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본 연구는 아동기 부모의 자녀 COVID-19 백신접종 의도에 영향을 미치는 요인을 규명하는 가설적 모형을 구축하여 영향을 미치는 변수 간의 인과관계 및 강도를 확인하고 아동기 COVID-19 백신 접종률 촉진을 위한 전략개발의 근거를 제공하고자 시도된 구조방정식 모형구축 연구이다.
    Skinner 등 (2015)의 건강신념모델과 선행연구를 토대로 가설적 모형을 구축하였다. 가설적 모형은 COVID-19 백신접종 의도에 영향을 미치는 아동기 부모의 COVID-19 백신 지식이 해당하는 외생변수 1개, COVID-19에 대한 지각된 민감성과 지각된 심각성, COVID-19 백신접종에 대한 지각된 유익성, 지각된 장애성, 지각된 자기효능감, 지각된 행동의 계기와 COVID-19 백신접종 의도라는 7개의 내생변수로 총 18개의 가설을 설정하였다.
    자료 수집은 2021년 12월 10일부터 2022년 1월 31일까지 서울 소재의 상급 종합병원 1곳에서 소아청소년과 외래와 병동에 방문한 1∼13세 아동기 부모를 대상으로 이루어졌다. 배포한 설문지 220부 중에 회수된 것은 208부로, 이 중 응답이 불충분한 설문지는 4부를 제외한 204부의 설문지를 본 연구의 최종 자료 분석에 사용하였다. 자료의 분석은 IBM SPSS Statistics 27.0과 IBM SPSS AMOS 20.0을 이용하여 가설적 모형의 적합도 검증 및 가설 검정을 실시하였다.
    본 연구의 결과는 다음과 같다.

    첫째, 가설적 모형의 적합도 검증 결과는 x2(p)=1.459(p=.227), DF=1, x2/DF=1.459, GFI=.998, AGFI=.936, CFI=.998, NFI=.995, TLI=.955, SRMR=.04, RMSEA=.048로 수정 모델 없이 분석을 진행하였다.

    둘째, 연구가설은 총 18개의 가설 중 가설적 모형에서부터 최종모형까지 효과분석에서 직접 효과와 간접효과, 총 효과를 고려하여 유의한 것으로 나타난 9개의 가설이 지지가 되었다.

    셋째, 최종모형에서 COVID-19 백신접종 의도에 아동기 부모의 COVID-19 백신 지식은 간접적인 영향을 미치며, COVID-19 백신접종 관련된 지각된 장애성, 자기효능감, 행동의 계기는 COVID-19 백신접종 의도에 직접적인 영향을 미치는 것으로 나타났다.

    넷째, COVID-19 백신접종 의도를 통계적으로 유의하고 가장 효과 크기가 큰 설명 변인은 COVID-19 백신접종 관련된 지각된 장애성과 행동의 계기로 나타났다.

    본 연구를 통해 확인된 아동기 부모의 자녀 COVID-19 백신접종 의도에 미치는 영향요인과 모형 검증을 통해 도출된 결과들은 아동기 자녀의 COVID-19 백신접종 관련 연구에 기반이 될 수 있을 것으로 사료된다.

    This study established a hypothetical model of factors influencing the intent of COVID-19 vaccination by parents of young children, and determined the causal relationship among the factors and their strengths. The structural equation model provides a basis for the development of strategies that promote COVID-19 vaccination for young children.  
    This study established a hypothetical model based on the health belief model developed by Skinner et al. (2015). Eighteen hypotheses were set with the parents’ knowledge of COVID-19 vaccines as the exogenous variable, and perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, cues to action, and COVID-19 vaccination intent as the seven endogenous variables.  
    Data was collected from parents of children aged 1 to 13 and who visited the pediatrics department of a tertiary general hospital in Seoul between December 10, 2021 and January 31, 2022. A total of 220 questionnaires were distributed, and, of those, 208 were returned. The final questionnaire count used in the analysis was 204, after excluding 4 incomplete questionnaires. IBM SPSS Statistics 27.0 and IBM SPSS AMOS 20.0 were employed for goodness of fit analysis and hypothesis testing.
    The results of this study are as follows.
    First, the goodness of fit of the hypothetical model was x2(p)=1.459(p=.227), DF=1, x2/DF=1.459, GFI=.998, AGFI=.936, CFI=.998, NFI=.995, TLI=.955, SRMR=.04, and RMSEA=.048. As such, analysis was carried out without modifying the model.  
    Second, out of the 18 hypotheses, 9 hypotheses were found to be significant considering the total effects of the direct and indirect effects from the hypothetical model to the final model. 
    Third, in the final model, COVID-19 vaccination intent was indirectly influenced by parents’ knowledge of COVID-19 vaccines and directly influenced by perceived barriers related to COVID-19 vaccines, self-efficacy, and cues to action.
    Fourth, the descriptive variables with statistical significance and high effect were perceived barriers related to COVID-19 vaccines and cues to action. 
    The factors identified as influencing the COVID-19 vaccination intent of parents of young children and the results derived through model validation are expected to stimulate further research related to the COVID-19 vaccination of young children.

Ⅰ. 서론 ···································································1
  1. 연구의 필요성································································1
  2. 연구의 목적··································································6
  3. 용어의 정의 ·································································7

Ⅱ. 문헌고찰······························································12
  1. COVID-19 바이러스 와 아동감염 및 백신접종························12
  2. 건강신념모델 과 백신접종 의도··········································17

Ⅲ.  개념적 기틀 및 가설적 모형·······································26
  1. 개념적 기틀 ································································26
  2. 가설적 모형·································································28
  3. 연구가설·····································································35

Ⅳ. 연구 방법····························································38
  1. 연구설계·····································································38
  2. 연구 대상자·································································38
  3. 연구 도구····································································39
  4. 자료 수집 방법·····························································44
  5. 자료 분석 방법·····························································45
  6. 윤리적 고려사항····························································46

Ⅴ . 연구 결과··························································47
  1. 아동기 부모와 자녀의 일반적 특성 및 COVID-19 관련 
    특성···········································································47
  2. 측정 변수에 대한 기술 통계··············································50
  3. 가설적 모형 검증···························································54
  4. 연구가설 검정·····························································63

Ⅵ. 논의··································································68
  1. 아동기 부모의 자녀 COVID-19 백신접종 의도에 영향을 미치는 
    요인···········································································69
  2. 연구의 의의·································································76

Ⅶ. 결론 및 제언·························································77
  1. 결론··········································································77
  2. 제언··········································································78
  3. 연구의 제한점······························································80

Ⅷ. 참고문헌·····································································82
부록················································································96
Abstract···········································································111