Hastane Öncesi Acil Sağlık Hizmetlerinde Kadın Paramediklerin Çalışma Süreçlerinin İncelenmesi

Öz

Bu araştırma, hastane öncesi acil sağlık hizmetlerinde görevli kadın paramediklerin çalışma süreçlerine ilişkin deneyim ve algılarını nitel bir yaklaşımla incelemektedir. Çalışma, kadın paramediklerin vardiya planlaması, görev dağılımı, izin uygulamaları ve gebelik-doğum sonrası döneme yönelik kurumsal düzenlemeler hakkındaki algılarını ortaya koymayı amaçlamaktadır. Fenomenolojik desenle yürütülen araştırmada, sahada aktif çalışan 10 kadın paramedik ile yarı yapılandırılmış görüşmeler yapılmış ve veriler tematik analizle değerlendirilmiştir. Araştırma bulguları, gebelik ve doğum sonrası dönem, toplumsal cinsiyet algısı, sahadaki fiziksel ve güvenlik riskleri, iş–aile rol çatışması ve kurumsal destek algısı olmak üzere beş ana tema belirlemiştir. Bulgular, kadın paramediklerin sahada fiziksel iş yükü ve toplumsal cinsiyet temelli önyargılarla karşılaşabildiğini; ancak ekip içi dayanışma ve bazı durumlarda kadın sağlık personeline yönelik mahremiyet temelli hasta tercihinin süreci kolaylaştırabildiğini göstermektedir. Sonuç olarak, esnek çalışma düzenlemeleri ve toplumsal cinsiyete duyarlı kurumsal politikaların önemi vurgulanmaktadır.

Anahtar Kelimeler

• Acil Sağlık Hizmetleri
• Kadın Paramedikler
• Nitel Araştırma

Examination of the Working Processes of Female Paramedics in Pre-Hospital Emergency Medical Services

Öz

This study examines the experiences and perceptions of female paramedics working in pre-hospital emergency medical services regarding their work processes, using a qualitative approach. The study aims to reveal female paramedics’ perceptions of shift planning, task allocation, leave policies, and institutional arrangements relating to pregnancy and the postnatal period. Conducted using a phenomenological design, the study involved semi-structured interviews with 10 female paramedics currently working in the field, and the data were analysed using thematic analysis. The research findings identified five main themes: the pregnancy and postnatal period, perceptions of gender, physical and safety risks in the field, work–family role conflict, and perceptions of institutional support. The findings indicate that female paramedics may face physical workloads and gender-based biases in the field; however, they also suggest that team solidarity and, in some cases, patient preference for female healthcare staff based on privacy considerations can facilitate the process. Consequently, the importance of flexible working arrangements and gender-sensitive institutional policies is emphasised.

Anahtar Kelimeler

• Emergency Medical Services
• Female Paramedics
• Qualitative Research

Kaynakça

1. Alhomayani, K. M., Bukhary, H. A., Aljuaid, F. I., Alotaibi, T. A., Alqurashi, F. S., Althobaiti, K. N., Althobaiti, N. S., Althomali, O. Y., Althobaiti, A. A., Aljuaid, M. M., & Muhyei, A. M. (2025). Gender preferences in healthcare: A study of Saudi patients’ physician preferences. Patient Preference and Adherence, 19, 295–303. https://doi.org/10.2147/PPA.S494766
2. Alobaid, A. M., Gosling, C., McKenna, L., & Williams, B. (2022). Saudi female paramedics’ perceptions of challenges in the workplace: A qualitative study. International Emergency Nursing, 63, Makale 101176. https://doi.org/10.1016/j.ienj.2022.101176
3. Alshagraawi, S. A., Alanazi, B. G., Alobaidi, I. M., Alturki, N., & Kofi, M. (2022). Impact of shift work on sleep and the quality of life of healthcare workers in a tertiary hospital, Saudi Arabia. Journal of Family Medicine and Primary Care: Open Access, 6, 176. https://doi.org/10.29011/2688-7460.100076
4. Baltacı, A. (2018). Nitel araştırmalarda örnekleme yöntemleri ve örnek hacmi sorunsalı üzerine kavramsal bir inceleme. Bitlis Eren Üniversitesi Sosyal Bilimler Dergisi, 7, 231-274. https://izlik.org/JA98FN96XR
5. Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11, 589–597. https://doi.org/10.1080/2159676X.2019.1628806
6. Corchero-Falcón, M. d. R., Gómez-Salgado, J., García-Iglesias, J. J., Camacho-Vega, J. C., Fagundo-Rivera, J., & Carrasco-González, A. M. (2023). Risk factors for working pregnant women and potential adverse consequences of exposure: A systematic review. International Journal of Public Health, 68, Makale 1605655. https://doi.org/10.3389/ijph.2023.1605655
7. Caruso, C. C. (2014). Negative impacts of shiftwork and long work hours. Rehabilitation Nursing Journal, 39, 16–25. https://doi.org/10.1002/rnj.107
8. Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches (3. baskı). SAGE Publications.

9. Düzcü, T. (2021). COVID-19 pandemi sürecinde kadın sağlık çalışanlarının sosyal hayatlarındaki zorluklar. İçinde Y. D. Uslu & F. Ayanoğlu (Ed.), Ulusal sağlık sektöründe kadın istihdamı çalıştayı (Pandemi özel). 61-68 . İstanbul Medipol Üniversitesi Yayınları.
10. Ekrem, E. C., Ozturk, A., & Buyuktarakci, M. K. (2023). The relationship between perceived stress, social support, psychological resilience and health care practices in pregnant women. International Journal of Caring Sciences, 16, 255-262. https://doi.org/10.12961/aprl.2023.24.03.04
11. Ericsson, C. R., Lindström, V., Rudman, A., & Nordquist, H. (2022). Paramedics’ perceptions of job demands and resources in Finnish emergency medical services: A qualitative study. BMC Health Services Research, 22(1), 1469. https://doi.org/10.1186/s12913-022-08856-9
12. Franzoi, I. G., Sauta, M. D., De Luca, A., & Granieri, A. (2024). Returning to work after maternity leave: A systematic literature review. Archives of Women's Mental Health, 27, 737–749. https://doi.org/10.1007/s00737-024-01464-y
13. Gauci, S., Cartledge, S., Redfern, J., Gallagher, R., Huxley, R., Lee, C. M. Y., Vassallo, A., & O'Neil, A. (2022). Biology, Bias, or Both? The Contribution of Sex and Gender to the Disparity in Cardiovascular Outcomes Between Women and Men. Current atherosclerosis reports, 24(9), 701–708. https://doi.org/10.1007/s11883-022-01046-2
14. Guraya, S. Y., Dias, J. M., Eladl, M. A., Rustom, A. M. R., Alalawi, F. A. S., Alhammadi, M. H. S., Ahmed, Y. A. M., Al Shamsi, A. A. O. T., Bilalaga, S. J., Nicholson, A., Malik, H., & Salman Guraya, S. (2025). Unfolding insights about resilience and its coping strategies by medical academics and healthcare professionals at their workplaces: A thematic qualitative analysis. BMC Medical Education, 25, 177. https://doi.org/10.1186/s12909-024-06415-w
15. Halpern, J., Maunder, R. G., Schwartz, B., & Gurevich, M. (2012). Identifying risk of emotional sequelae after critical incidents. Emergency Medicine Journal, 28, 51–56. https://doi.org/10.1136/emj.2009.082982 Hanna-Osborne, S. (2022). ‘You will never be as good as we are’: A qualitative study of women paramedics’ experiences of sex-based harassment in an Australian ambulance service. British Paramedic Journal, 7, 1–7. https://doi.org/10.29045/14784726.2022.09.7.2.1
16. Hınız, G., & Yavuz, A. (2023). Yansıtıcı tematik analiz: Bir doktora tez çalışması örneği. Eğitimde Kuram ve Uygulama, 19, 388-408. https://doi.org/10.17244/eku.1300330
17. Hino, M., Ebina, Y., & Yano, R. (2025). Pregnant nurses' occupational stress and associated factors: A comparative cross-sectional study with other healthcare workers, physical workers, and desk workers. Japan Journal of Nursing Science: JJNS, 22, e70000. https://doi.org/10.1111/jjns.70000
18. Hong, L., Yang, A., Liang, Q., He, Y., Wang, Y., Tao, S., & Chen, L. (2024). Wife-mother role conflict at the critical child-rearing stage: A machine-learning approach to identify what and how matters in maternal depression symptoms in China. Prevention Science, 25, 699–710. https://doi.org/10.1007/s11121-023-01610-5
19. Jefferson, L., Bloor, K., Birks, Y., Hewitt, C., & Bland, M. (2013). Effect of physicians' gender on communication and consultation length: a systematic review and meta-analysis. Journal of health services research & policy, 18(4), 242–248. https://doi.org/10.1177/1355819613486465
20. Johnson, E., Elder, E., & Kosiol, J. (2025). What are the experiences of nurses returning to work following maternity leave: A scoping review. BMC Nursing, 24, 230. https://doi.org/10.1186/s12912-024-02625-1
21. Katsiroumpa, A., Moisoglou, I., Papathanasiou, I. V., Malliarou, M., Sarafis, P., Gallos, P., Konstantakopoulou, O., Rizos, F., & Galanis, P. (2025). Resilience and social support protect nurses from anxiety and depressive symptoms: Evidence from a cross-sectional study in the post-COVID-19 era. Healthcare, 13, 582. https://doi.org/10.3390/healthcare13060582 Kearney, J., Muir, C., & Smith, K. (2022). Occupational injury among paramedics: A systematic review. Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention, 28, 175–184. https://doi.org/10.1136/injuryprev-2021-044405
22. Khan, A. N. S., Billah, S. M., Mannan, I., Mannan, I. I., Begum, T., Khan, M. A., Islam, M., Ahasan, S. M. M., Rahman, J. N., George, J., Arifeen, S. E., Meena, U. S. J., Rashid, I., & Graft-Johnson, J. (2018). A cross-sectional study of partograph utilization as a decision making tool for referral of abnormal labour in primary health care facilities of Bangladesh. PLoS ONE, 13, e0203617. https://doi.org/10.1371/journal.pone.0203617
23. Kızıl, M. (2016). İzmir 112 Ambulanslarinda Çalişan Paramedik Ve Acil Tip Teknisyenlerinin Anksiyete Düzeyleri Ve İş Stresörleri. Hastane Öncesi Dergisi, 1(1), 43-54. https://izlik.org/JA47LH53FK
24. Kitole, F. A., Ali, Z., Song, J., Ali, M., Fahlevi, M., Aljuaid, M., Heidler, P., Yahya, M. A., & Shahid, M. (2025). Exploring the gender preferences for healthcare providers and their influence on patient satisfaction. Healthcare, 13, 1063. https://doi.org/10.3390/healthcare13091063
25. Li, Y., Zhou, Z., Fu, M. R., Tang, J., Peng, H., Zhu, L., Huang, C., Chen, Q., & Hu, Y.(2025). "A mother makes a better nurse": A phenomenological study of neonatal nurses' readiness recalibration following postpartum return to work. Journal of Nursing Management, 2025, 9095340. https://doi.org/10.1155/jonm/9095340
26. Maguire, B. J., O'Meara, P., O'Neill, B. J., & Brightwell, R. (2018). Violence against emergency medical services personnel: A systematic review of the literature. American Journal of Industrial Medicine, 61, 167–180. https://doi.org/10.1002/ajim.22797
27. Makkink, A. W., & Nkhoma, B. E. (2025). Gender discrimination in the emergency services: Female paramedic experiences in South Africa. African Journal of Primary Health Care & Family Medicine, 17(1), Article a4945. https://doi.org/10.4102/phcfm.v17i1.4945
28. Matsuo, T., Kobayashi, D., Taki, F., Sakamoto, F., Uehara, Y., Mori, N., & Fukui, T. (2020). Prevalence of Health Care Worker Burnout During the Coronavirus Disease 2019 (COVID-19) Pandemic in Japan. JAMA network open, 3(8), e2017271. https://doi.org/10.1001/jamanetworkopen.2020.17271
29. Mausz, J., Johnston, M., Arseneau-Bruneau, D., Batt, A. M., & Donnelly, E. A. (2023). Prevalence and characteristics of violence against paramedics in a single Canadian site. International Journal of Environmental Research and Public Health, 20, 6644. https://doi.org/10.3390/ijerph20176644
30. McCann-Pineo, M., Keating, M., McEvoy, T., Schwartz, M., Schwartz, R. M., Washko, J., Wuestman, E., & Berkowitz, J. (2024). The female emergency medical services experience: A mixed methods study. Prehospital Emergency Care, 28, 626–634. https://doi.org/10.1080/10903127.2024.2306248
31. Merriam, S. B., & Tisdell, E. J. (2016). Qualitative research: A guide to design and implementation (4. baskı). Jossey-Bass.
32. Neşe, A., & Gündoğan, R. (2022). Hastane öncesi acil sağlık hizmetleri çalışanlarında mesleki kaygı düzeyinin iş doyumu üzerine etkisi: Adıyaman ili örneği. Hastane Öncesi Dergisi (JPH), 7(3), 289-301. https://doi.org/10.54409/hod.1142419
33. Olivieri, R., Lo Presti, A., Costa, S., Ariemma, L., & Fabbri, M. (2025). Mothers balancing work and family: The associations with emotional well-being, sleep-wake problems and the role of basic needs. BMC Psychology, 12, 750. https://doi.org/10.1186/s40359-024-02241-3
34. Özden, S., & Gölbaşı, Z. (2018). Sağlık çalışanlarının toplumsal cinsiyet rollerine ilişkin tutumlarının belirlenmesi. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, 4(3), 95-100. https://doi.org/10.30934/kusbed.420223
35. Öztürk, U., Yavuz, A., Kaya, M., & Yavuz, A. (2023). Vardiyalı Çalışmanın İşle Bütünleşme Algısı ve İş-Yaşam Dengesi Üzerine Etkisi. Akademik İzdüşüm Dergisi, 8, 407-431. https://izlik.org/JA63UM97CU
36. Palabıyık, N., & İşözen, H. (2021). İş yaşam dengesi ve iş doyumu hastane çalışanları örneği. Sosyal, Beşeri Ve İdari Bilimler Dergisi, 4, 309–325. https://www.sobibder.org/index.php/sobibder/article/view/154
37. Polat, Z., & Köse, A. (2024). Sağlık çalışanlarında algılanan yönetici desteği ile psikolojik sahiplenme arasında örgütsel öğrenmenin rolü ve sosyodemografik özelliklerin etkisi. Pamukkale Üniversitesi İşletme Araştırmaları Dergisi, 11, 222-241. https://doi.org/10.47097/piar.1484116
38. Sahebi, A., Jahangiri, K., Sohrabizadeh, S., & Golitaleb, M. (2019). Prevalence of workplace violence types against personnel of emergency medical services in Iran: A systematic review and meta-analysis. Iranian Journal of Psychiatry, 14, 325–334.
39. Scerpella, T. A., Spiker, A. M., Lee, C. A., Mulcahey, M. K., & Carnes, M. L. (2022). Next steps: Advocating for women in orthopaedic surgery. The Journal of the American Academy of Orthopaedic Surgeons, 30, 377–386. https://doi.org/10.5435/JAAOS-D-21-00932
40. Sulisetyawati, S. D., Kamila, I., & Setiyawan, S. (2025). The relationship between dual role conflict and the performance of female nurses in nursing services in the inpatient wards. Proceedings Series on Health & Medical Sciences, 8, 246–252. https://conferenceproceedings.ump.ac.id/pshms/article/view/2062
41. Şahin, S., Dunbar, S. S., Sehgal, G., Roberts, L. R., & Nick, J. M. (2025). The decision-making process and experiences of women returning to work after parental leave: A qualitative systematic review protocol. Systematic Reviews, 14, 37. https://doi.org/10.1186/s13643-025-02778-3
42. Şimşek, P., Günaydın, M., & Gündüz, A. (2019). Hastane öncesi acil sağlık hizmetleri: Türkiye örneği. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 8(1), 120-127. https://izlik.org/JA37ZY33GH
43. Tosun, S., Sarıipek, D. B., & Çerev, G. (2025). In the shadow of gender: A phenomenological study on the experiences of discrimination, violence, and professional challenges of female paramedics in Türkiye. Women's Studies International Forum, 112, Makale 103165. https://doi.org/10.1016/j.wsif.2025.103165
44. Vasconcelos, S. W., Guedes, J. C., Dias, E. C., & Matias, A. (2023). Pregnancy and working conditions in the hospital sector: A scoping review. Revista Brasileira de Medicina do Trabalho, 21, e2023947. https://doi.org/10.47626/1679-4435-2023-947
45. Yılmaz, S., & Çağatay, A. (2023). Sağlık çalışanlarının iş tatmini ve iş performansı ekseninde iş-aile çatışması. Eskişehir Osmangazi Üniversitesi Sosyal Bilimler Dergisi, 24, 165-178. https://doi.org/10.17494/ogusbd.1249516