중소병원간호사의 안전문화인식이 환자안전간호활동에 미치는 영향: 전문직자아개념에 의한 간호근무환경의 조절된매개효과

Abstract

Purpose The objective of this study was to examine the moderated mediating effect of nursing work environment by professional self-concept on the influence of safety culture awareness on patient safety care activity of nurse in small-medium sized hospitals. Method A cross-sectional survey was used and data were collected from July to August 2019. Participants were 186 nurses in seven small-medium sized hospitals of Busan metropolitan city, in Korea. The patient safety care activity measurement tool used a questionnaire developed with 6 types of Korea Institute Healthcare Accreditation items and international patient safety goal. The safety culture awareness tool used a Korean safety culture measurement questionnaire, and the nursing work environment measurement tool used a Korean version nursing work environment. As a tool for measuring professional self-concept, a shortened NSCI questionnaire was used. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Next, moderated mediation analyses proposed by Hayes. The data were analyzed using IBM SPSS statistics 25.0 software and PROCESS macro v3.5 for SPSS. Statistical significance was defined as a two-tailed p-value of <.001. Result As a result, the mean and correlation of the variables are as follows. The mean of professional self-concept was 5.81±0.89 on the 8-point Likert scale, the safety culture awareness was 3.36±0.35 on the 5-point Likert scale, the nursing work environment was 2.55±0.41 on the 4-point Likert scale, and the patient safety care activity was 4.25±0.57 on the 5-point Likert scale. Patient safety care activities was a significant positive correlation with professional self-concept(r=.30, p<.001), safety culture awareness(r=.38, p<.001), nursing work environment(r=.21, p=.004). Mediating role of nursing work environment between safety culture awareness and patient safety care activity did not play a mediating effect(β=-.11, p=.245). Moderating role of professional self-concept between nursing work environment and patient safety care activity did play a moderating effect(β=.18, p=.012). When the professional self-concept was negative, there was a moderated mediating effect of the nursing work environment.(β=.21, p=.037). Conclusion In order to improve patient safety care activities of small and medium hospital nurses, it is necessary to develop a positive professional self-concept and a nursing work environment at the organizational level for individual-environment fit.