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    ์กฐ์ง๊ตฌ์กฐ๊ฐ€ ์ง๋ฌดํƒˆ์ง„๊ฐ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๊ด€ํ•œ ์—ฐ๊ตฌ: ๊ณ ์šฉ์„ผํ„ฐ์˜ ์ผ์„ ๊ด€๋ฃŒ๋“ค์„ ์ค‘์‹ฌ์œผ๋กœ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ํ–‰์ •๋Œ€ํ•™์› : ํ–‰์ •๋Œ€ํ•™์› ํ–‰์ •ํ•™๊ณผ ํ–‰์ •ํ•™ ์ „๊ณต, 2016. 2. ์ตœํƒœํ˜„.๊ตญ๋ฌธ์ดˆ๋ก ์˜ฌํ•ด ์ดˆ, 150๋ช…์˜ ์‚ฌ๋ง์ž๋ฅผ ๋‚ธ ๋…์ผ ํ•ญ๊ณต์‚ฌ ์ €๋จผ์œ™์Šค(German wings) ํ•ญ๊ณต๊ธฐ์˜ ์ถ”๋ฝ์‚ฌ๊ณ ๊ฐ€ '์ง๋ฌดํƒˆ์ง„๊ฐ(๋ฒˆ์•„์›ƒ์ฆํ›„๊ตฐ)'์„ ์•“์€ ์กฐ์ข…์‚ฌ์™€ ๊ด€๋ จ์ด ์žˆ์—ˆ๋˜ ๊ฒƒ์œผ๋กœ ํ™•์ธ๋˜๋ฉด์„œ ์ง๋ฌดํƒˆ์ง„๊ฐ์ด ์ด์Šˆ๊ฐ€ ๋˜๊ณ  ์žˆ๋‹ค. ์ตœ๊ทผ ์–ธ๋ก ์—์„œ๋Š” ๋Œ€ํ•œ๋ฏผ๊ตญ์˜ ์ง์žฅ์ธ 85%๊ฐ€ ์ง๋ฌดํƒˆ์ง„๊ฐ์„ ์•“๊ณ  ์žˆ์Œ์„ ๋ณด๋„ํ•˜๋ฉด์„œ ํ•œ๊ตญ์‚ฌํšŒ๋„ ์ง๋ฌดํƒˆ์ง„๊ฐ์ด ์‹ฌ๊ฐํ•œ ์‚ฌํšŒ๋ฌธ์ œ๋กœ ์ด์–ด์งˆ ์ˆ˜ ์žˆ์Œ์„ ๊ฒฝ๊ณ ํ–ˆ๋‹ค. ์ตœ๊ทผ์—๋Š” ์„œ์šธ์‹œ์ฒญ ๊ณต๋ฌด์›๋“ค์˜ ์ž‡๋”ฐ๋ฅธ ์ž์‚ด ์›์ธ์ด ์ง๋ฌดํƒˆ์ง„๊ฐ ๋•Œ๋ฌธ์ด์—ˆ๋‹ค๋Š” ์œ ๊ฐ€์กฑ๊ณผ ๋™๋ฃŒ๋“ค์˜ ์ง„์ˆ ์ด ๋‚˜์˜ค๋ฉด์„œ ๋‹ค์‹œ ํ•œ ๋ฒˆ ์ง๋ฌดํƒˆ์ง„๊ฐ์— ๋Œ€ํ•œ ๊ด€์‹ฌ์ด ๋†’์•„์ง€๊ณ  ์žˆ๋‹ค. ์ด๋Š” ์ง๋ฌดํƒˆ์ง„๊ฐ์ด ์‚ฌ์กฐ์ง๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ๊ณต์กฐ์ง์—์„œ๋„ ๋‚˜ํƒ€๋‚˜๊ณ  ์žˆ๊ณ , ๊ณต๊ณต์กฐ์ง์ด ๊ฐ–๋Š” ์กฐ์ง๊ตฌ์กฐ์˜ ํŠน์ง•์ด ์ง๋ฌดํƒˆ์ง„๊ฐ์— ์–ด๋– ํ•œ ์˜ํ–ฅ์„ ์ฃผ๊ณ  ์žˆ๋Š”์ง€์— ๋Œ€ํ•œ ์—ฐ๊ตฌ ํ•„์š”์„ฑ์„ ์ œ์‹œํ•œ๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ๊ณ ์šฉ๋…ธ๋™๋ถ€ ์†Œ์†๊ธฐ๊ด€์ธ ๊ณ ์šฉ์„ผํ„ฐ์˜ ์กฐ์ง๊ตฌ์กฐ๊ฐ€ ์ผ์„ ๊ด€๋ฃŒ์˜ ์ง๋ฌดํƒˆ์ง„๊ฐ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์„ ์‚ดํŽด๋ณด์•˜๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์กฐ์ง๊ตฌ์กฐ์™€ ์ง๋ฌดํƒˆ์ง„๊ฐ ์‚ฌ์ด์— ๋ฆฌ๋”์‹ญ์ด ์กฐ์ ˆํšจ๊ณผ๊ฐ€ ์žˆ๋Š”์ง€ ๋ฐํ˜€๋‚ด๋Š” ๋ฐ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์ด ์žˆ๋‹ค. ๊ธฐ์กด์˜ ๋ณต์žก์„ฑ(complexity), ๊ณต์‹์„ฑ(formalization), ์ง‘๊ถŒํ™”(centralization) ์„ธ ๊ฐ€์ง€์˜ ์กฐ์ง๊ตฌ์กฐ์˜ ๊ธฐ๋ณธ๋ณ€์ˆ˜๋“ค์„ ๋ฐ”ํƒ•๋กœ ์—…๋ฌด๋ถ€๋‹ด์ธ์‹, ์žฌ๋Ÿ‰๊ถŒ, ์˜์‚ฌ๊ฒฐ์ • ์ฐธ์—ฌ๋„๋ฅผ ๋…๋ฆฝ๋ณ€์ˆ˜๋กœ ์„ค์ •ํ•˜์˜€๊ณ , ์ข…์†๋ณ€์ˆ˜๋Š” ์ง๋ฌดํƒˆ์ง„๊ฐ์ด๋‹ค. ์กฐ์ ˆ๋ณ€์ˆ˜๋Š” ๊ธฐ์กด ์„ ํ–‰์—ฐ๊ตฌ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ๋ณ€ํ˜์ ๋ฆฌ๋”์‹ญ์„ ์™ธ๋ถ€์ ๋ฆฌ๋”์‹ญ๊ณผ ๋‚ด๋ถ€์ ๋ฆฌ๋”์‹ญ์œผ๋กœ ์„ค์ •ํ•˜์˜€๋‹ค. ๊ธฐ์กด์˜ ๊ณต์กฐ์ง ์„ ํ–‰์—ฐ๊ตฌ ๋Œ€์ƒ๋“ค๊ณผ ๋‹ฌ๋ฆฌ ์ด ์—ฐ๊ตฌ์—์„œ๋Š” 86๊ฐœ์˜ ๊ณ ์šฉ๋…ธ๋™๋ถ€ ์†Œ์†๊ธฐ๊ด€ ์ „๊ตญ ๊ณ ์šฉ์„ผํ„ฐ ํŒ€์žฅ์ดํ•˜ ์ผ๋ฐ˜์ง์›(ํŒ€์žฅ ๋ฏธํฌํ•จ)์„ ๋Œ€์ƒ์œผ๋กœ ์—ฐ๊ตฌํ•˜์˜€๋‹ค. ๊ณ ์šฉ์„ผํ„ฐ ์ง์›๋“ค์€ ๊ตฌ์กฐํ™”๋œ ์„ค๋ฌธ์ง€๋ฅผ ํ™œ์šฉํ•œ ์„ค๋ฌธ์กฐ์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์˜€๋‹ค. ์ด ๋ฐ์ดํ„ฐ๋“ค์„ SPSSํ”„๋กœ๊ทธ๋žจ์„ ํ†ตํ•ด ํšŒ๊ท€๋ถ„์„ํ•˜์˜€๋‹ค. ์—ฐ๊ตฌ๊ฒฐ๊ณผ ์—…๋ฌด๋ถ€๋‹ด์ธ์‹์€ ์ง๋ฌดํƒˆ์ง„๊ฐ๊ณผ ์ •(+)์˜ ๊ด€๊ณ„์žˆ์œผ๋ฉฐ, ์žฌ๋Ÿ‰๊ถŒ์€ ์ง๋ฌดํƒˆ์ง„๊ฐ๊ณผ ๋ถ€(-)์˜ ๊ด€๊ณ„๊ฐ€ ์žˆ์Œ์ด ๋‚˜ํƒ€๋‚ฌ๋‹ค. ํ•˜์ง€๋งŒ ์˜์‚ฌ๊ฒฐ์ •์ฐธ์—ฌ๋„๋Š” ๋…๋ฆฝ๋ณ€์ˆ˜๋กœ์„œ ์ง๋ฌดํƒˆ์ง„๊ฐ๊ณผ ์ •(+)์˜ ๊ด€๊ณ„์— ์žˆ์œผ๋‚˜ ํšŒ๊ท€๋ถ„์„์„ ํ†ตํ•ด์„œ๋Š” ์œ ์˜๋ฏธํ•œ ๊ฒฐ๊ณผ๊ฐ€ ๋‚˜ํƒ€๋‚˜์ง€ ์•Š์•˜๋‹ค. ์™ธ๋ถ€์ ๋ฆฌ๋”์‹ญ์˜ ์กฐ์ ˆํšจ๊ณผ์—์„œ๋Š” ์—…๋ฌด๋ถ€๋‹ด์ธ์‹๊ณผ ์ง๋ฌดํƒˆ์ง„๊ฐ ์‚ฌ์ด์—์„œ ์™ธ๋ถ€์ ๋ฆฌ๋”์‹ญ์ด ์œ ์˜๋ฏธํ•œ ๊ฒฐ๊ณผ๋ฅผ ๊ฐ€์ ธ์˜ค์ง€ ์•Š์•˜๋‹ค. ๋ฐ˜๋ฉด์— ์˜์‚ฌ๊ฒฐ์ •์ฐธ์—ฌ๋„๋Š” ์™ธ๋ถ€์ ๋ฆฌ๋”์‹ญ์ด ๋‚˜ํƒ€๋‚ฌ์„ ๋•Œ, ์ง๋ฌดํƒˆ์ง„๊ฐ์„ ๋†’์ด๋Š” ํšจ๊ณผ๋ฅผ ๊ฐ€์ ธ์˜ค๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๋‚ด๋ถ€์ ๋ฆฌ๋”์‹ญ์˜ ์กฐ์ ˆํšจ๊ณผ์—์„œ๋Š” ์—…๋ฌด๋ถ€๋‹ด์ธ์‹๊ณผ ์ง๋ฌดํƒˆ์ง„๊ฐ, ์žฌ๋Ÿ‰๊ถŒ๊ณผ ์ง๋ฌดํƒˆ์ง„๊ฐ ์‚ฌ์ด ๋ชจ๋‘์—์„œ ์œ ์˜๋ฏธํ•œ ๊ฒฐ๊ณผ๊ฐ€ ๋‚˜ํƒ€๋‚˜์ง€ ์•Š์•˜๋‹ค. ๋ณธ ์—ฐ๊ตฌ์˜ ์—ฐ๊ตฌ๊ฒฐ๊ณผ๋ฅผ ์ข…ํ•ฉํ•ด ๋ณด๋ฉด, ์ง๋ฌดํƒˆ์ง„๊ฐ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์š”์ธ์€ ์กฐ์ง์˜ ๊ตฌ์กฐ์—์„œ๋„ ๋‚˜ํƒ€๋‚˜๋ฉฐ ์ง๋ฌดํƒˆ์ง„๊ฐ์— ๋Œ€ํ•œ ์˜ˆ๋ฐฉ๊ณผ ์ด๋ฅผ ์œ„ํ•œ ๋Œ€์ฒ˜ ๋ฐฉ์•ˆ์ด ์กฐ์ง์˜ ๊ตฌ์กฐ์  ์ธก๋ฉด์—์„œ๋„ ์ด๋ฃจ์–ด์ ธ์•ผ ํ•œ๋‹ค๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ๋‹ค. ๊ณ ์šฉํ™˜๊ฒฝ๊ณผ ์ด๋ฅผ ๋ฐ˜์˜ํ•˜๋Š” ๊ณ ์šฉ์ •์ฑ…์„ ์ˆ˜์šฉํ•˜์—ฌ ์ œ๊ณตํ•˜๋Š” ๊ณผ์ •์—์„œ ๊ณ ์šฉ์„ผํ„ฐ๋Š” ์กฐ์ง์— ๋Œ€ํ•œ ๋ถ„์„๊ณผ ๊ตฌ์„ฑ์›์— ๋Œ€ํ•œ ์ดํ•ด๊ฐ€ ๋ถ€์กฑํ–ˆ๋‹ค. ์ด๋Ÿฌํ•œ ์กฐ์ง์˜ ์ƒํ™ฉ์€ ์ ์ฐจ ๊ณ ์šฉ์„ผํ„ฐ ์กฐ์ง์›๋“ค์˜ ์ง๋ฌดํƒˆ์ง„๊ฐ์„ ๋†’์˜€๋‹ค. ๊ณ ์šฉ์„ผํ„ฐ ์ผ์„ ๊ด€๋ฃŒ๋“ค์˜ ์ง๋ฌดํƒˆ์ง„๊ฐ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์—…๋ฌด๋ถ€๋‹ด์ธ์‹์„ ํ•ด์†Œํ•˜๊ณ  ์žฌ๋Ÿ‰๊ถŒ์„ ํ™•๋ณดํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ์ฒด๊ณ„์ ์ธ ์ง๋ฌด๋ถ„์„์„ ํ†ตํ•œ ์—…๋ฌด๋ถ„์žฅ์ด ํ•„์š”ํ•˜๋‹ค. ํŠน์ • ์ง์›์ด๋‚˜ ๋ถ€์„œ์— ์—…๋ฌด๊ฐ€ ํŽธ์ค‘๋˜๋Š” ํ˜„์ƒ์„ ๊ฐœ์„ ํ•˜๊ณ  ์—…๋ฌด๋ถ„์žฅ์„ ์œ„ํ•œ ๋ช…๋ฃŒํ•œ ์ ˆ์ฐจ์™€ ์ดํ›„ ์กฐ์ง๊ตฌ์„ฑ์›๋“ค์ด ๋ถ„์žฅ๋œ ์—…๋ฌด์— ์ง‘์ค‘ํ•  ์ˆ˜ ์žˆ๋Š” ์‹œ์Šคํ…œ์„ ํ™•๋ฆฝํ•œ๋‹ค๋ฉด ์ง๋ฌดํƒˆ์ง„๊ฐ์„ ์™„ํ™”ํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋‹ค. ์™ธ๋ถ€์ ๋ฆฌ๋”์‹ญ๊ณผ ๋‚ด๋ถ€์ ๋ฆฌ๋”์‹ญ์˜ ์กฐ์ ˆํšจ๊ณผ๋Š” ์ผ์„ ๊ด€๋ฃŒ์˜ ์˜์‚ฌ๊ฒฐ์ •์ฐธ์—ฌ๋„๊ฐ€ ๋†’์€ ์ƒํ™ฉ์—์„œ ๋ฆฌ๋”๊ฐ€ ๊ตฌ์„ฑ์›๋“ค๊ณผ ์ธ๊ฐ„์ ์ธ ์œ ๋Œ€๊ด€๊ณ„๋ฅผ ๋งบ๊ณ  ์นœ๋ฐ€๊ฐ๊ณผ์„ ํ˜•์„ฑํ•˜๋Š” ๊ฒƒ๋„ ์ง๋ฌดํƒˆ์ง„๊ฐ์„ ๋†’์ด๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚œ๋‹ค. ๊ตฌ์„ฑ์›๋“ค์˜ ์ธ๊ฐ„์  ์œ ๋Œ€๊ด€๊ณ„๋„ ์ง๋ฌดํƒˆ์ง„๊ฐ์— ์˜ํ–ฅ์„ ์ค„ ์ˆ˜ ์žˆ๋Š” ์ค‘์š”ํ•œ ์‚ฌ์‹ค์„ ๋ฐœ๊ฒฌํ•  ์ˆ˜ ์žˆ๋‹ค. ์ด๋Ÿฌํ•œ ๊ฒฐ๊ณผ๋Š” ํ–ฅํ›„ ์ง๋ฌดํƒˆ์ง„๊ฐ์„ ๊ด€๋ฆฌํ•˜๋Š” ๋ฐ์— ๋ฆฌ๋”์™€ ๊ตฌ์„ฑ์›๋“ค ๊ฐ„์˜ ์ธ๊ฐ„๊ด€๊ณ„ํ˜•์„ฑ๊ณผ ์œ ์ง€, ์ด๋ฅผ ์œ„ํ•œ ๋ฆฌ๋”์˜ ์—ญํ• ์„ ์ œ์‹œํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋‹ค. ์ฃผ์š”์–ด: ์—…๋ฌด๋ถ€๋‹ด์ธ์‹, ์žฌ๋Ÿ‰๊ถŒ, ์˜์‚ฌ๊ฒฐ์ •์ฐธ์—ฌ๋„, ์ง๋ฌดํƒˆ์ง„๊ฐ, ์™ธ๋ถ€์ ๋ฆฌ๋”์‹ญ, ๋‚ด๋ถ€์ ๋ฆฌ๋”์‹ญ ํ•™๋ฒˆ: 2013-21910โ… . ์„œ๋ก : ์—ฐ๊ตฌ๋ชฉ์  ๋ฐ ํ•„์š”์„ฑ 1 โ…ก. ์ด๋ก ์  ๋…ผ์˜์™€ ์„ ํ–‰์—ฐ๊ตฌ ๊ฒ€ํ†  4 1. ์กฐ์ง๊ตฌ์กฐ 4 1) ๋ณต์žก์„ฑ(complexity)๊ณผ ์—…๋ฌด๋ถ€๋‹ด(overload)์ธ์‹ 5 2) ๊ณต์‹์„ฑ(formalization)๊ณผ ์žฌ๋Ÿ‰๊ถŒ 6 3) ์ง‘๊ถŒํ™”(centralization)์™€ ์˜์‚ฌ๊ฒฐ์ •์ฐธ์—ฌ๋„ 7 2. ์ง๋ฌดํƒˆ์ง„๊ฐ (Burnout) 9 1) ์ง๋ฌดํƒˆ์ง„๊ฐ(Burnout) 9 2) ์ง๋ฌด์ŠคํŠธ๋ ˆ์Šค์™€ ์ง๋ฌดํƒˆ์ง„๊ฐ 10 3) ์กฐ์ง๊ตฌ์กฐ์™€ ์ง๋ฌดํƒˆ์ง„๊ฐ์— ๊ด€ํ•œ ์„ ํ–‰์—ฐ๊ตฌ ๊ฒ€ํ†  11 3. ๋ณ€ํ˜์ ๋ฆฌ๋”์‹ญ 15 1) ๋ณ€ํ˜์ ๋ฆฌ๋”์‹ญ 15 2) ๊ณต์กฐ์ง์—์„œ์˜ ๋ณ€ํ˜์ ๋ฆฌ๋”์‹ญ 16 4. ์„ ํ–‰์—ฐ๊ตฌ์˜ ๋น„ํŒ์  ๊ฒ€ํ†  20 โ…ข. ์—ฐ๊ตฌ์„ค๊ณ„ 22 1. ์—ฐ๊ตฌ๋ชจํ˜•๊ณผ ์—ฐ๊ตฌ๊ฐ€์„ค 22 2. ์กฐ์ž‘์  ์ •์˜ 25 1) ๋…๋ฆฝ๋ณ€์ˆ˜ 25 2) ์ข…์†๋ณ€์ˆ˜ - ์ง๋ฌดํƒˆ์ง„๊ฐ 26 3) ์กฐ์ ˆ๋ณ€์ˆ˜- ์™ธ๋ถ€์ ๋ฆฌ๋”์‹ญ๊ณผ ๋‚ด๋ถ€์ ๋ฆฌ๋”์‹ญ 26 3. ์—ฐ๊ตฌ๋ฐฉ๋ฒ• ๋ฐ ํ‘œ๋ณธ๊ตฌ์„ฑ 29 1) ์ž๋ฃŒ์ˆ˜์ง‘ ๋ฐ ๋ณ€์ˆ˜์˜ ์ธก์ • 29 2) ์ธ๊ตฌํ†ต๊ณ„ํ•™์  ๋ถ„์„(ํ‘œ๋ณธํŠน์„ฑ) 29 โ…ฃ. ๋ถ„์„๊ฒฐ๊ณผ 31 1. ์ธก์ •๋„๊ตฌ: ์„ค๋ฌธ๋ฌธํ•ญ์˜ ๊ตฌ์„ฑ ๋ฐ ์‹ ๋ขฐ๋„ 31 2. ๊ธฐ์ˆ ํ†ต๊ณ„๋ถ„์„๊ณผ ์ƒ๊ด€๊ด€๊ณ„๋ถ„์„ 35 1) ๊ธฐ์ˆ ํ†ต๊ณ„๋ถ„์„ 35 2) ์ƒ๊ด€๊ด€๊ณ„๋ถ„์„ 37 3. ํšŒ๊ท€๋ถ„์„ 39 1) ๊ฐ€์„ค 1 ๊ฒ€์ฆ 40 2) ๊ฐ€์„ค 2 ๊ฒ€์ฆ 42 3) ๊ฐ€์„ค 3 ๊ฒ€์ฆ 44 โ…ค. ๊ฒฐ๋ก ๊ณผ ์ •์ฑ…์  ํ•จ์˜ 49 1. ๊ณ ์šฉ์„ผํ„ฐ ์ผ์„ ๊ด€๋ฃŒ๋“ค์˜ ์ง๋ฌดํƒˆ์ง„๊ฐ 49 2. ์กฐ์ ˆ๋ณ€์ˆ˜๋กœ์„œ์˜ ์™ธ๋ถ€์ ๋ฆฌ๋”์‹ญ๊ณผ ๋‚ด๋ถ€์ ๋ฆฌ๋”์‹ญ์˜ ์ค‘์š”์„ฑ 50 โ…ฅ. ์ฐธ๊ณ ๋ฌธํ—Œ 53 Abstract 66Maste

    ๋ฌด์‹ฌํ๊ธฐ ๊ด€์ƒ๋™๋งฅ ์šฐํšŒ์ˆ ์„ ๋ฐ›๋Š” ํ™˜์ž์˜ ์ˆ˜์ˆ  ์ค‘ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„์™€ ์ˆ˜์ˆ  ํ›„ ์„ฌ๋ง ๋ฐœ์ƒ์˜ ์ƒ๊ด€๊ด€๊ณ„

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :์˜๊ณผ๋Œ€ํ•™ ์˜ํ•™๊ณผ,2020. 2. ์ „์œค์„.Introduction: Cerebral oximetry has been widely used to measure regional oxygen saturation in brain tissue, especially during cardiac surgery. Despite its popularity, there have been inconsistent results on the use of cerebral oximetry during cardiac surgery, and few studies have evaluated cerebral oximetry during off pump coronary bypass graft surgery (OPCAB). Methods: Between October 2004 and December 2016, 1,439 patients underwent OPCAB. Among them, 815 patients with sufficient data on regional cerebral oxygen saturation (rSO2) were enrolled in this study. Retrospectively, we analysed perioperative variables and the reduction in rSO2 below cut-off values of 75%, 70%, 65%, 60%, 55%, 50%, 45%, 40%, and 35%. Furthermore, we evaluated the relationship between the reduction in rSO2 and postoperative delirium. Results: Delirium occurred in 105 of 815 patients. In both univariable and multivariable analyses, the duration of rSO2 reduction was significantly longer in patients with delirium at cut-offs of <50% and 45% (for every 5min, adjusted odds ratio (OR) 1.007, 95% confidence interval [CI] 1.001-1.014; and adjusted OR 1.012, 95% CI,1.003-1.021; p=0.024 and 0.011, respectively). The proportion of patients with an rSO2 reduction <45% was significantly higher among those with delirium (adjusted OR 1.737, 95% CI 1.064-2.836, p=0.027). Conclusions: In patients undergoing OPCAB, intraoperative rSO2 was associated with postoperative delirium. The cut-off values for intraoperative rSO2 were 50% for the total patient population and 55% for patients younger than 68 years.์„œ๋ก :ใ€€๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„๋Š” ๋‡Œ ์กฐ์ง์˜ ๊ตญ์†Œ์  ์‚ฐ์†Œ ํฌํ™”๋„๋ฅผ ์ธก์ •ํ•˜๊ธฐ ์œ„ํ•ด, ํŠนํžˆ ์‹ฌ์žฅ์ˆ˜์ˆ ์—์„œ, ๊ด‘๋ฒ”์œ„ํ•˜๊ฒŒ ์‚ฌ์šฉ ๋˜์–ด ์™”๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๊ทธ ๋Œ€์ค‘์„ฑ์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ , ์‹ฌ์žฅ ์ˆ˜์ˆ  ์ค‘ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„์˜ ์‚ฌ์šฉ์— ๋Œ€ํ•œ ๊ฒฐ๊ณผ๋Š” ์ผ๊ด€๋˜์ง€ ์•Š์•˜๊ณ , ๋ฌด์‹ฌํ๊ธฐ ๊ด€์ƒ๋™๋งฅ ์šฐํšŒ์ˆ  ์ค‘์˜ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„๋ฅผ ํ‰๊ฐ€ํ•œ ์—ฐ๊ตฌ๋Š” ๊ฑฐ์˜ ์—†์—ˆ๋‹ค. ๋ฐฉ๋ฒ•: 2004๋…„ 10์›”๋ถ€ํ„ฐ 2016๋…„ 12์›”๊นŒ์ง€, 1,439๋ช…์˜ ํ™˜์ž๊ฐ€ ๋ฌด์‹ฌํ๊ธฐ ๊ด€์ƒ๋™๋งฅ ์šฐํšŒ์ˆ ์„ ์‹œํ–‰๋ฐ›์•˜๋‹ค. ๊ทธ ์ค‘, ๊ตญ์†Œ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„์— ๋Œ€ํ•œ ์ถฉ๋ถ„ํ•œ ์–‘์˜ ๋ฐ์ดํ„ฐ๋ฅผ ๊ฐ€์ง„ 815๋ช…์˜ ํ™˜์ž๊ฐ€ ์—ฐ๊ตฌ์— ํฌํ•จ๋˜์—ˆ๋‹ค. ํ›„ํ–ฅ์ ์œผ๋กœ, ์ฃผ์ˆ ๊ธฐ ๋ณ€์ˆ˜๋“ค๊ณผ ๊ตญ์†Œ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„์˜ 75%, 70%, 65%, 60%, 55%, 50%, 45%, 40%, ๊ทธ๋ฆฌ๊ณ  35% ์˜ ์ปท์˜คํ”„ ๊ฐ’ ์ดํ•˜๋กœ ๊ฐ์†Œํ•œ ์ด ์‹œ๊ฐ„์„ ๋ถ„์„ํ•˜์˜€๋‹ค. ๋˜ํ•œ, ๊ตญ์†Œ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„์˜ ๊ฐ์†Œ์™€ ์ˆ˜์ˆ  ํ›„ ์„ฌ๋ง ๋ฐœ์ƒ ๊ฐ„์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ํ‰๊ฐ€ํ•˜์˜€๋‹ค. ๊ฒฐ๊ณผ: 815๋ช…์˜ ํ™˜์ž ์ค‘ 105๋ช…์—์„œ ์„ฌ๋ง์ด ๋ฐœ์ƒํ•˜์˜€๋‹ค. ๋‹จ๋ณ€์ˆ˜ ๋ฐ ๋‹ค๋ณ€์ˆ˜ ๋ถ„์„ ๋ชจ๋‘์—์„œ, ์„ฌ๋ง์ด ๋ฐœ์ƒํ•œ ํ™˜์ž ๊ตฐ์—์„œ ์ปท์˜คํ”„ ๊ฐ’ 50%, ๊ทธ๋ฆฌ๊ณ  45% ์ดํ•˜๋กœ์˜ ๊ตญ์†Œ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„์˜ ๊ฐ์†Œ๊ฐ€ ์œ ์˜ํ•˜๊ฒŒ ๊ธธ์—ˆ๋‹ค(๋งค 5๋ถ„๋งˆ๋‹ค, ๊ต์ •๋œ ์˜ค์ฆˆ๋น„์™€ 95% ์‹ ๋ขฐ๊ตฌ๊ฐ„์€ ๊ฐ๊ฐ 1.007, 1.001-1.014, ๊ทธ๋ฆฌ๊ณ  1.012, 1.003-1.021, p-value๋Š” ๊ฐ๊ฐ 0.024, 0.011). ๊ตญ์†Œ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„์˜ 45% ์ดํ•˜๋กœ์˜ ๊ฐ์†Œ ๋น„์œจ์€ ์„ฌ๋ง์ด ๋ฐœ์ƒํ•œ ํ™˜์ž๊ตฐ์—์„œ ์œ ์˜ํ•˜๊ฒŒ ๋†’์•˜๋‹ค(๊ต์ •๋œ ์˜ค์ฆˆ๋น„ 1.737, 95% ์‹ ๋ขฐ๊ตฌ๊ฐ„์€ 1.064-2.836, p-value๋Š” 0.027). ๊ฒฐ๋ก : ๋ฌด์‹ฌํ๊ธฐ ๊ด€์ƒ๋™๋งฅ ์น˜ํ™˜์ˆ ์„ ๋ฐ›๋Š” ํ™˜์ž์—์„œ, ์ˆ˜์ˆ  ์ค‘ ๊ตญ์†Œ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„๋Š” ์ˆ˜์ˆ  ํ›„ ์„ฌ๋ง์˜ ๋ฐœ์ƒ๊ณผ ๊ด€๋ จ์ด ์žˆ์—ˆ๋‹ค. ์ˆ˜์ˆ  ์ค‘ ๊ตญ์†Œ ๋Œ€๋‡Œ ์‚ฐ์†Œ ํฌํ™”๋„์˜ ์ปท์˜คํ”„ ๊ฐ’์€ ์ „์ฒด ํ™˜์ž๊ตฐ์—์„œ๋Š” 50%, 68์„ธ ์ดํ•˜์˜ ํ™˜์ž๊ตฐ์—์„œ๋Š” 55% ์˜€๋‹ค.Introduction 1 Methods 3 Study population and anesthetic methods 3 Data collection and definition 4 Statistical analysis 5 Results 7 Discussion 11 References 16 Tables 21 Figures 38 Abstract in Korean 40Maste

    ๆ—ฅๅธธ็š„ ๋Œ€์ƒ์— ํˆฌ์‚ฌ๋œ ๅฟƒๅƒ่กจๅ‡บ ์—ฐ๊ตฌ : ๆœฌไบบ์˜ ไฝœๅ“์„ ไธญๅฟƒ์œผ๋กœ

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :๋™์–‘ํ™”๊ณผ ๋™์–‘ํ™”์ „๊ณต,2003.Maste

    Concentration of Large Housing Builders in Korean Housing Supply Market

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ํ™˜๊ฒฝ๋Œ€ํ•™์› : ํ™˜๊ฒฝ๊ณ„ํšํ•™๊ณผ, 2014. 2. ์ตœ๋ง‰์ค‘.์ผ๋ฐ˜์ ์ธ ์ฃผํƒ์‹œ์žฅ์€ ๋‹ค์ˆ˜์˜ ์†Œ๊ทœ๋ชจ ๊ฑด์„ค์—…์ฒด๊ฐ€ ๊ฒฝ์Ÿํ•˜๋ฉฐ ๊ณต๊ธ‰ํ•˜๋Š” ์ฒด์ œ์ธ๋ฐ ๋น„ํ•ด ์šฐ๋ฆฌ๋‚˜๋ผ๋Š” ์†Œ์ˆ˜์˜ ๋Œ€๊ทœ๋ชจ ๊ฑด์„ค์—…์ฒด์— ์ง‘์ค‘๋˜์–ด ์žˆ๋Š” ์ฒด์ œ์ด๋‹ค. ๊ทธ ์ด์œ ๋Š” ์ •๋ถ€์ •์ฑ…, ๊ฑด์„ค์—…์ฒด์˜ ์ด์œค์ถ”๊ตฌ์ „๋žต, ์ˆ˜์š”์ž์˜ ์„ ํ˜ธ ๋“ฑ์œผ๋กœ ์„ค๋ช…ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ •๋ถ€์˜ ์ฃผํƒ์ •์ฑ…๊ณผ ๊ธˆ์œต์ •์ฑ…์€ ๋Œ€๊ธฐ์—…์— ์œ ๋ฆฌํ•œ ์‹œ์žฅ ํ™˜๊ฒฝ์„ ์กฐ์„ฑํ–ˆ๋‹ค. ๊ฒฝ์ œ์„ฑ์žฅ๊ธฐ์— ๋„์‹œํ™”๋กœ ์ธํ•ด ์ˆ˜๋„๊ถŒ์œผ๋กœ ์ธ๊ตฌ๊ฐ€ ์ง‘์ค‘๋˜๋ฉด์„œ ์ฃผํƒ๋ถ€์กฑ๋ฌธ์ œ๊ฐ€ ๋Œ€๋‘๋˜์—ˆ๊ณ  ์ •๋ถ€๋Š” ์ด๋ฅผ ๋‹จ๊ธฐ๊ฐ„์— ํ•ด๊ฒฐํ•˜๊ธฐ ์œ„ํ•ด ๋Œ€๊ทœ๋ชจ ์ฃผํƒ๊ฑด์„ค์„ ๊ณ„ํšํ–ˆ๋‹ค. ํ•œํŽธ ๋ถ€๋™์‚ฐ ์‹œ์žฅ์— ์ž๊ธˆ์œ ์ž…์„ ์ฐจ๋‹จํ–ˆ๋˜ ๊ธˆ์œต์ •์ฑ…์œผ๋กœ ์ค‘์†Œ๊ธฐ์—…์€ ์ƒ๋Œ€์ ์œผ๋กœ ์ž๊ธˆ์กฐ๋‹ฌ์ด ์–ด๋ ค์› ์ง€๋งŒ ๊ฒฝ์ œ์„ฑ์žฅ๊ณผ ํ•จ๊ป˜ ๋ง‰๋Œ€ํ•œ ์ž๋ณธ์„ ์ถ•์ ํ•œ ์žฌ๋ฒŒ๊ธฐ์—…์˜ ๋Œ€ํ˜•๊ฑด์„ค์—…์ฒด๋Š” ๋ชจ๊ธฐ์—…์˜ ํƒ„ํƒ„ํ•œ ์ž๊ธˆ๋ ฅ์„ ๋ฐ”ํƒ•์œผ๋กœ ๋Œ€๊ทœ๋ชจ ์•„ํŒŒํŠธ ๋‹จ์ง€๋ฅผ ๊ฑด์„คํ•  ์ˆ˜ ์žˆ์—ˆ๋‹ค. ํ•œํŽธ, ์ฃผํƒ๊ฑด์„ค์—…์ฒด๊ฐ€ ์ด์œค์„ ๋‚จ๊ธฐ๋Š” ์ „๋žต์—๋Š” ํ† ์ง€๋งค์ž…๊ฐ€๊ฒฉ์„ ๋‚ฎ์ถ”๊ฑฐ๋‚˜, ๊ฑด์„ค๋น„์šฉ์„ ์ ˆ๊ฐํ•˜๊ฑฐ๋‚˜, ๊ณ ๋ถ€๊ฐ€๊ฐ€์น˜์˜ ์ฃผํƒ์„ ์ƒ์‚ฐํ•˜์—ฌ ๋†’์€ ๊ฐ€๊ฒฉ์— ํŒ๋งคํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ํ† ์ง€๋Š” ๋Œ€๋ถ€๋ถ„ ๊ณต๊ณต์—์„œ ๊ณต๊ธ‰ํ•˜๊ณ  ์žˆ์—ˆ๊ณ , ๊ฑด์„ค๋น„์šฉ์€ ์ ˆ๊ฐํ•˜๊ธฐ ์–ด๋ ค์› ์œผ๋ฉฐ, ๋ถ„์–‘๊ฐ€ ์ƒํ•œ์ œ๋กœ ์ฃผํƒ๊ฐ€๊ฒฉ ๋˜ํ•œ ๋ฌถ์—ฌ์žˆ๋Š” ์ƒํƒœ์˜€๋‹ค. ์ด๋Ÿฌํ•œ ์ƒํ™ฉ์—์„œ ๋Œ€ํ˜•๊ฑด์„ค์—…์ฒด๊ฐ€ ํšŒ์‚ฌ ๊ทœ๋ชจ๋ฅผ ์œ„์ง€ํ•˜๊ธฐ ์œ„ํ•ด ๋Œ€๊ทœ๋ชจ ์ด์œค์„ ์ทจ๋“ํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ๋ฌผ๋Ÿ‰์„ ๋Œ€๊ฑฐ ํ™•๋Œ€ํ•˜๋Š” ์ˆ˜๋ฐ–์— ์—†์—ˆ๋‹ค. ์ด์— ๋”ฐ๋ผ ๋Œ€๊ธฐ์—…์— ์˜ํ•œ ๋Œ€๋Ÿ‰๊ณต๊ธ‰์ฒด์ œ๊ฐ€ ํ˜•์„ฑ๋˜๊ฒŒ ๋œ ๊ฒƒ์ด๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ˆ˜์š”์ธก๋ฉด์—์„œ๋„ ์•„ํŒŒํŠธ ๊ฑฐ์ฃผ๋Š” ์ค‘์‚ฐ์ธต์˜ ์ƒ์ง•์ด์—ˆ์œผ๋ฉฐ ์•„ํŒŒํŠธ ๊ฐ€๊ฒฉ์ด ๊ณ„์† ์˜ค๋ฅด๋Š” ์ƒํ™ฉ์—์„œ ์•ˆ์ •์ ์ธ ํˆฌ์ž์ฒ˜๋ผ๋Š” ์ธ์‹์ด ํ™•์‚ฐ๋˜์–ด ์‹œ์žฅ์—๋Š” ์•„ํŒŒํŠธ์— ๋Œ€ํ•œ ๋Œ€๋Ÿ‰์ˆ˜์š”๊ฐ€ ์กด์žฌํ–ˆ๋‹ค. ๋˜ํ•œ ๋ถ„์–‘๊ธˆ์„ ์„ ์ง€๊ธ‰ํ•  ๋•Œ ๋ถ€๋„์œ„ํ—˜์ด ๋‚ฎ์€ ๋Œ€๊ธฐ์—…์˜ ๋ธŒ๋žœ๋“œ ์•„ํŒŒํŠธ๋ฅผ ์„ ํ˜ธํ–ˆ๋‹ค. ์ฆ‰ ์‹œ์žฅ์ˆ˜์š”๊ฐ€ ๋Œ€๊ธฐ์—…์˜ ๋ธŒ๋žœ๋“œ ์•„ํŒŒํŠธ ๋Œ€๋Ÿ‰๊ณต๊ธ‰์„ ํก์ˆ˜ํ•  ์ˆ˜ ์žˆ์„ ๋งŒํผ ๋Œ€๋Ÿ‰์œผ๋กœ ์กด์žฌํ–ˆ๊ธฐ ๋•Œ๋ฌธ์— ๋Œ€๊ธฐ์—… ์œ„์ฃผ์˜ ๋Œ€๋Ÿ‰๊ณต๊ธ‰์ฒด์ œ๊ฐ€ ์ง€์†๋  ์ˆ˜ ์žˆ์—ˆ๋˜ ๊ฒƒ์ด๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ํ˜„์žฌ ์ฃผํƒ์ˆ˜์š”๋Š” ๋ณ€ํ™”ํ•˜๊ณ  ์žˆ๋‹ค. ์ƒํ™œ์ˆ˜์ค€์ด ํ–ฅ์ƒ๋˜๊ณ  ์ฃผํƒ์— ๋Œ€ํ•œ ์š”๊ตฌ๊ฐ€ ๋ณ€ํ™”ํ•˜๋ฉด์„œ ์‹œ์žฅ์ˆ˜์š”๋Š” ์—ฐ๋ น์ธต๋ณ„, ์†Œ๋“๊ณ„์ธต๋ณ„๋กœ ์„ธ๋ถ„ํ™”๋˜๊ณ  ์žˆ๋‹ค. ํŒŒํŽธ์ ์ธ ์ฃผํƒ์ˆ˜์š”๋Š” ๋” ์ด์ƒ ์ฒœํŽธ์ผ๋ฅ ์ ์ธ ์•„ํŒŒํŠธ ๋Œ€๋Ÿ‰๊ณต๊ธ‰์„ ํก์ˆ˜ํ•  ์ˆ˜ ์—†๋‹ค. ๋˜ํ•œ ์•„ํŒŒํŠธ ๋ถˆํŒจ์˜ ์‹ ํ™”๊ฐ€ ๊นจ์ง€๋ฉด์„œ ์ง€๋ฐฉ์— ์ด์–ด ์ˆ˜๋„๊ถŒ์—์„œ๋„ ๋ฏธ๋ถ„์–‘์‚ฌํƒœ๊ฐ€ ์ผ์–ด๋‚˜๊ณ  ์žˆ๊ณ , ์ฃผํƒ๋งค๋งค๊ฑฐ๋ž˜๊ฑด์ˆ˜๊ฐ€ ๊ฐ์†Œํ•˜๋ฉฐ ์ฃผํƒ๊ฐ€๊ฒฉ๋„ ํ•˜๋ฝ์„ธ๋ฅผ ๋ฉด์น˜ ๋ชปํ•˜๊ณ  ์žˆ๋‹ค. ์ˆ˜์š”๊ฐ€ ๋ณ€ํ™”ํ•จ์— ๋”ฐ๋ผ ๊ณต๊ธ‰์ฒด์ œ์—๋„ ๋ณ€ํ™”๊ฐ€ ์ผ์–ด๋‚˜๊ณ  ์žˆ์ง€๋งŒ ์—ฌ์ „ํžˆ ์ฃผํƒ๊ณต๊ธ‰์ฒด์ œ๋Š” ๋Œ€๊ธฐ์—… ์˜์กด๋„๊ฐ€ ๋†’๋‹ค. ์ฃผํƒ๊ณต๊ธ‰์ฒด์ œ์˜ ๋Œ€๊ทœ๋ชจ ๊ตฌ์กฐ์กฐ์ •์— ๋Œ€์‘ํ•˜๊ธฐ ์œ„ํ•ด์„œ ํ˜„ ์ฒด์ œ๋ฅผ ๊ฐ๊ด€์ ์œผ๋กœ ํ‰๊ฐ€ํ•˜๋Š” ์ž‘์—…์ด ํ•„์š”ํ•˜๋‹ค. ์ฆ‰, ์ฃผํƒ๊ณต๊ธ‰์ด ์–ผ๋งˆ๋‚˜ ๋Œ€๊ธฐ์—…์— ์ง‘์ค‘๋˜์–ด ์žˆ๋Š”์ง€, ๊ทธ ํŠน์„ฑ์€ ๋ฌด์—‡์ธ์ง€ ํŒŒ์•…ํ•ด์•ผ ํ•œ๋‹ค. ์ด๋ฅผ ์œ„ํ•ด ์ „๊ตญ ์•„ํŒŒํŠธํ˜„ํ™ฉ์ž๋ฃŒ์™€ ๋Œ€ํ˜•๊ฑด์„ค์—…์ฒด์˜ ์ฃผํƒ๊ฑด์„ค์‹ค์ ์„ ํ†ตํ•ด ์ง‘์ค‘๋„๋ฅผ ์‚ดํŽด๋ณด์•˜๊ณ , ๋Œ€ํ˜•๊ฑด์„ค์—…์ฒด์˜ ์—ฐ๊ฐ„ ์ฃผ๊ฑฐ์šฉ๊ฑด๋ฌผ๊ฑด์„ค์—… ๋งค์ถœ์•ก์„ ํ† ๋Œ€๋กœ ์‹œ์žฅ์ง‘์ค‘๋„๋น„์œจ, ์ง€๋‹ˆ๊ณ„์ˆ˜ ๋ฐ ๋กœ๋ Œ์ธ ๊ณก์„ , ์ˆœ์œ„๊ทœ๋ชจ๋ฒ•์น™์˜ ์ˆ˜์œ„๋„๋ฅผ ๊ตฌํ•˜์—ฌ ๋Œ€๊ธฐ์—…์ง‘์ค‘์˜ ํŠน์„ฑ์„ ํŒŒ์•…ํ–ˆ๋‹ค. ๋Œ€๊ธฐ์—…์„ ๋ถ„๋ฅ˜ํ•˜๋Š” ๊ธฐ์ค€์€ ์—ฐ๊ฐ„๊ฑด์„ค์‹ค์ ์œผ๋กœ ๋ถ„๋ฅ˜ํ–ˆ๋‹ค. ์—ฐ๊ฐ„๊ฑด์„ค์‹ค์ ์ด 300ํ˜ธ ์ด์ƒ์ธ ๊ธฐ์—…์„ ๋Œ€๊ธฐ์—…์œผ๋กœ ๋ถ„๋ฅ˜ํ–ˆ๊ณ  ๋Œ€๊ธฐ์—…์„ ๋‹ค์‹œ ๋Œ€๋Œ€๊ธฐ์—…(์—ฐ๊ฐ„ 5,000ํ˜ธ ์ด์ƒ), ์ค‘๋Œ€๊ธฐ์—…(์—ฐ๊ฐ„ 2,000~5,000ํ˜ธ ๋ฏธ๋งŒ), ์†Œ๋Œ€๊ธฐ์—…(์—ฐ๊ฐ„ 300~2,000ํ˜ธ ๋ฏธ๋งŒ)์œผ๋กœ ๋ถ„๋ฅ˜ํ–ˆ๋‹ค. ๋ถ„์„์— ํ™œ์šฉํ•œ ๋Œ€๊ธฐ์—…์€ ๋Œ€๋Œ€๊ธฐ์—…์ด 5๊ฐœ์‚ฌ, ์ค‘๋Œ€๊ธฐ์—…์ด 7๊ฐœ์‚ฌ, ์†Œ๋Œ€๊ธฐ์—…์ด 48๊ฐœ์‚ฌ๋กœ ์ด ๋Œ€๊ธฐ์—…์€ 60๊ฐœ์‚ฌ์ด๋‹ค. ์ „๊ตญ ๋ฐ ์ˆ˜๋„๊ถŒ์˜ ์•„ํŒŒํŠธ ํ˜„ํ™ฉ(์Šคํ†ก)์„ ๋ณด๋ฉด ์—ฐ๊ฐ„ 2,000ํ˜ธ ์ด์ƒ ๊ณต๊ธ‰ํ•˜๋Š” ์ค‘ยท๋Œ€๋Œ€๊ธฐ์—…์˜ ๊ณต๊ธ‰๋น„์œจ์€ ์ „๊ตญ์ด 1990๋…„ 13.8%์—์„œ 2010๋…„ 23.6%๋กœ ์ฆ๊ฐ€ํ–ˆ๋‹ค. ์ˆ˜๋„๊ถŒ์€ 14.4%โ†’26.8%๋กœ ๋” ๋งŽ์ด ์ฆ๊ฐ€ํ–ˆ๋‹ค. ์ด๋Š” ์ค‘ยท๋Œ€๋Œ€๊ธฐ์—…์ด ๊ฑด์„คํ•œ ์ฃผํƒ์— ๊ฑฐ์ฃผํ•˜๋Š” ๊ฐ€๊ตฌ๊ฐ€ 1990๋…„์—๋Š” 7๊ฐ€๊ตฌ ์ค‘ ํ•œ ๊ฐ€๊ตฌ์˜€๋˜ ๊ฒƒ์ด 20๋…„ ํ›„์—๋Š” 4๊ฐ€๊ตฌ ๋‹น ํ•œ ๊ฐ€๊ตฌ๋กœ ์ฆ๊ฐ€ํ–ˆ๋‹ค๊ณ  ๋ณผ ์ˆ˜ ์žˆ๋‹ค. ์ด ์ค‘ยท๋Œ€๋Œ€๊ธฐ์—…์ด 2000๋…„๋ถ€ํ„ฐ 2010๋…„๊นŒ์ง€ ๋งค๋…„ ๊ณต๊ธ‰ํ•œ ์ฃผํƒ๊ฑด์„ค์‹ค์ ์ด ์ „์ฒด๊ฑด์„ค์‹ค์ ์—์„œ ์ฐจ์ง€ํ•˜๋Š” ๋น„์œจ์„ ์‚ดํŽด๋ณด๋ฉด ํ‰๊ท  37.6%๋กœ ์Šคํ†ก๋ณด๋‹ค ๋” ๋งŽ์€ ๋น„์ค‘์œผ๋กœ ๊ณ„์†ํ•ด์„œ ๊ณต๊ธ‰ํ•ด์˜จ ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ๋‹ค. ์ด๋ฅผ ํ†ตํ•ด ํ–ฅํ›„ 5๋…„ ๋’ค๋‚˜ 10๋…„ ๋’ค์— ์ค‘ยท๋Œ€๋Œ€๊ธฐ์—…์ด ๊ฑด์„คํ•œ ๋ธŒ๋žœ๋“œ ์•„ํŒŒํŠธ์—์„œ ๊ฑฐ์ฃผํ•  ๊ฐ€๊ตฌ๊ฐ€ ๋” ์ฆ๊ฐ€ํ•  ๊ฒƒ์ด๋ž€ ์˜ˆ์ธก์ด ๊ฐ€๋Šฅํ•˜๋‹ค. ๋˜ํ•œ 2004๋…„๋ถ€ํ„ฐ 2011๋…„๊นŒ์ง€ ๋Œ€๊ธฐ์—…์˜ ๊ณต๊ธ‰ ๋งค์ถœ์„ ์‚ดํŽด๋ณด์•˜๋‹ค. 5๊ฐœ ๋Œ€๋Œ€๊ธฐ์—…์˜ ๊ฒฝ์šฐ ํ‰๊ท  ๋งค์ถœ์ด 20.7%๋กœ ๊ฐ™์€ ์‹œ๊ธฐ ๊ณต๊ธ‰๋Ÿ‰ ๋น„์œจ์˜ ํ‰๊ท ์ด 22.2%์ด๋‹ค. ์ „์ฒด ๋Œ€๊ธฐ์—… 60๊ฐœ์‚ฌ์˜ ๋งค์ถœ ํ‰๊ท ์€ 62.4%๋กœ ์ ˆ๋ฐ˜ ์ด์ƒ์„ ์—ฐ๊ฐ„ 300ํ˜ธ ์ด์ƒ ๊ฑด์„คํ•˜๋Š” ๋Œ€ํ˜•์—…์ฒด๊ฐ€ ๊ณต๊ธ‰ํ•˜๊ณ  ์žˆ์Œ์„ ์•Œ ์ˆ˜ ์žˆ๋‹ค. ์šฐ๋ฆฌ๋‚˜๋ผ ์ฃผํƒ์‹œ์žฅ์˜ ๋Œ€๊ธฐ์—… ์ง‘์ค‘ ํŠน์„ฑ์„ ํŒŒ์•…ํ•˜๊ธฐ ์œ„ํ•ด 2004๋…„๋ถ€ํ„ฐ 2011๋…„๊นŒ์ง€ ๋Œ€๊ธฐ์—…์˜ ์ฃผํƒ๊ฑด์„ค๋งค์ถœ์•ก์„ ํ† ๋Œ€๋กœ ์‹œ์žฅ์ง‘์ค‘๋„๋น„์œจ, ์ง€๋‹ˆ๊ณ„์ˆ˜์™€ ๋กœ๋ Œ์ธ ๊ณก์„ , ์ˆœ์œ„๊ทœ๋ชจ๋ฒ•์น™์˜ ์ˆ˜์œ„๋„๋ฅผ ๊ตฌํ•˜์˜€๋‹ค. ์‹œ์žฅ์ง‘์ค‘๋„๋น„์œจ์˜ ๊ฒฝ์šฐ 5๊ฐœ ๋Œ€๋Œ€๊ธฐ์—…์˜ ํ‰๊ท  20.7%, ์ค‘๋Œ€๊ธฐ์—…์ด 15.9%, ์†Œ๋Œ€๊ธฐ์—…์ด 25.8%์˜ ๋น„์ค‘์„ ์ฐจ์ง€ํ•˜๊ณ  ์žˆ๋‹ค. 1๊ฐœ ๊ฑด์„ค์—…์ฒด๋‹น ํ‰๊ท  ์‹œ์žฅ์ง‘์ค‘๋„๋น„์œจ์„ ๋ณด๋ฉด ๋Œ€๋Œ€๊ธฐ์—…์˜ ๊ฒฝ์šฐ 4.1%, ์ค‘๋Œ€๊ธฐ์—…์€ 2.3%, ์†Œ๋Œ€๊ธฐ์—…์€ 0.5%๋กœ ๋Œ€๊ธฐ์—… ์ค‘์—์„œ๋„ ๊ทœ๋ชจ๊ฐ€ ํฐ ๋Œ€๋Œ€๊ธฐ์—…์œผ๋กœ์˜ ์‹œ์žฅ์ง‘์ค‘๋„๊ฐ€ ๋†’์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ง€๋‹ˆ๊ณ„์ˆ˜์˜ ๊ฒฝ์šฐ๋„ ํ‰๊ท  0.583์œผ๋กœ ๋Œ€๊ธฐ์—… ๋‚ด์—์„œ๋„ ๋งค์ถœ๋ถ„ํฌ๊ฐ€ ๋ถˆ๊ท ํ˜•ํ•˜๊ฒŒ ๋‚˜ํƒ€๋‚˜๊ณ  ์žˆ๋‹ค. ์ˆœ์œ„๊ทœ๋ชจ๋ฒ•์น™์˜ ์ˆ˜์œ„๋„๋Š” 60๊ฐœ ๋Œ€๊ธฐ์—…์˜ ์ฃผํƒ๊ฑด์„ค๋งค์ถœ์„ ์ „์ฒด์ฃผํƒ๊ฑด์„ค๋งค์ถœ์—์„œ ๋Œ€๊ธฐ์—… ๋งค์ถœ์„ ์ œ์™ธํ•œ ๊ฒƒ์œผ๋กœ ๋‚˜๋ˆ„์–ด์„œ ๊ตฌํ–ˆ๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ์—ฐ๋„๋ณ„ ๋“ฑ๋ฝ์ด ์žˆ์ง€๋งŒ ํ‰๊ท  2.33์œผ๋กœ 1๋ณด๋‹ค ํฌ๊ฒŒ ๋‚˜ํƒ€๋‚˜๊ณ  ์žˆ๋‹ค. ์ด๋Š” ์ง€๋‹ˆ๊ณ„์ˆ˜ ๋ฐ ๋กœ๋ Œ์ธ ๊ณก์„ ์˜ ๊ฒฐ๊ณผ์™€ ๋งˆ์ฐฌ๊ฐ€์ง€๋กœ ์ฃผํƒ๊ณต๊ธ‰์ด ๋Œ€๊ธฐ์—…์— ์ง‘์ค‘๋˜์–ด ์žˆ์ง€๋งŒ ๋Œ€๊ธฐ์—… ์ค‘์—์„œ๋„ ๊ทœ๋ชจ๊ฐ€ ํฐ ๋Œ€๋Œ€๊ธฐ์—…์— ๋”์šฑ ์ง‘์ค‘๋˜๊ณ  ์žˆ์Œ์„ ์˜๋ฏธํ•œ๋‹ค. ์ง€๊ธˆ๊นŒ์ง€์˜ ๋ถ„์„์„ ์š”์•ฝํ•˜๋ฉด ์šฐ๋ฆฌ๋‚˜๋ผ ์ฃผํƒ๊ณต๊ธ‰์€ ๋Œ€๊ธฐ์—…์— ์ง‘์ค‘๋˜์–ด ์žˆ๊ณ  ๋Œ€๊ธฐ์—… ์ค‘์—์„œ๋„ ๊ทœ๋ชจ๊ฐ€ ํฐ ์—ฐ๊ฐ„ 5,000ํ˜ธ ์ด์ƒ์˜ ์ฃผํƒ์„ ๊ณต๊ธ‰ํ•˜๋Š” ๋Œ€๋Œ€๊ธฐ์—…(5๊ฐœ ์‚ฌ)์˜ ๊ณต๊ธ‰๋น„์ค‘ ๋ฐ ๋งค์ถœ๋น„์ค‘์ด ๋†’์€ ํŠน์„ฑ์„ ๊ฐ–๋Š”๋‹ค. ์•ž์œผ๋กœ ์ฃผํƒ๊ณต๊ธ‰์˜ ๋Œ€๊ธฐ์—… ์ง‘์ค‘์€ ์ ์  ๋” ์‹ฌํ™”๋  ์ˆ˜ ์žˆ์ง€๋งŒ ๊ณต๊ธ‰์—์„œ ๋Œ€๊ธฐ์—…์ด ์ฐจ์ง€ํ•˜๋Š” ๋น„์ค‘์ด ๋†’์•„์ง„๋‹ค๋Š” ๊ฒƒ์ด ๋Œ€๊ธฐ์—…์ด ๊ณต๊ธ‰ํ•˜๋Š” ๋ฌผ๋Ÿ‰ ์ž์ฒด์˜ ์ฆ๊ฐ€๋ผ๊ณ ๋Š” ํ•  ์ˆ˜ ์—†๋‹ค. ์™œ๋ƒํ•˜๋ฉด ๋Œ€๋Ÿ‰ ์ˆ˜์š”๊ฐ€ ์—†๋Š” ์ƒํ™ฉ์ด๊ธฐ ๋•Œ๋ฌธ์ด๋‹ค. ๊ธฐ์กด์˜ ๋Œ€๊ธฐ์—…-๋Œ€๋Ÿ‰๊ณต๊ธ‰์ฒด์ œ๋Š” ๊ตญ๊ฐ€๋ฐœ์ „๋‹จ๊ณ„์—์„œ ํšจ์œจ์ ์ธ ๊ณต๊ธ‰๊ตฌ์กฐ์˜€์„์ง€๋Š” ๋ชจ๋ฅด์ง€๋งŒ ํ–ฅํ›„ ์ˆ˜์š”๊ฐ€ ๊ฐ์†Œํ•˜๋Š” ์ƒํ™ฉ์—์„œ๋Š” ์ ์ ˆํ•˜์ง€ ์•Š์„ ์ˆ˜ ์žˆ๋‹ค. ๋ณด๋‹ค ํšจ์œจ์ ์ธ ๊ณต๊ธ‰๊ตฌ์กฐ๋ฅผ ํ˜•์„ฑํ•˜๊ธฐ ์œ„ํ•ด ์ •๋ถ€๋Š” ๋Œ€๊ธฐ์—… ์˜์กด๋„๋ฅผ ๋‚ฎ์ถœ ์ˆ˜ ์žˆ๋Š” ์ •์ฑ…๋ฐฉ์•ˆ์„ ๊ฐ•๊ตฌํ•ด์•ผ ํ•  ๊ฒƒ์ด๋‹ค.I. ์„œ๋ก  1 1. ์—ฐ๊ตฌ์˜ ๋ฐฐ๊ฒฝ๊ณผ ๋ชฉ์  1 2. ์—ฐ๊ตฌ์˜ ๋ฐฉ๋ฒ•๊ณผ ๋ฒ”์œ„ 3 II. ์ด๋ก ์  ๊ณ ์ฐฐ๊ณผ ์„ ํ–‰์—ฐ๊ตฌ ๊ฒ€ํ†  4 1. ์ด๋ก ์  ๊ณ ์ฐฐ 4 1) ์ฃผํƒ์‹œ์žฅ์˜ ์ •์˜์™€ ํŠน์„ฑ 4 2) ์ฃผํƒ์‹œ์žฅ๊ตฌ์กฐ ํ˜•์„ฑ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์š”์ธ 7 2. ์„ ํ–‰์—ฐ๊ตฌ ๊ฒ€ํ†  9 III. ์šฐ๋ฆฌ๋‚˜๋ผ ์ฃผํƒ์‹œ์žฅ์˜ ํŠน์„ฑ 11 1. ์šฐ๋ฆฌ๋‚˜๋ผ ์ฃผํƒ์‹œ์žฅ๊ตฌ์กฐ์˜ ํŠน์ˆ˜์„ฑ 11 1) ๋Œ€๊ธฐ์—… ์ง‘์ค‘์  ์‹œ์žฅ๊ตฌ์กฐ 11 2) ๋Œ€๊ธฐ์—… ์ง‘์ค‘์  ์‹œ์žฅ๊ตฌ์กฐ ํ˜•์„ฑ์›์ธ 12 2. ์šฐ๋ฆฌ๋‚˜๋ผ ์ฃผํƒ๊ณต๊ธ‰ ํ˜„ํ™ฉ 17 1) GDP ๊ทœ๋ชจ์™€ ์ฃผํƒ์‚ฐ์—…๊ทœ๋ชจ์˜ ๋ณ€ํ™” 17 2) ์ฃผํƒ๊ณต๊ธ‰ ํ˜„ํ™ฉ 19 3) ์ฃผํƒ์ˆ˜์š”์˜ ๋ณ€ํ™” 21 3. ์†Œ๊ฒฐ 24 IV. ์ฃผํƒ์‹œ์žฅ ๋Œ€๊ธฐ์—… ์ง‘์ค‘๋„ ์‹ค์ฆ๋ถ„์„ 25 1. ๋ถ„์„ํ‹€ ์„ค์ • 25 1) ๋Œ€๊ธฐ์—…์˜ ์ •์˜ 25 2) ๋ถ„์„์„ ์œ„ํ•œ ์ž๋ฃŒ 27 3) ๋Œ€๊ธฐ์—… ์ง‘์ค‘๋„ ๋ถ„์„ ๋ฐฉ๋ฒ• 29 2. ๋Œ€๊ธฐ์—… ์ง‘์ค‘๋„ ์‹ค์ฆ ๋ถ„์„ 31 1) ์•„ํŒŒํŠธ ๊ณต๊ธ‰์˜ ๋Œ€๊ธฐ์—… ์ง‘์ค‘๋„ 31 2) ์šฐ๋ฆฌ๋‚˜๋ผ ์ฃผํƒ์‹œ์žฅ์˜ ๋Œ€๊ธฐ์—… ์ง‘์ค‘ ํŠน์„ฑ 36 V. ๊ฒฐ๋ก  41 ์ฐธ๊ณ ๋ฌธํ—Œ 44 Abstract 51Maste

    Exploration of Psychological, Academic Competence, and Environmental/Support Factors Influencing College Students Academic Achievements

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    ๋ณธ ์—ฐ๊ตฌ๋Š” ๋Œ€ํ•™์ƒ๋“ค์„ ๋Œ€์ƒ์œผ๋กœ ์ด๋“ค์˜ ํ•™์—…์„ฑ์ทจ ์ˆ˜์ค€์— ๋”ฐ๋ผ ๊ตฌ๋ถ„๋œ ํ•™์—… ์ €์„ฑ์ทจ ์ง‘๋‹จ-์ผ๋ฐ˜์ง‘๋‹จ-ํ•™์—… ์šฐ์ˆ˜์ง‘๋‹จ ์‚ฌ์ด์— ์‹ฌ๋ฆฌ์  ๋ณ€์ธ(ํ•™์—…์  ์ž๊ธฐํšจ๋Šฅ๊ฐ, ์„ฑ์‹ค์„ฑ), ํ•™์Šต์—ญ๋Ÿ‰ ๋ณ€์ธ(ํ•™์Šต๋™๊ธฐ, ํ•™์Šต์Šต๊ด€), ํ™˜๊ฒฝ ๋ฐ ์ง€์ง€ ๋ณ€์ธ(๊ต์ˆ˜์ง€์ง€, ํ•™์Šตํ™˜๊ฒฝ)์˜ ์ฐจ์ด๊ฐ€ ์žˆ๋Š”์ง€ ํ™•์ธํ•˜์˜€๋‹ค. ๋˜ํ•œ ์‹ฌ๋ฆฌ์  ํŠน์„ฑ ๋ณ€์ธ(ํ•™์—…์  ์ž๊ธฐํšจ๋Šฅ๊ฐ, ์„ฑ์‹ค์„ฑ), ํ•™์Šต์—ญ๋Ÿ‰ ๋ณ€์ธ(ํ•™์Šต๋™๊ธฐ, ํ•™์Šต์Šต๊ด€), ํ™˜๊ฒฝ ๋ฐ ์ง€์ง€ ๋ณ€์ธ(๊ต์ˆ˜์ง€์ง€, ํ•™์Šตํ™˜๊ฒฝ)์ด ํ•™์—…์„ฑ์ทจ ์ˆ˜์ค€์— ๋”ฐ๋ผ ๊ตฌ๋ถ„๋œ ์ง‘๋‹จ์„ ์–ผ๋งˆ๋‚˜ ์˜ˆ์ธกํ•ด์ฃผ๋Š”์ง€๋ฅผ ํƒ์ƒ‰ํ•˜์˜€๋‹ค. ์ด๋ฅผ ์œ„ํ•ด ์ „๊ตญ 18๊ฐœ ๋Œ€ํ•™์˜ ๋Œ€ํ•™์ƒ 1,567๋ช…์„ ์—ฐ๊ตฌ๋Œ€์ƒ์œผ๋กœ ์„ ์ •ํ•˜์˜€์œผ๋ฉฐ, ์ด๋“ค์„ ํ•™์—…์„ฑ์ทจ ์ˆ˜์ค€์— ๋”ฐ๋ผ ์„ธ ์ง‘๋‹จ์œผ๋กœ ๊ตฌ๋ถ„ํ•˜์˜€๋‹ค. ์ˆ˜์ง‘๋œ ์ž๋ฃŒ๋Š” ๋‹ค๋ณ€๋Ÿ‰๋ถ„์„๊ณผ ๋‹คํ•ญ๋กœ์ง€์Šคํ‹ฑ ํšŒ๊ท€๋ถ„์„๋ฐฉ๋ฒ•์„ ์‚ฌ์šฉํ•˜์—ฌ ๋ถ„์„ํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ, ํ•™์—…์  ์ž๊ธฐํšจ๋Šฅ๊ฐ, ์„ฑ์‹ค์„ฑ, ํ•™์Šต๋™๊ธฐ, ํ•™์Šต์Šต๊ด€, ๊ต์ˆ˜์ง€์ง€, ํ•™์Šต ํ™˜๊ฒฝ์€ ์ง‘๋‹จ์— ๋”ฐ๋ผ ์œ ์˜๋ฏธํ•œ ์ฐจ์ด๊ฐ€ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๋˜ํ•œ ๋‹คํ•ญ๋กœ์ง€์Šคํ‹ฑ ํšŒ๊ท€๋ถ„์„์„ ์‹ค์‹œํ•œ ๊ฒฐ๊ณผ, ์„ฑ์‹ค์„ฑ, ํ•™์Šต์Šต๊ด€, ํ•™์—…์  ์ž๊ธฐํšจ๋Šฅ๊ฐ, ํ•™์Šต๋™๊ธฐ๊ฐ€ ์œ ์˜๋ฏธํ•œ ์˜ˆ์ธก๋ณ€์ธ์œผ๋กœ ํ™•์ธ๋˜์—ˆ๋‹ค. ์„ฑ์‹ค์„ฑ, ํ•™์Šต์Šต๊ด€์ด ๋‚ฎ์„์ˆ˜๋ก ํ•™์—… ์ €์„ฑ์ทจ ์ง‘๋‹จ์— ์†ํ•  ํ™•๋ฅ ์ด ๋†’์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ์œผ๋ฉฐ, ํ•™์—…์  ์ž๊ธฐํšจ๋Šฅ๊ฐ, ํ•™์Šต๋™๊ธฐ๊ฐ€ ๋†’์„์ˆ˜๋ก ํ•™์—… ์šฐ์ˆ˜ ์ง‘๋‹จ์— ์†ํ•  ํ™•๋ฅ ์ด ๋†’์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ด๋Ÿฌํ•œ ์—ฐ๊ตฌ๊ฒฐ๊ณผ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ๋Œ€ํ•™์ƒ์˜ ํ•™์—…์„ฑ์ทจ๋ฅผ ํšจ๊ณผ์ ์œผ๋กœ ํ–ฅ์ƒ์‹œํ‚ค๋Š”๋ฐ ํ•„์š”ํ•œ ์ฐจ๋ณ„ํ™”๋œ ์ „๋žต์˜ ํ•„์š”์„ฑ๊ณผ ๋ฐฉํ–ฅ์„ฑ์„ ๋…ผ์˜ํ•˜์˜€๋‹ค. The purpose of this study is to investigate the differences of psychological characteristics(academic self-efficacy, conscientiousness), academic competence(learning motivation, study habits) and academic environment and support(faculty support, learning environment) among the three different collge student groups of under-achiever, average achiever, and high-achievers. In addition, this study examined how these psychological, academic competence and environment/support factors differentiate the three groups. This study was based on the survey conducted on 1,567 college students and they were divided into three groups based on the academic achievements. The collected data were analyzed using MANOVA and multinomial logistic regression. As a result, academic self-efficacy, conscientiousness, learning motivation, study habits, faculty support, and learning environment were significantly different among the three groups. Also the result of a regression analysis showed that conscientiousness, study habits, academic self-efficacy, and learning motivation were confirmed as significant variables which predicted academic achievements. Based on these results, the need for a differentiated strategy for improving academic achievement was discussed

    Economic impact of medication adherence among patients with hypertension or diabetes mellitus : a systemic analysis of the literature

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    ์ œ์•ฝ์˜๋ฃŒ์‚ฐ์—…ํ•™๊ณผ/์„์‚ฌ์ตœ๊ทผ ์˜์•ฝํ’ˆ์˜ ํšจ๊ณผ์™€ ๋น„์šฉ์˜ ๊ท ํ˜•์„ ํ‰๊ฐ€ํ•˜๊ธฐ ์œ„ํ•œ ์˜์•ฝํ’ˆ ๊ฒฝ์ œ์„ฑ ํ‰๊ฐ€๊ฐ€ ๋งŽ์ด ์ด๋ฃจ์–ด์ง€๋ฉด์„œ ๋น„์šฉ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์•ฝ๋ฌผ ์ˆœ์‘๋„๊ฐ€ ๋งค์šฐ ์ค‘์š”ํ•œ ์š”์†Œ๋กœ ์•Œ๋ ค์ง€๊ณ  ์žˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ์‹ฌํ˜ˆ๊ด€ ๊ด€๋ จ ์งˆํ™˜ ์ค‘ ๊ณ ํ˜ˆ์••๊ณผ ๋‹น๋‡จ๋ณ‘ ์น˜๋ฃŒ์•ฝ๋ฌผ์— ๋Œ€ํ•œ ์•ฝ๋ฌผ ์ˆœ์‘๋„์˜ ์‹ฌํ˜ˆ๊ด€ ์งˆํ™˜ ์˜ˆ๋ฐฉ ํšจ๊ณผ ๋ฐ ์˜๋ฃŒ๋น„์šฉ ์ ˆ๊ฐ์— ๋”ฐ๋ฅธ ๊ฒฝ์ œ์  ํšจ๊ณผ๋ฅผ ํ‰๊ฐ€ํ•˜๊ธฐ ์œ„ํ•ด ๊ณ ํ˜ˆ์••๊ณผ ๋‹น๋‡จ๋ณ‘ ํ™˜์ž์—์„œ ์น˜๋ฃŒ์•ฝ๋ฌผ์— ๋Œ€ํ•œ ์•ฝ๋ฌผ ์ˆœ์‘๋„ ๋ฐ ์ง€์†๋„์™€ ๋น„์šฉ ๋ฐ ๋น„์šฉ-ํšจ๊ณผ์„ฑ์„ ์กฐ์‚ฌํ•œ ๋ฌธํ—Œ๋“ค์„ ๊ฒ€์ƒ‰ํ•˜์˜€๋‹ค. ๋ฌธํ—Œ๊ฒ€์ƒ‰์€ PubMed ๋ฐ์ดํ„ฐ๋ฒ ์ด์Šค๋ฅผ ์‚ฌ์šฉํ•˜์—ฌ ์ด๋ฃจ์–ด์กŒ๊ณ , 1995๋…„ 1์›”๋ถ€ํ„ฐ 2010๋…„ 9์›”๊นŒ์ง€ ๋ฐœํ–‰๋œ English language, human study๋ฅผ ๋ณธ ์—ฐ๊ตฌ์˜ ๊ด€๋ จ ์ž๋ฃŒ๋กœ์„œ ๊ฐ„์ฃผํ•˜์˜€๋‹ค. ๋ถ„์„ ๋ฐฉ๋ฒ•์€ ์—ฌ๋Ÿฌ ์—ฐ๊ตฌ์—์„œ ์‚ฌ์šฉ๋˜์–ด์ง„ ๋ฐฉ๋ฒ•๋ก , ์•ฝ๋ฌผ ์น˜๋ฃŒ๋ฐฉ๋ฒ•, ๋น„์šฉ๋‹จ์œ„๊ฐ€ ๋‹ค์–‘ํ•˜์—ฌ ์–‘์  ๋น„๊ต๋ถ„์„์€ ์–ด๋ ค์›Œ ์—ฌ๋Ÿฌ ๊ด€์ ์— ๋”ฐ๋ผ ์ฒด๊ณ„์ ์œผ๋กœ ๋ถ„์„ํ•˜์˜€๋‹ค. ๊ณ ํ˜ˆ์••๊ณผ ๋‹น๋‡จ๋ณ‘ ํ™˜์ž์—์„œ ์˜๋ฃŒ๋น„์šฉ์— ๋Œ€ํ•œ ์•ฝ๋ฌผ ์ˆœ์‘๋„ ๋ฐ ์ง€์†๋„์˜ ์˜ํ–ฅ์„ ์กฐ์‚ฌํ•œ ๋ฌธํ—Œ์€ ์ด 25๊ฐœ๊ฐ€ ํ™•์ธ๋˜์—ˆ๋‹ค. ์ด ์ค‘ 8๊ฐœ๋Š” ๊ณ ํ˜ˆ์••, 14๊ฐœ๋Š” ๋‹น๋‡จ๋ณ‘, ๋‚˜๋จธ์ง€ 1๊ฐœ๋Š” ์‹ฌํ˜ˆ๊ด€ ๊ด€๋ จ ์งˆํ™˜๊ณผ ๊ด€๋ จ๋œ ์—ฐ๊ตฌ์˜€๋‹ค. ์•ฝ๋ฌผ ์ˆœ์‘๋„์— ๋”ฐ๋ฅธ ๋น„์šฉ์„ ๋ถ„์„ํ•œ ๊ฒฐ๊ณผ, ๊ณ ํ˜ˆ์••๊ณผ ๋‹น๋‡จ๋ณ‘ ํ™˜์ž์—์„œ ์•ฝ๋ฌผ ์ˆœ์‘๋„๊ฐ€ ๋†’์„์ˆ˜๋ก ์ด ์˜๋ฃŒ๋น„์šฉ์ด ๊ฐ์†Œ๋˜๋Š” ๊ฒฝํ–ฅ์ด ์žˆ์—ˆ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ํ•ญ๊ณ ํ˜ˆ์••์ œ์™€ ๋‹น๋‡จ๋ณ‘ ์น˜๋ฃŒ ์•ฝ๋ฌผ ์ข…๋ฅ˜์— ๋”ฐ๋ผ ์•ฝ๋ฌผ ์ˆœ์‘๋„ ๋ฐ ์ง€์†๋„์™€ ๋น„์šฉ์— ์ฐจ์ด๊ฐ€ ์žˆ์—ˆ์œผ๋ฉฐ, 1๊ฐœ ์ข…๋ฅ˜ ์ด์ƒ์˜ ์•ฝ๋ฌผ์„ ๋ณต์šฉํ•  ๋•Œ free-dose ๋ณ‘์šฉ์š”๋ฒ•์— ๋น„ํ•ด fixed-dose ๋ณ‘์šฉ์š”๋ฒ•์—์„œ ์•ฝ๋ฌผ ์ˆœ์‘๋„๊ฐ€ ๋” ๋†’๊ณ  ์ด ์˜๋ฃŒ๋น„์šฉ์ด ๋” ๋‚ฎ๊ฒŒ ๋ฐœ์ƒํ•˜๋Š” ๊ฒฐ๊ณผ๋ฅผ ๋ณด์˜€๋‹ค. ๋˜ํ•œ ๋‹น๋‡จ๋ณ‘ ํ™˜์ž์—์„œ ์ธ์Š๋ฆฐ ํˆฌ์—ฌ ๋ฐฉ๋ฒ•์ด ์•ฝ๋ฌผ ์ˆœ์‘๋„์™€ ๋น„์šฉ์— ์˜ํ–ฅ์„ ๋ฏธ์นœ๋‹ค๋Š” ๊ฒƒ๋„ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ๋‹ค. ์‹ฌํ˜ˆ๊ด€ ์งˆํ™˜์—์„œ์˜ ์น˜๋ฃŒ ์•ฝ๋ฌผ์— ๋Œ€ํ•œ ์ˆœ์‘๋„๋Š” ๋งค์šฐ ์ค‘์š”ํ•˜๋‹ค. ํŠนํžˆ ๊ณ ํ˜ˆ์••๊ณผ ๋‹น๋‡จ๋ณ‘ ๋“ฑ๊ณผ ๊ฐ™์€ ๋งŒ์„ฑ์งˆํ™˜ ํ™˜์ž์—์„œ์˜ ์ง€์†์ ์ธ ์•ฝ๋ฌผ ๋ณต์šฉ์€ ๋” ์ค‘์š”ํ•˜๋‹ค. ์ผ๋ฐ˜์ ์œผ๋กœ ์•ฝ๋ฌผ ์ˆœ์‘๋„๊ฐ€ ๋†’์œผ๋ฉด ์•ฝ๋ฌผ ๋น„์šฉ์ด ๋†’์•„์ง€๊ธฐ ๋•Œ๋ฌธ์— ๊ฒฝ์ œ์ ์ธ ๋ถ€๋‹ด์ด ์ฆ๊ฐ€ํ•  ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€ํ•œ๋‹ค. ํ•˜์ง€๋งŒ, ์•ฝ๋ฌผ ์ˆœ์‘๋„๊ฐ€ ๋‚ฎ์•„์ง€๋ฉด ์•ฝ๋ฌผ์˜ ํšจ๊ณผ๊ฐ€ ๊ฐ์†Œ๋˜์–ด ์˜๋ฃŒ ์„œ๋น„์Šค ์ด์šฉ์ด ์ฆ๊ฐ€๋˜๊ธฐ ๋•Œ๋ฌธ์— ์ด ์˜๋ฃŒ๋น„์šฉ์€ ๋†’์•„์ง„๋‹ค๊ณ  ์กฐ์‚ฌ๋˜์—ˆ๋‹ค. ์ด์ฒ˜๋Ÿผ ๋†’์€ ์•ฝ๋ฌผ ์ˆœ์‘๋„๋Š” ์•ฝ๋ฌผ์˜ ํšจ๊ณผ๋ฅผ ๋†’์ด๋Š” ๊ฒƒ ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ๋” ๋‚˜์•„๊ฐ€ ์˜๋ฃŒ์„œ๋น„์Šค์˜ ์ด์šฉ์„ ๊ฐ์†Œ์‹œํ‚ค๋ฉฐ ์ด๋Š” ๊ฒฐ๊ณผ์ ์œผ๋กœ ์˜๋ฃŒ๋น„์šฉ์„ ๊ฐ์†Œ์‹œํ‚ค๋Š” ๊ฒƒ์œผ๋กœ ํ™•์ธ๋˜์—ˆ๋‹ค.restrictio

    Nanoscale arrangement of gold nanorods in a single layer of diblock copolymer micelles

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ํ™”ํ•™๋ถ€, 2011.2. ์†๋ณ‘ํ˜.Maste

    Analyzing the Relationship of Factors Constructing Self-regulated Learning among Elementary School Underachieving Students

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    ๋ณธ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์€ ํ•™์—…์„ฑ์ทจ๋„๊ฐ€ ํ˜„์ €ํžˆ ๋‚ฎ์€ ํ•™์Šต๋ถ€์ง„ํ•™์ƒ์„ ๋Œ€์ƒ์œผ๋กœ ํ•™์—…์„ฑ์ทจ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์ž๊ธฐ์กฐ์ ˆํ•™์Šต์˜ ๊ตฌ์„ฑ์š”์ธ ๊ฐ„์˜ ๊ด€๊ณ„์„ฑ์„ ํŒŒ์•…ํ•˜๋Š” ๋ฐ ์žˆ๋‹ค. ์ด์— ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ์„ ํ–‰ ์—ฐ๊ตฌ๋ฅผ ์ฐธ๊ณ ํ•˜์—ฌ ์ž๊ธฐ์กฐ์ ˆํ•™์Šต์˜ ๊ตฌ์„ฑ์š”์ธ์„ ์ธ์ง€, ๋™๊ธฐ, ํ–‰๋™์ „๋žต์œผ๋กœ ๋ถ„๋ฅ˜ํ•˜์˜€๋‹ค. ์ด ๋ถ„๋ฅ˜๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ํ™˜๊ฒฝ์  ๋ณ€์ธ์„ ํฌํ•จํ•œ ๊ฐ ๋ณ€์ธ ๊ฐ„์˜ ๊ด€๊ณ„์„ฑ์„ ๊ณ ๋ คํ•˜์—ฌ ๋™๊ธฐ์ „๋žต๊ณผ ํ–‰๋™์ „๋žต์˜ ๊ด€๊ณ„์—์„œ ์ธ์ง€์ „๋žต์˜ ๋งค๊ฐœํšจ๊ณผ ๋ฐ ์‚ฌํšŒ์  ์ง€์ง€์˜ ์กฐ์ ˆํšจ๊ณผ๋ฅผ ํŒŒ์•…ํ•จ์œผ๋กœ์จ ์ดˆ๋“ฑํ•™๊ต ํ•™์Šต๋ถ€์ง„ํ•™์ƒ์˜ ํ•™์—…์ง€๋„์— ํ•„์š”ํ•œ ๊ธฐ์ดˆ์ž๋ฃŒ๋ฅผ ์ œ๊ณตํ•˜๊ณ ์ž ํ•˜์˜€๋‹ค. ์ด๋ฅผ ์œ„ํ•ด ์ „๊ตญ์˜ ํ•™์Šต๋ถ€์ง„ํ•™์ƒ์ค‘์ธตํ™”ํ‘œ์ง‘์„ ํ†ตํ•ด 1069๋ช…์„ ํ‘œ์ง‘ํ•œ ์ž๋ฃŒ๋ฅผ ํ™œ์šฉํ•˜์—ฌ ๋ถ„์„ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์ฒซ์งธ, ๋™๊ธฐ์ „๋žต๊ณผ ํ–‰๋™์ „๋žต์˜ ๊ด€๊ณ„์—์„œ ์ธ์ง€์ „๋žต์€ ๋ถ€๋ถ„๋งค๊ฐœํšจ๊ณผ๋ฅผ ๋ณด์˜€๋‹ค. ๋‘˜์งธ, ๋™๊ธฐ์ „๋žต๊ณผ ํ–‰๋™์ „๋žต์˜ ๊ด€๊ณ„์—์„œ ๊ต์‚ฌ์ง€์ง€๊ฐ€ ์กฐ์ ˆํšจ๊ณผ๋ฅผ ๊ฐ€์ง€๋Š” ๊ฒƒ์œผ๋กœ ๋ถ„์„๋˜์—ˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ์ดˆ๋“ฑํ•™๊ต์˜ ํ•™์Šต๋ถ€์ง„ํ•™์ƒ์„ ํšจ๊ณผ์ ์œผ๋กœ ์ง€๋„ํ•˜๊ธฐ ์œ„ํ•œ ๊ต์œก์  ์‹œ์‚ฌ์ ์„ ์ œ์‹œํ•˜์˜€๋‹ค.The purpose of this study is to investigate the relationship of factors constructing self-regulated learning strategy and to identify the magnitude of their effect among elementary school underachieving students. The construct of self-regulation was classified into three factors: cognitive regulation, motivation regulation, and behavior regulation. Based on this classification, the study examine the mediating effects of the cognitive strategy between the motivation strategy and behavior strategy. In addition, the moderating effect of the social support between the relationship between the motivation strategy and behavior strategy. In order to achieve the purpose of the study, the survey result of 1069 underachieving students collected by Korean Institute for Curriculum and Evaluation(KICE) was analyzed. The results show that the cognitive strategy was found as a partial mediator and the teacher support was found as a moderator between the motivation regulation and the behavior regulation. Implications for addressing academic challenges to underachieving students were discussed
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