고령 간호사의 극복력, 전문직 자아개념, 간호조직문화가 재직의도에 미치는 영향 = The Effects of Resilience, Professional Self-Concept, and Nursing Organizational Culture on Intention of Retention in Older Nurses

국문 초록 (Abstract)

본 연구는 40세 이상 고령 간호사 들을 대상으로 극복력, 전문직 자아개념, 간호조직문화가 재직의도에 미치는 요인을 규명 함으로써 고령 간호사의 재직의도를 높일 수 있는 중재방안을 모색하는데 필요한 기초자료를 제시하고자 시도되었다. 연구 대상자는 J도 S시에 소재한 3곳의 100병상 규모 이상의 종합병원, 임상경력 1년 이상, 환자의 직접 간호에 종사하는 40세 이상 간호사 대상 서면 설문조사와 눈덩이 표집방법을 통한 온라인 설문조사를 실시해 모집된 137명을 대상으로 하였으며, 자료수집 기간은 8월부터 9월까지였다.
대상자의 일반적 특성 으로는 평균연령은 44.7 세로 95%이상이 여성 기혼 간호사 였다. 100~299병상 병원에 근무하는 간호사가 55.5%, 300병상 이상 44.5%, 직위는 일반간호사 54.7%, 책임간호사 45.3%, 총경력 25년이상 18.3%, 상근직이 50.4%이었다. 근로환경만족도는 보통이 54.0%, 만족한편이 24.1% 이었다.
고령 간호사의 극복력, 전문직 자아개념, 간호조직문화, 재직의도의 정도는, 극복력 평균평점은 5점 만점에 3.81±0.39점 이었고, 전문직 자아개념의 평균평점은 4점 만점에 2.84±0.27점 이었다. 간호조직문화 하위항목들은 5점 만점에 업무지향 문화 3.47±0.63점, 관계지향문화 4.01±0.71점, 혁신지향 문화 3.52±0.70점, 위계지향 문화 4.22±0.52점이었다. 재직의도는 평균평점 8점 만점에 5.06±1.24점 이었다.
고령 간호사의 일반적 특성 및 직무관련 특성에 따른 재직의도의 차이는 주관적건강상태(F=3.50, p=.033), 병원규모(t=2.48, p=.014), 근무형태(t=-2.16, p=.032), 일·가정양립의 적절성(F=15.32, p<.001), 근로환경 만족도(F=10.50, p<.001)이었다.
고령 간호사의 재직의도는 극복력(r=.20, p=.016), 전문직 자아개념(r=.45, p<.001), 간호조직문화의 혁신지향 문화(r=.17, p=.047)과 정적상관이 있었다.
고령 간호사의 재직의도에 미치는 요인의 위계적 회귀분석 결과
모형1에서 재직의도에 유의한 영향을 미치는 변인은 일·가정 양립적절성(β=.29, p=.001), 근로 환경만족도(β=.20, p=.021) 이었다. 즉 일·가정 양립적절성이 높을수록, 근로 환경만족도가 높을수록 재직의도가 높아진다고 할 수 있다. 모형1에 의한 설명력은 23.4% 이었다(F=8.00, p<.005, R2=.234, Adj-R2=.205).
모형2에 추가로 투입된 극복력, 전문직 자아개념, 간호조직문화의 혁신지향 문화 중 재직의도에 유의한 영향을 미치는 변인은 전문직 자아개념(β=.49, p<.001) 이었다. 즉, 전문직 자아개념이 높을수록 재직의도가 높아진다고 할 수 있다. 모형2에 의해 추가로 설명된 비율은 11.59% 이었으며, 모형2의 총 설명력은 35.0% 이었다(F=8.59, p<.001, R2=.349, Adj-R2=.309).

다국어 초록 (Multilingual Abstract)

This study aimed to investigate the effects of resilience, professional self-concept, and nursing organizational culture on the intention of retention with regards to nurses who were 40 years of age and over. In addition, the study provided to ultimately present foundational data that is needed to develop strategies and procedures that increase older nurses’ intention of retention. A total of 137 nurses that were 40 years of age and older were enrolled as participants of the study. The nurses had to work at one of the three secondary hospitals located in S city, J Province, that had 100 beds or more, with at least one year of clinical experience and currently involved in direct patient care. A written questionnaire and online questionnaire were both administered and participants were selected through the snowball sampling method. The data were collected within a period of two months, between August and September.

The results of the study can be summarized as follows:

1. The mean age of the participants was 44.7 years, and more than 95% were married female nurses. Most of the participants worked in a hospital that had a capacity of 100–299 patient beds (55.5%), while 44.5% worked in a hospital that had a capacity of 300 patient beds or more. In accordance to the position of the nurses’ jobs, 54.7% were staff nurses, and 45.3% were nurses-in-charge to whom the other nurses report to during duty. A total of 18.3% of the nurses had 25 or longer years of career, and 50.4% worked fixed, full-time schedules. In terms of satisfaction with work environment, 54.0% were moderately satisfied, while 24.1% were satisfied.

2. The mean resilience score was 3.81±0.39 out of a total of 5. The mean professional self-concept score was 2.84±0.27 out of a total of 4. For the nursing organizational culture, the mean scores (out of a total of 5) were 3.47±0.63 for the task-oriented culture, 4.01±0.71 for the relationship-oriented culture, 3.52±0.70 for the innovation-oriented culture, and 4.22±0.52 for the hierarchy-oriented culture. The intention of retention by the nurses had a mean score of 5.06±1.24 out of a total of 8.

3. In terms of the demographic and work-related characteristics, the intention of retention by the nurses significantly differed in accordance to the nurses’ subjective health status (F=3.50, p=.033), the size of the hospital they worked at (t=2.48, p=.014), the type of work they did (t=-2.16, p=.032), the appropriateness of the work-family balance (F=15.32, p<.001), and the nurses’ level of satisfaction with the work environment (F=10.50, p<.001).

4. The intention of retention by the nurses positively correlated with resilience (r=.20, p=.016), the professional self-concept (r=.45, p<.001), and the innovation-oriented nursing organizational culture (r=.17, p=.047).

5. The results of the hierarchical regression were to identify the predictors of the older nurses’ intention of retention

In model 1, the work-family balance (β=.29, p=.001) and the level of satisfaction with the work environment (β=.20, p=.021) significantly predicted the nurses’ intention of retention. In other words, the nurses’ intention of retention increased with a more appropriate balance between work and family as well as an increasing level of satisfaction with the work environment. Model 1 clarified the 23.4% of the variance (F=8.00, p<.005, R2=.234, Adj-R2=.205).

The resilience, the professional self-concept, and the innovation-oriented nursing organizational culture were additionally added in model 2. The professional self-concept (β=.49, p<.001) was the only significant predictor of the nurses’ intention of retention. In other words, the nurses’ intention of retention increased as the professional self-concept increased as well. Model 2 additionally clarified the 11.59% of the variance, with a total explained variance of 35.0% (F=8.59, p<.001, R2=.349, Adj-R2=.309).

Based on these findings, educational programs that boost the professional self-concept and innovate measures to ameliorate the work environments are needed to increase older nurses’ intention of retention. Policy support is also required to increase the retention of older nurses that have more experience and are competent for the job.

목차 (Table of Contents)

• I. 서론 1
• 1. 연구의 필요성 1
• 2. 연구목적 3
• 3. 용어정의 4
• II. 문헌고찰 6
• 1. 고령 간호사 6
• 2. 간호사의 재직의도 7
• 3. 간호사의 재직의도에 영향을 미치는 요인 10
• III. 연구방법 23
• 1. 연구설계 23
• 2. 연구대상 23
• 3. 연구도구 23
• 4. 자료 수집 25
• 5. 자료 분석 26
• 6. 윤리적 고려 27
• Ⅳ. 연구결과 28
• 1. 대상자의 일반적 특성 및 직무관련 특성 28
• 2. 대상자의 극복력, 전문직 자아개념, 간호조직문화, 재직의도의 정도 31
• 3. 대상자의 일반적 특성 및 직무관련 특성에 따른 재직의도의 차이 33
• 4. 극복력, 전문직 자아개념, 간호조직문화, 재직의도의 상관관계 36
• 5. 대상자의 재직의도에 영향을 미치는 요인 37
• Ⅴ. 논의 39
• Ⅵ. 결론 및 제언
• 1. 결론 45
• 2. 제언 47
• 참고문헌 48
• 부록 61