• 제목/요약/키워드: the Phase of Order

검색결과 6,130건 처리시간 0.043초

사차원전산화단층촬영과 호흡연동 직각 Kilovolt 준비 영상을 이용한 간 종양의 움직임 분석 (Evaluation of the Positional Uncertainty of a Liver Tumor using 4-Dimensional Computed Tomography and Gated Orthogonal Kilovolt Setup Images)

  • 주상규;홍채선;박희철;안종호;신은혁;신정석;김진성;한영이;임도훈;최두호
    • Radiation Oncology Journal
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    • 제28권3호
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    • pp.155-165
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    • 2010
  • 목 적: 4-dimensional computed tomography (4DCT) 영상과 on board imaging (OBI) 및 real time position management (RPM) 장치로 매 회 치료 시마다 얻은 호흡연동 직각 kilovolt (KV) 준비 영상(gated orthogonal kilovolt setup image)을 이용해 간암 환자를 치료하는 동안 발생하는 종양 위치의 불확실성을 평가하고자 했다. 대상 및 방법: 3차원입체조형치료가 예정된 20명의 간암 환자를 대상으로 RPM과 전산화단층촬영모의치료기를 이용해 치료계획용 4DCT를 시행했다. 표적 근처에 위치한 간동맥화학색전술 후 집적된 리피오돌(lipiodol) 혹은 횡격막을 종양의 위치 변이를 측정하는 표지자로 선택했다. 표지자의 위치 차이를 이용해 온라인 분할간 및 분할중 내부 장기 변이와 움직임 진폭을 측정했다. 측정된 자료의 정량적 평가를 위해 통계 분석을 실시했다. 결 과: 20명 환자로부터 측정된 표지자의 분할간변이의 중앙값은 X (transaxial), Y (superior-inferior), Z (anterior-posterior) 축에서 각각 0.00 cm (범위, -0.50~0.90 cm), 0.00 cm (범위, -2.4~1.60 cm), 0.00 cm (범위, -1.10~0.50 cm) 였다. 4명의 환자에서 X, Y, Z축 중 하나 이상에서 0.5 cm를 초과하는 변이가 관찰되었다. 4DCT와 호흡연동 직각 준비 영상으로부터 얻은 표적의 움직임 진폭의 차이는 X, Y, Z 축에서 각각 중앙값이 -0.05 cm (범위, -0.83~0.60 cm), -0.15 cm (범위, -2.58~1.18 cm), -0.02 cm (범위, -1.37~0.59 cm) 였다. 두 영상간 표적의 움직임 진폭 차이가 1 cm를 초과하는 환자가 Y축 방향으로 3명 관찰되었으며, 0.5 cm 초과 1 cm 미만의 차이를 보이는 환자도 Y축과 Z축 방향을 합쳐 5명 관찰되었다. 분할중 표지자 위치 변이의 중앙값은 X, Y, Z축에서 각각 0.00 cm (범위, -0.30~0.40 cm), -0.03 cm (범위, -1.14~0.50 cm), 0.05 cm (범위, -0.30~0.50 cm)였으며 2명의 환자에서 1 cm를 초과하는 변이가 Y축 방향으로 관찰되었다. 결 론: 4DCT와 호흡연동 직각 KV 준비 영상으로 얻은 표지자의 분할간, 분할중 및 움직임 진폭에서 큰 변이가 관찰되었다.

자연지리학 일반: 회고와 전망 (The physical geography in general:yesterday and tomorrow)

  • 손일
    • 대한지리학회지
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    • 제31권2호
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    • pp.138-159
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    • 1996
  • 해방후 50년간 우리 나라의 자연지리학 연구는 주로 지형학과 기후학에 의해 주도 되어 왔다. 자연지리학이 지니는 종합적인 학문적 성격에도 불구하고 개별 각론들이 독자적 으로 연구되어 왔고 그 연구 대상이나 연구 방법이 워낙 다양하기 때문에, 자연지리학 연구 의 전체적인 방향성이나 패러다임을 찾기가 힘들다. 지난 50년간 우리 나라 자연지리학 연 구중에서 지형학과 기후학을 제외한 나머지 연구를 자연지리학 일반으로 간주하고 이들 연 구를 자연지리학 총론, 토양지리학, 식물지리학, 수문지리학, 인간과 자연 환경이라는 주제로 구분해 정리하였다. 원래 자연지리학이 추구하던 통합적 접근방법이 점차 사라지고 자연지 리학 각론들이 각기 이웃한 지구과학과 밀접한 관계를 맺으면서 발전하여 왔다. 다학문적 해결책만이 유일한 대안이 되어 버린 환경 시대를 맞아, 자연지리학이 자연 환경에 대한 고 유의 통합적 접근 방법으로 재무장하여 환경 문제에 대한 주도적 학문으로 부활되기를 기대 한다.

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의료기관 경쟁력 향상에 영향을 미치는 핵심 요인 (The Critical Factors on Improvement of Medical institution Competitiveness)

  • 염재광;강창렬
    • 한국병원경영학회지
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    • 제12권1호
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    • pp.1-30
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    • 2007
  • The study carried out a survey with employees of hospitals located in Daejeon, Chungnam, and Chungbuk from Sep. 12 to Sep. 30, 2005 in order to derive primary elements that affect the improvement of hospital's competitiveness. The study investigated and analyzed the employees' recognition on the change of competitive environment caused by the change of medical environment. The study also analyzed the elements that affect the hospital's competitiveness and the competitive strategies of the hospitals. The conclusion of this study can be summarized as follows. 1. Summary 1) Most of the employees responded that there is a rival in the competitive environment and the competitive is intense. Especially when the employees are married, live in urban areas, have an education level of university graduate or are managers, they tend to think the competitive is very intense. Also, they said that the competitive is based upon the quality of medical service. They mentioned the element that has the biggest effect on the competitiveness is the element of medical consumer and they recognized that the medical services in university and general hospitals have more competitiveness than the one-department hospitals. 2) It was investigated that the medical technique service has the most effect on the hospital's competitiveness. Also, the external service of medical techniques also has a large effect on the hospital's competitiveness. 3) When they were asked for the factors that affect the patients' decision on selecting a hospital, most of them responded "capability and technique of the medical staffs." Also, they said that "sufficient explanation from doctors" and "special center and clinic" are the factors that have big effects on the patients' decision. 4) In the SWOT analysis, most of them responded that the strength is the hospital's characteristics and the weakness is insufficient and obsolete equipment. They said the opportunity is the demands for professional medical service and the risk is the intense competitive among the hospitals. 5) In the SWOT strategy, they emphasized the strategy that uses the opportunity and the strength and the strategy that uses the opportunity while overcoming the weakness. 6) As for the basic competition strategy, most of them thought of the strategy of professionalizing the medical service most importantly. Next, they focused on the strategy of distinct service and the strategy of lower prime cost. 2. Conclusion 1) Because service competition between hospitals is happening seriously, need competitiveness security through right awareness transfer and satisfaction upgrade about medical consumer. 2) For medical technique service upgrade that equip Hospital's competitiveness but affects most, must solidify the countermeasure because professionalizing the medical service and newest medical technique induction should be achieved first, and compose task force for the external service of medical techniques improvement. 3) To improve SWOT of hospital, opportunity and the strength strategy choice that rescue hospital's characteristics heightening professionalizing the medical service level is fancied. 4) As for the basic competition strategy, will have to try in phase triangular position of hospital which is trusted medical level upgrade and excellent manpower security and finance independence through upgrade. The study was only done with hospitals in Daejeon, Chungnam and Chungbuk. Also, it is a study from the side of suppliers of medical service so there are limitations. However, the significance of the study is to present the basic data for improvement of hospital's competitiveness by examining the importance of medical techniques and external service of medical techniques that are the main effects on the improvement of hospital's competitiveness.

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韓國加入亞太空間合作組織的可能性 : 基于法律与政策的分析 (The possibility of South Korea to become a member state of APSCO: an analysis from Legal and political perspectives)

  • 섭명암
    • 항공우주정책ㆍ법학회지
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    • 제31권2호
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    • pp.237-269
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    • 2016
  • Asia-Pacific Space Cooperation Organization (APSCO) is the only intergovernmental space cooperation organization in Asia. Since its establishment to date, eight countries have signed the convention and become member states. South Korea participated actively in the preparatory phase of creating the organization, and one conference organized by AP-MCSTA which is the predecessor of APSCO was held in South Korea. However, after the APSCO Convention was opened for signature in 2005 to date, South Korea does not ratify the Convention and become a member. The rapid development of space commercialization and privatization, as well as the fastest growing commercial space market in Asia, provides opportunities for Asian countries to cooperate with each other in relevant space fields. And to participate in the existing cooperation framework (e.g., the APSCO) by the Asian space countries (e.g., South Korea) could be a proper choice. Even if the essential cooperation in particular space fields is challenging, joint space programs among different Asian countries for dealing with the common events can be initiated at the first steps. Since APSCO has learned the successful legal arrangements from ESA, the legal measures established by its Convention are believed to be qualified to ensure the achievement of benefits of different member states. For example, the regulation of the "fair return" principle confirms that the return of interests from the relevant programs is in proportion to the member's investment in the programs. Moreover, the distinguish of basic and optional activities intends to authorize the freedom of the members to choose programs to participate. And for the voting procedure, the acceptance of the "consensus" by the Council is in favor of protecting the member's interest when making decisions. However, political factors that are potential to block the participation of South Korea in APSCO are difficult to be ignored. A recent event is an announcement of deploying THAAD by South Korea, which causes tension between South Korea and China. The cooperation between these two states in space activities will be influenced. A long-standing barrier is that China acts as a non-member of the main international export control mechanism, i.e., the MTCR. The U.S takes this fact as the main reason to prevent South Korea to cooperate with China in developing space programs. Although the political factors that will block the participation of South Korea in APSCO are not easy to removed shortly, legal measures can be taken to reduce the political influence. More specifically, APSCO is recommended to ensure the achievement of commercial interests of different cooperation programs by regulating precisely the implementation of the "fair return" principle. Furthermore, APSCO is also suggested to contribute to managing the common regional events by sharing satellite data. And it is anticipated that these measures can effectively response the requirements of the rapid development of space commercialization and the increasing common needs of Asia, thereby to provide a platform for the further cooperation. In addition, in order to directly reduce the political influence, two legal measures are necessary to be taken: Firstly, to clarify the rights and responsibilities of the host state (i.e., China) as providing assistance, coordination and services to the management of the Organization to release the worries of the other member states that the host state will control the Organization's activities. And secondly, to illustrate that the cooperation in APSCO is for the non-military purpose (a narrow sense of "peaceful purpose") to reduce the political concerns. Regional cooperation in Asia regarding space affairs is considered to be a general trend in the future, so if the participation of South Korea in APSCO can be finally proved to be feasible, there will be an opportunity to discuss the creation of a comprehensive institutionalized framework for space cooperation in Asia.

보건진료원 직무교육 교과과정 개선을 위한 일 연구 (A Study on Curriculum Development For Community Health Practitioners)

  • 조원정;이경자
    • 대한간호학회지
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    • 제22권2호
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    • pp.207-226
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    • 1992
  • This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

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Laser 반사측정법을 이용한 전치부 후방 견인시 치조골 높이와 치근길이 감소에 따른 저항중심의 위치변화에 관한 연구 (A Study about the Change of Locations of the Center of Resistance According to the Decrease of Alveolar Bone Heights and Root Lengths during Anterior Teeth Retraction using the Laser Reflection Technique)

  • 민영규;황충주
    • 대한치과교정학회지
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    • 제29권2호
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    • pp.165-181
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    • 1999
  • 교정치료시 치아와 주위조직의 부작용을 최소로 하면서 최대의 치료결과를 얻기 위해서는 치료역학을 각 환자의 치아 및 주위 해부학적 환경에 맞도록 개인화 시켜야한다. 특히 성인 교정시 문제되기 쉬운 치근흡수 또는 치주질환으로 인한 치조골 손실로 인하여 치관/치근 비율이 변했을 때 치아의 저항중심위치의 변화와 관련된 생역학적 반응의 차이에 주의하여야 한다. 본 연구에서는 정상 치주조직뿐만 아니라 다양한 비정상적 치주 및 치아상태에서 치관/치근 비율이 변하였을 때 일정한 교정력하에서의 치아의 초기이동 양상을 연구하기 위하여, 성인의 인체 건조 두개골 및 하악골상에서 laser 반사측정법 및 lever and pulley force applicator와 photodetector를 이용하여, 상악 6전치군을 대상으로는 치조골높이를 각각의 치아에 대하여 2mm씩 총 8mm까지 감소시켰고, 하악 6전치군을 대상으로는 치근길이를 각각의 치아에 대하여 2mm씩 총6mm까지 감소시키면서, 이렇게 다양하게 정량화된 변수들 하에서 상하악6전치군의 저항중심의 위치변화를 연구한 결과 다음과 같은 결론을 얻었다. 1. 초기상태에서 상악 6전치군의 초기이동시의 저항중심점의 위치는 6전치 전체 평균치아 치근의 치경부(CEJ)로부터 치근첨 방향으로 약 $42.4\%$되는 위치에 있었으며, 각 치아의 치조골의 높이가 감소할수록 저항중심점은 치근첨방향으로 약 $76.7\%$되는 부위까지 이동하였다. 2. 상악 6전치군에서 저항중심점의 6전치 전체 평균 치조정으로부터의 거리는 치조골의 감소와 함께 지속적으로 감소하였으나, 치조골내의 평균 치근의 길이에 대한 비율은 치조골의 감소에 상관없이 약 $33\%$내외에서 비교적 일정하였다. 3. 초기상태에서 하악 6전치군의 초기이동시의 저항중심점의 위치는 6전치 전체 평균치아 치근의 CEJ로부터 치근첨방향으로 약 $43\%$되는 위치에 있었으며, 각 치아의 치근의 길이가 감소할수록 이 비율은 약 $54\%$까지 증가하였다. 그러나 CEJ로부터 저항중심점까지의 거리는 5.3mm전후로부터 3.3mm내외까지 감소하여 치근의 길이가 감소할수록 저항중심점이 CEJ방향으로 이동하였다. 4.치조골 또는 치근흡수시, 각각의 단위 흡수량에 따른 저항중심위치의 변화에 미치는 영향은 초기에는 치조골이 감소 될 때가 더 컸으나 전체 평균 치근길이의 중간부위에서의 영향은 비슷했다.

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무의식의 창조성 관점으로 고찰한 창조신화: 흑암/혼돈, 천지개벽/분리, 섬/육지 창조 중심 (Psychological Meaning of Creation Myths: Focused on Darkness/Massa Confusa, Separation of World Parent and Creation of Land/Island)

  • 김진숙
    • 심성연구
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    • 제38권2호
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    • pp.269-304
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    • 2023
  • 본 논문의 취지는 창조신화에 보편적으로 나타나는 흑암/혼돈 천지개벽/분리, 육지/산 창조 관련 신화의 심리학적 의미를 임상현장에서 관찰한 꿈, 적극적 상상 및 예술작업과 연관하여 무의식의 창조성과 치유적인 기능을 드러내는 것에 있다. 먼저 창조신화가 개인사나 인류사에서 혼돈에서 새로운 질서를 필요로 할 때 무의식의 창조성에 의하여 저절로 만들어지는 원형적인 투사 현상으로서 자아의 태도에 따라 새로운 의식의 도약(재건)의 조짐이 될 수도 있고 자아의식의 침범이 될 수 있음을 논하고, 융, 폰 프란츠, 노이만, 하딩, 에딘져 및 국내의 연구현황과 연구자의 선행연구를 소개하면서 사례를 연관시켜서 연구하게 된 배경을 밝힌다. 창조신화의 흑암/원초적인 혼돈(massa confusa)'의 심리학적 의미에서 '흑암'은 어두워서 보지 못하는 무의식 상태로 보고 어둠속에서 기어다니는 에스키모의 창조자와 어둠속에 있거나 보는 것에 문제가 있는 꿈들과 상황을 소개하면서 연금술의 니그레도(nigredo)공정과 연관하였다. '원초적인 혼돈'은 하나 속에 모든 것이 들어있는 우로보로스, 플레로마, 유아기의 경험 또는 근원적인 자궁의 의미를 가지며 창조의 전조이기도 하지만 심연(abyss)에 갇힌 경험이 될 수 있다는 점을 관련된다고 보는 꿈과 상황을 함께 논한다. '천지개벽(분리)'은 무의식적인 내용이 의식이 되기 전에 의식의 문턱을 건드릴 때 두 개로 쪼개지는 것과 관련되고 의식의 진보가 있을 때 나타난다고 보면서 관련신화로서 '천지에 간극이 생겨서 만들어지는 세상', '천상의 존재가 지상으로 내려와 만들어지는 세상', '산 이동 설화'를 소개하고 각 신화가 가지는 심리학적 의미를 관련 사례와 함께 논한다. 관련문헌을 토대로 천지분리가 자체적으로 일어난다는 것과 창조자의 외로움, 불안함 등 정서적인 부분이 개입한다는 것, 그리고 지연된 분리가 크레아투라(creatur 창조물)의 죽음이 되고 성급한 분리가 천재 혼돈의 죽음이 된다는 것이 임상에서 시사하는 바를 논한다. '천지개벽'을 연금술의 분리(separatio)공정과 연관하면서 흑암/혼돈/무의식에서 빛/의식성을 획득해 가는 과정과 동일하다고 보았다. '육지 창조'는 무의식의 내용물이 자아의 영역으로 구체화되는 의식성의 출현을 의미하며. 관련 신화로서 메르쿠리우스 영의 육화라고 볼 수 있는 '괴물/거신의 몸이 육지가 되는 신화', '흙을 가지고 오는 등 창조자의 부단한 노력으로 만들어지는 육지'와 '저절로 만들어지는 육지'에 관련되는 신화와 관련 사례를 소개한다. '육지 창조'를 연금술의 땅처럼 구체화되는 응고(coagulatio)와 연관시키면서 적극적 상상 및 미술, 음악, 무용 등의 창조적인 작업이 추상적이라고 할 수 있는 심상을 자아영역으로 구체화한다는 점에서 무의식의 치유적 기능을 허용 내지 활성화하는 방편이 될 수 있다는 점을 부각한다. 마지막으로 세계멸망 후 다시 떠오른 육지관련 신화를 '자아의 재구축'의 의미로 보고 관련 임상 자료를 소개하면서 분석가/치료사/임상감독자의 무의식이 임상에 미치는 영향을 보여주는 것으로 마감한다.

임대주택단지의 생활안전 위해요인 해소방안 (Resolution Method of Hazard Factor for Life Safety in Rental Housing Complex)

  • 손정락;조건희;김진원;송상훈
    • 토지주택연구
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    • 제8권1호
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    • pp.1-11
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    • 2017
  • The government has been constructing and supplying public rental housing to ordinary people in order to stabilize housing since 1989. However, the public rental houses initially supplied to ordinary people are at high risk for safety accidents due to the deterioration of the facilities. Therefore, this study is aimed to propose a solution to solve the life safety hazards of the old rental housing complex as a follow-up study of Analysis of Accident Patterns and Hazard Factor for Life Safety in Rental Housing Complex. Types of life safety accidents that occur in public rental housing complexes are sliding, falling, crash, falling objects, breakage, fire accidents, traffic accidents and criminal accidents. The types of safety accidents that occur in rental housing complexes analyzed in this study are sliding, crashes, falling objects, and fire accidents. Although the incidence of safety accidents such as falling, breakage, traffic accidents and crime accidents in public rental housing complexes is low, these types are likely to cause safety accidents. The method of this study utilized interviews and seminar results, and it suggested ways to solve the life safety hazards in rental housing complexes. Interviews were conducted with residents and managers of rental housing complexes. Seminars were conducted twice with experts in construction, maintenance, asset management, housing welfare and safety. Through interviews and seminars, this study categorizes the life safety hazards that occur in rental housing complexes by types of accidents and suggests ways to resolve them as follows. (1) sliding ; use of flooring materials with high friction coefficient, installation of safety devices such as safety handles, implementation of maintenance, safety inspections and safety education, etc. (2) falling ; supplementation of safety facilities, Improvement of the design method of the falling parts, Safety education, etc. (3) crash ; increase the effective width of the elevator door, increase the effective width of the lamp, improve the lamp type (U type ${\rightarrow}$ I type), etc. (4) falling objects and breakage ; design of furniture considering the usability of residents, replacement of old facilities, enhancement of safety consciousness of residents, safety education, etc. (5) fire accidents ; installation of fire safety equipment, improvement by emergency evacuation, safety inspection and safety education, etc. (6) traffic accidents ; securing parking spaces, installing safety facilities, conducting safety education, etc. (7) criminal accidents; improvement of CCTV pixels, installation of street lights, removal of blind spots in the complex, securing of security, etc. The roles of suppliers, administrators and users of public rental housing proposed in this study are summarized as follows. Suppliers of rental housing should take into consideration the risk factors that may arise not only in the design and construction but also in the maintenance phase and should consider the possibility of easily repairing old facilities considering the life cycle of rental housing. Next, Administrators of rental housing should consider the safety of the users of the rental housing, conduct safety checks from time to time, and immediately remove any hazardous elements within the apartment complex. Finally, the users of the rental housing needs to form a sense of ownership of all the facilities in the rental housing complex, and efforts should be made not to cause safety accidents caused by the user's carelessness. The results of this study can provide the necessary information to enable residents of rental housing complexes to live a safe and comfortable residential life. It is also expected that this information will be used to reduce the incidence of safety accidents in rental housing complexes.

노인성 치매 환자의 돌봄경험에 대한 문화기술지 (Ethnography of Caring Experience for the Senile Dementia)

  • 김귀분;이경희
    • 대한간호학회지
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    • 제28권4호
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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조선시대 궁궐 후원 농경지(農耕地) 조영의 특성 (Studies on the Construction Characteristics of Rear Garden Farmland at Joseon Palace)

  • 정우진;심우경
    • 한국조경학회지
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    • 제40권4호
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    • pp.62-77
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    • 2012
  • 본 연구는 조선시대 궁궐 내에 조성된 농경지 조영의 양상과 공간적 특성을 분석하여 유교적 농본 중심의 시대상이 궁궐 안에서 특수한 권농의 공간으로 반영되었음을 구명하고자 하였다. 대상지는 경복궁 후원, 창경궁 후원과 경복궁 신무문 밖 후원이 되며, 문헌조사를 중심으로 수행되었다. 궁궐 후원 농경지는 "농사직설"의 편찬, 친경례와 기곡제의 설행으로 대변되는 조선 통치집단의 권농정책의 연장선상에서 임금이 자신의 거주지인 궁궐 안에 한 해 농사의 풍흉을 가늠할 포지를 조성한 것이며, 국초부터 일제 강점기 직전까지 각 궁궐에서 운영되었다. 조선시대 후원 농경지 4개소에 대한 분석 결과로는 첫째, 세종 때 조성된 경복궁 후원 농경지는 현 향원지 내부에 존재하고 있었으며, 선진농법을 확인하기 위한 시험포지로 조성되었다. 성종이 조영한 창경궁 후원 농경지는 조선 최초의 친경례 직후에 조성되어 적전친경의 맥락으로 이해해 볼 수 있다. 인조는 경덕궁이 임시로 거처했던 시어소임에도 불구하고, 체류의 기간이 장기화되자 정전의 뜰을 파고 농포로 조성하였는데, 조선시대 정치사에서 후원 농경지의 비중이 매우 높았다는 것을 시사한다. 고종이 조성한 경농재 일곽의 농포는 선대의 권농행보를 계승하면서 창경궁 후원 농경지의 공간 구성을 그대로 가져온 특성을 보이고 있다. 둘째, 관수와 수체계, 관경대의 명칭, 입지에 있어서 일정한 공통점이 도출되었는데, 이는 조선시대 농본공간의 보편적 형식으로 판단하였다. 본 연구에서는 후원 농경지 외에 궁궐 내에서 내관들에 의해 관리되던 채전과 국가의 큰 제사에 쓰일 과일을 위한 궁궐 내 과수원의 운영 양상을 고찰하여 조선시대 궁궐 조경이 엄숙함, 질서정연함이나 장식성에만 치중되지 않고, 실생활에 도움이 되는 실용적 생산적 조경공간으로 존재하고 있었음을 밝힐 수 있었다. 또한 궁궐에서 왕실의 주도로 생산적 조경의 다양한 활동이 전개되고 있었고, 임금이 솔선수범하여 선진농법을 시험하였다는 점은 우리의 고유한 궁궐조경의 일면이 되며, 조선의 독자적인 궁궐문화로서 그리고 여타의 유교 국가에는 없었던 유일한 애민농본의 조경으로 보아야 할 것이다.