• 대한간호학회지
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• 제49권5호
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• pp.601-612
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• 2019

Purpose: The purpose of this study was to construct and test a hypothetical model of clinical decision-making ability of nurses based on the Decision Making Process model and the Cognitive Continuum theory. Methods: The data were collected from nurses working at 11 hospitals in Busan, Daejeon, and South Gyeongsang Province from June 30 to August 1, 2017. Finally, the data from 323 nurses were analyzed. Results: The goodness-of-fit of the final model was at a good level ($x^2/df=2.46$, GFI=.87, AGFI=.84, IFI=.90, CFI=.90, SRMR=.07, RMSEA=.07) and 6 out of 10 paths of the model were supported. The clinical decision-making ability was both directly and indirectly affected by task complexity and indirectly affected by experiences, autonomy, and work environment. Specifically, it was strongly directly affected by analytical competency but was insignificantly affected by intuitive competency. These variables accounted for 66.0% of clinical decision-making ability. Conclusion: The nurses' clinical decision-making ability can be improved by improving their analytical competency. Therefore, it is necessary to organize nursing work, create a supportive work environment, and develop and implement various education programs.

• 지역사회간호학회지
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• 제12권1호
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• pp.239-246
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• 2001

This paper attempts to identify the occupational stress-related factors among the workers at the manufacturing industry and to provide the basic data concerning development of stress management program focused on the manufacturing industry. The subjects exhibit significantly highest level of 'the characteristics of task and participation in decision making factor'. And the mean score of 'the avoid coping strategies' was higher than 'the control coping strategies'. The main factor that affected the occupational stress responses was 'the physio-environmental factor' and it was explained 15.6% out of the total variance of the stress responses. Also, it would be explained 29% out of the total variance of the stress responses with 'the characteristics of task/participation in decision making factor', sex, social support, and 'extra-organizational stressor'. In conclusion. For developing the stress management program in workplace, 'the physical environmental factor' and 'the characteristics of task and participation in decision making factor' should be considered. Also, It should be identified the direct and indirect paths among factors that significantly related factors to the occupational stress of workers further more.

• 대한간호학회지
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• 제29권4호
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• pp.880-891
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• 1999

The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

• 간호행정학회지
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• 제7권2호
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• pp.301-314
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• 2001

The main purpose of this research is to describe comprehensively the processes of clinical decision making in novice critical care nurses through clinical experience. This research was an exploratory, longitudinal study using a fieldwork approach incorporating "think-aloud" method and in-depth interviews with the study participants. The study participants consisted of 5 novice nurses assigned to critical care units at a tertiary medical center located in Seoul, among a group of 27 novice nurses who started at the same period at this hospital. The data were collected from March 1999 to April 2000. The major findings of the study is that the novice nurses followed the analytic linear model of clinical decision making in the beginning, but were changed increasingly to follow the comprehensive, integrated model of clinical decision making. Through repeated experience that resulted in increasing repertoire of clinical schema and familiarity of task environments of clinical practice the novice nurses expanded their ability to arrive at comprehensive integration of information and to arrive at accurate and time-efficient decisions. Both the analytic, linear model mostly used at the beginning period and the comprehensive, integrated model that seems to be the mode significantly dependent upon experience seem to have strengths and weaknesses as decision making processes in clinical situations. Hence, it is imperative to develop an effective orientation and training program for novice nurses through the use of clinical preceptors. In addition, students should be exposed to the process of clinical decision making early in their nursing education through an appropriate clinical experiences and clinical assignments.

• 중환자간호학회지
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• 제8권1호
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• pp.25-40
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• 2015

Purpose: The purpose of the study was to identify the frequency and importance of task performance and the perceived competence to perform of the emergency nurse practitioners (ENPs) certified in Korea. Method: This cross-sectional study was conducted with 41 ENPs certified by March 2012. The questionnaire to identify frequency, importance, autonomy, and perceived competence to perform 131 typical ENP task elements was developed on the basis of the standardized role of an ENP defined by the Korean Accreditation Board of Nursing Education. The data were analyzed using descriptive statistics. Results: The professional nursing practice showed the highest scores for performance frequency, task importance, autonomy, and perceived competence to perform as compared to other job categories. Clinical decision making was the most frequently performed duty. Data collection was the duty with highest levels of importance, autonomy, and perceived competence for the ENPs. However, the ENPs reported that research was the duty with the lowest levels of frequency, importance, autonomy, and perceived competence Conclusion: ENPs in Korea perform various tasks. In order to improve their position in the field, it is necessary to clarify their job description and enhance their competence to perform evidencebased professional nursing practices.

• 가정간호학회지
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• 제18권1호
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• pp.48-57
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• 2011

Purpose: The aim of this study was to develop and to analyze the task of hospital based home care nurse practitioners in Korea. Method: The definition of home care nurse practitioners and job description was developed based on developing a curriculum(DACUM) by 7 panels who have experienced in home care nursing. One hundred fifty four nurses who were working at hospital based on home care were participated. Result: Fourteen kinds of duties were identified : the selection of home care patients; basic home care nursing; advanced home care nursing; patient/family education and counseling; medical decision making and coordination of patient service; management of home care supplies and drugs for patients; management of medical records; management of home care the agency; management of home care personnel; management of the home care supplies for agency; home care public relations; improvement of home care quality; management of long-term care service; and self-improvement. Ninety-six tasks were classified. Conclusion: The abilities for quality improvement and the advanced nursing practice of home care nurses should be empowered.

• 대한간호학회지
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• 제35권2호
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• pp.323-335
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• 2005

Purpose: The purpose of this study was to examine the problems and relevant variables for effective Organizational Socialization of new nurses, to produce a causal map, to build up a simulation model and to test its validity. Method: The basic data was collected from Sep. 2002 to July 2003. The Organizational Socialization process of new nurses was analyzed through a model simulation. The VENSIM 5.0b DSS program was used to develop the study model. Result: This Model shows interrelation of these result variables: organizational commitment, job satisfaction, job performance, intention of leaving the work setting, decision making ability, and general results of Organizational Socialization. The model's factors are characteristic of organization and individual values, task-related knowledge and skills, and emotion and communication that affects new nurses' socialization process. These elements go through processes of anticipatory socialization, encounter, change and acquisition. The Model was devised to induce effective Organizational Socialization results within 24 months of its implementation. The basic model is the most efficient and will also contribute to the development of knowledge in the body of nursing. Conclusion: This study will provide proper direction for new Nurse's Organizational Socialization. Therefore, developing an Organizational Socialization Process Model is meaningful in a sense that it could provide a framework that could create effective Organizational Socialization for new nurses.

• 의료법학
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• 제15권2호
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• pp.285-316
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• 2014

As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.

• 한국전문물리치료학회지
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• 제23권4호
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• pp.16-26
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• 2016

Background: Deficiencies in the ability to maintain balance are common in elderly. Augmented feedback such as knowledge of results (KR) can accelerate learning and mastering a motor skill in older people. Objects: We designed this study to examine whether one session of Wii-Fit game with self-regulated KR is effective for elderly people, and to compare the effect of two different timings of self-regulated KR conditions. Methods: Thirty-nine community-dwelling elders, not living in hospice care or a nursing home, participated in this study. During acquisition, two groups of volunteers were trained in 10 blocks of a dynamic balancing task under the following 2 conditions, respectively: (a) a pre-trial self-regulated KR ($n_1=18$), or (b) a post-trial self-regulated KR ($n_2=21$). Immediate retention tests and delayed retention tests of balancing performance were administered in 15 minutes and 24 hours following acquisition period, respectively. Results: In both groups, significant improvements of balancing performances scores were observed during the acquisition period. Regardless of the group, mean of balancing performance scores on retention tests were well-maintained from the final session. There were no significant differences between groups in balancing performance scores during the acquisition period (p>.05); however, the post-trial self-regulated KR group exhibited significantly higher balancing performance scores in both the immediate retention test and delayed retention test than that of the pre-trial self-regulated KR group (p<.05). Conclusion: Therefore, subjects who regulated their feedback after a dynamic balancing task, during the acquisition period, experienced more efficient motor learning during the retention period than did subjects who regulated their feedback before a dynamic balancing task. Accordingly, in case of presenting the KR of motor learning in clinical settings to elders who reduced dynamic balance abilities, the requesting time of KR is imperative according to self-estimation processes as well as types of KR and practice.

• 문화기술의 융합
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• 제8권3호
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• pp.105-112
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• 2022

본 연구는 보건 클러스터 교육과정에 참여한 고등학생들의 경험을 통해 클러스터 교육과정의 성과 및 과제를 분석한 질적연구이다. 연구결과 '경쟁적 환경에서 최선의 선택', '보건에 대한 인식의 변화', '다양한 보건세계에 대해 경험해 보고 싶은 욕구', '비정규 교과과정 운영의 한계', '기분 좋은 상상을 하게 됨'의 주제가 도출되었다. 본 연구를 통해 클러스터 교육과정에 참여한 학생들의 보건에 대한 인식이 긍정적으로 변화되고, 보건의료계열에 대한 정보습득을 통해 진로의 방향설정 및 진로결정에 대한 자신감이 향상되는 성과는 있었으나, 수업운영 및 실습을 포함한 보건의료의 세부전공에 대한 교과내용의 보완은 개선해 나가야 할 과제로 나타났다. 본 연구에서 제기된 성과 및 과제를 공유함으로써 진로교육의 정책적 대안이 마련되어야 함을 제언한다.