ArticleBMC health services research2026
Work environment of nurses and technicians in Brazilian Intensive Care Units during the COVID-19 pandemic: a multicenter cross-sectional study.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFavorable 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.
methodsAn 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.
resultsOf 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).
conclusionsWork 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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