ABSTRACT

Objectives

While increasing numbers of North Korean refugees (NKRs) are migrating to South Korea, different understandings of physical pain between NKR patients and the South Korean healthcare providers may create miscommunication and less satisfaction with their care management. To identify strategies to improve care, this study elicits and presents an ethnomedical model of chronic pain among NKR women.

Design

Twenty semi-structured individual interviews were conducted with NKR women with chronic pain living in South Korea. Inductive and deductive thematic analysis was performed on three types of data: interview transcripts, field notes created after each interview, and memos written during the analysis.

Results

Participants reported that pain started after a certain period of resettlement and expressed frustration when there was no definite diagnosis for pain. They identified physical factors (e.g. excessive labor, exposure to violence, and poor diet) as the primary causes, while psychological factors (e.g. loneliness, rumination, and financial burden of sending remittances to North Korea) were viewed as collateral or contributing causes. Several participants indicated emotional discomfort when they were referred to psychiatrists for unceasing pain. Physical treatment (injections, medications, or acupuncture) and providers’ sincere attitudes were expectations of care considered capable of addressing both physical and emotional distress.

Conclusions

Findings highlight the need to understand NKR women’s ethnomedical model of chronic pain, which is distinct from illness model of healthcare providers. These preliminary findings could be used to improve care strategies based on NKRs’ care needs.

中文翻译：

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“我一直工作到我的身体被打破”：朝鲜难民妇女慢性疼痛的民族医学模型

摘要

目标

虽然越来越多的朝鲜难民 (NKR) 移居韩国，但 NKR 患者与韩国医疗保健提供者之间对身体疼痛的不同理解可能会造成沟通不畅，并降低对其护理管理的满意度。为了确定改善护理的策略，本研究提出并提出了 NKR 女性慢性疼痛的民族医学模型。

设计

对生活在韩国的患有慢性疼痛的 NKR 女性进行了 20 次半结构化的个人访谈。对三种类型的数据进行了归纳和演绎主题分析：访谈记录、每次访谈后创建的现场笔记以及分析期间编写的备忘录。

结果

参与者报告说，在重新安置一段时间后开始出现疼痛，并在没有明确的疼痛诊断时表示沮丧。他们将身体因素（例如过度劳动、遭受暴力和不良饮食）确定为主要原因，而将心理因素（例如孤独、沉思和向朝鲜汇款的经济负担）视为附带或促成因素。一些参与者在被转诊给精神科医生时表现出情绪上的不适，因为他们一直感到疼痛。物理治疗（注射、药物或针灸）和提供者的真诚态度是对被认为能够解决身体和情绪困扰的护理的期望。

结论

研究结果强调需要了解 NKR 女性慢性疼痛的民族医学模型，这与医疗保健提供者的疾病模型不同。这些初步研究结果可用于根据 NKR 的护理需求改进护理策略。