| A new theoretical framework for designing the process of knowledge production within nursing practice is necessary to take into account the individual and the collective process of knowledge production as well as the influence of the context on this production. The theory of reflexivity of Giddens seems to be most relevant. This study aimed to describe and understand the process of knowledge production within nursing practice through reflexivity. More specifically, it was important to uncover the conditions and dynamics of the institutional, professional and practice context which influence the process of knowledge production within nursing practice and to identify the steps of this process. Projective constructivism was the paradigm that has guided the study. The research design was a secondary analysis of qualitative data. The study context was a critical care unit of a general and university hospital in Barcelona. Data were collected through systematic observation, six structured interviews, seven focus groups, and documents analysis. Data were analysed according to the mixed approach of Miles and Huberman, the qualitative analysis of Morse, and recommendations from various authors on secondary analysis. The rigor criteria were used and the ethical aspects were covered. The study results suggest that the conditions and dynamics of institutional, practical and professional contexts impact profoundly the nursing action and knowledge production. These conditions and dynamics are internalized in the working lives of nurses and provide "normal" ways of nursing practice. However, although there is an acceptance of the status quo, the conflicting feelings and suffering emerge easily. These conditions and dynamics cause incapacity among nurses to act fairly, ethically and responsibly and limit their exploration of new possibilities, formulations and demonstrations of practice. The results propose also the stages of knowledge production through four major themes: the recognition of daily reflexivity, systematic review of practices, the construction of new knowledge and the reconstruction of emancipatory knowledge. Finally, this thesis suggests the importance of Giddens' theory for the study of knowledge production and the relationship between the nurse and the context, as well as the use of secondary analysis of qualitative data for the nursing discipline.;Keywords: knowledge production, reflexivity, practical context, structuration theory, critical care, professional context, secondary analysis, institutional context, nursing, reflective practice... |
