Guirardello Edineis Brito, Oliveira Henrique Ceretta, Cimiotti Jeannie P
School of Nursing, State University of Campinas, Campinas, São Paulo, Brazil.
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States of America.
Int J Nurs Stud Adv. 2023 Aug 11;5:100150. doi: 10.1016/j.ijnsa.2023.100150. eCollection 2023 Dec.
Primary care is a fundamental component of healthcare in Brazil. Often provided by nurses, little is known about the practice environment of nurses in primary care and if nurses are satisfied with their role in the primary care setting.
The purpose of this study was to determine if aspects of the primary care practice environment in Brazil are associated nurse reported outcomes of job satisfaction, intention to stay on the job, and the quality of care.
A cross-sectional survey that included a randomized cluster stratified sample of nurses who provided primary care services.
55 health centers within five health districts located in Campinas, São Paulo, Brazil.
148 primary care nurses who completed and returned a survey.
The paper-based survey was made available to nurse participants. Nurses were queried on demographic and practice characteristics. Specific measures included the Practice Environment Scale-Brazilian, the job satisfaction subscale of the Safety Attitudes Questionnaire, and single items that assessed intention to stay on the job and the perceived quality of care. Generalized linear and Poisson regression models were used to estimates outcomes of interest.
Slightly more than half (56.5%) of the nurses reported a favorable practice environment and they provided on average a high score of 75.29 (SD = 21.03) on job satisfaction. High scores were also reported on intention to stay on the job (mean = 8.08; SD = 2.91) and the quality of patient care (mean = 7.68; SD = 1.38). In a fully adjusted regression model, a favorable practice environment was significantly associated with a 2.15 ( <0.0001) increase in job satisfaction, a 1.72 ( = 0.0003) increase in the intention to stay on the job and a 1.16 ( < 0.001) increase in the nurse reported quality of patient care.
Overall, our sample of Brazilian nurses that work in primary care reported a favorable perception of their practice environment. This likely contributed to their high scores on intention to stay on the job and the overall quality of patient care. Nurse managers and administrators should focus their attention on aspects of the practice environment as a low cost means to attract and retain nurses in primary care and to improve the overall quality of care.
初级保健是巴西医疗保健的一个基本组成部分。通常由护士提供，但对于初级保健中护士的执业环境以及护士对其在初级保健环境中角色的满意度知之甚少。
本研究的目的是确定巴西初级保健执业环境的各个方面是否与护士报告的工作满意度、留职意愿和护理质量相关。
一项横断面调查，包括提供初级保健服务的护士的随机整群分层样本。
巴西圣保罗坎皮纳斯五个卫生区的55个卫生中心。
148名完成并返回调查问卷的初级保健护士。
向护士参与者提供纸质调查问卷。询问护士的人口统计学和执业特征。具体测量包括巴西执业环境量表、安全态度问卷的工作满意度子量表，以及评估留职意愿和感知护理质量的单项指标。使用广义线性和泊松回归模型估计感兴趣的结果。
略多于一半（56.5%）的护士报告了良好的执业环境，他们在工作满意度上平均给出了75.29分的高分（标准差=21.03）。留职意愿（平均分=8.08；标准差=2.91）和患者护理质量（平均分=7.68；标准差=1.38）也报告了高分。在一个完全调整的回归模型中，良好的执业环境与工作满意度提高2.15（<0.0001）、留职意愿提高1.72（=0.0003）以及护士报告的患者护理质量提高1.16（<0.001）显著相关。
总体而言，我们样本中的巴西初级保健护士对其执业环境有良好的感知。这可能是他们在留职意愿和患者护理总体质量上得分较高的原因。护士管理人员和行政人员应将注意力集中在执业环境的各个方面，作为吸引和留住初级保健护士以及提高护理总体质量的低成本手段。
