• 자원환경지질
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• 제43권2호
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• pp.163-176
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• 2010

2001년부터 제주도 전역의 중산간 이하 저지대에서 시행된 69개 시추공으로 부터 획득된 시추 코어 용암류와 66곳의 노두에서 분석된 전암 암석화학 및 전암 $^{40}Ar/^{39}Ar$ 절대연대 자료(539개)를 검토하여, 그 중 제주도 형성 초기 용암 분출 산물로 확인되는 20개의 자료를 보고한다. 시추공 중 남부와 남서부의 법호천공(고도 235 m, 섬도 210 m), 돈내코공(고도 240 m, 심도 230 m), 동홍S공(고도 263 m, 심도 270 m), 05동흥공(고도 187.6 m, 심도 340 m), 도순공(고도 305 m, 심도 287 m), 상예공(고도 230 m, 심도 260 m), 무릉1호공(고도 10.2 m, 심도 160 m), 가파공(고도 17.5m, 심도 92m)에서만 확인되었고, 노두 중에서는 이미 알려져 있는 산방산, 월라봉, 원만사, 각수바위 지역에서 재확인하였다. 이들의 $^{40}Ar/^{39}Ar$ 절대연대 자료는 1 Ma-0.7 Ma를 나타내어, 제주도 형성 초기 용암 분출시기 및 그 지화학적 특정을 규제할 수 있다. 특히 05동홍공의 심도 143~137 m와 135~123 m 구간에서 조면현무암 성분인 용암으로 부터 각각 $992\pm21$ Ka와 $988\pm38$ Ka인 가장 오래된 연대를 보고한다. 이 연구는 제주도 형성 초기의 용암분출이 약 1 Ma 경 조면현무암질 용암 분출로 시작하여, 이후에 약 0.9-0.7 Ma 기간 동안 주로 조면암-조변안산암-현무암질 조면안산암 성분을 지닌 용암류의 용암 돔 형성 그리고 간헐적인 알칼리현무암 및 조면현무암질 용암의 분출로 진행하였음을 제시한다. 산방산, 각수바위 등 현재 지표에 노출되어 돔상 지형을 이루는 일부 지역을 제외하면, 초기 용암류는 지표 하에서 서귀포층에 협재하거나 피복하고 있음을 나타낸다. 이는 제주도 형성 초기 용암 분출이 간헐적이며 국지적이었고, 주변에서 수성화산활동 및 퇴적작용이 동시에 진행되었음을 지시한다.

• 대한방사선기술학회지:방사선기술과학
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• 제19권1호
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• pp.95-120
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• 1996

College level educational training system for the allied health manpower in the country is one of the oldest junior college education programs, and has been developed at very steady phase. Since the school years of the programs limited for 2 to 3 years by the education related law, qualification of the manpower is insufficient to meet the rapidly changing needs in the field of allied health and medicine. The system is comparable with that of developed countries where 4-year baccalaureate degree programs are basically required to be an allied health personnel. Thus, education and training background of allied health program graduates of the country confronts the barriers in competition and cooperation with the graduates of foreign countries at equal basis. Beside, junior college graduates can hardly find the way through advanced courses at 4-year colleges in their specialties except a few programs such as environmental sicience or courses in hygiene. It has long been sought to develop the education and training programs for junior college graduates. Some of them are already materilized and some show remarkable progress while some need to tackle. Wide opening of the opportunity to enroll extensive education program for the junior college graduates of allied health science majors in 4-year colleges with eventual grant of bachelor's degree for those who successfully completed the programs should soon be substantiated. The study was focused to emphasize the necessity of the extensive education and training for the junior college graduate allied health manpower, and to show possibility of the education program development in connection with the 4-year degree granting education programs. The outcome of the study can be summarized as followings. 1. A total number of graduates from eight allied health sciences related programs of junior colleges by the year of 1995 are 109,320. 2. According to the survey report analysed through questionnaires, 99.7% of respondents including administrative deans and professors of junior colleges agreed with the establishment of extensive education and training programs in junior colleges. 53.9% of administrative deans, 52.9% of professors and 47.6% of the graduates expected that it is possible to learn more about their majors, and to earn bachelor's degree through the extensive education programs. Other opinions include that the programs can provide supplementary opportunities to fortify in the area of basic life science, and development of research and technology. 3. It was also found through the survey that 91.2% of the deans, 87.8% of the professors and 68.2% of the graduates responded that the most appropriate organizations to open the extensive education and training programs for allied health manpower are junior colleges where allied health personnel are taught and trained. The majority of the respondents agreed that the acceptable number of credits offered for the previous 2-year junior college graduates are $50\sim60$, and those for the current 3-year graduates are $20\sim30$ units. 4. It was strongly suggested through the survey that baccalaureate degree should be granted for those who successfully completed the extensive courses. The suggestion was claimed by 94.1% of the deans, 89.4% of the professors and 83.4% of the graduates. 5. The model curricula for the extensive education and training programs for the allied health manpower are designed for the purpose of broad capability in practice, enrichment of knowledge and promotion of proficiency for the self access in the major areas. 6. To meet the universal standards of allied health education and training program, it is recommended that opening of the curricula for the extensive, and as well as intensive, courses within junior colleges(continuation education institute) should be materialized. The special baccalaureate degree programs within junior colleges are also recommended to accommodate the junior college graduates and to grant the degree fellowing successful completion of the courses. As a part of the education revolution in progress, the school years at junior college level should be flexible depending upon the nature of course and trend of the universe. For instance, the school years for the allied health manpower should be extended to two to four years from current two to three years.

• The Korean Journal of Pain
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• 제1권1호
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• pp.106-119
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• 1988

For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

• Radiation Oncology Journal
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• 제23권1호
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• pp.32-42
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• 2005

목적 : 본 연구의 목적은 유방암 치료 후 상지의 림프부종, 어깨관절 운동범위 감소, 주관적 증상과 이에 영향을 미치는 변수를 파악하기 위함이다. 대상 및 방법 : 본 대학 병원에서 유방암 진단을 받고 수술 또는 수술 후 방사선치료 및 항암치료를 받은 환자 159 명을 대상으로 림프부종 정도와 어깨관절 운동범위를 측정하였고, 질문지를 이용하여 주관적 증상을 측정하였다. 대상 환자의 $47.2\%$인 75명이 40대였으며 89의 환자가 병기 I 또는 II 이었다. 결과 : 림프부종(건측과 환측의 차이가 2 cm 이상)은 52명($32.7\%$)의 환자에서 발생하였다. 이 중 상지 하부 림프부종은 3명, 상지 상부 림프부종은 34명에서 발생하였으며 상지 상부와 하부 모두 림프부종이 발생한 경우는 15명이었다. 각 부위별 발생 빈도는 손목으로부터 10 cm 지점에서 $6.3\%$, 20 cm 지점에서 $10.7\%$, 30 cm 지점에서 $22.6\%$, 40 cm 지점에서 $23.3\%$이었다. 어깨관절 운동범위 감소(건측과 환측의 차이가 $20^{\circ}$ 이상)의 빈도는 굴곡에서 $37.2\%$, 외전에서 $37.7\%$, 내회전에서 $48.4\%$, 외회전에서 $24.5\%$이었다. 이 중 내회전의 경우 정상운동범위의 $50\%$ 이상 감소되는 경우도 흔하였다. 주관적 증상으로 통증 호소가 $63.5\%$, 팔을 움직이기 힘들다고 하는 경우가 $48.4\%$, 팔저림 호소가 $59.8\%$, 뻣뻣함(stiffness) 호소가 $69.2\%$이었다. 특히 림프부종이 없는 108명의 환자 중 65명($61.1\%$)이 통증을 호소하였다. 림프부종의 발생과 유의한 관계가 있는 요인으로는 연령, 체질량지수(BMI), 치료방법 및 수술 후 경과 기간이 있었고, 어깨관절 운동범위 감소의 경우 치료방법과 수술 후 경과기간이었다. 주관적 증상의 경우는 치료방법과 수술 후 경과기간 그리고 항암화학요법 종류가 유의한 관계가 있는 요인이었다. 다변량분석 결과 체질량지수(BMI)와 수술 후 경과기간이 림프부종에 영향을 미치는 유의한 변수인 것으로 나타났다. 결론 : 림프부종은 수술 후 기간이 경과되어도 계속 진행되며 특히 체질량지수가 유의한 요인으로 확인되어 지속적인 체중관리를 포함한 예방대책이 필요하다. 그리고 어깨관절 운동범위의 감소도 환자의 약 1/3에서 발생하였으며 특히 굴곡, 외전, 내회전 운동범위의 감소가 빈번하였고 내회전의 경우 그 정도가 심하였으며 이를 근거로 한 치료 후 재활관리 프로그램이 환자에게 도움을 줄 것으로 기대한다.

• 수산경영론집
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• 제16권1호
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• pp.91-124
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• 1985

Mariculture is contrasted with inland aqua-culturing fisheries. It is defind as the Industry of rearing Aquaorganism in limited coastal area relatively shallow in depth. Then, It's coming into being realization of Mariculture in it is long in history that Mariculture was realized in Korea. But it is from the early part of 1960s, that this industry has normally developed. Owing to 200 miles economy-zone problems of coastal countries, the development of deep sea fishing was limited, so the Korean Government has now appreciated the importance of cultured industries in the field of coastal fisheries. And the Korean Mariculture the output of which was only 18, 000 M/T in '60s attained 540, 000M/T in 1980s, has now occupied its relative importance in Korean Fisheries Industry. So the purpose of this report is to suggest the prospect of technical development of mariculture in the future of Korea, through the analysis of the various problems that affect upon the individual management '||'&'||' fishing ground utilization, along with the appreciation of "how to extend of those technical innovation" and "how the fishermen's technique level is extended at this stage. According to this study, the result is summarized as follows. First, Maricultural technique is classified into 8 sub-techniques as follows, as shown in fig. 1.Fig. 1. The Formation structure of mariculture technique Second, the change of technical method of mariculture in coastal area of Korea has made as 5 stages; 1) Scattering of culturing organism 2) Culturing by putting stone and installing bamboo 3) Culturing by installing rope and seeding 4) Culturing of putting objectives in cages 5) Culturing fish by feed Third, the maricultural fisheries of Korea has about 70 years long in history. It began from 1910s. But at that time there was no special technique in aquaculture and its technique was confined in searching out the object of species. The species was laver, oyster ect.Forth, although realization of mariculture in Korea has been long time, it is of late from 1960s that this has been industrial with normal development, and its technique of mariculture has mainly has developed from 1970s. Its result not only contributed to the high growth in Korean ecconomy along with the well balanced development between industires, but also it played a great role for the resolution of nation's food problem. Especially maricultural production has shown its sustained annual increase of 13.8% during the last 20 years. So the portion of mariculture among total fisheries stucture was extended from 4.1% in the early 1960s to 22.4% in 1980s.Fifth, it could be safely said that such development in maricultural field is resulted from the activity of aquacultural institutes such as Fisheries Reseach '||'&'||' Development production of major kinds such as Oyster, Sea-mustard, and Laver etc. As well as in the innovation of aquaculturing method with synthetic fiber utilization. FRDA has played important role in the efficient propargation of new aquacultural technique.Sixth, as for the change in aquaculture structure and its during period between 1970s and 1980s, the private management participation shown 25% increase from household number of 45, 173 to 56, 268 in total number. And in the respect of the management scale, of their management decreased, while it showed an increase in relative large scale management, the increase over 3 employees compared with other fisheries field between '70s and 80s. This must be an major trait to be recorded, Now the data above mentioned are shown as in table 1 and 2.Table 1. The maricultural fishing ground development situation in 982.Table 2. The mariculture management as seen in the employmnet size in high seasion.Owing to the technical innovation, of the mariculture in coastal area new income of fishermen increased and it also is true that the number of fishermen participating in its industrialization increased. But the problem being from now on is the self-discharge of the destruction fishing ground considered resulted from rapid expansion in aquaculture industry and the preventive system of sentility of fishing ground. sentility of fishing ground.

• 대한간호학회지
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• 제29권1호
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• pp.161-173
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• 1999

The purpose of this study was to develope and test the structural model for quality of life in women having hysterectomies. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around eight constructs. Exogenous variables included in this model were marital intimacy, importance of uterus, professional support, positive coping behavior and pre-operative symptoms. Endogenous variables were spouse's support, sense of loss and quality of life. Empirical data for testing the hypothetical model was collected using a self-report questionnare from 203 women having hysterectomies at the outpatient clinics of four general hospitals and a mail survey in Pusan City. The Data was collected from December, 1997 to January, 1998. Reliability of the eight instruments was tested with Cronbach's alpha which ranged from 0.639-0.915. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows : 1. Hypothetical model showed a good fit with the empirical data. ［$\chi$$^2$＝6.93(df＝5, P＝.23), GFI＝.99, AGFI＝.94, RMSR＝.019, NNFI＝.97, NFI＝.98, CN＝440, standardized residuals(-2.14-2.10)］ 2. For the parsimony of model, a modified model was constructed by deleting 3 paths and adding 1 path according to the criteria of statistical significance and meaning. 3. The modified model also showed a good fit with the data. ［$\chi$$^2$＝5.26(df＝7, P＝.63), GFI＝.99, AGFI＝.97, RMSR＝.014, NNFI＝1.02, NFI＝.99, CN＝710, standardized residuals(-1.46-1.70)］ Results of the testing of the hypothesis were as follows : 1. Marital intimacy(${\gamma}$11＝.78, t＝14.37) and professional support(${\gamma}$13＝.12, t＝2.12) had a significant direct effect on the spouse's support. 2. Pre-operative symptoms(${\gamma}$25＝.32, t＝3.12), importance of uterus(${\gamma}$22＝.20, t＝2.61) and spouse's support($\beta$2l＝-.19, t＝-2.43) had a significant direct effect on the sense of loss. 3. Sense of loss($\beta$32＝-.66, t＝-9.83) had a direct effect on the quality of life. Marital intimacy had a direct(${\gamma}$31＝.19, t＝3.33), indirect(${\gamma}$31＝.14, t＝2.52) and total effect(${\gamma}$31＝.25, t＝4.41) on the quality of life. Professional support had a direct effect(${\gamma}$33＝.11, t＝2.07) and total effect(${\gamma}$33＝.13, t＝2.31) on the quality of life. The direct effect of pre-operative symptoms(${\gamma}$35＝-.36, t＝4.02) and positive coping behavior(${\gamma}$34＝.15, t＝2.06) had the insignificant effect on the quality of life while, due to the idirect effect these variables had overall significant effect on the quality of life. The results of this study showed that the sense of loss had the most significant direct effect on the quality of life. Marital intimacy, pre -operative symptoms and spouse's support had a significant direct effect on this sense of loss. These four variables, the sense of loss, marital intimacy, pre-operative symptoms and spouse's support, were identified as relatively important variables. The results of this study suggested that there is needed to determine if nursing intervention would alleviate this sense of loss and promote a greater quality of life in women who have had hysterectomies.

• 수면정신생리
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• 제6권1호
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• pp.68-75
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• 1999

목 적 : 본 연구는 야간 광 노출시 야간교대근무자의 수면양상과 기분상태가 어떠한 변화를 보이는지와 광 노출의 부작용의 정도와 빈도를 알아보고자 하였다. 이런 과정을 통해 광 노출이 야간교대근무적응에 사용될 수 있는지를 밝히고자 하였다. 방 법 : 용인정신병원에 근무하는 야간교대근무 간호사 12명이 본 연구에 참여하였다. 본 연구는 야간근무 대조연구, 야간근무 광노출연구, 주간근무 대조연구의 3부분으로 구성 되었으며 1명의 간호사가 주간근무 대조연구에 참여하지 않은 것을 제외하고는 모든 간호사가 세 연구에 모두 참여하였다. 야간근무 광노출연구시 새벽 1시부터 새벽 5시까지 4시간동안 빛에 노출되었다. 수면양상은 활동기록기와 자동수면 분석프로그램을 통해, 기분상태와 광노출의 부작용은 자기보고척도에 의해 평가하였다. 결 과 : 수면기간시간, 총수면시간, 수면효율은 야간근무 대조연구에 비해 야간근무 광노출연구시 증가되었으며 야간근무 광노출연구는 주간근무 대조연구와 차이를 보이지 않았다. 야간근무 광노출연구시 수면효율의 일간변동도 야간근무 대조연구에 비해 현저하지 않고 안정된 양상을 보였다. 야간근무 광노출연구시 간호사들은 주간수면을 취한 후 저녁시간에 야간근무 대조연구에 비해 좀 더 기분이 고양되고 활기가 넘친다고 보고하였다. 광 노출이 진행되면서 광노출 부작용에 대한 내성이 생겨 부작용의 빈도나 정도가 감소하였으며 광노출 3일째 심한 정도의 부작용을 호소한 사람은 한명도 없었다. 결 론 : 광 노출시 주간수면은 주간근무시의 야간수면만큼 호전되는 것으로 관찰되었고 이러한 수면호전으로 인해 야간교대근무자들은 기분이 고양되고 좀 더 활기가 넘친다고 보고하였다. 광 노출의 부작용도 시간이 지남에 따라 감소하므로 야간교대근무 적응을 위해 광 노출법을 권장할 수 있을 것이다.

• 수면정신생리
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• 제14권1호
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• pp.33-41
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• 2007

목 적：기존의 정신분석 이론과 달리 꿈의 내용은 남녀의 신경 발달적 차이, 나이에 따른 변화, 환경의 변화 등에 따라 변화되는 것으로 알려져 있다. 이를 알아보기 위해 "가장 최근 꿈 보고서"를 수거, Hall/Van de Castle System을 사용하여 꿈 내용 분석을 실시하였다. 방 법：만 $12{\sim}14$세에 해당하는 중학생 $1{\sim}3$학년 2,673명(남자 1,544명, 여자 1,129명)의 가장 최근 꿈을 수집하였고, 이의 내용은 Hall/Van de Castle System을 사용하여서 분석되었고, SAS와 Dream SAT를 사용하여 통계처리하였다. 결 과：남학생과 여학생 간에는 남성/여성 비율(남학생/여학생；56%/35%), 친숙도 비율(57%/69%), 공격/우호비율(79%/65%), 적극적 우호성 비율(50%/33%), 물리적 공격 비율(90%/70%), 실내 장면 비율(40%/55%), 부정적 정서 비율(56%/68%), 몸통/해부 비율(51%/36%) 등에서 두드러진 차이를 나타내었다. 남성에서는 1학년과 2학년 간에 남성/여성 비율(65%/44%)에서 두드러진 차이를 보인 것을 비롯하여, 우호성, 물리적 공격 비율, 부정적 자기 비율 등에서 의미 있는 차이를 보여주었고, 여성에서도 1학년과 2학년 간에 우호성, 친숙도, 친구비율 등에서 의미 있는 차이를 보여주었으나, 남녀 모두 2학년과 3학년 간에는 거의 유사한 꿈 내용을 나타냈다. 또한, 남성의 경우 남성 등장인물에 대한 공격 지수가 2학년이 되면서 두드러지게 증가하였으며(1학년/2학년/3학년；0.48/1.04/0.98), 여성의 경우 남성 등장인물에 대한 우호지수가 2학년이 되면서 두드러지게 감소하였다(1학년/2학년/3학년；0.38/0.19/0.20). 결 론：$12{\sim}14$세에서 남녀 차는 뚜렷하여 거의 모든 항목에서 차이를 보였다. 남성은 주로 대인관계의 공격성과 통합성에 관련된 항목에서, 여성은 주로 환경이나 등장인물 비율에서 차이를 나타내었다. 이는 남성이 초기 청소년기에 여성에 비해 발달이 늦으며, 상대적으로 더 감정적인 대인 관계를 하는 것과 관련된 것으로 보이며, 여성은 주변의 실제 환경과 덜 활동적인 대인관계가 꿈에 반영되는 것으로 생각되었다. 같은 성별 내에서는 연령 간에 큰 차이를 보이지는 않았으나, $12{\sim}13$세 간에 주로 이성간의 상호작용에 대한 항목에서 의미 있는 차이를 보여주었다. 이는 성별과 관련된 차이 및 주변 환경, 대인 관계의 변화가 꿈 내용에 영향을 주고 있음을 의미한다. 추후 다른 나이 혹은 국가간의 꿈 분석 비교와 신경 인지적 연구를 통하여 꿈의 발달 과정이 파악될 것으로 생각된다.

• 농촌의학ㆍ지역보건
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• 제30권1호
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• pp.63-74
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• 2005

본 연구는 농촌지역 고령자의 신체기능유지에 대한 구체적인 지침이 될 자료를 제공하기 위해 농촌지역 거주자를 대상으로 사지부자유의 실태를 조사하고 연령증가에 따른 변화 및 그 이유에 대해 검토하였으며, 사지부자유에 따른 우울 정도를 조사하였다. 조사는 2004년 3월부터 5월까지의 기간에 충남 금산군과 청양군 농촌지역에 거주하고 있는 40세 이상 주민 432명을 대상으로 자기기입식 방법으로 설문조사 하였으며, 주요 결과는 다음과 같다. 1. 사지부자유를 갖고 있는 자의 비율은 남자보다 여자에서 높았으며, 연령이 증가할수록 사지부자유 기능도는 저하되었다. 2. 부자유의 비율은 상지에 비해 하지의 부자유 비율이 더 높았으며, 사지부자유에 대한 이유로는 관절질환이 주된 요인이었다. 4. 전체 조사대상자의 우울정도는 정상 41.2%, 경도우울 47.5%, 중등도 우울 6.3%, 중증우울 5.1%로 나타났으며, 성별 및 연령별로는 유의한 차이가 없었다. 5. 상 하지 모두 부자유 기능정도가 나빠질수록 우울정도가 심해지는 분포를 보였으나 통계적인 유의한 차이는 없었다. 6. 사지부자유 여부에 대한 위험비는 "남자"에 비해 "여자"에서 2.6배 상승하였고, 연령별로는 "40대"에 비해 "50대"에서 3.5배, "60대"에서 4.3배, "70대"에서 4.9배 상승하였으며 연령이 높아질수록 위험비가 상승한 것으로 나타났다. 7. 우울 여부에 대한 위험비는 성별, 연령별 및 사지부자유 정도 모두에서 유의한 차이가 인정되지 않았다. 위와 같은 결과를 종합하여 보면 사지부자유 정도는 남자보다 여자에서 높았고, 연령이 증가할수록 높아지는 경향이었으며, 상지보다는 하지에서 높은 비율을 보이고 있음을 알 수 있다. 또한 사지부자유의 원인으로는 관절 질환이 주요 원인임을 지적할 수 있으며 사지부자유 기능정도가 심할수록 우울정도가 심해지는 경향을 보였고 사지부자유에 대한 위험비는 남자보다 여자에서, 연령이 높아질수록 위험비가 상승한 것으로 나타났다. 이 같은 사지부자유의 실태를 파악하고 사지부자유에 따른 우울정도를 알아보는 것은 고령자의 신체 기능유지 및 보건의료서비스에 대한 구체적인 지침의 기초자료가 될 것으로 생각된다.

• 근관절건강학회지
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• 제2권1호
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• pp.17-40
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• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.