• Journal of Preventive Medicine and Public Health
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• 제56권2호
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• pp.128-144
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• 2023

Objectives: The health system reform process is highly political and controversial, and in most cases, it fails to realize its intended goals. This study was conducted to synthesize factors underlying the failure of health system reforms. Methods: In this systematic review and meta-synthesis, we searched 9 international and regional databases to identify qualitative and mixed-methods studies published up to December 2019. Using thematic synthesis, we analyzed the data. We utilized the Standards for Reporting Qualitative Research checklist for quality assessment. Results: After application of the inclusion and exclusion criteria, 40 of 1837 articles were included in the content analysis. The identified factors were organized into 7 main themes and 32 sub-themes. The main themes included: (1) reforms initiators' attitudes and knowledge; (2) weakness of political support; (3) lack of interest group support; (4) insufficient comprehensiveness of the reform; (5) problems related to the implementation of the reform; (6) harmful consequences of reform implementation; and (7) the political, economic, cultural, and social conditions of the society in which the reform takes place. Conclusions: Health system reform is a deep and extensive process, and shortcomings and weaknesses in each step have overcome health reform attempts in many countries. Awareness of these failure factors and appropriate responses to these issues can help policymakers properly plan and implement future reform programs and achieve the ultimate goals of reform: to improve the quantity and quality of health services and the health of society.

• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.55-65
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• 2022

Caring for patients with cancer is highly stimulating and rewarding, attracting health professionals to the field who enjoy the challenge of managing a complex illness. Health professionals often form close bonds with their patients as they confront ongoing disease or treatment impacts, which may be associated with multiple losses involving function and/or eventual loss of life. Ongoing exposure to patient loss, along with a challenging work setting, may pose significant stress and impact health professionals' well-being. The prevalence rates of burnout and compassion fatigue (CF) are significant, yet health professionals have little knowledge on these topics. A 6-week continuing education program consisting of weekly small-group video-conferencing sessions, case-based learning, and an online community of practice was delivered to health care providers providing oncology care. Program content included personal, organization and team-related risk and protective factors associated with CF, grief models, and strategies to mitigate against CF. Content analysis was completed as part of the program evaluation. In total, 189 participants (93% nurses) completed the program, which was associated with significant improvements in confidence and knowledge of CF and strategies to support self and team resilience. Qualitative themes and vignettes from experiences with the program are presented. Key themes included knowledge gaps, a lack of support related to CF and strategies to support resilience, organization-and team-based factors that can inhibit expression about the impacts of clinical work, the health professional as a "person" in caregiving, and the role of personal variables, self-skill practices, and recommendations for education and support for self and teams.

• 한국환경교육학회지:환경교육
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• 제23권2호
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• pp.46-64
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• 2010

The purpose of this study is to analyze how the contents of education for sustainable development are reflected in the middle school environment curriculum revised in 2007, and to propose how to integrate content for improving sustainable development education. For this, I analyzed the 2007 Revised Environment Curriculum for Middle Schools by using social network analysis which is the useful methodology to understand the relations of contents. Social Network analysis is a useful tool to excavate the forms of structure or relationship and to explain the characteristics of the system that arise through relationships or to explain the units composing the system. When sustainable development education was examined from 3 points of view, it included environmental sustainability, economical sustainability, and social sustainability. I used the 2007 Revised Environment Curriculum for Middle Schools and manual of curriculum for analysis. The results are 1) The biodiversity conservation and energy efficiency have taken most important positions. 2) In case of economical sustainability pillar, sustainable production had been emphasized. 3) In the case of the social sustainability pillar, health improvement are considered significant. 4) The efforts of trying to approach sustainable development education as an integrated curriculum is week. Integrated themes based on the results were developed. Five main themes were the energy and climate change, water resource and environmental pollution, sustainable village and sustainable food production, sustainable city and sustainable production, sustainable tourism and biodiversity. I hope these could function as theme of integrated-content. Based on the results of study, I propose joint researches on scope of sustainable development for environmental education.

• 과학교육연구지
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• 제44권3호
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• pp.273-288
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• 2020

본 연구에서는 2015 개정 교육과정 고등학교 통합과학 교과서에 나타난 과학의 본성(NOS) 분포를 분석하였다. 분석 대상은 2015 개정 교육과정으로 출판된 통합과학 교과서 5종 모두를 분석하였으며, 분석의 개념적 틀로는 과학적 소양 기반 4가지 영역의 과학의 본성(NOS)(Lee, 2013)을 활용하였다. 4가지 영역의 과학의 본성(NOS)은 1. 과학지식의 본성(nature of scientific knowledge), 2. 과학적 탐구의 본성(nature of scientific inquiry), 3. 과학적 사고의 본성(nature of scientific thinking), 그리고 4. 과학과 기술 및 사회의 상호작용의 본성(nature of interactions among science, technology, and society)이다. 분석은 2명의 분석자가 수행하였으며, 두 분석자간의 신뢰도는 Cohen's kappa 계수 0.83 ~ 0.96으로 비교적 높은 신뢰도 값을 나타냈다. 분석 결과는 다음과 같다. 첫째, 2015 개정 교육과정 통합과학 교과서에서는 과학의 본성(NOS) 4가지 측면 중에서 '과학탐구의 본성(nature of scientific inquiry)' 영역을 전반적으로 가장 강조하고 있었다. 이것은 통합과학 교과서 5개 출판사 전체 영역에서 '과학 탐구의 본성(범주 II)'의 분포가 평균 약 44 %로 나타나는 것에서 확인할 수 있었다. 둘째, 2015 개정 교육과정 통합과학 교과서는 출판사에 상관없이 '과학탐구의 본성(범주 II)'을 가장 강조하고 있었지만, 그외 다른 측면의 과학의 본성(NOS) 부분은 출판사별로 다소 차이가 나타나고 있었다. 따라서 통합과학 교과서들은 과학적 내용과 활동을 탐구하는 방법으로서 주로 제시하면서 출판사별로 다소 다르게 과학의 본성(NOS) 특징을 강조하고 있다고 말할 수 있다. 셋째, 2015 개정 교육과정 통합과학 교과서에서 강조하는 과학의 본성(NOS) 측면은 4. 환경과 에너지 단원을 제외하고 모든 단원에서 유사하게 나타났다. 이것은 과학의 본성(NOS) 단원별 분석 결과가 대부분의 단원에서 전체 교과서 분석 결과와 유사한 양상이었으며, 4. 환경과 에너지 단원에서만 범주 II의 '과학 탐구의 본성' 영역 다음으로 '과학-기술-사회와 상호작용하는 과학의 본성(STS)(범주 IV)'이 강조되고 있는 것에서 확인할 수 있다. 이와 같은 결과는 2015 개정 교육과정 통합 과학 교과서가 지난 교육과정에 비하여 비교적 다양하고 균형 있는 과학의 본성(NOS) 측면을 제시하고 있으며, 2015 개정 교육과정의 목표인 과학적 문제해결력과 창의력 증진을 위하여 과학적 탐구를 강조를 하고 있다는 것을 알 수 있었다.

• 대한수학교육학회지:학교수학
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• 제15권1호
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• pp.101-120
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• 2013

본 연구에서는 수학과 학습 개선 방안 탐색을 위하여 본 연구에서는 중학교 3학년 학생을 대상으로 함수 영역과 관련된 과제를 기반으로 하는 심층 면담을 실행하여 우리나라 중학생의 학습양식에서 나타나는 경향성을 탐구하였다. 심층면담에서 학생들이 제시된 과제를 해결한 뒤 해결방법에 대해 설명하는 과정에서 연구자는 학생들이 과제 해결에 활용한 수학적 아이디어가 형성된 배경에 대한 추가 질문을 제기하는 방식으로 그들의 학습양식에 관한 자료를 수집하였다. 면담 자료 분석 결과, 우리나라 중학생들의 대표적인 학습양식으로 '사례 중심의 귀납적 학습', '유형 중심의 문제 풀이 학습', '몰입없는 학습', 그리고 '학습태도의 이중성'을 도출하였고 면담 자료에 기초하여 이들 학습양식의 특징을 서술하였으며 수학과 교수-학습 개선을 위한 시사점을 논의하였다.

• 한국보건간호학회지
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• 제32권2호
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• pp.235-248
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• 2018

Purpose: This qualitative study examined the participation in ICT-based management from the perspectives of patients with chronic diseases. This study was conducted as one of several studies evaluating the effectiveness of chronic disease management in the Ministry of Health and Welfare. Methods: Focus group interviews were used as its guiding methodology. Group interviews with 16 patients were carried out using semi-structured interview questions developed from a literature review and discussion with researchers. Content analysis was used to analyze the data. Results: A total of 11 sub-themes were extracted through a comparison of the concepts and semantic analysis, and finally, four themes were derived: "Satisfied with systematic management of health care", "Leading in health care", "Understanding the pattern of blood pressure and blood sugar change" and "Adherence to existing health care habits". Conclusion: This study is meaningful in that it used qualitative analysis through FGI to evaluate the effects of an ICT-based chronic disease management project. Based on this study, a mixed-method design study and an intervention study among patients with metabolic syndrome is proposed.

• 대한간호학회지
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• 제47권3호
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• pp.367-379
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• 2017

Purpose: This study aimed to understand and describe the caring experiences of spouses of elderly people with dementia. Methods: The hermeneutic phenomenological method was used and participants were 12 spouses aged 65 and over who were taking care of their husbands or wives with dementia at home. Data were collected from individual in-depth interviews on participants' actual caring experiences. Additionally, novels, movies, and memoirs on elderly couples with partner who had dementia were included as data for the analysis. The qualitative data analysis software program was used to manage and process the collected qualitative data. Data were analyzed using hermeneutic phenomenological analysis based on four fundamental existentials including lived body, lived space, lived time, and lived others. Results: Five essential themes emerged from the analysis: 1) body moving like an old machine, 2) swamp of despair filling with hope, 3) sweet time after bitterness, 4) disappointed elderly couple in the empty nest, and 5) unappreciation vs. empathetic feelings. These essential themes were comprehensively summarized as "the road leading to the maturation of life with dedication and hope while bearing the weight of caring based on the couple's relationship." Conclusion: The findings indicate that the nature of the caring experience of spouses of elderly individuals with dementia is filled with many dynamic and paradoxical dimensions. Thus, results of the study would help with developing interventions tailored specifically for elderly spouse caregivers to support their role adaptation and ultimately improving their quality of life.

• 한국간호교육학회지
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• 제28권3호
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• pp.223-235
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• 2022

Purpose: This study aimed to explore nursing students' experience with community-linked nursing education programs. Methods: This study utilized a qualitative content analysis. Participants were 55 sophomore nursing students. The community-linked nursing education program was conducted for eight weeks using the Analysis, Design, Development, Implementation, Evolution (ADDIE) model. Data were collected from 55 reflection records and five individual interviews and then analyzed through the three steps of qualitative content analysis, coding, condensing, and categorizing. Results: Twelve categories, 26 subcategories, and six topics emerged. The themes of impression and lesson from the community-linked nursing education programs were "recognizing the importance of professional competence in performing the role of nurse," "recognizing the need for leadership and cooperation in nursing practice," and "increased awareness of the role as a nursing professional for community residents." The themes of the strategies used were "looking at the goal and moving forward," and "aligning differences and working together with team/community members." The theme of strategies for the advancement of community-linked nursing education programs was "establishing a sustainable student-participating community-linked education program." Conclusion: The community-linked nursing education programs made students aware of the necessary competencies as professionals. In particular, they gave them hope for their role as professional nurses in the community. It could also be seen that they developed the ability to engage in team activities for community activities. Community-linked nursing education programs will need to be developed into continuous programs with community residents.

• 동의신경정신과학회지
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• 제34권3호
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• pp.319-334
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• 2023

Objectives: The purpose of this study was to identify the doctor-patient relationship perceived by doctors in clinical settings and the effect of doctor-patient relationships on treatment schemes. A qualitative case study was conducted for this purpose. Methods: In-depth interviews were conducted with five oriental medicine doctors and doctors working in clinical settings using a semi-structured questionnaire. Transcription and coding were performed to analyze the data. By analyzing each case individually through within-case analysis, we attempted to find themes that emerged from the research subjects' experiences with establishing relationships with patients. Afterward, a cross-case analysis was conducted to identify the meaning of the experiences through commonalities and differences. Results: Within-case analysis confirmed the thoughts and emotions of the research participants in recognizing, defining, and participating in doctor-patient relationships while delivering treatments. Case-to-case analysis derived two themes, seven categories, and 20 meaningful units for doctor-patient relationships. Conclusions: The study found that a doctor-patient relationship regarding patient treatment could be established based on the doctor's 'professional qualifications' and 'human qualities'. In the future, it is necessary to present an educational model for relationship-based intervention techniques and personality maturity. Follow-up research should be conducted to enable the establishment of therapeutic relationships between doctors and patients.

• 여성건강간호학회지
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• 제18권1호
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• pp.49-61
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• 2012

Purpose: The purpose of this study was to examine the experiences of the use of external breast prostheses among breast cancer survivors in Korea. Methods: A qualitative descriptive study was conducted, using focus groups. Data were collected from breast cancer survivors who were patients of C women's hospital in Seoul, Korea. Data were analyzed using content analysis in order to identify significant themes. Results: Participants included forty breast cancer survivors who had mastectomy as a surgical treatment. Four themes emerged from the collected data were: 1) concern over the high price of external breast prosthesis, 2) irregular use of external breast prosthesis, 3) unsatisfied with mastectomy bra, and 4) wanting to hide or not to talk about using breast prosthesis openly. Conclusion: Since most participants reported irregular use and negative experiences related to external breast prosthesis or mastectomy bra use, healthcare workers should allow more time for proper fitting and counseling and consulting with breast cancer survivors. In addition, health care providers as well as family and friends should keep in mind that cancer survivors need support that can help them cope by using positive reframing. Furthermore, improvements in the coverage of costs and services are needed for these women. This would be helpful for breast prosthesis users.