Path analysis the influence of self-efficacy and professional identity on attitudes toward prescriptive authority among oncology nurse specialists

Table 1 General information

Sports event	Clusters	n	Composition ratio (%)
Age (years)	< 30	73	22.26
	30-39	208	63.41
	40-49	41	12.50
	≥ 50	6	1.83
Distinguishing between the genders	Male	53	16.16
	Female	275	83.84
Nursing experience (years)	< 3	32	9.76
	3-5	25	7.62
	6-10	77	23.48
	11-20	161	49.09
	> 20	30	9.15
Level of hospital	Primary hospital	29	8.84
	Secondary hospital	32	9.76
	Tertiary hospital	267	81.40
Title	Registered nurse	43	13.11
	Senior nurse	64	19.51
	Nurse manager	164	50.00
	Associate chief nurse	46	14.02
	Chief nurse	11	3.35
Highest education level	Secondary/tertiary	32	9.76
	Undergraduate	272	82.93
	Postgraduate student	24	7.32
Duties	Charge nurse	167	50.91
	Care team leader	106	32.32
	Head nurse	40	12.20
	Director/deputy director of nursing	10	3.05
	Nursing department officer	5	1.52
Nurse competence	N1	53	16.16
	N2	102	31.10
	N3	136	41.46
	N4	37	11.28
Specialist nurse grade	Courtyard	91	27.74
	Municipal	79	24.09
	Provincial level (e.g., government)	119	36.28
	National level (e.g., nature reserve)	39	11.89
Participation in outpatient nursing clinic visits	No	207	63.11
	Yes	121	36.89
Master's degree	No	304	92.68
	Yes	24	7.32
Years of practice as a specialist oncology nurse	1-5	254	77.44
	6-10	52	15.85
	> 10	22	6.71

Table 2 Oncology nurses' beliefs and attitudes scores, professional identity scores, and self-efficacy scores regarding prescribing authority (mean ± SD)

Dimension or total score	Entry	Score	Average score for each entry
Sensing the need for prescriptive authority	6	23.61 ± 4.61	3.94 ± 0.77
Self-efficacy for exercising prescriptive authority	6	23.21 ± 4.83	3.87 ± 0.81
Perceived benefits of prescriptive authority	10	42.06 ± 7.53	4.21 ± 0.75
Perceived barriers to exercising prescriptive authority	5	12.99 ± 4.69	2.60 ± 0.94
Beliefs and attitudes toward prescriptive authority	27	101.88 ± 15.13	3.77 ± 0.56
Professional identity	21	122.79 ± 20.10	5.85 ± 0.96
Self-efficacy	10	32.06 ± 6.38	3.21 ± 0.64

Table 3 Correlation analysis of oncology nurses' beliefs and attitudes scores, self-efficacy scores, and professional identity scores regarding prescriptive authority [r value (P value)]

Norm	Nurse prescriptive authority beliefs and attitudes	Professional identity	Self-efficacy
Nurses’ beliefs and attitudes about having prescriptive authority	1	-	-
Professional identity	0.6209 (0.0000)	1
Self-efficacy	0.4999 (0.0000)	0.7048 (0.0000)	1

Table 4 Univariate analysis of oncology nurses’ beliefs and attitudes toward their prescriptive authority (mean ± SD)

Sports event		n	Score	t value/F	P value
Age (years)	< 30	73	101.03 ± 15.93	0.2532	0.8590
	30-39	208	101.83 ± 15.31
	40-49	41	103.17 ± 12.85
	≥ 50	6	104.83 ± 11.72
Gender	Male	53	106.34 ± 15.02	2.369	0.0184
	Female	275	101.01 ± 14.99
Nursing experience (years)	< 3	32	101.46 ± 15.50	0.2615	0.9025
	3-5	25	102.52 ± 14.03
	6-10	77	101.06 ± 16.82
	11-20	161	102.58 ± 14.52
	> 20	30	100.13 ± 13.82
Level of hospital	Primary hospital	29	104.86 ± 13.77	3.442	0.0332
	Secondary hospital	32	95.66 ± 16.21
	Tertiary hospital	267	102.30 ± 14.94
Title	Registered nurse	43	102.93 ± 15.24	1.425	0.2252
	Senior nurse	64	103.70 ± 15.76
	Nurse manager	164	99.95 ± 15.13
	Associate chief nurse	46	104.41 ± 14.10
	Chief nurse	11	105.18 ± 10.50
Highest education level	Secondary/tertiary	32	102.25 ± 15.57	1.422	0.2428
	Undergraduate	272	101.40 ± 15.33
	Postgraduate student	24	106.79 ± 10.64
Duties	Charge nurse	167	101.22 ± 15.28	0.5714	0.6836
	Care team leader	106	101.87 ± 15.38
	Head nurse	40	102.80 ± 14.80
	Director/deputy director of nursing	10	108.10 ± 7.80
	Nursing department officer	5	104.20 ± 14.66
Nurse competence	N1	53	101.92 ± 16.82	2.599	0.0522
	N2	102	98.97 ± 15.64
	N3	136	102.79 ± 13.93
	N4	37	106.43 ± 13.73
Specialist nurse grade	Courtyard	91	100.74 ± 16.22	2.536	0.0567
	Municipal	79	99.48 ± 18.47
	Provincial level (e.g., government)	119	102.62 ± 11.74
	National level (e.g., nature reserve)	39	107.10 ± 12.45
Participation in outpatient nursing clinic visits	No	207	101.57 ± 14.81	0.4740	0.6358
	Yes	121	102.39 ± 15.63
Master's degree	No	304	101.57 ± 15.40	1.293	0.1969
	Yes	24	105.71 ± 10.36
Years of practice as a specialist oncology nurse	1-5	254	101.04 ± 15.30	2.783	0.0633
	6-10	52	106.38 ± 13.09
	> 10	22	100.91 ± 15.74

Table 5 Multiple linear regression analyses of beliefs and attitudes about oncology nurses’ prescriptive authority

Factor	Unstandardized coefficient		Standardized coefficient	t value	P value	Covariance statistics
	β	SE	β			tolerances	VIF
Gender (female)	-1.7447	1.9068	-0.0425	-0.9150	0.3609	0.9312	1.0739
Level of the hospital in which it is located (level II)	-4.9737	3.1676	-0.0976	-1.5702	0.1174	0.5192	1.9260
Level of the hospital in which it is located (tertiary)	1.1699	2.4393	0.0301	0.4796	0.6318	0.5092	1.9639
Professional identity	0.3126	0.0450	0.4154	6.9482	0.0000	0.5608	1.7830
Self-efficacy	0.4906	0.1437	0.2071	3.4142	0.0007	0.5450	1.8347

Table 6 Test results of the fit indicators of the structural equation modeling

Commonly used indicators	χ2	df	P value	χ2/df	GFI	RMSEA	TLI	CFI	NFI	NNFI	IFI
Standard of judgment	-	-	> 0.05	< 3	> 0.9	< 0.10	> 0.9	> 0.9	> 0.9	> 0.9	> 0.9
Value	1.0466	1	0.3063	1.0466	0.9976	0.0119	0.9994	0.9999	0.9968	0.9994	0.9999
Is it up to the standard?	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

Table 7 Summary of model regression coefficients

X - Y	Unstandardized path coefficients	SE	z (CR value)	P value	Standardized path factor
Self-efficacy - professional identity	2.0796	0.1256	16.5611	0.0000	0.6748
Self-efficacy - nurses’ beliefs and attitudes about their prescriptive authority	0.5334	0.1451	3.6764	0.0002	0.2249
Professional identity - nurses’ beliefs and attitudes about their prescriptive authority	0.3075	0.0471	6.5307	0.0000	0.3995

Table 8 Significance test of the mediating effect

Pathway relationship	Efficiency value	LLCI	ULCI	P value	Percentage (%)
The mediating effect: Self-efficacy - Professional identity - Beliefs and attitudes about their prescriptive authority	0.6390	0.3543	0.9849	-	54.46
Direct effect: Self-efficacy - Beliefs and attitudes about their prescriptive authority	0.5343	0.2544	0.8142	0.0002	45.54
Total effect: Self-efficacy - Beliefs and attitudes about their prescriptive authority	1.1733	0.9490	1.3976	0.0000	100.00

LLCI: Lower limit confidence interval; ULCI: Upper limit confidence interval.