응급구조사의 재난의료 역량과 재난의료 관리 성과의 구조적 관계 : 회복탄력성의 매개효과와 조직지원인식의 조절효과 = The Structural Relationship between Disaster Medical Competency and Disaster Medical Management Performance among Emergency Medical Technicians : The Mediating Effect of Resilience and the Moderating Effect of Perceived Organizational Support

다국어 초록 (Multilingual Abstract)

The Structural Relationship between Disaster Medical Competency and Disaster Medical Management Performance among Emergency Medical Technicians : The Mediating Effect of Resilience and the Moderating Effect of Perceived Organizational Support Bae Chan Mi Advisor : Prof. Kang In Ho, Ph.D. Department of Fire Protection and Disaster Prevention Graduate School of Chosun University This study was conducted to analyze and verify the effect of emergency medical technicians’ disaster medical preparedness and response competency on disaster medical management performance in organizational-level, as well as the mediating effect of resilience and the moderating effect of perceived organizational support. Through theoretical and literature reviews, this study examined the meanings and characteristics of ‘disaster medical preparedness competency’ and ‘disaster medical response competency’ as independent variables, ‘disaster medical management performance’ as dependent variable, ‘resilience’ as mediating variable, and ‘perceived organizational support’ as moderating variable, as well as their respective components. Based on these reviews, ‘operational definitions’ for each variable were derived, and the research model and hypotheses were established accordingly. As an empirical analysis to verify research hypotheses, a survey was conducted among Level-1 emergency medical technicians working at medical institutions of various levels across the country. Using the SPSS Statistics 21.0 software package program, this study analyzed the 402 collected survey responses. The results of this study are summarized as follows. First, the five sub-factors of disaster medical preparedness competency were found to have significant positive （+） effects on disaster medical management performance in the order of mental and psychological preparedness （0.299**） 〉 basic concepts related to disaster medicine （β=0.245**） 〉 personal preparedness （β=0.232**） 〉 communication （β=0.186**） 〉 institutional disaster response plans （β=0.121**）. It was also confirmed that emergency medical technicians’ resolute mental preparedness and determination to solve problems, as well as their accurate understanding and familiarity with the disaster medical system and principles, and their personal preparedness, are decisive factors for achieving more effective performance during the disaster medical preparedness phase. Second, the three sub-factors of disaster medical response competency were found to have significant positive （+） effects on disaster medical management performance in the order of first aid competency （β=0.451**）, triage competency （β=0.265**）, and transport competency （β=0.190**）. Immediately performing first aid at the disaster medical scene, accurately assessing and triaging patients, and safely transporting them to rear medical facilities are key elements in minimizing loss of lives and mitigating social trauma. A significant achievement of this study is that it not only confirmed that these essential competencies have significant effects on overall disaster medical management performance but also identified the relative priorities of these specific sub-factors. Third, the three sub-factors of resilience were found to have significant ‘partial mediating effects’ on the relationship between disaster medical preparedness competency and disaster medical management performance in the order of self-regulation （E=0.250（0.808×0.309）） 〉 positivity （E=0.161（1.126×0.143）） 〉 interpersonal skills （E=0.076（0.355×0.214））. 4th, the three sub-factors of resilience were found to have significant ‘partial mediating effects’ on the relationship between disaster medical response competency and disaster medical management performance in the order of self-regulation （E=0.159（0.704×0.225）） 〉 positivity （E=0.122（0.832×0.147）） 〉 interpersonal skills （E=0.056（0.335×0.166））. It was newly established that resilience can indirectly amplify the effects of emergency medical technicians’ disaster medical preparedness and response competency on disaster medical management performance in organizational-level. 5th, emotional support（BX×W=-0.374**） and instrumental support（BX×W=-0.187**） as two sub-factors of perceived organizational support were verified to significantly moderate the relationship between disaster medical preparedness competency and disaster medical management performance. 6th, emotional（BX×W= -0.376**） and instrumental support（BX×W=-0.099*） were verified to significantly moderate the relationship between disaster medical response competency and disaster medical management performance. It was confirmed that perceived organizational support, an extrinsic and environmental variable, can moderate the direct effect of disaster medical preparedness and response competency on disaster medical management performance. However, as the level of perceived organizational support increases, the conditional effect of preparedness and response competency on management performance is alleviated. Related institutions need to develop and implement more efficient support strategies that can increase both competencies and performances among the higher group of perceived organizational support who indirect effects are relatively limited, rather than simply strengthening organizational support unconditionally. Almost for the first time, this study comprehensively and multifacetedly elucidated the direct causal relationship between disaster medical preparedness, response competency and disaster medical management performance in the field of disaster medicine, as well as the indirect effects of resilience and perceived organizational support, specifically among emergency medical technicians. Through these research ahievements, this study intensified and expanded theoretical-academic and practical-operational implications. It is hoped that the results, conclusions, and implications of this study will contribute to the future-oriented development and sustainability of disaster medical management and be widely utilized as basic materials and valid evidence. Keywords : disaster medical preparedness competency, disaster medical response competency, disaster medical management performance, resilience, perceived organizational support, emergency medical technician（EMT）

목차 (Table of Contents)

• 제1장 서론 1
• 제1절 연구 목적 1
• 제2절 연구 내용 및 방법 5
• 1. 연구 내용 5
• 2. 연구 방법 6
• 제3절 연구 절차 6
• 제2장 이론적 논의 8
• 제1절 재난의료 8
• 1. 재난의 개념과 의미 8
• 2. 재난의료의 개념과 의미 12
• 제2절 재난의료 대비·대응 역량 17
• 1. 재난의료 대비 역량의 의미와 구성 요인 18
• 2. 재난의료 대응 역량의 의미와 구성 요인 22
• 3. 재난의료 대비·대응에서의 응급구조사 역할 31
• 4. 주요 선진국의 재난의료 대비·대응 체계 36
• 제3절 재난의료 관리 성과 42
• 1. 재난의료 관리 성과의 의미와 구성 요인 42
• 2. 재난의료 관리와 회복탄력성 45
• 3. 재난의료 관리와 조직지원인식 55
• 제4절 선행 연구 검토 65
• 1. 재난의료 대비·대응 역량 관련 선행 연구 65
• 2. 재난의료 관리 성과의 매개·조절효과 관련 선행 연구 69
• 제3장 연구 설계 72
• 제1절 연구 모형 및 가설 72
• 1. 연구 모형 72
• 2. 연구 가설 설정 74
• 제2절 변수의 조작적 정의 및 측정 도구 82
• 1. 변수의 조작적 정의 82
• 2. 측정 도구 83
• 제3절 자료 수집 및 분석 방법 87
• 1. 자료 수집 방법 87
• 2. 자료 분석 방법 88
• 제4장 연구 결과 90
• 제1절 자료 및 측정변수 검정 90
• 1. 설문 응답자의 인구통계학적 특성 90
• 2. 인구통계학적 특성에 따른 측정변수의 차이 92
• 3. 측정 변수의 타당성 및 신뢰성 검증 103
• 4. 상관 관계 분석 109
• 제2절 가설 검증 및 결과 해석 114
• 1. 재난의료 대비 역량과 재난의료 관리 성과 관의 영향 관계 114
• 2. 재난의료 대응 역량과 재난의료 관리 성과 관의 영향 관계 123
• 3. 연구가설 검증 결과 요약 132
• 제3절 분석 결과에 대한 논의 134
• 제5장 결론 137
• 제1절 연구 의의 및 정책 시사점 137
• 1. 연구 의의 137
• 2. 정책 시사점 139
• 제2절 연구의 한계 및 향후 과제 140
• 1. 연구의 한계 140
• 2. 향후 과제 141
• 참고문헌 142
• 부록 159