정신간호사의 간호근무환경, 보상, 무례함의 경험이 재직 의도에 미치는 영향

임소정 영산대학교 일반대학원 간호학과 2021 국내석사

연구 목적 : 본 연구는 정신간호사들이 인식하는 간호근무환경, 보상의 중요성, 무례함의 경험 및 재직 의도의 정도와 재직 의도의 영향요인을 파악하여, 정신의료기관의 간호인력 관리를 위한 전략 및 근거를 마련하기 위한 기초자료를 제공하기 위해 시도되었다. 연구 방법 : 본 연구는 서술적 조사연구로 2021년 2월 15일부터 3월 17일 까지 자료 수집이 시행되었고, 연구 시행에 앞서 Y 대학교 기관윤리위원회의 승인 (YSUIRB-202012-HR-083-02)을 받았다. 11개의 정신병원에서 근무하는 임상경력이 6개월 이상이며, 본 연구의 목적을 이해하고 참여하기 위해 서면 동의를 한 간호사를 대상으로 202부의 설문지를 배부하였고, 최종 196부를 분석에 사용하였다. 수집된 자료는 IBM SPSS Statistics version 26.0 program을 이용하여 분석하였다. 일반적인 특성은 기술통계로 분석하였고 일반적 특성에 따른 주요 변수들의 차이검정은 t-검정, 일원분산분석과 사후검정은 Scheffé test로 하였다. 주요변수들 간의 관계는 Pearson’s correlation coefficients으로 분석하였고, 주요 변수들이 재직의도에 미치는 영향은 다중회귀분석(Multiple Regression Analysis)으로 분석하였다. 본 연구의 결과를 요약하면 다음과 같다. 1) 전체 대상자는 총 196명 이었고, 여성이 87.2%로 대다수를 차지하였다. 평균연령은 50세 이상이 30.1%로 가장 많았고, 기혼이 59.2%이었다. 최종학력은 학사가 54.6%로 가장 많았고, 근무부서는 병동이 86.7%로 대다수를 차지하였으며, 근무형태는 3교대가 56.6%로 가장 많았다. 총 임상경력은 20년 이상이 39.3%로 가장 많았으며 현재 직장에 근속한 연수는 1년 이상~ 5년 미만이 38.8%로 가장 많았다. 직위는 일반간호사가 61.2%이었고, 평균 월급은 300만원 미만이 69.4%이었다. 이직경험이 있는 대상자가 73.5%이었고, 이들의 이직횟수는 1회가 32.7%로 가장 많았다. 2) 정신간호사가 인식한 간호근무환경, 보상, 무례함, 재직 의도의 정도는 다음과 같다. 간호근무환경은 4점 만점에 평균 2.60(±0.46)점이었고, 보상의 중요성은 4점 만점에 평균 3.17(±0.53)점이었다. 무례함의 경험은 5점 만점에 평균 2.41(±0.67)점이었고, 재직 의도는 8점 만점에 평균 5.84(±1.53)점이었다. 3) 정신간호사의 일반적 특성에 따른 간호근무환경의 차이를 분석한 결과, 근무부서(t=-2.173, p=.031), 평균 월급(t=-2.212, p=.028)에 따라 통계적으로 유의한 차이가 있었다. 4) 정신간호사의 일반적 특성에 따른 보상의 중요성 대한 인식의 차이를 분석한 결과, 근무부서(t=-2.052, p=.041), 평균 월급(t=-2.794, p=.006)에 따라 통계적으로 유의한 차이가 있었다. 5) 정신간호사의 일반적 특성에 따른 무례함 경험의 차이를 분석한 결과, 총 임상경력(F=3.425, p=.010), 현재 직장 근무경력(F=2.885, p=.024)에 따라 통계적으로 유의한 차이가 있었다. 6) 정신간호사의 일반적 특성에 따른 재직 의도의 차이를 분석한 결과, 연령(F=2.759, p=.044)과 최종학력(F=3.117, p=.047)에 따라 통계적으로 유의한 차이가 있었다. 7) 정신간호사의 간호근무환경, 보상, 무례함, 재직 의도 간의 상관관계를 분석한 결과, 간호근무환경과 보상은 정적 상관관계가 있었고(r=.226, p<.001), 간호근무환경과 무례함은 부적 상관관계가 있었다(r=-.455, p<.001). 재직 의도와 간호근무환경은 정적 상관관계가 있었고(r=.350, p<.001), 재직 의도와 무례함은 부적 상관관계가 있었다(r=-.306, p<.001). 8) 회귀분석 결과, 정신간호사의 재직 의도에 영향을 미치는 요인은 간호근무환경(β=.239, p=.001), 무례함(β=-.216, p=.004), 연령(β=.153, p=.033)이었고, 설명력은 17.6%이었다. 즉 나이가 많고, 간호근무환경을 긍정적으로 인식하는 경우, 무례함 경험이 적은 경우에 재직 의도가 높았다. 이상의 연구결과를 통해 정신간호사의 연령, 간호근무환경, 무례함의 경험이 재직 의도에 영향을 미치는 주요 요인임을 확인하였다. 의료기관의 적극적인 간호 인력 충원과 적절한 보상체계를 포함한 간호근무환경을 긍정적으로 개선하고 조직차원의 관리 감독을 강화하고 적절한 교육 프로그램을 마련한다면 무례함의 감소에 영향을 미쳐 정신간호사들의 재직 의도 향상에 도움이 될 것이다. 따라서 본 연구결과를 토대로 정신간호사의 재직 의도를 향상하기 위해서는 간호근무환경을 개선하고 무례함을 감소시키고, 이와 관련하여 개인적 요소와 조직적 요소를 고려한 병원의 통합적 전략이 마련되어야 한다. This study was attempted to identify nursing work environment recognized by mental health nurses, importance of compensation, incivility experience and retention intention, and influencing factors on retention intention and provide basic data for establishing strategies and foundations for managing nursing staffing in mental institutions. This is a descriptive research study and our data collection was conducted from Feb. 15 to Mar. 17, 2021 and prior to executing research, this study was approved by the Institutional Ethics Committee of Y University (YSUIRB-202012-HR-083-02). Our 202 copies of questionnaire were distributed to nurses who had over 6 months of clinical career working at 11 mental hospitals and understood the purpose of this study and agreed in writing to participate in this survey and finally 196 copies were only used for our analysis. The collected data were analyzed with IBM SPSS Statistics version 26.0 program. The general characteristics were analyzed with descriptive statistics and to analyze the difference between main variables depending on general characteristics, t-test and one-way ANOVA were used and for post-hoc test, Scheff’s test was used. The relation between main variables was analyzed with Pearson’s correlation coefficients and the effect of main variables on retention intention was analyzed through multiple regression analysis. The findings from this study can be summarized as follows: 1) The total number of participants was 196 individuals: females occupied the majority at 87.2%. To look at the average age, ‘50 years or older’ occupied the most at 30.1% and ‘married’ occupied 59.2%. To look at the highest level of education, bachelor’s degree occupied the majority at 54.6% and when it comes to work unit, ‘ward’ occupied the majority at 86.7% and in case of pattern of duties, ‘three shifts’ occupied the most at 56.6%. To look at total clinical career, ‘20 years or more’ was the most at 39.3% and to look at the length of working years at the present workplace, ‘1–5 years’ was the most at 38.8%. To look at position, ‘staff nurse’ occupied 61.2% and in case of average salary, ‘3 million won or less’ occupied the most at 69.4%. Those who had experience of turnover occupied 73.5% and with respect to the number of turnover, ‘one time’ occupied the most at 32.7%. 2) Mental health nurses recognized nursing work environment, importance of compensation, incivility, and retention intention as follows. Nursing work environment scored 2.60(±0.46) points on average out of 4 and the importance of compensation scored at 3.17(±0.53) on average out of 4. Incivility experience scored 2.41(±0.67) points on average out of 5 and retention intention scored at 5.84(±1.53) on average out of 8. 3) As a result of analyzing the difference in nursing work environment depending on general characteristics of mental health nurses, it was found that there was a statistically significant difference in work unit (t=-2.17, p=.031) and average salary (t=-2.21, p=.028). 4) As a result of analyzing the difference in recognition toward importance of compensation depending on general characteristics of mental health nurses, it was found that there was a statistically significant difference in work unit (t=-2.05, p=.041) and average salary (t=-2.79, p=.006). 5) As a result of analyzing the difference in incivility experience depending on general characteristics of mental health nurses, it was found that there was a statistically significant difference in total clinical career (F=3.42, p=.010) and years of working at the present workplace (F=2.88, p=.024). 6) As a result of analyzing the difference in retention intention depending on general characteristics of mental health nurses, it was found that there was a statistically significant difference in age (F=2.75, p=.044) and highest level of education (F=3.11, p=.047). 7) The results of analyzing the correlation between nursing work environment, importance of compensation, incivility, and retention intention in mental health nurses are as follows. It was found that nursing work environment was positively correlated with importance of compensation (r=.226, p<.001) and nursing work environment was negatively correlated with incivility (r=-.455, p<.001). Retention intention was positively correlated with nursing work environment (r=.350, p<.001) and retention intention was negatively correlated with incivility (r=-.306, p<.001). 8) As a result of multiple regression analysis, it was found that the influencing factors on retention intention in mental health nurses were nursing work environment (β=.239, p=.001), incivility (β=-.216, p=.004), and age (β=.153, p=.033) and the explanatory power was 17.6%. In other words, in case a nurse was older and recognized the nursing work environment positively, the nurse with less incivility experience showed higher retention intention. The above results together, it was found that mental health nurses’ age, nursing work environment, and incivility experience were the factors influencing the retention intention. Therefore, in order to improve the retention intentions of mental health nurses to work, efforts should be made at the institution level to actively nursing staffing and improve the nursing work environment including an appropriate compensation system. In addition, organizational supervision and appropriate education programs should be prepared so that mental health nurses can cope with incivility from colleagues and patients.