醫藥品價格構造와 流通體系에 관한 硏究

강정화 홍익대학교 1998 국내석사

신입사원의 직무스트레스와 심리적 부적응의 관계 : 자기격려와 자기낙담의 매개효과

강정화 서울여자대학교 일반대학원 2017 국내석사

The purpose of this study is to verify the mediating effect of self-encouragement and self-discouragement between new employees’jobstress and psychological maladjustment. The data from 351 new employees are analyzed. And covert Korean Occupational Stress Scale(KOSS), Self-Encouragement Scale, Self-Discouragement Scale and SCL-90-R are used for measurement. The data were analyzed through correlation analysis and multiple regression analysis. To examine mediating effect of self-encouragement and self-discouragement between new employees’jobstress and psychological maladjustment, Baron and Kenny(1986) model was used. The results of this study are as follows. First, jobstress showed statistically significant positive correlations with self-discouragment and psychological maladjustment. And self-encouragement showed statistically significant negative correlations with jobstess, self-discouragment and psychological maladjustment. Second, the mediating effect of self-encouragement between new employees’jobstress and psychological maladjustment revealed that self-encouragement has a partial mediating effect in the relationship between the two variables. Thrid, the mediating effect of self-discouragement between new employees’jobstress and psychological maladjustment revealed that self-discouragement has a partial mediating effect in the relationship between the two variables. Based on these result, the implications and limitations of this study were discussed with the suggestions for the further study.

니켈촉매를 이용한 유지 수소화반응에서 공정변수의 영향

강정화 서울대학교 대학원 1997 국내석사

Characterization and anticancer effects of human breast cancer-specific NK cells

姜廷和 德成女子大學校 大學院 2024 국내박사

Department of Pharmacy Graduate School JungHwa Kang In this study, we aimed to explore how to directly use immune cells to enhance the body's cellular immune function to recognize and kill tumor cells to induce antitumor effects. To develop NK cells with breast cancer-specific killing ability, we applied two methods to explore the possibility. The first method is to select specific markers by analyzing the cultures of breast cancer cell lines and priming the cells by applying the selected proteins to the cultures. The second method is to induce ADCC through co- culture with antibodies that recognize breast cancer-specific tumor antigens to select antibodies with maximum anti-cancer effects and to select the optimal treatment concentration of the antibodies. The human breast cancer-specific NK cells obtained by these two methods were characterized and their anti-cancer effects on breast cancer were confirmed. In the first method, NK cells with breast cancer-specific killing capacity were induced by treatment with breast cancer-specific proteins. When cultured with Breast cancer cell conditioned media, we found that Breast cancer cell conditioned media tended to increase the proportion and expansion of NK cells without significantly affecting the morphology of the cells. In addition, when HER- 2 positive and Triple negative Breast cancer cell conditioned media were treated at different times and concentrations, we found that the expression of NKG2D, an activation receptor of NK cells, was significantly increased compared to the control group in both the first half of the culture (Day0) and the second half of the culture (Day5). Based on these results, we analyzed the cell killing ability of NK cells according to the treatment of breast cancer cell conditioned media and determined that the cell killing ability of NK cells was increased in the overall treatment group, but the difference was not confirmed in some cell lines. This is not only due to cell line differences, but also because the conditioned media is a mixture of various substances, so it is difficult to directly confirm the efficacy of a specific substance contained in a small amount. Therefore, to determine which specific substances in breast cancer cell conditioned media increase the killing capacity of the cells, we commissioned LC-MS/MS analysis of cultures of six breast cancer cell lines and selected CD48, B6-H7 as breast cancer- specific proteins, which are related to overlapping protein components, cell adhesion, and activation of NK cells. When PBMCs obtained from healthy donors were treated with CD48 and B7H6 and cultured, sufficient numbers of highly viable priming NK cells were obtained over a two-week culture period. After analyzing the priming NK cells, we found that the NK ratio and activation receptors of NK cells remained higher in the treated group than in the untreated group. We also found that the priming NK cells exhibited higher cytotoxicity in the breast cancer cell line than in the colon cancer cell line used as a control, indicating that the treatment with the breast cancer-specific protein was more toxic to the breast cancer cell line. The second method, enhancing the ADCC of NK cells by treating them with breast cancer-specific antibodies, induced NK cells with breast cancer-specific killing capacity. Antibodies targeting CCR5 were co-cultured with NK cells to confirm the ADCC effect in MDA-MB-231, MDA-MB-436 (CCR5-), and MDA-MB-436 (CCR5+) cells. The effect of treatment with antibodies targeting CCR5 on the viability of MDA-MB- 231, MDA-MB-436 (CCR5-), and MDA-MB-436 (CCR5+) cells was checked, we selected the antibody that increased the significance of the co-culture of target cells and NK cells compared to the co-culture of MDA-MB-231, MDA-MB-436 (CCR5-), and MDA-MB-436 (CCR5+) cells and NK cells respectively. Through this, we confirmed the possibility of developing breast cancer-specific NK cells by selecting antibodies that have maximum anti-cancer effects by inducing ADCC through co-culture of NK cells with antibodies that recognize breast cancer-specific tumor antigens. If disease-specific killing capacity can be induced by treatment with indication- specific proteins or antibodies, as demonstrated in this study, to selectively proliferate activated NK cells, the potential for NK cell development as a therapeutic agent is expanded. 본 연구에서는 면역세포를 직접 사용하여 인체의 세포 면역 기능을 증강시킴으로써 종양 세포를 인지하고 살상하여 항종양 효과를 유도하는 방법을 탐색하였다. 따라서 유방암 특이적 살상능을 가지는 NK세포를 개발하기 위해 본 연구에서는 2가지 방법을 적용하여 그 가능성을 탐색하였다. 첫번째 방법은 유방암 세포주의 배양액 분석을 통해 특이적인 마커를 선별하고, 선별된 단백질을 NK세포 배양에 적용하여 NK세포를 priming 시키는방법이다. 두번째 방법은 유방암 특이적 tumor antigen을 인식하는 항체와 NK세포의 공배양을 통해 NK세포의 ADCC를 유도하여, 해당 적응증에 대해 최대의 항암 효과를 가지도록 NK세포를 활성화시키는 방법이다. 그리고 이 두가지 방법에 의해 획득한 사람 유방암 특이적 NK세포의 특성 분석 및 유방암에 대한 항암 효과를 확인하였다. 본 연구에서 사용한 유방암 세포주는 HER-2 positive인 HCC-1954, SKBR-3, MCF-7와 triple negative인 MDA-MB-231, HCC-38, HCC-70이며, 해당 유방암 세포주의 배양액을 획득하여 시험에 사용하였다. 우선, 첫번째 방법으로 유방암 특이적 단백질 처리에 의해 유방암 특이적살상능을 가지는 priming NK세포를 유도하였다. 유방암 세포주의 배양액을 처리하여 NK세포를 배양한 결과, 해당 배양액이 세포의 morphology에는 크게 영향을 주지 않으면서 NK세포의 portion과 expansion을 증가시키는 경향을 확인하였다. 또한 HER-2 positive 및 triple negative breast cancercell conditioned media를 처리 시점과 농도를 달리하여 처리하였을 때, NK세포의 활성화 receptor인 NKG2D의 expression이 전체 배양 중 처리군(Day0)과 후반부 처리군 (Day5)에서 모두 대조군에 비해 증가하는 것을 확인하였다. 이 결과들을 토대로 유방암 세포주의 배양액 처리에 따른 NK세포의 세포살상능은 분석한 결과, 처리군에서 NK세포의 세포살상능이 전반적으로 증가되는 것으로 판단되었으나 일부 유방암 세포주에서는 그 차이가 확인되지 않았다. 이는 유방암 세포주에 따른 차이 뿐만 아니라 해당 배양액 자체가 다양한 물질들의 mixture이기 때문에 상대적으로 소량 포함된 특정 물질의 효능을 직접적으로 확인하기에는 무리가 있는 것으로 판단되었다. 따라서 유방암 세포주의 배양액 중 어떤 특정 물질이 NK세포의 살상능을 증가시키는지 확인하기 위해, LC-MS/MS 방법으로 6가지 유방암 세포주의 배양액을 분석하였다. 단백질 분석 결과를 유방암 세포주 별로 list up한 후 공통으로 겹치는 단백질 성분들을 참고문헌들과 비교하여 그 기능을 분석하였고, celladhesion 및 NK cell의 activation과 관련된 CD48, B6-H7을 NK세포의 priming 물질로 선정하였다. 건강한 공여자로부터 획득한 PBMC에 CD48, B7H6를 처리하여 배양한 결과, 2주의 배양 기간 동안 충분한 수의 생존율이 높은 priming NK세포를 획득하였다. 유방암 특이적 단백질을 처리하지 않은 군보다 처리한 군에서 NK 비율 및 NK세포의 활성화 receptor가 더 높게 유지됨을 확인하였다. 즉, 선정된 유방암 특이적 단백질은 NK세포의 활성화에 기여할 수 있는 ligand로써 더 많은 NK세포로 증식하고 분화될 수 있도록 유도한다고 하겠다. 이 결과들을 토대로 유방암 특이적 단백질을 처리하여 배양된 priming NK세포의 세포살상능을 확인한 결과, 대조군으로 사용한 대장암 세포주에서 보다 유방암 세포주에서 더 높은 세포독성을 나타냄을 확인하였다. 즉, 유방암 특이적 단백질을 처리하여 배양한 priming NK세포가 유방암 세포주에 더 높은 독성을 가지는 것으로 판단되었다. 두번째 방법인 유방암 특이적 항체를 처리하여 NK 세포의 ADCC를 향상시키는 방법으로 유방암 특이적 살상능을 가지는 NK 세포를 유도하였다. CCR5를 target으로 하는 7종의 항체를 NK세포와 공배양하여 MDA-MB-231, MDA-MB-436 (CCR5-), MDA-MB-436 (CCR5+) cell에서 ADCC 효과를 확인하였다. CCR5를 target으로 하는 항체의 처리가 MDA-MB-231, MDA-MB436 (CCR5-), MDA-MB-436 (CCR5+) cell의 viability에 미치는 영향을 확인하였으며, MDA-MB-231, MDA-MB-436 (CCR5-), MDA-MB-436 (CCR5+) cell과 NK cell을 각각 공배양한 군 대비 target cell과 NK cell의 공배양 시 항체를 처리한 군에서 유의성이 증가한 항체를 선정하였다. 따라서 유방암 특이적 tumor antigen을 인식하는 항체와 NK세포의 공배양을 통해 NK세포의 ADCC를 유도하여 유방암 특이적 NK세포 개발에 대한 적용 가능성을 확인하였다. 본 연구에서 확인한 것처럼 NK세포에 적응증 특이적 단백질 또는 항체 처리 방법에 의해 질환 특이적 살상능을 유도하여 적응증에 대해 선택적으로 활성화된 NK세포를 증식시킬 수 있다면 NK세포의 치료제로서의 개발 및 적용 가능성이 확대된다고 할 수 있겠다.

섭식태도를 매개로 완벽주의와 외모인식이 여자청소년의 정서s행동문제에 미치는 영향

강정화 조선대학교 일반대학원 2011 국내박사

The purpose of the study was to investigate effects of perfectionism and appearance awareness on emotional/behavioral problems with eating attitude as a mediator in female adolescents. This study was done by surveying 420 female students of general and vocational high school in Gwangju and analyzed 409 data except for 11 data being left out or not being collected. Data were collected through the use of Eating Disorders Inventory (EDI-Ⅱ), Multdimensional Perfectionism Scale (MPS), Sociocultural Attitudes Towards Appearance Questionnare (SATAQ), Korean-Youth Self Report (K-YSR) from 17 November to 9 November. Collected data was processed by descriptive statistics, correlation analysis using SPSS win 18.0 program and casuality analysis using LISREL 8.8 program. The following is result of analysing this study: First, The degrees and types of eating attitude among the female adolescents showed that Bulima(M=3.35, SD=1.13), body dissatisfaction(M=3.35, SD=1.13), the desire to be thin(M=2.81, SD=.80) and were ranked. The number of a high risk group under each item in eating attitude was 70(17.1%) students for the desire to be thin, 112(27.3%) for body dissatisfaction, 14(3.4%) for bulima. Based on the total cutoff scores, 30 (7.9%) students out of 409 (100%) students fell under a high risk group. Second, Regarding emotional/behavioral problems and the relative variables, externalizing problem was statistically significant with every variable; however, internalizing problems did not have significant correlation with awareness, which is a subfactor of appearance awareness. It was shown to have correlation with self-oriented perfectionism, other-oriented perfectionism, socially prescribed perfectionism, internalization, the desire to be thin, bulima, and body dissatisfaction. Third, The casuality between emotional/behavioral problems and relative variable indicated that perfectionism and eating attitude directly influence internalizing problems (Model 1), but appearance awareness does not. Perfectionism and appearance awareness indirectly reflect themselves through eating attitude. As an externalizing problem (Model 2), perfectionism directly influence on externalizing problem, but eating attitude and appearance awareness do not. Perfectionism and appearance awareness indirectly work through eating attitude. PSI() showed that perfectionism, appearance awareness, and eating attitude explain externalizing problem better than internalizing problems. The results were discussed in relation to previous research and some considerations for future research were presented.

일기쓰기가 초급 학습자의 의사소통능력 향상에 미치는 영향 : 일본어권 학습자 중심으로

강정화 충남대학교 교육대학원 2007 국내석사

This study is a research project investigating the effect of using learning diaries to improve Korean speaking abilities for Japanese learners. L2 learners given a chance to write in a journal are known to better personalize grammatical and syntactical knowledge of the target language. Furthermore, it helps them learn and practice new vocabularies. Dialogue Journals have been used as a research tool to examine students' writing ability or writing anxiety in Korean as a Foreign Language field. However, there has not been any research for learning diaries. For this study, 14 Japanese students' diaries were collected from June to October, 2006. The students were studying Korean language at MIL Language Center in Chiba, Japan and their Korean level was elementary. They were encouraged to keep diaries at least 3 times a week. Errors were corrected by a teacher and there was no limit of subject or length. To examine their communicative ability, diaries were analyzed by communicative functions. Communicative functions are reporting personal fact, reporting general fact, reporting personal opinion, questions for personal opinion/information and intellectual/general information, evaluating, predicting/guessing, complaint, apology, command, making a promise. As a result of diaries analysis, reporting personal fact and reporting opinion, evaluating, complaint, predicting/guessing, command, making a promise were used frequently. Those functions are frequently used in daily lives for native speakers. Questions for personal opinion/general opinion/intellectual opinion, apology, giving acknowledgement were used occasionally. The result shows students had a chance to practice different kinds of communicative functions through learning diaries. Finally, all students were asked to fill out a questionnaire about the advantages or disadvantages of writing diaries. Consequently, 48% of students said that writing Koran sentences became easier, and felt more comfortable in the process of writing. 13% of students felt the use of diaries improved their thinking and speaking of Korean in their daily lives. 10% of students said that they had a better knowledge of grammar after writing diaries. 6% of students remembered the expressions they wrote in the diaries and it helped them when they had chance to use them. In conclusion, keeping learning diaries help students memorize and personalize grammatical knowledge and structure. It gives them chance to practice their knowledge and make them think in Korean in their daily lives. The use of diaries are a tool for improving Korean speaking abilities for Japanese learners.

프로젝트 접근법을 활용한 중학교 음악 가창 수업지도 방안

강정화 중앙대학교 교육대학원 2023 국내석사

음악교육은 ‘음악을 통한 인간 교육’을 목표하며, 교육현장에서 가창 활동은 가장 기초적인 활동이다. 2015 개정 음악과 교육과정의 중학교 음악 교과서 구성을 살펴보면, 서양음악과 한국 전통음악으로 나누어져 제시되고 있다. 가창 영역에서 서양음악과 한국음악은 발성의 차이가 있어 구별하여 수업할 수 있는 음악교사의 역량이 필요하다는 것을 확인할 수 있었다. 그러나 한국음악 전통 가창은 구전심수의 전승 방식이 특징이기 때문에 국악을 전공하지 않은 교사들이 국악 가창 수업을 진행하는 것에 어려움이 있다. 게다가 음악교사뿐만 아니라 학습자도 국악이 접하기 어려운 음악, 배우기 어려운 음악이라고 인식하곤 하는데 프로젝트 접근법은 이러한 인식 문제를 해결하고 음악 가창 수업 시, 학습자의 자발적이고 능동적인 참여를 촉진한다. 또한 프로젝트 접근법은 수업 중에 주체적으로 학습 주제, 문제에 대한 탐구, 그리고 다양한 표현 방식을 이끌어내기 때문에 필자는 이 접근법을 활용한 가창 수업 지도방안을 제시하여 중학교 1학년 학습자를 대상으로 1차시와 2차시에 걸쳐 수업을 진행해보았다. 본 연구의 결과들을 종합적으로 살펴보면, 현재 교육현장에서 활용되고 있는 단원 접근법은 학습자의 흥미를 강조할 수 있지만 자발적이고 주도적인 참여로 이루어질 수 없으며 교사의 판단과 결정으로 흥미위주의 교육에서 학습이 마무리 될 수 있다. 이에 반해 프로젝트 접근법은 학습자의 주도적인 역할을 강조하고 학습 주제와 개인의 관심 분야를 연결하기 때문에 소통과 협력이라는 방법을 사용한다. 게다가 프로젝트 접근법은 학습주제에 관한 탐구와 심층 학습이 다양한 표현 방식과 연결되어 학습자 자신의 생각과 감정을 표현하는 능력을 개발하는데 효과적이라는 것을 확인하였다. 본 연구가 프로젝트 접근법을 활용한 음악 가창 수업에 도움이 되기를 바라며, 프로젝트 접근법의 학습 절차를 활용한 음악 가창 수업지도안의 지속적인 개발과 연구가 이루어지길 기대해 본다. Music education aims to ‘Human education using music,’ and singing activities are the most basic activities in education. Looking at the composition of middle school music textbooks revised in 2015, is divided into Western and Korean traditional music. Since Western music and traditional Korean music have differences in vocalization methods, music teachers need the ability to distinguish them. However, since the vocalization of Korean traditional music is unofficially inherited by the teacher’s teaching, music teachers who do not major in Korean traditional music are having difficulty in proceeding with the class. Not only music teachers but also learners recognize Korean traditional music that is hard to access and hard to learn. ‘The Project Approach’ solve this perception problem and promotes the voluntary and active participation of learners in music singing classes. In addition, since ‘The Project Approach’ leads to topics, exploration of problems, and various expression methods during the class, I presented a singing guidance plan using this approach to conduct classes for first-year middle school students in the first and second classes. According to the results, the section approach currently used in the schools can induce learners’ interest, but it cannot be achieved by voluntary and leading participation. In the end, learning can be completed at the step of interest at the teacher’s judgment. On the other hand, ‘The Project Approach’ emphasizes the leading role of students and connects topics with individual areas of interest, so it uses through communication and cooperation. In addition, ‘The Project Approach’ links the topic and deep learning to the way of expression, so students become more and more proficient in expressing their thoughts and feelings. I hope this study will help teachers who use ‘The Project Approach’, and hope that continuous development and research of class guidance plan using ‘The Project Approach’ will be conducted.

재무분석가의 이익예측치 달성을 위한 이익조정수단

강정화 부산대학교 2011 국내석사

본 연구는 재무분석가의 이익예측치를 달성(meet or beat)하는데 기업이 이용하는 수단에 대한 통찰력을 얻기 위해 예측치유도(forecast guidance)와 이익조정(earnings management)수단을 포괄적으로 연구한다. 이익조정수단으로는 재량적 발생액(Accruals-based earnings management), 계정분류법(classification shifting, McVay, 2006), 그리고 음(-)의 비정상 재량적 지출(Gunny, 2005), 양(+)의 비정상 생산과 음(-)의 비정상 영업현금흐름(Roychowdhury, 2005)을 이용한 실물이익조정(real activity manipulation)을 고려한다. 본 연구는 예측치 하향유도와 재량적 발생액의 상향조정을 통해 재무분석가의 이익예측치 달성 가능성이 증가함을 밝혔다. 그리고 실물이익조정의 대용치인 음(-)의 비정상 재량적 지출은 재무분석가의 이익예측치를 달성 할 가능성이 증가한 반면, 양(+)의 비정상 생산과 음(-)의 비정상영업현금흐름은 재무분석가의 이익예측치를 달성할 가능성을 감소시킴을 밝혔다. 또한 예측치 유도, 재량적 발생액, 계정분류법을 이용하여 재무분석가의 이익예측치를 달성한 경우 보상수익률이 감소함을 밝혔다. 이러한 결과를 통해 투자자들은 기업이 기준이익(benchmark) 달성에 이용하는 수단을 인식하고, 기준이익 달성에 따른 보상수익률을 조정하는 것으로 나타났다. We examine a comprehensive set of earnings management tools and forecast guidance to gain insights into the tools used by firms to meet or beat analysts' earnings forecast. Among the earnings management tools, in addition to discretionary accruals, we consider classification shifting(McVay 2006) and real activity manipulation: negative abnormal selling, general and administrative expenses(Gunny 2005), positive abnormal production and negative abnormal cash flow from operations(Roychowdhury 2005). We find that the use of downwards forecast guidance and upwards discretionary accruals increases the probability of meeting or beating analysts' earnings forecasts; negative abnormal selling, general and administrative expense increases the probability of meeting or beating analysts' earnings forecasts; and positive abnormal production and negative abnormal cash flow from operations decrease the probability of meeting or beating analysts' earnings forecasts. We also find downwards forecast guidance, discretionary accruals and classification shifting decreases the meet or beat premium: investors appear to recognize the tools for achieving the benchmark and appropriately adjust the meet or beat premium.

중환자실 간호사의 죽음 인식에 대한 조사 연구

강정화 삼육대학교 대학원 2011 국내석사

Death is such a part of human life as everyone must face in the end without exception. Owing to advanced latest medical technologies, most of our contemporary people face their end of life in medical institutions, and nurses come to play a role in caring for dying patients who face the end of life. Therefore, it is important that nurses assist dying patients in pursuing the implications of death and accepting it with positive attitudes. Particularly, Intensive Care Unit (ICU) nurses are frequently exposed to deaths, so ICU nurses ’ recognition of death has more influences on dying patients and their family. Thus, it is expected that ICU nurses' sound recognition of death could help assure the original dignity of dying patients and provide quality medical services for them. This study is based on descriptive survey to investigate actual conditions of ICU nurses' recognition about death. For data collection, a sample population of ICU nurses working for 10 general hospitals in Seoul Metropolitan City and Gyeonggi Province were asked to respond to a questionnaire survey for 3 months from November 2009 through February 2010, so that total 230 valid and complete questionnaires could be adopted for data processing and analysis. In this study, Inumiya Yoshiyuki deveoloped tools, ‘View of life & death scale’ was adopted as a death recognition measurement inventory except view of life after death, and the said questionnaire consisted of total 67 question items falling under 4 major categorical factors such as death meanings, death anxiety, death concem and life respect will. Each question item was measured using Likert 7-point scale. All data collected from survey were analyzed using the SPSS WIN 12.0 program. The results of this study can be summed up as follows: 1. It was found that ICU nurses scored 4.27 points on average out of full 7 points in their understandings about meaning of death. Here, it was noted that they scored 4.18 and 4.38 on average out of full 7 points in their understandings about the positive and negative meaning of death respectively. ICU nurses was more understanding negative meaning of death than positive meaning of death. It was found that ICU nurses scored 4.43, 4.12 and 4.18 points on average in their death anxiety, death concern and life respect will. 2. It was found that ICU nurses' understanding about meaning of death was negatively correlated with their death anxiety(r=- .44) and death concern(r=-.53), but was positively correlated with their life respect will(r=.54). It was found that ICU nurses' death anxiety was positively correlated with their death concern (r=.35), but was negatively correlated with their life respect will(r=-.55).And it was found that ICU nurses' involvement with death was negatively correlated with their life respect will(r= -.52). 3. According to analysis on potential influential factors in ICU nurses' recognition of death. it was found that the older age, the higher academic career, the longer working years at hospital, the longer working years at ICU, woman nurses, married nurses, religious nurses and nurses with children were correlated sig nificantly with higher level of understanding about meaning of death. According to analysis on ICU nurses' death anxiety, it was found that irreligious nurses, the shorter working years at hospital and the shorter working years at ICU were correlated significantly with the higher level of death anxiety. According to analysis on ICU nurses ’ death concern, it was found that unmarried nurses, irreligious nurses, the shorter working years at hospital and the shorter working years at ICU were correlated significantly with higher death concern. According to analysis on ICU nurses' life respect will, it was found that the older age, married nurses, nurses with children and religious nurses were correlated sig nificantly with the higher life respect will. Conclusively, this study could analyze potential influential factors in ICU nurses ’recognition of death found and thereby could help rediscover why it is important to have correct understandings about death. Hence, it is expected that ICU nurses' correct acceptance of death will have positive effects on their own life and will make it possible to keep original dignity of patients and provide multilateral nursing cares for them. 죽음은 모든 인간에게 일어나는 동일한 상황으로 인생의 일부분이다. 최근 의료 기술의 발달로 대부분의 사람이 의료기관에서 죽음을 맞이하게 되었고, 간호사는 임종환자의 생의 마지막을 함께 하게 되었다. 그러므로 간호사는 죽음을 맞이하는 대상자가 적극적인 자세로 죽음의 의미를 추구하고 받아들일 수 있도록 도와주어야 한다. 특히, 중환자실 간호사는 죽음에 빈번하게 노출되므로 중환자실 간호사의 죽음에 대한 인식이 임종환자와 가족에게 더 많은 영향을 미치게 된다. 그러므로 중환자실 간호사가 죽음에 대해 올바르게 인식하면 임종환자의 존엄성을 지켜주며 양질의 의료서비스를 제공할 수 있으리라 생각한다. 본 연구는 중환자실 간호사의 죽음 인식 수준을 알아보기 위한 서술적 조사 연구이다. 본 연구의 자료 수집은 서울․경기 소재 10개 종합병원의 중환자실 간호사를 대상으로 2009년 11월부터 2010년 2월까지 3개월간 설문지 수집 후 최종 230부를 분석 처리하였다. 본 연구의 죽음 인식 측정 도구는 이누미야 요시유키가 개발한 사생관 척도(View of Life and Death Scale)에서 내세관을 제외한 죽음 의미, 죽음 불안, 죽음 관여도, 생명존중의지의 4개의 요인으로 총 67문항으로 구성되었다. 각 문항은 Likert 7점 척도로 ‘매우 그렇다’ 7점, ‘전혀 그렇지 않다’ 1점으로 측정하였다. 자료 분석은 SPSS WIN 12.0 프로그램을 이용하여 분석하였으며 연구 결과는 다음과 같다. 1. 중환자실 간호사의 죽음 의미 이해 정도는 7점 만점에 4.27점으로 나타났다. 그 중 죽음에 대한 긍정적 의미는 4.18점이었고 죽음에 대한 부정적 의미는 4.38점으로 죽음에 대한 부정적 의미 점수가 죽음에 대한 긍정적 의미 점수보다 높게 나타났다. 죽음 불안 점수는 4.43점으로 나타났으며, 죽음 관여도는 4.12점, 생명존중의지는 4.18점으로 나타났다. 2. 죽음 의미 이해는 죽음 불안(r=-.44)과 죽음 관여도(r=-.53)와는 부적 상관관계를 보였고, 생명존중의지(r=.54)와 정적 상관관계를 보였다. 죽음 불안은 죽음 관여도(r=.35)와 정적 상관관계를 보였고, 생명존중의지(r=-.55)와 부적 상관관계를 보였다. 죽음 관여도는 생명존중의지(r=-.52)와 부적 상관관계를 보였다. 3. 죽음에 대한 인식에 영향을 미치는 요인은 다음과 같았다. 대상자의 나이가 많을수록, 학력이 높을수록, 총 근무기간이 길수록, 중환자실 근무기간이 길수록, 여자, 기혼, 종교가 있는 대상자, 자녀가 있는 대상자가 죽음 의미 이해 정도가 높게 나타났다. 죽음 불안은 종교가 없는 대상자, 총 근무기간이 짧을수록, 중환자실 근무기간이 짧을수록 죽음 불안 정도가 높게 나타났다. 죽음관여도는 미혼, 종교가 없는 대상자, 총 근무기간이 짧을수록, 중환자실 근무기간이 짧을수록 죽음 관여도는 높게 나타났다. 생명존중의지 정도는 나이가 많을수록, 기혼, 자녀가 있는 대상자, 종교가 있는 대상자가 생명존중의지가 높았다. 결론적으로 본 연구를 통해 파악된 죽음에 대한 인식에 영향을 미치는 요인을 통해 죽음에 대한 올바른 이해의 중요성을 다시 확인할 수 있었으며, 중환자실 간호사가 죽음에 대해 올바르게 수용함으로 자신의 삶에 긍정적인 영향을 미치고, 환자의 존엄성을 지키며 다각적인 간호 제공이 가능하리라 생각된다.

한국교회 여성의 해방 교육을 위한 해석학적 접근 : E. S. Fiorenza와 Walter Wink의 이론을 중심으로

강정화 梨花女子大學校 敎育大學院 1992 국내석사