Social Representations of Nurses about their Profession: Integrative Review

Yanna Gomes de Souse

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

Soraya Maria de Medeiros

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

Milva Maria Figueiredo de Martino

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

Francisco Arnoldo Nunes de Miranda

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

Danielle Rezende Ferreira

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

Aline Dannyele Souza de Oliveira

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

Eva Emanuella Lopes Cavalcante Feitosa

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

Xenia Alves Freire

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

Tayssa Suelen Cordeiro Paulino

Federal University of Rio Grande do Norte UFRN/PGENF, Natal-RN, Brazil

*Corresponding Author:
Yanna Gomes de Souse
Nursing Department, Federal University of Rio Grande do Norte – UFRN
Natal, Rio Grande do Norte, Brazil
Tel: (83) 9904-7686
E-mail: [email protected]

Submitted date: May 17, 2017; Accepted date: June 01, 2017; Published date: June 08, 2017

 
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Abstract

An integrative literature review to identify the social representations of nurses about their profession. The literature searching was between September and November 2015 through the following databases: SCOPUS, PUBMED, Cochrane Library, Science Direct, Web of Science, CINAHL and MEDLINE. The final sample consisted of 05 articles. In the results, it was possible to identify characteristics of the publications and the social representations that nurses have of their profession. Thus, it was possible to know the differences in the perceptions of nurses about the social representations in their profession.

Keywords

Nursing; Social representation; Profession

Introduction

Considering the importance of the profession in the nursing context, it was decided to carry out an integrative review of the literature on the social representations that nurses have about their profession.

The Theory of Social Representations - TSR began in France in the 50s, when the social psychologist Serge Moscovici sought to understand how psychoanalysis, as new expertise knowledge, was understood by the French society at that time [1]. Social representations are a way of socially organized and shared knowledge which has a practical purpose and contributes to the creation of a reality common to a social group, called as knowledge of common sense or natural knowledge. The TSR is comprehensive because it uses concepts of attitudes, opinions, pictures and other, not excluding, but incorporating them, with relevance for social life as it indicates embodied cognitive processes in social interactions [2].

The concept of profession came from the characteristics of the artisan type work developed in guilds or corporations of craftsmen in the middle ages, constituted in production units, training and marketing of products. Although there was a division of labor, hierarchy and coordination and management of the production process activities, the producers were the owners of the instruments, had control over the process, the product and the pace of work, and in the production and reproduction of knowledge necessary for their work [3].

As a health profession, Nursing has been recognized since the second half of the nineteenth century, when Florence Nightingale added attributes to a health care field of activities developed for thousands of years by individuals or groups with different skills and different scenarios [3].

As human science, Nursing is related to the field of knowledge, justifications, and practices of care for human beings that cover the areas of health and diseases. Regarding nursing care, the actions occur through personal, professional, scientific, ethical and political relationships.

Over the years, the nursing profession has achieved professional autonomy and technical-scientific and legal expertise, also contributing to the development of a civic practice. As a profession, it seeks for an identity, accepted by its peers, without sophistry and syllogisms, defining the nurse as what he is and not by what he does [4].

As a profession, his role has been discussed by nurses and other health professionals. The discussion goes through the understanding of his importance in the health scenario and his potential to contribute to a new and more inclusive, holistic and critical paradigm in health [1].

This idea of building an identity for the profession means the attribution of meanings that support the understandings and interpretations that people have of themselves, the group to which they belong, or they consume. When we think of nursing or nurses, we evoke codes, images, representations that given a priori, they allow us to recognize people, abstract concepts, visualize places, landscapes and legitimize them as such. This perspective makes us think that the identity, at the same time is something changing, changed, revealed not only by the inexorable biological condition making the people as unique but also by the culture, profession, and lifestyle adopted [3,4].

A research of nurses showed that social representations about the profession influence their choice for nursing and this profession is motivated by the desire to provide care to others, by expressing their ideas about the care demonstrating that the choice of their profession is based on criteria that emphasize not only the concepts of their professional area but also in personal attributes, the psychological aspects and especially in motivation [5]. Considering this context, it is realized the need for a study showing the consensual knowledge of the nurses about their profession. We think that revealing these social representations, it enables an understanding of the psychosocial universe that involves professional regarding their profession.

From this study, it aims to understand the process of organizing representations that the professionals build and are being created and socialized in their daily professional practice of the care process and the interactions between the various social actors in the nursing work.

Thus, there is the urgent need to characterize the studies produced in this area to know its peculiarities. Based on these, this study aims to integrate literature studies produced on the social representations of nurses about their profession and know them.

Method

This is an integrative literature review, summarizing the available studies on a given topic and leading the practice based on scientific knowledge [6]. This method contributes to the deepening of knowledge about the investigated object, showing the conclusions of the literature on a particular phenomenon, as well as identifying the gaps in knowledge about the phenomenon under study [7].

The following steps were followed to operationalize this review: selection of the problem or research question; literature search, including the definition of inclusion and exclusion criteria of the articles; evaluation of data to establish the information to be extracted from the selected articles; interpretation of results; synthesis of data and presentation of the review [8].

The following question was formulated: “What is published in the scientific literature of nursing, relating the social representations of nurses about their profession?”

The literature search took place between September to November 2015, through the use of a proxy licensed by the Federal University of Rio Grande do Norte (http://www.capes. ufrn.br/ porta 3128), accessed by Capes journals website (http://www-periodicos-capes-gov-br.ez18.periodicos.capes. gov.br/) by the following databases: SCOPUS (Elsevier), National Library of Medicine - PUBMED, Cochrane Library, ScienceDirect (Elsevier), Web of Science (Main Collection - Thomson Reuters Scientific), Cumulative Index to Nursing and Allied Heath Literature - CINAHL and Medical Literature Analysis and Retrieval System Online - MEDLINE Complete (EBSCO).

The descriptor 1# nursing with the keywords 2# social representation and 3# profession were used to search the databases. The use of two keywords is justified by the fact of not having found specific descriptors (social representation and profession). The crosses were performed using the Boolean AND operator: 1# AND 2# AND 3#.

In each database, an uncontrolled search was conducted to identify a larger number of studies and also because the crossing was not done with descriptors only.

The inclusion criteria were full articles available on selected databases and articles that address the social representations of nurses about their profession. Editorials, letters to the editor, abstracts, expert opinions, correspondence, reviews, book chapters, theses and dissertations were excluded.

The studies were pre-selected with a close reading of the titles and abstracts to identify if they were related to the guiding questions of the review and the adopted inclusion and exclusion criteria. Then, the repeated articles in databases were excluded and text reading was carried out in full. For the analysis and extraction of data from publications, a script with the following information was elaborated: a publication of the identification, location of the study, objective and results (Figure 1).

primarycare-extraction-process

Figure 1: Summary of the data extraction process. Natal, Brazil, in 2015. After reading the articles, the data were described and presented in a table.

Results

On 107 articles identified, 52 (48.6%) were included in the first selection (title reading and abstract). In those selected, 19 (36.5%) were excluded because they are repeated in the databases. Thus, 33 articles (63.4%) were elected to read in full. Thus, the final review sample was composed of five (5) studies.

Table 1 below shows the consolidated of the studies included in the review, representing the essence for the preparation of results, discussion and conclusions regarding the studies produced on the social representations of nurses about their profession. The results showed that in the objectives, the studies vary in their understanding of social representations about the meanings of nursing as a profession.

Article Year/Databases Title Authors Objectives Results
(Social representations of nurses about their profession)
A1 LILACS, 2010 Current nursing dynamics in Portugal: The representation of nurses. Felismina Rosa; Parreira Mendes; Maria de Fátima Mantovani To identify the representations of the Portuguese nurses bout the current dynamics of the profession references to their evolution and prospects of nursing. The meanings in the self-image are inseparable and are closely linked to the social representations of the profession and non-recognition of their daily experience.
A2 LILACS, 2005 Alterity in nursing relationships. Ana Cláudia Giesbrecth Puggina; Maria Júlia Paes da Silva To identify the representation of the “other” (patient and family) in the Nursing relationship and understand how these relationships happen. Most of the nurses are dissatisfied with their work and the recognition of the profession; they have difficulty in communicating with the patient without demonstrating their authority.
A3 CINAHL, 2010 The center of the representations of nurses about nursing: the proper role of the profession. Antonio Marcos
Tosoli Gomes I Denize Cristina de Oliveira II
To analyze the structure of the social representation of nursing and the connection relationship between its elements. In the organization of the nursing social representation, it was observed that for the study participants, the profession has elements that place it in a position to provide answers to some of the major health problems.
A4 SCOPUS, 1997 The nursing and its practice: the thinking and the living of the nurses at the hospital-school São Francisco de Assis. Maria José de Souza; Suely de Souza Baptista To study the social representations of nurses about nursing and professional practice and how they perform this practice. Aspects were identified such as the desire to help others, the influence of the family and previous experience in the Health area. Some of them would like to study medicine.
A5 SCOPUS, 1997 The understanding of
nursing ideas for the transformation of professional practice.
Maria Itayra
Coelho de
Souza Padilha,
Nazaré Otília
Nazario, Marléa
Chagas Moreira
To understand the social representations about nursing as a profession meaning. Nursing is perceived as a profession of love to others. One way to get close to God, but also a challenge and struggle for a better profession.

Table 1: Characterization of articles according to year/databases, title, authors, objective and results. Natal, Brazil, in 2015.

About the characterization of the articles according to year/databases, title, authors, objective and results, there were five articles selected answering the research question, two (2) were in LILACS database, two (2) in SCOPUS and 1 (one) in CINAHL.

According to the characteristics of each study, we can observe that the articles mentioned several social representations of the nursing profession such as current dynamics of the profession, the desire to help the other, the influence of family, previous experience in health care, the recognition of the profession, able to provide answers to some of the main health problems and as a profession of love for others and a way to get close to God.

Discussion

Representations of nurses about the profession

Social representations are ways of knowledge guided by communication and understanding of the social, material and ideological context where we live, as cognitive elements (images, concepts, categories, theories), but not reduced only to cognitive knowledge. They are social phenomena to be understood from their production context, that is, from the symbolic and ideological functions they serve and the forms of communication [9].

Not only had the scientific theories feed the social representations, but also the great cultural axes of formalized ideologies, experiences and everyday communications [10].

The study of social representations of nurses in their profession can provide very useful information in the context of research and it could be the knowledge of the professional and scientific community in an educational context about their profession.

In recent times, nursing lives historical conflicts and challenging moments. The historical conflicts are based on in the care carried out primarily by the family and, more specifically, by the mother, as a direct way of maintaining the individual and collective life going through the various historical defining moments of the paradigms of our civilization [11].

The foundations at the beginning of the nursing profession according to Florence Nightingale were focused on normative aspects and not in technical and scientific knowledge, ruled on empirical knowledge and closely linked to charity and the biomedical model.

Exercised in a wide variety of contexts, now nursing includes the care of the physical and organic needs, sometimes the psychological, emotional and spiritual needs, with an emphasis on human subjectivity [1], achieving its more effective role to its essence, with human care as its main focus.

The reinterpretation of nursing as a profession and science occurs under certain circumstances influenced by social, political, ideological and religious factors, with the challenge of understanding the process of organizing representations that the professionals have built, in the midst of this complex and multifaceted context, about the profession [12].

During our life, we build representations of what we know and/or experienced, even if that experience does not happen in full but partially. The studies analysis of the results on the production of representations of nurses about the profession and their prospects of professional practice aims at the biomedical model to care and a more comprehensive view of the human being, as new possibilities to the profession that emerged in everyday practice.

The prospects for the profession guide to the employability, career and entering the profession at various levels of power, corroborating the expectation of appreciation and recognition that nursing professionals want in their daily practice. These characteristics are also directly linked to the nurses´ ability to demonstrate the socio-economic importance of the profession through the delimitation of socially important actions, necessary and unique to their professionality [1].

In the selected studies, social representation of the profession was also associated with the construction of care in nursing as their work object. Care is seen as the profession identifier held from specific health or potential needs, characterized by professional expertise and ability to problem formulation and application of therapeutic care intervention, by its technical and art in its performance.

Caring begins, develops and ends in the person and with the person who becomes the momentary object of this action, but also transcends it, ensuring its extension to the community. It is for people and in people that the nursing professional works (privileged work object) and, for this, this action must be fully known, from its moral and social reasons until their objective resulting in therapeutic terms, that is, in their epistemology [13].

Care also runs through the issue of nurse’s professional autonomy. In the process, it allows the possibility of reviewing the nursing as a profession, from its historical tradition, as well as linking with other scientific areas, a modern exercise of interdisciplinary.

Understanding the representations of nursing staff about their profession allows knowing the real and symbolic world that is present in the development of nursing practice every day.

Conclusion

This study allowed understanding the main social representations that permeate the nursing profession. The findings of this study revealed differences in the perceptions of nurses about the social representations in the profession.

Thus, to analyze the selected studies, the current dynamics of the profession, the desire to help the other, the influence of the family, previous experience in health care and the recognition of the profession provide answers to some of the major health problems and also as a profession of love for others a way to get close to God. It is concluded that the representation of nursing for the nurses has multifaceted signs and meanings, complex with some unspecific and other elements important for the development of the profession.

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