Prontidão para a mudança em enfermeiros no contexto hospitalar: associação com job engagement e percepção de autoeficácia
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Data
2014
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Resumo
Os enfermeiros enfrentam diariamente diretivas que alteram os métodos de trabalho,
nomeadamente no âmbito da qualidade e segurança do doente. Como tal, é importante que
o gestor identifique se os profissionais estão prontos e comprometidos com as novas
medidas, e de que forma fenómenos como o Job Engagement (JE) e a Perceção de
Autoeficácia (PAE) influenciam este processo, de forma a prever comportamentos e a
adequar estratégias na implementação da mudança.
Esta investigação teve por objetivo caracterizar a prontidão e o compromisso com a
mudança de enfermeiros em contexto hospitalar, no âmbito de mudanças organizacionais
promotoras da segurança do doente (SD), e analisar a associação entre JE e PAE na
adoção de novas medidas de prevenção de infeção (lavagem de mãos) e de identificação do
doente (uso de pulseira).
O estudo baseia-se numa abordagem quantitativa, do tipo descritivo, observacional e
transversal. A recolha de dados foi efetuada através de questionários autoadministrados a
enfermeiros do Centro Hospitalar Lisboa Norte E.P.E. – Hospital Santa Maria (CHLN-HSM).
Trata-se de um censos de enfermeiros integrados em serviços dos departamentos de
cirurgia e medicina. Os questionários foram distribuídos com apoio da enfermeira-chefe de
cada serviço, sendo a resposta anónima e confidencial (questionários entregues em
envelope fechado e depositados em caixa de recolha apenas acessível pelo investigador). O
questionário incluía um conjunto de escalas previamente estudadas: a adaptação do
University of Rhode Island Change Assessment (URICA), o Commitment to Organizational
Change, o General Self-Efficacy (GSE) e a Utrecht Work Engagement Scale (UWES).
No total, participaram 265 enfermeiros (o que corresponde a uma taxa de resposta
de 57,1%). Os resultados obtidos demonstram que há uma correlação significativa entre JE,
PAE, compromisso com a mudança (CM) e prontidão para a mudança (PM). Verifica-se que
os enfermeiros “engajados” e com elevada perceção de autoeficácia estão mais
comprometidos com a mudança (em especial, com compromisso afetivo com a mudança). A
perceção de autoeficácia é variável mediadora da relação JE e CM afetivo.
Conclui-se ser fundamental que os gestores adotem estratégias que mantenham os
funcionários motivados, promovendo a perceção de autoeficácia quanto às suas
capacidades enquanto profissionais e promovendo o job engagement continuado no tempo.
Desta forma será expectável maior adesão e envolvimento por parte dos enfermeiros a
novas medidas a implementar.
Nurses face daily guidelines that change their working methods, mainly in the context of quality and patient safety. As such, it is important to the manager to identify professional’s readiness and commitment to new measures, and understand how phenomena such as Job Engagement (JE) and Self-efficacy Perception (PAE) influence this process, in order to predict behaviours and adjust strategies throughout change implementation. This research aims to characterize the readiness and commitment to change of nurses in a hospital during organizational changes that aspire patient safety (SD), and to analyse the association between JE and PAE in the course of the acceptance of new measures of infection prevention (washing hands) and patient identification (use of bracelet). The study is based on a quantitative, descriptive, observational, cross-sectional approach. Data collection was conducted through self-administered questionnaires to nurses working at Centro Hospitalar Lisboa Norte E.P.E. – Hospital Santa Maria (CHLN-HSM). This is a census of nurses integrated in units of the department of surgery and medicine. The questionnaires were distributed with the support of the head chief nurse of each unit, and the response was anonymous and confidential (questionnaires were delivered in a sealed envelope and deposited in the collection box, accessible only by the investigator). The questionnaire included a set of scales previously studied: the adaptation of the University of Rhode Island Change Assessment (URICA), the Commitment to Organizational Change, the General Self-Efficacy (GSE) and the Utrecht Work Engagement Scale (UWES). In total, 265 nurses participated (which corresponds to a response rate of 57.1%). The results show that there is a significant correlation between JE, PAE, commitment to change (CM) and readiness to change (PM). It indicates that engaged nurses with high selfefficacy perception are more committed to change (especially with affective commitment to change). The perception of self-efficacy mediates the relationship between JE and CM affective. Therefore it is essential that managers adopt strategies that keep employees motivated, promoting the perception of self-efficacy regarding their abilities as professionals and promoting continued job engagement in time. This could lead to greater support and involvement by nurses to new measures.
Nurses face daily guidelines that change their working methods, mainly in the context of quality and patient safety. As such, it is important to the manager to identify professional’s readiness and commitment to new measures, and understand how phenomena such as Job Engagement (JE) and Self-efficacy Perception (PAE) influence this process, in order to predict behaviours and adjust strategies throughout change implementation. This research aims to characterize the readiness and commitment to change of nurses in a hospital during organizational changes that aspire patient safety (SD), and to analyse the association between JE and PAE in the course of the acceptance of new measures of infection prevention (washing hands) and patient identification (use of bracelet). The study is based on a quantitative, descriptive, observational, cross-sectional approach. Data collection was conducted through self-administered questionnaires to nurses working at Centro Hospitalar Lisboa Norte E.P.E. – Hospital Santa Maria (CHLN-HSM). This is a census of nurses integrated in units of the department of surgery and medicine. The questionnaires were distributed with the support of the head chief nurse of each unit, and the response was anonymous and confidential (questionnaires were delivered in a sealed envelope and deposited in the collection box, accessible only by the investigator). The questionnaire included a set of scales previously studied: the adaptation of the University of Rhode Island Change Assessment (URICA), the Commitment to Organizational Change, the General Self-Efficacy (GSE) and the Utrecht Work Engagement Scale (UWES). In total, 265 nurses participated (which corresponds to a response rate of 57.1%). The results show that there is a significant correlation between JE, PAE, commitment to change (CM) and readiness to change (PM). It indicates that engaged nurses with high selfefficacy perception are more committed to change (especially with affective commitment to change). The perception of self-efficacy mediates the relationship between JE and CM affective. Therefore it is essential that managers adopt strategies that keep employees motivated, promoting the perception of self-efficacy regarding their abilities as professionals and promoting continued job engagement in time. This could lead to greater support and involvement by nurses to new measures.
Descrição
Orientação: Vasco Reis ; co-orientação: Osvaldo Santos
Palavras-chave
GESTÃO DE UNIDADES DE SAÚDE, GESTÃO HOSPITALAR, MUDANÇA ORGANIZACIONAL, COMPROMISSO ORGANIZACIONAL, AUTO-EFICÁCIA, ENFERMEIROS, HEALTH UNITS MANAGEMENT, HOSPITAL MANAGEMENT, ORGANIZATIONAL CHANGE, ORGANIZATIONAL COMMITMENT, SELF EFFICACY, NURSES, MESTRADO EM GESTÃO DE UNIDADES DE SAÚDE