Psychological Empowerment as a Mediator of Effort-Reward Imbalance Effects on Burnout, Anxiety and Depression Among Nursing Home Professionals: A Cross-Sectional Study.

Aims: Few studies have explored empowerment as a predictor of mental health outcomes in geriatric healthcare professionals. This research addresses this gap by using the 'effort-reward imbalance' theory of work-related stress to develop a comprehensive model, examining the role of psychological empowerment in the psychological outcomes of nursing home professionals.

Design: This cross-sectional exploratory study used structural equation modelling (SEM) to test a model on the mediating role of psychological empowerment in the relationship between effort-reward ratio and burnout, anxiety and depression.

Methods: From 2021 to 2023, we used convenience sampling to enrol 280 physicians, nurses and other healthcare workers from 13 nursing homes in France. Self-administered measurements included Psychological Empowerments Scale, Effort-Reward Imbalance Questionnaire, Maslach burnout inventory-Human Services Survey and Hospital Anxiety and Depression Scale. Of the 280 healthcare professionals included, 245 had complete data.

Results: Findings confirmed direct predictive paths from the effort-reward ratio to burnout, anxiety and depression. The negative direct path between effort-reward ratio and psychological empowerment was significant, as was burnout and depression prediction by psychological empowerment. Anxiety was not explained by psychological empowerment. Mediation effects were confirmed. Model fit indices indicated a good fit, supporting the role of psychological empowerment in reducing the negative impact of effort-reward imbalance on psychological outcomes, except for anxiety.

Conclusion: Psychological empowerment appears to be a promising way to enhance and protect psychological work-related health of nursing home healthcare professionals.

Implications For The Profession And/or Patient Care: Understanding the impact of psychological empowerment on healthcare is a first step towards implementing interventions for healthcare professionals to enhance the quality of care and work conditions.