The evolution of the role of nursing in primary health care using Bourdieu’s concept of habitus. A grounded theory study

Abstract

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.