The impact of self-stereotyping in the nursing profession on life satisfaction: a pilot study

INTRODUCTION

Concern for other people is associated with women and nursing more than with any other characteristic [1]. When thinking of a nurse, one envisions a woman accompanying a patient and caring for their health. Since the inception of the nursing profession, it has been burdened by recurring stereotypes. According to prevailing patterns of thought, those who practice this profession are driven by passion, exhibit a tendency to help selflessly, and are gentle, nurturing, naturally kind, and compassionate [2]. Moreover, the public image of nursing is also influenced by various other factors, including information portrayed in media, films, and television series which often cast nursing in a negative light [3, 4]. Nurses themselves evaluate their professional position as lower compared to other medical professions. Paradoxically, they thereby reinforce these stereotypes to align with societal expectations, even if they believe that practicing this profession also requires possessing other qualities [1]. Why is this the case? Fulfilling the demands of social roles and engaging in self-stereotyping can lead to several positive effects, such as enhancing the sense of belonging, fostering positive interpersonal relationships, reducing the perception of discrimination, and increasing overall life satisfaction [5, 6].
Self-stereotyping is a phenomenon wherein a specific social group behaves oppositely and tends to reinforce and utilize stereotypes about itself [5-7]. This process leads members of a social group – often in a disadvantaged position compared to privileged groups – to describe themselves using both positive and negative stereotypical personality characteristics attributed to their group [6]. The tendency to conform to social roles and self-stereotype is stronger in lower-status groups. Thus, self-stereotyping is closely linked to overall well-being. It is also worth noting that practicing the nursing profession, the sense of belonging to this professional group, and self-stereotyping may influence well-being, including overall life satisfaction [8]. Life satisfaction is understood as the sense of fulfillment resulting from achieving desired outcomes and conditions in life, tied to the cognitive processes of each individual [8, 9]. Consequently, it impacts the individual’s well-being. Life satisfaction is assessed by comparing one’s life situation to subjectively defined criteria.
Stereotypes have long been a subject of research in various scientific fields. Stereotypes along with the phenomenon of stereotyping affect our lives and are far more complex than they might appear. They can have both positive and negative connotations and be more or less accurate. Some stereotypes remain stable and resistant to change, while others evolve rather quickly [7]. It should be emphasized that stereotypes operate in two ways – affecting both the person stereotyping and the one being stereotyped. However, in the case of the person being stereotyped, they tend to cause more harm than benefit [10].
Despite many differences in nursing environments, nurses around the world perceive themselves as a unified and unique professional group. Nursing organizations publish slogans that promote pride in being nurses. This serves as evidence that a positive nursing identity exists. Widespread beliefs play a very important role in how this profession is perceived. The nurses themselves also reinforce stereotypes about their own profession, thereby conforming to what society expects of them. They do this both individually and within the context of their group.
Despite this strong, positive professional identity, nurses tend to evaluate their professional standing as lower compared to other medical professions. The nursing profession itself, the sense of belonging to the professional group, and the phenomenon of self stereotyping and social isolation can be factors that affect overall wellbeing and life satisfaction.
The aim of this study was to assess self-stereotyping in the nursing profession and its impact on life satisfaction.

MATERIAL AND METHODS

ORGANIZATION AND COURSE OF THE STUDY

Research tools were applied in the form of an author-developed questionnaire and a standardized tool – the Satisfaction with Life Scale (SWLS). The study was conducted online among actively employed nurses between February and April 2024. Approval was obtained from the Ethics Committee of the Jagiellonian University Medical College, under number 118.6120.167.2023, dated 26^th January 2024. The completion of the questionnaire by respondents was preceded by informed consent for participation in the study.

CHARACTERISTICS OF THE STUDY GROUP

The study focused on women actively working as nurses. A total of 182 questionnaires were collected, of whom 174 were ultimately included in the study group. Eight questionnaires were incorrectly completed and thus excluded from the analysis. The respondents were aged between 21 and 65 years (with a mean age of 34 years).
Educational levels were as follows: 8% (14 participants) had secondary education, 50% (87 participants) had a bachelor’s degree, 11.5% (20 participants) had a master’s degree, and 24.1% (42 participants) had a master’s degree with specialization. 6.3% (11 participants) reported having secondary education or a bachelor’s degree with specialization. The vast majority of the nurses reported being single (52.9%, 92 participants), while 43.7% (76 participants) were married and 3.4% (6 participants) were divorced. Regarding their place of residence, 36.8% (64 participants) lived in a village and 63.2% (110 participants) lived in a town/city.
Work experience ranged from 4 months to 40 years. 79.9% (139 participants) reported working in hospitals, while the remaining 20.1% (35 participants) worked in other settings.

STATISTICAL ANALYSIS

The statistical analysis was conducted using Microsoft Excel and the R programming language. The Spearman correlation test was used to assess relationships between variables, and the Wilcoxon test was applied for non-parametric data or data that did not meet the assumptions of parametric tests. The Kruskal-Wallis test was used to compare medians among three or more groups. Normality of distribution was tested using the Shapiro-Wilk test. For variable analysis, the mean (M), median (Me), standard deviation (SD) and Kendall correlation were used. A significance level of 0.05 was adopted, though results approaching this threshold were also considered statistically significant.

RESEARCH TOOLS

The study used an author-developed questionnaire and a standardized tool – the Satisfaction with Life Scale (SWLS).
The author-developed questionnaire consisted of the following sections:
• Part I: Information for study participants, assumptions, and the successive stages of the study;
• Part II: Consent for participation in the study;
• Part III: Questions regarding sociodemographic data (age, work experience, workplace, place of residence, marital status);
• Part IV: Respondents’ perceptions regarding the professional status of nurses, societal treatment, group identification and the history of nursing;
• Part V: A self-constructed questionnaire assessing the degree of self-stereotyping (2 sets of questions: self-assessment and group assessment). Sixteen personality characteristics were evaluated, four of which were stereotypically positive (caring, kindness, patience, empathy), four stereotypically negative (humility, obedience, grumpiness, laziness), four positive characteristics contrary to stereotypes (independence, industriousness, self-confidence, cheerfulness), and four negative characteristics counter to stereotypes (indifference, unfriendliness, nervousness, egocentricity). Four additional characteristics (not relevant to the group) were added to the list: honesty, loyalty, ruthlessness, extravagance. Participants first evaluated themselves and then their professional group, using a scale from 1 to 5 to indicate the extent to which they agreed that they possessed certain personality traits and that their professional group shared these characteristics. The self-stereotyping index was calculated by determining the correlation between self-assessments and group assessments [5, 6].
The SWLS, developed by E. Diener et al. and adapted into Polish by Z. Juczyński, contains 5 statements that respondents assess in terms of their agreement with them regarding their life thus far [11]. The result serves as an overall indicator of life satisfaction. A higher score indicates greater satisfaction with life.

RESULTS

AUTHOR’S QUESTIONNAIRE SURVEY INVESTIGATING THE SELF-STEREOTYPING COEFFICIENT

In the first stage of analysis, a correlation study was conducted among all characteristics examined in nurses, including protectiveness, kindness, patience, empathy, humility, obedience, grumpiness, laziness, independence, diligence, self-confidence, cheerfulness, indifference, unfriendliness, nervousness, and egocentricity. In this context, characteristics irrelevant to the studied group which were added to complement the questionnaire, such as honesty, loyalty, ruthlessness, and extravagance, were excluded.
Kendall’s correlation was used to assess the relationship between listed characteristics. Considering that the results did not meet the assumptions of a normal distribution, the Wilcoxon rank-sum test for two independent samples was applied. The purpose of this step was to verify whether the median level of stereotyping among nurses significantly differs from zero.
Among nurses surveyed, the median self-stereotyping coefficient was Me = 0.64 (SD = 0.30). The analysis demonstrated a significant difference between the median level of self-stereotyping and zero (p < 0.001). This suggests a statistically significant correlation between all stereotypical characteristics nurses attribute to themselves and characteristics they assign to their professional group.
In second stage of statistical analysis, correlations were examined separately for each characteristic. Spearman’s correlation test was used. The results are presented in Table 1.
For all characteristics, except for “laziness”, the criterion for the accepted level of significance (p < 0.05) was met. There is a statistically significant correlation between individual stereotypical characteristics nurses attribute to themselves and characteristics they assign to their professional group.
Subsequently, the relationship between self-stereotyping and the perception of the professional position of nurses was examined. Each nurse was assigned a self-stereotyping level calculated using Kendall’s correlation. The choice of this method was due to the small sample size (a total of 16 variables), the lack of normal distribution, and the ability of this measure to handle irregularities in the data. The nurses were divided into two groups: the first group consisted of individuals who believe that the nursing profession is lower in the hierarchy of medical professions, while the second group included those who think nursing does not occupy a lower position. Due to the lack of normality in the distribution of the obtained self-stereotyping levels, the Wilcoxon rank-sum test was applied to evaluate differences between the groups. The analysis did not reveal a statistically significant difference between nurses who undervalue their professional position and those who do not undervalue their position (p > 0.05).
In the next analysis the relationship between self-stereotyping and the sense of respect for the nursing profession was examined. Nurses were divided into two groups: those who believe that the nursing profession is not publicly respected and those who believe that nursing is a respected profession. As in previous analysis, due to the lack of normality in the distribution of the obtained self-stereotyping levels, the Wilcoxon rank-sum test was applied. No statistically significant difference was found between nurses who consider nursing to be a disrespected profession and those who believe it to be a publicly respected profession.
The relationship between self-stereotyping and sociodemographic data was analyzed. Using Spearman’s correlation test, the relationship between the self-stereotyping coefficient, age, and work experience was calculated. Spearman’s test was applied due to the lack of normality in the data distribution. The Wilcoxon rank-sum test was used to assess the relationship between self-stereotyping and place of residence, workplace, and marital status. A statistically significant relationship was found between age and self-stereotyping. As age and work experience increase, the self-stereotyping coefficient in the studied group of nurses also increases.
No statistically significant relationship was found between the place of residence of the participants and self-stereotyping. However, the p-value suggests a potential relationship (p < 0.1).
The analysis conducted using the Wilcoxon test showed borderline significance (p ≈ 0.05) for the relationship between place of residence of participants and the self-stereotyping coefficient.
The average self-stereotyping coefficient for married nurses was M = 0.65 (SD = 0.28), while for single nurses the average was M = 0.51 (SD = 0.31). The self-stereotyping coefficient was statistically significantly higher in the group of married nurses compared to the group of single individuals.

SATISFACTION WITH LIFE SCALE

The statistical analysis of life satisfaction involved calculating the sum of scores for the study group of nurses (N = 174) on the SWLS and then comparing the results to the sten scale according to the response key [11]. Among the group of surveyed nurses, 45.4% (79 individuals) reported a high level of life satisfaction; 44.3% (77 individuals) reported an average level of life satisfaction; and 10.3% (18 individuals) reported a low level of life satisfaction.
The relationship between the level of life satisfaction and sociodemographic data was analyzed. Using Spearman’s correlation test, the relationship between SWLS score (expressed on the sten scale) and age, as well as work experience, was calculated. Additionally, the Wilcoxon rank-sum test was used to assess the relationship between level of life satisfaction and place of residence, workplace, and marital status. The Kruskal-Wallis test was applied to examine the impact of education on the level of self-stereotyping, considering that the analyzed group includes more than two educational categories. The analysis did not reveal a statistically significant correlation between age of the participants and their level of life satisfaction.
No statistically significant difference was found between place of residence and level of life satisfaction of participants.
No statistically significant difference was found between workplace and level of life satisfaction of participants, as well as between marital status and level of life satisfaction of respondents.
The analysis conducted using the Kruskal-Wallis test revealed a statistically significant difference (p < 0.05) between education level and level of life satisfaction of participants. Higher average life satisfaction was observed among individuals with a Master’s degree (M = 7.20) and those with a specialization (M = 7.02). Individuals with lower education levels showed noticeably lower life satisfaction: secondary education (M = 5.86) and Bachelor’s degree (M = 6.28).

SELF-STEREOTYPING AND LIFE SATISFACTION

The analysis conducted using Spearman’s correlation test revealed a statistically significant correlation between the self-stereotyping coefficient of participants and their level of life satisfaction. The determined value does not fall within the significance threshold (p > 0.05); however, the p-value of 0.068 suggests a potential relationship that could be detected with a larger sample size. No statistically significant correlation was found between the attribution of stereotypical characteristics to specific groups among participants and their level of life satisfaction (Table 2).

DISCUSSION

Self-stereotyping is a phenomenon that has been studied primarily among stigmatized groups, such as those experiencing gender-based discrimination and those discriminated against due to racial or residential background [5, 6]. The nursing group has not been mentioned in any study, which may explain differences in research outcomes.
Based on the findings of Latrofa et al. and Li et al., low social status is one of the factors contributing to the attribution of stereotypical characteristics [5, 6]. When comparing results of the present study, it can be observed that a large portion of the respondents – 76.4% (133 individuals) – perceive their professional position as lower compared to other medical professions. Furthermore, 61.5% (107 individuals) consider nursing to be a profession that is not publicly respected. Similar conclusions can be drawn from Machul et al.’s study, where nurses rated their professional position as average (49.7%) or low (25.4%) [3]. Contrary conclusions were drawn from the 2019 report by the Public Opinion Research Center, which ranked nurses second in terms of social respect, as well as from the 2024 ranking, where they ranked fourth [12, 13]. In contrast to these findings, respondents themselves consider nursing to be a profession with a low social status, which could predispose them to attribute stereotypical characteristics to themselves.
The respondents, as a group with low social status, attribute stereotypically positive and counter-stereotypically positive characteristics to themselves, while rejecting stereotypically negative and counter-stereotypically negative characteristics. The strongest correlations were found with characteristics such as patience, kindness and empathy. Among stereotypically negative characteristics, humility was rated highest. Nurses rejected characteristics such as obedience and grumpiness. These results cannot be compared to other studies, as none have been conducted in this specific area.
45.4% (79 individuals) of participants reported a high level of life satisfaction. Similar results were obtained by Bartosiewicz and Nagórska in 2020 [8], where 38.65% (468 individuals) of 1,211 nurses reported high life satisfaction. In that study, a higher percentage of respondents reported low life satisfaction compared to the results of this study.
The current research revealed a statistically significant correlation between self-stereotyping and life satisfaction among nurses, which is also confirmed by Latrofa et al. and Li et al. [5, 6].
No correlation was found between self-stereotyping and the respondents’ opinions on their professional position. This may be because nurses tend to underestimate their own professional status. They are perceived differently by the general public, which regards them as trustworthy.
Not all sociodemographic data are related to the self-stereotyping coefficient. A association was found between self-stereotyping and age as well as work experience. Among the participants, self-stereotyping increased with age and work experience. One possible explanation for this observed relationship is the training system for nurses before 1998, when nurses attended Medical High Schools and Medical Professional Colleges [14, 15]. The generation of older nurses entered the profession during the time of educational reform and the development of the target curriculum and teaching methods. During this period, nurses were instilled with values important for nursing which differ from the values currently emphasized at the higher education level. This may explain stronger presence of self-stereotyping among older nurses. The study also found an association between self-stereotyping in the nursing profession and marital status. The self-stereotyping coefficient was higher among married individuals than among those who were single. This result may be closely related to the age and work experience of respondents. Older nurses were more likely to be married. A similar trend can be observed in the case of the borderline significant relationship between self-stereotyping and workplace, as well as between self-stereotyping and residential location. Older nurses were more likely to live in rural areas and work exclusively in non-hospital settings.
A higher level of life satisfaction was reported by nurses with a specialization and those with a second-degree university education.
Nursing is a feminized and aging profession [16-18]. Older nurses tend to accept undervaluation of their professional status and are not inclined to seek greater professional independence. Younger nurses, on the other hand, are better educated, more likely to improve their professional qualifications, and are eager to gain greater professional autonomy.

CONCLUSIONS

This study demonstrates that stereotypes cannot be entirely comprehended. However, they serve a significant function at both the societal and individual levels. Stereotypes can act as a source of benefits for the nursing environment, while also posing potential risks.
The present study reveals its investigative potential; however, it is necessary to include a greater number of nurses in future research.

Disclosures

This research received no external funding.
The study was approved by the Ethics Committee of the Jagiellonian University Medical College (118.6120.167.2023, dated 26th January 2024).
The authors declare no conflict of interest.

References