El buen cuidado en la proximidad de la muerte. Impacto del bienestar y la vinculación laboral en los profesionales de enfermería

Resumo

This thesis includes the study of the quality of end of life nursing care, and its relationship with different organizational and personal variables. A questionnaire of Palliative Nursing Care Quality (CCEP) is designed and validated, showing evidence of internal and convergent validity for the construct, and a mediation analysis between the predicting variables (anxiety about death and sense of care), mediating variables (psychological well-being and work engagement) and target variable (quality of care) is carried out. For this purpose, three studies are performed. Study 1, qualitative, integrates the opinion of experts in the palliative field and the personal experience of the different professionals who form the palliative teams, collected through semi-structured interviews. Study 2 includes the exploratory factorial analysis of the CCEP and the adaptation of the Provisional Sense scale (SP) to nursing professionals, both of which show very good psychometric properties. Study 3 contemplates the confirmatory factorial analysis of the CCEP, whose results show an appropriate goodness of fit, the convergent validity, obtained through the correlations between the CCEP and the Phsycological Well-being scale (BP), the SP scale and the Utretch Work Engagement Scale (UWES), and, finally, the mediation analysis. The most relevant results of the mediation analysis confirm the following hypotheses: first, nurses with greater psychological well-being and work engagement report a higher quality of palliative care. Second, less anxiety about death is related to a greater psychological well-being of nursing professionals. Third, finding meaning in care has a positive influence on psychological well-being and work engagement of nursing professionals. Fourth, teamwork, autonomy, and a good work environment fosters job engagement, and emotional skills training increases the psychological well-being of nursing professionals. Finally, the relationship between the anxiety about death and quality of care is explained through the psychological well-being, and the relationship between sense of care and quality of care can be explained by the mediation of the psychological well-being and work engagement.