Impacto del tamaño del ámbito de control de las jefas de unidad en los comportamientos laborales de las enfermeras / Impact of charge nurses’ span of control on the work attitudes of nurses

Fundamento: Conocer el número de enfermeras a cargode las jefas de unidades de Enfermería de los hospitalespúblicos generales aragoneses y analizar cómo afecta alos comportamientos organizacionales de la enfermera ya la calidad de las relaciones que se establecen con lajefa de unidad. Método: Estudio descriptivo transversal realizado ennueve hospitales públicos. Se evaluó mediante cuestionarios validados los comportamientos laborales de lasenfermeras y la calidad de las relaciones de la enfermeracon la jefa de unidad y de esta con la enfermera y consu inmediato superior. Se analizó si existía relación entreestas variables y el número de enfermeras por unidad. Resultados: La muestra se compuso de 2541 enfermeras y192 jefas de unidad. La media del ámbito de control fue de29 enfermeras (DE = 22,4). Se obtuvieron puntaciones menores al aumentar el ámbito de control en: empoderamiento (p<0,001), satisfacción (p = 0,027), apoyo organizacionalpercibido (p<0,001) y calidad de las relaciones entre lasenfermeras y las jefas de unidad (p<0,001) y de la jefa deunidad con su inmediato superior (p<0,001). No se observaron asociaciones significativas respecto a la intenciónde rotación, los comportamientos cívicos organizacionales y el compromiso organizacional. Conclusiones: El tamaño del ámbito de control se relaciona con la percepción de los comportamientos organizacionales de las enfermeras, así como con la calidad delas relaciones interpersonales que establecen con la jefade unidad, indicando la necesidad ajustar el ámbito decontrol por unidad con el objetivo mejorar la calidad dela gestión de las unidades de Enfermería.(AU)

Background: To determine the number of nurses whoare supervised by a charge nurse in the Nursing Unitsof Aragonese general public hospitals and to analyzehow this affects the organizational behaviors of nursesand the quality of the relationships established with thecharge nurses. Methods: Cross-sectional study carried out in nine publichospitals. Validated questionnaires were used to assessthe working behavior of nurses and the quality of theirrelationships with charge nurses, and the charge nurse’srelationship with their immediate superior and nursingstaff. We analyzed whether there was an association between these variables and the number of nurses per unit. Results: The study included 2,541 nurses and 192 super-visors. The mean span of control was 29 (SD = 22.4). Statistically significant differences were observed with re-spect to empowerment (p<0.001), satisfaction (p = 0.027),perceived organizational support (p<0.001) and thequality of the nurse’s relationships with the supervisor(p<0.001) and the supervisor with her immediate superior (p<0.001), obtaining lower scores as the span of con-trol increased. No significant associations were observedwith respect to turnover intention, organizational citizenship behavior and organizational commitment. Conclusions: The span of control is related to the perception of nurses’ organizational behaviors and with thequality of interpersonal relationships with the chargenurse, indicating a need to adjust the span of of controlper unit in order to improve the quality of the management of the units.(AU)

[Impact of charge nurses' span of control on the work attitudes of nurses].

BACKGROUND: To determine the number of nurses who are supervised by a charge nurse in the Nursing Units of Aragonese general public hospitals and to analyze how this affects the organizational behaviors of nurses and the quality of the relationships established with the charge nurses. METHODS: Cross-sectional study carried out in nine public hospitals. Validated questionnaires were used to assess the working behavior of nurses and the quality of their relationships with charge nurses, and the charge nurse's relationship with their immediate superior and nursing staff. We analyzed whether there was an association between these variables and the number of nurses per unit. RESULTS: The study included 2,541 nurses and 192 supervisors. The mean span of control was 29 (SD=22.4). Statistically significant differences were observed with respect to empowerment (p<0.001), satisfaction (p=0.027), perceived organizational support (p<0.001) and the quality of the nurse's relationships with the supervisor (p<0.001) and the supervisor with her immediate superior (p<0.001), obtaining lower scores as the span of control increased. No significant associations were observed with respect to turnover intention, organizational citizenship behavior and organizational commitment. CONCLUSIONS: The span of control is related to the perception of nurses' organizational behaviors and with the quality of interpersonal relationships with the charge nurse, indicating a need to adjust the span of of control per unit in order to improve the quality of the management of the units.

Adapting the revised prenatal coping inventory (NuPCI) for use in a Spanish population.

OBJECTIVE: To adapt the Revised Prenatal Coping Inventory (NuPCI) for the evaluation of prenatal stress coping strategies utilised by Spanish women. METHODS: A cross-sectional study was performed to evaluate the psychometric properties of NuPCI adapted for a Spanish population. Two hundred and sixty one puerperium women completed the NuPCI at the time of discharge after childbirth. Instrument construct validity was evaluated using subscale item correlations. Internal consistency was assessed using Cronbach's α test. RESULTS: Items from each subscale (Preparation, Avoidance and Spiritual - Positive Coping) were significantly correlated with the global result (p < .001). The internal reliability of the NuPCI demonstrated suitable values for each of the three coping strategies (α > 0.7). The most frequently used coping strategy was Preparation and the least used was Avoidance. Utilisation of the coping strategies with Preparation decreased with increasing parity (p = .002) and greater prenatal stress was associated with increased use of the Avoidance coping strategy (p < .001). CONCLUSIONS: The NuPCI adapted for Spanish women demonstrates good psychometric properties for evaluating the three types of prenatal stress coping strategies: Preparation, Avoidance and Spiritual - Positive Coping. Results were similar to those presented by the instrument in its English language version.

Assessment of significant psychological distress at the end of pregnancy and associated factors.

The aim of this study is to study the prevalence of mental distress at the end of pregnancy and after birth and the impact of selected socio-demographic and obstetric factors. This is a cross-sectional study. The sample is consisted of 351 puerperal women at the age of 18 and over. Sociodemographic, obstetric variables were collected to detect significant psychological distress; the instrument used was General Health Questionnaire (GHQ-28). Logistic multivariable regressions were used to investigate associations. The prevalence of significant mental distress amounted to 81.2%, mostly related to social relationship and anxiety. The women who affirmed having more stress during pregnancy had too significantly increased emotional distress before the birth as well as during early puerperium, increasing somatic symptoms (p < 0.001; OR 2.685; CI 95% 1.583-4.553), anxiety (p < 0.001; OR 4.676; CI 95% 2.846-7.684), and depressive symptoms (p < 0.01). Somatic symptoms (p < 0.05; OR 2.466; CI 95% 1.100-5.528) and social dysfunction (p < 0.001; OR 1.672; CI 95% 0.711-3.932) occur most frequently in women who already had children. Regarding socio-demographic data, being an immigrant is the only protective factor reducing the social dysfunction in the last weeks of pregnancy (p < 0.01; OR 0.478; CI 95% 0.274-0.832). Psychological distress at the end of a full-term pregnancy and in the postpartum period occurs frequently and was associated mainly with stress experienced during pregnancy and parity. It is advisable to perform proper assessment of stress and significant psychological distress at the early stage of pregnancy and repeatedly later on until delivery. Information and support from professionals can help to decrease and prevent their negative impact on maternal and fetal health, as observed in the current evidence.