A satisfação profissional dos enfermeiros especialistas em enfermagem de reabilitação

Em termos profissionais, a satisfação no trabalho é sem dúvida um tema bastante debatido e atual. Neste sentido, este estudo teve como objetivo analisar a satisfação profissional dos enfermeiros especialistas em enfermagem de reabilitação e também averiguar se o local de trabalho ou o exercício de cuidados de especialidade influenciam a satisfação profissional deste grupo de enfermeiros. A satisfação profissional foi avaliada através da aplicação da “Escala de Avaliação da Satisfação no Trabalho dos Enfermeiros”, construída e validada por Frederico & Loureiro (2009) a 306 profissionais de Enfermagem, especialistas em enfermagem de reabilitação. O Alpha de Cronbach foi de 0,85, refletindo um bom nível de consistência interna. Foram analisadas seis dimensões da satisfação: satisfação com as chefias; satisfação com benefícios e recompensas; satisfação com a natureza do trabalho; satisfação com a comunicação; satisfação com a equipa e satisfação com os requisitos do trabalho. Foi realizado um estudo transversal analítico. Na análise estatística dos dados, recorreu-se à análise fatorial, ao coeficiente de correlação de Spearman, a testes paramétricos t-student para amostras independentes e One-Way ANOVA. Os resultados mostram que os enfermeiros especialistas em enfermagem de reabilitação encontram-se ligeiramente insatisfeitos. Os fatores de insatisfação estão relacionados com benefícios e recompensas, requisitos do trabalho e com a comunicação. A natureza do trabalho e o relacionamento com a equipa são fatores com os quais obtêm maior satisfação. Em relação às chefias existe uma aproximação à satisfação. Relativamente à avaliação do grau de satisfação profissional global, concluiu-se que os enfermeiros que exercem funções nos Cuidados de Saúde Primários encontram-se mais insatisfeitos profissionalmente, do que os que exercem a sua atividade profissional ao nível hospitalar. Os enfermeiros que exercem cuidados gerais apresentam-se mais insatisfeitos do que os que exercem cuidados de especialidade. Também a idade e a remuneração pelo cargo desempenhado são fatores determinantes. Os enfermeiros mais jovens são os que se apresentam mais insatisfeitos. Os enfermeiros que não são remunerados pelo cargo desempenhado demonstram maior insatisfação profissional.

Satisfação profissional dos enfermeiros em unidades de cuidados continuados integrados

A Satisfação no trabalho, definida como reações individuais, cognitivas, afetivas e avaliativas perante o trabalho (Locke, 1983), tem sido amplamente estudada no âmbito das organizações. A sua medição na área da saúde contribui para incrementar um bom ambiente na prática e bem-estar dos profissionais e para aumentar a qualidade dos cuidados. Em 2006 surge um novo contexto de trabalho através da criação da RNCCI, que pretende fazer face ao crescente aumento de população em situação de dependência ou incapacidade, mas também aliviar a sobrecarga e custos associados aos cuidados hospitalares. A reorganização do trabalho nas unidades de cuidados continuados acenta nos princípios da interdisciplinariedade e cooperação entre a equipa, requerendo mudança e adaptação à prática. Sendo os enfermeiros a classe profissional com maior tempo de contacto nos cuidados, importa verificar se estão satisfeitos com a mudança induzida. Assim, este estudo de natureza quantitativa pretende medir e analisar a satisfação profissional ddos enfermeiros que trabalham no serviço de longa duração e manutenção nas unidades de cuidados continuados do distrito de Braga, e verificar se esta variável é influenciada por fatores sociodemográficos e laborais. Para a recolha de dados utiliza-se a Escala de Avaliação da Satisfação no Trabalho para Enfermeiros - EASPE© (α=0,814) e um questionário sociodemográfico e profissional. A análise dos dados é efetuada com recurso à estatística descritiva e inferencial com utilização dos testes de Mann-Whitney e de Kruskal-Wallis. Os resultados obtidos evidenciam que os enfermeiros apresentam um nível de satisfação global no trabalho positivo, mas negativo nas dimensões satisfação com benefícios e recompensas e satisfação com promoção. Conclui-se, ainda, que a satisfação com promoção é influenciada pelas habilitações literárias, que a satisfação com a comunicação é influenciada pela remuneração, que a satisfação com benefícios e recompensas é influenciada pelo horário semanal e que a unidade de cuidados é determinante na satisfação global no trabalho.

Certificação ISO 9001 e Gestão de Recursos Humanos: precedentes e consequentes: estudo de caso das Unidades de Serviços Certificadas da Universidade do Minho

Dissertação de mestrado em Gestão de Recursos Humanos

Family doctors' consultations with people suffering from chronic pain without objective findings: Which protective practices might they develop in these challenging medical encounters?

Introduction: Consultations with patients suffering from chronic pain without objective findings represent a challenge fo r family doctors (FDs). A mutual lack of understanding may arise, which threatens the doctor-patient relationship and may lead to dissatisfaction of both patient and doctor and to a breakdown of the therapeutic alliance. Objectives: This study aims to investigate FDs' potential protective practices to preserve the doctor-patient relationship during this type of consultation. Method: In the first step of this qualitative research, I carried out a range of 10 se- mi-structured interviews with FDs to explore their reported practices and repre- sentations during consultations with people suffering from chronic pain without objective findings. The interviews' transcripts were integrally analysed with computer-assisted thematic content analysis (QSR NVivo ® ) to highlight the main themes related to the topic in the participants' talk. Results: At this point of the research, two types of FDs' protective practices can be identified: first the use of complementary sources of knowledge in addition to the medical model to provide explanations to patients, second the collaboration with multidisciplinary teams or support gr oups that allow them to share profes- sional expertise and emotional experiences. Conclusion: The findings could be useful to develop ways to improve the follow- up of patients suffering from chronic pain without objective findings and conse- quently the FDs' work satisfaction.

Contribuição dos factores motivacionais para a satisfação no trabalho

A motivação é vista, desde meados do Século XX, como o principal factor de satisfação no trabalho, de aumento da produtividade e de melhoria da qualidade dos produtos e serviços. Na conclusão de um curso conducente ao Mestrado em Gestão Global, interessou-nos abordar o valor humano da organização, cujo componente importante é o nível de satisfação das pessoas no trabalho, obtido da avaliação a um leque de variáveis independentes, relacionadas com duas coisas – o conteúdo do trabalho e o contexto do trabalho. O objectivo da presente dissertação é identificar em que medida as variáveis do meio envolvente do trabalho contribui para a satisfação no trabalho. Inspirados na Teoria dos dois Factores (Herzberg, 1959 e 1982) e na Teoria da Avaliação Cognitiva (Deci, 1971), pretendemos justapor a satisfação das pessoas à diferentes variáveis particulares que formam dois subsistemas – o intrínseco ou motivador, que inclui a aprendizagem, as emoções, o trabalho em si, a realização e o reconhecimento; e o extrínseco ou higiénico, que inclui o salário, a supervisão e as condições físicas. Além de uma incursão à literatura especializada, realizamos dois inquéritos em empresas cabo-verdianas, um em Outubro de 2003 e outro em Outubro de 2007, que nos permitiram determinar índices específicos e gerais de satisfação no trabalho, fazer correlações e análises comparativas. Concluímos que as pessoas estão razoavelmente satisfeitas no trabalho, dão mais ênfase aos factores do conteúdo que aos factores do contexto do trabalho, mas a fonte de satisfação varia de categoria por categoria. Work motivation is viewed, since middle of the 20th Century, as a main factor of job satisfaction, also for increasing of productivity and quality of goods and services. By the ending of a Master’s Programme in Global Management, we was moved by a great interest to research and report about the organization human values, important component of which is the people’s satisfaction level in work conditions, obtained through an evaluation of a great number of independent variables, related to two items – work content and work context. The main objective of the present dissertation is to identify in which measure the job environmental variables contribute to work satisfaction. Inspired into the Two Factors Theory (Herzberg, 1959, 1982) and into The Cognitive Evaluation Theory (Deci, 1971), we intent to relate people satisfaction to different particular variables, which perform two subsystems – intrinsic or motivator, that includes learning, emotions, work itself, achievement and recognition and; extrinsic or hygienic, that includes salary, supervision and work physical conditions. Besides a specialized literature review, we took up two separated inquiries within capeverdian companies, the first conducted in October, 2003, and the second in October, 2007, which allowed specifics and general job satisfaction indexes, correlations and comparative analysis. We concluded that people are fair satisfied on job, and give more emphasis on work content factors, than on work context factors, but the source of satisfaction is different category by category.

Implementing the intermed in a post-acute care rehabilitation clinic for traumatic injuries: Obstacles and benefits

In 2003, the INTERMED, an instrument to assess biopsycho- social case complexity and to direct care, was introduced in daily clinical practice in the .Clinique romande de réadaptation suvaCare., a national rehabilitation hospital for traumatic injuries, located in the French speaking part of Switzerland. The introduction of the INTERMED was easy to realize and no major obstacles hampered its systematic implementation. Up to now, about 2,000 patients have been evaluated with the INTERMED and are followed for different outcomes. The INTERMED improved not only patients. assessment by including relevant psychosocial aspects of the clinical situation, it also favoured interdisciplinary communication, enhanced work satisfaction of the nursing staff and allowed early identification and adaptation of treatment for the injured patient showing a high degree of case complexity. Upon follow up, patients with a high degree of case-complexity showed a less favourable outcome, i.e. more health care utilization and lower rates of return to work. In conclusion, the systematic implementation of the INTERMED enabled the reorganization of medical rehabilitation, anchored it in a bio-psycho-social framework, improving interdisciplinary communication and collaboration and ameliorated treatment outcome.

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Career interventions for adults frequently include personality assessment. Personality in career counseling contexts should no longer be considered as vocational personality associated with personality interests but, rather, as a set of dispositions that has an impact on several vocational and career-related outcomes, such as work engagement, work satisfaction, job performance, etc. Although the relationship between personality and the vocational and career related outcomes is not direct, it might certainly be mediated by several regulatory processes, such as work adaptability, and moderated by contextual and environmental factors. Personality assessment initiates an individual's self-regulatory process and contributes to the overall effectiveness of career interventions when feedback is individualized and stimulates a deconstruction, reconstruction, and co-construction of the vocational or multiple self-concept. Personality assessments can also promote the reconstruction of a self-concept more aligned with the perception of the environment about the personality of the counselee, strengthening the reality principle allowing more rational and controlled choices. In addition, some specific personality profiles, such as having high levels of neuroticism and low levels of conscientiousness, can be considered as risk factors frequently leading to career decision-making difficulties. Moreover, people with low conscientiousness benefit less from career interventions, so special attention should be devoted to counselees having that characteristic. Two case studies are provided to illustrate these important aspects of personality assessment in career interventions.

Ammatti-identiteetin rakentuminen sairaanhoitajilla

Ammatti-identiteetti luo pohjan henkilön ammattitaidolle, oman, henkilökohtaisen ammatillisen osaamisen arvostamiselle sekä koko ammattikuvalle, sille millaisena työntekijänä jokainen itsensä näkee. Vahva ammatti-identiteetti aikaansaa positiivisen takaisinkytkennän, kun hyvin tehdyn työn seurauksena saadaan kannustavaa palautetta, mikä kasvattaa itsetuntoa, joka puolestaan luo positiivinen omakuvan, jonka seurauksena syntyy vahva ammatti-identiteetti. Tämän tutkimuksen tarkoituksena on selvittää millä tavoin ammatti-identiteetti rakentuu ja muotoutuu, ja millaisia ovat sitä muovaavat tekijät. Samalla pyritään selvittämään millainen merkitys ammatti-identiteetillä on työn suorittamiseen, työssä viihtymiseen sekä omaan näkemykseen itsestään tietyn alan ammattilaisena. Tutkimuksen kontekstina on terveydenhoitoala, ja empiriassa tutkitaan sairaanhoitajien ammatti-identiteettiä. Tutkimuksen perusteella näyttää siltä, että sairaanhoitajat arvostavat ammattiaan ja ammattitaitoaan huolimatta yhteiskunnallisesta aliarvostuksesta. Tämä tukee käsitystä sairaanhoitajien vahvasta ammatti-identiteetistä. Tutkimuksen tulokset osoittavat, että sairaanhoitajan ammatti-identiteetti on moniulotteinen ilmiö. Ammatti-identiteetti ei ole irrallinen henkilön persoonallisesta identiteetistä, vaan ne tukevat toinen toistaan.

Työponnistus ja organisaation uudistumiskyky:Haluammeko björnborgeja vai henrykissingerejä?

Tämän Pro Gradu –tutkielman tavoitteena oli tutkia, onko työponnistuksen ja organisaation uudistumiskyvyn välillä yhteyttä. Lisäksi selvitettiin, vaikuttavatko työtyytyväisyys, työmotivaatio ja henkilökohtainen uudistumiskyky organisaation uudistumiskykyyn. Niiden yhteys selvitettiin myös työponnistukseen. Tutkimuksessa käytettiin kahta erilaista tiedonhankintaa. Esimerkkiyritykselle tehtiin määrällinen tutkimuskysely. Lisäksi tehtiin kolme puolistruktuoitua ryhmähaastattelua. Myös kolme yksikönjohtajaa haastateltiin. Tutkielma antoi selkeän todisteen siitä, että työponnistuksella ja organisaation uudistumiskyvyllä on yhteys toisiinsa. Vielä vahvempi yhteys löytyi työmotivaation ja uudistumiskyvyn välillä. Henkilökohtaisen uudistumiskyvyn ja organisaation uudistumiskyvyn välillä oli hyvin heikko yhteys. Vielä heikompi oli sen yhteys työponnistukseen. Työtyytyväisyys korreloi hyvin vahvasti työponnistuksen kanssa, mutta sen suhde organisaation uudistumiskykyyn oli selvästi huonompi kuin työmotivaation ja työponnistuksen. Esimerkkiorganisaation yksikköjen, osastojen ja suoritusportaiden välisiä eroja tutkittiin myös. Toimitusosastojen ja muiden osastojen väliltä löytyi merkitseviä eroja, mutta muuten yrityksen arvot eri tahoilla olivat melko tasaisia.

Mental Health of Expatriates in Finnish Enterprises in Brazil

Expatriation has become increasingly common due to the global trade expansion. Many large companies base their production facilities in far-flung countries, where experts are sent from their own countries to launch the operations. Working in a foreign environment demands from so-called expatriates considerable adaptability. This study aimed to investigate if following expatriation mental health difficulties were experienced by the employees themselves or their family members. This study investigated by a questionnaire and interviews how expatriate employees in Finnish companies operating in different regions of Brazil and their families adjusted. Investigated employees were required to be at least 6 months in expatriation. Data were collected in Brazil during their stay at least 3 months after the arrival. The survey covered 121 expatriate employees, that operated in 17 different companies, from which 71 employees from 10 different companies responded to the questionnaire. All the employees from the two largest enterprises and their spouses were invited to focus groups; in total 43 persons (22 employees and 21 employees’ spouses) participated in a group or individual interviews. No significant mental health difficulties were found among the expatriate employees. Only a tenth of the expatriate employees reported strain. The experience of strain symptoms was found to be related to long working days, intense working rhythm and lack of friends. Work satisfaction seemed to be an important mediator in the coping process. While abroad, the expatriate employees were highly recognized for their work. Due to the immature organization of work they could often use their creative capacities to improve the work flow. The opportunity to see the effects of their own contribution with their own eyes to the development of the enterprise made them feel good. The association between the expatriate employees’ adjustment and that of their spouses’ was evident. The spouses’ situation was markedly different than that of the expatriate employees’ themselves. Expatriation changed the family members’ previous division of tasks considerably. The expatriate spouses had to change their roles more than the expatriate employees themselves; since most of them were highly educated women, who were leaded through an identity crisis due to at least temporary renunciation of own work and career.

Kielikeskuksissa toimivien kieltenopettajien käsityksiä ja kokemuksia massayliopiston luomista haasteista

Challenges of mass university conceived and experienced by university language centre language teachers The massification of the university involved not only an expansion but also a transition from one period to another, from elite higher education to mass higher education. Massification cannot be viewed as expansion and structural change but it has to be viewed in a context of a number of changes involving universities, state, economy, society and culture as well as science, technology, education and research. In the Finnish academic context, massification is often associated with negative development and it may be used as an excuse for poor teaching. The objective of the present study is to find out how the mass context is manifested in the work of university language centre language teachers. The data were collected by means of semi-structured questionnaires from 32 language teachers working at language centres at the universities of Helsinki, Jyväskylä, Tampere and Turku in Finland. Both Finnish and native speakers, 6 male and 26 female teachers, were included. All the teachers in the study had taught more than 10 years. The data were complemented by interviews of four teachers and email data from one teacher. Phenomenographic analysis of the informants’ conceptions enabled a description of their experiences of students at a mass university, conceptions of teaching and learning and of issues related to work health. Some conceptions were consonant with earlier results. The conceptions revealed differences between two teacher groups, teachers of subject-specific language, or language for specific purposes (LSP), and teachers of elementary and advanced language courses (general language teachers). For the first, the conceptions of the investigated teachers provided a picture of the students as a member of a mass university. The students were seen as customers who demanded special services to facilitate their studies or were selective about the contents of the course. The finding that appeared only in the LSP teachers’ data was the unengaged attitude towards language study, which appeared as mere hunt for credits. On the other hand, the students were also seen as language learning individuals, but a clear picture of a truly interested language learner was evident in the data of general language teachers. The teachers’ conceptions of teaching and learning revealed a picture of experienced teachers with a long background of teaching, reflecting experiences from different time periods and influences from their own education and illustrating the increasing problems with organizing individual tutoring due to large, heterogeneous groups. It seemed, however, that in spite of the large student groups, general language teachers were able to support the students’ learning processes and to use learner-centred methods, whereas LSP teachers were frequently compelled to resort to knowledge transmission type of teaching. The conditions of the mass university were clearly manifested in the respondents’ conceptions about work satisfaction: there were a number of factors related to administration, teaching arrangements and the status of the language centres that were likely to add to the teachers’ work stress, whereas traditional characteristics of academic work were viewed as promoting work satisfaction. On the basis of the teachers’ conceptions, it is safe to assume that academic mass context and students’ orientations have an effect on the teacher’s approach to teaching, while there is no unequivocal association between mass university teaching and poor teaching.

Esimiehen ydinkompetenssit tuloksen ja työtyytyväisyyden selittäjänä – Case S-market

Työn tarkoituksena on kehittää suorittavalle esimiestasolle työkalu, millä voidaan mitata esimiehen kompetensseja. S-market esimiehen ydinosaamiset työssä jakautuvat kahteen kokonaisuuteen vuorovaikutus- ja ketjuyksikön johtamiseen. Työn tavoitteena on myös tarkastella millä esimiehen ydinosaamisella on merkitystä työtyytyväisyyteen ja yrityksen tulokseen. Tutkimus on kvantitatiivinen ja sen aineisto on verkkokyselylomakkeen avulla kerätystä 129 vastauksesta. Verkkokyselylomakkeen väittämät ovat rakennettu esimiestyön kompetensseista, jotka pohjautuvat tutkielman teoriaan. Verkkokyselyn, työtyytyväisyyden ja tuloksen lukuarvot on analysoitu tilastollisella tulostenkäsittelyohjelmalla, SPSS:llä. Työtyytyväisyystulokset ovat koottu tutkimukseen osallistuneen viidentoista S-marketin työtyytyväisyystutkimuksen tuloksista vuodelta 2008. Tuloksen mittareina tutkielmassa on käytetty samojen S-markettien työtehokkuutta ja toimintakateprosenttia vuodelta 2008. Työn tulokset vahvistivat sen, että esimiestyöllä on suora syy-seuraussuhde työtyytyväisyyteen ja tuloksellisuuteen. Tutkimustuloksien perusteella esimieskäyttämisen vaikutus työtyytyväisyyden kokemiseen on vahva. Hyvällä vuorovaikutusjohtamisella tuloksien perusteella oli vaikutusta työtyytyväisyyteen. Tuloksista kävi ilmi, että työtyytyväisyyteen esimiehen kompetensseista eniten vaikuttivat yksilöllinen huomiointi, tavoitteisiin kannustaminen ja motivointi sekä asiakaslähtöisyys. Tuloksen mittareihin eniten vaikutti tulos- ja tavoitejohtaminen. Tuloksellisuuteen vaikuttavat tutkimuksen mukaan esimiehen jämäkkä ja vaativa tavoitteisiin ohjaava toiminta sekä päätöksenteko ja organisointikyky. Tarkempien ja täsmällisimpien S-market esimiehen kompetenssien löytämiseksi kehitysehdotuksena tutkielmassa on laajemman tutkimusaineiston käsittely neljän faktorin avulla.

Le Programme Hors Normes en santé au travail : représentations d’infirmières du secteur public

Depuis 2006, le Programme Hors Normes (PHN) dicte une nouvelle marche à suivre que doivent privilégier les équipes de santé au travail (SAT) lorsque des travailleurs sont exposés à des concentrations environnementales de produits chimiques supérieures aux valeurs d’exposition admissibles, c’est-à-dire à des « hors normes ». Le PHN encadre les activités de signalements des hors normes aux instances concernées et demande des suivis plus rigoureux en établissements. Ce faisant, il redéfinit les rôles des infirmières et des membres des équipes SAT. Dans le but de mieux comprendre l’implication des infirmières dans le cadre du PHN, sept entretiens individuels semi-dirigés ont été réalisés afin d’explorer et de décrire leurs représentations. L’analyse qualitative de ces représentations, par catégorisation et comparaisons constantes des discours, révèle que les infirmières se représentent de diverses façons leur pratique dans le cadre du PHN. En effet, les résultats de l’étude montrent qu’afin de comprendre l’implication des infirmières dans ce programme d’intervention, il importe de considérer les quatre éléments suivants : l’organisation du travail, les aspects relationnels (dynamique de relations), les cibles d’intervention et l’utilité du travail des infirmières (sens donné au travail). Afin de faciliter leur participation dans les programmes d’intervention et d’encourager la collaboration, tant intersectorielle qu’interprofessionnelle, il est suggéré en premier lieu de favoriser l’implication des infirmières dans les processus d’élaboration et d’implantation de programmes d’intervention. En second lieu, il est proposé de mettre en place une formation continue interprofessionnelle permettant une meilleure harmonisation des pratiques professionnelles.

Favoriser la santé psychologique des professionnels de la santé en début de carrière : l'importance du soutien à l'autonomie, de la concordance des tâches et de la conscience de soi

Les études mettent en évidence des problèmes de santé psychologique chez les professionnels de la santé. Par contre, les facteurs permettant d’expliquer ces difficultés sont peu connus (p. ex., Cohen & Patten, 2005). Le but de cette thèse est d’étudier les déterminants de la santé psychologique des professionnels de la santé en se basant sur une théorie validée empiriquement. À cette fin, la théorie de l’autodétermination (Deci & Ryan, 1985, 2000) est utilisée comme cadre conceptuel et le soutien à l’autonomie (Black & Deci, 2000; Grolnick & Ryan, 1989) est proposé comme déterminant principal de la santé psychologique. Le premier article consiste en une recension des conséquences et corrélats associés au soutien à l’autonomie dans divers domaines de vie. Le deuxième article a pour objectif de tester un modèle prédictif de la santé psychologique auprès de médecins résidents. Le modèle propose que la concordance des tâches (Sheldon & Elliot, 1999) et la conscience de soi (Goldman & Kernis, 2002) sont deux sources distinctes d’autonomie qui prédisent de façon indépendante la santé psychologique. De plus, le soutien à l’autonomie de la part des superviseurs est suggéré comme étant un déterminant important de la concordance des tâches et de la conscience de soi. Au total, 333 médecins résidents de la province de Québec (Canada) ont rempli un questionnaire comportant différentes mesures. Des analyses par équations structurelles révèlent une excellente adéquation du modèle. Le troisième article examine l’influence du soutien à l’autonomie des collègues sur la satisfaction au travail ainsi que sur la santé psychologique des professionnels de la santé. Au total, 597 jeunes professionnels de la santé ont rempli un questionnaire incluant diverses mesures. Les résultats confirment que le soutien à l’autonomie perçu de la part des collègues prédit la santé psychologique et la satisfaction au travail. De plus, des régressions hiérarchiques démontrent que le soutien à l’autonomie des collègues contribue à la prédiction de la satisfaction au travail, du bien-être subjectif et des idéations suicidaires au-delà de ce qui est prédit par le soutien à l’autonomie des superviseurs. Les implications théoriques et pratiques de ces recherches sont discutées.

Étude exploratoire des facteurs de risque du détournement en interne du patrimoine informationnel

Rapport de stage présenté à la Faculté des arts et sciences en vue de l'obtention du grade de Maîtrise ès sciences (M. Sc.) en criminologie (option Analyse Criminologique).