병원간호사의 직업존중감과 건강증진행위가 직무열의에 미치는 영향

Abstract

본 연구는 제주지역 종합병원과 대학병원에 근무하는 간호사의 직업 존중감과 건강증진행위가 직무열의에 미치는 영향을 확인하기 위하여 시도한 서술적 조사 연구이다. 연구 대상은 제주지역 종합병원과 대학병원에 근무하는 간호사 179명을 대상으 로 하였으며, 관련 자료는 2022년 8월 22일부터 9월 15일까지 수집되었다. 직업 존중감 측정 도구로는 최현주(2018)가 개발한 Job-Esteem Scale for Hospital Nurse (JES-HN), 건강증진행위는 김민영, 최순옥과 김은하(2020)가 개발한 Nurse’s Health Promotion Behavior Scale 도구, 직무열의는 Schaufeli와 Bakker(2004)가 개발한 Utrecht Work Engagement Scale (UWES)를 이랑(2006) 이 번안한 도구를 사용하였다. 수집된 자료는 IBM SPSS Win 23 프로그램을 이용하여 분석하였다. 본 연구에 사용된 조사 도구의 신뢰도 검증을 위해 Cronbach’s α 계수를 분석하였다. 대상 자의 일반적 특성과 대상자의 직업존중감, 건강증진행위, 직무열의 차이를 파악하 기 위해 빈도, 백분율, 평균, 표준편차, independent t-test, one-way ANOVA를 실 시하였다. 사후 검증은 Scheffé test를 실시하여 분석하였다. Pearson’s correlation coefficient를 이용하여 상관관계 분석하였고, 직무열의에 대한 영향요인을 위계적 회귀분석을 통해 유의성 검증하였다. 병원간호사가 인식하는 직업존중감 수준은 5점 만점에 평균 3.86점으로 나타났다. 일반적 특성에 따른 직업존중감은 결혼상태, 건강 상태, 총 임상 경력, 근무부서에 따라 유의한 차이를 나타냈다. 즉 결혼(3.95점)이 미혼(3.80점)보다 유의하게 높게 나타났다(t=-2.442, p=.016). 건강 상태는 좋음(4.02), 보통(3.80), 나쁨(3.80)으로 유 의한 차이를 보였고(F=5.459, p=.005), 총근무경력은 20년 이상(4.08)이 가장 높고, 3년 이하(3.95), 3년 이상-20년 이하(3.78)보다 높아 유의한 차이를 보였다 (F=5.217, p=.002). 근무부서는 특수부서(3.99)가 가장 높았고, 기타부서(3.90), 외과 계 병동(3.75), 내과계 병동(3.74)으로 유의한 차이를 보였다(F=4.674, p=004). 병원간호사가 인식하는 건강증진행위 수준은 5점 만점에 평균 3.54점으로 나타났 다. 일반적 특성에 따른 건강증진행위는 성별, 나이, 결혼상태, 건강 상태, 총 임상 경력, 근무부서에 따라 유의한 차이를 보였다. 즉, 남자(3.98)가 여자(3.52)보다 평 균이 높았고, 유의하였다(t=2.711, p=.007). 40대 이상(3.70)이 20대(3.47), 30대(3.51) 보다 평균이 높았고, 유의하였다(F=3.378, P=.036). 건강 상태 좋음(3.77)이 보통 (3.49), 나쁨(3.32)보다 높았고, 유의하였다(F=9.502, p<.001). 총 임상 경력은 20년 이상(3.76)이 3년 이하(3.52), 3년 이상~10년 이하(3.44), 10년 이상~20년 이하(3.57) 보다 평균이 높고, 유의하였다(F=3.053, p=.030). 근무부서는 외과계 병동(3.78)이 특수부서(3.71), 기타부서(3.60), 내과계 병동(3.46)보다 평균이 높고, 유의하였다 (F=4.775, p=.003). 병원간호사가 인식하는 직무열의 수준은 5점 만점에 평균 3.14로 나타났다. 일반적 특성에 따른 직무열의는 나이, 결혼상태, 종교, 건강 상태, 총 임상 경력, 근무부서, 직위, 근무 형태에 따라 유의한 차이를 보였다. 즉, 40대(3.48)가 30대(3.05), 20대 (3.00)보다 평균이 높고, 직무열의에 유의한 차이가 있었다(F=11.853, P<.001). 종 교 있음(3.34)이 종교 없음(3.08)보다 높았고, 유의했다(t=2.569, p=.011). 건강 상태 좋음(3.39)이 나쁨(3.06), 보통(3.04)보다 높고, 유의했다(F=6.679, p=.002). 총 임상 경력은 20년 이상(3.61)이 3년 미만(3.17), 3년 이상-10년 미만(2.96), 10년 이상~20 년 미만(3.10)보다 높고, 유의했다(F=10.312, p<.001). 근무부서는 기타부서(3.35)가 특수부서(3.31), 외과계 병동(2.99), 내과계 병동(2.88)보다 평균이 높고, 유의했다 (F=6.889, p<.001). 근무 형태는 기타 형태(3.59)가 상근(3.36), 3교대(3.04)보다 높았 고, 유의하였다(F=8.245, p<.001). 직업존중감, 건강증진행위, 직무열의 간의 상관관계를 분석한 결과, 직무열의는 직업존중감(r=.652, p<.001), 건강증진행위(r=.594, p<.001)와 양의 상관관계를 보이 며 통계적으로 유의하게 나타났다. 회귀분석 결과, [Model 1]에서 종교(β=.155, p=.038), 근무형태(β=-.294, p=.048)으로 나타났으며, 이 모형은 18.0%의 설명력이 있었고, 통계적으로 유의 한 것으로 나타났다(F=4.253, p<.001). [Model 2]에서는 일반적 특성을 통제한 후 직업존중감, 건강증진행위를 추가로 투 입한 결과 직무열의에 유의한 영향을 주는 요인은 직업존중감(β=.455, p<.001), 건 강증진행위(β=.201, p=015)의 순으로 나타났다. [Model 2]의 설명력은 50.6%로 [Model 1]에 비해 32.6%의 설명력이 향상하였고, 이 모형은 통계적으로 유의했다 (F=14.013, p<.001). 결과적으로 직업존중감이 증가할수록 직무열의가 증가하고, 건 강증진행위가 증가할수록 직무열의가 증가함을 알 수 있다. 본 연구 결과 병원 간호사의 직업존중감과 건강증진행위는 직무열의에 영향을 미치 는 것으로 확인하였다. 따라서 간호단위 관리자와 병원조직은 병원 간호사들이 직무 열의를 향상할 수 있도록 더욱 관심을 가져 노력하고 프로그램 개발 및 지원이 필요 하다.|This study is descriptive research attempting to confirm the influence of job esteem and health promotion behavior on the job engagement of nurses working at general hospitals and university hospitals in Jeju. The study subjects were 179 nurses working at general hospitals and university hospitals in Jeju. Relevant data were collected from August 22 to September 15, 2022. Job-Esteem Scale for Hospital Nurses (JES-HN), developed by Choi Hyun-joo (2018), was used to measure job esteem. Nurse's Health Promotion Behavior Scale tool developed by Kim Min-young, Choi Soon-ok, and Kim Eun-ha (2020) was used to measure health promotion behavior. For the measurement of job engagment, a tool adapted from the Utrecht Work Engagement Scale (UWES) developed by Schaufeli and Bakker (2004) by Lee Rang (2006) was used. The collected data were analyzed using the IBM SPSS Win 23 program. Cronbach's α coefficient was analyzed to verify the reliability of the survey tool used in this study. An independent t-test and a one-way ANOVA were conducted to identify the differences in the subjects’ general characteristics and the differences between their job esteem, health promotion behavior, and job engagement. The post-hoc verification was analyzed through a Scheffé test. The correlation was analyzed using Pearson's correlation coefficient, and factors influencing job engagement were verified through hierarchical regression analysis. The level of job esteem perceived by hospital nurses was an average of 3.86 points out of 5 points. Job esteem according to general characteristics showed significant differences depending on the subject’s marital status, health status, total work experience, and department. In short, those who were married (3.95 points) showed significantly higher scores than those who were not (3.80 points) (t=-2.442, p=.016). Differences in health status showed different results as the following: Good (4.02), average (3.80), and poor (3.80) (F=5.459, p=.005). By total work experience, the scores were highest in 20 years or more (4.08), followed by less than 3 years (3.95), and 3 to 20 years (3.78), showing significant differences (F=5.217, p=.002). As for the department, the special department scored the highest rate (3.99), followed by other departments (3.90), the surgical ward (3.75), and the internal medicine ward (3.74), showing significant differences (F=4.674, p=004). The level of health promotion behavior recognized by hospital nurses was an average of 3.54 points out of 5 points. Health promotion behaviors according to general characteristics showed significant differences depending on the subject’s gender, age, marital status, health status, total clinical experience, and department. In summary, males (3.98) showed a higher average than females (3.52), and the difference was significant (t=2.711, p=.007). Those in their 40s or older (3.70) showed a higher average than those in their 20s (3.47) and 30s (3.51). The differences were significant (F=3.378, P=.036). For health status, those who answered that they were Good (3.77) were higher than those whose answers were average (3.49) and poor (3.32). The differences were significant as well (F=9.502, p<.001). For total clinical experience, the mean of those who worked for 20 years or more (3.76) was the highest, followed by means of those who worked for 3 years or less (3.52), 3 to 10 years (3.44), or 10 to 20 years (3.57). The differences were significant (F=3.053, p=.030). As for the working department, those who worked in the surgery ward (3.78) showed the highest average than those who worked in the special department (3.71), other departments (3.60), and internal medicine ward (3.46). The differences were significant (F=4.775, p=.003). The level of job engagement perceived by hospital nurses was 3.14 on average out of 5 points. Job engagement according to general characteristics showed significant differences depending on the subjects’ age, marital status, religion, health status, total clinical experience, department, position, and type of work. In short, those in their 40s (3.48) showed the highest average than those in their 30s (3.05) and 20s (3.00), with significant differences in their job engagement (F=11.853, P<.001). Those who were religious scored higher rates (3.34) than those who had no religion (3.08). The difference was significant (t=2.569, p=.011). Those who answered that they were in good health showed the highest rates (3.39) than those whose answers were poor (3.06) and average (3.04), with differences being significant (F=6.679, p=.002). For total clinical experience, those who worked for more than 20 years (3.61) showed the highest average rates, followed by those who worked for less than 3 years (3.17), 3 to 10 years (2.96), and 10 to 20 years (3.10), with significant differences (F=10.312, p<.001). By department, the mean scores of those who worked in other departments (3.35) were the highest, followed by those who worked in special departments (3.31), surgical wards (2.99), and internal medicine wards (2.88), with differences being significant as well (F=6.889, p<.001). By the type of work, those who worked in other types (3.59) showed the highest rates, followed by those who worked full-time (3.36) and three shifts (3.04). The differences were significant (F=8.245, p<.001). As a result of the analysis of the correlation between job esteem, health promotion behavior, and job engagement, it was found that job engagement was positively correlated with job esteem (r=.652, p<.001) and health promotion behavior (r=.594, p<.001). The result was statistically significant. As a result of regression analysis, [Model 1] showed religion (β =.155, p=.038) and work type (β=-.294, p=.048), and this model had 18.0% explanatory power and was statistically significant (F=4.253, p<.001). In [Model 2], as a result of additionally inputting job-esteem and health-promoting behavior after controlling general characteristics, the factors having a significant effect on job engagement were in the order of job-esteem (β =.455, p<.001) and health-promoting behavior (β =.201, p=015). The explanatory power of [Model 2] was 50.6%, which was 32.6% higher than [Model 1], and this model was statistically significant (F=14.013, p<.001). As a result, as job esteem increases, job engagement increases, and as health promotion behavior increases, job engagement increases. As a result of this study, it was confirmed that job esteem and health promotion behavior of hospital nurses affect job engagement. Therefore, nursing unit managers and hospital organizations need to pay more attention to hospital nurses so that they can improve their job engagement and develop and support programs. As a result of the study, it was confirmed that hospital nurses' job esteem and health promotion behavior influenced job engagement. Therefore, nursing unit managers and hospital organizations need to pay more attention to and develop programs and support so that hospital nurses would improve their job engagement.