• 가정간호학회지
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• 제21권2호
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• pp.147-155
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• 2014

Purpose: Clinical decision-making carried out by nurses is a complex process that influences the quality of care provided and various patient outcomes. This study examined the relationship between critical thinking disposition and clinical decision-making abilities in home health advanced practice nurses. Method: The study had a non-experimental correlational design. Data were collected from 100 home health advanced practice nurses in 20 hospitals. Results: The mean critical thinking disposition score was $3.69{\pm}.39$ out of 5 and the mean score for clinical decision-making abilities was $3.48{\pm}.22$ out of 5. In this correlation analysis, a significant positive correlation (r=.58, p<.001) was found between critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses. Conclusion: In order to improve the clinical decision-making ability of home health advanced practice nurses, we need to improve their critical thinking disposition. In order to make this change, appropriate training program are needed to increase the critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses.

• 중환자간호학회지
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• 제15권2호
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• pp.27-38
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• 2022

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.

• 간호행정학회지
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• 제19권5호
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• pp.613-621
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• 2013

Purpose: To identify the extents of nursing professionalism, clinical decision making abilities and job performance of advanced practice nurses and investigate the relationship among the variables Methods: Participants, selected by a convenience sampling method, were 135 advanced practice nurses working in 4 tertiary care general hospitals in 'B' Metropolitan City and in 1 tertiary care general hospital in 'J' city. Data collection was done from January 15 to February 28, 2013 using self-reporting questionnaires. Results: The average score for nursing professionalism of study participants was $81.19{\pm}7.56$. for clinical decision making abilities, $140.42{\pm}9.62$ and for job performance, $102.54{\pm}10.30$. These averages are relatively high. The relationship between the extent of nursing professionalism and the extent of clinical decision making abilities showed an intermediate level positive correlation (r=.45, p<.001). The relationship between the extent of nursing professionalism and the extent of job performance was also an intermediate level positive correlation (r=.42, p<.001). The extent of clinical decision making abilities and the extent of job performance was an intermediate level positive correlation (r=.41, p<.001). Conclusion: Developing a program, which can improve nursing professionalism and clinical decision making abilities of nurse, is required to enhance their job performance.

• 기본간호학회지
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• 제17권2호
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• pp.274-281
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• 2010

Purpose: The purpose of this study was to identify the correlation between level of professional autonomy and clinical decision making abilities in clinical nurses, and to provide basic information for promoting competency nurses in making independent decisions. Method: Data were collected from July 1 to July 18, 2008, and participants were 202 clinical nurses in general hospitals. Collected data were analyzed using descriptive statistics: frequency and percentage and Pearson correlation coefficients with the SPSS WIN 14.0 program. Results: The professional autonomy index for the nurses was 159.63 points. The clinical decision making ability index was 119.79 points. The most highly ranked factor in clinical decision making was search for information and unbiased assimilation of new information. There was a statistically significant difference in professional autonomy according to age, clinical experience, and type of duty. Relation between level of professional autonomy and clinical decision making showed a positive correlation. Conclusion: As a results show a significant correlation between professional autonomy and clinical decision making in clinical nurses, improvement in professional autonomy of clinical nurses, would be promoted through continuous support and training.

• 한국간호교육학회지
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• 제22권3호
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• pp.304-315
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• 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.

• 디지털융복합연구
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• 제19권2호
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• pp.275-288
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• 2021

본 연구는 간호사를 대상으로 임상적 의사결정능력에 미치는 영향을 파악하고자 시도되었다. G도 병원에 근무하는 156명을 자료수집 하였다. IBM SPSS WIN/25.0을 이용하여 t-test, ANOVA, Pearson correlation coefficient, Multiple regression을 사용하였다. 대상자의 임상적 의사결정능력에 가장 영향을 미치는 요인은 간호연구 '매우관심', 비판적 사고성향, '석/박사', 총 임상경력 '20년1개월 이상', 도덕적 행동, 간호연구 '중요하다', '미혼', 총 임상경력 '5년1개월-10년', 부서근무경력 '3년1개월-5년' 순이었다. 설명력은 51.4%이었다. 간호연구에 관심과 중요성, 도덕적 행동과 학력, 경력이 임상적 의사결정능력에 영향을 미치는 변수임을 확인하였다는 점에서 의의가 있었다. 본 연구결과는 프로그램 개발 기초자료로 활용될 수 있을 것이다. 또한, 윤리적 딜레마 상황에서 임상적 의사결정능력을 높일 수 있는 교육 프로그램을 개발하여 적용하고 그 효과를 검증할 것을 제언한다.

• 간호행정학회지
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• 제19권5호
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• pp.668-678
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• 2013

Purpose: This study was done to develop a realistic clinical case and investigate nurses' decision-making about nurses' ethical dilemmas with physicians in the fields of nursing practice. Methods: Case development and a hypothetical case study were used. Participants were 52 nurses. Data were collected in 2012 and 2013 using an open-ended questionnaire and interviews and analyzed using content analysis and descriptive statistics. Results: Various dilemma situations between nurses and physicians, such as violence, deathbed, medication prescription, and physicians' incapacity unfairness, were suggested. A clinical dilemma case about medication prescription was developed based on nurses' experiences. Nurses' responses to the developed case situation and responses were classified into five types. Various reasons were given for making the decisions and about 56% of the nurses decided to notify their supervisor without deleting nursing records. Conclusion: In this study, a realistic clinical dilemma case was developed, and nurses' ethical decision making was identified. These findings can be used in developing effective strategies for nurses to solve ethical dilemmas and to improve ethical decision-making abilities.

• The Journal of Korean Physical Therapy
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• 제24권3호
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• pp.171-180
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• 2012

Purpose: The purpose of this study was to investigate the clinical decision making (CDM) development process throughout the comparison between novice and expert physical therapist as well as develop a CDM model for physical therapists under the fee-for-service (FFS) and physicians' prescriptions. Methods: Purposive sampling techniques were used to select 10 clinical physical therapists paired into five groups (each pair consisted of 1 novice and 1 expert physical therapist). The coding schemes were extracted from interviews and through within- and across-case analyses, cases were summarized. The reliability of coding schemes was confirmed by checking of case summaries by the participants. Results: Novice and expert physical therapists were influenced by two themes, internalized theme and external forces or information. Novice clinicians depended more on external forces or information. Although clinicians should care patients under the FFS and physician's prescription, expert clinicians were more likely to rely on internalized knowledge. Conclusion: The findings of the present study may be used by educators or association officials enhance CDM abilities and knowledge pools of student or novices as well as develop a guide to suitable novices or students under the specific context limiting the development of their CDM.

• 동서간호학연구지
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• 제23권2호
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• pp.124-133
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• 2017

Purpose: The purpose of this study was to identify factors that affect nursing students' clinical practice ability. Methods: The data were collected from 303 nursing students who had more than 500 hours of experience in clinical practicum at 4 universities in Seoul and the metropolitan area. The instruments consisted of 27 items of critical thinking, 19 items of professionalism, 40 items of self reported leadership, 20 items of communication evaluation tool, and 61 items of nursing practice performance evaluation. Results: For the clinical practicum, most difficult for nursing students were cardiopulmonary resuscitation, fecal enema, stoma care, and blood transfusion. Clinical practice abilities were positively correlated with nursing professionalism(r=.26, p<.001), leadership (r=.16, p=.007) and critical thinking(r=.12, p=.031). Professionalism(${\beta}=.32$, p=.001) was the most significant factor influencing the clinical practice ability of nursing students. Critical thinking was the second largest factor but not significant(${\beta}=.16$, p=.058). Conclusion: The findings suggest that the nursing curriculum should include nursing knowledge and nursing skills as well as various case-based or field-based decision making training programs to cultivate professionalism, critical thinking and other abilities for clinical practice.

• 치위생과학회지
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• 제20권1호
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• pp.16-24
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• 2020

Background: Dental treatment has shifted to the center of the community, and the public policy of the country has expanded to support the vulnerable classes such as the disabled. The dental profession needs education regarding oral health services for persons with disabilities, and it is necessary to derive the competencies for this. Therefore, we conducted this study to derive the normative ability to understand the role of a dental hygienist in the oral health service for persons with disabilities and improvement plans for education. Methods: We conducted a qualitative analysis for deriving competencies by analyzing the data collected through in-depth interviews with experts in order to obtain abilities through practical experience. Based on the competency criterion, relevant competency in the interview response was derived using the priori method, and it was confirmed whether the derived ability matched the ability determined by the respondent. Results: The professional conduct competencies of dental hygienists, devised by the Korean Association of Dental Hygiene, consists of professional behavior, ethical decision-making, self-assessment skills, lifelong learning, and accumulated evidence. Also, core competencies of the American Dental Education Association competencies for dental hygienist classification such as ethics, responsibility for professional actions, and critical thinking skills were used as the criterion. The dental hygienist's abilities needed for oral health care for people with disabilities, especially in the detailed abilities to fulfill these social needs, were clarified. Conclusion: To activate oral health care for people with disabilities, it is necessary for dental hygienists to fulfill their appropriate roles, and for this purpose, competency-based curriculum restructuring is indispensable. A social safety net for improving the oral health of people with disabilities can be secured by improving the required skills-based education system of dental hygienists and strengthening the related infrastructure.