한국형 중환자실 간호근무환경 측정도구 개발 및 평가
Development and Validation of a Korean Nursing Work Environment Scale for Critical Care Nurses
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목적: 본 연구의 목적은 한국형 중환자실 간호근무환경 측정 도구를 개발하고, 개발된 도구의 타당도와 신뢰도를 평가하는 것이다. 방법: 문헌 고찰 및 중환자실 간호사와의 심층 인터뷰를 통해 64개의 후보문항을 선정하였다. 64개 후보문항에 대한 내용타당도 평가 후 선정된 46개 항목으로 예비도구를 개발하였다. 2021년 2월부터 3월까지 21개 병원의 총 535명의 중환자실 간호사를 대상으로 예비도구를 이용한 설문을 시행하였다. 타당도와 신뢰도는 구성타당도, 집중타당도, 판별타당도, 내적 일관성 신뢰도, 검사-재검사 신뢰도를 평가하였다. 결과: 문항분석 및 직접 오블리민법을 포함한 최대우도법을 이용한 탐색적 요인분석을 통해 4개 요인 23개 문항을 도출하였고, 요인에 의한 누적분산비율은 55.6%를 보였다. 확인적 요인분석을 시행하여 요인부하량이 .50 이상, 다중상관자승값이 .30 이상의 조건을 충족하지 않는 문항을 삭제한 후 KNWES-CCN은 4개 요인 21개 항목으로 선정되었다. 모델적합도 지수를 평가한 결과 권장 수준을 만족하여 모델이 적합하다고 판단하였다.(χ2=440.47(p<.001), CMIN/DF= 2.41, GFI=.86, SRMR=.06, RMSEA=.07, TLI=.90, CFI=.91). 문항 총점 간 상관관계는 .32에서 .73이었고, 도구에 대한 내적 일관성 신뢰도 Cronbach's α=.92 였다. 검사-재검사 신뢰도의 상관계수는 .72였으며, 급내상관계수는 .83이었다. 결론: KNWES-CCN은 타당도와 신뢰도가 확인된 도구로 한국 중환자실 간호사의 간호 업무 환경을 측정하고 개선할 수 있을 것이다.
Abstract
Purpose: The purpose of this study was to develop a Korean nursing work environment scale for critical care nurses (KNWES-CCN) and verify its validity and reliability. Methods: A total of 46 preliminary items were selected using content validity analysis of experts on 64 candidate items derived through literature reviews and in-depth interviews with critical care nurses. 535 critical care nurses from 21 hospitals responded to the preliminary questionnaire from February to March 2021. The collected data were analysed using construct,convergent and discriminant validities, and internal consistency and test-retest reliability. Results: The 23 items in 4 factors accounted for 55.6% of the total variance were identified through item analysis and exploratory factor analysis (EFA). EFA was performed with maximum likelihood method including direct oblimin method. In the confirmatory factor analysis, KNWES-CCN consisted of 21 items in 4 factors by deleting the items that were not meet the condition that the factor loading over .50 or the squared multiple correlation over .30. Thismodel was considered to be suitable because it satisfied the fit index and acceptable criteria of the model [x2 =440.47(p<.001), CMIN/DF=2.41, GFI=.86, SRMR=.06, RMSEA=.07, TLI=.90, CFI=.91]. The item total correlation values ranged form .32 to .73 and its internal consistency was Cronbach's ⍺=.92. The reliability of the test-retest correlation coefficient was .72 and the intra-class correlation coefficient was .83. Conclusion: The KNWES-CCN showed good validity and reliability. Therefore, it is expected that the use of this scale would measure and improve nursing work environment for critical care nurses in Korea.
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