• The Korean Nurse
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• v.20 no.4 s.112
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• pp.39-49
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• 1981

기존 간호 영역 내 간호는 질적으로, 양적으로 급격히 팽창 확대되어 가고 있다. 많은 나라에서 건강관리체계가 부적절하게 분배되어 있으며 따라서 많은 사람들이 적절한 건강관리를 제공받지 못하고 있어 수준 높은 양질의 건강관리를 전체적으로 확대시키는 것이 시급하다. 혹 건강관리의 혜택을 받는다고 해도 이들 역시 보다 더 양질의 인간적인 간호를 요하고 있는 실정이다. 간호는 또한 간호영역 자체 내에서도 급격히 확대되어가고 있다. 예를들면, 미국같은 선진국가의 건강간호사(Nurse practitioner)는 간호전문직의 새로운 직종으로 건강관리체계에서 독자적인 실무자로 그 두각을 나타내고 있다. 의사의 심한 부족난으로 고심하는 발전도상에 있는 나라들에서는 간호원들에게 전통적인 간호기능 뿐 아니라 건강관리체계에서 보다 많은 역할을 수행하도록 기대하며 일선지방의 건강센터(Health center) 직종에 많은 간호원을 투입하고 있다. 가령 우리 한국정부에서 최근에 시도한 무의촌지역에서 졸업간호원들이 건강관리를 제공할 수 있도록 한 법적 조치는 이러한 구체적인 예라고 할 수 있다. 기존 간호영역내외의 이런 급격한 변화는 Melvin Toffler가 말한 대로 ''미래의 충격''을 초래하게 되었다. 따라서 이러한 역동적인 변화는 간호전문직에 대하여 몇가지 질문을 던져준다. 첫째, 미래사회에서 간호영역의 특성은 무엇인가? 둘째, 이러한 새로운 영역에서 요구되는 간호원을 길러내기 위해 간호교육자는 어떤 역할을 수행해야 하는가? 셋째 내일의 간호원을 양성하는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가 등이다. 1. 미래사회에서 간호영역의 특성은 무엇인가? 미래의 간호원은 다음에 열거하는 여러가지 요인으로 인하여 지금까지의 것과는 판이한 환경에서 일하게 될 것이다. 1) 건강관리를 제공하는 과정에서 컴퓨터화되고 자동화된 기계 및 기구 등 새로운 기술을 많이 사용할 것이다. 2) 1차건강관리가 대부분 간호원에 의해 제공될 것이다. 3) 내일의 건강관리는 소비자 주축의 것이 될 것이다. 4) 간호영역내에 많은 새로운 전문분야들이 생길 것이다. 5) 미래의 건강관리체계는 사회적인 변화와 이의 요구에 더 민감한 반응을 하게 될 것이다. 6) 건강관리체계의 강조점이 의료진료에서 건강관리로 바뀔 것이다. 7) 건강관리체계에서의 간호원의 역할은 의료적인 진단과 치료계획의 기능에서 크게 탈피하여 병원내외에서 보다 더 독특한 실무형태로 발전될 것이다. 이러한 변화와 더불어 미래 간호영역에서 보다 효과적인 간호를 수행하기 위해 미래 간호원들은 지금까지의 간호원보다 더 광범위하고 깊은 교육과 훈련을 받아야 한다. 보다 발전된 기술환경에서 전인적인 접근을 하기위해 신체과학이나 의학뿐 아니라 행동과학 $\cdot$ 경영과학 등에 이르기까지 다양한 훈련을 받아야 할 필요가 있다. 또한 행동양상면에서 전문직인 답게 보다 진취적이고 표현적이며 자동적이고 응용과학적인 역할을 수행하도록 훈련을 받아야 한다. 그리하여 간호원은 효과적인 의사결정자$\cdot$문제해결자$\cdot$능숙한 실무자일 뿐 아니라 소비자의 건강요구를 예리하게 관찰하고 이 요구에 효과적인 존재를 발전시켜 나가는 연구자가 되어야 한다. 2. 미래의 간호교육자는 어떤 역할을 수행해야 하는가? 간호교육은 전문직으로서의 실무를 제공하기 위한 기초석이다. 이는 간호교육자야말로 미래사회에서 국민의 건강요구를 충족시키기는 능력있는 간호원을 공급하는 일에 전무해야 함을 시사해준다. 그러면 이러한 일을 달성하기 위해 간호교육자는 무엇을 해야 하는가? 우선 간호교육자는 두가지 측면에서 이 일을 수정해야 된다고 본다. 그 하나는 간호교육기관에서의 측면이고 다른 하나는 간호교육자 개인적인 측면엣서이다. 우선 간호교육기관에서 간호교육자는 1) 미래사회에서 요구되는 간호원을 교육시키기 위한 프로그램을 제공해야 한다. 2) 효과적인 교과과정의 발전과 수정보완을 계속적으로 진행시켜야 한다. 3) 잘된 교과과정에 따라 적절한 훈련을 철저히 시켜야 한다. 4) 간호교육자 자신이 미래의 예측된 현상을 오늘의 교육과정에 포함시킬 수 있는 자신감과 창의력을 가지고 모델이 되어야 한다. 5) 연구 및 학생들의 학습에 영향을 미치는 중요한 의사결정에 학생들을 참여시키도록 해야한다. 간호교육자 개인적인 측면에서는 교육자 자신들이 능력있고 신빙성있으며 간호의 이론$\cdot$실무$\cdot$연구면에 걸친 권위와 자동성$\cdot$독창성, 그리고 인간을 진정으로 이해하려는 자질을 갖추도록 계속 노력해야 한다. 3. 미래의 간호원을 양성하는 능력있는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가? 내일의 도전을 충족시킬 수 있는 능력있는 간호교육자를 준비시키기 위한 실질적이고 현실적인 전략을 논함에 있어 우리나라의 실정을 참조하겠다. 전문직 간호교육자를 준비하는데 세가지 방법을 통해 할 수 있다고 생각한다. 첫째는 간호원 훈련수준을 전문직 실무를 수행할 수 있는 단계로 면허를 높이는 것이고, 둘째는 훈련수준을 더 향상시키기 위하여 학사 및 석사간호교육과정을 발전시키고 확대하는 것이며, 셋째는 현존하는 간호교육 프로그램의 질을 높이는 것이다. 첫째와 둘째방법은 정부의 관할이 직접 개입되는 방법이기 때문에 여기서는 생략하고 현존하는 교과과정을 발전시키고 그 질을 향상시키는 것에 대해서만 언급하고자 한다. 미래의 여러가지 도전에 부응할 수 있는 교육자를 준비시키는 교육과정의 발전을 두가지 면에서 추진시킬 수 있다고 본다. 첫째는 국제간의 교류를 통하여 idea 및 경험을 나눔으로서 교육과정의 질을 높일 수 있다. 서로 다른 나라의 간호교육자들이 정기적으로 모여 생각과 경험을 교환하고 연구하므로서 보다 체계적이고 효과적인 발전체인(chain)이 형성되는 것이다. ICN같은 국제적인 조직에 의해 이러한 모임을 시도하는 것인 가치있는 기회라고 생각한다. 국가간 또는 국제적인 간호교육자 훈련을 위한 교육과정의 교환은 한 나라안에서 그 idea를 확산시키는데 효과적인 영향을 미칠 수 있다. 충분한 간호교육전문가를 갖춘 간호교육기관이 새로운 교육과정을 개발하여 그렇지 못한 기관과의 연차적인 conference를 가지므로 확산시킬 수도 있으며 이런 방법은 경제적인 면에서도 효과적일 뿐만 아니라 그 나라 그 문화상황에 적합한 교과과정 개발에도 효과적일 수 있다. 간호교육자를 준비시키는 둘째전략은 현존간호교육자들이 간호이론과 실무$\cdot$연구를 통합하고 발전시키는데 있어서 당면하는 여러가지 요인-전인적인 간호에 적절한 과목을 이수하지 못하고 임상실무경험의 부족등-을 보충하는 방법이다. 이런 실제적인 문제를 잠정적으로 해결하기 위하여 1) 몇몇 대학에서 방학중에 계속교육 프로그램을 개발하여 현직 간호교육자들에게 필요하고 적절한 과목을 이수하도록 한다. 따라서 임상실무교육도 이때 실시할 수 있다. 2) 대학원과정 간호교육프로그램의 입학자의 자격에 2$\~$3년의 실무경험을 포함시키도록 한다. 결론적으로 교수와 학생간의 진정한 동반자관계는 자격을 구비한 능력있는 교수의 실천적인 모델을 통하여서 가능하게 이루어 질수 있다고 믿는 바이다.

• Journal of the East Asian Society of Dietary Life
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• v.18 no.4
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• pp.436-445
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• 2008

Stroke is a serious disease despite recent improvements in the medical treatments available. Thirty-six stroke patients were interviewed as case and 36 non-stroke patients were interviewed as controls between February 2005 and August 2005 at Daegu S Medical Center. Information regarding the subjects' food habits was collected using the recall method from 5 years before the onset of stroke. Using interview techniques, we investigated how dietary habits and attitude influence nutrient intake. These results were analyzed by the $X^2$, Student's t-test and Chi-square test using the SPSS 12.0 program. This case-control study was performed to demonstrate the relationships among general quality factors (BMI, WHR, and family history of stroke) and lifestyle factors (smoking, exercise and alcohol drinking). The results were as follows. Analysis of the percentage of nutrient intake in terms of meal pattern showed that WHR was significantly higher in the case group than in the control group. Hypertension and diabetes were the most common preceding diseases associated with the risk of stroke. The frequencies of smoking, alcohol consumption (p<0.001) and exercise (p<0.05) were higher in the cases than in the controls. Thus, the findings of this study are consistent with those of previous studies and suggest that people should be advised to control hypertension, smoking, alcohol drinking and obesity in order to prevent the occurrence of stroke as these factors are major risk factors for stroke.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.74-89
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• 1995

Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

• Journal of Nutrition and Health
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• v.43 no.5
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• pp.433-442
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• 2010

The study aim was to examine the effect of sensory responses of subjects after 6-month dietary sodium reduction with the aid of nutritional education. Fourteen female college students voluntarily restricted their sodium intake for 6 months, during which time they received nutritional education on the low sodium diet. As a control group, 10 students, whose anthropometric measurement, sodium intake behavior, and blood pressure were not different from those of the experimental group, were maintained on a normal diet. For the sensory responses of subjects, the salt taste perception and pleasantness for graded (0.15-1.3%) NaCl solutions were measured by a 9-point hedonic scale. The optimum sodium concentration, urinary sodium excretion, and blood pressure were measured. All the measurements were done at the beginning and end of the experiment. The sensory evaluation revealed an absence of any difference between the two groups in salt taste perception and pleasantness responses at the beginning. After 6-month adaptation, the experimental group subjects showed higher responses to low NaCl solution (0.15, 0.3, 0.5%) in salt taste perception and pleasantness evaluation while the control group subjects exhibited the opposite response. The optimum sodium concentration was reduced from 105.6 mmol to 80.7 mmol (p = 0.015) and the urinary sodium excretion was also reduced from 1,398 mg to 906 mg (p = 0.041) only in the experimental group. Systolic blood pressure was significantly reduced in the experimental group, although there was no correlation between the urinary sodium excretion and blood pressure. The optimum sodium concentration was negatively correlated with the urinary sodium excretion (r = 0.418, p = 0.053), indicating that adaptation to low sodium diet can reduce sodium intake. Further study on the individual responses of subjects on a low sodium diet by periodical evaluation may provide useful data for setting the duration needed to stabilize a lowered appetite for sodium.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.125-137
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• 2001

We investigated the self-concept, subjective depression, and state-trait anxiety of the school boys with learning disabilities(abbr. LD, n=86) and compared them with normal boys(n=52) using Piers-Harris Self-Concept Inventory, Child Depression Inventory(abbr. CDI), and State-Trait Anxiety Inventory(abbr. STAI). With regard to Piers-Harris Self-Concept Inventory total scores, there was no significant difference between two groups, but normal boys showed higher scores in intellectual and school status, physical appearance, and happiness-satisfaction subscales than patients with LD. The male patients with LD showed significantly higher ratings in CDI total scores, and CDI subscales - ineffectiveness, anhedonia, negative self-esteem than normal children. The patients with LD reported significantly higher state anxiety, but not trait anxiety. Correlation analyses revealed that self-concept decreased over time, and depression-anxiety increased across grades in the patients with LD, but not in normal children. Especially, negative mood, anhedonia, negative self-esteem subscales of CDI, and state-trait anxiety showed significant positive correlation with grades. In both groups, CDI scores were inversely correlated with Piers-Harris Self-Concept and positively with State-Trait anxiety. In conclusion, self-concept problems which were related with school achievement and self-esteem were more abundant in the patients with LD than normal children, self-image problem, depression and anxiety increased across grades. According to regression analysis, age, behavior subscale, intellectual-school status, anxiety, popularity, happiness-satisfaction, CDI-ineffectiveness, interpersonal problem, negative self-esteem, and state anxiety could explain the self-concept in the patients with LD, not in normal children. So, the self-concept of the patients with LD were found to be related to the school achievement and stress when comparing with peers. In conclusion, elementary school boys with LD showed lower self-concept, higher depression and anxiety, and these differences increased across grades. Since the patients with LD have concomitant depression and anxiety disorders, it is important that comorbidity with emotional problems should be explored and managed properly.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.57-69
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• 1997

Objective：At the present time in Korea, for a considerable proportion of children and adolescent, delinquent behavior and violence has become as a way of life in their lives and a major social problem issue as well. The contributing factors to this problem were assumed to be the negative interaction between family environment and character of adolescent. The purpose of this study is to search the relationship between these constructs and juvenile delinquency. Method：Data were collected through questionnaire survey over a period of 2 months. Subjects served for this study consisted of 1,863 adolescents including 657 delinquent adolescents and 1,206 student adolescents in Korea, sampled from Korean student population and delinquent adolescent population confined in juvenile corrective institutions, using proportional stratified random sampling method. Their age ranged between 12 and 18 years. Data were analysed by IBM PC using SAS program. Statistical methods employed were Chi-square and principal component analysis. Results：The results of this study were as follows：Inconsistency by parental child rearing patterns tended to affect delinquent behavior among delinquent adolescents. On the other hand, adolescent students were consistently reared by their parent with democratic, flexible, trusting their children and reward-oriented attitudes. In comparison of both parents in the degree of influence on their children, it was revealed that paternal child rearing pattern was more influential on their children’s behaviors than maternal’s. The psychological instability of family, disharmonious parent-child relationships tended to be contributing to delinquent behavior among delinquent adolescents. Especially, It was an interesting finding that student’s mother is the higher employed than delinquent’s mother. However working mother was more prevalent in the student’ adolescents than in student adolescents in previous studies. The delinquent adolescents have more depressive trend, more complaints of psychosomatic symptoms, the higher degree of need frustration, the more maladaptive and antisocial personality pattern than student adolescents. Conclusion：Recently, many studies on association between family factor, character of adolescent and juvenile delinquent behavior have produced relatively consistent results. This study showed that family environment and character trait of adolescent also were linked with delinquent behavior such as smoking, drinking, runaway and physical assaults etc. The results of this survey may provide impetus for future speculation and study of correlation or reciprocal interaction between family factor, character trait of adolescent and delinquent behavior during adolescence and beyond.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.1
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• pp.91-100
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• 2004

Objectives：The effects of repeated maternal separation on the expression of glucocorticoid receptor (GR) and cyclooxygenase-2(COX-2) in the hippocampus of rat pups at preweanling stage were evaluated. Methods：The experimental, Repeated Maternal Separation group(N=4) was separated from the mother for four hours a day over a period of ten days beginning with postnatal day 4. The Control group(N=4), on the other hand, did not separated from the mother at all. GR and COX-2 expression in the hippocampus was examined by immunohistochemistry on postnatal day 14. Results：It was determined that the number of GR-immunopositive cells in the dentate gyrus of the hippocampus was significantly increased in the Repeated Maternal Separation group. The numbers of COX-2-immunopositive cells in the CA1 and CA3 were also significantly higher in the Repeated Maternal Separation group. Conclusion：These results suggest that maternal separation may be a significant developmental stress that induces GR and COX-2 expression in the hippocampus of developing pups.

• Journal of Korean Home Economics Education Association
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• v.30 no.3
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• pp.19-42
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• 2018

The purpose of this study is to analyze the tasks of 'dietary life' in the textbook developed according to the 2015 revised middle school 「Technology·Home economics」 education curriculum based on the multiple intelligence teaching and learning methods. To accomplish this purpose, 12 textbooks of middle school 「Technology·Home economics」 textbooks were titled "Nutrition and Dietary Behavior of Adolescents", "Planning and Choosing Meals", "Choosing Foods and Safe Cooking" except the questions, the tasks that the students can perform are analyzed based on the teaching and learning methods using multiple intelligences. Analysis methods were analyzed by using contents analysis method, focusing on learning activities, and sub-questions of activities were all included in each activity, and the process of preparing activities on a continuous line was grouped into one. Three people analyzed the activities and proceeded to revise and supplement the analysis standard through consultation. The other three researchers confirmed it. As a result of analyzing 12 kinds of textbooks, the number of activity tasks was 25~74 for each kind of textbooks, and the total number of activities was 527. According to the ratio of multiple intelligences, 35% of the tasks were using logical-mathematical intelligence, and 26.8% of linguistic intelligence, 23% of intrapersonal intelligence, 7.2% of interpersonal intelligence, 3.8% of spatial intelligence, bodily-kinesthetic(2.7%) and musical intelligence(1.5%). On the other hand, it was analyzed that there is no activity task using naturalist intelligence. Except to the naturalist intelligence, general intelligence was utilized. This indicates that the home economics curriculum is a convergence of the home economics curriculum in that it is a reorganization by extracting the contents and methods of other curriculum related to dietary life, is interpreted. This study is expected to provide a framework for various teaching and learning methods to activate students' participation classes and to provide an alternative to realize convergence education in home economics curriculum.

• The Journal of Korean Academy of Sensory Integration
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• v.7 no.2
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• pp.23-35
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• 2009

Objective : The purpose of this study is to understand whether group Sensory Integration(SI) therapy has the effect on improvement of motor skill and social function for children with developmental disorder. Method : The subjects were recruited among children received sensory integration therapy at a Children's Development Institute in Dae-Jeon, experimental group is total 5 participating in group sensory integration therapy and control group is also 5 participating in individual sensory integration therapy. The program was constructed for 90 minutes and all children either in the experimental or in the control group went through intervention for 20 weeks. Bruininks-Oseretsky test of Motor Proficiency II, Korean-Scales of Independent Behavior-Revised and Social Maturity Scale were used in order to evaluate the degree of improvement in motor skill and social function. Results : Most children in the experimental group showed improvement in overall aspects of motor skill and the social function comparing pre-intervention with post-intervention, but they did not show any statistically significant differences. However, comparing experimental group with control group, children in the experimental group showed improvement in motor skill and social function. Furthermore, there is statistically significant improvement especially in manual coordination, manual dexterity, and social age and social quotient in Behavior-Revised and Social Maturity Scale. Conclusions : It is found that a group Sensory Integration therapy program has effect on motor skill and social function for children with developmental disorder in this study. In the future study, group SI therapy should be applied for children with diverse diagnosis in order to generalize the effectiveness of therapy.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.3
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• pp.103-108
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• 2017

Kabuki syndrome is a rare congenital disorder that causes multiple birth defects and mental retardation. Mutation of the lysine methyltransferase 2D (KMT2D) gene is the primary cause of Kabuki syndrome. We report a 4-year-old Korean girl diagnosed with Kabuki syndrome based on distinctive facial features (eversion of the lower lateral eyelid, arched eyebrows, depressed nasal tip, prominent ears), skeletal anomalies, short stature, and molecular analysis, which revealed a novel frameshift mutation in the KMT2D gene. A 4-year-old patient had a past history of congenital cardiac malformations (coarctation of the aorta, ventricular septal defect, atrial septal defect, patent ductus arteriosus), subclinical hypothyroidism and dysmorphic features at birth including webbed neck, short fingers, high arched palate, micrognathia and horseshoe kidney. She showed unique facial features such as a long palpebral fissure, long eyelashes, arched eyebrows with sparseness of the lateral third, broad nasal root, anteverted ears, and small mouth. Her facial features suggested Kabuki syndrome, and genetic analysis discovered a novel heterozygous frameshift mutation (c.4379dup, p.Leu1461Thrfs*30) in exon 15 of the KMT2D gene. The diagnosis of our 4-year-old patient was made through thorough physical examination and history taking, and genetic testing. It is challenging to diagnose patients with Kabuki syndrome at birth, since the characteristic facial features are expressed gradually during growth. Clinical suspicion aroused by regular follow-ups may lead to earlier diagnosis and interventions.