Relationships among Emotional labor, Burnout, Compassion Satisfaction and Patient Safety Management Activities in Emergency Department nurses

Abstract

This study is based on a descriptive correlation research to verify the relationship of Emergency Department nurses' Patient Safety management activities of the Emotional labor, Burnout, Compassion Satisfaction and Patient Safety management activities. The date collected from March 18, 2019 to April 29, 2019. The subjects were 165 nurses with clinical experience of more than 6 months in the emergency rooms of 4 general hospitals in Seoul and Kyonggi-do, South Korea. The research tool used emotional labor tools developed by Morris and Feldman(1996) and modified by Song(2011) for nurses. The tool used for measuring Burnout and Compassion Satisfaction is the Professional Quality of Life is based on the Korean version of Compassion Satisfaction/Fatigue subscale(ProQOLS) developed by Figley(1995) and modified by Stamm(2010). The Patient Safety Management Activity tool used the developed by Lee(2009) and modified by Chae(2017) for emergency department nurses. Using the SPSS 24.0 program, the collected data were analyzed using frequency and percentage, mean and standard deviation, independent t-test, one-way ANOVA, Pearson's correlation coefficient. The result of this study are as follows. 1. Emotional labor of Emergency Department nurses averaged 3.63 out of 5 points. Frequency of emotional labor was 3.85, Emotional dissonance was 3.56, and Emotional expressiveness was 3.49. Burnout was 30.89 and 30.35 points out of 50 points, Patient safety management activities were 4.05 out of 5 points. 2. The difference in the degree of Emotional labor differences according to the general characteristics of Emergency department nurses were statistically significant according to level of education(F=5.39, p=.005), emergency room career(F=3.19, p=.025) and Emergency medical delivery system(t=-3.16, p=.002). Burnout varied according to Emergency room career(F=5.50, p =.001) and Emergency medical delivery system(t=-4.57, p<.001). Compassion Satisfaction was significantly associated with age(F=3.77, p=.012), Total clinical career(F=3.15, p=.027), emergency room career (F=3.60, p=.015), p=.021). The differences in Patient safety management activities were according to position(t=-2.42, p=.017), total clinical career(F=5.49, p=.001), emergency room career (F=3.47, p=.018). And Nurses who had experience in activities such as safety committees related to patient safety in hospitals were higher(t=1.99, p=.027). 3. Compassion Satisfaction and Emotional Labor(r=-.25, p=.001) and Burnout(r=.64, p<.001) showed a negative correlation. Burnout and Emotional labor(r=.40, p=.010) showed a positive correlation. Negative correlation between Burnout and Compassion Satisfaction (r=-.64, p<.001). Patient safety management activities and Emotional labor(r=.16, p=.036), Frequency of Emotional labor(r=.29, p<.001), Compassion Satisfaction(r=.28, p<.001) has a positive correlation. and, there was a negative correlation between patient safety management activities and Burnout(r=-.27, p<.001). According to the results of this study, Emotional labor, frequency of emotional labor, burnout and Compassion Satisfaction were related to Patient Safety Management Activities. It is necessary to apply stress management program to prevent emotional labor from being consumed for a long time. In order to reduce burnout and increase Compassion satisfaction, it is necessary to apply supportive intervention such as adequate rest and award, mentoring, healing programs, and education and training programs in the management aspect of nursing departments.

본 연구는 응급실 간호사의 감정노동, 소진, 공감만족과 환자안전관리활동의 관계를 파악하기 위한 횡단적 상관조사연구로, 응급실 간호사의 감정노동과 소진을 완화하고 공감만족을 높여 환자안전관리활동을 향상시키기 위한 프로그램 개발의 기초자료를 제공하고자 시도되었다. 본 연구는 서울시 및 경기도 소재 4개 종합병원 응급실에서 근무하는 임상경력 6개월 이상의 간호사 165명을 대상으로 하였으며, 자료 수집은 2019년 3월 18일부터 4월 29일까지 이루어졌다. 연구도구는 Morris와 Feldman(1996)이 개발한 감정노동 도구를 송윤정(2011)이 간호사 대상으로 수정・보완한 도구와 Figley(1995)가 개발한 돌봄 제공자를 위한 공감만족/공감피로 자가 측정도구(Compassion Statisfaction/Fatigue Self test for Helpers)를 Stamm(2010)이 수정·보완한 공감만족/공감피로(Professional Quality of Life Scale; Compassion Statisfaction/Fatigue subscale) 한국어 번역판에서 소진과 공감만족 하위 척도를 사용하였으며, 이금옥(2009)이 개발한 환자안전관리활동 도구를 채우리(2017)가 응급실 간호사를 대상으로 수정·보완한 도구를 사용하였다. 수집된 자료는 SPSS statistics 24.0 프로그램을 이용하여 빈도, 백분율, 평균, 표준편차, independent t-test, one-way ANOVA, Pearson's correlation coefficient로 분석하였다. 본 연구의 결과는 다음과 같다. 1. 응급실 간호사의 감정노동은 5점 만점에 평균 3.63(±0.50)점이었으며, 소진은 총점 50점 만점에 평균 30.35(±4.60)점, 공감만족 30.89(±5.37)점이었으며, 환자안전관리활동은 5점 만점에 4.05(±0.44)점으로 나타났다. 2. 응급실 간호사의 일반적 특성에 따른 감정노동의 차이는 학력(F=5.39, p=.005), 응급실경력(F=3.19, p=.025), 응급의료전달체계(t=-3.16, p=.002)에 따라 유의한 차이가 있었으며, 소진은 응급실경력(F=5.50, p=.001), 응급의료전달체계(t=-4.57, p<.001)에 따라 차이가 있었으며, 공감만족은 연령(F=3.77, p=.012), 총 임상경력(F=3.15, p=.027), 응급실 경력(F=3.60, p=.015), 응급의료전달체계(t=2.32, p=.021)에 따라 통계적으로 유의한 차이가 있었다. 환자안전관리활동은 직위(t=-2.42, p=.017), 총 임상경력(F=5.49, p=.001), 응급실경력(F=3.47, p=.018)에 따라 유의한 차이가 있었으며, 병원 내 환자안전과 관련된 활동에 참여한 경험이 있는 경우(t=1.99, p=.027) 환자안전관리활동이 유의하게 높았다. 3. 응급실 간호사의 공감만족과 감정노동(r=-.25, p=.001), 소진(r=.64, p<.001)은 유의한 음의 상관관계를 보였고, 소진과 감정노동(r=.40, p<.001)은 유의한 양의 상관관계가 있었으며, 소진과 공감만족(r=-.64, p<.001)과는 음의 상관관계가 있는 것으로 나타났다. 환자안전관리활동과 감정노동(r=.16, p=.036), 감정노동빈도(r=.29, p<.001), 공감만족(r=.28, p<.001)은 양의 상관관계가 있었고, 환자안전관리활동과 소진(r=-.27, p<.001)간에는 유의한 음의 상관관계가 있었다. 이상의 결과를 바탕으로 감정노동이 장기간 지속되어 소진되지 않도록 적절히 대처하고 완화할 수 있도록 스트레스 관리 프로그램 도입이 필요하다. 또한 소진을 낮추고 공감만족을 높이기 위해 간호부서의 관리적 차원에서 휴식과 보상, 멘토링, 힐링 프로그램, 교육 프로그램과 같은 중재가 필요하다.