Researchers have also turned their attention to psychological
factors, particularly self-esteem; a concept allied to
empowerment but that does not represent it per se. Selfesteem
relates to perception of self-worth (Sasat et al. 2002)
and is a narrow concept in contrast to the abstract, dynamic
concept of empowerment that involves sharing of power,
growth and development and critical introspection (Kuokkanen
& Leino-Kilpi 2000).
Levels of self-esteem in nursing students have been
reported variously: a cross cultural study between Thailand
and the UK found that self-esteem was not a problem for
nursing students (Sasat et al. 2002); self-esteem in students in
Ireland was found to be average overall, but rose near the end
of their programme (Begley & White 2003); while other
researchers reported fragmentation of students esteem as a
result of negative influences (Randle 2001). Perceptions of
nursing student autonomy and empowerment have been
explored recently (Mailloux 2006) but not specifically in
relation to clinical practice.
Existing literature in relation to nursing student empowerment
tends to emanate from Canada (Sinclair 2000, Siu
et al. 2005), Ireland (Begley & White 2003), New Zealand
(Pearson 1998) and USA (Zerwekh 1990, Hokanson Hawks
1992, 1999). Leyshon (2002) examines empowerment as an
issue within nurse education in the UK, but not from a
clinical placement perspective.
While the current body of nursing knowledge provides
some insight into nursing student empowerment, there is
a paucity of research regarding the actual context of
experiences. Additionally, there is limited literature that
specifically addresses disempowerment as a means of
illuminating the phenomenon of empowerment. Campbell
(2003) however, did study empowerment and disempowerment
and described them as an encircled process; but the
specific situations in which they occurred were not made
explicit. The literature review of international research
therefore, demonstrates a gap in nursing knowledge calling
for further study of the issue of power and empowerment of
nursing students in practice.