간호사의 직무스트레스 증상 유형별 대처 및 간호업무수행: 혼합연구 = Job Stress Symptom Typology and Differences in Coping Strategies and Nursing Performance among Nurses: A Mixed Methods Study

다국어 초록 (Multilingual Abstract)

Purpose : This study aimed to identify latent profiles of job stress symptoms among nurses; to explore factors influencing profile membership; to examine differences in coping strategies and nursing performance across profiles; and to analyze job stress appraisal and coping experiences within each latent profile.

Methods : An explanatory sequential mixed-methods design was employed. In the quantitative phase, data were collected from 521 shift nurses using structured online questionnaires. Latent profile analysis was conducted to identify job stress symptom profiles. In the qualitative phase, focus group interviews were conducted with 16 participants from the quantitative sample, and the data were analyzed using directed content analysis.

Results :
In the quantitative phase, four job stress symptom profiles were identified: mild symtom-sleep difficulty predominant, mild symptom-fatigue predominant, moderate symptom-anger predominant, severe symptom-depression predominant types. Influencing factors included subjective health status, work experience, satisfaction with work environment, work-life balance, presence of spouse, job stress, and self efficacy. The levels of coping and nursing performance differed significantly among the groups.
In the qualitative phase, differences in job stress, appraisal, and coping were identified. In the mild symptom-sleep difficulty predominant type, nurses experienced job stress due to workload and sought to appraise this stress as challenge and controllable situation. They employed a combination of problem-focused and emotion-focused coping strategies. In the mild symptom-fatigue predominant type, nurses experienced job stress due to role transition and appraised this stress as a threat, yet perceived that they had resources around them. They managed their job stress by engaging in coping strategies that involved seeking social support. In the moderate symptom-anger predominant type, nurses additionally experienced job stress stemming from interpersonal relationships. They appraised this stress as a threat but perceived that they had no social resources around them. They managed their job stress through relaxation coping strategies. Finally, in the severe symptom-depression predominant type, nurses experienced job stress arising from interpersonal conflicts with senior nurses. They appraised this stress as a loss and perceived that the situation was viewed as beyond their capacity for action. They managed their job stress through relaxation coping strategies.
By integrating the quantitative and qualitative results, five themes were identified: typologies based on the severity and characteristics of nurses’ job stress symptoms; physiological, situational, and psychological factors influencing job stress symptoms; job stress symptoms varying according to cognitive appraisal; differences in coping strategies according to job stress symptoms; and quality of nursing performance according to job stress symptoms.

Conclusion : Considering the findings of this study, improving the work environment to reduce nurses’job stress and developing interventions to enhance self-efficacy are essential. Furthermore, tailored job stress symptom manage strategies are needed to effectively address the distinct characteristics and needs of each job stress symptom profile.

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 4
• 3. 용어의 정의 5
• Ⅱ. 문헌고찰 7
• 1. 간호사의 직무스트레스 증상과 간호업무수행 7
• 2. 불쾌 증상 이론과 직무스트레스 증상 영향요인 11
• 3. 스트레스 대처 이론과 직무스트레스의 인지적 평가와 대처 16
• Ⅲ. 개념적 기틀 19
• Ⅳ. 연구방법 21
• 1. 연구 설계 21
• 2. 연구 대상 22
• 3. 연구 도구 24
• 4. 자료 수집 28
• 5. 윤리적 고려 31
• 6. 자료 분석 32
• Ⅴ. 연구결과 36
• 1. 대상자의 생리적, 상황적, 심리적 특성 36
• 2. 대상자의 직무스트레스 증상과 대처 및 간호업무수행의 수준 39
• 3. 대상자의 직무스트레스 증상에 따른 잠재유형 분류 41
• 4. 대상자의 직무스트레스 증상 유형에 영향을 미치는 요인 48
• 5. 대상자의 직무스트레스 증상 유형별 대처 및 간호업무수행의 차이 53
• 6. 유형별 면담 참여자의 일반적 특성 55
• 7. 유형별 내용분석 결과 57
• 8. 결과의 통합 및 해석 71
• Ⅵ. 논의 77
• Ⅶ. 결론 및 제언 84
• Ⅷ. 참고문헌 85
• Ⅸ. Abstract 97
• Ⅹ. 부록 99