emilia-Romagna region alone, an estimated 4200-4500 additional nurses are required to meet current healthcare needs.

Cultural Perceptions

The study aimed to better understand how the image of Italian nurses is perceived by members of different ethnic groups living in Italy.

The researchers analyzed 205 responses to the Italian version of the Nursing Attitude Questionnaire, collected through cultural associations in Emilia-Romagna. Participants were of European (n = 85; 41.5%), African (n = 46; 22.4%), Asian (n = 45; 22%), American (n = 21; 10.2%), and “other” (n = 8; 3.9 %) origins, with others defined as individuals originating from Oceania or the Antarctic region.

The analysis identified significant differences between ethnic groups across the four domains assessed by the questionnaire: role and professionalism, stereotypes, values and advocacy, and motivation and satisfaction.

Higher total scores, indicating a more favorable overall perception of the nursing profession, were observed among participants of American origin (mean score, 106.4 of a maximum 150), and European origin (106.3). Lower scores were reported among participants of African (96.2) and Asian (82.5) origin.

A key finding was the limited recognition of nursing as an intellectual profession among some of the groups. Only 24.4% of Asian and 43.5% of African respondents believed that a university degree was required to practice nursing. The authors wrote, “Even more significantly, only a small proportion of African and Asian respondents consider nursing as important as medicine.”

Simultaneously, the study found a broad recognition of the value of nursing research. “The correlation between nursing research and improved patient care was recognized even by the most skeptical ethnic groups,” wrote the authors and urged the nursing community to reflect on challenging the notion of an immutable nursing identity, which is sometimes deeply ingrained in the professional framework.

This story was translated from Univadis Italy, part of the Medscape Professional Network.