상급종합병원근무자의 연명치료중단에 미치는 영향요인 -장기기증·이식의 지식 및 태도, 죽음에 대한 인식, 호스피스완화의료에 대한 지식 및 인식-

제남주,화정석,Je, Nam Joo,Hwa, Jeong Seok 한국호스피스완화의료학회 2018 한국호스피스.완화의료학회지 Vol.21 No.3

목적: 본 연구는 병원 근무자의 연명치료 중단에 영향을 미치는 장기기증, 장기이식, 죽음, 호스피스 완화의료의 지식, 태도 및 인식을 알아본 서술적 조사연구이다. 방법: K도 J시에 위치한 일개 상급종합병원에 근무하는 228명의 대학병원 근무자를 대상으로 자가 보고식 설문지를 이용하여 자료를 수집하였다. 자료는 SPSS WIN 21.0 프로그램으로 t-test, ANOVA, and Pearson's correlation coefficient를 이용하여 분석하였다. 결과: 대상자의 생명의료윤리 의식관련 지식은 연령, 학력, 직종, 근무부서, 생명의료윤리 교육유무에 따라 차이를 보였다. 뇌사 장기기증 장기이식에 대한 지식은 인체조직기증 및 이식에 대한 태도, 호스피스 완화의료에 대한 지식, 호스피스 완화의료의 인식에서 유의한 양의 상관관계가 있었다. 인체조직기증 및 이식에 관한 태도는 호스피스 완화의료에 대한 지식, 호스피스 완화의료의 인식, 연명치료 중단에서 유의한 상관관계가 있었고, 죽음에 대한 인식은 호스피스 완화의료에 대한 지식, 호스피스 완화의료의 인식, 연명치료 중단에서 유의한 상관관계가 있었다. 호스피스 완화의료의 인식은 연명치료 중단에서 유의한 상관관계가 있었다. 연명치료 중단 태도에 영향을 주는 요인은 호스피스 병동 근무와 인체조직기증 및 이식에 관한 태도, 호스피스 완화의료의 인식으로 연명치료 중단 태도를 32.5% 설명하였다. 결론: 연명치료 중단 태도에 호스피스 병동 근무와 인체조직기증 및 이식에 관한 태도, 호스피스 완화의료 인식이 관련이 있었으며, 생명의료윤리에 기반을 둔 다양한 교육과정의 개발 및 적용에 대한 연구가 필요함을 제언한다. Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

대학생의 대학적응, 인성, 의사소통능력이 현장실습적응에 미치는 영향 -대인관계 유능성의 매개효과

제남주,박미라,화정석,Je, Nam-Joo,Park, Mee-Ra,Hwa, Jeong-Seok 한국디지털정책학회 2019 디지털융복합연구 Vol.17 No.9

본 연구 목적은 대학생의 대학적응, 인성, 의사소통능력, 대인관계 유능성이 현장실습적응에 미치는 영향을 분석하기 위해 시행하였다. G도의 J시와 C시에 소재한 대학교 간호대학생과 의과대학생 231명을 대상으로 하였으며, SPSS/WIN 20.0를 이용하여 Baron & Kenny의 3단계 절차를 이용한 다중회귀분석과 Sobel test를 이용한 매개효과의 유의성을 검증하였다. 현장실습적응에 직접적인 영향은 대학적응(${\beta}=.22$, p=.003)과 대인관계 유능성(${\beta}=.38$, p<.001)이었으며, 인성과 의사소통능력은 현장실습적응에 직접적인 영향을 미치는 효과(${\beta}=.02$, p=.740), (${\beta}=.04$, p=.590)는 유의하지 않았으나 대인관계 유능성을 통한 간접효과가 유의하였다(${\beta}=.15$, p=.004), (${\beta}=.19$, p=.011). 인성과 의사소통능력이 대인관계 유능성을 매개로 현장실습적응에 영향을 미치는 요인이므로, 대학에서 바람직한 인성교육과 의사소통능력, 대인관계 향상을 위한 훈련프로그램 마련이 중요하다. The purpose of this study is to analyze the effects of college adjustment, character, communicative competence, and interpersonal competence on field practice adaptation of college student. Subjects were 231 nursing students and medical students in J city and C city, G-do. Using SPSS/WIN 20.0, multiple regression analysis using Baron & Kenny's three-step procedure and Sobel test were used to verify the significance of the mediator effect. The variables directly affecting field practice adaptation were college adjustment (${\beta}=.22$, p=.003) and interpersonal competence (${\beta}=.38$, p<.001). Character and Communicative competence did not have a direct affect on field practice adaptation (${\beta}=.02$, p=.740), (${\beta}=.04$, p=.590) but indirect effect through interpersonal competence was significant(${\beta}=.15$, p=.004), (${\beta}=.19$, p=.011). As character and communicative competence are the variables affecting field practice adaptation through interpersonal competence, training programs to improve character, communicative competence, and interpersonal competence in college are needed.

몽골유학생의 그릿과 학업지속의향의 관계에서 친숙도와 사회적지지의 매개효과

제남주,박미라,윤지원,Je, Nam Joo,Park, Meera,Yoon, Jiwon 국제문화기술진흥원 2022 The Journal of the Convergence on Culture Technolo Vol.8 No.6

This study is a descriptive correlation study to investigate the mediating effect of familiarity and social support in the relationship between grit and academic continuity for Mongolian students. A survey was conducted from May 1 to June 30, 2021 on 124 Mongolian students from universities across the country using Google questionnaires. As a result of the study, grit had a significant effect on the familiarity and social support of Korean culture. The intention to continue school was significantly influenced by grit, familiarity with Korean culture, and social support. Grit directly had a significant effect on academic continuity, and familiarity with Korean culture and social support had a partial mediating effect in the relationship between grit and academic continuity. Based on the results of this study, it is necessary to increase grit and seek counseling and education programs to help using Korean cultural familiarity and social support systems.

간호대학생의 비판적 사고성향, 임상수행능력, 간호전문직 자아개념이 셀프리더십에 미치는 영향

제남주(Nam Joo Je),방설영(Sul Yeong Bang) 한국산학기술학회 2018 한국산학기술학회논문지 Vol.19 No.12

본 연구의 목적은 간호대학생을 대상으로 셀프리더십 정도에 따른 비판적 사고성향, 임상수행능력, 간호전문직 자아개념의 관계를 확인하는 서술적 조사연구이다. K도 C시 소재 C대학교 간호학과 3.4학년 165명을 대상으로 자가 보고식 설문지를 이용하여 자료를 수집하였고, 수집된 자료는 t-test, ANOVA, Pearson`s correlation coefficient, Multiple Regression으로 분석하였다. 일반적 특성에 따른 셀프리더십은 학년, 학업성적, 입학동기, 전공만족도에 따라 유의한 차이가 있었고, 셀프리더십은 비판적 사고성향, 임상수행능력, 간호전문직 자아개념과 순상관관계가 있는 것으로 확인되었다. 셀프리더십에 영향을 미치는 일반적 특성과 비판적 사고성향, 간호전문직 자아개념 및 임상수행능력의 영향을 분석하였을 때 49.9%의 설명력을 보였고, 이 중 비판적 사고성향이 가장 중요 요인이었다. 이를 통해 간호대학생의 비판적 사고성향을 증진함으로써 셀프리더십을 효과적으로 향상시킬 수 있을 것으로 사료된다. 또한 본 연구는 일 대학교를 대상으로 하여 연구결과를 일반화하는데 무리가 있으며, 현실적으로 전공이수 체계상의 문제점 등 여러 어려움이 있지만 다양한 방법을 모색하여 간호대학생에게 셀프리더십을 강화시켜 나갈 지속적인 교육프로그램을 운영할 필요가 있음을 제언한다. This study is a descriptive research to examine the relationship between critical thinking disposition, clinical performance ability, and self-concept of nursing profession according to degree of self-leadership among nursing college students. The data were collected from 165 nursing students in 3rd & 4th grade using self-report questionnaire and analyzed by t-test, ANOVA, Pearson`s correlation coefficient, and Multiple Regression. Self-leadership according to general characteristics showed significant differences according to grade, academic achievement, motivation, and major satisfaction. Self-leadership was found to have a positive correlation with critical thinking disposition, clinical performance ability, and self-concept of nursing professional. Analysis of the effects of general characteristics affecting sief-leadership, critical thinking disposition, nursing proFessional selF-concept and clinical performance on selF-leadership showed that they were explained by 49.9%, critical thinking disposition was the most important factor. This suggests that nursing students" self-leadership can be improved effectively by promoting critical thinking disposition. Also in reality, there are many difficulties such as the problems in the system of the majors, but it is necessary to operate a continuous education program to strengthen the self-leadership for the nursing college students by seeking various methods.

예비부부 대상 웹 기반 수태 전 건강증진 프로그램 개발 및 평가

제남주(Je, Nam Joo),최소영(Choi, So Young) 한국간호과학회 2016 Journal of Korean Academy of Nursing Vol.46 No.5

Purpose: This study was done to develop a Web-based preconception health promotion program to improve preconception health promotion awareness, perceived benefits, perceived self-efficacy and health behavior, and to reduce perceived barriers in couples about to be married. Methods: Participants were assigned to the experimental group (n=26 couples) or control group (n=25 couples). This program was comprised of a six hour Web-based lecture series which was given to the experimental group over a four week period. Results: Results for the two groups showed: 1) a significant difference in preconception health promotion awareness in men (self-perception: z=-3.62, p <.001 content: F=18.49, p <.001) and in women (self-perception: z=-2.89, p =.004 content F=36.93, p <.001), 2) a significant difference in perceived benefits in men (z=-3.09, p =.002), and in women (F=6.38, p =.004), 3) a significant difference in perceived barriers in men (F=3.64, p =.030), and in women (F=11.36, p <.001), 4) a significant difference in perceived self-efficacy in men (F=12.16, p <.001), but no significant difference in women (F=1.93, p =.166), 5) a significant difference in health promoting behavior in men (F=16.31, p <.001), and in women (F=10.99, p =.001). Conclusion: The results of this study show that the program is an effective nursing intervention in couples about to be married. Therefore, this program can be useful in encouraging health-promoting behavior for couples about to be married.

예비 신혼부부의 수태 전 건강관리 인식수준과 생식 건강증진 행위에 관한 연구

제남주 ( Nam Joo Je ),최소영 ( So Young Choi ) 여성건강간호학회 2015 여성건강간호학회지 Vol.21 No.2

Purpose: The purpose of this study was 1) to examine levels of awareness on preconception care and pregnancy, and reproductive health promoting behavior among pre-honeymooners; and 2) to explore the relationship between awareness levels of preconception care and pregnancy, and reproductive health promoting behavior. Methods: This study was a correlation design with a total of 134 participants (67 couples of pre-honeymooners). Data were collected with questionnaire Results: Mean score of self-perception of awareness of preconception care and pregnancy was 2.82 out of 4. Content awareness level was 6.83 out of 13, and reproductive health promoting behavior score was 3.02 out of 4, indicating low to mid-level. Women reported higher scores in all variables than those in men. Self-perception awareness and content awareness of care and pregnancy had a weak positive correlation (r=.18, p=.038). Reproductive health promoting behavior was positively related to self-perception awareness of care and pregnancy (r=.33, p<.001) and content awareness of care and pregnancy (r=.23, p=.008). Conclusion: Based on this results, a variety of nursing intervention strategies may need to promote reproductive health behavior such as raising awareness of the preconception care and pregnancy.

간호대학생의 현장실습적응, 대학적응, 죽음에 대한 인식이 학과적응에 미치는 영향

제남주(Nam Joo Je),박미라(Meera Park) 한국산학기술학회 2018 한국산학기술학회논문지 Vol.19 No.10

본 연구는 간호대학생의 현장실습적응과 대학적응, 죽음에 대한 인식이 학과적응에 미치는 영향을 파악하여 전공적응과 현장실습적응 및 죽음에 대한 인식을 높이기 위한 대책 마련의 기초자료를 마련하고자 시도되었다. 연구대상자는 C시, J시 간호학과 3.4학년 252명을 대상으로 하였다. 자료수집은 C 대학교 IRB의 승인을 받은 후부터 2018년 4월 30일까지였고, 자료분석은 IBM SPSS WIN/21.0을 이용하여 빈도와 백분율, 평균, 표준편차, t-test, ANOVA, pearson correlation coefficient, multiple regression를 사용하였다. 대상자의, 현장실습적응은 평균 3.58점, 대학적응은 평균 3.33점, 죽음에 대한 인식은 평균 3.15점, 간호학과 학과적응은 평균 3.38점이었다. 대상자의 학과적응과 현장실습적응(r=.56, p<.001), 죽음에 대한 부정도(r=-.15, p=.016), 생명존중의지(r=.33, p<.001)와 유의한 상관관계가 있으며, 현장실습적응과 대학적응(r=.48, p<.001), 생명존중의지(r=.16, p=.009)과 상관관계가 있었고, 대학적응과 생명존중의지(r=.32, p<.001)와 유의한 상관관계가 있었다. 간호대학생의 현장실습적응, 대학적응, 죽음에 대한 인식이 학과적응에 미치는 영향을 확인한 결과 가장 큰 영향을 미치는 요인은 대학적응이었으며(F=171.67, p<.001), 이 모형은 67.5%의 설명력을 보였다. 따라서 죽음에 대한 긍정적 태도 변화를 위해 학부 과정에서 죽음에 대한 긍정적 태도 및 인식 변화와 관련된 교육과정이 제공되어야 하며 생명존중의지 프로그램 실시 후 간호학과 적응 효과에 대한 연구가 필요함을 제언한다. This study was conducted to identify the impact on department adaptation of field practice adaptation, college adaptation, and awareness of death of nursing students, as well as to establish basic data for adaptation of the major, adaptation to field practice, and measures to raise awareness of death. The subjects of this study were 252 Junior and Senior nursing students living in C, J city. Data were collected after approval from the IRB of C University on April 30, 2018 and analyzed by the mean values, percentages, t-test, ANOVA, Pearson"s correlation coefficient and multiple regression using IBM SPSS 21.0. The subjects" field practice adaptation was 3.58, college adaptation was 3.33, awareness of death was 3.15 and department adaptation was 3.38. There were significant correlations between department adaptation and field practice adaptation (r=0.56, p<0.001), negative of death (r=-0.15, p=0.016), respect for life (r=0.33, p<0.001) of nursing students, field practice adaptation and college adaptation (r=0.48, p<0.001) and respect for life (r=0.16, p=0.009) of nursing students and between college adaptation and respect for life (r=0.32, p<0.001) of nursing students. The factors that have effect on the department adaptation of the subjects; As a factor influencing the department adaptation, department adaptation, field practice adaptation, and respect for life were explained by 67.5% (F=171.67, p<0.001). Therefore, a positive attitude toward death and a curriculum related to change in perception must be provided to undergraduates to change the attitude toward death. It is also suggested that research regarding nursing department adaptation effects be conducted after implementing the program to improve respect for life.

일 지역 성인의 노화지식과 노인에 대한 성인식 및 성태도에 관한 연구

제남주(Nam Joo Je),양현주(Hyun Joo Yang),박미라(Meera Park) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.11

본 연구는 일 지역 성인의 노화지식과 노인에 대한 성인식 및 성태도를 탐색하여 우리사회 노인에 대한 성인식 및 성태도를 확인하고, 노인에 대한 올바른 성인식 확립에 필요한 교육 프로그램 개발을 위한 기초자료를 마련하고자 시도되었다. 연구대상자는 B․U광역시, K도에 거주하는 20~59세 성인 340명을 대상으로 하였다. 자료수집은 2015년 6월 9일부터 8월 23일까지였고, 자료분석은 IBM SPSS WIN/21.0을 이용하여 빈도와 백분율, 평균, 표준편차, t-test, ANOVA, Pearson’s correlation coefficient를 사용하였다. 연구결과 대상자의 노화지식은 12.12점, 노인에 대한 성인식은 2.99점, 노인에 대한 성태도는 4.04점이었다. 대상자의 노화지식과 노인에 대한 성인식(r=.227, p<.001), 노화지식과 노인에 대한 성태도(r=.369, p<.001), 노인에 대한 성인식과 성태도(r=.299, p<.001)는 유의한 순 상관관계를 나타내어 노화지식과 노인에 대한 성인식 및 성태도는 유의한 관련성이 있음을 알 수 있었다. 따라서 우리사회 노인에 대한 성인식 및 성태도 전환을 위해 노화지식 및 노인의 성에 관한 체계적인 교육이 연령별에 따라 제공되어야 할 것이다. This study was conducted to: (a) explore correlations between aging knowledge, sexual perception and sexual attitude of aged people among adults, and (b) provide a database to develop an educational program to instill the right perception and sexual attitude of aged people in our society. The subjects were 340 adults aged 20-59 years living in K do, B and U city. The data were collected from June 9, 2015 to August 23, 2015 and analyzed based on the means, percentages, t-tests, ANOVA and Pearson`s correlation coefficient using IBM SPSS 21.0. The subjects" score of aging knowledge was 12.12, sexual perception of aged people was 2.99, sexual attitude of aged people was 4.04. There were significant correlations between aging knowledge and sexual perception of aged people (r=0.227, p<0.001), aging knowledge and sexual attitude of aged people (r=0.369, p<0.001), sexual perception of aged people and sexual attitude of aged people (r=0.299, p<0.001). Therefore, it is necessary to provide systematic education about aging knowledge and sex of aged people by to change the perception and attitude of the elderly in our society.

치매교육 프로그램이 대학생의 치매에 대한 지식, 태도, 노인부양의식, 인지-정서적 공감에 미치는 효과

제남주(Nam Joo Je),박미라(Meera Park),양현주(Hyun Joo Yang),김수연(Soo Yeon Kim) 한국산학기술학회 2019 한국산학기술학회논문지 Vol.20 No.4

본 연구는 대학생을 대상으로 치매교육 프로그램을 제공하고, 치매에 대한 지식, 치매에 대한 태도, 노인부양의식, 인지-정서적 공감에 미치는 효과를 파악하고자 시도되었다. 연구대상자는 K도 C시의 대학생 실험군 20명, 대조군 20명이었으며, 12시간의 치매교육프로그램을 제공하고 그 효과를 검증하였다. 자료수집은 2018년 11월 5일부터 12월 7일까지 이었고, 자료조사는 실험군에게 프로그램 제공 전, 제공 후, 프로그램 종료 4주후에 시행하였으며, 대조군 역시 같은 시기에 조사하였다. 자료분석은 IBM SPSS WIN/21.0을 이용하여 실수와 백분율, 평균, 표준편차, Shapiro-Wilks 검증, x²-test, Fisher’s exact probability test와 Independent t-test, Friedman test, Mann-Whitney U, Repeated Measure ANOVA를 이용하여 분석하였다. 연구결과, 치매에 대한 지식(F=19.80, p<.001), 치매에 대한 태도(z=-4.10, p<.001), 부양의식(F=6.26, p=.017)은 집단과 시점 간에 유의한 교호작용이 있었으나, 인지-정서적 공감은 집단과 시점 간의 교호작용이 유의하지 않았다(F=1.32, p<.256). 추후 치매 관련 교육프로그램 구성 시 해당 내용을 강화하고, 인지-정서 공감을 함양할 수 있도록 대상자의 특성을 고려한 맞춤형 프로그램 개발과 효과를 검증하는 추후연구가 필요하다. This study was undertaken to recommend a dementia education program for college students, and to understand the outcome on knowledge and attitude towards dementia, awareness of aged support, and cognitive-affective empathy. Totally, 40 college students in C city, K do, were enrolled for the study, and divided into two groups of 20 each: experimental group and control group. The experimental group subjects were provided a 12-hour dementia education program; effectiveness of this program has been verified in later studies. Data were collected from November 5, 2018 to December 7, 2018; collection was before, after, and 4 weeks after the program was provided to the experimental group. Control group data were also collected in the same time frame. Data analysis was done using IBM SPSS WIN/21.0, and the percentage, mean and standard deviation were analyzed using Shapiro-Wilks test, x2-test, Fisher"s exact probability test, Independent t-test, Friedman test, Mann-Whitney U and Repeated Measure ANOVA. Knowledge of dementia (F=19.80, p<0.001), attitude toward dementia (z=-4.10, p<0.001), and awareness of aged support (F=6.26, p=0.017) had a significant interaction between group and time; however, cognitive-affective empathy showed no correlation (F=1.32, p<0.256). We therefore suggest strengthening the contents of future education program for dementia, developing a customized program for cognitive-affective empathy by considering subject characteristics, and further research verifying the effectiveness of the program.

미혼남녀의 사회적 부모역할 인식과 교육요구도 및 준비도

제남주(Nam Joo Je),박미라(Meera Park) 한국콘텐츠학회 2019 한국콘텐츠학회논문지 Vol.19 No.3

본 연구는 미혼남녀를 대상으로 부모역할 인식과 교육요구도 및 준비도를 파악하여 예비부모교육 프로그램 개발을 위한 기초자료를 마련하고자 시도되었다. 연구대상자는 K도의 미혼남녀 196명을 대상으로 하였다. 자료수집은 2018년 11월 1일~ 20일까지였고, 자료분석은 IBM SPSS WIN/21.0을 이용하여 빈도와 백분율, 평균, 표준편차, t-test, ANOVA, sheffe-test, paired t-test, IPA matrix 를 사용하였다. 분석결과, 대상자의 사회적 부모역할 인식은 평균 3.41±0.27점(5점 만점)이었다. 교육요구도는 평균 3.48±0.41점(4점 만점)이었고, 역할준비도는 평균 2.65±0.57점(4점 만점)으로, 교육요구도가 역할준비도보다 높았다. IPA matrix 로 분석한 결과, 강화해야 할 부분은 ‘가족관계나 부모역할’이었으며, 이 영역을 위해 투입될 노력을 다른 영역에 투입하도록 권장하는 영역은 ‘자기이해’로 나타났다. 더 이상의 노력 투입이 불필요하며 앞으로 개선을 요하는 영역은 ‘배우자의 선택 및 결혼’이었으며, 향후 집중적으로 개선해야 할 영역은 ‘임신과 출산’ 그리고 ‘자녀양육’ 영역으로 나타났다. 따라서 요구도와 준비도가 높은 A 영역은 계속적으로 잘 유지할 수 있는 표준화된 전략을 수립할 필요성이 있으며, 요구도와 준비도가 낮은 C 영역을 더 이상의 노력투입이 불필요한 영역으로 받아들일 것이 아니라, 준비도를 끌어올리기 위한 전략과 대책이 필요하다고 본다. The purpose of this study is to provide basic data for the development of pre-parent education program by grasping parent role recognition, educational needs and readiness of unmarried men and women. The subjects were 196 unmarried male and female students from K-do. Data were collected from November 1st to 20th, 2018, and analyzed using IBM SPSS WIN/21.0 to get frequency, percentage, average, standard deviation, t-test, ANOVA, sheffe-test, paired t-test, and IPA matrix. The average score of recognition of social pre-parent role was 3.41 ± 0.27 (out of 5 points), educational needs was 3.48 ± 0.41 points (out of 4 points), and educational readiness was 2.65 ± 0.57 points (out of 4 points). educational needs being higher than educational readiness. Through IPA matrix analysis, the area to be strengthened was ‘family relation or parent role’, and self understanding was the area to encourage putting effort into other evaluation attributes. The area where no further effort is needed and needs improvement in the future was spouse selection and marriage, and pregnancy and childbirth and child rearing were the areas to intensively improve. Therefore, there is a need for establishing a standardized strategy in the area A, which has high degree of readiness and needs. Also, it is necessary to take strategies and countermeasures to raise the readiness of area C with low degree of readiness and needs, rather than accepting it as an unnecessary area of further effort input.