• 한국지역사회생활과학회지
• /
• 제25권4호
• /
• pp.511-531
• /
• 2014

This study explores supportive and conflictual network structures of elderly single and couple households and analyzes the effects of supportive and conflictual networks on suicidal thoughts by gender and family type. The analysis considered a sample of 522 individuals over the age of 60 who did not live with their adult children. The statistical methods used to analyze data were descriptive statistics, a t-test, a chi-square test and a regression analysis using SPSS WIN 20.0. The results are as follows. First, men and elderly single households had support networks that were smaller than those of women and elderly couple households. The conflictual network of elderly couples households was larger than that of elderly single households. In addition, the larger the network, the more the conflictual was. Second, elderly single households thought about suicide more often than elderly couple households. Third, economic status, the number of adult children, the size of conflictual network and subjective health had considerable influence on suicidal thoughts of elderly single and couple households. The size of the conflictual network had a greater effect on suicidal thoughts of elderly individuals than that of the supportive network. These results have important policy implications for elderly single and couple households.

• 동남아시아연구
• /
• 제20권2호
• /
• pp.31-72
• /
• 2010

This study is to explain the nature of transnational activities being involved in by Filipina intermarriage migrants in Korea by examining the institutional backgrounds of market, society and the state. The increasing number of Filipina intermarriage with Korean coincides with the advance of liberal market economy, which governs internal and bilateral interactions between and among the three institutions in both countries. While existing various reasons for engaging in intermarriage, a significant number of Filipina wives in Korea ventured into it with uncertain expectations that they might earn better lives and could support their families. Such hopes usually turn out in vain when they meet the real lives in Korea. It is mainly because their spouses in Korea would rather be those who left behind in the marriage market due to their lack of competitiveness. Filipina wives are also suffering from social isolation caused by language and other barriers such as family relations or rural life they might settle in. Their transnational activities usually tend to be their effort to breakthrough their unexpected condition of difficult lives in Korea. They usually make use of transnational sort of community activities to cultivate chances to engage in bread earning activity. Migrant's transnational activity has a great impact on sociocultural changes in the country of origin and of arrival. Transnational activity provides migrants with economic opportunities, and uplifts self-esteem as well. Intermarriage couples, especially with Southeast Asian wives, and their offsprings show a tendency of downward assimilation to Korean society. Korean state policy toward them should not simply apply undiscriminated assimilation theory, but take into account their possible strength of transnational identity with which they could find a means to integrate themselves successfully into the mainstream Korean society.

• 한국인구학
• /
• 제4권1호
• /
• pp.105-130
• /
• 1981

This study was conducted to compare the characteristics of high performane areas for family planning with that of low performance areas and to find factors which strongly affected contraceptive practice behavior. For the study, eight areas were selected from 274 rural family planning canvassing areas of Korean Population Policy and Program Evaluation Study, which was an action study operated in all areas of Cheju Island from July 1, 1976 until December 31,1979. As a first step of the action study, Cheju Island was devided up 318 family planning canvasser areas Each area was consisted of 200 households in rural district and 300 households in urhan one Duriog the period of project, each canvassing area had been managed by a female family planning canvasser, selected by director of health center considering several individual conditions needed for family planning activities Basic activities of canvassers were to counsell all the eligihie couples in own charged area about family planning methods and also to distribute contraceptives such as condoms and oral pills. In case couples desire to accept sterilization including vasectomy and tubal-ligation, the canvassers played a linking role connecting potential client with family planning field workers. Canvassng areas shows significant differentce in performance for family planning, nevertheless they are supposed to have almost the same conditions regarding family planning distribution channel. Because the purpose of the Cheju project was to eliminate all the problems that existed in governmental distribution system, that is to remove geographic, economic, cognitive and administrative barriers Accumulated performances of family planning methods accepted by residents in each area were calculated by eligible women aged 14-49. And then canvassing areas were ranked according to performance score. Consequently, 4 areas in extremely high and low family planning performance areas were selected respectively. Major results were obtained by comparing characteristics of high performance area with that of low performance areas, which are as follows: 1. The mean number of living children was about the same both in high and low performance areas for family planning. But respondents' mean age (38.5) in high performance areas was higher than that (37.0) in low performance areas 2. Respondents' perception in the expectant educational level of others' children in high performance areas was higher than that in low performance areas, although respondents educational level, monthly expenditure and ratio of children in high school and above was not different. 3. Ratio of ownerships of TV and newspaper in high performance areas was highen than that in low performance areas 4. The duration of canvasser' charge in high performance areas was longer than that of low performance areas, showing the fact that canvassers didn't move cut in high performance areas 5. In high performance areas, canvassers' houses were relatively located in the center part of the village. And so villagers resided in near distances from the anvasser's house 6. 4H clubs' activities in high performance areas were more active than those in low performance areas Therefore it was assumed that cohesiveness of community in high performance areas were stronger than that in low areas. 7. Canvassers' family planning practice rate was higher than that in low performance areas, and also canvassers' human relationship was more sociable than that of canvassers in low performance areas. 8. Fourteen variables which showed relatively high significance level in $X^2$ and F test were selected as independent variables for stepwise regression analysis. According to the results of regression analysis. five of 14 variables-distributors education level ($R^2$=.4439), duration of distributor's charge ($R^2$=.6166), 4H club activities ($R^2$=.6697), canvasser's contraceptive practice ($R^2$=.7377) and location of distributions house ($R^2$=.8010) explained 80.1 percent of total variance.

• 한국노년학
• /
• 제31권4호
• /
• pp.939-967
• /
• 2011

본 연구에서는 근거 이론적 접근을 통하여 농촌지역에 살고 있는 여성 노인의 사별적응을 살펴보고 확인하여 그에 대한 실체이론을 개발하고자 하였다. 연구의 참여자는 농촌노인의 배우자를 사별한 여성으로 배우자 상실 후 단독거주자로서 홀로 살고 있으며 배우자를 사별한지 12개월 미만이 되는 14명이었다. 수집기간은 2010년 1월부터 8개월간의 기간이 소요되었고, 인터뷰는 1회기 당 40분-90분까지 소요되었으며 현장메모를 동시에 기록하였고 녹음된 내용은 본 연구자가 직접 필사하였다. 연구 자료는 심층면담과 참여관찰 및 참여자를 돌보는 지역사회 담당간호사의 도움을 받아 수집하였다. 수집된 자료는 Strauss & Corbin(1998)의 근거이론방법을 적용하여 분석하였다. 연구결과 개방코딩 과정에서 80개의 개념과 28개의 하위범주, 12개의 범주가 도출되었으며, 배우자 사별 적응과정은 '울타리가 무너져 내림'의 인과적 조건과 '살아생전부부의 금실정도', '살아생전 부부의 주도권'의 맥락적 조건에 영향을 받아 나타나는 '홀로 여생을 감당해 나감'의 중심현상에 대한 '지원체계', '건강상태가 달라짐', '경제상황 정도'의 중재적 조건에 영향을 받으면서 '상황 끌어안기', '생활의 변화를 시도함'의 전략을 사용하여 '홀로 살아갈 길을 찾음'의 과정인 것으로 나타났다. 시간의 흐름에 따른 적응과정은 충격과 감정분출 단계, 그리움과 원망단계, 체념과 수용단계, 삶의 재구성단계의 4단계로 나타났다. 이상의 결과는 농촌여성의 배우자를 사별하고 살아가야하는 참여자들이 여러 맥락요인들의 영향을 조절하면서 중재전략을 적정하게 사용하여 삶에 적응할 수 있도록 하는 '홀로 살아갈 길을 찾음'의 과정 및 유형에 노인복지 중재의 방향을 제시하고 실질적인 실천적 복지중재를 개발하고 적응하는데 기초 자료를 제공하였다.

• 자원환경지질
• /
• 제47권4호
• /
• pp.405-420
• /
• 2014

도심환경의 인위적 오염원에 의한 토양오염과 대기오염의 특성을 파악하기 위하여 서울지역 가로수의 플라타너스 잎과 토양을 격자형으로 52개의 지역에서 시료채취 및 중금속원소 함량을 측정하였다. 비교 대조를 위하여 비교적 오염이 적을 것으로 예상되는 충청남도 예산에 전원지역에서 2개 지점의 시료를 분석하였다. 서울시 토양 내 중금속 함량을 지역별로 측정한 결과, Cd, Co, Cr, Ni은 산업지역에서, Cu, Zn, Pb는 교통량 밀집지역에서 높았고, 도심 내 전원지역은 비교 대조지역보다 높은 중금속 함량을 보였다. 플라타너스 잎의 세척 전과 후의 차이는 Cd, Cu, Pb, Zn가 교통량 밀집지역에서 높았다. 토양은 Cd-Co, Cr-Ni, Cu-Zn, Pb-Zn는 상관계수 값이 0.8이상으로 양의 상관성을 보여 이들 원소간의 배출원은 유사하고, 플라타너스 잎은 Pb-Cu, Cu-Zn 원소간 상관성이 높았다. 플라타너스 잎의 중금속 조성이 토양으로부터 기인되는지를 확인하기 위해 토양과 세척한 잎과의 관계를 분석한 결과, Cr, Cu, Pb, Zn는 양의 상관성을 보였고, 반면 Cd, Co, Fe, Mn, Ni은 이들의 상관성이 낮은 것으로 보여 이들 원소들은 대기로부터 기인된 것으로 생각된다. 서울지역의 중금속 원소 분산을 등함량도의 원소별 패턴을 분석한 결과, 토양은 산업지역에서 Ni, Cr원소와 교통량 밀집지역에서 Cd, Cu, Zn원소의 오염도가 크고, 세척하지 않은 잎에 대한 Cd-Pb, Cu-Zn의 오염양상이 유사한 것으로 나타났다. 대기 중 부유된 원소별 부화지수 값을 예측을 위해 가로수 잎의 원소별 부화지수 값을 분석한 결과, Cu, Zn, Pb, Mn, Co, Ni, Cd, Cr 순으로 높았으며, 특히 서울지역에서는 Cu, Zn, Pb, Mn 으로 인한 오염이 심각한 것으로 판단된다.

• Clinical and Experimental Reproductive Medicine
• /
• 제2권2호
• /
• pp.27-36
• /
• 1975

The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

• Journal of Preventive Medicine and Public Health
• /
• 제20권1호
• /
• pp.165-203
• /
• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.