Nurses’ adaptation to digital transformation in healthcare: A grounded theory of progressive digital adaptation

Abstract

BackgroundDigital transformation in healthcare requires nurses to use new technologies while maintaining care quality. Adaptation becomes challenging in resource-limited settings where training, support, and infrastructure vary and where nurses often face competing demands.ObjectiveThis study aimed to develop a grounded theory explaining how nurses progressively adapt to digital transformation, the conditions that facilitate or hinder their movement, and the strategies they use to manage challenges.MethodsA grounded theory design guided the study. Thirty nurses in an Egyptian private hospital participated in in-depth semi-structured interviews conducted over four months. Data collection and analysis followed constant comparison and continued until theoretical saturation.ResultsThe study produced the Progressive Digital Adaptation theory. Two trajectories were identified. The sustaining trajectory showed confident and continuous integration, while the struggling trajectory reflected resistance or stalled movement. Five themes shaped adaptation. These were recurring resistance to technology, iterative learning and skill acquisition, integration into clinical routines, contextual factors influencing progression, and mechanisms supporting sustained transformation.ConclusionsEffective digital adaptation depends on consistent organizational commitment. The theory clarifies how nurses progress or regress between stages and identifies practical targets for interventions that strengthen digital transformation in varied healthcare settings.