Using Empowerment to Build Trust and Respect in the Workplace: A Strategy for Addressing the Nursing Shortage

Heather K. Spence Laschinger; Joan Finegan

Disclosures

Nurs Econ. 2005;23(1):6-13. 

In This Article

Method

Design and Sample

A nonexperimental predictive design was used to test the proposed model in a random sample of staff nurses working in medical-surgical or intensive care units in urban teaching hospitals across Ontario. A questionnaire package was mailed to their homes and the Total Design method advocated by Dillman (1978) was used to maximize the return rate. Two hundred and eighty-nine questionnaires were returned (12 were returned as undeliverable). The final return rate was 59%. Of these, 273 cases were used for the analysis reported in this study. Sixteen cases were removed from the analysis due to missing data on some of the items measuring the variables in the model to be tested. These cases did not differ significantly from those retained for the analysis on either demographic or major study variables.

Nurses in the final sample represented all areas of Ontario. Most nurses worked either full (59.7%) or part time (40.3%) in medical-surgical (70%) areas. Thirty percent worked in critical care. The majority (63%) were diploma prepared, 37% held baccalaureate degrees. Nurses averaged 33 years of age, with 9 years of nursing experience, and 2 years experience on their current unit.

Data Collection Instruments

All items were rated on Likert scales. Scale scores were created by summing and averaging items pertaining to each scale. The internal consistency of these scales was acceptable (see Table 1 ).

The Conditions of Work Effectiveness Questionnaire-II (CWEQ-II) (Laschinger et al., 2001b) measures nurses' perceptions of their access to the six elements of structural empowerment described by Kanter (1977): access to opportunity, information, support, and resources, informal power, and formal power. The CWEQ-II consists of 19 items (three for each of Kanter's empowerment structures). Based on the results of a confirmatory factor analysis that validated the factor structure of this instrument conducted by Laschinger et al. (2001b), a total empowerment score is created by summing the subscales of the CWEQ-II (score range: 6-30). Items are rated on a 5point Likert scale with higher scores representing higher levels of empowerment. A 2-item global empowerment scale was included for validation purposes. Cronbach alpha reliabilities in previous studies ranged from 0.79 to 0.82.

Interactional Justice was measured by nine-items from Moorman's (1991) Justice Scale. Each item was rated on 7-point scale. The internal consistency reliability of this measure is excellent (alpha = 0.81 to 0.91) (Rahim, Magner, Antonioni, & Rahman, 2001).

Respect was measured by Siegrist's (1996) Esteem Scale. It contains three items designed to measure nurses' perceptions of respect they receive from their managers and peers. Items are rated on a 7-point scale. This scale can significantly predict positive mental and physical health outcomes and satisfaction with control in the work setting (Hanson, Schaufeli, Vrijkotte, Plomp, & Godaert, 2000). Alpha reliability in their study was acceptable (0.76).

Mishra's (1996) 17-item Trust in Management Scale consists of four dimensions: reliability, openness/ honesty, competence, and concern. Items are rated on a 7-point scale. Trust in management can predict both job satisfaction and organizational commitment (Mishra, 1996), providing evidence of predictive validity. Alpha reliability estimates for this scale have been acceptable (>0.70) (Mishra, 1996).

Job satisfaction and organizational commitment were measured using subscales from Williams and Cooper's (1998) Pressure Management Indicator. Items are rated on a 6-point Likert scale. The job satisfaction subscale measures how satisfied employees are with the type of work they are involved in, in terms of tasks and functions. This scale predicts organizational commitment, positive organizational climate, and degree of control in the workplace and has acceptable internal consistency reliability (0.89) (Williams & Cooper, 1998). The organizational commitment subscale measures employees' attachment to their organization and the extent to which they believe that work improves their quality of life. Previous internal consistency estimates for this sub-scale have been acceptable (0.84-0.88). Scores are related to job satisfaction, positive interpersonal relationships at work, and reasonable workloads (Williams & Cooper, 1998).

Data Analysis

Path analysis techniques with maximum likelihood estimation were employed to test the hypothesized model using a structural equation modelling program, AMOS 4.0 (Arbuckle, 1997). Several criteria were used to evaluate fit of the model, including the Chi-square ( X 2), the Cumulative Fit Index (CFI), the Incremental Fit Index (IFI), and the Root Mean Square Error of Approximation (RMSEA).

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