Perceived stress and structural empowerment profiles among clinical nurses: a latent profile analysis in occupational health.

BACKGROUND

Healthcare workers, particularly nurses, face high occupational stress andinadequate organizational support, which threaten workforce stability and public health service quality. Structural empowerment is a core organizational resource for improving occupational health and wellbeing among nurses.

OBJECTIVE

To identify latent profiles of structural empowerment among clinical nurses, examine their distribution characteristics, and explore associations with perceived stress and occupational factors, to support evidence-based occupational health interventions and workforce management strategies.

METHODS

A cross-sectional survey was conducted among 518 clinical nurses from a tertiary general hospital in Inner Mongolia, China. We collected demographic data using a general information questionnaire. Structural empowerment was measured using the six-dimensional Conditions of Work Effectiveness Questionnaire-II, and perceived stress was assessed with the Perceived Stress Scale-10. Latent profile analysis was performed in Mplus8.3 to identify empowerment profiles, followed by pairwise binary logistic regression to examine the cross-sectional associations between perceived stress, demographic variables, and profile membership.

RESULTS

The mean score of structural empowerment among clinical nurses was (43.76 ± 12.93), and the mean score of perceived stress was (26.83 ± 7.92). The optimal latent profile model was a 4-class model: low structural empowerment group (66.6%, n = 345), moderate-low structural empowerment group (10.2%, n = 53), moderate structural empowerment group (11.4%, n = 59), and high structural empowerment group (11.8%, n = 61). Multivariate Logistic regression analysis showed that monthly night shift frequency in the past year, self-rated health status, involvement in or occurrence of nursing adverse events in the past year, and perceived stress were core influencing factors of structural empowerment.

CONCLUSION

Structural empowerment among clinical nurses comprises four levels: low, moderate-low, moderate, and high. It is influenced by night shift frequency, self-rated health, nursing adverse events, and perceived stress. These findings support targeted interventions: optimizing shift scheduling, reducing work stress, prioritizing nurse health, and reframing adverse events as learning opportunities, to enhance nurse wellbeing, workforce stability, and public health service delivery.