Impact of Career Barriers, Career Decision-Making Self-Efficacy on the Career Preparation Behavior : Focused on College Students Majoring in Secretarial Science

최근 들어 대학생들의 취업에 대한 열망이 더욱 더 높아지고 그 경쟁이 치열해 지면서 어떤 특정 분야를 전공하였다 해도 자신이 원하는 분야의 직업을 갖는 것이 어려워지고 있는 것이 현실이다. 이러한 현실로 인해 대학이나 전문대학에서도 학생들의 학문적인 목표 달성 외에도 취업을 위한 진로지도와 상담의 역할에 많은 중점을 두고 있으며 취업을 위한 현실적인 다양한 방안을 지원하고 노력하는 추세에 있다. 특히, 대학생들에게 진로지도와 상담을 통해서 진로에 임하는 마음가짐이나 태도와 같은 의식적인 측면의 중요성과 더불어 실천적인 행동과 노력을 강조하고 있다. 그러나, 이러한 추세에도 불구하고 학문적인 연구에 있어서는 많은 연구들이 진로준비를 위한 실질적인 행동보다는 진로의식적인 면에 주로 중점을 두고 있다. 또한 진로와 관련된 연구들의 경우에도 그 연구대상이 4년제 대학생이나 청소년, 특정분야를 대상으로 주로 이루어지고 있으며 아직까지 전문대학생을 대상으로 하는 연구가 많이 이루어지지 않고 있다. 특히 학과 특성상 취업을 목적으로 하는 전문대학 비서학 전공생의 경우 실무적이고 현실적인 진로준비행동에 대한 연구가 이루어져야 할 필요성이 있다. 또한 이러한 진로준비행동이 보다 원활히 이루어지기 위하여 이에 영향을 주는 요인들을 파악함으로써 체계적인 진로지도를 실시할 수 있을 것이다. 진로를 위한 준비행동에 영향을 주는 요인으로는 많은 선행연구들에서 진로장벽과 진로결정 자기효능감이 주로 다루어지고 있으며 이에 전문대학 비서학 전공생들에 있어 두 변인이 진로준비행동에 미치는 영향을 파악하는 것은 의미가 있을 것으로 보인다. 이에 이 연구의 목적은 전문대학 비서학 전공생이 인식하고 있는 진로장벽, 진로결정 자기효능감이 진로준비행동에 미치는 영향을 살펴보고자 하는 것이다. 이러한 연구목적을 달성하기 위하여 다음과 같은 가설을 설정하여 검증하였다. 가설1: 전문대학 비서학 전공생이 인식한 진로장벽은 진로준비행동에 유의미한 영향을 미칠 것이다. 가설2: 전문대학 비서학 전공생의 진로결정 자기효능감은 진로준비행동에 유의미한 영향을 미칠 것이다. 가설3: 전문대학 비서학 전공생의 진로장벽과 진로결정 자기효능감은 부(-)적인 상관관계가 있을 것이다. 위의 가설들을 검증하기 위하여 선행연구에서 사용되었던 진로장벽, 진로결정 자기효능감, 진로준비행동의 세 측정도구를 사용하였다. 연구대상은 전문대학에서 비서학을 전공하고 있는 전공생들을 대상으로 하였으며 총 172명의 자료를 수집하여 분석하였다. 분석방법은 가설 1과 가설2의 검증을 위하여 상관분석과 회귀분석을 실시하였고 가설3을 검증하기 위하여 상관분석을 실시하였다. 또한 학년에 따른 차이를 보기 위하여 가설1과 가설2의 회귀분석을 학년별로 실시하였고 진로준비행동의 정도를 학년별로 비교분석하였다. 가설 검증을 위한 분석의 연구결과는 다음과 같다. 연구를 통하여 가설1, 가설2와 같이 전문대학 비서학 전공생들이 인식한 진로장벽, 진로결정 자기효능감은 진로준비행동에 유의미한 영향을 미치고 있음이 부분적으로 지지되었다. 또한 가설3을 검증한 결과 진로장벽과 진로결정 자기효능감은 서로 부(-)적인 상관관계가 있다는 것을 보여주었다. 또한 전문대학 비서학 전공생들이 진로장벽으로 크게 인식하는 요인은 ‘미래불안’요인으로 나타났으며 ‘목표선택’요인에 대해 높은 진로결정 자기효능감을 보이고 있음을 알 수 있었다. 진로준비행동을 학년에 따라 비교해 본 결과는 2학년이 1학년보다 진로준비행동을 많이 수행하고 있음을 알 수 있었다. 이는 학년이 올라갈수록 진로준비행동도 활발해진다는 선행연구들의 결과와 일관된 결과를 보여주고 있다. 이러한 연구결과를 통하여 알 수 있듯이 전문대학 비서학 전공생들의 진로준비행동의 적극적 수행을 위하여 이들이 처한 진로장벽을 잘 파악하고 극복하여 진로결정 자기효능감을 확립하는 것은 매우 중요하다고 할 수 있다. 또한 이 연구가 지닌 다음과 같은 한계점이 잘 극복되어 후속연구가 계속되어야 할 것이다. 우선, 연구목적에 적합한 타당성 있는 측정도구가 개발되어 다양한 지역을 대상으로 하여 폭넓은 연구가 이루어져 전문대학 비서학 전공생의 현황을 보다 일반적으로 설명하는 것이다. 또한 이 연구에서는 학년별 차이를 살펴보는 것에 그쳤지만 후속연구에서는 인구통계학적이나 심리적인 다양한 변인들에 대한 비교분석을 시도하는 것이 필요하다. 그리고 좀더 구체적으로 접근하여 진로장벽과 진로결정 자기효능감의 하위요인별로 진로준비행동에 미치는 영향력을 심도있게 설명하는 것이 이루어져야 할 것이다. 이 과정에서 진로결정 자기효능감의 매개효과에 대한 구체적 연구가 이루어진다면 진로발달 준비에서 진로결정 자기효능감의 역할을 파악할 수 있을 것이다. 이러한 연구의 결실은 대학에서의 진로지도와 상담에 활용될 수 있는 경험적 자료로써 기여할 것이며 더 나아가 학생들이 진로준비행동을 원활하게 수행하는데 뒷받침이 될 것이다.;In these days, people’s passion for occupation increases, resulting in greater competition for jobs. It is very hard to be accepted to an occupation they desire. Due to these circumstances, universities and colleges are taking charge of not only helping students acquire academic achievements, but also guiding and counseling them with practical ways to seek jobs. These schools emphasize practical behavior as well as positive attitude and cognition through career guidance and counseling. However, there were only little researches from experience in academic studies. In addition, studies related to careers stressed the cognition and attitude instead of emphasizing practical behavior for career preparation. Furthermore, the previous studies have been conducted only for 4-year-university students, teenagers, and people for special areas. There were only a few studies and researches performed for 2-year-college students. Through previous studies, it has shown that career barriers and career decision-making self-efficacy were perceived as significant variables for career preparation behavior. Therefore, it is necessary to study career barriers and career decision-making self-efficacy to efficiently carry out career preparation behaviors of 2-year-college students majoring in Secretarial Science. The purpose of this study is to examine the impact of career barriers, career decision-making self-efficacy on the career preparation behavior among college students majoring in Secretarial Science. In this study, the following hypotheses are set up to achieve above research objective. Hypothesis 1 : The career barriers of college students will have significant effects on the career preparation behavior. Hypothesis 2 : The career decision-making self-efficacy of college students will have significant effects on the career preparation behavior. Hypothesis 3 : There will be a significant negative relationship between the career barriers and decision- making self-efficacy of college students. To test the above-mentioned hypotheses, data were collected using instruments to measure career barriers, career decision-making self-efficacy, and career preparation behavior. This study collected data from 172 college students majoring in Secretarial Science. As for the statistical methods, correlation analysis and regression analysis for hypothesis 1 and hypothesis 2 were used while correlation analysis for hypotheses 3 were used. To compare career preparation behavior between freshmen and sophomores, comparison analysis was performed. The results of this study are as follows: First, the career barriers of college students majoring in secretarial science had a partial effect on the career preparation behavior as mentioned in hypothesis 1. According to the study, the factor of 'the uncertainty of future' among career barriers mainly impacted the college students while 'economical issues', 'ages, and physical difficulties' barely had an impact. Second, the career decision-making self-efficacy of college students majoring in secretarial science had a partial effect on the career preparation behavior as mentioned in hypothesis 2. The factors of career decision-making self-efficacy affected all of the career preparation behavior except the factor of 'solving problems'. Third, there was a negative relationship between career barriers and career decision-making self-efficacy. These results correspond with previous reports that career barriers and career decision-making self-efficacy have a negative relationship. Fourth, the career preparation behavior had a difference between freshmen and sophomores. The higher the grade of students, the more the career preparation behavior was conducted. These results agree well with previous reports. Based upon the results of this study, the following recommendations were suggested for future research: First, a wider research for various areas must be performed in the future with appropriate measured tools that need to be developed. Second, it is necessary to attempt comparison analysis for demographic or psychological variables in future studies. Third, in future studies, detailed studies are needed for variable influences of career decision-making self-efficacy in the process of career barriers impacting career preparation behavior. Fourth, the sub-factors of career barriers have different impact on the career preparation behavior. Therefore, it would be useful to explore specific sub-factors of career barriers in future studies. The results of this study will be used as a research from experience in career guidance and counseling of colleges. Moreover, these results will contribute to accomplishing career preparation behavior for college students.논문개요 = ⅶ I. 서론 = 1 A. 연구 배경과 필요성 = 1 B. 연구 목적과 연구 문제 = 3 II. 이론적 배경 = 5 A. 진로장벽 = 5 B. 진로결정 자기효능감 = 14 C. 진로준비행동 = 19 D. 진로장벽, 진로결정 자기효능감과 진로준비행동 간의 관계 = 26 III. 연구 방법 = 33 A. 연구 가설 = 33 B. 용어 정의 = 34 C. 연구 대상 = 36 D. 측정 도구 = 37 E. 분석 방법 = 39 IV. 연구 결과 = 41 A. 연구대상의 일반적 구성 = 41 B. 진로장벽, 진로결정 자기효능감, 진로준비행동 분석 결 = C. 가설 검증 = 53 D. 학년별 비교 = 59 V. 결론 = 64 A. 연구결과 요약 및 제언 = 64 B. 연구의의 및 한계점 = 68 참고문헌 = 71 부록 = 78 <부록 - 1> 측정도구의 변경내용 = 78 <부록 - 2> 설문지 = 85 Abstract = 9

Role effectiveness of Advanced practice registered nurses

1. Introduction Advanced practice registered nurses are professional medical support nurses who perform tasks under the delegation of an attending physician and also play a variety of roles according to the needs of their clinical departments. Recently, the number of advanced practice registered nurses has increased rapidly due to clinical environment changes, such as the application of doctor's special laws, including a minimum of three years in an internal medicine specialization, at least three years in a surgery specialization, and the avoidance of support. The importance of advanced practice registered nurses is increasing due to their various roles in the medical field. As the importance of these roles increases, an evaluation of the role effectiveness of advanced practice registered nurses should also be required. Therefore, this study examined the general, professional, and psychological characteristics; organizational factors, such as the practice environment; the role and the role enactment; and the performance outcomes of advanced practice registered nurses. 2. Objective The purpose of this study was to identify the general, professional, and psychological characteristics of advanced practice registered nurses, and practice environment, which is an organizational factor, along with the role, role enactment, and performance outcomes of these nurses. In addition, these factors were analyzed to determine how they affect advance practice nurses’ work performance. 3. Theoretical framework Sidani and Irvine (1999) suggested a conceptual framework for evaluating the role of nurse practitioners working in hospitals. A conceptual framework consists of Structure, Process, Outcome. The three sub-factors of their proposed structure were the general, professional, and psychological characteristics of nurses, such as experience, academic background, professional nursing certification, clinical department, primary workplace, job satisfaction, turnover intention, and burnout. Patient factors included age, diagnosis, hospitalization route, accompanying diseases, surgeries, primary diseases, and treatment severity. The organizational factors were the practice environment such as professional visibility, relationship with administrators, relationship with medical staff, and independent behavior. Process means the role and role enactment of advanced practice registered nurses. The advanced practice registered nurse has a role in professional practice, consultation, education, research, and professional activities and acts in ways to extend both nursing and physician services. Outcome means the satisfaction and financial performance and is measured by work performance. The work performance index involves patient satisfaction, the satisfaction of neighboring departments, the patient length of stay, the discharge prescription prepared the day before discharge, and the number of treatments. 4. Research method 1) Research design The participants in this study are advanced practice registered nurses who work at two superior general hospitals with more than 2,000 beds and more than 800 beds and one general hospital with more than 400 beds in Seoul and Gyeonggi. This study is based on the general, professional, and psychological characteristics, the organizational factors, the roles, the role enactments, and the performance outcomes of advanced practice registered nurses. This was a descriptive research study that analyzed factors that influenced the nurses’ work performance using their roles and role enactments along with organizational factors, such as the nursing work environment. 2) Measurement scale ① Psychological characteristics of advanced practice registered nurses Job satisfaction The job satisfaction measurement tool was the same tool used in the study of Sang-han Kim (2017) that was developed by Steers (1984). This tool includes five items and records responses using a Likert-type scale. The higher the score on the 5-point Likert scale, the higher the job satisfaction. The reliability of this measure showed a Cronbach’s α = .83 in Sang-han Kim study and a Cronbach’s α = .84 in the present study. Turnover intention The tool for measuring turnover intention was developed by Mobley (1979) and then modified and supplemented by Ham Jeong-hwa (2013). Thirteen total items are included. The higher the score on the 5-point Likert-type scale, the higher the degree of turnover intention among respondents. The reliability showed a Cronbach’s α = .89 in Jeonghwa Ham’s (2013) study and a Cronbach’s α = .93 in the present study. Burnout The Korean version of the Maslach Burnout Inventory developed by Maslach and Jackson (1981) was used after obtaining permission from the tool developer. Burnout was assessed using nine questions that were scored from 1 point to 5 points each. The higher the score, the higher the degree of burnout. At the time of development, the reliability of the tool had a Cronbach’s α = .76; in the present study, the Cronbach’s α = .88. ② Organizational factors Environment measurement scale The NP-PCOCQ developed by Poghosyan et al. (2013) was used to measure the working environment of a nurse in charge of advanced practice registered nurses in Korea. The tool consists of 29 total questions: 4 that assess professional visibility, 9 that involve the relationship with administrators, 7 that explore the relationship with physicians, and 9 that deal with independent practice and support items. The higher the score on a 4-point Likert-type scale, the better the working environment. The previous Cronbach’s α of all tools was .93, while that of the present study was Cronbach’s α = .92. ③ Role measurement scale The tool for measuring the role of a professional nurse used in the study of Cho Myung-sook et al. (2011) was applied, modified, and supplemented to assess the role of advanced practice registered nurses in the current study. We divided the role of extended nursing roles, and extended physician duties to differentiate nursing tasks performed by the respondents. To determine how much role nurses play in Advanced practice registered nurses' role, the factors consisted of advanced clinical practice (15 questions), consultation (4 questions), research (3 questions), education and counseling (4 questions), and professional activities (5 questions). To assess the amount of role enactment nurses play in an extended nursing role, the respondents answered questions about advanced clinical practice (8 questions), consultation (2 questions), research (2 questions), education and counseling (3 questions), and professional activities (5 questions). To examine the amount of role enactment nurses play in roles that extended the duties of a physician, questions assessed advanced clinical practice (7 questions), consultation (2 questions), research (1 question), education and counseling (1 question), and professional activities (0 questions). Respondents used a 5-point scale to answer the questions, and points were added up for each response. The higher the total score, the more frequent the role. The reliability had a Cronbach’s α = .90 in the original tool and a Cronbach’s α = .84 in the present study. ④ Outcome measurement scale Patient satisfaction The La Monica-Oberst Patient Satisfaction Scale was developed by La Monica et al. (1986) and translated by Eunjoo Choi et al. (2015); the modified and supplemented tool was revised and supplemented to describe advanced practice registered nurses and included 18 items assessed using a 5-point Likert scale. The higher the total score, the higher the patient satisfaction. The original reliability had a Cronbach’s α = .91, and the present study demonstrated a Cronbach’s α = .94. Coworker satisfaction The coworker satisfaction tool was developed by Lee So-yeon (1996) and used with modifications to assess the role of a professional nurse in the study of Kim Sung-ryul, et. al. (2003). It includes 23 items that are rated using a 5-point Likert-type scale. The higher the total score, the higher the amount of coworker satisfaction. The overall reliability had a Cronbach’s α = .86; doctor satisfaction had a Cronbach’s α = .94 in this study, and nurse satisfaction had a Cronbach’s α = .95. Patient data analysis During the three-month period of the study, data on patients in charge of hospitalized patients at three medical institutions in Seoul and Gyeonggi were collected regarding approved procedures, age, sex, clinical department, accompanying diseases, primary disease, surgeries, treatment severity, and hospitalization routes. Accompanying diseases were classified using the Charlson Comorbidity Index; disease severity and surgical severity were examined using the KDRG(Korean diagnosis related group) version 4.0 (2018), and treatment severity was classified based on whether chemotherapy and radiation therapy were required. Financial outcome Length of stay During the study period, the number of days of the length of stay of the patient was verified and measured in days. Discharge prescription on the day before During the study period, it was determined whether the patient had a discharge prescription plan prepared the previous day. If there was no discharge plan from the previous day, it was recorded as 0; if there was a discharge prescription from the previous day, it was recorded as 1. The number of treatment activities In the patient data, the types of treatments administered by nurses per patient were verified, and the number of treatments by patient was also recorded. 3) Data collection The participants of the study were advanced practice registered nurses working at two superior general hospitals with 2000 beds or more and with 800 beds or more, and at one general hospital with 400 or more beds in the Seoul and Gyeonggi areas. This study was conducted from May–September 2020. The researcher who manages the participants did not participate in the research survey to protect the participants’ privacy. The inventory was distributed by researchers to those who understood the purpose of the study and who voluntarily provided informed consent. In addition, a satisfaction questionnaire was administered after the study’s completion by a researcher who explained the purpose of the study both to the participants and also to the patients, physicians, and nurses. In-office research-related bulletin posters were produced and posted, and questionnaires were provided to those who voluntarily signed an informed consent form after the researcher explained that there was no disadvantage if they discontinued their participation. The performance outcome was checked using surveys and medical records. The medical records were submitted to the medical records department at the hospitals for research-related matters, and the data were used after obtaining approval. 4) Data analysis For work performance, the factors influencing financial outcome were identified using a multi-level regression analysis that examined the length of stay, a multi-level logistic regression analysis for the presence of a discharge prescription the day before discharge, and a multi-level Poisson regression analysis for the number of treatment activities. 5. Research Results 1) General, professional, and psychological characteristics of advanced practice registered nurses Among the general characteristics of advanced practice registered nurses, the average age was 34.43 ± 5.51 years, with most nurses being in their 30s. College graduates accounted for the largest number of advanced practice registered nurses at 77 (59.2%), and 53 (40.8%) had a master’s degree or higher. The advanced practice registered nurses by department were as follows: 20 in general surgery (15.4%), 17 in neurosurgery (13.1%), and 12 in cardiology (9.2%). Regarding their type of work, 87 (66.9%) worked in a ward, 13 (10%) assisted in outpatient areas, and 30 (23.1%) performed both ward and outpatient work. Of the total nurses, 93 (71.6%) worked overtime hours during the study period. Job satisfaction was rated as 3.69 ± 0.57. The turnover intention was rated as 2.90 ± 0.73. Burnout was rated as 2.97 ± 0.71. 2) Organizational factors For factors affecting the working environment of the advanced practice registered nurses, professional visibility was rated as 2.67 ± 0.58 points. The relationship with administrators was given 2.29 ± 0.52 points, while the relationship with physicians scored 3.11 ± 0.41 points. Finally, the availability of independent practice and support was given 2.80 ± 0.38 points. 3) Role of advanced practice registered nurses Among the roles of advanced practice registered nurses by area, advanced clinical practice scored the highest with 4.06 ± 0.68 points, followed by education and counseling at 3.59 ± 0.72 points, consultation and referral at 3.52 ± 1.07 points, research at 2.56 ± 1.12 points, and professional activities at 2.45 ± 0.99 points. 4) Outcome Satisfaction was rated as 4.71 ± 0.37 among patients, 4.21 ± 0.59 among doctors, and 4.06 ± 0.62 among nurses. The length of stay was 6.50 ± 6.91 days. The presence of a discharge prescription on the day before discharge was 0.61 ± 0.48, and the number of treatment activities was 0.61 ± 0.57. 5) Factors influencing outcome (financial outcome) General characteristics, job characteristics, and psychological factors Among the factors of advanced practice registered nurses, the patient length of stay was shorter in those with a professional master’s degree (β = -0.042, p = .050) than it was for nurses with a bachelor’s degree, and the presence of a discharge prescription on the day before discharge was high with an odds ratio of 1.99 (95% CI: 1.05-2.78). For nurses who completed general master’s programs, the number of treatment activities had an RR of 1.28 (95% CI: 1.06-1.70). For nurses who completed a professional master’s course after a bachelor’s program, the number of treatments had an RR of 1.08 (95% CI: 1.01-1.38). In regards to experience, having a discharge prescription prepared the day before discharge was higher in nurses with 3–7 years at their current position compared to those who had worked just 1 year (Odds 1.73 (95% CI: 1.09-2.74)). When nurses with 7 years’ experience were compared with those with just 1 year on the job, the Odds was 1.24 (95% CI: 1.08-1.49). The average length of stay was longer in the internal medicine department than in the surgical department (β = 0.266, p = .000), and there were fewer treatment activities in the internal medicine department with an RR of 0.71 (95% CI: 0.59-0.85). The length of stay was shorter for outpatient and ward nurses than for nurses who worked in a ward (β = -0.224 p = .004), and the odds of having a discharge plan the day before discharge were 1.37 (95% CI: 1.02-2.05) for nurses who worked both in a ward and in an outpatient setting than for ward nurses. Practice environment Having a better relationship with physicians was associated with a shorter length of stay (β = -0.221, p = .020) and also with a higher number of treatment activities (RR: 1.68 (95% CI: 1.54-1.86)). Nurses who reported a better environment for independent behavior and support also were associated with a higher number of treatment activities (RR: 1.33 (95% CI: 1.05-1.68)). Roles Among nursing roles, the greater the consultation, the shorter the length of stay (β = -0.268, p = .009). The greater the amount of advanced clinical practice responsibilities, the higher the RR 1.06 (95% CI: 1.00-1.31) for the number of treatment activities. 6. Discussion This study aimed to provide basic data on the role, role enactment, and outcome of advanced practice registered nurses through an analysis of their work performance and influencing factors, as well as the proper role establishment and quality of their work. In an academic background comparison study of professional support personnel at medical institutions nationwide, advanced practice registered nurses notified general nurses of basic qualifications at the time of selection, received documented support, and were finally selected through interviews. However, a professional nurse’s license is currently not required due to the absence of the qualification policy, and it is still insufficient compared to NP and PA roles in the U.S., which require master’s degrees and professional certifications (Kwak Chan-young, Park Jin-ah, 2014). Each medical institution should require basic qualification regulations through an official selection process. Furthermore, it is urgent to establish a national qualification standard policy that allows professional nurses to play a role only when they obtain professional nursing certifications. Internal medicine departments accounted for a large percentage of the participants in this study compared with other similar studies. This means that the proportion of these nurses is gradually increasing due to the application of the three-year internal medicine major. Because a system of advanced practice registered nurses in surgical departments has already been tried , a clear analysis of the role of advanced practice registered nurses in the internal medicine department should be carried out to prevent trials and errors in the internal medicine department. Currently, the special law on majors in certain departments or the application of a three-year medical major is increasing the rate of change of nurses to shift or on-call work rather than regular hours, and many advanced practice registered nurses still work overtime. This practice causes many advanced practice registered nurses to experience exhaustion due to the burden of overtime (Kim Yoo-jin, et al., 2019) and also requires changes in their work to compensate for the lack of medical majors. Some nurses leave advanced practice registered nursing due to a reduction in job satisfaction (choi Hee-sun, 2012). To prevent this behavior, the current practice should be changed through an agreement with advanced practice registered nurses rather than an appropriate level of working hours and coercion depending on the situation. Advanced clinical practice, education, and counseling are recognized as major roles of nursing professionals (Lee Hye-ran, 2017). An investigation into the perception of advanced practice registered nurses revealed that the medical team is highly satisfied with and recognizes the importance of this role (Kim min-ji, 2015). Recognizing the importance of the role and identifying the exact duties required by the roles will be necessary to ensure better performance of the role, along with individual efforts to ensure competence. However, only 68.3% of medical institutions have standardized work guidelines (Kim Min-young et al., 2017), so it is urgent to establish standards and work categories at medical institutions to revitalize the role of advanced practice registered nurses. Furthermore, as has been done with NPs in the US, it will be necessary to institutionalize laws on the roles and the role enactments of these professionals. A 10-year survey of publications on NPs and PAs revealed that many studies have linked the role and performance of professional nurses (Ruth M. Kleinpell et al., 2019). This is seen as an opportunity to demonstrate to patients and medical staff the importance of the role by presenting high-quality nursing and cost-effective aspects and also to highlight the importance of the role and performance-related studies. This study is believed to have been difficult to influence patient satisfaction because of advanced practice registered nurses’ various, unclear roles. Prior study on the satisfaction of patients and medical staff with professional nurses, such as the work of Kim Soo-hyun (2014), has found patient satisfaction with professional nurses to be low. Advanced practice registered nurses should recognize that they are professional nursing personnel and should be responsible for engaging in their work and striving for better patient satisfaction. In terms of doctor and nurse satisfaction, surgical department advanced practice registered nurses represented the majority. Medical staff members were highly satisfied with the schedule, care of surgery, wound management, simple drug administration, testing, and discharge prescription support of nurses (Kim Sung-ryul, 2013). The length of stay was shorter in advance practice registered nurses who had completed a professional master-level course than for traditional college graduates. In addition, It was higher in those with a professional master’s course for preparing a discharge plan on the previous day. In those with a general master-level education or a professional master’s course, the number of treatment activities had respectively, compared with those who only had completed an undergraduate degree. In a study on the importance, satisfaction, and contribution of professional nurses, Cho Myoung-sook (2011) reported that professional nurse have completed a professional master’s program and obtained professional nursing certificates as part of their efforts to ensure patient care and nursing continuity. Therefore, professional nurses have the opportunity to increase their professional practical skills through professional nursing programs and their own personal efforts to perform better roles as advanced practice registered nurses with the goal of a more positive performance. In addition, professional competence, which is the ability to solve various clinical situations obtained through professional training courses, allows nurses to quickly make decisions in patient care, enabling autonomous intervention to meet patient needs. The competence of advanced practice registered nurses is a important factor for the growth of advanced practice registered nurses and is necessary

신경망 기반의 물질의 열역학적 특성 예측을 통한 화학 공정의 위험성 평가에 대한 연구

Thesis (master`s)--서울대학교 대학원 :응용화학부,2003.The accidents, caused in chemical industries, can cause a loss of lives and properties and damage to the surrounding environment as well. Therefore, when designing the new chemical process, it is vital to assess the safety of the overall processes. Especially, the risk assessment for the chemical reactor should be evaluated more attentively than other equipments because it is one of the most hazardous equipments. It seems to be useful to predict the amount of heat release of the reactions and the adiabatic temperature rise by reactions as the preliminary screening procedures of reactive chemical hazard evaluation. These data can be measured experimentally or calculated theoretically. Theoretical approaches are effective because they can reduce the cost and the risk caused by the experiments and besides it is not easy to get the experimental data, especially for the new materials or the high molecular substances. In this study, we developed the new method for the prediction of physical properties. This method can be applied to predict 16 physical properties for the chemicals that consist of C, H, N, O, and S. In order to improve the accuracy and applicability of the predictive model, we extended the database in large numbers, modified the existing group contribution methods and then established new method for predicting the physical properties using neural networks. Neural network-based approach could develop nonlinear structure property correlations more accurately and easily in comparison with other conventional approaches. The results from the new estimation method were found to be more reliable, accurate and applicable. Besides, this model could distinguish isomers.Maste