.

Synopsis (MS/MBA)

A STUDY OF SOCIO CULTURAL CHALLENGES IN THE

NURSING PROFESSION IN PAKISTAN

RUBINA SHAHIN
MBA : 1st YEAR
Reg#MBA-20F-0066
__________________
(Signature of student)
Supervised by
DR. Muhammad Asif
Head of Department
________________________
(Signature of supervisor)

Submitted to the
DEPARTMENT OF MANAGEMENT SCIENCES
SHIFA TAMEER-E-MILLAT UNIVERSITY
ISLAMABAD
(2021)

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 TABLE OF CONTENT

Sr.N Topic Page #

o.
1.1 Introduction 03

1.2 Statement of the problem 04

1.3 Objectives of the study 04

1.4 Significance of the study 05

1.5 Research questions 05

1.6 Hypotheses 06

1.7 Delimitations of the study 06

1.9 Review of related literature 06

1.10 Methodology of the study 07

1.10. Population 07

1
1.10. Sample and sampling technique 08

2
1.10. Instruments for the study 08

3
1.10. Preparation of the research tools 09

4
1.10. Pilot Testing 09

5
1.10. Collection of Data 09

6
1.10. Analysis and interpretation of data 10

7
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 1.11 Operational plan 10

1.12 References 11

1.1 INTRODUCTION

The disparity of man and women in certain societies, such as Pakistan is a

growing concern. The disparity, unchanging mind-set and definitions rooted in

traditions do not free individuals from the socially bound gender identities.

The cultural and social system of Pakistan is highly dominated by strong

patriarchal trends. The working women in Pakistan have to carry dual responsibility

of work, contributing toward professional as well as domestic chores.

In a patriarchal social system a women dominated profession like nursing is

mostly seen as a disempowered group, due to its stereotypical image and negative

connotations. The low social prestige of this profession is based on roles typically

assigned to man and women to maintain gender identity according to their

performance and embodiment.

Nurses pledge to offer care without any discrimination. Unfortunately, their

care is not always perceived in an unbiased manner. Despite of nobility of their

profession nurses face many challenges at various levels due to certain highly in

graved and inevitable socio cultural factors. The aim of this study was to explore the

social and cultural challenges faced by nurses while creating their professional image

within the regional context of Sargodha in Pakistan.

In Pakistan, the inferior status of the nursing profession is related to a variety

of stigmas because of its negative portrayal by the media, interacting with and

touching male patients while caring, gender roles distribution on identity basis, and

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crossing social boundaries in the spotlight of Purdha, the religious and social practice

of female seclusion among Muslim communities. All of these stigmas are intensifying

the decrease in nurse-to-patient ratio

There are four major challenges for nurses

1. Pakistan is a male dominated society whereas most of the nurses are observed to

be females

2. Healthcare delivery system of Pakistan tends to be hierarchical where physicians

and medical staff are seen superior to nurses. Consequently, female nurses in

Pakistan carry double burden of subordination as a women as a nurse.

3. The media disseminates a stereotypical image of nurses, along with the concept

of objectification.

4. Marriage settlements for nurses in this society also emerged as a challenge. The

intimate nature of the nursing profession violates the social and cultural taboos in

relation to bodily contact.

1.2 STATEMENT OF THE PROBLEM

Inspite of being considered as a noble profession globally nursing not

attract many female as a career in Pakistan. The shortage of nurses has been a

continue challenge for the nursing profession in many countries, including

Pakistan.

This shortage is associated with multiple factors that include the low

status and socio cultural issues related to nursing profession. Statement of the

problem to find out and enlist the socio cultural challenges face by women in

Pakistan that are working as a nurse.

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1.3 OBJECTIVES OF THE STUDY

During this study the following objectives will be focused on;

1. To explore social and cultural challenges faced by nurses

2. To evaluate the factors that shapes the image of nursing profession.

3. To develop the recommendation for improving nursing profession.

1.4 SIGNIFICANCE OF THE STUDY

1. The study identifies the current status of nursing profession solely form

nurses perspectives about their clinical experience and also explore social

and cultural challenges in nursing profession.

2. The study will be show there is a need for positive portal in the media. The

positive depiction of nursing profession to general public through media

will remove social cultural stigmas of stereotypical image, gender

integration in nursing would increase acceptance of male nurses within

nursing profession.

3. The study will also help for understanding social and cultural boundaries

that have affected the nursing profession and ultimately cause the shortage

of nurses in medical profession, which can affect the healthcare delivery.

4. The study will be significant for highlighting the problems of recruitment

and retention in nursing profession. The study will also help in improving

quality of healthcare and remove disparities of its public image.

5. The study also put forward recommendation for nursing profession bodies

and also serves as a guide to enhance further development in nursing

profession to overcome the issues in nursing

1.5 RESEARCH QUESTIONS

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 The study will answer the following research questions.

1. To explore what kind of social factors that shape the image of nursing

profession?

2. To what are the perceptions that prevail for nurses and nursing profession

from a religious perspective?

3. To what type of gender differences and traditional values exist altering the

status of the nursing profession?

4. How did the media portraying the image of the nursing profession?

1.6 HYPOTHESIS

Following non directional research hypothesis is formulated keeping in view

the objectives of the study.

H1: There is a relationship between the nursing profession and social

cultural factors.

H2: Social factors that shape the image of nursing profession.

1.7 DELIMITATIONS OF THE STUDY

This study will be delimited to:

1. Three THQ public sector hospitals within the regional context of Sargodha

(Punjab) Pakistan.

2. An only female staff nurse, head nurses, midwifes.

3. Only the social and cultural issues will be considered for the purpose of the

research.

1.9 REVIEW OF RELATED LITERATURE

1.9.1 Theory of Gender Performativity

The principle of gender performativity developed by Butler and Le Blanc was once
applied, along with the notion of objectification, in order to highlight this

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performativity and discover its linkage to the located identification of nurses within
the given social context. This concept emphasizes the developed identity of nurses
which they have gained thru their performativity of precise behaviors through
following the virtue script of femininity. These outcomes in a closure of culturally
conditioned norms and motives gender inequality for male nurses. The stereotypical
portrayal and objectification of nursing has placed nurses in a subservient position to
medical practitioner and compelled them to supply their emotional and bodily labour
to others, which has devalued the picture of the nursing profession.
Although there's an emphasis in Butler’s paintings at the way wherein discourses have
an effect on our behaviour: in place of gender overall performance being a function
performed and created through the person creatively, gender overall performance is
habitually always acted and finished on a everyday foundation in ordinary life.
Although as she shows in her exam of drag overall performance creativity can serve
to subvert the performativity of the jobs we're assigned to perform.
Butler’s key thoughts are consequently primarily based totally at the perception that
gender isn't always a simplified ‘function’ however a deep seated psyche gambling
out of identification and behaviour, there's additionally now no longer informal
hyperlink among sex, gender and sexuality. The per formative gender roles are
established upon repetition and re-new release in developing identification, which in
flip bring about instability of the ‘gendered roles’ we're assigned.

1.10 METHODOLOGY OF THE STUDY

ii) Research Design:

It will be qualitative research.

1.10.1 Population

The public sector THQ hospitals within the regional context of Sargodha

(Punjab) in Pakistan, including Sahiwal, Kot Momin and Bhalwal will be considered

as a population of this study.

The detail of population will be as under:

Sr. Hospital Name Head Staff Nurses Midwife

No Nurses Nurses
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 1 THQ Hospital Kot Momin 1 13 3
2 THQ Hospital Bhalwal 3 16 3
3 THQ Hospital Sahiwal 2 10 3

.2 Sample and Sampling Technique

Cluster purposive sampling technique will be adopted from the three target hospital in

Sargodha to learn about nurses perception of social and cultural challenges in the

nursing profession. Thematic analysis will be conduct using the data analysis software

package Nvivo 12 plus.

Sr. No Nurses Numbers Of Average Years of

Participants Experience
1 Head Nurses 4 22 Years
2 Staff Nurses 4 10 Years
3 Midwife Nurses 4 08 Years

1.10.3 Instruments for the Study

Questionnaires, observation focus group discussion will be used as research tools for

collecting data from the respondents. The detail of the tools will be as:

To carry out the study survey techniques will be used.

1. Questionnaire for the nurses will be used to collect their views regarding the

four variables of Gender identity, media portals, identify from religious

perspective and issue in marriage settlement.

2. Observation during the session to analyze the perception of staff nurses about

the level and kind of the issues. An observation schedule will be used for the

purpose of observation.

3. Focus group discussion will be conducted separately for the nurses. `It will be

conducted to get the views of the nurses about their professional image related

issues. It will be multi session focus group discussion.

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1.10.4 Preparation of the research tools

Preparation of the questionnaire will be done by searching different books and

related materials and with the expert’s discussion in the fields and with the

consultation of the supervisor. Check list for the purpose of observation and the

questions for the focus group discussion will also be prepared in the same way.

1.10.5 Pilot Testing

Pilot testing will be done before the conduction of the research on the nurses

in sleeted three hospitals through the purposive sampling technique. (Which will be

part of the population but not included in the sample)? In order to determine the

validity of the questionnaires for the nurses, the researcher will be done pilot testing.

The researcher will also seek the expert opinions for the validation and

refinement of the research tools. The tools will be further simplified and reorganized

for large scale usage. Reliability of the observation schedule, questionnaire and

questions / topics for focus group discussion design will be checked.

1.10.6 Collection of Data

The data will be collected through post, emails and personal meeting from the

target sample of the population. And for the purpose of observation the researcher

himself or the will visit the hospitals and will observe the wards using the observation

schedule. Observation will be done with due consent of the concerned authorities.

The researcher will arrange the focus group discussion sessions and during the

discussion the researcher will try to get the answers of the questions designed to meet

the purpose of the research.

1.10.7 Analysis and interpretation of data

Data collected by the use of the given instruments of research will be

tabulated, analyzed and interpreted. In the light of the objectives and research

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questions of the study, the suitable statistics will be applied in order to measure the

variables:

The suggestions given by the staffs during the focus group discussion sessions

the responses and suggestions will be categorized on the basis of more frequent

suggestions in descending order.

OPERATIONAL PLAN

The study may be completed according to the following proposed schedule.

Activity wise Time Frame

Collection of material for the review of related literature. (three months)

Development of research instrument.

Formulation of statements for the questionnaire.

Development of check lists for the purpose of observation and

interview.
Pilot testing of research instruments. (one month)

Compilation of the relevant Material for the review of related

literature.
Administration of the research instruments to the study sample (six months)
and collection of data.

Sequencing the material of the review of related literature.

Analysis and interpretation of the collected data. (two months)

Revision of the review of related literature.

Findings and Recommendations. (one month)

Citation of references and bibliography.

Summary and Conclusions (one month)

Proof reading, final print and binding (one month)

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REFERENCES

Sidra Abbas, Rubeena Zakar and Florian Fischer,(2020)

Qualitative study of socio-cultural challenges in the nursing profession in Pakistan

Sleema G, Rozina K, Nasreen L, Qurattulain N,(Volume 2015) Are We Empowered?

A Qualitative Approach to Unfold The Experiences of Female Nurses in Pakistan

Maria H L , Carla D S , Kellay R F , Kiciosan D S , Mariane S X , (2017), Cultural

studies: new perspectives on research possibilities in nursing

Raisa B Gul (June 2008) The Image of Nursing from Nurses' and Non-Nurses'

Perspective in Pakistan

Josh Jone, (2018) Theorist Judith Butler Explains How Behavior Creates Gender: A

Short Introduction to “Gender Performativity”

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