• Title/Summary/Keyword: 수용유형

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Christine M. Korsgaard's Constructivism and Moral Realism (Christine M. Korsgaard의 구성주의와 도덕적 실재론)

  • Roh, Young-Ran
    • Journal of Korean Philosophical Society
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    • v.129
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    • pp.23-51
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    • 2014
  • Christine M. Korsgaard believes that constructivism can respond to moral skepticism without depending upon moral realism. The purpose of this paper is to examine Korsgaard's kantian constructivism and her positions on moral realism. According to Korsgaard moral realism cannot answer normative questions in that it sees the function of moral concepts as describing the reality and so accepts the model of applied knowledge for action. In contrast Korsgaard insists that constructivism is better at justifying normativity since it regards moral concepts as representing the solutions to practical problems and so shows that moral principles are necessarily involved in the practical problems of agency. Korsgaard's constructivism has antirealistic elements such as pure proceduralism, the constitutive model to exclude ontological, metaphysical meanings, and the account of human beings as the sources of values. In spite of those antirealistic elements it is difficult to jump to a conclusion that Korsgaard's constructivism is antirealism. Korsgaard, in the early book, The Sources of Normativity, says that kantian constructivism has something to do with a form of realism, or procedural moral realism. And in the following books she argues that constructivism is compatible with realism although she pays attention to the practical implications of constructivism and then sets aside its ontological relevance. That is, Korsgaard does not want that her constructivism results in antirealism. Korsgaard's realism, however, is too weak to be called as realism. There is, also, a question why one would rather take a constructivist approach if one holds on to realism.

Environmentally Available Potential of Renewable Energy in Korea: Onshore Wind and Photovoltaic (육상풍력 및 육상태양광의 환경적 가용입지 분석)

  • Lee, Young-Joon;Park, Jong-Yoon
    • Journal of Environmental Impact Assessment
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    • v.30 no.6
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    • pp.339-354
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    • 2021
  • The purpose of this study is to provide valuable information and data by analyzing the environmental status and potential forrenewable energy projects (or plans) based on environmental assessment (EA) data, so that more objective and scientific environmental assessments can be conducted. The study also suggests regional directions that could satisfy the goals of nature conservation and renewable energy. Based on the analysis of EA data that was conducted up until June 2019, the study analyzed the size, location and characteristics of both onshore wind power and onshore photovoltaic. The environmentally available potential by region was also derived by considering the main constraints and requirements related to the potential siting ofrenewable energy projects at the EA. Based on EA data, 63 out of 80 (79%) onshore wind power projects are shown to be located in mountainous areas. For onshore photovoltaic projects, a total of 7,363 projects were subjected to environmental assessment over the country. The environmentally potential area for onshore wind power, considering all the environmental regulatory factors, is 2,440 km2. For onshore photovoltaic, the environmentally available area estimated as idle farmland is 2,877 km2. The distribution and characteristics of the environmentally available potential of the region may be the most important factor that local governments should bear in mind in terms of promoting renewable energy development projects in the region. Based on the results of this study, even if we consider the national energy plan including the expected future increase, as well as environmental goals and socio-economic acceptance through an environmental assessment, the available resources forrenewable energy projects are not insufficient. It is possible to examine the adequacy of the target distribution rate of renewable energy sources by region taking into consideration the quantitative and scientific results such as the environmentally available potential data derived from this study.

Value and Prosect of individual diary as research materials : Based on the "The 12th May Diaries Collection" (개인 일기의 연구 자료로서의 가치와 전망 "5월12일 일기컬렉션"을 중심으로)

  • Choi, Hyo Jin;Yim, Jin Hee
    • The Korean Journal of Archival Studies
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    • no.46
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    • pp.95-152
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    • 2015
  • "Archives of Everyday Life" refers to an organization or facility which collects, appraises, selects and preserves the document from the memory of individuals, groups, or a society through categorizing and classifying lives and cultures of ordinary people. The document includes materials such as diaries, autobiography, letters, and notes. It also covers any digital files or hypertext like posts from blogs and online communities, or photos uploaded on Social Network Services. Many research fields including the Records Management Studies has continuously claimed the necessity of collection and preservation of ordinary people's records on daily life produced every moment. Especially diary is a written record reflecting the facts experienced by an individual and his self-examination. Its originality, individuality and uniqueness are considered truly valuable as a document regardless of the era. Lately many diaries have been discovered and presented to the historical research communities, and diverse researchers in human and social studies have embarked more in-depth research on diaries, their authors, and social background of the time. Furthermore, researchers from linguistics, educational studies, and psychology analyze linguistic behaviors, status of cultural assimilation, and emotional or psychological changes of an author. In this study, we are conducting a metastudy from various research on diaries in order to reaffirm the value of "The 12th May Diaries Collection" as everyday life archives. "The 12th May Diaries Collection" consists of diaries produced and donated directly by citizens on the 12th May every year. It was only 2013 when Digital Archiving Institute in Univ. of Myungji organized the first "Annual call for the 12th May". Now more than 2,000 items were collected including hand writing diaries, digital documents, photos, audio and video files, etc. The age of participants also varies from children to senior citizens. In this study, quantitative analysis will be made on the diaries collected as well as more profound discoveries on the detailed contents of each item. It is not difficult to see stories about family and friends, school life, concerns over career path, daily life and feelings of citizens ranging all different generations, regions, and professions. Based on keyword and descriptors of each item, more comprehensive examination will be further made. Additionally this study will also provide suggestions to examine future research opportunities of these diaries for different fields such as linguistics, educational studies, historical studies or humanities considering diverse formats and contents of diaries. Finally this study will also discuss necessary tasks and challenges for "the 12th May Diaries Collection" to be continuously collected and preserved as Everyday Life Archives.

Enactment of the Japanese Cultural Heritage Protection Act in the 1950s and the Korean Cultural Heritage Protection Act in the 1960s: Focusing on intangible cultural heritage and folklore materials (1950년대 일본 문화재보호법과 1960년대 한국문화재보호법의 성립 - 무형문화재와 민속자료를 중심으로 -)

  • IM, Janghyuk
    • Korean Journal of Heritage: History & Science
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    • v.55 no.1
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    • pp.35-50
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    • 2022
  • The Korean cultural heritage protection act, enacted in 1962, is known to have been enacted in imitation of the Japanese cultural heritage protection act. The Japanese law differs from the current law dealing with intangible cultural heritage, folklore materials, and buried cultural properties. The Japanese law was enacted in consultation with the GHQ, and reflected the historical issues at the time of the enactment. Recently, in Japan, GHQ documents have been released and so research on the cultural heritage protection act is carried out. Therefore, it is necessary to understand the meaning and achievements of the Japanese cultural heritage protection act before comparing it with the Korean law. GHQ stipulated the emperor as a symbolic entity in the Japanese constitution and prescribed the country as a liberal democracy. Influenced by this, the cultural heritage protection act was enacted to identify the people's cultural heritage. Accordingly, the cultural heritage protection committee is a private and independent organization in Japan. The committee designates cultural heritage assets, and it operates as the national museum and the cultural heritage research institute. This system was a part of policy changes shifting cultural heritage management to the private sector. Since many cultural heritages are associated with the imperial family, museums were managed by the imperial family. Meanwhile, the Japanese house of councillors persuaded GHQ, which was negative about including intangible cultural heritage in the cultural heritage protection act. The purpose of this idea was to provide the system of the government support for Japanese imperial court music and dance. In addition, folk materials were included with the consent of the GHQ in that they represent the cultural heritages and the academic achievements of the people at the time in Japan. According to the Korean Law, the subject of designation of cultural heritage is the government, and the cultural heritage committee acts as an advisory body with its limited functions. In the early days, the committee confused the concept of intangible cultural heritage and folklore materials. This was because the concepts of cultural property was borrowed from Japanese law and applied to the Korean law without a full understanding. In response, the cultural heritage committee urged the ministry to investigate the current situation in Japan. The cultural heritage committee, mainly consisting of folklore scholars, was confused about the concepts of intangible cultural heritage and folklore materials, but the concept became clear when the enforcement regulations of the cultural heritage protection Act was enacted in 1964.

Problems with Comparative Research on Daesoon Thought and Shamanism as Related to Jeungsan's Concept of Grievance-Resolution (무속과 증산의 해원사상 비교를 통해 본 대순사상 연구 관점의 문제)

  • Cha, Seon-keun
    • Journal of the Daesoon Academy of Sciences
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    • v.38
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    • pp.115-151
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    • 2021
  • According to Lee Young-geum, the ideas of grievance resolution and mutual beneficence were already present in shamanism. She also insists that Jeungsan merely theorized upon these ideas by inheriting them and his religious activities must be identified from within a shamanistic worldview. Contrary to Lee's claim, Cha Seon-keun argues that the grievance resolution of Jeungsan is far beyond the contents and level of development found in shamanism. He also insists that Jeungsan's religious activities must be identified as having a certain orderly uniqueness distinct from shamanism. The argument between these two different perspectives has not attracted other researchers besides those who are directly involved. However, this debate deserves attention with regard to the problem of how one approaches a given religion and which academic perspective should be applied. Based on the perspective of the Daesoon Jinrihoe, this study examines their debate by considering four issues. Firstly, whether Jeungsan inherited or expanded upon the subject of grievance resolution and its range remains undetermined. Secondly, the ethics of mutual beneficence and grateful reciprocation in Jeungsan's concept of grievance resolution should be analyzed as to whether that idea reasserts the ethics of shamanism. Thirdly, it is necessary to study whether his method of grievance resolution fully embraced the methods of grievance resolution that exist in shamanism. Lastly, it should be determined whether or not Jeungsan's religious activities and system of thought should be identified within a shamanistic worldview. Through this review, Lee and Cha can be shown to have different opinions on the academic approach to research on religion. Accordingly, this study concludes that Lee's method of only interpreting Jeungsan's religious thought via a shamanic worldview is incompatible with academic methodology. A scholar of religious studies should discuss Jeungsan on his own merits rather than just imply that Jeungsan thoroughly reflects the worldview of shamanism, doctrinal studies of Buddhism, and Daoist thought as well as other theologies. In other words, if certain tangible and intangible elements found in shamanism, Buddhism, Confucianism, Daoism, and Christianity are also observed in Jeungsan's religious thought, it is necessary to comprehend how different or similar those elements are or whether they are re-interpreted in any manner. In the case of Lee, her method of overemphasizing similarities is now criticized as outdated. Nowadays, it is necessary to demonstrate awareness of modern religious studies tendency to pay equal attention to similarities and differences.

Exploring the Trend of Korean Creative Dance by Analyzing Research Topics : Application of Text Mining (연구주제 분석을 통한 한국창작무용 경향 탐색 : 텍스트 마이닝의 적용)

  • Yoo, Ji-Young;Kim, Woo-Kyung
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.53-60
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    • 2020
  • The study is based on the assumption that the trend of phenomena and trends in research are contextually consistent. Therefore the purpose of this study is to explore the trend of dance through the subject analysis of the Korean creative dance study by utilizing text mining. Thus, 1,291 words were analyzed in the 616 journal title, which were established on the paper search website. The collection, refining and analysis of the data were all R 3.6.0 SW. According to the study, keywords representing the times were frequently used before the 2000s, but Korean creative dance research types were also found in terms of education and physical training. Second, the frequency of keywords related to the dance troupe's performance was high after the 2000s, but it was confirmed that Choi Seung-hee was still in an important position in the study of Korean creative dance. Third, an analysis of the overall research subjects of the Korean creative dance study showed that the research on 'Art of Choi Seung-hee in the modern era' was the highest proportion. Fourth, the Hot Topics, which are rising as of 2000, appeared as 'the performance activities of the National Dance Company' and 'the choreography expression and utilization of traditional dance'. However, since the recent trend of the National Dance Company's performance is advocating 'modernization based on tradition', it has been confirmed that the trend of Korean creative dance since the 2000s has been focused on the use of traditional dance motifs. Fifth, the Cold Topic, which has been falling as of 2000, has been shown to be a study of 'dancing expressions by age'. It was judged that interest in research also decreased due to the tendency to mix various dance styles after the establishment of the genre of Korean creative dance.

The World View on the Recreation of the Later World in Daesoonjinrihoe (대순진리회의 후천개벽 세계관)

  • Yoon, Yong-bok
    • Journal of the Daesoon Academy of Sciences
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    • v.27
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    • pp.1-34
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    • 2016
  • This paper aims to understand how Daesoonjinrihoe perceives the Later World. Daesoonjinrihoe supports to establish an earthly paradise through the re-creation of the real world unlike other religions which tend to relegate ultimate fulfillment to the afterlife. In other words, Daesoonjinrihoe endeavors to achieve their objectives in the human world rather than outside of it in a potential act of escapism. The new religions in Korea have been characterized by ethnocentrism and doctrines which present Koreans as the new chosen people by emphasizing Korea's crucial role in world leadership. However, the doctrine of Daesoonjinrihoe differ with other new religions of Korea in this regard as its purpose is to redeem the whole world. Daesoonjinrihoe proposes an open embrace of the religious diversity found in Korean society. Daesoonjinrihoe argues that the Later World has not come yet, even though the Former World is over and progress towards the Later World has already been set in motion. The meaning of human nobility is akin to anthropocentricity. According to a variety of myths and legends, animals and supernatural often attempt to become human. Moreover, it would not be an overstatement to assert that the re-creation of the real world and the Daesoon concept of human nobility correspond with these myths and legends. There were not definite interpretations regarding heaven in Confucianism historically, yet Daesoonjinrihoe differentiates clearly that heaven and Sangje are cosmic structures. Buddhism perceives that heaven separately exists as a cosmic structure and that Buddha is a transcendental entity, however; that entity is not accessible for intercession. On the contrary, the ways to save the world have been adduced in Daesoonjinrihoe. In addition, the earthly paradise of the Later World has likewise been introduced. Specifically, it is Sangje that opens the door to that paradise. Unresolved issues in the formation of a world view still persist. There are no shortage of studies on the notion of gods or divine beings, however; most of these studies focus on genealogical classification, forms, functions and other such topics. The concept of god, ghost, or soul does not seem to have been clearly defined in these studies nor has the relationship among these entities and humanity been satisfactorily examined. For example, if human beings become either gods or divine beings, questions regarding divine beings who have acted as protectors or guardians of human beings then arises. The Daesoon cosmology should be specifically compared to cosmology in Daoism. By conducting additional studies such as a comparative research with Daoism, it will be possible to interpret mantras and Daoist art as they appear in Daesoonjinrihoe in a thought-provoking way which can in turn be compared with other religions.

Pergola's Shading Effects on the Thermal Comfort Index in the Summer Middays (여름철 낮 그늘시렁의 차양이 온열쾌적 지표에 미치는 영향)

  • Ryu, Nam-Hyong;Lee, Chun-Seok
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.6
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    • pp.52-61
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    • 2013
  • This study was conducted to investigate the effects of pergola's shading on the thermal comfort index in the summer. The 3 type of pergolas($4m{\times}4m{\times}h2.7m$) which were screened overhead(I)/overhead west(II)/overhead west north(III) plane with reed blind for summer shading and winter wind break, were constructed on the 4th floor rooftop. Thereafter the meteorological variables(air temperature, humidity, radiation, and wind speed) of pergola I, III and rooftop were measured from 14 to 16 August 2013(1st experiment), those of pergola I, II and rooftop were measured from 26 to 28 August 2013(2nd experiment). The effects of pergola's shading on the radiation environment and mean radiant temperature($T_{mrt}$), standard effective temperature($SET^*$) were as follows. The maximum 1 h mean values of differences ${\Delta}$ of the sums of shortwave radiant flux densities absorbed by the human body (${\Delta}K_{abs,max}$) between pergola I, III and nearby sunny rooftop were $-119W/m^2$, $-158W/m^2$, those between pergola I, II and rooftop were $-145W/m^2$, $-159W/m^2$. The maximum 1 h mean values of differences ${\Delta}$ of the sums of long wave radiant flux densities absorbed by the human body (${\Delta}L_{abs,max}$) between pergola I, III and nearby sunny rooftop, were $-15W/m^2$, $-17W/m^2$, those between pergola I, II and nearby rooftop, were $-8W/m^2$, $-7W/m^2$. The response of the direction dependent long wave radiant flux densities $L_1$ on the pergola's shading turned out to be distinctly weaker as compared to shortwave radiant flux densities $K_1$. The pergola's shading leads to a lowering of $T_{mrt}$ and $SET^*$. The peak values of $T_{mrt}$ absorbed by the human body were decreased $16^{\circ}C$ and $21.4^{\circ}C$ under pergola I and III as compared to that of nearby rooftop in the 1st experiment. Those were decreased $18.8^{\circ}C$ and $20.8^{\circ}C$ under pergola I and II as compared to that of nearby rooftop in the 2nd experiment. The peak values of $SET^*$ absorbed by the human body were decreased $2.9^{\circ}C$ and $2.6^{\circ}C$ under pergola I and III as compared to that of nearby rooftop in the 1st experiment. Those were decreased $3.5^{\circ}C$ and $2.6^{\circ}C$ under pergola I and II as compared to that of nearby rooftop in the 2nd experiment. The relative $SET^*$ decrease in pergola II, III compared to nearby sunny rooftop $SET^*$ were lower than that in pergola I, revealing the influence of the wind speed. Therefore it is essential to design pergola to maximize wind speed and minimize solar radiation to achieve comfort in the hot summer. The $SET^*$ under pergola I, III were exceeded $28.7^{\circ}C$ and $30.4^{\circ}C$ which were the upper limit of thermal comfort and tolerable zone during all most daytimes in the 1st experiment(maximum air temperature $37.5^{\circ}C$). The $SET^*$ under pergola I was exceeded $28.7^{\circ}C$ which was the upper limit of thermal comfort zone at 13h, that under pergola II was exceeded $28.7^{\circ}C$ from 8h to 14h, meanwhile the $SET^*$ under pergola I, II were within thermal tolerable zone during most daytimes in the 2nd experiment(maximum air temperature $34.4^{\circ}C$). Therefore to ensure the thermal comfort of pergola for summer hottest days, pergola should be shaded with not only reed blind but also climbing and shade plants. $T_{mrt}$ and $SET^*$ were suitable index for the evaluation of pergola's shading effects and outdoors.

The 1998, 1999 Patterns of Care Study for Breast Irradiation After Breast-Conserving Surgery in Korea (1998, 1999년도 우리나라에서 시행된 유방보존수술 후 방사선치료 현황 조사)

  • Suh Chang-Ok;Shin Hyun Soo;Cho Jae Ho;Park Won;Ahn Seung Do;Shin Kyung Hwan;Chung Eun Ji;Keum Ki Chang;Ha Sung Whan;Ahn Sung Ja;Kim Woo Cheol;Lee Myung Za;Ahn Ki Jung
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.192-199
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    • 2004
  • Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.

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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