Faculty of Nursing, University of Cantabria, Santander, Cantabria, Spain.
Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.
PLoS One. 2022 May 17;17(5):e0265378. doi: 10.1371/journal.pone.0265378. eCollection 2022.
To analyse the global process by which Spanish nurses have acquired a differentiated role in primary health care and to develop a theory that explains the evolution of this role.
Grounded Theory was selected, as proposed by Glaser and Strauss, following the theoretical framework of Bourdieu's habitus.
Thirteen in-depth interviews were conducted between 2012 and 2015, using theoretical sampling and seeking maximum variability. The analysis of the data included progressive coding and categorization, constant comparative analysis and memo writing.
A core category emerged, "Autonomy", composed of three categories: "Between illusion and ignorance. Genesis of a habitus", "The recognisable and recognised habitus" and "Habitus called into question", showing the genesis of the nursing role in primary health care and the elements that influence the autonomy of the role: the ability to decide their training, assume their own leadership, configure teams and acquire independent skills. "Seeking autonomy" was the substantive theory that emerged from the data.
The results reveal the elements that strengthen the autonomous professional role and that this role is legitimated when two elements are identified: the acquisition of a habitus, based on practices carried out regularly and the recognition of this habitus by the population and others professionals.
The results of this study identify the elements that guide and strengthen the professional role and redefine the concept of autonomy. These are operational findings and could potentially be used to define new strategies for advancing the role of nursing in primary health care.
分析西班牙护士在初级卫生保健中获得差异化角色的全球进程,并构建一个解释该角色演变的理论。
我们选择了格拉斯和施特劳斯提出的扎根理论,遵循布迪厄的惯习理论框架。
2012 年至 2015 年期间进行了 13 次深度访谈,采用理论抽样并寻求最大变异性。数据分析包括逐步编码和分类、恒定性比较分析和备忘录撰写。
出现了一个核心类别“自主性”,由三个类别组成:“在幻想与无知之间。惯习的起源”、“可识别和被认可的惯习”和“受到质疑的惯习”,展示了初级卫生保健中护理角色的起源以及影响角色自主性的因素:决定自身培训的能力、承担自身领导角色、配置团队和获得独立技能的能力。“寻求自主性”是从数据中得出的实质性理论。
结果揭示了强化自主专业角色的要素,当识别出两个要素时,该角色具有合法性:惯习的获得,基于定期进行的实践,以及该惯习被民众和其他专业人员的认可。
本研究的结果确定了指导和强化专业角色的要素,并重新定义了自主性的概念。这些是操作性发现,有可能用于定义推进初级卫生保健中护理角色的新策略。