Int. J. of Health Serv. Res. and Policy (2021) 6(1):117- 127 https://doi.org/10.33457/ijhsrp.

854266

International Journal of Health Services

Research and Policy
INTERNATIONAL www.dergipark.org.tr/ijhsrp
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Research Article

DETERMINATION OF GENDER PERCEPTIONS OF NURSING AND MIDWIFERY

STUDENTS

Seda SÖGÜT1 Eda CANGÖL1 Gözde ÖZSEZER*2

1
Çanakkale Onsekiz Mart University, Faculty of Health Sciences, Dep. of Midwifery, Çanakkale, Turkey
2
Çanakkale Onsekiz Mart University, Faculty of Health Sciences, Dep. of Nursing, Çanakkale, Turkey
*
Corresponding author; [email protected]

Abstract: The culture of the society in which the individual lives determines the characteristics
revealing the expectations about how a woman or a man behave, think and act, that is, structuring
woman and man socially. This study was carried out to determine gender perceptions of nursing and
midwifery students. Descriptive design type was used in the study. The universe of the study consisted
of 750 students studying in Nursing and Midwifery Departments in 2018-2019. The sample consisted of
471 students who were not willing to attend the study. The participation rate is 63%.
“Sociodemographic Information Form” and “Perception of Gender Scale" were used to collect data.
The ethics committee, institutional permission, and consent of the students were obtained for the study.
In this study, percentage and frequency distributions of variables were examined. Comparisons between
groups; Mann-Whitney U and Kruskal Wallis-H tests. The mean score of Gender Perception of the
students was 108.18 ± 108.18 (min = 25 / max = 125). A significant relationship was found between the
variables of gender, class, type of school, nationality, family styles, food preparation before the spouse
of the woman, and marital status before starting work and earning money (p <0.05). The gender scores
of female students (109.68 ± 11.45) were higher than that of male students (93.38 ± 13.46) (p<0.01). In
this study, the mean gender score of the students is good. Nurses and midwives, by raising the awareness
of individuals through training programs on gender roles; develop an awareness of gender roles and
gain egalitarian attitudes and perspectives.
Keywords: student, nursing, midwifery, gender perception

Received: January 5, 2021 Accepted: April 24, 2021

1. Introduction

The concept of "gender" expresses socially determined personal characteristics, roles, and
responsibilities of women and men. The definition of this concept includes values expectations,
judgments, and roles about how society sees and perceives us as a man and a woman, what they think
about us and what they expect us to behave [1, 2].
What the culture expects from a man and a woman is similar to the observations related to the
physical characteristics (Gender) of woman and man [3]. The culture of the society in which the

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individual lives determines the characteristics revealing the expectations about how a woman or a man
behave, think and act, that is, structuring woman and man socially. Children gain roles appropriate to
their genders and acquire gender identity. While household chores and childcare stand out for women,
the roles of working in a job become more important than family roles for men [4].
The components like the functions, responsibilities, and rights of woman and man in society and
their positions in the production process are shaped based on gender. As a result, men are directed to
the public area while women are directed to the private sector [5]. Thoughts like glorifying masculine
gender and leaving female gender as a secondary position are seen to be the traces of the social lives in
men [6]. Traditional perspectives on the gender roles of men negatively affect the status of women in
society. It is therefore seen that today women do not reach the desired status in society and they fall
behind men [7].
In patriarchal societies, it is not only difficult for women to make independent decisions, but also
they are not even allowed to spend money without their husbands’ consent. This negatively affects
women’s effective use of or access to social resources in the field of health protection and promotion. It
can also make it difficult for women to access healthcare services even in an emergency situation [8].
To give an example, female circumcision, which is applied mostly in African countries and causes
gynecological and obstetric problems, is a cultural practice and also may be made for the sexual
satisfaction of men. This situation reflects the violence against women and also reveals the gender and
sexuality perception of the woman through the eyes of some men [9].
In the literature, it is stated that parents who are role models for their children are effective in the
development of gender roles and children prepare their own roles by internalizing what they see from
their parents. Therefore, it is very important to raise awareness of the parents about gender perception.
The most basic individual of the family which is the main component of society is a woman. Midwife
and nurse frequently interact with women and family because of their profession and gender [7]. For
example, encouraging and supporting the father to continue kangaroo care of the infant with joint
responsibility of the mother and father by midwife and nurse would definitely contribute to the
development of positive attitudes in the society toward gender roles.
Firstly, developing an egalitarian attitude by midwives and nurses for themselves will provide a
significant contribution to both the enhancement of health care quality and further development of
professional identity. With this study, it will be possible to determine the differences between the gender
perceptions of midwifery and nursing students, to shape programs and training intended for increasing
awareness about this subject and motivating individuals about behavioral changes and to reach a wider
audience.
This study was conducted to determine the gender perception of midwifery and nursing students.

2. Materials and Methods

2.1. Type of the Study

This research is a descriptive type study.

2.2. Population and Sample of the Study

The population of the study was composed of 750 students studying in the Midwifery and Nursing
Departments of a University in the 2018-2019 Academic Year. Without sample selection from the

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population, the study was completed with 471 students who voluntarily participated in the study and
from school. The participation rate for the study was determined as 63%.

2.3. Data Collection Tools

The data of the study were collected with “Sociodemographic Information Form”, prepared upon
the literature review, and “Perception of Gender Scale”.
Sociodemographic Information Form: The form prepared by the researchers includes questions about
the students' age, gender, year, cause of choosing the major, family types and cultural situations, and
roles of women and men about gender roles.
Perception of Gender Scale: The scale was developed by Altınova and Duyan (2013) and its validity
and reliability studies were conducted [10]. It is a scale developed to be applied particularly to adults. It
has the capability of measuring individuals' attitudes about how they perceive gender roles in different
fields. The scale is composed of a total of 25 items. For each item, one of the options "I strongly agree",
"I agree", "undecided", "I disagree", "I strongly disagree" is selected and scored between 1 and 5. Some
items are reversely scored while calculating the total scale score (the items 2, 4, 6, 9, 10, 12, 15, 16, 17,
18, 19, 20, 21, 24, and 25 were reversely scored). While the lowest score on the scale is 25, its highest
score is 125. A high score indicates high gender perception while a low score refers to low gender
perception. The analyses about the internal consistency of the scale were calculated over a total of 443
people and the Cronbach’s Alpha internal consistency coefficient is 0.872. In this study, the Cronbach’s
Alpha internal consistency coefficient of the scale was found as 0.899.

2.4. Application of the Study

The data collection tools were applied to the students, who were included in the study, through a
face-to-face interview method for 20-25 minutes.

2.5. The Inclusion Criteria of the Study

 Studying in Nursing Department of Canakkale Onsekiz Mart University Faculty of Health
Sciences
 Studying in Midwifery Department of Canakkale Onsekiz Mart University Faculty of Health
Sciences
 Volunteering to participate in the study

2.6. The Exclusion Criteria of the Study

 Declining to participate in the study.

2.7. Data Assessment

The data obtained from the study were evaluated in Statistical Package for Social Sciences for
Windows (SPSS 25.0) statistical package program. In the study, percentage and frequency distributions
of the variables were examined. Comparisons between the groups were conducted with Mann-Whitney
U and Kruskal Wallis-H tests in non-parametric variables. In case of significant differences in the
Kruskal Wallis-H Test, the groups having differences were determined with post hoc Tukey B test. The
value of 0.05 was used as the significance level while interpreting the results.

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3. Results

It was determined that the mean age of the participants was 20.92±1.75 and the majority of them
were female (88.7%) and studying in the 3rd and 4th years (29.3% and 27.2%). The participants were
mostly (94.5%) Turkish citizens. The majority had nuclear family type (84.3%), their family income
level was middle (74.1%) and their family type was democratic family (64.8%).
It was found that male child was not wanted more than the female child in 90.7% of the
participants and women's clothes have not interfered in 67.3% of the participants. Of the participants,
81.3% expected men in the family to help household chores, 71.5% believed that women should not
come home earlier than men and prepare the meals, 97.7% had the idea that giving birth to a boy would
not increase the woman’s value, and 90% did not think about getting married before starting to work
and earn money (Table 1).
In the study, it was found that the gender showed a significant difference in terms of gender
perception (p<0.05) and women’s gender perception scores (109.68±11.45) were higher than the scores
of male participants (93.38±13.46).
It was determined that the gender perception scores of the participants showed a significant
difference in terms of class type (p=0.009), gender perception scores of the 2nd-year students
(109.15±12.33) were higher than those of the 1st -year students
(104.37±14.04), gender perception scores of the 3rd -year students (108.11±12.21) were higher
than those of the 1st-year students (104.37±14.04) and the scores of the 4th -year students (110.40±10.69)
were higher than those of the 1st -year students (104.37±14.04).
When the students’ gender perception was examined in terms of school type, it was determined
that the gender perception scores of the students who graduated from Anatolian High School
(109.59±11.66) were higher than the students who graduated from Regular High Schools
(108.11±12.21) and the students who graduated from Health Vocational High school (108.40±10.91)
were more positive compared to the students who graduated from Regular High Schools (101.77±15.78)
(p=0.006). Besides, the perception scores of the students whose nationality is the Republic of Turkey
(109.11±11.65) were seen to be higher than the foreign students (92.19±14.28) (p=0.000).
When the gender perception of the participants was examined in terms of family type, it was
determined that the gender perception of those who had nuclear families (108.86±11.75) was more
positive than those with extended families (102.57±15.26) (p=0.002)
A significant correlation was found between those who believed that woman should come home
earlier than her husband and prepare the meals and those who did not (p<0.01). Those who did not think
that the woman should come home earlier than her husband and prepare the meals (111.15±10.42) were
more positive than those who did (95.82±14.93).

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Table 1. Sociodemographic, Familial, and Social Characteristics of the Participants

Characteristics Mean+SD Min-Max
Age 20.92±1.75 18-37
N %
Gender
Female 418 88.7
Male 53 11.3
Year
1st Year 99 21
2nd Year 106 22.5
3rd Year 138 29.3
4th Year 128 27.2
Nationality
Republic of Turkey 445 94.5
Others 26 5.5
Income level of the Family
Income less than expenses 83 17.6
Income equal to expenses 349 74.1
Income more than expenses 39 8.3
Family type
Nuclear family 397 84.2
Extended family 61 13.0
Others 13 2.8
Family style
Oppressive 38 8.1
Democratic 305 64.7
Free 128 27.2

Do you think a baby boy is wanted/expected more than a baby girl?

Yes
44 9.3
No
427 90.7
Is there anyone interfering with the clothes of female members of the family?
Yes, My father 103 21.6
Yes, Brother 27 5.6
Yes, Me 12 2.7
Yes, Others 12 2.5
No 317 67.6
Are the male members of your family expected to do and help with household chores
(cooking, cleaning, tidying the house, etc.)?
Yes 383 81.3
No 88 18.7
Should a woman be at home before her husband and prepare the meal?
Yes 50 10.6
No 337 71.6
Undecided 84 17.8
Does giving birth to a boy increase the value of a woman?
Yes 11 2.3
No 460 97.7
Do you consider getting married before starting to work?
Yes 47 10.0
No 424 90.0

It was observed that there was a statistically significant difference between the gender perception
scores of those who did not consider getting married before starting work and earning money
(108.64±12.03) and the gender perception scores of those who considered getting married before starting
work and earning money (104.06±14.91) (p=0.044, Table 2).

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Table 2. Comparison of Gender perception with Some Variables

Characteristics n Mean±SD Mean rank. Test and p-value
Gender
Female 418 109.68±11.45 U=4834.00
Male 53 93.38±13.46 p<0.05*
Year
1st Year 1 99 104.37±14.04 197.78
2nd Year 2 109.15±12.33 H=11.651
106 247.18
3rd Year 3 108.11±12.21 p=0.009**
138 235.14
4th Year 4 110.40±10.69 1-2 1-3 1-4
128 257.22
Graduated High School
Anatolian High School 270 109.59±11.66 251.12
H=12.476
Health Vocational High School 112 108.40±10.91 230.29
p=0.006**
Regular High School 47 101.77±15.78 179.28
1-3 2-3
Other 42 105.71±14.35 217.52
Nationality
Republic of Turkey 445 109.11±11.65 U=1998.00
Others 26 92.19±14.28 p=0.000**
Income level of Your Family
Income less than Expenses 83 106.77±11.57 212.95
Income equal to Expenses 108.69±12.32 H=3.428
349 242.62
Income higher than Expenses 106.62±14.72 p=0.180
39 225.81
Family Types
Nuclear Family 397 108.86±11.75 241.63 H=12.413
Extended Family 61 102.57±15.26 185.03 p=0.002**
Family Styles
Oppressive 38 109.00±11.93 245.87
Democratic 107.96±12.33 H=0.484
305 232.95
Free 108.47±12.80 p=0.785
128 240.34
Do you think a baby boy is more wanted than a baby girl in your family?
Yes 44 108.23±12.88 U=9366.00
No 427 108.18±12.38 p=0.974
Is there anyone who interferes with the clothes of female members in your house?
Yes. My Father 103 108.39±11.64 234.60
Yes. Brother 27 106.19±9.94 194.65
Yes. Me 12 101.92±12.62 161.00
H=0.484
Yes. Others 12 107.75±16.29 250.58
p=0.785
No 317 108.54±12.67 242.26
Would you expect the male individuals in the family to do household chores ?
Yes 383 108.43±12.64 U=15149.50
No 88 107.10±11.37 p=0.139
Do you think a woman should be at home early and prepare the meals before her husband?
Yes 1 50 95.82±14.93 122.21 H=67.326
No 2 337 111.15±10.42 267.09 P=0.010*
Undecided 3 84 103.62±12.32 179.00 1-2 1-3 2-3
Do you think giving birth to a baby boy will increase a woman’s value?
Yes 11 89.27±16.09 U=15149.50
No 460 108.63±11.97 p=0.139
Do you consider getting married before starting to work and earning money?
Yes 47 104.06±14.91 U=8179.00
No 424 108.64±12.03 p=0.044*
Gender perception Score
Mean score 471 108.18±12.40 (min :68-max:125)
* p<0.05 ; **p<0.01

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4. Discussion

Inequality based on gender roles determines the relationship between the man and woman in all
segments of the society based on gender roles as well as their gender roles [7]. The reflections of gender
roles on social life shape the lives of men and women as traditional and egalitarian roles in different
directions [2].
When equality in gender is mentioned, it refers to an individual not facing any discrimination due
to his/her gender in using opportunities, allocating and using resources, and receiving services [11]. As
it is understood, there is an attitude difference towards gender roles among male and female students.
Nurses and midwives have professions with important responsibilities in their society for shaping
attitudes toward gender roles in an egalitarian manner and adopting them to the society which they serve
for.
In the 2018 Global Gender Gap Report published by the World Economic Forum, Turkey is stated
to be ranked as 130 out of 149 countries in gender equality order [12]. This result is quite remarkable
for Turkey.
In the study, the gender perception mean scores of the participants were at a good level. The
gender perception mean scores of the female students participating in the study were found to be higher
than male students (p<0.05). In the literature, when the students' perceptions towards gender roles
according to gender type were examined, it was stated that the female students’ thoughts on egalitarian
gender were highly positive [6, 7, 13-21]. Unlike the results of this study, in a study conducted by Balcı
Akpınar et al., (2019) with university students (n=2356), a significant difference was found between the
gender perception mean score and gender [22]. It was stated that the gender perception score was lower
in female students than in male students. In this context, it was believed that there was a more positive
gender perception in women.
In terms of gender perceptions of the participants according to their class type, gender perceptions
of the 4th-year students were higher than the 1st -year students (p<0.05). The results of the study are in
line with the results in the literature [15, 23, 24]. In contrast to the results of this study, it was expressed
in the study of Özpulat and Özvarış (2019) conducted with the students (n=360) from the Department
of Nursing and Department of Nutrition and Dietetics that there was no statistically significant difference
between the class variable and gender perception score [16]. It was emphasized that the “Instructional
Training for Gender Equality and Fighting with Violence Against Women” given (n=28) in the study
with pretest and posttest design conducted by Uzun et al. (2017) positively affected the participants’
gender perceptions and attitudes towards gender roles [25]. It was determined that those who had gender
courses in their curricula had higher gender perceptions than those who did not [6]. This result may be
related to the fact that 4th -year students took gender courses and increased their awareness of this subject
further.
Concerning the participants’ opinions about the type of high school they graduate from it was
found that the gender perception scores of the students who graduated from Anatolian High School were
more positive than the students who graduated from Regular High School and those of the students who
graduated from Health Vocational High School were more positive than the students who graduated
from Regular High School (p<0.05). It was determined in the study by Çelik et al. (2013) that equality
gender attitudes of those who graduated from Anatolian High Schools were higher than those who
graduated from other high school types and those of the students studying in Health Sciences were

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higher than the students studying in the other fields [26]. The study results are similar to the results of
the present study. It may be due to the fact that the parents of the students studying in Anatolian High
Schools have higher education levels and have egalitarian attitudes towards gender equality. In similar
studies by Kavuran (2011) and Atış (2010), it was determined that the students studying in the health
department had a more egalitarian attitude towards gender roles [27, 28]. This striking result will give
priority to women’s health care needs with a positive discrimination perspective in the field of
reproductive health where gender discrimination is quite a lot in women.
It was determined that the perception scores of the Turkish students were higher than the foreign
students (92.19±14.28) (p<0.05). No relevant data have been found in the literature. The culture in which
the individual lives determines the characteristics expected from the woman and man. This important
result is thought to be caused by the that the culture of this country does not coincide with the culture of
foreign students.
When the gender perception mean scores of the participants were evaluated by family styles, the
nuclear family had a higher score than the extended family. When the literature was examined, it is
consistent with the study results [15, 29, 30]. Unlike the results of this study, it was observed in the
studies of Balcı Akpınar et al. (2019), Köken Durgun and Cambaz Ulaş (2019) and Uçtu and Karahan
(2016) that the variable of the extended family increased the gender perception score [19, 22, 23]. It was
believed to be caused by that the students have grown up with their parents. In addition, this result may
be caused by the fact that the parents have egalitarian attitudes towards gender roles.
As a result of rapid social changes, the traditional family structure has tried to renew itself in
terms of changing gender roles. In the study, a significant correlation was found between those who
thought that woman should come home earlier than her husband and prepare the meals and those who
did not (p<0.05). Those who did not believe that woman should come home earlier than her husband
and prepare the meal had more positive gender perception scores than those who did. In the study
conducted by Kahraman et al., (2014) with the teaching staff (n=209) working in Nevşehir Hacı Bektaş
Veli University, 20.6% of the participants agreed that woman must prepare the meal after coming home
before her husband following the work while 77.5% did not agree [31]. It is seen that gender roles are
accepted in line with the culture of society.
The gender perception scores of those who did not consider getting married before starting to
work and earn money were higher than those who considered getting married before starting to work
and earning money. When the literature was examined, no study was found giving similar results. As
stated by Kodan (2013), this may be explained by the openness of an individual to new ideas and not
remaining under the influence of culture-society [32].

5. Conclusion

It is important to determine first the attitudes of university students towards gender roles in order
to ensure them acquiring an egalitarian perspective by changing their traditional perspectives on gender
roles. In the study, the gender means a score of the students was at a good level. It was determined to
be negatively affected by variables such as gender, class, school type, nationality, family styles, woman's
status of coming home before her husband and preparing the meal, and the status of getting married
before starting to work and earn money.

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As a result of the study, it was determined that the mean scores of the perception of gender scale
were higher in the students who took gender courses than those who did not. Therefore, it can be
recommended to add gender and related concepts into the curricula of midwifery and nursing
departments and organize in-service training programs on gender roles. Since men have a more
traditionalist attitude, the participation of men should be ensured as much as possible in the training
programs to be carried out in this process. More comprehensive studies should be planned to determine
students' gender perspectives and find out regional differences.
Limitations of the Study: The limitations of the study are the inability to reach all the students in the
study, incomplete filling of the data collection forms, and those who were not willing to participate in
the study. The results of the study can be generalized to the population where the study was carried out.
Conflict of interest: The authors declare that they have no conflict of interest.
Acknowledgments: This research was supported by Çanakkale Onsekiz Mart University Scientific
Research Projects Coordination Unit (Project No: TSA-2019-2829).
Ethical Approval: The institutional permission from the school administration and the ethics committee
approval from the Clinical Trials Ethics Committee of the University (04.01.2019 / No:18920478-
050.01.04-E.1900001718) were obtained. Before starting the data collection process in the study, the
students were informed about the purpose and scope of the study and then their verbal and written
consents on agreeing to participate in the study were obtained.
The compliance to the Research and Publication Ethics: This study was carried out in accordance
with the rules of research and publication ethics.

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