Association between work empowerment and interprofessional collaboration among health care professionals working in cancer care settings.

This study aimed to analyze work-related empowerment and interprofessional collaboration and to identify possible associations among healthcare professionals working in cancer care settings. A cross-sectional survey design was employed in this study. Healthcare professionals (n = 175) in one Finnish Cancer Center participating in the care of patients with cancer at least on a monthly basis took part in the study. The data were collected with three instruments: Interprofessional Collaboration and Leadership, Performance of an Empowered Personnel (PEN), and Work-related Empowerment Promoting Factors (WEP). The data were analyzed with descriptive statistics, Pearson and Spearman's correlation coefficients and multivariate analysis using generalized liner models. Healthcare professionals rated their work empowerment as rather high. Performance of an Empowered Personnel (PEN) was perceived as high (mean 4.08, SD 0.47). Promoting factors for Work Empowerment (WEP) were also assessed as high (mean 3.98, SD 0.61). Interprofessional collaboration in the cancer care setting was perceived as moderate (mean 2.94, SD 0.36). Managerial position explained work empowerment based on multivariate analysis. Work empowerment and interprofessional collaboration had a strong correlation. The results can be used in the leadership and management of interprofessional collaboration and in developing new structures to support health professionals' work empowerment. In the future, work empowerment needs to be promoted by constructing solutions and practices that support interprofessional collaboration and thus improve the quality of cancer care.

Work empowerment among cancer care professionals: a cross-sectional study.

BACKGROUND: There is a growing understanding that empowerment of interprofessional personnel is linked to job satisfaction levels and quality of care, but little is known about empowerment in the context of cancer care. This study describes how interprofessional cancer care personnel perceive their performance and factors that promote work empowerment. METHODS: This cross-sectional study enrolled 475 (45.2%) of the 1050 employees who work at a regional cancer centre. The participants used two self-administered questionnaires - the Performance of an Empowered Personnel (PEN) questionnaire and Work Empowerment Promoting Factors (WEP) questionnaire - to report perceptions of work empowerment. Both questionnaires' categories comprise moral principles, personal integrity, expertise, future orientation, and sociality. The data were analyzed using IBM SPSS Statistics, Versions 24 and 25. RESULTS: Overall, the performance of work empowerment was evaluated as being rather high (overall sum score mean: 4.05; range: 3.51-4.41; scale: 1-5). The category that rated highest was moral principles (4.41), and the one rated lowest was the social category (3.51). The factors that promoted work empowerment also ranked high (3.93; range: 3.55-4.08; scale: 1-5), with personal integrity (4.08) the highest and future orientation (3.55) the lowest. Performance and factors that promoted work empowerment correlated positively, moderately, and highly statistically significantly (r = 0.531; p < 0.001). Statistically significant associations also were found between empowered performance of personnel and empowerment promoting factors (sex, education, leadership position, belonging to an interprofessional team, and time elapsed since training in interprofessional cooperation). CONCLUSION: The personnel rated their performance and the factors perceived to promote work empowerment rather highly. Personal empowerment can be promoted through teamwork training and supportive management in interprofessional cancer care.

Nurse Competence Scale: a systematic and psychometric review.

AIM: The aim of this study was to report a systematic and psychometric review. BACKGROUND: The Nurse Competence Scale is currently the most widely used generic instrument to measure Registered Nurses' competence in different phases of their careers. Based on a decade of research, this review provides a summary of the existing evidence. DESIGN: A systematic literature review of research evidence and psychometric properties. DATA SOURCES: Nine databases from 2004 - October 2015. REVIEW METHODS: We retrieved scientific publications in English and Finnish. Two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist. RESULTS: A total of 30 studies reported in 43 publications were included. These consisted of over 11,000 competence assessments. Twenty studies were from Europe and 10 from outside Europe. In addition to experienced nurses, the Nurse Competence Scale has been used for the competence assessment of newly graduated nurses and nursing students, mainly in hospital settings. Length of work experience, age, higher education, permanent employment and participation in educational programmes correlated positively with competence. Variables including empowerment, commitment, practice environment, quality of care and critical thinking were also associated with higher competence. The Nurse Competence Scale has demonstrated good content validity and appropriate internal consistency. CONCLUSION: The value of Nurse Competence Scale has been confirmed in determining relationships between background variables and competence. The instrument has been widely used with experienced and newly graduated nurses and their managers. Cross-cultural validation must be continued using rigorous methods.

Newly graduated nurses' empowerment regarding professional competence and other work-related factors.

BACKGROUND: Although both nurse empowerment and competence are fundamental concepts of describing newly graduated nurses' professional development and job satisfaction, only few studies exist on the relationship between these concepts. Therefore, the purpose of this study was to determine how newly graduated nurses assess their empowerment and to clarify professional competence compared to other work-related factors. METHODS: A descriptive, cross-sectional and correlational design was applied. The sample comprised newly graduated nurses (n = 318) in Finland. Empowerment was measured using the 19-item Qualities of an Empowered Nurse scale and the Nurse Competence Scale measured nurses' self-assessed generic competence. In addition to demographic data, the background data included employment sector (public/private), job satisfaction, intent to change/leave job, work schedule (shifts/business hours) and assessments of the quality of care in the workplace. The data were analysed statistically by using Spearman's correlation coefficient as well as the One-Way and Multivariate Analysis of Variance. Cronbach's alpha coefficient was used to estimate the internal consistency. RESULTS: Newly graduated nurses perceived their level of empowerment and competence fairly high. The association between nurse empowerment and professional competence was statistically significant. Other variables correlating positively to empowerment included employment sector, age, job satisfaction, intent to change job, work schedule, and satisfaction with the quality of care in the work unit. The study indicates competence had the strongest effect on newly graduated nurses' empowerment. CONCLUSIONS: New graduates need support and career opportunities. In the future, nurses' further education and nurse managers' resources for supporting and empowering nurses should respond to the newly graduated nurses' requisites for attractive and meaningful work.

Does organizational justice predict empowerment? Nurses assess their work environment.

PURPOSE: The purpose of the study was to explore how nurses assess their empowerment and clarify organizational justice compared to other work-related factors. In addition, we examined the major variables pertinent to empowerment. DESIGN: Cross-sectional survey data were used. METHODS: A total of 2,152 nurses returned the completed questionnaire. The instruments consisted of nurse empowerment, organizational justice, job control, and possibilities for developing work. The data analysis was based on descriptive statistics and further statistical tests. FINDINGS: Organizational justice and empowerment had a clear correlation. Job control, possibilities for developing work and organizational justice were statistically significant predictors of nurse empowerment. CONCLUSIONS: Organizational justice and the possibility to use one's individual skills at work are significant factors in staff activity and its development in nursing. They increase the level of empowerment and commitment as well as motivation to work. CLINICAL RELEVANCE: The results of this study confirm that nurses regard organizational justice as highly important. We can facilitate both work-related empowerment and organizational justice by creating and maintaining a culture of fairness and justice. Employees should be heard and involved more in the planning and decision making of work.

Lithuanian nurses' assessments of their empowerment.

AIMS AND OBJECTIVES: The aim was to explore nurse empowerment and the factors associated with it from the viewpoint of surgical nurses. DESIGN: A multicentre cross-sectional, descriptive, correlational study design was used. SETTING AND PARTICIPANTS: The data were collected from 11 units of seven largest Lithuanian hospitals located in three major cities during the period of 11/2007 to 01/2008. All the nurses (N = 270) working in the abdominal perioperative settings were invited to participate in the study; 247 questionnaires were returned giving the response rate of 91 %. The data were analyzed on the basis of 218 responses. The statistical analysis was performed by SPSS (12.0 version). INSTRUMENTS: Two instruments, both originally developed in Finland and adapted to the Lithuanian cultural context, were used: Nurse Empowerment Scale (NES) and Good Nursing Care Scale for Nurses (GNCS-N). RESULTS: Surgical nurses evaluated their work empowerment positively. Several background factors were associated with nurse empowerment, such as nurse education, type of nurse license (working area), the continuing nurse education (completed courses during last 5 years), the workload at hospital, the work independence, and work satisfaction. The connection between nurse empowerment and quality of nursing care was also identified (r = 0.139-0.525, p < 0.01). CONCLUSIONS: Surgical nurses feel empowered at their work when they have higher education and have completed the continuing education courses. Nurses should have possibility to continue their studies at the university. Independent at work, satisfied, and motivated nurses have more power at their work in the surgical units in Lithuania. However, further research is needed to explore nurse empowerment in other fields of nursing care nationally and internationally.

Organizational vision: experience at the unit level.

AIMS: The main focus of this follow-up study was to describe how the vision statements were perceived to describe the work in the units and what kind of relationships there were between the vision statements and background factors during the 3-year follow-up. BACKGROUND: he vision statement gives a competitive advantage to the organization. It helps find the desired direction during a period of transformation in the organization. Satisfaction, empowerment and motivation are challenged in the vision-realization process. METHODS: he data were gathered by questionnaire from the multidisciplinary team members on three occasions. The response rate was 58% (n = 115, n = 112) for the first and second data sets, and 53% (n = 103) for the third data set. The data was analysed statistically. RESULTS: The organizational vision was perceived as quite stable during the 3 years. Factors associated with the vision statement at the end of the 3-year period were workload, experience of stress, work motivation, work satisfaction, importance of work independence and general empowerment. IMPLICATIONS FOR NURSING MANAGEMENT: eaders are able to sustain the vision statement by motivating and empowering the staff. Empowerment especially is worth reinforcing in a vision-realization process.

Graduating Nursing Students' Empowerment and Related Factors: Comparative Study in Six European Countries.

New nurses are needed in healthcare. To meet the role expectations of a registered nurse, nursing students must feel empowered at graduation. However, there are only a few studies focusing on nursing students' empowerment. This study aims to describe and analyze graduating nursing students' level of empowerment in six European countries and potential related factors. A comparative and cross-sectional study was performed in the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain with graduating nursing students (n = 1746) using the Essential Elements of Nurse Empowerment scale. Potentially related factors included age, gender, a previous degree in health care, work experience in health care, graduation to first-choice profession, intention to leave the nursing profession, level of study achievements, satisfaction with the current nursing programme, clinical practicums, theoretical education, and generic competence measured with the Nurse Competence Scale. The data were analysed statistically. Graduating nursing students' self-assessed level of empowerment was moderate, with statistical differences between countries. Those with high empowerment had no intention to leave the nursing profession, had a higher level of study achievements, and a higher self-assessed generic competence level. The results suggest that empowerment needs to be enhanced during nursing education. Further research is needed to understand the development of empowerment during the early years of a nursing career.

Continuing professional education for care staff: evaluation of training and development project.

This study describes the "Professional Career in Arthritis Care (PCA) 2003-2005" training and development project conducted at one hospital in Finland. The project consisted of 5,194 training days for 93 participants and 13 practical development tasks. The research task is to describe (1) the level of need for additional training once the project had ended, (2) the significance of the development task from the perspective of professional development, and (3) how the development task has been introduced into the work community. The material was gathered by questionnaire. The training needs remained quite stable in spite of lengthy training when measured by the themes of the curriculum covered during the PCA. When asked about their need for further training in general in order to manage their current job, a total of 66% of participants still expressed a need for training at the end of the PCA. The development task was viewed mostly positively. The PCA project has given some support to professional development and organizational change, general empowerment, motivation, and satisfaction.

Effects of organizational change on work-related empowerment, employee satisfaction, and motivation.

This article reports the results of a longitudinal quantitative study on nurses' views on factors promoting and impeding empowerment and examines the relationship between work-related empowerment and background variables in one hospital. Data were collected using a self-administered questionnaire and analyzed statistically. Nurses gave lowest assessments of promoting factors on the second measurement occasion, a time when the organization was going through major changes. Both job satisfaction and motivation showed a positive relationship with factors promoting empowerment. Organizational changes have a direct effect on the work environment in terms of empowerment and job satisfaction. To cope successfully with changes, special attention must be paid to personnel management. It seems that factors promoting and impeding empowerment can be used to measure effects of organizational changes as well.

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.

Do nurses who work in a fair organization sleep and perform better and why? Testing potential psychosocial mediators of organizational justice.

We examined whether organizational justice is associated with sleep quality and performance in a population-based sample of 1,729 Finnish registered nurses working full time. In addition, we tested psychological mechanisms mediating the potential association. The results of multivariate linear regression analyses showed higher organizational justice to be associated with fewer sleeping problems (ß values range from -.20 to -.11) and higher self-reported performance (ß values range from .05 to .35). Furthermore, psychological distress (related to the psychological stress model) and job involvement (related to the psychosocial resource model) mediated the association between organizational justice and sleep. Sleeping problems partly mediated the association between organizational justice and performance. Psychological distress explained 51% to 83% and job involvement explained 10% to 15% of the total effects of justice variables on sleeping problems. The findings provide support for the psychological stress model and offer practical implications for reducing nurses' sleeping problems.

Organizational change and work-related empowerment.

AIM: This study describes the views of multidisciplinary teams on work-related empowerment in a transitional organization. METHODS: The data were collected between September 2003 and January 2004 (n=115) and one year later (n=112) using a self-administered questionnaire consisting of verbal and behavioural items, empowerment outcomes, and factors promoting and impeding empowerment. The target population consisted of all members working in multidisciplinary teams at the Rheumatism Foundation Hospital in Finland. The response rate was 58% at both data collections. The data were analysed statistically using SPSS software. RESULTS: The multidisciplinary teams rated their work empowerment quite highly. The number of empowerment promoting factors was lowest for the category of future orientedness, consisting of continuity of work, opportunities for advancement, and access to information. The number of impeding factors was also highest for the same category of future orientedness, consisting here of organizational bureaucracy and hierarchy, authoritarian leadership, poor access to information, and short working periods. CONCLUSIONS: It is important not to underestimate the impacts of organizational changes: they have a direct effect on the work environment and may contribute to higher rates of dissatisfaction, burnout and absenteeism among health care workers.

The constancy of work-related empowerment.

OBJECTIVE: This study describes experiences of work empowerment among staff members at the Rheumatism Foundation Hospital in Helsinki, Finland. METHODS: The data were collected on two occasions in 2004 and 2005 using a structured questionnaire with background variables and items concerning verbal, behavioural and outcome empowerment. The questionnaires were sent to all (n1=115, n2=112) members of multidisciplinary teams at the Rheumatism Foundation Hospital, with the exception of physicians, departmental secretaries and administrative personnel. The response rate at both data collections was 58%. The data were analysed by statistical methods. RESULTS: No statistically significant differences were seen in work empowerment between the two data collections. Perceptions of work-related empowerment were relatively strong. CONCLUSIONS: Work-related empowerment appears to be relatively constant and independent of changes in the organization. Indeed there is good reason to ask whether work empowerment is primarily a function of the individual employee's strengths and competencies.

Work-related empowerment of the multidisciplinary team at the Rheumatism Foundation Hospital.

Carried out as part of a staff development project, this study describes the experiences of work-related empowerment within a multidisciplinary team at the Rheumatism Foundation Hospital in Finland. The data were collected using a structured questionnaire consisting of background variables and questions concerning verbal, behavioural and outcome empowerment. The questionnaire was sent to all members of the multidisciplinary team at the Rheumatism Foundation Hospital, with the exception of physicians, departmental secretaries and administrative personnel. The response rate was 58%. The data were examined using statistical methods. The multidisciplinary team felt quite strong verbal and behavioural empowerment, but was less confident in terms of outcome empowerment. Several factors were found to be associated with the different fields of empowerment. In conclusion, the multidisciplinary team felt quite strong work-related empowerment.

Promoting or impeding empowerment? Nurses' assessments of their work environment.

OBJECTIVE: This article reports the results of a quantitative study of individual nurses' views concerning factors promoting or impeding empowerment in healthcare organizations. BACKGROUND: Changes in healthcare have lead to the formation of ever larger units, reduced resources, and an increasing demand for efficiency. Besides having extensive professional knowledge, personnel are expected to be independent decision-makers engaged in continuous development of both themselves and their work. The leadership must be goal-directed, providing support and opportunities to the personnel. Concerns exist as to how to safeguard the attractiveness of the healthcare field in a possible future competition for potential workers and students. METHODS: The concept used as theoretical framework is empowerment, which has widely been found useful not only in developing patient care but also in education and personnel management. Data (n = 416) were collected by a questionnaire based on five categories obtained in an earlier qualitative study. RESULTS: Factors that prevented empowerment included authoritarian leadership, poor access to information, and short working periods. Factors found to increase empowerment were job satisfaction, career consciousness, further training, and commitment. Further research into the effects of personnel governance and organizational changes upon empowerment seems indicated.

Nurse empowerment, job-related satisfaction, and organizational commitment.

Developing nursing care and the new technologies involved also require nurses to learn continuously and update their expertise. Attention has also been paid to the attractiveness of the profession-its ability to attract young people and retain nurses currently working in the profession. The concept of empowerment has been widely adopted in nursing research and in development of nursing care, education, and management. In the literature it has generally considered in the context of organizations' functioning and personnel management methods. In the psychological theory, used in this study, empowerment is seen as a process of personal growth and development. The qualities, values, and endeavours inherent in the individual as well as environmental factors are key factors here. The purpose of this article is to describe the results of a quantitative study (n = 416) dealing with nurse empowerment and to identify the background factors significant for its realization. Consistent with numerous previous studies, job satisfaction and organizational commitment were found to be crucial elements of nurse empowerment, too.