Effects of Nursing professionalism on Clinical decision making ability of Clinical nurses: Dual mediating effects of Critical thinking disposition and Confidence in performing core nursing skills
본 연구는 임상간호사의 간호전문직관과 임상의사결정능력 간의 관계에서 비판적 사고성향과 핵심간호술 수행자신감의 이중매개효과를 검증하여 임상의사결정능력 향상을 위한 기초자료로 활용하기 위해 실시한 서술적 조사연구이다. 연구대상자는 일 지역의 종합병원 임상간호사 173명이며, 2023년 9월 15일~10월 13일까지 자료수집을 하였다. 자료분석은 SPSS/AMOS 23.0 프로그램을 이용하여 연구변인들 간의 인과적 관계 분석과 부트스트래핑 추정방식으로 매개효과를 검증하였으며, t-test, ANOVA, Scheffe’s test, Pearson's correlation coefficient, hierarchical regression을 실시하였다. 연구결과, 첫째, 임 상간호사의 간호전문직관, 임상의사결정능력, 비판적 사고성향과 핵심간호술 수행자신감 간의 인과모형의 적합성은 타당하게 성립하였다. 둘째, 간호전문직관에서 임상의사결정능력에 대한 영향관계에서 비판적 사 고성향은 부분매개효과를 나타냈다. 셋째, 이중매개효과를 검증한 결과, 비판적 사고성향의 간접효과가 비 판적 사고성향과 핵심간호술 수행자신감의 간접효과보다 크게 나타나 이중매개효과보다는 단일매개 효과 가 큰 것으로 나타났다. 따라서 임상간호사들의 높은 간호전문직관의 함양은 임상의사결정능력을 향상시킬 수 있으며, 특히, 비판적 사고성향을 강화시키는 것이 더 효율적임을 검증하였다.
This study is a descriptive research study conducted to verify the dual mediating effect of critical thinking disposition and core nursing skill performance confidence in the relationship between clinical nurses' nursing professionalism and clinical decision-making ability and to use it as basic data for improving clinical decision-making ability. The study subjects were 173 clinical nurses at a general hospital in a region, and data were collected from September 15 to October 13, 2023. Data were analyzed using the SPSS/AMOS 23.0 program to verify the mediating effect by analyzing the causal relationship between the research variables and the bootstrapping estimation method, and t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, and hierarchical regression were performed. The results of the study include: First, the appropriateness of the causal model between clinical nurses' nursing professionalism, clinical decision-making ability, critical thinking disposition, and core nursing skill performance confidence was valid. Second, critical thinking disposition showed a partial mediating effect in the relationship between nursing professionalism and clinical decision-making ability. Third, as a result of verifying the dual mediating effect, the indirect effect of critical thinking disposition was greater than the indirect effect of critical thinking disposition and core nursing skill performance confidence, indicating that the single mediating effect was greater than the dual mediating effect. Therefore, it was verified that fostering high nursing professionalism in clinical nurses can improve clinical decision-making ability, and in particular, strengthening critical thinking disposition is more effective.