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    ์ด์Šฌ๋žŒ ๊ตญ์ œ์ฒด์ œ์˜ ์—ญ์‚ฌ์  ํƒ๊ตฌ๋ฅผ ํ†ตํ•œ ๊ฑธํ”„์œ„๊ธฐ์˜ ์žฌ๊ตฌ์„ฑ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์ •์น˜์™ธ๊ตํ•™๋ถ€, 2017. 2. ์‹ ๋ฒ”์‹.๊ฑธํ”„์ „์€ ๋ƒ‰์ „ ์ดํ›„ ์ƒˆ๋กœ์šด ์„ธ๊ณ„์งˆ์„œ์˜ ์‹œ์ž‘์„ ์•Œ๋ฆฌ๋Š” ์‚ฌ๊ฑด์ด์—ˆ๋‹ค๋Š” ์ ์—์„œ ์ „ ์ง€๊ตฌ์ ์œผ๋กœ ์ค‘์š”ํ•œ ์˜๋ฏธ๋ฅผ ์ง€๋‹ˆ๋Š” ๋™์‹œ์—, ์ง€์—ญ์  ์ฐจ์›์—์„œ๋„ ๋ณธ๊ฒฉ์ ์ธ ๊ทผ๋Œ€ ๊ตญ์ œ์ •์น˜์˜ ์‹œ๋Œ€๋กœ ๋ณ€ํ™”ํ•˜๊ฒŒ ๋œ ์—ญ์‚ฌ์  ๋ถ„๊ธฐ์ ์œผ๋กœ์„œ ํ‰๊ฐ€๋ฐ›์•„์™”๋‹ค. ์ด์ „๊นŒ์ง€ ์ฃผ๋กœ ๋ฒ”-์•„๋ž์ฃผ์˜ ํ˜น์€ ๋ฒ”-์ด์Šฌ๋žŒ์ฃผ์˜์— ์˜ํ•ด ๊ทœ์ •๋˜๋˜ ์ง€์—ญ์งˆ์„œ๊ฐ€ ์ด๋ผํฌ์˜ ์ฟ ์›จ์ดํŠธ ์นจ๊ณต๊ณผ ์ด์— ๋Œ€ํ•œ ์ง€์—ญ ๊ตญ๊ฐ€๋“ค์˜ ๊ตฐ์‚ฌ์  ์‘์ง•์— ์˜ํ•ด ์™€ํ•ด๋˜์—ˆ์œผ๋ฉฐ, ์ด ๋•Œ๋ถ€ํ„ฐ ์•„๋ž ๊ตญ๊ฐ€๋“ค์€ ๋น„๋กœ์†Œ ๊ฐœ๋ณ„์  ์ •์ฒด์„ฑ๊ณผ ์ด์ต์„ ๊ฐ•ํ™”ํ•˜๊ฒŒ ๋˜์—ˆ๋‹ค๋Š” ๊ฒƒ์ด๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ์ด๋Ÿฌํ•œ ๋…ผ์˜ ์•ˆ์—์„œ ๋ฏธ๊ตญ์˜ ํŒŒ๋ณ‘ ๊ฒฐ์ • ์ด์ „๊นŒ์ง€ ์ „๊ฐœ๋˜์—ˆ๋˜ ์•„๋ž ์†”๋ฃจ์…˜์˜ ๋…ธ๋ ฅ, ๊ฒฝ์ œ์ ยท๊ตฐ์‚ฌ์  ์œ„ํ˜‘์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ๋‹ค๊ตญ์ ๊ตฐ ํ•ฉ๋ฅ˜๋ฅผ ๊ฑฐ๋ถ€ํ–ˆ๋˜ ์š”๋ฅด๋‹จ์˜ ๊ฒฐ์ • ๋“ฑ์€ ๋ณ„๋‹ค๋ฅธ ์ค‘์š”์„ฑ์„ ํš๋“ํ•˜์ง€ ๋ชปํ–ˆ์œผ๋ฉฐ, ๋ฐ˜ ์ด๋ผํฌ ์ „์„ ์— ์„ฐ๋˜ ๋‹ค๋ฅธ ๊ตญ๊ฐ€๋“ค์˜ ์„ ํƒ ์—ญ์‹œ ์ถฉ๋ถ„ํžˆ ์„ค๋ช…๋˜์ง€ ๋ชปํ–ˆ๋‹ค. ๋ณธ ๋…ผ๋ฌธ์€ ์ด๋Ÿฌํ•œ ํ•œ๊ณ„๊ฐ€ ๊ทผ๋ณธ์ ์œผ๋กœ๋Š” ํ•ฉ๋ฆฌ์  ํ–‰์œ„์ž๋กœ์„œ์˜ ๊ตญ๊ฐ€์™€ ๊ทธ๋Ÿฌํ•œ ๊ตญ๊ฐ€๋“ค๋กœ ์ด๋ฃจ์–ด์ง„ ์ฃผ๊ถŒ๊ตญ๊ฐ€์ฒด์ œ๋ฅผ ๋‹น์—ฐ์˜ ์ „์ œ๋กœ ํ•˜๋Š” ์„œ๊ตฌ ์ค‘์‹ฌ์  ์ด๋ก ์˜ ๊ฐ€์ •์—์„œ ๊ธฐ์ธํ•œ๋‹ค๊ณ  ๋ณธ๋‹ค. ์—ญ์‚ฌ์ ์œผ๋กœ ๋ณผ ๋•Œ ์ด ์ง€์—ญ์—๋Š” ๊ทผ๋Œ€๊ตญ์ œ์งˆ์„œ์™€๋Š” ๋‹ค๋ฅธ ์ด์Šฌ๋žŒ ์งˆ์„œ๊ฐ€ ์˜ค๋žซ๋™์•ˆ ์œ ์ง€๋˜์–ด ์™”์œผ๋ฉฐ, ๊ทผ๋Œ€๊ตญ์ œ์ฒด์ œ๋Š” ์„œ๊ตฌ ์ œ๊ตญ์ฃผ์˜์— ์˜ํ•ด ๋ถ€๊ณผ๋˜์–ด ์ƒ๋Œ€์ ์œผ๋กœ ๋งค์šฐ ์งง์€ ์‹œ๊ฐ„ ๋™์•ˆ ์œ ์ง€๋˜์–ด ์™”์„ ๋ฟ์ด๋‹ค. ๋”ฐ๋ผ์„œ ์ค‘๋™์˜ ๊ทผ๋Œ€์ฒด์ œ๋Š” ์—ฌ์ „ํžˆ ๊ณผ๊ฑฐ์˜ ์ด์Šฌ๋žŒ ์งˆ์„œ์˜ ์œ ์‚ฐ ์†์—์„œ ์ž‘๋™ํ•˜์˜€์œผ๋ฉฐ, ๋‚ด๋ถ€์˜ ๊ตญ๊ฐ€ํ–‰์œ„์ž๋“ค ์—ญ์‹œ ์ „ํ˜•์ ์ธ ๊ทผ๋Œ€๊ตญ๊ฐ€์˜ ํ–‰๋™๊ณผ๋Š” ๋‹ค๋ฅธ ์–‘ํƒœ๋ฅผ ๋ณด์˜€๋‹ค. ๊ทธ๋Ÿผ์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ๊ฑธํ”„์œ„๊ธฐ ๋‹น์‹œ์˜ ์ง€์—ญ์ •์น˜๋Š” ์ด๋Ÿฌํ•œ ๊ตฌ์กฐ์  ํŠน์„ฑ์ด ๊ฐ„๊ณผ๋œ ์ฑ„ ์„ค๋ช…๋˜์—ˆ๋˜ ๋ฐ”, ์‚ฌ๊ฑด์˜ ์ง€์—ญ์  ์˜๋ฏธ์™€ ๋งฅ๋ฝ, ๊ฐœ๋ณ„ ๊ตญ๊ฐ€๋“ค์˜ ์™ธ๊ต์ •์ฑ…๊ฒฐ์ •๊ณผ์ •์„ ์„ค๋ช…ํ•˜๋Š”๋ฐ ํ•œ๊ณ„๋ฅผ ๊ฐ€์กŒ๋˜ ๊ฒƒ์ด๋‹ค. ์ด๋Ÿฌํ•œ ๋ฌธ์ œ์˜์‹์„ ๋ฐ”ํƒ•์œผ๋กœ ๋ณธ ๋…ผ๋ฌธ์€ ํฌ๊ฒŒ ๋‘ ๊ฐ€์ง€ ๋ชฉํ‘œ๋ฅผ ๊ฐ€์ง„๋‹ค. ์ฒซ์งธ, ๊ทผ๋Œ€์  ๊ตญ์ œ์ฒด์ œ์™€๋Š” ๋‹ค๋ฅธ ์ค‘๋™ ์ง€์—ญ์ฒด์ œ์˜ ํŠน์„ฑ์„ ์—ญ์‚ฌ์  ์—ฐ์†์„ฑ๊ณผ ๋‹จ์ ˆ ์†์—์„œ ๊ณ ์ฐฐํ•ด๋ณด๊ณ , ๋‘˜์งธ, ์ด๋ฅผ ํ†ตํ•ด ๊ฑธํ”„์œ„๊ธฐ์˜ ์ง€์—ญ์ •์น˜๋ฅผ ์‚ฌ์šฐ๋””์•„๋ผ๋น„์•„, ์ด์ง‘ํŠธ, ์š”๋ฅด๋‹จ์˜ ์™ธ๊ต์ •์ฑ…์„ ์ค‘์‹ฌ์œผ๋กœ ์žฌ๊ตฌ์„ฑํ•ด ๋ณด์ด๊ณ ์ž ํ–ˆ๋‹ค. 624๋…„ ์›€๋งˆ์˜ ํƒ„์ƒ ์ดํ›„, ์ด์Šฌ๋žŒ ์„ธ๊ณ„๋Š” ์ •์น˜ ๋‹จ์œ„์˜ ์กด์žฌ์–‘์‹, ๊ตญ์ œ ๊ณต๊ฐ„์˜ ํ‘œ์ƒ ๋ฐ ๊ด€๋…, ๋‹จ์œ„๋“ค ๊ฐ„์˜ ํ–‰์œ„ ๊ทœ๋ฒ” ๋“ฑ์— ์žˆ์–ด ๋‹ค๋ฅธ ๊ถŒ์—ญ๊ณผ๋Š” ๊ตฌ๋ณ„๋˜๋Š” ๋…์ž์ ์ธ ๊ตญ์ œ์ฒด์ œ๋ฅผ ์˜ค๋žซ๋™์•ˆ ์˜์œ„ํ•ด์™”๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ์ด๋Š” 18,19์„ธ๊ธฐ๋ฅผ ๊ฑฐ์น˜๋ฉฐ ์ ์ฐจ ํ•ด์ฒด๋˜์—ˆ์œผ๋ฉฐ ์œ ๋Ÿฝ์œผ๋กœ๋ถ€ํ„ฐ ๊ฐ•์ œ๋œ ๊ทผ๋Œ€ ๊ตญ์ œ์ฒด์ œ๊ฐ€ ์ž๋ฆฌ ์žก์•˜๋‹ค. ์ด๋Ÿฌํ•œ ๊ณผ์ •์—์„œ ํƒ„์ƒํ•œ ์ค‘๋™์˜ ๊ทผ๋Œ€ ๊ตญ๊ฐ€๋“ค์€ ๋ถˆ์™„์ „ํ•œ ์ฃผ๊ถŒ์„ ์†Œ์œ ํ•œ ์˜ํ† ๊ตญ๊ฐ€ ์ƒํƒœ์— ๋จธ๋ฌผ๋ €์œผ๋ฉฐ, ์ด๋“ค ๊ฐ„์˜ ๊ด€๊ณ„ ์—ญ์‹œ ๊ทผ๋Œ€ ์ฃผ๊ถŒ ๊ทœ๋ฒ”์— ๋”ฐ๋ผ ํ˜•์„ฑ๋˜์ง€ ๋ชปํ–ˆ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ด ๋•Œ, ์•„๋ž์ฃผ์˜์™€ ์ด์Šฌ๋žŒ์€ ๊ฐœ๋ณ„ ๊ตญ๊ฐ€์˜ ์ •์ฒด์„ฑ ์ฐจ์›์„ ๋„˜์–ด ๊ตญ๊ฐ€๋“ค์˜ ํ–‰์œ„๋ฅผ ๊ทœ์ •ํ•˜๋Š” ๊ทœ๋ฒ”์œผ๋กœ ์ž‘๋™ํ•˜์˜€๋‹ค. ์•„๋ž ๊ตญ๊ฐ€๋“ค์€ ์•„๋ž๊ณผ ์ด์Šฌ๋žŒ์˜ ์ผ๋ถ€๋กœ์„œ ํ–‰๋™ํ•˜๋„๋ก ์ œ์•ฝ๋ฐ›์•˜์„ ๋ฟ ์•„๋‹ˆ๋ผ, ๊ฐœ๋ณ„ ๊ตญ๊ฐ€์˜ ์ด์ต์„ ์ถ”๊ตฌํ•˜๋Š” ํ–‰์œ„ ์—ญ์‹œ ์•„๋ž-์ด์Šฌ๋žŒ์˜ ๊ทœ๋ฒ” ํ•˜์—์„œ ์ด๋ฅผ ์ •๋‹นํ™”ํ•˜๋Š” ๊ณผ์ •์„ ๊ฑฐ์ณ์•ผํ–ˆ๋˜ ๊ฒƒ์ด๋‹ค. ๊ฑธํ”„ ์œ„๊ธฐ ๋‹น์‹œ 3๊ฐœ๊ตญ์˜ ์™ธ๊ต์ •์ฑ…๊ฒฐ์ • ์—ญ์‹œ ๊ฐ™์€ ๋งฅ๋ฝ์—์„œ ์ดํ•ด๋  ์ˆ˜ ์žˆ๋‹ค. ๋‹ค๊ตญ์ ๊ตฐ์— ํ•ฉ๋ฅ˜ ํ˜น์€ ๊ฑฐ๋ถ€ํ–ˆ๋˜ ์ด๋“ค์˜ ์„ ํƒ์€ ์•„๋ž-์ด์Šฌ๋žŒ ๊ทœ๋ฒ” ์•ˆ์—์„œ ์ด๋ผํฌ์˜ ํ–‰์œ„๋ฅผ ์ธ์‹ํ•˜๊ณ , ์ž๊ตญ์˜ ์ƒ์กด๊ณผ ์ด์ต์„ ์žฌ๊ตฌ์„ฑํ•œ ๊ฒฐ๊ณผ๋ฌผ์ด์—ˆ๋‹ค.โ… . ์„œ๋ก  1 1. ๋ฌธ์ œ์ œ๊ธฐ 1 2. ๊ธฐ์กด์—ฐ๊ตฌ ๊ฒ€ํ†  6 3. ์—ฐ๊ตฌ์˜ ๋ฐฉ๋ฒ• 11 4. ์—ฐ๊ตฌ์˜ ๊ตฌ์„ฑ 14 โ…ก. ๊ทผ๋Œ€ ์ด์ „ ์ด์Šฌ๋žŒ ์งˆ์„œ์˜ ํŠน์„ฑ๊ณผ ๋ณ€ํ™˜ 16 1. ์ •์น˜๋‹จ์œ„์˜ ๋ณ€์ฒœ 17 1) ์ด์Šฌ๋žŒ ์›€๋งˆ 17 2) ๊ตฐ์‚ฌ-์‹œํ˜œ ๊ตญ๊ฐ€(military-patronage state) 18 3) ์ด์Šฌ๋žŒ ์ œ๊ตญ 20 2. ๊ตญ๊ฐ€ ๊ฐ„ ๊ด€๊ณ„ ์„ค์ •๊ณผ ๊ตญ์ œ์˜ ์ธ์‹ 23 1) ์ด์Šฌ๋žŒ ์„ธ๊ณ„์˜ ์ด๋ถ„๋ฒ•์  ๊ตญ์ œ๊ด€๋… 23 2) ์ด์Šฌ๋žŒ ์„ธ๊ณ„์˜ ๋ถ„์—ด 24 3) ์ด์Šฌ๋žŒ ์ œ๊ตญ ์‹œ๋Œ€์˜ ๊ตญ์ œ ๊ณต๊ฐ„ 25 (1) ์ „์Ÿ ์˜์—ญ: ์œ ๋Ÿฝ๊ณผ์˜ ๊ด€๊ณ„ 26 (2) ์ด์Šฌ๋žŒ ์˜์—ญ 27 3. ์ƒค๋ฆฌ์•„์™€ ์ง€ํ•˜๋“œ 30 โ…ข. ์˜ค์Šค๋งŒ ์ œ๊ตญ์˜ ํ•ด์ฒด์™€ ๊ทผ๋Œ€ ์ดํ–‰ 33 1. ์˜ค์Šค๋งŒ ๊ตฌ์ฒด์ œ์˜ ์ข…๋ง 34 1) ํ€ด์ทฉ ์นด์ด๋‚˜๋ฅด์ž ์กฐ์•ฝ๊ณผ ๊ทธ๋ฆฌ์Šค ๋…๋ฆฝ์ „์Ÿ 34 2) ๊ตญ๊ฐ€ ์ฃผ๋„ํ˜• ๊ฐœํ˜๊ณผ ๋‚ด๋ถ€์  ๊ฐˆ๋“ฑ์˜ ์‹ฌํ™” 35 3) ๋ฐœ์นธ์˜ ๋…๋ฆฝ์šด๋™๊ณผ ์˜ํ† ์ƒ์‹ค 37 4) ๊ทผ๋Œ€๊ตญ์ œ์ฒด์ œ๋กœ์˜ ํŽธ์ž… 38 2. ์ œ๊ตญ์˜ ์‡ ํ‡ด์™€ ์•„๋ž์ง€์—ญ 40 1) ๊ตฌ์งˆ์„œ์˜ ๋ถ•๊ดด์™€ ์ด์Šฌ๋žŒ ๊ณต๋™์ฒด 41 2) ์•„๋ž๋ฏผ์กฑ์œผ๋กœ์„œ์˜ ์ž๊ธฐ์ธ์‹ 43 โ…ฃ. ๊ทผ๋Œ€ ์ค‘๋™์˜ ์ง€์—ญ์งˆ์„œ 45 1. ์ค‘๋™ ์ง€์—ญ์ฒด์ œ์˜ ๊ตฌ์กฐ์  ํŠน์„ฑ 47 1) ๋ถˆ์™„์ „ํ•œ ์ฃผ๊ถŒ ๋‹จ์œ„: ๊ทผ๋Œ€์  ์˜ํ†  ๊ตญ๊ฐ€ 48 2) ์ค‘๋™ ์ง€์—ญ ์ฒด์ œ์˜ ์ž‘๋™ 51 2. ๊ทœ๋ฒ”๊ณผ ์ •์ฒด์„ฑ, ๊ทธ๋ฆฌ๊ณ  ์™ธ๊ต์ •์ฑ…๊ฒฐ์ • 53 1) ์•„๋ž-์ด์Šฌ๋žŒ ๊ทœ๋ฒ”๊ณผ ์™ธ๊ต์ •์ฑ…๊ฒฐ์ • 53 2) ๋‹ค์ธต์  ์ •์ฒด์„ฑ๊ณผ ์™ธ๊ต์ •์ฑ…๊ฒฐ์ • 55 โ…ค. ๊ฑธํ”„์œ„๊ธฐ์˜ ์ง€์—ญ์ •์น˜ 57 1. ๊ฑธํ”„์œ„๊ธฐ์˜ ๋Œ€๋‘์™€ ์•„๋ž ์„ธ๊ณ„์˜ ๋ฐ˜์‘ 58 1) ์ด๋ผํฌ์˜ ์ฟ ์›จ์ดํŠธ ์นจ๊ณต 58 2) ์•„๋ž ์†”๋ฃจ์…˜์˜ ๋ชจ์ƒ‰๊ณผ ์ขŒ์ ˆ 62 3) ๊ฑธํ”„์œ„๊ธฐ์˜ ์ง€์—ญ์  ์˜๋ฏธ 66 2. ์•„๋ž ์†”๋ฃจ์…˜ ์ดํ›„ ์ฃผ์š” ๊ตญ๊ฐ€๋“ค์˜ ์„ ํƒ 69 1) ์‚ฌ์šฐ๋””์•„๋ผ๋น„์•„ 70 (1) ์ „ํ†ต์  ์™ธ๊ต๋…ธ์„ ๊ณผ ๋ณตํ•ฉ์  ์œ„ํ˜‘์ธ์‹ 70 (2) ์•„๋ž-์ด์Šฌ๋žŒ ๊ทœ๋ฒ”์˜ ์žฌํ•ด์„์„ ํ†ตํ•œ ์™ธ๊ต์ •์ฑ…๊ฒฐ์ • 72 2) ์ด์ง‘ํŠธ 75 (1) ๊ฑธํ”„ ์œ„๊ธฐ ์ƒํ™ฉ์— ๋Œ€ํ•œ ์ „๋žต์  ๊ณ„์‚ฐ 75 (2) ์•„๋ž-์ด์Šฌ๋žŒ ๊ทœ๋ฒ” ์ˆ˜ํ˜ธ๋ฅผ ์œ„ํ•œ ๋‹ค๊ตญ์ ๊ตฐ ํŒŒ๋ณ‘ 76 3) ์š”๋ฅด๋‹จ 78 (1) ์š”๋ฅด๋‹จ์„ ๋‘˜๋Ÿฌ์‹ผ ๋‹ค์ธต์  ์œ„ํ˜‘ 79 (2) ์ฃผ๊ถŒ ๊ทœ๋ฒ”๊ณผ ์•„๋ž-์ด์Šฌ๋žŒ ๊ทœ๋ฒ”์˜ ์กฐ์‘ 81 3. ์†Œ๊ฒฐ 85 โ…ฅ. ๊ฒฐ๋ก  87 ์ฐธ๊ณ ๋ฌธํ—Œ 91Maste

    Development of a Video-Based Critical Care Nutrition Support Education Program for Intensive Care Unit Nurses

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    This methodological study developed a video-based critical care nutrition support education program for intensive care unit (ICU) nurses based on a literature review and focus group interviews. In this study, the steps of analysis, design, and development within the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model were followed. The following results were obtained in each stage of research. 1. The composition items for critical care nutrition support included the contents commonly addressed in the relevant literature. The items consisted of the importance of nutrition support for critically ill patients, assessment of nutritional status, nutrition support plan, implementation of nutrition support, assessment and monitoring of nutritional support, management of complications and the role of nutrition support team. 2. Focus group interviews were conducted with 12 nurses working in the adult ICU of a tertiary academic medical center. The main categories that emerged from the interview data were difficulties in nutritional support for critically ill patients, educational needs related to provision of nutrition support for critically ill patients and preferred educational methods. 3. Content validity of the composition and the draft scenario was evaluated by the expert group. Content Validity Index (CVI) scores for all items were .80 or higher. The final scenario was compiled after addressing and incorporating additional suggestions from the expert group. 4. Based on the scenario, the draft of the education program was completed. Education contents, animation production and filming, narration recording, and editing were performed by the author. Interviews with the medical staff working as a nutrition support team significantly enhanced the expertise. Content validity of the draft of the education program was evaluated by the expert group and CVI scores for all items were .80 or higher. 5. Twelve intensive care unit nurses evaluated the acceptability of the education program video using the video program evaluation tool developed by Hyo-Jeong Park (2001). The score for each item ranged from 4.0 to 4.8. Additional suggestions were incorporated to finalize the education program. This education program is one of the few critical care nutrition education programs targeting Korea ICU nurses. Disseminating this video-based education program is likely to promote ICU nursesโ€™ knowledge, attitude and competency in implementing nutritional assessment for the management of the critically ill patients. Future studies should evaluate the practical impact of this educational program. ๋ณธ ์—ฐ๊ตฌ๋Š” ๋ฌธํ—Œ๊ณ ์ฐฐ, ํฌ์ปค์Šค ๊ทธ๋ฃน ์ธํ„ฐ๋ทฐ๋ฅผ ํ†ตํ•œ ์ค‘ํ™˜์ž์‹ค ๊ฐ„ํ˜ธ์‚ฌ์˜ ์ค‘ํ™˜์ž ์˜์–‘์ง€์› ๊ด€๋ จ ๊ต์œก ์š”๊ตฌ ์กฐ์‚ฌ๋ฅผ ํ† ๋Œ€๋กœ ๋™์˜์ƒ ๊ธฐ๋ฐ˜ ์ค‘ํ™˜์ž ์˜์–‘์ง€์› ๊ต์œก ํ”„๋กœ๊ทธ๋žจ์„ ๊ฐœ๋ฐœํ•˜๊ธฐ ์œ„ํ•œ ๋ฐฉ๋ฒ•๋ก ์  ์—ฐ๊ตฌ์ด๋‹ค. ๊ต์ˆ˜ ์„ค๊ณ„ ๋ฐฉ๋ฒ• ์ค‘ ํ•˜๋‚˜์ธ ADDIE (Analysis, Design, Development, Implementation, Evaluation) ๋ชจํ˜• ์ค‘ ๋ถ„์„(Analysis), ์„ค๊ณ„(Design), ๊ฐœ๋ฐœ(Develop) ๋‹จ๊ณ„๋ฅผ ๊ฑฐ์ณ ์ง„ํ–‰ํ•˜์˜€๋‹ค. ๊ฐ ๋‹จ๊ณ„์˜ ๊ตฌ์ฒด์ ์ธ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. 1. ๋ถ„์„(Analysis) 1) ๋ฌธํ—Œ๊ณ ์ฐฐ: ๊ธฐ์กด ๊ต์œก์ž๋ฃŒ ๊ฒ€ํ† ๋ฅผ ํ†ตํ•ด ๊ฐ€์ด๋“œ๋ผ์ธ 6ํŽธ, ๋…ผ๋ฌธ 4ํŽธ, ์ถœํŒ๋ฌผ 2ํŽธ, ๋™์˜์ƒ 3ํŽธ์„ ๋ถ„์„ํ•˜์˜€๋‹ค. ํ•ด๋‹น ๋ฌธํ—Œ๋“ค์—์„œ ๊ณตํ†ต์œผ๋กœ ์–ธ๊ธ‰๋œ ๋‚ด์šฉ์„ ๋ฐ”ํƒ•์œผ๋กœ ๋„์ถœ๋œ ์ค‘ํ™˜์ž ์˜์–‘์ง€์› ๊ต์œก์— ๊ด€ํ•œ ๊ตฌ์„ฑ์€ ์ค‘ํ™˜์ž ์˜์–‘์ง€์› ์ค‘์š”์„ฑ, ์˜์–‘์ƒํƒœ ์‚ฌ์ •, ์˜์–‘์ง€์› ๊ณ„ํš, ์˜์–‘์ง€์› ์ˆ˜ํ–‰, ์˜์–‘์ง€์› ์ ์ •์„ฑ ํ‰๊ฐ€์™€ ๊ฐ์‹œ, ์˜์–‘์ง€์›๊ณผ ๊ด€๋ จ๋œ ํ•ฉ๋ณ‘์ฆ๊ณผ ๊ฐ„ํ˜ธ, ์˜์–‘์ง‘์ค‘์ง€์›ํŒ€ ์—ญํ•  ์ด 7๊ฐœ์˜€๋‹ค. 2) ํฌ์ปค์Šค ๊ทธ๋ฃน ์ธํ„ฐ๋ทฐ: ์ผ ์ƒ๊ธ‰์ข…ํ•ฉ๋ณ‘์› ์„ฑ์ธ ์ค‘ํ™˜์ž์‹ค์— ๊ทผ๋ฌดํ•˜๋Š” ๊ฐ„ํ˜ธ์‚ฌ 12๋ช…์„ ๋ชฉ์  ํ‘œ์ง‘ ํ•˜์—ฌ ํฌ์ปค์Šค ๊ทธ๋ฃน ์ธํ„ฐ๋ทฐ๋ฅผ ์‹œํ–‰ํ•˜์˜€๋‹ค. ํฌ์ปค์Šค ๊ทธ๋ฃน ์ธํ„ฐ๋ทฐ ๋ถ„์„์„ ํ†ตํ•ด ๋„์ถœ๋œ ์ค‘ํ™˜์ž ์˜์–‘์ง€์›๊ณผ ๊ด€๋ จ๋œ ์ค‘์š”ํ•œ ์ฃผ์ œ๋Š” ์ค‘ํ™˜์ž ์˜์–‘์ง€์› ์‹œ ์–ด๋ ค์šด ์ , ์ค‘ํ™˜์ž ์˜์–‘์ง€์› ๊ต์œก ์š”๊ตฌ ๋‚ด์šฉ, ์„ ํ˜ธํ•˜๋Š” ๊ต์œก ๋ฐฉ๋ฒ•์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. 2. ์„ค๊ณ„(Design) ๊ต์œก ๋ชฉํ‘œ๋ฅผ ์„ค์ •ํ•˜๊ณ , ๊ต์œก์ „๋žต ๋ฐ ํ‰๊ฐ€๋„๊ตฌ๋ฅผ ์ˆ˜๋ฆฝํ•˜์˜€๋‹ค. 3. ๊ฐœ๋ฐœ(Develop) 1) ๊ตฌ์„ฑ์•ˆ๊ณผ ์‹œ๋‚˜๋ฆฌ์˜ค ์ดˆ์•ˆ์„ ๊ฐœ๋ฐœ ํ›„ ์ „๋ฌธ๊ฐ€ ํƒ€๋‹น๋„ ํ‰๊ฐ€๋ฅผ ๊ฑฐ์ณค๋‹ค. ๊ฐ ์ „๋ฌธ๊ฐ€ ๋‚ด์šฉ ํƒ€๋‹น๋„์˜ ๋ชจ๋“  ํ•ญ๋ชฉ์ด 0.80 ์ด์ƒ์œผ๋กœ ์ „๋ฌธ๊ฐ€ ํ•ฉ์˜๋ฅผ ์ด๋ฃจ์—ˆ๋‹ค. ์ถ”๊ฐ€ ์ „๋ฌธ๊ฐ€ ์˜๊ฒฌ์„ ๋ฐ”ํƒ•์œผ๋กœ ์ตœ์ข… ์‹œ๋‚˜๋ฆฌ์˜ค๋ฅผ ์™„์„ฑํ•˜์˜€๋‹ค. 2) ์‹œ๋‚˜๋ฆฌ์˜ค๋ฅผ ํ† ๋Œ€๋กœ ๊ต์œก ํ”„๋กœ๊ทธ๋žจ ์ดˆ์•ˆ์„ ๊ฐœ๋ฐœํ•˜์˜€๋‹ค. ๋™์˜์ƒ์€ ๊ต์œก ๋‚ด์šฉ ์• ๋‹ˆ๋ฉ”์ด์…˜ ์ œ์ž‘, ๋‚ด๋ ˆ์ด์…˜ ๋…น์Œ, ์ดฌ์˜, ํŽธ์ง‘ ๊ณผ์ •์„ ๊ฑฐ์ณ ์™„์„ฑํ•˜์˜€๋‹ค. ๋‚ด๋ ˆ์ด์…˜ ๋…น์Œ์€ ์—ฐ๊ตฌ์ž๊ฐ€ ์ง์ ‘ ์‹œํ–‰ํ•˜์˜€์œผ๋ฉฐ, ์˜์–‘์ง‘์ค‘์ง€์›ํŒ€์œผ๋กœ ๊ทผ๋ฌดํ•˜๋Š” ์˜๋ฃŒ์ง„์„ ์ธํ„ฐ๋ทฐํ•˜์—ฌ ์ „๋ฌธ์„ฑ์„ ๋†’์˜€๋‹ค. ๊ต์œก ํ”„๋กœ๊ทธ๋žจ ์ดˆ์•ˆ ์ „๋ฌธ๊ฐ€ ๋‚ด์šฉ ํƒ€๋‹น๋„์˜ ๋ชจ๋“  ํ•ญ๋ชฉ์ด 0.80 ์ด์ƒ์œผ๋กœ ์ „๋ฌธ๊ฐ€ ํ•ฉ์˜๋ฅผ ์ด๋ฃจ์—ˆ๋‹ค. ์ถ”๊ฐ€ ์ „๋ฌธ๊ฐ€ ์˜๊ฒฌ์„ ๋ฐ”ํƒ•์œผ๋กœ ๊ต์œก ํ”„๋กœ๊ทธ๋žจ์„ ์™„์„ฑํ•˜์˜€๋‹ค. 3) ์™„์„ฑ๋œ ๊ต์œก ํ”„๋กœ๊ทธ๋žจ์— ๋Œ€ํ•˜์—ฌ ๋ฐ•ํšจ์ •(2001)์ด ๊ฐœ๋ฐœํ•œ ๋น„๋””์˜ค ํ”„๋กœ๊ทธ๋žจ ํ‰๊ฐ€๋„๊ตฌ๋ฅผ ์‚ฌ์šฉํ•˜์—ฌ ์ ํ•ฉ์„ฑ ํ‰๊ฐ€๋ฅผ ์‹œํ–‰ํ•˜์˜€๋‹ค. ๊ต์œก ์š”๊ตฌ ์กฐ์‚ฌ์— ์ฐธ์—ฌํ•œ ์ค‘ํ™˜์ž์‹ค ๊ฐ„ํ˜ธ์‚ฌ 12๋ช…์ด ํ‰๊ฐ€ํ•˜์˜€๊ณ  ํ•ญ๋ชฉ๋ณ„ ์ ์ˆ˜๋Š” 4.0-4.8์ด์—ˆ๋‹ค. ์ถ”๊ฐ€ ์˜๊ฒฌ์„ ํ† ๋Œ€๋กœ ๋™์˜์ƒ ๊ธฐ๋ฐ˜ ์ค‘ํ™˜์ž ์˜์–‘์ง€์› ๊ต์œก ํ”„๋กœ๊ทธ๋žจ์„ ์ตœ์ข… ์™„์„ฑํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ์ค‘ํ™˜์ž ์˜์–‘์ง€์›๊ณผ ๊ด€๋ จ๋œ ์ตœ์‹  ๋ฌธํ—Œ๊ณ ์ฐฐ, ์ค‘ํ™˜์ž์‹ค ๊ฐ„ํ˜ธ์‚ฌ์˜ ๊ต์œก ์š”๊ตฌ์— ๊ธฐ๋ฐ˜ํ•˜์—ฌ ์ค‘ํ™˜์ž์‹ค ๊ฐ„ํ˜ธ์‚ฌ๋ฅผ ์œ„ํ•œ ์ค‘ํ™˜์ž ์˜์–‘์ง€์› ๊ต์œก ํ”„๋กœ๊ทธ๋žจ ๊ฐœ๋ฐœ์„ ์‹œ๋„ํ•œ ๊ฒƒ์— ์˜์˜๊ฐ€ ์žˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ ๊ฐœ๋ฐœ๋œ ๋™์˜์ƒ ๊ธฐ๋ฐ˜ ์˜์–‘์ง€์› ๊ต์œก ํ”„๋กœ๊ทธ๋žจ์˜ ๋ณด๊ธ‰์„ ํ†ตํ•ด ์ค‘ํ™˜์ž ์˜์–‘์ง€์›์— ๊ด€ํ•œ ์ค‘ํ™˜์ž์‹ค ๊ฐ„ํ˜ธ์‚ฌ์˜ ์ง€์‹๊ณผ ์ธ์‹, ์ˆ˜ํ–‰์˜ ํ–ฅ์ƒ์„ ๊ฐ€์ ธ์˜ฌ ๊ฒƒ์„ ๊ธฐ๋Œ€ํ•œ๋‹ค. ์ถ”ํ›„ ์—ฐ๊ตฌ๋กœ, ๊ต์œก ํ”„๋กœ๊ทธ๋žจ์— ๋Œ€ํ•œ ํšจ๊ณผ ํ‰๊ฐ€๋ฅผ ์ œ์–ธํ•œ๋‹ค.open์„

    ๋‹ด๋„ ์•”์—์„œ์˜ ์ƒˆ๋กœ์šด fusion gene(์œตํ•ฉ์œ ์ „์ž) ๋™์ •๊ณผ ๊ธฐ๋Šฅ์—ฐ๊ตฌ

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    Department of Medical Science๋‹ด๋„ ์•”์€ ์˜ˆํ›„๊ฐ€ ๋งค์šฐ ๋ถˆ๋Ÿ‰ํ•œ ๋Œ€ํ‘œ์ ์ธ ์•”์œผ๋กœ 5๋…„ ์ƒ์กด์œจ์ด ๋งค์šฐ ๋‚ฎ๊ณ  ๊ธฐ์กด์˜ ์ง„๋‹จ ๋ฐฉ๋ฒ•๋“ค๊ณผ ์ƒ์šฉ๋˜๋Š” ๋งˆ์ปค๋“ค์€ ํ™˜์ž์˜ ์•”์กฐ๊ธฐ ๋ฐœ๋ณ‘ ์ง„๋‹จ์— ์–ด๋ ค์›€์„ ๊ฐ–๊ณ  ์žˆ๋‹ค. ์•”์˜ ๋ฐœ์ƒ๊ณผ ์ง„ํ–‰๊ณผ์ • ์ค‘ Somatic mutation์œผ๋กœ ์ธํ•ด ์„œ๋กœ ๋‹ค๋ฅธ ์œ„์น˜์— ์กด์žฌํ•˜๋Š” ๋‘ ์œ ์ „์ž๊ฐ€ ์œ ์ „์  ๋ณ€์ด์— ์˜ํ•ด ๋‚˜๋ž€ํžˆ ๋ฐฐ์—ด๋จ์œผ๋กœ fusion gene์ด ๋ฐœ์ƒํ•˜๊ฒŒ ๋˜๋ฉฐ oncogenicํ•œ ํŠน์„ฑ์„ ๊ฐ–๊ฒŒ ๋œ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๋‹ด๋„ ์•” ํ™˜์ž์—์„œ ํŠน์ด์ ์œผ๋กœ ๋ฐœํ˜„๋˜๋Š” fusion gene์„ ๋™์ •ํ•˜๊ธฐ ์œ„ํ•ด ๋‹ด๋„ ์•” ํ™˜์ž์˜ ์•”์กฐ์ง๊ณผ ์ด์™€ ์ธ์ ‘ํ•œ ์ •์ƒ์กฐ์ง์—์„œ RNA๋ฅผ ์ถ”์ถœํ•˜์—ฌ RNA sequencing์„ ์ง„ํ–‰ํ•˜์—ฌ ๋„์ถœ๋œ sequencing ๊ฒฐ๊ณผ๋ฅผ ํ† ๋Œ€๋กœ fusion gene์„ ๊ฒ€์ถœํ•  ์ˆ˜ ์žˆ๋Š” ChimeraScan, Jaffa ๊ทธ๋ฆฌ๊ณ  Fusionchacher ๋ผ๋Š” ํˆด์„ ์ด์šฉํ•˜์—ฌ PUM1-TRAF3๋ฅผ ์„ ๋ณ„ํ•˜๊ฒŒ ๋˜์—ˆ๋‹ค. ์šฐ๋ฆฌ๋Š” 55๋ช…์˜ ๋‹ด๋„์•”ํ™˜์ž์™€ ๋‹ด๋„์•” ์„ธํฌ์ฃผ์—์„œ fusion gene์ด ๋ฐœํ˜„๋˜๋Š”์ง€ conventional PCR๊ณผ ddPCR์„ ํ†ตํ•ด ๊ฒ€์ฆํ•˜์˜€๊ณ  55๋ช…์˜ ํ™˜์ž์ค‘์—์„œ 28๋ช…์˜ ํ™˜์ž์—์„œ PUM1-TRAF3 fusion gene์ด ๋ฐœ๊ฒฌ๋˜์—ˆ์œผ๋ฉฐ ๊ทธ ๋นˆ๋„๋Š” 50.9%์ด๋‹ค. ๋‹ด๋„์•” ์„ธํฌ์ฃผ์—์„œ๋Š” ํ•ด๋‹น fusion gene์ด ๋ฐœํ˜„๋˜์ง€ ์•Š์•˜์œผ๋ฉฐ ๊ทธ์ค‘ SNU1196์— PUM1-TRAF3๋ฅผ ํ˜•์งˆ์ฃผ์ž…์‹œ์ผœ fusion protein์˜ ๊ณผ๋ฐœํ˜„์„ ์œ ๋„ํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ PUM1-TRAF3๋Š” EMT marker๋“ค์˜ ์ฆ๊ฐ€์™€ ์„ธํฌ ์ฆ์‹๋ ฅ๊ณผ ์ด๋™์„ฑ ๋ฐ ํด๋ก ํ˜•์„ฑ๋ ฅ์ด ์ฆ๊ฐ€ ํ•˜์˜€์œผ๋ฉฐ ์ด๋Ÿฌํ•œ ๋ฐœ๊ฒฌ์€ ๋‹ด๋„ ์•” ํ™˜์ž๋“ค์˜ ์˜ˆํ›„๋ฅผ ์˜ˆ์ธกํ•  ์ˆ˜ ์žˆ๋Š” ํ•˜๋‚˜์˜ ๋งˆ์ปค๋กœ์˜ ๊ฐ€๋Šฅ์„ฑ์„ ์‹œ์‚ฌํ•˜๊ณ  ์žˆ๋‹ค.open์„

    ้„ญๆ•พ๊ณผ ๏งกๆ˜ฅ? ๅฎถ้–€์˜ ็นช็•ต ้…ฌๆ‡‰ ็ก็ฉถ : ใ€Š่ฅฟๅœ’ๅธ–ใ€‹์„ ์ค‘์‹ฌ์œผ๋กœ

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ) --์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :๊ณ ๊ณ ๋ฏธ์ˆ ์‚ฌํ•™๊ณผ(๋ฏธ์ˆ ์‚ฌํ•™์ „๊ณต),2011.2.Maste

    ์ˆ™์„ฑ ํ™์–ด์˜ ์›ํ•ต์ƒ๋ฌผ ๊ตฐ์ง‘๊ตฌ์กฐ ๋ฐ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์ง€๊ตฌํ™˜๊ฒฝ๊ณผํ•™๋ถ€, 2014. 8. ์กฐ๋ณ‘์ฒ .Fermented skate is a popular traditional alkaline food in a few countries (e.g. Iceland and Korea). Alkaline fermentation of skate is performed by mainly microbes which are primarily derived from fresh skate and its associated marine environments. Decomposition of urea was a major source of ammonia observed in fermented skates. Quantitative PCR showed that bacterial abundance were much higher than archaeal abundance in both fresh and fermented skates, suggesting that bacteria, not archaea, play an important role in skate fermentation. Bacterial pyrosequencing analysis revealed that fresh skate was predominated by Psychrobacter- and Carnobacterium-like sequences, whereas 4 โ„ƒ-and 14 โ„ƒ-fermented skates were predominated by Atopostipes- and Myroides-like sequences, respectively. The most distinguishing feature of this study was that the order Lactobacillales were dominant in fresh and fermented skates. The order Lactobacillales is a major group of lactic acid bacteria (LAB), responsible for acidic fermentation. Probably, LAB is important in alkaline fermented seafood. Urease and arginine deiminase activity tests suggested that genera Pychrobacter and Carnobacterium play important roles in alkali fermentation of skate. Out of 211 isolated stains, 24 isolates were identified as putatively novel strains based on 16S rRNA gene similarity. Interestingly, about 42% (n=10) of the putatively novel strains belonged to order Lactobacillales, indicating that skates might be a useful source for finding novel marine LAB.Abstract Table of Contents List of Figures List of Tables List of Abbreviations 1. Introduction 2. Materials and Methods 3. Results 4. Discussion Supplementary Materials References ๊ตญ๋ฌธ์ดˆ๋ก (In Korean)Maste
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