Global Leadership Initiative on Malnutrition criteria using calf and upper arm circumference as phenotypic criteria for assessing muscle mass demonstrate satisfactory validity for diagnosing malnutrition in hospitalized patients: A prospective cohort study.

BACKGROUND: Hospitalized individuals present high rates of malnutrition and loss of muscle mass (MM). Imaging techniques for assessing MM are expensive and scarcely available in hospital practice. The Global Leadership Initiative on Malnutrition (GLIM) proposed a framework for malnutrition diagnosis that includes simple measurements to assess MM, such as calf circumference (CC) and mid-upper arm circumference (MUAC). This study aimed to analyze the validity of the GLIM criteria with CC and MUAC for malnutrition diagnosis, using Subjective Global Assessment (SGA) as the reference standard, in inpatients. METHODS: A prospective cohort study was conducted on 453 inpatient adults in a university hospital. The presence of malnutrition was assessed within 48 h of hospital admission using SGA and GLIM criteria using CC and MUAC as phenotypic criteria for malnutrition diagnosis. Accuracy, agreement tests, and logistic regression analysis adjusted for confounders were performed to test the validity of the GLIM criteria for malnutrition diagnosis. RESULTS: The patients were aged 59 (46-68) years, 51.4% were male, and 67.8% had elective surgery. Compared with SGA, the GLIM criteria using the two MM assessment measures showed good accuracy (area under the curve > 0.80) and substantial agreement (κ > 0.60) for diagnosing malnutrition. The highest sensitivity was obtained with GLIMCC (89%), whereas GLIMMUAC showed high specificity (>90%). Also, malnutrition identified by GLIMCC and GLIMMUAC was significantly associated with prolonged hospitalization and in-hospital death. CONCLUSION: In the absence of imaging techniques to assess MM, the use of CC and MUAC measurements from the GLIM criteria demonstrated satisfactory validity for diagnosing malnutrition in hospitalized patients.

Full range leadership style and its effect on effectiveness, employee satisfaction, and extra effort: an empirical study.

The purpose of this study is to determine if there is a positive relationship between full-range leadership and employees' effort, efficiency, and satisfaction. A questionnaire was administered to 577 executives from Colombian companies, and the data was analyzed using a partial least squares structural equation modeling (PLS-SEM) approach. The results show that both transformational and transactional leadership have a direct and significant impact on extra effort, effectiveness, and satisfaction, with transformational leadership having the greatest impact on these factors. Conversely, passive-avoidant leadership has negative effects on these three constructs. This study validates the effectiveness of the MLQ 5X in a South American country, a geographical region where such studies are in their early stages. Finally, the whole range of leadership styles-transformational, transactional, and passive-avoidant-is looked at. These styles are seen as second-order constructs that challenge latent multidimensional models as they emerge.

Fonoaudiologia empresarial: revisão de dissertações defendidas entre 2002-2022 / Corporate speech therapy: review of dissertations and theses defended between 2002-2022 / Fonoaudiología corporativa: revisión de disertaciones y tesis defendidas entre 2002-2022

Introdução: o presente estudo visa mapear e avaliar a produção registrada sobre Fonoaudiologia Empresarial, a fim de identificar as temáticas mais pesquisadas, bem como as temáticas pouco exploradas em dissertações e teses na área. Objetivo: analisar a produção científica brasileira defendida entre 2002-2022, considerando nível de produção, ano, rede de ensino, instituição de ensino superior (localização geográfica), tipo de pesquisa, descritor registrado (primeiro), local, temática, total da amostra pesquisada e áreas de conhecimento. Método: revisão realizada na Biblioteca Digital Brasileira de Teses e Dissertações, em 05 de maio de 2023, considerando os termos "Fonoaudiologia" e "Empresa", pesquisados no período 2002-2022, segundo as variáveis anteriormente descritas, analisados de forma descritiva. Resultados:dentre 30 fontes registradas, 24-80,0% são dissertações, sendo 2007 o ano mais produtivo (6-20,0%). A Região Sudeste liderou a pesquisa (20-66,7%), representada pela PUC-SP (10-33,3%) e o destaque foi de pesquisas do tipo observacional (22-73,3%), sendo Empresas os locais mais pesquisados (20-66,7%) e o descritor "saúde do trabalhador" o mais utilizado (03-10,0%). A área de conhecimento (CNPq) que mais pesquisou foi Ciências da Saúde (25-83,3%) por meio da subárea Fonoaudiologia (20-66,7%%), sendo a Audiologia a temática mais pesquisada (16-53,3%). Conclusão: foram encontrados 16,53,3% registros na área de Audiologia e as pesquisas realizadas na área de Voz (7-23,3%) abordam os temas relacionados a qualidade vocal, comunicação e expressividade, no entanto, não abordam liderança. Tal dado sugere esforços em pesquisas científicas e atuação profissional, já que a Fonoaudiologia tem como objeto de estudo e atuação, a comunicação humana.(AU)

Introduction: this study aims to explore the Speech-Therapy's literature and its contribution to identify the most researched and few explored themes in dissertations and theses in the area. Objective:to analyze the Brazilian scientific production submitted between 2002 and 2022, considering production level, publication year, institution of defense, geographical location, research methodology, the first descriptor, research location, the thematic focus, total sample size and knowledge areas. Method: the review analysis was conducted using data obtained from the Brazilian Digital Library of Theses and Dissertations on May 5, 2023, using the terms: "Speech-Therapy" and "Company" to retrieve theses and dissertations from 2002 to 2022 according to the variables described above. Data were analyzed descriptively. Results: among the 30 entries retrieved, 24-80,0% were dissertations, most of which defended in 2007 (6-20,0%). The majority of the studies were from the Southeast region (20- 66.7%), represented by Pontifícia Universidade Católica de São Paulo: PUC-SP (10-33.3%) and the highlight was observational researches (22-73.3%) and the majority of the research was conducted at business companies (20-66,7%). In addition, "worker's health" was the most used descriptor (3-10,0%). The knowledge area (CNPQ) that produced the most studies was Health Sciences (25-83,3%) through the subarea of Speech-Language-Pathology (20-66,7%%), with Audiology being the most researched theme (16-53,3%). Conclusion: Audiology was the area with the highest number of studies found 16,53,3%. Research conducted in the Voice field (7-23,3%) addresses topics related to vocal quality, communication and expressiveness, however, they do not address leadership. The findings suggest a need for future research. Further studies can build upon insights to advance knowledge and promote evidence-based practice in the field of business companies, considering that Speech-Therapy has as its object of study and activity human communication. (AU)

Introducción: este estudio tiene como objetivo mapear y evaluar la producción grabada sobre Fonoaudiología Empresarial, con el fin de identificar los temas más investigados, así como los temas poco explorados en disertaciones y tesis en el área. Objetivo: analizar la producción científica brasileña defendida entre 2002-2022, considerando nivel de producción, año, red educativa, institución de educación superior (ubicación geográfica), tipo de investigación, descriptor registrado (primero), ubicación, tema, muestra total investigada y áreas. del conocimiento. Método: revisión realizada en la Biblioteca Digital Brasileña de Tesis y Disertaciones, el 5 de mayo de 2023, considerando los términos "Fonoaudiología" y "Empresa", investigados en el período 2002-2022, según las variables previamente descritas, analizadas en una manera descriptiva. Resultados: entre 30 fuentes registradas, 24-80,0% son disertaciones, siendo 2007 el año más productivo (6-20,0%). La Región Sudeste lideró la investigación (20-66,7%), representada por la PUC-SP (10-33,3%) y destaque para la investigación observacional (22-73,3%), siendo las Empresas las localidades más investigadas (20-66,7%) y el descriptor "salud del trabajador" el más utilizado (03-10,0%). El área del conocimiento (CNPq) más investigada fue Ciencias de la Salud (25-83,3%) a través de la subárea Fonoaudiología (20-66,7%), siendo la Audiología el tema más investigado (16-53,3%). Conclusión: Se encontraron 16,53,3% registros en el área de Audiología y las investigaciones realizadas en el área de Voz (7-23,3%) abordan temas relacionados con la calidad vocal, la comunicación y la expresividad, sin embargo, no abordan el liderazgo. Estos datos sugieren esfuerzos en la investigación científica y en el desempeño profesional, ya que la Fonoaudiología tiene como objeto de estudio y actividad la comunicación humana. (AU)

The influence of political disagreements and corruption on state health leader turnover during the COVID-19 pandemic in Brazil.

PURPOSE: Governments faced formidable challenges in coordinating public health responses to the COVID-19 pandemic. This study aims to enhance the understanding of effective organizational leadership during crises by investigating the factors influencing the turnover of health leaders during the COVID-19 pandemic in Brazil. DESIGN/METHODOLOGY/APPROACH: Using primary data encompassing all appointments and dismissals of federal and state health secretaries, this paper conducted a quantitative analysis of the relational and reputational factors that contributed to leader turnover during the COVID-19 pandemic. This paper also examined whether leaders' management and public health experience increase the duration of tenure. FINDINGS: States encountered significant challenges in retaining experienced and effective leadership during the health emergency, primarily due to political conflicts in policymaking and, to a lesser extent, allegations of corruption. Furthermore, leaders with expertise in public health were found to be less likely to be removed from office. However, managerial experience did not prolong the tenure of state health secretaries during the emergency. RESEARCH LIMITATIONS/IMPLICATIONS: Since most health leaders have public health and management experience, the contributions of each factor to the duration of a secretary's tenure are difficult to separate and analyze separately. PRACTICAL IMPLICATIONS: This study provides empirical insights into what factors drive health leader turnover during major health emergencies. SOCIAL IMPLICATIONS: During major health emergencies, health leaders often strongly disagree with elected officials on the response. This paper test how crisis leadership theories help explain state health leaders' duration in one of the world's largest public health systems during the COVID-19 pandemic. This paper find that policy disagreements contributed to significant turnover. ORIGINALITY/VALUE: To the best of the authors' knowledge, this paper is the first that are aware of that uses novel primary data on public health executive leader characteristics and turnover causes in the context of the COVID-19 pandemic. It provides empirical evidence contributing to the crisis leadership literature by examining health leader turnover in one of the world's largest public health systems.

GLIM criteria validation and reliability in critically ill patients with cancer: A prospective study.

BACKGROUND: The present study aims to assess the interrater reliability of the Global Leadership Initiative on Malnutrition (GLIM) criteria, a framework to provide a consensus diagnosis of malnutrition. We also aimed to investigate its concurrent and predictive validity in the context of patients with cancer admitted to the intensive care unit (ICU). METHODS: Individuals aged ≥19 years with cancer who were admitted to the ICU within 48 h of their initial hospital admission were included. Nutrition status was assessed with the Nutritional Risk Screening 2002, the Subjective Global Assessment (SGA), and the GLIM criteria. Interrater reliability was assessed by the kappa test (>0.80). The SGA served as the established benchmark for assessing concurrent validity. To evaluate predictive validity, the occurrence of mortality within 30 days was the outcome, and Cox regression models were applied. RESULTS: A total of 212 patients were included: 66.9% were at nutrition risk, and 45.8% were malnourished according to the SGA. According to the GLIM criteria, 68.4% and 66% were identified as malnourished by evaluators 1 and 2, respectively (κ = 0.947; P < 0.001). The GLIM combination incorporating weight loss and the presence of inflammation exhibited sensitivity (82.4%) and specificity (92%). In the multivariate Cox regression models, most GLIM combinations emerged as independent predictors of complications. CONCLUSION: The GLIM criteria demonstrated satisfactory interrater reliability, and the combination involving weight loss and the presence of inflammation exhibited noteworthy sensitivity and specificity. Most GLIM combinations emerged as independent predictors of 30-day mortality.

Health Information System Strengthening During Antenatal Care in Haiti: Continuous Quality Improvement Study.

BACKGROUND: Journey to 9 Plus (J9) is an integrated reproductive, maternal, neonatal, and child health approach to care that has at its core the goal of decreasing the rate of maternal and neonatal morbidity and mortality in rural Haiti. For the maximum effectiveness of this program, it is necessary that the data system be of the highest quality. OpenMRS, an electronic medical record (EMR) system, has been in place since 2013 throughout a tertiary referral hospital, the Hôpital Universitaire de Mirebalais, in Haiti and has been expanded for J9 data collection and reporting. The J9 program monthly reports showed that staff had limited time and capacity to perform double charting, which contributed to incomplete and inconsistent reports. Initial evaluation of the quality of EMR data entry showed that only 18% (58/325) of the J9 antenatal visits were being documented electronically at the start of this quality improvement project. OBJECTIVE: This study aimed to improve the electronic documentation of outpatient antenatal care from 18% (58/325) to 85% in the EMR by J9 staff from November 2020 to September 2021. The experiences that this quality improvement project team encountered could help others improve electronic data collection as well as the transition from paper to electronic documentation within a burgeoning health care system. METHODS: A continuous quality improvement strategy was undertaken as the best approach to improve the EMR data collection at Hôpital Universitaire de Mirebalais. The team used several continuous quality improvement tools to conduct this project: (1) a root cause analysis using Ishikawa and Pareto diagrams, (2) baseline evaluation measurements, and (3) Plan-Do-Study-Act improvement cycles to document incremental changes and the results of each change. RESULTS: At the beginning of the quality improvement project in November 2020, the baseline data entry for antenatal visits was 18% (58/325). Ten months of improvement strategies resulted in an average of 89% (272/304) of antenatal visits documented in the EMR at point of care every month. CONCLUSIONS: The experiences that this quality improvement project team encountered can contribute to the transition from paper to electronic documentation within burgeoning health care systems. Essential to success was having a strong and dedicated nursing leadership to transition from paper to electronic data and motivated nursing staff to perform data collection to improve the quality of data and thus, the reports on patient outcomes. Engaging the nursing team closely in the design and implementation of EMR and quality improvement processes ensures long-term success while centering nurses as key change agents in patient care systems.

Factores asociados al liderazgo docente / Factors asociated to teacher leadership

Abstract: El liderazgo docente resulta ser una variable importante debido al papel que juega en la mejora de la calidad del profesorado y su relación positiva con los resultados escolares; sin embargo, en las realidades institucionales persisten situaciones que obstaculizan o desalientan al magisterio a asumir estos roles. El objetivo de la presente investigación fue el de describir cuáles son los factores que facilitan o inhiben el desarrollo del liderazgo docente en una escuela primaria de Mérida, Yucatán, México. Se siguió un estudio de caso con métodos mixtos. Para el análisis cualitativo, se trabajó con los datos recabados mediante las técnicas de observación participante y la entrevista semi-estructurada. Para el análisis de datos cuantitativos se utilizó la técnica de la administración de encuestas online, y se llevaron a cabo inferenciales no paramétricos: Ji cuadrada y prueba U de Mann Whitney. Se encontró que tener un liderazgo docente alto está relacionado positivamente con tener iniciativa para emprender proyectos innovadores escolares; a diferencia, el nivel bajo de liderazgo se asoció con la incomodidad con roles de liderazgo. Se detectaron diferencias en los resultados de las técnicas cualitativas y las cuantitativas. En el estudio cualitativo se obtuvo que ser docente de apoyo, la figura del director, el individualismo, la disponibilidad de tiempo, la carga administrativa, los grupos numerosos, entre otros, fueron categorías que pueden influir en el hecho de actuar o no con liderazgo. Es indispensable conocer todas las situaciones por la que atraviesan los profesores para poder tomar las decisiones de manera informada, así como encontrar las raíces reales de los problemas que están estrechamente relacionadas con las decisiones sobre po lítica pública.

Abstract: Teacher leadership is an important variable due to the role it plays in improving teacher quality and its positive relationship with school results. However, contextual situations exist within institutions that hinder or discourage teachers from assuming these roles. The objective of this research was to describe the characteristics and factors that foster or inhibit the development of teacher leadership in a primary school in Mérida, Yucatán. A case study with mixed methods was followed. For the qualitative phase data were collected employing participant observation and semi-structured interviews. For the quantitative phase of the study online surveys were administered and the following non-parametric inferential tests were carried out: chisquare and Mann-Whitney U test; Findings suggest that high levels of leadership are positively correlated to having the initiative to undertake innovative school projects. In contrast, low levels of leadership were associated to discomfort with leadership roles. Significant differences were identified in the results of the qualitative and quantitative phase. The qualitative phase revealed that being a support teacher, the principal's role, individualism, the availability of time, the administrative burden, large groups, among others, were categories that can influence teacher's intentions to act or not with leadership. It is essential to know the situations that all teachers go through in order to make decisions in an informed manner, as well as to find the real roots of the problems that are closely related to decisions on public policy.

Before and during COVID-19: the roles of transformational leadership, organizational culture and work-life balance in healthcare.

PURPOSE: This research aims to investigate the role of transformational leadership and organizational culture - encompassing Clan, Adhocracy, Hierarchical and Market Cultures - in the context of work-life balance for healthcare workers. It aims to present a comparison of observations made pre and mid-pandemic. DESIGN/METHODOLOGY/APPROACH: A structured questionnaire was utilized to collect data from a varied sample of 355 employees (258 before and 97 during the pandemic) representing multiple sectors and positions within a hospital. The interpretation of the data was accomplished using Partial Least Squares Structural Equation Modeling (PLS-SEM). FINDINGS: Findings reveal that prior to the pandemic, transformational leadership significantly influenced all forms of organizational culture perceptions, with a strong influence on Clan Culture. Clan Culture displayed a consistent positive correlation with WLB both before and during the pandemic. During the pandemic, Market Culture exhibited a negative effect on WLB and Adhocracy Culture demonstrated a positive effect, impacts which were absent before the pandemic. Transformational leadership had a positive impact on WLB before the pandemic, but no discernible effect during the pandemic was observed. ORIGINALITY/VALUE: The results indicate that the dynamics between transformational leadership, organizational culture and work-life balance are susceptible to alterations in the face of external crisis events. This study offers a unique exploration of these dynamics in the healthcare sector during the ongoing global pandemic.

Understanding the Impact of the Nurse Manager's Vocation for Leadership on the Healthcare Workplace Environments in Mexico: A Grounded Theory Approach.

BACKGROUND: Leadership in any managerial position that a nurse may hold appears to be closely connected to fostering positive and productive work environments within healthcare settings. However, not all nurse managers are characterized by leadership, and not all nurse leaders are nurse managers. In countries, such as Mexico, those who occupy these roles have barely sufficient training in management, are mainly characterized by their experience in one clinical specialty and their vocation for leadership is not a requirement. Our study aims to understand how the leadership vocation that some nurse managers have in their daily practice could impact the work environments of healthcare organizations in Mexico. METHODS: A qualitative design was carried out through a grounded theory approach based on Corbin & Strauss, interviewing individually 13 nurse managers with representative experience in Mexican public sector hospitals. RESULTS: According to the interviewees, the meaning of vocation is based mainly on the love for their profession, on the vocation of being a nurse and caring for people, as well as on the development of their own natural leadership potential for decision-making in practice. This situation produces positive feedback on themselves by generating productive effects in the work environment, consequently strengthening them to better organize professional resources and therefore producing improvements. CONCLUSIONS: The nurse manager's vocation of leadership derives from both the vocation of being a practicing nurse and the vocation for being a leader, positively impacting and productively contributing to the improvement of the work environment. Consequently, nurse managers with vocation for leadership should be the gold standard role in any healthcare organization. This study was retrospectively registered with the (registros-OSF-bmyvz-v1) on the (26 July 2023) registration number (10.17605/OSF.IO/BMYVZ).

Nurse Champions: Transforming Evidence-Based Practice

Nursing practice in an organization result from the leadership processes developed for the profession. It is reflected in the performance of nurses in interprofessional teams and the quality of care they provide to patients1. Evidence-based practice (EBP) refers to decision-making in the development and delivery of health care services according to the best available research evidence, the experience of health care providers, and the values and preferences of patients. The adoption or implementation of EBP by organizations can lead to safer practices, better outcomes for individuals, and lower healthcare costs2. In the literature, "champions" have been identified as determinants and agents of change to ensure adoption within institutions.

The Impact of Motherhood on Women's Career Progression: A Scoping Review of Evidence-Based Interventions.

(1) Background: Despite the progress made by women in the workplace, mothers still face systemic barriers that prevent them from advancing professionally. This "motherhood penalty" involves a variety of discriminatory practices and experiences that mothers can face at work, including being held to stricter standards regarding salary and recruitment. Despite ongoing research on the association between motherhood and career outcomes, few studies specifically explore how motherhood impacts career advancement and, consequently, access to leadership. This scoping review seeks to gain an understanding of how motherhood impacts women's career progression, and how interventions can address the underrepresentation of mothers in leadership. (2) Methods: Following the PRISMA-ScR framework, we analyzed 52 articles from 2010 to 2022, drawn from 10 databases. (3) Results: The results showed both negative and positive impacts of motherhood on career progression, affecting mothers' attitudes, feelings, and behaviors and yielding changes in interpersonal relationships and work conditions. Intersectionality is highlighted, urging a nuanced examination of challenges faced by mothers from a diversity of backgrounds. Recommendations for interventions include individual and institutional efforts, comprising societal support structures, organizational policy changes, and cultural shifts. (4) Conclusions: This scoping review offers an updated perspective on a classic challenge, providing practical insights for a more inclusive and structural understanding of the career trajectories of working mothers.

Evidence of validity and reliability of the controlling motivational style questionnaire in the work context.

According to the self-determination theory (SDT), leaders may adopt a controlling motivational controlling style (CMS) that forces employees to think, feel, or behave in a certain way to promote employee motivation. However, a scale has yet to be developed to measure CMS in the work environment. Usually, researchers use questionnaires adapted to different contexts or designed for another motivational style. However, whether these questionnaires capture the behaviors that represent CMS in the work context is little known. This research aimed to elaborate on and analyze the validity and reliability of the questionnaire on Controlling Motivational Style at Work (CMS-W). The study was based on a literature review of the types of controlling behaviors and a review of questionnaires used by SDT researchers who assessed the controlling motivational style in different contexts. A Peruvian sample of 1100 public sector employees participated. The results show that the short and encompassing CMS-W-11 has a one-dimensional structure with good fit indices: Robust RMSEA = 0.071 with 90 % CI from 0.064 to 0.078; Robust CFI = 0.975; Robust TLI = 0.969; SRMR = 0.025 and good reliability coefficients: Ω = 0.930 and AVE 0.630. Furthermore, it shows convergent validity with controlled motivation (r = 0.260, p < .001) and discriminant validity with autonomous motivation (r = -0.270, p < .001). Moreover, the invariance of the gender category was tested. The fit indices were adequate, and the comparative results between the models were also satisfactory. In addition, the behaviors of the CMS in a work context are conditional negative regard, judging and devaluing, control through objectives, intimidation, and intrusive authority. Therefore, labor organizations will have the CMS-W validated and tested in a work context to evaluate the CMS of leaders and study how it related to the motivation of human capital and organizational objectives.

O papel do enfermeiro educador no desenvolvimento da liderança / The role of the nurse educator in leadership development

Compreender o papel do enfermeiro educador no desenvolvimento da liderança. Método: Trata-se de um relato de experiência, realizado com cinco grupos de enfermeiros com a temática de acordo com as suas especializações: pediatria, gestão, cuidados paliativos, centro cirúrgico e geriatria no Hospital Cruz Azul de São Paulo, no período de 2021 até 2023. Resultados: Notou-se progresso nos pontos elencados a partir do plano estratégico anteriormente desenvolvido nos setores de gestão, cuidados paliativos e clínica cirúrgica. Na perspectiva de autonomia e participação, o enfermeiro docente é peça chave na promoção de mudanças no ensino, como também, deve ser responsável pela criação de medidas para fomentar o pensamento crítico e criativo de sua equipe. Conclusão: A inserção de práticas pedagógicas bem como a aproximação dos indivíduos em desenvolvimento de liderança à equipe multidisciplinar são estratégias metodológicas exitosas na formação de enfermeiros-líderes.(AU)

To understand the role of nurse educator in the development of leadership. Method: This is an experience report, conducted with five groups of nurses with the theme according to their specializations: pediatrics, management, palliative care, surgical center and geriatrics at the Cruz Azul Hospital of São Paulo, from 2021 to 2023. Results: Progress was noted in the points listed from the strategic plan previously developed in the management, palliative care and surgical sectors. From the perspective of autonomy and participation, the teaching nurse is a key player in promoting changes in teaching, as well as being responsible for creating measures to foster critical and creative thinking of his team. Conclusion: The insertion of pedagogical practices as well as the approach of individuals in leadership development to the multidisciplinar team are successful methodological strategies in training nurses-leaders.(AU)

Comprender el papel del enfermero educador en el desarrollo del liderazgo. Método: Se trata de un relato de experiencia, realizado con cinco grupos de enfermeros con la temática de acuerdo con sus especializaciones: pediatría, gestión, cuidados paliativos, centro quirúrgico y geriatría en el Hospital Cruz Azul de São Paulo, en el período de 2021 hasta 2023. Resultados: Se notó progreso en los puntos enumerados a partir del plan estratégico anteriormente desarrollado en los sectores de gestión, cuidados paliativos y clínica quirúrgica. En la perspectiva de autonomía y participación, el enfermero docente es pieza clave en la promoción de cambios en la enseñanza, como también, debe ser responsable por la creación de medidas para fomentar el pensamiento crítico y creativo de su equipo. Conclusión: La inserción de prácticas pedagógicas así como el acercamiento de los individuos en desarrollo de liderazgo al equipo multidisciplinar son estrategias metodológicas exitosas en la formación de enfermeros-líderes.(AU)

The triggers and consequences of the Queen Bee phenomenon: A systematic literature review and integrative framework.

Staines, Tavris and Jayaratne (1974) first introduced the Queen Bee Phenomenon (QBP). The term has been extensively employed to explain specific behaviors driven by organizational inequalities where women engaged in leadership positions actively restrain the opportunities of upper mobility for junior women. While the literature constantly addresses the causes and behaviors of this phenomenon, the current scholarship still lacks an integrated view of the QBP literature and a concise integrative framework that explores its triggers and consequences to advance research and provide evidence-based results to guide policy and managerial decisions. Thus, the purpose of this paper is to identify, analyze and synthesize the literature on the QBP. We conducted a systematic literature review engaging bibliometrics and content analysis. Our results highlight the current state of the art of the QBP literature and introduce a new integrative framework that shows the interplay between the triggers, traits and consequences of the QBP. We contribute to the field by integrating previous research in the field into a framework that synthesizes and connects the scattered literature. Our results are helpful for designing new organizational policies that reduce the impacts of the QBP in the workplace. The research agenda propose avenues for advancing our understanding of the phenomenon.

Success of sports organizations and correlation with efficiency and leadership style / éxito de las organizaciones deportivas y correlación con eficiencia y estilo de liderazgo / Sucesso de organizações esportivas e correlação com eficiência e estilo de liderança

ABSTRACT Objective: The objective of this research is to determine how managers evaluate the success of sports organizations. Methods: A system of a total of 119 variables (9 variables of the structure of sports organizations, 7 variables of the management structure of sports organizations, 3 variables of the performance of sports organizations, 45 variables of leadership styles and 55 variables of organizational effectiveness) was applied to a sample of 175 respondents aged 19-66. In the research, we used multiple regression analysis. Results: It was found that there is a statistically significant influence of the management of sports organizations on predicting the success of sports organizations, while organizational effectiveness and leadership styles do not have a significant impact. Conclusion: The success of sports organizations can be predicted based on the characteristics of the management of sports organizations. Level of Evidence II; Therapeutic Studies - Examination of Results.

Resumen Objetivo: El objetivo de esta investigación es determinar cómo los directivos evalúan el éxito de las organizaciones deportivas. Métodos: Sistema de un total de 119 variables (9 variables de estructura de organizaciones deportivas, 7 variables de estructura de gestión de organizaciones deportivas, 3 variables de desempeño de organizaciones deportivas, 45 variables de estilos de liderazgo y 55 variables de eficacia organizacional) se aplicó a una muestra de 175 encuestados de entre 19 y 66 años. En la investigación, utilizamos análisis de regresión múltiple. Resultados: Se encontró que existe una influencia estadísticamente significativa de la gestión de las organizaciones deportivas en la predicción del éxito de las organizaciones deportivas, mientras que la eficacia organizacional y los estilos de liderazgo no tienen una influencia significativa. Conclusiõn: El éxito de las organizaciones deportivas se puede predecir en base a las características de la gestión de las Organizaciones deportivas. Nivel de Evidencia II; Estudios Terapéuticos - Examen de los Resultados.

RESUMO Objetivo: O objetivo desta pesquisa é determinar como os gerentes avaliam o sucesso das organizações esportivas. Métodos: Um sistema com um total de 119 variáveis (9 variáveis da estrutura das organizações desportivas, 7 variáveis da estrutura de gestão das organizações desportivas, 3 variáveis do desempenho das organizações desportivas, 45 variáveis dos estilos de liderança e 55 variáveis da eficácia organizacional) foi aplicado a uma amostra de 175 entrevistados com idades entre 19 e 66 anos. Na pesquisa, utilizamos a análise de regressão múltipla. Resultados: Verificou-se que existe uma influência estatisticamente significativa da gestão das organizações desportivas na previsão do sucesso das organizações desportivas, enquanto a eficácia organizacional e os estilos de liderança não têm influência significativa. Conclusão: O sucesso das organizações esportivas pode ser previsto com base nas características da gestão das organizações esportivas. Nível de Evidencia II; Estudios Terapêuticos - Investigação dos Resultados.

Autoavaliação de soft skills em enfermagem: construção e validação de conteúdo de um instrumento / Autoevaluación de soft skills en enfermería: elaboración y validación de contenido de un instrumento / Self-assessment of soft skills in nursing: construction and content validation of an instrument

Resumo Objetivo Construir e validar um instrumento para autoavaliação de soft skills em liderança autêntica de enfermagem. Métodos Pesquisa metodológica desenvolvida em três etapas: revisão de literatura, elaboração do instrumento intitulado "LEADERSKILLS" e validação de conteúdo do instrumento com experts, usando a Técnica Delphi Online. A primeira etapa foi composta por duas revisões narrativas. A segunda etapa incluiu um teste piloto ao desenvolvimento do instrumento contendo a descrição narrativa das soft skills mais relevantes (relacionadas ao exercício da liderança autêntica do enfermeiro) que foram apresentadas pela revisão narrativa da literatura. A terceira e última etapa incluiu a alteração do instrumento após as considerações realizadas pelos experts. Resultados O painel de experts da primeira rodada foi composto por 13 participantes. Das 17 questões de múltipla escolha avaliadas na primeira rodada, só duas (pertencentes aos componentes conteúdo e linguagem) não obtiveram Índice de Validade de Conteúdo (IVC) ≥0,85. A primeira questão era sobre a compreensão inadequada do que seriam os títulos e subtítulos do "LEADERSKILLS" e a segunda era sobre clareza e objetividade do instrumento. As principais sugestões dos juízes estavam concentradas nos componentes conteúdo, linguagem e layout. A segunda rodada foi composta pela resposta de cinco experts, sendo possível alcançar o consenso das questões obtendo IVC ≥0,80. Conclusão O instrumento construído para desenvolver soft skills em enfermagem foi considerado válido quanto ao conteúdo, layout, linguagem, motivação e cultura, alcançando avaliação coerente e aplicabilidade ao público-alvo.

Resumen Objetivo Elaborar y validar un instrumento para la autoevaluación de soft skills en liderazgo auténtico de enfermería. Métodos Investigación metodológica llevada a cabo en tres etapas: revisión de la literatura, elaboración del instrumento llamado "LEADERSKILLS" y validación del contenido del instrumento con expertos mediante el método Delphi vía internet. La primera etapa estuvo compuesta por dos revisiones narrativas. La segunda etapa incluyó una prueba piloto del desarrollo del instrumento, que contenía la descripción narrativa de las soft skills más relevantes (relacionadas con el ejercicio del liderazgo auténtico del enfermero) y que fueron introducidas por la revisión narrativa de la literatura. La tercera y última etapa incluyó la modificación del instrumento después de las reflexiones realizadas por los expertos. Resultados El panel de expertos de la primera ronda estuvo compuesto por 13 participantes. De las 17 preguntas de selección múltiple evaluadas en la primera ronda, solo dos (pertenecientes a los componentes contenido y lenguaje) no obtuvieron Índice de Validez de Contenido (IVC) ≥0,85. La primera pregunta era sobre la comprensión inadecuada de lo que serían los títulos y subtítulos del "LEADERSKILLS" y la segunda era sobre la clareza y objetividad del instrumento. Las principales sugerencias de los jueces estaban centradas en los componentes contenido, lenguaje y diseño. La segunda ronda estuvo compuesta por la respuesta de cinco expertos y fue posible llegar al consenso de las preguntas con un IVC de ≥0,80. Conclusión El instrumento elaborado para desarrollar soft skills en enfermería fue considerado válido respecto al contenido, diseño, lenguaje, motivación y cultura, y logró una evaluación coherente y aplicabilidad en el público destinatario.

Abstract Objective To build and validate an instrument for self-assessment of soft skills in authentic nursing leadership. Methods This methodological research was developed in three stages: literature review, development of the instrument entitled "LEADERSKILLS", and validation of the instrument's content by experts using the Delphi Online Technique. The first stage consisted of two narrative reviews. The second stage included a pilot test for the development of the instrument containing a narrative description of the most relevant soft skills (related to the exercise of authentic leadership by nurses) that were presented by the narrative literature review. The third and final stage included changes to the instrument after considerations made by the experts. Results In the first round, the panel of experts was composed of 13 participants. Of the 17 multiple-choice questions evaluated in the first round, only two (belonging to the content and language components) did not obtain the Content Validity Index (CVI) ≥0.85. The first question was about the inadequate understanding of what the titles and subtitles of "LEADERSKILLS" were, and the second was about the instrument's clarity and objectivity. The judges' main suggestions were concentrated on the content, language, and layout components. The second round consisted of responses from five experts, and reaching a consensus on the questions was possible by obtaining CVI≥0.80. Conclusion The instrument constructed to develop soft skills in nursing was considered valid in terms of content, layout, language, motivation, and culture, achieving coherent assessment and applicability to the target audience.

Randomized crossover clinical trial of a Mindfulness-based intervention for nurse leaders: A pilot study / Ensayo clínico aleatorizado cruzado de una intervención basada en mindfulness con enfermeros líderes: estudio piloto / Ensaio clínico randomizado cruzado de uma intervenção baseada em mindfulness em enfermeiros líderes: estudo-piloto

Objective: to analyze the effects of a Mindfulness-based intervention on nurse leaders' emotional intelligence and resilience. Method: a pilot study of a randomized crossover clinical trial. The sample (n=32) was randomized into Group A (n=18) and Group B (n=14) and evaluated at the pre-test, post-test and follow-up moments. The outcomes were assessed using the Emotional Intelligence Measure, the Connor-Davidson Resilience Questionnaire and the Five Facet Mindfulness Questionnaire, and analyzed using Generalized Linear Mixed Models. Results: a total of 32 nurses with a mean age of 42.6 years old were evaluated. The analyses showed significant interactions between the effects of the group x moment factors on the Self-motivation (p=0.005), Sociability (p<0.001), Self-control (p=0.013), and Total (p=0.002) emotional intelligence skill scores; as well as on the Observe (p=0.042), Describe (p=0.008), Non-judgment (p<0.001), Act with awareness (p=0.004) and Total (p<0.001) mindfulness facets. Post-test: there was a statistically significant increase in the Sociability (p=0.009) and Self-control (p=0.015) emotional intelligence skills; as well as in the Non-judgment (p=0.022) and Total (p=0.002) mindfulness facets. Follow-up: a significant increase was observed in the Non-judgment (p=0.024) and Total (p=0.026) mindfulness facets. The "resilience" variable did not present statistical significance in the "group x moment" factor, both in the post-test and during follow-up. Conclusion: the Mindfulness-based intervention used proved to be effective in increasing nurse leaders' emotional intelligence and dispositional mindfulness skills. Brazilian Registry of Clinical Trials (RBR-3c62gy), registered on March 4 th , 2020, updated on September 16 th , 2022.

Objetivo: analizar los efectos de una intervención basada en mindfulness sobre la inteligencia emocional y la resiliencia de enfermeros líderes. Método: estudio piloto de un ensayo clínico aleatorizado cruzado. Muestra (n=32) aleatorizada en el grupo A (n=18) y grupo B (n=14), se los evaluó en el pretest, postest y seguimiento. Los resultados fueron evaluados mediante la Medida de Inteligencia Emocional, el Cuestionario de Resiliencia de Connor-Davidson y el Cuestionario Mindfulness de Cinco Facetas, y analizados por el Generalized Linear Mixed Models . Resultados: fueron evaluadas 32 enfermeras con una edad promedio de 42,6 años. Los análisis mostraron interacciones significativas de los efectos de los factores grupo vs. momento en los puntajes de las habilidades de automotivación (p=0,005), sociabilidad (p<0,001), autocontrol (p=0,013) y total (p=0,002) de inteligencia emocional; de las facetas observar (p=0,042), describir (p=0,008), no juzgar (p<0,001), actuar con conciencia (p=0,004) y total (p<0,001) de mindfulness. Postest: hubo un aumento estadísticamente significativo de las habilidades de sociabilidad (p=0,009) y autocontrol (p=0,015) de inteligencia emocional; de las facetas no juzgar (p=0,022) y total (p=0,002) de mindfulness . Seguimiento: se observó un aumento significativo en las facetas no juzgar (p=0,024) y total (p=0,026) de mindfulness . La variable resiliencia no presentó significación estadística en el factor grupo vs. momento en el postest y seguimiento. Conclusión: la intervención basada en mindfulness utilizada demostró ser eficaz para aumentar la inteligencia emocional y las habilidades de mindfulness disposicional de los enfermeros líderes. Registro Brasileño de Ensayos Clínicos (RBR-3c62gy), registrado el 4 de marzo de 2020, actualizado el 16 de septiembre de 2022.

Objetivo: analisar os efeitos de uma intervenção baseada em mindfulness na inteligência emocional e resiliência de enfermeiros líderes. Método: estudo-piloto de ensaio clínico randomizado cruzado. Amostra (n=32) randomizada em grupo A (n=18) e grupo B (n=14), avaliados nos momentos pré-teste, pós-teste e seguimento. Os desfechos foram avaliados pela Medida de Inteligência Emocional, pelo Questionário de Resiliência Connor-Davidson e pelo Questionário das Cinco Facetas de Mindfulness , e analisados pelo Generalized Linear Mixed Model . Resultados: foram avaliadas 32 enfermeiras com idade média de 42,6 anos. As análises mostraram interações significativas dos efeitos dos fatores Grupo x Momento nos escores das habilidades de automotivação (p=0,005), sociabilidade (p<0,001), autocontrole (p=0,013) e total (p=0,002) de inteligência emocional; das facetas observar (p=0,042), descrever (p=0,008), não julgar (p<0,001), agir com consciência (p=0,004) e total (p<0,001) de mindfulness . Pós-teste: houve aumento estatisticamente significante das habilidades de sociabilidade (p=0,009) e autocontrole (p=0,015) de inteligência emocional; das facetas não julgar (p=0,022) e total (p=0,002) de mindfulness . Seguimento: observou-se aumento significativo das facetas não julgar (p=0,024) e total (p=0,026) de mindfulness . A variável resiliência não apresentou significância estatística no fator Grupo x Momento, no pós-teste e seguimento. Conclusão: a intervenção baseada em mindfulness utilizada mostrou-se efetiva no aumento das habilidades de inteligência emocional e mindfulness disposicional de enfermeiros líderes. Registro Brasileiro de Ensaios Clínicos (RBR-3c62gy), registrado em 04 de março de 2020, atualizado em 16 de setembro de 2022.

Nurses' perceptions about the patient safety climate in Primary Health Care / Percepción de los enfermeros sobre el clima de seguridad del paciente en la atención primaria de la salud / Percepção dos enfermeiros sobre o clima de segurança do paciente na atenção primária à saúde

Objective: to evaluate the patient safety climate in Primary Health Care from the perspective of nurses working in the services. Method: a quantitative and cross-sectional study conducted with 148 nurses from a municipality in the state of São Paulo. The Brazilian version of the Primary Care Safety Questionnaire Survey and personal, professional, and organizational performance variables (intention to stay at work, job satisfaction, care quality, and frequency of incidents) were used. Parametric and non-parametric comparison tests and Spearman's correlation coefficient were performed, considering a 5% significance level. Results: the safety climate was positive, varying from 4.52 to 5.33 and differing across districts for workload (p=0.0214) and leadership (p=0.0129). The safety climate professional variables and dimensions differed in relation to the frequency of incidents. Teamwork and safety and learning system were strongly correlated with job satisfaction and moderately with perceived care quality. Conclusion: teamwork and safety and learning system stood out for their positive correlations with job satisfaction and care quality. A positive safety climate favors the involvement of Primary Care nurses to develop improvement plans aligned with the National Patient Safety Program.

Objetivo: evaluar el clima de seguridad del paciente en la Atención Primaria de la Salud, desde la perspectiva de los enfermeros de los servicios. Método: estudio cuantitativo y transversal, con 148 enfermeros de un municipio del Estado de São Paulo. Se utilizó la versión brasileña del Primary Care Safety Questionnaire Survey y variables personales, profesionales y de desempeño organizacional (intención de permanecer en el empleo, satisfacción laboral, calidad de la atención y frecuencia de incidentes). Se realizaron pruebas de comparación paramétricas y no paramétricas y coeficiente de correlación de Spearman, considerando un nivel de significación del 5%. Resultados: el clima de seguridad fue positivo, osciló entre 4,52 y 5,33; difirió entre distritos en carga de trabajo (p=0,0214) y liderazgo (p=0,0129). Las variables profesionales y dimensiones del clima de seguridad difirieron en la frecuencia de incidentes. El trabajo en equipo, el sistema de seguridad y el aprendizaje tuvieron una correlación alta con la satisfacción laboral y una moderada con la percepción de la calidad de la atención. Conclusión: el trabajo en equipo y el sistema de seguridad y aprendizaje se destacaron por su correlación positiva con la satisfacción laboral y la calidad de la atención. Un clima de seguridad positivo favorece la participación de los enfermeros de la atención primaria en el desarrollo de planes de mejora que sigan las indicaciones del Programa Nacional de Seguridad del Paciente.

Objetivo: avaliar o clima de segurança do paciente na Atenção Primária à Saúde, sob a perspectiva dos enfermeiros dos serviços. Método: estudo quantitativo e transversal, com 148 enfermeiros de um município do Estado de São Paulo. Foram utilizadas a versão brasileira do Primary Care Safety Questionnaire Survey e variáveis pessoais, profissionais e desempenho organizacional (intenção permanecer no trabalho, satisfação no trabalho, qualidade do cuidado e frequência de incidentes). Realizaram-se testes de comparação paramétricos, não paramétricos e coeficiente de correlação de Resultados: o clima de segurança foi positivo, com variação de 4,52 a 5,33; diferiu entre distritos para carga de trabalho (p=0,0214) e liderança (p=0,0129). As variáveis profissionais e dimensões do clima de segurança diferiram em relação à frequência de incidentes. Trabalho em equipe, sistema de segurança e aprendizagem foram fortemente correlacionados à satisfação no trabalho e moderadamente com percepção da qualidade do cuidado. Conclusão: trabalho em equipe e sistema de segurança e aprendizagem se destacaram pela correlação positiva com satisfação no trabalho e qualidade do cuidado. O clima de segurança positivo favorece o envolvimento dos enfermeiros da atenção primária para desenvolver planos de melhorias alinhados ao Programa Nacional de Segurança do Paciente.

Comportamento empoderador do enfermeiro-líder na perspectiva de técnicos e auxiliares de enfermagem / Comportamiento empoderador de enfermeros líderes bajo la perspectiva de técnicos y auxiliares de enfermería / Empowering behavior of the nurse-leader from the perspective of nursing technicians and assistants

Resumo Objetivo Associar dados demográficos e laborais e o comportamento empoderador do enfermeiro-líder na perspectiva de técnicos e auxiliares de enfermagem. Métodos Pesquisa transversal e correlacional realizada em hospital universitário terciário do estado de São Paulo. Participaram 260 profissionais de enfermagem de nível médio (técnicos e auxiliares de enfermagem), por meio de instrumentos autoaplicáveis no período de maio a agosto de 2021. Para verificar a associação entre as classes da escala e as variáveis explanatórias, foi realizado teste qui-quadrado ou exato de Fisher no programa SAS. As relações foram estatisticamente significativas se p<0,05. Resultados O perfil dos participantes predominou o sexo feminino, média de idade de 41,9 anos, trabalhadores do período diurno, carga horária de 36,7 horas e satisfeitos com o trabalho. A aplicação do instrumento Comportamento Empoderador do Líder evidenciou que o domínio com maior média de comportamento empoderador foi "trabalho significativo" e o com menor média foi "autonomia em relação à burocracia". Os auxiliares e técnicos de enfermagem que trabalhavam no período diurno não possuíam outros vínculos de trabalho e estavam satisfeitos com o mesmo, além de terem observado mais o comportamento empoderador do líder. Conclusão O comportamento do enfermeiro para empoderar sua equipe, na perspectiva de técnicos e auxiliares de enfermagem no hospital estudado, foi bom na maioria dos domínios, exceto no domínio "autonomia em relação à burocracia", em que foi razoável. Trabalhar no turno diurno, não ter outros vínculos e estar satisfeito com o trabalho foram aspectos de maior empoderamento.

Resumen Objetivo Asociar datos demográficos y laborales con el comportamiento empoderador de enfermeros líderes bajo la perspectiva de técnicos y auxiliares de enfermería. Métodos Estudio transversal y correlacional realizado en un hospital universitario terciario del estado de São Paulo. Participaron 260 profesionales de enfermería de nivel medio (técnicos y auxiliares de enfermería), mediante instrumentos autoaplicados durante el período de mayo a agosto de 2021. Para verificar la asociación entre las clases de la escala y las variables explicativas, se realizó la prueba ji cuadrado o exacta de Fisher en el programa SAS. Las relaciones fueron estadísticamente significativas si p<0,05. Resultados En el perfil de los participantes predominó el sexo femenino, promedio de edad de 41,9 años, trabajadores del período diurno, carga horaria de 36,7 horas y satisfechos con el trabajo. La aplicación del instrumento Comportamiento Empoderador del Líder evidenció que el dominio con mayor promedio de comportamiento empoderador fue "trabajo significativo" y con menor promedio fue "autonomía con relación a la burocracia". Los auxiliares y técnicos de enfermería que trabajaban en el período diurno no tenían otros vínculos de trabajo y estaban satisfechos con este, además de haber observado más el comportamiento empoderador del líder. Conclusión El comportamiento de los enfermeros para empoderar a su equipo, bajo la perspectiva de técnicos y auxiliares de enfermería en el hospital estudiado, fue bueno en la mayoría de los dominios, excepto en el dominio "autonomía con relación a la burocracia", que fue razonable. Trabajar en el turno diurno, no tener otros vínculos y estar satisfecho con el trabajo fueron aspectos de mayor empoderamiento.

Abstract Objective Associate demographic and work data and the empowering behavior of the nurse-leader from the perspective of nursing technicians and assistants. Methods Cross-sectional and correlational research carried out in a tertiary university hospital in the state of São Paulo. A total of 260 mid-level nursing professionals (nursing technicians and assistants) participated, using self-administered instruments from May to August 2021. To verify the association between the scale classes and the explanatory variables, a chi-square or Fisher's exact test was performed in the SAS program. Relationships were statistically significant if p<0.05. Results The profile of the participants was predominantly female, mean age 41.9 years, daytime workers, workload of 36.7 hours and satisfied with their work. The application of the Leader's Empowering Behavior instrument showed that the domain with the highest average of empowering behavior was "meaningful work" and the one with the lowest average was "autonomy in relation to bureaucracy". Nursing assistants and technicians who worked during the day did not have other work relationships and were satisfied with it, in addition to observing the leader's empowering behavior more. Conclusion Nurses' behavior to empower their team, from the perspective of technicians and nursing assistants in the studied hospital, was good in most domains, except in the domain "autonomy from bureaucracy", where it was reasonable. Working the day shift, not having other jobs and being satisfied with the job were aspects of greater empowerment.

Nurses' perceptions of leadership in Brazilian hospitals during COVID-19 through Kotter's conception / Percepções de enfermeiros sobre liderança em hospitais brasileiros na COVID-19 pela concepção de Kotter / Percepciones de los enfermeros sobre el liderazgo en hospitales brasileños durante la pandemia de COVID-19 según la concepción de Kotter

Abstract Objective: to understand nurses' leadership perceptions during the COVID-19 pandemic in Brazilian university hospitals, through the lens of John Kotter's concepts and his eight-step change model. Method: a multicenter qualitative research with an analytical design. The sample comprised 139 nurses working in COVID-19 settings, interviewed using a semi-structured interview guide. Data were categorized through Bardin's content analysis based on John Kotter's concepts and his eight-step change model. Results: the findings yielded significant insights into nurses' perceptions of leadership during the COVID-19 response, which exhibited characteristics consistent with Kotter's principles. There is evidence of leadership based on the pursuit of knowledge, grounded in polished communication, facilitating teamwork through a relationship of trust and respect. The recognition of the complexity and difficulty of exercising nursing leadership, particularly in crisis contexts, is apparent. Conclusion: nurses' perceptions reinforce essential elements for leadership practice, such as the importance of seeking diverse knowledge, polished communication, relationships based on trust and respect, and recognition of the complexity of leadership, thus presenting characteristics in line with Kotter's principles.

Resumo Objetivo: conhecer as percepções de liderança de enfermeiros durante a pandemia da COVID-19 em hospitais universitários brasileiros, pela concepção dos conceitos do referencial de John Kotter e seu modelo de mudança de oito etapas. Método: pesquisa multicêntrica de natureza qualitativa e delineamento analítico. A amostra foi constituída por 139 enfermeiros atuantes na COVID-19 entrevistados mediante um roteiro de entrevistas semiestruturadas, categorizadas por meio de análise de conteúdo de Bardin com base nos conceitos de John Kotter e seu modelo de mudança de oito etapas. Resultados: os achados resultaram em importantes percepções dos enfermeiros acerca da liderança durante o enfrentamento da COVID-19, que apresentaram características condizentes com os preceitos de Kotter. Evidencia-se uma liderança baseada na busca pelo conhecimento, pautada em uma comunicação polida, facilitando o trabalho em equipe por meio de uma relação de confiança e respeito. O reconhecimento da complexidade e dificuldade que é exercer a liderança do enfermeiro, principalmente, em contextos de crise. Conclusão: as percepções dos enfermeiros reforçam elementos essenciais para a prática da liderança, como a importância pela busca de conhecimentos múltiplos, comunicação polida, relação baseada na confiança e respeito, e o reconhecimento da complexidade em liderar, apresentando, assim, características acerca dos preceitos de Kotter.

Resumen Objetivo: comprender las percepciones sobre liderazgo de los enfermeros durante la pandemia de COVID-19 en hospitales universitarios brasileños, a través de la concepción de los conceptos del marco de John Kotter y su modelo de cambio de ocho pasos. Método: investigación multicéntrica de carácter cualitativo y diseño analítico. La muestra estuvo compuesta por 139 enfermeros que trabajaban durante la pandemia de COVID-19 entrevistados mediante una guía de entrevistas semiestructuradas; categorizadas a través del análisis de contenido de Bardin basándose en los conceptos de John Kotter y su modelo de cambio de ocho pasos. Resultados: los hallazgos revelaron importantes percepciones de los enfermeros sobre el liderazgo en la lucha contra el COVID-19, que presentó características consistentes con los preceptos de Kotter. Se observa un liderazgo basado en la búsqueda del conocimiento y una comunicación respetuosa, que facilita el trabajo en equipo por medio de una relación de confianza y respeto. Se reconoce lo complejo y difícil que es ejercer el liderazgo como enfermero, especialmente en contextos de crisis. Conclusión: las percepciones de los enfermeros destacan elementos esenciales para la práctica del liderazgo, como la importancia de adquirir múltiples conocimientos, tener una comunicación respetuosa, relaciones basadas en la confianza y el respeto, y reconocer la complejidad del liderazgo, que representa las características de los preceptos de Kotter.