Associations between level of services integration and nurses’ workplace well-being

Abstract

BackgroundTo respond better to population needs, in recent years Quebec has invested in improving the integration of services and care pathways. Nurses are on the front lines of these transformation processes, which require them to adopt new clinical practices. This updating of practices can be a source of both satisfaction and stress. The aim of this study was to gain a better understanding of the relationship between the transformation processes underlying services integration and nurses’ workplace well-being.MethodThis study was based on a descriptive cross-sectional correlational design. The target population included all nurses working in four care pathways in a Quebec healthcare establishment: palliative oncology services, mental health services, autonomy support for the elderly, and chronic obstructive pulmonary disease. In all, 107 nurses took part in the study and completed a questionnaire sent to them. Hierarchical linear regression analyses were used to examine the relationship between level of integration, measured using the Development Model for Integrated Care; nurses’ perceptions of organizational change, measured on four dimensions (challenge, responsibility, threat, control); and nurses’ workplace well-being, measured on three dimensions (negative stress, positive stress, satisfaction), as defined by the Flexihealth model.ResultsNurses in the palliative oncology care pathway, which was at a more advanced level of integration, presented a lower negative stress level and a higher positive stress level than did nurses in other care pathways. Their mean satisfaction score was also higher. More advanced integration was associated with nurses’ feeling less threatened, as well as improved workplace well-being. The perception of threat appeared to be a significant mediating variable in the relationship between level of integration and well-being.ConclusionThe association observed between level of services integration and workplace well-being contributes to a better understanding of nurses’ experiences in such situations. These results provide new perspectives on interventions that could be implemented to remedy the potential negative consequences of these types of transformations.

Integrality of care: challenges for the nurse practice

“…Another important aspect to point out is the integration of services, which demonstrates that achieving a networked care is a condition for integrality of care (23)(24) . Just as a professional is not able to attend to all the demands of an individual, an isolated service is also not, which explains the logic of internal organization of the FU's services.…”

Fostering development of nursing practices to support integrated care when implementing integrated care pathways: what levers to use?

“…Depending on the care pathway, important variations can be observed in clinical practices, reflecting contrasting ways of implementing mechanisms for care integration [ 2 ], as well as an association between nurses’ well-being and the integration processes and their perceptions of these processes [ 8 ]. Given these observations, identifying the factors that facilitate or hinder nursing practice in an integration context seems particularly relevant.…”

Dificuldades e estratégias na integração ao cuidado da pessoa em situação crítica: uma scoping review

“…La transmisión de feedback en forma de reuniones informativas también promueve el aprendizaje (1,8) . Finalmente, la literatura también prioriza la construcción de estrategias de resiliencia, como mindfulness, autocuidado y bienestar, para proteger a los enfermeros de los efectos negativos del estrés en el local de trabajo (11,20,22) .…”

“…Associations between level of services integration and nurses' workplace well-being (22) Longpré C, Dubois C-A, Nguemeleu ET.…”