Nurse Professional Competence as a Mediator Between Structural Empowerment and Person-Centered Climate in Hospital Settings: A Cross-Sectional Observational Study.

Background: The work-related empowerment of nurses is essential for enhancing person-centered care and climate. However, research on more complex relationships that consider mediation remains sparse. Objective: This study aimed to investigate the relationship between nurse-rated structural empowerment and a person-centered climate, as well as the mediating role of nurse professional competence. Design: A cross-sectional survey study. Settings and Participants: This study was conducted among 2172 nurses, at three general hospitals in China, between April 2023 and October 2023. Methods: The Conditions of Work Effectiveness Questionnaire, which measured structural empowerment, the Nurse Professional Competence Scale, and the Person-Centered Climate Questionnaire-Staff Version were employed to collect data. The PROCESS macro (Model 4) and bootstrapping tests were used to examine the relationships and mediation effects. Results: The results showed that nurse-rated structural empowerment was significantly positively related to the person-centered climate and professional competence of nurses. Nurse professional competence, in turn, was significantly positively related to person-centered climate. Furthermore, the nurse professional competence significantly mediated the relationship between structural empowerment and a person-centered climate. The model explained 49.9% of the variance in person-centered climates. Conclusions: Structural empowerment and nurses professional competence are both essential for fostering a person-centered climate in hospital wards. Professional competence mediates the relationship between structural empowerment and a person-centered climate. Implications for Nursing Management: Nurse managers and policymakers should promote empowering work environments by ensuring access to information, support, resources, and opportunities for professional development. Enhancing both formal empowerment (e.g., recognizing and elevating the role of nurses within the organization) and informal empowerment (e.g., supporting meaningful professional networks) can help nurses strengthen their competence and contribute to a more person-centered climate at the unit level.