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Article(id=1322924416291713853, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.17.017, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1763049600000, receivedDateStr=2025-11-14, revisedDate=1783958400000, revisedDateStr=2026-07-14, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339359591, onlineDateStr=2026-10-30, pubDate=1788969600000, pubDateStr=2026-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339359591, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339359591, creator=13701087609, updateTime=1793339359591, updator=13701087609, issue=Issue{id=1322924415817757501, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='17', pageStart='2961', pageEnd='3152', issueExtLink='null', onlineDate='null', pubDate='1788969600000', pubDateStr='2026-09-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793339359478, creator='13701087609', updateTime=1793343089343, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940060072542250, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940060072542251, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3074, endPage=3079, ext={EN=ArticleExt(id=1322924416484651838, articleId=1322924416291713853, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Methodological application and reflection of constructivist grounded theory in nursing research, columnId=1322165088144962406, journalTitle=Chinese Nursing Research, columnName=Methodology Study, runingTitle=null, highlight=null, articleAbstract=

This paper systematically explained the philosophical foundations and key methodological steps of constructivist grounded theory.Using practical examples from nursing research,it highlighted reflective strategies that position researchers as co-constructors of meaning.The paper also examined the method's limitations and ethical challenges in nursing research, and discussed its future integration with digital tools.Ultimately,we aim to provide methodological support for developing culturally sensitive and explanatory nursing theories tailored to local contexts.

, authors=Xiyi WANG1, Yun HU1, Li XU1, 2, Zhaozhang SUN3, 4, authorsList=Xiyi WANG, Yun HU, Li XU, Zhaozhang SUN, authorCompany=null, correspAuthors=Zhaozhang SUN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322924416753087295, articleId=1322924416291713853, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=护理研究中建构性扎根理论的方法学应用与反思, columnId=1322165088312734568, journalTitle=护理研究, columnName=方法学研究, runingTitle=null, highlight=null, articleAbstract=

系统阐释建构性扎根理论的哲学基础、方法学应用关键环节，并结合护理研究实例重点剖析研究者作为意义共建者的反思性策略。在此基础上，反思该方法在护理研究中的应用局限与伦理挑战，并展望其与数智化工具融合的未来方向，以期为构建具有文化敏感性与解释力的本土化护理理论提供方法学支持。

, authors=王喜益1, 胡韵1, 许莉1, 2, 孙照彰3, 4, *, *, authorsList=王喜益, 胡韵, 许莉, 孙照彰, authorCompany=null, correspAuthors=孙照彰, authorNote=

王喜益,副研究员

, correspAuthorsNote=
孙照彰，E-mail：
SUN Zhaozhang, E-mail:
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护理研究中建构性扎根理论的方法学应用与反思
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王喜益 1 , 胡韵 1 , 许莉 1, 2 , 孙照彰 3, 4, *, *
护理研究 | 方法学研究 2026,40(17): 3074-3079
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护理研究 |方法学研究 2026 , 40 (17) : 3074 -3079
护理研究中建构性扎根理论的方法学应用与反思
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王喜益1, 胡韵1, 许莉1, 2, 孙照彰3, 4, *, *
作者信息
  • 1上海交通大学护理学院，上海 201318
  • 2上海交通大学医学院附属仁济医院
  • 3伯明翰大学医学与健康学院 健康科学学院应用健康科学系
  • 4英国国家行为科学培训与研究中心
通讯作者:
孙照彰，E-mail：
SUN Zhaozhang, E-mail:
作者简介:

王喜益,副研究员

Methodological application and reflection of constructivist grounded theory in nursing research
Xiyi WANG1, Yun HU1, Li XU1, 2, Zhaozhang SUN3, 4
Affiliations
  • 1School of Nursing, Shanghai Jiao Tong University, Shanghai 201318 China
  • 2Renji Hospital, Shanghai Jiao Tong University School of Medicine
  • 3Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham
  • 4National Centre for Behavioural Science Training and Research, UK
出版时间: 2026-09-10 doi: 10.12102/j.issn.1009-6493.2026.17.017
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摘要
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系统阐释建构性扎根理论的哲学基础、方法学应用关键环节，并结合护理研究实例重点剖析研究者作为意义共建者的反思性策略。在此基础上，反思该方法在护理研究中的应用局限与伦理挑战，并展望其与数智化工具融合的未来方向，以期为构建具有文化敏感性与解释力的本土化护理理论提供方法学支持。

建构性扎根理论  /  方法学  /  护理研究  /  反思性实践  /  理论创新

This paper systematically explained the philosophical foundations and key methodological steps of constructivist grounded theory.Using practical examples from nursing research,it highlighted reflective strategies that position researchers as co-constructors of meaning.The paper also examined the method's limitations and ethical challenges in nursing research, and discussed its future integration with digital tools.Ultimately,we aim to provide methodological support for developing culturally sensitive and explanatory nursing theories tailored to local contexts.

constructivist grounded theory  /  methodology  /  nursing research  /  reflective practice  /  theoretical innovation
王喜益, 胡韵, 许莉, 孙照彰. 护理研究中建构性扎根理论的方法学应用与反思. 护理研究, 2026 , 40 (17) : 3074 -3079 . DOI: 10.12102/j.issn.1009-6493.2026.17.017
Xiyi WANG, Yun HU, Li XU, Zhaozhang SUN. Methodological application and reflection of constructivist grounded theory in nursing research[J]. Chinese Nursing Research, 2026 , 40 (17) : 3074 -3079 . DOI: 10.12102/j.issn.1009-6493.2026.17.017
正文
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质性研究因能深入揭示人类经验的内涵、意义、建构过程及社会互动机制，在护理研究中日益受到重视 [1]。其核心在于理解个体在特定情景中的生命体验，与护理学“以人为中心”的整体照护理念高度契合[2-3]。在多种质性方法中，扎根理论（grounded theory）作为重要的理论生成范式，为研究者从经验资料中系统建构概念和理论提供了坚实的方法学支撑[4]。自2002年李峥教授将该方法引入我国护理领域以来，相关研究[5-6]数量虽逐年增长，但总体增幅仍较有限。近年来，建构性扎根理论（constructivist grounded theory,CGT）在慢性病管理、心理社会适应、照护关系及健康行为等领域应用不断拓展，展现出理论创新与实践转化潜力[7-8]。然而，目前国内护理研究中扎根理论的应用仍存在方法论混用现象和“反思性中立”“意义饱和”等关键概念缺乏可溯源的操作性定义，以及理论建构深度不够等问题，多数研究停留在描述性主题归纳阶段，未能充分体现建构性扎根理论所强调的情景化解释、意义共构与理论升华。在护理理论多元化与本土化并行的背景下，我国护理学亟需构建既符合国际方法论规范，又契合本土文化语境的理论建构路径。建构性扎根理论所倡导的情景化理论生成、共建式知识生产与反思性实践，为研究者在保持方法学严谨性的同时，更深入呈现病人经验、照护关系与文化语境的复杂性提供了可操作框架。基于此，现从哲学基础、方法学应用与反思性实践3个方面梳理建构性扎根理论在护理研究中的应用进展，以期助力本土护理研究的理论深化、方法创新与实践价值提升。
1　建构性扎根理论发展的哲学理念和方法论取向
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扎根理论由Glaser与Strauss于1967年提出，旨在通过系统化的资料分析自下而上生成理论，突破传统社会科学中“理论先行、数据验证”的逻辑，建立以经验为基础的理论建构路径。此后，Strauss与Corbin于1990年发展出程序化扎根理论，确立了开放、主轴与选择编码等步骤，加强了方法的系统性与可操作性[9-10]。然而，程序化导向在一定程度上削弱了研究者与研究情景的能动互动，使“理论发现”与“理论建构”之间产生方法学张力。
传统扎根理论立基于实证主义范式，将研究者视为“中立的发现者”[4]，较少关注研究者与参与者的互动及知识生成的社会情景性。伴随社会科学认识论由经验主义向解释主义的历史性转向，扎根理论逐渐吸纳诠释学、现象学与符号互动论等思想资源，使其哲学基础从强调客观发现转向关注意义生成与情景解释 [11]。在此背景下，有学者发展出建构性扎根理论[12]。建构性扎根理论立足建构主义认识论，强调知识是研究者与参与者在互动、对话与诠释中共同建构的产物[11]，标志着扎根理论由实证主义向解释主义的重要范式跃迁[13]。建构性扎根理论调整了传统扎根理论“客观主义”假设，强调理论生成的动态性、反思性与解释性，为探索护理情境中多层次、多主体、多情景交织的经验与行为机制提供了更契合人文特质的研究框架[8]。Charmaz[9]强调，研究者的立场、经验、情感与价值观不仅不可剥离，而且是理论生成不可或缺的组成部分；理论并非对客观现实的简单再现，而是对经验世界的解释性重构。由此可见，建构性扎根理论主张理论生成是“解释性共构”的持续实践[14]，方便护理研究在理论建构过程中呈现病人经验、照护关系与文化语境的深度复杂性[7-8]，并为构建具有本土文化敏感性与国际方法论规范性的护理理论提供可能。
2　建构性扎根理论的方法学应用
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建构性扎根理论在继承经典扎根理论系统性与逻辑严谨性的基础上，融入了建构主义对知识、情景与主体反思的关注，认为理论不是被“发现”的，而是在研究者与参与者互动中形成的。其研究过程贯穿研究设计、数据收集、分析与理论生成的全过程，呈现出持续比较、循环建构和反思生成的动态特征。
2.1　基于理论取向与研究者立场的研究设计
建构性扎根理论研究设计强调研究问题的开放性与研究者的理论敏感性，关注“现象如何被理解、被形成和被赋予意义”。问题的提出源于实践观察与理论空白识别，而非假设验证。研究者需避免预设框架，通过对护理现象的深入感知提出探索性问题。例如，Andrews等[7]以护士群体的自我照护与自我同情为研究主题，发现护理规范、政策及公众叙事多强调“病人优先”，护士被期望提供同理心护理，却缺乏对自我的关照与同情。这一研究揭示了护士在制度与职业文化中面临的“获得许可式”自我照护困境，体现了建构性扎根理论对于社会结构如何塑造意义建构的关注。同时，建构性扎根理论研究者往往兼具研究情景的参与身份，应在研究初期明确自身立场与假设意识，认识到专业经验对数据理解与解释的潜在影响。以智利重症监护室（ICU）护士家庭-工作互动研究为例[15]，主要研究者为男性且具有ICU实践经验，熟悉女性护理实践语境并具备性别敏感性，这一经验为理解护士在家庭与职业冲突中的意义建构提供了文化与情境基础。Charmaz[9]指出，研究者应通过持续反思与备忘录书写，将主观立场转化为理论生成的资源，而非偏倚来源[9]。这种“反思性中立”并非否认立场，而是在承认立场存在的基础上，对其影响进行识别、觉察与整合，从而实现理论的开放共构[16]。
2.2　基于互动性访谈与情境化观察的数据收集
建构性扎根理论的数据收集遵循理论抽样原则，即根据分析中出现的概念与范畴动态调整样本，以确保理论的深度与多样性[17]。数据收集与分析并非线性推进，而是呈现持续比较、循环往复的互动特征。研究者需依据研究问题的情景性特征，采用多种资料来源捕捉参与者经验及其社会文化语境。半结构式访谈是建构性扎根理论最常用的方法之一。通过开放式提问、对话式追问及即时澄清，研究者可引导参与者对其经验进行深入反思与意义阐释[18]。在访谈过程中，研究者需保持理论敏感性，关注经验中意义生成的动态过程，并据此调整访谈方向与问题深度。文本分析亦是重要资料来源，包括政策文本、临床记录、教育文件、社交媒体叙事等，可为理论提供制度、文化与社会结构的补充性解释框架。多元文本的纳入能够增强理论的情境适配性与文化解释力。此外，建构性扎根理论研究还可结合非参与观察，通过捕捉行为模式、互动过程及情境特征，为理论建构提供丰富的实践背景[15]。例如，Grosvenor等[19]以12名成年护理学专业本科生为研究对象，开展纵向访谈与观察（12、24、36 个月），分析学生与认知障碍老年人及家庭互动的变化过程，提炼出“理解老年痴呆的整体图景”理论。该研究不仅揭示了学生在临床学习中的认知成长与职业认同建构，也体现了建构性扎根理论对“过程性理解”与“情境化理论”的强调。建构性扎根理论通过互动性访谈、文本资料整合与情境化观察的结合，使研究者能够在深度描述参与者经验的同时，理解其背后的社会文化背景，从而确保理论解释具备深度与语境契合度。
2.3　基于建构性编码与理论化抽象的数据分析
建构性扎根理论的数据分析延续扎根理论的系统编码逻辑，同时强调研究者在分析中的反思性参与。初级编码通过逐行分析文本，以开放、贴近数据的方式捕捉参与者叙事中的关键经验与意义，是理论生成的基础。在Andrews等[7]以护士自我照护研究为例，初级编码包括“缺乏对关键概念的理解”“需要角色模范”“无法从认识转向行动”“被阻挡”“需要认识与接纳自我”等。这些编码直接来自护士对自我照护认知、行为障碍及心理冲突的原始叙述，虽数量众多且较为分散，但为后续理论提升提供了丰富的真实素材。聚焦编码从初级编码中筛选最具解释力、重复频次最高的编码进行整合，形成更高层次的范畴。例如Andrews等[7]研究中，“护理人格特征”“护理职业认同”“天生就是照顾者”“专业角色与身份”“培训与经验”“背景与早期经历”“需要角色模范”等均源于对初级编码的系统整合。其中，“天生就是照顾者”整合了关于护理动机、职业身份与自我概念的若干初级代码，形成了影响自我照护接纳能力的重要中层范畴。理论编码则用于识别聚焦编码与核心范畴之间的逻辑关系，通过条件-互动-结果矩阵或其他理论框架建构整合性理论模型。Andrews等[7]分析中，“天生就是照顾者”（护理身份）与“需要稳定基础”（工作与自我安全感）构成自我照护行为的条件维度；核心互动过程表现为护士在组织文化、专业规范与个人价值之间进行的协商；最终形成“需要许可”（来自他人与自我）核心范畴，并解释了主动与被动自我照护行为的差异及其影响结果（如护理质量下降与职业倦怠风险）。由此可见，与采用经典扎根理论识别“共同关切问题”普遍规律的研究不同，建构性扎根理论更强调意义如何在互动与情境中被建构。例如，Connor等[20]采用经典扎根理论分析护士应用早期预警系统的临床判断逻辑；而若在建构性扎根理论视角下，研究者更关注护士如何在组织文化、专业价值与临床经验的交互中生成意义与决策逻辑[8,21-22]。两者均体现质性研究中归纳、演绎与解释的交织[10]。符号互动论也指出，研究者的理解不可避免地受到经验与价值观的影响[12]。因此，建构性扎根理论的理论提炼需在持续比较、反思性对照与跨情境验证中不断深化，以确保概念具有内涵清晰、逻辑严整与情境适应的特征。
2.4　基于反思性中立与意义饱和的理论建构
理论建构的核心在于“意义生成”，通过研究者与参与者的持续互动，将经验抽象为解释性理论[10,23]。建构性扎根理论强调“意义饱和”而非单纯的“概念饱和”。意义饱和指研究者与参与者对核心范畴的内涵、边界、变异与相互关系达到充分理解，不再出现可影响理论解释的重要新意义或新关系[23]。其判断标准包括：范畴间关系趋于稳定、理论解释具备完整性与一致性、研究者与参与者在意义上达成共识[24]。以Jahner等[25]农村护士创伤研究为例，研究者通过分阶段理论抽样招募了19名护士，并开展了33次访谈，另收集14份反思日志。研究者在形成核心范畴“保持坚强”（staying strong）后，通过追加4个创伤应激的反面案例，进一步检视理论边界、作用机制与失效情形。在访谈第12名参与者后，研究者虽观察到数据重复，但仍通过后续抽样验证理论稳定性，最终确认理论在经验维度与情境维度均达到“意义饱和”。这一研究过程显示建构性扎根理论特别强调对现象复杂性的深度理解，而非仅停留在表层编码的重复验证。在这一过程中，研究者需要持续反思自身立场、价值与经验对理论解释的影响，检视理论与数据之间的一致性，并评估理论的情境适用性与临床实践价值[26]。最终，意义饱和的达成标志着理论在特定情境下具有充分的解释力，体现研究者对经验复杂性与社会语境的整合性理解。
3　护理研究应用建构性扎根理论的反思性实践
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建构性扎根理论强调研究者的主体参与性、反思性以及方法学自觉，其实践策略体现了从经验到理论的动态共建。由于护理研究者常兼具观察者、护理者和解释者多重角色，因此，在研究过程中更需持续觉察自身立场、情感与价值观如何影响数据获取、意义生成与理论构建[15,27]。
3.1　研究者作为意义共建者
在建构性扎根理论框架下，研究者不再被视为“中立的旁观者”，而是参与数据共同建构与意义生成的关键行动者。研究者的提问方式、叙事回应、非语言行为、学术背景及专业身份均可能影响数据的呈现形式与概念的发展方向，因此访谈提纲、追问逻辑乃至情感流动都应被视为资料的一部分，而非背景变量[28]。护士作为研究者时，其临床经验与专业身份在理论共建中发挥独特作用。例如，在中国文化情境下探讨男护士为女病人提供隐私护理的建构性扎根理论研究中 [29]，男性护理学者的研究者身份不仅为理解“做还是不做”的伦理困境提供了文化洞察，也促成了深度信任关系，使研究能够深入揭示护理专业职责、传统性别规范与家庭成员态度三者之间的张力。研究者通过撰写反思性备忘录记录访谈中的情感共鸣、自身立场与理论敏感性转变，最终构建出“在文化规范与专业伦理之间协商身份”的理论模型。此外，在以病人为中心的健康服务研究中，护理人员在访谈中的自我定位（如倡导者、照护者、协调者）影响其对经验事件的叙述方式，进而影响理论的建构路径[21]。建构性扎根理论通过引导研究者在访谈、观察与分析中持续觉察“我是谁、我如何理解他人、我如何影响数据”，可以实现从“反思性自省”到“理论性共建”的方法转化。贯穿研究全过程的研究者主体性，是理论创新的动力来源，而非需要排除的偏倚，同时使得理论生成的“真实”是多主体互动与协商的结果，而非客观现实的机械再现。
3.2　反思性策略与实践路径
为有效落实建构性扎根理论的反思性原则，护理研究者可从3个层面实现系统性反思。首先，可通过撰写研究日志系统记录访谈现场的情境变化、个人感受及分析决策逻辑，从而追溯研究思维演变过程[19]。其次，有研究者指出，研究者应通过持续反思与备忘录书写，将主观立场转化为理论生成的资源[16]。反思性中立指研究者在承认立场存在的基础上，对其影响进行识别、监测与调适，从而实现理论的开放共构。反思性备忘录作为建构性扎根理论的核心方法学工具，应清楚记录标准化要点与最小合规要素，包括场景（描述何事、何地、与谁）、立场（研究者的身份、预设与情感状态）、影响（立场对编码、解释的可能作用）、调适（采取的补救与校正措施）。备忘录不仅是分析的过程记录，更是研究者“自我介入的证据链”，可揭示理论生成背后的解释逻辑[24]。再者，建构性扎根理论强调滚动式理论对照与文献更新来辅助比较性反思。初期识别研究空白，中期在聚焦编码阶段开展定向对照，后期结合理论框架进行概念定位与边界辨析。研究者通过记录“何时、为何、如何对照”，以强化理论链条的清晰性与原创性[11,16]。此外，团队讨论与同行审阅是建构性扎根理论研究的重要质量保障机制。团队讨论与同行审阅可通过多视角比较减少解释偏差，增强理论建构的可信度与准确性[19,30-31]。通过集体反思机制使建构性扎根理论研究从个体经验的阐释迈向群体意义的共建[11]。
3.3　信度与伦理的再界定
在建构性扎根理论框架下，研究信度不再以传统实证主义的“客观一致性”为标准，而是以研究过程的透明化、反思性记录及研究者与参与者之间的意义共识为核心。建构性扎根理论护理研究审核清单可作为质量监测的操作化工具，对抽样、数据收集、编码、备忘、理论化及可追溯性进行全流程追踪。理论的可信度体现在概念形成的逻辑清晰性与概念密度、数据与理论链条的透明性与验证性，以及研究者反思与多视角审阅的深度[9,21]。伦理层面，建构性扎根理论强调“关系伦理”而非单纯的程序伦理。研究者需在共情与边界之间保持平衡，既保护参与者免受再度伤害，又忠实呈现其意义世界。例如，在探讨护士应对创伤事件影响的研究中，研究者需在共情基础上避免再度伤害，同时理解其“保持坚强”的心理建构过程[25]。在中国文化语境中，研究者还需处理好权威结构、集体关系与互动礼仪等文化因素，确保研究在信任与尊重基础上推进[29]。
4　建构性扎根理论在护理研究中的应用反思
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4.1　方法学应用中的实践挑战
建构性扎根理论在护理研究中展现出高度的灵活性与理论生成力，使复杂的临床经验与社会文化情景得以被系统地理解。然而，建构性扎根理论在实际应用的过程中也面临方法学挑战。尽管建构性扎根理论倡导研究者系统记录立场、经验与情感对分析的影响，但实际研究中，立场陈述常流于形式，如仅说明“研究者具有护理专业背景”，缺乏对情境、情绪与价值立场如何影响访谈互动和概念生成的具体记录，从而削弱了理论推演过程的透明性。再者，许多研究仍习惯以“数据不再出现新编码”作为饱和标准，而忽略了建构性扎根理论所强调的“意义饱和”，即对范畴内涵、边界与变异的深入理解。由此导致理论发展停留在主题总结或描述性分类层面，难以生成具有解释力的理论模型。此外，建构性扎根理论主张延迟系统性文献回顾，以避免概念先入为主。然而，研究者在伦理审批与课题申报中必须提供充分的文献依据，这与建构性扎根理论保持理论敏感性的原则存在实践张力。研究者因此需要在“理论生成”与“理论先行”之间寻求平衡 [4]，确保既满足研究审批要求，又不牺牲理论构建的开放性。
4.2　文化情境中的适配性挑战
护理实践深受文化、制度与社会互动方式的影响，而建构性扎根理论源于西方社会文化，其概念与框架在中国情景下的适配性面临挑战。建构性扎根理论倡导在研究中关注互动性伦理，包括情感、信任与关系动态。但在中国文化体系中，研究者与参与者之间常涉及科层等级、面子文化与群体价值观。例如在涉及职业倦怠或护理差错等敏感议题时，参与者可能出于“维护科室形象”或避免风险而隐藏真实经验，影响理论完整性。此外，直接借用西方概念框架往往难以充分反映中国文化语境下护理现象的特征与关系[32]。如“获得许可式自我照护”概念反映个人主义文化中自我与他人边界的强调，而在中国文化中，护士的自我照护更可能体现为“在家庭责任与职业义务之间的平衡”。因此，过度依赖西方理论框架可能掩盖本土护理现象的文化逻辑。面对跨系统、跨文化的护理现象，单一理论难以涵盖其复杂性[33]。建构性扎根理论所倡导的开放性、灵活性与多理论融合路径，为构建更具文化适配性与应用价值的本土护理理论提供了方法基础。
4.3　方法融合与技术创新的发展潜力
随着人工智能、自然语言处理、多模态分析等技术的发展，建构性扎根理论正向数智化辅助的研究生态拓展，为理论生成带来新的可能。人工智能辅助编码、计算扎根理论与交互式备忘系统，可帮助研究者从多模态数据（访谈、观察、文本、影像）中识别复杂关系模式，提升理论生成的效率与可视化程度。但研究者仍需保持方法学主体性，避免算法在意义生成中取代人类的反思性判断[34-35]。借助数智化工具实现数据饱和检测、编码追溯及理论图谱可视化的同时[35]，研究者应通过团队讨论与同行审阅，持续检验理论解释的文化适切性与临床相关性。同时，也为建构性扎根理论所得的情境化理论嵌入临床决策支持系统、护理教育课程设计与管理政策制定，构建以意义建构为核心的护理实践改进模式提供基础。
5　小结
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建构性扎根理论为护理研究提供了兼具科学性与人文性的范式，强调研究者与参与者共同建构意义，从而强化理论生成的逻辑严密性与科学规范性。然而，其应用仍面临方法学透明度、文化适配性与技术融合等方面的挑战。未来研究亟需在反思性实践、数智化工具运用与本土理论创新三个方向持续探索，以促进护理学从经验描述迈向理论建构与知识创新的深度发展。

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doi: 10.12102/j.issn.1009-6493.2026.17.017
  • 接收时间：2025-11-14
  • 首发时间：2026-10-30
  • 出版时间：2026-09-10
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  • 收稿日期：2025-11-14
  • 修回日期：2026-07-14
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    1上海交通大学护理学院，上海 201318
    2上海交通大学医学院附属仁济医院
    3伯明翰大学医学与健康学院 健康科学学院应用健康科学系
    4英国国家行为科学培训与研究中心

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孙照彰，E-mail：
SUN Zhaozhang, E-mail:
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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