중환자실 간호사의 연명의료중단 태도, 연명의료 지식과 간호스트레스와의 관계

조은혜 한림대학교 간호대학원 2022 국내석사

본 연구는 중환자실 간호사의 연명의료중단에 대한 태도, 연명의료 지식 과 간호스트레스 정도와 이들간의 상관관계를 파악하기 위한 서술적 조사 연구이다. 본 연구를 위한 자료수집은 한림대학교병원 생명윤리심의위원회의 IRB 심의를 거쳐 연구승인(HALLYM 2022-09-014-002)을 받은 후 2022년 10월 25일부터 11월 10일까지 서울, 경기 소재 3개 종합병원에서 이루어졌다. 연구의 목적과 취지를 이해하고 동의한 간호사들의 서면동의를 받고 연구를 시행하였다. 설문지는 구조화된 웹기반 설문지를 제작하여 데이터를 수집하였다. 연명의료중단에 대한 태도를 진술한 박계선(2002)의 도구를 기초로 하여 변은경 등(2003)이 19문항으로 수정, 보완한 도구를 사용하였다. 연명의료에 대해 긍정적인 태도를 나타내는 각 문항은 Likert 5점 척도로 사용하였다. 연명의료 지식 측정은 홍선우와 김신미(2013)가 1차 개발한 도구 26항목을 김신미 등(2022)이 최종 개정한 도구를 사용하였다. 연명의료 간호스트레스의 측정은 이수정(2016)에 의해 개발된 도구를 사용하였다. 간호스트레스에 대한 문항은 총 28문항으로 구성되어 있으며, 각 문항은 Likert 5점 척도로 사용하였다. 수집된 자료는 SPSS/WIN 23.0 버전을 이용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, Pearson's Correlation Analysis로 분석하였다. 본 연구의 신뢰도는 연명의료중단에 대한 태도의 경우 Cronbach's α=.87, 연명의료지식의 경우 Cronbach's α=.88, 연명의료 간호스트레스의 경우 Cronbach's α=.91이었다. 연구 결과는 다음과 같이 요약된다. 1) 연명의료중단에 대한 중환자실 간호사의 태도는 평균 3.43점, 연명의료지식은 17.14점, 연명의료간호스트레스는 평균 3.75점이었다. 2) 연명의료중단에 대한 태도는 임상근무경력, 중환자실 근무경력, 연명의료에 대한 교육경험에서 유의한 차이를 보였다. 3) 연명의료지식은 종교, 연명의료에 대한 교육경험, 연명의료 교육에서 유의한 차이를 보였다. 4) 연명의료간호스트레스는 연령, 직위에 따라 통계적으로 유의한 차이를 보였다. 5) 연명의료중단 태도, 연명의료 지식과 간호스트레스간의 관계를 알아보기 위해 Pearson's Correlation Analysis를 실시하였다. 그 결과 연명의료중단 태도와 연명의료 지식은 통계적으로 유의한 상관관계가 있었다. 반면 연명의료 간호스트레스는 연명의료 지식과 연명의료중단태도와 각각 통계적으로 유의한 상관관계가 없는 것으로 나타났다. 본 연구결과에서는 연명의료중단 태도, 연명의료 지식과 간호스트레스와의 관련성을 확인한 결과 연명의료중단 태도는 연명의료 지식과 유의한 상관관계가 있었다. 중환자실 간호사가 연명의료에 대한 지식정도가 높을수록 연명의료중단에 대한 태도가 긍정적인 것으로 나타났다. 반면 연명의료중단 태도와 연명의료 간호스트레스, 연명의료 지식과 간호스트레스는 통계적으로 유의한 상관관계가 없는 것으로 나타났다. 따라서 본 연구의 결과를 토대로하여 다음과 같이 제언한다. 중환자실 간호사를 대상으로 사전연명의료의향서와 연명의료계획서에 대한 지식을 높일 수 있는 병원교육과 보수교육개발을 통해서 환자와 가족이 효과적인 연명의료결정을 할 수 있도록 돕는 것이 필요하다. 중환자실 간호사의 연명의료에 대한 간호스트레스 완화를 위한 의사, 간호사와 환자와 가족 모두 함께 의사소통을 위한 상담과 사례별 교육프로그램 마련이 필요하다. 본 연구는 일개 종합병원의 중환자실 간호사를 편의 추출하여 수집한 결과이므로 모든 중환자실 간호사에게 적용하여 일반화에 제한이 있으므로 추후 반복 연구를 제언한다. The purpose of this study investigated the intensive care unit nurses' attitude toward discontinuation of life-sustaining treatment, knowledge of life-sustaining treatment, and nursing stress. This is a descriptive research study to find out the correlation between the two. Data collection for this study was approved by the IRB of the Bioethics Review Committee of Hallym University Hospital from October 25, 2022 to November 10, 3 species in Seoul and Gyeonggi. It was done at the merger. Written consent was obtained from nurses who understood and agreed to the purpose and purpose of the study. A study was conducted. For the questionnaire, data was collected by creating a structured web-based questionnaire. Based on the tool of Park Gye-sun (2002) who stated his attitude toward the termination of life-sustaining treatment, Byun Eun-kyung et al. (2003). A modified and supplemented tool with 19 questions was used. Each person showing a positive attitude toward life-sustaining treatment Items were used on a Likert 5-point scale. For the measurement of life-sustaining medical knowledge, 26 items of tools initially developed by Seonwoo Hong and Shinmi Kim (2013) were used by Shinmi Kim (2022). The last revised tool was used. A tool developed by Sujeong Lee (2016) was used to measure life-sustaining care nursing stress. nursing stress The questions for the study consisted of a total of 28 questions, and each question was used on a 5-point Likert scale. Using the SPSS/WIN version 23.0, the collected data were analyzed as frequency, percentage, average, standard deviation, t-test, ANOVA, and Pearson's Correlation Analysis. The reliability of this study is Cronbach's α=.87 in the case of attitude toward discontinuation of life-sustaining treatment, and knowledge of life-sustaining treatment. Cronbach's α=.88 for life-sustaining treatment, and Cronbach's α=.91 for life-sustaining treatment nursing stress. The study results are summarized as follows. 1) The attitude of the nurses in the intensive care unit toward the discontinuation of life-sustaining treatment was 3.43 on average, and the knowledge of life-sustaining treatment was 17.14. The mean medical care stress was 3.75. 2) Attitude toward discontinuation of life-sustaining treatment was determined by clinical work experience, intensive care unit work experience, and educational experience on life-sustaining treatment. showed a significant difference in. 3) Life-sustaining treatment knowledge showed significant differences in religion, life-sustaining treatment education experience, and life-sustaining treatment education. 4) Life-sustaining care nursing stress showed statistically significant differences according to age and position. 5) Pearson's to investigate the relationship between life-sustaining treatment discontinuation attitude, life-sustaining treatment knowledge, and nursing stress Correlation Analysis was conducted. As a result, attitudes toward discontinuing life-sustaining treatment and knowledge of life-sustaining treatment were statistically. There was a significant correlation with on the other hand, life-sustaining care nursing stress is It was found that there was no statistically significant correlation with single attitude. The results of this study confirmed the relationship between life-sustaining treatment discontinuation attitude, life-sustaining treatment knowledge and nursing stress. Therefore, based on the results of this study, the following suggestions are made. To increase the knowledge of advance directives and life-sustaining treatment plans for nurses in intensive care units. Doctors, nurses, patients and their families for relieving nursing stress for life-sustaining care of intensive care unit nurses. It is necessary to prepare counseling and case-by-case training programs for communication with all. This study was collected by convenience sampling of ICU nurses in a general hospital, so all critically ill patients. As it is applied to real nurses, there is a limit to generalization, so a repeat study is suggested in the future.

신종감염병 발생에 따른 감염관리간호사의 소진 경험 : 코로나19를 중심으로

박선진 한림대학교 간호대학원 2024 국내석사

Purpose : The purpose of this study was to identify in-depth the burnout experience of infection control nurses according to the outbreak of new infectious diseases: focusing on COVID-19. Method : This study is a qualitative study to explore and describe in-depth the experiences of infection control nurses according to the occurrence of new infectious diseases through a phenomenological approach. One-on-one in-depth interviews were conducted with infection control nurses who have worked in the infection control room (team) for more than 1 year, and the results were analyzed using the phenomenological method of Colaizzi (1978). increases when new infectious diseases occur, it is necessary to have a system for improving appropriate treatment by comprehensively grasping their exhaustion experiences. Results : The topics raised by the participants were categorized into 6 topics. The subjects were <Burden as an infection control nurse> <Environment that causes heavy work> <Uncertainty of new infectious diseases> <Tension with colleagues and other departments> <Lack of personal achievement due to inadequate compensation> <Conflict due to implementation of guidelines>. conclusion : As the importance of infection control nurses increases when new infectious diseases occur, it is necessary to have a system for improving appropriate treatment by comprehensively grasping their exhaustion experiences. 목적 : 본 연구의 목적은 감염관리간호사의 신종감염병 발생에 따른 소진경험 : 코로나19 중심으로 심층적으로 파악하였다. 방법 : 본 연구는 현상학적 접근을 통하여 감염관리간호사의 신종감염병 발생에 따른 경험을 심층적으로 탐색하고 기술하기 위하여 질적 연구를 시행하였다. 감염관리실(팀)에서 1년 이상 근무한 종합병원 이상의 간호사를 대상으로 일대일 심층면담을 실시하였으며, Colaizzi(1978)의 현상학적 방법을 활용하여 결과를 분석하였다. 결과: 연구 수행결 6가지 주제로 확인되었다. <감염관리간호사로서의 부담감> <업무 과중의 원인이 되는 환경><신종감염병의 불확실성><동료 및 타부서와의 긴장><부적절한 보상으로 인한 개인 성취감 결여><지침 이행에 따른 갈등>이었다. 결론: 신종감염병 발생 시 중점적 역할을 하는 감염관리간호사의 중요성이 증대됨에 따라 소진을 경험을 총체적으로 파악하여 적절한 처우 개선을 위한 체계를 갖추는 것이 필요하다.

임상간호사의 세대 간 직업 가치관, 의사소통 유형, 직무만족, 조직몰입의 차이

이슬아 한림대학교 간호대학원 2022 국내석사

This study examines the occupational values of clinical nurses between generations and was conducted to understand the differences in communication types, job satisfaction, and organizational commitment. The study collected data from 159 clinical nurses working at H University Hospital from Aug. 1st, 2022 to Aug. 15th, 2022. The research tools were occupational values, communication type, job satisfaction, and organizational commitment. The data collected in this study were analyzed using the SPSS Windows version 21.0 program. Subject general characteristics were analyzed technical statistically using percentages, means, and standard deviations. Differences in general characteristics between generations of subjects were analyzed by one-way ANOVA. Occupational values, types of communication, job satisfaction, and organizational commitment were analyzed by frequency, percentage, mean, and standard deviation. Intergenerational differences in occupational values, communication types, job satisfaction, and organizational commitment were analyzed using ANOVA, and Tukey post-hoc was used for post hoc analysis. Correlations of occupational values, communication types, job satisfaction, and organizational engagement across all subjects and subject generations were analyzed using Spearman's correlation analysis. As a result of the analysis, a statistically significant difference was found as a result of comparing job satisfaction among groups. In addition, comparing organizational commitment between groups, there was a statistically significant difference at (F = 4.371, p = .010). On the other hand, it was found that there was no statistically significant difference between occupational values ​​and communication types. Spearman's correlation analysis was performed to understand the correlation among all subjects' occupational values, types of communication, job satisfaction, and organizational commitment, and the correlation between variables was investigated. (r = 0.357, p = .001), the correlation between job satisfaction and organizational immersion (r = 0.727, p = .001) showed the largest significant correlation, and the correlation between occupational values ​​communication type (r = 0.197, p = .013) showed a significant correlation. This study confirmed that there were generational differences in occupational values, types of communication, job satisfaction, and organizational commitment of clinical nurses. Therefore, important to develop various arbitration programs due to generational differences in clinical nurses, reduce conflicts due to generational differences, and ultimately establish the necessary system through mutual understanding education. 본 연구는 임상간호사의 세대간 직업적 가치관을 살펴보고 의사소통 유형, 직무만족도, 조직몰입의 차이를 파악하기 위해 수행되었다. 이번 연구는 2022년 8월 1일부터 2022년 8월 15일까지 H대학병원에 근무하는 임상간호사 159명을 대상으로 데이터를 수집했다. 연구 도구는 직업적 가치관, 의사소통 유형, 직업 만족도, 조직몰입이었다. 본 연구에서 수집된 데이터는 SPSS Windows 버전 21.0 프로그램을 이용하여 분석하였다. 주제 일반 특성은 백분율, 평균 및 표준 편차를 사용하여 기술 통계적으로 분석되었습니다. 피험자 세대 간의 일반적인 특성의 차이는 일원 분산 분석(one-way ANOVA)으로 분석되었습니다. 직업가치, 의사소통유형, 직무만족도, 조직몰입도를 빈도, 백분율, 평균, 표준편차로 분석하였다. 직업가치관, 의사소통유형, 직무만족도, 조직몰입의 세대간 차이는 ANOVA를 이용하여 분석하였고, 사후분석은 Tukey post-hoc을 사용하였다. Spearman의 상관 분석을 사용하여 모든 주제 및 주제 세대에 걸친 직업 가치, 의사 소통 유형, 직업 만족도 및 조직 참여의 상관 관계를 분석했습니다. 분석결과 집단간 직무만족도를 비교한 결과 통계적으로 유의미한 차이가 나타났다. 또한 집단간 조직몰입도를 비교한 결과(F=4.371, p=.010)에서 통계적으로 유의미한 차이가 있었다. 반면 직업적 가치관과 의사소통 유형 간에는 통계적으로 유의한 차이가 없는 것으로 나타났다. 모든 피험자들의 직업가치관, 의사소통의 종류, 직무만족도, 조직몰입의 상관관계를 파악하기 위해 Spearman의 상관분석을 실시하여 변수간의 상관관계를 조사하였다. (r=0.357, p=.001), 직무만족도와 조직몰입도 간의 상관관계(r=0.727, p=.001)가 가장 큰 유의한 상관관계를 보였으며, 직업가치 소통유형 간의 상관관계는 r=0.197, p = .013) 유의한 상관관계를 보였다. 본 연구를 통해 임상간호사의 직업가치관, 의사소통의 종류, 직업만족도, 조직몰입도에 세대차이가 있음을 확인하였다. 따라서 임상간호사의 세대차이로 인한 다양한 중재 프로그램을 개발하고, 세대차이로 인한 갈등을 줄이고, 궁극적으로는 상호이해 교육을 통해 필요한 제도를 확립하는 것이 중요하다.

중소병원으로 전원 온 환자의 카바페넴내성장내세균속균종(carbapenem resistant Enterobacteriaceae, CRE) 보균 위험요인

이미선 한림대학교 간호대학원 2022 국내석사

Background: Carbapenem-resistant Enterobacteriaceae (CRE) infection is a worldwide problem due to the increase in medical costs and high mortality when antibiotics that can treat it are limited. There are limited studies on CRE colonization in general wards of small and medium hospitals in Korea, so there is insufficient evidence to apply an infection control guideline to these patients. Purpose: To identify CRE colonization rates, characteristics of CRE isolates, and risk factors for CRE colonization in CRE culture tests performed within 24 hours of admission in patients transferred to general wards of small and medium-sized hospitals. Methods: Among patients transferred to the general ward of a 280-bed C general hospital in Gyeonggi-do from January 2020 to December 2021, patients who underwent CRE culture tests within 24 hours of admission were enrolled. Forty-seven patients confirmed as positive for CRE were classified to the patient group. For the control group, 235 patients, five times the number of the patient group, were matched by gender, age, and diagnosis, and then selected at random using a random number table. Retrospective data were collected through patients’ medical records, and the statistical program SPSS statistics 25.0 was used for data analysis. General and therapeutic characteristics of patients, and characteristics of CRE isolates were analyzed using, the mean, standard deviation, frequency, and percentage. Factors influencing on CRE colonization were identified using multiple logistic regression analysis. Results : CRE colonization rate was confirmed as 5%, with 47 out of 933 patients were confirmed as colonization. For CRE isolates, Klebsiella pneumoniae was 68% and Escherichia coli was 24%, and the Carbapenemase-producing Enterobacteriaceae (CPE) positive rate was 61.7%. As CPE degrading enzymes, Klebsiella pneumoniae carbapenemase (KPC) was 61.3% and New Delhi metallo-β-lactamase (NDM) was 32.3%. Renal disease (OR 4.933, 95% CI 1.491 to 16.317), heart disease (OR 3.863, 95% CI 1.355 to 11.012), indwelling urinary catheters (OR 4.435, 95% CI 1.591 to 12.362), and cephalosporin antibiotics (OR 8.577, 95% CI 1.234 to 59.605) were identified as risk factors for CRE. Conclusion : Patients with comorbid renal or cardiac disease, having an indwelling urinary catheter, or a history of exposure to cephalosporin antibiotics could be classified as risk factors for CRE colonization in patients transferred to general wards of small and medium size hospitals. It is necessary for patients with risk factors to proactively conduct a CRE culture test, and perform standard precautions and infection control by transmission route. Rapid identification of patients at high risk for CRE would contribute to the prevention of CRE transmission. 배경 : CRE 감염증은 치료할 수 있는 항생제가 제한되면 의료비용의 증가와 사망률이 높아 전 세계적으로 문제가 되고 있으며 CRE 조기 전파 억제를 위해 적극적으로 보균자를 확인하기 위한 능동감시 배양을 권장하고 있다. 이에 CRE 위험요인을 연구한 결과들이 보고되고 있지만, 국내 중소병원의 일반병동을 대상으로 한 연구는 부족하여 중소병원으로 입원하는 환자에게 적용할 수 있는 근거가 부족하다. 목적 : 중소병원 일반병동으로 전원 온 환자의 입원 24시간 내 시행된 CRE 선별검사에서의 CRE 보균율과 특성 및 CRE 보균 위험요인을 파악한다. 방법 : 2020년 1월부터 2021년 12월까지 경기도 소재 280병상의 C 종합병원 일반병동으로 전원 온 환자 중 24시간 이내 CRE 선별검사를 시행한 환자를 대상으로 하였다. CRE 양성으로 확인된 환자 47명을 환자군으로 분류하였으며, 대조군은 환자군의 5배수인 235명을 성별, 나이, 진단명으로 매칭하여 난수표를 이용해 무작위 표출로 선정하였다. 의무기록을 통해 후향적 자료를 수집하였으며 자료 분석은 통계 프로그램 SPSS statistics 25.0을 사용하였다. 연구대상의 일반적 특성, 치료적 특정, CRE 분리 균의 특성은 기술통계를 이용하여 평균, 표준편차, 빈도, 백분율을 산출하였으며 CRE 보균 유무에 따른 특성의 차이는 카이제곱 검정, 독립표본 t 검정으로 시행하였다. CRE 유무에 영향을 미치는 요인은 다중 로지스틱 회귀분석을 실시하였다. 결과 : 연구 결과 CRE 보균율은 933명 중 47명이 보균자로 확인되어 보균율 5%로 확인되었다. CRE 분리 균은 Klebsiella pneumoniae 68%, Escherichia coli 24%로 나타났으며 CPE 양성률은 61.7%로 나타났다. CPE 분해효소로는 KPC 61.3%, NDM 32.3%로 나타났다. 다중 로지스틱 회귀분석을 통해 확인된 CRE 위험요인은 신장질환을 동반한 경우 그렇지 않은 환자에 비해 4.93배 (OR 4.933, 95% CI 1.491~16.317) , 심장질환을 동반한 경우 그렇지 않은 환자에 비해 3.86배 (OR 3.863, 95% CI 1.355~11.012), 유치 도뇨관을 보유한 경우 그렇지 않은 환자에 4.45배(OR 4.435, 95% CI 1.591~12.362), 3개월 이내 세팔로스포린계 항생제에 노출된 경우 그렇지 않은 환자에 비해 8.58배 (OR 8.577, 95% CI 1.234~59.605) 높은 것으로 나타났다. 결론 : 중소병원으로 전원 온 일반병동 입원환자 중 신장질환과 심장질환을 동반하고 유치도뇨관 보유, 세팔로스포린계 항생제 노출 이력 환자는 CRE 보균 위험요인으로 분류할 수 있을 것이다. 위험요인으로 분류된 환자들은 선별검사를 시행하여 CRE 보균 유무를 확인하고 표준주의 준수와 전파경로별 감염관리 수행을 할 필요가 있다. CRE 위험 환자를 조기에 선별하는 것은 CRE 전파를 조기에 차단하는 것에 기여할 수 있을 것이다.

수술실 간호사가 인지하는 조직건강, 안전분위기, 간호근무환경이 환자안전관리활동에 미치는 영향

김미라 한림대학교 간호대학원 2018 국내석사

This study was conducted to identify the effects of organizational health, safety climate, nursing practice environment on patient safety management activities perceived by operating room nurses, to examine the relationships among them, and then to provide basic information for improvement patient safety management activities. The 176 staff nurses in the operating room were collected from one advanced general hospital and five general hospitals located in Seoul, Gyeonggi-do and Gangwon-do. And data collection was conducted from August 10 to August 25, 2018 using structured questionnaire. The tools for this study were the organizational health scale, PSCHO(Patient Safety Climate in Healthcare Organization) scale, PES-NWI(Practice Environment Scale of the Nursing Work Index) scale, and the patient safety management activity scale. Data were analyzed using independent t-test, One way ANOVA, Scheffé test, Pearson's correlation coefficients and stepwise multiple regression with the SPSS/WIN 25.0 program. Finds of the study are as follows. 1. The degree of organizational health perceived by operating nurses was 2.85 points(range: 1~5), that of safety climate was 2.96 points(range: 1~5), that of nursing practice environment was 2.39 points(range: 1~4), and that of patient safety management activities was 4.18 points(range: 1~5). 2. Organization health of operating room nurses in the aspect of general characteristics showed statistically meaningful differences depending on work experience and participation in accreditation. There were statistically differences on safety climate in the aspect of general characteristics relying on positions and number of safety education. Nursing practices environment from an aspect of general characteristics showed statistically meaningful differences depending on participation in accreditation. Characteristics that showed statistically significant differences in patient safety management activities were worked experience, number of safety education, hospital size, and participation in accreditation. 3. In correlational analysis, Organizational health and Safety climate had a significantly positive correlation with patient safety management activities. There was no correlation between nursing work environment and patient safety management activities. 4. Factors affecting patient safety management activities include organizational health, nursing practice environment, participation in accreditation, work experience, and hospital size, and their explanatory power was 17%. Consequently, this study is meaningful in providing basic information by identifying the relationship and impact of operating room nurses on their patient safety management activities through access to organizational levels beyond individual levels. It is also meaningful to promote hospital-level interest in nursing activities. The factors that the greatest impact on patient safety management activities of operating room nurses have identified as organizational health. Therefore, Hospitals should make efforts to construct healthy organizations to improve patient safety management activities of operating room nurses, increase the level of participation in accreditation by actively delegating authority, and prepare to maintain their work experience. In addition, repeated studies of the nursing practices environment and patient safety activities of operating room nurses are required, and support is provided to meet the size and needs of the hospital.

신규간호사의 간호실무준비도, 회복탄력성, 프리셉터 교육행동이 이직의도에 미치는 영향

김진희 한림대학교 간호대학원 2024 국내석사

The purpose of this study was to provide basic data for efficient human resource management by identifying the factors that influence nursing practice readiness, resilience and preceptors' teaching behavior on turnover intention among new graduate nurses with a high resignation rate. A descriptive survey was conducted on 168 new graduate nurses from August 7 to August 31, 2023. To evaluate nursing practice readiness, resilience, preceptors' teaching behavior and turnover intention, a structured questionnaire was administered online (Google Questionnaire) and offline. Data analysis was performed using descriptive statistics, t-test, ANOVA, Pearson's correlation and hierarchical multiple regression analysis. The factors affecting turnover intention were found to be preceptors' teaching behavior (β=-.287, p=.001) and resilience (β=-.211, p=.026). The explanatory power of this model was 32.0%. As a result of the above study, it was confirmed that resilience and preceptors' teaching behavior are factors influencing the turnover intention of new graduate nurses. Therefore, an organizational support system is needed to reduce turnover intention. There is a need to develop and apply practical programs to improve resilience. Participation in resilience promotion programs should be carried out on a regular basis. To reduce the preceptors' workload, work relief and appropriate compensation should be provided. Advice and support should be provided by dedicated educational nurses. An experienced nurse with a mature personality who has completed preceptor training should be selected as a preceptor. To strengthen the capabilities of preceptors, it is necessary to establish an organized system for periodic education, such as workshops and advanced preceptor training courses.

간호사의 간호근무환경과 업무강도가 사회심리적 건강에 미치는 영향

김영아 한림대학교 간호대학원 2024 국내석사

This study was conducted to identify the influencing factors of nurses' nursing work environment and labor intensity on their psychosocial well-being and to provide basic data for efficient human resource management. Data were collected from 170 nurses with more than 6 months of experience working in a university hospital from September 6 to September 13, 2023. The collected data were subjected to descriptive statistics, t-test, ANOVA, correlation analysis, and hierarchical multiple regression analysis using SPSS 25.0 program. The results of the study showed that nursing work environment showed significant differences in gender, marital status, housing status, subjective health status, helpers, salary satisfaction, and overtime hours, labor intensity showed significant differences in number of children, subjective health status, position, work department, salary satisfaction, and overtime hours and psychosocial well-being showed significant differences in gender, subjective health status supptor, and overtime hours. There was a negative correlation between nursing work environment and labor intensity, a negative correlation between nursing work environment and psychosocial well-being, and a positive correlation between labor intensity and psychosocial well-being, indicating that the more positive the nursing work environment and the lower the labor intensity, the higher the level of psychosocial well-being. The main factors affecting psychosocial well-being were subjective health status, labor intensity, and supptor, and the nursing work environment did not have a significant effect on psychosocial well-being. The results of this study can serve as a basis for human resource management by identifying the psychosocial well-being status of nurses and suggesting management measures to increase the level of psychosocial well-being. In addition, we recommend further research on intervention studies that can increase the level of psychosocial well-being of nurses by expanding the region and sample size and identifying various variables that affect psychosocial well-being. Keywords: nurses, work environment, labor Intensity, psychosocial well-being

간담췌 수술 노인의 일상생활 수행능력과 건강정보 이해능력이 자가간호에 미치는 영향

진보라 한림대학교 간호대학원 2024 국내석사

PURPOSES : The purpose of this study was to evaluate the activities of daily living, health literacy, and self-care levels of individuals aged 65 years or older who are hospitalized after surgery for liver, bile duct, gallbladder, and pancreatic cancers. The objective is to understand the impact on self-care and to collect foundational data for establishing nursing interventions and discharge care plans to enhance the self-care capabilities of post-hepatobilliary and pancreatic surgery. METHODS : The study was performed with a cross-sectional descriptive survey design. Participants in this study were 95 elderly with patients who elderly patients diagnosed with liver, biliary tract, gallbladder, and pancreatic cancer, who agreed to participated and underwent surgery at the Hepatobiliary and Pancreatic Surgery Center in H University Hospital, Gyeonggi-do were collected and analyzed. Participants completed self-report questionnaires regarding activities of daily living, health literacy, and self- care.Data were analyzed with descriptive statistics, independent t-tests, ANOVA, Pearson’s correlation coefficient, and Multiple linear regression. RESULTS : Overall, the levels of activities of daily living, health literacy, and self-care were reported as moderate to high in elderly with after hepatobiliary and pancreatic surgery Participants’self-care showed significant correlations with ADL(r=-.516, p<.001), IADL(r=-7.44, p<.001) and health literacy(r=0.739, p<.001). The results of the multiple regression analysis on factors influencing self-care among the subjects indicated that health literacy, IADL, being 80 years old or older, and having three or more comorbidities were identified as factors influencing self-care. This regression model accounted for 64.2% of the variances. CONCLUSIONS: This study identifies that the self-care of the elderly after hepatobiliary pancreatic surgery had a significant correlation with the activities of daily living, health literacy. The factors identified as influencing self-care were activities of daily living, health literacy, over 80 years of age, and three or more comorbidities. .Therefore, the development of a comprehensive evaluation tool to evaluate the level of elderly patients, customized self-care intervention program and nursing plan after discharge are needed in order to improve the level of self-care of elderly patients after hepatobiliary pancreatic surgery.

국내 전담간호사의 전문직 자율성, 의사와의 협력, 도덕적 고뇌가 직무만족도에 미치는 영향

김윤미 한림대학교 간호대학원 2018 국내석사

Background: In nursing research, professional autonomy, nurse-physician relationship, or moral distress has been regarded as crucial influencing factors on nurses’ job satisfaction. However, there is little known research about these variables on job satisfaction among physician assistant nurses in South Korea. Purpose: The purpose of this study was to verify the impact of professional autonomy, nurse-physician collaboration and moral distress on job satisfaction among physician assistant nurses in South Korea. Methods: A descriptive and correlational research was adopted by a convenience sample of 130 physician assistant nurses from five general hospitals in South Korea. Data was collected between August and September in 2017. Data was analyzed by SPSS/WIN 21.0 program for t-test, ANOVA, Pearson correlation coefficient, and Stepwise multiple regression analysis. Ethical considerations: This study was approved by the Institute Review Board of Hallym University before data collection(HIRB-2017-047). Results: The level of job satisfaction was positively correlated with professional autonomy(r =.193, p =.028) and nurse-physician collaboration(r =.343, p <.001). In the final regression model, the adjusted R square was significantly 18.9% of the variance of job satisfaction (F=4.349, p<.001), The nurse-physician collaboration related to cooperativeness (β=.432, p<.001) perceived by physician assistant nurses was significantly an influential factor on the level of job satisfaction among physician assistant nurses. Conclusion: In hospital settings, nurses and physicians should be required to improve their professional relationship to be more cooperative in order to increase physician assistant nurses` job satisfaction, which can enrich quality of care and enhance patients` outcome.

간호대학생의 간호전문직관, 임상실습 스트레스, 진로정체감과의 관계

이아람 한림대학교 간호대학원 2018 국내석사

Purpose: The purpose of this study was to investigate the relationship among nursing professional value, clinical practice stress, and career identity among nursing students. Methods: The data were collected by 190 nursing students in G city from September 3 to October 31, 2018. A self-reported questionnaire was conducted to 190 participants who understanding the purpose of this study. In order to measure the nursing professional value, the items developed by Yeun, Eun-Ja et al(2005) were used. Clinical practice stress measuring instrument was developed by Beck & Srivastava(1991) and, modefied and adopted by Kim, Soon-Lea, Lee, Jong-Eun(2005) was used. Career identity measurement was used a Instrument developed by Holland & Power(1980) that was adapted by Kim Bong-hwan and Kwon Yoon-hee that was adapted for a nursing students. This study was approved by the Institute Review Board of Hallym University before data collection(HIRB-2018-038). The collected data was analyzed using statistics programs SPSS WIN 22.0. frequency and percentage, mean, standard deviation, t-test, ANOVA, Scheffétest, Pearson's Correlation Coefficient, and Multiple Regression Analysis were performed to analyze. Results: The average score of nursing professional value, clinical stress and career identity were 3.27, 3.22, and 2.47. There were positive correlations between nursing professional value, and career identity. There were negative correlation between clinical stress, and career identity. Satisfaction of major, nursing professional value, school grades, motivation of entrance(aptitude and interest), interpersonal relationship, and clinical stress were significant predictors of career identity in nursing students. The regression model resulted in 33.8% career identity. Conclusions: The development of programs to enhance the career identity and research to prove their effectiveness is necessary.