임상간호사의 감성지능이 심리적 소진에 미치는 영향

Abstract

의료서비스의 질적 향상과 의료 환경의 변화에 따라 현대의 많은 병원들은 기업적 경영전략을 도입하고 있으며, 최상의 의료서비스 제공을 위하여 병원의 고객만족 극대화와 병원의 재이용율 높이기에 초점을 맞추고 있다. 그 중에서도 환자중심병원의 다양한 요구에 맞게 질적 서비스제공을 위한 인적서비스 요구가 강화되고 있다. 특히, 간호조직은 병원 전체 인력의 대부분을 차지하며, 최일선에서 환자 또는 보호자에게 간호를 제공하며 병원내 여러 직종과 협력하고 있다. 그로 인하여, 간호사들은 효율적으로 업무를 수행하려는 과정에서 갈등을 경험하게 되고 스트레스가 과중해지면서 정서적 탈진을 경험하게 된다. 본 연구의 목적은 임상간호사의 감성지능이 심리적 소진에 미치는 영향을 파악하고 감성지능과 심리적 소진의 관계에서 감정노동의 효과를 파악하여, 의료기관의 서비스경쟁화 속에서 간호사들의 업무 수행과정 중 겪는 심리적 소진을 줄일 수 있도록 하고자 하였다. 서울시에 소재한 일개 대학병원에 근무하는 간호사 270명을 대상으로 하였으며, 2012년 5월 17일부터 5월 24일까지 설문 조사를 실시하였다. 연구분석은 SPSS 19.0프로그램을 이용하여 기술통계, 분산분석, 사후검증, Pearson's correlation coefficient, 단순회귀분석을 통하여 분석하였으며 sobel test를 통한 매개효과검증 및 위계적 회귀분석으로 조절효과를 입증하였다. 본 연구 결과를 요약하면 다음과 같다. 첫째, 대상자의 일반적 특성에 따른 감성지능, 심리적 소진, 감정노동에는 차이가 있었다. 감성지능의 경우 연령이 높을수록, 기혼일 경우, 학력이 높을수록, 임상근무경력이 높을수록 높게 나타났으며, 감정노동의 경우 미혼의 간호사가 기혼의 간호사보다 감정노동이 높은 것으로 나타났다. 또한, 심리적 소진의 경우 연령대가 높고 근무경력이 높을 경우 낮은 것으로 나타났으며, 20대의 경우 와 근무경력이 5년 미만일 경우에 심리적 소진이 높은 것으로 나타났다. 또한 수간호사 집단보다 일반간호사 집단이 심리적 소진이 높은 것으로 나타났다. 둘째, 상관관계분석에서는 감성지능은 감정노동과 유의한 정적상관관계를, 심리적 소진과 유의한 부적 상관관계를 나타내었으며, 심리적 소진의 하위요인인 정서적 고갈, 비인격화, 성취감 저하와도 유의한 부적 상관관계를 나타내었다. 감정노동은 심리적 소진과 유의한 정적 상관을 나타내었고, 심리적 소진의 하위요인인 정서적 고갈, 비인격화와 유의한 정적 상관관계를 성취감 저하와는 부적 상관관계를 나타내었다. 셋째, 회귀분석에서는 감성지능이 심리적 소진에 유의한 영향을 미치며, 간호사의 감성지능이 높을수록 심리적 소진은 유의하게 낮은 것으로 나타났다(β=-.65, p<.001). 감성지능이 감정노동에 미치는 영향에서는 감성지능이 높을수록 감정노동이 높은 것으로 나타났으나 유의하지는 않았다(β=.20, n.s). 또한, 감정노동이 심리적 소진에 미치는 영향에서는 감정노동이 많을수록 간호사의 심리적 소진이 유의하게 높은 것으로 나타났다(β=.23, p<.001). 넷째, 감성지능과 심리적 소진간의 관계에서 감정노동의 매개효과 검증을 위한 Sobel test결과 감정노동의 매개효과가 없음이 증명되었다. 그로 인하여 감성지능이 심리적 소진에 미치는 영향에서 감정노동의 조절효과를 알아보기 위한 위계적 회귀분석을 실시하였다. 그 결과 간호사의 감성지능과 감정노동은 간호사의 심리적 소진 변량의 48%를 설명하는 것으로 나타났고, 간호사의 감성지능과 감정노동의 상호작용 효과가 포함되어 간호사의 심리적 소진을 50%설명하는 것으로 나타나 설명력()이 2% 증가하였고,, 결과적으로 조절효과는 유의한 것으로 나타났다(F=89.09 p<.001).

이상의 연구결과를 종합하면, 감성지능이 높을수록 심리적 소진이 낮은 것으로 나타났으며, 감정노동이 많을수록 심리적 소진이 높은 것으로 나타났다. 감정노동의 긍정적인 요인에 관한 본 연구의 의도를 규명하지는 못 하였지만, 감정노동이 감성지능과 심리적 소진의 관계에서의 조절효과가 있음을 규명하였다. 따라서 간호사들의 심리적 소진을 완화하고 직무의 만족도를 높여 외부고객의 만족도까지 올릴 수 있는 긍정적인 조절요소로 감성지능을 올릴 수 있는 감성교육프로그램의 개발과 실시가 중요할 것으로 사료된다. 또한 연령대가 낮을수록 근무경력이 짧을수록 감성지능이 낮고 심리적 소진이 높은 것으로 나타났으므로, 신규간호사 교육시 감성지능을 향상시킬수 있는 프로그램을 실시하여 궁극적으로는 간호업무성과를 높이고 간호조직이 효율적으로 운영될 수 있는 기반을 구축해야 될 것으로 사료된다.|With the quality improvement of medical service and the changing medical environments, many modern hospitals are increasingly introducing corporate management strategies and focusing on the maximization of customer satisfaction and the higher reuse rate of hospital in order to provide the best medical service. Human service needs are further reinforced to provide quality service according to the diverse needs of patient-centered hospital. The nurses, in particular, account for the majority of hospital workforce, offer nursing to patients or their caregivers in the frontline, and collaborate with various departments in hospital. They experience conflicts and suffer much stress in the process of trying to perform efficiently, facing emotional exhaustion. This study set out to investigate the effects of clinical nurses' emotional intelligence on their burnout and the effects of emotional labor on the relations between emotional intelligence and burnout, thus contributing to a lower burnout level of nurses during their performance in service competitions among many different medical institutions. For those purposes, a survey was taken with 270 nurses working for a university hospital in Seoul from May 17 to 24, 2012. Collected data were put to descriptive statistics, analysis of variance, post-hoc test, Pearson's correlation coefficient, and simple regression analysis with the SPSS 19.0 program. In addition, Sobel test and hierarchical regression analysis were conducted to test mediating effects and demonstrate moderating effects, respectively. The research findings were summarized as follows: First, there were no differences in emotional intelligence, burnout, and emotional labor according to the general characteristics of the subjects. Those who were older, married, more educated, and had a longer duration of clinical service tended to have high emotional intelligence. The single nurses had more emotional labor than the married ones. The burnout level was low in those who were older and had a longer duration of service and high in those who were in their twenties and those who had five years of service or fewer. In addition, general nurses suffered more burnout than charge nurses. Second, the correlation analysis results show that emotional intelligence had significant positive correlations with emotional labor and significant negative correlations with burnout. It also had significant negative correlations with such burnout subfactors as emotional exhaustion, impersonalization, and lower sense of achievement. Emotional labor had significant positive correlations with burnout. More specifically, it had significant positive correlations with emotional exhaustion and impersonalization and negative correlations with lower sense of achievement. Third, the regression analysis results reveal that emotional intelligence had significant impacts on burnout and that the higher emotional intelligence nurses had, the more significantly lower their burnout was(β=-.65, p<.001). The higher emotional intelligence they had, the more emotional labor they had, but there was no significant relation between them(β=.20, n.s). The more emotional labor they had, the more significantly higher their burnout was(β =.23, p<.001). Fourth, the Sobel test, which was performed to test emotional labor's mediating effects between emotional intelligence and burnout, proved that emotional labor had no mediating effects. Hierarchical regression analysis, which was carried out to examine emotional labor's moderating effects on the influence of emotional intelligence on burnout, finds that emotional intelligence and emotional labor explained 48% of burnout variate and 50% of burnout by including interactive effects between them, increasing in explanatory power() by 2% and eventually demonstrating significant moderating effects(F=89.09 p<.001).

In short, the higher emotional intelligence nurses had, the lower their burnout was. The more emotional labor they had, the higher their burnout was. Even though the study did not identify the positive factors of emotional labor as it intended, it did demonstrate emotional labor's moderating effects between emotional intelligence and burnout. The findings highlight the importance of developing and implementing an emotional education program to improve nurses' emotional intelligence as a positive moderating element for them to alleviate their burnout and increase their job satisfaction and further client satisfaction. In addition, it was found that those who were younger and had a shorter duration of service tended to have lower emotional intelligence and higher burnout, which raises a need to implement a program to help beginning nurses increase their emotional intelligence as part of their education and ultimately build a foundation to improve nursing performance and run the nursing organization efficiently.; With the quality improvement of medical service and the changing medical environments, many modern hospitals are increasingly introducing corporate management strategies and focusing on the maximization of customer satisfaction and the higher reuse rate of hospital in order to provide the best medical service. Human service needs are further reinforced to provide quality service according to the diverse needs of patient-centered hospital. The nurses, in particular, account for the majority of hospital workforce, offer nursing to patients or their caregivers in the frontline, and collaborate with various departments in hospital. They experience conflicts and suffer much stress in the process of trying to perform efficiently, facing emotional exhaustion. This study set out to investigate the effects of clinical nurses' emotional intelligence on their burnout and the effects of emotional labor on the relations between emotional intelligence and burnout, thus contributing to a lower burnout level of nurses during their performance in service competitions among many different medical institutions. For those purposes, a survey was taken with 270 nurses working for a university hospital in Seoul from May 17 to 24, 2012. Collected data were put to descriptive statistics, analysis of variance, post-hoc test, Pearson's correlation coefficient, and simple regression analysis with the SPSS 19.0 program. In addition, Sobel test and hierarchical regression analysis were conducted to test mediating effects and demonstrate moderating effects, respectively. The research findings were summarized as follows: First, there were no differences in emotional intelligence, burnout, and emotional labor according to the general characteristics of the subjects. Those who were older, married, more educated, and had a longer duration of clinical service tended to have high emotional intelligence. The single nurses had more emotional labor than the married ones. The burnout level was low in those who were older and had a longer duration of service and high in those who were in their twenties and those who had five years of service or fewer. In addition, general nurses suffered more burnout than charge nurses. Second, the correlation analysis results show that emotional intelligence had significant positive correlations with emotional labor and significant negative correlations with burnout. It also had significant negative correlations with such burnout subfactors as emotional exhaustion, impersonalization, and lower sense of achievement. Emotional labor had significant positive correlations with burnout. More specifically, it had significant positive correlations with emotional exhaustion and impersonalization and negative correlations with lower sense of achievement. Third, the regression analysis results reveal that emotional intelligence had significant impacts on burnout and that the higher emotional intelligence nurses had, the more significantly lower their burnout was(β=-.65, p<.001). The higher emotional intelligence they had, the more emotional labor they had, but there was no significant relation between them(β=.20, n.s). The more emotional labor they had, the more significantly higher their burnout was(β =.23, p<.001). Fourth, the Sobel test, which was performed to test emotional labor's mediating effects between emotional intelligence and burnout, proved that emotional labor had no mediating effects. Hierarchical regression analysis, which was carried out to examine emotional labor's moderating effects on the influence of emotional intelligence on burnout, finds that emotional intelligence and emotional labor explained 48% of burnout variate and 50% of burnout by including interactive effects between them, increasing in explanatory power() by 2% and eventually demonstrating significant moderating effects(F=89.09 p<.001).

In short, the higher emotional intelligence nurses had, the lower their burnout was. The more emotional labor they had, the higher their burnout was. Even though the study did not identify the positive factors of emotional labor as it intended, it did demonstrate emotional labor's moderating effects between emotional intelligence and burnout. The findings highlight the importance of developing and implementing an emotional education program to improve nurses' emotional intelligence as a positive moderating element for them to alleviate their burnout and increase their job satisfaction and further client satisfaction. In addition, it was found that those who were younger and had a shorter duration of service tended to have lower emotional intelligence and higher burnout, which raises a need to implement a program to help beginning nurses increase their emotional intelligence as part of their education and ultimately build a foundation to improve nursing performance and run the nursing organization efficiently.