Structural and psychological empowerment and reflective thinking: is there a link?

Baccalaureate nursing education prepares students to become registered nurses in evolving health care systems. During their program, students' perceptions of empowerment in the nursing profession begin to form, and they are introduced to the process of reflective thinking. The purpose of this integrative literature review is unique in that three concepts are examined and linked-structural empowerment (as conceptualized by Kanter), psychological empowerment (as described by Spreitzer), and reflective thinking (as characterized by Mezirow)-and a theoretical model for testing is proposed. In examining the conceptual links, it is apparent that all three are required for learning and nursing practice. By preparing students to be empowered, reflective professionals, it is proposed that they will be more effective in their academic and future practice work. The conceptual links and proposed model described in this article provide the foundation for building a body of evidence to support or refute this contention.     

专业护理实践环境、心理授权和护士工作投入关系模型的建立

目的探讨专业护理实践环境和心理授权对护士工作投入的影响,建立其关系模型。方法采用护士工作环境量表、心理授权量表和护士工作投入量表对天津市2所三级甲等医院的218名注册护士进行调查。结果专业护理实践环境和心理授权均可直接正性影响护士工作投入,专业护理实践环境还可通过心理授权的中介作用间接影响工作投入。结论医院和护理部应共同采取措施改善护士的工作环境,通过有效心理授权提高其工作投入水平。     

Evolution of a Graduate-Level Informatics Course for the Noninformatics Specialist Nurse

The design evolution of a novice-level informatics course for nurses in a nurse practitioner, educator, and leadership track graduate nursing program is described in this article. The support of nurse empowerment to recognize a personal role and develop skill competency in information management is the desired course outcome. The course evolution incorporates activities that encourage students to make connections between the concepts of informatics and the practice environment.     

Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care

spence laschinger h.k., gilbert s., smith l.m. & leslie k. (2010) Journal of Nursing Management 18, 4–13
Towards a comprehensive theory of nurse/patient empowerment: applying Kanter's empowerment theory to patient care
Aim  The purpose of this theoretical paper is to propose an integrated model of nurse/patient empowerment that could be used as a guide for creating high-quality nursing practice work environments that ensure positive outcomes for both nurses and their patients.
Background  There are few integrated theoretical approaches to nurse and patient empowerment in the literature, although nurse empowerment is assumed to positively affect patient outcomes.
Evaluation  The constructs described in Kanter's (1993) work empowerment theory are conceptually consistent with the nursing care process and can be logically extended to nurses' interactions with their patients and the outcomes of nursing care.
Key issues  We propose a model of nurse/patient empowerment derived from Kanter's theory that suggests that empowering working conditions increase feelings of psychological empowerment in nurses, resulting in greater use of patient empowerment strategies by nurses, and, ultimately, greater patient empowerment and better health outcomes.
Conclusions  Empirical testing of the model is recommended prior to use of the model in clinical practice.
Implications for Nursing Management  We argue that empowered nurses are more likely to empower their patients, which results in better patient and system outcomes. Strategies for managers to empower nurses and for nurses to empower patients are suggested.     

Applying the concept of structural empowerment to interactions between families and home‐care nurses

Interpretations of family carer empowerment in much nursing research, and in home‐care practice and policy, rarely attend explicitly to families’ choice or control about the nature, extent or length of their involvement, or control over the impact on their own health. In this article, structural empowerment is used as an analytic lens to examine home‐care nurses’ interactions with families in one Western Canadian region. Data were collected from 75 hrs of fieldwork in 59 interactions (18 nurses visiting 16 families) and interviews with 12 nurses and 11 family carers. Generally, nurses prioritized client empowerment, and their practice with families appeared oriented to supporting their role and needs as carers (i.e. rather than as unique individuals beyond the caring role), and reinforcing the caring role through validation and recognition. Although families generally expressed appreciation for these interactions, a structural empowerment lens illustrates how the broad context of home care shapes the interpretation and practice of empowerment in ways that can, paradoxically, be disempowering for families. Opportunities to effectively support family choice and control when a client is being cared for at home are discussed.     

Do nurses feel empowered? Nurses'' assessments of their own qualities and performance with regard to nurse empowerment

Empowerment ideology has been adopted increasingly as one conceptual framework for the development of nursing care, training, and management. The present article examines a quantitative study (n = 416) on critical care, long-term care, and public health nurses' views over their personal qualities and performance in relation to an ideal model of nurse empowerment. The results obtained provide strong evidence that nurses do have a positive image of their own empowerment. There was only slight variation between different groups of nurses. Length of working history and employment status (permanent/temporary) correlated highly with empowerment. The ideal model seems to depict nurse empowerment relatively well. It might be feasible to develop these concepts further so as to obtain a tool for the enhancement of professional competence, nursing education, and personnel management.     

Irish nurses' and midwives' understanding and experiences of empowerment

AIM: This study explored conceptualizations of empowerment among Irish nurses and midwives. BACKGROUND: Current literature on the meaning of empowerment lacks consensus. As a result there is a likelihood that empowerment will be conceptualized differently between managers and subordinates. METHOD: In order to get a sense of how Irish practitioners viewed empowerment, 10 focus groups were held in locations throughout Ireland (n = 93). A national distribution of participants was obtained. RESULTS: Twenty-one different responses emerged representing what nurses and midwives understood by the term empowerment. In relation to experiences of empowerment, six themes were found to impact on empowerment experiences. Three themes emerged as central to empowerment. One theme (education for practice) was identified as an antecedent to empowerment. CONCLUSION: Empowerment is a complex concept and its meaning is contextually determined. Managers play a key role in impacting on the empowerment perceptions of Irish nurses and midwives.     

Empowerment of Nursing as a Socially Significant Profession in Vietnam

Purpose: To describe nursing education and practice in Vietnam, and strategies that support empowerment of nursing as a socially significant profession for that country.
Design: The Jones-Meleis health empowerment model was used as a framework to examine barriers and identify strategies that support empowerment.
Methods: Fieldwork, interviews, and participation-observation in collaborative partnerships with the Ministry of Health, the national nurses association, and schools of nursing in Vietnam.
Findings: Nurses in Vietnam are eagerly poised to make significant and essential contributions to the well-being of society.
Conclusions: Baccalaureate and master's degree nursing curricula taught by nurses are necessary for professionalization of nursing practice in Vietnam.     

Shared governance and empowerment in registered nurses working in a hospital setting

Empowerment of registered nurses through professional practice models inclusive of shared governance has been proposed as essential to improve quality patient care, contain costs, and retain nursing staff. The purpose of this study was to determine the relationship between perceptions of governance and empowerment among nurses working in acute care hospital units in which a shared governance model had been in place for 6 to 12 months. The 158 nurses who participated perceived themselves to be moderately empowered and in an early implementation stage of shared governance. There was a statistically significant positive relationship between perceptions of shared governance and empowerment. Recommendations for professional practice and future research are included.     

Envisioning nursing in 2050 through the eyes of nurse theorists: Rosemarie Rizzo Parse and Martha E. Rogers

Rosemarie Rizzo Parse and Rogerian scholar, Violet Malinski, on behalf of Martha E. Rogers, envision how their respective theoretical ideas will be expressed in 2050. Parse introduces several changes highlighting the idea of indivisible cocreation in the ontology of the humanbecoming school of thought and concomitant changes in the wording of its principles. Notions of human freedom and dignity will be extremely important given increasingly mechanized healthcare. Malinski describes Rogerian formulations for practice and research that will continue to facilitate well-being for humankind and the environment. She also addresses challenges and opportunities for an evolving science of unitary human beings.     

Philosophical issues in the Rogerian science of unitary human beings

In the Rogerian science of unitary human beings, the requirements for meaning and evidence are problematic. Four-dimensionality, a major building block, is postulated to be nonspatiotemporal, nonlinear, and not predictable through knowledge of the parts. A problem arises primarily because the Rogerian system also presents "verification of concepts" as the means of testing "fit" with the real world. Evidence usually understood in the criterion of verifiability in the logical empiricist tradition is specifiable through physicalistic terms under particular three-dimensional conditions. What are the consequences if integral (phenomenologic) evidence is taken as the criterion of meaning in the Rogerian conceptual system?     

The application in public health nursing of the employee empowerment model and relevant considerations

Empowerment, rooted in the black civil rights and other civic movements of the 1960s, has greatly impacted thought and theories on health promotion activities, management strategies, and educational reform. Public health nurses are vital facilitators to the introduction and implementation of the empowerment concept in the health care field. Employee empowerment, based on the concept of empowerment, comprises the two domains of ability and power, which may be assessed through psychological and organizational empowerment. This article illustrates the employee empowerment model, the combination of cognitive empowerment model, and its application in public health nursing. The empowering process includes confirming feelings of powerlessness during the dialogue phase; empowerment education and organizational dialogue during the development phase; and collective action for goal-setting during the action phase. This paper also notes issues that should be considered related to model implementation, including new technology of old paradigm, the risk for more disempowered status, and an appropriate methodology for research paradigms. The employee empowerment model presented in this paper may be used as a guide to design empowerment education curricula for public health nurses.     

Examination of Factors Affecting Therapeutic Attitude and Empowerment of Perianesthesia Nurses Who Care for Patients With Opioid Use Disorder

PurposePatients with opioid use disorder (OUD) and associated complexities are presenting to hospitals in increasing numbers. Preparation of perianesthesia nurses caring for this patient population has lagged, with noted deficits in continuing education, resources, and role support. Previous research found education without considering therapeutic attitude (TA), empowerment and factors that influence nursing practice does not translate into feelings of competence in nursing care. The purpose of this study was to identify correlates and predictors that affect TA and empowerment among perianesthesia nurses caring for patients with OUD.DesignA cross-sectional, correlation design was used to identify correlates and predictors of TA and empowerment in a national sample of perianesthesia nurses (N = 215)MethodsA national survey collected data from perianesthesia nurses. The Perianesthesia Nurse Empowerment and Therapeutic Attitude Model was the guiding framework. Pearson product-moment correlation and hierarchical multiple regression analyses were used to examine relationships between personal factors, the professional practice environment and societal factors of perianesthesia nurses.FindingsThe standardized regression coefficients indicated the professional practice environment (β = -0.28), drug user stigma (β = 0.27), access to a pain specialist (β = 0.25), and exposure to drug users (β = 0.25) were the strongest predictors of TA. Access to a pain specialist (β = -0.15) and the professional practice environment (β = 0.72) were the strongest predictors of empowerment.ConclusionsThe professional practice environment directly influenced the degree of empowerment and TA reported by perianesthesia nurses. Exposure to persons with OUD and personal stigmatization of persons who misuse drugs decreased TA but had no association with empowerment. Access to a pain specialist was moderately predictive of empowerment and negatively associated with TA suggesting a lack of role legitimacy and the need for further research into perianesthesia nurses’ perceptions of their role when caring for this population.     

Nurses' Experiences of Restructuring in Three Ontario Hospitals

Purpose: To describe the effects of restructuring, particularly redeployment, on nurses' personal and work lives, and to compare the utility of "survivor syndrome" and empowerment as alternative concepts for understanding these effects and planning change.
Methods: Twenty-six focus groups or interviews were held with 59 nurses working in three hospitals in Ontario, Canada.
Findings: Participants described how restructuring strategies had affected them as individuals, as members of nursing teams, and as employees. In each of these aspects of their work lives, relationships became less integrated, their work activities became less controllable, and the changes compromised their ability to deliver effective care.
Conclusions: Restructuring intensifies structural weaknesses in professions, such as nursing, whose members are primarily employed by bureaucracies. Nurses may not find survivor syndrome a useful model to explain their low morale following restructuring because it identifies nurses as "patients" in need of therapy. An empowerment model that takes into account nurses' concerns about uncertainty and integration may be more fruitful for devising strategies to enhance their ability to practice effectively in hospital settings.     

Predictors of professional nursing practice behaviors in hospital settings

BACKGROUND: Many hospital nurses perform isolated, routine tasks, rather than use their professional training, because they are subject to control by organizational and medical divisions of labor. The environment may interfere with a nurse's ability to practice autonomously and according to professional standards. OBJECTIVES: The purpose of the study was to explore how certain factors in the environment and personal characteristics interact to affect hospital nursing practice behaviors. METHODS: The study used a nonexperimental, comparative design. Surveys were sent to a random sample of 500 nurses throughout the state of Michigan. Three instruments, measuring structural empowerment, self-efficacy for nursing practice, and professional practice behaviors, were included. Path analysis was used for statistical analysis. RESULTS: Three hundred sixty-four nurses responded (73%), of whom 251 provided usable protocols for the final analysis. Environmental factors (structural empowerment) contributed both directly to professional practice behaviors as well as indirectly through self-efficacy. Self-efficacy mainly exerted its effect as a mediator in the relationship between environmental factors and practice behaviors. Support for the proposed theoretical model was mixed, although the proposed model fit the data well (chi = 11.02 [(5, N = 251), p < .05, CFI = .999, NNFI = .991, RMSEA = .069]). An alternative model emerged from the data analysis. DISCUSSION: Nurses may practice more professionally when the environment provides opportunities and power through resources, support, and information. Self-efficacy may contribute to professional practice behaviors, especially in an environment that has the requisite factors that provide empowerment.     

护士结构授权与心理授权的关系

目的调查护士结构授权和心理授权水平,分析两者之间的关系,为护理管理者改善护士工作环境、提高管理效率提供依据。方法采用问卷调查法,对上海市2所综合医院的206名护士的工作效能与心理授权情况进行调查。结果护士结构授权总分为(17.42±3.059)分,处于中等水平;心理授权总分为(3.49±0.583)分,处于中等偏上水平;结构与心理授权呈显著正相关(P<0.01);结构授权中的正式权力、信息和非正式权力是护士心理授权的预测变量(P<0.01)。结论我国护士结构和心理授权水平还有待于进一步提升;本研究建立的心理授权多元线性回归模型基本反映了其与结构授权之间的相互关系;提示护理管理者需注重创造结构性授权环境,注重信息传达与提高护士正式与非正式权力,从而提高护士心理授权水平,稳定护士队伍,提高护士工作效率和护理质量。     

Power and empowerment: critical concepts in the nurse-client relationship

Two key concepts in health promotion within the nurse-client relationship are power and empowerment. Theorists and researchers have not achieved consensus on how they are to be defined and addressed. However, both power and empowerment are recognized to occur at macro and micro levels, and as such need to be addressed at each level. Using a critical nursing perspective, this article explores these concepts it identifies concerns that arise around power and risks that arise in empowerment practice. Nurses are challenge to develop a new way of seeing empowerment practice, and encouraged to focus on 'being with' clients, rather than 'doing to' them.     

授权管理在连续性肾脏替代治疗专科护士培训中的应用研究

目的 探讨授权管理在连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)专科护士中的应用效果.方法 在武汉大学人民医院开展CRRT专科护士培训,并对通过考核的49名专科护士进行授权和管理.比较培训前后护士的结构授权水平、心理授权水平、工作满意度水平和突发事件处理能力....