국문초록

의료기관인증제에 대한 요양병원 간호 인력의 인식,
직무스트레스 및 소진탄력성 조사연구

본 연구는 요양병원에 의무화된 의료기관인증제를 시행하면서 간호 인력들의 인식과 직무스트레스 및 소진탄력성을 알아보고 변수들 간의 상관관계를 확인하고자 시도되었다.
연구 대상자는 2015년 3월을 기준으로 1년 이내에 인증을 마친 J지역에 간호 1 등급 요양병원의 간호사와 간호조무사를 동일한 비중으로 한 총 176명을 편의 추출하였고, 설문기간은 2015년 3월 15일부터 3월 30일까지였다. 구조화된 설문지를 사용하여 수집된 자료는 SPSS/WIN 18.0 Window Program을 이용하여 빈도분석, 평균, 표준편차를 산출하고, t-test, ANOVA, Pearson''s correlation으로 분석하였다.
연구 도구로는 배정임(2008)개발하고 최연순(2011)이 수정 보완한 의료기관인증에 대한 인식 도구, 배정임(2008)의 직무스트레스 도구, 최명민(2007)이 개발하고 김현주 이해랑, 최순옥(2013)이 수정 보완한 소진탄력성의 도구를 사용하였다.

본 연구의 결과는 다음과 같다

첫째, 의료기관인증제에 대한 인식은 간호사 3.41±0.50점, 간호조무사 3.58±0.53점 이었으며, 직무스트레스는 간호사 3.10±0.47점, 간호조무사 2.80±0.48점 이었고, 소진탄력성은 간호사 3.46±0.48점, 간호조무사 3.64±0.40점으로 나타났다.

둘째, 일반적 특성에 따른 결과에서 간호사의 경우 의료기관인증제에 대한 인식은 연장 근무 경험(F=2.14, p<.035)에 따라, 직무스트레스는 결혼상태(t=-2.17, p<.033), 요양병원 임상경력(F=5.46, p<.006), 이전병원 규모에 따라(F=6.81, p<.002), 소진탄력성은 결혼상태(t=-2.79, p<.007), 근무형태(t=-2.40, p<.019)에 따라 유의한 차이가 있었다. 간호조무사의 경우 의료기관인증제에 대한 인식은 요양병원 임상경력(F=4.57, p<.013), 이전병원 규모(F=3.86, p<.025), 월수입(t=2.20, p<.031)에 따라, 직무스트레스는 연령(F=5.35, p<.002), 요양병원 임상경력(F=5.14, p<.008), 월수입(t=-2.49, p<.015), 연장경험(t=2.64, p<.010)에 따라, 소진탄력성은 요양병원 임상경력(F=3.82, p<.026)에 따라 유의한 차이가 있었다.

셋째, 변수간의 상관관계에서, 의료기관인증제 인식과 직무스트레스는 간호사(r=-0.45, p<.001)와 간호조무사(r=-0.57, p<.001) 모두 유의한 음의 상관관계로 나타났으며, 의료기관 인증제 인식과 소진탄력성도 간호사(r=0.62, p<.001)와 간호조무사(r=0.50, p<.001) 모두 유의한 양의 상관관계로 나타났다. 또한, 직무스트레스와 소진탄력성은 간호사(r=-0.39, p<.001)와 간호조무사(r=-0.45, p<.001) 모두에게 유의한 음의 상관관계로 나타났다.

본 연구를 통해 노인요양병원 간호사들의 의료기관인증제에 대한 인식을 높여주면, 직무스트레스를 줄여줄 수 있음을 확인하였다. 또한, 소진탄력성은 기혼인 경우와 상근하는 간호사에서 높았던 결과로 자신의 소진을 관리할 개인적 지지요소가 중요한 작용을 했던 것으로 사료된다. 이에 의료기관인증제에 대해 의료기관차원에서의 사전의 체계적인 교육과 직원들이 평가에 대한 긍정적인 인식을 갖도록 하면서, 인증을 준비하면서 받게 될 직무스트레스를 줄여주고 소진 탄력성을 향상시켜줄 프로그램 개발이 요구된다.

ABSTRACT

The study on the Recognition of healthcare Accreditation, Job Stress and Resilience to Burnout of Nursing staff in
Long-term Care Hospitals.

This study was conducted to figure out the recognition of accreditation, job stress and resilience to burnout related with obligatory healthcare accreditation among nursing staff of long-term care hospitals.
Participants were randomly chosen 176 nursing staff with the same proportion of registered nurses and nurse aids of long-term care hospitals located in J district, which had received accreditation within one year until march, 2015.
Data were collected through structured questionnaires from March 15, 2015 to March 30, 2015 to conduct frequency analysis and calculate mean and standard deviation using SPSS/WIN 18.0 Window Program and analyzed through t-test, ANOVA and Pearson''s correlation.
As for study tools, the tool for the recognition of healthcare accreditation was one developed by Jungim Bae(2008) and corrected by Yeonsun Choi(2011). For job stess, the tool developed by Jungim Bae(2008) was used while the tool developed by Myugmin Choi and corrected by Hyunju Kim, Haerang Lee and Sunok Choi (2013) was used for resilience to burnout.

The result was in the following.

1. The mean score for the recognition of healthcare accreditation was 3.41±0.50 among registered nurses while 3.58±0.53 among nurse aids. In case of job stress, the score of registered nurses was 3.10±0.47 while that of nurse aids was 2.80±0.48. Also resilience to burnout was scored 3.46±0.48 among registered nurses and 3,64±0.40 among nurse aids.

2. When it comes to general characteristics which may be influential, for registered nurses, the recognition of healthcare accreditation showed significant differences according to overtime labor experiences(t=2.14, p<.035) while marriage status(t=2.17, p<.033), job experiences in long-term care hospitals(F=5.46, p<.006) and the size of hospitals as former work places(F=6.81, p<.002) brought significant differences to job stress. In the realm of resilience to burnout, marriage status (t=-2.79, p<.007) and shift pattern of duties did(t=-2.40, p<.019).
In case of nurse aids the variables of making significant differences to the recognition of healthcare accreditation were job experiences in long-term care hospitals(F=4.57, p<.013) and the size of former hospitals(F=5.35, p<.002) and monthly income(t=2.20, p<.031). Job stress showed significant differences according to age(F=5.35, p<.002), job experiences in long-term care hospitals(F=5.14, p<.008), monthly income (t=-2.49, p<.015) and overtime labor experiences(t=2.64, p<.010) while resilience to burnout did according to job experiences in long-term care hospitals(F=3.82, p<.026).

3. As for the correlation of variables, the recognition of healthcare accreditation and job stress showed significant negative correlation among both registered nurses(r=-0.45, p<.001) and nurse aids(r=-0.57, p<.001) while the recognition of healthcare accreditation and resilience to burnout had significant positive correlation among both registered nurses(r=0.62, p<.001) and nurse aids(r=0.50, p<.001). Also the significant negative correlation was shown between job stress and resilience to burnout for both registered nurses(r=-0.39, p<.001) and nurse aids (r=-0.45, p<.001).
The result suggests that the more recognition of healthcare accreditation nursing staff of long-term care hospitals will have, the less job stress they will have. Given the score of resilience to burnout was higher among married nursing staff and full time ones, it is considered that individual supportive factors played important roles in relieving burnout state. Therefore a program is needed that nursing staff can have less job stress which is caused by preparation for the accreditation and more resilience to burnout, through systematic training sessions of healthcare institutions for better recognition healthcare accreditation and positive thinking about job performance evaluation after receiving healthcare accreditation.