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はじめに
クライエントにとって最も望ましい健康状態を作り出すために,看護の質を向上させることは,看護に従事する者の責務である。看護師の行為は,その人の価値観の表現ととらえることが可能であり(Holmes,1992;Kim,1993),職業的アイデンティティが看護観を象徴する(Fagermoen,1997)ならば,個々の看護師が職業的アイデンティティを確立することは,看護の質を向上させる1つの方法であると考えられる。このように考える時,看護師の職業的アイデンティティに関する理解は非常に重要になる。
職業的アイデンティティという概念を理解するための有用な理論として,Erikson(1959,1963,1982)の心理社会的発達理論,Stryker(1977)のアイデンティティ理論,およびBiddleとThomas(1966),Biddle(1979)の役割理論がある。しかしこれらの理論は,看護師の職業的アイデンティティそのものを説明しうるものではない。また実証的研究においても,看護師の職業的アイデンティティに関しては十分な研究が行なわれていない。本論文の目的は,この領域における理論構築の必要性を明らかにし,帰納的方法により開発された,初期の領域密着型中範囲理論を記述することである。
The purpose of this paper was to identify the necessity of a theory construction about nurses' professional identity and to describe a beginning substantive middle range theory. A conceptual map was made using 21 empirical-based articles in nursing, psychology, sociology, and education from 6 databases. The conceptual map indicated that there was not enough evidence on what kinds of factors influence the professional identity of nurses and how they establish professional identity.
Two inductive studies were used to develop a substantive middle-range theory of nurses' professional identity. The first study using grounded theory was conducted by having formal/informal interviews and discussions with a total of 30 participants, participant observations in three hospitals, and theoretical memos. The second study used a qualitative descriptive method and was conducted with 6 nurses by having both formal interviews and participant observations as a major source of data generation. A schematic model was developed from the findings, which explained the process of establishing the professional identity of nurses. It had seven steps: learning from working experiences. recognizing the value of nursing, establishing one's own philosophy of nursing, gaining influence from education, approving one's own nursing practice, having a commitment to nursing, and integrating a nurse into self. The beginning substantive middle-range theory did explain how nurses establish their professional identity: however, it could not explain why professional identity is important to improve the quality of nursing care.
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