Predicting emotional exhaustion among haemodialysis nurses : a structural equation model using Kanter’s structural empowerment theory

Aim To test an explanatory model of the relationships between the nursing work environment, job satisfaction, job stress and emotional exhaustion for haemodialysis nurses, drawing on Kanter's theory of organizational empowerment. Background Understanding the organizational predictors of burnout (emotional exhaustion) in haemodialysis nurses is critical for staff retention and improving nurse and patient outcomes. Previous research has demonstrated high levels of emotional exhaustion among haemodialysis nurses, yet the relationships between nurses' work environment, job satisfaction, stress and emotional exhaustion in this population are poorly understood. Design A cross-sectional online survey. Methods 417 nurses working in haemodialysis units completed an online survey between October 2011–April 2012 using validated measures of the work environment, job satisfaction, job stress and emotional exhaustion. Results Overall, the structural equation model demonstrated adequate fit and we found partial support for the hypothesized relationships. Nurses' work environment had a direct positive effect on job satisfaction, explaining 88% of the variance. Greater job satisfaction, in turn, predicted lower job stress, explaining 82% of the variance. Job satisfaction also had an indirect effect on emotional exhaustion by mitigating job stress. However, job satisfaction did not have a direct effect on emotional exhaustion. Conclusion The work environment of haemodialysis nurses is pivotal to the development of job satisfaction. Nurses' job satisfaction also predicts their level of job stress and emotional exhaustion. Our findings suggest staff retention can be improved by creating empowering work environments that promote job satisfaction among haemodialysis nurses.

Empowerment and intentions to resist future change: the moderating effect organization-based self-esteem

Nowadays, organizations face a constant need for adaptability, increasing the importance of change management. Our study focuses of how empowering leadership influences intentions to resist future changes, mediated by the effects of psychological and structural empowerment. From the responses of the two questionnaires (N1=230; Ntf=113), we found that empowering leadership fosters psychological and structural empowerment. Structural empowerment was the main driver in reducing intentions to resist future change when an employee has high organization-based self-esteem. Our findings add to the literature by examining how we can anticipate and manage change under an empowering context, building on social exchange and uncertainty reduction theories

Perceção do empowerment dos enfermeiros numa organização de saúde

Introduction: O conceito de Empowerment na Enfermagem tem sido utilizado e analisado na literatura académica, conceito digno de exploração e interesse para os enfermeiros, chefes e gestores das organizações de saúde. A perceção dos Enfermeiros acerca do Empowerment é determinante nos resultados organizacionais, no aumento da autonomia profissional, no ganho do poder individual e coletivo e nos cuidados ao utente. Objetivos: Avaliar a perceção dos Enfermeiros acerca do Empowerment (Psicológico e Estrutural), identificar os fatores que influenciam essa perceção e analisar e refletir sobre as consequências dessa perceção. Métodos: Estudo quantitativo, numa amostra de 269 enfermeiros predominantemente o sexo feminino (76,6%), faixa etária entre os 21 e os 59 anos, cuja média das idades se situa nos 40,36 anos, 68,8% dos participantes licenciados, em exercício de funções num hospital da região da Beira Alta, Portugal. Resultados: Nos enfermeiros, a perceção de Empowerment Psicológico está relacionado com a perceção de empowerment Estrutural. Os enfermeiros com mais idade e maior tempo de exercício profissional revelaram maior competência e menor oportunidade. Os enfermeiros com maior tempo no atual serviço, apresentam maior competência, mas menor oportunidade, informação, suporte e globalmente, Empowerment Estrutural. Na categoria profissional há diferenças na informação, recursos e poder informal dos Enfermeiros Especialistas. Conclusão: Os Enfermeiros revelaram bons níveis de Empowerment Psicológico e baixos níveis de Empowerment Estrutural.

Haemodialysis work environment contributors to job satisfaction and stress: A sequential mixed methods study

Background: Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Methods: Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction(IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. Results: From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Conclusions: Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.

Exploring a model of skillful engagement in nursing practice

Prominent challenges facing nurse leaders are the growing shortage of nurses and the increasingly complex care required by acutely ill patients. In organizations that shortage is exacerbated by turnover and intent to leave. Unsatisfactory working conditions are cited by nurses when they leave their current jobs. Disengagement from the job leads to plateaued performance, decreased organizational commitment, and increased turnover. Solutions to these challenges include methods both to retain and to increase the effectiveness of each nurse. ^ The specific aim of this study was to examine the relationships among organizational structures thought to foster the clinical development of the nurse, with indicators of the development of clinical expertise, resulting in outcomes of positive job attitudes and effectiveness. Causal loop modeling is incorporated as a systems tool to examine developmental cycles both for an organization and for an individual nurse to look beyond singular events and investigate deeper patterns that emerge over time. ^ The setting is an academic specialty-care institution, and the sample in this cross-sectional study consists of paired data from 225 RNs and their nurse managers. Two panels of survey instruments were created based on the model's theoretical variables, one completed by RNs and the other by their Nurse Managers. The RN survey panel examined the variables of structural empowerment, magnet essentials, knowledge as identified by the Benner developmental stage, psychological empowerment, job stage, engagement, intent to leave, job satisfaction and the early recognition of patient complications. The nurse manager survey panel examined the Benner developmental stage, job stage, and overall level of nursing performance. ^ Four regression models were created based on the outcome variables. Each model identified significant organizational and individual characteristics that predicted higher job satisfaction, decreased intent to leave, more effectiveness as measured by early recognition and acting upon subtle patient complications, and better job performance. ^ Implications for improving job attitudes and effectiveness focus on ways that nursing leaders can foster a more empowering and healthy work environment. ^

Psychometric validation of the growth and empowerment measure (GEM) applied with Indigenous Australians

Objective: Empowerment is a complex process of psychological, social, organizational and structural change. It allows individuals and groups to achieve positive growth and effectively address the social and psychological impacts of historical oppression, marginalization and disadvantage. The Growth and Empowerment Measure (GEM) was developed to measure change in dimensions of empowerment as defi ned and described by Aboriginal Australians who participated in the Family Well Being programme.---------- Method: The GEM has two components: a 14-item Emotional Empowerment Scale (EES14) and 12 Scenarios (12S). It is accompanied by the Kessler 6 Psychological Distress Scale (K6), supplemented by two questions assessing frequency of happy and angry feelings. For validation, the measure was applied with 184 Indigenous Australian participants involved in personal and/or organizational social health activities.---------- Results: Psychometric analyses of the new instruments support their validity and reliability and indicate two-component structures for both the EES (Self-capacity; Inner peace) and the 12S (Healing and enabling growth, Connection and purpose). Strong correlations were observed across the scales and subscales. Participants who scored higher on the newly developed scales showed lower distress on the K6, particularly when the two additional questions were included. However, exploratory factor analyses demonstrated that GEM subscales are separable from the Kessler distress measure.---------- Conclusion: The GEM shows promise in enabling measurement and enhancing understanding of both process and outcome of psychological and social empowerment within an Australian Indigenous context.

Factors affecting peasants’ empowerment in West Halmahera District – a case study from Indonesia

Agricultural development has not yet created empowered farmers in Indonesia. Most farmers living in eastern Indonesia are peasants with low access to development resources. This condition causes most of the peasants to be classified as poor citizens. This research was meant to formulate improvement strategies for empowerment of the peasants. The data were collected between March – May 2012 using the following methods: observation, interview and focus group discussion. The data was analysed using descriptive statistic and structural equation modelling (SEM) and showed that: (1) the empowerment of peasants was within the lowest category for all variables, namely: the peasant characteristics, the role of the agents for development, program quality, the learning process and access to environmental support, (2) the determining factors affecting the empowerment of the peasants were: program implementation quality, the role of the agents of development, environmental access and support, the peasant characteristics, and the appropriateness of the learning process and (3) the strategy to improve empowerment of the peasants could be through corrective efforts towards program implementation quality, the role of facilitators, environmental access and support while considering the peasant characteristics and the learning process of the peasants.

Are we there yet? Exploring empowerment at the microscale in the South African wine industry

Empowerment is a standard but ambiguous element of development rhetoric and so, through the socially complex and contested terrain of South Africa, this paper explores its potential to contribute to inclusive development. Investigating micro-level engagements with the national strategy of Broad-Based Black Economic Empowerment (B-BBEE) in the South African wine industry highlights the limitations, but also potential, of this single domain approach. However, latent paternalism, entrenched interests and a ‘dislocated blackness’ maintain a complex racial politics that shapes both power relations and the opportunities for transformation within the industry. Nonetheless, while B-BBEE may not, in reality, be broad-based its manifestations are contributing to challenging racist structures and normalising changing attitudes. This paper concludes that, to be transformative, empowerment needs to be re-embedded within South Africa as a multi-scalar, multi-dimensional dialogue and, despite the continuation of structural constraints, positions the local as a critical scale at which to initiate broader social change.

Structural challenges in a multipolar and multicultural global legal era : BRICS’ global legal politics beyond cultural and economic partnerships

New emerging international dynamics introduce a global poly-axiological polycentric disorder which undermines the tradition of a unique global legal order in international law. Modern Era was characterized by Western European civilizational model – from which human rights is a byproduct. This consensus had its legitimacy tested by XXst century’s scenario – and the ‘BRICS factor/actor’ is a symptom of this reality. Its empowerment in world politics lead to the rise of distinct groups of States/civilizations provided with different legal, political, economic and social traditions – promoting an unexpected uprise of otherness in international legal order and inviting it to a complete and unforeseeable reframing process. Beyond Washington or Brussels Consensus, other custom-originated discourses (Brasília, Moscow, New Delhi, Peking or Cape Town Consensus, among other unfolded possibilities) will probably henceforth attempt shaping international law in present global legal disorder.

The effect of vision congruence on employee empowerment, commitment, satisfaction, and performance

Five models delineating the person-situation fit controversy were developed and tested. Hypotheses were tested to determine the linkages between vision congruence, empowerment, locus of control, job satisfaction, organizational commitment, and employee performance. Vision was defined as a mental image of a possible and desirable future state of the organization.^ Data were collected from 213 employees in a major flower import company. Participants were from various organizational levels and ethnic backgrounds. The data collection procedure consisted of three parts. First, a profile analysis instrument was used which was developed employing a Q-sort based technique, to measure the vision congruence between the CEO and each employee. Second, employees completed a survey instrument which included scales measuring empowerment, locus of control, job satisfaction, organizational commitment, and social desirability. Third, supervisor performance ratings were gathered from employee files. Data analysis consisted of using Kendall's tau to measure the correlation between CEO's and each employee's vision. Path analyses were conducted using the EQS structural equation program to test five theoretical models for goodness-of-fit. Regression analysis was employed to test whether locus of control acted as a moderator variable.^ The results showed that vision congruence is significantly related to job satisfaction and employee commitment, and perceived empowerment acts as an intervening variable affecting employee outcomes. The study also found that people with an internal locus of control were more likely to feel empowered than were those with external beliefs. Implications of these findings for both researchers and practitioners are discussed and suggestions for future research directions are provided. ^

Structural adjustment and labor in Jamaica and the Dominican Republic

Statement of the problem. It seeks to examine whether structural adjustment in Jamaica produced the desired developmental effects for labor--both organized and non-unionized--and if there is any significant difference in the Dominican Republic, which did not undergo that economic transformation. The research hypothesis is; "Structural Adjustment leads to Marginalization of labor."^ Methodology used. The methodology is mostly a straight cross-sectional analysis using data sets and publications from the UN, ILO, World Bank and IDB, as well as local statistical sources. The dissertation is primarily an historical to contemporary analysis of the Jamaican experience under structural adjustment, as it related to labor. To a greater extent it involves a straight cross-national comparison on the historical experiences of each country and a discussion of the relative similarities and differences between them, and the impact these features had on labor.^ Summary of findings. In the end, the question is asked as to whether internal factors are important in the relative success or failure of development strategies. From the data there is some indication that under structural adjustment there has been limited economic benefits for labor in Jamaica while labor standards have not improved. In the Dominican Republic the economic performance has been similar but the labor standards have improved significantly. This thus leads to the conclusion that structural adjustment may have been a factor in the resistance to labor's empowerment.^ Nevertheless, the study also shows that there may have been a causal role which local power relations had. The suggestion from the study is that in analyzing the phenomenon, attention must be paid to internal as well as external dynamics and variables. ^

Adapting prospective structural analysis to strengthen sustainable management and capacity building in community-based natural resource management contexts

Local communities collectively managing common pool resources can play an important role in sustainable management, but they often lack the skills and context-specific tools required for such management. The complex dynamics of social-ecological systems (SES), the need for management capacities, and communities’ limited empowerment and participation skills present challenges for community-based natural resource management (CBNRM) strategies. We analyzed the applicability of prospective structural analysis (PSA), a strategic foresight tool, to support decision making and to foster sustainable management and capacity building in CBNRM contexts and the modifications necessary to use the tool in such contexts. By testing PSA in three SES in Colombia, Mexico, and Argentina, we gathered information regarding the potential of this tool and its adaptation requirements. The results suggest that the tool can be adapted to these contexts and contribute to fostering sustainable management and capacity building. It helped identify the systems’ dynamics, thus increasing the communities’ knowledge about their SES and informing the decision-making process. Additionally, it drove a learning process that both fostered empowerment and built participation skills. The process demanded both time and effort, and required external monitoring and facilitation, but community members could be trained to master it. Thus, we suggest that the PSA technique has the potential to strengthen CBNRM and that other initiatives could use it, but they must be aware of these requirements.