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계획된 행위이론 기반 COVID-19 환자 간호의도 예측요인: 지각된 행위통제의 조절효과

Predicting Factors of Nurses' Intention to Care for COVID-19 Patients based on the Theory of Planned Behavior: The Moderating Effect of Perceived Behavior Control

유미|안법왕
병원간호사회 (Hospital Nurses Association)|2024.04|임상간호연구 (Journal of Korean Clinical Nursing Research)|제30권 제1호|pp. 24-34|DOI 10.22650/JKCNR.2024.30.1.24

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참고문헌

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태도Attitude공감행위통제Theory of Planned Behavior의도IntentionEmpathy계획된 행위이론Behavior Control
주제분류간호학

초록

목적: 본 연구의 목적은 계획된 행위이론에 근거하여 감염병 지정병원 간호사의 코로나바이러스감염증-19 (Coronavirus Disease 2019; COVID-19) 환자 간호의도에 미치는 영향요인을 분석하고, 행위의도에 영향을 미치는 변인으로 공감능력을 추가하여 COVID-19 환자 간호의도에 대한 영향을 파악하는 것이다. 방법: 연구 대상자는 대한민국 J 시와 C 시에 위치한 감염병 지정병원의 일반병동, 중환자실, 응급실에서 직접 간호업무를 수행하는 간호사 167명이었다. 자료수집은 COVID-19 팬데믹 시기인 2020년 10월 12일부터 10월 25일까지 수행되었으며, 독립표본 t-검정, 분산분석(ANOVA), 피어슨 상관 계수 및 위계적 회귀 분석을 사용하여 분석하였다. 지각된 행위 통제 조절 효과는 Process Macro Model 1을 이용하여 분석하였고(10,000번의 부트스트래핑, 95% 신뢰 구간), 그룹별 차이를 확인하기 위해 단순기울기 분석이 수행되었다. 결과: 연구결과 1단계 모형에서 COVID-19 환자 간호의도에 영향을 미치는 요인은 행위에 대한 태도(=.32 p<.001), 지각된 행위통제(=.37, p<.001)였으며 모형의 설명력은 49.0% (R2=.49, F=19.27, p<.001)였다. 2단계 모형에서 공감능력의 하위영역 중 COVID-19 환자 간호의도와 상관성을 보였던 공감적 관심, 관점수용을 추가하여 분석한 결과, 행위에 대한 태도(=.28, p<.001), 지각된 행위통제(=.36, p<.001), 공감능력 중 관점수용(=.26, p<.001)이 COVID-19 환자 간호의도에 유의한 영향을 미치는 것으로 나타났으며 최종적으로 모형의 설명력은 65.0%(R2=.65, F=18.41, p<.001)였다. COVID-19 환자 간호행위에 대한 태도와 간호의도와의 관계에서 지각된 행위통제의 조절효과를 분석한 결과, COVID-19 환자 간호행위에 대한 태도와 지각된 행위통제의 상호작용은 유의하지 않았고(β=.04, t=0.64, p=.525), 주관적 규범과 간호의도와의 관계에서 지각된 행위통제의 조절효과에서는 주관적 규범과 지각된 행위통제의 상호작용은 유의하여(β=.14, t=2.14, p=.034), 주관적 규범이 간호의도에 영향을 미치는 경로에서 지각된 행위통제의 조절효과는 유의한 것으로 나타났다. 결론: 본 연구결과를 통해 COVID-19 환자 간호의도를 증진시키기 위해서 실무교육, 자신감 강화 프로그램 개발 및 공감 능력 향상 프로그램을 개발하고 적용할 필요가 있다.

Abstract

Purpose: This study aimed to identify factors influencing nurses' intention to care for COVID-19 patients basedon the theory of planned behavior, and to test the moderating effect of perceived behavior control betweenattitude, subjective norms, and nurses' intention to care. Methods: The participants were 167 nurses workingat two designated hospitals for infectious diseases located in J and C city, South Korea. Data were collectedfrom October 10th to 25th, 2020, and analyzed using independent t-test, ANOVA, and Pearson correlationcoefficient, and hierarchical multiple regression analysis. The moderating effect was analyzed using the ProcessMacro model 1 (95% confidence interval, 10,000 bootstrapping), and a simple slope analysis was performedto identify the moderating effect of perceived behavior control. Results: The factors affecting nurses’ intentionto care for patients with COVID-19 were attitude toward the behavior (β=.32, p<.001) and perceivedbehavior control (β=.37, p<.001) in model 1, attitude toward the behavior (β=.28, p<.001) and perceivedbehavior control (β=.36, p<.001), and perspective taking (β=.26, p<.001) in model 2. The explanation powerof this model was 65.0% (F=18.41, p<.001). The moderating effect of perceived behavioral control wasstatistically significant in the relationship between subjective norms and intention to care for patients withCOVID-19 (F=16.37, p<.001). In the simple slope analysis, the reinforcement effect was greatest when thelevel of perceived behavioral control was at the mean (95% CI=0.46~0.67) and high (95% CI=0.70~1.08). Conclusion: Developing and applying a training program that enhances confidence and improves empathy isnecessary to increase nurses’ intention to care for COVID-19 patients.

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