• 제목/요약/키워드: Direct practice

검색결과 599건 처리시간 0.034초

종합병원 외래환자 진료시 의사의 보건교육활동 평가 (An Evaluative Study on Physician's Health Education Activities in Outpatient Medical Care)

  • 김숙자
    • 보건교육건강증진학회지
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    • 제2권1호
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    • pp.56-80
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    • 1984
  • The main objectives of the present study is to evaluate Physician's Health Education Activities by means of physician's direct response to the prepared questionnaire and patient's perception to the physician in the course of medical care. For the data collection, the present study was conducted from Aug. 16 to Oct. 7, 1983 for 739 patients and 91 physicians who were attended outpatient clinics of 5 general hospitals in Seoul. The major findings are summarized as follows: 1. Self-evaluation on Physician's Health Education Activities (1) In consideration of health education services for the patient, the data revealed that 9.9% of the sampled physician wanted to strength public health and preventive medicine lecture in the curricula at medical education. On the other hand, only 1.1% expressed that they wanted to make it short. (2) In consideration of the necessity of health education service, it was shown that 95.6% of physicians agreed to take it into consideration. Self expression for the practice of health education was placed on the 3.15 score when 5 point scale used. (3) To evaluate the degree of an explanation about medical care for the patient, Index score with 4 point scale was employed. The Index score for the first time was shown that scale was placed on 3.23 for 'diagnosis', 3.12 for 'progress of the disease', 3.11 for 'discription of procedure' and 3.02 for 'cause of the disease' respectively. In comparison of the physician's explanation about the status of disease for the first and the second visitors to clinic, they evaluated themselves as giving more detailed explanation for the second visitors rather than the first visitors. 2. Physician's Health Education Services evaluated by patients (1) To evaluate physician-patient communication at beginning time for taking history about disease, the Index score with 5 point scale was employed. The data on taking history have shown that the score placed on 3.07 for those patients who visited the first time and 2.53 for second visitors. And the score about listening from the patients was placed on 3.52 and 3.42 respectively. (2) The Index score with 5 point scale, as used before, was also employed to evaluate medical care services for the patient. The data evaluated by the patients was shown that the score placed on 4.21 for patient treatment in general, 4.58 for physician's credibility, and 3.6 for physician's kindness. However, approximately 80% of those who failed to understand physician's explanation was caused by highly sophisticated medical terminology. (3) According to the Index score with 4 point scale, to evaluate physician's explanation, the data was shown that the patient who visited the first time gave 2.51 for 'diagnosis', 2.35 for 'progress', 2.11 for 'cause of the disease' and so on. It is acknowledged on the whole that the patients who visited the second time have more satisfaction in physician's explanation about their disease, than those who visited the first time. 3. Comparison of self-evaluation of Physician's Health Education Activities and patient's perception. (1) There was communication barriers between physicians and patients in expressing some medical terminology. For example physician understood that they explained more than 50% of medical terminology into common words for the patient, but 30% of patient complained medical terminology used by physician. (2) Comparing the index score of health education practice recognized by patients and physicians for both first visit and revisit groups, it was shown that the Index score of health education activities evaluated by physicians themselves were slightly higher than the score evaluated by patients.

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저소득층의 디스트레스에 따른 전문가 도움추구의 결정에 영향을 미치는 개인 및 사회인지 요인들의 관계구조 탐색 (Exploration of the Relationship Structure of Personal and Social Cognitive Factors Affecting Professional Help-seeking Decisions for Distress among People in Low-income)

  • 박선영
    • 한국사회복지학
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    • 제67권2호
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    • pp.85-112
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    • 2015
  • 이 연구는 저소득층이 디스트레스를 완화하기 위해 사회복지사를 비롯한 전문가로부터 도움을 추구하고자 결정하는 데 기여하는 개인 및 사회인지 요인들의 구조를 살펴보고 보다 적절한 모형을 선정하여 사회복지실천에 유용한 지식을 얻고자 하였다. 편의표집에 의한 저소득층 331명의 자료를 구조방정식모형으로 계획행동이론(TPB)을 응용한 기본모형과 확장된 모형 두 단계로 분석하였다. 우선 TPB 기본모형의 분석을 통해 사회인식을 반영하는 주관적 규범, 도움추구에 대한 긍정적 태도, 자신의 행동통제력 순서로 추구의도에 정적으로 기여하고 다시 의도는 추구결정에 정적인 기여를, 행동통제력은 추구결정에 부적 기여를 하는 것으로 나타났다. 다음 단계로, 디스트레스와 가족지지의 영향을 포함하고 합리적 행동계획인 의도(intention)와 함께 상황에 대한 반응으로서 자진 추구의사(willingness) 경로를 포함하여 확장한 모형을 탐색적으로 검토하였다. 확장모형의 경로분석에서 디스트레스와 가족 지지 각각은 도움추구에 대한 태도, 주관적 규범, 행동통제력에 상당한 수준으로 정적 영향을 주었다. 태도와 주관적 규범은 추구의도와 의사 각각에 유의한 정적 영향을, 행동통제력은 추구의사에 정적 영향을, 추구결정에는 부적 영향을, 그리고 의도는 추구결정에 정적인 직접효과를 보였다. 행동통제력이 추구의사를 통해 추구의도에 미치는 간접효과와 추구의사가 의도를 통해 추구결정에 미치는 간접효과가 유의하였다. 이러한 결과들은 TPB 모형이 저소득층의 전문가 도움추구와 관련되는 개인 및 사회인지 요인들의 관계구조 파악에 유용함을 시사하였고, 특히 주관적 규범의 영향력을 통해 사회인지의 중요성이 함의되었다. 나아가 저소득층의 특수성을 살릴 수 있는 확장모형의 필요성과 함께 행동통제력과 자진 추구의사가 시사하는 클라이언트의 자기의지의 중요성과 활용 등 사회복지실천을 위한 함의를 제시하였다.

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가정간호 서비스 질 평가를 위한 도구개발연구 (A basic research for evaluation of a Home Care Nursing Delivery System)

  • 김모임;조원정;김의숙;김성규;장순복;유호신
    • 가정간호학회지
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    • 제6권
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    • pp.33-45
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    • 1999
  • The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

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HPLP와 사상체질설문(四象體質說問)을 이용(利用)한 근로자(勤勞者)들의 건강상태(健康狀態) 평가(評價) (The Assessment on Health Status of Workers by using HPLP and Sa-sang Constitutional Questionnaire)

  • 최문일;이은경;권소희;고광재;서병윤;정재열;장두섭;송용선;이기남
    • 대한예방한의학회지
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    • 제5권1호
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    • pp.41-56
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    • 2001
  • 개인의 건강증진사업을 진행하기 위해서는 건강에 긍정적인 영향을 미치는 생활양식과 생활양식에 영향을 미치는 요인에 대한 역학적 조사가 필요하며 이는 연령집단별로 건강위험인자나 생활양식 및 건강실천행위 등이 모두 다르게 나타나기 때문이다. 체질에 따른 생활양식 등의 차이를 규명하는 것은 체질의학이 예방서비스의 일환으로 적용될 수 있는 기초자료를 제공하는 데 큰 역할을 할 뿐 아니라 체질의학을 현대화하는 데에도 기여할 것으로 사고된다. 이에 본 연구에서는 각 체질을 분석하고 체질별 건강증진 생활양식 실천정도를 파악한 결과 몇 가지 결과를 얻었기에 보고하는 바이다. 1. 연구대상자 중 태음인(太陰人)은 43.7%였고 소음인(少陰人)은 33.6%였으며, 소양인(少陽人)은 22.7%로 나타났다. 2. 연구대상자의 자아실현, 건강책임, 운동, 영양, 대인관계, 스트레스 관리를 포함한 건강증진 생활양식의 총 평균은 138.9이고 총 평점은 2.62이었다. 각 영역별 평점은 대인관계 2.94, 자아실현 2.86, 스트레스관리 2.71, 영양상태 2.68, 건강책임 2.37, 운동영역 2.21의 순으로 대인관계가 가장 높고 운동영역이 가장 낮았다. 3. 건강증진 생활양식 전체영역과의 관계를 보면 여성의 경우와 연령이 높을수록 건강증진 생활양식 실천정도가 높게 나타났다. 건강증진 생활양식 각 영역과의 관계를 보면 성별에서 보면 건강책임영역과 영양영역, 스트레스관리 영역에서 여자가 더 높은 실행정도를 보였고 운동영역에서 남자가 더 높은 실행정도를 보였다(P<0.05). 연령에서는 건강책임영역에서는 30대가, 영양영역과 스트레스관리영역에서는 50대가 가장 높은 실행정도를 보였다(p<0.05). 결혼상태에 따라서는 영양의 영역에서만 기혼자가 유의하게 실행정도가 높게 나타났다(P<0.05). 4. 건강증진 생활양식 각 영역과 사회경제적 특성과의 차이를 보면 월수입에서는 대인관계영역에서만 월수입이 100만원 미만이 가장 높게 나타났고(P<0.05), 교육수준별로는 자아실현영역에서만 교육수준이 높을수록 이행정도가 높게 나타났으나(P<0.05) 나머지 영역에서는 유의한 차이가 나타나지 않았다. 5. 대인관계영역을 제외한 모든 영역에서 태음인(太陰人)의 건강증진 생활양식의 실천정도가 가장 높았으며 자아실현영역에서는 소양인(少陽人)과 거의 비슷했다. 소음인(少陰人)은 건강책임 영역을 제외하고는 모든 영역에서 실천정도가 가장 낮은 것으로 나타났고 건강책임은 태음인(太陰人), 소음인(少陰人), 소양인(少陽人)의 순서로, 대인관계 영역에서는 소음인(少陰人), 태음인(太陰人), 소양인(少陽人)의 순으로 실천정도가 높음을 알 수 있다.

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붓다의 신통에서 고승의 신이로 (From the Shintong of the Buddha to the Shini of Eminent Monks)

  • 정천구
    • 대순사상논총
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    • 제39집
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    • pp.215-247
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    • 2021
  • 불교에는 기적이나 이적과 관련된 특유한 용어가 존재한다. 산스크리트로 '아비즈냐Abhijñā'이며 한자어로 신통(神通)이 그것이다. 본래 '직접적인 지식'이나 '고도의 지식' 또는 '상식을 넘어선 지식'을 뜻하는 말인데, 붓다나 보살들, 고승들이 지니고 있다고 하는 초인간적이고 초월적인 능력으로 이해된다. 그런데 이 신통은 붓다 당시와 후대, 인도와 중국에서 각기 다른 용어와 의미로 쓰였다. 본고에서는 『장아함경』의 「견고경」, 그리고 탁월한 불교문학인 『불소행찬』, 중국에서 저술된 『고승전』과 『속고승전』 등을 중심으로 신통의 주체와 대상, 유형과 목적 등을 분석해서 인도와 중국에서 역사적으로 신통이 어떻게 인식되고 변화해 왔는지를 고찰했다. 「견고경」에서 붓다는 세 가지 신통, 즉 신족(神足)과 관찰타심(觀察他心), 교계(敎誡)가 있다고 했다. 이 가운데서 신족과 관찰타심은 부정되었는데, 당시에 대중의 정서에 호소하며 신심을 끌어내는 데 널리 이용되고 있었고 붓다의 가르침을 전하는 데에 아무런 소용이 없었기 때문이다. 반면에 올바른 수행으로 깨달음을 얻은 이라야 갖출 수 있는 교계는 불교에만 특유한 신통이어서 인정되었다. 『불소행찬』에서는 교계가 작품 전반을 관통하면서 신족과 관찰타심도 깨달음으로 이끄는 중요한 방편으로 묘사되었다. 이는 붓다 입멸 뒤에 교세의 확장을 위해 교화가 중시되면서 신족과 관찰타심이 허용되었음을 의미한다. 중국에서 불교는 처음에 외래 종교였으므로 수용되는 일이 급선무여서 교화가 중시되었고, 교세가 커진 뒤에는 확고하게 뿌리를 내리기 위해 수행과 실천에 대한 반성이 깊어졌다. 이에 맞추어 신통과 이적들도 중국적 상황에 맞게 변용되고 확장되었다. 그러한 불교사의 변화는 『고승전』과 『속고승전』이 잘 보여준다. 『고승전』에서는 「신이」를, 『속고승전』에서는 「감통」을 두었는데, 용어 변화를 읽을 수 있다. 신이의 주체는 고승이었으나 그 대상은 『고승전』에서는 불교를 모르거나 믿지 않는 이들이었고, 『속고승전』에서는 승려들 자신이었다. 대상의 변화는 교화에서 자각과 자성으로 목적이 변화했음을 의미한다. 신이가 단순히 교화에 치중했다면, 감통은 교세가 확장된 6~7세기에 승려들의 청정한 수행과 실천의 중요성을 다시 강조하기 위함이었다. 초인간적이고 초월적인 능력이 신통이지만 현실적 변화와 밀접한 관련 속에서 그 의미와 목적 등이 변화해 왔음을 알 수 있다. 이는 동아시아 각국에서 신통이 독특하게 수용되고 다양하게 변용되었을 것임을 시사한다.

119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도 (Recognition and Request for Medical Direction by 119 Emergency Medical Technicians)

  • 박주호
    • 한국응급구조학회지
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    • 제15권3호
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    • pp.31-44
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    • 2011
  • Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

1949년~1966년 시기 중국 선전화 연구 - 유화와 포스터를 중심으로 (Study of Chinese Propaganda Paintings from 1949 to 1966: Focusing on Oil Paintings and Posters)

  • 전희원
    • 미술이론과 현장
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    • 제4호
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    • pp.77-104
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    • 2006
  • The propaganda paintings in oil colors or in forms of posters made from 1949 to 1966 have gone through some changes experiencing the influence of the Soviet Union Art and discussion of nationalization, while putting political messages of the time in the picture planes. The propaganda paintings which have been through this process became an effective means of encouraging the illiterate people in political ideologies, production, and learning. Alike other propaganda paintings in different mediums, the ones which were painted in oil colors and in the form of posters have been produced fundamentally based on Mao Zedong's intensification of the literary art on the talks on literature at Yenan. Yet, the oil paintings and posters were greatly influenced by the socialist realism and propaganda paintings of the Soviet Union, compared to other propaganda paintings in different mediums. Accordingly, they were preponderantly dealt in the discussions of nationalization of the late '50s. To devide in periods, the establishment of People's Republic of China in 1949 as a diverging point, the propaganda paintings made before and after 1949 have differences in subject matters and styles. In the former period, propaganda paintings focused on the political lines of the Communists and enlightenment of the people, but in the latter period, the period of Cultural Revolution, the most important theme was worshiping Mao Zedong. This was caused by reflection of the social atmosphere, and it is shown that the propaganda painters had reacted sensitively to the alteration of politics and the society. On the side of formalities, the oil paintings and posters made before the Cultural Revolution were under a state of unfolding several discussions including nationalization while accepting the Soviet Union styles and contents, and the paintings made afterwards show more of unique characteristics of China. In 1956, the discussion about nationalization which had effected the whole world of art, had strongly influenced the propaganda paintings in oil colors more than anything. There were two major changes in the process of making propaganda paintings in oil colors. One was to portray lives of the Chinese people truthfully, and the other was to absorb the Chinese traditional styles of expression. After this period, the oil painters usually kept these rules in creating their works, and as a result, the subject matters, characters, and backgrounds have been greatly Sinicized. For techniques came the flat colored surface of the new year prints and the traditional Chinese technique of outlining were used for expressing human figures. While the propaganda paintings in oil colors achieved high quality and depth, the posters had a very direct representation of subject matters and the techniques were unskilled compared to the oil paintings. However, after the establishment of People's Republic of China, the posters were used more than any other mediums for propagation of national policy and participation of the political movements, because it was highly effective in delivering the policies and political lines clearly to the Chinese people who were mostly illiterate. The poster painters borrowed techniques and styles from the Soviet Union through books and exhibitions on Soviet Union posters, and this relation of influences constantly appears in the posters made at the time. In this way, like the oil paintings, the posters which have been made with a direct influence of the Soviet Union had developed a new, sinicised process during the course of nationalization. The propaganda paintings in oil colors or in forms of posters, which had undergone the discussion of nationalization, had put roots deep down in the lives of the Chinese people, and this had become another foundation for the amplification of influences of political propaganda paintings in the following period of Cultural Revolution.

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질적 간호에 대한 환자와 가족의 지각 (Perceptions of Quality Nursing care of Patients and Families)

  • 지성애;권성복;박은희
    • 간호행정학회지
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    • 제4권1호
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    • pp.247-275
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    • 1998
  • The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

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한국 재활간호 현황과 전망 (Current Status and the Future Prospect of Rehabilitation Nursing in Korea)

  • 강현숙;서연옥;이혜숙
    • 재활간호학회지
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    • 제4권2호
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    • pp.240-247
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    • 2001
  • The history of rehabilitation of disabilities in Korea began with the foreigners and missionaries who were interested in it after Korean War. In 1981, Disabled Persons Welfare Act was enacted and the 88 Paralympics brought the nations attention to the welfare and rehabilitation of persons with disabilities. Since then, the facilities and the services for the disabled persons have expanded rapidly and the rehabilitation treatment and nursing intervention are drawing more attention. Against this background, the survey on the current status of disabilities, welfare service, facilities, and rehabilitation nursing was conducted. The results of this survey are as follows. 1. According to the 2000 census of disabilities, the number of persons with disabilities in Korea is estimated at 1,449,500, or 3.09% of the entire Korean population, 0.74% up from 2.35% in 1995. 2. Disability Types in 2000 The 2000 census showed that the persons with disabilities numbered 1,449,496 out of the total population and 1,024,371 persons are registered for disability, making up 70.7% of the estimated disabled population. Among them, physically disabled persons accounted for the largest 41.7% (605,127) and mentally retarded persons stood at the smallest 9% (13,481). 3. Percentage of Disability Presence The survey showed that more than 90% of disability were acquired. However, 44.8% of mental disability and 61.4% of hearing/speaking disability were not acquired after birth. This means that these disabilities happened by congenital cause or birth accident. 4. Yearly Figure of Registered Disabled Persons In 1989, 218,601 persons registered for disability and, in 2000, the number increased by 4.7 times to 1,024,371. These figures are different from the actual number of disabled persons. According to the 1995 census, 1,053,486 were disabled persons but only 378,323registered for disability. And, in the 2000 census, 1,024,371 out of the 1,449,496 of disabled persons registered for disability. 5. Welfare Service for Persons with Disability 62.6% of the total disabled people are registered and physically disabled persons accounted for the highest percentage of 96.7%. 26.5% of non-registered disabled people said that they didnt know the registration procedure. The rest of them replied that they didnt think they were disabled or that registration didnt seem to give any benefits. 6. Welfare Policies for Disabled Persons The welfare benefits given to the disabled are as follows: Issuance of disabled sign for car drivers, Permission to use LPG fuel, Communication fee reduction, Tax exemption related to cars, Reduction of public facility fees, Household allowance, Tax reduction or exemption, Medical allowance and education subsidy for children, and Housing. 7. Current Condition of Welfare Facilities by Disability Type The welfare institutions for disabilities numbered 188 in total and they can accommodate 16,823 persons. Categories of these institutions are physical disability(37), visual disability(10), hearing/speaking disability(14), mental retardation(59), and sanatoriums(68). 8. Human Resource of Rehabilitation of Disabilities Advanced education programs include rehabilitation nursing in its curriculum and this was selected as the program of Korean Academic Society of Nursing in 1990. In November 1997, Korean Academic Society of Rehabilitation Nursing was launched and many academic meeting and seminars were held. This organization is also making efforts to develop the education program for qualified rehabilitation nursing professionals and to develop the standards of rehabilitation nursing practice. In the professionals of the rehabilitation, there are rehabilitation specialist, physical therapist, speech therapist, occupational therapist. It is needed to come up with the measures to supply stable human resources following the demand of disabled persons and to recognize the private certificates for rehabilitation professionals as official ones after reviewing the education and training programs of private institutions. 9. Rehabilitation Nursing 1) Rehabilitation nursing was taught as an independent subject in 11 undergraduate programs and 9 graduate programs. 2) Research on rehabilitation nursing in Korea were 24 experimental research and 11 non-experimental research. The intervention of experimental research were mostly education and exercise rehabilitation programs. 3) In the three rehabilitation hospitals, nursing is divided into two categories, direct nursing and education & counseling. Direct nursing includes tracheostomy or nasogastric tube care, urination and defication, skin care, pain control, complication prevention and care, prevention of injury from a fall, etc.

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베단따의 '듣기·숙고하기·명상하기'(문·사·수)에 관하여 (On Listening, Reflection and Meditation in Vedānta)

  • 박효엽
    • 철학연구
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    • 제116권
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    • pp.155-180
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    • 2010
  • 베단따의 주요 실천 방법인 '듣기 숙고하기 명상하기'(이하 '3수단'으로 부름)는 연속적인 단계(step)로서가 아니라 동일한 목적의 방편적 연장(extension)으로서 파악되어야 한다. 즉 3수단은 듣기에서 직접적 지식을 획득하지 못하는 경우에 방편적으로 숙고하기, 명상하기로 연장되어야 하는 것이라고 듣기 중심적인 방식으로 해석되어야 한다. 이러한 해석은 3수단이 암시하는 인도철학의 주요 특징들을 드러냄으로써 더욱 정당화될 수 있을 것이다. 인도철학에서 해탈 중심적 전통에 속하는 베단따는 쉽게 말해 자기를 앎으로써 자기가 되려고 하는 '본래의 자기 되찾기' 프로젝트이다. 이 경우 본래의 자기에 대한 지식을 얻기 위해서는 그것을 듣는 것만으로도 충분하기에, 3수단을 듣기 중심적으로 해석하는 것은 베단따의 근본 가르침과도 부합된다. 게다가 '본래의 자기 되찾기' 프로젝트는 3수단을 통해 실행되므로, 3수단은 베단따의 형이상학이라는 그 시나리오에 따라 실행되는 일종의 이벤트(event)라고 부를 수 있다. 이 경우 듣기란 자신이 참가한 이벤트의 시나리오를 이해하는 과정으로서, 스스로 더 효과적이라고 판단한 그 시나리오를 듣기만 해도 프로젝트의 완성에 도달할 수 있어야 한다. 그런데 성언이라는 지식수단의 중요성으로 말미암아 듣기 중심적일 수밖에 없는 3수단에 대해, 후대에 점점 명상하기가 강조됨으로써 연장이 아닌 단계로 이해하고자 하는 해석이 등장한다. 이는 '증언되는 것 혹은 주어진 것'을 '특별하게 지각되는 것 혹은 받아들이는 것'으로 만들고자 하는 욕망이 반영된 결과이다. 지식의 간접성과 직접성을 나눈 채 전자에서 후자로 단계적 이행을 강조하는 이 해석은, 프로젝트의 실질적 실패로서 이벤트의 반복적 지연을 합리화하려는 시도라고 볼 수 있다. 더 나아가 3수단에 삼매를 더하여 4수단을 언급하는 후대 베단따의 주장은 텍스트 바깥에서 텍스트와 별도로 깨달음이 가능하다는 논리를 바탕으로 하기 때문에, 텍스트의 절대성을 강조하면서 그 시나리오가 오직 그대로 재현되는 것을 깨달음으로 간주하는 초기 베단따의 주장과 양립하기 힘들다. 결국 3수단에 대한 베단따의 표준적 해석은 명상하기 중심적 혹은 삼매 중심적인 것이 아니라 듣기 중심적인 것이어야 한다.