Psychological Empowerment Scale Research Articles

The effect of practice environments and psychological empowerment perceptions of nurses on their care behaviours: A cross-sectional study.

The aim of this study was to examine the effect of professional and individual characteristics, practice environments and psychological empowerment perceptions of nurses on their care behaviours. The study used a cross-sectional research design following the STROBE guidelines. The sample of this descriptive and correlational study consisted of 584 nurses working in a university hospital in Turkey. The data were collected between January and June 2023 using the Nursing Information Form, the Practice Environment Scale of the Nursing Work Index (PES-NWI), the Psychological Empowerment Scale (PES), and the Caring Behaviours Scale-30, and analysed using descriptive statistics, Spearman's correlation and multiple linear regression. It was determined that PES-NWI, PES andCaring Behaviours Scale(CBI-30) scores of nurses were higher than the average. The study revealed that certain professional and individual characteristics of nurses, practice environments and psychological empowerment perceptions had an effect on their care behaviours. The results of the study showed that nurses' PES-NWI, PES and CBI-30 scores were higher than the average, and that certain professional and individual characteristics of nurses, practice environments and psychological empowerment perceptions had an effect on care behaviours. Nursing service managers, in particular, are required to understand the importance of this relationship and create appropriate working conditions which are integrated with psychological empowerment to improve caring behaviours of nurses.

JOB SATISFACTION OF TEACHERS AS INFLUENCED BY PUBLIC LEADERSHIP BEHAVIORS AND PSYCHOLOGICAL EMPOWERMENT: A CONVERGENT DESIGN

This mixed methods study employs a convergent design to explore the job satisfaction of public elementary school teachers in Region XI by examining the influence of public leadership behaviors and psychological empowerment. Quantitative data were collected from 300 teachers across 20 public elementary schools using the Public Leadership Behaviors Questionnaire, the Psychological Empowerment Scale, and the Job Satisfaction Questionnaire (JS-Q). The quantitative analysis utilized mean, standard deviation, and multiple regression. The results revealed that public leadership and psychological empowerment significantly predict job satisfaction, F(2, 296) = 115.33, p < .05. Additionally, qualitative data were gathered through in-depth interviews (IDI) with 10 teachers and focus group discussions (FGD) with 7 teachers. Qualitative thematic analysis highlighted the participants’ experiences, the impact of grouping variables, and the influence of these experiences on their beliefs and attitudes. The joint display of findings from both approaches indicated a convergence of data, emphasizing the role of public leadership and psychological empowerment in enhancing job satisfaction. Based on these results, a series of recommendations was formulated and proposed to further improve teacher job satisfaction. KEYWORDS: Education, public leadership behaviors, psychological empowerment, job satisfaction of teachers, convergent design, Philippines

Exploring the influence of the spiritual climate on psychological empowerment among nurses in China: a cross-sectional study

BackgroundPsychological empowerment notably impacts nurses’ work engagement and high-quality care. A spiritual climate is a work environment that respects individuals and encourages them to express personal views. Previous studies have shown that a spiritual climate enhances psychological empowerment, however, the relationship between them among the nursing population remains unclear. This study aimed to explore the effect of a spiritual climate on nurses’ psychological empowerment and provide a scientific basis for improving psychological empowerment among nurses.MethodsA cross-sectional survey of 837 nurses from five hospitals in Sichuan Province, Southwest China, was conducted using a convenience sampling method; this survey included nurses’ demographic characteristics, the Psychological Empowerment Scale (PES), and the Chinese version of the Spiritual Climate Scale (C-SCS). The data were analysed using one-way analysis of variance (ANOVA), correlation analysis, and multiple linear regression.ResultsThe sample of 837 nurses attained a psychological empowerment score of (45.49 ± 6.42) and a spiritual climate score of (75.25 ± 16.75). The one-way ANOVA revealed that psychological empowerment scores among nurses varied based on differences in age, department, years of work experience, professional title, level of work intensity, and children (yes/no). Pearson’s correlation analyses revealed a significant positive correlation between the spiritual climate and nurses’ psychological empowerment (r = 0.564, P < 0.001), and multiple linear regression analysis showed that working in the intensive care unit (ICU), work intensity, and the four items pertaining to spiritual climate influenced nurses’ psychological empowerment, explaining 32.6% of the total variance in psychological empowerment.ConclusionThe findings suggested that the spiritual climate perceived by nurses and psychological empowerment are moderately high. Working in the ICU, work intensity, and the four items pertaining to spiritual climate influence nurses’ psychological empowerment. Nursing managers should pay attention to the daily work intensity of nurses, especially ICU nurses, organize work tasks reasonably, promote dynamic and balanced nurse human resource deployment based on patients’ conditions and nurses’ workloads, and implement scientific scheduling plans to establish a positive spiritual climate in the workplace. Additionally, group workshops and systematic training programs can effectively enhance psychological empowerment among nurses.

Psychological empowerment and its relationship to organizational anomie and enhancing creative behavior among employees in the Saudi Ministry of sports

The purpose of this study was to examine the relationship between psychological empowerment, organizational deviation and creative behavior among employees of the Saudi Ministry of sports. The researchers employed a descriptive approach specifically using a survey study method to collect data. The study sample consisted of 1480 participants who were deliberately selected from different categories within the study population. Data was collected using the psychological empowerment scale and questionnaires. The findings revealed that the level of psychological empowerment among employees of the Saudi Ministry of sports was determined to be 60.60%. Additionally, the level of organizational deviation was found to be 52.40% while the level of creative behavior was measured at 51.20%. The study also identified a significant relationship between psychological empowerment, organizational deviation and creative behavior. The study proposes several recommendations based on its findings. Firstly, it suggests promoting a culture of psychological empowerment within sports institutions to enhance organizational effectiveness and encourage employee creative behavior. This can be achieved through initiatives that empower individuals, give them autonomy and involve them in decision-making processes. Secondly, the study recommends the implementation of development and training programs for employees in sports institutions and departments. These programs should focus on reducing organizational disintegration and fostering creative behavior. Organizations can create an environment that supports innovation and collaboration by providing employees with the necessary skills and knowledge. Furthermore, the study highlights the importance of respecting and considering employee motivations and behaviors in organizational management.

Psychometric evaluation of the Chinese version of the service user psychological empowerment scale in a sample of youth service users

ABSTRACT This study aimed to evaluate the psychometric properties of the translated Chinese version of the Service User Psychological Empowerment Scale (C-SUPES) in a youth service setting in Hong Kong. Data were collected from a cross-sectional survey of 381 youth residing in Hong Kong and participating in services provided by community-based children and youth services centres. The results of confirmatory factor analysis indicate a good fit for the proposed threefold factor structure with the original Positive Attitude and Involved Attitude subscales combined. The scale’s criterion validity was supported by significant correlations between creative self-efficacy, youth – adult partnerships, and civic engagement in the community, and its internal consistency reliability was satisfactory. Overall, youth service users with a higher level of participation in youth services reported a higher level of psychological empowerment. Altogether, the results suggest that C-SUPES is a reliable, valid instrument for measuring psychological empowerment among youth service users in Hong Kong.

Validation of the Psychological Empowerment Scale and Client-Centered Care Questionnaire in budget holders with disabilities

Purpose Several high-income countries install Cash-for-Care Schemes (CCSs) by granting budgets to care users. However, little quantitative evidence exist on empowerment and client-centered care levels, due to a lack of validated scales. This research aimed to validate the Psychological Empowerment Scale (PE scale) and Client-Centered Care Questionnaire (CCCQ) in budget holders with disabilities. Methods A survey was developed based on a literature review and experts and budget holders input. Principal Axis Factoring with direct oblimin rotation, Cronbach’s Alpha, and hypotheses testing with socio-demographic and budget characteristics as independent variables, and PE scale and CCCQ as dependent, were undertaken to assess both scales’ internal consistency and validity. Results A convenience sample of 224 Flemish (proxy) budget holders completed the survey. Our analysis showed a two-factor solution for both scales; for the PE scale consisting of “meaning” and “competence,” and “self-determination” and “impact,” for CCCQ consisting of items 1–7 (conduct by caregiver) and items 8–15 (autonomy). Cronbach’s Alpha of both scales was 0.94. The majority of our hypotheses were confirmed. Conclusions The findings show that both scales are valid and internally consistent, meaning that they can be further tested in a respondent sample of people with disabilities and in other care contexts.

The Impact of Psychological Empowerment on Workforce Agility in Organization X

This study aims to determine the effect of psychological empowerment on labour agility in the State Civil Apparatus at Agency X. This questionnaire is based on the Labour Agility Scale and Psychological Empowerment Scale measures. The results of the regression test showed that psychological empowerment has a significant influence on workplace agility, with a large effect size of 56.2%. In addition, the descriptions of both variables, psychological empowerment and workforce agility, are categorised as moderate. The findings of this study are in line with previous research on the impact of psychological empowerment on employees of public and private sector companies in the manufacturing and services sectors in India.

Patterns of occupational commitment among nurses: a latent profile analysis.

Occupational commitment (OC) is a multidimensional construct that predicts turnover intentions. The interindividual variability of nurses' OC merits further exploration. Therefore, this study aims to examine patterns of OC and its relationship with psychological empowerment and job crafting in nurses. A sample of 1,061 nurses was recruited from February 2022 to April 2022 by using a stratified four-stage cluster sampling procedure. A self-report survey included the Psychological Empowerment Scale, Job Crafting Scale, and Occupational Commitment Scale. Latent profile analysis (LPA) was used to examine the patterns of OC. Associations of the latent class membership with individual characteristics, psychological empowerment and job crafting were examined using multinomial logistic regression. Three patterns of OC were identified: (1) "Low OC group" (n = 224, 21.1%); (2) "Moderate OC group" (n = 665, 62.7%); (3) "High OC group" (n = 172, 16.2%). Nurses with higher education, fewer years of service, working in medicine, lower psychological empowerment and lower job crafting had a higher likelihood of belonging to Class 1 (Low OC group). In contrast, nurses working in emergency and with higher psychological empowerment and job crafting were more likely to belong to Class 3 (High OC group). The findings revealed the heterogeneity of occupational commitment among nurses in China and could guide the identification and early intervention of nurses with low level of occupational commitment.

Structural and psychological empowerment among newly graduated nurses and related factors: A mixed methods study.

To discuss the levels of structural empowerment (SE) and psychological empowerment (PE) and the factors that influence perceptions of empowerment among newly graduated nurses (NGNs). Mixed methods study. The quantitative part of the study was conducted with 220 NGNs with <1 year of job experience. The study was conducted between February and May 2023. Focus group discussions were conducted with 30 NGNs. Data were collected by using the Conditions for Work Effectiveness Questionnaire (CWEQ-II), the Psychological Empowerment Scale (PES) and a Semi-Structured Interview Form. Quantitative data were analysed using stepwise regression analysis. Content analysis was used to analyse qualitative data. CWEQ-II and PES were moderate. The regression analysis showed that NGNs' SE scores increased in association with the following factors, including an increase in the total score on the PES, being married/having a partner, working a day shift, having career planning, increased satisfaction with the orientation programmes of the institution and increased satisfaction with the employing institution. As a result of the descriptive analysis of the focus group interviews conducted to determine the empowerment perceptions of NGNs, we identified three contexts along with the associated themes and subthemes. These three contexts were the 'concept of power', 'professional impression' and 'empowerment process'. The results of this study indicate that the SE and PE levels of NGNs are moderate, and their empowerment perceptions are influenced by many factors that can be individual, organizational and work environment relevant. This study's findings will guide policymakers, educators, researchers and administrators in empowering NGNs essential to the healthcare workforce. The paper adheres to the COREQ checklist. No patient or public contribution.

Development and validation of teachers’ psychological empowerment scale in Ethiopian context

The low motivations of teachers in Ethiopia reflect the psychological deempowerment of teachers. Thus, developing a scale is required to know exactly the empowerment level of teachers. Therefore, this study aimed at developing and validating a psychological empowerment scale in the Ethiopian context. The data were gathered from two different groups of 720 teachers (300+420) from 83 schools using a questionnaire. The exploratory factor analysis (EFA) results discovered four dimensions with a total variance of 69.685%. To know the fitness of the instrument in this study, the researcher carried out confirmatory factor analysis (CFA) with the LISREL 8.7 program with 420 participants. RMSEA (RootMean Square Error of Approximation) = .065 level, GFI (Goodness of Fit Index) = .93, adjusted goodness of fit index (AGFI) = .90, incremental fit index (IFI) = .98, relative fit index (RFI) = .96, non-normed fit index (NNFI) = .98 and comparative fit index (CFI) = .98. These values depict the good fitness of the model. Regading reliability, Cronbach’s alpha for goal internalization. Meaning, influence, and competence dimensions were 0.87, 0.842, 0.777, and 0.789, respectively. Total Cronbach’s alpha was .904. For this scale, the Average Variance Extracted and Combined Reliability are more than .7. Thus, the findings revealed that the psychological empowerment Scale, consisting of four dimensions and 15 items, was a valid and reliable instrument in Ethiopian school settings.

Çevik Liderlik ve Yenilikçi Davranışların Psikolojik Güçlendirmeye Olan Etkisinin İncelenmesi

This study focuses on the impact of agile leadership and innovative behaviours on psychological empowerment and its dimensions via a questionnaire form based on the "Agile Leadership Scale", "Innovative Behaviours Scale", and "Psychological Empowerment Scale". The study sample comprises 410 people in the Turkish information and communication industry. The data obtained were analysed with SPSS 21.0 with %95 credibility. Parametric test techniques were used, and the relationship between the scale scores was analysed by Pearson correlation, and regression analysis was used to analyse its effect. The analysis showed that agile leadership and innovative behaviours affect psychological empowerment and the dimensions of competence, autonomy and impact. However, no effect on the meaning dimension can be found. The study highlights the importance of agile leadership and innovative behaviour in encouraging psychological empowerment. The conclusion emphasises that agile improvement is essential to success and how to boost innovative behaviour and psychological empowerment in business. Organisations should take action to improve agile leaders, encourage innovative behaviour and boost psychological empowerment among employees. One of the limitations of the study is that it was conducted in only one sector. The results can be compared by conducting research in different sectors. Further studies can be carried out at regular intervals to obtain more comprehensive findings. In the study, 410 samples were reached. By reaching a larger sample, the results can be compared. New models can be created with different variables that affect psychological empowerment. In addition, different quantitative and qualitative methods can be used.

Burnout, resilience, and empowerment among COVID-19 survivor nurses in Indonesia.

The primary frontline healthcare providers who have frequent contact with COVID-19 patients are nurses. Many nurses have been infected with COVID-19 and have experienced severe emotional exhaustion and burnout. It is essential to assess nurses' psychological health during the COVID-19 pandemic. This study aimed to analyze the factors associated with burnout, resilience, and empowerment among Indonesian COVID-19 nurse survivors. In this cross-sectional study, 182 COVID-19 survivor nurses participated from September to November 2022 with convenience sampling. An online survey using the Copenhagen Burnout Inventory (CBI), the Connor-Davidson Resilience Scale (CD-RISC), and the Psychological Empowerment Scale (PES) were used to collect data. The data were analyzed using descriptive and binary logistic regression analyses. The majority of the nurses were aged between 30-45 years (61.6%), and females (67.4%) experienced burnout. Higher resilience was found among nurses contracting COVID-19 (83.1%). In the multivariate logistic regression analysis, the absence of psychological impact (OR = 0.44, 95% CI = 0.21-0.93) is significantly related to higher burnout experience. In addition, workplace, especially in hospital (OR = 4.32, 95% CI = 1.09-17.09) was associated with resilience, and a gap time after receiving negative COVID-19 result (OR = 3.90, 95% CI = 1.27-12.03) was correlated with psychological empowerment, in our results 4-6 month after had a negative result was at higher risk. To maintain a positive psychological aspect for COVID-19 nurse survivors, it needs to implement psychological support in the workplace and ensure an appropriate workload of nurse professionals.

The role of principals’ pedagogical leadership practice in predicting teachers’ psychological empowerment: the case of East Gojjam province, Ethiopia

ABSTRACT Recently, pedagogical leadership has been regarded as an effective style in the education sector across the globe. Even if practicing pedagogical leadership makes capital available to foster teachers’ psychological empowerment, no previous study has done on this issue so far in the context of Ethiopia. Thus, this research was undertaken to explore the role of principals’ pedagogical leadership practice in predicting teachers’ psychological empowerment, in terms of teachers’ sense of meaning, competence, influence and goal internalization. The correlational survey model design was used. This study was conducted in East Gojjam province, Ethiopia. Data were collected from 420 teachers through the questionnaire and analyzed through SPSS 25. The validity and reliability of the pedagogical leadership and psychological empowerment scale were checked. As a result, according to the views of teachers, the results of simple correlation analyses showed there were a moderate to strong, positive and significant relationships between each dimension of pedagogical leadership and each dimension of psychological empowerment. Finally, principals’ practices of pedagogical leadership significantly predicted teachers’ psychological empowerment. In addition to, its contribution to the theory and literature, this study also empirically highlighted that to make teachers psychologically empowered; and developing various capitals of teachers should be considered.

The relationship between perceived management commitment to safety, psychological empowerment, and safety performance among emergency nurses in Jordan

PurposeNurses are susceptible to unfavorable effects of workplace accidents and injuries, therefore, perceived management commitment to safety and psychological empowerment can help nurses to participate in safety measures and adhere to safety performance. Thus, this study aimed to examine the relationship between perceived management commitment to safety, psychological empowerment, and safety performance among emergency nurses in Jordan. MethodsA cross-sectional, descriptive correlational design was used and 306 registered nurses working in the emergency department in Jordanian governmental hospitals were recruited. A self-structured questionnaire consisting of the perceived management commitment to safety scale, psychological empowerment scale, and safety performance scale was used to collect data during the period from July 2022 to August 2022. ResultsThe findings demonstrated that the levels of study variables revealed as follows: the perceived management commitment to safety mean was 3.1 (SD = 0.66) out of 5, which indicated an acceptable level, the mean score of psychological empowerment was 5.37 (SD = 0.94) out of 7, which reflected that the nurses perceived the work environment to be psychologically empowered, and the mean score for safety performance was 4.02 (SD = 0.56) out of 5, which indicated an acceptable level of safety performance among the participants, and the mean for subscales (safety compliance and participation) was 4.07 (SD = 0.57) and 3.93 (SD = 0.69) out of 5, respectively. Also, there was a positive correlation between safety performance and perceived management commitment to safety (r = 0.334, p < 0.001), and psychological empowerment (r = 0.592, p < 0.001). ConclusionIt is necessary to implement continuous interventions centered on empowering emergency nurses psychologically, which has a positive effect on safety performance. Given management’s commitment to safety as a priority topic of discussion at group meetings creating a work environment that encourages nurses' safety performance should be encouraged.

The mediating role of psychological empowerment in perceptions of decent work and work immersion among Chinese nurses: A cross-sectional study.

The purpose of this study was to explore the relationships among perceptions of decent work, psychological empowerment, and work immersion among nurses, hypothesizing that psychological empowerment mediates the relationship between perceptions of decent work and work immersion. At present, there are many studies on nurses' perceptions of decent labor and work immersion in China, but the relationship between them has not been discussed from a psychological perspective. The sample consisted of clinical nurses in Jiangxi, Zhejiang, Hubei, and Guangdong provinces, China, and the nurses' general information, decent labor perception, psychological empowerment, and work immersion scores were assessed using the General Information Scale, Decent Labor Perception Scale, Psychological Empowerment Scale, and Work Immersion Scale, respectively. Pearson correlation analysis and structural equation modeling were used to analyze the data. The total scores of nurses' perceptions of decent work, psychological empowerment, and work immersion were at a moderate level. The total nurse work immersion score and each dimension score were positively correlated with the total nurse decent work perception score and the total psychological empowerment score. Decent work perception and psychological empowerment directly and positively predicted work immersion; decent work perception also indirectly acted on work immersion through psychological empowerment. Nurses' work immersion was moderate, and this study explored the mechanisms by which perceptions of decent work affect nurses' work immersion from a psychological perspective, validating the mediating role of psychological empowerment. This study emphasizes that nursing managers should fully understand the importance of nurses' work immersion, continuously improve nurses' decent labor perceptions, enhance their psychological empowerment level, improve their work immersion, and enhance the quality of nursing services.

The Relationship between Transformational Leadership and Early Childhood Teachers' Occupational Well-being: A Moderated Mediation Model

Enhancing the occupational well-being of early childhood teachers is of vital importance for the stability of the teaching workforce and the improvement of educational quality, as well as the healthy development of young children. This study surveyed 327 early childhood teachers using the Principal Transformational Leadership Scale, the Early Childhood Teacher Occupational Well-being Scale, the Psychological Empowerment Scale, and the Perceived Social Support Scale. The results are as follows: (1) Transformational leadership has a positive influence on the occupational well-being of early childhood teachers, and psychological empowerment mediates the relationship between transformational leadership and occupational well-being. (2) Perceived social support among early childhood teachers moderates the relationship between psychological empowerment and occupational well-being. Specifically, when teachers have a lower level of perceived social support, the predictive role of psychological empowerment on occupational well-being is stronger. Conversely, when teachers have a higher level of perceived social support, the predictive role of psychological empowerment on occupational well-being is not significant.

The Relationship Between Supportive Behaviors of School Administrators and Psychological Empowerment According to Teacher Perceptions

This study aims to determine the relationship between school administrators' supportive behaviours and psychological empowerment according to teacher perceptions, relational survey model as a quantitative research method was used. The population of the study consisted of 400 teachers working at primary schools in central Bolu, Turkey in the 2020-2021 academic year. As data collection instruments, Administrator Support Scale (PSS) and Psychological Empowerment Scale (PES) were used. Since the data showed normal distribution, parametric tests were employed in the analysis of the data. According to the results of the study, the fact that the teachers' perceptions of the supportive behaviors of the school administrators in terms of emotional and educational support are at the level of slightly agree shows that school administrators are inadequate at supporting teachers emotionally and educationally. Since the school administrators who should be the closest source of information in the professional development of the teachers have supervision and guidance duties, it should be taken into consideration that they are incapable of supporting the teachers in educational sense. That the teachers’ perceptions of psychological empowerment in the dimension of self-determination are at the moderate level is also a striking result. There is a positive and highly significant relationship between the supportive behaviours of school administrators and teachers' perceptions of psychological empowerment. Supportive behaviors of school administrators are a significant predictor of teachers' perceptions of psychological empowerment

Impact of Job Crafting Intervention on Psychological Empowerment, Work Engagement, and Affective Well-being in Teachers

Organizations are under a lot of pressure to survive in the ever-changing world of competition. Human resources are a critical aspect for which there is no substitute. Job crafting is a component that can assist employees to improve the positive aspects of their work while reducing the negative aspects' impact. The study's main goal is to see how a job crafting intervention affects employees' psychological empowerment, work engagement, and affective well-being. It is a quasi-experimental design including both experimental and control groups. The population consists of teachers. Job crafting intervention was provided to the employees. It consists of six core elements including three sessions and pre-post testing taking a total of the six-week time period. Pre-testing and post-testing were done by using the Job Crafting questionnaire developed by Tims et al. (2012), Psychological Empowerment Scale (Spreitzer, 1995), Utrecht Work Engagement Scale (UWES; Schaufeli et al., 2006) and Job-related Affective Well-being Scale, JAWS (Van Katwyk et al., 2000). A paired sample t-test was run to see the effect of job crafting intervention on job crafting, psychological empowerment, work engagement, and affective well-being. The results were positive and significant. The relationship between job crafting, psychological empowerment, work engagement, and affective well-being was also assessed and there was a positive and significant correlation. The job crafting training can make it achievable to initiate employees’ active job crafting behavior and work engagement. Employers should recognize the need to assist and motivate staff to maximize their resources and meet their challenges.

Causal Modelling of Factors Influencing Quality of Nursing Care in China

The quality of nursing care is essential and contributes to restoring people’s health and well-being, especially when people are hospitalized. Various factors relating to the quality of nursing care have been identified, including nursing shortages. However, in China, there has been little research undertaken on factors influencing nursing care quality. This cross-sectional study aimed to develop and test the Chinese Model of Quality Nursing Care. A multi-stage, proportional stratified random sampling was used to recruit 784 registered nurses in three affiliated hospitals of a medical university in the People’s Republic of China. Eight Instruments were used for data collection: a demographic data form, the Good Nursing Care Scale, the Nurse Staffing Item, the Practice Environment Scale of the Nursing Work Index, the 3-item Utrecht Work Engagement Scale, the Psychological Empowerment Scale, the High-performance Work Systems Scale, the 8-item Survey of Perceived Organizational Support. In addition, the Analysis of Moment Structure software program was used to test the hypothesized model. Results indicated that the modified model fitted the empirical data and explained 31% of the variance in the quality of nursing care. Nursing practice environment, psychological empowerment and work engagement had positive direct effects on the quality of nursing care, with the nursing practice environment having the strongest total effect. Nursing practice environment, high-performance work systems, and perceived organizational support indirectly positively affected the quality of nursing care through psychological empowerment and work engagement. Unexpectedly, the patient-to-nurse ratio had no significant influence on the quality of nursing care. The results support the need for hospital managers to take action to improve the organizational support and work environment and create high-performance work systems to retain more nurses and midwives to enhance the quality of nursing care. The model requires further testing in practice and possible refinement.

The mediating effect of psychological empowerment on the relationship between work environment and clinical decision-making among midwives: a multicentre cross-sectional study

BackgroundClinical decision-making is considered an essential behaviour in clinical practice. However, no research has been done to examine the associations among midwives’ clinical decision-making, work environment and psychological empowerment. Thus, this study aimed to determine the influence of work environment on midwives’ clinical decision-making and confirm the mediating role of psychological empowerment.MethodThis study was designed as a multicentre cross-sectional study, and included 602 registered midwives from 25 public hospitals in China. A sociodemographic questionnaire, Work Environment Scale, Psychological Empowerment Scale and Clinical decision-making Scale were applied. A structural equation model was conducted to estimate the hypothesis model of the clinical decision-making among midwives and explore the potential mediating mechanism of midwives’ clinical decision-making. This model was employed maximum likelihood estimation method and bootstrapping to examine the statistical significance.ResultsThe mean score of clinical decision-making among midwives was 143.03 ± 14.22, at an intermediate level. The data of this hypothesis model fitted well, and the results showed that work environment positively affected psychological empowerment, which in turn positively affected clinical decision-making; psychological empowerment partly mediated the relationship between work environment and clinical decision-making among midwives.ConclusionsMidwives’ clinical decision-making could be promoted directly or indirectly by providing a healthy work environment and improving psychological empowerment. It is essential for hospital managers to pay attention to the assessment of the midwives’ work environment and actively improve it, such as establishing a supportive, fair and just workplace, and maintaining effective communication with midwives. Furthermore, managers can also promote midwives’ clinical decision-making behaviour by enhancing their psychological empowerment via enhancing job autonomy.