• Title/Summary/Keyword: home stay

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The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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A Study on the Informal Cost Burden of the Patients Admitted to the Hospital (입원환자의 비공식적 의료비용 부담에 관한 연구)

  • Han, Mi-Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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Impact of Indoor Pan-frying Cooking Activity on Change of Indoor PMPM2.5 Concentration Level in Asthmatics' Homes (천식 환자 가정 내 굽기조리 활동에 의한 실내 미세먼지(PM2.5) 농도 수준의 변화)

  • Park, Su Jung;Park, Choon sik;Lim, Dae hyun;Lee, Sang woon;Jang, So young;Yu, Sol;Kim, Sung Roul
    • Journal of Environmental Science International
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    • v.29 no.1
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    • pp.109-117
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    • 2020
  • Asthmatics are more susceptible to fine particulate matters (PM2.5), compared to the general population. It has been reported that indoor PM2.5 is mainly generated by combustion of fossil fuels, meat or fish In particular, asthmatics are known to be more susceptible to indoor PM2.5 because 65~95% of child or adult asthmatics stay inside the house. Thus, understanding the association between indoor activity patterns and variations in indoor PM2.5 levels is important. The purpose of this study is to determine the distribution of hourly indoor PM2.5 concentrations in asthmatics' homes, and to evaluate its association with pan-frying cooking activity patterns, the most common PM2.5 emission related activity. From November 2017 to February 2018, real-time PM2.5 concentrations were measured in the living room of each asthmatic's house (n = 35) for three weeks at 1 minute intervals. At the same time, self-reported daily activity patterns, hourly proportion (%) of cooking activities, were also recorded every hour over three weeks for each patient. In this study, we provided quantitative evidence that the distribution patterns of indoor hourly PM2.5 concentrations were associated with indoor cooking activities, especially in the homes of adult asthmatics. In addition, we observed that PM2.5 emitted by pan-frying could maintain even over up to 2 hour lagtime.

Analysis on Gender Characteristics Expressed in Male and Female Costume During the Ancient Greek Age (그리스 시대의 남성복과 여성복에 표현된 젠더(gender) 특성 분석)

  • Yi, Myoung-Hee;Choi, Yoonmi
    • Journal of the Korean Society of Costume
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    • v.63 no.4
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    • pp.84-100
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    • 2013
  • Ancient Greece was a patriarchal society that distinguished gender roles between men and women. Although their costumes were composed of simple rectangular fabric without any technical complications in itself, the Greeks did try to express gender differences in their clothing. The final look of the Greek costume was dependent on the way the cloth draped onto its wearer as well as the wearer's identity. Greeks costume could just be seen as a rectangular fabric when it was not draped on a person's body. The purpose of this study is to examine how the gender differences were expressed in the ancient Greek drapery costume, which was made by using a completely different technical process, compared with the modern tailored costume. There are four elements of the costume that give the costume its formative shape, which are the wearer's body, the rectangular fabric (material as the first formative costume), the way the fabric is draped, and the final appearance as the second formative costume (the relationship between the wearer's body and the costume) and this study analyzes these elements individually. It is intended to analyze the gender characteristics and how each element appears in a different way from the perspective of Structuralism, an analytical method that considers a phenomenon as a total sum of the elements. Literature research was conducted and representative sculpture, painting and pottery, were used between the Archaic Period (B.C. 800~500) and the Classical Period (B.C. 500~323). The results show that the gender differences appear in each formative element of costume: First, the body was distinguished by the ancient Greek custom. The man's nudity was accepted while the woman's body was concealed. Second, in regards to the first formative costume, which was the rectangular fabric, men's were made with thick high quality wool because their involvement in outdoor activities meant that they needed clothes to stay warm, while the women wore clothes made of thin wool or hemp cloth, because their most of their activities were at home. Third, the way to drape the fabric shows the gender differences by changing the length of the clothing and its design ; men's short khiton was practical for big movement and at the same time the clothing exposed the man's body. The woman's doric khiton diversified its decoration by the size of the apotigma and by using the belt. Finally the second formative costume reflected the Greeks' social distinction between a man's body and a woman's body. The man's costume naturally exposed the man's body. On the other hand, the woman's long costume has a variety of shapes on the ground, that concealed her lower body, while the ornamental function was more accentuated than the man's costume. The gender differences expressed in Greek costume fundamentally reflected the point of view of the male and female body and their social roles in society.

The actual type of domestic safety accident of children and the safety knowledge according to variables of parents (가정내 유아의 안전사고 유형과 부모의 변인에 따른 안전지식)

  • Kim, Ji-Young;Kim, Na-Rim
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.454-461
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    • 2017
  • The purpose of this study is to investigate the types of domestic safety accidents involving children and to verify the difference of safety knowledge according to variables of parents. Subjects include 226 parents who have 3-5 year old infants enrolled in kindergartens and day care centers in I-city, Jeollabuk-do. The study tools are modified and complemented questionnaire for the study purpose referred to the preceding research data and the literature. For the processing of collected data, frequency analysis, descriptive statistics, one-way ANOVA, and the Duncan post-test were utilized using the SPSS program. The results of this study are as follows: First, safety accidents occurred at the majority of homes which have infant children. On average, the occurrence frequency was 1.78 times per six months. The accidents involving infants occurred in the order of drop or slip, crash or impact, stricture or jamming, fall, stab or cut, burn, swallow or inhalation. Second, both parents had an average level of safety knowledge. There was a distinction in the areas of 'fall' and 'first aid' according the mother's age. In addition, stay-at-home mothers had the higher level of safety knowledge compared with working mothers in the areas of 'general safety knowledge' and 'fire'. There was a distinction in the area of 'fire' according to the father's age. Given these findings, safety training programs for parents to improve safety knowledge needs to be developed.

Parents' concern for child oral health (부모의 자녀에 대한 구강건강 관심도 조사)

  • Kim, Kyung-Seon;Kim, Sun-Ju;Kim, Chang-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.4
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    • pp.405-418
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    • 2007
  • The purpose of this study was to examine the interest level of mothers in oral health. The subjects in this study were 184 mothers whose children attended daycare centers in the city of K. A survey was conducted from March 15 through April 30, 2007, and SPSS WIN 11.5 program was employed to analyze their answer sheets. The findings of the study were as follows: 1. A group of mothers whose children brushed their teeth three times a day on the average made up 55.7 percent of those who were at the age of 35 and under. Among the mothers having three or more children, those mothers accounted for 59.1 percent. The daily mean toothbrushing frequency of children was higher among the better-educated mothers. 2. Concerning dietary and oral guidance, the mothers whose academic background was better curbed their children's excessive sugar intake more often, and the gap between them and the others was statistically significant(pE.05). As to the importance of oral health by the number of child and academic credential, those who had two children(36.0%) taught them the importance of oral health frequently(pE.01), and the better-educated mothers taught about it often(pE.05). The gap between the groups and the others was significant. 3. As for experience of visiting dental institutions, the working mothers visited dental institutions more often than the stay-at-home mothers, and the gap between them was statistically significant(pE.05). Regarding purpose of the visit, the largest group aimed to get treatment(64.6%), followed by having a dental checkup(14.6%) and receiving preventive treatment(13.5%). As to any inconveniences in using dental institutions, those who were working and who were in the upper income bracket found it more inconvenient to do that because of a long distance or time constraints. The gap between them and the others was significant. 4. In regard to concern for dental care, the mothers who were better educated(pE.001) and whose family income was 3 million won or more had their teeth scaled more often, and the gap between them and the others was statistically significant(pE.01). The rate of the regular visitors of dental institutions stood at 32.7 percent of the junior-college graduates, 31.0 percent of the mothers receiving college or higher education and 10.1 percent of the high-school graduates(pE.01). And those who earned larger income paid a visit to dental institutions more often and on a regular basis. The gap between them and the others was statistically significant(pE.05).

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On the Legality of the Telemedicine between the Patient and Doctor Under the Medical Service Act - Focused on the Prescriptions to the Distanced Patients- (의사 환자 간 원격 의료의 의료법상 적법성에 관하여 - 원격 환자에 대한 처방 중심으로 -)

  • Kim, Jang Han
    • The Korean Society of Law and Medicine
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    • v.22 no.1
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    • pp.3-23
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    • 2021
  • Telemedicine is a field of medicine in which medicine doctors who are in remote distance can treat the patients using audio, video devices which can help the diagnosis. In medicine, even the face-to-face diagnosis and treatment is the traditional way, the telemedicine could provide the convenient way for the patients in long distance, disabled or anyone who want to be stay ones' home. But telemedicine has the task to maintain the quality of medical cares compare with the traditional medicine. Among the several types of telemedicine, the specific type telemedicine in which the medicine doctors examine, diagnosis and do the prescription to the remotely distanced patients could be defined tele-prescription. Under The Medical Service act, it is unclear that teleprescription could be allowed. The Medical Service Act has introduced the specific clause for the prescription. That clause includes the duty of patients who have to receive the prescriptions directly from medical doctors. Under this clause, the constitutional court had decided the tele-prescription was illegal, but the supreme court has been decided tele-prescription could be legalized under the certain circumstances. But the other supreme court decided the tele-prescription was illegal under the article 34 of presenting Medical Service Act. So to understand the interpretations of Supreme court and Constitutional court decisions for the cases of prescription via telephone, we need to understand the history and presented reasons for the revision of prescription clause and also need to understand the other related clauses in the same act. In conclusion, To consider the values of telemedicine should be the level with the ordinary treatments, It is reasonable to interpret that the presenting Medical Service Act only legalize the telemedicine between doctor to doctor and which is regulated by the telemedicine clause.

Guidelines for dental clinic infection prevention during COVID-19 pandemic (코로나 바이러스 대유행에 따른 치과 의료 관리 가이드라인)

  • Kim, Jin
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.1-7
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    • 2020
  • Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

College Students' Re-Acculturation to their "Home" Country: Focusing on their Cultural Identity (해외거주 귀국 대학생들의 "모국" 문화재적응: 문화정체성을 중심으로)

  • Ansuk Jeong;Kyung Ja Oh;Seojin Oh;Curie Park
    • Korean Journal of Culture and Social Issue
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    • v.21 no.1
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    • pp.1-20
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    • 2015
  • Among the cultural groups that increase South Korea's diversity, there are adolescents returning to Korea after their stay abroad. From 15 in-depth interviews with those who stayed abroad for longer than 5 years, 11 codes were generated. The codes were divided into two categories: "assets" when the multicultural experience served as resources for the returnees adapting to Korean culture successfully and "disadvantages" when the multiple experience remained fragmented for the returnees experiencing difficulty in re-acculturation. The distinguishing factors between the success and difficulty in re-acculturation appeared to be the cultural identity as Korean and the "openness to experience." The interwoven nature of personal and social factors stood out, along with the role of cultural identity throughout the process. Also the "openness to experience" as a strategy of integrating the past experiences is discussed, as well as the implications of the findings and the suggestions for future studies in the contemporary multicultural South Korea as a host society.

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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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