Nurses’ Self‐Efficacy, Job Embeddedness, and Psychological Empowerment: A Cross‐Sectional Study

<b>Background:</b> To strengthen and motivate the nursing workforce, this study explored the relationship between nurses' self-efficacy, job embeddedness, and psychological empowerment, and how this relationship varied across three regions in the Guangdong-Hong Kong-Macao Greater Bay Area of China. <b>Methods:</b> A multicenter cross-sectional study surveyed 3806 nurses between March and July 2023 using the Sociodemographic Information Questionnaire, Self-Efficacy Scale, Job Embeddedness Scale, and Psychological Empowerment Scale. A directed acyclic graph was used to expose the minimum sufficient adjustment sets for the influence hypothesized model, which was used as a covariate in the model. Pearson correlation analysis, multiple linear regression, and mediation effect analysis were used to test the relationship between variables. The moderated mediation model was employed to test the moderating effect of regions. <b>Results:</b> The psychological empowerment score of 3806 participants was medium-high level (45.22 ± 6.89); self-efficacy (<i>B</i> = 0.642, <i>p</i> < 0.001) and job embeddedness (<i>B</i> = 0.189, <i>p</i> < 0.001) directly affected psychological empowerment. Job embeddedness mediated self-efficacy and psychological empowerment (<i>B</i> = 0.300, 95% CI: [0.266, 0.355]), but there was no indirect association between self-efficacy and psychological empowerment among Hong Kong participants (<i>B</i> = 0.024, 95% CI: [-0.079, 0.150]). Specifically, regions of Guangdong-Hong Kong moderated the relationship between self-efficacy and job embeddedness (<i>B</i> = -1.447, <i>p</i> < 0.001), and self-efficacy was not significantly associated with job embeddedness (<i>B</i> = 0.147, <i>p</i>=0.539) among Hong Kong nurses. <b>Conclusion:</b> Managers should acknowledge the influence and significance of nurses in the current healthcare environment. By truly enhancing nurses' psychological empowerment, organizations can foster a genuine sense of empowerment, thereby promoting nurse leadership and improving nurse retention. Improving nurses' self-efficacy can increase job embeddedness and further increase psychological empowerment. This model needs further validation in regions with different cultural and societal backgrounds. Future interventions can be made by identifying work scenarios that affect nurses' self-efficacy, providing information on self-efficacy and increasing nurses' job embeddedness, which may help to improve their psychological empowerment.