Autonomía de las enfermeras en los servicios de salud del primer nivel de atención
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Date
2025
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Universidad Nacional de Trujillo
Abstract
La autonomía es la capacidad de actuar libremente y de cuestionar, analizar y transformar su entorno laboral de manera crítica. El objetivo del estudio fue analizar la autonomía de las/os enfermeras/os en los servicios de salud del primer nivel de atención. Se fundamentó en la teoría de Paulo Freire, centrado en la autonomía y la conciencia crítica, que permitió destacar la importancia que los profesionales de enfermería se conviertan en agentes activos y reflexivos de su práctica. Se utilizó el diseño cualitativo, descriptivo y dialéctico; como instrumento la entrevista semiestructurada, aplicada a 10 enfermeras denominadas “Navegantes”. Los resultados evidenciaron que la autonomía de las/os enfermeras/os está influenciada por varios factores evidenciadas en V categorías: la categoría I: “Estructuración General de la Autonomía en Enfermería” reveló que, aunque existen políticas que promueven cierta independencia, las decisiones siguen siendo limitadas por la jerarquía médica; la categoría II: “Factores que condicionan la autonomía de las enfermeras” mostraron que la burocracia y falta de recursos limitan significativamente su capacidad de acción; la categoría III “Variaciones Necesarias para lograr la Autonomía”, se identificó la necesidad de reformas institucionales y mayor capacitación; la categoría IV: “Impacto de la Autonomía en la Práctica Diaria de Enfermería”, indicaron que una mayor independencia mejora la calidad del cuidado y la capacidad de respuesta ante situaciones críticas. La categoría V: “Impacto de la Autonomía en el Desarrollo Laboral”, demostró que las enfermeras/os que ejercen mayor autonomía experimentan mayor motivación y compromiso. Se concluye: que la autonomía en las enfermeras tiene el potencial de elevar la calidad del cuidado y la satisfacción laboral, evidenciando la necesidad de mejora de la autoconfianza, capacitación y reformas institucionales que fortalezcan la independencia profesional.
Autonomy is the ability to act freely and to question, analyze and transform one's work environment in a critical manner. The objective of the study was to analyze the autonomy of nurses in primary care health services. It was based on Paulo Freire's theory, focused on autonomy and critical awareness, which highlighted the importance of nursing professionals becoming active and reflective agents of their practice. The qualitative, descriptive and dialectical design was used; as an instrument, the semi-structured interview was applied to 10 informants called "Navigators". The results showed that the autonomy of nurses in primary care health services is influenced by several factors: the category: "General Structuring of Autonomy in Nursing" revealed that, although there are policies that promote a certain independence, decisions continue to be limited by the medical hierarchy; Category II: “Factors that influence the autonomy of nurses” showed that bureaucracy and lack of resources significantly limit their capacity for action; Category III: “Necessary Changes to Achieve Autonomy” identified the need for institutional reforms and more training; Category IV: “Impact of Autonomy on Daily Nursing Practice” indicated that greater independence improves the quality of care and the ability to respond to critical situations. Category V: “Impact of Autonomy on Professional Development” showed that nurses who exercise greater autonomy experience greater motivation and commitment. It is concluded that autonomy in nurses has the potential to improve the quality of care and job satisfaction, evidencing the need for improved self-confidence, training and institutional reforms that strengthen professional independence.
Autonomy is the ability to act freely and to question, analyze and transform one's work environment in a critical manner. The objective of the study was to analyze the autonomy of nurses in primary care health services. It was based on Paulo Freire's theory, focused on autonomy and critical awareness, which highlighted the importance of nursing professionals becoming active and reflective agents of their practice. The qualitative, descriptive and dialectical design was used; as an instrument, the semi-structured interview was applied to 10 informants called "Navigators". The results showed that the autonomy of nurses in primary care health services is influenced by several factors: the category: "General Structuring of Autonomy in Nursing" revealed that, although there are policies that promote a certain independence, decisions continue to be limited by the medical hierarchy; Category II: “Factors that influence the autonomy of nurses” showed that bureaucracy and lack of resources significantly limit their capacity for action; Category III: “Necessary Changes to Achieve Autonomy” identified the need for institutional reforms and more training; Category IV: “Impact of Autonomy on Daily Nursing Practice” indicated that greater independence improves the quality of care and the ability to respond to critical situations. Category V: “Impact of Autonomy on Professional Development” showed that nurses who exercise greater autonomy experience greater motivation and commitment. It is concluded that autonomy in nurses has the potential to improve the quality of care and job satisfaction, evidencing the need for improved self-confidence, training and institutional reforms that strengthen professional independence.
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Keywords
Autonomía, Enfermeras, Primer nivel de atención, Promoción de autonomía, Calidad del cuidado