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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The dynamism of modern life brought complexity and emphasis on work, along with the concern for well-being. There are several approaches to that construct, either by subjective, cognitive, social or labor perspective. Well-being at work describes the relationship between an individual and his work. Several authors have proposed structures for it, with theoretical models, dimensions and empirical evidence. However, any model was not empirically tested or it was composed of the variables such as job satisfaction (JS), job involvement (JI) and Affective Commitment to the Organization (ACO). This dissertation aimed to empirically test this theoretical model for well-being at work (WBW) composed of ACO, JS and JI from two studies. In the first, aiming at analyzing the dimensionality of the scales of each variable, exploratory factor analyses were performed by the analysis of the principal components. The sample consisted of 259 workers who responded in person and virtually to the following instruments: Affective Organizational Commitment Scale (AOCS), Job Satisfaction Scale (JSS), Job Involvement Scale (JIS) and an occupational questionnaire. The results showed that AOCS and JIS remained one-dimensional, with 5 items each scale. The JSS presented four factors, bringing 15 items in total. It was noted a significant relationship between ACO and the type of company, because the ones allocated in the private sector is more affectively committed than whoever is in public sector employment. There was also a significant association between ACO and the number of employees of the company, the fewer employees a company has, the greater the ACO. Moreover, there was a significant relationship between JS and wage increase, so that those who had an increase feel more satisfied than those who did not. The JI was related to salary increase, those who received no raise are more involved with work than those who received. The second study consisted of 206 respondents, also workers and those responded to the online questionnaire as well. When evaluating the factor structure found in Study 1 for each scale by confirmatory factor analysis, we obtained ratification of the data. However, the AOCS and JIS remained one-dimensional with 4 items each one. The JSS, after several adjustments recommended in the analysis, gathered 12 items distributed in 4 factors. In addition, a structural equation modeling was carried out to verify if the variables presented by the theoretical model of WBW is confirmed empirically in the explanatory model of WBW. The adjustment indexes indicated the existence of WBW, remaining the model with 20 items distributed unevenly in three variables. Therefore, the data show that when the employee is satisfied with the job, he feels more involved with it, shows affectively committed to the organization and tends to present well-being at work. It is thereby suggested the development of more studies on specific populations of workers in order to corroborate the influence of these variables on the constitution of the construct and, in addition, examine correlations between the WBW and other constructs. / O dinamismo da vida moderna trouxe complexidade e ênfase ao trabalho, aliados à preocupação com o bem-estar. Há várias abordagens desse construto, seja pela perspectiva subjetiva, cognitiva, social ou laboral. O bem-estar no trabalho descreve a relação existente entre o sujeito e seu trabalho. Diversos autores propuseram estruturas para ele, com modelo teórico, dimensões e comprovações empíricas. Todavia, um modelo não havia sido testado empiricamente, composto pelas variáveis satisfações no trabalho (ST), envolvimento com o trabalho (ET) e comprometimento organizacional afetivo (COA). Essa dissertação objetivou testar empiricamente tal modelo teórico para bem-estar no trabalho (BET) composto por COA, ST e ET, a partir da realização de dois estudos. No primeiro, com o objetivo de analisar a dimensionalidade das escalas de cada variável - COA, ST e ET -, foram feitas análises fatoriais exploratórias por meio da análise de componentes principais. A amostra foi composta por 259 trabalhadores que nesse estudo responderam presencial e virtualmente aos instrumentos: Escala de Comprometimento Organizacional Afetivo (ECOA), Escala de Satisfação no Trabalho (EST), Escala de Envolvimento com o Trabalho (EET) e um questionário socioprofissional. Os resultados apontaram que ECOA e EET permaneceram unidimensionais, com 5 itens cada uma das escalas. A EST apresentou 4 fatores, congregando 15 itens ao todo. Notou-se relação significativa entre COA e o tipo de empresa em que trabalha, pois quem está alocado no âmbito privado está mais comprometido afetivamente que quem se encontra em emprego público. Houve também significância entre COA e quantidade de funcionários da empresa, em que quanto menos funcionários a empresa tiver, maior o COA. Existiu ainda relação significativa entre ST e aumento salarial, de modo que quem obteve aumento sente-se mais satisfeito que quem não o recebeu. O ET apresentou relação com aumento salarial, em que aqueles que não receberam aumento estão mais envolvidos com o trabalho do que quem recebeu. O segundo estudo foi composto por 206 respondentes, também trabalhadores, que responderam ao questionário online. Ao avaliar as estruturas fatoriais encontradas no estudo 1 para cada escala, mediante análise fatorial confirmatória, obteve-se ratificação das mesmas, contudo com a retirada de alguns itens. A ECOA e a EET permaneceram unidimensionais, porém, com 4 itens cada uma. A EST, após diversos ajustes recomendados nas análises, reuniu 12 itens distribuídos em 4 fatores. Realizou-se ainda modelagem por equação estrutural para verificar se as variáveis apresentadas pelo modelo teórico de BET confirmam-se empiricamente no modelo explicativo de BET. Os índices de ajuste apontaram a existência de BET, ficando o modelo com 20 itens distribuídos desigualmente em 3 variáveis. Portanto, os dados demonstram que quando o funcionário está satisfeito com o trabalho, sente-se envolvido com o mesmo e ainda se mostra comprometido afetivamente em relação à organização em que trabalha e tende a apresentar bem-estar no trabalho. Sugere-se a elaboração de mais estudos, com populações específicas de trabalhadores, a fim de corroborar a influência destas variáveis na constituição do construto e, além disso, verificar correlações entre o BET e outros construtos.

Thèse en administration des services-infirmiers subventionnée par "Formation et expertise en recherche administration des services infirmiers" (FERASI) / Cette étude a pour but de comprendre les processus de transformation de la pratique clinique chez les infirmières à la faveur des initiatives d’intégration des soins et services et d’examiner l’impact de ces processus sur le bien-être au travail des infirmières. De façon spécifique, l’étude vise: 1) à décrire les pratiques infirmières dans le contexte d’intégration des soins et services au Québec 2) à analyser la relation entre les processus de changement sous-jacents aux efforts d’intégration et le bien-être au travail des infirmières selon leurs perceptions et 3) à identifier les principaux leviers, sur les plans de la gestion et de la clinique, que peuvent mobiliser les organisations afin de soutenir la pratique infirmière dans un contexte d’intégration des soins. L’étude a été organisée en trois volets correspondant respectivement aux trois objectifs précédemment mentionnés. Le cadre de référence développé et utilisé pour cette étude est le « Modèle infirmier du développement de l’intégration des soins » (MIDIS). Il s’appuie sur les prémisses du modèle de Cazale, Touati et Fleury (2007), qui couvrent les interrelations entre les variables contextuelles (organisationnelles et structurelles), l’adoption et l’institutionnalisation des pratiques intégratives, et les effets qui y sont associés pour les infirmières en termes de bien-être au travail. Pour atteindre les objectifs de l’étude, un devis mixte a été utilisé, incluant : un devis quantitatif descriptif (volet 1), un devis quantitatif corrélationnel (volet 2) et un devis qualitatif d’étude de cas unique avec niveaux d’analyse imbriqués (volet 3). La collecte des données a été menée dans le cadre de quatre trajectoires de soins (TdeS) : Soutien à l’autonomie (SoAu), Palliatifs/oncologiques (PaOn), Santé mentale (SaMe) et Maladie pulmonaire obstructive chronique (Mpoc). L’étude a été effectuée auprès d’infirmières, de professionnels autres, et de gestionnaires. Pour les volets un et deux, 107 questionnaires ont été complétés et 37 entrevues semi-dirigées ont été effectuées pour le volet 3. Les résultats du premier volet ont démontré non seulement d’importantes variations dans le développement de l’intégration entre les TdeS mais également un décalage entre l’évolution de la pratique infirmière et l’introduction des changements visant une plus grande intégration des soins. Deux dimensions seulement de la pratique intégrative sur neuf (Qualité des soins et Équipe interprofessionnelle) prévalent dans l’ensemble des TdeS et seule la TdeS PaOn a atteint une étape plus avancée du processus d’intégration. Les résultats du deuxième volet démontrent que plus l’intégration se situe à un niveau avancé de développement, moins elle est associée à une perception de menace chez les infirmières et plus elle est associée à des réactions positives et un bien-être au travail. Le troisième volet a mis en lumière trois types de leviers qui doivent être mobilisés de manière complémentaire dans le but de favoriser l’intégration : les processus organisationnels, les processus cliniques, les investissements dans des ressources clés et dans le renouvellement de certaines structures organisationnelles. Ces résultats apportent des éclairages quant aux défis posés par les processus d’intégration des soins et montrent l’importance d’une pluralité d’interventions qui doivent être conduites à tous les paliers organisationnels afin de faciliter l’institutionnalisation des pratiques intégratives et obtenir les effets escomptés. / The aim of this study is to understand processes of transformation of clinical practice among nurses in the context of care and service integration initiatives, and to examine the impact of these processes on nurses’ well-being at work. Specifically, the study’s objectives are to: 1) describe nursing practices that underpin efforts to integrate care and services in Quebec; 2) analyze the relationship between the change processes underpinning integration efforts and nurses’ self-perceived well-being at work; and 3) identify the main levers that organizations can use at management and clinical levels to support nursing practices in an care integration context. The study was set up in three parts, corresponding respectively to the three objectives mentioned above. The reference framework developed for this study, is the Modèle infirmier du développement de l’intégration des soins (MIDIS – Development model for integrated care in nursing). It is based on the premises of the model of Cazale, Touati et Fleury, (2007) that cover the interrelationships between contextual variables (organizational and institutional), the adoption and institutionalization of integrative practices, and the associated effects on professionals with respect to well-being in the workplace. To achieve the study’s objectives, a mixed-method design was used, which included: a descriptive quantitative component (Part 1), a correlational quantitative component (Part 2), and a single case qualitative study with nested levels of analysis (Part 3). Data were collected within four care pathways (CPs): autonomy support for the elderly (ASE); palliative oncology services (POS); mental health services (MHS); and chronic obstructive pulmonary disease (CPOD). Data were collected from nurses, health professionals, and managers. For Parts 1 and 2, 107 questionnaires completed and 37 semi-structured interviews conducted for Part 3. The results of the first part of the study showed not only significant variations across CPs in the development of integration, but also a gap between the evolution of nursing practice and the introduction of changes aimed at greater integration of care. Only two out of nine dimensions of integrative practice (‘quality of care’ and ‘interprofessional teamwork’) were prevalent across all CPs and only one CP (POS) had reached a more advanced stage in the integration process. The results of the second part of the study showed that, as integration became more highly developed, it was associated less with a perception of threat by nurses and more with positive reactions and well-being at work. The third part of the study identified three types of levers that should be used in a complementary way to speed up the progress of integration: organizational processes; clinical-administrative processes; investment in key resources and in renovation of certain organizational structures. These results shed additional light on the challenges posed by the process of integration of care, and show the importance of leading multiple interventions at all organizational levels to facilitate institutionalization of integrative practices and achieve the intended effects.

La santé psychologique en emploi s’avère un sujet d’intérêt au Québec vu ses nombreuses retombées importantes sur les travailleurs et les organisations. Parmi les différents secteurs d’activités, les travailleurs du milieu de l’éducation, plus spécifiquement les directions d’établissement scolaire, présentent un état de santé psychologique moindre que la population générale. Des responsabilités professionnelles composées de conflits relationnels et d’une surcharge de travail engendrent un coût psychologique pour ces travailleurs. Il s’avère donc important d’identifier les moyens qui permettront d’améliorer et de maintenir une bonne santé psychologique. Le modèle des demandes ressources de l’emploi avance que les ressources interagissent avec les demandes de manière à réduire l’effet négatif de ces dernières sur la santé psychologique en emploi. La thèse aura pour objectif de valider l’effet protecteur de certaines ressources en fonction des principales causes de mauvaise santé des directions d’établissement scolaire. En effet, certaines ressources seraient plus appropriées en fonction des caractéristiques de l’emploi. En considérant que leur état de santé psychologique est principalement engendré par les conflits relationnels et la surcharge de travail vécue en emploi, les habiletés politiques et le sentiment d’efficacité personnel ont été retenus comme ressource. En effet, les études antérieures montrent que posséder un niveau élevé d’habiletés politiques protégerait des difficultés relationnelles, alors que le sentiment d’efficacité personnelle s’avérait utile face à une grande charge de travail. Sous cette perspective, le premier article vise à étudier la structure factorielle des dimensions de l’inventaire des habiletés politiques auprès d’un poste de gestion et plus particulièrement de directions d’établissement scolaire. Une étude antérieure réalisée auprès de gestionnaires montre que l’outil se déploie en cinq facteurs chez cette population. Les constats indiquent que l’outil se déploie en quatre facteurs pour une population de directions d’établissement scolaire, tel que l’outil original validé auprès d’une population non-cadre. Le deuxième article valide le rôle des habiletés politiques comme ressources personnelles pour minimiser l’effet néfaste des conflits interpersonnels sur la santé psychologique en emploi, en concordance avec le modèle demande ressource de l’emploi. Le sentiment d’efficacité personnelle sera également considéré comme étant une ressource personnelle pour contrer l’effet des demandes de l’emploi sur la santé psychologique en emploi. Les résultats constatent que seulement la dimension des habiletés politiques, astuce sociale, modère la relation entre l’anxiété et les demandes de l’emploi. / Psychological health at work is a subject of interest in Quebec because of is many important repercussions on workers and organizations. Among the different sectors of activity, workers in the education sector, more specifically school principals, have a lower level of psychological health than the general population. Professional responsibilities composed of relational conflicts and overwork, generate a psychological cost for these workers. It is therefore important to identify ways to improve and maintain good psychological health. The Employment Resource Requests model suggests that resources interact with demands to reduce the negative impact of demands on psychological health in employment. The aim of the thesis will be to validate the protective effect of certain resources according to the main causes of poor health of school management. Indeed, some resources would be more appropriate depending on the characteristics of the job. Considering that their psychological state of health is mainly caused by relational conflicts and the overload of work experienced in employment, political skills and the feeling of personal efficiency were retained as resources. Indeed, previous studies show that having a high level of political skills would protect relational difficulties, while the feeling of self-efficacy proved useful in the face of a large workload. From this perspective, the first article aims to study the factorial structure of the dimensions of the inventory of political skills in a management position and more specifically school management. An earlier study of managers shows that the tool is deployed in five factors in this population. The findings indicate that the tool is deployed in four factors for a population of principals, such as the original tool validated with a non-executive population. The second article validates the role of political skills as a personal resource to minimize the adverse effect of interpersonal conflict on psychological health in employment, in line with the employment demand model. Self-efficacy will also be considered as a personal resource to counter the effect of job demands on psychological health in employment. The results find that only the dimension of political skills, social trick, moderates the relationship between anxiety and job demands.

För att främja hälsa och välbefinnande på arbetsplatser börjar ett perspektiv på arbetsmiljöarbete gå från att fokusera på vad som gör människor sjuka, till att fokusera på vad som gör människor friska. Ett hälsofrämjande arbetsmiljöarbete har därmed börjat att växa fram som innebär att utveckla, möjliggöra och bevara det som fungerar bra på arbetsplatsen. Känsla av sammanhang (KASAM), är en teori som myntades av Aaron Antonovsky (2005). Teorin kan användas i ett hälsofrämjande arbetsmiljöarbete då den kan ge en förståelse över vilka faktorer som kan främja hälsa. Begriplighet, hanterbarhet och meningsfullhet är teorins tre komponenter. Genom att stärka komponenterna kan hälsa främjas. Syftet med föreliggande studie är att skapa en förståelse för vilka faktorer som kan stärka känslan av sammanhang i arbetet och vidare beskriva hur känslan av sammanhang upplevs av de anställda på ett detaljhandelsföretag. Genom en abduktiv tematisk analys av åtta semistrukturerade intervjuer, studeras vilka förutsättningar arbetsgivaren ger de anställda för att stärka KASAM. Vidare studeras hur upplevelsen av känslan av sammanhang är ur ett medarbetarperspektiv. Studiens teoretiska referensram utgörs av Antonovskys teori känsla av sammanhang och dess tre komponenter. Utifrån intervjuerna visade det sig att det är ett öppet och familjärt klimat på företaget. Det visade sig även att de anställda stöttar varandra och är engagerade i sitt arbete. Av resultatet framkom att företaget har flera värderingar, varav en är tillsammans, vilket genomsyrar det mesta på företaget. Samtliga av de anställda tar fasta på värderingen tillsammans vilket präglar deras sätt att vara och agera. Genom värderingen tillsammans skapas en gemenskap på det undersökta detaljhandelsföretaget som är av betydelse för att stärka känslan av sammanhang. / To promote health and well-being at workplaces, a perspective on work environment management has shifted from mainly focusing on what makes people sick, to another perspective, what makes them healthy and causes well-being. Health-promoting work environment management has thus begun to emerge, which means developing, enabling and preserving what works well in the workplace. Aaron Antonovsky (2005), founded a theory: Sense of coherence (SOC), which can be used in health-promoting work environment management as it can provide an understanding of which factors that can promote health. The SOC theory's components are comprehensibility, manageability, and meaningfulness and by strengthening the components, health can be promoted. The purpose of this study is to create an understanding of which factors that can strengthen the sense of coherence at work and also describe how the sense of coherence is experienced by the employees at a retail company. Through an abductive thematic analysis of eight semi-structured interviews, the prerequisites the employer gives the employees to strengthen SOC are studied. Furthermore, the experience on how the SOC is from the perspective of an employee are studied. The theoretical framework of the study is based on Antonovsky's theory sense of coherence and the three components. Based on the interviews, it turned out that there is an open and familiar atmosphere within the company. It also turned out that the employees support each other and are committed to their work. The results indicate that the company has several values, one of which is togetherness,which permeates most of the company. All employees adhere to the value togetherness, which characterizes their way of being and acting. Through the value togetherness, a fellowship is created within the retail company, which is important for strengthening the sense of coherence.

La présente thèse de doctorat porte sur la relation entre la perception de la justice organisationnelle, l’émission de comportements inadaptés au travail et la santé psychologique des individus au travail. En plus de développer un outil de mesure des comportements inadaptés au travail et d’entreprendre un processus de validation de celui-ci, le présent travail propose que les comportements inadaptés au travail puissent occuper un rôle soit protecteur ou explicatif dans la relation qui unit la perception de la justice organisationnelle avec la santé psychologique des individus au travail. Au sein de cette thèse, le premier article recense la documentation scientifique quant aux variables de la perception de la justice organisationnelle, de l’émission des comportements inadaptés au travail et de la santé psychologique des individus au travail, ainsi que les liens qui unissent ces variables. Aussi, les modèles conceptuels des rôles modérateur et médiateur des comportements inadaptés au travail sont proposés au sein de la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail. Le deuxième article a pour objectif de développer un outil de mesure des comportements inadaptés au travail et de tester ses propriétés psychométriques. Ainsi, des analyses statistiques exploratoires et confirmatoires ont été effectuées. Afin d’appuyer la valeur critériée de l’outil proposé, une analyse corrélationnelle a été réalisée avec le critère de l’adaptation. Certaines valeurs psychométriques de l’outil sont validées par les résultats obtenus. Le troisième article examine empiriquement les modèles conceptuels des rôles anticipés des comportements inadaptés au travail dans la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail. La perception de la justice organisationnelle a été vue sous les composantes distributive, procédurale, informationnelle et interpersonnelle. De son côté, la santé psychologique des individus a été observée par le biais des éléments du bien-être et de la détresse psychologique au travail. Les différentes analyses de régressions multiples hiérarchiques ont permis d’observer l’absence du rôle modérateur des comportements inadaptés au travail. Pour sa part, l’utilisation du test de Sobel a démontré la présence du rôle médiateur des comportements inadaptés au travail dans certaines relations. Plus exactement, celles-ci sont la relation entre la justice interpersonnelle et le bien-être psychologique au travail, la relation entre la justice interpersonnelle et la détresse psychologique au travail, ainsi que la relation entre la justice distributive et la détresse psychologique au travail. Finalement, la conclusion de la thèse présente une synthèse des résultats et expose les limites et pistes de recherches futures. / The present doctoral thesis treats of the relation between perception of organizational justice, emission of misbehaviours at work, and individuals’ psychological health at work. In addition to developing and undertaking a validation process for a measuring scale of misbehaviours at work, the present thesis proposes that these behaviours may occupy either a protective or an explicative role in the relationship that unites the perception of organizational justice with individuals’ psychological health at work. Within the thesis, the first article lists scientific literature concerning the perception of organizational justice, the emission of misbehaviours at work, and individuals’ psychological health at work. This article also includes a revue of links that unite the variables presently at study. Following this review, two conceptual models about possible roles played by misbehaviours at work in the relationship between perception of organizational justice and individuals’ psychological health at work are developed. More precisely, these models are conceptualisation of the moderating and mediating roles of inadequate work behaviours. The second article’s goal is the development of a measuring scale for misbehaviours at work and testing its psychometric proprieties. In this context, exploratory and confirmatory statistical analyses were made. Also, in order to support the criterion value of the proposed tool, a correlation analysis was made with the criteria of adaptation. The results showed that certain psychometric values were validated. The third article empirically examines the conceptual models developed about the possible roles played by misbehaviours at work in the relationship between perception of organizational justice and individuals’ psychological health at work. Organisational justice perception was analysed under distributive, procedural, informational and interpersonal components. As for individuals’ psychological health at work, it was observed through the psychological well-being and distress elements. The different multiple hierarchical regression analyses helped observe the absence of a moderator role for misbehaviours at work. Using the Sobel test showed the presence of a mediator role for misbehaviours at work in the relationship between the interpersonal organizational justice component and well-being, as well as psychological distress at work. This same test highlighted the mediator role of misbehaviours at work in the relationship between the distributive component of organizational justice and the psychological distress at work of individuals. Finally, the conclusion of this thesis presents a synthesis of the results and highlights the limits and future research ideas.