Integrating Theoretical and Psychobiological Perspectives to Enhance Nursing Autonomy and Clinical Decision-Making

Contemporary nursing practice faces significant challenges in promoting autonomy and ethical decision-making in high-pressure environments. This paper presents a descriptive literature review integrating three theoretical frameworks: contemporary nursing theories, Sustained Anticipatory Engagement (SAE), and Cyclical Strain with Circadian Dysregulation (NER Spec D7). An integrated conceptual model is proposed to support nurses’ professional autonomy and clinical decision-making under organizational and shift-related pressures. The model offers a foundation for the development of assessment tools, scales, and organizational policies, linking theory, psychobiological knowledge, and practical autonomy.