Exploring the link between structural empowerment and job satisfaction through the mediating effect of role stress: a cross-sectional questionnaire study

Background: Role stress (ambiguity and conflict) is a major psychosocial risk at work negatively associated with job satisfaction in the nursing context. According to Kanter's empowerment theory, high levels of structural empowerment reduce role stress, so role ambiguity and conflict could be potential mediators of the relationship between empowerment and job satisfaction. Objective: The aim of this study was to analyze the relationships between structural empowerment, role stress (ambiguity and conflict), and job satisfaction, assuming the mediating role of role stress on the relationship between structural empowerment and job satisfaction. Design: A cross-sectional design was utilized, using questionnaires for data collection and convenience sampling. Setting(s): : Private health care organizations in southern Portugal. Participants: One hundred and twenty-four registered nurses (sample 1) and one hundred and thirty certified nursing assistants (sample 2) completed self-report measures of structural empowerment, role stress, and job satisfaction. Methods: Mediation analysis was performed using linear regression models and the bootstrapping method. Bias-Corrected confidence intervals (95%) were calculated for the study of direct and indirect effects. Results: In both samples, structural empowerment, role ambiguity, and role conflict were significant predictors of job satisfaction. Both ambiguity and role conflict partially mediated the effect of structural empowerment on job satisfaction. The effect mediated by ambiguity was greater than the effect mediated by role conflict in both registered nurses and certified nursing assistants. Conclusions: Two processes could explain the effect of structural empowerment on job satisfaction in the nursing context: a direct effect generating experiences and perceptions of power in professionals; and an indirect effect reducing role stress levels in the workplace. The creation of empowering workplaces which clarify work roles and functions of nursing staff should be a priority issue for health managers and nurse executives. (C) 2020 Elsevier Ltd. All rights reserved.