The Relationship between Decision-Making Style and Self-Efficacy among Nurses: Cross-Sectional Study
DOI:
https://doi.org/10.54133/ajms.v11i1.3091Keywords:
Decision-Making Style, Hospitals, Jordan, Nurses, Self-efficacyAbstract
Background: In professional nursing practice, decision-making style and self-efficacy are important elements that directly impact patient safety, care equality, and healthcare outcomes. Objective: To examine the relationship between decision-making styles and self-efficacy among nurses in Jordanian hospitals. Methods: A cross-sectional design was used. A convenience sample of 150 nurses was recruited from Jordanian private and governmental hospitals in the central region of Jordan (Amman, Zarqa, and Balqa). The General Self-Efficacy Scale and the Nursing Decision-Making Instrument were used to gather data. Results: 88.7% were categorized as intuitively oriented decision makers, and the overall mean score of nurses’ decision-making styles was high (M=3.74/5). Nurses scored highest in the areas of documenting, anticipating the results of nursing interventions, and conducting structured patient evaluations. Additionally, there was a high level of self-efficacy (M=3.36/4), especially in problem-solving skills and handling clinical problems. Self-efficacy and decision-making styles showed a positive correlation (r=0.412, p<0.001). Significant differences in self-efficacy and decision-making styles were found based on age, years of experience, job title, and educational level. Significantly higher scores were reported in older nurses holding postgraduate degrees, more experienced, and having administrative positions. Nurses’ decision-making styles were significantly predicted by years of experience (β=0.24, p=0.021) and self-efficacy (β=0.34, p<0.001). Conclusions: To improve nurses' confidence, clinical reasoning, and decision-making skills, healthcare organizations should encourage continuous professional development, mentorship, and support structural training programs, which ultimately will improve patient care quality and healthcare outcomes.
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Sosan NYN, Almonis JAM, Almones RAM, Al-aklobi SA, Alshahrani HMH, Alamri ZDA, et al. The impact of nursing interventions in emergency care settings: A comprehensive review of clinical decision-making, patient safety, and outcome improvement. Rev Diabet Stud. 2025:901-11. doi: 10.70082/1prafr06.
Hossny EK, Alotaibi HS. Relationship between dominant decision-making style and creativity of nursing managers: A cross-sectional study. BMC Nurs. 2024;23(1):829. doi: 10.1186/s12912-024-02397-8. DOI: https://doi.org/10.1186/s12912-024-02397-8
Bandura A. Social-cognitive theory. In: An introduction to theories of personality, Psychology Press; 2014. p. 341-60.
Kaya S, Bakir GK. The relationship between clinical decision-making levels and self-efficacy levels of operating room nurses. Perioper Care Oper Room Manag. 2024;37:100416. doi: 10.1016/j.pcorm.2024.100416. DOI: https://doi.org/10.1016/j.pcorm.2024.100416
Allari RS, Atout M, Hasan AA. The value of caring behavior and its impact on students' self-efficacy: Perceptions of undergraduate nursing students. Nurs Forum. 2020;55(2):259-266. doi: 10.1111/nuf.12424. DOI: https://doi.org/10.1111/nuf.12424
Allari RS, Abu-El-Noor NI, Abu-El-Noor MK. Professional values in nursing students in Jordan: Baccalaureate nursing students' perception. Front Nurs. 2022;9(3). doi: 10.2478/fon-2022-0041. DOI: https://doi.org/10.2478/fon-2022-0041
Raghavan S. Global advancements in international nursing science and healthcare innovation: Trends, challenges, and future directions. J Comparative Nurs Res. 2025;1(2).
Aboalrob W, Ayed A, Malak MZ, Aqtam I. Understanding the influence of self-concept on clinical decision-making among nurses: A cross-sectional study. PLoS One. 2025;20(8):e0330905. doi: 10.1371/journal.pone.0330905. DOI: https://doi.org/10.1371/journal.pone.0330905
Al-Otaibi H, Kerari A. Quality of nursing work life, compassion fatigue, and self-efficacy among primary care nurses in Saudi Arabia. Healthcare (Basel). 2025;13(15):1811. doi: 10.3390/healthcare13151811. DOI: https://doi.org/10.3390/healthcare13151811
Toqan D, Ayed A, Aqtam I, Harazne L, Ejheisheh MA, Younis MB, et al. Academic self-efficacy as a predictor of clinical decision-making among nursing students: A cross-sectional correlational study conducted in Palestine. SAGE Open Nurs. 2026;12:23779608261444447. doi: 10.1177/23779608261444447. DOI: https://doi.org/10.1177/23779608261444447
AL Btoush MR, Malak MZ, Hamaideh SH, Shuhaiber AH. The relationship between emotional intelligence, self-efficacy, and clinical decision-making among critical care nurses in Jordan. J Hum Behav Soc Environ. 2025;35(3):454-468. doi: 10.1080/10911359.2024.2310261. DOI: https://doi.org/10.1080/10911359.2024.2310261
Al-Qudah MM, Oweidat IA, Omar SA, Shosha GA, Dalky A, Al-Mugheed K, et al. The relationship between nursing informatics competencies and clinical decision-making among registered nurses working at tertiary hospitals. Digit Health. 2025;11:20552076251346015. doi: 10.1177/20552076251346015. DOI: https://doi.org/10.1177/20552076251346015
Rababah J, Al-Hammouri MM. Improving clinical decision-making and self-directed learning among Jordanian nursing students using concept mapping. Teach Learn Nurs. 2024;19(2). doi: 10.1016/j.teln.2023.11.011. DOI: https://doi.org/10.1016/j.teln.2023.11.011
AlAmer NA. Decision-making styles and managerial creativity of nursing managers in Saudi Arabia: A multi-center cross-sectional study. Healthcare (Basel). 2023;11(12):1719. doi: 10.3390/healthcare11121719. DOI: https://doi.org/10.3390/healthcare11121719
Raoust G, Kajonius P, Hansson S. Personality traits and decision-making styles among obstetricians and gynecologists managing childbirth emergencies. Sci Rep. 2023;13(1):5607. doi: 10.1038/s41598-023-32658-6. DOI: https://doi.org/10.1038/s41598-023-32658-6
Polit D, Beck C (Editors), Essentials of nursing research: Appraising evidence for nursing practice (9th Ed.), Lippincott Williams & Wilkins; 2020.
Grujičić J, Nikolić A. Alzheimer’s disease: Epidemiological characteristics and its prevention. Zdravstvena Zast. 2021;50(2). DOI: https://doi.org/10.5937/zdravzast50-32931
Ministry of Health. The strategic plan of the Ministry of Health for the years 2023-2025 [Internet]. 2023. Available from: https://www.moh.gov.jo/ebv4.0/root_storage/en/eb_list_page/summary_of_the_strategic_plan_for_2018-2022.pdf
Grove SK, Gray JR, (Editors), Understanding nursing research e-book: Building an evidence-based practice, (7th Ed.), Elsevier Health Sciences; 2018.
Lauri S, Salanterä S. Developing an instrument to measure and describe clinical decision making in different nursing fields. J Prof Nurs. 2002;18(2):93-100. doi: 10.1053/jpnu.2002.32344. DOI: https://doi.org/10.1053/jpnu.2002.32344
Hammond KR, (Editor), Human judgment and social policy: Irreducible uncertainty, inevitable error, unavoidable injustice. Oxford University Press; 2000.
Bjørk IT, Hamilton GA. Clinical decision making of nurses working in hospital settings. Nurs Res Pract. 2011;2011:524918. doi: 10.1155/2011/524918. DOI: https://doi.org/10.1155/2011/524918
Schwarzer R, Jerusalem M. Generalized Self-Efficacy scale. In: Weinman J, Wright S, Johnston M, (Editors), Measures in health psychology: A user’s portfolio. Causal and control beliefs, Windsor, UK; 1995. pp. 35-37. DOI: https://doi.org/10.1037/t00393-000
Di W, Nie Y, Chua BL, Chye S, Teo T. Developing a single-item general self-efficacy scale: An initial study. J Psychoeduc Assess. 2023;41(5):583-598. doi: 10.21203/rs.3.rs-342642/v1. DOI: https://doi.org/10.1177/07342829231161884
Kalfoss M. Translation and adaption of questionnaires: A nursing challenge. SAGE Open Nurs. 2019;5:2377960818816810. doi: 10.1177/2377960818816810. DOI: https://doi.org/10.1177/2377960818816810
George D, Mallery P. IBM SPSS statistics processes for Mac. IBM SPSS Statistics. 2019;26:26-42. doi: 10.4324/9780429056765. DOI: https://doi.org/10.4324/9780429056765-3
Maharmeh M, Alasad J, Salami I, Saleh Z, Darawad M. Clinical decision-making among critical care nurses: A qualitative study. Health. 2016;8(15):1807-19. doi: 10.4236/health.2016.815173. DOI: https://doi.org/10.4236/health.2016.815173
Alzahrani A, Bahari G, Alharbi K, Alqahtani N. Decision-making styles and job security among nurses working at public hospitals in Saudi Arabia: A cross-sectional multicentre study. J Clin Diagn Res. 2022;16(6). doi: 10.7860/JCDR/2022/55689.16520. DOI: https://doi.org/10.7860/JCDR/2022/55689.16520
Benner P. From novice to expert. Am J Nurs. 1982;82(3):402-407. PMID: 6917683. DOI: https://doi.org/10.1097/00000446-198282030-00004
Munro CL, Swamy L. Documentation, data, and decision-making. Am J Crit Care. 2024;33(3):162-165. doi: 10.4037/ajcc2024617. DOI: https://doi.org/10.4037/ajcc2024617
Schøllhammer H, Jørgensen TM, Jensen HI. Documenting care together with patients: the experiences of nurses and patients. BMC Nurs. 2023;22(1):143. doi: 10.1186/s12912-023-01309-6. DOI: https://doi.org/10.1186/s12912-023-01309-6
Almoajel A. Attitudes, knowledge, and skills toward adopting evidence-based practice in clinical decision-making of registered nurses in Saudi Arabia. Res Theory Nurs Pract. 2021:RTNP-D-20-00119. doi: 10.1891/RTNP-D-20-00119. DOI: https://doi.org/10.1891/RTNP-D-20-00119
Abu Arra AY, Ayed A, Toqan D, Albashtawy M, Salameh B, Sarhan AL, et al. The factors influencing nurses’ clinical decision-making in emergency department. Inquiry. 2023;60:00469580231152080. doi: 10.1177/00469580231152080. DOI: https://doi.org/10.1177/00469580231152080
Alaseeri R, Rajab A, Banakhar M. Do personal differences and organizational factors influence nurses' decision making? A qualitative study. Nurs Rep. 2021;11(3):714-727. doi: 10.3390/nursrep11030067. DOI: https://doi.org/10.3390/nursrep11030067
Bandura A. Social cognitive theory: an agentic perspective. Annu Rev Psychol. 2001;52:1-26. doi: 10.1146/annurev.psych.52.1.1. DOI: https://doi.org/10.1146/annurev.psych.52.1.1
Barnawi N, Barnawi B. The relationship between nurses' self-efficacy and occupational stress in the critical care unit at King Abdul-Aziz Hospital in Jeddah, Saudi Arabia. Nurs Commun. 2023;7:e2023028. doi: 10.53388/IN2023028. DOI: https://doi.org/10.53388/IN2023028
Bawazier BS, Almulla H, Mansour M, Hammad SS, Alameri RA, Aldossary L, et al. The relationship between perceived self-efficacy and resilience among pediatric nurses in Eastern Province of Saudi Arabia. Risk Manag Healthc Policy. 2025:739-746. doi: 10.2147/RMHP.S510084. DOI: https://doi.org/10.2147/RMHP.S510084
Khosravi S, Sajadi M, Mehrabi F. Relationship between clinical environment stressors and nursing students self-efficacy in clinical performance. J Nurs Educ. 2019;8(2). doi: 10.21859/JNE-08206.
Khalifa DA, Abdallah ES, Sallam TA, Mohamoud HE. Effect of assertiveness on job satisfaction and nurses' job performance among staff nurses at Matai Central Hospital. Helwan Int J Nurs Res Pract. 2025;4(11):79-97. doi: 10.21608/hijnrp.2025.404410.1387. DOI: https://doi.org/10.21608/hijnrp.2025.404410.1387
Kausar T, Fatima F, Naureen A, Yasmeen S, Noreen S, Tariq R, et al. Analysis of achievement, motivation and self-efficacy among undergraduate nursing students. Pak J Health Sci. 2024:98-102. doi: 10.54393/pjhs.v5i12.2447. DOI: https://doi.org/10.54393/pjhs.v5i12.2447
Alharbi A, Alkubati SA, Albaqawi H, Ali AZ, Hamed LA, Mohammed S, et al. Mediating roles of psychological empowerment and self-efficacy in the relationship between leadership and clinical decision-making among nursing students: A path-analysis approach. Nurse Educ Today. 2026;161:107022. doi: 10.1016/j.nedt.2026.107022. DOI: https://doi.org/10.1016/j.nedt.2026.107022
Albooghobeish M, Saidkhani V, Ahmadi AK, Farzaneh M. Clinical decision-making and self-efficacy skills in anesthesiology nursing students: A cross-sectional study. Shiraz E-Med J. 2023;24(4). doi: 10.5812/semj-134178. DOI: https://doi.org/10.5812/semj-134178
Akça K, Berşe S. Nursing students' self-efficacy and clinical decision-making in the context of medication administration to children: A descriptive-correlational study. Nurse Educ Pract. 2023;72:103775. doi: 10.1016/j.nepr.2023.103775. DOI: https://doi.org/10.1016/j.nepr.2023.103775
Al-Dweik G, Al-Daken L, Abu-Snieneh H, Ahmad M. Work-related empowerment among nurses: Literature review. Int J Product Qual Manag. 2016;19(2):168-186. DOI: https://doi.org/10.1504/IJPQM.2016.078885
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