The Barriers and Facilitators Influencing Nurses’ Political Participation or Healthcare Policy Intervention: A Systematic Review and Qualitative Meta-Synthesis

Background. Nurses, who comprise the largest proportion of healthcare professionals, must advocate for public health in a changing healthcare environment. Therefore, nurses have a social responsibility to be interested in politics, political participation, or healthcare policy interventions as leaders in healthcare policy reforms. However, previous research has reported that nurses’ political interests and participation are insufficient in most countries. Aim. This study systematically reviewed and synthesized qualitative data to identify the barriers and facilitators influencing nurses’ political participation and healthcare policy interventions. Methods. This study performed a systematic review and qualitative meta-synthesis. Literature searches were conducted using seven databases to comprehensively examine published journals, including doctoral dissertations, until December 31, 2023. The selection criteria for this study were articles analyzed using phenomenology, ethnography, qualitative research, and grounded theory, targeting nurses with extensive experience in healthcare policy intervention and political activities. Two researchers, professors in nursing with extensive experience in healthcare policy interventions and qualitative research screened the qualitative studies and extracted the data. Eighteen papers were analyzed, and the quality of each study was evaluated using the Critical Appraisal Skills Program Qualitative Checklist. Meta-ethnography was applied as the qualitative meta-synthesis method using ATLAS. ti. Results. Barriers include nurses’ lack of political interest and competence, nursing education, restrictive organizational cultures, and the nursing profession’s political activities. Facilitators include recognizing social responsibilities, enhancing political competence, innovating organizational environments, and strengthening nursing organizations’ political activities and policy interventions. Conclusions. This study could be used as data to enhance nurses’ political participation and to plan policy interventions and strategies. Implication for Nursing Management. To activate nurses’ political participation in the future, it is necessary to develop strategies, such as developing nursing political education programs and expanding opportunities for policy intervention.