Nursing practice environment and work satisfaction in critical units

a cross-sectional study was performed in eight adult ICUs of a public university hospital between 2012 and 2015. The Nursing Work Index-Revised (NWI-R), in their short forms, and the Index of Work Satisfaction (IWS) were applied to investigate the environment of nursing practices and work satisfaction, respectively.

Results:

a total of 100 (34.84%) nurses and 187 (65.15%) nursing assistants/technicians participated in this study. The environment was favorable for autonomy and relationships and it showed vulnerability for control of practices and organizational support. The IWS score indicated low work satisfaction. "Environment of practices", "length of work in the ICU" and "willingness to work" were associated with work satisfaction.

Conclusion:

to invest in the environment of practices, in factors that promote willingness to work and length of experience in the ICU increases nursing work satisfaction.

Descriptors:
Nursing; Intensive Care Units; Workplace; Environment of Health Institutions; Work Satisfaction

NWI-R instrument	Mean	Standard deviation	Median	Minimum	Maximum	n
AutonomyRelationships between physicians and nursesControl of the environmentOrganizational supportTotal	2.312.292.522.372.40	0.590.660.600.500.51	2.402.332.572.402.36	1.001.001.001.101.07	4.004.004.004.003.80	282282282282282

Domain	Paired comparisons(Part A)	Mean non-weighed score of the domain of the scale	Weighed score of the domain
Income	3.562	2.15	7.67
Autonomy	3.070	3.90	11.99
Work requirements	3.017	3.39	10.24
Professional status	2.662	5.16	13.75
Organizational norms	2.910	2.98	8.68
Interaction	3.377	3.96	13.39
		Mean score of the scale 3.66 (from 1 to 7)	IWS 10.95 (from 5.98 to 17.91)

NWI-R domains	IWS r (p)
Organizational support	-0.48^β β Pearson’s correlation test; (0.00)
Autonomy	-0.40^† † Spearman’s correlation test; NWI-R = Nursing Work Index-Revised (0.00)
Control of the environment	-0.44^β β Pearson’s correlation test; (0.00)
Relationships between physicians and nurses	-0.42^β β Pearson’s correlation test; (0.00)
Total	-0.50^β β Pearson’s correlation test; (0.00)

Variables	NWI-R		IWS
Variables	Mean (sd)	p value	Mean (sd)	p value
Gender
Male	2.36 (0.47)	0.57^β β Student’s t-test;	11.35 (1.55)	0.11^β β Student’s t-test;
Female	2.41 (0.52)		10.88 (1.86)
Total	2.40 (0.51)		10.95 (1.82)
Marital status
With a partner	2.34 (0.51)	0.04^β β Student’s t-test;	10.92 (1.94)	0.81^β β Student’s t-test;
Without a partner	2.46 (0.51)		10.97 (1.71)
Total	2.40 (0.51)		10.94 (1.82)
Children
No	2.36 (0.46)	0.29^β β Student’s t-test;	10.99 (1.72)	0.79^β β Student’s t-test;
Yes	2.43 (0.54)		10.93 (1.88)
Total	2.40 (0.51)		10.95 (1.82)
Undergraduate course
No	2.44 (0.52)	0.24^β β Student’s t-test;	10.88 (1.73)	0.50^β β Student’s t-test;
Yes	2.37 (0.50)		11.03 (1.92)
Total	2.40 (0.51)		10.95 (1.82)
Sufficient technological and material resources
No	2.51 (0.49)	0.00^β β Student’s t-test;	10.56 (1.80)	0.00^† † Mann Whitney’s test; SD = Standard deviation; NWI-R = Nursing Work Index-Revised
Yes	2.24 (0.49)		11.50 (1.58)
Total	2.40 (0.51)		10.95 (1.77)
Sufficient nursing human resources
No	2.47 (0.48)	0.00^β β Student’s t-test;	10.70 (1.69)	0.00^β β Student’s t-test;
Yes	2.13 (0.53)		11.76 (1.82)
Total	2.40 (0.51)		10.94 (1.77)
Feels satisfied working in the ICU
No	2.60 (0.53)	0.03^β β Student’s t-test;	10.56 (2.07)	0.22^β β Student’s t-test;
Yes	2.35 (0.51)		11.01 (1.79)
Total	2.40 (0.51)		10.96 (1.82)
Is willing to work
No	2.52 (0.53)	0.00^β β Student’s t-test;	10.36 (1.80)	0.00^β β Student’s t-test;
Yes	2.29 (0.48)		11.52 (1.68)
Total	2.40 (0.51)		10.96 (1.83)

IWS	Coefficient B	95%CI		p value^* * Multiple linear regression model; ICU = Intensive Care Unit; NWI-R = Nursing Work Index-Revised
Length of work in the institution’s ICU	0.03	0.00	0.06	0.04
NWI-R	-1.67	-2.02	-1.32	0.00
Willingness to work	0.78	0.41	1.14	0.00

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[1] CORRESPONDING AUTHOR: Elaine Machado de Oliveira. E-mail: elainemachado@usp.br