신규간호사의 재직의도에 대한 구조모형

고진희 경상대학교 대학원 2021 국내박사

본 연구는 Cowden과 Cummings (2012)의 임상간호사의 재직의도 모형을 기반으로 하면서 선행연구에서 신규간호사와 간호사의 재직의도에 대한 영향 및 관련 요인으로 규명된 변수들을 선정하여 신규간호사의 재직의도에 대한 구조모형을 구축하여 검증함으로써 신규간호사의 재직의도 향상을 위한 간호인력관리 전략에 기초자료를 제공하고자 시도되었다. 본 연구의 대상자는 P, U, G광역시, 경남 M시, 경북 G시, 전남 S시의 6개 지역에 위치한 300~500병상 규모의 5개 종합병원, 700~1000병상의 3개 종합병원, 2개 상급종합병원, 총 10개 병원에서 근무하는 신규간호사 277명이다. 자료수집은 2020년 10월 6일부터 10월 23일까지 시행되었다. 자료분석은 SPSS/WIN 21.0 프로그램을 이용하여 서술통계, Pearson's correlation coefficient 분석을 실시하였고, AMOS 21.0 프로그램을 이용하여 확인적 요인분석, 가설적 모형의 적합도 검증, 경로계수 및 효과 검증을 실시하였다. 본 연구결과는 다음과 같다. 최종 모형의 적합도는 절대적합지수인 정규화된 χ²/df=1.85, RMR(.03), RMSEA(.06), GFI(.92), AGFI(.87)와 증분적합지수인 NFI(.92), TLI(.94), CFI(.96)가 권장수준을 만족하여 모형이 적합하다고 할 수 있다. 연구가설 27개 중 18개의 가설이 지지되었고 9개의 가설이 기각되었다. 신규간호사의 조직몰입에 영향을 미치는 변수를 살펴보면 가장 큰 영향을 미치는 변수는 간호근무환경(γ=.48, p<.001)이었으며, 다음으로 그릿(γ=.19, p<.001), 사회적지지(γ=.16, p=.008), 교육훈련 만족도(γ=.12, p=.011), 업무충격(γ=-.12, p=.015), 급여만족도(γ=.08, p=.033) 순이었다. 낙관성, 임상수행능력은 유의한 영향을 미치지 않았으며 모형의 설명력은 69.9%였다. 신규간호사의 직무만족에 영향을 미치는 변수를 살펴보면 가장 큰 영향을 미치는 변수는 그릿(γ=.45, p=.026)이었으며, 다음으로 조직몰입(β=.25, p<.001), 사회적지지(γ=.18, p=.049), 낙관성(γ=.15, p=.012), 임상수행능력(γ=.12, p=.014) 순이었다. 교육훈련 만족도, 간호근무환경, 급여만족도, 업무충격은 유의한 영향을 미치지 않았으며 모형의 설명력은 65.7%였다. 신규간호사의 재직의도에 영향을 미치는 변수를 살펴보면 가장 큰 영향을 미치는 변수는 그릿(γ=.60, p=.008)이었으며, 다음으로 조직몰입(β=.26, p=.011), 직무만족(β=.25, p=.003), 낙관성(γ=.22, p=.013), 사회적지지(γ=.15, p=.032), 간호근무환경(γ=.11, p=.018) 순이었다. 임상수행능력, 교육훈련 만족도, 급여만족도는 유의한 영향을 미치지 않았으며 모형의 설명력은 65.4%였다. 결론적으로 본 연구를 통해 구축한 모형은 신규간호사의 재직의도를 설명하고 예측하는데 적합한 모형으로 판단된다. 신규간호사 특성인 그릿과 낙관성, 관리자 특성인 사회적지지, 조직 특성인 간호근무환경 및 매개변수인 조직몰입, 직무만족은 재직의도를 증가시켰고, 반면 직무 특성인 업무충격은 재직의도를 감소시켰으며, 이들 변수 중 그릿이 재직의도를 증가시키는데 가장 영향력이 큰 것으로 나타났다. 본 연구결과를 기반으로 신규간호사의 재직의도를 증가시키는 신규간호사 인력관리 전략을 개발 및 적용할 것을 권장한다. The purpose of this study was to develop and test an structural equation model for new graduate nurses’ intent to stay. The hypothetical model was constructed on the basis of model of clinical nurses’ intent to stay by Cowden & Cummings (2012) and previous studies related to influencing and related factors of intent to stay of new graduate nurses and nurses. The participants were 277 new graduate nurses from five general hospitals with 300~500 beds and three general hospitals with 700~1000 beds and two university hospitals located in P, U, G metropolitan cities, M city in Gyeongsangnamdo, G city in Gyeongsangbukdo and S city in Jeollanamdo. Data were collected from October 6 to October 23, 2020. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and structural equation modelling by SPSS/Win 21.0 program and AMOS 21.0 program. The results of this study were as follows. 1. Final model showed good fit to the empirical data (χ2/df=1.85, RMR=.03, RMSEA=.06, GFI=.92, AGFI=.87, NFI=.92, TLI=.94, CFI=.96). 2. Hypothesis testing of the study showed: 1) Among 18 hypotheses, 27 hypotheses were supported. 2) The variables affecting organizational commitment of new graduate nurses were nursing work environment (γ=.48, p<.001), grit (γ=.19, p<.001), social support (γ=.16, p=.008), educational training satisfaction (γ=.12, p=.011), work shock (γ=-.12, p=.015), and pay satisfaction (γ=.08, p=.033), whereas optimism and clinical competence did not show any effects. Variables of the final model accounted for 69.9% of the organizational commitment of new graduate nurses. 3) The variables affecting job satisfaction of new graduate nurses were grit (γ=.45, p=.026), organizational commitment (β=.25, p<.001), social support (γ=.18, p=.049), optimism (γ=.15, p=.012), and clinical competence (γ=.12, p=.014), whereas educational training satisfaction, nursing work environment, pay satisfaction, and work shock did not show any effects. Variables of the final model accounted for 65.7% of the job satisfaction of new graduate nurses. 4) The variables affecting intent to stay of new graduate nurses were grit (γ=.60, p=.008), organizational commitment (β=.26, p=.011), job satisfaction (β=.25, p=.003), optimism (γ=.22, p=.013), social support (γ=.15, p=.032), and nursing work environment (γ=.11, p=.018), and work shock (γ=-.05, p=.005), whereas clinical competence, education training satisfaction, and pay satisfaction did not show any effects. Variables of the final model accounted for 65.4% of the intent to stay of new graduate nurses. In conclusion, the model for new graduate nurses‘ intent to stay constructed in this study is recommended as a model to explain and predict the intent to stay of new graduate nurses. The results suggest that strategies for increasing the intent to stay of new graduate nurses should focus on grit, optimism, social support, nursing work environment, organizational commitment, job satisfaction, and work shock.

간호사가 지각하는 관리자의 돌봄-배려행위와 동료간 돌봄-배려행위가 재직의도에 미치는 영향

공문연 제주대학교 대학원 2015 국내석사

The study purpose was to identify the effects of nurse manager and peer group caring behaviors as perceived by nurses on retention intention. A descriptive correlational study was conducted with a convenience sample of 229 registered nurses who had worked for over 6 months in the units of five general hospitals located in J province. Data were collected from Aug. 1 to Aug. 20, 2015 using a self-reported questionnaire on participants’ general and job-related characteristics, manager caring behaviors (by OCCS, 1998), peer group caring behaviors (by PGCIS, 1998), and retention intention (by Korean version of Cowin’s Nurses’ Retention Index, 2002). Data were analyzed using Cronbach’s alpha, descriptive statistics, t-tests, ANOVAs with Scheffé’s post-hoc testing, Pearson's correlation coefficients, and hierarchical regression analysis. Our results were as follows: 1. The mean total score for manager caring behaviors was 4.27. The mean sub-scale scores were as follows: modeling (4.26); dialogue (4.18); practice (4.33); and confirmation (4.29). The mean total score for peer group caring behaviors was 4.31, while the sub-scale scores were 4.21 and 4.44 for modeling and giving assistance, respectively. As such, the giving assistance score was higher than was that of modeling. The mean score of retention intention was 4.72, indicating a moderate level. 2. There were significant differences in 'manager caring behaviors' scores by suitability for present working department and employment status and in 'peer group caring behaviors' scores by suitability for present working department. 3. Nurses' retention intention showed statistically significant differences according to age, marital status, religion, suitability for present department, total clinical experience and monthly salary. 4. Nurses’ retention intention was significantly positively correlated with ‘manager and peer group caring behaviors’, respectively. Furthermore, ‘manager caring behaviors’ were significantly positively correlated with ‘peer group caring behaviors’. Furthermore, After controlling confounding variables, religion, suitability for present working department, clinical experience of over ten years, 'manager caring behaviors', and 'peer group caring behaviors' were significantly associated with nurses' retention intention. In conclusion, the scores for 'manager and peer group caring behaviors' and retention intention were all at a moderate level, although the subjects perceived 'peer group caring behaviors' as higher compared to 'manager caring behaviors'. the factors influencing retention intention were religion, suitability for present department, clinical experience of over ten years, 'manager caring behaviors', and 'peer group caring behaviors', and 'manager caring behaviors' was more influential than 'peer group caring behaviors'. Therefore, to improve nurses’ retention intention, it may be necessary to alter the transfer and arrangement strategies of their working environments to better consider nurses’ aptitude and competence, and thereby increase both manager and peer group caring behaviors. Furthermore, it should be made strategies to promote manager caring behaviors in hospitals and hospital organizations and to encourage caring-relationship formation among peers, as this would help in building a more friendly organizational culture. Based on our results, we suggest the following: 1. When developing strategies to enhance nurses’ retention intention, manager and peer group caring behaviors should be targeted, especially it would be necessary to consider facilitating caring behaviors that offer actual and specific assistance. 2. In order to improve nurses' retention intention, it should develop rotation system that considered nurses’ aptitude and nursing competency. 3. It is necessary to develop strategies to improve retention intention of newly graduated nurses or nurses who has less than three years’ clinical experience. 4. It will needed to conduct further research of various affecting factors on nurses' retention intention.

Nurses, Politics and Policy: Moving a Critical Initiative Forward through Education, Inspiration and Motivation for Political Activity

Clark, Elizabeth Maurine ProQuest Dissertations & Theses Yale University 2022 해외박사(DDOD)

Texas has the highest rate of uninsured and underserved residents in the United States. Texas also is one of the most restricted states for advanced practice registered nurses (APRN) to practice. As shown in other states, one means of obtaining full practice authority for APRNs is by gaining more of a nursing presence in the legislature. This project created a program to educate, motivate and inspire Texas nurses for political involvement. The project was completed in collaboration with the Texas Nurses Association. 78 nurses participated in surveys focusing on nurses’ attitudes and opinions, knowledge level, mental preparedness for political involvement and running for political office. Nurse participants expressed two types of interest in political activity – “Political Candidacy,” and “Political Involvement.” Findings revealed that only a small percentage of nurses wish to run for office, while a much larger group of nurses no not wish to run, but are strongly motivated and inspired to be involved on a local or state level, and to support nurse candidates.Of concern is the predominant sentiment among these nurses that they lack preparation and feel ill-prepared, intimidated and discriminated against when considering political involvement. Their most common stated barrier to political involvement was time constraints, followed by lack of education about politics and policy in nursing school. The majority were interested in further educational programs on preparing nurses for political involvement. This project highlights a need for expanded educational programs to prepare nurses on topics including legislation & regulation, election law, voting rights, campaign finance, and administrative law.

임상간호사의 임종간호수행에 미치는 영향요인 : 긍정심리자본, 임종간호스트레스, 환자-가족 중심 간호에 대한 인식

구연희 경상국립대학교 대학원 2023 국내석사

The purpose of this study was to examine the effects of clinical nurses’ positive psychological capital, terminal care stress and perception of patient-family centered care on performance of terminal care in order to improve their performance of terminal care. The subjects of this study were 198 nurses who had worked for more than 12 months of clinical experiences at an advanced general hospital in J city as well as had nursing experiences for dying patients at least once. Data were collected from August 9th to August 23rd, 2022. The collected data were analyzed using frequency percentage, mean, standard deviation, independent t-test, one-way ANOVA, Scheffés test, Pearson’s correlation coefficient, and stepwise multiple regression analysis by SPSS/WIN 25.0 program. The results of this study are summarized as follows. 1) The general characteristics of clinical nurses were as follows. The clinical nurses’ mean age was 29.08±4.63 years old and most of them were female (97.4%). The mean years of nursing experiences in the current department was 3.46±2.49 years. More than one third of nurses (32.1%) worked in the medical ward, followed by intensive care unit (24.4%), hemato-oncology (20.7%), surgical ward (18.7%), and hospice ward (4.1%). With regard to characteristics of terminal care performance, 123 nurses (63.7%) reported that they had experience of family members’ and acquaintances’ death. The average number of terminal care for dying patients within 1 year was 7.44±14.08. More than half of nurses (59.1%) had no experiences of terminal care education. Most nurses (63.2%) said that they had heard of patient-family-centered care. Majority of nurses (83.9%) had no experiences of patient-family centered care education. 2) According to the mean scores of each variable, positive psychological capital was 3.88±0.56 (range 1-6), terminal care stress was 3.67±0.55 (range 1-5), perception of patient-family centered nursing was 3.20±0.41 (range 1-4), and performance of terminal care was 2.38±0.35 (range 1-4). 3) There were significant differences between clinical nurses’ performance of terminal care and nursing experiences in current department (F=3.60, p=.015), work department (t=2.36, p=.019), number of terminal care provided to dying patients within 1 year (F=2.76, p=.044), and experience of patient-family centered care education (t=-2.26, p=.025). 4) There were significant positive relationships between clinical nurses’ performance of terminal care and positive psychological capital (r=.46, p<.001), and patient-family centered care (r=.36, p<.001). However, there was no significant correlation between clinical nurses’ performance of terminal care and terminal care stress (r=.03, p=.373). 5) The factors affecting clinical nurse’s performance of terminal care were positive psychological capital (β=.38, p<.001), perception of patient-family centered care (β=.23, p=.001), department (β=.15, p=.014), and experience of patient-family centered care education (β=.14, p=.026), explaining 30.4% of the variance. In conclusion, the factors affecting clinical nurses’ performance of terminal care were positive psychological capital, perception of patient-family centered care, work department, and experience of patient-family centered care education. Based on the results of this study, the effective education program is needed to enhance clinical nurses’ positive psychological capital as well as to increase their education experience and awareness of patient-family centered care in order to better perform terminal care.

Oncology Nurses’ Confidence in Providing Palliative Care

Parajuli, Jyotsana The Pennsylvania State University ProQuest Dissert 2019 해외박사(DDOD)

Background: The number of people with cancer continues to increase in the United States with the graying of baby boom generation resulting in an increased demand for cancer care. Patients with cancer suffer from complex health issues including high symptom burden, psychological distress, and diminished quality of life. Palliative care can help manage symptom burden and improve the quality of lives of patients with cancer and their families. Oncology nurses are consistent providers of care to patients with cancer throughout the illness trajectory. They play a crucial role in providing palliative care to patients with cancer. However, most often oncology nurses lack education and training in providing appropriate palliative care and feel stressed when providing palliative care. Little is known about the confidence of oncology nurses in delivering palliative care to patients with cancer.Purpose: The purpose of this study was to examine oncology nurses’ confidence in providing the eight domains of palliative care as posited by the National Consensus Project for Quality Palliative Care (NCP) guidelines. One of the main purposes of this study was also to validate the Palliative Care Nursing Self-Competence (PCNSC) Scale in oncology nurses’ population in the United States.Methods: A descriptive correlational design using an online survey methodology was employed. Registered nurses who provided care to patients with cancer were recruited from the Oncology Nursing Society (ONS) listserv. Participants completed an online survey that consisted of a demographic form, a confidence scale, and two open ended questions. Data were analyzed using descriptive and correlational statistics and multiple regression analysis. All data were analyzed using Statistical Package for Social Sciences, SPSS.Results: The results of this study revealed that most of the oncology nurses were somewhat confident to confident in providing palliative care. Results of correlational analysis and multiple regression analysis revealed that years of experience as an oncology nurse and palliative care training were associated with nurses’ confidence in providing palliative care to patients with cancer. The results of the confirmatory factor analysis revealed that the PCNSC scale retained the same 10 factor structure as the original PCNSC scale. In terms of meaning of the term “palliative care”, most participants regarded it as “symptom management” and oncology nurses needed to learn more about several areas of palliative care that were consistent with NCP’s 8 domains of palliative care which are structure and process of care, physical aspects of care, psychological and psychiatric aspects of care, social aspects of care, spiritual, religious, and existential aspects of care, care of the patients nearing the end of life, and ethical and legal aspects of care.Conclusions: To our knowledge this is the first nationally representative study that examined oncology nurses’ confidence in providing palliative care. The results of this study will help design interventions geared towards enhancing oncology nurses’ confidence in providing palliative care to patients with cancer and their families.

수술실 간호사가 인지하는 간호사 및 의사와의 협력이 간호업무성과에 미치는 영향

정미애 전북대학교 일반대학원 2017 국내석사

Purpose: The study was aimed to identify the effects of nurses' perceived nurses-nurses collaboration and nurses-physicians collaboration on nursing performance in perioperative nurses. Methods: A cross-sectional survey was used and data were collected with Nurse- nurse collaboration scale, Nurse-physician collaboration scales, and Performance measurement scale for hospital nurses in September 2016. Participants were 186 perioperative nurses in three advanced general hospitals and nine general hospitals. Data were analyzed with descriptive statistics, independent t-test, One-way ANOVA, Scheffé test, Pearson’s correlation coefficients and hierarchical multiple regression using the SPSS WIN 23.0 program. Results: The mean of nurse-nurse collaboration was 2.92±0.28 out of 4, nurse-physician collaboration was 3.29±0.65 out of 5, and nursing performance was 3.85±0.47 out of 5. There were statistically significant positive correlations among nurse-nurse collaboration, nurse-physician collaboration, and nursing performance. Hierarchical multiple regression analysis revealed that the nurse-nurse collaboration explained an additional 28.5%p of nursing performance. Shared processes, conflict management, and professionalism of nurse-nurse collaboration were statistically significant predictors of nursing performance. The nurse-physician collaboration explained an additional 2.9%p of nursing performance. Sharing of patient information was a statistically significant predictor of nursing performance. Conclusions: This study empirically shows that the nurse-nurse collaboration and nurse-physician collaboration significantly effect on nursing performance in perioperative nurses. Intervention programs that integrate and strengthen shared processes, conflict management, professionalism, and sharing of patient information may be useful to enhance nursing performance. Further research is required to identify other factors related to the nurses’ collaboration and nursing performance. These findings can be used to develop effective strategies for nursing educators, nursing researchers, professional nurses, and nursing administrators to improve nursing performance.

정신 간호사의 성장 경험에대한 현상학적 연구

이진아 조선대학교 일반대학원 2018 국내박사

성인중환자실 간호사의 소음관리 수행도에 영향을 미치는 요인

김서정 경상국립대학교 대학원 2022 국내석사

The purpose of this study was to examine the relationships between nurses’ performance of noise management, noise experience, noise-related knowledge, response to noise, and patient safety culture and to identify factors affecting nurses’ performance of noise management in adult intensive care units. The subjects of this study were 148 nurse in adult intensive care unit with over 3 months of clinical experience working at advanced general hospitals in J and C cities. Data were collected from April 1st to 20th, 2022. The collected data were analyzed using frequency, percentage, mean, standard deviation, Independent t-test, one-way ANOVA, Scheffe's test, Pearson's correlation coefficient, and hierarchical multiple regression analysis by SPSS/WIN 25.0 program. The results of this study are summarized as follows. 1) The general characteristics of nurses in adult intensive care units were as follows. The nurses’ mean age was 28.36±4.29 years old and most of them was general nurses (96.6%). The mean years of nurses’ nursing experience was 5.52±4.34 years and the mean years of working experience in the intensive care unit was 4.23±2.30 years. Regarding noise-related characteristics, 35 nurses (23.6%) reported that the unit applied ‘quiet time’ and ‘quiet time’ was applied between midnight and 8 am. However, 113 nurses (76.4%) reported that the unit did not apply ‘quiet time.’ 147 nurses (99.3%) reported that they had no experience of receiving education on noise management. 112 nurses (75.5%) reported that the education on noise management is needed. 2) The mean score of noise experience frequency was 3.05±0.62 (range 1-4). The mean scores of its subcategories were: 3.41±0.62 of medical device factors, 2.99±0.63 of human factors, 2.96±0.84 of environmental factors. The mean score of perceived noise levels was 4.69±1.51 (range 0-10). The mean scores of its subcategories were: 5.93±1.84 of medical device factors, 4.50±1.51 of human factors, 4.05±1.90 of environmental factor. The total score of noise-related knowledge was 28.91±9.98 (range 0-54) and the percentage of correct answer was 54%, which was generally low. The mean score of response to noise was 4.89±2.32 (range 0-10). The mean scores of its subcategories were: 4.22±2.29 of physiological response and 5.42±2.55 of emotional response. The mean score of patient safety culture was 3.52±0.49 (range 1-5). The mean scores of its subcategories were: 3.86±0.66 of patient safety knowledge and attitude, 3.72±0.63 of teamwork, 3.62±0.71 of leadership, 3.53±0.72 of patient safety policy and procedure, 3.30 ±0.74 of patient safety improvement system, 3.26±0.83 of non-punitive environment, and 2.86±0.70 of patient safety priority. The mean score of performance of noise management performance was 3.45±0.64 (range 1-5). 3) There was a significant difference between the necessity of noise management education in nurses’ performance of noise management (t=2.66, p=.009). 4) There were significant positive relationships between nurses’ performance of noise management and noise experience frequency (r=.20, p=.013), noise-related knowledge (r=.21, p=.009), response to noise (r=.23, p=.005) as well as patient safety culture (r=.50, p<.001). 5) The factors affecting nurses’ performance of noise management in adult intensive care units were noise experience frequency (β=.16 p<.030), teamwork of patient safety culture (β=.33, p=.006) and patient safety policy and procedure of patient safety culture (β=.25, p=.037) explaining 37.9% of the variance. In conclusion, the factors affecting nurse’ performance of noise management in the adult intensive care unit were noise experience frequency, teamwork of patient safety culture, and patient safety policies and procedures of patient safety culture. Based on these results, we suggest that the a noise reduction intervention program should be developed using teamwork reinforcement and team approach to improve performance of noise management for nurses in adult intensive care units. Also, in addition to nurses’ personal efforts for noise management, organizational efforts and strategies are needed by establishing patient safety policies and procedures related to hospital noise at the hospital level.

제주지역 병원간호사의 직무만족도에 관한 연구

김진심 제주대학교 행정대학원 2017 국내석사

병원조직이 소비자 중심으로 변화되면서 그들의 건강관련 욕구를 만족시켜주기 위해 최일선에서 간호서비스를 제공하게 되는 간호 인력의 관리는 매우 중요하게 대두되고 있다. 간호사의 직무만족을 높이기 위한 전략을 수립할 필요가 있으며, 이를 위해서는 이들의 직무만족에 영향을 주는 요인들을 파악할 필요가 있다. 본 연구에서는 제주지역 종합병원 간호사를 대상으로 직무만족도, 요인인 일반적 특성요인과 근무환경요인이 직무만족도에 미치는 영향을 분석하여 간호사의 이직률을 낮추기 위한 조직운영에의 정책적 함의를 탐색하고자 한다. 연구대상은 제주시에 소재하고 있는 3개의 종합병원과 서귀포시에 소재하고 있는 1개의 종합병원 간호사들을 대상으로 하여 직접 방문하여 간호부의 협조를 얻어 설문조사를 실시하였다. 설문조사는 2017년 5월 26부터 6월 2일까지 실시하였고, 배부된 총 200부의 설문지 중 설문내용이 불성실하고 일관성 없는 응답이라고 판단된 자료 7부를 제외하고 193부를 분석에 사용하였으며, 수집된 자료는 SPSS(Statistical Package for the Social Science) WIN 18.0 프로그램을 이용하여 분석하였다. 본 연구의 결과는 다음과 같다. 첫째, 대상자의 일반적 특징을 살펴 볼 경우, 성별로는 여성이 95.9%로 대부분을 차지하였고 연령은 29세 이하(47.2%), 결혼유무로는 미혼(52.3%), 교육정도는 4년제 및 학사학위(69.4%)로 가장 높았다. 둘째, 간호사의 업무관련 특성을 살펴보면, 총 근무경력으로는 10년 이하 55.4%, 현 병원 부서 10년 이상이 29.0%, 직위는 일반간호사 79.2%, 근무부서는 일반병동61.7%로 가장 많았고, 평균 급여수준은 201만원-300만원 이하가 60.6%로 가장 많았다. 셋째, 병원간호사의 만족도를 보면 대인관계 항목의 ‘업무가 매우 바쁠 때는 다른 간호사들과 서로 도우며 일한다.’가 3.93으로 가장 높은 점수를 보이며, 전문성 항목(3.81)과 인정과 신뢰 항목이 각각 3.40,3.31로 높은 점수를 보이고 있다. 또한, 영역별 간호사의 만족도를 보면 전문성이 3.51점, 인정과 신뢰3.35점, 대인관계3.25점 순으로 나타났다. 넷째, 병원간호사들의 일반적 특성에 따른 만족도의 차이를 검증한 결과 연령(F=3.316, p=0.021), 총 근무경력(F=11.746, p=0.000), 월 평균 급여수준(F=2.364, p=0.073)에서 통계적으로 유의한 차이가 있었다. 즉 연령이 많고 근무경력이 높을수록, 급여수준이 높을수록 전반적인 만족도가 높았다. 다섯째, 병원간호사들의 연령에 따른 만족도 관련 요인의 만족도 평균을 비교해 본 결과, 보수 및 승진 요인, 전문성 요인, 조직운영 요인, 인정과 신뢰 요인에서 유의한 차이가 있었으며, 가장 만족도가 높은 요인은 전문성 요인이었고, 보수 및 승진 요인과 근무형태 요인은 만족도가 가장 낮은 것으로 나타났다. 여섯째, 병원간호사들의 총 근무경력에 따른 직무만족도 관련 요인의 만족도 평균을 비교해 본 결과, 보수 및 승진 요인, 전문성 요인, 대인관계 요인, 조직운영 요인, 인정과 신뢰 요인에서 유의한 차이가 있었으며, 근무형태 요인은 유의한 차이가 없었다. 일곱째, 병원간호사들의 월평균 급여수준에 따른 직무만족도 관련 요인의 만족도 평균을 비교해 본 결과, 보수 및 승진 요인, 전문성 요인, 조직운영 요인, 인정과 신뢰 요인에서 유의한 차이가 있었으며, 대인관계 요인과 근무형태 요인은 유의한 차이가 없었다. 여덟째, 직무만족도에 영향을 미치는 근무환경 요인 개별 독립변수의 종속변수에 대한 기여도와 통계적 유의성을 검정한 결과, 유의수준 0.01에서 모든 독립변수가 만족도에 유의하게 영향을 미치는 것으로 나타났다. 즉 병원간호사들이 근무환경 요인인 보수 및 승진, 전문성 수준, 대인관계, 조직운영, 근무형태, 인정과 신뢰 요인 모두 간호사의 직무만족도에 영향을 미치는 것으로 나타났다. 본 연구의 결과를 바탕으로 간호사의 직무만족을 제고시키기 위한 방안을 제언하면 다음과 같다. 첫째, 본 연구에서 제시된 간호사의 직무만족에 영향을 미치는 요인에 대한 후속연구와 간호사의 직무만족에 영향을 미치는 다른 요인들을 규명하는 연구가 필요하다. 둘째, 근무형태에 대한 부담감을 최대한 줄이고 대인관계를 높이기 위한 조직적 차원의 다양한 프로그램과 개발 및 적용을 위한 구체적인 전략방안을 마련 할 필요가 있다. 셋째, 연구의 일반화를 위해 다양한 병원을 대상으로, 더 많은 수의 간호사를 대상으로 연구할 필요가 있다. 넷째, 환자와 지속적으로 대면하며 직접적인 간호를 제공하고 환자의 만족에 기여하는 비중이 높은 만큼 간호사의 자기만족과 직무만족도를 고려하기 위하여 병원차원의 동기부여 방안의 마련이 필요할 것으로 생각된다. As hospital organizations are becoming consumer-centered, it has been very important to manage the nursing staff who provide nursing services directly to patients to satisfy their health-related desires. It is necessary to establish strategies to improve the nurses' occupational satisfaction, and it is important to identify the factors that affect their occupational satisfaction in order to do so. This study analyzed the occupational satisfaction of nurses working for general hospitals in Jeju and the influence of demographical factors and work environment factors on occupational satisfaction to seek the implications for the operation of organizations to reduce the transfer rate of nurses. The subjects of this study were the nurses working for three general hospitals in Jeju City and one general hospital in Seogwipo City. We visited them to seek their cooperation for a survey. The survey took place from May 26, 2017 through June 2 and among the 200 copies of survey forms distributed, 193 copies were analyzed excluding seven copies that were considered incomplete and inconsistent. The collected data were analyzed using the SPSS (Statistical Package for the Social Science) WIN 18.0 program. The following are the findings of this study: First, considering the demographics of the subjects, women took 95.9% in terms of sex and the largest groups were under 29 years of age (47.2%), unmarried (52.3%), and holding a 4-year degree or a bachelor's degree (69.4%). Second, considering the occupational characteristics of the nurses, 55.4% had less than 10 years of experience, 29.0% had served in the current hospital for more than 10 years, 79.2% were ordinary nurses, and 61.7% were working in ordinary hospital units. The average salary was 2,010,000-3,000,000 KRW for 60.6%. Third, considering the satisfaction of hospital nurses, 'I cooperate with other nurses when I am busy' earned the highest points of 3.93 in the interpersonal relationship section, while specialization (3.81) and recognition and trust earned high points of 3.40 and 3.31, respectively. Also, considering the satisfaction of nurses in each area, specialization earned 3.51 points, recognition and trust earned 3.35 points, and interpersonal relations earned 3.25 points. Fourth, as a result of discussing the difference in satisfaction according to the hospital nurses' demographics, there were statistically significant differences according to age (F=3.316, p=0.021), total length of experience (F=11.746, p=0.000), and average monthly salary (F=2.364, p=0.073). In other words, overall satisfaction was higher with older age, longer experience, and higher salary. Fifth, as a result of comparing the average of satisfaction in terms of the satisfaction factors according to the age of hospital nurses, there were significant differences in terms of compensation and promotion factors, specialization factors, operation of organization factors, and recognition and trust factors. The most satisfactory factors were specialization factors, while the least satisfactory factors were compensation and promotion factors and service type factors. Sixth, as a result of comparing the average of satisfaction in terms of the satisfaction factors according to the total length of experience of hospital nurses, there were significant differences in terms of compensation and promotion factors, specialization factors, interpersonal relation factors, operation of organization factors, and recognition and trust factors and no significant difference in terms of service type factors. Seventh, as a result of comparing the average of satisfaction in terms of the satisfaction factors according to the average salaries of hospital nurses, there were significant differences in terms of compensation and promotion factors, specialization factors, operation of organization factors, and recognition and trust factors and no significant differences in terms of interpersonal relation factors and service type factors. Eighth, as a result of analyzing the contribution and statistical significance of individual independent variables of work environment factors that affect occupational satisfaction to the dependent variables, it was found that all independent variables have a significant influence on satisfaction with the significance level of 0.01. In other words, all of the hospital nurses' work environment factors had an influence on their occupational satisfaction, including compensation and promotion, specialization, interpersonal relations, operation of organization, service type, and recognition and trust. Based on the findings of this study, the following suggestions were made to improve the nurses' occupational satisfaction: First, it is necessary to further study the factors that influence the nurses' occupational satisfaction suggested in this study and clarify other factors that influence the nurses' occupational satisfaction. Second, it is necessary to develop various programs to reduce the burden of service type and improve interpersonal relations within each organization and the specific strategies to apply them. Third, it is necessary for each hospital to develop ways to motivate the nurses for their self-complacency and occupational satisfaction as they provide direct services to patients and contribute to the patients' satisfaction.

암성통증관리에 대한 암 환자와 간호사의 인식비교

최은하 전북대학교 일반대학원 2013 국내석사

Purpose : This is a research study which compares awareness on strength of cancer pain, degree of pain control, satisfaction of pain control and barriers between cancer patients and their nurses. Method: The subject of this research is 75 patients who entered hemato-oncology of some university hospital during the period of this research and 53 nurses working in medical ward hemato-oncology patients mainly enter and nurses working in palliative care ward. And, data was collected by questionnaires and medical record and the period of this research was Aug. 08 to Sep. 15, 2013. Result: 1. For the pain intensity and degree of pain control, which were recognized by cancer patients and nurses, all of average pain, the most severe pain and pain after treatment were significantly higher in cancer patients than nurses(p<.001). For the degree of pain control, the score was significantly higher in patients than nurses(p<.001). 2. Satisfaction of pain control was compared and analyzed between cancer patients and nurses. As the result, differences between cancer patients and nurses showed significantly higher satisfaction in patients than nurses(p<.001). 3. Awareness on the degree of barriers of pain control recognized by cancer patients and nurses was compared and analyzed between patients and nurses. As the result, for the difference of awareness on the degree of barriers of nurse factor(p<.001), patient factor and social system factor(p<.001) between patients and nurses, the degree of barriers of nurse factor and social system factor was significantly higher in nurses than patients(p<.001). Conclusion: In consideration of the above results, it's necessary to make an effort to evaluate the pain accurately so as to minimize difference of the awareness on pain intensity between cancer patients and nurses the mostly. And, it's necessary to manage pain management education program which emphasizes changes and importance of the awareness on pain control based on the results of pain control barriers and pain control satisfaction so as to improve pain control satisfaction through the proper pain control.