그릿, 긍정심리자본이 간호사의 혁신행동에 미치는 영향 : 간호조직문화의 매개효과를 중심으로 = Effect of Grit and Positive Psychological Capital on the Innovative Behavior Among Nurses : Mediating Effect of Nursing Organizational Culture

국문 초록 (Abstract)

이 연구는 그릿, 긍정심리자본이 간호사의 혁신행동에 미치는 영향을 간호조직문화를 매개로 분석하기 위해 시도되었다. 연구를 위해 서울시 소재 두 곳의 종합병원에서 근무하고 있는 189명의 간호사를 대상으로 구조화된 설문지를 이용하여 2023년 4월 4일부터 4월 17일까지 설문조사를 실시하였다.
설문지는 간호사의 그릿을 측정하기 위하여 Duckworth(2007)가 개발한 그릿측정도구를 기초로 한국문화와 임상간호환경을 반영하여 박효선, 이경미, 신나연(2020)이 개발한 임상간호사의 그릿 측정도구(Clinical Nurses Grit Scale: CN-GRIT), 긍정심리자본 척도는 Luthans, Youssef & Avolio(2007)의 도구를 보완하여 한혜영(2013)이 번안한 척도, 간호조직문화는 간호조직문화(Nursing organizational culture)를 측정하기 위해 한수정, 김문실, 김지현이 개발한 간호조직문화 측정도구, 혁신행동 척도는 Kleysen & Street(2001)가 개발한 개인의 혁신행동척도(Individual Innovative Behavior)를 김성진(2004)이 번안한 도구를 사용하였다. 자료분석은 SPSS 28.0 프로그램을 이용하여 빈도분석, t-test와 ANOVA, 상관관계 분석, 다중회귀분석, sobel test를 실시하였으며 연구결과는 다음과 같다.

첫째, 설문대상자의 연령층은 30~39세가 35.8%로 가장 많았고, 성별은 여성이 96.8%였다. 결혼상태는 기혼이 56.7%, 학력은 대졸(학사)이 75.9%로 가장 많았다. 총 임상경력은 10~20년 미만이 37.4%, 직위는 일반간호사가 81.3%, 근무 부서는 일반 병동이 41.7%로 가장 많았고, 근무 형태로는 3교대 근무자가 56.7%. 간호직 만족도는 보통이 50.8%이었다. 그릿의 총 평균은 4점 만점에 3.05점, 긍정심리자본의 총 평균은 5점 만점에 3.75점, 간호조직문화의 평균은 3.30점, 혁신행동은 6점 만점에 4.16점이었다.

둘째, 대상자의 일반적 특성은 그릿, 긍정심리자본, 간호조직문화, 혁신행동에 따라 유의한 차이를 보였다. 구체적으로 그릿은 연령(p<.001), 결혼(p<.01), 학력(p<.01), 총 임상경력(p<.001), 직위(p<.001), 간호직 만족도(p<.001)에 따라 유의한 차이를 보였으며, 긍정심리자본은 연령(p<.001), 결혼(p<.01), 학력(p<.05), 총 임상경력(p<.01), 직위(p<.001), 간호직 만족도(p<.001)에 따라 유의한 차이를 보였다. 간호조직문화는 연령(p<.001), 직위(p<.01), 간호직 만족도(p<.001), 근무부서(p<.05)에 따라 유의한 차이를 보였고, 혁신행동에서는 연령(p<.001), 결혼(p<.01), 학력(p<.05), 총 임상경력(p<.01), 직위(p<.01), 간호직 만족도(p<.001), 근무부서(p<.05)에 따라 유의한 차이를 보였다.

셋째, 변수 간 상관관계분석을 한 결과 그릿과 긍정심리자본(r=.679, p<.01), 그릿과 간호조직문화(r=.380, p<.01)와 혁신행동(r=.547, p<.01)도 정(+)의 상관관계를 보였으며, 긍정심리자본과 간호조직문화(r=.438, p<.01), 긍정심리자본과 혁신행동(r=.608, p<.01)도 정(+)의 상관관계를 보였고, 간호조직문화와 혁신행동 또한 뚜렷한 정(+)의 상관관계를 보였으며(r=.499, p<.01), 통계적으로 유의하였다.
넷째, 단순 모형을 추정한 결과 혁신행동에 유의한 영향을 미치는 변수는 그릿(β=.577, p<.001), 설명력은 29.6%(adj R²= .296)이었고, 긍정심리자본(β=.082, p<.001), 설명력은 36.7%(adj R²= .367), 간호조직문화도(β=.499, p<.001) 총 설명력 24.5%(adj R²= .245)로 유의한 영향을 미치는 변수였다. 즉 간호사의 그릿, 긍정심리자본, 간호조직문화는 혁신행동에 긍정적인 영향을 미쳤다.
다섯째, 그릿과 긍정심리자본이 혁신행동에 미치는 영향에서 간호조직문화의 매개효과를 분석한 결과, 그릿과 혁신행동 간 간호조직문화는 통계적으로(β=.362, p<.001) 유의하게 부분 매개하고 있음이 추정되었고, 간호조직문화 하위영역 중 관계지향문화(β=.200, p<.01), 혁신지향문화(β=.306, p<.001), 업무지향문화(β=.330, p<.001)는 부분 매개효과를 보였으나, 위계지향문화는 매개효과가 없는 것으로 추정되었다. 긍정심리자본과 혁신행동 간 간호조직문화도 통계적으로(β=.303, p<.001) 유의하게 부분 매개하고 있음이 추정되었고, 간호조직문화 하위영역 중 혁신지향문화(β=.288, p<.001), 업무지향문화(β=.299, p<.001)는 부분 매개효과를 보였으며, 관계지향문화와 위계지향문화는 매개효과가 없는 것으로 추정되었다. 이를 통하여 간호사들이 그릿, 긍정심리자본과 간호조직문화에 대해 긍정적으로 인식할 때 혁신행동을 촉진시킬 수 있는 것으로 추정되었다.

요약하면, 그릿, 긍정심리자본, 간호조직문화가 혁신행동에 긍정적인 영향을 미쳤고, 그릿, 긍정심리자본, 간호조직문화에 대한 인식이 높을수록 혁신행동 또한 증진되는 것을 알 수 있었다. 이에 임상간호사들의 그릿과 긍정심리자본을 향상시키기 위한 프로그램을 개발하고, 적용하여 간호의 질적 향상을 도모하고, 혁신행동을 증진할 수 있는 의료환경의 조성과 다양한 지원방안 및 보상체계를 위한 전략이 필요하다고 생각된다.

다국어 초록 (Multilingual Abstract)

This study attempted to analyze the effect of grit and positive psychological capital on nurses' innovative behavior mediated by nursing organizational culture. For the study, 189 nurses working at the two general hospitals in Seoul were surveyed from April 4 to April 17, 2023, using a structured questionnaire.
Based on the grit measurement tool developed by Duckworth(2007) to measure the grit of nurses, the questionnaire was developed reflected
Korean culture and the clinical nursing environment, and the Clinical Nurses Grit Scale(CN-GRIT) developed by Park Hyo-sun, Lee Kyung-mi, and Shin Na-yeon(2020) were reflected too. For the innovative behavior
scale, Kim Sung-jin(2004) used a tool developed by Kleysen & Street(2001) to convert the individual innovative behavior scale. For data analysis, frequency analysis, t-test and ANOVA, correlation analysis, multiple regression analysis, and sobel test were conducted using the SPSS 28.0 program.
The results of the study are as follows.
First, 35.8% of the age groups of the respondents were aged between 30 and 39, and 96.8% were women. Among the respondents, 56.7% were married and 75.9% were college graduates. The total clinical experience under 10 to 20 years, was 37.4%, 81.3% were general nurses, 41.7% were working in general wards 56.7% for three shifts, and 50.8% for nursing satisfaction. Average score of grit was 3.05 out of 4, and positive psychological capital was 3.75 out of 5, average score of nursing organizational culture was 3.30 points, and average score of innovative behavior was 4.16 out of 6.

Second, the general characteristics of the subjects differed significantly in scores of grit, positive psychological capital, nursing organizational culture, and innovative behavior. Specifically, grit were significant different by age(p<.001), marital status(p<.01), academic background(p<.01), and total clinical experience(p<.001), position(p<.001) and nursing job satisfaction(p<.001). And age(p<.001), marital status(p<.01), academic background(p<.05), total clinical experience(p<.01), position(p<.001) and nursing job satisfaction(p<.001) showed significant differences in psychological capital score.
Nursing organizational culture were significant different by age(p<.001), position(p<.01), nursing job satisfaction(p<.001), and working department(p<.05). Innovative behavior were significant different by age(p<.001), marital status(p<.01), academic background(p<.05), total clinical experience(p<.01), position(p<.01), nursing job satisfaction(p<.001), and working department(p<.05).

Third, according to the correlation analysis was a positive(+) correlation between grit and positive psychological capital(r=.679, p<.01), grit and nursing organizational culture(r=.380, p<.01), grit and innovative behavior(r=.547, p<.01). And according to the correlation analysis was a positive(+) correlation between positive psychological capital and nursing organizational culture(r=.438, p<.01), positive psychological capital and innovative behavior(r=.608, p<.01). And nursing organizational culture and innovative behavior also showed a significant positive(+) correlation(r=.499, p<.01).

Fourth, as a result of was the simple regression model, the variable that significantly affects innovation behavior was grit(β=.577, p<.001), the explanatory power was 29.6% (adj R²=.296). And positive psychological capital was significant too(β=.082, p<.001). The explanatory power of the model affecting the innovation behavior was 36.7%(adj R²=.367). Organizational culture of nursing was significant and positive(β=.499 , p<.001). Total explanatory power of the model was 24.5%(adj R²=.245). In other words, nurses' grit, positive psychological capital, and nursing organizational culture had a positive effect on innovative behavior.

Fifth, as a result of analyzing the mediating effect of nursing organizational culture in the effect of grit and positive psychological capital on innovative behavior, the nursing organizational culture between grit and innovative behavior is statistically(β=.362, p<.001). It was estimated that it was significantly partially mediated, and among the sub-areas of nursing organizational culture, relationship-oriented culture(β=.200, p<.01), an innovation-oriented culture(β=.306, p<.001), a work-oriented culture(β=.330, p<.001) showed a partial mediating effect, but it was estimated that the hierarchical-oriented culture had no mediating effect. The nursing organizational culture between positive psychological capital and innovative behavior is also statistically(β=.303, p<.001). It was estimated that it was significantly partially mediated, and among the sub-areas of nursing organizational culture, an innovation-oriented culture(β=.288, p<.001), a work-oriented culture(β=.299, p<.001) showed a partial mediating effect, and it was estimated that relationship-oriented culture and hierarchical-oriented culture had no mediating effect. Through this, it was estimated that nurses could promote innovative behavior when they positively perceive grit, positive psychological capital, and nursing organizational culture.

In summary, it was found that grit, positive psychological capital, and nursing organizational culture had a positive effect on innovative behavior, and the higher the awareness of grit, positive psychological capital, and nursing organizational culture, the higher the innovative behavior. Therefore, it is necessary to develop and apply programs to improve the grit and positive psychological capital of clinical nurses to create a medical environment that can improve the quality of nursing and promote innovative behavior, and strategies for various support measures and compensation systems.

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 6
• Ⅱ. 문헌고찰 7
• 1. 그릿(GRIT) 7
• 2. 긍정심리자본 10
• 3. 간호조직문화 13
• 4. 혁신행동 16
• Ⅲ. 연구 방법 19
• 1. 연구설계 및 연구모형 19
• 2. 연구대상 20
• 3. 연구도구 21
• 4. 자료수집 방법 24
• 5. 가설 24
• 6. 자료 분석 30
• 7. 연구의 윤리적 고려 31
• Ⅳ. 분석 결과 32
• 1. 대상자의 일반적 특성 32
• 2. 대상자의 그릿, 긍정심리자본, 간호조직문화, 혁신행동의 정도 34
• 3. 일반적 특성에 따른 그릿, 긍정심리자본, 간호조직문화, 혁신행동의 차이검정 43
• 4. 그릿, 긍정심리자본, 간호조직문화 및 혁신행동 간의 상관관계 55
• 5. 그릿, 긍정심리자본, 간호조직문화가 혁신행동에 미치는 영향 57
• 6. 그릿, 긍정심리자본이 혁신행동에 미치는 영향에서 간호조직문화의 매개효과 63
• 7. 가설검증 결과 77
• Ⅴ. 논의 78
• Ⅵ. 결론 및 제언 88
• 1. 결론 88
• 2. 제언 91
• 참고문헌 92
• ABSTRACT 106
• 국문초록 110
• 부록 114