The moderating role of self-efficacy in influencing the level of competencies among Middle Nurse Managers: A cross-sectional study.

BACKGROUND

Middle Nurse Managers (MNMs) play a pivotal role in translating organizational strategy into operational practice, ensuring care quality, and fostering team performance. Despite their importance, limited research has examined the factors influencing MNMs' competencies, particularly the interplay between individual and organizational determinants.

AIM: To examine the direct and moderating effects of self-efficacy and other organizational and individual factors on MNMs' competence knowledge and competence application across Italy.

METHODS

A cross-sectional, multicenter study was conducted between September 2022 and December 2023 with the participation of 382 MNMs from public and private healthcare organizations. Data were collected using validated instruments, including the Chase Nurse Manager Competencies Scale, the Questionnaire on Experience and Work Evaluation (QEEW 2.0), and the Leadership Self-Efficacy Scale. Structural equation modeling (SEM) tested direct effects of educational appropriateness, leadership training intentions, autonomy, role clarity, and work complexity, and the moderating role of self-efficacy.

RESULTS

Educational appropriateness, autonomy, and role clarity were significantly associated with competence knowledge, while educational appropriateness and autonomy were associated with competence application. Self-efficacy was directly associated with both competence outcomes and significantly moderated the relationship between educational appropriateness and autonomy with each competence dimension, with positive associations observed among individuals with higher self-efficacy (β = -0.456 for knowledge; β = -0.459 for application, p < 0.001).

CONCLUSIONS

Self-efficacy was associated with competence outcomes and moderated the associations between organizational factors and competence. High self-efficacy may reduce reliance on perceived educational appropriateness, whereas lower self-efficacy increases its importance.