Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator
Abstract Background Clinical decision-making in the context of nursing practice is considered an essential skill for nursing practitioners. Nonetheless, various factors, such as the work environment and nurses’ psychological empowerment (PE), may negatively influence their decision-making ability. T...
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| Format: | Article |
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BMC
2025-07-01
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| Series: | BMC Nursing |
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| Online Access: | https://doi.org/10.1186/s12912-025-03482-2 |
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| author | Abdulhafith Alharbi Sameer A. Alkubati Hamdan Albaqawi Aziza Z. Ali Laila A. Hamed Shaimaa Mohammed Larry Terence O. Cornejo Eddieson Pasay-an |
| author_facet | Abdulhafith Alharbi Sameer A. Alkubati Hamdan Albaqawi Aziza Z. Ali Laila A. Hamed Shaimaa Mohammed Larry Terence O. Cornejo Eddieson Pasay-an |
| author_sort | Abdulhafith Alharbi |
| collection | DOAJ |
| description | Abstract Background Clinical decision-making in the context of nursing practice is considered an essential skill for nursing practitioners. Nonetheless, various factors, such as the work environment and nurses’ psychological empowerment (PE), may negatively influence their decision-making ability. Therefore, this study assessed the relationship between clinical decision-making (CDM) and the nursing work environment (NWE), focusing on the mediating role of PE among clinical nurses in Hail Province, Saudi Arabia. Methods This cross-sectional study used a self-administered questionnaire to collect data from 298 nurses at five hospitals in Hail Province, Saudi Arabia, from January to March 2025. Besides demographic characteristics, the questionnaire included the following tools: the CDM, the NWE-questionnaire, and the PE Scale. Multiple linear regression was used to identify significant predictors of both CDM and PE. The mediating role of PE on the relationship between NWE and CDM was examined using Hayes’ Process Macro program v4.2 (Model 4). Results Multiple linear regression revealed that being a head nurse and perceiving a more positive NWE were significant predictors of higher scores of nurses’ PE (P < 0.05). On the other hand, being a registered or head nurse, working more than five days per week, and perceiving a more supportive NWE were significant predictors of higher levels of nurses’ CDM (P < 0.05). Conversely, working regular night shifts was a significant predictor of lower scores of nurses’ CDM. A significant positive direct effect and total effect were found between NWE and nurses’ CDM (B = 0.136, P = 0.017 and B = 0.273, P < 0.001, respectively). The indirect effect (B = 0.137), based on 5,000 bootstrap resamples, had a bootstrap confidence interval above zero (0.021 to 0.263), indicating a partial positive mediating role of PE in the relationship between NWE and CDM. Conclusion PE plays a vital role in fostering CDM and promoting a supportive NWE for nurses in clinical settings across Hail Province. These insights emphasize the need for establishing psychologically empowering conditions in the workplace to level up nurses’ self-perceived competence and confidence in CDM. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-7d7f505db5884a85b5f4d2043fac470c |
| institution | Kabale University |
| issn | 1472-6955 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nursing |
| spelling | doaj-art-7d7f505db5884a85b5f4d2043fac470c2025-08-20T03:37:20ZengBMCBMC Nursing1472-69552025-07-0124111110.1186/s12912-025-03482-2Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediatorAbdulhafith Alharbi0Sameer A. Alkubati1Hamdan Albaqawi2Aziza Z. Ali3Laila A. Hamed4Shaimaa Mohammed5Larry Terence O. Cornejo6Eddieson Pasay-an7Department of Psychiatric and Mental Health Nursing, College of Nursing, University of HailDepartment of Medical Surgical Nursing, College of Nursing, University of HailDepartment of Medical Surgical Nursing, College of Nursing, University of HailDepartment of Nursing Administration, College of Nursing, University of Ha’ilDepartment of Medical Surgical Nursing, College of Nursing, University of HailDepartment of Psychiatric and Mental Health Nursing, College of Nursing, University of HailDepartment of Psychiatric and Mental Health Nursing, College of Nursing, University of HailDepartment of Nursing Administration, King Khalid UniversityAbstract Background Clinical decision-making in the context of nursing practice is considered an essential skill for nursing practitioners. Nonetheless, various factors, such as the work environment and nurses’ psychological empowerment (PE), may negatively influence their decision-making ability. Therefore, this study assessed the relationship between clinical decision-making (CDM) and the nursing work environment (NWE), focusing on the mediating role of PE among clinical nurses in Hail Province, Saudi Arabia. Methods This cross-sectional study used a self-administered questionnaire to collect data from 298 nurses at five hospitals in Hail Province, Saudi Arabia, from January to March 2025. Besides demographic characteristics, the questionnaire included the following tools: the CDM, the NWE-questionnaire, and the PE Scale. Multiple linear regression was used to identify significant predictors of both CDM and PE. The mediating role of PE on the relationship between NWE and CDM was examined using Hayes’ Process Macro program v4.2 (Model 4). Results Multiple linear regression revealed that being a head nurse and perceiving a more positive NWE were significant predictors of higher scores of nurses’ PE (P < 0.05). On the other hand, being a registered or head nurse, working more than five days per week, and perceiving a more supportive NWE were significant predictors of higher levels of nurses’ CDM (P < 0.05). Conversely, working regular night shifts was a significant predictor of lower scores of nurses’ CDM. A significant positive direct effect and total effect were found between NWE and nurses’ CDM (B = 0.136, P = 0.017 and B = 0.273, P < 0.001, respectively). The indirect effect (B = 0.137), based on 5,000 bootstrap resamples, had a bootstrap confidence interval above zero (0.021 to 0.263), indicating a partial positive mediating role of PE in the relationship between NWE and CDM. Conclusion PE plays a vital role in fostering CDM and promoting a supportive NWE for nurses in clinical settings across Hail Province. These insights emphasize the need for establishing psychologically empowering conditions in the workplace to level up nurses’ self-perceived competence and confidence in CDM. Clinical trial number Not applicable.https://doi.org/10.1186/s12912-025-03482-2NursingClinical decision-makingWork environmentPsychological empowermentSaudi Arabia |
| spellingShingle | Abdulhafith Alharbi Sameer A. Alkubati Hamdan Albaqawi Aziza Z. Ali Laila A. Hamed Shaimaa Mohammed Larry Terence O. Cornejo Eddieson Pasay-an Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator BMC Nursing Nursing Clinical decision-making Work environment Psychological empowerment Saudi Arabia |
| title | Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator |
| title_full | Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator |
| title_fullStr | Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator |
| title_full_unstemmed | Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator |
| title_short | Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator |
| title_sort | relationship between nursing work environment and clinical decision making among saudi nurses psychological empowerment as mediator |
| topic | Nursing Clinical decision-making Work environment Psychological empowerment Saudi Arabia |
| url | https://doi.org/10.1186/s12912-025-03482-2 |
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