4 research outputs found

    The Effects of Apo E Genotype and Physical Activity on Homocysteine, hs-CRP, Plasma Antioxidants and Lipid Profile of the Aged with Mild Cognitive Impairment

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    The degenerative Alzheimer's disease(AD) gradually occur and progress, and mild cognitive impairment is clinically important as an indicator of AD. This study attempted to classify a mild cognitive impairment(MCI) group of 10 and another normal control(NC) group of 10 after MMSE tests and utilize Borg's scale of physical activity on which the aged over 65 participated in 'Uri Dance Gymnastics' with 12 to 14 intensity, twice a week, 120 minutes a day in the period of 12 weeks. Accordingly, repeated measured ANOVA(RM ANOVA), independent and paired t-tests at the significant level of a=.05 revealed following findings. First, the most frequent Apo E genotypes included E3, E4 and E2 in order. In specific, E2 frequently occurred in NC but E4 in MCI. Second, RM ANOVA revealed a significant effect of group factor on levels of Homocysteine. In specific, it was found that the MCI group had significantly higher levels of Homocysteine in both pre and post physical activity but levels of Homocysteine significantly decreased only in the NC group. Third, RM ANOVA revealed a significant effect of group factor on levels of hs-CRP. However, following post-hoc tests indicated no significant effects of both physical activity and group factors. Fourth, RM ANOVA revealed significant effects of group factor on levels of uric acid and Total bilirubin. The MCI group had significantly higher levels of uric acid but lower levels of Total bilirubin in both pre and post physical activity. Fifth, a significant interaction effect was found in Total cholesterol and a significant decrease occurred only in the NC group. HDL-C had a significant group effect and the NC group had significantly higher levels of HDL-C. In addition, LDL-C had a significant interaction effect between physical activity and group factors but a significant difference occurred only in the NC group. In conclusion, it is implied that the physical activity can generate positive effects on biochemical factors associated with AD. Therefore, it is expected that the aged over 65 with a high mobility rate of AD can benefit from participating in physical activities and physical activities can contribute to preventing degenerative diseases in the aged society.LIST OF TABLES โ…ฒ LIST OF FIGURES โ…ณ ABSTRACT โ…ด โ… . ์„œ๋ก  1 1. ์—ฐ๊ตฌ์˜ ํ•„์š”์„ฑ 1 2. ์—ฐ๊ตฌ์˜ ๋ชฉ์  3 3. ์—ฐ๊ตฌ์˜ ๋ฌธ์ œ 4 4. ์šฉ์–ด์˜ ์ •์˜ 4 โ…ก. ์ด๋ก ์  ๋ฐฐ๊ฒฝ 5 1. ์ธ์ง€๊ธฐ๋Šฅ 5 2. Apolipoprotein E 6 3. Homocysteine 9 4. hs-CRP 11 5. Plasma antioxidants 12 โ…ข. ์—ฐ๊ตฌ๋ฐฉ๋ฒ• 14 1. ์—ฐ๊ตฌ๋Œ€์ƒ 14 2. ์—ฐ๊ตฌ์ ˆ์ฐจ 15 3. ์ธก์ •๋ฐฉ๋ฒ• 16 4. ์‹ ์ฒดํ™œ๋™ ํ”„๋กœ๊ทธ๋žจ 25 5. ์ž๋ฃŒ๋ถ„์„ 26 โ…ฃ. ๊ฒฐ๊ณผ 27 1. Apo E genotype์˜ ์ƒ๋Œ€๋นˆ๋„์ˆ˜ 27 2. Homocysteine 29 3. hs-CRP 30 4. Plasma antioxidants 31 5. Lipid profile 34 โ…ค. ๋…ผ์˜ 38 1. Apo E genotype 38 2. Homocysteine 39 3. hs-CRP 40 4. Plasma antioxdants 41 5. Lipid profile 42 โ…ฅ. ๊ฒฐ๋ก  45 ์ฐธ๊ณ ๋ฌธํ—Œ 47 LIST OF TABLES Table 1. The codon type of Apo E allele 7 Table 2. Physical characteristics of subjects 14 Table 3. PCR master mix solution 18 Table 4. Cycle for PCR 19 Table 5. Program configuration 25 Table 6. Number of Apo E genotype 27 Table 7. Comparisons of homocysteine 29 Table 8. Result of two-way repeated ANOVA for homocysteine 29 Table 9. Comparisons of hs-CRP 30 Table 10. Result of two-way repeated ANOVA for hs-CRP 30 Table 11. Comparisons of albumin 31 Table 12. Result of two-way repeated ANOVA for albumin 31 Table 13. Comparisons of uric acid 32 Table 14. Result of two-way repeated ANOVA for uric acid 32 Table 15. Comparisons of total bilirubin 33 Table 16. Result of two-way repeated ANOVA for total bilirubin 33 Table 17. Comparisons of total cholesterol 34 Table 18. Result of two-way repeated ANOVA for total cholesterol 34 Table 19. Comparisons of HDL-C 35 Table 20. Result of two-way repeated ANOVA for HDL-C 35 Table 21. Comparisons of LDL-C 36 Table 22. Result of two-way repeated ANOVA for LDL-C 36 Table 23. Comparisons of triglyceride 37 Table 24. Result of two-way repeated ANOVA for triglyceride 37 LIST OF FIGURES Figure 1. Metabolism of homocysteine 10 Figure 2. Research procedures 15 Figure 3. Examples of results with the Apo E 20 Figure 4. BCG method for albumin 21 Figure 5. Enzymatic method for uric acid 22 Figure 6. Colorimetric method for total bilirubin 22 Figure 7. Enzymatic method for total cholesterol 23 Figure 8. Apo E genotype distribution 2

    ์ค‘ยท๋…ธ๋…„๊ธฐ ์‚ฌ๋ณ„๊ณผ ์ธ์ง€๊ธฐ๋Šฅ์˜ ๊ด€๊ณ„-์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์˜ ์กฐ์ ˆํšจ๊ณผ๋ฅผ ์ค‘์‹ฌ์œผ๋กœ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์‚ฌํšŒ๋ณต์ง€ํ•™๊ณผ, 2017. 2. ๊น€ํ˜œ๋ž€.์˜ํ•™ ๊ธฐ์ˆ ์˜ ๋ฐœ์ „์œผ๋กœ ํ‰๊ท  ์ˆ˜๋ช…์ด ๋Š˜์–ด๋‚˜๋ฉด์„œ, ์ด๋ฅธ๋ฐ” 100์„ธ ์‹œ๋Œ€์˜ ์žฅ์ˆ˜ ์‹œ๋Œ€๋ฅผ ๋งž๊ฒŒ ๋˜์—ˆ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ด์ œ๋Š” ๋‹จ์ˆœํžˆ ์˜ค๋ž˜ ์‚ฌ๋Š” ์ˆ˜๋ช…์˜ ์–‘์  ์ธก๋ฉด๋ณด๋‹ค, ์–ด๋–ป๊ฒŒ ์‚ฌ๋Š” ๊ฐ€์˜ ์งˆ์  ์ธก๋ฉด์ด ์ค‘์š”ํ•˜๊ฒŒ ์—ฌ๊ฒจ์ง€๊ณ  ์žˆ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ด์ฒ˜๋Ÿผ ํ‰๊ท  ์ˆ˜๋ช…์ด ๋Š˜์–ด๋‚˜๊ณ  ์žˆ์Œ์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ๋ฐฐ์šฐ์ž ์‚ฌ๋ณ„ ์ธ๊ตฌ ์—ญ์‹œ ๋‚˜๋‚ ์ด ์ฆ๊ฐ€ํ•˜๋Š” ์ถ”์„ธ์ด๋‹ค. ์‚ฌ๋ณ„์€ ์ค‘ยท๋…ธ๋…„๊ธฐ์— ๋งž์ดํ•˜๊ฒŒ ๋˜๋Š” ๋ถˆ๊ฐ€ํ”ผํ•œ ์ƒ์• ์‚ฌ๊ฑด์ธ ๋™์‹œ์—, ๋‚จ๊ฒจ์ง„ ์‚ฌ๋ณ„์ž์˜ ์‚ถ์— ์ปค๋‹ค๋ž€ ๋ณ€ํ™”๋ฅผ ์•ผ๊ธฐํ•œ๋‹ค. ๋‚จ๊ฒจ์ง„ ์‚ฌ๋ณ„์ž์˜ ์ง€์†๋˜๋Š” ์‚ถ์— ๋Œ€ํ•œ ์ ์‘๊ณผ ์•ˆ๋…•์„ ์–ด๋–ป๊ฒŒ ๋„๋ชจํ•˜๊ณ  ์œ ์ง€ํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ธ๊ฐ€๊ฐ€ ์ˆ˜๋ช…์˜ ์งˆ์ ์ธ ์ธก๋ฉด์„ ๋ณด์žฅํ•˜๋Š” ์˜๋ฏธ์—์„œ ์ค‘์š”ํ•˜๋‹ค๊ณ  ๋ณผ ์ˆ˜ ์žˆ๋‹ค. ๋…ธ๋…„๊ธฐ ์ธ๊ตฌ์˜ ์ฆ๊ฐ€๋กœ ๋…ธ์ธ ๊ด€๋ จ ์—ฐ๊ตฌ๊ฐ€ ํ™œ๋ฐœํžˆ ์ด๋ค„์ง€๋ฉด์„œ, ๋™์‹œ์— ์‚ฌ๋ณ„์— ๋Œ€ํ•œ ๊ด€์‹ฌ๊ณผ ์—ฐ๊ตฌ์˜ ํ•„์š”์„ฑ ์—ญ์‹œ ์ฆ๊ฐ€ํ•˜๋Š” ์ถ”์„ธ์ด๋‹ค. ๋…ธ๋…„๊ธฐ ๋…๋ฆฝ์ ์ธ ์‚ถ์˜ ์˜์œ„์— ๊ฒฐ์ •์ ์ธ ์ธ์ง€๊ธฐ๋Šฅ์€ ์„ฑ๊ณต์  ๋…ธํ™”์˜ ์ฃผ์š” ์š”๊ฑด์œผ๋กœ ์†๊ผฝํžŒ๋‹ค. ๊ทธ๋Ÿฐ๋ฐ ์„ ํ–‰์—ฐ๊ตฌ๋“ค์„ ์ข…ํ•ฉํ•˜์—ฌ ๊ณ ์ฐฐํ•œ ๊ฒฐ๊ณผ, ์‚ฌ๋ณ„์ด ์‚ฌ๋ณ„์ž๋กœ ํ•˜์—ฌ๊ธˆ ๋ถ€์ •์  ์ •์„œ์™€ ์ŠคํŠธ๋ ˆ์Šค ๋“ฑ์„ ๊ฐ–๊ฒŒ ํ•ด ์ธ์ง€๊ธฐ๋Šฅ์— ๋ถ€์ •์  ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ด๋Ÿฌํ•œ ์‚ฌ๋ณ„์ด ๋ฏธ์น˜๋Š” ๋ถ€์ •์  ์˜ํ–ฅ์œผ๋กœ๋ถ€ํ„ฐ ์ธ์ง€๊ธฐ๋Šฅ์„ ๋ณดํ˜ธํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ์ฃผ์š” ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์˜ ๋Œ€์ƒ์ด์—ˆ๋˜ ๋ฐฐ์šฐ์ž์˜ ๋ถ€์žฌ๋ฅผ ๋‹ค๋ฅธ ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ๋“ค๋กœ ๋Œ€์ฒดํ•จ์œผ๋กœ์„œ ์ตœ์†Œํ™”ํ•˜๋Š” ๊ฒƒ์ด ์ค‘์š”ํ•˜๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ์•„์ง๊นŒ์ง€ ๊ตญ๋‚ด์—์„œ๋Š” ์‚ฌ๋ณ„ ๊ด€๋ จ ์—ฐ๊ตฌ๊ฐ€ ๋ถ€์กฑํ•˜๊ณ , ์‚ฌ๋ณ„๊ณผ ์ธ์ง€๊ธฐ๋Šฅ์˜ ๊ด€๊ณ„๋ฅผ ๋ณธ ์—ฐ๊ตฌ ์—ญ์‹œ ๋“œ๋ฌผ๋‹ค. ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์„ ๋‹ค๋ฃฌ ์—ฐ๊ตฌ์— ์žˆ์–ด์„œ๋„, ํŠน์ • ์กฐ๊ฑด ํ•˜์—์„œ ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์˜ ์ž‘๋™ํ•˜๋Š” ๊ธฐ์ œ๋ฅผ ์‚ดํŽด๋ณธ ์—ฐ๊ตฌ๋„ ๋งŽ์ง€ ์•Š์€ ์‹ค์ •์ด๋‹ค. ์ด๋Ÿฌํ•œ ํ•œ๊ณ„๋ฅผ ์—ผ๋‘์— ๋‘๊ณ  ๋ณธ ์—ฐ๊ตฌ๋Š” (1)์ค‘ยท๋…ธ๋…„๊ธฐ์˜ ์‚ฌ๋ณ„ ์—ฌ๋ถ€์— ๋”ฐ๋ผ ์ธ์ง€๊ธฐ๋Šฅ์˜ ์ˆ˜์ค€์— ์ฐจ์ด๊ฐ€ ์žˆ๋Š”์ง€ ๋น„๊ตํ•˜๊ณ , (2)์‚ฌ๋ณ„๊ณผ ์ธ์ง€๊ธฐ๋Šฅ์˜ ๊ด€๊ณ„๋ฅผ ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์ด ์กฐ์ ˆํ•˜๋Š”์ง€ ํ™•์ธํ•˜๊ณ ์ž ํ•˜์˜€๋‹ค. ๋˜ํ•œ, ์‚ฌ๋ณ„์ž์˜ ์ธ์ง€๊ธฐ๋Šฅ ์ˆ˜์ค€ ์•…ํ™”๋ฅผ ์˜ˆ๋ฐฉํ•˜๊ธฐ ์œ„ํ•œ ์ƒˆ๋กœ์šด ๊ฐœ์ž…์ง€์ ์„ ์ฐพ๊ณ , ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์˜ ์ข…๋ฅ˜์— ๋”ฐ๋ผ ์‚ฌ๋ณ„์˜ ๋ถ€์ •์  ์˜ํ–ฅ์„ ์กฐ์ ˆํ•˜๋Š” ํšจ๊ณผ๊ฐ€ ๋‹ค๋ฅธ์ง€ ์‚ดํŽด๋ณด์•˜๋‹ค. ์ด๋ฅผ ์œ„ํ•ด ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์„ (1)์ฐธ์—ฌํ•˜๋Š” ์‚ฌํšŒํ™œ๋™์˜ ๊ฐœ์ˆ˜, (2)์‚ฌํšŒํ™œ๋™ ์ฐธ์—ฌ๋นˆ๋„, (3)์ž๋…€์™€ ์—ฐ๋ฝํ•˜๊ณ  ๋งŒ๋‚˜๋Š” ์ ‘์ด‰๋นˆ๋„, ๊ทธ๋ฆฌ๊ณ  (4)๊ฐ€์กฑ ์ด์™ธ ์ธ๊ฐ„๊ด€๊ณ„์™€์˜ ์ ‘์ด‰๋นˆ๋„์˜ 4๊ฐ€์ง€ ๋ณ€์ˆ˜๋กœ ์ธก์ •ํ•˜์—ฌ ๊ฐ๊ฐ์˜ ์กฐ์ ˆํšจ๊ณผ๋ฅผ ์‚ดํŽด๋ณด์•˜๋‹ค. ์–‘์  ๋ถ„์„์ž๋ฃŒ๋Š” ๊ณ ๋ นํ™”์—ฐ๊ตฌํŒจ๋„์กฐ์‚ฌ(KLoSA)์˜ 5์ฐจ(2014๋…„) ๊ธฐ๋ณธ์กฐ์‚ฌ๋ฅผ ํ™œ์šฉํ•˜์˜€์œผ๋ฉฐ, ๊ฒฐ๊ณผ ๋ฐ ํ•ด์„์—์„œ์˜ ํ˜ผ๋ž€์„ ๋ง‰๊ณ  ์‚ฌ๋ณ„์— ๋”ฐ๋ฅธ ๋ฐฐ์šฐ์ž ์œ ๋ฌด์— ์ดˆ์ ์„ ๋‘๊ณ ์ž ์ดํ˜ผ์ด๋‚˜ ๋ณ„๊ฑฐ, ๋…์‹  ๋“ฑ์˜ ๊ฒฝ์šฐ๋Š” ๋ถ„์„์—์„œ ์ œ์™ธํ•˜์˜€๋‹ค. ์—ฐ๊ตฌ ๋Œ€์ƒ์ž๋Š” ๋งŒ 53์„ธ์—์„œ 97์„ธ์˜ ์‚ฌ๋ณ„์ž 622๋ช…, ์œ ๋ฐฐ์šฐ์ž 1,495๋ช…์œผ๋กœ ์ด 2,117๋ช…์ด์—ˆ๋‹ค. ์ž๋ฃŒ์˜ ๋นˆ๋„ ๋ฐ ๊ธฐ์ˆ ํ†ต๊ณ„๋ฅผ ํ†ตํ•ด ๋ถ„์„๋Œ€์ƒ์˜ ํŠน์„ฑ์„ ์‚ดํŽด๋ณด๊ณ , ์œ„๊ณ„์  ํšŒ๊ท€๋ถ„์„์„ ํ†ตํ•ด ๋ณ€์ธ ๊ฐ„์˜ ๊ด€๊ณ„๋ฅผ ์‚ดํŽด๋ณด์•˜๋‹ค. ๋ถ„์„ ๊ฒฐ๊ณผ, ์ธ์ง€๊ธฐ๋Šฅ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๋ณ€์ˆ˜๋“ค์„ ํ†ต์ œํ•œ ์ƒํƒœ์—์„œ ์ค‘ยท๋…ธ๋…„๊ธฐ ์‚ฌ๋ณ„์ž๋Š” ์œ ๋ฐฐ์šฐ์ž์— ๋น„ํ•ด ์ธ์ง€๊ธฐ๋Šฅ์˜ ์ˆ˜์ค€์ด ๋‚ฎ๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ด๋Ÿฌํ•œ ์‚ฌ๋ณ„์˜ ๋ถ€์ •์  ์˜ํ–ฅ์œผ๋กœ๋ถ€ํ„ฐ ์ฐธ์—ฌํ•˜๋Š” ์‚ฌํšŒํ™œ๋™ ๊ฐœ์ˆ˜, ์‚ฌํšŒํ™œ๋™ ์ฐธ์—ฌ๋นˆ๋„, ์ž๋…€ ์ ‘์ด‰๋นˆ๋„๋Š” ์ธ์ง€๊ธฐ๋Šฅ์„ ๋ณดํ˜ธํ•˜๋Š” ์—ญํ• ์ด ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•œ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ์œผ๋‚˜, ๊ฐ€์กฑ ์ด์™ธ ์ธ๊ฐ„๊ด€๊ณ„์˜ ์กฐ์ ˆํšจ๊ณผ๋Š” ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•˜์ง€ ์•Š์•˜๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” 2์ฐจ ์ž๋ฃŒ ๋ถ„์„์˜ ํ•œ๊ณ„๋ฅผ ๋ณด์™„ํ•˜์—ฌ, ํ’๋ถ€ํ•œ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ์˜ ๋„์ถœ๊ณผ, ๊นŠ์€ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ์˜ ํ•ด์„ํ•˜๊ธฐ ์œ„ํ•ด FGI๋ฅผ ํ™œ์šฉํ•œ ์งˆ์  ์—ฐ๊ตฌ๋ฅผ ํ•จ๊ป˜ ์‹ค์‹œํ•˜์˜€๋‹ค. FGI ๋ฉด๋‹ด์€ ์ด 1์‹œ๊ฐ„ 30๋ถ„ ๋™์•ˆ ์ด๋ฃจ์–ด์กŒ์œผ๋ฉฐ, ์ถฉ์ฒญ๋ถ๋„ โ—‹โ—‹์‹œ์— ๊ฑฐ์ฃผํ•˜๊ณ  ๋ฐฐ์šฐ์ž ์‚ฌ๋ณ„์„ ๊ฒฝํ—˜ํ•œ ๋งŒ 65์„ธ ๋ฏธ๋งŒ์˜ ์ค‘๋…„์ธต์ด 2๋ช…, ๋งŒ 65์„ธ ์ด์ƒ์˜ ๋…ธ๋…„์ธต์ด 6๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๋‹ค. ์งˆ์  ์—ฐ๊ตฌ ๋ถ„์„๊ฒฐ๊ณผ, ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž๋“ค์€ ์‚ฌ๋ณ„๋กœ ์ธํ•œ ์ถฉ๊ฒฉ์œผ๋กœ ๊ฐ‘์ž๊ธฐ ๋‹จ์–ด๊ฐ€ ๊ธฐ์–ต์ด ์•ˆ ๋‚˜๊ฑฐ๋‚˜, ๊ธ€์„ ์ฝ์ง€ ๋ชปํ•˜๋Š” ๋“ฑ์˜ ์ธ์ง€๊ธฐ๋Šฅ์˜ ๋ณ€ํ™”๊ฐ€ ๋‚˜ํƒ€๋‚ฌ๋‹ค๊ณ  ์ด์•ผ๊ธฐํ•˜์˜€๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์—ฌ๋Ÿฌ ์‚ฌํšŒํ™œ๋™์— ์ฐธ์—ฌํ•จ์œผ๋กœ์„œ ๋‹ค์–‘ํ•œ ์‚ฌ๋žŒ์„ ๋งŒ๋‚˜๋Š” ๊ฒƒ์ด ๊ธฐ๋ถ„์„ ์ „ํ™˜์‹œํ‚ค๊ณ  ์žก๋…์„ ์‚ฌ๋ผ์ง€๊ฒŒ ํ•œ๋‹ค๊ณ  ํ•˜์˜€๋‹ค. ์‚ฌํšŒํ™œ๋™์— ์ž์ฃผ ์ฐธ์—ฌํ•˜๋Š” ๊ฒƒ์€ ํ™œ๋ ฅ์„ ์–ป๊ฒŒ ํ•˜๋ฉฐ ํ˜ผ์ž ๋œ ์‚ถ์„ ์žŠ๋„๋ก ํ•˜๋ฉฐ, ์ž๋…€์™€ ์ž์ฃผ ์—ฐ๋ฝํ•˜๊ณ  ๋งŒ๋‚˜๋Š” ๊ฒƒ์€ ์ž์‹ ์ด ์‹ฌ์ ์œผ๋กœ ๋Œ๋ด„ ๋ฐ›๊ณ  ์žˆ๋‹ค๋Š” ๋Š๋‚Œ์œผ๋กœ ๊ฐ์‚ฌํ•œ ๋งˆ์Œ์ด ๋“ค๊ฒŒ ํ•œ๋‹ค๊ณ  ํ•˜์˜€๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๊ฐ€์กฑ ์ด์™ธ ์ธ๊ฐ„๊ด€๊ณ„์— ๋Œ€ํ•ด์„œ๋Š” ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž๋“ค์˜ ์ƒ๊ฐ์ด ์„œ๋กœ ๋‹ฌ๋ž๋Š”๋ฐ, ์นœ๊ตฌ๋“ค์„ ๋งŒ๋‚˜ ์ŠคํŠธ๋ ˆ์Šค๋ฅผ ํ•ด์†Œํ•˜๊ฒŒ ๋˜๊ณ  ๊ณต๊ฐ ๋ฐ›๋Š” ๋Š๋‚Œ์œผ๋กœ ์œ„์•ˆ์„ ์–ป๋Š”๋‹ค๋Š” ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž๊ฐ€ ์žˆ๋Š” ํ•œํŽธ, ์•„๋ฌด๋ฆฌ ๊ฐ€๊นŒ์šด ์นœ๊ตฌ๋ผ ํ•ด๋„ ๋‚จ์ด๊ธฐ ๋•Œ๋ฌธ์— ํ•œ๊ณ„๊ฐ€ ์žˆ๋‹ค๊ณ  ์ƒ๊ฐํ•œ๋‹ค๋Š” ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž๋„ ์กด์žฌํ–ˆ๋‹ค. ์ค‘ยท๋…ธ๋…„๊ธฐ ์‚ฌ๋ณ„์ด ์ธ์ง€๊ธฐ๋Šฅ์— ๋ฏธ์น˜๋Š” ๋ถ€์ •์  ์˜ํ–ฅ์„ ์™„์ถฉํ•˜๊ธฐ ์œ„ํ•œ ์‹ค์ฒœ์ ์ธ ํ•จ์˜๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์ฒซ์งธ, ์ธ์ง€๊ธฐ๋Šฅ ๋ฟ ์•„๋‹ˆ๋ผ ์‚ฌ๋ณ„์ด ์‚ฌ๋ณ„์ž์—๊ฒŒ ๋ฏธ์น˜๋Š” ์—ฌ๋Ÿฌ ์˜ํ–ฅ๋“ค์— ๋Œ€ํ•œ ๋ฉด๋ฐ€ํ•œ ์ ‘๊ทผ์ด ํ•„์š”ํ•˜๋‹ค๋Š” ์ ์ด๋‹ค. ์‚ฌ๋ณ„์ž์˜ ์ธ์ง€๊ธฐ๋Šฅ ๋‹จ์ˆœํžˆ ๋…ธํ™”์— ๋”ฐ๋ผ ์ž์—ฐ ๋ฐœ์ƒํ•˜๋Š” ๊ฐœ์ธ์˜ ์ƒ์•  ์‚ฌ๊ฑด์œผ๋กœ ์—ฌ๊ธธ ๊ฒƒ์ด ์•„๋‹ˆ๋ผ, ์‚ฌ๋ณ„์ž๊ฐ€ ์‚ฌ๋ณ„์ด๋ž€ ์ƒ์• ์‚ฌ๊ฑด์œผ๋กœ ์ธํ•ด ๊ฒช๊ฒŒ ๋˜๋Š” ์—ฌ๋Ÿฌ ์ด์ฐจ์  ๋ฌธ์ œ๋“ค์— ๋Œ€ํ•œ ์‚ฌํšŒ์  ๊ด€์‹ฌ๊ณผ ์ ‘๊ทผ์ด ํ•„์š”ํ•˜๋‹ค. ๋‘˜์งธ, ์‚ฌ๋ณ„์ด ์ธ์ง€๊ธฐ๋Šฅ ์ €ํ•˜์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์„ ์™„์ถฉํ•˜๊ธฐ ์œ„ํ•œ ์—ฌ๋Ÿฌ ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ ๊ด€๋ จ ํ”„๋กœ๊ทธ๋žจ ๊ฐœ๋ฐœ๋  ํ•„์š”๊ฐ€ ์žˆ๋‹ค. ๊ฐ€๋ น, ๋ณธ ์—ฐ๊ตฌ์—์„œ ์ฐธ์—ฌํ•˜๋Š” ์‚ฌํšŒํ™œ๋™์˜ ๊ฐœ์ˆ˜๊ฐ€ ๋งŽ์„์ˆ˜๋ก ์‚ฌ๋ณ„์ด ๋ฏธ์น˜๋Š” ๋ถ€์ •์  ์˜ํ–ฅ์œผ๋กœ๋ถ€ํ„ฐ ์ธ์ง€๊ธฐ๋Šฅ์ด ๋ณดํ˜ธ๋˜๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค. ์ด๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ, ์‚ฌ๋ณ„์ž๊ฐ€ ์ฐธ์—ฌํ•  ์ˆ˜ ์žˆ๋Š” ์‚ฌํšŒํ™œ๋™์˜ ์ข…๋ฅ˜๋ฅผ ๋‹น์‚ฌ์ž ์š•๊ตฌ์— ๊ทผ๊ฑฐํ•˜์—ฌ ๋‹ค์–‘ํ•˜๊ฒŒ ๊ฐœ๋ฐœํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋‹ค. ๋˜ํ•œ ์‚ฌ๋ณ„์ž ์ž๋…€๋“ค์„ ๋Œ€์ƒ์œผ๋กœ ํ•˜๋Š” ์‚ฌ๋ณ„์ž ์ดํ•ด ๊ด€๋ จ ๊ต์œก์„ ์‹ค์‹œํ•จ์œผ๋กœ์จ, ์ž๋…€๋“ค๊ณผ์˜ ๊พธ์ค€ํ•œ ๋งŒ๋‚จ๊ณผ ์—ฐ๋ฝ์ด ์‚ฌ๋ณ„์ž์˜ ์ง€์†๋˜๋Š” ์‚ถ์— ๋ณดํ˜ธ์  ์—ญํ• ์„ ํ•จ์„ ๊ฐ•์กฐํ•˜๊ณ  ์‹ค์ œ๋กœ ๊ทธ๋Ÿฌํ•œ ์ ‘์ด‰์ด ์ง€์†์ ์œผ๋กœ ์ด๋ค„์งˆ ์ˆ˜ ์žˆ๋„๋ก ํ•ด์•ผ ํ•œ๋‹ค. ์…‹์งธ, ์‚ฌ๋ณ„์ž๋ฅผ ์œ„ํ•œ ํ”„๋กœ๊ทธ๋žจ์˜ ๋Œ€๋ถ€๋ถ„์ด ๋ณ‘์›์ด๋‚˜ ์ข…๊ต๋‹จ์ฒด ๋“ฑ์—์„œ ์ฃผ๋กœ ์ œ๊ณต๋˜๊ณ  ์žˆ์–ด ๋ณด๋‹ค ์ง€์—ญ์‚ฌํšŒ ์ค‘์‹ฌ์œผ๋กœ ์ ๊ทน์ ์ด๊ณ  ๋ณดํŽธ์ ์œผ๋กœ ํ™•์‚ฐ๋˜์–ด์•ผ ํ•œ๋‹ค๋Š” ์ ์ด๋‹ค. ๋” ๋งŽ์€ ์‚ฌ๋ณ„์ž๋“ค์ด ๋ณดํŽธ์ ์œผ๋กœ ์ด์šฉํ•˜๊ณ  ์‚ฌ๋ณ„์— ๋Œ€์ฒ˜ํ•  ์ˆ˜ ์žˆ๋„๋ก ํ•˜๋Š” ์ œ๋„์  ์ง€์›๊ณผ ๊ธฐ๋ฐ˜์ด ํ˜•์„ฑ๋  ํ•„์š”๊ฐ€ ์žˆ๋‹ค.์ œ1์žฅ. ์„œ๋ก  1 ์ œ1์ ˆ. ์—ฐ๊ตฌ์˜ ๋ฐฐ๊ฒฝ ๋ฐ ํ•„์š”์„ฑ 1 ์ œ2์ ˆ. ์—ฐ๊ตฌ๋ฌธ์ œ 4 ์ œ2์žฅ. ์ด๋ก ์  ๋ฐฐ๊ฒฝ 5 ์ œ1์ ˆ. ์ค‘ยท๋…ธ๋…„๊ธฐ์˜ ์‚ฌ๋ณ„๊ณผ ์ธ์ง€๊ธฐ๋Šฅ 5 1. ์ค‘ยท๋…ธ๋…„๊ธฐ์˜ ์ธ์ง€๊ธฐ๋Šฅ 5 2. ์ค‘ยท๋…ธ๋…„๊ธฐ์˜ ์‚ฌ๋ณ„๊ณผ ์ธ์ง€๊ธฐ๋Šฅ 7 ์ œ2์ ˆ. ์ ์‘์œ ์—ฐ์„ฑ ๋ชจํ˜•(Resilience Model) 11 ์ œ3์ ˆ. ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ(Social Interaction) 13 1. ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์˜ ์ •์˜ 13 2. ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ์˜ ์กฐ์ ˆํšจ๊ณผ 14 ์ œ4์ ˆ. ์ค‘โ€ง๋…ธ๋…„๊ธฐ ์ธ์ง€๊ธฐ๋Šฅ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๋ณ€์ˆ˜๋“ค 18 ์ œ5์ ˆ. ๊ธฐ์กด ์—ฐ๊ตฌ์˜ ํ•œ๊ณ„ 20 ์ œ3์žฅ. ์—ฐ๊ตฌ๊ฐ€์„ค ๋ฐ ์—ฐ๊ตฌ๋ชจํ˜• 22 ์ œ1์ ˆ. ์—ฐ๊ตฌ๋ฌธ์ œ ๋ฐ ๊ฐ€์„ค 22 ์ œ2์ ˆ. ์—ฐ๊ตฌ๋ชจํ˜• 23 ์ œ4์žฅ. ์—ฐ๊ตฌ ๋ฐฉ๋ฒ• 24 ์ œ1์ ˆ. ์ž๋ฃŒ ๋ฐ ๋ณ€์ˆ˜ ์ธก์ • 24 1. ์–‘์ ์—ฐ๊ตฌ 24 2) ๋ณ€์ˆ˜์˜ ์ธก์ • 25 2. ์งˆ์ ์—ฐ๊ตฌ 30 ์ œ2์ ˆ. ๋ถ„์„ ๋ฐฉ๋ฒ• 33 1. ์–‘์ ์—ฐ๊ตฌ 33 2. ์งˆ์ ์—ฐ๊ตฌ 34 ์ œ5์žฅ. ์–‘์  ์—ฐ๊ตฌ ๊ฒฐ๊ณผ 35 ์ œ1์ ˆ. ์—ฐ๊ตฌ๋Œ€์ƒ์ž์˜ ์ธ๊ตฌ์‚ฌํšŒํ•™์  ํŠน์„ฑ 35 ์ œ2์ ˆ. ์ฃผ์š” ๋ณ€์ˆ˜์˜ ๊ธฐ์ˆ ํ†ต๊ณ„ ๋ฐ ๋ณ€์ˆ˜ ๊ฐ„ ์ƒ๊ด€๊ด€๊ณ„ 39 1. ์ฃผ์š” ๋ณ€์ˆ˜์˜ ๊ธฐ์ˆ ํ†ต๊ณ„ 39 2. ์ฃผ์š” ๋ณ€์ˆ˜ ๊ฐ„ ์ƒ๊ด€๊ด€๊ณ„ 40 ์ œ3์ ˆ. ๊ฐ€์„ค๊ฒ€์ฆ 44 1. ์ค‘ยท๋…ธ๋…„๊ธฐ ์‚ฌ๋ณ„๊ณผ ์ธ์ง€๊ธฐ๋Šฅ์˜ ๊ด€๊ณ„ 44 2. ์‚ฌ๋ณ„๋กœ๋ถ€ํ„ฐ ์ธ์ง€๊ธฐ๋Šฅ์„ ๋ณดํ˜ธํ•˜๋Š” ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ 47 ์ œ6์žฅ. ์งˆ์  ์—ฐ๊ตฌ ๊ฒฐ๊ณผ 51 1. ์—ฐ๊ตฌ ์ฐธ์—ฌ์ž 51 2. ์—ฐ๊ตฌ๊ฒฐ๊ณผ 51 ์ œ7์žฅ. ๋…ผ์˜ ๋ฐ ๊ฒฐ๋ก  57 ์ œ1์ ˆ. ์—ฐ๊ตฌ๊ฒฐ๊ณผ ์š”์•ฝ 57 1. ์–‘์  ์—ฐ๊ตฌ๊ฒฐ๊ณผ ์š”์•ฝ 57 2. ์งˆ์  ์—ฐ๊ตฌ๊ฒฐ๊ณผ ์š”์•ฝ 60 ์ œ2์ ˆ. ์—ฐ๊ตฌ๊ฒฐ๊ณผ ๋…ผ์˜ 62 1. ์ค‘ยท๋…ธ๋…„๊ธฐ ์‚ฌ๋ณ„๊ณผ ์ธ์ง€๊ธฐ๋Šฅ์˜ ๊ด€๊ณ„ 62 2. ์‚ฌ๋ณ„๋กœ๋ถ€ํ„ฐ ์ธ์ง€๊ธฐ๋Šฅ์„ ๋ณดํ˜ธํ•˜๋Š” ์‚ฌํšŒ์  ์ƒํ˜ธ์ž‘์šฉ 63 ์ œ3์ ˆ. ์—ฐ๊ตฌ์˜ ํ•จ์˜ 66 1. ์ด๋ก ์  ํ•จ์˜ 66 2. ์‹ค์ฒœ์  ํ•จ์˜ 67 ์ œ4์ ˆ. ์—ฐ๊ตฌ์˜ ํ•œ๊ณ„ ๋ฐ ํ›„์†์—ฐ๊ตฌ ์ œ์–ธ 69 ์ฐธ๊ณ ๋ฌธํ—Œ 71 ๋ถ€๋ก: ์ธก์ •๋„๊ตฌ 86 Abstract 103Maste
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