• 근관절건강학회지
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• 제2권1호
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• pp.17-40
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• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

• 한국초등수학교육학회지
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• 제13권2호
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• pp.211-229
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• 2009

본 연구에서는 7차 교육과정에서 6학년 때 도입되는 교과서의 비례 문제들이 학생들의 비례 추론 능력과 어떠한 관련이 있는지를 알아보기 위해 교과서의 비례 문제 해결 실태를 파악하고, 수준별 비례 추론 능력을 하위영역으로 나누어 교과서 비례 문제 해결 능력에 따라 하위영역별로 비례추론 능력이 어떠한지 분석하였다. 연구결과 교과서의 비례 문제에서 정답률이 높은 문제들은 설명에서 비례식을 이용해서 풀 수 있도록 제시되어 있었으며, 비례식을 세웠을 때 두 비 사이의 관계가 정수비로 계산이 간단하였다. 비례 추론 하위 영역 중 비감각 영역의 문제 해결을 잘하였고, 양과 변화 영역에 대한 부분의 능력은 가장 뒤떨어졌다. 교과서의 비례 문제 해결 능력과 비례 추론의 관계에 대해서는 교과서의 비례 문제 해결이 우수한 학생일수록 비례 추론 능력이 우수였다. 교과서 비례문제의 해결 결과가 비례추론 능력을 예언할 수 있다고 볼 수 있다. 교과서 비례문제 수준에 따라서 비례 추론 문제 해결의 수준차를 알아본 결과, 차이가 많이 나지 않는 문제는 꼭 비와 비율 관련 단원이 아니라도 수학 교과서에서 다양하게 접할 수 있는 문제였고, 수준별 차이가 많이 나는 문제는 그동안 교과서에서 쉽게 접해보지 못한 유형으로 단순히 비례식을 이용해서는 해결할 수 없는 문제들이었다. 따라서, 비례추론 하위 영역별로 모든 영역에 대하여 능력을 향상시키기 위해서는 교과서에 비례식 외에 다양한 상황과 내용의 비례문제를 포함하여 지도하여야 할 것이다.