The purpose of the study was to identify the influence of North Korean Defectors’Cultural Orientation, Post-traumatic Stress Disorder (PTSD), and Resilience to their adaptation to South Korean society, and to provide evidence for North Korean defectors to improve their adjustment to South Korean society. This study compiled snowball sampling of North Korean defectors aged 19 years or older who completed Settlement Support Center for North Korean Refugees (Hanawon) education and live in the community.
Data collection was conducted from November, 2019. The participants were 171 who agreed to participate in this study. The Cultural Orientation of North Korean defectors was measured using Individualism-Collectivism (INDCOL) Tool, which was developed by Singelis et al. (1995) and revised by Kim (1996). Post-traumatic Stress Disorder (PTSD) was measured using PTSD Checklist civil version (PCL-C) developed by Weathers et al. (1993) and revised by Osong et al. (2014). Resilience was measured using the Korean version of CD-RISC, which was developed by Connor and Davidson (2003) and revised by Baek et al. (2010). Adjustment to South Korean society was measured using the social adaptation problem scale developed by Jang & Kim (2000) and modified by Kim (2019). The collected data were analyzed using SPSS/WIN 22.0. Descriptive statistics, Independent t-test, ANOVA Pearson’s correlation coefficients, and multiple regression were utilized.

The results of this study are as follows:

1. The cultural orientation score was calculated for each subject; then, these scores were classified into four subtypes according to the orientation which scored the highest. In this research, 55 subjects (38.7%) showed the cultural orientation of horizontal individualism and another 55 subjects (38.7%) displayed horizontal collectivism. Horizontal individualism and horizontal collectivism were present at the same ratio and aggregately was shown in 77.4% of the total study population. Post-traumatic stress disorder averaged 42.72±16.01 out of 85, resilience averaged 66.37±15.80 out of 100, and adjustment to South Korean society averaged 31.07±7.10 out of 40.

2. The vertical individualism of the subjects differed significantly depending on their gender (t=-2.62, p=.010), age (F=8.36, p<.001), marital status (F=9.58, p<.001), job classification (F=3.95, p=.021) and family currently living together (F=5.32, p=.007). The orientation of vertical individualism tended to appear in men rather than women and was also more common for subjects in their 40s, 50s and over rather than those in their 20s and 30s. This orientation was also more common among the others rather than unmarried and married, among the others rather than students and among couples immigrating together after marriage in North Korea than the others. The vertical collectivism of the subjects differed significantly depending on their age (F=2.73, p=.045), marital status (F=4.37, p=.014), and family currently living together (F=7.31, p=.001). Subjects showed a statistically significant tendency of vertical collectivism in their 50s and over rather than those in their 30s, among the others rather than unmarried. Also, the orientation of vertical collectivism tended to appear among couples immigrating together after marriage in North Korea or married in South Korea than the others. Horizontal individualism was shown significantly different depending on their family currently living together (F=3.86, p=.025). It was higher among couples immigrating together after marriage in North Korea or among married in South Korea than the others.

3. The severity of the Post-traumatic stress disorder of the subject was significantly different depending on age (F=3.67, p=.013), marital status (F=9.20, p<.001), job classification (F=3.42, p=.035), pattern of defection (F=5.44, p=.005), and family members who are currently living together (t=-2.58, p=.011). The rate of post-traumatic stress disorder was higher in the age groups of the 40s rather than the 20s and 30s and was higher among housewives than students. When considering the type of companion in defection, having no companion had a higher correlation with Post-traumatic stress disorder compared to arriving with family, friends or others. The rate of Post-traumatic stress disorder was higher among the others rather than unmarried and among those currently living alone than those living with family members. This result was statistically significant.

4. The resilience of the subject was significantly different depending on age (F=4.08, p=.008), religion (t=2.64, p=.009), educational level (F=-3.61, p=〈.001), the length of one's residence in South Korea (F=6.20, p=.003) and family members who are currently living together (F=9.26, p=〈.001). The resilience of North Korean defectors was higher among those in their 50s and over compared to those in their 40s. Resilience was also higher both in religious individuals compared to atheists. It was also higher among those who had graduated from a professional college, or higher to those whose highest education level was graduating high school or lower. The subjects who lived in South Korea for 10 or more years showed significantly higher resilience than those with fewer than five years of residency. Resilience was also higher among couples immigrating together after marriage in North Korea or among married in South Korea than the others.

5. The subject's adjustment to South Korean society differed significantly depending on marital status (F=4.41, p=.014), job classification (F=4.72, p=.010), educational level (F=-3.04, p=.003), subjective economic condition (F=2.78, p=.006), the length of one's residence in South Korea (F=6.61, p=.02), and family status currently living together(t=2.31, p=.022; F=7.05, p=.002). The adjustment degree of North Korean defectors to South Korean society was significantly higher among married or unmarried than the others, and also higher among students and the others than in housewives. Subjects with a higher level of education, having completed professional college or higher showed a higher degree of social adjustment than those who completed high school or less. The degree of social adjustment was also higher among those with a “middle and over”than a “low”subjective economic status. This result was statistically significant. Subjects who lived in South Korea for 10 or more years showed a significantly higher degree of social adjustment than those with a residency of fewer than five years. Additionally, the social adjustment degree was significantly higher for those currently living with family members than alone and among couples immigrating together after marriage in North Korea or among married in South Korea than the others.

6. The subject's adjustment to South Korean society had a significant amount of correlation between horizontal individualism(r=.21, p=.005) and horizontal collectivism(r=.21, p=.007). In addition, South Korean society adjustment showed a statistically significant negative correlation with Post-traumatic stress disorder(r=-.61, p<.001), and a statistically significant positive correlation with resilience(r=.46, p<.001).

7. The variables affecting the subject's adjustment to South Korean society were Post-traumatic stress disorder and resilience, and the variables were shown to affect the adjustment to South Korean society in the order of Post-traumatic stress disorder and resilience. The total variable's explanatory power was 47.2 percent. Post-traumatic stress disorder accounted for 37.7 percent, while resilience accounted for 8.8 percent of the adjustment to South Korean society. The higher the Post-traumatic stress disorder, the lower the adjustment of South Korean society, the more resilient the South Korean society is, the higher the adjustment of South Korean society. In comparison, cultural disposition did not have a significant impact on the adaptation of South Korean society.

The study found that about 77 percent of the subjects had horizontal cultural orientations and relatively high rates of post-traumatic stress disorder and low resilience, while post traumatic stress disorder and resilience had a significant influence on the degree of North Korean defectors ' adjustment to South Korean society. The results of this study suggest that it is necessary to develop nursing intervention and guidelines that can control post-traumatic stress disorder and improve resilience in order to improve the level of adjustment of North Korean defectors to South Korean society.

북한이탈주민은 우리 사회의 구성원으로서 간호학적 중재의 대상이며, 그들의 남한사회적응과 관련된 문제와 해결은 북한주민과의 교류협력이나 통일을 대비할 수 있을 뿐 아니라 한국 사회의 사회통합과도 관련이 있다. 북한이탈주민의 성공적인 남한 정착을 위한 많은 제도적 지원에도 불구하고 북한이탈주민은 남한사회적응 과정에서 많은 어려움과 고통을 겪고 있다. 따라서 그들의 남한사회적응을 높이기 위해 북한이탈주민의 특성과 그 특성이 사회적응에 어떠한 영향을 미치는지 알아보았다.
본 연구는 북한이탈주민의 문화성향, 외상후스트레스장애(Post-Traumatic Stress Disorder, PTSD), 회복탄력성이 남한사회적응에 미치는 영향을 확인하는 서술적 조사연구이다. 연구 대상자는 탈북 후 한국에 입국한 뒤 통일부 산하‘북한이탈주민정착지원사무소(하나원)’교육 수료 후 지역사회에 편입되어 수도권에 거주하는 만 19세 이상의 북한이탈주민 171명을 대상으로 하였다.
자료 수집은 2019년 11월 12일부터 11월 21일까지 시행되었다. 문화성향은 Singelis, Triandis, Bhawuk과 Gelfand (1995)가 개발하고 김기범(1996)이 번안한 Individualism-Collectivism (INDCOL)로 측정하였고, 외상후스트레스장애는 Weathers, Litz, Herman, Huska와 Keane (1993)이 개발하고 오송인 등(2014)이 번안한 PTSD Checklist civilian version (PCL-C)으로 측정하였다. 회복탄력성은 Connor와 Davidson (2003)이 개발하고 Beak, Lee, Joo, Lee와 Choi (2010)가 번안한 Korean Connor-Davidson Resilience Scale (K-CD-RISC) 측정도구를 사용하였으며, 남한사회적응은 장혜경과 김영란(2000)이 개발하고 김명선(2019)이 수정·보완한 사회적응문제 척도로 측정하였다. 수집된 자료는 SPSS/WIN 22.0 통계 프로그램을 이용하여 각각 실수와 백분율, 평균과 표준편차, t-test, ANOVA, Scheffé post hoc, Pearson’s correlation coefficients, multiple regression을 이용하여 분석하였다.
본 연구의 결과는 다음과 같다.

1. 대상자의 문화성향은 수평적 개인주의 55명(38.7%), 수평적 집단주의 55명(38.7%)으로 나타났다. 외상후스트레스장애는 85점 만점에 평균 42.72±16.01점, 회복탄력성은 100점 만점에 평균 66.37±15.80점, 남한사회적응은 40점 만점에 평균 31.07±7.10점이었다.

2. 북한이탈주민의 남한사회적응 정도는 결혼상태(F=4.41, p=.014), 직업분류(F=4.72, p=.010), 교육수준(F=-3.04, p=.003), 주관적 경제상태(F=2.78, p=.006), 남한 거주기간(F=6.61, p=.02), 현재 동거하는 가족여부(t=2.31, p=.022)와 가족(F=7.05, p=.002)에서 유의한 차이를 보였다. 미혼과 기혼이 기타(이혼 및 사별)보다, 학생과 기타가 주부보다, 전문대졸 이상이 고졸 이하보다, 주관적 경제상태가‘중간 이상’이 ‘하’보다, 10년 이상 남한거주기간이 5년 미만보다, 현재 동거하는 가족 있음이 없음보다, 북한에서 결혼 후 함께 이주와 한국에서 결혼이 기타보다 유의하게 높은 것으로 나타났다.

3. 대상자의 남한사회적응은 문화성향의 수평적 개인주의(r=.21, p=.005), 수평적 집단주의(r=.21, p=.007)와 유의한 양의 상관관계, 외상후스트레스장애와 유의한 음의 상관관계(r=-.61, p<.001), 회복탄력성과 통계적으로 유의한 양의 상관관계를 보였다(r=.46, p<.001).

4. 대상자의 남한사회적응에 영향을 미치는 변수로는 외상후스트레스장애, 회복탄력성으로 나타났고, 외상후스트레스장애(β=-.50, p<.001), 회복탄력성(β=.32, p<.001) 순으로 남한사회적응에 영향을 미치는 것으로 나타났다. 변수의 총 설명력은 47.2%이었고 외상후스트레스장애는 남한사회적응의 37.7%, 회복탄력성은 남한사회적응의 8.8%를 설명했다. 외상후스트레스장애가 높을수록 남한사회적응은 낮아지고, 회복탄력성이 높을수록 남한사회적응은 높아지는 것으로 나타났다.

이상의 연구결과를 통해 북한이탈주민의 남한사회적응에는 외상후스트레스장애와 회복탄력성이 상당한 영향을 미치고 그 중에서 외상후스트레스장애가 남한사회적응에 가장 영향을 많이 미친다는 사실을 확인할 수 있었다. 즉, 북한이탈주민의 외상후스트레스장애가 높아질수록 남한사회적응이 낮아지고 회복탄력성이 높아질수록 남한사회적응이 높아지게 되는데, 본 연구의 연구대상자는 비교적 높은 비율로 외상후스트레스장애를 겪고 낮은 회복탄력성을 갖는 것으로 나타났다. 그러므로 북한이탈주민의 남한사회적응 수준을 높이기 위해서 북한이탈주민의 외상후스트레스장애를 조절하고, 회복탄력성을 향상시킬 수 있는 방안이 모색되어야 할 것이다. 남한입국 직후 하나원에서뿐 아니라 지역사회 편입 이후에도 외상후스트레스장애 위험군의 북한이탈주민을 지역사회 유관기관으로 연계하는 간호중재가 포함되어야 하며 북한이탈주민을 대상으로 회복탄력성 향상을 위한 교육프로그램을 개발하고 적용하여 남한사회에 적응할 수 있도록 해야 하겠다.