沙特护士的护理工作环境与临床决策之间的关系：以心理授权为中介

Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator.

作者信息

Alharbi Abdulhafith, Alkubati Sameer A, Albaqawi Hamdan, Ali Aziza Z, Hamed Laila A, Mohammed Shaimaa, Cornejo Larry Terence O, Pasay-An Eddieson

机构信息

Department of Psychiatric and Mental Health Nursing, College of Nursing, University of Hail, Hail, SA, 55424, Saudi Arabia.

Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia.

出版信息

BMC Nurs. 2025 Jul 1;24(1):682. doi: 10.1186/s12912-025-03482-2.

DOI:10.1186/s12912-025-03482-2

PMID:40598102

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12210569/

Abstract

BACKGROUND

Clinical decision-making in the context of nursing practice is considered an essential skill for nursing practitioners. Nonetheless, various factors, such as the work environment and nurses' psychological empowerment (PE), may negatively influence their decision-making ability. Therefore, this study assessed the relationship between clinical decision-making (CDM) and the nursing work environment (NWE), focusing on the mediating role of PE among clinical nurses in Hail Province, Saudi Arabia.

METHODS

This cross-sectional study used a self-administered questionnaire to collect data from 298 nurses at five hospitals in Hail Province, Saudi Arabia, from January to March 2025. Besides demographic characteristics, the questionnaire included the following tools: the CDM, the NWE-questionnaire, and the PE Scale. Multiple linear regression was used to identify significant predictors of both CDM and PE. The mediating role of PE on the relationship between NWE and CDM was examined using Hayes' Process Macro program v4.2 (Model 4).

RESULTS

Multiple linear regression revealed that being a head nurse and perceiving a more positive NWE were significant predictors of higher scores of nurses' PE (P < 0.05). On the other hand, being a registered or head nurse, working more than five days per week, and perceiving a more supportive NWE were significant predictors of higher levels of nurses' CDM (P < 0.05). Conversely, working regular night shifts was a significant predictor of lower scores of nurses' CDM. A significant positive direct effect and total effect were found between NWE and nurses' CDM (B = 0.136, P = 0.017 and B = 0.273, P < 0.001, respectively). The indirect effect (B = 0.137), based on 5,000 bootstrap resamples, had a bootstrap confidence interval above zero (0.021 to 0.263), indicating a partial positive mediating role of PE in the relationship between NWE and CDM.

CONCLUSION

PE plays a vital role in fostering CDM and promoting a supportive NWE for nurses in clinical settings across Hail Province. These insights emphasize the need for establishing psychologically empowering conditions in the workplace to level up nurses' self-perceived competence and confidence in CDM.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

在护理实践中，临床决策被认为是护理从业者的一项基本技能。尽管如此，各种因素，如工作环境和护士的心理授权（PE），可能会对他们的决策能力产生负面影响。因此，本研究评估了沙特阿拉伯哈伊勒省临床护士的临床决策（CDM）与护理工作环境（NWE）之间的关系，重点关注PE的中介作用。

方法

本横断面研究采用自填式问卷，于2025年1月至3月从沙特阿拉伯哈伊勒省五家医院的298名护士中收集数据。除人口统计学特征外，问卷还包括以下工具：CDM、NWE问卷和PE量表。采用多元线性回归确定CDM和PE的显著预测因素。使用Hayes的Process Macro程序v4.2（模型4）检验PE在NWE与CDM关系中的中介作用。

结果

多元线性回归显示，担任护士长以及感知到更积极的NWE是护士PE得分较高的显著预测因素（P < 0.05）。另一方面，担任注册护士或护士长、每周工作超过五天以及感知到更支持性的NWE是护士CDM水平较高的显著预测因素（P < 0.05）。相反，定期值夜班是护士CDM得分较低的显著预测因素。在NWE与护士的CDM之间发现了显著的正向直接效应和总效应（分别为B = 0.136，P = 0.017和B = 0.273，P < 0.001）。基于5000次自抽样重抽样的间接效应（B = 0.137）的自抽样置信区间高于零（0.021至0.263），表明PE在NWE与CDM关系中具有部分正向中介作用。