Psychological and Structural Empowerment on the Personal Initiatives of Nurses in a Level 2 Government Hospital

Authors

Sherry Mae Y. Santillana., RN

Graduate School of Allied Health Sciences, University of the Visayas (Philippines)

Joan P. Bacarisas, DM, MAN, RN

Graduate School of Allied Health Sciences, University of the Visayas (Philippines)

Article Information

DOI: 10.51584/IJRIAS.2026.11030088

Subject Category: Empowerment

Volume/Issue: 11/3 | Page No: 1116-1129

Publication Timeline

Submitted: 2026-03-23

Accepted: 2026-03-28

Published: 2026-04-14

Abstract

This study utilized a quantitative descriptive–correlational research design to determine the levels of psychological empowerment, structural empowerment, and personal initiative among nurses in a Level 2 government hospital, and to examine the relationships among these variables. Data were gathered from nurse-respondents using standardized adopted questionnaires measuring psychological empowerment, structural empowerment, and personal initiative. Descriptive statistics were used to determine the levels of the variables, while Pearson r correlation was employed to test the significance of relationships. Findings revealed that nurses demonstrated very high levels of psychological empowerment, structural empowerment, and personal initiative. Further analysis showed significant positive relationships between psychological empowerment and personal initiative, and between structural empowerment and personal initiative. These results indicate that nurses who experience stronger empowerment, both internally and organizationally, tend to exhibit higher levels of proactive and self-starting behaviors at work. The study concludes that empowerment plays an important role in promoting personal initiative among nurses. Strengthening both psychological and structural empowerment may help sustain proactive nursing behaviors and improve organizational outcomes. A Professional Empowerment and Initiative Enhancement Blueprint was proposed to support empowerment-based nursing management practices.

Keywords

Psychological empowerment, Structural empowerment, Personal initiative, Nursing management, Government hospital

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References

1. Ahmed, H. A., Elshikh, M. S., Ahmed, A. A., & Abd El-Kader, A. A. (2025). Social undermining and psychological empowerment among nurses: The mediating role of psychological resilience. BioMedical Center Nursing, 24, 260. https://doi.org/10.1186/s12912-025-03260-0 [Google Scholar] [Crossref]

2. Ahmed, R., Mahmoud, A., & Elshazly, M. (2025). Psychological resilience as a mediator between social undermining and psychological empowerment among hospital nurses. Journal of Nursing Management, 33(1), 45–55. https://doi.org/10.1111/jonm.13912 [Google Scholar] [Crossref]

3. Al-Ghwary, A. A., Al-Oweidat, I. A., Al-Qudimat, A. R., Abu Shosha, G. M., Khalifeh, A. H., & AlBashtawy, M. (2024). The impact of the workplace environment on structural empowerment of registered nurses in governmental hospitals. Nursing Reports, 14(1), 482–493. https://doi.org/10.3390/nursrep14010037 [Google Scholar] [Crossref]

4. Al-Obiedat, A. M., Al-Tobaseen, S., & Al-Hammouri, M. (2024). The psychological empowerment and quality of work life among nurses. Frontiers in Medicine, 11, 1476225. [Google Scholar] [Crossref]

5. Al-Otaibi, A. G., AlAteeq, M. A., Al-Babtain, S. A., & AbuAl-Rub, R. (2024). Perceived structural empowerment, resilience, and intent to stay among nurses and midwives in obstetrics and gynecology departments. BioMedical Center Nursing, 23, 225. [Google Scholar] [Crossref]

6. Al-Otaibi, A. M., Almutairi, A. F., & Alshammari, F. (2024). Structural empowerment, resilience, and intent to stay among nurses and midwives. Journal of Advanced Nursing, 80(2), 567–578. https://doi.org/10.1111/jan.15942 [Google Scholar] [Crossref]

7. Alshaikh, Z., Alkhateeb, M., & Alharbi, R. (2024). Psychological empowerment and professional competence among hospital nurses. International Nursing Review, 71(1), 83–92. https://doi.org/10.1111/inr.12868 [Google Scholar] [Crossref]

8. Awad, N. A., Kassem, A. H., & El-Demerdash, S. M. (2024). Entrepreneurial leadership and proactive work behavior among nurses: The mediating role of autonomy. Journal of Nursing Scholarship, 56(1), 32–41. https://doi.org/10.1111/jnu.12936 [Google Scholar] [Crossref]

9. Bektaş, G., Aydın, A., & Tözün, M. (2025). The effect of transformational leadership on nurses’ innovative work behaviors: The mediating role of psychological empowerment. BioMedical Center Nursing, 24, 172. [Google Scholar] [Crossref]

10. Boamah, S. A., & Laschinger, H. K. S. (2022). Structural empowerment and innovative behavior among hospital nurses: The mediating role of work engagement. Journal of Nursing Management, 30(2), 283–292. https://doi.org/10.1111/jonm.13452 [Google Scholar] [Crossref]

11. Boamah, S. A., Hamadi, H. Y., & Havaei, F. (2023). Empowerment and engagement: Predictors of nurses’ job outcomes in acute care. BioMedical Center Nursing, 22(1), 112. https://doi.org/10.1186/s12912-023-01217-7 [Google Scholar] [Crossref]

12. Carmeli, A., Sheaffer, Z., Binyamin, G., Reiter-Palmon, R., & Shimoni, T. (2020). Transformational leadership and creative problem-solving: The mediating role of psychological empowerment and personal initiative. Journal of Creative Behavior, 54(2), 444–458. https://doi.org/10.1002/jocb.380 [Google Scholar] [Crossref]

13. Engström, M., Nilsson, P., & Skagerström, J. (2025). Thriving at work as a mediator between nurses’ structural empowerment and work–personal life benefits, performance, stress, and turnover intentions. BioMedical Center Nursing, 24, 82. https://doi.org/10.1186/s12912-025-02828-0 [Google Scholar] [Crossref]

14. Fang, Y., Zhou, X., & Wang, L. (2024). Proactive work behavior and work outcomes among nurses: The role of organizational support and empowerment. Journal of Advanced Nursing, 80(2), 745–756. https://doi.org/10.1111/jan.15824 [Google Scholar] [Crossref]

15. Fernandez, R., Johnson, M., & Tran, D. T. (2023). Nurses’ proactive behaviors and workflow efficiency in acute care units. Journal of Clinical Nursing, 32(15–16), 3014–3024. https://doi.org/10.1111/jocn.16598 [Google Scholar] [Crossref]

16. Frese, M., & Fay, D. (2001). Personal initiative: An active performance concept for work in the 21st century. Research in Organizational Behavior, 23, 133–187. https://doi.org/10.1016/S0191-3085(01)23005-6 [Google Scholar] [Crossref]

17. Frese, M., Fay, D., Hilburger, T., Leng, K., & Tag, A. (1997). The concept of personal initiative: Operationalization, reliability, and validity in two German samples. Journal of Occupational and Organizational Psychology, 70(2), 139–161. [Google Scholar] [Crossref]

18. Ghasemi, S., Torabi, M., & Jamasbi, M. M. (2024). The impact of psychological empowerment of nurses on their job involvement: A descriptive-correlational study. The Open Nursing Journal, 18, e18744346335042. [Google Scholar] [Crossref]

19. Gu, L., Wang, L., & Pan, B. (2022). Psychological empowerment and job satisfaction in nurses: A systematic review and meta-analysis. Frontiers in Public Health, 10, 1022823. https://doi.org/10.3389/fpubh.2022.1022823 [Google Scholar] [Crossref]

20. Harbridge, C., Ivanitskaya, L., & Raines, D. (2023). Psychological empowerment and job crafting among registered nurses. Journal of Nursing Management, 31(6), 1453–1462. https://doi.org/10.1111/jonm.13812 [Google Scholar] [Crossref]

21. Hashemi, R., Zarei, S., Wahabinejad, Z., & Moghadam, M. B. (2025). The role of psychological empowerment as a mediating variable between leader empowering behaviors and work engagement in nurses. BioMedical Center Nursing, 24, 71. https://doi.org/10.1186/s12912-025-03321-4 [Google Scholar] [Crossref]

22. Huang, L., Zhang, X., & Li, H. (2024). Interventions to support the psychological empowerment of nurses: A scoping review. Frontiers in Public Health, 12, 1427234. https://doi.org/10.3389/fpubh.2024.1427234 [Google Scholar] [Crossref]

23. Huang, Q., Zhou, Y., & Liu, X. (2025). Transformational leadership, psychological empowerment, work engagement, and ICU nurses’ job performance: A cross-sectional study using SEM. BioMedical Center Nursing, 24, 165. [Google Scholar] [Crossref]

24. Jiang, Z., Li, Y., & Chen, H. (2025). Personal initiative and resilience among healthcare professionals: A cross-sectional study in hospital settings. BioMedical Center Nursing, 24, 88. https://doi.org/10.1186/s12912-025-02188-1 [Google Scholar] [Crossref]

25. Jin, C., Fang, J., & Li, P. (2025). Association between psychological empowerment and intent to stay among nurses in military hospitals: A mediating model. Journal of Advanced Nursing, 81(4), 1004–1017. [Google Scholar] [Crossref]

26. Kagan, I., & Melamed, A. (2021). Personal initiative and work environment as predictors of job satisfaction among nurses: Cross-sectional study. BioMedical Center Nursing, 20, 140. https://doi.org/10.1186/s12912-021-00615-1 [Google Scholar] [Crossref]

27. Kanter, R. M. (1993). Men and women of the corporation (2nd ed.). Basic Books. [Google Scholar] [Crossref]

28. Kim, J. S., & Lee, Y. J. (2021). The influence of psychological empowerment on proactive work behavior among hospital nurses. International Journal of Environmental Research and Public Health, 18(4), 1784. https://doi.org/10.3390/ijerph18041784 [Google Scholar] [Crossref]

29. Kim, S., Park, J., & Lee, H. (2024). Autonomy and proactive clinical judgment among hospital nurses. Nursing Ethics, 31(2), 345–357. https://doi.org/10.1177/09697330231204576 [Google Scholar] [Crossref]

30. Lai, Y., Wong, C. A., & Laschinger, H. K. S. (2024). Proactive behaviors in healthcare professionals: A systematic review. Journal of Nursing Management, 32(1), 15–28. https://doi.org/10.1111/jonm.13895 [Google Scholar] [Crossref]

31. Laschinger, H. K. S., et al. (2022). Does empowerment enhance nurses’ organizational commitment? Journal of Nursing Management. https://doi.org/10.1111/jonm.13724 [Google Scholar] [Crossref]

32. Li, M., Liu, Y., & Zhang, Q. (2022). Empowerment and proactive behavior among nurses: The mediating role of work engagement. International Journal of Nursing Practice, 28(4), e13045. https://doi.org/10.1111/ijn.13045 [Google Scholar] [Crossref]

33. Liu, Y., et al. (2025). The effect of psychological empowerment on clinical nurses’ thriving at work: The mediating role of voice behavior. BioMedical Center Nursing. https://doi.org/10.1186/s12912-025-03403-3 [Google Scholar] [Crossref]

34. Lu, H., Zhao, Y., & While, A. (2025). Nurse leader empowerment and innovative behavior among clinical nurses: A chain mediation model. Journal of Nursing Management, 33(1), 89–99. https://doi.org/10.1111/jonm.13921 [Google Scholar] [Crossref]

35. Martinez, L. R., Smith, K. L., & Jones, A. (2023). Organizational justice, empowerment, and initiative among hospital nurses. Journal of Nursing Administration, 53(9), 451–458. https://doi.org/10.1097/NNA.0000000000001204 [Google Scholar] [Crossref]

36. Newberry, L. W. (2021). Using structural empowerment to improve outcomes. Journal of Nursing Administration, 51(7/8), 359–361. https://doi.org/10.1097/NNA.0000000000001028 [Google Scholar] [Crossref]

37. Ni, C., Wang, Y., & Zhang, X. (2024). Proactive personality, self-efficacy, and career self-concept among nurses. Journal of Nursing Management, 32(4), 654–663. https://doi.org/10.1111/jonm.13902 [Google Scholar] [Crossref]

38. Ni, Y., Liu, Y., Zhang, W., & Chen, L. (2024). Self-efficacy, proactive personality, and career self-concept among nurses: Mediating effects and implications. BioMedical Journal Open, 14, e081334. [Google Scholar] [Crossref]

39. Nurmeksela, A., Mikkonen, S., & Kinnunen, J. (2024). Structural empowerment as a buffer against destructive leadership in nursing units. Journal of Advanced Nursing, 80(4), 1032–1043. https://doi.org/10.1111/jan.15821 [Google Scholar] [Crossref]

40. Oducado, R. M. F., Alcoran, R. R., & Magsombol, R. V. (2021). Influence of self-esteem, psychological empowerment, and leader empowering behaviors on assertive behaviors of staff nurses. Belitung Nursing Journal, 7(3), 179–185. [Google Scholar] [Crossref]

41. Orgambídez, A., Benítez, M., León-Pérez, J. M., & Cantero-Sánchez, F. J. (2024). Structural empowerment, personal initiative, and job satisfaction in service employees: Exploring the mediating role of psychological empowerment. Scandinavian Journal of Psychology, 65, 911–918. https://doi.org/10.1111/sjop.13040 [Google Scholar] [Crossref]

42. Orgambídez, A., Cirano, S., & Borrego-Alés, Y. (2024). Structural empowerment, personal initiative, and job satisfaction in service employees: Exploring the mediating role of psychological empowerment. Scandinavian Journal of Psychology, 65(6), 801–812. https://idus.us.es/bitstreams/057c674e-0d3f-43c5-9d54-266e68480538/download [Google Scholar] [Crossref]

43. Orlowska, A., & Laguna, M. (2023). Structural and psychological empowerment in explaining job satisfaction and burnout in nurses: A two-level investigation. Journal of Nursing Management, 2023, 1–11. https://doi.org/10.1155/2023/9958842 [Google Scholar] [Crossref]

44. Phancharoen, S., Wichaikhum, O. A., & Chontawan, R. (2023). Structural empowerment and innovative practice behaviors among nurses in Thailand. *Pacific Rim International Journal [Google Scholar] [Crossref]

45. Rawah, R., & Banakhar, M. (2022). The relationship between empowerment and organizational commitment from nurse’s perspective in Ministry of Health hospitals. Healthcare, 10(4), 664. https://doi.org/10.3390/healthcare10040664 [Google Scholar] [Crossref]

46. Ribeiro, M., Sanches, D., Barros, S., Gonçalves, M., Castro, S., Oliveira, T., Gasparino, R., Ribeiro, O., & colleagues. (2025). Structural empowerment of nurses in the hospital setting: A cross-sectional study. Nursing Reports, 15(12), 444. https://doi.org/10.3390/nursrep15120444 [Google Scholar] [Crossref]

47. Sarıköse, S., Yıldırım, D., & Yıldırım, S. (2024). Structural and psychological empowerment among newly graduated nurses: A cross-sectional study. Journal of Advanced Nursing, 80(6), 1381–1395. https://doi.org/10.1111/jan.16022 [Google Scholar] [Crossref]

48. Schmitt, A., Den Hartog, D. N., & Belschak, F. D. (2021). Transformational leadership and proactive work behavior: A daily diary study. Journal of Occupational and Organizational Psychology, 94(2), 389–414. https://doi.org/10.1111/joop.12339 [Google Scholar] [Crossref]

49. Shokry, M., Abd-Elaziz, A., & El-Sayed, H. (2023). Proactive behavior and professional identity among hospital nurses. BioMedical Center Nursing, 22(1), 214. https://doi.org/10.1186/s12912-023-01288-4 [Google Scholar] [Crossref]

50. Spreitzer, G. M. (1995). Psychological empowerment in the workplace: Dimensions, measurement, and validation. Academy of Management Journal, 38(5), 1442–1465. https://doi.org/10.5465/256865 [Google Scholar] [Crossref]

51. Taketomi, K., Ogata, Y., Sasaki, M., Yonekura, Y., & Tanaka, M. (2024). The relationship between nursing practice environment and nurses’ psychological empowerment: A cross-sectional study. Scientific Reports, 14, 27222. [Google Scholar] [Crossref]

52. Wahyudin, F. S., Hamidah, H., & Santoso, B. (2023). The effect of transformational leadership and psychological empowerment on nurse organizational commitment using job satisfaction mediation at Level II hospital. Tec Empresarial, 17(2), 280–299. https://doi.org/10.1229/tecempresarialjournal.v17i2.106 [Google Scholar] [Crossref]

53. Wan, L., Zhang, T., & Qiao, X. (2025). Proactively seeking feedback from diverse networks: Feedback-seeking behavior and its relation to nurses’ work engagement and task performance. Journal of Nursing Management, Advance online publication. [Google Scholar] [Crossref]

54. Wang, H., Liu, Y., & Wang, L. (2024). Structural empowerment and innovative behavior among clinical nurses: The role of decent work perception. Journal of Nursing Management, 32(3), 411–421. https://doi.org/10.1111/jonm.13874 [Google Scholar] [Crossref]

55. Wang, Z., Wu, Y., & Zhang, J. (2024). Innovative behavior and structural empowerment among clinical nurses: A cross-sectional study. BioMedical Center Nursing, 23, 180. https://doi.org/10.1186/s12912-024-02554-z [Google Scholar] [Crossref]

56. Wang, Z., Yang, L., Zhu, Y., Tang, X., Wang, T., Chen, L., Li, L., Xie, W., Peng, J., Yang, J., et al. (2024). Innovative behavior and structural empowerment among Chinese clinical nurses: The mediating role of decent work perception. BioMedical Center Nursing, 23, 881. https://doi.org/10.1186/s12912-024-02554-z [Google Scholar] [Crossref]

57. Xie, X., Feng, Y., & Chen, J. (2024). The moderating role of work environment in the relationship between proactive personality and personal growth initiative among clinical nurses. BioMedical Center Nursing, 23, 240. https://doi.org/10.1186/s12912-024-02040-6 [Google Scholar] [Crossref]

58. Xu, L., Li, X., & Zhou, Y. (2025). Nurse professional competence as a mediator between structural empowerment and person-centered climate in hospital wards. Nursing Reports, 15(2), 215–227. [Google Scholar] [Crossref]

59. Yesilbas, H., & Kantek, F. (2024). Relationship between structural empowerment and job satisfaction among nurses: A meta-analysis. International Nursing Review. https://doi.org/10.1111/inr.12968 [Google Scholar] [Crossref]

60. Zhang, Y., Chen, J., & Li, X. (2024). Organizational support, empowerment, and clinical innovation in hospitals. International Journal of Nursing Studies, 148, 104608. https://doi.org/10.1016/j.ijnurstu.2024.104608 [Google Scholar] [Crossref]

61. Zheng, X., & Wang, W. (2023). Psychological empowerment and innovative work behavior: The mediating role of work engagement. Frontiers in Psychology, 14, 1142123. https://doi.org/10.3389/fpsyg.2023.1142123 [Google Scholar] [Crossref]

62. Zhuang, J., Chen, Y., & Li, S. (2025). The effect of psychological empowerment on clinical nurses’ thriving at work: The mediating role of voice behavior. BioMedical Center Nursing, 24, 100. https://doi.org/10.1186/s12912-025-03403-3 [Google Scholar] [Crossref]

63. Zhuang, Y., Wu, X., & Liu, H. (2025). Psychological empowerment, voice behavior, and thriving at work among nurses. Journal of Nursing Management, 33(1), 120–130. https://doi.org/10.1111/jonm.13934 [Google Scholar] [Crossref]

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