종합병원 간호사의 간호근무환경, 환자중심 의사소통, 직업대처 자기효능감, 전문직 자아정체성이 간호업무누락에 미치는 영향 = The Impact of Nursing Practice Environment, Patient-Centered Communication, Occupational Coping Self-efficacy, and Professional Identity on Missed Nursing Care among General Hospital Nurses

다국어 초록 (Multilingual Abstract)

Purpose To identify the impact of missed nursing care among nurses working in general hospitals, this study examined the effects of the nursing practice environment, patient-centered communication, occupational coping self-efficacy, and professional identity on missed nursing care. Method A descriptive cross-sectional design using data collected from 177 nurses working at a general hospital in Busan between August 12 and 23, 2025 was adopted. Structured self-administered questionnaires were used, including the Practice Environment Scale-5, Patient-Centered Communication Scale for Nurses, Korean Version of the Occupational Coping Self-efficacy for Nurses Scale, Professional Identity in Nursing Scale 2.0, and the MISSCARE Scale. Descriptive statistics, t-test, Pearson’s correlation, and multiple regression were conducted using SPSS 31.0. Results The mean of missed nursing care was 1.32±0.27, nursing practice environment was 2.26±0.67, patient-centered communication was 3.71±0.65, occupational coping self-efficacy was 3.28±0.63, and professional identity was 3.00±0.77. Missed nursing care differed significantly by marital status and position. Missed nursing care differed significantly by marital status and position was statistically significantly greater in unmarried nurses than in married nurses (p=.015). Missed nursing care was also statistically significantly greater in staff nurses than in charge nurses (p<.001). No significant differences were observed in gender, education level or department. Among general characteristics, total clinical experience was negatively correlated with missed nursing care (r=-.155, p=.040), whereas overtime hours were positively correlated (r=.415, p<.001). Nursing practice environment (r=-.505, p<.001), patient-centered communication (r=-.418, p<.001), occupational coping self-efficacy (r=-.333, p<.001), and professional identity (r=-.431, p<.001) showed negative associations with missed nursing care. Multiple regression with backward elimination revealed that overtime hours (β=.238, p<.001) increased missed nursing care, whereas the nursing practice environment (β=-.338, p<.001), patient-centered communication (β=-.211, p<.001), and professional identity (β=-.267, p<.001) decreased missed nursing care. The model explained 47.4% of the variance (F=32.741, p<.001). Conclusion Professional identity and patient-centered communication were identified as new factors influencing missed nursing care among nurses in general hospitals. Accordingly, efforts to reinforce nurses’ professional identity, patient-centered communication should be prioritized to reduce missed nursing care and enhance patient safety. Key words: Missed nursing care, Nursing practice environment, Patient-centered

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 4
• 3. 용어의 정의 4
• Ⅱ. 문헌고찰 8
• 1. 간호업무누락 8
• 2. 간호업무누락에 미치는 영향요인 12
• 1) 간호근무환경 12
• 2) 환자중심 의사소통 14
• 3) 직업대처 자기효능감 16
• 4) 전문직 자아정체성 18
• Ⅲ. 연구방법 21
• 1. 연구 설계 21
• 2. 연구 대상 21
• 3. 연구 도구 22
• 4. 윤리적 고려 25
• 5. 자료 수집방법 및 기간 26
• 6. 자료분석방법 27
• Ⅳ. 연구 결과 28
• 1. 대상자의 일반적 특성 28
• 2. 주요 변수의 서술통계 30
• 3. 일반적 특성에 따른 간호업무누락의 차이 32
• 4. 주요 변수와 연속 변수의 상관관계 34
• 5. 간호업무누락의 영향 요인 36
• Ⅴ. 논의 39
• Ⅵ. 결론 및 제언 47