Role of leadership in empowering nurses' professional identity to achieve research utilization: a grounded theory study
Binti Mohd Shamsuddin, Khairatul Azwa
Background: Research utilization in nursing practice has shown to improve quality of care (Dufault and Sullivan 2000; Rutledge and Bookbinder 2002), however, the extent to which nurses use research in practice remains questionable (Squires et al 2011). It is known that leadership is crucial in nurses’ research utilization (Newhouse 2007; Gifford et al 2011; Reichenpfader et al 2015) yet the dimensions of this vital leadership are largely unknown. Consequently, in this grounded theory study, I aimed to develop a middle range theory on the role of leadership in nurses’ research utilization. Design: I used a constructivist grounded theory (Charmaz 2014) methodology with Clarke’s (2005) situational analysis as an analytical tool within a constructivist framework. Beginning with purposive sampling and later progressing to theoretical sampling, I conducted 20 semi-structured interviews of healthcare professionals in various roles within one health board in Scotland from September 2017 to August 2018. Interviews were audio-recorded, transcribed, and NVIVO was used to manage data during the analysis. Findings: The findings of this study illuminate the links between leadership in the form of empowering constructs and nurses’ professional identity to achieve research utilization. The resulting theoretical model show three main categories – integrating research into the nursing role; building relationships; and shifting culture – that leadership can empower nurses structurally as well as psychologically in affecting the understanding of their own professional identity. Additionally, the theoretical model was informed by two other processes from using situational analysis in this study: a social world/arenas map of nurses’ research utilization and a positional map indicating the various stances within my data on nurses’ empowerment and subsequent research utilization. In this thesis, I have found support for recent contentions in the leadership literature of leadership as empowering others rather than focused on power-based individuals (Dambe and Moorad 2008; Kellerman 2013; Northouse 2016). Furthermore, I have opened new avenues for research in relating research utilization with professional identity, an assertion which is currently missing from the body of literature. This provides valuable guidance for nursing leaders at all levels of healthcare in understanding the role of professional identity in research utilization and the use of empowerment in affecting change. My use of situational analysis with constructivist grounded theory is also a novel research method and only done previously in three other studies (Mills et al 2007; den Outer et al 2012; Khaw 2012), although none have incorporated the use of positional maps.