中国社区护理中的组织地位与结构赋权:一项诠释性案例研究
Organizational Position and Structural Empowerment in Chinese Community Nursing: An Interpretive Case Study.
作者信息
Li Bo, Howard Natasha
机构信息
Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Mental Health Research Center, The Hong Kong Polytechnic University, Hong Kong, China.
出版信息
J Nurs Manag. 2025 Aug 6;2025:3611018. doi: 10.1155/jonm/3611018. eCollection 2025.
Nurse empowerment is widely recognized for advancing professional development and job satisfaction, yet its structural dimensions remain underexplored in China's community nursing sector. Guided by Kanter's structural empowerment theory, this interpretive case study examines how formal hierarchies and informal organizational dynamics converge to shape community nurses' access to power in nonward settings. Drawing on 24 semistructured remote interviews and unstructured observations in Shenzhen, four interrelated themes were identified: (1) dual-function caregiving roles, (2) entitlement to formal power, (3) variation in informal roles, and (4) inequities in informal power. Each theme explicitly connects to core components of structural empowerment, access to supply, information, support, and opportunities, illustrating how organizational structures and interpersonal relationships jointly shape nurses' empowerment experiences. Findings reveal tensions between formal structures intended to promote empowerment and informal dynamics that sustain power asymmetries. By unpacking these layered power relations, the study offers critical insight into structural empowerment in decentralized nursing contexts and calls for both policy and managerial reforms to foster inclusive, ethically grounded organizational cultures.
护士赋权在促进专业发展和工作满意度方面得到广泛认可,但其结构维度在中国社区护理领域仍未得到充分探索。本解释性案例研究以坎特的结构赋权理论为指导,考察正式层级和非正式组织动态如何相互作用,以塑造社区护士在非病房环境中获取权力的途径。通过对深圳的24次半结构化远程访谈和非结构化观察,确定了四个相互关联的主题:(1)双重功能的护理角色,(2)正式权力的赋予,(3)非正式角色的差异,(4)非正式权力的不平等。每个主题都明确与结构赋权的核心要素、供应、信息、支持和机会的获取相联系,说明了组织结构和人际关系如何共同塑造护士的赋权体验。研究结果揭示了旨在促进赋权的正式结构与维持权力不对称的非正式动态之间的紧张关系。通过剖析这些多层次的权力关系,该研究为分散式护理环境中的结构赋权提供了重要见解,并呼吁进行政策和管理改革,以培育包容、有道德基础的组织文化。