NURSES’ COACHING LEADERSHIP RELATED TO PRACTICE ENVIRONMENT WITHIN PRIMARY HEALTH CARE

Mattos, Julio Cesar de Oliveira; Gasparino, Renata Cristina; Cardoso, Maria Lúcia Alves Pereira; Bernardes, Andrea; Cunha, Isabel Cristina Kowal Olm; Balsanelli, Alexandre Pazetto

doi:10.1590/1980-265X-TCE-2021-0332en

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Original Artigo • Texto contexto - enferm. 31 • 2022 • https://doi.org/10.1590/1980-265X-TCE-2021-0332en copy

NURSES’ COACHING LEADERSHIP RELATED TO PRACTICE ENVIRONMENT WITHIN PRIMARY HEALTH CARE

LIDERAZGO COACHING DE LOS ENFERMEROS RELACIONADO CON EL AMBIENTE DE LA PRÁCTICA PROFESIONAL EN LA ATENCIÓN PRIMARIA A LA SALUD

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to correlate the nurses’ self-perception and the perception of nursing aides regarding coaching leadership and the practice environment within Primary Health Care.

Method:

cross-sectional and correlational study addressing 150 nursing workers: 75 nurses and 75 nursing aides of 13 Basic Health Units located in the south of São Paulo, SP, Brazil. The Brazilian version of the Practice Environment Scale, Questionário de Autopercepção do Enfermeiro no Exercício da Liderança [Questionnaire on Self-Perception of Nurses of Exercise of Leadership], and Questionário de Percepção de Técnicos e Auxiliares de Enfermagem no Exercício da Liderança [Questionnaire on Perception of Nurse Technicians and LPNs of Exercise of Leadership] were applied between January and May 2019. Univariate and Multivariate Analyses, and the Pearson’s Correlation test (p<0.05) were used, besides Rosenthal effect size.

Results:

two significant correlations were found among the nurses between the instruments’ domains: communication and nursing foundations for quality care (r=0.265; p=0.022) and communication and collegial nurse-physician relationships (r=0.263; p=0.023). The following stand out among the nursing aides: communication and nursing foundations for quality care (r=0.416) and the total score obtained in the Questionnaire on Perception of Nurse Technicians and LPNs of Exercise of Leadership and collegial nurse-physician relationships (r=0.409).

Conclusion:

for the nurses, communication contributed to a better perception of quality care and good relationships with physicians. For the nursing aides, all the domains of coaching leadership collaborate for environments that favor their practice within PHC.

DESCRIPTORS:
Leadership; Nursing; Health facility environment; Primary health care; Working environment

Variable	Group	Mean	SD^*	Median	Minimum	Maximum
Age (years)	Aides	37.52	7.64	37.00	19.00	57.00
Age (years)	Nurses	37.31	6.94	38.00	27.00	59.00
Time since graduation (years)	Aides	10.41	5.26	10.00	1.00	24.00
Time since graduation (years)	Nurses	11.89	6.38	11.00	3.00	34.00
Experience (years)	Aides	5.81	4.57	4.00	0.50	20.00
Experience (years)	Nurses	5.91	4.47	5.00	0.50	18.00

PES Domains	Group	Mean	SD^§	Median	Min^†	Max^‡	p^*	E.S. ^\|\|
Nursing Participation in hospital affairs^††	AG^¶	3.13	0.65	3.00	1.40	4.00	0.585	0.045^\|\|
Nursing Participation in hospital affairs^††	NG^**	3.07	0.60	3.00	1.40	4.00	0.585	0.045^\|\|
Nursing foundations for quality care^††	AG^¶	3.06	0.60	3.00	1.57	4.00	0.584	0.045^\|\|
Nursing foundations for quality care^††	NG^**	3.01	0.54	3.00	1.43	4.00	0.584	0.045^\|\|
Nursing manager leadership, ability, and support^††	AG^¶	3.07	0.68	3.20	1.00	4.00	0.311	0.083^\|\|
Nursing manager leadership, ability, and support^††	NG^**	3.19	0.70	3.40	1.00	4.00	0.311	0.083^\|\|
Adequate staffing and resources^††	AG^¶	2.71	0.79	2.75	1.00	4.00	0.095	0.137^\|\|
Adequate staffing and resources^††	NG^**	2.51	0.64	2.50	1.00	4.00	0.095	0.137^\|\|
Collegial nurse-physician relationships^††	AG^¶	3.21	0.67	3.33	1.33	4.00	0.557	0.048^\|\|
Collegial nurse-physician relationships^††	NG^**	3.27	0.61	3.33	1.33	4.00	0.557	0.048^\|\|
Total^††	AG^¶	3.04	0.57	3.04	1.50	4.00	0.755	0.026^\|\|
Total^††	NG^**	3.01	0.50	2.96	1.38	3.96	0.755	0.026^\|\|

Domains	Group	Mean	SD^§	Median	Min^†	Max^‡	p^*	E.S.^\|\|
Communication^††	AG^¶	22.00	3.87	23.00	8.00	25.00	0.563	0.048^\|\|
Communication^††	NG^**	22.28	1.57	22.00	18.00	25.00	0.563	0.048^\|\|
Give and receive feedback^††	AG^¶	21.01	3.81	22.00	9.00	25.00	0.020^*	0.190^\|\|
Give and receive feedback^††	NG^**	22.25	2.50	22.00	11.00	25.00	0.020^*	0.190^\|\|
Delegate power and exert influence ^††	AG^¶	20.61	4.07	21.00	8.00	25.00	0.015^*	0.198^\|\|
Delegate power and exert influence ^††	NG^**	21.93	2.23	22.00	14.00	25.00	0.015^*	0.198^\|\|
Support the team in reaching results^††	AG^¶	21.04	4.22	22.00	9.00	25.00	0.009^*	0.213^\|\|
Support the team in reaching results^††	NG^**	22.51	2.26	23.00	13.00	25.00	0.009^*	0.213^\|\|
Total^††	AG^¶	84.67	13.90	86.00	42.00	100.00	0.018^*	0.193^\|\|
Total^††	NG^**	88.97	6.99	90.00	67.00	99.00	0.018^*	0.193^\|\|

PES^‡		Questionnaire on Perception of Nurse Technicians and LPNs of Exercise of Leadership				Total
PES^‡		Communication	Give and receive feedback	Delegate power and exert influence	Support the team in reaching results	Total
Nursing participation in hospital affairs	Coef^*	0.375^* [0.160, 0.571]	0.347^* [0.164, 0.534]	0.219^* [-0.007, 0.459]	0.252^* [0.019, 0.481]	0.340^* [0.123, 0.543]
Nursing participation in hospital affairs	P	0.001^†	0.002^†	0.059	0.029^†	0.003^†
Nursing foundations for quality care	Coef^*	0.416^* [0.203, 0.597]	0.325^* [0.132, 0.524]	0.263^* [0.051, 0.462]	0.362^* [0.132, 0.558]	0.392^* [0.165, 0.588]
Nursing foundations for quality care	P	<0.001^†	0.004^†	0.023^†	0.001^†	<0.001^†
Nursing manager leadership, ability, and support	Coef^*	0.319^* [0.087, 0.526]	0.330^* [0.095, 0.550]	0.200^* [-0.024, 0.446]	0.119^* [-0.133, 0.388]	0.274^* [0.040, 0.500]
Nursing manager leadership, ability, and support	P	0.005^†	0.004^†	0.086	0.309	0.017^†
Adequate staffing and resources	Coef^*	0.280^* [0.043, 0.469]	0.190^* [0.014, 0.360]	0.103^* [-0.100, 0.296]	0.294^* [0.065, 0.483]	0.250^* [0.039, 0.432]
Adequate staffing and resources	P	0.015^†	0.103	0.380	0.010^†	0.031^†
Collegial nurse-physician relationships	Coef^*	0.385^* [0.134, 0.631]	0.422^* [0.247, 0.590]	0.242^* [0.020, 0.453]	0.379^* [0.150, 0.584]	0.409^* [0.193, 0.603]
Collegial nurse-physician relationships	P	0.001^†	<0.001^†	0.037^†	0.001^†	<0.001^†
Total	Coef^*	0.419^* [0.221, 0.591]	0.372^* [0.201, 0.541]	0.243^* [0.037, 0.465]	0.325^* [0.110, 0.543]	0.389^* [0.188, 0.583]
Total	P	<0.001^†	0.001^†	0.036^†	0.004^†	0.001^†

PES^‡		Questionnaire on Self-Perception of Nurses of Exercise of Leadership				Total
PES^‡		Communication	Give and receive feedback	Delegate power and exert influence	Support the team in reaching results	Total
Nursing participation in hospital affairs	Coef^*	0.099^* [-0.147, 0.351]	^*0.033 [-0.184, 0.234]	0.110^* [-0.090, 0.323]	0.020^* [-0.199, 0.262]	0.076^* [-0.146, 0.305]
Nursing participation in hospital affairs	P	0.398	0.778	0.346	0.868	0.519
Nursing foundations for quality care	Coef^*	0.265^* [0.053, 0.474]	0.001^* [-0.162, 0.159]	0.084^* [-0.116, 0.302]	0.139^* [-0.049, 0.330]	0.132^* [-0.049, 0.325]
Nursing foundations for quality care	P	0.022^†	0.992	0.472	0.233	0.259
Nursing manager leadership, ability, and support	Coef^*	0.210^* [0.018, 0.388]	0.110^* [-0.092, 0.321]	0.116^* [-0.097, 0.324]	0.021^* [-0.160, 0.245]	0.131^* [-0.056, 0.314]
Nursing manager leadership, ability, and support	P	0.070	0.346	0.322	0.855	0.264
Adequate staffing and resources	Coef^*	-0.014^* [-0.245, 0.213]	-0.036^* [-0.225, 0.156]	0.064^* [-0.137, 0.248]	0.130^* [-0.126, 0.360]	0.047^* [-0.174, 0.273]
Adequate staffing and resources	P	0.907	0.761	0.583	0.265	0.691
Collegial nurse-physician relationships	Coef^*	0.263^* [0.082, 0.450]	0.129^* [-0.080, 0.328]	0.179^* [-0.057, 0.424]	0.036^* [-0.161, 0.291]	0.174^* [-0.038, 0.396]
Collegial nurse-physician relationships	P	0.023^†	0.272	0.125	0.760	0.136
Total	Coef^*	0.208^*	0.053^* [-0.134, 0.238]	0.130^* [-0.093, 0.350]	0.088^* [-0.113, 0.289]	0.136^* [-0.073, 0.342]
Total	P	0.074	0.651	0.268	0.450	0.246

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Julio Cesar de Oliveira Mattos jumattos0702@gmail.com