• Journal of the Society of Disaster Information
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• v.17 no.3
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• pp.487-499
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• 2021

Purpose:The purpose of the paper is to review the problems of performance enhancement of safety certification standards and to suggest directions for improvement in order to rationalize safety certification standards for future industrial development and environmental changes. Method: The problems and limitations of the safety certification system are summarized through literature review and interview with manager, and the status of safety certification standards is classified into design standards, performance standards, and detailed standards, and the status analysis is performed. In addition, by synthesizing the results of the investigation and analysis, improvements are suggested to improve the performance of the safety certification standards. Result: Through the survey, the problems and limitations of safety certification could be grouped into six categories: government-led certification system operation, standardized certification standards, long time required to improve certification, poor certification standards preparation system, and lack of reflection of industry opinions. And, as a result of analyzing the certification standards by dividing them into performance and design standards, in the case of machinery, equipment, and protection devices, the design standards were high at 69.7% and 64.9%, whereas in the case of protective equipment, the performance standards were high at 61.1%. In order to improve the performance of safety certification standards centered on design standards, it is necessary to determine the possibility of performance enhancement of the certification standards and determine the feasibility of the inspection test method. In order to improve performance, it was reviewed that it was necessary to establish a systemic foundation and infrastructure, such as strengthening the Product Liability Act, systematizing market monitoring, etc., distributing certification test tasks, and participating in the preparation of certification standards by the private sector. Conclusion: Through this study, the problems and limitations of Korea's safety certification system were summarized and the necessity for performance improvement was reviewed. Performance improvement of safety certification standards is a matter that requires preparatory work, such as legislative revision and infrastructure construction, and requires mid-to-long-term promotion. In addition, rather than improving the overall safety certification standards, the performance requirements for each item subject to certification should be reviewed and promoted, and details should be specified through additional research.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.39 no.3
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• pp.33-41
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• 2021

This study identified the scale that traditional landscape design has taken up by analyzing a total of 1037 services for design of cultural heritage that had been ordered by the government agencies from 2018 to 2020, and has drawn characteristics of traditional landscape design focusing on major cases. The results are as follows. First, the number of order cases for traditional landscape design has shown differences annually in the services of design of cultural heritage, but the design amount has been found to have the similar average annually, which confirmed that the same level has been maintained each year. It was found that the number of cases of traditional landscape design requiring responsibilities or participations of landscape engineers for 3 years in the entire design had a high proportion of approximately 26%. Second, the traditional landscape design has required professional knowledge and experiences of landscape engineers that could not be replaced by the business operator for design of cultural heritage consisting of architects. The expertise has been shown differently depending on types of construction. First, the topographical design for the work to build a foundation has required understanding of ground shapes and its elevations and professional knowledge on calculation of the amount of the earth work and the remains maintenance technique etc. The plantation design has required basic knowledge on growth characteristics of trees and the environment for growth and understanding of the vegetation landscape of the past. Meanwhile, the design for traditional pavement and traditional landscape structures and facilities has required the expertise on traditional materials that are different from the modern ones and their processing and construction methods. The understanding of changes to water paths and ecosystem, the principles of fluids, and characteristics of each type of fluid was essential for the design for the ecological landscape work including the maintenance of a water system such as rivers etc. As such, the traditional landscape design has a scale accounting for approximately one fourth of the entire cultural heritage design and requires the expertise differentiated from other fields. This improves the provisions of the current law on limiting the actual design, suggesting the need for the establishment of a traditional landscape design company so that all traditional landscape designs can be carried out by landscape engineers.

• Korean Journal of Heritage: History & Science
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• v.53 no.4
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• pp.198-215
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• 2020

Official development assistance refers to assistance provided by governments and other public institutions in donor countries, aimed at promoting economic development and social welfare in developing countries. The purpose of this research is to examine the construction process of the "Myanmar Cultural Heritage Management System" that is underway as part of the ODA project to strengthen cultural and artistic capabilities and analyze the achievements and challenges of the Digital Cultural Heritage ODA. The digital cultural heritage management system is intended to achieve the permanent preservation and sustainable utilization of tangible and intangible cultural heritage materials. Cultural heritage can be stored in digital archives, newly approached using computer analysis technology, and information can be used in multiple dimensions. First, the Digital Cultural Heritage ODA was able to permanently preserve cultural heritage content that urgently needed digitalization by overcoming and documenting the "risk" associated with cultural heritage under threat of being extinguished, damaged, degraded, or distorted in Myanmar. Second, information on Myanmar's cultural heritage can be systematically managed and used in many ways through linkages between materials. Third, cultural maps can be implemented that are based on accurate geographical location information as to where cultural heritage is located or inherited. Various items of cultural heritage were collectively and intensively visualized to maximize utility and convenience for academic, policy, and practical purposes. Fourth, we were able to overcome the one-sided limitations of cultural ODA in relations between donor and recipient countries. Fifth, the capacity building program run by officials in charge of the beneficiary country, which could be the most important form of sustainable development in the cultural ODA, was operated together. Sixth, there is an implication that it is an ODA that can be relatively smooth and non-face-to-face in nature, without requiring the movement of manpower between countries during the current global pandemic. However, the following tasks remain to be solved through active discussion and deliberation in the future. First, the content of the data uploaded to the system should be verified. Second, to preserve digital cultural heritage, it must be protected from various threats. For example, it is necessary to train local experts to prepare for errors caused by computer viruses, stored data, or operating systems. Third, due to the nature of the rapidly changing environment of computer technology, measures should also be discussed to address the problems that tend to follow when new versions and programs are developed after the end of the ODA project, or when developers have not continued to manage their programs. Fourth, since the classification system criteria and decisions regarding whether the data will be disclosed or not are set according to Myanmar's political judgment, it is necessary to let the beneficiary country understand the ultimate purpose of the cultural ODA project.

• (The)Study of the Eastern Classic
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• no.69
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• pp.451-479
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• 2017

The objective of this study is to examine the tasks for listing martial arts of "Muyedobotongji" on the UNESCO Representative List of Intangible Cultural Heritage of Humanity. The conclusions are like below. First, "Muyedobotongji" was published in 1790(14th year of King Jeongjo). The 24 martial arts of "Muyedobotongji" were basically divided into three types like stabbing, chopping & cutting, and hitting. Second, the value of martial arts of "Muyedobotongji" is highly evaluated because it has systematically put together the martial arts of three countries like Korea, China, and Japan of the 18th century, suitable for the actual status of Joseon Dynasty, in the new perspective. The value of "Muyedobotongji" as a Memory of the World is the martial arts book emphasizing the practicality, so that everyone including officers and soldiers could easily learn. Third, the procedure of registering martial arts of "Muyedobotongji" in the UNESCO Representative List of Intangible Cultural Heritage of Humanity has three stages including preparation/submission, screening, and decision, which takes two years. Especially, the screening assistance organization, as an organization under the Intangible Cultural Heritage Convention Intergovernmental Committee is composed of total six countries(one for each area) out of 24 member countries. Fourth, the tasks for listing martial arts of "Muyedobotongji" in the UNESCO Representative List of Intangible Cultural Heritage of Humanity are like following. (1) It would be necessary to conduct a total inspection of the collection of "Muyedobotongji". (2) It would be necessary to designate the martial arts of "Muyedobotongji" as the municipal/provincial/national intangible cultural heritage. (3) It would be needed to standardize the practical martial arts technique/movement of "Muyedobotongji". (4) The historical evidence of martial arts costumes/weapons of "Muyedobotongji" should be studied. (5) A committee for the registration of martial arts of "Muyedobotongji" in the UNESCO Representative List of Intangible Cultural Heritage of Humanity should be organized. (6) There should be a close cooperation system between relevant departments like the World Heritage Team of Cultural Heritage Administration and the Ministry of Foreign Affairs. (7) Domestic/foreign data related to martial arts of "Muyedobotongji" should be comprehensively collected to meet the registration standard of UNESCO. (8) The registration type of Intangible Cultural Heritage of Humanity should be prepared.

• The Southeast Asian review
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• v.27 no.1
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• pp.163-191
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• 2017

This article aims to review the recent, especially focusing on the year of 2016, situations and prospects of the Vietnamese politics, economy, and international relations. Politically, Vietnam completed the election of members for the National Assembly and organized new leadership at the 12th National Congress of the Vietnamese Communist Party in 2016. One characteristic of the new leadership is that the politicians, especially the members of politburo, from the North continue to occupy the position of majority. The other one is that the new leadership promised to carry out the restructuring of economy toward industries producing higher value-added commodities even though Vietnam industries admittedly need to accelerate present industrialization and modernization as a developing country under the seemingly contradictory slogan of "the development of market economy for socialism." The declared goals of the new leadership in Vietnam are inevitable in a sense since the development of Vietnamese economy has been heavily dependent upon Foreign Direct Investment(FDI) taking advantage of Vietnamese cheap labor and simultaneously it is evident that its future is unsecure if it maintains status quo. In fact, the Vietnamese economy has impressively showed high growth rate by the help of foreign capitals since 1990s despite the repetitive recessions of global economy but its growth is not likely to be sustainable anymore if it will not reduce foreign dependency and social economic inequality in a long term. In a short run, global economic recession, the financial and monetary policies of global powers, and recent protectionism and uncertainty of trade agreements will be three crucial variables to affect Vietnamese economy. In terms of international relations, Vietnam is continuously expected to practise the policy of checks and balances among the powerful countries. Vietnam has seriously disputed with China on islands sovereignty in the South China Sea and attempted to maintain close relationship with other powerful countries including especially America. However, mainly due to the new protectionism by the regime of American president Donald Trump, the Vietnamese government also need to keep close relationship with China increasingly for both economic and diplomatic security. Under the circumstances, Vietnam is expected to maintain more practical and balanced international relations.

• 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.

• Journal of the Economic Geographical Society of Korea
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• v.25 no.1
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• pp.109-130
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• 2022

The Vietnamese government has proposed contract farming through a new type of cooperative as an institutional innovation which aims to restructure the agricultural sector. However, policy changes often impact farmers, who bear the primary effects of the transition process. Understanding households' strategies for land use and livelihood is crucial for policymaking in the agricultural development field. This study was conducted in the rural Binh Dao commune in Central Vietnam. We analyzed household members' labor force changes and their livelihood behaviors after their participation in a contract farming scheme using qualitative analysis methods combined with geographic information system (GIS) support, based on secondary data and in-depth interviews of 190 farmers. Simultaneously, we created a digital map of the cooperative's production area to investigate changes in land use and production activities. The findings show that contract farming shaped the vertical coordination of the value chain from the farmers to the cooperative and agricultural product trading companies. Subsequently, it encouraged land use and labor efficiency due to mechanical support. In addition, it also increased productivity and protected farmers from market risks. However, despite its positive effects on agricultural productivity in this case, the contract farming scheme could not achieve the restructuring of the rural labor force toward non-agricultural sectors. Ironically, farmers in the Binh Dao commune tended to increase cultivable land during the agricultural restructuring program, rather than switching their labor forces to non-agricultural sectors. The lack of stable non-farming job opportunities in rural Vietnam results in challenges to the efficiency of agricultural restructuring programs. Consequently, farmers in the Binh Dao commune are still smallholder farmers, depending on the family labor force.

• The Korean Journal of Franchise Management
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• v.2 no.1
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• pp.173-199
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• 2011

A franchisee has to depend on the overall system, such as knowhow and management support, from a franchisor in the franchise system and the two parties do not start with the same position in economic or information power because the franchisor controls or supports through selling or management styles. For this, unfair trades the franchisor's over controlling and limiting the franchisee might occur and other side effects by the people who give the franchisee scam trades has negatively influenced on the development of franchise industry and national economy. So, the purpose of this study is preventing unfair trade for the franchisee from understanding the causes and problems of dispute between the franchisor and the franchisee focused on the dispute cases submitted the Korea Fair Trade Mediation Agency and seeking ways to secure the transparency of recruitment process and justice of franchise management process. The results of the case analysis are followed; first, affiliation contracts should run on the franchisor's exact public information statement and the surely understanding of the franchisee. Secondly, the franchisor needs to use their past experiences and investigated data for recruiting franchisees. Thirdly, in the case of making a contract with the franchisee, the franchisor has to make sure the business area by checking it with franchisee in person. Fourthly, the contracts are important in affiliation contracts, so enacting the possibility of disputes makes the disputes decreased. Fifthly, lots of investigation and interests are needed for protecting rights and interests between the franchisor and franchisee and preventing the disputes by catching the cause and more practical solutions of the disputes from the government.

• Journal of Distribution Research
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• v.15 no.1
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• pp.49-71
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• 2010

Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

• 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.