• 지능정보연구
• /
• 제19권2호
• /
• pp.141-156
• /
• 2013

그 동안 한국 사회에서 지방자치단체(이하 지자체) 복지사업과 재정지출에 대한 연구는 장애인, 노인, 보육 등 복지사업 대상 등을 중심으로 부문별 복지지출에 대한 영향요인 연구가 대부분 이루어져 왔다. 최근 지자체의 자체적인 복지노력도 측면에서 자체 사업에 대한 연구가 특정 지역의 사례를 중심으로 이루어지기는 하고 있지만, 자료에 대한 접근과 조사의 한계로 여러 요인이 실증적으로 고려되지 못하여 정책적 함의를 도출해 내기 어려웠다. 현재 우리사회의 복지예산과 그 지출규모는 국가 예산의 30%에 이를 만큼 높은 비중을 차지하고 있다. 이에 따라 국가적 차원에서 공공복지 전달체계의 효율적 운영과 관리를 위해 사회보장 정보시스템을 구축, 운영하고 있다. 본 연구에서는 기존 연구에서 사용하는 지방재정시스템이 아닌 사회보장 정보시스템을 통하여 지자체 복지재정 지출과 관련, 기존 연구에서 한계점으로 지적되었던 전수데이터에 대한 접근과 조사를 실시하여 학문적이고 정책적인 함의를 도출해 내고자 한다. 사회보장정보시스템은 복지전달체계의 효율화를 위해 구축되었으며, 이를 통해 17개 부처 292개 복지사업이 집행되며, 230개 지자체 4만여 개 복지사업의 정보가 관리되고 있다. 이에 따라 본 연구는 사회보장정보시스템을 통해 관리되는 지자체 복지사업을 중심으로 지자체 복지지출에 미치는 영향요인을 탐색하고자 한다. 이를 위해 지자체 복지노력도로 대변되는 순수 시 군 구 복지예산액을 종속변수로 설정하였으며, 기존문헌 검토를 바탕으로 인구사회학적, 지역 경제적 그리고 지자체 재정적 요인을 독립변수로 설정하였다. 또한 독립변수 요인간 다중공선성 문제를 점검하였고, 다중공선성의 문제가 없는 것으로 확인된 수급자 비율, 영유아 비율, 아동청소년 비율, 복지비 비율, 구인배율, 재정자립도, 재정자주도의 총 7개 독립변수와, 소속 정당을 통제변수로 사용하여 결정요인의 변화를 분석하였다. 연구결과를 살펴보면 기본모델에서는 복지비 비율, 영유아 비율, 재정자립도, 재정자주도, 구인배율이 유의한 영향을 미치는 것으로 분석되었다. 그리고 기존 문헌에서 분석되지 못했던 시 군 구별 복지지출 영향요인의 차이점을 분석하였다. 또한 복지예산 총량 데이터에 근거한 기존 연구들이 논의하지 못했던 자체 복지사업 예산에 미치는 영향요인을 구체적으로 밝혀내는데 의의가 있다.

• 대한간호학회지
• /
• 제22권1호
• /
• pp.81-115
• /
• 1992

The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t＝3.95, p＜0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t＝1.93, p＜0.05), ‘I know that my baby wants most of the times’(t＝2.75, p＜0.01), ‘When the baby cries, 1 can tell what she/he wants’(t＝2.10, p＜0.05), ‘I have confidence in my ability to care for the baby’(t＝3.72, p＜0.01), ‘I trust my own judement in deciding how to care for the baby’(t＝1.96, p＜0.05), ‘I feel that I know my baby and what to do for him /her’(t＝2.44, p＜0.01), ‘I am concerned about being able to meet the baby's needs’(t＝2.87, p＜0.01), ‘I know what my baby likes and dislikes’(t＝3.26, p＜0.01), ‘I don't know to care for the baby as well as I should’(t＝2.07, p＜0.05), and ‘I am unsure about whether I give enough attention to the baby’(t＝3.04, p＜0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝3.95, p＜0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t＝2.31, p＜0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t＝2.29, p＜0.05), ‘I enjoy taking care of the baby’(t＝2.4g, p＜0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t＝2.87, P＜0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t＝2.51, p＜0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t＝2.43, p＜0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝2.31, p＜0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r＝0.57, p＜0.01)