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간호개념에 대한 기초조사 (The Empirical Exploration of the Conception on Nursing)

  • 백혜자
    • 대한간호학회지
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    • 제11권1호
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    • pp.65-87
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    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

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간호원의 환자교육 활동에 관한 연구 (Study of Patient Teaching in The Clinical Area)

  • 강규숙
    • 대한간호학회지
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    • 제2권1호
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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흑대추와 일반 건조대추의 추출 및 유산발효과정 중 특성 변화 (Comparison of Property Changes of Black Jujube and Zizyphus jujube Extracts during Lactic Acid Fermentation)

  • 어미선;김이슬;안승준;안준배;김광엽
    • 한국식품영양과학회지
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    • 제41권10호
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    • pp.1346-1355
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    • 2012
  • 본 연구에서는 포제법(炮製法) 중 가장 대표적인 구증구포(九蒸九炮)법을 응용하여 steam, 건조, 저온 숙성 과정을 통해 만들어진 흑대추를 활용하여 추출 및 발효과정에 일어나는 주요 특성 변화를 건대추와 비교 분석하였다. 대추의 구증구포 과정을 통해 만들어진 흑대추를 활용하여 추출 및 유산발효를 진행하고, 이러한 과정 중에 나타나는 약리활성 성분의 변화를 건대추와 비교함으로써 흑대추 추출물의 효능을 확인하여 기능성식품 소재로 활용하기 위한 기초자료를 확보하고자 하였다. AOAC법을 이용하여 일반성분을 분석한 결과, 조단백질의 함량에는 유의적인 차이가 없었으나, 수분과 조지방, 조회분의 함량은 흑대추가 건대추보다 더 높은 것을 확인하였다. TLC와 HPLC를 이용하여 당 분석을 하였고, 건대추와 흑대추 모두 fructose, glucose, sucrose로 조성되어 있었고, 각 함량은 건대추는 5.60, 6.30, 9.04 g/100 g이었고, 흑대추는 9.76, 12.76, 2.95 g/100 g으로 건대추는 sucrose의 함량이 fructose와 glucose에 비해 높은 반면, 흑대추는 상대적으로 더 낮은 sucrose 함량을 나타냈다. 이러한 결과는 흑대추 제조를 위한 구증구포 과정 중 sucrose의 분해에 의한 것으로 판단된다. 유용성분이 추출될 수 있는 최적조건을 선정하기 위해 16개의 조건에서 추출수율을 측정하여 반응표면분석법(RSM)으로 최적 조건을 선정하였다. 건대추와 흑대추의 추출수율에 대한 회귀식의 결정계수값 $R^2$은 각각 0.3518, 0.3870으로 모델식이 적합하지 않았고, 이러한 결과는 추출조건에 따라 수율의 차이가 크지 않고, 추출 용매의 에탄올 비율이 증가할수록 수율이 증가하다가 80% 이상이 되면 수율이 급격히 감소하는 것이 원인인 것으로 판단된다. 따라서 Jeong 등(15)의 추출조건을 응용하여 건대추와 흑대추 추출물을 제조하였다. 추출물을 YL-3로 유산발효를 진행한 결과, 두 추출물 모두 배양 8시간 후부터 대수증식기가 시작되었고 24시간 배양 후 대수증식기가 종료되었다. 두 추출물의 초기 pH는 차이가 있었으나 8시간 배양까지 일정하게 유지되고 12시간 후부터 72시간까지 감소하는 유사한 변화 패턴을 보였고, 본 연구에서 사용한 건대추와 흑대추의 일반성분 함량 차이와 단당류 및 이당류 조성비의 차이가 유산균의 생육에 영향을 거의 미치지 않았음을 확인할 수 있었다. 대추 추출물의 유산발효에 의한 기능성 성분의 변화를 분석하고자 폴리페놀과 플라보노이드, free 라디칼 소거능을 측정하였다. 발효 전 건대추와 흑대추의 페놀성 물질의 함량을 분석한 결과 흑대추가 건대추에 비해 폴리페놀과 플라보노이드 함량이 유의적으로 높았으며, 발효 후 건대추의 폴리페놀 함량은 감소하였지만 플라보노이드 함량은 높은 증가율을 보였고, 흑대추는 발효 후 두 물질 모두 증가하였다. 이 결과를 통해 발효에 의한 페놀성 물질의 증가 가능성을 확인하는 것과 동시에 항산화 활성 및 생리기능의 향상을 예측할 수 있었고, 발효가 폴리페놀이나 플라보노이드 이외에도 많은 유효성분의 함량에 영향을 줄 것으로 기대되며 이와 관련된 연구가 지속되어야 할 것으로 생각된다. DPPH에 의한 라디칼 소거능 측정 결과, 흑대추의 발효 전 전자공여능은 74.72%로 건대추보다 더 높았고, 발효에 의한 DPPH free 라디칼 소거능의 유의적인 증가 효과는 없었다. 흑대추의 AEAC값이 1.06 mgAAeq/g으로 건대추에 비해 ABTS free 라디칼 소거능이 더 높았으나, 두 추출물 모두 발효에 의한 ABTS free 라디칼 소거능의 증가 효과는 없었다. 본 연구를 통해 구증구포에 의한 유용성분의 증가효과를 확인하였고, 건대추에 비해 영양성분 및 기능성 물질의 함량이 높은 흑대추를 주원료로 하여 유산균 발효공정을 도입함으로써 기능성물질의 증가 효과를 얻고 다른 대추 가공품과 차별화를 두고 제품의 품질을 향상시킬 수 있을 것으로 생각되며, 흑대추를 이용한 기능성 발효식품 개발에 이용될 수 있을 것으로 판단된다.

해외 취업 및 인턴쉽에 대한 인식과 만족도에 관한 연구 -조리 및 외식관련 전공자를 대상으로- (Evaluation of the Perception and Satisfaction of Working and Internship Abroad -By Undergraduates Studying in Culinary and Foodservice Departments-)

  • 최영희;김일순;김수연
    • 동아시아식생활학회지
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    • 제19권2호
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    • pp.287-294
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    • 2009
  • 조리 및 외식 관련 전공자 가운데 해외 취업과 인턴쉽에 경험이 있는 사람을 대상으로 해외 취업 및 인턴쉽에 대한 인식과 만족도를 조사하였으며, 그 결과는 다음과 같다. 1. 조사 대상자는 남자가 50.9%, 여자가 49.1%이었으며, 20대가 주를 이루었다. 응답자의 42.1%는 해외 취업을, 57.9%는 인턴쉽을 경험하였으며, 체류 기간은 1년 미만이 42.1%로 가장 많았다. 2. 해외 취업 또는 인턴쉽을 하게 된 동기는 남녀 모두 다양한 해외 문화 체험과 견문 확대의 기회를 꼽았으며, 종사 업무는 남녀 모두 양식 분야가 54.4%로 가장 많았다. 3. 해외 취업 또는 인턴쉽을 희망하는 후배들에게 권하고 싶은 취업 분야는 남자의 경우 51.7%가 양식을, 37.9%는 일식을 권장한 반면 여자의 경우는 양식에 대해서는 46.4%가, 일식에 대해서는 7.1%가 권장하여 유의적인 차이를 보였다(p<0.001). 또한, 후배들에게 권하고 싶은 준비 항목으로 남녀 모두(72.4%, 60.7%) 언어 능력을 가장 많이 선택하였으며, 다음은 새로운 환경에 대한 적응력(남녀 각각 10.3%, 32.1%)으로 남녀간 유의한 차이가 나타났다(p<0.01). 4. 해외 취업 또는 인턴쉽 수행에 대한 인식을 5점 Likert법으로 조사한 결과, 남자는 '나는 현재의 업무를 계속하고 싶다(4.21)'가 가장 높았으며, 다음은 ‘나의 업무는 매우 가치가 있다(4.14)’로 나타났다. 여자는 '주방의 동료 및 선배와의 관계가 원활하다(4.11)'가 가장 높은 점수이었고, 다음은 '나는 업무 외의 해외 생활에 만족한다(4.00)'와 '나는 현재의 업무를 계속하고 싶다(4.00)'로 나타났으며, 전체 평균은 남자가 3.84와 여자가 3.78로 비교적 높은 인식 점수를 보였다. 5. 해외 취업 및 인턴 업무 수행에 대한 중요도 및 만족도를 5점 Likert법으로 조사한 결과, 중요도의 경우, 남자는 '부서간의 협력(4.52)', '언어(4.38)', '주방 환경(4.34)'을, 여자는 '언어(4.36)', '대인관계(4.21)' '급여(4.18)'를 매우 중요하게 생각하였다. 한편, 만족도의 경우는 남자는 '업체의 규모(4.28)', '주방 환경(4.21)', '업무시간(4.10)'을, 여자는 '주방 환경'과 '인센티브(4.14)', '대인관계(4.11)'를 만족스럽게 생각하였다. 중요도에 대한 전체적인 반응은 남자가 4.18, 여자가 4.06인 것에 비해 만족도에 대한 전체적인 생각은 남자가 3.75, 여자가 3.78로 나타나 중요하다고 생각하는 것에 비해 만족도는 상대적으로 낮음을 알 수 있었다. 본 연구는 조리 및 외식 관련 전공자들 중 해외 취업과 해외 인턴 경험자를 추적하기가 쉽지 않았던 관계로 표본수가 제한적이어서 그 결과를 일반화하는데 다소 무리가 있음을 간과할 수 없으나, 본 자료를 근거로 이들 전공자에 맞는 맞춤형 인턴 제도의 개발과 이를 통한 취업의 활로 개척이 시급함을 엿볼 수 있었다. 부분적으로 나마 이를 해소할 수 있는 방안으로는 조리 및 외식 관련 분야 인턴의 선발, 교육, 업체 확보, 관리 등 인턴 업무에 관한 모든 업무를 총괄하여 처리할 수 있는 센터나 기구의 설립이 그 예가 될 수 있을 것이다. 지금까지 주로 민간업체의 주도하에 인턴 파견 업무 알선을 이용함으로써 대행료 등의 부담스러운 비용 문제 발생과 신뢰성 여부의 부담을 주기는 하였지만, 조리 및 외식업계의 해외 진출은 거의 이들 사설업체의 기여도가 높은 편이다. 그러나 앞으로는 노동부와 한국산업인력공단이 함께 운영하는 월드 잡(world job) 사이트를 활용하면 보다 쉽고 보다 유리한 조건으로 해외 취업의 길이 열릴 것이므로 이에대한 적극적인 홍보가 필요하다. 또한, 자료를 통해 언급했던 2015년까지 정부 주도하의 글로벌 청년 리더 양성 프로그램을 이용하여도 좋은 기회가 될 것이다. 다만, 현장 경력이나 기본적인 의사 소통을 위한 외국어의 준비도 함께 병행해야함은 물론이다. 그리고 본 설문 조사에서 낮은 점수로 언급된 것과는 다르게 한식 자격증을 기본적으로 갖추는 것이 필요하다고 권장하고자 한다. 그 이유는 한국산업인력공단의 해외 취업고를 살펴보면 실제로 외국 주재 대사관이나 해외 진출 건설업계의 급식 시설에 파견할 파견 조리사중에는 한식 조리사를 찾는 비중이 높기 때문이다. 2005년 해외 취업 가이드에서 언급되었듯이 한식 분야에 대한 현지의 수요가 점차 늘어나는 추세인 만큼 이에 대한 새로운 각오로 임하는 것이 무엇보다도 필요하며, 드라마를 통한 한류 바람을 타고 일본, 중국을 비롯한 동남아 권에도 한식 열풍이 일기 시작하고 있으므로 한식 조리사에 대한 수요가 많아질 전망이다. 따라서 이런 현상에 대한 실제적인 수요 조사를 좀 더 구체적으로 실시한 후, 현지화 전략이 가능한, 한국 음식에 관한 제대로 된 조리교육을 받은 조리사 양성이 필요할 것으로 판단된다.

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고등학생을 위한 가정교과 기반 예비부모교육 프로그램 개발 및 평가 (Development and evaluation of Pre-Parenthood Education Program for high school students based on Home Economics subject)

  • 노희연;조재순;채정현
    • 한국가정과교육학회지
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    • 제29권4호
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    • pp.161-193
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    • 2017
  • 본 연구의 목적은 고등학교 교육과정에서 활용할 수 있는 가정교과 기반의 예비부모교육 프로그램을 개발하고 평가하여, 예비부모인 고등학생 학습자들이 훗날 우리 사회의 주역이 될 미래세대를 현명하게 보살필 수 있는 성숙한 부모가 되는데 필요한 역량을 갖추도록 하며 동시에 현재 정부가 추진하고 있는 부모교육 활성화 방안의 청소년 대상 예비부모교육을 실행하는 데 도움이 되는 기초자료를 제공하는데 있다. 본 연구의 예비부모교육프로그램 개발 및 평가 과정은 일반적체제설계모형인 ADDIE 모형을 따랐으며, ADDIE모형 중 실행단계(Implement)를 제외한 분석, 설계, 개발, 평가의 4가지 과정을 거쳐 이루어졌다. 먼저, 분석 단계에서는 프로그램 내용요소 추출과 프로그램 개발의 시사점을 얻기 위해 관련 선행연구와 2015 개정 중 고등학교 "기술 가정" 교육과정 문서를 대상으로 분석이 이루어졌다. 그 결과 가정교과 이 외의 분야에서 연구되어 온 예비부모교육의 9 가지 주제(1.자기이해, 2.예비부모의 성, 3.결혼, 4.임신과 출산, 5.부모됨, 6.부모역할, 7.부모 자녀관계, 8.부모와 가족, 9.부모와 사회)와 해당 내용요소들은 이미 가정교과 교육과정에 모두 포함되어 있음을 확인하였으며, 9가지 주제 이외에 가정교과만의 독자적인 주제(1.생애설계, 2.가정생활 내 의 식 주 실천역량, 3.가정생활과 자녀안전, 4.가족문화)와 해당 내용요소들을 별도로 확인함으로써 예비부모교육 시행에 있어 가정교과가 지닌 강점(청소년과 가정과 사회를 바라보며 부모교육 내용 뿐만 아니라 식 의 주 소비 생활 전반을 포함하는 총체적 관점의 교육과 실제로 부모 준비를 실천하게 하는 교육)을 확인하였다. 둘째, 프로그램 개발을 위한 설계는 가정교과와 예비부모교육 간의 접점을 찾고 이를 프로그램 구성요소(목적, 개발방향, 주제, 내용요소, 학습목표, 학습활동)에 반영하는 과정을 통해 이루어졌다. 이 연구의 예비부모교육 프로그램은 미래세대를 현명하게 길러낼 수 있는 성숙한 부모가 지녀야 할 관련 지식, 태도, 가치관, 실천적 문제 해결 능력을 고등학생 학습자가 갖추도록 지원하는 것을 일차 목적으로 두며, 부모됨의 준비 관점에서 학습자가 현재 생활 점검 및 개선을 통해 생활자립능력을 갖추도록 하는 것을 이차목적으로 둔다. 궁극적으로 이 두 가지 목적 달성을 통해 학습자가 장차 부모로서 살아갈 가정생활 영역과 개인적 성취와 관련된 직업생활 영역 그리고 사회 발전에 기여할 수 있는 민주시민으로서의 삶의 영역간의 균형을 이뤄 이를 조화롭게 영위할 수 있는 성숙한 부모로의 성장을 돕고자 하였다. 프로그램 개발방향은 '전체 전개', '내용구성', '교수 학습법 구성'으로 크게 세 가지 측면에서 설정되었다. 프로그램의 주제는 총 11개로 '1. 부모 됨: 부모가 된다는 건', '2. 배우자선택: 행복한 부부관계, 자녀에게 주는 최고의 선물', '3. 임신과 출산: 새로운 생명과의 감동적인 만남', '4. 신생아 돌봄: 24시간 신생아 돌봄', '5. 영유아자녀돌봅: 사랑스러운 나의 아기와의 관계, 애착', '6. 유아기 자녀 돌봄: 별에서 온 내 아이, 유아기 자녀 돌보기', '7. 부모와 건강가정: 건강가정 속 부모와 자녀', '8.부모 자녀 관계: 현명한 부모, 자녀와 효과적으로 상호작용하기', '9. 가정생활 내 자녀안전: 가정생활 속 안전관리자, 부모', '10. 영유아 돌봄 실습', '11. 지역사회 양육지원서비스 개발 실습'이다. 프로그램의 들어갈 최종 내용요소들은 분석단계에서 추출된 내용요소들을 11개 주제와의 관련성을 토대로 분배된 후 선정되었다. 학습목표와 학습활동은 해당 주제와 내용요소를 반영하여 구상되었으며, 특히 프로그램의 학습활동은 1) 부모 됨 관련 실천적 문제를 포함한 사례 활용, 2) 학습한 지식과 기술을 활용한 지역사회 교류활동, 3) 부모 됨 관련 학습내용을 활용한 실생활 프로젝트 활동, 4) 고등학생 학습자의 현재 삶의 긍정적인 변화를 유도하는 활동, 그리고 5) 자녀 발달을 지원하는 가정교과 내 의 식 주 실습활동을 주요 특징으로 한다. 셋째, 프로그램의 개발은 앞서 설정된 설계에 따라 이루어졌으며, 이에 총 11개 주제에 따른 17차시 분량에 해당하는 교수 학습과 정안 및 학습자료가 개발되었다. 개발된 교수 학습과정안은 수업흐름 및 교사 참고자료를 포함하며, 수업 도입부에 가상의 자녀로부터 수업관련 메시지를 받는 것을 시작으로, 정리단계에서는 받은 메시지에 대한 답장의 형태로 해당 차시의 내용 정리 및 예비부모로서의 다짐을 하는 것을 기본 틀로 하였다. 학습자료는 학습활동을 위해 필요한 각종 계획서나 보고서 양식을 포함하며, 정규교육과정에서의 교과서와 같은 역할을 하도록 구체적으로 작성되었다. 넷째, 개발된 프로그램의 평가는 프로그램 개발과정과 결과물 두 가지 측면에 대해 가정교과 전문가 13인으로부터 5점 리커트형 설문지를 활용하여 이루어졌다. 개발과정에 대한 기초분석 평가결과 평균 4.61점, 내용타당도 지수 97.4%였으며, 프로그램 결과물에 대한 평가결과는 평균 4.37점 내용타당도 지수 86.9%였다. 이와 같은 값은 이 연구 프로그램의 개발과정과 그 결과물에 대한 타당도가 상당히 높은 수준에서 확보됐음을 나타내며, 이에 이 연구의 가정교과 기반의 예비부모교육 프로그램은 고등학생 학습자를 대상으로 하는 예비 부모 교육 프로그램으로 타당하고 적합하다는 결론을 내릴 수 있다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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