Taiwanese nurses' empowerment and participation in decision making

The purposes of this cross-sectional and internet mixed methods study were: (a) to explore the level of structural empowerment (SEP), psychological empowerment (PE), participation in decision making (PDM), their relationships, and their predictors among Taiwanese nurses, and (b) to explore the influence of contextual factors (culture and gender) on the nurses’ perception on their work environment and PDM based on the feminist perspective and Laschinger’s expanded empowerment model. This study included an Internet questionnaire survey (quantitative) and a Web-based online forum (qualitative). A convenient sample of 163 Taiwanese registered nurses (a) who are currently working full time in health care institutions for at least 3 months, (b) can read and write Chinese on the computer, and (c) have access to the Internet was recruited and completed the internet survey. Among them, 20 completed the online forum discussion topics. The findings of the internet survey indicated that participants had moderate level of SEP, high-moderate level of PE and low level of PDM. Personal characteristics, such as age, education, and work experience, did not significantly correlate to Taiwanese nurses’ empowerment. However, the work structures, such as workload, types of hospitals, and work units, were significantly related to Taiwanese nurses’ empowerment and PDM. PE was a mediator between SEP and PDM, which indicated that with increased access to workplace empowerment structures, nurses perceived better personal empowerment, which in turn increased nurses’ PDM. In the online forum, two themes were discovered: (a) foot-binding unto nursing and (b) not open up. The first theme indicated that certain stereotypes regarding gender roles in Taiwanese society were restraints to the growth of nursing. Due to the stereotypes, nurses were located in the lower social status and developed powerless behaviors. The second theme indicated that communication among nurses was not sufficient, which might stem from the influence of Confucianism, collectivism, and power distance. The findings in this study extend our understanding of the empowerment and PDM among Taiwanese nurses within the context of gender and culture.