정신건강의학과 환자의 입원만족도에 미치는 병동분 위기의 영향 -보호병동 입퇴원 시 환자보고의 비교-
The effect of ward atmosphere on psychiatric inpatients' satisfaction -Comparison of patients' self-report at admission and discharge-
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최근 의료장면에서도 서비스의 중심이 서비스 제공자로부터 수요자로 이동함에 따라 정신건강 영역에서도 임상적 평가 외에 서비스에 대한 환자의 만족도가 중요하게 다루어지기 시작했다. 게다가 환자만족도에 대한 평가에서도 구조적인 면을 중시하던 과거와는 달리 점차 과정과 질을 중시하는 추세이다. 이에 본 연구에서는 질적 요소 중 병동 분위기에 주목하여 이것이 정신건강의학과 환자의 입원만족도에 어떠한 미치는 영향을 살펴보았고 만족도평가에 혼입될 수 있는 우울과 긍정 또는 부정 정서상태를 통제하는 절차를 포함하여 분석하였다. 한 대학병원 정신건강의학과 보호병동에 입원한 53명의 환자를 대상으로 입원직후와 퇴원직전에 입원만족도와 병동분위기, 우울 및 불안, 긍정 및 부정 정서, 삶의 만족도를 평가하였다. 위계적 중다회귀분석 결과, 입원만족도 변량에 대해 입원 직후에는 우울과 긍정정서, 치료진의 지지적인 병동분위기가 54.2%, 퇴원 직전에는 우울과 부정정서, 치료진의 지지적인 병동분위기가 59.2%를 설명하였다. 두 시점 모두에서 입원만족도를 유의하게 예측한 요인은 병동분위기 중에서도 치료진의 지지와 수용이었지만 측정시기에 따라 입원만족도를 예측하는 정서의 종류에는 차이가 있었다. 서비스 제공자의 입장에서 치료진의 노력으로 환자들의 입원만족도를 높일 수 있다는 점에 초점울 두어 결과를 논의하였다.
Abstract
Recently, with the movement from consumer-driven to provider-oriented mental health services, psychiatric patients' satisfaction is now being regarded as important. Besides, when assessing satisfaction of psychiatric patients, people are more concerned with process and quality than the structure and quantity. The present study examined the effect of ward atmosphere on inpatients' satisfaction in a closed psychiatric ward. In addition, the effects of depression and positive/negative affect which could be mixed on the level of satisfaction were controlled. A total of 53 patients in a closed psychiatric ward completed self-report scales on inpatient satisfaction, ward atmosphere, depression, anxiety, positive/negative affect two times, immediately after admission and just before discharge. In hierarchical multiple regression, depression, and positive/negative affect, and ward atmosphere(support and acceptance of staffs) explained 54.2% of total variance at the time of admission. When leaving the hospital, depression, negative affect, and ward atmosphere(support and acceptance of staffs) explained 59.2% of total variance. In particular, the support and acceptance of staffs showed significant predictive power on inpatients' satisfaction each time. However, the affect predicting inpatients' satisfaction was different with assessment time. Based on these findings, we discussed the results from the standpoint that service providers or staffs should focus on factors affecting psychiatric patients' satisfaction. In addition, the effort of hospital staff could improve psychiatric patients' satisfaction.
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