The public image of Italian nurses as perceived by different ethnic groups residing in Emilia Romagna, Italy

Abstract

Background: The image of nursing is a complex concept influenced by various social and cultural factors, often portrayed in a subordinate manner by the media and stereotypes. However, the COVID-19 pandemic has enhanced the image of nurses, increasing recognition of their value and improving their professional identity. Public perception of nurses influences job satisfaction, performance, and the profession's appeal to potential recruits/students/new graduates. Recent studies suggest the need to monitor and improve this image, particularly in response to social and political changes, to address the shortage of nursing staff. In the Emilia-Romagna region, there is a shortage of approximately 4200–4500 professionals to meet healthcare needs, and the local healthcare culture is strongly oriented toward collaboration, integration, and teamwork — elements that may pose adaptation challenges for professionals coming from regional contexts with more hierarchical and individualistic models. In Italy, studies have been conducted on the perception of the profession, but no research has specifically investigated how different ethnic groups evaluate the image of Italian nurses. This study aims to explore and analyse how the image of Italian nurses is perceived by various ethnic groups present in Italy. Methods: An observational study was conducted in northern Italy at cultural associations from February to September 2024. A total of 205 observations were collected. The sample consisted of 41.5% (n = 85) Europeans, 22.4% (n = 46) Africans, 22% (n = 45) Asians, 10.2% (n = 21) Americans, and 3.9% (n = 8) classified as ‘Other,’ referring to individuals of Oceanic and Antarctic origin. The instrument used was the validated Italian version of the Nursing Attitude Questionnaire (NAQ-IV). Results: Significant differences in perceptions were found among different populations. The overall score across the NAQ-IV domains, on a scale ranging from 30 to 150, indicated a more favourable perception of the profession in European settings, with a mean of 106.3 (SD = 18.77), and in American settings, with a mean of 106.4 (SD = 22.89), compared to the scores reported by Asian groups (mean = 82.5, SD = 22.2) and African groups (mean = 96.2, SD = 23.52). Cultural factors appear to play a key role. Conclusions: Overcoming stereotypes and enhancing nursing skills must become a priority to promote a more positive perception of the profession. Nurses’ behaviour should make the value of professional development more visible.