La relación entre el liderazgo auténtico de los enfermeros y el empoderamiento estructural: una revisión sistemática

Valle, Rebeca Beatriz Lucena Ribeiro do; Balsanelli, Alexandre Pazetto; Taminato, Mônica; Saconato, Humberto; Gasparino, Renata

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REVIEW • Rev. esc. enferm. USP 55 • 2021 • https://doi.org/10.1590/S1980-220X2019029003667 copiar

La relación entre el liderazgo auténtico de los enfermeros y el empoderamiento estructural: una revisión sistemática

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Verificar la relación entre el liderazgo auténtico del enfermero y el empoderamiento estructural.

Método:

Una revisión sistemática realizada en la Biblioteca Virtual en Salud, en el Portal de Periódicos de la Coordinación para el Perfeccionamiento del Personal de Educación Superior, Sistema en Línea de Búsqueda y Análisis de Literatura Médica, Scientific Electronic Library Online y Science Direct/Embase, consultado hasta abril de 2019 Los criterios de inclusión fueron: estudios con enfermeras, que mostraron la relación entre liderazgo auténtico y empoderamiento estructural, publicados entre 2012 y 2018 en portugués, inglés o español.

Resultados:

Se incluyeron cinco estudios, con variables distintas al empoderamiento estructural: satisfacción laboral, burnout, bullying, salud mental, desempeño, capital social, ambiente laboral, retención de enfermeras y calidad de la atención. El liderazgo auténtico mostró una relación positiva con el empoderamiento estructural, mejorando el compromiso y la satisfacción laboral, reduciendo el agotamiento y aumentando la calidad de la atención.

Conclusión:

Las instituciones de salud, además de Canadá, donde se encuentran los investigadores en este tema, pueden invertir en un liderazgo auténtico para mejorar el empoderamiento estructural, brindando un mayor compromiso por parte de los enfermeros, mayor satisfacción laboral y calidad de la atención brindada.

Enfermeria; Liderazgo; Ambiente de Trabajo; Poder Psicológico; Revisión

Database	Research formula
BVS	authentic leadership AND nurses AND empowerment AND (collection: ("06-national/BR" OR "05-specialized") OR db: ("LILACS" OR "MEDLINE"))	authentic leadership AND nurses AND empowerment structural AND (collection: ("06-national/BR" OR "05-specialized") OR db: ("LILACS" OR "MEDLINE"))	leadership AND health facility environment AND empowerment AND (collection: ("06-national/BR" OR "05-specialized") OR db: ("LILACS" OR "MEDLINE"))	leadership AND working environment AND empowerment AND (collection: ("06-national/BR" OR "05-specialized") OR db: ("LILACS" OR "MEDLINE"))	leadership AND nurses AND health facility environment AND empowerment AND (collection: ("06-national/BR" OR "05-specialized") OR db: ("LILACS" OR "MEDLINE"))	leadership AND nurses AND working environment AND empowerment AND (collection: ("06-national/BR" OR "05-specialized") OR db: ("LILACS" OR "MEDLINE"))
MEDLINE /PubMed	authentic [All Fields] AND ("leadership" [MeSH Terms] OR "leadership" [All Fields]) AND ("nurses" [MeSH Terms] OR "nurses" [All Fields]) AND ("empowerment" [MeSH Terms] OR "empowerment" [All Fields])	authentic [All Fields] AND ("leadership" [MeSH Terms] OR "leadership" [All Fields]) AND ("nurses" [MeSH Terms] OR "nurses" [All Fields]) AND ("empowerment" [MeSH Terms] OR "empowerment" [All Fields]) AND structural [All Fields]	("leadership" [MeSH Terms] OR "leadership" [All Fields]) AND ("health facility environment" [MeSH Terms] OR ("health" [All Fields] AND "facility" [All Fields] AND "environment" [All Fields]) OR "health facility environment" [All Fields]) AND ("empowerment" [MeSH Terms] OR "empowerment" [All Fields])	("leadership" [MeSH Terms] OR "leadership" [All Fields]) AND ("work" [MeSH Terms] OR "work" [All Fields] OR "working" [All Fields]) AND ("environment" [MeSH Terms] OR "environment" [All Fields]) AND ("empowerment" [MeSH Terms] OR "empowerment" [All Fields])	("leadership" [MeSH Terms] OR "leadership" [All Fields]) AND ("nurses" [MeSH Terms] OR "nurses" [All Fields]) AND ("health facility environment" [MeSH Terms] OR ("health" [All Fields] AND "facility" [All Fields] AND "environment" [All Fields]) OR "health facility environment" [All Fields]) AND ("empowerment" [MeSH Terms] OR "empowerment" [All Fields])	("leadership" [MeSH Terms] OR "leadership" [All Fields]) AND ("nurses" [MeSH Terms] OR "nurses" [All Fields]) AND ("work" [MeSH Terms] OR "work" [All Fields] OR "working" [All Fields]) AND ("environment" [MeSH Terms] OR "environment" [All Fields]) AND ("empowerment" [MeSH Terms] OR "empowerment" [All Fields])
Science Direct /Embase	"authentic leadership" and "nurses" and "empowerment"	"authentic leadership" and "nurses" and "empowerment structural"	"leadership" and "Health Facility Environment" and "empowerment"	"leadership" and "Working Environment" and "empowerment"	"leadership" and "nurses" and "Health Facility Environment" and "empowerment"	"leadership" and "nurses" and "Working Environment" and "empowerment"
SciELO	authentic leadership [All indexes] and nurses [All indexes] and empowerment [All indexes]	authentic leadership [All indexes] and nurses [All indexes] and empowerment structural [All indexes]	leadership [All indexes] and Health Facility Environment [All indexes] and empowerment [All indexes]	leadership [All indexes] and Working Environment [All indexes] and empowerment [All indexes]	leadership [All indexes] and nurses [All indexes] and Health Facility Environment [All indexes] and empowerment [All indexes]	leadership [All indexes] and nurses [All indexes] and Working Environment [All indexes] and empowerment [All indexes]
CAPES/MEC	"authentic leadership" and "nurses" and "empowerment"	"authentic leadership" and "nurses" and "empowerment structural"	"leadership" and "Health Facility Environment" and "empowerment"	"leadership" and "Working Environment" and "empowerment"	"leadership" and "nurses" and "Health Facility Environment" and "empowerment"	"leadership" and "nurses" and "Working Environment" and "empowerment"

Author	Objectives	Sample (n)
Laschinger HKS; Wong CA; Grau AL. Canada, 2013⁽¹⁶16 Heather KS, Wong CA, Grau AL. Authentic leadership, empowerment and burnout: a comparison in new graduates and experienced nurses. J Nurs Manag. 2013;21(3):541-52. doi: 10.1111/j.1365-2834.2012.01375.x https://doi.org/10.1111/j.1365-2834.2012... ⁾	To delve into the effect of authentic leadership and structural empowerment on emotional exhaustion and cynicism in newly graduated and experienced intensive care nurses.	616
Wong CA; Laschinger HKS Canada, 2012⁽¹⁷17 Wong CA, Laschinger HK. Authentic leadership, performance, and job satisfaction: the mediating role of empowerment. J Adv Nurs. 2013;69(4):947-59. doi: 10.1111/j.1365-2648.2012.06089.x https://doi.org/10.1111/j.1365-2648.2012... ⁾	To test a model that relates the authentic leadership of managers with nurses' perceptions on structural empowerment, performance and job satisfaction.	208
Boamah AS; Read EA; Laschinger HKS Canada, 2016⁽¹⁸18 Boamah AS, Read EA, Laschinger HKS. Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time-lagged study. J Adv Nurs. 2017;73(5):1182-95. doi: 10.1111/jan.13215 https://doi.org/10.1111/jan.13215... ⁾	To test a hypothetical model that links the perceptions of new graduated nurses about the authentic leadership behaviors of their managers to structural empowerment, lack of employees and work-life interference and subsequent wear and tear, job satisfaction and quality of patient care.	406
Laschinger HKS; Fida R Canada, 2015⁽¹⁹19 Laschinger HKS, Fida R. Linking nurses' perceptions of patient care quality to job satisfaction: the role of authentic leadership and empowering professional practice environments. J Nurs Adm. 2015;45(5):276-83. doi: 10.1097/NNA.0000000000000198 https://doi.org/10.1097/NNA.000000000000... ⁾	To test a model that links authentic leadership, structural empowerment and professional practice environments to support nurses' perceptions of quality of patient care and job satisfaction.	723
Read EA, Laschinger HKS Canada, 2015⁽²⁰20 Read EA, Laschinger HK. The influence of authentic leadership and empowerment on nurses' relational social capital, mental health and job satisfaction over the first year of practice. J Adv Nurs. 2015;71(7):1611-23. doi: 10.1111/jan.12625 https://doi.org/10.1111/jan.12625... ⁾	To delve into a theoretical model that tests the effects of authentic leadership, structural empowerment and relational social capital on the mental health and job satisfaction of recent graduates in the first year of practice.	191

Author	Other variables addressed	Study design	Outcomes	Instruments used to assess methodological quality
Author	Other variables addressed	Study design	Outcomes	Critical Appraisal of a Cross-Sectional study (Survey)⁽¹³13 Center for Evidence Based Management. Critical appraisal checklist for cross-sectional study [Internet]. Leiden; 2011 [cited 2019 Mar 9]. Available from: https://cebma.org/resources-and-tools/what-is-critical-appraisal/ https://cebma.org/resources-and-tools/wh... ⁾	Methodology Checklist 3: Cohort studies of the Scottish Intercollegiate Guidelines Network (SIGN)⁽¹⁴14 Healthcare Improvement Scotland. Metodology checklist 3: cohort studies [Internet]. London; 2014 [cited 2019 Mar 9]. Available from: https://www.sign.ac.uk/checklists-and-notes https://www.sign.ac.uk/checklists-and-no... ⁾
Laschinger HKS;Wong CA; Grau AL⁽¹⁶16 Heather KS, Wong CA, Grau AL. Authentic leadership, empowerment and burnout: a comparison in new graduates and experienced nurses. J Nurs Manag. 2013;21(3):541-52. doi: 10.1111/j.1365-2834.2012.01375.x https://doi.org/10.1111/j.1365-2834.2012... ⁾	Burnout	Longitudinal	The authentic behavior of nursing leaders was important for nurses, in which the perception of structural empowerment strengthened the working environment (β=0.411, P <0.001) for experienced nurses; β=0.402, P <0.001) for recent graduates, and contributed to lower levels of emotional exhaustion (β=0.314, P <0.001) for experienced nurses; (β=0.164, P=0.006) for recent graduates).	---	67%
Wong CA; Laschinger HKS⁽¹⁷17 Wong CA, Laschinger HK. Authentic leadership, performance, and job satisfaction: the mediating role of empowerment. J Adv Nurs. 2013;69(4):947-59. doi: 10.1111/j.1365-2648.2012.06089.x https://doi.org/10.1111/j.1365-2648.2012... ⁾	Performance and job satisfaction	Longitudinal	Authentic leadership significantly influenced nurses' structural empowerment (β=0.46, P <0.01), which had a direct effect on job satisfaction (β=0.41, P <0.01) and performance (β=0.17, P <0.01).	---	67%
Boamah AS; Read EA; Laschinger HKS⁽¹⁸18 Boamah AS, Read EA, Laschinger HKS. Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time-lagged study. J Adv Nurs. 2017;73(5):1182-95. doi: 10.1111/jan.13215 https://doi.org/10.1111/jan.13215... ⁾	Burnout, job satisfaction and quality of patient care	Longitudinal	Authentic leadership had a positive effect on structural empowerment (β=0.63, P <0.001), which can have a direct influence on reducing the emergence of burnout in nurses. Authentic leadership can positively influence nurses' job satisfaction and improve quality of patient care (β=0.17, P <0.001).	---	78%
Laschinger HKS; Fida R⁽¹⁹19 Laschinger HKS, Fida R. Linking nurses' perceptions of patient care quality to job satisfaction: the role of authentic leadership and empowering professional practice environments. J Nurs Adm. 2015;45(5):276-83. doi: 10.1097/NNA.0000000000000198 https://doi.org/10.1097/NNA.000000000000... ⁾	Job satisfaction and quality of patient care	Cross-sectional	Authentic leadership had a positive effect on structural empowerment (β=.77) and on the professional practice environment (β=.69). Nurses' perceptions about quality of care subsequently had a direct positive effect on job satisfaction (β=.21).	92%	---
Read EA, Laschinger HKS⁽²⁰20 Read EA, Laschinger HK. The influence of authentic leadership and empowerment on nurses' relational social capital, mental health and job satisfaction over the first year of practice. J Adv Nurs. 2015;71(7):1611-23. doi: 10.1111/jan.12625 https://doi.org/10.1111/jan.12625... ⁾	Social capital, mental health and job satisfaction	Longitudinal	By creating working environments with structural empowerment (β=0.50, p <0.05), authentic leaders promote relational social capital (β=0.70, p <0.05) among recent graduates, leading to positive mental health outcomes (β=0.21, p <0.05) and job satisfaction (β=0.50, p <0.05).	---	72%

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Rebeca Beatriz Lucena Ribeiro do Valle Universidade Federal de São Paulo, Escola Paulista de Enfermagem Rua Napoleão de Barros, 754, Vila Clementino CEP 04024-002 - São Paulo, SP, Brazil rebeca.lucena@uol.com.br