LAUSR

Aims This study examined the relationship between professional autonomy (PA) and organizational commitment (OC), with job satisfaction (JS) as a mediating factor among nurses employed in intensive care units (ICUs). Background Previous research has established a link between nurses' PA and OC, but the mediating role of JS remains underexplored. Addressing this gap effectively is essential for improving nursing care outcomes and providing novel insights into how autonomy shapes commitment through JS. Methods This descriptive-correlational study used structural equation modeling (SEM). A total of 420 ICU nurses were selected through quota sampling from Urmia educational hospitals in Iran from October 2022 to June 2023. Data were collected using a demographic survey questionnaire and Persian versions of the Minnesota Satisfaction Questionnaire (MSQ), Porter Organizational Commitment Questionnaire (P-OCQ), and Varjus Professional Autonomy Scale (V-PAS). Data were analyzed using SPSS version 23.0 and SmartPLS version 3.0. Results Out of 420 participants, 385 fully completed the questionnaires (response rate: 92%). PA had a positive, weak direct association with OC (β = 0.273, t = 4.328, p < 0.001). It was strongly associated with JS (β = 0.846, t = 38.073, p < 0.001), which in turn was strongly associated with OC (β = 0.640, t = 10.515, p < 0.001). JS significantly mediated the association between PA and OC (β = 0.2477, 95% CI: 0.1956, 0.3000). Conclusion PA was positively associated with OC among ICU nurses, with JS acting as a mediator. Enhancing both PA and JS is critical for improving nurses' commitment, leading to better quality care and patient safety. Implications for Nursing Management Healthcare managers can empower nurses by involving them in patient care decision-making and supporting their independent decisions. Training to update nursing knowledge can expand their decision-making scope. Providing stress reduction programs, managing workloads, addressing nursing shortages, and offering financial and moral support can boost JS and OC.