• Title/Summary/Keyword: 촉진정책

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A Study on the Support System for Reinforcement of Competitiveness of Small Business persons - Mainly Focused on Support System for Small Business Persons - (소상공인 경쟁력 강화의 지원제도에 관한 연구 - 소상공인 지원제도를 중심으로 -)

  • Woo, Dae-IL;Lee, Sang-Youn
    • The Korean Journal of Franchise Management
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    • v.2 no.2
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    • pp.95-110
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    • 2011
  • As global economic conditions are getting uneasy and polarization of our economy is intensified, the economic sentiment of small businesses is still low and unstable. The collapse of worldwide banking systems due to sub prime crisis in 2007 became the catalyst that shakes financial industries in each country in the world; the most sentiment people, small businesspersons, also have hard time facing survival way out, facing a great crisis. All organizing powers including manufactures, wholesales and retails are being gradually greater in mutual relations and dependence, and unstable factors about risks are also increasing. For exterior environmental and physical risk factors which cannot make small businesses survive themselves by developing ways out are eventually increasing, those who cannot cope with these factors face a great crisis. Although the government tries hard to overcome this situation conducting many ways, the effect does not continue. It is the real state that independent business markets including overall employment and establishing business have vicious cycle that they cannot be improved, due to increase of employment centered on short-term labors which lack durability in creation of employment and decline of household income. Recently, growth shows indication of slowdown because of multinational risk factors including financial crisis in each country in Europe, the death of Kim Jung-il, relationship with North Korea, and unstability of war situation in the Middle East Asia. Experts expect that growth rate will be about 4%, and independent business that ordinary people feel is still gloomy. It's reality that there is no adequate alternative for lack of jobs, unstable employment and a means of living after retirement. Also, the fact that large companies enter the market which is narrow and in the excessive competition should be an environmental factor that makes the situation worse. The business concept, a franchise, is the part we should think about whether it is the institutional solution that can guarantee independent businessmen stable life. Major companies are frightfully entering the market today, breaking the barrier to entry and shouting of a win-win with independent businesses. It's the small businesspersons who go through painful domestic recession, cannot predict the future and manage confusing and unstable independent business. It's very important to restore the domestic economy through wisely boosting consumption as soon as possible. It's also important to lead the situation by gathering powers of the government and related organizations, agonizing, suggesting solutions, and establishing accurate directions. The purpose of this study, therefore, is to suggest ways to strengthen competitiveness of small businesspersons by examining small business support policies which are currently implemented.

Association Between Structural and Functional Aspects of Social Networks and Health Promoting Behaviors: Focusing on Community-Dwelling Older Adults (사회적 관계망의 구조적, 기능적 측면과 건강증진행동과의 관계: 지역사회 거주 노인을 중심으로)

  • An, Hyunseo;Kim, Inhye;Yun, Sohyeon;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.81-96
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    • 2023
  • Objective : This study aimed to examine the association between the structural and functional aspects of social networks and health-promoting behaviors in community-dwelling older adults. Methods : Social networks based on structural and functional aspects and health-promoting behaviors by lifestyle were measured in 226 community-dwelling adults aged 65 years and over. To analyze the collected data, an independent t-test, one-way ANOVA, Pearson's correlation analysis, and hierarchical regression were performed. Results : The network size was the highest in the friend network, and the frequency of contact and social support was the highest in the non-living family network. Health-promoting behaviors were highest for activities of daily living and lowest for productive and social activities. All subfactors of social networks showed significant positive correlations with health-promoting behaviors. Hierarchical regression showed social support from neighbors as the variable with a significant effect on health-promoting behaviors; gender and depression were also influencing factors, and this model showed 37% explanatory power. Conclusion : To promote healthy behaviors of older adultsin the community, the development of health promotion programs and related policies considering social networks centering on social support from neighbors is required.

The Structural Relationship between Entrepreneurial Competency, Entrepreneurial Opportunity Recognition on and Entrepreneurial Intentions of Middle-aged Eldery Office Workers (중·장년 직장인의 창업역량과 창업기회인식 및 창업의지의 구조적 관계)

  • Choi, In Woo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.5
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    • pp.169-185
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    • 2022
  • This study analyzed the effect of entrepreneurial competency on entrepreneurial intentions by using the entrepreneurial opportunity recognition as a mediator for middle and middle-aged office workers. The sub-variables of entrepreneurial competency are classified into management competency, technology competency, business competency and funding competency. 222 copies of questionnaires collected from middle-aged and elderly office workers residing across the country centered on the metropolitan area were used for empirical analysis. Based on a simple mediating model with singular mediator using SPSS v22.0 and PROCESS macro v4.0. was analyzed. As a result of the analysis, first, among entrepreneurial competencies, business competency and funding capacity were found to have a positive (+) significant effect on the entrepreneurial intentions, but management and technical competency did not have a significant effect. The higher the business competency and funding competency. Second, it was found that all of the sub-variables of entrepreneurial competency had a significant effect in the positive (+) direction on the recognition of entrepreneurial opportunities. It was confirmed that management competency has the greatest influence on the entrepreneurial opportunity recognition and technology competence has the smallest effect. Third, it was found that the entrepreneurial opportunity recognition had a significant effect on entrepreneurial intentions. The discovery of an opportunity recognizing opportunities for start-up is a prerequisite for entrepreneur. Fourth, it was found that the entrepreneurial opportunity recognition mediates between the management competency, technological competency, business competency, funding competency, and entrepreneurial intention. It suggests that opportunity discovery by recognizing opportunities for entrepreneurship is a prerequisite for start-up. As implications of this study, it suggests that in order to inspire middle-aged and elderly office workers to start their own business, it is necessary to have indirect experience with education and to establish and promote a government support system for financing.. Second, It suggests that education on leadership and organizational management is particularly necessary to strengthen the opportunity recognition. Third, it suggests that the discovery of opportunities to recognize opportunities for start-up is a prerequisite for entrepreneur. Therefore, it is necessary to prepare a manual and conduct training on opportunity search, recognition, evaluation, and utilization according to the stage of opportunity development. Fourth, it suggests that in order to strengthen the intention to start a business, ALso, it is necessary to manage both the entrepreneurial competency and entrepreneurial opportunities recognition at the same time. By presenting the practical directions that can be given differentially, we intend to contribute to the provision of practical directions and policy establishment for the promotion of entrepreneurial activities of office workers who can give vitality to the ecosystem.

The Effect of Entrepreneurial Knowledge Acquisition on Entrepreneurial Intention via Entrepreneurial Self-Efficacy: The Moderated Mediation Effect of Family Entrepreneurship Background (창업지식습득이 창업자기효능감을 매개로 창업의도에 미치는 영향: 창업자 가족배경의 조절된 매개효과를 중심으로)

  • Lee, Juyon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.4
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    • pp.219-232
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    • 2022
  • Empirical studies on entrepreneurial intentions have been conducted from various perspectives over the past few decades. The unemployment rate has increased as the global economy stagnates in the aftermath of the COVID-19 pandemic, and entrepreneurship is emerging as an alternative to job creation. Although numerous antecedent variables have positive effects on entrepreneurial intention, this study focuses on entrepreneurial self-efficacy as an individual factor and the entrepreneur's family background as an environmental factor. This study analyzed the survey results of 300 global respondents through the online survey platform Prolific. The respondents were screened by asking a question about having had entrepreneurial education. Since the effects of entrepreneurial self-efficacy on entrepreneurial intention have been proved in numerous domestic studies, this study aims to generalize these results by investigating global samples. The moderated mediation analysis was performed using PROCESS to verify the research hypotheses. This research investigated the effect of entrepreneurial knowledge acquisition on entrepreneurial intention via entrepreneurial self-efficacy and the moderated mediation effect of the family background of entrepreneurs. The results of this study are summarized as follows. First, acquisition of entrepreneurial knowledge had a positive effect on entrepreneurial intention. Second, entrepreneurial self-efficacy mediated the relationship between entrepreneurship knowledge acquisition and entrepreneurial intention. Third, the entrepreneurship family background moderated this relationship. Specifically, when the family entrepreneurship background is strong (vs. weak), the positive effect of entrepreneurial knowledge acquisition on entrepreneurial intention via entrepreneurial self-efficacy significantly increased. The implications of this study are as follows. First, in the process of preparing for a own business, entrepreneurial education is a necessary condition to improve the entrepreneurial intention. Second, the higher the level of acquisition of entrepreneurial knowledge, the more positive attitudes toward entrepreneurial intention can be induced. Third, strong family background of entrepreneurship further promotes entrepreneurship intention by increasing entrepreneurial self-efficacy. In conclusion, in order to revitalize entrepreneurship, it is important to provide various entrepreneurial education programs. These educational programs will be able to improve entrepreneurial self-efficacy by providing more opportunities for students to acquire entrepreneurial knowledge, and thereby promote entrepreneurial intention. In addition, it is important to develop and provide advanced educational curriculum for those who have start-up business experiences in their families.

The Effects of Consumer Value Cognition on Benefits and Attributes of Culture-Art Products (문화예술상품 소비자의 가치인식이 추구혜택과 상품속성에 미치는 영향)

  • Shin, Eun Joo;Rhee, Young Sun
    • Asia Marketing Journal
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    • v.14 no.2
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    • pp.177-207
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    • 2012
  • Today's consumers perceive consumption as a representation of themselves. It is not simply an act that fulfills a consumer's physical and practical needs. Even in terms of life quality, consumers increasingly want to achieve an emotional and sensible experience through consumption. Consumers now make decisions based on their need to express their position in relation to other people, pursue emotional satisfaction, and try to improve the quality of life. Culture-art products that meet such internal and external demands of consumers have made significant improvements in both quantity and quality, because of the social interest and policy support. The recognition of personal and social values of culture and arts has brought about interest in and need for culture-art products. Businesses have agilely embraced such change and actively implemented various marketing strategies utilizing culture and arts. For example, businesses began to sponsor artists who produce culture-art products while building facilities for cultural and art performances or exhibitions. Businesses have also provided performances and exhibitions free-of-charge or at affordable prices. As a result, the supply in the market has started to exceed its demand as is often the case in many of other markets. However, such imbalance has occurred not because of over-supply but because of a lack of demand. Given these circumstances, the government and culture and art related organizations, which had mainly concentrated on the supply side, started to recognize the importance of creating personal and social values in culture and arts. As a result, the government and various organizations are now creating various strategies that include policy measures to achieve their new found goal. Unfortunately however, such efforts are not meeting the expectations. Focusing on above-mentioned circumstances and problems, this study aims to find measures to create demand for culture-art products in the internal conditions of those who consume culture-art products. In other words, given that the demand for culture-art products has not increased despite all external conditions to encourage consumption, this study aims to find the reasons in consumers' value judgment on culture-art products. Though there were recent studies on culture-art products that applied consumer behavior on marketing theories, most of them focused on peripheral aspects such as people's motivation for or satisfaction from watching culture-art events. Hence, there is a need to understand what kind of value consumers perceive from culture-art products and how such value cognition leads to consumption in a comprehensive manner. This study acts as follow-up to a separate study entitled "Qualitative Study about Value Cognition and Benefits of Consumer on Culture-Art Products". The current study aims to extend practical implications that enhance the effectiveness of marketing strategies among the producing and policy agencies in the industry. The purpose of this study is to investigate dimensions of value cognition, benefits and attributes of culture-art products, and identify the effects of consumer value cognition on benefits and attributes. The questionnaire was developed based on the conceptual structure of qualitative research and previous researches. It was composed of value cognition, benefits, attributes of culture-art products and demographic variables. This survey was conducted on-line and off-line among a total of 662 persons ranging from their teens to their 50's who were living in Seoul, Gyeonggi-do, various metropolitan cities, and small and medium-sized cities. The data collected was analyzed by factor analysis and path analysis using SPSS WIN 18.0 and AMOS 16.0. This empirical study found that the dimensions of value cognition of culture-art products were categorized into personal goods, aesthetic goods and public property. This shows that the consumers perceive culture-art products as products that are worthy enough to pay the costs not just for personal benefits but also for their social values. Also the formation of value cognition for culture-art products requires special conditions unlike that for physical consumer goods and services, which simply require marketing stimuli. The dimensions of benefits pursued by consuming culture-art products were found to be composed of four types - pursuit of aesthetic benefits, pursuit of actual benefits, pursuit of emotional benefits, and pursuit of conspicuous character. This result implies that people consume culture-art products not just to pursue pleasure from emotional and intelligent satisfaction as well as social relations, but also to seek the needs and benefits embodied at a social level. The dimensions of attributes of culture-art products had seven different factors, - environmental, price, evaluation, people, artwork, composition, and personal relations - which is plentiful. This is because the attributes of culture-art products are very complicated compared to other consumer goods or services. Since culture-art products include not just cultural or artistic works but also all physical, human, environmental, and systemic elements of the products in a comprehensive manner, consumers perceive everything they experience in the process of consuming culture-art products as part of the products. The dimensions of value cognition was found to affect attributes of the products, mostly using pursued benefits as a mediating factors. This result is consistent with the result of qualitative research, and proves that applying the means-end chain theory in the reverse direction is reasonable. The result can be interpreted that consumers' value cognitions for culture-art products turns into actual benefits leading to consumers' decisions. Furthermore, this result reveals that when consumers choose culture-art products, they take into account the attributes of culture-art products depending on the benefits they pursue. These results confirm that despite their conceptual and abstract attributes, culture-art products have values that contribute to actual benefits for individual consumers and society. Hence, value cognition generates benefits to be pursued and this in turn affects the consumers' choices of attributes on products. Based on the conceptual structure of consumers' value cognitions on culture-art products and its dimensions, it is possible to find detailed methods to provide opportunities for education and training to form and reinforce positive value cognition on culture-art products. And through those methods, it will be possible to develop attributes of culture-art products according to the dimensions of pursued benefits, and allow conceptual products become the subject to valuable consumption in real life. These results provide theoretical understanding of consumer behavior in culture marketing and useful information to culture-art producers, companies that use culture and art, and government agencies that use culture-art as a mean to improve the public perception of quality of life. As a follow up on this study, there should be experimental studies that can develop criteria visualizing the demands of consumers who purchase culture-art products and identify their detailed attributes. Studies that compare characteristics of different areas within the culture-art product category and in-depth studies on a specific area or genre will also be needed. In order to develop marketing strategies for culture-art products, studies on the formation and reinforcement of positive value cognition on culture-art products and education for the development of consumer demand as well as on the development and differentiation of attributes of culture-art products depending on types of consumer groups should also follow.

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An Analysis of the Imported Consumer Goods Distribution Sector of Korea: From a Vertical Structure Viewpoint (수입소비재(輸入消費財) 유통구조(流通構造)의 효율화(效率化) 방안(方案))

  • Nam, Il-chong
    • KDI Journal of Economic Policy
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    • v.13 no.1
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    • pp.3-33
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    • 1991
  • Since the early 1980's, the Korean government has gradually been widening the Korean market to foreign consumer goods. This, combined with the increased purchasing power of the Korean consumers resulting from the continued economic growth of the country, has sparked a spectacular influx of foreign consumer goods into Korea, ranging from BMW's to chopsticks. Import of foreign consumer goods amounted to more than 6 billion dollars in 1989 and is continuing to grow at a rapid rate. The increased import of foreign consumer goods doubtlessly improved the overall welfare of the Korean consumers by providing them with a wider range of options to choose from, by lowering the prices of some of the consumer goods domestically produced, and also by forcing the producers of some Korean goods to face competition with better foreign goods, thus giving them an incentive to raise the quality of their products. However, it is agreed by most economists that this increase in general welfare has been much smaller than what they had expected at the outset. Consumer prices of most imported consumer goods are easily double the import price, and in some cases, more than treble the import prices. Further, there has not been a noticeable drop in the prices of domestically produced consumer goods. Much of the blame has been attributed to the distribution sector of Korea. The objective of this paper is to analyze the imported consumer goods distribution sector of Korea, focusing on the possible sources of the poor performance of that sector, and to make policy suggestions that could potentially increase the welfare. This paper differs from all the previous research by others on this subject in that it analyzes the imported consumer goods distribution sector of Korea as a vertical structure. The distribution sector of an imported consumer good is a vertical structure since it consists of an international market, an import stage, and domestic wholesale and retail markets, in that order vertically. Our study naturally includes the analysis of the vertical restraints as well as the analysis of the industrial organization of each horizontal stage in the vertical structure. Each horizontal component of the imported consumer goods distribution sector is basically a monopolistically competitive market differentiated by characteristics of goods and by the locations and the services of firms. Further, restrictive dealership and resale price maintenance are found to be widely in use. Our main findings are the follwing; First, most consumer goods are imported monopolistically or oligopolistically through restrictive dealership contracts between foreign producers and domestic importers. Such restrictive dealership gives importers market power in the domestic market and explains many of the large discrepancies betwen the consumer prices and the import prices of many goods. Korean anti - trust law does not cover the issues arising from the market power of an importer resulting from a restrictive dealership contract. Second, some major producers of Korean goods are also importers of foreign goods that are substitutes of their products. The import of substitutes by major domestic producers is anti - competitive because it tends to raise the prices of both domestic goods and foreign goods, and also because it reduces the incentive of the domestic producers to raise the quality of their products. Third, wholesalers and retailers widely use resale price maintenance as a price fixing mechanism, and while this is against the anti- trust law, it seldom gets noticed. Fourth, the high level of rents of real estate for commercial use works as an entry barrier to the distribution sector and results in reduced competition by the firms in that sector. Finally, there are information problems. Consumers have inferior information to firms about the quality of a foreign consumer good that they have not tried before. Such information asymmetry often enables firms to raise prices. In addition, information asymmetry between importers frequently delays the import of cheaper substitutes. In order to alleviate the problems indentified above, we suggest the following policy changes. The government should strengthen the anti - trust law and its enforcement to regulate restrictive import contracts, import of competing goods by major domestic producers, and RPM by wholesalers and retailers that is aimed at price fixing. In addition, the government should loosen its tight real estate policy to encourage investment in the distribution sector. Finally, we suggest that the import price revelation policy that has been in use for some items since 1990 be expanded to most imported consumer goods that are introduced for the first time to give consumer better information and be used only for the period of time needed to inform sufficient number of consumers.

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Rural Migration and Changes of Agricultural Population (농민이촌(農民離村)과 농업인구(農業人口)의 변화(變化))

  • Wu, Tsong-Shien;Kim, Kuong-Ho
    • Korean Journal of Agricultural Science
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    • v.1 no.1
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    • pp.91-116
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    • 1974
  • Taiwan agricultural development in the last decade has not been changed much since the accomplishment of land reform program. This is mainly due to the rapid development taken place within industry that agricultural development can not keep pace with. The increasing gap of rural-urban income discrepancy has caused socio-psychological unstability among rural people and inspire wants of out-migration. From 1961 to 1970, population of the ten largest cities showed an annual growth rate of 4.05%, while the population of the remainder of Taiwan showed 2.06%. Assuming the natural increase rate of these two population sections are similar, the difference of rural and urban annual growth rate can be at tributed to the flow of people from rural to urban sectors. The main objective of this paper is to identify the amount of agricultural out-migration and its impact on agricultural development and agricultural extension programs. Specifically, the objectives are to examine (1) rural-urban population composition (2) rural out-migration estimation (3) changes of agricultural population, and (4) implications for agricultural development and extension programs Some of the important findings are listed below; (1) The average agricultural out migration of the period 1960-1969 is estimated at around 60,000 per year. Take Tainan prefecture for example, the Male-Female Migration Ratio is 0.39 for age 20-24, 0.55 for age 25-29, 0.90 for 30-34. It is understood between age 20 and 34, the rural female migration rate is higher than the rural male. (2) Based on the population growth rate of 1950-1969, agricultural population is projected for the period of 1953 to 1989. By 1978, the agricultural population will reach its peak and begin to dedaine from 1980. The projected agricultural population in 1989 is 5,847,566 which occupies 29% of the Taiwan total population. (3) Assuming area of cultivated land keep unchanged as 905,263 ha. in 1970, and tif we can eliminate all 72% of part-time farms, then the average farm acreage for hose full-time farms will be increased to 3.6 hactares. This is unlikely to happen before 1989 without the government interference. (4) Less than 10% of adult farmer s of age 25-64 in 1969 enrolled in Farm Discussion Club, only 5% of adult farm women enrolled in Home Economics Club, and 5% of rural youth enrolled in 4-H Club. These statistics show a fact that only few farmers are reached by extension workers. Based on findings in this paper, some important suggestions are listed for future agricultural development. (1) Improve agricultural structure by decreasing agricultural population (a) Encourage farmers with less than 0.5 ha. of land to seek jobs outside of agriculture (b) Encourage joint cultivation and farm mechanization (c) Discourage rural migrants to Keep farm land (d) Provide occupational guidance program through extension education programs (2) Establish future farmers settlement project to assure rural youth have enough resources for farming. (3) An optimum Population policy should be integrated into rural socio-economic development and national development programs.

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Philosophical Stances for Future Nursing Education (미래를 향한 간호교육이념)

  • Hong Yeo Shin
    • The Korean Nurse
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    • v.20 no.4 s.112
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    • pp.27-38
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    • 1981
  • 오늘 저희에게 주어진 주제, 내일에 타당한 간호사업 및 간호교육의 향방을 어떻게 정하여야 하는가의 논의는 오늘날 간호계 주변에 일어나고 있는 변화의 실상을 이해하는 데서 비롯되어져야 한다고 생각하는 입장에서 먼저 세계적으로 건강관리사업이 당면한 딜레마가 어떠한 것이며 이러한 문제해결을 위해 어떠한 새로운 제안들이 나오고 있는가를 개관 하므로서 그 교육적 의미를 정의해 보고 장래 간호교육이 지향해야할 바를 생각해 보려 합니다. 오늘의 사회의 하나의 특징은 세계 모든 나라들이 각기 어떻게 전체 국민에게 고루 미칠 수 있는 건강관리체계를 이룩할 수 있느냐에 관심을 모으고 있는 사실이라고 봅니다. 부강한 나라에 있어서나 가장 빈궁한 나라에 있어서나 그 관심은 마찬가지로 나타나고 있읍니다. 보건진료 문제의 제기는 발달된 현대의학의 지식과 기술이 지닌 건강관리의 방대한 가능성과 건강 관리의 요구를 지닌 사람들에게 미치는 실질적인 혜택간에 점점 더 크게 벌어지는 격차에서 발생한다고 봅니다. David Rogers는 1960년대 초반까지 갖고 있던 의료지식의 축적과 민간인의 구매력 향상이 자동적으로 국민 건강의 향상을 초래할 것이라고 믿었던 순진한 꿈은 이루어지지 않았고 오히려 의료사업의 위기는 의료지식과 의료봉사간에 벌어지는 격차와 의료에 대한 막대한 투자와 그에서 얻는 건강의 혜택간의 격차에서 온다고 말하고 있읍니다. 균등 분배의 견지에서 보면 의료지식과 기술의 향상은 그 단위 투자에 대한 생산성을 낮춤으로서 오히려 장애적 요인으로 작용해온 것도 사실이고 의료의 발달에 따른 일반인의 기대 상승과 더불어 의료를 태성의 권리로 규명하는 의료보호사업의 확대로 야기되는 의료수요의 급증은 모두 기존 시설 자원에 압박을 초래하여 전래적 의료공급체제에 도전을 가해 왔으며 의료의 발달에 건 기대와는 달리 인류의 건강 문제 해결은 더욱 요원한 과제로 남게 되었읍니다. 현시점에서 세계인구의 건강문제는 기아, 영양실조, 안전한 식수 공급 및 위생적 생활환경조성의 문제에서부터 가장 정밀한 의료기술발달에 수반되는 의료사회문제에 이르는 다양한 문제를 지니고 있으며 주로 각개 국가의 경제 사회적 여건이 이 문제의 성격을 결정짓고 있다고 볼수 있읍니다. 그러나 건강 관리에 대한 요구는 영구히, 완전히 충족될 수 없는 요구에 속한다는 의미에서 경제 사회적 발달 수준에 상관없이 모든 국가가 공히 요구에 미치지 못하는 제한된 자원문제로 고심하고 있는 실정입니다. 또 하나의 공통된 관점은 각기 문제의 상황은 달라도 오늘날의 건강 문제는 주로 의료권 밖의 유전적 소인, 사회경제적, 정치문화적인 환경여건과 각기 선택하는 삶의 스타일에 깊이 관련되어 있다는 사실입니다. 따라서 오늘과 내일의 건강관리 문제는 의학적 견지에서 뿐 아니라 널리 경제, 사회, 정치, 문화적 관점에서 포괄적인 접근이 시도되어야 한다는 점과 의료의 고급화, 전문화, 일변도의 과정에서 소외되었던 기본건강관리체계 강화에 역점을 둔 다양하고 탄력성 있는 사업전개가 요구되고 있다는 점입니다. 다양한 건강관리요구에 적절히 대처할 수 있기 위한 그간 세계 각처에서 시도된 새로운 건강관리 접근과 그 제안을 살펴보면 대체로 4가지의 뚜렷한 성격들로 집약할 수 있을 것 같습니다. 그 첫째는 건강관리사업계획 및 그 수행에 있어 지역 사회의 적극적 참여를 유도하는 일, 둘째는 지역단위의 일차보건의료에서 부터 도심지 신예 종합병원, 시설 의료에 이르기까지 건강관리사업을 합리적으로 체계화하는 일. 셋째로 의료인력이용의 효율화 및 비의료인의 훈련과 협조 유발을 포함하는 효과적인 인력관리에 대한 제안과 넷째로 의료보험 및 각양 집단 의료유형을 포함하는 대체 의료재정 운영관리에 관련된 제안들을 들 수 있읍니다. 건강관리사업에 있어 지역사회 참여의 의의는 첫째로 사회 경제적인 제약이 모든 사람에게 가능한 최대한의 의료를 모두 고루 공급하기 어렵게 하고 있다는 점에서 제한된 정부재정과 지역사회가용자원을 보다 효율적으로 이용할 수 있게 하는 자조적이고 자율적인 지역사회건강관리체제의 구현에 있다고 볼 수 있으며 둘때로는 개인과 가족 및 지역민의 건강에 영향하는 많은 요인들은 실질적으로 의료권 외적 요인들로서 위생적인 생활양식, 식사습관, 의료시설이용 등 깊이 지역사회특성과 관련되어 국민보건의 실질적 향상을 위하여는 지역 주민의 자발적인 참여가 필수여건이 된다는 점 입니다. 지역 단위별 체계적인 의료사업의 전개는 제한된 의료자원의 보다 합리적이고 효율적인 이용을 가능하게 하며 요구가 있을때 언제나 가까운 거리에서 경제 사회적 제약을 받지 않고 이용할 수 있는 일차건강관리망을 통하여 건강에 관련된 정보를 얻으며 질병예방, 건강증진 및 기초적인 진료의 도움을 얻을 수 있고 의뢰에 대한 제2차, 제3차 진료에의 길은 건강관리사업의 질과 폭을 동시에 높고 넓게 해 줄 수 있는 길이 된다는 것입니다. 인력 관리에 관련된 두가지 기본 방향으로서는 첫째로 기존보건의료인력의 적정배치 유도이고 둘째는 기존인력의 역할확대, 조정 및 비의료인의 교육훈련과 부분적 업무대체를 들수 있으며 이러한 인력관리의 기본 방향은 부족되는 의료인력의 생산성을 높이고 주민들의 자조적 능력을 강화시킨다는 데에 두고 있음니다. 대체적 의료재정운영안은 대체로 의료공급과 재정관리를 이원화하여 주민의 경제능력이 의료수혜의 장애요소로 작용함을 막고 의료인의 경제적 동기에 의한 과잉치료처치에 의한 낭비를 줄임으로써 의료재정의 투자의 효과를 증대하는 데(cost-effectiveness) 그 기본방향을 두고 있다고 봅니다. 이러한 주변의료 사회적인 동향이 간호교육의 미래상에 끼치는 영향은 지대한 것이라 봅니다. 첫째로 장래 세계인구의 건강문제는 정치, 사회, 경제, 환경적인 의료권 밖의 요인들에 의해 더욱 크게 영향 받는다고 전제한다면 건강문제해결에 있어서도 전통적인 의료사업의 접근에서 더나아가 문제발생의 근원이 되는 생활개선이라는 차원에서 포괄적 접근을 생각하여야 하고 이를 위해선 정치, 경제, 사회전반에 걸친 깊이있는 이해과 주민의 생활환경에 직접 영향하는 교통수단, 통신망 mass media, 전력문제, 농업경영방법 및 조직적 사회활동 등 폭넓은 이해가 요구된다고 봅니다. 둘째로, 지역사회참여의 의의를 인정한다면 지역민의 자발적 참여를 효과적으로 유발시킬수 있고 의료집단과 각종 주민조직과 일반주민들 사이에서 협조적으로 일할수 있는 역량을 기르기위한 교육적 준비가 요구된다고 봅니다. 셋째로, 지역주민의 건강관리 자조능력 강화를 하나의 목표로 삼는다면 치료자에서 교육자로, 지도자에서 촉진자로, 제공자에서 지원자료의 역할의 변화 내지 다양화를 요구하게 될 것이므로 그에 대처할 수 있는 준비가 필요하다고 봅니다. 넷째로, 생각되어야 할 점은 지역중심건강관리사업을 지향하는 보건의료의 이념적 방향과 그에 상응하는 구체적 접근방법을 효율적으로 적용하기 위해서는 종횡으로 연결되는 의사소통체계의 정립과 민활한 정보교환이 이루어질 수 있어야 한다는 점에서 의사소통의 구심체로서 역할할 수 있는 역량을 함양해야 할 교육적 과제가 있다고 봅니다. 마지막으로 생각되어야 할 점은 지역중심으로 전개될 건강관리사업은 건강증진 및 질병예방적 측면과 질병진료 및 회복과 재활에 이르는 종합적이고 포괄적인 사업이어야 한다는 점에서 종래 공공 의료부문과 사설의료기관 사이에 나누어져 있던 예방의학과 치료의학의 통합 뿐 아니라 정부주축으로 이루어 지고 있는 지역사회개발사업 및 농촌지도사업과 종교 및 각종 민간인 집단이 벌이고있는 사업들과의 전체적인 통합적 접근이 이루어져야 한다고 생각하는 입장에서 종래 간호교육이 강조하지 않던 진료의 의무와 대외적 조직활동에 대한 보완적인 교육조치가 요구된다고 봅니다. 간호의 학문체계로서의 입장은 오랜 역사를 두고 논의의 대상이 되어왔으나 아직까지 뚜렷이 어떤 것이 간호 특유의 지식체계이며 건강문제에 관련하여 무엇이 간호특유의 결정영역이며 이 결정과 그 결과를 어떠한 방법으로 치료적 행위로 옮길 수 있는가에 대한 확실한 답을 얻지 못하고 있는 실정이라고 봅니다. 다만 근래에 제시된 여러 간호이론들 속에서 공통적으로 이야기되어지고 있는 개념들로선 우선 간호학문을 건강과 질병에 관련된 인간의 전인적이고 전체적인 상황을 다루는 학제적 과학으로서보는 입장이 있고 따라서 생물신체적인 면 외에 정신심리적, 사회경제적, 정치문화적 환경과의 상호작용 속에서 인간의 건강과 질병문제를 생각한다는 지향을 갖고 있다고 말할 수 있겠읍니다. 간호교육은 간호계 내적인 학문적, 이론적 체계화의 요구에 못지않게 대민봉사하는 전문직으로서의 사회적 책임을 감당해야하는 중요과제를 안고있어 변화하는 사회요구에 효과적으로 대처해 나가야 할 당면문제를 안고 있읍니다. 간효역할 확대, 보건진료원훈련 등 이러한 사회적 요구에 대응하려는 조치가 되겠읍니다. 이러한 시점에서 간호계가 분명히 짚고 넘어가야 할 사실은 이러한 움직임들이 종래의 의사들의 외업무공급을 연장 확대하는 입장에 서서 간호의 특수전문직 명목을 흐리게 할수있는 위험을 감수할 것인지 아니면 가능한 대체방안을 갖고 간호전문직의 독자적인 진로를 개척하면서 다각적인 도전을 받아들일 준비를 갖추든지 그 방향을 뚜렷이 해야할 일이라 생각합니다. 저로서는 이미 잘 훈련된 간호원들과 조산원들의 교육적, 경험적 배경을 기반으로 지역사회 최일선 건강관리요원으로 사회적 효능을 다 할수 있는 일차건강관리간호조직의 구현을 대체방안으로 제시하고 싶습니다. 간호원과 조산원들의 훈련된 역량과 건강관리체제의 구조적 변화를 효과적으로 조화시킨다면 대부분의 세계인구의 건강문제는 해결가능하다고 보는 입장입니다. 물론 정책과 의료와 행정적지원이 활성화되어지는 환경속에서만 그 기대하는 결과가 확대되리라는 점 부언하는 바입니다. 마지막으로 언급하고 싶은 점은 바로 오늘의 주제 ''교육의 동역자-선생과 학생''이라는 개념입니다. 특히 상회정의적 입장에서 보는 의료사업전개에 지역민 내지 의료소비자의 참여를 강조하는 현시점에 있어 교육자와 학생이 교육의 현장에서 서로 동역자로서 학습의 책임을 나누는 경험은 아주 시기적으로 적합하여 교육적으로 지대한 의미를 갖는 것이라고 생각합니다. 이에 수반되어져야 할 역할의 변화에 수용적인 자세를 갖고 적극 실제적용하려 노력하는 선생앞에서 자주적 결정을 행사해본 학생이야말로 건강관리대상자로 하여금 같은 결정권을 행사할수 있도록 촉구하여 주민의 자조적 역량을 기르고 의료사업의 민주화, 인간화를 이룩할 수 있는 길잡이가 될 수 있으리라 믿는 바입니다.

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