간호대학생의 정신장애인에 대한 사회적 거리감 및 태도조사

Abstract

The purpose of this study was to examine the relationship between social distance and attitude in nursing students, who were actively playing a part in the early diagnosis, treatment, recovery, and rehabilitation of mentally disabled individuals with the goal, therefore it aimed of improving nursing students' attitudes toward a positive direction. The research was conducted under the principle of a descriptive design. Data collection was performed from September 22, 2014 to October 2, 2014. There were 359 subjects from three nursing colleges in D city. Data were analyzed using SPSS/WIN 21.0 program for frequency, and percentage, Independent t-test, ANOVA, Pearson's Correlation Coefficient, and Stepwise multiple regression. The results were as follows: 1. The mean score of participants' social distance toward a mentally disabled individual was 2.53 out of 5. The social distance scale has two subscales that are physical distance and interpersonal distance. The mean score of physical distance was 2.50 out of 5. The mean score of interpersonal distance was 2.56 out of 5. The attitude scale has four subscales: that are authoritarianism, benevolence, social restrictiveness, and community mental health ideology. The mean score of authoritarianism was 2.24 out of 5, benevolence was 3.89 out of 5, social restrictiveness was 2.28 out of 5, and community mental health ideology was 3.65 out of 5. 2. The demographic characteristics that showed a statistically significant difference in terms of social distance were gender (p=.020), hours of clinical practicum for mental health nursing (p=.001), length of volunteering for the mentally disabled individuals (p=.004), volunteering experience for the mentally disabled individuals (p=.006), frequency of encountering with the mentally disabled individuals (p=.005), and impression of encountering with the mentally disabled individuals (p<.001). The demographic characteristics that showed a statistically significant difference in terms of an attitude toward a mentally disabled individual are below. In the authoritarian subscale, hours of clinical practicum for mental health nursing (p=.001), and frequencies of encountering with the mentally disabled individuals (p=.020) were significantly different. In the benevolent subscale, hours of clinical practicum for mental health nursing (p=.010) were significantly different. In the subscale of social restrictiveness, satisfaction with academic major (p=.014), hours of clinical practicum for mental health nursing (p=.004), and impression of encountering with the mentally disabled individuals (p=.048) were significantly different. In the subscale of community mental health ideology, gender (p=.037), volunteering experience with the mentally disabled individuals (p=.040), and impression of encountering with the mentally disabled individuals (p=.008) were significantly different. 3. There were negative correlations between authoritarianism and benevolence (r=-.49, p<.001) as well as; between authoritarianism and community mental health ideology (r=-.46, p<.001). There were positive correlations between authoritarianism and social restrictiveness (r=.58, p<.001), authoritarianism and physical distance (r=.26, p<.001), between authoritarianism and interpersonal distance (r=.25, p<.001), and between authoritarianism and social distance (r=.27, p<.001). 4. In order to investigate the influential factors on the participants' attitude towards mentally disabled individuals, stepwise multiple regression analysis was performed. As a result, the most influential factor on the attitudes was social distance in the social restrictiveness domain (β=.57), explaining 32% of the variance in terms of the attitude. A social distance (β=-.28) and a physical distance (β=-.24) were significant predictors in the regression model, explaining 26% of the variances in terms of community mental health ideology. A social distance (β=-.32) was a significant predictor in the regression model, explaining 10% of the variance in terms of benevolence. In conclusion, the participants reported a moderate or less than the moderate level of closeness toward the mentally disabled individuals. The participants reported less authoritarian, more benevolence, less socially restrictiveness attitudes toward the mentally disabled individuals. The participants also reported the positive community mental health ideology toward the mentally disabled individuals. More importantly, a social distance was the strongest predictor of the attitudes toward the mentally disabled individuals. Therefore, development and utilization of intervention programs in order to minimize the social distance and authoritarianism and to facilitate benevolence would be needed is recommended for the nursing students.

본 연구는 정신장애인의 조기발견 및 치료, 재활과 사회복귀에 적극적으로 나서야하는 간호전문 인력인 간호대학생의 사회적 거리감 및 태도를 확인하고 향후 정신장애인에 대한 태도를 긍정적인 방향으로 향상시키고 더 나은 간호제공을 도모하기 위한 서술적 조사연구이다. 연구대상자는 정신간호학 이론교육과 임상실습을 거친 D광역시 소재 3, 4 년제 간호대학에 재학 중인 간호대학생 359명을 대상으로 하였다. 대상자의 사회적 거리감과 정신장애인에 대한 태도를 측정하고, 자료분석은 SPSS/WIN 21.0 통계프로그램을 이용하여 빈도분석, t-test, ANOVA, 상관관계분석, 단계적 다중회귀분석을 사용하였고, 본 연구의 연구결과를 요약하면 다음과 같다. 1. 대상자의 정신장애인에 대한 사회적 거리감은 평균 2.53점(5점 만점)이며 2개의 하위영역인 신체적 거리감은 2.50점(5점 만점), 대인적 거리감 2.56점(5점 만점)으로 나타났고, 정신장애인에 대한 태도는 4개의 하위 영역별로 권위주의는 2.24점(5점 만점), 자비심은 3.89점(5점 만점), 사회생활 제한은 2.28점(5점 만점), 지역사회정신보건 이념은 3.65점(5점 만점)으로 나타났다. 2. 대상자의 특성에 따른 사회적 거리감 차이에서 통계적으로 유의한 차이가 나타난 변수들은 성별(p=.020), 정신간호학 실습기간(p=.001), 정신장애인 관련 자원봉사기간(p=.004), 정신장애인 관련 자원봉사경험 유무(p=.006), 정신장애인 만남 빈도(p=.005), 정신장애인 만남 인상(p<.001)이었고, 정신장애인에 대한 태도에 통계적으로 유의한 결과를 보인 변수는 4개 하위 영역별로 권위주의는 정신간호학 실습기간(p=.001), 정신장애인 만남 빈도(p=.020)이었고 자비심은 정신간호학 실습기간(p=.010), 사회생활 제한은 전공만족도(p=.014), 정신간호학 실습기간(p=.004), 정신장애인 만남 인상(p=.048)이며 지역사회정신보건 이념은 성별(p=.037), 정신장애인 관련 자원봉사 경험유무(p=.040), 정신장애인 만남 인상(p=.008)이었다. 3. 정신장애인에 대한 태도가 권위주의적일수록 자비심(r=-.49, p<.001), 지역사회정신보건 이념(r=-.46, p<.001)과는 유의한 음의 상관관계를 사회생활 제한(r=.58, p<.001), 신체적 거리감(r=.26, p<.001), 대인적 거리감(r=.25, p<.001), 사회적 거리감(r=.27, p<.001)과는 유의한 양의 상관관계가 있었다. 4. 대상자의 정신장애인에 대한 태도 영향을 주는 요인을 회귀분석 한 결과 사회생활제한 영역에 사회적 거리감이(β=.57) 영향요인으로 32%의 설명력, 지역사회정신보건 이념에 사회적 거리감(β=-.28), 신체적 거리감(β=-.24)이 영향요인으로 26%의 설명력, 자비심 영역에 사회적 거리감(β=-.32)이 영향요인으로 10%의 설명력을 나타냈다. 결론적으로 대상자의 정신장애인에 대한 전체적으로 중간 이하로 정신장애인을 가깝게 느끼며, 정신장애인에 대해 덜 권위적이며 더 자비롭고, 덜 제한적이며 지역사회정신보건 이념이 긍정적인것으로 나타났으며, 사회적 거리감이 정신장애인에 대한 태도에 가장 많은 영향을 미치는 것으로 나타났다. 따라서 사회적 거리감을 낮추기 위한 관련 변수와의 폭넓은 이해와 사회적 거리감의 영향이 상대적으로 작았던 권위주의와 자비심에 긍정적인 영향을 줄 수 있는 관련 프로그램의 개발이 필요 할 것으로 사료된다.