Empowerment and staff nurse decision involvement in nursing work environments: testing Kanter's theory of structural power in organizations.

Abstract

Work redesign initiatives have transformed approaches to patient care that will require increased control of nurses over both the content and context of their practice. A secondary analysis of two studies linking perceived work empowerment with two aspects of staff nurse decisional involvement using Kanter's (1977, 1993) theory of structural power in organizations is described. In these studies, the pattern of relationships among variables in Kanter's theory and two different facets of work decisional involvement (control over the content and context of nursing practice) were examined using structural equation modeling techniques. Consistent with theoretical expectations, perceptions of formal and informal power significantly influenced perceived access to work empowerment structures. Informal power was found to mediate the relationship between formal power and access to work empowerment structures. Formal and informal power and access to empowerment structures, in combination, were found to be significant predictors of the extent of involvement in decisions related to the content and context of nursing practice, respectively. The results provide empirical support for propositions derived from Kanter's theory of work empowerment, and provide potential guidance for theory-based management practices to enhance nurses' involvement in professional and organizational decision making.