• 제목/요약/키워드: Science Programme

검색결과 243건 처리시간 0.027초

Quality of Life and Psychological Well-Being of Colorectal Cancer Survivors in Jordan

  • Abu-Helalah, Munir Ahmad;Alshraideh, Hussam Ahmad;Al-Hanaqta, Motasem Mohammad;Arqoub, Kamal Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권18호
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    • pp.7653-7664
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    • 2014
  • Background: Colorectal ranked first among cancers reported in males and ranked second amongst females in Jordan, accounting for 12.7% and 10.5% of cancers in males and females, respectively. Colorectal cancer patients can suffer several consequences after treatment that include pain and fatigue, constipation, stoma complications, sexual problems, appearance and body-image concerns as well as psychological dysfunction. There is no published quantitative data on the health-related quality of life and psychological wellbeing of Jordanian colorectal cancer survivors. Method: This project was a cross-sectional study of colorectal cancer survivors diagnosed in 2009 and 2010. Assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the colorectal cancer specific module (EORTC QLQ-CR 29) and the Hospital Anxiety and Depression Scale (HADS). Data on potential predictors of scores were also collected. Results: A total of 241 subjects completed the study with mean age of $56.7{\pm}13.6$. Males represented 52.3% of study participants. A majority of participants reported good to high overall health; the mean Global health score was $79.74{\pm}23.31$ with only 6.64% of study participants scoring less than 33.3%. The striking result in this study was that none of the study participants participated in a psychosocial support group; only 4 of them (1.7%) were even offered such support. The mean scores for HADS, depression score, and anxiety score were $8.25{\pm}9$, $4.35{\pm}4.9$ and $3.9{\pm}4.6$, respectively. However, 77.1% of study participants were within the normal category for the depression score and 81.7% were within this category for anxiety score; 5.4% of participants had severe anxiety and 5.4% of them had severe depression. Discussion: Patients with colorectal cancer in Jordan have a good quality of life and psychological wellbeing scores when compared with patients from western countries. None of the colorectal cancer patients managed at the Ministry of Health received any formal counselling, or participated in psychological or social support programmes. This highlights the urgent need for a psychosocial support programme, psychological screening and consultations for patients diagnosed with colorectal cancer at the Ministry of Health Hospitals.

중환자 가족의 요구 요인 분석 연구 (Factor Analysis of the Seriously-ill Patient인s Family Needs)

  • 권성복;이미라
    • 대한간호학회지
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    • 제17권2호
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    • pp.122-136
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    • 1987
  • A group of studies revealed that family members of the seriously ill patient had some needs during the period of patient's hospitalization. Needs of the seriously-ill patient family could be classified into three aspect, i. e. needs on the prognosis of patient, needs on the well-being of family members themselves and needs on hospital environment. Several instrument were developed to measure the needs of the seriously ill patient, but their content tended to overemphasize the aspect of the prognosis of patient. The purpose of this study was to develop a new instrument to measure the needs in the aspect of the seriously ill patient's family themselves in details to increase the cummulative Percentage of the scale. Subjects were 134 family members of the seriously-ill patients, who were bung cared in ICU of seven university hospitals and data were collected from march 16, 1987 to April 11, 1987. The instrument used in this study was made by the author on the basis of results of literature review. Content valitity of the instrument was tested by a professor majoring in nursing and reliability by calculation of Cronbach's α with data of the respondents. Data was analyzed as follows, using SAS, computer system. Factor structures of the seriously ill patients' family needs were elicited by factor analysis. The programme was the Principal Component Factor Analysis Method of factoring employing Varimax Orthogonal Rotation. The influences of the demographic variables on the degree of the seriously-ill patients' family need were analyzed by t-test and P-test. Results were as follows. 1. Needs of the seriously-ill patients' family elicited and their cummulative percentage were: Needs to be supported emotionally, 29.2% Needs to be informed on facilities available, 9.6% Needs to be informed on the patient's prognosis, 7.7%. Needs to be supported spiritually, 5.1%. Needs to be informed on hospital environment, 4.2%. Needs to be helped to spare time, 3.9%. Needs to be informed on their role, 3.5%. Needs to be present near patient, 3.3%. 2. Educational background was found to influence on some factors. College-graduate group had higher Bevel of needs to be . informed on facilities available to be informed on the patient's prognosis, needs to be supported spiritually, needs to be helped to spare time, needs to be informed on their role than high school graduate group. 3. Among the parents, sons and daughters and the relative groups, the parents of the seriously ill patient had highest level of needs to be present near patient. Suggestions for further studies were as follows. 1. As the instruments used in the previous studies had high cummulative percentages in the aspect of the prognosis of patient and that in this study in the aspect of the prognosis of patient and that in this study in the aspect of the seriously ill patient's family themselves, development of a new instrument which combined the items of both of them is needed. 2. A study to clarify the influence of type and number of admission on need to be supported emotionally is needed.

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The relationship between household income and dietary intakes of 1-10 year old urban Malaysian

  • Shariff, Zalilah Mohd;Lin, Khor Geok;Sariman, Sarina;Lee, Huang Soo;Siew, Chin Yit;Yusof, Barakatun Nisak Mohd;Mun, Chan Yoke;Mohamad, Maznorila
    • Nutrition Research and Practice
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    • 제9권3호
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    • pp.278-287
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    • 2015
  • BACKGROUND/OBJECTIVES: Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. SUBJECTS/METHODS: Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. RESULTS: For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. CONCLUSION: Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.

스웨덴과 한국 유아교육기관 교사의 급식 지도 태도 비교 연구 (A Study of Early Child Care Center Teachers' Attitudes for Meal and Snack Guidance between Sweden and Korea)

  • 한유미;이영환;이진숙;오연주;권정윤;안경온;박은숙
    • 대한지역사회영양학회지
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    • 제9권6호
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    • pp.706-715
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    • 2004
  • The objective of this study was to compare early child care center teachers' attitudes for meal and snack guidance between Sweden and Korea. Participants were 251 early child care center teachers (Sweden: 134, Korea: 117) working in Goetebory, Sweden, and Seoul, Korea. The survey was conducted from December in 2003 to February in 2004. SPSS programme was used for statistical analysis. Sixty five point eight percent of the Korean early child care center teachers provided a certain amount of foods for children. But $20.9\%$ of Swedish provided a certain amount of foods for children, $79.1\%$ of them provided the amount a child wanted. Sixty one point seven percent of Korean teachers allowed a child leave foods on the plate, but $95.5\%$ of Swedish teachers asked a child eat all food on the plate. When a child didn't want to eat, $61.1\%$ of the Korean teachers fed him/her, but $11.0\%$ of the Swedish teachers did. Only $42.4\%$ of the Swedish teachers allowed a children eat sweets, but $92.9\%$ of Korean did. The Swedish teachers' perception for food guidance were eating by child himself/herself > washing hands before eating > having appropriate table manner > eating as talking with friends > not playing during the meal time, while the Korean teachers' was taking various food > having appropriate table manner > eating by child himself/herself, not playing during the meal time > washing hands before eating. The Swedish teachers thought 'eating as talking with friends' and 'eating by child himself/herself' is important, where as the Korean's did 'eating without making noise', 'not playing during the mealtime' in the eating behavior. For 'brushing teeth after meal' the Swedish teachers' score (1.5) was lower than the Korean (4.2). The results is necessary to improve meal and snack guidance for Korean early child care center teachers' education.

암환자의 삶의 질, 지각된 건강상태 및 암재발 인지에 관한 연구 (A Study on Cancer Patients' Quality of Life, Perceived Health Status and Susceptibility.Severity for Cancer Recurrence)

  • 신임식;한상숙
    • 동서간호학연구지
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    • 제11권2호
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    • pp.146-154
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    • 2005
  • Purpose: This study was designed to identify the relationship between quality of life, perceived health status, perceived susceptibility severity to recurrence of cancer and character of object in cancer patients to provide the basic data of effective nursing interventions. Method: The subject of this study was randomly chosen from the patients diagnosed of cancer and being hospitalised or receiving chemotherapy as outpatients, at a Division of Hemato-Oncology, Department of Internal Medicine of a university hospital located in Seoul. The tool used in this study was a measurement tool for quality of life (${\alpha}=.829$), perceived health status (${\alpha}=.903$), and perceived susceptibility and severity for cancer recurrence (${\alpha}=.860$). The collected data were analysed using SPSS PC 12.0 Programme for real number, percentage, average, standard deviation, Pearson's Correlation, t-test and ANOVA, according to the purpose of this study. Result: 1) The score of quality of life in cancer patients was 3.64 point, perceived health status was 2.62 and perceived susceptibility severity to recurrence of cancer was 2.41. 2) There was a significant difference in the quality of life according to general characteristics, such as level of education, occupation, level of activity, pain, medication period, diagnosis, disease stage, purpose of medication, and recurrence. There was a significant difference in perceived health status according to age, level of activity, pain, diagnosis, purpose of medication, and recurrence. There was a significant difference in perceived susceptibility severity to recurrence of cancer according to age, level of education, and pain. 3) The cancer patients' quality of life showed significant correlation with perceived health status, perceived susceptibility severity to recurrence of cancer, pain, job, treatment purpose, relapse. The perceived health status showed significant correlation with perceived susceptibility severity to recurrence of cancer, pain, treatment purpose, relapse. The perceived susceptibility severity to recurrence of cancer showed significant correlation with pain. The relapse showed significant correlation with treatment purpose. The cancer patients' quality of life, perceived health status, and perceived susceptibility and severity for cancer recurrence, as confirmed above, showed differences according to the related factors of each subject, and it was also confirmed that those factors were significantly related with general characteristics. Upon these results, I suggest further studies on the factors that affect the cancer patients' quality of life.

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치과위생사들의 학점은행제에 대한 인식 및 요구 (A Study on the Recognition and Requirement of Dental Hygienists for Academic Credit Bank System)

  • 장영호;최미숙;김은희;양승경
    • 치위생과학회지
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    • 제7권4호
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    • pp.287-293
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    • 2007
  • 치과위생사의 학점은행제에 대한 인식도 및 요구를 조사하기 위해 2007년 7월 15일부터 8월 14일까지 서울 경기, 광역시, 강원도, 경상도에 위치한 치과 병 의원에 근무하는 치과위생사 271명을 대상으로 설문조사를 실시하여 SPSS 11.5를 이용하여 분석한 결과 다음과 같은 결론을 얻었다. 1. 학점은행제에 대한 인식은 70.8%, 인식한 정보매체로는 주위사람들이 52.4%로 가장 높았고, 참여하겠다 인 경우에는 학사학위 취득의 기회가 23.4%이었으며, 참여하지 않겠다 인 경우에는 교육활동에 참가할 시간 부족이 13.3%로 각각 가장 우선적인 선택으로 조사되었다. 2. 학점은행제에 대한 교육비는 3만원 이상~5만원 미만이 49.4%였고, 교육방법은 이론과 실습이 62.4%로 가장 많았고, 이론과 실습의 비율은 50 : 50이 가장 많았으며, 중점적으로 운영해야 할 사항으로는 사회적 인정 증대가 35.4%, 학습자의 요구 반영이 32.5%로 나타났으며, 교육내용은 근무 시 활용 가능한 임상내용이 55.0%로 가장 높게 나타났다. 3. 전공과목의 영역별 중요도는 예방치과처치영역이 3.61, 치과경영영역이 3.38, 구강보건교육영역이 3.09, 진료협조영역이 2.82, 공중구강보건영역이 2.11의 순으로 나타났다. 4. 전공과목의 영역 분야별 중요도는 구강보건교육영역 분야에서는 대상자별 구강보건교육분야가 2.30, 예방치과처치 영역 분야에서는 치태조절 및 치면세마분야가 3.53, 공중 구강보건영역 분야에서는 불소용액양치사업관리분야가 2.86, 치과경영영역 분야에서는 상담분야가 3.24, 진료협조영역 분야에서는 진료보조분야가 1.53으로 각각 가장 우선순위로 나타났다.

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RapidEye 영상을 이용한 북한의 논 면적 산정 (Estimation of Paddy Field Area in North Korea Using RapidEye Images)

  • 홍석영;민병걸;이지민;김이현;이경도
    • 한국토양비료학회지
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    • 제45권6호
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    • pp.1194-1202
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    • 2012
  • 북한과 같이 접근이 힘들고 농업과 관련된 정보가 부족한 지역을 대상으로 RapidEye 위성영상의 판독 및 분류를 통하여 가장 기초적인 농업 현황과 생산 기반인 논 면적을 산정하였다. 291개의 RapidEye 영상을 이용하여 북한 전역을 대상으로 시기별로 논을 분류하기 위한 영상 판독 기준을 설정하였다. 5월 초에서 6월 말은 벼 이앙을 위해 관개를 하기 때문에 벼 이앙 전후에 물의 특성이 위성영상에서 잘 관측되기 때문에 영상이 어둡게 보이는 점을 이용하여 논과 다른 토지이용을 구분한다. 주요 벼 생육시기인 7월 초부터 9월 말에는 RapidEye 영상을 5:3:2 밴드조합으로 하여 영상을 판독하면 벼논의 색상과 질감의 차이를 이용하여 밭작물, 초지, 산림으로부터 논을 분류한다. 9월 말부터 10월 말은 벼 수확을 한 후로 논에 식생이 없는 시기로써 5:3:2 밴드 조합에서 회색빛이 나는 경지 형태를 대상을 논으로 판독한다. 그 결과 북한 전역에 대한 논 분포지도를 작성하였고 시도 행정구역별로 논 면적을 살펴보았다. 대부분의 논은 평안남북도와 황해남도가 위치한 서해안 평야지대에 전체 논 면적의 66% 정도인 $3,521km^2$가 분포하였고 함경남북도, 강원도, 나선시와 같이 동해에 인접한 지역의 논 면적은 $1,172km^2$로 전체 논 면적의 약 20%를 차지하는 것으로 나타났다. RapidEye 영상을 이용하여 분류한 논 면적은 2001년 및 2010년 FAO/WFP 북한 보고서와 비교할 때 각각 1% 이내의 면적 편차를 나타내었다. RapidEye 위성영상을 이용한 북한의 논 분류 결과는 농경지 이용 면적의 산정과 변화, 벼 수량 추정을 위한 마스킹 (masking) 자료로 활용될 수 있는 기본 자료로 의미가 매우 큰 것으로 판단된다. 향후에는 밭에 대한 분류 지도를 구축하고 나아가 옥수수와 같은 주요 밭작물에 대한 판독 방법에 대해서도 연구할 필요가 있을 것으로 생각된다.

초등교사의 구강보건교육 경험에 따른 구강보건 인지 및 태도 (The Impact of the Oral-Health Education Experiences of Elementary School Teachers on Their Oral-Health Awareness and Attitude)

  • 장종화;장선희;김미정;이지연;장윤정
    • 한국치위생학회지
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    • 제1권2호
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    • pp.227-242
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    • 2001
  • The purpose of this study was 10 examine whether or not the dental- health education experiences of elementary school teachers have any influence on their oral-health awareness and attitude. The subjects in this study were 414 selected teachers from Seoul and North Cholla province. The instrument used by Lee Heung-su was modified into self- reporting questionnaire, and the schools where the subjects were working were visited to conduct a survey for 28 days from September 15 to October 13, 2000. For data analysis, SPSS was employed, and chi-squre, t-test and ANOVA were implemented. The findings of this study could be listed as below: 1. 184(44.4%) out of the techers investigated had ever been educated in dental health, and 230 teachers(55.6%) hadn't. 47% replied they hadn't received oral-health education for the lack of education opportunities. 2. In regard to dental-health awareness and attitude. the presence or absence of dental-health education experiences didn't make any difference to their daily toothbrushing frequency(p>0.05). The use of fluorine was significantly different between the groups(p<0.01), as 42.9% of the teachers with dental-health education experiences and 63.9% of the others with no such a experience didn't use that, 45.7% of the former group and 29.1 % of the latter accurately knew how to brush teeth, and the difference between the two was significant (p<0.01). 3. Concerning student-related dental-health awareness and attitude, the dental-health education experiences make 45.7% of the educated group and 31.7% of the uneducated group agreed to the strong need for oral examination, and the gap between the two was significant(p<0.01). 90.8% of the former group gave counsel to students on dental health, and 77.2% of the latter didn't. The gap between the two was significant as well (p<0.01). 77.2% of the educated group and 41.3% of the uneducated group offered frequent dental-health education, and the difference between the two was significant (p<0.01). 4. Their awareness of the fluorine-based toothbrushing project differed significantly by region(p<0.05), as the teachers from North Cholla province recognized it better than those from Seoul. The female teachers provided more education regarding that project, and those who were older or had more teaching experiences were more aggressive in instructing that project(p<0.01). And the married teachers took more forward attitude than the unmarried (p<0.01). By school location, the teachers from Seoul showed more active attitude than those from North Cholla province(p<0.01), and the gap between the two was significant. As to cooperation, those who were older or had more teaching experience were more cooperative, and the married teachers joined forces better than the unmarried. The gap was significant (p<0.01). 5. Concerning the awareness and attitude of the fluorine-based toothbrushing project, the educated teachers took more aggressive attitude, and the difference between the two was significant(p<0.01). The above-mentioned findings suggested that the dental-health awareness and attitude of the elementary school teachers were under a lot of influence of their oral-health education experiences, and there is a need to develop and carry out education programs for teacher.

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우라늄 섭취의 유도조사준위 산출 (Calculation of Derived Investigation Levels for Uranium Intake)

  • 이나래;한승재;조건우;정규환;이동명
    • Journal of Radiation Protection and Research
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    • 제38권2호
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    • pp.68-77
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    • 2013
  • 국내 원자력안전법, 산업안전보건법 및 최신 연구에 근거하여 우라늄 취급시설에서 종사자의 우라늄 섭취로 인한 방사선 위해의 최소화 및 화학적 독성 방지를 동시에 고려한 유도조사준위를 산출하였다. 본 연구에서 방사선 위해의 조사 준위는 연간 2 mSv-6 mSv의 예탁유효선량을 고려하였으며, 화학적 독성의 조사준위는 0.3 ${\mu}g$ $g^{-1}$의 신장의 우라늄 농도를 고려하였다. 결과로써 핵연료가공시설에서 3.5% 농축우라늄 취급 시, 공기 중 우라늄 농도측정의 유도조사준위는 Type F, Type M 및 Type S 우라늄 급성흡입 시 화학적 독성에 근거한 STEL의 값인 0.6 mg $m^{-3}$으로 산출되었다. 또한 Type F 우라늄 만성흡입 시 유도조사준위는 화학적 독성에 근거한 15.21 ${\mu}g$ $m^{-3}$으로 산출되었으며, Type M 및 Type S 우라늄 만성흡입 시 유도조사준위는 각각 방사선 위해에 근거한 0.41-1.23 Bq $m^{-3}$ 및 0.13-0.39 Bq $m^{-3}$으로 산출되었다. 폐 측정의 유도조사준위는 6개월 감시주기에서 Type M 우라늄 급성흡입 및 만성흡입 시 각각 0.37-1.11 Bq 및 0.39-1.17 Bq으로 산출되었으며, Type S 우라늄 급성흡입 및 만성흡입 시 각각 0.30-0.91 Bq 및 0.19-0.57 Bq으로 산출되었다. 이 값들은 일반적으로 사용되는 폐 측정 기기인 germanium 검출기의 검출한도인 4 Bq 이하로 나타나 폐 측정으로는 본 연구에서 설정한 조사준위를 만족시킬 수 없는 것으로 나타났다. 소변시료 분석에서 Type F 우라늄을 급성흡입 후 1개월 감시주기에서 유도조사준위는 화학적 독성에 근거한 14.57 ${\mu}g$ $L^{-1}$로 산출되었다. 또한 Type M 우라늄을 급성흡입 및 만성흡입 시 1개월 감시주기에서 유도조사준위는 각각 방사선 위해에 근거하여 2.85-8.58 ${\mu}g$ $L^{-1}$ 및 1.09-3.27 ${\mu}g$ $L^{-1}$으로 산출되었다.

지역아동센터 교사의 칫솔질 지도여부에 따른 아동과 교사의 구강보건행태 (The Oral Health Behaviors for Children and Teachers by Teacher-Supervised Toothbrushing in Community Child Center)

  • 신선정;장정유;김창희
    • 치위생과학회지
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    • 제12권6호
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    • pp.572-582
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    • 2012
  • 지역아동센터 아동의 구강건강증진을 위해 개인의 행동 변화, 물리적 환경의 변화와 더불어 교사의 역할과 책임을 고찰하고자 지역아동센터 내에서 양치시설이 설치되어 있는 센터와 그렇지 않는 센터와의 구강건강증진에 대한 견해를 비교한 결과는 다음과 같다. 1. 일상적으로 교사가 칫솔질을 지도하는 센터의 아동들이 급식 후 칫솔질 실천율이 높았고, 간식 후 칫솔질 칫솔질 또는 물양치를 실천하는 비율이 높았다(p<0.05). 또한 이를 교사가 지도하는 빈도는 일상적으로 칫솔질을 지도하는 센터의 경우 '항상 또는 자주 지도'하는 비율이 높았고, 더불어 치약의 사용량과 칫솔관리 및 보관 등 구체적인 구강건강관리 내용을 지도비율이 높았으며, 이는 일상적으로 칫솔질을 지도하지 않는 센터와 통계적으로 유의한 차이가 있었다(p<0.001). 2. 불량한 칫솔을 교체하지 못하는 아동의 비율이 40.0% 이상인 지역아동센터가 전체의 24.4% 수준이었고, 그 사유로는 대부분 부모의 관심부족으로 나타났으며, 이는 칫솔질 지도여부 간에는 통계적으로 유의한 차이가 없었다(p>0.05). 3. 지역아동센터 교사의 구강건강관련 보건행동은 칫솔질 지도여부와는 상관없이 일 평균 간식은 1회 정도 제공하며, 간식의 종류는 우식성 식품과 비우식성 식품을 반반 정도 제공하고 있었다. 또한 아동의 착한 행동에 대한 보상으로 일상적 또는 때때로 단것을 제공하는 비율이 각각 47.0%, 52.3%로 나타났다(p>0.05). 4. 지역아동센터 교사의 칫솔질을 지도여부와 상관없이 대부분의 교사들의 구강보건지식 수순은 높았고, 본인들의 칫솔질 실천도 일 평균 3회 정도로 높았으며, 회전법으로 칫솔질을 실천하고 있었다(p>0.05). 5. 지역아동센터 아동의 구강건강증진을 위한 환경 개선에 대한 견해는 칫솔질 지도여부와 상관없이 지역아동센터 아동의 건강증진 주체를 아동복지교사로 생각하고 있었으며(73.4%), 칫솔질 및 손씻기 용의 세면대 개선(77.2%)을 요구하였고, 대부분의 보건 프로그램을 건강증진 프로그램으로 생각하고 있으며, 그 중 양치와 손씻기 등 개인위생에 관한 내용의 요구도(100.0%)가 높았다. 뿐만 아니라 치과검진과 치과치료 연계(100.0%) 등 직접적인 치과의료 서비스제공의 요구도도 높았다. 이상의 결과로 지역아동센터 아동의 구강건강을 증진시키기 위해서는 아동의 올바른 구강건강관리 행동을 지속적으로 유지하기 위한 교사들의 적극적인 참여와 지도가 매우 중요하며, 이를 위해서 지역사회 내에서 교사를 위한 교육프로그램 마련뿐 아니라 사회적 지원이 함께 이루어져야 할 것으로 사료된다.