بسم اهلل الرمحن الرحيم

An-Najah National University

Faculty of Medicine and Health Sciences

Nursing and Midwifery Department

The Experience of Nursing Male Students

During Attending

Maternity Nursing Clinical Course

Prepared by:

Anees Abu-Shhab Basel Zawawi

Omar Swalmeh Yazeed Abu Tammam

Supervised by:

Dr. Mariam Al-Tell

First semester 2012-2013

Acknowledgment

We would like to express our greatest gratitude to our parents who were the kind embrace for their sons, who supported us financially and emotionally to the last day of our study.

We would like also to thank “Al-Najah National

University” represented by Dr. Rami Hammdallah who always supports us and our faculty.

We would like to thank the course tutor Dr. Aida Al-

Kaisi the kindhearted mother for all of her students, who taught us the principles of research and did her best to equip us with all necessary information we need in our practical future occupations.

And our great thank to our supervisor Dr. Mariam Al-

Tell who supported us to accomplish our study and who was committed, cooperative and friendly all the time.

Many thanks go to the Palestinian Universities for

facilitating data collection. Finally, sincere appreciation is extended to everybody who

helped in restoring our hope and confidence in ourselves.

Abstract

Background: Nursing as profession historically was considered as a feminine and

socially job, number of male entering the profession is recently changed and increased.

Culture and population background and religion might have its impact on health care

provision, some cultures may considered those who working with female as gay, other

cultures don’t prefers working and caring with mothers and women from religion point of

views, other might accept some type of caring and not accepting other aspects of care

especially that considered invading of intimate space of mothers. The aim of this study:

Was to explore the male student nurse's experience of the clinical maternity course.

Methodology: It was a descriptive quantitative design study. The sample was convenient

sample from 4 Palestinian universities randomly selected from the universities that teach

nursing of total 77 students who completed their maternity course. The tool was self

administrative questionnaire composed of 6 parts; demographic data, gender preferences

and related perception, common problems, students clinical experience and suggestions.

All students were interviewed at their universities. Data was analyzed used SPSS software.

Results: The results revealed that there were no significant differences between universities

in relation to the students’ experience, factors and problems faced them. It also showed that

high percentage of students didn’t perform the most embarrassing procedures in maternity

such as vaginal examination, assessment of perineum, and attending or assist in normal

vaginal delivery especially in private hospitals. Whereas the less embarrassing procedures

such as abdominal examination, fetal heart auscultation, and educational sessions were

done by most of students. Recommendation: Changes and actions have to be taken at level

of universities and training areas to further involve male student nursing in women care.

Contents Introduction………………………………………………………………1-5

Significant of the Study…………………………………………………...2

Aim of this Study…………………………………………………………3

Research Questions………........................................................................3

Hypothesis……………………………………………………………….3

Conceptual Definitions…………………………………………………...4

Operational Definitions…………………………………………………..4

Background……………………………………………………………...4

Literature review.......................................................................................6-25

Culture and Health care…………………………………………………..6

Men in nursing…………………………………………………………...8

Male nurses as perceived by both genders………………………………..10

Nursing as profession in Palestine……………………………………….17

Methodology…………..……………………………………………….26-28

Study design……………………………………………………………26

Setting………………………………………………………………….26

Population……………………………………………………………...26

Sample and sampling method……………………………………………26

Inclusion and exclusion criteria…………………………………………27

Instrumental tool of data collection……………………………………...27

Administrative part………….………………………………………….27

Ethical consideration……………………………………………………28

Reliability and validity…………………………......................................28

Field work……………………………………………………………...28

Statistical and analyzing method………………………………………...28

Result…………………………………………………………………..29-41

Discussion……………………………………………………………...42-46

Conclusion………………………………………………………………...47

Recommendations…………………………………………………………48

Summary……………………………………………………………….49-52

References……………………………………………………………..53-55

Annexes

List of Tables

No. Table of Results Page No.

1 Distribution of Percentages of Participants’ Personal Data. 29

2 Distribution of Percentages of Factors Affecting Students' Experience;

Students Gender Preferences, Perceptions, and Attitudes. 30

3 Distribution of Percentages of Common Problems Students Faced

During Maternity Clinical Course. 31

4 Distribution of Percentages of Students’ Clinical Experience. 32-34

5 Distribution of Percentages of Students’ Psychological Experiences. 34

6 Distribution of Percentages of Embarrassing Aspect in Clinical Area. 35-36

7 Distribution of Percentages of Applied Maternity Care Procedure

According to Training Area/Hospitals. 37-40

8 Distribution of Percentages of Students’ Suggestions. 41

Introduction

Introduction

Although the number of men entering the nursing profession has increased word wide,

(Madoka et al, 2006) and most western countries have men working in nursing jobs, they usually

constitute a minority, (Streubert, 1994). This imbalance actually was due to historical and

cultural rational. For example; Florence Nightingale believed that nursing was a natural extension

of women and motherhood, and she believed that all women were nurses and men were not

capable of being nurses and thus were not allowed to enroll in nursing education \ training, (Eswi

El Sayed, 2011), therefore men were purposefully excluded from entering the profession, (Evans,

2004; Mackintosh, 1997).

The social context of men entering the profession of nursing has evolved from this

historical context. The issue revolves around the perceptions of role strain for men working in a

female dominated profession (Evans, 2004; Bartfay and Bartfay, 2007; Crigge et al., 2007).

For instance In the United States, obstetric experience for male nurses has been accepted since

1960, this was made possible because of the National League for Nursing which reported that the

basic nursing curriculum should have no differentiation for men and women (McKenna, 1991).

This situation also has its effect on nursing education and training, male students were made to

feel uncomfortable during their training placement; many male students were not allowed to

participate in the full range of caring interventions during obstetric placement, (Madoka et

al,2006).

Different studies explored the male role and the related gender effect on health care

provision, (Sherrod, 1991) in his descriptive study examined the degree of role strain

experienced in the obstetrical area by male and female baccalaureate nursing students and

assessed whether role strain was greater for the male students. Results of the study indicated a

statistical significant difference (p ¼ .01) in role stain between male and female student nurse as it

was greater role strain for male than female. Difficulties encountered by male nursing students in

the obstetrical area may be related to social stereotypes.

1

Morin et al, (1999) conducted in his descriptive-research focused ethnography, in this

study; the focus was on identifying factors that influenced women’s decision making regarding

male students’ assignments in one small community hospital. A purposive convenience sample of

32 women who give birth to normal newborn were interviewed about how they would feel or had

felt if a male nursing student examined them particularly in the recovery and postpartum setting.

Approximately half of the women described the idea of being cared for by a male nurse

“uncomfortable” many participants believed that their permission, as should be obtained before

being assigned to a male nursing student.

Patterson and Morin, (2002) conducted a phenomenological study to assess the

experience of 8 male student nurses who had completed their maternal child rotation. Three

themes were emerged: preconception about the maternal child rotation, enduring the clinical

experience and surviving the clinical rotation students began their rotation with mixed feelings as

anxiety apprehension, and fear of rejection. Maternal child nursing was viewed by male students

as a woman’s domain, in which they were visitors. Students undertook special precautions when

performing postpartum assessment.

Keogh and Olynn, (2007) conducted a study to examine the prevalence and perceived

importance of gender-based barriers during nursing education programs of men, the participants

in the study were posted in obstetric ward, they reported that midwifery staff were cold and

hostile during the placement and male student were made to feel uncomfortable during the

placement many male students were not allowed to participate in the full range of caring

interventions during obstetric placement.

Significant of the Study:

The main reason for conducting this study was the noticed problems that students faced

during their clinical training through maternal health course, specially the training in some of the

private hospital which has very restrict policy about the presence of male students in the

obstetrical area. Though a lot of efforts to reduce discrimination are becoming evident in

educational communities, scattered research has been published to explore student's perception of

their learning experience in areas where men are to provide care to female clients.

2

Aim of this Study:

The current study aims to exploring the male nursing students’ experience regard the

clinical maternity course which might contribute to a better understanding of male nursing

experience during attending maternity nursing clinical course in Palestine. And trying to provide

nurses, clients and other health care professionals with a better understanding of male nursing

students’ experience of working with women clients and within a healthcare system where male

often feel excluded.

Research Questions:

1) What are the factors perceived by male student's that affect their learning experience of clinical

maternity nursing course?

2) What is the learning experience of male nursing students during attending the clinical maternity

nursing course?

3) Are there any differences between universities in relation to the problems students faced during

maternity clinical course?

Hypothesis:

1) There are no differences between universities in relation to the male students experience during

attending the clinical maternity nursing course.

2) There are no differences between universities in relation to the problems students faced during

maternity clinical course

3) There are no differences between private and governmental hospitals and the applied maternal

care procedures by male students.

3

Conceptual Definitions:

Social stereotypes:

Stereotypes about ethnicity, age groups, gender, sexual orientation, people with mental disorders

and anything else to do with different groupings in society, (Studymode.com,2008).

Experience:

Active participation in events or activities, leading to the accumulation of knowledge or skill

(thefreedictionary.com, 2003)

Operational Definitions:

This study measured the student 's experience by several terms:-

- Their psychological experience.

- Stressors they faced.

- Embarrassing procedures and history taking.

- Applied maternity care procedures.

Background

The cultural perceptions of health and illness, and the social factors that interplay in the

patient's personal decisions are essential for the betterment of health service provision to this

population.

There were some cultures which don't agrees or don’t even accept to be treated as a

patient from a male nurse just like in the Islamic countries which refuse this kind of ideas because

it doesn't fit with their basic belief and religious background. For example in Palestine, the

population culture that related to health and illness was based on their beliefs and attitudes which

defines health as free of disease and illness.

4

In the past the peoples who was sick and don’t feels very well tend to go to the hospital

for seeking care and the recommended attention if the health care providers but there was an

aspect of their receiving the treatments or the interventions which was provided only through

nurses who were female in gender. Historically, male entrance for the nursing profession was

affected by social and cultural factors as nursing was considered as a feminine profession and has

it extension for woman care and motherhood which led to constraints for the entering of male into

nursing profession as they are incapable for providing care for female patient in general. But

nowadays with the improvement of new modern and era of health and medicine and technology,

their beliefs were changed and tend to be better understandable behaviors for their own health.

But with the new modifications of life and new advancement of knowledge and the wide

open perspective of nursing and the shortage of members in hospitals, there was a new

modification for this type of career study as to include the male student for studying the nurse

course in the universities to be male nurse.

Changes in time and place in the different cultures have allowed for the males students to

get into the faculty of nursing nowadays, but even with this new improvement there would still be

remain that male student must respect local customs, traditions and religious beliefs that they hold

in respect to their culture especially when they are providing care for the opposite sex.

5

Literature

Review

Literature review

Culture and Health care

Health care is defined as the prevention, treatment, and management of illness and the

preservation of mental and physical well-being through the services offered by the medical and

allied health professions, (The American Heritage Dictionary, 2007).

Health care which can be affected by both gender and the cultural background of the

patients who receives the care which has been provided by the health care teams and also it can be

affected by the provision of the necessary care for patients, (ICN.ch12, 2010).

Then nursing and nursing care is one of these health care provision that also affected by

gender and the cultural background and the attitudes and beliefs of the patients who attend the

hospitals for caring, and there are some different cultures which prevents the providing

outstanding care by nurses or by the health team members based on their different beliefs and

attitudes toward health and nursing in general, (ICN.ch12, 2010).

Changes in time and place in the different cultures have allowed for the males students to

get into the faculty of nursing nowadays, but it remains that the male respect local customs,

traditions and religion they hold especially when dealing with the opposite sex,(ICN.ch12, 2010).

"Nursing encompasses autonomous and collaborative care of individuals of all ages,

families, groups and communities, sick or well and in all settings. Nursing includes the promotion

of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy,

promotion of a safe environment, research, participation in shaping health policy and in patient

and health systems management, and education are also key nursing roles, (ICN.ch12, 2010).

6

From this definition of nursing, nurses are capable of assessing, planning, implementing, and

evaluating care independently of physicians, and they provide support from basic triage to emergency

surgery, (Medicalnewstoday.com, 2009).

And so a nurse is a healthcare professional who is focused on caring for individuals,

families, and communities, ensuring that they attain, maintain, or recover optimal health and

functioning, (Medicalnewstoday.com, 2009).

The students who study in Nurse Faculty are called Nursing Students whether they are

male of a female students and this term is defined as ''the Individuals enrolled in a school of

nursing or a formal educational program leading to a degree in nursing", (Medconditions.net,

2010).

Nurses may practice in hospitals, clinics, physician offices, private homes, schools,

pharmaceutical companies (usually as researchers), industry (occupational health settings),

schools, retirement homes, hospice facilities, long-term care facilities, military facilities, and even

camps. Some nurses may also advise and work as consultants in the healthcare, insurance, or legal

industries. Nurses can work full- or part-time, (Medicalnewstoday.com, 2009).

One of the major practices or care that nurses are providing is for the maternal health care

which is defined as the health of women during pregnancy, childbirth and the postpartum period.

While motherhood is often a positive and fulfilling experience, for too many women it is

associated with suffering, ill-health and even death, (Who.Int, 2012).

There are different kind of nursing practices of woman can only take place in the clinical

field which can be Hospitals, Clinics, Community Health Services. That’s why the nursing

students of bachelor degree study in the university the maternal health care course which include

everything about the maternal health before ,during , and after pregnancy and even the different

kind of illness that might affect the woman's health, (The American Heritage Dictionary, 2007 ).

Clinical maternity health is defined by Nursing care provided to women and their families

during pregnancy and parturition and through the first days of puerperium “the time immediately

after the delivery of a baby'', (The American Heritage Dictionary, 2007 ).

7

Another type of wards in the hospital setting is the obstetrical ward which is defined as the

department of a hospital that provides care for women during pregnancy and childbirth as well as

for newborn infants, (The American Heritage Dictionary, 2007).

In general, the universities which has a course called maternity health in nursing faculty

has to send their students into these hospital wards whether it can be governmental or private

hospitals for training as a part of the clinical maternity course of actions for having the course

completed and to get the knowledge which recommended as a part of the academic achievements

of the students.

The most area of nursing practice that affected by culture and gender differences is the

obstetric ward.

Men in nursing:

What is interesting about today's perceptions of gender in nursing is Florence Nightingale

perception regard nursing which was a male-dominated profession, (Mackintosh, C. 1997).

Nightingale considered nursing a suitable job for women because it was an extension of

their domestic roles. Her image of the nurse as nurturing, domestic, humble, and self-sacrificing

became prevalent, (S. Sridevy, 2011).

The social context of men entering the profession of nursing has evolved from this

historical context and is now seen as the major deterrent for men to enter the profession.

Though they still represent a slim minority, men are increasingly pursuing careers in

nursing, attracted by abundant job opportunities, good salaries, and the opportunity to make a

difference in people's lives, (S. Sridevy, 2011).

8

It was believed by Florence Nightingale that nursing was a natural extension of women

and motherhood. She believed that all women were nurses and men were not capable of being

nurses and thus were not allowed to enroll in nursing education/training,(Eswi El Sayed, 2011).

Qualities associated with women, like compassion and dependency; align with those often

attributed to nurses, (Evans, J. A. 1997).

In modern times, the social construction of the role of a nurse has typically meant a

caring, hardworking woman. Nursing, in the span of Nightingale's lifetime, became identified as a

profession deeply embedded in the female gender, (Meadus, R. J. 2000).

One of the supposed reasons for the lack of men in nursing suggested is the lower

economic status associated with the nursing field, (Meadus, R. J., 2000).

However, the most commonly proposed reason is that men are less likely to enter jobs

associated with women than women are to enter those positions traditionally held by men, (S.

Sridevy, 2011).

Despite the obvious disproportion of male nurses to all men, studies have also shown men

are overrepresented in senior nursing posts, (Evans, J. A. 1997).

Studies have consistently reported that one of the major reasons for women's slower

progress in nursing is the number and length of career breaks taken, particularly to have children.

One such study indicated that women were 10 times more likely than men to have taken a

career break to care for children, (Finlayson, et al 1997).

Furthermore, male nurses may be thought to bring stability to the nursing profession,

which had always been considered at the mercy of marriage and motherhood, reflecting hidden

advantages for men and disadvantages for women. (Mackintosh, C. 1997).

9

Men in the nursing profession serve as much more than body guards and patient lifting

machines. Many patients are more at ease with a male nurse. They provide excellent care to their

patients, and also they can sympathize and empathize with their patients just as female

counterparts. They do realize patient comfort is not just pain control, but patient dignity, (Male

Nurse Magazine, 2009).

Nursing isn’t just for women anymore. Males play an important role in patient care. This

profession must continue to embrace the “male nurse” for the unique knowledge, skills and

abilities he has to offer his patients.

Male nurses as perceived by both genders:

Significant differences were also found between the female and male students' perceptions

regarding the effect of males on the image of nursing. Cultural values, a lack of understanding

about what nurses really do at work, and the way nurses are portrayed in popular media highly

affect the public image of nursing, (Cakmakci, A. 2003).

Cultural differences affect how people react to illness; respond to symptoms, how they

seek medical care, and how they perceive the health care team members. All this affects how they

will react to and respond to treatment, (S. Sridevy, 2011).

With respect to health care, many providers continue to find themselves in a position in

which they are unable to neither understand the cultural patterns of their diverse patient

populations nor comprehend the health-related behavioral motivations of these patients,

(S.Sridevy, 2011).

Nurses will encounter cultural differences in their health care team. The team members

will have varied beliefs and strategies for handling situations and patient care issues, (S. Sridevy,

2011).

Moreover, health providers tend to perceive client satisfaction from their own perspective,

without the ability to view their clients’ culturally specific perceptions of these services, (S.

Sridevy, 2011).

10

Most of the female students and nearly half of the male students chose emergency units as

the most "suitable" area for male nurses. Nearly 42% of the female nurses preferred men to work

as instructors in nursing schools after graduation, (S. Sridevy, 2011).

There were significant differences between both genders' perceptions about the nursing

positions men should occupy after graduation. While 48% of the female students considered men

as staff nurses, most of the male students said they should occupy administrative (40%) or

teaching posts (38%) after graduation, (S. Sridevy, 2011).

Nurses need to listen and be tolerant. Being understanding of differences will not only

broaden your own horizons, but also will help you to become a better nurse. Ask questions, listen

to the answers, be sensitive, show respect, and build trust, (S. Sridevy, 2011).

Another emerging aspect of providing culturally competent care is that of Ethno-

pharmacology. Research has shown that ethnic makeup can affect the response and effectiveness

of drugs. For instance, African-Americans have a greater risk for developing delirium from

tricyclic medications than whites. Asians have different reactions to some medications than other

races. This opens a whole new realm to understanding drugs, (S. Sridevy, 2011).

Another emerging aspect of providing culturally competent care is that of the presence of

male nurses the different type of care for the patients and specially the female patients in

obstetrical ward who in general refuse this type of care because it's conflicting with their basic

belief and religious and attitude. Even though the male nurse is capable to perform some of tasks

or activities for providing the suitable care for the patient more than female, (S. Sridevy, 2011).

And also male nurse can work together for delivering the suitable care for the patients in

the obstetrical ward but the patients point of views are different in their accepting this care from

the female nurse more than accepting it from the male nurse and that's why, (S. Sridevy, 2011).

One approach being emphasized by these researchers is to ask two important questions

and listen carefully to the answers in order to better understand the cultural diversity issues in

health care that affect your patient. These two questions are: “What do you think caused your

illness?” and “What do you think will help you the most?” (S. Sridevy, 2011).

11

This approach not only helps to cut through the layers of diversity, but also adheres to the

premise of putting the patient at the center of the health care delivery model. It also emphasizes

the patient's role in promoting his wellness and in his responsibility for his own care, (S. Sridevy,

2011).

On the other side of the gender divide, men who enter nursing may still face questions

about their masculinity or sexuality. Sociologists describe sex role socialization as "instrumental"

for men and "expressive" for women. The characteristics of instrumental socialization include

aggression and the ability to compete, lead, and wield power to accomplish tasks. Expressive

socialization includes learning to nurture and be sensitive to needs of others, (S. Sridevy, 2011).

Many female dominated positions, including nursing, have difficulty attracting male

recruits, (S. Sridevy, 2011).

The number of men entering the nursing profession has increased worldwide, as a

consequence of the move to a more gender-balanced profession; debates have ensued over how

intimate care should be performed when this requires male nurses to be physically close to

women clients, (Inoue M, et al. 2006).

This can be attributed in part to issues such as status and pay, but also to the gender

stereotyping of the profession. Although the number of males in nursing has increased in recent

years, the underlying feminization of nursing is still an important issue (Davies, C. 1995).

Keogh and Olynn, (2007) conducted a study to examine the prevalence and perceived

importance of gender-based barriers during nursing education programs of men. The participants

in the study were posted in obstetric ward, they reported that midwifery staffs were cold and

hostile during the placement and male student were made to feel uncomfortable during the

placement, many male students were not allowed to participate in the full range of caring

interventions during obstetric placement.

12

Joan A. Evans,(2002) conducted a study to examine the Cautious caregivers: gender

stereotypes and the equalization of men nurses' touch. The aim of this study was to explore the

experience of men nurses and the ways in which gender relations structure different work

experiences for women and men in the same profession, by the theme of men nurses as cautious

caregivers emerged from data that were collected in two rounds of semi-structured interviews

with eight men nurses practicing in Nova Scotia, Canada. Thematic analysis, informed by

feminist theory and masculinity theory, was used as the method for analyzing the data, and the

result shown that for men nurses, the stereotype of men as sexual aggressors is compounded by

the stereotype that men nurses are gay. These stereotypes sexualize men nurses' touch and create

complex and contradictory situations of acceptance, rejection and suspicion of men as nurturers

and caregivers. They also situate men nurses in highly stigmatized roles in which they are subject

to accusations of inappropriate behavior. For men nurses, this situation is lived as a heightened

sense of vulnerability and the continual need to be cautious while touching and caring for

patients. Ultimately, this situation impacts on the ability of men nurses to do the caring work they

came into nursing to do.

A study conducted to examine the gender and career: female and male nursing students’

perceptions of male nursing role in turkey. The aim of this study was to determine what female

and male undergraduate nursing students think of males in nursing. The method which was used

that senior nursing students (n=90) at an undergraduate program in School of Health located in

the Northwestern Region of Turkey were included in the study. A questionnaire was used for data

collection which received a response rate of 97 %.In conclusion Nursing continues to be seen as a

fit position for females. Even male students who study in nursing have role tension about nursing.

Male students’ desire to occupy mostly administrative positions in health care settings after their

graduation shows their intentions to distinguish themselves from female colleague, (Ozdemir A

et al, 2008).

Tzeng YL et al, (2009) conducted in their study the role strain of different gender nursing

students in obstetrics practice, a comparative study. A cross-sectional survey was used on a

sample of 95 female and 55 male baccalaureate nursing students who had completed their

obstetric practice at one of two universities in central Taiwan. The result showed role strain in

male nursing students to be significantly higher than that in female nursing students, especially in

terms of role incongruity. The attitude of male nursing students toward clinical instructors,

healthcare providers, and clients and their families and the stereotyped viewpoint about the gender

role and occupation were all significantly higher than those of their female counterpart.

13

A study conducted to examine mothers' responses to care given by male nursing students

during and after birth. Focused ethnography using a purposive convenience sample of 32 women,

aged 20 to 40 years, who spoke english, and who had given birth to normal newborns in one small

community hospital in the mid-Atlantic region of the United States. The women were interviewed

using a semi-structured format. Data from participants pertained to personal and contextual

factors. Personal factors were perception of postpartum self and personal feelings. Contextual

factors were student characteristics, establishment of relationships, nursing care activities, and

partner viewpoint (Morin KH et al , 1999).

A study conducted to examine Expectations and opinions of pregnant women about

medical students being involved in care at the time of delivery. The format of the study was a

self-administered questionnaire survey. The setting was a teaching hospital in the UK. In total,

118 pregnant women aged between 15 and 46 years, with a gestational age of 18-42 weeks were

surveyed. Factors which significantly influenced acceptance of medical students were found to be

previous number of children (P = < 0.001) and religious beliefs of the pregnant women (P =

0.002). Only 51.4% of antenatal women knew that a "medical student" is a doctor in training and

most assumed that the role of the student at the time of delivery required very few clinical skills.

Only 13.6% knew that medical students could deliver a baby under supervision. Of the 118

subjects, 95.4% thought that student participation at the time of delivery was a worthwhile

learning experience; however, only 74.6% were actually willing for a student to be involved,

(Nicum R, Karoo R, 1998).

A study conducted to examine nursing and health care management and policy men

nurses: a historical and feminist perspective, a search of the literature was carried out using

CINAHL, PubMed and Sociological Abstracts databases. Search words included: male nurses,

history, and nursing, Canada, Britain, United Kingdom and USA. Failure to recognize men’s

participation in nursing leaves men nurses with little information about their professional

background and historical position. It also maintains the invisibility of gender relations that have

shaped the experience of men and women nurses alike. Such relations, understood within their

broader social context, remain poorly understood and hence uninterrupted, to the detriment of

nurses and the profession of nursing involved, (Joan Evans, 2003).

A study conducted to examine the ascertain gynecological patients' perceived levels of

embarrassment with physical and psychological care given by female and male nurses, the sex

14

discrimination act lifted the barriers which prevented men from training and practicing as

midwives. However, cultural attitudes perceive nursing to be a female profession, and whilst care

from a male doctor is considered to be acceptable, care from a male nurse is said to be

embarrassing. The purpose of the study was to identify if there was any relationship between the

intimacy of a nursing interaction and the patient's level of embarrassment. Data collection was by

questionnaires with rating scales. Demographic data was obtained from nursing and medical

notes. Statistical analysis was performed by non-parametric methods using Mini-tab. Ninety-one

questionnaires were returned from a convenience sample of patients on a gynecological oncology

ward. Analysis of the data indicates that in a population of patients who have no prior experience

of hospital admission, or of being cared for by a male nurse, there is a preference for care by a

female nurse. However, this preference is not demonstrated in patients who have undergone

previous hospital admission within the last five years or who have been cared for by a male nurse.

These findings would indicate a cultural preference for care by a female nurse in patients with

gynecological cancer that is changed by experience during hospital admission, (Nicholas Lodge,

et al 1997).

A phenomenological study was conducted by (Patterson and Morin, 2002) to assess the

experience of 8 male student nurses who had completed their maternal child rotation. Three

themes were emerged: preconception about the maternal child rotation, enduring the clinical

experience and surviving the clinical rotation. Students began their rotation with mixed feelings

as anxiety, apprehension, and fear of rejection. Maternal child nursing was viewed by male

students as a woman’s domain, in which they were visitors. Students undertook special

precautions when performing postpartum assessment.

Chur-Hansen, (2002) conducted in his study the preferences for female and male nurses:

the role of age, gender and previous experience, a questionnaire study investigated the preferences

of both males and females for a male or female nurse, depending on four clinical situations. The

role of age and previous experience with a male nurse was also taken into account. Gender, age

and experience were further examined in relation to attitudes towards professional nursing

practice. To determine whether preferences and attitudes have changed over time, the study was

replicated in 2000, having been first conducted in 1984. Data were collected from the same

general practice waiting room on each occasion, the result shown that consistent with previous

research, the degree of intimacy in a clinical situation was found to be predictive of same-gender

15

preferences. Younger females may prefer female nurses’ more than older females. Experience

with male nurses was limited in both samples, but was not predictive of preferences or attitudes.

So In conclusion Generally speaking, results from 1984 and 2000 were not significantly different.

As a quantitative study, this research contributes to an understanding of patient preferences.

However, in-depth, qualitative research is recommended to understand better the reasons for

preferences and attitudes, for both male and female patients.

A study conducted to examine attitudes and perceptions towards men in nursing

education, a comparative study design was employed to investigate societal attitudes and

perceptions towards male nurses enrolled in school of nursing in a mid-sized university in

Ontario, Canada. A convenience non-random sampling method was employed that consisted of

undergraduate nursing (N = 82) and non-nursing (N = 67) students. Perceptions and attitudes

towards men in nursing were assessed using the Attitudes Towards Men in Nursing Scale

(ATMINS). The findings suggest that there is a general perception in Canadian society that

nursing is a more suitable career choice for women than men. Moreover, societal perceptions and

stereotypes towards male nurses (e.g., they are gay, effeminate, less compassionate and caring

than females nurses) prevail, which may negatively contribute to their recruitment and retention

in nursing programs, (Wally J. Bartfay et al, 2010).

Inoue M et al, (2006) conducted to examine Male nurses’ experiences of providing

intimate care for women clients, semi-structured, open-ended interviews were conducted with

male nurses working in various clinical sittings in Western Australia 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.

A study conducted to examine the Sexualizing Men's Touch: male nurses and the use of

intimate touch in clinical practice, drawn from a larger study, this article reports the experiences

of a group of male nurses regarding the use of intimate physical touch. Using discourse analysis,

interview data from 18 male nurses were analyzed and related to existing text on men as nurses.

16

The analysis reveals that although touch is important in nursing care, it is problematic for men

because discourses have normalized women's use of touch as a caring behavior and have

sexualized men's touch. Participants described their vulnerability, how they protected themselves

from risk, and the resulting stress. The complicity of nurses in sexualizing men's touch and the

neglect of educators in preparing men for providing intimate care are revealed. A paradox

emerged whereby the very measures employed to protect both patients and men as nurses

exacerbate the perceived risk posed by men carrying out intimate care. Deconstructing and

reframing prevailing discourses around nursing, gender, and caring involving touch can help to

legitimize men's involvement in physical caring, (Harding et al, 2008).

A study conducted to examine professional career development for male nurses, a

descriptive qualitative research design was used, with a convenience sample of 15 male nurses

(mean age 30æ8 years) with a bachelor’s degree in nursing science. Data were collected by semi-

structured interviews and analyzed by content analysis. Based on the nature of nursing work and

clinical experiences, Taiwanese male nurses believed that nursing was a profession suitable for

both men and women. Their preparation for career development started at the pre-study, (Cheng-I

Yang et al, 2004).

Nursing as profession in Palestine:

The Turkish rule (1517 -1917)

Palestine was under the Turkish rule for about 400years (dark period). Herbs and popular

medicine were generally used for treating diseases. Treatment by native practitioners depending

very much on trial and error. Hospitals were set up by religions orders mainly Christian, foreign

governments. For example:

• Al-watani hospital in 1905

• The French and German hospitals in Jerusalem.

• Barracks and tents were used for patients who suffered from contagious diseases nurses

were trained by physicians.

17

The British mandate (1921 – 1948)

British brought public health laws and scanty health services to meet some of the needs of

the Palestine people in major cities. Palestinian people continued to suffer from ignorance and

sickness. Spafford baby home was established in 1925 in Jerusalem city. In this hospital, a nurses

training program was started some hospitals were established in major cities in Palestine.

Government general hospital in Jaffa city British nurses taught Arab girls nursing for 3

years. Girls who studied nursing where mainly from well-known christian families. Graduated

nurse were offered certificates from the department of health, government of Palestine. British

government hospital in Jerusalem city had nursing school (3 years training program).

After war

Swedish hospital offered 3 years training program for nurses, from 1948 – 1953 graduated

nurses were granted their certificate by the Jordan ministry.

Jordanian control over west bank including

East Jerusalem 1948 – 1967, Egyptian control of Gaza, first nursing school for staff nurses

were established in 1951 at Augusta Victoria hospital in Jerusalem. Saint john school for practical

nurses in 1960. Saint Luke School for practical nurses in 1965.

In Gaza:

Baptist school of nursing was established in 1956. Initiation of the Palestine nursing

association (PNA) in 1956in Jerusalem by the staff nurse Betty majaj. PNA obtained membership

in the international council for nurses in England.1960 Mrs. Rafidi became the representative of

the PNA. Later (JNA) was established in Amman city under Miss. Mussalems' supervision. While

Mrs. Rafidi continued to direct the PNA in Jerusalem till 1967.

18

Israeli occupation of west bank and Gaza strip in 1967 till now:

After the six day war in June 1967

All health service institution runs by the Jordanian government or the Egyptian

government were taken over the Israeli government. Nurses worked in the government

institutions suffered from low salaries, poor promotions, and limited continuing education

opportunities.

Nurses worked in the non-government institutions received better salaries but also limited

continuing education opportunities till eighties. Differences in regulations, rules, followed by both

kinds of institutions, lack of communication between nurses working in these institutions resulted

gap among those nurses, till late eighties and early nineties many highly populated refugee camps

were created and suffered from complex health this lead to increase number of nurses through

establish.

Some nursing schools for example:-

• Late sixties the caritas baby hospital nursing school.

• In seventies, Ibn sina governmental nursing school.

• Al Makassad School of nursing.

• Al Hukama practical nursing school in Gaza.

• Al – Ittihad School in 1976.

• Nursing college at Bethlehem University started in 1976.

• Arab college of medical professions in 1979.

Nursing was very much affected by the outbreak of the Palestinians uprising in 1987.

Economy weakened by strikes, curfews and restrictions imposed by Israeli authorities indirectly

affected nursing:-

Several practical nursing schools were established, this effect nursing because:-

1) Not all selected students were committed to the nursing profession. Not all

programs were of the desired quality

2) The need for more specialization in nursing especially in ICU, O.R, ER,

Psychiatric nursing.

3) Nursing become more respected and appreciated by the Palestinian society.

19

Social forces and nursing :

Movement of nursing from charitable responsibility to paid occupation. Task of slavery to

a service for God Care of sick in institution help nurses to develop and paid.

Future of nursing:

• Improve their knowledge and practice through research.

• Workshops, conferences, interactions.

• Independent and autonomous.

• Specialization.

• Accountability.

• Responsibility.

• Prevention of diseases.

• Increase quality and years of healthy life.

• Promote healthy and safe communities.

There is evidence, however, that there is an increase in the number of men entering the

nursing profession. For example, in Ireland, in 2005, there were 2826 men on the active register

as general nurses compared with 1541 in the year 2002. However, women make up almost 96%

of the general nursing workforce, (An Board Altranias, 2006).

Nursing education at An-Najah National University briefly in regard

to courses clinical training ; where and how

Introduction:

The college of nursing at An-Najah National University offers a four-year undergraduate

program leading to the degree Bachelor of Science in Nursing.

This program prepares professional nurses who can work with a multidisciplinary health

team in order to meet the client’s health needs and to upgrade the quality of health care in various

health settings.

20

To obtain the Bachelor of Science in nursing degree the student should have :

• Acquired the knowledge and skills required to be able to work independently as a nurse

in general health care.

• Acquired knowledge in general and specific nursing.

• Developed self-knowledge and the power of insight, and through an ethical approach

and a holistic picture of man thereby developed the ability to have good relationships

with patients and their families.

• Acquired knowledge about conditions in society that affect the health of men and

women and be able to initiate and participate in health promotion and preventive care.

Clinical evaluation

Clinical evaluation methods:

Clinical training must be in every season and in every course of nursing science courses,

and the goal of clinical studies is the integration of scientific theory and methods used and

methods of application together, and also the practice of nursing care based on a scientific basis

and well-proven experience.

Are clinical studies in health institutions in places specialized different to give the student

the opportunity to meet members of different ages and health problems different matter who earns

the student the opportunity to learn to work the nurse in places different health, and so the student

gets a solid base and wide to build his career future.

Students self-assessment weekly so register their goals clinical before sessions laboratory

clinical and thereafter, and the students evaluate their performance by reviewing their own goals,

as students lists nonfiction describes any experiences exceptional could face students as well as

take notes on their personal or academic, where the student throwing lecture a week and have

come from the scientific publications and folders court and modern.

The students take responsibility for their personal and professional development by

highlighting certain experiences during practical training, students becomes more aware of these

tests that you need to accomplish their clinical goals.

Since assessments may be discussed in sessions after clinical training, students contribute

to the growth and self-development colleagues jointly together in the learning experience, and

21

students become more aware of their responsibilities being members of the health team, In

addition, the evaluation of students self works to provide coach with more for the student's

personality, which is derived from the perspective of the student himself, it allows the instructor

to pinpoint areas that need attention and which cannot be present in the form used to assess

student.

The assessment of the student in the middle of the semester and the final evaluation of the

student will be by coach clinical with each student individually, and then the clinical instructor

summarize student performance and student will discuss aspects of the developer and the aspects

that need to be developed.

Criteria for Admission to the Nursing Program :

Tawjihi grade of 75% or above.

Completed secondary scientific education.

Satisfactory outcome of an interview evaluating background and suitability for a

Nursing Specialty.

Proficient knowledge of English.

Maternity course teaching in Nursing faculty in An-Najah National

University

Theory course

Course Description

The theory course provides opportunities for the students to acquire adequate knowledge

base in the area of reproductive health, and gynecologic and neonatal nursing utilizing knowledge

from the biophysical sciences, humanities, growth and development, problem solving and the

nursing process: to promote, and maintain, health of individual’s families and groups with needs

related to reproductive health, and safe motherhood, (Najah.edu, 2004).

Common gynecological and neonatal problems are also introduced with an expanded

knowledge related to women’s health issues. The course includes the study of obstetrics and the

nursing care of women during various phases of child-bearing.

22

Nursing educational program was influenced by culture; found that each of the students or

by the patients in the hospital .Where it can be seen in that nursing students must finish 6 hours in

a course tutorial called nursing care for Mother of 3 hours at the university and other 3 in the

hands of the hospital.

According to the standards of the course, the nurse student whether male or female who

enter into sections and Gynecologists to apply university requirements for them in this course and

here there is a problem of culture and religion in some countries they prevent male student from

entering to these sections even if the goal was to provide care for patients.

General Course Objectives

Upon completion of this course, the student will be able to:

1) Provide nursing care to the maternity patient and her family effectively.

2) Utilize the nursing process to administer care for the maternity and/or newborn patients

with clearly defined, commonly occurring health care needs and problems.

3) Provide basic health information to the patient and her family during the childbearing

experience.

4) Utilize therapeutic communication skills, guidance and support in interacting with the

child bearing family and record observations in proper sequence and format.

5) Assume responsibility for personal and professional growth in the maternity setting

6) Utilize critical thinking strategies with childbearing families within diverse settings to

determine priorities and to promote self care/dependent.

Clinical course

Course Description

This course integrates knowledge from previous course and the basic sciences to attain

high competency level of reproductive health and safe motherhood practices. Students will apply

the nursing process, the psychomotor skills, and the problem solving technique to determine and

deal with the physical, emotional, social and ethical nursing problems in the areas of reproductive

health, safe motherhood and gynecology, (Najah.edu,2004).

23

Experience will be provided in maternity hospitals, antenatal clinics, mother child

clinics and women’s health clinics. Students will be given opportunities to develop basic skills in

the care of women during the various stages of the life cycle including phases such as menarche,

menopause, etc.

The different type of practices such as caring for the health of woman that is being

performed by the nurses should include planning programs which include keys for interventions

to improve the Maternal and Newborn health and these programs are divided into some categories

such as Routine care activities for pregnant woman which can be performed in community health

services and outpatient clinics and even hospitals for example:

Respond to other reported complaints.

Tetanus immunization, anemia prevention and control (iron and folic acid

supplementation).

Information and counseling on self care at home, nutrition, safer sex, breastfeeding,

family planning, healthy lifestyle.

And other category is additional care activates for pregnant woman who can take place in

community health services but mainly the hospitals for example:

Support for women with special needs e.g. adolescents, women living with violence.

Treatment of syphilis (woman and her partner).

Treatment of mild to moderate pregnancy complications:

mild to moderate anemia

urinary tract infection

vaginal infection

Post abortion care and family planning, (Searo.who.int, 2009).

Intended Learning Outcomes and Competences;

A- Intellectual Skills.

Demonstrate proper therapeutic communication techniques in delivering nursing care

with pregnant women.

Formulate leadership, management and delegation skills in organizing nursing care for

childbearing families.

24

Interpret testing techniques required for diagnosis of pregnancy.

Demonstrate the gravidity and parity by using the five – and two – digit systems.

Demonstrate the estimation date of birth (expected date of delivery).

Identify risk factors related to major complication during pregnancy.

Recognize signs and asymptotes of labor.

Identify specific nursing interventions related to major acute and chronic disorders

during pregnancy, labor and post partum.

B- General and transferable skills

1) Independently learning.

2) Health education in front of the mothers in the postnatal ward.

3) Work in a team spirit with colleagues

4) Search internet data base for updating articles.

In summary:

So, the current study aims at exploring the male student nurses’ experience of the clinical

maternity course. This might contribute to a better understanding of male nurse experience when

working with women clients within health care system where they often feel excluded.

25

Methodology

Methodology

Study design:

Cross sectional, descriptive design was used to achieve the aim of the study that was intended

to explore the male students’ experience during attending maternity nursing clinical course in West

Bank / Palestine.

Setting:

The study was conducted at Palestinian National Universities. Simple randomly test was

used to select 4 of 6 different universities; (An-Najah National University, Al Quds University,

Birzeit University, and Arab American University).

These universities are providing bachelor nursing degree in whole 4 years of nursing science

which is mainly of the desired objective of the study that the male student nurse who finished their

maternity clinical course are included in the study and that's why those universities are considered

very suitable for conducting the study.

Population:

Male nursing students with 4th year level, a total of 83 from all national universities included

in the study and consisting of (30, 25, 22, 6) from An-Najah National University, Al Quds

University, Arab American University, and Birzeit University respectively.

Sample and sampling method:

Simple random method was used in this study to select 4 universities from the 6 national

universities that providing bachelor degree in nursing science. Convenient sample was used to select

the male students who participated in this study as the total number of 77 students was reached with

rate of (36.14%), (26.5%), (24.1%) and (6 %) from An-Najah University, Al Quds University, Arab

American University, and Birzeit University respectively, and (7.26%) refused to participate in the

study.

26

Inclusion and exclusion criteria:

o The sample which was selected was chosen in basic of inclusion criteria:

1) Male students

2) Level of 4th year student nurses

3) Students completed their maternity clinical course

4)

o Exclusion criteria for selecting the sample which is the:

Students who are conducting the study.

Instrumental tool of data collection:

One tool was used to collect the data; "Self administrative questionnaire” compose of

multiple choice and likert scale of three statement questions.

The questionnaire was developed by the researches in english language based on related

literature review and from previous study (Eswi, El Sayed, 2011), in addition to supervisor opinion,

it compromised from sixth parts (Annex I).

First part: "Demographic data for the participants", included age, level of academic year, total

grades, place of residency and university name.

Second part: Consisting of student gender preferences, perceptions, and attitudes regard working

with women/mothers during maternity course.

Third part: Composed of common problems that might the students faced during maternity clinical

course.

Fourth part: Students clinical experience which composed of the experience of the students during

their training in relation to their preference of clinical rotation and reason behind that,

positive aspects of training, embarrassing procedures, stressors, and students

psychological experience.

Fifth part: Involved applied maternity care procedure.

Sixth part: Consist of students' suggestions.

Administrative part:

Approval letters were attained from all national universities included in the study, after

request letters have been sent by An-Najah National University to conduct the study (Annex II).

27

Ethical consideration:

Approval from the IRB committee at An-Najah National University was obtained before

starting data collection (Annex III).

A written signed consent form indicated student agreement to participate in the study was

obtained after study objectives and aims were explained to student before distribution of the

questionnaire and fulfilling it (Annex IV).

Reliability and validity:

After the study tool was developed, it was reviewed by 3 nursing specialized academic staff

and to ascertain and test the content validity of the tool it was tested twice:

o Cronbach's (alpha) test: Was done to measure the internal consistency and

reliability of the tool which was (0.778).

o Pilot study: Was accomplished after developing of questionnaire on 10% of the sample

aiming to ensure students understanding of the questionnaire, time needed for fulfilling

it, and as result of the piloting no correction was made.

Field work:

After having the acceptance from the universities that were included in the study and the data

collection tool and consent form were developed, the study was conducted at each university

separately through 10 - 15 / 11 / 2012 .

At each university, principle of nursing faculty was met to explain aim of the study, then

subjects of the study were met at their class room, where study aim, related questionnaire, ethical

issues and consent form have been explained to them.

Statistical and analyzing method

Coding, tabulating, data entry and statistical analysis was done using Statistical Package for

Social Science (SPSS).

The Statistical analysis tests used in the study were:

Mean of the students age and their academic grads.

Frequency distribution and percentage were used for categorized data.

Chi square test to approve the hypothesis and compare variable and their distribution.

The 0.05 value was chosen as level of significance in all tests used.

28

Results

Table (1): Distribution of Percentages of Participants’ Personal Data:

Table (1) showed that (67.5%) of the participants were (21) years old. According

to their clinical training areas; (41.6%) of them got training at private hospital, most of

them from Birzeit and Al-Quds University. And (33.8%) at governmental ones. And

regard their academic achievements and related grads in their clinical training, (53.2%)

of them have a grade between (70 – 80).

29

Items University Name

Total An-Najah Birzeit Al-Quds American

1) Age of

participants

21 No. 20 3 13 16 52

% 66.7% 60.0% 59.1% 80.0% 67.5%

22 No. 7 2 9 2 20

% 23.3% 40.0% 40.9% 10.0% 26.0%

23 No. 1 - - 1 2

% 3.3% - - 5.0% 2.6%

24 No. 2 - - 1 3

% 6.7% - - 5.0% 3.9%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2) Academic

grad for

maternity

clinical course

less than

60

No. - - - 1 1

% - - - 5.0% 1.3%

60-70 No. 5 - 3 3 11

% 16.7% - 13.6% 15.0% 14.3%

70-80 No. 18 2 10 11 41

% 60.0% 40.0% 45.5% 55.0% 53.2%

80-90 No. 4 2 9 5 20

% 13.3% 40.0% 40.9% 25.0% 26.0%

90-100 No. 3 1 - - 4

% 10.0% 20.0% - - 5.2%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3) Place of

training for

maternity

clinical course

Govern-

mental

No. 6 - - 20 26

% 20.0% - - 100.0% 33.8%

Private No. 5 5 22 - 32

% 16.7% 100.0% 100.0% - 41.6%

Both No. 19 - - - 19

% 63.3% - - - 24.7%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

Table (2): Distribution of Percentages of Factors Affecting Students' Experience; Students

Gender Preferences, Perceptions, and Attitudes:

Item University Name

Total An-Najah Birzeit Al-Quds American

1) Gender

Preferences

Male No. 2 3 3 4 12

% 6.7% 60.0% 13.6% 20.0% 15.6%

Female No. 15 - 8 10 33

% 50.0% - 36.4% 50.0% 42.9%

Both No. 13 2 11 6 32

% 43.3% 40.0% 50.0% 30.0% 41.6%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2) Students

perceptions of

mothers’

attitude

towards male

student nurse

in general

Normal No 18 2 8 13 41

% 60.0% 40.0% 36.4% 65.0% 53.2%

Dealing with

restriction

No. 8 2 9 5 24

% 26.7% 40.0% 40.9% 25.0% 31.2%

Refuse to receive

care by male

No. 4 1 5 2 12

% 13.3% 20.0% 22.7% 10.0% 15.6%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3)Students

attitude

towards

mothers

during your

clinical

training in

general

Accepting

attitude

No. 16 3 12 12 43

% 53.3% 60.0% 54.5% 60.0% 55.8%

Neutral attitude No. 9 1 8 6 24

% 30.0% 20.0% 36.4% 30.0% 31.2%

Rejecting

attitude

No. 5 1 2 2 10

% 16.7% 20.0% 9.1% 10.0% 13.0%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

Table (2) showed that (42.9 %) of the participants prefer to deal with female client and

(15.6 %) of them prefer to deal with male only, and (41.6 %) prefer to deal with both male

and female.

According to the mothers’ attitude toward male nursing student, (53.2 % ) of students

who participate in this study realize a normal attitude from mothers, with (60%, 40%, 36.4%

and 65%) of their groups respectively from An-Najah, Birzeit, Al-Quds and American

Universities. And (31.2%) of the students feel that mothers deal with them with restriction,

and (15.6%) face refusal attitude from mothers to receive care by them . Whereas (55.8%) of

the students have an accepting attitude toward mothers, (31.2%) of them have a neutral

attitude, and (13.0%) have a rejecting attitude to deal with mothers in gynecological ward.

30

Table (3): Distribution of Percentages of Common Problems Students Faced During

Maternity Clinical Course:

Items University Name

Total Sig. An-Najah Birzeit Al-Quds American

1) High

clinical

training

requirements

Disagree No. 5 1 5 10 21

.094

% 16.7% 20.0% 22.7% 50.0% 27.3%

Neutral No. 11 2 11 6 30

% 36.7% 40.0% 50.0% 30.0% 39.0%

Agree No. 14 2 6 4 26

% 46.7 % 40.0% 27.2% 20.0% 33.8%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2)

Unfavorable/

non

supportive

attitude of

the clinical

instructors

Disagree No. 12 3 12 12 41

.820

% 40.0% 60.0% 63.6% 60.0% 53.3%

Neutral No. 9 1 6 5 21

% 30.0% 20.0% 27.3% 25.0% 27.3%

Agree No. 9 1 2 3 15

% 30% 20.0% 9.1% 15.0% 19.5%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3) Attending

clinical

training in

the afternoon

especially

labor and

delivery

Disagree No. 12 1 9 6 28

.226

% 40% 20.0% 40.9% 30% 36.4%

Neutral No. 12 1 7 9 29

% 40.0% 20.0% 31.8% 45.0% 37.7%

Agree No. 6 3 6 5 20

% 20% 60.0% 27.3% 25.0% 26%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

4) Difficulty

of acquiring

the skills

Disagree No. 13 1 8 11 33

.538

% 43.3% 20.0% 36.4% 55.0% 42.9%

Neutral No. 6 1 6 5 18

% 20.0% 20.0% 27.3% 25.0% 23.4%

Agree No. 11 3 8 4 26

% 36.7% 60.0% 36.3% 20.0% 33.8%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

Table (3) illustrated the problems faced by students during maternity clinical course;

it showed that; difficulties of acquiring the skills and high clinical training requirements

ranked the main problems as (33.8%) of students agreed upon both of them with no

significant differences between universities.

31

Table (4): Distribution of Percentages of Students’ Clinical Experience:

Items University Name Total

Sig.

An-Najah Birzeit Al-Quds American

1)

Students

description

of the

clinical

training in

maternity

nursing

1 ) Very effective No. 4 0 2 6 12

.006

% 13.3% - 9.1% 30.0% 15.6%

2 ) Interesting No. 13 1 7 6 27

% 43.3% 20.0% 31.8% 30.0% 35.1%

3 ) Very embarrassing for

the male student nurse

No. 9 0 6 8 23

% 30.0% - 27.3% 40.0% 29.9%

4 ) Boring No. 4 4 7 0 15

% 13.3% 80.0% 31.8% - 19.5%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2) Favorite

clinical

rotation

during

maternity

nursing

clinical

course

1) Critical care unit for

high risk pregnancy

No. 3 2 1 4 10

.303

% 10.0% 40.0% 4.5% 20.0% 13.0%

2) Labor and delivery unit No. 10 1 6 6 23

% 33.3% 20.0% 27.3% 30.0% 29.9%

3) Antenatal and

gynecology clinic

No. 8 - 5 1 14

% 26.7% - 22.7% 5.0% 18.2%

4) Post partum unit No. 9 2 10 9 30

% 30.0% 40.0% 45.5% 45.0% 39.0%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3) Reason

for

selecting

clinical

rotation

1 ) Gaining

knowledge

about

maternity care

and newborn

care

Disagree No. 5 1 5 5 16

.408

% 16.6% 20.0% 22.7% 25.0% 20.8%

Neutral No. 3 1 9 7 20

% 10.0% 20.0% 40.9% 35.0% 26.0%

Agree No. 22 3 8 8 41

% 73.4% 60.0% 36.3% 40.0% 53.3%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2 ) Favorable

attitude of

clinical

instructors

Disagree No. 1 - 4 3 8

.206

% 3.3% - 18.1% 15.0% 10.4%

Neutral No. 10 4 7 11 32

% 33.3% 80.0% 31.8% 55.0% 41.6%

Agree No. 19 1 11 6 37

% 63.3% 20.0% 50% 30.0% 48.1%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3 ) Presence of

role model

during clinical

training

Disagree No. 5 2 5 9 21

.447

% 16.7% 40.0% 22.7% 45.0% 27.3%

Neutral No. 11 1 11 5 28

% 36.7% 20.0% 50.0% 25.0% 36.4%

Agree No. 14 2 6 6 28

% 46.7% 40.0% 27.3% 30.0% 36.4%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

4 ) Minimal

dealing with

mothers

through

examination

Disagree No. 10 - 3 5 18

.587

% 33.3% - 13.6% 25.0% 23.4%

Neutral No. 9 1 7 5 22

% 30.0% 20.0% 31.8% 25.0% 28.6%

Agree No. 11 4 12 10 37

% 36.7% 80.0% 54.5% 50.0% 48.1%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

4) Positive

aspect of

clinical

training

1 ) Estimation

of the expected

date of delivery

and calculation

of gestational

age

Disagree No. 4 1 5 2 12

.917

% 13.3% 20.0% 22.7% 10.0% 15.5%

Neutral No. 6 1 6 6 19

% 20.0% 20.0% 27.3% 30.0% 24.7%

Agree No. 20 3 11 12 46

% 66.7% 60.0% 50% 60.0% 59.8%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2 ) Assessment

and care of the

newborn

Disagree No. 4 1 1 2 8

.769

% 13.3% 20.0% 4.5% 10.0% 10.4%

Neutral No. 5 - 5 7 17

% 16.7% - 22.7% 35.0% 22.1%

Agree No. 21 4 16 11 52

% 70.0% 80.0% 72.8% 55.0% 67.6%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3 ) Attending

cesarean

section

delivery

Disagree No. 3 1 1 1 6

.523

% 10.7% 20.0% 4.5% 5.0% 7.8%

Neutral No. 6 3 8 9 26

% 20.0% 60.0% 36.4% 45.0% 33.8%

Agree No. 21 1 13 10 45

% 70.0% 20.0% 59.1% 50.0% 58.5%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

4 ) Providing

mother classes

as well

Disagree No. 2 1 3 2 8

.763

% 6.6% 20.0% 13.6% 10.0% 10.4%

Neutral No. 12 2 5 9 28

% 40.0% 40.0% 22.7% 45.0% 36.4%

Agree No. 16 2 14 9 41

% 53.3% 40.0% 63.6% 45.0% 53.3%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

5) Stressor

during

clinical

training

1 ) High

clinical area

requirements

Disagree No. 6 1 8 8 23

.743

% 20.0% 20.0% 36.3% 40.0% 29.9%

Neutral No. 15 2 8 8 33

% 50.0% 40.0% 36.4% 40.0% 42.9%

Agree No. 9 2 6 4 21

% 30.0% 40.0% 27.2% 20.0% 27.3%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2 ) Attitude of

some clinical

instructors

Disagree No. 8 2 4 9 23

.338

% 26.7% 40.0% 18.2% 45.0% 29.9%

Neutral No. 11 2 13 5 31

% 36.7% 40.0% 59.1% 25.0% 40.3%

Agree No. 11 - 5 6 23

% 36.7% - 22.7% 30.0% 29.9%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3 ) Rejection

and un-

cooperation of

some mothers

Disagree No. 9 - 3 10 22

.336

% 30.0% - 13.6% 50.0% 28.6%

Neutral No. 10 2 9 6 27

% 33.3% 40.0% 40.9% 30.0% 35.1%

Agree No. 11 3 10 4 28

% 36.7% 60.0% 45.5% 20.0% 36.4%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

4 ) Midterm

exams during

clinical

training

Disagree No. 6 1 9 9 25

.511

% 20.0% 20.0% 40.9% 45.0% 32.5%

Neutral No. 9 3 5 6 23

% 30.0% 60.0% 22.7% 30.0% 29.9%

Agree No. 15 1 8 5 29

% 50.0% 20.0% 36.4% 25.0% 37.7%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

Table (4) displayed the students experience during maternity course; it showed that

(35.1%) of students described it as an interesting course, and (29.9%) of them described it as

embarrassing for the male students nurse, (19.5%) of them think that it’s a boring course, and

(15.6%) think it’s a very effective course .

Regarding the favorite clinical rotation during maternity nursing clinical course; (39.0%)

of the participants preferred to train in post partum unit and (53.3%) of them related their

selection of their clinical rotation to gaining knowledge about maternity and newborn care.

According to the positive aspect of clinical training; the study shows that (67.6%) of the

participants find that assessment and caring of newborns is a positive aspect of maternity training.

In relation to the stressors during clinical training; (37.7%) of students considered that

midterm exam is the main cause of stress and (36.4%) of them believed that the rejection and

uncooperation of some mothers is another cause of stress.

Table (5): Distribution of Percentages of Students’ Psychological Experiences:

Item No. %

Negative

Being embarrassed 40 51.9 %

Being afraid to cause problems to mother 39 50.6 %

Feeling very anxious and afraid to ask questions 31 40.3 %

Positive

Feeling like gaining a lot of skills 32 41.6 %

Feeling very happy when attending delivery process 29 37.7 %

Feeling like crying while attending delivery process 14 18.2 %

Table (5) illustrated students psychological experience as positive and negative ones; according

to the positive experience, the study showed that (41.6% , 37.7% , 18.2%) of students feel like gaining a

lot of skills, feel very happy when attending delivery process, and feel like crying while attending

delivery process respectively. And according to negative experience; (51.9%, 50.6%, 40.3%) of

students being embarrassed, being afraid to cause problems to mother, and feel very anxious and afraid

to ask questions during their training respectively.

34

Table (6): Distribution of Percentages of Embarrassing Aspect in Clinical Area:

Items University name Sig.

An-Najah Birzeit Al-Quds American Total

1) Taking

history

1 ) Taking

menstrual

history make

student

embarrassed

Disagree No. 5 6 12 27

.285

% 30.0% 27.3% 60.0% 35.1%

Neutral No. 7 1 4 2 14

% 23.3% 20.0% 18.2% 10.0% 18.2%

Agree No. 14 4 12 6 36

% 46.6% 80.0% 54.5% 30.0% 46.8%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2 ) Taking

contraceptive

history make

student

embarrassed

Disagree No. 12 1 7 11 31

.776

% 40.0% 20.0% 31.8% 55.0% 40.3%

Neutral No. 8 1 8 4 21

% 26.7% 20.0% 36.4% 20.0% 27.3%

Agree No. 10 3 7 5 25

% 33.3% 60.0% 31.8% 25.0% 32.5%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3 ) Taking

previous and

present

obstetric

history make

student

embarrassed

Disagree No. 18 1 5 13 27

.203

% 60.0% 20.0% 22.7% 65.0% 48.1%

Neutral No. 5 2 10 4 21

% 16.7% 40.0% 45.5% 20.0% 27.3%

Agree No. 7 2 7 3 19

% 23.3% 40.0% 31.8% 15.0% 24.7%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2)Embarrassing

procedure

1 ) Abdominal

examination

Disagree No. 11 - 4 10 25

.315

% 36.7% - 18.1% 50.0% 32.5%

Neutral No. 7 - 8 3 18

% 23.3% - 36.4% 15.0% 23.4%

Agree No. 12 5 10 7 34

% 40.0% 100.0% 45.4% 35.0% 44.2%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2 ) Breast

examination

Disagree No. 4 1 9 9 33

.009

% 13.3% 20.0% 40.9% 45.0% 29.9%

Neutral No. 6 - 3 3 12

% 20.0% - 13.6% 15.0% 15.6%

Agree No. 20 4 10 8 42

% 66.7% 80.0% 45.4% 30.0% 54.6%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3 )

Examination of

episiotomy

Disagree No. 5 1 7 6 19

.147

% 16.7% 20.0% 31.8% 30.0% 24.7%

Neutral No. 3 - 5 5 13

% 10.0% - 22.7% 25.0% 16.9%

Agree No. 22 4 7 9 45

% 73.3% 80.0% 45.4% 45.0% 58.5%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

4 ) Perineal

care

Disagree No. 5 - 9 8 22

.391

% 16.7% - 40.9% 40.0% 28.6%

Neutral No. 5 2 4 3 14

% 16.7% 40.0% 18.2% 15.0% 18.2%

Agree No. 20 3 9 9 41

% 66.7% 60.0% 40.9% 45.0% 53.3%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3) Mothers

teaching topics

1 ) Breast

feeding

Disagree No. 9 1 8 7 25

.854

% 30.0% 20.0% 36.3% 45.0% 32.5%

Neutral No. 8 2 6 6 22

% 26.7% 40.0% 27.3% 30.0% 28.6%

Agree No. 13 2 8 7 30

% 43.3% 40.0% 26.3% 35.0% 39.0%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2 ) Dangerous

sings during

pregnancy

Disagree No. 15 2 6 9 32

.663

% 50.0% 40.0% 27.3% 45.0% 41.6%

Neutral No. 5 2 9 5 21

% 16.7% 40.0% 40.9% 25.0% 27.3%

Agree No. 10 1 7 6 24

% 33.4% 20.0% 31.8% 30.0% 31.2%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3 ) Minor

discomfort

during

puerperium

Disagree No. 10 1 2 6 19

.336

% 33.3% 20.0% 9.1% 30.0% 24.7%

Neutral No. 12 4 13 6 35

% 40.0% 80.0% 59.1% 30.0% 45.5%

Agree No. 8 - 7 8 23

% 26.3% - 31.8% 40.0% 29.9%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

4 ) Vaginal

infection

Disagree No. 9 - 11 6 26

.448

% 30.0% - 50.0% 30.0% 33.8%

Neutral No. 6 3 4 2 15

% 20.0% 60.0% 18.2% 10.0% 19.5%

Agree No. 15 2 7 12 36

% 50.0% 40.0% 31.8% 60.0% 46.8%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

Table (6) displayed the embarrassing aspect in clinical areas. Regarding taking history;

(46.8%) of the students considered taking of menstrual history is the most embarrassing aspect.

According to procedures; (58.5%) of student assumed/ believed that examination of episiotomy is

the most one. In relation to teaching topics, (46.8%) though that vaginal infection is the most

embarrassing topic in mother teaching session during maternity clinical course with no significant

differences between universities.

36

Table (7): Distribution of Percentages of Applied Maternity Care Procedure According to

Training Area/Hospitals:

Items Place of training for maternity clinical course

Total Sig. Governmental Private Both

1) Abdominal examination

.074

Observed \ Attend No. 4 11 7 22

% 15.4% 34.4% 36.8% 28.6%

Assist No. 3 11 3 17

% 11.5% 34.4% 15.8% 22.1%

Performed No. 8 3 2 13

% 30.8% 9.4% 10.5% 16.9%

All No. 9 5 4 18

% 34.6% 15.6% 21.1% 23.4%

Non No. 2 2 3 7

% 7.7% 6.3% 15.8% 9.1%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

2) Breast examination

.066

Observed \ Attend No. 3 5 9 17

% 11.5% 15.6% 47.4% 22.1%

Assist No. 2 4 - 6

% 7.7% 12.5% - 7.8%

Performed No. 3 1 - 4

% 11.5% 3.1% - 5.2%

All No. 2 2 - 4

% 7.7% 6.3% - 5.2%

Non No. 16 20 10 46

% 61.5% 62.5% 52.6% 59.7%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

3) Vaginal examination

.003

Observed \ Attend No. 1 4 9 14

% 3.8% 12.5% 47.4% 18.2%

Assist No. 1 3 - 4

% 3.8% 9.4% - 5.2%

Performed No. 5 1 - 6

% 19.2% 3.1% - 7.8%

All No. 2 2 - 4

% 7.7% 6.3% - 5.2%

Non No. 17 22 10 49

% 65.4% 68.8% 52.6% 63.6%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

4) Normal vaginal delivery

.010

Observed \ Attend No. 7 7 14 28

% 26.9% 21.9% 73.7% 36.4%

Assist No. 1 3 - 4

% 3.8% 9.4% - 5.2%

Performed No. 3 1 - 4

% 11.5% 3.1% - 5.2%

All No. 2 1 1 4

% 7.7% 3.1% 5.3% 5.2%

Non No. 13 20 4 37

% 50.0% 62.5% 21.1% 48.1%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

5) Fetal heart auscultation and monitoring

.402

Observed \ Attend No. 10 9 3 22

% 38.5% 28.1% 15.8% 28.6%

Assist No. 2 11 6 19

% 7.7% 34.4% 31.6% 24.7%

Performed No. 4 4 3 11

% 15.4% 12.5% 15.8% 14.3%

All No. 8 5 5 18

% 30.8% 15.6% 26.3% 23.4%

Non No. 2 3 2 7

% 7.7% 9.4% 10.5% 9.1%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

6) Care for laboring women

.026

Observed \ Attend No. 9 5 10 24

% 34.6% 15.6% 52.6% 31.2%

Assist No. 2 12 1 15

% 7.7% 37.5% 5.3% 19.5%

Performed No. 4 3 4 11

% 15.4% 9.4% 21.1% 14.3%

All No. 4 5 2 11

% 15.4% 15.6% 10.5% 14.3%

Non No. 7 7 2 16

% 26.9% 21.9% 10.5% 20.8%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

7) Care for women during pregnancy

.310

Observed \ Attend No 10 6 8 24

% 38.5% 18.8% 42.1% 31.2%

Assist No 3 7 2 12

% 11.5% 21.9% 10.5% 15.6%

Performed No 5 5 4 14

% 19.2% 15.6% 21.1% 18.2%

All No 5 3 2 10

% 19.2% 9.4% 10.5% 13.0%

Non No 3 11 3 17

% 11.5% 34.4% 15.8% 22.1%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

8) Educational session

.029

Observed \ Attend No. 5 7 1 13

% 19.2% 21.9% 5.3% 16.9%

Assist No. 1 7 5 13

% 3.8% 21.9% 26.3% 16.9%

Performed No. 8 11 8 27

% 30.8% 34.4% 42.1% 35.1%

All No. 12 7 3 22

% 46.2% 21.9% 15.8% 28.6%

Non No. - - 2 2

% - - 10.5% 2.6%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

9) Breast feeding

.616

Observed \ Attend No. 5 4 2 11

% 19.2% 12.5% 10.5% 14.3%

Assist No. 5 9 2 16

% 19.2% 28.1% 10.5% 20.8%

Performed No. 7 9 6 22

% 26.9% 28.1% 31.6% 28.6%

All No. 5 5 2 12

% 19.2% 15.6% 10.5% 15.6%

Non No. 4 5 7 16

% 15.4% 15.6% 36.8% 20.8%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

10) Assessment of lochia

.013

Observed \ Attend No. 4 12 5 21

% 15.4% 37.5% 26.3% 27.3%

Assist No. 2 7 - 9

% 7.7% 21.9% - 11.7%

Performed No. 4 - 1 5

% 15.4% - 5.3% 6.5%

All No. 1 3 - 4

% 3.8% 9.4% - 5.2%

Non No. 15 10 13 38

% 57.7% 31.3% 68.4% 49.4%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

11) Assessment of uterine fundal height

.788

Observed \ Attend No. 6 8 3 17

% 23.1% 25.0% 15.8% 22.1%

Assist No. 2 4 2 8

% 7.7% 12.5% 10.5% 10.4%

Performed No. 4 5 4 13

% 15.4% 15.6% 21.1% 16.9%

All No. 8 6 2 16

% 30.8% 18.8% 10.5% 20.8%

Non No. 6 9 8 23

% 23.1% 28.1% 42.1% 29.9%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

12) assessment of premium

.047

Observed \ Attend No. 4 14 4 22

% 15.4% 43.8% 21.1% 28.6%

Assist No. 3 2 - 5

% 11.5% 6.3% - 6.5%

Performed No. 3 1 - 4

% 11.5% 3.1% - 5.2%

All No. 3 2 - 5

% 11.5% 6.3% - 6.5%

Non No. 13 13 15 41

% 50.0% 40.6% 78.9% 53.2%

Total No. 26 32 19 77

% 100.0% 100.0% 100.0% 100.0%

39

Table (7) viewed the applied maternity care procedure in relation to training

area/hospitals; it showed that (63.6%), (53.2%), (49.4%) of students that didn’t observe,

assist or perform a vaginal examination, assessment of perineum, and assessment of

lochia respectively, and (48.1%) of them didn’t observe or assist in normal vaginal

delivery, with significant differences between private and governmental hospitals.

Regard breast examination (59.7%) of student didn’t observe, assist or perform

it, with no significant differences between hospitals. Whereas (9.1%) of them didn’t

observe, assist or perform neither abdominal examination nor fetal heart auscultation

and monitoring with no significant differences between hospitals, and only (2.6%) of

them didn’t perform educational session in private hospitals.

40

Table (8): Distribution of Percentages of Students’ Suggestions:

Table (8) showed students suggestions regard maternity course; (52.0%) of

students though that working mutually with female students in the same training group

is the best suggestion to solve the problems they face in maternity clinical course.

41

Items

University Name

Total Sig. An-Najah Birzeit Al-Quds

Americ

an

1 ) Labor and

delivery clinical

training should

be in the skill

lab only

Disagree No. 12 1 8 12 33

.482

% 40.0% 20.0% 36.4% 60.0% 42.9%

Neutral No. 8 - 3 3 14

% 26.7% - 13.6% 15.0% 18.2%

Agree No. 10 4 11 5 30

% 33.3% 80.0% 50.0% 25.0% 39.0%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

2 ) Maternity

training should

be for female

students only

Disagree No. 17 2 8 13 40

.079

% 56.7% 40.0% 36.4% 65.0% 52.0%

Neutral No. 6 - 2 1 9

% 20.0% - 9.1% 5.0% 11.7%

Agree No. 7 3 12 6 28

% 23.4% 60.0% 54.5% 30.0% 36.4%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

3 ) Working

mutually with

female students

in the same

training group

Disagree No. 2 1 4 8 15

.204

% 6.6% 20.0% 18.2% 40.0% 19.5%

Neutral No. 11 1 4 6 22

% 36.7% 20.0% 18.2% 30.0% 28.6%

Agree No. 17 3 14 6 40

% 56.6% 60.0% 63.6% 30.0% 52.0%

Total No. 30 5 22 20 77

% 100.0% 100.0% 100.0% 100.0% 100.0%

`

Discussion

Discussion

The aims of the present study was to exploring the male student nurse's experience

of the clinical maternity course which might contribute to a better understanding of male

nursing experience during attending maternity nursing clinical course in Palestine. And

trying to provide nurses, clients and other health care professionals with a better

understanding of male nursing students’ experience of working with women clients and

within a healthcare system where male often feel excluded.

The study results (Table 1) revealed that the mean age of participants is 21.

Regarding to the clinical training areas, more than third (41.6%) of them got their training

at private hospital, most of them from Birzeit and Al-Quds University. And almost one-third

of the participants (33.8%) got training at governmental ones. According to the participants

academic achievements and related grads in their clinical training, almost half of them

(53.2%) have a grade between (70 – 80).

The study results (Table 2) showed that almost more than third of the participants

(42.9%) preferred to deal with female client and nearly tenth of them (15.6%) preferred to

deal with male only, and also more than the third of them (41.6%) preferred to deal with

both male and female. Ozdemir A et al, (2008) in their study revealed that nursing is

continuing to be fit position for females even though male nursing have tension toward

nursing and it was showed that male desires to occupy administrative positions rather than

working in gynecology ward like this study shows.

According to the mothers’ attitude toward male nursing student as showed in (Table

2), the study showed that nearly half of the participants (53.2%) realized a normal attitude

from mothers, with almost (60%, 40%, 36.4% and 65%) of their groups respectively from

An-Najah, Birzeit, Al-Quds and American Universities. And also it showed that one-third of

the participants (31.2%) felt that mothers deal with them with restriction, and nearly tenth of

them (15.6%) faced refusal attitude from mothers to receive care by them with no

significant differences between universities.

42

Nicum R, Karoo R, (1998) in their study showed that almost (95.4%) of woman

accepted the students participation in the time of delivery and almost (74.6%) of them are

willing for letting the students to be involved. In contrast, Chur-Hansen (2002) who

conducted a study for examining the mothers’ attitude toward male nursing student, pointed

that the degree of intimacy in clinical situation was found to be predictive of the same

gender and also younger females may prefer female nurse more than males.

Morin KH et al, (1999) showed that mothers’ attitude toward male nursing student

are different and it depends on personal factors that means the perception of participant and

personal feelings, and to the contextual factors were student characteristics and

establishment of relationships, nursing care activities, and partner viewpoint.

Regarding students attitudes toward mothers (Table 2), the study revealed that

nearly half of the participants (55.8%) have an accepting attitude toward mothers, with no

significant differences between universities.

In contrast, Inoue M et al, (2006) examined in their study the experience of

providing intimate care for women clients, the result showed that the participants had a

challenging experience and they described it as an invading to personal space of the clients.

According to the problems faced by students during maternity clinical course (Table

3) results showed that difficulties of acquiring the skills and High clinical training

requirements ranked the main problems as nearly one-third of the participants (33.8%) had

agreed upon both of them.

In a similar study by Keogh and Olynn, conducted (2007) results indicated that

cold and hostile attitude of midwives towards students made the placement uncomfortable

for the male participants and they were not allowed to in a full range of caring interventions

during obstetric placements.

Also, Madoka et al, (2006) pointed out that there was still argument over the

perception of intimate care provided by male nurses to women clients specially those

procedures that require physical closeness, so the main problem for the participant would

still the difficulty of acquiring the skills during training in maternal clinical ward.

43

In contrast, a study by Nicum R, Karoo R, (1998) revealed that almost (95.4% )of woman

accepted the students participation in the time of delivery and almost (74.6%) of them are

willing for letting the students to be involved and it showed that student has no difficult in

gaining the required skills.

According to student’s clinical experience (Table 4), this study displayed the

students experience during maternity course, it showed that nearly one-third of the

participants (35.1%) had described it as an interesting course, and almost one-third of them

(29.9%) had described it as embarrassing for the male students nurse, it also showed that

one-fifth of the participants (19.5%) thought that it’s a boring course, and the nearly tenth of

them (15.6%) thought it’s a very effective course.

Inoue M et al, (2006) in their study found that students considered there experience

as a challenging one and they described it as an invading to personal space of female

clients. In similar study by Patterson and Morin, (2002) which conducted to assess the

experience of 8 male student nurses who had completed maternal child rotation, it showed

that students had fear of rejection. It seems that working with woman as a male nurse still

has its cultural background impact, regardless the different societies.

Regarding the favorite clinical rotation during maternity nursing clinical course

(Table 4), results showed that nearly more than one-third of the participants (39.0%)

preferred to be trained in post partum unit and almost half of them (53.3%) related their

selection of their clinical rotation to gaining knowledge about maternity and newborn care.

Nicum R, Karoo R, (1998) in their study found that that the antenatal unit was the

preferable unit for learning for students, and almost (95.4%) of woman accepted the

students participation in the time of delivery and almost (74.6%) of them were willing for

letting the students to be involved. It might be that selecting post-partum unit as preferable

unit is related to that caring of delivered mothers is more comfortable than providing care

for laboring woman.

In relation to the stressors during clinical training (Table 4), the study revealed that

almost more than one-third of the participants (37.7%) had considered that midterm exam as

the main cause of stress, and almost one-third of them (36.4%) believed that the rejection

and un-cooperation of some mothers is another cause of stress. This nearly in coherent with

44

study by Patterson and Morin, (2002) who pointed out that one of the stressors was fear of

rejection from mothers. In addition that maternal child nursing was viewed as a woman’s

domain, in which the students were considered as visitors were another stress factor.

Another study by Inoue M et al, (2006) examined the experience of providing intimate care

for women clients, showed that the participants had a challenging experience and they

described it as an invading to personal space of the clients. Another study by Kelly et al,

(1996) reported that fears of being perceived as gay or being feminine are negative

perceptions in male students. Another aspect of stress recourse comes from nursing course

pressure.

Regarding to students psychological experience (Table 5), the study revealed that

students have a positive and negative experiences. According to the positive experience, the

study results showed that nearly more than one- third of participants felt like gaining a lot of

skills (41.6%) and nearly more than one- third of participants (37.7%) were very happy

when attending delivery process. This results in agreement with the results of a study by

Nicum R, Karoo R (1998) that showed that almost (95.4%) of woman accepted the

students participation in the time of delivery and almost (74.6%) of them are willing for

letting the students to be involved and it showed that student has no difficult in gaining the

required skills and also making them happy for attending delivery process.

And according to negative experience the study showed that nearly more than half of

participants (51.9 %) were being embarrassed, and nearly half of them (50.6 %) were being

afraid to cause problems to mother, and nearly more than one-third of participants (40.3 %)

felt very anxious and afraid to ask questions during their training. In a phenomenological

study conducted by Patterson and Morin, (2002) showed that students began with mixed

feelings of anxiety and apprehension, and fear of rejection. Another study by Kelly et al,

(1996) revealed that the negative perception among male students was the fears of being

perceived as gay or being feminine. Also Inoue M et al, (2006) in their study showed that

participants experienced various negative feelings during delivery care.

In relation to the embarrassing aspects in clinical areas (Table 6). the study showed

that nearly more than one-third of participants (46.8%) considered taking of menstrual

history is the most embarrassing aspect in history taking. According to procedures, (Table 6)

result showed that almost more than half of participants (58.5%) assumed that examination

of episiotomy is the most embarrassing one. and almost more than one-third of participants

45

(46.8%) though that vaginal infection is the most embarrassing topic in mother teaching

session during maternity clinical course.

Nicum and Karoo, (1998) found that male students were very anxious about

maternal clinical practice and women did not prefer care which was offered by male nursing

students, especially the breast and perineal care.

According to the applied maternity care procedures according training area (Table

7), the study showed that almost two-third (63.6%), and half of them (53.2%), (49.4%)

didn’t observe, assist or perform a vaginal examination, assessment of perineum, assessment

of lochia, respectively. And it showed that nearly half of the participants (48.1%) didn’t

observe or assist in normal vaginal delivery, with significant differences between private

and governmental hospitals.

Regarding breast examination the results, (Table 7) showed that that nearly two-third

of the participants (59.7%) didn’t observe, assist or perform it, with no significant

differences between hospitals. Yaling et al, (2007) reported that role strain in male nursing

students was significantly higher than that in female nursing students when compared role

strain between male and female nurse students, especially in terms of role incongruity.

Another study by Nicum and Karoo, (1998) found that male students were very anxious

about maternal clinical practice also, women did not prefer care which was offered by male

nursing students, especially, care related to breast and perineal.

In relation to the suggestions regard maternity course (Table 8), the results showed

that nearly half of the participants (52.0%) thought that working mutually with female

students in the same training group is the best suggestion to solve the problems they face in

maternity clinical course. Different studies by Nicholas Lodge et al, (1997) and Chur-

Hansen, (2002) showed that younger female preferred dealing with nurses from the same

gender .in addition, previous experience of being cared by male nurse is another factor

affecting the preference of female nurse to perform care.

46

Conclusion

&

Recommendation

Conclusion

This study aimed to evaluate the experience of male nursing students during attending

maternity nursing clinical course.

The main factors affecting students’ experiences were gender preferences, students’

perceptions of mothers’ attitude towards male students nurse, students’ attitude towards mothers

during clinical training.

There were no significant differences between the universities in relation to the problems

students’ faced during maternity clinical course. The common problems students faced during

their training were difficulties of acquiring the skills and high clinical training requirements.

There were no significant differences between the universities in relation to the male

students experience during attending the clinical maternity nursing course.

The study showed that one third of students’ described it as an interesting course, and one

third of them considered it as embarrassing one. The most preferable clinical training area was

the post partum unit, and most of the students related their selection of clinical rotation to

gaining knowledge about maternity and newborn care.

Regarding to students psychological experience; most of the participants express their

psychological experience as negative ones.

In addition, taking of menstrual history, examination of episiotomy, and teaching about

vaginal infection topic were the most embarrassing experiences for students.

Unless that more than half of students realized a normal attitude from mothers, the study

showed that high percentage of them didn’t perform the most embarrassing procedures in

maternity such as vaginal examination, assessment of perineum, and attending or assist in normal

vaginal delivery especially in private hospitals. Whereas the less embarrassing procedures such

as abdominal examination, fetal heart auscultation, and educational sessions were done by most

of students.

47

In the end of the study, the students suggest that working mutually with female students

in the same training group is the most acceptable solution to solve their problems, decrease their

embarrassed, and increase the benefits they may gain from this course.

Recommendations

Farther studies needed to assess the experience of female nursing students and compare

their experience with male to develop a clear idea about students experience in general, and to

keep the students suggestion in mind to make an appropriate action to solve students’ problems.

48

Summary

Summary

Although the number of men entering the nursing profession has increased word wide,

(Madoka et al, 2006) and most western countries have men working in nursing jobs, they

usually constitute a minority (Streubert, 1994). This imbalance actually was due to historical

and cultural rational. For example; Florence Nightingale believed that nursing was a natural

extension of women and motherhood, and she believed that all women were nurses and men

were not capable of being nurses and thus were not allowed to enroll in nursing

education\training (Eswi, El Sayed, 2011), therefore men were purposefully excluded from

entering the profession (Evans, 2004; Mackintosh, 1997).The social context of men entering

the profession of nursing has evolved from this historical context. The issue revolves around

the perceptions of role strain for men working in a female (Evans, 2004; Bartfay and

Bartfay, 2007; Crigge et al, 2007). For instance In the United States, obstetric experience for

male nurses has been accepted since 1960, this was made possible because of the National

League for Nursing which reported that the basic nursing curriculum should have no

differentiation for men and women (McKenna, 1991). This situation also has its effect on

nursing education and training. Male students were made to feel uncomfortable during their

training placement; many male students were not allowed to participate in the full range of

caring interventions during obstetric placement (Madoka et al, 2006).

The aim of this study was to explore the male student nurse's experience of the

clinical maternity course which might contribute to a better understanding of male nursing

experience during attending maternity nursing clinical course in Palestine. Try to provide

nurses, clients and other health care professionals with a better understanding of male nursing

students’ experience of working with women clients and within a healthcare system where

male often feel excluded.

Hypothesis:

1) There are no differences between universities in relation to the male students experience

during attending the clinical maternity nursing course.

2) There are no differences between universities in relation to the problems students faced

during maternity clinical course.

3) There are no differences between private and governmental hospitals and the applied

maternal care procedures by male students.

49

Methodology:

Descriptive quantitative design was used to collect data from Convenient sample was

used to select the male students who participated in this study as the total number of 77

students was reached with rate of (36.14% , 26.5% , 24.1% and 6%) from An-Najah

University, Al Quds University, Arab American University and Birzeit University

Respectively, and (7.26%) refused to participate in the study.

Instrumental tool of data collection

One tool was used to collect the data; "Self administrative questionnaire"

The questionnaire was developed by the researches in english language based on

related literature review and from previous study (Eswi, El Sayed, 2011), in addition to

supervisor opinion it compromised from sixth parts (Annex I)

First part: "Demographic data for the participants", included age, level of academic

year, total grades, place of residency, university name.

Second part: Consisting of student gender preferences, perceptions, and attitudes regard

working with women/mothers during maternity course.

Third part: Composed of common problems that might the students faced during

maternity clinical course.

Fourth part: Students clinical experience which composed of the experience of the

students during their training in relation to their preference of clinical

rotation and reason behind that, positive aspects of training, embarrassing

procedures, stressors, and students psychological experience.

Fifth part: Involved applied maternity care procedure.

Sixth part: Consist of students’ suggestions.

Result:

The study revealed that the main problems faced by students during maternity clinical

course were difficulties of acquiring the skills and high clinical training requirements as

(33.8%) had agreed upon both of them.

50

The study also displayed the students experience during maternity course, and it

showed that nearly one-third of the participants (35.1%) had described it as an interesting

course, and almost one-third of them (29.9%) had described it as embarrassing for the male

students nurse.

According to psychological experience, the study revealed and illustrated students

psychological experience as positive and negative ones, according to the positive experience,

the study showed that nearly more than one-third of participants felt like gaining a lot of skills

(41.6%) and nearly more than one-third of participants (37.7%) were very happy when

attending delivery process .

Regarding negative psychological experience (51.9%, 50.6%, 40.3%) of students

being embarrassed, being afraid to cause problems to mother, and feel very anxious and afraid

to ask questions during their training respectively.

According to the applied maternity care procedures the study showed that high

percentage of students didn’t perform the most embarrassing procedures in maternity such as

vaginal examination, assessment of perineum, and attending or assist in normal vaginal

delivery especially in private hospitals. Whereas the less embarrassing procedures such as

abdominal examination, fetal heart auscultation, and educational sessions were done by most

of students

The study pointed the students’ suggestion of working mutually with female students

in the same training group is the most acceptable solution to solve their problems, decrease

their embarrassed, and increase the benefits they may gain from this course.

Conclusion:

Male nursing students faced different problems that affect their experience regarding

caring of women during maternal care. The common problems students faced during their

training were difficulties of acquiring the skills and high clinical training requirements. In

addition, they have negative psychological experiences; as being embarrassed, being afraid to

cause problems to mother, and feel very anxious and afraid to ask questions during their

training.

51

The results revealed that there were no significant differences between universities in

relation to the students’ experience, factors and problems faced them. It also showed that high

percentage of students didn’t perform the most embarrassing procedures in maternity such as

vaginal examination, assessment of perineum, and attending or assist in normal vaginal

delivery especially in private hospitals. Whereas the less embarrassing procedures such as

abdominal examination, fetal heart auscultation, and educational sessions were done by most

of students.

52

References

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55

Annexes

"The Experience of Nursing male students during

attending maternity nursing clinical course"

This questioner for male nursing student who's finished the maternity clinical

course...

Part I: Personal data for the participants

University name :-

Original residence :-

a) Rural b) Urban c) Camp

Age :-

Social status :-

a) Single b) Married

High schools :-

a) Private b) Public

Academic grad for maternity course :-

a) < 60 b) 60 – 70 c) 70 – 80 d) 80 – 90 e) 90 - 100

Place of training for maternity clinical course :-

a) Governmental hospital b) Private hospital c) Both , private and governmental hospital

Shift during training :-

a) Morning b) Afternoon c) Night

Part II : Student gender preferences and related perceived attitudes :

Patient’s gender preference in general :-

a) Male b) Female c) Both

Your perceptions of mothers’ attitude towards male student nurse in general :-

a) Normal

b) Dealing with restriction

c) Refuse to receive care by male student nurse

Your attitude towards mothers during your clinical training in general :-

a) Accepting attitude

b) Neutral attitude

c) Rejecting attitude

Part III: problems that students faced during maternity clinical course.

Part IV: Students clinical experience:

The most satisfying aspects of studying maternity nursing is :-

“select one please”

a) Comprehensiveness of theoretical contents

b) Learning how to deal with high risk pregnant mothers

c) Gaining skills of caring for mother in labor and delivery

Favorite clinical rotation during maternity nursing clinical course :-

a) Critical care unit for high risk pregnancy

b) Labor and delivery unit

c) Antenatal and gynecology clinic

d) Post partum unit

Your description of the clinical training in maternity nursing :-

a) Very effective

b) Interesting

c) Very embarrassing for the male student nurse

d) Boring

Your psychological experience :- "select five of these experiences"

1) Feeling like gaining a lot of skills 2) Feeling very happy when attending delivery process 3) Feeling like crying while attending delivery process 4) Being embarrassed 5) Being afraid to cause problems to mother 6) Having shaky hands while dealing with pregnant mothers 7) Feeling very anxious and afraid to ask questions 8) Imagining causing harm to mothers 9) Being scared to observe the process of labor that made you feeling to cry 10) Having observed mothers while suffering labor pain 11) Having to perform procedures with shaky hands 12) To be self-contained while feeling very uncomfortable 13) Feeling embarrassed while observing mothers breast fed their babies 14) Feeling embarrassed while observing vaginal examinations 15) Feeling embarrassed while having to instruct mothers about self-hygiene and family planning

Common problems you have faced during maternity clinical course :

a) High clinical training requirements

b) Unfavorable/non supportive attitude of the clinical instructors

c) Attending clinical training in the afternoon especially labor and delivery

d) Difficulty of acquiring the skills

Reasons of choosing special clinical rotation (between

gynecological wards) : Disagree Neutral Agree

Gaining knowledge about maternity care and newborn care

Presence of role model during clinical training

Minimal dealing with mothers through examination

Favorable attitude of clinical instructors

Stressors during clinical training: Disagree Neutral Agree

High clinical area requirements

Attitude of some clinical instructors

Rejection and un-cooperation of some mothers

Midterm exams during clinical training

About taking history : Disagree Neutral Agree

Taking menstrual history make me embarrassed

Taking contraceptive history make me embarrassed

Taking previous and present obstetric history make me embarrassed

The most embarrassing procedures : Disagree Neutral Agree

Abdominal examination

Breast examination

Examination of episiotomy

Perineal care

The most embarrassing topic in mother class (Mother's teaching) : Disagree Neutral Agree

Breast feeding

Dangerous signs during pregnancy

Minor discomfort during puerperium

Vaginal infection

Positive aspects of more clinical training Disagree Neutral Agree

Estimation of the expected date of delivery and calculation of

gestational age

Assessment and care of the newborn

Attending cesarean section delivery

Providing mother classes as well

Part V: maternity care procedure.

Procedure Observed/attend Assist Preformed All Non

Abdominal exam

Breast exam

Vaginal exam

Normal Vaginal Delivery

Instrumental assisted delivery

Caesarian section

Fetal heart auscultation and monitoring

Care of laboring women

Care of women during pregnancy

Education sessions

Assist/help /teach in breast feeding

Assessment of lochia

Determine uterine fundal height

Care of new born

Resuscitation of new born

Assessment of perineum

Part VI: students’ suggestions:

Your suggestions : Disagree Neutral Agree

Labor and delivery clinical training should be in the skill lab only

Maternity training should be for female only

Working mutually with female students

Other suggestions :

AANN--NNAAJJAAHH UUNNIIVVEERRSS

PROTOCOL FOR HUMAN SUBJECTS RESEARCH

NEW PROJECTS ONLY

REV 9/08

Office of the Institutional Review Board

PLEASE BE SURE TO COMPLETE ALL SECTIONS

Current Date of Submission: 1/10/2012

IRB office use only: Date received in IRB office (stamp)___________________

If this is a revision in response to an IRB Report of Action (ROA)-approval pending,

indicate the date of the ROA: _______________________

Title of Research:

The Experience of Nursing male students during attending maternity nursing clinical

course

Principal Investigator: Basel Adel Zawawi , Anees Abu-Shhab , Omar Swalmeh , Yazeed

Abu Tammam

Department/School An-Najah National University / Nursing College

Room # where mail can be sent ______________

Phone 00972595264764 E-mail z.i.w@hotmail.com

Phone 00972597637302 E-mail anees-2050@hotmail.com

Phone 00972599132752 E-mail swa_omar_swa@hotmail.com

Phone 00972597219468 E-mail Lil-wayne_2010@msn.com

**Faculty Sponsor (for Student Research): D . Mariam Al-Tell

Department/School An-Najah National University / Nursing college

Room # where mail can be sent ______________

Phone 2570 E-mail m.altell@najah.edu

_

Student Street Address ________________________________________

City Nablus State Palestine Zip _______________

Type of Research (please check):

Dissertation ______ (PLEASE NOTE: IRB review of dissertation

research requires prior successful proposal

defense.)

PhD Defense Date: ______________________

Master’s Thesis _____

Class project √

all other projects_____

** If the primary investigator is a student, check here to indicate that your faculty sponsor has read the

entire application, including cover letters, informed consents, and data collection instruments, and

asserts that this application is accurate and complete.

Dates Human Subjects Portion of Research Scheduled: from: 15/10/2012 to 10/11/2012

Site(s) of Human Subject Data Collection: ( An- Najah National University, Al Quds

University , Birzeit University, Arab American University )

(NOTE: If sites are administratively separate from the University, please submit approval

letters, or indicate when they will be forthcoming.)

Funding Agency (if applicable): We do not have any financial support

I. NATURE OF THE RESEARCH

In the judgment of the Principal Investigator, this research qualifies for which of the

following types of review:

Review Type: exempt (category) √ expedited (category) full Board1

1 All research that is either externally funded or greater than minimal risk must be reviewed by the full Board

II. PURPOSE OF RESEARCH

Briefly describe the objective(s) of the research (please keep description jargon free and use

100 words or less; the IRB will file this information in our descriptions of approved

projects).

The current study aims to exploring the male student nurse's experience of the clinical

maternity course which might contribute to a better understanding of male nursing

experience during attending maternity nursing clinical course in Palestine.

We wish to provide nurses, clients and other health care professionals with a better

understanding of male nursing students’ experience of working with women clients and

within a healthcare system where we often feel excluded.

III. METHODS

Approximate number of subjects: 80 nursing male students

Subjects will be (check only if applicable):

minors (under 18)

involuntarily institutionalized

mentally handicapped

Describe in detail how the subjects will be selected and recruited:

We will involve all of the nursing male student who complete their clinical maternity course

after the consent form taken, and all of them have the right to accept or refuse the

participation in this study without involving any penalty

Describe exactly what will be done to subjects once they have agreed to participate in the

project:

They have to fullfil the questionnaire that consist of 50 items

What incentives will be offered, if any? There is no incentive

IV. RISKS/BENEFITS TO PARTICIPANTS

Identify possible risks to subjects:

(NOTE: These may be of a physical, psychological, social or legal nature. If subjects are

vulnerable populations, or if risks are more than minimal, please describe what additional

safeguards will be taken.)

There is no potential risk from their participation , it doesn’t contain any experiment or

intervention , it’ss only a descriptive study .

What are the benefits and how will they be optimized?

There is no direct personal benefit , but it can benefit other students who don’t take this

course yet

Do benefits outweigh risks in your opinion? Yes No

Are there potential legal risks to the Principal Investigator or University? Yes No

V. INFORMED CONSENT

Describe how participants will be informed about the research before they give their consent.

Be sure to submit with this protocol a copy of the informed consent/assent letter(s) you will

use. Please prepare your informed consent letter at the 8th

grade reading level or lower as

dictated by the needs of the subjects. (See IRB website for required elements of an informed

consent.)

The subject will be informed about the study overview, its aim and objectives through

explanation befor the distribution of questionnaire in site of research, in addition their

approval for participation will be ensured before fulfilling the related questionnaire using

the attached informed consent.

VI. PRIVACY/CONFIDENTIALITY

Please describe whether the research would involve observation or intrusion in situations where

subjects have a reasonable expectation of privacy. If existing records are to be examined, has

appropriate permission been sought; i.e. from institutions, subjects, physicians? What specific

provisions have been made to protect the confidentiality of sensitive information about individuals?

All data and information which will be gathered , will be treated in confidentiality and will

not be accessed by any other without permission from the participants, moreover, and all

the questionnaires will saved in closed box with high attention for privacy.

Consent Form

Study name :

The Experience of Nursing male students during attending maternity nursing clinical

course.

Aim of this Study:

The current study aims to exploring the male student nurse's experience of the clinical

maternity course which might contribute to a better understanding of male nursing experience

during attending maternity nursing clinical course in Palestine.

The expected duration of the subject's participation:

Your participation in this study may take twenty minutes to complete the following

questionnaire which consist of 50 items about your training experience in this course.

About your participation:

* There is no potential risk from your participation, it doesn’t contain any experiment or

intervention, and it’s only a descriptive study.

* There is no direct personal benefit, but it can benefit other students who didn’t take this

course yet.

* Be sure that we respect your privacy and all of your information will be kept a secret , and

no one have the right to use it except the researchers themselves .

* You can ask the researcher about any information about the questionnaire and any unclear

question it may contain.

Remember that:

You have the right to accept or refuse the participation in this study without involving

any penalty.

Researchers names:

Basel Zawawi , Anees Abu-Shhab , Omar Swalmeh , Yazeed Abu Tammam .

Supervisor of research: Dr. Mariam Al-Tell.

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