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의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

  • Kim, Ok-Gyeom
    • Korean Journal of Hospice Care
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    • v.2 no.2
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    • pp.28-48
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    • 2002
  • The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

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Effect of Temperature on Development and Life Table Parameters of Tetranychus urticae Koch (Acari: Tetranychide) Reared on Eggplants (가지에서 온도별 점박이응애 발육특성 및 생명표 통계량)

  • Kim, Ju;Lee, Sang-Koo;Kim, Jeong-Man;Kwon, Young-Rip;Kim, Tae-Heung;Kim, Ji-Soo
    • Korean journal of applied entomology
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    • v.47 no.2
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    • pp.163-168
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    • 2008
  • Temperature dependent development of Tetranychus. urticae Koch was studied on the leaf of eggplant at 17, 22, 27, 32 and $37^{\circ}C$. T. urticae showed a minimum mortality at $27^{\circ}C$ and it increased at higher or lower temperatures than $27^{\circ}C$. The hatchability was low at 17 and $37^{\circ}C$. The duration of development decreased with increasing temperatures i.e., 5.3d at $37^{\circ}C$ and 25.8d at $17^{\circ}C$. Linear regression analysis of temperature vs. rate of development yielded the higher $r^2{\geq}0.88$ resulting in a good fit of the estimated line in the range of $17{\sim}37^{\circ}C$. Developmental zero temperature was $12.5^{\circ}C$ for the entire immature stage of female and $12.8^{\circ}C$ for that of male. Thermal constants were 80.5 and 74.7 degree days for those of female and male, respectively. Adult life span and oviposition period decreased with increasing temperatures. The number of eggs laid per female peaked at 141.0 eggs at $27^{\circ}C$, while that was a minimum 78.0 eggs at $37^{\circ}C$. Rate of hatchability, ratio of female, and $R_o$ were increased up to $27^{\circ}C$, and than declined thereafter. Intrinsic rate of natural increase (Rm) increased with rising temperatures and showed a maximum 0.5652 at $37^{\circ}C$. Also, ${\lambda}$ increased with increasing temperature. Doubling time (Dt) and generation time (T) decreased with increasing temperature.

List-event Data Resampling for Quantitative Improvement of PET Image (PET 영상의 정량적 개선을 위한 리스트-이벤트 데이터 재추출)

  • Woo, Sang-Keun;Ju, Jung Woo;Kim, Ji Min;Kang, Joo Hyun;Lim, Sang Moo;Kim, Kyeong Min
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.309-316
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    • 2012
  • Multimodal-imaging technique has been rapidly developed for improvement of diagnosis and evaluation of therapeutic effects. In despite of integrated hardware, registration accuracy was decreased due to a discrepancy between multimodal image and insufficiency of count in accordance with different acquisition method of each modality. The purpose of this study was to improve the PET image by event data resampling through analysis of data format, noise and statistical properties of small animal PET list data. Inveon PET listmode data was acquired as static data for 10 min after 60 min of 37 MBq/0.1 ml $^{18}F$-FDG injection via tail vein. Listmode data format was consist of packet containing 48 bit in which divided 8 bit header and 40 bit payload space. Realigned sinogram was generated from resampled event data of original listmode by using adjustment of LOR location, simple event magnification and nonparametric bootstrap. Sinogram was reconstructed for imaging using OSEM 2D algorithm with 16 subset and 4 iterations. Prompt coincidence was 13,940,707 count measured from PET data header and 13,936,687 count measured from analysis of list-event data. In simple event magnification of PET data, maximum was improved from 1.336 to 1.743, but noise was also increased. Resampling efficiency of PET data was assessed from de-noised and improved image by shift operation of payload value of sequential packet. Bootstrap resampling technique provides the PET image which noise and statistical properties was improved. List-event data resampling method would be aid to improve registration accuracy and early diagnosis efficiency.

Effects of Temperature on the Life History of Indian Meal Moth (Phralidae: Lepidoptera) on Brown Rice (온도가 화랑곡나방(나비목:명나방과)의 생활사에 미치는 영향)

  • 나자현;류문일
    • Korean journal of applied entomology
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    • v.37 no.2
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    • pp.143-149
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    • 1998
  • Development and life table statistics of indian meal moth (Plodia interpunctella, Hiibner)on brown rice (Sativa oryzae L., var 'Ilpum' ) were tested under five different temperatures (17, 20, 25,28 and 3 2 f 0.5"C). The developmental response of females to the temperature was not significantlydifferent from that of males. In the tested temperature range, developmental period and life span of adultmoth decreased as the temperature increased and ranged from 149.9f30.4 to 38.1 k5.6 days and from19.4f 5.1 to 6.9k2.0 days at 17$^{\circ}$C and 32"C, respectively. Emergence rate increased with the increaseof temperature and ranged from 13.0f 6.2% at 17$^{\circ}$C to 49.2f 25.9% at 32$^{\circ}$C. However, hatching ratecurve in relation to the temperature was dome shape with the peak of 73.8 k5.37~a t 25"C, suggesting thathatching is inhibited by high temperature above that temperature. As the temperature increased, femalesconcentrated their oviposition on the second day after emergence. In the temperature range of 17 SIM 25"C, the number of eggs laid per female were not related to the temperature and ranged from 133.4f 37.6to 154.3k57.4. But the number of eggs laid per female decreased at 32$^{\circ}$C which suggests closerelationship with hatching ability. The net reproduction rate was highest at 28$^{\circ}$C and followed by those at25$^{\circ}$C and 20$^{\circ}$C. However intrinsic rate of natural increase of the moth population on brown rice wasestimated to be highest at 32$^{\circ}$C (0.065 per day), probably due to the short developmental period, highemergence rate and the concentrated oviposition of females on earlier days of the emergence.ition of females on earlier days of the emergence.

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The fracture resistance of heat pressed ceramics with wire reinforcement (금속선 강화에 따른 열 가압 도재의 파절저항)

  • Jo, Deuk-Won;Dong, Jin-Keun;Oh, Sang-Chun;Kim, Yu-Lee
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.191-198
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    • 2009
  • Statement of problem: Ceramics have been important materials for the restoration of teeth. The demands of patients for tooth-colored restorations and the availability of various dental ceramics has driven the increased use of new types of dental ceramic materials. Improved physical properties of theses materials have expanded its use even in posterior crowns and fixed partial dentures. However, ceramic still has limitation such as low loading capability. This is critical for long-span bridge, because bridge is more subject to tensile force. Purpose: The wire reinforced ceramic was designed to increase the fracture resistance of ceramic restoration. The purpose of this study was to evaluate the fracture resistance of wire reinforced ceramic. Material and methods: Heat pressed ceramic(ingot No.200 : IPS Empress 2, Ivoclar Vivadent, Liechtenstein) and Ni-Cr wire(Alfa Aesar, Johnson Matthey Company, USA) of 0.41 mm diameter were used in this study. Five groups of twelve uniform sized ceramic specimens(width 4 mm, thickness 2 mm, length 15 mm) were fabricated. Each group had different wire arrangement. Wireless ceramic was used as control group. The experimental groups were divided according to wire number and position. One, two and three strands of wires were positioned on the longitudinal axis of specimen. In another experimental group, three strands of wires positioned on the longitudinal axis and five strands of wires positioned on the transverse axis. Three-point bending test was done with universal testing machine(Z020, Zwick, Germany) to compare the flexural modulus, flexural strength, strain at fracture and fracture toughness of each group. Fractured ceramic specimens were cross-sectioned with caborundum disc and grinded with sandpaper to observe interface between ceramic and Ni-Cr wire. The interface between ceramic and Ni-Cr wire was analyzed with scanning electron microscope(JSM-6360, JEOL, Japan) under platinum coating. Results: The results obtained were as follows: 1. The average and standard deviation in flexural modulus, flexural strength and fracture toughness showed no statistical differences between control and experimental groups. However, strain was significantly increased in wire inserted ceramics(P<.001). 2. Control group showed wedge fracture aspects across specimen, while experimental groups showed cracks across specimen. 3. Scanning electron microscopic image of cross-sectioned and longitudinally-sectioned specimens showed no gap at the interface between ceramic and Ni-Cr wire. Conclusion: The results of this study showed that wire inserted ceramics have a high strain characteristic. However, wire inserted ceramics was not enough to use at posterior area of mouth in relation to flexural modulus and flexural strength. Therefore, we need further studies.

Study on the Adolescent′s Attitude Patterns toward the Meaning of Aging and the Elderly - Q-Methodology - (노인의 의미에 관한 청소년의 태도 유형 연구 - Q 방법론 적용 -)

  • Park In Sook;Lee Keum Jae
    • Child Health Nursing Research
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    • v.5 no.3
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    • pp.292-304
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    • 1999
  • The lengthened average span of human life by virtue of recent developments in medicine has caused the Population of elders to increase. The development of modern industrial society has transformed family structure from the large family system to that of a nuclear family. Due to the shift in family structure, the problem of support for the aged has surfaced as a nursing problem as well as a social problem. With regard to this problem, this study aims to investigate the adolescent's understanding of elders and aging. By identifying their understanding and classifying their attitude patterns, this study will help the nursing assessment of the support of elders in the family. This study employed Q-methodology and the research was conducted from December 1998 to May 1999. One method of the research included deep interviews with elders, those who are in their 50's. 40's or 30's. and the adolescent. 183 Q-Populations taken from literary works such as poems or novels were also formed as another method. Finally. 36 Q-cards were made after consultation with Professors of the nursing department. The subjects of the P- sample were 30 high sohoolboys/girls - who were in first, second, and third years. The result showed that 3 factors provided an explanation for 59.14% of the whole variables: the first factor, 41.37%; the second factor. 11.49%, and the third factor. 6.28%. These three factors were analyzed and categorized as three types. Twenty subjects out of the 30 were included in Type 1: Respecting Elders. The statements which showed the most positive consent were as follows: 'The declining age is a perfect time to prosper completing a worthy life' ; 'Getting old. one needs financial stability' and 'Elders wish the best for their children' The statements showing the most negative response were as follows: 'It is better to die than to live as an older person' ; 'Elders are insignificant' ; and 'Getting old is the worst unhappiness that tortures human.' Four subjects were included in Type 2. Resenting Elders. The statements which showed the most positive consent were as follows: 'Aging is a process of dying that nobody can escape from'. 'Elders should be concerned about his health and try to maintain their health' ; and 'When you set older. you regret about the life in the Past.' The statements showing the most negative response were as follows: 'When You get older. You should stand aloof greed and worldly things' 'When You got older, You become generous and gentle' ; and 'When You set he gets old. You change to become a comfortable and warm person.' Six out of 30 subject were included in Type 3 Caring Elders. The statements which showed the most positive consent were as follows: 'Elders should be concerned about his health and try to maintain their health' ; 'Elders wish the best for their children' ; and 'Elders deserve to be treated with filial respects.' The statements showing the most negative response were as follows 'Elders are insignificant' ; 'Elders have freedom and plenty of free time.' and 'Elders are alienated form and drove out of the society.' The above-mentioned results show that most adolescents in Korea recognize aging as the time of fruition and development: it is a time of benefiting and giving back to society. Aging can also be seen as a time of generosity and magnanimity and the time of respect and favorable treatment from society. despite the change of modern society and the ostensible transformation of a family system. Their recognition seems deeply rooted in the traditional confucian values and the dual family system which is Peculiar especially to the Korea - one which maintains both the superficial form of nuclear family and the substantial mode of the enlarged family system. In sum, many Korean adolescents attribute the meaning of the elderly and aging to the type of the respect with the elderly and the type of the elderly's caretaking.

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An Analysis on Changing Pattern of Economic Active Population by Working Life Table for Korean Men (우리나라 노동생명표에 의한 노동력추이 분석)

  • 조진만
    • Korea journal of population studies
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    • v.13 no.2
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    • pp.1-18
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    • 1990
  • This is a study which attempt to analyze changing patierns of economic active popu-lation, t o estimato- future patterns, and exa- mine vartons problems arises by changing c ire u mst ances of t he labor force market in- clunging soici al, economic ic, heathl th and demoi-graph ic aspects. We have constructed series of wotking life table which are useful in syt uiolyioig the lirocess of growth and structural change of labor force. Work i ng life tables represent ihie life eyele of econrmic' activity in hi ypothetical cohorts, that is. gen-erat i on of men Sn bject at eat' b period ot f their lives th given ra to's o mor tali it y and of par-- tici pation in economic activities. The tabloes prot' ide measorues of the alvet'age he ng t able of economically aeti \- e life. and agespecific rates of en trannee' into and retirement from the hahn' force. In const routing working life tables, age-specific activity rates and life tabole popula- titoto which represents contemporary condi-tions of moortality in Korea au'e the basic' maltoerials. We have derived the age-specific rates foorm economically active population survey, whoich were conducted by the Bureau of Statistics, Economic Planning Borard of the Korean government. Working life tables are constructed for men wtable these materi- als in the year of 1970, 1980 and 1988 by a modified Wolfbein-Wool's method. Some of the findings may be summerized as follow : 1) A central part of constructing working life table is calculation of stationary' economic active population, which represents the number of men in the stationtary population extoected to be in the labor force at each age group in the life span. The stationary economic active population by age have generally a universal pattern, where they rise sharply in the early twenties, approach its' peak in the thirties decline thereafter. at first graolually and then more rapidly at an advanced age. Korean men show the same general pa ttern of age distribution of stationary eco-- nomic active population with sharp increase hegining from the age interval of 20 to 24, reaching to maximum level at older age. The population. however, presumably, increased substantially due to increaseing school atte endance rates. Another difference exiSts in the youngest age groups, that is the activity rate in the year of 1988 is lower than that of Japan. The table shows an analysis of changes in the age distrihution of labor force between 1970, 1980 and 1988. 2) It was shown an analysis of changes in the age distribution and cause of separation from labor force. The entrance rate to labor force has increased from 18~\5 persons to 299 persons per 1000 head of stationary population between that of 1980 than that of 1988 for Korean men in 20~24 age group. The entrace rate to labor force shows a rapid entrance appearance concentrated on the 15~24 age group. The separation rate from labor force by retirment in Korea in the year of 1988 shows a great difference of the about four times as much as that of Japan. 3) The functions of table illustrate the patterns of working life of males in Korea in 1970, 1980 and 1988. The average remaining number of economically active years, e at age 15 in 1988 is 46.39 which is 2.12 years of increase compared with that of at age 15 in 1970,1980 and 1988 are 43.90,44.27 and 46.39 respectively, showing steadily increase dur- ing the past double decade the increase in the length of economically active life various age may be considered to have come both from extention of general life expectancy and from increasing entrance rate to economic activity in high age that of working is far greater in 1988 than that of 1980. The gaps between expectation of life and average remaining years of economically active widened due to rapid improvement of mortality level in Ko- rea. This observation together with the population pressure by the appearance of a group of younger population implies that constant increase of economically inactive population among older age group.

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Revised Fission-track Ages and Chronostratigraphies of the Miocene Basin-fill Volcanics and Basements, SE Korea (한국 동남부 마이오세 분지 화산암과 기반암의 피션트랙 연대 재검토와 연대층서 고찰)

  • Shin, Seong-Cheon
    • The Journal of the Petrological Society of Korea
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    • v.22 no.2
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    • pp.83-115
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    • 2013
  • Erroneous fission-track (FT) ages caused by an inappropriate calibration in the initial stage of FT dating were redefined by re-experiments and zeta calibration using duplicate samples. Revised FT zircon ages newly define the formation ages of Yucheon Group rhyolitic-dacitic tuffs as Late Cretaceous to Early Paleocene ($78{\pm}4$ Ma to $65{\pm}2$ Ma) and Gokgangdong rhyolitic tuff as Early Eocene ($52.1{\pm}2.3$ Ma). In case of the Early Miocene volcanics, FT zircon ages from a dacitic tuff of the upper Hyodongri Volcanics ($21.6{\pm}1.4$ Ma) and a dacitic lava of the uppermost Beomgokri Volcanics ($21.3{\pm}2.0$ Ma) define chronostratigraphies of the upper Beomgokri Group, respectively in the southern Eoil Basin and in the Waeup Basin. A FT zircon age ($19.8{\pm}1.6$ Ma) from the Geumori dacitic tuff defines the time of later dacitic eruption in the Janggi Basin. Based on FT zircon ages for dacitic rocks and previous age data (mostly K-Ar whole-rock, partly Ar-Ar) for basaltic-andesitic rocks, reference ages are recommended as guides for stratigraphic correlations of the Miocene volcanics and basements in SE Korea. The times of accumulation of basin-fill sediments are also deduced from ages of related volcanics. Recommended reference ages are well matched to the whole stratigraphic sequences despite complicated basin structures and a relative short time-span. The Beomgokri Group evidently predates the Janggi Group in the Eoil-Waeup basins, while it is placed at an overlapped time-level along with the earlier Janggi Group in the Janggi Basin. Therefore, the two groups cannot be uniformly defined in a sequential order. The Janggi Group of the Janggi Basin can be evidently subdivided by ca. 20 Ma-basis into two parts, i.e., the earlier (23-20 Ma) andesitic-dacitic and later (20-18 Ma) basaltic strata.

Decreased Neutrophil Apoptosis in Patients with Sepsis is Related to the Activation of NF-κB (패혈증 환자에서 NF-κB 활성화에 의한 호중구 아포프토시스의 억제)

  • Kwon, Sung Youn;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.5
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    • pp.495-509
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    • 2003
  • Background : Neutrophil-mediated inflammation is usually self-limiting, because neutrophils have a remarkably short life span. Prolonged neutrophil survival, which is caused by decreased spontaneous apoptosis, leads to persistent inflammation in sepsis. Because many inflammatory cytokines, which generate signals that delay apoptosis, are regulated by nuclear factor-${\kappa}B$ transcription factor, we hypothesized that nuclear factor-${\kappa}B$ might be related to the reduced neutrophil apoptosis observed in sepsis. Methods : Neutrophils of healthy volunteers and sepsis patients were freshly isolated from venous blood. Neutrophil apoptosis was assayed with two approaches : by counting apoptotic cells under a microscope and by flow cytometry using Annexin V. The activity of nuclear factor-${\kappa}B$ was assessed by immunofluorescent staining or electrophoretic mobility shift assay. Expression of X-linked inhibitor of apoptosis was measured by western blot assay. Results : We confirmed reduced spontaneous neutrophil apoptosis in patients with sepsis. The number of apoptotic neutrophils in patients with sepsis increased to the level of that in healthy controls after cycloheximide treatment, suggesting that decreased spontaneous neutrophil apoptosis is dependent on de novo protein synthesis. In patients with sepsis, basal neutrophil nuclear factor-${\kappa}B$ was activated compared to the level in healthy controls. Moreover, a blockade of nuclear factor-${\kappa}B$ activity reversed the decreased spontaneous neutrophil apoptosis in sepsis patients. Meanwhile, X-linked inhibition of apoptosis expression, which is regulated by nuclear factor-${\kappa}B$, decreased 24 hours after incubation in healthy persons, but persisted for 24 hours in patients with sepsis. Conclusion : These observations suggest that the reduced spontaneous neutrophil apoptosis observed in patients with sepsis may be related to the induction of survival protein by nuclear factor-${\kappa}B$.

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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