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1 J Dent Hyg Sci Vol. 13, No. 1, 2013, pp RESEARCH ARTICLE 치과위생사의감정노동과소진에관한연구 오혜영 ㆍ진기남 1 동남보건대학교치위생과, 1 연세대학교보건과학대학보건행정학과 A Study on Emotional Labor and Burnout in Dental Hygienist Hye-Young Oh and Ki-Nam Jin 1 Department of Dental Hygiene, Dongnam Health College, Suwon , 1 Department of Health Administration, College of Health Sciences, Yonsei University, Wonju , Korea The purpose of this study was to examine the relationship of service education to the emotional labor of dental hygienists and influential factors for their job burnout. The subjects in this study were 155 dental hygienists, on whom a survey was conducted. The findings of the study were as follows: The respondents who ever received service education and were satisfied with that education were better at emotional regulation. After job burnout was classified into physical symptoms and psychological symptoms, a multiple regression analysis was carried out to explore what variables would affect the two subfactors. And it's found that psychological symptoms were positively affected by emotional dissonance. The above-mentioned findings illustrated that service education had something to do with the emotional labor of the dental hygienists, and that the emotional labor of the dental hygienists had an impact on their job burnout. Key Words: Burnout, Emotional labor, Service education 서론 서비스산업의경쟁력은고객만족이다. 서비스접점에서고객과대면하는직원의얼굴표정이나몸짓, 언어등의서비스형태는기업이나조직의이익에중요한영향을미친다고하였다 1). 치과의료시장의경쟁또한심화되면서일반서비스산업이추구해왔던서비스품질향상을위한다양한노력이이루어지고있다. 서비스품질의향상은고객만족도를높이고이는곧고객의충성도로이어져병원의재이용과구매의사결정에영향을미친다 2). 조직의경쟁력은개개인의서비스품질이좌우한다. 그러므로조직은양질의서비스품질을유지하기위한다양한교육의기회를제공해야만한다. 이러한교육적효과는양질의의료서비스를제공받고자하는고객의다양한요구를충족시켜주었지만지 속적으로똑같은표정과몸짓으로고객을대면하고서비스를수행해야하는직원들은감정노동으로인해스트레스가증가하고있다 3). 고객을대하는서비스품질을일정하게유지하기위해개인의감정보다는조직이정해놓은규칙을수용할수밖에없으며친절한서비스는고객만족이라는긍정적인효과를가져오지만부당한요구를하는고객을만나거나자신의감정과는상관없이항상미소를지어야하는직원의감정노동은증가한다 4). 조직은직원들로하여금고객과대면하는과정에서감정표현에대한일정한규칙을정하고이를통제하고있다 5,6). 이와같은규제는조직의경쟁력강화와생존을위한불가피한선택이라고하지만조직의경쟁력확보를위해서는무엇보다종업원인내부고객의만족이우선되어야양질의서비스품질을유지할수있다 7). Received: January 6, 2013, Revised: March 4, 2013, Accepted: March 4, 2013 Correspondence to: Hye-Young Oh Department of Dental Hygiene, Dongnam Health College, 50, Cheoncheon-ro 74-gil, Jangan-gu, Suwon , Korea Tel: , Fax: , ohhy@dongnam.ac.kr ISSN (Print) / ISSN (Online) Copyright 2013 by the Korean Society of Dental Hygiene Science This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

2 J Dent Hyg Sci Vol. 13, No. 1, 2013 감정을노동으로개념화한것은 Hochschild 5,6) 였다. Hochschild는감정노동이란조직에서개인이직무를수행하는과정에서자신의내면또는표면행위가조직의규범에의해요구되는감정표현에차이가있을때이를조절하고자하는노력이라고하였다 6). 감정노동은직무를수행하는데있어부정적인영향을미치고결과적으로조직의성과에도나쁜영향을미치게된다 7). 또다른관점에서감정노동과소진의연관성이다. 간호사의감정노동에관한연구에서변과염 8) 그리고양 9) 은감정노동과소진 (burnout) 의연관성을밝혔다. 소진은업무적인스트레스상황이지속될때경험하게되는것으로서업무에대해부정적인것을포함하여피로감, 권태, 신체적, 정신적, 정서적인탈진등을경험하게되는것을말한다 10). 소진은신체적으로나정신적으로개인에게부정적인영향을끼칠수있으며이는곧조직의업무성과에도영향을미칠수있음을의미한다 9). 감정노동에관한연구는항공사승무원을대상으로한 Hochschild 6) 의연구에서시작되었다. 국내에서도승무원외판매직, 호텔, 미용업등다양한직종에서연구가이루어졌으며간호사와같이의료기관종사자를대상으로하는연구도이루어지고있다 8,9,11,12). 최근치과계에서도가장많은접점에서고객을대하는치과위생사의감정노동에대한연구가시작되었으며, 감정노동은스트레스의증가와직원의만족도를감소시켜개인과조직모두에게부정적인영향을줄수있다고하였다 13,14). 그러나감정노동은현대사회에서없어서는안될노동의한분야이기에피할수는없다. 따라서조직은감정노동의부정적인측면을적극적으로관리하고직원은감정노동을잘이해하고조절할수있도록해야한다 15). 따라서본연구에서는서비스교육과감정노동의관련성을규명하고직무소진에영향을미치는감정노동요인을파악하여치과위생사의감정노동을효과적으로관리하는방안을모색해보고자하였다. 연구대상및방법 1. 연구대상본연구는서울, 경기지역에위치한 9개치과병 ( 의 ) 원을편의추출하여치과위생사 155명을조사대상으로하였다. 자료수집기간은 2010년 7월부터 2011년 1월까지구조화된자기기입식설문조사를실시하였으며총 250부의설문지를배부, 220부가회수되었고이중응답이부족한설문 65부를제외한 155부의응답지만을분석에활용하였다. 2. 연구방법치과위생사의서비스교육과감정노동이직무소진에영향을미치는관련요인을설명하고자관련문헌 16-19) 을검토하여본연구의목적에맞도록다음과같이설문을구성하였다. 서비스교육 5문항, 치과위생사의감정노동에관한 12문항, 직무소진 6문항이었으며응답자의조직관련특성은 6문항이었다. 감정노동, 직무소진의각문항은 Likert 5점척도로서 1점은전혀그렇지않다, 2점은그렇지않다, 3점은보통이다, 4점은그렇다, 5점은매우그렇다였다. 감정노동과직무소진은점수가높을수록감정노동과직무소진의정도가높음을의미한다. 부정적문항에대한변수는역환산하여분석하였다. 본연구에서사용한변수의신뢰도를검증하기위해신뢰도분석을시행하였다. 감정노동의하위차원으로추출된 3개의요인은감정표현 (Cronbach's α=0.80), 감정조절 (Cronbach's α=0.74), 감정부조화 (Cronbach's α=0.76) 였다. 직무소진은 2개의요인으로각각의특성을고려하여신체적증상과심리적증상으로구분하였으며각요인의신뢰도는 Cronbach's α=0.86과 Cronbach's α=0.67이었다. 3. 통계분석수집된자료는 PASW ver for Windows 통계프로그램 (IBM Co., Armonk, NY, USA) 을이용하여분석하였다. 조직관련특성과서비스교육은빈도와백분율로산출하였으며, 서비스교육과감정노동의차이를검정하기위해 Independent samples t-test를사용하였다. 직무소진에영향을미치는요인을알아보기위해직무소진의하위요인인신체적증상과심리적증상을종속변수로하고직위, 부서, 경력, 병원유형등조직관련특성과서비스교육경험, 교육횟수, 교육만족여부, 감정노동의하위요인인감정표현, 감정조절, 감정부조화를독립변수로하여다중회귀분석 (multiple regression analysis) 을시행하였다. 결과 1. 대상자의조직관련특성조사대상자의조직관련특성은 Table 1과같다. 직위는일반직원이 68.4% 로팀장이상 31.6% 보다더많았다. 부서는진료담당이 85.2% 였다. 경력은 5년미만이 54.2%, 5년이상이 45.8% 였다. 병원의유형으로는치과의원이 82.6% 였다. 2. 서비스교육서비스교육현황을알아보았다. 서비스교육경험이있는 72

3 오혜영ㆍ진기남 : 치과위생사의감정노동과소진에관한연구 경우가 66.5% 였다. 지난 1년간교육횟수가 1회이상이되는경우는 51.4% 로 1회를받은 48.6% 보다조금많았다. 교육내용으로는 서비스마인드 가 23.5% 로가장많았고다음으로인사말교육및실습이 20.7%, 전화응대기술 17.4%, 표정관리가 16.2% 등으로나타났다. 서비스교육에대해만족하는가하는질문에 58.3% 가만족하고있었다 (Table 2). 3. 감정노동감정노동의하위요인인감정표현, 감정조절, 감정부조화가서비스교육과의관련성을알아보기위해 independent sample t-test를시행하였다. 통계적으로유의미한차이를나타낸변수는교육경험과서비스교육만족이었으며, 교육경험이있는경우와서비스교육에대해만족하고있는경우감정조절을더잘하고있는것으로나타났다 (Table 3). Table 1. Subjects' Organization-Related Characteristics Variable Item Frequency (%) Job position General staff 106 (68.4) More than team leader 49 (31.6) Department Medical treatment 132 (85.2) Administration 23 (14.8) Career Under 5 years 84 (54.2) Over 5 years 71 (45.8) Type Dental hospital 27 (17.4) Dental clinic 128 (82.6) 4. 직무소진을종속변수로한다중회귀분석직무소진에영향을미치는요인을알아보기위해직무소진을종속변수로하고조직관련특성, 서비스교육, 감정노동을독립변수로하여다중회귀분석을시행하였다. 신체적증상에영향을미치는변수는 R 2 =0.087로낮은설명력을나타내었다. 심리적증상에영향을미치는독립변수는감정노동의하위요인인감정부조화였다. 감정부조화를겪을수록심리적소진이높아진다고할수있다. 심리적증상의결 Table 2. Service Education Variable Item Frequency (%) Educational experience Yes 103 (66.5) No 52 (33.5) Education frequency for the past one year Once 35 (48.6) Over once 37 (51.4) Educational contents Service mind 84 (23.5) Greeting education and practice 74 (20.7) Telephone answering skills 62 (17.4) Facial expression management 58 (16.2) Explaining method about customer's question 42 (11.8) Customer direction method 34 (9.5) Others 3 (0.8) Satisfaction with service education Satisfied 60 (58.3) Dissatisfied 43 (41.7) Table 3. Difference in Emotional Labor according to Service Education Variable Item Emotional expression Emotional regulation Emotional dissonance Educational experience Yes (N=103) 3.54± ± ±0.70 No (N=52) 3.37± ± ±0.67 t * 1.28 Education frequency for the past one year Once (N=35) 3.46± ± ±0.78 Over once (N=37) 3.65± ± ±0.63 t Satisfaction with service education Satisfied (N=60) 3.62± ± ±0.70 Dissatisfied (N=43) 3.44± ± ±0.69 t * Values are presented as mean±sd. *p<0.05 statistically significant by independent sample t-test. 73

4 J Dent Hyg Sci Vol. 13, No. 1, 2013 Table 4. Multiple Regression Analysis of Having Job Burnout as Dependent Variable Classification Physical symptom (β) Psychological symptom (β) Organization-related Job position (team leader=1) Department (administration=1) Career (over 5 years=1) Type (dental hospital=1) Service education Educational experience (yes=1) Education frequency for the past one year (once=1) Satisfaction with service education (dissatisfied=1) Emotional labor Emotional expression Emotional regulation Emotional dissonance 0.282* 0.426** R R 2 change F * *p<0.05, **p<0.01, statistically significant by multiple regression analysis. 정계수 R 2 =0.136 이었다 (Table 4). 고찰 본연구는서비스교육이감정노동에어떠한차이를보이는지알아보고치과위생사의직무소진에영향을미치는감정노동과서비스교육요인을파악하고자하였다. 대상자의 66.5% 가서비스교육경험이있었고교육내용으로는서비스마인드교육이가장많았다. 치과위생사는치과의료기관에서치과의사나간호조무사또는그외의어떤직종보다환자와의접촉이가장빈번하게이루어지며치과위생사의서비스수행에대한마음가짐이나기술은조직의경쟁력을뒷받침하는데매우중요하다고할수있다. 따라서조직은서비스교육이나조직내규칙을통해고객만족서비스를추구하기위해치과위생사개인의감정을관리통제한다. 고객이궁극적으로원하는서비스는진정성이다 20). 따라서서비스를수행하는접점직원들이고객에게좀더진정성있는서비스를제공하도록하기위해서비스마인드교육이가장많이이루어지는것이라고볼수있다. 또한고객에게보다진정성있는서비스를수행함으로서업무에서오는스트레스를감소시킬수있을것이다. 김등 21) 의연구에서도의료서비스교육을받은의료종사자가교육을받지않은종사자들보다서비스만족도가높게나타났으며치과의이미지또한교육경험이있는경우더높게나타났다고하였다. 기업이나조직에서경영적성과를 위한가장중요한이념적가치가된것은 고객만족 이다. 고객을위한질높은서비스는곧고객만족으로이어지고고객만족은구매나재이용으로이어지기때문이다 22). 서비스교육과감정노동의차이를살펴보았다. 서비스교육경험이있고교육에대해만족하는응답자가감정조절을더잘하는것으로나타났다. 교육으로인한서비스마인드변화가환자를대면하는데있어개인의감정에진정성을포함시키게되고실제자신의감정을조절할수있는능력이높아졌기때문으로생각된다. 감정표현과감정부조화에서는통계적으로유의한차이가발견되지않았다. Brotheridge와 Grandey 23) 는사람들과대면한직무수행이이루어지는경우감정적인고갈이높아진다고하였다. 본인의신체적, 정신적상태와는상관없이조직적차원에서규범화된감정표현은감정의부조화를일으킬수있다. 이와같은결과가의미하는바는감정노동은서비스교육에의해조직적차원의조절이가능하지만개인이가지고있는본래의감정과표현해야하는감정의차이로인한부조화를근본적으로감소시키는것은부족하다는것을시사한다. 따라서감정노동은개인적차원이아닌조직적차원에서보상이나효과적인관리체계의마련이필요하다고하겠다. 직무소진의신체적증상과심리적증상에미치는영향을알아보기위해다중회귀분석을시행하였다. 심리적증상에영향을미치는요인으로감정부조화가있었다. 감정부조화는실제내면의감정과외적인감정규칙에차이가있을때 74

5 오혜영ㆍ진기남 : 치과위생사의감정노동과소진에관한연구 발생한다고하였다 24). 감정부조화가높은경우일에대한흥미를잃는등의심리적증상이높아짐을의미한다. 이는이와홍 25) 의연구와 Judge 등 26) 의연구결과와일치한다. 이와같은연구결과로감정노동은직무소진의심리적증상에영향을미치는것으로나타났다. 감정노동은서비스를수행하는과정에서불가피한과정이고이를위한서비스교육도매우중요하지만내부고객인종업원에감정노동의효과적인관리를위해서조직적차원의접근이필요하다. 성공적인감정노동을수행하기위해서관리자는감정표현의중요성을바르게인식하고적절한감정표현규칙을만들어야한다고하였다 27). 감정노동을회피하기보다얼마나적절하게관리하느냐가더중요하다고할수있다. 본연구는일부지역에한정된치과위생사만을대상으로한조사였으므로연구결과를확대해석할수는없으나치과위생사의감정노동과서비스교육의관계를파악하고직무소진과의연관성을확인했다는데의의를둘수있다. 추후감정노동을유발하는구체적인요인을규명하고치과위생사의소진에영향을미치는변이를밝히는추가적인연구가필요할것으로생각한다. 요약 서비스교육과감정노동이치과위생사의직무소진에영향을미치는지알아보기위해서울, 경기지역에치과위생사 155명을대상으로설문조사하여다음과같은결론을얻었다. 1. 서비스교육경험이있는경우가 66.5% 였으며교육내용으로는서비스마인드가 23.5% 로가장많았으며인사말교육및실습이 20.7%, 전화응대기술이 17.4%, 표정관리가 16.2% 등의순으로나타났다. 58.3% 의응답자가서비스교육에만족하고있었다. 2. 서비스교육에따른감정노동의차이는서비스교육경험이있고, 서비스교육에만족하는경우감정조절을더하는것으로나타났다. 3. 직무소진의하위요인인신체적증상과심리적증상을종속변수로하여다중회귀분석을시행한결과심리적증상에서감정부조화가영향을미치는변수로서감정부조화를경험할수록심리적소진이증가하는것으로나타났다. 이상의결과로감정노동은직무소진에영향을미치는요인이라고할수있으며개인의감정노동을관리하기위한조직적차원의관리가필요하다고생각한다. 참고문헌 1. Staw BM, Barsade SG: Affect and managerial performance: a test of the sadder but wiser vs. happier and smarter hypothesis. Administrative Science Quarterly 38: , Kim YK, Jung KT, Ann YS, Lee SE, Jang YH, Han BR: The influence of dental service qualities on the patient satisfaction and royalty in dental clinics and hospitals. Korean J Hosp Manag 8: 49-71, Kim JG: How to resolve problems of emotional labor in the service industry. Labour Soc Res 12: 29-34, Spencer S, Rupp DE: Angry, guilty, conflicted; injustice toward coworkers heightens emotional labor through cognitive and emotional mechanisms. J Appl Psychol 94: , Hochschild AR: Emotion work, feeling rules, and social structure. Am J Sociol 85: , Hochschild AR: The managed heart; communication of human feeling. University of California Press, Berkeley and Los Angeles, Kwon MY, Yoon KH: A study on the internal service quality on the internal customer satisfaction and firm performance with focus on the financial service. BER 19: 1-26, Byun DS, Yom YH: Factors affecting the burnout of clinical nurses; Focused on emotional labor. J Korean Acad Nurs Adm 15: , Yang YK: A study on burnout, emotional labor, and self-efficacy in nurses. J Korean Acad Nurs Adm 17: , Ryan MA: Professional survival. Superv Nurse 12: 16-17, Choo HJ, Kim HS, Jun DG: The effect of a salesperson`s affectivity and the performance stressor on emotional labor at the department stores. J Korean Soc Cloth Text 34: , Hwang SY, Kwon TL: The effects of emotional labor and job stress on burnout in hotels. Korea J Tour Hosp Res 22: , Yoon SU, Kim JS: Relations between emotional labor and job stress among some dental hygienists. J Korean Soc Dent Hyg 11: , Lee YS, Jang JH, Moon AE: The effects of emotional labor 75

6 J Dent Hyg Sci Vol. 13, No. 1, 2013 and stress on job satisfaction in oral health professional. J Korean Soc Dent Hyg 11: , Lim HC: Causes and outcome of emotional labor and the implementation of emotional management. KEF Compensation Quarterly 16: 36-44, Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB: The job demands-resources model of burnout. J Appl Psychol 86: , Demerouti E, Bakker AB, Vardakou I, Kantas A: The convergent validity of two burnout instruments; A multitraitmultimethod analysis. Eur J Psychol Assess 19: 12-23, Christine TE, Geoffrey VR, Martin RB: Importanceperformance analysis and the measurement of service quality. Eur J Mark 27: 59-70, Kang JH, Kim MJ: A study on the difference of emotional labor and its consequence according to the interaction styles with customer: focused on the relation. Korean J Hosp Adm 17: , Pugh SD: Service with a smile: emotional contagion in the service encounter. Acad Manag J 44: , Kim CH, Lee JY, Lee HO: The effect of the medical service instruction of dental health care worker. J Dent Hyg Sci 1: 59-65, Lee ES, Park JR, Choi MS: Factors affecting patient satisfaction of dental services organizations. J Korean Acad Dent Hyg Educ 5: , Brotheridge CM, Grandey AA: Emotional labor and burnout: comparing two perspectives of people work. J Vocat Behav 60: 17-39, Rafaeli A, Sutton RI: The expression of emotion in organizational life. Res Organ Behav 11: 1-42, Lee YR, Hong SH: An effect of the emotional labor on the burnout and the job satisfaction of the hotel employees. Korea J Tour Res 25: , Judge TA, Woolf EF, Hurst C: Is emotional labor more difficulty for some than for other? A multilevel, experiencesampling study. Pers Psychol 62: 57-88, Batchelor JH, Burch GF, Humphrey RH: Emotional labor; a key to customer happiness and employee satisfaction. International Labor Brief 5: 4-15,

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012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar