Evaluación de las bases teóricas del agotamiento en enfermería
DOI:
https://doi.org/10.5281/zenodo.6903388Palabras clave:
agotamiento, enfermería, escala de Maslach, escala de Copenhagen, ambiente laboral, estrésResumen
Los estudios laborales a menudo identifican el agotamiento como un "resultado" de enfermería. Sin embargo, el agotamiento en sí mismo, qué lo constituye, qué factores contribuyen a su desarrollo y cuáles son las consecuencias más amplias para las personas, las organizaciones o sus pacientes, rara vez se hace explícito. El objetivo de esta revisión fue proporcionar un resumen exhaustivo de la investigación que examinan las relaciones teóricas entre el agotamiento y otras variables, a fin de determinar qué se sabe (y qué no se sabe) sobre las causas y consecuencias del agotamiento en enfermería, y cómo esto se relaciona con las teorías del agotamiento. Se incluyeron estudios empíricos primarios cuantitativos que examinaron las asociaciones entre el agotamiento y los factores relacionados con el trabajo en enfermería. Noventa y un documentos fueron identificados. La mayoría (n=87) fueron estudios transversales; 39 estudios utilizaron las tres subescalas de la Escala de Maslach para medir el agotamiento. Según la hipótesis de Maslach, se identifica una gran carga de trabajo, incongruencia de valores, bajo control sobre el trabajo, baja latitud de decisión, clima/apoyo social deficientes y bajas recompensas como predictores de agotamiento. Maslach sugirió que la rotación, la ausencia por enfermedad y la salud en general eran efectos del agotamiento. Sin embargo, se identificaron relaciones solo con la ausencia general de salud y enfermedad. Otros factores que se clasificaron como predictores de agotamiento en la literatura de enfermería fueron niveles bajos o inadecuados de personal de enfermería, turnos ≥ 12 h, baja flexibilidad de horario, presión de tiempo, altas demandas laborales y psicológicas, baja variedad de tareas, conflicto de roles, baja autonomía, relación negativa entre enfermera y médico, apoyo deficiente del administrador/jefe, liderazgo deficiente, relación negativa de equipo e inseguridad laboral. Entre los resultados del agotamiento, se encontró un desempeño laboral reducido, mala calidad de la atención, mala seguridad del paciente, eventos adversos, experiencia negativa del paciente, errores de medicación, infecciones, caídas del paciente e intención de renunciar. Los patrones identificados por estos estudios muestran consistentemente que las características adversas del trabajo están asociadas con el agotamiento en la enfermería. Las posibles consecuencias para el personal y los pacientes son graves. La literatura sobre el agotamiento en enfermería en parte apoya la teoría de Maslach, pero algunas áreas no están suficientemente probadas, en particular, la asociación entre el agotamiento y la rotación, y se encontraron relaciones solo para algunas dimensiones de la Escala de Maslach.
Descargas
Referencias
Dall’Ora C, Ball J, Recio-Saucedo A, Griffiths P. Characteristics of shift work and their impact on employee performance and wellbeing: a literature review. Int J Nurs Stud. 2016;57:12–27
Griffiths P, Ball J, Drennan J, Dall’Ora C, Jones J, Maruotti A, et al. Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development. Int J Nurs Stud. 2016;63:213–225
Cummings GG, MacGregor T, Davey M, Lee H, Wong CA, Lo E, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review. Int J Nurs Stud. 2010;47(3):363– 385
Rafferty AM, Ball J, Aiken LH. Are teamwork and professional autonomy compatible, and do they result in improved hospital care? Qual Health Care. 2001;10(suppl 2):ii32-iii7
Freudenberger HJ. Staff burn-out. J Soc Issues. 1974;30(1):159–165
Maslach C, Jackson SE. The measurement of experienced burnout. J Occup Behav. 1981;2(2):99–113
Maslach C. A Multidimensional theory of burnout. In: Cooper CL, editor. Theories of Organizational Stress Oxford University Press Inc.; 1999
Maslach C, Leiter M. Burnout. Fink G, editor. London, UK: Academic Press; 2016. 351-7 p
Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52(1):397–422
Eks tedt M. Burnout and sleep: Institutionen f ör folkhälsovetenskap/Department of Public Health Sciences. 2005
Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. The job demands- resources model of burnout. J Appl Psychol. 2001;86(3):499
Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career Dev Int. 2009;14(2-3):204–220
Cherniss C. Burnout in new professionals: a long-term follow-up study. J Health Hum Resour Adm. 1989;12(1):11–24
Gus tavsson JP, Hallsten L, Rudman A. Early career burnout among nurses: modelling a hypothesized process using an item response approach. Int J Nurs Stud. 2010;47(7):864–875
Shir om A. Job-related burnout: a review. Handbook of occupational health psychology. Washington, DC, US: American Psychological Association; 2003. p. 245-264
Melamed S, Kushnir T, Shirom A. Burnout and risk factors for cardiovascular diseases. Behav Med. 1992;18(2):53–60
Cam pbell M, Egan M, Lorenc T, Bond L, Popham F, Fenton C, et al. Considering methodological options for reviews of theory: illustrated by a review of theories linking income and health. Syst Rev. 2014;3(1):114
Pare G, Trudel MC, Jaana M, Kitsiou S. Synthesizing information systems knowledge: a typology of literature reviews. Inf Manag. 2015;52(2):183– 199
Lavoie P, Michaud C, Bélisle M, Boyer L, Gosselin É, Grondin M, et al. Learning theories and tools for the assessment of core nursing competencies in simulation: a theoretical review. J Adv Nurs. 2018;74(2):239–250
Thom pson D. The examination of practice environment, burnout, and missed care on pressure ulcer prevalence rates using a complexity science framework: University of Kansas; 2014
Parker PA, Kulik JA. Burnout, self- and supervisor-rated job performance, and absenteeism among nurses. J Behav Med. 1995;18(6):581–599
Maslach C, Jackson SE, Leiter M. Maslach burnout inventory manual. 3rd ed. ed: Mind Garden, Inc.; 2010
Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress. 2005;19(3):192–207
Malach-Pines A. The burnout measure, short version. Int J Stress Manag. 2005;12(1):78–88
Hunsak er S, Chen HC, Maughan D, Heaston S. Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. J Nurs Scholarsh. 2015;47(2):186–194
Rudman A, Gustavsson JP. Early-career burnout among new graduate nurses: a prospective observational study of intra-individual change trajectories. Int J Nurs Stud. 2011;48(3):292–306
Leiter MP, Maslach C. Areas of worklife survey manual. Centre for Organizational Research and Development, Acadia University, Wolfville. 2006
Boamah SA, Laschinger H. The influence of areas of worklife fit and work- life interference on burnout and turnover intentions among new graduate nurses. J Nurs Manag. 2016;24(2):E164–E174
Gr eco P, Laschinger HK, Wong C. Leader empowering behaviours, staff nurse empowerment and work engagement/burnout. Nurs Leadersh (Tor Ont) 2006;19(4):41–56
Laschinger HK, Borgogni L, Consiglio C, Read E. The effects of authentic leadership, six areas of worklife, and occupational coping self-efficacy on new graduate nurses ’ burnout and mental health: a cross-sectional study. Int J Nurs Stud. 2015;52(6):1080–1089
Laschinger HK, Read EA. The effect of authentic leadership, person-job fit, and civility norms on new graduate nurses ’ experiences of coworker incivility and burnout. J Nurs Adm. 2016;46(11):574–580
Flynn L, Thomas-Hawkins C, Clarke SP. Organizational traits, care processes, and burnout among chronic hemodialysis nurses. West J Nurs Res. 2009;31(5):569–582
K owalski C, Ommen O, Driller E, Ernstmann N, Wirtz MA, Kohler T, et al. Burnout in nurses – the relationship between social capital in hospitals and emotional exhaustion. J Clin Nurs. 2010;19(11-12):1654–1663
K onstantinou AK, Bonotis K, Sokratous M, Siokas V, Dardiotis E. Burnout evaluation and potential predictors in a Greek cohort of mental health nurses. Arch Psychiatr Nurs. 2018;32(3):449–456
Leit er MP, Maslach C. Nurse turnover: the mediating role of burnout. J Nurs Manag. 2009;17(3):331–339
V an Bogaert P, Kowalski C, Weeks SM, Van Heusden D, Clarke SP. The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: a cross-sectional survey. Int J Nurs Stud. 2013;50(12):1667–1677
Janssen PP, Jonge JD, Bakker AB. Specific determinants of intrinsic work motivation, burnout and turnover intentions: a study among nurses. J Adv Nurs. 1999;29(6):1360–1369
Andela M, Truchot D, Van der Doef M. Job stressors and burnout in hospitals: the mediating role of emotional dissonance. Int J Stress Manag. 2016;23(3):298–317
Levert T, Lucas M, Ortlepp K. Burnout in psychiatric nurses: contributions of the work environment and a Sense of Coherence. S Afr J Psychol. 2000;30(2):36–43
Galletta M, Portoghese I, Ciuffi M, Sancassiani F, Aloja E, Campagna M. Working and environmental factors on job burnout: a cross-sectional study among nurses. Clin Pract Epidemiol Ment Health. 2016;12:132–141
Kitaoka-Higashiguchi K. Burnout as a developmental process among Japanese nurses: investigation of Leiter ’s model. Jpn J Nurs Sci. 2005;2(1):9–16
Gr eenglass ER, Burke RJ, Fiksenbaum L. Workload and burnout in nurses. J Community Appl Soc Psychol. 2001;11(3):211–215
Madathil R, Heck NC, Schuldberg D. Burnout in psychiatric nursing: examining the interplay of autonomy, leadership style, and depressive symptoms. Arch Psychiatr Nurs. 2014;28(3):160–166
Le wis HS, Cunningham CJ. Linking nurse leadership and work characteristics to nurse burnout and engagement. Nurs Res. 2016;65(1):13–23
L u M, Ruan H, Xing W, Hu Y. Nurse burnout in China: a questionnaire survey on staffing, job satisfaction, and quality of care. J Nurs Manag. 2015;23(4):440–447
Dhaini SR, Denhaerynck K, Bachnick S, Schwendimann R, Schubert M, De Geest S, et al. Work schedule flexibility is associated with emotional exhaustion among registered nurses in Swiss hospitals: a cross-sectional study. Int J Nurs Stud. 2018;82:99–105
Aik en LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of hospital care environment on patient mortality and nurse outcomes. J Nurs Adm. 2008;38(5):223–229
Aik en LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288(16):1987–1993
Zhou W, He G, Wang H, He Y, Yuan Q, Liu D. Job dissatisfaction and burnout of nurses in Hunan, China: A cross-sectional survey. Nurs Health Sci. 2015;17(4):444–450
Hanr ahan NP, Aiken LH, McClaine L, Hanlon AL. Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals. Issues Ment Health Nurs. 2010;31(3):198–207
Liu X, Zheng J, Liu K, Baggs JG, Liu J, Wu Y, et al. Hospital nursing organizational factors, nursing care left undone, and nurse burnout as predictors of patient safety: a structural equation modeling analysis. Int J Nurs Stud. 2018;86:82–89
Akman O, Ozturk C, Bektas M, Ayar D, Armstrong MA. Job satisfaction and burnout among paediatric nurses. J Nurs Manag. 2016;24(7):923– 933
Faller MS, Gates MG, Georges JM, Connelly CD. Work-related burnout, job satisfaction, intent to leave, and nurse-assessed quality of care among travel nurses. J Nurs Adm. 2011;41(2):71–77
Boamah SA, Read EA, Spence Laschinger HK. Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time-lagged study. J Adv Nurs. 2017;73(5):1182–1195
K anai-Pak M, Aiken LH, Sloane DM, Poghosyan L. Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals. J Clin Nurs. 2008;17(24):3324–3329
Leine weber C, Westerlund H, Chungkham HS, Lindqvist R, Runesdotter S, Tishelman C. Nurses ’ practice environment and work-family conflict in relation to burn out: a multilevel modelling approach. PLoS One. 2014;9(5):e96991
Leiter MP, Spence Laschinger HK. Relationships of work and practice environment to professional burnout: testing a causal model. Nurs Res. 2006;55(2):137–146
A dali E, Priami M, Evagelou H, Mougia V, Ifanti M, Alevizopoulos G. Burnout in psychiatric nursing personnel in Greek hospitals. European Journal of Psychiatry. 2003;17(3):173–181
Cao X, Naruse T. Effect of time pressure on the burnout of home-visiting nurses: the moderating role of relational coordination with nursing managers. Jpn J Nurs Sci. 2019;16(2):221–231
Jansen PG, Kerkstra A, Abu-Saad HH, van der Zee J. The effects of job characteristics and individual characteristics on job satisfaction and burnout in community nursing. Int J Nurs Stud. 1996;33(4):407–421
Gandi JC, Wai PS, Karick H, Dagona ZK. The role of stress and level of burnout in job performance among nurses. Ment Health Fam Med. 2011;8(3):181–194
Vido tti V, Ribeiro RP, Galdino MJQ, Martins JT. Burnout syndrome and shift work among the nursing staff. Rev Lat Am Enfermagem. 2018;26:e3022
Shamian J, Kerr MS, Laschinger HK, Thomson D. A hospital-level analysis of the work environment and workforce health indicators for registered nurses in Ontario ’s acute-care hospitals. Can J Nurs Res. 2002;33(4):35– 50
Rouxel G, Michinov E, Dodeler V. The influence of work characteristics, emotional display rules and affectivity on burnout and job satisfaction: a survey among geriatric care workers. Int J Nurs Stud. 2016;62:81–89
Colindr es CV, Bryce E, Coral-Rosero P, Ramos-Soto RM, Bonilla F, Yassi A. Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses. Int Nurs Rev. 2018;65(2):190–199
Shao J, Tang L, Wang X, Qiu R, Zhang Y, Jia Y, et al. Nursing work environment, value congruence and their relationships with nurses’ work outcomes. J Nurs Manag. 2018;26(8):1091–1099
Molone y W, Boxall P, Parsons M, Cheung G. Factors predicting registered nurses’ intentions to leave their organization and profession: a job demands-resources framework. J Adv Nurs. 2018;74(4):864–875
An war MM, Elareed HR. Burnout among Egyptian nurses. Journal of Public Health-Heidelberg. 2017;25(6):693–697
Wisetborisut A, Angkurawaranon C, Jiraporncharoen W, Uaphanthasath R, Wiwatanadate P. Shift work and burnout among health care workers. Occup Med (Lond) 2014;64(4):279–286
Ilhan MN, Durukan E, Taner E, Maral I, Bumin MA. Burnout and its correlates among nursing staff: questionnaire survey. J Adv Nurs. 2008;61(1):100–106
Canadas-De la Fuente GA, Vargas C, San Luis C, Garcia I, Canadas GR, De la Fuente EI. Risk factors and prevalence of burnout syndrome in the nursing profession. Int J Nurs Stud. 2015;52(1):240–249
Bagheri Hosseinabadi M, Ebrahimi MH, Khanjani N, Biganeh J, Mohammadi S, Abdolahfard M. The effects of amplitude and stability of circadian rhythm and occupational stress on burnout syndrome and job dissatisfaction among irregular shift working nurses. J Clin Nurs. 2019;28(9-10):1868–1878
Khamisa N, Peltzer K, Ilic D, Oldenburg B. Work related stress, burnout, job satisfaction and general health of nurses: a follow-up study. Int J Nurs Pract. 2016;22(6):538–545
Dall ’Ora C, Griffiths P, Ball J, Simon M, Aiken LH. Association of 12 h shifts and nurses ’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open. 2015;5(9):e008331
Stimpfel AW, Sloane DM, Aiken LH. The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Aff (Millwood) 2012;31(11):2501–2509
P oncet MC, Toullic P, Papazian L, Kentish-Barnes N, Timsit JF, Pochard F, et al. Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med. 2007;175(7):698–704
S tone PW, Du Y, Gershon RR. Organizational climate and occupational health outcomes in hospital nurses. J Occup Environ Med. 2007;49(1):50– 58
Bourbonnais R, Comeau M, Vezina M, Dion G. Job strain, psychological distress, and burnout in nurses. Am J Ind Med. 1998;34(1):20–28
Basinsk a BA, Wilczek-Ruzyczka E. The role of rewards and demands in burnout among surgical nurses. Int J Occup Med Environ Health. 2013;26(4):593–604
Gar cia-Sierra R, Fernandez-Castro J, Martinez-Zaragoza F. Relationship between job demand and burnout in nurses: does it depend on work engagement? J Nurs Manag. 2016;24(6):780–788
Laeeq ue SH, Bilal A, Babar S, Khan Z, Rahman SU. How patient- perpetrated workplace violence leads to turnover intention among nurses: the mediating mechanism of occupational stress and burnout. J Aggress Maltreat Trauma. 2018;27(1):96–118
Laschinger HKS, Shamian J, Thomson D. Impact of magnet hospital characteristics on nurses ’ perceptions of trust, burnout, quality of care, and work satisfaction. Nurs Econ. 2001;19(5):209–219
Li B, Bruyneel L, Sermeus W, Van den Heede K, Matawie K, Aiken L, et al. Group-level impact of work environment dimensions on burnout experiences among nurses: a multivariate multilevel probit model. Int J Nurs Stud. 2013;50(2):281–291
Van Bogaert P, Meulemans H, Clarke S, Vermeyen K, Van de Heyning P. Hospital nurse practice environment, burnout, job outcomes and quality of care: test of a structural equation model. J Adv Nurs. 2009;65(10):2175–2185
Laschinger HKS, Leiter MP. The impact of nursing work environments on patient safety outcomes – the mediating role of burnout/engagement. J Nurs Adm. 2006;36(5):259–267
Garrett DK, McDaniel AM. A new look at nurse burnout: the effects of environmental uncertainty and social climate. J Nurs Adm. 2001;31(2):91–96
Bobbio A, Bellan M, Manganelli AM. Empowering leadership, perceived organizational support, trust, and job burnout for nurses: a study in an Italian general hospital. Health Care Manag Rev. 2012;37(1):77–87
Spence Laschinger HK, Wong CA, Grau AL. The influence of authentic leadership on newly graduated nurses ’ experiences of workplace bullying, burnout and retention outcomes: a cross-sectional study. Int J Nurs Stud. 2012;49(10):1266–1276
Lee HF, Chiang HY, Kuo HT. Relationship between authentic leadership and nurses’ intent to leave: the mediating role of work environment and burnout. J Nurs Manag. 2019;27(1):52–65
Kanste O, Kyngas H, Nikkila J. The relationship between multidimensional leadership and burnout among nursing staff. J Nurs Manag. 2007;15(7):731–739
Lak e ET. Development of the practice environment scale of the Nursing Work Index. Res Nurs Health. 2002;25(3):176–188
N antsupawat A, Kunaviktikul W, Nantsupawat R, Wichaikhum OA, Thienthong H, Poghosyan L. Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. Int Nurs Rev. 2017;64(1):91–98
V ahey DC, Aiken LH, Sloane DM, Clarke SP, Vargas D. Nurse burnout and patient satisfaction. Med Care. 2004;42(2 Suppl):II57–II66
Klopper HC, Coetzee SK, Pretorius R, Bester P. Practice environment, job satisfaction and burnout of critical care nurses in South Africa. J Nurs Manag. 2012;20(5):685–695
Zhang LF, You LM, Liu K, Zheng J, Fang JB, Lu MM, et al. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nurs Outlook. 2014;62(2):128–137
Liu Y, Aungsuroch Y. Factors influencing nurse-assessed quality nursing care: a cross-sectional study in hospitals. J Adv Nurs. 2018;74(4):935–945
Mar ques-Pinto A, Jesus EH, Mendes A, Fronteira I, Roberto MS. Nurses ’ intention to leave the organization: a mediation study of professional burnout and engagement. Span J Psychol. 2018;21:E32
Aiken LH, Sloane DM. Effects of organizational innovations in AIDS care on burnout among urban hospital nurses. Work Occup. 1997;24(4):453– 477
Spence Laschinger HK, Leiter M, Day A, Gilin D. Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes. J Nurs Manag. 2009;17(3):302–311
Dutra HS, Cimiotti JP, Guirardello EB. Nurse work environment and job- related outcomes in Brazilian hospitals. Appl Nurs Res. 2018;41:68–72
Laschinger HK. Job and career satisfaction and turnover intentions of newly graduated nurses. J Nurs Manag. 2012;20(4):472–484
Es tryn-Behar M, Van der Heijden BI, Oginska H, Camerino D, Le Nezet O, Conway PM, et al. The impact of social work environment, teamwork characteristics, burnout, and personal factors upon intent to leave among European nurses. Med Care. 2007;45(10):939–950
Basar U, Basim N. A cross-sectional survey on consequences of nurses ’ burnout: moderating role of organizational politics. J Adv Nurs. 2016;72(8):1838–1850
V an Bogaert P, Timmermans O, Weeks SM, van Heusden D, Wouters K, Franck E. Nursing unit teams matter: impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events– a cross- sectional survey. Int J Nurs Stud. 2014;51(8):1123–1134
Firth H, Britton P. Burnout, absence and turnover amongst British nursing staff. J Occup Psychol. 1989;62(1):55–59
Giorgi F, Mattei A, Notarnicola I, Petrucci C, Lancia L. Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study. J Adv Nurs. 2018;74(3):698–708
Tourigny L, Baba VV, Wang XY. Burnout and depression among nurses in Japan and China: the moderating effects of job satisfaction and absence. Int J Hum Resour Manag. 2010;21(15):2741–2761
Johnson J, Louch G, Dunning A, Johnson O, Grange A, Reynolds C, et al. Burnout mediates the association between depression and patient safety perceptions: a cross-sectional study in hospital nurses. J Adv Nurs. 2017;73(7):1667–1680
Nantsupawat A, Nantsupawat R, Kunaviktikul W, Turale S, Poghosyan L. Nurse burnout, nurse-reported quality of care, and patient outcomes in Thai hospitals. J Nurs Scholarsh. 2016;48(1):83–90
Poghosyan L, Clarke SP, Finlayson M, Aiken LH. Nurse burnout and quality of care: cross-national investigation in six countries. Res Nurs Health. 2010;33(4):288–298
Zarei E, Khakzad N, Reniers G, Akbari R. On the relationship between safety climate and occupational burnout in healthcare organizations. Saf Sci. 2016;89:1–10
Halbesleben JR, Wakefield BJ, Wakefield DS, Cooper LB. Nurse burnout and patient safety outcomes: nurse safety perception versus reporting behavior. West J Nurs Res. 2008;30(5):560–577
Teng CI, Shyu YI, Chiou WK, Fan HC, Lam SM. Interactive effects of nurse- experienced time pressure and burnout on patient safety: a cross- sectional survey. Int J Nurs Stud. 2010;47(11):1442–1450
Cimiotti JP, Aiken LH, Sloane DM, Wu ES. Nurse staffing, burnout, and health care-associated infection. Am J Infect Control. 2012;40(6):486– 490
Antonakis J, Bendahan S, Jacquart P, Lalive R. On making causal claims: a review and recommendations. Leadersh Q. 2010;21(6):1086–1120
Maben J, Latter S, Clark JM. The sustainability of ideals, values and the nursing mandate: evidence from a longitudinal qualitative study. Nurs Inq. 2007;14(2):99–113
Publicado
Número
Sección
Licencia
Derechos de autor 2020 Marizza Marlene Arrieta-Valdéz (Autor/a)
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Los artículos publicados en la Revista UniNorte de Medicina y Ciencias de la Salud se distribuyen bajo una licencia Creative Commons Reconocimiento 4.0 Internacional (CC BY 4.0).
Esta licencia permite a cualquier usuario copiar, distribuir, adaptar, transformar y construir a partir del material para cualquier propósito, incluso comercial, siempre que se otorgue el crédito adecuado a los autores y a la fuente original de publicación.
Los autores conservan los derechos de autor y otorgan a la revista el derecho de primera publicación.
La reutilización del contenido deberá reconocer la autoría, citar la fuente original e indicar si se han realizado modificaciones.
