Relação entre a qualidade de vida e o ambiente de trabalho do enfermeiro
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Data
2017-12-19
Autores
Santos, Roselaine Raimundo
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: O processo de trabalho em enfermagem é complexo e tem particularidades que contemplam o assistir de forma ininterrupta os usuários dos serviços de saúde, em especial os que estão internados e seus familiares, com relações interpessoais contínuas. Esse trabalho é desenvolvido em um ambiente que pode interferir na qualidade de vida. Objetivo: correlacionar a qualidade de vida e ambiente de trabalho dos enfermeiros em um hospital de ensino no interior do Estado de São Paulo e elaborar um manual de boas práticas no trabalho para melhoria da qualidade de vida e ambiente de trabalho. Método: Pesquisa quantitativa, transversal e correlacional. O cenário foi um hospital universitário terciário e os participantes foram enfermeiros que concordaram participar do estudo. A coleta de dados foi realizada por meio de instrumentos autoaplicáveis (questionário demográfico e laboral, WHOQOLBref e Versão brasileira do Nursing Work Index Revised - B-NWI-R). O período de coleta de dados foi de janeiro a junho de 2017. A relação entre os escores dos domínios da qualidade de vida, ambiente de trabalho e dados demográficos e laborais foi analisada pelo ajuste de modelos de regressão linear múltipla com resposta normal para cada domínio do instrumento. As relações foram consideradas estatisticamente significativas se p < 0,05. Aprovado pelo Comitê de Ética em Pesquisa (CEP) da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista, CAAE 62214116.7.0000.5411. Resultados: Amostra de 143 enfermeiros, 88,8% do sexo feminino; 81,8%, de etnia branca; 52,4% sem companheiro; 57,3% trabalham de 36 a 40 horas semanais; 52,4% atuam em unidades de longa permanência de paciente; 91,6% trabalham no diurno ou noturno; 87,4% não têm outro emprego formal, 48,3% têm menos de 5 anos de tempo de trabalho, 69,9% não estão satisfeitos com o salário e 63,6% têm curso de especialização. A aplicação da escala B-NWIR demonstrou que a mediana dos itens gerais do instrumento e das subescalas: autonomia, controle sobre o ambiente, relação médico-enfermeiro e o suporte organizacional é menor que 2,5 e a qualidade de vida, mensurada pelo WHOQOL-Bref, evidenciou que, tanto no geral quanto nos domínios físico, psicológico, social e meio ambiente, a mediana é superior a 14. Na associação com o domínio físico o trabalho em unidades especiais é em média 1,53 (p= 0,002) e nas unidades fechadas 1,25 (p= 0,002) pontos menor que nos demais tipos de unidade. No domínio psicológico apresenta que em média, o escore é 1,11 (p=0,023) pontos menor entre os que trabalham em unidades especiais, 1,19 (p=0,004) pontos menor entre os que trabalham nas unidades fechadas, 1,14 (p=0,017) pontos menor entre os que receberam promoção nos últimos 12 meses e em média é 0,76 (p=0,039) pontos maior entre os que estão satisfeitos com o salário. No domínio social há importância estatística para os que foram avaliados positivamente, em média 2,73 (p=0,007) pontos menor, 4,91 (p=0,003) pontos menor entre os que têm suporte organizacional e 3,65 (p=0,002) pontos maior entre os que têm controle sobre o ambiente. Na associação do domínio ambiental a significância estatística refere-se aos que trabalham 36 ou 40 horas, em média 0,74 (p=0,015) pontos menor e escores maiores no que se refere ao tempo de trabalho que são: 2,65 (p=0,000) pontos entre os que trabalham mais que 20 anos, 1,01 (p=0,018) pontos entre os que têm 11 a 15 anos, 1,02 (p=0,004) entre os que têm de 6 a 10 anos e aos que estão satisfeitos com o salário 1,09 (p=0,001) pontos maior. Produto: Construção de um e-book de boas práticas no trabalho enfatizando a qualidade de vida e o ambiente de trabalho positivo ao desempenho profissional. Conclusão: Nos domínios físico, psicológico, social e ambiental do WHOQOL-Bref a percepção da qualidade de vida é boa. O ambiente de trabalho mensurado pelo B-NWI-R e suas subescalas: autonomia, controle sobre o ambiente, relações entre médicos e enfermeiros e suporte organizacional é favorável. As correlações mostraram importância estatística negativa nos dados: trabalho em unidades especiais e fechadas nos domínios físico e psicológico; receberam promoção nos últimos 12 meses no domínio psicológico; avaliados positivamente no domínio social; suporte organizacional no domínio social e trabalham de 36 a 40 horas no domínio ambiental. Quanto a importância estatística positiva nos dados têm-se: estão satisfeitos com o salário nos domínios psicológico e ambiental; controle sobre o ambiente no domínio social e tempo de trabalho de seis a 15 e maior que 20 anos no domínio ambiental.
Introduction: the nursing work process is complex and has particularities that contemplate the uninterrupted attendance of users of health services, especially those who are hospitalized and their families, with continuous interpersonal relationships. This work happens in environment that can interfere in the quality of life. Aim: to correlate the quality of life and work environment of the nurses in a university hospital in the State of São Paulo and to elaborate a manual of good practices in the work to improve the quality of life and work environment. Method: cross-sectional study. The setting was a tertiary university hospital and the participants were nurses who agreed to participate in the study. Data collection was performed using self-administered instruments (demographic and labor questionnaire, WHOQOL-BREF and Brazilian version of the Nursing Work Index Revised - B-NWI-R). The data collection period was from January to June 2017. The relationship between the scores of the domains of quality of life, work environment and demographic and labor data was analyzed by the adjustment of multiple linear regression models with normal response for each domain of the instrument. The relationships were considered statistically significant if p <0.05. Approved by the Research Ethics Committee (CEP) of the Botucatu Medical School, São Paulo State University (UNESP), CAAE 62214116.7.0000.5411. Results: A sample of 143 nurses, 88.8% female; 81.8%, white; 52.4% without partner; 57.3% work from 36 to 40 hours a week; 52.4% work in long-term patient units; 91.6% work day or night; 87.4% have no other formal employment, 48.3% have less than 5 years of work time, 69.9% are not satisfied with their salary and 63.6% have a specialization course. The application of the B-NWIR scale showed general average items of the instrument and subscales: autonomy, control over the work environment, relationship with physicians, and organizational support is less than 2.5 and the quality of life measured by WHOQOL -BREF, showed that, in general, as well as in the physical, psychological, social and environmental domains, the median is greater than 14. In the association with the physical domain, the work in special units is on average 1.53 (p = 0.002) and in closed units 1.25 (p = 0.002) points lower than in the other unit types. In the psychological domain, the average score was 1.11 (p = 0.023) lower among those working in special units, 1.19 (p = 0.004) lower among those working in the closed units, 1.14 (p = 0.017) points among those who received promotion in the last 12 months and on average is 0.76 (p = 0.039) higher among those who are satisfied with the salary. In the social domain there is statistical significance for those who were evaluated positively, on average 2.73 (p = 0.007) points lower, 4.91 (p = 0.003) points lower among those with organizational support and 3.65 (p = 0.002) points higher among those who have control over the work environment. In the association of the environmental domain the statistical significance refers to those that work 36 or 40 hours, on average 0.74 (p = 0.015) points lower and higher scores regarding work time which are: 2.65 (p = 0.000) points among those who work more than 20 years, 1.01 (p = 0.018) points among those who are 11 to 15 years old, 1.02 (p = 0.004) among those who are 6 to 10 years old and who are satisfied with the salary 1.09 (p = 0.001) points higher. Product: Construction of a good practice at work e-book emphasizing quality of life and a positive work environment for professional performance. Conclusion: In the physical, psychological, social and environmental domains of the WHOQOL-BREF the perception of quality of life is good. The work environment measured by -B-NWI-R and the subscales: autonomy, control over the work environment, relationships with physicians and organizational support is favorable. Correlations showed negative statistical significance in: work in special and closed units in the physical and psychological domains; received promotion in the last 12 months in the psychological domain; positively assessed in the social domain, organizational support in the social domain and work from 36 to 40 hours in the environmental domain. As for the positive statistical significance in the data they are: satisfied with the salary in the psychological and environmental domains; control over the environment in the social domain and working time from six to 15 and greater than 20 years in the environmental domain.
Introduction: the nursing work process is complex and has particularities that contemplate the uninterrupted attendance of users of health services, especially those who are hospitalized and their families, with continuous interpersonal relationships. This work happens in environment that can interfere in the quality of life. Aim: to correlate the quality of life and work environment of the nurses in a university hospital in the State of São Paulo and to elaborate a manual of good practices in the work to improve the quality of life and work environment. Method: cross-sectional study. The setting was a tertiary university hospital and the participants were nurses who agreed to participate in the study. Data collection was performed using self-administered instruments (demographic and labor questionnaire, WHOQOL-BREF and Brazilian version of the Nursing Work Index Revised - B-NWI-R). The data collection period was from January to June 2017. The relationship between the scores of the domains of quality of life, work environment and demographic and labor data was analyzed by the adjustment of multiple linear regression models with normal response for each domain of the instrument. The relationships were considered statistically significant if p <0.05. Approved by the Research Ethics Committee (CEP) of the Botucatu Medical School, São Paulo State University (UNESP), CAAE 62214116.7.0000.5411. Results: A sample of 143 nurses, 88.8% female; 81.8%, white; 52.4% without partner; 57.3% work from 36 to 40 hours a week; 52.4% work in long-term patient units; 91.6% work day or night; 87.4% have no other formal employment, 48.3% have less than 5 years of work time, 69.9% are not satisfied with their salary and 63.6% have a specialization course. The application of the B-NWIR scale showed general average items of the instrument and subscales: autonomy, control over the work environment, relationship with physicians, and organizational support is less than 2.5 and the quality of life measured by WHOQOL -BREF, showed that, in general, as well as in the physical, psychological, social and environmental domains, the median is greater than 14. In the association with the physical domain, the work in special units is on average 1.53 (p = 0.002) and in closed units 1.25 (p = 0.002) points lower than in the other unit types. In the psychological domain, the average score was 1.11 (p = 0.023) lower among those working in special units, 1.19 (p = 0.004) lower among those working in the closed units, 1.14 (p = 0.017) points among those who received promotion in the last 12 months and on average is 0.76 (p = 0.039) higher among those who are satisfied with the salary. In the social domain there is statistical significance for those who were evaluated positively, on average 2.73 (p = 0.007) points lower, 4.91 (p = 0.003) points lower among those with organizational support and 3.65 (p = 0.002) points higher among those who have control over the work environment. In the association of the environmental domain the statistical significance refers to those that work 36 or 40 hours, on average 0.74 (p = 0.015) points lower and higher scores regarding work time which are: 2.65 (p = 0.000) points among those who work more than 20 years, 1.01 (p = 0.018) points among those who are 11 to 15 years old, 1.02 (p = 0.004) among those who are 6 to 10 years old and who are satisfied with the salary 1.09 (p = 0.001) points higher. Product: Construction of a good practice at work e-book emphasizing quality of life and a positive work environment for professional performance. Conclusion: In the physical, psychological, social and environmental domains of the WHOQOL-BREF the perception of quality of life is good. The work environment measured by -B-NWI-R and the subscales: autonomy, control over the work environment, relationships with physicians and organizational support is favorable. Correlations showed negative statistical significance in: work in special and closed units in the physical and psychological domains; received promotion in the last 12 months in the psychological domain; positively assessed in the social domain, organizational support in the social domain and work from 36 to 40 hours in the environmental domain. As for the positive statistical significance in the data they are: satisfied with the salary in the psychological and environmental domains; control over the environment in the social domain and working time from six to 15 and greater than 20 years in the environmental domain.
Descrição
Palavras-chave
Qualidade de vida, Ambiente de trabalho, Gerenciamento da prática profissional, Enfermagem, Quality of life, Working environment, Practice management, Nursing