Tono R. (2015). Professional Nursing Governance: A qualitative systemic review and transcultural adaptation from the Index of Professional Nursing Governance for use in Brazil. Federal University of Santa Catalina. (Portuguese)
Professional governance in nursing can be understood as a model and structure of organizational management that gives nurses more control over decisions in their professional practice, contributing to greater autonomy practice as well. In 1994, Dr. Robert Hess, a North American researcher, created an instrument, the Index of Professional Nursing Governance (IPNG), to measure professional governance. The IPNG has 86 items divided into six subscales: control over personnel, access to information, influence over resources supporting practice, ability to participate, control over practice, and the ability to set goals and resolve conflict.
The IPNG measures the type of professional governance of a hospital, with scores varying between 86 to 430 points. A five-point Likert scale is used for answering item questions. Low scores identify a traditional management model, where managers make decisions without staff participation, while high scores shows a shared governance or self-governed model, where decisions are made exclusively by staff. Middle scores reflect shared governance where managers and staff share decision-making.
The IPNG has been used widely in USA for more than 20 years to measure shared governance, and shared governance is gaining ground in the international arena as it relates to greater satisfaction and retention of nurses. The goal of this study was to demonstrate the relationships between experiences and management practices of Brazilian nurses and professional nursing governance in the hospital environment and complete a transcultural adaptation of IPNG to the Brazilian Portuguese language. The ethics committee of the Federal University of Santa Catarina approved the research project (CAAE:38860614.5.0000.0114). An assumption of this study is that the theoretical approximation of professional nursing governance relates to nursing management in a Brazilian context.
Research was conducted in two phases: A qualitative and systematic review of literature and a methodological study of the transcultural adaptation of INPG. During the systematic review phase 1,446 articles from PUBMED, LILACS, BDENF and SCIELO were analyzed. Articles were read and critically evaluated based on the Critical Appraisal Skills Programme (CASP). The next step was data systematization on the analysis category. Data extraction was based on the professional nursing governance model and the findings after extraction pointed to quantitative order synthesis.
The transcultural adaptation involved the following phases: initial translation, synthesis of translation, back translation, synthesis of back translation, jury committee and pretest. In all those phases the author of IPNG was aware about the suggested changes. The pretest was performed at the University Hospital, Prof. Polydoro Ernani de São Thiago, in Florianópolis city, state of Santa Catarina in Brazil. The instrument was applied to a random sample of 52 nurses. After that the data was submitted to statistical analysis using the software Statistical Package for the Social Sciences (SPSS), version 13.0. The statistical data was considered significant with a Cronbach correlation coefficient of 0.9, showing an adequate internal confidence level. It was concluded that IPNG is likely to be successfully used in Brazil. However, validation of the IPNG in Brazil will need a bigger sample with subsequent psychometric analysis.