• Title/Summary/Keyword: 사이 중심성

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Daesoonjinrihoe from both Superficial Religious Perspectives and Deep Religious Perspectives : Focused on Religious Experience (표층과 심층의 시각에서 바라본 대순진리회 - 종교적 경험의 관점에서 -)

  • Lee, Eun-hui
    • Journal of the Daesoon Academy of Sciences
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    • v.27
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    • pp.245-282
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    • 2016
  • Currently, the whole world is being swept away by spiritual movements seeking divinity in oneself. Yet there are terror attacks, religious disputes and other conflicts continuously taking place on larger and larger scales as well as expanding further and further throughout the world. Interreligious harmony seems like a distant ideal. What is the ultimate cause of religious conflicts? Is interreligious communication truly that difficult? Even among different cultures, said cultures' varieties of ritual expressions, and various religious doctrines, there are points of general common to be appreciated if a deep perspective is adopted. When we find the common ground and understand each other's difference, it will be easier to communicate since everyone will be learning from each other. What could serve as common ground for different religions? Many scholars speak about the state of 'oneness' that is claimed by mysticism throughout a large array of religions. This state of oneness is typically not achieved overnight, but it serves as a prospective state which is pluralistically inclusive. This "religion of enlightenment" emphasizes the process of reaching comprehensive interreligious agreement would be characterized by a deep religious perspective. If superficial religious perspectives focuses only on faith to attain blessings and engage in blind belief, then, by contrast, deep religious perspectives emphasize inner divinity, the true self, orthe higher self. The words, 'superficial religious perspective' and 'deep religious perspective' were defined for personal convenience by O Gang-nam, a scholar of comparative religion. Consequently, this classification is a relative binary concept lacking hard and fast rules with regards to distinctions. But the concept of superficial religious perspectives and deep religious perspectives has its advantage in allowing clearer and easier discussion about religions because it could embrace all aspects of religious life and the development of various religious sentiment. In this way, the terms surface religious perspectives and deep religious perspectives will be used in limited framework. I both borrow this concept and reconsider it by referring to other scholars' methods of classification. From that point, I explore and these views in relation to religious experience. How does religiosity develop, maturity of religious faith take place, deep awareness of truth reveal itself, or an attitude of open-mindedness arise? After these states are realized, is interreligious agreement possible? Most religious studies scholars point out 'religious experience.' They say people could develop their faith from superficial religious beliefs into a more mature and deeper faith through religious experience while continuously aspiring towards enlightenment and practicing their religion in daily life. This study will try to examine aspects of superficial religious perspectives and deep religious perspectives represented in each religion and also explore criticism of each religion. With this view of superficial religious perspectives and deep religious perspectives, some cases documenting the religious experience of Daesoonjinrihoe disciples will be analyzed to see how their religiosity develops from superficial religious perspectives into deep religious perspectives through certain religious experiences. The characteristics of those experiences will also be investigated.

Status and Implications of Hydrogeochemical Characterization of Deep Groundwater for Deep Geological Disposal of High-Level Radioactive Wastes in Developed Countries (고준위 방사성 폐기물 지질처분을 위한 해외 선진국의 심부 지하수 환경 연구동향 분석 및 시사점 도출)

  • Jaehoon Choi;Soonyoung Yu;SunJu Park;Junghoon Park;Seong-Taek Yun
    • Economic and Environmental Geology
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    • v.55 no.6
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    • pp.737-760
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    • 2022
  • For the geological disposal of high-level radioactive wastes (HLW), an understanding of deep subsurface environment is essential through geological, hydrogeological, geochemical, and geotechnical investigations. Although South Korea plans the geological disposal of HLW, only a few studies have been conducted for characterizing the geochemistry of deep subsurface environment. To guide the hydrogeochemical research for selecting suitable repository sites, this study overviewed the status and trends in hydrogeochemical characterization of deep groundwater for the deep geological disposal of HLW in developed countries. As a result of examining the selection process of geological disposal sites in 8 countries including USA, Canada, Finland, Sweden, France, Japan, Germany, and Switzerland, the following geochemical parameters were needed for the geochemical characterization of deep subsurface environment: major and minor elements and isotopes (e.g., 34S and 18O of SO42-, 13C and 14C of DIC, 2H and 18O of water) of both groundwater and pore water (in aquitard), fracture-filling minerals, organic materials, colloids, and oxidation-reduction indicators (e.g., Eh, Fe2+/Fe3+, H2S/SO42-, NH4+/NO3-). A suitable repository was selected based on the integrated interpretation of these geochemical data from deep subsurface. In South Korea, hydrochemical types and evolutionary patterns of deep groundwater were identified using artificial neural networks (e.g., Self-Organizing Map), and the impact of shallow groundwater mixing was evaluated based on multivariate statistics (e.g., M3 modeling). The relationship between fracture-filling minerals and groundwater chemistry also has been investigated through a reaction-path modeling. However, these previous studies in South Korea had been conducted without some important geochemical data including isotopes, oxidationreduction indicators and DOC, mainly due to the lack of available data. Therefore, a detailed geochemical investigation is required over the country to collect these hydrochemical data to select a geological disposal site based on scientific evidence.

Characteristics of Mise en abyme expression in Modern architectural space - Focusing on the construction work of Jean Nouvel - (현대 건축 공간에서 나타난 미장아빔적 표현 특성 - 장누벨의 건축 작품을 중심으로 -)

  • Yoon, Deuk Geun;Kim, Kai Chun
    • Korea Science and Art Forum
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    • v.20
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    • pp.315-326
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    • 2015
  • This study has started from a curiosity about how the concept and characteristics of mise en abyme, which is one of meta-discourse in the contemporary aesthetics and has affected every aspect of modern philosophy, art, and culture, are expressed in modern architecture. 'Mise en abyme' is a technique mainly used by writers of the nouveau roman after it was introduced first in the work of novelist Andre Gide; this technique of artistic expression has been extended across the whole contemporary art and has become the meta-discourse which essentially makes its appearance in the art after postmodernism. 'Mise en abyme', meaning endless formation of image between two mirrors, got involved with discourse of the various philosophers of the time such as Deleuze and Derrida, and was also expressed in the language of architecture by modern architects who have been influenced by their philosophy. In this context, the technique of mise en abyme which is mostly used in art has a relation to methods of space expression of architects. This research studied the characteristics of mise en abyme which show in the expressional method of the modern architecture based on the relationship between the technique of mise en abyme and the modern method of architectural expression. Moreover, on the basis of this an analysis was carried out on architectural works of Jean Nouvel, who uses de-materialization and singularity as the architectural language. Through the research it was confirmed that the characteristics of expression of mise en abyme in architecture are embodied in material of the surface which forms buildings' exterior, or expressed by using reflection and graphical factors. Through analysis this study allows the chance to see that even though the means and field for expressing mise en abyme are different, the characteristics of the fundamental concept are shared among them, and to think about the meaning in the technique of mise en abyme as one yardstick to understand modern architecture in modern times with no specific mainstream.

A Study on the Effect of Healing Experience Program on Satisfaction: Focused on Experience Cost and Experience Time (치유체험프로그램이 만족도에 미치는 영향에 관한 연구: 체험비용과 체험시간을 중심으로)

  • An, Hye-Jung;Kan, Soon-Ah
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.3
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    • pp.183-200
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    • 2022
  • This study is a study on the effect of a healing experience program on satisfaction in the field of healing agriculture. In the development of a rural experience program, what factors constituting the healing experience program affect satisfaction, and how much time and participation cost affect the satisfaction of the healing experience program from the marketing point of view of the healing experience program. I want to analyze By researching the effect of experience cost and experience time on satisfaction of the healing experience program, I would like to suggest the development direction of the healing experience program. To this end, by empirically analyzing the effect of a healing experience program using experience cost and experience time as parameters on satisfaction, we present a theoretical basis for priority considerations when developing a rural experience program. There are entertainment experience, educational experience, deviant experience, and aesthetic experience as sub-factors of the experience program, experience time and experience cost as parameters, and satisfaction as a dependent variable. In addition, the reliability of the research results was secured by setting the demographic variables of the survey subjects as control variables. The empirical analysis was conducted on 314 valid questionnaires from the unspecified majority who were interested in or aware of the healing experience program. SPSS v22.0 was used, and to test the mediating effect, the three-step verification method of Baron & Kenny(1986) and the SPSS PROCESS Macro Model No. of Andrew F. Hayes(2018). 4 The reliability of the mediating effect was secured by applying the verification method and comparing the analysis resul. As a result of the study, it was found that educational experience (𝛽=.134, t=1.759*) had a positive (+) effect on experience cost, and aesthetic experience (𝛽=.144 t=1.684*) had a positive (+) effect on experience time. +) was found to have an effect. Also, educational experience (𝛽=.239, t=4.112***) was found to have a positive (+) effect on satisfaction, and aesthetic experience (𝛽=.330 t=4.921***) had a positive effect on satisfaction. It has been shown to have a (+) effect. Experience time was found to have a negative (-) inconsistent mediating effect between aesthetic experience and satisfaction. That is, it is the total effect (𝛽=.330 t=4.921***), and the direct effect (𝛽=.349 t=5.241***) increased by 𝛽=.019 compared to the total effect when the experience time was input, while the indirect effect (𝛽=-.019), which was shown to exert a negative (-) mediating effect.

Eurasian Naval Power on Display: Sino-Russian Naval Exercises under Presidents Xi and Putin (유라시아 지역의 해군 전력 과시: 시진핑 주석과 푸틴 대통령 체제 하에 펼쳐지는 중러 해상합동훈련)

  • Richard Weitz
    • Maritime Security
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    • v.5 no.1
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    • pp.1-53
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    • 2022
  • One manifestation of the contemporary era of renewed great power competition has been the deepening relationship between China and Russia. Their strengthening military ties, notwithstanding their lack of a formal defense alliance, have been especially striking. Since China and Russia deploy two of the world's most powerful navies, their growing maritime cooperation has been one of the most significant international security developments of recent years. The Sino-Russian naval exercises, involving varying platforms and locations, have built on years of high-level personnel exchanges, large Russian weapons sales to China, the Sino-Russia Treaty of Friendship, and other forms of cooperation. Though the joint Sino-Russian naval drills began soon after Beijing and Moscow ended their Cold War confrontation, these exercises have become much more important during the last decade, essentially becoming a core pillar of their expanding defense partnership. China and Russia now conduct more naval exercises in more places and with more types of weapons systems than ever before. In the future, Chinese and Russian maritime drills will likely encompass new locations, capabilities, and partners-including possibly the Arctic, hypersonic delivery systems, and novel African, Asian, and Middle East partners-as well as continue such recent innovations as conducting joint naval patrols and combined arms maritime drills. China and Russia pursue several objectives through their bilateral naval cooperation. The Treaty of Good-Neighborliness and Friendly Cooperation Between the People's Republic of China and the Russian Federation lacks a mutual defense clause, but does provide for consultations about common threats. The naval exercises, which rehearse non-traditional along with traditional missions (e.g., counter-piracy and humanitarian relief as well as with high-end warfighting), provide a means to enhance their response to such mutual challenges through coordinated military activities. Though the exercises may not realize substantial interoperability gains regarding combat capabilities, the drills do highlight to foreign audiences the Sino-Russian capacity to project coordinated naval power globally. This messaging is important given the reliance of China and Russia on the world's oceans for trade and the two countries' maritime territorial disputes with other countries. The exercises can also improve their national military capabilities as well as help them learn more about the tactics, techniques, and procedures of each other. The rising Chinese Navy especially benefits from working with the Russian armed forces, which have more experience conducting maritime missions, particularly in combat operations involving multiple combat arms, than the People's Liberation Army (PLA). On the negative side, these exercises, by enhancing their combat capabilities, may make Chinese and Russian policymakers more willing to employ military force or run escalatory risks in confrontations with other states. All these impacts are amplified in Northeast Asia, where the Chinese and Russian navies conduct most of their joint exercises. Northeast Asia has become an area of intensifying maritime confrontations involving China and Russia against the United States and Japan, with South Korea situated uneasily between them. The growing ties between the Chinese and Russian navies have complicated South Korean-U.S. military planning, diverted resources from concentrating against North Korea, and worsened the regional security environment. Naval planners in the United States, South Korea, and Japan will increasingly need to consider scenarios involving both the Chinese and Russian navies. For example, South Korean and U.S. policymakers need to prepare for situations in which coordinated Chinese and Russian military aggression overtaxes the Pentagon, obligating the South Korean Navy to rapidly backfill for any U.S.-allied security gaps that arise on the Korean Peninsula. Potentially reinforcing Chinese and Russian naval support to North Korea in a maritime confrontation with South Korea and its allies would present another serious challenge. Building on the commitment of Japan and South Korea to strengthen security ties, future exercises involving Japan, South Korea, and the United States should expand to consider these potential contingencies.

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Various Life Conditions of Actors of Joseon Periods in Unofficial Historical Stories (야담 문학에 나타난 조선 배우의 삶)

  • Choi, Nakyong
    • (The) Research of the performance art and culture
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    • no.23
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    • pp.281-312
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    • 2011
  • The aim of this study is to examine various life conditions of actors of Joseon periods in unofficial historical stories. Yadam Literature(Korean unofficial historical stories) had been collected Sadaebu(the past Korean nobility and Confucian intelligentsia) among the people that stories had been handed down orally. and they had been wrote them. So Yadam Literature was heterozygous between the folk culture and the ruling class. And it was mixed and adapted legends and folktales, adding literary imagination. had a decisive role to cultivating novel that owed much to prosaic inspiration during A. D. 18~19. Besides, set a high value on excellent novel itself. Yadam Literature had a verisimilitude because it described a contemporary reality as it was founded on freely prosaic inspiration. In those days, so called Suchok and Seunggwangdae had performed Uhee(a comic theatrical performance) in Joseon periods. Suchok was the lowest class of people and Seunggwangdae was performing Buddhist monk in that time. Uhee had performed three kinds of comedies. One satirized and insinuated kings. Other satirized corrupt officials, too. Another had mimic everything. It is famous at that time as a king knew repertoire. Confucian scholars very were fond of Uhee in those ages. Because they favored a criticism of Uhee's satire. They thought that it gave people good lesson or instruction. Heri Bergson said that comic and Humor included lesson. At that time, those thought were universal in the world whether east or west. At any rate, I classify six kinds of types Uhee in Yadam Literature. First, satirizing and accusing corrupt officials. Second, an actor who use a satire in order to appeal secure a government position of his lord to a king. Third, shamans and actors who use a satire in order to appeal sufferings themselves to a king. Forth, actors and performing Buddhist monks that skillfully mimic anything. Fifth, describing actor's extremely miserable life. Sixth, wit and humor of actors. The contents of Uhee were various. Korean traditional actors adeptly dealt with aspects comic of wit, satire, humor, etc. Sometimes they used changeable transition them. By doing that, a great number of people enjoyed fully the sense of freedom. Korean traditional actors were the lowest class of people. They had lived extremely miserable life. But they had been exist as actions, interactions, and relationship in society those days. they were not only open to people, but also might foster community to peoples.

Validity and Pertinence of Administrative Capital City Proposal (행정수도 건설안의 타당성과 시의성)

  • 김형국
    • Journal of the Korean Geographical Society
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    • v.38 no.2
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    • pp.312-323
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    • 2003
  • This writer absolutely agrees with the government that regional disequilibrium is severe enough to consider moving the administrative capital. Pursuing this course solely to establish a balanced development, however, is not a convincing enough reason. The capital city is directly related to not only the social and economic situation but, much more importantly, to the domestic political situation as well. In the mid-1970s, the proposal by the Third Republic to move the capital city temporarily was based completely on security reasons. At e time, the then opposition leader Kim, Dae-jung said that establishing a safe distance from the demilitarized zone(DMZ) reflected a typically military decision. His view was that retaining the capital city close to the DMZ would show more consideration for the will of the people to defend their own country. In fact, independent Pakistan moved its capital city from Karachi to Islamabad, situated dose to Kashmir the subject of hot territorial dispute with India. It is regrettable that no consideration has been given to the urgent political situation in the Korean peninsula, which is presently enveloped in a dense nuclear fog. As a person requires health to pursue his/her dream, a country must have security to implement a balanced territorial development. According to current urban theories, the fate of a country depends on its major cities. A negligently guarded capital city runs the risk of becoming hostage and bringing ruin to the whole country. In this vein, North Koreas undoubted main target of attack in the armed communist reunification of Korea is Seoul. For the preservation of our state, therefore, it is only right that Seoul must be shielded to prevent becoming hostage to North Korea. The location of the US Armed Forces to the north of the capital city is based on the judgment that defense of Seoul is of absolute importance. At the same time, regardless of their different standpoints, South and North Korea agree that division of the Korean people into two separate countries is abnormal. Reunification, which so far has defied all predictions, may be realized earlier than anyone expects. The day of reunification seems to be the best day for the relocation of the capital city. Building a proper capital city would take at least twenty years, and a capital city cannot be dragged from one place to another. On the day of a free and democratic reunification, a national agreement will be reached naturally to find a nationally symbolic city as in Brazil or Australia. Even if security does not pose a problem, the governments way of thinking would not greatly contribute to the balanced development of the country. The Chungcheon region, which is earmarked as the new location of the capital city, has been the greatest beneficiary of its proximity to the capital region. Not being a disadvantaged region, locating the capital city there would not help alleviate regional disparity. If it is absolutely necessary to find a candidate region at present, considering security, balanced regional development and post-reunification scenario of the future, Cheolwon area located in the middle of the Korean peninsula may be a plausible choice. Even if the transfer of capital is delayed in consideration of the present political conflict between the South and the North Koreas, there is a definite shortcut to realizing a balanced regional development. It can be found not in the geographical dispersal of the central government, but in the decentralization of power to the provinces. If the government has surplus money to build a new symbolic capital city, it is only right that it should improve, for instance, the quality of drinking water which now everyone eschews, and to help the regional subway authority whose chronic deficit state resoled in a recent disastrous accident. And it is proper to time the transfer of capital city to coincide with that of the reunification of Korea whenever Providence intends.

The Relics of Wae Lineage and the Keyhole-Shaped Mounds in the Honam Area (호남지역(湖南地域)의 왜계자료(倭系資料)와 전방후원형고분(前方後圓形古墳))

  • Tsuchida, Junko
    • Korean Journal of Heritage: History & Science
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    • v.51 no.2
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    • pp.170-203
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    • 2018
  • From the period of Japanese colonialism up to the present, the researchers of archaeology and ancient history in Korea and Japan have paid much attention to the Honam area. Recently the ruins and relics of Wae lineage are often discovered at archaeological excavation sites in this region. In particular, at least 17 keyhole-shaped mounds were confirmed. The fact that three mounds were built on one site was newly revealed. Haniwa, a representative earthenware object of the Kofun period in Japan, was discovered as well. Therefore, the study of a historical meaning of archaeological materials about Wae lineage in the Honam area thus far must be reexamined. The ruins and relics of Wae lineage in the Honam area have been studied by selecting only specific cases. I identified all the ruins and relics of Wae lineage in the Honam area and analyzed the process of their change in this paper. I reviewed the relationship between Wae and Mahan, and the purpose of their negotiation based on archaeological characteristics, changing processes, and historical records on a quarterly basis. The ruins and relics of Wae lineage have increased and widely spread since the early period of the 5th century in the Honam area. This tendency continued until the late period of the 6th century. Weapons of Wae lineage were introduced and tombs in the style of Wae were built from the late 4th century to the early period of the 5th century (TG232~TK216 period). Sueki was introduced from the middle to late period of the 5th century (TK208~TK23 period). Keyhole-shaped mounds and tombs in the style of Wae were built from the late period of the 5th century to the early period of the 6th century (TK47~MT15 period). Japanese weapons were introduced from the middle to late period of the 6th century (TK10~TK209 period). In other words, the archaeological appearance is different in each quarterly period. There was an intensive diplomatic relationship between Baekje and Wae in the TG232~TK216 period. The military might be included in a mission of Wae. The materials of Wae lineage of this period are likely to be related to this. Sueki spread to the inland part of the Honam area in the TK208~TK23 period. This Sueki tends to be excavated on advantageous sites for the accumulation and distribution of supplies. The main characters of the keyhole-shaped mounds are presumed to be a group of traders which were under the control of a certain influence in the north of Kyushu. The keyhole-shaped mounds were abruptly built at some distance from mounds of the leaders in the Honam area. Additionally, there was no special influence base to which the characters of the keyhole-shaped mounds belonged in the surroundings. However, it might have been impossible for the group of traders to build the keyhole-shaped mounds without the support from the residents at all because there was a big difference in the building technology of the keyhole-shaped mounds between Japan and the Honam area. The time of building some keyhole-shaped mounds is the same or almost the same with that of the mounds built for the regional leaders. This proves a close relationship with the residents as well. What do the archaeological materials of Wae lineage which have been used and buried mean over 200 years in the Honam area? Geumgwan Gaya, which had exported iron resources to Japan, perished in the early period of the 5th century. Instead of Gaya, the Honam area might have played an important role to supply the necessary resources to Japan. We assume that the Japanese (Wae) actively worked to acquire various resources focusing on the underground resources in the Honam area.

Philosophical Stances for Future Nursing Education (미래를 향한 간호교육이념)

  • Hong Yeo Shin
    • The Korean Nurse
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    • v.20 no.4 s.112
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    • pp.27-38
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    • 1981
  • 오늘 저희에게 주어진 주제, 내일에 타당한 간호사업 및 간호교육의 향방을 어떻게 정하여야 하는가의 논의는 오늘날 간호계 주변에 일어나고 있는 변화의 실상을 이해하는 데서 비롯되어져야 한다고 생각하는 입장에서 먼저 세계적으로 건강관리사업이 당면한 딜레마가 어떠한 것이며 이러한 문제해결을 위해 어떠한 새로운 제안들이 나오고 있는가를 개관 하므로서 그 교육적 의미를 정의해 보고 장래 간호교육이 지향해야할 바를 생각해 보려 합니다. 오늘의 사회의 하나의 특징은 세계 모든 나라들이 각기 어떻게 전체 국민에게 고루 미칠 수 있는 건강관리체계를 이룩할 수 있느냐에 관심을 모으고 있는 사실이라고 봅니다. 부강한 나라에 있어서나 가장 빈궁한 나라에 있어서나 그 관심은 마찬가지로 나타나고 있읍니다. 보건진료 문제의 제기는 발달된 현대의학의 지식과 기술이 지닌 건강관리의 방대한 가능성과 건강 관리의 요구를 지닌 사람들에게 미치는 실질적인 혜택간에 점점 더 크게 벌어지는 격차에서 발생한다고 봅니다. David Rogers는 1960년대 초반까지 갖고 있던 의료지식의 축적과 민간인의 구매력 향상이 자동적으로 국민 건강의 향상을 초래할 것이라고 믿었던 순진한 꿈은 이루어지지 않았고 오히려 의료사업의 위기는 의료지식과 의료봉사간에 벌어지는 격차와 의료에 대한 막대한 투자와 그에서 얻는 건강의 혜택간의 격차에서 온다고 말하고 있읍니다. 균등 분배의 견지에서 보면 의료지식과 기술의 향상은 그 단위 투자에 대한 생산성을 낮춤으로서 오히려 장애적 요인으로 작용해온 것도 사실이고 의료의 발달에 따른 일반인의 기대 상승과 더불어 의료를 태성의 권리로 규명하는 의료보호사업의 확대로 야기되는 의료수요의 급증은 모두 기존 시설 자원에 압박을 초래하여 전래적 의료공급체제에 도전을 가해 왔으며 의료의 발달에 건 기대와는 달리 인류의 건강 문제 해결은 더욱 요원한 과제로 남게 되었읍니다. 현시점에서 세계인구의 건강문제는 기아, 영양실조, 안전한 식수 공급 및 위생적 생활환경조성의 문제에서부터 가장 정밀한 의료기술발달에 수반되는 의료사회문제에 이르는 다양한 문제를 지니고 있으며 주로 각개 국가의 경제 사회적 여건이 이 문제의 성격을 결정짓고 있다고 볼수 있읍니다. 그러나 건강 관리에 대한 요구는 영구히, 완전히 충족될 수 없는 요구에 속한다는 의미에서 경제 사회적 발달 수준에 상관없이 모든 국가가 공히 요구에 미치지 못하는 제한된 자원문제로 고심하고 있는 실정입니다. 또 하나의 공통된 관점은 각기 문제의 상황은 달라도 오늘날의 건강 문제는 주로 의료권 밖의 유전적 소인, 사회경제적, 정치문화적인 환경여건과 각기 선택하는 삶의 스타일에 깊이 관련되어 있다는 사실입니다. 따라서 오늘과 내일의 건강관리 문제는 의학적 견지에서 뿐 아니라 널리 경제, 사회, 정치, 문화적 관점에서 포괄적인 접근이 시도되어야 한다는 점과 의료의 고급화, 전문화, 일변도의 과정에서 소외되었던 기본건강관리체계 강화에 역점을 둔 다양하고 탄력성 있는 사업전개가 요구되고 있다는 점입니다. 다양한 건강관리요구에 적절히 대처할 수 있기 위한 그간 세계 각처에서 시도된 새로운 건강관리 접근과 그 제안을 살펴보면 대체로 4가지의 뚜렷한 성격들로 집약할 수 있을 것 같습니다. 그 첫째는 건강관리사업계획 및 그 수행에 있어 지역 사회의 적극적 참여를 유도하는 일, 둘째는 지역단위의 일차보건의료에서 부터 도심지 신예 종합병원, 시설 의료에 이르기까지 건강관리사업을 합리적으로 체계화하는 일. 셋째로 의료인력이용의 효율화 및 비의료인의 훈련과 협조 유발을 포함하는 효과적인 인력관리에 대한 제안과 넷째로 의료보험 및 각양 집단 의료유형을 포함하는 대체 의료재정 운영관리에 관련된 제안들을 들 수 있읍니다. 건강관리사업에 있어 지역사회 참여의 의의는 첫째로 사회 경제적인 제약이 모든 사람에게 가능한 최대한의 의료를 모두 고루 공급하기 어렵게 하고 있다는 점에서 제한된 정부재정과 지역사회가용자원을 보다 효율적으로 이용할 수 있게 하는 자조적이고 자율적인 지역사회건강관리체제의 구현에 있다고 볼 수 있으며 둘때로는 개인과 가족 및 지역민의 건강에 영향하는 많은 요인들은 실질적으로 의료권 외적 요인들로서 위생적인 생활양식, 식사습관, 의료시설이용 등 깊이 지역사회특성과 관련되어 국민보건의 실질적 향상을 위하여는 지역 주민의 자발적인 참여가 필수여건이 된다는 점 입니다. 지역 단위별 체계적인 의료사업의 전개는 제한된 의료자원의 보다 합리적이고 효율적인 이용을 가능하게 하며 요구가 있을때 언제나 가까운 거리에서 경제 사회적 제약을 받지 않고 이용할 수 있는 일차건강관리망을 통하여 건강에 관련된 정보를 얻으며 질병예방, 건강증진 및 기초적인 진료의 도움을 얻을 수 있고 의뢰에 대한 제2차, 제3차 진료에의 길은 건강관리사업의 질과 폭을 동시에 높고 넓게 해 줄 수 있는 길이 된다는 것입니다. 인력 관리에 관련된 두가지 기본 방향으로서는 첫째로 기존보건의료인력의 적정배치 유도이고 둘째는 기존인력의 역할확대, 조정 및 비의료인의 교육훈련과 부분적 업무대체를 들수 있으며 이러한 인력관리의 기본 방향은 부족되는 의료인력의 생산성을 높이고 주민들의 자조적 능력을 강화시킨다는 데에 두고 있음니다. 대체적 의료재정운영안은 대체로 의료공급과 재정관리를 이원화하여 주민의 경제능력이 의료수혜의 장애요소로 작용함을 막고 의료인의 경제적 동기에 의한 과잉치료처치에 의한 낭비를 줄임으로써 의료재정의 투자의 효과를 증대하는 데(cost-effectiveness) 그 기본방향을 두고 있다고 봅니다. 이러한 주변의료 사회적인 동향이 간호교육의 미래상에 끼치는 영향은 지대한 것이라 봅니다. 첫째로 장래 세계인구의 건강문제는 정치, 사회, 경제, 환경적인 의료권 밖의 요인들에 의해 더욱 크게 영향 받는다고 전제한다면 건강문제해결에 있어서도 전통적인 의료사업의 접근에서 더나아가 문제발생의 근원이 되는 생활개선이라는 차원에서 포괄적 접근을 생각하여야 하고 이를 위해선 정치, 경제, 사회전반에 걸친 깊이있는 이해과 주민의 생활환경에 직접 영향하는 교통수단, 통신망 mass media, 전력문제, 농업경영방법 및 조직적 사회활동 등 폭넓은 이해가 요구된다고 봅니다. 둘째로, 지역사회참여의 의의를 인정한다면 지역민의 자발적 참여를 효과적으로 유발시킬수 있고 의료집단과 각종 주민조직과 일반주민들 사이에서 협조적으로 일할수 있는 역량을 기르기위한 교육적 준비가 요구된다고 봅니다. 셋째로, 지역주민의 건강관리 자조능력 강화를 하나의 목표로 삼는다면 치료자에서 교육자로, 지도자에서 촉진자로, 제공자에서 지원자료의 역할의 변화 내지 다양화를 요구하게 될 것이므로 그에 대처할 수 있는 준비가 필요하다고 봅니다. 넷째로, 생각되어야 할 점은 지역중심건강관리사업을 지향하는 보건의료의 이념적 방향과 그에 상응하는 구체적 접근방법을 효율적으로 적용하기 위해서는 종횡으로 연결되는 의사소통체계의 정립과 민활한 정보교환이 이루어질 수 있어야 한다는 점에서 의사소통의 구심체로서 역할할 수 있는 역량을 함양해야 할 교육적 과제가 있다고 봅니다. 마지막으로 생각되어야 할 점은 지역중심으로 전개될 건강관리사업은 건강증진 및 질병예방적 측면과 질병진료 및 회복과 재활에 이르는 종합적이고 포괄적인 사업이어야 한다는 점에서 종래 공공 의료부문과 사설의료기관 사이에 나누어져 있던 예방의학과 치료의학의 통합 뿐 아니라 정부주축으로 이루어 지고 있는 지역사회개발사업 및 농촌지도사업과 종교 및 각종 민간인 집단이 벌이고있는 사업들과의 전체적인 통합적 접근이 이루어져야 한다고 생각하는 입장에서 종래 간호교육이 강조하지 않던 진료의 의무와 대외적 조직활동에 대한 보완적인 교육조치가 요구된다고 봅니다. 간호의 학문체계로서의 입장은 오랜 역사를 두고 논의의 대상이 되어왔으나 아직까지 뚜렷이 어떤 것이 간호 특유의 지식체계이며 건강문제에 관련하여 무엇이 간호특유의 결정영역이며 이 결정과 그 결과를 어떠한 방법으로 치료적 행위로 옮길 수 있는가에 대한 확실한 답을 얻지 못하고 있는 실정이라고 봅니다. 다만 근래에 제시된 여러 간호이론들 속에서 공통적으로 이야기되어지고 있는 개념들로선 우선 간호학문을 건강과 질병에 관련된 인간의 전인적이고 전체적인 상황을 다루는 학제적 과학으로서보는 입장이 있고 따라서 생물신체적인 면 외에 정신심리적, 사회경제적, 정치문화적 환경과의 상호작용 속에서 인간의 건강과 질병문제를 생각한다는 지향을 갖고 있다고 말할 수 있겠읍니다. 간호교육은 간호계 내적인 학문적, 이론적 체계화의 요구에 못지않게 대민봉사하는 전문직으로서의 사회적 책임을 감당해야하는 중요과제를 안고있어 변화하는 사회요구에 효과적으로 대처해 나가야 할 당면문제를 안고 있읍니다. 간효역할 확대, 보건진료원훈련 등 이러한 사회적 요구에 대응하려는 조치가 되겠읍니다. 이러한 시점에서 간호계가 분명히 짚고 넘어가야 할 사실은 이러한 움직임들이 종래의 의사들의 외업무공급을 연장 확대하는 입장에 서서 간호의 특수전문직 명목을 흐리게 할수있는 위험을 감수할 것인지 아니면 가능한 대체방안을 갖고 간호전문직의 독자적인 진로를 개척하면서 다각적인 도전을 받아들일 준비를 갖추든지 그 방향을 뚜렷이 해야할 일이라 생각합니다. 저로서는 이미 잘 훈련된 간호원들과 조산원들의 교육적, 경험적 배경을 기반으로 지역사회 최일선 건강관리요원으로 사회적 효능을 다 할수 있는 일차건강관리간호조직의 구현을 대체방안으로 제시하고 싶습니다. 간호원과 조산원들의 훈련된 역량과 건강관리체제의 구조적 변화를 효과적으로 조화시킨다면 대부분의 세계인구의 건강문제는 해결가능하다고 보는 입장입니다. 물론 정책과 의료와 행정적지원이 활성화되어지는 환경속에서만 그 기대하는 결과가 확대되리라는 점 부언하는 바입니다. 마지막으로 언급하고 싶은 점은 바로 오늘의 주제 ''교육의 동역자-선생과 학생''이라는 개념입니다. 특히 상회정의적 입장에서 보는 의료사업전개에 지역민 내지 의료소비자의 참여를 강조하는 현시점에 있어 교육자와 학생이 교육의 현장에서 서로 동역자로서 학습의 책임을 나누는 경험은 아주 시기적으로 적합하여 교육적으로 지대한 의미를 갖는 것이라고 생각합니다. 이에 수반되어져야 할 역할의 변화에 수용적인 자세를 갖고 적극 실제적용하려 노력하는 선생앞에서 자주적 결정을 행사해본 학생이야말로 건강관리대상자로 하여금 같은 결정권을 행사할수 있도록 촉구하여 주민의 자조적 역량을 기르고 의료사업의 민주화, 인간화를 이룩할 수 있는 길잡이가 될 수 있으리라 믿는 바입니다.

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The Mid-Term Outcome Evaluation of Community Organization: Three-year Experience of Health Plus Happiness Plus Projects in Gyeongsangnam-Do (지역사회조직화 전략의 중간 결과평가: 경남 건강플러스 행복플러스 사업 3년 경험)

  • Kim, Jang-Rak;Jeong, Baekgeun;Park, Ki-Soo;Kang, Yune-Sik
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.146-160
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    • 2014
  • Objective: This study was performed to explore the effectiveness of community organization as a strategy for health promotion. Methods: We used data from community health interviews from 6 administrative sections (eup, myeon, or dong) with high mortality from August to October, conducted once in both 2010 and 2013 as part of the Health Plus Happiness Plus Projects based on the concept of community empowerment in Gyeongsangnam-do Province. For 2010, the study subjects comprised a systematic sampling of 220 adults from each of the six sections for a total of 1320 subjects, and for 2013, 200 from each section for a total of 1200 subjects. We compared main health behavior indicators and empowerment score between these two years. Results: Smoking prevalence in men was 47.4% in 2013, and 47.7% in 2010, respectively. Prevalence of walking 5 days or more per week was 35.6% in 2013, significantly lower than 46.2% in 2010. Also, during that period, both biennial health examination rate and biennial gastric cancer screening rate among those 40 years of age and over significantly increased from 57.7% to 63.6% and from 49.3% to 55.0%, respectively. Mean empowerment score at the community level significantly increased from 12.6 to 14.0. Conclusions: This study suggests that the three-year implementation of community organization might have helped to increase the participation rate of biennial health examinations including cancer screenings in the community. However, this was not the case for smoking cessation and walking. Further studies are needed for evidence-based health promotion.