Park Min Kyoung, Kim Soukyoung
Department of Nursing, Koje College, Geoje, Korea.
College of Nursing, Eulji University, Daejeon, Korea.
J Korean Acad Nurs. 2019 Oct;49(5):601-612. doi: 10.4040/jkan.2019.49.5.601.
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.
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.
The goodness-of-fit of the final model was at a good level (χ²/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.
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.
本研究旨在基于决策过程模型和认知连续体理论构建并检验护士临床决策能力的假设模型。
数据收集于2017年6月30日至8月1日在釜山、大田和庆尚南道11家医院工作的护士。最终，对323名护士的数据进行了分析。
最终模型的拟合优度处于良好水平（χ²/df = 2.46，GFI = 0.87，AGFI = 0.84，IFI = 0.90，CFI = 0.90，SRMR = 0.07，RMSEA = 0.07），模型的10条路径中有6条得到支持。临床决策能力直接和间接受任务复杂性影响，间接受经验、自主性和工作环境影响。具体而言，它受分析能力的直接影响较大，但受直觉能力的影响不显著。这些变量占临床决策能力的66.0%。
通过提高护士的分析能力可以提高其临床决策能力。因此，有必要组织护理工作，营造支持性的工作环境，并制定和实施各种教育项目。
