NURSES’ LEADERSHIP COACHING AND ITS RELATIONSHIP WITH THE PROFESSIONAL PRACTICE ENVIRONMENT IN NURSINGABSTRACT
Objectives: to assess nurses’ self-perception of coaching leadership in the hospital environment; to classify professional nursing practice environment; and to correlate nurses’ self-perception of coaching leadership and professional nursing practice environment.
Method: a cross-sectional study, carried out in a private hospital, in the city of São Paulo, with 67 nurses, between August and December 2022, using the Nurse Self-Perception Questionnaire in Leadership Exercise (Questionário de Autopercepção do Enfermeiro no Exercício da Liderança) and the Brazilian version of the Practice Environment Scale. The data were analyzed with descriptive statistics, whereas, for correlations, Pearson’s correlation test, with effect size by Cohen’s classification, and sensitivity analysis of statistical power were used. The statistical significance adopted was 5% (p ≤ 0.05).
Result: the results showed that 70.1% of participants were female and had completed their training in 10.7 years (SD=6.98). The mean self-perception of coaching leadership was 86.7 (SD=8.43), indicating a positive assessment. Regarding the work environment, four out of five subscales of the Practice Environment Scale obtained a mean above 2.5 points, classifying the hospital environment under analysis as favorable. Nine correlations of medium effect size were found between the domains of coaching leadership and professional nursing practice environment.
Conclusion: coaching leadership was perceived positively by nurses; the professional practice environment in nursing was considered favorable; and important correlations were identified between the domains of coaching leadership and professional nursing environment.
DESCRIPTORS: Leadership; Health facility environment; Professional practice; Nursing; Nursing administration research
RESUMEN
Objetivos: evaluar la autopercepción de enfermeros sobre el liderazgo en coaching en el ambiente hospitalario; clasificar el ambiente de la práctica profesional de enfermería; y correlacionar la autopercepción de enfermeros sobre el liderazgo en coaching y el ambiente de la práctica profesional de enfermería.
Método: estudio transversal, realizado en un hospital privado, de la ciudad de São Paulo, con 67 enfermeros, entre agosto y diciembre de 2022, utilizando el Cuestionario de Autopercepción del Enfermero en el Ejercicio de Liderazgo (Questionário de Autopercepção do Enfermeiro no Exercício da Liderança) y la versión brasileña de la Practice Environment Scale. Los datos fueron analizados con estadística descriptiva, mientras que, para las correlaciones, se utilizaron la prueba de correlación de Pearson, con tamaño del efecto basado en la clasificación de Cohen, y el análisis de sensibilidad del poder estadístico. La significación estadística adoptada fue del 5% (p≤ 0,05).
Resultados: los resultados mostraron que el 70,1% de los participantes eran mujeres y se habían graduado en 10,7 años (DE=6,98). La autopercepción media del liderazgo en coaching fue de 86,7 (DE=8,43), lo que indica una valoración positiva. En cuanto al ambiente de trabajo, cuatro de cinco subescalas de la Practice Environment Scale tuvieron promedio superior a 2,5 puntos, clasificando el ambiente hospitalario, en el análisis, como favorable. Se encontraron nueve correlaciones de tamaño de efecto medio entre los dominios del coaching de liderazgo y el entorno de la práctica profesional de enfermería.
Conclusión: los enfermeros percibieron positivamente el liderazgo del coaching; el ambiente de práctica profesional de enfermería se consideró favorable; y se identificaron correlaciones importantes entre los dominios del liderazgo del coaching y el entorno profesional en enfermería.
DESCRIPTORES: Liderazgo; Ambiente de instituciones de salud; Práctica profesional; Enfermería; Investigación en administración de enfermería
RESUMO
Objetivos: avaliar a autopercepção sobre liderança coaching do enfermeiro no ambiente hospitalar; classificar o ambiente da prática profissional em enfermagem; e correlacionar a autopercepção do enfermeiro sobre liderança coaching e o ambiente da prática profissional em enfermagem.
Método: estudo transversal, realizado em hospital privado, na cidade de São Paulo, com 67 enfermeiros, entre agosto e dezembro de 2022, com o uso do Questionário de Autopercepção do Enfermeiro no Exercício da Liderança e da versão brasileira da Practice Environment Scale. Os dados foram analisados com estatística descritiva, ao passo que, para as correlações, empregaram-se o Teste de Correlação de Pearson, com tamanho do efeito pela classificação de Cohen, e a análise de sensibilidade do poder estatístico. A significância estatística adotada foi de 5% (p≤ 0,05).
Resultados: os resultados mostraram que 70,1% dos participantes eram do sexo feminino e com tempo de formação em 10,7 anos (DP=6,98). A média de autopercepção da liderança coaching foi de 86,7 (DP=8,43), indicando uma avaliação positiva. Quanto ao ambiente de trabalho, quatro entre cinco subescalas da Practice Environment Scale obtiveram média acima de 2,5 pontos, classificando o ambiente hospitalar, em análise, como favorável. Foram encontradas nove correlações de tamanho de efeito médio entre os domínios da liderança coaching com o ambiente da prática profissional em enfermagem.
Conclusão: a liderança coaching foi percebida positivamente pelos enfermeiros; o ambiente de prática profissional em enfermagem foi considerado favorável; e correlações importantes foram identificadas entre os domínios da liderança coaching e o ambiente profissional em enfermagem.
DESCRITORES: Liderança; Ambiente de instituições de saúde; Prática profissional; Enfermagem; Pesquisa em administração de enfermagem.
INTRODUCTION
Leadership generates repercussions on individuals within an organization, and can be directly related to the work environment, being able to affect professionals’ individual and organizational productivity within their context of practice1.
In the context of nursing, leadership transcends the actions of a nurse, and can be applied to their administrative, technical and relational knowledge, directly impacting their team and quality of patient care so that, when not well exercised, it increases the generation of interpersonal conflicts2.
This process involves an interpersonal relationship between leader and follower. Therefore, for this study, coaching leadership was chosen, believing that the concepts established in this leadership model help professionals to deal with these diversities, promoting an effective work environment aligned with organizational objectives2. The use of coaching techniques enables more adaptable leadership focused on the continuous development of nurses’ skills, resulting in high-quality health care provision in tune with the rapid changes in the contemporary world and technological developments3.
Given the importance of the applied leadership model, coaching leadership, based on the coaching process, has been gaining ground and becoming contextualized in the Brazilian reality2 by encouraging and motivating followers to learn by influencing the group to achieve goals, promoting the development of skills during this process, which will generate as a constant result quality care for patients and promote job satisfaction1-2,4.
The essence of coaching leadership process dimensions comprises the following domains: Communication; Give and receive feedback; Delegate power and exert influence; and Support the team so that the organizational results are reached3.
Since leadership is a necessary skill for nurses’ professional practice5, it is desirable that institutions analyze possible barriers that may distance nurses from their primary functions and that result in an accumulation of secondary functions that directly affect the professional environment, compromising leadership and the care provided6.
An integrative review indicates that coaching leadership for nurses positively impacts professionals in organizational culture, influencing elements such as organizational commitment, empowerment and productivity. Furthermore, the article concludes that further studies are needed to analyze the relationship between leadership and other variables, such as practice environment2.
For nursing, the professional practice environment is known as the organizational characteristics that facilitate or limit the exercise of nursing work, and, when facilitating characteristics are present, they can benefit people and quality of care5.
In this regard, it is worth highlighting that, since the 1980s7, the professional practice environment has been the subject of research in the United States, mainly with regard to nurses’ professional performance. The practice environment is justified by the interaction between job satisfaction, institutional support and participatory management5. These factors influence both nurses’ performance and their level of job satisfaction. Investigating these elements is extremely important to understand nursing practices, such as leadership, organizational structure and care provided6,8.
Given the importance of promoting a favorable professional environment, there are studies in the literature that aim to assess the nursing professional practice environment and its relationship with possible variables that may influence this environment both positively and negatively.
Thus, considering the promising model of coaching leadership and professional practice environment assessment as the basis of this study, it is necessary to carry out research that investigates evidence that considers the relationship of these variables, since there is a gap in the literature on this relationship. As an initial hypothesis of this work, it is suggested that coach nurse leaders promote a favorable professional nursing practice environment.
Thus, this research is guided by the question: is there a relationship between the professional practice environment in nursing and the coaching leadership exercised by nurses? To this end, this study aimed to assess nurses’ self-perception of coaching leadership in a hospital environment, classify professional nursing practice environment and correlate nurses’ self-perception of coaching leadership and professional nursing practice environment.
Finally, the results obtained in this research have the potential to make a significant contribution to the field of nursing and to healthcare management more broadly. The data and evidence obtained offer the possibility for managers to employ coaching leadership to promote a professional practice environment that is both healthy and productive. Furthermore, the results may inspire other institutions to adopt similar models in their leadership practices.
METHOD
This is a cross-sectional correlational study, whose description of results was guided by STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Studies of this nature seek to investigate the relationships between variables, analyzing them both in isolation and in association9.
This study was submitted, assessed and approved by the Universidade Federal de São Paulo Research Ethics Committee (REC), obtaining a Certificate of Presentation for Ethical Consideration.
Data collection was carried out between August and December 2022 using Google Forms® in a private hospital in the city of São Paulo, SP, Brazil, which is accredited with excellence by the National Accreditation Organization at level three and which has cutting-edge structure and technology, being a reference in the region, with 204 beds available for care for the adult public in the clinical and surgical areas.
The approach strategy was carried out through corporate emails of nurses from all care areas who met the study inclusion criteria, in which the main researcher sent an invitation to participate along with the link to the filling tool. A second direct and in-person approach was also carried out with all employees, 30 days after sending the email, to remind them of the research and the importance of participating.
Inclusion criteria were nursing assistants, supervisors (coordinate and monitor nurses’ and nursing technicians’ daily activities in a specific health unit) or managers (carry out general management of a nursing department or unit, including the definition of policies, strategic planning, management of human and financial resources) with at least three months of work in the institution, a period in which a worker is made effective based on the assumptions of the Constitution of Labor Laws. Exclusion criteria were participants being on leave during the data collection period, nurses who did not work directly in care and/or who did not have nursing technicians directly subordinate to them, such as nurse auditors, nurses from infusion therapy teams and skin group.
At the time of data collection, the hospital had a total of 142 nurses, of whom 117 were intentionally invited to participate in the research because they held positions in which leadership practice was required. All who agreed to participate (n=67) completed the instruments correctly, with no losses in the sample.
Study variables were sociodemographic (biological category (sex), age, time since graduation, area of specialization (lato sensu), whether students had a master’s and/or doctoral degree, type of training institution, time working at the current institution and current position), self-perception of coaching leadership and nursing professional practice environment assessment.
To measure the coaching leadership variable, a questionnaire developed and validated in Brazil was used, the Nurse Self-Perception Questionnaire in Leadership Exercise (Questionário de Autopercepção do Enfermeiro no Exercício da Liderança)10, aimed at nurses, whose estimated time for completion is eight minutes.
QUAPEEL is subdivided into three parts: the first contains data for the sample social and professional characterization; the second is composed of open-ended and closed-ended questions that address the concept and model of leadership exercised and leader skills; and the third is composed of 20 items, distributed in four dimensions: Communication (items 1 to 5); Give and receive feedback (items 6 to 10); Delegate power and exert influence (items 11 to 15); and Support the team so that the organizational results are reached (items 16 to 20)10.
The items are assessed using a six-point Likert scale, in which one represents “never - I do not understand the statement” and five represents “always - I understand the statement every time”, i.e., the higher the score obtained, the greater the perception of the exercise of the behavior described in daily practice. In the response scale, participants also have the option to respond “not applicable”. The scores for the subscales are obtained by averaging the sum of professionals’ responses, with the exception of the “not applicable” option, which is equivalent to zero, and when selected, will not be part of mean calculation10.
To analyze the “professional nursing practice environment” variable, the Practice Environment Scale (PES) was used - Brazilian version, validated for assessing nurses11.
The validated version of PES aims to assess professional nursing practice environment through 24 items, distributed in five subscales: Nurse participation in hospital affairs (five items); Nursing foundations for quality of care (seven items); Nurse manager ability, leadership, and support of nurses (five items); Staffing and resource adequacy (four items); and Collegial nurse-physician relations (three items)11.
The measurement scale used is the Likert type, but with four points, in which participants respond whether a certain characteristic is present in their daily work by choosing four options: “totally agree” (four points); “partially agree” (three points); “partially disagree” (two points); and “totally disagree” (one point). Therefore, the higher the score, the greater the perception of the presence of characteristics favorable to nurses’ professional practice. The scores for the subscales are obtained by averaging the scores of subjects’ responses.
Concerning scale interpretation, scores with values of 2.5 can be identified as a neutral point. Above this point, the environment is considered favorable to professional practice, as it reflects the agreement that the characteristics described are present in the environment in which professionals carry out their activities. Institutions with scores above 2.5 in none or in one subscale can be considered as unfavorable to nursing professional practice; those with scores above 2.5 in two or three subscales can be considered as having mixed environments; and those above 2.5 in four or five subscales can be considered as having environments favorable to nursing professional practice12. Cronbach’s alpha of the instrument’s subscales ranged from 0.76 to 0.8711.
SPSS Statistics version 28.0 (IBM Corp., Armonk, NY, USA) was used. The theoretical basis used for data analysis is described in detail by Field13. To calculate the 95% Confidence Intervals, the bias-corrected and accelerated method was used based on 1,000 bootstrap samples. The values in brackets in the tables indicate the upper and lower limits of the 95% Confidence Intervals.
Descriptive statistical tests, such as mean, median, standard deviation (SD), and inferential tests, such as Pearson’s correlation test and effect size, were adopted to assess “self-perception of coaching leadership” and “nursing professional practice environment assessment”, considering the total value and their respective domains. The statistical significance value adopted was equal to 5% (p ≤ 0.05).
The interpretation of the effect sizes was performed using the proposed classification14 for the coefficient “r”, with the following criteria being adopted for classification: small size, with a value between |0.100| and |0.299|; medium size, with a value between |0.300| and |0.500|; and large size, with a value above |0.500|.
According to the data analysis previously performed, a post-hoc analysis (post-test) of statistical power sensitivity was performed with the aim of identifying the lowest level of detectable correlation with the collected sample. For this purpose, G*Power version 3.1.9.7 was used15.
The following parameters were considered: Pearson’s correlation test; type I and II errors set at 5% and 20%, respectively; expected correlation in the null hypothesis = 0; and a total sample of 67 individuals.
It was found that the sample collected was sufficient to detect correlation coefficients ≥ 0.334, although the sample may not have been large enough to detect correlation coefficients <0.334 (disregarding the signal). It was not necessary to assess data normality, because the bootstrap technique already circumvents any possible problem of abnormal data distribution13.
Considering the classification of effect sizes proposed14, it is possible to conclude that the collected sample is capable of identifying any strong correlation and almost all moderate correlations (excluding those between 0.300 and 0.333).
RESULTS
A total of 67 nurses responded to the data collection instruments; 70.1% (n=47) were female; and of the 92.5% (n=62) who worked as nursing assistants, 52.2% (n=35) worked night shifts. Thus, 98.5% (n=66) completed their training in a private institution and 92.5% (n=62) had specialization, 50.7% (n=34) in intensive care. None of the respondents reported having a master's or doctoral degree.
The remaining respondents who did not fit the role of clinical nurse (7.46%; n=5) were nurses who held supervisory or managerial positions.
Respondents’ mean age was 38.58 (SD 8.05) years, with a minimum of 25 years and a maximum of 58 years, with a mean training time of 10.72 years (SD 6.98), with a minimum variation of one year and a maximum of 28 years, and a mean time of service in the institution of 4.85 years (SD 4.25), with a minimum of 0 years and a maximum of 17 years.
As for sample characterization through QUAPEEL, 94.0% (n=63) of respondents considered themselves leaders and stated that they exercised a leadership style oriented towards people and tasks, depending on the situation (73.13%) (n=49). Respondents were also found who exercised only the leadership style oriented towards people (19.40%) (n=13) and tasks (7.46%) (n=5).
Regarding the interpersonal skills considered necessary for a leader, 25.37% (n=17) considered communication skills exclusively. Subsequently, 17.91% (n=12) focused exclusively on the ability to give and receive feedback, whereas 4.48% (n=3) highlighted only the importance of the ability to empower and exert influence. On the other hand, the majority of respondents, corresponding to 68.66% (n=46), recognized the importance of all the skills mentioned above.
Table 1 shows the mean and median scores of the QUAPEEL and PES subscales.
When analyzing the results of the subscales of the instruments applied, it was noted that nurses had a mean result of 86.7 points (SD 8.43) out of 100 possible in QUAPEEL. They demonstrate an inclination to exercise coaching leadership, since it is understood that the closer to 100 points, the greater degree of coaching leadership is exercised by nurses. Concerning PES, it was noted that four subscales achieved scores higher than 2.5, classifying the environment as favorable.
The internal consistency investigation for QUAPEEL and PES was carried out by calculating the ω (omega) coefficient16, obtaining the total result in QUAPEEL of ω=900 and PES of ω=931, showing that the instruments presented high internal consistency.
Table 2 presents the correlation of the scores of the QUAPEEL subscales with the PES subscales using Pearson’s correlation test. A parametric test was used because all variables were quantitative in nature. The correlations found were of small and medium effect sizes. In Table 2, presented below, correlations with a coefficient ≥0.334 were considered sensitive.
DISCUSSION
The sociodemographic variables of this study’s sample presented results consistent with the Nursing Profile Survey in Brazil, carried out by the Conselho Federal de Enfermagem (Federal Nursing Council (COFEN)) in collaboration with the Fundação Oswaldo Cruz17, showing that the majority were female, graduated from private educational institutions, had a graduate degree, but completed more time since graduation. Participants’ mean age fell into the “professional maturity” category17, which corresponds to the third phase of career development. In this phase, individuals are between 36 and 50 years old, characterizing themselves as professionals who are fully developing their cognitive, technical and practical capacities in the field of nursing. They are, therefore, adequately prepared and qualified for the job market, enjoying the peak of professional recognition.
In this context, it is noticeable that the sample is in a stage of improving its skills in the field of nursing. Therefore, coaching leadership exercise assessment, a leadership model that emphasizes the relevance of developing communication skills, giving and receiving feedback, exercising influence and supporting the team so that the organizational results are achieved, is pertinent and timely.
From another perspective, a percentage of respondents was also obtained who did not consider themselves leaders, justifying that they were recent graduates and that they believed that, due to lack of experience, they were not yet able to exercise leadership.
Therefore, it is understood that the development of leadership skills is crucial for nurses, ensuring the establishment of participatory, present, empathetic, effective leadership based on solid interpersonal relationships, essential to guarantee patient safety18 so that they can consequently face the difficulties of adapting to the environment, an insufficient approach to leadership in professional training18-19, overcome resistance to accepting their leadership, especially by nursing technicians and nursing assistants19.
Regarding the application of QUAPEEL, a tendency was identified in the sample that composed this study to exercise coaching leadership. There is evidence that this leadership model presents a more improved development of communication, in addition to demonstrating a significant capacity to establish more solid relationships with the team1, acting as facilitating agents in the organization’s transformation process and promoting an environment conducive to evolution and collective growth20.
Regarding the comparison between samples on nurses’ self-perception, similar means were noted among respondents. It is noteworthy that the mean obtained in the present study, 86.7 points (SD 8.43), was similar to that of other studies, 86.23 (SD 8.95)21 and 84.41 (SD 9.44)22, demonstrating a linearity between the exercise of coaching leadership among nurses in hospitals.
The results obtained indicated a clear perception of the different dimensions of the coaching process. The scores attributed to these dimensions were consistently high, evidencing a comprehensive understanding of this type of leadership by participants. Moreover, few variations were observed in the assessments of subscales throughout the study, suggesting a uniformity in the interpretation and application of the concepts related to coaching.
The “Communication” subscale had a high mean value among respondents, in line with data from another survey that also found a positive assessment of this dimension. Communication is crucial in nurses’ routine, as it influences their followers’ behavior and performance, in addition to helping to reduce stress, promote team well-being and improve workers’ quality of life, favoring patient safety22.
The “Give and receive feedback” subscale was the one that obtained the highest mean among respondents, being consistent with other studies1,23 that also demonstrated higher means in this subscale. This suggests that nurses recognize the importance of carrying out a process that aims to change inappropriate behaviors, maintain desirable behaviors and provide guidance for new behaviors20, aiming to improve team professional performance and contribute to organization success. Therefore, feedback should be considered an essential tool and integrated into the work process, providing valuable insights for improvement and adaptation in healthcare provision21.
In contrast, the “Delegate power and exert influence” subscale recorded the lowest mean among subscales, which highlights the need for nurses to reconsider the importance of exercising this function. It is crucial to understand that granting authority and being open to influence are intrinsically linked to subordinates’ participation in management and to sharing responsibilities with the aim of achieving more favorable results1,23. Nurses’ performance becomes more relevant to the team when decisions are made collaboratively, since, in this way, subordinates feel more valued, resulting in greater satisfaction and motivation in the performance of their functions24.
The professional nursing practice environment in this study was assessed as favorable. Research25 that included 46 studies that used PES demonstrated that, in 16 studies, mean results of the environment were presented that ranged from 2.30 to 3.07. The lowest-scoring study had a small sample size and investigated turnover intentions among nurses in the Eastern Caribbean, whereas the highest-scoring study was conducted in an Australian hospital seeking Magnet recognition. In studies of nurses in magnet hospitals, composite scores ranged from 2.92 to 3.00.
The “Staffing and resource adequacy” subscale was the only one that did not reach a mean above 2.5 points, which demonstrated an unfavorable assessment of this item. Research26 demonstrated that patients in hospital institutions with more favorable levels of nursing staff sizing and qualification had a lower probability of in-hospital death compared to those treated in environments with deficiencies in nursing resource allocation.
The other PES subscales received favorable ratings, with emphasis on “Collegial nurse-physician relations”, which was the best rated by respondents, supporting research27 that also had this subscale with the highest score, which found that a good relationship among professionals is essential to foster a favorable work environment as well as ensuring patient care safety.
When analyzing the correlations between the QUAPEEL and PES subscales, significant correlations were observed, and those that presented a mean effect size and that contemplated sensitivity analysis with coefficient “r” ≥0.334 are explained below.
The “Communication” subscale was correlated with “the Nursing foundations for quality of care” subscale. Thus, it can be understood that exercising effective communication among nursing team members and other health professional members is essential to ensure the quality of care provided. Through clear and precise communication, nursing foundations can be shared and applied appropriately, contributing to excellent patient care28.
The next correlations to be presented will be between the “Delegate power and exert influence” subscale, including the “Nurse participation in hospital affairs”, “Nursing foundations for quality of care” and “Practice Environment Scale total” subscales.
This subscale measures nursing professionals’ perception about the support of coaching leadership for professional development. Through the correlation with “Nurse participation in hospital affairs”, it is understood that when nurses have the opportunity to actively participate in discussions about hospital affairs, they acquire greater power of influence in decisions that affect the care provided, which may justify the positive correlation found27.
Similarly, the correlation of the “Delegate power and exert influence” subscale with “Nursing foundations for quality of care” subscale suggests that professional development can help nursing professionals to better understand their work. This means that when professionals have the opportunity to develop professionally, they tend to have a clearer and deeper understanding of the fundamentals of their nursing practice, which can increase their engagement and satisfaction28.
Concerning the correlation between the final result of PES and the “Delegate power and exert influence” subscale, it can be inferred that coaching leadership support in nursing becomes more significant for the team when decisions are made collaboratively, as, in this way, team members feel more appreciated, which results in a favorable work environment.
The “Support the team so that the organizational results are achieved” subscale was correlated with the “Nurse participation in hospital affairs” subscale. This finding highlights the importance of the active inclusion of nursing team members in political decisions, commissions and committees27. This inclusion provides significant potential for achieving established organizational outcomes, as decisions made by management will have a direct impact on clinical nurses, influencing their work environment and their ability to achieve organizational goals. Therefore, promoting nurses’ active participation in hospital affairs can be an effective strategy for improving the quality and effectiveness of nursing care and, by extension, the overall results of health institutions.
Finally, this study will explain the correlation between the QUAPEEL-total subscale “Nursing coaching leadership” and the PES subscale “Nursing foundations for quality of care”. This correlation indicates that coaching leadership practice by nurses in the nursing context is directly associated with the application of fundamental nursing principles, acquired through their training and professional experience, with the aim of promoting high-quality care provision. As a result, this approach contributes to creating a work environment that is conducive and favorable to achieving the objectives established in hospital environments.
It is important to highlight that nursing coaching leadership is not limited to technical guidance, but also encompasses the development of interpersonal skills, promotion of a culture of continuous learning and facilitation of continuous improvement processes in health care. Therefore, nurses as coach leaders play a crucial role in the pursuit of excellence in nursing care provision and in optimizing the hospital work environment.
The results found are in line with research1:3-4 that also pointed to the potential of coaching leadership in developing communication skills and establishing solid relationships with the team. By applying nursing foundations for quality of care, coach leaders are able to convey their vision in a clear and inspiring manner, which positively influences employee engagement and motivation. Furthermore, by acting as facilitators in the organizational transformation process, coach leaders promote an environment conducive to collective evolution and growth, creating a virtuous circle of professional development.
The sample size collected was observed as a limitation of this study, as it does not guarantee the identification of possible weak and moderate correlations with a value ≤0.333.
CONCLUSION
Through statistical analysis of collected data, significant results were obtained that deserve to be highlighted. The mean score on the coaching leadership scale was calculated at 86.70 points (SD = 8.43), values that indicate a clear trend towards the ability to exercise coaching leadership within the context studied.
Regarding the nursing practice environment, the overall results characterized the environment as favorable, with the exception of the “Staffing and resource adequacy” subscale, which had a mean below 2.5 points. This finding highlights the need for specific attention to resource allocation and staffing within the nursing work environment, especially in a context where responsibilities are substantial.
Through statistical analysis of collected data, results of positive coefficient values with statistical significance were obtained, being synonymous with a directly proportional correlation. In other words, the increase in PES score is associated with the increase in QUAPEEL score and vice versa.
A medium effect size correlation was found between the coaching leadership domains and the professional practice environment in nursing domains, which are:
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“Communication” with “Nursing foundations for quality of care”;
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“Delegate power and exert influence” with “Nurse participation in hospital affairs”;
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“Delegate power and exert influence” with “Nursing foundations for quality of care”;
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“Delegate power and exert influence” with “Practice Environment Scale total”;
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“Support the team so that the organizational results are reached” with “Nurse participation in hospital affairs”;
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“Support the team so that the organizational results are reached” with “Practice Environment Scale total”;
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“Self-perception of coaching leadership” with “Nurse participation in hospital affairs”;
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“Self-perception of coaching leadership” with “Nursing foundations for quality of care”;
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“Self-perception of coaching leadership” with “Practice Environment Scale total”.
Considering the context presented, in which the nurses’ role involves great responsibilities, it is crucial to recognize that leadership decisions and practices play a fundamental role in creating a favorable work environment, as obtained through the analysis. This dynamic contributes not only to the quality of the work environment, but also to the effective structuring of staff organization and performance.
In summary, this research provides valuable insights that can guide coaching leadership practices in nursing, and highlights the importance of a supportive work environment for effective team performance. However, there is a clear need for further studies that explore and correlate the coaching process with the professional nursing practice environment in order to broaden our understanding of this complex and dynamic relationship.
ACKNOWLEDGMENTS
I would like to thank the nurses who participated in this study. Without their dedicated time, none of this would be possible. I admire their efforts to improve lives, despite the daily challenges, while maintaining quality care.
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NOTES
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ORIGIN OF THE ARTICLE
Extraacted from dissertation “Liderança Coaching e sua relação com o ambiente de prática profissional em Enfermagem”, presented to the Graduate Program in Nursing, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, in 2023.
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APPROVAL OF ETHICS COMMITTEE IN RESEARCH
Approved by the Ethics Committee in Research of the Universidade Federal de São Paulo, under Opinion 5.168.320 and Certificate of Presentation for Ethical Consideration (Certificado de Apresentação para Apreciação Ética) 52018021.0.0000.5505.
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TRANSLATED BY
Letícia Belasco
Edited by
Publication Dates
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Publication in this collection
16 Dec 2024 -
Date of issue
2024
History
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Received
20 Feb 2024 -
Accepted
21 Aug 2024
