간호간병통합서비스를 제공하는 간호사의 역할갈등 및 역할모호성이 전문직업성에 미치는 영향

Abstract

국문요약

본 연구의 목적은 간호·간병통합서비스 실태조사와 간호·간병통합서비스를 제공하는 간호사의 역할갈등 및 역할모호성을 확인하고 이들이 전문직업성에 미치는 영향을 규명하는데 있다. 2016년 11월2일부터 11월 16일까지 서울 시내 소재 4개의 종합병원 간호·간병 통합서비스 병동에서 6개월 이상 근무하고 있는 간호사 139명을 대상으로 자료를 수집하였다. 간호·간병통합서비스 실태조사를 위한 문항은 선행연구 및 간호·간병통합서비스 표준운영지침, 연구자의 소속기관인 c병원의 간호·간병통합서비스 병동에서 근무하는 간호사 7명과 포커스 그룹 토의한 내용을 바탕으로 총 12개의 예비문항을 작성한 후, 간호·간병통합서비스 병동 간호관리자 1인, 간호관리학 전공교수 1인에게 검토를 받아 사용하였다. 역할갈등 및 역할모호성에 대한 척도는 Rizzo와 Lirtzman(1970)이 제시한 10가지 설문문항을 김현우(2014)가 번안한 도구를 사용하여 측정하였고, 전문직업성에 대한 도구는 Hall(1968)이 개발하고 Snizek(1972)이 수정한 도구를 백희정(2007)이 국문화한 25문항의 전문직업성 척도를 사용하여 측정하였다. 수집된 자료는 SPSS WIN 20.0 프로그램을 이용하여 빈도, 백분율, 평균, 표준편차, 순위 등 서술통계, t-test, oneway-ANOVA, Scheffe test, Pearson's Correlation Coefficient, Multiple Linear Regression등을 이용하여 분석하였다.

본 연구의 주요 결과는 다음과 같다.

1. 연구대상자는 여성이 97.8%였으며, 연령은 평균 29.76세로 25세-30세미만이 가장 많았다. 결혼상태는 미혼이 67.6%였고, 종교는 무교가 53.2%였다. 최종학력은 4년제 졸업이 50.4%였으며, 총 근무경력은 평균 5.74년으로 1년-5년 미만이 43.2%였다. 간호·간병통합서비스 병동경력은 평균 14.57개월로 1년 미만이 59.7%를 차지하였다. 근무병동은 과구분 없음이 38.8%였고, 직위는 일반간호사가 83.5%였다.

2. 역할갈등과 역할모호성은 5점 만점으로 역할갈등은 평균 3.07점, 역할모호성은 평균 2.78점이었다. 전문직업성은 125점 만점으로 평균 76.73점이었다. 하위요인 중 자체규제에 대한 신념이 25점 만점에 평균 16.55점으로 가장 높았으며, 다음으로 공적서비스에 대한 신념 평균 16.50점, 직업에 대한 소명의식 평균 15.51점, 자율성 평균 15.40점, 전문조직의 준거성 평균 12.77점 순으로 높았다.

3. 최종학력에 따라서 역할갈등이 통계적으로 유의미한 차이가 있었다(F=3.839, p=.024). 대학원이상 집단이 역할갈등이 가장 높았다. 근무경력에 따라서 역할모호성이 통계적으로 유의미한 차이가 있었다(F=3.233, p=014). 근무경력 15년 이상 집단이 역할모호성이 가장 낮았다.

4. 간호·간병통합서비스 병동경력에 따라서 전문직업성이 통계적으로 유의미한 차이가 있었다(t=-1.998, p=.048). 간호·간병통합서비스 병동경력 1년 이상인 집단이 1년 미만 집단보다 전문직업성이 높은 것으로 나타났다. 5. 역할갈등은 역할모호성과 양의 상관관계가(r=.405, p<.001), 전문직업성과는 음의 상관관계(r=-.330, p<.001)가 있는 것으로 나타났다. 전문직업성의 하위영역들과의 관계에서는 전문조직의 준거성을 제외한 모든 하위영역과 유의한 음의 상관관계가 있었다.

6. 전문직업성에 영향을 미치는 요인을 분석한 결과 간호·간병통합서비스 병동경력, 역할갈등, 역할모호성이 전문직업성에 미치는 영향력은 약 41.8%의 설명력을 갖는 것으로 나타났다. 회귀계수의 유의성 검정결과는 간호·간병통합서비스 병동경력(t=2.539, p=.012), 역할모호성(t=-7.940, p<.001)이 전문직업성에 유의한 영향을 미치는 것으로 나타났다. 역할모호성(β=-.571)이 가장 영향력이 컸으며, 다음으로 간호·간병통합서비스 병동경력(β=.167)순으로 전문직업성에 영향을 미쳤다.

간호·간병통합서비스를 제공하는 간호사의 역할모호성이 감소한다면 전문직업성은 향상될 것이다. 간호·간병통합서비스를 제공하는 간호사의 전문직업성 향상은 간호·간병통합서비스의 미래 안정적인 제도 정착과 환자에게 수준 높은 간호서비스를 제공하고 간호성과를 극대화하기 위해 필수적이다. 따라서 조직적 차원에서의 관리 방안이 모색되어야 할 것이며, 이를 뒷받침할 수 있는 정부나 기관의 지원이 필요하다고 본다.|ABSTRACT

Impacts of Role Conflict and Ambiguity on Professionalism of Clinical Nurses Working at Total Care Service Unit

Shin, Chae Mi College of Nursing The Graduate School of Hanyang University Directed by Professor Kim, Jung A, Ph.D, RN

The aim of this study is to conduct a survey on total care services, to verify role conflict and ambiguity among nurses, and to investigate their influences on professionalism. In four total care service wards in Seoul, samples of 139 nurses who had been working at the ward for six months or more were collected from November 2nd to November 16th, 2016. Items in the survey of total care services include twelve preliminary items generated using preceding studies, clinical practice guidelines of total care services, and the focus group discussion with nurses working in the total care service unit of Hospital C where the researcher is affiliated with. Before the use of the aforementioned items, the review was conducted by one nurse manager at the total care service unit and one nursing management professor. Role conflict and ambiguity are measured using the scale composed of ten items proposed by Rizzo and Lirtzman(1970) and adapted by Kim (2014). Professionalism is measured using the professionalism scale composed of twenty five items developed by Hall(1968), edited by Snizek(1972), and adapted into Korean by Baek(2007). The SPSS WIN 20.0 program is used to analyze the frequency, percentage, mean, standard deviation, rank, descriptive statistics, t-test, oneway-ANOVA, Scheffe test, Pearson's correlation coefficient, multiple linear regression of the collected data.

The main findings of this study are as follows.

1. 97.8% of the subjects were female, and the mean age was 29.76 with majority of the subjects in the age group of 25-30. 67.6% of subjects were unmarried, and 53.2% had no religion. 50.4% had a four-year college degree as the highest level of education. The total work experience was 5.74 years on average, and 43.2% had worked for between one and five years. Ward experience at a total care service unit was 14.57 months on average, and an experience of below one year accounted for 59.7%. 38.8% had no division for current post, and 83.5% were general nurses.

2. Role conflict and ambiguity are measured on a 5-point scale; the mean score for role conflict was 3.07 and the mean score for role ambiguity was 2.78. Professionalism is measured out of 125 points, with the mean score of 76.73. Among the subfactors measured out of 25 points, belief in self-regulation scored the highest with a mean score of 16.55, followed by belief in public service with a mean score of 15.51, autonomy with a mean of 15.40, and professional organization as a major referent with a mean score of 12.77.

3. There was a statistically significant difference in role conflict depending on the highest level of education(F=3.839, p=.024). Role conflict was highest in the group of graduate school or above. There was a statistically significant difference in role ambiguity depending on the work experience(F=3.233, p=014). Role ambiguity was lowest for the group with a work experience of 15 years or above.

4. There was a statistically significant difference in professionalism depending on the ward experience at a total care service unit(t=-1.998, p=.048). Professionalism of the group with a ward experience of one year or above was higher than that of the group with an experience of below one year.

5. Role conflict showed a positive correlation (r=.405, p<.001) with role ambiguity and a negative correlation(r=-.330, p<.001) with professionalism. Professionalism had a significant negative correlation with all its subfactors excluding the professional organization as a major referent.

6. Analyzing the factors that influence professionalism showed that the influences of ward experience at total care service unit, role conflict, and role ambiguity on professionalism have an explanatory power of approximately 41.8%. The significance test of the regression coefficient showed that the work experience at total care service unit(t=2.539, p=.012) and role ambiguity(t=-7.940, p<.001) have a significance influence on professionalism. Role ambiguity(β=-.571) had the highest influence on professionalism followed by work experience at total care service unit(β=.167). Professionalism would be enhanced if there is a decrease in role ambiguity of the nurses who provide total care services. The improvement in the professionalism of the nurses who provide total care services is essential to ensure a stable settlement of the total care service system, high-quality nursing services to patients, and maximization of the nursing outcomes. Therefore, the management strategies must be developed at an organizational level with a governmental or institutional support to assist nurses.; ABSTRACT

Impacts of Role Conflict and Ambiguity on Professionalism of Clinical Nurses Working at Total Care Service Unit

Shin, Chae Mi College of Nursing The Graduate School of Hanyang University Directed by Professor Kim, Jung A, Ph.D, RN

The aim of this study is to conduct a survey on total care services, to verify role conflict and ambiguity among nurses, and to investigate their influences on professionalism. In four total care service wards in Seoul, samples of 139 nurses who had been working at the ward for six months or more were collected from November 2nd to November 16th, 2016. Items in the survey of total care services include twelve preliminary items generated using preceding studies, clinical practice guidelines of total care services, and the focus group discussion with nurses working in the total care service unit of Hospital C where the researcher is affiliated with. Before the use of the aforementioned items, the review was conducted by one nurse manager at the total care service unit and one nursing management professor. Role conflict and ambiguity are measured using the scale composed of ten items proposed by Rizzo and Lirtzman(1970) and adapted by Kim (2014). Professionalism is measured using the professionalism scale composed of twenty five items developed by Hall(1968), edited by Snizek(1972), and adapted into Korean by Baek(2007). The SPSS WIN 20.0 program is used to analyze the frequency, percentage, mean, standard deviation, rank, descriptive statistics, t-test, oneway-ANOVA, Scheffe test, Pearson's correlation coefficient, multiple linear regression of the collected data.

The main findings of this study are as follows.

1. 97.8% of the subjects were female, and the mean age was 29.76 with majority of the subjects in the age group of 25-30. 67.6% of subjects were unmarried, and 53.2% had no religion. 50.4% had a four-year college degree as the highest level of education. The total work experience was 5.74 years on average, and 43.2% had worked for between one and five years. Ward experience at a total care service unit was 14.57 months on average, and an experience of below one year accounted for 59.7%. 38.8% had no division for current post, and 83.5% were general nurses.

2. Role conflict and ambiguity are measured on a 5-point scale