title: Nursing work: challenges for health management in the northeast of Brazil.
abstract: OBJECTIVE
  Social exchange theory is used as the framework to examine the interaction between supervisor-subordinate relationships, training and affective commitment for Northeast Brazilian public sector nursing professionals.
  
  
  BACKGROUND
  There are continuing challenges to nursing management worldwide in terms of the supply of nursing professionals, their work relationships, nurse training and commitment to their employing organisations. The interplay between these factors for nurses in the Northeast of Brazil has not been well understood.
  
  
  METHODS
  Quantitative data were collected from 550 nursing professionals using a cross-sectional, survey-base design. Qualitative data were collected from 25 participants using in-depth interviews and focus group discussions.
  
  
  RESULTS
  Using path analysis, and the ordinary least squares approach, the findings demonstrated a significant, but weak, linkage between supervisor-subordinate relationships, training and organisational commitment. The qualitative data suggest that contracting out may be a causative factor.
  
  
  CONCLUSIONS
  Healthcare managers in Brazil need to create more positive environments to strengthen supervisor-nurse relationships, improve the provision of training and to strengthen organisational commitment.
  
  
  CONCLUSIONS
  Healthcare policy-makers in hospital can make significant contributions to improving organisational commitment by reducing multiple job holding, improving the ratio of registered nurses to nursing technicians/assistants and beginning nurse supervision training in effective people management.
authors: School of Commerce and Management, Southern Cross University, Gold Coast, Queensland, Australia.
authors: Silvia Azevedo
authors: SA
authors: Nelson
authors: Patricia Ribeiro
authors: PR
authors: Azevedo
authors: Rosilda Silva
authors: RS
authors: Dias
authors: Santana de Maria Alves
authors: Sde M
authors: de Sousa
authors: Liscia Divana Pacheco
authors: LD
authors: de Carvalho
authors: Andrea Cristina Oliveira
authors: AC
authors: Silva
authors: Poliana Pereira Costa
authors: PP
authors: Rabelo
mesh_terms: D000328:Adult; D001938:Brazil; D003284:Contract Services; D003430:Cross-Sectional Studies; D004651:Employment / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D009718:Nurse Administrators; D009726:Nurses / Q000191:economics / Q000706:statistics & numerical data; D015401:Nursing Administration Research; D017150:Public Sector; D012456:Salaries and Fringe Benefits; D011795:Surveys and Questionnaires
keywords: affective commitment; nursing management; public sector; supervisor-subordinate relationship; training