Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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Relationship between Job Stress and Turnover of Registered Nurses in a University Hospital

간호사의 직무 스트레스와 이직 간의 관련성

Lee, Eun-Hee;Chang, Sei-Jin;Kim, Hyun-Ok;Roh, Jae-Hoon;Park, Eun-Jung;Won, Jong-Uk
이은희;장세진;김현옥;노재훈;박은정;원종욱

  • Published : 20070600
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Abstract

Objectives: This study was performed to investigate the relationship between job stress and the type of turnover of registered nurses in a university hospital. Methods: A total of 553 registered nurses who left the hospital between 1994 and 2005 were surveyed, and aninterview record and self-administered questionnaire completed at the time of the turnover were used to assess the relationship. Job stress was categorized into four sub-scales (factor I: insufficient work authority and lack of autonomy, factor II: work overload and time urgency, factor III: interpersonal conflict and communication problems, and factor IV: role strain and ambiguity) using factor analysis. The type of turnover was classified into two categories: voluntary and involuntary. SPSS (version 11.0) was used for the statistical analyses. Results: The direct cause of the turnover was getting a new job, and the nurses in the voluntary turnover group were younger and less experienced than those in the involuntary turnover group. The discriminant analysis findings indicated that the determinant factors affecting the type of turnover were marital status, factor I (insufficient work authority and lack of autonomy), factor II (work overload and time urgency), educational background, and the intention to get a new job. Meanwhile, the voluntary turnover was associated with marital status (single), insufficient work authority and lack of autonomy, high educational background, the intention to get a new job, and low work overload and time urgency. Conclusions: Job stress played a crucial role in the turnover of the registered nurses, and some job stressors such as insufficient work authority and lack of autonomy, work overload and time urgency were more related to the type of turnover. These results confirm the necessity for a management program or job redesign to eliminate or reduce job stressors which lead to turnover such as insufficient work authority, lack of autonomy, work overload and time urgency. Furthermore, greater opportunities need to be provided for developing their careers. Finally, further research is required to elucidate the specific job stressors affecting the turnover of registered nurses.

목적: 이 연구는 한 대학병원의 이직 간호사를 대상으로 이직에 미치는 관련요인을 규명하고 자발적 이직과 비자발적 이직으로 구분하여 이직에 미치는 위험 요인을 구명하기 위해 수행되었다. 방법: 연구대상자는 한 대학병원 이직 간호사를 대상으로 면담과 설문조사를 통하여 1994년부터 2005년 3월 사이에 이직한 간호사 총 553명이었으며, 자료 수집은 구조화된 설문지를 이용하여 개인적인 특성과 직무스트레스 관련 요인으로 구분하여 총 22문항을 분석에 사용하였다. 자료 분석은 SPSS+ 통계 프로그램을 이용하여 전산처리하였으며, 간호사의 직무 스트레스와 이직 간의 관련성 비교를 위해 실수, 백분율, 산술평균, 표준편차, t 검정, 분산분석과 요인분석을 통해 하부 요인을 도출하고 각 하부요인별 내적 일치도를 구해 신뢰도 검정을 실시하였다. 또한, 이직 유형에 미치는 요인을 규명하기 위하여 판별분석을 시행하였다. 결과: 연구대상자는 총 553명으로 평균연령은 27.0세였으며, 기혼이 165명(29.8%), 미혼 385명(69.5%)이고 교육수준은 간호대학졸업(52.0%)이 가장 많았다. 이직 유형별 분포에서 자발적 이직은 타기관 취업, 학업, 유학을 포함한 것으로 343명(61.9%)이였으며, 비자발적 이직은 건강, 부적응, 가정적 책임을 비롯하여 거주지 이동을 포함한 것으로 210명(37.9%)이었다. 이직 유형에 따라 연령, 결혼상태, 교육수준, 총근무년 수는 유의한 차이가 있었으며, 30세 미만의 경우 자발적 이직이 높았으나 35세 이상의 경우 비자발적 이직이 더 높았다. 결혼 상태에서는 기혼은 비자발적 이직이 103명(62.8%)으로 높았으며, 미혼은 자발적 이직이 280명(72.7%)으로 높았다. 교육정도에 있어서는 대학원 이상의 경우 자발적 이직이 29명(78.4%)으로 비자발적 이직보다 높았으며, 총 근무기간은 10년 이내에서는 자발적 이직이 비자발적 이직보다 높았으나, 10년 이상에서는 비자발적 이직이 자발적 이직보다 더 높았다. 직무스트레스요 요인을 비교한 결과 결혼 상태에 따라, 업무권한 및 자율성 부족과 대인관계 및 의사소통 문제는 미혼이 더 높았고, 역할긴장 및 모호성은 미혼이 더 낮았으며, 통계학적 유의한 차이를 보였다. 교육수준에 따라 직무과중 및 시간압박감은 교육수준이 높을수록 통계학적으로 유의하게 낮았다. 이직 유형별로 하부요인을 비교한 결과, 잠재력 발휘기회 부족, 교육기회 부족, 복지 후생시설 열악, 불분명한 업무한계, 업무 수행의 자율성 부족, 작업환경 요인에 대한 항목은 자발적 이직이 통계적으로 유의하게 높았다. 이직유형별 관련 요인을 파악하기 위하여 단계별 판별 분석을 시행한 결과, 미혼일수록 업무 권한 및 자율성 부족의 점수가 높을수록 교육수준이 높을수록, 타 직장 구직의도가 있을 경우, 그리고 직무과중 및 시간 압박감의 점수가 낮을 경우 자발적 이직의 가능성을 높이는 것으로 분석되었다. 반면에 비자발적 이직은 기혼일수록 업무권한 및 자율성 부족에 대한 점수가 낮을수록(즉, 업무권한이나 자율성에 대한 불만이 적을수록), 교육수준이 낮을수록, 타 직장 구직의도가 없는 경우, 그리고 직무과중 및 시간 압박감을 많이 느낄수록 비자발적 이직과 관련성이 있었다. 결론: 간호사의 자발적 이직은 근무기간이 상대적으로 짧은 간호사의 경우가 많으며, 여기에 가장 큰 직무 스트레스 요인은 업무권한 및 자율성 부족이며, 특히 잠재력 발휘 기회의 부족, 교육기회 부족, 복지후생시설 열악, 불분명한 업무한계, 업무수행의 자율성 부족, 물리적 작업환경 등이었다. 따라서 자발적 이직율의 감소를 위해서는‘업무권한 및 자율성 부족’을 완화시키기 위한 다각적 노력이 필요하겠다.

Keywords

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