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Factors Influencing Nursing Performance of Intensive Care Unit Nurses: Role of Clinical Reasoning Competence, Positive Psychological Capital, and Nursing Work Environment

중환자실 간호사의 임상추론역량, 긍정심리자본, 간호근무환경이 간호업무성과에 미치는 영향

  • Heo, MiRim (Dong-A University Hospital) ;
  • Jang, Haena (College of Nursing, Dong-A University)
  • 허미림 (동아대학교병원) ;
  • 장해나 (동아대학교 간호학부)
  • Received : 2024.05.04
  • Accepted : 2024.06.20
  • Published : 2024.06.30

Abstract

Purpose : This study aimed to investigate the impact of clinical reasoning competence, positive psychological capital, and nursing work environment on nursing performance of intensive care unit (ICU) nurses in tertiary general hospitals. Methods : Data were collected from 169 ICU nurses in tertiary general hospitals in Busan, South Korea, from July 27 to August 15, 2023, using a self-report questionnaire. After excluding 12 questionnaires with insufficient responses, 157 responses were analyzed. Descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis were employed. Results : Factors influencing nursing performance included clinical reasoning competence (β=.51, p <.001), hope as a subfactor of positive psychological capital (β=.31, p <.001), and the nursing foundations for quality of care in the nursing work environment (β=.21, p <.001). The explanatory power of the regression model was 62% (F=87.41, p <.001). Conclusion : The study underscores the importance of improving clinical reasoning competence among ICU nurses to enhance nursing performance and foster a hopeful attitude through reflective practices and personal growth. Organizational interventions, such as educational and psychological support programs, along with creating a supportive nursing environment, are crucial for improving nursing performance among intensive care unit nurses.

Keywords

References

  1. Ko YK, Lee TW, Lim JY. Development of a performance measurement scale for hospital nurses. Journal of Korean Academy of Nursing. 2007;37(3):286-94. https://doi.org/10.4040/jkan.2007.37.3.286
  2. Lake ET, Sanders J, Duan R, Riman KA, Schoenauer KM, Chen Y. A meta-analysis of the associations between the nurse work environment in hospitals and 4 sets of outcomes. Medical Care. 2019;57(5):353-61. https://doi.org/10.1097/mlr.0000000000001109
  3. Shin NY, Yu S, Kang SS, Lee SS, Park MJ, Lee D, Nam SM. Influence of nurse manager and peer group caring behaviors as perceived by nurses on organizational socialization and nursing performance. Journal of Korean Academy of Nursing Administration. 2020;26(2):110-9. https://doi.org/10.11111/jkana.2020.26.2.110
  4. Jung, SY. Park, HJ. Factors influencing nursing professionalism on the nursing performance in intensive care unit nurses. Journal of Korean Academy of Fundamentals of Nursing. 2022; 29(4), 451-60. https://doi.org/10.7739/jkafn.2022.29.4.451
  5. Kwon EO, Lee MH, Jeong SH, Kim HS. Effects of nurse-physician collaboration on nursing performance and organizational commitment in intensive care unit nurses. Journal of Korean Academy of Nursing Administration. 2019;25(3):186-97. https://doi.org/10.11111/jkana.2019.25.3.186
  6. Henriksen KF, Hansen BS, Woien H, Tonnessen S. The core qualities and competencies of the intensive and critical care nurse, a meta-ethnography. Journal of Advanced Nursing. 2021; 77(12):4693-710. https://doi.org/10.1111/jan.15044
  7. Alfaro-Lefevre R. Critical thinking, clinical reasoning, and clinical judgment: A practical approach. 7th ed. Philadelphia: Elsevier Health Sciences; 2019.
  8. Simmons B. Clinical reasoning: Concept analysis. Journal of Advanced Nursing. 2010;66(5):1151-8. https://doi.org/10.1111/j.1365-2648.2010.05262.x
  9. Joung JW, Han JW. Validity and reliability of a Korean version of nurse clinical reasoning competence scale. Journal of the Korea Academia-Industrial cooperation Society. 2017;18(4): 304-10. https://doi.org/10.5762/KAIS.2017.18.4.304
  10. Liu Z, Sun N, Chen C, Zhang G, Hu Y. Comparative study of clinical reasoning competence and self-directed learning competence in nurses across varied years of experience. Journal of Clinical Nursing. 2024. Forthcoming. https://doi.org/10.1111/jocn.17051
  11. Liou S, Liu H, Tsai H, Tsai Y, Lin Y, Chang C, et al. The development and psychometric testing of a theory-based instrument to evaluate nurses' perception of clinical reasoning competence. Journal of Advanced Nursing. 2016;72(3):707-17. https://doi.org/10.1111/jan.12831
  12. Go YH, Lee MH. Effect of resilience and positive psychological capital on the professional quality of life in hospital nurses. Journal of the Korea Convergence Society. 2021;12(12):551-62. https://doi.org/10.15207/JKCS.2021.12.12.551
  13. Lee SN, Kim JA. Prediction model for nursing work outcome of nurses: Focused on positive psychological capital. Journal of Korean Academy of Nursing Administration. 2020;50(1):1-13. https://doi.org/10.4040/jkan.2020.50.1.1
  14. Youssef CM, Luthans F. Positive organizational behavior in the workplace: The impact of hope, optimism, and resilience. Journal of Management. 2007;33(5):774-800. https://doi.org/10.1177/0149206307305562
  15. Lee SK. Effects on nursing performance by positive psychological Capital [master's thesis]. Seoul: Sungkyunkwan University; 2019. p. 1-59.
  16. Lee SN, Kim JA. Concept analysis of positive psychological capital. Journal of Korean Academy of Nursing Administration. 2017;23(2):181-90. https://doi.org/10.11111/jkana.2017.23.2.181
  17. Lake ET. Development of the practice environment scale of the nursing work index. Research in Nursing and Health. 2002;25(3):176-88. https://doi.org/10.1002/nur.10032
  18. Goktepe N, Turkmen E, Fener I, Yalcin B, Sarikose S. The effect of nurses' individual, professional and work environment characteristics on their perception of quality of nursing care. Journal of Health and Nursing Management. 2021;8(2):139-47. http://doi.org/10.5222/shyd.2021.54366
  19. Kramer M, Brewer BB, Maguire P. Impact of healthy work environments on new graduate nurses' environmental reality shock. Western Journal of Nursing Research. 2013;35(3):348-83. https://doi.org/10.1177/0193945911403939
  20. Kim SH, Park SK, Lee MH. Effect of a nursing practice environment on nursing job performance and organizational commitment: Focused on the mediating effects of job embeddedness. Journal of Korean Academy of Nursing Administration. 2019;25(3):208-19. http://doi.org/10.11111/jkana.2019.25.3.208
  21. Luthans F, Avolio BJ, Avey JB, Norman SM. Positive psychological capital: Measurement and relationship with performance and satisfaction. Personnel Psychology. 2007;60(3):541-72. https://doi.org/10.1111/j.1744-6570.2007.00083.x
  22. Lee DS, Choi YD. A Study on Antecedents and Consequences of Positive Psychological Capital in Organizations. Korean Management Review. 2010;39(1):1-28.
  23. Kim IS, Seo RB, Kim BN, Min AR. The Effects of positive psychological capital, organizational commitment, customer orientation in clinical nurses. Journal of Korean Academy of Nursing Administration. 2015;21(1):10-9. https://doi.org/10.11111/jkana.2015.21.1.10
  24. Cho EH, Choi MN, Kim EY, Yoo IY, Lee NJ. Construct validity and reliability of the korean version of the practice environment scale of nursing work index for korean nurses. Journal of Korean Academy of Nursing. 2011;41(3):325-32. https://doi.org/10.4040/jkan.2011.41.3.325
  25. Curran PJ, West SG, Finch JF. The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods. 1996;1(1):16-29. https://.doi.org/10.1037//1082-989x.1.1.16
  26. Kang MJ, Chung KH. Perception of Healthcare Accreditation System on Patient Safety Management Activities and Nursing Performance of Regional Public Hospital Nurses. Journal of Korean Academy of Nursing Administration. 2017;23(4):416-26. https://doi.org/10.11111/jkana.2017.23.4.416
  27. Lee SJ. Emotional intelligence, interpersonal relationship and nursing performance among clinical nurses [master's thesis]. Suwon: Ajou University; 2013. p. 1-62.
  28. Choi EB, Yoo KH. The influence of social support and health promotion behaviors on nursing work performance among nurses. The Journal of Korean Academic Society of Nursing Education. 2021;27(3):333-41. https://doi.org/10.5977/jkasne.2021.27.3.333
  29. Hahn SW, Chun Y. Convergence factors influencing clinical reasoning competency of nursing students. Journal of the Korea Convergence Society. 2020;11(10):181-6. https://doi.org/10.15207/JKCS.2020.11.10.181
  30. Jeon SM, Kim MY. The effects of college simulation practical education on new nurses' clinical competence. Journal of Learner-Centered Curriculum and Instruction. 2023;23(15):869-79. https://doi.org/10.22251/jlcci.2023.23.15.869
  31. Griffits S, Hines S, Moloney C, Ralph N. Characteristics and processes of clinical reasoning in nurses and factors related to its use: a scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports. 2017;15(12):2832-6. https://doi.org/10.11124/jbisrir-2016-003273
  32. Higgs J. Developing clinical reasoning capabilities. Clinical education for the Health Professions. 2023;1571-87. https://doi.org/10.1007/978-981-15-3344-0_103
  33. Linn A, Khaw C, Kildea H, Tonkin A. Clinical reasoning - a guide to improving teaching and practice. Australian Family Physician. 2012;41(1-2):18-20.
  34. Kang H, Kang HY. The effects of simulation-based education on the clinical reasoning competence, clinical competence, and educational satisfaction. Journal of the Korea Academia-Industrial cooperation Society. 2020;21(8):107-14. https://doi.org/10.5762/kais.2020.21.8.107
  35. Daniel M, Rencic J, Durning SJ, Holmboe E, Santen SA, Lang V, et al. Clinical reasoning assessment methods: A scoping review and practical guidance. Academic Medicine. 2019;94(6):902-12. https://doi.org/10.1097/acm.0000000000002618
  36. Bringsvor HB, Bentsen SB, Berland A. Sources of knowledge used by intensive care nurses in Norway: An exploratory study. Intensive and Critical Care Nursing. 2014 ;30(3):159-66. https://doi.org/10.1016/j.iccn.2013.12.001
  37. Alessandri G, Consiglio C, Luthans F, Borgogni L. Testing a dynamic model of the impact of psychological capital on work engagement and job performance. Career Development International. 2018;23(1):33-47. https://doi.org/10.1108/cdi-11-2016-0210
  38. Ali I, Khan MM, Shakeel S, Mujtaba BG. Impact of psychological capital on performance of public hospital nurses: the mediated role of job embeddedness. Public Organization Review. 2021;22(1):135-54. https://doi.org/10.1007/s11115-021-00521-9
  39. Park SJ. Effect of the positive psychological capital and professionalism on the nursing performance among perioperative Nurse [master's thesis]. Seoul. Han yang University; 2016. p. 1-79.
  40. Luthans KW, Lebsack SA, Lebsack RR. Positivity in healthcare: relation of optimism to performance. Journal of Health Organization and Management. 2008;22(2):178-88. https://doi.org/10.1108/14777260810876330
  41. Youssef CM, Luthans F. Positive organizational behavior in the workplace: The impact of hope, optimism, and resilience. Journal of Management. 2007;33(5):774-800. https://doi.org/10.1177/0149206307305562
  42. Luthans F, Jensen SM. Hope: A New Positive Strength for Human Resource Development. Human Resource Development Review. 2002;1(3):304-22. https://doi.org/10.1177/1534484302013003
  43. Snyder CR. Hope theory: Rainbows in the Mind. Psychological Inquiry. 2002 ;13(4):249-75. https://doi.org/10.1207/s15327965pli1304_01
  44. Gillespie BM, Chaboyer W, Wallis M, Grimbeek P. Resilience in the operating room: developing and testing of a resilience model. Journal of Advanced Nursing. 2007 ;59(4):427-38. http://doi.org/10.1111/j.1365-2648.2007.04340.x
  45. Nasurdin AM, Ling TC, Khan SN. The role of psychological capital on nursing performance in the context of medical tourism in malaysia. International Journal of Business and Society. 2018;19(3):748-61.
  46. Sarikose S, Goktepe N. Effects of nurses' individual, professional and work environment characteristics on job performance. Journal of Clinical Nursing. 2022;31(5-6):633-41. http://doi.org/10.1111/jocn.15921
  47. Sharma J, Dhar RL. Factors influencing job performance of nursing staff: mediating role of affective commitment. Personnel Review. 2016;45(1):161-82. http://doi.org/10.1108/pr-01-2014-0007