Abstract
Purpose: Unlike in Western countries, where nurse practitioners (NPs) have greater autonomy, NPs in Taiwan face regulatory restrictions that may affect their self-efficacy. However, how these structural and cultural factors shape their experiences remains underexplored. This study aims to examine how Taiwan's healthcare environment and policies influence NPs' self-efficacy.
Methods: This phenomenological study used online focus group interviews with licensed hospital-based nurse practitioners in Taiwan (Jan–Jul 2025). Participants were recruited through a purposive sampling strategy and snowball sampling. Data were analyzed using Colaizzi's method with NVivo, supported by peer debriefing, reflective journaling, and expert-validated interview guidelines (S-CVI = 0.91–0.98).
Results: Thirty NPs participated, including 10 from medical centers, 15 from regional hospitals, and 5 from district hospitals. Specialties included internal medicine (n=15), surgery (n=12), obstetrics/gynecology (n=1), pediatrics (n=1), and psychiatry (n=1). Most held bachelor's degrees (80%), while 20% had master's or doctoral degrees, with an average of 10.2 years of experience. Three themes emerged: (1) Ambiguities in Regulatory Authority and Legal Protections — Legal Risks in Frontline Clinical Practice; Unclear Role Definitions and Practice Constraints; Absence of Specific Legal Provisions for NPs. (2) Disproportionate Compensation and Responsibility Risks — High Responsibility with Inadequate Pay; Unbalanced Workload and Lack of Nurse-Patient Ratio Rules. (3) Inadequate Institutionalization of Management and Educational Resources — Disorganized Management; Limited Access to Continuing Education; Uncertain Professional Identity.
Conclusions: Taiwan's nurse practitioners face structural barriers that limit autonomy, confidence, and professional identity. International comparisons (US, Thailand) confirm that granting NPs greater autonomy and support significantly enhances performance. Therefore, clarifying legal authority, improving compensation, and expanding educational and institutional support are essential to enhance NP' self-efficacy and retention. Systemic reform can empower NPs, strengthen their clinical competence, and improve healthcare quality and workforce sustainability.
Notes
References:
1. Chiu, H.-J. (2023). Practicing difficulties of nurse practitioners and suggestions for future law amendment. Journal of Taiwan Nurse Practitioners, 10(1), 9–14.
https://doi.org/10.53106/2410325X2023081001002
2. Heath, J., Hampton, D. C., Melander, S., & Rayens, M. K. (2023). Evaluating the domain specificity of self-efficacy for nurse practitioner leadership development. The Journal for Nurse Practitioners, 19(7), 104618. https://doi.org/10.1016/j.nurpra.2023.104618
3. Nantsupawat, A., Srisuphan, W., Sripetchwadee, N., Nantsupawat, P., Courtwright, S. E., Horton, M. D., Flandrick, K., Pollifrone, M. M., & Poghosyan, L. (2025). A scoping review of empirical evidence on the nurse practitioner workforce in Thailand. International Nursing Review, 72(1), e70016. https://doi.org/10.1111/inr.70016
4. Poghosyan, L., Stein, J. H., Liu, J., Spetz, J., Osakwe, Z. T., & Martsolf, G. (2022). State level scope of practice regulations for nurse practitioners impact work environments: Six state investigation. Research in nursing & health, 45(5), 516-524). https://doi.org/10.1002/nur.22253
5. Xin, D. A. N., Huang, Y., Jian-Hua, R. E. N., Ya-Lin, T. I. A. N., & Ya-Lin, H. E. (2023). Professional nursing practice environment and work engagement: the mediating roles of self-efficacy and achievement motivation. Journal of Nursing Research, 31(4), e285. https://doi.org/10.1097/jnr.0000000000000563
Sigma Membership
Lambda Beta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Phenomenology
Research Approach
Qualitative Research
Keywords:
Continuing Education, Competence, Health Equity or Social Determinants of Health, Nurse Practitioners, Self-Efficacy, Nursing Role, Taiwan
Recommended Citation
Tseng, Shu-Ting and Chang, Hsiu-Ju, "Factors Influencing Self-Efficacy Among Nurse Practitioners in Taiwan" (2026). International Nursing Research Congress (INRC). 62.
https://www.sigmarepository.org/inrc/2026/presentations_2026/62
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-26
Factors Influencing Self-Efficacy Among Nurse Practitioners in Taiwan
Toronto, Ontario, Canada
Purpose: Unlike in Western countries, where nurse practitioners (NPs) have greater autonomy, NPs in Taiwan face regulatory restrictions that may affect their self-efficacy. However, how these structural and cultural factors shape their experiences remains underexplored. This study aims to examine how Taiwan's healthcare environment and policies influence NPs' self-efficacy.
Methods: This phenomenological study used online focus group interviews with licensed hospital-based nurse practitioners in Taiwan (Jan–Jul 2025). Participants were recruited through a purposive sampling strategy and snowball sampling. Data were analyzed using Colaizzi's method with NVivo, supported by peer debriefing, reflective journaling, and expert-validated interview guidelines (S-CVI = 0.91–0.98).
Results: Thirty NPs participated, including 10 from medical centers, 15 from regional hospitals, and 5 from district hospitals. Specialties included internal medicine (n=15), surgery (n=12), obstetrics/gynecology (n=1), pediatrics (n=1), and psychiatry (n=1). Most held bachelor's degrees (80%), while 20% had master's or doctoral degrees, with an average of 10.2 years of experience. Three themes emerged: (1) Ambiguities in Regulatory Authority and Legal Protections — Legal Risks in Frontline Clinical Practice; Unclear Role Definitions and Practice Constraints; Absence of Specific Legal Provisions for NPs. (2) Disproportionate Compensation and Responsibility Risks — High Responsibility with Inadequate Pay; Unbalanced Workload and Lack of Nurse-Patient Ratio Rules. (3) Inadequate Institutionalization of Management and Educational Resources — Disorganized Management; Limited Access to Continuing Education; Uncertain Professional Identity.
Conclusions: Taiwan's nurse practitioners face structural barriers that limit autonomy, confidence, and professional identity. International comparisons (US, Thailand) confirm that granting NPs greater autonomy and support significantly enhances performance. Therefore, clarifying legal authority, improving compensation, and expanding educational and institutional support are essential to enhance NP' self-efficacy and retention. Systemic reform can empower NPs, strengthen their clinical competence, and improve healthcare quality and workforce sustainability.
Description
This phenomenological study investigated the impact of Taiwan's healthcare environment and policies on the self-efficacy of nurse practitioners. Online focus group interviews revealed three themes: regulatory ambiguities, disproportionate compensation, and limited educational resources. Findings underscore the need for clearer policies, equitable pay, and professional support to enhance NP' confidence, role identity, and clinical effectiveness.