Variáveis preditivas para burnout, intenção de turnover e busca de emprego em profissionais de enfermagem

Abstract

This is a doctoral thesis that was carried out in the Study Group on Career Development (GEDC) of the Pontifical Catholic University of Rio Grande do Sul. The research problem to be investigated arose from the concern about the possibility of Burnout being a variable involved on the intention of leaving the job and on the Turnover of adult professionals. In view of my professional career also in the field of nursing, the construction of the doctoral project was concentrated in the nursing population, for which Burnout is very present. In order to get a closer look at the relationship between the Burnout variables and the Turnover intention, a Systematic Review (RS) was carried out, through which it was possible to verify the strong relationship between Burnout and intention to quit. This SR, titled "The Predictive Function of Burnout Syndrome for the Turnover in Nursing Professionals: Systematic Review" was submitted and published in Volume 3 of 2017 of the journal "Advances in Latin American Psychology". The SR also allowed us to conclude that the research problem was coherent and pertinent to the Brazilian field of research, since no work was found on the topic of the article that had been produced in the national context. Another important result indicated the global trend of a decrease in the number of nursing professionals, to the point of speaking about the shortage of nursing workers, both in Western and Eastern countries. This fact reinforced the proposal to investigate possible predictors of the increase of the voluntary Turnover in nursing. It was necessary to define the instruments that would be used for the measurement of burnout and the intention of Turnover, justifying the relevance of the study of prediction analysis of Burnout on Turnover Intent. This fact, added to the objective of using instruments developed specifically for the Brazilian context, led to the choice of an instrument developed by Tamayo and Tróccoly (2009) to evaluate Burnout through three dimensions: emotional exhaustion, dehumanization and disappointment at work. The use of the term dehumanization as a substitute for depersonalization (used in the Maslach Scale) is adequate, not only because it is a more proper use of nursing, but because it is a concern of the entire Brazilian public health system, to which humanization has become a goal to be achieved in patient care. Following the doctoral proposal to develop and make available new research tools for psychology, the scale for the evaluation of Turnover's intention was adapted from an initial proposal developed by Hom and Griffeth (1991). The choice of this instrument is due to the fact that it encompasses two factors considered in the literature that are important for the study of the intention of Turnover, namely the cognitions of exit from employment and the search behavior of employment, and therefore, an innovative instrument. The study of cultural adaptation and validation of the instrument for use in the Brazilian context has been submitted and accepted for publication in the journal Psychological Evaluation, in a special edition consisting of studies that involved innovative methods of analysis. In the case of this article: "Psychometric properties of the Turnover Intentionality Scale and Job Search (EITBE)" the analyzes were carried out with Programming R. In the research sequence, we sought to have a cohesive study line from the beginning to the end of the doctorate degree. In this sense, the research project was built with the aim of investigating Burnout and its direct relation with the intention of Turnover in the nursing population and the doctoral thesis was constituted in the defense that the Burnout was an important predictor for the intention of Turnover. From the SR, career theoretical references and organizational psychology, the research was proposed to investigate variables with possible relationships with Burnout and Turnover intent, which encompassed personal, organizational and contextual factors. They entered the study as independent variables: career adaptability, organizational commitment, Coping strategies and employment opportunity variables. In the first moment these VIs and their predictive potential with respect to the Burnout were tested and in the second moment these VIs were tested with the addition of Burnout related to the intention of Turnover. These tests consisted of multiple linear regression analyzes and resulted in two articles, article 3: "Predicting variables for Burnout syndrome among nursing professionals" a prediction analysis for Burnout and article 4: "Predictors variables for the Intention of Turnover among Nursing Professionals "prediction analysis for Turnover intent, using the EITBE scale. Brief description of the studies. In study 1, a systematic review (SR) about Burnout's prediction of the intention to quit. Study 2 was a validation and cultural adaptation of EITBE (Turnover Intention Scale and Job Search). From the cultural adaptation, the instrument was validated through an evaluation of the factorial structure of the scale (Exploratory Factor Analysis (AFE) and Confirmatory Factor Analysis (AFC) through Program R. The statistical analysis showed adequate adjustment factors for its In order to produce a suitable and sufficient model for a factorial analysis, 5 to 20 participants per item of the evaluated instrument were required, due to the heterogeneous composition of the sample. The sample was made up of 201 professionals from various areas of the southern region of Brazil and the data were stored on the Qualtrics platform. Study 3 had the objective of the study was to analyze how occupational impairment and perceived job opportunities (organizational factors), career adaptability and Coping (individual factors) contribute to the prediction of Burnout. This quantitative study had a sample of 246 nurses from three hospitals in the southern region of Brazil. Data were subjected to stepwise backward multiple regressions using SPSS software. Predictive analysis of all independent variables with respect to Burnout characterization revealed a R²aj (predictive factor) of 49.5%. The results confirm that the organizational factors trigger the Burnout, although, among the results, it is possible to perceive also the importance of individual factors to trigger the Burnout syndrome. It is possible to highlight the need to build an environment that minimizes the predictive variables of Burnout. In study 4 we used the same explanatory variables added from the Burnout to analyze the best predictors for the intention of Turnover using the EITBE scale. The aim of this study was to analyze the predictive factor about the Turnover intention of variables present in the nursing work environment. The research sample consisted of 246 nursing professionals from three hospitals in the southern region of Brazil. The quantitative study was analyzed through multiple linear regression using SPSS software version 22. The results indicate that Turnover's intention is a result of personal, organizational and contextual factors. Organizational commitment and Burnout presented the major explanatory factors for Turnover's intent. There is a need to adapt the work environment, valuation of the nursing professional and prevention of ill-health factors, which can prevent suffering and encourage the maintenance of qualified human capital.