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Ambientes de Prática de Enfermagem nos Cuidados de Saúde Primários: Olhares dos Enfermeiros Gestores
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| 1.91 MB | Adobe PDF |
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Abstract(s)
Nas últimas décadas, as necessidades de cuidados mais complexas, a evolução tecnológica e a preocupação com a garantia da qualidade dos cuidados, têm constituído um enorme desafio para a enfermagem. Existe evidência de que os fatores preditivos comuns ao bem-estar dos enfermeiros, à qualidade e à segurança dos cuidados, se referem às dimensões dos ambientes de prática profissional, reforçando a importância de avaliar e identificar oportunidades de melhoria. Os enfermeiros gestores assumem um papel crucial nos ambientes de prática profissional, devendo a sua ação centrar-se na qualificação e monitorização desses ambientes. É notória a carência de estudos sobre os ambientes de prática de enfermagem nos cuidados de saúde primários. Neste contexto, planeou-se uma investigação com o objetivo de analisar, na perspetiva dos enfermeiros gestores, as características dos ambientes de prática de enfermagem nos cuidados de saúde primários. Trata-se de um estudo descritivo, exploratório, quanti-qualitativo. Participaram 112 enfermeiros gestores dos cuidados de saúde primários de Portugal Continental e Ilhas. A técnica de amostragem foi não probabilística por conveniência. Como instrumento de colheita de dados foi utilizado, um questionário de autopreenchimento, elaborado no Google Forms e enviado online por email. A colheita de dados foi efetuada de fevereiro a junho de 2024. Com recurso ao software Statistical Package for the Social Sciences (versão 27.0), foi realizada estatística descritiva e inferencial. Os dados qualitativos foram analisados por meio da análise temática de Bardin (2016), alicerçada no referencial teórico de Donabedian. Da aplicação da escala de avaliação dos ambientes de prática de enfermagem, os resultados demonstram que todas as dimensões foram consideradas favoráveis à qualidade dos cuidados e ao bem-estar dos enfermeiros. A idade do enfermeiro gestor teve um efeito positivo nas componentes Processo e Resultado, assim como na escala global, na medida em que as pontuações são superiores no caso dos enfermeiros com mais idade. A dimensão “políticas institucionais e envolvimento dos enfermeiros“, da componente Estrutura, foi a que apresentou valores mais baixos (média 3,20), emergindo ainda nesta componente a dimensão com maior média a “gestão de pessoas e liderança no serviço” (média 4,20). A componente Resultado apresentou a média mais baixa (3,30), verificando-se fragilidades nas suas dimensões, que carecem de atenção. Da análise das perceções e contributos dos enfermeiros gestores para a criação de ambientes mais positivos emergiram a necessidade de investir na participação dos enfermeiros nas políticas e decisões dos serviços, em garantir o desenvolvimento profissional e promover ambientes seguros e saudáveis, utilizando estratégias de liderança, comunicação assertiva, escuta ativa, valorização e motivação.
In recent decades, the need for more complex care, technological developments, and concerns about guaranteeing the quality of care has posed a huge challenge for nursing. There is evidence that the common predictors of nurses' well-being, quality, and safety of care refer to the dimensions of professional practice environments, reinforcing the importance of evaluating and identifying opportunities for improvement. Nurse managers play a crucial role in professional practice environments, and their actions should be centered on qualifying and monitoring these environments. There is a notable lack of studies on nursing practice environments in primary healthcare. In this context, an investigation was planned to analyze, from the perspective of nurse managers, the characteristics of nursing practice environments in primary healthcare. This is a descriptive, exploratory, quantitative, and qualitative study. A total of 112 nurse managers from primary healthcare centers in mainland Portugal and the islands took part. The sampling technique was non-probabilistic for convenience. The data collection instrument used was a self-completion questionnaire, designed in Google Forms and sent online by email. Data was collected from February to June 2024. Descriptive and inferential statistics were carried out using the Statistical Package for the Social Sciences software (version 27.0). The qualitative data was analysed using Bardin's (2016) thematic analysis, based on Donabedian's theoretical framework. The application of the evaluation scale for nursing, the results show that all dimensions were considered favorable to the quality of care and the well-being of nurses. The nurse manager's age had a positive effect on the Process and Outcome components, as well as on the overall scale, in that the scores are higher in the case of older nurses. Older nurses scored better on this component. The ‘institutional policies and involvement of nurses’ dimension of the Structure component was the one with the lowest scores (average 3.20), while the dimension with the highest mean was ‘management of people and leadership in the service’ (average 4.20). The Outcome component had the lowest average (3.30), showing weaknesses in its dimensions that need attention. The analysis of nurse managers‘ perceptions and contributions to creating more positive environments revealed the need to invest in nurses’ participation in service policies and decisions, to guarantee professional development, and to promote safe and healthy environments, using leadership strategies, assertive communication, active listening, appreciation, and motivation
In recent decades, the need for more complex care, technological developments, and concerns about guaranteeing the quality of care has posed a huge challenge for nursing. There is evidence that the common predictors of nurses' well-being, quality, and safety of care refer to the dimensions of professional practice environments, reinforcing the importance of evaluating and identifying opportunities for improvement. Nurse managers play a crucial role in professional practice environments, and their actions should be centered on qualifying and monitoring these environments. There is a notable lack of studies on nursing practice environments in primary healthcare. In this context, an investigation was planned to analyze, from the perspective of nurse managers, the characteristics of nursing practice environments in primary healthcare. This is a descriptive, exploratory, quantitative, and qualitative study. A total of 112 nurse managers from primary healthcare centers in mainland Portugal and the islands took part. The sampling technique was non-probabilistic for convenience. The data collection instrument used was a self-completion questionnaire, designed in Google Forms and sent online by email. Data was collected from February to June 2024. Descriptive and inferential statistics were carried out using the Statistical Package for the Social Sciences software (version 27.0). The qualitative data was analysed using Bardin's (2016) thematic analysis, based on Donabedian's theoretical framework. The application of the evaluation scale for nursing, the results show that all dimensions were considered favorable to the quality of care and the well-being of nurses. The nurse manager's age had a positive effect on the Process and Outcome components, as well as on the overall scale, in that the scores are higher in the case of older nurses. Older nurses scored better on this component. The ‘institutional policies and involvement of nurses’ dimension of the Structure component was the one with the lowest scores (average 3.20), while the dimension with the highest mean was ‘management of people and leadership in the service’ (average 4.20). The Outcome component had the lowest average (3.30), showing weaknesses in its dimensions that need attention. The analysis of nurse managers‘ perceptions and contributions to creating more positive environments revealed the need to invest in nurses’ participation in service policies and decisions, to guarantee professional development, and to promote safe and healthy environments, using leadership strategies, assertive communication, active listening, appreciation, and motivation
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Keywords
Ambientes de Trabalho Prática Profissional Cuidados de Saúde Primários Gestão de Enfermagem Qualidade dos Cuidados de Saúde