비자살성 자해(NSSI)에 대한 학교상담에서의 개입 (Intervention of Nonsuicidal Self-Injury in School Counseling)
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- 정신신체의학
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- 제30권1호
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- pp.1-6
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- 2022
최근 학교상담에서 비자살성 자해가 상당히 증가하고 있다. 청소년 상담복지 개발원에 따르면, 전국 230개 청소년 상담복지 센터의 상담 건수를 분석한 결과 2018년 자해 청소년 상담 지원 건수는 전년보다 3배 이상 높았으며, 자해 행동이 처음 나타난 시기는 평균적으로 12.43세였다고 한다. 이처럼 최근 청소년 자해가 계속 증가하고 있으며, 그 연령 또한 점차 낮아지는 추세를 보이고 있다. 그럼에도 불구하고 현재 국내 청소년을 대상으로 자해의 동기와 특징에 관한 연구는 아직 부족한 상황이다. 이는 자해 행동이 은밀하게 이루어지기 때문에 연구를 수행하기 어렵기 때문이라고 볼 수도 있다. 하지만, 이러한 현실이 학생들의 정신건강 문제가 점점 심각해지는 상황에서 이들에 대한 상담적 개입과 예방이 시급하게 요구되는 학교 현장의 또 다른 한계가 있는 것도 사실이다. 또한, 학교장면에서 자해 상담은 상담교사들의 가장 큰 소진 원인이 되고 있는데, 이는 그들이 학교 상황에서 상담자이자 교사라는 이중적인 역할 속에서 반복되는 자해에 대처해야 하는 매우 큰 스트레스를 겪고 있기 때문이다. 이에 본 연구에서는 선행 연구 분석을 통해 비자살성 자해의 원인과 특징을 살펴보고, 학교상담자로서 겪게 되는 여러 가지 어려움과 함께 학교상담에서 비자살성 자해 사안의 효과적인 개입 방법을 함께 고찰해 보고자 한다.
본 연구에서는 현재 국내에서 시행되고 있는 연극치료의 효과성을 메타분석을 통해 살펴보고 이를 통해 향후 보다 효과적이고 구체적인 연극치료의 실행방안을 제시하기 위하여, 국내에서 시행된 연극치료의 효과성에 대한 개별연구들을 메타분석하였다. 메타분석을 위한 자료 수집은 2021년 6월까지 국내에서 발표된 연극치료의 효과성과 관련된 학위논문 및 학술논문 등을 검색하여 이루어졌고, 구체적 선정기준에 따라서 최종 18편의 논문을 선정하여 메타분석을 실시하였다. 분석을 위해서 메타분석 통계프로그램인 CMA(Comprehensive Meta-Analysis) software 2.0을 사용하였으며, 주요 결과는 다음과 같다. 첫째, 연극치료의 평균효과크기를 살펴보면, 자아존중감은 평균효과크기가 1.325, 우울·불안은 -1.230, 스트레스는 1.025, 사회성은 1.018, 정서지능은 0.907, 심리적 안녕감은 0.897로 모두 큰 효과크기를 나타내었다. 둘째, 연극치료의 효과성이 조절 변수에 따라 차이가 나는지 살펴본 결과, '자아존중감'의 효과크기에 있어서 '대상자의 특성(아동·청소년 or 성인)', '총회기수(10회 미만 or 10회 이상)', '연극치료유형(복합연극치료유형 or 공연중심 연극치료유형)' 이 통계적으로 유의미한 차이를 나타내었다. 이러한 측면을 고려할 때, 향후 연극치료를 실행하는데 있어서 효과성의 종속변수로 '자아존중감'을 향상시키기 위해서는 성인대상, 총회기수는 10회 이상, 공연중심의 연극치료유형 등을 보다 확대해서 실시할 필요가 있음을 제시하였다. 이와 같은 본 연구결과를 바탕으로 향후 국내 연극 치료의 실행방안과 함의를 제안하였다.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
이 연구는 지식재산 분야의 실무형 인재를 양성하는 NCS 기반 교육체계를 도입 운영하기 위해서 지식재산교육체제에 대한 만족도와 문제점, 지식재산 NCS(지식재산관리, 지식재산정보조사분석, 지식재산평가 거래)에 대한 교육요구를 조사 분석하였다. 이에 대한 연구의 결론은 다음과 같다. 첫째, 지식재산교육체제에 대한 만족도는 교육내용(M=3.86), 강사(M=3.79), 강의방법 및 환경(M=3.66), 교육평가(M=3.50) 순으로 높게 나타났다. 개선해야 할 문제점은 교육내용에 대해 내용 체계성 미흡과 산업현장 요구를 미반영하여 현업적용도가 낮은 것, 강사는 교육역량과 수강생과의 상호작용이 미흡하며 실무 능력보다 이론 지식을 강조하는 것, 강의 방법은 교육매체 활용성이 낮고 흥미 및 동기부여 방법이 미흡한 것, 평가방법은 이론 지식과 실무 능력의 목표 달성이 부족, 이론 위주로 평가를 실시한다는 것 등이 높게 나타나 이에 대한 개선방안이 마련되어야 한다. 둘째, 지식재산 NCS에 대한 교육요구도는 지식재산평가 거래(요구도 평균=4.33), 지식재산관리(요구도 평균=3.68), 지식재산정보조사분석(요구도 평균=2.99)순으로 높게 나타났으며, 이를 NCS 기반 교육과정을 개편하거나 신규 개발하는 데 반영할 수 있도록 검토해야 한다. 결론적으로 기존 지식재산교육은 보통이상의 만족도를 보였지만 산업현장의 활용성을 높이기 위해 이론보다 실무 능력을 높이는 직무 중심의 교육을 요구하고 있는 것으로 나타났다. 이를 위해서는 산업현장의 요구를 반영한 지식재산 NCS를 도입하여 NCS 기반 교육과정으로 개편하거나 신규 개발이 이루어져야 한다. 또한 공급자가 아닌 수요자 중심의 교수학습방법, 이론 지식이 아닌 수행 및 과정 중심의 평가방법 등의 변화된 교육 패러다임으로 지식재산교육이 개선되어야 한다.
According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.