• 제목/요약/키워드: married working men

검색결과 51건 처리시간 0.027초

노인 돌봄 서비스관리자의 직무만족에 영향을 미치는 요인연구 (A Study of Effecting Factors on Job Satisfaction of the Elderly Care Social Workers)

  • 김근홍;박준기
    • 한국노년학
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    • 제30권1호
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    • pp.195-220
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    • 2010
  • 본 연구의 목적은 전국의 노인 돌봄 서비스관리자를 대상으로 직무만족 현황을 살펴봄과 동시에, 개인적요인, 근무관련요인, 서비스관련요인들이 직무만족에 어떠한 영향을 미치는지 알아보는데 있다. 이를 통해 직무만족 향상을 위한 정책적 대안과 실천적 방안들을 제시해 보고자 한다. 본 연구 목적을 달성하기 위하여 전국에서 현재 수행 중에 있는 노인 돌봄 사업수행기관 244개 가운데 각 기관을 대표한 231명에 대해 수집된 자료 중, 분석 유효한 자료 220개를 활용하여 분석하였다. 분석을 통해 어떠한 요인이 서비스관리자의 직무만족에 영향을 미치며, 어느 정도 영향을 미치는지 파악한 결과 직무만족의 수준은 3.01로 중간을 조금 넘는 수준에 머무르고 있는 것으로 나타났다. 그런데 여성보다는 남성이, 연령이 낮은 미혼이, 계약직보다는 정규직이 그리고 타 업무를 병행하지 않는 서비스 관리자의 만족도가 상대적으로 더 높은 것으로 나타났다. 또한 직무만족에 영향을 미치는 요인을 살펴본 바, 개인관련요인으로는 성별이, 근무관련요인은 타 업무 병행 여부와 기관장의 의지가, 서비스관련 요인은 서비스 태도가 직무만족에 영향을 미치는 것으로 나타났다. 그 가운데도 기관장의 의지가 가장 큰 영향을 미쳤으며, 그 다음은 서비스 태도, 타 업무 병행 여부, 성별 순으로 밝혀졌다. 이러한 결과를 바탕으로 볼 때, 사업수행기관의 기관장 지지와 관심이 높거나, 서비스 태도가 좋고, 타 업무를 병행하지 않으며, 남성일수록 만족도가 높음을 알 수 있었다. 따라서 만족도가 평균 이하로 낮은 수준인 급여 및 각종 혜택과 고용의 안정성 및 업무량이나 근무시간의 적절성, 근무시설 및 복지후생여건의 개선 등에 관한 방안의 개선이 요구되었다. 특별히 급여의 경우 3년 연속 동결된 낮은 급여로 인하여 그 개선이 절실히 필요하며, 업무량 및 근무시간의 적절성 문제 해결을 위해서는 사업수행기관에서 타 업무와의 병행을 하지 않도록 하며, 노인돌보미의 인력을 활용하여 행정지원을 받는 방법도 고려해 볼 수 있을 것 같다. 특히 사업의 성공 및 효과성을 유지하기 위해서는 휴먼서비스의 핵심이 되는 서비스 관리자들의 직무만족 향상을 위한 지속적인 노력이 요구된다.

흡연자와 비흡연자의 행동양상 연구 (A Study on Behavior Patterns Between Smokes and Non-Smokers)

  • 김화신
    • 대한간호학회지
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    • 제20권1호
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    • pp.79-87
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    • 1990
  • Clinical and epedemiologic studies of coronary heart disease(CHD)have from time to time over the last three decades found associations between prevalence of CHD and behavioral attributes and cigarette smoking. The main purpose of this study is reduced to major risk factor of coronary heart disease through prohibition of smoking and control of behavior pattern. The subjects consisted of 120 smokers and 90 non-smokers who were married men older than 30 years working in officers. The officers were surveyed by means of questionnaire September 26 through October 6, 1989. The Instruments used for this study was a self-administered measurement tool composed of 59 items was made through modifications of Jenkuns Activity Survery(JAS). The Data were analysed by SAS(Statistical Analsis System) program personal computer. The statistical technique used for this study were Frequency, x$^2$-test, t-test, ANOVA, Pearson Correlation Coefficient. The 15 items were chosen with items above 0.3 of the factor loading in the factor analysis. In the first factor analysis 19 factors were extracted and accounted for 86% of the total variance. However when the number of factors were limited to 3 in order to derive Jenkins classification, three factors were derived. There names are Job-Involvement, Speed & Impatience, Hard-Driving. Each of them includes 21 items, 21 and 9, respectively. The results of this study were as follow : 1. The score of the smoker group and non-smoker group in Job-Involvement(t=5.7147, p<0.0001), Speed & Impatience(t=4.6756, p<.0001), Hard-Driving(t=8.0822, p<.0001) and total type A behavior pattern showed statistically significant differences(t=8.1224, p<.0001). 2. The score of type A behavior pattern by number of cigarettes smoked daily were not statistically significant differences. 3. The score of type A behavior pattern by duration of smoking were not significant differences. It was concluded that the relationship between smokers and non - smokers of type A behavior pattern was statistically significant difference but number of cigarettes smoked daily and duration of smoking were not significant differences. Therefore this study is needed to adequate nursing intervention of type A behavior pattern in order to elevated to educational effect for prohibition of cigarette smoking.

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보건관리형태에 따른 산업보건에 대한 지식, 태도 및 실천 (Knowledge, Attitude and Practice according to Types of Occupational Health Management)

  • 김성희;신혜련;김상우;우극현;박완섭;박재용
    • Journal of Preventive Medicine and Public Health
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    • 제29권3호
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    • pp.579-596
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    • 1996
  • 중소영세 섬유업체 근로자들 1,138명을 대상으로 자기기입식 설문조사를 하여 근로자의 보건관리형태에 따른 산업보건에 관한지식, 태도 및 실천의 정도를 비교하고 다음으로는 집단보건관리군 694명만을 대상으로 하여 집단보건관리 기간이 지식, 태도 및 실천에 미치는 영향을 알아보고자 하였다. 1. 보건관리형태에 따라서 산업보건에 관한지식, 태도 몇 실천의 평균점수는 개별보건관리군에서 모두 높았으나 실천의 점수만 통계적으로 유의한 차이를 보였다. 그러나 비교하고자 하는 두 집단간에는 대부분의 일반 특성이 유의한 차이가 있으므로 이를 교정하고자 중회귀분석을 실시하였다. 중회귀분석 결과, 지식에 유의한 영향을 미치는 변수는 연령, 교육 수준, 총 근무기간이었고, 태도에 유의한 영향을 미치는 변수는 연령, 교육수준, 결혼상태였다. 실천에 유의한 영향을 미치는 변수는 성, 연령, 교육수준, 결혼유무, 총 직장근무기간이었다. 연구의 목적인 보건 관리형태별로 비교시는 지식, 태도 및 실천에 미치는 영향은 집단보건관리군의 경우 지식의 평균점수가 조금 높았을 뿐이며, 태도 및 실천의 점수는 낮았다. 그러나 두 가지 보건관리형태에 따른 유의한 차이는 없었다. 2. 집단보건관리군에 국한하여 분석한 결과, 보건관리기간(개월수)은 대상 근로자들의 산업보건에 관한 지식, 태도 및 실천 모두에 유의한 영향을 미친다고 할 수 있다.

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전북지역 인쇄공의 심신 자각증상 조사연구 (A Study on the Subjective Symptoms of the Printers in Chunbuk Area)

  • 김성숙;유은주;이종섭
    • 한국환경보건학회지
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    • 제17권2호
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    • pp.67-77
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    • 1991
  • The purpose of this study was to investigate the psychosomatic health status of printers. The 77 printers and 24 control group were analysed about salary, drinking, smoking, education, sex, marriage, age and working age by the THI (Todai Health Index) questionaire. THI was modified from CMI(Cornell Medical Index) and developed by Tokyo University Research Team in Japan. The resuts obtained were summarized as follows. 1. The printers, who get more salary showed high score about mental conplaints, especially, mental irritability(j), nervusness (E), lie Scale(L), aggressiveness(F) and irregualr life(G) and lower salary showed generally high score about physical complaints, especially, mouth and anus (D), digestive symptom(C) multiple subjective symptom(I). 2. According to the printers drinking amount shows the difference, eg nondrinker scored higher on mouth and anus(D), 90mg/week drinker scored higher on multiple subjective symptom(I), digestive symptom(C), depression(K), nervousness(E), and irregular life(G), 91~179mg/week drinker scored higher on impulsiveness(H), mental irritability(J), 270~359mg/week drinker scored higher on respiratory(A), lie scale (L) and aggressiveness (F). 3. The nonsmoker scored high level on mouth and anus(D), mental irritability(J). The previous smoker scored on multiple symptom(I), eyes and skin(B), digestive(C), lie scale(L), and depression(K). The present smoker scored on respiratory(A), impulsivehess(H), aggressiveness(F), nervousness(E), and irregular life(G). 4. According to the printers working age showed almost high score about subjective symptoms on 1~3 year. 5. Men printers high scored on respiratory(A). lie scale(L), aggressiveness(F), women printers scored about mental complaints, especially, impulsiveness(H), mental irritability(J), depression (K), nervousness (E). 6. According to the printers age showed high scored about, below 20 years were lie scale(L). aggressiveness(F), irregular life(G) 21~30years were multiple subjective symptom(I) respiratory (A), eyes and skin(B), mouth and anus(D), impulsiveness(H), mental irritability(J), depression (K), nervousness(E), and over 41 years were digestive(C). 7. Married printers scored high level on eyes and skin(B), digestive(C) and impulsivehess(H), and single printers on respiratory(A), mouth and anus(D), lie scale(L), mental irritability(J). 8. According to education shows the difference, eg high school scored higher on eyes and skin (B), mental irritability(J), depression(K), nervousness(E), collage and over scored higher on multiple subjective symptom(I ), respiratory (A), mouth and anus (D), lie scale (L), aggressiveness (F), irregular life (G), and middle school scored high on digestive (C), impulsiveness (H).

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관절염환자(關節炎患者)의 특성(特性)에 대한 조사(調査) 연구(硏究) (A Research in the Characteristic of Arthritis Patienth)

  • 강점덕;남철현;김기열
    • 대한예방한의학회지
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    • 제1권1호
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    • pp.149-165
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    • 1997
  • In order that, investigating the feature of patients suffering arthritis, analysing its contents, and grasping a Primary factor affecting it, I might offerbasic datas which could help to plan and perform healthy affairs to thake precautions beforehand, I have investigated, analysed, and studied a total of 320 patients suffering arthritis, who have received physiotherapy in hospital located in Teaegu area for five months, from November 1 1995 to March 30 1996, of which summary and conclusion is this. 1. The general feature of patients in investigative objects In the distribution of the distinction of sex, men accounted for 26.9% and women, for 73.1%, and, in the fistribution of age, 60-year-old or more, most for 27.2% and from 20 to 29 years old, least for 14.0%. In the distinction of a vocation, housewives most accounted for 34.7% and students(jobless men), least for 19.3%. In the distinction of a matrimonial state, married persons most accounted for 76.7% and people living alone(divorce, separation by death, separation), least for 11.4%. In the distinction of an economic state, the middle classes most accounted for 73.5% and the upper classes, least for 2.9%. In the distinction of their academic careers, graduates of a primary school most accounted for 26.9% and graduates of university, for 14.1%, of which patients, having the ability to decode the national language, reached to 11.3%. In the distinction of the house form, people living in independent houses most accounted for 76.4% and residents in apartment(having an elevator), least for 9.4%. 2. In the distribution of the recurring state in the distinction of the feature, the recurring group was more than the group of patients falling that ill at first as 62.2% and in the distinction of the feature of the recurring group, the recurring group turned high in case of men being from 50s to 60s years old or more, people living alone (divorce, separation by death, separation), students (joblessmen), people working in farming, stockbeeding, forestry, fisheries, a simple labour, graduates of a primary school I having the ability to decode the national language, the upper classes, people part two years since they begined to suffer arthritis, people who had members having ever experienced arthritis among families. 3. In the distribution of arthritis on the distinction of bodily pars, a knee articulation most accounted for 50.2% and the articulation of fingers, for 8.8%, wile the simultaneous, several parts (multiple) accounted for 35.1%. In the distinction of the feature, arthritis of a knee turned high in case of men being from 20s to 30s years old, unmarried persons, people having academic careers of university, the middle classes, residents in apartment (having stairs). In the dictnction of a feature the case of several parts (multiple) turned high in case of women being from 50s to 60s years old or more, people living alone (divorce, separation by death, separation), people having the ability to decode th. national language, the graduates of a primary school, the upper classes, residents in apartment (having elevator). 4. In the distribution of arthritis on e distinction of a contracting term, two years or more most accounted for 51.6% and the case of contacting from one year to two years, for 15.3%. Analysing the distinction of the feature, the case of two years or more turned high in case of women being from 50s to 60s years old or more, people living alone (divorce separation by death, separation), the upper classes, people having the ability to decode the national language, residents in apartment (having elevator). 5. In the distribution of an treatment institution before patients came to help, their not curing most accounted for 39.1%, general, orthopedic, neurological surgery (physical therapy), for. 20.0%, and th. therapy of Chinese medicine (acupuncture, moxacautery, Chinese medicine), for 17.5%, and a pharmacy (medical therapy), for 13.4%. The case of patients not curing, in the distinction of a feature, turned high in case of men 20s years old, unmarried, the lower classes, people having academic careers of university, residents in apartment (having elevator). 6. In e distribution of the extent of satisfaction with treatment, common most accounted for 54.4% and some satisfaction, for 32.8%. The case of common, in the distinction of a feature, turned high, in case of men living alone from 50s to 60s years old (divorce, separation by death, separation), married persons, the upper classes, people having academic careers of university, residents in independent house, residents in apartment (having elevator), 7. In the distribution of the degree of knowledge of the cause of arthritis, patients knowing that the cause is to use very much a articulation in normal times most accounts for 60.1%, and patients knowing the state of short nutrition as a cause, for 2.5%. The case of patients knowing that the cause is to use very much in normal times, in the distinction of a feature, turned high in·case of ment being 20s and 60s years old or more, unmarried persons, e lower classes, people having the ability to decode. the national language, people having academic careers of university, residents in apartment (having stairs), 8. In the distribution of the state of physical exercise before arthritis contracted, patients exercising very much on the whole most accpimend for 40.3%, and patients not exercising, for 34.7%. The case of patients exercising very much on the whole, in the distinction of the feature, turned high in case of men being from 50s to 60s years old or more, people living alone(divorce, separation by death, separation), the lower classes, people having the ability to decode the national language, graduates of a primary school, residents in apartment (having elevator). 9. In the taste of patients suffering from arthritis, while the group of patients falling that ill at first and the recurring group didn't smoke cigarets, during alcohol and coffee on the whole, and the group of patients falling once again that ill drank a cup of distilled linquor and three cup of coffee or more on the whole per one day, and the group of patients falling that ill at first liked sort of vegetables and the recurring group liked very much sons of vegetables and fresh and meat in their loving food normal times. 10. Analysing the distribution on the dining table used by patients and the structure of a powder room, at first, in the structure of a powder room, the group of patients filling that ill have a toilet stool using as their sits, and a Bush toilet on the whole, and the recurring group, a toilet stool using as their sits and conventional type, and in the structure of a dinning table, the group of patients falling that ill at first and the recurring group turned high, each as 66.9% and 6.3%, who have a dining table carring here and there. 11. In the distribution of patients of arthritis in relation to stress, the case that they feeled severly symptoms of arthritis when thay got stress, turned high, each, as 78.6% in the recurring poop, and the case not knowing, as 61.5% in the first group. In the extent of stress normal times, the case that they got much stress on the whole turned high, each, as 72.4% in e recurring group, and the care that got less stress on the whole, as 60.0%. 12. In the distribution on the distinction of symptoms and impedimental extent, the recurring group turned high in each variable. Analysing the feature of the recurring group, in the distinction of symptoms, the case that they fooled much that the node of an articulation is stiff, turned high, as 71.6, and in the distinction of treatment before. patients came to helpk, the theraphy of Chinese medicine (physical theraphy), as 84.4%, the theraphy of Chinese medicine (acupuncture, moxacautery, Chinese medicine), as 73.2%, and in the distinction of the satisfing extent on treatment, the case of comman, as 72.3%, and in the cause of arthritis, the case not recruiting their health after a birth, as 68.5%, and the case not recovering wholely an articulation having got hurt, as 62.8%, and in the state of physical exercise before they begined suffering from arthritis, the case exercising very much on the whole, (as 74.2%), and in the extent of subjective impediment, the case of not being able to act almost, as 66.7%, the case of acting but feeling some hard, as 66.3%. 13. The correlation in variables in relation to arthritis Analysing realted variables, the recurring frequency showed correlation with such as the extent that patients got stress normal times, and the exercising state before suffering arthritis, and showed contra-correlation with academic careers, the wights, coffee. The cigaret, e loving food of taste, showed corralation with the weight, stature, alcohole as the loving food of taste. On the basis of this result medical members of heal, who are related to the regular education, public education or development of this program, should be concerned to prevent orthris.

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유통업체 종사자의 유동근무제에 대한 선호성향에 대한 연구 (Distributors' Preference for the Flextime System)

  • 이원행
    • 유통과학연구
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    • 제10권4호
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    • pp.13-20
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    • 2012
  • 유동근무제는 고정된 시간대에만 근무하지 않고 조직과 종업원의 협의에 의하여 근무시간대를 유연하게 조절하는 제도를 의미한다. 대부분의 선행연구에서는 유동근무제가 성과나 생산성, 조직에 대한 태도, 결근율 및 이직률에 미치는 영향을 밝히는데 그 초점을 맞추었으나, 한국의 대부분 기업들이 아직 이 제도를 채택하지 않기 때문에 본 연구는 서울에 주소지를 둔 유통업체에 종사하는 노동자들을 대상으로 현장조사를 실시하여 노동자들의 개인적 특성이 유동근무제의 선호성향에 미치는 영향을 분석함으로써 제도도입을 위한 이론적 틀을 제공하는데 그 목적을 두고 있다. 본 연구의 결과를 요약하면 다음과 같다. 노동자들의 연령은 유동근무제의 선호성향에 영향을 미치지 않는 것으로 나타났다. 다만 통계적으로 유의하지는 않았지만 36세 이상의 노동자들은 35세 미만의 노동자들에 비해 선호성향이 낮은 것으로 나타났다. 남성의 선호성향이 여성보다 더 높게 나타났는데, 이것 역시 유동근무제는 자기개발과 직장생활을 공존하게 할 수 있어 아무래도 자기개발에 관심이 적은 여성보다는 남성들의 태도가 더 호의적인 것으로 분석되고 있다. 통제의 위치와 유동근무제에 대한 선호성향은 약한 상관관계가 존재하는 것으로 나타났는데 이것은 내적 통제를 지향하는 노동자일수록 유동근무제에 대해 호의적인 태도를 갖고 있음을 의미한다. 성취욕구가 높은 노동자일수록 유동근무제에 대해 호의적인 태도를 보여줬다. 성취욕구가 높은 사람들은 새로운 제도를 도입하는데 있어서 과감하게 도전을 하기 때문으로 보인다. 직무만족과 유동근무제의 선호성향과는 유의한 관련성을 나타내고 있지 않았다. 끝으로 본 연구의 한계를 제시하고 향후 연구의 방향을 제시한다.

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성인지적 일·생활균형 조직문화 교육 콘텐츠 개발 : 전남지역의 중소기업을 중심으로 (Development of Content for Gender-Sensitive Work-Life Balance Organizational Culture Education : Focusing on Small and Medium-Sized Enterprises in Jeonnam Area)

  • 이유리
    • 가족자원경영과 정책
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    • 제27권4호
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    • pp.49-62
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    • 2023
  • 본 연구는 여성의 경력단절예방 및 경제활동촉진을 위한 조직문화를 조성하고자 전남지역의 중소기업에 종사하는 남녀근로자 대상의 직장문화개선 교육 콘텐츠를 개발하고자 하였다. 콘텐츠의 현장활용성, 교안내용의 타당성 및 일관성을 확보하기 위해 실무담당자 및 전문가의 자문회의를 통해 전남지역의 특성을 고려하여 콘텐츠 설계의 방향 및 핵심 내용 구성을 구체화하였다. 교육 콘텐츠는 성인지적 일·생활균형 조직문화의 이해, 성인지적 일·생활균형의 효과, 성인지적 일·생활균형을 위한 실천의 3개 대영역으로 구분하였다. 콘텐츠의 방향은 전직원이 기본적으로 개인, 가족, 기업, 사회의 관점에서 일·생활균형의 의미와 조직문화 개선의 취지를 이해하는 것이다. 전남지역 기업의 일·생활균형의 현황을 제시하면서 직장문화개선과 직접 연관된 일과 생활영역의 세부항목에 대한 이해를 돕고자 하였다. 또한, 일·생활균형의 선순환적 효과와 실천적인 측면에서 각자의 일·생활균형에 대한 권리 이상으로 책임이 함께 이루어져야 함을 강조하였다. 특히 개인적으로 직장뿐 아니라 가정 및 여가생활에서 성평등한 일·생활균형의 개선방안을 모색하고 실천할 수 있도록 지지하고자 하였다. 나아가 다양성을 포괄하는 성인지적 관점에서 여성, 남성, 미(비)혼, 기혼, 청년, 노년, 장애인 등을 대상으로 한 제도 및 프로그램을 사례로 설명하고 조직문화 개선을 위해 우리가 모두 적극적으로 참여해야 함을 강조하였다. 본 연구에서 개발한 성인지적 일·생활균형 교육 프로그램이 여성의 경력단절예방 및 경제활동촉진에 견인차 역할을 할 것으로 기대한다. 이와 더불어 여성새로일하기센터는 기업의 자발적 참여동기를 높이고 일·생활균형 교육 강사의 전문성을 강화하는 방안을 강구해야 할 것이다.

여성의 가사노동에 대한 태도 및 사회적 규범에 대한 여성의 인식이 가사노동시간의 성불평등에 영향을 미치는가?: 합리적 행위이론을 통한 매개효과 분석 (Do Women's Attitude to Domestic Works and Self-perception of Social Norms Enforce the Gender Division of Housework? - Analysis of Mediation Effects Using the Theory of Reasoned Action -)

  • 이승주;이소민
    • 한국가족복지학
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    • 제58호
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    • pp.5-36
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    • 2017
  • 본 연구는 합리적 행위이론을 활용하여, 사회적 규범을 통해 형성된 여성 자신의 성역할에 대한 인지적 태도가 가사노동에 있어 성불평등적 행동으로 발현되는데 영향을 미치는지 실증적으로 분석하고자 한다. 이에 여성가족패널(Korean Longitudinal Survey of Women and Family) 5차 자료를 활용하여 기혼여성 중 18세 이상 59세 이하 4,435명을 분석대상으로 선정하여 연구하였다. 본 연구에서는 가사노동을 바라보는 여성자신의 태도와 사회적 요구에 의한 주관적규범을 독립변수로 하여 가사노동시간에 미치는 영향을 살펴보는 동시에 이들 변수들 간의 관계에서 합리적 행위이론에서 주장하는 가사노동 전담에 대한 행동의지가 어떻게 작용하는지에대해 알아보기 위해서 구조방정식 모형(Structural Equation Models: SEM)을 통하여 매개효과를 검증하였다. 연구결과 여성 스스로의 가사노동에 대한 태도는 가사노동시간에 직접적인 영향을 주는 동시에 가사노동 전담에 대한 행동의도를 통해 간접적으로 가사노동시간에 영향을미치는 것으로 드러났고, 주관적 규범은 가사노동시간에 직접적으로 영향을 주진 않으나 가사노동전담에 대한 행동의도를 통해 간접적으로 가사노동시간에 영향을 주는 완전매개효과가 나타나는 것으로 밝혀졌다. 본 연구를 통해 성별 간 평등한 가정생활을 보장해주기 위해 마련된일련의 제도를 인지하고 있음에도 가정 내의 성역할 분화가 여전히 나타나는 것은 단순히 제도 운용상의 문제만이 아닌 오랜 가부장적인 문화에 기반한 여성 스스로의 성역할 인식도 어느정도 영향을 미치고 있음을 알 수 있었다. 따라서 사회구성원들로부터 진정한 성평등 행동변화를 이끌어 내기 위해서는 남성이 상대의 성(gender)에 대한 가치를 존중해주는 것도 중요하지만 여성 스스로 자신의 성(gender)을 바라보는 고착화된 인식의 전환을 시도하는 등 다각적차원에서의 통합적 변화를 모색해 나가야 할 것이다.

만성통증 환자의 통증 조절 (Chronic pain control in patients with rheumatoid arthritis)

  • 은영
    • 근관절건강학회지
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    • 제2권1호
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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일본 '고증파(考證派)' 의학에 관한 연구 (A Study on The 'Kao Zheng Pai'(考證派) of The Traditional Medicine of Japan)

  • 박현국;김기욱
    • 대한한의학원전학회지
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    • 제20권4호
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    • pp.211-250
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    • 2007
  • 1. The 'Kao Zheng Pai(考證派) comes from the 'Zhe Zhong Pai' and is a school that is influenced by the confucianism of the Qing dynasty. In Japan Inoue Kinga(井上金娥), Yoshida Koton(吉田篁墩) became central members, and the rise of the methodology of historical research(考證學) influenced the members of the 'Zhe Zhong Pai', and the trend of historical research changed from confucianism to medicine, making a school of medicine based on the study of texts and proving that the classics were right. 2. Based on the function of 'Nei Qu Li '(內驅力) the 'Kao Zheng Pai', in the spirit of 'use confucianism as the base', researched letters, meanings and historical origins. Because they were influenced by the methodology of historical research(考證學) of the Qing era, they valued the evidential research of classic texts, and there was even one branch that did only historical research, the 'Rue Xue Kao Zheng Pai'(儒學考證派). Also, the 'Yi Xue Kao Zheng Pai'(醫學考證派) appeared by the influence of Yoshida Kouton and Kariya Ekisai(狩谷掖齋). 3. In the 'Kao Zheng Pai(考證派)'s theories and views the 'Yi Xue Kao Zheng Pai' did not look at medical scriptures like the "Huang Di Nei Jing"("黃帝內經") and did not do research on 'medical' related areas like acupuncture, the meridian and medicinal herbs. Since they were doctors that used medicine, they naturally were based on 'formulas'(方劑) and since their thoughts were based on the historical ideologies, they valued the "Shang Han Ja Bing Lun" which was revered as the 'ancestor of all formulas'(衆方之祖). 4. The lives of the important doctors of the 'Kao Zheng Pai' Meguro Dotaku(目黑道琢) Yamada Seichin(山田正珍), Yamada Kyoko(山田業廣), Mori Ritsi(森立之) Kitamura Naohara(喜多村直寬) are as follows. 1) Meguro Dotaku(目黑道琢 1739${\sim}$1798) was born of lowly descent but, using his intelligence and knowledge, became a professor as a Shi Jing Yi(市井醫) and as a professor for 34 years at Ji Shou Guan mastered the "Huang Di Nei Jing" after giving over 300 lectures. Since his pupil, Isawara Ken taught the Lan Men Wu Zhe(蘭門五哲) and Shibue Chusai, Mori Ritsi(森立之), Okanishi Gentei(岡西玄亭), Kiyokawa Gendoh(淸川玄道) and Yamada Kyoko(山田業廣), Meguro Dotaku is considered the founder of the 'Yi Xue Kao Zheng Pai'. 2) The family of Yamada Seichin(山田正珍 1749${\sim}$1787) had been medical officials in the Makufu(幕府) and the many books that his ancestors had left were the base of his art. Seichin learned from Shan Ben Bei Shan(山本北山), a 'Zhe Zhong Pai' scholar, and put his efforts into learning, teaching and researching the "Shang Han Lun"("傷寒論"). Living in a time between 'Gu Fang Pai'(古方派) member Nakanishi Goretada(中西惟忠) and 'Kao Zheng Pai' member Taki Motohiro(多紀元簡), he wrote 11 books, 2 of which express his thoughts and research clearly, the "Shang Han Lun Ji Cheng"("傷寒論集成") and "Shang Han Kao"("傷寒考"). His comparison of the 'six meridians'(3 yin, 3 yang) between the "Shang Han Lun" and the "Su Wen Re Lun"("素問 熱論) and his acknowledgement of the need and rationality of the concept of Yin-Yang and Deficient-Replete distinguishes him from the other 'Gu Fang Pai'. Also, his dissertation of the need for the concept doesn't use the theories of latter schools but uses the theory of the "Shang Han Lun" itself. He even researched the historical parts, such as terms like 'Shen Nong Chang Bai Cao'(神農嘗百草) and 'Cheng Qi Tang'(承氣湯) 3) The ancestor of Yamada Kyoko(山田業廣) was a court physician, and learned confucianism from Kao Zheng Pai 's Ashikawa Genan(朝川善庵) and medicine from Isawa Ranken and Taki Motokata(多紀元堅), and the secret to smallpox from Ikeda Keisui(池田京水). He later became a lecturer at the Edo Yi Xue Guan(醫學館) and was invited as the director to the Ji Zhong(濟衆) hospital. He also became the first owner of the Wen Zhi She(溫知社), whose main purpose was the revival of kampo, and launched the monthly magazine Wen Zi Yi Tan(溫知醫談). He also diagnosed and prescribed for the prince Ming Gong(明宮). His works include the "Jing Fang Bian"("經方辨"), "Shang Han Lun Si Ci"("傷寒論釋司"), "Huang Zhao Zhu Jia Zhi Yan Ji Yao"("皇朝諸家治驗集要") and "Shang Han Ja Bing Lun Lei Juan"("傷寒雜病論類纂"). of these, the "Jing Fang Bian"("經方辨") states that the Shi Gao(石膏) used in the "Shang Han Lun" had three meanings-Fa Biao(發表), Qing Re(淸熱), Zi Yin(滋陰)-which were from 'symptoms', and first deducted the effects and then told of the reason. Another book, the "Jiu Zhe Tang Du Shu Ji"("九折堂讀書記") researched and translated the difficult parts of the "Shang Han Lun", "Jin Qui Yao Lue", "Qian Jin Fang"("千金方"), and "Wai Tai Mi Yao"("外臺秘要"). He usually analyzed the 'symptoms' of diseases but the composition, measurement, processing and application of medicine were all in the spectrum of 'analystic research' and 'researching analysis'. 4) The ancestors of Mori Rits(森立之 1807${\sim}$ 1885) were warriors but he became a doctor by the will of his mother, and he learned from Shibue Chosai(澁江抽齋) and Isawaran Ken and later became a pupil of Shou Gu Yi Zhai, a historical research scholar. He then became a lecturer of medical herbs at the Yi Xue Guan, and later participated in the proofreading of "Yi Xin Fang"("醫心方") and with Chosai compiled the "Jing Ji Fang Gu Zhi"("神農本草經"). He visited the Chinese scholar Yang Shou Jing(楊守敬) in 1881 and exchanged books and ideas. Of his works, there are the collections(輯複本) of "Shen Nong Ben Cao Jing"(神農本草經) and "You Xiang Yi Hwa"("遊相醫話") and the records, notes, poems, and diaries such as "Zhi Yuan Man Lu"("枳園漫錄") and "Zhi Yuan Sui Bi"("枳園隨筆") that were not published. His thoughts were that in restoring the "Shen Nong Ben Cao Jing", "the herb to the doctor is like the "Shuo Wen Jie Zi"("說文解字") to the scholar", and he tried to restore the ancient herbal text using knowledge of medicine and investigation(考據). Also with Chosai he compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志") using knowledge of ancient text. Ritzi left works on pure investigation, paid much attention to social problems, and through 12 years of poverty treated all people and animals in all branches of medicine, so he is called a 'half confucianist half doctor'(半儒半醫). 5) Kitamurana Ohira(喜多村直寬 1804${\sim}$1876) learned scriptures and ancient texts from confucian scholar Asaka Gonsai, and learned medicine from his father Huai Yaun(槐園). He became a teacher in the Yi Xue Guan in his middle ages, and to repay his country, he printed 266 volumes of "Yi Fang Lei Ju("醫方類聚") and 1000 volumes of "Tai Ping Yu Lan"("太平禦覽") and devoted it to his country to be spread. His works are about 40 volumes including "Jin Qui Yao Lue Shu Yi" and "Lao Yi Zhi Yan" but most of them are researches on the "Shang Han Za Bing Lun". In his "Shang Han Lun Shu Yi"("傷寒論疏義") he shows the concept of the six meridians through the Yin-Yang, Superficial or internal, cold or hot, deficient or replete state of diseases, but did not match the names with the six meridians of the meridian theory, and this has something in common with the research based on the confucianism of Song(宋儒). In clinical treatment he was positive toward old and new methods and also the experience of civilians, but was negative toward western medicine. 6) The ancestor of the Taki family Tanbano Yasuyori(丹波康賴 912-955) became a Yi Bo Shi(醫博士) by his medical skills and compiled the "Yi Xin Fang"("醫心方"). His first son Tanbano Shigeaki(丹波重明) inherited the Shi Yao Yuan(施藥院) and the third son Tanbano Masatada(丹波雅忠) inherited the Dian You Tou(典藥頭). Masatada's descendents succeeded him for 25 generations until the family name was changed to Jin Bao(金保) and five generations later it was changed again to Duo Ji(多紀). The research scholar Taki Motohiro was in the third generation after the last name was changed to Taki, and his family kept an important part in the line of medical officers in Japan. Taki Motohiro(多紀元簡 1755-1810) was a teacher in the Yi Xue Guan where his father was residing, and became the physician for the general Jia Qi(家齊). He had a short temper and was not good at getting on in the world, and went against the will of the king and was banished from Ao Yi Shi(奧醫師). His most famous works, the "Shang Han Lun Ji Yi" and "Jin Qui Yao Lue Ji Yi" are the work of 20 years of collecting the theories of many schools and discussing, and is one of the most famous books on the "Shang Han Lun" in Japan. "Yi Sheng" is a collection of essays on research. Also there are the "Su Wen Shi"("素問識"), "Ling Shu Shi"("靈樞識"), and the "Guan lu Fang Yao Bu"("觀聚方要補"). Taki Motohiro(多紀元簡)'s position was succeeded by his third son Yuan Yin(元胤 1789-1827), and his works include works of research such as "Nan Jing Shu Jeng"("難經疏證"), "Ti Ya"("體雅"), "Yao Ya"("藥雅"), "Ji Ya"("疾雅"), "Ming Yi Gong An"("名醫公案"), and "Yi Ji Kao"("醫籍考"). The "Yi Ji Kao" is 80 volumes in length and lists about 3000 books on medicine in China before the Qing Dao Guang(道光), and under each title are the origin, number of volumes, state of existence, and, if possible, the preface, Ba Yu(跋語) and biography of the author. The younger sibling of Yuan Yin(元胤 1789-1827), Yuan Jian(元堅 1795-1857) expounded ancient writings at the Yi Xue Guan only after he reached middle age, was chosen for the Ao Yi Shi(奧醫師) and later became a Fa Yan(法眼), Fa Yin(法印) and Yu Chi(樂匙). He left about 15 texts, including "Su Wen Shao Shi"("素間紹識"), "Yi Xin Fang"("醫心方"), published in school, "Za Bing Guang Yao"("雜病廣要"), "Shang Han Guang Yao"(傷寒廣要), and "Zhen Fu Yao Jue"("該腹要訣"). On the Taki family's founding and working of the Yi Xue Guan Yasuka Doumei(失數道明) said they were "the people who took the initiative in Edo era kampo medicine" and evaluated their deeds in the fields of 'research of ancient text', 'the founding of Ji Shou Guan and medical education', 'publication business', 'writing of medical text'. 5. The doctors of the 'Kao Zheng Pai ' based their operations on the Edo Yi Xue Guan, and made groups with people with similar ideas to them, making a relationship 'net'. For example the three families of Duo Ji(多紀), Tang Chuan(湯川) and Xi Duo Cun(喜多村) married and adopted with and from each other and made prefaces and epitaphs for each other. Thus, the Taki family, the state science of the Makufu, the tendency of thinking, one's own interests and glory, one's own knowledge, the need of the society all played a role in the development of kampo medicine in the 18th and 19th century.

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