Community nursing practice in hypertension management in China : qualitative analysis using a Bourdieusian framework

Abstract

Objective: This study explores the practices of Chinese community nurses in hypertension management, using Pierre Bourdieu's theory of practice to understand how their routines are shaped by sociocultural and institutional forces, along with their professional dispositions. Design: A qualitative descriptive study was conducted in Shenzhen, China, between March and June 2024, and is reported following the COREQ guidelines. Sample: Eighteen nurses, each with at least 1 year of full-time experience in hypertension care within the local community healthcare system, were recruited from a participant pool established through prior research. Measurements: Face-to-face individual semistructured interviews were conducted using a structured interview protocol, and data were analyzed through thematic analysis. Results: Community nurses face tensions between traditional health beliefs and modern hypertension care, as well as institutional pressures that prioritize efficiency over personalized care. Power imbalances, particularly the authority of doctors, complicate their role. However, nurses adapt their care strategies through embodied practices, balancing clinical standards with patient needs. Conclusions: Community nurses are not mere enforcers of guidelines but adaptive professionals who navigate complex sociocultural norms, institutional demands, and power dynamics in hypertension care. This study underscores the necessity for flexible, culturally sensitive practices to improve public health outcomes.