• 제목/요약/키워드: Education Development

검색결과 16,660건 처리시간 0.04초

간호조무사의 근무환경인식과 성격성향에 관한 연구 (A Study on the Working Environment Recognition and the Caracter Disposition of Nurse Aides)

  • 이선이
    • 한국보건간호학회지
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    • 제4권1호
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    • pp.57-74
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    • 1990
  • As the whole world took on the tendency to be highly industrialized, it became necessary for each field of occupation to require professional man power. Especially, since the World War n, the participation of woman power in economic activities has been continually increasing. In our country also, because of the rapid economic growth, change in the way of thinking of women as well as their participation in economic activities are increasing. Thus, woman power is being utilized in various occupational fields from simple physical labor to those that require high-professional skill. Also, continued economic development policies, by setting the establishment of welfare society as the ideology to be fulfilled, brought expansion of medical facilities in the field of public health and increase in man power in that field. As for the nursing specialists, more than 6000 have been being produced per year and as of the end of 1988, the total number of nursing specialists, reached 123, 115. Therefore, this study is done to recognize the professional knowledge and ability of nursing specialists, who take up $40\%$ of the total public-health related man power in our country, through evaluating their working environment and their disposition of character. This study, which was done from September 18th to September 30th 1989, took on the method of using formed questionnaires that had been amended and supplemented during two preparatory investigations, 322 of such questionnaires were used as an analytical material. In the formation of questionnaires, 12 questions were related to the working environment, and 26 in fortotal were related to the disposition of character, 5 for wise-disposition, 11 for activedisposition and 10 for open-disposition. The measuring method, which used 5-point-standard, allowed 5 points for affirmative recognition of the working environment, also 5 points for showing wise, active and open disposition of character and only point in opposite cases. Collected materials were analyzed, through an electronic calculation, into the average value, the standard deflection percentage, pearson corelative number and stepwise multiple regression. Summarizing the results from this study is as follows: 1. It was shown that the nursing specialists with the average of 3.07 have affirmative recognition of their working environment. The questions which drew most affirmative reaction were those concerning finance-management system such as hand, the questions that received negative reaction were those concerning communication method with the average of 2.49. Such reaction seems to have resulted from the cramming regulation by the superior authorities. Concerning the recognition of working environment in relation to employment conditions, more affirmative recognition is shown with the average of 3.14. at hospitals where injection job is not performed. The nursing specialists working at regular hospitals show more affirmative recognition than those at general hospitals, the averages being respectiely 3.16 and 3.03. 2. As for the disposition of character of the nursing specialists, active-disposition was highest with the average of 3.38, next was wise-disposition with 3.20 and the lowest was open-diposition with 2.98. Variable-wise disposition of character shows that wise-disposition and academic background are beneficially correlated by 0.12. Ative-disposition and open-disposition show correlation to the office term by respectively 0.16 and 0.21. In other words. better academic background leads to higher wise-disposition and more - experience results in higher active and open disposition. Also, the class that performs the injection job, in relation to the working environment, might cause change in the self-conceit that identify those in that class with the nurses; however, as far as professional judgment and action, in dealing with nursing job, being wise, active and open is concerned, not much effect is made. 3. The relation between the recognition of the working environment and the disposition of character is that more afirmative recognition- a nursing specialist has about her working environment, the higher the active-disposition becomes by 0.13. The degrees of the relation between recongnition of environment and wise and open dispositions show respectively 0.06 and -0.06 and -0.06. That is to say that when having more affirmative recognition of the working environment, a nursing specialist shows wise but closed disposition of character. This, howerver, didn't mean much statistically. When observing the results mentioned above, it is conspicuous that the nursing specialists, working as substitutes for the nurse at medical institutions of various sizes, get the feeling of being somewhat equal to the nurses and to some extent, fulfill their desire to accomplish their ego; however, as far as professional ability expansion if concerned. they lack wise and open dispositions. Therefore, considiering upon the results of this study, in medical institutions where the work of nursing specialists is regaded equal to that of the nurses, as a medical member who deals with human lives, it is desirable to make the nursing specialists work under the supervision of the nurses and to offer them continuous education to strengthen and improve their natural dispositions.

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경상분지 동남부의 상부 경상누층군에 발달한 호성퇴적층에 대한 비교퇴적학적 연구 (Comparative Sedimentology for the Lacustrine Deposits of the Upper Gyeongsang Supergroup in the Southeastern Gyeongsang Basin, Korea)

  • 백인성;김현주;이준동;김인수;김진섭;문병찬
    • 한국지구과학회지
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    • 제21권4호
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    • pp.423-436
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    • 2000
  • 경상분지 동남부 지역에 발달된 하양층군 퇴적말기의 진동층 및 건천리층과 하양층군 최상부 또는 유천층군 최하부의 지층으로 설정되어 있는 부산 황령산 지역의 호성퇴적층을 대상으로, 이들 퇴적층의 퇴적상, 화석상, 고토양상 등을 비교퇴적학 및 층서학적인 측면에서 분석하였다. 세 호수퇴적층의 공통적인 발달특성은 1) 전반적으로 쇄설성퇴적층이 지배적인 반면, 2) 삼각주퇴적층이 수반되어 있지 않으며, 3) 이질평원퇴적층이 흔히 발달되어 있고, 4)스트로마톨라이트의 발달이 없는 점 등이다. 한편 세 호수퇴적층 발달특성의 대표적인 차이점은 다음과 같다: 1) 진동층은 다른 두 호성퇴적층에 비하여 이질평원퇴적층의 발달이 지배적이며, 석회질고토양의 발달이 빈번하고, 다른 두 호성퇴적층에서는 산출되지 않는 공룡족흔 화석층의 발달이 일반적이다. 2) 건천리층은 다른 두 호성퇴적층에 비하여 무척추동물화석의 산출이 일반적이며, 다른 두 호성퇴적층에서는 발달하는 폭풍퇴적층이 발달되어 있지 않다. 3)황령산지역 호성퇴적층은 진동층 및 건천리층에서는 산출하지 않거나 매우 드물게 나타나는 증발광물의 캐스트가 흔히 산출되며, 응회질 저탁암층의 협재가 일반적이다. 세 호성퇴적층의 층서관계의 경우, 건천리층은 진동층의 하부에 대비되고, 황령산 지역 호성퇴적층은 진동층의 상위에 놓이는 지층으로 추정된다. 이들 3개 호성퇴적층의 층서관계 및 발달특성을 토대로 해석된 하양층군 퇴적말기에서 유천층군 퇴적초기에 이르는 동안의 경상분지 동남부 지역의 퇴적특성은 다음과 같다. 하양층군 퇴적말기의 경상분지는 지반이 비교적 안정된 상태였으며, 이에 따라 화산활동은 그리 활발한 편이 아니었다. 기후조건의 경우 하양층군 퇴적중기 때보다는 비교적 습윤하여져 호수환경이 확장된 상태였으나, 전반적으로는 건조한 기후가 지배적인 환경이었으며, 특히 건기와 우기가 교호되는 기후조건이발달하는 가운데에 매우 극심한 가뭄이 빈번히 발달하였다. 하양층군 퇴적말기에 경상분지의 동남부 지역은 호수연변부의 이질평원이 넓게 발달한 가운데에 퇴적작용이 매우 느리게 진행되었으나, 백악기 후기(하양층군 퇴적최후기 및 유천층군 퇴적초기)에 접어들면서 조구조운동과 이에 따른 화산활동이 활발해짐에 따라 이 지역의 퇴적속도는 상대적으로 빨라지게 되었다. 백악기 후기의 기후조건은 이전과 마찬가지로 건조한 기후가 전반적으로 유지되었으며, 일부 지역은 증발암광물이 형성될 정도로 건조한 기후가 발달하였다.

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베트남 중부고원지대 커피농가의 사회경제적 격차: 민족성의 영향을 중심으로 (Socio-Economic Differentials along the Ethnic Line among Coffee Farms in Central Highland, Vietnam)

  • 정수열;이승철;조영국
    • 한국경제지리학회지
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    • 제19권2호
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    • pp.360-377
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    • 2016
  • 베트남 중부고원 지대는 1986년 개혁개방 이후 커피생산의 비약적 증대, 글로벌 커피시장과의 적극적 연계 등을 통해 베트남뿐만 아니라 세계 유수의 커피생산 지역으로 변모하였다. 중부고원지대 커피산업의 비약적 발전은 베트남 저지 주민의 대규모 유입과 맞물려 진행되었다. 그 결과 중부고원지대는 소수민족 중심 사회에서 저지 출신 주류 민족, 킨(Kinh)족 중심 사회로 변모하였다. 한편 커피산업의 발전은 중부고원지대 가족농의 사회경제적 격차 나아가 계층 분화를 촉발하는 계기가 되었다. 커피 재배 여부 및 커피재배에서의 생산성 격차가 그대로 사회경제적 격차로 발현되었다. 이 과정에서 민족간 사회경제적 격차 문제, 소수민족의 주변화 문제가 부각되었다. 민족간 사회경제적 격차는 단순히 커피재배 참여 여부만이 아니라 커피경영에 있어서 수익성 격차에 의해서도 나타나고 있다. 기존 연구들은 소수민족농가의 커피 경영에 있어서 상대적 저효율이 소수민족의 인적 자본 및 사회적 자본의 취약성과, 문화적 특성에 따른 상업적 농업 부적응 측면을 지적하였다. 하지만 기존 연구들은 여전히 생산성의 격차가 발생하는 구체적인 메카니즘을 충분히 밝히지 못하고 있다. 이에 본 연구는 소수민족 원주민 커피농가와 다수민족 이주민 커피농가의 커피 생산 판매 과정을 비교 분석하여 커피소득 격차가 나타나게 되는 원인을 규명하고자 하였다. 사례 연구로 닥락 성의 다수민족 이주민인 킨족과 소수민족 원주민인 에데(Ede )족 커피농가를 설문하였다. 분석결과는 다음과 같다. 민족성은 커피농가간 토지생산성 격차를 설명하는 핵심 변인으로 확인되었다. 아울러 소수민족 커피농가의 낮은 생산성은 취약한 자본에 따른 조방적 경영, 부채 문제, 나아가 낮은 소득과 부채부담으로 인한 비효율적 판매전략-대표적으로 판매시기 조절-에서 비롯되는 것으로 판명되었다.

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IUHPE를 통한 건강 증진 프로그램의 발달-동아시아권의 공동연구의 가능성- (Development of Health Promotion Program through IUHPE - Possibilities of collaboration in East Asia -)

  • Moriyama, Masaki
    • 한국보건교육건강증진학회:학술대회논문집
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    • 한국보건교육건강증진학회 2004년도 국제학술대회
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    • pp.1-16
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    • 2004
  • 이 논문은 다음 관점들로부터 건강 증진의 가능성들을 고찰해 본다. (1) IUHPE, (2) 사회문화적 유사성들 (3) 행동 연구, 그리고 (4) 과거로부터의 학습 1, IUHPE는 여러 지역에 걸쳐서 분산된 활약들을 평가하며, 일본, 한국, 홍콩, 대만과 중국은 NPWP 지역에 속한다. IUHPE 세계회의가 1995년에 일본에서 개최된 이래로, NPWP 회원수의 60% 이상을 일본이 차지하곤 했다. 2001년 이후로 중국어권 소구역에서 회원수가 급속히 증가하는 중이다. 다국적 합작(국적을 초월한 공동연구)은 여전히 그 초기 단계에 있다. 2. 유교는 중요한 부분중의 하나다. 유교적 전통은 단지 장애물로써 보여져선 안되며, 동아시아에서 더욱 만족스러운 건강증진의 형태를 추구하기 위한 이점들로써 보여져야 한다. 3. 새로운 공중보건체제 내에서, 사람들은 그들의 건강을 창조하고 존속시키도록 되어있다. 그러나 특히 일본에서는, 여전히 '직접 대면하는 숨김없는 상호작용의 부족' 추세가 학구적인 환경뿐 아니라 건강증진 환경에서도 흔하게 있다. 그러므로 저자는 WIFY 의뢰(사람들의 매일의 생활과 환경을 재검토하기 위한 주제를 놓고 고안된 상호 작용하는 질문들)나 토론회(원탁 회의 참석자들) 상호작용을 소개하는 것과 같은 참여적 접근들을 시도했다. 지금까지, 참여자 대다수가 새로운 시도들을 기꺼이 받아들이고 있다. 4. 1945년에 일본의 한국침입과 점령이 종결된 이후, 다음의 사회적 현상은 상대적으로 논의된다. -동양 의술의 상태, -공공 의료시설의 분리, 그리고 -국립 면허로써의 건강증진 전문가. 현 상태로 유지를 고집하고 실속 있는 사회 변화를 뒤로 미루는 일본의 경향에 반하여, 한국에서는 빠르고 역동적인 사회적 변화를 향한 추세가 더욱 흔하게 관찰되고 있다. 위의 모든 가능성들이 여전히 그 시작 단계에 있음에도 불구하고, 그들은 한층 더한 도전과 수반하는 연구들을 기다리고 있는 흥미로운 방향들을 제시할 것이다.연구에서 제시하는 유지관리 모델을 기반으로 각 지자체별로 적절한 컨설팅이 진행되고 이에 따라 담당자의 실천이 이루어진다면 지자체 GIS의 투자대비 효과에 대한 기대는 이상이 아닌 현실로 다가오게 될 것이다.가오게 될 것이다. 동일하게 25%의 소유권을 가지고 있다. ?스굴 시추사업은 2008년까지 수행될 계획이며, 시추작업은 2005년까지 완료될 계획이다. 연구 진행과 관련하여, 공동연구의 명분을 높이고 분석의 효율성을 높이기 위해서 시료채취 및 기초자료 획득은 4개국의 연구원이 모여 공동으로 수행한 후의 결과물을 서로 공유하고, 자세한 전문분야 연구는 각 국의 대표기관이 독립적으로 수행하는 방식을 택하였다 ?스굴에 대한 제1차 시추작업은 2004년 3월 말에 실시하였다. 시추작업 결과, 약 80m의 시추 코아가 성공적으로 회수되어 현재 러시아 이르쿠츠크 지구화학연구소에 보관중이다. 이 시추코아는 2004년 8월 중순경에 4개국 연구팀원들에 의해 공동으로 기재된 후에 분할될 계획이다. 분할된 시료는 국내로 운반되어 다양한 전문분야별 연구에 이용될 것이다. 한편, 제2차 시추작업은 2004년 12월에서 2005년 2월 사이에 실시될 계획이다. 수백만년에 이르는 장기간에 걸쳐 지구환경변화 기록이 보존되어 있는 ?스굴호에 대한 시추사업은 후기 신생대 동안 유라시아 대륙 중부에서 일어난 지구환경 및 기후변화를 이해함과 동시에 이러한 변화가 육상생태계 및 지표지질환경에 미친 영향을 이해하는데 크게 기여할 것이다.lieve in safety with Radioactivity wastes control for harmony with Environment.d by the experiments under various conditions.뢰, 결속 등 다차원의 개념에 대한 심도 깊은 연구와 최근 제기되고 있는 이론의 확대도 필요하다. 마지막으로 신뢰와 결속에 영향을 미치는 요소간의 개념적 분류, 차이의 검증, 영향력 등을 광범위하게 진행

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한방간호에 대한 간호학생들의 인식 및 태도에 대한 예비연구 (A Pilot Study in Cognition and Attitude of Nursing Students on Oriental Nursing)

  • 한상숙;김원옥;원정숙;현경선;최경옥;장경화;이미애;김숙영;전은영;김정숙;이은숙;배영숙
    • 동서간호학연구지
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    • 제8권1호
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    • pp.81-88
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    • 2003
  • This research has been conducted to examine the cognition and attitude of nursing students on Oriental Nursing, the subject of this research being 789 nursing students from 9 different universities who took the Oriental Nursing class. A questionnaire, the construct validity and reliability of which have been verified through enquiries into records and references as well as preliminary researches, was used as a research tool. The questionnaire, a set of 86 questions, was developed by the researchers of this study, and the reliability of the questionnaire is Cronbach's=.85. The collected data have been analysed using SPSS windows programme 11.0 for t-test and ANOVA, and the results are as follows: 1. There was a significant difference in cognition and attitude points according to the academic year (F=14.15, p=.000). After the post-hoc test, it was revealed that the points of the students in their 4th year were significantly higher than the points of the students in their 2nd or 3rd year. 2. There was a significant difference in cognition and attitude points according to the credits the students have taken (F=28.66, p=.000). After the post-hoc test, it was revealed that the points of the students who have taken from $3{\sim}5$ to $6{\sim}8$ credits were significantly higher than the points of those who have taken from 1 to 2 credits. 3. There was a significant difference in cognition and attitude points according to the period of time the students have experienced Oriental Nursing (F=32.06, p=.000). After the post-hoc test, it was revealed that the points of the students who have practised Oriental Nursing from 1 to 2 weeks were significantly higher than the points of those who have not practised it at all. 4. There was no significant difference in cognition and attitude points according to the treatment or hospitalisation of the students themselves or their family members. 5. The cognition and attitude points of the students who are deeply interested in Oriental Nursing were significantly higher than the points of those who are not (t=8.83, p=.000). 6. The cognition and attitude points of the students who have higher expectations for the development of Oriental Nursing were significantly higher than the points of those who have not(t=5.90, p=.000). 7. The cognition and attitude points of the students who believe that the Oriental Nursing will contribute to the expansion of the roles of nurses were significantly higher than the points of those who do not (t=6.60, p=.000). 8. The cognition and attitude points of the students who expect that the Oriental Nursing will be effective in prevention of chronic diseases were significantly higher than the points of those who do not (t=5.80, p=.000). According to the results above, it was confirmed that proper education on Oriental Nursing can have affirmative effects on the cognition and attitude of the nursing students towards Oriental Nursing.

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농촌 거주 비농업 종사 가족의 식습관과 건강 행동 (Non-farming family's Food Habits and Health Behavior Compared with Farming Family living in Rural, Korea)

  • 정금주;조숙자;조영숙;박동연;원향례;이승교
    • 한국지역사회생활과학회지
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    • 제16권4호
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    • pp.139-157
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    • 2005
  • In rural area, as the source of family income is related with the agriculture works, the living condition of non-farming family used to be lower except some family groups with a little higher income. In order to find out the improvement in rural life, data about the health behavior and diet habits of non-farming family were observed. This study evaluated the health behavior and diet habits of non-farming families by comparing them with those of the farming families in rural area. The survey was made by trained interviewers and a total of 1,870 subjects from 9 provinces were questioned to collect the data through sampling probability proportional to size. The non-farming families were $29.6\%$ of the total and they were with no spouse($38\%$), low number of family members(2.86), and aged husband(66.8 years) or wife(58.5 years). $83.1\%$ of the non farming families were having breakfast however, $95.1\%$ of the farming families were doing it. And the number of side dishes in non farming families was low(1-2 kinds: $17.7\%$). Out of non farming families, $47.3\%$ took no nutritional supplements and out of the farming families it was 40.8 $\%$ With regard to having snacks, $22\%$ of non-farmers had snacks daily and it was greater than that of farmers($16.6\%$). But the ratio of non-snack taking of the non-farmers($29.6\%$) was higher than that of farmers($24.5\%$). The sorts of snacks also varied and for farmers it used to be fruit and noodles and for non-farmers it was bread and milk. Instant foods were often selected by $35.6\%$ of non-farmers. Dining out with a frequency of once per month was reported in $23.2\%$ of non-farming families, but $47.6\%$ of them did not dine out at all. In case of food production for family consumption, small portion of non-farmers cultivated pepper($13.3\%$), Korean cabbage ($16.2\%$), and sesame($6.2\%$) but almost all of the farmers cultivated such crops. However, non-farmers produced soybean sprouts($0.7\%$), soybean curd($0.2\%$), and eggs($7.2\%$) and it was compared with the fact that farmers produced soybean sprouts($9.7\%$), soybean curd ($4.6\%$), and eggs($5.1\%$). Non-farmers stocked the fermented foods: Doenjang ($57.8\%$), Kochujang ($56.1\%$), Kanjang ($53.6\%$), Kimchi ($77.9\%$) and Jangajji ($37.2\%$), and this ratios were smaller than those of farmers: Doenjang ($93.6\%$), Kochujang ($92.9\%$), Kanjang ($87.9\%$), Kimchi ($97.7\%$) and Jangajji ($66.7\%$). As to health behavior of the subjects, non-farmers had less medical examinations and bathing than farmers did. Non-farmers and their wives used public bath facilities more often and it may be due to the low condition of bathing facilities. And the ratio of daily alcohol consumption was $15\%$ and it was higher than that of the farmers. Most of the spouse of the farmers did not drink($78\%$), but the wives of the non-farmers were drinking more frequently. More farmers smoked than non-farmers and $45\%$ of male farmers were smokers.

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모성 간호 실습 후 분만과정에 대한 간호학생의 심리적 반응 고찰 -모성 간호 실습, 실습에 대한 간호학생의 심리적 반응- (A Review of Responses of Nursing Students Following Clinical Maternity Nursing Practice)

  • 조정호
    • 모자간호학회지
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    • 제4권1호
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    • pp.41-51
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    • 1994
  • The purposes of this study were to identify responses of nursing students following clinical maternity nursing practice, to develop data of further effective clinical maternity nursing practice, to understand nursing students perceive the natural maturation process toward pregnancy delivery and puerperal process, to help the nursing students achieve personality growth and development through clinical maternity nursing practice. The subjects were 35 senior nursing students from the Department of Nursing Science of Chung-Ang University. The data were collected from the 1st semester (Feb.22$\sim$June 9) to the 2nd semester(Aug.23$\sim$Nov.10), 1993 through self-reporting using an open ended questionnaire about perception and feelings regarding the normal delivery process. The data analysis used descriptive method. Results of the study were as follows : 1. Following clinical practice in maternity nursing, the responses of the nursing students were collected included both positive and negative aspects. The positive responses were classified in to four categories and each category included subgroups. One group, labelled as $\ulcorner$The birth of noble life$\lrcorner$ had a subgroup, (I felt the mystery and wonder of life), another group, $\ulcorner$After delivery, comfort and satisfaction$\lrcorner$ with the subgroup (I can bear to see the comfort and relief beyond pain) (C/S is better than vaginal delivery) (Very easy), the 3rd group, $\ulcorner$ I realized family friendship and support$\lrcorner$ with subgroup (Honorable, Magnificient) (I thank my parents ) (It's good to looking at my husband's support), and the 4th group, $\ulcorner$The birth of a healthy baby$\lrcorner$, with its subgroup, (baby looks pretty and healthy). 2. The negative responses were classified in eight categories and each category included subgroups. One group labelled as $\ulcorner$Fear$\lrcorner$, had subgroups of (Terrible, Horrible) (Shock) (Dread), another group, $\ulcorner$Tension$\lrcorner$, and its subgroup, (I became tense about stories heard before clinical practice), the 3rd group, $\ulcorner$surprise$\lrcorner$ and its subgroup (I was surprised at the delivery process), the 4th group, $\ulcorner$Power lessness$\lrcorner$ and its subgroup, (I watched the labor pain impatiently), the 5th group $\ulcorner$Apathy$\lrcorner$ ; and its subgroup, (I didn't feel the empathy for the labor pain of the pregnant women), the 6th group, $\ulcorner$Disgust$\lrcorner$ and its subgroup, (Disgust, Embarrassed), the 7th group, $\ulcorner$Inevitable destiny$\lrcorner$ and its subgroups (necessity of self-sacrifice and difficulty) (I accepted it as a women's destiny) (I can't do it), the last group, $\ulcorner$There seems to be trouble$\lrcorner$ and its subgroup, (It seems to have been a little too hard for mother and baby). Suggestions for further studies are as follows : 1. Nursing students should receive intensive education about $\ulcorner$The birth of noble life$\lrcorner$ $\ulcorner$After delivery, comfort and satisfaction$\lrcorner$ $\ulcorner$I realized family friendship and support$\lrcorner$ $\ulcorner$The birth of a healthy baby$\lrcorner$, so that a more positive attitude can be developed before clinical maternity nursing. 2. Nursing students should be given an orientation which is reality based and related clinical maternity nursing (using for A.V. Materials), so that they will not feel they tension, of the negative categories. 3. Nursing students should be received articles on Pain Relief Method, so that they will be prepared activie and positive in the clinical practice, and therefore they will not feel the powerlessness, of the negative categories. 4. F/U for responses of nursing students should be checked following clinical maternity nursing to evaluate the effects of the instruction.

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관상동맥 우회술 환자를 위한 Critical Pathway개발 (Development of a Critical Pathway for Patients with Coronary Artery Bypass Graft)

  • 김기연
    • 대한간호학회지
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    • 제28권1호
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    • pp.117-131
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    • 1998
  • The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

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한국인의 건강관행에 대한 민속과학적 접근 (Ethnosientific Approach of Health Practice in Korea)

  • 김귀분;최연희
    • 대한간호학회지
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    • 제21권3호
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    • pp.396-417
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    • 1991
  • In order that nursing care an essential quality of nursing practice be acceptable and satisfying, it is necessary that client's culture be respected and that nursing practice be appropriate to that culture. Since cultural elements are an important influence on health practices and life patterns related to medical treatment, recovery from and prevention of disease, nurses need to have an understanding and knowledge of social and cultural phenomena to aid in the planning of nursing interventions. To understand the health practices surrounding health and illness, the health beliefs and practices of both folk and professional healing systems should be ascertained. Cultural data are required to provide care of high quality to clients and to reduce possible conflict between the client and the nurse. It is nursing's goal to provide clients from various cultures with quality nursing care which is satisfying and valuable. The problem addressed by this study was to identify Korean health practices which would contribute to the planning of professional caring practice with the culture : ultimately this study was intended to make a contribution to the development of the science of nursing. The concrete objectives of this study were ; 1) to identify Korean health practices, 2) to interpret the identitial health practices through traditional cultural thought, and 3) to compare the Korean health practices with those of other cultures. The investigator used the ethnosceintific approach outlined by spradly in a qualitative study. To discover ancestral wisdom and knowledge related to traditional health practeces, the subjects of this study were selected from residents of a small rural mountain village in south west Korea, a place considered to be maintaining and transmitting the traditional culture in a relatively well -preserved state because of being isolated from the modern world. The number of subjects was 18, aged 71 to 89. Research data were collected from January 8 to March 31, 1990. Five categories of health practices were identified : “Manage one's own mind”, “Moderation in all thing”, “Live in accord with nature”, “Live in mutuality with others”, and “Live to the best of one's ability”. Values derived from these ways of thinking from Confucianism, Taoism and Buddhism help fashion a traditional way of life, examplified by the saying “Benifience to all”. Korean thought and philosophy is influenced primerily by Confucianism, Confucian principles of ethics, embedded deeply in the peoples' minds, form the idea that “heaven and human being are intimately united” based on concept that “heaven is, so to speak, reason”. Twoe Gae's theory of existential subjectivity develops the concept of self which is the basis of the spirit of reverence in modern Confucian philosophy. The human md is granted from heaven out of the idea of matter, and what control the mind is the spirit of reverence. Hence the idea of “The primacy of the mind" and provided that one should control one's own mind. The precepts of duty to parents, respect for elders and worship of ancestors, and moderation in all behavior put a restraint on life which directed that one live earnestly according to Nature's laws with their neighbors. Not only Confucianism, but also Buddism and Taoism have had an important effect upon these patterns of ideas. When compared with western culture, Korean health practices tend to be more inclusive, abstract and intuitive while westerner health practices found to be mere concrete, practical and personal. Values and beliefs based and pragmatism and existentialism infuence western civilization, Ethical values may be founded on utilitarianism, which considers what is good for the persons in their circumstances as the basis of conduct and takes a serious view of their practical lives including human aspirations rather than an absolute truth. These philosophical and ethical ideas are foundations for health practices related to active, practical and progressive attitudes. This study should be enable nursing not only to understand clients as reflections of the traditional culture when planning nursing practice, but to dovelop health education corresponding to cultural requiments for the purpose of protection against disease and improvement of health, and thus promote sound health practice. Eventually it is hoped that through these processes quality nursing care as the central idea of the science of nursing will be achieved.

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Structural Equation Modeling을 통한 노인(老人)의 구강건강(口腔健康) 관련요인(關聯要因) 분석(分析) (Oral Health and Related Factors for the Elderly)

  • 성정희
    • 치위생과학회지
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    • 제4권3호
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    • pp.91-95
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    • 2004
  • 본 연구는 구강보건실태와 관련요인을 분석하고 관련요인의 인자구조모델을 구축하는데 그 목적이 있다. 연구 대상자는 2002년 1월부터 12월까지 국민건강보험공단이 실시한 지역가입자 건강검진(1차)을 받은 65세 이상 노인 9,340명이다. 대상자는 구강검진을 포함한 모든 검진을 받고 문진표를 작성한 노인들이다. 분석의 주요결과는 다음과 같다. 1. 구성개념타당성에 대한 검토체위검사, 요 검사, 혈액검사, 식 습관, 음주 흡연, 치료 예방, 구강증상, 구강건강상태 등 인자구조모델의 구성개념타당성은 적합도 지수 GFI, CFI, TLI, RMSEA를 이용하여 분석한 결과 모두 적합한 범위에 있었으므로 구성개념타당성은 인정되었다. 2. 각 요인과 구강건강상태와의 관련성을 보기 위한 구조방정식 모델을 분석한 결과 요 검사를 제외한 모든 요인이 구강건강상태에 영향을 미치고 있음이 확인되었으며 이를 설명할 종합적인 구조모델을 구축할 수 있었다. 이상의 결과, 치과 방문과 치면세마 경험이 적은 농촌지역이 도시지역에 비해 치아우식증, 치아 결손을, 의치필요자율이 높았으며, 음주 흡연이 치아우식증, 치주질환, 치아결손율에 부정적인 영향을 주고 있음을 확인할 수 있었다. 또한 치주질환은 전체의 3.2%에서 관찰되었으며 낮은 연령에서 많이 확인되었다. 대부분의 구강질환은 올바른 구강건강행동의 실천으로 예방 가능하므로 전국 각 지역 보건소를 중심으로 구강보건전문가에 의해 바른 식 습관과 구강건강관리에 관한 노인구강보건교육이 체계적으로 이루어져야 하며, 경제적, 지리적인 장애로 인해 치과기관을 방문하지 못하거나 치면세마, 의치장착 등의 구강 건강행위를 소홀히 하지 않도록 하기 위한 치과 의료서비스 접근도를 높히는 정책전환이 요구된다. 또한, 구강건강상태와 전신건강과의 관련성을 설명하기 위해 구조모델을 구축하기 위해서는 보다 정확한 검사방법과 효과적인 지표 개발이 선행되어야 한다. 이 연구에서는 국민건강보험공단에서 개발한 항목을 그대로 적용하였기 때문에 모델 구성에 한계점이 있었다. 향후 계속적인 연구가 필요할 것으로 사료된다.

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