노년기 부부를 위한 성적 갈등 대처교육 프로그램 = Educational program that will develop aging couples' abilities to deal with problems and conflicts in their sexual functioning

다국어 초록 (Multilingual Abstract)

The purpose of this study is to develop an educational program that will develop aging couples' abilities to deal with problems and conflicts in their sexual functioning while experiencing intimacy helping the couples improve the degree of satisfaction in their later life, and also to prove the effectiveness of the program.
To develop an educational program that enables the aging couples to deal with problems and conflicts in sexual activities in later life, 163 older adults over the age of 60 who resided in home were sampled and asked to complete a survey of needs that composed of the questions relating to attitudes toward sexuality and aging, sexual activity, including the questions that enabled grasping the idea about the relations between sexuality in old age and their later life, and base on the results of the survey of needs, I developed an educational program that allowed aging adults to deal with their sexual conflicts and problems, and accordingly the program was put into practiced. Followings are results of the survey of needs.
First, as the result of examination that dealt with whether or not there were any differences between attitudes toward sexuality in later life and sexual activities in light of the realities of sexual functioning, there were no significant differences in sexual attitudes and behavior according to the length of time they had spent with their spouses, and the results revealed that more positive attitudes toward sexuality were displayed at the time when they had a sexual partner, rather than the time they didn't have one except spouse.
It also revealed that the couples who had more frequency of sexual encounters, and who were most sexually active in their younger days tended to have positive attitudes towardsexuality and also showed more affirmative manner in their sexual activities. The more they perceived about sexual needs and feeling in later life in natural way, and the more they perceived about sex education and consulting in positive manner, the survey results revealed that their attitudes and behavior toward sexuality became more positive and active.
When examined the difference of the degree of satisfaction from livelihood according to sexual activity, the point of life dissatisfaction was low in case of having relations with the sexual partner other than spouse, and the degree of satisfaction exhibited higher when the couples had more frequent sexual encounters rather than the time they didn't have, and when they perceived changes in sexuality in later life with accepting attitudes, the degree of satisfaction was higher than the time when they perceived it as a subject making them unhappy compared to their younger years. Also when they perceived that sex education and counseling were not required, the degree of life satisfaction was high, while the degree of life dissatisfaction was high when the perceived the requirements of sex education.
Second, I examined if there were any differences between attitudes toward sexuality and sexual functions, and the degree of satisfaction with life according to socio-demographic background. The results revealed that in terms of gender, male elder displayed more positive attitudes toward sexuality and more active sexual behavior. Elderly who had shorter length of marriage, higher educational background, and higher level of income per month showed more affirmative attitudes toward sexuality and also displayed more positive sexual activities. When examined the difference of life satisfaction according to socio-demographic background, the male elder displayed greater life satisfaction than the female elder, and the degree of satisfaction with life showed a decrease as the length of marriage increased. Regarding the difference of satisfaction with life in terms of educational background, the more educated people had greater life satisfaction and the people with higher monthly income showed higher degree of satisfaction.
Third, when examined the influences of the socio-demographic variables, sexual attitudes andsexual behavior that impacted the degree of life satisfaction, I found that the male elder displayed higher degree of life satisfaction than the female elder, and older adults with higher income including the ones with more open and affirmative attitude toward sexuality revealed higher degree of life satisfaction. Having combined above results, I confirmed that the sexuality in later life in the relationship between the couple was close emotional exchanges between husband and wife, and sexual responding between the couple played an important role in solving conflicts in between and increased the degree of satisfaction with marriage. Furthermore, I confirmed that it affected greatly the quality of life of aging adults. Based on the research results of the survey of needs, I developed an educational program in order to treat sexual difficulties in elderly persons, and to improve the quality of life of aging population having them developed abilities to cope with sexual conflicts, which may arise in their laterlife, and promoted positive attitudes toward sexuality, and 15 older couples were sampled, and the program was applied to them, and also evaluation was carried out, and accordingly I analyzed the effectiveness of the program.
Followings are the evaluation results of effectiveness of the program.
First, as the results of verifying the difference of the pre-and-post examinations on the experimental group and the controlled group, in case of experimental group, it showed that negative attitudes toward sexuality was decreased, and regarding the method for dealing with sexual difficulties, after implementation of this program, tendency of avoiding the problematic situation of sexuality was reduced, and the aspect of trying to cope with the sexual problems in an positive manner was improved. Regarding satisfaction with elderly sexuality, the experimental group didn't revealed any significant differences in both pre and post stage of implementation of the program, however, in view of the degree of satisfactionwith livelihood, the degree of life satisfaction showed an increase. In case of the control group, it didn't show any differences, almost nothing, in averages points of pre and post evaluation in all areas of attitudes toward sexuality, how to cope with sexual difficulties when encountering such situations, satisfaction with elderly sexuality, and the degree of satisfaction from livelihood. Thus it exhibited the influences of the program that impacted the group of having implemented the educational program, and the group of having not.
Second, as the result of the analysis of covariate in order to find out the differences that caused by the effect of the program on the experimental group and the control group, it didn't revealed any significant differences in the attitudes toward sexuality in terms of positive attitudes, however, in view of negative attitudes toward sexuality, the experimental group revealed less negative attitudes toward sexuality than the control group. Also, regarding the topic how to deal with sexual difficulties when facing it, the experimental group revealed that they dealt with such sexual problems upon facing it in more positive manner, and that they didn't make much use of the method for avoiding the problem.
In case of the degree of satisfaction from livelihood, the experimental group showed an increased degree of life satisfaction more than the control group, and the educational program that dealt with sexual difficulties reduced negative attitudes toward sexuality, and improved the method to deal with sexual conflicts of older couple, and at the same time the program revealed effectiveness in improving the degree of life satisfaction.
The above results were ample evidences that the program was effective in every perspective of its purposes, which aimed to obtain right knowledge about sexuality in older adults as well as in later life, and to promote more permissive attitudes toward sexuality, and to dispel negative myths about sexuality of older couples, and to improve the degree of satisfaction from livelihood having them educated how to deal with sexual difficulties.
In addition, the results, by learning how to deal with sexual difficulties for the purpose of improving sexual conflicts in intimacy of oldercouples, not only revealed the satisfaction of sexuality in later life but also improvements of life satisfaction in a more comprehensive perspective. Again, this is good evidence that sexual function is important human needs in both the life of older adults and relationship of the couple in later life.
Consequently, the study results, which revealed the fact that sexuality in later life influenced the degree of satisfaction from the livelihood, suggested a necessity of consideration about attitudes and behavior toward health sexuality. Thus, I was trying to seek a meaning of this study through means of making an occasion to emphasize the importance of the couple's sexual relationship in later years having developed an educational program based on the suivey of needs targeted aging population with regard to awareness of sexuality and sexual activity, and implemented the program and evaluated its effectiveness under a national situation in that the topic of sexuality of elderly had been generally avoided and biased with misconceptions.

목차 (Table of Contents)

• 목차 = ⅰ
• Ⅰ. 서론 = 1
• Ⅱ. 이론적 배경 = 6
• 1. 노년의 성 = 6
• 1) 성의 개념 = 6
• 2) 건강과 성생활 = 8
• 2. 노년의 부부관계 = 10
• 1) 노년기 부부관계 = 10
• 2) 노년기 부부관계에서 성의 중요성 = 11
• 3. 노년기 성생활 = 14
• 1) 노년의 성 욕구 = 14
• 2) 노년의 성생활 실태 = 16
• 3) 노년기 성에 있어서의 갈등 = 18
• 4. 노년기 부부의 성적 갈등 대처교육 프로그램의 필요성 = 25
• Ⅲ. 노년기 부부의 성적 갈등 대처교육 프로그램 = 28
• 1. 욕구조사 = 28
• 1) 욕구조사방법 = 28
• 2) 욕구조사 결과 및 해석 = 35
• 2. 프로그램의 근거이론 = 55
• 1) 인지적 평가(문제의식) = 55
• 2) 대처 = 56
• 3. 프로그램의 목적 및 목표 = 57
• 1) 프로그램 목적 = 57
• 2) 프로그램 목표 = 58
• 4. 프로그램의 내용 및 방법 = 59
• 1) 프로그램의 내용구성 및 방법 = 59
• 2) 각 세션 별 프로그램 내용 및 방법 = 61
• Ⅳ. 노년기 부부의 성적 갈등 대처교육 프로그램의 실행 = 66
• 1. 프로그램 대상 = 66
• 2. 프로그램의 실행 = 67
• 3. 프로그램 수행 장소 = 68
• 4. 교육자 섭외 = 69
• Ⅴ. 노년기 부부의 성적 갈등 대처교육 프로그램의 효과성 분석 = 70
• 1. 실험설계 = 70
• 2. 측정도구 = 70
• 1) 생활만족도 = 70
• 2) 성에 대한 태도 = 72
• 3) 성생활만족 = 73
• 4) 성생활 갈등에 관한 대처 = 74
• 3. 분석방법 = 74
• 4. 분석대상 = 74
• 1) 분석대상의 사회 인구학적 특성 = 74
• 2) 실험집단과 통제집단의 성생활 실태 = 76
• 5. 프로그램 효과분석 = 77
• 1) 노부부의 성적 갈등 대처교육 프로그램이 성에 대한 태도 및 성생활만족도 향상에 미친 효과 분석 : Paired t-test = 77
• 2) 노부부의 성적 갈등 대처교육 프로그램이 성에 대한 태도 및 성생활 갈등 시 대처방법 향상에 미친 효과 분석 : 공변량분석 = 80
• Ⅵ. 요약 및 결론 = 83
• 1. 노년의 성에 대한 인식과 생활만족도 = 83
• 2. 노년기 성적 갈등 대처교육 프로그램 효과성 분석 = 85
• Ⅶ. 참고문헌 = 91
• (Abstract) = 100
• 부록 1 프로그램 개발을 위한 욕구조사 설문지 = 108