Journal of Korean Critical Care Nursing (중환자간호학회지)

Korean Society of Critical Care Nursing (한국중환자간호학회)
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Mediating Effects of Role Clarity between Clinical Decision-Making Abilities and Job Stress for Advanced Practice Nurses at Tertiary Hospitals

상급종합병원 전문간호사의 임상적 의사결정능력과 직무스트레스 간의 관계에서 역할 명확성의 매개효과

  • Kim, Min Young (College of Nursing, Health and Nursing Research Institute, Jeju National University) ;
  • Kim, Jeong Hye (Department of Clinical Nursing, University of Ulsan) ;
  • Choi, Su Jung (Graduate School of Clinical Nursing Science, Sungkyunkwan University)
  • Received : 2022.01.13
  • Accepted : 2022.03.30
  • Published : 2022.06.30
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Abstract

Purpose : The purpose of this study was to identify the mediating effect of role clarity in the relationship between clinical decision-making abilities and job stress among advanced practice nurses at tertiary hospitals. Methods : The participants were 137 advanced practice nurses. The assessment tools were clinical decision-making in nursing scale, role ambiguity scale, and Korean occupational stress scale (KOSS-26). Data were analyzed with the SPSS/24.0 program and mediation analysis was performed according to the Baron and Kenny methods. Results : There were significant relationships between clinical decision-making abilities and job stress (r=-.33, p<.001), and role clarity and job stress (r=-.29, p=.001). Role clarity showed partial mediating effects in the relationship between clinical decision-making abilities and job stress (Z=2.02, p=.043). Conclusion : Therefore, to reduce advanced practice nurses' job stress, it is necessary to develop a program and strategies to increase their clinical decision-making abilities.

Keywords

Acknowledgement

본 연구는 2016년 병원간호사회에서 연구비를 지원받아 진행한 연구의 일부임

References

  1. Korean Accreditation Board of Nursing Education. Role of advanced practice nurse [cited 2021 June, 17]. Available from: http://www.kabone.or.kr/mainbusin/nurse04outline.do.
  2. Kang Y-A, Lim K-C, Kim JH, Jeoung JS, Han JE. Experiences of health-care providers about advanced practice nurses: Focusing on the perspectives of physicians and advanced practice nurses. Journal of Muscle and Joint Health. 2019;26(3):290-306. https://doi.org/10.5953/JMJH.2019.26.3.290
  3. Kim N, Jang MJ, Choi N, Choi JY, Kim MK, Choi SJ. Clinical outcomes of direct interhospital transfers of patients with acute aortic syndrome led by advanced practice nurses. Journal of Korean Critical Care Nursing. 2020;13(2):12-23. https://doi.org/10.34250/jkccn.2020.13.2.12
  4. Kim MY, Jeon M-K, Choi SJ, Kim JH, Kim H, Leem CS. Experience of healthcare providers in the advanced practice nurse system Journal of Korean Critical Care Nursing. 2021;14(2):42-56. https://doi.org/10.34250/jkccn.2021.14.2.42
  5. Hospital Nurse Association. 2020 Survey on the status of hospital nursing staff placement. Seoul: Hospital Nurse Association; 2020 [cited 2021 December 10]. Available from: https://khna.or.kr/home/pds/utilities.php
  6. Kim MY, Choi SJ, Seol M, Kim JH, Kim HY, Byun SJ. The current status of professional medical support staffs in medical institutions with over 500 beds. Journal of Korean Clinical Nursing Research. 2017;23(2):131-41. https://doi.org/10.22650/JKCNR.2017.23.2.131
  7. Lee HJ, Kang YS, Choi ES. A Study on role conflict and job satisfaction of neurosurgery clinical nurse specialist. Korean Journal of Adult Nursing. 2006;18(2):304-13.
  8. Kim MY, Choi SJ, Seol M, Kim JH, Kim HY, Byun SJ. Survey to establish the role of professional medical support staffs. Policy research report. Seoul: Korean Hospital Nurses Association, 2016.
  9. Park MK, Kim SY. Structural equation modeling on clinical decision making ability of nurses. Journal of Korean Academy of Nursing. 2019;49(5):601-12. https://doi.org/10.4040/jkan.2019.49.5.601
  10. Jenkins HM. Clinical decision making in nursing scale. Measurement of Nursing Outcomes. 2001;1:33-40.
  11. Moon KH. A study on restructuring to a patient-oriented primary care team model. [master's thesis]. Seoul: Yonsei University;2004.
  12. Chen SL., Hsu HY, Chang CF, Lin E.CL. An exploration of the correlates of nurse practitioners' clinical decision making abilities. Journal of Clinical Nursing. 2016;25:1016-24., https://doi.org/doi:10.1111/jocn.13136
  13. Kim MY, Choi SJ, Seol M, Kim JH, Kim HY, Byun SJ. The frequency of job performance of the korean professional medical support staff at medical institutions over 500 beds Journal of Korean Critical Care Nursing. 2018;11(1):15-27.
  14. Sastre-Fullana P, De Pedro-Gomez JE, Bennasar-Veny M, Serrano-Gallardo P, Morales-Asencio JM. Competency frameworks for advanced practice nursing: a literature review. International Nursing Review. 2014;61(4):534-42. doi: 10.1111/inr.12132. Epub 2014 Oct 6.
  15. Kim KS, Lim KC, Kang SY, Yi YH. Development of core competencies of advanced practice nurse. Policy Research Report Seoul: Korean Nurses Association, 2014.
  16. Kim YS, Park JS. The relationship between nursing professionalism, clinical decision making abilities, and job performance in advanced practice nurses. Journal of Korean Academy of Nursing Administration. 2013;19(5):613-21. https://doi.org/10.11111/jkana.2013.19.5.613
  17. Kim BN, Ho HS, Park YS. A study of nurses' resilience, occupational stress and satisfaction. Korean Journal of Occupational Health Nursing. 2011:20(1):14-23. https://doi.org/10.5807/KJOHN.2011.20.1.014
  18. Kim Y-E. The effect of clinical decision-making ability and resilience on end-of-life care stress of nurses in cancer care unit. [master's thesis]. Pusan: Catholic University of Pusan; 2021.
  19. Kim KS., Kim BJ, Yi YH, Kang JY.Korean critical care advanced practice nurses' work experience: A focus group study. Journal of Korean Critical Care Nursing. 2011;4(2):1-14.
  20. Tae YS, Kwon SH, Lee YS. The job experience of oncology nurse specialists. Asian Oncology Nursing. 2014;14(4):236-48. https://doi.org/10.5388/aon.2014.14.4.236
  21. Karimi R, Alipour F. Reduce job stress in organizations: Role of locus of control. International Journal of Business and Social Science. 2011;18(2):232-6.
  22. Faraz A. Facilitators and barriers to the novice nurse practitioner workforce transition in primary care. Journal of the American Association of Nurse Practitioners. 2019;31(6):364-70. https://doi.org/10.1097/JXX.0000000000000158
  23. Kim S, Lee TW, Kim GS, Cho E, Jang Y, Choi M, et al. Nurses in advanced roles as a strategy for equitable access to healthcare in the WHO Western Pacific region: a mixed methods study. Human Resources for Health. 2021;19(1):1-9. https://doi.org/10.1186/s12960-021-00555-6
  24. Donelan K, DesRoches CM, Guzikowski S, Dittus RS, Buerhaus P. Physician and nurse practitioner roles in emergency, trauma, critical, and intensive care. Nursing Outlook. 2020;68(5):591-600. https://doi.org/10.1016/j.outlook.2020.04.010
  25. Mihalca L, Ratiu L, Brendea G, Metz D, Dragan M, Dobre F. Exhaustion while teleworking during COVID-19: a moderated-mediation model of role clarity, self-efficacy, and task interdependence. Oeconomia Copernicana. 2021;12(2):269-306. http://doi.org/10.24136/oc.2021.010
  26. Orgambidez A, Almeida H. Social support, role clarity and job satisfaction: a successful combination for nurses. International Nursing Review. 2020;67(3):380-6. https://doi.org/10.1111/inr.12591
  27. Pahi MH, Ahmed U, Sheikh AZ, Dakhan SA, Khuwaja FM, Ramayah T. Leadership and commitment to service quality in Pakistani hospital: The contingent role of role clarity. SAGE Open. 2020;10(4):1-14.https://doi.org/10.1177/2158244020963642
  28. Kim SY. A study on participation in clinical decision making by home healthcare nurses. Journal of Korean Academy of Nursing. 2010;40(6):892-902. https://doi.org/10.4040/jkan.2010.40.6.892
  29. Peterson MF, Smith PB, Akande A, Ayestaran S, Bochner S, Callan V, et al. Role conflict, ambiguity, and overload: A 21-nation study. Academy of Management Journal. 1995;38(2):429-52. https://doi.org/10.2307/256687
  30. Kim MY, Kang S, Kim YM, You M. Nurses' willingness to report near misses: a multilevel analysis of contributing factors. Social Behavior and Personality. 2014;42(7):1133-46. https://doi.org/10.2224/sbp.2014.42.7.1133
  31. Chang SJ. Reevaluation of the KOSS based on the items and structure. Journal of Korean Occupation Stress. 2007;1(1):83-96.
  32. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 1986;51:1173-82. https://doi.org/10.1037/0022-3514.51.6.1173
  33. Jang IS, Lee KS. Effects of critical thinking and nursing practice environment on clinical decision making among nurses. Journal of Digital Convergence 2019;17(2):255-64. https://doi.org/10.14400/JDC.2019.17.2.255
  34. Sung JH, Eun OB. Relationship between critical thinking disposition, professional nursing competence and job satisfaction in clinical nurses. The Journal of Korean Nursing Administration Academic Society. 2010:17(2):274-81
  35. Jeong SC, Jeong DY. Relationship between critical thinking disposition, clinical decision making and job satisfaction of cancer center nurses. Journal of Korean Academy of Nursing Administration. 2011:17(4):443-50. https://doi.org/10.11111/jkana.2011.17.4.443
  36. Choi SM, Lee MY. Thinking disposition and clinical decision-making abilities in home health advanced practice nurses. The Journal of Korean Academic Society of Home Care Nursing. 2014;21(2):147-55.
  37. Tunc T, Kutanis RO. Role conflict, role ambiguity, and burnout in nurses and physicians at a university hospital in Turkey. Nursing & Health Sciences, 2009;11(4):410-16. https://doi:10.1111/j.1442-2018.2009.00475.x
  38. Kamarudin K, Zulkafaly F, Hassan NM. Role conflict, role ambiguity and job stress among piolice officers. International Journal of Academic Research in Business and Social Sciences. 2018;8(2):843-55. https://doi.org/10.6007/IJARBSS/v8-i2/4496
  39. Bostrom E, Hornsten A, Lundman B, Stenlund H, Isaksson U. Role clarity and role conflict among Swedish diabetes specialist nurses. Primary Care Diabetes. 2013;7(3):207-12. https://doi.org/10.1016/j.pcd.2013.04.013
  40. Ministry of Health and Welfare, Legislative notice of partial amendment to the rules for recognition of advanced professional nurse ualifications etc. 2021. 8.3 [cited 2021 December, 13]. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=366700
  41. Kim AS. The relationship of hospital employees' job stress, emotional labor, resilience and mental health [master's thesis]. Suwon: Ajou University; 2011.
  42. Ryu JG., Choi-Kwon S. Predictors of blood and body fluid exposure and mediating effects of infection prevention behavior in shift-working nurses. Application of analysis method for zero-inflated count data. Journal of Korean Academy of Nursing. 2020;50(5):658-70. https://doi.org/10.4040/jkan.20025
  43. Park MM, Han SJ. Relations of job satisfaction with emotional labor, job stress, and personal resources in home healthcare nurses. Journal of Korean Academy Community Health Nursing. 2013;24(1):51-61. https://doi.org/10.12799/jkachn.2013.24.1.51
  44. Chen CH, Wang J, Yang CS, Fan JY. Nurse practitioner job content and stress effects on anxiety and depressive symptoms, and self perceived health status. Journal of Nursing Management. 2016;24(5):695-704. https://doi.org/10.1111/jonm.12375
  45. Griffith PB, Kelly MM, Becker D. On-call simulation for adult gerontology acute care nurse practitioner students: A comparative descriptive study. Journal of the American Association of Nurse Practitioners. 2021;33(6):429-40. https://doi.org/10.1097/JXX.0000000000000355