title: Impact of nurses' uniforms on patient and family perceptions of nurse professionalism.
abstract: BACKGROUND
  Patients and visitors may perceive nurses as professional based on uniform color and style. Nurse image may affect patient and visitor trust and satisfaction with nursing care. Fitted white dresses have been replaced by loose-fitting or scrub white, colored, or patterned pant sets.
  
  
  OBJECTIVE
  This study examines nurse professionalism by assessing the nurse image traits of eight pant uniforms as perceived by pediatric patients, adult patients, and adult visitors. We also examined if uniform preference is congruent with nurse image traits.
  
  
  METHODS
  A convenience sample of 499 patients and visitors were surveyed at a large Midwestern tertiary health care center. Subjects viewed photographs of the same registered nurse identically posed in eight uniforms and rated each by image traits. Kruskal-Wallis, Steel-Dwass multiple comparison method, and Wilcoxon signed-rank sum tests were used to test for differences in the Nurse Image Scale (NIS) score by uniform style and color and subject demographics.
  
  
  RESULTS
  Subjects were 390 adult patients and visitors (78%) and 109 pediatric patients (21.4%); 66% were female, and 78% were Caucasian. In adults, NIS scores for white uniforms (two styles) were higher than NIS scores for uniforms with small print, bold print, or solid color (all p < .001). White uniform NIS score increased with subject age (all < or = .007). In pediatric patients (7-17 years) and young adults (18-44 years), the highest uniform NIS scores did not differ significantly from the others. Uniform preference was different from NIS score in pediatric and adult subjects, reflecting noncongruence between the perception of nurse professionalism by uniform and uniform preference.
  
  
  CONCLUSIONS
  With aging, adults create perceptions of nurse professionalism based on uniform color and style. Traits of nurse professionalism were highest in white uniforms. Future research is needed to determine if transition to white nurse uniforms improves patient and family satisfaction with nursing care.
authors.affiliation: Nursing Research and Innovation, The Cleveland Clinic, Cleveland, OH, USA. albertn@ccf.org
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Albert
authors.forename: Lucia
authors.initials: L
authors.lastname: Wocial
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Meyer
authors.forename: Jie
authors.initials: J
authors.lastname: Na
authors.forename: Kathleen
authors.initials: K
authors.lastname: Trochelman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002648:Child; D003020:Clothing; D022143:Family Nursing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010371:Pediatric Nursing; D011364:Professional Practice; D012938:Social Perception; D055815:Young Adult