Structural and psychological empowerment in relation to nurse job satisfaction and burnout: a systematic review and meta-analysis

To concurrently evaluate the impact of both structural empowerment (SE) and psychological empowerment (PE) on the dual outcomes of nurse job satisfaction and burnout, and to compare findings with published meta-analyses to clarify incremental value. Systematic searches were conducted in databases including PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library from inception until September 30, 2025. Cross-sectional studies reporting correlation coefficients between SE/PE and satisfaction/burnout were included. Effect sizes were pooled using random-effects models. Subgroup analyses by geographical region were performed, and publication bias was assessed using a triple-testing method. Thirty-seven studies involving 18,104 participants were included. SE demonstrated a moderate positive correlation with job satisfaction (r = 0.52), a negative correlation with emotional exhaustion (r = -0.25), but a positive correlation with depersonalization (r = 0.27). PE showed a weaker correlation with satisfaction (r = 0.33) and no significant associations with any burnout dimensions. Effect sizes were significantly larger in Chinese samples compared to those from Europe and North America. Trim-and-fill analyses indicated robust results. Across predominantly cross-sectional studies, higher empowerment—particularly structural empowerment—was consistently associated with higher nurse job satisfaction and lower emotional exhaustion. Associations with other burnout dimensions were less consistent (including an unexpected positive correlation with depersonalization), warranting cautious interpretation and careful attention to measurement/scoring harmonization. Overall, the findings indicate correlational relationships rather than causal effects and can inform the design of context-appropriate empowerment strategies and future longitudinal research.