연구자는 현대 한국 사회에 큰 충격을 던져주었던 N번방 사건을 계기로 한국 청소년성교육을 둘러싼 각종 논쟁들과 시각의 차이를 살펴보았다. 한국 청소년 성교육은 학교 성교육과 및 청소년성문화센터를 통해 이루어지는 공적 성교육과 보수적·전통적 개신교 성교육으로 나누어질 수 있다. 공적 성교육은 여성주의 성윤리 및 해외의 포괄적 성교육의 영향을 일부 받아 성인지 감수성 및 성적 자기 결정권을 기본으로 성희롱, 성매매, 성폭력, 가정폭력 예방의 4가지 예방을 주요 사업으로 실시 중이다. 단, 학교 성교육표준안은 성역할 고정관념 및 성차별적 내용, 성폭력에 대한 왜곡된 통념 강화 및 성적 다양성과 다양한 가족 형태의 배제 등으로 비판받았으며, 청소년성문화센터 교육의 일부 내용 역시 마찬가지의 비판을 받고 있다. 보수적·전통적 개신교는 양성에 의한 결혼 등의 정상 가족 이데올로기와 혼전순결주의, 결혼 관계 안에서만 인정되는 성관계 윤리 등을 기본으로 하여 청소년들에게 피임법을 성에 대한 생물학적이고 의학적 지식을 가르치는 것-피임법 등-에 대해 강하게 반대하면서 공적 성교육과 대치하는 형태를 이루고 있다. 연구자는 한국 청소년 성교육을 위한 커리큘럼을 구성하면서 먼저 공적 성교육, 보수적·전통적 개신교 성윤리와 성교육, 여성주의 성윤리와 성교육, 해외 청소년성교육의 특징을 각각 분석하였다. 그리고 청소년 성교육의 보다 근본적인 해결책으로 금욕주의나 혼전순결주의, 성인지 감수성과 성적 자기결정권 교육으로는 한계가 있음을 지적하면서 이의 대안을 여성신학에서 말하는 몸과 성 개념에서 찾았다. 연구자는 다양한 여성신학자의 연구를 중심으로 왜곡된 성인식과 성문화는 이원론적 성과 몸 이해가 가장 근본적인 원인이라는 인식 하에 몸과 성에 대한 재개념화가 필요하다고 지적하며 이를 통전적 성, 타인과의 관계 속에서 이해되는 상호연대적인 성, 전 지구적인 공동체로 확장되는 영성으로서의 성 개념의 세 가지로 개념화하였다. 그리고 각각의 영역을 위한 교육과정으로 1)통전적 성: 호흡하기, 내러티브, 자신의 몸과 마음의 형태를 만들어보기 2)타인과의 관계성 안에서 이해되어지는 상호연대적인 성: 다른 사람의 호흡 느껴보기, 의식화를 통한 미디어 리터러시, 선한 바람 보내기 3)전 지구적 관심으로 확장되는 영성으로서의 성: 자연에 주의를 기울이고 공동 경작하기, 지구의 신음을 듣고 새로운 삶의 형식 만들어가기, 지구 및 동료 생명체들과 함께 하는 기도문 작성하기로 제안하였다.
본 연구의 대상인 허주부군산수유첩(虛舟府君山水遺帖)은 고서벽(古書癖), 탄금벽(彈琴癖), 화훼벽(花卉癖), 서화벽(書畵癖) 그리고 주유벽(舟遊癖) 등 오벽(五癖)을 가진 인물인 고성 이씨 11대 종손 허주(虛舟) 이종악(李宗岳: 1726-1773)이 1763년 4월 4일부터 8일까지 5일간 18명의 친인척들과 임청각에서 시작해 양정(羊汀), 칠탄(七灘), 사빈서원(泗濱書院), 선창(船倉), 낙연(落淵), 선찰(仙刹)과 선유정(仙遊亭), 몽선각(夢仙閣), 백운정(白雲亭)과 내앞마을(川前里), 이호(伊湖), 선어대(鮮魚帶)를 거쳐 귀착지인 반구정(伴鷗亭)에 이르기까지 '안동팔경' 또는 '임하구곡'으로 불리우는 반변천(半邊川) 주변의 절경지를 선유(船遊)하며 남긴 십이폭의 화첩이다. 산수유첩에 표현된 장소 및 경물 그리고 식물요소를 중심으로 과거와 현재의 경관 및 풍물에 대한 물리 생태적, 시각 미학적 변화에 주목한 연구 결과는 다음과 같다. 산수유첩의 표현된 맑은 강물과 하얀 백사장 그리고 기암절벽을 배경으로 이루어진 시회(詩會), 거문고 소리에 귀 기울이는 선상(船上) 풍류는 조선시대 상류층의 선유(船遊) 놀이문화를 보여주는 좋은 사례다. 아쉽게도 임하댐과 안동댐 건설로 초래된 심대한 시각적 변화와 생태적 변동으로 인해 양정과범(羊汀過帆), 칠탄후선(七灘候船), 사수범주(泗水泛舟), 선창계람(船倉繫纜), 낙연모색(落淵莫色), 망천귀도(輞川歸棹), 이호정도(伊湖停棹)의 경관상은 본래의 정취를 전혀 느낄 수 없으며, 단지 화폭에 묘사된 그림을 통해 당시의 풍광과 정취를 가늠할 수 있다. 허주부군산수유첩의 제1도(동호해람(東湖解纜))와 제11도(선어반조(鮮魚返照))에는 회화나무나 시무나무 또는 느릅나무 등 낙엽활엽교목으로 판단되는 수목들이 표현되었고, 제9도(운정풍범(雲亭風帆))의 '개호(開湖)'라 불리는 솔숲을 운천공이 1617년에 소나무를 식재해 형성한 숲이다. 그 외 승경도에서는 자연지형과 조화를 이룬 소나무 등의 상록침엽수와 정자나 건물 주변에 식재된 낙엽교목류가 표현되고 있다. 허주부군산수유첩과 신암의 동유십소기(東遊十小記)의 비교 고찰한 결과, 임하구곡의 일곡의 백운정으로부터, 이곡 임천과 임천서원, 사곡 사수의 사빈서원, 오곡 송석, 육곡 선창의 수석, 칠곡 낙연현류, 팔곡 선찰사와 선유정, 구곡 표옹 유허로 재차 확인되었으며, 모호했던 삼곡은 마천과 칠탄으로 추정된다. 허주부군산수유첩은 조선 후기의 낙동강 최대 지류인 반변천 연안의 경관이 절묘하게 표현되어 있으며, 댐 건설로 현재는 찾아보기 힘든 선인들의 선유 풍류와 경관요소들을 음미할 수 있는 도형사료로써의 가치를 확인한 것이 본 연구의 작은 성과로 판단된다.
Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.