Influence of Work Environment Conditions on the Ability of Critical Care Nurses to Provide PDF
Preview Influence of Work Environment Conditions on the Ability of Critical Care Nurses to Provide
UUnniivveerrssiittyy ooff MMaassssaacchhuusseettttss AAmmhheerrsstt SScchhoollaarrWWoorrkkss@@UUMMaassss AAmmhheerrsstt Doctoral Dissertations Dissertations and Theses November 2017 IInnflfluueennccee ooff WWoorrkk EEnnvviirroonnmmeenntt CCoonnddiittiioonnss oonn tthhee AAbbiilliittyy ooff CCrriittiiccaall CCaarree NNuurrsseess ttoo PPrroovviiddee EEffifficcaacciioouuss NNuurrssiinngg CCaarree iinn PPuueerrttoo RRiiccoo Yolanda M. Torres University of Massachusetts Amherst Follow this and additional works at: https://scholarworks.umass.edu/dissertations_2 Part of the Critical Care Nursing Commons, and the Nursing Administration Commons RReeccoommmmeennddeedd CCiittaattiioonn Torres, Yolanda M., "Influence of Work Environment Conditions on the Ability of Critical Care Nurses to Provide Efficacious Nursing Care in Puerto Rico" (2017). Doctoral Dissertations. 1132. https://doi.org/10.7275/10405189.0 https://scholarworks.umass.edu/dissertations_2/1132 This Open Access Dissertation is brought to you for free and open access by the Dissertations and Theses at ScholarWorks@UMass Amherst. It has been accepted for inclusion in Doctoral Dissertations by an authorized administrator of ScholarWorks@UMass Amherst. For more information, please contact [email protected]. Influence of Work Environment Conditions on the Ability of Critical Care Nurses to Provide Efficacious Nursing Care in Puerto Rico A Dissertation Presented by YOLANDA M. TORRES Submitted to the Graduate School of the University of Massachusetts Amherst in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY September 2017 Nursing © Copyright by Yolanda M. Torres 2017 All Rights Reserved Influence of Work Environment Conditions on the Ability of Critical Care Nurses to Provide Efficacious Nursing Care in Puerto Rico A Dissertation Presented by YOLANDA M. TORRES Approved as to style and content by: ––––––––––––––––––––––––––––––––––––––––––––––––– Genevieve E. Chandler, Chair _________________________________________________ Elizabeth Henneman, Member _________________________________________________ Luis A. Marentes, Member __________________________________________ Stephen Cavanagh, Dean College of Nursing DEDICATION I dedicate my dissertation work to my family and many friends. A special feeling of gratitude to my parents: my father José J. Torres Seijo, who taught me to never give up, and my mother Yolanda Vélez Marina, who taught me that even the toughest task can be accomplished if it is done one step at a time. My sons Iván and Brian, who were always by my side and are my strength and inspiration. I also dedicate this work to my cousin Luis J. Zayas Seijo, who has inspired me to dream. ACKNOWLEDGMENTS Over the past 7 years, I have received support and encouragement from many special individuals. Dr. Yadira Regueira has been a mentor, colleague, and friend. Her guidance has made this journey possible. I would like to thank Dr. Christine King, who had the vision and commitment to start it all. My colleague and friend Sherily Pereira, who has walked with me every step of the way. Dr. Genevieve Chandler has been an outstanding dissertation director. I would like to thank her as well as Dr. Elizabeth Henneman and Dr. Luis A. Marentes, members of my dissertation committee. I would also like to thank Dr. Rubén Vélez, whose sage advice, insightful criticisms, and patient encouragement aided the writing of this document in innumerable ways. During data collection my very good friend Elvia Cardona supported me mightily. Could not have done it without her. Thanks to Dr. Aurea Ayala for giving me the push to get started. Finally, my utmost appreciation to my editor Elizabeth Earl Phillips, who walked with me through the finish line. v ABSTRACT INFLUENCE OF WORK ENVIRONMENT CONDITIONS ON THE ABILITY OF CRITICAL CARE NURSES TO PROVIDE EFFICACIOUS NURSING CARE IN PUERTO RICO SEPTEMBER 2017 YOLANDA M. TORRES, B.S., UNIVERSITY OF DAYTON B.S.N., UNIVERSIDAD INTERAMERICANA M.S.N., UNIVERSIDAD METROPOLITANA Ph.D., UNIVERSITY OF MASSACHUSETTS AMHERST Directed by: Professor Genevieve E. Chandler The purpose of this study was to explore the conditions in the work environment that may contribute to caring efficacy of critical care nurses in Puerto Rico. The study measured nurses’ perceptions of the empowering structures in the work environment, and the relationship to their perceived caring efficacy and explored the correlation between sociodemographic factors of age, education, and experience of work empowerment and/or caring efficacy. The Conditions for Work Effectiveness Questionnaire and Caring Efficacy Scale were used to assess the association between the nurses’ work environment conditions and caring efficacy. The instruments were translated to Spanish and adapted to the Puerto Rican culture. Using convenience sampling, the instruments were paired and administered to nurses from selected critical care units of hospitals in Puerto Rico. Participation was voluntary. Findings support that there is no relationship between the working conditions environment and caring efficacy. Supplemental findings, however, support a significant positive correlation between relationships with patients and families and caring efficacy. vi TABLE OF CONTENTS Page ACKNOWLEDGMENTS .................................................................................................. v ABSTRACT ....................................................................................................................... vi LIST OF TABLES .............................................................................................................. x LIST OF FIGURES ........................................................................................................... xi CHAPTER 1. CONDITIONS FOR WORK EFFECTIVENESS, CARE EFFICACY, AND THE EMPOWERED NURSE ..................................................................................................... 1 Problem Statement .......................................................................................................... 3 Background ..................................................................................................................... 4 Significance to Nursing ............................................................................................... 8 Purpose ............................................................................................................................ 8 Hypotheses .................................................................................................................. 9 Summary ....................................................................................................................... 10 2. REVIEW OF LITERATURE ....................................................................................... 11 Puerto Rico .................................................................................................................... 11 Cultural Influence ...................................................................................................... 11 Nursing Work Environment Conditions in Puerto Rico ............................................ 12 Work Empowerment ..................................................................................................... 14 Caring Efficacy .............................................................................................................. 21 Critical Care Nurse Work Environment ........................................................................ 26 Conceptual Framework of the Study ............................................................................. 28 Conceptual and Operational Definitions of Terms ........................................................ 33 Summary ....................................................................................................................... 35 3. METHODS ................................................................................................................... 37 Research Design ............................................................................................................ 37 Setting and Sample .................................................................................................... 38 Instruments ................................................................................................................ 39 Procedures ................................................................................................................. 43 vii Data Analysis ............................................................................................................. 45 Summary ....................................................................................................................... 46 4. RESULTS ..................................................................................................................... 47 Introduction ................................................................................................................... 47 Sample Characteristics and Sociodemographic Profile ................................................. 47 Instrumental Analyses ............................................................................................... 50 Sample's Descriptive Statistics of the Research Variables ............................................ 51 Research Hypotheses ..................................................................................................... 54 Hypotheses 1, 2, and 3 ............................................................................................... 54 Hypothesis 4 .............................................................................................................. 56 Hypothesis 5 .............................................................................................................. 57 Summary of Findings .................................................................................................... 59 5. DISCUSSION ............................................................................................................... 60 Introduction ................................................................................................................... 60 Strengths and Limitations .......................................................................................... 68 Conclusion ..................................................................................................................... 69 Implications ............................................................................................................... 71 Summary ....................................................................................................................... 72 APPENDICES A. CONDITIONS FOR WORK EFFECTIVENESS QUESTIONNAIRE (ENGLISH AND SPANISH VERSIONS) .......................................................................................... 73 B. CARING EFFICACY SCALE (ENGLISH AND SPANISH VERSIONS) ................ 81 C. SOCIODEMOGRAPHIC DATA SHEET ................................................................... 88 D. HOSPITAL AUTHORIZATION LETTERS .............................................................. 89 E. SURVEY CONSENT FORM (ENGLISH AND SPANISH VERSIONS) .................. 91 viii F. DESCRIPTIVE STATISTICS OF WORK EMPOWERMENT: ACCESS TO OPPORTUNITY AND INFORMATION ITEMS ........................................................... 93 G. DESCRIPTIVE STATISTICS OF WORK EMPOWERMENT: SUPPORT AND RESOURCES ITEMS ...................................................................................................... 94 H. DESCRIPTIVE STATISTICS OF WORK EMPOWERMENT: WORK RELATIONSHIPS WITH PEERS & COLLEAGUES AND PATIENTS & FAMILIES ITEMS ............................................................................................................................... 95 I. DESCRIPTIVE STATISTICS OF WORK EMPOWERMENT: WORK RELATIONSHIPS WITH MENTORS ITEMS ............................................................... 96 J. DESCRIPTIVE STATISTICS: POSITIVE STATEMENTS OF THE CARING EFFICACY SCALE .......................................................................................................... 97 K. DESCRIPTIVE STATISTICS: NEGATIVE STATEMENTS OF THE CARING EFFICACY SCALE .......................................................................................................... 98 BIBLIOGRAPHY ............................................................................................................. 99 ix
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