Factors associated with Nurse’s Intention to care COVID-19 Patients

Abstract

This descriptive correlation study is set out to examine factors regarding nursing intention to care for COVID-19 patients by extending and applying Theory of The Planned Behavior. Total 200 questionnaires were distributed to the nurses at S University Hospital in Cheonan, Chungcheongnamdo Province on October 16~30, 2020 after giving them an explanation about the objectives of this study and getting consent from. After the exclusion of four questionnaire, total 189 were used in final analysis. As for research instruments, the Knowledge and Attitude Scale was employed which was developed and used in Choi Yeong-eun and Lee Eun-suk(2019) that investigated the knowledge, attitude, intention for infection management activities, and need for education regarding novel respiratory infections among nurses with no experiences with taking care of such patients. Professional pride was measured with the Professional Pride Scale in the Nursing Professional Pride Scale developed by Jeon Jae-hee, Lee Eun-hee, and Kim Eun-ju(2020). Nursing intention and perceived behavioral control were measured with a revised and supplemented version of the scale of Lee Ji-yeon(2018) that investigated effects on nursing intention for patients of novel infectious diseases. Collected data was analyzed with the SPSS/WIN 26.0 program in descriptive statistics, independent-sample t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression analysis. The findings were as follows: Among factors regarding nursing intention to care for COVID-19 patients, the subjects scored mean 14.23±2.04 points out of 20 in knowledge of COVID-19, and their rate of correct answers was approximately 71%. They scored mean 4.16±0.33 out of five in attitude, mean 3.37±0.53 out of five in professional pride, mean 4.12±1.28 out of seven in perceived behavioral control, and mean 3.90±1.54 out of seven in nursing intention. There were no significant differences in their nursing intention to care for COVD-19 patients according to their characteristics, but significant differences were found in it according to experiences of taking care of patients of novel respiratory infectious diseases and COVID-19(t=2.359, p<.020), awareness of protective methods against COVID-19(t=2.401, p<.018), and wish for education on novel respiratory infectious diseases(t=2.936, p<.004) under the category of characteristics related to novel infectious diseases. In correlations among factors about nursing intention to care for COVID-19 patients of subjects, their attitude toward COVID-19 had significant positive correlations with their professional pride(r=.324, p<.001), perceived behavioral control for patients(r=.184, p=.011) and nursing intention(r=.299, p=.002). Their professional pride had significant positive correlations with their perceived behavioral control for COVID-19 patients(r=.277, p<.001) and nursing intention(r=.345, p<.001). Their perceived behavioral control for COVID-19 patients had significant positive correlations with their nursing intention(r=.598, p<.001). Factors Influencing Their Nursing Intention for COVID-19 Patients The analysis results show that gender(β=.159, p=.007), wish for education on novel respiratory infectious diseases(β=.145, p=.015), professional pride(β=.117, p=.009), and perceived behavioral control(β=.779, p<.001) had statistically significant impacts on their nursing intention. Their general characteristics, characteristics related to novel infectious diseases, and the core factors of the theory of planned behavior including attitude, professional pride, and perceived behavioral control had explanatory power of 42.0% for their nursing intention for COVID-19(F=12.344, p<.001). In short, perceived behavioral control had the biggest influence on it, which suggests that nurses should have self-confidence that they can control their nursing behavior for COVID-19 patients. If clinical simulation education is provided to nurses in preparation of epidemic novel infectious diseases, it will help them lower their anxiety, stress, and tension, increase their perceived behavioral control including their faith in their nursing performance, and It is believed that clinical simulation training will be effective in reducing anxiety, stress, and tension, and increasing perceived behavioral control, including the belief that nursing can be performed to COVID-19 patients, resulting in a positive change in nursing intent To reinforce perceived behavioral control, it is also believed that self-confidence in nursing COVID-19 patients can be reinforced with personal devices to protect themselves from COVID-19 or new respiratory infectious diseases, continuously updated protocols, admission of effort to nurse COVID-19 patients, and psycological and material support such as stress management program or compensation.

본 연구는 계획된 행위이론을 확장 적용하여 간호사의 코로나19 환자 간호의도에 관련된 요인을 파악하기 위한 서술적 상관관계 연구이다. 연구 대상자는 2020년 10월 16일부터 10월 30일까지 충청남도 천안소재의 S대학병원에서 근무하는 간호사이며 연구 목적을 설명하고 동의를 구한 후 200부를 배부하고 응답이 미흡한 설문지를 제외한 189부를 대상으로 최종분석에 이용하였다. 연구 도구로 최영은, 이은숙(2019)이 개발한 간호사의 신종호흡기감염병에 대한 지식, 태도, 감염관리활동 의도와 교육요구도의 연구의 지식, 태도 측정도구를 사용 하였고 전재희, 이은희, 김은주(2020)의 간호전문직 자부심 측정도구 개발에서 개발한 전문직 자부심 측정도구를 사용하였다. 간호의도와 지각된 행위통제는 이지연(2018)이 간호사의 신종감염병 환자 간호의도에 영향을 미치는 요인 연구에서 수정·보완한 도구를 사용하였다. 수집된 자료는 SPSS/WIN 26.0 프로그램을 이용하여 기술통계, Independent t-test, one-way ANOVA, Pearson's Correlation Coefficient, 다중회귀분석으로 분석하였다. 본 연구결과는 다음과 같다. 대상자의 코로나19 환자 간호의도 관련요인 정도 중 코로나19에 대한 지식은 20점 만점 중 14.23±2.04로 약71%의 정답률을 보였다. 태도는 5점 척도로 전체 평균점수 4.16±0.33점, 전문직 자부심은 5점 척도로 전체 평균점수 3.37±0.53점, 지각된 행위통제는 7점 척도로 전체 평균점수 4.12±1.28점, 간호의도는 7점 척도로 전체 평균점수 3.90±1.54점으로 나타났다. 대상자의 특성에 따른 코로나19 환자 간호의도 차이는 신종호흡기감염병 및 코로나19 환자 간호 경험이 있는 간호사(t=2.359, p<.020), 코로나19로부터의 보호 방법에 대해 인지한 간호사(t=2.401, p<.018), 신종호흡기감염병에 대한 교육을 희망하는 간호사(t=2.936, p<.004)가 높게 나타났다. 대상자의 코로나19 환자 간호의도에 관련된 요인들의 상관관계에서 코로나19의 태도는 전문직 자부심(r=.324, p<.001), 지각된 행위 통제(r=.184, p=.011), 간호의도(r=.299, p=.002)와 양의 상관관계를 나타냈으며 전문직 자부심은 지각된 행위 통제(r=.277, p<.001), 간호의도(r=.345, p<.001)와 양의 상관관계를 나타냈다. 코로나19 환자에 대한 지각된 행위 통제는 간호의도(r=.598, p<.001)와 양의 상관관계를 나타났다. 대상자의 코로나19 환자 간호의도에 영향을 미치는 요인은 성별(β=.159, p=.007), 신종호흡기감염병에 대한 교육 희망 여부(β=.145, p=.015), 전문직 자부심(β=.117, p=.009), 지각된 행위통제(β=.779, p<.001)이었으며 42.0%의 코로나19에 대한 간호의도 설명력을 나타냈다(F=12.344, p<.001). 이상의 연구결과를 종합해보면 지각된 행위통제가 가장 큰 영향력이 높은 것으로 나타나 코로나19 환자 간호 행위를 통제 할 수 있다는 자신감이 중요하다. 이에 임상 시뮬레이션 교육을 시행하여 불안, 스트레스, 긴장감등을 낮추고 간호를 수행할 수 있다는 믿음을 포함한 지각된 행위통제를 높여 결과적으로 간호의도를 긍정적으로 변화 시키는데 효과적일 것이라 사료된다. 또한 지속적이고 강화시킬 수 있도록 신종감염병 및 코로나19 환자 간호에 있어 충분한 개인보호장비 지급, 지속적인 최신 프로토콜 제공, 코로나19 환자 간호 수행에 따른 노력 인정과 간호수행 후의 스트레스와 같은 심리적 지원, 특별한 보상금과 같은 물질적 지원이 지원된다면 간호사의 간호수행에 있어 자신감을 강화시킬 수 있다고 사료된다.