• 제목/요약/키워드: social work skills

검색결과 183건 처리시간 0.037초

치과의사와의 관계에서 치과위생사와 간호조무사의 직종 간 갈등 연구 (A study on conflicts between different occupational categories of dental hygienists and nursing assistances in terms of relationships with dentist)

  • 문희정;김영선;성미경
    • 대한치위생과학회지
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    • 제1권2호
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    • pp.9-19
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    • 2018
  • The purpose of this study was to examine the state of conflicts among dental health care workers. A survey was conducted on 266 dental hygienists and nursing assistants who worked in dental institutions from September 12 to November 13, 2017, and SPSS(statistical package for the social science) version 20.0 was employed to analyze the collected data. The findings of the study were as follows: 1. The most common reason of the dental hygienists for turnover was working hours and heavy workload(24.6%), followed by pay (22.6%), conflicts with dentists(16.0%) and conflicts with colleagues (11.3%). The most dominant reason of the nursing assistants for turnover was pay(31.1%), followed by working hours(24.4%), heavy workload(17.8%), conflicts with dentists(15.6%) and conflicts with colleagues(8.9%). 2. The largest reason for unsuccessful communication with dentists was that heavy workload reduced the opportunity to communicate well(54.5%). The second biggest reason was that they couldn't communicate well though they had the opportunity(24.0%), and the third greatest reason was that they tended to lag behind dentists in terms of professional knowledge(16.9%). 3. The biggest reason for unsuccessful communication among the dental health care workers was that they didn't have a lot of chances to communicate well on account of heavy workload(41.0%). The second largest reason was the differences in professional knowledge(24.9%), and the third greatest reason was that they couldn't communicate well though they had the chance(23.7%). 4. The most dominant reason for conflicts with dentists was the difference in power(24.0%), followed by poor communication skills(22.1%) and a lack of mutual respect(18.1%). But the opinions of the nursing assistants were different from those of the dental hygienists, as they cited poor communication skills as the most common reason, which was followed by the difference in power and a shortage of understanding of each other's work. 5. The most common reason for conflicts among the dental health care workers was a shortage of communication and communication skills(22.9%), and the second most dominant reasons were a lack of mutual respect and poor understanding of each other's work(17.5%), followed by a lack of mutual respect(17.2%). 6. As to the ways of resolving conflicts with dentists, the most common case was making some mutual concessions to compromise (28.9%), followed by delivering opinions through the staff meeting (23.9%), resolving conflicts by candidly exchanging opinions(15.8%), avoiding each other in moderation(11.7%) and following the opinions or assertions of dentists(1.3%). 7. Concerning the conflict resolution methods among the dental health care workers, the most prevalent way was making some mutual concessions to compromise(36.4%), followed by resolving conflicts by candidly exchanging opinions(23.0%) and conveying opinions through the staff meeting(18.5%). 8. Regarding communication among the dental health care workers, the dental hygienists(3.53±.729) considered themselves to be better at communicating than the nursing assistants(3.29±.745) did(p<0.05), and the dental hygienists(3.45±.809) who thought there was respectful treatment among workers who were different in occupational categories found themselves to be better than the nursing assistants(3.21±.952) who had the same thought did(p<0.05). As a result of analyzing whether frequent job-related meetings occurred among the workers whose occupational categories were different, the dental hygienists(3.05±.975) perceived that there were more frequent meetings than the nursing assistants(2.67±.955) did (p<0.01).

청소년 임신과 스트레스 (Adolescents Pregnancy and Stress)

  • 김만지
    • 한국사회복지학회:학술대회논문집
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    • 한국사회복지학회 2000년도 춘계학술대회 자료집
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    • pp.615-628
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    • 2000
  • 스트레스란, 개인과 환경간의 특별한 관계가 개인의 안녕을 위협하고 개인이 가진 자원을 초과하는 것을 말한다. 븐 연구는 청소년 임신과 스트레스에 관한 문헌연구를 통하여 청소년 임신과스트레스와의 관계에 대해서 살펴봄으로써 임신력 있는 청소년들을 위한 스트레스 관련 임상사회 사업 서비스 개입 방안을 제시하고자 하는데 목적이 있다. 임신으로 인한 부모됨의 변화가 청소년기 자체의 인생 주기 상에서의 스트레스와 중복될 때, 누적된 스트레스는 보다 커진다. 변화의 중첩은 개인 역할의 애매함을 초래하여 스트레스를 가중시키고 발달 과업의 우선순위에 혼란을 가져온다. 청소년기의 임신은 성인기로 이동하는 청소년 당사자, 그 자녀, 사회이 부정적인 영향을 미친다. 이러한 부정적인 영향은 단기간에 끝나지 않으므로 임신한 청소년들의 대처 기술과 적응력을 향상시키기 위한 개입의 노력이 필요하다. 임신한 청소년들의 경우에는 개인 상담 접근만으로는 불충분하며 효과적인 예방 프로그램은 보다 나은 대안이자 동시에 목적이 될 수 있다. 이러한 개입은 임신한 청소년들을 출산 이후에 노출되기 쉬운 디스트레스로부터 보호해주고 성인으로 성장하게 될 청소년들의 건강한 정신건강 도모이 기여하는 것으로 나파났다. 이는 결국, 임신한 청소년들을 대상으로 한 스트레스 대처 능력을 향상시키고 긍정적인 인지를 발달시킬 수 있는 스트레스 관리 프로그램의 필요성을 암시하고 있다. 이러한 연구 결과가 갖는 결론과 함께 앞으로 실천적 개입방안에 대한 더욱 정교한 연구가 요구된다.

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현장실습경험이 대학생의 진로자신감에 미치는 영향에 관한 연구 (The Effect of Field Practice on Career Confidence of University Students)

  • 가혜영;김보영
    • 벤처창업연구
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    • 제16권2호
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    • pp.143-152
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    • 2021
  • 최근 대학은 정부의 청년고용 활성화 정책 방향과 사회변화에 따른 산업 수요에 대응하기 위하여 더 넓은 범위의 기술적, 사회적 스킬을 교육하도록 요구받고 있다. 이에 따라, 대학의 현장실습은 더욱 강화되고 있다. 학생들이 현장실습을 통해 얻은 일 경험과 정보가 진로에 대한 자신감을 향상시키고, 아울러 졸업 이후에는 취업뿐만 아니라 창업의 동기로 작용할 수 있는지를 확인하는 것은 중요하다. 본 연구에서는 학생들이 현장실습을 통해 진로에 대한 자신감을 향상시킴으로써 그에 따른 결과와 행동을 끌어내는 동기적 측면에 대해 분석하였다. 아울러 현장실습 경험이 고용 가능성과 창업 의도에 주는 영향을 자기 주도적 경력 태도를 매개변수로 설정하여 함께 살펴보았다. 본 연구의 주요 결과는 다음과 같다. 첫째, 대학생의 현장실습 경험은 고용 가능성에 유의한 영향을 미치지만 창업 의도에는 직접적으로 유의한 영향을 미치지 않는 것으로 나타났다. 둘째, 현장실습 경험이 있는 학생은 자기 주도적 경력 태도가 높을수록 고용 가능성에서 정(+)의 영향을 미치는 것으로 나타났다. 셋째, 자기 주도적 경력 태도가 높을수록 창업 의도에 정(+)의 영향을 미치는 것이 확인되었다. 본 연구에서는 취업과 창업으로 양분되던 기존의 연구에서 벗어나 대학생의 현장실습 활동이 고용 가능성과 창업 의도에 미치는 영향을 분석하고자 하였다. 이를 통하여 대학이 정부의 취·창업지원정책을 충족시키는 동시에 실질적인 성과를 거둘 수 있는지 분석하는 이론적 토대를 제공하고자 한다.

독어권 국가의 도제훈련제도 비교연구 (A Comparative Study of the Vocational Education Training in Germany, Switzerland and Austria)

  • 최수정;배수현;정성지
    • 직업교육연구
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    • 제35권6호
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    • pp.113-141
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    • 2016
  • 세계 경제 위기에 따라 심화되는 청년 실업 문제에 대한 해결책으로 도제훈련제도가 제시되었다. 이는 기업이 청년층을 고용하여 직접 인력을 양성하는 제도로서 각국에서 시행하고 있으며, 우리나라에서는 '일학습병행제'로 실시되고 있다. 한국형 도제훈련은 독어권 국가인 독일과 스위스의 도제훈련에 의해 시작되었다. 독어권 국가들의 도제훈련제도는 성공적인 사례로서 공통적으로 기업이 주도하는 수요중심적인 훈련이라는 특징을 갖고 있다. 또한 도제훈련이 교육과정에 통합되어 있어 학업과 연계가 가능했고, 학생 또한 적극적으로 훈련에 참여하고 있다. 이에 본 연구는 성공적으로 운영되고 있는 독일, 스위스, 오스트리아 독어권 국가들의 도제훈련제도를 살펴 공통점과 예비도제훈련과정, 도제훈련과정 운영, 운영주체, 기업 내 트레이너, 비용 편익분석 측면에서의 차이점을 심층적으로 분석하였다. 연구의 결과로 주요요소별 비교사항은 다음과 같다. 첫째, 독일은 도제훈련 이전 예비과정으로 실습을 진행하는 반면, 스위스와 오스트리아는 예비교육과정코스가 운영된다. 둘째, 독일과 스위스는 단일형의 도제훈련을 제공하는 반면, 오스트리아의 경우 모듈형으로 도제훈련을 진행하고 있다. 셋째, 독어권 국가는 사회적 파트너가 적극적으로 참여하는 운영 체계로서 산업이 요구하는 요소를 시스템에 적극적으로 반영하고 있다. 넷째, 독어권 국가는 기업 내 트레이너의 자격을 명시하여 기업 내 현장훈련의 질 관리를 엄격하게 시행하고 있다. 다섯째, 기업의 비용 편익 분석에 있어 독일과 오스트리아는 편익보다 비용이 많이 드는 반면, 스위스는 비용보다 순이익이 발생한다. 이러한 세 국가의 비교 분석을 바탕으로 한국의 일학습병행제에 시사점을 제공하고자 한다.

만 7~9세 학령기아동의 감각통합 임상관찰평가의 발달기준에 관한 일연구 (Developmental Standard of the Short Sensory Profile for Korean Children of School Age (7 to 9 years old))

  • 지석연;김미선;금효진;김성희
    • 대한감각통합치료학회지
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    • 제7권1호
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    • pp.27-36
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    • 2009
  • 서론: 작업치료사들이 임상에서 아동의 감각통합 기능을 평가할 때, 기초적인 요소로써의 감각, 운동에 관한 신경근계 검사로써임상관찰을 사용하는 것은 표준화된 검사들을 보완하는 것과 더불어 보다 정확한 추론을 위해 중요한 것으로 여겨진다. COMPS(Clinical Observations of Motor and Postural Skills)는 임상관찰의 일부 내용을 7개 항목으로 정리하여 통계적으로 표준화 한 검사도구로서 아동의 문제가 신경근계와 감각통합에 기인한 것인지를 보다 간소한 과정을 거쳐 선별'하는 데 목적을 두고 있다. 선행연구들에서 부분적으로 국내 아동의 점수가 외국규준에 비해 높은 것으로 나타나는 등, 국내 적용을 위한 연구가 필요하다. 이에 본 연구에서는 국내 일반아동에게 COMPS를 실시하여 국내의 정상군 검사결과와 항목에 대한 분석을 통해 우리나라에 맞는 발달기준을 제시하고자 하였다. 연구방법: 7~9세 남학생 76명, 여학생 70명을 대상으로 하였다. 연령대별로는 7세군에서 남학생 21명, 여학생 29명, 8세군에서 남학생 32명, 여학생 22명, 9세군에서 남학생 23명, 여학생 19명이었다. 결과 분석은 COMPS 항목에 대한 성별, 연령별 차이를 분석하기 위해 t 검정과 ANOVA를 실시하였다. 결과: 남녀 성별간에는 복와위 신전 항목을 제외한 나머지 6개 항목에서는 유의미한 차이를 보이지 않았다. 연령별 결과는 7세와 9세간의 차이를 유의미하게 보이는 항목이 느린 동작, 손가락-코 짚기, 비대칭경반사, 배와위 굴곡이었고, 8세와 9세간에서는 느린 동작, 손가락-코 짚기, 비대칭경반사 항목에서 유의미한 차이를 보였다. 7세와 8세간에서는 통계적으로 유의미한 차이는 없는 것으로 나타났다. 결론: 본 연구를 통하여 국내의 7~9세 사이의 임상관찰검사를 통한 신경근계의 발달적인 특성을 살펴볼 수 있었다. 연구대상을 보다 확대하여 국내인구에서의 임상관찰평가를 표준화하는 연구가 이루어질 필요가 있을 것이다.

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조선시대(朝鮮時代) 전기(前期)의 의료제도(醫療制度)에 대한 연구(硏究) (A study of the Medical System in the Early Chosun-Dynasty)

  • 한대희;강효신
    • 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.

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간호학 교과과정 개선을 위한 조사 연구 (A Study on improvement of curriculum in Nursing)

  • 김애실
    • 대한간호학회지
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    • 제4권2호
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    • pp.1-16
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    • 1974
  • This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

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서울시 일 지역 주민의 인생회고 및 죽음준비 인식 (Community Dwellers' Perception of Past Life Recollection and Preparation for Death)

  • 강경아;이경순;박강원;김용호;장미자;이은
    • Journal of Hospice and Palliative Care
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    • 제14권2호
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    • pp.81-90
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    • 2011
  • 목적: 본 연구는 서울시 노원구 주민을 대상으로 자신의 인생회고 및 품위 있는 죽음에 대한 인식 정도를 파악하고자 수행되었다. 방법: 본 연구는 서울시 노원구에 거주하는 40대 이상 성인을 대상으로 설문에 참여할 것을 서면 동의한 160명의 자료가 분석되었다. 본 연구팀에 의해 개발된 설문지는 내용타당도 검증절차를 통해 일부 문항이 수정되었으며, 설문내용은 총 28문항이었다. 수집된 자료는 서술적 통계방법을 이용하여 분석하였다. 결과: 대상자들이 가장 힘들었다고 회고하는 연령대는 30~40대였고 반면 가장 보람되었다고 생각하는 기간도 30~40대였다. 가장 힘든 인생고비경험에서, 개인적으로는 가족이 건강을 잃었을 때, 부부 및 자녀와의 갈등이 가장 힘들었던 사건으로 회고하고 있었고, 가장 힘들었던 사회관계는 삶에 대한 상실감 경험, 실패, 친척 및 친구의 배신 등 이었으며, 가장 보람되었다고 회고하는 내용에서, 개인적 사건은 목표성취, 인생의 역경 극복이었고, 가족관계에서는 자녀로 인한 즐거움이 월등히 높았고, 사회관계에서는 직업을 통한 사회공헌, 봉사활동, 성실한 종교생활이었다. 가장 후회하는 삶의 경험에는, 자신의 삶에서는 목적 없이 바쁘게만 살아온 것, 여유 있는 시간을 갖지 못한 것이었고, 부모형제관계에서는 부모의 뜻을 잘 살피지 못하고 많은 시간을 갖지 못한 것과 형제들과 불화이었으며, 자녀와의 관계에서는 올바로 훈육하지 못한 것과, 사랑을 많이 주지 못한 것이었다. 직장 및 사회관계에서는 원하는 직업을 갖지 못한 것과 관계보다는 일 중심으로 살아온 것과 대인관계 기술부족이 두드러진 회고내용이었으며 건강에 관해서는 운동이 부족한 점 등이었다. 대상자들이 인식하고 있는 임종과 죽음준비에 대한 내용으로, 약 60%에서 자신의 종교에 대한 강한 믿음을 가지고 있었고, 약 50%에서 종교에 따른 내세관을 소유하고 있었다. 무의미한 연명치료로 생명을 연장하는 상황에 처했을 경우, 약 87% 이상에서 본인 및 가족의 경우 모두 무의미한 연명치료 중단 의사를 가지고 있었으며, 불치의 질병인 경우 진단을 정확히 말해주기 원함, 유언장 및 사전의료의향서 작성하기 원함이 4점 척도 중 약 3.1점 이상으로 높게 나타났다. 결론: 본 연구결과를 토대로 중 노년층을 위한 죽음 준비교육 내용 중 인생회고 시간에서는 과거의 경험을 후회하는 사건이 아닌 일어난 사실 그대로 받아들이며 자신의 삶으로 통합하도록 돕는 기회가 주어져야 하며, 사전의료의향서를 작성함으로 연명치료 중단, 심폐소생술 금지, 임종 장소 등 자기결정권이 부여되는 품위 있는 죽음을 준비할 수 있도록 하는 수요자 중심의 죽음 준비교육을 제공해야 하겠다.

간호사를 위한 호스피스 완화의료 교육과정 개발 (Curriculum Development for Hospice and Palliative Care Nurses)

  • 최은숙;김현숙;이소우;유양숙
    • Journal of Hospice and Palliative Care
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    • 제9권2호
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    • pp.77-85
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    • 2006
  • 목적: 호스피스 완화간호 실무를 향상시키기 위하여 간호사를 위한 호스피스 완화의료 기본 교육과정을 개발하기 위함이다. 방법 간호사를 대상으로 하는 국내외 호스피스 완화의료 7개 교육과정의 내용을 비교하였으며, 전국의 호스피스 완화의료 기관에서 근무하는 간호사 162명에게 우편으로 교육 요구도를 조사하였다. 결과: 1. 국내외 교육과정에서 공통적으로 다루고 있는 내용은 호스피스 완화요법의 이해, 삶과 죽음의 이해, 말기 환자의 통증 및 증상관리, 기관견학 및 실습, 호스피스 병동 운영의 실제, 가정 호스피스, 건강사정(신체사정), 치료적 의사소통, 아동 호스피스, 호스피스 운영관리, 호스피스 완화의료 팀, 호스피스 완화의료의 윤리와 법, 심리적 사회적 영적 돌봄, 임종 관리, 사별가족관리 등이었다. 2. 간호사의 호스피스 완화의료에 대한 교육 요구도가 3.5점 이상인 문항은 34개였다. 교육 요구도가 높았던 문항은 '죽음의 이해 ', '죽음에 대한 태도와 반응', '통증의 이해와 평가' 등이었고, 이전에 교육받은 경험이 많았던 문항은 '통증 및 증상완화', '호스피스의 윤리와 법', '호스피스 협력 및 홍보체계 구축'이었다. 3. 17개 내용을 강의, 토론 및 증례 등의 교육방법을 통하여 이론교육 48시간과 실습교육 30시간, 총 78시간의 기본 교육과정 을 구성하였다. 결론: 앞으로 개발된 교육과정으로 교육을 시행하여 효과를 평가하고, 호스피스 완화의료기관 실무자들의 교육 요구도를 정기적으로 파악하여 실무의 발전에 기여할 수 있는 표준 교육과정을 개발하는 것이 필요하다.

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고위험가족 선별을 위한 위험요인 분석 (The factors to identify high risk family)

  • 방숙명
    • 대한간호학회지
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    • 제25권2호
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    • pp.351-361
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    • 1995
  • The main purpose of the study is to identify critical risk factors for development of a family assessment tool to screen high risk family. This study used a conceptual framework of family diagnosis developed by Eui-sook Kim's (1993) and analyzed risk factors to identify the high risk family. As employing a explorative and methodological study design, this study has four stages. 1. In the first stage, 34 family risk factors were identified by doing intensive literature review on conceptual framework of family diagnoses. 2. In the second stage, above risk factors were tested for content validity by consultation with 29 persons in community health nursing, nursing education, family theory, and social work. 3. In the third stage, existing survey data was used for actual application of the identified risk factors. The survey data used for this purpose was previously collected for the community diagnosis in a region of Seoul. At the final stage, through the comparison between high risk and low risk families, initially identified 34 risk factors decreased to 25 risk factors. Among 34 risk factors, six factors did not agree with content of questionnaries sand two factors were not significant in differentiating the high risk family Also, two risk factors showed high correlation between themselves, so only one of those two factors was chosen. As a result, twenty-five risk factors chosen to identify the high risk family are following ; 1. A single parent family due to divorce or death of a partner, or unweded single mother 2. A family with an unrelated household members 3. A family with a working mother with a young child 4. A family with no regular income 5. A family with no rule in family or too strict rules 6. A family with little or no support from other lam-ily members 7. A family with little or no support from friends or relatives 8. A family with little or no time to share with each other 9. A family with family history of hypertension, diabetus, cancer 10. A family with a sick person 11. A family with a mentally ill person 12. A family with a disabled person 13. A family with an alcoholic person 14. A family with a excessive smoker who smokes more than 1 pack / day 15. A family with too much salt intake in their diet. 16. A family with inappropriate management skills for family health 17. A family with high utilization of drug store than hospital to solve the health problems of the family 18. A family with disharmony between husband and wife 19. A family with conflicts among the family members 20. A family with unequal division of labor among family members 21. An authoritative family structure 22. A socially isolated family 23. The location of house is not residential area 24. A family with high risk of accidents 25. The drinking water and sewage systems are not hygienic. The main implication of the results of this study is clinical use. The high risk factors can be used to identify the high risk family effectively and efficiently. The use of high risk factors woule contribute to develop a conceptual framework of family diagnosis in Korea and the list of risk factors need to be revised continuously. Further researches are needed to develop an index of weight of each risk factor and to validate the risk factors.

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