The Relational Resource Distribution Model: an evaluation of control over nursing practice and the design of nurses’ work

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  • March 22, 2019
Creator
  • Yurek, Leo A.
    • Affiliation: School of Nursing
Abstract
  • The conception of control over nursing practice (CONP) is examined in the nursing literature along with the business and organizational behavior literature in an effort to reduce the conceptual ambiguity associated with control. Measures for control in the nursing literature are examined. In particular, the number and variation among different scales used to measure control, confounding of disparate conceptions within the same measure, conceptual definitions, dimensionality, reliability, and assessments of validity are investigated that may explain the falsifiability and empirical disconfirmation, threats to construct validity, and the diminution of explanatory power associated with the measurement instability of CONP. The Relational Resource Distribution Model, an investigator developed framework is introduced and evaluated as a relevant tool in the examination and design of nurses' work. The Relational Resource Distribution Model is used to examine the influence of CONP on staff nurse perceptions of patient care quality and job satisfaction. CONP is examined as a 2-dimensional construct with a content dimension related to the sanctioned duties of nurses bound to a special body of knowledge and specific set of nursing skills; and the context dimension of CONP that relates to how nurses perform within the structural dimensions of organization. Both dimensions of control are investigated in different models to explore the differential effects related to each specific dimension. Empirical support from confirmatory factor analytic techniques distinguishes the content dimension of CONP from the context dimension of CONP. Each dimension is evaluated separately at the work-group level for its effects on patient care quality and job satisfaction using hierarchical linear modeling. Content-CONP is a stronger predictor of patient care quality than job satisfaction at the group level of analysis. However, context-CONP is not a significant predictor of either job satisfaction or patient care quality in this analysis for this sample. Lastly, emotional exhaustion is evaluated as a mediator in the CONP-outcome relationship and found to have a significant indirect effect. Indirect effects were confirmed with the Sobel product coefficient test. A 95% CI was established with the use of PRODCLIN, a web-based calculator that uses an asymmetric distribution of the product coefficient resulting in a more accurate estimate.
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  • In Copyright
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  • "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the School of Nursing (Hospital Systems)."
Advisor
  • Havens, Donna
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  • Chapel Hill, NC
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  • Open access
Date uploaded
  • March 18, 2013

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