How Does Professional Habitus Impact Nursing Autonomy? A Hermeneutic Qualitative Study Using Bourdieu's Framework.

Abstract

Background/Objective: In nursing practice, differences have been noted between the shared habitus acquired during academic training and professional practices within healthcare systems. In this context, nurses tend to experience an impact on their autonomy due to the ways in which their professional habitus has been established, which, in some way, alters the cultural capital acquired during their academic training. The objective of this study was to identify factors that facilitate and/or limit autonomy in nursing practice based on professional habitus. Method: This research was conducted using a hermeneutic qualitative study framed within a critical approach that incorporated Bourdieu's theory of fields (habitus, field, and capital). This study included 11 registered nurses working in hospital settings, 17 nursing students, and six university professors. Data collection included 34 sociodemographic forms, 34 individual semi-structured interviews, and five focus group discussions conducted with an interview guide. The collected data were analyzed using an interpretative hermeneutic approach, integrating grounded theory and Bourdieu's theory of fields, focusing on the concepts of habitus, field, and capital. Results: This study identified a central theme-clarification of the nurse's role (professional habitus)-alongside three subthemes: (1) strengthening the nursing identity (identity habitus), (2) optimizing nursing education (optimization habitus), and (3) reinforcing professional credibility (validation habitus). Autonomy was found to be influenced by hierarchical structures, power relations, and institutional constraints within the healthcare social field, which led to limitations in the accumulation of nurses' symbolic capital. Conclusions: The professional habitus of nurses is shaped by various elements within the healthcare social field. This field is constrained by hierarchical structures and factors such as subordination to the hegemonic biomedical discourse and the medical profession, limited recognition of humanized care, institutional restrictions on acknowledging the nursing process, and a lack of solidarity and leadership. These constraints ultimately hinder the accumulation of symbolic and social capital in nursing, leading to a loss of autonomy and hindering professional development.