본 연구는 병동 및 응급실 간호사를 대상으로 극복력, 간호근무환경, 소진이 이직의도에 미치는 영향을 알아보기 위한 서술적 조사연구이다.

본 연구 자료는 G 도에 소재하는 4개 종합병원 간호사를 대상으로 설문조사를 실시하였다. 자료수집은 2019년 6월 15일부터 2020년 4월 15일까지 구조화된 설문지를 이용하여 시행되었고, 수집된 자료 중 총 237부의 자료가 SPSS 26.0으로 분석되었다.

본 연구의 결과는 다음과 같다.

1. 연구 대상자의 극복력은 5점 만점에서 병동 간호사는 총점 평균 3.60±0.46점, 응급실 간호사는 총점 평균 3.62±0.42점으로 통계적으로 유의한 차이가 없었다(t=-0.31, p=.761). 극복력의 패턴별 점수에서 병동 간호사는 전문가적 패턴이 3.82±0.51점으로 가장 높았고 철학적 패턴이 3.45±0.55점으로 가장 낮았고, 응급실 간호사는 전문가적 패턴이 3.83±0.44점으로 가장 높았고, 철학적 패턴이 3.36±0.57점으로 가장 낮았다.

2. 연구 대상자의 간호근무환경은 4점 만점에서 병동 간호사는 총점 평균 2.54±0.39점, 응급실 간호사 2.48±0.45점으로 두 집단 간에 통계적으로 유의한 차이가 없었다(t=0.99, p=.325). 병동 간호사와 응급실 간호사의 간호근무환경 하위영역별 정도 비교에서 간호사와 의사의 협력관계가 병동 간호사 2.54±0.59점, 응급실 간호사 2.77±0.48점으로 통계적으로 유의한 차이가 있었고(t=-3.17, p=.002), 양질의 간호를 위한 기반에서 병동 간호사 2.72±0.41점, 응급실 간호사 2.59±0.48점으로 나타났고, 통계적으로 유의한 차이가 있었다(t=2.26 p=.025). 간호근무환경의 하위영역별 점수에서 병동 간호사는 간호 관리자 능력, 리더십, 간호사에 대한 지지가 2.84±0.46점으로 가장 높았고, 충분한 인력과 물질적 지원이 1.96±0.53점으로 가장 낮았다. 간호근무환경의 하위영역별 점수에서 응급실 간호사는 간호사와 의사의 협력관계가 2.77±0.48점으로 가장 높았고, 충분한 인력과 물질적 지원이 2.00±0.59점으로 가장 낮았다.

3. 연구 대상자의 소진은 5점 만점에서 병동 간호사는 2.87±0.44점, 응급실 간호사 2.89±0.49점으로 두 집단 간의 통계적으로 유의한 차이는 없었다(t=-0.29, p=.776).

4. 연구 대상자의 이직의도는 5점 만점에서 병동 간호사는 3.11±0.77점, 응급실 간호사 3.45±0.98점으로 두 집단 간의 통계적으로 유의한 차이가 있었다(t=-3.00, p=.003).

5. 일반적 특성에 따른 이직의도의 차이에서 병동 간호사는 연령(F=6.02, p=.003) 연봉(F=4.34, p=.006), 연장근무시간(F=4.70, p=.011) 따라 유의한 차이가 있었다. 응급실 간호사는 연령(F=3.98, p=.022), 경력(F=3.10, p=.019) 따라 통계적으로 유의한 차이가 있었다.

6. 병동 간호사의 극복력, 간호근무환경 및 소진과 이직의도와의 상관관계는 이직의도와 소진(r=.52, p<.001)이 유의한 양의 상관관계가 있었고, 이직의도와 간호근무환경(r=-.44, p<.001), 극복력(r=-.21, p=.012)은 유의한 음의 상관관계가 있었다. 응급실 간호사의 극복력, 간호근무환경 및 소진과 이직의도와의 상관관계는 이직의도와 소진(r=.57, p<.001)이 유의한 양의 상관관계가 있었고, 이직의도와 간호근무환경(r=-.39, p<.001)은 유의한 음의 상관관계가 있었고, 극복력(r=-.14, p<.172)은 통계적으로 유의하지 않았다.

7. 병동 간호사와 응급실 간호사의 이직의도에 미치는 영향 요인을 위계적 회귀 분석으로 시행한 결과 병동 간호사의 영향요인은 소진(β=.39, p<.001), 간호근무환경(β=-.29, p<.001)으로 나타났고, 이직의도에 대한 설명력은 37.5%였다. 응급실 간호사의 영향요인은 소진(β=.45, p<.001), 현 부서 경력 7년이상(β=.36, p=.006), 3년이상∼5년미만(β=.34, p=.006), 1년이상∼3년미만(β=.31, p=.016), 5년이상∼7년미만(β=.30, p=.010), 연령 40세이상(β=-.24, p=.010)으로 나타났고, 이직의도에 대한 설명력은 40.3%로 나타났다.

이상의 연구 결과를 종합해 볼 때, 이직의도에 미치는 영향요인으로 병동 간호사는 소진, 간호근무환경이었고, 응급실 간호사는 소진, 현 부서 경력, 연령이었다. 이로 볼 때, 병동 간호사와 응급실 간호사의 이직의도를 감소시키기 위하여 소진을 지속적으로 관리하고, 소진을 예방하기 위한 중재 프로그램의 도입이 필요하다. 또한 병동 간호사의 이직의도를 낮추기 위해서는 충분한 인력 충원과 물질적 지원을 통하여 간호근무환경 개선이 필요하다. 응급실 간호사는 1년이상의 경력직 간호사를 대상으로 이직의도를 감소시키기 위한 실제적인 원인을 파악하여 이를 개선하도록 하며, 조직 내에서 업무에 따른 적절한 보상이 필요하다.

Abstract

Effect of Resilience, Practice Environment of Nursing and Burnout on Turnover Intention between Ward Nurses and Emergency Room Nurses


General Graduate School of Catholic Kwandong University
Kim Ji-yeon
Department of Nursing Science
(Supervised by professor Ji Eun Joo)

This study investigated the effects of resilience, practice environment of nursing and burnout on turnover intention among ward nurses and emergency room nurses, in order to provide the basic data for the efficient strategy to manage nursing personnel in the future.
For the research data, a questionnaire survey was conducted on nurses working in 4 general hospitals located in G Province. Data collection was performed between June 15, 2019 and April 15, 2020 using a structured questionnaire, and among the collected questionnaires, a total of 237 responses were analyzed with SPSS 26.0.

The results of this study are as follows.

1. As for resilience of the research participants, the mean score of ward nurses was 3.60±0.46 out of 5.0 while that of emergency room nurses was 3.62±0.42, which showed no statistically significant difference (t=-0.31, p=.761). In the scores for each pattern of resilience, ward nurses showed 3.82±0.51 for the specialist pattern as the highest score and 3.45±0.55 for the philosophical pattern as the lowest while emergency room nurses showed 3.83±0.44 for the specialist pattern as the highest score and 3.36±0.57 for the philosophical pattern as the lowest.

2. As for the mean score for practice environment of nursing of the research participants, ward nurses showed 2.54±0.39 out of 4, and emergency room nurses did 2.48±0.45, which showed no statistically significant difference between the two groups (t=0.99, p=.325). In the comparison of sub-domains of practice environment of nursing between ward nurses and emergency room nurses, the score for cooperative relationship between nurses and doctors was 2.54±0.59 with ward nurses and 2.77±0.48 with emergency room nurses, which showed a statistically significant difference (t=-3.17, p=.002), and the ground for good quality nursing was 2.72±0.41 with ward nurses and 2.59±0.48 with emergency room nurses, which also showed a statistically significant difference (t=2.26 p=.025). In the scores for the sub-domains of practice environment of nursing, ward nurses showed 2.84±0.46 for nursing manager''s competence, leadership and support for nurses as the highest score, and 1.96±0.53 for sufficient personnel and material resource as the lowest. In addition, emergency room nurses showed 2.77±0.48 for the cooperative relationship between nurses and doctors as the highest score and 2.00±0.59 for sufficient personnel and material resource as the lowest.

3. The scores for burnout of the research participants was 2.87±0.44 out of 5 with ward nurses and 2.89±0.49 with emergency room nurses, which showed no statistically significant difference between the two groups (t=-0.29, p=.776).

4. The score for turnover intention of the research participants was 3.11±0.77 out of 5 with ward nurses and 3.45±0.98 with emergency room nurses, which showed a statistically significant difference between the two groups (t=-3.00, p=.003).

5. In the difference in turnover intention according to general characteristics, ward nurses showed statistically significant differences according to age (F=6.02, p=.003), salary (F=4.34, p=.006) and overtime working hours (F=4.70, p=.011). In the difference in turnover intention according to general characteristics, emergency room nurses showed statistically significant differences according to age (F=3.98, p=.022) and service time (F=3.10, p=.019).

6. In the correlation analysis of resilience, practice environment of nursing and burnout with turnover intention among ward nurses, turnover intention was shown to have a significant positive correlation with burnout (r=.52, p<.001) while having a significant negative correlation with practice environment of nursing (r=-.44, p<.001), and resilience (r=-.21, p=.012). In the correlation analysis of resilience, practice environment of nursing and burnout with turnover intention among emergency room nurses, turnover intention was shown to have a significant positive correlation with burnout (r=.57, p<.001), and a significant negative correlation with practice environment of nursing (r=-.39, p<.001) while showing no correlation with resilience (r=-.14, p<.172).

7. The hierarchical regression analysis of the effects on turnover intention of ward nurses showed that the factors affecting turnover intention were burnout (β=.39, p<.001) and practice environment of nursing (β=-.29, p<.001), and their explanatory power for turnover intention was 37.5%. The hierarchical regression analysis of the effects on turnover intention of emergency room nurses showed that the factors affecting turnover intention were burnout (β=.45, p<.001), service time at the current department of over 7 years (β=.36, p=.006), that of 3 - 5 years (β=.34, p=.006), that of 1 - 3 years (β=.31, p=.016), that of 5 - 7 years (β=.30, p=.010), and age over 40s (β=-.24, p=.010), and their explanatory power for turnover intention was 40.3%.

In this regard, it is necessary to introduce intervention programs that manage burnout continuously and even prevent it in order to reduce turnover intention of ward nurses and emergency room nurses. Furthermore, to lower turnover intention of ward nurses, it is necessary to improve practice environment of nursing through reinforcement with sufficient personnel and material support. In case of emergency room nurses, actual causes should be identified and improved, and appropriate rewards for the work within the organization need to be offered, to reduce turnover intention of the experienced nurses with more than 1 year of service time.