Journal of Korean Academy of Nursing

Volume 52(2); April 2022

Research Papers

Effect of Virtual Reality Program for Alleviating Behavioral and Psychological Symptoms of Dementia Patients: Park, Seon-Min , Choi, Seung-Yi , Kim, Jung-Hee; J Korean Acad Nurs 2022;52(2):121-133. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.22008

Purpose
This study examined the impact of a virtual reality intervention program based on psychological needs on behavioral and psychological symptoms, apathy, and quality of life (QOL) in patients with dementia or mild cognitive impairment living in nursing facilities.
Methods
This study is nonequivalent control group pretest-posttest design of quasi-experimental study. The study collected data from November 18, 2020 to July 24, 2021 from patients with dementia or mild cognitive impairment (30 in the experimental group and 30 in the control group) at three nursing facilities in G city using self-reporting and caregiver-informant reporting methods. The analysis employed the chi-square test, Fisher’s exact test, paired t-test, independent t-test, Wilcoxon signed rank test, Mann–Whitney U, repeated measures ANOVA, GEE, using SPSS/WIN 27.0.
Results
The severity of behavioral and psychological symptoms (Wald χ2 = 2.68, p = .102) and the care burden of caregivers (Wald χ2 = 1.72, p = .190) were not significant and was no significant time and group interaction effect (Wald χ2 = 0.63, p = .426, Wald χ2 = 0.52, p =. 471). The difference in apathy and QOL score were statistically significant for the group-time interaction (F = 43.65, p < .001; F = 4.35, p= .041).
Conclusion
The virtual reality intervention program of this study shows a positive effect on the apathy reduction and QOL of patients with dementia or mild cognitive impairment residing in nursing facilities.

Citations

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The effectiveness of nursing interventions for elderly dementia patients based on virtual reality technology: A systematic review and meta-analysis
Jun Wen, Hong Yan, Siyu Wang, Jialan Xu, Zitong Zhou
Ageing Research Reviews.2024; 93: 102135. CrossRef
Development of the “living well” concept for older people with dementia
Jiyoung Kim, Nayeon Shin
BMC Geriatrics.2023;[Epub] CrossRef

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Delirium Experience of the Intensive Care Unit Patients: Jung, Jaeyeon , Jang, Sujin , Jo, Seonmi , Lee, Sunhee; J Korean Acad Nurs 2022;52(2):134-143. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21240

Abstract PDF

Purpose
The study aimed to understand the delirium experience of intensive care unit (ICU) patients.
Methods
We performed a qualitative study using Colaizzi’s phenomenological method. Eleven patients, who experienced delirium according to the Confusion Assessment Method for ICU, participated after transferring to general wards from the ICU. Individual in-depth semi-structured interviews ranging from 30 minutes to 2 hours in length were conducted between November 2018 and August 2019.
Results
Nine themes and four theme clusters emerged. The four theme clusters were: 1) “Overwhelmed by fear,” which describes the experience of a patient close to death and the feeling of difficulty in understanding disorganized thinking; 2) “Anxious about not understanding the situation,” which means that patients’ sense of time and space were disordered in the ICU; 3) “Being deserted,” which indicates the feeling of being separated from others and yourself; and 4) “Resistance to protect my dignity,” which indicates that the dignity and autonomy of an individual in the patient’s position at the ICU, are ignored.
Conclusion
Nursing interventions are needed that would enable patients to maintain orientation and self-esteem in the ICU. In addition, healthcare providers need to provide information about the unfamiliar environment in the ICU in advance.

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Patients' and family members' dyadic experience of post‐operative delirium in the intensive care unit: A qualitative study
Dong Jing, Sui Weijing, Zhuang Yiyu
Nursing in Critical Care.2025;[Epub] CrossRef
Factors Influencing Intensive Care Unit Nurses’ Competency in Delirium Care in A Tertiary General Hospital
Mi Ran Lim, Gyoo Yeong Cho
Journal of Korean Critical Care Nursing.2024; 17(3): 37. CrossRef
Exploring patients’ and families’ preferences for auditory stimulation in ICU delirium prevention: A qualitative study
Yajun Ma, Nianqi Cui, Zhiting Guo, Yuping Zhang, Jingfen Jin
Intensive and Critical Care Nursing.2024; 82: 103629. CrossRef
The Influence of Ethical Nursing Competence and Positive Nursing Organizational Culture on Person-Centered Care in Intensive Care Unit Nurses: A Cross-Sectional Survey
Jae Eun Lee, Hye-Young Jang
Journal of Korean Academy of Fundamentals of Nursing.2024; 31(3): 304. CrossRef
A Study on Nurses' Communication Experiences with Intubation Patients
Ye Rim Kim, Hye Ree Park, Mee Kyung Shin
The Korean Journal of Rehabilitation Nursing.2023; 26(1): 28. CrossRef
Intensive Care Experience of Critical Care Patients and Its Related Factors : A Secondary Analysis Study
Jiyeon Kang, Hyojeong Woo
Journal of Korean Critical Care Nursing.2023; 16(3): 11. CrossRef
Item analysis of the Korean version of the Intensive Care Experience Questionnaire: Using the Rasch Model based on Item Response Theory
Jiyeon Kang, Minhui Kim
Journal of Korean Critical Care Nursing.2022; 15(3): 37. CrossRef

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Influence of Social Capital on Depression of Older Adults Living in Rural Area: A Cross-Sectional Study Using the 2019 Korea Community Health Survey: Jung, Minho , Kim, Jinhyun; J Korean Acad Nurs 2022;52(2):144-156. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21239

Abstract PDF

Purpose
This study aimed to investigate the influence of social capital on the depression of older adults living in rural areas.
Methods
Data sets were obtained from the 2019 Korea Community Health Survey. The participants were 39,390 older adults over 65 years old living in rural areas. Indicators of social capital included trust, reciprocity, network, and social participation. Depression—the dependent variable—was measured using the Patient Health Questionnaire-9 (PHQ-9). Hierarchical ordinal logistic regression was conducted to identify factors associated with depression after adjusting the data numbers to 102,601 by applying the Synthetic Minority Oversampling Technique (SMOTE).
Results
The independent variables—indicators of social capital—exhibited significant association with the depression of older adults. The odds ratios of depression were higher in groups without social capital variables.
Conclusion
To reduce depression, we recommend increasing social capital. Factors identified in this study need to be considered in older adult depression intervention programs and policies.

Citations

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The Effects of Perceived Stress on Depression among Middle-aged Adults with Diabetes Mellitus in Korea: Exploring the Mediating Role of Social Capital through a Descriptive Correlational Study
Kyung Ae Kim, Mi Ran Bang
Korean Journal of Adult Nursing.2025; 37(1): 50. CrossRef
An Observational Study on the Association Between Nutritional Intake and Mental Health Among Older Adults in Rural Areas
Kyeongmin Jang
Nursing & Health Sciences.2025;[Epub] CrossRef
Prediction model of weight control experience in men with obesity in their 30 s and 40 s using decision tree analysis
Myeunghee Han
Scientific Reports.2024;[Epub] CrossRef
The relationship between human capital and depression among middle-aged rural adults: The multiple-parallel mediating effects of social capital
Soo Mi Jang, Hyung Mi Ha
Korean Journal of Health Education and Promotion.2023; 40(1): 33. CrossRef

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A Prediction Model of Exercise Level in Patients with Ankylosing Spondylitis: Kim, Moon Ja , Lee, Eun Nam; J Korean Acad Nurs 2022;52(2):157-172. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21238

Abstract PDF

Purpose
This study aimed to construct and test a hypothetical model to explain the predictive factors and causal pathways for exercise levels in patients with ankylosing spondylitis based on the self-determination theory. A conceptual framework was constructed assuming that autonomy support by health care providers would satisfy the three basic psychological needs of patients, which would increase their autonomous motivation for exercise, resulting in its initiation and continuation.
Methods
This cross-sectional study included 221 patients with ankylosing spondylitis who were visiting rheumatology clinics in two tertiary hospitals. Health Care Climate Questionnaire-exercise regularly, Basic Psychological Needs Satisfaction scale, Behavior Regulation in Exercise Questionnaire-2, and exercise level were used to collect data.
Results
The fitness of the hypothetical model met the recommended level (χ2/df ≤ 3, SRMR ≤ .08, RMSEA ≤ .08, GFI ≥ .90, AGFI ≥ .85, NFI ≥ .90, TLI ≥ .90, CFI ≥ .90). The model effect analysis revealed that autonomy support by health care providers had a positive effect on patients' autonomy, competence, relatedness, autonomous motivation, and exercise level. Competence and relatedness had positive effects on autonomous motivation and exercise level, respectively. Autonomous motivation had a positive effect on exercise level.
Conclusion
The predictive factors of exercise level in patients with ankylosing spondylitis were autonomous motivation, health care providers' autonomy support, competence, and relatedness. Considering these factors, we recommend the development of an effective program for improving exercise levels in these patients.

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A Structural Equation Model for Low Back Pain Management Behavior in Patients With Spinal Disease
Raewan Kim, Aekyung Kim
Pain Management Nursing.2025; 26(1): e107. CrossRef
Exercise and adults with hemophilia: a systematic review and meta-analysis
Doo Young Kim, Mi Yang Jeon, Young Eun, Da In Jeong
Journal of Korean Biological Nursing Science.2024; 26(1): 1. CrossRef

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Validity and Reliability of the Korean Version of the Climate, Health, and Nursing Tool: Jeong, Da Woon , Kim, Gwang Suk , Park, Min Kyung; J Korean Acad Nurs 2022;52(2):173-186. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21211

Abstract PDF

Purpose
Climate change has various negative effects on human health, which has resulted in increased burden on the health care system. Nurses contribute significantly to assessing climate-related health risks and creating a healthy environment. This study aimed to evaluate the reliability and validity of the Korean version of the Climate, Health, and Nursing Tool (K-CHANT) to measure nurses’ awareness, motivation, concern, and behaviors at work and at home regarding climate change and health.
Methods
The 22 items of English CHANT were translated into Korean with forward-backward translation techniques. Internal consistency reliability, test-retest reliability, and construct validity using confirmatory factor analysis were performed using SPSS WIN (25.0) and AMOS (26.0). Survey data were collected from 220 master’s, doctoral, and post-doctoral nursing students.
Results
The K-CHANT consists of 20 items across 5 domains.Two items of the original CHANT were excluded because of low content validity index and standardized regression weights. The internal consistency reliability of the K-CHANT, assessed by Cronbach’s αá was .81, with an intraclass correlation coefficient of .66~.90. The five subscales model was validated by confirmatory factor analysis (SRMR < .08, RMSEA < .08, AGFI > .70, CFI > .70).
Conclusion
The K-CHANT has satisfactory construct validity and reliability to measure nurses’ awareness, motivation, concern, and behaviors at work and at home regarding climate change and health. Future research should examine nurses’ perceptions and behaviors related to the health effects of climate change and develop an action plan to improve it.

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Climate change perceptions and behaviors among Korean nurses: The role of organizational initiatives
Dukhyun Back, Kihye Han, Jieun Kim, Hyang Baek
Nursing Outlook.2025; 73(3): 102383. CrossRef
Measuring Nurses’ Knowledge and Awareness of Climate Change and Climate-Associated Diseases: Systematic Review of Existing Instruments
Omar Portela Dos Santos, Élodie Perruchoud, Filipa Pereira, Paulo Alves, Henk Verloo
Nursing Reports.2024; 14(4): 2850. CrossRef
Validation of the Sustainability Attitudes in Nursing Survey-2 for nurses: A cross-sectional study
Sophia J. Chung, Sun Joo Jang, Haeyoung Lee
Nurse Education in Practice.2024; 75: 103898. CrossRef
Factors affecting environmental sustainability attitudes among nurses – Focusing on climate change cognition and behaviours: A cross‐sectional study
Sophia J. Chung, Haeyoung Lee, Sun Joo Jang
Journal of Advanced Nursing.2024;[Epub] CrossRef
Nurses' Perceptions and Behaviours Regarding Climate Change and Health: A Quantile Regression Analysis
Min Kyung Park, Seoyoung Baek, Da Woon Jeong, Gwang Suk Kim
Journal of Advanced Nursing.2024;[Epub] CrossRef
Exploring influences of environmental information, beliefs and self‐efficacy on nurses' climate health behaviours and their relationships
Jeongmin Yi, Yeojin Yi
Journal of Advanced Nursing.2024;[Epub] CrossRef
Factors related to perceptions of climate health impact and climate action: Focusing on the Health Belief Model
Hansol Lee, Jaehee Kim, Yuri Lee
Korean Journal of Health Education and Promotion.2024; 41(2): 31. CrossRef
Climate Change and Nursing
Yoomi Jung
Journal of Korean Academy of Nursing.2024; 54(4): 475. CrossRef
Development and Validation of a Dignity in Care Scale of Terminally Ill Patients for Nurses
Yun Sil Ahn, Pok Ja Oh
Journal of Korean Academy of Nursing.2023; 53(3): 340. CrossRef
Climate, Health, and Nursing Tool (CHANT): A confirmatory factor analysis
Anna Winquist, Elizabeth C. Schenk, Cara Cook, Shanda Demorest, Ekaterina Burduli
Public Health Nursing.2023; 40(2): 306. CrossRef
Factors Influencing Nursing Graduate Students’ Perception and Behavior Related to Climate Change and Health: A Secondary Data Analysis
Min Kyung Park, Seoyoung Baek, Da Woon Jeong, Gwang Suk Kim
Korean Journal of Adult Nursing.2023; 35(1): 71. CrossRef

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Experience of Peer Support Work among People with Mental Illness in the Community: A Grounded Theory Approach: Hyun, Myung Sun , Kim, Hyunlye , Nam, Kyoung A , Kim, Su Young; J Korean Acad Nurs 2022;52(2):187-201. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21208

Abstract PDF

Purpose
This study discovered a substantive theory of the experience and process of peer support work among people with mental illness.
Methods
The participants were members of community-based mental health facilities and had been working as peer supporters for more than six months. The data were collected through in-depth interviews with twelve participants and analyzed using Corbin and Strauss’s grounded theory approach.
Results
The core category was “becoming a healer going with patients in the journey of recovery,” and the core phenomenon was “identity confusion as a peer supporter.” The causal conditions were “starting peer support work without certainty” and “standing at the boundary between the therapist and patient.” The intervening conditions were “willingness to become a successful peer supporter,” “feeling a sense of homogeneity with the patient,” “accepting the mental illness,” and “support from people around.” The action and interaction strategies were “letting go of greed,” “being open about oneself,” “developing professional skills,” “maintaining wellness in the body and mind,” and “being with the patient.” The consequences were “becoming a useful person,” “changing attitude toward life,” “expansion of the sense of self-existence,” “recovering from mental illness,” and “discovering a role as peer supporter.” Finally, the substantive theory of “becoming a healer going with patients in the journey of recovery” was derived.
Conclusion
This study provides a holistic understanding of peer support work and the implications of interventions to help people with mental illness in a person-centered recovery process.

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A model for the involvement of service users as instructors into the psychiatric nursing curriculum in Korea: A qualitative study on participation experience
Suyoun Ahn, Soyoung Shin, Jaewon Joung
International Journal of Mental Health Nursing.2024; 33(4): 917. CrossRef
Experience of Mental Health Professionals Collaborating with Peer Supporters in a Community Mental Health Service Team
Sowon Lee, Boyoung Kim, Chung Kil Park
International Journal of Mental Health Promotion.2024; 26(4): 251. CrossRef
Experience of Peer Supporters for Patients with Schizophrenia
Hae Kyung Jo, Se Na Ryu
Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(3): 280. CrossRef

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Interorganizational Networks for Smoking Prevention and Cessation: A Blockmodeling Approach: Park, Eun-Jun , Kim, Hyeongsu , Lee, Kun Sei , Cho, Junghee , Kim, Jin Hyeong , Jeong, Ho Jin , Lee, Ji An; J Korean Acad Nurs 2022;52(2):202-213. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21192

Abstract PDF: Purpose
This study examined characteristics and patterns of interorganizational networks for smoking prevention and cessation in Korea.
Methods
We surveyed two community health centers, ninety-five hospitals or clinics, ninety- two pharmacies, and sixty-five health welfare organizations in two districts of Seoul in 2020. Data on the organizations’ characteristics of smoking cessation and interorganizational activities for information sharing, client referral, and program collaboration were collected and analyzed using network statistics and blockmodeling.
Results
Network size was in the order of information sharing, client referral, and program collaboration networks. Network patterns for interorganizational activities on information sharing, client referral, and program collaboration among four organizations were similar between the two districts. Community health centers provided information and received clients from a majority of the organizations. Their interactions were not unidirectional but mutual with other organizations. Pharmacies were involved in information sharing with health welfare organizations and client referrals to hospitals or clinics. Health welfare organizations were primarily connected with the community health centers for client referrals and program collaboration.
Conclusion
A community health center is the lead agency in interorganizational activities for smoking prevention and cessation. However, hospitals or clinics, pharmacies, and health welfare organizations also participate in interorganizational networks for smoking prevention and cessation with diverse roles. This study would be evidence for developing future interorganizational networks for smoking prevention and cessation.

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Incidence and Risk Factors of Dyslipidemia after Menopause: Jeong, Ihn Sook , Yun, Hae Sun , Kim, Myo Sung , Hwang, Youn Sun; J Korean Acad Nurs 2022;52(2):214-227. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21188

Abstract PDF

Purpose
This study was aimed at investigating the incidence and risk factors of dyslipidemia in menopausal women using a Korean community-based longitudinal study.
Methods
The subjects were 245 postmenopausal women without dyslipidemia who had participated in the Ansan-Ansung cohort study from 2001~2002 (baseline) to 2015~2016 (seventh follow-up visit). The dyslipidemia incidence was measured as incidence proportion (%) and incidence rate per 100 person-years. The predictors of developing dyslipidemia were analyzed with Cox’s proportional hazard model.
Results
The incidence of new dyslipidemia during the follow-up period was 78.4% (192 patients), and 11.9 per 100 person-years. Mean duration from menopause to developing dyslipidemia was 5.3 years in new dyslipidemia cases. The triglyceride/high density lipoprotein (TG/HDL-C) ratio at baseline (hazard ratio = 2.20; 95% confidence interval = 1.39~3.48) was independently associated with developing dyslipidemia.
Conclusion
Dyslipidemia occurs frequently in postmenopausal women, principally within five years after menopause. Therefore, steps must be taken to prevent dyslipidemia immediately after menopause, particularly in women with a high TG/HDL-C ratio at the start of menopause.

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Middle-aged women’s experiences of physical activity for managing menopausal symptoms: a phenomenological study
Hee Jung Cho, Sukhee Ahn
Korean Journal of Women Health Nursing.2023; 29(2): 104. CrossRef
Relationship between sleep duration and prevalence of hypertension among Korean postmenopausal middle-aged women
Eun Young Hong, Hye Ja Gu
Korean Journal of Health Education and Promotion.2023; 40(5): 43. CrossRef
Identification of subgroups with poor lipid control among patients with dyslipidemia using decision tree analysis: the Korean National Health and Nutrition Examination Survey from 2019 to 2021
Hee Sun Kim, Seok Hee Jeong
Journal of Korean Biological Nursing Science.2023; 25(2): 131. CrossRef

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Validity and Reliability of the Korean Version of the Couple Satisfaction Index: Kim, Suk-Sun , Gil, Minji , Kim, Daeun , Kim, Sunhai , Heo, Dayeon , Moon, Nan Young; J Korean Acad Nurs 2022;52(2):228-227. Published online April 30, 2022; DOI: https://doi.org/10.4040/jkan.21177

Abstract PDF

Purpose
The study aimed to translate the Couple Satisfaction Index (CSI 32) into Korean, to evaluate the reliability and validity of CSI 32 and short-form (CSI 16, 4) in the Korean context, and to determine a cut-off score for Korean couples.
Methods
Korean Versions of the Couple Satisfaction Index (K-CSI) 32 was translated, back-translated, and reviewed by five bilingual experts. Confirmatory factor analysis (CFA) was conducted with data from a sample of 218 couples (N = 436) to test construct validity. Validity and reliability were evaluated. The receiver’s operating characteristics curve analysis was used to obtain the cut-off score.
Results
The construct validities of K-CSI 32, 16, and 4 were verified using one-factor structures. The results of CFA showed a slightly better fit for K-CSI 16 and 4 than for K-CSI 32. Convergent validity was supported by significant positive correlations of K-CSI with Kansas Marital Satisfaction Scale, Dyadic Adjustment Scale, and Family Relationship Assessment Scale. Moreover, the significant differences in K-CSI between normal and depressive group demonstrated known-group validity. Cut-off scores of 105.5 on K-CSI 32, 50.25 on K-CSI 16, and 13.25 on K-CSI 4 were validated to identify distressed couple relationships.
Conclusion
For clinical practice, the reliable and valid K-CSI 32 has the potential to measure changes in couple satisfaction after couple therapy or interventions. Applying K-CSI 32 may facilitate research on couple and family relationships in nursing and contribute to the discussion on the role of couple satisfaction in mental health.

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Online coaching blended couple‐oriented intervention for preventing depression among Korean middle adulthood: A feasibility study
Minji Gil, Suk‐Sun Kim, Daeun Kim, Sunhai Kim
Family Process.2023; 62(4): 1478. CrossRef

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