Significance
Many factors contribute to the current nursing shortage,
high nurse turnover is considered one of the main
contributors (Hauck et al. 2011) while job dissatisfaction
is the primary cause of nursing turnover (Lautizi
et al. 2009).
Nursing retention is related to workplace variables
and to job satisfaction (Coomber & Barriball 2007).
Furthermore, nurses’ perceptions of workplace empowerment
is related to intent to stay, independently of
individual factors (Nedd 2006).
Recent studies show that workplace empowerment
has a strong relationship with nurse retention and an
important impact on factors related to recruitment,
particularly on job satisfaction (Laschinger et al.
2001a, Faulkner & Laschinger 2008) and commitment
(McDermott et al. 1996).
The aim of the review was to identify and synthesize
recent studies on the relationship between nurse
empowerment and job satisfaction and to make recommendations
for further research.
The following research questions guided this review:
● Can structural and psychological empowerment promote
job satisfaction in nurses’ work environment?
● What is the relationship between structural empowerment
and job satisfaction in nurses’ work environment?
● What is the relationship between psychological
empowerment and job satisfaction in nurses’ work
environment?
Methods
Design
A systematic literature review with narrative synthesis
was performed, because the methodologies of the
included studies were not appropriate for a statistical
summary of the studies. The integrative method proposed
by Whittemore and Knalf (2005) was used. This
method allows a combination of different methodologies
to understand the varied perspectives on a specific
phenomenon of concern better (Whittemore &
Knalf 2005).
Search strategy
The search included the following on-line databases:
MEDLINE (through PubMed), CINAHL (through EBSCOhost)
and SCOPUS (through EBSCOhost). The
search period included articles published between
1998 and 2012 in order to select recent studies that
may have more relevance to the current nursing workplace.
The MeSH headings and free text terms were
combined to research the specific topic. Key search
terms included: workplace empowerment, nurse*,
structural empowerment, psychological empowerment,
job satisfaction and work satisfaction. Two web sites
were searched for additional studies: Laschinger H.K.S.,
http://publish.uwo.ca/~hkl and Spreitzer G., http://webuser.
bus.umich.edu/spreitze/Empowerment_Research.htm.
For the search and retrieval process see Figure 1.
Inclusion criteria
The inclusion criteria for the studies were: (1) papers
published in English language, (2) with a study sample
that included nurses (no student nurses, no nurse educators,
no nurse managers or assistant nurse managers),
(3) studies investigating the impact of empowerment
on job satisfaction and/or the relationship between
workplace empowerment and job satisfaction, (4) studies
reporting direct measures of empowerment (structural
and/or psychological) and job satisfaction, (5)
studies using CWEQ or CWEQ-II for measuring structural
empowerment and studies using PES for measuring
psychological empowerment, (6) quantitative or
qualitative research designs, (7) peer reviewed research.
Screening
The selection of studies was conducted through an initial
screening of the title and abstract in order to identify
potentially relevant articles. Then, a screening was
carried out of all the full text articles identified as relevant
in the initial selection. Additional papers, not
identified in the initial literature search, were obtained
through examination of the references in the published
studies.
Each abstract was examined by two independent
reviewers according to the inclusion criteria. The
first author reviewed all titles and abstracts, deleted
duplication of articles and selected studies that
investigated the impact of empowerment on nurses’
job satisfaction. The second author, separately, evaluated
a sample of titles and abstracts according to
the same inclusion criteria. Sixty-five titles and
abstracts were selected and full manuscripts were
retrieved for the first screening according to the
recruitment criteria. Twenty-three articles were
retained for the second screening using an inclusion
screening tool, adapted from Wagner et al. (2010)
(Figure 1).
Both reviewers agreed on which studies met the
inclusion criteria.
Fourteen articles were retained for quality assessment
and data extraction.