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강윤숙 / Kang YS
김이돌 / 권연숙 / 이수진 / Kim ID / Kwon YS / Lee SJ
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Abstract
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The reunion of one's dispersed family members has to further develop from just accomplishing a meeting. It needs a systematic approach to care of health of an 'individual' and 'family'. There have been actual physical problems with family members who participated in the First North-South Family Reunion. There have been predictions that these health problems will continue to rise in the future. Therefore, there are demands for health management measures.
This research closely examined the health problems of 200 reunited members from the first meeting. Also, their physical and psychological experience were subject matters in this research. This research suggests on what kind of measures are needed in approaching systematic health management. In addition, it developed a health management instruction for those dispersed family members.
Out of 200 family members, 66% (122) of family members replied to this research. 71% of Southern family members who reunited at Pyongyang answered. Also, 51% of family member who reunited at Seoul responded. The average age of participants was 74.5 years old and 74.5% of them had physical illness. Major physical illnesses were hypertension, diabetic, heart problems, chronic bronchitis, arthritis, and digestive problems. Some of the participants even had an artificial joint and artificial heart.
The results of research, completed with questionnaire, interviews, and telephone interviews, were categorized into 11 different aspects. Also, It compared between Pyongyang and Seoul participants according to 3 stages: prior to the meeting, during, and after. The Physical-Psychological experiences were categorized into different categories. The Physical experiences were divided into 'positive physical experience' and 'negative physical experience'. Also, the psychological experiences were categorized into 9 different aspects: positive emotional reaction', 'psychological shock', 'anxiety/uneasiness/nervousness', 'uncertainity/state of despondency', 'lack of intimacy/no emotional fluctuation', 'disappointment/sadness/regret', 'heartbroken/dissatisfaction', 'yearning', and 'resentment/anger'
The ratio of negative physical-psychological experiences increased as the reunion meeting continued. The ratio showed 68.8% prior to the meeting. During the meeting, it increased to 79.7%. Finally, the ratio amplified to 82.5% at the end of the reunion meeting.
All the results of research, under the physical experience category, were divided into 'positive physical experience' and 'negative physical experience'.
The positive physical experience had 0% ratio before and during the meeting. However, it increased to 3.6% after the meeting. The Pyongyang participants (3.1%) had higher ratio than Seoul participants (0.5%). This result has thread of connection to ratio of negative physical experiences. The Pyongyang participants had 10.9% of negative outcome, whereas Seoul Participants showed 11.9%.
The negative physical experience had similar ratio of 32.9% (before the meeting) and 22.8% (after the meeting). However, the ratio sharply declined to 2.2% during the reunion process. The reason for showing such a low ratio is that all the energy, relating to the 'reunion', have exerted into the psychological factor.
The research results of 9 categories of psychological experiences are the followings:
First, the positive emotional reaction showed 31.2% (before the meeting), 20.3% (during the meeting), and 13.9% (after the meeting). The feeling of anticipation, happiness, thankfulness, and hope showed most strongly at the 'before-the-meeting stage'. However, Pyongyang participants showed higher ratio of positive emotional reaction in all 3 stages. The level of readiness in reunion participants could only speculate this outcome. The Pyongyang participants requested the meeting, and prepared themselves. However, the Seoul participants were not prepared.
Second, The 'Emotional Shock' showed ratio of 11.4% (before the meeting), 27.5% (during the meeting), the 6.8% (after the meeting). The 'during the meeting' stage showed highest level. The ratio of emotional shock was a bit higher for Seoul participants than Pyongyang participants at the 'after the meeting' stage. In other hand, The Pyongyang participants had higher ratio at the 'during the meeting' stage.
Third, The aspect of 'anxiety/uneasiness/nervousness' showed 18.6% (before the meeting), 1.1% (during the meeting), and 8.4% (after the meeting). This aspect showed highest at the stage of the 'during the meeting'. It is due to the feeling of uncertainty and unreality. Moreover, The feeling of anxiety came from whether families are reuniting or not. It contributed to this aspect.
Fourth, The aspect of 'lack of intimacy/no emotional fluctuation' showed higher during the reunion process. This aspect had a ratio of 3.9% (before the meeting), 19.1% (during the meeting), and 1.0% (after the meeting). Especially, the Pyongyang participants (15.0%) had higher ratio than the Seoul participants (9.0%). This caused due to the feeling of heterorganic made by long period of separation. Also, Korean's way of not expressing their feelings have contributed to this feeling of distance.
Fifth, the aspect of 'disappointment/sadness/ regret' showed 1.0% (before the meeting), 9.6% (during the meeting), and 9.9% (after the meeting).
Sixth, aspect of 'uncertainty/state of despondency' showed 1.0% (before the meeting), 1.0% (during the meeting), and 9.8% (after the meeting).
Seventh, The aspect of 'heartbroken/dissatisfaction' showed 0% (before the meeting), 18.1% (during the meeting), and 8.3% (after the meeting).
Eighth aspect of 'yearning' showed same ratio of 0% at the 'before stage' and 'during stage.' However, this aspect showed 14.5% at the 'after the meeting' stage. The result of 'before stage' signifies the short time period between confirmations of meeting to actual reunion process. Ergo, The other feelings were portrayed stronger than the emotional yearning.
Ninth, the aspect of 'resentment/anger' showed 1.1% (during the meeting), and 1.0% (after the meeting). However, this aspect only showed only to Seoul participants in small numbers. This is caused by the frustration about the current system's situation. This situation is keeping the families apart. This frustration accumulated and expressed in aspect of anger.
The identity of 'separated family members' is the cause of persisting stress to those older family members. Also, other stresses are caused by the incidents of 'reunion process' and 'waning circumstances.' Under these situations, participants may have sudden serious illnesses. It is caused by not deliverately preparing themselves. The outcome of illness may differ from person to person. However, the stress will eventually cause serious health sickness. In addition, reunion participants may influence psychological disturbance or chaos to their family members in a situation of 2nd or 3rd person. Therefore, It may danger or cause imbalance in family's function. Hence, The health issues of separated family members must concern all individual level and family level.
According to the research, the participant's physical-psychological stress response to the cause of the stress (reunion process) can be divided into two major responses: positive and negative. Nevertheless, the positive response and negative response cannot be overlooked as divided result. There are possibilities that 2 or more different responses may exhibit at the same time. Ergo, The total stress response will increase.
If these kinds of primary stress responses are not appropriately controlled, it may cause physical-psychological disorders. The research began after 2 to 3 months after the first reunion meeting. Therefore, the research must continue to see if the responses persist further in the future. According to research's subject matters, the duration of responses continued from 3days to 2-3months. If the family separation issues are not solved permanently the psychogenesis illness might occur. The causes of psychogenesis illness might continue to remain in one's consciousness without knowing.
Therefore, there are need for persisting monitoring and managing health plan for separated family members. Also, the proposals made by the first of reunited family members are 'visiting home town/visiting ancestral grave/ exchange of a letter/ extending the visit/ mutual visit.' These proposals took up 64.9% of total suggestions. These kinds of desires must be solved by north-south government's careful consideration. The second biggest proposal was the consideration for the elders. The average age of majority of research subjects were 74.5 years old. Most of the participants complained about lack of health consideration and unpleasant travel. Especially, the participants had a hard time following stringent schedules. These participants strongly expressed their wishes to consider participants in the future. Moreover, There was a proposal for strengthening the medical support unit in case of an emergency.
The third biggest proposition (10.2%) was a wish to know the physical situation of family in North Korea and list of necessary items needed before hands. Other suggestions were 'need for health management instructions (5.9%)' and 'restriction on media coverage (4.4%).' In addition, the participants wanted to prepare a list of conversation subjects prior to the meeting. Most of the participants did not have effective discussion during the meeting.
The conclusion, basis on the research, suggests to agencies in concern to apply detailed strategies of managing health.
First, The government must form and support agencies to effectively execute health management projects. As of this moment, the Korean Red Cross handles all the planning and execution of North-South reunion process. Therefore, it is advisable for Korean Red Cross to select and establish proper manpower. If this agency or organization becomes formal, other agencies, such as the Unification Agency, and central government must support this agency for an effective execution. This agency can be titled as the 'Separated Family Health Management Committee', 'Separated Family Health Management Team', or 'Research Institute for Separated Family Health Management.'
Second, The manpower for health management projects must be all volunteers. These volunteers should be professionals who majored in nursing, medicine, psychology, sociology, social welfare, and others. Also, majority of volunteers should have knowledge and interest in issues of separate family. Most important of all, volunteers must have a humanistic sense of duty.
Third, the organization must provide health management education and counseling to family members through the health project. Also, the organization must have thorough knowledge of health conditions of families and must continue with the research. In addition, it must provide sufficient support to enlarge the medical-health area between North and South Korea. Fourth, the method of securing fund for health management must consider both corporate sponsor and individual. Also, the monetary support from the government must be considered.
Fifth, any kind of reunion pathway for families must be open at all times. An open visit would be ideal. However, the reality could only demand fixed location for reunion process to take, exchange of letters, and telephone exchange. These must be provided from the government level. If the reunion meeting location is established, proper manpower adequate to counsel and provide medical support to participants must be stationed at all times.
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KeyWords
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남북이산가족상봉, 건강관리, North-South Family Reunion, Health management
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원문 및 링크아웃 정보
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등재저널 정보
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