• 제목/요약/키워드: Nursing approach

검색결과 947건 처리시간 0.028초

방문건강관리사업 담당자의 공공부문 사례관리 연계협력 경험: 포커스 그룹 인터뷰 (Experiences of Public Visiting Nurses on the Linkage Cooperation of public case management: Focus Group Interview)

  • 김형선
    • 한국산학기술학회논문지
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    • 제21권8호
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    • pp.160-169
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    • 2020
  • 이 연구는 공공 행정에서 서비스 전달 조직과 절차를 관리하고 재정을 지원하는 공공부문 사례관리 사업 중 방문건강관리 사업 실무자를 대상으로 타 사례관리 사업과의 연계협력 업무에 대한 경험을 파악하기 위해 실시하였다. 광역시와 시군 소재 보건소 방문건강관리사업 담당자 3명을 대상으로 포커스 그룹 인터뷰를 실시하였고, 자료 수집을 위해 사용한 인터뷰 질문들은 사전에 연구진간 논의를 거쳐 도출한 반구조화 질문지를 활용하였다. 연구 참여자들은 방문건강관리 업무를 수행하면서 경험한 연계협력의 성공과 실패 요인들을 심층적으로 기술하였다. 인터뷰 내용은 질적으로 분석되어 3개의 주제, 9개의 하위주제가 도출되었다. 연구결과, 공공부문 사례관리 사업 간 연계협력 업무안내서는 연계협력을 수행하는 데 있어 긍정적 성과요인이었지만, 방문건강관리 전문 인력의 불안정한 고용문제와 통합시스템의 부재는 연계협력의 장애요인이었으며, 성공적인 연계협력을 위해서는 인적 인프라 강화, 기능적 시스템 개선, 조직적 차원의 방안 마련 등 다각적인 접근이 필요한 것으로 확인되었다. 이에 명확한 연계협력 표준 및 절차 수립, 방문간호 전문인력의 처우 개선, 사례관리 통합정보시스템 개발을 제안한다. 또한, 지역 간 편차가 큰 방문건강관리 사업의 특성을 고려하여 다양한 지역을 대상으로 한 추후 연구가 필요함을 제안한다.

청소년의 주관적 행복감 구조모형 : 스트레스 인지와 의도적 활동중심으로 (Structural Equation Model for the Subjective Happiness of Adolescents : Focused on Perceived Stress, Activities and Practices)

  • 위옥연;이지현
    • 한국산학기술학회논문지
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    • 제17권7호
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    • pp.585-596
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    • 2016
  • 본 연구는 청소년의 스트레스 인지, 식생활, 신체활동, 음주, 흡연, 잠으로 피로회복 정도에 따라 주관적 행복감에 미치는 영향을 파악하고, 이를 바탕으로 향후 청소년의 주관적 행복감을 향상시키는 실질적인 방안을 위한 기초자료를 제공하고자 한다. 2015년 제11차 청소년건강행태온라인조사 원시자료의 9,599명을 대상으로 IBM SPSS 20.0과 IBM SPSS AMOS 23 프로그램을 이용하였으며, 빈도분석, 기술통계, 상관분석, 부트스트래핑과 팬텀변수를 이용하였다. 연구결과, 주관적 행복감에 가장 많은 영향을 미치는 직접효과는 스트레스 인지(${\beta}=-.457$, p =. 005), 잠으로 피로회복(${\beta}=.136$, p = .004), 신체활동(${\beta}=.055$, p = .005), 식생활(${\beta}=-.035$, p = .014), 흡연(${\beta}=-.030$, p = .011이었다. 스트레스 인지가 주관적 행복감으로 가는 경로의 간접효과(${\beta}=-.052$, p = .006)가 있었으며, 팬텀변수를 이용하여 다중매개의 간접효과 크기와 유의도를 분석한 결과 스트레스 인지와 주관적 행복감 사이에 간접효과는 잠으로 피로회복(${\beta}=-.041$, p = .001), 신체활동(${\beta}=-.007$, p = .003), 식생활(${\beta}=-.003$, p = .008), 흡연(${\beta}=-.002$, p = .001)순으로 나타났으며, 음주는(${\beta}=000$, p = .636) 간접효과가 없었다. 그러므로 청소년의 주관적 행복감을 증진시키기 위하여 다학제간의 협력이 요구되며 가정, 학교, 지역사회 및 국가차원의 교육환경 개선과 인력 및 재정적 지원이 모색되어야 할 것이다.

여성의 자살시도 고위험군 선별을 위한 관련요인 분석 (A Study on the Analysis of the Related Factors to Distinguish High Risk Group of Female Suicidal Attempts)

  • 최향숙;허명륜;김은미
    • 한국산학기술학회논문지
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    • 제18권5호
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    • pp.308-317
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    • 2017
  • 본 연구는 한국 여성의 자살시도 경험 현황을 확인하고, 관련요인을 확인하여 고위험군 선별을 위한 기초자료를 제공하고자 시도하였다. 2013년부터 2015년까지 질병관리본부에서 전국적으로 조사한 국민건강영양조사 자료 중 제 6기 3차 자료를 이용하였고. 전체 대상자중 여성만을 선별하여 일반적 특성, 정신건강 관련 특성, 일상생활 활동 특성 등의 자료를 수집하였다. 수집된 자료는 가중치를 적용하여 SPSS 20.0 프로그램의 복합표본 분석방법을 이용하여 빈도분석, 교차분석, 다변량 로지스틱 회귀분석으로 분석하였다. 그 결과 전체 여성의 1%에서 자살 시도 경험이 있는 것으로 파악 되었으며, 1년 이내의 정신 상담 경험이 있는 대상자가 없는 대상자보다 5.25배, 스트레스가 적은 대상자에 비해 많은 대상자가 14.92배, 일의 강도가 높은 대상자가 그렇지 않은 대상자에 비해 4.85배, 하루 중 앉아 있는 시간이 많은 대상자가 적은 대상자에 비해 3.76배 더 자살 시도를 한 것으로 나타났다. 따라서 이와 같은 대상자들을 자살시도의 고위험군으로 고려하여야 하며, 여성의 자살시도 예방을 위하여 일차적으로 정신 건강 상태와 일상생활의 활동 특성 변수를 고려한 선별 지침이 필요하겠다. 또한 사회적, 정책적으로 제공되는 자살 예방 프로그램의 개별적 접근이 필요할 것으로 사료 된다.

한국 미혼모의 임신 체험 연구 (A Phenomenological Study on Pregnancy Experience of Unmarried Korean Mothers)

  • 한진숙;문영숙
    • 부모자녀건강학회지
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    • 제5권2호
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    • pp.206-223
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    • 2002
  • The purpose of this study was to discuss the nature of pregnancy experience among unwed Korean mothers and to figure out what it meant for them, by asking some of them to reflect on themselves in a written form from interpretative and phenomenological perspective, based on van Manen's research method of the same approach. The subjects in this study were seven unmarried mothers in Korea. The data were collected from July through December 2000 through in- depth interview and observation. The statements of the participants were taped, recorded, analyzed and select essential themes. To have a phenomenological understanding of the pregnancy unmarried mothers, literary works, including essays and novels, were reviewed. The findings of this study were as below: The selected substantial themes about the pregnancy and birth experiences of the single mothers included 'hatred for boy friend,' 'hatred for the fetus,' and 'hatred for myself.' The unmarried mothers met their boy friends through the introduction of friends. At first, they were good friends, but they soon went on a date and had sexual relation with no common knowledge about sex. Most of them were aware of their pregnancy after they felt fetal movement, but they put off taking the test because they didn't want to accept the fact and feared it. Such an attitude was rare among married pregnant women, and being pregnant with no prior preparation or sexual knowledge is not common in Western countries. They felt guilty and informed their boy friends of the fact, but the boy friends didn't admit their responsibility and rejected the babies. This made the poor girls hate them, and it turned into severe abhorrence. They thought their lives were ruined by the babies, and wished they would disappear. They reproached the babies, hitting their own bellies or making a kick. They considered themselves to be abandoned and didn't want to live any more. Giving themselves up to despair, some attempted to commit a suicide. They hoped to die, thinking their death would solve the problem. When they lost a chance of abortion and were about to have the babies adopted, they felt sorry for them. The unwanted pregnancy gave them a pain, but they keenly felt they were loved by their mothers, and learned the value of family. It's attempted in this study to clearly show how much unmarried Korean mothers suffered from pregnancy, and this effort paved the way for seeing unwed mothers in a new light and having a better understanding of them, instead of sticking to general perception.

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연희 영세지역 주민의 먹는 피임약 복용상태에 관한 조사연구 (A Study of the Use of Oral Contraceptive Among Women Rescinding in the Yonhee Dong Blum Area)

  • 최인숙
    • 대한간호학회지
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    • 제4권1호
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    • pp.121-134
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    • 1974
  • This study is an attempt to evaluate the use of an oral contraceptive by: 1. Deforming the acceptance rate of the oral contraceptive according to socio-demographic characteristics 5. Estimating the duration of the use of the contraceptive f. Discovering reasons why the contraceptive was discontinued 4. Computing the cumulative continuation and discontinuation rate according to socio-demographic characteristics, history of pregnancies, and attitude of husband at the time of selection of the contraceptive. One hundred sixty-eight women of child bearing age (14-49 years), residing in Yonhee Dong, Seoul, Korea and registered as oral contraceptive accepters at Yonsei Community Health Center, were interviewed during a three week period in 1973. The questionnaire was designed to determine the socio-demographic characteristics of the oral contraceptive accepters, the current status of their family planning practice, medical reactions if any, discontinuation practice, and the duration of the use of the contraceptive. The major findings of the study were as follows; 1. The acceptance rate was highest for women between 30 and 34 years of age, the mean age being 34.4 years. 2. Fifty six point five percent of all respondents said that thirty years of age was the ideal age to stop having children. 3. The average number of living children was 3.5 and fifty four point eight percent of respondents felt 2 boys and I girl was the ideal number of children. 4. The average number of pregnancies was 5.2 and the average number of induced abortion was I. 4. 5. Fifty eight point eight percent of the respondents had experience in the use of contraceptive methods in the past. 6. Forty one point seven percent of the respondents replied that they chose the oral contraceptive because, "it was not complicated to use." 7. Sixty four point eight percent of the women said their husband approved of their taking the pill. 8. The cumulative discontinuation rate was sixty point five percent of the total respondents for one year in first segment. 9. Sixty six point nine percent of the respondents had experienced side-effect while using the pill. The side effects for 68.9 percent of these women were castro-intestinal upsets. Twenty point eight percent of the women who had side effects consulted with medical personnel about them. Women who had more education had more side effects. 10. Seventy three point two percent of the women who discontinued the pill did so because of medical reasons. Women who were younger discontinued the pill for personal reasons more-often than older women. Among personal reasons listed for discontinuing the pill was the attitude of the husband. 11. The average duration of continuance of the contraceptive was 5.3 cycles under 29 years of age; 7.4 cycles between 30 and 34 years of age; and 8.4 cycles over 40 years of age. 12. The discontinuation rate was seem to increase sharply in the early cycle and increase more slowly in later cycle. Conclusions and suggestions: Since the attitude of the husband was shown to be important, the current family planning program should be expended to include approach to husband. For women who must use the oral contraceptive, education and support must be enhanced so that the discontinuation rate due to side effects will be decreased.

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치매노인에게 시청각 자극을 병행한 회상요법의 적용효과 (The Effect of Reminiscence with Audio-Visual Stimulation on Senile Dementia)

  • 김남초;유양숙;한숙원
    • 대한간호학회지
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    • 제30권1호
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    • pp.98-109
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    • 2000
  • The purpose of this study was to identify the effect on improvement of the Activity of Daily Living (ADL) and decrease the cognitive function and agitation behaviors by reminiscence with audio-visual stimulation for senile dementia. The quasi-experimental design was used in this study. Subjects were 26 with mild senile dementia who were cared for at a Day Care Center for Dementia in Seoul. The data were collected from March to July, 1999. Subjects were divided into three groups : Control Igroup with 10 subjects, reminiscence group(Control II group with 8 subjects), and reminiscence with audio-visual stimulation group(experimental group with 8 subjects). The Control I group got routine care as usual. Control II group participated in reminiscence sessions for one hour a day, five times a week , for a period of 4 weeks. The experimental group participated in reminiscence with audio-visual stimulation sessions for one hour a day, five times a week, for a period of 4 weeks. Instruments of this study were color photography with sound that was developed through an open questionnaire about events, objects, humans in action and animals that 100 Korean elderly over 60 would like to memorize. This was referred from the Sensory Stimuli Package by Namazi and Haynes(1994). The effects of treatment was evaluated through MMSE-K by Kwon & Park(1989). Also the Brief Cognitive Rating Scale(BCRS) by Reisberg et al(1983) for the cognitive function, through Agitation Inventory by Cohen- Mansfield and Colleague(1989) for behavioral response and through the Rapid Disability Rating Scale-2(RDRS-2) by Linn & Linn(1982) for the activity of daily living respectively. Data analysis was done using SPSS for $\chi$2- test, ANOVA, repeated measures ANOVA. The results were as follows : 1. Reminiscence with audio-visual stimulation did not improve cognitive function for senile dementia, but significantly improved verbal expression, the subscale of cognitive function. 2. Reminiscence with audio-visual stimulation reduced agitation behavior of experimental group significantly, but there was no significant difference between groups. 3. Reminiscence with audio-visual stimulation did not significantly effect the activity of daily living after treatment. In conclusion, it was shown that the reminiscence with audio-visual stimulation was an effective therapy to improve verbal expression and to reduce agitation behaviors of senile dementia. Further research with more indepth approach is needed, considering characteristic and level individualized for each senile dementia.

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서울특별시 지역사회 거주 노인의 통합돌봄 요구 (Needs for Integrated Care for Older Adults in Seoul)

  • 김형수;고영;손미선
    • 융합정보논문지
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    • 제10권5호
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    • pp.177-187
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    • 2020
  • 본 연구는 65세 이상 노인의 돌봄요구군을 분류하고, 군간 특성을 확인하기 위하여 수행되었다. 한국보건사 회연구원이 진행한 '2017년도 노인실태조사'의 자료를 이용한 이차자료 분석연구로, 분석대상은 2017년 노인실태 조사 참여자 중 서울시 노인 999명, 가중치 부여 1,295,491명이다. 돌봄요구군의 분류를 위하여, 의료요구, 일상생활수행 지원요구, 사회적 활동 지원요구의 특성을 파악하였다. 지원요구가 하나도 없는 일반군이 50.4%, 의료요구군이 17.9%, 일상생활수행 지원요구 또는 사회적 활동 지원요구가 있는 복지요구군이 14.2%, 의료요구와 복지요구가 모두 있는 복합요구군이 17.5%이었다. 성별, 흡연, 치매검진, 지난 1년간 외래이용, 일상생활수행 도움 여부, 비동거 자녀 또는 손녀 여부를 제외한 일반적 특성, 장기요양등급 및 장애등급 현황, 경제적 부담 및 일상생활 도움 정도, 건강행태와 건강상태, 삶의 만족도에서 돌봄요구군간 유의미한 차이를 보였다(p<.001). 복합요구군에게 의료와 복지의 통합돌봄 서비스를 우선 제공해야 한다. 특히 복합요구군은 의료, 복지, 운동, 영양, 정신건강, 간호의 요구를 모두 가지고 있는 대상자로 다학제적 팀 접근이 필요하다.

행동교정요법이 비만아동의 신체지수, 습관 및 자아존중감에 미치는 효과 (Effects of Behavior Modification on Physical Variables, Habit and Self-esteem in Obese Elementary School Children)

  • 김효신
    • Child Health Nursing Research
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    • 제7권3호
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    • pp.308-321
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    • 2001
  • Behavior modification is an approach to decrease degree of obesity through changing maladaptive eating habit and life style. It produces small amount of weight loss but it has few side effects and low dropout rate. It also has great effectiveness on maintenance of decreased weight. This study was performed to investigate effects of behavior modification on physical variables, fat and thin habit, and self-esteem in obese elementary school children. Sixty two students of 4th, 5th, and 6th grade were selected from two elementary schools located in the suburbs of Seoul. Thirty four children in one school were assigned to experimental group and twenty eight children in another school were assigned to control group. All subjects were healthy and were not on any type of obesity control. Behavior modification, in this study, was consisted of introduction, self-monitoring and stimuli control, education about diet and physical activities, individual counseling and reinforcement, requesting personal assistance, cognitive restructuring, and closing and long-term planning. Experimental group was received 60~70 minutes of behavior modification once a week for 8 weeks from October 16 to December 22, 2000. Control group was not received any intervention. Data were collected before and after intervention by measuring physical variables, fat and thin habit, and self-esteem. Physical variables consisted of obesity index, skinfold thickness, body fat(percentage of body fat, fat mass, fat free mass), serum lipids(total cholesterol, HDL-C, LDL-C, triglyceride) and serum leptin. The results were as follows ; 1. physical variables 1) Obesity index of the experimental group was significantly decreased after behavior modification. But there was no significant difference between two groups. 2) The increase of skinfold thickness was significantly low in the experimental group compared to the control group. 3) Percentage of body fat and fat mass were significantly decreased in the experimental group. Fat free mass was significantly increased in the experimental group. 4) Total cholesterol, HDL-C, triglyceride and serum leptin between the experimental group and control group showed no significant difference. LDL-C was significantly decreased in the control group. 2. Thin habit score was significantly increased in the experimental group. In subcategories of habit, thin scores of life style, attitude, social relationship, nutrition were signifi- cantly increased in the experimental group. 3. Self-esteem score was significantly increased in the experimental group. These results indicate that behavior modification is effective in decreasing percentage of body fat and fat mass, in less increasing skinfold thickness and in increasing fat free mass, thin habit, and self-esteem. In conclusion, behavior modification can be used as safe and effective strategy for managing obesity in elementary school children.

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입원대상자의 안위경험에 대한 근거이론적 접근 (A Grounded Theory Approach to the Comfort Experience of Hospitalized Patients)

  • 김경희;김금순;강규숙;강현숙;김원옥;백훈정;원종순;임난영;정인숙
    • 대한간호학회지
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    • 제30권3호
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    • pp.750-763
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    • 2000
  • This study is based on grounded theory methodology by Strauss & Corbin(1998). Ten hospitalized subjects were interviewed for data collection. In the process of data analysis, 'acceptance' is found to be the causal condition, while 'health professionals' skillfulness', 'ward environment', 'history of hospitalization', and 'general conditions' were identified as context, 'felling of relief' as the core phenomenon, 'self-efficacy', 'support of others', and 'life style' as the intermediate situation, 'passive reaction', 'alternative reaction' and 'active reaction' as the strategy and 'stabilization', 'satisfaction', 'hope' and 'carrying out' as consequences. 'Feeling of relief' is found to go through the three stages of recognition-generation-maintenance after the five different patterns. 1) In case the health professionals are skillful, the ward environment is favorable, the general conditions of the patients improved and as a result the feeling of relief is strong, during the first hospitalization, the self-efficacy of the subjects tends to be strong. They proceed toward the goal set for themselves with a renewed hope and active or alternative reaction toward the feeling of relief. 2) The subjects tend to proceed toward the goal set for themselves with a renewed hope and active and alternative reaction toward the feeling of relief in case health professionals are skillful, the ward environment is favorable the general conditions of the subjects improved, self-efficacy is strong, and lifestyle is autonomous, during the second hospitalization even though support of others is merely superficial. 3) The subjects tend to stabilize, and satisfy themselves with the given situation with passive and alternative reaction to the feeling of relief in case health professionals are skillful and the ward environment is favorable but the general conditions worsened and accordingly the feeling of relief, is weak and life style is dependent during the second hospitalization although the subjects' self-efficacy is strong and support of others is specific. 4) The subjects tend to stabilize and satisfy themselves with the given situation with passive and alternative reaction to the feeling of relief in case health professionals are unskillful the ward environment is unfavorable, the general conditions improved, support of others is specific but life style is dependent and self-efficacy is weak during the first hospitalization. 5) The subjects tend to stabilize and satisfy themselves with the given situation in case health professionals are unskillful the ward environment is unfavorable but the general conditions improved support of others is specific and as a result self-efficacy is strong but life style is dependent.

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육아시설 청소년의 부모 체험 연구 (A Phenomenological Study on Orphans′ Lived Experience of Their Parents)

  • 이양숙
    • 대한간호학회지
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    • 제30권2호
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    • pp.452-462
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    • 2000
  • There are currently 214 orphanages in Korea which house approximately 13,873 orphans aged between 3 and 18; this accounts for about 0.12% of all children in the same age range. Some have lost their parents, but most have come after their parents divorced or broke up. This means majority of the children in Child Care Centers have parents. Traditional virtue of obedience to parents (Hyo) was regarded as one of the highest value in Korea. Also the interaction between parents and their children was regarded as basic human nature that parents look after, both physically and spiritually, their children until they become one of the matured social member. Raised without having a chance to realize their filial duty and not having been cared for by their parents, most orphans feel that they lack something in their lives when compared with friends. In the end, they live their lives longing for their parents and go through mental discord about their parents. This paper is focused on understanding orphans' experience and views on parents. I approached the issue by applying van Manen's Hermeneutic Phenomenological Approach. The interviews, along with other reference material were phenomenologically reflected to draw essential themes as follows; 1. Orphans of pre-school age hazily long for parents without having any practical image of their parents. 2. They occasionally dream meeting their parents with image that can only last in their dreams, and this continues up through middle school. 3. At the age of elementary school, they crave the image of parents as they see their friends with their parents. 4. They start to despise their parents for having abandoned them when they reach puberty. 5. Meanwhile, as their vague image of parents fade away, they attempt to give up their thoughts toward their parents. 6. Highteens start to think in terms of fate. 7. They don't long for their parents anymore as they used to, but still wishes to meet them at least once. However, they don't want to start any kind of a relationship with them. 8. They fear that they will also fail in raising families of their own, and making their children orphans too, just like their parents have. They simply don't want to follow their footsteps. 9. Thinking that they were abandoned by their parents, they are reluctant to believe other people.

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