The mediating effect of psychological empowerment on the relationship between work environment and clinical decision-making among midwives: A multicentre cross-sectional study

Abstract

AbstractBackground Clinical decision-making is considered an essential behaviour in clinical practice. However, no research has been done to examine the associations among midwives’ clinical decision-making, work environment and psychological empowerment. Thus, the study aims to determine the influence of work environment on midwives’ clinical decision-making and confirm the mediating role of psychological empowerment. Method 602 registered midwives from 25 public hospitals in China were included in this multicentre cross-sectional study. A sociodemographic questionnaire, Work Environment Scale, Psychological Empowerment Scale and Clinical decision-making Scale were applied. A hypothetical path model was examined with SPSS 26.0 and AMOS 26.0. Results The mean clinical decision-making score was 143.03 ± 14.22, at an intermediate level. The hypothesis model of this study fitted the data well, and the results showed that work environment and psychological empowerment positively affected clinical decision-making for midwives; psychological empowerment partly mediated the relationship between work environment and clinical decision-making for midwives. Conclusions Midwives’ clinical decision-making could be promoted directly or indirectly by providing a healthy work environment and improving psychological empowerment. It is essential for hospital managers to pay attention to the assessment of the midwives’ work environment and actively improve it. Furthermore, managers can also promote midwives’ clinical decision-making behaviour by enhancing their psychological empowerment.