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Impacts of Professional Autonomy and Role Conflict Clinical Decision-Making Ability of Nurses on Comprehensive Nursing Care Service Wards

간호간병통합병동 간호사의 전문직 자율성, 역할갈등이 임상적 의사결정능력에 미치는 영향

  • Son, Yu-Lim (Department of Nursing, MunKyung College) ;
  • Kim, Eun-Ha (Department of Nursing, MunKyung College)
  • Received : 2018.04.12
  • Accepted : 2018.07.06
  • Published : 2018.07.31

Abstract

This investigation was a descriptive study that examined the relationship among factors including professional autonomy, role conflict, and clinical decision-making ability of nurses on comprehensive nursing service wards. To accomplish this, a survey of 234 nurses working at D city and G city who were selected based on convenience sampling was conducted. Data were collected using a self-reported questionnaire completed by 234 nurses at four clinical hospitals from October 12, 2017 to November 30, 2017. The collected data were evaluated by t-tests, ANOVA, Pearson's correlation and stepwise multiple regression analysis. The mean clinical decision-making ability score was $3.38{\pm}0.78$, which corresponded to an intermediate level of clinical decision-making ability. Clinical decision making ability was positively correlated with professional autonomy, but role conflict showed a negative correlation. The factors having the greatest impact on clinical decision-making ability were found to be, in order, length of work, education level, professional autonomy and role conflict, which together accounted for 38.7% of the total impact. To improve clinical decision making ability, it is important to improve autonomy and role conflict. Additionally, to improve clinical decision-making ability, it is necessary to improve clinical decision-making ability to determine nurses tasks through professional autonomy and role conflict. Overall, the results of this study can be utilized as baseline data when developing a program to enhance nurses' clinical decision making ability. Moreover, it is suggested that an interventional study analyzing validity and effectiveness of developed education programs be conducted.

본 연구는 간호간병통합서비스 병동간호사를 대상으로 전문직 자율성, 역할갈등, 임상적 의사결정능력과의 관계와 함께 임상적 의사결정능력에 영향을 미치는 영향요인 파악을 목적으로 한 서술적 조사연구이다. 본 연구에서는 D시와 G시에 근로간호사 234명을 편의 표집하여 조사하였다. 자료수집은 2017년 10월 12일부터 11월 30일 사이에 D시와 G시에 소재하는 4개의 종합병원의 234명을 대상으로 연구 참여에 서면 동의한 간호사에게 자가 보고식 설문조사지를 사용하여 자료를 수집하였다. t-test, ANOVA, Pearson's coefficients와 단계적 회귀분석으로 자료를 분석하였다. 연구결과에서 임상적 의사결정능력은 평균평점 $3.38{\pm}0.78$점으로 중간수준으로 나타났다. 임상적 의사결정능력은 전문직 자율성과 양의 상관관계(r=.40, p<.001)를 보였으나, 역할갈등과는 음의 상관관계(r=-.21, p<.001)가 있는 것으로 나타났다. 임상적 의사결정능력에 미치는 영향은 근무경력, 교육수준, 전문직 자율성과 역할갈등이었으며, 임상적 의사결정능력에 대한 설명력은 38.7%였다. 임상적 의사결정 능력을 개선하기 위해 중요한 변수인 전문직 자율성과 역할갈등을 통해 간호사의 직무를 결정할 수 있는 임상적 의사결정능력을 향상시킬 필요가 있다. 그러므로, 본 연구 결과가 간호사의 임상적 의사결정능력 향상 프로그램 개발의 근거자료로 활용될 수 있을 것으로 기대하며, 개발된 교육프로그램의 타당성과 효과성을 분석하는 중재연구의 필요성을 제안하는 바이다.

Keywords

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