COVID-19 팬데믹 상황에서 응급실 간호사의 소진에 영향을 미치는 융합적 요인 = Convergence factors Affecting Burnout of Emergency Room Nurses During the COVID-19 Pandemic

다국어 초록 (Multilingual Abstract)

This study is descriptive research to investigate the effects of COVID-19 stress, interpersonal (caregiver-patient) stress, and emotional labor on burnout in emergency room (ER) nurses during the COVID-19 pandemic. The data collection of this study was conducted from December 9 to 23, 2021 with ER nurses working at five tertiary general hospitals and general hospitals of Medical Center H. The data was collected with a questionnaire using tools measuring the subjects’ general & job-related characteristics, COVID-19 stress, interpersonal(caregiver-patient) stress, emotional labor and burnout.
The collected data was analyzed using the SPSS/WIN 25.0 statistical program for frequency analysis, descriptive statistical analysis, independent sample t-test, one-way ANOVA, Scheffé test, correlation analysis, and multiple regression analysis. The average score of COVID-19 stress in ER nurses was 3.64, interpersonal(caregiver-patient) stress 4.35, emotional labor 3.38, and burnout 3.44. As a result of analyzing differences according to general & job-related characteristics, burnout showed a significant difference according to gender, marital status, total clinical experience, and working organization. And burnout showed a significant positive correlation with COVID-19 stress, interpersonal stress and emotional labor. As a result of multiple linear regression analysis, regional emergency medical centers and local emergency medical centers among the work organization types, interpersonal stress, COVID-19 stress, and gender and the explanatory power was 28.6%. Through these results, we intend to provide basic data for the development of an intervention program to prevent burnout of emergency room nurses and improve nursing performance at the time of a new infectious disease pandemic.

국문 초록 (Abstract)

본 연구는 응급실 간호사를 대상으로 COVID-19 대유행 상황에서 COVID-19 스트레스, 대인관계(보호자-환자) 스트레스, 감정노동이 소진에 미치는 영향을 파악하기 위한 서술적 조사 연구이다. 자료수집은 H 의료원 산하기관5개 상급종합병원과 종합병원 응급실 간호사를 대상으로 2021년 12월 9일부터 12월 23일까지 시행되었다. 대상자의일반적 특성과 직무 관련 특성, COVID-19 스트레스, 대인관계(보호자-환자) 스트레스, 감정노동, 소진을 측정하기 위해 자기기입식 설문지로 진행하였다. 수집된 자료는 SPSS/WIN 25.0 통계 프로그램을 이용하여 빈도 분석, 기술통계분석, Independent sample t-test, One-way ANOVA, Scheffé test, Correlation analysis, 다중회귀분석을 실시하였다. 응급실 간호사의 COVID-19 스트레스의 평균은 3.64점, 대인관계(보호자-환자) 스트레스 4.35점, 감정노동3.38점, 소진 3.44점이었다. 일반적 특성 및 직무 관련 특성에 따른 간호사의 소진은 성별, 결혼상태, 총 임상 경력, 근무 기관 형태에 따라 유의한 차이를 보였다. 소진은 COVID-19 스트레스, 대인관계 스트레스, 감정노동과 모두 유의한 정적 상관관계를 보였다. COVID-19 팬데믹 상황에서 응급실 간호사의 소진에 영향을 미치는 융합적 요인으로는근무 기관 형태 중 권역 응급의료센터, 지역응급의료센터, 대인관계 스트레스, COVID-19 스트레스, 성별로 나타났고설명력은 28.6%로 나타났다. 이와 같은 결과를 통해 신종감염병 대유행 시점에서 응급실 간호사의 소진을 예방하고간호업무성과를 높이기 위한 중재프로그램 개발을 위한 기초자료를 제공하고자 한다.

참고문헌 (Reference)

1 최희정 ; 김미연, "한국어판 감정노동전략 측정도구의 신뢰도와 타당도: 임상간호사를 대상으로" 간호행정학회 24 (24): 161-170, 2018

2 김경수 ; 이원재, "한 상급종합병원 근무자들의 정신심리적 요인이 PTSD에 미치는 영향" 사단법인 대한보건협회 47 (47): 71-82, 2021

3 엽주용 ; 박진형 ; 박현경 ; 표창해 ; 박근홍 ; 김한범 ; 함은미 ; 이유성, "코로나바이러스감염증-19 유행이 감염병 전담병원 근무자에게 미치는 영향: 감정 변화와 스트레스의 직종 간 비교" 대한응급의학회 32 (32): 120-133, 2021

4 오희 ; 이나경, "코로나바이러스 감염증-19 환자를 간호한 간호사의 경험: 현상학적 연구" 한국간호과학회 51 (51): 561-572, 2021

5 박유진 ; 차경숙 ; 이기령, "코로나19 범유행 상황에서 임상간호사의 소진 영향요인－신체증상, 우울, 감염스트레스와 직무스트레스 중심으로－" 한국간호연구학회 5 (5): 11-23, 2021

6 변대식 ; 염영희, "임상간호사의 소진에 영향을 미치는 요인 - 감정노동을 중심으로 -" 간호행정학회 15 (15): 444-454, 2009

7 염영희 ; 손희숙 ; 이현숙 ; 김명애, "임상간호사의 감정노동 실태와 신체적 증상, 소진, 우울 및 사회적 지지와의 관계" 병원간호사회 23 (23): 222-235, 2017

8 정애리 ; 홍은주, "일반 대중의 코로나19에 대한 불안, 지식, 감염 가능성, 감염예방 가능성, 감염예방행위 수행에 관한 연구" 중소기업융합학회 10 (10): 87-98, 2020

9 김미연 ; 하태욱 ; 황용 ; 강지숙, "응급실 종사자의 폭력 경험에 따른 폭력 반응 소진 및 직무 만족" 한국산학기술학회 18 (18): 406-416, 2017

10 황수연 ; 한지영, "응급실 간호사의 폭력경험에 대한 반응, 회복탄력성이 소진에 미치는 영향" 병원간호사회 24 (24): 303-312, 2018

11 조수연 ; 성미혜, "응급실 간호사의 이직의도 영향요인" 기본간호학회 19 (19): 503-510, 2012

12 전소영 ; 하주영, "응급실 간호사의 외상 사건 경험과 전문직 삶의 질 및 신체적 증상" 한국성인간호학회 24 (24): 64-73, 2012

13 권소영 ; 손민서 ; 강인순, "응급실 간호사의 대인관계 스트레스가 소진 및 직무만족도에 미치는 영향: 회복탄력성의 매개효과" 간호과학연구소 11 (11): 21-31, 2021

14 최은미 ; 배선형, "응급실 간호사의 공감피로와 간호업무수행 및 직무 스트레스" 대한근관절건강학회 27 (27): 41-49, 2020

15 최경숙 ; 이경희, "요양병원 관리직 간호사의 코로나19 대응 경험" 인문사회 21 11 (11): 1307-1322, 2020

16 임은주 ; 이여진, "수술실간호사와 병동간호사의 의료진과의 의사소통 능력 및 대인관계 능력 비교" 간호행정학회 20 (20): 313-321, 2014

17 권혁민 ; 김태형 ; 최말례 ; 김병조 ; 김형욱 ; 송옥선 ; 은헌정, "메르스(Middle East Respiratory Syndrome)사태에 따른 병원종사자와 일반인의 스트레스 정도가 사회심리적 건강에 미치는 영향과 회복탄력성의 매개효과" 한국정신신체의학회 25 (25): 111-119, 2017

18 문숙자 ; 한상숙, "간호사의 이직의도 예측모형" 한국간호과학회 41 (41): 633-641, 2011

19 김희정 ; 조민정, "간호사의 감정노동과 직무스트레스 관계에서 의사소통 능력의 조절 효과" 대한임상건강증진학회 22 (22): 143-152, 2022

20 H. S. Kang, "Working experiences of nurses during the Middle East respiratory syndrome outbreak" 24 (24): e12664-, 2018

21 Y. Mo, "Work stress among Chinese nurses to support Wuhan in fighting against COVID-19epidemic" 25 (25): 1002-1009, 2020

22 H. N. Cho, "The relationship of Job stress, Hardiness and Burnout among Emergency Room Nurses" Chonnam National University 2011

23 M. D. Braquehais, "The impact of the COVID-19 pandemic on the mental health of healthcare professionals" 113 (113): 613-617, 2020

24 L. M. Baker, "The effects of fatigue on performance in simulated nursing work" 54 (54): 815-829, 2011

25 J. M. Diefendorff, "The dimensionality and antecedents of emotional labor strategies" 66 (66): 339-357, 2005

26 K. A. Park, "The Strategy Research through the Analysis of Sensibility Satisfaction Elements of the Medical Service and a Customer Contact Point–Focusting on Facility’s improvement of the Pediatric Primary Hospital-" Ewha Womans University 2013

27 S. H. Heo, "The Relationship between COVID-19 Stress and Burnout in Nurses of Tertiary General Hospitals:Mediating effect of Social Responsibility" Yonsei University 2021

28 Y. H. Choe, "The Mediating Effect of Infection Control Fatigue in the Relationship between Infection Control Job Stress and Burnout in the Emergency Room Nurses" Silla University 2020

29 H. M. Kim, "The Influence of Traumatic Events on Turnover Intention among Intensive Care Unit Nurses:Moderating Effect of Emotional Intelligence" Inje University 2020

30 M. R. Kim, "The Influence Of the Emotional Labor, Professional Self-Concept, Self-Efficacy & Social Support Of Emergency Room Nurse's Burnout" Kyung Hee University 2017

31 E. H. Jeong, "The Effects of Job Stress and Fatigue on Burnout in Nurses in Hospitals Dedicated to Caring for Patients with COVID-19" Kongju National University 2021

32 S. M. Choi, "The Effect that Emotional Labor of Clinical Nurse in Public Hospital has on Nursing Performance and Intention to Leave" The Catholic University of Korea 2017

33 M. K. Kwon, "The Effect of Knowledge related to COVID-19, Performance of Infection Control and Job stress of Nurse in Emergency Department on the Nursing Performance" Changshin University 2022

34 M. J. Kim, "The Development of the Stresses Measurement Tool for StaffNurses working in the Hospital" 14 (14): 28-37, 1984

35 D. Banerjee, "The COVID-19 outbreak: Crucial role the psychiatrists can play" 50 : 2014

36 H. V. Fineberg, "Ten Weeks to Crush the Curve" 382 : e37-, 2020

37 Y. K. Jin, "Study on factors related to burnout of nurses in public hospitals" Kyung Hee University 2020

38 M. S. Lee, "Study of Nurses in Emergency Department on the Stress and Job Satisfaction Related to Nursing of Emergency Pediatric Patients" Kyung Hee University 2012

39 N. H. Oh, "Stress of Nurses in Local Medical Centers who Experienced the MERS Situation and Nursing Intention for Patients with New Infectious Diseases" Kyungpook National University 2016

40 A. Hofmeyer, "Strategies and resources for nurse leaders to use to lead with empathy and prudence so they understand and address sources of anxiety among nurses practising in the era of COVID-19" 30 (30): 298-305, 2021

41 J. S. Shin, "Relationships among Emotional labor, Burnout, Compassion Satisfaction and Patient Safety Management Activities in Emergency Department nurse" Ajou University 2019

42 S. N. Lee, "Relation of among Emotional Labor, Burn Out and Job Involvement of Nurses" Hanyang University 2010

43 A. N. Master, "Psychological impact of COVID-19 outbreak on frontline nurses: A cross-sectional survey study" 29 (29): 4217-4226, 2020

44 K. D. Kim, "Post-traumatic Stress Disorder and Burnout of Healthcare Providers Cared for Patients with Coronavirus Disease (COVID-19) in a Tertiary General Hospital" Sungkyunkwan University 2022

45 R. G. Hughes, "Patient Safety and Quality: An Evidence-based Handbook for Nurses Volume 3" AHRQ 2008

46 J. Arnetz, "Nurse Reports of Stressful Situations during the COVID-19Pandemic: Qualitative Analysis of Survey Responses" 17 (17): 126-, 2020

47 B. H. Stamm, "Measuring Compassion Satisfaction as Well as Fatigue" Routledge 2002

48 R. Y. Seo, "Interpersonal relationship(Guardian–patient)stress of emergency room nurse and resilience" Ajou University 2016

49 Y. S. Byeon, "Interpersonal Conflict Experiences of Nurses" 10 (10): 142-151, 2009

50 H. R. Park, "Hospital employee's anxiety, perceived stressor and coping strategies during COVID-19outbreaks in South Korea" Hallym University 2020

51 Y. Huang, "Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey" 288 : 112954-, 2020

52 "Framework Act On The Management Of Disasters And Safety"

53 N. Y. Yi, "Factors affecting performance of infection control guidelines related to emerging infectious disease among emergency department nurses" Ewha Womans University 2021

54 김지수 ; Jeong Sil Choi, "Factors Influencing Emergency Nurses' Burnout During an Outbreak of Middle East Respiratory Syndrome Coronavirus in Korea" 한국간호과학회 10 (10): 295-299, 2016

55 S. H. Lee, "Facing SARS: psychological impacts on SARS team nurses and psychiatric services in a Taiwan general hospital" 27 (27): 352-358, 2005

56 Y. Ng, "Evaluation of the Effectiveness of Surveillance and Containment Measures for the First 100 Patients with COVID-19 in Singapore — January 2–February 29, 2020" 63 (63): 307-311, 2020

57 S. K. K. Lam, "Emergency nurses’ strategies in addressing uncertainty and change in the management of emerging infectious diseases: A grounded theory approach" 2019

58 S. Trzeciak, "Emergency department overcrowding in the United States: an emerging threat to patient safety and public health" 20 (20): 402-405, 2003

59 Y. D. Na, "Effects of Nurse Emotional Labor and Job Satisfaction on Job Stress" Kongju National University 2018

60 K. J. Lee, "Effect of the Professional Quality of Life on Verbal Abuse Experience in Emergency Nurses:Mediating Effect of Job Stress" Keimyung University 2018

61 Korea Disease Control and Prevention Agency, "Coronavirus(COVID-19)"

62 World Health Organization, "Coronavirus disease (COVID-19) pandemic"

63 "Central Defense Response Headquarters"

64 C. Wenham, "COVID-19: the gendered impacts of the outbreak" 395 (395): 846-848, 2020

65 진달래 ; 이규영, "COVID-19 감염으로 임시 폐쇄된 서울 종합병원 간호사의 경험" 한국간호교육학회 26 (26): 412-422, 2020

66 A. M. Pines, "Burnout: From Tedium to Personal Growth" The Free Press 1981

67 S. Barello, "Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic" 290 : 113129-, 2020

68 C. Maslach, "Burnout" 5 : 116-122, 1976

69 E. H. Park, "An influence of emotional labor, emotional intelligence, and social support of emergency room nurse on turnover intention" Chodang University 2015

70 S. S. Park, "An analysis of emergency medical center use behaviors based on the National Emergency Department Information System(NEDIS) : factors within the In-hospital in the emergency medical system" General University of Seoul 2020

71 K. S. Yoon, "A study on the job stress and coping of emergency nurses" Chung-Ang University 2003

72 N. S. Kim, "A study on infectious disease prevention and control systems of Korea: Focused on the Middle East Respiratory Syndrome Coronavirus" 237-240, 2016

73 N. W. S. Chew, "A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak" 88 : 1559-1565, 2020

74 Y. J. Song, "A Study on the Effect of Emotional Hardship on Job Satisfaction and Turnover of Nurses" The Catholic University of Korea 2011