Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Andrusyszyn, Mary-Anne

Abstract

With reports of a steady increase in cancer risk as the present population ages (Canadian Cancer Society’s Advisory Committee on Cancer Statistics, 2017; Statistics Canada, 2017), and little knowledge of a definitive cure, ensuring cancer sufferers and their families are adequately supported is increasingly essential. Oncology nurses must therefore be the focus of current and future research, as their front-line presence in the lives of those afflicted, is quite substantial. Further, oncology nurses report the most physical symptoms and second highest levels of emotional distress among cancer care health professionals (Jones, Wells, Gao, Cassidy, & Davie, 2013; Kash et al., 2000).

In this study, a model integrating Avolio, Gardner, Walumbwa, Luthans, and May’s (2004a) authentic leadership theory; Milliman, Czaplewski, and Ferguson’s (2003) conception of workplace spirituality; and a learning-centered version of Kanter’s (1977) organizational empowerment theory, was tested in a sample of N=274 acute care oncology nurses in Ontario, Canada. Specifically, links between authentic leadership, workplace spirituality, structural empowerment (with a focus on learning at work), and nursing stress; and the subsequent mental health, physical health, and affective commitment of oncology nurses were examined. The moderating influence of individual spirituality on the workplace spirituality-nursing stress relationship was also explored.

A predictive, non-experimental, cross-sectional design was used following Dillman’s (2000) Method for survey-based studies. The initial model demonstrated poor fit, though adding structural empowerment-workplace spirituality and physical health-mental health paths; correlating two error terms associated with nursing stress; and removing one indicator associated with workplace spirituality resulted in improved fit: X2(164, N=274)=384.254, pX2/df=2.3. All hypothesized direct relationships were significant, except for the authentic leadership-nursing stress, and structural empowerment-nursing stress paths. The indirect effect of authentic leadership on nursing stress via workplace spirituality was also supported, though the indirect effect via structural empowerment was not. The moderation hypothesis was also unsupported.

The study results offer a unique way for authentic leaders to impact the work environment of acute care oncology nurses; with a structurally empowering learning environment and workplace spirituality identified as pathways to impact nursing stress, and foster health and commitment in this priority group.

Summary for Lay Audience

With reports of a steady increase in cancer risk as the present population ages (Canadian Cancer Society’s Advisory Committee on Cancer Statistics, 2017; Statistics Canada, 2017), and little knowledge of a definitive cure, ensuring cancer sufferers and their families are adequately supported is increasingly essential. Oncology nurses must therefore be the focus of current and future research, as their front-line presence in the lives of those afflicted, is quite substantial. Further, oncology nurses report the most physical symptoms and second highest levels of emotional distress among cancer care health professionals (Jones et al., 2013; Kash et al., 2000).

In this study, a model integrating Avolio et al.’s (2004a) authentic leadership theory; Milliman et al.’s (2003) conceptions of workplace spirituality; and a learning-centered version of Kanter’s (1977) organizational empowerment theory, was tested in a group of 274 acute care oncology nurses in Ontario, Canada. Specifically, links between authentic leadership, workplace spirituality, structural empowerment (with a focus on learning at work), and nursing stress; and the subsequent mental health, physical health, and affective commitment of oncology nurses were examined. The potential for individual spirituality to strengthen or dampen the relationship between workplace spirituality and nursing stress was also explored.

A survey was mailed to potential study participants, to support measurement of the study variables. Study results demonstrated significant links between: authentic leadership and workplace spiritualty; authentic leadership and structural empowerment; structural empowerment and workplace spiritualty; workplace spirituality and nursing stress; physical health and mental health; nursing stress and physical health; nursing stress and mental health; and nursing stress and affective commitment. Further analysis revealed that authentic leadership had an impact on nursing stress via workplace spirituality, though it did not have an impact via structural empowerment. Individual spirituality did not impact the strength of the workplace spirituality-nursing stress relationship.

The results of this study offer a unique way for authentic leaders to impact the work environment of acute care oncology nurses; with a structurally empowering learning environment and workplace spirituality identified as pathways to impact nursing stress, and foster health and commitment in this priority group.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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