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*Corresponding Author: María Guadalupe Trujillo Ruiseco, Degree in Nursing. Spain.
Citation: María Guadalupe Trujillo-Ruiseco, (2023), Psychological Well-being and the relationship with Nursing Competence in an Intensive Care Unit, J. Obstetrics Gynecology and Reproductive Sciences, 7(2) DOI: 10.31579/2578-8965/159
Copyright: © 2023, María Guadalupe Trujillo-Ruiseco, this is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 24 February 2023 | Accepted: 15 March 2023 | Published: 27 March 2023
Keywords: nursing competence; psychological well-being; intensive care unit
Objective: To determine the relationship between the psychological Bienestar (BP) and the nursing competence of nursing staff in a Unidad de Cidados Intensivos (ICU).
Methodology: Quantitative, relational, cross-sectional and prospective, a census was conducted among 31 ICU nurses at the ISSSTE (Institute of Security and Social Services of State Workers), Aguascalientes. Carol Ryff’s “Psychological Well-Being Scale" and Ritta Meretoja's "Nursing Competence Scale" were used.
Results: 67.7% of nurses working in the ICU have a high level of BP, and 83.9% have a very good level of nursing competence. Through a correlation test by Rho Spearman, he obtained that there is no relationship between the level of nursing competence of those who work in the ICU with their level of BP.
Conclusion: There is not enough statistical evidence to say that there is a relationship between nursing competence and BP. The BP does not affect nursing competence, despite being a service of high demand for care and adequate attention and care is provided to the critical patient.
In recent decades, technological development in health and the increase in life expectancy have led to the increase of specific care units for patients in critical clinical conditions, making them an area that demands nurses with a very special profile for the type of work that must be developed in the care of patients who are there. For this reason, the knowledge and development of their own skills makes the worker able to manage himself to boost his professional maturation, improve his motivation at work and offer his best contributions as owner of his own performance [1].
Currently, Mexico's health system requires competent health personnel to respond adequately to the needs of the population; The competencies of the staff are the basis for providing efficient health services, with quality, warmth and safety for the patient [2].
Thus, skills are a fundamental element of human capital; Buelna argues that the important thing to face the challenges of the environment in which the organization operates is to demonstrate the skills of its workers to perform their functions [3]. Therefore, the competencies of the nursing professional refer to the perception of the professional nursing staff regarding their expertise or expertise to perform their daily work according to the cognitive aspects that allow them to provide the care that each patient needs and/or support other nurses using their knowledge and skills [3].
Benner (1984), defines nursing competence as the ability of the nursing professional to help the patient by providing conditions that he needs to meet his basic needs. The nurse caring for patients in the intensive care unit must meet all the attributes defined by Benner for the expert nurse [4].
Indeed, the care of critically ill patients tests the competence of knowledge, clinical and socio-affective skills of nurses, not only because of the health status of patients with multiple interfered needs, but also because of the barriers and distortions that arise so that interaction and communication with patients offers the expected results in terms of contributing to the recovery of health or to quiet death [5].
For this reason, international entities such as the World Health Organization (WHO), the International Council of Nurses (ICN) and the International Labour Organization (ILO) have recognized the importance of nursing work in the field of health, while identifying working conditions that affect this nursing population [6].
Nurses who work in critical units and under potentially stressful situations have an impact on their mental health basically in relation to the psychological field, so they need to use psychological skills and effective coping strategies to achieve quality care and effective psychological well-being [7]. Therefore, for nursing staff to develop a nursing clinical practice and adequate nursing care, the psychological well-being of these professionals is essential [8].
The authors Guevara, Zambrano and Evies (2011) state that "to take care of others it is first necessary to take care of our physique and our emotional world" [9]. Likewise, the body not only needs its organs to function properly to feel good, but also good mental function, so that it can develop fully, it is said that if a person is physically well he can achieve many things, but what happens if the subject is mentally exhausted, that the person is well physically and mentally, Consequently the body and mind go hand in hand, so it is necessary to function well at the organic level and at the mental level, through this balance the man can achieve all the goals that he sets achieving feeling good about himself, achieving his psychological well-being. [10] Theobjective of our research is tofinalize the relationship between nursing competence and the psychological competence of nursing staff in the Adult Intensive Care Unidad of the ISSSTE (Institute of Security and Social Services of State Workers), Aguascalientes. Given the theoretical background, the following hypothesis is established: Nursing competence is related to the psychological well-being of nursing staff in an adult intensive care unit.
Lodge method
A study of quantitative, relational, cross-sectional and prospective approach was conducted in the nursing staff of the ICU (31 nurses) at the Institute of Security and Social Services of State Workers (ISSSTE), Aguascalientes. In January 2019.
For the collection, prior authorization of the ethics and research committee of the Hospital and the signing of informed consent of the participants, the "Psychological Well-being Scale" was used, developed by Carol Ryff, has a total of 39 items, has a Crombach Alpha greater than or equal to .80.; This is an instrument with acceptable psychometric characteristics to be applied to the Mexican population. It is made up of six dimensions, they are: Self-acceptance, Mastery of environment, positive interpersonal relationships, personal growth, autonomy and purpose of life; the scale is answered through a Likert-type response format with scores between 1 and 6 that you can choose from "Strongly disagree", "Disagree Little", "Moderately agree", "Strongly agree", "Strongly agree" and "Strongly agree" for a total of 234 points maximum. Scores greater than 176 in the total indicate a high Psychological Well-being; Psychological Well-being between 141 and 175 high; between 117 and 140 points Moderate psychological well-being; and less than 116 points Low Psychological Well-being.
The "Nursing Competence Scale" was also used, developed by Ritta Meretoja based on Benner's literature, to assess the generic competence of nurses at different stages of their careers and in a variety of clinical settings, has a Crombach Alpha of .814. Consisting of seven items. That evaluate the planification of patient care according to individual needs, in support of coping strategies, is critical of the nursing methodology itself, method of care according to the individual needs of the patient, Use of scientific nursing evidence in patient care, make contributions to the development of care in the work unit, Decisions guided by ethical values.
The level of competence is measured with a visual analogue scale (VAS 0-100) and the frequency of the use of competences with a four-point Likert scale (0=Not applicable in my work, 1=Used very rarely, 2=Used occasionally, 3=Used very often). The Proficiency Level scores are considered Low when it goes from 0-25, Fair >25-50, Good > 50-75 and Very Good >75-100.
For data analysis and hypothesis testing, the statistical program SPSS version 25 was used.
61.3% of the nurses working in the intensive care unit of ISSSTE Aguascalientes are women and the remaining 38.7% are men. The average age of nurses is approximately 37 years. The difference between the oldest and the youngest nurse is 33 years. Where the minimum age is 24 years and the maximum 57 years.
Regarding the level of BP of nurses, most have a high BP level, with 67.7% (Table 1).
Table 1: Level of Psychological Well-being of the nursing staff of the ICU of the ISSSTE Aguascalientes.
Most nurses have a very good level of nursing competence, with 83.9% (Table 2).
Table 2: Level of Nursing Competence of nurses working in the ICU of ISSSTE Aguascalientes.
The BP dimension with the highest percentage at the "High" level is "Life Purpose" with 74.2%. And the dimension with the highest percentage in the "Low" level is positive relationships with 51.6% (Figure 1).
Figure 1: Levels of dimensions of the Psychological Well-being of nurses working in the ICU of ISSSTE Aguascalientes.
Most nurses have a very good levelin all dimensions of nursing competence. The dimension with the highest percentage in the niv the "Very good" is the one that measures the planning of patient care according to their individual needswith 93.6%. And the dimension with the lowest percentage in very good level is the five that evaluates the use of nursing scientific evidence in the care of the paciente with a percentage of 74.2% (Figure 2).
Figure 2: Levels of Nursing Competencies of nurses working in the ICU of ISSSTE Aguascalientes.
For the hypothesis test, a Shapiro-Wilk normality test was performed in the variables "BP score" and "nursing competence scores" (Table 3).
Table 3: Normality test of the variables "Psychological Well-being score" and "Nursing Competence Scores".
The competency score value is .003 and the BP score value is .000, therefore there is no normality in the data of both variables, so Spearman's Rho test was used where it was obtained that the p-value is .359 and >.05, therefore the null hypothesis is not rejected, therefore, there is insufficient statistical evidence to say that PR is related to nursing competence. On the other hand, Spearman's correlation coefficient is -.171, which indicates a very weak negative correlation (Table 4).
Table 4: Spearman's Rho Correlation Test.
According to Ritta Meretoja et al., we differed based on the results found regarding general nursing competence, since the level of nursing competence in this study was higher than that of this author [11].
On the other hand, concluding with Pérez and Aparicio, we agree that in terms of sociodemographic variables, such as (age, sex, marital status, academic level, work shift, seniority and type of hiring), they have no relationship with the level of nursing competence and psychological well-being in an ICU [12].
Henriques Camelo S. H. in his research "Professional competencies of nurses to work in Intensive Care Units", identified the following competencies of nurses: managing nursing care, performing the most complex nursing care, decision making, leadership, communication, continuing and continuing education and management of human and material resources, On the contrary, in this research the following dimensions of nursing competence were identified: care planning according to individual needs, support in coping strategies, criteria with the nursing methodology itself, modification of the care plan according to individual needs, use of nursing scientific evidence in care, making contributions for the development of care in the unit of Work and decision-making guided by ethical values [13].
Finally, García E. F, et al. in their research concluded that the psychological well-being of intensive care unit employees is related to professional status and level of training, compared to the results obtained in this study in whichno relationship was found between psychological well-being and academic level [14].
According to the results found, it is concluded that nursing competence is not related to the psychological well-being of staff in an adult intensive care unit, and responding to the specific objectives, it was found that the level of nursing competence is not related to the professional category, as well as there is no difference between nursing competence and having an intensive care specialty.
Thus, we conclude that in the observed population it was favorable to find that BP does not affect nursing competence, despite being a service with high demand for care and therefore adequate attention and care can be provided to the critical patient. Some of the nursing professionals who have a very good level of nursing competence do not exactly have a high BP in general, but if it is agreed that most of them have high scores in the dimension of personal growth, that is, according to what Carol Ryff proposes, these professionals have a feeling of continuous development and improvement over the years and feel that their potential is being developed; which explains the high levels of her nursing competence.
This research addresses in an important but not profound way the ability of a group of nurses located in a context where they can carry out their work without involving their good or bad psychological well-being. This capacity becomes a fundamental point in its competence, so it impacts on providing necessary and effective care.
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