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1 : (Pr ofe s s ion a l Nu r s e Au t on om y ) * ** ***. 1. (,,, ).,, (Rot h m a n, ).... (McClu r e, 19 84, Kim, 1994 ; Sin glet on & N ail, 1984 ; E dw ar d s, 1988 ; F r eidson, ). (Kim, ) , (P a nk r a t z & P a nk r at z, ) (Alexa n d er, Weism a n & Ch a se, ; Edw ar ds, ), (Cu rt in, ), (McKay, ), (Ba t ey & Lewis, 1982 ; H olden, 199 1), (Ca ssidy, 199 1), (Wien s, 1990 ), (Dwyer, Sch wa rt z & F ox,19 92 ), (Sch u t zenh ofer & Mu sser, ), (Wa de, 1999 ) (Seon g, 1983 ), * ** ***

2 (Kim, ),,,,, (Lee, 1996 ; Lee, ), 3 4 (Kim, 1998 )., (pr ofession a l nu r se a u t on om y ). 2.,,,. Walk er & Ava nt (198 8 ) 1), 2 ), 3 ), 4 ),,,, 5), 6 ). 17 4, 2 1,.?,?,?,?,?., ) (st r u ct u r e ), (t r a it ).,. Gr een wood (P ar k, 1997 ) (1), (2 ), (3 ). (pr ofession al power ) (Lee, )., au t on omy au t os n om os (self r u le) (Cu rt in, 1982 ; Dem pst er, 1994 ; Wa d e, ).,..,, (Dem pst er, 1994 ). (self r egu lat ion ), (F r eidson, 1994 ). McKay (198 3 )

3 F r eidson (197 1).,., (H a ge, ).,,, (McKa y, ),.,., (McKa y, 1983 ) (Lee, ; Ch o, Lee, Lee, ; Lee, ; Alexa n der, Weism a n, & Ch a se, 1982 )..,, (Kim, 1994 ; Wien s, ), (Sin glet on & N a ils, 1984 ),, (Lee, ; Ch o, Lee, Lee ; ), (Lee, ).., (work au t on omy ) (En gel, 1970 ; Ba t ey & Lewis, 1982 ; Mck a y, ), (Ba t ey & Lewis, ; Lee, ). H a ll (1968 ). 2 ). (Ba t ey & Lewis, ).,,,,, (Slavit t, St am p, P iedm ont & H a sse, 1978 ; Lee, 1996 ) (Cu r t in ; Ch er ow, 1994 ; Dem pst er, 1994 )

4 (McKay, 1983 ).,... (Fr eidson, 197 1).... (Weism a n, )... (McKa y, 1983 )...., ( P a nk r a t z & P a nk r a z, 1974 ), (a dvoca cy ) (Cu rt in, 1982 ; Pin ch, ; Ca ssidy & Oddy 1988 ). Bou gh n (199 5 ).,. Sch u zenh ofer (198 3 ),,,,... -,, (Krit ek, ; Kim, 1994 )., (em p ow er m ent ),. (E n gel, ; McKa y, ).,. Wa de (199 9 ),.,

5 3 1 5.,.,,,,,. 3 ), (Th e N ew Dict ion ar y of Kor ea n, ),,,,,, (Ma rria m - Webst er, ), (H a n Dict ion ary of Kor ea n, ),,,, (Th e Gr ea t E n cyclop edia of Kor ea n, ), 3,, (Th e Dict ion ary of E du ca t ion, ), (Th e Gr eat E n cyclopedia of Wor ld Ph ilosoph y, ), - (Kor ea n Associa t ion for St u dies of ph ilosoph ica l Th ou gh t, ). 2. 1), 2 ), 3 ), 4 ), 5), 6 ) 7 ), 8 ), 9 ), 10 ), 11). 1), 2 ), 3 ), 4 ), 5), 6 ), 7 ), 8 ), 9 ), 10 ), 1 1), 12 ), 13 ), 14 ), 15), 16 ), 17 ), 18 ), 19 ), 2 0 ), 2 1). 3.,,,,,,,,.. 1) 2 ) 3 ) 4 ) 5 ) 6 ) 7 ) 8 ) 9 ) 10 ) 1 1) 12 )

6 ) 14 ) 15) 4.,,.,,,,,,, (Alexa n der, Weism a n & Ch a se, 1982 ),,,,. -,,,,,,,,., (em powerm ent ),,,, (Kim, ; Lee, ; Ch o, lee, Lee, 1999 ; Lee, ; Alexa n d er, Weism a n, & Ch a se, 1980 ; Dwyer, Sch w ar t z & F ox ; ; Hin sh aw, Sm elt zer & At wood, 1987 ; Wa d e, 1999 ). 5. 1) , ,

7 3 1 5.,,,,,,,,,,.. 500cc BU N, Cr cc 100 0cc.. 2 ) 5. Wh ipple oper a t ion 73. (AP C) 8 E BL ( ) cc 700 0cc/ cc cc cc.. AP C cc CH F. CVP. (CVP ) CVP 4 cm H 2 O 10cc 3 ) 10.,,.,..,.,,,

8 ) KCL KCL Toler able Diet, 4.,,.,,. Act ivit y Scale (NAS ) (Sch u t zenh ofer, ), Au t on om y, t h e Car in g P er spect ive (ACP ) (Bou gh n, 199 5). PNAS 1), 2 ), 3 ) 3., (Collin s & H en der son, 199 1). NAS,,.. ACP,,, 4, 50, PNAS NAS, ACP NAS.,,, (Wa de, ). <F igu r e 1>. 6. (em pir ical r efer en t ),, (, ; Wa d e, 1999 ). P a nk r a zt Nu r sin g At t it u de Sca le (PNAS) (P a nk r a t z & P a nk r at z, 1974 ), N u r sin g.,,,

9 3 1 5 Definit ion : com pet en cy a n d cr ea t ive p er for m a n ce of pr ofession al n u r se in pr a ct ice t o decide in d ep en dent ly or int er d ep en dent ly n u r sin g a ct ivit ies a n d t o a ccou nt able for r esu lt s of d ecision s, t h at r eflect a dv oca cy a n d car ing Ant ecedent s : P er son a l Ch a r a ct er est ics E du ca t ion a l Ba ck gr ou n d Exp er ien ce St ru ct u r a l Ch a r a ct erist ics At t ribu t es : In d ep en dent Decision Mak in g Self- Init ivies Keep Nu r sing St a n da r d A la w- a biding Spirit Con scien ce & Et h ics, Respon sibilit y Cr eat ivit y Act ive Ta sk Ma n agem ent Discr et ion, Collegia l in depen den ce Coop er at ive Rela t ion sh ip wit h Clien t Advoca cy &Ca rin g Devot ion t o t h eir Pr ofession Recept iv e Ca pa cit y t o Ot h er s Self- Confid en ce Con sequ en cies : F eeling of Self- Effica cy Em pow er m en t J ob Sa t isfa ct ion Redu ct ion of Int en t ion t o lea ve J ob Devot ion t o Nu rr sin g Profession alism <F ig u re 1> A Co nc e pt o f P ro f e s s io n a l N u rs e A ut o n o m y Wa de (1999 ) 1), 2 ), 3 ), 3 ),,,, 4 ), 5 ).,,,,.,,,,,,,,,,,,,,. -,,,,,,,,., (em powerm ent ),,,,.,,,,. -,,,,,,,,. (em powerm ent ),.,.,

10 ,,. Re fe re nce Alexa n d er, C. S., Weism a n, C.S. & Ch a se, G. A. (198 2 ). Det erm in a nt s of St a ff N u r ses' P er cept ion s of Au t on omy wit h in Differ ent Clinical Cont ext s. N u rsing R esearch, 3 1 (1), Bat ey, M. V., & Lewis, F. M. (1982 ). Clar ifyin g Au t on om y a n d Accou nt a bilit y in Nu r sin g Ser vice : P ar t 1. J of N u rsin g A dm n ist rat ion, 12 (9 ), Bou gh n, S. (199 5). An In st r u m en t for Mea su rin g Au t on om y- Rela t ed At t it u des a n d Beh a vior s in Wom a n Nu r sin g St u d ent s. J of N u rsing E du cat ion, 34 (3 ), Ca ssidy, V. R., & Oddy, L. F. (19 9 1). Pr ofession a l Au t on om y a n d Et h ica l Decision Mak in g am on g Gr a du at e a n d U n der gr a du a t e Nu r sin g Maj or s : A Replica t ion. J of N u rsing Edu cat ion, 3 0 (4 ), Ch er ow, E. (1994 ). Pr ofession al Au t on om y : Th en is N ow. S em in ars in H earing, 15 (3 ), Ch o, H., Lee, O. C., & Lee, H. S. (199 8 ). A Cor r ela t ion a l St u dy on Nu r ses ' P r ofession al Au t on om y, Self- con cept, a n d J ob Sa t isfa ct ion, J of R ed Cross N u rsing, 20, Collin s, S. S., & H en der son, M. C. (199 1). Au t on om y : P a rt of t h e N u r sin g Role? N u rsing Foru m, 26 (2 ), Cu r t in, L. (198 2 ). Au t on om y, Accou nt a bilit y, a n d Nu r sin g Pr a ct ice. T opics in Clinical N u rsin g, 4 (1), Dem p st er, J. S. (19 94 ). Au t on om y : A Pr ofession a l Issu e of Con cer n for Nu r se Pr a ct it ion er. N u rse Pract it ion er Foru m, 5 (4 ), Dwyer, J. P., Sch wa rt z, R. H., & F ox, M. L. (199 2 ). Decision Ma kin g Au t on om y in Nu r sin g. J of N u rsing A dm inist rat ion, 2 (2 ), E dwa r ds, D. (198 8 ). In cr ea sin g St aff Nu r se Au t on om y : A Key t o Nu r se Ret ent ion. J of Pediat ric N u rsing, 3 (4 ), E n gel, G. (19 70 ). Pr ofession al Au t on omy a n d Bu r eau cr at ic Or ga niza t ion. A dm inist rat iv e S cien ce Q u art erly, 15 (3 ), F r eidson, E. (19 7 1). Profession of M edicin e. N ew Yor k : Dod d Mea d. F r eidson, E. (1990 ). Pr ofession alism, Ca rin g, a n d Nu r sin g. P a per pr epa r ed for t h e P ark Ridge Cent er, P ar k Rid ge, Illin ois, h t t p :/ / it sa.u csf.edu / eliot f F r eidson, E. (1994 ). Met h od a n d Su b st a n ce in Th e Com p ar a t ive St u dy of Pr ofession. Plen a ry Addr ess, Confer en ce on Regu la t in g Exp er t ise, P aris, Apr il 14, h t t p :/ / it sa.u csf. edu/ eliot f/ m et h od_an d Subst an ce_in_co.h t m l Gr eenwood, E. (198 1). At t ribu t es of a Pr ofession Revisit ed. Gilbert, N. a n d Sp ech t, H.(E ds ). T h e Em ergen ce of S ocial W elfare an d S ocial W ork. 2n d ed., It a sca, III.F.E.P ea cock H a ge, J. (19 80 ). T h eoris of Organizat ion : Form s, Process, an d T ran sform at ion. N ew York : Wiley H a ll, R. H. (19 68 ). Pr ofession a lizat ion a n d Bu r eau cr at izt ion. A m erican S ociological R ev iew, 33, Hin sh aw, A. S., Sm elt zer, C. H., & At wood, J. R. (19 87 ). In n ova t ive Ret en t ion St r a t egies for N u r sin g St aff. J of nu rsing A dm n ist rat ion, 17 (6 ), H olden, R. J. (199 1). Respon sibilit y a n d Au t on om ou s N u r sin g Pr a ct ice. J A dv N u rs, 16,

11 3 1 5 Kim, E. S. (19 94 ). A S t u dy on A t t it u d e T ow ard Prfession al A u t on om y an d J ob S at isfact ion of Clinical N u rses. Th e Gr a du at e Sch ool of Edu cat ion, Ewh a Wom a n s U niver sit y. Kim, S. Y. (1998 ). A S t u dy of A u t on om y of A ssociat e an d B accalau rat e Degree W om en N u rsing S t u dent. Th e Gr a du at e Sch ool of Edu cat ion, Ewh a Wom a n s U niver sit y. Kor ea n Associat ion for St u dies of Ph ilosoph ica l Th ou gh t. (19 97 ). T h e Great E n cy clop edia of Ph ilosophy. Seou l :Don gn yok Pu blish er. Krit ek, P. B. (19 8 5). F a cu lt y Gover n a n ce : A Key t o Pr ofession a l Au t on om y, J of N u rsing Edu cat ion. 24 (9 ), Lee, S. K. (1996 ). A S t u dy on t h e R elat ion sh ip bet w een A u t on om y an d Grou p Coh esiv en ess, Th e Gr a du at e Sch ool of N u r sin g, Seou l N a t ion a l U niver sit y. Lee, S. M. (2 000 ). Th e Cau sa l Rela t ion sh ip am on g Nu r ses P er ceived Au t on om y J ab Sat isfa ct ion a n d r ela t ed va rria bles. J of Korean N u rsin g A dm in A cad S ociet y, 6 (1), M arriam -W eb st er 's N in et h N ew Collegiat e Dict ion ary (1988 ). Ma rria m Webst er In c. McClu r e, M. L. (1984 ). Ma n a gin g t h e Pr ofession a l N u r se. P a rt II. Ap plyin g Ma n a gem ent Th eor y t o t h e Ch allen ges. J of N u rsing A dm inist rat ion, Ma r ch, 14 (3 ) Mck a y, P. S. (19 83 ). In t er depen dent Decision Mak in g : Redefinin g Pr ofession al Au t on om y, N u rsing A dm inist rat ion Q u art erly, 7 (4 ), P a nk r a t z, L., & P a nk r a t z, D. (1974 ). N u r sin g Au t on om y a n d P a t ient s Righ t s : Developm ent of a Nu r sin g At t it u de Scale. J of H ealt h an d S ocial Beh av ior, 15, P a rk, J. W. (1997 ). A St u dy for a Th eory of Pr ofession. Social Scien ce Reser ch In st it u t e Kyu n gsu n g U niver sit y, S ocial S cien ce R eserch 13. h t t p :/ / ssr i.kyu n g.a c.k r/ doc/ 13-7.h t m l Pin ch, W. J. (198 5 ). Et h ical Dilemm a s in Nu r sin g. Th e r ole of t h e Nu r se a n d P er cept ion s of Au t on omy. J of N u rsin g Edu cat ion, 24 (9 ), Rot h m a n, R. A. (19 87 ). W ork ing S ociological Persp ect iv es. Pr ent ice H all. Sch u t zenh ofer, K. K., & Mu sser, D. B. (19 94 ). Nu r se Ch ar a ct er ist ics a n d Pr ofession al Au t on om y. Im age : J of N u rsing S ch olarsh ip, 26, Sch u t zenh ofer, K. K. (19 83 ). Th e developm ent of Au t on om y in Adu lt Wom a n. J of Psy ch ological N u rsin g an d M ent al H ealt h S erv ices, 2 1 (4 ), Sch u t zenh ofer, K. K. (19 88 ). Mea su rin g Pr ofession a l Au t on om y in N u r ses. St rickla n d, O. L. & Walt z, C. F. (eds ). M easu rem ent N u rsin g Ou t com es. N ew York : Sprin ger Pu blish in g Com p a ny, Seon g, I. S. (1983 ). A S t u dy Det erm int s of st aff N u rses ' Percep t ion of A u t on om y in Pract ice. Th e Gr a du a t e Sch ool of H ealt h Seou l N a t ion a l U n iver sit y. Sh in, K. R. (1994 ). A Con cept An alysis of Int u it ion. J Korean A cad N u rs, 24 (2 ), Sim, Y. J., Yoo, H. J., & P ar k, S. H. (1992 ). In du st rial S ociology. Seou l :Kyu n gm oon sa. Sin glet on, E. K. & N ail, F. C. (1984 ). Role Clar ifica t ion ; A Pr er equ isit e t o Au t on om y. J of nu rsing A dm nistration, 14 (10 ), Sla vit t, D. B., St am p, P. L., P iedm ont, E. B., & H a sse, M. B. (1978 ). N u r ses' Sat isfa ct ion wit h Th eir Work Sit u a t ion. N u rsing R esearch, 2 7 (2 ), T h e Dict ion ary of E du cat ion. (1972 ). Seou l : Kyoyook Kw ah a k sa Pu blish in g. T h e Great En cy clop edia of Korean. (199 8 ). Seou l : Minj u n gser im. T h e Great E n cy clop edia of W orld Ph ilosoph y. (199 9 ). Seou l : Cor yo Pu bu lish in g Com pa ny. T h e N ew Dict ion ary of Korean. (199 0 ). Seou l : Don gah Pu bilish in g Com pa ny. Wa d e, G. H. (1999 ). Pr ofession a l N u r se

12 Au t on omy : Con cept An a lysis a n d Applicat ion t o Nu r sin g E du ca t ion. J of A dv N u rs, 30 (2 ), Wallk er, L. O., & Ava nt, K. C. (1988 ). S t ret egies for T h eory Con st ru ct ion in N u rsing (2 n d Ed.), N orwa lk : Ap plet on & La n ge. Weism a n, et al. (1980 ). J ob Sat isfa ct ion am on g H ospit a l N u r ses : A Lon git u din al St u dy. H ealt h S erv ices R esearch, 15, Wien s, A. G. (199 0 ). Exp a n ded Nu r se Au t on omy. J of N u rsing A dm nist rat ion, 20 (12 ), H an Dict ion ary of Korean (19 98 ). Seou l : Seon ga n d a n g. - Ab s t r a c t - Con c ep t An a ly s is of Pr ofes s ion a l Nu r s e Au t on om y Ch i, S u n g -Ai * Y oo, Hy u n g -S ook ** Pr ofession a l nu r se Au t on om y is a n essen t ia l a t t r ibu t e of a disciplin e st rivin g for fu ll pr ofession al st at u s. P u r p o s e : Th is st u dy w a s t o cla rify t h e con cept of pr ofession a l n u r se a u t on om y t o pr ovide b a sic da t a n eeded for developm ent of pr ofession al au t on omy enh a n cin g st r at egies. Me t h o d : Th is st u dy u se t h e pr ocess of Walk er & Ava nt e' s con cept a n alysis b a sed on Wa de ' s r esear ch (1999 ), a n d field dat a of 2 1 nu r ses. R e s u lt s : Pr ofession a l nu r se a u t on om y is defin ed a s com pet en cy a n d cr eat ive p er for m a n ce of t h e pr ofession al n u r se in pr a ct ice, t o decide in dep en den t ly or in t er depen dent ly n u r sin g a ct ivit ies a n d t o be h a d a ccou n t able for r esu lt s of decision s, t h a t r eflect a dvoca cy a n d car in g. It wa s ident ified t h at cr it ica l at t ribu t es in clu de r esp on sible discr et ion ar y decision m a kin g, collegia l in t er depen den ce, init ia t ive, cr eat ivit y, a n d ca rin g, a dvoca cy, cooper a t ive r elat ion sh ip wit h client s, r ecept ive ca pa cit y t o ot h er s, a ct iven ess, self confiden ce, a n d devot ion a n d r espon sibilit y t o t h eir pr ofession. An t eced ent s in clu de p er son a l ch ar a ct er ist ics, edu ca t ion a l b a ck gr ou n d, exp er ien ce a n d st ru ct u r a l ch ar a ct erist ics t h a t enh a n ce pr ofession al nu r se a u t on om y. Con sequ en ces of pr ofession al nu r se a u t on om y ar e feelin gs of self- effica cy, em powerm ent, j ob sat isfa ct ion, r edu ct ion of in t ent ion t o lea ve t h eir j ob. Co n c lu s i o n : Accor din g t o t h ese r esu lt s, it is r ecom m en ded t h at t h e cu rr icu lu m pr ovides a n envir onm ent for lear nin g pr ofession al nu r se a u t on om y, a n d t h at is u sed a s b a sic da t a t o develope st r at egies t o enh a n ce pr ofession al au t on omy of nu r se in pr a ct ice a n d it ' s effect s Ke y w o rd s : Pr ofession al nu r se a u t on om y * P r ofe ss or, D ep t. of N u r sin g, Ch u n g An g U n iv er sit y ** D oct or a l C a n did a t e, Gr a du a t e S ch ool, Ch u n g An g U n iv er sit y

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완성09E02박은숙.PDF : * 1 ) 2 ) 3 ) 4 ) 1 ) 5 ) 6 ). 1.,., (cont ent - ba sed cu rricu la ) (pr ocess- b a sed cu rricu la ),,,,,., -, (Ben -Zu r, Ya gil & Spit zer, 1999 ; H egge, 19 9 5 ; Oer m a n n, 19 94 : Spit ser,