ArticleBMC nursing2023
The mediating effect of psychological empowerment on the relationship between work environment and clinical decision-making among midwives: a multicentre cross-sectional study.
Article in BMC nursing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- From struggle to strategy: unpacking midwives' psychosocial workplace stressors and pathways to empowerment.BMC health services research · 2026Article
- The Effect of Emergency Department Nurses' Core Self-Evaluations on Their Perceptions of Clinical Decision-Making: A Cross-Sectional Study.Journal of nursing management · 2026Article
- Relationship between nursing work environment and clinical decision-making among Saudi nurses: psychological empowerment as mediator.BMC nursing · 2025Article
- The mediating effect of job burnout on the relationship between practice environment and workplace deviance behavior of nurses in China: a cross-sectional study.BMC nursing · 2025Article
- Exploring the influence of the spiritual climate on psychological empowerment among nurses in China: a cross-sectional study.BMC nursing · 2024Article
- Article
- Web-Based Development of Standard Operating Procedures and Midwifery Trainings at Ugandan Birth Clinic in the Framework of Implementing a Quality Improvement System for the MEWU-Midwife Exchange with Uganda.Women's health reports (New Rochelle, N.Y.) · 2024Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundClinical 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.
methodThis 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.
resultsThe 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.
conclusionsMidwives' 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.
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