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병원 간호사의 선호근무시간대에 관한 연구 (A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours)

  • 이경식;정금희
    • 대한간호
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    • 제36권1호
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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천연 및 양식산 담수어의 식품성분 (Food Components of Wild and Cultured Fresh Water Fishes)

  • 김경삼;이응호
    • 한국수산과학회지
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    • 제19권3호
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    • pp.195-211
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    • 1986
  • 한국산 양식어의 식품성분을 개선하기 위한 학술적 기초자료를 얻기 위하여 뱀장어, 가물치, 잉어를 천연산과 양식산으로 구분하고, 식품성분에 관하여 분석비교한 연구결과는 아래와 같다. 1. 담수어의 일반 성분중 공통적 특징은 천연산은 조단백질 함량이 많고 양식산은 조지질 함량이 많았다. 2. 천연산 뱀장어, 가물치, 잉어육 중의 무기질중 나트륨, 칼리움, 칼슘, 마그네슘 등은 분석한 9종의 무기질 총량의 $99.75{\sim}99.90%$를 차지하였으며, 양식산에서도 이들 4종의 무기질이 $99.52{\sim}99.92%$의 많은 양을 나타내었다. 또한 사료도 이들 4종의 무기질이 $99.68{\sim}99.92%$로 많았다. 3. 지질획분은 중성지질이 뱀장어, 가물치, 잉어 모두 $55.7{\sim}95.8%$로서 대부분을 차지하고 있으나 가물치는 인지질이 $24.5{\sim}41.5%$로서 뱀장어, 잉어에 비하여 많았다. 4. 천연산 및 양식산 뱀장어, 가물치, 잉어의 중성지질은 triglyceride가 $85.0{\sim}95.2%$로서 대부분을 차지하였고, 그외에 diglyceride, monoglyceride, free sterol 및 sterol ester, hydrocarbon 등이 소량 검출되었다. 5. 뱀장어와 잉어의 지질의 조성은 phosphatidyl choline이 $71.3{\sim}83.9%$로 대부분을 차지하였고 phosphatidyl ethanolamine of $12.1{\sim}23.5%$, phosphatidyl serine이 $2.1{\sim}9.8%$로 소량 확인되었다. 또한 가물치의 인지질조성은 phosphatidyl choline이 $50.7{\sim}64.5%$로서 그 함량이 뱀장어와 잉어에 비하여 다소 낮았다. phosphatidyl choline은 천연산이 양식산에 비해 그 함량이 많았으며 phosphatidyl ethanolamine 및 phosphatidyl serine은 양식산이 많았다. 6. 총지질의 지방산 조성은 뱀장어, 가물치, 잉어 모두 천연산은 $C_{16:0},\;C_{20:5}$가 많았고, 양식산에는 $C_{18:1},\;C_{18:2}\;,C_{22:6}$이 많았다. 중성지질의 지방산 조성은 총지질과 유사하였으며, 인지질은 양식산이 $C_{18:1}$$C_{18:2}$가 많았고, 또한 당지질은 천연산이 $C_{20:5}$$C_{22:6}$이, 양식산은 $C_{18:2}$가 많았다. 7. 양식어와 이들 사료중 총지질의 지방산 조성을 보면 monoene산은 사료보다 양식어쪽의 함량이 높았고, 포화산과 polyene산은 사료보다 양식어쪽이 낮은 경향이었다. 8. 천연 및 양식산 뱀장어의 아미노산 총량은 각각 $16.65\%$$15.99\%$로서 양자간에 거의 차이가 없었으며, 함량이 많은 것은 glutamic acid, leucine, aspartic acid, lysine 순이었다. 가물치는 천연산이 $18.06\%$이며, 양식산은 $18.52\%$이며 천연산은 glutamic acid, alanine, glycine 및 leucine은 많았으며 양식산은 aspartic acid 및 proline이 많았다. 또한 잉어는 천연산이 $16.94\%$, 양식산은 $20.95\%$로서 양식산은 glutamic acid, aspartic acid, glycine, proline 및 alamine이 천연산에 비해 그 함량이 다소 많았으나 이외의 아미노산 함량은 큰 차이가 없었다. 9. 양식산 뱀장어의 유리아미노산은 aspartic acid가 총 유리아미노산의 약 $1.0\%$였으나 천연산은 $2.9\%$를 차지하였다. 반면 histidine, arginine 및 tyrosine등은 양식산이 천연산보다 약 2배 가량 많았다. 그러나 양식산지에 따른 유리 아미노산 조성비는 큰 차이가 없었다. 가물치의 경우 arginine, aspartic acid, glutamic acid, methionine, phenylalanine 함량은 천연산이 양식산보다 그 함량이 많았으나 lysine, histidine, glycine 및 alanine은 그 반대였다. 천연산 잉어의 유리아미노산 중 histidne, glycine 및 lysine 함량이 총유리아미노산의 $76.9\%$를 차지하였다. lysine, histidine, aspartic acid, alanine, valine 및 leucine은 양식산에 비해 천연산의 함량이 많았으나 glycine과 tyrosine은 그 반대였다. 10. 양식 뱀장어 육중의 유리아미노산의 필수아미노산패턴과 사료중의 필수아미노산패턴과는 거의 같은 경향이었다.

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사무 자동화에 따른 사무직 근로자의 건강과 연관된 자각 증상에 대한 조사연구 (An Investigation on the self-consciousness Symptoms of the Clerical Workers attendant upon Office Automation)

  • 정미화
    • 한국직업건강간호학회지
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    • 제3권호
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    • pp.54-70
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    • 1993
  • According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.

    . In conclusion, the self-consciousness symptoms of the subjects to use OA apparatus appeared differently, according to sex distiction, skillfull degree of OA apparatus, use hours of OA apparatus, the rest hours during th use of OA apparatus, and the satiafaction degree of persent business. Therefore, it is necessary that the nurse in the inuctry field must recognize to receive the education about the human technological physical condition which is most proper for te use of OA apparatus and about the proper rest method until they get accustomed to the use of OA apparatus. In addition, the simple exercise relax the tention of muscle due to the repetitive simple movement, and the education for the protection of eyesight are necessary.

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