Resultados sensíveis em Enfermagem

: avaliação da qualidade dos cuidados

Abstract

Throughout the last decade, a stimulating field of nursing investigation has revealed importantassociations between the organizational context, nursing interventions and client’s outcomes. This coreof research has led to the identification of nurses’ work environment variables with repercussions onthe level of performance, as well as, on a group of nursing sensitive outcomes.With the growing concern of minimizing health care costs and optimizing results, contention politicshave emerged. These have triggered new and diverse challenges, not only, at a microsystem level, wheredaily relations develop between the nursing process participants, but also, at a macrosystem level,through health care politics aiming to simultaneously contain resources and promote health carequality. Therefore, it becomes crucial to highlight nursing role effectiveness, placing the patient at thecenter of health care, in order to obtain nursing sensitive outcomes. Management science contributionis recognized, allowing for the achievement of the finest results. For the study of this problematic thefollowing aims were defined:• To analyze nursing sensitive outcomes with regard to the structure and process dimensions thatincorporate nursing care;• To evaluate structure features that influence nursing practice’ work environment;• To characterize nursing care centrality dimensions valued by nurses and patients;• To evaluate management and leadership practices which best contribute to health centeredcare.The present study subscribes the research quantitative paradigm, it is transversal, correlational/differential. It was studied a random simple sample, composed by 288 clients and 236 nurses fromtwo Hospital Centers, one of them inserted in an urban area and the other in a semi-urban onefrom the same region of the country. In the data collecting there were used questionnairescomposed by socio-demographic and socio-professional/situational variables and scales validatedto Portuguese. We administrated the PESNWI scale and PCC to the nurses and PCC, TSC and SF-36to the clients.We point as the main results of this study, the following ones:The Hospital Centers exosystem insertion influences the nursing working environment;Nurses value health care and consider that the head nurse leadership and management practicesare consistent with a transformational paradigm;Resultados Sensíveis em Enfermagem. Avaliação da qualidade dos cuidados.7Nurses and clients value the health care centrality, what integrates not only the answer to theclients’ needs but also the attention to their values and preferences, develop healthcare educationactions and promote health informations. However nurses´ perception in what concerns healthcentered care is higher to that one which is perceived by clients.The health centered care assumptions are therapeutic self-care predictors revealing client´svaluation as a self-care agency with whom the nurse, through the support and education system,promotes the client’s autonomy;The assumptions of health centered care are also nursing cares quality satisfaction predictors;Socio-demographic and socio-professional variables have impact in the health centered carevaluation by nurses and, at the same time, clients’ socio-demographic and situational variablesinfluence health centered care valuation;Health centered care doesn’t have a direct influence on the person’s/client functional state.The results support the reference model of this study, finding that nursing role effectiveness showsthe nursing sensible results because these ones are the outcome of nursing cares impact.

Date of Award	14 Jul 2015
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	José Amendoeira (Supervisor)