폭력 예방 및 대처프로그램이 간호사의 폭력 경험 및 폭력 반응, 자기효능감과 조직몰입에 미치는 영향

Abstract

The purpose of this study was to implement an hospital-based violence-preventing and coping program for nurses and to assess effectiveness of the program on violence experiences and responses, self-efficacy, and organizational commitment. A non-equivalent control group pretest-posttest design was used with 53 participants assigned to either an experimental (n=27 in A hospital) or a control group (n=26 in B hospital) in 2 general hospitals of a city. The program was developed with analysis of needs for developing the program, literature reviews, and reviews of the developed contents of program using experts. The program included the following contents: understanding violence, preventing and coping with violence, guidelines and protocols for coping with violence, reporting and recording violent events, guidelines for legal action against violence, hospital policy-related violence-preventing and coping, writing scenarios on violence in hospital, and role play. The program demonstration was conducted for six weeks with 6 sessions. The experimental group participated in the program weekly, whereas the control group was waiting group. Data were collected before and immediately after the intervention and 4 weeks after the intervention from September 5 to November 6, 2019. The data were analyzed using descriptive statistics, χ²-test, Fisher's exact test, independent samples t-test, repeated measured ANOVA, and repeated measured ANCOVA, with SPSS WIN 23.0. The study obtained the following results. 1) No statistically significant differences were showed in experiences of violence between the experimental and control groups (F=1.20, p=.279) and also by time within group (F=1.44, p=.235) and group-time interaction (F=0.84, p =.773). 2) No statistically significant differences were observed in the response to violence between the experimental and control groups (F=0.03, p=.866) and also by time within group (F=0.23, p=.796). However, there was a statistically significant difference by group-time interaction (F=3.67, p=.029). • The study found no statistically significant differences in the emotional responses to violence between the two groups (F=0.68, p=.414) and by group-time interaction (F=0.47, p=.497), but there was a statistically significant difference by time within group (F=18.64, p<.001). • The study found no statistically significant differences in the physical responses to violence between the two groups (F=1.10, p=.300) and by time within group (F=0.09, p=.913), but there was a statistically significant difference by group-time interaction (F=3.44, p=.036). • There were no statistically significant differences in the social responses to violence between the two groups (F=0.25, p=.622) and also by time within group (F=0.66, p=.517) and group-time interaction (F=0.90, p=.411). 3) Scores for self-efficacy was significantly higher in the experimental group than in the control group. The difference was significant between the two groups (F=7.90, p=.007) and also by time within group (F=4.13, p=.047) and group-time interaction (F=10.81, p=.002). 4) Scores for organizational commitment was significantly higher in the experimental group than in the control group. The difference was significant between the two groups (F=25.95, p<.001), and also time within group (F=6.88, p =.002) and group-time interaction (F=6.01, p=.003). The following are the suggestions from this study based on the results: First, hospitals need to develop and apply violence-preventing and coping programs for nurses with experiencing violence. Second, further research is needed to assess the effects of violencepreventing on and coping programs by applying more rigorous research designs and methods, such as randomization. Third, future studies should examine the effects of violence-preventing and coping programs on violence experiences and physical and social responses to violence using long-term measurement. Key words: Violence, Hospital, Violence-preventing and coping program, Nurses, Violence experiences, Violence responses, Self-efficacy, Organizational commitment