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[Modification of nursing practice through reflection: participatory action research].
P Delgado Hito1, A Sola Prado, I Mirabete Rodríguez
1Profesora Colaboradora de la Escuela Universitaria de Enfermería del Hospital de la Santa Creu i Sant Pau. Licenciada en Enfermería por la Universidad de Montreal, Canada..
This study explored how nurses can improve their daily work by reflecting on their own practices. By participating in group discussions and systematic observations, nurses identified ways to make care more human-centered. The findings suggest that this reflective approach leads to better patient support, improved teamwork, and higher quality care.
Area of Science:
- Nursing education and participatory action research within clinical practice
- Health services research investigating nursing care quality
Background:
Modern intensive care environments increasingly rely on sophisticated technological tools and complex medical procedures. These advancements often define daily clinical routines while simultaneously risking the dehumanization of patient interactions. No prior work had resolved how to balance technical proficiency with compassionate care delivery. Prior research has shown that clinical staff often struggle to maintain a humanistic focus amidst high-pressure settings. That uncertainty drove the need for interventions that prioritize professional introspection. This study addresses the gap between technical requirements and the necessity for empathetic nursing engagement. Previous investigations have highlighted the potential for burnout when technology overshadows the patient-nurse relationship. This inquiry seeks to bridge that divide by fostering a culture of critical self-assessment among healthcare providers.
Purpose Of The Study:
The general aim of this study was to stimulate reflection on nursing care within intensive care environments. This research sought to address the increasing role of complex techniques that often characterize modern clinical practice. The investigators identified a need to counteract the dehumanizing effects associated with these technological advancements. By involving the staff directly, the study intended to produce meaningful changes in daily nursing routines. This project was motivated by the desire to improve the quality of patient-centered care. The researchers aimed to bridge the gap between technical proficiency and empathetic professional engagement. No prior work had resolved how to effectively integrate reflective practices into high-pressure clinical settings. This study provides a structured approach for nurses to evaluate and refine their own professional actions.
Main Methods:
The research team adopted a qualitative design to investigate professional behaviors within the clinical setting. Review approach involved the implementation of the Kemmis and McTaggart framework to guide the investigative process. Eight registered nurses participated in the study to ensure a diverse range of perspectives. Systematic observations were conducted to capture real-time interactions and clinical decision-making patterns. The team organized seven group meetings to facilitate deep discussion and collective reflection among the participants. All sessions were recorded and subsequently transcribed verbatim into a computer system for detailed examination. Investigators performed a rigorous codification and categorization process to interpret the qualitative data. Document synthesis cards were utilized to organize findings and track the evolution of clinical perspectives throughout the study period.
Main Results:
Key findings from the literature demonstrate that the reflection in action method effectively stimulates tangible changes in clinical behavior. The study revealed that this approach leads to a more humanistic way of conceiving nursing actions. Participants showed greater respect for patients following the reflective intervention. Families experienced closer contact and received significantly higher levels of support from the nursing staff. The analysis indicated an improvement in the coordination of various nursing care acts. Collaboration among healthcare professionals increased as a direct result of the reflective sessions. These changes collectively contributed to an overall enhancement in the quality of nursing care provided. The results confirm that the intervention successfully addressed the dehumanizing tendencies associated with modern intensive care technology.
Conclusions:
Synthesis and implications indicate that participatory action research serves as a robust framework for professional development. The authors suggest that engaging in structured reflection allows staff to actively reshape their routine clinical behaviors. Evidence demonstrates that this method successfully promotes a more humanistic approach to patient interactions. The findings imply that improved coordination among team members results from these collaborative reflective sessions. Researchers propose that families benefit significantly from the increased support and closer contact facilitated by these changes. The study confirms that nurses possess the agency to enhance care quality through systematic self-evaluation. These results support the adoption of reflective practices to mitigate the dehumanizing effects of modern medical technology. The authors conclude that this methodology provides a practical pathway for sustained improvement in nursing standards.
Frequently Asked Questions
The researchers propose that reflection in action stimulates changes by fostering a humanistic approach. This process increases care quality, improves coordination among professionals, and provides families with closer contact, contrasting with the dehumanizing effects of complex technology in intensive care units.
The investigators utilized the Kemmis and McTaggart method, which involves systematic observation, seven group meetings, and document analysis. This approach differs from traditional observational studies by actively involving the eight participating nurses in the process of producing changes.
The authors state that the eight nurses were necessary to allow for group meetings and collective analysis. This group size provided the required depth for the codification and categorization process, which would be difficult to achieve with fewer participants or through individual interviews alone.
Verbatim transcriptions of recorded meetings served as the primary data source. These transcripts were subjected to a codification and categorization process, alongside document synthesis cards, to extract meaning and identify shifts in nursing behavior.
The study measured changes in practice through the exploration of nursing actions and the resulting humanization of care. This phenomenon was evidenced by greater respect for patients and increased collaboration, compared to the previous state of dehumanized care.
The authors claim that participatory action research is a valid and appropriate tool for nurses to modify their daily practice. They suggest this method is effective for overcoming the challenges posed by the increasing role of technology in clinical settings.