• 제목/요약/키워드: Family support

검색결과 3,340건 처리시간 0.031초

초산모의 분만유형별 분만경험에 대한 지각과 모아상호작용 과정에 관한 연구 (Primiparas만 Perceptions of Their Delivery Experience and Their Maternal-Infant Interaction : Compared According to Delivery Method)

  • 조미영
    • 대한간호학회지
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    • 제20권2호
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    • pp.153-173
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    • 1990
  • One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p=0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p=0.000) but no differences for labor or the bady according to the delivery method(p=0.096, p=0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p=0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p=0.042), 2nd day (p=0.009), and the 3rd day(p=0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F=.3206, p=.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r=.4363, p=.000, r=.2881, p=.012). No correlations between perceptions of labor and maternal-infant interaction were found(p=0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p=0.000) and from the fourth to sixth weeks after birth(P=0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p=0.002) and breast feeding(p=0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p=0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p=0.010), a wanted pregnancy (P=0.030) and her confidence in her role as a mother(p=0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

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치위생과 학생의 건강증진행위 결정요인에 관한 연구 (The Determinants of Health Promoting Behavior in Students on Dept of Dental Hygiene)

  • 김은미;이향님
    • 치위생과학회지
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    • 제4권3호
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    • pp.141-148
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    • 2004
  • 본 연구는 2004년 9월 13일부터 17일까지 전라남도 K시에 소재하는 4개의 대학에 재학중인 치과위생과 학생 1,2,3학년을 대상으로 자기기입식 설문지로 건강증진 행위와 자기효능감, 인지된 이익, 인지된 장애, 건강통제위, 자아존중감과 인구사회학적 요인을 조사하여 건강증진 행위에 영향을 미치는 요인을 조사하였으며 결과는 다음과 같다. 1. 대상자의 건강증진 행위는 2.60 이었고, 하부요인으로 자아실현 2.89, 건강책임 2.12, 운동 1.89, 영양 2.45, 대인관계 2.97, 스트레스관리 2.63 이었다. 자기효능감은 2.56, 인지된 이익문항은 3.45, 인지된 장애 문항은 2.32, 건강통제위는 3.04, 자아존중감은 2.81이었다. 2. 인구사회학적 특성과 건강증진 행위와의 관계에서는 학년, 종교, 경제수준, 가족질병경험, 본인의 질병경험, 인지된 건강상태(p<0.05)에 따라 유의한 차이가 존재하였고, 인지된 구강건강상태(p<0.001)에 따라 유의한 차이가 존재하였다. 하부영역중 자아실현은 학년, 경제수준, 인지된 건강상태(p<0.05)에 따라 유의한 차이가 있었고 종교, 인지된 구강건강상태(p<0.01)에서 유의한 차이를 보였다. 건강책임은 학년, 종교, 경제수준, BMI(p<0.05)에 따라 유의한 차이가 있었고, 본인의 질병경험, 인지된 구강건강상태(p<0.001)에 따라 유의한 차이가 있었다. 운동영역은 모의 교육정도, 가족 질병경험, 인지된 구강건강상태(p<0.05)에서 유의한 차이를 보였고, 영양영역은 경제수준, 인지된 구강건강상태(p<0.01)에서 유의한 차이를 보였으며, 인지된 건강상태(p<0.05)에서 유의한 차이를 보였다. 대인관계 영역은 인지된 구강건강상태(p<0.05)에서 만이 유의한 차이를 보였으며, 스트레스 관리 영역은 학년, 인지된 구강건강상태(p<0.05)에서 유의한 차이를 보였다. 3. 인구사회학적 특성과 인지-지각요인과의 관계에서는 자기 효능감은 경제수준, 인지된 건강상태(p<0.05)에 따라 유의한 차이를 보였고, 인지된 구강건강상태(p<0.01)에 따라 유의한 차이를 보였다. 인지된 유익성은 종교(p<0.05)에 따라 유의한 차이를 보였다. 인지된 장애는 경제수준, 인지된 구강건강상태(p<0.05)에 따라 유의한 차이를 보였고, 본인의 질병경험(p<0.01)에 따라 유의한 차이를 보였다. 건강통제위는 학년(p<0.05)에 따라 유의한 차이를 보였으며, 자아존중감은 인지된 구강건강상태(p<0.01)에 따라 유의한 차이를 보였다. 4. 건강증진행위와 자기효능감(r=0.376), 인지된 유익성 (r=0.188), 인지된 장애(r=-0.155), 건강통제위(r=0.064), 자아존중감(r=0.318), 인지된 건강(r=0.084), 인지된 구강 건강(r=0.165)은 모두 통계적으로 의미있는 상관이 존재하였다. 5. 건강증진 행위에 영향을 미치는 변수를 조사한 결과 가장 영향력 있는 변수는 자기효능감이었고, 자아존중감, 인지된 유익성, 인지된 구강건강 순서였으며, 이 네 변수를 투입하여 건강증진 행위 18.5%를 설명할 수 있었다. Pender의 건강증진모형을 이용하여 건강증진행위에 영향을 미치는 요인을 찾아 보았으나 설명력이 18.5%로 낮아 좀 더 많은 요인을 찾아내는 연구가 필요할 것으로 사료된다.

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성주사 창건과 철불 조성 연구 (The Establishment of Seongjusa Temple and the Production of Iron Buddhas)

  • 강건우
    • 미술자료
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    • 제104권
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    • pp.10-39
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    • 2023
  • 충청남도 보령에 위치한 성주사(聖住寺)는 낭혜화상(朗慧和尙) 무염(無染, 800~888)이 창건한 사찰이다. 무염은 중국 유학을 마치고 귀국한 후 잠시 수도 경주에 머물다 김인문(金仁問, 629~694)의 후손들이 관리하던 사찰에 주석하였다. 이곳에서 무염은 불타고 남은 사찰을 중수하여, 847년에 선종사찰 성주사로 개창하였다. 이후 성주사는 사세가 번창하였고, 사역 내 여러 전각이 들어서며 대규모 가람의 모습을 갖추었다. 지역 내 성주사의 영향력은 「숭암산성주사사적(崇巖山聖住寺事蹟)」에서 살펴볼 수 있다. 「숭암산성주사사적」을 보면 성주사에 건립된 불전은 모두 73간으로 전한다. 이 중에서 주목되는 기록은 '전단림구간(栴檀林九間)'이다. 전단림구간은 '전단으로 지어진 건물이 9간' 혹은 '전단을 보관한 곳이 9간'이라는 의미가 될 수 있다. 해석의 차이는 있지만, 성주사에 전단이 많았음을 알 수 있다. 이 시기 전단은 유향목재(有香木材)로 동남아시아 자바나 수마트라에서 생산되었다. 장보고 사후, 서남해안일대를 장악한 군소 해상세력이 동남아시아 전단을 대량으로 입수하여 성주사에 시주한 것으로 보인다. 문성왕대 김양(金陽, 808~857)은 무열왕계인 자신의 입지를 강화하기 위해 지역 내 명망이 높았던 무염의 성주사를 후원하여 왕실과 성주산문을 잇는 가교 역할을 하였다. 원성왕계 왕실에서는 성주사를 지방 거점사찰로 삼아 반왕실적인 기운이 남아있는 지역에서 왕실의 권위를 회복하고자 하였다. 무염은 사찰을 수호하고, 민심을 교화하고, 나아가 지역의 안정을 도모하기 위해 철불을 조성한 것으로 추정된다. 성주사 문도가 2,000여 명에 달할 정도로 사세가 확장되었다는 점에서, 성주산문의 중심사찰인 성주사에 봉안된 철불은 지역의 민심을 결집하는 하나의 존상(尊像)으로 인식되었을 것이다. 성주사 철불은 모두 2구로 확인되며, 현재 전하는 철불편과 대좌의 크기로 볼 때 각각 금당과 삼천불전에 봉안된 것으로 보인다. 금당에 봉안된 철불1은 2m가 넘는 대형 철불이고, 삼천불전에 봉안된 철불2는 1m가 넘는 중형 철불로 판단된다. 「숭암산성주사사적」을 보면 '개창선법당오층중각(改創選法堂五層重閣)'이라는 기록이 전하는데, 이를 통해 성주사 개창시 철불1과 같은 대형 불상을 봉안하기 위해 중층식 금당이 건립되었음을 알 수 있다. 또한 철불1은 「성주사비(聖住寺碑)」와 손가락편의 모양을 통해 시무외여원인(施無畏與願印)을 결한 불상으로 추정된다. 성주산문은 동시기의 실상사(實相寺), 보림사(寶林寺), 삼화사(三和寺)와 같이 노사나불(盧舍那佛)을 주존불로 조성하였을 가능성이 높다. 무염이 초년에 화엄을 수학하였고 귀국 후 왕실의 후원을 받았다는 점에서, 신라하대 왕실을 중심으로 한 화엄종의 복고적인 경향이 선종사찰 성주사에도 반영된 것으로 생각된다.

병원 간호사의 선호근무시간대에 관한 연구 (A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours)

  • 이경식;정금희
    • 대한간호
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    • 제36권1호
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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재래시장 환경개선 지원정책 개발에서의 지역 장소적 기능 도입 (Introduction of region-based site functions into the traditional market environmental support funding policy development)

  • 정대용;이세호
    • 한국유통학회:학술대회논문집
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    • 한국유통학회 2005년도 춘계학술대회 발표논문집
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    • pp.383-405
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    • 2005
  • 재래시장은 지역의 중심지적인 특성과 문화적인 특성이 고스란히 반영된 지역 거점지이며 인근 지역주민의 상거래라는 1차적 장소적 기능과 사회문화적 측면의 상호 정보문화교류, 커뮤니티 공간 형성으로 유통의 집객시설과 집적시설로서 중요한 역할과 기능을 하고 있다. 5인 이하 가족 단위의 생계형으로 취급상품, 구입방범, 판매방식 등이 전근대적인 경영기법을 통해 한국의 대표적 소매업태로서의 역할을 해오고 있다. 1990년대 이후 신유통업태와 대형할인점 진출로 인해 재래시장은 급격한 경쟁력 상실과 소비자들의 생활수준의 향상, 구매패턴의 변화, 인터넷의 급속한 확산 등 외부적인 유통 환경변화에서 경쟁력을 상실하고 설 자리를 잃어가고 있다. 정부의 지역경제 활성화와 국민경제의 발전 측면에서 고령화된 재래시장에 대한 대책 중 정부의 예산지원 정책으로 환경개선사업, 연구용역, 경영현대화중심의 국고지원 사업은 2001년부터 2004년까지 총 3,853억원의 국고가 지원되었으나 활성화 사업의 실효성에는 아직 정확히 나타나고 있지 않은 상황으로 조사되었다. 또한 지원사업을 추진함에 있어 시장상인리더들의 전문성결여로 종합적인 추진전략과 중장기적 계획수립 및 자발적인 상인들의 합의점 유도 반감으로 지속적인 사업추진방향에 한계점을 나타냈다. 재래시장이 단순히 물건을 사고파는 물리적인 장소적 의미에서 벗어나 새로운 지역 장소적 생활공간으로 커뮤니티적 접근을 통한 장소적 창조전략이 필요하다. 이에 시대적 패러다임 변화에 따른 새로운 사업 방향 전환을 통해 재래시장의 장소적 기능 도입을 동해 문화적 경제적 의미를 지닌 공간으로 재조명을 동해 발전방향을 제시하고자 한다. 재래시장은 지역 기반으로 한 지역생활자들과 자연스럽게 커뮤니티를 상호 형성하고 정보와 지식 공유를 통해 부 창출 공간으로 재생되어야 할 것이다 재래시장이 부 창출 공간으로 재생하려면 시대적 장소적 환경에 맞는 시설과 교류활동을 통찬 상호신뢰구축 활동 속에서 고객이 원하는 방향으로 영업환경도 변화하여야 하며, 지역단위 중심 영국의 TCM, 미국의 BID, 일본의 TMO 등 해외 벤치마킹을 통한 단위 시장상가 점포단위의 점(點)정책에서 선(線)단위의 상가로 환경사업과 거시적인 지역단위중심인 면(面) 정책적 접근을 통한 커뮤니티적인 발상 전환이 필요하다. 국내외 사례비교 분석을 통해 사회적 정책수요 발굴과 기존의 추진방법에 대한 선진사례 연구를 통한 NPO, NGO 등의 시민기업가와 이를 수행키 위한 혁신성과 전문성조정능력을 갖춘 리더자 양성이 무엇보다 중요하다. 특히 지역자원 활용 소스 중심의 문화관린 산업의 seeds 발굴과 향토상품의 상품화와 네트워크 조직망 구축을 위한 지역중심의 복합 생활문화 공간이 필요할 것이며, 이를 촉진키 위한 mentor academy시스템 접근을 통해 점점 고령화되어 가고 있는 재래시장에 대해 차별적 특성이 반영된 종합적이고 체계적 접근 방법연구가 필요하다.

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제 1, 2회 학생 과학 공동탐구 토론대회의 종합적 평가 (Summative Evaluation of 1993, 1994 Discussion Contest of Scientific Investigation)

  • 김은숙;윤혜경
    • 한국과학교육학회지
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    • 제16권4호
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    • pp.376-388
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    • 1996
  • The first and the second "Discussion Contest of Scientific Investigation" was evaluated in this study. This contest was a part of 'Korean Youth Science Festival' held in 1993 and 1994. The evaluation was based on the data collected from the middle school students of final teams, their teachers, a large number of middle school students and college students who were audience of the final competition. Questionnaires, interviews, reports of final teams, and video tape of final competition were used to collect data. The study focussed on three research questions. The first was about the preparation and the research process of students of final teams. The second was about the format and the proceeding of the Contest. The third was whether participating the Contest was useful experience for the students and the teachers of the final teams. The first area, the preparation and the research process of students, were investigated in three aspects. One was the level of cooperation, participation, support and the role of teachers. The second was the information search and experiment, and the third was the report writing. The students of the final teams from both years, had positive opinion about the cooperation, students' active involvement, and support from family and school. Students considered their teachers to be a guide or a counsellor, showing their level of active participation. On the other hand, the interview of 1993 participants showed that there were times that teachers took strong leading role. Therefore one can conclude that students took active roles most of the time while the room for improvement still exists. To search the information they need during the period of the preparation, student visited various places such as libraries, bookstores, universities, and research institutes. Their search was not limited to reading the books, although the books were primary source of information. Students also learned how to organize the information they found and considered leaning of organizing skill useful and fun. Variety of experiments was an important part of preparation and students had positive opinion about it. Understanding related theory was considered most difficult and important, while designing and building proper equipments was considered difficult but not important. This reflects the students' school experience where the equipments were all set in advance and students were asked to confirm the theories presented in the previous class hours. About the reports recording the research process, students recognize the importance and the necessity of the report but had difficulty in writing it. Their reports showed tendency to list everything they did without clear connection to the problem to be solved. Most of the reports did not record the references and some of them confused report writing with story telling. Therefore most of them need training in writing the reports. It is also desirable to describe the process of student learning when theory or mathematics that are beyond the level of middle school curriculum were used because it is part of their investigation. The second area of evaluation was about the format and the proceeding of the Contest, the problems given to students, and the process of student discussion. The format of the Contests, which consisted of four parts, presentation, refutation, debate and review, received good evaluation from students because it made students think more and gave more difficult time but was meaningful and helped to remember longer time according to students. On the other hand, students said the time given to each part of the contest was too short. The problems given to students were short and open ended to stimulate students' imagination and to offer various possible routes to the solution. This type of problem was very unfamiliar and gave a lot of difficulty to students. Student had positive opinion about the research process they experienced but did not recognize the fact that such a process was possible because of the oneness of the task. The level of the problems was rated as too difficult by teachers and college students but as appropriate by the middle school students in audience and participating students. This suggests that it is possible for student to convert the problems to be challengeable and intellectually satisfactory appropriate for their level of understanding even when the problems were difficult for middle school students. During the process of student discussion, a few problems were observed. Some problems were related to the technics of the discussion, such as inappropriate behavior for the role he/she was taking, mismatching answers to the questions. Some problems were related to thinking. For example, students thinking was off balanced toward deductive reasoning, and reasoning based on experimental data was weak. The last area of evaluation was the effect of the Contest. It was measured through the change of the attitude toward science and science classes, and willingness to attend the next Contest. According to the result of the questionnaire, no meaningful change in attitude was observed. However, through the interview several students were observed to have significant positive change in attitude while no student with negative change was observed. Most of the students participated in Contest said they would participate again or recommend their friend to participate. Most of the teachers agreed that the Contest should continue and they would recommend their colleagues or students to participate. As described above, the "Discussion Contest of Scientific Investigation", which was developed and tried as a new science contest, had positive response from participating students and teachers, and the audience. Two among the list of results especially demonstrated that the goal of the Contest, "active and cooperative science learning experience", was reached. One is the fact that students recognized the experience of cooperation, discussion, information search, variety of experiments to be fun and valuable. The other is the fact that the students recognized the format of the contest consisting of presentation, refutation, discussion and review, required more thinking and was challenging, but was more meaningful. Despite a few problems such as, unfamiliarity with the technics of discussion, weakness in inductive and/or experiment based reasoning, and difficulty in report writing, The Contest demonstrated the possibility of new science learning environment and science contest by offering the chance to challenge open tasks by utilizing student science knowledge and ability to inquire and to discuss rationally and critically with other students.

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누항도(陋巷圖)와 누항록(陋巷錄)을 통해 본 이만부의 공간철학과 식산정사의 원형경관 (A Study on Lee, Man-Bu's Thought of Space and Siksanjeongsa with Special Reference of Prototype Landscape Analyzing Nuhangdo(陋巷圖) and Nuhangnok(陋巷錄))

  • 강병선;이승연;신상섭;노재현
    • 한국전통조경학회지
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    • 제39권2호
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    • pp.15-28
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    • 2021
  • 경상북도 민속문화재 제76호로 지정된 '천운정사(天雲精舍)'는 식산 이만부가 1700년에 건립한 식산정사이다. 본 연구에서는 식산정사와 관련한 이만부의 생애와 은일관을 알아보고, 그의 정사경영의 결과물인 「누항록」과 《누항도》를 분석해 정사의 풍수적 입지와 영역성 및 원형경관을 추정하고, 은거한 선비가 자신의 공간에 담고자 했던 철학을 고찰하여 다음의 결과를 도출하였다. 첫째, 식산 이만부는 조선 후기 대표적 은둔형 유학자이다. 정사의 이름이자 이만부의 호인 '식산'은 마을의 뒷산(主山)에서 연유한 것으로 그는 생각(思), 몸(躬), 말(言), 사귐(交) 네 가지를 쉬고자 했다. 다난했던 숙종년간 남인 집안의 이만부는 '식산'이라는 호를 통해 은둔하고자 하는 그의 의지를 표상하였다. 둘째, 이만부는 식산정사의 입지, 공간구조, 건축물 및 조경시설물, 수목, 주변경관, 이용행태 등을 「누항록」에 기록하였고, 《누항도》화첩을 남겨 원형에 가까운 식산정사 복원 가능성이 비교적 높다. 셋째, 이만부는 외노곡이 밖에서 보면 사면이 두로 막혀있으나 안으로 들어서면 아늑하고 깊숙하며 멀리까지 내다보인다는 풍수적 지리관을 언급하고 있으며, 노곡마을 전체를 일컬어 식산정사라 했는데 이는 명명을 통해 의미를 부여하고 영역을 형성·확장하였음을 알 수 있다. 넷째, 식산정사의 공간구성은 연식공간, 교육공간, 후원공간, 휴식공간, 채원 및 약초밭으로 구분할 수 있다. 당과 루, 연지로 구성된 연식공간은 개인적 공간으로 호연지기, 천인합일의 흥취, 군자의 도리, 인을 생각하는 이만부의 거처이자 강학을 베풀던 공간이다. 다섯째, 양정재 영역은 교육공간으로서 양정재는 주역 몽괘에서 취한 이름으로 어린 학생들의 학문과 덕이 크고 밝게 성장하기를 기원한 이름이다. 여섯째, 간지정, 고반대, 세한단 등으로 구성된 후원공간은 식산정사 가장 안쪽의 숲이 우거진 곳을 정리하고 자연 입석과 고송을 병풍삼아 작은 정자를 지을 축대를 쌓은 곳으로, 멈춤의 미덕과 은자의 여유, 군자의 지조 등에 관한 뜻을 담고 있다. 일곱째, 식산정사 담장 밖 동쪽 시내 건너 고목이 우거진 곳에 단을 조성하여 영귀사라 하고 괴석을 쌓고 화초를 심어 휴식의 장소로 삼았다. 여덟째, 조선시대 선비들처럼 채소와 약초의 효능을 상세히 알고 있던 이만부는 정사 내에 채원과 약초밭을 가꾸었다. 아홉째, 식산 이만부는 식산정사의 각 공간별 건축물과 조경시설물에 대한 명명을 통한 의미 부여와 고사(古事)를 따른 식재를 통해 자신의 정사에 성리학적 이상향을 실현했음을 알 수 있다.

대퇴경부 골절 환자의 입원 생활 (The Hospital Life of the Patient with Femoral Neck Fracture)

  • 김경자;지성애
    • 간호행정학회지
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    • 제2권1호
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • 대한간호학회지
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    • 제11권2호
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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조산수습과정 지도자 강습회를 통한 조산교육 평가조사연구 (The Evaluation of Midwifery Program Through the Midwifery Leadership Training Program)

  • 이경혜
    • 대한간호학회지
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    • 제11권2호
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    • pp.23-32
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    • 1981
  • The purpose of the study was to evaluate the educational content which had been given by midwifery training program. It was hoped that this result would help. It was sponsored by com-munity health worker plan effective health education. College of Nursing Ewha Womans University and The Korean Nurses Academic Society during the November 19 thru 24, 1979. It was carried out on July through on September 1980, and involved 22 community health workers. The results were as follows: 1. Most of the community health workers came from Seoul & Pusan areas and have been working at the hospitals. There were 31.82% of Head Nurses, 27.2% of Staff Nurses, 22.73% Nurse Supervisons, 13.6% of Nurse Directors and 4.5% of educational coordinator for Nurses. These participant had nurse-midwifery lincences by 63.64%. None of there had just midwifery lincences. 2, Age structures of the study population shows 31.82% of whom are.26-30 years and 22.73% of whom are 36. 40 years of age. This shown that seniority proportion is higher than the younger. There are 31.82% of 1-5 years, 27.27% of 6-10 year and 11-15 years, respectively by work career. 3. There are 54.55% of the institutions have opened their own midwifery training course for their nursing staff members. Because of lack of the facilities, shortage of instructors, and problems of administrative process. 4. According to the institution which opened for midwifery training courses, the participant was responsible for “midwifery”“Infant care”“MCH”“practice of midwifery”“Nursing adjustment”and“F. P.”5. During the midwifery couse, there were 8 institution who used the textbook and 4 institution who did not. Least of there referned to content matinals which was given by the sponsored. 6. There are 7 insititues who kept their training courses with other professional helps such as physicians., professiors and nurses. Some problems are pointed out by respondents such as“conflict with residents”“poor suportive administration”and“lake of manpower”. 8. The participant showed that they learned new knowledge as trends during this programs for there quality work so it need (one or twice times) a year. But they suggested that it needed more emphasis on the“maternal health care”and“role of the nurse-midwifery”. 9. The analysis of the results are as follows within the 6 areas which are given by the sponsored: There are highest ranks between“basic theory & family planning”“role of midwifery & nursing practice”. In the prenatal care the highest rank ware related to“health risk”on“idenify of risk symtoms”. In the health care areas which related to delivery, the responsers were related to“general conditions”or“high risk criteria”. In the health care area which related to high risk maternity care. In the neonatal health care, the highest rank was related to”health assessment of normal infant”. In the infant health care the responses was related to“abnormal symptoms”and“risk symptoms”. Actually, the participants show that they are more interested in“role of midwifery”“health assessment”and “high risk maternity care”are which emphasised on health promotion, health maintenance & disease preventive. 1) The midwifery training program need higher education for midwifery on a regular basis. 2) Within the open institution of midwifery training program, the nurses must be supported by their own institution and administry of social welfare must give systematic support. Also non-open institution must be open very soon. 3) All health workers including the residents & other workers, must cooperate for their phased common good of impovement of the maternity health. 4) Administration agonies & education institutions must provide the curriculum facilitis and administration systems which are needed for training of nurse-midwifery.

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