Association Between Psychological Empowerment and Work Engagement Among Rural Nurses: A Latent Profile and Moderation Analysis.

Aim: This study explored the latent classes of psychological empowerment. In addition, we analyzed their relationship with perceptions of decent work and work engagement, thereby providing a scientific basis for enhancing work engagement among rural nurses. Background: Most studies focus on nurses working in urban areas, with relatively fewer investigations examining those in rural healthcare institutions. While many studies have explored psychological empowerment, decent work perception, and work engagement, few have analyzed the relationships from the perspective of psychological empowerment. Methods: The sample consisted of clinical nurses from 3 rural healthcare institutions in Hunan Province, China. The nurses' general information, psychological empowerment, decent work perception, and work engagement scores were assessed using the General Information Scale, Decent Labor Perception Scale, Psychological Empowerment Scale, and Utrecht Work Engagement Scale, respectively. Furthermore, latent profile analysis and moderation analysis were performed. Results: The total scores of rural nurses' work engagement were 62.85 (±15.44). Rural nurses' psychological empowerment exists in three latent categories: low psychological empowerment, competent but constrained, and high psychological empowerment. Level 1 hospitals (OR = 1.95, 95% CI: 1.24-3.09, p = 0.004) and internal medicine (OR = 1.18, 95% CI: 1.06-1.31, p = 0.004) were associated with low psychological empowerment. Holding a leadership position (OR = 0.28, 95% CI: 0.09-0.88, p = 0.029) and days of monthly night shifts (≤ 4) (OR = 0.63, 95% CI: 0.41-0.97, p = 0.036) were associated with high psychological empowerment. The category of psychological empowerment has a moderating effect on the relationship between decent work perception and work engagement (p < 0.05). Conclusions: In summary, the levels of work engagement among rural nurses are moderate. Rural nurses' psychological empowerment is heterogeneous, and attention should be paid to those in the low psychological empowerment group. This study demonstrated that nurses' psychological empowerment partially moderates the relationship between perceptions of decent work and work engagement. Therefore, emphasizing psychological empowerment and fostering a decent work perception should be considered when exploring measures to promote high work engagement among rural nurses. Implications for Nursing Management: Based on the study findings, nursing managers should adopt an evidence-based approach to support psychological empowerment. Particular attention should be given to early identification of nurses at higher risk for low psychological empowerment, especially those in Level 1 hospitals and internal medicine departments. Targeted interventions should also be implemented, such as establishing peer mentoring programs facilitated by highly empowered nurses, creating regular feedback mechanisms, and involving nurses in clinical decision-making processes. In addition, management should promote leadership opportunities and optimize scheduling to limit night shifts to not more than four per month. Notably, these factors have a significant association with enhanced psychological empowerment.