Contributions of Paulo Freire to understanding the dialogic leadership exercise of nurses in the hospital setting. / Contribuições freirianas para entender o exercício da liderança dialógica dos enfermeiros no ambiente hospitalar.

OBJECTIVE: To know the understanding of nurses regarding the exercise of dialogic leadership in the hospital setting, and the challenges of leadership. METHODS: Qualitative and exploratory-descriptive study Thirty-five nurses of a mid-sized hospital in the city of Pelotas/RS participated in this study. Data were collected by means of semi-structured interviews, subsequently analysed using the operative proposal of Minayo. RESULTS: The results led to the following categories: exercise of dialogic leadership and challenges in the exercise of dialogic leadership. Dialogic leadership is understood as being the nurses' ability to coordinate and organise the nursing team in horizontally-oriented relationships guided by dialogue. Regarding the challenges, the nurses stressed the lack of professional experience, and relationships of hierarchy and power. FINAL CONSIDERATIONS: Leadership based on dialogue can facilitate the management of care, of the nursing team, and of health services.

[Conflict management: challenges experienced by nurse-leaders in the hospital environment]. / Gerenciamento de conflitos: desafios vivenciados pelos enfermeiros-líderes no ambiente hospitalar.

This study aimed to understand the main conflicts experienced by nurses-leaders in the hospital environment, as well as the strategies adopted to face them.The study reflects a qualitative descriptive type approach, which was used in the case study as research strategy. The study included 25 nurses who worked in three hospitals in the city of Florianopolis, Santa Catarina. Information where obtained in the months of May to December of 2010 through semi-structured interviews, non-participant observation and dialogical workshops. Data were analyzed using the Thematic Analysis. The results demonstrated the predominant of interpersonal conflicts involving the multidisciplinary team, nurses and the nursing staff Adopting a participatory leadership, based on dialogue emerges as a strategy for coping with conflicts in the hospital environment.

Nursing leadership strategies in addressing COVID-19 in light of John Kotter's framework.

OBJECTIVE: To analyze the leadership strategies of nurses in university hospitals in response to care management changes during the COVID-19 pandemic, informed by John Kotter's insights. METHODS: This multicentric study utilized qualitative and analytical methods. It was conducted through semi-structured interviews with 139 lead nurses from 10 university hospitals in Brazil. Data analysis included Bardin's content analysis and the webQDA software. RESULTS: The primary category identified was "Nursing Leadership Strategies in the Battle Against COVID-19," encompassing five subcategories. This category underscored the importance of strategic vision in nursing leadership for combating COVID-19 within hospital settings, as well as the necessity of working collaboratively with their teams and other healthcare professionals. FINAL CONSIDERATIONS: The results highlight the strategies used by lead nurses in confronting COVID-19, which can be associated with John Kotter's theoretical framework and his model of change.

Nurses' perceptions of leadership in Brazilian hospitals during COVID-19 through Kotter's conception.

OBJECTIVE: to understand nurses' leadership perceptions during the COVID-19 pandemic in Brazilian university hospitals, through the lens of John Kotter's concepts and his eight-step change model. METHOD: a multicenter qualitative research with an analytical design. The sample comprised 139 nurses working in COVID-19 settings, interviewed using a semi-structured interview guide. Data were categorized through Bardin's content analysis based on John Kotter's concepts and his eight-step change model. RESULTS: the findings yielded significant insights into nurses' perceptions of leadership during the COVID-19 response, which exhibited characteristics consistent with Kotter's principles. There is evidence of leadership based on the pursuit of knowledge, grounded in polished communication, facilitating teamwork through a relationship of trust and respect. The recognition of the complexity and difficulty of exercising nursing leadership, particularly in crisis contexts, is apparent. CONCLUSION: nurses' perceptions reinforce essential elements for leadership practice, such as the importance of seeking diverse knowledge, polished communication, relationships based on trust and respect, and recognition of the complexity of leadership, thus presenting characteristics in line with Kotter's principles. HIGHLIGHTS: (1) Nurses' perceptions of leadership during COVID-19 were highlighted. (2) COVID-19 intensified the complexity in nurses' leadership roles. (3) Nurses' leadership was consolidated in knowledge, communication, trust. (4) Working in the COVID-19 response as a nurse-leader has become challenging. (5) Kotter's principles assist in reflections on nurses' leadership.

Relationship between leadership coaching and nurses' resilience in hospital environments.

OBJECTIVE: To analyze the relationship between leadership coaching and nurses' resilience in hospital environments. METHOD: This is a cross-sectional study, carried out with nurses, nursing assistants and technicians. Nurses answered the Nurse Self-Perception Questionnaire in Leadership Exercise Questionnaire (QUAPEEL) and the Connor-Davidson Scale for Brazil-25 (CD-RISC-25BRASIL). Nursing technicians/assistants answered the Nursing Technician and Assistant Perception in Leadership Exercise Questionnaire (QUEPTAEEL). Student's t test and Pearson's correlation were used (p ≤ 0.05). RESULTS: There was a statistically significant difference between nurses' self-perception and nursing technicians/assistants' hetero-perception in coaching leadership exercise for the total score (p = 0.002) and in the "Give and receive feedback" (p < 0.001), "Delegate power and exert influence" (p < 0.001) and "Support the team so that the organizational results are reached" (p = 0.020) domains. There was a statistically significant correlation between all the Nurse Self-Perception Questionnaire in Leadership Exercise Questionnaire Coaching and Resilience domains. CONCLUSION: Resilience was positively related to nurses' self-perception of coaching leadership.

Experience of the patient regarding their safety in the hospital environment.

OBJECTIVES: to analyze the factors that can impact patients' experience concerning safety-related measures in the hospital setting. METHODS: this qualitative, descriptive, and exploratory study was conducted with patients and their family members at a hospital in southern Brazil. Semi-structured interviews were carried out using the Critical Incident Technique between January and February 2022. The collected data underwent content analysis with the assistance of IRaMuTeQ software. RESULTS: five patients, four family members, and three patient-family units participated in the study. The following categories emerged: "Patientprofessional interaction as a component of safe care," "Recognition of safety protocols in the patient's experience," and "Safe care and the challenges in hospital care." CONCLUSIONS: patient-professional interaction, communication, awareness of safety protocols, and the availability of the nursing team are factors that influence patients' experience regarding the safety of their care during hospitalization.

[The scientific production regarding leadership in the context of nursing]. / Produção científica sobre liderança no contexto da enfermagem.

The objective of this study is to identify the scientific production in the context of nursing produced in the last decade (1999-2008). This literature review was performed using the LILACS database and included studies published as articles, theses, dissertations, editorials and presentations in events. Studies were written in Portuguese, English, or Spanish with the electronic full-text version available. A form was developed to register the data regarding the production, which included: reference, source of the manuscript, year, category, objective, methodology and theoretical framework. A total of 57 publications were found; most were original, descriptive articles performed in the hospital environment, and very few studies were founded on the Leadership Theory. It is necessary to adopt leadership development programs and permanent education projects within health services, with the purpose of preparing nurses to work as leaders.

Influencing factors in the nurses' decision-making process in Ibero-American university hospitals. / Fatores influenciadores do processo decisório de enfermeiros em hospitais universitários ibero-americanos.

OBJECTIVE: to analyze the factors that influence nurses' decision-making process in Ibero-American university hospitals. METHOD: a case study with a qualitative approach and of the multicenter type, carried out with 30 Ibero-American nurses. The data were collected through semi-structured interviews, analyzed by thematic categories and interpreted according to the theoretical framework of Creating Effective Organizations. RESULTS: it was identified that the decision-making process permeates the development of nurses' own competencies, suffering influences from health management training and previous individual experiences. The following categories emerged: Technical-scientific preparation in decision-making; Hierarchization of the decision-making process; and Autonomous professional practice. CONCLUSION: the absence/presence of a rigid hierarchy, as well as technical-scientific preparation and autonomy, are factors that limit or expand the range of possibilities in nurses' decision-making, with consequences in care management. Thus, discussions about this theme should be encouraged, in order to promote nurses' autonomy for decision-making and favor a reduction of bureaucracy in the processes that prevent/hinder advances in these services.

Meaning of work from the perspective of hospital nurses.

OBJECTIVES: to know the meaning of the role of nurses in the hospital environment. METHODS: this is a descriptive study with a qualitative approach, whose setting was a university hospital in Minas Gerais with 50 nurses. Data were collected through interviews and analyzed according to content analysis, with the contribution of the Interface software from R pour les Analyzes Multidimensionalnelles de Textes et de Questionnaires. RESULTS: three categories emerged: "Nurses' daily work in the hospital environment"; "Work motivation as an influential factor in the meaning of work"; "The two faces of the meaning of work: pleasure and suffering". Nurses attributed a positive meaning to their work. FINAL CONSIDERATIONS: three dimensions of the meaning of work were highlighted: individual, organizational and social. These influenced the professional, social, working and individual life of nurses.

Fragilities and potentialities in the training of nurse leaders.

OBJECTIVE: To know the perception of nursing professors about the fragilities and potentialities in the training of nurse leaders. METHOD: Multiple case study, with a qualitative approach, performed with 36 nursing professors from a public university in the State of Bahia, Brazil. Data were collected through semi-structured interviews, interpreted in the light of Paulo Freire's theoretical framework and analyzed according to Thematic Analysis and the Nvivo®11 software. RESULTS: Were highlighted as fragilities the need to improve the transversality of leadership throughout graduation and teaching focused on the banking model. The potentialities refer to the insertion of the students in the practice scenarios, enabling the approximation with the nursing and multidisciplinary teams, the use of active methodologies and participation in research groups. FINAL CONSIDERATIONS: Professors consider the importance of problematizing pedagogical practices and invest in methodological strategies capable of promoting the training of nurse leaders.

Theoretical-practical articulation of the continuous learning of leadership in Nursing in light of Peter Senge.

OBJECTIVE: To analyze the theoretical-practical articulation of the continuous learning of leadership in undergraduate Nursing. METHODS: Case study carried out at a Northeast federal public university. For data collection, semi-structured interview techniques, workshops, and document analysis were applied. Forty Nursing students participated in the interviews, and 26 in the workshops. The data were submitted to Minayo's operative analysis using the Nvivo software. Peter Senge's concepts were adopted. RESULTS: The students demonstrated a greater understanding of the theme throughout the course and recognized contributing elements to the continuous learning of leadership, such as behavioral characteristics and the use of methodological approaches integrated with theoretical and practical spaces. FINAL CONSIDERATIONS: The teaching of leadership is relevant in Nursing education, and this has been recognized by students, but still requires changes for it to become operational, with an improvement and a theoretical-practical integration of the cultivated experiences, suitable to the reality of the craft.

[Parallel between permanent education and health administration complex]. / Paralelo entre educação permanente em saúde e administração complexa.

Education is a political process, in which the society operates consistently on the development of the individual, aiming to integrate it into the way of living being. The present work represents a theoretical refection, from a parallel between the guidelines of the National Politics in Continuing Education in Health and the principles of the Complex Administration. From a brief review of the literature, it is attempted to contextualize the policy and this new form of administration based on freedom, cooperation, aggregation and self-organization. Results of the study suggest that the relation between continuing education and complex administration could facilitate the implementation of nursing care and health, as well as management's activities by promoting autonomy, as well as personal, professional and organizational growth.

[Dialogical leadership in hospitals institutions]. / Liderança dialógica nas instituições hospitalares.

The aim of this study is make a theorical-reflection about the importance of using dialogical leadership in hospital institutions through Freirean referencial. The dialogical leadership pattern differs from the coercive and autocratic methods, for being reasoned on the establishment of an efficient communicational process, able to stimulate autonomy, co-responsibility and appreciation of each member from nurse team. The dialogical leadership, unlike the directive one, is a management instrument, that pursuits to minimize the conflicts and stimulate the formation of healthy interpersonal relationships, which can contribute to the improvement of organizational atmosphere and quality care provided to health services users.

Conflict management strategies used by Portuguese nurse managers.

OBJECTIVES: to analyze the perception and conflict management strategies used by nurses in the management of people in Portuguese health services. METHODS: descriptive, correlational study, carried out in Portuguese health services, with an intentional non-probabilistic sample, totaling 95 nurse managers. A questionnaire and Conflict Management Scale were used, analyzing the variables of managerial activities and conflict management, with the aid of software. RESULTS: it was identified that 60% of the managers, report having to mediate conflicts daily, and the majority report adopting dialogue in conduct. However, through the Kruskal-Wallis test, it was shown that enforcement strategies in conflict management prevail (p = 0.008), with collaborative ones being more restricted to monthly intervals (p = 0.049). CONCLUSIONS: managers perceive the importance of collaboration in the mediation of conflicts, however, in their daily lives; they tend to maintain imposing behaviors, signaling for a little transformational leadership style.

Technical schools of the Unified Health System: an analysis of nursing education.

OBJECTIVE: To analyze nursing education in the Technical Schools of the Unified Health System in the Northeastern region of Brazil. METHOD: A documentary study with a qualitative approach, having its locus as Technical Schools of the Unified Health System in the Northeast Region which offer the technical course in nursing. Data sources were the Pedagogical Political Projects of the school and the Teaching Plans of the referred courses, and three structured scripts on the pedagogical aspects of training were used as instruments. The systematization/data analysis was based on thematic content analysis. RESULTS: Technical training in nursing occurs through: an integrative approach, being considered a pedagogical trend; problematizing approach, used as a methodological way for teaching-learning; and qualitative assessment, enhancing the scope of professional skills. CONCLUSION: The training in focus points to the commitment to the Unified Health System and professional excellence, as it strengthens the integration between teaching-service-community, encourages student proactivity and indicates teaching-learning in the demands of the population and the public health system, and enhances the acquiring and improving professional skills.

Transformational leadership in nursing practice: challenges and strategies.

OBJECTIVE: to understand the challenges and strategies adopted by nurses for the exercise of Transformational Leadership in a university hospital. METHODS: qualitative and exploratory study, in which 25 nurses working in a university hospital in the state of Bahia, Brazil participated. Data collection took place through semi-structured interviews and categorized according to Thematic Analysis, using Nvivo software. RESULTS: The prevalent challenges involved: lack of encouragement from the institution for the training of leaders; professional inexperience and young age; resistance to leadership and insubordination. The strategies adopted by nurses consist of acting as team examples and establishing dialogic relationships. Final considerations: The practice of Transformational Leadership has been relevant in the daily lives of nurses and contributes to the quality of care.

[Children with special needs: counterpoints between law and reality]. / Criança portadora de necessidades especiais: contrapontos entre a legislação e a realidade.

This study is as theoretical and philosophical reflection and it aims to confront the Brazilian legislation (which is about children who have special needs) with the daily practice Although children's rights have been legalized in 1990 by Statute for Children and Teenagers, we can daily see that there is a gap between what the law guarantees and what is performed in practice. It is necessary to put this legislation into practice so that it is possible to break off with a historical trajectory of prejudice which is imposed against these children. However in order to reach such practicality it is essential that families of children with special needs know their rights in order to exercise their citizenship and enjoy a better quality of life According to the available literature, reality can be changed through the exercise of children and family citizenship and this fact makes them aware of their rights.

[Perceptions of nurses about leadership]. / As percepções dos enfermeiros acerca da liderança.

This study aimed at ascertaining the perceptions of nurses facing the use of managerial leadership as a tool in their work process. This was a qualitative study of descriptive and exploratory type, conducted with eleven nurses from a large hospital in the southern region of Rio Grande do Sul, Brazil, during the months of February and March 2008. For data collection were used semi-structured interviews and focus group. The content analysis was chosen as a technique for processing the data, resulting in two categories: meanings attributed to the leadership and authority versus authoritarianism. It was noticed that even the leadership offering advantages in nursing work, are still great the difficulties to understand it and, especially, to put it into practice, making it necessary to create programs and strategies to improve the performance of the leadership as a nurses managerial instrument.

[Institutional characteristics that interfere in the leadership of nurses]. / Características institucionais que interferem na liderança do enfermeiro.

The development of this study aimed at knowing the institutional characteristics that interfere with leadership of the nurse. This is a qualitative survey of descriptive and exploratory type, held in a large hospital located in the southern Rio Grande do Sul, Brazil, during the months of February and March 2008, in which participated 11 nurses. For the collection of data, we used semistructured interview. It was opted for the analysis of content as a technique for data processing in which emerged a category concerning institutional character that consists of six subcategories: remuneration, material resources, autonomy and institutional support, rotation, devaluation of the profession, and lack of incentive to develop leaders. It was identified that the little incentive to the improvement of the nurses front to the leadership is one institutional problem that can be minimized through the permanent education and the creation and implementation of programs of development for leaders in nursing.

[Mothers experiencing the diagnosis of cerebral palsy in their children]. / Mães vivenciando o diagnóstico da paralisia cerebral em seus filhos.

The study aimed at understanding how the mothers of children with special needs, due to the diagnosis of cerebral palsy, experienced the disclosure of the diagnosis. An exploratory-descriptive research was held from a qualitative approach. Data were collected and recorded through semi-structured interviews with six mothers of children with cerebral palsy that attended the institution of the study and analyzed according to Roy's Adaptation Model. The results pointed out that the main difficulties faced by the mothers were related to the understanding and acceptance of the situation by the family and the lack of preparation of the health professionals in revealing the diagnosis of special needs of their children.