Purpose
This study aimed to suggest directions for legislation regarding medical support tasks in the Nursing Act to promote the advancement of nursing.
Methods
This study reviewed the history of medical support nurses in South Korea and the educational programs for advanced practice providers, both domestically and internationally.
Results
Nurses have performed medical support tasks traditionally carried out by physicians, but legal controversies have persisted. As a result of the escalation of conflicts surrounding policies aiming to increase the physician workforce, training doctors left hospitals. This prompted the initiation of pilot programs allowing nurses to legally engage in medical support tasks, culminating in the enactment of the Nursing Act in September 2024. Internationally, advanced practice providers such as advanced practice nurses (APNs) and physician assistants (PAs) undergo graduate-level education and certification. Since Korea lacks a PA system, integrating medical support tasks within the APN framework would be preferable. Achieving this will require absorbing clinical practice nurses (referred to as PA nurses) into the APN system, implementing government-supported education programs to address regional disparities, and establishing reimbursement policies for APNs.
Conclusion
With the implementation of the Nursing Act, a long-term approach is needed to establish professional qualifications, accreditation, education, training, examination, and regulatory systems. A comprehensive discussion should be undertaken to develop an optimal workforce, ensuring the delivery of safe and high-quality healthcare services to patients and the public.

Citations

• Lessons from the US Advanced Practice Registered Nurse system
  Eun-Ok Im, Dongmi Kim
  Journal of Korean Academy of Nursing.2025; 55(4): 492.     CrossRef

Purpose
This study analyzed the methodological characteristics of machine learning (ML) applications in nursing research, evaluated their reporting quality against standardized guidelines, and assessed progress toward clinical implementation. Methods: A PRISMA-compliant systematic review (PROSPERO CRD42024595877) searched nine English- and Korean-language databases through September 27, 2024. Included studies applied ML to a nursing question and had at least one nursing-affiliated author. Two reviewers independently extracted data following the Cross-Industry Standard Process for Data Mining (CRISP-DM) framework. Reporting quality was appraised using the TRIPOD+AI checklist. Results: Of 125 included studies, supervised learning predominated (93.6%), with random forest, logistic regression, and support vector machines as common algorithms. The most frequent performance metrics were the area under the receiver operating curve and accuracy. Mean TRIPOD+AI compliance was 50.4% (standard deviation=9.37), with reporting quality lowest for data preparation (48.0%) and class imbalance handling (22.4%). Research focused on predicting pressure injuries, falls, and readmissions. Only seven studies described clinical deployment, often citing ethical or workflow barriers. Conclusion: While ML studies in nursing are increasing and show strong discriminatory accuracy, their impact is limited by inconsistent reporting, limited external validation, and rare clinical deployment. Translating these algorithms into practice requires adopting comprehensive reporting guidelines like TRIPOD+AI, documenting each CRISP-DM phase, and integrating nurse-centered decision-support pathways.

Purpose
This study aimed to identify the characteristics and efficacy of Intermittent Pneumatic Compression (IPC) interventions for preventing Venous Thromboembolism (VTE) in critically ill patients. Methods: The CENTRAL, Embase, OVID, CINAHL, KMbase, KoreaMed, and KoreaScience databases were searched from January 7 to 11, 2023. The search included all records from the inception of each database up to January 2023, with publication language restrictions to English and Korean. Three reviewers independently carried out the entire process, which included data search, quality assessment, and data extraction. Results: Out of 1066 articles, six Randomized Controlled Trials (RCTs) were included. One of the four studies that reported on the incidence of DVT, and one of the six studies that measured the incidence of Pulmonary Embolism (PE), found that IPC alone was effective in reducing the incidence of DVT and PE. One of the four studies that reported on VTE incidence demonstrated a significant reduction in VTE incidence with a triple intervention of IPC, anticoagulants, and elastic compression stockings compared to a combined intervention of anticoagulants and graduated compression stockings. Four studies that reported data on the incidence of bleeding reported no effect on reducing bleeding. Conclusion: Our findings suggest that IPC interventions may reduce the incidence of DVT as a preventive strategy in critically ill patients. Further RCTs are necessary to evaluate the effect of IPC interventions on DVT prevention in this patient population and to provide robust evidence for critical care nursing.

Purpose
Emerging evidence indicates that eating patterns—particularly skipping meals and eating alone—are associated with excess body weight. However, few studies have assessed whether these behaviors contribute to weight gain across different age groups. This study examined the associations of skipping breakfast or dinner, and of eating those meals alone, with overweight or obesity among Korean adults compared to children and adolescents. Methods: This cross-sectional secondary analysis used data from the 2019 Korea National Health and Nutrition Examination Survey. Information on skipping meals, eating alone, and sociodemographic characteristics was obtained via self-report for adults and proxy report for participants under 12 years of age. Overweight or obesity was determined from measured height and weight. Multivariable logistic regression analyses were performed separately by age group. Results: Among adults, eating dinner alone was associated with higher odds of obesity (odds ratio [OR]=1.27, 95% confidence interval [CI]=1.06–1.52). Among adolescents, skipping dinner three or more times per week was associated with higher odds of obesity (OR=2.60, 95% CI=1.04–6.54). No significant associations were observed in children. Skipping breakfast or eating breakfast alone was not significantly associated with overweight or obesity in any age group. Conclusion: Although the cross-sectional design precludes causal inference, the findings suggest age-specific links between eating behaviors and weight status. For adults, reducing solitary dinners may help prevent obesity, whereas for adolescents, preventing frequent dinner skipping could be beneficial. Nursing strategies promoting shared mealtimes in adults and regular dinners in adolescents may help address obesity in Korea.

Purpose
This study aimed to clarify the concept of nursing competence in coping with clinical deterioration by employing Rodgers’ evolutionary concept analysis, which reflects both sociocultural and temporal dimensions. Methods: A six-step concept analysis was conducted following Rodgers’ methodology. A systematic literature review was performed using PubMed, Embase, CINAHL, and Google Scholar, yielding 35 relevant studies published between 2000 and 2025. Data extraction followed the Joanna Briggs Institute template, and quality was appraised using the STROBE checklist. Results: Four key attributes of nursing competence were identified: technical skills in patient monitoring, situational awareness and clinical intuition, decision-making regarding escalation of care, and communication and teamwork to ensure timely intervention. Antecedents included formal education, clinical experience, and institutional support. Consequences encompassed enhanced patient safety, increased nurse confidence, and greater professional autonomy. The concept was demonstrated to be dynamic and influenced by healthcare policies, such as the implementation of rapid response systems. Conclusion: Nursing competence in managing clinical deterioration is a multidimensional and evolving concept that is essential for patient safety. Clarification of this concept can inform the development of assessment tools and simulation-based education. Further research should explore its application across diverse healthcare contexts and address challenges related to escalation of care.

Purpose
This systematic review and meta-analysis aimed to investigate the effects of aromatherapy interventions on stroke symptoms in stroke patients.
Methods
This study adhered to the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. Relevant studies published between 2004 and 2022 were searched in the PubMed, CINAHL, Cochrane Library, EMBASE, ERIC, and RISS databases. The review included randomized and non-randomized studies of stroke patients who received aromatherapy interventions targeting stroke symptoms. The extracted literature was evaluated via the ROB 2 and ROBINS-1 quality appraisal checklists and visualized using a risk-of-bias visualization tool.
Results
The review included five randomized controlled trials and five quasi-experimental studies. The results showed that aromatherapy, administered through massage, inhalation, acupressure, mouth care, and olfactory stimulation, was effective in alleviating pain, constipation, oral health, motor power, muscle strength, balance, fatigue, and sleep quality. Aromatherapy also demonstrated beneficial effects in reducing depression, stress, delirium, blood pressure, pulse rate, respiration rate, serum cortisol, and antioxidants, while enhancing happiness, body temperature, and quality of life. A meta-analysis of mean differences in post-test results revealed that three studies reported a significant effect on pain, with an effect size of 1.85 (95% CI, 0.18~3.51).
Conclusion
Aromatherapy had positive effects on physical, physiological, psychological, cognitive, and integrative health outcomes. We recommend the use of aromatherapy in stroke patients to improve pain relief and health outcomes.

Citations

• Traditional, complementary, and integrative medicine in the management of ischemic stroke: a narrative review
  S. Sowmiya, Rukaiah Fatma Begum, L. S. Dhivya, Praveen Rajendran, N. Harikrishnan, Ankul Singh S
  Frontiers in Pharmacology.2025;[Epub]     CrossRef

Purpose
The aim of this study was to systematically review the literature on the effects of mobile health applications in older adults with dementia or Mild Cognitive Impairment (MCI) and to quantify the effect size of these interventions through meta-analysis.
Methods
A systematic review and meta-analysis was conducted, with a total of seven databases searched on April 18, 2023. The risk of bias was evaluated using the Revised Cochrane Risk of Bias and the Risk of Bias in Non-randomized Studies of Interventions tools. Effect sizes were calculated using Hedges’ g within a random effects model, and subgroup analyses were also performed.
Results
A total of 10 studies were included in the systematic review, and six studies were included in the meta-analysis. Intervention groups exhibited a statistically significant improvement in cognitive function (Hedges’ g=0.33, 95% Confidence Interval [CI]=0.09~0.56, p=.007). Subgroup analyses revealed that older adults with MCI (Hedges’ g=0.41, 95% CI=0.12~0.69, p=.006) and interventions lasting more than 4 weeks (Hedges’ g=0.47, 95% CI=0.09~0.85, p=.016) demonstrated a significant cognitive improvement.
Conclusion
The results of this study indicate that mobile health applications may represent a suitable approach for improving cognitive function in older adults with MCI, emphasizing the need for at least a four-week intervention. These findings underscore the potential of mobile health interventions as a practical option for cognitive improvement in the early stages of cognitive decline.

Citations

• An umbrella review and meta-meta-analysis on the effectiveness of digital health interventions for cognitive function improvement in the elderly
  Yi Deng, Minqi Wang, Can Li, Hong Wu
  European Geriatric Medicine.2025; 16(5): 1599.     CrossRef
• Digital assistive technologies for community-dwelling people with dementia: A systematic review of systematic reviews by the INTERDEM AI & assistive technology taskforce
  David Neal, Michael P Craven, Jane Cross, Shirley Evans, Christopher Fox, Laila Oksnebjerg, Isabel Alexandre, Aidin Aryankhesal, Arlene Astell, Ahmet Begde, Annabel Ditton, Thomas Engelsma, Rikke Gregersen, Pascale Heins, Eef Hogervorst, Aysegul Humeyra K
  DIGITAL HEALTH.2025;[Epub]     CrossRef
• Terrapino: a mobile application for Alzheimer’s risk assessment and cognitive health promotion
  Ross Andel, Katerina Sheardova, Jan Pavlik, Martin Vališ, Jana Amlerova, Jakub Hort
  Frontiers in Digital Health.2025;[Epub]     CrossRef

Purpose
This study analyzed nursing students’ guided reflective journals following simulation-based practice using standardized patients for the initial care of older adults experiencing falls. It aimed to provide a deeper understanding of how changes in students’ thinking occurred through the learning experience and to describe their levels of reflection.
Methods
An eight-hour simulation-based education program was implemented during a geriatric clinical practicum. The program consisted of orientation, pre-learning activities, simulation practice, and a wrap-up session. Reflective journals from 53 third-year nursing students were analyzed using qualitative content analysis.
Results
Fifty-three third-year nursing students participated and submitted reflective journals. Three categories emerged from the analysis: “preparing for simulation-based practice,” which involved students setting care plans and employing observation; (2) “experiencing patient fall management through simulation-based practice,” where students actively engaged in realistic fall management scenarios; and (3) “critical reflection after simulation-based practice,” encompassing students’ acquisition of new insights and their personal growth. In the first category, students prepared for patient encounters by developing care plans and conducting observations. The second category highlighted realistic fall management scenarios utilizing standardized patients. The third category focused on personal growth through critical reflection. In the 53 reflective journals (185,021 words), level 3 reflections accounted for 31.6% of the content, while level 5, the highest reflection level, comprised only 8.6%.
Conclusion
Post-simulation reflective journaling stimulated critical thinking and self-assessment, enabling nursing students to analyze and reflect deeply on clinical practices. This process reinforced their knowledge base and behavioral foundations essential for clinical practice.

Citations

• Effectiveness of a high-fidelity simulation program based on flipped learning for nurses’ emergency management of seizures: a mixed-methods design
  Jae-Kyun Ju, Okja Choi, Shinhye Ahn, Hye Won Jeong
  BMC Nursing.2025;[Epub]     CrossRef
• Effect of structured community-based older people education program on empathy, emotional intelligence, and caring behavior among nursing students
  Jing Ma, PingLei Chui, Mei Chan Chong, Jingru Yuan, Yongyan Zhu, Luyao Liu, Zhenqing Sun
  Frontiers in Medicine.2025;[Epub]     CrossRef

Purpose
Falls and medication errors are the most common patient safety incidents globally. Kolb’s experiential learning theory supports the application of cognitive learning in clinical settings. This study examined the effectiveness of Experiential Learning–Based Fall and Medication Error Prevention Education (EFMPE), utilizing virtual reality and room of errors.
Methods
A randomized controlled trial was conducted with 28 fourth-year nursing students (15 experimental, 13 control). The experimental group participated in EFMPE from February 1 to 6, 2024, comprising six sessions of 2 hours each. The control group received traditional lectures. Safety control confidence and course interest were measured before and immediately after the intervention; safety control confidence was reassessed 6 weeks later.
Results
Both groups showed immediate improvement; however, only the experimental group sustained increased safety control confidence after 6 weeks (Wald χ²=13.21, p<.001). Course interest was significantly higher in the experimental group post-intervention (Wald χ²=10.64, p=.001).
Conclusion
These preliminary findings suggest that EFMPE potentially supports the prevention of falls and medication errors in clinical practice.

Purpose
Middle-aged women often experience weight gain, particularly as visceral fat, due to hormonal changes associated with menopause. Visceral fat, which accumulates in the abdomen, poses significant risks to cardiometabolic health. This cross-sectional study aimed to compare the cardiometabolic risks associated with Visceral Fat Obesity (VFO) and Subcutaneous Fat Obesity (SFO) in middle-aged Korean women and to identify factors that influence VFO.
Methods
Women aged 40 to 64 with overweight or obesity were recruited from March to April 2019. The study involved anthropometric measurements, fasting blood tests, and low-volume abdominal computed tomography. Additionally, participants provided self-reported sociodemographic, health-related, and lifestyle information, including Physical Activity (PA) and dietary intake.
Results
Of all participants, 70.8% were post-menopausal, and 55.1% had VFO. Those with VFO exhibited significantly higher mean values for waist circumference, total cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting glucose, high sensitivity C-reactive protein, and the Framingham risk score compared to those with SFO. The factors influencing VFO were age (odds ratio (OR)=1.14; 95% confidence interval (CI), 1.032~1.247), body mass index (OR=1.47; 95% CI, 1.151 ~1.875), days of vigorous PA per week (OR=0.42; 95% CI, 0.244~0.735), and intake of animal calcium (OR=0.99; 95% CI, 0.988~0.997).
Conclusion
The findings indicate that middle-aged women with VFO face increased cardiometabolic risks. Since menopause is inevitable in women, targeting modifiable behaviors to reduce weight, particularly visceral fat, is crucial for lowering cardiometabolic risk.

Citations

• Literature Review on the Effects of Functional Food Ingredients for Blood Glucose and Body Fat Reduction on Glycemic Control in Insulin Resistance and Diabetes
  Nohyeon Kim, Minhee Lee, Yoo Kyung Park, Jeongmin Lee
  Journal of the Korean Society of Food Science and Nutrition.2025; 54(10): 805.     CrossRef

Purpose
This study aimed to identify the main keywords, network structures, and topical themes in patient safety incident reports using text network analysis. Methods: The study analyzed patient safety incident reports from a general hospital in Seoul, covering a total of 3,576 cases reported over five years, from 2019 to 2023. Unstructured data were extracted from the text of the incident reports, detailing how the patient safety incidents occurred and how they were managed according to the six-part principles. The analysis was conducted in four steps: 1) word extraction and refinement, 2) keyword extraction and word network generation, 3) network connectivity and centrality analysis, and 4) topic modeling analysis. The NetMiner program was used for data analysis. Results: The analysis of degree, betweenness, and closeness centrality revealed that the most common keywords among the top five were "confirmation," "medication," "inpatient room," "caregiver," and "condition." Topic modeling analysis identified three main topic groups: 1) incidents caused by a lack of awareness of fall risk, 2) incidents of non-compliance with basic medication principles, and 3) incidents due to inaccurate patient identification.
Conclusion
To prevent patient safety incidents, it is necessary to promote a culture of safety in hospitals, standardize patient identification procedures, and provide basic training in medication safety and fall prevention to healthcare staff. Furthermore, empirical research on patient safety practices is necessary to encourage active participation in patient safety activities by patients and family caregivers.

Purpose
This study aimed to explore the roles, facilitators, barriers, and future directions of rapid response teams (RRTs) in Korean hospitals from the perspectives of both RRT and ward nurses.
Methods
Focus group interviews were conducted with 10 RRT nurses and 10 ward nurses across three hospitals that employed RRTs in Korea from August 2021 to February 2022. The interviews were recorded, transcribed, and analyzed using qualitative content analysis to identify themes relevant to RRT operations.
Results
The analysis yielded 10 subtopics and 4 main themes: the exploration of RRT's essential roles, the facilitators and barriers impacting RRT operations, and the construction of a blueprint for future systems. Notable barriers included unclear job assignments without legal safeguards, conflict arising from hierarchical structures, and insufficient organizational support. The following facilitators were identified: transformed perceptions through collaborative efforts, organizational recognition and support, and self-reinforcement by demonstrating expertise.
Conclusion
This study highlights the challenges and opportunities associated with implementing RRTs in Korean hospitals, including the need for clear role definitions, effective interprofessional collaboration, and organizational support. Based on these findings, future efforts should focus on establishing legal frameworks that define the scope of practice for RRT nurses.

Citations

• Enhancing postoperative recovery with multimodal prehabilitation: the journey begins before surgery
  Ah-Reum Cho, Wariya Vongchaiudomchoke, Detlef Balde, Do Jun Kim, Francesco Carli
  Korean Journal of Anesthesiology.2025; 78(5): 401.     CrossRef

Purpose
Person-centered care is essential to improving patient outcomes, yet the factors that influence it require further investigation. This study examines the relationships among nurses’ compassion competence, cultural competence, intercultural communication skills, and person-centered care, and it identifies key predictors of person-centered care. Methods: A descriptive survey was conducted among 191 nurses from two general hospitals using convenience sampling between April 1 and April 22, 2024. Data collection included measures of compassion competence, cultural competence, intercultural communication skills, and person-centered care. Statistical analyses involved descriptive statistics, the independent t-test, analysis of variance, Pearson’s correlation coefficient, and stepwise multiple regression. Results: Of the 191 participants, 172 (90.1%) were females and 19 (9.9%) were males, with an average clinical experience of 8.89 years. Person-centered care showed significant positive correlations with compassion competence (r=.58, p<.001), cultural competence (r=.62, p<.001), and intercultural communication skills (r=.63, p<.001). Key predictors of person-centered care included intercultural communication skills (β=.29, p=.001), compassion competence (β=.27, p<.001), cultural competence (β=.20, p=.024), and non-shift work status (β=.12, p=.031). The model explained 47.9% of the variance in person-centered care (F=44.76, p<.001). Conclusion: In this study, person-centered care among nurses was influenced by compassion competence, cultural competence, intercultural communication skills, and work type. Further research is warranted on the delivery of person-centered care among nurses who provide care to patients from diverse cultural backgrounds.

Purpose
This study identified the mediating effect of resilience on the relationship between job stress and the professional quality of life of hospice and palliative care nurses.
Methods
The participants included 136 hospice and palliative care nurses from 13 inpatient hospice and palliative care wards at a tertiary hospital in a metropolitan city in South Korea. Data were collected from February 2022 to March 2022. Hayes' PROCESS macro 3.5 was used to test the significance of the parameter's indirect effects. Professional quality of life was divided into three subdomains: compassion satisfaction, secondary traumatic stress, and burnout.
Results
As a mediator, resilience had both direct and indirect effects on the relationship between job stress and the compassion satisfaction of hospice and palliative care nurses. Furthermore, there were both direct and indirect effects on the relationship between job stress and secondary traumatic stress. Finally, although there was no direct effect on the relationship between job stress and burnout, there was an indirect mediating effect.
Conclusion
This study confirmed the direct effect of compassion satisfaction on job stress and the professional quality of life of hospice and palliative care nurses, as well as the mediating effect of resilience on job stress and burnout. To improve the professional quality of life of hospice and palliative care nurses, it is necessary to develop and apply programs that enhance resilience in order to promote its mediating effects on compassion satisfaction and burnout.

Purpose
Over 10% of intensive care unit (ICU) patients die; however, research aimed at assessing and improving the quality of their deaths remains scarce. This study investigated the impact of communication among healthcare professionals and person-centered care provided by ICU nurses on the quality of dying and death (QODD) experienced by ICU patients.
Methods
We measured general characteristics of ICU nurses, interprofessional communication, and person-centered care, and identified their impact on the quality of death for patients who died in the ICU. Participants consisted of 103 ICU nurses employed at two tertiary hospitals in South Korea. Data were collected between January and May 2023. Descriptive statistics, the t-test, analysis of variance, the Mann-Whitney U test, Pearson correlation coefficients, and multiple linear regression analyses were conducted using SPSS version 23.0.
Results
The mean QODD score was 44.73±21.26. QODD was positively correlated with openness (nurse-physician), understanding (nurse-physician), satisfaction (nurse-physician), and person-centered care. Factors significantly influencing QODD included nurse-physician communication, specifically understanding (β=.35, p=.010), and person-centered care (β=.19, p=.033), explaining 20.2% of the total variance (F=7.44, p<.001).
Conclusion
Improved communication among healthcare professionals and enhanced person-centered care are essential for improving the QODD for ICU patients. To achieve this, educational initiatives focusing on end-of-life care and communication training programs for healthcare professionals should be implemented.

Citations

• Intensive care nurses’ perceptions of good death and end-of-life care attitudes and behaviors: a descriptive and correlational quantitative study
  Rumeysa Bayram, Belkız Kiziltan
  BMC Palliative Care.2025;[Epub]     CrossRef

Purpose
The purposes of this study were to develop a prediction model for pressure injury using a machine learning algorithm and to integrate it into clinical practice.
Methods
This was a retrospective study of tertiary hospitals in Seoul, Korea. It analyzed patients in 12 departments where many pressure injuries occurred, including 8 general wards and 4 intensive care units from January 2018 to May 2022. In total, 182 variables were included in the model development. A pressure injury prediction model was developed using the gradient boosting algorithm, logistic regression, and decision tree methods, and it was compared to the Braden scale.
Results
Among the 1,389,660 general ward cases, there were 451 cases of pressure injuries, and among 139,897 intensive care unit cases, there were 297 cases of pressure injuries. Among the tested prediction models, the gradient boosting algorithm showed the highest predictive performance. The area under the receiver operating characteristic curve of the gradient boosting algorithm's pressure injury prediction model in the general ward and intensive care unit was 0.86 (95% confidence interval, 0.83~0.89) and 0.83 (95% confidence interval, 0.79~0.87), respectively. This model was integrated into the electronic health record system to show each patient's probability for pressure injury occurrence, and the risk factors calculated every hour.
Conclusion
The prediction model developed using the gradient boosting algorithm exhibited higher performance than the Braden scale. A clinical decision support system that automatically assesses pressure injury risk allows nurses to focus on patients at high risk for pressure injuries without increasing their workload.

Citations

• Machine Learning Applications in Nursing-Affiliated Research: A Systematic Review
  Eun Joo Kim, Seong Kwang Kim
  Korean Journal of Adult Nursing.2025; 37(3): 189.     CrossRef
• Data Analytics and Administrative Decision‐Making in Nursing Management: A Systematic Review
  Nathidathip Darach, Min Su Kim, Wasinee Wisesrith, Eileen G. Collins, Majd Mrayyan
  Journal of Nursing Management.2025;[Epub]     CrossRef

Purpose
Cancer diagnosis is associated with psychological distress, which often leads to a significant reduction in adaptation and quality of life. This study aimed to identify the prevalence and related factors of psychological distress in newly diagnosed breast cancer patients.
Methods
The study included 138 women scheduled for surgery or neoadjuvant chemotherapy following a recent breast cancer diagnosis at a university hospital in Korea. Psychological distress was assessed using the National Comprehensive Cancer Network Distress Thermometer and problem lists. Data collection occurred from November 1, 2021, to November 30, 2022. Descriptive statistics and logistic regression analysis were utilized for data analysis.
Results
The average age of the participants was 51.72 years. Among the 138 participants, 67.4% (n=93) reported moderate to severe levels of psychological distress. Multivariate logistic regression analysis identified financial burden (Odds Ratio [OR]=4.32), fears (OR=5.35), and nervousness (OR=5.50) as predictors of moderate to severe psychological distress.
Conclusion
Approximately two-thirds of newly diagnosed breast cancer patients experienced significant psychological distress. Nervousness, fears, and financial burden were significant factors influencing this distress. Therefore, management of psychological distress should be implemented for patients experiencing financial burdens or emotional problems, such as nervousness and fear, from the time of diagnosis.

Citations

• Psychological Resilience and Associated Factors in Cancer Patients: A Cross‐Sectional Analysis
  Marta Esteban Blanco, Inmaculada Martinez de la Viuda, Maria Gemma Rodriguez Chico, Maria del Mar Félix Montalvo, Aurea Garcia Salas, Andrés Garcia Palomo, Maria Teresa Quintana Asenjo
  Cancer Reports.2026;[Epub]     CrossRef
• Impact of fragmented care on cancer outcomes among korean women with breast and cervical cancer: a focus on regional and economic disparities
  Sun Jung Kim, Noorhee Son, Woo-Ri Lee, Dong-Woo Choi, Seojin Park, Kyu-Tae Han
  International Journal for Equity in Health.2025;[Epub]     CrossRef
• Family roles and limitations as mediators in medical communication for cancer patients: A qualitative study
  Yeori Park, Jiyeon Kang, Yeonju Kim, Young Su Park, Sang-Ho Yoo, Taiwo Opeyemi Aremu
  PLOS One.2025; 20(10): e0333669.     CrossRef
• Belief-Based Family Support Intervention to Strengthen Family Resilience among Breast Cancer Caregivers: A Quasi-Experimental Study in Indonesia
  Dwi Retnaningsih, Nursalam, Ferry Efendi, Hanik Endang Nihayati, Kristiawati, Mira Triharini
  European Journal of Oncology Nursing.2025; : 103092.     CrossRef

Purpose
This study aimed to determine the rates of intensive care unit readmission and to identify the factors influencing readmission among intensive care unit patients aged≥65 years with internal medicine conditions.
Methods
We retrospectively reviewed electronic medical records from a tertiary care hospital in Seoul, analyzing the characteristics of patients who were and were not readmitted between December 2020 and September 2022.
Results
A total of 351 patients were included. The unplanned intensive care unit readmission rate was 4.8% within 7 days and 9.1% beyond 7 days after discharge. Comorbid diabetes, higher total bilirubin levels at intensive care unit admission, lower PaO₂/FiO₂ ratios at discharge, and elevated Blood Urea Nitrogen (BUN) levels at discharge were associated with an increased risk of readmission within 7 days. In contrast, hypertension, prolonged intensive care unit stays, and lower hemoglobin levels at discharge were associated with readmissions occurring after 7 days.
Conclusion
Intensive care unit readmission among older patients is influenced by several clinical and hematological factors. Nurses should consider a patient's history of diabetes and hypertension, length of intensive care unit stay, and laboratory values-specifically total bilirubin at admission, and PaO₂/FiO₂ ratio, hemoglobin, and BUN levels at discharge-when making discharge decisions. These findings can inform the development of discharge guidelines.

Purpose
This study aimed to examine the relationship among professor-student interactions, grit, and adaptation to college life.
Methods
In this quantitative, cross-sectional study, participants completed a structured questionnaire comprising 48 items: 8 on general characteristics, 8 on professor-student interactions, 12 on grit, and 20 on adaptation to college life. Data were collected from 165 nursing students at two four-year universities between April 15 and May 20, 2023.
Results
Professor-student interactions had a mean score of 3.76±0.59 out of 5, grit had a mean score of 3.09±0.53, and adaptation to college life had a mean score of 3.48±0.51. Regression analysis identified significant predictors of adaptation to college life, including professor-student interactions (β=.26, p<.001), grit-perseverance of effort (β=.18, p=.047), and satisfaction with the major, with the "very satisfied" (β=.40, p<.001) and "satisfied" (β=.24, p=.002) categories showing significant impacts. The overall regression model was statistically significant (F=20.76, p<.001) and accounted for 32.5% of the variance in adaptation to college life.
Conclusion
Educational programs designed to strengthen professor-student interactions, enhance grit, and improve satisfaction with one's major should be developed to help nursing students adapt to college life. These findings have important implications for nursing education practices, the improvement of student support systems, and the preparation of students for their professional roles.

Purpose
This descriptive correlational study aimed to evaluate the impact of patient activation on self-management and explore the mediating role of shared decision-making (SDM) among patients on hemodialysis.
Methods
A cohort of 136 participants was recruited from hemodialysis units in Gwangju, South Korea, between August 9 and 22, 2024. Patient activation, self-management, and SDM were assessed using the Patient Activation Measure (PAM-13), the Hemodialysis Self-Management Instrument (HDMI-K), and the 9-item Shared Decision-Making Questionnaire (SDM-Q-9), respectively. Descriptive statistics, Pearson’s correlation analysis, and mediation analysis using the PROCESS macro were conducted to analyze the data.
Results
Patient activation, SDM, and self-management were positively correlated with one another. Mediation analysis showed that patient activation significantly predicted both SDM and self-management. SDM also significantly predicted self-management, confirming its partial mediating effect. The final model explained 54.5% of the variance in self-management. The indirect effect of patient activation on self-management through SDM was statistically significant (indirect effect=0.05, 95% confidence interval [CI]=0.02–0.10). The indirect effect of patient activation on self-management through SDM was statistically significant (indirect effect=0.05, 95% CI=0.02–0.10).
Conclusion
Patient activation directly and indirectly enhances self-management through SDM, verifying the partial mediating role of SDM. Integrating SDM into nursing interventions is essential for effectively supporting self-management in patients undergoing hemodialysis.

Purpose
This scoping review aimed to identify the current state of the application of theories in research related to advance care planning and to analyze the types and characteristics of the theories applied. Methods: Using the scoping review methodology presented by Arksey & O'Malley, the articles published from 2010 to 2022 were searched by combining the terms "advance care planning," "theory," and "model" in five electronic databases; PubMed, CINAHL, EMBASE, KMBASE, and KISS. Results: Thirty-two studies were identified. Theory-based research has been actively conducted since 2019, with a total of 25 theories applied. Psychological theories were the most prevalent, accounting for 75.0% of the applications, followed by sociological theories (12.5%), public health theories (6.3%), and one nursing theory (3.1%). Theories were utilized to create a framework for data analysis, establish a philosophical underpinning, develop intervention frameworks, and derive new tools. Conclusion: Various theories have been applied to research on advance care planning, yet the application of nursing theory has been limited. To optimize end-of-life care and advance care planning from a nursing perspective, further research incorporating nursing theory is essential.

Citations

• Nurses’ high valuation of palliative care versus patient and family misconceptions: A mixed-approach study of Advanced Care Planning implementation in China
  Chenyan Liang, Suzhen Lv, Jia Song, Leiwen Tang, César Leal-Costa
  PLOS One.2025; 20(10): e0333739.     CrossRef

Purpose
This study was a scoping review aimed at evaluating Simulation-Based Education for recognizing and responding to deteriorating patients within Korean nursing school curricula, and at developing educational strategies for these competencies.
Methods
A literature search was conducted from April 1 to April 30, 2024. The review followed the scoping review framework by Arksey and O’Malley and the manual by the Joanna Briggs Institute. Relevant studies were identified through databases such as the Korean Medical Database, Korean Studies Information Service System, DataBase Periodical Information Academic, Research Information Sharing Service, ScienceOn, and the Cumulative Index to Nursing and Allied Health Literature.
Results
Eleven studies published from 2010 to 2019 were reviewed. The simulations typically included several lectures and practice sessions on advanced cardiopulmonary life support before the simulation exercises, which were then repeated. Cardiac arrest was frequently used as a scenario subject. The learning outcomes focused on the cognitive and psychomotor domains, as well as self-efficacy.
Conclusion
Although simulation for recognizing and responding to deteriorating patients was available in Korean nursing school curricula, it was infrequently incorporated as a regular part of the training. Future initiatives should include adding educational content to enhance nursing students' competencies in recognizing and responding to deteriorating patient simulations. Subsequent studies should assess the effectiveness of these educational methods.

Purpose
Lung cancer (LC) is the leading cause of cancer-related death globally, and understanding symptom clusters (SCs) among LC patients could improve symptom management. This scoping review provides a comprehensive summary of the most common SCs and their compositions identified in studies specifically investigating SCs of LC patients.
Methods
A scoping review was conducted following the Joanna Briggs Institute methodology. The study included LC patients as participants, SCs as the concept, and studies with distinct aim to investigate LC SCs as the context. We searched studies from inception to September 2022 in PubMed, Embase, PsycINFO, CINAHL, and the Cochrane Library databases using the terms: "lung cancer," "cancer survivors, " and "symptom cluster." Results: Of 41 reviewed reports, 188 SCs were identified. Both a priori and de novo method were used to identify LC SCs, with exploratory factor analysis being the most commonly used statistical method in the de novo approach. The three most frequent SCs were respiratory, gastrointestinal (GI), and psychological SCs. The most common respiratory SC included cough + dyspnea. Nausea + vomiting was the most prevalent cluster membership among GI SCs. Sad + feeling irritable + feeling nervous + worrying was the most common cluster membership among psychological SCs.
Conclusion
Respiratory, GI, and psychological SCs were common among LC patients, and addressing these clusters could improve symptom management strategies. Further research on SCs across the lung cancer trajectory is essential to enhance our understanding about SCs and facilitate effective symptom management throughout the disease course.

Purpose
This study aimed to comprehensively understand the experiences of emergency nurses performing triage during the peak and plateau periods of the Coronavirus Disease 2019 (COVID-19) pandemic over the past two years. Methods: Twenty triage nurses from three emergency medical centers were recruited through purposive and snowball sampling. Data collection occurred from February to May 2022 via focus group interviews and was analyzed using qualitative content analysis. Results: The experiences of emergency nurses in triage revealed four themes: "changes in priorities due to infectious diseases", "barriers to tirage", "the emotional burden experienced by triage nurses", and "the journey toward growth". The pandemic heightened the focus on infection screening in triage. Triage nurses faced numerous challenges concerning their own safety and that of their patients and encountered difficulties in performing triage. Nonetheless, these experiences provided them with opportunities for professional growth. Conclusion: The experiences of nurses performing triage during the peak and plateau periods of the COVID-19 pandemic provide valuable insights for future preparedness and coping strategies in the face of similar infectious disease outbreaks. It is necessary to establish integrated triage guidelines for patient safety, develop operations manuals for triage, implement policies on staffing standards, and provide mental health support for triage nurses during pandemics.

Purpose
This study aimed to examine the relationships among death anxiety, attitudes toward death, and burnout in nurses working in hemodialysis units. Methods: A cross-sectional, self-report questionnaire-based survey was conducted. Eighty-six nurses, each with more than one year of experience in hemodialysis units across six general hospitals, participated. Data were collected from July to December 2021. Statistical analyses included Pearson correlation coefficients and multivariate linear regression. Results: The mean death anxiety score was 2.71±0.73 out of 5. Among attitudes toward death, neutral acceptance was most prevalent, with a mean score of 5.48±1.07 out of 7. The average burnout score was 3.94±0.77 out of 7. Death anxiety showed a significant negative correlation with neutral acceptance of death (r=–.33, p=.002) and a significant positive correlation with fear of death attitudes (r=.65, p<.001). Multiple regression analysis identified marital status (being married) (β=–.35, p=.005) and the death attitude of escape acceptance (β=.37, p=.002) as significant predictors of burnout, together explaining 22.3% of the variance (F=2.43, p=.005). Conclusion: Attitudes toward death among hemodialysis nurses may be linked to burnout. Burnout management programs for nurses in hemodialysis units should provide opportunities for neutral discussions and emotional expression regarding death, and should address strategies to mitigate escape acceptance attitudes.

Purpose
The aim of this study was to identify the effects of stigma, social support, and resilience on post-traumatic growth in patients with stroke and to provide foundational data for developing nursing interventions that can effectively promote post-traumatic growth in this population.
Methods
This cross-sectional study employed a questionnaire-based survey. The participants were 150 patients who attended the neurology outpatient clinic three months after a stroke diagnosis. Data were collected between February and April 2024 using a structured self-report questionnaire. Analyses included descriptive statistics, reliability analysis, inferential statistics(independent t-test, one-way ANOVA, and Scheffé's test), and hierarchical multiple regression using SPSS/WIN 27.0.
Results
The mean post-traumatic growth score was 2.52±1.05 out of 5. Significant factors affecting post-traumatic growth were age, education, religion, the presence of a housemate, income, time since stroke onset, stroke type, and stroke recurrence. Post-traumatic growth was positively correlated with social support (r=.44, p<.001) and resilience (r=.53, p<.001), but not significantly correlated with stigma. Regression analysis identified resilience (β=.37, p<.001), religion (β=.29, p<.001), and stroke type (β=.23, p=.033) as significant predictors, explaining 44.2% of the variance in post-traumatic growth (F=9.45, p<.001).
Conclusion
Developing and implementing nursing interventions to increase resilience may be crucial for promoting post-traumatic growth in patients with stroke. Further research is needed to design and evaluate these interventions.

Purpose
The incidence of diabetes mellitus (DM) rises significantly in the post-middle-age population, and stress along with depressive symptoms hinders effective DM management. This study examined the mediating effect of social capital (trust in the physical environment, reciprocity, social participation, and social networks) on the relationship between perceived stress and depression among middle-aged adults with DM in Korea. It also aimed to provide data for developing targeted interventions to enhance blood glucose management in this population.
Methods
A descriptive correlational study using data from the 2019 Community Health Survey by the Korea Disease Control and Prevention Agency (KDCA) was conducted. Complex sample regression analysis and the Sobel test were employed for mediation analysis. The study included 9,394 middle-aged adults (aged 45-64 years) diagnosed with DM. The analysis assessed the effects of perceived stress on social capital and depression, as well as the mediating role of social capital.
Results
Perceived stress negatively impacted social capital (β=-0.16, p<.001) and positively influenced depression (β=0.37, p<.001). Both perceived stress and social capital significantly affected depression (F=998.83, p<.001), with social capital showing a partial mediating effect (z=2.65, p<.001).
Conclusion
Social capital partially mediated the relationship between stress and depression, suggesting its potential as a strategy for reducing stress and lowering depression among middle-aged adults with DM. These findings lay the groundwork for targeted interventions to improve blood glucose management in this population. Future research should explore the relationships among specific components of social capital, stress, and depression.

Purpose
This study evaluated the effectiveness of an intervention combining the abdominal draw-in maneuver (ADIM) and body mechanics for nurses with chronic low back pain (LBP).
Methods
A non-equivalent control group pretest-posttest design was used, with data collected from August 30 to December 29, 2023. Participants were nurses experiencing chronic LBP (≥3 months) from a university hospital. Participants were allocated by ward units, with the experimental group (n=30) enrolled first, followed by the control group (n=30). The experimental group received ADIM and body mechanics training, performed ADIM exercises three times weekly for 6 weeks, and received daily text reminders. Exercise adherence and body mechanics usage were monitored weekly. The control group received educational materials upon request after study completion. Outcomes included LBP intensity, LBP disability, lumbar flexibility, and body mechanics performance, analyzed using SPSS version 27.0 through descriptive statistics, the chi-squared test, the Fisher exact tests, the independent t-test, the Mann-Whitney U test, and analysis of covariance.
Results
Compared to the control group, the experimental group showed significant reductions in LBP intensity (Z=4.65, p<.001) and LBP disability (F=7.04, p=.010), as well as improvements in lumbar flexibility (t=6.15, p<.001) and body mechanics performance (t=6.91, p<.001).
Conclusion
The intervention effectively alleviated LBP, reduced disability due to LBP, and improved lumbar flexibility and body mechanics performance. Thus, integrating ADIM with body mechanics may represent a practical and beneficial approach for reducing pain and enhancing functional outcomes among nurses experiencing chronic LBP in clinical settings.

Purpose
Self-rated health in individuals with chronic diseases is influenced by various factors, including dietary adherence and physical activity. However, limited research has investigated how these factors relate to self-rated health among people with chronic kidney disease. Therefore, this study aimed to describe self-rated health and identify its associated factors in this population. Methods: This cross-sectional, secondary data analysis utilized datasets from the seventh Korea National Health and Nutrition Examination Survey, which were collected between 2016 and 2018. A total of 557 participants (mean age=74.8 years) with a glomerular filtration rate of <60 mL/min/1.73 m² were included. Data from health interviews and examinations were analyzed to assess self-rated health, dietary adherence, and physical activity. Descriptive and inferential statistical methods were employed for analysis. Results: Among the 557 participants, 42.6% rated their health as poor. Factors such as sex, age, income, smoking history, anxiety/depression, number of comorbidities, glomerular filtration rate, and physical activity were significantly associated with self-rated health. In contrast, dietary adherence did not exhibit a significant association. Conclusion: Understanding the factors associated with self-rated health can inform the development of nursing interventions aimed at improving self-rated health among patients with chronic kidney disease.

Purpose
This study was performed to identify factors associated with nursing performance, classify potential profiles of nursing performance-related variables, and explain their effects on nursing performance.
Methods
The study involved 245 nurses at a University Hospital in South Korea from September 1 to 14, 2021. The participants were nurses in a ward who operated within a team and had at least 6 months of clinical experience. Structured questionnaires were used to measure variables, and data were collected online using Google Forms. Using latent profile analysis, the participants were classified into four human resource and job attitude profiles. Linear regression was used to identify relevant factors, and one-way analysis of variance was employed to examine the differences in nursing performance between the four profiles.
Results
Shared leadership (β=.30, p<.001) was most strongly associated with nursing performance, followed by authentic leadership (β=.16, p=.009), and education level (β=.15, p=.006). Significant differences in nursing performance (F=22.48, p<.001) were observed across profiles, with the groups deemed "excellent" and "best" scoring higher in nursing performance and authentic leadership compared to the "fair" and "worst" groups. However, no significant difference in education level was found across the latent profiles (p=.212).
Conclusion
This research examined the impact on nursing performance through variable-centered analysis and a person-centered approach. Accordingly, this study provides valuable insights for interpreting the results of linear regression analysis, highlighting the need to consider individual heterogeneity.

Purpose
This study examined the effects of cognitive function, health literacy, and social support influence the risk of self-care non-adherence among older adults with chronic kidney disease. Methods: A cross-sectional survey was conducted using structured questionnaires. The study included 105 older adults (≥65 years) in the pre-dialysis stage, all of whom were receiving regular follow-up at a nephrology outpatient clinic in Jeonju, Jeollabuk-do, Korea. Data were collected through one-on-one interviews from April to May 2024 and analyzed using SPSS version 26.0. Predictive factors were assessed using hierarchical multiple regression analysis. Results: The risk of self-care non-adherence was significantly correlated with cognitive impairment (r=.61, p<.001), lower social support from healthcare providers (r=–.36, p<.001), and reduced health literacy (r=–.42, p<.001). Multiple regression analysis indicated that decreased physical activity (β=.25, p=.002), greater cognitive impairment (β=.29, p<.001), and lower support from healthcare providers (β=–.26, p=.008) were significant predictors of increased risk of self-care non-adherence. The model explained 46% of the variance in the risk of self-care non-adherence. In contrast, family support and health literacy were not significant predictors. Conclusion: To reduce the risk of self-care non-adherence in older adults with chronic kidney disease, routine cognitive screening and tailored education for those with cognitive impairment should be implemented in outpatient care. Promoting physical activity and strengthening support from healthcare providers are also key strategies to improve adherence in this population.

Purpose
This study aimed to assess the level of depression among older adults experiencing tinnitus and to identify predictive factors of depression through an analysis of secondary data.
Methods
Data from the ninth Korea National Health and Nutrition Examination Survey conducted in 2022 were utilized for this analysis. We examined individuals aged 60 years or older who had experienced tinnitus for more than 6 months. Complex sample analysis techniques were conducted, and multiple regression analysis was performed to identify predictors of depression.
Results
The study included 231 participants. Significant differences in depression levels were observed across several demographics and health factors, including gender, education level, self-rated health status, living alone, and stress level. Depression levels were significantly correlated with self-rated health status, stress levels, and average sleep duration. Additionally, significant correlations were found between self-rated health and stress levels, self-rated health and the number of chronic diseases, as well as between stress levels and the number of chronic diseases. Multiple regression analysis indicated that self-rated health status (p<.001), stress level (p<.001), and average sleep duration (p=.042) were significantly associated with depression. Specifically, poorer self-rated health, higher stress levels, and shorter sleep duration were associated with higher levels of depression.
Conclusion
In older patients with tinnitus, self-rated health status, stress level, and average sleep duration significantly impact depression levels. These findings provide an important foundation for developing interventions to reduce depression in individuals with tinnitus.

Purpose
This study involved a meta-synthesis of qualitative research concerning the experiences of women with infertility and infertility treatments. Based on an analysis of emotional changes and adaptation processes, it aimed to propose an interaction model encompassing expectation, loss, and resilience and clarify the conceptual meaning of each component.
Methods
Thomas and Harden’s five-step qualitative meta-synthesis methodology was employed. A total of 22 studies published between 2014 and 2024 were comprehensively analyzed and synthesized. The findings were integrated into a model representing the experiences of women undergoing infertility and infertility treatments.
Results
The meta-synthesis identified six key themes: changes in identity and inner growth; strengthening resilience through the roles of spouses, family, and peers; strategies for recovery and growth; support systems amidst economic and social burdens; life in the tension of waiting and hope; and the reconfiguration of couple and family relationships. Based on these themes, a dynamic interaction model, named the Model of Psychological Changes and Resilience (PCR Model), was developed to illustrate the interrelationships among expectation, loss, and resilience. The conceptual implications of these relationships were also explicated.
Conclusion
The cyclical interplay between expectation and loss among women experiencing infertility is intensified by social ideologies and cultural contexts, while resilience is strengthened through overcoming distress and finding meaning in life. Further quantitative research is necessary to validate these relationships in clinical settings by obtaining empirical data that apply this model.

Purpose
This study was conducted to develop a conceptual framework for understanding non-adherence to self-management among patients with Chronic Obstructive Pulmonary Disease (COPD). This was accomplished through a literature review, in-depth interviews with patients, and a survey of healthcare professionals featuring semi-structured open-ended questions.
Methods
First, a systematic literature review was conducted across five databases. Next, 25 patients with COPD participated in detailed interviews that included seven semi-structured questions. Subsequently, 15 healthcare professionals completed a survey about factor categories and specific factors associated with non-adherence to COPD self-management. Categories and factors identified at least once across these three methods were documented. Finally, two researchers conducted preliminary mapping of the relationships between factor categories and individual factors, which was assessed for face validity by a third researcher. All processes were conducted from March 28, 2022, and January 30, 2023.
Results
The research revealed eight factor categories and 53 individual factors associated with non-adherence to COPD self-management. The categories encompassed personal, socioeconomic, disease-related, functional, treatment- related, health system-related, and environmental characteristics. The literature review, patient interviews, and survey of healthcare professionals yielded 35, 19, and 44 factors, respectively. Twelve factors were identified using all three sources. All processes were conducted from March 28, 2022, and January 30, 2023.
Conclusion
In this study, quantitative and qualitative methods were employed to develop a conceptual framework for non-adherence to COPD self-management. The findings indicate that effective self-management of this condition requires not only patient effort but also adaptations to complex treatment regimens, societal perceptions, and workplace environments.

Citations

• Development of a deep learning model to predict smoking status in patients with chronic obstructive pulmonary disease: A secondary analysis of cross-sectional national survey
  Sudarshan Pant, Hyung Jeong Yang, Sehyun Cho, EuiJeong Ryu, Ja Yun Choi
  DIGITAL HEALTH.2025;[Epub]     CrossRef
• Enhancing deep learning models for predicting smoking Status using clinical data in patients with chronic obstructive pulmonary disease
  Sehyun Cho, Hyeonseok Jin, Kyungbaek Kim, Sola Cho, Ja Yun Choi
  DIGITAL HEALTH.2025;[Epub]     CrossRef
• Factors Associated with Non-Adherence to Self-Management Among Patients with Chronic Obstructive Pulmonary Disease: A Survey Using the Delphi Technique and Analytic Hierarchy Process
  Ja Yun Choi, Eui Jeong Ryu
  International Journal of Chronic Obstructive Pulmonary Disease.2024; Volume 19: 1247.     CrossRef

Purpose
During the coronavirus disease 2019 (COVID-19) pandemic, anxiety and need satisfaction may predict turnover intention among emergency room nurses, with need satisfaction negatively influencing turnover intention. This study aimed to examine the mediating effect of need satisfaction on the relationship between COVID-19–induced anxiety and job turnover intention among emergency room nurses during the pandemic.
Methods
This descriptive cross-sectional study recruited 206 emergency room nurses from 11 hospitals in South Korea. Data were collected using a questionnaire from December 2022 to February 2023.
Results
High COVID-19–induced anxiety was associated with increased turnover intention among nurses. Physiological needs partially mediated the relationship between COVID-19–induced anxiety and turnover intention. However, safety and belongingness needs showed no mediating effect.
Conclusion
During the COVID-19 pandemic, if physiological needs were not satisfied, reducing anxiety and turnover intention among emergency room nurses proved challenging, even when other needs were met. Therefore, physiological needs should be prioritized and addressed before focusing on other types of needs.

Purpose
The purpose of this study was to identify factors influencing the readmission of heart transplant recipients through survival analysis. Methods: We collected data from heart transplant recipients who were discharged after surgery between November 2005 and September 2020 from the electronic medical records of Y University Hospital in Seoul. The Kaplan-Meier estimation was utilized to calculate the survival rate, and Cox's proportional hazards model was employed to determine the factors influencing readmission within 1 year. Results: Out of 150 heart transplant recipients, 81 (54.0%) were readmitted within one year. The median time to readmission was 231 days. An increased duration of postoperative days was associated with a higher risk of readmission (p=.016). Groups with abnormal sodium levels (p<.001), those requiring postoperative hemodialysis (p=.013), patients with chronic kidney disease (p=.002), dyslipidemia (p=.040), or diabetes mellitus (p=.045) also faced higher readmission risks. In the final model, sodium levels (hazard ratio [HR]=2.31, p<.001) and chronic kidney disease (HR=1.67, p=.045) were significant risk factors for readmission (x² =31.90, p<.001). Conclusion: Interventions to improve kidney function and a multidisciplinary approach are needed to reduce readmission of heart transplant recipients.

Purpose
The aim of this study was to better understand the concept of patient activation in patients with cancer by identifying its dimensions and attributes and clarifying its definition through concept analysis. Methods: This concept analysis study used the method of Walker and Avant (2019), and systematically reviewed dictionary entries and 30 studies in various academic fields. Results: The concept of patient activation in patients with cancer was found to have four attributes: seeking health information, participating in treatment decision-making, confidence in health care, self-management behaviors. The antecedents identified were cancer history, fear of recurrence, information and resources provided by healthcare professionals, access to healthcare providers, negative perceptions of cancer, social support, and sociodemographic status. The consequences were appropriate treatment implementation, satisfaction with treatment, improved physical and mental health conditions, improved quality of life, reduced healthcare costs, and reduced stress. Conclusion: The development of patient activation measurements tailored to the characteristics of the disease and the goal of strengthening the role of patients, as well as the development and implementation of policies, programs, and guidelines to promote patient activation, will improve the medical experience and outcomes of cancer patients and adopt a more person-centered treatment approach.

Purpose
This study aimed to investigate the mediating role of patient safety perception (PSP) in the relationship between the right to know (RtK) and patient participation (PP) among inpatients.
Methods
This descriptive study used a convenience sample of inpatients from three small and medium-sized hospitals in October 2023. A total of 231 inpatients completed a self-report questionnaire assessing PP, RtK, and PSP. Data were analyzed using a mediation model with the PROCESS Macro (Model 4), applying 95% bias-corrected bootstrap confidence intervals.
Results
The findings revealed significant positive correlations between PP and RtK (r=.78, p<.001) and PSP (r=.83, p<.001). Both RtK and PSP had significant effects on PP. PSP was identified as an important mediator in the relationship between RtK and PP (B=.35, boot standard error=.06, 95% confidence interval=.27–.44). The findings confirm that inpatients’ RtK is associated with improved PSP and increased PP.
Conclusion
These findings highlight the critical role of safeguarding patients’ right to information as a strategy for promoting patient safety. To ensure safe and effective care in small and medium-sized hospitals, ongoing support is essential for developing and systematically implementing patient safety education initiatives that actively involve patients.

Purpose
This study aimed to investigate the impact of physical performance and fear of falling on fall risk in patients with End-Stage Renal Disease (ESRD) undergoing hemodialysis. Methods: This study included 132 patients who regularly received hemodialysis treatment at outpatient clinics in B City from January to April 2022. Data were collected on demographic and clinical characteristics, physical performance (the Short Physical Performance Battery [SPPB]), fear of falling (the Korean Falls Efficacy Scale-International [KFES-I]), and fall risk (the Morse Fall Scale [MFS]). The collected data were analyzed using hierarchical multiple regression in the SPSS/WIN 25.0 program. Results: Thirty-eight patients (28.8%) had experienced accidental falls in the past year, with an average of 1.68 falls per patient. The average SPPB score was 7.89±3.55 (range, 0 to 12), the KFES-I score was 23.18±9.36 (range, 16 to 64), and the MFS score was 45.68±19.52 (range, 0 to 125). Fall risk showed a significant negative correlation with physical function (r=-.72, p<.001) and a significant positive correlation with fear of falling (r=.65, p<.001). Factors affecting the patients' fall risk included the level of serum intact parathyroid hormone (β=.15, p=.004), fear of falling (β=.24, p=.010), number of falls (β=.34, p<.001), and physical performance (β=-.41, p<.001). The regression model was statistically significant (F=22.71, p<.001), with an explanatory power of 64.9%. Conclusion: To prevent accidental falls in ESRD patients undergoing hemodialysis treatment, it is necessary to develop and apply interventions that can enhance physical performance and reduce the fear of falling.

Citations

• Fear of Falling among Elderly Individuals with Various Medical Conditions
  T.K. Konovalchik
  Clinical Psychology and Special Education.2025; 13(4): 76.     CrossRef
• Latent profiles of falls self-awareness and associated factors in older maintenance hemodialysis patients
  Jun Xu, Suping Guo, Xintao Yu, Xiaojing Ji
  Scientific Reports.2025;[Epub]     CrossRef

Purpose
This study examined the relationships of health literacy, physical activity, and grip strength with self-care compliance in older male patients with chronic heart failure.
Methods
A cross-sectional descriptive was conducted, and 106 older male outpatients with chronic HF were recruited from a veterans’ hospital in Seoul. Data were collected from February 7, 2022 to April 10, 2022 using a self-reported questionnaire and were analyzed using SPSS/WIN 23.0.
Results
The average age of the participants was 76.3±4.5 years, and the average time elapsed since the heart failure diagnosis was 3.22±2.01 years. The mean self-care compliance score was 42.21±6.03 out of 60 points. In the univariate analysis, grip strength was not significantly correlated with self-care compliance. The hierarchical regression analysis indicated that health literacy (β=.33, p<.001), physical activity (β=.32, p=.001), and alcohol drinking (β=-.28, p=.001) had statistically significant effects on self-care compliance, collectively explaining 34% of the variance (adjusted R² =.34, F=12.00, p<.001).
Conclusion
The study highlights the necessity of periodically assessing and considering health literacy and the level of physical activity when developing educational strategies to promote self-care compliance among older male patients with heart failure in outpatient nursing practice.

Purpose
The purpose of this study was to develop and validate a tool to evaluate slow nursing performance for older adults in long-term care hospitals.
Methods
The search period was set from March 2013, when the term "slow nursing" was first used in the literature, to October 2021. A slow nursing tool was developed in two phases: development and verification. In the tool development phase, 29 items were developed through an extensive literature review and in-depth interviews with seven long-term care hospital nurses. Construct validity testing was performed by a 10-member expert panel, and a pilot survey was conducted on long-term care hospital nurses. In the tool validation phase, the construct validity, criterion validity, and reliability of the tool were tested by applying it to 181 nurses in long-term care hospitals .
Results
The final tool comprised five factors and 23 items, with an overall explanatory power of 56.8%. Construct validity was examined using confirmatory factor analysis, and the model fit was good. Known-group validity was established by the observation of a significant difference in the slow nursing score between intensive care unit and long-term care hospital nurses, and criterion validity was established by a significant correlation between the slow nursing and person-centered assessment scores. Internal consistency reliability was shown by a Cronbach's ⍺ coefficient of .781.
Conclusion
The concept of slow nursing has been clarified, improving the understanding and implementation of slow nursing care by nurses in long-term care hospitals. The Slow Nursing Tool for Long-term Care Hospital Nurses (SNT-LCHN) is expected to increase interest in and contribute to the effectiveness of slow nursing practices. It will serve as a valuable tool for improving nursing performance in these settings.

Purpose
The incidence of gynecological cancers is increasing, presenting significant challenges for patient care and outcomes. Perceived stress and negative affect can impede self-care behaviors and reduce health-related quality of life (HRQoL). This study examined the mediating effects of negative affect and cancer coping on the relationship between perceived hospital stress and HRQoL among patients with gynecological cancer. Methods: A cross-sectional mediation analysis was conducted with 118 gynecological cancer patients recruited from the outpatient clinic of a university hospital (October 2023 to February 2024). Participants completed validated instruments assessing perceived stress, negative affect, cancer coping, and HRQoL. Data were analyzed using Spearman’s correlations and the PROCESS macro (Model 4) with 95% bootstrap confidence intervals (CIs). Results: Perceived stress was significantly correlated with negative affect (r=.58, p<.001), cancer coping (r=.23, p=.012), and HRQoL (r=–.45, p<.001). Negative affect was correlated with HRQoL (r=–.59, p<.001). Furthermore, negative affect and cancer coping mediated the relationship between stress and HRQoL (B=–0.18, 95% CI=–0.27 to –0.11 and B=0.04, 95% CI=0.01 to 0.08, respectively). Conclusion: Negative affect and cancer coping significantly mediated the relationship between hospital stress and HRQoL. Targeted interventions aiming to reduce stress and strengthen emotional and coping strategies could enhance HRQoL among gynecological cancer patients.

Purpose
This scoping review aimed to explore the characteristics and educational effects of game-based virtual reality (VR) programs used in nursing education, providing foundational insights for future instructional design and research. Methods: Following the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, a comprehensive literature search was conducted across eight databases for studies published between April 2014 and March 2025. Studies were screened and selected using the population, concept, context framework. Twenty-four studies met the inclusion criteria and were analyzed. Results: Most of the 24 included studies targeted nursing students, with some involving practicing nurses. Interventions primarily employed immersive VR head-mounted displays and incorporated diverse game elements such as mission-based scenarios, challenges, feedback loops, and virtual patient interactions. Educational effects were categorized into cognitive, affective, and psychomotor domains. Improvements in knowledge acquisition, self-efficacy, learning motivation, and skill performance were consistently reported. Additionally, most studies reported enhanced learner satisfaction, engagement, and emotional immersion. However, limited evidence was found regarding teamwork and communication skills. Conclusion: Game-based VR programs show substantial potential as effective instructional strategies in nursing education. Their design features—including immediate feedback, repeatable immersive scenarios, and engaging game mechanics—support learner-centered and self-directed learning. Nevertheless, the current evidence base largely focuses on nursing students and short-term outcomes. Future studies should encompass diverse nursing populations and assess long-term effects and real-world applicability, particularly in team-based and clinical practice contexts.

Purpose
The subjective experiences of middle-aged individuals during the coronavirus disease 2019 (COVID-19) pandemic play a pivotal role in fostering resilience for reintegration into normal life post-pandemic and preparing for potential future infectious disease outbreaks. This study aimed to explore the experiences of middle-aged individuals during the COVID-19 pandemic using the Q methodology.
Methods
Forty-six middle-aged individuals from 10 cities in South Korea participated in this study. The participants arranged and ranked 39 Q statements describing their experiences with the COVID-19 pandemic using a Q-sort table. Subsequently, the data were analyzed using the PQ method.
Results
Three distinct viewpoints were identified: concerns regarding government policies related to COVID-19 (political perspective: consistent government policies are of utmost importance); concerns about personal loss related to COVID-19 (personal perspective: daily life is of the utmost importance); and concerns about social losses related to COVID-19 (social perspective: societal interests take precedence over individual needs).
Conclusion
The nursing interventions recommended for these three factors serve as a strategic blueprint for effectively addressing future outbreaks of infectious diseases. These nursing intervention strategies can significantly enhance positive perceptions of the three identified elements of the COVID-19 experience, providing an opportunity to transform negative outlooks into positive ones.

Purpose
This study developed a self-management program for patients undergoing lumbar spinal stenosis surgery utilizing the information-motivation-behavioral skills (IMB) model. Methods: This study employed a quasi-experimental design with a nonequivalent control group and pretest–posttest design. Data were collected from August 11, 2022, to March 31, 2023, at a general hospital in South Korea. A total of 58 patients participated in the study (30 experimental, 28 control group). The experimental group received a six-session self-management program based on the IBM model, whereas the control group received usual education and information. Data were analyzed with SPSS/WIN 23.0 using the independent t-test, chi-square test, Fisher’s exact test, Shapiro-Wilk test, and Mann-Whitney U test. Results: Significant differences were observed in self-management information (p<.001), personal motivation (p=.002), social motivation (p=.002), behavioral skills (p=.002), behaviors (p=.003), health-related quality of life (p<.001), and disc height (p=.006) in the experimental group following program implementation, compared to the control group. However, no significant differences were found in lower extremity muscular strength, lumbar lordotic angle, or the visual analog scores for low back pain and leg pain between the two groups. Conclusion: The self-management program developed in this study, based on the IMB model, was effective in improving self-management information, motivation, behavioral skills, behaviors, health-related quality of life, and self-management health outcomes in patients undergoing lumbar spinal stenosis surgery. Nevertheless, future research should aim to verify the long-term effects of such self-management programs by extending the intervention period.

Purpose
This study explored tools to measure service experiences for families of older adults living in long-term care facilities, with the goal of suggesting directions for developing service experience measurement indicators for these families in the Korean context.
Methods
In this scoping review, English-language literature on the service experiences of families of older adults in long-term care facilities published in academic journals from January 1990 to December 2021 was reviewed. The CINAHL, Embase, and PubMed databases were searched. The review process involved identifying the research question; searching for relevant published studies; selecting studies; mapping the data; and collating, summarizing, and reporting the results. This method helped identify knowledge gaps, explore, and define key concepts, and obtain an overview of extant studies’ focus by determining the literature scope. Among 118 articles, seven were finally selected according to predetermined criteria.
Results
Through an analysis of the sub-factors of the tools used in the seven selected articles, the following themes were derived: environment, information and family member involvement, tailored care, respect, and responsive workforce. Concept definitions were clarified and examined.
Conclusion
Measuring the service experiences of families serving as surrogates for older adults who are in long-term care facilities and cannot express their opinions is essential for improving service quality. Developing a measurement tool for experiences of facility service experience that accurately reflects the perspectives of family members of older adults in these facilities in the Korean context is a pressing need given South Korea’s rapidly aging population.

Purpose
The aim of this study was to identify the coping profiles of patients with coronary artery disease and to examine their associations with cardiac health behavior.
Methods
In this cross-sectional study, data from 203 patients undergoing percutaneous coronary intervention for coronary artery disease were analyzed. Data collection occurred between September 2020 and June 2021, utilizing self-report questionnaires and electronic medical records at a cardiology outpatient clinic. Descriptive statistics, latent profile analysis, and logistic regression were employed for data analysis.
Results
The Type I coping profile was characterized by the greater use of most coping strategies, particularly problem-focused approaches, relative to the other profiles. The Type II coping profile exhibited below-average use of all coping strategies, except for substance use. The Type III coping profile displayed higher tendencies toward venting, self-blame, denial, behavioral disengagement, and substance use compared to the other profiles. Patients with the Type I coping profile displayed greater engagement in cardiac health behavior than those with Type II and Type III, as indicated by odds ratios of 2.57 (95% confidence interval=1.31~5.07) and 7.19 (95% confidence interval=2.10~24.56), respectively.
Conclusion
Participation in cardiac health behavior varies according to the coping profiles of patients with coronary artery disease. Healthcare providers should recognize and support appropriate coping strategies in these patients to promote healthy behaviors. A longitudinal study investigating how changes in coping profiles relate to cardiac health behavior could assist patients with coronary artery disease in maintaining such behaviors.

Purpose
This study describes the attitudes toward Personal Protective Equipment (PPE), physical discomfort with wearing PPE, obsession with Coronavirus Disease 2019 (COVID-19), and perceived psychosocial stress among operating room nurses during the COVID-19 pandemic and identifies factors affecting perceived psychosocial stress.
Methods
This study used a descriptive, cross-sectional design to evaluate physical discomfort experienced when wearing PPE, attitudes toward PPE, and obsession with COVID-19. We collected the data between December 2020 and January 2021. The participants were 127 nurses who worked in operating rooms at three hospitals in South Korea. Perceived psychosocial stress was assessed using the Psychosocial Well-being Index Short Form. Data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple linear regression.
Results
Having a bachelor's degree (β=.28, p=.031), attitude toward PPE (β=-.22, p=.011), experiencing shortness of breath while wearing PPE (β=.26, p=.008), and obsession with COVID-19 (β=.23, p=.006) were identified as factors affecting the psychosocial stress of nurses who wore PPE and participated in surgery.
Conclusion
Nurses who had a negative attitude toward PPE, experienced shortness of breath while wearing it, and had a high level of obsession with COVID-19 had higher psychosocial stress. To reduce the psychosocial stress of nurses who wear PPE and participate in surgery, we suggest research on education that can reduce repetitive thinking about infectious diseases, such as obsession with COVID-19. Additionally, support is needed to improve positive attitudes toward PPE and alleviate physical discomfort.

Purpose
The purpose of this study was to examine the experiences of nurse managers in clinical nursing education during an emerging infectious disease outbreak. Methods: Individual semi-structured interviews were conducted with 12 nurse managers from seven general or tertiary hospitals, each with 300 or more beds, in South Korea. Data were collected between February 17 and June 10, 2023, and analyzed using qualitative content analysis. Results: Four themes and 11 subthemes were identified. Nurse managers faced significant challenges in departmental management during the infectious disease outbreak, encountered a wide range of student attitudes toward learning, adapted their teaching methods flexibly in response to changing infectious disease conditions, and ultimately found meaning in the irreplaceable value of clinical practice education. Conclusion: During the emerging infectious disease outbreak, nurse managers not only encountered substantial difficulties but also experienced professional growth as clinical nursing educators. To enhance clinical nursing education in such challenging environments, it is essential to minimize uncertainty caused by infectious diseases and foster positive perceptions among nursing students regarding clinical practice education under restrictive circumstances. Institutional support is also necessary to reduce the work burden on nurse managers.

Purpose
This study aimed to identify sex-specific predictors of microalbuminuria in patients with type 2 diabetes mellitus. Recognizing sex-based differences in risk factors may facilitate the early detection and prevention of diabetic kidney disease. Methods: A cross-sectional analysis was performed using data from the Korea National Health and Nutrition Examination Survey. Microalbuminuria was defined as a urinary albumin-to-creatinine ratio ≥30 mg/g. Multivariable complex sample logistic regression analyses were conducted separately for male and female. Independent variables included age, duration of diabetes, glycated hemoglobin (HbA1c), fasting blood sugar (FBS), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), TG, HDL-C, waist circumference, and systolic blood pressure (SBP). Results: The prevalence of microalbuminuria was higher in male than in female. In both sexes, longer diabetes duration and elevated SBP were associated with microalbuminuria. Among male, FBS, TG/HDL-C ratio, TG, and low HDL-C were significant predictors. In female, HbA1c showed the strongest association, followed by age and diabetes duration. Conclusion: Sex-specific differences were identified in the predictors of microalbuminuria among patients with type 2 diabetes. Incorporating these differences into early screening and individualized care strategies may help improve the prevention of diabetic kidney complications.