American Journal of Nursing Research
ISSN (Print): 2378-5594 ISSN (Online): 2378-5586 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Nursing Research. 2018, 6(6), 625-637
DOI: 10.12691/ajnr-6-6-33
Open AccessArticle

The Effect of Head Nurses’ Empowerment Educational Program on Staff Nurses’ Burnout

Aziza Zakaria Farmawy Ali1, , Shaimaa Mohamed Nageeb2 and Farida Mahmoud Hassona3

1Nursing Administration, Faculty of Nursing, Benha University, Egypt

2Mental Health Nursing, Faculty of Nursing, Zagazig University, Egypt

3Nursing Administration, Faculty of Nursing, Zagazig University, Egypt

Pub. Date: October 28, 2018

Cite this paper:
Aziza Zakaria Farmawy Ali, Shaimaa Mohamed Nageeb and Farida Mahmoud Hassona. The Effect of Head Nurses’ Empowerment Educational Program on Staff Nurses’ Burnout. American Journal of Nursing Research. 2018; 6(6):625-637. doi: 10.12691/ajnr-6-6-33


Background: Empowerment is necessary for the era of competition and service because every organization needs employees who are fast, responsive and independent so they can be competitive through human resources and strengthen the capability and commitment of employees. The lack of empowerment of nurses in hospitals is one of the main causes of nurses’ burnout. Aim of the study: The aim of this study was to examine the effect of head nurses’ empowerment educational program on staff nurses’ burnout. Research Design: A quasi-experimental design utilized to achieve the aim of the current study. Study Setting: The study conducted in medical, surgical and critical care units at Benha University Hospital, Egypt .Study sample: were all available head nurses who met the inclusion criteria (65) distributed as the following; 24 of head nurses working at medical units, 19 of head nurses working at surgical units and 22 head nurses working at critical care units. Convenience sample of staff nurses (342) who meet the inclusion criteria from the total number (716) nurses. Tools of data collection: Four tools utilized; namely, empowerment knowledge questionnaire, Conditions of Work Effectiveness Questionnaire, Psychological Empowerment Scale and Maslach-Burnout-Inventory-General Survey. Results: There was statistically significant improvement in head nurses' knowledge and level of empowerment after implementation of the program. In addition, there was a statistically significant improvement of staff nurses' level of burnout after implementation of the program. Also, there was a highly statistically significant negative correlation between head nurses’ empowerment level and studied staff nurses' level of burnout post-program (P<0.001). Conclusion: The study concluded that there was a positive effect of the educational program regarding empowerment for head nurses on the burnout of staff nurses. Recommendations: Future studies recommended to investigate the effect of psychological empowerment and employee engagement on other variables such as staff turnover, absenteeism, performance, and safety.

Head nurses Empowerment Staff nurses Burnout Educational program

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Hassona, F. M. (2013). Relationship between Structural Empowerment, Work Engagement, and Job Satisfaction among Nursing Staff at Zagazig University Hospitals. Zagazig Nursing Journal. Vol.9, No.1. 15-30.
[2]  Nursalam, N., Fibriansari, R. D., Yuwon, S. R., Had, M., Efendi, F., &, Bushy, A. (2018). Development of an empowerment model for burnout syndrome and quality of nursing work life in Indonesia. International Journal of Nursing Sciences. 5; 309-395.
[3]  Whatley, L. (2012). Just Imagine, You Can Experience a Whole New Life Now(Link), Living Now Magazine, April 2012.
[4]  Oladipo, S., (2009). psychological empowerment and development. Vol. 2, No.1 May 2009. 121.
[5]  Cicolini, g., Comparcini, d, & Simonetti, v. (2013): Workplace empowerment and nurses’ job satisfaction: a systematic literature review. Journal of Nursing Management. Journal of Nursing Management; 22(7): 855-71.
[6]  Breau, M., & Rhéaume, A. (2014). The relationship between empowerment and work environment on job satisfaction, intent to leave, and quality of care among ICU nurses. Dynamics, 25(3), 16-24.
[7]  Choong, Y., Wong, K., Lau, T. (2011). Psychological empowerment and organizational commitment in the Malaysian private higher education institutions: a review and research agenda. Academic Research International. Volume 1, Issue 3, 236-245.
[8]  El Dahshan, M. E., & Dorgham, L. S. (2013). The Effect of Structural and Psychological Empowerment on Occupational Burnout in Staff Nurses Working in Shebin El-Kom Hospitals, Menoufiya Governernate, Egypt. Life Science Journal; 10(1).
[9]  Mudallal, R. H, Othman, W. M., Hassan, N. F. (2017). Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. The Journal of Health Care Organization, Provision, and Financing. Volume 54: 1-10.
[10]  Elbarazi, I., Loney, T., Abdelrazeq, S. Y. and Elias, A. (2017). Prevalence of and factors associated with burnout among health care professionals in Arab countries: A systematic review. BMC Health Services Research; 17(1).
[11]  Maslach C., Jackson S.E. & Leiter M.P. (1996). Maslach Burnout Inventory Manual, 3rd edn. Consulting Psychologists Press, Palo Alto, CA.
[12]  Sorour, A. S., & Abd El-Maksoud, M. M. (2012). Relationship between Musculoskeletal Disorders, Job Demands, and Burnout among Emergency Nurses. Advanced Emergency Nursing Journal. Vol. 34, No. 3, pp. 272-282.
[13]  Abdo, S.A.M., El-Sallamy, R.M., El-Sherbiny, A.A.M. & Kabbash, I. A. (2015). Burnout among physicians and nursing staff working in the emergency hospital of Tanta University, Egypt. Eastern Mediterranean Health Journal. VOL. 21, NO. 12, 906-915.
[14]  Elrassas, H., Shorub, E., & El-Okda, E. (2016). Testing burnout syndrome as a psychiatric disorder among nursing staff of different medical settings. Middle East Current Psychiatry. 23(4): 208-214.
[15]  Khosravani, M., Borhani, F., Loghmani, L., Mohsenpour, M. (2018). Ethical sensitivity relationship with communication skills in Iranian nursing managers International Journal of Pharmaceutical Research, 10 (4), pp. 143-147.
[16]  Maleki, MR., Gohari, MR., & Ghorbanian. A. (2012). The relationship between structural empowerment and individual readiness of nurses for change. Journal of Nursing, 25 (76), 10-18.
[17]  Tayebi Arasteh M, Pouragha B and Norouzinia R (2018). Studying the conformity of self-assessment results of higher education lecturers with the assessment by others. International Journal of Pharmaceuti¬cal Research. 10(3): 269-276.
[18]  Ghalesefidi M. J., Maghsoudi J., Pouragha B (2018). Effectiveness of gratitude on psychological well-being and quality of life among hospitalized substance abuse patients. Electronic Journal of General Medicine.; 16(2): em128.
[19]  Pouragha, B., Pourreza, A., Jaafaripooyan, E., Heydari, H., Rahimi Froushani, A. and Hassanzadeh, A., 2013. The effect of access and out of pocket payment on the utilization of physicians services. World Appl Sci J, 22(1), pp.104-12.
[20]  RashidAzar, S., Mohammadzadeh, K. A., & Akhyani, N. (2018). Ivestigation of the relationship between structural empowerment and reduction of nurses’ occupational stress and job burnout (case study: nurses of public hospitals in Tehran). Revista Latinoamericana de Hipertensión. Vol. 13 - N 6. 547-553.
[21]  Zangaro G.A., & Soeken K.L. (2007). A meta-analysis of studies of nurses’ job satisfaction. Res Nurs Health; 30:445-58.
[22]  Babaeipour-Divshali, M., Amrollahimishavan, F., Vanaki, Z., Abdollahimohammad, A., & Firouzkouhi, M. (2016). Effect of head nurse empowerment program on staff nurses’ job satisfaction at two educational hospitals in Rasht, Iran. Iranian J Nursing Midwifery Res; 21:306-9.
[23]  Kanter, R. M. (1993). Men and women of the corporation (2nd ed.). New York, NY: Basic Books.
[24]  Wagner, J. J., Cummings, G., Smith, D. L., Olson, J., Anderson, L., & Warren S. (2010). The relationship between structural empowerment and psychological empowerment for nurses: a systematic review. Journal of Nursing Management; 18, 448-462.
[25]  Dinardo, J. (2008). "Natural experiments and quasi-natural experiments". The New Palgrave Dictionary of Economics; pp. 856-859.
[26]  Çavuş, M.F. Demir, Y. (2010) “The Impacts of Structural and Psychological Empowerment on burnout: A research on staff nurses in Turkish hospitals. Canadian Social Science, 6, 63 72.
[27]  Maynard, M. T., Gilson, L. L.,&Mathieu, J. E. (2012). Empowerment fad or fab? A multilevel review of the past two decades of research. Journal of Management, 38, 1231-1281.
[28]  Lundqvist, D., Reineholm, C., Gustavsson, M., & Ekberg, K. (2013). Investigating work conditions and burnout at three hierarchical levels. Journal of Occupational and Environmental Medicine, 55, 1157-1163.
[29]  Laschinger, H. K., Finegan, J., Shamian, J., & Wilk, P. (2001). Impact of structural and psychological empowerment on job strain in nursing work settings: Expanding Kanter model. Journal of Nursing Administration, 31, 260-272.
[30]  Jaimez, M. J.,&Bretones, F. D. (2013). Spanish adaptation of the structural empowerment scale. The Spanish Journal of Psychology, 16, 1-7.
[31]  Spreitzer, G. M. (1995). Psychological empowerment in the workplace: Dimensions, measurement, and validation. Academy of Management Journal, 38, 1442-1465.
[32]  Jaimez, M. J. (2013). Organizaciones saludables: el papel del empoderamiento organizacional [Healthy organisations: the role of organisational empowerment]. Doctoral dissertation.
[33]  Maslach, C. and Jackson S.E. (1981). The measurement of experienced burnout, Journal of Occupational Behaviour 2. 99-113.
[34]  Connolly M, Jacobs S, Scott K. (2018). Clinical leadership, structural empowerment and psychological empowerment of registered nurses working in an emergency department. J Nurs Manag; 26(7): 881-887.
[35]  Nasiripour, A.A., Siadati, S. A. (2011). A Propose Model for Nurses Empowerment Through Characteristics of Workplace and Management Strategies; A Study in Iranian Hospitals. Australian Journal of Basic and Applied Sciences; 5(6): 906-911.
[36]  O¨ zbas¸ A.A & Tel, H. (2016). The effect of a psychological empowerment program based on psychodrama on empowerment perception and burnout levels in oncology nurses: Psychological empowerment in oncology nurses. Palliative and Supportive Care; 14, 393-401.
[37]  Abou Hashish E, Abdel All N, Mousa A. (2018). Nurses’ perception of psychological empowerment and its relationship to work engagement and job insecurity. Journal of Nursing Education and Practice, Vol. 8(9): 36-44.
[38]  Van Bogaert P, Peremans L, Diltour N, Van heusden D, Dilles T, Van Rompaey B, (2016). Staff Nurses’ Perceptions and Experiences about Structural Empowerment: A Qualitative Phenomenological Study. PLoS ONE; 11(4).
[39]  Rashed, N.M & Fekry, N.E. (2015). Workplace Empowerment as Perceived by Staff Nurses in Acute Health Care Hospitals. Journal of Biology, Agriculture and Healthcare ISSN 2224-3208 (Paper).
[40]  Bish M, Kenny A and Nay R (2014) Perceptions of structural empowerment: Nurse leaders in rural health services. Journal of Nursing Management 22(1): 29-37.
[41]  Laschinger, H.K.S., Wong, C.A., Grau, A.L., Read, E.A., & Pineau Stam, L.M. (2011). The influence of leadership practices and empowerment on Canadian nurse manager outcomes. Journal of Nursing Management, 20(7), 877-888.
[42]  Davies A, Wong CA and Laschinger HKS (2011). Nurses’ participation in personal knowledge transfer: The role of leader-member exchange (LMX) and structural empowerment. Journal of Nursing Management 19(5): 632-643.
[43]  Regan, L.C., & Rodriguez, L. (2011). Nurse empowerment from a middle-management perspective: murse managers’ and assistant nurse managers’ workplace empowerment views. The Permanente Journal, 15(1), 101-107.
[44]  Garcia-Sierra, R., & Fernandez-Castro, J. (2018). Relationships between leadership, structural empowerment, and engagement in nurses. Journal of Advanced Nursing, 74(12), 2810-2818.
[45]  Patrick, A., & Laschinger, H.K.S. (2006). The effect of structural empowerment and perceived organizational support on middle level nurse managers’ role satisfaction. Journal of Nursing Management, 14, 13-22.
[46]  Casey, M., Saunders, J., & O’Hara, T. (2010). Impact of critical social empowerment on psychological empowerment and job satisfaction in nursing and midwifery settings. Journal of Nursing Management, 18, 24-34.
[47]  Oliver, B., Gallo, K. & Griffin, M.Q. (2014). Structural empowerment of clinical nurse managers. Journal of Nursing Administration, 44(4), 226-231.
[48]  Hagerman, H., Skytt, B., Wadensten, B., Hogberg, H., & Engstrom, M. (2016). A longitudinal study of working life among first-line managers in the care of older adults. Applied Nursing Research, 32, 7-13.
[49]  Spencer, C., & McLaren, S. (2016). Empowerment in nurse leader groups in middle management: a quantitative comparative investigation. Journal of Clinical Nursing, 26, 266-279.
[50]  Suominen, T., Rankinen, S., Kuokkanen, L., Kukkurainen, M.L., Savikko, N., & Doran, D.I. (2007). The constancy of work-related empowerment. Journal of Nursing Management, 15, 595-602.
[51]  Calvo, J.C.A & Garcia, G.M (2018). Hardiness as moderator of the relationship between structural and psychological empowerment on burnout in middle managers. Journal of Occupational and Organizational Psychology; 91, 362-384.
[52]  Chang, L.C., Liu, C.H.&Yen, E.H. (2008). Effects of an empowerment- based education program for public health nurses in Taiwan. Journal of Clinical Nursing; 17(20), 2782-2790.
[53]  Wahlin, I., Ek, A.C. & Idvall, E. (2010). Staff empowerment in intensive care: Nurses’ and physicians’ lived experiences. Intensive& Critical Care Nursing; 26(5), 262-269.
[54]  O’Brien, J.L. (2011). Relationships among structural empowerment, psychological empowerment, and burnout in registered staff nurses working in outpatient dialysis centers. Nephrology Nursing Journal, 38(6), 475-481.
[55]  Hochwälder J. & Bergsten-Brucefors A. (2005). Psychological empowerment at the workplace as a predictor of ill health. Personality and Individual Differences, 39, 1237-1248.
[56]  Fibriansari, R. D., Nursalam, N., & Yuwono, S. R. (2017). The Relationship Between Nurse Empowerment And Quality Of Nursing Work Life In Hospital. In Proceeding 3Rd International Confrence: Community Health Empowerment: Step Up Action Attaining Sustainable Development Goals (hal. 121-127). Faculty of Nursing University of Jember.
[57]  Gilbert, S., Laschinger, H. K., & Leiter, M. (2010). The mediating effect of burnout on the relationship between structural empowerment and organizational citizenship behaviours. Journal of Nursing Management, 18(3), 339-348.
[58]  Sirin, M. Sokmen,S. (2015). Quality of Nursing Work Life Scale: The Psychometric Evaluation of the Turkish Version. International Journal of Caring Sciences; 8( 3): 54. Accessed from:
[59]  Bakker, AB and Leiter, MP (2010). Where to go from here: Integration and future research on work engagement Work Engagement: A Handbook of Essential Theory and Research, Taylor & Francis,, pp.181-196.