| Background:Kanter' structural empowerment theory is to instruct employee to finish their job in a more inefficient and effective manner through constructing positive workplace. Nurses who are dissatisfied with their workplace will leave nursing job and it make negative effect on the stability of nurses population. At present, it has been the focus in nursing field. Hospitals presenting strong support to nurses' workplace had lower mortality than those hospitals which had not these characteristics.Now days, as domestic clinical nurses are lacking, nurses take on overload clinical work, so it influenced clinical nurses' work positivity and stability; there exist some phenomenon in some nurses, such as instability of nurses' professional idea, weakness of service consciousness and working initiative, therefore it is difficult for clinical nurses to practice professional nursing behavior, which it has been the difficult problem in nursing management. Furthermore on the view of nursing manager, lack of scientific management knowledge and weakness of management ability are important reasons resulting in low level of nursing management.Nurses believe empowering positive workplace was related to high level of job-control sense, easily managing workload, recognizing their contribution to organizational goal, good working relationship, more strong sense of organizational justice and respect, and so on. Significant positive relationships were found between nurses' self-efficiency and work satisfaction, and nurses' perceived self-efficiency was promotive factor to high level of productivity and work performance. It was also main reason for nurses leaving nursing occupation that restrict their job-control on work environment. Employee' sense of job-control not only could promote their work satisfaction and devotion, but also was a method that ease up work stress and improve work efficiency.It has been the focus in our nursing field that how to stabilize the nurses size, promote nurses' work satisfaction and positivity and to realize professional nursing behavior. Kanter' theory provides guides for those managers who are interested in designing empowering workplace, which make employee participate in their job in better manner and easily realize nurses' specialized practical behavior. Kanter' theory has instructive effect on problems in our nursing field. Kanter' theory has been studied extensively in the overseas nursing population, but there are few literatures in our country.Objectives:1. To survey the level of clinical nurses' work empowerment and perceived self-efficacy and the degree of job-control;2. To get the message of actuality of nurses' work empowerment, self-efficacy and job-control in chengdu city;3. To analyze the effect of demology characteristics on these level above;4. To confirm the relative relationship among nurses' work empowerment, self-efficacy and job-control, and analyze the effect of work empowerment on job-control if self-efficacy as modulatory variable.5. To discuss applicable degree of Kanter' theory in our nursing field.Method:1. Design method: cross-sectional survey2. sampling and survey method Three randomized hospital of third class general hospital in chengdu city were selected as survey units. Estimated sample were distributed according to the constituent ratio of clinical nurses in the three hospital, then every survey unit was divided into medical section, surgical section, emergency department and ICU. According to the constituent ratio of clinical nurses in sections, the samples were distributed and the questionnaire was handed out to the objects in group-survey. 585 questionnaires were handed out, which the callback ratio was 94%, the efficiency ratio was 95%.3. survey tool and reliability and efficiency of questionnairesurvey tool included three questionnaires: Conditions Work Effectiveness Questionnaires, General Self-efficacy Scale and Job-control Questionnaires. The Content Validity Index, repeated measure reliability, Alpha internal consistency and translation consistency of the three questionnaires measured up.4. Data processing methodsSPSS11.5 statistical package was used to analyze data. Mean, standard deviation and constituent ratio were used to describe demology data, the level of clinical nurses' work empowerment, self-efficacy and job-control;one-way ANOVA and multivariate regression were used to analyze the effect of demology characteristics on the level of clinical nurses' work empowerment, self-efficacy and job-control; Pearson relation was used to analyze the relativity of clinical nurses' work empowerment, self-efficacy and job-control; multivariate regression was used to analyze the influencing degree of work empowerment on self-efficacy and job-control; path analysis was used to confirm the influencing degree of work empowerment on job-control if self-efficacy as modulatory variable.Result:1. survey objects' demology characteristicsIn the surveyed clinical nurses, medical and surgical nurses account for the main (73.8%); about half of nurses were in 20-25 years of age group, 1-5 years of length of service; nurses' educational background was mainly junior college degree (73.2%); the proportion of nurses' primary professional title was 55.7%.2. The level of clinical nurses' work empowerment, self-efficacy and job-controlThe survey result revealed clinical nurses' total empowerment was on the moderate and more level (the mark range: 1～5, X=2.662-3.187), which the mean value of opportunity structure was on the highest level (X=3.187); one of the information structure was on the lowest level (X=2.293). Clinical nurses' self-efficacy was on the upper level (the mark range: 1～6, X=5.010); their sense of job-control was on the moderate degree (the mark range: 1～5, X=2.849).3. The effect of the demology characteristics on work empowerment, self-efficacy and job-controlThe influencing factors on clinical nurses' work empowerment by multivariate analysis were length of service, headship and professional title (β=-0.333,β=-0.177,β=-0.101). The influencing factors on clinical nurses'perceived self-efficacy by multivariate analysis were professional title, section, headship and labor relationship (β=-0.138,β=-0.105,β=0.135,β=0.094). The influencing factors on clinical nurses' job-control by multivariate analysis were length of service, professional title, headship and section (β=-0.292,β=0.173,β=0.147,β=0.131).4. The influencing effect of work empowerment on self-efficacy and job-controlSignificant positive relationships were found between total work empowerment and self-efficacy(r=0.115) and between total work empowerment and job-control(r= 0.491). Multivariate regression revealed the effect of the total work empowerment on job-control was significant and moderate (β=0.491), and the influencing effect of information structure, resources structure, formal power and informal power of work empowerment on job-control was significant. When self-efficacy was as modulatory factor, the total influencing effect of work empowerment and self-efficacy on job-control was enhanced (β=0.527), and the influencing effect of work empowerment on job-control slightly decreased (β=0.487), but through the path of self-efficacy, the influencing effect of work empowerment on job-control was not significant (β= 0.040, P＞0.05).Conclusion1. Survey results that clinical nurses' work empowerment was on the moderate level showed there is the room which nurses' work empowerment could be promoted, but the score of information structure reveal such information as the hospital's status and change was limitedly received by nurses, which it would influence nurses' perceived organizational justice. The upper level of clinical nurses' self-efficacy showed they had strong confidence in completing work and resolving problems. The lower level of clinical nurses' job-control went against high-quality nursing.2. The main influencing factors on clinical nurses' work empowerment, self-efficacy and job-control were length of service, professional title and headship. Compared with young nurses, the level of the senior nurses' work empowerment, perceived self-efficacy and sense of job-control were on the decline.3. The influencing effect of work empowerment on self-efficacy and job control was positive, and the effect on job-control was stronger. The results revealed constructing empowering workplace for clinical nurses not only could promote the level of nurses' confidence, but also could enhance the sense of nurses' job-control on work environment and nursing work, which it would make for high quality nursing service.Significance 1. Kanter' theory was rarely studied in domestic nursing field. This investigation could offer basic data and method reference for our nursing human resource management.2. The survey results offer academic basis for nursing manager promoting and improving managing strategy and guide for how to constructing positive workplace.
|
PDF Full Text Request