Abstract
Abstract
Background
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, this study aimed to determine the influence of work environment on midwives’ clinical decision-making and confirm the mediating role of psychological empowerment.
Method
This study was designed as a multicentre cross-sectional study, and included 602 registered midwives from 25 public hospitals in China. A sociodemographic questionnaire, Work Environment Scale, Psychological Empowerment Scale and Clinical decision-making Scale were applied. A structural equation model was conducted to estimate the hypothesis model of the clinical decision-making among midwives and explore the potential mediating mechanism of midwives’ clinical decision-making. This model was employed maximum likelihood estimation method and bootstrapping to examine the statistical significance.
Results
The mean score of clinical decision-making among midwives was 143.03 ± 14.22, at an intermediate level. The data of this hypothesis model fitted well, and the results showed that work environment positively affected psychological empowerment, which in turn positively affected clinical decision-making; psychological empowerment partly mediated the relationship between work environment and clinical decision-making among 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, such as establishing a supportive, fair and just workplace, and maintaining effective communication with midwives. Furthermore, managers can also promote midwives’ clinical decision-making behaviour by enhancing their psychological empowerment via enhancing job autonomy.
Funder
Nursing Special Scientific Research Fund of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical University
Publisher
Springer Science and Business Media LLC
Reference50 articles.
1. World Health Orgnization. New report sounds the alarm on global shortage of 900 000 midwives. 2021. https://www.who.int/news/item/05-05-2021-new-report-sounds-the-alarm-on-global-shortage-of-900-000-midwives. Accessed 20 Sep 2022.
2. Hu L, Jiang M, Xu X, et al. Investigation on the current situation of midwives human resources in China. Chin J Nurs. 2020;55(2):192–7.
3. United Nations. 2020 Sustainable development-Goal 3: Ensure healthy lives and promotewell-being for all at all ages. 2020. https://www.un.org/sustainabledevelopment/zh/health/. Accessed 20 Sep 2022.
4. Tang J C. Vigilance against midwife gap in "two child era" in China. China Health Hum Resoure. 2014;194(06):14.
5. Tatum M. China’s three-child policy. Lancet. 2021;397(10291):2238.