The Role of Empowerment in Mitigating Cognitive Decline Among Nurses: A Systematic Review

Abstract

Background: Cognitive decline among nurses—manifesting as memory loss, reduced attention, and decision fatigue—is a growing concern in high-demand healthcare settings. Chronic stress, burnout, shift fatigue, and underutilization of professional autonomy exacerbate this decline. Empowerment has emerged as a multidimensional intervention that may buffer against these effects, yet evidence has not been systematically synthesized to understand its full impact on nurses’ cognitive functioning.

Aim: To systematically examine how empowerment strategies mitigate cognitive decline among nurses across diverse global contexts.

Methods: A systematic review was conducted following PRISMA 2020 guidelines. Eligible studies included those published between 2019 and 2025, in English, investigating registered nurses exposed to empowerment strategies (psychological, structural, technological, or educational) with outcomes related to cognitive decline. Databases searched were PubMed, Scopus, Web of Science, CINAHL, and grey literature. A total of 223 records were identified; 112 were screened, and 14 studies met inclusion criteria. Quality appraisal tools included CASP, STROBE, MMAT, and JBI checklists.

Results: Four main themes emerged: psychological empowerment reduced cognitive fatigue via improved self-efficacy and stress management (e.g., Hoying et al., 2023; Soni, 2024); organizational empowerment via shift control and rest reduced memory loss (e.g., Lin et al., 2024; Moosavi et al., 2025); technological empowerment, such as AI and checklists, offloaded mental workload (e.g., Lukkahatai et al., 2025); and educational empowerment promoted cognitive flexibility and adaptive decision-making (e.g., Al-Shomrani et al., 2024; Iwaanakuchi et al., 2023). Empowerment was consistently associated with reduced burnout, improved attention, and enhanced clinical judgment.

Conclusion: Empowerment acts as a critical cognitive safeguard for nurses. Integrating empowerment holistically across psychological, structural, technological, and educational domains is essential to sustaining nurses’ cognitive health, clinical accuracy, and professional longevity.