Abstract
Aim: To investigate the current state of work-related quality of life among Chinese nurses and to explore the mediating effect of clinical leadership between psychological empowerment and quality of work life. Background: The quality of work-life significantly affects nursing team stability and the provision of high-quality care. Psychological empowerment and clinical leadership are considered influential factors in nurses' work-life quality. However, there is a lack of large-scale studies investigating the relationships between these variables. Methods: This nationwide cross-sectional study utilized a multistage stratified proportional sampling approach to select 2633 registered nurses with more than one year of work experience from 17 tertiary general hospitals in China. The data were analyzed using descriptive analysis, Pearson correlation analysis, and structural equation modeling. Results: The quality of work-life score for nurses was 3.38 ± 0.67. Positive correlations were observed between clinical leadership and quality of work life (r = 0.470, p < 0.01). Psychological empowerment was also positively associated with quality of work life (r = 0.570, p < 0.01). The structural equation model revealed that psychological empowerment had a positive direct effect on the quality of work life (β = 0.587, p < 0.001), with clinical leadership playing an intermediary role, accounting for 8.42% of the total effect. Conclusion: Nurses' psychological empowerment was positively associated with the quality of work life and was partially mediated by clinical leadership. These results suggest that psychological empowerment and clinical leadership are key facilitators improving nurses' work-life quality. Implications for Nursing Management: Hospital managers should further raise awareness of empowerment among nurse managers, implement scientifically sound empowerment and clinical leadership programs for nurses, enhance nurses' clinical leadership skills, and promote the quality of nurses' work-life.