요양병원 간호 관련 종사자들의 낙상지식과 태도 및 환자안전문화가 낙상예방활동에 미치는 영향

홍수련 경상국립대학교 대학원 2022 국내석사

본 연구는 요양병원에 근무하는 간호 관련 종사자를 대상으로 낙상지식, 낙상태도, 환자안전문화, 낙상예방활동의 정도를 파악하고, 낙상지식, 낙상태도, 환자안전문화가 낙상예방활동에 미치는 영향을 확인하여 매년 증가하는 노인의 낙상을 예방하기 위한 전략을 마련하기 위한 기초자료로 제공하고자 시도되었다. 자료 수집 기간은 2021년 9월 17일부터 10월 1일까지이었으며 G대학교 생명윤리심의위원회의 심의를 받은 후 경상남도 J시와 T시에 소재한 요양병원 4곳에 근무하는 간호사와 간호조무사 139명을 대상으로 하였다. 수집된 자료는 SPSS/WIN 25.0 프로그램을 이용하여 Independent t-test, One-way ANOVA, Scheffe' test, Pearson’s Correlation Coefficient, Multiple Regression analysis로 분석하였다. 본 연구의 결과는 다음과 같다. 1) 요양병원 간호 관련 종사자들의 낙상지식은 14점 만점에 평균 11.75±2.00점, 낙상태도는 5점 만점에 평균 3.68±0.37점, 환자안전문화는 5점 만점에 평균 3.88±0.48점, 낙상예방활동은 5점 만점에 평균 4.44±0.56점이었다. 2) 요양병원 간호 관련 종사자들의 낙상지식은 간호사와 간호조무사 두 집단 간에 유의한 차이가 있었으며(t=3.37, p<.001), 간호사(12.35±1.52)가 간호조무사(11.14±2.49)에 비해 높았다. 낙상태도(t=0.13, p=.894), 환자안전문화(t=-0.40, p=.688), 낙상예방활동(t=0.60, p=.550)은 두 집단 간 유의한 차이가 없었다. 3) 요양병원 간호 관련 종사자들의 낙상지식, 낙상태도, 환자안전문화 및 낙상예방활동의 상관관계 분석 결과 간호사의 경우 낙상예방활동은 낙상태도(r=.60, p<.001), 환자안전문화(r=.59, p<.001)와 유의한 양의 상관관계가 있었다. 또한 낙상태도는 환자안전문화(r=.41, p<.001)와 유의한 양의 상관관계가 있었다. 간호조무사의 경우 낙상예방활동은 낙상태도(r=.41, p<.001), 환자안전문화(r=.74, p<.001)와 유의한 양의 상관관계가 있었다. 또한 낙상태도는 환자안전문화(r=.36, p=.003)와 유의한 양의 상관관계가 있었다. 4) 요양병원 간호 관련 종사자들의 낙상예방활동에 영향을 미치는 요인은 간호사의 경우 환자안전문화(β=.44, p<.001), 낙상태도(β=.38, p<.001), 현부서 경력(β=.20, p=.017)이었으며, 설명력은 52%이었다. 간호조무사의 경우 환자안전문화(β=.74, p<.001)이었으며, 설명력은 54%이었다. 결론적으로 요양병원의 간호 관련 종사자의 낙상예방활동에 영향을 미치는 요인은 간호사는 환자안전문화, 낙상태도, 현부서 경력이었으며, 간호조무사는 환자안전문화이었다. 이에 요양병원 간호 관련 종사자들의 낙상 예방을 위하여 환자안전문화의 수준을 높이기 위한 전략을 개발하고 적용할 것을 제안한다. The purpose of this study is to examine the effects of knowledge and attitudes regarding fall and patient safety culture on fall prevention activities among nursing staffs in long-term care hospitals. The data collection period was from September 17 to October 1, 2021, and the study participants included 139 nurses and nursing assistants working at four nursing hospitals located in J and T cities in Gyeongsangnam-do. The study measurements include a fall prevention activity tool developed by Kim Min-young (2008), a fall knowledge tool developed by Kim Cheol-gyu (2002), a fall knowledge tool modified and supplemented by Lee Eon-joo (2014), a fall status tool developed by Kim Cheol-gyu (2002), and a patient safety culture tool developed by Lee Soon-kyo (2015). The collected data were analyzed using frequency, percentage, standard deviation, Independent t-test, One-way ANOVA, Scheffe's test, Pearson's correlation coefficient and Stepwise Multiple Regression by SPSS/Win 25.0 program. The results were as follows: 1) The mean score of fall knowledge was 11.75±2.00(range 1-14), The mean score of attitudes regarding fall was 3.68±0.37(range 1-5), The mean score of patient safety culture was 3.88±0.48(range 1-5), The mean score of fall prevention activities was 4.44±0.56(range 1-5). 2) There was a significant difference between nurses and nursing assistants working in long-term care hospitals in terms of the level of fall knowledge (t=3.37, p<.001). nurses (12.35±1.52) were higher than nursing assistants (11.14±2.49). Attitudes regarding fall (t=0.13, p=.894), patient safety culture (t=-0.40, p=.688), fall prevention activities (t=0.60, p=.550) showed no significant difference between the two groups. 3) As the result of analyzing relationships between fall knowledge, Attitudes regarding fall, patient safety culture, and fall prevention activities of among nursing staffs in long-term care hospitals, there were significant positive relationships between fall prevention activities and attitudes regarding fall (r=.60, p<.001) and patient safety culture (r=.59, p<.001) for nurses. In addition, there was a significant relationship between nurses’ attitudes regarding fall and patient safety culture (r=.41, p<.001). In the case of nursing assistants, there was a significant positive relationships between fall prevention activities and attitudes regarding fall (r=.41, p<.001) and patient safety culture (r=74, p<.001). In addition, there was a significant positive relationship between nursing assistants’ attitudes regarding fall patient safety culture (r=.36, p=.003) 4) The factors influencing fall prevention activities for nurses in long-term care hospitals were patient safety culture (β=.44, p<.001), attitudes regarding fall (β=.38, p<.001) and nursing experiences of current department (β=.20, p=.017) explaining 52% of the variance. In the case of nursing assistants, the factors influencing fall prevention activities was a patient safety culture (β=.74, p<.001) explaining 54% of the variance. Conclusion: We suggest that the effective program is developed to improve the levels of patient safety culture for nursing staffs in order to prevent patients’ falls in long-term care hospitals.

임상간호사의 임종간호수행에 미치는 영향요인 : 긍정심리자본, 임종간호스트레스, 환자-가족 중심 간호에 대한 인식

구연희 경상국립대학교 대학원 2023 국내석사

The purpose of this study was to examine the effects of clinical nurses’ positive psychological capital, terminal care stress and perception of patient-family centered care on performance of terminal care in order to improve their performance of terminal care. The subjects of this study were 198 nurses who had worked for more than 12 months of clinical experiences at an advanced general hospital in J city as well as had nursing experiences for dying patients at least once. Data were collected from August 9th to August 23rd, 2022. The collected data were analyzed using frequency percentage, mean, standard deviation, independent t-test, one-way ANOVA, Scheffés test, Pearson’s correlation coefficient, and stepwise multiple regression analysis by SPSS/WIN 25.0 program. The results of this study are summarized as follows. 1) The general characteristics of clinical nurses were as follows. The clinical nurses’ mean age was 29.08±4.63 years old and most of them were female (97.4%). The mean years of nursing experiences in the current department was 3.46±2.49 years. More than one third of nurses (32.1%) worked in the medical ward, followed by intensive care unit (24.4%), hemato-oncology (20.7%), surgical ward (18.7%), and hospice ward (4.1%). With regard to characteristics of terminal care performance, 123 nurses (63.7%) reported that they had experience of family members’ and acquaintances’ death. The average number of terminal care for dying patients within 1 year was 7.44±14.08. More than half of nurses (59.1%) had no experiences of terminal care education. Most nurses (63.2%) said that they had heard of patient-family-centered care. Majority of nurses (83.9%) had no experiences of patient-family centered care education. 2) According to the mean scores of each variable, positive psychological capital was 3.88±0.56 (range 1-6), terminal care stress was 3.67±0.55 (range 1-5), perception of patient-family centered nursing was 3.20±0.41 (range 1-4), and performance of terminal care was 2.38±0.35 (range 1-4). 3) There were significant differences between clinical nurses’ performance of terminal care and nursing experiences in current department (F=3.60, p=.015), work department (t=2.36, p=.019), number of terminal care provided to dying patients within 1 year (F=2.76, p=.044), and experience of patient-family centered care education (t=-2.26, p=.025). 4) There were significant positive relationships between clinical nurses’ performance of terminal care and positive psychological capital (r=.46, p<.001), and patient-family centered care (r=.36, p<.001). However, there was no significant correlation between clinical nurses’ performance of terminal care and terminal care stress (r=.03, p=.373). 5) The factors affecting clinical nurse’s performance of terminal care were positive psychological capital (β=.38, p<.001), perception of patient-family centered care (β=.23, p=.001), department (β=.15, p=.014), and experience of patient-family centered care education (β=.14, p=.026), explaining 30.4% of the variance. In conclusion, the factors affecting clinical nurses’ performance of terminal care were positive psychological capital, perception of patient-family centered care, work department, and experience of patient-family centered care education. Based on the results of this study, the effective education program is needed to enhance clinical nurses’ positive psychological capital as well as to increase their education experience and awareness of patient-family centered care in order to better perform terminal care.

중환자실 간호사의 인간중심 간호 수행 영향요인 : 대상자중심 의사소통 능력, 의사소통 유형 및 간호조직문화를 중심으로

전혜민 경상국립대학교 대학원 2023 국내석사

The purpose of this study was to examine the relationships between person-centered nursing, patient-centered communication competence, communication style, and nursing organizational culture and to identify influential factors on person-centered nursing of intensive care unit nurses. The subjects of this study were 139 nurses who had worked for more than 6 months in intensive care units (ICU) at hospitals in J and C cities and provided direct care to patients. Data were collected from September 2nd to October 19th, 2021. The collected data were analyzed using frequency, percentage, mean, standard deviation, Independent t-test, one-way ANOVA, Scheffe's test, Pearson's correlation coefficient, and stepwise multiple regression analysis by SPSS/WIN 26.0 program. The results of this study are summarized as follows. 1) The mean age of ICU nurses was 28.56±4.37 years old. The mean years of nursing experiences were 5.59±4.27 years and the mean years of ICU nursing experiences were 4.31±3.14 years. Majority of nurses (76.3%) reported that they had heard about person-centered nursing. More than half of nurses (64.7%) had no experience about person-centered nursing education. Most nurses (71.9%) agreed on the necessity of person-centered nursing education. 2) The mean score of ICU nurses’ person-centered nursing was 3.41±0.48 (range 1-5). The mean score of patient-centered communication competence was 4.01±0.74 (range 1-6). The mean scores of communication style subcategories were: 3.85±0.50 for informative communication, 3.47±0.62 for affiliative communication, and 2.72±0.40 for authoritative communication (range 1-5). The mean scores of nursing organizational culture subcategories were: 3.54±0.51 for hierarch-oriented culture, 3.26±0.69 for relation-oriented culture, 2.97±0.59 for innovation-oriented culture, and 2.64±0.48 for task-oriented culture (range 1-5). 3) There were significant differences between ICU nurses’ person-centered nursing and experience of person-centered nursing education (t=2.65, p=.009), necessity of person-centered nursing eduction (F=6.66, p=.002). 4) There were significant positive correlations between ICU nurses’ person-centered nursing and patient-centered communication competence (r=.77, p<.001), informative communication (r=.55, p<.001), affiliative communication (r=.62, p<.001), relation-oriented culture (r=.23, p=.007), innovation-oriented culture (r=.36, p<.001) as well as task-oriented culture (r=.30, p<.001). However, there was a significant negative correlation between person-centered nursing and authoritative communication (r=-.49, p<.001). 5) Influential factors on ICU nurses’ person-centered nursing were patient-centered communication competence (β=.69 p<.001) and authoritative communication (β=-.18, p=.002) explaining 62.0% of the variance. In conclusion, factors affecting ICU nurses’ person-centered nursing were patient-centered communication competence and authoritative communication. Based on these results, we suggest that the intervention program of patient-centered communication competence considering the ICU environment should be developed to improve person-centered nursing for ICU nurses. Also, we suggest providing communication training for ICU nurses that can reduce the authoritative communication.

간호대학생의 노인차별주의에 미치는 영향요인 : 노인에 대한 지식 및 태도, 가족건강성, 노인이미지

하수정 경상국립대학교 대학원 2023 국내석사

The purpose of study was to examine the relationships between knowledge and attitude toward the elderly, family health, image of the elderly, and elderly discrimination for nursing students and to identify the factors affecting elderly discrimination for them. The subjects of this study were 208 nursing students from G University located in J city and from M University located in C city. Data were collected from October 13th to October 25th, 2022. The collected data were analyzed using frequency, percentage, standard deviation, Independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and multiple regression by the SPSS/WIN 25.0 program. The results of this study are summarized as follows. 1) The nursing students’ mean score of knowledge of the elderly was 11.46±3.23 (range 0-25) and the percentage of correct answers was 46%. There was a significant differences between the levels of grade in knowledge of the elderly (F=3.55, p=.015). 2) The nursing students’ mean score of attitudes toward the elderly was 3.86±0.73 (range 1-7). There were significant differences between gender (t=2.00, p=.047), levels of grade (F=2.72, p=.045), and experience of elderly-related education (t=-2.38, p=.018) in attitudes toward the elderly. 3) The nursing students’ mean score of family health was 3.89±0.69 (range 1-5). There was no significant differences between general characteristics in family health. 4) The nursing students’ mean score of the elderly image was 3.02±0.34 (range 1-5). There was a significant difference between gender in elderly image (t=-4.27, p<.001). 5) The nursing students’ mean score of elderly discrimination was 2.21±0.27 (range 1-4). There were significant differences between experience of elderly-related education (t=-3.90, p<.001) and experience of elderly-related volunteer (t=-2.79, p=.009) in elderly discrimination. 6) There was a positive relationship between elderly discrimination and attitudes toward the elderly (r=.42, p<.001), while there were negative relationships between elderly discrimination and knowledge of the elderly (r=-.16, p=.016), family health (r=-.25, p<.001) as well as images of the elderly (r=-.43, p<.001). 7) The factors affecting elderly discrimination for nursing students were experience of elderly-related education (β=.19, p=.002), attitude toward the elderly (β=.16, p=.041), family health (β=-.16, p=.008), image of the elderly (β=-.26, p=.001) explaining 30.1% of the variance. In conclusion, the factors affecting nursing student’s elderly discrimination were attitude toward the elderly, family health, and image of the elderly. Based on the results of this study, it is suggested that various efforts and strategies such as research about the development of educational program are needed to improve the perception of elderly discrimination.

요양병원 간호인력의 의사소통능력, 공감력, 인간중심돌봄환경이 인간중심돌봄에 미치는 영향

오은정 경상국립대학교 대학원 2022 국내석사

본 연구는 요양병원 간호인력의 의사소통능력, 공감력, 인간중심돌봄환경 및 인간중심돌봄의 관계를 파악하고, 이들 요인이 인간중심돌봄에 미치는 영향을 확인하기 위한 서술적 조사연구이다. 이번 연구 대상은 경남 J·S시에 위치한 100병상 이상 400병상 미만의 요양병원 소속 요양인력 149명이다. 데이터는 2022년 3월 2일부터 3월 25일까지 수집되었다. 본 연구는 SPSS/WIN 25.0 프로그램을 통해, 빈도, 백분율, 표준 편차, Independent t-test, One-way ANOVA, Scheffé test, Pearson’s Correlation Coefficient 및 (Multiple Regression을 사용하여 실시하였다. 본 연구 결과를 요약하면 다음과 같다. 1) 간호사의 의사소통능력은 평균 3.69±.06점(1-5점)이었고, 간호조무사 평균 3.56±.05점(1-5점)이었다. 대상자의 일반적 특성에 따른 간호사의 의사소통능력은 임금만족도(F=7.78, p=.001)에 따라 유의한 차이가 있었고, 대상자의 일반적 특성에 따른 간호조무사의 의사소통능력은 임상경력(F=2.96, p=.037)에서 유의한 차이가 있는 것으로 나타났다. 2) 간호사의 공감력은 평균 3.76±.05점(1-5점)이었으며, 간호조무사의 공감력은 평균 3.73±.05점(1-5점) 이었다. 대상자의 일반적 특성에 따른 간호사의 공감력은 유의한 차이를 보이지 않았고, 대상자의 일반적 특성에 따른 간호조무사의 공감력은 임금만족도(F=5.46, p=.006)에 따라 유의한 차이가 있는 것으로 나타났다. 3) 간호사의 인간중심돌봄환경은 평균 4.31±.10점(1-6점)이었고, 대상자의 일반적 특성에 따른 간호사의 인간중심돌봄환경은 유의한 차이를 보이지 않았다. 간호조무사의 인간중심돌봄환경은 평균 4.24±.09점(1-6점)이었고, 대상자의 일반적 특성에 따른 간호조무사의 인간중심돌봄환경은 임금만족도(F=3.60, p=.031)에 따라 유의한 차이가 있는 것으로 나타났다. 4) 간호사의 인간중심돌봄은 평균 3.41±.08점(1-5점)이었으며,대상자의 일반적 특성에 따른 간호사의 인간중심돌봄은 유의한 차이를 보이지 않았다. 간호조무사의 인간중심돌봄은 평균 3.47±.60점(1-5점)이었으며, 대상자의 일반적 특성에 따른 간호조무사의 인간중심돌봄은 현병원경력(F=3.58, p=.017)에 따라 유의한 차이가 있었다. 5) 간호사의 인간중심돌봄은 의사소통능력(r=.59, p<.001), 공감력(r=.65, p<.001), 인간중심돌봄환경(r=.41, p<.001)과 양의 상관관계가 있었다. 간호조무사의 인간중심돌봄은 의사소통능력(r=.35, p<.001), 공감력(r=.34, p<.001), 인간중심돌봄환경(r=.26, p<.001)과 양의 상관관계가 있었다. 6) 간호사의 인간중심돌봄에 영향을 미치는 요인으로 공감력(β=.48, p=.002)이었으며, 설명력은 46.3%이었다. 간호조무사의 인간중심돌봄에 영향을 미치는 요인으로 현병원경력 10년 이상(β=.32, p=.002), 인간중심돌봄환경(β=.26, p=.008)이었고, 설명력은 27.9%이었다. 결론적으로 요양병원 간호사의 인간중심돌봄에 영향을 미치는 요인은 공감력이었고, 요양병원 간호조무사사의 인간중심돌봄에 영향을 미치는 요인은 현병원경력 10년이상, 인간중심돌봄환경이었다. 이에 요양병원 간호인력의 인간중심돌봄을 향상을 위해서는 지속적인 인간중심돌봄 교육과 인간중심돌봄 향상을 위한 프로그램을 개발 및 환경개선 등의 다양한 노력과 전략이 필요하다고 사료된다. Key words: Person-centered care; Communication ability; Empathy, Person-centered climate; Nursing staff; Long-term care hospital The purpose of study was to examine the effects of communication ability, empathy, person-centered climate on person-centered care among nursing staffs in long-term care hospitals. The subjects of this study were 149 nursing staffs from nursing hospitals with 100 or more and less than 400 beds located in J and S cities of Gyeongsangnam-do. Data were collected from March 2nd to March 25th, 2022. The collected data were analyzed using frequency, percentage, standard deviation, Independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and multiple regression by the SPSS/WIN 25.0 program. The results of this study are summarized as follows. 1) The mean scores of communication ability were 3.69±0.06 (range 1-5) for nurses and 3.56±.05 (range 1-5) for nursing assistants. There was a significant difference between salary satisfaction for nurses in communication ability (F=7.78, p=.001). There was a significant difference between years of clinical nursing experience for nursing assistants in communication ability (F=2.96, p=.037). 2) The mean scores of empathy was 3.76±0.05 (range 1-5) for nurses and 3.73±0.05 (range 1-5) for nursing assistants There was no significant difference between general characteristics for nurses in empathy. There was a significant difference between salary satisfaction for nursing assistants in empathy (F=5.46, p=.006). 3) The mean scores of person-centered climate was 4.31±0.10 (range 1-6) for nurses and 4.24±.09 (range 1-6) for nursing assistants. There was no significant difference between general characteristics for nurses in person-centered climate. There was a significant difference between salary satisfaction for nursing assistants in person-centered climate (F=3.60, p=.031). 4) The mean scores of person-centered care was 3.41±0.08 (range 1-5) for nurses and 3.47±0.60 (range 1-5) for nursing assistants. There was no significant difference between general characteristics for nurses in person-centered care. There was a significant difference between years of current hospital’s nursing experience for nursing assistants in person-centered care (F=3.58, p=.017). 5) There were positive relationships between Person-centered care and communication ability(r=.59, p<.001), empathy(r=.65, p<.001), and person-centered climate(r=.41, p<.001) for nurses. There were positive relationships between person-centered care and communication ability(r=.35, p<.001), empathy(r=.34, p<.001), and person-centered climate(r=.26, p<.001) for nursing assistants. 6) The factor affecting person-centered care for nurses was empathy (β=.48, p=.002) explaining 46.3% of the variance. In case of nursing assistants, the factors affecting person-centered care were more than 10 years of current hospital’s nursing experience(β=.32, p=.002) and person-centered climate(β=.26, p=.008) explaining 27.9% of the variance. In conclusion, the factor affecting person-centered care was empathy for nurses in long-term care hospitals. The factors affecting person-centered care were more than 10 years of current hospital’s nursing experience and person-centered climate for nursing assistants in long-term care hospitals. Based on the results of this study, we suggest that the continuous education and various efforts such as the development of effective program and improvement of hospital environment are needed to promote person-centered care for nursing staffs in long-term care hospitals. Key words: Person-centered care; Communication ability; Empathy, Person-centered climate; Nursing staff; Long-term care hospital

성인중환자실 간호사의 소음관리 수행도에 영향을 미치는 요인

김서정 경상국립대학교 대학원 2022 국내석사

The purpose of this study was to examine the relationships between nurses’ performance of noise management, noise experience, noise-related knowledge, response to noise, and patient safety culture and to identify factors affecting nurses’ performance of noise management in adult intensive care units. The subjects of this study were 148 nurse in adult intensive care unit with over 3 months of clinical experience working at advanced general hospitals in J and C cities. Data were collected from April 1st to 20th, 2022. The collected data were analyzed using frequency, percentage, mean, standard deviation, Independent t-test, one-way ANOVA, Scheffe's test, Pearson's correlation coefficient, and hierarchical multiple regression analysis by SPSS/WIN 25.0 program. The results of this study are summarized as follows. 1) The general characteristics of nurses in adult intensive care units were as follows. The nurses’ mean age was 28.36±4.29 years old and most of them was general nurses (96.6%). The mean years of nurses’ nursing experience was 5.52±4.34 years and the mean years of working experience in the intensive care unit was 4.23±2.30 years. Regarding noise-related characteristics, 35 nurses (23.6%) reported that the unit applied ‘quiet time’ and ‘quiet time’ was applied between midnight and 8 am. However, 113 nurses (76.4%) reported that the unit did not apply ‘quiet time.’ 147 nurses (99.3%) reported that they had no experience of receiving education on noise management. 112 nurses (75.5%) reported that the education on noise management is needed. 2) The mean score of noise experience frequency was 3.05±0.62 (range 1-4). The mean scores of its subcategories were: 3.41±0.62 of medical device factors, 2.99±0.63 of human factors, 2.96±0.84 of environmental factors. The mean score of perceived noise levels was 4.69±1.51 (range 0-10). The mean scores of its subcategories were: 5.93±1.84 of medical device factors, 4.50±1.51 of human factors, 4.05±1.90 of environmental factor. The total score of noise-related knowledge was 28.91±9.98 (range 0-54) and the percentage of correct answer was 54%, which was generally low. The mean score of response to noise was 4.89±2.32 (range 0-10). The mean scores of its subcategories were: 4.22±2.29 of physiological response and 5.42±2.55 of emotional response. The mean score of patient safety culture was 3.52±0.49 (range 1-5). The mean scores of its subcategories were: 3.86±0.66 of patient safety knowledge and attitude, 3.72±0.63 of teamwork, 3.62±0.71 of leadership, 3.53±0.72 of patient safety policy and procedure, 3.30 ±0.74 of patient safety improvement system, 3.26±0.83 of non-punitive environment, and 2.86±0.70 of patient safety priority. The mean score of performance of noise management performance was 3.45±0.64 (range 1-5). 3) There was a significant difference between the necessity of noise management education in nurses’ performance of noise management (t=2.66, p=.009). 4) There were significant positive relationships between nurses’ performance of noise management and noise experience frequency (r=.20, p=.013), noise-related knowledge (r=.21, p=.009), response to noise (r=.23, p=.005) as well as patient safety culture (r=.50, p<.001). 5) The factors affecting nurses’ performance of noise management in adult intensive care units were noise experience frequency (β=.16 p<.030), teamwork of patient safety culture (β=.33, p=.006) and patient safety policy and procedure of patient safety culture (β=.25, p=.037) explaining 37.9% of the variance. In conclusion, the factors affecting nurse’ performance of noise management in the adult intensive care unit were noise experience frequency, teamwork of patient safety culture, and patient safety policies and procedures of patient safety culture. Based on these results, we suggest that the a noise reduction intervention program should be developed using teamwork reinforcement and team approach to improve performance of noise management for nurses in adult intensive care units. Also, in addition to nurses’ personal efforts for noise management, organizational efforts and strategies are needed by establishing patient safety policies and procedures related to hospital noise at the hospital level.

신규간호사의 그릿, 사회적지지와 재직의도 관계에서 전환충격의 매개효과

지혜영 경상국립대학교 대학원 2023 국내석사

The purpose of this study was to examine the relationships between grit, social support, transition shock, and retention intention for new graduate nurses and to determine the mediating effect of transition shock on the relationships among grit, social support, and retention intention for new graduate nurses. The study participants were 174 new graduate nurses who had worked at one university hospital and one general hospital with more than 500 beds located in C city, G province. Data were collected from November to December 2022. The collected data were analyzed using frequancy, percentage, mean and standard deviation, independent t-test, one-way ANOVA, Scheffés test, Pearson’s correlation coefficient, Baron and Kenny’s (1986) three-step regression analysis, and bootstrapping by SPSS/WIN 27.0 program. The results of this study are summarized as follows: 1) Regarding the general characteristics of new graduate nurses, most participants were women(82.2%), and their mean age was 23.99±1.85 years old. Majority were unmarried(98.3%) and had no religion(74.1%). Participants’ mean work experience was 7.51±2.05 months; most had worked from 5 to 8 months(51.7%). Most did shift work(93.7%), and more than one-third of participants worked in Emergency/ICU/Surgery(36.2%). Most participants were assigned to departments they desired(68.4%) and reported that they could get off on any day they desired(78.7%). More than half of the participants (52.9%) reported being satisfied with their job, and about one-third (28.7%) reported being satisfied with their salary. 2) According to the mean scores of each variable, grit was 2.95±0.32 out of 4, social support was 3.81±0.61 out of 5, transition shock was 2.57±0.49 out of 4, and retention intention was 5.25±1.35 out of 8. 3) There were statistically significant differences between the retention intention of new graduate nurses and work type (t=-2.73, p=.007), availability of desired department placement (t=3.02, p=.003), availability of taking desired day off (t=2.21, p=.029), job satisfaction (F=3.40, p<.001), and salary satisfaction (F= 13.78, p<.001). 4) There were statistically significant positive correlations between the retention intention of new graduate nurses and grit (r=.56, p<.001) and social support (r=.48, p<.001). However, there was a statistically significant negative correlation between retention intention of new graduate nurses and transition shock (r=-.56, p<.001). 5) Transition shock had a partial mediating effect on the relationship between grit and retention intention as well as on the relationship between social support and retention intention. Based on the results of this study, an effective training program is needed to enhance grit and reduce transition shock for new graduate nurses to increase their retention intention. Moreover, providing more active social support to new graduate nurses for 12 months could help improve their intention to stay. Keywords: New graduate nurses; Grit; Social support; Transition shock; Retention intention

임상간호사의 조직침묵이 조직시민행동에 미치는 영향 : 조직공정성에 의해 조절된 조직몰입의 매개효과

황신애 경상국립대학교 대학원 2024 국내석사

The purpose of this study was to identify the relationships between organizational silence, organizational commitment, organizational justice, and organizational citizenship behavior for clinical nurses and to determine the mediating effect of organizational commitment moderated by organizational justice on the relationship between organizational silence and organizational citizenship for clinical nurses. The study participants were 160 clinical nurses who had worked at a university hospital with more than 500 beds located in C city, G province. Data were collected from June to July 2023. The collected data were analyzed using frequency, percentage, mean and standard deviation, independent t-test, one-way ANOVA, Scheffé’s test, Pearson’s correlation coefficient, Baron and Kenny(1986)’s three-step regression analysis, Hayes(2013)’ PROCESS macro models, bootstrapping, and Johnson-Neyman technique by SPSS/Win 27.0 program. The results of this study are summarized as follows: 1) Regarding the general and job-related characteristics of clinical nurses, most participants were women(96.2%), and their mean age was 27.24±3.00 years. The majority were unmarried(83.8%), had no religion(81.3%), and had a bachelor’s degree(85.0%). All participants were staff nurses(100%). The mean work experience of the participants was 4.61±2.80 years, and the mean work experience at their current working unit was 2.09±1.90 years. More than half of the participants worked in general wards(58.8%). Half of the participants(50.0%) reported that they were satisfied with their current working unit, and about two-thirds(63.8%) reported that they did not want to change their work unit. Most Participants did shift work(78.1%). 2) According to the mean scores of each variable, organizational silence was 2.43±0.63, organizational commitment was 3.03±0.57, organizational justice was 3.06±0.63, and organizational citizenship behavior was 3.45±0.40, and each variable was scored out of 5. 3) There were statistically significant differences between clinical nurses’ organizational citizenship behavior and age(F=5.20, p=.007), marital status(t=-2.03, p=.044), total work experience(F=3.19, p=.044), and unit satisfaction(F=12.19, p<.001). 4) Clinical nurses’ organizational citizenship behavior had a statistically significant negative correlation with organizational silence(r=-.23, p=.003), but a positive correlation with organizational commitment(r=.52, p<.001). Organizational commitment had a statistically significant negative correlation with organizational silence(r=-.24, p=.002). 5) Clinical nurses’ organizational commitment had a full mediating effect on the relationship between organizational silence and organizational citizenship behavior. 6) Among the sub scales of organizational justice, distributive justice had a moderating effect on the relationship between organizational silence and organizational commitment. 7) There was no significant mediating effect of organizational commitment moderated by organizational justice on the relationship on the organizational silence and organizational citizenship behavior. In conclusion, there were statistically significant relationships among organizational silence, organizational commitment, organizational justice, and organizational citizenship behavior for clinical nurses. Organizational commitment had a full moderating effect on the relationship between organizational silence and organizational citizenship behavior. Distributive justice had a moderating effect on the relationship between organizational silence and organizational commitment. Based on the results of this study, appropriate strategies are needed to effectively manage nursing personnel and improve nursing performance.