Discriminative nursing care: A grounded theory study

BACKGROUND: Discriminative nursing care is one of the most important challenges in the field of ethical care and the rights of patients. Experiencing discrimination has negative impacts. OBJECTIVE: The aim of this study was to explore the process of the development of the discriminative nursing care. METHODS: Sampling was begun purposefully and gradually continued, according to the obtained codes and categories, using theoretical sampling until data saturation. Data collection methods included semi-structured interviews, observations, and field notes. In this study, 13 clinical nurses and 5 patients in Iran were selected from public hospitals. The inclusion criteria were willingness to participate, having adequate experience about the considered phenomenon, and being able to discuss the subject. Data analysis was performed simultaneously to data collection using the method of Corbin and Strauss 2008. RESULTS: Five categories were extracted. The categories include: “context,” “causal conditions,” “phenomena,” “strategies,” and “outcomes.” Each of these categories contained subcategories with specific characteristics. The context was classified into “nurse's characteristics” and “patient's characteristics. “”Complete conflict” and “hatred” were extracted from the category of causal conditions. The causal conditions and context led to “discriminative nursing care” phenomena. The two strategies were “avoiding the patients” and “robotic care.” Outcomes were located in a spectrum ranging from “annoyance and discomfort” to “imposition of costs.” Finally, the categories were connected together and the meaning of “care in the context of the sense of interaction with the patient” was theorized. CONCLUSIONS: It is important to provide nursing education on the development of discriminative nursing care and its associated complications. Nurses should understand the nature, components, and the process of discriminative care. Understanding discrimination improves the action of nurses.