본문 바로가기
KERD
논문KCI 등재

자기조절학습자로서의 암 환자를 위한 치료 여정에 적응적인 온라인 지원 시스템 설계전략 개발

Development of Design Strategies for an Online Support System to Help Cancer Patients Become a Self-Regulated Learner in Accordance with Their Treatment Journey

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류교육학

초록

본 연구의 목적은 암 환자가 치료 여정에서 겪게 되는 포괄적인 건강위기를 고려하여 자기조절학습자로서의 암 환자가 스스로 자신의 건강상태와 치료과정을 점검하며 필요한 건강정보를 학습하고 수행하는 자기조절학습 능력을 신장하기 위한 온라인 지원 시스템의 설계전략을 개발하는 것이다. 이 목적을 달성하기 위하여 보건의료분야와 교육공학분야의 문헌분석을 통해 암 환자가 겪게 되는 다양한 위기와 치료 여정, 그들의 삶의 질을 향상시키는 주요 요인과 중재 방법을 확인하였으며 효과적인 온라인 지원 시스템의 구조와 기능, 지원도구의 가능성을 탐색하였다. 연구 결과, 암 환자가 겪게 되는 자기평가, 현실수용, 변화준비, 의사결정, 계획, 환경조성, 실행, 피드백 및 유지의 8개의 치료 여정과 총 24개의 세부 단계에 따라 환자의 자기조절학습을 지원하기 위한 온라인 시스템의 설계전략이 개발되었다. 또한 환자의 자기조절학습을 지원하는 온라인 시스템에서 환자에게 제공되어야 할 건강정보의 종류 및 시스템의 기능 등을 도출하였다. 개발된 설계전략을 통해 암 환자가 현재의 건강상태와 바람직한 건강상태간의 차이를 인지하고 둘 사이의 간격을 좁히기 위한 계획을 세워 수행하며 자신의 상태를 지속적으로 평가하는 자기조절행위를 다차원적으로 지원하고자 하였다. 본 연구는 자기조절학습자로서의 암 환자가 자신의 치료과정을 스스로 극복해나갈 수 있도록 지원하는 온라인 지원 시스템 설계에 관한 탐색적 연구로서 보건의료 분야에서의 교육공학 이론과 실천의 지평이 확장되기를 기대한다.

Abstract

The aim of this study was to develop design strategies for online support systems that enable cancer patients as self-regulated learners to improve self-regulated learning abilities for acquiring health information and monitoring their own health condition and treatment process, taking into account the comprehensive healthcare crises experienced by them. To achieve the goal, literature review of the healthcare and educational technology fields have identified the various health crises, treatment routes, and the major factors and intervention methods that improve the quality of life for cancer patients. We explored the structure of online support systems, the possibility of the support tool, and then derived design strategies of online support systems to help cancer patients for self-regulated learning skills during their treatment journey. As a result of the research, we developed design strategies of an online support system to help cancer patients self-regulate their learning based on eight their therapeutic journey of self-evaluation, reality acceptance, preparation for change, decision making, planning, creating environments, implementation, and feedback and maintenance and twenty-four detailed procedures. In addition, we derived the types of health information to be provided to the patients and the functions of the system in the online support system. Through design strategies, we sought to multi-dimensionally support cancer patients’ self-regulated learning behaviors in perceiving the gaps between the current health status and the desired health status and performing a continuous assessment of the patient's condition by setting the plans to make up the gaps. This study was an exploratory study to expand the scope of theory and practice of educational technology in health care fields on the design of an online support system that supports cancer patients as self-regulated learners to overcome their treatment process by themselves.

참고문헌 (78)

  1. 권성연, "자기조절학습의 단계와 구성요인의 규명", 교육학연구, 41(3), pp.239~273 (2003), 한국교육학회
  2. 권영은, "화학요법 암환자의 피로조절 행위에 관한 구조모형", 박사, 간호학, pp.1997
  3. 김숙영, "성인병 환자들의 건강과 관련된 자기조절에 대한 현상학적 연구", 대한간호학회지, 25(3), pp.562~580 (1995)
  4. 김정호, "동기상태이론 : 스트레스와 웰빙의 통합적 이해", 한국심리학회지: 건강, 11(2), pp.453~484 (2006), 한국건강심리학회
  5. 김창수, "e-러닝환경에서 자기조절학습을 지원하는 도구의 프로토타입 개발", 교육정보미디어연구, 14(2), pp.237~266 (2008), 한국교육정보미디어학회
  6. 김현정, "대장암 환자의 질병여정에 따른 자기관리", 박사, 간호학, pp.2010
  7. 박정숙, "자기역량강화프로그램이 저소득층 재가 암환자의 암증상, 자기효능감, 자아존중감 및 자기역량에 미치는 효과", 한국보건간호학회지, 27(1), pp.50~63 (2013), 한국보건간호학회
  8. 보건복지부, "2014년 국가암등록통계", ~ (2016)
  9. 신민희, "자기조절 학습이론(Self-regulated learning theory): 의미, 구성요소, 설계원리", 교육공학연구, 14(1), pp.143~162 (1998)
  10. 신윤희, "성인 만성질환자가 지각하는 운동 자기효능감과 운동 유익성 및 장애성에 관한 연구", 대한간호학회지, 30(4), pp.869~879 (2000)
  11. 이은경, "암환자의 극복력 영향요인", 한국간호교육학회지, 13(1), pp.52~58 (2007), 한국간호교육학회
  12. 임철일, "웹 기반 자기 조절 학습 환경을 위한 설계전략의 특성과 효과", 교육공학연구, 17(3), pp.53~83 (2001)
  13. 임철일, "자기조절학습을 지원하는 기업의 이러닝 학습관리체제의 개발과 효과에 관한 연구", 교육공학연구, 21(4), pp.77~100 (2005), 한국교육공학회
  14. 임철일, "암 환자의 건강경영을 위한 온라인 지원 시스템 개발", 한국교육정보미디어학회 춘계학술대회 발표 (2015)
  15. 임철일, "자기조절학습을 위한 감성조절 지원 이러닝 인터페이스 설계전략 개발", 교육정보미디어연구, 21(3), pp.389~421 (2015), 한국교육정보미디어학회[DOI]
  16. 정애경, "자기조절학습을 지원하는 모바일 연동 학습관리시스템 개발연구", 컴퓨터교육학회 논문지, 12(4), pp.23~34 (2009), 한국컴퓨터교육학회
  17. 조남기, "유방암 환자의 여가적 댄스 스포츠 참여에 따른 신체적 자기효능감 향상과 건강 기대에 관한 반성적 고찰", 한국여가레크리에이션학회지, 32(3), pp.211~219 (2008), 한국여가레크리에이션학회
  18. 조성진, "호스피스 완화의료와 정신의학", 한국호스피스완화의료학회지, 10(3), pp.109~119 (2007), 한국호스피스완화의료학회
  19. 지영주, "자기조절 학습전략을 이용한 금연 프로그램이 흡연 남자 중학생에게 미치는 효과", 정신간호학회지, 20(1), pp.1~12 (2011), 정신간호학회
  20. 통계청, "2015년 사망원인통계", ~ (2016)
  21. 하은혜, "유방암 환자의 화병과 우울증상의 관계", 한국심리학회지:여성, 16(1), pp.115~133 (2011), 한국여성심리학회
  22. 홍성경, "극복력(resilience) 개념 개발 - 암 환자를 중심으로 -", 한국간호교육학회지, 15(1), pp.109~119 (2009), 한국간호교육학회
  23. 황숙연, "여성 암 환자의 실존적 경험에 관한 탐색적 분석", 신경정신의학, 45(6), pp.554~564 (2006), 대한신경정신의학회
  24. Ahlberg, K, "Assessment and management of cancer-related fatigue in adults", The Lancet, 362(9384), pp.640~650 (2003)
  25. Ahn, E, "Suicide rates and risk factors among Korean cancer patients, 1993-2005", Cancer Epidemiology Biomarkers & Prevention, 19(8), pp.2097~2105 (2010)
  26. Azevedo, R, "Theoretical foundations of learning environments", pp.171~197 (2012), Routledge
  27. Azevedo, R., "New science of learning: Computers, cognition, and collaboration in education", pp.225~247 (2010), Springer
  28. Bandura, A, "The primacy of self-regulation in health promotion", Applied Psychology, 54(2), pp.245~254 (2005)
  29. Bartels, J, "Self-regulation: Decision of the chronically ill", doctor, pp.1990
  30. Biswas, G, "Learning by teaching : A new agent paradigm for educational software", Applied Artificial Intelligence, 19(3), pp.363~392 (2005)
  31. Bloom, J. R, "Social support, accommodation to stress and adjustment to breast cancer", Social Science & Medicine, 16(14), pp.1329~1338 (1982)
  32. Bodenheimer, T, "Patient self-management of chronic disease in primary care", The Journal of the American Medical Association, 288(19), pp.2469~2475 (2002)
  33. Brusilovsky, P, "Adaptive and intelligent web-based educational systems", International Journal of Artificial Intelligence in Education, 13, pp.156~169 (2003)
  34. Chen, C. M, "Personalized e-learning system with self-regulated learning assisted mechanisms for promoting learning performance", Expert Systems with Applications, 36(5), pp.8816~8829 (2009)
  35. Cheville, A. L, "The detection and treatment of cancer-related functional problems in an outpatient setting", Supportive Care in Cancer, 17(1), pp.61~67 (2009)
  36. Clark, N. M, "A social cognitive view of self-regulated learning about health", Health Education Research, 5(3), pp.371~379 (1990)
  37. Dabbagh, N, "Supporting self-regulation in student-centered web-based learning environments", International Journal on E-learning, 3(1), pp.40~47 (2004)
  38. Driscoll, M, "Psychology of learning for instruction" (2005), Allyn and Bacon
  39. DuBenske, L. L, "Web-based cancer communication and decision making systems : Connecting patients, caregivers, and clinicians for improved health outcomes", Medical Decision Making, 30(6), pp.732~744 (2010)
  40. Efklides, A, "Interactions of metacognition with motivation and affect in self-regulated learning : The MASRL model", Educational Psychologist, 46(1), pp.6~25 (2011)
  41. Ganz, P. A, "Quality of life in long-term, disease-free survivors breast cancer : Follow-up study", Journal of the National Cancer Institute, 94(1), pp.39~49 (2002)
  42. Herndon, J. E, "Is quality of life predictive of the survival of patients with advanced nonsmall cell lung carcinoma?", Cancer, 85(2), pp.333~340 (1999)
  43. Hileman, J. W, "Self-identified needs of patients with cancer at home and their home caregivers : A descriptive study", Oncology Nursing Forum, 17(6), pp.907~913 (1990)
  44. Hofer, K. H, "Self-regulated learning from teaching to self-reflective practice", pp.57~85 (1998), Guilford Press
  45. Johnson, J, "An overview of psychosocial support services : Resources for healing", Cancer Nursing, 23(4), pp.310~313 (2000)
  46. Kaplan, S, "Directed attention as a common resource for executive functioning and self-regulation", Perspectives on Psychological Science, 5(1), pp.43~57 (2010)
  47. Kim, S. H, "Randomized pilot test of a simultaneous stage-matched exercise and diet intervention for breast cancer survivors", Oncology Nursing Forum, 38(2), pp.E97~E106 (2011)
  48. Kastenbaum, R, "Death, Society and Human Experience" (2001), Allyn & Bacon
  49. Kauffman, D. F, "Self-regulated learning in web-based environments: Instructional tools designed to facilitate cognitive strategy use, metacognitive processing, and motivational beliefs", Journal of Educational Computing Research, 30(1), pp.139~161 (2004)
  50. Kogan, H. N, "Self-management : A nursing mode of therapeutic influence", Advances in Nursing Science, 6(4), pp.55~73 (1984)
  51. Krishna, S, "Diabetes self-management care via cell phone : a Systematic review", Journal of diabetes science and technology, 2(3), pp.509~517 (2008)
  52. Kübler-Ross, E, "On grief and grieving: Finding the meaning of grief through the five stages of loss" (2005), Scribner
  53. Kuiper, R. A, "Promoting cognitive and metacognitive reflective reasoning skills in nursing practice : Self-regulated learning theory", Journal of Advanced Nursing, 45(4), pp.381~391 (2004)
  54. Lazarus, R. S, "Toward better research on stress and copying", American Psychologist, 55(6), pp.665~673 (2000)
  55. Lee, E. S, "Health-related quality of life in survivors with breast cancer 1 year after diagnosis compared with the general population: A prospective cohort study", Annuals of Surgery, 253(1), pp.101~108 (2011)
  56. Lee, M. K, "Employment status and work-related difficulties in stomach cancer survivors compared with the general population", British Journal of Cancer, 98(4), pp.708~715 (2008)
  57. Leventhal, H, "Behavioral theories and the problem of compliance", Patients Education and Counselling, 10(2), pp.117~138 (1987)
  58. Leventhal, H, "Self-regulation, health and behavior : A perceptual-cognitive approach", Psychology and Health, 13(4), pp.717~733 (1998)
  59. 2015, , 631~635
  60. Luciani, A, "Fatigue and functional dependence in older cancer patients", American Journal of Clinical Oncology, 31(5), pp.424~430 (2008)
  61. Maes, S, "Self‐Regulation Assessment and Intervention in Physical Health and Illness : A Review", Applied Psychology, 54(2), pp.267~299 (2005)
  62. McQuiggan, S, "Intelligent tutoring systems", pp.530~539 (2008), Springer
  63. Pintrich, P. R, "Understanding self-regulated learning", pp.3~12 (1995), Jossey-Bass
  64. Pintrich, P. R, "A conceptual framework for assessing motivation and self-regulated learning in college student", Educational Psychology Review, 16(4), pp.385~407 (2004)
  65. Prochaska, J. O, "The transtheoretical model of health behavior change", American journal of health promotion, 12(1), pp.38~48 (1997)
  66. Rhee, Y. S, "Depression in family caregivers of cancer patients : the feeling of burden as a predictor of depression", Journal of Clinical Oncology, 26(36), pp.5890~5895 (2008)
  67. Shih, K, "The development and implementation of scaffolding-based self-regulated learning system for e", m-learning, 2010, pp.13(1), 80~93
  68. Shin, H. W, "Correlates of existential well-being and their association with health-related quality of life in breast cancer survivors compared with the general population", Breast cancer research and treatment, 118(1), pp.139~150 (2009)
  69. Stoyanov, S, "Expert concept mapping method for defining the characteristics of adaptive e-learning : ALFANET project case", Educational technology research and development, 52(2), pp.41~54 (2004)
  70. Sultan, S, "Self-regulated learning in a mobile health initiative for diabetic patients", Proceedings of the 12th IEEE International Conference on Advanced Learning Technologies, pp.706~707 (2012)
  71. Tangney, J. P, "High self-control predicts good adjustment, less pathology, better grades, and interpersonal success", Journal of Personality, 72(2), pp.271~324 (2004)
  72. van Harten, W. H, "Assessment of rehabilitation needs in cancer patients", International Journal of Rehabilitation Research, 21(3), pp.247~258 (1998)
  73. Winne, P. H, "How software technologies can improve research on learning and bolster school reform", Educational Psychologist, 41(1), pp.5~17 (2006)
  74. Wood, D. J, "Psychosomatic self-regulation and recovery from surgery", Nursing Research, 31(3), pp.189~190 (1982)
  75. Yun, Y. H, "Patient-reported assessment of self-management strategies of health in cancer patients : Development and validation of the Smart Management Strategy for Health Assessment Tool(SAT)", Psycho-Oncology, 24, pp.1723~1730 (2015)
  76. Yun, Y. H, "Web-based tailored education program for disease-free cancer survivors with cancer-related fatigue : A randomized controlled trial", Journal of Clinical Oncology, 30(12), pp.1296~1303 (2012)
  77. Zimmerman, B. J, "Handbook of self-regulation", pp.13~39 (2000), Academic Press
  78. Zimmerman, B. J, "Development of a structured interview for assessing student use of self-regulated learning strategies", American educational research journal, 23(4), pp.614~628 (1986)

관련 논문AI추천

이 간행물의 다른 논문 (4건)