• 제목/요약/키워드: neglected child

검색결과 50건 처리시간 0.032초

저소득 모자가족 아동방임 개입 프로그램 개발 및 효과성 연구 (Intervention Program on the Child Neglect of Low-income Female-headed Families)

  • 박영희;신혜섭
    • 한국사회복지학
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    • 제44권
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    • pp.146-177
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    • 2001
  • One of the difficulties of female-headed families face is economic hardship. Low-income single mothers work long hours, become isolated and feel burdened for dual roles. And many of them don't have relatives to share parenting roles. As a result, children of low-income female-headed families are easy to be neglected and left to form a delinquency-prone group in neighborhood. Traditionally, it has been viewed that children in female-headed families have problems due to the loss of father role. However, study indicates that these children can adjust well if the relationship between mothers and children is consistent and adequate. An Intervention program for low-income female-headed elementary children was developed and delivered in two community social welfare centers. The purpose of the program is to raise self-esteem. Two goals were 1) management of daily living habits and 2) improvement of family relations. Social workers maintained contact with mothers to talk about children's behaviors and to prompt hugging and touching. In addition, workers helped children to form good relationships with peers and school teachers. Children were satisfied with the program. Their family relations were improved statistically significantly after the program(wilcoxon signed rant test z=-2.934 p<.05). However, their self esteem were not improved significantly (wilcoxon signed test z=-1.173 p>.05). Qualitative analysis of each children were also discussed. The implications of the study are the followings: Intervention programs need to be delivered separately for low-grade and high grade elementary children because they have different developmental needs. The program also need to include education on sex and marriage as well as aggression reduction. Society needs to provide more support to single mothers for their personal and parenting needs.

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사회성측정 지위 유형과 한국 아동 성격검사와의 관계 (Relationship between Status Type of Sociometric Measurement and Korean Personality Test for Children)

  • 이명숙;안이환;홍상황
    • 초등상담연구
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    • 제11권3호
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    • pp.391-405
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    • 2012
  • 본 연구의 목적은 한국형으로 개발된 5가지 사회성측정 지위 유형의 특징을 알아보기 위하여 한국 아동 성격검사(KCPI-S)의 10가지 임상척도를 사용하여 5가지 지위 유형의 아동들이 보이는 독특한 성격 특징을 발견하는 데 있다. 이러한 연구목적을 달성하기 위하여 A시 B초등학교 4.5.6학년 남녀 아동 502명을 대상으로 아동의 5가지 사회성측정 지위 유형과 아동의 성별을 각각 독립변인으로 삼고, 한국 아동 성격검사의 10가지 임상척도를 종속변인으로 하여 2개의 연구가설을 설정하고 검증하였다. 연구가설은 차례대로 다변량분석(MANOVA), t-검증을 통해 분석되었다. 그 결과 첫째, 5가지 지위 유형에 따른 10개의 임상척도에서의 차이를 분석한 결과, 언어발달 척도를 제외한 나머지 9개 임상척도에서 모두 유의한 차이가 나타났으며, 이때 종속변인에 대한 독립변인의 설명력을 나타내는 ${\eta}^2$는 9개 임상척도에서 최저 2%에서 최대 10%범위로 나타났다. 둘째, 성별에 따른 차이를 분석한 결과 양면성아동과 무시된아동은 10개의 임상척도 가운데 8-9개에서 남녀아동간에 유의미한 차이가 나타났지만 나머지 3가지 지위유형(인기, 평범, 배척아동)의 남녀아동간에 2-3개만 차이가 나타났다. 이러한 결과로 볼 때, 5가지 지위유형의 아동들은 각각 고유한 성격구조를 가진 것으로 보이며, 양면성아동과 무시된아동의 두가지 지위 유형은 성별을 적용한 성격 특징이 해석되어야 할 것으로 보였다. 따라서 후속연구에서는 아동의 언어발달과 사회성측정간의 관계구조에 대한 탐색연구가 필요하였으며 또한, 양면성아동과 무시된아동의 성별간 심리적 비교 및 나머지 사회성측정 유형과의 성별에 따른 관계구조를 연구해 볼 필요성이 있었다.

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로웨 증후군 환아의 치아우식 치료 증례 보고 (DENTAL TREATMENT UNDER GENERAL ANESTHESIA IN A PATIENT WITH LOWE SYNDROME : A CASE REPORT)

  • 류지연;신터전;현홍근;김영재;김정욱;장기택;김종철;이상훈
    • 대한장애인치과학회지
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    • 제12권2호
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    • pp.82-86
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    • 2016
  • 저자는 백내장, 지적장애, 신수질 석회화(medullary nephrocalcinosis), 근 긴장저하 증상을 보이는 로웨 증후군 환아의 다발성 치아우식 치료를 시행하였다. 협조도 부족 및 근 긴장저하로 인한 흡인 가능성을 고려하여 전신마취 하 술식을 진행하였다. 치료 결과의 유지를 위하여 적절한 구강위생 관리가 중요하며 향후 나타날 수 있는 구강내 증상의 진단과 관리를 위해 정기적이 검진이 필요하다.

지속적(持續的) 상기도(上氣道) 양압술(陽壓術)을 시행(施行)하여 치료효과(治療效果)를 본 주의력(注意力) 결핍(缺乏).과잉(過剩) 운동장애(運動障碍)를 동반(同伴)한 소아기(小兒基) 폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症) 1례(例) (A Case of Childhood Obstructive Sleep Apnea Syndrome with Co-morbid Attention Deficit Hyperactivity Disorder Treated with Continuous Positive Airway Pressure Treatment)

  • 손창호;신민섭;홍강의;정오언
    • 수면정신생리
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    • 제3권1호
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    • pp.85-95
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    • 1996
  • Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

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문화속의 인간심성과 문화를 넘어선 인간심성 - 동과 서의 보다 나은 만남을 위하여 - (Human Mind Within and Beyond the Culture - Toward a Better Encounter between East and West -)

  • 李符永
    • 심성연구
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    • 제28권2호
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    • pp.107-138
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    • 2013
  • 현대 임상정신의학이 그동안 잊어버렸거나 소홀히 해온 문화와 심성의 관계를 다음과 같은 내용으로 살펴보았다. 1. 문화 :01) 문화정신의학의 공적과 한계 및 그 해결책 ; 2) C.G. 융의 비 서구문화의 경험 ; 3) 융의 분석심리학적 입장에서 본 문화 ; 4) 문화스펙트럼 모델 2. 심성 :01) 원시시대 및 고대의 심(心) 신(身)관 ; 2) 동양적 심성론 ; 3) 자기Self와 동양사상 문화정신의학은 정신건강문제의 문화적 요인을 규명함으로써 정신의학에 큰 기여를 해왔으나 문화적 차이에만 관심을 집중한 나머지 인류보편의 공통된 심성을 도외시하는 경향이 있었고, 인간의 건강한 심성을 등한시하고 문화의 역사적 측면을 간과하였으며 문화 상호간의 역동적 상호관계의 무의식적 심층적 측면을 보지 못했다. C.G. 융의 여행을 통한 이異 문화 체험 양식과 C.G. 융의 분석심리학설은 이 점에서 문화정신의학의 한계를 넘을 수 있는 가능성을 제시했다. 이에 따르면 인류학자들의 문화에 대한 다양한 개념 속에는 집단적 의식collective consciousness뿐 아니라 집단적 무의식에 뿌리박은 내용이 발견된다. 저자는 이를 효孝를 예로 설명했다. 저자는 또한 문화 스펙트럼cultural spectrum이라는 설명모형을 제창하였는데 한국인의 경우 샤머니즘, 불교, 도교, 유고, 기독교 문화가 한 개체의 인격을 여러 가지 스펙트럼으로 구성됨을 제시하였다. 주로 네 가지 유형을 분류하였는데 그것은 1) 주로 불교문화가 우세한 사람, 2) 주로 유교문화가 우세한 사람, 3) 주로 샤머니즘문화가 우세한 사람, 4) 주로 기독교문화가 우세한 사람이다. 비록 의식표면은 하나의 종교문화가 우세하지만 내면에는 다른 종교문화가 섞이게 되며 가장 심층에 샤머니즘 문화를 공유하고 있다고 보았다. 문화와 정신건강의 관계를 이해하고 치유의 접근을 할 때 이러한 스펙트럼 시각이 필요하다. 저자는 인간심성에 대한 고대중국의 개념과 동양종교의 관념, 그리고 C.G. 융의 자기개념에 대한 이해를 소개하고 이에 비길 수 있는 전체정신의 중심에 관한 한국의 선사, 원효의 생각, 대승기승론의 일심(一心), 노자의 도(道), 이퇴계의 천명도(天命圖), 이기설(理氣說)을 융의 분석심리학적 입장에서 해석하였다. 궁극적으로 정신요법의 목적은 분석심리학적 입장에서는 '하나가 되는 것' 이며 '하나'가 됨은 문화에 제약된 인간으로서가 아니라 문화를 포함하나 이를 넘어선 인간 심성 전체가 되도록 하는 것이다.

임신 및 산후 우울증 (Depression during Pregnancy and the Postpartum)

  • 김율리
    • 정신신체의학
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    • 제15권1호
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    • pp.22-28
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    • 2007
  • 임신과 출산은 일부 여성들을 주요우울증 발병에 취약하게 한다. 산모의 10%에서 출산 후 수주 이내에 산후 우울증이 발병하며 이는 장차 아동의 인지적, 정서적 발달에 부정적 영향을 줄 수 있다고 알려졌다. 임신 중 우울증은 상대적으로 간과되어 왔지만 산후 우울증과 마찬가지로 흔하며 임산부의 정신병리가 태아의 생리 발달에 영향을 미친다는 증거가 축적되고 있어 주목을 받고 있다. 임신 및 출산과 관련된 우울증의 원인을 이해하기 위해서는 다양한 정신사회학적, 생물학적 위험 요인을 포괄적으로 고려할 필요가 있다. 임신과 관련된 우울증을 치료하기 위해 정신과 의사는 임신 및 치료 방법과 관련된 여러 가지 상황의 위험 혹은 이득을 포괄적으로 분석해야 하며 치료 방법을 능숙하게 결정할 수 있어야 한다. 임신 중 우울증에는 심리치료, 약물치료, 전기 충격 요법 등이 효과적이라고 알려져 있다. 산후 우울증을 치료하는 데에는 생물학적, 심리학적, 환경적 개입 등의 방법이 있으며, 구체적으로는 세로토닌 재흡수 억제제 등의 항우울제, 지지적 상담 등의 효과가 증명되었고, 증상이 심할 경우에는 Estrogen이 효과적이라고 알려져 있다. 한편, 임신 및 출산과 관련된 우울증의 신경내분비학적, 심리사회학적 병인을 규명하기 위한 연구들이 진행되고 있다. 향후 임산부의 산전 및 산후 관리에 있어서 임상각과 간의 통합적인 접근에 의한 우울증의 조기 진단 및 치료가 필요할 것으로 보인다.

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니키 드 생 팔의 트라우마를 통해 살펴본 아상블라주와 사격회화의 양면적 특성 (A Study on the Ambivalent Characteristic Displayed in Niki de Saint Phalle's Assemblages and Shooting Paintings by Looking Into Her Trauma)

  • 유가은
    • 미술이론과 현장
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    • 제6호
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    • pp.77-99
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    • 2008
  • The purpose of this study is to show that the reason behind the ambivalent characteristic displayed in Niki de Saint Phalle's works is in her trauma and how such characteristic can be extracted from her works. During her creative years, Saint Phalle worked on various materials from different genres such as assemblages, shooting paintings, a series on Bride and Monster, 'Nana', 'Tarot Garden'and public sculptures. One commonality found among her various works is the ambivalent characteristic that contains contrasting elements simultaneously. Saint Phalle suffered a terrible psychological damage inflicted by her parents during her childhood. Specifically, she was sexually assaulted by her father and emotionally neglected by her mother, the trauma that affected her for the rest of her life. As a result, she came to develop extreme love- hate relationships with her parents and this became the main reason for the ambivalent characteristic displayed in her works. The love-hate relationship Saint Phalle developed can be identified through various researches done on the subject of the affect of sexual assault. It is common for incest victims to develop ambivalent feelings towards the perpetrator and Saint Phalle was no exception. Dissociation disorder and a snake well explain the trauma from her father. It is a generally accepted belief in the field of psychology that dissociation disorder commonly occurs to children who experience incest. And dissociation disorder is similar to the characteristic of ambivalence in the sense that a single entity contains more than two contrasting elements at the same time. In addition, the amputated doll objects used in her assemblages coincide with the expression of body detachment of people with dissociation disorder. These facts clearly indicate that the trauma from her father is showing through in her works. A snake is a subject matter that reflects the ambivalent tendency of Saint Phalle that resulted from her trauma. She remembers her father's rape as an image of a snake which is related to a phallic symbol in mythology or art reflecting her trauma. Moreover, she displays a similar pattern of ambivalent emotion like love and hate or fear towards a snake and her father. This is also confirmed by her portrayal of a snake as a monster or reversely as a creature with fundamental vitality in her works. The lack of affection from her mother can be explained by her mother's maternal deprivation. It appears that Saint Phalle's mother possessed all the causes for maternal deprivation such as maternal separation, personality disorder and inappropriate attitude towards child rearing. Especially, a study that shows mother's negative attitude towards child breeding tends to increase dissociation experience of children is another important evidence that supports Saint Phalle's dissociation tendency. These traces of Saint Phalle's trauma are clearly revealed in her assemblages and shooting paintings. The violent objects in her assemblages such as a hammer, razor, nail represent the rage and defensiveness towards her father. The objects such as fragments of broken plates of feminine patterns, pots and mirrors that her mother used symbolize the affection towards her mother. On the other hand, the destructed objects can be interpreted as her hate and resentment towards her mother. Shooting paintings contain her extreme fury and hate. Things such as acts of shooting and the image associated with blood after shooting are blunt expressions of her bursts of emotions. I have tried to define and classify the ambivalent characteristics shown in her assemblages and shooting paintings as hate, rage, violence, calm, love and pleasure according to the frame of Thanatos and Eros. Out of the six, hate, rage, violence and clam are associated with Thanatos while love and pleasure are associated with Eros and they correspondingly form an ambivalent structure. These ambivalent characteristics can be found in her assemblages and shooting paintings. The objects in her assemblages such as a razor, saw, hammer imply hate, rage, violence and the silence felt throughout her works represent calmness. And, as mentioned, the feminine objects can be seen as symbolizing love. In shooting paintings, hate, rage, violence can be found in the use of force and in the traces of watercolor after shooting, and a sense of pleasure in her feelings of catharsis after her shooting. Moreover, a shielded calmness can be found on the plywood all covered with plaster before the shooting. This study looked into the ambivalent characteristic of Saint Phalle's works by examining her trauma to find its correlation, and a meaning of this study can be found from the fact that it refocused the origin of Saint Phalle who is generally known as a feminist artist. Additionally, a meaning of the study can be found also from the fact that it examined the ambivalent characteristics of her works through a frame of Thanatos and Eros.

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아동의 또래지위에 따른 교우관계문제 (Peer Relationship Problems in Relation to Children's Peer Status)

  • 정성철;홍상황;김종미
    • 초등상담연구
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    • 제10권2호
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    • pp.167-184
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    • 2011
  • 본 연구는 사회성측정을 사용하여 선별한 5가지 또래지위 집단의 교우관계문제에 어떤 차이가 있는 지를 알아보는데 초점을 두었다. 이를 위해 경남지역 소재 9개 초등학교의 5, 6학년 551명을 대상으로 안이환(2007)이 개발한 사회성측정과 정혜원(2007)이 개발한 교우관계문제 검사를 실시하여 5개의 또래지위 집단별 교우관계문제의 평균과 표준편차를 구하고 또래지위 집단에 따른 8가지 교우관계문제 영역의 점수를 비교하기 위해 다변량 분석을 실시하였다. 연구결과를 요약하면 다음과 같다. 첫째, 연구에 포함된 551명의 아동을 사회성 지위를 분석한 결과 평범아동(319명, 57.9%), 인기아동(111명, 20.1%), 배척아동(70명, 12.9%), 양면성 아동(41명, 7.4%), 무시된 아동(10명, 1.8%) 순으로 나타났다. 둘째, 아동의 또래지위에 따른 교우관계문제검사의 요인별 평균점수를 비교한 결과 아동의 또래지위에 따라 교우관계문제에 통계적으로 유의미한 차이가 있음이 밝혀졌다. 특히 인기아동 집단은 통제지배, 자기중심성, 냉담, 비주장성이 5가지 또래지위 유형 중 가장 낮게 나타났고 배척아동 집단은 사회적 억제, 비주장성, 자기희생이 가장 높은 것으로 나타났다. 셋째, 아동의 또래지위 집단에 따라 교우관계문제검사 프로파일에 확연한 차이가 있음을 알 수 있었다. 인기아동 집단의 프로파일이 가장 작게, 배척아동 집단의 프로파일이 가장 크게 나타나는 특성을 보였으며 교우관계문제의 하위요인에서 배척아동이 인기아동보다 사회적 억제와 비주장성이 유의하게 더 높은 것으로 나타났다. 이는 인기아동 집단이 다른 집단에 비해 또래관계 문제가 적음을 시사되었다.

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농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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간호개념에 대한 기초조사 (The Empirical Exploration of the Conception on Nursing)

  • 백혜자
    • 대한간호학회지
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    • 제11권1호
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    • pp.65-87
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    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

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