A qualitative study of the work environments of Mexican nurses

Background: Studies of the nursing work environment are increasingly common in developed countries, but few exist in developing countries. Because of resource differences between the two contexts, researchers need to clarify what aspects of the work environments are similar and different. Objectives: To study the perspectives of Mexican nurses about their work environments to determine similarities and differences to results from developed world studies. Design: A secondary, directed content analysis of qualitative data from 46 Spanish language interviews using workplace-oriented themes. Setting: Purposively selected Mexican states from four regions of the country that reflect the country's socioeconomic differences. Participants: Practicing Mexican nurses with at least 1. year of clinical experience and currently working in nursing. Participants were recruited through convenience and snowball sampling techniques. Methods: Initial data collection occurred in 2006 and 2008 during a broader study about professionalization processes that occurred in Mexican nursing between 1980 and 2005. The secondary, directed content analysis focused on an in-depth exploration of a central theme that emerged from the two original studies: the workplace. The directed content analysis used themes from the global nursing work environment literature to structure the analysis: professional relationships, organizational administrative practices, and quality of care and services. Results: The three themes from the global literature were relevant for the Mexican context and a new one emerged related to hiring practices. By category, the same factors that created positive or negative perceptions of the work environment matched findings from other international studies conducted in developed countries. The descriptors of the category, however, had different conceptual meanings that illustrate the health system challenges in Mexico. Conclusions: Findings from this study suggest that studies that seek to measure nursing work environments will most likely apply in Mexico and other Latin American or middle-income countries. Instruments designed to measure the work environment of nurses in these countries may prove relevant in those contexts, but require careful adaptation and systematic translations to ensure it.