Graduating Nursing Students' Empowerment and Related Factors: Comparative Study in Six European Countries
Status PubMed-not-MEDLINE Language English Country Switzerland Media electronic
Document type Journal Article
Grant support
2017_2018
THE FINNISH NURSING EDUCATION FOUNDATION SR
PubMed
35627891
PubMed Central
PMC9140337
DOI
10.3390/healthcare10050754
PII: healthcare10050754
Knihovny.cz E-resources
- Keywords
- competence, empowerment, intention to leave, nursing education, nursing students,
- Publication type
- Journal Article MeSH
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.
Azienda per i Servizi Sanitari Provinciali University of Verona 38123 Trento Italy
Department of Biostatistics University of Turku 20014 Turku Finland
Department of Medicine Udine University 33100 Udine Italy
Department of Nursing Administration Lisbon School of Nursing ESEL 1600 096 Lisbon Portugal
Department of Nursing Science University of Eastern Finland 70211 Kuopio Finland
Department of Nursing Science University of Turku 20014 Turku Finland
Diaconia University of Applied Sciences 00580 Helsinki Finland
School of Health Care Savonia University of Applied Sciences 70201 Kuopio Finland
School of Health Sciences University of Aveiro 3810 193 Aveiro Portugal
See more in PubMed
World Health Organization State of the World’s Nursing 2020: Investing in Education, Jobs and Leadership. 2020. [(accessed on 24 March 2022)]. Available online: https://www.who.int/publications/i/item/9789240003279.
World Health Organization Health 2020: A European Policy Framework Supporting Action across Government and Society for Health and Well-Being. 2020. [(accessed on 24 March 2022)]. Available online: https://www.euro.who.int/__data/assets/pdf_file/0006/199536/Health2020-Short.pdf.
International Council of Nurses Nurses’ Role in Achieving the Sustainable Development Goals. 2017. [(accessed on 24 March 2022)]. Available online: https://www.icnvoicetolead.com/wp-content/uploads/2017/04/ICN_AVoiceToLead_guidancePack-9.pdf.
World Health Organization Urgent Health Challenges for the Next Decade. 2020. [(accessed on 24 March 2022)]. Available online: https://www.who.int/news-room/photo-story/photo-story-detail/urgent-health-challenges-for-the-next-decade.
European Commission Forces Shaping and Challenging the Resilience of the Health Work Force. 2020. [(accessed on 24 March 2022)]. Available online: https://ec.europa.eu/health/workforce/overview_en.
Scheffler R.M., Arnold D.R. Projecting shortages and surpluses of doctors and nurses in the OECD: What looms ahead. Health Econ. Policy Law. 2019;14:274–290. doi: 10.1017/S174413311700055X. PubMed DOI
Moore S.C., Ward K.S. Nursing student perceptions of structural empowerment. Nurs. Educ. Perspect. 2017;38:32–33. doi: 10.1097/01.NEP.0000000000000096. PubMed DOI
Kennedy S., Hardiker N., Staniland K. Empowerment an essential ingredient in the clinical environment: A review of the literature. Nurse Educ. Today. 2015;35:487–492. doi: 10.1016/j.nedt.2014.11.014. PubMed DOI
Leineweber C., Chungkham H.S., Lindqvist R., Westerlund H., Runesdotter S., Smeds Alenius L., Tishelman C., RN4CAST Consortium Nurses’ practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study. Int. J. Nurs. Stud. 2016;58:47–58. doi: 10.1016/j.ijnurstu.2016.02.003. PubMed DOI
Kajander-Unkuri S., Koskinen S., Brugnolli A., Cerezuela Torre M.A., Elonen I., Kiele V., Lehwaldt D., Löyttyniemi E., Nemcová J., Simão de Oliveira C., et al. The level of competence of graduating nursing students in 10 European countries—Comparison between countries. Nurs. Open. 2021;8:1048–1062. doi: 10.1002/nop2.712. PubMed DOI PMC
Sasso L., Bagnasco A., Catania G., Zanini M., Aleo G., Watson R., RN4CAST@IT Working Group Push and pull factors of nurses’ intention to leave. J. Nurs. Manag. 2019;27:946–954. doi: 10.1111/jonm.12745. PubMed DOI
Duchscher J.E.B. Transition shock: The initial stage of role adaptation for newly graduated registered nurses. J. Adv. Nurs. 2009;65:1103–1113. doi: 10.1111/j.1365-2648.2008.04898.x. PubMed DOI
Labrague L.J., McEnroe-Petitte D.M. Job stress in new nurses during the transition period: An integrative review. Int. Nurs. Rev. 2018;65:491–504. doi: 10.1111/inr.12425. PubMed DOI
Nantsupawat A., Kunaviktikul W., Nantsupawat R., Wichaikhum O.A., Thienthong H., Poghosyan L. Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. Int. Nurs. Rev. 2017;64:91–98. doi: 10.1111/inr.12342. PubMed DOI
Li H., Shi Y., Li Y., Xing Z., Wang S., Ying J., Zhang M., Sun J. Relationship between nurse psychological empowerment and job satisfaction: A systematic review and meta-analysis. J. Adv. Nurs. 2018;74:1264–1277. doi: 10.1111/jan.13549. PubMed DOI
Favaro A., Wong C., Oudshoorn A. Relationships among sex, empowerment, workplace bullying and job turnover intention of new graduate nurses. J. Clin. Nurs. 2021;30:1273–1284. doi: 10.1111/jocn.15671. PubMed DOI
Kuokkanen L., Leino-Kilpi H. Power and empowerment in nursing: Three theoretical approaches. J. Adv. Nurs. 2000;31:235–241. doi: 10.1046/j.1365-2648.2000.01241.x. PubMed DOI
Woodward K.F. Individual nurse empowerment: A concept analysis. Nurs. Forum. 2020;55:136–143. doi: 10.1111/nuf.12407. PubMed DOI
Kuokkanen L., Leino-Kilpi H., Numminen O., Isoaho H., Flinkman M., Meretoja R. Newly graduated nurses’ empowerment regarding professional competence and other work-related factors. BMC Nurs. 2016;15:22. doi: 10.1186/s12912-016-0143-9. PubMed DOI PMC
Regan S., Laschinger H.K., Wong C. The influence of empowerment, authentic leadership, and professional practice environments on nurses’ perceived interprofessional collaboration. J. Nurs. Manag. 2016;24:E54–E61. doi: 10.1111/jonm.12288. PubMed DOI
Fragkos K., Makrykosta P., Frangos C. Structural empowerment is a strong predictor of organizational commitment in nurses: A systematic review and meta-analysis. J. Adv. Nurs. 2020;76:939–962. doi: 10.1111/jan.14289. PubMed DOI
Spreitzer G.M. Psychological empowerment in the workplace: Dimensions, measurement, and validation. Acad. Manag. J. 1995;38:1442–1465. doi: 10.2307/256865. DOI
Kuokkanen L. Ph.D. Thesis. University of Turku; Turku, Finland: Jun 17, 2003. Nurse Empowerment. A Model of Individual and Environmental Factors.
Thomas K.W., Velthouse B.A. Cognitive elements of empowerment: An “interpretive” model of intrinsic task motivation. Acad. Manag. Rev. 1990;15:666–681. doi: 10.2307/258687. DOI
Kuokkanen L., Leino-Kilpi H., Katajisto J. Nurse empowerment, job-related satisfaction, and organizational commitment. J. Nurs. Care Qual. 2003;18:184–192. doi: 10.1097/00001786-200307000-00004. PubMed DOI
Kuokkanen L., Suominen T., Rankinen S., Kukkurainen M.-L., Savikko N., Doran D. Organizational change and work-related empowerment. J. Nurs. Manag. 2007;15:500–507. doi: 10.1111/j.1365-2834.2007.00733.x. PubMed DOI
Tan H.V.D., Conde A.R. Nurse empowerment—Linking demographics, qualities and performance of empowered Filipino nurses. J. Nurs. Manag. 2021;29:1302–1310. doi: 10.1111/jonm.13270. PubMed DOI
Siekkinen M., Kuokkanen L., Kuusisto H., Leino-Kilpi H., Rautava P., Rekunen M., Seppänen L., Stolt M., Walta L., Sulosaari V. Work empowerment among cancer care professionals: A cross-sectional study. BMC Health Serv. Res. 2021;21:502. doi: 10.1186/s12913-021-06528-8. PubMed DOI PMC
Al-Dweik G., Al-Daken L.I., Abu-Snieneh H., Ahmad M.M. Work-related empowerment among nurses: Literature review. Int. J. Prod. Qual. Manag. 2016;19:168–186. doi: 10.1504/IJPQM.2016.10000161. DOI
Ta’an W.F., Alhurani J., Alhalal E., Al-Dwaikat T.N., Al-Faouri I. Nursing empowerment: How job performance is affected by a structurally empowered work environment. J. Nurs. Adm. 2020;50:635–641. doi: 10.1097/NNA.0000000000000951. PubMed DOI
Alhalal E., Alrashidi L.M., Alanazi A.N. Predictors of patient-centered care provision among nurses in acute care setting. J. Nurs. Manag. 2020;28:1400–1409. doi: 10.1111/jonm.13100. PubMed DOI
Kim J.H., Shin H.S. Exploring barriers and facilitators for successful transition in new graduate nurses: A mixed methods study. J. Prof. Nurs. 2020;36:560–568. doi: 10.1016/j.profnurs.2020.08.006. PubMed DOI
Numminen O., Leino-Kilpi H., Isoaho H., Meretoja R. Newly graduated nurses’ competence and individual and organizational factors: A multivariate analysis. J. Nurs. Scholarsh. 2015;47:446–457. doi: 10.1111/jnu.12153. PubMed DOI
Meretoja R., Leino-Kilpi H., Kaira A.M. Comparison of nurse competence in different hospital work environments. J. Nurs. Manag. 2004;12:329–336. doi: 10.1111/j.1365-2834.2004.00422.x. PubMed DOI
Kelley K., Clark B., Brown V., Sitzia J. Good practice in the conduct and reporting of survey research. Int. J. Qual. Health Care. 2003;15:261–266. doi: 10.1093/intqhc/mzg031. PubMed DOI
Polit D.F., Beck C.T. Essentials of Nursing Research: Appraising Evidence for Nursing Practice. 9th ed. Wolters Kluwer Health; Philadelphia, PA, USA: 2018.
Cook C., Heath F., Thompson R.L. A meta-analysis of response rates in web- or internet-based surveys. Educ. Psychol. Meas. 2000;60:821–836. doi: 10.1177/00131640021970934. DOI
Meretoja R., Isoaho H., Leino-Kilpi H. Nurse competence scale: Development and psychometric testing. J. Adv. Nurs. 2004;47:124–133. doi: 10.1111/j.1365-2648.2004.03071.x. PubMed DOI
Flinkman M., Leino-Kilpi H., Numminen O., Jeon Y., Kuokkanen L., Meretoja R. Nurse Competence Scale: A systematic and psychometric review. J. Adv. Nurs. 2017;74:1035–1050. doi: 10.1111/jan.13183. PubMed DOI
Squires A., Aiken L.H., van den Heede K., Sermeus W., Bruyneel L., Lindqvist R., Schoonhoven L., Stromseng I., Busse R., Brzostek T., et al. A systematic survey instrument translation process for multi-country, comparative health workforce studies. Int. J. Nurs. Stud. 2013;50:264–273. doi: 10.1016/j.ijnurstu.2012.02.015. PubMed DOI PMC
All European Academies The European Code of Conduct for Research Integrity. 2017. [(accessed on 24 March 2022)]. Available online: https://allea.org/code-of-conduct/
World Medical Association The World Medical Association Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects. 2013. [(accessed on 24 March 2022)]. Available online: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ PubMed
European Commission: Directive 2013/55/EU. [(accessed on 24 March 2022)];2013 Available online: https://www.legislation.gov.uk/eudr/2013/55/contents.
Cusson R.M., Meehan C., Bourgault A., Kelley T. Educating the next generation of nurses to be innovators and change agents. J. Prof. Nurs. 2020;36:13–19. doi: 10.1016/j.profnurs.2019.07.004. PubMed DOI
Almeida S., Montayre J. An integrative review of nurse-led virtual clinics. Nurs. Prax. N. Z. 2019;35:18–28. doi: 10.36951/NgPxNZ.2019.003. DOI
Visiers-Jiménez L., Suikkala A., Salminen L., Leino-Kilpi H., Löyttyniemi E., Henriques M.A., Jiménez-Herrera M., Nemcová J., Pedrotti D., Rua M., et al. Clinical learning environment and graduating nursing students’ competence: A multi-country cross-sectional study. Nurs. Health Sci. 2021;23:398–410. doi: 10.1111/nhs.12819. PubMed DOI
Halter M., Boiko O., Pelone F., Beighton C., Harris R., Gale J., Gourlay S., Drennan V. The determinants and consequences of adult nursing staff turnover: A systematic review of systematic reviews. BMC Health Serv. Res. 2017;17:824. doi: 10.1186/s12913-017-2707-0. PubMed DOI PMC
Glomsås H.S., Tranum T.S., Johannessen A.K. Piloting a practice model in a Norwegian nursing home—A student-managed ward: A way to empower students for the nursing role. Nurse Educ. Pract. 2019;34:161–166. doi: 10.1016/j.nepr.2018.11.017. PubMed DOI