임상간호사의 회복탄력성과 사회적 문제해결능력이 소진에 미치는 영향

Abstract

This study was conducted as a descriptive study with the aim of identifying the effects resilience and social problem solving abilities on burnout of clinical nurses. Data collection for the study was carried out between May 30th and June 19th, 2013 by surveying 192 clinical nurses working in university medical centers and general hospitals located in Daegu. In order to measure subjects’ resilience, the Korean Resilience Quotient (KRQ-53) developed by Reivich and Shatté (2003) and translated and modified by Joo Hwan Kim (2011) was used. For measuring subjects’ social problem solving abilities, a tool that was developed by D’Zurilla and Nezu (1990), revised by Maydeu-Olivares and D’Zurilla (1996) for adult subjects, and translated into Korean by Yi Soon Choe (2002) was used. To measure subjects’ burnout, a tool that was developed by Maslach and Jackson (1981) and translated into Korean by Eun Sook Jang (1995) was used. For the analysis of the data, the statistical methods of frequency, percentage, mean and standard deviation, t-test, one-way ANOVA, Pearson’s correlation coefficients, and Stepwise multiple regression analysis were employed. The findings of the study are summarized as follows: 1. On the resilience test, subjects scored 3.43 on average on a 5.00 scale. In subcategories, subjects scored 3.31 for self-control, 3.53 for interpersonal competence, and 4.51 for positivity. In social problem solving ability testing, subjects scored 2.59 on a 4.00 scale. In subcategories, subjects scored 2.47 in problem solving motivation and 2.67 in problem solving skill. For subjects’ burnout testing, the subjects’ average score was 2.78 out of 5.00 and in subcategories, subjects scored 2.98 for emotional exhaustion, 2.73 for depersonalization, and 2.63 for lack of sense of personal accomplishment. 2. There were significant differences, depending on age, marital status, reason for choosing a nursing career, frequency of night work, and work patterns. For subjects’ social problem solving abilities, there were also significant differences, depending on marital status, frequency of night work, work patterns, and number of patients cared for daily. When the category of burnout was analyzed by general features, depending on reason for choosing a nursing career, frequency of night work, work patterns, placement in a desired department, number of patients cared for daily, and size of hospital, there were significant differences. 3. There was a significant negative correlation between subjects’ resilience and burnout and also between their social problem solving abilities and burnout. Also, between subjects’ resilience and social problem solving abilities, there was a significant statistical correlation. 4. Factors affecting clinical nurses burnout were identified in the order of resilience (β=-.445), size of hospital (β=.210), social problem solving abilities (β=-.173), and placement in a desired department (β=-.132) and the explanatory power was 43.1%. The findings of the study indicate that in order to decrease clinical nurses burnout, their resilience and social problem solving abilities have to be enhanced. Thus, to find intervention to control clinical nurses burnout and reduce the turnover rate of clinical nurses, various strategies that will strengthen clinical nurses resilience and social problem solving abilities will have to be explored.

본 연구는 임상간호사의 회복탄력성과 사회적 문제해결능력이 소진에 미치는 영향을 파악하기 위한 서술적 조사연구이다. 자료 수집은 A시에 소재한 대학병원과 종합병원에서 근무하는 임상간호사 192명을 대상으로 2013년 5월 30일에서 6월 19일까지 진행하였다. 연구도구로 회복탄력성은 Reivich와 Shatté (2003)가 개발하고 김주환 (2011)이 번역, 수정 개발한 한국형 회복탄력성지수(KRQ-53)를 사용하였으며, 사회적 문제해결능력은 D’Zurilla와 Nezu (1990)가 개발한 것을 Maydeu- Olivares와 D’Zurilla (1996)가 성인대상으로 수정하고 최이순 (2002)이 한국어로 번역한 도구를 사용하였다. 소진은 Maslach와 Jackson (1981)이 개발하고 장은숙 (1995)이 번역한 것을 사용하였다. 자료 분석은 실수와 백분율, 평균 및 표준편차, t-test, ANOVA, Pearson's correlation coefficients, Stepwise multiple regression analysis를 이용하였다. 본 연구의 결과를 요약하면 다음과 같다. 1. 회복탄력성은 5점 만점에 평균 3.43점 이었으며, 하위영역에서 자기조절능력 3.31점, 대인관계능력 3.53점, 긍정성은 4.51점으로 나타났다. 사회적 문제해결능력은 4점 만점에 2.59점 이었으며, 하위영역에서 문제해결지향 2.47점, 문제해결기술 2.67점으로 나타났다. 그리고 소진은 5점 만점에 2.78점 이었으며, 하위영역에서 정서적 탈진 2.98점, 비인격화 2.73점, 개인적 성취감 결여 2.63점으로 나타났다. 2. 일반적 특성에 따른 회복탄력성은 연령, 결혼상태, 간호직 선택 동기, 밤 근무 개수, 근무형태에서 유의한 차이가 있었으며, 사회적 문제해결능력은 결혼상태, 밤 근무 개수, 근무형태, 매일 돌보는 환자 수에서 유의한 차이가 있었다. 그리고 일반적 특성에 따른 소진은 간호직 선택 동기, 밤 근무 개수, 근무형태, 희망부서 배치 여부, 매일 돌보는 환자 수, 병원크기에서 유의한 차이가 있었다. 3. 회복탄력성과 소진, 사회적 문제해결능력과 소진은 유의한 부적 상관관계가 있었으며, 회복탄력성과 사회적 문제해결능력은 유의한 정적 상관관계가 있었다. 4. 임상간호사의 소진에 영향을 미치는 요인은 회복탄력성(β=-.445), 병원크기(β=.210), 사회적 문제해결능력(β=-.173), 희망부서 배치(β=-.132)순서로 나타났으며, 설명력은 43.1% 이었다. 본 연구결과를 통해 임상간호사의 소진을 감소시키기 위해 회복탄력성과 사회적 문제해결능력을 증진시킬 필요가 있다. 따라서 임상간호사의 소진을 조절하고 더 나아가 이직을 줄이기 위한 방안으로 회복탄력성과 사회적 문제해결능력을 증진시킬 수 있는 다양한 전략을 모색해야할 것이다.