• 한국노년학
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• v.31 no.4
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• pp.1083-1101
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• 2011

The purpose of this study is to describe how the structural and functional features of social network change among widowed middle and older adults and to examine the effect of personal predictors of the social network change. Data was obtained from men and women between 45 to 98 years of age(N=118) who were bereaved by the death of their spouse since the first wave survey and participated in the second wave survey of the Korean Longitudinal Study of Ageing(KLoSA). The main findings are as follows: First, their social network after the bereavement was strengthened centered around children; for example, the number of adult children living in proximity to the parent, frequency of contact with children, and the financial and non-financial support from children generally increased. Second, the social network change pattern was categorized into four types such as "overall increased type," "children-centered increased type," "children/close relationship-centered increased type," and "stagnation type." Finally, the health condition of the widowed middle and older adults was a strong predictor of the social network change.

• 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.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.56-64
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• 1998

Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

• Journal of agricultural medicine and community health
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• v.35 no.4
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• pp.370-382
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• 2010

Objectives: The purpose of this study was to investigate the level of health promoting behaviors and the significant factors in rural elderly(young-old vs old-old). Methods: The data was collected using structured questionnaires from June 22th to Sep. 18th, 2009. A total of 556 elderly aged 65 years or over were selected from 14 rural districts in C province, South Korea. Age was divided into two groups as below 65-74 and 75 or older. A structured questionnaire was used to obtain information on the demographic characteristics, their perceived health status, the difficulty of activities of daily living, quality of life, self-efficacy and health promoting behaviors. The health promoting behaviors included nutrition, stress management, interpersonal support, exercise, health responsibility and self-actualization. The scores for health promoting behaviors were used mean and standard deviation. The data was analyzed using SPSS Win 12.0. Results: Of the 556 subjects, we found that the young-old(65-74 aged) were 359 and the old-old elderly(over 75 aged) were 197. We found that the level of health promoting behavior was higher for young-old ($2.75{\pm}0.374$) compared to old-old elderly people ($2.67{\pm}0.399$). In multiple linear regression, quality of life, self-efficacy, living with spouse, and number of generation living together for the young-old, and quality of life for old-old elderly were significantly associated with health promoting behaviors. Conclusions: The study findings indicate that there are age differences in associated factor of health promoting behaviors. Therefore our findings may provide useful assistance in developing effective intervention programs to improve health promoting behavior of the elderly in rural areas according to their age differences.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.5
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• pp.73-83
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• 1998

This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

• KDI Journal of Economic Policy
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• v.31 no.1
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• pp.105-138
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• 2009

Although the decline in fertility rate is generally observed along the history of economic development throughout the world, the continuing decline hitting below the replacement level in Korea over the recent years gathered serious social concerns on the ground that it accelerates the process of population aging. The total fertility rate in Koreareached 2.08 in 1983, and gradually fell to the levels of 1.08 in 2005 and 1.26 in 2007. The policy debate over the role of the government has been focused mainly on the level of theoretical discussion without substantial basis on firm empirical evidence and the determinants of fertility. The objective of the paper is to empirically investigate the fertility effect of the female wage, which is understood as one of the most important determinants of fertility in Koreasince 1980 focusing on one aspect of fertility, namely birth spacing. Using the Korean National Fertility Survey conducted in 2006, I estimate a duration model of first and second births taking into account individual heterogeneity, which turned out to be an important factor to control for. Compared with previous studies in the literature on the Korean fertility, the study has an advantage of using the complete pregnancy history of women in a more representative sample. Unlike the previous studies, the analysis also deals with the endogeneity of marriage by treating a certain age, rather than age at marriage, as the time in which a woman becomes exposed to the risk of pregnancy. The study shares the common problem in the literature on birth spacing of lacking relevant wage information for respondents in a retrospective survey. I estimate the wage series as a function of the basic characteristics using the annual Wage Structure Survey from 1980 to 2005, which is considered as a nationally representative sample for wage information of employees. The results suggest that the increase in female wage by 10 percent leads to a decrease in second birth hazard by 0.56~0.92 percentage points and that the increase in spouse's wage by the equal amount is accompanied by the increase in second birth hazard by 0.36~1.13 percentage points. These estimates are more precisely estimated and of smaller magnitude than those presented by the previous studies. The results are robust to the different specifications of the wage equation. The simulation analysis based on the predicted values shows that about 17% of the change in the second birth hazard over the period 1980 to 2005 was due to the change in the female wage. Although there is some limitation in data, the results can be viewed as one estimate of the role of female wage on the recent fertility decline in Korea. The question raised by the paper is not a normative one of whether a government should promote childbearing but a positive one thatexplains fertility decline. Therefore, if there is a wide consensus on promoting childbearing, the finding suggests that the policies designed to reduce the opportunity cost of women in the labor market would be effective. The recent movement of implementing a wide range of family-friendly policies including child care support, maternity leave, parental leave and tax benefit in developed countries should be understood in this context.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.2 no.1
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• pp.67-85
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• 1995

The purpose of this study was to determine the effects of rhythmic movement therapy for adaptation state in mastectomy patients. The quasi-experimental study was designed using nonequivalent control group pretest-posttest design within the framework of Laszarus & Folkman's stress-adaptation model. The subjects of the study were composed thirty-two mastectomy patients, of these fifteen were assigned to the experimental group and seventeen to the control group. Rhythmic movement therapy was carried out twice a week for thirty-five, minutes or forty minutes for six weeks period from August 22 to September 30 in 1994. Data was collected before and after the experimentation. Collected data was analyzed by mens of chi-square test, t-test, two-way ANOVA, Pearson's correlation coefficient with $SPSS/PC^+$. The results were summarized as follows : 1. Physical symptom score in the experimental group and control group was not significant difference. 2. Joint Movement Parameter in the experimental group and control group was significant difference. 3. Depression score in the experimental group and contrl group was significant difference. 4. Body image score in the experimental group and control group was significant difference. 5. Stress perception score in the experimental group and control group was significant difference. 6. Social adjustment score in the experimental group and control group was significant difference. 7. Each adaptational level in the experimental group and control group according to type of Health Locus of Control were partially significant difference. Depression score and social adjustment score between the experimental group and control group according to others Health Locus of control were significant difference. This data suggest that rhythmic movement therapy was more effective in the group of Others health Locus of Control. 8. Each adaptational level between the experimental group and control group according to amount of spouse support were not significant difference. 9. The significant positive correlation between physical symptom score and body image, between body image and social adjustment, were observed. The significant negative correlation between stress perception score and social adjustment, between depression and body image, between depression and social adjustment, were observed. This data suggest that the more physical symptom score increased, the more body image increased and the more body image, the more social adjustment. And then the more stress perception score decreased, the more social adjustment increasded and the more depression score, the more body image and social adjustment. Thus it is concluded that the rhythmic movement therapy was a useful nursing intervention for adaptation of mastectomy patients.

• 한국노년학
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• v.38 no.4
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• pp.811-835
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• 2018

Social relations and cognitive function in old age are closely related to each other, and social relation is classified into structural characteristics and qualitative characteristics reflecting cognitive and emotional evaluation. The concept of social isolation is the focus of attention in relation to the social relations of old age. Social isolation has a multidimensional theoretical structure that is divided into objective dimension such as social network, type of furniture, social participation, and subjective dimension such as lack of perceived social support and loneliness. There is also a close relationship between cognitive function and interpersonal conflict in old age. In this study, we examined the effect of subjective social isolation, which shows the structural characteristics of social relations, and subjective social isolation and interpersonal conflict on the dementia occurrence by age group in the elderly. The data were analyzed by applying a random effect panel logit model using 1,740 panel data from the first year to the third year of KSHAP. The results of the analysis are summarized as follows. First, the cognitive impairment increased sharply with age. Objective and subjective social isolation were both U-shaped distribution with an inflection point of 80 years old. Second, the main effect on the probability of cognitive impairment was statistically significant with objective and subjective social isolation, but the type of interpersonal conflict did not appear to be significant. Third, the results of two-way interaction effect analysis on the probability of cognitive impairment are as follows. The relationship between subjective social isolation and the probability of occurrence of cognitive impairment was significantly different according to the level of conflict with spouse. In addition, the higher the subjective social isolation, the higher the probability of cognitive impairment in the elderly(over 85) than in the young-old(65~74). In addition, as the level of conflict with spouses increases, the probability of cognitive impairment of the oldest-old(aged 85 or older) is drastically lower than that of the young-old(aged 65~74). Based on the results of this study, policy and practical implications for reducing the cognitive impairment of the elderly age group were suggested, and limitations of the study and suggestions for future research were discussed.

• The Korean Society of Law and Medicine
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• v.24 no.2
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• pp.147-196
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• 2023

Advances in brain science have made it possible to stimulate the brain to treat brain disorder or to connect directly between the neuron activity and an external devices. Non-invasive neurotechnologies already exist, but invasive neurotechnologies can provide more precise stimulation or measure brainwaves more precisely. Nowadays deep brain stimulation (DBS) is recognized as an accepted treatment for Parkinson's disease and essential tremor. In addition DBS has shown a certain positive effect in patients with Alzheimer's disease and depression. Brain-computer interfaces (BCI) are in the clinical stage but help patients in vegetative state can communicate or support rehabilitation for nerve-damaged people. The issue is that the people who need these invasive neurotechnologies are those whose capacity to consent is impaired or who are unable to communicate due to disease or nerve damage, while DBS and BCI operations are highly invasive and require informed consent of patients. Especially in areas where neurotechnology is still in clinical trials, the risks are greater and the benefits are uncertain, so more explanation should be provided to let patients make an informed decision. If the patient is under guardianship, the guardian is able to substitute for the patient's consent, if necessary with the authorization of court. If the patient is not under guardianship and the patient's capacity to consent is impaired or he is unable to express the consent, korean healthcare institution tend to rely on the patient's near relative guardian(de facto guardian) to give consent. But the concept of a de facto guardian is not provided by our civil law system. In the long run, it would be more appropriate to provide that a patient's spouse or next of kin may be authorized to give consent for the patient, if he or she is neither under guardianship nor appointed enduring power of attorney. If the patient was not properly informed of the risks involved in the neurosurgery, he or she may be entitled to compensation of intangible damages. If there is a causal relation between the malpractice and the side effects, the patient may also be able to recover damages for those side effects. In addition, both BCI and DBS involve the implantation of electrodes or microchips in the brain, which are controlled by an external devices. Since implantable medical devices are subject to product liability laws, the patient may be able to sue the manufacturer for damages if the defect caused the adverse effects. Recently, Korea's medical device regulation mandated liability insurance system for implantable medical devices to strengthen consumer protection.

• Journal of the Daesoon Academy of Sciences
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• v.42
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• pp.45-73
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• 2022

The phenomenon of veneration for Queen Mother of the West [西王母 Chn: Xiwangmu Kr: Seowangmo] is a 'cultural flow' that has garnered great interest not only in China but also in Korea for many years. To properly understand the cultural trend regarding the Queen Mother of the West, it is essential to view the related mythology as it corresponds to East Asian women as well as the transformation of society's view of women. In addition to the outcomes that result from the establishment of a patriarchal society, the relationship between goddesses and gods gradually becomes a relationship of discrimination based upon differences. Accordingly, as women change into objects that are given meaning rather than subjects that give meaning, the de-sacredization of the goddess occurs. This paper focused on the changes in the perception of the Queen Mother of the West from the view of Yin-Yang theory. This approach shows a transition process of transforming wherein she has morphed into an assistant or spouse of a god as part of a trend that deemphasizes the divinity of her as a stand-alone goddess. Yin-Yang theory is the key to understanding culture, history, and art as well as Chinese philosophy. This key can be further applied to the theme of women in mythology. What is particularly noteworthy about the process by which the Queen Mother of the West was defined as a goddess is that she was original described as half-human and half-beast and yet by the time her depictions became fully human and fully woman, she was described instead as an absolute beauty endowed with great artistic talent. In this paper, it will be revealed that the perception of the Queen Mother of the West, as an absolute beauty and artistic talent, is embedded with the male societal desire for an image of the feminine as understood via Yin-Yang theory. Queen Mother of the West as she was depicted in the Classic of Mountains and Seas (山海經 Chn: Shanhaijing Kr: Sanhaegyeong) had a half-human half-beast form that instilled people with fear of disasters and punishments from heaven. However, in the Han Dynasty, her religious significance became that of an object to ward off evil and attain blessings. By the time of the novel, Tales of the Strange (志怪小說 Chn: Zhiguaixiaoshuo Kr: Jigoesoseol), from the Wei, Jin, Southern and Northern Dynasties, she was transformed into a goddess in the image of beautiful woman in charge longevity and immortality. From the perspective of Yin-Yang theory, the changes in the perception of Queen Mother of the West was found to contain the following meaning: as an extension of the establishment of a patriarchal system and subordinate laws, her new form was made to be pleasing to the male gaze and Yin-Yang theory was brought in to support those changes later.