Introduction: As jobdemands in the healthcare system increases, one of the main protective factors involves support within the work environment. Limited knowledge exists about the work environment of nurse assistants and their well-being at work. A relatively small number of studies on this topic in the Nordic countries, and their results indicate high job demands and risk for negative health outcomes. Purpose:This study aimed to investigate nurse assistants’ perception of job demands, the servant leadership of their next superior, job satisfaction, symptoms of emotional exhaustion, and physical well-being at work. It wasalso investigatedwhether perception of servant leadership of their next superior related to job satisfaction and symptoms of emotional exhaustion.Methods: Questionnaires sent to all nurse assistants with registered email addresses at the Icelandic Nurse Assistants Association yielded 588 participants (49% response rate). A new Dutch inventory on servant leadership (SLI) was used to measure perception of servant leadership in nursing; additional questions explored work environment, demands, control and support at work, symptoms of burnout, and job satisfaction. To answer the research questions, a cross-sectional descriptive designwas used Results:The majority of participants experienced high job demands and reported on control and support at work. Despite high levels of burnout, the majority of nurse assistants weresatisfied at work. Servant leadership was practicedsomewhat within nurse assistant’s workplaces. The correlation between perception of servant leadership, job satisfaction, and emotional exhaustion was significant for all SLI sub-factors except courage, and the strongest correlation was for empowerment, humility, and stewardship as sub-factors of servant leadership.Conclusion:This study highlights supportive factors within the work environment, particularly regarding the leadership-empowering role of servant leadership in nursing. Results showhow thissupportis related to nurse assistants ́ well-being at work andsuggeststhat servant leadership can support health promotion within the work environment of nurse assistants. These findings are valuable for nurse assistants, nurse managersand leadershipin the health care system, thus contributingto public health / <p>ISBN 978-91-86739-28-7</p>

Introduction: As jobdemands in the healthcare system increases, one of the main protective factors involves support within the work environment. Limited knowledge exists about the work environment of nurse assistants and their well-being at work. A relatively small number of studies on this topic in the Nordic countries, and their results indicate high job demands and risk for negative health outcomes. Purpose:This study aimed to investigate nurse assistants’ perception of job demands, the servant leadership of their next superior, job satisfaction, symptoms of emotional exhaustion, and physical well-being at work. It was also investigated whether perception of servant leadership of their next superior related to job satisfaction and symptoms of emotional exhaustion. Methods: Questionnaires sent to all nurse assistants with registered email addresses at the Icelandic Nurse Assistants Association yielded 588 participants (49% response rate). A new Dutch inventory on servant leadership (SLI) was used to measure perception of servant leadership in nursing; additional questions explored work environment, demands, control and support at work, symptoms of burnout, and job satisfaction. To answer the research questions, a cross-sectional descriptive designwas used Results: The majority of participants experienced high job demands and reported on control and support at work. Despite high levels of burnout, the majority of nurse assistants were satisfied at work. Servant leadership was practiced some what within nurse assistant’s workplaces. The correlation between perception of servant leadership, job satisfaction, and emotional exhaustion was significant for all SLI sub-factors except courage, and the strongest correlation was for empowerment, humility, and stewardship as sub-factors of servant leadership. Conclusion: This study highlights supportive factors within the work environment, particularly regarding the leadership-empowering role of servant leadership in nursing. Results showhow thissupportis related to nurse assistants ́ well-being at work andsuggeststhat servant leadership can support health promotion within the work environment of nurse assistants. These findings are valuable for nurse assistants, nurse managersand leadershipin the health care system, thus contributingto public health / <p>ISBN 978-91-86739-28-7</p>

The overall aim of this thesis is to describe perception of conscience, stress of conscience (stress related to troubled conscience) and burnout, to explore their relationships and to illuminate meanings of the lived experience of troubled conscience in one’s work among registered nurses (RNs) and nurse assistants (NAs) in municipal residential care for the elderly. The thesis comprises four studies; studies I-III are based on questionnaire data from 50 RNs and 96 NAs and study IV is based on interview data from 6 RNs and 6 NAs selected from the participants in the questionnaire study. Questionnaire data was analysed with multivariate statistics (I-III). Narrative interviews were interpreted with a phenomenological hermeneutic method (IV). Study I showed two relationships explaining a noteworthy amount of the shared variance by themselves (25.6% and 17.8%). One relationship was shown between having to deaden one’s conscience in order to keep working in healthcare and stress of conscience related to external demands which was interpreted as having to deaden one’s conscience in order to be able to collaborate with co-workers. The other relationship was shown between having to deaden one’s conscience in order to keep working in healthcare and stress of conscience related to internal demands which was interpreted as having to deaden one’s conscience in order to be able to feel like a good healthcare professional. Study II showed a relationship between stress of conscience and burnout (43.6% explained variance) indicating that experiences of shortcomings and of being exposed to contradictory demands are strongly related to burnout. The relationship between perceptions of conscience and burnout (33.9% explained variance) indicated that having to deaden one’s conscience in order to keep working in healthcare is strongly related to burnout. Study III showed that both RNs and NAs perceived conscience mainly as an asset and a guide and not as a burden in their work. Lack of time and high demands of work influencing home life were the situations related to the highest stress of conscience for both RNs and NAs. The predictive pattern for RNs was interpreted as RNs showing sensitivity to expectations and demands and NAs using their conscience as a guide in their work. Study IV showed that meanings of the RNs’ lived experience of troubled conscience in their work are of being trapped in feelings of powerlessness and a sense of being inadequate. They feel they are failing to live up to expectations from residents and their families, colleagues and themselves because of feelings of powerlessness, cowardice and incompetence. Meanings of NAs’ lived experience of troubled conscience in their work are a sense of being hindered in providing the level of care they would like to provide because of pre-determined conditions and by feelings of being inadequate. They are betraying the residents and themselves by accepting perceived inadequate working conditions and through their own perceived sense of cowardice and negligence. The conclusion of these studies is that stress of conscience is related to burnout among RNs and NAs in municipal residential care for the elderly. Experiences of inadequacy, powerlessness and feelings of being hindered are shown in situations where they have troubled conscience. When the norms of others and/or the pre-determined conditions do not correspond to their own values and norms it may result in the feeling that they cannot perceive themselves as good healthcare professionals.

The impact of an education program on perception, knowledge, and infection rate was evaluated in this study. The educational intervention consisted of a video on infection control and a World Health Organization (WHO) pamphlet for hand hygiene. The study was conducted in one nursing home in the Southeastern United States. The survey sample consisted of 66 certified nurse assistants (CNAs). A pre- and post-intervention design was employed using the WHO’s Hand Hygiene Knowledge Questionnaire and the WHO Perception Survey. Friedman’s test and central tendencies showed no statistical relationship between the educational intervention and the overall knowledge scores of the sample. There also were no statistical differences in perception of hand hygiene in the CNA sample. Infection frequency was reduced with a percent change of -42%. While results of knowledge and perception surveys were not statistically significant, multiple conclusions were derived to suggest that educational opportunities may impact hand hygiene practice in CNAs and lead to a decrease in infection.

Made available in DSpace on 2014-12-17T14:47:00Z (GMT). No. of bitstreams: 1 ElianeSantosC.pdf: 383211 bytes, checksum: 9084c4210107f08d95090f4afcc07f34 (MD5) Previous issue date: 2003-12-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The great demand of accidents resulting in victims with rachi-medullar traumatism (RMT) and the need for indetifying how they are being assisted, led us to proceed with this investigation. It had as its goal to identify and analyze the knowledge of nurses and nurse assistents regarding the nursing assistance to these patients. It consists of a descriptive exploratory study, with a quantitative method and prospective data. For its execution, 193 subjects were interviewed, 37 of them nurses and 157 nurse assistents in 02 hospitals of the metropolitan zone of Natal. The results reveal that the subjects are not coherent when questioned whether they are prepared to assist victim of RMT and the content described by order of piority regarding the steps followed in the assistance of these victims, both in the pre-hospital and hospital care. Thus, we observe that only 06 nurses and 07 assistents, described correctly all the steps necessary to pre-hospital care and only 01 nurse and 02 assistents registered all the steps in the correct sequence regarding the hospital care. We conclude that, in face of the obtained results, we can urgently modify this reality, improving the nursing staff and giving them better work conditions / A grande demanda de acidentes produtores de v?timas com traumatismo raquimedular (TRM) e a necessidade de identificar como est?o sendo assistidas, levaram-nos a fazer esta investiga??o. Teve como objetivo identificar e analisar o conhecimento dos enfermeiros e os auxiliares de enfermagem acerca da assist?ncia de enfermagem a estes acientes.Trata-se de um estudo explorat?rio descritivo, com abordagem quantitativa e dados prospectivos. Para a sua realiza??o, foram entrevistados 193 sujeitos sendo 37 enfermeiros e 157 auxiliares de enfermagem de 02 hospitais da grande Natal. Os resultados revelam que os sujeitos n?o s?o coerentes quando questionados se est?o preparados para assistir ?s v?timas de TRM e o conte?do descrito por ordem de prioridade em rela??o aos passos utilizados na assist?ncia, tanto no atendimento pr?-hospitalar como hospitalar. Assim sendo, observamos que apenas 06 enfermeiros e 07 auxiliares descreveram corretamente todos os passos necess?rios ao atendimento pr?-hospitalar e somente 01 enfermeiro e 02 auxiliares registraram todos os passos na seq??ncia correta, no que se refere ao atendimento hospitalar. Conclu?mos que diante dos resultados obtidos, faz-se necess?rio modificar esta realidade, aperfei?oando a equipe de enfermagem e dando-lhe melhores condi??es de trabalho