• Journal of Korean Academy of Nursing
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• v.29 no.6
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• pp.1221-1232
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• 1999

The purpose of this study was to study how nurses interpreted the meaning of Hwa-Byung. It was carried through a review of literature, and the result is expected to explore ways that nursing intervention can promote the understanding of Hwa-Byung. The literature review focused on cultural psychology and psychiatrists' views toward Hwa-Byung. After that, it was reconfirmed concept of Hwa-Byung in nursing devived from historical analysis of the examples of Hwa-Byung from a true record of the Cho-Sun Dynasty(CD ROM, 1997). Characteristics of patients with Hwa-Byung include 'Hwa', an aspect of somatization, and self-diagnosing. It also could find that Hwa-Byung is characterized as 'Hwa', 'somatization' and 'self-diagnosis(subjectiveness)' according to a true record of the Cho-Sun Dynasty(CD ROM, 1997). The conceptual definition of 'Hwa', 'somatization' and 'self-diagnosing (subjectiveness)' are as follows. The core concept of Hwa-Byung, 'Hwa,' has the property of 'fire', and equals the feeling of injustice. Hwa-Byung means congestion of 'Hwa'. Therefore Hwa-Byung is the accumulation of being mistreated and mortified. The feeling of mistreatment comes from subjective experiences, which cannot be in harmony with the values, beliefs and rights of the patients. The situations that they have to endure again and again, though they are the sufferers, connote suppressed aggression and powerlessness endured over time. Suppressed aggression subordinated hostility, hatred and revengeful thoughts; powerlessness subordinates frustration, resignation, and fatalism. Somatization is another form of expressing 'Hwa' through physical symptoms. The somatization of clients with Hwa-Byung plays a role in expressing non-verbalized and suppressed emotions within themselves. The clients who experiences Hwa-Byung think that they know the cause of their illness and self-diagnose their problem as Hwa-Byung. Therefore, the feeling of unfairness which is the premise of Hwa-Byung infers 'subjectiveness' In conclusion, nursing's concept of Hwa-Byung is the accumulation of feelings of being mistreated and mortified. Hwa-Byung is the internalized 'Hwa' from enduring again and again. The feeling of being mistreated comes from subjective judgements about unfairness that cannot be harmonized with the clients' values, beliefs and rights. Those who can express their 'Hwa' only through their bodies imply suppressed aggression and powerlessness.

• Journal of Oriental Neuropsychiatry
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• v.22 no.1
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• pp.25-35
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• 2011

Objectives : This case series was conducted to report the efficacy of traditional Korean medicine treatments for Hwa-Byung. Methods : Patients were diagnosed with Hwa-byung through Hwa-Byung diagnostic interview schedule(HBDIS). instrument of pattern identification for Hwa-Byung was applied to develop an individualized traditional Korean medicine treatment plan. SCL-90-R, STAI, STAXI, BDI, and instrument of oriental medical evaluation for Hwa-Byung were measured. After 2 weeks of tradiational Korean medicine treatments and K-MBSR practice, STAI, STAXI, BDI, and instrument of oriental medical evaluation for Hwa-Byung were re-assessed to determine the progress of Hwa-Byung. Results : After treatments, chief complaints have improved. STAI, STAXI, BDI and instrument of oriental medical evaluation for Hwa-Byung score have decreased. Conclusions : According to the study, traditional Korean medicine treatments using instrument of pattern identification for Hwa-Byung have shown positive results in managing Hwa-Byung symptoms evaluated by instrument of oriental medical evaluation for Hwa-Byung.

• Journal of Oriental Neuropsychiatry
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• v.22 no.2
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• pp.15-25
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• 2011

Objectives : The aim of this study was to find correlations between characteristics of Four constitution and Hwa-byung. Methods : Clinical data were collected from Hwa-byung Epidemiologic study data. we selected 130 self-labelled Hwa-byung patients data and 83 of them were diagnosed as Hwa-byung by SCID. We used Hwa-byung SCID, Hwa-byung scale, CES-D, STAI, STAXI and Personality and Physiological Symptom Questionnaire(PPSQ) as evaluation tools. We performed statistical analysis of each 2 groups, self-labelled Hwa-byung group(N=130) and diagnosed Hwa-byung group(N=83). Results : 1. In self-labelled Hwa-byung group, Greater yin score showed significant negative correlation with 3 indices of Hwa-byung scale and significant positive correlation with 1 index. Lesser yin score showed significant positive correlation with 6 indices. In diagnosed Hwa-byung group, Greater yin score showed significant negaitive correlation with 5 indices. In both groups, Lesser yang score showed no significant correlation with any indices of Hwa-byung scale. 2. In self-labelled Hwa-byung group, Greater yin score showed significant negative correlation with both trait anger score and state anger score of STAXI. Lesser yin score showed significant positive correlation with trait anxiety score, state anxiety score and CES-D score self-labelled Hwa-byung group. Lesser yang score showed significant positive correlation with anger-out score of STAXI. But Lesser yin score showed significant negative correlation with same index diagnosed Hwa-byung group. Conclusions : 1. The higher Greater yin score, suppression or denial, psychological defense mechanism, become more stronger. 2. The higher Lesser yin score, anger-out tendency become more weakened and increased prevalence of Hwa-byung symptoms. 3. The higher Lesser yang score, anger-out tendency become more stronger.

• Journal of Oriental Neuropsychiatry
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• v.25 no.4
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• pp.359-370
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• 2014

Objectives: To describe the progress and influencing factors of Hwa-byung. Methods: Data were collected from semi-structured interviews. The progress of and recovery from Hwa-byung were examined using the collected experiences of eight middle-aged women who suffered from Hwa-byung. For analysis of the data collected, a Consensual Qualitative Research (CQR) methodology was used. Results: Of the eight participants who thought they had Hwa-byung, six were actually Hwa-byung patients and two were non-Hwa-byung patients. Four years later, four of the six Hwa-byung patients recovered, while the Hwa-byung of one patient persisted, and the remaining patient had circular Hwa-byung. Over time, the symptoms of Hwa-byung declined substantially. However, the patients recognized that their disease continuously persisted. Moreover, they thought their symptoms had worsened. Many types of changes were observed during the recovery period, including environmental, physical, cognitive, and emotional changes, as well as changes in attitudes toward others. Recovery factors included the reduction of stimuli, social support, exercise, treatment, control of rumination, and some cognitive changes. Conclusions: To recover from Hwa-byung, it is necessary for patients to experience changes in environment, cognition, and emotion, and to employ self-management in everyday life.

• Journal of Oriental Neuropsychiatry
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• v.19 no.2
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• pp.133-139
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• 2008

Objective : The purpose of this research was to investigate the prevalence rate of Hwa-Byung for the whole population in a local community. Method : Hwa-Byung Diagnostic Interview Schedule(HBDIS) was carried out for 671 participants in Wonju Cohort study. HBDIS is objective questionnaire for diagnose Hwa-Byung. Collected data was analyzed by the chi-square test. Result: Prevalence rate of Hwa-Byung was 5.4% in the whole population. Prevalence rate of Hwa-Byung in male participants was 2.5%, 1.5% in 40s, 3.2% in 50s, 2.5% in 60s. Prevalence rate of Hwa-Byung in female participants was 7.4%, 7.6% in 40s, 5.5% in 50s, 8.7% in 60s. Conclusion : There was significant difference on the prevalence rate of Hwa-Byung according to sex.

• Journal of East-West Nursing Research
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• v.8 no.1
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• pp.126-134
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• 2003

Purpose: The purpose of this study is to supply the basic materials for the development of objective tools to measure 'Hwa-byung' and for the development of the theories and statements associated with 'Hwa-byung' by making clear the meaning and characteristics of 'Hwa-byung' and by analyzing the concept of 'Hwa-byung'. Method: The concept analysis of Hwa-byung was proceeded according to the concept analysis process of Walker and Avant(1995). Result: The conceptual characteristics of Hwa-byung resulted from the research are like these : (1) Injustice (2) Anger (3) Rumination (4) Anxiety. Therefore, we can describe Hwa-byung as the feeling repeatedly accumulated through the heavy mental pain, injustice, and anger and it is appeared with the physical and behavioral symptoms. Conclusion: Through this concept analysis, we propose as followings ; First, there's need of the objective tools which make it possible to assess Hwa-byung through the theory development and the statement associated with Hwa-byung. Second, there's need of interdisciplinary approach in the development of nursing intervention to coordinate the characteristics of Hwa-byung by understanding the total nature of Hwa-byung and finding the variables associated with Hwa-byung.

• Journal of Korean Academy of Nursing
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• v.33 no.1
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• pp.104-112
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• 2003

Purpose: While most psychiatrists diagnose Hwa-Byung as a chronic psychogenic disorder associated with familial, financial and personality, the purpose of study was to shed light on the nature of Hwa-Byung through pragmatics. Hwa-Byung is characterized as ‘Hwa’ which means fire ‘Byung’ which means disease. This condition cannot be empirically experienced, rather it is represented by suffering internally (in the mind). It also could find an aspect of somatization, and self-diagnosing. Method: As patients themselves diagnose Hwa-Byung, pragmatical approach was taken to analyze the context of the learning through their communication with others. The case examples resulted from in-depth telephone counseling with a client who is housewife with Hwa-Byung over a period of time at the Women's Hot Line. Result: The study showed that the client experienced continuous improper attacks by her husband. She expressed improperness by applying her personal emotions to social-justice reasoning. Conclusion: ‘Hwa’ means lack of mutual intimacy in this research. By expressing this ‘Hwa’, the client would like to recover mutual intimacy with her husband.

• Journal of Oriental Neuropsychiatry
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• v.23 no.4
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• pp.169-182
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• 2012

Objectives : The purpose of this study is to examine the effects of a 3 day Hwa-Byung forests healing program, which consists of helpful contents of Korean medicine. Methods : This study examined the effects of forests healing for Hwa-Byung patients, visited Korean medicine hospital neuropsychiatry clinic for outpatients. The Hwa-Byung forests healing program was run with 20 participants; 4 of them quit in the middle of the program and excluded in data analysis. The Hwa-Byung forests healing program consisted of 3 day helpful Korean medicine contents. The primary outcome measurement was Hwa-Byung symptom score, which measured various symptoms of Hwa-Byung. Results : The results of this study showed that Hwa-Byung symptoms were significantly alleviated. General psychological states, including depression, anxiety, and anger, were significantly improved. Quality of life was also enhanced after 3 day program. These results indicate that the 3 day Hwa-Byung forests healing program was effective for the overall improvements of Hwa-Byung patients. Conclusions : The 3 day Hwa-Byung forests healing program were shown to be an effective intervention in improving the overall aspects of Hwa-Byung patients, including symptoms, depression, anxiety, anger, and Quality of life.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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• pp.1-14
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• 2007

The objective of tills study is to identify the difference of somatic characteristics between Hwa-Byung and Major Depression by comparing the pattern identification of Hwa-Byung group and Hwa-Byung with Major Depression group(double diagnosis) Method: According to Hwa-Byung Diagnostic Interview Schedule(HBDIS) and SCID, 17 patients as diagnosed Hwa-Byung and 20 patients as diagnosed Hwa-Byung with Major Depression group(double diagnosis) were recruited. and by depression scale like Hamilton Rating Scale for Depression(HRDS) & Montgomery-Asberg Depression Rating Scale(MADRS), we excluded patients complaining moderate & severe depression among Hwa-Byung group and excluded patients showing mild depression among Hwa-Byung with Major Depression group. After this evaluation, we analysed and compared the pattern identification of both groups by OMS-prime. Result: 1. There were no significant differences of demographic data between both groups. 2. In the result of 'analysis on pattern identification' for all participant used by OMS-prime, most frequent pattern was deficiency of Yin and Yang of the heart(49%). 3. In the result of 'analysis on most correlated pattern identification' used by OMS-prime, for Hwa-Byung group was deficiency of Yin and Yang of the heart(45%) and the next were disharmony of the liver and spleen (20%), generation of phlegm due to stagnation of Gallbladder(15%) deficiency of Qi and Yin of the heart(l0%), And for Hwa-Byung with Major Depression group(double diagnosis) was deficiency of Yin and Yang of the heart(53%), the next were generation of phlegm due to stagnation of Gallbladder(18%), and deficiency of Qi and blood of the heart(l2%), 4. In the result of 'analysis on significant pattern identification' used by OMS-prime, for Hwa-Byung group was deficiency of Yin and Yang of the heart(20%) and the next were disharmony of the liver and spleen(15%), generation of phiegm due to stagnation of Gallbladder(15%), deficiency of Qi and Yin of the heart(14%), And for Hwa-Byung plus Major Depression group(double diagnosis) was deficiency of Yin and Yang of the heart(18%), the next were deficiency of Qi and Yin of the heart(18%), deficiency of Qi and blood of the heart(l0%), generation of phiegm due to stagnation of Gallbladder(18%), Conclusion: Hwabyung is syndrome that have many different symptoms, but there is no difference between Hwa-Byung group and Hwa-Byung with Major Depression group(double diagnosis) on the side of symptoms. Therefore, Hwabyung could be a new model for research on depression in Korean.

• Journal of Oriental Neuropsychiatry
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• v.24 no.1
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• pp.75-92
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• 2013

Objectives : The objective of this study is to investigate various factors concerning Hwa-byung Methods : The research for various factors of Hwa-Byung was carried out for 686 female Participants. Hwa-Byung was diagnosed by Hwa-Byung Diagnostic Interview Schedule (HBDIS). Results : The rate of Past History about Chronic Bronchitis, Peptic Ulcer, Chronic Hepatitis/Hepatic Cirrhosis, Allergy, Arthritis, Hyperlipidemia is high in the Hwa-Byung group compared with the Control group. In the study of external environments, Hwa-Byung has tendency diagnosed in monthly income under 2,000,000 won, doing regular occupation, marriage, below graduation from high school. In the study of personal relationship, Hwa-Byung has tendency more influenced by negative influencing people than by positive influencing people. In the study of personal factors, Hwa-Byung has a short sleeping time, does not exercise regularly, feels more overburdened, and understimates their own condition to do easy tasks. Conclusions : According to the below results, in the study of Past History, the rate of Chronic Bronchitis, Peptic Ulcer, Chronic Hepatitis/Hepatic Cirrhosis, Allergy, Arthritis, and Hyperlipidemia is high in the Hwa-Byung group compared with the Control. Hwa-Byung has a tendency to be diagnosed by various factors such as the external environment, personal relationships, and personal factors.