Health  Vol.6 No.20 , December 2014
Conformity to Traditional Gender Norms in a Feminized Occupation: The Influence on Health Behaviors
ABSTRACT
The object of this study is to examine the relationships between conformity to traditional gender norms and health in a special group of the Spanish population, male/female nurses. Nursing is a particularly good example of feminized occupation. Spanish male (n = 98) and female (n = 98) nurses matched in diverse sociodemographic variables complete measures of gender norms and health behavior variables. Measures of conformity to gender norms in female and male nurses are compared with those of the general population. The analysis of the inter-gender relationships and health highlights a clearly masculine pattern for men and a clearly feminine one for women. A detailed analysis of the scores in each of the scales reveals a pattern of illness in male nurses that is still masculine despite their lower conformity, as a group, to masculine norms, and a clearly feminine illness pattern in female nurses. The consideration of gender from a multidimensional perspective (the different factors that make up Masculinity and Femininity, as assessed in this work) has allowed us to study the relations between gender norms and health in more detail. Limitations and implications are discussed.
KEYWORDS
Health, Gender, Nursing, Spain

Cite this paper
Sánchez-López, M.P., Saavedra, A.l., Dresch, V. and Limiñana-Gras, R.M.(2014) Conformity to Traditional Gender Norms in a Feminized Occupation: The Influence on Health Behaviors. Health, 6, 2775-2789. doi: 10.4236/health.2014.620317.
References
[1]   World Health Organization (2007) What Is a Gender-Based Approach to Public Health?
http://www.who.int/features/qa/56/en/index.html

[2]   Yoder, J.D. and Kahn, A.S. (2003) Making Gender Comparisons More Meaningful: A Call for More Attention to Social Context. Psychology of Women Quarterly, 27, 281-290.

[3]   Bem, S. (1974) The Measurement of Psychological Androgyny. Journal of Consulting and Clinical Psychology, 42, 155-162.
http://dx.doi.org/10.1037/h0036215

[4]   Helmreich, R.L, Spence, J.T. and Wilhelm, J.A. (1981) A Psychometric Analysis of the Personal Attributes Questionnaire. Sex Roles, 7, 1097-1108.
http://dx.doi.org/10.1007/bf00287587

[5]   Auster, C.J. and Ohm, S.C. (2000) Masculinity and Femininity in Contemporary American Society: A Reevaluation Using the Bem Sex-Role Inventory. Sex Roles, 43, 499-528.
http://dx.doi.org/10.1023/a:1007119516728

[6]   Mahalik, J.R., Locke, B., Ludlow, L., Diemer, M., Scott, R.P.J. and Gottfried, M. (2003) Development of the Conformity to Masculine Norms Inventory. Psychology of Men and Masculinity, 4, 3-25.
http://dx.doi.org/10.1037/1524-9220.4.1.3

[7]   Mahalik, J.R., Morray, E.B., Coonerty-Femiano, A., Ludlow, L.H., Slattery, S.M. and Smiler, A. (2005) Development of the Conformity to Feminine Norms Inventory. Sex Roles, 52, 417-435.
http://dx.doi.org/10.1007/s11199-005-3709-7

[8]   Mahalik, J.R. (2000) Men’s Gender Role Conflict as Predictors of Self-Ratings on the Interpersonal Circle. Journal of Social and Clinical Psychology, 19, 276-292.
http://dx.doi.org/10.1521/jscp.2000.19.2.276

[9]   Liu, W.M. and Iwamoto, D.K. (2007) Conformity to Masculine Norms, Asian Values, Coping Strategies, Peer Group Influences and Substance Use among Asian American Men. Psychology of Men and Masculinity, 8, 25-39.
http://dx.doi.org/10.1037/1524-9220.8.1.25

[10]   Mahalik, J.R., Burns, S.M. and Syzdek, M. (2007) Masculinity and Perceived Normative Health Behaviors as Predictors of Men’s Health Behaviors. Social Science & Medicine, 64, 2201-2209.
http://dx.doi.org/10.1016/j.socscimed.2007.02.035

[11]   Sánchez-López, M.P., López-García, J.J., Dresch, V. and Corbalán, J. (2008) Sociodemographic, Psychological and Health-Related Factors Associated with Poor Mental Health in Spanish Women and Men in Midlife. Women & Health, 48, 445-465.
http://dx.doi.org/10.1080/03630240802575096

[12]   Addis, M. and Mahalik, J. (2003) Men, Masculinity, and the Contexts of Help Seeking. American Psychologist, 58, 5-14.
http://dx.doi.org/10.1037/0003-066X.58.1.5

[13]   Prakash, J., Kotwal, A.S.M., Ryali, V.S.S.R., Srivastava, K., Bhat, P.S. and Shashikumar, R. (2010) Does Androgyny have Psychoprotective Attributes? A Cross-Sectional Community-Based Study. Industrial Psychiatry Journal, 19, 119-124.
http://dx.doi.org/10.4103/0972-6748.90343

[14]   Sánchez-López, M.P., Cuéllar-Flores, I. and Dresch, V. (2012) The Impact of Gender Roles on Health. Women & Health, 52, 182-196.
http://dx.doi.org/10.1080/03630242.2011.652352

[15]   Kirchengast, S. and Haslinger, B. (2008) Gender Differences in Health-Related Quality of Life among Healthy Aged and Old-Aged Austrians: Cross-Sectional Analysis. Gender Medicine, 5, 270-278.
http://dx.doi.org/10.1016/j.genm.2008.07.001

[16]   Liminana-Gras, R.M., Sánchez-López, M.P., Saavedra-San Román, A.I. and Corbalán-Berná, J. (2013) Health and Gender in Female Dominated Occupations: The Case of Male Nurses. The Journal of Men’s Studies, 21, 135-148.
http://dx.doi.org/10.3149/jms.2102.135

[17]   World Health Organization (2002) Gender and Women’s Mental Health. Retrieved on 5 January, from: Mental Health.
http://www.who.int/mental_health/prevention/genderwomen/en/

[18]   Sánchez-López, M.P., Rivas-Díez, R. and Cuéllar-Flores, I. (2013) Masculinity and Femininity as Predictors of Tobacco and Alcohol Consumption in Spanish University Students. Health and Addictions, 13, 15-22.

[19]   Brabete, A.C. and Sánchez-López, M.P. (2012) How Does the Gender Influence People’s Health? Data of a Sample of Romanian People Living in Spain. Procedia-Social and Behavioral Sciences, 33, 148-152.
http://dx.doi.org/10.1016/j.sbspro.2012.01.101

[20]   World Health Organization (2003) Gender, Health and Ageing. WHO, Geneva.

[21]   Deeks, A., Lombard, C., Michelmore, J. and Teede, H. (2009) The Effects of Gender and Age on Health-Related Behaviors. BMC Public Health, 9, 213-221.
http://dx.doi.org/10.1186/1471-2458-9-213

[22]   Instituto Nacional de Estadística (INE) (2012) Estadística de Profesionales Sanitarios Colegiados, ano 2012 [Survey of the Number of Health Professionals Registered in Spain, 2012]. INE, Madrid.
http://www.ine.es/jaxi/menu.do?L= 0&type= pcaxis&path= /t15/p416&file= inebase

[23]   Mullan, B. and Harrison, J. (2008) Male and Female Nursing Applicants’ Attitudes and Expectations towards Their Future Careers in Nursing. Journal of Research in Nursing, 13, 527-539.
http://dx.doi.org/10.1177/1744987107085500

[24]   The National Union of Nurses Associations, Republic of China (2008) Statistics of Nurses in Taiwan.
http://www.nurse.org.tw/DataSearch/Manpower.aspx/

[25]   Battice, J. (2010) The Changing Face of Nursing in a Developing Country. Journal of Clinical Nursing, 19, 1765-1766.
http://dx.doi.org/10.1111/j.1365-2702.2009.02882.x

[26]   Kanter, R.M. (1977) Men and Women of the Corporation. Basic Books, New York.

[27]   Kmec, J.A. (2008) The Process of Sex Segregation in a Gender-Typed Field: The Case of Male Nurses. Sociological Perspectives, 51, 259-279.
http://dx.doi.org/10.1525/sop.2008.51.2.259

[28]   Williams, C.L. (1995) Still a Man’s World. Men Who Do Women’s Work. University of California Press, Berkeley.

[29]   Connell, R.W. and Messerschmidt, J.W. (2005) Hegemonic Masculinity: Rethinking the Concept. Gender & Society, 19, 829-859.
http://dx.doi.org/10.1177/0891243205278639

[30]   Loughrey, M. (2008) Just How Male Are Male Nurses? Journal of Clinical Nursing, 17, 1327-1334.
http://dx.doi.org/10.1111/j.1365-2702.2007.02250.x

[31]   Fisher, M.J. (2011) Sex Differences in Gender Characteristics of Australian Nurses and Male Engineers: A Comparative Cross-Sectional Survey. Contemporary Nurse: A Journal for the Australian Nursing Profession, 39, 36-50.
http://dx.doi.org/10.5172/conu.2011.39.1.36

[32]   Canadian Institute for Health Information. (2007) The Work and Health of Nurses. How Do Nurses’ Perceptions Vary across Canada? CIHI, Ottawa.

[33]   Tucker, S.J., Harris, M.R., Pipe, T.B. and Stevens, S.R. (2010) Nurses’ Ratings of Their Health and Professional Work Environments. American Association of Occupational Health Nurses, 58, 253-267.

[34]   Ushiro, R. and Nakayama, K. (2010) Gender Role Attitudes of Hospital Nurses in Japan: Their Relation to Burnout, Perceptions of Physician-Nurse Collaboration, Evaluation of Care, and Intent to Continue Working. Japan Journal of Nursing Science, 7, 55-64.
http://dx.doi.org/10.1111/j.1742-7924.2010.00138.x

[35]   Talley, G., Thomas, R.E. and Brown, K.C. (2009) A Health Comparison of Alabama Nurses versus US, UK and Canadian Normative Populations. Journal of Orthopedic Nursing, 13, 172-182.
http://dx.doi.org/10.1016/j.joon.2009.03.005

[36]   Evans, O. and Steptoe, A. (2002) The Contribution of Gender-Role Orientation, Work Factors and Home Stressors to Psychological Wellbeing and Sickness Absence in Male-and Female-Dominated Occupational Groups. Social Science & Medicine, 54, 481-492.
http://dx.doi.org/10.1016/S0277-9536(01)00044-2

[37]   Steinfeldt, J.A., Zakrajzek, R., Carter, H. and Steinfeldt, M.C. (2011) Conformity to Gender Norms among Female Student-Athletes: Implications for Body Image. Psychology of Men and Masculinity, 12, 401-416.
http://dx.doi.org/10.1037/a0023634

[38]   Izú, M., Cortez, E.A., Valente, G.C. and Silvino, Z.R. (2011) Trabalho noturno como factor de risco na carcinogênese [Working Nights as a Risk and Carcinogenic Factor]. Ciencia y Enfermeria, 17, 83-95.
http://dx.doi.org/10.4067/S0717-95532011000300008

[39]   European Union (2011) The State of Men’s Health in Europe. European Union, Brussels.

[40]   Ministerio de Sanidad y Consumo [Ministry of Health and Consumption] (2005) Informe Salud y Género (Report on Health and Gender]. Ministerio de Sanidad y Consumo, Madrid.

[41]   Ministerio de Sanidad, Servicios Sociales e Igualdad [Ministry of Health, Social Services, and Equality] (2006) Encuesta nacional de salud [National Health Survey]. Instituto de Información Sanitaria e Instituto Nacional de Estadística, Madrid.

[42]   Sanchez-Lopez, M.P. and Dresch, V. (2008) The 12-Item General Health Questionnaire (GHQ-12): Reliability, External Validity and Factor Structure in the Spanish Population. Psicothema, 20, 839-843.

[43]   Ministerio de Sanidad, Política Social e Igualdad [Ministry of Health, Social Policy, and Equality] (2013). Encuesta nacional de salud [National Health Survey]. Instituto Nacional de Estadística, Madrid.

[44]   Cuellar-Flores, I., Sánchez-López, M.P. and Dresch, V. (2011) El Inventario de Conformidad con las Normas de Género Masculinas (CMNI) en la población espanola [Conformity to Masculine Gender Norms Inventory in the Spanish Population]. Anales de Psicología, 27, 170-178.

[45]   Sánchez-López, M.P., Cuellar-Flores, I., Dresch, V. and Aparicio-Garcia, M. (2009) Conformity to Feminine Gender Norms in the Spanish Population. Social Behavior and Personality, 37, 1171-1185.
http://dx.doi.org/10.2224/sbp.2009.37.9.1171

[46]   Instituto de la Mujer [Women’s Institute] (2013) Estadísticas. Usos del tiempo I [Statistics. Uses at time I]. Retrieved on 5 January 2014, from: Mental.
http://www.inmujer.es/estadisticas/consulta.do?area= 6

[47]   Hsu, C.H.I., Chen, S.H., Yu, H.Y. and Lou, J.H. (2010) Job Stress, Achievement Motivation and Occupational Burnout among Male Nurses. Journal of Advanced Nursing, 66, 1592-1601.
http://dx.doi.org/10.1111/j.1365-2648.2010.05323.x

[48]   Rotenberg, L., Fernandez-Portela, L., Banks, B., Griep, R.H., Fischer, F.M. and Landsbergis, P. (2008) A Gender Approach to Work Ability and Its Relationship to Professional and Domestic Work Hours among Nursing Personnel. Applied Ergonomics, 39, 646-652.
http://dx.doi.org/10.1016/j.apergo.2008.02.013

[49]   Cuellar-Flores, I., Liminana-Gras, R.M. and Sánchez-López, M.P. (2013) The Health of Paid Caregivers: A Cross-Sectional Study in Spanish Population. Psychology, 4, 50-56.
http://dx.doi.org/10.4236/psych.2013.46A1008

[50]   Kulminski, A.M., Culminskaya, I.V., Ukraintseva, S.V., Arbeev, K.G., Land, K.C. and Yashin, A.I. (2008) Sex-Specific Health Deterioration and Mortality: The Morbidity-Mortality Paradox over Age and Time. Experimental Gerontology, 43, 1052-1057.
http://dx.doi.org/10.1016/j.exger.2008.09.007

[51]   Mahalik, J.R., Lagan, H.D. and Morrison, J.A. (2006) Health Behaviors and Masculinity in Kenyan and U.S. Male College Students. Psychology of Men and Masculinity, 7, 191-202.
http://dx.doi.org/10.1037/1524-9220.7.4.191

[52]   Muldoon, O. and Reilly, J. (2003) Career Choice in Nursing Students: Gendered Constructs as Psychological Barriers. Journal of Advanced Nursing, 43, 93-100.
http://dx.doi.org/10.1046/j.1365-2648.2003.02676.x

[53]   Pontin, D. (1988) The Use of Profile Similarity Indices and the Bem Sex Role Inventory in Determining the Sex Role Characterization of a Group of Male and Female Nurses. Journal of Advanced Nursing, 13, 768-774.
http://dx.doi.org/10.1111/j.1365-2648.1988.tb00568.x

[54]   Bird, C.E. and Rieker, P.P. (2008) Gender and Health. The Effects of Constrained Choices and Social Policies. Cambridge University Press, New York.
http://dx.doi.org/10.1017/CBO9780511807305

[55]   Simpson, R. (2009) Men in Caring Occupations: Doing Gender Differently. Palgrave Macmillan, New York.
http://dx.doi.org/10.1057/9780230594333

[56]   Lupton, B. (2000) Maintaining Masculinity: Men Who Do Women’s Work. British Journal of Management, 11, 33-48.
http://dx.doi.org/10.1111/1467-8551.11.s1.4

[57]   Locke, B.D. and Mahalik, J.R. (2005) Examining Masculinity Norms, Problem Drinking, and Athletic Involvement as Predictors of Sexual Aggression. Journal of Counseling Psychology, 52, 279-283.
http://dx.doi.org/10.1037/0022-0167.52.3.279

[58]   Mahalik, J.R., Levi-Minzi, M. and Walker, G. (2007) Masculinity and Health Behaviors in Australian Men. Psychology of Men & Masculinity, 8, 240-249.
http://dx.doi.org/10.1037/1524-9220.8.4.240

[59]   Tager, D. and Good, G.E. (2005) Italian and American Masculinities: A Comparison of Masculine Gender Role Norms. Psychology of Men & Masculinity, 6, 264-274.
http://dx.doi.org/10.1037/1524-9220.6.4.264

[60]   Smiler, A.P. (2006) Conforming to Masculine Norms: Evidence for Validity among Adult Men and Women. Sex Roles, 54, 767-775.
http://dx.doi.org/10.1007/s11199-006-9045-8

[61]   Parent, M.C. and Smiler, A.P. (2013) Metric Invariance of the Conformity to Masculine Norms Inventory-46 among Women and Men. Psychology of Men & Masculinity, 14, 324-328.
http://dx.doi.org/10.1037/a0027642

 
 
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