본 연구는 응급실 간호사를 대상으로 폭력경험, 폭력반응, 폭력대처가 전문직 삶의 질에 미치는 영향을 파악하기 위한 서술적 조사연구이다. 연구대상자는 국내 300병상 이상 종합병원급 이상 응급실에서 근무하는 응급실 경력 1년 이상인 간호사이며, 최종 179명을 대상으로 자료수집 하였다. 자료수집은 2022년 6월 24일부터 7월 31일까지 이루어졌으며 수집된 자료는 IBM SPSS 28.0 프로그램을 이용하여 일반적 특성의 빈도, 백분율, 평균과 표준편차를 구하였고, 일반적 특성에 따른 전문직 삶의 질 차이는 t-test, ANOVA, 사후검정으로 Scheffé test를 사용하여 분석하였다. 폭력경험, 폭력반응, 폭력대처, 전문직 삶의 질 간의 관계는 Pearson correlation coefficient를 이용하여 분석하였고, 전문직 삶의 질에 미치는 영향요인은 multiple regression analysis를 이용하여 분석을 시행하였다.

본 연구의 주요 결과는 다음과 같다.

1. 연구대상자의 폭력경험은 평균평점 5점 중 1.58±0.29점이었으며 하위 영역별로 언어적 폭력 2.19±0.54점, 신체적 위
협 1.66±0.40점, 신체적 폭력 1.12±0.13점 순이었다. 폭력반응은 평균평점 5점 중 2.73±0.73점이었으며 하위 영역
별로 정서적 반응이 3.24±0.79점으로 가장 높았고, 신체적 반응 2.34±0.90점, 사회적 반응 1.78±0.77점 순으로 나타
났다. 폭력대처에서 문제중심 대처는 3.36±0.51점, 정서중심 대처는 3.27±0.55점이었다. 전문직 삶의 질은 공감만족,
소진, 이차 외상성 스트레스로 구성되어 있으며 평균평점 5점 중 공감만족은 3.11±0.69점, 소진 2.91±0.54점, 이차 외
상성 스트레스 2.61±0.66점으로 나타났다.

2. 연구대상자의 일반적 특성에 따른 전문직 삶의 질의 차이를 살펴보면, 공감만족, 소진에서는 통계적으로 유의한 차이를
보이는 일반적 특성은 없었으 며, 이차 외상성 스트레스에서는 임상경력(F=3.75, p=.025), 응급실 경력
(F=3.67,p=.027)에서 통계적으로 유의한 차이를 보였다.

3. 연구대상자의 전문직 삶의 질 중 공감만족은 문제중심 대처와 통계적으로 유의한 양의 상관관계(r=.328, p<.001)
를 보였다. 소진은 폭력경험(r=.271, p<.001), 폭력반응(r=.449, p<.001)과 통계적으로 유의한 양의 상관관계를 보였
으며 문제중심 대처(r=-.172, p<.001)와는 음의 상관관계를 나타냈다. 이차 외상성 스트레스는 폭력경험(r=.318,
p<.001), 폭력반응(r=.606, p<.001), 문제중심 대처(r=.173 p=.021)와 통계적으로 유의한 양의 상관관계를 보였다.

4. 연구대상자의 전문직 삶의 질에 유의한 영향을 미치는 요인을 파악하기 위한 회귀분석을 시행한 결과, 전문직 삶의 질 중
공감만족은 문제중심 대처(β=.328, p<.001)가 유의한 영향요인으로 나타났으며, 모형의 설명력은 10.3%
(adj.R2=0.103)로 나타났다(F=21.36, ρ<.001).
소진은 폭력반응(β=.460, ρ<.001), 문제중심 대처(β=-.320, p<.001), 폭력경험(β=.151, ρ=.030)이 유의한 영향요인
으로 나타났으며, 모형의 설명력 은 28.8%(adj. R2=0.288)로 나타났다(F=24.99, ρ<.001).
이차 외상성 스트레스는 폭력반응(β=.594, ρ<.001), 임상경력(β=.246, ρ<.001)이 유의한 영향요인으로 나타났으며,
모형의 설명력은 41.3%(adj.R2=0.413)로 나타났다(F=47.34, ρ<.001).

결론적으로 응급실 간호사의 전문직 삶의 질 중 공감만족은 문제중심 대처가 높을수록 증가하고, 소진은 폭력경험, 폭력반응이 높을수록, 문제중심 대처가 낮을수록 증가하는 것으로 나타났으며, 이차 외상성 스트레스는 폭력반응이 높을수록, 임상경력이 길수록 증가하는 것으로 나타났다. 따라서 응급실 간호사의 폭력을 예방하고 폭력 후 부정적 반응을 감소시키기 위한 적절한 대처를 통해 전문직 삶의 질을 향상시킬 수 있을 것으로 사료된다.

This is a descriptive investigation study to better understand the influence of violence experience, violence response, coping with violence on emergency department nurses'' professional quality of life. The subjects of the study were nurses with at least 1 year of experience working in a emergency department with more than 300 beds in Korea, and final data were collected from 179 subjects. Data was collected online from June 24 to July 31, 2022. The collected data were analyzed using the IBM SPSS 28.0 program to determine the frequency, percentage, mean, and standard deviation of general characteristics, and the difference in professional quality of life based on general characteristics was investigated using the t-test, ANOVA, and post hoc analysis using Scheffé test. The Pearson correlation coefficient was used to examine the relationship between violence experiences, violence response, coping mechanism of violence and professional quality of life, and multiple regression analysis was used to examine the influencing factors on professional quality of life.

The following are the study''s main findings.

1. violence experience was 1.58±0.29 out of 5 average scale, and when divided by subarea, verbal abuse was
2.19±0.54, physical threat was 1.66±0.40 , and physical assault was 1.12±0.13. The violence response
was 2.73±0.73 out of 5 average scale, and the emotional response was the highest with 3.24±0.79,
followed by the physical response at 2.34±0.90 and the social response at 1.78±0.77. Among coping
with violence, problem focused coping was 3.36±0.51, while the emotional focused coping was
3.27±0.55. compassion satisfaction, burnout, and secondary traumatic stress are the factors that evaluate
the quality of professional life, and out of the 5 average scale, compassion satisfaction was 3.11±0.69 ,
burnout was 2.91±0.54, and secondary traumatic stress was 2.61±0.66.

2. When the difference in professional quality of life was examined based on the general characteristics of
the study subjects, there were no statistically significant differences in compassion satisfaction, burnout.
However. in secondary traumatic stress clinical experience(F=3.75, p=.025), experience in an emergency
department(F=3.67, p=.027) showed a statistically significant difference.

3. Compassion satisfaction has a statistically significant positive correlation with problem focused coping
among the professional quality of life (r=.328, ρ<.001). Burnout showed statistically significant positive
correlation with violence experience(r=.271, ρ<.001), and a violence response(r=.449, ρ<.001) while
showing negative correlation with problem focused coping(r=-.172, p<.001). Secondary traumatic stress
showed statistically significant positive correlation with violence experience(r=.318, ρ<.001), and a
violence response(r=.606, ρ<.001), problem focused coping(r=. 173, ρ=.021)

4. Following a regression analysis to identify the factors that significantly affect the professional quality of life,
the significant influencing factor In the compassion satisfaction, problem focused coping(β=.328,
p<.001), and the model''s explanatory power was 10.3% (adj. R2=0.103)(F=21.36,ρ<.001).
In the burnout category, violence response (β=.460, ρ<.001), problem focused coping(β=-.320, p<.001),
and violence experience(β=.151, ρ =.030) were found to be significant influencing factors, and the model''s
explanatory power was 28.8%(adj. R2=0.288) (F=24.99,ρ<.001).
In the secondary traumatic stress category, violence response(β=.594, ρ <.001), clinical
experience(β=.246,ρ<.001) were found to be significant influencing factors, and the model''s
explanatory power was 41.3%(adj.R2=0.413)(F=47.34, ρ<.001).

Ultimately, among the professional quality of life of emergency department nurses compassion satisfaction improves as problem focused coping increased, and burnout was found to increased as violence experience and violence response were higher, and problem focused coping was lower. secondary traumatic stress was found to increase as the violence response was higher and clinical experience was longer. As a result, it is considered that appropriate measures to prevent violence in emergency department nurses and reduce negative response to violence can improve their professional quality of life.