Organizational factors associated with primary care nurses' self-efficacy in pandemic response: a multilevel study in China

Background Building primary care nurses' self-efficacy in the pandemic response has great potential to improve their well-being and work performance. We identified the organizational factors associated with their self-efficacy in pandemic response and propose potential management levers to guide primary care response for the pandemic. Methods We conducted a cross-sectional survey with 175 nurses working in 38 community health centres varying in size and ownership in Shanghai, Shenzhen, Tianjin, and Jinan. Guided by self-efficacy theory, 4 nurse-level factors and 2 organization-level factors were selected, and a linear regression model accounting for the cluster-robust standard errors was built to examine their association with primary care nurses' self-efficacy in the pandemic response. Results Primary care nurses exhibited a high level of self-efficacy in responding to the pandemic (mean = 4.34, range: 0-5). For nurse-level factors, with a 1-point increase in job skill variety, job autonomy, work stress and perceived organizational support, primary care nurses' pandemic response self-efficacy increased by 0.193 points, 0.127 points, 0.156 points, and 0.107 points, respectively. Concerning organization-level factors, each point of improvement in organizational structure, representing higher mechanical organizational structure, was associated with a 0.145-point increase in nurses' self-efficacy. Conclusions Our study added the knowledge of organizational factors' impact on the pandemic response self-efficacy among primary care nurses and identified the potential management levers for frontline primary care managers to build primary care nurses' self-efficacy in the pandemic response.