Journal of Korean Academy of Nursing

Articles in E-pub version are posted online ahead of regular printed publication.

Research Papers

Effects of a practitioner-led empowerment program for low-income social service recipients in South Korea: a quasi-experimental study: Myung Sun Hyun, Eunyoung Park, Hyuncheol Kang, Mi-hye Kim; Received February 3, 2026 Accepted April 29, 2026 Published online May 26, 2026; DOI: https://doi.org/10.4040/jkan.26015 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to evaluate the effects of a practitioner-led empowerment program on self-sufficiency motivation, self-esteem, and self-efficacy among low-income service recipients at self-sufficiency centers.
Methods
A quasi-experimental repeated-measures design was used. Participants were recipients of social services from 11 local self-sufficiency centers in Gyeonggi-do, South Korea. In total, 100 participants were recruited, with 51 assigned to the experimental group and 49 assigned to the control group. The experimental group received an eight-session program delivered by center practitioners who had been trained by mental health nurses, whereas the control group received usual services. Self-sufficiency motivation, self-esteem, and self-efficacy were assessed at three time points: baseline (pretest: T0), immediately after the intervention (post-test: T1), and 4 weeks after the intervention (follow-up: T2).
Results
Using generalized estimating equations, participants in the experimental group showed significantly greater improvements than those in the control group at both T1 and T2 in self-sufficiency motivation (T1: B=1.61, p=.030; T2: B=2.88, p<.001), self-esteem (T1: B=2.77, p<.001; T2: B=2.78, p<.001), and self-efficacy (T1: B=3.95, p=.004; T2: B=4.19, p<.001).
Conclusion
The practitioner-led program is associated with significant short-term improvements in psychosocial determinants of self-sufficiency among low-income service recipients. These findings may inform the development of community nursing interventions that support the psychosocial foundations of independent living in this population and provide a basis for training programs designed to strengthen the capacity of practitioners at local self-sufficiency centers (Clinical Research Information Service of Korea registration number: KCT0010027; registration date: December 12, 2024).

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Lived experiences of correctional officers in treating drug offenders: a hermeneutic phenomenological approach: Hyun-Ok Jung; Received December 9, 2025 Accepted April 28, 2026 Published online May 26, 2026; DOI: https://doi.org/10.4040/jkan.25166 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study explored the lived experiences of correctional officers working with individuals convicted of drug offenses.
Methods
Data were collected through individual in-depth interviews and observations with 10 correctional officers who had experience working with individuals convicted of drug offenses. Data were collected from September 15 to November 2, 2025, and analyzed using van Manen’s hermeneutic phenomenological approach to identify essential themes.
Results
The themes were interpreted within four existential grounds: body, space, other, and time. The lived body was experienced as a body of blurred judgment and growing powerlessness, a body of heightened alertness and preparedness, and a body that closes itself off for self-preservation. The lived space was experienced as a space in which recovery stagnation and potential coexist, a space in which drug proliferation and interdiction collide, and a space in which correctional responsibility and avoidance conflict. The lived other was experienced as a relationship oscillating between hope and resignation and as a relationship characterized by withheld trust and sustained vigilance. The lived time was experienced as a transition from fulfillment to vigilance, a time of recognizing the power of addiction and issuing warnings, a transition from punishment to recovery, and a time of cycles and growth.
Conclusion
This study shows that working with individuals convicted of drug offenses is not merely the execution of regulation and control, but an existential practice of care in which correctional officers continually attune themselves to sensing risk, negotiating relationships, and sustaining the possibility of recovery.

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Review Paper

Effectiveness of mobile health interventions to improve medication adherence for patients with cardiovascular disease: a systematic review and meta-analysis: Yeoungsuk Song, Seurk Park, Yuyoung Lee, Sohye Lee; Received February 4, 2026 Accepted April 22, 2026 Published online May 22, 2026; DOI: https://doi.org/10.4040/jkan.26016 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study systematically reviewed and synthesized the evidence on the effectiveness of mobile health (mHealth) interventions in improving medication adherence among patients with cardiovascular disease.
Methods
This systematic review included randomized controlled trials that evaluated the effects of mHealth interventions on medication adherence among patients with cardiovascular disease. PubMed, the Cochrane Library, CINAHL, and Embase were searched for peer-reviewed studies and grey literature published in English between January 1, 2013, and July 31, 2025. The Cochrane Risk of Bias 2 (RoB 2) tool was used to assess the risk of bias in the included studies. R software ver. 4.5.2 was used to perform the meta-analysis.
Results
Fifty-two studies were included in the systematic review, of which 20 were included in the meta-analysis. The pooled analysis demonstrated a significant improvement in medication adherence among patients with cardiovascular disease receiving mHealth interventions, with a moderate to large effect size (Hedges’ g=0.72; 95% confidence interval, 0.20–1.25; p<.001), despite substantial heterogeneity (I2=97%). However, a considerable proportion of the included studies were assessed as having a high risk of bias, which may limit the internal validity of the findings. Subgroup analyses indicated that the effects of mHealth interventions on medication adherence did not differ significantly according to intervention type, duration, or outcome measurement tools.
Conclusion
mHealth interventions appear to be effective in improving medication adherence among patients with cardiovascular disease. However, these findings should be interpreted with caution because of the high risk of bias and substantial heterogeneity among the included studies. Future research should explore the use of emerging technologies, such as artificial intelligence and virtual reality, to address medication non-adherence (PROSPERO registration number: CRD42023450502).

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Research Papers

Nursing management competencies among nurses in national specialized hospitals in Korea: a mixed-methods study: Jiyoung Choi, Jee-In Hwang; Received December 13, 2025 Accepted February 26, 2026 Published online May 22, 2026; DOI: https://doi.org/10.4040/jkan.25175 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to examine nursing management competencies among nurses working in national specialized hospitals, to identify competency development needs and influencing factors, and to provide foundational data for the development of educational and competency-enhancement programs.
Methods
A mixed-methods design was employed. Quantitative data were collected via an online survey of 162 nurses from five national specialized hospitals from January 10 to February 10, 2025, and qualitative data were obtained through in-depth interviews with 20 participants from March 7 to April 16, 2025. Quantitative data were analyzed using descriptive statistics, independent t-tests, analysis of variance, importance–performance analysis, the Borich Needs Assessment, the Locus for Focus model, and multiple regression analysis. Qualitative data were analyzed using content analysis with ATLAS.ti.
Results
The mean performance score for nursing management competencies was 3.56±0.71 on a 5-point scale. Customer orientation received the highest score (4.03±0.78), whereas business and marketing received the lowest score (2.92±1.03). Across needs-assessment models, leadership, nursing ethics and law, quality improvement, and standard development consistently emerged as high-priority areas. In multiple regression analysis, the nursing work environment was the only factor significantly associated with nursing management competency performance (β=.33, p<.001). Qualitative content analysis corroborated these findings and identified three facilitator themes and three barrier themes.
Conclusion
Nursing management competency performance among nurses in national specialized hospitals was associated with the nursing work environment, including organizational conditions. These findings underscore the importance of organizational support and suggest that competency-based education should be redesigned to prioritize high-need competency areas. This study provides a foundation for developing educational interventions and programs to enhance nursing management capacity.

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Development and evaluation of a health education program to enhance middle school students’ climate adaptation competencies: a nonequivalent control group pretest–posttest study in Korea: Jiyu Hyun, Ju Hee Kim; Received October 13, 2025 Accepted February 7, 2026 Published online May 22, 2026; DOI: https://doi.org/10.4040/jkan.25139 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to develop and evaluate the Climate and Health Action Mitigation Program (CHAMP), a health education intervention designed to enhance middle school students’ competencies for practicing climate adaptation behaviors in response to the health impacts of climate change.
Methods
A quasi-experimental pretest-posttest nonequivalent control group design was employed. Data were collected from October to December 2024. A total of 3rd-year middle school students; 9th grade equivalent, aged 14-15 students were assigned to either an experimental group that received the CHAMP intervention or a control group that received conventional health education. The CHAMP curriculum comprised six sessions developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) instructional design model and was aligned with the 2022 revised national health curriculum and the instructional hours stipulated in the School Health Act. Climate adaptation competency and its seven subdomains—climate-change knowledge, climate sensitivity, reflective thinking, integrative thinking, communication skills, decision-making ability, and willingness to act—were assessed before and after the intervention.
Results
Compared with the control group, the experimental group demonstrated statistically significant improvements (p<.01) in overall climate adaptation competency as well as in all seven subdomains. The largest improvements were observed in willingness to act, climate sensitivity, and climate-change knowledge. The CHAMP intervention was associated with meaningful improvements in students’ climate adaptation competencies, encompassing cognitive, behavioral, and attitudinal domains.
Conclusion
These findings support the feasibility and educational value of integrating climate–health content into the national curriculum. Future research should examine the scalability of CHAMP and evaluate its long-term sustainability and effects across diverse educational settings.

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A structural equation model of respiratory infection prevention behaviors among elementary school teachers in South Korea: a cross-sectional study: Yoon-Ji Lee, JONG-EUN LEE; Received January 22, 2026 Accepted April 29, 2026 Published online May 21, 2026; DOI: https://doi.org/10.4040/jkan.26010 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to develop and test a structural equation model of respiratory infection prevention behaviors among elementary school teachers based on the Information–Motivation–Behavioral Skills model.
Methods
This study included 250 teachers who were currently working in elementary schools and had experience as homeroom teachers. Data were collected from December 18 to December 31, 2023 using self-reported questionnaires. The proposed model included school organizational culture as the exogenous variable and respiratory infection prevention knowledge, respiratory infection prevention attitude, social support, self-efficacy, and respiratory infection prevention behavior as endogenous variables. Data were analyzed using IBM SPSS for Windows ver. 24.0 and Smart PLS ver. 4.1.
Results
Of the 19 hypothesized paths in the research model, five were statistically significant. School organizational culture had a significant direct effect on respiratory infection prevention knowledge (β=.20, p=.041), social support had a significant direct effect on self-efficacy (β=.33, p=.001), and self-efficacy had a significant direct effect on respiratory infection prevention behaviors (β=.22, p=.021). Respiratory infection prevention attitude (direct: β=.23, p=.029; total: β=.26, p=.008) and school organizational culture (direct: β=.22, p=.017; total: β=.30, p=.002) had significant direct and total effects on respiratory infection prevention behaviors.
Conclusion
To enhance respiratory infection prevention behaviors among elementary school teachers, interventions should focus on strengthening positive attitudes toward infection prevention and improving self-efficacy. Organizational-level strategies, including establishing supportive school organizational cultures, promoting peer support among teachers, and sharing infection prevention practices within schools, are also needed to facilitate and sustain preventive behaviors.

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Development of emergency nursing educational materials in Lao People's Democratic Republic: a methodological study: Jina Oh, Eunsil Won, Seohyun Won, Sunmi Kim, Seryung Oh, Souksavanh Phanpaseuth, Anousone Sisoulath, Lamngeun Silavong; Received December 12, 2025 Accepted April 28, 2026 Published online May 21, 2026; DOI: https://doi.org/10.4040/jkan.25174 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to develop contextualized emergency nursing educational materials tailored to the Lao People’s Democratic Republic (Lao PDR). Emergency nurses in Lao PDR face challenges arising from the lack of standardized, culturally relevant learning resources. Existing materials are often adopted from other countries and do not adequately reflect local needs, contributing to inconsistencies in clinical practice. Developing locally tailored resources, supported by official development assistance, is therefore essential for improving emergency nursing education and practice.
Methods
This study used a methodological design based on the Four-Door Model—Define, Design, Develop, and Disseminate—from 2021 to 2024. A situational analysis was conducted using a mixed-methods approach that included a quantitative survey of 70 nursing professionals and qualitative interviews with 52 stakeholders. Content validity and suitability were evaluated by a panel of six local experts using standardized validation forms and the Suitability Assessment of Materials (SAM).
Results
Ten emergency nursing domains were developed to address both universal principles, including triage protocols and life support interventions, and Lao PDR-specific challenges. Validity and suitability were supported by a SAM score of 77.3%, indicating clinical accuracy and cultural appropriateness. The 269-page coursebook was distributed to partner nursing colleges, three central hospitals, and international organizations.
Conclusion
This study developed the first comprehensive emergency nursing educational materials tailored to the Lao PDR context and written in the local language. These materials support continuing professional development and license renewal every 5 years. They also exemplify an international development paradigm that prioritizes recipient-country ownership and sustainable capacity building through collaborative knowledge creation.

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Migrant health research in South Korea, 2010–2021: a scoping review: Soo Jin Kang, Bok-Nam Seo; Received November 10, 2025 Accepted March 16, 2026 Published online May 19, 2026; DOI: https://doi.org/10.4040/jkan.25152 [Epub ahead of print]

Abstract PDF ePub: Purpose
This scoping review mapped research trends in migrant health in Korea and evaluated their alignment with global priorities.
Methods
We conducted a scoping review using the Arksey and O’Malley framework. We searched PubMed, CINAHL, Scopus, KoreaMed, ScienceON, RISS, and KISS for articles published between 2010 and 2021, which defined the review period. The inclusion criteria were studies of adult migrants residing in Korea, primary empirical research, and academic journal articles with full text available in Korean or English. Two reviewers performed inductive coding and assigned each study to one primary subject area for frequency counts.
Results
Of 1,669 records, 273 studies met the inclusion criteria. Marriage-migrant women were the most frequently studied group (56.4%), followed by migrant workers (20.5%) and international students (7.0%). Ten subject areas were identified. Mental health (56/273; 20.5%) and health status and quality of life (47/273; 17.2%) were the most common, whereas infection was the least common (6/273; 2.2%). According to World Health Organization priority areas, P4 (tackling the social determinants of health) was the most common (132/273; 48.4%), followed by P1 (promoting health through public health interventions) (73/273; 26.7%). P3 (mainstreaming health policies and fostering partnerships) and P5 (strengthening health monitoring and information systems) were minimally represented (6/273; 2.2% and 11/273; 4.0%, respectively).
Conclusion
Migrant health research in Korea is heavily concentrated on individual-level topics and marriage-migrant populations, with limited evidence on policies, monitoring systems, and underserved groups (e.g., refugees and diverse populations). Future studies should diversify the populations examined, standardize national monitoring and linked data infrastructure, strengthen the P3 and P5 priority areas, and include more longitudinal, interventional, and policy evaluation research.

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Nurse retention discourse in YouTube comments: a structural topic modeling analysis: Taewha Lee, JooHyun Lee; Received December 11, 2025 Accepted March 10, 2026 Published online May 18, 2026; DOI: https://doi.org/10.4040/jkan.25172 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study analyzed public discourse on nurse retention through YouTube comments posted between 2018 and 2024 to examine how retention issues are collectively framed in online public spheres, thereby extending individual-level retention research to societal-level discourse analysis.
Methods
Comments were collected from 226 YouTube videos uploaded between January 2015 and December 2024, identified using search terms that combined “nurse” with retention-related keywords. After duplicates and comments posted outside the study period were removed, 32,399 comments were analyzed using structural topic modeling with year and number of likes as covariates. Topic correlation network analysis with community detection was used to identify discourse coalitions.
Results
Fourteen substantive topics and one noninterpretive topic emerged, spanning individual coping strategies, organizational workplace issues, and systemic policy structures. “International nursing migration and career pathways” (12.8%) and “Disputes regarding the scope of practice among professionals” (11.4%) were the most prevalent topics. Temporal analysis revealed discourse shifts consistent with focusing events theory: COVID-19 (coronavirus disease 2019) activated structural critique frames while suppressing career mobility discourse; the 2022 Nursing Law followed an issue-attention cycle pattern; and the 2024 medical school quota expansion embedded retention discourse within broader healthcare policy debates. Network analysis identified two discourse communities, professional identity and structural exploitation, with international migration serving as a bridging frame across both.
Conclusion
Public discourse framed nurse retention as a systemic and structural issue rather than as an expression of individual professional rejection. These collective framing patterns complement traditional survey-based research and may inform policy design by identifying which frames achieve public resonance and where discourse fragmentation may challenge policy implementation.

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Experiences of nurses working as physician assistants under the expanded scope-of-practice policy following the 2024 resignation of medical residents in South Korea: a phenomenological study: Tae Yeong Yang, Myung Jin Jang, NaHyun Lee; Received January 12, 2026 Accepted April 25, 2026 Published online May 14, 2026; DOI: https://doi.org/10.4040/jkan.26001 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to explore the lived experiences of clinical support nurses under the expanded scope-of-practice policy implemented after the mass resignation of medical residents in Korea in 2024. In Korea, these nurses are often referred to as physician assistant (PA) nurses, although they differ from licensed physician assistants or nurse practitioners in the United States. The study sought to understand how the policy was perceived, implemented, and interpreted by nurses who played a key role in maintaining clinical services during a healthcare workforce crisis.
Methods
A qualitative phenomenological design based on Colaizzi’s method was used. Fourteen clinical support nurses from a tertiary hospital in Seoul participated in in-depth, semi-structured interviews conducted between August and December 2025. The interviews were transcribed verbatim and analyzed through iterative reading, extraction of significant statements, formulation of meanings, and thematic integration. Trustworthiness was established using the criteria of credibility, dependability, transferability, and confirmability.
Results
Four essential themes were identified: (1) multifaceted perceptions of the 98-item expanded scope-of-practice policy; (2) gaps in the current education system and demands for structured training; (3) ambivalent experiences during policy implementation; and (4) conditional acceptance of the policy’s sustainability and calls for improvement. Participants reported increased professional recognition and autonomy while also experiencing ambiguity in role boundaries, concerns about legal accountability, and emotional burden related to insufficient preparation and protection.
Conclusion
The expanded scope-of-practice policy both strengthens professional competence and creates role instability among clinical support nurses. Its sustainable implementation requires clear legal protection, standardized education and certification systems, appropriate compensation, and the active involvement of frontline nurses in policy development.

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Editorial

Toward an end-to-end K-AI nursing ecosystem: digital twins across the care continuum: Jeung-Im Kim, Jiyeon Kang, YeoJin Im, Sung Reul Kim, Sun Ju Chang; Received December 28, 2025 Accepted December 31, 2025 Published online April 17, 2026; DOI: https://doi.org/10.4040/jkan.25180 [Epub ahead of print]

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Research Paper

The mediating effects of perceived organizational support and coping strategies on the relationship between job stress and professional quality of life among nurse managers in tertiary and general hospitals: Seo-In Yang, Min-Jung Choi; Received July 17, 2025 Accepted January 21, 2026 Published online April 6, 2026; DOI: https://doi.org/10.4040/jkan.25099 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to examine the mediating effects of perceived organizational support and coping strategies on the relationship between job stress and professional quality of life among nurse managers working in tertiary and general hospitals.
Methods
The participants were 299 nurse managers employed at tertiary and general hospitals located in Seoul and Gyeonggi Province. Data on job stress, perceived organizational support, coping strategies, and professional quality of life were collected using an online self-report questionnaire between June 28, 2024, and May 31, 2025. The collected data were analyzed using IBM SPSS Statistics ver. 27.0 and the PROCESS Macro ver. 4.0.
Results
Job stress was identified as a significant predictor of professional quality of life among nurse managers. Perceived organizational support and active coping demonstrated significant mediating effects on compassion satisfaction. Active coping showed a significant mediating effect on burnout, whereas perceived organizational support mediated secondary traumatic stress. Passive coping did not demonstrate a significant mediating effect on any of the three subdomains of professional quality of life.
Conclusion
Job stress is closely associated with compassion satisfaction, and this relationship is partially mediated by perceived organizational support and active coping. Accordingly, targeted interventions are required to reduce job stress, strengthen organizational support, and enhance coping competencies among nurse managers. Furthermore, reinforcing institutional- and policy-level support is essential to mitigate secondary traumatic stress and to ensure the sustainability of nurse managers’ professional roles.

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