노인의 주관적 건강상태, 죽음불안, 삶의 의미가 신체화 증상에 미치는 영향 : 지역사회 중심으로

김해연 가야대학교 2018 국내석사

본 연구는 지역사회 노인의 주관적 건강상태, 죽음불안, 삶의 의미가 신체화 증상에 미치는 영향을 파악하기 위해 시도된 서술적 조사연구이다. 연구 대상자는 K도와 B시에 있는 65세 이상 노인 241명을 임의 표출하였으며, 자료 수집기간은 2018년 2월 1일부터 3월 25일까지였다. 연구도구는 주관적 건강상태, 죽음불안, 삶의 의미, 신체화 증상 도구를 사용하였다. 수집된 자료는 SPSS WIN 21.0을 이용하여 빈도분석 t-test와 ANOVA로 분석 후 Scheffé 사후검정, 피어슨의 상관관계분석(Pearson's correlation coefficients), 단계적 다중 회귀분석(Multiple Stepwise Regression)으로 분석하였다. 본 연구의 결과는 다음과 같았다. 첫째, 본 연구의 대상자는 평균 연령이 73.83±7.29세이며 여자가 63.1%로 대부분을 차지하였으며 교육정도에서는 무학이 가장 많았고 종교는 불교가 높았다. 동거형태에서는 배우자와 함께가 가장 높았고 소득에서는 50만원 미만이 높았으며 생활 만족은 보통이다가 높았다. 대화상대에서는 있는 노인이 가장 많았으며 죽음에 대한 교육 경험이 없는 노인이 높게 나타났고 현재 신체질환 수에서는 1-2개가 가장 높게 나타났다. 둘째, 대상자의 신체화 증상은 총점 26점 만점에 평균 7.20±4.47점, 주관적 건강상태는 5점 만점에 평균 3.15±.82점, 죽음불안은 4점 만점에 평균 2.42±.53점, 삶의 의미는 총점 140점 만점에 평균 94.12±17.14점으로 나타났다. 셋째, 일반적 특성에 따른 신체화 증상의 정도는 성별(t=-2.65, p=.008), 연령(F=15.34, p<.001), 최종학력(F=12.51, p<.001), 동거가족(F=10.88, p<.001), 소득(F=15.79, p<.001), 생활만족(F=9.52, p<.001), 대화상대(t=-2.06, p=.041), 현재 신체질환 수(F=13.15, p<.001)에 따라 통계적으로 유의미한 차이가 나타났다 넷째, 주관적 건강상태는 죽음불안(r=-.16, p=.011), 신체화 증상(r=-.46, p<.001)과 통계적으로 유의미한 부(-)의 상관관계, 삶의 의미(r=.40, p<.001)와는 통계적으로 유의미한 정(+)의 상관관계, 죽음불안은 삶의 의미(r=-.25, p<.001)와 통계적으로 유의미한 부(-)의 상관관계, 신체화 증상(r=.32, p<.001)과는 통계적으로 유의미한 정(+)의 상관관계, 삶의 의미는 신체화 증상(r=-.47, p<.001)과 통계적으로 유의미한 부(-)의 상관관계가 있는 것으로 나타났다. 다섯째, 지역사회 노인의 신체화 증상에 영향을 미치는 요인은 주관적 건강상태(β=-.28, p<.001), 삶의 의미(β=-.25, p<.001), 학력(β=-.18, p=.002), 죽음불안(β=.18, p=.001), 순으로 신체화 증상에 유의미한 영향을 미치는 것으로 나타났다. 이들 변인은 36.5%의 설명력을 보였다(F=35.45, p<.001). 따라서 지역사회 노인의 주관적 건강상태가 좋지 않을수록, 삶의 의미가 낮을수록, 학력이 낮을수록, 죽음불안이 높을수록, 신체화 증상이 높아짐을 의미한다. 그러므로 신체화 증상을 감소시키는 프로그램 개발과 적용이 필요하다 생각된다. This descriptive study was undertaken in order to investigate how subjective health status, death anxiety and life meaning of the elderly living in local commnity might influence somatization. 241 participants who were 65 years of age or older and living in K city and B city were sampled at random. The study data have been collected from February 1 to March 25, 2018. The used study methods were subjective health status, death anxiety, life meaning and somatization. Using SPSS WIN 21.0 program, the collected data were analyzed with frequency t-test, ANOVA, Scheffé test, pearson‘s correlation coefficients and Multiple Stepwise Regression Analysis. The study results are as follows: First, the average age of the elderly was 73.83±7.29 and 63.1% of them were women. In educational background, uneducated participants were most common. In religion, Buddhism was most common. Participants who were living with their spouse had large proportion statistically and monthly income below 500,000 wons were answered most and in living satisfaction, most common participants answered common. Most common participants had the parties to talk with. Most common participants had no experience of death education and had one or two physical diseases. Second, the average point from a 26-point-scale for somatization was 7.20±4.47. The average point from a 5-point-scale for subjective health status was 3.15±.82.. The average point from a 4-point-scale for death anxiety was 2.42±.53 and the average point from a 140-point-scale for life meaning was 94.12±17.14. Third, examining somatization in accordance with general characteristics, it showed statistically significant differences in sex (t=-2.65, p=.008), age(F=15.34, p<.001), educational background(F=12.51, p<.001), family living together(F=10.88, p<.001), income(F=15.79, p<.001), living satisfaction(F=9.52, p<.001), parties to talk with(t2.059, p=.041) and present physical disease(F=13.145, p<.001). Fourth, the study results showed that subjective health status had statistically and significantly negative correlation with death anxiety(r=-.16, p=.011) and somatization(r=-.46, p<.001) and positive correlation with life meaning(r=.40, p<.001). Death anxiety had statistically and significantly negative correlation with life meaning(r=-.25, p<.001) and positive correlation with somatization(r=.32, p<.001). Life meaning had statistically and significantly negative correlation with somatization(r=-.47, p<.001). Fifth, it showed that the factors which influence somatization of the elderly in local community were subjective health status(β=-.28, p<.001), life meaning(β=-.25, p<.001), educational background(β=-.18, p=.002) and death anxiety(β=.18, p<.001), which accounted for 36.5%(F=35.45, p<.001). In conclusion, the result was obtained that somatization of the elderly was shown high when subjective health status was not good, meaning of life was thought to be useless, educational level was low and death anxiety was high. Therefore, a program which can reduce somatization should be developed and utilized.

요양병원 간호사의 감정노동과 극복력이 조직몰입에 미치는 영향

안진옥 가야대학교 2018 국내석사

본 연구는 요양병원 간호사의 감정노동, 극복력, 조직몰입의 정도 및 관계를 확인하고, 조직몰입에 영향을 미치는 요인을 파악하기 위한 서술적 조사연구이다. 연구대상은 2017년 현재 건강보험심사평가원에 등록되어 있으며, 인증평가를 받은 Y시와 G시에 소재한 13곳의 요양병원에 근무하고 있는 간호사이며, 자료수집 기간은 2018년 2월 1일부터 2월 28일까지이었다. 자료수집방법은 대상자에게 구조화된 설문지를 배부하고 직접 작성토록 한 후 회수하였다. 수집된 자료분석은 SPSS 21 통계 프로그램을 이용하였고 대상자의 일반적 특성은 빈도와 백분율로, 감정노동과 극복력 및 조직몰입 정도는 평균과 표준편차로 분석하였다. 대상자의 일반적 특성에 따른 감정노동, 극복력, 조직몰입 정도 차이는 t-test, ANOVA, Scheffé test로 분석하였으며, 감정노동, 극복력, 그리고 조직몰입 간의 상관관계는 Pearson's correlation coefficients로, 조직몰입에 대한 영향요인은 Hierarchical Regression Analysis로 분석하였다. 본 연구 결과는 다음과 같다. 첫째, 본 연구의 대상자는 연령이 40–50세 미만이 37.4%, 50세 이상이 31.5%, 기혼이 78.3%, 종교는 있는 경우가 62.1%로 나타났다. 최종학력은 전문학사가 54.5%, 총 임상경력은 5–10년 미만이 24.1%, 현 병원경력은 1–3년미만 47.7%, 소득은 250만원 미만이 68.1%, 근무형태는 3교대 근무가 40.4%, 직무만족도는 보통이 61.2%로 각각 나타났다. 둘째, 대상자의 감정노동은 5점 만점에 평균 2.96±0.58점, 극복력은 5점 만점에 3.75±0.41점, 조직몰입은 5점 만점에 3.31±0.54점으로 나타났다. 셋째, 일반적 특성에 따른 감정노동 차이를 살펴보면 총 임상경력(F=3.140, p=.015), 현 병원경력(F=3.105, p=.072), 근무형태(F=3.265, p=.022)에 따라 유의미한 차이를 보였다. 일반적 특성에 따른 극복력 차이를 살펴보면 연령(F=4.66, p<.001), 결혼상태(F=3.71, p=.020), 소득(F=5.61, p<.001), 직무만족도(F=3.54, p=.030)에 따라 유의미한 차이를 보였다. 일반적 특성에 따른 조직몰입 차이를 살펴보면 연령(F=4.38, p<.001), 결혼상태(F=3.15, p<.001), 직무만족도(F=26.80, p<.001)에 따라 유의미한 차이를 보였다. 넷째, 대상자의 극복력은 조직몰입(r=.478, p<.001)과 통계적으로 유의미한 정(+)의 상관관계가 있는 것으로 나타났다. 반면, 감정노동은 극복력(r=-.118, p=.072), 조직몰입(r=-.062, p=.342)과 통계적으로 유의미한 상관관계가 나타나지 않았다. 다섯째, 대상자의 조직몰입에 영향을 미치는 요인은 극복력(β=.478, p<.001), 직무만족도(β=.377, p<.001), 결혼상태(β=.118, p=.045)로 나타났으며, 이들 변수는 조직몰입을 37.8% 설명하였다 요양병원 간호사의 극복력이 높을수록, 조직몰입 정도가 높았다. 따라서 요양병원 간호사의 조직몰입을 높이기 위해서는 극복력을 증진시키는 프로그램의 개발과 적용이 필요하다고 사료된다. This is a descriptive study in order to examine the relationship among emotional labor, resilience and organizational commitment and to find out factors which influence organizational commitment of long term care hospital nurses. The study subjects were nurses working in 13 long term care hospitals which have registered in Health Insurance Review & Assessment Service and received accreditation in 2017 in Y city and G city. The structured questionnaires were distributed to the nurses and collected from February 1 to February 28, 2018. The collected data were analyzed using SPSS 21 program. The general characteristics of nurses were analyzed with frequency and the percentage and degree of emotional labor, resilience and organizational commitment were analyzed using mean and standard deviation. The difference among emotional labor, resilience and organizational commitment according to general characteristics were analyzed using t-test, ANOVA and Scheffé test. Pearson's correlation coefficients was used to analyze the correlation among emotional labor, resilience and organizational commitment and Hierarchical Regression Analysis was used to analyze influence factor of organizational commitment. The study results are as follows: First, the age of 37.4% of nurses was over 40 below 50 and over 50 were 31.5%. The married nurses were 78.8% and the nurses who had religion were 62.1%. In the highest level of education, college graduation was 54.5%. The percentage of the nurses with 5 to 10 year clinical careers was 24.1% and the working tenure in the present hospital with 1 to 3 years was 47.7%. The monthly pays of 68.1% of nurses were below 2,500,000 wons. 40.4% of nurses have worked in three shifts and 61.2% of nurses answered normal at a job satisfaction. Second, the study shows that emotional labor was mean 2.96±0.58 out of 5 points, resilience was 3.75±0.41 out of 5 and organizational commitment was 3.31±0.54 out of 5. Third, the study shows that the difference of emotional labor according to general characteristics had significantly influenced by total clinical career(F=3.140, p=.015), working period in the present hospital(F=3.105, p=.072) and duty type(F=3.265, p=.022). In the difference of resilience according to general characteristics, age(F=4.66, p<.001), marriage(F=3.71, p=.020), income(F=5.61, p<.001) and job satisfaction(F=3.54, p=.030) were significant factors. In the difference of organizational commitment according to general characteristics, age(F=4.38, p<.001), marriage(F=3.15, p<.001) and job satisfaction(F=26.80, p<.001) were significant factors. Fourth, the resilience of nurses was positively correlated with organizational commitment(r=.478, p<.001) statistically. On the contrary, emotional labor was not significantly correlated with resilience(r=-.118, p=.072) and organizational commitment(r=-.062, p=.342) statistically. Fifth, the factors which have effect on organizational commitment of nurses were resilience(β=.478, p<.001), job satisfaction(β=.377, p<.001) and marriage(β=.118, p=.045), which could explain organizational commitment at the ratio of 37.8%. Higher resilience of the nurses in long term care hospitals, higher organizational commitment. In conclusion, to increase organizational commitment of nurses in long term care hospitals, a program to promote resilience needs to be developed and utilized.

요양병원간호사의 직무스트레스, 셀프리더십, 사회적 지지가 간호업무성과에 미치는 영향

박소영 가야대학교 2018 국내석사

본 연구는 요양병원간호사의 직무스트레스, 셀프리더십, 사회적 지지, 간호업무성과의 정도 및 관계를 확인하고, 간호업무성과에 영향을 미치는 요인을 파악하기 위한 서술적 조사연구이다. 연구대상은 B시와 G시에 소재한 10개의 요양병원에 근무하고 있는 간호사이며, 자료수집기간은 2018년 2월 1일부터 2월 25일까지이었다. 자료수집방법은 대상자에게 구조화된 설문지를 배부하고 직접 작성토록 한 후 회수하였다. 수집된 자료분석은 SPSS WIN 22.0 통계프로그램을 이용하였고 대상자의 일반적 특성은 빈도와 백분율로, 직무스트레스, 셀프리더십, 사회적 지지 및 간호업무성과 정도는 평균과 표준편차로 분석하였다. 대상자의 일반적 특성에 따른 직무스트레스, 셀프리더십, 사회적 지지, 간호업무성과 차이는 t-test, ANOVA, Scheffé test로, 직무스트레스, 셀프리더십, 사회적 지지 및 간호업무성과간의 상관관계는 피어슨의 상관관계(Pearson’s correlation coefficients), 간호업무성과에 미치는 영향요인은 위계적 회귀분석(Hierarchical Regression Analysis)으로 분석하였다. 본 연구 결과는 다음과 같다. 첫째, 대상자의 평균연령은 42.73세로 50세이상이 34.9%로 가장 많았고, 결혼상태는 기혼이 72.1%, 종교는 있음이 53.9%로 많았다. 교육정도는 3년제 졸업이 59.7%, 직위는 일반간호사가 71.3%, 임상경력은 15년 이상이 39.5%, 현재병원 경력은 5년 미만이 75.2%, 근무형태는 고정근무가 48.4%, 월급여는 250만원 미만이 68.6%, 자기계발 학습활동 참여횟수는 연 1회 이상이 60.1%로 나타났다. 둘째, 대상자의 직무스트레스 정도는 5점 만점에 3.40±0.57점, 셀프리더십 정도는 5점 만점에 평균 3.77±0.46점, 사회적 지지 정도는 5점 만점에 평균 3.34±0.49점, 간호업무성과 정도는 5점 만점에 3.70±0.42점으로 나타났다. 셋째, 대상자의 일반적 특성에 따른 셀프리더십은 결혼상태(t=2.527, p=.012), 자기계발 학습활동(F=6.037, p=.003)에서 통계적으로 유의한 차이를 보였다. 대상자의 일반적 특성에 따른 간호업무성과는 연령(F=19.169, p<.001), 결혼상태(t=5.080, p<.001), 종교(t=2.021, p=.044), 교육정도(F=4.050, p=.019), 직위(F=7.411, p<.001), 임상경력(F=10.444, p<.001), 근무형태(F=9.800, p<.001), 월급여(t=2.273, p=.024), 자기계발 학습활동(F=9.551, p<.001)에 따라 통계적으로 유의한 차이를 보였다. 대상자의 일반적 특성에 따른 직무스트레스와 사회적 지지 차이는 없는 것으로 나타났다. 넷째, 대상자의 간호업무성과는 직무스트레스(r=-.223, p<.001)와는 음의 상관관계가 있었고, 셀프리더십(r=.546, p<.001), 사회적 지지(r=.325, p<.001)와 양의 상관관계가 있는 것으로 나타났다. 사회적 지지는 셀프리더십(r=.237, p<.001)과 양의 상관관계가 있는 것으로 나타났다. 다섯째, 간호업무성과에 영향을 미치는 요인은 셀프리더십(β=.415, p<.001), 연령(β=.251, p=.001), 사회적 지지(β=.206, p<.001), 직무스트레스(β=-.159, p=.001), 직위(β=.102, p=.047)로 나타났고(F=21.116 ,p<.001), 이들 변수의 설명력은 48.4% 였다. 본 연구결과 요양병원간호사의 직무스트레스가 낮을수록, 셀프리더십이 높을수록, 사회적 지지가 높을수록, 간호업무성과 정도가 높았다. 따라서 요양병원간호사의 간호업무성과를 향상시키기 위해서는 요양병원간호사의 직무스트레스를 감소시키고 셀프리더십과 사회적 지지를 증진시킬 수 있는 프로그램의 개발과 적용이 필요하다고 사료된다 This descriptive study was undertaken in order to examine the relation among job stress, self-leadership, social supports and Nursing Performance and to find out factors which influence Nursing Performance of long-term care hospital nurses. The study subjects were nurses working at 10 long-term care hospitals in B city and G city. The survery has been conducted from February 1 to February 25, 2018. The structured questionnaires were directly completed by the nurses and returned. The collected data were analyzed with SPSS WIN 22.0 program. The general characteristics of nurses were analyzed with frequency and percentage. Job stress, self-leadership, social supports and Nursing Performance were analyzed with mean and standard deviation. The differences among job stress, self-leadership, social supports and Nursing Performance according to general characteristics were analyzed using t-test, ANOVA and Scheffé test. The correlations among job stress, self-leadership, social supports and Nursing Performance were analyzed with pearson‘s correlation coefficients. Hierarchical Regression Analysis was used to analyze influence factor of Nursing Performance. The study results are as follows: First, the average age of nurses was 42.74 and 34.9% of nurses were aged over 50. 72.1% of nurses were married and 53.9% of nurses had religion. As for level of education, 59.7% of nurses were graduated from three-year course colleges. 71.3% of nurses were general duty nurses and the percentage of nurses with over 15 year clinical careers was 39.5% and the percentage of nurses whose working tenures in the present hospitals with below 5 years was 75.2%. 48.4%of nurses were working on fixed duties The monthly pays of 68.6% of nurses were below 2,500,000 wons. 60.1% of nurses have participated in study activities for self development more than once a year. Second, in the study, job stress was 3.40±0.57 out of 5 points, self-leadership was 3.77±0.46 out of 5, social supports was 3.34±0.49 out of 5 and Nursing Performance was 3.70±0.42 out of 5. Third, self-leadership according to general characteristics showed statistical significant differences from marriage(t=2.527, p=.012) and study activities for self development(F=6.037, p=.003). Nursing Performance according to general characterisgtics showed statistical significant differences from age(F=19.169, p<.001), marriage(t=5.080, p<.001), religion(t=2.021, p=.044), education(F=4.050, p=.019), position(F=7.411, p<.001), clinical career(F=10.444, p<.001), duty type(F=9.800, p<.001), montly pay(t=2.273, p=.024) and study activities for self development(F=9.551, p<.001). Otherwise the study showed that job stress according to general characteristics had no relation with social supports. Fourth, Nursing Performance was negatively correlated with job stress(r=-.223, p<.001) while it was positively correlated with self-leadership(r=.546, p<.001) and social supports(r=.325, p<.001). It also showed that social supports were positively correlated with self-leadership(r=.237, p<.001). Fifth, the factors which had effect on Nursing Performance were self-leadership(β=.415, p<.001), age(β=.251, p=.001), socical supports(β=.206, p<.001), job stress(β=-.159, p=.001) and position(β=.102, p=.047)(F=21.116 ,p<.001), which could explain Nursing Performance at the ratio of 48.4%. In conclusion, the result was obtained that Nursing Performance was higher as job stress was lower and self-leadership and social supports were higher. Therefore, as a way to promote Nursing Performance, the constant development and the application of a program which may reduce job stress and promote self-leadership and socical supports of long- term care hospital nurses are needed.