OBJECTIVE: This study investigated the mediation effect of stress between the experience of discrimination and life satisfaction among North Korean refugees who resettled in South Korea. The findings of the current study provide empirical evidence for the need of social interventions to mitigate adverse effects of stress on North Korean refugees who are subject to social discrimination on a daily basis. METHODS: In this study, we included 500 subjects among 2,138 North Korean refugees who took refuge in South Korea in 2007. The interview started from April 6th 2009 and finished on May 25th 2009. We conducted moderator effect analysis with Path analysis was conducted because we confirm the experience of discrimination was affected by life satisfaction and stress can affected life satisfaction as a moderator. RESULTS: The experience of discrimination significantly affects stress and stress significantly affects life satisfaction. However, the experience of discrimination was not directly related to life satisfaction. The more stress the study respondents experienced, the lower the life satisfaction they reported. CONCLUSION: The present finding suggests that the effects of discriminating experiences on the life satisfaction of North Korean refugees in South Korea were mediated by their own perceived stress.
Discrimination (Psychology) ; Humans ; Korea ; Negotiating ; Refugees ; Social Discrimination ; Surveys and Questionnaires

OBJECTIVE: This study aims to observe the factors that influence the development of national identity of North Korean refugees who have resettled in South Korea. METHODS: The study population was comprised of 500 North Korean refugees who immigrated to South Korea in 2007. The variables measured national identity as South Korean, a scale for discrimination perceived during daily life, a social for supporting social network, a for childhood trauma experience, traumatic experiences in North Korea, and traumatic experiences during the escape process. Factor analysis was conducted on the result from the scale for national identity as South Korean which produced 4 factors including national consciousness, positive emotions, positive values, and negative values. Multiple regression was done to identify how variables such as demographic data, discrimination, social network, and past trauma had influenced each of 4 factors. RESULTS: National identity was negatively related by traumatic experience during childhood, perceived discrimination, and positively influenced by social networks. Positive emotion was related negatively to education level in North Korea and perceived discrimination, but positively related to traumatic experiences in North Korea. Negative value was related positively age and perceived discrimination but negatively related to supporting social network. CONCLUSION: The results of this study suggests that promoting social networks, decreasing discrimination and healing past traumas were important factors for North Korean refugees in South Korea to facilitate a new national identity as a South Korean.
Consciousness ; Democratic People's Republic of Korea ; Discrimination (Psychology) ; Humans ; Refugees ; Republic of Korea ; Social Discrimination ; United Nations

OBJECTIVES: This study aimed to investigate North Korean refugees' knowledge of mental illnesses and treatments and analyze the factors affecting this knowledge. METHODS: Subjects were selected via a snowball sampling method, and the survey outcomes of 152 North Korean refugee participants were analyzed. The factors affecting knowledge of mental illnesses were analyzed via a regression analysis by constructing a multivariate model with mental illness knowledge score as the dependent variable. RESULTS: The North Korean refugees' mental illness scores ranged from 3 to 24 points, with an average score of 13.0. Regarding the factors that influence mental illness knowledge, the subjects with South Korean spouses and those who had spent more time in South Korea had higher knowledge scores. Furthermore, the subjects who considered the mental health of North Korean refugees to be a serious issue revealed lower knowledge scores than those who did not believe it was a serious issue. The subjects who visit psychiatric clinics showed higher knowledge scores than those who do not. The South Korean subjects who had at least a college education exhibited higher scores than did those without advanced education. The subjects who are satisfied with life in South Korea manifested a higher mental illness knowledge score than those who are not. CONCLUSIONS: This study is significant as being the first study to ever measure and evaluate the level of North Korean refugees' knowledge of mental illnesses. In addition, the evaluations of North Korean refugees' mental illness knowledge and influencing factors while residing in South Korea created basic data that formed the foundation of an effort to enhance mental health literacy and provide proper mental health services. The results of this study can be utilized to solve mental health problems that might frequently occur during the unification process of North and South Korea in the future.
Adult ; Aged ; Democratic People's Republic of Korea ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Literacy ; Male ; *Mental Health ; Middle Aged ; Refugees/*psychology ; Republic of Korea ; Surveys and Questionnaires

OBJECTIVES: The present study aimed to analyze the factors that could affect the health-promoting behaviors of North Korean adolescent refugees residing in South Korea. METHODS: Questions about their sociodemographic variables, subjective health status, healthy living habits, and health-promoting behaviors were asked. RESULTS: Statistically significant differences were found in religion (t=2.30, p<0.05), having family members in South Korea (t=2.02, p<0.05), and subjective health status (t=4.96, p<0.01). Scores on health-responsible behaviors were higher with higher age (t=2.90, p<0.01) and for subjects without family or friends (t=2.43, p<0.05). Higher physical-activity behaviors were observed in males (t=3.32, p<0.01), in those with better subjective health status (t=3.46, p<0.05) and lower body mas index (t=3.48, p<0.05), and in smokers (t=3.17, p<0.01). Nutritional behaviors were higher in those who followed a religion (t=2.17, p<0.05). Spiritual growth behaviors were higher in those who followed a religion (t=4.21, p<0.001), had no family in South Korea (t=2.04, p<0.05), and had higher subjective health status (t=5.74, p<0.01). Scores on interpersonal relationships and stress-management behaviors were higher for those with higher subjective health status. A multiple regression analysis showed greater effects on health-promoting behaviors when subjective health status was better. Older people and non-smokers exhibited more health-responsible behaviors, while more physical-activity behaviors and spiritual growth activities were observed when subjective health status was better. Interpersonal relationship behaviors had positive effects on those with good subjective heath status and on non-smokers. CONCLUSIONS: Based on the results of the current study, an alternative was suggested for promoting health in North Korean adolescent refugees.
Adolescent ; Adolescent Behavior/psychology ; Body Mass Index ; Democratic People's Republic of Korea ; Female ; Health Behavior ; *Health Promotion ; Health Status ; Humans ; Male ; Refugees/*psychology ; Republic of Korea ; Socioeconomic Factors ; Surveys and Questionnaires ; Young Adult

PURPOSE: The present study was done to discover the structure of universal actual experiences 'Considering tomorrow' of health and quality of life among North Korean refugees in terms of the socio-cultural context of South Korea. METHOD: The research question was 'what is the structure of the actual experience of 'Considering tomorrow?', which was examined based on the Parse's human becoming research method. Five North Korean adult refugees were recruited from a National Reconciliation Committee in Seoul/Incheon. The data was gathered from dialogues and collected from February, 2006 to November, 2006. RESULTS: The structures found in this study were: 'hope for future life by taking responsibility and having harmony with South Koreans, by forming an integrated identification; having a chance for positive engagement, by attaining human freedom and hope; feeling respected, by assimilating self to the new world; getting freedom back, by facing a new challenge and preparing self for a new social role; overcoming cultural differences with fortified hardiness for survival, by making a decision for a life course with individual growth. In addition, conceptual integration was that 'Considering tomorrow is transforming the enabling-limiting values'. CONCLUSION: Health professionals need to know North Korean refugees' psychological difficulties, expectations of treatment, help seeking behavior, and expectations from mainstream culture. Additionally, understanding North Korean refugees' needs for reality, health education and a multi-disciplinary team approach are necessary to improve their health.
*Acculturation ; *Adaptation, Psychological ; Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Interviews as Topic ; Life Change Events ; Male ; Mental Health ; Nursing Methodology Research ; Refugees/*psychology ; Social Alienation ; Social Identification ; Tape Recording/methods

PURPOSE: This study was conducted to develop a health education program for preschoolers who have defected from North Korea with their mothers, and to evaluate the effects on health knowledge and behavior. METHODS: A non-equivalent control group pre-post test design was used with 58 preschoolers who were assigned to either the experimental or control group (29 for each group). The program was composed of five sessions in health education and contracts. To test the effectiveness of the intervention, health knowledge and behaviors, and total bacterial colony counts on hands were measured at one pretest and two post tests (1 week and 4 weeks after the intervention ended). Data were analyzed using the SAS program. RESULTS: Health knowledge and behavior in the experimental group increased significantly compared to the control group. The effects of the intervention were evident even at 4 weeks after the intervention ended. Total bacterial colony counts in the experimental group decreased significantly at the 1 and 4 week posttest intervention compared to the control group. CONCLUSION: Results indicate that this program is effective in improving health knowledge and behavior in these children and therefore can be utilized to ensure efficient management their health care.
Bacteria/isolation & purification ; Child ; Child, Preschool ; Democratic People's Republic of Korea ; Female ; Hand/microbiology ; Health Behavior ; *Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; *Program Development ; *Program Evaluation ; Refugees/*psychology

PURPOSE: The study was done to explore meanings and essence of the experience in South Korea of men defectors from North Korea. METHODS: Data were collected from March, 2011 to May, 2012, through in-depth interviews with ten men defectors. Data analysis was conducted using the process of hermeneutic phenomenological reflection. RESULTS: Eight essential themes were extracted; 'buoyant expectation for a new life', 'feeling guilty about family left behind in North Korea', 'inability to become acclimatized due to communication difficulties', 'inability to socialize with South Koreans due to different lifestyles', 'finding strength through trustworthy acquaintances', 'continuing reconciliation with oneself while trying to assimilate into South Korean culture', 'self-realization of one's original self', and 'continuing to feel out the possibility of a future in South Korea'. CONCLUSION: The findings indicate that North Korean men who defect to South Korea shape their identity through three phases: forming self-image during escape from North Korea, trying to become accustomed to South Korean society, and finding their own identity by self-realization of their original self. Eventually, the whole process enables them to recover their identity, to feel a sense of belonging, and to discover possibilities for a better future.
Acculturation ; *Adaptation, Psychological ; Adult ; Democratic People's Republic of Korea ; Female ; Humans ; Interviews as Topic ; *Life Change Events ; Life Style ; Male ; Mental Health ; Middle Aged ; Refugees/*psychology ; Republic of Korea ; Social Alienation ; Social Identification

PURPOSE: The purpose of this study was to identify health knowledge, health promoting behavior and factors influencing health promoting behavior of North Korean defectors in South Korea. METHODS: Participants in this study were 410 North Korean defectors, over 20 years of age residing in Seoul. They were recruited by snowball sampling. Data were collected from April to June, 2010. Health knowledge, health promoting behavior, self-efficacy, perceived barriers to health promoting behavior and social support were measured by structured questionnaires, and perceived physical and mental health status were measured by one item with 10-point numeric rating scale. The data were analyzed using t-test, ANOVA, and multiple regression. RESULTS: Health knowledge, health promoting behavior, and perceived barriers to health promoting behavior were moderate while self-efficacy and social support were high. Factors influencing health promoting behavior of the participants were found to be self-efficacy, social support and perceived barrier to health promoting behavior. CONCLUSION: The results of this study indicate that nursing intervention programs enhancing self-efficacy, social support and reducing perceived barriers to health promoting behavior need to be developed for North Korean defectors in South Korea.
Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; *Attitude to Health ; Democratic People's Republic of Korea ; Female ; *Health Behavior ; *Health Promotion ; Humans ; Male ; Middle Aged ; Questionnaires ; Refugees/*psychology ; Republic of Korea ; Self Efficacy ; Social Support ; Stress, Psychological

PURPOSE: This study investigated prediction of North Korean refugees' adaptation to the South Korean society and verified the goodness of fit between a hypothetical model and actual data in order to suggest the best model. METHODS: This survey was conducted with 445 North Korean refugees living in a metropolitan area. Data were collected from September 1st to November 20th, 2012, and analyzed using SPSS Windows 18.0 and AMOS 17.0. RESULTS: Traumatic experiences of North Korean refugees increased self-efficacy and psychological trauma. Acculturation stress decreased self-efficacy and increased passive coping. Self-efficacy affected active and passive coping, decreased psychological trauma, and increased resilience. Resilience is successful adaptation and refers to North Korean refugees' abilities to adapt effectively to stress. In particular, self-efficacy as the main parameter affecting resilience was confirmed. CONCLUSIONS: The results suggest that resilience can be improved through self-efficacy. It was the most significant factor decreasing psychological trauma and increasing resilience. Therefore, we need to develop programs for self-efficacy. The results also provide basic data for policy making for North Korean refugees.
Acculturation ; Adaptation, Psychological/*physiology ; Adult ; Aged ; Democratic People's Republic of Korea/ethnology ; Female ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Personal Satisfaction ; Psychological Trauma/*ethnology ; Refugees/*psychology ; Republic of Korea/epidemiology ; Resilience, Psychological ; Self Efficacy ; Young Adult

OBJECTIVES: Cases of psychiatric disorders are reported with a review of literature on mental health problems in North Korean defectors in South Korea. METHODS: Four patients who were admitted to a psychiatric hospital with major depression, schizophrenia, bipolar affective disorder, or mixed disorder of conduct and emotions of adolescent were studied. RESULTS: The most common precipitating factor was the separation from close persons they had been dependent on. Defector-specific stress included unfamiliar culture of South Korea, lack of ability to adapt to South Korean society, uselessness of past education and professional skills, stress with regard to being identified or discriminated as a North Korean defector, and guilt feeling for leaving their family behind in North Korea. North Korean defector-specific clinical findings were noted; these included reluctance to expose themselves as North Koreans, negative emotional reaction to discrimination of South Korean neighbors, submissive and passive attitude, loneliness, anxiety for the future related to refugee status, and strong stigma related to psychiatry. CONCLUSION: This case report suggests that an individualized or tailored treatment that considers their unique psychosocial situation, which especially focuses on discrimination and social support, is needed for North Korean defectors with mental disorders.
Adolescent ; Anxiety ; Bipolar Disorder ; Conduct Disorder ; Democratic People's Republic of Korea ; Depression ; Discrimination (Psychology) ; Guilt ; Hospitals, Psychiatric ; Humans ; Loneliness ; Mental Disorders ; Mental Health ; Mood Disorders ; Precipitating Factors ; Refugees ; Republic of Korea ; Schizophrenia