Introduction
The rapid global socioeconomic development and an aging population have led to an ever-increasing demand for healthcare services [1]. According to the statistical report on healthcare development in mainland China, the total number of medical services reached 818 million, with 244 million inpatient admissions, marking a 3.2% and 7.5% increase from the previous year. However, this rising demand is juxtaposed with high levels of professional burnout among nurses, leaving the profession as high as 49.7%. This contradictory situation threatens the quality of patient care [2]. Work engagement, the antithesis of professional burnout, reflects a positive, fulfilling, work-related state of mind characterized by vigor, dedication, and absorption [3‐5] and is crucial for improving nursing quality and efficiency.
The impact of structural empowerment and psychological capital on nurses’ work engagement
In the field of nursing management, structural empowerment and psychological capital have been widely studied to explore their impact on nurses’ work engagement. Current research indicates that these two factors play a critical role in enhancing nurses’ job satisfaction and work efficiency [4, 6, 7].
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Structural empowerment involves the support, resources, opportunities, and information available to nurses within their work environment. Studies have found that when nurses feel adequately empowered by their organization, their work engagement increases significantly. This empowerment includes not only decision-making authority but also access to essential resources and support. Perceived structural empowerment motivates nurses to engage more actively in their roles, enhancing their sense of professional identity and responsibility. Additionally, effective communication mechanisms and a collaborative team atmosphere further enhance nurses’ sense of empowerment, thereby boosting work engagement [8, 9].
Psychological capital refers to positive psychological traits in the workplace, such as optimism, self-efficacy, resilience, and hope. Research shows that nurses with high psychological capital often exhibit greater work engagement. This is because psychological capital strengthens nurses’ ability to cope with challenges and stress, helping them maintain a positive outlook and increase job satisfaction. Psychological capital can be cultivated through training and support programs, which help nurses build confidence and enhance their capacity to handle difficulties [10, 11].
Structural empowerment and psychological capital are not isolated; they interact and jointly influence nurses’ work engagement. High psychological capital enables nurses to better utilize the opportunities and resources brought by structural empowerment, and conversely, a supportive empowerment environment can promote the development of nurses’ psychological capital. This bidirectional relationship suggests that nursing managers should focus on both aspects to improve overall nurse performance and care quality.
Relationship between structural empowerment and nurses’ work engagement
Work engagement, as the opposite of occupational burnout, reflects a positive and satisfying emotional and cognitive state related to work, encompassing the dimensions of vigor, dedication, and absorption [3‐5]. Studies show that structural empowerment, as an effective organizational management strategy, can significantly improve nurses’ work environment, access to resources, and career development opportunities, thereby enhancing work engagement [12, 13]. Previous literature indicates that empowerment is negatively correlated with occupational burnout and turnover intention and positively correlated with nurses’ work engagement and satisfaction [14, 15]. For example, some studies have explored how structural empowerment strengthens nurses’ work engagement by enhancing their sense of control and responsibility at work, a mechanism that is particularly important in China’s unique healthcare environment.
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In conclusion, structural empowerment enhances nurses’ work engagement by providing support, resources, information, and career opportunities, making them feel recognized and supported at work, thereby stimulating their enthusiasm and professional identification, ultimately significantly increasing their level of work engagement [16].
The relationship between psychological capital and nurses’ work engagement
Psychological capital, as an essential part of individual resources, plays a key role in nurses’ work engagement [17‐19]. It encompasses optimism, hope, self-efficacy, and resilience, directly impacting nurses’ ability to cope with stress. Research indicates that high levels of psychological capital are significantly associated with nurses’ sense of professional accomplishment and job performance [20, 21]. Especially in high-stress work environments, the positive effects of psychological capital can be crucial in preventing burnout and enhancing job satisfaction [22].
Self-efficacy, a core component of psychological capital, enables nurses to feel more assured and engaged when handling complex and challenging tasks. Nurses with high self-efficacy can better manage work pressures and difficulties, directly enhancing their focus and sustained engagement. Similarly, optimism helps nurses maintain a positive mindset, reducing negative emotions when facing challenges at work. This positive outlook not only boosts job satisfaction but also increases dedication and involvement in nursing tasks [23]. Resilience, meanwhile, is critical for maintaining high levels of work engagement in high-stress environments. Resilient nurses can quickly adjust their mindset, recovering to their optimal state even in adversity, thus sustaining their efficiency and high engagement levels [24].
Psychological capital is also closely tied to teamwork. Nurses with high psychological capital are more likely to build positive relationships with colleagues, enhancing team collaboration. This strong workplace connection not only improves the work atmosphere but further strengthens nurses’ sense of professional belonging and work engagement [25]. Therefore, managers should focus on fostering psychological capital by providing mental health training, psychological support, and a positive work environment to help nurses enhance their self-efficacy, optimism, resilience and hope. This approach will effectively increase nurses’ work engagement and positively impact the entire nursing team [26].
The combined impact of structural empowerment, psychological capital, and work engagement
Research suggests that enhancing nurses’ work engagement can be achieved through two primary pathways: by increasing work resources through structural empowerment and by activating personal potential through psychological capital. Structural empowerment provides the necessary resources and support in the workplace, which enhances nurses’ sense of control and responsibility, thus significantly boosting job satisfaction and professional identity, ultimately leading to greater work engagement [27, 28]. Conversely, psychological capital encourages nurses to leverage their positive psychological traits, enhancing their resilience in facing challenges and pressure, thereby allowing them to better utilize available resources and maintain high levels of engagement even in difficult situations [29].
The Job Demands-Resources (JD-R) model posits that work engagement is influenced by both job resources and personal resources [30, 31]. Although previous studies mainly focused on organizational resources, the role of personal resources has gained increasing attention with the expansion of the model [32]. This study examines how structural empowerment and psychological capital jointly influence nurses’ work engagement.
Combining structural empowerment and psychological capital in nursing practice in China is a novel approach. Together, these two variables can create a more dynamic work environment in complex healthcare settings. Therefore, this study aims to propose effective strategies to enhance nurses’ work engagement, improve healthcare quality and efficiency, optimize hospital management systems, and promote nurses’ job satisfaction and mental health, ultimately providing better care for patients.
Methods
Sampling and data collection
This study employed a method of random and convenient sampling. The research team first identified the target population as registered nurses from six top general hospitals. After obtaining approval from the nursing departments of each hospital, the team developed a questionnaire distribution plan based on the number of nurses and work shifts in various departments to ensure diversity. Departments with high and low workload levels were selected for comparison. The questionnaire underwent initial design and expert review to ensure its validity and reliability.
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In each hospital, nurses were randomly selected from different departments to ensure participant diversity. The number of nurses selected in each hospital was proportionally allocated based on the total number of nurses and the study’s needs. The research team scheduled time in multiple departments to explain the study’s purpose and the importance of the questions to the nurses. The questionnaire was distributed to each department in rotation and handed out directly by project team members to ensure that nurses understood the survey’s objectives and were encouraged to respond based on their actual experience. To ensure participants could freely express their opinions, the questionnaire included a statement outlining the study’s goals and guaranteeing the anonymity of personal information.
After completing the questionnaire, nurses placed it in a sealed envelope provided by the research team to protect their privacy. This study strictly adhered to the principles of data anonymity and confidentiality and received support from the Ethics Committee of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Project team members were responsible for collecting the completed questionnaires and ensuring that all questionnaires were safely returned to the research team for data collation within the designated timeframe. During the collection process, the team checked for incomplete or invalid responses and recorded disqualified questionnaires for exclusion from the final analysis.
Through this sampling and questionnaire distribution process, a total of 778 nurses completed the survey effectively, achieving a response rate of 91.5%, which ensured the validity of the study results.
Survey instruments
The study utilized the following tools for data collection and analysis: Demographic Questionnaire, Conditions for Work Effectiveness Questionnaire II (CWEQ-II), Psychological Conditions Questionnaire (PCQ), and Utrecht Work Engagement Scale-9 (UWES-9).
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The Demographic Questionnaire, designed by the researchers, collected basic information from participants, including gender, age, education, workplace, and years of experience.
CWEQ-II consists of 20 items and aims to measure nurses’ perceptions of structural empowerment. The scale includes 12 items rated on a 6-point Likert scale (from 1 = none to 6 = very much). The total score is obtained by averaging four subscales (information, support, resources, and opportunity), with lower scores indicating a lack of perceived empowerment in the work environment.
PCQ contains 21 items to assess nurses’ psychological capital, covering self-efficacy, optimism, hope, and resilience. All items are rated on a 6-point Likert scale (from 1 = strongly disagree to 6 = strongly agree), with higher scores indicating a higher level of psychological capital.
UWES-9 consists of 22 items to measure nurses’ work engagement, encompassing vigor, dedication, and absorption. This scale also uses a 6-point Likert scale (from 0 = never to 5 = always), with higher scores indicating higher work engagement.
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Regarding reliability and validity, the Cronbach’s alpha coefficients for these scales ranged from 0.94 to 0.96, with factor loadings exceeding 0.5 and adjusted fit indices over 0.9, indicating that the scales have good reliability and validity, providing a solid foundation for subsequent data analysis.
Overall, this study selected CWEQ-II, PCQ, and UWES-9 as assessment tools based on their wide application in relevant fields and their significant impact on nurses’ professional performance. Structural empowerment is measured through factors such as support, information, resources, and opportunities in the workplace, while psychological capital focuses on individual self-efficacy, optimism, hope, and resilience. Together, these two factors influence nurses’ work engagement, ultimately reflected in the dimensions of vigor, dedication, and absorption.
Data analysis
This study utilized SPSS version 27.0 for data analysis. Initially, descriptive analysis was conducted on demographic data as categorical variables, with distribution presented in percentages. Descriptive analysis of the main study variables (structural empowerment, psychological capital, and work engagement) was also performed, with mean (M) and standard deviation (S.D.) used to describe their distributions. Pearson correlation analysis was applied to examine the relationships between variables. In the regression analysis, each dimension of the CWEQ-II and PCQ was included as an independent variable to analyze structural empowerment and psychological capital, while demographic data were used as independent variables to analyze work engagement. Finally, in the complete model, demographic data and each dimension of the CWEQ-II and PCQ were included as independent variables, showing that gender and all dimensions of structural empowerment and psychological capital entered the regression model.
This study also employed structural equation modeling (SEM) to analyze the relationships among variables. Based on the literature and theoretical framework, an initial model was constructed, including independent and dependent variables. The collection of questionnaire data ensured the representativeness of the sample, with 778 valid samples obtained. Prior to SEM analysis in AMOS, data preprocessing was conducted, including handling missing values, normality testing, and outlier detection, to meet SEM analysis requirements. Maximum likelihood estimation (MLE) was used for parameter estimation. A path diagram was created in AMOS, and standardized path coefficients were calculated. Model fit was evaluated using chi-square (χ²), Comparative Fit Index (CFI), Adjusted Goodness-of-Fit Index (AGFI), and Root Mean Square Error of Approximation (RMSEA). Subsequently, the significance of the path coefficients was tested to verify the hypotheses, and the direct and indirect effects among variables were analyzed. Ultimately, the relationships among latent variables were explored in depth based on the model results, and the practical implications and theoretical contributions of the study findings were discussed.
Results
Study sample
This study involved 778 participants, primarily registered nurses. The gender distribution was predominantly female (96.8%), with male nurses constituting only 3.2%. Regarding age, 18.4% of participants were 25 or younger, 33.9% were between 26 and 29 years, 31.5% were between 30 and 36 years, and 16.2% were over 37 years old.
Regarding educational attainment, 93.3% of the participants held a bachelor’s degree, 4.3% had education below a bachelor’s level, and only 2.4% possessed a master’s degree or higher. Concerning work experience, 6.3% of nurses had less than one year of experience, 14.8% had 1 to 2 years, 27.2% had 3 to 5 years, 22.4% had 6 to 10 years, and 29.3% had over 10 years of experience. Regarding the distribution across work units, 41.3% of the nurses were from internal medicine, 31.7% from surgery, 8.7% from obstetrics and gynecology, 10.4% from emergency departments, and 7.8% from other departments.
Predicting work engagement based on demographic factors
This study involved 778 participants, primarily registered nurses. Demographic factors, including gender, age, educational level, work experience, and work unit, were preliminarily analyzed (Table 1). However, while these factors provide context for understanding nurses’ work environments, the primary focus of this study is on how structural empowerment and psychological capital collectively influence work engagement. As the regression analysis demonstrates, gender and education level significantly contribute to predicting work engagement, but these demographic factors were considered alongside the key variables of structural empowerment and psychological capital.
Table 1
Demographic Characteristics of Nurse Participants in the Study
Variables | Group | n | Percentage (%) |
|---|---|---|---|
Gender | Male | 25 | 3.2 |
Female | 753 | 96.8 | |
Degree | Bachelor below | 33 | 4.3 |
Bachelor | 726 | 93.3 | |
Master or above | 19 | 2.4 | |
Units | Internal medicine | 321 | 41.3 |
Surgery | 247 | 31.7 | |
Obstetrics and gynecology | 68 | 8.7 | |
Emergency | 81 | 10.4 | |
Others | 61 | 7.8 | |
Age | ≤ 25 | 143 | 18.4 |
26 ~ 29 | 264 | 33.9 | |
30 ~ 36 | 245 | 31.5 | |
≥ 37 | 126 | 16.2 | |
Working years | < 1 | 49 | 6.3 |
1 ~ 2 | 115 | 14.8 | |
3 ~ 5 | 212 | 27.2 | |
6 ~ 10 | 174 | 22.4 | |
> 10 | 228 | 29.3 |
Factors influencing structural empowerment
Nurses scored an average of 3.50 on structural empowerment (Table 2). which is at a moderate level. The highest scores were observed in support (mean = 3.78), followed by opportunity (3.59) and resources (3.51), while the score for work-related information was slightly lower (3.46). Although the score for information was somewhat lower, the overall data suggest that structural empowerment positively influences nurses’ work engagement. As indicated in Table 3, there is a significant positive correlation between structural empowerment and work engagement (r = 0.775, p <0.01). This suggests that providing adequate support, resources, and opportunities helps to increase nurses’ engagement in their work. Therefore, nursing administrators can improve nurses’ work engagement by enhancing these aspects of empowerment, ultimately contributing to better patient care and job satisfaction.
Table 2
Descriptive Statistics of Structural Empowerment, Psychological Capital, and Work Engagement in Nurses
Variables | M | SD |
|---|---|---|
CWEQ-II | ||
Structural empowerment | 3.50 | 0.72 |
Support | 3.78 | 0.80 |
Opportunity | 3.59 | 0.75 |
Resources | 3.51 | 0.72 |
Information | 3.46 | 0.94 |
PCQ | ||
Psychological capital | 4.36 | 0.72 |
Optimistic | 4.51 | 0.90 |
Resilience | 4.33 | 0.81 |
Self-efficacy | 4.20 | 0.44 |
Hope | 4.18 | 0.82 |
UWES-9 | ||
Work engagement | 3.79 | 0.98 |
Absorption | 4.07 | 1.01 |
Dedication | 3.78 | 1.04 |
Vigor | 3.52 | 1.07 |
Table 3
Correlation Analysis of Structural Empowerment, Psychological Capital, and Work Engagement among Nurses
Variable | Structural empowerment | Psychological capita |
|---|---|---|
Structural empowerment | ||
Psychological capital | 0.655** | |
Work engagement | 0.775** | 0.737** |
Factors contributing to nurses’ psychological capital
According to Table 2, nurses exhibited relatively high levels of psychological capital, with an average score of 4.36. Among the subdimensions, optimism (4.51), resilience (4.33), and self-efficacy (4.20) had higher scores, while hope had a lower score (4.18). Based on the correlation analysis in Table 3, there is also a significant positive correlation between psychological capital and work engagement (r = 0.737, p < 0.01). When combined with structural empowerment, psychological capital significantly predicts nurses’ work engagement. High levels of psychological capital help nurses manage stress, stay focused, and maintain high dedication to their work, ultimately enhancing their professional performance and job satisfaction.
The relationship between psychological capital, structural empowerment, and work engagement
This study demonstrates a strong and positive relationship between psychological capital, structural empowerment, and work engagement among nurses. Nurses with higher scores in structural empowerment and psychological capital also showed higher levels of work engagement. The correlation analysis reveals statistically significant relationships, with a correlation coefficient of 0.655 between structural empowerment and psychological capital, 0.775 between structural empowerment and work engagement, and 0.737 between psychological capital and work engagement (P < 0.01) (Table 3).
It indicates that structural empowerment and psychological capital interact synergistically to enhance work engagement. For example, nurses who perceive greater access to work-related support, opportunities, resources, and information (structural empowerment) are more likely to feel confident, optimistic, and resilient (psychological capital), which collectively enhances their work engagement. Moreover, positive psychological traits such as self-efficacy, resilience, and hope can help nurses manage work stress more effectively, promoting energy, dedication, and greater absorption.
This interrelationship emphasizes the importance of fostering psychological capital and structural empowerment in nursing practice. By enhancing support mechanisms and empowerment opportunities, nurse managers can not only build a stronger sense of psychological capital among nursing staff but also directly elevate their engagement at work. It has meaningful implications for reducing professional burnout and improving overall job satisfaction.
Key factors influencing nurses’ work engagement
Based on the study sample and data analysis, we found that several important factors influence nurses’ work engagement. First, the gender distribution, with the majority of participants being female, suggests that gender may have a certain impact on work engagement. Second, variations in age distribution may lead to differences in work engagement among different age groups. In terms of educational level, a high proportion of nurses with bachelor’s degrees may be associated with higher work engagement. Work experience also plays a crucial role, as nurses with more experience tend to show higher levels of engagement. Additionally, the work unit may impact work engagement, as different departments have distinct work environments and requirements. Overall, gender, age, education level, work experience, and work unit are key factors influencing nurses’ work engagement.
In addition, nurses’ psychological capital and structural empowerment levels also significantly impact work engagement. High psychological capital scores, particularly in optimism, resilience, self-efficacy, and hope, are often linked to higher levels of work engagement. Similarly, perceived structural empowerment, including support, opportunities, resources, and information from the work environment, has been proven to play an important role in enhancing work engagement. Together, these two factors encourage nurses to demonstrate higher levels of engagement in their work.
In summary, gender, age, education level, work experience, work unit, psychological capital, and structural empowerment are critical factors affecting nurses’ work engagement. While demographic factors like gender, age, and education level provide useful context for understanding variations in work engagement, the primary conclusion is the strong influence of structural empowerment and psychological capital in driving work engagement. We encourage managers to prioritize the development of these core variables to foster an engaged, resilient, and effective nursing workforce.
Predictive factors of work engagement in nursing staff: a comprehensive regression analysis of structural empowerment and psychological capital
Work engagement is crucial for ensuring high-quality patient care in the nursing sector. This study employed regression analysis to integrate structural empowerment, psychological capital, and demographic variables, aiming to reveal how these factors collectively influence the work engagement of nursing staff. Figure 1 provides a visual representation of our statistical model, illustrating the individual impact of each independent variable on work engagement.
Fig. 1
Hypothesis Model and Regression Coefficients. Note: This figure presents the hypothetical model and regression coefficients for work engagement. In the figure, Series A represents the regression coefficients for structural empowerment and psychological capital using dimensions of CWEQ-II and PCQ as independent variables. A1 to A4 denote the sequence of the regression coefficients. Series B represents the regression coefficients for work engagement using demographic data and dimensions of CWEQ-II and PCQ as independent variables, with B1 to B4 indicating the sequence of coefficients. Series C represents the regression coefficients for work engagement using only demographic data as independent variables. All regression coefficients demonstrated significant differences (P < 0.05), indicating that each factor influences work engagement
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The study was conducted among 778 nurses from six top-tier general hospitals in Hangzhou. Utilizing dimensions of structural empowerment (resources, information, support, and opportunities) and psychological capital (hope, resilience, optimism, and self-efficacy) as independent variables, we found a positive correlation with work engagement, with all dimensions significantly contributing to the regression model (p < 0.01). Additionally, gender and education level, as demographic variables, were also identified as significant predictors of work engagement. These variables collectively accounted for 69% of the variance in work engagement (R2 = 0.69), indicating a high explanatory power of our model.
Through a comprehensive regression analysis of structural empowerment, psychological capital, and demographic variables, the study affirmed the importance of these factors in enhancing the work engagement of nursing staff. The findings provide empirical support for clinical nursing management, suggesting that administrators should integrate these factors and take appropriate measures to strengthen nurses’ work engagement, thereby improving the overall quality of nursing services. Future research may further explore the dynamic interplay of these relationships across different demographic characteristics and work environments.
Results of structural equation modeling (SEM) analysis
This study used SEM to explore the interrelationships among structural empowerment, psychological capital, and work engagement (Fig. 2). The overall model fit results show the normed chi-square (CMIN/DF) is 3.727, which is below the commonly accepted threshold of 5, indicating a good model fit. The Root Mean Square Error of Approximation (RMSEA) is 0.059, which is below the threshold of 0.08, indicating an acceptable level of fit. Additionally, the Adjusted Goodness of Fit Index (AGFI) is 0.944, both showing a good model fit and high explanatory power. Overall, these fit indices suggest that the SEM model in this study has good statistical validity and applicability.
Fig. 2
Path Diagram of Structural Equation Modeling for the Relationship Among Psychological Capital, Work Engagement, and Structural Empowerment. Note: This figure presents the structural pathways among Psychological Capital, Work Engagement, and Structural Empowerment as analyzed in the SEM. The sample size was 778. Standardized path coefficients are labeled beside the arrows in the diagram, and “***” denotes statistically significant path coefficients (P < 0.001). Psychological Capital comprises four latent variables: Optimism, Resilience, Hope, and Self-efficacy; Work Engagement comprises three latent variables: Vigor, Dedication, and Absorption; Structural Empowerment comprises four latent variables: Opportunity Empowerment, Information Empowerment, Support Empowerment, Resources Empowerment
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Discussion
This study focuses on a critical issue in the current healthcare sector: the shortage of nurses. By exploring key factors affecting nurses’ work engagement, particularly structural empowerment and psychological capital, this study aims to provide insights into improving the work environment of nurses and enhancing the quality of healthcare services.
The impact of structural empowerment on nurses’ work engagement
The study confirms the direct impact of structural empowerment on enhancing nurses’ work engagement, aligning with previous research findings [33]. The rapid development of eastern coastal regions, providing more hardware facilities and economic support, has contributed to higher nurse work engagement to some extent [34‐36]. Work engagement in nursing plays a critical role in improving the quality of healthcare services. Nurses’ work engagement not only affects their job satisfaction but is also directly linked to patient care quality and the overall operational efficiency of hospitals. Studies have shown that nurses’ work engagement is influenced by various factors, including job stress, career development opportunities, work support, and organizational management strategies [37, 38]. For instance, some studies have found that increased work support and resources can alleviate nurses’ feelings of burnout, effectively enhancing their sense of work engagement [39]. Effective organizational empowerment measures can further promote nurses’ professional growth and optimize the quality of nursing services [12]. At the same time, nursing managers can optimize nurses’ professional experience through structural empowerment by providing more career development opportunities and support.
The impact of psychological capital on nurses’ work engagement
Moreover, as a personal resources, psychological capital also plays a key role in this process. Research has shown that high levels of psychological capital can enhance nurses’ ability to cope with job stress, thereby increasing their work engagement and sense of career accomplishment [40]. In the specific context of the nursing profession, nurses frequently face high-intensity work-related stress. By enhancing their psychological capital, such as boosting self-confidence and resilience, nurses can better manage their challenges, thereby increasing their work engagement. Psychological capital plays a significant role in nurses’ career development [4, 41]. The relationship between psychological capital and work engagement found in this study aligns with the conclusions of Laschinger [32] and Bonner [42]. Additionally, the correlation between psychological capital and structural empowerment suggests that work engagement is influenced not only directly by professional and personal resources but also by the interplay of these factors [4, 43, 44]. However, compared to studies in developed countries using the same measurement tools [28], the level of work engagement among Chinese nurses is relatively lower, possibly due to the pressure of China’s large population and aging demographic on the healthcare system [45‐47], which puts nurses under more work and psychological pressure. This social background difference suggests that the factors influencing nurses’ work engagement may vary across different countries and regions, requiring targeted management strategies.
Study significance and future directions
This study is the first to attempt to test the combined mechanism of structural empowerment and psychological capital, making a significant contribution to validating the JD-R theory and complementing related research. The results indicate that resources, information, hope, and resilience play crucial roles in structural empowerment and psychological capital. When considering environmental and individual factors, different elements alter the extent of impact on work engagement, offering a new perspective for understanding human behavior. Nursing managers should focus on how to empower nurses at different levels and foster and enhance nurses’ psychological capital [48, 49]. By implementing effective empowerment strategies, providing more work support and resources, and optimizing information communication mechanisms, managers can significantly improve nurses’ work efficiency and engagement. In particular, encouraging peer support and implementing mental health programs can enhance nurses’ psychological capital. This management approach not only reduces nurses’ work stress but also significantly improves the quality of care. For example, establishing professional hospital information teams and transparent information-sharing mechanisms, developing professional nurse training programs, and using peer support systems to provide psychological support are strategies that can enhance nurses’ work effectiveness and effectively address challenges within the organization [50].
The empirical approach of this study provides a new perspective for nursing management research. Through a large sample analysis, it reveals that work engagement is a key quality for addressing the increasing healthcare demands and the global nursing shortage challenge. Compared to survey results from nurses in Liaoning Province, China, nurses in this study reported higher-than-average work engagement, reflecting the influence of regional economic development and technological innovation on work engagement. The study highlights the impact of China’s traditionally centralized power system on the distribution of organizational power. Thus, the results are influenced by specific cultural contexts, which is crucial for understanding the diversity of global nursing practices.
Fig. 3
Bridging the Gap: Investigating the Relationship between Sstructural Empowerment, Psychological Capital, and Work Engagement in Nursing
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Conclusion and limitations
The conclusions of this study reveal the significant impact of structural empowerment and psychological capital on enhancing nurses’ work engagement (Fig. 3). Through an in-depth analysis of the relationship between nurses’ work engagement, structural empowerment, and psychological capital, the study emphasizes the importance of integrating these factors into nursing management practices. Although compared with developed countries, the work engagement among Chinese nurses is relatively low, enhancing structural empowerment and psychological capital can significantly improve nurses’ job satisfaction and engagement. These findings provide valuable insights for nursing managers, guiding them to support their nursing teams more effectively in daily management and decision-making. Additionally, the study highlights the importance of combining personal and professional resources for nurses, which is vital for the long-term sustainable development of the nursing profession. The study found that structural empowerment (e.g., resources, information, support, and opportunity) and psychological capital (e.g., hope, resilience, optimism, and self-efficacy) positively influence nurses’ work engagement. In China, nursing shortages and high workload environments are pressing issues [51]. Optimizing work conditions and enhancing individual capabilities can significantly improve nurses’ work experience and quality of professional life. Furthermore, enhancing nurses’ work engagement and positive attitudes can improve the quality and efficiency of nursing services, meeting the growing healthcare demands, especially given the rapid aging of the population and the increase in chronic disease cases in China [52]. This study provides specific recommendations for managers, including integrating work and personal resources and implementing more effective measures to promote comprehensive nurse development. This guidance is valuable for hospital administrators and policymakers on improving management strategies and investing in nurses’ career development to achieve sustainable and high-quality nursing services.
Despite providing valuable insights, this study has limitations. Firstly, the research sample is limited to six top-tier general hospitals in Hangzhou, China, potentially restricting the generalizability of the results. Economic development levels and cultural backgrounds in different regions may affect nurses’ work engagement differently. Secondly, using self-report questionnaires in this study may lead to response bias, affecting the objectivity of the data. Moreover, the study mainly focuses on structural empowerment and psychological capital, potentially overlooking other factors influencing work engagement, such as organizational culture and work environment.
Considering the limitations and findings of this study, future research could adopt various methods to expand knowledge in this field. Firstly, similar studies are recommended in different regions and types of healthcare institutions to increase the representativeness and general applicability of the results. Secondly, future studies should consider using alternative reporting questionnaires or more objective data collection methods to reduce the bias of self-reported data. Additionally, exploring more factors that could influence nurses’ work engagement, such as organizational culture, work environment, and career development opportunities, will provide a more comprehensive understanding of and approaches to improving nurses’ work engagement. Lastly, research should consider employing longitudinal study designs to understand better the changes over time and the long-term effects of these factors.
Acknowledgements
Thank you to all the nurses who participated in this survey.
Declarations
Human ethics and consent to participate
The study was approved by the Ethics Committee of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (2023 No. 0772). It adhered to all applicable ethical guidelines and regulations, ensuring participants’ rights and welfare. Before data collection, all participating nurses were fully informed about the study’s objectives, procedures, potential risks, and benefits and provided voluntary informed consent. The study strictly protected participants’ privacy and personal information, ensuring data confidentiality and anonymity. The research design and implementation aimed to minimize adverse impacts on participants while ensuring scientific validity and effectiveness. All research activities were conducted under the supervision of the Ethics Committee to ensure compliance with ethical standards. The questionnaire and scale used in this study were developed specifically for this research.
Consent for publication
Consent for the publication of recognizable images or data was obtained from the individuals involved.
Competing interests
The authors declare no competing interests.
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