• 대한간호학회지
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• 제10권2호
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• pp.95-115
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• 1980

Current statistics reveal remarkable prolongation of the average longevity in this country for the past decade. Welfare of the aged is no longer sole concern of the person or/and family. but has aroused social concern on the community and national level. This study was designed to assess social, economic and emotional needs of the aged. and to identify problems they are confronting. Data were gathered through questioning 273 subjects living in Seoul from July 25, to August 31. 19 80. Frequencies and percentile scores were analysed to describe the fact. and the significance of int or-variable differences was tested by Chi-square method. Results are : 1. Majority of the subjects (male : 65.38%). (female : 62.13%)“talk about past experiences”to re-collect their past days, the difference between male and female respondents was not significant. 2. Except few who earn their pocket money (4.21%). majority were doing household errands (34.52% ) and looking after their garnd children (29.26 ％）. Main sources of their pocket money revealed to be their children (84.02%) and their own savings (24.64% ). Except few (15％）engaged with social activities directly or indirectly. leisure hours are spent in chatting with aged neighbors (44.81%). Highest in the rank order on the joyous moments for the aged revealed to be when the members of family living apart paying a visit (male : 37.5%, female : 63.72%)difference of male and female was significant ( P<0.05). Among female respondents. significant difference between age group was revealed (p<0.05). 3. Majority prefered sin91e houses (84.30% ). as residential environment. the suburban (36.26% ) area was the filet in the rank order : difference between age group and the educational status were not significant. Majority of respondents revealed to have their own room in the house. The first preference was given to live with their children (68.86%). Memory of the past (37.36% )revealed to be the highest in the rank order among the reasons why they dislike moving the house. 4. Majority favored current welfare benefts provided for the old age. however. the ideal way to live at their old age they responded was to live on their own savings (50.54%). 5. Majority revealed to be daunted occasionally (62.27%) by not being less active (34.16%) socially and by poor physical health(29.75%). Male and female differ in the causes of loneliness significantly (P <0.001) : retirement (37.89%) in ale and helpessness (43.05%) in female revealed the highest in the rank order. Majority talk over their feelings with aged neighbors to overcome the loneliness. 6 Majority were in favor of planting and looking after pet animal in the house. however. male and female differ in the kind significantly (p <0.001), 7. Majority think about death and dying occasionally or more (84.11% ). Many of the respondents believes in the life after life (53.49%) : female revealed to be significantly higher (p <0.01). and subjects with christian belief were significantly higher than non-christians (P<0.001). Attitude towards death and dying differs significantly between male and female (P <0. 001) and between christians ans and nonchristians (p <0.001). Highest preference was given to simple funeral (69.85%). Precious heritage that they would pass on to their descendants was onoscience and ethical value(57. 51%) : christian response as the first value was christian belief (52.38%).

• 한국산학기술학회논문지
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• 제20권12호
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• pp.622-628
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• 2019

<단지 세상의 끝 Juste la fin du monde>은 죽음을 눈앞에 둔 한 인간의 죽음에 대한 인식, 태도 그리고 성찰을 심도 있게 표현한 작품이다. 에이즈에 걸려 시한부 인생을 선고 받은 주인공이 12년 만에 고향으로 가족을 찾아간다는 단순한 스토리로 구성되어있는 이 작품은 이 과정에서 가족이란 무엇인지 우리에게 끊임없이 질문한다. 자신의 상태를 알리고 가족과의 소원했던 관계를 회복하고 영원하지만 아름다운 이별을 목적으로 한 이 방문은 오히려 그동안 숨겨왔던 혹은 애써 태연한척 받아들였던 가족 간의 원망, 증오, 비난의 감정을 여과 없이 드러낸다. 그렇다면 가족이라는 관계는 언제나 서로 이해가 되는 관계이며 서로 무조건 용서하고 보듬어 주어야만 하는 관계인가? 자비에 돌란 감독은 우리가 감추고자했던 가족 구성원 사이의 아픈 진실을 보여준다. 그리고 이 아픈 진실이 현실의 모습임을 자각토록 한다. 주인공 루이의 소극적인 자세, 그리고 그를 기다리고 있던 가족들의 불평과 불만 등은 멀어진 간극을 좁히는데 절대적으로 부족한 시간이었다. 저마다 상처를 간직한 채 서로를 진정으로 이해하지 못하고 있는 이 가족은 비록 '가족'이라는 공동체로 묶여 있긴 하지만 약한 결속력으로 인해 오히려 서로에 대한 감정의 골이 심화되는 모습을 보여줄 뿐이다.

• 철학연구
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• 제130권
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• pp.1-22
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• 2014

이 글의 목적은 '안지약명(安之若命)'으로 대표되는 장자 운명관을 현실 체념적이고 노예적인 순응주의로 간주하는 이택후(李澤厚)의 입장과 해석상의 충돌을 시도하고 장자의 입장이 참된 운명 긍정론임을 밝히는 것이다. 이것은 특히 망(忘)의 역할 분석을 통해 진행된다. 그 결과 새롭게 창조되는 가치는 두 가지다. 하나는 통상적으로 인식의 결여나 질병 상태 등 부정적 기능으로 간주되어 온 망각의 긍정적 역할이며, 다른 하나는 몸 생사 세계 변화를 일기(一氣)의 운행으로 통찰함으로써 운명에 긍정적으로 대처하는 '기 통하는 인간'의 가능성이다. 이러한 논의를 위한 글의 전개는 다음과 같다. 먼저 명(命)의 용례 분석을 통해 '안지약명(安之若命)'의 의미를 밝힌다. 분석 결과 안지약명은 '인간의 힘으로 어찌할 수 없는 상황 앞에서는 마음 편히 운명을 따르라'는 의미다. 다음으로 안지약명을 노예적 순응주의로 간주하는 이택후의 입장에 반대해 장자 입장이 운명 긍정론임을 밝힌다. 이것은 장자의 운명 대면법을 네 단계로 추적함으로써 진행된다. 첫째 부득이(不得已)한 운명적 상황을 있는 그대로 직시한다. 둘째 이 때 망각을 통해서 인간적 애락(哀樂)의 고통과 물아(物我) 구분을 해소한다. 셋째, 몸 생사 세계 변화를 일기(一氣)의 운행으로 통찰한다. 넷째, 이러한 과정은 운명 앞에 긍정적으로 대처하는 기(氣) 통하는 인간을 탄생시킨다. 그는 왜 운명 앞에서 긍정적일 수 있는가? 기 통하는 인간은 사물의 이치에 통달하고 그것의 흐름에 따라서 자유자재로 변화하며, 그 결과 외계 사물로 인해 자신의 생명을 해치지 않는다. 따라서 어떤 운명적 상황 앞에서도 사태를 있는 그대로 긍정하며 담담히 포용할 수 있다. 즉 장자의 기 통하는 인간은 운명을 긍정한다. 여기서 이택후의 비판은 극복된다. 필자는 이처럼 부득이한 운명 앞에서 비관 혹은 도피나 노예적 순응이 아닌 적극적 대면과 긍정적 포용의 태도를 취하는 장자의 안지약명을 '장자의 운명애'라고 부를 수 있다고 본다. 이러한 점에도 불구하고 필자는 '기 통하는 인간'의 실제적 가능성과 역할 등에 관해서는 면밀히 논하지 못했다. 이것은 장자의 기론과 수양론을 연관시켜 분석할 때 밝혀질 수 있는 문제들이다. 이러한 점에 대해서는 차후의 지면을 통해 좀 더 구체적인 논의를 진행할 수 있기를 바란다.

• 간호행정학회지
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• 제7권3호
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• pp.403-414
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• 2001

The study was intended to identify the nurses' experiences, understanding, and attitudes on DNR. Also, the study was to provide the data base for a standard of DNR decision-making and practice. The sample consisted of 347 nurses in eight general hospitals. The data were collected between August 1 and August 31, 2000. The data were analyzed using descriptive statistics and $x^2-test$. The results of the study were as follows : 1. Regarding DNR-related experience, 74.6 percent of the participants experienced DNR situations. Eleven percent of the participants received DNR education. DNR was most frequently (81.5%) requested by family members and relatives of patients. The decision-making on DNR was most frequently (76.8%) made by agreement between family members and medical staff. The DNR order was recorded at 81.9 percent on charts. Problems after DNR order were negligence in treatment and nursing care (30.6%) and guilty feelings due to doing the best (22.1%). CPR (cardiopulmonary resuscitation) was performed about 49.8 percent of DNR cases. 2. Regarding understanding and attitude on DNR, most of the participants (93.1%) thought DNR was necessary. The major reasons for the necessity of DNR were impossible recovery (44.4%) and death with dignity (41.1%). The decision-making on DNR was most frequently made by patient and family members (47.8%) and followed by agreement between family members and medical staff (25.6%), and patients themselves (16.4%). Most of the participants thought that medical staff must explain DNR to critical and end-of-life patients and their family members. Forty four percent of the participants thought that the most appropriate time for DNR explanation was when patients with critical disease were admitted to hospitals. Most of the participants (90.2%) thought a guide book for DNR is necessary to be made in hospitals. 3. There were significant differences in the participants' understanding and attitudes on DNR according to religion career education and experience of DNR. Of the participants those who have religions and education experience on DNR thought that there would be more DNR requests after DNR is explained to patients and family members (p<.05). In addition, there was higher understanding on the necessity of DNR in those who have more career and DNR experience(p<.01). The findings of the study suggest that a guide book for DNR need to be made with inclusion of legal, ethical, and cultural aspects. Also, there needs to be more education on DNR in medical ethics to health care professional and to provide more information on DNR to the general public.

• 한국의료질향상학회지
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• 제7권2호
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• pp.190-202
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• 2000

Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

• Journal of Hospice and Palliative Care
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• 제4권2호
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• pp.145-153
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• 2001

목적 : 본 연구는 자원봉사자에 의해서만 호스피스 활동이 이루어지고 있는 W병원의 호스피스 활동을 확대시키고 체계화시키기 위한 목적으로 1단계 호스피스 자원봉사자의 활동분석에 이은 2단계 연구로서 직원들의 호스피스 프로그램에 대한 태도를 조사한 서술연구이다. 방법 : 연구대상자는 W병원의 의사, 간호사, 의료 관련기사, 사무직 등 전체 1200여명의 직원에서 각 직종별 층화표집법을 이용하여 임의표출된 430명이다. 자료수집은 본 연구자들이 개발한 질문지를 이용한 자가보고법에 의하여 수행되었으며, 자료분석은 SPSS를 이용한 서술통계와 내용분석법을 이용하였다. 결과 : 1) 호스피스 개념에 대한 이해를 조사한 결과 대상자의 97% (n=417)가 호스피스에 대해 알고 있었고, 97.4%(n=419)가 죽음을 앞둔 환자들은 존귀한 대접을 받아야한다고 응답한다. 또한 호스피스팀 구성요원에 대한 의견조사 결과 가족(57%), 의사(17.9%), 성직자(9.5%), 간호사(7.9%)가 포함되어야 한다고 응답하였으며 이외에도 사회사업가, 자원봉사자, 물리치료사등 다양하게 응답하였다. 2) 호스피스 프로그램 운영에 대한 태도를 조사한 결과 W병원의 체계적인 호스피스 프로그램 운영을 위하여 최우선적으로 이루어져야 할 활동은 "호스피스 전담부서를 만든다"가 31.4%(n=135)로 가장 높았으며, 다음은 "호스피스 전담병동을 만든다"로 28.6%(n=123)였다. 또한 현재 자원봉사자에 의한 W 병원의 호스피스활동 인지도는 대상자의 67.2%(n=289)만이 알고 있었으며, 반면에 호스피스 서비스 이용 의도는 85.3%(n=367)로 나타났다. 호스피스 프로그램 운영시 장점은 '기독교 정신을 바탕으로 한 인간존중의 병원사명 구현'이 45%로 가장 높은 분포를 보였다. 3) 말기환자에 대한 태도를 조사한 결과 죽음에 대한 태도(4점척도)를 조사한 결과 평균 2.84점(SD=.471) 이었으며, 말기환자들의 병원입원 치료이외에 필요로 되는 서비스는 '종교, 가족, 환자간 지지체계의 구축'이 28.3%로 가장 높은 분포를 나타냈다. 결론 : 본 연구결과 W병원 직원 대부분은 체계적인 호스피스 활동의 필요성을 인식하고 있으며 이를 위하여 최우선으로 필요한 것은 호스피스 활동을 위한 행정구조적 지원임을 알 수 있다. 그러므로 본 연구결과는 W병원의 호스피스 프로그램을 계획하고 추진하는데 기초자료로 활용될수 있을 것으로 기대된다.

• 한국호스피스완화의료학회:학술대회논문집
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• 한국호스피스완화의료학회 2004년도 정기총회 및 하계학술대회
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• pp.100-102
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• 2004

Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

• 한국콘텐츠학회논문지
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• 제13권10호
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• pp.325-346
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• 2013

본 연구는 노인의 인구사회학적 특성에 따른 종교활동, 신앙태도, 우울 및 자아통합감의 차이를 분석하고, 종교활동과 신앙태도가 우울 및 자아통합감에 미치는 영향을 분석하였다. 설문조사는 서울 수도권 지역에서 기독교 신앙을 가진 60세 이상의 노인을 대상으로 2013년 5월 4일에서 25일까지 실시하였으며, 총 408부의 자료를 분석하였다. 연구결과를 요약하면, 첫째, 노인의 인구사회학적 특성에 따라 종교활동, 신앙태도, 우울 및 자아통합감에서 부분적인 차이가 분석되었다. 둘째, 주관적 종교활동과 신앙태도는 우울 요인에 부(-)적인 영향을 미쳤고, 노인의 주관적, 조직적 및 비조직적 종교활동은 비활력 요인에 부(-)적인 영향을 미치고 있었다. 셋째, 주관적 종교활동은 자아통합감의 삶에 대한 태도와 죽음의 수용에, 조직적 종교 활동은 노령의 수용에 정(+)적인 영향을 미쳤고, 종교활동의 모든 요인은 현재 생활 만족에 정(+)적인 영향력을 나타냈다.

• 기독교교육논총
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• 제63권
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• pp.65-89
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• 2020

현재 인류는 전염병의 대유행 가운데 다양한 변화를 경험하고 있다. 교회와 성도 역시 Covid-19로 인해 예배, 성경 모임, 기도회 등 공동체 모임과 개인의 영적 삶에 영향을 받고 있다. 전염병의 대유행은 현시대를 포함해 인류에서 여러 차례 지속해서 발생했다. 가까운 예로는 1918-인플루엔자가 있고, 잘 알려진 예로는 14세기 이래로 진행된 페스트(흑사병)가 있다. 기독교는 전염병의 대유행에 어떻게 대응하였을까? 본 연구는 이 질문에 대해 영성의 관점에서 연구를 수행한다. 과거 전염병이나 질병의 창궐로 인한 사회와 교회의 변화를 연구하고, 이로부터 교회와 성도가 배워야 할 점은 무엇인지 살펴본다. 전염병 상황 가운데 본 논문이 제시하는 세 가지 제안은 영적 선구자의 삶과 태도, 침묵, 그리고 삼위일체 체험을 바탕으로 하는 영성의 사회적 실천이다.

• 여성건강간호학회지
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• 제10권2호
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• pp.150-161
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• 2004

The importance of screening or repeat screening for cervical and breast cancer is well known to decrease the chance of death from cancer. Few data is avaliable regarding factors associated with participation in cervical and breast cancer screening and repeat screening examinations. This study was to investigate the associations of demographic factors, health status and cancer risk recognition, attitude to cancer screening, health behaviors, and inhibiting or facilitating factors to cervical and breast cancer screening with participation in the screening tests. Data was collected with self-administrated questionnaires from 342 women, aged 40 to 69 years. The cancer screenings were classified into have had or never groups and repeat or not repeated groups. In the case of cervical and breast cancer screening, the have had group was 90 (26.3%), and 82 (24.0%) and the repeat group was 17 (5.0%), and 13 (3.8%) respectively. According to logistic regression analysis, age (<60 vs ${\geq}60$ : OR=3.25, 95% CI=1.27-8.26), breast cancer screening (Do vs Don't : OR=14.49, 95% CI=7.46-27.78) and other person's cancer (Yes vs No : OR=4.27, 95% CI=1.01-18.05) were statistically significantly associated with participation in screening for cervical cancer. Regular exercise (Do vs Don't : OR=2.76, 95% CI=1.30-5.88) and cervical cancer screening (Do vs Don't : OR=13.70, 95% CI=7.09-26.32) were statistically significantly related to participation in screening for breast cancer.