Open Access, Peer-reviewed
pISSN 1225-9330
eISSN 2288-4955
    J Korean Acad Nurs Adm. 2017 Mar;23(2):161-169. Korean.
    Published online Mar 31, 2017.
    https://doi.org/10.11111/jkana.2017.23.2.161
    Copyright © 2017 Korean Academy of Nursing Administration
    Original Article

    Effects of Nursing Practice Environment and Self-esteem on Critical Thinking Disposition among Clinical Nurses

    Eunju Choi,1 Jihyeon Hwang,1 and Insil Jang2
      • 1Department of Nursing, Asan Medical Center, Korea.
      • 2Department of Nursing, University of Ulsan, Korea.
    • Corresponding author: Jang, Insil. Department of Nursing, University of Ulsan, 93 Daehak-ro, Nam-gu, Ulsan 44610, Korea. Tel: +82-52-259-1570, Fax: +82-52-259-1236, Email: isjang@ulsan.ac.kr
    Received November 14, 2016; Revised February 18, 2017; Accepted March 11, 2017.

    This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    This study was a cross-sectional study done to determine the relevance and impact factors of nursing practice environment and self-esteem on critical thinking disposition in clinical nurses.

    Methods

    A survey was conducted from March to May 2015 with self-report questionnaire. Participants were 281 registered nurses working in one tertiary hospital. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression with SPSS/WIN 21.0.

    Results

    Factors affecting the nurses' critical thinking disposition included age (F=7.23, p<.001), educational background (F=7.82, p<.001), position (F=14.95, p<.001), clinical career (F=7.66, p<.001). Further, critical thinking disposition had a positive correlation with nursing practice environment (r=.60, p<.001) and self-esteem (r=.41, p<.001). Self-esteem and nursing practice environment accounted for 43% of the variance in critical thinking disposition.

    Conclusion

    The study findings show that critical thinking disposition is influenced by nursing foundations for quality of care and the collegial nurse-physician relations of nursing practice environment. Therefore, it's necessary to provide continuing education for clinical nurses to reconstruct the organizational culture of nurses and physician partnerships. In addition, increasing self-esteem through various motivational programs should increase critical thinking disposition.

    Keywords
    Nurses; Thinking; Environment; Self-concept

    Tables

    Table 1
    General Characteristics of Participants (N=281)

    Table 2
    Mean Scores for Nursing Practice Environment, Self-esteem and Critical-thinking Disposition (N=281)

    Table 3
    Differences in Nursing Practice Environment, Self-esteem and Critical-thinking Disposition according to General Characteristics (N=281)

    Table 4
    Correlations of Nursing Practice Environment, Self-esteem and Critical-thinking Disposition (N=281)

    Table 5
    Influencing Factors on Critical-thinking Disposition (N=281)

    References

      1. Alfaro-LeFevre R. In: Critical thinking, clinical reasoning, and clinical judgment: a practical approach. 5th ed. St. Louis, MO: Saunders/Elsevier; 2013.
      1. Sung KS. Education for critical thinking. J Educ Idea 2010;24(3):155–172.
      1. Zuriguel Pérez E, Lluch Canut MT, Falco Pegueroles A, Puig Llobet M, Moreno Arroyo C, Roldan Merino J. Critical thinking in nursing: Scoping review of the literature. Int J Nurs Pract 2015;21(6):820–830. [doi: 10.1111/ijn.12347]
      1. Lunney M. In: Critical thinking to achieve positive health outcomes: nursing case studies and analyses. 2nd ed. New York, NY: John Wiley & Sons; 2013.
      1. Gang M. Critical thinking disposition and self-esteem of psychiatric mental health nurses. J Korean Acad Psychiatr Ment Health Nurs 2011;20(4):404–413. [doi: 10.12934/jkpmhn.2011.20.4.404]
      1. Park S, Kwon IG. Factors influencing nurses' clinical decision making - focusing on critical thinking disposition. J Korean Acad Nurs 2007;37(6):863–871.
      1. Jung SC, Jung DY. Relationship between critical thinking disposition, clinical decision making and job satisfaction of cancer center nurses. J Korean Acad Nurs Adm 2011;17(4):443–450. [doi: 10.11111/jkana.2011.17.4.443]
      1. Park JA, Kim BJ. Critical thinking disposition and clinical competence in general hospital nurses. J Korean Acad Nurs 2009;39(6):840–850. [doi: 10.4040/jkan.2009.39.6.840]
      1. Shoulders B, Follett C, Eason J. Enhancing critical thinking in clinical practice: Implications for critical and acute care nurses. Dimens Crit Care Nurs 2014;33(4):207–214. [doi: 10.1097/dcc.0000000000000053]
      1. Lee JY, Pak SY. Relationship between the practice environment of nursing and critical thinking disposition of nurses in local general hospitals. J Korean Acad Nurs Adm 2014;20(2):145–153. [doi: 10.11111/jkana.2014.20.2.145]
      1. Lake ET, Friese CR. Variations in nursing practice environments: relation to staffing and hospital characteristics. Nurs Res 2006;55(1):1–9. [doi: 10.1097/00006199-200601000-00001]
      1. Cornell P, Riordan M, Townsend-Gervis M, Mobley R. Barriers to critical thinking: workflow interruptions and task switching among nurses. J Nurs Adm 2011;41(10):407–414. [doi: 10.1097/NNA.0b013e31822edd42]
      1. Raterink G. Critical thinking: reported enhancers and barriers by nurses in long-term care: implications for staff development. J Nurses Staff Dev 2011;27(3):136–142. [doi: 10.1097/NND.0b013e318217b3f3]
      1. Rosenberg M. In: Society and the adolescent self-image. Princeton, N.J.: Princeton University Press; 1965.
      1. Olthuis G, Leget C, Dekkers W. Why hospice nurses need high self-esteem. Nurs Ethics 2007;14(1):62–71. [doi: 10.1177/0969733007071359]
      1. Profetto-McGrath J, Hesketh KL, Lang S, Estabrooks CA. A study of critical thinking and research utilization among nurses. West J Nurs Res 2003;25(3):322–337. [doi: 10.1177/0193945902250421]
      1. Suliman WA, Halabi J. Critical thinking, self-esteem, and state anxiety of nursing students. Nurse Educ Today 2007;27(2):162–168. [doi: 10.1016/j.nedt.2006.04.008]
      1. Chan ZC. A systematic review of critical thinking in nursing education. Nurse Educ Today 2013;33(3):236–240. [doi: 10.1016/j.nedt.2013.01.007]
      1. Kang YS, Choi YJ, Park DL, Kim IJ. A study on nurses' self-leadership, self-esteem, and organizational effectiveness. J Korean Acad Nurs Adm 2010;16(2):143–151. [doi: 10.11111/jkana.2010.16.2.143]
      1. Lake ET. Development of the practice environment scale of the Nursing Work Index. Res Nurs Health 2002;25(3):176–188. [doi: 10.1002/nur.10032]
      1. Cho E, Choi M, Kim EY, Yoo IY, Lee NJ. Construct validity and reliability of the Korean version of the practice environment scale of nursing work index for Korean nurses. J Korean Acad Nurs 2011;41(3):325–332. [doi: 10.4040/jkan.2011.41.3.325]
      1. Jon BJ. Self-esteem: a test of its measurability. Yonsei Nonchong 1974;11(1):107–130.
      1. Berkow S, Virkstis K, Stewart J, Aronson S, Donohue M. Assessing individual frontline nurse critical thinking. J Nurs Adm 2011;41(4):168–171. [doi: 10.1097/NNA.0b013e3182118528]
      1. Kwon JO, Kim EY. Impact of unit-level nurse practice environment on nurse turnover intention in the small and medium sized hospitals. J Korean Acad Nurs Adm 2012;18(4):414–423. [doi: 10.11111/jkana.2012.18.4.414]
      1. Lee MH, Kim JK. A comparative study on nursing practice environment, professionalism, and job satisfaction according to hospital size. J Korean Acad Nurs Adm 2013;19(4):470–479. [doi: 10.11111/jkana.2013.19.4.470]
      1. Ma C, Park SH. Hospital magnet status, unit work environment, and pressure ulcers. J Nurs Scholarsh 2015;47(6):565–573. [doi: 10.1111/jnu.12173]
      1. Song HJ, Lee SM. The effects of hospital nurses' self-esteem and communication skill on self-leadership and the quality of nursing service. J Korean Acad Nurs Adm 2016;22(3):220–229. [doi: 10.11111/jkana.2016.22.3.220]
      1. Choi H, Cho DS. Influence of nurses' performance with critical thinking and problem solving process. Korean J Women Health Nurs 2011;17(3):265–274. [doi: 10.4069/kjwhn.2011.17.3.265]
      1. Benner P. In: From novice to expert: excellence and power in clinical nursing practice. London: Addison-Wesley; 1984.
      1. Boschma G, Einboden R, Groening M, Jackson C, MacPhee M, Marshall H, et al. Strengthening communication education in an undergraduate nursing curriculum. Int J Nurs Educ Scholarsh 2010;7(1) [doi: 10.2202/1548-923X.2043]
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    MeSH Terms
    Cross-Sectional Studies
    Education, Continuing
    Foundations
    Humans
    Nurses
    Nursing*
    Organizational Culture
    Physician-Nurse Relations
    Tertiary Care Centers
    Thinking*
    Metrics
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