RESUMO
PURPOSE: The purpose of this study was to conduct a grounded theoretical analysis on the hospital accreditation experience of head nurses in order to understand their behavior on the adaption of this new system. METHODS: The participants were 8 head nurses with more than 3 years of experience. The data were collected through in-depth interviews using audiotape recording analyzed by the constant comparative method described in Strauss and Corbin's methodology. RESULTS: There were 113 concepts, 26 subcategories and 12 categories identified through the open coding process. In the axial coding, the following paradigm model was proposed: 1) the causal conditions were ‘hardware problem’ and ‘software problem’, 2) the contextual conditions were ‘vertical relationship’, ‘individual preference’, and ‘family support’, 3) the intervening conditions were ‘passive conditions’ and ‘active conditions’, 4) the action/interaction strategies were ‘leading role’ and ‘dependent role’, 5) the consequences were ‘positive acceptance’ and ‘negative acceptance’, 6) the central phenomenon was ‘difficult situation’ and 7) the core category was ‘leading in harmony’. CONCLUSION: The new system led head nurses having difficulties as the middleman between the hospital administration and general nurses, but they made a continuous effort to overcome and adapt to it through a number of strategies.