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중환자실 간호사의 경력개발제도에 따른 경력개발제도의 인식, 전문직 자아개념, 자기효능감, 조직몰입

Perception of Clinical Ladder System, Professional Self-Concept, Self-Efficacy, and Organizational Commitment by the Level of Clinical ladder among Intensive Care Unit Nurses

  • Lee, Ji Hyun (Department of Nursing, Samsung Medical Center) ;
  • Choi, Su Jung (Graduate School of Clinical Nursing Science, Sungkyunkwan University School of Medicine)
  • 투고 : 2022.09.04
  • 심사 : 2022.10.17
  • 발행 : 2022.10.31

초록

Purpose : This study aimed to verify the effectiveness of the clinical ladder system (CLS) by identifying the perception of the CLS, professional self-concept, self-efficacy, and organizational commitment among intensive care unit (ICU) nurses. Methods : Data were collected through a questionnaire survey of 173 nurses working in 11 ICUs at a tertiary hospital in Seoul. Results : The perception of the CLS, self-efficacy, and organizational commitment showed significant difference according to the CLS level. As a result of the partial Spearman correlation analysis after adjusting for demographic difference according to CLS (age, marital status, education, and clinical career), CLS positively correlated with the perception of the CLS (r=.16, p=.045), professional self-concept (r=.24, p=.001), and self-efficacy (r=.21, p=.007). On the contrary, organizational commitment negatively correlated with the perception of the CLS (r=-.43, p<.001) and self-efficacy (r=-.32, p<.001). Conclusion : The CLS is effective for professional self-concept and self-efficacy. However, specialists 2 nurses, who had high professional self-concept and self-efficacy, showed low level of organizational commitment. Thus, it is necessary to examine the factors of work burden and career plateau that are imposed after promotion and improve experience and planning according to the growth needs. Moreover, regular evaluation of the CLS will require hospital support to ensure that ICU nurses appreciate and actively participate in the support.

키워드

참고문헌

  1. Lee JM, Han CH, Lee SM, Lee SC, Hong JH, Park HY, et al. Current status analysis of use of the adult intenstive care unit according to patients' severity and the healthcare utilization. National Health Insurance Service Ilsan Hospital & Clinical Research. Ilsan; National Health Insurance Service Ilsan Hospital, 2020 Feburary. Report No.: NHIS 2020-20-011.
  2. Benner P. From novice to expert. American Journal of Nursing. 1982;82(3):402-7.
  3. Kwon IG, Sung YH, Park KO, Yu OS, Kim MA. A study on the clinical ladder system model for hostpital nurses. Journal of Korean Clinical Nursing Research. 2007;13(1):7-23.
  4. Chae SN, Ko IS, Kim IS, Yoon KS. Effect of perception of career ladder system on job satisfaction, intention to leave among perioperative nurses. Journal of Korean Academy of Nursing Administration. 2015;21(3):233-42. https://doi.org/10.11111/jkana.2015.21.3.233
  5. Kim MS, Park SA. Comparison of nursing performance by career levels in a nurse career ladder system. Journal of Korean Academy Society of Nursing Education. 2012;18(2):284-92. https://doi.org/10.5977/jkasne.2012.18.2.284
  6. Ko YK, Yu S. Clinical ladder program implementation: A project guide. The Journal of Nursing Administration. 2014;44(11):612-6. https://doi.org/10.1097/NNA.0000000000000134
  7. Oh SM, Kim SH. Effect of job stress, working bullying, self-efficacy on the professional self-concept of intensive care unit nurses. Journal of Korean Critical Care Nursing. 2020;13(2):60-72. https://doi.org/10.34250/jkccn.2020.13.2.60
  8. Yoon MY, Park GJ. The relationships between self efficacy, autonomy and professional self conception among nurses working in intensive care units. Journal of Wholistic Nursing Science. 2013;6(1):109-22.
  9. Arthur D. Measuring the professional self-concept of nurses: a critical review. Journal of Advanced Nursing. 1992;17(6):712-9. https://doi.org/10.1111/j.1365-2648.1992.tb01969.x
  10. Min A, Kim IS. Relationship of perception of clinical ladder system with professional self-concept and empowerment based on nurses' clinical career stage. Journal of Korean Academy of Nursing Administration. 2013;19(2):254-64. https://doi.org/10.11111/jkana.2013.19.2.254
  11. Bandura A. Perceived self efficacy in cognitive development and functioning. Educational Psychologist. 1993;28(2):117-48. https://doi.org/10.1207/s15326985ep2802_3
  12. Mowday RT, Steers RM, Porter LW. The measurement of organizational commitment. Journal of Vocational Behavior. 1979;14(2):224-47. https://doi.org/10.1016/0001-8791(79)90072-1
  13. Kim MS. The influence of career ladder system on nursing preformance, job satisfaction, organizational commitment, turnover intension [dissertation]. Seoul: Seoul National University; 2013.
  14. Choi YJ, Park YI, Jung GH. Concept analysis on the organizational commitment: Focused on the nursing organizations. The Journal of Korean Academic Society of Nursing Education. 2014;20(2):276-87. https://doi.org/10.5977/jkasne.2014.20.2.276
  15. Hall LM, Waddell J, Donner G, Wheeler MM. Outcomes of a career planning and development program for registered nurses. Nursing Economics. 2004; 22(5):231-8.
  16. Bjork IT, Torstad S, Hansen BS, Samdal GB. Estimating the cost of professional developmental activities in health organizations. Nursing Economics. 2009;27(4):239-44.
  17. Riley JK, Rolband DH, James D, Norton HJ. Clinical ladder: Nurses' perceptions and satisfiers. The Journal of Nursing Administration. 2009;39(4): 182-8. https://doi.org/10.1097/NNA.0b013e31819c9cc0
  18. Pertiwi B, Hariyati RTS. The impacts of career ladder system for nurses in hospital. Enfermeria Clinica. 2019;29:106-10. https://doi.org/10.1016/j.enfcli.2019.04.016
  19. Nelson JM, Cook PF. Evaluation of a career ladder program in an ambulatory care environment. Nursing Economics. 2008;26(6):353-60.
  20. Park KO, Lee YY. Career ladder system perceived by nurses. Journal of Korean Academy of Nursing Administration. 2010;16(3):314-25. https://doi.org/10.11111/jkana.2010.16.3.314
  21. Sohng KY, Noh CH. An analytical study of the professional self-concept of hospital nurses in Korea. Journal of Korean Academy of Nursing. 1996;26(1):94-106.
  22. Chung YH. Comparative study of professional selfconcept and role conflict between new graduated nurse and experienced nurse in ICU [master's thesis]. Seoul: Hanyang Universiy; 2007.
  23. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 1977; 84(2):191-215. https://doi.org/10.1037//0033-295x.84.2.191
  24. Kim A. A study on the academic failure-tolerance and its correlates. Journal of Educational Psychology. 1997;11(2):1-19.
  25. Kang KH, Park SA. Relationship between perception for appraisal of perioperative nurses and performance and organizational commitment. Journal of Korean Academy of Nursing Administration. 2011; 17(2):189-97. https://doi.org/10.11111/jkana.2011.17.2.189
  26. Ahn HJ. The improvement of career ladder system for the intensive care unit nurses: Focusing on the analysis of the experience of nurses in one hospital [master's thesis]. Seoul: Yonsei University; 2019.
  27. Pierson MA, Liggett C, Moore KS. Twenty years of experience with a clinical ladder: A tool for professional growth, evidence-based practice, recruitment, and retention. Journal of Continuing Education in Nursing. 2010;41(1):33-40. https://doi.org/10.3928/00220124-20091222-06
  28. Filani M, Novieastari E, Nuraini T. Nurses' understanding and perception of career ladder system are related to work motivation: A multicenter crosssectional study in Aceh, Indonesia. Enfermeria Clinica. 2019;29:434-8. https://doi.org/10.1016/j.enfcli.2019.04.064
  29. Chang CS. Moderating effects of nurses' organizational support on the relationship between job satisfaction and organizational commitment. Western Journal of Nursing Research. 2015;37(6):724-45. https://doi.org/10.1177/0193945914530047
  30. Warman GA, Williams F, Herrero A, Fazeli P, WhiteWilliams C. The design and redesign of a clinical ladder program: Thinking big and overcoming challenges. Journal for Nurses in Professional Development. 2016;32(6):E1-E7. https://doi.org/10.1097/NND.0000000000000307
  31. Hong JY, Sohn SK. Effect of professional quality of life on the professional self-concept of intensive care unit nurses in tertiary hospital. Journal of Korean Critical Care Nursing. 2019;12(2):13-25. https://doi.org/10.34250/jkccn.2019.12.2.13
  32. Yim JY, Lee MJ, Ki EJ, Chang BH, Chung MS, Jo HJ, et al. ICU nurses' clinical competence according to clinical ladder by job analysis tool. Journal of Korean Critical Care Nursing. 2010;3(1):1-13.
  33. Winslow SA, Fickley S, Knight D, Richards K, Rosson J, Rumbley N. Staff nurses revitalize a clinical ladder program through shared governance. Journal for Nurses in Staff Development. 2011;27(1):13-7. https://doi.org/10.1097/NND.0b013e3182061c97
  34. Kim M, Seo E, Shin SH. The influence of the emotional labor, professional self-concept, self-efficacy & social support of emergency room nurse's burnout. Korean Journal of Stress Research. 2019;27(4): 404-11. https://doi.org/10.17547/kjsr.2019.27.4.404
  35. Kim SN, Yoo MS. Relationships between resilience, job stress, and organizational commitment in ICU nurses. Journal of Korean Academic Society of Home Health Care Nursing. 2014;21(1):36-48.
  36. Lee N, Kim YS. Effects of relational bonds and professional authority in the organizational commitment on intensive care unit nurses. Journal of Korean Academy of Nursing Administration. 2017; 23(2):151-8. https://doi.org/10.11111/jkana.2017.23.2.151
  37. Hsu CP, Chiang CY, Chang CW, Huang HC, Chen CC. Enhancing the commitment of nurses to the organisation by means of trust and monetary reward. Journal of Nursing Management. 2015;23(5):567-76. https://doi.org/10.1111/jonm.12180
  38. Kim YM, Kang YS. Effects of self-efficacy, career plateau, job embeddedness, and organizational commitment on the turnover intention of nurses. Journal of Korean Academy of Nursing Administration. 2015;21(5):530-41. https://doi.org/10.11111/jkana.2015.21.5.530