Work environment of nurses and technicians in Brazilian Intensive Care Units during the COVID-19 pandemic: a multicenter cross-sectional study

Favorable nursing work environments are associated with better outcomes and well-being, yet the COVID-19 pandemic intensified workload and stress in intensive care settings. This exploratory descriptive study examined associations between sociodemographic and work-related factors and nursing work environment scores among registered nurses and nursing technicians working in exclusive COVID-19 ICUs in 10 public university hospitals. An exploratory descriptive multicenter cross-sectional study was conducted between April and December 2021. The Portuguese version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) was administered, along with sociodemographic and work-related items, which were analyzed as potential explanatory factors of work-environment perceptions. Data were analyzed using descriptive and comparative statistics (t-tests, Mann–Whitney tests, χ² tests). Reliability was assessed with Cronbach’s α. Of 996 eligible professionals, 431 responded (43.3%): 194 nurses (45%) and 237 nurse technicians (55%). Participants were predominantly female (78%) with a mean age of 40.9 ± 9.1 years. Technicians were older (42.3 ± 9.8) than nurses (39.2 ± 8.0; p < 0.001). Race/color distributions differed (White: nurses 58.8% vs. technicians 41.8%; Black: 37.6% vs. 57.4%; p < 0.001). Most received institutional COVID-19 training (80%) and reported feeling protected at work (71.7%). PES-NWI internal consistency was excellent (total α = 0.94). All subscale means exceeded 2.5; technicians rated four subscales— participation in hospital affairs, foundations for quality, staffing/resources, and nurse/physician relations —higher than nurses did, while leadership support showed no difference. The total PES-NWI score was higher for technicians (2.98 ± 0.60 vs. 2.83 ± 0.58; p = 0.013). Work environments in COVID-19 ICUs of Brazilian public university hospitals were generally perceived as favorable. Differences between categories likely reflect variations in job roles and expectations rather than causal effects. As an exploratory descriptive study, findings should be interpreted as associative and hypothesis-generating, supporting future research on equity, management practices, and workforce well-being in critical care.

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Journal
BMC Health Services Research
Published
2026-03-11
DOI
https://doi.org/10.1186/s12913-026-14309-4
Primary Topic
Nursing education and management
Type
article
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article

Work environment of nurses and technicians in Brazilian Intensive Care Units during the COVID-19 pandemic: a multicenter cross-sectional study

Liana Amorim Corrêa Trotte, MARIA GEFÉ DA ROSA MESQUITA, Gabriela Marcellino de Melo Lanzoni, Danielle Saraiva Tuma dos Reis et al.
BMC Health Services Research
Nursing education and management
article

Work environment of nurses and technicians in Brazilian Intensive Care Units during the COVID-19 pandemic: a multicenter cross-sectional study

Liana Amorim Corrêa Trotte, MARIA GEFÉ DA ROSA MESQUITA, Gabriela Marcellino de Melo Lanzoni, Danielle Saraiva Tuma dos Reis, Allison Patricia Squires, Graciele Oroski Paes, Etiane Oliveira Freitas, Silviamar Camponogara, Fernando Henrique Antunes Menegon, Alexandre Pazetto Balsanelli, José Luís Guedes dos Santos, Alacoque Lorenzini Erdmann, Marluci Andrade Conceição Stipp
article en

Abstract

Favorable nursing work environments are associated with better outcomes and well-being, yet the COVID-19 pandemic intensified workload and stress in intensive care settings. This exploratory descriptive study examined associations between sociodemographic and work-related factors and nursing work environment scores among registered nurses and nursing technicians working in exclusive COVID-19 ICUs in 10 public university hospitals. An exploratory descriptive multicenter cross-sectional study was conducted between April and December 2021. The Portuguese version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) was administered, along with sociodemographic and work-related items, which were analyzed as potential explanatory factors of work-environment perceptions. Data were analyzed using descriptive and comparative statistics (t-tests, Mann–Whitney tests, χ² tests). Reliability was assessed with Cronbach’s α. Of 996 eligible professionals, 431 responded (43.3%): 194 nurses (45%) and 237 nurse technicians (55%). Participants were predominantly female (78%) with a mean age of 40.9 ± 9.1 years. Technicians were older (42.3 ± 9.8) than nurses (39.2 ± 8.0; p < 0.001). Race/color distributions differed (White: nurses 58.8% vs. technicians 41.8%; Black: 37.6% vs. 57.4%; p < 0.001). Most received institutional COVID-19 training (80%) and reported feeling protected at work (71.7%). PES-NWI internal consistency was excellent (total α = 0.94). All subscale means exceeded 2.5; technicians rated four subscales— participation in hospital affairs, foundations for quality, staffing/resources, and nurse/physician relations —higher than nurses did, while leadership support showed no difference. The total PES-NWI score was higher for technicians (2.98 ± 0.60 vs. 2.83 ± 0.58; p = 0.013). Work environments in COVID-19 ICUs of Brazilian public university hospitals were generally perceived as favorable. Differences between categories likely reflect variations in job roles and expectations rather than causal effects. As an exploratory descriptive study, findings should be interpreted as associative and hypothesis-generating, supporting future research on equity, management practices, and workforce well-being in critical care.

BMC Health Services Research
Universidade Federal do Rio de Janeiro (BR), Universidade Federal de Santa Maria (BR), Universidade Federal de Santa Catarina (BR), New York University (US), Universidade Federal do Pará (BR), Universidade Federal do Estado do Rio de Janeiro (BR), Universidade Federal de São Paulo (BR)
Openalex Percentile: Top 25%
Nursing education and management
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