한국응용과학기술학회지 (Journal of the Korean Applied Science and Technology)

  • 제41권4호
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  • Pages.962-980
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  • 2024
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  • 1225-9098(pISSN)
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  • 2288-1069(eISSN)
한국응용과학기술학회 (The Korean Society of Applied Science and Technology)
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임상간호사의 간호전문직관이 임상의사결정능력에 미치는 영향: 비판적 사고성향과 핵심간호술 수행자신감의 이중매개효과

Effects of Nursing professionalism on Clinical decision making ability of Clinical nurses: Dual mediating effects of Critical thinking disposition and Confidence in performing core nursing skills

  • 투고 : 2024.06.15
  • 심사 : 2024.08.26
  • 발행 : 2024.08.30
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초록

본 연구는 임상간호사의 간호전문직관과 임상의사결정능력 간의 관계에서 비판적 사고성향과 핵심간호술 수행자신감의 이중매개효과를 검증하여 임상의사결정능력 향상을 위한 기초자료로 활용하기 위해 실시한 서술적 조사연구이다. 연구대상자는 일 지역의 종합병원 임상간호사 173명이며, 2023년 9월 15일~10월 13일까지 자료수집을 하였다. 자료분석은 SPSS/AMOS 23.0 프로그램을 이용하여 연구변인들간의 인과적 관계 분석과 부트스트래핑 추정방식으로 매개효과를 검증하였으며, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, hierarchical regression을 실시하였다. 연구결과, 첫째, 임상간호사의 간호전문직관, 임상의사결정능력, 비판적 사고성향과 핵심간호술 수행자신감 간의 인과모형의 적합성은 타당하게 성립하였다. 둘째, 간호전문직관에서 임상의사결정능력에 대한 영향관계에서 비판적 사고성향은 부분매개효과를 나타냈다. 셋째, 이중매개효과를 검증한 결과, 비판적 사고성향의 간접효과가 비판적 사고성향과 핵심간호술 수행자신감의 간접효과보다 크게 나타나 이중매개효과보다는 단일매개 효과가 큰 것으로 나타났다. 따라서 임상간호사들의 높은 간호전문직관의 함양은 임상의사결정능력을 향상시킬 수 있으며, 특히, 비판적 사고성향을 강화시키는 것이 더 효율적임을 검증하였다.

This study is a descriptive research study conducted to verify the dual mediating effect of critical thinking disposition and core nursing skill performance confidence in the relationship between clinical nurses' nursing professionalism and clinical decision-making ability and to use it as basic data for improving clinical decision-making ability. The study subjects were 173 clinical nurses at a general hospital in a region, and data were collected from September 15 to October 13, 2023. Data were analyzed using the SPSS/AMOS 23.0 program to verify the mediating effect by analyzing the causal relationship between the research variables and the bootstrapping estimation method, and t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, and hierarchical regression were performed. The results of the study include: First, the appropriateness of the causal model between clinical nurses' nursing professionalism, clinical decision-making ability, critical thinking disposition, and core nursing skill performance confidence was valid. Second, critical thinking disposition showed a partial mediating effect in the relationship between nursing professionalism and clinical decision-making ability. Third, as a result of verifying the dual mediating effect, the indirect effect of critical thinking disposition was greater than the indirect effect of critical thinking disposition and core nursing skill performance confidence, indicating that the single mediating effect was greater than the dual mediating effect. Therefore, it was verified that fostering high nursing professionalism in clinical nurses can improve clinical decision-making ability, and in particular, strengthening critical thinking disposition is more effective.

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참고문헌

  1. H. M. Jenkins, "Improving clinical decision making in nursing", Journal of Nursing Education, Vol.24, No.6 pp. 242-243, (1985). https://doi.org/10.3928/0148-4834-19850601-07
  2. M. L. Johansen, J. L. O'Brien, "Decision making in nursing practice a concept analysis", Journal of Nursing Forum, Vol.51, No.1 pp. 40-48, (2015). https://doi.org/10.1111/nuf.12119
  3. M. J. Kim, M. O. Kim, "Mediating effect of job satisfaction and moderating effect of burnout in the relationship between clinical decision-making ability and nursing performance", The Journal of Learner-Centered Curriculum and Instruction, Vol.21, No.19 pp. 525-538, (2021). https://doi.org/10.22251/jlcci.2021.21.19.525
  4. S. E. Lee, Y. J. Ha, "Effects of Critical Thinking Disposition and Clinical Decision Making Ability of Nurse in Tertiary Hospitals on Medication Safety Competency", Korean society for Wellness, Vol.17, No.2 pp. 73-80, (2022). http://dx.doi.org/10.21097/ksw.2022.5.17.2.73
  5. M. Y. Kim, E. H. Choi, "Effects of Critical Thinking Disposition, Knowledge Sharing Activity and Professional Work Environment on Clinical Decision-making Ability at General Hospital Nurses", The Journal of Muscle and Joint Health, Vol.30, No.1 pp. 48-57, (2023). http://dx.doi.org/10.5953/JMJH.2023.30.1.48
  6. M. Y. Kim, J. H. Kim, S. J. Choi, "Mediating Effects of Role Clarity between Clinical Decision-Making Abilities and Job Stress for Advanced Practice Nurses at Tertiary Hospitals", Journal of Korean Critical Care Nursing, Vol.15, No.2 pp. 27-38, (2022). https://doi.org/10.34250/jkccn.2022.15.2.27
  7. Y. L. Son, E. H. Kim, "Impacts of Professional Autonomy and Role Conflict Clinical Decision-Making Ability of Nurses on Comprehensive Nursing Care Service Wards", Journal of Korean Academia-Industrial cooperation Society, Vol.19, No.7 pp. 463-473, (2018). https://doi.org/10.5762/KAIS.2018.19.7.463
  8. M. J. Kim, H. S. Jeong, "Influence of the Nursing Work Environment on the Clinical Decision-Making Ability of Clinic Nurses: The Mediating Effect of Nursing Professionalism and Communication Competence", Journal of Korean Entertainment, Vol.16, No.8 pp. 327-339, (2022). https://doi.org/10.21184/jkeia.2023.4.17.3.363
  9. E. J. Yeun, Y. M. Kwon, O. H. Ahn, "Development of a Nursing Professional Value Scale", Journal of Korean Academy of Nursing, Vol.35, No.6 pp. 1091-1100, (2005). https://doi.org10.4040/jkan.2005.35.6.1091
  10. S. Y. Yeo, I. J. Song, O. H. Ahn, "Factors Affecting on Nursing Service Quality of Small and Medium-sized Hospital Nurses", Journal of the Korean Convergence Society, Vol.13, No.2 pp. 331-340, (2022). https://doi.org/10.15207/JKCS.2022.13.02.331
  11. E. A. Lee, M. J. Park, "Factors Related to Patient Safety Nursing Activities of Comprehensive Nursing Care Service Ward Nurses", The Journal of the Korea Contents Association, Vol.23, No.7 pp. 304-313, (2023). https://doi.org/10.5392/JKCA.2023.23.07.304
  12. J. W. Kim, H. J. Park, "The Influence of Knowledge on Standard Precautions, Nursing Professionalism, and Organizational Culture for Infection Control on Hospital Nurses' Performance with Guidelines for Standard Precautions", The Korean journal of fundamentals of nursing, Vol.30, No.2 pp. 225-235, (2023). https://doi.org/10.7739/jkafn.2022.30.2.225
  13. S. Y. Jung, H. J. Park, "Factors Influencing Nursing Professionalism on the Nursing Performance in Intensive Care Unit Nurses", The Korean journal of fundamentals of nursing, Vol.29, No.4 pp. 451-460, (2022). http://dx.doi.org/10.7739/jkafn.2022.29.4.451
  14. Y. M. Jung, B. B. Lee, S. W. Hwang, M. J. Lee, "Influences of Nursing Professionalism, Resilience, and Self-leadership on Clinical Competency of Nursing Officers in Military Hospitals", Korean Journal of Military Nursing Research, Vol.40, No.3 pp. 14-28, (2022). http://dx.doi.org/10.31148/kjmnr.2022.40.3.14
  15. W. Y. Park, T. W. Lee, "Factors Affecting Political Competency of Advanced Practice Nurses", Journal of Korean Academy of Nursing Administration, Vol.29, No.3 pp. 246-257, (2023). https://doi.org/10.11111/jkana.2023.29.3.246
  16. H. J. Jang, Y. J. Koo, S. Y. Hong, J. E. Park, S. J. Bae, S. J. Park, "Influences of Nursing Professionalism and Nursing Intention on Disaster Nursing Competency among Nurses when a Disaster Occurs in a Community: Response to COVID-19", Journal of Fisheries and Marine Sciences Education, Vol.35, No.2 pp. 276-290, (2023). https://doi.org/10.13000/JFMSE.2023.4.35.2.276
  17. H. S. Jeong, E. H. Park, "The Effects of General Hospital Nurses Sense of Calling, Social Responsibility, and Nursing Professionlism on Subjective Happiness", Journal of Korean Entertainment, Vol.17, No.7 pp. 353-363, (2023). https://doi.org/10.21184/jkeia.2023.10.17.7.353
  18. N. C. Facione, P. A. Facione, & C. A. Sanchez., "Critical thinking disposition as a measure of competent clinical judgement: the development of the California critical thinking disposition inventory", Journal of Nursing Education, Vol.33, No.8 pp. 345-350, (1994). https://doi.org/10.21184/jkeia.2023.10.17.7.353
  19. S. H. Yoon, H. J. Kim, "The influences of Tansformational Leadership of Nurse manager, Safety Climate, and Critical Thinking Disposition on Medication Safety Competence in Hospital Nurse", The Journal of Learner-Centered Curriculum and Instruction, Vol.23, No.16 pp. 557-566, (2023). http://dx.doi.org/10.22251/jlcci.2023.23.16.557
  20. J. S. Yi, H. J. Kim, C. S. Park, "Influence Factors of Critical Thinking Disposition and Core Basic Nursing Skills Achievement on Clinical Competence in Nursing Students ", Journal of Oil & Applied Science, Vol.35, No.4 pp. 1359-1368, (2018). http://dx.doi.org/10.12925/jkocs.2018.35.4.1359
  21. Y. H. Jeong, S. H. Choi, "The Effects of Empathic Ability and Critical Thinking Disposition on Nursing Work Performance in Clinical Nurses", The Korean Society of Living Environmental System, Vol.30, No.6 pp. 594-603, (2023). https://doi.org/10.21086/ksles.2023.12.30.6.594
  22. Korean Accreditation Board of Nursing Education, The Guideline of Nursing Education Accreditation, Korean Accreditation Board of Nursing Education, (2022).
  23. A. Bandura. A., "Self-effocacy : Toward a unnifying theory of behavioral change", Psychological Review, Vol.84 pp. 191-215, (1977). https://doi.org/10.1016/0146-6402(78)90002-4
  24. J. Moneva, S. M. Tribunalo, "Students' Level of Self-confidence and Performance Tasks", Asia Pacific Journal of Academic Research in Social Sciences, Vol.5, No.1 pp. 42-48, (2020). https://research.lpubatangas.edu.ph/wp-content/uploads/2020/06/APJARSS-2020.006.pdf
  25. Y. N. Jeong, J. Y. Kim, E. H. Bae, "The Effect of Perception of Importance, Problem Solving Process and Self Confidence in the Performance of Core Nursing Skills of Nursing Students", Journal of Korea Academia-Industrial cooperation Society, Vol.21, No.8 pp. 379-387, (2020). https://doi.org/10.5762/KAIS.2020.21.8.379
  26. S. E. Chung, E. H. Kim, S. J. Shin, "New Clinical Nurses' Experiences with Learning Transfer of Core Basic Nursing Skill", Journal of Qualitative Research, Vol.17, No.1 pp. 50-59, (2016). https://doi.org/10.22284/QR.2016.17.1.50
  27. Y. J. Koo, "Correlations among Self-directed Learning, Confidence of Performance in Core Nursing Skills, Clinical Learning Environment and Clinical Competency in Nursing Students", The Journal of the Convergence on Culture Technology, Vol.9, No.1 pp. 501-511, (2023). https://doi.org/10.17703/JCCT.2023.9.1.501
  28. S. Y. Oh, "Development of Clinical Decision-Making Ability Scale for Hospital Nurses in Korea", Doctoral dissertation, Kyung Hee University, (2023).
  29. I. S. Kwon, K. E. Lee, G. D. Kim, Y. H. Kim, K. M. Park, H. S. Park, S. K. Sohn, W. S. Lee, K. S. Jang, "Development of a Critical Thinking Disposition Scale for Nursing Students", Journal of Korean Academy of Nursing, Vol.36, No.6 pp. 950-958, (2006). https://doi.org/10.4040/jkan.2006.36.6.950
  30. S. S. Bang, I. O. Kim, "Relationship among Essentials of Fundamental Nursing Skills Performance, Stress from Work and Work Capability of New Clinical Nurses", The Journal of Korean Academic Society of Nursing Education, Vol.20, No.4 pp. 628-638, (2014). https://doi.org/10.5977/JKASNE.2014.20.4.628
  31. M. S. Kim, "The Influences of Confidence in Performing Core Nursing Skills, Problem-Solving Skills and Task-Performance Skills on the Field Adaptation of New Clinical Nurses", Master's Thesis, Catholic University of Busan, (2023).
  32. A. F. Hayes, M. Scharkow., "The Relative Trustworthiness of Inferential Tests of the Indirect Effect in Statistical Mediation Analysis: Does Method Really Matter?", Psychological Science, Vol.24, No.10 pp. 1918-1927, (2013). https://doi.org/10.1177/095679761348018
  33. H. J. Park, M. Yu., "Effects of Fatigue, Nursing Professionalism, and Nursing Work Environment on Nursing Intention for COVID-19 Patients among Nurses in a Designated COVID-19 Hospital", The Journal of Korean Nursing Administration Academic Society, Vol.29, No.3 pp. 223-233, (2023). https://doi.org/10.11111/jkana.2023.29.3.223
  34. H. J. Hwang, "The Effects of Clinical Nurses' Empathy Ability and Cognition of Nursing Organizational Culture, and Clinical on Decision Making-Ability", The Journal of Learner-Centered Curriculum and Instruction, Vol.23, No.18 pp. 229-241, (2023). https://doi.org/10.22251/jlcci.2023.23.18.229
  35. M. Bijani, S. Abedi, S. Karimi, B. Tehranineshat, "Major challenges and barriers in clinical decision-making as perceived by emergency medical services personnel: a qualitative content analysis", BMC emergency medicine, Vol.21, pp. 1-12, (2021). https://doi.org/10.1186/s12873-021-00408-4
  36. H. Li, B. Cheng, X. P. Zhu., "Quantification of burnout in emergency nurses: a systematic review and meta-analysis", Internal Emergency Nursing. Vol.39, pp. 46-54, (2018). https://doi.org/10.1016/j.ienj.2017.12.005
  37. N. J. Je, "The Influence of Moral Behavior, Moral Anguish, and Critical Thinking Tendency on Clinical Decisionmaking Ability in Nurse", Journal of Digital Convergence, Vol.19, No.2 pp. 275-288, (2021). https://doi.org/10.14400/JDC.2021.19.2.275
  38. K. Y. Shin, S. J. Shin, "Critical thinking disposition, job competency, and educational needs of home visiting nurses in the long-term care insurance", Journal of Korean Gerontological Nursing, Vol.23, No.1 pp. 54-65, (2021). https://doi.org/10.17079/jkgn.2021.23.1.54
  39. W. J. Lee, C. L. Chae, B. R. Kim, E. J. Kim, J. S. Kim, H. W. Kim, H. J. Kim, S. Y. Park, "Relationship Between Clinical Reasoning Competence, Critical Thinking Propensity and Confidence in Performing Core Basic Nursing Skills of Nursing Students", Journal of Industrial Convergence, Vol.21, No.4 pp. 81-89, (2023). https://doi.org/10.22678/JIC.2023.21.4.081
  40. J. B. Yoo, M. J. Hong, J. C. De Gagne, "Factors Affecting Clinical Competency of Korean Nurses in the Perianesthesia Setting", Journal of The Korean Data Analysis Society, Vol.19, No.6 pp. 3345-3359, (2017). http://dx.doi.org/10.37727/jkdas.2017.19.6.3345