App lication of Kanters structure pow er theory in nursing administration

W ang Xu,W ipada Kunavik tikul,Zhang Huim in

(The Second A ffiliated Hospital of Harbin M edical University,Heilongjiang 150086 China)

W ang Xu,W ipada Kunavik tikul,Zhang Huim in

(The Second A ffiliated Hospital of Harbin M edical University,Heilongjiang 150086 China)

It introduced the concep tion,theory,d im ension and related research of Kanters structure pow er theory.Follow ing up nurses increasing over load,in order to prom ote the working effectively,w ork empowerm ent w as paid more attention.According to Kanters structure pow er theory,these individuals w ho accessmore power w ill find they benefitmuch from it:Theym ay feel con fidence in their jobs,have good relationships,they are less likely to experience burnout and increased w ork effectiveness.

Work em pow erment;Kanter structure power theory; Nu rse

The w orking conditions of nurses have d ramatically changed during the decade after healthcare reform.Several researchers indicated that staff nurses in the hospitalw ere faced w ith more intensive patient care,longer w ork time,m ore demands from patients and fam ilies,m ore interaction between patients and physicians,and additional office w ork[1,2].Thus,it is imperative to find w ays to assist nurses to perform their work effectively.Kanter demonstrated that w ork empowerment had significantly promoted w ork efficiency.W ork em powermen t is the w ork env ironm en t which p rovides or enhances em ployeespow er to accomp lish w ork w ithin an organization[3].Nearly,people pay more attention to work empowerment.

1 Definition of W ork Empowerment

Kanter states that work empow erment is a w ork environment providing the opportunity,necessary information,support and resources to learn and develop and otherw ise increase em ployeesabilities to complete their tasks in an organization.The ability to utilize such empow ering structures is controlled by the form al and in formal pow er netw orks of the organization.Formal pow er is a term descr ibing those aspects of a job which allow an individuals job to be recognized in the organization due to conscientious actions relating to the organizations goals.Inform al power, on the other hand,is a term that describes building significant relationshipsw ith ones equals,leaders and junior members of the organization[3].The theory of work em powermentKanter proposed that individuals w ith access to more opportunity,inform ation,suppor t,resources,formal pow er and informal power w ill experience more pow er[3].These individuals who accessm ore pow er w ill find they benefit much from it: They may feel con fidence in their jobs,take opportunities for grow th and mobility,take par t in organizational decision making,have reasonableworkloads and control over their work,have good relationships,be rew arded for their contributions,and develop values consistent w ith organizational goals.As a result,they are less likely to experience burnout and w ill bemore engagem en t in their w orking.

2 Dimensionsof work empowerment

3 Studies related to work empowerment

W ilson eta l[4]exam ined the relationship betw een nursesperceptions ofw ork em pow erment and organizational comm itm ent in a study on 161 nurses.The findings show ed a strong positive correlation am ong nursespercep tions o f pow er and opportunity and comm itm ent to the organization.Moreover,Laschinger[5]examined correlation among staff nursespercep tions of w ork em pow erment and controlover nursing practice and consequen t job satisfaction and perceived w ork effectiveness.The sample included 200 staff nurses.The findings showed that staff nurses perceived work empowerment w as positively correlated to percep tions of con trol over nursing practice; there w as strong positive correlation among access to work empow erment and work satisfaction and perceivedw ork effectiveness.A fter that,they studied the effect of w ork empow erment on staff nursesoccupationalmental health and w ork effectiveness in 1997. The findings show ed that staff nursespercep tions of work empowermentw erenegatively related to perceptions of their occupational stress,greater access to work empowerment w as strongly related to high levels of perceived work effectiveness.

Laschinger etal[6]also tested Kanters structure pow er theory entitled empow erment and staff nurse decision invo lvem ent in nu rsing w ork env ironm en ts, there were 403 staff nurses par ticipated and 304 returned reliable questionnaires.The findings show ed that therew aspositive correlation between staff nurse access to w ork empowerm ent and control over decisions.M anojlovich etal[7]dem onstrated thatpow erless nurses w ere less satisfied w ith their jobs.Similarly, Sarmiento etal[8]surveyed 89 co llege nurse educators in Canada.The resultsshow ed that therewas positive correlation betw een w ork empow erment and job satisfaction.Laschinger etal[9]stated that staff nurses felt morewo rk em powermen t can resu lted in higher levels of control over their work,more manageable workloads,greater rew ards and recognition for their contributions to meeting organizationalgoals.

A lmost etal[10]demonstrated thatnurse perceived work em powerm ent resu lted in higher levelso f collaboration w ith both physicians and managers,that is,a greater sense o f trust and respect,greater au tonomy, and shared responsibility for solving p roblems and decision-m aking to effectively accomplish w orking.

A rmstrong et al[11]surveyed 79 staff nurses in Canada,the resu lt indicated that perception of staff nurses on w ork empowerment w as positive correlated w ithm agnet hospital professionalpracticecharacteristics and patient safety culture.Liu et al[12]indicated that work empow erment enhances self- efficacy through m otivation and comm itm ent,leads to increased performance and w ork effectiveness.Faulkner et a l[13]indicated that nurses who perceived more work empowerment w ere more likely to feel be respected.

In summary,based on Kanter structure pow er theory,many researchers had conducted the positive correlationalstudies betw een work empow erment and self efficiency,organization comm itment,job satisfaction,perfo rmance,control over decisions and wo rking effectiveness in w estern countries.

In nursing adm inistration,w ork empowerm ent can p rom ote job satisfaction and work effectiveness. Redesign of nursing work environments w ill increase access to opportunity, inform ation,support, resources,formal power and inform al power[5].Laschinger et al[14]also indicated that the organizationally empowered one had less occupational stress and m ore work effectiveness.Moreover,staff nurses thought that more work empow erment resulted in higher level of control over their w ork,more manageab le workloads,greater rewards and m ore recognition for their contributions tom eet organizational goals[9]。

[1] A iken LH,Clarke SP,Sloane DM.H ospital staffing,organization, and quality of care:Cross- national findings[J].International Journal for Quarter in H ealth Care,2002,14:5-13.

[2] A iken LH,Clarke SP,Sloane DM,etal.Nursing reports on hospital care in five countries[J].H ealth A ffairs,2001,20:43-53.

[3] Laschinger HKS.A theoretical approach to studying w ork empowerm ent in nursing:A review of studies testing Kanters theory of struc tu ral pow er in organizations[J].Nu rsing Adm inistration Quarterly,1996,20:25-41.

[4] W ilson B,Lashinger HKS.Staff nursesperception of job empowerm ent and organ izational commitm ent:A test Kanters theory of struc tu ral power in organ izations[J].Jou rnal of Nursing Adm inistration,1994,24:39-47.

[5] Laschinger HKS,H avens DS.Staff nursework empowerm ent and perceived control over nursing practice[J].Journal of Nursing Adm inistration,1996,26:27-35.

[6] Laschinger HKS,Sabiston JA,Kutszcher L.Em powerment an d staff nu rse decision in volvement in nursing w ork en vironmen ts: Testing Kanters theory of structural power in organizations.Research in Nursing and H ealth,1997,20:341-352.

[7] M anojlovich M,Laschinger HKS.The relationship of empow ermen t and selected personality characteristics to nursing job satisfaction [J].Journal of Nursing Administration,2002,32(11):586-595.

[8] Sarm iento TP,Lasch inger H KS,Lwasiw C.Nurse educatorsw orkplace empow ermen t,burnout,and job satisfac tion:Testing Kanter's theory[J].Jou rnalof Advanced Nursing,2004,46:134-143.

[9] Laschinger H KS,Finegan J.Em powering nu rses for work engagem ent and health in hospital settings[J].Journal of Nursing Administration,2005,35:439-449.

[10] A lm ost J,Laschinger HKS.W orkplace em powerment,collaborative work relationships,an d job strain in nurse practitioners[J]. Jou rnal of the American Academy of Nurse Practitioners,2002, 14(9):408-420.

[11] A rmstrong KJ,Lasch inger H.Structural empowerment,magnet hospital characteristics,and patient safety cultu re[J].Jou rnal of Nursing Care Quality,2006,21:124-132.

[12] Liu AM M,Chiu WM.Enhancing comm itment through work empow ermen t[J].Jou rnal of Engineering,Construction and A rchitecturalM anagem ent,2007,15:568-580.

[13] Faulkner J,Laschinger H.The effec ts of structural and psychological empow erm ent on perceived respect in acute care nurses [J].Journal of Nursing M anagement,2007,16(2):214-221.

[14] Laschinger HKS,H avens DS.The effect of workp lace empowerm ent on staff nursesoccu pationalmental health and work effectiveness[J].Jou rnal of Nursing Adm inistration,1997,27:42-50.

kanter權利結構理論在護理管理中的應用

汪 旭,W ipada Kunaviktiku l,張慧敏

介紹了Kanter權力結構理論的概念,理論,維度及國外相關護理研究。隨著護士工作負荷的不斷加重,為了提高工作效率,工作授權被人們逐漸所重視,根據Kanter授權理論,個人在工作中得到的授權越多,越可以提高其在工作中的自信,建立很好的人際關系,減輕工作倦怠感,增加工作的成就感,并提高其工作效率。

工作授權;Kan ter權利結構理論;護士

R473.6

C

10.3969/j.issn.1009-6493.2010.09.15.052

1009-6493(2010)5C-1407-03

2009-08-09)

Introduction of the author Wang Xu,birth in 1978,W ork Unit:The Sec

ond Affiliated Hospital of Harbin Medical University,H eilong jiang 150086 China;W ipada Kunaviktiku l W ork Unit:Faculty of Nursing, Chiang M ai University,50200,Thailand;Zhang H uimin W ork Unit:The Second A ffiliated Hospital of Harbin M edical U niversity,H eilong jiang 150086 China.

(本文編輯 呂佩)