Evaluating the organisational climate in Italian public healthcare institutions by means of a questionnaire

<p>Abstract</p> <p>Background</p> <p>By means of the ICONAS project, the Healthcare Agency of an Italian Region developed, and used a standardised questionnaire to quantify the organisational climate. The aims of the project were (a) to investigate whether the healthcare institutions were interested in measuring climate, (b) to estimate the range of applicability and reliability of the instrument, (c) to analyse the dimensions of climate among healthcare personnel, (d) to assess the differences among employees with different contractual positions.</p> <p>Methods</p> <p>The anonymous questionnaire containing 50 items, each with a scale from 1 to 10, was offered to the healthcare organisations, to be compiled during ad hoc meetings. The data were sent to the central project coordinator. The differences between highly specialised staff (mostly physicians) and other employees were assessed after descriptive statistical analysis of the single items. Both Principal Component Analysis and Factor Analysis were used.</p> <p>Results</p> <p>Ten healthcare organisations agreed to partecipate. The questionnaire was completed by 8691 employees out of 13202. The mean value of organisational climate was 4.79 (range 1–10). There were significant differences among single items and between the 2 groups of employees. Multivariate methods showed: (a) one principal component explained > 40% of the variance, (b) 7 factors summarised the data.</p> <p>Conclusion</p> <p>Italian healthcare institutions are interested in assessing organisational phenomena, especially after the reforms of the nineties. The instrument was found to be applicable and suitable for measuring organisational climate. Administration of the questionnaire leads to an acceptable response rate. Climate can be discribed by means of 7 underlying dimensions.</p

A identidade do agente comunitário de saúde: uma abordagem fenomenológica The identity of the community healthcare agent: a phenomenological approach

A construção do Sistema Único de Saúde ganhou sustentação com programas que engendraram a participação de um novo elemento na equipe multiprofissional, o agente comunitário de saúde. O objetivo deste estudo foi compreender os fatores psicossociais, segundo as perspectivas destes agentes, que são significativos na construção de sua identidade. O referencial metodológico adotado foi a fenomenologia hermenêutica de Paul Ricoeur. Os sujeitos da pesquisa foram sete agentes comunitários de saúde que, após aprovação do Comitê de Ética em Pesquisa e consentimento esclarecido, foram entrevistados com a questão norteadora: "Conte-me sua experiência como agente comunitário de saúde". A análise dos discursos resgatou os temas: "A experiência anterior", "A capacitação para o trabalho", "O estabelecimento de vínculo", "A conquista do conhecimento", "Experiência gratificante", "Sentimentos de (im) potência", "A comunicação", "O cotidiano do trabalho", "O crescimento pessoal", "A crítica da instituição", "A experiência do agente usuário", "A inserção na realidade social". A análise do geral desvelou o fenômeno a partir das convergências e divergências do agrupamento dos temas engendrando, na perspectiva do agente comunitário de saúde, os aspectos psicossociais que constroem a sua identidade.<br>The structure of Brazil's National Health System (SUS) is being firmed up through programs adding a new element to its multi-professional healthcare teams: Community Healthcare Agents. This study examines psycho-social factors that are significant for the construction of this identity, from the standpoint of these Community Healthcare Agents, using the hermeneutic phenomenology of Paul Ricoeur as its reference methodology. The subjects of this survey were seven Community Healthcare Agents who were asked during interviews (with informed consent and after approval by the Research Ethics Committee) to: 'Tell me about your experience as Community Healthcare Agent'. The analysis of their replies indicated the following topics: previous experience; capacity-building for the job; bonding; building up expertise; gratifying experience; feelings of power(lessness); communications; daily work routines, personal growth; criticisms of the institution; user-agent experiences; and insertion into the social reality. The overall analysis disclosed the phenomenon through the convergence and divergence of the grouping of these topics, viewed from the standpoint of these Community Healthcare Agents and the psycho-social aspects constructing their identity

O significado do trabalho em equipe na reabilitação de pessoas com malformação craniofacial congênita El significado del trabajo en equipo en la rehabilitación de la persona con malformación congénita craneofacial The meaning of team work in the rehabilitation of people with congenital craniofacial malformation

Este estudo objetivou compreender o significado do trabalho em equipe dos profissionais de reabilitação em anomalias craniofaciais. Realizou-se análise fenomenológica por contemplar a compreensão e interpretação do sentido considerando o sujeito. Entrevistou-se 12 profissionais de diferentes áreas, norteadas pela questão: O que significa para você trabalhar em equipe na reabilitação de anomalias craniofaciais? Resgatando-se os temas: Capacitação para o trabalho, Dificuldade para trabalho em equipe, Relação com paciente e família, Condições de trabalho e A inserção do profissional na equipe. A análise visou refletir o fenômeno engendrando convergências e divergências destacando a explicitação das diferenças e aprendizado contínuo.<br>Este estudio tuvo como objetivo entender el significado del trabajo en equipo de los profesionales de rehabilitación en anomalías craneofaciales. Ocurrió análisis fenomenológico para contemplar la comprensión e interpretación del sentido que consideraba el tema. Fueron entrevistados 12 profesionales de diversas áreas, orientados por la pregunta: ¿Qué significa para usted trabajar en equipo en la rehabilitación de personas con anomalías craneofaciales. Se rescataron los temas: Entrenando para el trabajo, dificultad para el trabajo en equipo, la relación con el paciente y familia, las condiciones del trabajo y la inserción del profesional en el equipo. El análisis intentó reflejar el fenómeno que engendraba convergencias y divergencias para expresar las diferencias y el aprendizaje continuo.<br>This study aimed to understand the meaning of teamwork of rehabilitation professionals in craniofacial anomalie. It was carried out a phenomenological analysis for contemplating the understanding and interpretation of the sense considering the subject. Twelve professionals from different areas were interviewed, guided to the subject: What does work in a team on the rehabilitation of craniofacial anomalies mean to you? These themes were brought up: training for the task, difficulty in working with a team, relationship with patient and family, work conditions and the professional insertion in the team. The analysis sought to reflect the phenomenon engendering convergences and divergences to express the differences and continuous learning