ORIGINAL ARTICLE Child Health Nurs Res, Vol.20, No.4, October 2014: ISSN(Print) ISSN(On
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1 ORIGINAL ARTICLE Child Health Nurs Res, Vol.20, No.4, October 2014: ISSN(Print) ISSN(Online) 고등학생의정신건강및문제행동에영향을미치는요인 : 사회인지진로이론에근거하여 손해경 1, 이혜정 2, 김미영 1 1 연세대학교일반대학원간호학과, 2 연세대학교간호대학 Factors Affecting Mental Health and Behavioral Problems in High School Students: Based on a Social Cognitive Career Theory Hae Kyoung Son 1, Hyejung Lee 2, Miyoung Kim 1 1 Department of Nursing, Graduate School, Yonsei University, Seoul; 2 College of Nursing, Yonsei University, Seoul, Korea Purpose: This study was conducted to identify factors affecting mental health and behavioral problems among high school students through the lens of a Social Cognitive Career Theory. Methods: A descriptive study was carried out with 384 high school students in Seoul, Korea. A self-administrative questionnaire was used. It consisted of items on person background variables, career-related variables including career barriers, learning experiences, self-efficacy, outcome expectations, and career indecision, and mental health and behavioral problems. Descriptive statistics, correlation analysis and multiple regression analysis were performed using the SPSS 21.0 program. Results: The results showed that perceived stress (t=5.12, p <.001), perceived health status (t=-4.08, p =.002), and school record (t=5.46, p <.001) were statistically significant variables. Also, career barriers (t =10.57, p <.001) was a significant factor influencing mental health and behavioral problems. Conclusion: These findings indicate that among career-related variables, career barrier needs to be considered for preventive and therapeutic approach to mental health and behavioral problems in adolescents. Furthermore, the results suggest that career-related stress level should be assessed in high school students on a regular basis. Key Words: Adolescent, Behavioral problem, Mental health, Social cognitive career theory 연구의필요성 서론 우리나라청소년의약 86% 는입시위주의교육환경으로인해학업 이나진로와관련된스트레스를경험하고있다. 또한다른나라에비 해진로를선택하지못하는청소년이많은것으로나타났다 (Eom, Park, & Joo, 2011; National Youth Commission, 2003; National Youth Corresponding author Miyoung Kim College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul , Korea TEL FAX lilyanna0@gmail.com Key words 청소년, 문제행동, 정신건강, 사회인지진로이론 투고일 2014/7/16 1 차수정 2014/9/5 게재확정일 2014/10/6 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non- Commercial License ( which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Policy Institute, 2012). 특히청소년후기의고등학생은진로에대한준비와결정을하는중요한시기에처해있고 (Seon & Kim, 2008), 이시기에진로를결정하지못한경우불안, 우울등정신건강문제나집단따돌림, 폭력, 가출등의문제행동을경험하는것으로보고되고있다 (Jeong, 2003; Kim, Lee, Kweon, Oh, & Kim, 2009; Lee, 2000; Park, Cho, & Park, 2003; Tomas, James, Alison, Sean, & Ori, 2001). 청소년기정신건강상의취약성을고려하여정서및문제행동을보일가능성이있는학생을조기에발견하여예방적, 중재적접근을하는것이무엇보다필요하다 (Pelkonen, Marttunen, & Aro, 2003). 우리나라는청소년정신보건사업과같은범국가적, 정책적차원의노력과함께대부분의시간을학교에서보내는학생의경우학교를중심으로한정신보건사업의중요성이부각되었다 (Kim, Kim, Park, Lee, & Kim, 2000). 이를위해보건복지부연구로 Ahn (2006) 이청소년정신건강및문제행동선별질문지 (Adolescent Mental health and Problem-behavior 314 Copyright 2014 Korean Academy of Child Health Nursing
2 Questionnaire, AMPQ) 를개발한후 Kim 등 (2009) 이고등학생을대상으로사용할수있는정신건강및문제행동선별질문지의타당성을검증하고학교에서사용할수있도록하였다. 그외에도청소년정신건강및문제행동의치료와교정을위한정신보건센터의운영등다양한정신보건사업이시도되고있다 (Kim et al., 2009). 그러나청소년의정신건강및문제행동을다룬기존의연구는청소년이겪는전반적인스트레스에초점을두거나그영향요인으로진로를단일변인으로다루고있다 (Kim, 2001; Lee, 2000; Lee, 2011; Lee & Yu, 2009). 그리고진로에관한연구는일반적으로진로결정과정이일어나는고등학생보다는대부분대학생을대상으로이루어졌다. 진로관련변인은진로를앞둔상황에서갑자기획득되기보다는성장발달과정동안꾸준히영향을받는요인으로고등학생의진로관련변인에대한연구는그의의가크다 (Whang et al., 2005). 진로결정은오랜시간에걸쳐계획하고준비하는것이필요하므로단일변인으로설명될수없다 (Eom et al., 2011). 따라서, 고등학생의정신건강및문제행동의영향요인으로써진로와관련된변인을구체적으로규명하는것이필요하다. 특히 Lent, Brown과 Hackett (1994) 의사회인지진로이론 (Social Cognitive Career Theory, SCCT) 은개인의복합적인진로선택행동을보다포괄적으로이해할수있게하여최근주목을받고있다 (Eom et al., 2011). Bandura (1986) 의사회인지이론을기반으로하여개발된사회인지진로이론은개인 배경변인뿐만아니라맥락적변인들간의상호작용까지초점을맞추고있는것이장점이다 (Lent et al., 1994; Lent, Brown, & Hackett, 2000). 이이론에서진로를선택하는데영향을미치는요인으로개인 배경변인과함께맥락적변인으로진로장벽, 학습 경험, 자기효능감, 그리고결과기대를제시하고있으며이는진로에대한관심과목표선정, 진로를결정하는행동에영향을준다고하였다. 이에본연구는우리나라고등학생의정신건강및문제행동에영향을미치는요인을진로와관련하여확인하기위해, 사회인지진로이론에근거하여진로를선택하는데영향을미치는개인 배경변인과진로관련변인 ( 진로장벽, 학습경험, 자기효능감, 결과기대, 진로미결정 ) 을조사하였다. 궁극적으로는진로관련변인들을토대로우리나라청소년의정신건강및문제행동을이해하고자하였다 (Figure 1). 연구목적본연구는사회인지진로이론 (Lent et al., 1994) 에입각하여우리나라고등학생의정신건강및문제행동에영향을미치는요인을규명하기위함이며, 구체적인목적은다음과같다. 첫째, 고등학생의개인 배경변인과진로관련변인 ( 진로장벽, 학습경험, 자기효능감, 결과기대, 진로미결정 ) 을조사한다. 둘째, 고등학생의정신건강및문제행동을조사한다. 셋째, 고등학생의정신건강및문제행동에영향을미치는요인을규명한다. 연구방법 연구설계본연구는고등학생의정신건강및문제행동의영향요인으로써진로관련변인을규명하기위한서술적조사연구이다. Figure 1. Theoretical framework based on a social cognitive career theory (Lent et al., 1994). 손해경, 이혜정, 김미영 315
3 Child Health Nurs Res, Vol.20, No.4, October 2014: 연구대상본연구의표적모집단은우리나라의고등학생이며, 근접모집단은서울에소재한 3개의인문계고등학교 ( 남고 1개교, 여고 1개교, 남녀공학 1개교 ) 에재학중인고등학생이었다. 대상자는각고등학교의 1, 2학년에재학중인고등학생으로연구의목적을이해하고부모의동의를받고자발적참여를희망하는자, 그리고설문지작성이가능한자를선정기준으로하여편의표집하였다. 고등학교 3학년은진로결정에몰입하는시기로서 (National Youth Policy Institute, 2012), 본연구의자료수집기간이대학수학능력시험이종료된시점임을고려하여제외되었다. 대상자의수는 G*Power 3.1을이용하여유의수준 (α).05, 검정력 (1-β).80, 효과크기 (f2).02, 예측변수의수를 13개로산출한결과최소 381명이요구되었으며, 무응답을고려하여 400명을모집하였다. 설문지는선정기준에적합하지않는 4명과개체무응답인 12명의자료를제외한총 384부 (96.0%) 를최종분석하였다. 연구도구개인 배경변인개인적변인은대상자의성별, 학년, 평상시건강상태, 스트레스인지에관한 4문항이고배경적변인은경제상태, 학업성적, 부모의최종학력과직업에관한 4문항으로구성되어있다. 진로관련변인진로장벽진로장벽은진로선택과정에서개인이극복할수없는장애물이있다고지각하는것으로 (Russell & Rush, 1987), 남자 / 여자청소년용진로장벽척도 (Whang, Lee, & Park, 2005; Whang, Lee, & Yoo, 2005) 로측정하였다. 본도구는총 42문항으로자기이해부족 (1요인), 학습효능감 (2 요인 ), 성역할갈등및성차별 (3요인), 중요한타인과의갈등 (4요인), 미래에대한불확실성 (5요인), 진로및직업정보의부족 (6요인), 경제적어려움 (7요인) 의하부요인으로구성되어있다. 성역할갈등및성차별 (3요인) 에해당하는 8문항은성별을고려하여문항구성및타당도가검증되어있고, 본연구에서남학생용과여학생용을구분하여성별에맞게사용하였다. 진로장벽척도는 전혀그렇지않다 (1점 ) 에서 매우그렇다 (5점) 의 5점리커트식척도로응답하며, 총점이높을수록진로장벽에대한지각이높음을의미한다. Cronbach s α는남학생용은 , 여학생용은 (Whang, Lee, & Park, 2005; Whang, Lee, & Yoo, 2005) 이었고, 본연구에서는남학생용과여학생용각각.94,.93이었다. 연구자는전자우편으로도구사용에대한승인을받았다. 학습경험학습경험은한국청소년정책연구원 (National Youth Policy Institute, 2012) 에서제공하는고등학교재학중진로와관련된학습경험 ( 진로관련강연, 학교 / 학과안내, 적성 / 흥미검사, 직업체험, 진로상담 ) 을묻는 5문항을선택하여측정하였다. 학습경험에대한경험여부와만족도를 경험한적없음 (0점) 과 매우불만족 (1점 ) 에서 매우만족 (5점) 의 5점리커트식척도로응답하며, 총점이높을수록노출된학습경험에대한만족이높음을의미한다. 연구자는유선으로문항사용에대한승인을받았으며, 본연구에서의 Cronbach s α는.83이었다. 자기효능감자기효능감은진로와관련된다양한진로탐색활동을성공적으로수행할수있는지에대한개인적인확신을의미한다 (Hackett & Betz, 1981). 즉, 자기효능감은진로결정에서요구되는과제들을성공적으로완성할수있는지에대한개인적신념으로 (Kim & Seo, 2010) Betz, Klein과 Taylor (1996) 의진로결정자기효능감단축형척도 (Career Decision Making Self Efficacy Scale-Short Form, CDMSE-SF) 를 Lee (2001) 가요인분석하여타당도가입증된도구로측정하였다. 본도구는총 25문항으로목표선택 (11문항), 직업정보 (6문항), 문제해결 (3문항), 미래계획 (5문항) 의하부요인으로구성되어있으며, 전혀그렇지않다 (1 점 ) 에서 매우그렇다 (5점) 의 5점리커트식척도로응답하고, 총점이높을수록진로결정에대한개인적효능감이높음을의미한다. Cronbach s α는.88 (Lee, 2001) 이었고, 본연구에서는.91이었다. 연구자는전자우편으로도구사용에대한승인을받았다. 결과기대결과기대는한국청소년정책연구원 (National Youth Policy Institute, 2012) 의진로결과기대 ( 자기개발, 직업, 배우자, 친구, 사회적대우 ) 에대한 5문항으로측정하였다. 전혀그렇지않다 (1점 ) 에서 매우그렇다 (5 점 ) 의 5점리커트식척도로응답하고, 총점이높을수록진로결과에대한기대수준이높음을의미한다. 연구자는유선으로문항사용에대한승인을받았으며, 본연구에서의 Cronbach s α는.74였다. 진로미결정진로미결정은한국청소년정책연구원 (National Youth Policy Institute, 2012) 의진로미결정 ( 적성 / 소질에대한이해부족, 진로설정에대한부모님과의의견차이, 정보부족등과관련된진로선택의어려움과잦은변경 ) 에대한 6문항으로측정하였다. 전혀그렇지않다 (1점 ) 에서 매우그렇다 (5점) 의 5점리커트식척도로응답하고, 총점이높을수록진로미결정수준이높음을의미한다. 연구자는유선으로문항사용에대한승인을받았으며, 본연구에서의 Cronbach s α는.79였다. 316 고등학생의정신건강및문제행동에영향을미치는요인
4 정신건강및문제행동정신건강및문제행동은 Kim 등 (2009) 의고등학생용정신건강및문제행동선별질문지 (Adolescent Mental health and Problem-behavior Questionnaire, AMPQ) 로측정하였다. 본도구는총 31 문항으로정신의학적문제, 학업문제, 가족문제, 섭식문제를포함하는내재화문제 (18 문항 ) 와비행문제, 위험행동, 유해환경을포함하는외재화문제 (13문항 ) 로구성되어있다. 전혀그렇지않다 (1점 ) 에서 매우그렇다 (5점) 의 5점리커트식척도로응답하며총점이높을수록정신건강및문제행동수준이높음을의미한다. Cronbach s α는.85 (Kim et al., 2009) 이었고, 본연구에서는.90이었다. 연구자는전자우편으로도구사용에대한승인을받았다. 자료수집방법자료수집기간은 2013년 11월 18일부터 29일까지이며, 해당고등학교의학교장, 보건관련담당자와교사에게자료수집에대한동의를구한후자료수집을시행하였다. 자료수집은구조화된설문지를통해이루어졌다. 설문작성은평균 15-20분가량소요되었다. 연구자는대상자개인에게제공할조사패키지 ( 연구설명문및동의서, 설문지, 반송봉투, 답례품 ) 를해당고등학교의보건교사에게직접전달한후보건교사가대상자에게밀봉하여조사패키지를배부하고, 대상자가부모의서면동의를받은후설문지를개별작성하여제출하도록하였다. 대상자는연구목적과방법, 기밀성, 참여의자발성, 참여거부의사의존중등이상세히기술된연구설명문을읽고자발적으로참여를원하는자에한해연구동의서를작성한후연구를진행하도록하였다. 작성된설문지는동봉된반송봉투에넣은후다시밀봉하여보건교사에게제출하도록하였으며, 연구자는해당보건교사로부터반송봉투를직접수거하였다. 본연구는연구자가소속된간호대학의기관생명윤리위원회의승인을받았으며 (No ), 연구대상자전원에게소정의답례품 ( 학용품 ) 을제공하였다. 자료분석방법수집된자료는 SPSS 21.0 프로그램을이용하여분석하였다. 대상자의개인 배경변인은기술통계분석을하였고, 도구의내적일관성신뢰도는 Cronbach s α 계수로나타내었다. 개인 배경변인, 진로관련변인과정신건강및문제행동의상관관계는피어슨상관계수로분석하였으며정신건강및문제행동의영향요인을확인하기위해서다중회귀분석을실시하였다. 본연구의항목무응답은 4.6% 였으며, 항목무응답이 5% 미만으로낮은경우자료대체법으로가장적합한평균대체법을활용하였다 (Tabachnick & Fidell, 2007). 연구결과 개인 배경및진로관련변인대상자의성별은남학생이 186명 (48.4%), 여학생이 198명 (51.6%) 이었으며, 고등학교 1학년이 189명 (49.2%), 2학년이 195명 (50.8%) 이었다. 평상시건강상태는보통이상의양호한수준이 253명 (92.9%) 이었다. 스트레스는 조금느낀다 가 196명 (51.0%), 많이느낀다 가 92명 (24.0%), 매우많이느낀다 가 22명 (5.7%) 으로총대상자의 80.7% 가평상시스트레스를느낀다고한반면에 3.9% 만이스트레스를 전혀받지않는다 고하였다. 대상자가운데 333명 (85.8%) 이친부모와함께거주하였고, 부모의대부분은고등학교졸업 ( 아버지 =38.8%, 어머니 = 48.4%) 과대학교졸업이상 ( 아버지 = 52.1%, 어머니 = 44.5%) 의학력을가지고있었다. 부모의직업은일반사무 / 기술 / 판매서비스직종사자 ( 아버지 = 46.9%, 어머니 = 39.3%) 가가장많았고, 어머니의경우에는무직 ( 주부 ) 인자가 103명 (26.8%) 이었다. 경제적상태는중상정도가 104명 (27.1%), 평균정도가 188명 (49.0%) 이었고, 학업성적은중상이상이 113명 (29.4%), 평균정도가 118명 (30.7%), 중하이하가 147명 (38.3%) 이었다 (Table 1). 진로관련변인의평균평점은진로장벽이 2.0 ± 0.3점, 학습경험이 2.3 ± 0.3점, 자기효능감이 3.4 ± 0.3점, 결과기대가 3.6 ± 0.4점, 진로미결정이 2.5 ± 0.4점으로나타났다. 그리고정신건강및문제행동의문항평균은 1.6 ± 0.5점, 내재화문제가 1.9 ± 0.4점이었으며그중학업문제가 2.3 ± 0.4점으로비교적높았고, 외재화문제는 1.3± 0.3점이었다 (Table 2). 개인 배경변인, 진로관련변인과정신건강및문제행동간상관관계개인 배경변인에서스트레스인지 (r =.43, p <.001), 평상시건강상태 (r = -.31, p <.001), 경제적상태 (r = -.26, p <.001), 학업성적 (r = -.37, p <.001) 이정신건강및문제행동과통계적으로유의한상관관계를보였고, 진로관련변인중에서진로장벽 (r =.60, p <.001), 학습경험 (r = -.15, p <.001), 자기효능감 (r = -.30, p <.001), 진로미결정 (r =.26, p <.001) 이유의한상관관계가있었다 (Table 3). 정신건강및문제행동의영향요인상관관계분석결과를토대로개인 배경변인에서스트레스인지, 평상시건강상태, 경제적상태, 학업성적과진로관련변인에서진로장벽, 학습경험, 자기효능감, 진로미결정을독립변수로하여정신건강및문제행동에영향을미치는요인에대한다중회귀분석결과, 회귀모형에대한설명력은 51.1% 였고, 회귀식모형의적합성이검증되었다 (F = , p <.001). 분산팽창계수 (Variance Inflation Factor, VIF) 는최소 1.13에서최대 1.91 로다중공선성의문제는나타나지않았으며 Durbin- Watson 은 로잔차간상관관계가없었다. 손해경, 이혜정, 김미영 317
5 Child Health Nurs Res, Vol.20, No.4, October 2014: Table 1. Person Background Variables Variables Categories (N=384) Frequency n (%) Person Gender Male 186 (48.4) Female 198 (51.6) Grade 1st 189 (49.2) 2nd 195 (50.8) Perceived health status Very good 113 (29.4) Good 182 (47.4) Fair 58 (15.1) Poor 25 (6.5) Very poor 1 (0.3) Perceived stress Very much 22 (5.7) Much 92 (24.0) A little 196 (51.0) Little or no 52 (13.5) None at all 15 (3.9) Cohabitants With both parents 333 (85.8) With single parent 41 (10.6) With foster parent 4 (1.0) Background Economic status High 12 (3.1) Above average 104 (27.1) Average 188 (49.0) Under average 61 (15.9) Low 12 (3.1) School record Good 19 (4.9) Above average 94 (24.5) Average 118 (30.7) Under average 106 (27.6) Poor 41 (10.7) Educational level (father) Elementary school 7 (1.8) Middle school 11 (2.9) High school 149 (38.8) College/University 200 (52.1) Educational level (mother) Elementary school 5 (1.3) Middle school 10 (2.6) High school 186 (48.4) College/University 171 (44.5) Occupation (father) Professional/Executive/Administrative 115 (29.9) Office worker/technical/sales 180 (46.9) Agro-livestock/Simple labor 4 (1.0) Unemployed 8 (2.1) Others 60 (15.6) Occupation (mother) Professional/Executive/Administrative 49 (12.8) Office worker/technical/sales 151 (39.3) Agro-livestock/Simple labor 3 (0.8) Unemployed 103 (26.8) Others 64 (16.7) 정신건강및문제행동에유의미한영향을주는요인은개인 배경 변인에서스트레스인지 (t = 5.12, p <.001), 평상시건강상태 (t= -4.08, p <.001), 학업성적 (t = 5.46, p <.001) 과진로관련변인중에서진로장벽 (t = Table 2. Career-related Variables, and Mental Health and Behavioral Problems (N=384) Variables Total 10.57, p <.001) 으로나타났다 (Table 4). 논의 본연구는사회인지진로이론에근거하여우리나라고등학생을대상 으로정신건강및문제행동에영향을미치는요인을규명하기위한서 술적조사연구로서스트레스인지와평상시건강상태, 학업성적, 진로 장벽이영향요인임을확인하였다. Mean (SD) Item Range Career-related Career barriers 85.8 (18.8) 2.0 (0.3) Learning experiences 11.4 (6.4) 2.3 (0.3) 0-25 Self-efficacy 85.2 (13.4) 3.4 (0.3) Outcome expectations 20.0 (4.2) 3.6 (0.4) 6-30 Career indecision 13.0 (4.0) 2.5 (0.4) 5-25 Mental health and behavioral problems 50.8 (18.8) 1.6 (0.5) Internal 33.6 (10.9) 1.9 (0.4) Psychiatric problems 17.2 (6.4) 1.9 (0.4) 9-45 Academic troubles 9.1 (3.6) 2.3 (0.4) 4-20 Family problems 4.8 (2.3) 1.6 (0.2) 3-15 Eating problems 2.7 (1.4) 1.4 (1.4) 2-10 External 16.9 (5.0) 1.3 (0.3) Delinquency 7.3 (2.7) 1.2 (0.1) 6-30 Hazardous behavior 4.4 (1.5) 1.1 (0.0) 4-20 Harmful circumstance 5.2 (2.1) 1.7 (0.6) 3-15 Table 3. Correlations of Variables with Mental Health and Behavioral Problems (N=384) Variables Mental health and behavioral problems r (p) Person Perceived stress.43 ( <.001) Perceived health status -.31 ( <.001) Background Economic status -.26 ( <.001) School record -.37 ( <.001) Career-related Career barriers.60 ( <.001) Learning experiences -.15 ( <.001) Self-efficacy -.30 ( <.001) Outcome expectations.06 (.230) Career indecision.26 ( <.001) 본연구에서고등학생의스트레스가높을수록정신건강및문제행 동에유의미한영향을주었는데다수의선행연구에서도스트레스에 318 고등학생의정신건강및문제행동에영향을미치는요인
6 Table 4. Multiple Regression Analysis for Variables Predicting Mental Health and Behavioral Problems (N=384) Variables B SE Std β t p Person Perceived stress <.001 Perceived health status <.001 Background Economic status School record <.001 Career-related Career barriers <.001 Learning experiences Self-efficacy Career indecision R 2 =.511, F = , p <.001 대한지각이높을수록공격성, 흡연, 음주, 약물중독등의정신건강및 문제행동이증가하는것으로나타나본연구결과와일치하였다 (Jeong, 2003; Park et al., 2003; Tomas et al., 2001). 특히, 본연구에서고등학생의 80.7% 가평상시에도스트레스를인지하는것으로나타나청소년의약 86% 가평소에도스트레스를경험한다는청소년보호위원회 (National Youth Commission, 2003) 의보고와유사하여우리나라고등학생의다 수가스트레스를경험하는것을재확인하였다. 평상시건강상태가좋다고보고한학생일수록정신건강및문제행 동수준은유의미하게낮아졌는데, Pelkonen 등 (2003) 의연구에서도 주관적인건강상태가부정적일수록우울등의정신건강문제가많았 다. 그리고우울한증상이나자존감저하등의정신건강문제가많을 수록문제행동수준이높았는데이는성인초기의우울에도영향을 미치는것으로나타났다. 즉, 건강상태는학업을지속하고성취욕구에 부응할수있는충분조건이며정신건강및문제행동에직 간접적으 로영향을미치는것으로생각된다. 배경적변인에서학업성적이청소년의정신건강및문제행동에영향 을주는것으로나타나선행연구결과와일치하였다 (Eom et al., 2011; Jeong, 2003; Park et al., 2003; Pelkonen et al., 2003). Park 등 (2003) 의연구 에서도여자청소년의경우학업성적의저하가흡연을지속하는데영 향을주는요인으로나타났다. 학업성적은학교에대한적응및학업성 취도를반영하고학업성취에대한만족도가정신건강및문제행동과 관계가있음을알수있었다 (Pelkonen et al., 2003). 반면에경제적상태는정신건강및문제행동에유의미한영향을미 치지않았다. 일반적으로경제적수준이낮은경우가족및이웃과의 부정적인상호작용으로인해자아존중감과자신의미래에대한기대 치가낮고, 상호관련성이높은사회적지지요인들로인해진로결정 측면에서도기회가제한적이라고하였다 (Eom et al., 2011). 하지만본 연구에서는경제적상태나부모의교육수준, 직업등편의표집된대 상자의해당고등학교가소재한지역적특성즉, 사회경제적수준이반영되어대상자간편차가없었던것으로보인다. 진로관련변인가운데진로장벽이정신건강및문제행동에유의미한영향을주었다. 즉, 본연구에서진로장벽에대한인식이높을수록정신건강및문제행동수준이높아지는부정적인영향을확인할수있었다. 사회인지진로이론에의하면진로장벽은진로를탐색하는데동기를부여하거나진로를결정하는데영향을미치는주요변수로서, 진로장벽을지각하는것은진로결정을어렵게만들고정신건강에도부정적인영향을미칠수있다 (Kim & Seo, 2010; Lee & Yu, 2009; Lent et al., 1994; Tokar, Withrow, Hall, & Moradi, 2003). Eom 등 (2011) 은빈곤청소년을대상으로한연구에서진로장벽이높을수록진로미결정수준이높아진다고보고하였다. Kim과 Seo (2010) 의종단적자료를분석한연구에서도사회인지진로이론의변수가운데진로장벽을적게지각할수록자기효능감수준이높을수록진로미결정수준또한낮은것으로나타났다. 진로미결정수준은고등학교 1, 2학년에서각각평균 2.34 ± 0.70 점, 2.35 ± 0.73 점으로본연구에서의 2.5 ± 0.4점과유사한것을알수있었다. 그리고 Lee (2000) 의연구에서는진로미결정집단이진로결정집단에비해강박증, 우울, 불안, 적대감, 편집증등정신건강및문제행동이높은것으로나타나본연구결과를맥락적으로지지하였다. 그러나본연구에서는진로미결정수준이높을수록정신건강및문제행동이높은상관관계를보였으나회귀분석에서다른변인들이통제된상태에서는유의하지않았다. 정신건강및문제행동에서는진로미결정보다는진로장벽이영향을미치는것을알수있었고, 이변인들은고등학생을대상으로정신건강및문제행동에관한중재를계획할때고려되어야함을시사한다. 특히본연구에서인문계고등학생을대상으로조사한정신건강및문제행동의문항평점은 1.6 ± 0.5점으로비교적낮은수준이었으며한국청소년정책연구원 (National Youth Policy Institute) 에따르면인문계와실업계등고등학생간의특성차이를고려할때인문계고등학생의정신건강및문제행동수준이보다낮은것으로나타났다 (Moon & Shin, 2008). 이에개인적특성에따른정신건강및문제행동과진로관련변인의비교와정신건강및문제행동수준이높은청소년만을대상으로진로관련변인에서의영향요인을규명하는것이필요하다. 본연구결과를토대로다음과같이제언한다. 첫째, 본연구는 S시소재의고등학교에재학중인 1, 2학년을편의표집한연구이므로결과를일반화하는데신중해야하며보다많은수의다양한특성을가진고등학생을대상으로하는종단적연구가필요하다. 둘째, 고등학생의진로미결정수준과스트레스와의관계를규명하고셋째, 정신건강및문제행동의하위요인을반복적으로측정하여비교 검증할수있는추후연구를제언한다. 손해경, 이혜정, 김미영 319
7 Child Health Nurs Res, Vol.20, No.4, October 2014: 결론 본연구는고등학생의정신건강및문제행동에영향을미치는요인을규명하기위해시도되었다. 입시위주의교육환경속에서학업과진로로스트레스를받고있는고등학생의진로관련변인을사회인지진로이론에근거하여포괄적으로이해하고접근한점에서의의가있다. 특히본연구에서규명된진로장벽은지역사회와학교보건측면에서청소년정신건강및문제행동의개선을위한개입시적극적으로고려되어야할것으로보인다. 그리고청소년기의주요관심인진로선택이정신건강및문제행동에미치는영향을고려하여중재를개발하거나대처전략을모색하는것이필요할것으로생각된다. 진로결정은오랜시간에걸쳐계획하고준비하면서진행되는과정이므로후속연구에서는다양한연령층의청소년을대상으로정신건강및문제행동에영향을미치는진로관련변인을종단적으로자료수집하여진로선택과정을지속적으로확인하고정신건강및문제행동에대한예방적, 치료적접근에활용할것을기대한다. Conflict of Interest No potential conflict of interest relevant to this article was reported. 요약 목적본연구는사회인지진로이론에입각하여우리나라고등학생의정신건강및문제행동에영향을미치는요인을규명하기위해수행되었다. 방법본연구는 2013년 11월 18일부터 29일까지, S시에소재한인문계고등학교재학생 384명 ( 남자 186명, 여자 198명 ) 을대상으로한서술적조사연구이다. 연구도구는개인 배경변인, 진로관련변인 ( 진로장벽, 학습경험, 자기효능감, 결과기대, 진로미결정 ), 정신건강및문제행동에관한자기기입식설문지였으며수집된자료는 SPSS 21.0 프로그램을활용하여기술통계, 상관관계및다중회귀분석을하였다. 결과다중회귀분석결과, 개인적변인으로스트레스인지 (t = 5.12, p <.001) 와평상시건강상태 (t = -4.08, p <.001), 배경적변인으로학업성적 (t = 5.46, p <.001), 진로관련변인에서진로장벽 (t = 10.57, p <.001) 이정신건강및문제행동에유의미한영향을미치는요인으로나타났다. 결론고등학생의정신건강및문제행동의영향요인으로개인 배경변인과함께진로장벽을확인하였다. 특히, 진로결정은발달과정동안지속적으로영향을받으므로진로를선택하는청소년후기에이를고려한예방적, 중재적접근이필요하다. 본연구결과를토대로청소년의정신건강및문제행동수준을개선하기위한중재개발과학교보건및실무에의적용에기초자료로활용될것을기대한다. References Ahn, D. H. (2006). Development of screening test and auxiliary textbook for adolescent mental health. Seoul: Korea Ministry of Health and Welfare. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall1. Betz, N. E., Klein, K. L., & Taylor, K. M. (1996). Evaluation of a short form of the career decision-making self-efficacy scale. Journal of Career Assessment, 4(1), Eom, T. Y., Park, E. W., & Joo, E. S. (2011). A study on the influence of self-respect and social support on career decision among low-income adolescents in Korea: Focusing on the mediation effect of career barrier. Health and Social Welfare Review, 31(3), Hackett, G., & Betz, N. E. (1981). A self-efficacy approach to the career development of women. Journal of Vocational Behavior, 18(3), Jeong, K. T. (2003). Social support and perceived stress influence to adolescent aggressiveness. The Journal of Child Education, 12(2), Kim, M. S., & Seo, Y. S. (2010). A longitudinal study on the influence of self-efficacy, status and contextual variables on adolescents career indecision. Studies on Korean Youth, 21(2), Kim, S. J., Lee, C. S., Kweon, Y. R., Oh, M. R., & Kim, B. Y. (2009). Test of validity and reliability of the adolescent mental problem questionnaire for Korean high school students. Journal of Korean Academy of Nursing, 39(5), Kim, Y. A. (2001). This study investigated the relationship of stress levels, social support, and health behaviors in the adolescent population. Korean Journal of Child Health Nursing, 7(2), Kim, Y. H., Kim, W. J., Park, K. O., Lee, H. S., & Kim, C. G. (2000). Primary study of developing prevention program for adolescents deviant behaviors in low income families. Journal of the Korean Home Economics Association, 38(6), Lee, B. J. (2011). Mediating effects of career decision-making self-efficacy 320 고등학생의정신건강및문제행동에영향을미치는요인
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