디지털융복합연구 (Journal of Digital Convergence)

  • 제19권2호
  • /
  • Pages.275-288
  • /
  • 2021
  • /
  • 2713-6434(pISSN)
  • /
  • 2713-6442(eISSN)
한국디지털정책학회 (The Society of Digital Policy and Management)
권호 표지
DOI QR코드

DOI QR Code

간호사의 도덕적 행동, 도덕적 고뇌, 비판적 사고성향이 임상적 의사결정능력에 미치는 영향

The Influence of Moral Behavior, Moral Anguish, and Critical Thinking Tendency on Clinical Decision-making Ability in Nurse

  • 투고 : 2020.12.12
  • 심사 : 2021.02.20
  • 발행 : 2021.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 간호사를 대상으로 임상적 의사결정능력에 미치는 영향을 파악하고자 시도되었다. G도 병원에 근무하는 156명을 자료수집 하였다. IBM SPSS WIN/25.0을 이용하여 t-test, ANOVA, Pearson correlation coefficient, Multiple regression을 사용하였다. 대상자의 임상적 의사결정능력에 가장 영향을 미치는 요인은 간호연구 '매우관심', 비판적 사고성향, '석/박사', 총 임상경력 '20년1개월 이상', 도덕적 행동, 간호연구 '중요하다', '미혼', 총 임상경력 '5년1개월-10년', 부서근무경력 '3년1개월-5년' 순이었다. 설명력은 51.4%이었다. 간호연구에 관심과 중요성, 도덕적 행동과 학력, 경력이 임상적 의사결정능력에 영향을 미치는 변수임을 확인하였다는 점에서 의의가 있었다. 본 연구결과는 프로그램 개발 기초자료로 활용될 수 있을 것이다. 또한, 윤리적 딜레마 상황에서 임상적 의사결정능력을 높일 수 있는 교육 프로그램을 개발하여 적용하고 그 효과를 검증할 것을 제언한다.

This study was attemted to grasp the factors affecting the clinical decision-making ability of nurse. Data were collected from 156 nurse working in hospital in G-do. Analysis was done using t-test, ANOVA, Pearson correlation coefficient, and Multiple regression with IBM SPSS WIN/25.0. The most influential factor on the subjects' clinical decision-making ability was nursing Research 'very interest', critical thinking tendency, 'master/doctor', clinical experience 'more than 20 years and 1 month', moral behavior, nursing research 'important', 'single', clinical work experience '5 years, 1 month-10 years', department work experience '3 years 1 month-5 years'. The explanatory power was 51.4%. It was significant in that it was confirmed that interest and importance, moral behavior, academic background, and career are variables that influence clinical decision-making ability. The results of this study can be utilized as basic data for the development of intervention plans and programs that can increase clinical decision-making ability in the context of an ethical dilemma. In addition, developing and verifying educational programs that can increase clinical decision-making abilities in ethical dilemmas is needed.

키워드

참고문헌

  1. K. J. Lee, & S. Y. Yoo. (2011). Relationships between nurses' ethical dilemma, coping types, job satisfaction and turnover intention in Korea. Journal of Korean Clinical Research, 17(1), 1-15.
  2. C. Y. Chang, & Y. S. Kim. (2011). Attitude toward forgoing life-sustaining treatment among cancer patient families. Mental Health & Social Work 38, 5-30.
  3. K. Lutzen, V. Dahlqvist, S. Eriksson, & A. Norberg. (2006). Developing the concept of moral sensitivity in health care practice. Nursing Ethics, 13(2), 187-196. https://doi.org/10.1191/0969733006ne837oa
  4. P. S. Thompkins. (2009). Rhetorical listening and moral sensitivity. Journal of Listening, 23(2), 60-79. https://doi.org/10.1080/10904010802591912
  5. M. O. Suh. (2007). The pathways to moral behavior in an undergraduates: Based on the rest's four component model. Korean Journal of Educational Research, 45(3), 25-51.
  6. M. S. Jung, K. O. Park, M. H. Ko, D. H. Kim, S. Y. Kim, E. K. Kim, et al. (Eds.). (2015). Introduction to nursing. Seoul: Hyunmoon.
  7. M. S. Kim. (2015). Influence of moral sensitivity and ethical values on biomedical ethics awareness of nursing students. The Journal of Korean Academic Society of Nursing Education, 21(3), 382-392. DOI : 10.5977/jkasne.2015.21.3.382
  8. H. Park. (2009). Ethical dilemma of nurses. Journal of Korean Academy of Nursing Administration, 15, 128-135.
  9. C. M. Ulrich, C. Taylor, K. Soeken, P. O'Donnell, A. Farrar, M. Danis, et al. (2010). Everyday ethics: Ethical issues and stress in nursing practice. Journal of Advanced Nursing, 66, 2510-2519. DOI : 10.1111/j.1365-2648.2010.05425.x
  10. A. B. Margaret, & K. N. Alvita. (2013). Ethics & Issues in contemporary nursing, Stamford, Cengage Learning.
  11. A. S. Burston & A. G. Tuckett. (2013). Moraldistress in nursing: Contributing factors, outcomes and interventions. Nursing Ethics, 20(3), 312-324. https://doi.org/10.1177/0969733012462049
  12. S. M. Park, & I. G. Kwon. (2007). Factors influencing nurses clinical decision making- Focusing on critical thinking disposition. Journal of Korean Academy of Nursing, 37(6), 863-871 https://doi.org/10.4040/jkan.2007.37.6.863
  13. K. J. Kang, E. M. Kim, & S. A. Ryu. (2011). Factors influencing clinical competence for general hospital nurses. The Journal of the Korea Contents Association, 11(1), 284-293. DOI : 10.5392/JKCA.2011.11.1.284
  14. M. Banning. (2008). A review of clinical decision making: Models and current research. Journal of Clinical Nursing. 17(2), 187-195. DOI : 10.1111/j.1365-2702.2006.01791.x
  15. T. K. Bucknall. (2000). Critical care nurses' decision‐ making activities in the natural clinical setting. Journal of Clinical Nursing, 9(1), 25-36. DOI : 10.1046/j.1365-2702.2000.00333.x
  16. C. Thompson, N. Cullum, D. McCaughan, T. Sheldon, & P. Raynor. (2004). Nurses, information use, and clinical decision making-the real world potential for evidence-based decisions in nursing. Evidence-Based Nursing, 7(3), 68-72. DOI : 10.1136/ebn.7.3.68
  17. M. K. Park, & S. Y. Kim. (2019). Structural equation modeling on clinical decision making ability of nurses. Journal of Korean Academy Nursing, 49(5), 601-612. DOI : 10.4040/jkan.2019.49.5.601
  18. I. T. Bjork, & G. A. Hamilton. (2011). Clinical decision making of nursesworking in hospital settings. Nursing Research and Practice, 2011, 524918. DOI : 10.1155/2011/524918
  19. F. Faul, E. Erdfelder, A. Buchner, & A. G. Lang. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 41(4), 1149-1160. DOI : 10.3758/BRM.41.4.1149
  20. M. S. Yoo. (2003). The Development of a Measurement Tool for Moral Distress in Nurses. Master's Thesis, Yonsei University.
  21. S. J. Lee. (2001). A Study of the Relationship between Multiple Intelligences and Prosocial Behavior of Children. Master's Thesis, Sookmyung Women's University.
  22. I. S. Kwon, G. E. Lee, G. D. Kim, Y. H. Kim, K. M. Park, H. S. Park, et al. (2006). Development of a Critical Thinking Disposition Scale for Nursing Students. Journal of Korean Academy Nursing, 36(6), 950-958. https://doi.org/10.4040/jkan.2006.36.6.950
  23. M. K. Baek. (2005). Relationship between Level of Autonomy and Clinical Decision-making in Nursing Scale of E.T Nurse. Master's Thesis, Yonsei University.
  24. S. J. Han, J. W. Oh, B. Y. Huh, & H. W. Kim. (2020). Mediating effects of resilience between nurse's character and happiness for nurses in general hospitals. Journal of Korean Academy of Nursing Administration, 26(1), 22-30. DOI : 10.11111/jkana.2020.26.1.22
  25. N. J. Je, & M. R. Park. (2020). The effects of nursing college students' moral self, moral behavior, self-control, empathy, and interpersonal competence on nursing professionalism in age of convergence. Journal of Digital Convergence, 18(8), 361-370. DOI : 10.14400/JDC.2020.18.8.361
  26. D. B. Noh, S. A. Kim & S. H. Kim. (2013). Moral distress, moral sensitivity and ethical climate of nurses working in psychiatric wards. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 22(4), 307-319. DOI : 10.12934/jkpmhn.2013.22.4.307
  27. H. R. Kim & S. H. Ahn. (2010). Moral sensitivity and moral distress among korean hospital nurses. The Korean Society for Medical Ethics. 13(4), 321-336. DOI : 10.5977/jkasne.2016.22.2.228
  28. O. H. Kim, S. A. Ahn, S. M. Oh, J. H. Kong, & H. O. Choi. (2019). The mediating effect of biomedical ethics awareness in the relationship between the moral distress and moral sensitivity of hospital nurses. Journal of Convergence for Information Technology, 9(9), 78-86. DOI : 10.22156/CS4SMB.2019.9.9.078
  29. M. C. Corley, R. K. Elswick, M. Gorman M & T. Clor. (2001). Development and evaluation of a moraldistress scale. Journal of Advanced Nursing, 33, 250-256. DOI : 10.1111/j.1365-2648.2001.01658.x
  30. M. S. Yoo. (2006). A Study on the Degree of Moral Distress of Nurses in a City. Journal of Korean Academy of Nursing Administration 12(1), 131-139.
  31. Y. Chae, S. Yu, E. J. Lee, & E. H. Park. (2017). The relation among moral distress, physical symptoms and burnout of hospital nurses. Journal of Korean Academic Society of Nursing Education, 23(4), 430-440. DOI : 10.5977/jkasne.2017.23.4.430
  32. H. S. Kim, S. Yu, & K. C. Lim. (2019). Influencing factors on moral distress in long-term care hospital and facility nurses. Journal of the Korea Society of Computer and Information, 24(5), 121-130. DOI : 10.9708/jksci.2019.24.05.121
  33. J. Lim, F. Bogossian, & K. Ahern. (2010). Stress and coping in Australian nurses: A systematic review. International NursingReview, 57, 22-31. DOI : 10.1111/j.1466-7657.2009.00765.x
  34. L. B. Tiedje. (2000). Moral distress in perinatal nursing. Journal of Perinatal & Neonatal Nursing 14(2), 36-43. https://doi.org/10.1097/00005237-200009000-00005
  35. J. H. Shin, & M. H. Seo. (2018). A survey on the ethical issuesand needs for ethics education of nurses in long-term care hospitals. Journal of the Korea Contents Association, 18(6), 180-192. DOI : 10.5392/JKCA.2018.18.06.180
  36. M. C. Corley. (2002). Nurse moral distress: A proposed theory and research agenda. Journal of Nursing Ethics, 9(6), 636-650. DOI : 10.1191/0969733002ne557oa
  37. B. H. Park & Y. J. Oh. (2017). Impact of ethical climate and ethical leadership perceived by nurses on moral distress. Journal of the Korean Data Analysis Society, 19(2), 1099-1116. DOI : 10.37727/jkdas.2017.19.2.1099
  38. Y. M. Kang, & Y. Eun. (2018). The effects of self-efficacy, critical thinking disposition, self-leadership, and communication competency on the core competencies of the preceptor in advanced general hospitals. The Journal of Korean Academic Society of Nursing Education 24(3), 279-289. DOI : 10.5977/jkane.2018.24.3.279
  39. K. Y. Kim, & E J. Lee. (2016). The relationship among critical thinking disposition, nursing process competency and evidence-based practice competency in nurses working in hospitals. Journal of the Korean Data And Information Science Society 27(2), 451-461. UCI(KEPA) : I410-ECN-0101-2018-041-001377791 https://doi.org/10.7465/jkdi.2016.27.2.451
  40. J. Y. Lee, & S. Y. Park. (2014). Relationship between the practice environment of nursing and critical thinking disposition of nurses in local general hospitals. The Journal of Korean Nursing Administration Academic Society, 20(2), 145-53. DOI : 10.11111/jkana.2014.20.2.145
  41. A. N. Park, K. H. Chung, & W. G. Kim. (2016). A study on the critical thinking disposition, self-directed learning readiness and professional nursing competency. The Journal of Korean Nursing Administration Academic Society, 22(1), 1-10. DOI : 10.11111/jkana.2016.22.1.1
  42. I. S. Oh, & J. H. Kim. (2016). Impacts of critical thinking disposition and nursing work environment on nurses' clinical decision making abilities. The Journal of Korean Academic Society of Nursing Education, 22(3), 304-15. DOI : 10.2977/jkasne.2016.22.3.304
  43. S. H. Park. (2015). Impact of nursing professional self-concept, clinical decision making ability, critical thinking disposition, professional autonomy of clinical nurses. Journal of the Korea Entertainment Industry Association 9(4), 325-334. DOI : 10.21184/jkeia.2015.12.9.4.325
  44. I. S. Jang, K. S. Lee. (2019). Effects of critical thinking and nursing practice environment on clinical decision making among nurses. Journal of Digital Convergence, 17(2), 255-264. DOI : 10.14400/JDC.2019.17.2.255
  45. S. H. Lee, & E. J. Lee. (2018). Influence of nurses' critical thinking disposition and self-leadership on clinical competency in medium sized hospitals. Journal of Korean Clinical Nursing Research 24(3), 336-346. DOI : 10.22650/JKCNR.2018.24.3.336
  46. J. A. Kim, & Y. S. Kang. (2020). Effects of moral sensitivity and self-assertiveness on ethical decision-making confidence of nurses working in long term care hospitals. Journal of the Korea Academia-Industrial cooperation Society, 21(6), 144 -153. DOI : 10.5762/KAIS.2020.21.6.144
  47. I. Oh, & J. H. Kim. (2016). Impacts of critical thinking disposition and nursing work environment on nurses' clinical decision making abilities. The Journal of Korean Academic Society of Nursing Education, 22(3), 304-315. DOI : 10.5977/jkasne.2016.22.3.304
  48. S Park, I. G. Kwon. (2007). Factors influencing nurses' clinical decision making: Focusing on critical thinking disposition. Journal of Korean Academy of Nursing, 37(6), 863-871. DOI : 10.4040/jkan.2007.37.6.863
  49. R. Harrison, Y. Birks, J. Hall, K. Bosanquet, M. Harden, & R. Iedema(in press). (2013). The contribution of nurses to incident disclosure: A narrative review. International Journal of Nursing Studies, 51(2), 334-345. DOI : 10.1016/j.ijnurstu.2013.07.001