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Most-read are based on citations from 2023 ~ 2025.

Research Papers
The Effects of a Self-Efficacy Theory-Based Exercise Program for Patients Undergoing with Total Knee Arthroplasty
Kyung-Hye Park, Hee-Young Kang
J Korean Acad Nurs 2024;54(4):547-562.   Published online October 22, 2024
DOI: https://doi.org/10.4040/jkan.24027
AbstractAbstract PDFSupplementary MaterialePub
Purpose

This study was performed to develop a self-efficacy theory-based exercise program for total knee arthroplasty (TKA) and to test the program’s efficacy in ameliorating knee pain and restoring function as measured by lower extremity muscle strength, 3 meter walking time, Korean Western Ontario McMaster Index (WOMAC), exercise self-efficacy, and length of hospital stay for TKA patients.

Methods

This quasi-experimental study incorporating a non-equivalent control group and pretest-posttest non-synchronized design non-synchronous design was applied to assess self-efficacy reinforcement strategies based on self-efficacy theory. The exercise program consisted of the following steps: TKA, education to prevent postoperative complications, and muscle strength exercises. Respective exercise and control groups included 29 and 27 participants. The experimental group received eight sessions of the program from three weeks before TKA to four weeks after TKA. Collected data were analyzed using the chi-square test, Mann–Whitney U test, and ranked ANCOVA and t-tests using IBM SPSS Statistics 23.

Results

Experimental group showed significant improvement in lower extremity muscle strength (F = 8.63, p = .005), 3 meter walking time (z = - 5.02, p < .001), WOMAC index (z = - 2.22, p = .027), self-efficacy for exercise (z = - 3.29, p = .001), and length of hospital stay (t = - 2.11, p = .040) compared to the control group. No significant differences in knee pain and range of motion were observed.

Conclusion

These findings indicate that a self-efficacy theory-based exercise program can be an effective exercise strategy that patients undergoing TKA can easily follow at home without assistance. It is thus recommended as an exercise intervention for TKA patients.

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Exploring Traumatic Experiences and Posttraumatic Growth among Korean Veterans: A Photovoice Study
Riah Kim, Heese Choi, Minsung Kim
J Korean Acad Nurs 2024;54(4):519-533.   Published online October 14, 2024
DOI: https://doi.org/10.4040/jkan.24049
AbstractAbstract PDFePub
Purpose

This study aimed to explore traumatic experiences and posttraumatic growth among Korean veterans.

Methods

A qualitative study was conducted using photovoice. Purposive sampling strategies yielded five veterans who had experienced traumatic events. Participants engaged in three discussion sessions between August 5, 2023, and October 28, 2023. The collected data were analyzed using photovoice document analysis and thematic analysis.

Results

Study results identified the following themes: ‘The collapse of my life as a result massive trauma,’ ‘Sinking into endless isolation and disconnection,’ ‘The process of finding myself through reflection,’ and ‘My life journey moving forward together.’ Despite the irreversible damage caused by traumatic experiences during military service, the participants continuously reflected on the meaning of their trauma and posttraumatic growth, thereby recovering their authentic selves.

Conclusion

Veterans who have experienced traumatic events face severe difficulties, however through their efforts at recovery, they recognize the individuals they are now. This study suggests the need for social support and highlights the necessity of providing various opportunities and policy assistance to traumatized veterans.

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Review Papers
Exploring Symptom Cluster Patterns in Adult Cancer Patients Undergoing Chemotherapy: A Systematic Review
Pan Yang, Hui-juan Mei, Hao-yu Zhao, Rong-rong Wu, Yong-qin Ge, Yin Lu
J Korean Acad Nurs 2024;54(4):478-494.   Published online November 25, 2024
DOI: https://doi.org/10.4040/jkan.24041
AbstractAbstract PDFSupplementary MaterialePub
Purpose

This systematic review aimed to scrutinize the progression of symptom cluster research in adult cancer patients who received primary or adjuvant chemotherapy between 2001 and 2023, providing a comprehensive understanding of clinical practice and future research.

Methods

PubMed, Ovid MEDLINE, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and Web of Science databases were searched for theme words and free words related to symptom clusters, cancer, and chemotherapy. Eligible studies were published between January 1, 2001, and May 30, 2023; adults who were diagnosed with cancer and received primary or adjuvant chemotherapy were evaluated.

Results

Twenty-eight studies were included in this review. The Memorial Symptom Assessment Scale emerged as the predominant instrument and exploratory factor analysis was the most frequently employed statistical method to identify symptom clusters. Psychological, gastrointestinal, and physical image symptom clusters were the most commonly delineated. Furthermore, the temporal stability of the symptom clusters showed varying dynamics, with psychological symptom clusters displaying relative consistency over time.

Conclusion

Interventions are needed for the most common and stable symptoms in patients with cancer undergoing chemotherapy. Future endeavors may necessitate more longitudinal studies to delve deeper into the temporal stability and dynamic variations of symptom clusters. Such investigations hold promise for advancing symptom cluster research, elucidating the underlying mechanisms, and fostering the development of targeted interventions, thereby enriching the symptom management paradigm in oncological care.

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Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis
Jo, Sojeong , Lee, Haejung , Park, Gaeun
J Korean Acad Nurs 2024;54(3):311-328.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24019
AbstractAbstract PDF
Purpose
In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI).
Methods
A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2).
Results
Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality.
Conclusion
Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).
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Legal and Practical Solutions for the Expanding the Roles of Medical Support Staff Nurses
Choi, Su Jung , Kim, Min Young
J Korean Acad Nurs 2024;54(3):300-310.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24075
AbstractAbstract PDF
Purpose
Medical support staff nurses have traditionally performed various supportive tasks for physicians, often extending beyond standard nursing roles. Despite these long-standing practices, there is a notable lack of official recognition and legal protection for these expanded responsibilities, leading to increasing legal concerns. Therefore, there is a need for proposing a rational solution to address these issues.
Methods
The number of medical support staff nurses is rising, particularly as they fill gaps left by the 2024 resident physician strike. The study focuses on identifying potential challenges arising from this shift and developing strategic improvements to address these challenges effectively.
Results
This study proposed legally expanding the scope of nursing duties and creating a robust system for training and certifying nurses to handle these responsibilities effectively, by integrating these roles within the advanced practice nurse (APN) framework.
Conclusion
Integrating these roles within the framework of APN can offer a sustainable and legally sound solution to the ongoing healthcare crisis, ensuring patient safety and safeguarding healthcare workers’ legal rights.
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Editorial
Challenges for the Activation of Advanced Practice Nursing in Korea
Yi, Young Hee
J Korean Acad Nurs 2024;54(3):297-299.   Published online August 31, 2024
DOI: https://doi.org/10.4040/jkan.24074
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Research Papers
Keyword Network Analysis and Topic Modeling of News Articles Related to Artificial Intelligence and Nursing
Ha, Ju-Young , Park, Hyo-Jin
J Korean Acad Nurs 2023;53(1):55-68.   Published online February 28, 2023
DOI: https://doi.org/10.4040/jkan.22117
AbstractAbstract PDF
Purpose
The purpose of this study was to identify the main keywords, network properties, and main topics of news articles related to artificial intelligence technology in the field of nursing.
Methods
After collecting artificial intelligence-and nursing-related news articles published between January 1, 1991, and July 24, 2022, keywords were extracted via preprocessing. A total of 3,267 articles were searched, and 2,996 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4.
Results
As a result of analyzing the frequency of appearance, the keywords used most frequently were education, medical robot, telecom, dementia, and the older adults living alone. Keyword network analysis revealed the following results: a density of 0.002, an average degree of 8.79, and an average distance of 2.43; the central keywords identified were ’education,’ ‘medical robot,’ and ‘fourth industry.’ Five topics were derived from news articles related to artificial intelligence and nursing: ‘Artificial intelligence nursing research and development in the health and medical field,’ ‘Education using artificial intelligence for children and youth care,’ ‘Nursing robot for older adults care,’ ‘Community care policy and artificial intelligence,’ and ‘Smart care technology in an aging society.’ Conclusion: The use of artificial intelligence may be helpful among the local community, older adult, children, and adolescents. In particular, health management using artificial intelligence is indispensable now that we are facing a super-aging society. In the future, studies on nursing intervention and development of nursing programs using artificial intelligence should be conducted.
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The Mediating Role of Psychological Resilience in Chinese Nursing Students’ Professional Identity and Learning Burnout
Liu Zhang, Qin Zhang, ShuWen Li, YuHong Li, GuoCui Wu, Ying Chen, YunNa Zhou
J Korean Acad Nurs 2024;54(4):509-518.   Published online November 25, 2024
DOI: https://doi.org/10.4040/jkan.24044
AbstractAbstract PDFePub
Purpose

This study investigated whether professional identity predicts learning burnout among Chinese nursing students, and whether resilience moderates this relationship.

Methods

This cross-sectional study recruited 635 students from a nursing college at a medical university in Hefei, China. Data were collected using the professional identity questionnaire, learning burnout scale for college students, and 10-item Connor-Davidson Resilience Scale. Pearson’s correlation analysis was used to investigate the relationships between variables. The mediation effect was evaluated using linear regression and the bootstrap method in SPSS.

Results

Nursing students exhibited intermediate learning burnout levels (score: 54.95 ± 10.42). Professional identity was positively correlated with psychological resilience (r = .42, p < . 001), whereas learning burnout was negatively correlated with professional identity (r = - .54, p < . 001) and psychological resilience (r = - .57, p < . 001). Psychological resilience mediated the relationship between professional identity and learning burntout to the tune of 32.8%.

Conclusion

Psychological resilience mediates the relationship between professional identity and learning burnout. Thus, nursing educators can mitigate student burnout by developing their students' professional identities and psychological resilience.

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Factors Influencing Clinical Nurses’ Perception of Structural and Content Career Plateau
Ji Hye Kim, Ji Yun Lee
J Korean Acad Nurs 2024;54(4):534-546.   Published online October 23, 2024
DOI: https://doi.org/10.4040/jkan.24002
AbstractAbstract PDFePub
Purpose

This study was intended to provide basic data for reducing the career plateaus of clinical nurses.

Methods

The participants were 288 clinical nurses who worked at five hospitals, general hospitals, and tertiary hospitals in Seoul, Gyeonggi, and Chungcheong provinces and had more than one year of clinical experience. The research data were collected from December 26, 2022, to April 7, 2023, using structured questionnaires and analyzed using SPSS software. The study conducted mean, standard deviation, percentage, t-test, ANOVA, Pearson‘s correlation coefficient, and hierarchical regression analysis.

Results

Perceived organizational support was identified as the factor influencing structural career plateaus. Factors influencing content career plateaus included growth needs, skill variety, organizational justice, and perceived organizational support.

Conclusion

The above research results suggest that to increase the motivation of clinical nurses and reduce career plateaus, it is necessary to improve awareness and systems of human resource management at the organizational level.

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Perceptual Factors Associated with Gestational Weight Gain: A Cross-Sectional Survey
Sehee Kim, Sukhee Ahn
J Korean Acad Nurs 2024;54(4):495-508.   Published online November 1, 2024
DOI: https://doi.org/10.4040/jkan.24052
AbstractAbstract PDFePub
Purpose

Recent years have seen an increase in the number of pregnant women whose weight gain during pregnancy exceeds the recommended range. This study was intended to determine the relationships among demographic attributes, key perceptual factors, and gestational weight gain (GWG).

Methods

This cross-sectional study was conducted between April and July 2022. First-time pregnant women beyond 36 weeks of gestation who were recruited via social media completed an online survey. Data were analyzed using one-way ANOVA, chi-square test, and logistic regression, all performed using SPSS software.

Results

Of the 369 participants, 63 (17.1%) exceeded the recommended GWG guidelines, while 148 (40.1%) fell within the recommended range, and the remaining 158 (42.8%) had inadequate GWG. Being overweight or obese before pregnancy significantly increased the risk of excessive GWG (p < .001). This risk was also significantly greater for women with low internal weight locus of control (OR = 0.58, 95% CI 0.41~0.82), high external weight locus of control (OR = 1.75, 95% CI 1.31~2.34), and negative body image (OR = 0.62, 95% CI 0.51~0.75).

Conclusion

The growing trend of excessive GWG among pregnant women is influenced by a combination of prepregnancy body mass index (BMI) and perceptual factors, including weight locus of control and body image. These findings underscore the need to implement weight management intervention strategies before pregnancy, taking into consideration BMI, and to enhance positive body image and internal locus of control.

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Editorial
Climate Change and Nursing
Yoomi Jung
J Korean Acad Nurs 2024;54(4):475-477.   Published online November 4, 2024
DOI: https://doi.org/10.4040/jkan.24098
PDFePub
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Research Paper
Analysis of ROX Index, ROX-HR Index, and SpO 2 /FIO 2 Ratio in Patients Who Received HighFlow Nasal Cannula Oxygen Therapy in Pediatric Intensive Care Unit
Choi, Sun Hee , Kim, Dong Yeon , Song, Byung Yun , Yoo, Yang Sook
J Korean Acad Nurs 2023;53(4):468-479.   Published online August 31, 2023
DOI: https://doi.org/10.4040/jkan.22152
AbstractAbstract PDF
Purpose
This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit.
Methods
A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ2 test, Mann–Whitney U test, and area under the curve (AUC).
Results
Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption.
Conclusion
The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.
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Review Paper
Factors Related to Emotional Leadership in Nurses Manager: Systematic Review and Meta-Analysis
Jang, Se Young , Park, Chan Mi , Yang, Eun Hee
J Korean Acad Nurs 2024;54(2):119-138.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.24026
AbstractAbstract PDF
Purpose
This study aimed to identify research trends related to emotional leadership among nurse managers by conducting a systematic literature review and meta-analysis. This study sought to derive insights that could contribute to improving emotional leadership in nursing practice.
Methods
A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and Meta-Analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Research Information Sharing Service, Koreanstudies Information Service System, Korean Medical Database, KoreaMed, ScienceON, and DBpia were searched to obtain papers published in English and Korean. Literature searches and screenings were conducted for the period December 1, 2023 to December 17, 2023. The effect size correlation (ESr) was calculated for each variable and the meta-analysis was performed using the statistical software SPSS 29.0, R 4.3.1.
Results
Twenty-five (four personal, six job, and fifteen organizational) relevant variables were identified through the systematic review. The results of the meta-analysis showed that the total overall effect size was ESr = .33. Job satisfaction (ESr = .40) and leader-member exchange (ESr = .75) had the largest effect size among the job and organizational-related factors.
Conclusion
Emotional leadership helps promote positive changes within organizations, improves organizational effectiveness, and increases member engagement and satisfaction. Therefore, it is considered an important strategic factor in improving organizational performance.
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Research Papers
Development and Validation of a Dignity in Care Scale of Terminally Ill Patients for Nurses
Ahn, Yun Sil , Oh, Pok Ja
J Korean Acad Nurs 2023;53(3):340-358.   Published online June 30, 2023
DOI: https://doi.org/10.4040/jkan.23039
AbstractAbstract PDF
Purpose
This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability.
Methods
A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews. Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions. The data were analyzed using item analysis, exploratory and confirmatory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity, reliability was tested using Cronbach’s alpha.
Results
The final instrument consisted of 25 items, with four factors identified through confirmatory factor analysis. Four factors-ethical values and moral attitudes, interaction-based communication, main-taining comfort, professional insight and competence–accounted for 61.8% of the total variance. Cronbach’s ⍺ for total items was .96, and test-retest reliability of intraclass correlation coefficient was .90.
Conclusion
Since its validity and reliability have been verified through various methods, the Dignity in Care Scale of Terminally Ill Patients for Nurses can be used for develop nursing interventions and improve dignity in care of terminally ill patients.
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Development and Effectiveness of Progressive Simulation Education Program on Medication Safety for Nursing Students
Se-Young Jung, Eun-Young Kim
J Korean Acad Nurs 2024;54(4):563-576.   Published online October 14, 2024
DOI: https://doi.org/10.4040/jkan.24054
AbstractAbstract PDFePub
Purpose

This study aimed to develop and verify a progressive simulation education program aimed at enhancing nursing students’ medication safety competency.

Methods

A non-equivalent control group pretest-posttest design was adopted. The participants were 40 third-year nursing students with no prior simulation education experience, comprising 20 each in the experimental and control groups. The experimental treatment utilized a hybrid simulation approach incorporating both full-body mannequins and standardized patients and was, conducted over three sessions with durations of 65, 80, and 95 minutes for the first, second, and third sessions, respectively, for a total of 240 minutes. The program was constructed based on Jeffries’ simulation model.

Results

The levels of medication safety competencies, communication self-efficacy, learning self-efficacy, and problem-solving abilities of the experimental group were significantly higher than that of the control group.

Conclusion

Our results confirm that the program effectively improves nursing students’ medication safety competence, communication self-efficacy, learning self-efficacy, and problem-solving ability. Therefore, this program can serve as a basis for developing educational strategies related to medication safety for nursing education institutions. Furthermore, the program is anticipated to have a positive impact on novice nurses’ education and practice in clinical settings.

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Effect of Digital Health Interventions on Psychotic Symptoms among Persons with Severe Mental Illness in Community: A Systematic Review and Meta-Analysis
Oh, Eunjin , Gang, Moonhee
J Korean Acad Nurs 2023;53(1):69-86.   Published online February 28, 2023
DOI: https://doi.org/10.4040/jkan.22121
AbstractAbstract PDF
Purpose
This study aimed to evaluate the effects of digital health interventions on the psychotic symptoms among people with severe mental illness in the community.
Methods
A systematic review and meta-analysis were conducted in accordance with the Cochrane Intervention Research Systematic Review Manual and PRISMA. A literature search was conducted of published randomized controlled trials (RCTs) for digital health interventions from January 2022 to April 2022. RevMan software 5.3 was used for quality assessment and meta-analysis.
Results
A total 14 studies out of 9,864 studies were included in the review, and 13 were included in meta-analysis. The overall effect size of digital health interventions on psychotic symptoms was - 0.21 (95% CI = - 0.32 to - 0.10). Sub-analysis showed that the reduction of the psychotic symptoms was effective in the schizophrenia spectrum group (SMD = - 0.22; 95% CI = - 0.36 to - 0.09), web (SMD = - 0.41; 95% CI = - 0.82 to 0.01), virtual reality (SMD = - 0.33; 95% CI = - 0.56 to - 0.10), mobile (SMD = - 0.15; 95% CI = - 0.28 to - 0.03), intervention period of less than 3 months (SMD = - 0.23; 95% CI = - 0.35 to - 0.11), and non-treatment group (SMD = - 0.23; 95% CI = - 0.36 to - 0.11).
Conclusion
These findings suggest that digital health interventions alleviate psychotic symptoms in patients with severe mental illnesses. However, well-designed digital health studies should be conducted in the future.
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Experiences of Patients and Their Families Receiving Medical Services Provided by Advanced Practice Nurses at Tertiary General Hospitals
Mi-Kyeong Jeon, Su Jung Choi, Ji Eun Han, Eun Kyung Kwon, Jeong Hee Park, Jeong Hye Kim
J Korean Acad Nurs 2024;54(4):594-606.   Published online November 4, 2024
DOI: https://doi.org/10.4040/jkan.24069
AbstractAbstract PDFePub
Purpose

This study aimed to understand and describe the experiences of patients and their families who have received medical services from advanced practice nurses in tertiary general hospitals in Korea.

Methods

Data were collected through four focus group interviews with 20 patients and their families who had received medical services from advanced practice nurses for more than six months at four tertiary hospitals from November 29 to December 28, 2023. Verbatim transcripts were analyzed using qualitative content analysis.

Results

The four themes extracted from the experiences of patients and their families were as follows: unfamiliar medical personnel encountered during the treatment process, healthcare professionals who exhibited excellence, companions to light my way through the tunnel of illness, and an advanced practice nurse system that must be activated urgently.

Conclusion

The study’s findings indicate that patients and their families view the care provided by advanced practice nurses as excellent, reliable, and holistic. Research suggests that advanced practice nurses are valuable healthcare professionals in team-based care. The findings suggest that hospitals should utilize an advanced practice nurse system to improve patient outcomes and ensure the quality of care.

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An Investigation of the Cumulative Effects of Depressive Symptoms on the Cognitive Function in Community-Dwelling Older Adults: Analysis of the Korean Longitudinal Study of Aging
Kim, Eunmi , Oh, Jinkyung , Huh, Iksoo
J Korean Acad Nurs 2023;53(4):453-467.   Published online August 31, 2023
DOI: https://doi.org/10.4040/jkan.23018
AbstractAbstract PDF
Purpose
This study investigated the cumulative effects of depressive symptoms on cognitive function over time in community-dwelling older adults. Methods: Data were investigated from 2,533 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) from the 5th (2014) to the 8th wave (2020). The association between cumulative depressive symptoms and cognitive function was identified through multiple regression analysis. Results: When the multiple regression analysis was conducted from each wave, the current depressive symptoms scores and cognitive function scores were negatively associated, regardless of the waves (B5th = - 0.26, B6th = - 0.26, B7th = - 0.26, and B8th = - 0.27; all p < .001). Further, when all the previous depressive symptoms scores were added as explanatory variables in the 8th wave, the current one (B8th = - 0.09, p < .001) and the previous ones (B5th = - 0.11, B6th = - 0.09, and B7th = - 0.13; all p < .001) were also negatively associated with the cognitive function score. The delta R2 , which indicates the difference between the model’s R2 with and without the depressive symptoms scores, was greater in the model with all the previous and current depressive symptoms scores (6.4%) than in the model with only the current depressive symptoms score (3.6%). Conclusion: Depressive symptoms in older adults have a long-term impact. This results in an accumulated adverse effect on the cognitive function. Therefore, to prevent cognitive decline in older adults, we suggest detecting their depressive symptoms early and providing continuous intervention to reduce exposure to long-term depressive symptoms.
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Factors Influencing the COVID-19 Vaccination Intentions in Parents for Their Children Aged 5~11: Korea, April 2022
Choi, In Suk , Kim, Eun A
J Korean Acad Nurs 2023;53(2):208-221.   Published online April 30, 2023
DOI: https://doi.org/10.4040/jkan.22096
AbstractAbstract PDF
Purpose
This study aimed to investigate COVID-19 vaccination intentions in Korean parents for their children aged 5 to 11 years and the factors influencing them.
Methods
A cross-sectional online survey of 363 parents of children aged 5 to 11 years was conducted in Korea in April 2022. Data were analyzed using independent t-test, χ2-test, Fisher’s exact test, and hierarchical logistic regression analysis using SPSS/WIN 26.0 and MedCalc software version 20.113.
Results
Of 363 Korean parents with children aged 5 to 11, 42.4% intended to vaccinate their children. Significant factors influencing vaccination intention were the second or third birth order of children (OR = 3.45, 95% CI = 1.45~8.21), vaccine hesitancy-confidence (OR = 2.00, 95% CI = 1.51~2.65), vaccine hesitancy-collective responsibility (OR = 1.57, 95% CI: 1.10~2.25), and COVID-19 anxiety-avoidance (OR = 1.55, 95% CI = 1.13~2.11).
Conclusion
Findings suggest that COVID-19 vaccine campaigns based on reliable information and evidence from health authorities are needed to increase COVID-19 vaccination. Well-designed health communications for the target population may help to increase parental vaccine acceptance.
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Validity and Reliability of the Korean Version of the Occupational Coping Self-Efficacy Scale for Nurses
Youngrye Park, Sunah Park, Hee Ran Kang
J Korean Acad Nurs 2024;54(4):633-644.   Published online November 30, 2024
DOI: https://doi.org/10.4040/jkan.24094
AbstractAbstract PDFePub
Purpose

This study aimed to evaluate the validity and reliability of the Korean version of the occupational coping self-efficacy for nurses (K-OCSE-N) scale.

Methods

The English version of the OCSE-N scale was translated into Korean using a translation and back-translation process. Data were gathered from 213 nurses employed in a general hospital in South Korea. The content validity was assessed using the content validity index. The construct validity was verified through exploratory and confirmatory factor analyses. Criterion validity was assessed using Pearson’s correlation coefficients with the job stress coping and general self-efficacy scales. Reliability was examined using item-total score correlation and Cronbach’s α coefficient for internal consistency.

Results

The exploratory factor analysis identified two factors that explained 61.8% of the cumulative variance: occupational burden and relational difficulty. In confirmatory factor analysis, the model exhibited adequate fit (χ2/df = 2.07, GFI = .95, SRMR = .04, RMSEA = .07, CFI = .97, and TLI = .95), with both convergent and discriminant validity deemed acceptable. The criterion validity presented a positive correlation of the K-OCSE-N with both job stress coping (r = .72, p < .001) and general self-efficacy (r = .72, p < .001). The internal consistency of the scale using Cronbach’s α for the total items was .89.

Conclusion

The K-OCSE-N scale is a valid and reliable tool for measuring nurses’ occupational coping self-efficacy. This study suggests that various intervention studies can use the scale to assess and strengthen nurses’ occupational coping self-efficacy in nursing practice.

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A Structural Equation Model on Social Re-Adjustment of Stroke Patients: Based on Roy’s Adaptation Model
Kim, Jungmi , Kim, Hwasoon
J Korean Acad Nurs 2023;53(4):480-495.   Published online August 31, 2023
DOI: https://doi.org/10.4040/jkan.22140
AbstractAbstract PDF
Purpose
This study aimed to develop and test a structural equation model on social re-adjustment of individuals with stroke based on a literature review and Roy’s adaptation model.
Methods
This study involved 321 participants who had a stroke and visited the outpatient department after discharge. The hypothetical model was developed based on Roy’s adaptation model and a comprehensive review of previous literature on the topic. The model comprised four exogenous variables (neurological damage, gender [man], age, and social support) and five endogenous variables (activities of daily living, acceptance of disability, depression, rehabilitation motivation, and social re-adjustment). The data were analyzed using SPSS Windows software version 22.0 and AMOS 23.0.
Results
Out of 28 research hypotheses, 18 were supported, and they indicated approximately 64% probability of social re-adjustment. Social re-adjustment is directly and significantly affected by age, social support, activities of daily living, and depression. Social re-adjustment is indirectly affected by neurological impairment, gender (men), age, social support, and rehabilitation motivation.
Conclusion
Continuous assistance and care should be provided for individuals with disabilities caused by sudden neurological damage to facilitate gradual improvement in their social re-adjustment. To enhance social re-adjustment, especially among older adults, newly developed interventions should focus on improving their activities of daily living, preventing depression, and enhancing support from family and healthcare personnel.
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Sleep Deprivation and Fatigue among Nurses Working Consecutive Night Shifts: A Prospective Observational Study
Min, Ari , Seo, Jisu , Kang, Minkyung , Hong, Hye Chong
J Korean Acad Nurs 2024;54(2):139-150.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23164
AbstractAbstract PDF
Purpose
This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work.
Methods
This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis.
Results
Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning.
Conclusion
Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.
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Adolescents’ Experiences of Non-Suicidal Self-Injury: An Interpretative Phenomenological Analysis Study
Ko, Jung A , Kim, Ji Young
J Korean Acad Nurs 2023;53(5):538-555.   Published online October 31, 2023
DOI: https://doi.org/10.4040/jkan.23075
AbstractAbstract PDF
Purpose
This qualitative study used interpretative phenomenological analysis and photovoice methods to explore the meaning of non-suicidal self-injury experienced by adolescents.
Methods
Participants were adolescents enrolled in middle and high schools in Gyeonggi-do and Jeollabuk-do who were selected through snowball sampling. Six participants had repeatedly engaged in self-injurious behavior for over a year. Data were collected through in-depth interviews and the photovoice method between November 2020 and July 2021. The collected data were analyzed using six steps of interpretative phenomenological analysis.
Results
The results yielded 5 main themes and 18 subthemes. The main themes were ‘a silent cry to an indifferent world’, ‘a heartache that one endures with scars’, ‘an inescapable cycle’, ‘filling the space in one’s heart’, and ‘healing the wounds’. The study findings revealed that the self-injurious behavior of adolescents began as a consequence of feeling lost and struggling with conflicts at home and school, which helped them relieve tension and pain. Nonetheless, inflicting self-injury only left signs of regret and remorse, which became a trace that the participants wanted to hide. However, the wounds healed after receiving attention and support from others. They were determined to stop engaging in repeated self-injurious behaviors and made efforts to do so.
Conclusion
This study can be used as a basis for the development of educational programs to prevent non-suicidal self-injury in adolescents. Additionally, it can inform nursing interventions that focus on building support systems to help adolescents who attempt self-injury.
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Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients
Kim, Soomi , Kim, Chul-Gyu
J Korean Acad Nurs 2023;53(3):275-294.   Published online June 30, 2023
DOI: https://doi.org/10.4040/jkan.22109
AbstractAbstract PDF
Purpose
This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol.
Methods
The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol’s effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses’ outcome variables were evaluated using a questionnaire.
Results
First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001).
Conclusion
This protocol may help prevent infections and pressure injuries in patients, and improve nurses’ satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.
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Effect of the Spinning Babies Program on Birth Outcomes and Satisfaction during Labor: A Non-Randomized Controlled Trial
Mi-Yeon Jeong, Hyang Mi Jung
J Korean Acad Nurs 2024;54(4):607-619.   Published online November 20, 2024
DOI: https://doi.org/10.4040/jkan.24097
AbstractAbstract PDFePub
Purpose

This study evaluated the effects of the Spinning Babies program applied during labor on birth outcomes and satisfaction among pregnant women.

Methods

This non-equivalent control group, non-synchronized post-test only design study included 42 participants (22 in the experimental group and 20 in the control group). The Spinning Babies program was conducted four times in the experimental group during the first and second stages of delivery for 50 min per session. The program comprised performing pelvic circles on a birth ball, followed by wide squatting and adopting of open knee-chest and side-lying positions.

Results

Compared with those in the control group, pregnant women in the experimental group had a significantly shorter labor time (t = - 6.64, p < .001), a higher success rate for normal vaginal delivery (χ2 = 4.86, p = .043), improved Apgar scores of newborns (z2 = - 2.18, p = .029), differences in neonatal oxygen therapy use (χ2 = 4.86, p = .043), and improved birth satisfaction (t = 11.99, p < .001).

Conclusion

The Spinning Babies program improves the birth environment by increasing the normal vaginal delivery success rate, as well as pregnant women’s birth satisfaction, and promotes neonatal health.

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Effects of a Modified Six-Sigma-Methodology-Based Training Program on Core Competencies in Rehabilitation Nurse Specialists
Gu, Jiayi , Luo, Lan , Li,, Chengjuan , Ma, Sumin , Gong, Fanghua
J Korean Acad Nurs 2023;53(4):412-425.   Published online August 31, 2023
DOI: https://doi.org/10.4040/jkan.22122
AbstractAbstract PDF
Purpose
Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform—a modified Six-Sigma-based training program—against a conventional educational program on rehabilitation specialist nurses’ core competencies, post-training performance, and satisfaction.
Methods
A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base’s 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented.
Results
Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05).
Conclusion
The modified training program strengthens rehabilitation nurses’ base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.
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Internal Structure of the Health-Related Quality of Life Instrument with 8-Items in a Nationally Representative Population
Lee, Eun-Hyun
J Korean Acad Nurs 2023;53(3):359-369.   Published online June 30, 2023
DOI: https://doi.org/10.4040/jkan.23007
AbstractAbstract PDF
Purpose
This study evaluated the internal structure (structural validity, internal consistency, and measurement invariance) of the Health-Related Quality of Life Instrument with Eight Items (HINT-8), developed to measure Korean people’s health-related quality of life.
Methods
A secondary analysis was conducted using data from the Korea National Health and Nutrition Examination Survey, involving 6,167 adults aged over 18 years. The structural validity of the HINT-8 was assessed using exploratory graph analysis and confirmatory factor analysis. Internal consistency and measurement invariance were analyzed using McDonald’s omega (ω) and multigroup confirmatory factor analysis, respectively.
Results
The HINT-8 had a single dimension and good internal consistency (ω = .804). The one-dimension HINT-8 ex-hibited matric invariance but not scalar invariance across sociodemographic groups (sex, age, education, and marital status). Further, it exhibited scalar or partial scalar invariance across medical condition groups (hypertension, diabetes, depressive symptoms, and cancer).
Conclusion
The study finds that the HINT-8 demonstrated satisfactory structural validity and internal consistency, indicating its suitability for practice and research. However, the HINT-8 scores cannot be compared across different groups regarding sex, age, education, and marital status, as the interpretation varies within each sociodemographic category. Conversely, interpretation of the HINT-8 is consistent for individuals with and without hypertension, diabetes, depressive symptom, and cancer.
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Factors Influencing Sexual Experiences in Adolescents Using a Random Forest Model: Secondary Data Analysis of the 2019~2021 Korea Youth Risk Behavior Web-based Survey Data
Yang, Yoonseok , Kwon, Ju Won , Yang, Youngran
J Korean Acad Nurs 2024;54(2):193-210.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23134
AbstractAbstract PDF
Purpose
The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the “variable importance.” Methods: The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ2 tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix.
Results
The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. “Variable importance” for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol.
Conclusion
Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.
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Development and Effectiveness Evaluation of Comprehensive Mobile-Based, Breastfeeding Promotion Program for Mothers with Gestational Diabetes
Kwak, Eunju , Park, Seungmi
J Korean Acad Nurs 2024;54(2):224-236.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23098
AbstractAbstract PDF
Purpose
This study aimed to evaluate the effects of a mobile-based breastfeeding promotion program (M-BFGDM) that helps mothers with gestational diabetes.
Methods
Forty-seven mothers participated in the study, of whom 22 were in the experimental group and 25 in the control group. To verify the effects, a lag design before and after the non-equivalence control group was used. The data collection for the experimental group was done before and after the intervention.
Results
In the results, breastfeeding knowledge showed a significant difference in the interaction between measurement period and group (χ2 = 8.14, p = .017), whereas breastfeeding intention did not show a significant difference in the interaction (χ2 = 4.73, p = .094). There was no difference in self-efficacy interaction (F = 0.13, p = .856). The breastfeeding method showed no difference in interaction (F = 0.04, p = .952), whereas cross-analysis showed a significant difference in breastfeeding practice rate between the experimental group and the control group at 1 month postpartum (χ2 = 7.59, p = .006).
Conclusion
A mobile-based breastfeeding promotion program was developed and applied for gestational diabetic mothers, resulting in an increase in breastfeeding knowledge and an improvement in breastfeeding practice rate one month after childbirth. In addition, M-BFGDM managed to create a breastfeeding practice environment with fewer time and place restrictions. A program study that complements motivation is needed to improve breastfeeding in pregnant diabetic mothers in the future.
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Experiences of Unmarried Women Undergoing Planned Oocyte Cryopreservation
Miok Kim, Kim Mingyoung
J Korean Acad Nurs 2024;54(4):577-593.   Published online November 30, 2024
DOI: https://doi.org/10.4040/jkan.24064
AbstractAbstract PDFePub
Purpose

The present study investigated the experiences of unmarried women undergoing planned oocyte cryopreservation (OC).

Methods

Data were collected from August 2022 to February 2023 through individual in-depth interviews with thirteen unmarried women undergoing planned OC. Data were analyzed using Colazzi’s phenomenological method.

Results

The findings revealed four distinct clusters. The first cluster, “Safeguards against Future Uncertainty,” examined experiences associated with uncertainties in several aspects of reproductive health threats and decision-making regarding planned OC. The second cluster, “Indescribable Pain and Chaos,” explored the psychological and physical pain, complications, concerns about repeat procedures, and uncertainties about the use of frozen oocytes experienced during the planned OC process and afterward. The third cluster, “Motivation to Rebuild Resilience,” explored participants’ resilience in overcoming difficulties and shocks during the planned OC process and regaining their inner strength through the support of family and friends. The fourth cluster, “Finally Freeing the Mind,” focused on the sense of liberation from the pressure of marriage and childbirth, which enabled participants to engage in their present self and concentrate on self-stability and growth in preparation for the future.

Conclusion

The present study enhances our understanding of the emotional difficulties and distress experienced by women considering OC, thereby assisting in improving approaches for psychological support and clinical management. Furthermore, providing insights into these first-hand experiences to women considering planned OC, healthcare professionals, and policymakers could help establish systems to support the decision-making process.

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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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