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сувилахуйн
анхаарвал зохих

간호의 관심:

환경(Environment)
орчин
간호사는 왜 환경을 이해해야
하는가?
• Healthy environment lead to
healthy people
• 건강한 환경은 사람을 건강하게 한다.

• Ýð¿¿ë îð÷èíä ýð¿¿ë õ¿ì¿¿ñ áèé áîëíî.
간호: 환경 지킴이
сувилахуй орчныг
хамгаалах нь
Dictionary definition

환경의 사전적 정의
Òîëü áè÷èãèéí òîäîðõîéëîëò
• 사람에게 두루 영향을 끼치는 자연이나 사회의
조건이나 형편, 상태따위
• Хүн бүрт нөлөөлөх байгаль болоод
нийгмийн нөхцөл байдал
생활하고 있는 곳의 주변상태 амьдарч байгаа
газрын орчин тойрны нөхцөл
1.

Definitions정의(1)
òîäîðõîéëîëò 1

• 아프거나 건강한 사람의 건강에 영향을 미치는 사람의 외부감염의
주된 원인이 되는 환경은 신선한 공기, 맑은 물, 적합한 배수, 청결,

빛과 같은 것이다(Nightingale, 1859).
• 삶과 발달에 영향을 미치는 모든 외적 조건과 영향(Henderson,
1966)
Definitions정의(2)Òîäîðõîéëîëò
2

• 사람이나 가족의 발달과 행위에 영향을 주는 모든 조건, 상
황, 주위의 요소(Roy, 1984)
• 환자가 자기 간호요구를 충족시키지 못하게 하는 어떤 주변
상황(Orem, 1985)
사람과 환경의 상호교환적 관계`
humuus ba orchnii hariltsaa
정치환경улс төрийн орчин
영향

물리환경байгаль
орчин
영향

영향

사람 хүн

경제환경эдийн засгийн
орчин

영향

사회, 문화환경нийгэм соёлын орчин
환경의 예
사회
환경

물리
환경

경제
환경

정치
환경

사회적
지지

역할

물

산업장

법

사회환경의

교육

식물

사업체

정치세력

하나로서

가족

기후

교통

건강정책

사람에게

집단,

공해

서비스유용성

정부구조

중요한

지역사회

빛

서비스경비

흥미집단

기능을

결혼

소음

기술

경제정책

하는 것이

규범

주택

경제성장

생활양상

사회적지지(S
ocial
support)다.
환경의 예
Social Variables
нийгмийн

Physical Variables Economic
Физикийн
Variables Эдийн
засгийн

Political Variables
Улс төрийн

Roles
¿¿ðýã

Water
óñ

Business
Áèçí

Laws
õóóëü

Education áîëîâñðîë

Plants
óðãàìàë

Industry
¿éëäâýð

Political power
Óëñ òºðèéí õ¿÷

Family
ãýð á¿ë

Weather
Öàã àãààð

Transportation
Òýýâðèéí õýðýãñýë

Health policy
Ýð¿¿ë óëñ òºð

Marriage
ãýðëýëò

Pollution
àãààðûí áîõèðäîë

Availability of
services
¯éë÷èëãýýíèé
õýðýãöýý

Governmental
structure çàñãèéí
ãàçðûí á¿òýö

Norms
Түвшин

Light
Ãýðýë

Payment of services
¿éë÷èëãýýíèé òºëáºð

Interest groups
Ñîíèðõîëûí á¿ëãýì

Life-style àìüäðàëûí
õýâ ìàÿã

Noise
Äóó ÷èìýý

Technology
Òåõíîëîãè

Economic policy
ýäèéí çàñãèéí óëñ
òºð

Religion øàøèí
ø¿òëýã

Shelter орон сууц

Economic growth
Ýäèéí çàñãèéí ºñºëò

Litigation зарга
Immediate physical environment
Ýíãèéí áèå ìàõ áîäèéí îð÷èí
•
•
•
•
•
•
•

Safety factors Àþóëã¿é ¿éëäâýð¿¿ä
Mechanical injury Ìåõàíèêèéí ãýìòýë
Thermal injury Äóëààíû ãýìòýë
Electrical injury Öàõèëãààíû ãýìòýë
Radiation Öàöðàã òóÿà
Chemical hazards Õèìèéí áîäèñíû àþóë
Infection control õàëäâàðûí õÿíàëò
▫ Temperature and humidity Áèåèéí õýì
õºëðºëò
▫ noise and odors Äóó ÷èìýý áà ¿íýð
▫ Layout and decor
Áàéðøèë áà
ýëäýâ òóóðàëò
Physical environment of the community Áèå
ìàõáîäèéí îð÷èíû õàðèëöàà õàìààðàë

지역사회의 물리적 환경

 Climate îþóí óõààí

 Geography Ãàçàðç¿é
 Air Quality Àãààðûí ÷àíàð
 Water Quality óñíû ÷àíàð
 Soil Quality õºðñíèé ÷àíàð
 Food Purity Ýð¿¿ë õ¿íñ
Nursing Implications: Ñóâèëõóéí ¿ð äàãàâàð

12

Caring for the Environment Õ¿ðýýëýí áóé
îð÷èíã àíõààðàõ
• Community health nurses are actively involved in identifying or
intervening with environmentally caused health problems.
• Niigmiin eruul mendiin suvulagchid
• hureelen bui orchnoos shaltgaalan uussen uvchiniig sudlahad iheehe
n anhaaral handuuldag.
• Epidimologi bol uvchnii nuluulul , huree, tarhal, hyanaltiig sudaldag
uhaan.
• Suvilagchid Epidemiologiin sudalgaanii uvchtun oloh, eruul mendiin
uzleg hiih zeregt mun oroltsoh bolomjtoi.
Nursing Implications: Ñóâèëõóéí ¿ð äàãàâàð

Caring for the Environment Õ¿ðýýëýí áóé
îð÷èíã àíõààðàõ
• Epidemiology is the study of the incidence,
distribution, and control of disease in a
human population. Ýïèäèîìîëîãè áîë
• Nurses in the community may be involved in
case-finding or health-screening programs
that produce data for Epidemiologic studies.
14

Nursing Implications: Caring for the

Environment
uureg: HUreelen bui orchinii eruul ahuid suvilagc
h herhen sanaa tavih
• For example, nurses may identify a large number of
cases of giardiasis. They then report their findings
to the local water treatment authorities, who test the
community’s water supply and confirm the presence
of the parasite. The nurses implement a program of
preventive education in the area to curb further
incidence of the disease.
• an intestinal infection caused by ingesting a flagellate
protozoan, usually from water that contains the faeces of
infected animals. The symptoms are prolonged
diarrhoea and abdominal pain.
• jishee n suvilagchid olon toonii giardiasis-tai holbootoi a
suudluudiig gargaj irehed ted niitiin heregleenii usiig sha
lgadag oron nutgiin usnii bolovsruulaltiig hariutssan udi
rdah gazart usand parasite bga bolohiig helne. Tegsneer
suvilagchid ireeduid delgereh uvchinii tarhuulahguin tul
d surgalt zohion baiguulj yavuulda
16

The Social Environment
• Structure of Social System: 사회체제의 구조: structural components,
among which are boundaries, norms, roles, and positions. 구조, 규범,
역할, 지위 Нийгмийн тогтолцооны бүтэц: бүтцийн бүрэлдэхүүн
хэсгүүд болон тэдгээрийн хил хязгаар, хэм хэмжээ, үүрэг болон
байршил
Norms are expected behaviors. Хэм хэмжээ нь зан аашаар
илэрхийлэгдэнэ.
Roles are sets of expected behaviors that are
normatively
defined Үүрэг нь хэм хэмжээгээр тодорхойлогдсон зан байдлаар
илэрхийлэгдэнэ.
Positions are syntheses of related roles and represent the locations
of persons in a social system. Байршил нь үүрэгтэй хамааралтай
синтез бөгөөд хүний нийгмийн тогтоцоонд хаана байгаа
байрлалыг заадаг.
• Process of Social System. 사회체제의 과정
нийгмийн тогтолцооны процес
• Types of Social Systems 사회체제의 형태:
нийгмийн тогтолцооны төрөл
Families гэр бүл
Groups групп
Communities хамт олон
These systems will be detailed in the
sessions of nursing clients. Эдгээр
системүүд нь сувилахуйн хэрэглэгчид
гэсэн хичээл дээр илүү нарийн авч үзнэ.
18

Social support Нийгмийн хангамж
An important function of the systems that compose the social
environment is social support. Classic definitions of social support
include: хүрээлэн буй нийгмийí нэг чухал ¿¿ðýã нь нийгмийн
хангамж юм. Ñîíãîäîã íийгмийн хангамжийн тодорхойлолтîä:
Information leading a person to believe he or she is cared for and
loved, esteemed and valued, and belongs to a network of
communication and mutual obligation (Cobb, 1976, p. 300) хүнд
итгэдэг, өөрт нь хайртай, түүнийг халамжилдаг, үнэлдэг ,
нийгмийн ямар нэгэн сүлжээнд хамааралтай болон харилцан
үүрэг хүлээсэн зэрэг мэдээлэл
Support accessible to an individual through social ties to other
individuals, groups, and the larger community (Lin, Ensel, Simeone,
and Kuo, 1979, p. 109) нийгмийн сүлжээ холбоогоороо
дамжуулан хувь хүнийг бусад хүмүүстэй, бүлэгтэй болон
нийгмийн арай том хэсэгтэй холбож дэмжиж өгөх
Social support Нийгмийн
хангамж
A flow of emotional concern, instrumental aid, information,
or appraisal between people (House, 1981, p. 26) хүмүүс
хоорондын сэтгэл хөөрөл, эд материалын тусламж,
мэдээлэл болон үнэлгээний урсгал
Interpersonal transactions that include one or more of the
following elements: expression of positive affect; affirmation
of another person’s behaviors, perceptions, or view; giving
aid to another (Norbeck, Lindsey, & Carrieri, 1981) дараах
элементүүдийн нэг болон түүнээс дээш ийг багтаасан
хувь хүмүүс хоорондын харилцаа: эерэг үр нөлөөтэй
илэрхийлэл, өөр хэн нэгний үзэл суртал, зан аашийг
хүлээн зөвшөөрсөн , өөр хэн нэгэнд тусалах тусламж
20

Functions and Sources of Social Support
Нийгмийн хангамжийн үйл ажиллагаа
болон эх үүсвэр
Pender (1996) identified four ways that social support may positively
affect health. Пэндэр эрүүл мэндэд эергээр нөлөөлж болох
нийгмийн хангамжийн дөрвөн аргыг тодорхойлжээ. Social networks
may Нийгмийн сүлжээ нь :
Create an environment that enhances self-esteem and well-being.
Өөрийгөө үнэлэн болон эрүүл байдлыг хангах хүрээлэн буй
орчинг бий болгох
Decrease the likelihood of stressful life events. Стресс төрүүлсэн
үйл явдалыг багасгах
Provide feedback regarding the consequences of one’s actions for
health and well-being. Эрүүл мэнд болон энх тунх байдлын
төлөөх хэн нэгний үйлдэлийн үр дагаварыг дэмжих
Buffer the negative effects of stressful events. Стресс төрүүлсэн
үйл явдалын сөрөг үр дагаварыг багасгах
21

Nursing Implications
Who provides support: Хэн дэмжлэг хийдэг вэ
Does the client have a confidant?
Үйлчлүүлэгч бат
итгэлтэй байна уу?
Are the spouse, family, and friends supportive? Хосууд, гэр
бүл болон найзууд
Does the client participate in organizations or activities?
Үйлчлүүлэгч зохион байгуулалт болон үйл ажиллагаанд
оролцдог уу?
Nursing Implications
• What helping behaviors are important to the client: financial
assistance, emotional support, information sources, and so
forth? Үйлчлүүлэгчид ямар төрлийн тусламж хэрэгтэй вэ?
Санхүүгийн, сэтгэл санааны, мэдээллийн болон өөр ямар
тусламж дэмлэг хэрэгтэй байна вэ?

• Is the support system adequate from the client’s
perspective: Is there enough support of the kind
desired by the client? Үйлчлүүлэгчийн хүсэж
байгаа тусламж дэмжлгийг хангалттай үзүүлж
чадах уу?
The Cultural Environment
문화적 환경 Õ¿ðýýëýí áóé îð÷èíû ñî¸ë
• 경험을 해석하는 습득된 지식과 사회적 행위 ”
(Spradley, 1979, p. 5)
• 인종, 국민,가치,언어와 의사소통, 가족체제,치
유와 치료에 대한 신념, 종교의 신념과 실행에
따라 영향을 받는다.
24

The Cultural Environment Соѐлын
хүлээлэн буй орчин
• A classic definition of culture is “the acquired
knowledge that people use to interpret experience
and generate social behavior” (Spradley, 1979, p. 5
• соѐлын талаарх нэг сайн тодорхойлолт нь
“ хүмүүсийн туршлага хуримтлуулахдаа мөн
нийгмийн зан төлөвийг ойлгохдоо ашигладаг
хүмүүсийн олж авсан мэдлэг” юм.
The Cultural Environment Соѐлын
хүлээлэн буй орчин
• A nurse anthropologist, Leininger(1991) defined as
the learned, shared, and transmitted values, beliefs,
norms, and lifeways of a particular group that guided
their thinking, decisions, and actions in patterned
ways(p.47)
• сувилагч
антрапологч
Leininger
–ийн
тодорхойлсоноор хүмүүсийн өөрсдийнх нь
шийдвэр үзэл санааг нь тодорхой замаар
дагуулдаг
бусдаас
суралцсан,
дамжуулсан
үнэлэмж , итгэл хэм хэмжээ, амьдралынх нь хэв
маягыг хэлнэ гэсэн байна.
26

Cultural variables Ñî¸ëûí õóâüñàë
• Cultural variables refer to those characteristics that
a person exhibits or identifies with from a particular
cultural group Ñî¸ëûí õóâüñàë íü ñî¸ëûí îíöãîé
á¿ëýãýýñ òîäîðõîéëîãäîõ ýñâýë òóõàé õ¿í áîäèò
íîòëîãäñîí
áàðèìò
ýñâýë
øèíæ
òýìäýã¿¿äèéã
õàìààðäàã.
• These variables may or may not be exhibited by
every person from a cultural group Ýäãýýð õóâüñàë
íü ñî¸ëûí á¿ëýãýýñ õ¿í á¿ðýýð íîòëîãñîí áàéæ ÷ áîëíî
¿ã¿é ÷ áàéæ áîëíî.
Cultural variables Ñî¸ëûí õóâüñàë
• Any individual, depending on personal experience,
may have all, none, or any combination of these
variables Õóâü õ¿í á¿ð õóâèéí äàäëàãà òóðøëàãà,
á¿õ ç¿éëòýé, þó ÷ ã¿é ýñâýë ýäãýýð õóâüñëóóäûí
õîñëóóëñàí çýðãýýñ õàìààðíà.
•
•
•
•

Ethnic and racial identity ¯íäýñòýí áà õóâü õ¿í
Value orientations ¿íýò ç¿éëñèéí ÷èã áàðèìæàà
Language and communication õýë áîëîí õàðèëöàà
Family system ãýð á¿ëèéí á¿òýö
간호 이론가들의 환경
Both internal & external forces surrounding the
client, influencing and being influenced by the
client at any print in time and an open
system(Neuman, p.45)
The background for human interactions. It is both
external to and internal to, the individual(King, )
Conditions, circumstances, and influences that
…effect the development and behavior of
humans as adaptive system(Roy).
사회구조와 세계관

문화

정치

혈연

종교

기술

경제

인간의 건강과
간호에 주는 영향

건강체제에서 개인, 가족, 문화집단

Leininger 의 해돋이 모델

교육
나이팅게일의 개념틀
물리적 환경

청결
공기
소음
침구
보온

의사소통
충고
변화

정신적 환경

환기
햇빛
물
배수
식이

환자의
상태와 본성

사망률
질병의 예방

사회적 환경
31

Readings
Cobb, s.(1976). Social support as a moderator of life stress.
psychosomatic medicine, 38, 300-314.
Hous, J.S.(1981). work stress and social support. Reading. MA.:
Addison-WesLey.àæëèéí ñòðåññ áà íèéãìèéí õàëàìæ óíøëàãà
Kleffel. D.(1991). Rethinking the environment as a domain of
nursing knowledge advances in nursing science, 14(1), 40-51.
Lin, N., Ensel, W.M., Simeone, R.S., & Kuo, W.(1979). Social
support, stressful life envents and illness: A model and an
empirical test. Journal of health and social behavior, 20, 109119
Norbeck, J.S., Lindsey, A.M., & Garrieri, V.L.(1981). The
development of an instrument to measure social support.
Nursing Research, 30, 264-269.
Pender, N.J.(1996). health promotion in nursing practice(3rd ed.).
Stamford, CT: Appleton & Lange,
32

Learning activities
1.

2.

Review a newspaper or news magazine for one
week. What environmental issues are receiving
media attention? As a nurse what actions could
you take to affect these problems? Ñîíèí áîëîí
ñýòã¿¿ëèéí òîéì äîëîî õîíîã íýã óäóó óíøèõ. ßìàð
õ¿ðýýëýí áóé îð÷èíû àñóóäàë çóðàãòèéí
àíõààðàëä îðæèéí?
How social support can be applied to your client?
Give a specific situation exampler. Íèéãìèéí õàëàìæ
ÿàæ ÷èíèé ¿éë÷ë¿¿ëýã÷èä õàìòðàã÷ áîëæ áàéíà?
Áîäèò íºõöºë áàéäàëûí æèøýý ºãºíº ¿¿.

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9.환경

  • 2. 간호사는 왜 환경을 이해해야 하는가? • Healthy environment lead to healthy people • 건강한 환경은 사람을 건강하게 한다. • Ýð¿¿ë îð÷èíä ýð¿¿ë õ¿ì¿¿ñ áèé áîëíî.
  • 3. 간호: 환경 지킴이 сувилахуй орчныг хамгаалах нь
  • 4. Dictionary definition 환경의 사전적 정의 Òîëü áè÷èãèéí òîäîðõîéëîëò • 사람에게 두루 영향을 끼치는 자연이나 사회의 조건이나 형편, 상태따위 • Хүн бүрт нөлөөлөх байгаль болоод нийгмийн нөхцөл байдал 생활하고 있는 곳의 주변상태 амьдарч байгаа газрын орчин тойрны нөхцөл
  • 5. 1. Definitions정의(1) òîäîðõîéëîëò 1 • 아프거나 건강한 사람의 건강에 영향을 미치는 사람의 외부감염의 주된 원인이 되는 환경은 신선한 공기, 맑은 물, 적합한 배수, 청결, 빛과 같은 것이다(Nightingale, 1859). • 삶과 발달에 영향을 미치는 모든 외적 조건과 영향(Henderson, 1966)
  • 6. Definitions정의(2)Òîäîðõîéëîëò 2 • 사람이나 가족의 발달과 행위에 영향을 주는 모든 조건, 상 황, 주위의 요소(Roy, 1984) • 환자가 자기 간호요구를 충족시키지 못하게 하는 어떤 주변 상황(Orem, 1985)
  • 7. 사람과 환경의 상호교환적 관계` humuus ba orchnii hariltsaa 정치환경улс төрийн орчин 영향 물리환경байгаль орчин 영향 영향 사람 хүн 경제환경эдийн засгийн орчин 영향 사회, 문화환경нийгэм соёлын орчин
  • 9. 환경의 예 Social Variables нийгмийн Physical Variables Economic Физикийн Variables Эдийн засгийн Political Variables Улс төрийн Roles ¿¿ðýã Water óñ Business Áèçí Laws õóóëü Education áîëîâñðîë Plants óðãàìàë Industry ¿éëäâýð Political power Óëñ òºðèéí õ¿÷ Family ãýð á¿ë Weather Öàã àãààð Transportation Òýýâðèéí õýðýãñýë Health policy Ýð¿¿ë óëñ òºð Marriage ãýðëýëò Pollution àãààðûí áîõèðäîë Availability of services ¯éë÷èëãýýíèé õýðýãöýý Governmental structure çàñãèéí ãàçðûí á¿òýö Norms Түвшин Light Ãýðýë Payment of services ¿éë÷èëãýýíèé òºëáºð Interest groups Ñîíèðõîëûí á¿ëãýì Life-style àìüäðàëûí õýâ ìàÿã Noise Äóó ÷èìýý Technology Òåõíîëîãè Economic policy ýäèéí çàñãèéí óëñ òºð Religion øàøèí ø¿òëýã Shelter орон сууц Economic growth Ýäèéí çàñãèéí ºñºëò Litigation зарга
  • 10. Immediate physical environment Ýíãèéí áèå ìàõ áîäèéí îð÷èí • • • • • • • Safety factors Àþóëã¿é ¿éëäâýð¿¿ä Mechanical injury Ìåõàíèêèéí ãýìòýë Thermal injury Äóëààíû ãýìòýë Electrical injury Öàõèëãààíû ãýìòýë Radiation Öàöðàã òóÿà Chemical hazards Õèìèéí áîäèñíû àþóë Infection control õàëäâàðûí õÿíàëò ▫ Temperature and humidity Áèåèéí õýì õºëðºëò ▫ noise and odors Äóó ÷èìýý áà ¿íýð ▫ Layout and decor Áàéðøèë áà ýëäýâ òóóðàëò
  • 11. Physical environment of the community Áèå ìàõáîäèéí îð÷èíû õàðèëöàà õàìààðàë 지역사회의 물리적 환경  Climate îþóí óõààí  Geography Ãàçàðç¿é  Air Quality Àãààðûí ÷àíàð  Water Quality óñíû ÷àíàð  Soil Quality õºðñíèé ÷àíàð  Food Purity Ýð¿¿ë õ¿íñ
  • 12. Nursing Implications: Ñóâèëõóéí ¿ð äàãàâàð 12 Caring for the Environment Õ¿ðýýëýí áóé îð÷èíã àíõààðàõ • Community health nurses are actively involved in identifying or intervening with environmentally caused health problems. • Niigmiin eruul mendiin suvulagchid • hureelen bui orchnoos shaltgaalan uussen uvchiniig sudlahad iheehe n anhaaral handuuldag. • Epidimologi bol uvchnii nuluulul , huree, tarhal, hyanaltiig sudaldag uhaan. • Suvilagchid Epidemiologiin sudalgaanii uvchtun oloh, eruul mendiin uzleg hiih zeregt mun oroltsoh bolomjtoi.
  • 13. Nursing Implications: Ñóâèëõóéí ¿ð äàãàâàð Caring for the Environment Õ¿ðýýëýí áóé îð÷èíã àíõààðàõ • Epidemiology is the study of the incidence, distribution, and control of disease in a human population. Ýïèäèîìîëîãè áîë • Nurses in the community may be involved in case-finding or health-screening programs that produce data for Epidemiologic studies.
  • 14. 14 Nursing Implications: Caring for the Environment uureg: HUreelen bui orchinii eruul ahuid suvilagc h herhen sanaa tavih • For example, nurses may identify a large number of cases of giardiasis. They then report their findings to the local water treatment authorities, who test the community’s water supply and confirm the presence of the parasite. The nurses implement a program of preventive education in the area to curb further incidence of the disease.
  • 15. • an intestinal infection caused by ingesting a flagellate protozoan, usually from water that contains the faeces of infected animals. The symptoms are prolonged diarrhoea and abdominal pain. • jishee n suvilagchid olon toonii giardiasis-tai holbootoi a suudluudiig gargaj irehed ted niitiin heregleenii usiig sha lgadag oron nutgiin usnii bolovsruulaltiig hariutssan udi rdah gazart usand parasite bga bolohiig helne. Tegsneer suvilagchid ireeduid delgereh uvchinii tarhuulahguin tul d surgalt zohion baiguulj yavuulda
  • 16. 16 The Social Environment • Structure of Social System: 사회체제의 구조: structural components, among which are boundaries, norms, roles, and positions. 구조, 규범, 역할, 지위 Нийгмийн тогтолцооны бүтэц: бүтцийн бүрэлдэхүүн хэсгүүд болон тэдгээрийн хил хязгаар, хэм хэмжээ, үүрэг болон байршил Norms are expected behaviors. Хэм хэмжээ нь зан аашаар илэрхийлэгдэнэ. Roles are sets of expected behaviors that are normatively defined Үүрэг нь хэм хэмжээгээр тодорхойлогдсон зан байдлаар илэрхийлэгдэнэ. Positions are syntheses of related roles and represent the locations of persons in a social system. Байршил нь үүрэгтэй хамааралтай синтез бөгөөд хүний нийгмийн тогтоцоонд хаана байгаа байрлалыг заадаг.
  • 17. • Process of Social System. 사회체제의 과정 нийгмийн тогтолцооны процес • Types of Social Systems 사회체제의 형태: нийгмийн тогтолцооны төрөл Families гэр бүл Groups групп Communities хамт олон These systems will be detailed in the sessions of nursing clients. Эдгээр системүүд нь сувилахуйн хэрэглэгчид гэсэн хичээл дээр илүү нарийн авч үзнэ.
  • 18. 18 Social support Нийгмийн хангамж An important function of the systems that compose the social environment is social support. Classic definitions of social support include: хүрээлэн буй нийгмийí нэг чухал ¿¿ðýã нь нийгмийн хангамж юм. Ñîíãîäîã íийгмийн хангамжийн тодорхойлолтîä: Information leading a person to believe he or she is cared for and loved, esteemed and valued, and belongs to a network of communication and mutual obligation (Cobb, 1976, p. 300) хүнд итгэдэг, өөрт нь хайртай, түүнийг халамжилдаг, үнэлдэг , нийгмийн ямар нэгэн сүлжээнд хамааралтай болон харилцан үүрэг хүлээсэн зэрэг мэдээлэл Support accessible to an individual through social ties to other individuals, groups, and the larger community (Lin, Ensel, Simeone, and Kuo, 1979, p. 109) нийгмийн сүлжээ холбоогоороо дамжуулан хувь хүнийг бусад хүмүүстэй, бүлэгтэй болон нийгмийн арай том хэсэгтэй холбож дэмжиж өгөх
  • 19. Social support Нийгмийн хангамж A flow of emotional concern, instrumental aid, information, or appraisal between people (House, 1981, p. 26) хүмүүс хоорондын сэтгэл хөөрөл, эд материалын тусламж, мэдээлэл болон үнэлгээний урсгал Interpersonal transactions that include one or more of the following elements: expression of positive affect; affirmation of another person’s behaviors, perceptions, or view; giving aid to another (Norbeck, Lindsey, & Carrieri, 1981) дараах элементүүдийн нэг болон түүнээс дээш ийг багтаасан хувь хүмүүс хоорондын харилцаа: эерэг үр нөлөөтэй илэрхийлэл, өөр хэн нэгний үзэл суртал, зан аашийг хүлээн зөвшөөрсөн , өөр хэн нэгэнд тусалах тусламж
  • 20. 20 Functions and Sources of Social Support Нийгмийн хангамжийн үйл ажиллагаа болон эх үүсвэр Pender (1996) identified four ways that social support may positively affect health. Пэндэр эрүүл мэндэд эергээр нөлөөлж болох нийгмийн хангамжийн дөрвөн аргыг тодорхойлжээ. Social networks may Нийгмийн сүлжээ нь : Create an environment that enhances self-esteem and well-being. Өөрийгөө үнэлэн болон эрүүл байдлыг хангах хүрээлэн буй орчинг бий болгох Decrease the likelihood of stressful life events. Стресс төрүүлсэн үйл явдалыг багасгах Provide feedback regarding the consequences of one’s actions for health and well-being. Эрүүл мэнд болон энх тунх байдлын төлөөх хэн нэгний үйлдэлийн үр дагаварыг дэмжих Buffer the negative effects of stressful events. Стресс төрүүлсэн үйл явдалын сөрөг үр дагаварыг багасгах
  • 21. 21 Nursing Implications Who provides support: Хэн дэмжлэг хийдэг вэ Does the client have a confidant? Үйлчлүүлэгч бат итгэлтэй байна уу? Are the spouse, family, and friends supportive? Хосууд, гэр бүл болон найзууд Does the client participate in organizations or activities? Үйлчлүүлэгч зохион байгуулалт болон үйл ажиллагаанд оролцдог уу?
  • 22. Nursing Implications • What helping behaviors are important to the client: financial assistance, emotional support, information sources, and so forth? Үйлчлүүлэгчид ямар төрлийн тусламж хэрэгтэй вэ? Санхүүгийн, сэтгэл санааны, мэдээллийн болон өөр ямар тусламж дэмлэг хэрэгтэй байна вэ? • Is the support system adequate from the client’s perspective: Is there enough support of the kind desired by the client? Үйлчлүүлэгчийн хүсэж байгаа тусламж дэмжлгийг хангалттай үзүүлж чадах уу?
  • 23. The Cultural Environment 문화적 환경 Õ¿ðýýëýí áóé îð÷èíû ñî¸ë • 경험을 해석하는 습득된 지식과 사회적 행위 ” (Spradley, 1979, p. 5) • 인종, 국민,가치,언어와 의사소통, 가족체제,치 유와 치료에 대한 신념, 종교의 신념과 실행에 따라 영향을 받는다.
  • 24. 24 The Cultural Environment Соѐлын хүлээлэн буй орчин • A classic definition of culture is “the acquired knowledge that people use to interpret experience and generate social behavior” (Spradley, 1979, p. 5 • соѐлын талаарх нэг сайн тодорхойлолт нь “ хүмүүсийн туршлага хуримтлуулахдаа мөн нийгмийн зан төлөвийг ойлгохдоо ашигладаг хүмүүсийн олж авсан мэдлэг” юм.
  • 25. The Cultural Environment Соѐлын хүлээлэн буй орчин • A nurse anthropologist, Leininger(1991) defined as the learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group that guided their thinking, decisions, and actions in patterned ways(p.47) • сувилагч антрапологч Leininger –ийн тодорхойлсоноор хүмүүсийн өөрсдийнх нь шийдвэр үзэл санааг нь тодорхой замаар дагуулдаг бусдаас суралцсан, дамжуулсан үнэлэмж , итгэл хэм хэмжээ, амьдралынх нь хэв маягыг хэлнэ гэсэн байна.
  • 26. 26 Cultural variables Ñî¸ëûí õóâüñàë • Cultural variables refer to those characteristics that a person exhibits or identifies with from a particular cultural group Ñî¸ëûí õóâüñàë íü ñî¸ëûí îíöãîé á¿ëýãýýñ òîäîðõîéëîãäîõ ýñâýë òóõàé õ¿í áîäèò íîòëîãäñîí áàðèìò ýñâýë øèíæ òýìäýã¿¿äèéã õàìààðäàã. • These variables may or may not be exhibited by every person from a cultural group Ýäãýýð õóâüñàë íü ñî¸ëûí á¿ëýãýýñ õ¿í á¿ðýýð íîòëîãñîí áàéæ ÷ áîëíî ¿ã¿é ÷ áàéæ áîëíî.
  • 27. Cultural variables Ñî¸ëûí õóâüñàë • Any individual, depending on personal experience, may have all, none, or any combination of these variables Õóâü õ¿í á¿ð õóâèéí äàäëàãà òóðøëàãà, á¿õ ç¿éëòýé, þó ÷ ã¿é ýñâýë ýäãýýð õóâüñëóóäûí õîñëóóëñàí çýðãýýñ õàìààðíà. • • • • Ethnic and racial identity ¯íäýñòýí áà õóâü õ¿í Value orientations ¿íýò ç¿éëñèéí ÷èã áàðèìæàà Language and communication õýë áîëîí õàðèëöàà Family system ãýð á¿ëèéí á¿òýö
  • 28. 간호 이론가들의 환경 Both internal & external forces surrounding the client, influencing and being influenced by the client at any print in time and an open system(Neuman, p.45) The background for human interactions. It is both external to and internal to, the individual(King, ) Conditions, circumstances, and influences that …effect the development and behavior of humans as adaptive system(Roy).
  • 29. 사회구조와 세계관 문화 정치 혈연 종교 기술 경제 인간의 건강과 간호에 주는 영향 건강체제에서 개인, 가족, 문화집단 Leininger 의 해돋이 모델 교육
  • 30. 나이팅게일의 개념틀 물리적 환경 청결 공기 소음 침구 보온 의사소통 충고 변화 정신적 환경 환기 햇빛 물 배수 식이 환자의 상태와 본성 사망률 질병의 예방 사회적 환경
  • 31. 31 Readings Cobb, s.(1976). Social support as a moderator of life stress. psychosomatic medicine, 38, 300-314. Hous, J.S.(1981). work stress and social support. Reading. MA.: Addison-WesLey.àæëèéí ñòðåññ áà íèéãìèéí õàëàìæ óíøëàãà Kleffel. D.(1991). Rethinking the environment as a domain of nursing knowledge advances in nursing science, 14(1), 40-51. Lin, N., Ensel, W.M., Simeone, R.S., & Kuo, W.(1979). Social support, stressful life envents and illness: A model and an empirical test. Journal of health and social behavior, 20, 109119 Norbeck, J.S., Lindsey, A.M., & Garrieri, V.L.(1981). The development of an instrument to measure social support. Nursing Research, 30, 264-269. Pender, N.J.(1996). health promotion in nursing practice(3rd ed.). Stamford, CT: Appleton & Lange,
  • 32. 32 Learning activities 1. 2. Review a newspaper or news magazine for one week. What environmental issues are receiving media attention? As a nurse what actions could you take to affect these problems? Ñîíèí áîëîí ñýòã¿¿ëèéí òîéì äîëîî õîíîã íýã óäóó óíøèõ. ßìàð õ¿ðýýëýí áóé îð÷èíû àñóóäàë çóðàãòèéí àíõààðàëä îðæèéí? How social support can be applied to your client? Give a specific situation exampler. Íèéãìèéí õàëàìæ ÿàæ ÷èíèé ¿éë÷ë¿¿ëýã÷èä õàìòðàã÷ áîëæ áàéíà? Áîäèò íºõöºë áàéäàëûí æèøýý ºãºíº ¿¿.