응급실 이용현황과 환자의 간호 만족도 조사연구

Abstract

[한글]

본 연구는 응급실 환자의 간호 만족도를 조사하고 이에 영향을 미치는 관련 요인들을 파악하기 위해 실시된 서술적 조사 연구이다.

자료 수집 기간은 1998년 4월 15일부터 5월 2일까지였고, 연구대상은 서울시내 소재 일개 대학 부속 병원 응급실 두 곳을 내원한 환자 98명과 간호사 58명이었으며, 자료수집 방법은 연구대상에게 질문지를 배부하고 즉석에서 응답하게 한 후 회수하는 자가보고식 질문지법을 이용하였다.

연구도구로는 응급실 환자의 간호만족도 측정 도구는 Barbara A. Davis(1988)가 고안한 Consumer Emergency Care Satisfaction Scale(CECSS)를 번역, 수정하여 사용하였고, 환자의 일반적 특성과 응급실이용 현황은 질문지에 첨부하여 사용하였다. 간호사가 인지하

는 간호만족도 조사 도구는 간호사의 일반적 특성과 간호만족도 관련 문항을 포함하였으며, 자료분석은 SPSS Windows를 이용하였다.

연구 결과는 다음과 같다.

1. 대상 환자의 응급실 이용현황으로는 내과계·신경과·정신과가 60.8%, 처음 내원이 63.9%, 거주지부터 응급실까지의 소요시간이 30분 이내의 환자가 61.9%, 월요일-금요일에 내원한 환자가 82.5%, 08:00-16:00 시간대에 내원한 환자가 66%, 응급실 밖에서 대기하지 않은 군이 63.9%, 응급실 내 체류시간이 24시간 이내인 군이 58.8%로 가장 높은 비율을 나타내고 있었다.

2. 응급실환자의 간호만족도 평균은 2.70이었고, 범주별 간호만족도 평균은 정신적 안위 범주 3.05, 기술적 숙련 범주 2.77, 정보제공 범주 2.49,퇴원교육 범주가 1.35로 나타났다.

3. 대상환자의 일반적 특성에 따른 간호만족도는 남자, 51세 이상, 기혼, 고졸이하, 주부, 불교, 경제상태 '중'인 군에서 높게 나타났다. 응급실 환자의 응급실 이용현황에 따른 간호만족도는 내과계 ·신경과 ·정신과, 처음 내원, 거주지부터 응급실까지의 소요시간 30분 이내, 월요일부터 금요일까지 내원, 08:00-16:00시간대 내원, 대기하지 않은 군, 24시간 이내의 응급실 체류군에서 높게 나타났다.

4. 대상환자의 일반적 특성, 이용현황과 간호만족도와의 상관관계에서는 대기시간이 길수록 간호만족도가 낮게 나타났다.

5. 응급실 간호사가 인지하는 환자의 간호만족도 중요도 1순위인 범주는 정신적 안위 범주였고, 예상 1순위인 범주는 기술적 숙련도 였다.

6. 응급실 간호사는 환자의 간호만족도가 낮은 가장 큰 이유를 '업무량과다. 내원 환자가 많아서'로 답하였다.

이상의 결과를 종합해 볼 때 응급실 환자의 간호만족도를 높이기 위해 간호사들은 퇴원 교육에 대한 간호중재방법을 개발하여야 하며, 응급실 이용현황 개선을 위해 병원 행정자의 지원이 요구된다.

Patients Satisfaction with Nursing Care in the Emergency Department

Dosun Kim

Department of Nursing The graduate School Yonsei University

The purpose of this study was to describe patients' satisfaction with nursing

care in the emergency department and factors influencing satisfaction rates.

Two emergency departments of Y university medical center located in Seoul were

selected for data collection. Using a self report questionnaire, data were

collected from 98 patients who had been admitted in either emergency department and

58 registered nurses working in the departments. Data collection was done between

April 15 and May 2, 1998. The subjects were given the questionnaire and requested

to answer it immediately and retuned it to the researcher.

After translation into Korean and partial modification, the Consumer Emergency

Care Satisfaction Scale (CECSS), developed by Barbara A. Davis(1988), was used to

investigate patient satisfaction with nursing care. Other questions about the

patients' general characteristics and service utilization in the emergency

department were also included. The registered nurses were asked to complete a

questionnaire to investigate patient satisfaction as perceived by the nurses. It

also included questions about the general characteristics of the nurses. Data were

analysed using SPSS Windows.

The results from this study are as follows:

1. Patients' utilization of the emergency department: The main service areas for

the patients who visited the emergency departments were internal medicine,

neurology and psychiatry(60.8%). First time users of the emergency department made

up 63.9% of the patients in this study. Those visiting the emergency department

from Monday to Friday made up 82.5% and 66% visited between 8AM and 4PM, Patients

who did not have to wait outside the department made up 63.9% of the sample and

patients who strayed in the department less than 24 hours, 58.8%.

2. The mean score of patient satisfaction with nursing care in the emergency

departments was 2.70. The mean scores of patient satisfaction with different

aspects of nursing care services were 3.05 for nursing services for psychological

safety; 2.67 for technical competence; 2.49 for information giving; and 1.35 for

discharge teaching.

3. Patient satisfaction with nursing care services provided, according to the

general characteristics of the patients, was revealed as being significantly high

for the groups of patients made up of those who were male, those over 51years of

age, married subjects, those with an education level of high school or below level,

housewives, Buddhists, and those in the middle economic level. Patient satisfaction

with nursing care according to their service utilization in the emergency

departments revealed that satisfaction was significantly high for patients who were

in internal medicine, neurology or psychiatry, those admitted for the first time,

those for whom the distance from the department to home was less than 30 minutes,

patients who visited between Monday and Friday and between 8AM and 4PM, patients

who did not have to wait to be seen and those who stayed in the department less

than 24 hours.

4. The correlation between the patients' general characteristics, nursing service

utilization of the patients in the department and their satisfaction with nursing

care showed that patients with longer waiting time had lower satisfactory scores

for nursing service.

5. The expected priority for patient satisfaction with nursing care, as perceived

by the patient, was technical competence of the nurses but the most important

aspect of nursing care for patient satisfaction, as perceived by the registered

nurses working in the emergency department and provided nursing care in this study,

was nursing care for the patients' psychological safety.

6. The registered nurses working in the emergency department reported that the

main reasons for low satisfaction rates included' over worked nurses' and' too many

patients' in the emergency department.

In conclusion, the results of this study suggest the necessity of developing

relevant nursing interventions for discharge teaching to increase patient

satisfaction with nursing care services in emergency departments; and the need for

adequate support from hospital administrators to improve patients' service

utilization.

[영문]

The purpose of this study was to describe patients' satisfaction with nursing care in the emergency department and factors influencing satisfaction rates.

Two emergency departments of Y university medical center located in Seoul were selected for data collection. Using a self report questionnaire, data were collected from 98 patients who had been admitted in either emergency department and 58 registered nurses working in the departments. Data collection was done between April 15 and May 2, 1998. The subjects were given the questionnaire and requested to answer it immediately and retuned it to the researcher.

After translation into Korean and partial modification, the Consumer Emergency Care Satisfaction Scale (CECSS), developed by Barbara A. Davis(1988), was used to investigate patient satisfaction with nursing care. Other questions about the

patients' general characteristics and service utilization in the emergency department were also included. The registered nurses were asked to complete a questionnaire to investigate patient satisfaction as perceived by the nurses. It also included questions about the general characteristics of the nurses. Data were analysed using SPSS Windows.

The results from this study are as follows:

1. Patients' utilization of the emergency department: The main service areas for the patients who visited the emergency departments were internal medicine, neurology and psychiatry(60.8%). First time users of the emergency department made up 63.9% of the patients in this study. Those visiting the emergency department from Monday to Friday made up 82.5% and 66% visited between 8AM and 4PM, Patients who did not have to wait outside the department made up 63.9% of the sample and patients who strayed in the department less than 24 hours, 58.8%.

2. The mean score of patient satisfaction with nursing care in the emergency departments was 2.70. The mean scores of patient satisfaction with different aspects of nursing care services were 3.05 for nursing services for psychological safety; 2.67 for technical competence; 2.49 for information giving; and 1.35 for

discharge teaching.

3. Patient satisfaction with nursing care services provided, according to the general characteristics of the patients, was revealed as being significantly high for the groups of patients made up of those who were male, those over 51years of age, married subjects, those with an education level of high school or below level, housewives, Buddhists, and those in the middle economic level. Patient satisfaction with nursing care according to their service utilization in the emergency departments revealed that satisfaction was significantly high for patients who were in internal medicine, neurology or psychiatry, those admitted for the first time, those for whom the distance from the department to home was less than 30 minutes, patients who visited between Monday and Friday and between 8AM and 4PM, patients

who did not have to wait to be seen and those who stayed in the department less than 24 hours.

4. The correlation between the patients' general characteristics, nursing service utilization of the patients in the department and their satisfaction with nursing care showed that patients with longer waiting time had lower satisfactory scores for nursing service.

5. The expected priority for patient satisfaction with nursing care, as perceived by the patient, was technical competence of the nurses but the most important aspect of nursing care for patient satisfaction, as perceived by the registered nurses working in the emergency department and provided nursing care in this study, was nursing care for the patients' psychological safety.

6. The registered nurses working in the emergency department reported that the main reasons for low satisfaction rates included' over worked nurses' and' too many patients' in the emergency department.

In conclusion, the results of this study suggest the necessity of developing relevant nursing interventions for discharge teaching to increase patient satisfaction with nursing care services in emergency departments; and the need for adequate support from hospital administrators to improve patients' service

utilization.