Abstract
BACKGROUND: The emergence of infectious diseases such as SARS, MERS, and COVID-19 underscores the need for effective nursing preparedness. OBJECTIVES: This cross-sectional study sought to pinpoint the factors that impact nursing performance during the COVID-19 pandemic, focusing on nurses' self-efficacy, work environment, knowledge, and attitudes. DESIGN: The study utilized a cross-sectional design. SETTINGS & PARTICIPANTS: Between December 13, 2021, and January 21, 2022, an online and offline survey was conducted with 314 nurses who provided in-person care in tertiary and general hospitals throughout South Korea. METHODS: Using t-tests and ANOVA, the research compared nursing performance based on various demographic and work-related characteristics like age, gender, education, marital status, and other working conditions. A research model was formulated via structural equation modeling, positioning nursing performance as the dependent variable. The independent variables included career experience (indirect effect), work environment (indirect effect), COVID-19 knowledge (indirect effect), attitude toward COVID-19 (direct effect), and self-efficacy (direct effect). Data analysis was carried out using SPSS 26 and AMOS 28. RESULTS: The study demonstrated that self-efficacy and attitude toward COVID-19 significantly influence nursing performance, as reflected by robust critical ratios (CR) for self-efficacy (CR = 11.291, p < 0.001) and attitude (CR = 5.133, p < 0.001). They account for 43 % (R (2) = 0.43) of the variability of nursing performance. Self-efficacy was positively predicted by clinical experience (CR = 3.160, p = 0.002) and work environment (CR = 4.328, p < 0.001), while attitude was similarly influenced (CR = 3.557 and 2.926, respectively). However, clinical experience and work environment only explained 8 % (R (2) = 0.08) of self-efficacy and 16 % (R (2) = 0.16) of attitude. Knowledge about COVID-19 exhibited a statistically insignificant influence in the dynamics. CONCLUSIONS: This study, conducted among Korean nurses during the COVID-19 pandemic, reveals that self-efficacy and attitudes towards COVID-19 are key predictors of nursing performance, overshadowing knowledge's influence. These findings suggest the critical role of psychological factors in healthcare delivery during crises and underscore the need for enhanced focus on developing self-efficacy and positive attitudes in nursing education and professional development. Additionally, demographic and professional variables, including age, clinical experience, educational level, and marital status affect nursing performance.