• 과학교육연구지
• /
• 제42권2호
• /
• pp.256-271
• /
• 2018

본 연구는 과학영재들이 문제발견 과정에서 나타내는 과학개념 연결방식과 융합적 사고의 특징을 분석하는데 목적을 두었다. 이를 위해 2015학년도 광역시 소재 대학부설 과학영재교육원 중등 심화과정 전공영역별로 지원한 228명을 모집단으로 설정하고, 연구대상은 선발과정 1차 전형에서 실시한 과학 창의적 문제해결력 검사도구 점수를 기준으로 상위 30%에 속하는 67명을 상위집단으로, 하위 30%에 속하는 64명을 하위집단으로 구분하고, 두 집단에 속하는 총131명을 표집하였다. 자료수집을 위한 검사도구 문항은 초등과학 교육과정에서 추출한 소리, 전기, 무게, 온도, 호흡, 광합성, 날씨, 지진의 과학개념 8개를 활용하여 개발하였다. 검사문항은 과학개념 8개 가운데 가장 선호하는 과학개념 2개를 연결하여 과학적 질문을 생성하도록 제시하였으며, 연구대상이 진술한 과학적 질문을 분석하였다. 연구결과 과학영재들은 심화과정 전공영역에 따라 과학개념 연결 선호도에서 차이를 나타냈다. 과학적 질문에서 나타난 과학개념 연결방식의 특징을 분석하기 위해 수집한 자료를 먼저 관계, 유사성, 비유사성에 근거한 연결방식으로 분류하였다. 나아가 관계에 근거한 과학개념 연결방식은 속성, 수단, 영향, 예측, 원인, 측정, 현상으로, 유사성에 근거한 과학개념 연결방식은 속성, 대상, 과학적 원리, 현상에 근거한 연결로, 비유사성에 근거한 과학개념 연결방식은 병렬, 자원, 제거에 근거한 연결로 세분화하였다. 상위집단과 하위집단 간에 과학개념 연결방식은 통계적으로 유의미한 (p<.000) 차이를 보였다. 상위집단은 하위집단에 비해 서로 다른 과학영역에 해당하는 개념을 연결하여 과학적 질문을 더 많이 생성하였으나, 하위집단은 상위집단에 비해 동일한 과학영역 내 개념들을 연결하여 과학적 질문을 더 많이 생성하였다. 상위집단은 하위집단에 비해 유사성에 근거한 과학개념 연결방식을 더 빈번하게 사용하는 특징을 나타낸 반면, 하위집단은 상위집단에 비해 비유사성에 근거하여 단순하게 병렬시키는 연결을 더 빈번하게 사용하는 것으로 나타났다.

• 여성건강간호학회지
• /
• 제4권1호
• /
• pp.161-178
• /
• 1998

In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.

• 대한간호학회지
• /
• 제25권1호
• /
• pp.61-79
• /
• 1995

When children are admitted to hospital, they have to adapt to new and unfamiliar stimuli. Children may respond with fear to stimuli such as pain or unfamiliar experiences. One goal of nursing is to help hospitalized children to adapt effectively to their hospital experience. Accordingly, nurses need to assess childrens' fears of their hospital experience to contribute to the planning of care to alleviate these fears. The problem addressed by this study was to identify and measure hospital-related fears(hereafter called HRF) in hospitalized school-aged children. The study was conceptualized with Roy's model. A descriptive qualitative approach was used first, followed by a quantitative approach. This study was conducted from November 30, 1989 to January 12, 1991. The sample consisted of 395 hospitalized school-aged children selected through an allocated sampling technique in nine general hospitals. The HRF questionnaire (three point likert scale ) was developed by a delphi technique. The data were analyzed by an SAS program. Factor analysis was used for the examination of component factors. Differences in the HRF related to demographic variables were examined by t-test, analysis of variance and the Scheffe test. The crude scores of the HRF scale were transformed into T- scores to calculate the standard scores. The results included the following : 1. Forty-four items were derived from 188 statements identifying the childrens' hospital-re-lated fears. These items clustered into 14 factors, fear of injections, operations, bodily harm others' pain, medical rounds, physical examinations, medical staff, disease process, blood and X-rays, drugs and cockroaches, tests, harsh discipline from parents or staff, being absent from school, and separation from family. The 14 factors was classified into four categories,'pain','the unfamiliar','the un-known' and 'separation'. 2. The reliability of the HRF instruments was .92(Cronbach's alpha). In the factor analysis, Cronbach's alpha coefficients for the 14 factors ranged from .84 to .86 and Cronbach's alpha coefficients for the four categories ranged from .70 to .84. Pearson correlation coefficient scores for relationships among the 14 factors ranged from ,11 to .50, and among the four categories, from ,44 to ,63, indicating their relative independence. 3. The total group HRF score ranged from 45 to 130 in a possible range of H to 132, with a mean of 74.51. The fears identified by the children were, in order, injections, harsh discipline by parents or staff, bodily harm, operations, medical staff, disease process, and medical rounds ; the least feared was others' pain. The fear item with the highest mean score was surgery and the lowest was examination by a doctor. HRF scores were higher for girls than for boys, and for grade 1 students than for grade 6 students. HRF scores were lower for children whose fathers were over 40 than for those whose fathers were in the 30 to 39 age group, and whose mothers were over 35 than for those whose mothers were in the 20 to 34 age group. HRF scores were lower when the mother rather than any other person stayed with the child. The expressed fear of pain, the unfamiliar, the un-known and of separation directs nurses' concern to the threat felt by hospitalized children to their concept of self. This study contributes to the assessment of fears of hospitalized children and of stimuli impinging on those fears. Accordingly, nursing practice will be directed to the alleviation of pain, pre-admission orientation to the hospital setting and routines, initiation of information about procedures and experiences and arrangments for mothers to stay with their children. Recommendations were made for further research in different settings and for development and testing of the instrument.

• Tuberculosis and Respiratory Diseases
• /
• 제59권4호
• /
• pp.380-388
• /
• 2005

배 경 : 증가하는 사회적, 가정 문제들로 인하여 약물 중독은 해마다 늘고 있는 추세이나 최근 이에 대한 보고들이 적었고 특히 약물중독의 합병증 중 흔히 경험하게 되는 폐렴과 연관되어서는 잘 알려진 바가 없다. 이에 본 연구자들은 급성약물 중독 환자에서 발생한 폐렴의 임상양상과 그에 연관된 위험인자 및 예후인 자에 대해 조사하였다. 방 법 : 2000년 5월부터 2004년 5월까지 건양대학교 병원 응급실로 내원한 급성 약물 중독환자 237명을 대상으로 환자군의 연령, 성별, 약물 복용목적과 종류, 경과 및 중환자실 치료 여부, 특히 폐렴과 관련된 인자들을 의무기록을 통하여 후향적으로 조사, 분석하였다. 결 과 : 급성 약물중독환자에서 발생한 폐렴은 18.6%였으며 고령에서 많이 발생하였고 (45%) 유기인제에 의한 중독이 가장 많았으며 (28.3%) 성별간의 유의한 차이는 없었다. 자살 목적의 음독이 68.8% 에 해당하였으며 폐렴 발생의 독립적인 위험인자는 65세 이상의 고령 (${\beta}=0.128$,p<0.05)과 초기 저하된 의식상태 (${\beta}=-0.209$, p=0.006) 그리고 긴 재원기간 (${\beta}=0.361$, p<0.001) 이었다. 폐렴의 예후와 관련하여서는 기도 삽관 (${\beta}=-0.628$, p<0.05)과 중환자실 입원기간 (${\beta}=0.710$, p<0.01) 및 전체 재원 일수가 많을수록 (${\beta}=-0.541$ p=0.010) 불량한 예후를 보였다. 균 배양 검사 결과 MRSA (37%) 가 가장 흔한 균으로 동정되었다. 결 론 : 급성 약물 중독 환자에서 폐렴 발생과 연관된 독립적인 위험인자로는 65세 이상의 고령과 초기 저하된 의식상태 및 긴 재원일수 이며 예후인자로는 기도 삽관 여부와 중환자실 및 총 재원 일수이다.

• 시큐리티연구
• /
• 제42호
• /
• pp.393-422
• /
• 2015

학교는 학생의 효과적인 학업성취와 지적능력 개발을 위해 공교육을 실현하는 거점임과 동시에 최전선의 위치를 담당하고 있다. 비단 학업뿐만 아니라 사회의 한 구성원으로써 타인과 함께 하기위한 배려와 이해의 폭을 넓혀주는 공간이기도 하다. 그러나 우리나라 학교교육의 현실은 타인을 배려하고 책임감을 느끼는 삶의 태도와 관련된 인성교육에 대해서는 부족한 면이 많다는 지적을 받고 있다. 한 개인이 성인으로 성장해 나가는 데에는 지적능력뿐만 아니라 정서적인 측면이 반드시 필요하고, 학교에서는 그와 관련된 다양한 방법을 가르치는 것이 의무화되어 있다. 그럼에도 불구하고 우리나라 중등교육은 교사들의 과도한 행정업무를 비롯한 기타 업무로 인해 인성교육의 과정이 소홀해 지거나 형식적인 활동을 벗어나지 못하고 있다. 이러한 영향으로 학생들의 문제적 행동을 개선하지 못하는 결과를 가져왔으며, 결국 학교폭력과 같이 타인에게 직접적인 피해를 주는 심각한 사회문제를 야기한 측면이 있다. 따라서 이 연구는 교육학과 범죄학의 청소년비행 행위에 기초하여 인성의 개념을 구체화하고 학교폭력과의 관계를 경험적 연구를 통해 검증하고자 하였다. 이에 따라 2013년 7월 1일부터 2013년 9월 31일 까지 전국 277개교에 재학 중인 고등학교 3학년 학생들 중 경기도에 소재한 K대학의 입학설명회 및 모의전형에 참여한 학생들 중 무응답과 분석에 사용할 수 없다고 판단된 자료를 제외하고 최종분석에서 총 1045명의 자료가 활용되었다. 그 결과 학교폭력 피해경험이 많고, 남자학생일 수 록 학교폭력의 가해 경험이 많을 것으로 나타났다. 또한 건강한 학생일수 록 학교폭력의 가해경험이 많고, 분노조절과 공감, 배려의식이 낮은 학생이 학교폭력의 가해경험이 많은 것으로 나타났다.

• 대한간호학회지
• /
• 제22권1호
• /
• pp.81-115
• /
• 1992

The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t＝3.95, p＜0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t＝1.93, p＜0.05), ‘I know that my baby wants most of the times’(t＝2.75, p＜0.01), ‘When the baby cries, 1 can tell what she/he wants’(t＝2.10, p＜0.05), ‘I have confidence in my ability to care for the baby’(t＝3.72, p＜0.01), ‘I trust my own judement in deciding how to care for the baby’(t＝1.96, p＜0.05), ‘I feel that I know my baby and what to do for him /her’(t＝2.44, p＜0.01), ‘I am concerned about being able to meet the baby's needs’(t＝2.87, p＜0.01), ‘I know what my baby likes and dislikes’(t＝3.26, p＜0.01), ‘I don't know to care for the baby as well as I should’(t＝2.07, p＜0.05), and ‘I am unsure about whether I give enough attention to the baby’(t＝3.04, p＜0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝3.95, p＜0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t＝2.31, p＜0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t＝2.29, p＜0.05), ‘I enjoy taking care of the baby’(t＝2.4g, p＜0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t＝2.87, P＜0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t＝2.51, p＜0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t＝2.43, p＜0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝2.31, p＜0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r＝0.57, p＜0.01)

• Tuberculosis and Respiratory Diseases
• /
• 제46권3호
• /
• pp.350-362
• /
• 1999

연구배경: 침습적 기계 호흡 이탈에 성공하여 기관내 관을 제거하였으나 48시간 이내에 급성 호흡 부전이 경우 또는 환자 스스로 기관내 관을 제거한 후 발생된 급성 호흡 부전은 이탈 실패의 중요한 원인이며, 발생시 기관내 관의 재삽관을 통한 호흡 보조가 표준적 치료이다. 비침습적 양압 환기법(noninvasive positive pressure ventilation이하 NIPPV)은 비 혹은 안면마스크를 통해 양압 환기를 시행하므로 기관내 삽관을 회피할 수 있다. 본 연구는 기계 호흡 이탈 후 기관내 관을 제거한 환자들에게 발생된 급성 호흡 부전 시 NIPPV 적용이 기관내 삽관을 통한 양압 환기 치료를 대체할 수 있는지를 알아보고자 하였다. 방 법: 대상은 아산 재단 서울 중앙병원 내과계 중환자실에 입원하여 기계적 환기 치료를 받고 이탈 과정에서 기관내 관 제거 후 48시간 이내에 급성 호흡 부전이 발생한 환자 21명 및 스스로 기관내 관을 제거한 후 급성 호흡 부전이 발생한 환자 7명과 기관내 관이 기도내 분비물로 막혀 기관내 관을 제거한 환자 2명등 총 31명에게 NIPPV를 적용하였다. NIPPV는 환자 상태에 따라 기계 환기 양식, 압력 보조 수준 및 흡입 산소의 양이 조절 되어졌으며, 압력 보조 8cm $H_2O$미만에서 임상적으로 안정된 상태를 유지하는 경우 완전히 NIPPV에서 이탈하였다. 성공군은 NIPPV 이탈후 48 시간 이상 자발 호흡을 유지한 경우로 정의하였고, 실패군은 NIPPV 시행 후 호흡 부전 소견이나 동맥혈 가스검사의 호전이 없어 다시 기관내 삽관을 시행하여 기계호흡을 시행한 환자로 정의하였다. 각 군에서 NIPPV적용 직전, 적용 후 30분, 6시간, 24시간, NIPPV 이탈 작전 또는 실패하여 기관내 재삽관으로 전환 직전의 심박동수, 분당 호흡수, 동맥혈 가스검사, 압력 보조 수준 및 호기말 양압등을 비교하였다. 결 과: 총 31명에서 NIPPV를 적용하였고, 이 중 성공군은 14명(45%)이었다. 성공군과 실패군을 비교 시 나이, 중환자실 입원 당시의 APACHE III 점수, 기관 내 삽관 기간, 기관내 관 제거 후 NIPPV적용시까지의 시간 및 NIPPV 시행 직전의 분당 호흡수, 심박동수, 동맥혈 가스검사, $PaO_2/FiO_2$ 등은 양군간에 유의한 차이가 없었다. 모든 환자에서 NIPPV적용 30분후부터 분당 호흡수 및 심박동수는 감소하였고 동맥혈 산소 포화도는 증가하였다.(p<0.05) 그러나, 실패군에서는 NIPPV 시행중에 상태가 악화되어 기관내 재삽관을 시행하였고, 재삽관 작전의 분당 호흡수 및 심박동수는 다시 증가하였으며 동맥혈 산소포화도는 감소하였다(p<0.05). 기저 질환이 COPD 이면서 기관내 관 제거 후 급성 호흡부전이 발생한 환자 8명에게 NIPPV 적용 시 COPD가 아닌 다른 환자들에 비해 NIPPV의 성공률이 의미 있게 높았다(62% 대 39%)(p=0.007). NIPPV를 이용한 이탈 시 실패의 원인으로는 기저 질환의 악화 없이 동맥혈 가스 소견이 악화되었던 예가 9예, 그 외 기저 질환 악화 5예, 마스크 부적응이 2예, 기도내 분비물 축적이 1예였다. 결 론: NIPPV는 침습적 기계 호흡이탈과정에서 특히 기저질환이 COPD인 환자들의 경우 기관내 관 제거 후 발생한 급성 호흡 부전 시 기관내 관의 재삽관을 피할 수 있는 유용한 치료적인 방법으로 사료된다.