• 대한한의학원전학회지
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• 제9권
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• pp.555-652
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• 1996

Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

• 대한간호학회지
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• 제27권2호
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• pp.411-422
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• 1997

The purpose of this study is twofold : (i) to investigate how much effort the married couples are making for the good health of both the pregnant woman and her unborn child from the time of their marriage to and during the period of conception : and (ii) to comprehensive investigate socio-cultural back-grounds which affect prenatal effort. Result of this study provide a basis for the prenatal care program which will be appropriate to our culture. This study has been done by the ethnographic research method. The subjects of this study are 53 people in all consisting of 33 pregnant women and 20 husbands. In order to investigate socio-cultural factors which influence Taegyo, producers of Taegyo music were interviewed. In addition the researcher surveyed the markets of Taegyo music, participated in special courses of prenatal education, analyzed the content of the books and periodicals dealing with Taegyo, and collected the concept of Taegyo distributed by the mass media. The full-fledged study continued for eight months from February to August.1996. The data were analyzed as soon as they were collected. Spradly's(1979, 1980) developmental, sequential method of domain analysis. taxonomic analysis, componential analysis, and theme analysis in this order was adopted as the procedure of analyzing the data. To obtain the exactness of study, Sandelowski's (1986) four criteria, that is, Credibility, Fittingness, Auditability, and Confirmability were applied to all stages of data collection, data analysis, the interpretation of the result, and the description of the result. The following are the result : 1. The couples' Taegyo at the stage of preconception was related to their physical, psychological, spiritual conditions under which a healthy baby will be born. Specific methods they prefer are : "the choice of one's spouse." "physical check-up," "physical good health, " "praying, " and so on. 2. When the marriod couple have sex in order to conceive, their Taegyo was related to the imposition of their physical, psychological, and environmental conditions. Specific methods they prefer are : "having sex at specific time, " "having sex in nice place." "to purify their minds while having sex," and so on. 3. The married couples' Taegyo while they are in pregnancy was related to the imposition of their physical. psychological, emotionmental. environmental, social and spiritual conditions. Specific methods they prefer are : "listening to music. " "reading," "looking at beautiful things only," "to avoid looking at or listening to bad things." "to eat food in good shape, " "to avoid drugs," "eating Korean herbal medicine." "sexual abstinence," "to avoid dangerous places," "to keep emotional tranquility," "moderate exercises and rest." "leading a pure life." "praying." "being aware of their words and behavior." "for the couple to keep a good relationship." "interaction with their unborn child," "to support Taegyo for pregnant women," and so on. 4. The married couple put Taegyo into practice on the basis of the following principles : the principle of respecting an unborn child, the principle of forming a good disposition. the principle of top-down parental love, the principle of synergy between a pregnant woman and her unborn child, the principle of expecting a good child, the principle of forming a good habit, and the principle of acquiring a parental role. 5. The practice of Taegyo is influenced by such factors as the married couple, the supporting system, and the mass media. As the husband -and-wife factor, their information of Taegyo, the degree of importance is assigned to their characters, their time to spare, their healthiness, the age of pregnant woman, their conception plan, their religion, their belief of the Taegyo effects, and the birth of a baby in this order. The factor of the supporting system consists of her husband's support, her family support, and her neighbor's support. The mass media factors include the broadcasting media, books specialized in Taegyo, periodicals for pregnant women, booklets for advertizing powdered milk, Taegyo music of record manufacturing companies, and the teaching materials for gifted children. Among these the mass media is especially taking advantage of Taegyo as its main source of economic profits are leading the public behavior pattern to a prodigal one. Taegyo is a self-control behavior which requires practice for the following : the physical and psychological good health of the pregnant woman and her unborn child, the development of the unborn child's good character, the development of the unborn child's intelligence and talents, the expectation of the unborn child's good features. shape a good habit, the expectation of the unborn child's bright future, and the learning of a parental role, the expectation of male birth. Above all it is a type of our good cultural tradition which pursues a value higher than the one that the prenatal care does. The principles of pregnancy care inherent in the habit of Taegyo will provide us a guideline for the development of the prenatal care.

• Child Health Nursing Research
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• 제2권2호
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• pp.45-57
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• 1996

A serious disease in a family influences the entire family member given the fact that the members closely interact with each other. Especially in terms of pediatric nursing, study on family gains importance as the need to care of families whose children with developmental disabilities and chronic disease This study was done based on The Resiliency Model of Family Adjustment and Adaptation(McCubbin, 1991) is intended to examine the stress of parents whose children suffer from cleft lip or /and cleft palate. It also helps them to cope with the stress and analyze the relationship between the stress and coping This study used Family Inventory of Life Events and Changes (FILE) and Coping Health Inventory for Parents(CHIP) for measuring family stress and coping. The two instruments are revised to fit the social and cultural environment of Korean culture. Data collection was done from April 18, 1996 to May 18, 1996 at 8 University medical centers located in Seoul. Those who answered questionnaires were 84 parents whose children have cleft lip or /and cleft palate. SPSS PC+ was used to analyze the data collotted. Programs used for data analysis were t-test, ANOVA, Pearson correlation coefficient. The study is summarized as follows .1. The average score of family stress is 10.46(percentage of the full score 24.90) and 'finance and business strains'(3.25), and 'intrafamily strains'(2.65) ranked the highest. The average score of family's coping is 1.93, which is close to the answer of' moderately helpful' and they are measured to put their utmost efforts to' intergration and cooperation of family and optimistic definition on the situation'. 2. There is no significant statistical correlation between the family stress and coping. 3. Mothers show more stress than fathers in the parts of 'illness and family care strains' and 'losses'(t〓-2.34, t〓-2.32, p<.05). 4. Fathers show more willingness to cope with the stress than mothers do in the parts of' seeking social support','self-esteem','emotional comfort' 5. Mothers are more stress than fathers in the parts of family stress and its coping with it by usual traits(t〓-2.78, p<.05). Parents with religion are measured to cope more willingly than those who are not 6. Income of a family shows positive correlationship with family coping (r〓.28, p<.05). The study shows that gender difference is significant variable in studying on family stress and coping. Mothers get more stress than fathers, which has much to do with the fact that they are in charge of raising children and keeping houseworks. Accordingly, managing family crisis and its survival can be induced by giving support for the mothers, studying fathers including the rest of the family members and giving nursing care and arbitration ; religious background is also considered to be one of the important factors in family stress , judging from the relationship between family income and family's coping, caring given to suffering children is needed on societal levels. The above considerations bring up the need to have a longitudinal study of children with congenital anomaly including cleft lip or /and cleft palate and their families about family stress and coping. Resiliency programs on family system and their effectiveness and the relationship between the enlarged families with social and cultural values reflecting Korean tradition are also needed to be studied.

• 농촌의학ㆍ지역보건
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• 제36권4호
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• pp.238-250
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• 2011

지속적인 암환자 및 암 관련 의료비용 급증은 환자 개인의 고통 및 경제적 부담으로 작용할 뿐만아니라 사회적인 부담이 되고 있다. 이에 재가암 환자에 대한 통증관리 등의 서비스 제공은 의료 비용을 절감하는데 효과가 있을 것으로 여겨지고 있다. 따라서 재가암환자에 대한 적절한 의료 및 복지 서비스 등을 제공하기 위한 자료로 활용하고자 재가암환자관리사업 수혜자의 서비스 요구도에 대하여 각 보건소의 재가암환자관리사업 담당자가 재가암환자관리사업 수혜자 방문시 면접조사방법으로 조사하였고, 불충분응답자 15명을 제외한 661명을 최종 분석대상으로 하였다. 재가암환자의 서비스 요구도에 대한 요인분석 결과 5가지 영역으로 분류할 수 있었고, 요인별 신뢰도는 0.593~0.890이었다. 요구도의 순위는 사회적 지지, 정보 및 교육제공, 심리적 문제해결, 신체증상해결, 가사도움 순으로 조사되었다. 대상자를 암 치료 및 진행 정도에 따라 말기암 환자, 치료중인 암환자, 암 완치자로 분류하였을 때, 말기암환자의 요구도가 가장 높게 나타났으며, 사회적지지, 심리적 문제 해결, 정보 및 교육 순서로 요구도가 높았다. 나머지 그룹에서는 사회적지지, 정보 및 교육, 심리적 문제 해결 순으로 말기 암환자와 차이를 보였다. 뿐만 아니라, 연령별, 거주 지역별, 종교 유무에 따른 서비스 요구도에 차이가 관찰되었고, 이를 바탕으로 현재 제공되고 있는 재가암환자관리의 효율적인 추진을 위해 대상자 분류, 연령별 및 거주 지역별 특성에 따른 서비스가 제공될 수 있도록 해야 할 것이다.

• 간호행정학회지
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• 제3권1호
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• pp.51-64
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• 1997

The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.

• 대순사상논총
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• 제27집
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• pp.171-200
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• 2016

이 글은 전통 효(Filial Piety) 윤리와 대순진리회(Daesoonjinrihoe)의 효 윤리를 비교의 지평에서 분석한 것이다. 그동안 한국의 전통 효 윤리는 현대와 맞지 않는다는 이유로 변화를 요구받아 왔고, 그 핵심은 부모와 자식 간의 관계가 수직적·일방적인 게 아닌 수평적·상호 호혜적이어야 한다는 것이었다. 하지만 이에 대한 구체적인 이념과 대안에 대한 깊이 있는 연구는 거의 없었다. 이런 측면에서 한국의 대표적인 민족종교인 대순진리회가 근대화 이후에 전통과 현대의 충돌을 경험하면서 성장해 왔다는 점을 감안하면, 그 교리체계에서 효 윤리가 어떻게 구축되어 있는지를 관찰하는 작업은 전통 효가 현대적 감각에 맞게 어떻게 윤색될 수 있는지를 살피게 하는 하나의 좋은 사례를 제공해줄 수 있으리라 본다. 이것을 요약하면, 첫째, 유교와 대순진리회는 봉친(奉親)을 효 윤리로 삼지만, 유교는 가부장적인 봉건성에 입각하여 아랫사람의 일방적·맹목적 희생을 강조하고, 대순진리회는 어느 한쪽의 일방적인 희생을 지양하며 부모와 자식 사이의 상생(mutual beneficence)을 도모하고 있다. 이러한 차이는 유교적 효가 봉건질서를 추구하는 이념 속에서, 대순진리회 효가 새로운 종교적 세계인 후천 신세계의 원리인 보은상생과 인존(Respect For Man)의 이념 속에서 구축된 결과로 나타난 것이다. 둘째, 불교와 도교의 효는 부모 생전에 수복(壽福)을 누릴 것을 기원하고 사후에는 천도를 위해 발원하는 소극적·수동적인 것이다. 대순진리회의 효 역시 그러한 관념을 일부 포함하지만, 거기에 그치지 않고 부모 스스로가 죄를 벗고 앞길을 닦아나가도록 유도하는 것까지 효의 범주를 더 넓게 잡는다. 부모와 자식의 수행을 동시에 요구하는 이런 효 윤리는, 자식이 수행 끝에 종교적 목표를 이룬 연후 받게 되는 복록을 부모도 동시에 누릴 수 있게 하고자 하는 대순진리회 세계관 때문에 성립된다. 셋째, 유교와 대순진리회는 선령향화를 효 윤리로 삼지만, 무속적 사고를 배제한 본래 유교(성리학)적 세계관 속의 효는 향화의 대상을 비인격적 존재로, 대순진리회는 인격적 존재로 상정한다. 따라서 유교에 비해 대순진리회의 선령향화는 관념에 치우치지 않는다는 점에서 보다 현실적이다. 넷째, 유교와 대순진리회는 모두 조상들의 은혜를 갚고자 하나 그 은혜의 내용과 보은에 차이가 있다. 유교에서는 조상들이 생명을 준 존재이기에 그에 대한 감사로써 향화를 올리는 것만으로 효가 성립되지만, 대순진리회에서는 조상신들이 자손의 도성덕립을 목적으로 60년 적공(積功)으로써 생명을 주면서 동시에 수도를 하도록 독려하는 존재로 설정되어 있기 때문에 향화를 올리는 것과 더불어 수도까지 해야 효가 성립된다. 다섯째, 유교에서는 세속에서의 출세를 의미하는 입신양명이 효이지만, 대순진리회에서는 그 보다는 수도를 성공시켜 종교적 목표를 달성시키는 것이 더 큰 효로 규정된다. 여섯째, 유불도는 모두 도덕에 기반한 가족윤리로 효를 규정한다. 대순진리회 역시 그러하지만, 그 외에도 효에 종교적 구원을 위한 필수 윤리라는 위상을 더 부여한다. 왜냐하면 효의 부재는 세상을 병들게 하고 멸망케 하는 직접적인 원인이면서, 동시에 60년 동안 적공(積功)을 한 조상신들과 직접적으로 생명을 준 부모들의 은혜를 저버리는 배은이 개벽시대에는 용납되지 않는다고 보기 때문이다. 이러한 사실들로부터, 대순진리회는 자신의 독특한 사상을 바탕으로 하여 유불도의 전통 효 윤리들을 일부는 수용하고 일부는 재해석과 재창조 과정을 거쳐 윤색해 두고 있음을 살필 수 있다. 즉 대순진리회의 효는 인간 존중의 이념, 구체적으로는 보은상생과 인존(Respect For Man)사상 위에서 정립된 윤리 규정이며, 인격 완성과 도통이라는 종교적 목표에 도달하기 위한 나 자신의 수행이자 복록을 더불어 누리기 위한 부모의 일정한 수행까지 요구하는 개념으로 이해되고, 개벽시대에 구원을 받기 위한 필수 윤리라는 대단히 강화된 종교적 색채를 띠고 있는 것이라고 크게 그려 볼 수 있다는 말이다.