J Dent Hyg Sci Vol. 15, No. 4, 2015, pp.465-471 http://dx.doi.org/10.17135/jdhs.2015.15.4.465 RESEARCH ARTICLE 치과위생사의교육훈련, 자기효능감및사회적지지가직무몰입에미치는영향 정다이 1,2 ㆍ장세진 2 ㆍ노희진 3 ㆍ정원균 3 1 연세대학교대학원의학과, 2 연세대학교원주의과대학예방의학교실ㆍ직업및환경의학연구소, 3 연세대학교원주의과대학치위생학과 Effects of Educational Training and Psychosocial Characteristics on Job Involvement in Dental Hygienists Da-Yee Jeung 1,2, Sei-Jin Chang 2, Hie-Jin Noh 3, and Won-Gyun Chung 3 1 Department of Medicine, The Graduate School, Yonsei University, Seoul 03722, 2 Department of Preventive Medicine, Institute of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, 3 Department of Dental Hygiene, Yonsei University Wonju College of Medicine, Wonju 26426, Korea The purpose of this study was to investigate the effects of educational training and psychosocial characteristics such as self-efficacy and social support on job involvement in dental hygienists. A total of 418 dental hygienists who were working in S, I and G area were recruited in this study. A self- administered questionnaire was used to evaluate individual and job characteristics, educational training, self-efficacy and social support of the study subjects. Hierarchical regression analysis was performed to examine the relationship of individual and job characteristics, educational training, self-efficacy and social support to job involvement. All statistical analyses were performed using the IBM SPSS Statistics ver. 20.0 for Windows, and p<0.05 was considered significant. The results show that learning experiences of liberal arts or social sciences as a part of college curriculum (t=-2.406), self-efficacy (t=3.728) and social support at work (t=4.391) were significantly associated with job involvement in dental hygienists. Dental hygienists who were having experiences of liberal arts or social sciences as a part of college curriculum, showing higher levels of self-efficacy, and receiving adequate social support from supervisors or coworkers at work were more likely to feel job involvement. They explained 17.4% of total variance of job involvement. This result suggests that experiences of liberal arts or social sciences as a part of college curriculum, higher levels of self-efficacy, and adequate social support from supervisors or coworkers at work might play an important role in increasing job involvement of dental hygienists. It is strongly required to develop individual and organizational program or training to promote a positive attitude to their job as a key professionals in the field of dental health, and to increase job involvement of dental hygienists. Key Words: Dental hygienists, Educational training, Job involvement, Self efficacy, Social support 서론 근로자들의삶의질향상, 직무만족도및직무생산성의증가는근로자개인뿐만아니라조직적측면, 나아가국가경쟁력향상의측면에서중요한의미를갖는다. 직무성과 (job performance) 의대표적지표인직무몰입 (job involvement) 에대한연구는보건의료계를포함한각계에서최근활발하게수행되고있다. 치과의료기관이전문적으로세분화되는추세에따라보건의료직종사자인치과위생사는국민의구강건강증진업 Received: July 11, 2015, Revised: July 27, 2015, Accepted: July 28, 2015 Correspondence to: Won-Gyun Chung Department of Dental Hygiene, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea Tel: +82-33-741-0392, Fax: +82-33-735-0391, E-mail: wgchung@yonsei.ac.kr ISSN 1598-4478 (Print) / ISSN 2233-7679 (Online) Copyright 2015 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 (http://creativecommons.org/licenses/ by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
J Dent Hyg Sci Vol. 15, No. 4, 2015 무를넘어치과의료서비스의질을결정하는데기여하는전문직업인으로서의역할과비중도커지고있다 1). 치과위생사직종의현재직업분류는전문가및관련종사자내에포함되어있다 2). 그러나치과위생사에대한사회적인식과전문가치과위생사의역할과기능에대한치과의사의인식이부족할뿐아니라치과위생사자신도직업에대한만족도가낮아보건의료인으로서의직업에대한정체성이아직확립되지않았다 3). 직업에대한정체성이부족하면낮은자아상과직무불만족을초래할수있고이직률을증가시키며양질의의료서비스를제공하는능력을감소시키기때문에 4) 이에대한적절한해결방법을모색하여야한다. 위의현상들로인하여치과위생사의직무성과 ( 직무만족, 직무몰입, 조직몰입 ), 권한부여 (empowerment), 직무스트레스 ( 감정노동, 직무요구, 직무자율성결여, 보상부적절, 직업불안정 ), 이직의도, 건강문제 ( 근골격계질환, 소진 ) 등에대한관심이점차증가하고있고이들간의관계를규명하려는다양한연구가진행되고있다 5-12). 그러나지금까지수행된대부분의연구는변수들간의관계를단편적으로분석한것이었으며, 치과위생사의개인적요인을비롯하여직무성과에영향을줄수있는학부교육과정에서의인문사회과목수강경험이나취업후보수교육과같은다양한형태의 교육훈련 (educational training) 과자기효능감 (self-efficacy) 이나사회적지지 (social support) 와같은 심리사회적특성 (psychosocial characteristics) 을반영하여분석한연구는아직보고된바없었다. 이연구의목적은치과위생사의일반적특성및직업특성, 대학교육과정에서수강한인문사회교육및취업후보수교육과훈련의경험, 자신에대한긍정적평가의지표인자기효능감, 직장동료와상사로부터제공받는사회적지지가직무몰입에어떠한영향을미치는지를분석하고자한다. 연구대상및방법 1. 연구대상이연구는 S, I 및 G지역의치과병ㆍ의원에서 1년이상근무경력이있는여성치과위생사 418명을최종연구대상으로하였다. 연구대상자의권리, 안전, 복리를보호하기위하여연세대학교원주의과대학연구윤리심의위원회의승인을받은후이연구를시행하였다 (YWDR-14-2-019). 2. 조사변수구조화된자기기입형설문지 (self-administered questionnaire) 를사용하여연구대상자의일반적특성 ( 연령, 최종학력 ) 과직업특성 ( 근무연수, 고용형태, 주5일근무여부, 의료기관형태, 주업무등 ) 에대한자료를수집하였다. 교육훈련은 학부인문사회과목수강경험 과 취업후보수교육등의참여경험 에대하여 예 와 아니오 로응답하게하였다. 학부인문사회과목수강경험 은학부시의료윤리ㆍ의료정책등철학관련내용, 정치ㆍ사회ㆍ경제ㆍ문화등사회학과행동과학관련내용, 글읽기ㆍ글쓰기ㆍ해석하기등문학관련내용, 대인관계ㆍ의사소통ㆍ인격함양등심리학관련내용, 세계의료ㆍ한국의료등역사관련내용의교과목을선정하였다. 취업후보수교육 은임상진료ㆍ환자관리ㆍ보험청구등실무관련내용과마케팅ㆍ회계등병원경영지원관련내용을포함하여인성개발관련내용, 직무스트레스관련내용등의보수교육에의참여여부에대해포괄적으로질문하였다. 자기효능감과사회적지지의평가는각각 8개의문항으로구성된자기효능감척도 13) (Cronbach =0.861) 와사회적지지척도 14) (Cronbach =0.859) 를사용하였고, 점수가높을수록자기효능감과사회적지지가높음을의미한다. 종속변수인직무몰입에대한평가는 Job Involvement Questionnaire 15) (Cronbach =0.885) 를사용하였고, 점수가높을수록직무몰입수준이높음을의미한다. 3. 통계분석치과위생사의일반적특성과직업특성, 교육훈련의경험여부, 자기효능감수준, 직장내형성된사회적지지정도등의독립변수들과종속변수인직무몰입간의관련성을분석하기위하여단변량분석 (t-검정, one-way ANOVA) 과위계적다중회귀분석 (hierarchical multiple regression analysis) 을시행하였다. 모든통계분석은 IBM SPSS Statistics ver. 21.0 for Windows (IBM Co., Armonk, NY, USA) 를사용하여분석하였고, 유의수준 (significance level) 은 =0.05로하였고, p<0.05인경우유의한것으로판정하였다. 결과 단변량분석결과, 직무몰입과유의한관련성을보인변수는최종학력 (t=-2.808, p=0.005), 주업무내용 (F=5.287, p=0.005), 의료기관형태 (F=5.372, p=0.005) 였다. 4년제이상졸업자, 환자예방및처치 / 구강보건교육업무수행자, 치과병원근무자의직무몰입수준이유의하게높았다 (Table 1). 교육훈련영역에서는학부인문사회과목수강경험자들이비경험자에비해직무몰입이유의하게높았다 (t=3.129, p=0.002). 자기효능감과사회적지지는삼분위수 (tertile) 을 466
정다이외 : 치과위생사의교육훈련, 자기효능감및사회적지지가직무몰입에미치는영향 이용하여저, 중, 고로구분하여분산분석을시행한결과, 자기효능감 (F=11.455, p<0.001) 과사회적지지 (F=12.297, p<0.001) 의수준이높을수록직무몰입이유의하게높았다 Table 1. Mean Values and Standard Deviations (SD) of Job Involvement by General and Job Characteristics Characteristic n Mean±SD F/t p-value Age (y) 0.019 0.982 29 304 20.92±4.025 30 34 82 20.85±3.367 35 31 21.00±3.568 Educational level -2.808 0.005 College 305 20.60±3.945 University/graduate school 112 21.79±3.504 Job content 5.287 0.005 Prevention/education 30 23.00±4.402 Treatment support 287 20.64±3.849 Counselling/management 100 21.08±3.561 Type of dental organization 5.372 0.005 Clinic 309 20.58±3.776 Hospital 73 22.11±4.377 General hospital 36 21.64±3.146 Work tenure (y) 0.968 0.381 4 232 21.06±4.065 5 9 123 20.51±3.652 10 62 21.16±3.474 (Table 2). 독립변수들과직무몰입간의관련성을파악하기위하여위계적다중회귀분석을시행하였다. 모형 1에는인구학적특성과직업특성을회귀모형에투입하였다. 분석결과, 치과위생사의직무몰입에유의한관련성을보인변수는주 Table 2. Mean Values and Standard Deviations (SD) of Job Involvement by Educational Training and Psychosocial Characteristics Characteristic n Mean±SD t p-value Learning experiences a 3.129 0.002 Yes 182 21.60±3.607 No 236 20.42±4.008 Participation in job training -0.241 0.809 Yes 326 20.91±3.825 No 92 21.02±4.087 Self-efficacy 11.455 <0.001 Low 147 19.93±3.773 Intermediate 185 21.08±3.368 High 86 22.36±4.578 Social support 12.297 <0.001 Low 114 19.76±3.877 Intermediate 181 20.80±3.579 High 121 22.19±3.961 a Learning experiences of liberal arts or social science. Table 3. Result of Hierarchical Multiple Linear Regression on Job Involvement Variable Model 1 Model 2 Model 3 b t p b t p b t p Age -0.136-0.346 0.729-0.134-0.343 0.732 0.031 0.005 0.934 Marital status (0: married, 1: unmarried) -0.208-0.384 0.701-0.137-0.253 0.801-0.032-0.003 0.950 Employment type (0: regular, 1: irregular) -0.465-0.774 0.439-0.493-0.824 0.410-0.754-0.072 0.182 Type of dental organization 1 (0: general hospital, 1: dental clinic) -1.460-1.889 0.060-1.254-1.619 0.106-1.289-0.146 0.077 Type of dental organization 2 (0: general hospital, 1: dental hospital) -0.080-0.090 0.928 0.038 0.043 0.966-0.212-0.021 0.800 Job content 1 (0: treatment support, 2.101 2.747 0.006 1.864 2.389 0.017 1.093 0.071 0.142 1: prevention/education) Job content 2 (0: treatment support, 1: counselling/management) 0.708 1.377 0.169 0.734 1.415 0.158 0.386 0.043 0.432 Learning experiences of liberal arts or social sciences (0: yes, 1: no) -0.935-2.406 0.017-0.867-0.111 0.018 Participation in job training (0: yes, 1: no) -0.056-0.117 0.907 0.296 0.032 0.518 Self-efficacy 0.245 3.728 <0.001 Social support 0.257 4.391 <0.001 Intercept 21.956 23.307 11.050 F 2.841** 2.877** 7.591** R 2 0.047 0.061 0.174 Significance of R 2 change 0.007 0.056 <0.001 ** =0.01. 467
J Dent Hyg Sci Vol. 15, No. 4, 2015 업무로진료지원업무를수행하는집단에비해환자예방및교육을담당하는직업군의직무몰입이유의하게높았다 (t=2.747, p=0.006, R 2 =0.047). 모형 1에교육훈련변수를추가하여분석한모형 2에서는모형 1에서유의했던주업무 ( 예방 / 교육 ) 와함께대학교과과정에서인문사회과목을수강한경험이있는자가직무몰입수준이유의하게높았다 (t=-2.406, p=0.017, R 2 =0.061). 최종모형인모형 3의분석결과, 치과위생사의직무몰입에영향을미치는유의한변수로는학부인문사회과목수강경험 (t=-0.111, p= 0.018), 자기효능감 (t=3.728, p<0.001), 사회적지지 (t=4.391, p<0.001) 였다. 즉, 대학교육과정에서인문사회과목의수강경험이있을수록, 업무수행능력에대한믿음인자기효능감이높을수록, 직장내에서상사와동료로부터적절한사회적지지를제공받을수록직무몰입이유의하게높았다. 이들변수로전체직무몰입총변량의약 17.4% (R 2 =0.174) 를설명하였다 (Table 3). 고찰 이연구는치과위생사의일반적특성, 직업특성, 교육훈련의경험, 그리고심리사회적특성인자기효능감과사회적지지등이직무성과의대표적지표인직무몰입과어떠한관련성을보이는가를분석하고자하였다. 분석결과, 치과위생사들의직무몰입에영향을주는요인은일반적특성이나직업특성보다는대학교육과정에서의인문사회과학의수강경험과심리사회적특성인자기효능감, 사회적지지였다. 대학교육과정에서인성을함양하고인문학적소양을넓힐수있는과목인인문사회과목의수강경험이치과위생사의직무몰입을향상시키는데기여함을확인함으로써이연구는기존연구와의차별성을갖는다. 다양한형태의교육과훈련은자신의업무에대한동기부여 (motivation) 와함께직무에대한만족감 (satisfaction) 을상승시키는역할을한다 16). 산업심리학자들은직무동기를 근로자로하여금행위를유도하는내적인동력뿐아니라, 행위를조장시켜주는외적인동력으로도간주하게되고, 결과적으로근로자의직무동기가높아질경우직무성과도자연스럽게향상되는것 으로보고있다 17). 직무동기를향상시키는인성중심의다양한교과과정의수강경험은전문직업인으로서의치과위생사의자기정체성 (self-identity) 을높여준다. 이는자신의업무에대한이해도를높이게되고조직이지향하는목적에동조할수있는직무몰입의수준을향상시키게되어결과적으로업무수행능력을높일수있는경쟁력있고성공적인직무수행에긍정적역할을하게될것이다. 최근, 긍정심리학 (positive psychology) 에서대표적으로논의되는개념인자기효능감과사회적지지는다양한측면에서긍정적인영향을주는심리사회적완충요인이자중재요인으로서스트레스의부정적요인을약화시키고건강수준을향상시키고, 직무성과나직무만족도를고취시킴으로써궁극적으로삶의질을향상시키는요인으로보고되고있다. 한개인이기대하는결과를수행할수있는능력에대한믿음으로정의되는자기효능감은긍정심리학에서빈번하게언급되는개념이다. 높은자기효능감을소유한사람은자신이속한조직의목적에순응하고자신이수행한직무성과에긍정적인영향을주며외부적저항에부딪혔을때에도목적달성을위한일관성을보이기도한다 18). 자기효능감은건강증진 (health promotion) 19), 학업성취도 (academic success) 20), 경력개발 21), 그리고직무성과와관련성이높고 22), 실업시적절한대응능력 23) 과의관련성도확인되었다. 치과위생사본인이인지하는자기효능감과직무몰입간의관련성을분석한결과, 자기효능감이높은경우그렇지않은경우에비해직무몰입수준이유의하게높았다. 이는자기효능감이낮은치과위생사에비해자기효능감이높은치과위생사가치과위생사로서의정체성, 자신의업무에대한자존감, 직무몰입의수준이상대적으로높다고해석할수있다. 자기효능감은선천적으로부여받는기질이라기보다학습되고변화가가능하기때문에각개인은자기효능감을향상시킬수있도록노력해야한다. 자기효능감은기존의익숙함을극복하고새로운지식을받아들여실천할수있는용기로서의의미가있으며교육훈련의동기부여에영향을준다 24). 또한자기효능감이높은사람은낮은사람에비해성과지향적인행동을보임으로써개인성과를예측하는주요한선행요인으로해석될수있다 25). 직장내에서상사나동료로부터적절한사회적지지를제공받는치과위생사의경우그렇지않은치과위생사에비해직무몰입수준이유의하게높아직장내에서상사와동료로부터받은지지와도움이긍정적으로작용한것으로보인다. 사회적지지는사람또는조직과상호작용을하는과정에서형성되고제공되는사회적산물로서, 적절한사회적지지는스트레스를완화시키고 26-30), 심각한사건경험후의회복에도움을주며, 조직내구성원들간의긴밀한접촉을통해소속감을높이고 감정적전염 (emotional contagion) 31) 을통해조직구성원들과의행복하고의미있는관계를가능하게해줌으로써원만한조직생활을가능하게해주는기능을한다. 또한적절한사회적지지를통해형성되는건강한네트워크는한개인의직무성과나지위에대한전략적인정보제공과조언, 실제적인도움, 방어와피드백을제공해 468
정다이외 : 치과위생사의교육훈련, 자기효능감및사회적지지가직무몰입에미치는영향 주는순기능적인역할을하기도한다 32). 적절한사회적지지는환자응대과정에서발생하는다양한형태의스트레스나긴장을완화시키고직장동료로서의귀속감과연대감 (embedding) 을강화시켜직장내의화목하고즐거운분위기를조성하는데기여하는것으로이해할수있다. 직장내에서상사와동료들간에형성된적절한사회적지지네트워크는개인학습능력 (individual learning), 문제해결능력 (problem solving), 실수관리능력 (error management) 을향상시켜준다 33). 이러한조직문화의공유는근로자가조직이추구하는목적을이해하고직무에몰입할수있도록하여조직생산성향상에기여할수있는구성원이될수있도록하는역할을한다. 치과위생사는고객과의치료및상담과정에서다양한형태의직무스트레스에노출되게되는바, 자신의업무에대한이해의정도, 자신감이나정체성을제공해줄수있는 교육훈련, 자기효능감이나사회적지지등의 심리사회적특성 에대한관심과접근이필요하다. 치과위생사의교육과훈련의경험이업무수행과정에서어떤양태로든지영향을줄수있고업무수행과관련된자기역량의수준과그에대한믿음으로평가되는자기효능감, 그리고직장내동료와상사로부터제공받는정서적정보적지지가직무만족도를높이고직무몰입을향상시키는데영향을주게된다는점에주목할필요가있다. 결론적으로치과위생사의직무몰입은대학교육과정에서의인문사회과목수강경험, 전문직업인으로서의정체성과직업에대한자존감을높이는자기효능감, 직장내동료와상사의정서적정보적지지에의해영향을받게된다. 치과위생사의직무몰입향상을위해인성강화를위한대학교육과정의인문사회교과목편성의제도적보완, 자신의업무역량을강화시키고업무에대한효능감을향상시킬수있는역량강화, 자기개발기회의보장과조성, 그리고직장동료나상사와의다양한정보공유와도움을가능하게해줄수있는직장내멘토링제도등의도입이절실하게필요하다. 직무몰입은개인의특성이아닌개인과직무상황간의상호작용에따른결과로형성된다 15,34). 이는근로자의상황적요인들이자신의목표에대한성취와보상, 그리고욕구를충족시켜줄수있다고인지될때직무몰입이높아지고직무몰입의수준은성과와관련된상황과교육훈련의경험을통해더욱강화된다. 직무몰입은조직의목적을이해하고자신의일에대한동기부여의수준을평가하는대표적인조직성과지표로서근로자개인이인지하는업무수행에대한낙관적이고긍정적인믿음인자기효능감과직장내에서제공되는다양한형태의사회적지지에의해영향을받는 다. 높은직무몰입은자신의직무에대한정체성과직무만족도를향상시키는데긍정적인역할을하게되고업무생산성을증가시키며근로자개인의삶의질을향상시키게된다. 이연구는치과위생사의직무몰입관련요인을직업특성외에교육훈련참여경험과심리사회적특성을중심으로분석한최초의연구로서의의가있다. 그럼에도불구하고몇가지연구의제한점이논의될수있을것이다. 첫째로, 교육훈련및심리사회적특성과직무몰입간의유의한관련성이입증되었지만연구설계상이연구는단면적연구이기때문에인과적관계로결론짓는데는제한점이있다. 향후전향적추적연구를통해이들요인간의인과적관련성을확인할수있는후속연구가요청된다. 둘째로, 연구대상이 S, I 및 G지역에서근무하는치과위생사들로국한되어있기때문에우리나라전체치과위생사들의특성을반영하지못하였다. 향후전국규모의대표성표본을통한전향적연구가요청된다. 셋째로, 응답자들의기억편의 (recall bias) 의문제로, 과거의기억에의존하는일부설문 ( 예 : 학부인문사회과목수강경험 ) 의경우정확성에대한문제를간과할수없다. 요약 이연구는치과위생사의일반적특성, 직업특성, 교육훈련의경험, 그리고심리사회적특성인자기효능감과사회적지지등이직무성과의대표적지표인직무몰입과어떠한관련성을보이는지를분석하고자하였다. S, I, G지역의치과병ㆍ의원에서 1년이상근무경력이있는여성치과위생사 418명을최종연구대상으로하였고, 구조화된자기기입형설문지를사용하여연구대상자의일반적특성, 직업특성, 교육훈련 ( 학부인문사회과목수강경험, 취업후보수교육등의참여경험 ), 심리사회적특성 ( 자기효능감, 사회적지지 ) 등과직무몰입간의관련성을분석하였다. 분석결과, 치과위생사들의직무몰입에영향을주는요인은일반적특성이나직업특성보다는대학교육과정에서의인문사회과목수강경험과심리사회적요인인자기효능감과사회적지지였다. 치과위생사의직무몰입향상을위해인성강화를위한대학교육과정의인문사회교과목편성의제도적보완, 자신의업무역량을강화시키고업무에대한효능감을향상시킬수있는자기개발기회의보장과조성, 그리고직장동료나상사와의다양한정보공유와도움을가능하게해줄수있는직장내멘토링제도등의도입이절실하게필요하다. 469
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