the effect of structural empowerment and organizational commitment on chinese nurses' job...

Applied Nursing Research xxx (2014) xxx–xxx

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Applied Nursing Research

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The effect of structural empowerment and organizational commitment on Chinesenurses' job satisfaction

Jinhua Yang, MSN, RN a,⁎, Yanhui Liu, PhD b, Yan Chen, PhD c, Xiaoyan Pan, MSN c

a School of Nursing, Hunan University of Chinese Medicine, Hanpu science park, Changsha, Hunan, China, 410208b School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China, 300193c School of Nursing, Hunan University of Chinese Medicine, Hunan, China

a b s t r a c ta r t i c l e i n f o

⁎ Corresponding author. Tel.: +86 0731 88458317.E-mail address: [email protected] (J. Yang).

0897-1897/$ – see front matter © 2013 Elsevier Inc. Alhttp://dx.doi.org/10.1016/j.apnr.2013.12.001

Please cite this article as: Yang, J., et al., Tsatisfaction, Applied Nursing Research (2014

Article history:
Received 8 February 2013Revised 4 December 2013Accepted 14 December 2013Available online xxxx
Keywords:ChinaEmpowermentJob satisfactionNursesNursing

Purposes: The purposes of this study were (1) to examine the level of structural empowerment, organizationalcommitment and job satisfaction in Chinese nurses; and (2) to investigate the relationships among the threevariables.Background: A high turnover rate was identified in Chinese staff nurses, and it was highly correlated withlower job satisfaction. Structural empowerment and organizational commitment have been positively relatedto job satisfaction in western countries.Methods: A cross-sectional survey design was employed. Data analysis included descriptive statistics andmultiple step-wise regression to test the hypothesized model.Results:Moderate levels of the three variables were found in this study. Both empowerment and commitmentwere found to be significantly associated with job satisfaction (r = 0.722, r = 0.693, p b 0.01, respectively).The variables of work objectives, resources, support and informal power, normative and ideal commitment
were significant predictors of job satisfaction.Conclusions: Support for an expanded model of Kanter's structural empowerment was achieved in this study.
© 2013 Elsevier Inc. All rights reserved.

1. Introduction

A serious shortage and a high turnover of nurses have becomeglobal issues (Baernholdt & Mark, 2009), and studies have found thatnurse turnover was highly linked with job satisfaction (Sullivan,2009). As a result, the exploration of nurses' job satisfaction and itsunderpinning variables are of growing importance for the interna-tional nursing community to explore. According to Vinita, Ken, andAnn (2009), lower job satisfaction resulted in professional burnoutand increased sick leave and absenteeism. In addition, lower jobsatisfaction has been linked to reduced patient care quality and lowerpatient satisfaction (Szecsenyi, Goetz, Campbell, et al., 2011).Organizational administrators have the responsibility for helping toincrease nurses' job satisfaction.

The Ministry of Health (2012) estimated that the nursingworkforce in China was 2,244,000 persons—a ratio of 1.66 nursesper 1,000 people. The causes of nurse shortage vary across differentcountries. For China, three main reasons exist. Firstly, with theincrease of both the population and elder people, more and morenurses are needed in China. The number of graduates from allprograms each year is not sufficient to meet the needs of the country.Secondly, nurses' poor working conditions are related to the shortage.Conditions include the poor position, hard work, and relative lower

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he effect of structural empo), http://dx.doi.org/10.1016

pay that causes work stress and strain, which have caused a highdegree of dissatisfaction among nurses as a whole. As a consequence,nurses are seeking employment in other fields, which exacerbates thenursing shortage even more (Cao, Shi, Chen, et al., 2013). Thirdly,more andmore international RNs migrate to western countries whereopportunities and salaries are better over the last 20 years, such asNorth America and Europe. The migration fills the gaps of westerncountries' healthcare needs, but this migration makes the shortagemore severe for the exporting nations, such as China.

According to Kanter (1977), empowerment was highly related withorganizational effectiveness. Therefore, understanding how organiza-tions create structural empowering workplaces to bring about positivenurse outcomes is significant. Many independent variables, includingpersonal, organizational and contextual characteristics, have beenproven to have positive effects on nurses' job satisfaction in westerncountries. SomeChinesenurse administratorshavebecomemore awareof the significance of empowering working settings and the relation-ships among the three study variables. However, scant studies areavailable on this issue in China. The purpose of this studywas to explorethe relationships among work empowerment, organizational commit-ment and job satisfaction among nurses in China.

1.1. Review of the literature

Power is defined as the ability to get things done, to mobilizeresources, to get and use whatever it is that a person needs for the

werment and organizational commitment on Chinese nurses' job/j.apnr.2013.12.001

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2 J. Yang et al. / Applied Nursing Research xxx (2014) xxx–xxx

goals he or she is attempting to meet (Kanter, 1993). The concept ofstructural empowerment originated from Kanter's Theory of Struc-tural Power in Organizations, which describes the conditions of thework environment. Kanter's theory (1977) states that in anempowered work environment, the work activity of empoweredemployees would be enhanced. Empowered employees have lesswork pressure and job burn-out, and therefore, are more likely toaccomplish their work successfully and be satisfied with their jobs.Lautizi, Laschinger, and Ravazzolo (2009) argued that structuralempowerment was the core of the work environment and includedorganizational strategies for individuals to work in an empoweredenvironment and enable these individuals to accomplish the workeffectively.

Kanter' organizational empowerment structures stems from foursources: access to information, receiving support, the ability tomobilize resources, and the structure of opportunity. Access toinformation means that employees have the chance to learn theorganizational decisions, policies, data, as well as goals. At the sametime, employees should also have technical knowledge and expertisefor achieving their work effectively in the work place. Whenemployees get feedback and leadership from superiors, peers andsubordinates, it means that they have received the support. Access toresources relates to one's ability to acquire money, materials, time,and equipment to finish work and organizational aims. Access toopportunity refers to job conditions, which provide more learning,challenges, knowledge, and skills for employees to advance anddevelop. According to Kanter's (1993) model of structural empower-ment, the four structural factors within the work environment have agreater impact on employees' work attitudes and behaviors thanpersonal predispositions or socialization experiences. Structuralempowerment comes from both the formal and informal systems inthe workplace.

A growing number of studies have supported Kanter's empower-ment theory in the nursing staff members and have linkedempowerment to various organizational outcomes. The outcomesincluded organizational commitment (Laschinger, Finegan, & Wilk,2009), job satisfaction (Laschinger, Leiter, Day, & Gilin, 2009; Sun, He,& Wang, 2009), lower levels of burnout, and job strain (Manojlovich,2003). A convenience sample of 416 nurses was tested in Korea (Han,Ja, & Kyoung, 2009). The results showed structural empowermentwas related to job satisfaction and organizational commitment.Similar results were found in Taiwan (Kuo, Yin, & Li, 2008) and Italy(Lautizi et al., 2009).

Organizational commitment, as the relative strength of anindividual's involvement in and identification with a particularorganization, is a crucial issue in current restructured health caresettings. Organizational commitment is a multidimensional workattitude, determined to include affective, continuance, and normativecommitment. Allen and Meyer (1990) have demonstrated thatorganizational commitment positively associated with job satisfac-tion, job retention as well as job performance. In this study,organizational commitment is defined by Lin, Zhang, and Fang(2001) as the strong desire of an employee to maintain membershipof an organization. He described five components of organizationalcommitment: affective, normative, ideal, economic, and opportunitycommitment. Affective commitment refers to an employee's emo-tional attachment to and identification with the organization. Theemployee is willing to consecrate to the survival and development ofthe organization, evenwithout any kind of reward, and never considerjob-hopping in any temptation. Normative commitment refers to anemployee's desire to stay with the organization based on a sense ofduty, social norms, or ethical standards. Ideal commitment refers to anemployee's attention paid to personal growth and the pursuit ofrealization of the ideal. The employee concerns about whether theindividual expertise can be exerted in the organization. Economiccommitment refers to an employee's fear of suffering economic loss

Please cite this article as: Yang, J., et al., The effect of structural emposatisfaction, Applied Nursing Research (2014), http://dx.doi.org/10.1016

after leaving the organization. Opportunity commitment refers to anemployee's fundamental reason to stay in the organization in that nomore satisfying job could be found or no opportunity is found to lookfor another job due to the employees' low level of technology skills.

Employees who were highly committed to the organization mightincrease their willingness to be involved in the organization'sactivities to stay with the employing organization (Felfe, Schmook,Schyns, & Six, 2008). Thus, the nurse manager must assess the nurses'commitment levels to better understand what motivates nurses. Themediating role of organizational commitment has been proven in theperceptions of the practice environment–intention to leave relation-ship (Lious & Grobe, 2008).

Job satisfaction represents the degree to which employees' needsand wants are satisfied within the workplace (Utriainen & Kyngs,2009). Namely, job satisfaction is related to the extent to whichindividuals love or enjoy their jobs. Job satisfaction comprised of threecomponents: intrinsic, extrinsic, and general job satisfaction. Intrinsicjob satisfaction refers to individuals' value in the light of theircreativity, future development and stability, opportunities for re-source mobilization derived from their work. Extrinsic job satisfactionincludes factors related to job performance within the workplace,which refers to salary, promotion and the management. General jobsatisfaction refers to the work environment and relationship betweenthe employees.

Many independent variables influenced nurses' job satisfaction.Studies have found that autonomy was the strongest predictor ofnurses' job satisfaction, which was subsequently related to nurseretention (George & Meg, 2009). Laschinger (2008) indicated that astatistically significant positive relationship existed between struc-tural empowerment and perceived control over nursing practice,which in turn reflected positively on job satisfaction. A convenientsample of 416 nurses was tested in Korea (Han et al., 2009), and theresults showed that structural empowerment was related to jobsatisfaction.

In conclusion, structural empowerment can increase nurses' jobsatisfaction by optimizing use of professional expertise and nursingskills. Structural empowerment and organizational commitment arelinked. Because job dissatisfaction is a primary cause of turnover in thenursing population, previous findings have important implications inthe current shortage of nursing staff in China as in other countries. Inthis study, the relationships among structural empowerment, orga-nizational commitment, and job satisfaction of RNs working in Chinaare tested. Kanter's organizational empowerment theory provides thetheoretical framework for this study.

1.2. Hypotheses

It is significant to investigate whether or not support for anexpandedmodel of Kanter's organizational empowerment theorywasachieved in Chinese nurses. Thus, we tested two hypotheses in asample of Chinese nurses:

• Staff nurses' structural empowerment is statistically related totheir organizational commitment and job satisfaction.

• Staff nurses with high levels of empowerment and organiza-tional commitment are more satisfied with their jobs.

2. Methods

2.1. Design and sample

A cross-sectional survey design was used in the present study. Aconvenience sample of 600 full-time qualified nurses employed byfive tertiary first-class hospitals in Tianjin was surveyed. The fiveteaching hospitals are in the highest Chinese health-care systemranking by the Ministry of Health. Of 600 questionnaires, 574



Table 1Demographic characteristics of nurses (n = 524).

Variables n (%)

GenderFemale 512 (97.7)Male 12 (2.3)

Age (years), M ± SD(range) 30.2 ± 5.76 (18–54)Year(s) working

b1 78 (14.9)1–5 252 (48.1)6–10 90 (17.1)N11 104 (19.9)

Marital statusMarried 344 (65.7)Single 180 (34.3)

Educational levelBachelor's degree 209 (39.9)Associate degree 254 (48.5)Secondary technical certificate 61 (11.7)

Professional titleSenior nurse 58 (11.1)Junior nurse 164 (31.3)Primary nurse 302 (57.6)

Work objectiveLove nursing 85 (16.2)Satisfy parents' expectation 41 (7.8)Survival need 398 (76.0)

3J. Yang et al. / Applied Nursing Research xxx (2014) xxx–xxx

questionnaires were completed and returned. Our actual final sampleconsisted of 524 usable questionnaires with a response rate of 87%.Data were collected in March 2012.

2.2. Procedure

Ethical approval was gained from the Tianjin University ofTraditional Chinese Medicine's Research Ethics Committee. Beforethe distribution of the questionnaires, a nominated survey coordina-tor contacted the nursing department of the five hospitals andobtained consent from the nursing administrators, who provided uswith a meeting schedule. Around 20 questionnaires were distributedto nurses in 5–8 key departments in each of the 5 hospitals for a totalof 600 questionnaires. All the departments had similar organizationalstructures. A trained researcher explained the purposes of this studyto the potential participants. Informed consent was obtained from allparticipants, and all participants were assured of their right towithdraw from the study at any time with no negative ramifications.Anonymity and confidentiality were assured. The four questionnaireswere placed in an envelope and nurses who consented to participatecompleted the questionnaires immediately upon receipt and placedthe questionnaires back into the envelope. All completed question-naires were collected after the meeting, and a small gift was given tothe participants. Only the researchers could examine the completedquestionnaires on which code numbers were placed after collection.

2.3. Instruments

Participants were asked to complete four questionnaires.Structural empowerment was measured with the 19-item Condi-

tions for Work Effectiveness Questionnaire–II (CWEQ-II) (Laschinger,Finegan, Shamian, & Casier, 2000). With three items for each of thefive subscales (opportunity, resource, information, support, andformal empowerment) and four items for the subscale of informalempowerment, CWEQ-II demonstrated adequate confirmatory factoranalytic structure across Chinese nurse samples (X2 = 300, df = 136,Comparative Fit Index [CFI] = 0.94, Tucker Lewis index (TLI) = 0.93,Root Mean Square Error of Approximation [RMSEA] = 0.07) and hadstrong internal reliability (alpha = 0.936) (Huang & Liu, 2011). Itemsare rated on a 5-point scale. To get a composite empowerment score(score range: 6–30), all items for each of the six subscales are summedand averaged to provide a subscale composite average. In this study,the alpha reliability of the total scale was 0.94 and for each subscalewas between 0.76–0.91. The two-item global empowerment scalewas significantly related to the CWEQ-II (r = 0.704, p b 0.01), whichdemonstrated reasonable construct validity of the translatedinstrument.

Organizational commitment was operationalized using ProfessorLin Wenquan's (2001) multidimensional concept (OCQ for Chinese,COCQ) which included five dimensions of commitment: affective,normative, ideal, economic, and opportunity. Each dimension has 5questions, with a total of 25 questions. All measures are self-assessments and use a 5-point Likert scale. All five responses foreach of the five dimensions are summed and averaged to obtain adimension mean score, with higher scores representing higher levelsof perceived affective, normative, ideal, economic and opportunitycommitment. An overall organizational commitment score is obtainedby summing themeans of the 5 scales. The alpha reliability of the totalscale in the current study was 0.85 and for each subscale was between0.67–0.78.

Job satisfaction was measured with the 20-item MinnesotaSatisfaction Questionnaire (MSQ) developed by Weiss and Davis(1967). MSQ has been used in previous studies of Chinese nurses' jobsatisfaction. The items form 3 subscales: intrinsic, extrinsic andgeneral satisfaction, with twelve, six and two items, respectively. Thesubscales use a 5-point Likert score from strongly dissatisfied (1) to


strongly satisfied (5), with high scores representing high levels of jobsatisfaction. In this study, the alpha reliability coefficients were 0.94for the total scale.

To measure demographic data, we designed six items to collectinformation on characteristics such as age, education level, specialtyarea and work objective.

2.4. Data analysis

The data analysis was conducted by SPSS (version 11.5, SPSS Inc.,Chicago, IL, USA), using descriptive statistics, correlation analysis andmultiple stepwise regression analysis.

3. Results

3.1. Demographic characteristics

Demographic characteristics are presented in Table 1. The re-spondents all worked full-time, and most were women (97.7%). Theage of the respondents ranged from 18–54 years old with a mean ageof 30.2 years (SD = 5.76, median = 27). In terms of marital status,34.3%were single, and 65.7%weremarried. Nearly half of respondentshad been in their current workplace for 1 to 5 years. Majority of thesamples were primary nurses (57.6%), had an associate degree(48.5%) and worked for survival needs (76.0%).

3.2. Structural empowerment of the nurses

Structural empowerment scores are shown in Table 2. Therespondents did not consider their workplace to be highly empower-ing (mean = 13.36, SD = 3.54), slightly lower than Lautizi et al.(2009) hospital-based study in America but much lower thanAmerican nurse practitioners in Stewart, McNulty S., Quinn Griffin,et al.'s (2010) study. Within the six dimensions of structuralempowerment, support (mean = 2.40, SD = 0.77) and opportunity(mean = 2.39, SD = 0.70) were the two highest scored dimensions.The formal power was the lowest dimension (mean = 1.92, SD =0.76). This pattern is similar to those in Young-Ritchie andLaschinger's (2009) study, although the ratings of each subscalewere considerably lower in the current study.



Table 2Item, range, means (M), and standard deviations (SD) among variables (n = 524).

Variable Item Range M SD

1. Total empowerment 19 6–30 13.36 3.54Support 3 1–5 2.40 0.77Opportunity 3 1–5 2.39 0.70Resource 3 1–5 2.33 0.77Information 3 1–5 2.04 0.78Informal power 4 1–5 2.28 0.66Formal power 3 1–5 1.92 0.76

2. Total commitment 25 5–25 14.38 3.07Normative 5 1–5 3.17 0.73Economic 5 1–5 2.92 0.70Affective 5 1–5 2.82 0.82Opportunity 5 1–5 2.75 0.68Ideal 5 1–5 2.72 0.79

3. Total JS 20 1–5 2.95 0.75Intrinsic JS 12 1–5 3.09 0.67Extrinsic JS 6 1–5 2.95 0.80General JS 2 1–5 2.51 0.98


3.3. Organizational commitment of the nurses

Organizational commitment scores are shown in Table 2. Theoverall mean score of organizational commitment was 14.38 ± 3.07(mean ± SD), indicating a moderate level of organizational commit-ment. These findings are consistent with numerous studies of staffnurses in various clinical settings (Laschinger et al., 2000; Young-Ritchie & Laschinger, 2009). Within the different dimensions oforganizational commitment, normative (mean = 3.17, SD = 0.73)and economic (mean = 2.92, SD = 0.70) were the two highestscored dimensions.

3.4. Job satisfaction of the nurses

Job satisfaction scores are shown in Table 2. The respondents hada medium-high level of job satisfaction, with an average degree of2.95 ± 0.75, lower than the level of nursing assistants in Taiwan(Kuo et al., 2008). Within the three dimensions, the highestdimension of job satisfaction was the intrinsic satisfaction(mean = 3.09, SD = 0.67).

3.5. Job satisfaction related factors

The correlations between the variables of the current study arepresented in Table 3. Structural empowerment was significantly andpositively related to organizational commitment (r = 0.63, p b 0.01).Both structural empowerment and organizational commitment weresignificantly and positively related to job satisfaction (r = 0.72, r =

Table 3Correlations among structural empowerment, organizational commitment and job satisfact

1 2 3 4 5

1.Total empowerment —

2.Opportunity .76 —

3.Information .80 .51 —

4.Support .85 .60 .70 —

5.Resources .81 .53 .54 .65 —

6.Formal power .85 .54 .63 .66 .647.Informal power .78 .52 .50 .53 .588.Total commitment .63 .45 .52 .50 .579.Affective .55 .40 .40 .49 .5110.Normative .51 .37 .38 .42 .4511.Ideal .58 .41 .49 .47 .5212.Economic .33 .29 .27 .27 .2613.Opportunity .36 .26 .33 .30 .3614. Job satisfaction .72 .54 .49 .59 .67

All correlations significant at p b 0.01 (two-tailed test).


0.69, p b 0.01, respectively). All dimensions in both structuralempowerment and organizational commitment had statisticallysignificant association with job satisfaction. Similar results havebeen found in other countries, such as North America (Laschinger,Leiter, Day, & Gilin, 2009), England and Malaysia (Ahmad & Oranye,2010).

We used the method of multiple stepwise regression analysis tounderstand which of the variables predicted the nurses' jobsatisfaction, and the results are shown in Table 4. In the regressionanalysis, job satisfaction was used as a dependent variable. Thedemographic variables, all significant variables of structural empow-erment (containing the total six dimensions) and all significantvariables of organizational commitment (containing the total fivedimensions) were used as independent variables. The variables ofwork objectives in demographic factors (standardized B = −0.379,t = −2.641), support, resources and informal power in structuralempowerment (standardized B = 3.774, t = 3.910; standardizedB = 3.497, t = 3.919; standardized B = 2.828, t = 2.787; respec-tively) and normative, ideal in organizational commitment (stan-dardized B = 3.970, t = 3.542; standardized B = 4.301, t = 4.014;respectively) were significant independent predictors of job satisfac-tion, explaining 67.0% of the variance (adjusted R2 = 0.670, F =35.915, p b 0.001). This finding is consistent with those of Laschin-ger's study (2009b) in America and Kuo's study (2008) in Taiwan.

4. Discussion

The paper examines the levels of job satisfaction, structuralempowerment and organizational commitment and investigates therelationships among the three variables in Chinese nurses. All in all,the respondents have a moderate level of job satisfaction, and manyfactors appeared to contribute to their job satisfaction. The resultshighlight the importance of empowerment to positive employeeoutcomes.

The findings of the study revealed that the participants hadmoderate levels of structural empowerment and organizationalcommitment. And similar level has been demonstrated in previousstudies in China (Cai & Zhou, 2009). Concerning organizationalcommitment, normative and economic commitments got the top twohigh scores. Concerning structural empowerment, support andopportunity got the top two high scores. Nurses rated their accessto information and formal power lowest. Nurses perceived them-selves to be highly empowered when they collaborated with otherprofessionals and had autonomy to any problems within theorganization. Recent research supports our results (Chen & Lin,2002). In China, the lack of access to information and resources mayaccount for the moderate level of empowerment.

ion among nurses (n = 524).

6 7 8 9 10 11 12 13

—

.61 —

.50 .47 —

.44 .46 .79 —

.41 .43 .78 .67 —

.50 .43 .81 .61 .55 —

.24 .37 .70 .57 .49 .52 —

.33 .27 .72 .48 .47 .51 .69 —

.57 .61 .69 .69 .61 .69 .38 .45



Table 4Stepwise regression analysis of job satisfaction (n = 524).

Variable B Beta t p

Work objectives −0.379 −0.274 −2.641 0.009Support 3.774 0.216 3.910 0.000Resources 3.497 0.199 3.919 0.000Informal power 2.828 0.138 2.787 0.006Normative 3.970 0.206 3.542 0.000Ideal 4.301 0.252 4.014 0.000

R2 = 0.689, adjusted R2 = 0.670, F = 35.915, p b 0.001.

5J. Yang et al. / Applied Nursing Research xxx (2014) xxx–xxx

In the correlation analysis, nurses' overall perceptions of structuralempowerment were significantly and positively correlated with jobsatisfaction, which supported previous research (Lautizi et al., 2009).When nurses perceive they that cannot be fully empowered, theyexperience lower job satisfaction. Because nurses who are satisfiedwith their jobs are less likely to experience burnout (Laschinger,Leiter, Day, & Gilin, 2009), our results suggest that organizationaladministrators should assure that working situations are helpful toimprove nurses' satisfaction with their jobs. Moreover, we found thatorganizational commitment was statistically significant and positivelyrelated to job satisfaction, consistent with those of previous studies(Ahmad & Oranye, 2010). In order to improve the ardently love ofnursing staff for their work, nurse managers could address theorganizational commitment, with particular emphasis on the recog-nition for the young nurses on organizational values, culture, socialnorms to help them develop practical career planning, which areessential for the formation of organizational commitment.

In the multiple regression analysis, work objective was the onlydemographic variable that significantly predicted job satisfaction. Theresult is consistent with Sun & Wang (2009) finding. Nurses wholoved the nursing profession perceived higher job satisfaction.However, only 16.2% respondents in this study loved the nursingprofession, most respondents worked to survive. Therefore, toimprove job satisfaction, nurse managers should focus on theeducation of nursing professionals and improve the level of pro-fessionals' acceptance of nurses.

The three significant predictors of job satisfaction in structuralempowerment were resources, support, as well as informal power.Loretta (2011) reported that middle managers authorized to obtainmore resources would be seen as more effective leadership to front-line nurses, which lead to the nurses also getting more resources,thereby enhancing the quality of care. Respondents who perceivedthemselves gaining support from managers showed increased jobsatisfaction. According to Manojlovich (2003), support from theirorganization can ensure nurses with creative solutions to care issues,and enable them to demonstrate higher performance. In order toimprove nurses' work satisfaction, managers should support the workof nurses, concern about their clinical work, and provide effectiveadvice and recommendations to help them to maximize theirperformance. In this study, informal power had an impact on eachdimensions of job satisfaction. However, respondents felt lessinformal power than the nurses in other studies (Laschinger, Wong,& Greco, 2006). To a large extent, the reason is that front-line nurses inChinese nursing environment do not participate in decision-makingand have less autonomy. Furthermore, frontline nurses in China havelittle chance to build relationships with other professionals becausecollaborations with healthcare professionals are often the nursemanger's responsibility.

The two significant predictors of job satisfaction in organiza-tional commitment were normative and ideal. Lu (2008) reportedthat commitment to the organization was a significant independentpredictor of job satisfaction explaining 46.7% of the total variance.Our results suggest that the hospital should pay attention toimprove nurses' satisfaction, which can enhance these nurses' sense


of pride. Meanwhile, these nurses would have a sense of obligationfor a return to hospital. This inner satisfaction can produce a morelasting impact, so the nurses would regard work as their ownresponsibilities and obligations, and devote more effort to theorganization. According to the attitude–behavior consistency prin-ciple and the theory of attitude determines behavior, nursemanagers should start with the molding of attitudes and try tocreate the conditions for the professional development of nurses,thereby increasing job satisfaction.

5. Implications for practice

Results of these studies suggest that nurse managers can increasenurses' job satisfaction in terms of empowering them and improvingthe staff nurses' commitment to the organization by means ofmanipulating workplace structures. An understanding of currentperceptions of empowerment and its relationships to organizationalcommitment and job satisfaction in the nursing workforce may beinstructive in removing barriers to access of power sources,facilitating acceptance of change, increasing organizational commit-ment, and providing high quality patient care. Thus, nurse managersshould encourage and support interdependence among health careproviders; enable these providers to accomplish the work effectively;and create a supportive environment for nurses to build effectiverelationships with peers, superiors and subordinates within andoutside the organization. Furthermore, the nurses need to formulateindividualized professional development plans and be encouraged toparticipate in the management of the organization.

6. Limitations

Concerning the cross-sectional nature of the data, we do not knowwhether there are causal relationships among structural empower-ment, organizational commitment and job satisfaction. Futureresearch should test the causal model using a longitudinal design.Limitations of this study are the use of a convenience sample, and thedata were collected from nurses in only one city in China, which bothlimit the generalization of these findings. Additional unmeasuredvariables may have also affected our results, such as psychologicalempowerment, job strain, and leadership, which could have directeffects on job satisfaction.

7. Conclusions

Further support was obtained from this study for Kanter's theory,which could be used with Chinese nurses. The most compellingfinding from this study is that structural empowerment andorganizational commitment contribute to higher job satisfaction inthe Chinese work environment. Since the links between thesevariables were quite powerful, surely efforts to enhance workempowerment and organizational commitment could be justified. InChina, nurse managers should focus on the above factors and activelytake measures to improve the organizational empowering workconditions. These findings would be beneficial to the stability ofnursing personnel in China and Chinese nursing profession.

Acknowledgments

Financial support for this research was received from the NationalMinistry of Education (11YJCZH112). The authors also gratefullyacknowledge the supervisors and 600 nurses who participated in thisstudy for their assistance as well as all the experts andmembers of ourgroup who participated in the research for their help and advice.




References

Ahmad, N., & Oranye, N. O. (2010). Empowerment, job satisfaction and organizationalcommitment: A comparative analysis of nurses working in Malaysia and England.Journal of Nursing Management, 18(5), 582–591.

Allen, D., & Meyer, J. (1990). The measurement and antecedents of affective,continuance and normative commitment to the organization. Journal of Occupa-tional and Organizational Psychology, 63, 1–18.

Baernholdt, M., & Mark, B. A. (2009). The nurse work environment, job satisfaction andturnover rates in rural and urban nursing units. Journal of Nursing Management,17(8), 994–1001.

Cai, C., & Zhou, Z. (2009). Structural empowerment, job satisfaction and turnoverintention in Chinese clinical nurses. Nursing Health Science, 11(4), 397–403.

Cao, J., Shi, Y. P., & Chen, Y. D. (2013). The reasons for leaving and re-employmentintentions among nurses in a tertiary first-class hospital in Beijing. Chinese Journalof Nursing, 48(7), 618–620.

Chen, Y. C., & Lin, L. H. (2002). Relationships between empowerment and structuralcommitment of nurses. Journal of Tzu-Chi Nursing, 1, 53–64.

Felfe, J., Schmook, R., Schyns, B., & Six, B. (2008). Does the form of employment make adifference?—commitment of traditional, temporary, and self-employed workers.Journal of Vocational Behavior, 72(1), 81–94.

George, Z., & Meg, J. (2009). Registered nurses' job satisfaction in Navy hospitals.Military Medicine, 174(1), 76–81.

Han, S. S., Ja, S., & Kyoung, E. (2009). Empowerment, job satisfaction, and organizationalcommitment: Comparison of permanent and temporary nurses in Korea. AppliedNursing Research, 22(4), E15–E20.

Huang, C. P., & Liu, Y. H. (2011). Reliability and validity of Chinese version of theConditions of Work Effectiveness Questionnaire-II. Chinese Journal of Nursing,46(12), 1213–1215.

Kanter, R. M. (1977). Men and women of the corporation. New York, NY: Basic Books.Kanter, R. M. (1993). Men and women of the corporation (2nd ed.)NY: Basic Books.Kuo, H. T., Yin, T. J. C., & Li, I. C. (2008). Relationship between organizational

empowerment and job satisfaction perceived by nursing assistants at long-termcare facilities. Journal of Clinical Nursing, 17, 3059–3066.

Laschinger, H. K. S. (2008). Effect of empowerment on professional practiceenvironments, work satisfaction, and patient care quality: Further testing thenursing worklife model. Journal of Nursing Care Quality, 23(4), 322–330.

Laschinger, H. K. S., Finegan, J., Shamian, J., & Casier, S. (2000). Organizational trust andempowerment in restructured healthcare settings: Effects on staff nurse commit-ment. Journal of Nursing Administration, 30(9), 413–425.

Laschinger, H. K. S., Finegan, J., & Wilk, P. (2009). Context Matters: the impact of unitleadership and empowerment on nurses’ organizational commitment. Journal ofNursing Administration, 39(5), 228–235.


Laschinger, H. K. S., Leiter, M., Day, A., & Gilin, D. (2009). Workplace empowerment,incivility, and burnout: Impact on staff nurse recruitment and retention outcomes.Journal of Nursing Management, 17(3), 302–311.

Laschinger, H. K. S., Wong, C., & Greco, P. (2006). The impact of staff nurseempowerment on person-job fit and work engagement/burnout. Journal of NursingAdministration, 4, 358–367.

Lautizi, M., Laschinger, H. K. S., & Ravazzolo, S. (2009). Workplace empowerment, jobsatisfaction and job stress among Italian mental health nurses: An exploratorystudy. Journal of Nursing Management, 17, 446–452.

Lin, W. Q., Zhang, Z. C., & Fang, L. L. (2001). The study of organizationalcommitment in Chinese employees. Chinese Journal of Social Science, 21(2),90–102 (in Chinese).

Lious, S. R., & Grobe, S. J. (2008). Perception of practice environment, organizationalcommitment, and intention to leave among Asian nurses working in U.S. hospitals.Journal of Nursing Staff Development, 24, 276–282.

Loretta, C. R. (2011). Nurse empowerment from a middle-management perspective:Nurse managers’ and assistant nurse managers’ workplace empowerment views.The Permanent Journal, 15(1), 101–107.

Lu, H. (2008). The practical verification and discussion of a new model to improve thejob satisfaction of nurses. Chinese Nursing Management, 8(2), 22–25 (in Chinese).

Manojlovich, M. (2003). Environmental and personal predictors of professional nursingpractice behaviors in hospital setting. Michigan: The University of Michigan.

Ministry of Health of the People's Republic of China. (2012). http://wsb.moh.gov.cn/wsb/pxwfb/201205/54644.shtml.

Stewart, J. G., McNulty, R., Griffin, M. T., & Fitzpatrick, J. J. (2010). Psychologicalempowerment and structural empowerment among nurse practitioners. Journal ofthe American Academy of Nurse Practitioners, 22, 27–34.

Sullivan, E. J. (2009). Effective leadership and management in nursing (7th ed.)NewJersey: Prentice Hall, 265–268.

Sun, N., He, Z., & Wang, L. B. (2009). The impact of nurse empowerment on jobsatisfaction. Journal of Nursing Advancement, 65(12), 2642–2648.

Szecsenyi, J., Goetz, K., Campbell, S., Broge, B., Reuschenbach, B., & Wensing, M. (2011).Is the job satisfaction of primary care team members associated with patientsatisfaction? BMJ Quality & Safety, 20, 508–514.

Utriainen, K., & Kyngs, H. (2009). Hospital nurses' job satisfaction: A literature review.Journal of Nursing Management, 17(8), 1002–1010.

Vinita, D., Ken, P., & Ann, M. (2009). The impact of work stress and job satisfaction onturnover intentions. Informa Healthcare, 16(3), 217–231.

Weiss, D. J., & Davis, R. V. (1967). Manual for the Minnesota satisfaction questionnaire.Minneapolis MN: The University of Minnesota Press.

Young-Ritchie, C., Laschinger, H. K. S., & Wong, C. (2009). The Effect of EmotionallyIntelligent Leadership Behavior on Emergency Staff Nurses’ Workplace Empower-ment and Organizational Commitment. Nursing leadership, 22(1), 70–85.


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