한국인의 행복과 좋은 죽음에 대한 표상과 인식의 특징

김명숙 ( Myung Sook Kim ) 충남대학교 인문과학연구소 2012 인문학연구 Vol.39 No.1

행복``은 개인이 삶에서 행동하여 얻고자 하는 성취의 궁극적 목적으로, 시대를 막론하고 모든 사람의 관심의 대상이다. 그러나 막상 ``행복이 무엇인지``에 대한 물음에 접했을 때, 행복에 대해 쉽게 설명할 수 있는 사람은 많지 않다. 삶의 목적이 행복이라면, "행복은 무엇인가? 어떻게 살아야 행복할까?"에 대해 고민하고 이를 좀 더 분명하게 알아야 할 필요가 있다. 경제적 발전에 온 관심이 집중되었던 지난 세기에, 행복은 흔히 물질적 풍요에 따라오는 것이라 생각되었다. 그러나 최근의 여러 연구들은 돈이 많고 물질적으로 풍요롭다고 해서 행복한 것이 아니라 오히려 반대의 인과관계가 성립한다고 보고한다. 본고에서 필자는 한국 성인들을 대상으로 수집한 질적 자료에 근거하여, 한국인이 지닌 ``행복``과 삶의 마무리로서의 ``잘 죽기``에 대한 표상과 인식의 특징을 밝히고 그에 대한 철학적 논의를 펼쳐 보고자 하였다. 자료의 분석을 통해서 한국인들이 암묵적으로 인식하고 있는 행복의 8가지 범주-① 신체적 안녕, ② 정서적 안녕, ③ 심리적 안녕, ④ 사회적 안녕, ⑤ 영적 안녕, ⑥ 윤리적 충만, ⑦ 미래세대의 안녕, ⑧ 경제적 안정-와, ``잘 죽기`` 위해 사람들은 후회와 미련 없이 최선을 다해 살고(심리적 안녕), 건강을 잘 관리하며(신체적 안녕), 긍정적인 마음으로 살아야 한다(정서적 안녕)고 인지하고 있음을 발견하였다. 본 연구를 종합하면서 몇 가지 주목할 점을 발견하였다. 첫째, 암묵적으로 사람들은 ``사회적 안녕``이 자신들의 행복에 가장 큰 영향을 미친다고 인지하고 있었다. 그럼에도 불구하고, 사회적 안녕 상태를 유지, 발전시켜 나가기 위해 행동하겠다고 한 사람은 전체의 1%에 불과했다. 둘째, 사람들이 암묵적으로 가장 바라는 상태의 행복은 심리적 안녕임에도 불구하고, 이들은 행복의 조건으로 정서적 안녕을 더 높이 들고 있었다. 셋째, 최근 한국인들이 ``물질 = 행복``이라고 여겨 불행한 사회가 되어 간다고 많은 대중매체들에서 우려하고 있는데, 행복의 조건이 경제적 안정이라고 한 응답은 전체의 12%에 지나지 않았다. 본 연구에서 얻어진 행복 개념의 8가지 범주는 인류(혹은 생태계) 전체의 행복이라는 시스템을 위해 작동하고 있는 자기조절(self-regulation) 체계의 하위 요소들의 건강으로 이해할 수 있다. 각 부분들이 통합되고 위계적인 전체를 형성하는 방식으로 상호작용하기 위해서는, 체계의 각 부분들은 저마다의 역할을 제대로 하고 긴밀하게 상호 연결되어야 한다. 균형 잡히고 지속가능한 ``행복``은 이를 구성하는 각 요소들이 하나로 통합되어서 ``행복``이라는 전체적인 체계를 구성할 때 비로소 출현하는 속성에 해당한다고 하겠다. 행복해지고자 한다면, 행복의 본질에 대해 시간을 들여 숙고하고, 구체적 계획과 실천 방안을 마련하여 이를 실천하고 점검하는 행동으로 옮겨야 한다. Characteristics of the Korean`s Representation and Understanding on Happiness and Good Death Kim, Myung-Sook ``Happiness`` is the ultimate purpose for every individuals behavior for achievement. Regardless of all era ``Happiness`` has been a interest for everybody. However, There is not much people who can answer when confronted by the question "What is happiness?". Considering that purpose of life is happiness needs for consideration of the questions such as "What is happiness? How can we achieve happiness?". During the past century happiness was considered normally accomplished by material affluence. Though recent researches shows that happiness is not only fulfilled by fortune and material affluence also there is a inverse proportion between those two. This paper, based on qualitative data, were examined representation and understanding on happiness and good death of Korean adults and discussed results in terms of philosophical thoughts. 10 Korean adults were deeply interviewed about happiness and good death by trained interviewers. 8 categories of happiness were found by grounded theoretical analysis:① physical well-being; ② emotional well-being; ③ psychological well-being; ④ social well-being; ⑤ spiritual well-being; ⑥ ethical fulfillment; ⑦ future generational well-being; ⑧ financial security. Koreans are implicitly recognized that, in order to live happy and well-dying, people should do his/her best to live without regret and remorse (psychological well-being), to manage the physical health (physical well-being), and to live with a positive mind (emotional well-being). Some notable findings of the study were as follow:First, Koreans implicitly aware that ``social well-being`` is the most influential to their own happiness. Nevertheless, only 1% of the sample engaged in that activities in order to promote and sustain their own social well-being; Second, Koreans implicitly understand psychological well-being of the most desired state, albeit as a condition of happiness, emotional well-being they listened to; Third, although ``material prosperity = happiness`` is considered a going concern in nowadays Korea, financial security condition of happiness is nothing more than one response was 12%. Happiness is a system that works for the entire system of self regulation of human beings. 8 categories of happiness can be understood as sub-components` health of the whole happiness system. In system theory, in order to regulate harmoniously whole happiness system, sub-components should play their own roles and are connected each other closely, and integrated as a unified system. Balanced and sustainable happiness is emerging when 8 categories of happiness make a integrated whole system. If you want to be happy, you should take the time to ponder about the nature of happiness, and make specific action plan and monitor it`s trajectories.

임상 증상이 심하지 않은 심낭 삼출 환자의 장기 추적 결과

배장호,김기식,강미숙,남명희,김미정,김민수,김기영,님창욱,김윤년,김권배,정시전,김여희 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.7

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

중환자실 전문간호사의 전문간호행위 분류와 수행분석

김진현,김명애,김미원,김경숙,유정숙,이은희 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4

Purpose: The purpose of this study was to reclassify the advanced nursing practices of critical care nurse practitioners(CCNPs) in intensive care unit and measure the time and frequency of CCNP's activities. Method: Practices of ICU nurses are divided into RN's and CCNP's practices by a panel of ICU nursing experts. Each practice of CCNP is defined and CCNP's working time and service frequencies are monitored in general hospitals. Result: Practices of CCNP were classified into 4 domains and 32 practices. Fourteen practices by CCNPs were completed in 10 minutes and the other 12 practices consumed 10-30 minutes. A priority of practice in respiratory therapy was given to artificial airway management, management of tracheostomy patient, lower respiratory care, and the priority of CRRT was management of anticoagulation. Conclusions: Advanced nursing practices of CCNPs were recognized from those of RNs. A further research of CCNPs practices should be extended to other advanced practices and it is required to evaluate economic value of advanced nursing practice in the national health insurance system.

한국인 알코올 의존 환자에서 알코올 대사 효소 유전자형 빈도의 남녀 차이

김성곤,김철민,이덕기,황인복,이현숙,김성연,전은숙,송영상,박제민,최병무,김명정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.2

Objectives : There are a number of preceding epidemiological studies reporting gender differences in the genetic etiology of alcohol dependence. The author investigated gender difference in the frequencies of ADH2 and ALDH2 genoypes between the patients with alcohol dependence and normal control. Methods : The subjects were 141 alcohol dependent patients (104 males, 37 females) and 138 normal control (79 males, 59 females). The frequencies of 1/1 and 1/2+2/2 (2+ afterward) genotypes for ADH2 and ALDH2 were investigated in male and female between alcohol dependence and normal control group. DNA was extracted from WBC in peripheral venous blood and PCR-RFLP method was used out for genotyping. Results : First, the frequency of ADH2 1/1 genotype was significantly higher in alcohol dependent patients than normal control in both genders. Second, while there was no gender difference in the frequency of ADH2 1/1 genotype in normal controls, in the patient group however, the frequency was significantly higher in females than males. Third, in male subjects with alcohol dependence, the frequency of ALDH2 1/1 genotype was significantly higher than in male normal control subjects. On the other hand, in female subjects with alcohol dependence, the frequency of ALDH2 2+ genotype was significantly higher than in female normal control subjects. Conclusion : These results suggest that while the risk of alcohol dependence is predominantly affected by ALDH2 1/1 geno-type in male, the female ADH2 1/1 genotype is mainly associated with the risk of alcohol dependence. This means that there are gender differences in the genetic etiology of alcohol dependence.

알코올의 섭취가 흰쥐의 혈액과 간의 지질대사에 미치는 영향

이명숙,김영연,김효숙,김매하,전진순,서진숙,송선미,양영재,윤원손,이미라,이효영,정승현 誠信女子大學校 生活文化硏究所 2004 生活文化硏究 Vol.18 No.-

To investigate the effects of ethanol on the lipid metabolism in blood and liver, twenty one male Sprague Dawley rats had orally taken the 25% alcohol and 50% alcohol by 5g per Kg of weight during 3 weeks after the adjusting period. For the energy balance, 85% sucrose and 45% sucrose was added in control group and 25% alcohol group each. The weight was reduced by alcohol treatment according to the levels, otherwise the weight of liver and heart was little increased in alcohol groups rather than in control without significance. Moreover, RBC, WBC, hemoglobin and hematocrit were increased by alcohol treatment according to the levels without significance. Otherwise, adjusted bilirubin levels by 100g of weight was significantly increased by alcohol treatment dose dependently. Alcohol induced RBC degradation and increased circulated bilirubin because of liver damage. For blood lipid profiles, blood cholesterol was increased in 50% of alcohol group compared to that of 25% and control groups, otherwise, blood triglycerides (TG) was increased by 30% in 25% alcohol groups rather than in control but not significantly different. The hepatic lipid composition, cholesterol levels in alcohol treatment groups was lower than those in control. The hepatic TG was not influenced by alcohol treatment. The two reasons of decreasing hepatic lipids were suggested by 85% sucrose of control for energy balance more synthesized cholesterol and TG than those in 25 or 50% alcohol groups, and by cholesterol and TG could not be synthesized because of liver damage from alcohol.

뜸요법과 세라밴드운동이 퇴행성 골관절염 노인의 신체적, 심리적 변수에 미치는 효과

한상숙 ( Sang Sook Han ),김원옥 ( Won Oak Kim ),김연정 ( Yeon Jung Kim ),백용현 ( Yong Hyun Back ),이명희 ( Myung Hee Lee ) 경희대학교 동서의학연구소 2008 동서간호학연구지 Vol.14 No.2

본 연구는 퇴행성 골관절염 노인을 대상으로 뜸요법과 세라 밴드 운동을 실시한 후 신체적 심리적 변수에 미치는 효과를 살펴보고자 실시하았다. 통증, 피로,우울은 뜸요법과 세라밴드운동 실시 후에 감소하였고, 유연성 측정으로 무릎각도, 족 배굴곡, 족저굴곡은 증가하였다. 따라서 뜸요법과 세라밴드 운동의 효과를 중심으로 논의하고자 한다. 실제적으로 뜸자극이 통증을 감소시키는 기전이 명확이 밝혀지지는 않았지만 뜸요법은 지각신경(知覺神經)의항분(亢憤)에따라 지각이 과민하고 통증이 있는 경우나 자율신경(自律神經)의 항분에 의해 발생하는 해장기관의 이상 시에 억제회선(抑制回善)하는 억제(抑制), 제지(制止), 진통(鎭痛) 등의 작용이 있다 (Chiba, Nakamsimshi& chichibu, 1997; East-West Nursing Research Institute1 2000). 뜸요법 후 자궁적 출술한 여성의 냉증과 통증이 감소하였고(Shin et al., 2001), 여대생의 생리통과 월경곤랑증이 감소(Kim&Cho,2001;Lee, 2004)한 것으로 나타나고 있는데, 이는 뜸요법의 작용인온경(溫經藥), 산한지통(散寒止痛),제습지양(除濕 止痒)의 효과로 설명할 수 있다. 즉 뜸여법은 혈을 따뜻하게 하여 한사(寒邪)를 ,제거하고 기혈을 잘 통하게 하여 어혈을 풀고 진통을 감소시킨다. 뜸요범은 통각신경의 흥분을 억제하는 작용을 하고 피가 잘 돌게 하며 말초신경을 자극하여 아픈 자리의 유해물질을 없애기 때문에 아픔을 멈추게 하며(Choi, 1993), 국소적인 근육의 긴장과 혈관의 긴장을 풀어줌으로써 혈액의 혈액의 흐름이 원활해지고 피로불질이나 통증을 재는 물질을 분해시켜 버린다(Kim, 1996). Chun 등(2003)은 퇴행성 관절염 노인의 경우 나이, 동통, 일상생활의존도를 포함한 대상자 특성이 우울에 영향을 미친다고 보고하고 있다 따라서 뜸요법과 세라밴드 운동은 퇴행성 골관절염 노인의 통증, 피로, 우울 점수를 감소시킴을 확인 할 수 있었다. 뜸요법은 상체에 약한 자극을 가하여 지각, 운동, 자율, 신경의 기능이 약화 되었을 때 이를 움직일 수 있도록 하는 항분작용(亢奮作用)이 있으며, 면역작용(免疫作用)으로는 뜸요법 시 화상독(火傷毒) “히스토키신``이 발생하여 이정 단백체에 의해 항체가 생산되어 변역반응을 일으키며 백혈구의 식균작용을 항분(亢奮)시켜준다(east-West Nursing Research Institute, 2000; Yamashita, Ichiman, & Tanno, 2001). 퇴행선 골간절염 환자의 주증상인 무릎 관절의 변형과 부종은 관절가종범위가 감소되고 통증을 유발하는 요인이다. Choi(2003)는 편마비가 동반된 상지부종의 감소와 함께 상지 운동능력이 향상된 것을 확인 하였다. 이는 퇴행성 골관절염 노인의 경우 뜸요법은 혈행과 신진대사를 촉진시켜 체액의 장애를 조절하여 무릎의 유연성을 증가시키는 것으로 추정할 수 있었다 면역기능과 관련하여 신경계와 면역계 사이의 상호교신은 시상하부-뇌하수체-부신을 축으로 분비되는 에피네프린, 토르티솔 등과 같은 체액성 인자 의 분비에 의한 것으로 인식되어 왔다. 그러나 최근의 신경면역조절(nuuroimmumodulation)에 대한 연구들에 의하면 자율신경말단과 변역세포들은 직접 접촉하고 있으면서 신경전달물질과 싸이토카인의 매개에 의해 서로 교신하고 있음이 시사되고 있다(Rainer, Straub, Jurgen, & Werner, 1998). 실제적으로 뜸요법을 받은 대다수의 최행성 관절염 노인들은 통증과 부종이 감소하였고, 걷을 때 훨씬 응직이기가 수월해졌다고 말하고 있다. 그러나 어떤 기전으로 통증과 부종이 감소되는지에 대한 반복연구가 필요하다. 세라밴드는 가볍고 휴대하기에도 편리하며 모든 방향에서의부하의 강도를 자유롭게 조절할 수 있어 쉽게 활용할 수 있는 운동기구이다. 본 연구에서 무릎각도, 족배굴곡, 족저굴곡이 증가하여 유연성이 증가한 것으로 나타났다. 이는 세라밴드 운동이 퇴행성 골관절염 환자를 대상으로 한 연구가 없는 실정이어서 비교하기는 어려우나 국내에서 대학생을 대상으로 등장성 근력에 효과가 있으며(Ham, 2000) 관절가동범위와 유연성을 증가시켜(Page, 2000) 일상생활의 기능을 향상시키는 한편, 통증을 경감시키는 효과(Bang & Deyle, 2000)가 있는 것으로 본 연구를 지지하고 있다. 그러나 뜸요법과 세라밴드 운동 중 어느것이 더 그 효과를 나타내는지는 알 수 없어 각각의 중재를 한반복연구가 필요하다고 사료된다. 본 연구에서 뜸요법 시행시 화상으로 인한 상처와 연기가 많이나서 눈이 따가운 경향이 있었는데, 이는 Kwon과 Park (2005)의 연구에서 실험에서 탈락한 대상자들은 뜸요법 시에‘배에뜸을 뜬 후 뜸뜬 자리가 몹시 가렵고 피부발진이 있었다’,‘ 연기가 많이 나서 눈이 따가웠다’,‘ 뜸이 탈 때 너무 뜨거워 참기 힘들었다’,‘ 뜸의 진액이 옷에 잘 묻고 냄새가 오래가며, 간간이뜸 연기 때문에 눈이 따가웠다’고 하였다는 보고는 본 연구의 실험처치에서도 부분적으로 일치하였다. 따라서 앞으로 뜸요법의 효율성이 입증되고 더욱더 활성화되기 위해서는 이러한 불편감들을 적극적으로 해소시키기 위한 노력이 필요하다. 본 연구는 퇴행성 골관절염 노인을 대상으로 뜸요법과 세라밴드 운동의 효과를 과학적으로 증명하였다는 것에 의의가 있다고 보며, 뜸요법과 세라밴드 운동이 퇴행성 골관절염 노인의 신체적으로 통증, 피로를 감소하고 유연성을 증가시키며, 심리적으로 우울을 감소시키는 간호중재로서 일반화할 수 있기를 기대한다. Purpose: To examine the effects of a nursing intervention including moxibustion and theraband exercise on pain, fatigue, flexibility, and depression in aged patients with degenerative osteoarthritis. Methods: This study had a one group pretest-posttest design. Thirty people over 60 yr-of-age with degenerative osteoarthritis were recruited from a community health center from November 1, 2005 to June 14,2006. The 6 week treatment intervention included twice weekly 60 min sessions of of theraband exercise (30 min) and moxibution (30min). Data was analyzed by SPSS Ver. 12.0. Results: Interventionwas associated with significant decreases in pain (t=8.28, p<.001) and fatigue (t=5.19, p<.001), and significant increases inknee flexibility (t=-3.54, p=.001), dorsal flexibility (t=-9.05, p<.001), and plantar flexibility (t=-4.09, p<.001). Depression was significantly decreased after intervention (t=-4.09, p<.001). Conclusions: Moxibustion and theraband exercise should be utilized as an effective nursing intervention for the aged with degenerative oateoarthritis.

청주대학교 간호학과 교육과정 개발 연구

안경주 김철규 전해옥 김봉정 김혜숙 채명옥 윤현정 한달롱 김아린 청주대학교 보건의료과학연구소 2014 보건의료과학연구 Vol.3 No.1

Dynamics in the workplace and in society have contributed to the paradigm shift to outcome-based education. This study was performed to develop the curriculum based on assessment of existing program for the baccalaureate nursing program at Cheongju University. We used three steps-Analysis, Design, and Development-in ADDIE model for developing curriculum. The subjects were 18 graduate nurses, 41 nursing students, 38 parents, and 2 nursing team leaders for analysis of core competence. In conclusion, developing an outcome-based curriculum might be used to facilitate the students' development and evaluate the competence of the student during and on completion of the nursing baccalaureate program at Cheongju University.