• 대한간호학회지
• /
• 제34권2호
• /
• pp.270-277
• /
• 2004

Purpose: The purpose of this study was to investigate the relationship between decision-making factors(theoretical knowledge, expertise, empowerment, intuition) and participation in proportion to nurses's clinical experience. Method: Data was collected by quota sampling from July 10, 2001 to August 22, 2001 from 132 clinical nurses who work for 3 General hospitals. Data was analyzed using SPSSWIN 10.0 with crosstab, ANOVA, and stepwise multiple regression. Result: Expertise(F=34.347, p=.000), empowerment(F=29.316, p=.000), and participation(F=3.276, p=.041) were significantly different among 3 clinical experience groups. Clinical experience correlated with expertise(r=.551, p=.000) and empowerment(r=.492, p=.000), and Decision-making participation also correlated with expertise(r=.351, p=.000) and empowerment(r=.265, p=.002). Decision-making participation is effected by theoretical knowledge(under 3.00yr clinical experience), expertise(3.01-5.00yr), and empowerment(above 5.01yr). Conclusion: These findings indicate that factors(theoretical knowledge, expertise, or empowerment) on decision-making participation varies as nurses's clinical experience differs. Therefore, decision-making needs bilateral agreement between staff nurses and nurse managers rather than the responsibility of one.

• 대한간호학회지
• /
• 제40권6호
• /
• pp.892-902
• /
• 2010

Purpose: This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making. Methods: A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used. Results: Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses. Conclusion: In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses’ participation in clinical decision making in cases where they can identify and solve the patient health problems.

• Child Health Nursing Research
• /
• 제24권1호
• /
• pp.9-17
• /
• 2018

Purpose: The purpose of this descriptive survey study was to characterize the relationship between clinical decision-making and job satisfaction among pediatric nurses and to elucidate the mediating effects of the nurse-parent partnership on that relationship. Methods: The subjects of the study were 174 nurses who had worked in a pediatric ward in a university hospital, general hospital, or children's hospital. Data were collected from June 20, 2016 to August 10, 2016 and analysed using descriptive statistics, the t-test, analysis of variance, the Pearson correlation coefficient, and three-step mediated regression analysis in SPSS version 22.0 for Windows. Results: The nurse-parent partnership had significant effects on clinical decision-making and job satisfaction, with an explanatory power of 19% and 26%, respectively. The nurse-parent partnership had a partial mediating effect on the relationship between clinical decision-making and job satisfaction (Sobel test: Z=4.31, p<.001). Conclusion: The nurse-parent partnership had a partial mediating effect on the relationship between clinical decision-making and job satisfaction among pediatric nurses. Therefore, in order to improve the job satisfaction of pediatric nurses, it is necessary to develop effective educational programs and strategies to address their clinical decision-making and their experiences of the nurse-parent partnership.

• 한국산학기술학회논문지
• /
• 제18권3호
• /
• pp.501-512
• /
• 2017

본 연구의 목적은 임상간호사의 윤리적 의사결정 자신감 영향요인을 파악하고자 시도되었다. 임상간호사 125명을 대상으로 구조화된 설문지를 실시하여 자료를 수집하였다. 자료수집 기간은 2014년 11월 10일부터 동년 11월 29일까지였다. 자료분석은 SPSS/WIN 21.0. 프로그램을 이용하여 실수와 백분율 평균, 평균평점과 표준편차, t-test, ANOVA와 Scheffe's test, Pearson's correlation coefficients 및 stepwise multiple regression으로 분석하였다. 임상간호사의 제 특성에 따른 윤리적 딜레마 정도는 연령(F=3.14, p=.017)에 따라 통계적으로 유의한 차이가 있었으며, 윤리적 의사결정 자신감 정도는 교육정도(F=7.36, p<.001), 임상경력(t=-2.31, p=.024), 윤리강령 인지여부(t=3.17, p=.002)에 따라 통계적으로 유의한 차이가 있었다. 윤리적 의사결정 자신감은 윤리적 가치관과 정적인 상관관계를 보여 주었다(r=.25, p<.001). 윤리적 의사결정 자신감은 윤리적 가치관, 교육정도, 윤리강령 인지여부에 따라서 유의한 차이가 있었다. 전체 설명력은 15%였으며, 다른 영향요인 보다 가장 큰 영향력은 윤리적 가치관 (${\beta}=.28$) 으로 나타났다. 따라서 임상간호사의 윤리적 의사결정 자신감을 향상시키기 위해서는 윤리적 가치관, 교육정도, 윤리강령에 대한 지식 정도를 향상시켜야 할 필요가 있을 것이다. 따라서 임상간호사의 윤리적 의사결정 자신감을 향상시키기 위한 프로그램의 실행이 필요하다.

• 간호행정학회지
• /
• 제4권1호
• /
• pp.33-71
• /
• 1998

본 연구의 목적은 한국의 간호사들이 행하는 간호중재를 규명하는 것이다. 연구대상은 한국의 2 병원에서 일하는 수 간호사와 평 간호사를 포함한 443면의 간호사이며, 연구도구는 Iowa Intervention Project Team 이 개발한 336 문항의 5점 척도로 이루어진 "간호중재"설문지를 사용하였다. 5점 척도는 다음과 같다 : (a) 거의 행하지 않는다 : (b) 거의 한달에 한번 행한다 : (c) 거의 일주일에 한 번 행한다 : (d) 거의 하루에 한 번 행한다 : (e) 하루에 여러 번 행한다. 한국자료를 위해 설문지는 본 연구자에 의해 한글로 번역되었고, Back-translation을 이용하여 한글로 번역한 설문지는 다시 bilingual nurse에 의해 영어로 옮겨졌고, 마지막으로 영어로 옮겨진 설문지를 원래의 영문으로 된 설문지와 비교한 후에(Equivalence Test) 수정${\cdot}$보완하여 사용하였다. 한국 간호사들은 336 간호중재 모두를 행하고 있으며, 21개의 간호중재가 적어도 하루에 한 번 정도는 이루어지고 있었다. 간호사들은 "생리적 : 복합영역"에 속하는 간호중재를 가장 빈번하게 행하였고, 이 중에서 "비경구적 투약"은 일주일에 거의 11번 정도로 가장 많이 행하여졌다. 가장 적게 행하는 간호중재는 "동물이용요법"이었다. 간호사들은 교육을 많이 받을수록, 임상경험이 많을수록 더 많은 간호중재를 빈번하게 행했다. 특히, 석사학위를 받은 간호사는 "행위 영역"에 속한 간호중재를 더 많이 행했는 데, 예를 들면 "적극적 경청", "적응 증진", "의사결정지지"등이다. 또한 4년제 대학을 졸업한 간호사들은 "생리적 : 복합영역"에 속한 간호중재들을 전문대학을 졸업한 간호사보다 더 많이 행했는 데, 예를 들면, "뇌부종 관리", "반사 장애 관리", "기구를 사용한 호흡"등이다. 10년 이상의 경험을 가진 간호사들은 "행위 영역"에 속한 간호중재를 임상 경험이 1년 미만이거나 또는 1-5년 사이의 경험을 가진 간호사보다 더 많이 행했는 데, 예를 들면, "죄책감 극복 증진", "진실 말하기"등이다. 또한 6-10년 사이의 임상경험을 가진 간호사들은 "자가 간호영역"에 속한 "옷 입히기", "두발 간호", "구강건강 유지" 등을 임상경험이 1년 미만인 간호사들보다 더 빈번하게 행했다. 이 연구는 간호중재 규명이 간호원가 산출을 위한 연구와, 간호의 질 향상을 위한 연구, 간호지식 탐구를 위한 연구에 공헌할 것을 기대한다.

• 한국간호교육학회지
• /
• 제22권3호
• /
• pp.304-315
• /
• 2016

Purpose: The purpose of this study was to explore the relationships of critical thinking disposition (CT), nursing work environment (NWE), and clinical decision making ability among nurses. Methods: A cross-sectional, descriptive study design was conducted on 192 nurses who had worked for more than six months in five general hospitals. A self-reported questionnaire was used to collect data, which included demographics, CT, NWE, and clinical decision making ability. Results: The mean score of CT was 3.5. The highest score was on the objectivity of CT and the lowest on systematicity. The mean score of NWE was 2.3. The highest score was on the collegial nurse-physician relations of NWE and the lowest on the staffing and resource adequacy. The mean score of clinical decision making ability was 3.3. In hierarchical multiple regression, affecting factors on clinical decision making ability were CT and NWE. Conclusion: The findings showed that clinical decision making ability is associated with CT and NWE. To improve clinical decision making ability, it is important to improve CT. In addition, it should be considered to improve NWE where the nurses can make a decision with their job through critical thinking.

• 근관절건강학회지
• /
• 제30권1호
• /
• pp.48-57
• /
• 2023

Purpose: The purpose of this study was to examine nurses' critical thinking disposition and knowledge sharing activity and professional work environment on clinical decision-making ability. Methods: The data collection period for this study was from May 24 to May 31, 2021. The data were collected from 167 nurses who consented to participate in this study and have worked for more than one year at general hospital in Seoul. The data were analyzed using the SPSS/WIN 25.0 program. Results: A significant positive correlation was found between clinical decision-making ability and critical thinking disposition, knowledge sharing activity, and a professional work environment. Critical thinking disposition (β=.32, p<.001), knowledge sharing activitiy (β=.24, p=.002) and professional work environment (β=.20, p=.006) had a significant effect on clinical decision-making ability. These factors explained 35.5% of clinical decision-making ability (F=24.22, p<.001). Conclusion: Therefore, in order to develop the critical thinking disposition of nurses, development of systematic educational programs and strategies for practical application are needed. Through this, nurses can improve the professional decision-making ability and clinical performance ability.

• 대한간호학회지
• /
• 제49권5호
• /
• pp.601-612
• /
• 2019

Purpose: The purpose of this study was to construct and test a hypothetical model of clinical decision-making ability of nurses based on the Decision Making Process model and the Cognitive Continuum theory. Methods: The data were collected from nurses working at 11 hospitals in Busan, Daejeon, and South Gyeongsang Province from June 30 to August 1, 2017. Finally, the data from 323 nurses were analyzed. Results: The goodness-of-fit of the final model was at a good level ($x^2/df=2.46$, GFI=.87, AGFI=.84, IFI=.90, CFI=.90, SRMR=.07, RMSEA=.07) and 6 out of 10 paths of the model were supported. The clinical decision-making ability was both directly and indirectly affected by task complexity and indirectly affected by experiences, autonomy, and work environment. Specifically, it was strongly directly affected by analytical competency but was insignificantly affected by intuitive competency. These variables accounted for 66.0% of clinical decision-making ability. Conclusion: The nurses' clinical decision-making ability can be improved by improving their analytical competency. Therefore, it is necessary to organize nursing work, create a supportive work environment, and develop and implement various education programs.

• 대한간호학회지
• /
• 제37권6호
• /
• pp.863-871
• /
• 2007

Purpose: The purpose of this study was to investigate the factors influencing nurses' clinical decision making focusing on critical thinking disposition. Methods: The subjects of this study consisted of 505 nurses working at one of the general hospitals located in Seoul. Data was collected by a self-administered questionnaire between December 2006 and January 2007. Data was analyzed by one way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS Win 14.0. Results: The mean scores of critical thinking disposition and clinical decision making were 99.10 and 134.32 respectively. Clinical decision making scores were significantly higher in groups under continuing education, with a master or higher degree, with clinical experience more than 5 years, or with experts. Critical thinking disposition and its subscales have a significant correlation with clinical decision making. Intellectual eagerness/curiosity, prudence, clinical experience, intellectual honesty, self-confidence, and healthy skepticism were important factors influencing clinical decision making(adjusted $R^2=33%$). Conclusion: Results of this study suggest that various strategies such as retaining experienced nurses, encouraging them to continue with education and enhancing critical thinking disposition are warranted for development of clinical decision making.

• 간호행정학회지
• /
• 제17권4호
• /
• pp.443-450
• /
• 2011

Purpose: This study was a descriptive correlation study to increase understanding of, and relationships among critical thinking disposition, clinical decision making and job satisfaction of cancer center nurses. Method: The participants in this study were 150 nurses working in one cancer center located in Gyeonggi Province. The statistic program, SPSS WIN17.0 was used for data analysis and data were analyzed using t-test, ANOVA, and Pearson correlation. Results: The critical thinking disposition of the participants showed statistically significant differences according to areas of practice (F=4.426, p=.005), and current position (F=9.346, p=.000). For clinical decision making of the participants, statistically significant differences were found according to current position (F=10.667, p=.000). Furthermore, for job satisfaction, there were statistically significant differences according to income (F=6.779, p=.002), length of career (F=2.701, p=.033) and current position (F=5.423, p=.005). There were significant positive correlations for critical thinking disposition with clinical decision making, and with job satisfaction. Conclusions: The results of the study indicate that to improve clinical decision making and job satisfaction of cancer center nurses, it is necessary to increase critical thinking disposition. To make this change, appropriate programs are needed to increase critical thinking and clinical decision making of general cancer center nurses.