유아기 자녀를 둔 아버지의 생성감과 돌봄 경험 만족도: 양육 책임감의 매개 효과

조윤주,김지현,한준아 한국아동권리학회 2018 아동과 권리 Vol.22 No.1

Objectives: The aim of this study was to explore the general tendencies of the major study variables and to analyze the variables that have an effects on father’s care work satisfaction. Methods: The sample included 119 male office workers with young children in dual-earner families. The data were analyzed by descriptive statistics, Pearson’s correlation, hierarchical multiple regression, and bootstrapping. Results: First, the mean of father’s generativity and care work satisfaction were 29.1 pts (range = 10∼40 pts), and 12.2 pts (range = 6∼18 pts) respectively. The mean of care work satisfaction was 16.4 pts (range = 5∼20 pts). Second, the correlation between generativity and child care responsibility, and generativity and care work satisfaction were positive. Third, the variables which explained care work satisfaction of the father were generativity and child care responsibility. The fathers reported higher levels of generativity and child care responsibility, when they were more satisfied with care giving of the child. Fourth, a significant partial mediating effect on father’s care work satisfaction was child care responsibility. Conclusions: Activating interventions using generativity were suggested. 연구 목적: 본 연구는 아버지의 자녀 양육 참여에 대한 학문적, 시대적인 관심을 반영하여 유아기 자녀를 둔 아버지의 양육 경험에 관한 과정을 알아보고자 실시되었다. 방법: 연구 대상은 만 3세에서 5세 사이의 자녀를 두었으며 사무직에 종사하는 아버지 119명으로, 수집된 자료는 기술 통계와 Pearson의 적률 상관관계, 위계적 중다회귀분석, Bootstrapping 검증을 통해 분석되었다. 결과: 첫째, 주요 변수인 생성감의 평균 점수는 29.1점(점수 범위=10∼40점)이었으며, 양육 책임감은 평균 12.2점(점수 범위=6∼18점), 돌봄 경험 만족도는 16.4점(점수 범위=5∼20점)이었다. 둘째, 주요 변수간 상관관계로 아버지의 생성감과 양육 책임감은 정적 상관관계였다. 또한 아버지의 생성감과 돌봄 경험 만족도 역시 정적인 상관관계를 보였다. 셋째, 아버지의 돌봄 경험 만족도에 영향을 미치는 변수 중 설명력이 가장 크면서 유의한 변수는 생성감, 양육 책임감의 순이었다. 그리고 생성감은 양육 책임감을 통해 간접적으로 돌봄 경험 만족도에 영향을 미쳐 부분 매개 효과를 보였다. 결론: 본 연구 결과를 바탕으로 생성감에 초점을 둔 양육 참여 활성화 방안 등의 논의와 제언을 하였다.

‘국가책임보육’에 대한 일고: 일본 보육정책을 통해 본 국가의 책임과 역할

장영인(Jang, Young-In) 한국영유아보육학회 2019 한국영유아보육학 Vol.0 No.117

본 연구는 우리나라에서 ‘국가책임보육’이 강조되고 있지만 그 의미와 내용이 모호한점에 대한 문제의식을 가지고, 공보육이 발전된 일본의 사례를 통해 국가의 책임의 내용을 살펴보고 시사점을 얻고자 하였다. 국가보육책임의 중요한 기준은 그동안 언급되어 왔던 보육재정의 크기나 국공립시설의 비중이 아니라 보육에서의 국가의 역할이 되어야 한다고 보고, 이를 위해 국가책임보육의 근간을 이루는 기본관점과 보육목표, 보육실무의 기본원칙, 그리고 이를 실현하기 위한 보육시스템 구축의 측면에서 국가의 역할을 살펴보았다. 이를 위해 본 연구는 일본의 보육관련 법과 지침을 분석하고, 그러한 원칙들이 보육정책을 통해 구체적으로 실행되는 모습을 확인하기 위해 일본의 보육관련 학자, 보육소 운영자, 행정담당자와의 인터뷰를 수행하여 내용을 보완하였다. 연구결과, 일본은 대기아 해소방안으로 몇 차례의 중요한 정책변화가 있었고, 특히 ‘아동·육아지원신제도’(2015. 4. 1. 시행) 이후 민영화가 추진되고 이용자와 시설간의 직접 계약방식이 도입되는 등의 변화를 근거로 국가책임의 약화와 준시장화가 진행된다는 우려가 있었지만, 국가가 아동의 보육권을 보장하기 위해 보육제공 전반을 총괄하는 역할에는 변함이 없고, 그 점에서 국가가 보육제공에 직접 책임을 진다는 의미에서 공보육을 여전히 수행하고 있음을 확인하였다. 이러한 일본의 예를 통해, 우리나라도 국공립시설확충의 측면에서 국가책임보육을 논하기보다, 아동양육의 기본관점과 목표, 원칙에 대한 사회적 합의와 공감대를 기초로 가정, 시설, 국가 간의 역할분담과 협력이 필요함을 제안하였다. This paper amis at having some implications for state’s roles and duties of child care from the research on Japanese case to clarify the concept of ‘the state responsibility for child care’. This paper premises that the criteria of what ‘the state responsibility for child care’ is the state’s roles in the child care field rather than the size of child care related state fund and the portion of public child care facilities. To identify the nature and contents of ‘the state responsibility for child care’, this paper analyzes the principal viewpoint of the state child care policy, major principles applied to child care practices, and the state roles in establishing child care system in Japan. For that purpose, this paper analyzes Japanese laws and regulations related to child care services. To confirm how the principles embodied in laws and regulations are practiced through the child care systems in Japan, this paper conducts interviews with scholars, persons in charge of child care centers, and public officers in Japan. Although there have been critics against Japanese new child care policies related to that state responsibility for child care became weakened and market oriented, this paper confirms that the nature of Japanese child care is still public care services in terms of the state being responsible for the provision of child care services. Based on the research on Japanese child care policy, this paper suggests that the new role division among families, service providers and the state in child care should be made after social consensus on basic viewpoint, purpose and principles of child care services rather than focusing on expanding of child care facility purchase by the state and local authorities.

돌봄접촉이 개심술환자의 스트레스 및 면역 반응에 미치는 효과

김혜순 성인간호학회 1999 성인간호학회지 Vol.11 No.3

Open heart surgery is itself a difficult and risky procedure, so patients who receive surgery experiences severe stress and anxiety from physiological and psychological sources. These stresses increase workload of heart and oxigen consumption so that increased pulse rate, blood pressure, arithmia can being a harmful effect to the patients. Thus, nursing intervention should be given in order to reduce these stresses. The purpose of this study was to define "caring touch" which could relieve a patient's anxiety and reinforce his immune reactions. This study examined how "caring touch" could be a easy and useful way of nursing care. Finally, this research attempted to find out when it is appropriate to begin this caring touch compared effect of caring touch given before and after operation. This study was designed using a quasi-experimental approach with non-equivalent control groups and non-synchronized design. The study subjects consisted of 65 adult patients who have undertaken open heart surgery in the two general hospitals of K. and S. located in Inchon and Buchon form the 4th of January to the 28th of May in 1998. Group A was a study group consisting of 22 patients who were given caring touch twice a day from the day before the operation until the 7th day after the operation. Group B was a study group consisting of 20 patients who received the care from the 1st day after the operation to the 7th day in the same manner as Group A. The control group consisted of 23 patients who were not given this care. This study used two measuring instrument : Visual Analogue Scale Anxiety which was developed by Cline(1922), and Trait and State Anxiety by Spielberger(1970). Measuring items were blood pressure, pulse rate, cortisol level percentages of T-lympgocyte, and natural killer cell in the blood. Data collected were analyzed by SAS program for χ²test, ANOVA. Repeated measures of ANOVA. Pearson-correlation, Scheffe multiple comparison, and Profile multiple comparison methods. The results of the study are as follows : 1. Emotional stress reaction Level of VAS anxiety and State anxiety of group A and B showed a significant decline compared to the control group(P<.05). The anxiety of group A and B showed significant lower level on the 1st day after operation than the day before operation, and the anxiety level was also lower on the 7th day after operation than 1st day after operation(P<.001). 2. Physiological stress reaction Systolic BP measured in groups A and B showed significant higher difference between before and after receiving caring touch compared to control group(P<.05). Systolic BP measured on the 1st day after the operation was lower than the day before and the 7th day after operation(P<.01). The control group however, showed no difference. Diastolic BP measured in group A showed significant higher difference between before and after receiving caring touch than control group(P<.05). However, there was no significant difference in it on the three points of measuring. Pulse rate measured in group A showed significant higher difference between before and after receiving caring touch than control group(P<.05), and the pulse rates measured on the 1st day after operation were significantly lower than the day before operation and the 7th day after operation(P<.01). But these was no difference in the control group. The cortisol level of all three groups showed no significant difference, and the level of cortisol measured on 1st day after operation was significantly higher than the day before operation and 7th day after operation(P<.01). 3. Immune reactions T-lymphocyte of group B was found higher rates than the control group(P<.05), and the T-lymphocyte measured on the day befor operation and 7th day after operation were significantly higher than the 1st day after operation(P<.001) NK-cell rate of all three groups revealed no significant difference and NK-cell measured on the 1st day after operation showed higher rates than the 7th day after operation(P<.001). Based on above mentioned results, it is found that emotional and physiological stress of open heart surgery patients can be relieved by giving caring and which was identified on the measured items of VAS Anxiety. State anxiety, BP and pulse rate. And those measuring were markedly decreased on the 1st day after operation. Especially group A, which began caring touch before undergoing operation showed less anxiety compared to group B, which received caring touch from the 1st day after operation. Thus, the most appropriate time for giving caring touch was a day before the operation. And also it was found that caring touch increased the T-lymphocyte rate, and immune reactions when anxiety level decreased. Therefore caring touch was proved to be a way of emotional nursing intervention to relieve anxiety and increase immune reaction.

응급의료와 형사책임

박철호,김양원,박득현,조준호,박경혜,권인호,박하영,여운형,윤유상 대한응급의학회 2013 大韓應急醫學會誌 Vol.24 No.5

Purpose: When a criminal act occurs during emergency care, it becomes fatal to both the patient and doctor. Criminal acts during emergency care and judged by the Supreme Court of Korea were analyzed and investigated to decrease and prevent medical malpractice. Methods: After assessing the Medical Act in Korea and Act on Emergency Care in Korea, a pattern of emergency care was categorized and applicable provisions were analyzed. Emergency medical malpractice cases were collected from previous reports and an internet site managed by the Supreme Court of Korea (http://glaw.scourt.go.kr). Results: The patterns of emergency care can be categorized into “general emergency care”, “interhospital patient transfer”, and the “request for medical treatment sent to another department or hospital”. Furthermore, inerthospiatl patient transfer can be categorized into “after request for emergency care” and “after medical treatment.” There were ten medical malpractice cases in emergency care in which criminal responsibility occurred. There were six cases related to general emergency care and four related to interhospital patient transfer. Conclusion: Though the emergency care cases in which criminal responsibility occurred were few, the results critically impacted the patient and doctor. Therefore, emergency physicians must do their best to decrease and prevent medical negligence. In addition, a nation has a primary responsibility to save lives and must support emergency care.

민간 의료기관에서의 보건교육사 활동 영역과 능력 개발

김영복 한국보건교육건강증진학회 2010 보건교육건강증진학회지 Vol.27 No.2

Objectives: In health care setting, patient education and health promotion services are inexpensive and effective initiatives to change health behavior due to use medical service resources and personnel. This study performed to define the responsibilities and competencies of health education specialist in private health care setting. For our suggestion, we reviewed regulatory, recommendation, and programs related to health education and promotion in clinics and hospitals. Results & Conclusion: The health promoting hospital and health services in Europe and innovative hospitals of community health promotion in the U.S. were examples of approaches that supply target groups with health promotion services in health care setting. The National Commission for Health Education Credentialing has suggested the specified responsibilities and competencies of health education specialist in health care setting according to their general duty. Considering the recommendation of the NCHEC, our suggestion included: 1) the three kinds of job scope, 2) the major targets, 3) the specified responsibilities and competencies, and 4) the available health promotion programs in clinic and hospital setting. The suggestion will contribute to the development of job market for health education specialist and to the cooperation with community health resources in health promotion services and comprehensive health care. Objectives: In health care setting, patient education and health promotion services are inexpensive and effective initiatives to change health behavior due to use medical service resources and personnel. This study performed to define the responsibilities and competencies of health education specialist in private health care setting. For our suggestion, we reviewed regulatory, recommendation, and programs related to health education and promotion in clinics and hospitals. Results & Conclusion: The health promoting hospital and health services in Europe and innovative hospitals of community health promotion in the U.S. were examples of approaches that supply target groups with health promotion services in health care setting. The National Commission for Health Education Credentialing has suggested the specified responsibilities and competencies of health education specialist in health care setting according to their general duty. Considering the recommendation of the NCHEC, our suggestion included: 1) the three kinds of job scope, 2) the major targets, 3) the specified responsibilities and competencies, and 4) the available health promotion programs in clinic and hospital setting. The suggestion will contribute to the development of job market for health education specialist and to the cooperation with community health resources in health promotion services and comprehensive health care.

<심포지엄 특집> 고령화 사회와 법 : 케어 윤리의 의의와 가능성 -사회구상의 핵심 개념 확립을 위해서-

정상광자 ( Inoue,Masako ) 아세아여성법학회 2014 아세아여성법학 Vol.17 No.-

Ethics of care is the concept that C. Gilligan as developmental psychologist has been presented in the definitive work “ In a Different Voice”1) in 1982. Gilligan, by the empirical analysis of the developmental psychology of the face of moral dilemma girls and young women of moral judgment and decision making process experiment, she found a “another” and “different” voice of women and called it Different Voice. And she criticized to ethics of justice by L. Kohlberg and his development theory as the mainstream which is centered on the fair logical reasoning, that it implies the gender bias, and has been assumed ethics of care as inferior one stage. Ethics of care as a rethinking of the social norms, has the impact on the broad range of fields, ethics, sociology, political philosophy, and jurisprudence, as well as gender theory and feminism. Also in Japan, the ethics of care had a major impact both the practice and the theoretical. A lot of feminists had much interests on it. But evaluation for it was controversial rather than simple. In one hand, ecological feminists based on the difference appreciated it, because it gave the named to the voice or emotion of women that have not been conceptualized. Moreover based on the scientific method of developmental psychology analysis, it asserted that female voice as moral judgment is not inferior to men’s voice, but equivalent which is based on a different philosophy. In the other hand, liberal feminism and radical feminism submitted critical evaluation. Because ethics of care occurs that women are exclusively tied to caring activities, and reinforces the traditional gender stereotypes in Japan. In spite that she clearly charged against gender bias, they criticized on it. Unfortunately, this twisted point had not been solved or digested on the discussions among various feminisms in the 1980s Japan. It is much more important that criticism of Gilligan rather than being directed only to Kohlberg, and gender bias such as Freud and Piaget, that is called as empirical research were included accusations of discrimination to the structure. The purpose of this essay is to point out the significances of the ethics of care as key concept of social theory for our days, at same time the problems to solve. Ethics of care, has only been considered to be a valid theory in special human relationships such as caring, care work, and family or intimate sphere. But ethics of care has significance and potentiality as the key concept of social theory. That it should not be to limit the adaptation range to “care relationship” or “care of the place”. Rather, in a relationship that also includes so-called civil society, the ethics of care is important as an idea. In order to function it as the key concept of social theory, I want to give the following two points, referring the discussion on Domestic Violence case organizing of the relationship between ethics and the essentialism of care.

노인의 경제적 부양과 신체적 부양 : 가족의무와 국가책임의 균형

석재은(Seok Jae-Eun),유은주(Yu Eun-Ju) 한국가족법학회 2007 가족법연구 Vol.21 No.1

  This paper examines how much the social support for the elderly is enough to make up for the decline of family support in our society. And it also evaluate to achieve the adequate balance between state-social responsibility and family responsibility (obligation) for elderly support. The elderly support is divided into income support and long-term care.<BR>  The first, in relation to income support, it is explored what the adequate balance between private-family support and public-social support against social risk of old-aged incomeless is. In this context, it is evaluated the family obligor standard of public assistance scheme and the role of public pension and security unit(household vs. individual) in old-aged income maintenance.<BR>  The second, in relation to long-term care, it is examined the role sharing between family as traditional care-giver and state as builder(enabler) social care system through introducing of Elderly Long-Term Care Insurance etc. Thus it is evaluated the balancing between state-social responsibility and family responsibility as intrinsic assumption of the design of Elderly Long-Term Care Insurance.

배려받는 자의 윤리

고미숙 ( Mi Suk Ko ) 한국윤리학회 2015 倫理硏究 Vol.100 No.1

배려 관계는 배려하는 자와 배려받는 자의 만남으로 이해되었지만, 배려하는 자가 중심적인 역할을 해왔고 배려받는 자는 배려하는 자의 배려를 수동적으로 받아들이는 존재로 간주되었다. 배려하는 자는 독립적이고 자율적인 존재인 반면, 배려받는 자는 취약하고 의존적인 존재라는 이분법적인 사유가 자율성을 중시하는 사회 속에서 배려받는 자를 경시하도록 만들었다. 이러한 배려받는 자에 대한 편견은 배려하는 자의 배려가 완성되지 못하도록 만들고 있다. 그리하여 본 연구는 배려받는 자에 대한 오해는 무엇이며, 배려받는 자가 갖추어야 할 윤리는 무엇인지, 배려받는 자를 위한 교육은 어떻게 해야 하는지를 탐구해 보았다. 인간의 취약성과 의존성은 배려받는 자만이 아닌 모든 인간의 조건이며, 이에 모든 인간은 배려가 필요하고 배려를 해야 하는 존재이다. 배려받는 자의 윤리로서 윤리적 응답과 자기 배려를 제시하였다. 배려받는 능력을 함양하기 위해서, 배려받는 자의 경험과 목소리가 들려질 수 있는 내러티브와 대화의 방법을 사용하고, 배려하는 자와 배려받는 자의 배려 방식 간에 조정하는 기술을 습득하는 것이 필요하다. 또한 도덕적인 관점에서 배려 경험에 대해 비판적으로 성찰하고 적절하지 못한 배려를 인식하는 능력을 길러주어야 한다. Although caring relation is the meeting between the carer and the cared-for, it has been regarded as the central role of carer and the passive role of cared-for, the carer independent-autonomous and the cared-for vulnerable-dependent. The dichotomy is related to the disdain on the cared-for in the society of autonomy. The prejudices on the cared-for make impossible the completion of caring. My question is that what are misunderstandings on the cared-for?, what are the ethics of the cared-for?, how can we learn to be the cared-for? Human vulnerability and dependence are conditions of our humanity, not only of the cared-for. I suggested the ethical responsiveness and care of self as the ethics of cared-for, the experiences and voices of the cared-for which can be heard through narrative and dialogue, how to mediate the differences on opinions of caring between the carer and the cared-for. Also, we should develop the critical reflection on our caring experiences and the capacity for awareness on improper caring in moral perspective.

가족의 노인 돌봄 경험과 딜레마 : 누가 돌보고 어디에서 돌봐야 하는가

문현아(Hyuna Moon),차승은(Seung-Eun Cha) 한국가족학회 2020 가족과 문화 Vol.32 No.1

South Korean society is quickly becoming an aging society where the responsibility of care falls on society from family burden. This paper takes this transition as the departure point of our analysis toward a journey to understand the reality Korean family members are facing in terms of elderly care. By using the 27 care stories collected in 2018, this paper investigates partially what specific aspects of the difficulties the family members face in elderly care with a presumption that there might be a clash or inconsistency in the care behaviors of the family members or in their ways of thinking on elderly care. Moreover, the paper aims to illustrate that the root of this inconsistency lies foremost at the difficulty of family care. We conclude in this paper that the issues of ‘where’ and ‘who’ take up another dimension of difficulties and burden, apart from physical hardship or labor of elderly care. Detailed policy implications are also discussed in the paper. 가족으로부터 사회로 돌봄의 책임이 옮겨가는 움직임이 진행되고 있기는 하나 여전히 가족은 돌봄과 관련된 주요 주체로 인식되고 있다. 시설과 기관으로 노인을 보내거나 집에서 재가요양을 선택해서 노인을 돌보는 방식이 가족이 전담해서 노인을 돌보는 것에 대한 대안으로 제안되고 있는 상황에서 사람들의 생각과 태도 그리고 돌봄 상황에서 경험은 어느 방향을 향하고 있을까? 이 논문은 구체적으로 노인을 돌보는 가족에 대한 심층 인터뷰(27 사례)를 통해 가족 돌봄의 현황과 문제점을 파악해 분석한 내용을 담고 있다. 먼저 한국 사회에서 돌봄과 관련된 사회적 규범과 현실이 얼마나 연결 또는 괴리되고 있는지 그 맥락을 점검한다. 이러한 맥락을 바탕으로 구체적으로 노부모를 ‘누가’ 돌보고 ‘어디서’ 돌볼 것인가의 문제를 둘러싸고 가족구성원들이 어떤 입장과 태도를 보이는지 분석하였다. 돌봄이 재가/시설이라는 두 개의 축으로 구분되어 제공되고 있는 현실에서 가족은 주로 ‘재가’를 담당하고 있는데, 가족이 동거/비동거의 상황에 따라 가족돌봄의 부담의 정도나 양상은 달라질 수밖에 없다. 노인을 돌보는 주체는 배우자인가 자녀인가? 자녀라면 남성인가, 여성인가? 딸과 며느리는 어떤 면에서 돌봄의 담당자로서 공통점과 차이를 지니는지 등을 살펴봄으로써, 가족의 돌봄에서 ‘가족’이 구체적으로 가족 내 ‘누구’를 이야기하고 있는 것인지를 보다 구체적으로 들여다보며 그 의미를 파악하였다.

이중돌봄 맥락에서 본 부정의한 세대 간 돌봄책임 재분배

백경흔(Baek, Kyungheun),송다영(Song, Dayoung),장수정(Jang, Soojung) 한국여성학회 2018 한국여성학 Vol.34 No.2

본 연구는 5060 중고령 여성의 이중돌봄 경험을 구체적으로 드러낸다. 주요 분석결과는 다음과 같다. 첫째, 이중돌봄 맥락에서 중고령 여성들은 부정의한 세대 간 돌봄책임 재분배를 통해 다중의 돌봄책임이 한 사람에게 수렴되는 ‘세대 독박 돌봄’을 수행하고 있다. 둘째, 이들은 ‘과잉 돌봄책임을 거절할 수 있는 권리’가 보장되지 않은 상태에서 충분한 지원 없이 독박 돌봄의 삶을 살고 있다. 셋째, 중고령 여성들은 딸, 며느리 등 자녀세대의 취업을 위해 예측하지 못한 비자발적 돌봄을 수행하고 있다. 마지막으로, ‘세대 독박 돌봄’은 제도가 역할을 제대로 못 하면서 제도의 부정의가 가족내 세대 간 부정의한 돌봄책임 재분배로 확장되어, 여성이 전 세대에 걸쳐 돌봄으로부터 자유롭지 못한 문제를 가져온다. 이에 이중돌봄이 불가피한 현실을 제대로 파악해 정책적 개선을 유도해야 한다. 첫째, 이중돌봄 맥락의 ‘세대 독박 돌봄’을 해결하기 위해 돌봄 대상에서 돌봄자 중심 접근으로 정책 패러다임 전환이 필요하다. 둘째, 전 세대에 걸쳐 노동권과 돌봄권이 적정하게 보장되는 생애주기 관점의 일가족양립 정책 수립이 필요하다. This study analyzes experiences of 5060 middle-old aged women’s grandchildren caring in the context of double care and induces policy implications. Research findings are as follows. First, 5060 women who care grandchildren in the context of double care take all responsibilities in a form of ‘Sedae Dokbak(one takes all care responsibilities of other generations)’ through unjust inter-generational re-distribution of care responsibilities. Secondly, these women take responsibilities with no proper assistance and no right to reject excessive care responsibilities. Thirdly, these women think grandchildren caring is an unexpected and involuntary life event but they accept it for their adult children’s economic participation. Lastly, as the institution fails to play a role of care safety net, unjust inter-generational re-distribution of care responsibilities within families is caused. As a result, women can not be free from care burdens through the entire life cycle. Following are policy suggestions. First, 5060 middle-old aged women should be considered as an important carer group in care policy. Secondly, these women should be considered as an important target of work and family balance policy in order to guarantee their right to work and care in a balanced way.