With the development of society and the continuous improvement of the healthcare system, the nursing profession is gradually crossing the gender barrier, and the number of male nurses is increasing, becoming an indispensable force in the field of nursing (Stanley et al., 2016). Relevant data show that the proportion of male nurses in the United States, Canada, Australia, and Europe ranges from 2% to 14% (Kellett et al., 2014; O’Connor, 2015), but in China it is less than 2% (Liang et al., 2023). This study was conducted in a tertiary care hospital in mainland China, where the local nursing profession is characterized by a significant gendered culture: nursing has traditionally been viewed as a “female-only profession” with a lower social status than that of the physician community, which has led to challenges in the identity of male nurses. Male nurses demonstrate unique advantages in terms of physical strength and emergency management (Chen et al., 2016; Peng et al., 2017), but they also face stereotypes and prejudices about gender roles from self, society, patients, and even peers (Dyck et al., 2009; Yang et al., 2004). Esinte's (2016) qualitative interviews with 15 male nurses about their professional experiences found that these male nurses generally reported that nursing was seen as a female-only profession with a low social status, which led to discrimination in their work. In addition, patients and their families often misperceived male nurses as careless and unskilled, and preferred female nurses for nursing care. The identity crisis has not only weakened the motivation of male nurses and increased the turnover rate, but also impeded the development of the nursing profession in the direction of diversification and specialization.

Identity has been understood as an individual's recognition of the identity of the group to which he or she belongs since the 1960s, when various cultural groups demanded recognition of their respective identities as the rights movements of groups such as homosexuals, minorities and feminists gained significant traction across European societies. Subsequently, it has been given different connotations and characteristics in many disciplinary fields, including philosophy, sociology, and psychology. Based on identity theory (Zhang et al., 2012), this study summarizes the concept of identity as the psychological journey of an individual's confirmation of self-identity and perception of the group to which he or she belongs, as well as the accompanying affective experience and integration of behavioral patterns, which is divided into two parts: self-identity and social identity (Zhang, 2010). Self-identity encompasses three aspects: the establishment of self-identity, the acquisition of a sense of self-belonging, and the pursuit of a sense of self-meaning; social identity refers to an individual's perceived self-image within the group to which he or she belongs, as well as the experience of emotions and values that he or she possesses as a member of the group (Tajfel & Turner, 1979). Based on this theoretical framework, male nurse identity refers to men's understanding and perception of their nurse identity in the nursing profession, as well as their acceptance and sense of belonging to the nursing professional group and culture to which they belong. However, the current study found that the male nurse in the Chinese healthcare environment identity problem is not optimistic, and it was found that male nurses are often reluctant to disclose their professional information to their friends or relatives, and seldom post nursing-related information on social platforms, what's more, male nurses try to choose departments in hospitals where they don't wear nurses' uniforms as a way of escaping from the image of nurses, which creates a more prominent identity crisis (G, X, & He, S., 2016; Zhou et al., 2021). Therefore, for male nurses, how to find self-positioning in the nursing profession and how to strike a balance between gender roles and professional roles is an issue that deserves in-depth discussion.

Identity issues have been emphasized in Western academia, resulting in a field of nontraditional professional male studies represented by male nurses (Gao, 2017). However, although there has been progress in some specific areas such as research on male nurse identity, overall, in-depth research and extensive development in this area still needs to be strengthened. Currently, research on male nurse identity is mostly phenomenological (Zhang, 2019), and is not carried out from the perspective of quantitative research, which, unfortunately, there is also a lack of assessment tools for male nurses. Existing instruments such as the Professional Identity in Nursing Scale focus on universal dimensions of nurses' professional identity (e.g., self-efficacy, organizational affiliation) (Landis et al., 2024a), and lack specific instruments for the male nurse population. More importantly, existing scales focus on individuals' perceptions and understandings of their professional roles, but fail to capture the broader and often gender-specific identity challenges that male nurses uniquely face, such as feeling isolated or marginalized within the profession, which impacts not only their professional identity but also their overall sense of self (Stanley et al., 2016). These limitations - lack of population specificity and inadequate multidimensional conceptualization of identity - highlight a fundamental gap: the lack of a theoretical framework that can address the complexity of male nurses' identities. Chen et al., (2024) developed the military identity scale based on identity theory, and its multidimensional structure provides insights into the potential multidimensional nature of male nurse identity based on identity theory. Consequently, there is a critical need to directly address the male nurse cohort and analyze the complexity of their multidimensional identity construction to address existing research gaps. It is imperative to develop a specialized identity measurement tool for male nurses, grounded in established identity theories (Zhang et al., 2012). This tool is crucial for comprehending their professional trajectories, uncovering fundamental barriers to cohesive integration within the profession, and ultimately enhancing workforce retention among male nurses. The development of an identity scale specifically for male nurses has far-reaching research and practical implications. The scale provides data that enable healthcare organizations to identify high-risk groups, design customized interventions (e.g., clinical expert mentoring, bias-mitigating training), and optimize retention strategies, thus providing critical support for building a diverse, resilient, and sustainable nursing workforce, especially in the context of the global nurse shortage. At the same time, enhancing male nurses' sense of identity is key to achieving more inclusive work environments and delivering high-quality care.

The purpose of this study was to develop and validate the Male Nurse Identity Scale.