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Inequalities in the everyday of care: dimensions of the incorporation of intersectional theory in nursing practice

Aim: To offer a practical proposal regarding the implications of integrating intersectional theory into nursing practice, drawing from the experiences and narratives of nurses across diverse professional contexts. Design: Qualitative Grounded theory, following the constructivist approach offered by Kathy Charmaz. Methods: Data collection was conducted between 2022 and 2023 with nursing professionals from Catalonia, Spain. Following Charmaz's approach, thematic analysis was performed after theoretical sampling was saturated through 17 in-depth interviews and 2 focus groups. Results: A total of 26 individuals participated in the study. The analysis identified five dimensions related to considerations for incorporating intersectionality into nursing practice. These dimensions are presented as a conceptual framework, organised from elements most closely related to reflexivity and professional positionality, to those more distally connected to a critique of the structural system within which nursing activities are situated. Conclusion: Although the findings reveal widespread agreement regarding the necessity of adopting a new perspective that challenges the dominance of biomedical knowledge and facilitates alternative approaches to the social and health complexities in our environments, there exists divergence in the methods for achieving this paradigm shift. Intersectional theory provides a theoretical framework conducive to this reassessment. Implications for the profession and/or patient care: The findings outlined in this study hold significant implications for both professional practice and the structuring of nursing education at the university level. Concerning professional practice, we advocate for a theoretical framework that offers lucidity and precision regarding the strategies and skill sets necessary for the integration of an intersectional perspective into nursing practice. This framework may prove beneficial not only to individual practitioners but also to managerial entities seeking to reshape institutional care paradigms. In terms of nursing education, this research provides a foundation for a critical revaluation of curricular structures and their practical execution. Impact (addressing): What problem did the study address? Since health and illness are influenced by social and cultural factors, nursing theories are evolving to address social determinants of health. Strategies are needed to integrate intersectional theory into nursing practice and education. WHAT WERE THE MAIN FINDINGS?: Findings underscore the importance of aligning nursing values with principles of equality, respect, and social justice to address social health inequalities effectively. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This study provides insights into the ambivalence surrounding the incorporation of intersectional theory in nursing practice, shedding light on its perceived value and feasibility among practitioners. A practical framework is developed which emphasises the significance of understanding power dynamics in healthcare settings and their implications for perpetuating or challenging social inequalities in health. Reporting method: The manuscript is based on the Consolidated Criteria for Reporting Qualitative Research (COREQ). Patient or public contribution: No Patient or Public Contribution.

(Wiley, 2025) Graells-Sans, Ariadna; Insa-Calderón, Esther; Sanclemente-Dalmau, Montserrat; Coll-Planas, Gerard