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병원간호사회> 임상간호연구> COVID-19 대유행 상황에서 응급실 간호사의 근무 경험

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COVID-19 대유행 상황에서 응급실 간호사의 근무 경험

The Work Experiences of Emergency Room Nurses during the COVID-19 Pandemic

현용환 ( Hyeon Yong Hwan ) , 채영희 ( Chae Young Hee )
  • : 병원간호사회
  • : 임상간호연구 27권3호
  • : 연속간행물
  • : 2021년 12월
  • : 221-232(12pages)
임상간호연구

DOI


목차

Ⅰ. 서 론
Ⅱ. 연구방법
Ⅲ. 연구결과
Ⅳ. 논 의
Ⅴ. 결론 및 제언
참고문헌

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Purpose: The purpose of this study was to explore emergency room nurse's work experiences during the COVID-19 pandemic. Methods: Data were collected from 15 registered nurses working in the emergency room between October, 10th and December 15th, 2020, through focus group interviews and in depth interviews. Collected data were analyzed using Colaizzi's phenomenological method. Results: The study derived four categories and eight themes. The four categories are ‘sense of cringing with fear’, ‘nursing in chaotic situation’, ‘lonely struggles’, and ‘career growth as a nurse’. Emergency room nurses experienced fear and confusion in the COVID-19 pandemic, but overcame the crisis and had positive experiences of professional growth as a nurse. Conclusion: To protect emergency room nurses from infectious disease and improve their professional quality of life during the COVID-19 pandemic appropriate education and healthcare resource should be provided. It is necessary to reflect clinical worker's opinions and improve the delivery system of guideline to reduce confusion in the field and develop practical infectious disease control guideline. Furthermore, better working conditions, appropriate rewards and social and mental support should be provided for nurses in emergency room.

UCI(KEPA)

I410-ECN-0102-2022-500-000953698

간행물정보

  • : 의약학분야  > 간호학
  • : KCI등재
  • :
  • : 연3회
  • : 1598-9186
  • : 2287-3694
  • : 학술지
  • : 연속간행물
  • : 1995-2022
  • : 802


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28권1호(2022년 04월) 수록논문
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KCI등재

1간호사 확보수준이 입원 환자의 병원사망과 입원 30일 이내 사망에 미치는 영향

저자 : 김윤미 ( Kim Yunmi ) , 이경아 ( Lee Kyounga ) , 김현영 ( Kim Hyun-young )

발행기관 : 병원간호사회 간행물 : 임상간호연구 28권 1호 발행 연도 : 2022 페이지 : pp. 1-12 (12 pages)

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Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x2 test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion: To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

KCI등재

2급성기 의료기관의 일혈 발생 현황 및 임상간호사의 일혈 예방 및 관리에 대한 지식과 태도에 관한 연구

저자 : 김정윤 ( Kim Jung Yoon ) , 이윤진 ( Lee Yun Jin ) , 고영옥 ( Ko Young Ok ) , 조현진 ( Cho Hyun Jin ) , 김희정 ( Kim Hee Jung ) , 주명진 ( Ju Myoung Jean ) , 김미진 ( Kim Mi Jin )

발행기관 : 병원간호사회 간행물 : 임상간호연구 28권 1호 발행 연도 : 2022 페이지 : pp. 13-22 (10 pages)

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Purpose: Extravasation of diagnostic and therapeutic materials might occur when the intravascular solution leaks into the surrounding tissues. Injury associated with extravasation depends on various factors. It may range from mild skin reaction to severe necrosis. However, the incidence rate for extravasation is largely unknown because of the limited reporting in Korea. Therefore, this study was conducted to identify the incidence of extravasation and nurses' attitude and knowledge of extravasation for providing high-quality nursing care. Methods: Three acute care hospitals were surveyed to estimate the occurrence of extravasation. Knowledge and attitude toward extravasation were investigated from 793 nurses working in six hospitals. Results: The incidence rate of extravasation was 0.5%. Extravasation commonly occurred in elderly patients aged 66 or older (59.9%) and internal medicine (48.2%), and it happened 13.73±20.68 days after hospitalization on average. It mostly occurred in the forearm site (52.9%) and was mainly caused by parenteral nutrition (33.6%). The mean scores of nurses' knowledge and attitude were 14.63±2.86 and 28.91±36.00, respectively. There was a significant negative correlation between the subjects' knowledge and attitude (r=-.11, p=.002). Conclusion: It is necessary to have a reporting system that can accurately monitor the occurrence of extravasation for patient safety management. In addition, it is necessary to develop a protocol that can be applied to clinical practice and a nurse education program.

KCI등재

3불쾌 증상 이론을 적용한 심방 세동 환자의 자가관리

저자 : 김민영 ( Kim Min Young ) , 이선희 ( Lee Sun Hee ) , 박한종 ( Park Han Jong )

발행기관 : 병원간호사회 간행물 : 임상간호연구 28권 1호 발행 연도 : 2022 페이지 : pp. 23-33 (11 pages)

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Purpose: This study aimed to identify the relationships among disease severity, anxiety, depression, social support, unpleasant symptoms and self-care among patients with atrial fibrillation based on the unpleasant symptom theory, and to examine the mediating effects of unpleasant symptoms. Methods: A cross-sectional study was conducted. The participants were 216 patients with atrial fibrillation who were being followed up on an outpatient basis at a university hospital in Seoul. Data were collected from November 1, 2020 to June 30, 2021, using self-report questionnaires. Data were analyzed using IBM SPSS/WIN 27.0 and PROCESS macro with 95% bias-corrected bootstrap confidence interval(CI). Results: The average age of participants in this study was 66.0years. Disease severity (β=10.19, p<.001) and depression (β=1.53, p<.001) had significant positive relationships with unpleasant symptoms. Also, unpleasant symptoms (β=-0.03, p=.006) had a negative relationship with physical activity, which is a subscale of self- care. Social support (β=0.06, p<.001) was positively related with physical activity. Unpleasant symptoms showed a mediation effect in the relationship between disease severity and physical activity (Bias corrected bootstrap CI -0.65, -0.04). Depression had an indirect effect on physical activity that was mediated by unpleasant symptoms (Bias corrected bootstrap CI -0.11, -0.00). Conclusion: The findings of this study suggest that integrated strategies including physical, psychological, and social factors should be considered to promote self-care in patients with atrial fibrillation.

KCI등재

4성인 중환자실 간호사의 인간중심간호 수행과 영향요인

저자 : 주영신 ( Joo Young Shin ) , 장연수 ( Jang Yeon Soo )

발행기관 : 병원간호사회 간행물 : 임상간호연구 28권 1호 발행 연도 : 2022 페이지 : pp. 34-44 (11 pages)

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Purpose: The purpose of this study was to examine the level of Person-centered Critical Care Nursing (PCCN) and the factors influencing PCCN for nurses in Intensive Care Units (ICU). Methods: This study was designed by cross-sectional descriptive correlational study. The participants included 147 ICU nurses in two general hospitals in Seoul, Korea. Demographic characteristics, PCCN, communication skills, professionalism, and work environment were measured. The collected data were analyzed using descriptive statistical analysis, independent t-test, One-way ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression with the SPSS/Win 25.0 program. Results: The average age of the participants was 29.6±4.7 years and the mean work experience in the ICU was 4.67±3.52 years. The level of PCCN was 3.70±0.41, which was moderate to high, and it significantly showed a positive correlation with therapeutic communication skills (r=.66, p<.001), global interpersonal communication competence (r=.42, p<.001), professionalism (r=.38, p<.001), and work environment (r=.16, p=.048). The factors influencing PCCN were identified as therapeutic communication skill and global interpersonal communication competence (Adj R2=.45, p<.001). Conclusion: The findings of this study were confirmed that the strategies to promote PCCN are necessary to enhance therapeutic communication skill and global interpersonal communication competence. In addition, they may be particularly meaningful in providing basic data for nursing education and future intervention development research to promote PCCN for the ICU nurses. For improving PCCN for healthcare providers in ICU, further studies should be conducted to develop education and intervention programs.

KCI등재

5신경외과 수술 환자의 수술 관련 욕창 발생 위험요인

저자 : 김상옥 ( Kim Sang Ok ) , 최선미 ( Choi Sun Mi ) , 이승아 ( Lee Seung A ) , 강재연 ( Kang Jae Yeon )

발행기관 : 병원간호사회 간행물 : 임상간호연구 28권 1호 발행 연도 : 2022 페이지 : pp. 45-53 (9 pages)

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Purpose: The purpose of this study was to evaluate risk factors of pressure injuries in patients after neurosurgery. Methods: A retrospective case-control study was conducted using 273 patients undergoing neurosurgery admitted to a general hospital from 2015 to 2021. Data were collected from September 1 to 30, 2021. The data were analyzed using the SPSS/WIN 26.0 program. Results: Risk factors significantly influencing the occurrence of pressure injuries in the patients undergoing neurosurgery were hypertension (OR=3.12, p=.024), postoperative hypoalbuminemia (OR=0.30, p=.028), and prolonged operative duration (OR=1.00, p=.001). The regression model explained 86.0% of the variance of the outcome variable. Conclusion: In order to prevent surgery-related pressure injuries in patients undergoing neurosurgery, thorough blood pressure management, avoidance of hypoalbuminemia, and preventive nursing intervention considering operative duration are required.

KCI등재

6신규간호사의 일의 의미, 조직몰입, 전문직 자기이미지 및 재직의도 간의 관계

저자 : 김미영 ( Kim Mi Young ) , 서형은 ( Seo Hyung Eun ) , 이지애 ( Lee Jihae ) , 박진화 ( Park Jin Hwa )

발행기관 : 병원간호사회 간행물 : 임상간호연구 28권 1호 발행 연도 : 2022 페이지 : pp. 54-65 (12 pages)

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Purpose: This study was conducted to explore the relationships among new nurses' meaning of work, organizational commitment, professional self-image, and retention intention through path analysis. Methods: The participants were 872 nurses with less than a year of clinical experience working at general or tertiary hospitals over 500 beds in Korea. The data were collected using structured questionnaires from May 15, 2021 to June 28, 2021, and analysis was conducted using SPSS/WIN 22.0 and AMOS 21.0 programs. Results: Retention intention was explained by meaning of work, organizational commitment, and professional self-image, its explanatory power was 46.5%. The mediating effect of professional self-image was found on the relationship between meaning of work and retention intention. Conclusion: To encourage the retention intention among new nurses, an environment where new nurses can set a high value on the meaning of work and sense of accomplishment should be created, and a strategy to improve organizational commitment and professional self-image should be established.

KCI등재

7응급실 간호사의 아동학대 신고의도 영향요인

저자 : 최윤지 ( Choi Yoon Ji ) , 양숙자 ( Yang Sook Ja )

발행기관 : 병원간호사회 간행물 : 임상간호연구 28권 1호 발행 연도 : 2022 페이지 : pp. 66-75 (10 pages)

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Purpose: The purpose of this study is to identify the factors influencing the intention to report child abuse of emergency room nurses based on the health belief model. Methods: This was a descriptive study that used a cross-sectional design. A total of 188 emergency room nurses working at general hospitals with more than 300 beds in Seoul participated in the study. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis with the SPSS 25.0 program. Results: Correlations and regression analyses showed that the perceived severity (β=.14, p=.024), perceived barrier (β= -.25, p<.001), and self-efficacy (β=.31, p<.001) were factors influencing emergency room nurses' intention to report child abuse, and the explanatory power of the model was 33.0%. Conclusion: The results of this study related to the health belief model, being a valid theoretical basis for child abuse reporting intention research, significantly suggest new research directions in the future. In addition, to increase the nurses' intention to report child abuse in the emergency room, the influencing factors identified in this study can be utilized and develop specific interventions using the health belief model.

KCI등재

8일회용 약물주입기로 가정에서 항암치료 중인 대장암 환자의 삶의 질

저자 : 이충은 ( Lee Chung Eun ) , 김나영 ( Kim Na Young ) , 박미희 ( Park Me Hee ) , 이윤정 ( Lee Yoon Jung ) , 김진라 ( Kim Jin Ra ) , 백민주 ( Baek Min Ju ) , 김효진 ( Kim Hyo Jin ) , 변은성 ( Byun Eun Sung ) , 길윤경 ( Kil Yun Kyung ) , 김희정 ( Kim Heejung )

발행기관 : 병원간호사회 간행물 : 임상간호연구 28권 1호 발행 연도 : 2022 페이지 : pp. 76-87 (12 pages)

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Purpose: The purpose of this study was to examine the psychological distress related to quality of life (QoL) of patients with colorectal cancer receiving 5-fluorouracil (5-FU) chemotherapy at home with disposable Elastomeric infusion pumps. Methods: In this study, 179 colorectal outpatients were recruited between September 2019 and January 2021. National Cancer Center Psychological Symptom Inventory scores, general self-efficacy, and the EORTC QLQ-C30 scores were measured. Data were analyzed using Independent t-test, One-way ANOVA with Bonferroni post hoc analysis, and hierarchical multiple linear regression with the SPSS/WIN 26.0 programs. Results: The overall prevalence of psychological distress was 52.0% in colorectal patients. In multiple regression, psychological distress (β=-.20, p=.005), appetite loss (β=-.20, p=.001), chemotherapy cycles (β= .19, p=.002), fatigue (β=-.16, p=.035), physical functioning (β=-.16, p=.024), and emotional functioning (β=-.15, p=.025) were significant factors of QoL, and the final model explained 45.0% of the total variance of QoL. Conclusion: Supporting patients toward decreased psychological distress and increased physical and emotional functioning, especially in the first or second cycle of chemotherapy, could be used to improve their QoL. To consider the thresholds for clinical importance, it is necessary to increase the interpretation of psychological distress in clinical practice and further research.

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1COVID-19 대유행 상황에서 응급실 간호사의 근무 경험

저자 : 현용환 ( Hyeon Yong Hwan ) , 채영희 ( Chae Young Hee )

발행기관 : 병원간호사회 간행물 : 임상간호연구 27권 3호 발행 연도 : 2021 페이지 : pp. 221-232 (12 pages)

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Purpose: The purpose of this study was to explore emergency room nurse's work experiences during the COVID-19 pandemic. Methods: Data were collected from 15 registered nurses working in the emergency room between October, 10th and December 15th, 2020, through focus group interviews and in depth interviews. Collected data were analyzed using Colaizzi's phenomenological method. Results: The study derived four categories and eight themes. The four categories are 'sense of cringing with fear', 'nursing in chaotic situation', 'lonely struggles', and 'career growth as a nurse'. Emergency room nurses experienced fear and confusion in the COVID-19 pandemic, but overcame the crisis and had positive experiences of professional growth as a nurse. Conclusion: To protect emergency room nurses from infectious disease and improve their professional quality of life during the COVID-19 pandemic appropriate education and healthcare resource should be provided. It is necessary to reflect clinical worker's opinions and improve the delivery system of guideline to reduce confusion in the field and develop practical infectious disease control guideline. Furthermore, better working conditions, appropriate rewards and social and mental support should be provided for nurses in emergency room.

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2상급종합병원과 종합병원의 근거기반 임상간호실무지침의 활용도

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발행기관 : 병원간호사회 간행물 : 임상간호연구 27권 3호 발행 연도 : 2021 페이지 : pp. 233-244 (12 pages)

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Purpose: The purpose of this study was to investigate the actual utilization of clinical practice guidelines developed by Hospital Nurses Association. Methods: The subjects were 70 nurses who were in charge of guideline distributions in 70 advanced general hospital and general hospitals with 500 beds or more nationwide. Data were collected between June and August, 2020 by mail (return rate: 88.6%). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 24.0. Results: Among the clinical practice guidelines developed by Hospital Nurses Association, 72.9~90.1% were placed with book and electronic file in nursing department and 24.3~35.8% were placed with book and electronic file in each nursing unit at hospital. The average number of utilized clinical practice guidelines were 3.96±3.88, and average score of guideline utilization was score 2.85±0.79 which means 'use sometimes'. Conclusion: To improve the distribution and utilization of the clinical practice guidelines, it is necessary to enhance the recognition of values of evidence based nursing practice targeting head of nursing department and to stimulate the distribution and utilization of the clinical practice guidelines using diverse education programs for staff nurses.

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Purpose: The purpose of this study was to explore professional self-concept, work environment, resilience and intention to stay for nurses in university hospitals, and to identify the relationship between these variables and factors that influence intention to stay. We aimed to provide basic data to develop measures for increasing intention to stay. Methods: This study used a descriptive design, the subjects were nurses who worked for more than 1 year at a university hospital with 744 beds, located in city C. Data were collected using a structured questionnaire from 120 nurses. The data collection period were from September 15 to 30, 2020. The data were analysed using the SPSS/WIN 25.0 program. Results: There was a positive correlation between the subject's intention to stay and the professional self-concept (r=.57, p<.001), the nursing working environment (r=.29, p=.002), and resilience (r=.50, p<.001). Significant factors influencing the subject's intention to stay was the sense of satisfaction (β=.40, p<.001), a sub-factor of professional self-concept, indicating the higher the satisfaction level, the higher the intention to stay. The regression model explained 45.0% of the variance of the outcome variable (F=9.64, p<.001). Conclusion: Sense of satisfaction was identified as a factor impacting the intention to stay. Therefore, it is necessary to develop and to apply intervention programs to improve the satisfaction of the professional self-concept in order to increase the nurses' intention to stay.

KCI등재

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저자 : 김영숙 ( Kim Yeong Sook ) , 강경자 ( Kang Kyung Ja )

발행기관 : 병원간호사회 간행물 : 임상간호연구 27권 3호 발행 연도 : 2021 페이지 : pp. 257-266 (10 pages)

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Purpose: This study examined the levels of traumatic event experience, self disclosure, social support, and posttraumatic growth of intensive care unit nurses and their relationships. Methods: Participants were 142 nurses who had worked for more than 3 months in six general hospitals, J province from August 7 to September 25, 2020. Collected data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using the program SPSS version 22.0. Results: The posttraumatic growth was found to correlate significantly with self disclosure (r=.23, p=.005), individual support (r=.54, p<.001), and organizational support (r=.32, p<.001). Factors influencing the participants of the posttraumatic growth were individual support (β=.46, p<.001) and organizational support (β=.21, p=.007). These factors explained 32.0% of the variance of ICU nurses' posttraumatic growth (F=14.13, p<.001). Conclusion: Efforts to support positive changes after traumatic event experience for ICU nurses are needed. We suggest to develop individual and organizational supportive programs for posttraumatic growth for ICU nurses and to investigate the effects of the programs.

KCI등재

5중환자실 간호사가 지각하는 인간중심 중환자간호 수행 정도 및 요구도

저자 : 임경령 ( Lim Kyoung Ryoung ) , 박정숙 ( Park Jeong Sook )

발행기관 : 병원간호사회 간행물 : 임상간호연구 27권 3호 발행 연도 : 2021 페이지 : pp. 267-278 (12 pages)

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Purpose: This study was attempted to identify the importance and performance of person-centered care in nurses in intensive care units (ICU) at general hospitals and to derive the priority of practical person-centered care needs and intervention by analysing their needs. Methods: A total of 156 ICU nurses who wrote a written consent participated in a survey questionnaire on person-centered critical care nursing (PCCN). The collected data were analyzed using paired t-test, Borich's needs assessment, and the Locus for Focus Model. Results: All 15 items of person-centered care in ICU nurses were found to be significantly higher in perception of importance than performance level (t=17.98, p<.001). According to the analysis of Borich's needs and the Locus of Focus Model, person-centered care items with highest priority in ICU were therapeutic contact, comfort words and actions, and efforts to empathize with patients in the compassion category. Conclusion: As a strategy to improve the person-centered nursing performance of ICU nurses in the 'individuality', it is necessary for ICU nurses to recognize the ICU patients as an individualized person, not as a disease or machine-dependent entity. Also, it is necessary to develop programs to improve the ICU nurses' compassion competence because 'compassion' was a top priority according to Borich's needs assessment model and the Locus for Focus Model.

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6한국형 중환자실 간호근무환경 측정도구 개발 및 평가

저자 : 이효진 ( Lee Hyo Jin ) , 문지현 ( Moon Ji Hyun ) , 김세라 ( Kim Se Ra ) , 심미영 ( Shim Mi Young ) , 김정연 ( Kim Jung Yeon ) , 이미애 ( Lee Mi Aie )

발행기관 : 병원간호사회 간행물 : 임상간호연구 27권 3호 발행 연도 : 2021 페이지 : pp. 279-293 (15 pages)

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Purpose: The purpose of this study was to develop a Korean nursing work environment scale for critical care nurses (KNWES-CCN) and verify its validity and reliability. Methods: A total of 46 preliminary items were selected using content validity analysis of experts on 64 candidate items derived through literature reviews and in-depth interviews with critical care nurses. 535 critical care nurses from 21 hospitals responded to the preliminary questionnaire from February to March 2021. The collected data were analysed using construct, convergent and discriminant validities, and internal consistency and test-retest reliability. Results: The 23 items in 4 factors accounted for 55.6% of the total variance were identified through item analysis and exploratory factor analysis (EFA). EFA was performed with maximum likelihood method including direct oblimin method. In the confirmatory factor analysis, KNWES-CCN consisted of 21 items in 4 factors by deleting the items that were not meet the condition that the factor loading over .50 or the squared multiple correlation over .30. This model was considered to be suitable because it satisfied the fit index and acceptable criteria of the model [x2 =440.47 (p<.001), CMIN/DF=2.41, GFI=.86, SRMR=.06, RMSEA=.07, TLI=.90, CFI=.91]. The item total correlation values ranged form .32 to .73 and its internal consistency was Cronbach's α=.92. The reliability of the test-retest correlation coefficient was .72 and the intra-class correlation coefficient was .83. Conclusion: The KNWES-CCN showed good validity and reliability. Therefore, it is expected that the use of this scale would measure and improve nursing work environment for critical care nurses in Korea.

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