The Influence of the Empowerment and the Organization Culture on the Competency of Professional Nurses in the University Hospitals in the Northern Region
Keywords:
organizational culture, power, clinical competenceAbstract
This study was a predictive correlational study intended to investigate the influence of the structural empowerment and organizational culture on the competence of professional nurses. The sample consisted of 142 practicing professional nurses with at least one year of work experience working in three university hospitals in the northern region of Thailand, each with fewer than 500 beds. The participants were selected using proportional stratified random sampling. The research instruments included a structural empowerment questionnaire, an organizational culture questionnaire, and a professional nurse competence questionnaire, all of which were 5-point Likert-scale instruments. The reliability coefficients of the instruments were 0.94, 0.92, and 0.97, respectively. Data were analyzed using descriptive statistics and stepwise multiple regression analysis.
The findings revealed that overall professional nurse competence was at a very high level (Mean = 4.34, S.D. = 0.40), structural empowerment was at a high level (Mean = 3.99, S.D. = 0.48), constructive organizational culture was at a high level (Mean = 4.26, S.D. = 0.47), and passive-defensive organizational culture was at a high level (Mean = 3.66, S.D. = 0.42), whereas aggressive-defensive organizational culture was at a moderate level (Mean = 2.97, S.D. = 0.62). Stepwise multiple regression analysis indicated that constructive organizational culture and structural empowerment together significantly predicted professional nurse competence, accounting for 48% of the variance (R² = 0.48, p < .05). Constructive organizational culture was the strongest predictor, followed by structural empowerment. The findings reflect that promoting an organizational culture that supports learning and collaboration, together with structural empowerment, plays a significant role in developing the competence of professional nurses.
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References
Somsap Y, Varee A. Thai nurse brand in 21st century: Challenges for nursing profession. Songklanagarind Journal of Nursing. 2019;39(3):169-78 (in Thai)
Charoenkraikamon C, Pitaksung A, Namthep J, Saysukanun P, Chimchalong R, Siritipakorn P, et al. Gerontological nursing competencies for registered nurses in a university hospital setting. Siriraj Medical Bulletin. 2024;17(3):197-208 (in Thai)
Ratchapakdee P. Digital competency of newly graduated nurses. Journal of The Royal Thai Army Nurses. 2023;24(2):336-47 (in Thai)
Office of the National economic and social development council. The Thirteenth national economic and social development plan (2023–2027). [internet]. 2022 [cited 2025 Jan 19]. Available from: https://www.nesdc.go.th (in Thai)
Thailand Nursing and Midwifery Council. Strategic plan for nursing and midwifery 2022–2026. 1st ed. Nonthaburi: Publishing of suetawan company limited; 2022. (in Thai)
Goedhart NS, Van Oostveen CJ, Vermeulen H. The effect of structural empowerment of nurses on quality outcomes in hospitals: A scoping review. Journal of Nursing Management. 2017;25(3):194–206. doi: 10.1111/jonm.12455
Lambrou P, Kontodimopoulos N, Niakas D. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital. Human Resources for Health. 2010;8(1):1-9. doi: 10.1186/1478-4491-8-26
Kanter RM. Men and women of the corporation. 2nd ed. New York: Basic Books; 1993.
Laschinger HK. Job and career satisfaction and turnover intentions of newly graduated nurses. Journal of Nursing Management. 2012;20(4):472-84. doi: 10.1111/j.1365-2834.2011.01293.x.
Çelik ŞŞ, Sariköse S, Çelik Y. Structural and psychological empowerment and burnout among nurses: A systematic review and meta-analysis. International Nursing Review. 2024;71(1):189-201. doi: 10.1111/inr.12878.
Phromyaem R. Relationship among personal factors, lifelong learning, empowerment of head nurses and orthopedic nurses competency, hospitals under the department of medical services [master’s thesis]. Bangkok: Chulalongkorn University; 2017. (in Thai)
Soonthongsiri S. The competency enhancement of professional nurses in medical correctional hospital [master’s thesis]. Nonthaburi: Sukhothai Thammathirat Open University; 2022. (in Thai)
Cooke RA, Lafferty JL. Level I: Organizational culture inventory. Plymouth (MI): Human Synergistics; 1989.
Aydogdu ALF. The Impact of Organizational Culture on Nursing: A Comprehensive Analysis. World Academic Journal of Management. 2023;11(4):32-41.
Boonmathat S. Public organizational culture suited for Thailand 4.0: Era for public organization under central administration. Journal of MCU Social Science Review. 2022;13(2):1–14 (in Thai)
Phunlapa C. Organizational culture affects the core competencies of staffs of the Institute of Molecular Biosciences Mahidol university. Mahidol R2R e-Journal. 2017;4(2):206-26. doi: 10.14456/jmu.2017.30 (in Thai)
Lu Y, Zhai S, Liu Q, Liu J, Chen C. The impact of head nurse empowerment on clinical nurses’ innovative behavior: The mediating role of organizational climate and professional autonomy. BMC Nursing. 2025;24:574. doi: 10.1186/s12912-025-03214-6
Office of the Permanent Secretary for Higher Education, Science, Research and Innovation. Framework of higher education, science, research and innovation policy and strategy 2023–2027 [internet]. 2022 [cited 2025 Jan 21]. Available from: https://www.mhesi.go.th/index.php/all-media/book-ministry/8310-2022-12-13-06-27-40.html (in Thai)
Nursing Department, Naresuan University Hospital. Annual report of the nursing department, Naresuan university hospital fiscal years 2019–2022. [internet]. 2022 [cited 2025 Jan 21]. Available from: https://www.plan.office.nu.ac.th/?page_id=847 (in Thai)
Faculty of Medicine, University of Phayao Hospital. Annual report (October 2021–September 2022). [internet]. 2022 [cited 2025 Jan 21]. Available from: https://anyflip.com/yrlwv/ghqb/basic (in Thai).
Mae Fah Luang University Medical Center Hospital. Strategic plan of Mae Fah Luang university medical center hospital 2022–2026. [internet]. 2023 [cited 2025 Jan 21]. Available from: https://www.mfu.ac.th/life-on-campus/lifeoncampus-healthy/mfu-medical-center.html (in Thai).
Laschinger HK. Condition for work effectiveness questionnaire I and II. Canada: Western University; 2012.
Thailand Nursing Council. Competencies of registered nurses. 1st ed. Bangkok: Siree Yodkarnpim 2010. (in Thai)
Srisatitnarakorn B. Effect size, power analysis, optimal sample size calculation using G*Power software. 1st ed. Bangkok: Chulalongkorn University Press; 2020. (in Thai)
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988.
Bualuang B. Influence of empowerment and physician–nurse relationships on quality of care among professional nurses in inpatient departments at Uttaradit Hospital [master’s thesis]. Nonthaburi: Sukhothai Thammathirat Open University; 2018. (in Thai)
Laokittisak R. Relationship between organizational culture, job empowerment, and quality of working life of professional nurses under the jurisdiction of the local government administration [master’s thesis]. Nonthaburi: Sukhothai Thammathirat Open University; 2009. (in Thai)
Polit DF, Beck CT. Essentials of nursing research: Appraising evidence for nursing practice. 10th ed. Philadelphia: Wolters Kluwer; 2021.
Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. 5th ed. New York: Springer 2017.
Srisaard B. Introduction to research. 10th ed. Bangkok: Suwiriyasarn; 2017. (in Thai)
Rungdecharat N. Core competencies of registered nurses at practitioner level in a university hospital. Vajira Nursing Journal. 2016;18(2):33–41 (in Thai)
Pumkliang M. Empowerment the performance of registered nurses at Palian hospital, Trang province. Journal of Education and Research in Public Health. 2023;1(3):163–73 (in Thai)
Thailand Nursing Council. Nursing standards [internet]. 2019 [cited 2024 Nov 27]. Available from: http://www.tnmc.or.th/images/userfiles/files/A111.PDF (in Thai)
Fakfai S. Desirable competencies of professional nurses in the new normal, health units under the ministry of public health, area health 2 [master’s thesis]. Phitsanulok: Naresuan University; 2023. (in Thai)
Akkadechanan T. Nurses’ competency and public healthcare innovation in Thailand 4.0 era. Journal of Thailand Nursing and Midwifery Council. 2019;34(1):5–13 (in Thai)
Pitaksang A, Phoyen J, Namthep J, Chimchalong R, Panyawong T, Rerkmongkol W, et al. Digital literacy among nurses working in a university hospital. Journal of Thailand Nursing and Midwifery Council. 2023;38(2):38–48 (in Thai)
Thepkarn P, Prutipinyo C, Phahuwatanakorn W, Sirichotiratana N. Perceptions of professional nurses regarding ethics and organizational culture in a university hospital. Public Health Policy and Laws Journal. 2020;6(2):279-92 (in Thai)
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