임상간호사의 전문직 자율성과 간호업무환경이 임상적 의사결정능력에 미치는 영향
Impact of Professional Autonomy and Nursing Work Environment on Clinical Decision Making of Clinical Nurses
1
조회
0
다운로드
15
인용
0
참고문헌
키워드
초록
Purpose: This study aimed to explore professional autonomy, nursing work environment, and clinical decision making ability and to determine predictors of clinical decision making ability among clinical nurses. Methods: A cross-sectional design was used in this study and 263 clinical nurses were selected from advanced-level hospitals with over 500 beds located in D metropolitan city. Independent t-test, ANOVA, Pearson’s correlation coefficients and hierarchical multiple regression analyses were done with the SPSS/WIN 20.0 program. Results: Clinical nurses reported moderate levels of professional autonomy, nursing work environment and clinical decision making ability. Marital status, professional autonomy and nursing work environment accounted for 25% of variance in clinical decision making ability required in various clinical settings. Importantly, being married, higher level of professional autonomy, and greater satisfaction with work environment were significantly associated with better decision making ability. Conclusion: Findings indicate that improving the quality of decision making in the healthcare settings requires awareness of the multiple effects of individual, occupational and environmental features. Nurses’ ability to make effective clinical decisions may rely on personal characteristics, the degree of autonomy in their job, and nurses’ satisfaction with their work environment.
Abstract
Purpose: This study aimed to explore professional autonomy, nursing work environment, and clinical decision making ability and to determine predictors of clinical decision making ability among clinical nurses. Methods: A cross-sectional design was used in this study and 263 clinical nurses were selected from advanced-level hospitals with over 500 beds located in D metropolitan city. Independent t-test, ANOVA, Pearson’s correlation coefficients and hierarchical multiple regression analyses were done with the SPSS/WIN 20.0 program. Results: Clinical nurses reported moderate levels of professional autonomy, nursing work environment and clinical decision making ability. Marital status, professional autonomy and nursing work environment accounted for 25% of variance in clinical decision making ability required in various clinical settings. Importantly, being married, higher level of professional autonomy, and greater satisfaction with work environment were significantly associated with better decision making ability. Conclusion: Findings indicate that improving the quality of decision making in the healthcare settings requires awareness of the multiple effects of individual, occupational and environmental features. Nurses’ ability to make effective clinical decisions may rely on personal characteristics, the degree of autonomy in their job, and nurses’ satisfaction with their work environment.
참고문헌 (30)
- Aiken, L., "Hospital staffing, organization, and quality of care: Cross-national findings", Nursing Outlook, 50, pp.187~194 (2002)
- Anthony, M. K., "The relationship between decentralization and expertise to participation in decision: among staff nurses working in acute care hospital", 박사, pp.1995
- Baek, M. K., "Relationship between level of autonomy and clinical decision-making in nursing scale of E. T. nurse", 석사, pp.2005
- Ballou, K. A., "A concept analysis of autonomy", Journal of Professional Nursing, 14(2), pp.102~110 (1998)
- Blengen, M. A., "Nurses’ job satisfaction: A meta analysis of related variables", Nursing Research, 42(1), pp.36~41 (1993)
- Chi, S. A., "Professional autonomy conception analysis", Journal of Korean Academy of Nursing, 31(5), pp.781~792 (2001)
- Han, K. J., "A research tool for nursing" (1994), Seoul National University Press
- Jenkins, H. M., "Improving clinical decision making in nursing", Journal of Nursing Education, 24(6), pp.242~243 (1985)
- Kang, K. N., "Nurses’ practice environment, nursing professionalism, career commitment, and turn over intention in the small-medium sized hospital", 석사, pp.2010
- Kang, S. Y., "Determination of organizational creativity at nursing care units of university hospital in Korea", Journal of Korean Society of Hospital Adminstration, 9, pp.1~20 (2004)
- Katerina, K. I., "Professional autonomy and job satisfaction : Survey of critical care nurses in mainland Greece", Journal of Advanced nursing, 66(11), pp.2520~2531 (2010)
- Kim, H. M., "A study of the autonomy and professional self concept of clinical nurses", Journal of Korean Academy of Psychiatric and Mental Health Nursing, 6(2), pp.278~289 (1997)
- Kim, J. H., "Nursing medical fee improvement differential system plan", Korean Nurses Association, 255, pp.22~25 (2012)
- Kim, S. Y., "A study on the clinical decision making of home healthcare nurses", 박사, pp.2010
- Ko, H. J., "Nurse work environments, job satisfaction and intention to leave among nurses in a general hospital", 석사, pp.2010
- Kwak, C. Y., "Relation of job satisfaction with perceived organizational support and quality of care among south Korean nurses", International Journal of Nursing Studies, 47, pp.1292~1298 (2010)
- Lake, E. T., "Variations in nursing practice environments : Relation to staffing and hospital characteristics", Nursing Research, 55(1), pp.1~9 (2006)
- Marlene, K., "The Practice of clinical autonomy in hospitals : 20000 Nurses tell their story", Clinical Care Nurse, 28(6), pp.58~71 (2008)
- Michael, T., "Autonomy, evidence and intuition : Nurses and decision-making", Journal of Advanced Nursing, 66(7), pp.1584~1591 (2010)
- Michael, T., "Professional autonomy in 21st century health care : nurses’ accounts of clinical decision making", Social Science & Medicine, 71, pp.1506~1512 (2010)
- Orem, L., "Decision making in clinical practice: How to expert nurses, midwives and health visitors make decisions", Nurse Education Today, 13, pp.270~276 (1993)
- Park, M. S., "The level of professional autonomy and clinical decision making abilities of advanced practice nurses", 석사, pp.2006
- 박승미, "간호사의 임상 의사결정능력 영향 요인 - 비판적 사고 성향을 중심으로 -", Journal of Korean Academy of Nursing, 37(6), pp.863~871 (2007), 한국간호과학회
- Randi, S., "The meaning of autonomy in nursing practice", Journal of Clinical Nursing, 19, pp.2226~2234 (2008)
- 성미혜, "임상간호사의 전문직 자율성과 임상적 의사결정능력과의 관계", 기본간호학회지, 17(2), pp.274~281 (2010), 기본간호학회
- Schutzenhofer, K. K., "The development of autonomy in adult women", Journal of Psychological Nursing and Mental Health Services, 12(4), pp.25~30 (1983)
- Smith, M., "Physiotherapy decision making in acute cardiorespiratory care is influenced by factors related to the physiotherapist and the nature and context of the decision : a qualitative study", Australian Journal of Physiotherapy, 53, pp.261~267 (2007)
- Stwart, J., "Clinical nurses' understanding of autonomy : Accomplishing patient goals through interdependent practice", Faculty of Nursing University Calgary, 34(10), pp.443~450 (2004)
- Westerman, J. W., "The effects of work environment on the personality relationship : Exploratory study", Journal of Managerial Issues, 19(2), pp.289~305 (2007)
- Yi, Y. J., "The causal relationships of the variables to decision making of clinical nurses", 박사, pp.2001