대학생의 자기초점주의 성향과 대학 생활 적응의 관계 : 대인관계 유능성의 매개효과

전지은 공주대학교 일반대학원 2021 국내석사

본 연구는 대학생의 자기초점주의와 대학 생활 적응의 관계에서 대인관계 유능성의 매개효과를 검증하고자 하였다. 연구목적을 달성하기 위하여 전국 대학교 1∼4학년 남녀 학생을 대상으로 온라인 설문을 실시하여 211명의 자료를 분석하였다. 연구 문제는 다음과 같이 제시하였다. 첫째, 대학생의 자기초점주의의 일반적 자기초점주의와 자기몰입, 대학 생활 적응, 대인관계 유능성은 어떤 관계가 있는가? 둘째, 대학생의 자기초점주의의 일반적 자기초점주의와 자기몰입은 대학 생활 적응과 대인관계 유능성에 어떠한 영향을 미치는가? 셋째, 대학생의 자기초점주의의 일반적 자기초점주의와 자기몰입과 대학 생활 적응 간의 관계에서 대인관계 유능성이 매개 역할을 하는가? 각 변인의 측정도구는 다음과 같다. 이지영과 권석만(2005)이 개발한 자기초점주의 성향 척도(SDSAS), Baker와 Siryk(1989)가 개발하고 이윤정(1999)이 번안하고 수정한 대학 생활 적응척도(SACQ), Buhrmester, Furman, Wittenberg와 Reis(1988)가 개발한 대인관계능력 검사지(Interpersonal Competence Questionnaire: ICQ)를 한나리와 이동귀(2010)가 한국 대학생들을 대상으로 번안하여 타당화한 한국판 대인관계 유능성 척도(K-ICQ)를 사용하였다. 통계분석을 위해 IBM SPSS 22.0를 사용하여 빈도분석, 내적합치도(Cronbach’s α) 산출, 기술통계 분석, 왜도와 첨도 확인, Pearson의 상관분석, 다중선형회귀분석과 Baron & Kenny의 매개회귀분석을 실시하였다. 연구 결과는 다음과 같다. 자기초점주의는 방향성이 다른 2개의 하위요인으로 구성되어 있어서 전체 합으로 구하지 않고 서로 다른 두 성향을 각각의 독립변인으로 분석하였다. 첫째, 일반적 자기초점주의는 대학 생활 적응과 정적 상관관계가 있는 것으로 나타났고, 자기몰입은 대학 생활 적응과 부적 상관관계가 있는 것으로 나타났다. 또한 일반적 자기초점주의는 대인관계 유능성과 정적 상관관계가 있는 것으로 나타났고, 자기몰입은 대인관계 유능성과 부적 상관관계가 있는 것으로 나타났다. 대학 생활 적응과 대인관계 유능성은 정적 상관관계가 있는 것으로 나타났다. 둘째, 일반적 자기초점주의보다 자기몰입이 대학 생활 적응에 상대적으로 높은 부적 영향을 주는 것으로 나타났다. 반면에 대인관계 유능성에 대해서는 자기몰입보다 일반적 자기초점주의가 상대적으로 높은 정적 영향을 주는 것으로 나타났다. 셋째, 일반적 자기초점주의와 자기몰입과 대학 생활 적응과의 관계에서 대인관계 유능성의 매개효과는 통계적으로 유의하다고 검증되었다. 일반적 자기초점주의와 대학 생활 적응과의 관계에서 대인관계 유능성은 완전 매개효과가 나타났고, 자기몰입과 대학 생활 적응과의 관계에서 대인관계 유능성은 부분 매개효과가 나타냈다. 본 연구는 대학생의 자기초점주의와 대학 생활 적응, 대인관계 유능성의 관계를 실증적으로 검증하였으며, 자기초점주의의 방향성이 다른 두 가지 성향이 각각 대학 생활 적응과 대인관계 유능성에 미치는 영향과 관계에 있어서 중요한 매개효과를 확인하였다. 이는 대학생들의 상담 장면에서 자기초점주의 성향을 지닌 대학생들이 불안이나 우울을 경험할 때, 대인관계 유능성에 중심을 두고 개입하는 것이 효과적임을 시사한다. 또한 부적응적인 자기초점주의를 적응적인 자기초점주의로 전환할 수 있는 긍정적 자기 자각을 활성화하여, 심리적 부적응으로 인한 문제를 완화한다면, 보다 적응적인 대학 생활에 도움이 될 것으로 기대한다. 따라서 대학 생활 적응을 높이기 위하여 대인관계 유능성을 향상시키기 위한 방안을 모색한다면, 보다 적응적인 대학 생활에 도움이 될 것으로 기대한다. 본 연구는 대학 생활 적응에 도움을 주기 위하여 교육현장이나, 상담장면에서 활용할 수 있는 상담기법과 적응 프로그램 개발 등을 위해 기초자료로 유용하게 활용될 수 있을 것이라는 점에서 의의가 있다. This study sought to verify the intermediate effectiveness of interpersonal ability in the relationship between college students' self-focused attention and college life adaptation. In order to achieve the purpose of research, data were analyzed by conducting an online survey of 211 male and female students in the first through fourth grades of colleges nationwide. The research questions were presented as follows. First, what is the relationship between general self-focused attention and self-immersion, college life adaptation, and interpersonal competence of college students? Second, how do the general self-focused attention and self-immersion of college students affect their college life adaptation and interpersonal competence? Third, does interpersonal competence play a mediating role in the relationship between general self-focused attention and self-immersion in college students' self-focused attention and college life adaptation? The measurement tools for each variable are as follows: The Scale for Dispositional Self-focused Attention in Social situations (SDSAS), developed by Ji-young Lee and Seok-man Kwon (2005), the Student Adaptation to College Questionnaire (SACQ) developed by Baker and Siryk (1989) and modified and revised by Yun-jung Lee (1999), the Interpersonal Competence Questionnaire (ICQ) developed by Reis (1988) and adapted and validated to the K-ICQ by Han Na-ri and Dong-Gwi Lee (2010) for Korean college students. For statistical analysis, IBM SPSS 22.0 was used for frequency analysis, Cronbach's α calculation, descriptive statistical analysis, skewness and kurtosis verification, Pearson's correlation analysis, multiple linear regression analysis, and Baron & Kenny's parametric regression analysis. The study results are as follows. Since self-focused attention is composed of two sub-factors with different directions, the two different dispositions were analyzed as independent variables, rather than as a total sum. First, general self-focused attention was found to have a positive correlation with college life adjustment, and self-immersion was found to have a negative correlation with college life adjustment. Additionally, general self-focused attention was found to have a positive correlation with interpersonal competence, and self-immersion was found to have a negative correlation with interpersonal competence. There was also a positive correlation between college life adaptation and interpersonal competence. Second, self-immersion had a relatively higher negative effect on college life adaptation than general self-focused attention. On the other hand, on interpersonal competence, general self-focused attention had a relatively higher positive effect than self-immersion. Third, the mediating effect of interpersonal competence in the relationship between general self-focused attention and self-immersion and college life adaptation was verified to be statistically significant. In the relationship between general self-focused attention and college life adaptation, interpersonal competence showed a fully mediating effect, and in the relationship between self-immersion and college life adaptation, interpersonal competence showed a partial mediating effect. This study empirically verified the relationship between university students' self-focused attention, college life adaptation, and interpersonal ability, and identified the significant mediating effects of two different orientations on university life adaptation and interpersonal ability, respectively. This suggests that intervention focusing on interpersonal competence is effective when college students with self-focused dispositions experience anxiety or depression in the college counseling scene. In addition, it is expected that it will be helpful for a more adaptive college life if the problem caused by psychological maladaptation is alleviated by activating positive self-awareness that can convert maladaptive self-focusing into adaptive self-focusing. Therefore, if we are looking for ways to improve interpersonal competence in order to increase college life adaptation, it is expected that it will be helpful for a more adaptive college life. This study is meaningful in that it can be usefully used as basic data for the development of counseling techniques and adaptation programs that can be used in the educational field or in the counseling scene to help them adapt to university life.

탄광부 진폐증 입원환자의 우울, 죽음불안, 가족기능 및 삶의 질의 관계

조성희 공주대학교 일반대학원 2020 국내석사

국문초록 탄광부 진폐증 입원환자의 우울, 죽음불안,가족기능 및 삶의 질의 관계 조 성 희 공주대학교 대학원 간호학과 간호학 전공 본 연구는 탄광부 진폐증 입원환자를 대상으로 우울, 죽음불안, 가족기능 및 삶의 질의 정도를 파악하고, 이들 간의 관계를 파악하기 위해 실시하였다. 대상자는 경상북도 1개, 대전광역시 1개, 충청남도 2개, 충청북도 1개의 진폐전문병원에 입원한 환자 165명이고, 자료수집 기간은 2019년 6월부터 8월까지였다. 수집된 자료는 SPSS/WIN 23.0 통계 프로그램을 이용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient로 분석하였다. 연구 결과를 요약하면 다음과 같다. 1) 탄광부 진폐증 입원환자의 우울 정도는 평균 8.73점(15점 만점), 죽음불안 정도는 평균 93.29점(144점 만점), 가족기능 정도는 평균 5.93점(10점 만점), 삶의 질의 정도는 평균 53.10점(100점 만점)였다. 2) 탄광부 진폐증 입원환자의 일반적 특성에 따른 우울의 차이를 살펴본 결과, 배우자(t=-9.12, p<.001), 월평균 소득(t=3.39, p<.001), 종교(t=-7.16, p<.001), 교육수준(F=10.96, p<.001), 진단 후 경과 기간(F=3.14, p=.027), 총 입원기간(F=3.94, p=.009)에서 유의미한 차이를 보였다. 3) 탄광부 진폐증 입원환자의 일반적 특성에 따른 죽음불안의 차이를 살펴 본 결과, 배우자(t=-12.70, p<.001), 월평균 소득(t=2.19, p=029), 종교(t=-87, p<.001), 교육수준(F=9.14, p<.001), 진단 후 경과 기간(F=2.85, p=.039), 진폐 합병증 경험(F=6.04, p=.003)에서 유의미한 차이를 보였다. 4) 탄광부 진폐증 입원환자의 일반적 특성에 따른 가족기능의 차이는 없었다. 5) 탄광부 진폐증 입원환자의 일반적 특성에 따른 삶의 질의 차이를 살펴본 결과, 배우자(t=-24.81, p<.001), 월평균 소득(t=4.61, p<.001), 종교(t=-9.56, p<.001), 교육수준(F=17.10, p<.001), 진단 후 경과 기간(F=3.85, p=.011), 진폐 합병증 경험(F=5.11, p=.007)에서 유의미한 차이를 보였다. 6) 탄광부 진폐증 입원환자의 우울은 죽음불안(r=.80, p<.001) 또는 삶의 질r=.70, p<.001)과 정 상관관계가 있었고, 죽음불안도 삶의 질과 정 상관관계가 있었다(r=.76, p<.001). 즉, 우울이 높을수록 죽음불안은 높았고, 삶의 질은 낮았으며, 죽음불안이 높을수록 삶의 질은 낮았다. 이와 같은 결과를 통해 탄광부 진폐증 입원환자의 우울, 죽음불안, 삶의 질 간의 강한 상관관계가 있음을 확인하였다. 따라서 탄광부 진폐증 입원환자의부정적 감정을 해소하고, 정서적 안정을 찾을 수 있도록 관심을 기울여야 하며, 삶의 질 향상을 위해 우울과 죽음불안을 고려한 간호 중재 프로그램 개발이 필요하겠다. 주요어: 우울, 죽음불안, 가족기능, 삶의 질, 탄광부 진폐증 ABSTRACT The Relationship between Depression, Death Anxiety, Family Function and Quality of Life in inpatients with Coal Worker's Pneumoconiosis. Sung hee Cho Department of nursing Graduate School of Kongju National University Gong Ju, Korea (Supervised by Professor : Ok-Hee Cho) The study was conducted to identify the degree of depression, death anxiety, family function, and quality of life for inpatients with coal worker' s pneumoconiosis and to identify the relationship between them. The participants were 165 patients who were hospitalized for treatment o f pneumoconiosis. The hospital is at one in Gyeongbuk, one in Daejeon Me tropolitan City, two in Chungnam, one in Chungbuk. And the data were collected between June and August 2019. For data analysis, SPSS 23.0 statistics package was used, and the study employed frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, Pearson’s correlation coefficient analysis. The findings may be summarized as follows: 1) Depression score of inpatients with coal worker's pneumoconiosis was an average of 8.76 out of 15; for death anxiety an average of 93.29 out of 144 ; for family function an average of 5.93 out of 10; for quality of life an average of 53.10 out of 100 points; 2) The level of depression according to the general characteristics of inpat ients with coal worker's pneumoconiosis differed in the spouse(t=-9.12, p<.001), monthly income(t=3.39, p<.001), religion(t=-7.16, p<.001), education level(F=10.96, p<.001), period after diagnosis(F=3.14, p=.027), and hospitaliza tion period(F=3.94, p=.009). 3) The level of death anxiety according to the general characteristics of in patients with coal worker's pneumoconiosis differed in the spouse (t=-12.70 , p<.001), monthly income(t=2.19, p=029), religion(t=-8.87, p<.001), education level(F=9.14, p<.001), period after diagnosis(F=2.85, p=.039), and Experience complications(F=6.04, p=.003). 4) There were no differences in family functions depending on the general characteristics of inpatients with coal worker's pneumoconiosis. 5) The level of quality of life according to the general characteristics of inpatients with coal worker's pneumoconiosis differed in the spouse (t=-24. 81, p<.001), monthly income(t=4.61, p<.001), religion(t=-9.56, p<.001), educa tion level(F=17.10, p<.001), period after diagnosis(F=3.85, p=.011), and Exper ience complications(F=5.11, p=.007). 6) Depression of inpatients with coal worker's pneumoconiosis was positiv ely correlated with death anxiety(r=.80, p<.001) or quality of life(r=.70, p<.001), and death anxiety was also positively correlated with quality of life (r=.76, p<.001). In other words, the higher the depression, the higher the death anxiety, and the lower the quality of life. And the higher the death anxiety, the lower the quality of life. These results confirmed that there is a strong correlation between depression, death anxiety, and quality of life among inpatients with coal worker's pneumoconiosis. Therefore, attention should be paid to resolve the negative feelings of inpatients with coal worker's pneumoconiosis. And to find emotional stabilit y, and the development of a nursing arbitration program considering depres sion and death anxiety is needed to improve the quality of life Key words: Depression, Death anxiety, Family function, Quality of life, Inpatients with coal worker's pneumoconiosis.

수술실 간호사의 공감능력, 팀워크, 간호근무환경이 환자중심간호에 미치는 영향

조해민 공주대학교 일반대학원 2023 국내석사

본 연구는 수술실 간호사의 공감능력, 팀워크, 간호근무환경과 환자중심간호의 관계를 파악하고, 이들이 환자중심간호에 미치는 영향을 파악하여 수술실에서 환자중심간호 수행을 활성화시키기 위한 중재 개발에 기초자료를 제시하고자 시도되었다. 자료 수집은 경기도, 충청도, 대전광역시, 전라도, 경상도 등에 소재한 종합병원 수술실에서 3개월 이상 근무한 간호사 200명을 대상으로 하였으며, 자료 수집기간은 2022년 5월부터 7월까지였다. 수집된 자료는 SPSS Win 27.0 program을 이용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, multiple regression analysis로 확인하였다. 본 연구의 결과를 요약하면 다음과 같다. 1) 수술실 간호사의 공감능력 정도는 7점 만점에 평균 5.25±0.77점, 팀워크 정도는 5점 만점에 평균 4.03±0.61점, 간호근무환경 정도는 4점 만점에 평균 2.64±0.57점, 환자중심간호 정도는 5점 만점에 평균 4.21±0.56점이었다. 2) 수술실 간호사의 일반적 특성에 따른 공감능력의 차이는 연령(F=3.25, p=.041), 월 평균 급여(t=-2.10, p=.037)에 따라 통계적으로 유의한 차이가 있었다. 수술실 간호사의 일반적 특성에 따른 팀워크의 차이는 성별(t=2.88, p=.004), 병원규모(F=5.41, p=.001)에 따라 통계적으로 유의한 차이가 있었다. 수술실 간호사의 일반적 특성에 따른 간호근무환경의 차이는 환자중심간호 교육 경험에서 통계적으로 유의한 차이가 있었다(t=2.43, p=.016). 수술실 간호사의 일반적 특성에 따른 환자중심간호의 차이는 병원규모에서 통계적으로 유의한 차이가 있었다(F=3.05, p=.030). 3) 수술실 간호사의 환자중심간호는 공감능력(r=.50, p<.001), 팀워크(r=.61, p<.001), 간호근무환경(r=.52, p<.001)과 정 상관관계가 있었다. 4) 수술실 간호사의 환자중심간호에 영향을 미치는 요인은 팀워크(β=.38, p<.001), 공감능력(β=.30, p<.001), 간호근무환경(β=.22, p<.001)이였고, 이들 변수는 수술실 간호사의 환자중심간호를 48.0% 설명하였다. 이상의 결과를 바탕으로 수술실 간호사의 공감능력, 팀워크, 간호근무환경이 환자중심간호에 영향을 주는 주요 요인임을 확인하였다. 따라서 수술실 간호사의 환자중심간호 수행을 활성화시키기 위해서는 공감능력을 높이고, 팀워크를 증진시킬 수 있는 표준화된 프로그램의 개발과 긍정적인 간호근무환경의 마련이 필요하다. The goal of this study is to identify the impact of operating room nurses' empathy, teamwork, and relationships between the nursing work environment and patient-centered care in order to suggest standard data for the development of interventions to activate patient-centered care in the operating room. Data were collected between May and July 2022 from 200 nurses who had worked in operating rooms at general hospitals in Gyeonggi-do, Chung-do, Daejeon, Jeolla-do, and Gyeongsang-do for more than three months. The data, which comprised frequency, percentage, mean, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, Scheffé test, and multiple regression analysis, were gathered using the SPSS Win 27.0 program. The following is a summary of the study’s findings: 1) The average score on the empathy scale was 5.25±0.77 points out of 7, the average score on the teamwork scale was 4.03±0.61 points out of 5, the average score on the nursing work environment scale was 2.64±0.57 points out of 4, and the average score of patient-centered care was 4.21±0.56 points out of 5. 2) There was a statistically significant difference in empathy based on age (F=3.25, p=.041) and average monthly salary (t=-2.10, p=.037), according to the general characteristics of operating room nurses. There was a statistically significant difference in teamwork based on gender (t=2.88, p=.004) and hospital size (F=5.41, p=.001), according to the general characteristics of operating room nurses. According to patient-centered care education experience, there was a statistically significant difference between the nursing work environment and the general characteristics of operating room nurses (t=2.43, p=.016). According to the general features of operating room nurses, there was a statistically significant difference in patient-centered care depending on the size of the hospital (F=3.05, p=.030). 3) The patient-centered care of operating room nurses showed a positive correlation with empathy (r=.50, p<.001), teamwork (r=.61, p<.001), and the nursing work environment (r=.52, p<.001). 4) The factors that affecting patient-centered care of the operating room nurses were teamwork (β=.38, p<.001), empathy (β=.30, p<.001), and nursing work environment (β=.22, p<.001) and these variables explained 48.0% of patient-centered care of operating room nurses. Based on the findings, it was established that the key influences on patient-centered care are the operating room nurses' empathy, teamwork, and nursing work environment. Therefore, it is essential to foster empathy, enhance teamwork through the development of standardized programs, and create a pleasant nursing work environment in order to activate patient-centered care conducted by operating room nurses.

인프라 자산관리를 위한 유지관리 예산규모 추정에 관한 연구 : 일반국도를 중심으로

우지원 공주대학교 일반대학원 2021 국내박사

This study was started to provide guidance on government policy direction and budget estimates based on variety social issues, such as the collapse of aging infrastructure. This year, the "Sustainable Infrastructure Management Act" was enacted and announced by forming a social consensus on the importance of maintenance of existing infrastructure facilities and the maintenance of facilities was carried out in accordance with this laws. This is to provide a framework for "proactive management" and investment efficiency-based away from the "reactive management" method. It is expected to be able to analyze the overall budget size and optimal management point to derive the most appropriate time to enable the best maintenance strategy. In this study, based on the maintenance cost calculation method derived from the recently performed national highway maintenance cost calculation method study, estimating the required budget for maintenance according to the facility size of the infrastructure after incense estimated the aging of the infrastructure facilities over time. Maintenance costs are largely calculated by dividing the general section (earthwork and general bridge), the tunnel section and the cable bridge, such as a cable-stayed bridge, suspension bridge is proposed to be calculated as a special bridge. In the case of the general section, including the earthwork and the general bridge, similar to the existing study, the tunnel section is proposed to be calculated separately. In the case of improvement, each itemized replacement cycle is proposed by a comprehensive review of the replacement cycle criteria and maintenance cost performance data for each facility. According to the results of this study, the required budget for the maintenance of the National Highway is continuously increased year by year, and in 2050, it was estimated to be 2.2675 billion KRW, which means that this year's budget is approximately 1.5 times the cost in 2019.. In addition, it was estimated the aging size of the national road infrastructure using the benchmark year method. The result of estimating show that even if the estimated maintenance costs are executed in a timely manner, because of aging 73.970.8 billion KRW of national road infrastructure facilities should be reconstructed in 2050. Therefore, if the government to establish a mid-to-long-term master plan to prepare for the timely commitment of the budget for the management of aging infrastructure facilities, it is possible to believe that more advanced management in terms of maintenance aspects and to use the facility more safetly.

치매 태도에 대한 영향요인 비교 : -남해군 시범 치매안심마을과 일반마을 대상으로-

김희경 공주대학교 일반대학원 2020 국내석사

본 연구는 치매에 대한 부정적 인식개선 및 치매친화적 환경조성을 위해 지역사회 기반을 활용한 마을형 치매 안전망 구축 추진 사업을 시범적으로 운영 중인 남해군 치매안심마을의 사업 효과를 알아보고자 시도되었다. 이에 본 연구는 치매안심마을에서 시행 중인 치매 예방교육과 치매 파트너 활동 등이 치매 태도에 어떠한 영향을 미쳤는지를 검증하기 위해 치매안심마을 113명과 일반마을 142명을 대상으로 2019년 10월 25일부터 10월 31일까지 구조화된 설문지를 이용하여 조사하였다. 치매 태도의 영향 요인을 파악하기 위해 치매에 대한 지식과 치매관련 특성, 인구사회학적 특성을 변수로 사용하였으며, SPSS Ver. 24.0 통계 프로그램을 이용하여 자료를 분석하였다. 본 연구 결과를 요약하면 다음과 같다. 첫째, 치매안심마을과 일반마을의 일반적 특성은 연령과 학력, 취업 여부, 경제만족도에서 통계적으로 유의한 차이를 보였다((p<0.05). 연령이 치매안심마을은 70세 이상이 92.9%인 반면, 일반마을은 78.1%였고, 학력은 치매안심마을은 초촐 이하가 94.7%인 반면, 일반마을은 90.1%였다. 또한 취업하고 있는 경우가 치매안심마을은 8.0%인 반면, 일반마을은 36.6%였고, 경제만족도가 낮은 경우가 치매안심마을은 58.4%, 일반마을은 46.8%였다. 둘째, 치매안심마을과 일반마을의 치매 지식의 차이를 검증한 결과, 전체 평균 안심마을 7.15/15점과 일반마을 8.01/15점으로 일반마을의 지식 수준이 높았다. 셋째, 치매안심마을과 일반마을의 치매 태도의 차이를 검증한 결과, 안심마을은 3.33/5점, 일반마을은 3.32/5점으로 태도 수준의 차이는 없었다. 넷째, 치매안심마을과 일반마을의 치매 관련 정보 습득 경로는 차이를 보였다. 안심마을은 보건소 프로그램 및 홍보자료가 가장 높은 반면, 일반 마을은 대중매체가 주요 정보를 획득하는 것으로 나타났다. 또한 치매에 대한 도움 요청은 안심마을은 보건소(74.3%)를 가장 선호한 반면, 일반마을은 보건소(52.5%)와 병원(42.6%)을 선호하는 것으로 나타났다(P<0.05). 다섯째, 치매안심마을과 일반마을의 치매 태도에 영향을 미치는 요인에 차이가 있었다. 치매안심마을은 치매에 대한 지식 수준(=0.438)이 가장 큰 영향을 미쳤으며, 초졸(=0.215), 중졸(=0.203) 순으로 나타났다. 반면, 일반마을의 경우에는 중졸(=0.294)이 상대적으로 가장 큰 영향력을 보였고, 여자(=0.273), 치매환자를 접한 경험((=0.222)과 초졸((=0.222), 연령(=-0.194) 순으로 나타났다(P<0.05). 본 연구의 결과를 바탕으로 다음과 같은 제언을 하고자 한다. 첫째, 치매에 대한 정확한 지식은 치매에 대한 태도를 높이는 것으로 나타났으므로, 성별, 연령별, 교육수준별 대상자 맞춤식 교육프로그램이 필요하다. 둘째, 치매안심마을에 제공되는 지식 전달을 위한 전문적인 인력 양성과 배치가 필요하다. 셋째, 보건소 중심 치매안심마을에서 제공되는 치매에 대한 서비스는 치매 태도를 높이는데 효과가 있는 것으로 파악되므로, 서비스 전략과 모델을 지역 특성에 맞게 도출하는 것이 필요하다. The purpose of this study was to investigate the effects of the dementia relief village in Namhae-gun, which is piloting the development of a village-type dementia safety net using the community base to improve the negative awareness of dementia and to create a dementia-friendly environment. In order to examine the effects of dementia prevention education and dementia partners' activities on dementia attitudes, this study examined 113 dementia and 142 general villages from October 25, 2019 to 10. The survey was conducted using the structured questionnaire by March 31. In order to understand the determinants of dementia attitudes, knowledge of dementia, dementia-related characteristics, and demographic characteristics were used as variables. SPSS Ver. The data were analyzed using a 24.0 statistical program. The results of this study are summarized as follows. First, the general characteristics of dementia relief villages and general villages showed statistically significant differences in age, educational background, employment status, and economic satisfaction (p <0.05). The age of dementia-insured villages was 92.9% for those over 70 years old, 78.1% in general villages. In addition, 8.0% of dementia-safe villages were found to be employed, while 36.6% were of general villages, and 58.4% of dementia-safe villages and 46.8% of ordinary villages had low economic satisfaction. Second, as a result of verifying the difference of dementia knowledge between dementia relief village and general village, the average knowledge level of general village was 7.15 / 15 and 8.01 / 15 general village. Third, as a result of verifying the difference of dementia attitude between dementia relief village and general village, there was no difference in attitude level between 3.33 / 5 points for security village and 3.32 / 5 points for general village. Fourth, there was a difference in the information acquisition paths between dementia relief villages and general villages. Relief villages have the highest public health center programs and promotional materials, while the average villages receive the main information. In addition, the request for help on dementia was found to be the most preferred among health centers (74.3%), whereas those in general villages prefer public health centers (52.5%) and hospitals (42.6%) (P <0.05). Fifth, there were differences in factors affecting dementia attitudes between dementia-safe and general villages. In dementia care villages, knowledge level of dementia (= 0.438) was the most influential, followed by elementary school (= 0.215) and middle school (= 0.203). On the other hand, middle school (= 0.294) was the most influential in the general villages, with women (= 0.273), experiences with dementia patients ((= 0.222), elementary school ((= 0.222), and age (= -0.194). ) (P <0.05). Based on the results of this study, I would like to make the following suggestions. First, accurate knowledge of dementia has been shown to increase attitudes toward dementia. Therefore, a personalized education program by gender, age, and education level is required. Second, it is necessary to train and arrange professional manpower for the knowledge transfer provided to the dementia relief village. Third, services for dementia provided by dementia relief villages centered on public health centers are found to be effective in improving dementia attitudes. Therefore, it is necessary to derive service strategies and models according to regional characteristics.

우리나라 청소년의 비타민· 무기질 보충제 섭취 실태 및 다양한 급원을 통한 비타민과 무기질 섭취량 조사

한지혜 공주대학교 일반대학원 2011 국내박사

ABSTRACT Usage Patterns of Vitamin?QMineral Supplements and Dietary Exposure Assessment of Vitamin and Mineral from Various Sources by Korean Adolescents Han Ji Hye Department of Home Economics Education, Graduate School of Kongju National University (Supervised by Professor Kim Sun Hyo) In recent years a concern about excessive intakes of vitamins and minerals from various sources has been increasing, since there has been a marked increase in the production and consumption of vitamin․mineral supplements and fortified foods. However effects of vitamin․mineral supplements intake are still controversial. There are many cases of over-lapped intake at once, and recently high unit supplements intake are preferred. So there is an issue about overtaking micronutrient through having indiscretion to take supplements. The purpose of this study was to investigate the usage behaviors by adolescents in Korea regarding vitamin․mineral supplements and to assess the maximum exposure of vitamins and minerals from various sources including diet, general drug supplements(GDS), health functional foods(HFF), and fortified foods(FF). Vitamin․mineral supplements are GDS and HFF. One thousand four hundred and seven adolescent boys and girls attending middle or high schools were chosen from various cities and rural communities in Korea. In this study, the factors affecting vitamin․mineral supplements consumption, and usage patterns were examined by a self-administered questionnaire. 'In-depth users of vitamin?Pmineral supplements'(IDU, n=60) were chosen from the above 1,407 students, and they were subjects for the exposure assessment of their daily vitamin․mineral supplements intake. The assessment was accomplished through research their intake of vitamins and minerals from diet, GDS, HFF, and FF. For comparison, 'In-depth non users of vitamin?Pmineral supplements'(IDNU, n=60) who took vitamins and minerals through just diet were also chosen from the above 1,407 students. The intake of vitamins and minerals through diet, GDS, HFF, and FF were determined, and compared with the recommended nutrition intake(RNI) and tolerable upper intake levels(UL) (DRIs for Koreans 2010). The results showed that vitamin․mineral supplements were taken by 65.5% of subjects. The middle school students and city dwellers took vitamin․mineral supplements more frequently than each corresponding group. The socioeconomic status of the family, and supplements consumption by their parents and siblings influenced the use of supplements by the subjects, respectively. GDS for vitamins and minerals were taken by 56.1%(n=790) of all subjects. One thousand three hundred and twelve kinds of supplement products in 9 kinds of nutrition were taken, especially vitamin C. Vitamins and minerals from HFF were taken by 41.7%(n=587) of all subjects. Most of the response of the question for time of GDS or HFF intake was ‥usually take…, and for information source of GDS or HFF was ‥from family…. The rate of the response ‥I am going to take supplements(GDS or HFF) continually… was high. Major reason given for FF intake was ‥good for health…(39.5%). The subjects preferred vitamin C most when they choose FF(34.7%). Nutrition intake through the diet of IDU was positive. Thirty seven percents of the IDU took overlapped GDS and HFF. In 36.5% of the IDU, there were 81.8% of them taking 2 kinds of supplement, and 9.1% of them taking 3 or 4 supplements at once. Major patterns of overlapped-intake were [multi-vitamins supplement + vitamin C supplement] of GDS, and [vitamin B-complex supplement + calcium supplement] of HFF. Vitamin C supplements had higher percentages(40.7%) of GDS for vitamin and mineral intake than followed multi-vitamin supplements(37%)≒ multi-vitamin and mineral(23.9%)≒ calcium(Ca) supplements(6.5%)≒ iron(Fe) supplements(4.3%)≒ vitamin A and vitamin D supplements(2.2%). The daily average exposure of vitamins and minerals of IDU through diet was 0.3 to 4.4 times as compared with RNI particularly vitamin E(4.4 times). Also through just GDS was 0.0 to 75.8 times especially vitamin E(75.8 times). As well as through HFF was 0.0 to 111 times especially vitamin B12(111times). Finally through FF was 0.0 to 10 times but with no particular nutrition. Making vitamin on 97.5th percentile and minerals on 95th percentile in the maximum exposure through diet, there was an excess of exposure to UL in IDU in the following areas: through diet were vitamin A(1.7%) and niacin(5.0%); through only GDS were vitamin C(9.1%) and Fe(5.6%); and through HFF were niacin(8.6%)≒ vitamin B6(7.5%)≒ folic acid(2.9%)≒ vitamin C(2.3%). Making a comparison in vitamins and minerals daily intake through diet between IDU and IDNU, intake of vitamin B6, folic acid, vitamin C, and Ca in both groups were lower than RNI, but other vitamins and minerals were satisfied RNI. The average daily intake of vitamin B1, niacin, and Zn in IDU was higher than in IDNU significantly, but in both groups satisfied RNI. The daily intake of Ca in IDU was also higher than in IDNU considerably, but calcium intake of both groups was in 60 to 70% intake of RNI. Therefore the both groups had similar daily intake of vitamins and minerals and satisfied RNI, so IDU hardly seemed a group to need supplements or HFF. The result of this study showed that the intake of vitamins and minerals has been common among adolescents in Korea, and supplement intake of the subjects has been related with various factors. The intake rate of GDS for vitamin․mineral supplements was higher than HFF. However, there was no particular difference in usage behavior between the 2 types of supplements. The subjects may have potential risks of having negative effects in their bodies caused by overuse of supplements though most of them took enough vitamins and minerals through diet. Therefore we have to make efforts to encourage right health care habit through systematic and educational aspects. The exposure assessment for vitamins and minerals should be continued every lifecycle, and then there will be applications for nutrition safety management and the set up of the UL with scientific bases. In this study, there are several limitations: first, there is a lack of representation because of the small number of IDU; second, all the source of vitamins and minerals are not treated. Therefore we need to increase the number of subjects and consider the difference among seasons. Also we need to continue researching about exposure for vitamins and minerals including water or other nutrition supplements not treated in this study. Key Words : vitamin and mineral exposure assessment, tolerable upper intake levels(UL), diet, vitamin․mineral supplements, general drug supplements(GDS), health functional foods(HFF), fortified foods(FF), adolescents

지역별 응급의료접근성이 노인의 허혈성 심장질환 사망률에 미치는 영향

고은정 공주대학교 일반대학원 2021 국내석사

Objective : This study is a data analysis study to identify the cause of the difference and to suggest appropriate improvements by analyzing regional emergency medical access, visit time (30minutes) and emergency medical death of elderly patients with ischemic heart disease. Methods : This study collected data from NEDIS(National Emergency Department Information System) and from the National Statistical Office. A total of 75,867 patients over 65 years old were analyzed among the patients with ischemic heart disease who visited emergency medical institutions for one year from January 1, 2018 to December 31, 2018. The analysis related to the patient’s visit time (30 minutes) was performed only on patients with acute myocardial infarction due to the nature of the variable. There were 25,753 patients, and 21,128 patients were analyzed excluding 4,625 patients with missing values. For the collected data, frequency analysis, chi-square test, logistic regression analysis, and simple logistic regression analysis were performed using SPSS PC Window 25.0 Results : The results of this study are as follows. 1) As a result of emergency medical treatment for ischemic heart disease in the elderly, the death rate was 1.2%, and the arrival rate of emergency medical institutions for less than 30 minutes after the onset of acute myocardial infarction in the elderly was 7.1%. 2) Direct visits from all regions were higher than those of other routes, with Jeju (75.5%), and Gyeongbuk (75.4%) being the highest. The region with the highest transfer rate was Gwangju (40.3%) (p=.000). The region with the highest utilization rate of 119 ambulances was Jeju (45.3%) and the lowest region was Gwangju (22.1%). Chungbuk (55.3%) was the region with the highest use of other automobiles, and Jeju (43.8%) was the lowest (p=.000). 3) The number of emergency medical resources was in the order of Gyeonggi, Seoul, and Gyeongnam, followed by Jeju and Ulsan. The number of emergency medical resources per 100,000 people was in the order of Gangwon, Jeonnam, and Gyeongbuk, followed by Gyeonggi and Seoul the least. The number of emergency medical resources per 100km2 of area was the highest in Seoul, Busan and Gwangju, and the lowest in Gyeongbuk and Gangwon. 4) The effects of general characteristics on the arrival of emergency medical facilities within 30 minutes after onset were expressed by age, visit route, visit way, initial severity classification, and region. The odds ratio of arrivals within 30 minutes decreased in all ages compared to 65-69 years old. It decreased to 0.220 times for external transfer than for direct visits. In addition, the odds ratio decreased when using other ambulances (0.404 times) and other cars (0.470 times) than 119 ambulances. The odds ratio of arrival decreased at all stages than level 1 of the initial severity classification. From Seoul, Gwangju (0.525 times), Busan (0.535 times), Jeonbuk (0.613 times), Gangwon (0.617 times), Gyeonggi (0.694 times), and Gyeongnam (0.741 times) decreased in that order(p<.05). 5) The effect of regional emergency medical access on arrival within 30 minutes after the onset, the odds ratio appeared to increase when the number of ambulances (1.001 times), regional emergency medical centers (1.042 times), local emergency medical centers (1.015 times), and angiography devices (1.003 times) increase (p<.01). In addition, as an emergency medical resource per 100km2 of area, fire departments (1.019 times), ambulances (1.016 times), paramedics (1.002 times), regional emergency medical centers (1.538 times), local emergency medical centers (1.098 times), and angiography devices (1.014 times) was found to increase the odds ratio for arrivals under 30 minutes(p<.001). 6) As for the effect of general characteristics on the mortality of elderly patients with ischemic heart disease, the risk ratio of death as a result of emergency treatment increased as the age increased from 65-69 years old(except 70-75 years old). The risk ratio decreased when using other vehicles (0.273 times) than 119 ambulances, and when the initial severity classification severity was lower than level 1, the death risk ratio decreased. Compared to Seoul, the risk of death increased as the following order: Daegu (3.477 times), Ulsan (3.073 times), Jeju (2.614 times), Jeonbuk (2.053 times), Busan (2.004 times), Chungnam (1.976 times), Chungbuk (1.891 times), Gwangju (1.848 times), Gyeongnam (1.749 times), and Gyeongbuk (1.632 times) (p<.05). 7) The effect of regional emergency medical access on ischemic heart disease death was found to decreased the risk of death when the total number of local emergency medical resources and emergency medical resources per area (100km2) increased (p<.05). In particular, as an emergency medical resource per 100km2 of area, the risk of death from ischemic heart disease decreased 0.967 times when one fire department increased, 0.970 times when one ambulance increased, 0.997 times when one paramedic increased, 0.391 times when one regional emergency medical center increased, 0.844 times when one local emergency medical centers increased, 0.825 times when one local emergency medical institution increased, and 0.975 times when one angiography device increased (p<.001). Conclusion : Emergency medical resources differ greatly according to regional characteristics, and there were differences between regions in arrivals within 30 minutes after the onset and the mortality rate of ischemic heart disease among the elderly. In order to reduce the arrival time after the onset, it will be very important to provide an educational program for the elderly to easily recognized emergency symptoms of ischemic heart disease and to actively use the 119 ambulance when visiting the hospital. In order to improve the accessibility of emergency medical services by region, when deploying emergency medical resources(emergency medical institution resources), the area as well as the existing population in the region can be an important standard.

중학교 자유학년제 교육과정에서의 과학 탐구기능 위계 분석 및 의의

박혜인 공주대학교 일반대학원 물리교육학과 2023 국내석사

In this study, the hierarchy of science process skills for middle school students enrolled in the middle school free school year system curriculum was examined. The foundations for improving each student's science process skills by using the free school year system curriculum's features were discussed. 150 science majors out of 167 freshmen at the coed B middle school in Seobuk-gu, Cheonan-si, Chungcheongnam-do, where the free school year system curriculum was implemented for the 2021 academic year, served as the study's subjects. The period of time between the pre-test and the post-test was set at 90 days, and the inquiry function test (also known as an isomorphic test) was completed twice before and after the basic form of inquiry class. Based on the material from the science 1 textbook's first semester, the examination was designed to evaluate the science process skill. Based on the outcomes of the inquiry function test, the hierarchy of science process skills was examined using the "Knowledge State Analysis Method." By using the procedures of the Hasse Diagram and hierarchical analysis, the analysis results were shown by drawing a hierarchical diagram. The results of the study are as follows. First, each student had a unique hierarchy of science process skills. Thus, it seems that there is no solid evidence to support the widespread belief that the basic inquiry function is subordinate to the integrated inquiry function. The hierarchy of the basic inquiry function and the integrated inquiry function were not easily distinguishable from one another and appeared at random on the hierarchy chart. Second, it was discovered that the assumption that top-performing students would have mastered fundamental inquiry abilities was unfounded. In other words, even among the best students, some pupils lacked the foundational abilities of inquiry. Academic accomplishment may not be seen as being compatible with the hierarchy of inquiry functions due, in instance, to a test result that had nothing to do with academic performance with relation to the "issue recognition" inquiry function. Third, no students showed appreciable improvement across the board on the post-test, which was administered after the general form of inquiry class. This highlights the necessity for personalized, one-on-one instruction provided to each student in the form of a project as opposed to a broad-based inquiry class. As a result, the conclusion is as follows. First, it's possible that the prediction that the integrated inquiry function would be in the higher hierarchy and the basic inquiry function will be in the lower hierarchy is incorrect. The hierarchy of inquiry function tends to be obscured when examined using the hierarchy chart. Second, there was no correlation between the hierarchy of inquiry skills and academic accomplishment. Students with high rankings did not master all fundamental inquiry abilities, and their proportion of right responses in the case of integrated inquiry skills was not noticeably greater than that of students with lower rankings. Third, it is inaccurate to claim that broad inquiry courses help students develop their unique inquiry abilities. In other words, inquiry courses that may be handled by individual pupils are necessary since the hierarchy of inquiry function looks differently for each individual. First-year middle school students are exposed to a free school year system curriculum that values independence, uniqueness, and flexibility. Additionally, a variety of possibilities are offered for inquiry-based courses, including subject selection exercises and club activities. If further study is done using this in the classroom, it is anticipated that middle school students' progress in scientific process abilities may be attained more efficiently. 본 연구에서는 중학교 자유학년제 교육과정에 놓인 중학생들을 대상으로 하여 과학 탐구기능의 위계를 분석하고, 자유학년제 교육과정의 특징을 활용하여 학생 개인의 과학 탐구기능을 개발하는 방안의 근거를 논의하였다. 연구 대상은 2021학년도에 자유학년제 교육과정이 적용된 충청남도 천안시 서북구에 위치한 남녀공학 B 중학교의 1학년 학생 167명 중에서 과학 교과를 수강하는 150명의 학생이다. 일반적인 형태의 탐구 수업을 전후로 탐구기능 검사(동형 검사)를 2회 실시하였으며, 사전 검사와 사후 검사의 실시 간격은 90일로 설정했다. 검사는 과학1 교과서의 1학기 내용을 토대로 과학 탐구기능을 평가할 수 있도록 제작했다. 탐구기능 검사 결과를 토대로 과학 탐구기능의 위계를 분석할 때는‘ 지식 상태 분석법’을 사용했다. 분석 결과는 위계 분석과 핫세 정보, 위계도 작성의 단계를 거쳐서 위계도를 도식화하여 나타냈다. 연구 결과는 다음과 같다. 첫째, 학생마다 과학 탐구기능의 위계가 상이하게 나타났다. 즉, 기초 탐구기능이 통합 탐구기능보다 하위의 위계를 갖는다는 일반적인 인식에 대한 명확한 근거가 없다는 것이 드러났다. 위계도에 따르면, 기초 탐구기능과 통합 탐구기능의 위계가 뚜렷하게 구별되지 않고 무작위하게 나타났다. 둘째, 상위권 학생은 기초 탐구기능이 발달됐을 것이라는 예상이 맞지 않다는 점이 드러났다. 즉, 상위권 학생일지라도 기초 탐구기능이 발달되지 못한 학생이 있었다. 특히 ‘문제인식’ 탐구기능에 관하여 학업성취도와 큰 관련 없는 검사 결과가 나왔는데, 이는 학업성취도가 탐구기능의 위계와 일치한다고 볼 수 없는 근거가 될 수 있다. 셋째, 일반적인 형태의 탐구 수업이 이루어진 후 시행된 사후 검사 결과에서, 사전 검사에 비해 눈에 띄게 모든 영역에서 향상된 학생이 없었다. 이는 일반적인 형태의 탐구 수업보다 학생 개개인에게 프로젝트 형식으로 주어지는 맞춤형 개별 학습의 필요성을 위시한다. 따라서 연구의 결론은 다음과 같다. 첫째, 기초 탐구기능이 하위 위계를 차지하고, 통합 탐구기능이 상위 위계를 차지할 것이라는 예측은 맞지 않을 수 있다. 위계도를 근거로 살펴보았을 때, 탐구기능의 위계는 뚜렷하게 구별되지 않는 경향을 보였다. 둘째, 탐구기능의 위계와 학업성취도 간에 관련이 있지 않고, 상위권 학생이 기초 탐구기능을 모두 익힌 것은 아니고, 통합 탐구기능에서도 하위권 학생보다 정답률이 확연히 높지 않은 결과를 보였다. 셋째, 일반적 탐구 수업은 개별 학생의 특정 탐구기능의 향상에 효과적이라고 말할 수 없다. 즉, 탐구기능의 위계는 개인마다 상이하게 나타나므로, 개별 학생에게 처치할 수 있는 탐구 수업이 요구된다. 중학교 1학년 학생들이 경험하는 자유학년제 교육과정은 자율성, 개별성, 유연성 등을 특징으로 갖는다. 또한, 주제선택 활동, 동아리 활동 등 다양한 형태의 탐구 수업이 이루어질 수 있는 기회가 많이 제공된다. 이를 활용하여 개인별 맞춤 탐구 과제가 제공되는 등의 수업 방식이 추가로 연구된다면, 중학생들의 과학 탐구기능 성장이 보다 효과적으로 이루어질 수 있을 것이라 예상한다.

통합교육 실행에 관한 교사의 주관성 분석

강성구 공주대학교 일반대학원 2021 국내박사

The purpose of this study is to explore the subjectivity of inclusive education of general teachers and special teachers, and to explore the meaning and structure inherent in tangible subjectivity. For this, the Q-method was used. 52 Q-samples related to the implementation of inclusive education were developed according to the procedure of the Q-method. 60 P-samples were composed of general teachers and special teachers and they conducted Q classification. The results were derived and discussed according to the analysis and interpretation in the procedure of the Q-method according to the procedure of the Q-method for analysis and interpretation and the conclusions and suggestions based on this research result and discussion are as follows. First, it was confirmed that the subjectivity of inclusive education of general teachers and special teachers appeared in four types. In addition, each type identified in this study was found to have significant differences in individual characteristics. The interpretation and naming were made in 'basic concept-scope of support' structure. As a result, the first type is SD-Inclusion Type(Students with Disability-Inclusive Education Type), the second type is AS-Inclusion Type(All Students-Inclusive Education Type), the third type is named as SD-Integration Type(Students with Disability- Integrated Education Type) and Type 4 is AS-Integration Type(All Students -Integrated Education Type). The first type(SD-Inclusion Type, Type 1) is a group centered on special teachers. They agree to implement inclusive education and to administer an inclusive school and resource room in a unified education system that does not distinguish between special education and general education. However, they did not agree with the role of special teachers that should support all students. The second type(AS-Inclusion, Type 2) was a group of general teachers. The teachers have subjectivity that all teachers should educate students without discrimination by administering a general school as an inclusive school for all students, and using a cooperative support strategy. The third type(SD-Inclusion Type, Type 3) had subjectivity that the implementation of inclusive education should be conducted by special teachers centering on students with disabilities. It is possible to improve the inclusive education by applying the curriculum by level, even in the current educational system. The fourth type(AD-Integration Type, Type 4) agreed that it was necessary to expand the scope of support for inclusive education to all students, and those in Type 4 had subjectivity that it is possible that special teachers are dedicated to these students in the current integrated education system. Second, differences and meanings were confirmed by five categories through comparison with each type in relation to the implementation of inclusive education in Korea. In the area related to policy development, all types agreed that inclusive education requires social consensus process. The subjectivity of Type 1 and Type 2 is inclusive education, and the subjectivity of Type 3 and Type 4 is integrated education. However, it was found that the Type 2 and Type 4 had the subjectivity that the scope of inclusive education support should be expanded to all students, whereas Type 1 and Type 3 had the subjectivity that they should be centered on students with disabilities. In the areas related to the education system and placement type, for the implementation of such inclusive education, Type 1 and Type 2 require a unified education system and the administration of the inclusive school. Type 3 and Type 4 want to maintain the current education system. They also had the subjectivity that the administration of inclusive education led by special classes was sufficient to achieve the ultimate purpose of inclusive education. Some types emphasize on education to improve understanding about disabilities (type 1, type 2) and cooperative support (type 2) strategies. In the area related to the role of teachers, type 1 and type 2 showed subjectivity that general teachers should take responsibility for inclusive education for all students, whereas type 4 showed the subjectivity that special teachers should be in charge of these students. Regarding the role of special teachers, negative subjectivity was also revealed in the role of special teachers supporting all students in all types. The most of types (type 1, type 2, and type 4) recognized that the role of parents and members in inclusive education is important. Lastly, in the areas related to the delivery system, the most of types did not show significant differences in subjectivity for support at the national level, regional level, school level, and special education support centers. The implication obtained through the analysis of the types is that inclusive education is a practical alternative to teach heterogeneous students together. In order to successfully implement inclusive education, both general and special teachers take responsibility for inclusive education. Relevant professional and systematic teacher training should be carried out together (Type 1, Type 2). However, some teachers believe that it is possible in the current inclusive education system, so research and evaluation on the implementation of the current inclusive education must be preceded(Type 3, Type 4). In order to establish the direction of inclusive education, Korea government should pursue the future direction and policies. The inclusive education should be promoted based on shared accountability after sufficiently sympathizing and communicating through such an objective evaluation and a forum for public debate between general and special teachers(Type 4). Next, the implications obtained through the comparative analysis between types are that there are differences between teachers in various perspectives on inclusive education policy, and the differences in these perspectives include changes in the national education system beyond the discretion of teachers in the classroom. The same perspective is also included (related to policy development), and various perspectives related to the implementation of inclusive education confuse the perception of the role of members of the education field, and it seems necessary to establish a clear policy direction for inclusive education and consistent education policy so that there is no confusion in the future(related to the member's role) That way, there will be no confusion in the form and method of operation of general schools, special classes, and special classes (related to education system and placement). In addition, when establishing an inclusive education policy in the future, the implementation of inclusive education should be presented along with a practical and specific implementation strategy(related to the curriculum and teaching-learning strategy). An efficient inclusive education delivery system should be established. The effectiveness of inclusive education and the burden of teachers' inclusive education should be reduced(related to the delivery system). 이 연구의 목적은 일반교사와 특수교사의 통합교육 주관성을 탐색하고, 유형화된 주관성에 내재된 의미와 구조를 탐구하는 데 있다. 이를 위해 연구방법으로서 Q방법을 활용하였다. Q방법의 절차에 따라 통합교육 실행과 관련된 52개의 Q표본을 개발하였으며, 일반교사와 특수교사로 구성된 60명의 P표본을 선정하고, 이에 대한 Q분류를 실시하였다. Q방법의 분석 및 해석 절차에 따라 결과를 도출하고 논의하였으며, 이 연구결과와 논의를 근거로 한 결론과 제언은 다음과 같다. 첫째, 이 연구를 통하여 우리나라 일반교사와 특수교사의 통합교육 주관성은 4가지 유형으로 나타나는 것으로 확인할 수 있었다. 또한 이 연구에서 확인된 각 유형은 유형간의 서로 간의 유의미한 개별적 특성의 차이가 있는 것으로 드러났으며, ‘기본 개념 - 지원의 범위’ 구조로 해석과 명명이 이루어졌다. 그 결과 제1유형은 장애학생 중심의 포함식 통합교육형(Students with Disability-Inclusive Education Type), 제2유형은 모든 학생을 위한 포함식 통합교육형(All Students-Inclusive Education Type), 제3유형은 장애학생 중심의 모음식 통합교육(Students with Disability-Integrated Education Type), 제4유형은 모든 학생을 위한 모음식 통합교육(All Students -Integrated education Type)으로 각각 명명할 수 있었다. 제1유형은 특수교사 중심 집단으로 특수교육과 일반교육을 구분하지 않은 일원화된 교육체계 속에서 포함식 통합교육 실행과 포함학교(inclusive school)와 학습도움실(resource room) 운영에 동의하는 것으로 나타났지만, 포함식 통합교육 실행에 따라 특수교사가 모든 학생을 지원해야하는 역할에는 동의하지 않는 주관성을 가지고 있었다. 제2유형은 일반교사 집단으로 모든 학생을 위해 일반학교를 포함학교로 운영하여 포함식 통합교육이 이루어져야 하고, 협력적 지원 전략을 활용하여 모든 교사는 이 학생들을 차별 없이 교육해야 한다는 주관성을 가지고 있었다. 제3유형은 통합교육의 실행은 장애학생 중심으로 특수교사가 이를 전담하여야 하고, 현행 교육체제의 유지 속에서도 수준별 교육과정의 적용을 통해 통합교육 내실화가 가능하다는 주관성을 가지고 있었다. 제4유형은 통합교육의 지원의 범위를 모든 학생으로 확대가 필요하다는 데 동의하고, 이는 모음식 통합교육체제 속에서 특수교사가 이 학생들을 전담하는 현행 방식으로도 가능하다는 주관성을 가지고 있었다. 둘째, 이 연구를 통하여 우리나라 통합교육 실행과 관련하여 각 유형 간 비교를 통해 차이와 의미를 5개 범주별로 확인할 수 있었다. 정책개발 관련 영역에서는 모든 유형이 통합교육은 사회적 해결 노력이 필요하다는 데 동의하였고, 제1유형과 제2유형은 포함식 통합교육으로 제3유형과 제4유형은 모음식 통합교육으로 통합교육이 실행되어져야 한다는 주관성을 가지고 있었다. 그러나 제2유형과 제4유형은 통합교육 지원의 범위를 모든 학생으로 확대해야 한다는 주관성을 가지고 있는 반면에 제1유형과 제3유형은 기존 장애학생 중심으로 이루어져야 한다는 주관성을 가지고 있는 것으로 나타났다. 교육체제 및 배치유형 관련 영역에서는 이와 같은 통합교육 실행을 위해 제1유형과 제2유형은 일원화된 교육체제와 포함학교 운영이 필요하다고 보았으며, 제3유형과 제4유형은 기존 교육체제의 유지와 특수학급 중심의 통합교육 운영으로도 통합교육의 궁극적인 목적을 달성을 위해 충분하다는 주관성을 가지고 있었다. 교육과정 및 교수-학습 관련 영역에서는 통합교육에서 중요한 교수-학습전략인 개별화교육과 교육자료, 교육환경에 대해 유의미한 주관성이 나타나지는 않았고, 일부 유형에서 장애인식개선 교육(제1유형, 제2유형)과 협력적 지원(제2유형) 전략이 강조되기도 하였다. 구성원의 역할 관련 영역에서는 제1유형과 제2유형은 일반교사가 모든 학생의 통합교육을 책임지는 역할을 해야 한다는 주관성을 보인 반면에, 제4유형은 이와 같은 학생들을 특수교사가 전담해야 한다는 주관성을 보였다. 특수교사의 역할에 대해서는 모든 유형에서 특수교사가 모든 학생을 지원하는 역할에 대해 부정적 주관성을 나타나기도 하였다. 그리고 대부분의 유형(제1유형, 제2유형, 제4유형)이 학부모 및 구성원의 통합교육에서의 역할에 대해 중요하게 인식하고 있었다. 마지막으로 전달체계 관련 영역에서는 대부분의 유형이 국가수준, 지역수준, 학교수준, 특수교육지원센터에서의 지원에 유의미한 주관성의 차이를 보이지는 않았다. 위 결과를 바탕으로 한 논의를 통해 도출한 시사점은 다음과 같다. 유형 분석을 통해 얻은 시사점은 포함식 통합교육이 이질적인 학생을 함께 수업하는 실질적 대안으로서 포함식 통합교육을 성공적으로 실행하기 위해서는 일반교사와 특수교사 모두 통합교육에 대한 책임을 가지고, 통합교육과 직접적으로 관련된 전문적이고 체계적인 교사훈련이 함께 이루어져야한다는 것이다(제1유형, 제2유형). 그러나 일부 교사들은 기존 통합교육체제에서도 가능하다고 여기기 때문에 우선적으로 기존 통합교육 실행에 대한 연구와 평가가 선행되어야 한다(제3유형, 제4유형). 향후 우리나라가 지향해야할 통합교육의 방향과 이에 대한 정책 수립을 위해서는 이와 같은 객관적인 평가와 함께 일반교사와 특수교사 간의 공론의 장을 통해 충분히 공감하고 소통한 후 책무성 공유를 기반으로 통합교육이 추진되어야 한다(제4유형). 다음으로 유형 간 비교분석을 통해 얻은 시사점은 우리나라 교사들 간에는 통합교육 정책에 대한 여러 가지 관점에 서로 다른 차이가 있으며 이 관점의 차이에는 교실에서의 교사의 재량을 넘어 국가적인 교육체제 전반의 변화와 같은 관점도 포함되어 있다(정책 개발관련 영역), 통합교육 실행과 관련한 여러 관점은 교육현장 구성원의 역할 인식에 혼란을 주고 있으며 향후 혼란이 없도록 명확한 통합교육의 정책 방향과 일관된 교육정책 수립이 필요해 보인다(구성원의 역할 관련 영역). 그래야 일반학교, 특수학급, 특수학급의 운영 형태와 방식에서도 혼란이 없을 것이다(교육체제 및 배치관련 영역). 또한 향후 통합교육 정책 수립 시, 통합교육의 실행은 실질적이고 구체적인 통합교육 실행전략과 함께 제시해야 하고(교육과정 및 교수-학습전략관련 영역), 이를 지원할 수 있는 효율적인 통합교육 전달체계를 함께 구축하여 통합교육의 실효성과 교사의 통합교육의 부담을 경감시켜 주어야 한다(전달체계관련 영역).

종합병원 간호사의 좋은 죽음 인식, 공감 역량과 회복탄력성이 임종간호 수행에 미치는 영향

강지윤 국립공주대학교 일반대학원 2024 국내석사

본 연구의 목적은 종합병원에서 근무하고 있는 간호사를 대상으로 좋은 죽음 인식, 공감 역량과 회복탄력성의 정도와 그 관계를 파악하고 임종간호 수행에 미치는 영향을 확인하여 정보를 제공하며, 임상실무 영역에서 교육프로그램 개발과 중재를 위한 기초자료를 마련하고자 한다. 본 연구는 서술적 상관성 연구이며, 연구 대상자는 D 광역시에 소재한 2곳의 종합병원에서 내과계 병동, 외과계 병동, 중환자실에 근무하고 있는 임상경력 6개월 이상이고 임종간호 경험이 있는 간호사 186명이었다. 일반적 특성, 좋은 죽음 인식, 공감 역량, 회복탄력성, 임종간호 수행의 정도를 측정하기 위해 구조화된 자가 보고식 설문지를 이용하였으며, 자료 수집 기간은 2023년 8월 8일부터 9월 26일까지였다. 수집된 자료는 IBM SPSS Statistics 27 프로그램을 이용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, Scheff’e test, Pearson’s correlation coefficient, multiple regression analysis로 확인하였다. 본 연구의 결과를 요약하면 다음과 같다. 1) 종합병원 간호사의 좋은 죽음 인식 정도는 5점 만점에 평균 3.80±0.57점, 공감 역량 정도는 5점 만점에 평균 3.83±0.45점, 회복탄력성 정도는 5점 만점에 평균 3.68±0.45점, 임종간호 수행 정도는 4점 만점에 평균 2.67±0.44점이었다. 2) 종합병원 간호사의 일반적 특성에 따른 좋은 죽음 인식의 차이는 연령(F=11.92, p<.001), 결혼상태(t=-2.46, p=.015), 종교(t=3.04, p=.003), 최근 1년간 임종간호 횟수(F=3.98, p=.020)에 따라 통계적으로 유의한 차이가 있었다. 종합병원 간호사의 일반적 특성에 따른 공감 역량의 차이는 연령(F=4.80, p=.009), 결혼상태(t=-2.58, p=.011), 임종 교육 경험(t=3.05, p=.003)에 따라 통계적으로 유의한 차이가 있었다. 종합병원 간호사의 일반적 특성에 따른 회복탄력성의 차이는 연령(F=5.61, p=.004), 성별(t=-2.12, p=.035), 결혼상태(t=-2.27, p=.024), 종교(t=2.44, p=.016), 총 임상경력(F=4.47, p=.013), 직위(t=-2.01, p=.046)에 따라 통계적으로 유의한 차이가 있었다. 종합병원 간호사의 일반적 특성에 따른 임종간호 수행의 차이는 연령(F=3.83, p=.023), 결혼상태(t=-3.12, p=.002), 임종 교육 경험(t=2.27, p=.024)에 따라 통계적으로 유의한 차이가 있었다. 3) 종합병원 간호사의 임종간호 수행은 좋은 죽음 인식(r=.22, p=.003), 공감 역량(r=.54, p<.001), 회복탄력성(r=.44, p<.001)과 양의 상관관계가 있었다. 4) 종합병원 간호사의 임종간호 수행에 미치는 영향 요인은 공감 역량(β=.39, p<.001), 결혼상태(기혼)(β=.18, p=.023)이고, 이들 변수는 종합병원 간호사 의 임종간호 수행을 30.7% 설명하였다. 이상의 연구 결과를 바탕으로 종합병원 간호사의 임종환자와 그 가족들에 대한 공감 역량과 일반적 특성 중 결혼상태(미혼)보다 가족을 돌본 경험과 가족의 구성으로 다양한 인간관계의 경험이 있는 결혼상태(기혼)가 전인 간호가 필요한 임종간호 수행에 영향을 주는 주요 요인임을 확인하였다. 따라서 종합병원 간호사의 일반적 특성인 결혼상태(기혼)의 특성을 고려하여 부서 배치를 하며, 일과 가정의 양립을 위해 유연근무제 시행 등의 근무환경 개선이 필요하다. 그리고, 간호사의 공감 역량을 증대시킬 수 있도록 공감 역량 강화교육 프로그램 마련하여 지속적인 훈련이 필요하다. The purpose of this study is to identify the degree and relationship between good death perception, compassionate competence, and resilience for nurses working in general hospitals, identify the impact on end-of-life care performance, and provide information in the area of clinical practice. We aim to prepare basic data for educational program development and intervention. This study was a descriptive correlational study, and the subjects of the study were 186 nurses with at least 6 months of clinical experience and experience in end-of-life care working in the internal medicine ward, surgical ward, and intensive care unit at two general hospitals located in metropolitan D. A structured self-report questionnaire was used to measure general characteristics, good death perception, compassionate competence, resilience, and degree of end-of-life care performance, and the data collection period was from August 8 to September 26, 2023. The collected data were confirmed using frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheff’e test, Pearson’s correlation coefficient, and multiple regression analysis using the IBM SPSS Statistics 27 program. The results of this study are summarized as follows. 1) The average degree of good death perception of general hospital nurses was 3.80±0.57 out of 5, the average degree of compassionate competence was 3.83±0.45 out of 5, the average degree of resilience was 3.68±0.45 out of 5, and the average degree of end-of-life care performance was 2.67±0.44 out of 4. 2) Differences in good death perception according to general characteristics of general hospital nurses were statistically significant according to age(F=11.92, p<.001), marital status(t=-2.46, p=.015), religion(t=3.04, p=.003), and the number of end-of-life care in the last year(F=3.98, p=.020). There were statistically significant differences in compassionate competence according to the general characteristics of general hospital nurses according to age(F=4.80, p=.009), marital status(t=-2.58, p=.011), and end-of-life education experience(t=3.05, p=.003). Differences in resilience according to general characteristics of general hospital nurses were statistically significant according to age(F=5.61, p=.004), sex(t=-2.12, p=.035), marital status(t=-2.27, p=.024), religion(t=2.44, p=.016), total clinical experience(F=4.47, p=.013), and position(t=-2.01, p=.046). There were statistically significant differences in end-of-life care performance according to the general characteristics of general hospital nurses according to age(F=3.83, p=.023), marital status(t=-3.12, p=.002), and end-of-life education experience(t=2.27, p=.024). 3) General hospital nurses' end-of-life care performance is based on good death perception(r=.22, p=.003), compassionate competence(r=.54, p<.001), and resilience(r=.44, p<.001) and there was a positive correlation. 4) The factors affecting the end-of-life care performance of general hospital nurses were compassionate competence(β=.39, p<.001) and marital status(marriage)(β=.18, p=.023), and these variables explained 30.7% of the end-of-life care performance of general hospital nurses. Based on the above research results, it was confirmed that among the general hospital nurses' compassionate competence for end-of-life patients and their families, marital status(marriage), which has experience in various human relationships and family composition rather than marital status(single), is a major factor influencing the performance of end-of-life care that requires holistic nursing. Therefore, it is necessary to assign departments in consideration of the characteristics of marital status(marriage), which is a general characteristic of general hospital nurses, and to improve the working environment, such as implementing a flexible work system to balance work and family. In addition, continuous training is needed by preparing an education program to strengthen compassionate competence to increase nurses' compassionate competence.