Maintaining equilibrium in professional role identity: a grounded theory study of health visitors' perceptions of their changing professional practice context.
OBJECTIVE
This article reports the study of a group of United Kingdom health visitors' interactions with their changing practice context, focusing on role identity and influences on its stability.


BACKGROUND
United Kingdom policies have urged health visitors to refocus their role as key public health nurses. Reduced role identity clarity precipitated the emergence of different models of health visiting public health work. An inconsistent role standard can lead to role identity fragmentation and conflict across a group. It may precipitate individual role crisis, affecting optimum role performance.


METHODS
Seventeen health visitors in two United Kingdom community healthcare organizations participated in a grounded theory study, incorporating constant comparative analysis. Direct observations and individual interviews were undertaken between 2002 and 2008.


RESULTS
Four interlinked categories emerged: professional role identity (core category); professional role in action; interprofessional working; and local micro-systems for practice; each influencing participants' sense of identity and self-worth. The Role Identity Equilibrium Process explains interactive processes occurring at different levels of participants' practice.


CONCLUSIONS
Re-establishing equilibrium and consistency in health visiting identity is a priority. This study's findings have significance for other nurses and health professionals working in complex systems, affected by role change and challenges to role identity.
School of Health Community and Education Studies, Northumbria University, Newcastle upon Tyne, UK. alison.machin@northumbria.ac.uk
Alison I
AI
Machin
Tony
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Machin
Pauline
P
Pearson
D000328:Adult; D001291:Attitude of Health Personnel; D002675:Child, Preschool; D003152:Community Health Nursing / Q000458:organization & administration* / Q000639:trends; D003220:Conflict, Psychological; D006291:Health Policy; D006801:Humans; D007400:Interprofessional Relations; D015404:Nursing Methodology Research; D009936:Organizational Innovation; D057184:Practice Patterns, Nurses' / Q000639:trends; D017009:Professional Autonomy; D024382:Professional Role / Q000523:psychology*; D011637:Public Health Nursing / Q000458:organization & administration* / Q000639:trends; D036301:Qualitative Research; D012649:Self Concept; D006113:United Kingdom