Studying the relationships between authentic leadership, structural empowerment, and civility in the palliative care sector in Portugal

Purpose This paper aims to propose a model studying the relationship of authentic leadership (AL), structural empowerment (SE) and civility in the palliative care sector. This model proposes SE as a mediator between AL and civility. Design/methodology/approach Data was collected from 213 employees working in five major public palliative care hospitals in central Portugal. The study sample was predominantly female (80.3%) and the response rate was 42.6%. Variables were measured using the Authentic Leadership Inventory, Workplace Civility Scale and Conditions of Work Effectiveness Questionnaire II scales. Hayes’ PROCESS macro for mediation analysis in SPSS was used to test the hypothesized model. Findings Results suggest that AL has a significant positive direct relationship with both SE and civility. Furthermore, SE demonstrated to play a partial mediation effect between AL and civility. Practical implications This study may be of use for healthcare administration encouraging the development of AL, suggesting that the more leaders are seen as authentic, the more employees will perceive they have access to workplace empowerment structures and a civil environment. Originality/value Considering the mainstream literature in healthcare management, to the best of the authors’ knowledge, this is the first study to date to integrate the relation of AL, SE and civility in the palliative care sector. Further, the research model has not previously been introduced when considering the mediating role structural empowerment can play between AL and civility.

I’ve Got the Power: Nurses’ Moral Distress and Perceptions of Empowerment

Background Nurses experience moral distress when they feel disempowered or impeded in taking the ethically right course of action. Research suggests an inverse relationship between moral distress and empowerment. In the intensive care unit, providing palliative care services may reduce moral distress because palliative care is often provided in situations that give rise to moral distress. Objective To evaluate the effect of nurses’ use of a palliative care screening tool on their moral distress and perceptions of empowerment. Methods A pretest-posttest pilot study was conducted involving day-shift medical intensive care unit nurses. The nurses administered a palliative care screening tool to their assigned patients daily for 8 weeks and communicated the results to an attending physician or fellow. Demographic information was collected, along with data on nurses’ moral distress and perceptions of structural and workplace empowerment before and after the intervention. Moral distress was evaluated using the Moral Distress Scale–Revised. Perceptions of structural and workplace empowerment were quantified using the Conditions for Work Effectiveness Questionnaire–II and the Global Empowerment Scale, respectively. Results Preintervention and postintervention surveys were completed by 17 nurses. Paired-sample t tests revealed a significant decrease in the frequency of moral distress (t16 = −2.22, P = .04) and a significant increase in workplace empowerment (t16 = −2.75, P = .01). No significant changes in moral distress intensity or structural empowerment were found. Conclusion Nurses’ sense of empowerment and the frequency of moral distress are favorably affected by active participation in assessing and communicating patients’ palliative care needs.

Training Corporate Bodies

In the global corporate world, dramatic techniques adapted from theatre for social change repertories provide tools for workplace empowerment. In corporate India, theatre training teaches employees to conform to implicit workplace codes of bodily conduct. Overlaps between managerial strategies and tactics of workshop participants reveal that corporate theatre engineers moments of human expression that exceed human capital formation.

The Perspective of Leader-Member Exchange and Its Relation with Workplace Empowerment and Organizational Citizenship Behavior among Nurses

Context: Leader-member exchange captures the impact of nurses’ perceptions of support from their supervisors’ high-quality relationships, which may promote extra-role behaviors, enabling increased job satisfaction and workplace empowerment and nurses` organizational citizenship behavior. Aim: Assess the perspective of leader-member exchange and its relation with workplace empowerment and organizational citizenship behavior among nurses. Methods: A descriptive correlational design was used to achieve the aim of the study. This study was conducted at Benha University Hospital in general medical and surgical units. A Convenient sample consisted of 190 nurses who were working in the study setting, as mentioned earlier. Three tools used to collect the data; Subordinate (LMX-MDM) survey portion, Condition of Work Effectiveness Questionnaire (CWEQ), and Organizational Citizenship Behavior Scale. Results: The findings of this study indicated that more than half of nurses (54.7%) reported that they had a high-quality relationship with their supervisors, and 71.1% of nurses had a moderate level of workplace empowerment. Also, more than half of nurses (51.1%) had a moderate level of organizational citizenship behavior. Conclusions: There was a highly statistically significant positive correlation between the total score of leader-member exchange and total workplace empowerment, total organizational citizenship behavior. Also was a highly statistically significant positive correlation between the total workplace empowerment, total organizational citizenship behavior. The study recommended that hospital management needs to focus on involving staff nurses in the political processes in an organization and keep them informed about significant changes in the organization and have a protective attitude toward it.

Developing serving culture: focus on workplace empowerment

Purpose Based on the data gathered from healthcare organizations, the purpose of this paper is to identify new antecedents of service quality. The proposed model posits that workplace empowerment should increase a level of employee helping behaviors, thus supporting the development of a firm’s serving culture. Consequently, while focusing on two forms of workplace empowerment, the study empirically tests mediating paths that link structural empowerment and psychological empowerment with service quality via serving culture. The findings expand the understanding of how companies could better manage evolving demands of their customers. Furthermore, the project provides clear guidelines to practitioners by suggesting how firms should allocate their organizational resources to boost service quality. Design/methodology/approach The study uses the original survey data collected from healthcare organizations to empirically test the mediating paths linking structural empowerment, psychological empowerment and service quality via serving culture. The data were tested using structural equation modeling. Findings Although the initial model assumed that both types of workplace empowerment should play equally important roles in the development of serving culture, the data reveal the statistical significance of structural empowerment. Thereby, findings emphasize that in health care, employees must be provided with access to key organizational resources (e.g., vertical and horizontal information flow) to drive up quality of service. Originality/value This research is one of a few empirical studies examining antecedents of serving culture. An overall implication of the study should be a reinforced call for more empirical studies that could identify how companies could develop serving culture. Furthermore, the paper proposes that managers must remove structural barriers that may exist in their organizations to empower employees to better manage changing customer needs.