간호원과 간호에 대한 환자의 만족도에 관한 연구

Abstract

[한글]

오늘날 간호의 역할과 전문적 책임이 확대되고 건강관리에 대한 대상자의 기대가 높아짐에 따라 간호의 질을 확보하기 위한 계속적인 평가가 요구되고 있다. 이에 따라 간호사업을 계획하고 그 질을 평가하는데 있어서 수요자의 참여에 대한 중요성이 강조되고 있으

며 특히 환자의 만족은 간호 질 평가의 주요기준으로서 부각되고 있다.

따라서 본 연구에서는 간호원과 간호에 대한 환자의 만족도를 측정할 수 있는 도구를 실제 간호활동에 적용하여 간호원이 행한 간호에 대한 환자의 만족수준을 알아보고, 간호의 영역별 환자의 만족도를 비교하여 현재 시행되고 있는 간호상황을 파악하고 이를 기반으로 간호의 질적 향상에 도움이 되고, 우리의 간호상황에 맞는 환자의 만족도 측정도구 개발에 기초가 되는 자료를 제공하고자 함을 연구목적으로 하였다.

연구기간은 1980년 11월 21일부터 11월 30일까지였으며 연구대상은 서울시에 소재한 Y대학교 부속병원 내과와 외과에 입원하고 있는 환자 전수를 모집단으로 하여 임의적 표본 추출방법에 의해 흉곽내과를 포함한 내과환자 및 일반외과 환자로서 16세 이상, 입원기일 3일 이상, 응급입원이 아니며, 연구의 목적을 이해하고 연구에의 참여를 수락한 환자를 선택하여 총 171명이었다.

연구도구로는 Risser의 만족도 측정도구를 번역보완한 질문지를 사용하였고 수집된 자료처리 방법으로 백분율, 산술평균 및 표준편차, Internal Consistency Reliability Test, T-test, Analysis of Variance를 사용하여 분석하였다.

연구의 결과를 요약하면 다음과 같다.

A. 대상자의 인구·사회학적 특성 및 입원에 관한 제 특성

1. 대상자의 인구·사회학적 특성

평균연령 약 41세로 50세 이상 집단이 31.6%로 가장 높은 구성비율을 차지하고, 남자가 56.1%, 기혼이 79.5%, 가족수가 4-6명인 사람이 56.7%, 종교가 없는 사람이 31.6%, 고등학교 졸업이 48.3%로 높은 구성비율을 보였다.

2. 대상자의 입원에 관한 제 특성

입원과는 흉곽내과를 포함한 내과가 66.7%이었고, 입원일수는 7일 이내가 70.2%를 차지하였으며, 과거에 입원경험이 있는 경우가 48.5%, 의료보험에 가입한 환자가 63.7%로 나타났다.

B. 간호원과 간호에 대한 영역별 환자의 만족도.

1. 간호의 기술-전문적 영역

기술-전문적 영역에서 만족도가 가장 높은 문항은 「치료할 때 의사를 능숙하게 도와준다」가 평균평점 1.89이었고, 가장 낮은 문항은 「나를 간호할 때 정확하고 꼼꼼하게 하지 않는다」로 평균평점 2.42이었으며, 문항전체의 평점산술평균은 2.21이었다.

2. 간호의 교육적 관계 영역

교육적 관계 영역에서 만족도가 가장 높은 문항은 「나에게 많은 것을 물어보기만 하고 아무 것도 해주지는 않는다」로 평균평점 2.09이었고, 가장 낮은 문항은 「나의 검사결과에 대해서 더 자세히 설명해 주었으면 좋겠다」가 평균평점 3.80이었으며, 문항전체의 평점산술평균은 2.60이었다.

3. 간호의 신뢰적 관계 영역

신뢰적 관계 영역에서 만족도가 가장 높은 문항은 「간호원이 너무 자세히 설명해서 짜증이 난다」가 평균평점 1.44이었고, 가장 낮은 문항은 「간호원은 환자에게 보다 더 깊은 관심을 기울여야 한다」로 평균평점 3.81이었으며, 문항전체의 평점산술평균은 2.63이었다.

이와 같이 간호원과 간호에 관한 세가지 영역에 대한 환자의 만족도가 높은 순위는 기술-전문적 영역, 교육적 관계 영역, 신뢰적 관계 영역의 순으로 나타났다. 이것으로 환자들은 간호의 신뢰적 관계 영역에 대해 가장 불만족하고 있음을 알 수 있다.

C. 연구도구의 영역별 신뢰도 검증

본 연구도구의 신뢰도는 기술-전문적 영역 7문항에서 .751, 역상관을 나타낸 문항 하나를 제외시킨 교육적 관계 영역 6문항에서 .717, 신뢰적 관계 영역 11문항에서 .761을 나타냄으로써 비교적 높은 신뢰도를 보였다.

D. 간호원과 간호에 대한 환자의 만족도와 제 변수들과의 관계

1. 환자의 만족도와 대상자의 인구·사회학적 특성과의 관계

간호의 전체 영역과 교육적 관계 영역 그리고 신뢰적 관계 영역에 대해서는 대상자의 교육수준이 높을수록 만족도가 낮은 것으로 나타났고(P<0.05), 기술-전문적 영역에 대해서는 교육수준이 높을수록 만족도가 낮았고, 남자가 여자보다 만족도가 낮았다.(P<0.05)

2. 환자의 만족도 와 대상자의 입원에 관한 제 특성과의 관계에는 간호의 전체영역과 각 영역에 있어 유의한 차가 없게 나타났다.(P>0.05)

A STUDY OF PATIENTS SATISFACTION WITH NURSES AND NURSING CARE

Hye Kyung Lim

Department of Nursing, Graduate School of Yonsei University

(Directed by Professor Chi Joung Shim)

Today as the roles and professional responsibilities of the nurse are expanding

greatly and consumer's expectations of health care services are increasing,

continuous evaluation is required to assure quality nursing care.

Accordingly emphasis is being placed on the consumer's involvement in planning

and evaluating the quality of nursing services.

The patient's satisfaction is especially emerging as a major criterion in the

evaluation of the quality of nursing care.

The purpose of this study was therefore, to determine the patient's level of

satisfaction with the nursing care given by nurses and compare the satisfaction

level with various areas of nursing care. Thereby to grasp the current nursing

situation in order to contribute to improvement of the quality of nursing care and

to provide basic information for the development of a tool to measure patient

satisfaction in our country. The subjects for this study were 171 medical and

surgical patients who had been hospitalized for 3 days or more. They were

arbitrarily selected from a university hospital located in Seoul.

Data was obtained through questionnaires from November 21st to November 30th

1980.

Data analysis included percentages, mean and standard deviation, internal

consistency reliability test, T-test and analysis of variance.

The findings of this study were as follows.

A. the socio-economic and demographic characteristics and characteristics related

to hospitalization of the respondents.

1. The Socio-economic and demographic characteristics of the respondents.

The mean age of the subjects was 41, 56.1% were male, 79.5% were married, 56.7%

had 4-6 family members, 31.6% did not have any religion and 43.3% graduated from

high school.

2. The characteristics related to hospitalization of the respondents.

Of the total respondents 66.7% were medical patients, 70.2% had been hospitalized

within 7 days, 48.5% had been previously hospitalized and 63.7% had medical

insurance.

B. The level of patients satisfaction with various areas of nursing care,

1. Technical-Professional area

The item which showed the highest level of patient satisfaction was "The nurse is

skillful in assisting the doctor with procedures" (mean score: 1.89), the item

which showed the lowest level of patient satisfaction was "The nurse is not precise

in doing her work" (mean score: 2.42) and the grand mean of this total area was

2.21.

2. Teaching Relationship area

The item which showed the highest level of patient satisfaction was "The nurse

asks a lot of questions, but once she finds the answers, she doesn't seem to do

anything" (mean score: 2.09), the item which showed the lowest level of patient

satisfaction was "I wish the nurse would tell me about the results of my tests more

than she does" (mean score: 3.80) and the grand mean of this total area was 2.60.

3. Trusting Relationship area.

The item which showed the highest level of patient satisfaction was "I'm tired of

the nurse talking down to me" (mean score 1.44), the item which showed lowest level

of patient satisfaction was "The nurse should be more attentive than she is" (mean

score: 3.81) and the grand mean of this total area was 2.63.

The results show that items in the trusting relationship area elicited the most

expressions of dissatisfaction from the respondents.

C. The reliability test of the measurement tool used in this study.

The measurement tool used in this study demonstrated a comparatively high level

of reliability(.751∼.761).

D. The relationship between the level of patient satisfaction with nursing care

and nurses and related variables.

1. Relationship between the level of patient satisfaction and the socio-economic

and demographic characteristics.

There was a significant difference between the educational level of the patient

and the level of satisfaction in the teaching relationship area and the trusting

relationship area.

The higher the educational level the lower the level of satisfaction.(P<0.05)

In the technical-professional area, there were significant differences between

the educational level of the respondents and the satisfaction level and between the

sex of respondents and level of satisfaction.

The higher the educational level the lower the level of satisfaction, male

respondents had a lower satisfaction level than female respondents. (P<0.05).

Also when the level of satisfaction in all three are as of nursing were

considered together a significant difference between the educational level and

level of satisfaction was found.(P<0.05).

2. There was no significant difference between the characteristics related to the

hospitalization of the respondents and satisfaction.(P>0.05).

[영문]

Today as the roles and professional responsibilities of the nurse are expanding greatly and consumer's expectations of health care services are increasing, continuous evaluation is required to assure quality nursing care.

Accordingly emphasis is being placed on the consumer's involvement in planning and evaluating the quality of nursing services.

The patient's satisfaction is especially emerging as a major criterion in the evaluation of the quality of nursing care.

The purpose of this study was therefore, to determine the patient's level of satisfaction with the nursing care given by nurses and compare the satisfaction level with various areas of nursing care. Thereby to grasp the current nursing situation in order to contribute to improvement of the quality of nursing care and to provide basic information for the development of a tool to measure patient satisfaction in our country. The subjects for this study were 171 medical and surgical patients who had been hospitalized for 3 days or more. They were arbitrarily selected from a university hospital located in Seoul.

Data was obtained through questionnaires from November 21st to November 30th 1980.

Data analysis included percentages, mean and standard deviation, internal consistency reliability test, T-test and analysis of variance.

The findings of this study were as follows.

A. the socio-economic and demographic characteristics and characteristics related to hospitalization of the respondents.

1. The Socio-economic and demographic characteristics of the respondents.

The mean age of the subjects was 41, 56.1% were male, 79.5% were married, 56.7% had 4-6 family members, 31.6% did not have any religion and 43.3% graduated from high school.

2. The characteristics related to hospitalization of the respondents.

Of the total respondents 66.7% were medical patients, 70.2% had been hospitalized within 7 days, 48.5% had been previously hospitalized and 63.7% had medical insurance.

B. The level of patients satisfaction with various areas of nursing care,

1. Technical-Professional area

The item which showed the highest level of patient satisfaction was "The nurse is skillful in assisting the doctor with procedures" (mean score: 1.89), the item which showed the lowest level of patient satisfaction was "The nurse is not precise

in doing her work" (mean score: 2.42) and the grand mean of this total area was 2.21.

2. Teaching Relationship area

The item which showed the highest level of patient satisfaction was "The nurse asks a lot of questions, but once she finds the answers, she doesn't seem to do anything" (mean score: 2.09), the item which showed the lowest level of patient satisfaction was "I wish the nurse would tell me about the results of my tests more

than she does" (mean score: 3.80) and the grand mean of this total area was 2.60.

3. Trusting Relationship area.

The item which showed the highest level of patient satisfaction was "I'm tired of the nurse talking down to me" (mean score 1.44), the item which showed lowest level of patient satisfaction was "The nurse should be more attentive than she is" (mean score: 3.81) and the grand mean of this total area was 2.63.

The results show that items in the trusting relationship area elicited the most expressions of dissatisfaction from the respondents.

C. The reliability test of the measurement tool used in this study.

The measurement tool used in this study demonstrated a comparatively high level of reliability(.751∼.761).

D. The relationship between the level of patient satisfaction with nursing care and nurses and related variables.

1. Relationship between the level of patient satisfaction and the socio-economic and demographic characteristics.

There was a significant difference between the educational level of the patient and the level of satisfaction in the teaching relationship area and the trusting relationship area.

The higher the educational level the lower the level of satisfaction.(P<0.05)

In the technical-professional area, there were significant differences between the educational level of the respondents and the satisfaction level and between the sex of respondents and level of satisfaction.

The higher the educational level the lower the level of satisfaction, male respondents had a lower satisfaction level than female respondents. (P<0.05).

Also when the level of satisfaction in all three are as of nursing were considered together a significant difference between the educational level and level of satisfaction was found.(P<0.05).

2. There was no significant difference between the characteristics related to the hospitalization of the respondents and satisfaction.(P>0.05).