Preferences for Decision‐Making Autonomy

Blegen, Mary A.; Goode, Colleen J.; Johnson, Marion; Maas, Meridean; Chen, Lily; Moorhead, Sue

doi:10.1111/j.1547-5069.1993.tb00269.x

Cited by 50 publications

(70 citation statements)

References 27 publications

(14 reference statements)

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“…Studies have indicated that control over nursing practice is associated with increased job satisfaction and improved patient outcomes 1,34,36 and with decreased job-related stress, burnout, and staff turnover. 37,38 The association between less autonomy and increased nurses' intentions to resign, along with decreased job satisfaction, is in accordance with previous findings 2 and emphasizes the importance of exercising autonomy in some aspects of nursing work. Although low clinical decision-making autonomy has been reported among Hellenic intensive care nurses, 16 the levels of autonomy in our study are difficult to compare with the levels in previous studies because of differences in the instruments used.…”

Section: Discussionsupporting

confidence: 78%

“…Objectives included the investigation of perceived levels of autonomy, collaboration, and moral distress; potential differences among national groups; and A mong nurses, the association between being able to exercise autonomy and job dissatisfaction, burnout, and intention to leave the profession is well established. [1][2][3] In intensive care units (ICUs), increased nursing autonomy is strongly linked with improved outcomes for patients 1,4,5 and nurses' health and well-being. 6,7 Exercising autonomy is a factor in supporting application of evidence-based practice 8 and in enhancing nurses' satisfaction and retention.…”

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confidence: 99%

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Professional Autonomy, Collaboration With Physicians, and Moral Distress Among European Intensive Care Nurses

Papathanassoglou

Karanikola

Kalafati

et al. 2012

American Journal of Critical Care

191

262

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Background Discretionary autonomy is a key factor in enhanced patient outcomes and nurses' work satisfaction. Among nurses, insufficient autonomy can result in moral distress. Objectives To explore levels of autonomy among European critical care nurses and potential associations of autonomy with nurse-physician collaboration, moral distress, and nurses' characteristics. Methods Descriptive correlational study of a convenience sample of 255 delegates attending a major European critical care conference in 2009. Respondents completed a selfadministered questionnaire with validated scales for nurses' autonomy, nurse-physician collaboration, and moral distress. Results The mean autonomy score (84.26; SD, 11.7; range, and the mean composite (frequency and intensity) moral distress score (73.67; SD, 39.19; range, were both moderate. The mean collaboration score was 47.85 (SD, 11.63; range,. Italian and Greek nurses reported significantly lower nurse-physician collaboration than did other nurses (P < .001). Greek and German nurses reported significantly higher moral distress (P < .001). Autonomy scores were associated with nurse-physician collaboration scores (P < .001) and with a higher frequency of moral distress (P = .04). Associations were noted between autonomy and work satisfaction (P = .001). Frequency of moral distress was associated inversely with collaboration (r = -0.339; P < .001) and autonomy (r = -0.210; P = .01) and positively with intention to quit (r = 0.257; P = .004). Autonomy is defined as the freedom to make decisions within the domain of an individual's profession and to act accordingly. 10,11 The ability to make discretionary and autonomous decisions based on comprehensive knowledge, clinical expertise, and evidence-based findings is a hallmark of professionalism. In general, ICU nurses make 1 care decision every 30 seconds 12 and approximately 9 important patient-care decisions per hour, 13 suggesting that exercising judgment is a core nursing activity and influences the quality of care provided. Previous studies 11,[14][15][16] in European ICUs indicated that the levels of nurse autonomy differ between countries and that the decision-making capacity of these clinicians needs to be developed and strengthened. However, factors that may be associated with low autonomy among European ICU nurses have not been systematically studied. Although, presumably, poor nursephysician collaboration may limit a nurse's ability to implement care-and unit-related decisions, associations between these 2 constructs have not been investigated. Evidence of the association between nurse-physician collaboration and ICU nurses' moral distress is likewise scant. Although the design of the study we report here was unsuitable for exploring either causative factors or antecedents of autonomy-and inferences may be limited by differences in responders' context of practice-we wished to address autonomy, nurse-physician collaboration, and moral distress simultaneously in a sample of European ICU nurses to gain preliminary insigh...

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Section: Discussionsupporting

confidence: 78%

mentioning

confidence: 99%

Professional Autonomy, Collaboration With Physicians, and Moral Distress Among European Intensive Care Nurses

Papathanassoglou

Karanikola

Kalafati

et al. 2012

American Journal of Critical Care

191

262

View full text Add to dashboard Cite

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“…Part I Autonomy scale. The autonomy scale of Blegen et al. (1993) was used to measure nurses’ autonomy.…”

Section: Questionnairementioning

confidence: 99%

Nurses’ autonomy: influence of nurse managers’ actions

Mrayyan

2004

Journal of Advanced Nursing

111

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“…Sustained role meaning discrepancy is likely to result in role dissatisfaction, and possibly role exit. Indeed, role discrepancy has been found to be a common problem among nurses (Blegen et al 1993;Takase et al 2005Takase et al , 2006bTaylor et al 2001;Yung 1996), regardless of the years of service and=or level of expertise (Takase et al 2006a). Research indicates that when the ''person-environment fit'' is absent, nurses are likely to experience increasingly negative feelings towards the work role, ultimately leading to negative behavioral outcomes such as role exit.…”

mentioning

confidence: 97%

Meaning, Discrepancy, and Satisfaction in the Nurse Role

Brennan

2009

Sociological Spectrum

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What it means to be a nurse has changed over time. This article explores the changing meanings for the nurse role in a sample of Bachelor of Science nursing students by analyzing 30 nurse role attributes documented in the nursing literature. Students' perceptions of obligatory and self-in-role meanings are assessed, and multiple role meaning dimensions are identified. Identity-discrepancy theory is used to determine whether discrepancies between obligatory and self-in-role meanings are related to role satisfaction. Findings suggest that discrepancies in some nurse role meaning dimensions are predictive of role satisfaction. The implications for role exit and the nursing shortage are discussed.

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Preferences for Decision‐Making Autonomy

Cited by 50 publications

References 27 publications

Professional Autonomy, Collaboration With Physicians, and Moral Distress Among European Intensive Care Nurses

Professional Autonomy, Collaboration With Physicians, and Moral Distress Among European Intensive Care Nurses

Nurses’ autonomy: influence of nurse managers’ actions

Meaning, Discrepancy, and Satisfaction in the Nurse Role

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