Factors Hindering and Facilitating Reflection Among Head Nurses: A Qualitative Study Examining Strategies for Effective Reflection

Abstract

Purpose: This study aimed to identify factors that hinder or facilitate reflection among head nurses and to explore strategies for promoting effective reflection in nursing management.

Methods: This study adopted a qualitative descriptive design. Semistructured interviews were conducted with 16 head nurses from six hospitals, and content analysis was used to analyze the transcripts.

Results: The analysis extracted six categories of factors hindering reflection, including time constraints, psychological resistance, limited understanding of reflection, dysfunction of facilitator roles, and difficulty in behavioral change. Conversely, factors facilitating reflection were classified into three core categories: individual factors, environmental/cultural factors, and process-related factors. In particular, individual factors such as intrinsic motivation for self-growth and flexible attitudes appeared to be unique to head nurses. Furthermore, the findings suggested a learning structure in which head nurses develop themselves through the growth of others.

Conclusion: Three key strategies were identified for effective reflection among head nurses: (1) assessment of head nurses’ psychological readiness, (2) establishment of psychologically safe and open forums for sharing experiences, and (3) development of organizational systems that enable continuous reflection. These strategies are interrelated and provide a foundation for transforming reflection from a superficial exercise into a sustainable learning process that fosters behavioral change and contributes to organizational learning in nursing management.