이 연구는 종합병원 신규간호사의 태움에 따른 건강증진생활양식, 신체증상 및 직무스트레스 간의 관계를 파악하기 위한 서술적 조사 연구이다.
연구 대상은 경기도 소재 100∼399병상의 5개 종합병원에 근무하는 경력 1년 이내인 신규간호사이며, 자료수집 기간은 2018년 1월 5일부터 2018년 2월 28일까지였고 157부가 분석에 사용되었다. 건강증진생활양식은 Walker, Sechrist와 Pender(1987)의 HPLP(Health Promotion Lifestyle Profile) 48문항의 연구 도구를 보완한 도구(백상이, 김영임과 차지은, 2018)를 이용하였으며, 신체증상은 오진환(2006)이 개발한 신체증상 도구를 수정한 도구(이규환, 2014)로 측정하였다. 직무스트레스는 김매자와 구미옥(1984)이 간호사를 대상으로 개발한 간호사의 직무스트레스 척도를 김선미(2013)가 신규간호사에 맞도록 수정, 보완한 도구를 사용하였다. 수집된 자료는 SPSS Statistics 20.0 프로그램을 이용하여 빈도와 백분율, 평균과 표준편차, t-test, ANOVA, Scheffe test, Pearson correlation coefficients로 분석하였다.
대상자의 평균 연령은 24.9(±2.16)세이며, 미혼이 94.3%, 집에서 출퇴근하는 경우가 41.1%, 출퇴근 교통수단이 도보인 경우가 46.5%, 출퇴근 소요시간은 평균 19.2(±10.27)분, 주당 근무시간은 평균 44.8(±3.40)시간, 월 밤 근무 일수는 평균 7.3(±1.28)일, 희망부서가 타인 선택이 65.6%, 프리셉터와의 만족도는 보통이 45.9%, 근무경력은 평균 7.2(±2.58)개월, 내외과계 및 포괄 병동에 근무하는 경우가 76.4%, 평균 급여는 243.1(±23.85)만 원이었다.
태움 경험이 있는 신규간호사는 60.5%로 태움 횟수가 월 10회 이상이 38.2%, 태움의 인지 정도가 심함이 32.4%, 첫 태움 경험 시기는 6개월 미만이 47.7%이었다. 태움 인지 정도가 심하지 않은 경우에 보통이거나 심한 경우보다 건강증진생활양식이 유의하게 높았고(p<.001), 태움 경험이 있는 경우(p=.015)와 태움 경험이 10회 이상(p=.028)인 경우, 태움 인지 정도가 심한 경우(p=.010)에 신체증상이 유의하게 높았다. 또한 태움 인지 정도가 심한 경우(p=.017) 직무스트레스가 유의하게 높았다.
건강증진생활양식은 6개 하위 영역으로 나누어지며, 4점 만점에 평균 1.94(±0.48)점이었다. 하부영역 중 식습관 영역이 1.48(±0.48)점으로 점수가 가장 낮았으며, 대인관계 영역은 2.42(±0.69)점으로 점수가 가장 높았다. 25세 이상(p=.002), 기혼(p=.022), 희망 휴무일 배정 가능성이 보통이거나 큰 경우(p=.007), 프리셉터와의 만족도가 만족(p=.002)인 경우, 근무경력이 6∼12개월 미만(p=.038)이 건강증진생활양식이 높았다.
신체증상은 4점 만점에 평균 1.83(±0.52)점이었다. 주당 근무시간이 46시간 이상(p=.044), 월 밤 근무 일수가 6일 이하인 경우(p=.022)가 신체증상이 유의하게 높았다.
직무스트레스는 4점 만점에 평균 3.13(±0.45)점이었다. 25세 미만(p<.001), 희망 휴무일 배정 가능성 크지 않은 경우(p<.001), 프리셉터와의 만족도가 보통 이하인 경우(p<.001), 근무경력 3∼6개월 미만인 경우(p<.001)가 직무스트레스가 유의하게 높았다.
태움 인지 정도는 건강증진생활양식과 부의 관계를 나타냈고, 신체증상과는 정의 관계를 보였다. 또한 건강증진생활양식은 신체증상, 직무스트레스와 부의 관계가 있었으며, 신체증상과 직무스트레스와는 정의 관계를 보였다. 태움 경험자의 태움 인지 정도는 건강증진생활양식(r=-.713, p<.001)과 강한 정도의 부의 관계가 있고, 신체증상(r=.271, p=.008)과 직무스트레스(r=.319, p=.002)와 약한 정도의 정의 관계가 나타났다.
결론적으로, 종합병원 신규간호사의 태움 경험은 높고, 태움 경험자의 태움 인지 정도는 건강증진생활양식과 강한 정도의 부의 관계가 있고, 신체증상과 직무스트레스와는 약한 정도의 정의 관계가 있으므로 태움 인지 정도는 직무스트레스와 관계가 있다. 이러한 결과를 토대로 병원에서는 신규간호사의 직무스트레스를 감소시키기 위해 태움의 빈도를 낮추는 것이 중요하며, 태움 정도를 심하게 인지할수록 직무스트레스가 높아지므로 태움 정도에 대해 관심을 가져야 한다. 이를 위해 희망 휴무일에 휴무할 수 있도록 사전 공지를 하여 신규간호사가 원하는 휴무일이 누락되지 않도록 하며, 프리셉터와의 만족도를 높이는 근무 분위기를 형성하고, 근무경력이 6개월 미만인 신규간호사에 대한 각별한 관심을 가져야 한다. 종합병원 신규간호사의 태움 경험은 높은 편이고, 태움 인지 정도는 건강증진생활양식과 신체증상과 관련이 있으므로 태움을 낮추기 위한 적극적 대안이 요구되며, 특히 신규간호사의 직무스트레스 감소를 위해 간호사를 대상으로 하는 스트레스 관리 및 대인관계 능력 향상을 위한 프로그램 개발을 제언한다.

This study is a descriptive study aimed at investigating the relationship between health promoting lifestyle, physical symptoms, and job stress in new general hospital nurses experiencing “taeoom”. The participants of this study were new nurses with less than one year of experience working at five general hospitals with 100∼399 beds located in Gyeonggi province, South Korea. The data collection period was from January 5 to February 28, 2018, and 157 questionnaire copies were used for analysis.
Health promoting lifestyle was measured by an instrument(Baek, Kim & Cha, 2018) that was modified based on the 48-item Health Promotion Lifestyle Profile(HPLP) developed by Walker, Sechrist, and Pender(1987). physical symptoms were measured by an instrument (Lee, 2014) that was modified based on the physical symptom instrument developed by Oh(2006). Job stress was measured by a job stress scale for nurses developed by Kim and Gu(1984) and modified and supplemented to suit new nurses by Kim(2013). The collected data were analyzed by frequency and percentage, mean and standard deviation, t-test, ANOVA, Scheffe test, and Pearson’s correlation coefficients using the SPSS Statistics 20.0 software program.
The average age of the participants was 24.9(±2.16) years. Of the participants, 94.3% were unmarried, 41.1% commuted to work from home, and 46.5% walked to and from work. The average commute time was 19.2(±10.3) minutes, the average number of working hours per week was 44.8(±3.40) hours, and the average number of days of night shifts per month was 7.3(±1.28) days. In addition, 65.6% reported that others chose their preferred department and 45.9% rated their satisfaction with their preceptors as average. The average work experience was 7.2(±2.58) months, and 76.4% of participants worked at internal, surgical, or comprehensive wards. Their average monthly salary was KRW 2,431,000(±238,500).
Totally, 60.5% of new nurses experienced “taeoom,” and 38.2% experienced “taeoom” more than 10 times per month. Further, 32.4% reported that their perceived “taeoom” level was severe, while 47.7% reported that they experienced their first “taeoom” less than six months.
Health promoting lifestyle was significantly higher(p<.001) in those whose perceived that the “taeoom” level was not severe than those whose perceived that the “taeoom” level was moderate or severe. physical symptoms were significantly higher in those who experienced “taeoom”(p=.015), those who experienced “taeoom” 10 or more times (p=.028), and those whose perceived that the “taeoom” level was severe(p=.010). Additionally, job stress was significantly higher in those whose perceived that the “taeoom” level was severe(p=.017).
Health promoting lifestyle was divided into six sub-domains, and the average score for health promoting lifestyle was 1.94(±0.48) out of 4 points. Among the sub-domains, the eating habits domain had the lowest score with 1.48(±0.48) points, while the interpersonal domain had the highest score with 2.42(±0.69) points. Health promoting lifestyle was higher in those who were 25 years or older(p=.002), married(p=.022), had a normal or higher possibility of getting preferred work days off(p=.007), gave a rating of satisfactory on satisfaction with their preceptors(p=.002), and had work experience of less than 6?12 months(p=.038).
The average physical symptom score was 1.83(±0.52) out of 4 points. physical symptoms were significantly higher in those who worked 46 hours or more per week(p=.044) and in those who had less than six days of night shifts per month(p=.022).
The average job stress score was 3.13(±0.45) out of 4 points. Job stress was significantly higher in those who were less than 25 years of age(p<.001), had low possibility of getting preferred days off (p<.001), had less-than-average satisfaction with their preceptors (p<.001), and had less than 3?6 months of work experience(p<.001).
The perceived “taeoom” level had a negative relationship with health promoting lifestyle, and a positive relationship with physical symptoms. Health promoting lifestyle had a negative relationship with physical symptoms and job stress, and there was a positive relationship between physical symptoms and job stress. The perceived “taeoom” level in those experiencing “taeoom” had a strong negative relationship with health promoting lifestyle(r=-.713, p<.001) and a weak positive relationship with physical symptoms(r=.271, p=.008) and job stress (r=.319, p=.002).
In conclusion, the prevalence of “taeoom” experience in new nurses working at general hospitals was high and their perceived “taeoom” level had a strong negative relationship with health promoting lifestyle and a weak positive relationship with physical symptoms and job stress. Therefore, the perceived “taeoom” level is related to job stress.
Based on these results, it is important for hospitals to reduce the frequency of “taeoom” in order to reduce jobs stress in new nurses. Additionally, more attention needs to be drawn to “taeoom” of nurses since its severity results in higher job stress. To this end, it is necessary to give advance notices to increase the possibilities of assigning days off?so that new nurses do not miss their desired work days off?in order to create a work environment that can increase satisfaction with preceptors, and to pay special attention to new nurses who have less than six months of experience.
Since the prevalence of “taeoom” experiences among new nurses was high and since the perceived “taeoom” level is related to health promoting lifestyle and physical symptoms, active measures to reduce “taeoom” are needed. In particular, the development of programs for stress management and improvement of interpersonal abilities to reduce job stress among new nurses are suggested.