O ambiente de trabalho em unidades de terapia intensiva privadas e públicas

Abstract

Objective: To analyze the work environment in intensive care units from public and private hospitals. Methods: This was a cross-sectional study conducted with 66 nurses in four intensive care units. Two questionnaires were used for data collection, one for the socioeconomic profile and the other composed by the subscales of the validated Brazilian version of the Nursing Work Index-Revised (B-NWI-R). Results: The nurses reported a favorable work environment for the exercise of professional nursing practices in the intensive care units (overall mean = 1.95 and SD = 0.40). By comparing private and public hospitals it was observed that the overall score of the B-NWI-R reached values of 1.91 (SD = 0.39) and 1.99 (SD = 0.42), respectively, with a p-value of 0.459. Conclusion: The four intensive care units analyzed in this study presented favorable work environments for nursing practices. The fact of belonging to private or public hospitals was not significant in the analysis. ResumoObjetivo: Analisar o ambiente de trabalho em Unidades de Terapia Intensiva em hospitais privados e públicos. Métodos: Estudo transversal realizado em quatro unidades de terapia intensiva do qual participaram 66 enfermeiros. Utilizou-se dois instrumentos de pesquisa, um para caracterização socioeconômica e as subescalas do Nursing Work Index Revised versão brasileira validadas (B-NWI-R). Resultados: Os enfermeiros consideraram que as unidades de terapia intensivapossuem ambientes de trabalho favoráveis ao exercício da prática profissional em enfermagem (média geral= 1,95 e dp=0,40).Ao comparar as UTI dos hospitais privados e públicos observa-se que o escore geral do B-NWI-R alcançou os valores de 1,91 (dp=0,39) e 1,99 (dp=0,42) respectivamente com p=0,459. Conclusão: As quatro UTI analisadas apresentaram ambientes favoráveis à prática profissional em enfermagem. O fato de pertencer a hospitais privados e públicos não foi significativo na análise.

Burnout and nursing work environment in public health institutions

“…Regarding the work environment, this study found values close to 2 in all NWI-R subscales, results similar to Brazilian investigations carried out in Intensive Care Units (8,12,15) and better than those observed in a study carried out in Primary Care Units (16) .…”

“…In the comparison with other countries, the work environment described by the NWI-R in Brazil (8,12,(15)(16) presents worse characteristics than the ones found in an Irish study which, in turn, found less favorable environments than those observed in north american institutions (17) .…”

“…In addition, the research data refer to the health institutions of the state's public administration, so the characteristics of the management model, the assistance standards and the clinical characteristics of the patients may be directly related to the results found. Despite the similarity between nursing settings found in a study about work environments in Brazilian public and private Intensive Care Units, this restriction should be considered, since this research refers to a type of unit of these institutions (12) .…”

“…As described in the method, the autonomy subscale represents the freedom of nurses to solve problems that affect the quality of nursing care. Higher values in this subscale indicate unfavorable characteristics for nursing practice (7,10,12) . This is similar to the interpretation of the emotional exhaustion and depersonalization scores of the MBI (the higher the score, the greater the feeling of exhaustion and depersonalization perceived by the nurses).…”

“…The subscale nurse-physician relationship addresses the professional respect necessary for an effective communication, which allows reaching the common objective of providing adequate care to the patient. Finally, organizational support consists of items derived from the subscales above and allows identifying the situations in which the organization provides support to nursing practice (7,10,12) . The scores of these subscales vary from one to four points, and in the Brazilian version of the NWI-R, lower values indicate that the institution has more favorable characteristics for nursing practice (10) .…”