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Work Engagement in Professional Nursing Practice Open Access


Other title
work engagement
nursing leadership
systematic review
relational ethics
health care systems
Type of item
Degree grantor
University of Alberta
Author or creator
Keyko, Kacey J
Supervisor and department
Dr. Greta Cummings (Faculty of Nursing)
Examining committee member and department
Dr. Carol Wong (School of Nursing- Western Health Sciences)
Dr. Olive Yonge (Faculty of Nursing)
Dr. Jude Spiers (Faculty of Nursing)
Faculty of Nursing

Date accepted
Graduation date
Master of Nursing
Degree level
Work engagement in nursing practice is critically important to consider in addressing key challenges of health systems, including the global nursing shortage, pressures to reduce health care spending, and increasing demands for quality care and positive outcomes for patients. There is a significant and growing body of research in other disciplines that demonstrates relationships between work engagement of employees and positive organizational outcomes. Recent interest in the work engagement of nurses has primarily been motivated by the desire to realize these documented positive organizational outcomes. However, research on work engagement in nursing practice has not yet been synthesized and therefore, there is not an accessible foundation of knowledge to guide practice and further research. Additionally, the ethical foundation of professional nursing demands attention to the ethical importance of work engagement, which has not previously been examined. The overall aim of this master’s thesis was to examine the importance of work engagement in nursing practice from an ethical perspective and to determine what is currently known about the antecedents and outcomes of work engagement in nursing practice. This master’s thesis is comprised of two papers, one theoretical, ethical paper, and one systematic review paper. In the first paper, I use a relational ethics perspective to examine the ethical importance of work engagement and I argue that work engagement is essential for ethical nursing practice and the subsequent provision of ethical nursing care. The second paper is a systematic review of studies in nursing that examine the relationship between work engagement and it’s antecedents and outcomes. The findings of the systematic review indicate that a wide range of antecedents, at multiple levels, are related to nurses’ work engagement and that the outcomes of work engagement also occur at multiple levels. Based on the results, I developed an adapted Job Demands-Resources (JD-R) model for work engagement in nursing practice, which offers a valuable framework to understand the current evidence on work engagement in nursing practice and can be used to guide practice, policy, and further research on the topic. Key findings are highlighted in the adapted model, including the role of the organizational climate, addition of professional resources, and expansion of outcomes to include personal and professional outcomes. The combined findings of the two papers demonstrate the importance of work engagement in nursing practice, from both an ethical and organizational perspective. However, significant gaps in research on work engagement in nursing remain. Greater theorization is needed to further understand the mechanisms and manifestations of work engagement in nursing practice. A concept analysis that explores all concepts, constructs, and labels that could be the same as, similar to, or distinctly different from work engagement would offer immense value to this field of research. Future research should also test the adapted JD-R model using longitudinal designs and multivariate analysis across more diverse samples of nurses. I recommend that future research include objective measurement of antecedents and outcomes, further qualitative exploration, and intervention-based studies.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
Keyko, K. (2014). Work engagement in nursing practice: A relational ethics perspective. Nursing Ethics. doi: 10.1177/0969733014523167

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