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Social Prototype of Nursing. An Integrative Review well-nigh a Notwithstanding Unknown Profession

Kinesthesia of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Espana

Ruby Cross Nursing Schoolhouse, University of Seville, 41009 Seville, Spain

Author to whom correspondence should exist addressed.

Bookish Editor: Richard Gray

Received: xiv April 2021 / Revised: 25 May 2021 / Accepted: 1 June 2021 / Published: vii June 2021

Abstract

Groundwork: Nursing is a discipline on which stereotypes have persisted throughout its history, considering itself a feminine profession and subordinated to the medical figure, without its own field of competence. All this leads to an paradigm of the Nursing Profession that moves away from reality, constituting a real, relevant and high-bear on problem that prevents professional person expansion, and that has a directly touch on social trust, the allocation of resources and quality of intendance, also as wages and professional satisfaction. The aim of this review was to identify and publicize the published material on the social image of Nursing, providing updated information near the different approaches to the subject. Methods: An integrative review of the literature has been made from main sources of information published from 2010 to 2020. For this, the databases CINAHL, Scopus, SciELO, Dialnet and Cuiden have been consulted. Results: In full, 17 articles have been included in the review, with qualitative, quantitative, and fifty-fifty bibliographic reviews performed in countries such every bit Spain, Egypt, Argentina, Iran, Venezuela, Turkey, United Kingdom, and Australia. The results of those papers generally showed that society has misinformation about the functions performed by nursing professionals, which is based on myths and stereotypes. Conclusions: Nursing is a greatly unknown and invisible profession, as society continues without recognizing its competence, autonomy and independence.

1. Introduction

"Care" is the essence of Nursing. This care is conducted past ways of various deportment aimed at improving or mitigating the discomforts caused by a disease procedure or to preserve wellness. For this reason, the individuals who exercise the Nursing Profession must possess the concrete skills, knowledge and intellectual power that permit them to solve the existent or potential problems of the people at which care is targeted, by resorting to critical thinking and effective communication [1]. An accent on intendance of an instrumental nature has been traditionally identified. The perception of patients differs from that of nurses; patients perceive a lower level of personal care than the one nurses believe that they evangelize. Caring behaviors are afflicted by the working surroundings, nurses' emotional intelligence and coping skills, and socio-demographic characteristics [2]. In fact, the perceived care in the nurse-patient relationship is high and instrumental in nature, and it can be stated that nurses consider that through their behaviors they transmit more than care than the users perceive they receive [three].

Throughout history, Nursing has been influenced by gender considerations, for existence understood that care is an activity inherent to women. In this way, its evolution and development has been conditioned, giving rising to a profession that is struggling to attain the goals established. In our times, although in theory we should take overcome the sexist roles, we discover that the profession is nevertheless being marginalized in different ways and that there is a devalued image of the activities performed by female and male nurses, although they perform indispensable work [4,five]. In addition, as a effect of the stereotypes about the gender roles, the male collective in Nursing is nonetheless a minority, thus limiting the development of its professionals, which, in turn, has a negative touch on on their image [half-dozen].

On the other hand, the advice media often reflects stereotypes that result in degrading and exerts a negative influence on the prototype of the Nursing Profession [7]. In this way, it is axiomatic how in films, Boob tube serial, commercials, and more than serious programs of greater repercussion such the news, a distorted image of the Nursing competences is projected, which has nothing to do with the truthful commitment of this collective towards the wellness of the population [eight].

Too, information technology can exist asserted that the professional person identity of Nursing does not coincide with the social image of the profession [9]. However, the first is influenced by the second, and vice versa. Consequently, social epitome has a negative impact on the construction of professional identity, because the population conditions the thoughts, beliefs and behaviors of female and male person nurses [10]; and, in its plow, what the Nursing professionals convey through their actions is going to decide the existing public image of the profession. It is then spoken of as a "weak" identity of the Nursing Profession that has been shaped based on the stereotypes which take persisted throughout its history, so that its professionals are probably going to project an inadequate image of Nursing to the population, with a negative impact on the social conception regarding the Nursing subject field [11].

By social image we understand an iconic and simple creation based on stereotypes, which represents through attributes the discourse of a concrete sociocultural setting regarding a social reality. It is a concept agreed upon by the members of a society about the social representations constructed in view of a reality that aims to visually summarize sure social discourse through the characteristics that best fit the ideological or moral content [12]. The public image of Nursing is given by its external aspect, by the mental scheme of the concept of the profession (which is determined by words or images), and to what it resembles when related to other professions. The gear up of characteristics that are repeated by means of the various mental representations of the individuals is what constitutes the social image of the profession [10].

On the other paw, we can talk about social prestige or condition, which is given by the public recognition attributed past the professional field [thirteen], which must be proportional to the social piece of work that is performed. In guild to attain greater social recognition, it is necessary that both piece of work and educational institutions bear witness a professionalized prototype of Nursing, giving visibility to all the intendance actions provided to the population, showing their scientific knowledge and competence, as well every bit assertiveness when making decisions and in problem resolution [xiv]. Therefore, Nursing professionals must be considered a cardinal component within the inter-professional team, for which it is fundamental to construct and reassert the concept of professional identity or, in other words, the conception that the individuals who exercise the profession have of it, and of themselves [15].

It is of vital importance that the Nursing professionals reflect on what they have achieved, and on the state of affairs they are in, to exist able to correctly define what they are and what they want to achieve, projecting it to order to give visibility to their essence [16].

At present focusing on the image that the population has of Nursing, it is worth noting a study conducted in the United States. Its objective was to know the perception held past the population regarding Nursing. The following results stand out: 17% of the immature individuals and fifteen% of the adults answered that the primary function of female and male nurses is to assist the medical figure; merely 39% of the young individuals and fifty% of the adult population stated that Nursing professionals fabricated use of critical thinking, intelligence and problem resolution; and forty% thought that nurses helped the medical professionals [17].

Therefore, it is non surprising that, in the 4 Nursing Conference of the Valencian Community, it was concluded that 60.five% of the patients did not trust in the health advice provided past the Nursing professionals [eighteen]. In addition, the users are nether the wrong idea that the Nursing activities are limited to the care scope in wellness institutions [19] and still perceive the Nursing professionals as subordinates of the medical collective [20].

Some of the answers given by patients in a study conducted in Spain to open up questions are as follows: "I recall that, in order to know how to treat a disease, there are the doctors; nurses are more for social dealings than for their cognition", "Regarding the social prototype, I believe that it'due south quite positive, possibly one of the professions that is seen every bit about kind", "And so when the nurse is at your bedside you tell her everything, it'southward easier to talk". It is therefore seen that both male and female patients value more than kindness and closeness than the nurses' cognition [21].

Nowadays, strengthening the image of Nursing supposes a challenge for its professionals. In countries such as Spain, many efforts accept been made to manage appropriate tools to evaluate, during the undergraduate grooming period of future nurses, aspects such every bit academic satisfaction [22] or the perception of care that clinical instructors demonstrate to students, considering the strong touch on it has on their futurity relationships with patients, relatives, and other wellness professionals [23]. However, the fact that the social paradigm of Nursing does not coincide with the reality of the profession implies a series of repercussions ranging from high professional dissatisfaction or burnout to multifariousness of conflicts that reduce potential and work capacity in multidisciplinary-interdisciplinary teams and prevent the expansion and advancement of the profession, without overlooking the fact that this situation directly affects quality of intendance and users' satisfaction. In addition, it besides has an affect on the social trust deposited in the Nursing professionals, on resource allocation and piece of work overload, likewise as on the salaries of its professionals [24]. Consequently, information technology is a real and relevant trouble, besides as one of high impact. By means of this newspaper, the intention is to contribute to eliminating the stereotypes and to construct a more than professional prototype of the discipline.

The Nursing Profession has experienced numerous changes throughout history, with both internal and external aspects exerting an influence on its evolution [25]. The scope of Nursing operation has been expanded, then that, in addition to exercising the profession at the aid level and managing care, nurses are a key component in the manufacture, education and research, amongst other aspects, performing their functions independently [26]; but, is gild aware of these changes? "Does the population commencement to understand what we are or what nosotros aspire to be?" [16].

It is fundamental to communicate what Nursing is, what cognition the Nurses take, and what Nursing provides as a whole to the profession [27], as well as to devise strategies aimed at showing social club what the truthful role of the profession is, correcting imitation ideas and providing an prototype of Nursing that adjusts to reality, so that those who exercise the profession command the communication process. giving visibility to what we are and what we desire to be [8]. Contemporary wellness care requires that female person nurses know who they are and the role they play, how to identify and update their mission in gild, and how to communicate so to others [28].

Given the to a higher place, the objective of this paper is to identify and disclose the material published on the social image of Nursing, providing updated information about the dissimilar approaches on the topic.

2. Materials and Methods

In order to develop this review objective, and applying the PICO (Patients, Interventions, Comparison, Outcomes) model for the formulation of clinical questions in the practice based on evidence [29], the following PICO question was established: "What is the social image that general population/patients have about the role and performance of nurses?", defining the following elements of the question:

✓: Patients/population: General population or general patients from any cultural context
✓: Intervention: Role or operation of nursing professionals
✓: Comparing: No comparison grouping (not applicable)
✓: Outcomes: Image that gild or patients in general have nearly these professionals.

To elaborate this integrative review and cognition update paper, primary information sources have been used, which have been obtained through the CINAHL, Scopus, SciELO, Dialnet and Cuiden databases. Searches were also conducted in PubMed, Medline, PsycInfo and Enfispo, only no articles were found that responded to the objectives of the review. The search was conducted between November and December 2020. The subsequent process for the selection of the articles was exactly the aforementioned for all the databases used, using the post-obit descriptors: "Nursing" "Social perception" "Patients" and "Population", all included in MeSH (Medical Subject Headings) and in DeCS (Descriptores en Ciencias de la Salud, created past BIREME, Latin American and Caribbean Center of Information in Wellness Sciences). Afterwards, in order to complement the search, the costless descriptors "Nursing Prototype" and "Clients" were added. The search strategy applied systematically combining the Boolean operators with the aforementioned descriptors was (("Nursing" AND "Social perception") AND ("patients" OR "population")). The search was repeated incorporating the aforementioned descriptor "Nursing Image", instead of "Nursing" AND "Social perception", defining the following search strategy: (("Nursing Epitome)" AND ("patients" OR "population")). Finally, the costless term "client" was included with the Boolean "OR" together with the residuum of the terms mentioned, defining the post-obit strategies:

✓: (("Nursing" AND "Social perception") AND ("patients" OR "clients" OR "population"))
✓: (("Nursing Image") AND ("patients" OR "clients" OR "population"))

The inclusion criteria were as follows:

✓: Original or review articles showing studies of a quantitative or qualitative nature, including literature reviews, that aim to identify and/or describe the image or possible stereotypes regarding the Nursing Profession.
✓: Studies of any of the described methodologies whose purpose is to describe what nurses do, which addresses the point of view of the general population, whether or not they take had experiences with wellness care; the perception of wellness professionals and/or nursing students, as well as the cocky-paradigm of the Nursing Profession.
✓: Year of publication (2010–2020): The search was prefixed in the last 10 years to focus on the most current image of the profession and to non include studies that may get results that are biased past the more historical vision of the profession.
✓: Language (Spanish or English).
✓: Access to the abstracts and full text.

On the other hand, the exclusion criteria were the following:

✓: Repeated manufactures
✓: Not having access to the full text
✓: Studies that were not related to the objective.

Two reviewers carried out the search strategy in the selected databases, applying the pre-established inclusion and exclusion criteria separately, consenting to the documents to be included in the review in a 2nd stage.

For the analysis of the contents of the selected articles, the full texts were obtained and following the standardized guidelines for integrative reviews [30,31] were undertaken in duplication and separately, collecting the variables of authorship, study methods, bias risks, intervention and comparison groups (if pertinent), results obtained and the main conclusions. The data extracted simultaneously by the two researchers were afterwards compared and completed between each other, in such a way that, after this joint analysis, manufactures were discarded in which it was mutually agreed and confirmed that at least 1 inclusion or exclusion criterion was non met.

Post-obit the PRISMA recommendations [32], the gamble of bias of the included studies was assessed past evaluating the methods followed in the articles. Quality appraisal was performed to select merely the highest quality papers, in social club to obtain the virtually reliable results and to identify the strengths and weaknesses of the selected articles, that could compromise the validity of the present review results [33]. For the evaluation of the methodological quality of the manufactures, the cess tool for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was applied [34]. For qualitative studies, Standards for Reporting Qualitative Research (SRQR) [35] was used and finally, in case of Literature Reviews, PRISMA 2020 checklist argument was practical in lodge to assess the quality of the papers [32].

The purpose of these appraisal tools was to assess the methodological quality of a written report and to decide the extent to which a report has addressed the possibility of bias in its design, development and analysis. It consists of the application of different checklists that can be assessed as "yes", "no", "unclear" or "non applicable". The results of this appraisal were used to inform synthesis and interpretation of the results of the studies reviewed. The research team agreed to include articles that obtained one item scoring "no" and one particular scoring "unclear" at most. Two studies out of the 19 papers included in the methodological quality appraisal were excluded considering they obtained a negative assessment in two items or more. Two researchers assessed the papers independently and agreed on the conclusions past consensus. For the data extraction process, a information extraction class was developed prior to including the variables to exist collected. These variables were stated past the inquiry team to answer the research question and meet the aim of this review. The variables were authorship, year of publication, country, aim of the study, report population, written report methods, results, outcomes, and conclusions. Data was extracted simultaneously from primary research selected papers by two researchers. The two information extraction forms obtained were compared, and they completed each other. The data obtained was analyzed, and a narrative synthesis was carried out describing the results [36].

3. Results

Following the described methodology, a full of 17 articles were finally selected. The flow diagram of the information through the different phases of the review, can be seen in Figure 1.

Selected papers mostly correspond to studies conducted in Kingdom of spain (due north = seven) [1,20,37,38,39,40,41], only studies conducted in Argentina (n = 2) [42,43], Iran (n = 2) [44,45], Egypt (northward = 2) [46,47] were included and too from the Great britain (n = 1) [9], Venezuela (n = i) [48], Turkey (n = 1) [49] and Australia (n = i) [seven]. The vast majority of the articles (n = 10) showed the results of quantitative descriptive studies through surveys of different population groups (professionals, nursing students and general population) [7,20,37,38,43,44,46,47,48,49] and some of them (n = 5) were qualitative studies through key informants (professionals, nursing students and/or patients) [1,9,38,42,45]. A literature review [40] and a mixed study that carried out a review of the literature combining a qualitative analysis of the press were included as well [41].

In this way, main results of the review are shown beneath, nerveless in Tabular array 1, including the authors, country and year of publication; general objective, methodology and primary results.

4. Give-and-take

In the literature reviewed, the characteristic of humanization as an indispensable and inherent element predominates, vocation beingness the fundamental nucleus in the nurses' image, because it as a requirement of the profession [1,37,43]. In this fashion, the value attributed to the preparation of the Nursing professionals derives more from their interpersonal skills than from their technical or critical thinking skills. In other words, greater importance is attributed to the fact that characteristics such as kindness and closeness are present in the Nursing personnel than to nurses having undergone good training at the scientific level [1,37,49].

Another aspect to be noted is the duality between the Nursing students' cocky-prototype and the external epitome of the Nursing Profession in a fashion that it does not coincide with the one held by the Nursing professionals themselves. Society has incorrect information about the functions performed by the Nursing professionals, which is based on myths and stereotypes that exert a negative influence on the image of the Nursing subject, which, among other things, favors that part of the population follows the Nursing guidelines only after contrasting them with the medical professional or, as volition be mentioned afterward, that the number of students choosing Nursing for their university studies is reduced [9,37,45,48].

Given the lack of knowledge amid the population regarding the competences of Nursing, its professionals are oftentimes mistaken for the residual of the health personnel [ane,20,forty]. In improver, the ATS (Technical Health Assistant) and nurse practitioner denominations persist to a sure extent to refer to the Nursing professionals, thus reinforcing an erroneous paradigm of the profession [1,37]. The aforementioned happens with the terms "parastar" and "nurse", which are used in Islamic republic of iran and in English-speaking countries, respectively, to designate whatsoever person that is in charge of providing any kind of care, either in a hospital or at homes (Nursing administration, people responsible for the domicile intendance of children or older adults…). Consequently, by using these terms, reference is fabricated both to the Nursing professionals and to individuals with express or no training. Therefore, using such terms to refer to Nursing lacks professionalism and exerts a negative influence on the public image [45]. Most of the population knows that Nursing is a university course, simply they rank it behind Medicine regarding its social importance [20,37].

Among the competences attributed to the Nursing Profession past part of the population, helping the medical professionals stand out in the commencement identify. They mainly attribute female and male nurses' activities targeted at providing medical treatments. They too define nurses as those people who are responsible for assisting the patients, without making any reference to the human action of caring in nearly of the cases, this act beingness understood as the essence of the Nursing Profession. On the other hand, gild is unaware of the independent or autonomous functions of the Nursing professionals [1,20,49].

Regarding the view of the Nursing Profession by the rest of the health personnel, information technology is to exist noted that the Nursing and Medical professionals testify hierarchical and vertical relationships; in addition, the latter deny the autonomy and specificity of Nursing, since those who practise the medical profession assert that the function of the Nursing professionals is to follow their indications. Consequently, there is tension in the definition of the function betwixt the one supposed by the biomedical model and that prescribed by Nursing. Conversely, the relationships are horizontal with the residue of the health professionals, attributing more recognition and value to the Nursing work [42,43].

On the other paw, regarding the Nursing students, in a study conducted in Spain by Albar and Sivianes-Fernández [39], the students attending offset year acknowledge the functions of the Nursing professionals in health recovery through care and assistance, likewise every bit by performing techniques such as measuring blood force per unit area. All the same, they are unaware of the democratic role of the Nursing Profession. Based on this, it tin can be asserted that, at the beginning, the students accept an image of the profession that is like to the one present in the full general population, for non having had direct contact with the performance of the Nursing competences. Regarding the students attending 4th year, they highlight wellness promotion and disease prevention as functions of Nursing, in improver to health recovery. Fourth-yr students also make reference to the Nursing professionals and to their competences through assistance, research, pedagogy, management, health care and promotion, and disease prevention, highlighting the post-obit characteristics: empathy, scientific knowledge, autonomy, and the importance of knowing how to piece of work as a team. On the other hand, similar results are observed in a study conducted in Venezuela by Restrepo, Roberti and Zambrano [48]. Consequently, the students attention the get-go semester indicated the provision of specific and direct care to the users focusing only on the disease process as the most important function of the Nursing Profession. However, the students attending the tenth semester pointed out that the virtually important functions of the nurses are to prevent diseases in school centers, industries, child circles and the community, thus acknowledging the of import work of the Nursing Profession every bit an educator in health, across pathological processes and the infirmary setting. In view of all of the above, a positive development of the Nursing students' self-perception regarding their epitome throughout the educational procedure has been discovered, since at the first, they beginning their studies with a perception that is similar to that of the public stance of the profession and they gradually go to know the discipline meliorate, constructing a self-image that is more than in accordance with its reality [39,45,46,48].

Male and female Nursing professionals show a common self-image, which, as already mentioned, is centered on intendance, which must be comprehensive and holistic [42]. Consequently, the terms used by the very individuals who exercise the Nursing Profession to refer to the benefits of being a nurse are diversity, privilege and compliance. Nursing professionals feel privileged of beingness present in all the important moments of people' lives and consider themselves indispensable in the wellness system where they piece of work since, without their performance, it would be impossible for that system to progress. The Nursing collective too feels privileged of being those who remain longest with the patients and, in addition, they are the kickoff professionals who come into contact with the users when they arrive at the health institution. The Nursing professionals consider it negative that, to construct the social prototype of the profession, their own Nursing functions are related to unpleasant situations or to stress and believe that, amongst other factors, the conception that still persists in society nigh the Nursing Profession is a consequence of its image throughout history, likewise equally of the behavior of the Nursing professionals themselves since, in numerous occasions, they minimize their importance in the organization and practise not intervene to improve their paradigm [9,44,45,47].

The social image of Nursing is blurred and certain gender stereotypes well-nigh the Nursing Profession and its functions withal persist [1,38]. However, predominantly in all the groups, Nursing is considered equally a profession that tin be practiced both by men and by women [44,45,48]. Therefore, a less stereotyped perception than some years ago is observed [39], even with one of the studies constitute making reference to certain masculinization accepted by the population, qualifying the care provided past male nurses as first-class [20]. All of the above contrasts another written report found which addresses the image of Nursing in the population from the perspective of Iranian male nurses, since the study makes a reference to a feminized Nursing Profession, which, alongside with the social conception of Nursing equally subordinated to the medical effigy, results in a minimal percentage of men working in the profession. However, information technology is worth noting that, although the Iranian male nurses abet that the Nursing Profession tin can be practiced in an adequate style both by men and women, they intend to solve the gender outcome by performing their functions in the scopes of management, armed forces, and in the emergency and intensive care services, because they believe that male Nursing professionals are more appropriate in services where more than speed, loftier technology and less contact are required. On the other hand, they consider that female nurses are more than qualified to develop their competences in the areas of pediatrics, maternity and customs health [45].

In its turn, the image of Nursing in the most renowned communication media frequently reflects stereotypes that are degrading for the profession; for that reason, the Nursing professionals consider it a gene that exerts a negative influence on the construction of the social epitome of the Nursing Profession [twoscore]. Consequently, it is spoken of a distorted image of Nursing, since the Nursing collective is shown in a negative manner because its skills are not reflected, whereas the medical professionals are portrayed in a positive way [7,9,45,46,47].

In summary and in society to respond to the proposed objectives, the reviewed bibliography on the image of nursing has contributed, as main findings, several approaches:

Humanization and vocation as a requirement of Nursing Profession, since the reviewed bibliography largely emphasizes this aspect.
The duality between the internal and external image of the Nursing Profession. This includes the analysis that the revised bibliography carries out of the different images that are perceived of the Nursing Profession from different perspectives (population, health professionals, nursing students...) and also the analysis of the self-prototype of the professionals of nursing.
The strong component related to gender stereotypes in the Nursing Profession, very nowadays in the findings of the reviewed bibliography.
The Nursing Profession in the media, which sometimes offers a distorted image, generating an erroneous vision of nursing that is highly accentuated in the technical component of the profession and in stereotypes.

In any case, some limitations in the review that could influence results that practise non have a high level of validity should be highlighted. In fact, the external validity was non measured, because the setting and nature of the studies differed, for case, designs (quantitative descriptive designs, qualitative designs, even literature reviews), cultural contexts, characteristics of participants, and and so on; sometimes with difficulties to compare their findings, hence undermining external validity.

A search was non performed on grayness literature pages or secondary sources. This can lead to increased publication bias, considering this sort of analysis virtually social prototype could even be expected to be published in this sort of literature. It should also be noted that in the selection criteria, in order to facilitate the assay, some limitations take been established, such as limitations by linguistic communication or by dates, which may have led to the loss of interesting information for the analysis and conclusions of this review.

5. Conclusions

In a full general way, it can be asserted that Nursing is a deeply unknown and invisible profession, because society withal does not acknowledge its competence, autonomy and independence. Consequently, certain duality predominates betwixt the cocky-image of those who exercise the Nursing Profession and its external image. For that reason, it is considered fundamental that the Nursing professionals reflect on what they are and on what they want to exist and to convey. In addition, it is crucial that they proclaim their competences so that the population is aware of all that they can offer considering, otherwise, order volition inappreciably identify their essence.

On the other hand, it can be asserted that at that place is certain inconsistency between the high levels of training attained, and the real recognition and status of the profession. Consequently, and so that the image of the Nursing Profession is more in accordance with reality, professional person progress must continue. To such end, encouraging the strengthening of autonomy, identity, status, the cribbing of the knowledge corpus, and the struggle to defend unionization must be the urgent commitment to achieve greater social recognition. Consequently, information technology is of import to devise dissimilar proposals aiming at strengthening all the dimensions that need improvement so every bit to raise positioning and to allow that the image of Nursing in social club is adjusted to reality.

Therefore, it is fundamental that the Nursing professionals reflect on what they have conquered and on the situation in which they are, so as to fairly define what they are and what they want to be, projecting information technology to lodge to give visibility to their essence.

Author Contributions

Conceptualization, F.J.L.-N. and M.50.-Five.; methodology, J.A.P.-B.; validation, J.A.P.-B. and M.D.G.-M.; formal analysis, 1000.L.-5.; investigation, F.J.L.-N. and One thousand.L.-Five.; resources, R.R.-C.; information curation, One thousand.L.-Five.; writing—original typhoon training, M.Fifty.-V. and J.A.P.-B.; writing—review and editing, R.R.-C.; supervision, F.J.L.-Due north. and J.A.P.-B.; project administration, G.D.G.-M. and J.A.P.-B. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Non applicable.

Informed Consent Statement

Not applicable.

Conflicts of Interest

The authors declare no conflict of interest.

References

De Nova de la Mata, Fifty.; Vargas-Machuca Guerrero, F.A. Percepciones de los pacientes sobre la enfermera y su trabajo. Estudio cualitativo en un hospital de Sevilla. In Investigación Y Género, Logros Y Retos. Three Congreso Universitario Nacional Investigación Y Género; Universidad de Sevilla: Sevilla, Espana, 2011; pp. 448–476. [Google Scholar]
Romero-Martín, M.; Gómez-Salgado, J.; Robles-Romero, J.M.; Jiménez-Picón, N.; Gómez-Urquiza, J.L.; Ponce-Blandón, J.A. Systematic review of the nature of nursing care described by using the Caring Behaviours Inventory. J. Clin. Nurs. 2019, 28, 3734–3746. [Google Scholar] [CrossRef]
Romero-Martín, M.; Ponce-Blandón, J.A.; Gómez-Salgado, J. El cuidado expresado en los comportamientos enfermeros desde la perspectiva de los profesionales y de los pacientes. Rol. Enferm. 2019, 42, 368–376. [Google Scholar]
García Bañón, A.M.; Sainz Otero, A.; Botella Rodríguez, M. La Enfermería Vista Desde el Género. Index de Enfermería 2004, 13, 45–48. [Google Scholar] [CrossRef]
Burguete Ramos, K.D.; Martínez-Riera, J.R.; Martín González, G. Actitudes de Género y Estereotipos en Enfermería. Cult. Cuid. 2010, 28, 39–48. [Google Scholar] [CrossRef]
Bernalte Martí, V. Minoría de hombres en la profesión de enfermería. Reflexiones sobre su historia, imagen y evolución en España. Enferm. Glob. 2014, xiv, 328–334. Bachelor online: https://revistas.um.es/eglobal/article/view/eglobal.fourteen.1.198631 (accessed on 10 October 2020). [CrossRef]
Weaver, R.; Salamonson, Y.; Koch, J.; Jackson, D. Nursing on goggle box: Student perceptions of idiot box's role in public image, recruitment and instruction. J. Adv. Nurs. 2013, 69, 2635–2643. [Google Scholar] [CrossRef]
Calvo Calvo, M.Á. Imagen Social de Las Enfermeras Y Estrategias de Comunicación Pública Para Conseguir Una Imagen Positiva. Alphabetize Enfermería Scieloes 2011, 20, 184–188. [Google Scholar] [CrossRef]
Morris-Thompson, T.; Sherpherd, J.; Plata, R.; Marks-Maran, D.I. Diverseness, fulfilment and privilege: The paradigm of nursing. J. Nurs. Manag. 2011, xix, 683–692. [Google Scholar] [CrossRef] [PubMed]
Solano López, A.Fifty. Imagen social de la enfermería en Costa Rica y su construcción desde la autoimagen profesional. Enferm. Costa Rica 2012, 33, 54–56. [Google Scholar]
Arreciado, A. Identidad Profesional Enfermera Construcción y Desarrollo en los Estudiantes Durante su Formación Universitaria. 2014. Available online: http://www.tdx.true cat/handle/10803/129270%0Ahttp://hdl.handle.internet/2445/49181 (accessed on 15 October 2020).
Robledo, J.; Younis, J. El papel de los medios de comunicación en los Procesos de la construcción de la realidad y sus implicaciones en la intervención social. In Ponencia Marco, Área de Medios de Comunicación Four Jornadas de Intervención Social; Colegio Oficial de Psicólogos: Madrid, Spain, 1994. [Google Scholar]
Gómez-Serrano, C.; Munar-Olaya, C. Albores de la enfermería profesional en Colombia. Temperamentum 2009, five, ix. [Google Scholar]
González Carrillo, East.; Arras Vota, A.M.; Moriel Corral, L. La profesionalización en enfermería: Hacia una estrategia de cambio. Tecnociencia 2012, 6, 1–8. [Google Scholar]
Zamorano Pabón, I.C. Gestión en equipo de enfermería. Investig. Educ. Enferm. 2008, 26, 168–171. Bachelor online: http://www.redalyc.org/articulo.oa?id=105215278017%0Acómo (accessed on eighteen October 2020).
Errasti-Ibarrondo, B.; Arantzamendi-Solabarrieta, M.; Canga-Armayor, N. La Imagen Social de la Enfermería: Una Profesión a Conocer. An. Sist. Sanit. Navar. Scieloes 2012, 35, 269–283. [Google Scholar] [CrossRef] [PubMed]
Heierle Valero, C. La Imagen de la Enfermera a Través de los Medios de Comunicación de Masas: La Prensa Escrita. Alphabetize Enfermería Scieloes 2009, xviii, 95–98. [Google Scholar] [CrossRef]
Remirez Suberbiola, J.M.; Pereda Arregui, East.; Delgado Aguilar, H.; Delgado Aguilar, M.J. Enfermería y futuro: Su evolución, ¿credibilidad? Asoc. Española Enfermería Urol. 2010, 113, 15–18. [Google Scholar]
Velázquez, A.S.; Carmen, M.; Aliste, Á. Título: Invisibilidad Enfermera: Una Realidad a Combatir. La Raíz Los Cuid Enfermeros 2014. Available online: world wide web.fabulacongress.es/certamenraquel/.../InvisibilidadEnfermera.pdf (accessed on 1 November 2020).
Muñoz Cruz, R.; Consuegra Alférez, M.D. Imagen social de la enfermería en una población no sanitaria de la ciudad de Madrid. Nuberos Científca 2015, 2, xv–nineteen. Bachelor online: http://nc.enfermeriacantabria.com/alphabetize.php/nc/article/viewFile/3/3 (accessed on 15 November 2020).
Santa Clotilde Jiménez, E.; Casado del Olmo, G.; Fernández Araque, A.Thousand. Opinión de los usuarios sobre la profesión y el trabajo desarrollado por los profesionales enfermeros. Bibl. Lascasas. 2006, 2, 1–23. Bachelor online: http://www.index-f.com/lascasas/documentos/lc0188.pdf (accessed on 21 November 2020).
Guerra-Martín, G.D.; Cano-Orihuela, A.; Martos-García, R.; Ponce-Blandón, J.A. Translation and First Airplane pilot Validation Report of the "Undergraduate Nursing Educatee Academic Satisfaction Scale" Questionnaire to the Spanish Context. Int. J. Environ. Res. Public Health 2021, 18, 423. [Google Scholar] [CrossRef]
Romero-Martín, M.; Gómez-Salgado, J.; de la Fuente-Ginés, M.; Macías-Seda, J.; García-Díaz, A.; Ponce-Blandón, J.A. Assessment of reliability and validity of the Spanish version of the Nursing Students' Perception of Teacher Caring (Southward-NSPIC). PLoS Ane 2019, 14, e0212803. [Google Scholar] [CrossRef]
Rezaei-Adaryani, M.; Salsali, K.; Mohammadi, Eastward. Nursing epitome: An evolutionary concept analysis. Contemp. Nurs. 2012, 43, 81–89. [Google Scholar] [CrossRef] [PubMed]
García-Carpintero Blas, Eastward. Reflexión del papel de la enfermería a lo largo de la historia. Enferm. Glob. Rev. Electrónica Semest. Enferm. 2007, 6, 26. [Google Scholar]
Organización Mundial de la Salud. Reglamento Sanitario Internacional 2005; WHO: Geneva, Switzerland, 2005; p. 104. [Google Scholar]
Vilchez Barboza, V.; Sanhueza Alvarado, O. Enfermería: Una disciplina social. Enferm. Costa Rica 2011, 32, 81–88. Available online: https://www.binasss.sa.cr/revistas/enfermeria/v32n2/art6.pdf (accessed on 23 November 2020).
Willis, D.G.; Grace, P.J.; Roy, C. A Central Unifying Focus for the Discipline: Facilitating Humanization, Meaning, Choice, Quality of Life, and Healing in Living and Dying. Adv. Nurs. Sci. 2008, 31. Available online: https://journals.lww.com/advancesinnursingscience/Fulltext/2008/01000/A_Central_Unifying_Focus_for_the_Discipline_.12.aspx (accessed on 28 November 2020). [CrossRef]
Martínez Díaz, J.D.; Ortega Chacón, V.; Muñoz Ronda, F.J. Blueprint of clinical questions in show-based practice. Formulation models. Enferm. Glob. 2016, 15, 431–438. [Google Scholar] [CrossRef]
Coughlan, Thou.; Ryan, F.; Cronin, P. Doing a Literature Review in Nursing, Health and Social Care; SAGE: Los Angeles, CA, U.s.a., 2013. [Google Scholar]
Whittemore, R.; Chao, A.; Jang, M.; Minges, Grand.East.; Park, C. Methods for cognition synthesis: An overview. Hear Lung J. Cardiopulm. Acute Care 2014, 43, 453–461. [Google Scholar] [CrossRef]
Folio, Grand.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, Southward.E.; et al. The PRISMA 2020 argument: An updated guideline for reporting systematic reviews. PLoS Med. 2021, 18, e1003583. [Google Scholar] [CrossRef] [PubMed]
Porritt, K.; Gomersall, J.; Lockwood, C. JBI'south Systematic Reviews: Study choice and disquisitional appraisal. Am. J. Nurs. 2014, 114, 47–52. [Google Scholar] [CrossRef] [PubMed]
Von Elm, Due east.; Altman, D.G.; Egger, Yard.; Pocock, S.J.; Gøtzsche, P.C.; Vandenbroucke, J.P.; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Lancet 2007, 370, 1453–1457. [Google Scholar] [CrossRef]
O'Brien, B.C.; Harris, I.B.; Beckman, T.J.; Reed, D.A.; Cook, D.A. Standards for reporting qualitative research: A synthesis of recommendations. Acad. Med. 2014, 89, 1245–1251. [Google Scholar] [CrossRef]
Tricco, A.C.; Tetzlaff, J.; Moher, D. The art and scientific discipline of knowledge synthesis. J. Clin. Epidemiol. 2011, 64, eleven–20. [Google Scholar] [CrossRef] [PubMed]
Rodríguez Porcel, Grand.D.; Rodríguez, M.D.One thousand.; Tortosa Salazar, V. ¿Cómo nos ven los usuarios a los profesionales de enfermería? Imagen. Soc. Rev. Paraninfo. Digit. 2015, 9, 22. [Google Scholar]
Aranda, Thousand.; Del Castillo-Mayén, Chiliad.R.; Montes-Berges, B. ¿Ha cambiado la percepción sobre los y las enfermeras? atribución de estereotipos y roles de género? [Has the traditional social perception on nurses changed? Attribution of stereotypes and gender roles?]. Acción Psicológica 2015, 12, 103–112. [Google Scholar] [CrossRef]
Albar, M.J.; Sivianes-Fernández, One thousand. Percepción de la identidad profesional de la enfermería en el alumnado del grado. Enferm. Clin. 2016, 26, 194–198. [Google Scholar] [CrossRef]
Baldrich-Rodríguez, I.; Navarro-Revueltas, C.; Lázaro-Maeso, Á. Imagen de la enfermería en la sociedad española y medios de comunicación = Nursing image in the Spanish society and media. Rev. Española Comun. En Salud. 2016, 7, 310–323. [Google Scholar] [CrossRef]
Sánchez-Gras, Due south. Imagen de la enfermería a través de la prensa escrita ¿necesitamos visibilizar los cuidados enfermeros? Cult. Los. Cuid. 2017, 21, 74–lxxx. [Google Scholar] [CrossRef]
Samaniego, C.; Frakel, D. La imagen profesional de enfermería en su contexto de trabajo. Hologramática 2011, 14, 59–92. Bachelor online: http://dialnet.unirioja.es/servlet/articulo?codigo=3728794&info=resumen&idioma=ENG (accessed on three December 2020).
Samaniego, Five.C.; Cárcamo, S. The nursing imagen and professional identity. The future of a construction. Invest Educ. Enferm. 2013, 31, 54–62. [Google Scholar]
Varaei, S.; Vaismoradi, Grand.; Jasper, M.; Faghihzadeh, S. Iranian nurses self-perception–factors influencing nursing image. J. Nurs. Manag. 2012, 20, 551–560. [Google Scholar] [CrossRef] [PubMed]
Valizadeh, Fifty.; Zamanzadeh, V.; Fooladi, K.M.; Azadi, A.; Negarandeh, R.; Monadi, M. The image of nursing, as perceived past Iranian male nurses. Nurs. Wellness Sci. 2014, 16, 307–313. [Google Scholar] [CrossRef] [PubMed]
El Rahman, R.M.A.; Shousha, A.A.E.F.A. Perceptions of the Public Paradigm of Nursing amid Baccalaureate Nursing Students. Life Sci. J. 2013, ten, 1061–1071. [Google Scholar]
Abdelrahman, S. Relationship among public nursing image, cocky-image, and self-esteem of nurses. Nurs. Health Sci. 2018, 7, 10–16. Bachelor online: https://www.researchgate.net/publication/323605325_Relationship_among_public_nursing_image_self-image_and_self-esteem_of_nurses (accessed on xv Dec 2020).
Restrepo, 50.; Roberti, J.A.; Zambrano, N.Southward. Percepción de la imagen social de enfermería entre los estudiantes del Programa de Enfermería Decanato de Medicina UCLA I lapso 2005. Revista EDUCARE UPEL-IPB Segunda Nueva Etapa 2015, 11. Available online: https://revistas.investigacion-upelipb.com/index.php/educare/article/view/332 (accessed on 18 December 2020).
Keçeci, A.; Çelik Durmuş, S.; Oruç, D.; Öner Kapisiz, Ö. The Society'south View of Nursing in Turkey. Hosp. Top. 2014, 92, 36–43. [Google Scholar] [CrossRef] [PubMed]

Figure 1. Flow diagram of the integrative review.

Nursrep 11 00043 g001

Table 1. Results of the review.

Table ane. Results of the review.

Authors, Country (yr)	General Objective	Method	Sample	Main Results
Restrepo, L., Roberti, JA. and Zambrano, N. Venezuela. (2015) [48]	To determine the perception of the social image of the Nursing Profession in Nursing students.	Cross-sectional and descriptive study. Structured questionnaire with 10 items.	Sample of 143 Venezuelan Nursing students attention the first, 7th and tenth semesters.	The students attending the first semester state that the well-nigh important function of Nursing is that of providing specific and direct care to the users based on their needs and bug. The students attending the tenth semester consider that the nigh important function of female and male person nurses is to forbid diseases in school centers, industries, child circles, and the community. The social paradigm of the profession does not correspond to the i they have.
Samaniego, C., Cárcamo, Due south. and Frankel, D. Argentina. (2011) [42]	To know the current social epitome of Nursing in the work context of different public and private hospitals.	Qualitative study.	Sample of 55 individuals, interviewed with open questions. (21 Nursing professionals, 21 professionals from other wellness areas, and thirteen users of the Argentinian wellness system).	Hierarchical and vertical relationships appear with the physicians; in addition, these professionals deny the autonomy and specificity of Nursing. Tension in the definition of the office between the ane supposed by the biomedical model and that prescribed past Nursing. The relationships are horizontal with the rest of the wellness professionals, greater recognition and appreciation existence given to the Nursing Profession. They agree in that comprehensive and holistic care is the essence of the Nursing Profession.
De Nova, L. and Vargas-Machuca, FA. Spain. (2011) [1]	To explore the social prototype that the patients accept of Nursing, then as to deepen on their perception of the nurses and of the functions they perform.	Qualitative study. Semi-structured interviews	Targeted at 15 patients in the Virgen Macarena University Hospital of Seville, Espana, belonging to the Andalusian public health system.	The nurses' participation is more valued in view of their interpersonal skills than due to their technical or critical thinking skills. Blurred social image, in which gender stereotypes persist. Nurses are mistaken for other health professionals and the work they perform is ignored. The Technical Wellness Banana (Asistente Técnico Sanitario, ATS) denomination persists to refer to the Nursing professionals. Virtually of the interviewees answered that the Nursing duty is "to assist the patients".
Morris-Thompson, T., Shepherd, J., Plata, R. and Marks-Maran, D. Britain. (2011) [9]	To explore the image that the Nursing collective has nigh its profession and the population'due south perception of Nursing.	Qualitative study. Information technology is conducted through focus groups and interviews.	Sample of 159 individuals: nurses who work in London, United kingdom of great britain and northern ireland, likewise equally with the participation of the population in general.	The population is misinformed about the functions performed by the Nursing professionals. The image they have is based on myths and stereotypes. The cocky-image of Nursing can be described with the post-obit words: diversity, privilege and compliance, since they are the principal terms with which they define the benefits of being a nurse. Invisibility or distorted project of Nursing in the communication media every bit a bulwark to perceive a existent paradigm of the profession. The perception held by the Nursing professionals does not coincide with the ane present in society.
Varaei, S., Vaismoradi, Yard., Jasper, M. and Faghihzadeh, S. Iran. (2012) [44]	To depict the nurses' perception with respect to the factors influencing their public image.	Descriptive report conducted with a questionnaire.	Participation of 220 Iranian female and male nurses.	They consider it positive that the population attributes Nursing the part of providing care or comfort during a affliction process. They consider information technology negative that the Nursing piece of work is associated with unpleasant situations or stress. Nursing as a profession targeted both at men and women.
Samaniego, C. and Cárcamo, Due south. Argentina. (2013) [43]	To describe the paradigm that the nurses, the medical collective, and the rest of the health professionals take about the Nursing professionals.	Descriptive study. Questionnaires with multiple-choice airtight questions were used.	Sample of 308 participants (100 female and male nurses, 103 medical professionals, and 105 professionals from other areas) from Buenos Aires, Argentina.	Overload and conflicts in the working group are more than frequent amidst the Nursing personnel. Discrepancies between what the nurses consider as their 'specific functions' and the opinion of the other health professionals. For the Nursing personnel and other wellness professionals, the nurses' functions are centered on care. Yet, the physicians merits that the function of Nursing is to follow their indications. There is tension between the function prescribed by the medical model and the one defined by Nursing.
Weaver, R., Salamonson, Y., Koch, J. and Jackson, D. Australia. (2013) [7]	To explore the perception held by the Nursing students regarding how the profession is represented in health-related TV programs.	Quantitative study.	Sample of 484 Nursing students from New S Wales, Australia.	The students are aware that telly can exist a negative influence for the prototype of Nursing, but they also acknowledge some of its educational values. They assert that the medical professionals are shown in a positive manner, whereas the Nursing collective is portrayed negatively, because their skills are not shown.
El Rahman, R.Thou.A. and Abou Shousha, A.A.E.F. Egypt. (2013) [46]	To investigate the perception held by the Nursing students from Damanhour, Egypt, about the public prototype of the profession.	A quantitative-descriptive study through a questionnaire.	Participants were 904 students attention each of the four undergraduate years and the practise year of the Nursing class	The information obtained near Nursing earlier starting their preparation comes from family unit members and friends in the first place, followed by the communication media. They show an improvement in the perception of the Nursing paradigm afterward starting their academy studies, mainly due to the working weather, to their family members' opinions, and to the influence of the kinesthesia.
Valizadeh, Fifty., Zamanzadeh, 5., Fooladi, MM., Azadi, A., Negarandeh, R. and Monadi, M. Iran. (2014) [45]	To explore how male person nurses perceive the public paradigm of Nursing and their self-perception.	Qualitative-descriptive written report. The report will be conducted by means of semi-structured interviews.	The sample consists of 18 male nurses working in the Tabriz Hospital, Islamic republic of iran.	The participants stated that the most important cistron that makes information technology hard for men wishing to become nurses is the public image of the profession equally female person and subordinated to the physician. They believe that the public image of the profession is influenced by the nurses' beliefs and by the epitome of the Nursing Profession throughout history. They assert that the communication media, every bit well as the gender stereotypes transmitted by the educational organization, exert a negative influence on the public image of the profession. Information technology can be asserted that the public image of Nursing does not coincide with the professionals' cocky-image.
Keçeci, A., Celik Durmuş, S., Oruç, D. and Öner Kapisiz, O. Turkey. (2014) [49]	To determine the population'south perception regarding the competences of the Nursing Profession.	Descriptive report.	The written report population is made up of 458 individuals from the Merket District, Düzce, Turkey	The population thinks that the work of female nurses is mainly to support the physicians. They associate Nursing mainly with activities targeted at providing medical treatments. The independent or democratic functions of Nursing are non correctly understood past gild. They assert that nurses simply possess good interpersonal skills and claim that the hereafter Nursing professionals must too be qualified.
Rodríguez, Physician., Rodríguez, MM. and Tortosa, Five. Spain. (2015) [37]	To know the social image that the population has nearly the Nursing professionals.	Cantankerous-exclusive and descriptive study.	Sample of 119 individuals from Almería (Spain)	Most of the population asserts that the nurses have their own functions and show respect for the commonage. Regarding social importance, they rank Nursing backside medicine and teaching. The majority knows that Nursing is a university course. The ATS (Technical Wellness Banana) and nurse practitioner denominations remain present and, in some cases, they only follow the Nursing recommendations if they are contrasted with the medical figure.
Muñoz, R. and Consuegra, Dr.. Espana. (2015) [20]	To identify the social image of Nursing through the non-health population.	Cross-exclusive and descriptive study through a cocky-administered questionnaire.	Sample of 220 not-health individuals from Madrid	The general population prefers that there are Nursing professionals of both genders, and they authorize the care provided by male nurses as excellent. Administration of injectables and helping the physician every bit principal functions. Lack of knowledge nearly the functions performed by the nurses, but they show respect and admiration for these professionals, obtaining good appreciation. They rank the Nursing collective behind the physicians.
Aranda, M., Castillo-Mayén, MR. and Montes-Berges, B. Spain. (2015) [38]	To analyze if a traditional view of the Nursing profession still exists in relation to the stereotypes and gender roles attributed to male and female Nursing professionals.	Qualitative written report.	The participants were 12 patients, non-patients and Nursing students from the province of Jaén, Espana.	The gender stereotypes attributed to male person and female nurses nowadays some similarities; therefore, a less stereotyped perception than some years ago is observed. A traditional attribution of stereotypes and gender is thus shown betwixt male person and female Nursing professionals, even among the group of Nursing students.
Albar, MJ. and Sivianes-Fernández, M. Spain. (2015) [39]	To place the perception of the professional identity of Nursing in the students attending the start and fourth years of the undergraduate course.	Descriptive study. Survey with xiv items and two open questions.	Random sampling of fifty Nursing students attending outset year and 51 students from fourth year at the University of Seville.	Nigh of the students attending outset year acknowledge the role of Nursing in health recovery, and they are in disagreement with the autonomy of the profession. The students attending fourth year highlight health promotion and disease prevention, in add-on to health recovery, as functions of Nursing. They make references to assistance, enquiry, teaching, management, care and health promotion, and disease prevention, highlighting the following characteristics: empathy, scientific knowledge, autonomy, and the importance of knowing how to work as a team.
Baldrich Rodríguez, I., Navarro Revueltas, C. and Lázaro Maeso, A. Spain (2016) [xl]	To know what Nursing conveys or communicates to society in Spain, from the 20th to the 21st century.	Bibliographic review.		Stereotypes, preconceptions, medical subordination, unawareness of Nursing competences, and sexist image. Respect and adoration for the profession.
Sánchez Gras, Southward. Spain. (2017) [41]	To nowadays a critical and thorough analysis of the treatment given by the written press to the profession and to the Nursing professional	Bibliographic review and qualitative-belittling study using the news published in the regional and national written press where Nursing is mentioned as sources.		Secondary function associated with some other profession, with no responsibleness, autonomy or chapters in decision-making.
Mohamed Abdelrahman, S. Egypt. (2018) [47]	To place the relationship betwixt the social image of Nursing, self-image, and the Nursing professional'south self-esteem.	Descriptive report. 28-item survey that assesses the social image of Nursing.	320 female nurses who work in the Minia infirmary.	Positive correlation betwixt professional self-image and social image. Slightly positive correlation between social image and professional nurses' cocky-esteem. Negative correlation betwixt professional cocky-paradigm and female person nurses' cocky-esteem.

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