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1 Vol.7, No.2, February (2017), pp 간호사이미지와이미지결정요인간호조무사와조무사교육생비교 하주영 유미화 요약 본연구는간호조무사와조무사교육생이지각하는간호사이미지와이미지결정요인에대한연구 이다자료수집은특성화고등학교보건간호과학생과간호조무사학원생및간호조무사 명을대 상으로실시하였다간호사의이미지와이미지결정요인은에개발된도구로측정되었고 수집된자료는기술통계와로분석하였다간호사이미지는두군간통계적으로유의한차이가없었다긍정적이미지가높은영역은전문적이미지전통적이미지매체적이미지사회적이미지 순이었으며통계적으로유의한항목중가장긍정적인항목은 간호사는깨끗하고단정하다로나타 났다이미지결정요인에서두군간통계적으로유의한차이는없었다주관적요인제도적요인매 체적요인순으로간호사이미지결정에영향을미치는것으로나타났으며통계적으로유의한항목 중 간호사의신속성이영향을많이미치는것으로나타났다간호사이미지와이미지결정요인에서 간호조무사가조무사교육생보다높은점수를보이고있으나선행연구의다른집단보다낮은점수 를보이고있다간호사이미지와이미지결정요인을향상시키기위해간호조무사와조무사교육생을위한교육과정과중재방안의개발이필요하다. 핵심어간호조무사간호사이미지결정요인학생 Abstract This study was to examine nurse image and image determinants perceived by nurse aids and student of nurse aid training course. The data were collected from 700 subject of heath nursing in Specialized high school students, institute students and nurse aids. The nurses' image and image determinants were measured by the instrument developed by Yang(1998). The collected data were analyzed with descriptive statistics and t-test. There was no statistically significant difference between the two groups in nurse image. The area Received (December 4, 2016), Review Result (December 16, 2016) Accepted (December 23, 2016), Published (February 28, 2017) 이논문은부산대학교기본연구지원사업년에의하여연구되었습니다 Copyright 2017 HSST 485

2 of positive image were in the order of professional image, traditional image, media image and social image and the item with the most positive statistically significant difference item was Nurse is clean and tidy. There was no statistically significant difference between the two groups in image determinants. In the order of subjective factors, Institutional factors and media factors influenced image determinants and the item with the most influential statistically significant difference item was Immediacy of nurse. The higher score were nurse aids than nurse aid students that nurse image and image determinants, but this study result showed lower score than the other groups of precedence studies. Nurse aids and nurse aid students are required curriculum development and intervention to improve the nurse image and image determinants. Key words: Nurses Aids, Nurses, Imagery, determinant, Students 연구의필요성 서론 이미지란실제로존재하지는않으나마음속에그려지는어떤대상에대하여각사람이가지고있는신념생각인상의집합체로서태도를형성하는심리적요소를말한다이러한간호사의이미지는일반인이지각하는병원내의간호사모습환자나보호자및입원환자의면회경험병원의다른직원들과의상호작용과간호사자신이갖는부정적인이미지등이간호사의이미지형성에영향을줄수있다과거에비해책임감과능력있고신뢰받는전문직으로간호사의학구적이고독창적인이미지는증가하였지만간호사에대한부정적인이미지는간호사자신들의자존감과신념가치자신감을손상시키고업무수행효율성에도영향을미쳐직무만족을저하시키는요인으로작용해왔으며간호사의이직률에도영향을미친다고보고하고있다우리나라의간호조무사제도는년부터정부의보건의료망강화계획과간호인력부족현상을해결하기위한단기인력수급계획의일환으로도입되었다간호조무사는간호업무현장에서간호사와밀접한관계를가지고있으며조무사교육과정생과간호조무사가지각하는간호사에대한이미지는간호조무사교육과간호보조업무수행과정에영향을미칠것으로여겨진다최근개정된간호법에서도간호사의업무로간호보조업무에대한지도를새롭게규정하였다그러나간호조무사를대상으로간호사이미지를파악한연구는부족하며특히간호보조인력이되기위해교육중인학생을대상으로한간호사이미지연구는거의없는실정이다따라서간호조무사와특성화고등학교보건간호과학생과간호조무사양성학원에서교육중인교육생을대상으로간호사에대한이미지를파악하여간호조무사교육자로서뿐만아니라간호현장에서의지도감독자로서긍정적이고바람직한간호사이미지확립을위한자료로활용하고자한다 연구목적 간호조무사와조무사교육생의간호사이미지와이미지결정요인의차이를파악한다 486 Copyright 2017 HSST

3 Vol.7, No.2, February (2017) 연구방법 연구설계 본연구는간호조무사와조무사교육생이지각하는간호사이미지와이미지결정요인을파악하는서술적조사연구이다 연구대상 본연구는특성화고등학교보건간호과학생명과간호조무사양성학원학생명을포함한조무사교육생명과의료기관에재직중인간호조무사명총명을대상으로하였다특성화고등학교보건간호과학생은시의보건간호과가개설된특성화고등학교가개교임을고려하여시소재보건간호과가개설된특성화고등학교개교를임의추출하여학교장에게연구허락을받은후각학교에서전학년중학부모와학생모두연구참여에동의한학생명씩을선정하였다조무사교육생은시와시에소재한간호학원을임의추출하여학원장이연구를허락한시곳시곳의학원을선정한후연구참여에동의한시학원생명시학원생명을대상으로하였다간호조무사는시와시에소재한종합병원곳과요양병원곳을각각임의추출하여부서장의연구허락을받은후연구참여에동의한시의간호조무사명시의간호조무사명을대상으로하였다 연구도구 본연구에서는 이개발한간호사이미지측정도구와간호사이미지결정요인측정도 구를개발자로부터사용승인을받아사용하였다간호사이미지측정도구는전통적이미지 문 항사회적이미지문항전문적이미지문항개인적이미지문항총 문항으로구성되어있 다각문항은점 척도를사용하여매우그렇다점전혀그렇지않다점으로측정하 며점수범위는 점 점으로점수가높을수록간호사이미지가긍정적임을의미한다개발당 시도구의신뢰도 는 였고본연구에서 는 였다간호사 이미지결정요인은간호사이미지가어떤요인에의해영향을받는가에대한것으로주관적요인 문항제도적요인문항매체적요인문항총 문항으로구성되어있다각문항은점 척도를사용하여매우그렇다점전혀그렇지않다점으로측정하며점수범위는 점 점 으로점수가높을수록해당요인이간호사이미지결정에영향을미치는것을의미한다개발당 시도구의신뢰도는 이었으며본연구에서는 으로나 Copyright 2017 HSST 487

4 타났다 자료수집방법 대학교생명윤리위원회의승인을받은후각단체장및부서장의동의를얻어년월일부터년월일까지이루어졌다 자료분석방법 수집된자료는을이용하여대상자의일반적특성간호사이미지이미지결정요인은실수백분율평균표준편차로분석하고두군간의차이는를이용하여분석하였다 대상자의일반적특성 연구결과 대상자의일반적특성은표과같다성별은간호조무사중조무사교육생중가여성이었고간호조무사는세가로가장많았고조무사교육생은세가로가장많았다간호조무사의와조무사교육생의가가족중간호사가있다고응답하였으며간호사이미지에영향을미친요인으로간호조무사와조무사교육생모두직간접경험이각각로가장높게나타났다간호사와간호조무사의차이에대해간호조무사는조무사교육생은가알고있다고응답하였다 표 간호조무사와조무사교육생이일반적특성 Total Nurse Aid Students Nurse Aids Category (n=500) (n=200) N(%) n(%) n(%) Gender male 59(8.4) 56(11.2) 3(1.5) female 641(91.6) 444(88.8) 197(98.5) Age 10~19 300(42.9) 300(60.0) 0(.00) 20~29 92(13.1) 66(13.2) 26(13.0) 30~39 74(10.6) 40(8.0) 35(17.5) 40~49 164(23.6) 73(14.6) 91(45.5) 50 69(9.9) 21(4.2) 48(24.0) Having a nurse among the family yes 443(63.3) 328(65.6) 115(57.5) no 257(36.7) 172(34.4) 85(42.5) 488 Copyright 2017 HSST

5 Vol.7, No.2, February (2017) Influencing factor of the nurse image Knowing the difference between nurse and nurse aid mass media 141(20.1) 110(22.0) 31(15.5) novels, 11(1.6) 8( 1.6) 3( 1.5) biographies family and 90(12.9) 66(13.2) 24(12.0) relatives direct or indirect experience 458(65.4) 316(63.2) 142(71.0) yes 667(95.3) 470(94.0) 197(98.5) no 33(4.7) 30(6.0) 3( 1.5) 간호사이미지 대상자의간호사이미지를살펴본결과는표와같다간호사이미지는 점만점에간호조 무사는평균 점조무사교육생은평균 점이었으나통계적으로유의한차이 는없었다 각하위영역에서개인적이미지는 점만점에간호조무사는평균 표 간호조무사와조무사교육생이지각하는간호사이미지 Area Traditional Image Social Image Nurse Aid Nurse Total Students Aids Item t p (N=700) (n=500) (n=200) M±SD M±SD M±SD Nurses are accurately 2.79± ± ± Nurses think the patients first 2.52± ± ± Nurses are comfortable 2.44± ± ± Nurses are logically and rationally 2.51± ± ± Nurses understand their patients 2.64± ± ± Nurses are reliable 2.57± ± ± Nurses deserve to be called 2.24± ± ± 'a white-robed angel' Nurses are cooperative and have 2.39± ± ± a good personal relationship Nurses quickly solve the needs 2.50± ± ± of the patient Nurses are clean and tidy 2.85± ± ± Nurses are highly respected 2.73± ± ± Nurses are very dedicated 2.33± ± ± Subtotal 30.39± ± ± (2.54±0.63) (2.54±0.65) (2.59±0.57) Nurse perform the maternal role 2.13± ± ± Nurses are health educators 2.49± ± ± Nurses have higher social status 2.29± ± ± Nurses are counselors 2.21± ± ± <.001 Nurses independently care for patients 2.06± ± ± Nurses are intellectual 2.60± ± ± Copyright 2017 HSST 489

6 Professional Image Personal Image Nurses shall cooperate to the 2.12± ± ± equivalent position of fellow doctors Subtotal 15.81± ± ± Nurses have professional knowledge (2.26±0.62) (2.25±0.64) (2.28±0.58) 2.81± ± ± Nurses are highly skilled 2.76± ± ± Nurses should be of 2.63± ± ± their profession Nurses are 2.61± ± ± systematically proceeding Their performance is valuable 2.75± ± ± and rewarding Nurses are active 2.54± ± ± Subtotal 16.10± ± ±3.49 (2.68±0.60) (2.66±0.61) (2.75±0.58) Nurses are selfish 2.38± ± ± Nurses are not kind 2.44± ± ± <.001 Nurses complain 2.49± ± ± Subtotal 7.31± ± ± <.001 (2.44±0.79) Total 69.72±15.91 (2.49±0.57) (2.37±0.81) 69.08±16.34 (2.47±0.58) (2.59±0.70) 71.32±14.68 (2.55±0.52) (-2.18).094 점조무사교육생은평균 점으로통계적으로유의한차이를보였으나 전통적이미지사회적이미지와전문적이미지는통계적으로유의한차이를보이지않았 다평균평점은점만점에전문적이미지는 점전통적이미지 점개인적이미지 점 사회적이미지 점순으로나타났다 하위항목중두군간통계적으로유의한차이를보인문항을살펴보면다음과같다전통적이 미지영역중간호사는환자우선주의로일처리한다에서간호조무사는 점조무사교육 생은평균평점 점으로나타났다 간호사는신뢰감을준다는간호조무사 는 점조무사교육생은평균평점 점으로나타났다 간호사는백 의의천사로불릴만하다는간호조무사는 점조무사교육생은평균평점 점으로 나타났다 간호사는환자의요구에즉시응한다에서간호조무사는 점 조무사교육생은평균평점 점으로나타났다 간호사는깨끗하고단정하 다는간호조무사는 점조무사교육생은평균평점 점으로나타났다 사회적이미지영역중에서는간호사는상담자이다는간호조무사는 점조무사 교육생은평균평점 점으로나타났고 간호사는독자적으로환자간호를수 행한다는간호조무사는 점조무사교육생은평균평점 점으로나타났다 전문적이미지영역중에서는간호사는직업에대한긍지를가지고있다에서간호조무사 는 점조무사교육생은평균평점 점을보였다 개인적이미지는 490 Copyright 2017 HSST

7 Vol.7, No.2, February (2017) 역환산점수로간호사는불친절하다항목에서간호조무사는점점으로통계적으로유의한차이를보였다 간호사이미지결정요인 점조무사교육생은평균평 본연구의이미지결정요인을살펴본결과는표과같다간호사이미지결정요인은 점만 점에간호조무사는 점조무사교육생은평균 점으로통계적으로유의한차이 는없었다 하위영역에서매체적요인은 점만점에간호조무사는평균 점조무사교육생은평균 점으로통계적으로유의한차이를보였으나 주관적요인과제도적요인에서는통계적으로유의한차이가나타나지않았다평균평점 은점만점에주관적요인 점제도적요인 점매체적요인 점순으로나타났다하위 항목중두군간통계적으로유의한차이를보인문항을살펴보면다음과같다주관적요인중 간호사의신속성에서간호조무사는 점조무사교육생은평균평점 점으로나타 났으며 매체적요인중에서는소설에서표현된간호사에서간호조무사는 점조무사교육생은평균평점 점을보였다 간호사자신의자아 상에서는간호조무사는 점을보였으며조무사교육생은평균평점 점으로나타 났으며통계적으로유의한차이를보였다 표 간호조무사와조무사교육생이지각하는간호사이미지결정요인 Area Subject factors Nurse Aid Nurse Total Students Aids Item t p (n=700) (n=500) (n=200) M±SD M±SD M±SD Reliability of nurse 2.91± ± ± Direct experience with nurse 2.81± ± ± Kindness of nurse 3.05± ± ± Immediacy of nurse 2.80± ± ± Consideration of nurse 2.97± ± ± Nurse the spirit of 2.87± ± ± sacrifice and service Nurse role of counselors 2.67± ± ± Cleanliness a nurse 2.97± ± ± The role of a nurse 2.89± ± ± Subtotal 25.91±5.87 Institutional factors Workplace and conditions of nurse 25.86± ± (2.88±0.65) (2.87±0.68) (2.89±0.57) 2.79± ± ± Nurse's education 2.53± ± ± Three shifts of nurse 2.64± ± ± Copyright 2017 HSST 491

8 Media factors Role of doctor's assistant 2.75± ± ± Nurse's uniform 2.87± ± ± Subtotal 13.58± ± ± A nurse who expressed in the novel A nurse who expressed in a nurse drama TV A nurse appeared in newspapers and magazines (2.72±0.65) (2.71±0.70) (2.74±0.52) 2.15± ± ± ± ± ± ± ± ± Nurse your own self-image 2.64± ± ± <.001 Subtotal 9.70± ± ± (2.42±0.64) Total 49.19±10.15 (2.73±0.56) (2.38±0.67) 48.93±10.75 (2.72±0.60) (2.53±0.56) 49.86±8.43 (2.77±0.47) (-1.58).275 논의 본연구는간호조무사와조무사교육생을대상으로간호사이미지와이미지결정요인을확인하여이들을교육하고관리 감독할간호사에대한긍정적이고바람직한이미지정립의기초자료로활용하고자시도되었으며주요연구결과를중심으로논의하고자한다본연구결과간호사이미지는점만점에평균점으로중간정도인것으로나타났으며간호조무사와조무사교육생간통계적으로유의한차이를보이지않았다이는종합병원준종합병원의원에서근무하는간호조무사를대상으로한의연구에서점만점에평균점으로나타난결과에비해상대적으로낮게나타났으나의연구에서는문항수와점수척도를수정사용하여본연구와직접적인비교가어려우므로추후반복연구를통해검증할필요가있을것이다다만동일한측정도구를사용하여간호과학생과비간호과학생을대상으로간호사이미지를비교한와의연구에서점만점에간호과학생은평균점비간호과학생은평균점으로중간이상으로높게나타난결과에비해본연구에서간호조무사는점조무사교육생은평균점으로낮은점수를보여주고있다현재간호실무현장에서간호사의보조인력으로근무하고있는간호조무사와앞으로간호조무사가되기위해훈련중인교육생을대상으로간호사에대한긍정적인이미지를강화할필요가있다고여겨진다본연구의간호사이미지중두간의차이를나타낸영역은개인적이미지로나타났다이는동일한도구를사용한환자보호자일반인을대상으로한의연구와간호과학생과비간호과학생을대상으로한와의연구및초중고생을대상으로한과의연구에서는모든영역에서유의한차이를보인결과와차이를보이고있다과의간호대학생과일반대학생을대상으로한연구에서는개인적이미지를제외한하위영역에서유의한차 492 Copyright 2017 HSST

9 Vol.7, No.2, February (2017) 이를보였다또한본연구의개인적이미지는점만점평균점으로중간정도점수로나타났으나의연구에서는평균점와의연구는평균점과의연구에서는평균점으로중상의점수를보이며본연구와차이를보이고있다간호조무사를대상으로한의연구에서문항수와총점에서차이는있으나개인적이미지는점만점에평균점을보였다본연구의결과는간호조무사나조무사교육생들이지각하는간호사이미지는환자나보호자일반인이나간호과학생과비간호과학생초중고생대상자가지각하는개인적이미지보다낮은점수를보이고있다이는간호조무사교육현장이나간호업무현장에서불친절하거나부정적인간호사의태도나행동이나타나고있지는않은지간호사스스로의자성과이를통한시정노력이필요할것으로여겨진다본연구에서간호사이미지결정요인은점만점에중간정도로나타났으며간호조무사와조무사교육생간에통계적으로유의한차이는없었다이미지결정요인의하위영역을살펴보면주관적요인제도적요인매체적요인순으로간호사이미지결정에영향을미치는것으로나타났는데간호사에대한직간접경험에의한주관적판단이나간호사근무환경이나교육에의한제도적요인은간호조무사와조무사교육생간통계적으로유의한차이를보이지않았다매스미디어를통한영향인매체적요인은간호조무사가조무사교육생보다통계적으로유의하게높게나타났으나점만점에중간이하정도로나타났다이는동일한도구를사용한선행연구에서일반인의매체적요인의평균이점간호과학생과비간호과학생의매체적요인의평균이점인것에비해낮게나타났다이는최근의드라마나영화에서는과거의전통적인간호사이미지외에좀더다양한측면으로다루게되면서긍정적인이미지외에부정적인영향도미치게된것으로여겨진다은한국의학드라마에나타난간호사는현실의다양한간호사들의모습을충분히보여주기에는미흡했다고했으며은국내신문에나타난간호사를연구한후전문적지식과기술을연마하고간호사의권익증진을도모하나윤리의식의결여나직무태만과같은불미스런일에연루되기도했다고하였다이와같이매체적요인은나드라마매스미디어에표현된간호사에대한내용으로구성되어있으므로간호사에대한올바르고긍정적인이미지를정립하기위해서는나드라마매스미디어에서표현되는간호사의이미지가왜곡되거나편향되지않도록간호계의관심과지속적인모니터링이필요할것이다 결론및제언 본연구는간호조무사와조무사교육생을대상으로간호사이미지와이미지결정요인을파악한것으로본연구결과간호조무사가조무사교육생보다간호사이미지중개인적이미지가간호사이미지결정요인중매체적요인에서통계적으로유의하게높게나타났다개인적이미지의경우간호사가이기적이며불친절하거나불평이많은것으로여기는것으로간호업무현장에서간호사의보조인력인간호조무사가간호사에대한부정적인이미지를갖게되면업무효율성이나환자 Copyright 2017 HSST 493

10 간호의질을떨어뜨릴수있으므로간호사의성찰적태도와이미지개선노력을통해긍정적인간호사이미지정립이필요할것으로여겨진다이미지결정요인에있어서는나드라마매스미디어와같은매체에서간호사에대한이미지가왜곡되지않도록관리함으로써조무사교육생들이이미지결정에있어긍정적영향을받도록해야할것이다본연구는일부지역의특성화고등학교와조무사양성학원및의료기관에서자료를수집하였기에연구결과해석에제한적일수있다그러나간호사의관리와감독이필요한간호보조인력을대상으로효율적인업무관계를형성하기위해간호사의이미지와이미지결정요인을파악하고자한데의의가있다본연구결과를토대로긍정적간호사이미지개선을위한전략을모색하고이를통해개선정도를확인하는연구가필요할것이다 References [1] M. J. Oh, Journal of Korean Academy of Public Health Nursing. A factor analysis on the degree of importance of the professional for advancing nursing image. (2000), Vol.14, N0.1, pp [2] I. S. Yang, A study on the image of nurse and determinants the image. Unpublished master's thesis. Yonse University, Seoul, Korea (1998). [3] H. Y. Kang, M. S. Kim, J. H. Kim, H. S. Kim, N. H. Lee and H. K. Jun, Chonnam Journal of Nursing Sciences. A survey on public nurses' image at local city-from the perspectives of teacher, legal and administrative officers. (2001), Vol.6, No.1, pp [4] S. S. Han, I. S. Sohn, M. H. Lee and K. S. Choi, The Journal of East-West Nursing Research. A Study on nurse' image in a medical center. (2003), Vol.8, No.1, pp [5] B. J. Kalisch, S. Beqeny and S. Neuman, Nursing Outlook. The image of the nurse on the internet. (2007), Vol.55, pp [6] H. J. Kim and H. O. Kim, The Journal of Korea Nursing Administration Academic Society. A study on the Image of the nurse. (2001), Vol.7, No.1, pp [7] M. S. Yang, J. H. Byeon and Y. G. Lee. Application for expending hospital care service nurse assistants workforce. Korea Institute of Hospital Management Publisher, (2006) [8] Y. R. Lee, Nurses' image perceived by certified nursing Assistants. Unpublished master's thesis. Chonbuk National University, Chonju, Korea (2008). [9] S. H. Lee and J. A. Kim, Image of nurse and it's determinants among nursing students and non-nursing students. Journal of Korean Nursing Administration. (2006), Vol.12, No.1, pp [10] Y. M. Kim and Y. S. Kang, Nurse's image perceived by elementary, middle and high school students. Jourmal of Korean Academic Society of Nursing Education. (2013), Vol.9, No.3, pp [11] H. J. Kim and H. O. Kim, A study on the Image of the nurse. The Journal of Korea Nursing Administration Academic Society. (2001), Vol.7, No.1, pp Copyright 2017 HSST

11 Vol.7, No.2, February (2017) [12] J. E. Kim, H. J. Jung, H. N. Kim, S. Y. Son, S. K. An, S. B. Kim, J. E. Son, H. W. Lee, M. K. Jung and K. H. Jeon, The image nurses and their clinical role portrayed in korean medical TV dramas in recent 5years. Perspectives in Nursing Science. (2013), Vol.10, No.2, pp [13] L. Jin, A thematic analysis on nurse in newspaper articles. Unpublished doctorate thesis. Ewha Womans University, Seoul, Korea (2014). Copyright 2017 HSST 495

서론 34 2

서론 34 2 34 2 Journal of the Korean Society of Health Information and Health Statistics Volume 34, Number 2, 2009, pp. 165 176 165 진은희 A Study on Health related Action Rates of Dietary Guidelines and Pattern of