Instrumental, communicative and strategic actions: a descriptive study of nursing practice according to critical theory

Aims: According to the literature consulted, the biomedical approach continues dominating the ways in which nurses think, work and inform. In order to study whether this situation also occurs in our context, this research proposes to 1) describe the value or weight nurses give to the different instrumental, strategic and communicative actions, according to Habermas' Theory of the Communicative Action; as well as 2) analyse its possible relationship with the type of unit in which nurses work. Methods: It is a descriptive study including 89 nurses, conducted in medical, surgical and oncohaematological hospital wards in the Hospital Reina Sofia of Cordoba. For the data collection, a questionnaire was created specifically for the study, made up of 4 instrumental actions, 4 strategic actions and 4 communicative actions that were scored 1-5 according to their value or importance. The questionnaire was self-administered and collected after one week. Results: The instrumental actions obtain the highest scores in the area of thoughts (19.49) and practice (18.9), followed by the communicative actions. Nevertheless, the strategic actions exceeded the communicative actions in the record (17.27 vs 14.49). Only in the onco-haematology units, communicative actions maintained high scores (17.26). Conclusions: The results from the present study emphasise the hegemony of the biomedical model, represented by instrumental and strategic actions, and draw a difficult situation for the communicative action, which has to find its place in the professional speech. (C) 2010 Elsevier Espana, S.L. All rights reserved.